[Degenerative changes in neutrophils as an indicator of neonatal sepsis]

Detection of the degenerative changes of neutrophils (D.C.N.) including vacuolization and toxic granulation in peripheral blood smear can be of value in identifying neonates with infection. A prospective study of 264 neonates who required septic work-ups in the first month of life was conducted. Thirty neonates were proved to have sepsis subsequently. The accuracy of the degree of the D.C.N. to predict neonatal sepsis was assessed. Vacuolization and/or toxic granulation in neutrophils varied from 0% to over 50%/100 neutrophils scanned. The higher the degree of D.C.N. the greater was the like-hood of sepsis. The positive predictive accuracy and specificity increased with the degree of D.C.N. from 24.7% to 100% and 70% to 100% respectively, but the sensitivity decreased accordingly. When D.C.N. was less than 10% the chance of sepsis was less than 5%. Most of newborns dying of proven sepsis had higher percentage of D.C.N.. These findings suggest that degree of D.C.N. may be associated with the outcome of the patients. This simple test can be performed easily in all hospital; it does not require special laboratory facilities and provide a valuable adjunct in early detection of severity and outcome of the neonates with sepsis.

The hemodynamic response of calves to tiletamine-zolazepam anesthesia

Six isoflurane-anesthetized calves were instrumented for hemodynamic studies and allowed to recover from anesthesia. When the mean arterial blood pressure rose to 100 mmHg or when vigorous movement occurred, a 1:1 tiletamine-zolazepam mixture (4 mg/kg) was administered intravenously (IV). Values for cardiac output, cardiac index, stroke index, central venous pressure, and right ventricular stroke work index did not change significantly. Systolic, mean, and diastolic arterial blood pressures and systemic vascular resistance were significantly decreased below baseline at 5 minutes; they were significantly increased above baseline at 20 minutes and remained so throughout the 60 minute study. Changes in left ventricular stroke work index and rate pressure product were similar to those of arterial blood pressure and systemic vascular resistance, although they were not significant. Heart rate and pulmonary capillary wedge pressure decreased significantly but gradually returned to baseline at 40 minutes and then increased significantly above baseline by the end of the study. Minor venous-arterial shunting or perhaps mismatching of ventilation and perfusion appeared to have developed in the later stages of the study. This was reflected in a minor increase in the arterial partial pressure of carbon dioxide (PaCO2) and a decrease in the arterial partial pressure of oxygen (PaO2) and arterial pH. At the dose administered, the hemodynamic changes induced by tiletamine-zolazepam were minimal and were compatible with safe anesthesia in calves.

Clinical significance of serum type-III procollagen aminopropeptide in hepatitis B virus-related liver diseases

Serum type-III procollagen aminopropeptide (PIIIP) has been considered a marker of hepatic fibrogenesis. In an attempt to evaluate the clinical significance of serum PIIIP in patients with hepatitis B virus (HBV)-related liver diseases, the levels of the peptide were measured in 66 healthy adults and 200 patients with HBV-related liver diseases. As compared with the healthy adults (12.3 +/- 3.1 ng/ml), the serum PIIIP levels were significantly elevated in patients with acute hepatitis (17.4 +/- 6.6 ng/ml), chronic persistent hepatitis (18.3 +/- 4.9 ng/ml), and inactive liver cirrhosis (22.1 +/- 7.1 ng/ml). The PIIIP levels in patients with chronic active hepatitis (CAH) (33.9 +/- 23.1 ng/ml) were the highest among HBV-related liver diseases and had a tendency to increase with the severity of CAH. Of the liver-diseased patients with serum PIIIP levels greater than 30 ng/ml, 91% had a recent episode of severe hepatocellular damage, whereas 56% of patients with greatly elevated serum liver aminotransferase levels had no associated high increase in serum PIIIP levels. Thus, we suggest that fibrogenesis in HBV-related liver diseases is initiated by severe hepatocellular damage, but liver damage can also take place without prominent hepatic fibrogenesis. Serum PIIIP may be a serum marker to predict the active fibrogenesis of HBV-related liver diseases.

Septo-optic dysplasia: report of a case

A female infant presented with poor feeding, hypotonia, prolonged jaundice, seizure and wandering nystagmus. A case of septo-optic dysplasia was proved by demonstrating the absence of septum pellucidum, small optic discs and hypothalamic-pituitary dysfunction at the age of three months. It is stressed that a diagnosis of septo-optic dysplasia must be entertained in infants who present with prolonged jaundice and hypoglycemia, particularly when rotatory nystagmus is associated.

