Contamination during removal of cement in revision hip arthroplasty. A cadaver study using ultrasound and high-speed cutters

Instruments used in surgery which rotate or vibrate at a high frequency can produce potentially contaminated aerosols. Such tools are in use in cemented hip revision arthroplasties. We aimed to measure the extent of the environmental and body contamination caused by an ultrasound device and a high-speed cutter. On a human cadaver we carried out a complete surgical procedure including draping and simulated blood flow contaminated with Staphylococcus aureus (ATCC 12600). After cemented total hip arthroplasty, we undertook repeated extractions of cement using either an ultrasound device or a high-speed cutter. Surveillance cultures detected any environmental and body contamination of the surgical team. Environmental contamination was present in an area of 6 x 8 m for both devices. The concentration of contamination was lower for the ultrasound device. Both the ultrasound and the high-speed cutter contaminated all members of the surgical team. The devices tested produced aerosols which covered the whole operating theatre and all personnel present during the procedure. In contaminated and infected patients, infectious agents may be present in these aerosols. We therefore recommend the introduction of effective measures to control infection and thorough disinfection of the operating theatre after such procedures.

Retrograde injection of a nutrient vein with cement in cemented total hip arthroplasty

An 80-year-old woman received a cemented total hip arthroplasty. The surgery was performed without intraoperative complications. Postoperative radiographs and a computed tomography scan revealed a nutrient vein perforating the femur, which was retrogradely filled with cement. An abdominal and thoracic computed tomography scan showed no further dissemination of cement.

Excessive heat generation during cutting of cement in the Robodoc hip-revision procedure

The ROBODOC system is a promising new method for removing cement with high-speed milling. Heat is generated during the milling process. This study was designed to measure temperatures in the cutting area, and to assess the risk of heat injury and the effectiveness of irrigation. We measured temperatures at the bone-cement cutting area in three experimental settings, two involving the proximal area comprising a cement mantle, and one the distal cement plug beneath the prosthesis. Without cooling facilities, a mean temperature of 94 degrees C was measured in proximal areas. However, this could effectively be reduced below 70 degrees C with irrigation. In the area of the distal cement plug, we measured a mean temperature of 172 degrees C without irrigation. In this area, the integrated irrigation system with an additional high-flow irrigation system could not guarantee cooling to an acceptable temperature of below 70 degrees C since the irrigation stream was impeded by the cutter in the narrow cavity. We need an integrated irrigation device that guarantees continuous cooling at the cutting interface in front of the cutter.

Multiple previous surgeries, infection, and preoperative radiation: a cause for arterial rupture in closed reduction?

We report a patient who underwent revision hip arthroplasty with preoperative radiation after a septic loosening of the primary hip prosthesis. Subsequently the patient presented with a dislocation of the hip. During the closed reduction with general anesthesia, a rupture of the arteria profunda femoris occurred. The patient was treated by angiographic obliteration of the arteria profunda femoris followed by an open reduction and augmentation of the acetabular component.

Environmental and body contamination through aerosols produced by high-speed cutters in lumbar spine surgery

STUDY DESIGN

A cadaver study to evaluate contamination in the operating room through the use of a high-speed bone cutter.

OBJECTIVES

To determine the grade of contamination of animate and inanimate objects through an aerosol intraoperatively, produced by a high-speed cutter during lumbar laminectomy.

SUMMARY OF BACKGROUND

In spinal surgery, high-speed cutters are used that produce an aerosol consisting of a mixture of irrigation solution, blood, and tissue debris. Such aerosols can be contaminated with potential pathogens. The surgical personnel and the environment are therefore exposed to a contamination risk.

METHODS

Laminectomies at three points (L2-L4) were performed on a human cadaver using a high-speed cutting device. The aerosol produced by the irrigation solution was contaminated with Staphylococcus aureus ATCC 12600. To detect the contamination of the environment and of the surgical team, surveillance cultures were used.

RESULTS

By air sampling, staphylococci were detected in the operating room at an extension of 5 by 7 m. The surgical team showed extensive face and body contamination with S. aureus. Despite protection by a barrier drape, similar contamination was observed on both the cadaver's head and the anesthesiologist.

CONCLUSIONS

The use of high-speed cutters in spinal surgery produces an aerosol that can be contaminated with blood-borne pathogens from infected patients. This aerosol is spread over the whole surgical room and contaminates the room and all personnel present. It is therefore critical to ensure that effective infection control measures are performed, not only by the surgeons but by everyone present in the operating room. The room itself must be sufficiently disinfected after such procedures.

Knee pain caused by a fiducial marker in the medial femoral condyle: a clinical and anatomic study of 20 cases

After 2-pin-based ROBODOC hip arthroplasty procedures, 10 of 18 patients reported persistent severe pain at the site of pin implantation in the medial femoral condyle. In a cadaver study, we found that the infrapatellar branch of the saphenous nerve, the saphenous nerve and the anterior cutaneous branches of the femoral nerve had been injured by the pins. At least one of these nerves was injured in 11 of the 20 specimens examined. Our findings indicate that the knee-pain may be partly caused by injuries to these nerves.

