Homozygous c.14576G>A variant of RNF213 predicts early-onset and severe form of moyamoya disease

OBJECTIVE

RNF213 was recently reported as a susceptibility gene for moyamoya disease (MMD). Our aim was to clarify the correlation between the RNF213 genotype and MMD phenotype.

METHODS

The entire coding region of the RNF213 gene was sequenced in 204 patients with MMD, and corresponding variants were checked in 62 pairs of parents, 13 mothers and 4 fathers of the patients, and 283 normal controls. Clinical information was collected. Genotype-phenotype correlations were statistically analyzed.

RESULTS

The c.14576G>A variant was identified in 95.1% of patients with familial MMD, 79.2% of patients with sporadic MMD, and 1.8% of controls, thus confirming its association with MMD, with an odds ratio of 259 and p < 0.001 for either heterozygotes or homozygotes. Homozygous c.14576G>A was observed in 15 patients but not in the controls and unaffected parents. The incidence rate for homozygotes was calculated to be >78%. Homozygotes had a significantly earlier age at onset compared with heterozygotes or wild types (median age at onset 3, 7, and 8 years, respectively). Of homozygotes, 60% were diagnosed with MMD before age 4, and all had infarctions as the first symptom. Infarctions at initial presentation and involvement of posterior cerebral arteries, both known as poor prognostic factors for MMD, were of significantly higher frequency in homozygotes than in heterozygotes and wild types. Variants other than c.14576G>A were not associated with clinical phenotypes.

CONCLUSIONS

The homozygous c.14576G>A variant in RNF213 could be a good DNA biomarker for predicting the severe type of MMD, for which early medical/surgical intervention is recommended, and may provide a better monitoring and prevention strategy.

PiSite: a database of protein interaction sites using multiple binding states in the PDB

The vast accumulation of protein structural data has now facilitated the observation of many different complexes in the PDB for the same protein. Therefore, a single protein complex is not sufficient to identify their interaction sites, especially for proteins with multiple binding states or different partners, such as hub proteins. PiSite is a database that provides protein–protein interaction sites at the residue level with consideration of multiple complexes at the same time, by mapping the binding sites of all complexes containing the same protein in the PDB. PiSite provides easy web interfaces with an interactive viewer working with typical web browsers, and the different binding modes can be checked visually. All of the information can also be downloaded for further analyses. In addition, PiSite provides a list of proteins with multiple binding partners and multiple binding states, as well as up-to-date statistics of protein–protein interfaces. PiSite is available at http://pisite.hgc.jp

Identification of transient hub proteins and the possible structural basis for their multiple interactions

Proteins that can interact with multiple partners play central roles in the network of protein-protein interactions. They are called hub proteins, and recently it was suggested that an abundance of intrinsically disordered regions on their surfaces facilitates their binding to multiple partners. However, in those studies, the hub proteins were identified as proteins with multiple partners, regardless of whether the interactions were transient or permanent. As a result, a certain number of hub proteins are subunits of stable multi-subunit proteins, such as supramolecules. It is well known that stable complexes and transient complexes have different structural features, and thus the statistics based on the current definition of hub proteins will hide the true nature of hub proteins. Therefore, in this paper, we first describe a new approach to identify proteins with multiple partners dynamically, using the Protein Data Bank, and then we performed statistical analyses of the structural features of these proteins. We refer to the proteins as transient hub proteins or sociable proteins, to clarify the difference with hub proteins. As a result, we found that the main difference between sociable and nonsociable proteins is not the abundance of disordered regions, in contrast to the previous studies, but rather the structural flexibility of the entire protein. We also found greater predominance of charged and polar residues in sociable proteins than previously reported.

Identification and characterization of an intermediate in the alkali degradation of (6-4) photoproduct-containing DNA

The (6-4) photoproduct formed by ultraviolet light is known as an alkali-labile DNA lesion. Strand breaks occur at (6-4) photoproducts when UV-irradiated DNA is treated with hot alkali. We have analyzed the degradation reaction of this photoproduct under alkaline conditions using synthetic oligonucleotides. A tetramer, d(GT(6-4)TC), was prepared, and its degradation in 50 mm KOH at 60 degrees C was monitored by high performance liquid chromatography. A single peak with a UV absorption spectrum similar to that of the starting material was detected after the reaction, and this compound was regarded as an intermediate before the strand break. The formation of this intermediate was compared with intermediates from the degradation of other alkali-labile lesions such as the abasic site, thymine glycol, and 5,6-dihydrothymine. The results strongly suggested that the first step of the alkali degradation of the (6-4) photoproduct was the hydrolysis between the N3 and C4 positions of the 5'-pyrimidine component. Analyses by NMR spectroscopy and mass spectrometry supported the chemical structure of this product. Assays of the complex formation with XPC.HR23B and the translesion synthesis by DNA polymerase eta revealed that the biochemical properties are indistinguishable between the intact and hydrolyzed photoproducts.

