Carcinoma associated mucins: molecular biology and clinical applications

Mucin is a viscous secretion of glycoproteins secreted by epithelial cells of normal and cancerous tissues. Excessive and abnormal mucin synthesis has been observed in a number of cancers. The conformation and configuration of the surface carbohydrates play a key role in generating multiple forms of mucins in different cancers. The epitopes on the surface of mucin are recognized by antibodies present in different cancer cells. The primary structure of some of the cancer-associated mucins has been determined by molecular cloning of their complementary DNAs. The detection methods for cancer-associated mucins and their clinical applications are discussed.

Refractive errors in preterm babies

Fifty preterm neonates were followed up at the age of 6 months and 1 year. In addition to developmental assessment, a complete ophthalmological examination was done on both visits. The largest (62%) gestational age group was of 34-36 weeks. At 6 months, none of the infants had normal vision. At 1 year of age, 64% of the babies had normal vision while incidence of myopia and hypermetropia was 16% and 20%, respectively. There was an inverse relationship noted between gestation and incidence of refractive errors. It was also noted that with decreasing weight, the incidence of myopia increased. Myopia was seen exclusively among infants of birth weight of 2000 g or less. Birth weight had a significant positive correlation with astigmatism. No correlation of asphyxia with refractive errors was observed. It is recommended that all preterm babies should have an ophthalmological examination at one year of age with follow up later on.

Neutrophil leukotriene generation increases after cardiopulmonary bypass

BACKGROUND

Leukotriene B4 has been shown to play a role in the systemic inflammatory response after cardiopulmonary bypass in experimental animal models; however, the importance of this mediator in human beings undergoing cardiac operations has not been established.

METHODS

The neutrophils of ten patients undergoing coronary artery bypass grafting with cardiopulmonary bypass were studied for their ability to generate leukotrienes at the time of the induction of anesthesia, the institution of cardiopulmonary bypass, the removal of the aortic crossclamp, at the end of the operation, on admission to the intensive care unit, and on postoperative days 1 and 2

RESULTS

After cardiopulmonary bypass, the generation of chemotactic leukotrienes rose significantly and remained elevated on the first postoperative day compared with prebypass values (prebypass 133.8 +/- 10.7 versus postbypass 192.7 +/- 19.2 [p < 0.05] and first postoperative day 196.6 +/- 13.8 [p < 0.05]). The increases in plasma complement and lactoferrin levels, although significant, were not sustained. In addition to the neutrophil count, the potential leukotriene and oxygen radical produced was significantly increased, and this increase was correlated with postoperative length of stay.

CONCLUSION

These observations support the laboratory data documenting that the rise in leukotriene generation after cardiopulmonary bypass includes human patients.

Obesity and hypertension in children

A study was conducted on two thousand five hundred and sixty school children to evaluate the prevalence of hypertension in apparently healthy school children of a prosperous, industrialized city of Punjab. The children belonged to 5-15 years age group of both sexes. The weight (kg) was taken by a standardized weighing machine while height was measured using a calibrated bar. For diagnosing obesity, the body mass index (BMI) was calculated by the formula: [formula: see text] A value of > or = 2.26 was considered as obesity. Blood pressure (BP) measurements were taken by a a mercury sphygmomanometer as per the recommendations of American Heart Association. Hypertension was diagnosed if blood pressure was more than 95th percentile for the age. Family history of hypertension was enquired from the parents of children. The BP of the hypertensive children was reassessed after six and nine months. The prevalence of hypertension was 2.8% at the first screening but decreased to 1.3% and 1.1% by 6 and 9 months, respectively. This fall was statistically significant (p < 0.01). There was no significant difference in the prevalence of hypertension between the two sexes. At the final screening, only children of 11 years or above were hypertensive. A statistically significant correlation with positive family history of hypertension was noted; 85.7% of hypertensive children had positive family history. The prevalence of hypertension was much higher in obese as compared to non-obese children (13.7% vs 0.4%). The correlation between obesity and hypertension was statistically significant (p < 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Canine U2 snRNA gene: nucleotide sequence, characterization and implications in RNA processing and cancer biology

Abnormal RNA processing (splicing) may lead a cell to become cancerous. Transcription of a gene starts in the nucleus where genomic DNA is converted to precursor RNA by removing introns and joining exons. Splicing, mediated by small nuclear RNA (snRNA) and nuclear proteins, is tightly regulated during growth and development. U2 snRNAs are small, stable RNAs located in the nucleus of eukaryotic cells that recognize the branch point of the intron-exon junction. We describe here the organization of DNA sequences complementary to canine U2 snRNA. From a genomic library we isolated one recombinant containing the U2 gene. Southern analysis revealed that the canine species possesses only 3 to 5 U2 snRNA genes or very closely related sequences. The size of the U2 gene is 125 nt whereas in rat, Drosophila, trypanosome and yeast it is 189, 234, 141, and 192 nt respectively. The nucleotide sequence showed 82, 78, 72 and 95% homology with rat, Drosophila, yeast, and trypanosome U2 snRNA, respectively. The sensitivity of U2 snRNA towards alpha-amanitin suggests that it is transcribed by RNA polymerase II. The conserved nucleotide sequences which have been implicated in heterogeneous nuclear RNA splicing have been identified. The implications of the knowledge gained through above studies in cancer biology are discussed.

