Peroxisome proliferator-activated receptor-gamma agonist, rosiglitazone, protects against nephropathy and pancreatic islet abnormalities in Zucker fatty rats

Rosiglitazone (BRL 49653), a peroxisome proliferator-activated receptor-gamma (PPAR-gamma) agonist and potent insulin action-enhancing agent, was given in the diet (50 micromol/kg of diet) to male Zucker rats ages 6-7 weeks for 9 months (prevention group). In this treatment mode, rosiglitazone prolonged the time to onset of proteinuria from 3 to 6 months and markedly reduced the rate of its subsequent progression. Progression was also retarded when treatment was commenced (intervention group) after proteinuria had become established (4 months; ages 24-25 weeks). In either treatment mode, rosiglitazone normalized urinary N-acetyl-beta-D-glucosaminidase activity, a marker for renal proximal tubular damage, and ameliorated the rise in systolic blood pressure that occurred coincidentally with the development of proteinuria in Zucker fatty control rats. The renal protective action of rosiglitazone was verified morphologically. Thus in the prevention group there was an absence of the various indexes of chronic nephropathy that were prominent in the Zucker fatty control group, namely, glomerulosclerosis, dilated tubules containing proteinaceous casts, a loss of functional microvilli on the tubular epithelium, and varying degrees of chronic interstitial nephritis. An intermediate pathology was observed in the intervention group. Also, pancreatic islet hyperplasia, ultrastructural evidence of beta-cell work hypertrophy, and derangement of alpha-cell distribution within the islet were prominent features of Zucker fatty control rats, but these adaptive changes were ameliorated (intervention group) or prevented (prevention group) by rosiglitazone treatment. These data demonstrate that treatment of Zucker fatty rats with rosiglitazone produced substantial protection over a prolonged period against the development and progression of renal injury and the adaptive changes to pancreatic islet morphology caused by sustained hyperinsulinemia.

Proof of fatal air embolism

Venous air embolism is a rare cause of death. Entry of gas into the circulation is caused by trauma, mostly surgical or therapeutic, and sometimes resulting from criminal intervention. The detection of air embolisms requires special precautions during autopsy. An aspirometer has to be used for the detection, measurement and storage of gas originating from the heart ventricles. The aspirometer has to be filled completely with distilled water containing two drops of Tween 80 to reduce the surface tension of the water and to prevent adherence of small air bubbles to the wall of the aspirometer. Subsequently the gas has to be analysed by gas chromatography. When the results correspond with the main criteria defined by Pierucci and Gherson [2] the diagnosis "air embolism" is justified. The technique for the detection of air embolism is simple but requires a careful procedure which is described in detail.

The piloting of a group for the fathers of children with Down syndrome

The health services often struggle in their attempts to engage and support fathers. This paper describes the piloting of a small group for the fathers of children with a disability, in this case Down Syndrome. The group is described from conception to conclusion and limitations of the study are discussed. The group approach meets a need for a proportion of fathers who prove able to explore their experiences and feelings.

Apoptotic response of spermatogenic cells to the germ cell mutagens etoposide, adriamycin, and diepoxybutane

In testis, apoptosis is a way to eliminate damaged germ cells during their development. In this study, we evaluated the ability of three germ cell mutagens to induce apoptosis (or programmed cell death) at specific stages of rat seminiferous epithelial cycle. These chemicals include the cancer chemotherapy drugs etoposide and adriamycin and the butadiene metabolite diepoxybutane. According to our results, etoposide is a very potent inducer of apoptosis in male rat germ cells and the cell types most sensitive to it include all types of spermatogonia, zygotene, and early pachytene spermatocytes and meiotically dividing spermatocytes. Also, adriamycin causes an increase in apoptosis at specific stages of seminiferous epithelial cycle and the most sensitive cell types are type A3-4 spermatogonia, preleptotene, zygotene, and early pachytene spermatocytes. Diepoxybutane does not cause any significant increase in the frequency of apoptosis in rat testis. In addition, we studied whether p53 is taking part in the apoptotic response of spermatogenic cells by studying the levels of p53 protein in testis before and after chemical treatment. No accumulation of p53 in testis was seen after treatment with these three chemicals. The expression of two p53-regulated genes, p21WAF1 and mdm2, was also studied but no increase in the levels of mRNA of these genes was observed after treatment. The results indicate that apoptosis should be taken into consideration when the genotoxic effects of chemicals are evaluated in germ cells.