Towards artificial repair of UV-damaged DNA: studies on drug binding and alkali hydrolysis

Properties of the DNA containing the (6-4) photoproduct, one of the major UV-induced lesions, were analyzed. Two basic studies towards artificial recognition and repair of this type of damaged DNA are presented here. One is recognition of the UV-damaged DNA by a minor groove-binding drug. It was found by CD spectroscopy that distamycin could bind DNA duplexes containing the (6-4) photoproduct as effectively as the unmodified DNA, whereas a DNA duplex containing the cyclobutane pyrimidine dimer was not recognized by this drug. The other is a mechanistic study on alkali degradation of this photoproduct. HPLC and NMR analyses revealed that hydrolysis between the N3 and C4 positions of the 5' pyrimidine component occurred first. This intermediate was relatively stable, and further degradation to the strand break required severe conditions like the hot piperidine treatment.

[A study of the relation between providing healthcare information and behavior changes of people in Japan. Parental behavior changes after receiving information about the sudden infant death syndrome]

OBJECTIVE

Considering the lack of evidence concerning the relationship between providing healthcare information and behavior of people in Japan, we utilized a questionnaire to survey the parents of infants to evaluate behavior change after receiving information about the Sudden Infant Death Syndrome (SIDS).

METHODS

A questionnaire about SIDS information was administered in 234 municipalities in Niigata, Gifu, Shizuoka, and Hiroshima Prefectures and in Yokohama City in November and December of 1999 to 14,879 parents who visited for the 18-month health examination of their children. The questionnaire did not ask for the participants' names. Logistic regression analysis was used to study the connection between behavior change and SIDS information sources.

RESULTS

10,900 parents returned the questionnaire to give a 73.3% response rate, 19.0% of these receiving information about SIDS risk factors from hospitals or clinics, 3.7% from public health centers, and 9.2% from their friends. More received information from the mass media such as TV programs, which provided the main source for 71.1% of the parents. The degree of behavior change was evaluated after adjustment for variables concerning a variety of information sources and other appropriate factors such as the age and sex of parents and the number of their children. We found that receiving information from hospitals or clinics significantly influences behavior changes for all kinds of risk factors. Information from public health centers, baby-care groups, and friends influenced behavior changes relevant to the risk factors for feeding methods, sleeping position, and parents' smoking. There was no relation between receiving information from the mass media and behavior change of parents.

CONCLUSIONS

The mass media provide far more information than do medical facilities, public health centers, baby-care groups and personal contacts but the latter played much more effective roles in making parents change their baby care behavior. These results point to an obvious discrepancy between efficiency in providing information and the degree of behavior change elicited. We should thus take the source of information and the target population into consideration when we examine the best way to provide healthcare information for people in the future.

[Utilization of Maternal and Child Health handbook in Japan]

OBJECTIVES

In Japan, Maternal and Child Health (MCH) handbook have been widely used for more than fifty years. However, there has been no evaluation research from the users' point of view. We therefore conducted a questionnaire survey of guardians to evaluate how they utilize MCH handbooks.

METHODS

A well-structured questionnaire survey was carried out in 231 municipalities, towns and villages of four prefectures (Gifu, Hiroshima, Niigata and Shizuoka) and one city (Yokohama) in November and December 1999. The targets were 13,271 guardians who visited health stations for 18-month examinations of their children and agreed to participated in our research. The questionnaire covered situation of usage and loss by guardians, utility from the users' perspective, and suggestions for improvement.

RESULTS

We obtained answers from 10,900 guardians. As for reading rate and writing rate, 98.3% of respondents had read and 97.8% of them had written down something in relation. Only 0.9% of respondents had lost this MCH handbook. Generally, 87.0% of respondents answered that MCH handbook was helpful for child bearing and 81.6% of them said the record for immunization was useful. However, 34.1% of respondents answered it was not simple to utilize MCH handbook and 60.6% of them requested more detail on child bearing. As for dental health, the completion rate for information was low and only 21.3% of respondents reported for the dental record was useful.

CONCLUSIONS

The research shows MCH handbook are highly utilized in Japan by almost all guardians. However, there are still problems to be solved; many guardians feel that they are not simple to use and the section on dental health is not highly particularly helpful. Improvements should be made in future in light of the viewpoints of guardians and parents.

Emerging and entraining patterns of the sleep-wake rhythm in preterm and term infants

It has been repeatedly reported that the sleep-wake rhythm in infants entrains around 3-4 months of age after a transient free-run rhythm. To clarify the emerging and entraining patterns of the sleep-wake rhythm, the sleep and wakefulness of 84 infants (44 preterm and 40 term infants) were longitudinally recorded at home for more than 16 weeks by the day-by-day plot method. Our results showed that the entrained sleep-wake rhythm emerged after transient manifestation of either ultradian or irregular sleep-wake patterns for 3-4 weeks in 75% of the infants. Only 7% of the infants showed a free-running sleep-wake rhythm before the entrainment. These facts suggest that most infants would be entrained to an ordinary daily schedule of mothers without expression of overt free-running rhythm of the biological clock. The mean age of the entrainment was 44.8 postconceptional weeks. There were no significant differences in either frequency of each pattern or the mean age of the entrainment, between preterm and term infants. In conclusion, the entrained sleep-wake rhythm emerges around 1 corrected month, after ultradian patterns in the majority of infants.