Safe motherhood: when to begin

Two thousand five hundred college girls were assessed for their knowledge and attitudes regarding sex, pregnancy and child rearing with the help of a pretested questionnaire. The site of menstruation was known to only 35.3% of the girls. The knowledge about the time and site of conception was 25.3% and 58.2%, respectively. Only 16.3% of the respondents knew the normal route of delivery although the duration of normal pregnancy was known to majority (87.7%). The girls were aware of the ideal timing of abortion (67.5%) but the safe method and legality were poorly known facts. Only 5% of the girls believed in pre-marital sex. More than half (54.9%) of the girls knew about some form of contraceptive, Copper-T being the best known. Nearly one fifth of the girls were either undecided or wished family members to decide about antenatal check-ups. The need for better diet and injections during pregnancy was well known although few (15.2%) were aware of the injections being tetanus toxoid. Only about 10% wanted a home delivery but one fourth felt that a Dai or a relative was suitable for conducting the delivery. An overwhelming majority of the students stated that knowledge about above facts was important and they would like to learn about them preferably during college education. It is recommended that 'Family life education' be provided during pre-adolescent and adolescent years to ensure a safe motherhood and a healthy child.

Inhibition of neutrophil leukotriene generation by the 21-aminosteroid, U-74389F

The 21-aminosteroids are potent inhibitors of iron-dependent lipid peroxidation and more protective than methylprednisolone in models of trauma and reperfusion, but without glucocorticosteroid side effects. Histologically, animals treated with 21-aminosteroids have decreased neutrophil (PMN) infiltrates and diminished tissue destruction associated with trauma or reperfusion. Since PMN contribute to organ failure following ischemia-reperfusion, we assessed the effect of U-74389F (U7), on normal PMN function. Neutrophils from normal volunteers were incubated for 90 min with either vehicle, 15 microM U7 or 80 microM methylprednisolone (MP), in DMSO. Lactoferrin released and generation of leukotrienes to calcium ionophore A23187, also oxygen consumed to PMA and leukotriene B4 (LTB4) and chemotaxis to FMLP and LTB4, were determined for each group of PMN. Lactoferrin released to A23187 was significantly decreased in both steroid groups (7.29 +/- 0.82 micrograms vs 3.06 +/- 0.57 micrograms U7 and 2.88 +/- 0.62 micrograms MP, P < 0.01). PMN incubated with U7 or MP generated significantly less LTB4 (60.6 +/- 4.3 ng vs 47.7 +/- 2.4 ng U7 and 43.3 +/- 5.6 ng MP, P < 0.05). There were no differences noted in the ability of PMN incubated with either compound to consume oxygen or to respond to chemotactic stimuli. We conclude that the proven protective action of the 21-aminosteroids in models of ischemia-reperfusion is related to the ability of "steroids" to inhibit leukotriene generation and degranulation and may be related to the prevention of tissue lipid peroxidation by scavenging oxygen radicals.

Triazines as anti-inflammatory agents

5,6-Diphenyl 1,2,4-triazine-3-thiol (III) was synthesized from alpha-diketone benzyl (II); II in turn was synthesized from benzoin (I). III on reaction with 1-chloro-2,3-epoxy propane yielded 3-[(oxiranyl methyl)thio]-5,6-diphenyl 1,2,4-triazine (IV). IV was converted to 3-[5,6-diphenyl-1,2,4-triazine-3-yl thio]-3-substituted propanols (V) on reaction with aryl amines. These compounds were screened for their anti-inflammatory activity in albino rats with carrageenin induced paw oedema. Two compounds, Ve and Vl, exhibited significant anti-inflammatory activity compared to the standard, phenylbutazone, with high ALD50 values.

Mucin coding sequences are remarkably conserved

Mucins are complex glycoproteins expressed by glandular epithelia and the carcinoma which develop from these tissues. The core protein is aberrantly glycosylated in cancers, and some antibodies show specificity in their reactions with the cancer-associated mucins, which also contains epitopes recognized by T-cells from pancreatic and breast cancer patients. Based on the PCR amplification of the mucin coding sequences, hybridization analysis and determination of the sequence divergence we present the evidence that mucin coding sequences are conserved in a number of species. A broad series of organisms were examined for analogous sequences. Data show that mucin-type sequences are present in a variety of mammals, but less apparent in chicken and yeast. Divergence increased in the order human, monkey, rabbit/rat/cow, mouse; chicken and yeast exhibited minimal homology. Furthermore, nucleotide sequences not included in the tandem repeats, a common feature of mucin core structure, are more conserved than the flanking sequences which also suggests that the flanking sequences may be functionally significant while repeats are structurally important. The hybridization bands showed different restriction patterns (suggesting for the existence of the restriction fragment length polymorphism). Northern analysis indicates message polydispersity, commonly seen with this class of RNA. The major features of the protein appear broadly conserved in the different mammalian species examined. The evolutionary significance of the above studies has been discussed.

