The two common mutations causing factor XI deficiency in Jews stem from distinct founders: one of ancient Middle Eastern origin and another of more recent European origin

Previous studies showed that factor XI (FXI) deficiency commonly observed in Ashkenazi Jews is caused by two similarly frequent mutations, type II (Glu117stop) and type III (Phe283Leu) with allele frequencies of 0.0217 and 0.0254, respectively. In Iraqi Jews, who represent the ancient gene pool of Jews, only the type II mutation was observed with an allele frequency of 0.0167. In this study we sought founder effects for each mutation by examination of four FXI gene polymorphisms enabling haplotype analysis in affected Jewish patients of Ashkenazi, Iraqi, and other origins and in Arab patients. Initial population surveys of 387 Middle Eastern Jews (excluding Iraqi Jews), 560 North African/Sephardic Jews, and 382 Arabs revealed allele frequencies for the type II mutation of 0.0026, 0.0027, and 0.0065, respectively. In contrast, the type III mutation was not detected in any of these populations. All 60 independent chromosomes bearing the type III mutation were solely observed in Ashkenazi Jewish patients and were characterized by a relatively rare haplotype. All 103 independent chromosomes bearing the type II mutation in patients of Ashkenazi, Iraqi, Yemenite, Syrian, and Moroccan Jewish origin and of Arab origin were characterized by another distinct haplotype that was rare among normal Ashkenazi Jewish, Iraqi Jewish, and Arab chromosomes. These findings constitute the first example of a mutation common to Ashkenazi Jews, non-Ashkenazi Jews, and Arabs and are consistent with the origin of type II mutation in a founder before the divergence of the major segments of Jews. Our findings also indicate that the type III mutation arose more recently in an Ashkenazi Jewish individual.

A radiation hybrid map of human chromosome 5 with integration of cytogenetic, genetic, and transcript maps

One of the major goals of the human genome project is to establish a physical map of each human chromosome with a density of sequence-tagged site (STS) markers exceeding one every 100 kb. We report here the generation of a human chromosome 5-specific radiation hybrid (RH) map that includes 556 markers. Of these markers, 132 loci are ordered with a maximum likelihood ratio of >1000:1 compared with the next most likely order. An additional 113 loci were ordered relative to these backbone markers with a maximum likelihood ratio of >10:1 but <1000:1. Together, these 245 loci form an ordered framework map for the chromosome. Using this framework, >300 more markers were localized based on two-point analysis with the ordered set. On average, there are 50 markers in common with the RH map presented here and other chromosome 5 maps included in the current whole genome cytogenetic, genetic, and physical maps. The accuracy of all the maps is evident in that there are no more than two discrepancies between any one of them and these data. All of the maps encompassing chromosome 5 complement each other providing excellent STS coverage with >2200 loci combined. The chromosome 5-specific RH map contains 20% of these independent loci. In addition, our RH map contains STSs derived from clones suitable for fluorescent in situ hybridization, allowing alignment to the cytogenetic map. Together, these maps will assist in the assembly of sequence-ready contigs and will aid in the identification of disease loci on chromosome 5 by positional cloning and positional candidate approaches.

Extracting concentrated guided light

The maximum concentration of radiation is proportional to the square of the refractive index of the medium in which it propagates. A medium with a high refractive index can also serve as a lightguide for concentrated radiation. However, if concentrated radiation is extracted from one medium, with a high refractive index, to another, whose index is lower (e.g., from fused silica into air), part of the radiation may be lost because of the total internal reflection at the interface. We present polygonal shapes suitable for efficient extraction of the concentrated radiation in a controllable way, without increasing the cross-section area (or diameter) of the lightguide. It is shown analytically and experimentally that the use of a secondary concentrator, followed by such a light extractor, both having a high refractive index, can provide considerably more power to a solar receiver with a specific aperture.

