Treatment of cataplexy in a dog with narcolepsy

A 1-year-old female Rottweiler with a history of narcolepsy and cataplexy lost weight and became worse when given cholinergic agents and/or prednisolone over a 12-day period. The dog was then treated with imipramine HCl, and has been almost clinically normal for 2 years.

Isolation and analysis of the C-terminal signal directing export of Escherichia coli hemolysin protein across both bacterial membranes

We have studied the C-terminal signal which directs the complete export of the 1024-amino-acid hemolysin protein (HlyA) of Escherichia coli across both bacterial membranes into the surrounding medium. Isolation and sequencing of homologous hlyA genes from the related bacteria Proteus vulgaris and Morganella morganii revealed high primary sequence divergence in the three HlyA C-termini and highlighted within the extreme terminal 53 amino acids the conservation of three contiguous sequences, a potential 18-amino-acid amphiphilic alpha-helix, a cluster of charged residues, and a weakly hydrophobic terminal sequence rich in hydroxylated residues. Fusion of the C-terminal 53 amino acid sequence to non-exported truncated Hly A directed wild-type export but export was radically reduced following independent disruption or progressive truncation of the three C-terminal features by in-frame deletion and the introduction of translation stop codons within the 3' hlyA sequence. The data indicate that the HlyA C-terminal export signal comprises multiple components and suggest possible analogies with the mitochondrial import signal. Hemolysis assays and immunoblotting confirmed the intracellular accumulation of non-exported HlyA proteins and supported the view that export proceeds without a periplasmic intermediate. Comparison of cytoplasmic and extracellular forms of an independently exported extreme C-terminal 194 residue peptide showed that the signal was not removed during export.

A prospective evaluation of the psychosocial effects of coronary artery bypass surgery

Eighty-nine patients were prospectively studied to determine psychological and psychosocial impairment prior to and after coronary artery graft surgery (CAGS). Psychological morbidity prior to surgery was high, with one-third having clinically significant levels of depression and/or anxiety symptoms. Scores on the Psychosocial Adjustment to Illness Scale indicated a generally high level of psychosocial impairment pre-operatively, with vocational and domestic functioning being most severely affected, social and sexual functioning being less impaired, and extended family relationships being largely unaffected. In general, there was a significant reduction in psychological morbidity and an improvement in psychosocial functioning at 6 months, which remained at 12 months. Vocational and domestic functioning showed the greatest improvement. Sexual and social functioning showed modest improvements overall, with significant numbers reporting residual impairment due to their heart disease. These findings add to a growing body of evidence demonstrating generally favourable psychological and social outcome following CAGS.

Overview of supported employment

This article traces the emergence of supported employment as a result of philosophical changes in expectations for persons with disabilities, based on scientific developments that challenged traditional service-delivery models. Supported employment program characteristics also are reviewed, and the influence of applied behavior analysis is outlined. Finally, areas for future research in supported employment are discussed.

Coronary artery bypass surgery--impact upon the patient's spouse

The spouses of 65 coronary artery bypass graft surgery (CAGS) patients were assessed to determine levels of psychological symptoms and social impairment both before and 12 months after surgery. There was substantial psychological morbidity in spouses pre-operatively, with from one-third to one-half having clinically significant levels of depression and/or anxiety symptoms. Pre-operatively there was also significant global psychosocial impairment in the spouse. Of the specific domains of psychosocial adjustment, recreational and psychological adjustment was most severely affected, vocational/domestic adjustment and sexual adjustment being less impaired, and extended family relationships showing minimal impairment. There was significant improvement in spouses' psychological and global psychosocial adjustment at 12 months, with recreational adjustment showing the greatest improvement. Significant improvements also occurred in vocational adjustment but not in domestic or sexual adjustment. Neither physical, psychological nor social adjustment variables preoperatively in either the patient or spouse were predictive of psychological morbidity in the spouse (anxiety or depression) at 12 months. Similarly there were no significant patient or spouse preoperative predictors of social adjustment in the spouse at 12 months. However, the patients post-operative psychological morbidity and the spouses social and psychological morbidity were related.

Teaching supported employees with severe mental retardation to solve problems

Two individuals with severe mental retardation, employed by a janitorial supply company, were taught to use self-instruction in combination with multiple exemplar training to solve work-related problems. Use of the combined strategy resulted in generalization of the effects of independent variables, as well as generalization to nontrained problems. Use of the strategy is discussed in terms of promoting independent performance among supported employees.

