Localisation of alpha, mu and pi class glutathione S-transferases in kidney: comparison with CuZn superoxide dismutase

We describe studies in whole kidney, cortical and medullary homogenates and, glomerular cells in culture to determine the relative levels of expression of alpha (Ya, Yc, Yk), mu (Yb1/Yb2), pi (Yf) glutathione S-transferases (GST) and CuZn superoxide dismutase (CuZn SOD) in different regions of the nephron. Immunoblotting and immunohistochemistry were used to demonstrate relatively weak expression of alpha, mu GST and, CuZn SOD in the glomerulus compared to that in particularly distal tubules. Whilst expression of Ya was found within glomerular cells, Yc, Yk and Yf were not detected. Immunofluorescence showed that Ya and Yb1/Yb2 but not Yf were expressed in cultured epithelial and mesangial cells studied between passages 1 and 3. While Ya was distributed in cytosol, Yb1/Yb2 was primarily located in nuclei.

Imprinting in Albright's hereditary osteodystrophy

Review of published reports of Albright's hereditary osteodystrophy (AHO) involving two or more generations shows a marked excess of maternal transmission. Full expression of the gene (AHO + hormone resistance, pseudohypoparathyroidism) occurs in maternally transmitted cases and partial expression (AHO alone) when the gene is inherited from the father, suggesting the involvement of genomic imprinting in the expression of this disorder.

Long fibre growth by axons of embryonic mouse hippocampal neurons microtransplanted into the adult rat fimbria

We have described a method for the microtransplantation of a suspension of a few thousand cells from mid to late embryonic mouse hippocampi into the fimbria of immunosuppressed adult rat hosts. There was close graft-to-host contact, across a non-scarred interface. The transplanted cells included CA3 type pyramids, and were enclosed within the host myelinated fibre tract, whose glial framework was largely undisturbed. Immunohistochemistry of two species-specific markers (M6 and Thy-1.2) showed that the donor mouse neurons grew fine (< 0.5 micron diameter) axons which extended singly or in fascicles through the rat host fimbria for a maximum distance of at least 10 mm. The donor axons were intimately integrated among and closely aligned to the host tract axons and to the interfascicular glial rows of the host tract. The axons travelled (i) laterally through the ipsilateral fimbria, (ii) medially across the midline in the ventral hippocampal commissure to reach the contralateral fimbria and alveus, and (iii) rostro-medially to the septum. On approaching the terminal fields appropriate to hippocampal CA3 pyramidal cell axons, the transplant axons gave rise to fine preterminal branches which were continuous with a reticular or amorphous immunoreactivity in the stratum oriens and stratum pyramidale of the ipsilateral hippocampus, and in the lateral and triangular septal nuclei. The donor axons extended along the host fimbria at a rate of approximately 1 mm per day, reaching their terminal field destinations by approximately 1-2 weeks. At 7 weeks the projections were maintained, but with little further extension. These observations indicate that the microenvironment of myelinated adult fibre tracts is permissive for an abundant and rapid growth of axons from transplanted embryonic cell suspensions. These axons can leave host tracts to invade appropriate terminal fields.

Should we still stitch the subcutaneous fat layer? A clinical and ultrasound assessment in 50 hip operations

Wound haematoma is an undesirable complication of surgery. We report a prospective trial to establish whether a subcutaneous fat stitch affects haematoma formation in hip surgery. A series of 50 patients undergoing hip surgery were randomised to have either a fat stitch or no fat stitch during wound closure. The wounds were assessed clinically with a minimum follow-up of 5 weeks. Subcutaneous haematomas were seen more easily with the patient standing. As clinical assessment for haematoma formation may be unreliable, each patient also had an ultrasound scan. Although the incidence of subcutaneous haematoma was slightly higher in the no fat stitch group (36% compared with 24% in the fat stitch group) this difference was not statistically significant (chi 2 test, P < 0.5). There were no significant differences in the incidence of wound infection and healing rate. From our study we also showed that ultrasound examination was twice as sensitive as clinical examination in diagnosing subcutaneous haematomas and that subcutaneous haematomas are common after hip surgery.