[Effects on health status in students from attending a "juku"]

Between November and December 1993 a questionnaire survey concerning the lifestyle and health status was performed on 1.314 elementary school children living in Tokyo and its suburbs. In this study the following items were included: 1) sleeping habits, 2) physical activity, 3) playing habits, 4) eating habits, 5) attending a "juku", private cram school to prepare children for entrance examinations, 6) commuting hours, 7) 20 subjective symptoms regarding health, and so on. The results were as follows: 1. 61.9% of students were attending a "juku". 2. The number of hours of sleep, playing after school and watching TV decreased with the frequency of attending a "juku". The students who were attending "juku" more than 3 times a week had the shortest number of those hours, and the students who did not attend any "juku" had the longest of those hours. 3. To determine health status, 20 subjective symptoms were scored. The average number of subjective symptoms was 5.0. That of the students who were attending "juku" more than 3 times a week was 5.5. 4. Of the 20 subjective symptoms, 7 items were correlated to the frequency of attending "juku". To remove the effect of other factors, multiple logistic regression analysis was applied to determine correlation of 7 subjective items and other factors including attending "juku". As a result attending "juku" more than three times a week were associated with the two symptoms of "sleepy" and "eye fatigue".

[Current status of the use of Welfare Centers Japan by foreign children and pregnant women living in Japan]

This survey was conducted to determine how Welfare Centers throughout Japan were addressing the health care and welfare issues of foreign children and pregnant women living in Japan, and to analyze statistics (1988-1992) on the number of consultations by foreigners living in Japan. Questionnaires were mailed to 1220 Welfare Centers throughout Japan in mid August 1993, and responses from 562 centers were received. The survey conducted among these centers revealed the following information: 1) About half of the Welfare Centers responding had had consultations with foreign children and pregnant women, and about 60% of them had encountered difficulties, including language problems. 2) Comparison of rural and urban areas revealed that a higher percentage of Welfare Centers in the urban areas had had foreigners as clients. Welfare Centers were more likely to be accessed by foreigners when there was a large foreign population in the area under their domain. About 90% of the Welfare Centers in large cities had been consulted by foreigners. 3) Only about 30% of the Welfare Centers responding had employees who were competent in foreign languages, and guidebooks in foreign languages were available at less than 10% of the Welfare Centers. In most of the Welfare Centers that had staff competent in a foreign language, the language of competency was English. About 30% of the Welfare Centers responded that they could obtain the service of interpreters when they were consulted by foreigners who spoke languages which they could not understand. 4) The responding Welfare Centers were found to have had consultations by foreign children and pregnant women from all over the world. Consultations by South American and Asian nationals were found to be increasing rapidly. With respect to visa status, an increase was noted in the number of people who had married Japanese spouses. As to the age of children, the majority of those seen at Welfare Centers were infants. 5) There was an increased number of cases related to application of the Child Welfare Law, and the Maternal and Child Health Law.

Sister chromatid exchanges in the peripheral lymphocytes of newborns with Down syndrome after in vitro exposure to blue or green light

This study determines whether irradiation by blue or green light has an adverse effect on the DNA of Down syndrome (DS) cells by examining the sister chromatid exchange (SCE) frequency of peripheral lymphocytes obtained from five neonates with DS and five karyotypically normal neonates (control). Lymphocytes in G0 of the cell cycle were irradiated with blue or green fluorescent light for 1, 2, 4 or 6 h, and then cultured using a conventional method. Our results revealed that the induction of SCEs per cell in both groups increased in a dose-dependent manner, although more SCEs were respectively induced by the blue light. In addition, after 6 h of blue light irradiation, the net-induced SCEs in the DS groups were higher than those in the control groups.

[Health and welfare of foreign children and pregnant women overstaying their visas in Japan]