Effect of delayed blood processing on the yield of factor VIII in cryoprecipitate and factor VIII concentrate

Current standards for the preparation of factor VIII (FVIII) concentrates from human plasma recommend separation of plasma from red cells (RBCs) within 6 hours of blood donation, thereby reducing the volume of plasma from donated whole blood available for processing to FVIII concentrate. The decay of FVIII clotting activity (FVIII:C) in whole blood and plasma stored at 22 and 4 degrees C and the recovery of FVIII:C in cryoprecipitate and FVIII concentrate prepared from plasma separated from whole blood stored overnight at 4 degrees C were investigated. In whole blood stored at 22 degrees C and plasma stored at either 4 or 22 degrees C, 90 percent of the original FVIII:C was present at 6 hours, 80 percent at 12 hours, and 65 to 70 percent at 18 hours. At these times lower levels of FVIII:C were recovered from whole blood stored at 4 degrees C, that is, 84, 68, and 56 percent, respectively. In cryoprecipitates prepared from plasma separated from RBCs after 18 hours' storage at 4 degrees C (18-hour plasma), 43 percent of FVIII:C activity was recovered, as compared with 61 percent recovered from standard plasma separated within 6 hours of donation (6-hour plasma), p less than 0.05. With large-scale preparation of FVIII concentrates, however, the yield of FVIII:C was similar whether 18- or 6-hour plasma was used. Thus FVIII concentrates--but not cryoprecipitates--can be prepared from plasma separated from whole blood stored at 4 degrees C for up to 18 hours without undue loss of potency.

Comparison of the haemolysin secretion protein HlyB from Proteus vulgaris and Escherichia coli; site-directed mutagenesis causing impairment of export function

The hlyB secretion genes of Proteus vulgaris and Escherichia coli showed 81% nucleotide homology and similar E. coli-atypical codon usage. The deduced protein sequences differed in 54 of 707 residues and shared a previously unreported sequence which corresponds to the ATP-binding motif characteristic of protein kinases. The motif was also conserved in the HlyB of Morganella morganii. Of 4 oligonucleotide-directed substitutions introduced into the putative E. coli HlyB motif, 2 non-conservative changes caused radical reductions in the export of active haemolysin protein.

Identification of the promoters directing in vivo expression of hemolysin genes in Proteus vulgaris and Escherichia coli

The hemolytic activity of Escherichia coli and Proteus vulgaris is determined by common contiguous genes encoding synthesis (hly C, hly A) and specific secretion (hly B, hly D) of active hemolysin. Nevertheless, the hly C-proximal DNA sequences directing production of the homologous hemolysins by the recombinant DNAs P. vulgaris pVU763-709 and E. coli pANN202-312 showed no extensive homology. Primer extension and S1 nuclease protection were used to define in the two sequences the 5' termini of hly transcripts synthesized in vivo and thus to infer the active hly promoters sequences. The E. coli hly C upstream region contained three separate promotors directing in vivo hly transcription, while the corresponding transcription of the P. vulgaris hly operon originated from a single distinct promotor, the -35 and -10 sequences of which formed part of an inverted repeat sequence. Elevated hemolytic activity caused by upstream Tn5 insertions in pVU763-709 resulted from increased transcription from this promotor.

Nuclear factors binding to the mini-exon repeat of Trypanosoma brucei

In trypanosomes and related kinetoplastida a common short 5' leader sequence is encoded by the highly repetitive mini-exon gene and added to all protein coding mRNAs by trans-splicing. To initiate a search for transcription factors associated with transcription of the mini-exon we have used an electrophoretic mobility shift assay to detect trypanosome nuclear factors which interact specifically with mini-exon DNA. A factor present in the nuclei of both infectious bloodstream forms and non-infectious culture forms of Trypanosoma brucei was shown by DNAase I footprinting and oligonucleotide competition to bind 5' to the transcription start site of the mini-exon. A second factor which bound to the mini-exon itself at a sequence conserved in other kinetoplastida was evident only in the nuclei of infectious bloodstream forms.

