RHAMM is a centrosomal protein that interacts with dynein and maintains spindle pole stability

The receptor for hyaluronan-mediated motility (RHAMM), an acidic coiled coil protein, has previously been characterized as a cell surface receptor for hyaluronan, and a microtubule-associated intracellular hyaluronan binding protein. In this study, we demonstrate that a subset of cellular RHAMM localizes to the centrosome and functions in the maintenance of spindle integrity. We confirm a previous study showing that the amino terminus of RHAMM interacts with microtubules and further demonstrate that a separate carboxy-terminal domain is required for centrosomal targeting. This motif overlaps the defined hyaluronan binding domain and bears 72% identity to the dynein interaction domain of Xklp2. RHAMM antibodies coimmunprecipitate dynein IC from Xenopus and HeLa extracts. Deregulation of RHAMM expression inhibits mitotic progression and affects spindle architecture. Structure, localization, and function, along with phylogenetic analysis, suggests that RHAMM may be a new member of the TACC family. Thus, we demonstrate a novel centrosomal localization and mitotic spindle-stabilizing function for RHAMM. Moreover, we provide a potential mechanism for this function in that RHAMM may cross-link centrosomal microtubules, through a direct interaction with microtubules and an association with dynein.

Insecticide treated nets: impact on vector populations and relevance of initial intensity of transmission and pyrethroid resistance

Insecticide treated bednets locate a deposit of a quick-acting insecticide of low human toxicity between a sleeper and host-seeking mosquitoes. Thus a chemical barrier is added to the often incomplete physical barrier provided by the net. Treated nets may be considered as mosquito traps baited by the odour of the sleeper. Trials in Assam, Tanzania and elsewhere have shown that when a whole community is provided with treated nets, so many mosquitoes of anthropophilic species are killed by contact with the nets that the density and/or sporozoite rate of the vector population is reduced. In order to gain this "mass" or community effect, in addition to widespread personal protection, and thus to achieve the full potential of the treated net method, a high per cent coverage of the community is needed. This suggests that organised free provision of treated nets, comparable to a house spraying programme, is likely to be more cost-effective than trying to market nets and insecticide to very poor rural people. In areas with high malaria transmission, where acquisition of immunity to malaria is very important, it has been argued that vector control (without vector eradication) could, in the long run, make the situation worse by preventing the normal build-up of immunity. However, our data from Tanzania do not support this idea--3-4 years after provision of nets (which are re-treated annually) young children are still showing clear health benefits; older children are not "paying" for this by showing worse impact of malaria. There is less malaria morbidity in a highland area where malaria transmission is about 15x less intense than in a nearby lowland area. The per cent impact of treated nets malaria morbidity in both area was very similar. At present only pyrethroids are used for net treatment which suggested that emergence of pyrethroid resistance would have a disastrous effect. However, in West Africa, where there is now a high frequency of the kdr resistance gene in Anopheles gambiae, it is reported that treated nets continue to have a powerful impact on vector populations. In Tanzania, pyrethroid resistance has not been detected in malaria vectors, but it has emerged in bedbugs after seven years use of treated nets.

In multiple myeloma, t(4;14)(p16;q32) is an adverse prognostic factor irrespective of FGFR3 expression