In recent years, the problems of foreign nationals who are working in Japan without proper visa status, or who are illegally staying in Japan (overstaying) have been actively discussed by the mass media as constituting a major social problem. The rapid increase in number of "stateless" children suggests that the issue of foreign mothers and children, in particular, can no longer be neglected. Obtaining accurate knowledge of the current state of this problem is, however, difficult as almost no nationwide surveys have been conducted. Our study was conducted among welfare centers throughout Japan for the purpose of determining the current state of overstaying foreign children and pregnant women, and to reveal problems in the health and welfare of these mothers and children. At the same time, future directions were examined. A questionnaire was mailed to welfare centers throughout Japan in August 1993, and 562 responses were received with the following information: 1) About 10% of the welfare centers investigated have been consulted by overstaying foreign children and pregnant women. 2) About 70% of the welfare centers consulted by overstaying foreigners have helped them as far as possible. 3) About 20% of the welfare centers have asked for the cooperation of individual volunteers and nongovernmental organizations to provide solutions in such cases. 4) Of the consultations related to children, infants of less than three years of age accounted for about 90%. 5) Common problems related to pregnant women were the cost of childbirth and guarantee of visa status. 6) Some of the problems in these cases were solved by application of the Livelihood Protection Law, the Child Welfare Law, and the Child and Maternal Health Law. 7) Individual cases were reported by welfare centers throughout Japan, and revealed the existence of various health and welfare problems. Mechanisms for welfare centers to handle these cases and provide assistance poses a significant challenge for the future.

The protein tyrosine kinase Fyn activates transcription from the HIV promoter via activation of NF kappa B-like DNA-binding proteins

Protein tyrosine kinase p59fyn (Fyn) associates with the TCR-CD3 complex, which suggests that Fyn plays a significant role in the signal transduction involving TCR complex. In addition to cellular genes, viral promoters such as the HIV long terminal repeat (LTR) are also activated upon T cell activation. To elucidate the functional significance of Fyn in the expression of viral promoters, we transfected a Fyn-expression vector together with a reporter plasmid containing the chloramphenicol acetyltransferase gene driven by HIV LTR into a human T cell line, Jurkat. In this assay, Fyn stimulated the promoter in HIV LTR when the transfected cells were treated with both concanavalin A and PMA as an antigen-mimic stimulation. This activation required the intact SH2 domain of Fyn. Mutational analysis of HIV LTR showed that the NF kappa B binding sites were responsible for this effect. Electrophoretic mobility shift assays and UV cross-linking experiments showed that activation of T cells by anti-CD3 antibody induced four kappa B-binding proteins (50, 60, 65 and 100 kDa) in Fyn-overexpressing cells more efficiently than in the parental cells. Our results suggested that Fyn was able to regulate expression of a subset of genes via kappa B-binding proteins upon T cell activation.

Chromosomal translocations in two feline T-cell lymphomas

Two feline malignant lymphoma cell lines, FT-1 and FT-G, established from cats naturally infected with the feline leukemia virus were analyzed for chromosomal aberrations. Both FT-1 and FT-G cells had a modal number of 38 which is the normal diploid (2n) chromosome number of the domestic cat. G-banding-analysis showed that FT-1 had a translocation involving the short arms of chromosome A2 and D3--t (A2;D3) (p-;p+), and FT-G had a translocation involving the short arms of chromosomes A2 and B2--t (A2;B2) (p-;p+). Our data suggest that the chromosomal translocations were closely associated with the tumorigenesis in malignant lymphoma in cats.

Determination of salivary cortisol by ELISA and its application to the assessment of the circadian rhythm in children

In 35 young children, circadian rhythms of salivary cortisol levels were determined by ELISA using a commercially available kit with a minor modification. The concentration of labeled cortisol in the serum kit was reduced in order to measure cortisol in 10 microliters of saliva. Intra- and interassay coefficients of variation for salivary cortisol ranged from 2.4 to 9.9 and 3.2 to 8.9%, respectively. Recovery of salivary cortisol was 82.9-107.0%. There was a highly significant correlation between cortisol levels in saliva and serum in adults (r = 0.857). Salivary cortisol levels ranged from 0.01 to 2.252 micrograms/100 ml and showed significant diurnal variation in the children. Our ELISA is a precise, simple, noninvasive and useful method for clinical practice and study in infants and children.

Elevated chromosome aberration frequency after X-ray exposure of cultured fibroblasts derived from patients with porokeratosis

Porokeratosis (PK) is a rare genetic skin disorder inherited as an autosomal dominant trait and regarded as a disease predisposing to cancer. To evaluate chromosomal radiosensitivity of PK cells, we examined chromosome aberration frequency after X-irradiation of cultured skin fibroblasts derived from PK patients and controls. Without X-ray exposure, frequencies of chromosome-type aberrations (exchanges or deletions) were not different between the patients and controls. Following X-ray irradiation, frequencies of deletions in the patient group were significantly increased, whereas those of exchanges were not elevated. No differences in chromatid-type aberration frequency were found between the patients and controls with or without exposure to X-ray. The observed radiosensitivity, though not as high as in ataxia telangiectasia (AT) cells, agrees well with the previously reported higher radiosensitivity of PK fibroblasts in survival analysis.