Aerosols produced by high-speed cutters in cervical spine surgery: extent of environmental contamination

High-speed cutters are used in the surgery of the cervical spine. Such high-speed devices can produce an aerosol cloud. As a patient can be a reservoir for pathogens, with aerosol-borne paths of transmission, such an aerosol has to be seen as a potential risk of infection for health care professionals present during the surgery and for patients if micro-organisms are transferred through the medical personnel. The study was performed in order to measure the extension of environmental and body contamination through contaminated aerosols produced by a high-speed cutter. Three laminectomies (C4-C6) were performed on an intact human cadaver with a high-speed 0.6-mm ball cutter. A complete surgical setup was arranged, including surgical draping and a barrier drape to the anesthesiologist's workplace. Body and environmental contamination was detected by the use of surveillance cultures. The irrigation solution was artificially contaminated with Staphylococcus aureus ATCC 12600. Following the surgery, staphylococci were detected in the operating room at an extension of 5x7 m. Everybody showed extensive face and body contamination with Staphylococcus aureus. The study showed that the use of high-speed cutters in surgery of the cervical spine produces an aerosol cloud that is spread over the whole surgical room and contaminates the theater and all personnel present. Such aerosols can be contaminated with pathogens if the patient was infected or colonized. Therefore, sufficient protective measures have to be recommended for everyone present in the operating room during such surgeries. In addition, efficient disinfection of the room and all mobile equipment is necessary after each surgery involving high-speed cutting devices.

Semiclassical treatment of reactions at surfaces with electronic transitions

The semiclassical treatment of reactions at surfaces with electronic transitions based on the fewest-switches algorithm is compared with full quantum mechanical results. As a model system the ionization probability in I2 scattering from a diamond surface is chosen. In the calculations we treat the molecular distance from the surface and one surface oscillator coordinate explicitly. Furthermore, we also consider molecular rotation in the semiclassical calculations. The semiclassical results agree with the quantum results although some discrepancies remain, as far as the phase coherence is concerned. We identify energy transfer to molecular and surface degrees of freedom as a possible mechanism that could explain the experimental dependence of the ionization probability on the incident kinetic energy of the molecule.

Syntheses, molecular structures, and vibrational spectra of chloropentacarbonylrhodium(III) and -iridium(III) undecafluorodiantimonate(V), [Rh(CO)5Cl][Sb2F11]2 and [Ir(CO)5Cl][Sb2F11]2: an experimental and density functional study

The reactions of either bis(mu-chloro)tetracarbonyldirhodium(I), [Rh(CO)2(mu-Cl)]2, or chlorotricarbonyliridium(I), [Ir(CO)3Cl]n, in the conjugate Brønsted-Lewis superacid HF-SbF5 and in a CO atmosphere, produce [Rh(CO)5Cl][Sb2F11]2 or [Ir(CO)5Cl][Sb2F11]2, respectively. In these oxidative carbonylation reactions, antimony(V) fluoride functions as an oxidizing agent. The reduced product is identified as 6SbF3.5SbF5. [Rh(CO)5Cl][Sb2F11]2 is obtained in the form of single crystals. Crystal data: monoclinic, space group P2(1) (No. 4); a = 9.721(1), b = 12.602(1), c = 10.538(1) A; beta = 106.51(1) degrees; V = 1237.7(2) A3; Z = 2; T = 300 K; R1 [I > 3 sigma (I)] = 0.0367, wR2 = 0.0739. Single crystals of [Ir(CO)5Cl][Sb2F11]2 are produced in small amounts from a solution of mer-Ir(CO)3(SO3F)3 in magic acid, HSO3F-SbF5. The possible source of chlorine will be discussed. Crystal data for [Ir-(CO)5Cl][Sb2F11]2: monoclinic, space group P2(1) (No. 4); a = 9.686(2), b = 12.585(2), c = 10.499(2) A; beta = 106.59(2) degrees; V = 1226.5(4) A3; Z = 2; T = 294 K; R1[I > 3 sigma (I)] = 0.032, Rw = 0.031. The bond lengths and bond angles are nearly identical in the two isostructural salts; however, the cell volume of [Ir(CO)5Cl][Sb2F11]2 is slightly smaller than that of [Rh(CO)5Cl][Sb2F11]2. The cations (point group C4v) feature unusually long M-C bonds (M = Rh, Ir) and correspondingly short CO bonds, as well as high CO stretching wavenumbers and high CO stretching force constants. The [Sb2F11]- anions are not symmetry related, and their dihedral and bridge angles differ slightly in both salts. There are significant interionic contacts in [Ir(CO)5Cl][Sb2F11]2 exclusively of the C-F type (about 2 for each C atom of the five carbonyl groups) resulting in extended structures. The vibrational spectra for both [M(CO)5Cl]2+ cations (M = Rh, Ir) are assigned with the help of density functional calculations, which also provide intensities for IR and Raman bands. While [Rh(CO)5Cl]2+ is the first cationic carbonyl derivative of Rh(III), the vibrational and structural parameters for [Ir(CO)5Cl]2+ are compared to data for [Ir(CO)6]3+ and mer-Ir(CO)3(SO3F)3.

Foraging ecology of the black flying fox (Pteropus alecto) in the seasonal tropics of the Northern Territory, Australia

Pteropus alecto uses landscape patchiness at two scales: firstly, between broad vegetation types (i.e. eucalypt open forest/savanna woodland versus rainforest vegetation); secondly, within vegetation types. Radio-collared Pteropus alecto selected foraging sites that were richer in flower or fruit resources than floristically similar sites and moved through the landscape in response to the flowering and fruiting of a number of plant species occurring in different vegetation types. Abundance of P. alecto within four monitored rainforest patches and the outside vegetation fluctuated substantially during the study. Overall, P. alecto was more abundant in the rainforests than in the surrounding vegetation. P. alecto foraged on the flowers and fruit from 23 species in 11 families.