Communication skills in clinical practice fad or necessity?

Communication skills of 40 final year medical students were assessed using Objective Structured Clinical Examination. The scores obtained were significantly less than those obtained in clinical skills. There was no significant correlation between the two sets of scores. It is suggested that emphasis should be placed on developing and evaluating communication skills during undergraduate medical curriculum.

DNA sequences encoding enolase are remarkably conserved from yeast to mammals

Enolase (2-phospho-D-glycerate hydrolase, EC 4.2.1.11), particularly isoform neuron-specific enolase (NSE), is primarily localized in neurons and neuroendocrine cells and is a cancer diagnostic marker for brain tumors. Homology of enolase-coding DNA sequences from human, dog, cow, rat, mouse, rabbit, chicken, and yeast cells was investigated using hybridization techniques, percent sequence divergence, and amino acid analysis. Because enolase is a significant enzyme of the glycolytic pathway, enolase-coding DNA sequences have been found in all organisms tested so far. The human enzyme was found to be more like those of monkey and dog in structure than to those of chicken and yeast. The implications of the existence of the genetic conservation of enolase-coding DNA sequences in understanding concerted evolution as well as post-transcriptional regulation during differentiation are discussed. This is the first report is which sequence divergence in the coding region for enolase has been determined in a variety of organisms.

Frequency-dependent alterations in enolase activity in Escherichia coli caused by exposure to electric and magnetic fields

Some neurochemical effects of low-intensity electric and magnetic fields have been shown to be nonlinear functions of exposure parameters. These effects occurred within narrow ranges of frequency and intensity. Previous studies on membrane-associated endpoints in cell culture preparations demonstrated changes in calcium efflux and in acetylcholinesterase activity following exposure to radiofrequency radiation, amplitude modulated (AM) at 16 and at 60 Hz, at a specific absorption rate of 0.05 W/kg. In this study, these modulation frequencies were tested for their influence on the activity of a cytoplasmic enzyme, enolase, which is being tested clinically for detection of neoplasia. Escherichia coli cultures containing a plasmid with a mammalian gene for enolase were exposed for 30 min, and cell extracts were assayed for enolase activity by measuring absorbance at 240 nm. The enolase activity in exposed cultures was compared to the activity in paired control cultures. Exposure to 147 MHz carrier waves at 0.05 W/kg, AM at 16 Hz showed enolase activity enhanced by 62%, and AM at 60 Hz showed enolase activity reduced by 28%. Similarly, exposure to 16 Hz fields alone, at 21.2 V/mrms (electric) and 97 nTrms (magnetic), showed enhancement in enolase activity by 59%, whereas exposure to 60 Hz fields alone, at 14.1 V/mrms (electric) and 65 nTrms (magnetic), showed reduction in activity by 24%. Sham exposures as well as exposure to continuous-wave 147 MHz radiation at 0.05 W/kg showed no change in enolase activity.(ABSTRACT TRUNCATED AT 250 WORDS)

Developing and standardizing a scale for measuring attitudes towards infant feeding

A Likert type scale was designed to assess the attitudes of urban college girls towards infant feeding. The scale was administered to a sample population of 50 girls and the scores thus obtained were used to calculate the internal consistency of the scale. The scale had a reliability of 0.82 (p < 0.01 at df 48).

Attitudes of medical students towards Objective Structured Clinical Examination (OSCE) in pediatrics

A standardized Likert type scale containing 10 items was administered to 40 Fourth year medical students to assess their attitudes towards Objective Structured Clinical Examination (OSCE). The overall attitudes were favorable. However, on certain aspects, a near neutral attitude was observed. Remedial changes in the teaching methodology have been undertaken to mould the attitudes favorably as well as to make pediatric teaching more effective.

Evaluation of commercially available antacid tablets

Antacids are commonly used for the treatment of acid peptic disease. There is a need to study the relative merits of various brands of antacids available commercially. Twenty three brands of antacid tablet preparations were evaluated with regard to their composition, cost, dispersion time, pH, neutralising capacity and time taken for neutralisation. The cost of various tablets ranged from Rs 0.13 to Rs. 1.48 per tablet and the dispersion time from 20 to 90 minutes. The pH of the dispersed tablet solution ranged from 5.7 to 9.5. The neutralising capacity varied between 8 to 169 meq/tablet and the neutralizing time between 20 and 45 minutes. The cost: neutralizing ratio was calculated and ranged from 102 to 9867 x 10(-3) Rs/meq. A scoring system with a maximum score of 12 has been devised. The study provides a guide for choosing a more potent, quick neutralising and low cost antacid preparation.

