Gene analysis in delta beta and delta (0) thalassemia

Restriction mapping of the globin genes from a homozygous delta beta thalassemia patient from Israel indicates that at least a 10-kilobase deletion is present extending 3' from within the large intervening sequence (IVS 2) of the delta globin gene and including the entire beta globin gene. Unique bands are seen when cellular DNA from this patient is digested with a variety of restriction endonucleases and hybridized with a probe specific for the delta IVS 2. Extensive analysis of the Israeli delta beta thalassemia DNA as well as material from an Italian delta beta thalassemia homozygote with enzymes which cleave more frequently in delta IVS 2 has localized the 5' end of the deletion to a 107-base pair region within delta IVS 2. This region contains a unique repetitive sequence (TG)4 which has been reported to be a specific recognition signal for recombination and may be involved in the formation of these mutant genes. Two homozygous delta(0) thalassemia DNA samples from Japan were also analyzed for gene rearrangements or other changes by restriction enzyme mapping. No changes from normal were seen using 14 different enzymes indicating the absence of large deletions in the region around the delta globin gene. More specifically, both the 5' and 3' splice junctions of the IVS 2 appear to be normal from hybridization of restriction fragments generated by HphI and AluI, respectively, with a delta IVS 2 specific probe. We have also shown that point mutations which could lead to termination codons are not present at codons 35, 37, 43, 61, and 121, since restriction enzymes which recognize these sites produce normal patterns. The delta(0) thalassemia phenotype in these two subjects is most likely due to a point mutation either at one of the other 24 potential termination codons not accessible to restriction analysis or to other single nucleotide changes which could either decrease delta globin gene transcription or lead to abnormal processing or transport of delta globin mRNA.

Gel filtration patterns of factor VIII coagulant antigen and factor VIII related antigen in normal and von Willebrand's disease

Gel filtration (sepharose 2B CL) patterns of factor VIII coagulant antigen (VIIIC:Ag) and factor VIII related antigen (VIIIR:Ag) were obtained using normal plasma and plasma from patients with von Willebrand's disease. The latter group consisted of five individuals with normal mobility of factor VIIIR:Ag on cross-immunoelectrophoresis (Type I) and five others with abnormal (increased) mobility (Type II). Results showed that the elution of VIIIC:Ag was delayed in those subjects whose ratio of VIIIR:Ag to VIIIC:Ag was reduced. It has previously been reported that VIIIR:Ag exerts a stabilizing influence on the coagulant activity of factor VIII (VIII:C); our data suggests that when VIIIR:Ag is deficient, abnormal (low molecular weight) forms of VIIIC:Ag circulate.

Embryogenesis of the gingival cyst

The embryogenesis of gingival cysts derived from the dental lamina was studied histologically in paraffin prepared sections of 10 pairs of human fetal jaws and in individual celloidin sections of human fetal skulls. Cystic degeneration in the dental lamina was noted as early as 10 weeks in utero prior to the separation of the developing tooth bud. Rapid proliferation and growth of such cysts was seen in 15-20 week old embryos during the morphodifferentiation stage of tooth development after fragmentation of the lamina had occurred. Islands, strands and nests of dental lamina epithelium were dispersed into extraosseous locations and demonstrated histomorphologic characteristics similar to odontogenically related epithelium seen in adult gingiva. Dental lamina epithelium appears to have a particular predisposition for cystic degeneration and is probably the source of other neoplasms and hamartomas seen in the gingiva.

Diabetes, a hypercoagulable state? Hemostatic variables in newly diagnosed type 2 diabetic patients

37 type 2 diabetic patients with no clinical evidence of retinopathy or vascular disease were studied at diagnosis and following control of hyperglycaemia for evidence of abnormalities of coagulation, fibrinolysis and platelet behaviour. 38% showed hyperactive platelets, demonstrating either in vitro hyperaggregability, circulating platelet aggregates, or raised plasma beta-thromboglobulin levels. 36% showed abnormally raised factor VIII coagulant activity (FVIIIc) levels, though this was mainly in female patients. The mean level of FVIIIc decreased with treatment. Anti-thrombin III (AT-III) levels were decreased, and 33% of the patients had levels less than 80%. In this group AT-III increased following treatment. No abnormalities of fibrinolysis were demonstrated. These findings support the concept that diabetes can be associated with a hypercoagulable state, which is not necessarily dependent on the presence of overt vascular disease, or correlated with the degree of chronic hyperglycaemia (HbA1c levels).

