An RMO in Sierra Leone

We enjoyed a very low level of DNBI during our deployment and no soldier had to be returned to the UK on medical grounds. None of the measures employed to reduce disease were complicated or new and most were merely common sense. The implementation does however require firm conviction by the chain of command. As in virtually all conflicts the greatest threat to a deployed force continues to be disease.

Pharmacological characterization of human recombinant melatonin mt(1) and MT(2) receptors

We have pharmacologically characterized recombinant human mt(1) and MT(2) receptors, stably expressed in Chinese hamster ovary cells (CHO-mt(1) and CHO-MT(2)), by measurement of [(3)H]-melatonin binding and forskolin-stimulated cyclic AMP (cAMP) production. [3H]-melatonin bound to mt(1) and MT(2) receptors with pK(D) values of 9.89 and 9.56 and B(max) values of 1.20 and 0.82 pmol mg(-1) protein, respectively. Whilst most melatonin receptor agonists had similar affinities for mt(1) and MT(2) receptors, a number of putative antagonists had substantially higher affinities for MT(2) receptors, including luzindole (11 fold), GR128107 (23 fold) and 4-P-PDOT (61 fold). In both CHO-mt(1) and CHO-MT(2) cells, melatonin inhibited forskolin-stimulated accumulation of cyclic AMP in a concentration-dependent manner (pIC(50) 9.53 and 9.74, respectively) causing 83 and 64% inhibition of cyclic AMP production at 100 nM, respectively. The potencies of a range of melatonin receptor agonists were determined. At MT(2) receptors, melatonin, 2-iodomelatonin and 6-chloromelatonin were essentially equipotent, whilst at the mt(1) receptor these agonists gave the rank order of potency of 2-iodomelatonin>melatonin>6-chloromelatonin. In both CHO-mt(1) and CHO-MT(2) cells, melatonin-induced inhibition of forskolin-stimulated cyclic AMP production was antagonized in a concentration-dependent manner by the melatonin receptor antagonist luzindole, with pA(2) values of 5.75 and 7.64, respectively. Melatonin-mediated responses were abolished by pre-treatment of cells with pertussis toxin, consistent with activation of G(i)/G(o) G-proteins. This is the first report of the use of [(3)H]-melatonin for the characterization of recombinant mt(1) and MT(2) receptors. Our results demonstrate that these receptor subtypes have distinct pharmacological profiles.

Growth response to rhIGF-I 80 microg/kg twice daily in children with growth hormone insensitivity syndrome: relationship to severity of clinical phenotype

BACKGROUND

rhIGF-I has been used effectively to promote growth in growth hormone insensitivity syndrome (GHIS) in doses ranging from 40 microg/kg twice daily to 150-200 microg/kg once daily. It appears that the dose of 80 microg/kg twice daily s.c. may induce an equivalent response to higher doses with less side-effects.

OBJECTIVE

To study the efficacy and safety of rhIGF-I, 80 microg/kg twice daily s.c., in children with GHIS and to analyse the relationship of growth response to severity of phenotype.

PATIENTS AND DESIGN

Eleven prepubertal children (3 females, 8 males) with GHIS; basal GH > 2.5 microg/l, IGF-I < 50 microg/l, IGFBP-3 < - 2SD; were treated with IGF-I 80 microg/kg twice daily in a multi-centre study. The baseline characteristics of these patients were as follows (mean +/- SD): age, 7.5 +/- 2.5 years (range, 2.5-11.7 years), bone age (Tanner-Whitehouse - 2 RUS), 5.2 +/- 2.4 years (range, 2.3-9.1 years), mean height SDS, - 5.6 +/- 1.6 (range, - 3.1 to - 8.1), height velocity (HV), 3.1 +/- 1.1 cm/year (range, 1.9-4.9 cm/year). Height, HV, weight, skinfold thickness, puberty stage and bone age were measured at baseline and 6 monthly for 2 years.