Antipyrine congeners as antidepressant agents

1-(N-Antipyrinylglycyl)-3-arylideneamino)-2-thiobarbituric acids (III) were synthesized from 1-arylidene-4-(N-antipyrinyl glycyl)-3-thiosemicarbazones (II). Compounds II in turn were prepared from 4-amino antipyrine. Compounds III were finally converted into 1-(N-antipyrinylglycyl)-3-[(3'-chloro-4-aryl)azitidinyl]-2-t hiobarbituric acids (IV). 4-Aminoantipyrine was also treated with different N-protected amino acids in the presence of N,N'-dicyclohexylcarbodiimide to yield N-(antipyrinylcarbamoyl) substituted alkyl benzamides (V); their debenzoylation yielded 2-(amino-N-antipyrinyl) substituted acetamides (VI). The compounds were screened for their antidepressant activity. Compounds IIId, Va and Vb exhibited activity better than imipramine with less toxicity (ALD50 > 1000 mg/kg).

Microwave induced alteration in the neuron specific enolase gene expression

Exposure of pNGE7, a recombinant clone containing the coding and regulatory sequences for the expression of neuron specific enolase gene, cells to electromagnetic radiations (915 MHz, 16 Hz AM, SAR 0.05 mW/kg) resulted in the elevation of neuron specific enolase (NSE), a diagnostic marker for neuron and lung cancer. Using ion-exchange chromatography we separated the neuron specific enolase activity from the non-neuronal enolase (NNE) activity and observed an alteration in the expression of neuron specific enolase and non-neuronal enolase. The clinical applications of the present studies have been discussed.

Molecular cloning and sequencing of a canine tracheobronchial mucin cDNA containing a cysteine-rich domain

To date the complete sequence of only one mammalian mucin cDNA, MUC1, has been reported, although several mucin proteins have been partially characterized. Here we report the nucleotide sequence of a canine tracheal mucin cDNA containing two potential translation initiation codons, one translation termination codon and a poly(A) tail. A lambda gt11 cDNA library prepared from canine tracheal epithelial cells was screened with polyclonal anti-apo-canine tracheal mucin antibodies with the aim of obtaining the deduced amino acid sequence of the mucin core protein. Antibody-positive clones containing overlapping inserts of various lengths were purified and used for nucleotide sequencing. Based on the sequencing data, synthetic oligonucleotide primers were constructed and both ends (5' and 3') of the cDNA were determined. The complete sequence was 3.7 kb and included an open reading frame with coding capacity for 1118 aa, two translation initiation ATG codons in context with Kozak consensus sequences, one polyadenylylation site, and a poly(A) stretch. The protein was rich in Thr, Pro, Ser, Gly, and Ala and poor in Tyr, Phe, and Trp. Although tandem repeats of amino acids were absent in the deduced canine tracheal mucin sequence, motifs TPTPTP and TTTTPV appeared 13 and 19 times, respectively. The C-terminal region contained a Cys-rich domain (although a few Cys residues were also present in the middle of the protein) as has been reported for bovine submaxillary mucin, porcine submaxillary mucin, rat intestinal mucin, human intestinal mucin, and frog skin mucin. This suggested that a broad group of mucins contain such a Cys-rich domain whose functional significance is yet to be understood. Three potential N-glycosylation sites were present in canine tracheal mucin and the amino acid sequence showed homology with both human tracheal and intestinal mucins. The N-terminal domain showed more flexibility (probably due to a high number of Pro residues in this region) when analyzed by the University of Wisconsin Genetics Computer Group program package to determine the predicted secondary structure. Evaluation of the transcripts using the canine mucin cDNA as a probe indicated a polydisperse message with total RNA.

Thiazolidinone congeners as central nervous system active agents

3-(Benzylidene amino)-2-imino-4-thiazolidinones (IIa-c) synthesized by cyclization of substituted thiosemicarbazones (Ia-c) were converted into 2-amino-3-(substituted benzylamino)-4-thiazolidinones (IIIa-c), 2-imino-3-(alpha-aryl azo benzylidene) amino-4-thiazolidinones (IVa-f) and 2-(2-amino-4-oxo-3-thiazolidinyl)-3-aryl-4-isothiazolidinones (VIa-c), IVa-f were finally converted into 5-(arylamino methyl)-2-imino-3-(alpha-aryl azobenzylidene)-amino-4-thiazolidinones (Va-l). These compounds III, V and VI were evaluated for their monoamine oxidase (MAO) inhibitory activity in vitro and various CNS activities in vivo. Some of the compounds exhibited promising CNS activity.