Oxidant stress and glomerular prostanoid production: influence of angiotensin converting enzyme inhibition

1. The effect of H2O2 (4.7 x 10(-9) -4.7 x 10(-3) M) on prostanoid production by isolated glomeruli from normotensive (WKY) and, spontaneously hypertensive rats (SHR) has been studied. 2. Oxidant stress significantly increased synthesis of prostaglandin E2 (PGE2), I2 (PGI2) and thromboxane A2 (TxA2) by glomeruli from both strains whereas the ratio (PGE2 + PGI2)/TxA2 increased in only SHR. 3. Pre-incubation of glomeruli with the angiotensin converting enzyme inhibitors captopril or lisinopril, had virtually no effect on H2O2-induced synthesis of individual prostanoids nor on the ratio (PGE2 + PGI2)/TxA2 by glomeruli from either WKY or SHR. 4. The findings suggest that H2O2-induced changes in glomerular function may be mediated, in part, by PGs but fail to support the suggestion that the ability of ACEI to protect glomeruli from H2O2-induced damage is determined by PGs.

Clinical evaluation of the peritoneal equilibration test: a population-based study

A total of 143 Peritoneal Equilibration Tests (PETs) were performed in 104 CAPD patients over a period of 18 months. A normal range (95% confidence limits) was constructed from 100 tests (68 consecutive new patients, 32 routine tests on problem-free patients) using a 2-dimensional plot of solute transfer (D/Pcreat) and ultrafiltration volume. These two parameters correlated inversely (r = -0.59, P < 0.0001) allowing calculation of a regression line. In the short term (< 3 months) D/Pcreat was stable across a wide range of values (0.45-0.98) with good correlation between tests indicating reproducibility (r = 0.94, P < 0.001). Repeated tests beyond 3 months were variable, explaining changes in the clinical picture, and in the majority of cases shifts in D/Pcreat and ultrafiltration parallelled the regression line for the whole population. Six of seven (85%) of patients with mechanical problems and 14 of 15 (93%) with poor ultrafiltration had at least one abnormal test, and these two problems could be distinguished in 90% of cases by 2-dimensional plotting. In five with ultrafiltration failure, dialysate volumes were less than predicted by solute clearance, and these patients failed continuous cycling peritoneal dialysis (CCPD). In contrast, a good response to CCPD was predicted correctly in five patients with high solute clearance. In nine patients with plasma creatinine > 1250 mumol/l the PET was normal. The PET is a useful adjunct to understanding and prescribing peritoneal dialysis, particularly when repeated tests are compared to a well-defined normal population.

Familial acrodysostosis: can it be distinguished from Albright's hereditary osteodystrophy?

A girl, who presented initially to the orthodontist because of anterior and posterior open-bite, was noted to have short stature and facial dysmorphism suggesting the diagnosis of acrodysostosis. Her father had similar features, though less marked. Photographs of the paternal grandfather showed short stature and a similar facies. This family presents a further example of autosomal dominant inheritance of acrodysostosis and highlights the difficulty in distinguishing between acrodysostosis and pseudohypoparathyroidism.

Bilateral split hand and split foot malformation in a boy with a de novo interstitial deletion of 7q21.3

A case of bilateral split hand and split foot malformation is reported in a boy with a complex rearrangement of chromosome 7 including a de novo interstitial deletion of 7q21.3.

Zinc alpha-2 glycoprotein levels in serum and breast fluids: a potential marker of apocrine activity

Zinc alpha-2 glycoprotein (ZnGP) was measured in human breast microcysts, breast secretions, breast cyst fluid and serum. Detectable amounts of ZnGP were found in all fluids but the highest levels were found in microcysts. Apocrine macrocysts had a higher ZnGP level than flattened macrocysts. In both cysts and secretions levels of ZnGP correlated with those of dehydroepiandrosterone sulphate. Levels were significantly higher in cyst fluids from women who developed further cysts during follow-up compared with those in fluid from women who did not. Concentrations of ZnGP in serum from breast cancer patients were significantly higher than controls but not women with breast cysts. Women with node positive breast cancer had higher serum levels compared with those in node negative patients. Women with more advanced breast cancer had higher serum ZnGP levels than those with earlier disease. ZnGP is a serum and breast marker of apocrine activity and may prove to be a useful prognostic marker in breast cancer.

The use of light-cured resin and orthodontic archwire to immobilise a transplanted maxillary canine

A technique is presented which uses light-activated bonding materials and orthodontic archwire to immobilise a surgically transplanted impacted maxillary canine. The technique is quick and effective. It uses materials commonly available in the dental surgery and does not require technical laboratory support. The treatment result of the presented case is encouraging.