RESULTS

During the first 12 months of IGF-I therapy, the mean +/- SD HV was 7.7 +/- 1.6 cm/year (range, 6.1-11.2 cm/year), the mean +/- SD increase in HV was 4.7 +/- 2.1 cm/year (range, 1.7-8.8 cm/year) and the mean +/- SD progression of bone age was 1.9 +/- 1.0 years (range, 0.8-3.8 years). Pre-treatment height SDS at the start of IGF-I therapy correlated positively with pretreatment serum IGFBP-3 SDS levels (r = 0.85; P < 0.01). There was a significant inverse correlation between gain in height SDS and pre-treatment height SDS (r = - 0.76; P < 0.01). During the 2nd 12 months of therapy, mean HV was 7.0 +/- 3.4 cm/year (range 3.8-12.4) change in height SDS from 12 to 24 months was not significantly correlated with pre-treatment height SDS. Subscapular skinfold SDS decreased significantly (P < 0.05) during the study period, whereas there was no significant change in body mass index and triceps skinfold thickness SDS. Adverse events reported in the patient group included headache (2 patients), hypoglycaemia (2 patients), papilloedema (transient, 1 patient), lipohypertrophy (5 patients) and tonsillectomy/adenoidectomy (2 patients).

CONCLUSION

This study reveals that IGF-I treatment at a dose of 80 microg/kg twice daily is effective in patients with growth hormone insensitivity syndrome. During the first 12 months of therapy, there was a significant inverse relationship between growth response to IGF-I therapy and the severity of the phenotype of growth hormone insensitivity syndrome, as measured by height SDS, at the start of therapy. Patients with a more severe clinical phenotype of growth hormone insensitivity syndrome, who also had most severe IGFBP-3 deficiency, responded better than those who were more mildly affected. An analogous situation has been shown to be the case in GH-deficient patients treated with hGH.

Calcium sensing properties of the GABA(B) receptor

The GABA(B) receptor has been shown to consist of a heterodimer of two related 7-transmembrane receptors GABAB-R1 and GABA(B)-R2. These receptors share close homology to the Ca2+-sensing receptor and also to the metabotropic glutamate receptors, which have also been shown to respond to extracellular calcium. We show here that the GABA(B) receptor also has Ca2+ sensing properties. Ca2+ (0.001-1 mM) potentiated the GABA stimulation of [35S]GTPgammaS binding in membranes prepared from CHO cells stably expressing the GABA(B)-R1/R2 heterodimer. The GABA EC50 was reduced from 72 to 7.7 microM by addition of 1 mM Ca2+, with no change in the maximum response. A similar effect was observed in membranes from rat brain cortex. Ca2+ also potentiated GABA inhibition of forskolin-stimulated cAMP levels in the CHO cells and enhanced coupling to GIRK K+ channels in Xenopus oocytes. Other divalent cations were ineffective. The effects of Ca2+ were found to be agonist dependent with baclofen having a reduced sensitivity compared to GABA. Calcium appears to act allosterically to enhance GABA responses at the GABA(B) receptor, however, unlike the Ca2+-sensing receptor and some of the mGluR family, Ca2+ does not act as a ligand in its own right.

A bioluminescent assay for agonist activity at potentially any G-protein-coupled receptor

Transient expression of apoaequorin in Chinese hamster ovary (CHO) cells and reconstitution with the co-factor coelenterazine resulted in a large, concentration-dependent agonist-mediated luminescent response following cotransfection with the endothelin ETA, angiotensin ATII, thyrotropin-releasing hormone (TRH), and neurokinin NK1 receptors, all of which interact pre-dominantly with the G alpha q-like phosphoinositidase-linked G-proteins. A substantially greater luminescence was obtained with mitochondrially targeted apoaequorin compared to cytoplasmically expressed apoaequorin. To generate a system amenable for the study of agonist activity at virtually any G-protein-coupled receptor the alpha subunit of the receptor promiscuous G-protein G alpha 16 was either transiently or stably expressed in CHO cells together with apoaequorin. In cells expressing G alpha 16, but not in its absence, agonists at a series of receptors which normally interact with either G alpha s or G alpha i were now able to cause a luminescent response from mitochondrially targeted apoaequorin. In the case of the A1 adenosine receptor, this response was clearly a result of activation of G alpha 16 and not a consequence of the release of the G alpha i-associated beta/gamma complex, as the luminescent response was unaffected by pertussis toxin treatment of the cells, whereas agonist-mediated inhibition of adenylyl cyclase activity was attenuated. These studies describe the use of coexpressed apoaequorin as a reporter for G-protein-coupled receptor-mediated calcium signaling. Furthermore, coexpression of G alpha 16 and apoaequorin provides a basis for a generic mammalian cell microplate assay for the assessment of agonist action at virtually any G-protein-coupled receptor, including orphan receptors for which the physiological signal transduction mechanism may be unknown.