Inhibition of gastric emptying by glucose depends on length of intestine exposed to nutrient

Nutrients inhibit gastric emptying in a dose-related fashion. We postulated that load-dependent gastric emptying results from the saturation of mucosal absorptive mechanisms, so that a longer length of the small intestine is exposed to unabsorbed nutrients as more nutrient enters the intestine to participate in this negative feedback. To test this idea, we limited exposure of 0.25 to 1.0 M glucose meals to various lengths of duodenum and jejunum in 17 dogs. The effects of these limited perfusions were then compared with experiments in which the whole gut (ALL) was exposed to the nutrient. Maximal inhibition was seen with 1.0 M meal and was similar with perfusions of 150 cm and ALL. By contrast, even with the 1.0 M load, no inhibition of gastric emptying was seen when glucose meal was confined to the first 15 cm of the proximal duodenum. Only 50-60% of maximal inhibition was observed during confinement of 1.0 M meal to the proximal 65 cm. We concluded that glucose sensors are present in both the proximal and the distal gut and the inhibition was related to the length of the small intestine exposed to glucose.

[Lateral calcaneal artery flap]

The lateral calcaneal artery flap provides a simple and reliable option for reconstructing the posterior heel defect. In our 10 cases including 3 diabetic patients, there was no flap necrosis, but one had the problem of wound healing. In another case, the skin graft over the flap donor site failed to take. All patients have protective sensation on the flap area, and 7 ambulatory patients can engage in a normal daily activity. Numbness over the lateral foot does not cause any trouble. There are a lot of spoke injuries in our 6-million-motorcycle country. When the conservative treatments do not achieve a satisfactory result, the lateral calcaneal artery flap should be the best surgical intervention for the defect less than 5 cm in diameter with bone or tendon exposure.

A preliminary comparison of lidocaine and xylazine as epidural analgesics in ponies

Xylazine (0.35 mg/kg) or lidocaine (0.35 mg/kg) was injected into the epidural space of six ponies to compare their effectiveness as epidural analgesics. Each pony received both treatments at 1 week intervals with the order of treatments randomized. Xylazine produced analgesia of significantly longer duration (247 +/- 58 minutes) than that produced by an equal dose of lidocaine (135 +/- 22 minutes). Mild transient ataxia of no clinical significance developed in all ponies with both treatments. Spinal cords were removed from two ponies and examined histologically. No discernible pathologic changes were noted.

Phase II study of mitoxantrone in unresectable primary hepatocellular carcinoma following hepatitis B infection

A total of 20 patients with histologically proven primary hepatocellular carcinoma (PHC) received mitoxantrone IV at a dose of 10-16 mg/m2 every 3 weeks. All patients had previous hepatitis B infection. None underwent remission after treatment; 2 had stable disease and 18 progressive disease. The median overall survival was 13 weeks (range, 1-59 weeks). There was no evidence of significant antitumor activity for mitoxantrone in our patients with PHC. Hematotoxicity occurred in 100% of the patients with grades 2-4 leukopenia, 89% of those with grades 1-4 anemia, and 26% of those with grades 2-3 thrombocytopenia. Cardiotoxicity occurred in 20% of the patients after 14-30 mg/m2 mitoxantrone; these included complete heart block with fatal outcome in one case, decreased ventricular ejection fraction in one, and sinus tachycardia in two. Nausea, vomiting, fever, diarrhea, and alopecia were mild and occurred in 15%-45% of the patients Therefore, patients with PHC following hepatitis B infection may be less tolerant to mitoxantrone, resulting in the apparent increase in toxicities.

Effect of epidermal growth factor on the sheet formation of the human keratinocyte in cell culture

Epidermal growth factor is an important element in maintaining keratinocyte proliferation and maturation. To evaluate its effect on keratinocyte growth in vitro, human foreskins were cultured. The epidermal keratinocyte growth in culture was separated into two stages by a conditional medium: the proliferation stage, in which the cells were maintained in a monolayer; and the differentiation stage, in which the cells grew to stratification and keratinization. The keratinocytes were cultured in various concentrations of epidermal growth factor, and their morphology and growth behavior were closely observed. Our results demonstrated that cultured keratinocytes grew in a confluent layer under the influence of epidermal growth factor. In contrast, in a culture without epidermal growth factor, the proliferation rate of cultured keratinocytes slowed down and eventually the cells stopped growing. During serum stimulation, with or without additional exogenous epidermal growth factor, the cultured keratinocytes grew continuously to the normal terminal differentiation. Under this two-stage culture model, the cultured keratinocytes could grow into an intact sheet of graftable epidermis.