C-myc, c-fos, and c-ras coding sequences are conserved from yeast to mammals

Oncogenes, along with the autocrine secretion growth factors, emerged as a unifying theme in the search for the molecular and cellular basis of malignant transformation. To investigate whether some of the oncogene coding sequences are phylogenetically conserved, we performed hybridization experiments using well characterized c-myc, c-fos and c-ras oncogene probes to establish the sequence divergence in the genomes of different organisms. Our results indicate the c-myc, c-fos, and c-ras coding sequences exist in human, cow, monkey, rabbit, chicken, and yeast genomes. To the best of our knowledge this is the first report wherein a correlation among species in the oncogenes coding region has been established. The evolutionary implication of the present studies is discussed.

Human lung enolase: cloning and sequencing of cDNA and its inducibility with dexamethasone

Corticosteroids used orally and intravenously lead to lung diseases and vascular disorder. To investigate whether enolase levels are also changed by treatment with synthetic steroid dexamethasone (as alteration in the enolase levels have been correlated with lung cancer) we performed the following studies. A cDNA library was prepared from poly(A) mRNA extracted from human lung fibroblast cells. cDNA clone HLE1 containing 1.7 kb insert coding for enolase was isolated. Its identity was confirmed by (a) translation of the hybrid selected mRNA and (b) nucleotide sequence analysis of the insert and comparison with known enolase sequences from other species. The lung enolase is coded by a polypeptide of 458 amino acid residues (mr = 49.5 kD). Nucleotide sequencing and derived amino acid sequence data suggest that the cloned enolase is non-neuronal isoform of enolase (NNE). In lung fibroblast cells, dexamethasone caused remarkable increase in the abundance of the enolase mRNA, which was concentration and time dependent. The induction by dexamethasone required de novo RNA synthesis but not de novo protein synthesis.

Experiences with objective structured clinical examination (OSCE) as a tool for formative evaluation in pediatrics

Mean scores obtained at objective structured clinical examination (OSCE) and clinical case (CC), by 4 groups of 15 students each were compared. The range of dispersion was more with OSCE as compared to CC. There was no correlation between the scores obtained at OSCE and CC. It is suggested that OSCE can be employed for evaluation of specific clinical skills; however, for comprehensive evaluation, a combination of OSCE and CC should be used.

Attitudes of medical students towards IAP Pediatric Quiz

Attitudes of medical students towards IAP Pediatrics Quiz were assessed, using a 5 point pre-tested, standardized Likert type scale, developed in our own department. Students had a favorable attitude towards the Quiz and felt that it helps them in the study of Pediatrics, but they are not able to devote sufficient time for preparations because of their preoccupation with other major subjects. The attitudes demonstrated a decline towards unfavorableness when comparison was made between the scores of third year and final year medical students. The difference was statistically significant (p < 0.05). It is suggested that the timing of the Quiz should be changed, so that it doesn't coincide with final professional examinations. This will make it more popular besides generating interest of medical students in Pediatric. Giving more weightage to Pediatrics in university examinations is also re-emphasized as a means of making students more interested in pediatrics.

Multifocal atrial tachycardia: a complication of pneumomediastinum

We report here an interesting case of multifocal atrial tachycardia (MAT) occurring as a complication of surgical emphysema with pneumomediastinum. The MAT reverted to sinus rhythm following aspiration of air from mediastinum.

Liposome-Mediated Modulation of Multidrug Resistance in Human HL-60 Leukemia Cells

BACKGROUND

Multidrug resistance (MDR) is a major obstacle in cancer treatment. Resistance of cultured tumor cells to major classes of cytotoxic drugs is frequently due to expression of a plasma membrane P-glycoprotein encoded by MDR genes. We have demonstrated that liposome-encapsulated doxorubicin is more toxic than the free drug and that it modulates MDR in Chinese hamster LZ cells and human colon cancer cells.

PURPOSE

To investigate further the association between expression of P-glycoprotein and modulation of MDR by liposome-encapsulated doxorubicin, we studied vincristine-resistant HL-60/VCR leukemia cells, which express P-glycoprotein, and doxorubicin-resistant HL-60/ADR leukemia cells, which do not.

METHODS

Cells were exposed to various concentrations of free doxorubicin and liposome-encapsulated doxorubicin. The cellular content of doxorubicin was determined by fluorescence analysis, and cytotoxicity was determined by cell growth inhibition. Photoaffinity-labeling studies of P-glycoprotein binding were performed on HL-60/VCR and HL-60/ADR cells and KB-GSV2 cells transfected with the MDR1 gene (also known as PGY1).