High-performance liquid chromatographic analysis of complex N-linked glycans derivatized with 2-aminoacridone

2-Aminoacridone (2-AMAC) has been used to derivatize mixtures of N-linked oligosaccharides released from alpha(1)-acid glycoprotein and immunoglobulin G. In each case, the HPLC profile obtained for the derivatized glycans was compared to that obtained after digestion with sialidase and a two-enzyme array system made up of sialidase and alpha-fucosidase, prior to derivatization by 2-AMAC. These studies are rapid and provide a wealth of preliminary information about the degree of sialylation and core fucosylation in the corresponding parent glycans. Moreover, collection of glycans from one single injection has provided enough material for molecular weight determination by MALDI-MS analysis. In this study we have also carried out limited MS-MS studies on enriched fractions of 2-AMAC-glycans using a nanospray orthogonal quadrupole time-of-flight mass spectrometer.

Inducible gene expression in mammalian cells and transgenic mice

Advances in biomedicine have accentuated the need to develop methods to deliberately modulate gene activity. In addition to improved versions of the system based on components of the tetracycline resistance operon, several strategies have recently emerged to control gene function at the transcriptional level. Particularly promising are approaches based on non-mammalian steroid hormones, and on small molecules that bind immunophilins.

Comparison of HPLC and CE for the analysis of dichlorprop in a case of intoxication

A 49-year-old white male was found lying unconscious at home. He had vomited, his mouth was filled with a white foam and a pungent odour filled the room. After emergency treatment blood, urine and stomach contents were screened for drugs after acid and alkaline extraction with subsequent derivatisation and GC-MS analysis. Large quantites of 2,4-dichlorophenoxypropionic acid (dichlorprop, 2,4-DP) were found in all acid extracts. The man died 3 h later in hospital. Body fluids and tissues obtained at autopsy were analysed for 2,4-DP by high-performance liquid chromatography and capillary electrophoresis. The concentrations of 2,4-DP in cardiac blood, stomach contents, bile, liver, spleen, kidney and brain found by both methods were very similar.

Stage-specific expression and phosphorylation of retinoblastoma protein (pRb) in the rat seminiferous epithelium

To assess the potential role of retinoblastoma protein (pRb) in the regulation of cell cycle during spermatogenesis, the expression of retinoblastoma (Rb) mRNA and protein, as well as the phosphorylation states of pRb, in the rat seminiferous epithelial cycle, were studied. Two transcripts, 5.4 kb and 3.4 kb long, were detected in total RNA from the adult rat testis and only the 5.4 kb transcript was detected in poly (A)+-RNA from 8, 14 and 23-day old rat testes by Northern hybridization. Polysome analysis revealed that only a small portion of both Rb transcripts could be efficiently translated. By in situ hybridization, Rb mRNA was localized to germ cells from stage V pachytene spermatocytes to step 13 spermatids along the epithelial cycle. pRb immunoreactivity was detected in Sertoli cells and spermatogonia at all stages, as well as in the elongated steps 14-19 spermatids by immunohistochemistry. The amount of pRb and the phosphorylation status varied in a stage-specific manner in Western blots. These results show that pRb is expressed in the rat seminiferous epithelium in a cyclic fashion and suggest that it is involved in the regulation of proliferation of spermatogonia and maintenance of the differentiation status of Sertoli cells and spermatids.

p21WAF1 expression during spermatogenesis of the normal and X-irradiated rat

The cyclin dependent kinase inhibitor p21WAF1 has been shown to be upregulated during differentiation and after DNA damage in somatic cells. We examined the expression of p21WAF1 mRNA during the differentiation of germ cells in normal and X-irradiated rat testis by in situ hybridization and Northern blotting. p21WAF1 was normally expressed in primary spermatocytes of the pachytene phase, but could also be detected in round spermatids. In preparations of defined segments of the seminiferous tubules, the strongest hybridization signals were detected in the segments containing stages VII VIII and IX XII of the seminiferous epithelium. Ionizing radiation (1-12 Gy) induced the expression of p21WAF1 in a dose-dependent manner and the lowest dose that showed a clear increase in mRNA levels was 3 Gy. The p21WAF1 mRNA levels peaked after 3-4 hours, but remained high compared with the control levels during the 24-h follow-up. No change in the in situ hybridization pattern was seen when comparing unirradiated and irradiated tissue. Thus, it appears that X-irradiation induces p21WAF1 in the pachytene spermatocytes. Since p21WAF1 mRNA was found in pachytene spermatocytes and in round spermatids in normal testis, the protein may take part in the regulation of meiosis and in the 'terminal' differentiation of the male germ cells.