Naturally occurring mutations in the human 5-lipoxygenase gene promoter that modify transcription factor binding and reporter gene transcription

Five lipoxygenase (5-LO) is the first committed enzyme in the metabolic pathway leading to the synthesis of the leukotrienes. We examined genomic DNA isolated from 25 normal subjects and 31 patients with asthma (6 of whom had aspirin-sensitive asthma) for mutations in the known transcription factor binding regions and the protein encoding region of the 5-LO gene. A family of mutations in the G + C-rich transcription factor binding region was identified consisting of the deletion of one, deletion of two, or addition of one zinc finger (Sp1/Egr-1) binding sites in the region 176 to 147 bp upstream from the ATG translation start site where there are normally 5 Sp1 binding motifs in tandem. Reporter gene activity directed by any of the mutant forms of the transcription factor binding region was significantly (P < 0.05) less effective than the activity driven by the wild type transcription factor binding region. Electrophoretic mobility shift assays (EMSAs) demonstrated the capacity of wild type and mutant transcription factor binding regions to bind nuclear extracts from human umbilical vein endothelial cells (HUVECs). These data are consistent with a family of mutations in the 5-LO gene that can modify reporter gene transcription possibly through differences in Sp1 and Egr-1 transactivation.

Common variable immunodeficiency associated with myelocathexis and altered membrane sodium-proton antiport

Alterations in protein kinase C (PKC) activity have been implied in the pathogenesis of common variable immunodeficiency (CVID). We analyzed amiloride-sensitive red blood cell Na+/H+ exchange (sodium-proton antiport, SPA) and its response to protein kinase stimulation in a patient with CVID. Compared with healthy subjects or patients with sepsis, a unique pattern of SPA activation has been shown. The patient's SPA was decreased and unresponsive to PKC stimulation, whereas stimulation by insulin, a tyrosine kinase activator, restored SPA activity. An alteration of serine-threonine phosphorylation is suggested as a possible mechanism for the immune failure.

Central neurocytoma. A clinicopathological, immunohistochemical and ultrastructural study of 7 cases

Characterised by distinctive clinicopathological features, the central neurocytoma (CN) is an uncommon and possibly under-recognised primary cerebral neuronal neoplasm. We present clinical and pathological details of seven patients with CN. Histological examination revealed a greater diversity of morphological appearances than is typically described in CN. No anaplastic features were identified. Cellular areas resembling both oligodendroglioma and ependymoma were present in all cases, but each tumour also contained stroma rich areas with hyalinised or aneurysmal vessels. Synaptophysin was expressed by all tumours and probably represents the immunohistochemical marker of choice for identifying CN. Distinguishing ultrastructural features included rounded cell bodies separated by numerous cell processes containing microtubules, pleomorphic neurosecretory granules and occasional synapses. Ki-67 immunostaining revealed a low cell proliferation index in each case. The distinction of CN from other pathological mimics can be reliably made using this multiparametric approach to diagnosis. The generally benign behaviour of CN is confirmed, though there was one patient death in the follow-up period of 10-122 months. Aggressive behaviour in this case was not associated with anaplastic histological features.

Gastrointestinal autonomic nerve tumors: a clinicopathological, immunohistochemical and ultrastructural study of 10 cases

Gastrointestinal Autonomic Nerve Tumors (GANTs) are an underrecognized group of gastrointestinal stromal tumors (GISTs) putatively arising from the neural plexuses of the bowel wall. Approximately 24 cases have been previously reported. Their histogenesis, malignant potential, morphology and phenotypic features are not well defined. We present details of 10 GANTs iterating features, predominantly ultrastructural, allowing distinction from other GISTs. Clinical details are: sex-7M, 3F; age range 31-79 yrs, mean 53; symptoms/signs--abdominal pain 3, GI bleeding 3, mass 2, anemia 2. Follow-up ranged from 1-102 mths, mean 29. Seven tumors involved the small intestine and 3 were gastric. Tumor size ranged from 30-160 mm, mean 79. They were solid and cystic, often transmural and usually involved mesentery and retroperitoneum. Spindled and epithelioid cells were "compartmentalized" by a branching microvasculature. Eosinophilic, PAS positive stromal globules were prominent. Paraffin immunostaining results were (number positive/total): vimentin (8/9), NSE (10/10), S100 protein (6/10), neurofilament protein (0/9), synaptophysin (3/9), desmin (2/9, focal), smooth-muscle actin (0/9). Ultrastructural diagnostic features were elaborate, branching cytoplasmic processes containing microtubules, intermediate filaments and varying numbers of neurosecretory granules. Characteristic features were elaborate smooth endoplasmic reticulum enmeshed with intermediate filaments, pleomorphic mitochondria with lamellar cristae, mitochondrial-RER complexes, confronting RER cisternae, and circumscribed collections of stromal "skeinoid" fibres. There were no features of smooth muscle, Schwannian or perineurial differentiation.(ABSTRACT TRUNCATED AT 250 WORDS)