Expression of the E.coli hemolysin secretion gene hlyB involves transcript anti-termination within the hly operon

The genes hly A and hly B dictating synthesis and secretion of hemolytic toxin by Escherichia coli are transcribed as part of an operon hly C, hly A, hly B but are separated by an inverted repeat and poly-T sequence characteristic of a rho-independent terminator. The hly A-hly B intergenic sequence caused a reduction of in vivo transcriptional read-through from the gal promotor into gal K when inserted in the pKG1900 terminator-probe vector and also in vitro 3' to the bacteriophage T7 luminal diameter 10 promotor. Hybridisation of mRNA generated by the hly determinant of recombinant DNA pBR202-312 to an antisense RNA probe spanning the hly intergenic sequence revealed specific termination of 80% of in vivo hly transcripts within the poly-T sequence, immediately preceding the hly B translation start. Extension of the hly determinant with 3.5kbp of hly promotor-proximal DNA sequence raised intracellular and cell-free hemolytic activity 3-fold and 20-fold respectively and increased markedly the secretion of the 107Kd hemolysin protein (HlyA). Parallel hybridisation of in vivo mRNA to hly A and hly B antisense probes revealed that levels of hly A and hly B mRNA were increased by approximately 3-fold and 90-fold. The dramatically enhanced level of hly B mRNA resulted primarily from specific suppression of transcription termination at the intergenic rho-independent terminator from 80% to 1%, thus allowing virtually all hly A transcripts to elongate into hly B.

Production and properties of haemolysins from clinical isolates of the Proteeae

A collection of 198 clinical isolates of strains belonging to the tribe Proteeae was examined for haemolytic activity on blood agar and in Brain Heart Infusion Broth. The strains were of diverse bacteriocin and O-antigenic types and from a wide variety of sources. They included representatives of all species of Morganella, Proteus and Providencia. Approximately half of the M. morgani strains were haemolytic on blood agar. This activity was not associated with any particular bacteriocin type. The haemolysin was also produced during exponential growth in broth and was thermolabile and calcium dependent. All P. mirabilis strains and some P. vulgaris strains were non-haemolytic on blood agar. However, most strains of the Proteus spp., irrespective of their bacteriocin and antigenic type, produced, over a short period during exponential growth in broth, a heat-stable, cell-associated calcium-independent haemolysin. A smaller proportion of P. vulgaris and P. penneri strains produced, in addition, a thermolabile, calcium-dependent haemolysin which was associated with the formation of large haemolytic zones on blood agar. The relationship of these haemolysins to Escherichia coli haemolysin and their possible role in virulence is discussed. Haemolysin production was not found in any of the 74 strains of four species of Providencia.

Immunochemical studies on the synthesis and secretion of link protein and aggregating proteoglycan by chondrocytes

Chondrocytes from pig laryngeal cartilage were maintained in culture, and the biosynthesis and secretion of link protein and proteoglycan were studied using immunochemical, biochemical and immunolocalisation techniques. In the presence of monensin there was a dose-dependent inhibition of link protein secretion which was very similar to that of aggregating proteoglycan, and suggested that they followed the same intracellular pathway during biosynthesis. In the presence of cycloheximide there was a similar dose-dependent inhibition of the secretion of both link protein and proteoglycan. Kinetics of secretion following inhibition of synthesis by cycloheximide showed that both proteins had similar intracellular pool sizes. Analysis of protein core and glycosaminoglycan biosynthesis showed that the time for synthesis and glycosylation of proteoglycan was 22 minutes, and this was quickly followed (within 6 minutes) by secretion. Intracellular electron microscopic immunolocalisation using protein A-gold showed link protein to be present in the Golgi cisternae and vesicles, and double-labelling experiments showed link protein only to be detected in vesicles that also labelled for proteoglycan protein core. When chondrocytes were maintained in monolayer culture for 10 days the rate of biosynthesis and secretion of proteoglycan increased although that of link protein remained constant. The control of their biosynthesis was thus shown to be independent. Within 4 hours of secretion a high proportion of link protein was incorporated into proteoglycan aggregates.

H1 histone synthesis and phosphorylation in mouse mammary gland in vitro

The synthesis and phosphorylation of H1 histones were studied in organ cultures of midpregnant mouse mammary glands exposed to various combinations of insulin, cortisol and prolactin over a 48-h period. The synthesis of specific H1 histone subtypes was changed only when all three hormones were present, and the effect was most pronounced during the first 24 h of culture, a period of cell replication. The 3-hormone combination also stimulated the phosphorylation of the N-terminal region of the H1 histone, and this also occurred maximally during the first 24 h of culture. The enhanced phosphorylation of the N-terminal region of the H1 histone included a site sensitive to phosphorylation by cyclic AMP-dependent protein kinase. Thus, hormones which stimulate mammary development in vitro influence the synthesis and specific phosphorylation of H1 histones during a period of cell replication preceding the expression of milk protein genes.