Expression of the mouse interleukin-2 receptor gamma chain in insect cells using a baculovirus expression vector--comparison with the human common gamma chain

The gene encoding the gamma-chain of the mouse Interleukin-2 receptor was expressed in lepidopteran insect cells using the baculovirus expression vector system. The corresponding gene was inserted under the polyhedrin promoter of the Autographa californica nuclear polyhedrosis virus and expressed in the Spodoptera frugiperda insect cell line Sf9 during viral infection. The recombinant receptor protein was identified by immunoblotting in cell lysates prepared from insect cells infected with the produced recombinant virus VL1392-mIL-2R gamma. Kinetic analysis demonstrated that the corresponding protein could be detected as an approximately 50 kDa protein already at 24 h post-infection. Intrinsic labelling with [35S]-methionine/cysteine and SDS-PAGE analysis of the recombinant baculovirus infected insect cells verified the immunoblotting data. The expressed IL-2R gamma protein could also be determined on the surface of infected insect cells by flow cytometric analysis. Comparison of the molecular weights between baculovirus expressed human and mouse IL-2R gamma chains indicated differences in the glycosylation pattern despite similar numbers of N-linked glycosylation sites.

Tetrahydrobiopterin biosynthesis in C6 glioma cells: induction of GTP cyclohydrolase I gene expression by lipopolysaccharide and cytokine treatment

The possibility that 5,6,7,8-tetrahydrobiopterin (BH4) biosynthesis is stimulated in glial cells by treatment with lipopolysaccharide (LPS) and tumor necrosis factor (TNF-alpha) was examined in the astrocyte-derived C6 glioma cell line. Under basal culture conditions BH4 levels were found to be at the limit of detection. Concurrent treatment with 10 micrograms/ml LPS and 50 ng/ml TNF-alpha caused a time-dependent 13-fold increase in the levels of BH4. This treatment paradigm also induced nitric oxide synthase activity, as evidenced by increased levels of nitrite, an oxidized metabolite of NO, in the culture medium. LPS and TNF-alpha treatment led to a 25-fold increase in GTPCH enzyme activity, the first and rate-limiting enzyme in BH4 synthesis, and a corresponding 23-fold increase in GTPCH protein levels. Northern blot analysis showed that increased levels of GTPCH mRNA preceded changes in GTPCH protein, GTPCH enzyme activity and BH4 levels and reached a maximal of 44-fold that was sustained for at least 48 h. These results demonstrate that LPS and TNF-alpha stimulate de-novo BH4 biosynthesis and suggest that C6 cells offer a model system for studying the molecular events that control the induction of GTPCH gene expression and BH4 synthesis in glial cells.

The development and validation of a predictive index for postpartum depression

A sample of over 6000 women was recruited in the last trimester of pregnancy and administered a 40-item self-report questionnaire designed to detect the presence of factors that were likely to increase the risk of postpartum depression. The mental state of almost 5000 of these women was determined at around 6 to 8 weeks postpartum. By conducting a series of logistic regressions on two-thirds of this sample the original set of variables was reduced to a predictive index of 17 items with weighted scores calculated for each. This index was then applied to the remaining one-third of the sample as a validating procedure and specificity and sensitivity calculated. The index offers a system for the prediction of postpartum depression that could be of use in both research and clinical practice.

Genomic organization of the human p57KIP2 gene and its analysis in the G401 Wilms' tumor assay

The p57KIP2 gene encodes an inhibitor of cyclin-dependent kinase activity, which negatively regulates cell cycle progression. The human p57 gene is located in 11p15.5, a region of DNA frequently altered in neoplasia. We have isolated a human genomic clone and mapped the p57 gene to a 2.2-kb region between D11S648 and D11S679. Sequence analysis revealed that the coding DNA of the human p57 gene is divided by 0.5-kb intron. A second intron was detected in the 3' untranslated region, indicating that the human p57 gene contains at least three exons. Our previous work with somatic cell hybrids mapped a tumor suppressor gene for the G401 Wilms' tumor cell line to a approximately 500-kb region of 11p15.5 that includes p57. Northern blot analysis detected a 0.8-kb p57 transcript in several of the G401 hybrid lines. However, p57 expression did not correlate with tumor suppression. These results suggest that p57 is not responsible for the tumor suppression observed in our somatic cell hybrid assay.