PCR amplification of microdissected wheat chromosome arms in a simple 'single tube' reaction

A novel method for the adaptor-mediated PCR amplification of microdissected chromosome arms is described. This simple and versatile protocol eliminates the need for enzymatic micromanipulation in nanoliter volumes and permits the efficient amplification of as little as two wheat chromosome arms in a 'single tube' reaction.

In vitro reactions of 2-cyanoethylene oxide with calf thymus DNA

2-cyanoethylene oxide (CEO) is a direct-acting mutagen and the postulated proximate carcinogenic form of acrylonitrile (AN). We have studied the reactions of CEO with 2'-deoxyribonucleosides and in vitro with calf thymus DNA at pH 7.0-7.5 and 37 degrees C for 3 h. Reaction of CEO with dAdo gave 2 adducts, N6-(2-hydroxy-2-carboxyethyl)-dAdo (N6-HOCE-dAdo) (2% yield) and 1,N6-etheno-dAdo (epsilon-dAdo) (11%); reaction with dCyd resulted in the isolation of 3-HOCE-dUrd (22%); reaction with dGuo gave 7-(2-oxoethyl)-Gua (7-OXE-Gua) (31%) and reaction with dThd yielded 3-OXE-dThd (3%). Structural elucidation of adducts was accomplished by ultraviolet spectroscopy, high-field proton NMR spectroscopy and mass spectrometry. Structural confirmation was provided by an accurate mass measurement technique where diagnostic ions in the electron impact mass spectra of trimethylsilyl derivatives were measured to within 0.0007 atomic mass units. The facile Dimroth rearrangement of 1-HOCE-dAdo to N6-HOCE-dAdo and hydrolytic deamination of a dCyd adduct to 3-HOCE-dUrd is postulated to be catalyzed by the hydroxyl group on the 3-carbon side chain of the adduct. Reaction of CEO with calf thymus DNA yielded (nmol/mg DNA) N6-HOCE-dAdo (2); epsilon-dAdo (11); 3-HOCE-dUrd (80); 7-OXE-Gua (110) and 3-OXE-dThd (1). Thus CEO, like its metabolic precursor AN, directly alkylates DNA in vitro but at a much more rapid rate.

Lidocaine pretreatment effectively decreases the incidence of hiccups during methohexitone administration for dilatation and curettage

The efficacy of lidocaine 1 mg.kg-1 for prevention of methohexitone-induced hiccups was assessed in a double-blind fashion in 200 patients undergoing dilatation and curettage for pregnancy interruption. The patients were randomly assigned to receive either lidocaine 1% or saline 0.9% in a similar way (1 ml for every 10 kg of body weight). The incidence of hiccups was 16% in the control group compared to 6% in the lidocaine group. We speculate that this reduction in the methohexitone-induced hiccup ratio is related to lidocaine's membrane-stabilizing properties, which decrease the excitability of all the nervous structures involved in this reflex.

Nitrogen mustard as induction therapy for rheumatoid arthritis: clinical and immunologic effects

We treated 5 patients diagnosed with rheumatoid arthritis (RA) with nitrogen mustard (HN2) and monitored clinical and immunologic variables. HN2, 0.3 mg/kg ideal body weight was given over 7 days. Disease activity and immune function were monitored during and after treatment. Duration of morning stiffness (p = 0.0044), joint count (p = 0.0140), and assessment of pain (p = 0.0264) and function (p = 0.0057) improved by Day 6. T lymphocytes (p = 0.0060), especially T memory cells (CD4CD29; p = 0.0017) fell dramatically. HN2 is effective for rapidly gaining control of active RA. This effect is T cell specific.