A quality assurance scheme for the Kleihauer test: the Scottish experience 1988-1996

This report describes the experience gained in the last 8 years of implementing and administering a Quality Assurance Scheme dedicated to improving the reliability of Kleihauer test results in Scotland. Initially the five transfusion centres in Scotland were the only participants, but since 1992 all 15 hospital laboratories in Scotland performing the Kleihauer test to ensure an adequate dose of anti-D is administered to Rh-negative women, at risk of developing allo anti-D, have joined this voluntary scheme. As a result of the standardization of technical methods, improvement in reporting of QA results has been observed since 1994.

In vivo expression of inducible nitric oxide synthase in experimentally induced neurologic diseases

The purpose of this study was to investigate the induction of inducible nitric oxide synthase (iNOS) mRNA in the brain tissue of rats and mice under the following experimental conditions: in rats infected with borna disease virus and rabies virus, in mice infected with herpes simplex virus, and in rats after the induction of experimental allergic encephalitis. The results showed that iNOS mRNA, normally nondetectable in the brain, was present in animals after viral infection or after induction of experimental allergic encephalitis. The induction of iNOS mRNA coincided with the severity of clinical signs and in some cases with the presence of inflammatory cells in the brain. The results indicate that nitric oxide produced by cells induced by iNOS may be the toxic factor accounting for cell damage and this may open the door to approaches to the study of the pathogenesis of neurological diseases.

MK: a pluripotential embryonic stem-cell-derived neuroregulatory factor

MK is a gene encoding a secreted heparin-binding polypeptide originally isolated by differential screening for genes induced by retinoic acid (RA) in HM-1 embryonal carcinoma cells. Here we report that MK is expressed at high levels in both embryonal carcinoma and pluripotential embryonic stem cells and their differentiated derivatives. MK expression in these cell types is unaffected by the presence or absence of RA. Recombinant MK protein (rMK) was produced by transient expression in COS cells and purified by heparin affinity chromatography. rMK is a weak mitogen for 10T1/2 fibroblast cells but inactive as a mitogen for Swiss 3T3 fibroblasts. rMK is a potent mitogen for neurectodermal precursor cell types generated by treatment of 1009 EC cells with RA but has no mitogenic or neurotrophic effects on more mature 1009-derived neuronal cell types. rMK is active as an in vitro neurotrophic factor for E12 chick sympathetic neurons and its activity is markedly potentiated by binding the factor to tissue-culture plastic in the presence of heparin. Stable 10T1/2 cells lines have been established which express MK. These cells do not exhibit any overt evidence of cell transformation but extracellular matrix preparations derived from these cells are a potent source of MK biological activity. It is concluded that MK is a multifunctional neuroregulatory molecule whose biological activity depends upon association with components of the extracellular matrix.

X chromosome inactivation in fibroblasts of mentally retarded female carriers of the fragile site Xq27.3: application of the probe M27 beta to evaluate X inactivation status

Over 30% of female carriers of the fragile X [fra(X)] syndrome are clinically affected. A nonrandom X chromosome inactivation in these cases could be a plausible explanation. A review of previous studies addressing this question showed inconclusive results; thus, we analysed the X inactivation pattern in fibroblasts of 4 unrelated, mentally retarded fra(X) carriers with a high expression of the fragile site Xq27.3. Using Southern analysis with a highly polymorphic probe M27 beta that recognizes methylation differences between the active and inactive X chromosome we found a 50/50 inactivation pattern in 2 cases and skewed patterns in the other 2. As biased patterns were also observed in control females we conclude that at present no evidence exists for a nonrandom X chromosome inactivation in the fra(X) syndrome in females.