The mouse and human homologs of DMC1, the yeast meiosis-specific homologous recombination gene, have a common unique form of exon-skipped transcript in meiosis

Genetic recombination in meiosis plays an important role in generating diversity of genetic information. In yeast an Escherichia coli RecA-like gene, DMC1, is expressed in meiotic prophase and its product co-localizes with Rad51 protein on zygotene chromosomes. We have cloned the mouse and human homologs of the yeast DMC1 gene. The predicted human and mouse DMC1 proteins showed 54.1% sequence identity with yeast Dmc1 protein. The domain II region, highly conserved in the E.coli RecA-like protein family, was also found in the mammalian DMC1 proteins, including the two ATP binding motifs and DNA binding sites with the region. In situ hybridization analysis revealed expression of the mouse Dmc1 gene in testicular germ cells in meiosis; RT-PCR showed expression in embryonal ovaries. These findings suggest that DMC1 plays an important role in meiotic homologous recombination. From both the man and mouse we have isolated an alternative spliced form of Dmc1 cDNA (Dmc1-d), which is deleted for a region between the two motifs involved in nucleotide binding. Since the alternatively spliced Dmc1-d transcript was detected in both male and female germ cells, the encoded protein DMC1-D may have a novel role in mammalian genetic recombination in meiosis.

Localization of a tumor suppressor gene in 11p15.5 using the G401 Wilms' tumor assay

Multiple studies have underscored the importance of loss of tumor suppressor genes in the development of human cancer. To identify these genes, we used somatic cell hybrids in a functional assay for tumor suppression in vivo. A tumor suppressor gene in 11p15.5 was detected by transferring single human chromosomes into the G401 Wilms' tumor cell line. In order to better map this gene, we created a series of radiation-reduced t(X;11) chromosomes and characterized them at 24 loci between H-RAS and beta-globin. Interestingly, three of the chromosomes were indistinguishable as determined by genomic and cytogenetic analyses. Each contains an interstitial deletion with one breakpoint in 11p14.1 and the other breakpoint between the D11S601 and D11S648 loci in 11p15.5. PFGE analysis localized the 11p15.5 breakpoints to a 175 kb MluI fragment that hybridized to D11S601 and D11S648 probes. Genomic fragments from this 175 kb region were hybridized to DNA from mouse hybrid lines containing the delta t(X;11) chromosomes. This analysis detected the identical 11p15.5 breakpoint which disrupts a 7.8 kb EcoRI fragment in all three of the delta t(X;11) chromosomes, suggesting they are subclones of the same parent colony. Upon transfer into G401 cells, one of the chromosomes suppressed tumor formation in nude mice, while the other two chromosomes lacked this ability. Thus, our mapping data indicate that the gene in 11p15.5 which suppresses tumor formation in G401 cells must lie telomeric to the D11S601 locus. Koi et al. (Science 260: 361-364, 1993) have used a similar functional assay to localize a growth suppressor gene for the RD cell line centromeric to the D11S724 locus. The combination of functional studies by our lab and theirs significantly narrows the location of the tumor suppressor gene in 11p15.5 to the approximately 500 kb region between D11S601 and D11S724.

Detection of germ cell mutagenicity of trophosphamide by the spermatid micronucleus test in the rat

The effects of the antineoplastic drug trophosphamide (TP) on male rat germ cells were examined with the spermatid micronucleus test (SMNT). We used the microdissection technique in order to isolate stage I of the seminiferous epithelial cycle, where the cells that have just passed the meiotic divisions can be found. Micronuclei (MN) were scored at different time-points after TP treatment at dose levels of 25 and 50 mg/kg. An induction of MN was detected in cells exposed at preleptotene (18 and 19 days) and late pachytene (3 days), as well as at the diplotene-diakinesis stage (1 day). The dose-response for MN induction was linear at all time intervals studied, except for 18 days time point. The highest frequency of MN (5.20 +/- 0.57/1000 spermatids) could be found with the lower TP dose at 18 days, corresponding to exposed preleptotene spermatocytes and reflecting S-dependent clastogenicity. While a significant increase in MN could only be detected in exposed preleptotene spermatocytes with the lower TP dose, the higher dose level also induced MN significantly in late pachytene and the diplotene-diakinesis stage. DNA flow cytometry at 18 days showed cytotoxicity of TP to exposed primary spermatocytes at pachytene, but no cytotoxicity to the preleptotene spermatocytes that exhibited a significant MN induction. The results show that the SMNT using the stage-I-specific examination of the rat seminiferous epithelium can detect the germ cell mutagenicity of TP and gives further evidence of the usefulness of this technique in the testing of chemicals for genotoxic effects in male germ cells.