[Impact of a selective screening for gestational diabetes in a Spanish population]

BACKGROUND

Recently, the American Diabetes Association (ADA) concluded that pregnant women with low risk factors for gestational diabetes need not to be tested. The aims of this study was to determine the prevalence of gestational diabetes in a Spanish low risk pregnant women population, to analyze the criteria that define low risk pregnancies for gestational diabetes, and to compare the differences in morbidity between pregnant women with and without gestational diabetes.

DESIGN AND METHODS

Cohort study of 2,262 gestations (2,085 Caucasians) during a period of 7 years in a reference hospital.

RESULTS

The gestational diabetes prevalence was 15%. Two-hundred and seventy-four (12.1%) women were considered as a low risk group for gestational diabetes. Among these, 13 (4.7%) presented gestational diabetes in comparison with 16.6% in the remaining women (p = 0.0001). Gestational diabetes in the low risk pregnant women constituted the 3.8% of all gestational diabetes. We did not find differences in gestational outcomes or fetal antropometry between the groups. The relative risk of macrosomia in the low risk pregnant was 0.9% (95% confidence interval for the mean: 0.86-0.94).

CONCLUSIONS

In spite of their capacity of identifying current complications, 4% of gestational diabetes would not have been diagnosed with the new ADA criteria. The misdiagnosis will prevent in this small group of women the adoption of preventive measures for subsequent pregnancies and for diabetes in later life.

Atrial natriuretic peptide clearance receptor participates in modulating endothelial permeability

The atrial natriuretic peptide (ANP)-C receptor is generally believed to clear ANP; however, the ANP-C receptor may serve to reduce cAMP by inhibiting adenylate cyclase. ANP decreases endothelial permeability in coronary endothelial cell monolayers. We tested the hypothesis that part of this effect might be mediated by the ANP-C receptor. We used an endothelial cell monolayer from rat coronary endothelium and measured albumin flux. We applied either ANP or a ring-deleted ANP (C-ANP), which only stimulates the ANP-C receptor. ANP and C-ANP both decreased permeability from 100 pM to 100 nM by 60 and 30%, respectively. ANP increased endothelial cGMP contents 5.5-fold, whereas C-ANP had no effect. ANP reduced endothelial cAMP contents by 75%, which was only partly blocked by pertussis toxin. C-ANP also reduced cAMP; however, this effect was completely blocked by pertussis toxin. Protein kinase G inhibition blocked the ANP-mediated decrease in permeability by 50%. In contrast, pretreatment with pertussis toxin, in the face of protein kinase G inhibition, blocked the effect completely. C-ANP decreased permeability by half the amount of ANP. This C-ANP effect was completely blocked by pertussis toxin but not by protein kinase G inhibition. Isoproterenol (10 microM) increased permeability by almost 50%, which was completely blocked by ANP but only partially blocked by C-ANP. The C-ANP effect was blocked completely by pertussis toxin. Isoproterenol increased cAMP threefold, which was abolished by ANP. C-ANP reduced the isoproterenol-induced increase in cAMP by 50%. Isoproterenol had no effect on cGMP. We conclude that agonist binding to the ANP-C receptor inhibits cAMP production via a Gi protein-coupled signaling system. This inhibition may contribute to the decreased endothelial permeability evoked by ANP in this system.

Molecular cloning, genomic characterization and expression of novel human alpha1A-adrenoceptor isoforms

We have isolated and characterized from human prostate novel splice variants of the human alpha1A-adrenoceptor, several of which generate truncated products and one isoform, alpha(1A-4), which has the identical splice site as the three previously described isoforms. Long-PCR on human genomic DNA showed that the alpha(1A-4) exon is located between those encoding the alpha(1A-1) and alpha(1A-3) variants. CHO-K1 cells stably expressing alpha(1A-4) showed ligand binding properties similar to those of the other functional isoforms as well as agonist-stimulated inositol phosphate accumulation. Quantitative PCR analyses revealed that alpha(1A-4) is the most abundant isoform expressed in the prostate with high levels also detected in liver and heart.

Expression of human dopamine beta-hydroxylase in Drosophila Schneider 2 cells

Human dopamine beta-hydroxylase (DBH) has been expressed in transformed Drosophila Schneider 2 (S2) cells with yields of > 16 mg/l. Most of the activity was found in the culture fluid. Similarly, human neuroblastoma cells also secrete native DBH into the medium, but at a much lower level than recombinant Drosophila cells. We have purified native and recombinant human DBH by a modified purification procedure using SP-Sepharose, lentil lectin-Sepharose and gel-filtration chromatography and carried out studies to compare the two enzymes. Two variants of human DBH that differ by a single amino acid (either serine or alanine) at position 304 were expressed in Drosophila cells, purified, and found to have no significant difference in enzyme activity. The molecular mass of human DBH monomer has been determined from SDS/PAGE to be 73 kDa, but the recombinant DBH from Drosophila is smaller at 66 kDa. The difference may be due to glycosylation as deglycosylated enzymes from both sources are identical in size (61 kDa). The Km of tyramine for native and recombinant human enzymes are virtually the same but higher than bovine DBH by about 3-fold. Likewise, the inhibition of native and recombinant human DBH by fusaric acid and SKF102698 is not significantly different but IC50 values are 2-3-fold higher than that for the bovine enzyme. These results strongly support the conclusion that recombinant human DBH from Drosophila S2 cells can be used in place of human neuroblastoma-derived DBH for drug screening, characterization of the enzyme's physicochemical properties, and determination of structure-function relationships. The Drosophila expression system has thus provided a convenient source for large quantities of human DBH enzyme.