This study analyzed the frequency and clinical significance of t(4;14)(p16;q32) in multiple myeloma (MM) among 208 patients with MM and 52 patients with monoclonal gammopathy of undetermined significance (MGUS); diagnosed between 1994 and 2001. Patients with the translocation were identified using reverse transcription-polymerase chain reaction (RT-PCR) to detect hybrid immunoglobulin heavy chain (IgH)-MMSET transcripts from the der(4) chromosome. We found 31 (14.9%) t(4;14)(+) MM patients and 1 (1.9%) t(4;14)(+) MGUS patient. IgH-MMSET hybrid transcripts were detected in bone marrow (BM) and blood. Breakpoint analysis revealed that 67.7% of t(4;14)(+) patients expressed hybrid transcripts potentially encoding full-length MMSET, whereas the remainder lacked one or more amino terminal exons. Expression of fibroblast growth factor receptor 3 (FGFR3), presumptively dysregulated on der(14), was detected by RT-PCR in only 23 of 31 (74%) patients with t(4;14)(+) MM. Patients lacking FGFR3 expression also lacked detectable der(14) products. Longitudinal analysis of 53 MM patients with multiple BM and blood samples showed that, over time, BM from t(4;14)(+) patients remained positive and that t(4;14)(-) patients did not acquire the translocation. IgH-MMSET hybrid transcripts and FGFR3 transcripts disappeared from blood during response to therapy. No correlation was observed between the occurrence of t(4;14) and known prognostic indicators. However, we find the t(4;14) translocation predicts for poor survival (P =.006; median, 644 days vs 1288 days; hazard ratio [HR], 2.0), even in FGFR3 nonexpressors (P =.003). The presence of t(4;14) is also predictive of poor response to first-line chemotherapy (P =.05). These results indicate a significant clinical impact of the t(4;14) translocation in MM that is independent of FGFR3 expression.

Mutations in dhfr in Plasmodium falciparum infections selected by chlorproguanil-dapsone treatment

Treatment with the novel antifolate drug combination chlorproguanil-dapsone effectively cleared asymptomatic Plasmodium falciparum infections in 246 (93.5%) of 263 children in the Usambara Mountains of Tanzania during the course of a 2-week follow-up. Samples from 71 recurrent infections, collected over a 9-week follow-up, showed selection for parasites with the triple mutant Ile(51)-Arg(59)-Asn(108) in dihydrofolate reductase. There was no selection for mutations in dihydropteroate synthetase, the target enzyme of dapsone. Search for complete identity in the highly polymorphic genes coding for merozoite surface proteins 1 and 2 in parasite samples collected before and after treatment indicated that the majority of recurrent parasitemias were new infections. These observations on selection in Tanzania and the lack of selection reported from a less endemic area suggest that the active metabolite of chlorproguanil, which has a short half-life in the blood, may persist in the liver, where it exerts selective pressure on growing preerythrocytic stages.

Use of floating layers of polystyrene beads to control populations of the filaria vector Culex quinquefasciatus

Floating layers of polystyrene beads suffocate mosquito larvae and pupae and inhibit egg laying. The layers are very durable in breeding sites with water contained within walls, as in wet pit latrines and soakage pits. In some areas such pits constitute an important breeding site for Culex quinquefasciatus. Trials have been conducted in communities in Zanzibar, Tanzania, and in Tamil Nadu, India, where such mosquito populations were the vectors of Wuchereria bancrofti. In each case, treatment of all the pits with polystyrene beads was integrated with mass treatment of the people with antifilarial drugs-in Zanzibar in 1988 with diethylcarbamazine (DEC) and in India in the 1990s with DEC plus ivermectin. The results were compared with those in communities with the mass drug treatment alone and with control communities with neither treatment. The polystyrene-bead treatments greatly and sustainably reduced the vector populations. Comparison of the communities after drug treatment ceased showed that this form of vector control contributed markedly to the prevention of a resurgence of filarial infection. Where Cx. quinquefasciatus breeding in pits form a major component of the vector population, use of polystyrene-bead layers could assist considerably in the process of eliminating lymphatic filariasis by mass drug administration.

Pyrethroid resistance in tropical bedbugs, Cimex hemipterus, associated with use of treated bednets

When Tanzanian villages were provided with pyrethroid-treated bednets, bedbugs (Cimicidae) disappeared; however, after about 6 years they have re-appeared in these villages. Using a newly devised test-kit, susceptibility tests of bedbugs Cimex hemipterus (Fabricius) from five of these villages showed that there is resistance to permethrin and alphacypermethrin in bedbugs from each of the villages, in contrast to those from five villages without treated nets. Circumstantial evidence indicates that bedbug resistance to pyrethroid insecticides may evolve more readily in villages with incomplete coverage rates of treated bednets, allowing bedbug infestations to become re-established. Bedbugs have not returned to a village where nearly all the beds have been provided with pyrethroid-treated bednets for 14 years.

