Sublingual nitroglycerin: improving patient compliance with a demonstration dose

Forty-four patients were studied for compliance in the use of their first prescription for sublingual nitroglycerin. Fourteen HMO physicians participated in this randomized, prospective study by administering the first dose to half the patients during the office visit in which the diagnosis of angina pectoris was made. No other changes were made in the physicians' customary methods of diagnosing and treating angina pectoris. Patients who received the demonstration dose were significantly more likely to have used the sublingual nitroglycerin at least once before their second visit (75 percent of the study group compared with 44 percent of the control group). There was no difference between the groups in having the drug with them at the second visit. While serious reactions to sublingual nitroglycerin are rare, 6 patients experienced symptoms from the first dose, including 1 patient who fainted. The results suggest that compliance in using the initial prescription for sublingual nitroglycerin can be improved when the physician supervises the first dose.

Specific serodiagnosis of visceral leishmaniasis using a Leishmania donovani antigen identified by expression cloning

A lambda gt11 expression library was constructed using mRNA from the promastigote form of Leishmania donovani (African isolate MHOM/ET/67/HU3). The library was screened with serum obtained from a patient who contracted visceral leishmaniasis in the Sudan. Several cDNA clones which expressed beta-galactosidase/L. donovani antigen fusion proteins were isolated. One of these clones corresponded to a 60 kDa membrane-associated antigen. By a Western blot assay antibodies against the fusion protein were detected universally in the sera of visceral leishmaniasis patients. They were not detected in sera from patients with cutaneous leishmaniasis or other parasitic protozoan infections. The gene coding for this antigen was specific to the genus Leishmania as judged by DNA hybridisation, and its chromosomal location was conserved. A 20 kb mRNA was detected on Northern blots of promastigote RNA.

Differences in the regulation of aldehyde dehydrogenase genes in Aspergillus niger and Aspergillus nidulans

In order to study mechanisms of gene regulation in A. niger, and to compare these to similar systems in A. nidulans, a gene encoding an aldehyde dehydrogenase enzyme has been cloned. In wild-type strains of A. niger the gene shows expression which is regulated by induction and repression. Levels of induction by various compounds and the extent of repression under various growth conditions differs from that seen for the A. nidulans aldA gene. Unlike the A. nidulans aldA gene, the A. niger gene has both carbon catabolite repressible and nonrepressible induction mechanisms. Studies of heterologous expression of the A. niger gene in A. nidulans have shown that its expression is regulated by the alcR gene product of A. nidulans.

Identification of the sites of action for regulatory genes controlling the amdS gene of Aspergillus nidulans

The amdS gene of Aspergillus nidulans, which encodes an acetamidase enzyme, is positively regulated by the trans-acting genes amdR, facB, amdA, and areA. Sequence changes in several cis-acting mutations in the 5' region of the gene which specifically affect amdS regulation were determined. The amdI9 mutation, which results in increased facB-dependent acetate induction, is due to a single-base change at base pair -210 relative to the start point of translation. The amdI93 mutation, which abolishes amdR-dependent omega-amino acid induction, is a deletion of base pairs -181 to -151. The amdI66 mutation, which causes increased gene activation in strains carrying amdA regulatory gene mutations, is a duplication of base pairs -107 to -90. Transformation of A. nidulans can generate transformants containing multiple integrated copies of plasmid sequences. When these plasmids carry a potential binding site for a regulatory gene product, growth on substrates whose catabolism requires genes activated by that regulatory gene can be reduced, apparently because of titration of the regulatory gene product. Introduction of 5' amdS sequences via cotransformation into strains of various genotypes was used to localize sequences apparently involved in binding of the products of the amdR, amdA, and facB genes. The position of these sequences is in agreement with the positions of the specific cis-acting mutations. Consistent with these results, a transformant of A. nidulans derived from a plasmid deleted for sequences upstream from -111 was found to have lost amdR- and facB-mediated control but was still regulated by the amdA gene. In addition, amdS expression in this transformant was still dependent on the areA gene.