Stimulated osteoperiosteal pedicle grafts in dogs

This descriptive study compared the healing of mucoperiosteal and "stimulated" osteoperiosteal flaps for the treatment of surgically created periodontal recessions in dogs. Surgically created defects on the canine teeth of 10 healthy mongrel dogs were covered by specially designed, cemented copper bands for 4 weeks (Several maxillary premolar teeth were managed in the same way). A plaque and calculus-promoting diet was fed to the animals during this period. When the bands were removed the diet was altered and an intensive oral hygiene program was instituted. The contralateral tooth, chosen randomly, was utilized for placement of the mucoperiosteal lateral sliding flap and acted as the control. The experimental side was surgically stimulated 21 days prior to elevation of a "stimulated" osteoperiosteal flap for repositioning over the denuded roots. The animals were sacrificed with an overdose of Nembutal and block sections for histologic study were taken at periods ranging from 14 to 50 days. Histologic findings indicate that healing of the stimulated flaps was accompanied by the formation of a relatively short dentogingival epithelium, cementogenesis which varied in amount and type, and new connective fiber insertion into cementum. By contrast, the mucoperiosteal flaps healed with a long dentogingival epithelial relationship and no cementogenesis or connective tissue reattachment.

The reduction in symptoms of diabetic patients after treatment in diabetic clinics

One hundred and seventy-six patients who were newly referred to two diabetic clinics completed an initial questionnaire and a second questionnaire 1 yr later. Over the 1-yr period the average 2-h postprandial blood sugar was reduced from 13.8 to 8.8 mmol/L. The questionnaire included 33 questions on symptoms, and four symptoms improved by more than 10%: increased thirst (reduced by 29%), dry mouth (reduced by 24%), pruritus (17%), and weakness in the limbs (10%). No symptom was increased by more than 7%. The changes in five symptoms were significantly related to the changes in blood sugar observed, the improvement in symptoms being associated with reductions in blood sugar. These results are contrasted with newly referred hypertensive patients in whom marked improvements in symptoms were not observed and an increased frequency of certain symptoms was observed owing to drug side effects.

Relationship between intellectual status and reading skills for developmentally disabled children

The relationship between WISC-R Full Scale IQ and scores on the Woodcock Reading Mastery Tests were explored for 80 developmentally disabled children. While the children's reading skills correlated moderately and significantly with intellectual status, abstract reading skills, e.g., word comprehension, correlated more highly with Full Scale IQ than did concrete ones, e.g., word identification. The development of concrete learning patterns by such children was discussed, with an emphasis on the emotional importance of these learning styles to the children and their families.

Problems in home monitoring of blood glucose

Two hundred and forty blood glucose readings were made on 5 Glucochek machines by 2 different operators. The results on all machines correlated poorly with equivalent results from an automatic glucose analyser with major discrepancies at all glucose concentrations. There was a wide gap in performance between the 2 operators. Analysis of variance suggested that errors were not only due to inter-operator and inter-machine differences. Possible sources of error were shown to include time of reaction and the amount of blood on Dextrostix. Dextrostix colour changes measured by eye were as accurate as those by Glucochek without the rogue values found at higher glucose concentrations with Glucochek.

A comparison of intellectually delayed and primary reading disabled children on measures of intelligence and achievement

Compared intellectually delayed and primary reading disabled children (N = 64) in respect to WISC-R Verbal-Performance IQ differences and subtest scores on the Woodcock Reading Mastery Tests. First, it was found that the two groups did not differ in respect to overall mean Verbal-Performance IQ differences or in the percentage of children who showed particular directional patterns. Second, the two groups demonstrated more similarities than differences on Woodcock subtest scores. The importance of these findings for the assessment of children's reading problems was discussed.

Disposable syringes for insulin injection

Results of a questionnaire on use of glass syringes among diabetic patients showed considerable variation in methods of keeping the syringes and in the duration of their useful life. Thirty patients took part in an investigation in which each patient used the same disposable syringe in place of the glass syringe for up to two months. No clinical or bacteriological evidence of infection was found. Used in this way, disposable syringes were less expensive than glass syringes. They are lighter than glass syringes, less susceptible to damage, and more easily carried on journeys.