The pharmacology and distribution of human 5-hydroxytryptamine2B (5-HT2B) receptor gene products: comparison with 5-HT2A and 5-HT2C receptors

1. Full length clones of the human 5-HT2B receptor were isolated from human liver, kidney and pancreas. The cloned human 5-HT2B receptors had a high degree of homology (approximately 80%) with the rat and mouse 5-HT2B receptors. 2. PCR amplification was used to determine the tissue distribution of human 5-HT2B receptor mRNA. mRNA encoding the 5-HT2B receptor was expressed with greatest abundance in human liver and kidney. Lower levels of expression were detected in cerebral cortex, whole brain, pancreas and spleen. Expression was not detected in heart. 3. Northern blot analysis confirmed the presence of 5-HT2B receptor mRNA (a 2.4 kB sized band) in pancreas, liver and kidney. An additional 3.2 kB sized band of hybridization was detected in liver and kidney. This raises the possibility of a splice variant of the receptor or the presence of an additional homologous receptor. 4. The human 5-HT2B receptor was expressed in Cos-7 cells and its ligand binding characteristics were compared to similarly expressed human 5-HT2A and 5-HT2C receptors. The ligand specificity of the human 5-HT2B receptor (5-HT > ritanserin > SB 204741 > spiperone) was distinct from that of the human 5-HT2A (ritanserin > spiperone > 5-HT > SB 204741) and 5-HT2C (ritanserin > 5-HT > spiperone = SB 204741) receptors. On the basis of a higher affinity for ketanserin and a lower affinity for yohimbine the human 5-HT2B receptor also appeared to differ from the rat 5-HT2B receptor. 5. These findings confirm the sequence of the human 5-HT2B receptor and they demonstrate that the receptor has a widespread tissue distribution. In addition, these data suggest that there are differences in ligand affinities between different species homologues of the receptor. Finally, the finding of two distinct bands on the Northern blots of liver and kidney raises the possibility of splice variants or subtypes of 5-HT2B receptors, within these tissues.

Effect of methyltransferase inhibitors on the regulation of baculovirus protein synthesis

In the presence of the methyltransferase inhibitor 3-deazaadenosine (3DA-Ado) the production of infectious Autographa californica nuclear polyhedrosis virus (AcMNPV) in tissue culture was only slightly affected, while the synthesis of very late proteins (polyhedrin and p10) was abolished. The synthesis of the influenza virus proteins NS1 and HA, expressed under the polyhedrin promoter, was also abolished by 3DA-Ado. Furthermore, 3DA-Ado interfered with the shut-off of early and late AcMNPV proteins. Most of these results were also obtained with 5-azadeoxycytidine (5A-dCyt). In cells in which NS1 was produced abundantly, at least one specific AcMNPV protein was not synthesized. However, if the production of NS1 was inhibited by 3DA-Ado, or if HA was synthesized instead, this AcMNPV protein showed up normally.

Purification, characterization and selective inhibition of human prostaglandin G/H synthase 1 and 2 expressed in the baculovirus system

Human prostaglandin G/H synthase 1 and 2 were expressed in the baculovirus expression system and purified to high levels. Both enzymes were glycosylated. PGHS-1 appeared to be homogeneous by SDS-PAGE analysis but two closely migrating bands were detected in PGHS-2 preparation which were evidently due to heterogeneity in glycosylation. The amino-acid sequence of the N-termini of both isoforms indicated that the signal sequences were efficiently cleaved by the insect cells. The recombinant human PGHS-1 and PGHS-2 possessed both cyclooxygenase and peroxidase activities. Both had high affinities for arachidonate as substrate and underwent self-inactivation during catalysis. The recombinant isoforms were not pharmacologically identical, since some NSAIDs were selective inhibitors of either PGHS-1 or PGHS-2. This is the first report of high levels of expression and purification of human PGHS isoforms. The recombinant enzymes are invaluable in developing potent PGHS-2 selective inhibitors that may be efficacious anti-inflammatory drugs with no or low levels of toxicity.

Cloning and expression of a 5-hydroxytryptamine7 receptor positively coupled to adenylyl cyclase

A cDNA clone (designated as GP2-7) encoding a novel 5-hydroxytryptamine (5-HT) receptor was isolated from a guinea pig hippocampal library. The receptor shares amino acid homology within the hydrophobic domains with other cloned 5-HT receptor subtypes (34-48%). The sequence of GP2-7 is homologous to that described for a novel receptor previously cloned from a rat brain cDNA library and provisionally designated as 5-HT7. mRNA for GP2-7 was detected in cortical and limbic brain regions. Transiently expressed GP2-7 showed high-affinity binding to [3H]5-HT (pKi = 9.0) with the following rank order of affinities: 5-carboxyamidotryptamine (5-CT) > 5-HT = 5-methoxytryptamine (5-MeOT) > methiothepin > 8-hydroxy-2-(dipropylamino)tetralin (8-OH-DPAT) > spiperone >> sumatriptan. Adenylyl cyclase activity in CHO-K1 cells transiently transfected with GP2-7 was stimulated by several analogues of 5-HT with the following order of potency: 5-CT > 5-HT = 5-MeOT > dipropyl-5-CT > 8-OH-DPAT. Methiothepin and spiperone were potent antagonists. Preliminary analysis suggests that GP2-7 closely resembles a receptor in the guinea pig hippocampus that exhibits a high affinity toward 5-CT.