Health, welfare and fertility implications of the use of bovine somatotropin in dairy cattle

Twenty-two Friesian and Friesian cross Ayrshire cows and 16 first lactation heifers were paired. Twenty were injected subcutaneously with 500 mg recombinant bovine somatotropin (sometribove) and 18 with a placebo at fortnightly intervals, starting 80 (+/- 7) days after calving, through the winter of 1986-87. The cows' weights and changes in condition, milk yields, milk solids, health and fertility were recorded regularly. Compound cake was fed at a fixed stepped rate according to the number of days since the cow calved. Silage was available on an easy-feed basis. Ten cows had their daily silage intake measured. Sometribove treated cows produced on average 27.7 kg of milk per day, 4.5 kg more than the controls. Treated heifers produced 23.5 kg per day, 2.5 kg more than the controls. Milk quality was unchanged. Treated cows gained weight during the trial, but not by as much as the controls. Control heifers also gained weight but the treated heifers lost, on average, 3 kg. Local reactions at the injection site were not felt to be of welfare concern, nor was the general effect of the extra milk production. A small number of treated animals experienced mastitis and had poorer fertility but the differences were mostly not statistically significant. If bovine somatotropin should become licensed for use in Britain it is recommended that clear guidelines should be issued on the management practices necessary for economic success and for the welfare of the treated animals.

Rapid characterization of recombinant λgtII clones expressing parasite antigens

Recombinant DNA techniques allow any parasite gene to be isolated, propagated and analysed in great detail. The techniques are now well known and widely used in research on parasite diagnosis, vaccine development and identification of chemotherapeutic targets. There are difficulties, for example in analysing carbohydrate antigens, and in selecting which genes merit the intensive investigation required. In this article john Kelly and Mark Blaxter discuss two simple procedures that allow recombinant clones to be characterized rapidly on the basis of both the parasite DNA sequences that they carry and the parasite antigens that they produce. They take examples from work on antigens of Leishmania donovani.

Methylene blue photosensitised strand cleavage of DNA: effects of dye binding and oxygen

It is shown that methylene blue (MB+) photosensitises DNA in either aerated or deaerated solutions, causing direct cleavage of phosphodiester bonds and rendering additional bonds labile to alkali. Evidence from unwinding and fluorimetric studies indicates that MB+ binds to DNA in at least 2 ways. Intercalation, which optimally induces helical unwinding of 24 degrees +/- 2 degrees per MB+, is markedly reduced upon neutralisation by Mg2+ of the DNA phosphates, while significant non-intercalative binding persists as shown by substantial fluorescence quenching at Mg2+ concentrations where there is little unwinding. MB+ induces photolysis at both low and high Mg2+ concentration - intercalation is apparently not required for photolysis. The quantum yield for strand breakage varies from 1-3 X 10(-7) under different conditions and is oxygen enhanced. The DNA cleavage is guanine specific. The 3' termini of the primary MB+-induced DNA photoproducts, unlike those generated by chemical sequencing retain an alkali labile adduct on the terminal phosphate.

Multiple copies of the amdS gene of Aspergillus nidulans cause titration of trans-acting regulatory proteins

It has been established that a plasmid containing the amdS gene of Aspergillus nidulans may be used to transform amdS+ strains by selecting for increased utilization of acetamide as sole nitrogen source. Analysis of transformants has shown that multiple tandem copies of the plasmid can be integrated into the chromosome, commonly at sites other than the amdS locus. While the transformed phenotype was relatively stable through mitotic and meiotic divisions evidence was found for variation in plasmid copy number presumably due to unequal recombination events. Expression of the integrated amdS genes was related to copy number, and the amdS RNA produced was similar in size to wild-type RNA. Evidence for titration of the product of the regulatory gene amdR by multiple copies of amdS was found. No titration of the product of the areA gene was observed, and amdS expression was still dependent on areA function. Multiple copies of the amdI9 mutation resulted in poor growth on acetate. This was not observed in the case of the amdS+ gene. The cis-acting amdI9 mutation causes increased facB dependent acetate induction of amdS expression. Titration of the facB gene produce by amdI9 DNA, but not by amdS+ DNA, therefore suggested that the mutation results in increased affinity for the facB gene product.

Capillary gas chromatographic analysis of amino acids in blood and protein hydrolysates as tert.-butyldimethylsilyl derivatives

A method is given for a one-step derivatization and gas chromatography of amino acids in blood and protein hydrolysates. Blood samples are partially purified by solvent extraction. Protein hydrolysates are neutralized with a triethylamine solution. Then tert.-butyldimethylsilyl derivatives of the amino acids are prepared in a one-step procedure and separated on a 30-m fused-silica SE-30 capillary column. Except for tryptophan and cystine, amino acids are eluted within 30 min. Amino acids are derivatized more rapidly than their corresponding trimethylsilyl derivatives and do not degrade on the long fused-silica columns.