In vitro reaction of ethylene oxide with DNA and characterization of DNA adducts

Ethylene oxide (EO) is a direct-acting SN2 alkylating agent and a rodent and probable human carcinogen. In vitro reactions of EO with calf thymus DNA in aqueous solution at neutral pH and 37 degrees C for 10 h resulted in the following 2-hydroxyethyl (HE) adducts (nmol/mg DNA): 7-HE-Gua (330), 3-HE-Ade (39), 1-HE-Ade (28), N6-HE-dAdo (6.2), 3-HE-Cyt (3.1), 3-HE-Ura (0.8) and 3-HE-dThd (2.0). Reference (marker) compounds were synthesized from reactions of EO with 2'-deoxyribonucleosides and DNA bases, isolated by paper and high performance liquid chromatography and characterized on the basis of chemical properties and UV, NMR and mass spectra. In agreement with our earlier studies with propylene oxide (PO) (Chem.-Biol. Interact., 67 (1988) 275-294) and glycidol (Cancer Biochem. Biophys., 11 (1990) 59-67), alkylation at N-3 of dCyd by EO under physiological conditions resulted in the rapid hydrolytic deamination of 3-HE-dCyd to 3-HE-dUrd. The hydroxyl group on the alkyl side chain which forms after epoxide alkylation is mechanistically involved in this rapid hydrolytic deamination. These results may provide important insights into the mechanisms of mutagenicity and carcinogenicity exhibited by EO and other SN2 aliphatic epoxides.

Premedication with metoclopramide decreases the frequency of methohexital induced hiccup

Metoclopramide is one of many drugs that have been recommended for the treatment of intractable hiccup. Methohexital may produce hiccup during induction of general anesthesia. 211 women received methohexital for induction and maintenance of general anesthesia for short gynaecological procedures. All the patients were premedicated with fentanyl, diazepam and atropine. 109 patients were randomly selected to receive metoclopramide before induction of anesthesia; the remaining 102 patients served as a control group, and were anesthetized without metoclopramide premedication. The frequency of hiccup was compared between the two groups. 7 patients had hiccup in the metoclopramide premedicated group, as compared to 17 patients in the control group. This difference was statistically significant. We conclude that metoclopramide reduces the frequency of methohexital induced hiccup, and recommend that metoclopramide be routinely used for the premedication of methohexital injection.

In vitro reactions of isopropyl methanesulfonate with DNA and with 2'-deoxyribonucleosides

Isopropyl methanesulfonate (IPMS), an SN1 alkylating agent, is a direct-acting mutagen in bacteria. We recently reported that s.c. and topical administration of IPMS to mice resulted in the rapid induction of thymic lymphomas. Thymic lymphoma induction was not observed following administration of the SN2 alkylating agents methyl methanesulfonate (MMS) and ethyl methanesulfonate (EMS). We have studied the reactions of IPMS with dAdo, dCyd, dGuo and dThd at pH 6.5 to 7.5 and 37 degrees C for 3 h. IPMS formed the following isopropyl (IP) adducts: 7-IP-Gua (4% yield), O6-IP-Gua (8%), O2-IP-Cyt (1%), O2-IP-dThd (2%), 3-IP-dThd (1%), and O4-IP-dThd (0.4%). Adducts were characterized from UV and mass spectra. IPMS was reacted in vitro with calf thymus DNA (pH 6.5 to 7.5, 37 degrees C, 3 h) and yielded (nmol/mg DNA): 7-IP-Gua (22) O6-IP-dGuo (11), O2-IP-Cyt (9), O2-IP-dThd (2), O4-IP-dThd (2), 3-IP-Ade (0.2) and 3-IP-dThd (0.2). The relatively greater alkylation of exocyclic oxygen atoms in DNA by IPMS compared to values for MMS and EMS reported by others, may play a role in the induction of thymic lymphomas in mice by IPMS and the lack of such activity by MMS and EMS.

[Neonatal dacryocystitis. A case report]

The authors report one case of neonatal dacryocystitis. They consider the diagnostic and therapeutic problems. One surgical intervention, with a large orifice of the lacrimal meatus, upon the catheter, with rhinoscopy, seems them the best solution, in this precise case.