RESULTS

The concentrations that caused 50% inhibition of growth (IC50) for free doxorubicin in HL-60, HL-60/ADR, and HL-60/VCR cells were 30 nM, 9 microM, and 0.9 microM, respectively. The values for liposome-encapsulated doxorubicin in parental HL-60 cells and HL-60/ADR cells were 20 nM and 9 microM, respectively, indicating little or no sensitization. In contrast, HL-60/VCR cells were fivefold more sensitive to liposome-encapsulated doxorubicin than to free doxorubicin, and IC50 was reduced to 0.17 microM. In HL-60 cells exposed to liposome-encapsulated doxorubicin, intracellular doxorubicin accumulation was less than that seen with free drug. In contrast, in HL-60/VCR cells, accumulation was twofold to threefold higher than that with free doxorubicin. Liposome-encapsulated doxorubicin completely inhibited the photoaffinity labeling of P-glycoprotein by azidopine in membrane vesicles of HL-60/VCR cells, with a potency comparable to that of azidopine, suggesting that circumvention of MDR by liposomes is related to their specific interaction with P-glycoprotein. The studies with KB-GSV2 cells indicated that blank liposomes can directly inhibit photoaffinity labeling of P-glycoprotein.

CONCLUSIONS

These results demonstrate the effectiveness of liposome-encapsulated doxorubicin in overcoming resistance in the multidrug-resistant phenotype of HL-60/VCR cells by direct interaction with P-glycoprotein. Furthermore, they indicate that liposome-encapsulated doxorubicin may be an effective treatment for human cancers.

Perinatal mortality in Ludhiana, Punjab--a seven year hospital study

Perinatal deaths occurring over a seven year period were studied in a teaching hospital in Punjab. Causes of death were analysed as per Wigglesworth's classification. We have further modified this by correlating different gestations and weight groups with causes of death. The perinatal mortality rate (PNMR) in the present study was 74/1000 and showed a downward trend secondary to a statistically significant fall of early neonatal mortality. There was a decline in PNMR among babies of 1500-2000 g. birth weight and 33-36 weeks gestation. Asphyxia and macerated still births were found to be the two main causes of death. Macerated still births were seen more commonly among babies of lower weight at all gestations. The PNMR of babies born to booked mothers was 22/1000 as compared to 152/1000 among unbooked mothers. It was concluded that to bring down the PNMR, economic development alone is not enough. Provision of adequate antenatal care to all mothers, health education and timely referral of high risk mothers is very essential.

Decreased access to medical care for girls in Punjab, India: the roles of age, religion, and distance

Risk factors that increase the likelihood of discrimination against girls in India have not been well studied. In this study of hospitalized children in Punjab, India, girls were less likely to be in the newborn or infant age groups, to be of the Sikh religion, or to come from far away than were boys. These differences suggest that these factors are significant risk factors for denied access to medical care for girls living in Punjab, India.

Measurement of neonatal skinfold thickness--is it of any clinical relevance?

The skinfold thickness (SFT) was measured in 750 Punjabi newborns at triceps and subscapular sites using a Harpenden's Caliper. It was correlated with various maternal and neonatal factors. SFT increased with increasing gestation but showed a decline after 40 weeks. There was a positive correlation of SFT with birth weight and length of the baby in both sexes. The correlation co-efficient for all these parameters was 0.9. The female babies had a higher SFT at all weight and length groups. Increasing maternal age, parity, weight and height all influenced the neonatal SFT positively. Mothers with higher SFT produced babies with more skinfold thickness. Similar relationship was observed between birth weight and these maternal factors. While severe pre-eclampsia and eclampsia led to a significant fall in SFT, hypertension alone did not affect it. A higher than normal SFT was seen among infants of diabetic mothers. It was concluded that the SFT does not give any additional information than that provided by the commonly measured parameters like birth weight and length.

Analytical procedures for a cryptic messenger RNA that mediates translational control of prostaglandin synthase by glucocorticoids

Expression of the enzyme prostaglandin H synthase in cultured vascular smooth muscle cells required epidermal growth factor (EGF) and type beta transforming growth factor (TGF-beta) and was inhibited by cycloheximide but not actinomycin D. Preincubation with the glucocorticoid dexamethasone (0.5 microM) blocked the EGF-induced expression of prostaglandin H (PGH) synthase. Following dexamethasone addition, levels of hybridizable mRNA for PG synthase were reduced by over 90% within 1 h. After dexamethasone was removed, PG synthase mRNA recovered within 3 h by a process that was not inhibited by actinomycin D. These observations, together with other findings, suggested that the mRNA was being converted into some nonextractable and nontranslated form, probably by binding of a glucocorticoid-induced protein to the conserved 3' untranslated region. In order to investigate further the nature of this phenomenon, seven different literature procedures were evaluated for extracting and determining the PG synthase mRNA. Five of the seven procedures failed to detect hybridizable PG synthase mRNA in glucocorticoid-treated cells. Two procedures, however, recovered mRNA in both glucocorticoid-treated and control cells. A comparison of the protocols indicated that only those methods that incorporate a cationic detergent (sodium N-lauroylsarcosine), instead of anionic detergents in the lysis or homogenization buffers, successfully extract the glucocorticoid-suppressed PG synthase mRNA. Based upon these results two procedures are described, one that optimizes the extraction and determination of the glucocorticoid-suppressed (cryptic) form of the mRNA, and another which optimizes the analysis of normal mRNA without extracting the cryptic form. The results indicate that translational control of PG synthase by glucocorticoids is regulated by converting the mRNA into a cryptic form that is more firmly tissue bound than normal mRNA.

