Anthropometric characteristics of X-linked hypophosphatemia

An anthropometric study was undertaken to assess head proportions of patients with X-linked hypophosphatemia (XLH). Fourteen morphometric parameters of the head were measured and 10 cephalic indices calculated in 82 affected persons (57 females and 25 males) from 55 unrelated families with XLH, and compared with the results obtained in the group of their healthy relatives (37 females and 33 males), as well as with general population control values. Normalized values (SD, z-score) were analyzed statistically. The group of healthy relatives, both males and females, differed significantly from Polish population control values in most of the normalized variables measured, making population control values useless as a control group for the analyzed XLH group. Intrafamilial values of cephalic parameters in healthy relatives of the XLH patients were finally applied for statistical analysis. Generally patients with XLH showed highly statistically significant increase in head length (males 0.95 +/- 1.07 vs. -0.37 +/- 1.02, females 0.57 +/- 1.59 vs. -0.06 +/- 1.15), significant decrease in occipital breadth (males -0.56 +/- 1.27 vs. 0.70 +/- 1.28, females -0.59 +/- 1.7 vs. 0.13 +/- 1.1) and several milder anomalies of craniofacial proportions. Mean cephalic index was significantly lower in XLH patients when compared with the healthy relatives (males -0.909 vs. 0.278 P < 0.0001, females -0.705 vs. 0.381 P = 0.007). The cephalic changes were found both in XLH children and XLH adults and were more pronounced in affected males than in females. There were no differences between offspring born by hypophosphatemic and normophosphatemic mothers.

Clinical heterogeneity and molecular findings in five Polish patients with glycerol kinase deficiency: investigation of two splice site mutations with computerized splice junction analysis and Xp21 gene-specific mRNA analysis

Five cases of glycerol kinase deficiency are presented with clinical, biochemical, and genetic results. Two had the glycerol kinase deficiency as part of an Xp21 contiguous gene deletion syndrome-complex form-and three had an isolated form of the enzyme deficiency. In these we found two splice site mutations (IVS1+4A>G, IVS9-1G>T) and one insertion (1393_1394insG). In patients with the complex form, a deletion of the DAX1, GK genes and the distal part of the DMD gene was found. A computerized study was performed to predict the effects of the splice site mutations. It showed that the IVS9-1G>T mutation substantially altered and removed the wild-type site and enhanced a cryptic site seven nucleotides downstream, and that the IVS1+4A>G diminished the strength of the wild-type donor site from strong to leaky. To verify these predictions, we developed an RT-PCR system with gene-specific primers that exclusively amplifies the Xp21 glycerol kinase gene transcript. Identification of individuals at risk is motivated by a need to avoid delay in a correct diagnosis. For reliable identification of heterozygotes for isolated glycerol kinase deficiency, knowledge of the specific mutation in the proband is required. This is easily obtained with the RT-PCR analyses developed in this study.

[Alpha-fetoprotein--diagnostic utility in squamous cell carcinoma of the head and neck]

The authors present results of evaluation of alpha-fetoprotein (AFP) in 146 persons (108 patients with head and neck carcinoma and 38 healthy persons as control group). We analyzed a concentration of AFP in preliminary study and in monitoring depending on clinical advances of tumour, mass of primary tumour and metastases to lymph nodes. Our results indicate that evaluation of AFP have not high value in diagnostic procedures and monitoring patients with head and neck carcinoma.

Antibiotic susceptibility of Escherichia coli dnaK and dnaJ mutants

The role of two chaperone proteins, DnaK and the cooperating factor DnaJ, in Escherichia coli antibiotic susceptibility to three antibiotics (a beta-lactam, chloramphenicol, tetracycline) has been studied. It was found that null dnaJ and dnaKdnaJ mutants are impaired in the functions leading to antibiotic susceptibility. The secretion of beta-lactamase to the periplasmic space is diminished in both mutants, and the additive effect of the two mutations was observed. The activity of chloramphenicol acetyltransferase is also impaired in an additive manner in both mutant strains. Tetracycline uptake is changed only in the double deletion mutant. These defects were observed only during incubation at high temperature (42 degrees C). Efficient complementation of some of these defects by the wild-type alleles introduced on low-copy number plasmid was achieved. Minimal inhibitory concentrations and the titer of the wild-type strains, delta dnaJ and delta dnaKdnaJ mutants treated with ampicillin, chloramphenicol, and tetracycline were also determined. Higher susceptibility of both mutants to chloramphenicol and tetracycline, as compared to their wild-type parent, was observed only after 1 h preincubation of cultures at 42 degrees C. On the contrary, both mutants were less susceptible to ampicillin than their parent strain.