[Effectiveness and tolerance of cefixime in the treatment of acute pyelonephritis]

In a prospective, open clinical study, 50 urological patients with acute pyelonephritis were treated with the oral cephalosporin cefixime. The medication (2 x 200 mg/day) was given for seven to ten days. Clinical, bacteriological as well as hematological examinations were carried out prior to, during and immediately after therapy. A late check-up was performed five to nine days after the end of therapy. 46 of the 50 cases were evaluable for efficacy, and all 50 patients were included in safety evaluation. The most frequent pathogens isolated prior to therapy were Escherichia coli (34 times), Proteus mirabilis (six times), Klebsiella pneumoniae (twice) and coagulase-negative staphylococci (twice). Immediately after the end of therapy the pathogens were eradicated in 44 (97.5%) patients. At the late check-up the urine was sterile in 29 (63%) patients. A relapse was observed in 11 patients, a reinfection in four and the initially isolated pathogens had persisted in two. Immediately after the end of therapy 44 (95.7%) patients were clinically cured and two patients had improved. At the late check-up 41 patients were classified as clinically cured, three showed improvement, and two improvement with relapse. Adverse reactions (one case nausea and exanthem, and one case of meteorism) occurred in two patients. No changes in the blood counts or in the liver and kidney functions were observed. In the study described here cefixime proved to be an effective and well tolerated antibiotic for the treatment of upper urinary tract infections; it is of particular interest that 16 of the 50 patients presented with underlying disease favoring infection.

[Retinal detachment caused by desinsertion at the ora serrata. Epidemiologic aspects and prognosis]

A study about 44 retinal detachments showed 44 cases of retinal detachment due to desinsertions at the ora serrata, including all etiologies. We found that most of the cases were young people (80% before 40 years old), and male and functional results were relatively poor (60%). In "idiopathic" cases and due to the ocular contusions, the rates of good anatomic results were respectively 86% and 95%, and visual acuity was improved in 70% and 81% of the eyes.

[Melanoma of the uvea in young patients. Apropos of 3 cases]

The authors report 3 cases of uveal melanoma, appeared on young women: 20, 23 and 28 years old. The melanomas were localized on the iris, the ciliary body and on the choroid. The authors studied the different notions of the literature about happened age of these lesions.

Multicenter evaluation of triamcinolone acetonide nasal aerosol in the treatment of adult patients with seasonal allergic rhinitis

Triamcinolone acetonide aerosol inhalation therapy is effective for the prophylactic treatment of asthma. Recently, the delivery system for this preparation has been modified for use in allergic rhinitis. A total of 180 adult patients with symptomatic seasonal allergic rhinitis participated in this double-blind, placebo-controlled, multicenter trial. Patients received either placebo or approximately 25 mg per actuation of triamcinolone acetonide aerosol per nostril, qid, for 4 weeks. Each patient kept a daily diary rating rhinitis symptoms. Both the patient and the physician also gave global evaluations of drug efficacy. Of 168 evaluable patients, significant reductions were seen at week 1, week 2, and in the overall study evaluation of ratings for intensity (P less than .001) and duration (P less than .05) of various rhinitis symptoms such as nasal stuffiness, discharge, and sneezing in the group given triamcinolone acetonide. Superiority to placebo group was evident as early as day 1 and maintained throughout the study. Both patients and physicians rated triamcinolone acetonide as significantly more effective than placebo for the duration of the study (P less than .001). There was a marked reduction in nasal smear eosinophils in the triamcinolone acetonide group. There was no difference between groups in safety evaluations including no evidence of suppression of the adrenal axis and no evidence of fungal infection. This study demonstrates that triamcinolone acetonide in a dose of 25 micrograms per nostril, qid, is effective, well tolerated, and safe in reducing symptoms in adult patients with seasonal allergic rhinitis.

[Ocular mutilating surgery. Its incidence and indications. A 5 years' study at the Regional Hospital Center of Reims]

The authors report the different types of mutilating surgery: evisceration, enucleation and exenteration, realized at Reims C.H.R., between 1983 and 1988. The authors specify the causes leaded on the anatomical waste of the eye ball.