Congenital malformations--a retrospective study of 10,000 cases

The frequency of congenital malformations in a retrospective study done on 10,000 consecutive births from January 1983 to March 1989 was 3.6%. The predominant system involved was CNS. Major malformations constituted 79.7% of the total. Malformations were seen 4 times more often among still births. The common malformations in still births were also of CNS. The frequency of malformations was similar in both the sexes, though genitourinary anomalies were commoner among male, while anencephaly in female babies. A statistically significant increase in the frequency of congenital malformations was observed with decreasing gestation and birth weight. There was a significant correlation between maternal factors, like previous abortions, drug intake and fever during 1st trimester, diabetes mellitus, pre-eclamptic toxemia, antepartum hemorrhage and congenital malformations in the baby.

Identification of a highly conserved 3' UTR in the translationally regulated mRNA for prostaglandin synthase

Prostaglandin H synthase (E.C. 1.14.99.1) is induced by growth factors and lymphokines such as EGF and IL-1, and is suppressed by anti-inflammatory glucocorticoids. Inhibition of enzyme synthesis by glucocorticoids is mediated by a novel translational control that appears to involve conversion of the PG synthase mRNA into a cryptic non-hybridizable form. In order to understand expression of the enzyme in more detail, a full length 2.8 Kb cDNA was cloned from a human embryonic lung cell cDNA library and the complete mRNA including the 3' untranslated region (3' UTR), was sequenced. The coding sequence for the human PG synthase shows greater than 90% homology with the sheep and mouse enzymes. A high degree of conservation (70%), however, was also observed in the approximately 750 nucleotide sequence that comprises the 3' non-coding domain of both sheep and human PG synthase mRNA's and with the approximately 900 nucleotide 3' UTR of the mouse RNA (68% sheep vs mouse; 47% human vs mouse). Extensive microregions of 10-30 nucleotides are distributed throughout the 3' UTR where homology between species is 95-100%. This high degree of conservation in a non-coding region and recent evidence from other genes suggests that these 3' UTR sequences have important regulatory functions possibly related to translational control of this mRNA by growth factors and glucocorticoids.

Expression of DNA sequences containing neuron specific enolase gene in Escherichia coli

There is evidence that the gene for gamma-gamma enolase (neuron specific enolase, NSE) is regulated during cell differentiation and development, conserved in a variety of organisms and contains mRNA destabilizing sequences. In order to investigate further the mechanisms of these processes and to obtain large quantity of this protein, the NSE gene was isolated from neuroblastoma cells and cloned in E. coli using standard molecular biology techniques. The NSE gene expression was studied and the expressed protein (recombinant NSE) was characterized extensively. The recombinant NSE behaves like parental NSE in antisera specificity, resistance for chaotropic agents like urea, thermal stability at higher temperatures etc. The physical parameters like secondary structure, hydrophilicity, antigenic index and flexibility of the expressed protein were studied. The results of the present investigation collectively form the basis for initial investigations of how the expression of NSE gene is regulated. This is the first report where the recombinant NSE gene has been characterized so extensively.

Aetiology of bacterial diarrhoea in north Indian children with special reference to Campylobacter jejuni

A total of 184 cases of acute diarrhoea, in patients aged 1-36 months, were studied clinicobacteriologically. Enteropathogens were isolated in 22.28% cases. Campylobacter jejuni was isolated from 2.17% cases only. Salmonellae were isolated from 7.6% cases and 64.28% of them were S typhimurium. More than 75% of all isolates of salmonellae, shigellae, Esch coli and Campylobacter jejuni were sensitive to gentamicin and cephaloridine. Secondary lactose intolerance was noted in 6.52% cases only.

Primary structure of the non-transcribed spacer region and flanking sequences of the ribosomal DNA of Neurospora crassa and comparison with other organisms