A specific immunoassay for the detection of flunitrazepam

The development of an immunochemical procedure for the determination of flunitrazepam in whole blood is described. Flunitrazepam was derivatized in position 3 of the benzodiazepine ring to a hapten which was coupled to a carrier protein. To obtain antibodies, rabbits were immunized with these immunogens and the collected antisera were tested in a heterogeneous, competitive RIA. The antibodies showed a very specific reaction with flunitrazepam and hardly any cross-reactivity with related 1,4-benzodiazepines. Because of its high specificity the antiserum has the advantage of a definite determination of low levels of flunitrazepam without the risk of false-negative results obtained by using the commercially available group-specific test systems. The drug was extracted from whole blood in a simple batch process with a polystyrene suspension and the extracts were measured by RIA. The advantages of an immunochemical system, such as short analysis time and simple sample preparation, and the exactness of a drug-specific method are combined in this procedure, which allowed the specific and very sensitive determination of flunitrazepam in the low therapeutic range.

Petechial haemorrhage following a partial seizure with secondary generalization: atypical presentation and differential diagnosis

A case is reported of a patient who had a respiratory arrest on a high dependency ward in a High Security Hospital with an unusual presentation. The patient had head and upper abdominal petechial haemorrhages with extensive conjunctival haemorrhaging. A considered antecedent for this potentially life-threatening presentation was strangulation. Analysis of all the available clinical information supports the hypothesis that he had a single tonic-clonic seizure with a focal-motor onset. This constitutes an unusual consequence of a partial seizure with secondary generalization.

Development of child-centered disease-specific questionnaires for living with asthma

Contemporary developments in the management of chronic diseases such as diabetes and asthma offer possibilities for optimal control, but patients increasingly need to take on responsibilities for self care. Health professionals require comprehensive assessments of outcome that include data reflecting patients' perceptions of their disorder and its management. Disease-specific, patient-centered questionnaires for evaluation of adults' health-related quality of life are available for diabetes and asthma. Little progress is evident in relation to pediatric instruments. This paper describes the development of such an instrument for measurement of 8- to 11-year-olds' perceptions of their asthma--the CAQ-B Psychometric characteristics of the CAQ-B are reported: principal axis factor analysis resulted in the derivation of four subscales reflecting children's perceptions of both active and passive aspects of living with asthma, together with their perceptions of its severity and any associated distress. Preliminary explorations with CAQ-B included comparisons of parents', doctors', and children's ratings of severity; comparisons of data from asthmatic and nonasthmatic children; comparisons of data from boys and girls.

Effects of a traffic club on road safety knowledge and self-reported behaviour of young children and their parents

Children in seven counties in eastern England and in six counties in a control region were interviewed just prior to the start of the introduction of a major traffic club scheme. Similar interviews were carried out in the experimental and control regions one year later. The traffic club increased the extent to which parents attempted to teach road safety to their children. In addition, the proportion of children who were said by parents to run ahead was reduced in the experimental compared with the control region after one year of traffic club operation. However, there was no evidence that parents exerted closer supervision of their children's behaviour in the streets. Children from nonmanual socioeconomic backgrounds did considerably better than those from manual backgrounds in terms of knowledge of road safety and were less likely to be left to play or ride bikes unsupervised in the streets. Male children were more knowledgeable about road safety, but were more likely to engage in potentially dangerous behaviour when out than were female children. The results showed that the traffic club scheme in its first year of operation had some impact of the behaviour of its target group but probably did not affect parental supervision. To inform the development of future schemes of this kind, it may be necessary to find out more about why many parents exert limited supervision of very young children in the streets.