Sulcular exudate flow in gingival inflammation

Sulcular exudate flow measurements were obtained from 45 subjects and compared to the clinical as well as histologic degrees of inflammation. The results of this investigation demonstrated no statistically significant difference between exudate flow and the clinical degree of inflammation while demonstrating a statistically significant difference between exudate flow and the clinical assessment of inflammation. It was proposed that current clinical indices do not accurately reflect the microscopic degree of gingival inflammation.

A comparison of an ITPA estimated psycholinguistic quotient and WISC-R IQS for developmentally disabled children

Compared an estimated Psycholinguistic Quotient, based on Cronkhite and Penner's (1975) revised scoring procedure for the ITPA Psycholinguistic Age, to the WISC-R Verbal, Performance, and Full Scale IQs of developmentally disabled children. The Quotient entered into strong relationships with the WISC-R Verbal and Full Scale IQs. The diagnostic significance of these correlations was discussed. The data indicated that the estimated Psycholinguistic Quotient was a valid measure for screening intellectual status in this population.

Changes in restricted human cellular DNA fragments containing globin gene sequences in thalassemias and related disorders

Human cellular DNA fragments from cells of normal subjects and patients with thalassemia obtained by restriction enzyme digestion were analyzed for their globin gene content. The fragments were separated on agarose gels, transferred to nitrocellulose filters, hybridized to globin [(32)P]cDNA, and radioautographed. One to ten picograms of globin gene sequences were detectable. With EcoRI digestion, eight to nine cellular DNA fragments were found to contain globin genes. Three of these contained beta-like gene sequences assayed with beta globin cDNA probe. One beta-like fragment was absent in DNA from a homozygous subject for hemoglobin Lepore. Two of the three beta gene-containing fragments present in normal DNA were absent in DNA from a patient with hereditary persistence of fetal hemoglobin. The same two fragments containing beta-like genes were absent from deltabeta thalassemic DNA and one new fragment containing beta-like genes was found. Together with results obtained by hybridization of these DNAs in solution, the data are consistent with deletion of specific restriction human DNA fragments in subjects with these disorders and a greater deletion of beta-like gene sequences in subjects with hereditary persistence of fetal hemoglobin than in those with deltabeta thalassemia.

Enterovenous fistulization in Crohn's disease

A case of Crohn's disease was complicated by enterovenous fistulization (ileum to superior mesenteric vein) with septic manifestations. The fistulization was diagnosed by the observation of gas in the liver and by the opacification of mesenteric veins following a barium meal.

Effect of levamisole on malignant experimental neurinoma grown subcutaneously in a young rat: brief communication

Levamisole, a drug that stimulates the immunologic defenses of the host, was tested on the experimental malignant neurinoma grown subcutaneously in young female inbred CDF rats in 3-month trial. The drug resulted in prevention of tumor growth in 80% of the treated animals, whereas tumors grew in 100% of the controls. After discontinuation of the drug, none of the animals in the treated group showed evidence of tumor growth upon clinical and pathologic examination 1 month after drug treatment was terminated. Treated animals failed to show any side effects related to levamisole upon clinical and pathologic examination.

Effect of levamisole on malignant experimental neurinoma grown subcutaneously in a young rat: brief communication

Levamisole, a drug that stimulates the immunologic defenses of the host, was tested on the experimental malignant neurinoma grown subcutaneously in young female inbred CDF rats in a 3-month trial. The drug resulted in prevention of tumor growth in 80% of the treated animals, whereas tumors grew in 100% of the controls. After discontinuation of the drug, none of the animals in the treated group showed evidence of tumor growth upon clinical and pathologic examination 1 month after drug treatment was terminated. Treated animals failed to show any side effects related to levamisole upon clinical and pathologic examination.

Aetiology of juvenile-onset diabetes. A prospective study

110 people in whom insulin-dependent diabetes developed when they were less than 30 years old were studied as soon as possible after diagnosis. There was evidence for clustering of cases with BW15-positive phenotypes during the winter peak (1976) but not during the autumn peak (1975). Subjects who were BW15-positive, and in particular those who were both B8 and BW15-positive, had higher neutralising antibody titres to Coxsackle virus types B1-B4 58% of cases had islet-cell antibodies (I.C.A.), but the presence of I.C.A. was not correlated with HLA phenotypes or viral antibody titres. In 41 subjects (37%), who gave a definite history of antecedent illness, evidence indicated that this was a precipitating infection and not the initiating event producing islet-cell damage. Nearly half the subjects had had diabetic symptoms for more than 4 weeks before diagnosis.