The non-transcribed spacer (NTS) region of the rDNA of Neurospora crassa contains the transcription regulatory sequences. We isolated a 3.4 kb EcoRI fragment from wild type N.crassa rDNA and cloned in the plasmid pBR325 at the EcoRI site. The insert contains the entire NTS region along with the flanking sequences. Nucleotide sequencing of 3592 nt shows many interesting features like: the NTS region is rich in G+C content (65% G+C); it contains the conserved rRNA processing site 6 (with the nucleotide sequence motif GGTGCGAGAACCCGG, from nt residue 226 to 240, a characteristic feature of most eukaryotic rDNA nontranscribed spacer region); and the NTS region also contains the transcription termination site with the representative Sal I box (from nt residue 1469 to 1477). The potential sequences of transcription termination site are located 288 nt downstream from the end of 26S rRNA gene, and another sequence motif CTTCCT (from nt residue 512 to 517) shows similarity with the human transcription termination site T-2 of its pre-rRNA. Nucleotide sequence homology matrix analysis suggests its relatedness to Saccharomyces cerevisiae and not to human, mouse, rat, Drosophila, Xenopus, wheat, rice and cucumber NTS region. The phylogenetic implication of the NTS region and exploitation of N.crassa NTS rDNA clone to correlate the otherwise indistinguishable species of Neurospora and the correlation with other organisms has been discussed. To the best of our knowledge this is the first report where the nucleotide sequence of the entire NTS region of a filamentous fungus has been determined.

G6PD deficiency in neonates: a prospective study

One thousand consecutively born babies were screened for G6PD deficiency and observed for seven days for development of jaundice. Frequency of the deficiency was 3.9%, being 5% in males and 2.8% in females. Religion did not have any bearing on the frequency. Parental screening in cases of babies deficient in G6PD enzyme revealed deficiency of the enzyme in majority of the mothers. Hyperbilirubinemia developed in 48.7% of babies having G6PD deficiency : It is recommended that any neonate presenting with jaundice must be screened for G6PD deficiency not only to define the etiology of hyperbilirubinemia but also to prevent future hemolytic episodes.

Platelet serotonergic mechanisms in ischaemic heart disease

The uptake, basal content and efflux of serotonin (5-HT) from the platelets of patients of ischaemic heart disease (I.H.D.) was studied and compared with normal platelets. A significant increase in uptake and basal content of 5-HT as well as increase in 5-HT efflux was observed as compared to control. Our data indicate that I.H.D. is associated with platelet serotonergic dysfunction which seems to indicate that the platelets are preactivated in I.H.D.

Leukotriene B4 generation in patients with established pulmonary failure

We investigated the cause of the reduced leukotriene B4 (LTB4) production seen in neutrophils from patients with established adult respiratory distress syndrome compared with control neutrophils. Lymphocytes/monocytes from controls were found to synergistically enhance the amount of LTB4 produced when incubated with neutrophils. This synergistic effect was not seen in cells from patients with adult respiratory distress syndrome. Fatty-acid analysis of neutrophils from patients with adult respiratory distress syndrome and controls showed remarkable similarity in all quantities of fatty acids measured except for arachidonic acid, where there was a 22% reduction in patients' cells compared with controls. Assay of the rate of generation of LTB4 and its degradation product, 20-hydroxy LTB4, revealed that reduced LTB4 generation in patients' neutrophils was not due to increased degradation of LTB4 by hydroxylase enzymes. When the amount of LTB4 being generated per milliliter of whole blood was analyzed in the patients with adult respiratory distress syndrome and compared with controls, it was determined that the potential to generate LTB4 in patients in the intensive care unit was three to five times greater than in controls.

Improved genomic blot hybridization

For restriction fragment length polymorphism (RFLP) and other molecular biology experiments, well prepared (undamaged) genomic DNA is needed, which is then digested with restriction enzymes, transferred to nitrocellulose paper and hybridized with radioactive or nonradioactive probe. DNA damage occurs in fields such as clinical genetics and forensic medicine in the form, for example, of single stranded breaks. If these DNAs are treated with T4 DNA ligase prior to restriction endonuclease digestion, the damaged DNA is repaired. This "repaired DNA" gives improved Southern hybridization results with single copy gene or repeated genes.

Clinical study of tetanus neonatorum

Seventy six cases of neonatal tetanus were studied. There was preponderance of males. Short incubation period, short period of onset, low birth weight, presence of fever and tachycardia were associated with a poor prognosis. The cases were divided into 2 groups of 46 and 30. First group was given TIG while second group was given ATS. All other therapies were kept identical. Mortality rate in two groups was 97.5% and 96.5%. Corrected mortality due to tetanus per se was 22.5% and 28.5% (p-0.5). Fifteen cases (32.7%) and 12 cases (40%) in group A & B respectively were born to mothers who had already received one to three doses of tetanus toxoid. The potency of the vaccine should be ensured before it is administered to mothers, through proper maintenance of cold chain. It is concluded that TIG is not superior to ATS in managing moderate and severe grade cases.

Platelet serotonergic mechanisms and glomerulonephritis

Proven cases (28) of glomerulonephritis (GN) were evaluated for clinico-biochemical profile, bleeding time, platelet count, platelet aggregation and platelet serotonergic mechanisms. Inordinate increase in platelet aggregation and altered platelet serotonergic mechanisms (reduced 5-HT, uptake, reduced intraplatelet 5-HT and increased plasma 5-HT) were demonstrated in some histopathological types of GN. The mechanisms and importance of these alterations have been discussed.