Neisseria meningitidis produces iron-regulated proteins related to the RTX family of exoproteins

A monoclonal antibody (A4.85) which reacted with Fe-regulated proteins of Neisseria meningitidis, was used to isolate a lambda gt11 clone from N. meningitidis FAM20. Chromosomal fragments flanking the fragment expressing the A4.85 epitope were cloned, and their DNA sequences revealed a 3,345-bp open reading frame predicting a 122-kDa protein. This gene was named frpA (Fe-regulated protein). A computer similarity search of GenBank revealed high levels of similarity to members of the RTX family of cytotoxins, especially in a region of tandem 9-amino-acid repeats. These repeats are found in all members of the RTX family; similar repeats were present 13 times in the predicted FrpA protein. Antigenic relatedness between the meningococcal proteins and the RTX proteins was demonstrated by the reactivity of A4.85 with Escherichia coli hemolysin (HlyA) and Bordetella pertussis adenylate cyclase-hemolysin (CyaA). Similarly, FrpA was recognized by 9D4, a monoclonal antibody directed against B. pertussis CyaA. In addition to the frpA gene, a second gene (frpC) produced a larger RTX-related protein. The frpA and frpC loci were mutagenized in strain FAM20, resulting in the loss of RTX-related proteins. A 120-kDa protein was expressed from the reconstructed frpA gene in E. coli. The biological function of FrpA is unknown, but its similarity to other RTX toxins suggests that it may play an important role in the pathogenesis of meningococcal infection.

The New York High-Risk Project: anhedonia, attentional deviance, and psychopathology

In the New York High-Risk Project (NYHRP) we followed subjects at risk for schizophrenic or affective disorders and low-risk controls from childhood to adulthood, with the goal of identifying early predictors of later schizophrenia-related psychopathology. In this article, we focus on two potential predictors: the Physical Anhedonia Scale administered in adolescence and the Attention Deviance Index obtained in childhood. Subjects of this report are 161 members of the NYHRP's first sample (sample A), who had scores on both attention and anhedonia and had followup clinical assessments in adulthood. We used a path analysis model and several separate regression analyses to examine the relationships of the parent diagnostic groups, attentional dysfunction, and anhedonia to each other and to each of three psychopathological outcomes: schizophrenia and schizophrenia-related psychoses, major affective disorder, and social isolation in nonpsychotic subjects. Subject groups did not differ in anhedonia scores but did differ in childhood attentional dysfunction, psychosis, and social isolation, all of which are more common in subjects at risk for schizophrenia. In these subjects at risk for schizophrenia, but not in the other two groups of subjects, childhood attentional dysfunction is related to anhedonia, social isolation, and possibly nonparanoid psychosis. Anhedonia is associated with social isolation and with psychosis in females. Several other gender effects are also noted.

Mitochondrial protein import

A dynamic picture of the mitochondrial protein import pathway is emerging, with conformational alteration a critical feature both preceding and following membrane translocation. The mediators of these steps of conformational alteration, as well as steps of recognition, translocation, and proteolytic cleavage, appear to be proteins. Using powerful tools of genetics and biochemistry, in years to come it should be possible to determine the precise molecular function of these proteins in mediating these novel reactions.

The Dolittle phenomenon: hallucinatory voices from animals

Individuals with severe psychotic illnesses may experience hallucinatory voices from animals. Six cases are described, and the significance of such hallucinations is discussed. The term 'Dolittle phenomenon' is proposed.

Assessing the injured ankle without X-rays

The frequent practice of X-raying all injured ankles is reviewed. A simple test using basic equipment to measure the injuries was assessed. A ratio comparing the swelling, expressed as the bimalleolar diameter of the patient's injured ankle to that of the uninjured ankle, gave a highly reliable method of predicting whether a fracture was seen on X-ray or not. All the fractured ankles had a bimalleolar ratio above 1.065. Patients whose ratios were less than 1,065 formed 62 per cent of the series, and as these contained no fractures, the use of X-rays in these cases is questioned.

Genetics and psychiatry: past discoveries, current dilemmas, and future directions

Family, twin, and adoption studies have suggested an important role for hereditary factors in the etiology and pathogenesis of several psychiatric disorders. Advances in molecular and statistical genetics may very well reveal the identity of these factors, which may include single genes. Linked markers, critical to the discovery of abnormal genes in several medical conditions, have been reported for Huntington's disease, Alzheimer's disease, bipolar disorder, and schizophrenia. Psychiatric disorders pose particular problems (etiologic heterogeneity, incomplete penetrance, variable expressivity) for genetic research. New practical and ethical questions also arise. Nevertheless, knowledge may emerge that will suggest new approaches to diagnosis, prevention, and treatment.