The effectiveness of bacillus Calmette-Guérin (BCG) vaccination against tuberculosis. A case-control study in Treaty Indians, Alberta, Canada

Bacillus Calmette-Guérin (BCG) vaccination against tuberculosis has been used around the world for 60 years, yet its efficacy in large, controlled prospective studies is inconsistent. The factors influencing BCG protection include variation in immunogenic potential, background exposure to environmental mycobacteria, and differences in host response to vaccine. As a means of addressing regional differences in protection, case-control studies provide a relatively inexpensive, rapid means of assessing regional vaccine effects. Treaty Indian cases (n = 160) resident in Alberta, Canada, presenting during a 5-year period (1975-1979) were individually matched for age, sex, and Band with two nontuberculous controls. A 57 percent protection by BCG vaccination was demonstrated. These results support the usefulness of case-control studies and their importance in planning tuberculosis control programs.

Molecular characterization of human X/Y translocations suggests their aetiology through aberrant exchange between homologous sequences on Xp and Yq

Several DNA sequences from two homologous regions, localized on the distal part of the human X chromosome short arm and on the long arm of the Y chromosome, have been hybridized to DNAs from seven human-rodent hybrids containing human X; Y translocation chromosomes. Molecular characterization of the translocated chromosomes has revealed, in all but one case, transfer of the Y cluster of sequences and complete deletion of the corresponding X-chromosomal sequences. The possible role of X/Y homology in the aetiology of X; Y translocations is proposed.

Linkage studies do not confirm the cytogenetic location of incontinentia pigmenti on Xp11

Linkage studies have been performed in 5 incontinentia pigmenti (IP) families totaling 29 potentially informative meioses. Ten probes of the Xp arm were used, six of them were precisely localized on the X chromosome, using hamster X human somatic cell hybrids containing a broken X chromosome derived from an incontinentia pigmenti patient carrying an X;9 translocation [46,XX,t(X;9)(p11.21;q34)]. The following order for probes is proposed: pter - (DXS7, DXS146, DXS255) - IP1 - (DXS14, DXS90) - DXS106 - qter. The negative lod scores obtained exclude the possibility that in the families studied, the gene for IP is located in Xp11 or in the major part of the Xp arm.

Isolation and characterization of a steroid sulfatase cDNA clone: genomic deletions in patients with X-chromosome-linked ichthyosis

We have isolated several cDNA clones from a lambda gt11 expression library by screening with antibodies prepared against the microsomal enzyme steroid sulfatase, which is deficient in classical X-chromosome-linked ichthyosis patients. One of these clones (p422) has been assigned by mapping with a somatic cell hybrid panel and by in situ hybridization to Xp22.3. Clone p422 therefore has a coincident localization with the previously identified locus for steroid sulfatase expression in the region of the X chromosome escaping from inactivation. Twelve steroid sulfatase-deficient patients, including eight cases of classical ichthyosis, were found to be deleted for genomic sequences detected by the clone.

Localisation of Y chromosome sequences in normal and 'XX' males

Three unique sequences derived from the Y chromosome have been mapped within the human genome. A Y specific sequence DYS20 is localised to Yq11.2. DXYS25 and DXYS27 are both X-Y homologous sequences which map to the Y short arm and to Xq21. DXYS25 maps more distally than DXYS27, on the Y short arm and on the X long arm. Y specific restriction fragments for these two sequences are shown to be present in the genome of two XX males, and an aberrant signal for DXYS25 is demonstrated at the tip of an X chromosome short arm in one XX male by in situ hybridisation. The implications of these findings for the location of the testis determining factor are discussed.

Identification of incomplete coding sequences for steroid sulphatase on the human Y chromosome: evidence for an ancestral pseudoautosomal gene?