The influence of verapamil and nifedipine on hepatic indocyanine green clearance in patients with HBsAg-positive cirrhosis and ascites

The influence of verapamil and nifedipine on hepatic indocyanine green kinetics was studied in 12 patients with HBsAg-positive cirrhosis and ascites. Hepatic clearance and its two biologic determinants, hepatic blood flow and metabolic activity (intrinsic clearance [maximum velocity/metabolite elimination rate constant, or Vmax/km]), were determined from hepatic indocyanine green elimination at steady state in patients with cirrhosis. Acute intravenous administration 10 mg verapamil significantly increased the hepatic indocyanine green blood flow (p less than 0.05), but significantly decreased the hepatic clearance (p less than 0.05), extraction ratio (p less than 0.05) and Vmax/km (p less than 0.05). However, acute sublingual administration of 10 mg nifedipine resulted in no significant change in any parameters of hepatic elimination function. These results show that verapamil, but not nifedipine, might impair the transhepatic extraction activity of hepatocytes in patients with HBsAg-positive cirrhosis and ascites.

Comparison of enzyme- and radio-immunoassay kits to detect hepatitis B surface antibody response among hepatitis B vaccinees

A total of 288 of sera was obtained from 96 hepatitis B vaccinees to test antibody to hepatitis B surface antigen (anti-HBs) by enzyme immunoassay (EIA) and radioimmunoassay (RIA), respectively. An anti-HBs titer greater than 10 mIU/mL is required for immunity; 172 (59.7%) were positive by EIA and 173 (60.1%) were positive by RIA. A correlation study of anti-HBs titers tested by these two methods showed a correlation coefficient r = 0.889 (n = 162, p less than 0.001). Of 173 serum specimens whose anti-HBs were positive by RIA, 10 were negative by EIA; those 10 had had anti-HBs titers between 11 to 20 mIU/mL by RIA. Among 172 serum specimens whose anti-HBs were positive by EIA, 9 were negative by RIA; 3 of those were between 21 to 70 mIU/mL, and 6 were between 11 to 20 mIU/mL by EIA. Of the 96 vaccinees, following first dose of hepatitis B vaccination their anti-HBs response rates were found to be 20.8% by EIA and 17.7% by RIA. Following second and third vaccinations, their anti-HBs response rates were 65.6% and 92.7% by EIA, and 71.9% and 90.6% by RIA, respectively. Thus, EIA correlates well with RIA for anti-HBs testing especially when its titers are greater than 70 mIU/ml.

Characterization of the Erwinia carotovora pelA gene and its product pectate lyase A

The pelA gene from Erwinia carotovora strain EC encodes pectate lyase A (PLa). The gene was cloned and sequenced. The PLa was purified from Escherichia coli containing the pelA gene on a recombinant plasmid. The optimum pH for the enzyme reaction is at pH 8.5; the optimum temperature for the enzyme reaction is at 40 degrees C; and the purified PLa alone can macerate potato slices. Nucleotide sequence of pelA and the deduced polypeptide sequence of PLa were compared with the pelB gene of E. carotovora and the deduced amino acid sequence of PLb. The nucleotide sequences are 82% homologous and the amino acid sequences are 88% homologous.

The Cronkhite-Canada syndrome with focus on immunity and infection. Report of a case

A 64-year-old man developed diffuse gastrointestinal polyposis, protein-losing enteropathy, skin pigmentation, hair loss, and unique nail changes. He also exhibited pulmonary tuberculosis and impaired immunity with skin anergy, poor lymphocyte mitogens stimulation test, and low serum immunoglobulin. We discuss the relationship of infection, nutrition, immunity, and the Cronkhite-Canada syndrome.