Multiple serial lycanthropy. A case report

A case is described who exhibited lycanthropy during an acute psychotic illness. During a short period she experienced herself as four different species of animal, an occurrence not previously reported. The phenomenon of lycanthropy is most appropriately regarded as a delusion, but the abnormal subjective experience is stressed, not just the falsely-held belief.

Ionic mechanisms of adenosine actions in pacemaker cells from rabbit heart

1. Whole-cell and patch clamp techniques have been applied to cells isolated from the rabbit sino-atrial (S-A) node to study the ionic mechanism(s) of adenosine-induced slowing of cardiac pacemaker activity. 2. Viable spontaneously active cells were isolated from the central region of the S-A node of the rabbit heart by an enzymatic dispersion procedure similar to that reported by Giles & van Ginneken (1985) and van Ginneken & Giles (1988). In these spontaneously beating cells application of adenosine caused a dose-dependent slowing accompanied by a small hyperpolarization of the maximum diastolic potential. Relatively high doses of adenosine (greater than 20 microM) caused complete arrest, associated with a hyperpolarization of 12-15 mV. 3. In corresponding whole-cell voltage clamp experiments adenosine activated a time-independent potassium current, IK(ADO), which at -50 mV is approximately 30 pA in normal Tyrode solution and 50 pA in high [K+]o (20 mM) Tyrode solution. This current is similar to the one identified previously in guinea-pig atrium (Belardinelli & Isenberg, 1983a; Kurachi, Nakajima & Sugimoto, 1986). 4. Patch clamp recordings of the single-channel events underlying IK(ADO) showed that they have a conductance of approximately 25.0 +/- 1.9 pS. The whole-cell or macroscopic current, IK(ADO), and the adenosine-induced single-channel events exhibit strong inward-going rectification. 5. Adenosine in doses (10 microM) which significantly activate IK(ADO) failed to produce any measurable effect on the calcium current, ICa, in these isolated cardiac pacemaker cells. However, after ICa has been enhanced by the addition of isoprenaline, adenosine (1-10 microM) caused a significant inhibition: it reduced ICa back to approximately the control levels. 6. A similar 'indirect' effect of adenosine was observed on If, the slow time- and voltage-dependent inward current which is activated by hyperpolarizing these S-A node cells. Adenosine (10(-5) M) failed to influence the control or basal If; however, after If was enhanced by isoprenaline, adenosine markedly inhibited it. 7. These results provide explanations for both the direct and the indirect effects of adenosine in mammalian cardiac pacemaker tissue: activation of IK(ADO), and of a time-independent background potassium current and inhibition of ICa and If, respectively. Since it is known that there is significant adrenergic tone in the mammalian S-A node both the indirect and the direct effects of adenosine may be of physiological importance.

Fragile sites at 16q22 are not at the breakpoint of the chromosomal rearrangement in AMMoL

There is much speculation about fragile sites on human chromosomes predisposing to specific chromosome rearrangements seen in cancer. Acute myelomonocytic leukemia is characterized by neoplastic chromosome rearrangements involving band 16q22 in patients who carry the rare fragile site at 16q22. This specific leukemic breakpoint is within the metallothionein gene cluster, which is here shown to be proximal to the rare fragile site (FRA16B) and to a common fragile site (FRA16C) in this region. Hence neither of these fragile sites are at the breakpoint in this leukemic chromosomal rearrangement.

The use of a metal locator in an accident and emergency department

During the past year the removal of metallic foreign bodies in an accident and emergency department has been aided by the use of a metal locator.

A 5' flanking region of the metallothionein, MT2A, gene identifies two moderately frequent RFLPs

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Structure and tissue-specific expression of the human metallothionein IB gene

The human metallothionein (MT) IB gene (hMT-IB) is located in a region of human DNA containing at least four tandemly arranged MT genes. As deduced from its sequence, hMT-IB is likely to encode a functional protein. However, the predicted amino acid sequence differed from the hMT-I amino acid sequence in four positions. Most remarkable was the presence of an additional cysteine. Like other MT genes, hMT-IB has at least two copies of the metal-responsive element upstream from the transcription initiation site. These elements probably are responsible for the metal responsiveness of the hMT-IB promoter, leading to inducible expression of fused heterologous genes. Unlike the hMT-IIA and hMT-IA genes described previously, which are expressed in many different cell types, a high level of expression of the endogenous hMT-IB gene could be detected only in human hepatoma and renal carcinoma cell lines. Therefore, this is the first MT gene described which exhibits tissue specificity of expression. This specificity is controlled by a cis-acting mechanism involving methylation, since incubation of nonexpressing cells with an inhibitor of DNA methylation led to activation of the hMT-IB gene. In support of this notion, we found that the 5' flanking region of the hMT-IB gene was highly methylated in HeLa cells, a nonexpressing cell type, but it was not methylated in a hepatoma (expressing) cell line.