Metabolic turnover of bone and peripheral monocyte release of cytokines during short-term bed rest

Immobilization induces abnormal bone metabolism and rapid decalcification. Measurements of bone mineral content disclosed rapid decalcification, especially in lumbar vertebral and metacarpal bones in our short-term 20-day bed rest study. Many factors could contribute to the marked demineralization. The activities of osteoclasts and osteoblasts were studied by following serum levels of tartrate-resistant acid phosphatase and alkaline phosphatase, biomarkers for osteocyte activity. There were no alterations in these enzymes during bed rest. However, urinary excretion of pyridinium cross-links, resorption markers of bone matrix itself, increased by day 10 with subsequent decrease at day 20. So decalcification was induced without any relation to osteoclast activity. As cytokines strongly modulate the function of osteoclasts, peripheral monocyte release of interleukin 1 alpha and tumor necrosis factor alpha were assayed to determine the contribution to this rapid demineralization. Cytokines were released transiently by day 7 and later rapidly decreased. However, there was no correlation between cytokine release and bone matrix resorption.

Ethics and fetal medicine

Ethical issues in the clinical practice of fetal medicine are discussed, largely from the point of view of early prenatal medicine. The discussion concentrates on several aspects including the time when human life begins, the pros and cons of fetal medicine, and ethical guidelines for fetal medicine. The emphasis is placed on the importance of informed consent and an increase in genetical knowledge amongst the general public.

The development of sleep-wakefulness rhythm in normal infants and young children

The development of circadian sleep-wakefulness rhythm was investigated by a longitudinal study of two normal newborns for two and a half years and by a transversal study of 182 normal infants and young children living in three different areas of Japan. The circadian rhythm became established before 4 months of age, and daytime sleep became concentrated within two time periods from 7 months of age, and then within a single peak from 14 months of age. The time period 00:00-04:00 developed into the "absolute sleep period" from 3 months of age, and the "absolute wakefulness period" appeared first in the time period 08:00-11:00 from 14 months of age, and then in the time period 16:00-21:00 from one and a half years of age. Establishment of circadian rhythm as indicated by the numbers of sleep epochs in daytime and in nighttime, and the longest continuous sleep or wakefulness periods reflect the development of the nervous system and were influenced by the change of light-dark in the environment. These parameters showed critical ages, but not sexual or regional differences. However, regional differences were found in the times of waking up in morning and falling asleep at night. This indicated the phase of the circadian rhythm was also influenced by natural and social environmental factors.

[Attitudes toward handicapped children--a study comparing parents of handicapped children and others, in the case of Down syndrome]

The physically handicapped have received increasing attention in recent years. Since 1981, the International Year of Handicapped Persons, a number of administrative measures have been passed and the rights of handicapped have been recognized. However some problems still remain. In this study, conducted in 1990, the knowledge people have about congenital defects and their thinking regarding the social system for the handicapped were examined. A similar survey of parents of children with congenital defects was conducted to understand problems they encountered in the medical care and education of their child. Eighty-four parents of Down Syndrome children (DS) and 118 controls including housewives, female office workers, and students were surveyed. Results showed that 44% of mothers of DS wanted their husbands to participate more intensively in the medical care and education of their child. A slight gap in knowledge between the parents and the controls was seen. Of the controls, 12% asserted that the relationship of the handicapped and the non-handicapped should be equal. However, some of controls expressed that if they had a child with congenital defects, they had no confidence that they could bring up the child in this society.

Development of the sleep and wakefulness rhythm in preterm infants discharged from a neonatal care unit

The purpose of this study was to investigate the effect of constant light in a neonatal care unit on the development of the sleep-and-wakefulness rhythm in preterm infants. Two groups of infants (57 preterm infants without other complications and 58 healthy term infants) were prospectively studied over infancy by a day-by-day plot method, by which sleep-and-wakefulness states were recorded at home for more than 14 d to compare developmental courses of the sleep-and-wakefulness rhythm between the two groups at corrected and postnatal ages. In the two groups, there were no significant differences in distribution of emergence of periodicity of sleep states and wakeful states, total sleep time, nocturnal sleep time, diurnal sleep time, longest sustained sleep period, and longest sustained wakeful period at the same corrected ages. Moreover, the SD of the time of onset of the longest sustained sleep period of each subject diminished with increase in postconceptional weeks. The results suggest that the development of the sleep-and-wakefulness rhythm in preterm infants is not necessarily retarded if they are discharged from the neonatal care unit under constant light before an infant's innate biologic clock is mature enough to respond to an environmental cycle; rather it depends on their corrected ages.

A seroimmunological analysis of Down syndrome

Down syndrome (DS) was studied in terms of immunological function and serological aspects. It was found that antibody levels against rubella and pertussis in the sera from 36 institutionalized DS patients were comparable with those of healthy controls while low antibody levels were detected against mumps and measles. Six tumor markers were also assayed in the serum from DS patients and the serum concentration of alpha-1-acid glycoprotein (alpha 1-AGP) and immunosuppressive acidic protein, an analogous glycoprotein of alpha 1-AGP, were significantly higher than those of the control group. Multivariate discriminant function was constructed based on the concentration of tumor markers. The function could discriminate between the two groups at a sensitivity of 92.3%. Flow-cytometrical analysis has revealed that helper T level of DS patients' sera was lower than that of the control group.