Doppler microwave. A clinical assessment of its efficacy as an arterial pulse sensing technique

A new Doppler microwave device designed for noninvasive arterial pulse detection by assessment of arterial wall motion was clinically evaluated. Carotid pulse tracings obtained with the microwave device were compared with simultaneously obtained intra-aortic pressure pulse waves. Ease and quality of the recording were also evaluated in 25 consecutive patients undergoing echocardiography. In 92% of the patients tested, good quality carotid pulse tracings could be obtained. T1/2 values and systolic time intervals were calculated from these recordings and correlated well with the known disease states of these patients, which ranged from aortic stenosis and aortic insufficiency to chronic heart failure. Finally, microwave tracings were faithful reproductions of invasive recordings of arterial pressures when compared on the basis of left ventricular ejection times and pulse contour.

Coinduction of glucose-regulated proteins and doxorubicin resistance in Chinese hamster cells

The glucose-regulated protein (GRP) system in mammalian cells is induced by glucose deprivation, anoxia, the calcium ionophore A23187, and 2-deoxyglucose. In Chinese hamster ovary cells the major GRPs are approximately equal to 76, 97, and 170 kDa. Removal of each of these four GRP-inducing stresses leads to the coordinate repression of GRPs and induction of the major heat shock proteins at 70 and 89 kDa. The application of each of these four GRP-inducing conditions leads to a significant induction of resistance to the drug doxorubicin. Removal of each GRP-inducing condition results in the rapid disappearance of this resistance in a manner that correlates with the repression of the GRPs. The retention of doxorubicin by GRP-induced cells does not explain the induced drug resistance. When the RIF in vitro/in vivo tumor system is probed with an antibody against the 76-kDa GRP, a significant increase in this GRP is observed in cells obtained from the central regions of tumors. Since hypoxia and/or nutrient deprivation can occur during tumor development, a GRP-induced state in the tumor may confer resistance to doxorubicin treatment.

The secreted hemolysins of Proteus mirabilis, Proteus vulgaris, and Morganella morganii are genetically related to each other and to the alpha-hemolysin of Escherichia coli

Secreted hemolysins were extremely common among clinical isolates of Proteus mirabilis, Proteus vulgaris, and Morganella morganii, and hemolytic activity was either cell associated or cell free. Southern hybridization of total DNA from hemolytic isolates to cloned regions of the Escherichia coli alpha-hemolysin (hly) determinant showed clear but incomplete homology between genes encoding production of hemolysins in the four species. One of the two E. coli secretion genes, hlyD, hybridized only with DNA from P. vulgaris and M. morganii, which produced cell-free hemolysis, but not with that from P. mirabilis, which showed only cell-associated activity. Molecular cloning of the genetic determinants of cell-free hemolytic activity from P. vulgaris and M. morganii chromosomal DNA allowed their functional analysis via inactivation with the transposons Tn1000 and Tn5. Both hemolysin determinants were about 7.5 kilobase pairs and comprised contiguous regions directing regulation, synthesis, and specific secretion out of the cell. Transposon mutations which eliminated secretion of the Proteus and Morganella hemolysins could be complemented specifically by the E. coli hemolysin secretion genes hlyB or hlyD. Alignment of the physically and functionally defined hly determinants from P. vulgaris and M. morganii with that of the E. coli alpha-hemolysin confirmed a close genetic relationship but also indicated extensive evolutionary divergence.

Growth study including stereophotogrammetry of a pair of monozygotic twins, one having a cleft lip and palate

This report is a serial growth study of a pair of monozygotic twin boys, one of whom suffered from a bilateral cleft of the lip and a unilateral cleft of the palate. Annual records for height and weight were registered from seven years eight months to 18 years 0 months. Soft tissue facial growth was also measured annually using short base stereophotogrammetry (Burke, 1967). Growth and development of the dentition was recorded as orthodontic study models at less frequent intervals. Measurements derived from the facial maps allowed not only measurement of soft tissue growth changes in the face, but also of surgical change to both lips related to an Abbe flap procedure carried out for the cleft twin. All changes are compared with those occurring in his monozygotic twin.