Bradykinin-B2 receptors in humans and rats: cDNA structures, gene structures, possible alternative splicing, and homology searching for subtypes

1. To identify and isolate cDNAs encoding rat and human bradykinin-B2 receptor subtypes we isolated a human bradykinin receptor cDNA homologous to a rat B2 receptor cDNA. 2. The cDNA was expressed in the bradykinin receptor negative cell line, CHO; membranes prepared from these cells bound bradykinin and had specificity similar to that of the known rat B2 receptor. In addition, the expressed receptor has a low affinity for des-Arg9-bradykinin. Thus, the cDNA encodes a human B2-bradykinin receptor. 3. Comparison of the human and rat cDNAs suggested that the human and rat genes are composed of three exons. Cloning, sequencing and characterization of parts of the human and rat B2-bradykinin receptor genes demonstrated the postulated three-exon structure. This structure includes two 5' exons upstream of the most favorable translation initiation methionine in exon-3. 4. The two 5' exons each contain methionines, which if independently spliced to the third exon, would yield an open reading frame that includes all of exon-3. This arrangement could thus vary the amino-terminal region of the protein. Do these potential arrangements occur in human RNAs, and will they lead to proteins with differing amino-termini? 5. Reverse transcriptase-polymerase chain reactions (RT-PCR) using human mRNA, nested primers from exon-1 and exon-3, and detection of the products by hybridization using an independent exon-1 oligonucleotide showed that the arrangement of exon-1 with exon-2 and exon-3 could not be detected in eight human RNAs. Furthermore, exon-1 spliced with exon-3 was a common arrangement. 6. Low stringency examination of human and rat Southern blots revealed only bands attributable to the known human or rat B2-bradykinin receptor. 7. Reduced stringency hybridization searches of seven different genomic and cDNA libraries--including two different human genomic libraries, a rat genomic library, two different rat uterus cDNA libraries, a rat brain library and a human lung library--yielded only rat or human B2-bradykinin receptors. The results of our low stringency hybridization experiments suggest that other bradykinin receptors are less than 60% identical, on the nucleotide level, to the known B2 receptor. 8. Degenerate polymerase chain reactions using rat genomic DNA as a template and degenerate primers, designed based on the homology of a B2-bradykinin receptor with angiotensin-II type-1 receptor, identified B2-bradykinin receptors, angiotensin-II-type-1 receptors and three novel orphan receptors.

Structure of influenza virus RNP. I. Influenza virus nucleoprotein melts secondary structure in panhandle RNA and exposes the bases to the solvent

The influenza virus genome consists of eight segments of negative-sense RNA, i.e. the viral (v) RNA forms the template for the mRNA. Each segment is encapsidated by the viral nucleoprotein to form a ribonucleoprotein (RNP) particle and each RNP carries its own polymerase complex. We studied the interaction of purified nucleoprotein with RNA in vitro, by using a variety of enzymatic and chemical probes for RNA conformation. Our results suggest that the nucleoprotein binds to the vRNA backbone without apparent sequence specificity, exposing the bases to the outside and melting all secondary structure. In this way, the viral polymerase may transcribe the RNA without the need for dissociating the nucleoprotein and without being stopped by RNA secondary structure, and the viral RNPs are ready to start transcription as soon as they enter the host cell.

Isolation of a cDNA encoding a human rolipram-sensitive cyclic AMP phosphodiesterase (PDE IVD)

cDNAs encoding human family-IV phosphodiesterase, subtype D (hPDE IVD) were isolated from a human heart cDNA library. The overlapping cDNAs encode a polypeptide of 604 amino acids (aa) with a predicted M(r) of 68,502, which is 91.4% identical to the rat homolog, rPDE IVD. hPDE IVD produced in Escherichia coli was inhibited by rolipram. Expression of the hPDE IVD mRNA is widespread in human tissues and most abundant in skeletal muscle.

The cDNA of a human lymphocyte cyclic-AMP phosphodiesterase (PDE IV) reveals a multigene family

Five protein families are needed to encompass the diversity of cyclic-AMP (cAMP) phosphodiesterases (PDE). Family IV PDEs (PDE IV) specifically hydrolyze cAMP with a low Km, and are selectively inhibited by rolipram (Rp) and related drugs. Cloned cDNAs from rat (r) suggest that the PDE IV family comprises four distinct members, designated A, B, C and D. Using RN from a human lymphocytic B-cell line (43D-Cl2), we have isolated a 3.8-kb cDNA by low-stringency screening using a rat PDE IV member B (r-PDE IVB) probe. Expression of the human (h) cDNA in Escherichia coli results in cAMP-specific PDE activity that is Rp sensitive. A single large open reading frame (ORF) predicts a 564-amino-acid protein with 92.9% identity to r-PDE IVB; at the nucleotide level the identity is 86.3%. This h-PDE IVB clone, HPB106, differs from a related cDNA clone isolated by others from h-monocytes [Livi et al., Mol. Cell. Biol. 10 (1990) 2678-2686]. Our analysis identifies the monocyte clone with r-PDE IVA. Southern blots using a 1.2-kb h-PDE IVB probe at low stringency suggest the presence of additional uncloned human PDE IV family members. Analysis of genomic Southern blots using short specific probes from the h-PDE IVA and h-PDE IVB cDNAs indicates that distinct genes encode these two PDE IV family members. RNA from fractionated normal human leukocytes shows major specific messages of 3.0 and 4.6 kb for h-PDE IVA and 3.7 kb for h-PDE IVB.(ABSTRACT TRUNCATED AT 250 WORDS)