Retrocaval ureter with recurrent pyelonephritis

A case of retrocaval ureter with recurrent pyelonephritis is presented with discussion of these clinical entities. An excretory urogram and retrograde ureterogram disclosed pronounced hydronephrosis as well as a dilated proximal part and reversed J-shaped appearance of the right ureter. The compressed retrocaval portion of the ureter was resected and an end-to-end anastomosis was performed anterior to the vena cava. Due to the progressive kidney damage leading to severe hydronephrosis, a rapid radiological diagnosis should be made to replace the retropositioned ureter.

The effect of aging on cell-cycle kinetics and X-ray-induced chromosome aberrations in cultured lymphocytes from patients with Down syndrome

To evaluate the effects of aging on cytogenetic characteristics of lymphocytes from Down syndrome (DS), cell-cycle kinetics after PHA stimulation and chromosome-type aberration frequencies after X-ray exposure were investigated in vitro in the lymphocytes derived from 4 (or 3 for X-ray treatment) age groups of DS patients and age-matched controls. The results clearly showed higher mitotic and proliferation index levels in younger groups compared to older groups at the various culture intervals, whether the lymphocytes were from the DS patients or controls. The age-related changes of the proliferation index were mainly attributed to a delayed response to PHA as age increased. The changes of PHA responses seemed to be particularly marked during adolescence. Nonetheless, no significant differences were observed between the DS patients and age-matched controls for each age group. In all age groups, frequencies of both chromosome-type exchanges and deletions were elevated in the DS patients by about 1.3 times in comparison with the controls. The magnitude of radiosensitivity, however, seemed to decrease slightly in the 40-49-year group. To our knowledge, the present study is the first report in the literature to deal with the effect of aging on the greater radiosensitivity of DS lymphocytes.

The development of sleep and wakefulness cycle in early infancy and its relationship to feeding habit

The purpose of this study was to evaluate the relationship between sleep and wakefulness patterns to feeding habits in early infancy. The population consisted of 33 neurologically normal infants studied during their first 4 months of life. The number of 30-min epochs with sleep (sleep epoch) were counted in each 4-hr period in a day and evaluated over time. The effects of feeding on sleep and wakefulness were examined by analyzing the rates of sleep epoch after feeding in each time period. The rates of sleep epochs in each time period showed specific patterns each week. From 2 weeks of age, sleep epochs appeared most frequently in time periods 0:00-4:00 and 4:00-8:00 (p less than 0.01). These periods also had significantly high rates of sleep epochs after feeding by week 2. From week 6 both the number of sleep epochs and the rate of sleep epochs after feeding in time periods from 8:00 to 20:00 tended to decrease. These results suggest that the development of the circadian oscillation is set as a sleep epoch first during the time period of 0:00 to 8:00. In addition, feeding alone seemed to have no role as a time cue in the first 4 months of life.

The combination of DNA methylation and H1 histone binding inhibits the action of a restriction nuclease on plasmid DNA

To investigate the potentials of DNA methylation and H1 histone in regulating the action of DNA binding proteins, well ordered complexes were formed by slow salt gradient dialysis of mixtures of H1 histone with either methylated or nonmethylated DNA. The sites methylated in the plasmids were CCGG. Methylation of cytosine in this site protects the DNA against HpaII endonuclease but not against MspI. However, when the methylated DNA was complexed to H1, it was protected against MspI. The protection was only effective for a subset of the MspI restriction sites. The protection of DNA afforded by the combination of H1 binding and DNA methylation did not apply to EcoRI, PstI, or BamHI sites and so did not seem to be due to aggregation of the DNA by H1 histone. Gel retardation assays indicated that the affinity of H1 for methylated DNA was not detectably different from its affinity for nonmethylated DNA. Probably methylated DNA when bound to H1 is in a conformation that is resistant to MspI endonuclease. Such conformational changes induced by DNA methylation and H1 binding might affect the action of other DNA binding proteins, perhaps in chromatin as well as in H1.DNA complexes.

Heterogeneity of serum and amniotic fluid prolactin in humans

The molecular heterogeneity of PRL was studied in serum and amniotic fluid using immunoperoxidase electrophoresis. In the amniotic fluid, larger molecular variants (greater than 117 kD), small PRL (20 and 23 kD) and cleaved PRL were present in the nonreduced condition. Newly, three mercaptoethanol (MCE)-resistant forms (76, 64 and 53 kD), and 25- and 23-kD forms appeared after treatment with MCE. Two variants, 64 and 23 kD, did not bind to concanavalin A (Con A), indicating a simple peptide without sugars. Other glycosylated forms, 76, 53 and 25 kD, bound to Con A. In maternal serum, the same components as those in the amniotic fluid were seen, except for a scanty amount of 23 kD and a newly appearing glycosylated variant of 28 kD in the reduced condition. This 23-kD form also appeared with the administration of TRH in women.