A cDNA clone (p422) containing about 200 bp of coding sequences for steroid sulphatase (STS) has been isolated from a λgt 11 expression library by antibody screening and has been assigned by mapping with a somatic cell hybrid panel and by in situ hybridization to Xp22.3; a localization coincident with the previously identified locus for STS expression. Although no significant hybridization of this clone to the Y chromosome was observed, p422 has been used to isolate a longer cDNA clone and genomic sequences which do recognize Y-specific restriction fragments. An abbreviated STS gene has been localized to Yq11.2. The coding sequences for the human enzyme shows little homology to sequences in mice.

Bacterial meningitis in Johannesburg--1980-1982

A 2-year retrospective study of aetiology, age distribution, seasonal variation and antimicrobial sensitivity patterns of bacteria isolated from patients with meningitis in five Johannesburg hospitals for White, Black, Coloured and Asian patients was performed. Neisseria meningitidis was isolated most frequently, followed by Streptococcus pneumoniae, Haemophilus influenzae, Escherichia coli and Streptococcus group B. In the Black population 73% of the meningococcal infections occurred in patients over 3 years of age, and the majority of these infections were caused by serogroup A organisms. Virtually all (93%) of the H. influenzae infections occurred in children of less than 3 years of age. Of the isolates tested, 16% of the meningococci, 4,5% of the H. influenzae and 47% of the pneumococci were resistant to sulphadiazine, ampicillin and penicillin respectively.

The internal organization of the varicella-zoster virus genome

DNA was extracted from varicella-zoster (VZ) virions prepared in sucrose gradients. Thirty-eight molecules examined by electron microscopy were found to have a mean length of 46.7 micrometers. Examination of self-annealed VZV DNA molecules revealed that the virus genome was composed of a unique linear large sequence with a mol. wt. of 74.4 X 10(6) to 78.4 X 10(6), and a unique short sequence of mol. wt. approx. 9.8 X 10(6) flanked by inverted repeat sequences of 4.7 X 10(6) mol. wt.

Extraction of cell-associated varicella-zoster virus DNA with triton X-100-NaCl

Varicella-zoster virus (VZV) DNA was extracted from infected cells with 0.25% Triton X-100-0.2 M NaCl and purified by isopycnic centrifugation in CsCl. In each of eight experiments, 1.8-9.8 micrograms VZV DNA was obtained from 107 infected cells. The VZV DNA obtained by this procedure had a molecular weight of 88-100 x 106 as determined by sucrose gradient sedimentation and electron microscopy, and cleavage patterns after digestion with four restriction enzymes that corresponded to patterns previously described with six strains of VZV; the pattern of BamHI-cleaved Triton-NaCl-extracted VZV DNA was identical to the pattern seen after DNA extraction from virions. These studies expand the usefulness of Triton X-100-NaCl for extraction of large molecular weight viral DNA from a system where considerable cell-free virus is produced (Pignatti et al., 1979, Virology 93, 260) to a system known for its marked cell association.

Adenovirus type 2 late mRNA's: structural evidence for 3'-coterminal species

Adenovirus type 2-infected HeLa cells were labeled with 32PO4 during the period 14 to 17 h postinfection. Viral mRNA's with polyadenylic acid were isolated by polyuridylic acid Sepharose chromatography and fractionated according to size by electrophoresis through an acrylamide-agarose slab gel. Messenger bands were eluted and partially degraded with alkali. RNA fragments from each band that contain polyadenylic acid were isolated by polyuridylic acid Sepharose chromatography and fingerprinted two-dimensionally after T1 RNase digestion. Three bands, with mobilities of approximately 26S, 21S, and 18S, shared two large characteristic T1 oligonucleotides in common in the fingerprints of their 3'-terminal sequences. These oligonucleotides were mapped with a Hpa II restriction fragment of adenovirus type 2 DNA with coordinates 49-50.2. We conclude that the three mRNA's are coterminal in sequence at their 3' ends and overlap at internal positions. Implications for the protein-coding potential of these mRNA's and the mechanisms of adenovirus tyep 2 late RNA processing are discussed.