[Lymph nodes metastases as a first sign of cancer]

The authors present three cases of cervical lymph nodes metastases from unknown primary lesion as a first and single sing of cancer. In follow-up the primary lesions of cancer was recognized (tonsil, hypopharynx, parotid gland). Presented patients pass through combined treatment: chemotherapy, radiotherapy and surgery with good results. Patients are in follow up of ENT Department.

[Serum levels of tissue polypeptide antigen in patients with the head and neck cancer according to presence of metastases in lymph nodes]

Aim of the work was estimation of Tissue Polypeptide Antigen (TPA) concentrations in serum and qualification its diagnostic value in patients with malignant neoplasm of head and neck in dependence from presence of metastasis to regional lymph nodes. The study comprised the group of 146 persons (108 with head and neck malignant neoplasm, 38 of persons determined group supervisory). At 35 ill one ascertained metastasis to lymph nodes. In presented work at ill without metastasis to lymphatic glands sensitivity of test TPA carried out 28.8%, and at ill with metastasis 42.9%, attaining 66.7% at ill from N3. One showed, that concentrations TPA grow together from spreading of neoplasm in lymph nodes, and presence of metastasis correlates with concentrations of TPA.

[Squamous cell carcinoma antigen (Scc-Ag): diagnostic utility in squamous cell carcinoma antigen of the head and neck with metastasis to lymph nodes]

Aim of the work was estimation of squamous cell carcinoma antigen (SCC) concentrations in serum and qualification its diagnostic value in patients with malignant neoplasm of head and neck in dependence from presence of metastasis to lymphatic glands. The study comprised the group of 146 persons (108 with head and neck malignant neoplasm, 38 of persons determined group supervisory). At 35 ill one ascertained metastasis to lymph nodes. In presented work sensitivity of SCC in initial investigation was (52.8%), specificity (97.4%), positive predicting value (PV+ = 94.2%) and negative predicting value (PV- = 64.0%). We observed not characteristic statistical dependence of concentrations SCC from presence of metastasis to lymph nodes. There was characteristic correlation between concentration of SCC and presence of metastasis to regional lymphatic glands using of correlation R-Spearman.

X-linked hypophosphatemia in Polish patients. 2. Analysis of clinical features and genotype-phenotype correlation

Clinical and molecular data of 59 affected persons from 36 unrelated families with XLH (36 probands and 23 members of their families) were analysed. Characteristic phenotypic features (degree of leg deformities, growth failure, tooth abnormalities, tubular reabsorption of phosphate, serum phosphate and 1,25-dihydroxyvitamin D3 concentrations, head length and hearing defect in some cases) were assessed in relation to the type and localisation of 29 different PHEX gene mutations. The severity of clinical symptoms did not strictly depend upon the type and localisation of the PHEX gene mutation. A hearing defect was correlated with mutations in the beginning fragment, while tooth abnormalities and increased head length with the mutations in the beginning and the terminal fragment of the gene. Phosphate and vitamin D3 supplementation usually slowed progressive growth retardation and leg bowing. Our results point to the probability that alternative splicing occurs in the PHEX gene, producing several active forms of the PHEX protein. Some of them might be involved in bone turnover and dentin formation, others in renal phosphate uptake and vitamin D3 metabolism.

Biosynthesis and secretion of several enzymes in Escherichia coli dnaK and dnaJ mutants

Escherichia coli null dnaJ and dnaKdnaJ mutants were defective in the biosynthesis and secretion of several enzymes. The synthesis of beta-galactosidase induced in delta dnaJ and delta dnaKdnaJ mutants was abolished at 42 degrees C and significantly decreased at 30 and 37 degrees C. The activity of alkaline phosphatase in the periplasm in both mutant strains at high temperature was lower than in the wild-type strain. The synthesis of b-type cytochromes was defective in two deletion mutants while the synthesis of nitrate reductase-A at 42 degrees C was influenced by dnaK mutation only. The lack of DnaK and DnaJ does not impair the activity of catechol 2,3-dioxygenase irrespective of growth temperature.