Effect of community-wide use of insecticide-treated nets for 3-4 years on malarial morbidity in Tanzania

OBJECTIVES

To investigate (1) benefits due to personal protection of individual net users vs. mass killing of mosquitoes within villages as a result of widespread net usage; (2) sustainability over several years of benefits against malarial morbidity of insecticide-treated nets; (3) distribution of the benefits in different age groups of children and (4) whether, as a result of fading immunity, older age groups 'paid for' the benefits which they had enjoyed when younger.

METHODS

(1) Tabulation of earlier data to compare personal and community-wide effects against mosquito vectors; (2) two cross-sectional surveys for malaria parasitaemia, malarial fever, anaemia and splenomegaly in children in eight Tanzanian villages, in which there had been community-wide use of bednets which had been annually re-treated with alphacypermethrin for 3-4 years; (3) comparison between children of different age groups and with intact, torn or no nets in these villages and in 4-6 villages without nets.

RESULTS

A 90-95% reduction in infective bites outside nets in netted villages and an additional 54-82% reduction of bites among individual net users. Highly significant reductions (by 55-75%) in malarial morbidity for children aged 6 months to 2 years were found in netted villages with, for some outcomes, better results among individuals who themselves had intact treated nets. For older children, benefits were less clear or absent, but there was no sign that the benefits early in life were 'paid for' by worse outcomes in the netted villages later in childhood.

CONCLUSIONS

The overall benefits to the community of widespread use of treated nets are sustainable and are not reversed in 3-4 years as a result of fading immunity. It is important to ensure high enough coverage to realize the full potential of the treated net method. By showing an impact on the vector population in the community these results provide a strong argument for organized free provision of net treatment, rather than relying on marketing.

The integration of tissue structure and nuclear function

Living cells can filter the same set of biochemical signals to produce different functional outcomes depending on the deformation of the cell. It has been suggested that the cell may be "hard-wired" such that external forces can mediate internal nuclear changes through the modification of established, balanced, internal cytoskeletal tensions. This review will discuss the potential of subnuclear structures and nuclear chromatin to participate in or respond to transduction of mechanical signals originating outside the nucleus. The mechanical interactions of intranuclear structure with the nuclear lamina will be examined. The nuclear lamina, in turn, provides a structural link between the nucleus and the cytoplasmic and cortical cytoskeleton. These mechanical couplings may provide a basis for regulating gene expression through changes in cell shape.

Hyaluronic acid skin fillers: adverse reactions and skin testing

BACKGROUND

Hyaluronic acid (HA) fillers have been proposed as alternatives to other temporary skin fillers, such as bovine collagen, for treating facial skin lines and for providing lip augmentation. Several types of commercial HA fillers are now available in many countries. They include Restylane, which is produced by microbiologic engineering techniques, and Hylaform, which is HA extract derived from rooster combs. They have been approved for use in several countries, but not currently in the United States. There are no recommendations to perform pretreatment skin testing by the manufacturers.

OBJECTIVE

Our purpose is to describe and comment on our experiences with Hylaform and Restylane fillers. Observation of any side effects and skin testing results were documented.

METHODS

Between September 1996 and September 2000, 709 patients were treated with Hylaform and Restylane and were followed up clinically for at least 1 year. Three of these patients (0.42%) developed delayed skin reactions. Three other patients were referred for evaluation of their skin reactions from other practitioners. Five of these 6 patients agreed to skin testing of their forearms.

RESULTS

In the 5 patients tested, challenge intradermal skin testing was positive in 4 patients; the reactions started approximately 8 weeks after injection.

CONCLUSIONS

There was a slight incidence of delayed inflammatory skin reactions to two HA fillers. Both of these reactions occurred after the first and repeat injections. Challenge skin testing was positive in 4 of 5 tested patients.