Livebirth prevalence and follow-up of malformation syndromes in 27,472 newborns

The results of a survey of the birth prevalence of congenital anomalies among 27,472 consecutive newborn babies at a large maternity hospital in Tokyo are reported. There were 29 cases with trisomy-21; 5 cases with trisomy-13 syndrome; 5 with trisomy-18 syndrome; 2 with cri-du-chat syndrome; and one each with partial monosomy 4p, partial trisomy 5p, partial trisomy 6p, partial trisomy 9p, partial trisomy 9q, partial monosomy 10p, and partial monosomy 13q. Single cases of the following were observed: the Hallermann-Streiff syndrome, the Treacher-Collins syndrome, achondroplasia, arthrogryposis, the Beckwith-Wiedemann syndrome, the asplenia syndrome, the Klippel-Trenaunay-Weber syndrome, the Marfan syndrome, the Carpenter syndrome, the Goldenhar syndrome, and the Pierre Robin syndrome. The results of follow-ups to determine the life-prognosis of each patient with an autosomal aberration are reported.

Mitomycin-C-induced sister-chromatid exchanges and cell-cycle kinetics in lymphocytes from patients with Klinefelter syndrome

The chromosomal sensitivity to mitomycin-C (MMC) and cell-cycle kinetics in cells from patients with Klinefelter syndrome, a sex chromosomal disorder giving a high risk of malignant tumor, were studied by techniques of sister-chromatid exchanges (SCEs). The frequencies of MMC-induced SCEs increased in proportion to the increase in MMC concentration in both patient and normal control cells. At low levels of MMC there were no significant differences in SCE frequencies between the patient and normal control cells, but at MMC concentrations of 3 X 10(-8) M (p less than 0.05) and 1 X 10(-7) M (p less than 0.01), significant increases in the frequency of MMC-induced SCEs were observed in cells from patients compared to cells from normal controls. Although the analysis of cell-cycle kinetics both after various culture times and after treatment with MMC revealed that there were no significant differences between the patient and normal control cells, patients with Klinefelter syndrome showed a tendency to cell-cycle delays after treatment with MMC in comparison with normal controls.

Ullrich-Turner syndrome and anorexia nervosa

We report on a 6-year-old girl with Ullrich-Turner syndrome and anorexia nervosa. The diagnosis was made at 6 years and she became anorectic at 14 years. She had been treated with low doses of estrogen just before the onset of anorexia. In spite of remarkable decrease in food intake, her body weight was in the normal range compared to standard weight. Rohrer indices were also normal, probably due to abnormal habitus in individuals with the syndrome. The pathogenetic relationship between this disorder and the hormone treatment in the onset of anorexia nervosa is discussed.

Synthesis and degradation of H1 histone subtypes in mouse lymphoma L5178Y cells

H1 histone of mouse lymphoma L5178Y was fractionated into five subtypes, I-V, by Bio-Rex 70 column chromatography. The rates of synthesis of subtypes III and V were higher than those of I, II, and IV, as determined by the measurement of [3H]lysine incorporation. The degradation of the subtype was estimated assuming first order kinetics; subtypes III and V had half-lives of 18 h and 25 h, respectively, and the three other subtypes all had half-lives of 63 h. The syntheses of these subtypes during the cell cycle were examined using synchronized cultures. The syntheses of subtypes I, II, and IV started at the beginning of S phase, whereas those of III and V started in mid-S phase. The syntheses of III and V were at least 1.5-2 times more rapid than those of I, II, and IV, and their active synthesis was accompanied by their rapid degradation. The five subtypes of H1 were further characterized in relation to phosphorylation. Each showed characteristic differences in its synthetic pattern or phosphorylation, and we concluded that each H1 subtype has its own specific function at least in the process of replication of chromatin.

Rett syndrome--an early catecholamine and indolamine deficient disorder?

The results of clinical and polysomnographical examinations on 11 Japanese Rett syndrome cases were summarized to substantiate further our previous results regarding the pathophysiology of the disease. It was concluded that the disease starts early in infancy and takes a progressive course. Each characteristic symptom appears in an orderly sequence which is thought to reflect the sequential systemic involvement of certain neuronal systems. Based on the characteristic symptoms and signs, and polysomnographical studies, we speculated that the initial lesion was the locus coeruleus with a hypoactive noradrenergic system combined with other hypoactive monoaminergic systems, including those of serotonin and dopamine, occurring along with the early developmental course. In later stages, hyperfunction possibly due to postsynaptic supersensitivity of the dopamine system causes the characteristic symptoms of the Rett syndrome.