Selective action of 4'-azidothymidine triphosphate on reverse transcriptase of human immunodeficiency virus type 1 and human DNA polymerases alpha and beta

4'-Azidothymidine (ADRT) is a novel nucleoside analogue that exhibits potent inhibitory activity against the replication of human immunodeficiency virus (HIV) in lymphocytes. The mechanisms by which ADRT inhibits HIV reverse transcriptase (HIV-RT) as ADRT 5'-triphosphate (ADRT-TP), the active intracellular metabolite of ADRT, and as the ADRT-MP molecule incorporated into DNA were examined and compared to their effects on human DNA polymerases alpha and beta. Inhibition of HIV-RT by ADRT-TP is competitive against TTP and is more potent against RNA to DNA synthesis (Ki = 0.009 microM versus Km = 3.3 microM for TTP) than it is against DNA to DNA synthesis (Ki = 0.95 microM versus Km = 16.3 microM for TTP). ADRT-TP is also a more potent inhibitor for primer elongation on RNA template than on DNA template. ADRT-TP is a poor inhibitor of human DNA polymerases alpha (Ki = 62.5 microM) and beta (Ki = 150 microM) (Chen et al., 1992). The consequences of ADRT incorporation into DNA are strikingly different for the HIV-RT and for human DNA polymerases alpha and beta. DNA polymerases alpha and beta incorporate a single ADRT-MP molecule into nascent DNA at a very slow rate and continue to elongate. They are unable to incorporate a second consecutive ADRT-MP. However, HIV-RT is able to efficiently incorporate two consecutive ADRT molecules. Incorporation of two consecutive ADRT-MP molecules by HIV-RT prevents further DNA chain elongation. Incorporation of two ADRT-MP molecules separated by one deoxyribonucleoside monophosphate (dAMP, dCMP, or dGMP) also abolishes DNA chain elongation by HIV-RT.

[Compulsory sterilization and euthanasia--on the origins of a development that lead to the Fascist management of psychiatric patients]

When discussing and dealing with the way things went with German psychiatry during fascism the question arises constantly as to the scientific and theoretic self-interpretation of a specialist discipline that allowed itself to be misused without offering much resistance, if at all. The article makes an attempt to trace a few paths of specialist ideology at the turn of the 19th to the 20th century. The misuse of psychiatry and by psychiatry that has been practised both in the past and in the present cannot be understood if the guiding concepts of science generally ruling at the time are ignored.

Expression cloning of a rat B2 bradykinin receptor

A cDNA encoding a functional bradykinin receptor was isolated from a rat uterus library by a clonal selection strategy using Xenopus laevis oocytes to assay for expression of bradykinin responses. The predicted protein is homologous to the seven transmembrane G protein-coupled superfamily of receptors. Bradykinin and its analogs stimulate a Cl- current oocytes expressing the receptor with the rank order of potency: bradykinin approximately Lys-bradykinin greater than [Tyr8]-bradykinin much greater than [Phe6]bradykinin. This is the rank order of potency observed for these compounds in competitive binding assays on soluble receptor from rat uterus. Des-Arg9-bradykinin (10 microM) elicits no response when applied to oocytes expressing the receptor; thus, the cDNA encodes a B2 type bradykinin receptor. [Thi5,8,DPhe7]bradykinin, where Thi is beta-(2-thienyl)-alanine, is a very weak partial agonist and inhibits the bradykinin-mediated ion flux, suggesting the cDNA encodes a smooth muscle, rather than a neuronal, B2 receptor subtype. Receptor message has a distribution consistent with previous reports of bradykinin function and/or binding in several tissues and is found in rat uterus, vas deferens, kidney, lung, heart, ileum, testis, and brain. Receptor subtypes are a possibility because several tissues contain two or three message species (4.0, 5.7, and 6.5 kilobases). Southern blot high-stringency analysis demonstrated that the rat, guinea pig, and human genomes contain a single gene. As bradykinin is a key mediator of pain, knowledge of the primary structure of this receptor will allow a molecular understanding of the receptor and aid the design of antagonists for pain relief.

Determination of DNA binding specificities of mutated zinc finger domains

By substituting non conserved amino acids present in the postulated alpha-helical region of zinc finger domains, we demonstrated that Cys2/His2 type zinc finger domains could be targeted to new DNA binding sites. The putative alpha-helical region of the second SP1 zinc finger (RSDELQRH) was replaced by amino acids (KSSALISH) occurring in analogous zinc finger positions of human zinc finger protein Kox 29. The DNA binding specificity of the FPLC purified chimaeric protein (SP1-Kox 29) was determined by use of the target detection assay (TDA). Chimaeric protein SP1-Kox 29 was subjected to randomized oligonucleotides (GGG NNNN GGC) that were designed on the basis that each SP1 zinc finger interacts with 3-4 nucleotides concerning its cognate target site GGG GCGG GGC. By this analysis the DNA binding specificity of SP1-Kox 29 was shown to have switched from the cognate SP1 binding site to GGG GGTG GGC. Structure-function analysis of this type should facilitate the determination of DNA binding specificities for any individual zinc finger of interest.