A trial of proguanil-dapsone in comparison with sulfadoxine-pyrimethamine for the clearance of Plasmodium falciparum infections in Tanzania

Considerable levels of resistance to sulfadoxine-pyrimethamine (SP) have been reported in Plasmodium falciparum in north-eastern Tanzania, and the identification of a suitable antimalarial to replace SP is now a high priority. We conducted a trial in July 2000 to determine the efficacy of proguanil (PG) plus dapsone (DS), compared with that of SP, for the treatment of asymptomatic falciparum infection. A total of 220 children with parasitaemia > or = 2000 per microL completed the study; 112 had received a single dose of SP (dosage calculated for pyrimethamine 1.25 mg/kg and sulfadoxine 25 mg/kg) and 108 had taken PG 10 mg/kg with DS 2.5 mg/kg each day for 3 days. Clearance of asexual parasites at day 7 was 14.3% with SP, but 93.5% with PG-DS. The remarkably high failure rate with SP was not associated with occurrence of leucine substitution at position 164 of the dhfr gene. Both treatment regimens were well tolerated. Compared with available data on another antifolate combination, chlorproguanil-dapsone ('Lapdap'), PG-DS was slightly but significantly inferior in achieving parasite clearance (99.5% versus 93.5%). The estimated cost of a 3-day course of PG-DS treatment for a child weighing 18 kg is US $0.15. With the rising incidence of SP-resistant P. falciparum infection, PG-DS could provide an effective, affordable and already available therapeutic alternative for malaria in East Africa at least until chlorproguanil-dapsone is registered.

The integration of tissue structure and nuclear function

Living cells can filter the same set of biochemical signals to produce different functional outcomes depending on the deformation of the cell. It has been suggested that the cell may be "hard-wired" such that external forces can mediate internal nuclear changes through the modification of established, balanced, internal cytoskeletal tensions. This review will discuss the potential of subnuclear structures and nuclear chromatin to participate in or respond to transduction of mechanical signals originating outside the nucleus. The mechanical interactions of intranuclear structure with the nuclear lamina will be examined. The nuclear lamina, in turn, provides a structural link between the nucleus and the cytoplasmic and cortical cytoskeleton. These mechanical couplings may provide a basis for regulating gene expression through changes in cell shape.Key words: gene expression, cell structure, nuclear structure, mechanotransduction, chromatin.

Increased control of the sheep biting louse Bovicola (Damalinia) ovis with deltamethrin formulated in a fractionated wool grease carrier

The synthetic pyrethroid deltamethrin (DM) containing a trace of [(14)C]-DM was formulated with non-oxidised sterol and wax ester fractions (F1) of wool grease and as the commercial preparation 'Clout-S'. These were applied as a 'backline' strip to sheep immediately after shearing and the concentration of [(14)C]-DM at meridians adjacent to the application strip and at 1/4 and 3/4 of the dorsal-ventral distance was determined. The F1 formulation resulted in significantly greater lateral spread of DM with less remaining at the application site (66+/-8% of dose) 98 days after treatment compared to 'Clout-S' (94+/-3% dose). Autoradiographic examination of treated wool demonstrated that there was more DM in the lower half of the wool staple when formulated in F1 compared to 'Clout-S'. Greater mortality occurred when sheep biting lice Bovicola (Damalinia) ovis were exposed in vitro to wool containing DM from F1 compared to 'Clout-S' treated sheep. In field trials there was increased efficacy against synthetic pyrethroid resistant B. ovis with F1 formulation than with 'Clout-S'. The study has demonstrated that synthetic pyrethroid availability, and therefore efficacy, can be significantly increased when the insecticide is formulated in a 'carrier' with the physicochemical characteristics of wool grease.

Production and oxidation of wool grease after shearing

OBJECTIVE

To measure the production and amount of oxidation of wool grease secreted immediately after shearing. To identify components of wool grease that might act as a carrier to facilitate lateral diffusion of topically applied insecticides.

DESIGN

Fine-wool Merino sheep were shorn and residual greasy wool was collected from the sheep's flank. The quantity of grease produced, and the amount of oxidation was measured during 18 days after shearing. Wool grease was fractionated into five component groups based on their polarity and the degree of oxidation in these fractions determined.