Characterization of the Erwinia carotovora pelB gene and its product pectate lyase

The pelB gene encodes pectate lyase B, one of three pectate lyases identified in Erwinia carotovora EC. Pectate lyase B was purified from Escherichia coli containing the pelB gene on a recombinant plasmid. The activity of the protein was optimal at a pH of 8.3. The amino acid composition, N-terminal amino acid sequence, and C-terminal peptide sequence were determined and compared with the polypeptide sequence deduced from the DNA sequence of pelB. Purified pectate lyase B started at amino acid 23 of the predicted sequence, suggesting that a 22-amino-acid leader peptide had been removed. Pectate lyase B of E. carotovora EC and pectate lyase B of E. chrysanthemi EC16 contain 352 and 353 amino acids, respectively (N. T. Keen, S. Tanaki, W. Belser, D. Dahlbeck, and B. Staskawicz, J. Bacteriol. 168:595-606, 1986). The two proteins are 72% homologous on the basis of DNA sequence data, and 75% of the amino acids are identical.

Different types of microcalcifications observed in breast pathology. Correlations with histopathological diagnosis and radiological examination of operative specimens

Microcalcifications taken from 50 systematized mammary excisions were submitted to light microscopic and scanning electron microscope analysis. Microprobe and x-ray diffraction analyses were also performed. Two main types were observed: Type I microcalcifications composed of weddellite crystals. They were observed in benign breast lesions only (11 cases out of 21) or, in lobular carcinomas in situ (L.C.I.S.) of the breast (5 cases out of 6). They were not seen in 3 cases of intraductal carcinoma (I.D.C.) nor in infiltrating (I.C.) carcinomas (20 cases). Type II microcalcifications, non-cristalline in nature, composed of calcium, phosphate, hydroxyapatite or of phosphorus and calcium associated with other elements, were observed in benign lesions (10 cases out of 21) and in all cases of infiltrating carcinomas. The microcalcifications observed on mammography were also found on the radiographs of systematised mammary excisions from the lesion or from its immediate vicinity, but only when using the appropriate technique. Microcalcifications are therefore an excellent marker of breast lesions but they cannot be simply divided into "benign" or "malignant" types. Nevertheless, the presence of a visible crystalline structure on the radiograph of the specimen argues in favour of a benign breast lesion or of a lobular carcinoma in situ.

araB Gene and nucleotide sequence of the araC gene of Erwinia carotovora

The araB and araC genes of Erwinia carotovora were expressed in Escherichia coli and Salmonella typhimurium. The araB and araC genes in E. coli, E. carotovora, and S. typhimurium were transcribed in divergent directions. In E. carotovora, the araB and araC genes were separated by 3.5 kilobase pairs, whereas in E. coli and S. typhimurium they were separated by 147 base pairs. The nucleotide sequence of the E. carotovora araC gene was determined. The predicted sequence of AraC protein of E. carotovora was 18 and 29 amino acids longer than that of AraC protein of E. coli and S. typhimurium, respectively. The DNA sequence of the araC gene of E. carotovora was 58% homologous to that of E. coli and 59% homologous to that of S. typhimurium, with respect to the common region they share. The predicted amino acid sequence of AraC protein was 57% homologous to that of E. coli and 58% homologous to that of S. typhimurium. The 5' noncoding regions of the araB and araC genes of E. carotovora had little homology to either of the other two species.

Evidence that polygalacturonase is a virulence determinant in Erwinia carotovora

Polygalacturonase (PG) was purified from Erwinia carotovora EC. A hybrid cosmid, pSH711, that encodes PG activity but not pectate lyase activity was identified from an E. carotovora genomic library by an immunological screening method. A cell extract of Escherichia coli cells containing pSH711 was able to produce plant tissue maceration when spotted on carrot, potato, or turnip slices. In addition, the E. coli strain containing this plasmid was able to macerate carrot, potato, and turnip slices. Our results suggest that PG plays an important role in soft-rot disease.

Human apolipoprotein B: identification of cDNA clones and characterization of mRNA

Apolipoprotein B (apoB) is a major protein component of low density and very low density lipoproteins. Because of its large size and heterogeneity, molecular studies of apoB have been difficult, and its structure and regulation remain poorly understood. We now report the identification of human apoB cDNA clones by antibody screening of hepatoma libraries in the expression vector lambda gt11. Both oligo(dT) primed and random primed libraries were constructed and screened with polyclonal antibodies to intact apoB, as well as with antibodies raised against a synthetic peptide based on the limited amino acid sequence available for apoB. The identity of the clones was unambiguously established by comparisons of the cloned cDNA sequences with apoB amino acid sequences. The clones hybridize to an exceptionally large 20 kb mRNA that is present in liver and intestine but not other tissues examined, consistent with the distribution expected from protein biosynthetic studies. The properties of the mRNA have implications for the biogenesis of the multiple apoB molecular weight forms secreted by liver and intestine.