Transition metals modulate DNA-protein interactions of SP1 zinc finger domains with its cognate target site

The metal free apoprotein of recombinant human transcription factor SP1 was used in metal reconstitution experiments to study the importance of zinc in facilitating DNA binding of zinc finger proteins. Our functional analysis indicates that several transition metals are capable of modulating DNA-protein interactions of zinc finger domains with their cognate DNA target sites. Excess or deficiency of divalent zinc, or the presence of transition metals, such as divalent cadmium, cobalt, copper, manganese and nickel impair DNA binding of zinc reconstituted SP1. In addition, functionally active SP1 protein can be obtained by metal reconstitutions in absence of zinc(II) by presence of cadmium(II)- and cobalt(II)-, to lesser extents by presence of nickel(II)- or manganese(II)chloride. This study indicates that zinc might play a functional role in regulating DNA protein interactions of zinc finger proteins in vivo. It is postulated that fluctuating divalent zinc alone or transition metals bound to cellular components might form mixed-ligand complexes that alter the zinc finger protein conformation and impair DNA binding.

Human beta nerve growth factor obtained from a baculovirus expression system has potent in vitro and in vivo neurotrophic activity

A baculovirus expression vector, which contains the coding sequences for human prepro (beta) nerve growth factor under control of the viral polyhedrin promoter, was constructed. Upon infection of insect cells with the recombinant virus, mature human beta nerve growth factor (rhNGF) was released into the culture fluid. The mature rhNGF was biologically active since rat pheochromocytoma (PC12) and human neuroblastoma (SH-SY5Y) cells were induced to extend neurites upon treatment with this material. This activity was abolished by treating with antiserum prepared against mature mouse beta NGF (mNGF). When compared with mNGF, rhNGF more rapidly elicited the differentiation response in both PC12 and SH-SY5Y cells. In an in vivo assay of cholinergic cell survival, rhNGF was nearly as potent as mNGF in protecting cholinergic neurons from degeneration following a fimbria-fornix lesion. These results show that the baculovirus expression system provides quantities of biologically potent human beta NGF suitable for a comprehensive program of research to ascertain beta NGF's potential as a therapeutic agent for the treatment of Alzheimer's disease.

Target Detection Assay (TDA): a versatile procedure to determine DNA binding sites as demonstrated on SP1 protein

We developed a rapid method designated Target Detection Assay (TDA) to determine DNA binding sites for putative DNA binding proteins. A purified, functionally active DNA binding protein and a pool of random double-stranded oligonucleotides harbouring PCR primer sites at each end are included the TDA cycle which consists of four separate steps: a DNA protein incubation step, a protein DNA complex separation step, a DNA elution step and a polymerase chain reaction (PCR) DNA amplification step. The stringency of selection can be increased in consecutive TDA cycles. Since tiny amounts of retained DNA can be rescued by PCR, buffer systems, salt concentrations and competitor DNA contents can be varied in order to determine high affinity binding sites for the protein of choice. To test the efficiency of the TDA procedure potential DNA binding sites were selected by the DNA binding protein SP1 from a pool of oligonucleotides with random nucleotides at 12 positions. Target sites selected by recombinant SP1 closely matched the SP1 consensus site. If DNA recognition sites have to be determined for known, mutated or putative DNA binding proteins, the Target Detection Assay (TDA) is a versatile and rapid technique for consideration.

[Benign tumors of the spine in the adolescent. Surgical considerations apropos of 4 cases]

About 4 observations of benign tumours of the spine of the adolescent, we have studied the surgical aspect of the treatment of these lesion. The choice of the surgical approach is fundamental in view of the necessity of a complete exeresis, which implies techniques of spinal reconstruction and stabilization. Those problems are illustrated by: 2 cases of aneurysmal cyst, 1 case of eosinophilic granuloma, and 1 case of osteochondroma.

Rotavirus carriage, asymptomatic infection, and disease in the first two years of life. I. Virus shedding

From September 1979 to July 1980 inclusive, rotaviruses were prospectively detected by electron microscopy (EM) and ELISA in 82 (29%) of 283 children under two years of age who were admitted to a general pediatric ward in Paris. Rotavirus was found in 43 (36%) of 119 children with diarrhea and in 40 (24%) of 164 children without diarrhea; thus of 83 children shedding rotavirus, 40 (48%) were not diarrheic. Virus shedding that was not associated with diarrhea was observed in 71% of neonates, in 50% of one- to six-month-old children, and in 26% of 7-24-month-old children. Rotavirus shedding was statistically correlated (P less than .01) only with those cases of diarrhea with fever and vomiting ( DFV syndrome). Consequently, relative risk (RR) for the DFV syndrome in patients who were shedding virus was 2.07 (P less than .001) vs. 0.95 for other types of diarrhea. These observations show that asymptomatic rotaviral infection is not an infrequent occurrence; that the association between rotavirus and diarrhea is not necessarily an etiologic one; and that the DFV syndrome appears as a major clinical expression of rotaviral disease. Consequently, recovery of rotavirus from feces is of little diagnostic significance since it does not give a differentiation between rotavirus-induced and rotavirus-associated diarrhea.