RESULTS

There was a 24% increase in grease production within 2 days after shearing but secretions returned to pre-shearing amounts after 4 days. During this period wool grease oxidized rapidly. Of the grease fractions examined, sterol and wax esters remained essentially unoxidized whereas free sterols such as cholesterol and lanosterol, fatty acids and polar lipids, aldehydes and alcohols were extensively oxidized within 7 days after shearing.

CONCLUSION

The transient increase in grease production after shearing may facilitate diffusion of topically applied synthetic pyrethroid insecticides. Oxidation of grease components may then contain the insecticide and limit further diffusion. Incorporating the insecticide in non-oxidising fractions of wool grease may make insecticide dispersion more efficient.

Studies on anti-folate antimalarials in east Africa

Chlorproguanil-dapsone (CD) appears to be a promising anti-folate combination (Amukoye et al., 1997) to substitute for pyrimethamine-sulfadoxine (PS), which has a long half-life and against which there is resistance in several Plasmodium falciparum populations including the highly endemic lowland area near Muheza, Tanzania (Trigg et al., 1997).

Biological problems with the replacement of a vector population by Plasmodium-refractory mosquitoes

Attempts are being made to backcross into Anopheles gambiae s.s. the gene(s) which cause zoophily in Anopheles quadriannulatus. Such a backcrossed strain might be preferable to a Plasmodium-refractory strain as a basis for genetic control because a refractory strain could select for evasion of refractoriness in the wild Plasmodium population. The species composition of the malaria vector population in several Tanzanian villages was overwhelmingly An. gambiae s.s. in a normal rainy season, but consisted of four species, all proved by ELISA and/or PCR to carry P. falciparum sporozoites, at the time of the heavy rains associated with El Niño. Thus any scheme, for malaria transmission control by replacement of vectors by genetically-manipulated non-vectors, would have to be able to replace more than one species.

Comparison of bednets impregnated with different pyrethroids for their impact on mosquitoes and on re-infection with malaria after clearance of pre-existing infections with chlorproguanil-dapsone

Comparisons of bednets treated either with alphacypermethrin or lambdacyhalothrin showed similar effectiveness by various entomological criteria. Lambdacyhalothrin was associated with significantly more reports of nasal irritation than alphacypermethrin. The 2 net treatments were equally effective in reducing incidence of new malaria infections and the treated nets were much more effective than untreated nets. These measurements were made after clearing existing infections with chlorproguanil-dapsone. This drug combination was more than 99% effective in clearing infections 1 week after treatment and a study of children taken to an altitude with no malaria transmission showed that there were very few recrudescences.

Can vector control play a useful supplementary role against bancroftian filariasis?

A single campaign of mass treatment for bancroftian filariasis with diethylcarbamazine (DEC) in Makunduchi, a town in Zanzibar, United Republic of Tanzania, combined with elimination of mosquito breeding in pit latrines with polystyrene beads was followed by a progressive decline over a 5-year period in the microfilarial rate from 49% to 3%. Evidence that vector control had contributed to this long-term decline was obtained by comparison with another town, Moga, where a DEC campaign was used without vector control and where resurgence of microfilariae could be observed 3-6 years after the campaign. In Zanzibar town, treatment of 3844 wet pit latrines and cesspits with polystyrene beads reduced the adult mosquito population in houses by about 65%. Supplementary treatment of open drains and marshes with Bacillus sphaericus produced little or no additional reduction compared to a sector of the town where only pit treatment with polystyrene was carried out. The cost and effort of achieving the 65% reduction in mosquito population could hardly be justified for its impact on filariasis alone, but its noticeable impact on biting nuisance might help to gain community support for an integrated programme.