[Allergology in internet]

The authors present all-Polish Internet Allergy Service www.allergen.info.pl working since February 1998. The system of mailing current allergenic pollen data to individual patients is presented. The results of Internet questionnaire filled by 4500 users of GlaxoWellcome Pollen Count Internet Service in 1998 are discussed. The authors also present possibility of cooperation for clinicians with the usage of IRC and picture and voice transmission.

X-linked hypophosphatemia in Polish patients. 1. Mutations in the PHEX gene

We present twenty-nine PHEX gene mutations extending our previous work, giving it to a total of 37 different mutations identified in Polish patients with familial or sporadic X-linked hypophosphatemia. Deletions, insertions and nucleotide substitutions leading to frameshift (27%), stop codon (29%), splice site (24%), and missense mutations (20%) were found. The mutations are distributed along the gene; exons 3, 4, 11, 12, 14, 15, 17, 20 and 22 are regions with the most frequent mutation events. Four mutations, P534L, G579R, R549X and IVS15+1nt, recurred in three, four, two and three unrelated patients, respectively. They have also been detected in affected persons from other countries. Twenty-eight mutations are specific for Polish population and almost all of them are unique. Most of the identified mutations are expected to result in major changes in protein structure and/or function.

Effect of DnaK and DnaJ proteins deprivation on Escherichia coli response to starvation

E. coli defects in response to nutritional starvation caused by DnaK and DnaJ proteins deprivation are examined. The ability of delta dnaKdnaJ mutant to survive carbon, nitrogen and phosphorus starvation is highly impaired while delta dnaJ mutant is characterized by the diminished survival of phosphorus starvation only. delta dnaKdnaJ mutant grows slowly utilizing maltose and glycerol and delta dnaJ mutant utilizes glycerol inefficiently. The growth on alternate nitrogen sources is comparable to wild-type strain.

[Squamous cell carcinoma antigen for monitoring patients with head neoplasm]

The authors present results of evaluation of squamous cell carcinoma antigen (SCC) in 73 persons (35 patients with head carcinoma and 38 healthy persons as control group). We analysed a concentration of SCC in preliminary study and in monitoring, depending on clinical advances of tumour, mass of primary tumour and metastases to lymph nodes. We observed high sensitivity (SE) (63%), high specificity (SP) (97.4%) and predictive values: positive PV(+)--95.6%, negative PV(-)--74% of SCC in preliminary study. These values changed to SE--83.3%, SP--92.3%, PV(+) 90.9%, PV(-)--85.7% in monitoring. Our results indicate that evaluation of SCC have high value in monitoring patients with head carcinoma.

[Evaluation of selected cellular immunity parameters in patients with seasonal allergic rhinitis]

The aim of the study was the estimation of selected parameters of cellular immunity in patients with seasonal allergic rhinitis and also the estimation of histamine effect on T lymphocytes. The study comprised 240 persons--180 patients with seasonal allergic rhinitis, 30 patients with nonallergic rhinitis (positive control group) and 30 healthy persons (negative control group). In all persons the following examinations were carried on: allergic skin tests, serum level of IgE, Multitest CMI, percentage of lymphocytes T (CD3), percentage of lymphocytes T helper (CD4), percentage of lymphocytes T cytotoxic (CD8) and influence of histamine on T lymphocytes in vitro. The analysis of acquired results suggests that the inflammatory changes in patients with seasonal allergic rhinitis arose from hypofunction of T lymphocytes, especially of lymphocytes T cytotoxic (CD8) in their reaction with histamine.

[Surgical treatment of rhinophyma using CO2 laser]

The authors present the method of combined treatment of rhinophyma (surgery and laser CO2). The advantages of this method are good cosmetic result, small intraoperative bleeding and short time of healing the wound.

[Gastrointestinal cancer antigen and immunoglobulins G, A, M in patients with head cancer]

The authors present the results of examinations of immunoglobulins A, G, M serum concentrations and of a sensitivity of test of biochemical tumor marker (Ca 19-9) in a group of 35 patients with head malignant tumors. There was a statistically significant increase of immunoglobulins IgA, IgG and decrease of immunoglobulin IgM. We observed statistical correlation between serum concentrations of IgA, IgG and serum concentrations of IgA, IgM. The sensitivity of Ca 19-9 was 23% in the preliminary study. The values of Ca 19-9 changed in monitoring of tumors to 26%. There was a statistically significant correlation between sensitivity of Ca 19-9 and serum concentration of IgM. We did not observe any statistical correlation between Ca 19-9 and the age of patients.