Rotavirus carriage, asymptomatic infection, and disease in the first two years of life. II. Serological response

Serological response to rotavirus and virus shedding were prospectively studied in 179 children (neonatal to 24-month-old) upon admission to a hospital during an 11-month period. Analysis of the evolution of IgG and IgM ELISA titers revealed 24 cases of rotaviral disease (serological response and diarrhea), 13 cases of asymptomatic infection (serological response and no diarrhea), 36 cases of virus carriage (absence of a serological response), three cases of past infection, and six possible cases of nosocomial infection. Rotaviral disease was encountered two out of three times and was characterized by diarrhea associated with fever and vomiting. Asymptomatic rotaviral infection and disease, observed from the neonatal period onwards, affected 2% of neonates, 20% of one- to six-month-old children, and 37% of 7-24-month-old children. In contrast, virus carriage occurred in 27%, 19%, and 14% of those children respectively. Altogether these results indicate that during the period 1-24 months of age, when asymptomatic rotaviral infection and disease were prevalent, approximately two of 10 children had rotaviral disease, one of 10 had asymptomatic infection, two of 10 were virus carriers, and five of 10 were not infected with rotavirus.

[Purulent pleurisy, esophagopleural fistula and presence of Torulopsis glabrata in the pleura]

The authors report the simultaneous discovery of a septic pleural effusion and an esophagopleural fistula in a 4 year-old patient. The yeast Torulopsis glabrata found in the pleural effusion does not seem to behave as a pathogen but more likely as a witness of a fistula between the gastrointestinal tract and the pleura.

[Mediastinal emphysema in diabetic ketoacidosis. 2 cases]

The authors report 2 cases of spontaneous pneumomediastinum observed in 2 male children aged 11 and 9 years respectively, during a bout of diabetic ketoacidosis. This association is probably not uncommon. The course of the pneumomediastinum is usually rapidly favorable. Its pathogenesis is discussed.

Virologic, immunologic, and genetic factors in insulin-dependent diabetes mellitus

A 16-month-old girl presented with an episode of fever and acute thrombocytopenic purpura caused by a Coxsackie B5 virus. On days 13 to 23, laboratory evidence of diabetes mellitus was present, followed by a 2 1/2-month remission, then by definitive insulin-dependent diabetes. The involvement of virologic, immunologic, and genetic factors in the pathophysiology was substantiated by the following data: (1) Virus-induced glucose intolerance was produced in selected mouse strains. (2) Islet-cell antibodies were found one week before onset of diabetes; however, circulating lymphocytes of the child at that time suppressed insulin release from islets in vitro. (3) Immunogenetic analysis of the child revealed the presence of high-risk genetic markers. It is suggested that the convergence of an insulotropic variant virus, genetic predisposition, and perhaps some uncontrolled adjuvant factors, e.g. steroid therapy and DPT vaccination, may have determined insular damage and anti-islet autoimmune reactions, leading to insulin-dependent diabetes mellitus.

Autonomic nervous system disturbance in patients on chronic hemodialysis

To demonstrate autonomic nervous system (ANS) disturbances in patients on chronic intermittent hemodialysis, simple noninvasive tests were used. These included the Valsalva maneuver ratio, measurement of the changes in blood pressure and pulse rate following standing up from the supine position, the finger-immersion test and calculating the R-R interval ratio of the 30th to the 15th beat on the ECG following standing. It was found that in all the patients who were compared with normal volunteers, some ANS disturbances were present, as evidenced by at least three positive tests of the five described. The Valsalva maneuver ratio was positive in only 58% of the cases, possibly because it is a less sensitive test than the others.

[Rotavirus gastro-enteritis in infants (author's transl)]

Deviation of complement antibodies were studied in 630 hospitalized infants aged from 0 to 4 years suffering from rotavirus gastro-enteritis, over a period of one year. Seroconversion was observed in 30 cases out of the 256 infants in whom 2 serological samples were taken. In 29 cases out of 30, these rotavirus infections occurred in infants under 18 months of age, and they were all seen during ther period from november to march, rotavirus being responsible for one third of the gastro-enteritis cases. A serological study according to age-group in 640 infants gave positive results in 75 per cent (1st semester), 68 per cent (2nd semester), 75 per cent (2nd year), 78 per cent (3rd and 4th years).

[Immunologic studies for the diagnosis of chronic prostatitis]

A prospective study comparing the results of Antibody-Coating-Test (ABC) in semen and aspiration biopsy of the prostate with immunodiffusion of the former was carried out. In 143 patients with clinical signs of prostatitis only 98 showed a positive ABC in their ejaculates. IGA-specific ABC was positive in 75%, IGG-specific ABC in 48%, and IGM-specific ABC in 9.6% respectively. Specimens gained by aspiration biopsy of the prostate were also demonstrating positive ABC. Consistently negative was the ABC in 15 healthy male who served as a control. In 30 patients the ABC-Test of ejaculate speciments was compared with complement (C3) and coeruloplasmin content of the ejaculates using immunodiffusion technique. Contrary to the reports in the literature, however, elevated levels of complement (C3) and coeruloplasmin were not correlated with local infection of the prostate proven by ABC.