Activation of immunocompetent cells in the peritoneum of patients treated with CAPD

Chemiluminescence and flow cytometry, employing a number of monoclonal antibodies, was used to investigate activation of immunocompetent cells in the blood and peritoneum of patients treated with CAPD. Increased expression of HLA-DR and RFD7, both markers of macrophage maturation, was observed on peritoneal macrophages, 78% and 33.5% cells positive, when compared to blood monocytes, which were 46% and 5.3%, respectively (P less than 0.001). Macrophage chemiluminescent response to opsonized zymosan was greater than that of circulating blood monocytes in CAPD patients, whereas the inverse was true for normal controls. Enhanced expression of IL-2 receptor and surface IgG by peritoneal macrophages were 24.9% and 65.3% cells positive compared with monocytes, 5.7% and 12.3% (P less than 0.01), and also suggests their activation. There was a marked increase in the HLA-DR expression by peritoneal lymphocytes from CAPD patients (32% cells positive) compared with those from CAPD blood (13.8%), normal blood (11.3%) and normal peritoneal fluid (14.5%), P less than 0.001. This was partially accounted for by increased numbers of B cells (18%) and activated T cells bearing HLA-DR. TFR and IL-2 receptor expression by CAPD peritoneal lymphocytes was similar to that of blood lymphocytes, implying the lack of an organized immune response within the peritoneum. Taken together, these results suggest that peritoneal macrophages from CAPD treated patients have features of maturation and activation, while changes in the lymphocyte populations are compatable with the actions of IL-1, indicating activity of the cellular immune system within the peritoneum.

Demonstration of somatic mutation and colonic crypt clonality by X-linked enzyme histochemistry

Cellular mosaicism resulting from X-chromosome inactivation in heterozygous females can be shown histochemically; using this approach we have demonstrated age-related gene reactivation and tumour clonality. We now show in female mice heterozygous for reduced expression of glucose-6-phosphate dehydrogenase (G6PD) activity that colonic epithelial cells express either normal or low enzyme activity, and form patches composed of multiple crypts of uniform phenotype. We also show that a low-enzyme colonic epithelial cell phenotype can be induced in normal mice by carcinogen treatment, these cells again occur in patches, but are restricted to scattered single crypts, the frequency of which is related to treatment. A small proportion of colonic tumours in carcinogen treated normal mice are also of low-enzyme phenotype. We conclude that we have visualized the effects of a sporadic carcinogen induced somatic mutation in the G6PD gene of crypt stem cells and that a single stem cell maintains each colonic crypt. This inducible defective activity of a ubiquitous 'housekeeping' enzyme provides a somatic clonal marker system of wide potential application.

Epithelial distribution in the human fetal larynx

Scanning and transmission electron microscopy and light microscopy were used to study the distribution of squamous epithelium and ciliated respiratory type epithelium in ten midtrimester human fetal larynges. Particular attention was paid to the subglottic region, where previous studies have reported areas of squamous metaplasia in neonates, infants, and nonsmoking adults. Both types of epithelium were found in different proportions in the supraglottic, glottic, and subglottic regions. There was considerable downward extension of squamous epithelium from the glottis into the subglottic region, with a wide transition zone where both types of epithelium were found in close association. These observations would suggest that such areas of squamous epithelium in the nonglottic larynx are normal, rather than always indicating a response to extrinsic trauma or irritation. Therefore, the term squamous metaplasia may be inappropriate when applied to such areas in the adult larynx.

Tibia vara due to focal fibrocartilaginous dysplasia. The natural history

We report five patients with tibia vara due to focal fibrocartilaginous dysplasia of the medial aspect of the proximal tibia. In three patients spontaneous correction occurred, while in one of the remaining two treated by operation, a valgus deformity and neurological complications resulted. Conservative management is therefore recommended.

Analysis of structural changes in the stria vascularis following chronic gentamicin treatment

Changes in the stria vascularis following chronic gentamicin treatment have been examined using quantitative methods. Albino guinea pigs were given gentamicin at 100 mg.kg-1.day-1 subcutaneously for 10 days. Comparisons were made of strial tissue from the treated animals sacrificed either 1 h or 4 weeks following the last injection with that from saline-injected controls. Strial width (spiral prominence to Reissner's membrane) and marginal cell (MC) number across the stria were determined from scanning electron micrographs. Strial thickness (endolymphatic surface to spiral ligament) and the volume fractions of the strial components (MCs, intermediate cells (ICs), basal cells (BCs) and capillaries) were derived from thin sections. Qualitative changes to both MCs and ICs were apparent 1 h after the last injection. At four weeks post-treatment, there was a small, but statistically significant, decrease in the number of marginal cells and a highly significant decrease in strial thickness. This was almost entirely due to a highly significant decrease in the volume fraction of MCs (i.e. shrinkage). The volume fraction of ICs was increased but this could be accounted for by MC shrinkage; after allowing for the reduction in strial thickness, the volume occupied by ICs was unchanged. Thus, following chronic gentamicin treatment, the stria is affected but significant progressive and permanent structural effects are confined to the marginal cells.