[A rare case of metastatic tumor in the neck with unknown primary focus]

The authors present a rare case of metastatic tumor in lymphoid gland in the neck without primary identification of the cancer. The authors discussed the clinical picture, as well as diagnostic and therapeutic procedures.

[Pleomorphic adenoma of the parapharyngeal space: a case report]

The authors described a case of parapharyngeal space pleomorphic adenoma in a 22-year-old patient. The excision of the tumor through the mouth, without cutting up the jaw bone, turned out safe and radical.

[Diagnostic value of osteotropic bone scintigraphy in maxillary sinus diseases]

The authors described the application of facial bone scintigraphy in 6 patients with acute and 47 patients with chronic sinusitis, 4 patients with cyst of maxillary sinus, 4 patients with sinus maxillary neoplasm and 4 patients with pyocele of frontal sinus. Facial bone scintigraphy was performed by gamma-camera Siemens Gammasonics ZLC-750 after intravenous administration of 15 mCi of 99mTcMDP in anteroposterior projection. The index of accumulation of the tracer (JAT) in maxillary sinus region was counted separately in men and in women in the reference group. In patients with purulent sinusitis marked JAT was predominated. Correlation between JAT and symptoms and rhinological signs has been shown in patients with chronic purulent sinusitis. In patients with sinus maxillary neoplasm high JAT was predominated.

[Delto-pectoral flap in reconstruction of esophagus after laryngectomy]

The authors present the case of 67 years old male with carcinoma of larynx and hypopharynx. The tumor was resected by total laryngectomy enlarged by partial resection of hypopharynx and esophagus. The reconstruction of hypopharynx and esophagus was made using deltopectoral flap because with a successful effect.

[The evaluation of cellular immunity in patients with allergy to pollen]

The study comprised 180 patients with pollinosis, 30 patients with vasomotor rhinitis and 30 healthy male adults. The skin reactions of cellular immunity were determined by Multitest CMI. The numbers of lymphocytes T and numbers of CD4 and CD8 lymphocytes were determined under influence of histamine or clemastinum and histamine or cimetidine and histamine. There were statistically significant decrease of percentage of CD8 lymphocytes in patients with pollinosis after addition of histamine. Statistically significant increase of percentage of CD8 lymphocytes after the addition of H2 receptor blocker indicated that blocking of this receptor neutralized the effect of histamine on the CD8 lymphocytes. Author observed increase of Multitest CMI skin reactions (particularly for antigens: Streptococcus and Proteus mirabilis).

[Rare malignant tumors of the larynx]

The study presents rare neoplasms of larynx. The authors introduce epidemiology, clinical history and medical treatment in two cases of adenocarcinoma and one case of sarcoma. The authors call attention to high malignancy of tumors, early metastases to neck lymph nodes and distant metastases.

[Rhinomanometry: a method of objective study of nasal patency]

Rhinomanometry is the most applied method of evaluation of nasal patency in the world. In the study the authors present application of rhinomanometry in the diagnosis of the nose disease. On own material the authors introduce the technique of rhinomanometry and interpretation of its results.

[Tumor markers in monitoring of neoplasms]

Prophylaxis, diagnosis, radical treatment and monitoring have a basic significance in the clinic of head cancers. The aim of the clinical course of malignant disease preferred prematurely detection of the recurrence. In the monitoring wide applications have tumor markers. The authors present the results on the sensitivity of seven biochemical tumor markers (AFP, Ca-9, CEA, TPA, NSE, ferritin and SCC) in 42 patients with neoplasm of the head. The sensitivity is for AFP-0%, CEA-10%. Attention was drawn to the relatively high sensitivity for TPA, NSE, ferritin and SCC, particularly for the neoplasms of oral cavity (TPA-45%, NSE-68%, ferritin-38%, SCC-55%) and the pharynx (Ca 19-9-38%, TPA-63%, NSE-62%, ferritin-42%, SCC-83%).