Primary process cognition and hemispheric asymmetry

Several theorists have hypothesized that the right hemisphere operates in a primary process manner, whereas the left hemisphere operates in a secondary process manner. Evidence for this hypothesis, though supportive, has been indirect. In two experiments, we applied a validated content-analytic measure of primary process cognition to verbal material produced by subjects while right-hemisphere and left-hemisphere alpha-wave amplitude was monitored. Both experiments indicated that amount of primary process content in language is related to basal or long-term hemispheric asymmetry (high levels of right-hemisphere activation, as compared to left-hemisphere activation), and that the relation with asymmetry is stronger than that with absolute levels of either right-hemisphere or left-hemisphere activation. Both experiments showed that primary process content is not closely related to momentary asymmetry. The second experiment indicated that within subjects, momentary asymmetry is in fact weakly related to primary process content in the direction opposite to that predicted.

The regulation of DNA synthesis in quiescent lymphocytes by cytoplasmic inhibitors

We previously have shown that proliferating lymphoid cells contain an extractable cytoplasmic protein that is capable of inducing DNA synthesis in isolated quiescent nuclei (activator of DNA replication, ADR). ADR is present in continuously proliferating (transformed) lymphoblastoid cell lines and in mitogen- or interleukin 2-stimulated human peripheral blood leukocytes (PBL) but is not detectable in extracts from resting (unstimulated) PBL. In the present study, we investigated the possibility that quiescent PBL may contain a factor than can inhibit ADR activity. We found that unstimulated human PBL contain a heat-stable protein greater than or equal to 50,000 Da that is capable of suppressing the induction of DNA synthesis in isolated nuclei by ADR derived from both normal and neoplastic sources. The inhibitor was not detectable in freshly isolated PBL but appeared within the cells after a brief (2-6 hr) culture period. Depletion experiments revealed that the inhibitor was neither derived from nor dependent upon the macrophage component of the PBL cultures. These results suggest that one mechanism by which resting lymphocytes may maintain quiescence may involve the suppression of cytoplasmic mitogenic signals by intracellular inhibitors. In addition, the implications of our findings provide a possible explanation for the loss of growth control in abnormal proliferative states, such as neoplasia.

Solitary osteochondroma of the foot: an in-depth study with case reports

Osteochondroma represents the most common benign bone tumor and occurs most frequently in the proximal humerus, tibia, and distal femur. The bones of the foot, by comparison, are less commonly involved. The tumor appears to be a developmental defect of bone preformed in cartilage rather than a true neoplasm. However, on rare occasions it may undergo chondrosarcomatous degeneration, thus demonstrating neoplastic behavior. A review of the literature, including clinical features of osteochondroma, radiologic and histologic characteristics, and theories on pathogenesis, is presented. Information concerning principles of surgical treatment, techniques of diagnosis, and facts to aid in the differential diagnosis of osteochondroma is presented also. Finally, a series of case reports is presented to demonstrate the surgical treatment of osteochondroma of the foot. Included are three cases of phalangeal osteochondroma, one of metatarsal osteochondroma, and an unusual report of osteochondroma of the talus. A case report and discussion of a patient with juxtacortical circumscripta myositis ossificans of the foot is also presented to demonstrate how information on lesions included in the differential of osteochondroma can be utilized clinically to make the diagnosis.

Marijuana-induced primary process content in the TAT

Seventy-two normal adult male subjects wrote TAT stories under baseline and either placebo- or marijuana-ingestion conditions. Marijuana subjects received 20 mg. doses of delta-9 tetrahydrocannabinol. The stories were keypunched and content analyzed with the Regressive Imagery Dictionary, which yields a score for primary process content. Results indicate that marijuana, relative to placebo, caused subjects to write stories with a higher proportion of primary process content than they had included in baseline stories.

Pemoline induced chorea and Gilles de la Tourette's syndrome

Pemoline is a central nervous system stimulant, with pharmacological effects resembling amphetamine and methylphenidate in increasing central dopamine transmission (Fuxe et al, 1970; Sheel-Kurge, 1971).