Atracurium infusions in major ophthalmic surgery

Fifteen patients who were undergoing major ophthalmic surgery were anaesthetized using controlled ventilation with nitrous oxide, oxygen, midazolam and fentanyl after induction with thiopentone. Each was then given a bolus dose of 0.6 mg kg-1 atracurium followed immediately by an infusion of the drug at the rate of 0.6 mg kg-1 h-1, neuromuscular function being monitored throughout. Even slight movement can jeopardize the success of this type of surgery but good control of neuromuscular blockade was achieved without inhalational supplementation. The mean duration of the atracurium infusion was 118 min (range 30-247 min). The mean time from stopping the infusion to recovery of the first twitch of the train of four (TOF) to 20% was 25 min (range 11-44 min). Atropine (1.2 mg) and 5.0 mg neostigmine were then given in divided doses and a rapid and complete recovery was achieved. This technique can be used safely even in bad-risk patients but the infusion should be discontinued about 25 min before the end of surgery.

Characterization of a human gene inducible by alpha- and beta-interferons and its expression in mouse cells

An intact interferon-inducible gene has been isolated from a cosmid library of human genomic DNA. The gene (designated 6-16) encodes a mRNA of approximately 1 kb which is induced well by alpha- and beta- but poorly by gamma-interferons. Genomic and cDNA sequences indicate that the gene contains five exons, and that the mRNA encodes a hydrophobic polypeptide of 130 amino acids with a putative NH2-terminal signal sequence. The 5' end has been identified by primer extension. The corresponding genomic DNA contains a TATA box 20 nucleotides upstream of the putative transcription initiation site. After transfection of the human genomic cosmid into mouse Ltk- cells, human 6-16 mRNA is expressed in response to mouse alpha- and beta- but not gamma-interferons with the same kinetics and dose-response as in the human cells. No such expression is observed in response to human interferons. It can be concluded that the human cosmid DNA contains all of the sequences necessary for alpha- and beta-interferon-induced gene expression and that the mechanisms governing such expression are conserved between murine and human cells.

The role of interferons in parasitic protozoan infection

Interferons are well-known for their role as a first line defence against viral attack, but they also modulate the host immune system in responses to protozoan infections. In this article, John Kelly explains what interferons are, and discusses their potential role against parasitic infection.

Anaesthesia for Friedreich's ataxia. Case report and review of the literature

A patient with Friedreich's ataxia was anaesthetised on two occasions. The neuromuscular blocking agent was atracurium 0.5 mg/kg on the first occasion and tubocurarine 0.5 mg/kg on the second. The effect of each was monitored using the train-of-four twitch technique. Friedreich's ataxia has been reported to cause a marked sensitivity to non-depolarising muscle relaxants and hyperkalaemia, with resulting cardiac dysrhythmias after suxamethonium. This patient did not demonstrate an abnormal response to either relaxant; the operating conditions were satisfactory and recovery was not delayed. These drugs may be safely used in this condition provided that monitoring is adequate.

The two alcohol dehydrogenases of Zymomonas mobilis. Purification by differential dye ligand chromatography, molecular characterisation and physiological roles

The two alcohol dehydrogenases found in Zymomonas mobilis have each been purified using dye-ligand chromatography and affinity elution with nucleotides. The isoenzyme with lower electrophoretic mobility (ZADH-1) is a zinc enzyme with properties essentially similar to preparations described elsewhere. The faster isoenzyme (ZADH-2) accounted for some 90% of the ethanol-oxidizing activity in freshly prepared extracts and corresponded to the iron-activated enzyme previously described. This enzyme was inactivated by zinc; activity could only be retained during purification by including either ferrous ions or cobaltous ions in the buffers. ZADH-2 has relatively low acetaldehyde reductase activity; consequently ZADH-1 is responsible for about half of the physiological activity (acetaldehyde reduction) in Zymomonas cells. Kinetic studies showed that ZADH-2 is activated by ethanol in both reaction directions; a hypothesis for the mechanism of activation is presented. Metal ion analyses of ZADH-2 prepared in the presence of iron or cobalt indicated one atom of the relevant metal per subunit, with no significant zinc content. N-terminal sequence analyses showed that the ZADH-1 has some homology with the Bacillus stearothermophilus enzyme, whereas ZADH-2 resembles the yeast enzyme more closely.