An improved DNA sequencing strategy

A modification of Hong's systematic DNA sequencing strategy is described. The original procedure has been simplified and transfectant yield increased. After DNase I limited cleavage in the presence of Mn2+, the single-cut linear DNA does not have to be separated from supercoiled or open circular DNA on an agarose gel. After ligation, the DNA is digested with a second restriction endonuclease for which a unique cleavage site resides between the insert and the first restriction endonuclease cutting site. The original intact DNA is linearized whereas the deleted subclone is not. The background is decreased to an undetectable level. This DNA sequencing strategy was tested on a 1.4-kb DNA fragment containing the araC regulatory gene from Erwinia carotovora. A set of subclones sufficient to sequence the fragment on both strands was produced in 2 days and the yield was at least 60-fold higher than in the original protocol.

The araBAD operon of Salmonella typhimurium LT2. I. Nucleotide sequence of araB and primary structure of its product, ribulokinase

Hybrid plasmids containing the araBAD operon of Salmonella typhimurium LT2 were characterized by Southern blot and genetic analyses. The nucleotide sequence of araB was determined. The araB gene product, ribulokinase (EC 2.7.1.16), was purified and the results of amino acid composition analysis and partial amino acid sequence are in agreement with predictions from the DNA sequence. Ribulokinase is 569 amino acid residues long and has a calculated Mr of 61 793. Ribulokinase shares significant homology with xylulose kinase from Escherichia coli. Codon usage in the araB gene does not favor those codons which have intermediate codon-anticodon binding energy.

The araBAD operon of Salmonella typhimurium LT2. III. Nucleotide sequence of araD and its flanking regions, and primary structure of its product, L-ribulose-5-phosphate 4-epimerase

The araD gene of Salmonella typhimurium LT2 consists of 744 nucleotides and has an ORF coding for a protein of 248 amino acid residues with a calculated Mr of 27059. The product of araD, L-ribulose-5-phosphate 4-epimerase, was purified and the amino terminal sequence was determined. It is identical to that predicted by the ORF. A 143-bp intercistronic region was found between the araA and araD genes which can form stem-loop structures with calculated free energies of up to -76.7 kcal/mol. Three sets of sequences within this 143-bp region are comparable to a consensus sequence deduced from several known intercistronic regions. Approximately equimolar amounts of the araBAD operon products were present in L-arabinose-induced cells. Sequences similar to both rho-independent and rho-dependent transcription terminators are present after the araD gene.

Cloning of the pectate lyase genes from Erwinia carotovora and their expression in Escherichia coli

A hybrid cosmid coding for pectate lyase (PL) activity was identified from an Erwinia carotovora genomic library by an immunological screening method. A 7-kb DNA fragment was identified which codes for three proteins identical in size to proteins with PL activity purified from E. carotovora culture supernatants. The three proteins had apparent Mrs of 41, 44 and 44 X 10(3) as estimated by SDS-PAGE. None of the PLs were exported from Escherichia coli strain HB101 but all were found in the periplasmic space. Plant tissue was macerated by the PLs made in E. coli.

The araBAD operon of Salmonella typhimurium LT2. II. Nucleotide sequence of araA and primary structure of its product, L-arabinose isomerase

The nucleotide sequence of gene araA of Salmonella typhimurium LT2 has been determined. The gene encodes an L-arabinose isomerase (EC 5.3.1.4) of 500 amino acid residues with a calculated Mr of 55814. The ATG start codon of araA is 10 bp distal to the TAA termination codon of araB. A presumed ribosome-binding site (RBS) "TAAGGA" 7 bp from the ATG codon overlaps the stop codon of araB. L-Arabinose isomerase was purified and the amino acid composition is in agreement with that predicted from the DNA sequence. The NH2-terminus of the protein is modified as the sequence cannot be analyzed by the automated Edman degradation. Amino acid composition analyses of both NH2-terminal and C-terminal cyanogen bromide (CNBr) cleaved peptides and partial amino acid sequence of the C-terminal peptide are consistent with the deduced amino acid sequence.