Phosphorylation of H1 subtypes in regenerating rat liver

H1 histone of rat liver consists of four molecular species designated as H1-1, -2, -3, -4. After partial hepatectomy, phosphorylation of H1-3 was induced first, occurring even within 15 h after the operation. By partial hepatectomy, the rate of incorporation of [3H]lysine into H1 histone increased an average of 4-5 times, but that into H1-4 increased 16-20 times. This actively synthesized H1-4 was subsequently degraded rapidly. Thus induction of this active turnover of H1-4 seems to be correlated with liver regeneration. The maximum activity for phosphorylation of H1-3 attained in regenerating liver was five times that in normal liver. By 36 h after the operation, the phosphorylated peak in the chromatographic pattern had moved forward to a position between the peaks of H1-2 and H1-3, named H1-3'. The newly synthesized H1-3 was not transferred appreciably to H1-3' within 30 h after the operation. At 48 h after the operation, H1-3' amounted to 40% of the total H1-3 subtype. The specificity of the phosphorylation reaction was examined in a reaction system consisting of isolated H1 histone and cAMP-dependent kinase. It was concluded that the specificity of the phosphorylation reaction in vivo was due mainly to the difference in structures of different H1 subtypes.

Bleomycin-induced chromosomal aberrations and sister chromatid exchanges in Down lymphocyte cultures

Peripheral blood lymphocytes from three patients with Down syndrome (DS; trisomy 21; aged 5-6 years) and three age-matched control children were studied for the induction of chromosomal aberrations and sister chromatid exchanges (SCEs). Cells in G0 were exposed to bleomycin (20-100 micrograms/ml) for 3 h, and then cultured in medium containing 5-bromodeoxyuridine and phytohemagglutinin for 66 h. By the sister chromatid differential staining method, chromosome analyses were performed on metaphase cells that had divided one, two, or three or more times after treatment. The results indicate that DS cells exposed to bleomycin are hypersensitive to the production of dicentric and ring chromosomes compared to normal cells. Bleomycin also led to a dose-related increase in the frequency of SCEs, but no difference was found between the SCE frequencies in DS or normal lymphocytes exposed to bleomycin.

An anthropometric study of girls with the Ullrich-Turner syndrome

Anthropometric measurements were made on 11 Japanese girls with Ullrich-Turner syndrome (UTS) from 8 months to 14 years. Height, lower limb length, and upper limb length of the UTS patients was less than that of normal control girls. Conversely, chest circumference, transverse chest diameter, and chest depth of UTS girls was well developed and equal to that of the control girls. Measurement results of head (head circumference, head length, and head breadth) and face (bi-zygomatic breadth, internal bi-ocular breadth and morphological face height) of the UTS patients were similar to those of normal girls. Bi-acromial breadth and bi-iliac diameter in the UTS were normal.

Mortality and survival for Down syndrome in Japan

Mortality and survival data for 1,052 Japanese patients with Down syndrome who were born between 1966 and 1975 were analyzed. The survival rate at age 10 was estimated to be about 86%. Mortality in each age group for Down syndrome was elevated over that of the general population. In the survival rate at age 10, there was no significant difference between males and females, but the difference between cases with and without congenital heart disease was highly significant. Using data from this study-for mortality up to age 10-and from the study of institutionalized cases for mortality over age 10, a hypothetical life table was constructed; it shows that the life expectancy at birth for cases with Down syndrome is nearly 50 years.

The birth prevalence of malformation syndromes in Tokyo infants: a survey of 14,430 newborn infants

A survey of the birth prevalence of congenital anomalies among newborn infants in Japan is under way at a large maternity hospital in Tokyo. Of 14,430 consecutive newborn babies (7,455 M; 6,975 F), 33 had a multiple congenital anomalies (MCA) syndrome. These included 2 with trisomy 13 (including a mosaic), 3 with trisomy 18 (including 1 mosaic), 16 with trisomy 21 (including 1 mosaic), 1 with cri-du-chat syndrome, 1 with 5p partial trisomy, 1 with Hallermann-Streiff syndrome, 1 with Treacher-Collins syndrome, 1 with achodroplasia, 2 with arthrogryposis multiplex congenita, 1 with hemihypertrophy, 1 with Wiedemann-Beckwith syndrome, 1 with asplenia syndrome, 1 with Klippel-Trenaunay-Weber syndrome, and 1 with probable Marfan's syndrome. Except for one infant with Ullrich-Turner syndrome, cases with sex-chromosome aberrations could not be diagnosed neonatally on a clinical basis.

Incidence of 47,XYY karyotype in a consecutive series of newborn males in Tokyo

A series of 3545 newborn males, born consecutively at a maternity hospital in the western suburbs of Tokyo and with no detectable physical abnormalities, were studied for fluorescent Y-chromatin. Buccal cell smears from each infant were screened. Cases with ambiguous results were subjected to a second test by blood smears, which were found to be more reliable. After the second test, chromosomal analysis was carried out in five infants: three had a 47,XYY karyotype; one, the karyotype 46,XY-D,t(D:Y) (Iijima et al., in preparation); and one, a normal male karyotype. The XYY karyotype occurred in 0.11% of newborn males in this series.