A comparison of use of a pyrethroid either for house spraying or for bednet treatment against malaria vectors

In an intensely malarious area in north-east Tanzania, microencapsulated lambdacyhalothrin was used in four villages for treatment of bednets (provided free of charge) and in another four villages the same insecticide was used for house spraying. Another four villages received neither intervention until the end of the trial but were monitored as controls. Bioassays showed prolonged persistence of the insecticidal residues. Light traps and ELISA testing showed reduction of the malaria vector populations and the sporozoite rates, leading to a reduction of about 90% in the entomological inoculation rate as a result of each treatment. Collections of blood fed mosquitoes showed no diversion from biting humans to biting animals. Incidence of re-infection was measured by weekly monitoring of cohorts of 60 children per village, after clearing preexisting infection with chlorproguanil-dapsone. The vector control was associated with a reduction in probability of re-infection per child per week by 54-62%, with no significant difference between the two vector control methods. Cross-sectional surveys for fever, parasitaemia, haemoglobin and weight showed association of high parasitaemia with fever and anaemia and beneficial effects of each intervention in reducing anaemia. However, passive surveillance by resident health assistants showed no evidence for reduced prevalence of fever or parasitaemia. Net treatment consumed only about one sixth as much insecticide as house spraying and it was concluded that the former intervention would work out cheaper and nets were actively demanded by the villagers, whereas spraying was only passively assented to.

Malarial infection and birthweight in urban Zanzibar, Tanzania

In urban Zanzibar, Tanzania, 389 women with full-term pregnancies were studied to see what effect their infection with malaria (at delivery) had on the birthweight (BW) of their infants. The overall prevalence of low birthweight (LBW) (i.e. < 2500 g) was 3.9% (15 out of 389). Overall, 21.3% (82/384) of the women only had peripheral parasitaemias at delivery, 17.6% (58/329) only had active placental infections and 47.9% (157/328) had both. The youngest women (< 20 years), the primiparae and those with Plasmodium infection gave birth to neonates with relatively low mean BW. The lowest mean BW (2967 g) was found among the offspring of women with active placental infection (N = 58). The women with past/chronic infection (N = 73) or no infection (N = 201) generally produced heavier infants, with mean BW of 3242 and 3338 g, respectively. The women with active placental infection were also far more likely to have babies of LBW (15.5%) than those with past/chronic infection (1.4%) or no infection (1.5%). Multivariate analysis indicated that the highest relative risk of LBW (10.1, with a 95% confidence interval of 2.9-35.4) was associated with active placental infection, with no significant difference between primiparae and multiparae. In the study population, therefore, with its low prevalence of LBW, malaria infection increased the risk of LBW in full-term neonates by about 10-fold, with a population-attributable proportion of 55.4%.

Insecticide-impregnated bed nets reduce malaria transmission in rural Zanzibar

There has been concern that impregnated bed nets are an insufficiently powerful method to control malaria in areas with very high perennial transmission, as in the humid lowland parts of tropical Africa. We carried out a 'cross-over' trial among children under 5 years of age in 2 villages in rural Zanzibar. In 1989, one village was supplied with newly permethrin-impregnated bed nets whereas the other served as unprotected control. In 1992, when those nets had lost their insecticidal activity and were badly torn, the village which had previously been the control was given newly impregnated bed nets. Each time, reinfection with Plasmodium falciparum was measured after initially clearing the parasites by administering a therapeutic dose of sulfadoxine/pyrimethamine. The introduction of bed nets led to a 74-78% reduction in the weekly rate of reinfection with malaria parasites, in all age groups. The nets apparently also affected perceived clinical symptoms, haemoglobin levels, and the mosquito sporozoite rate.

Molecular characterization and expression of alfalfa isoliquiritigenin 2'-O-methyltransferase, an enzyme specifically involved in the biosynthesis of an inducer of Rhizobium meliloti nodulation genes

A cDNA clone encoding an O-methyltransferase (OMT) from alfalfa has been isolated, which methylates the 2'-hydroxyl of isoliquiritigenin (2',4,4'-trihydroxychalcone) to form 4,4'-dihydroxy-2'-methoxychalcone, the most potent of the nod-gene-inducing flavonoid derivatives released from alfalfa roots. The cDNA clone was identified on the basis of N-terminal sequence identity to purified S-adenosyl-L-methionine:isoliquiritigenin 2'-O-methyltransferase (chalcone OMT) and expression of enzymatically active chalcone OMT protein in Escherichia coli. The deduced amino acid sequence showed significant similarities to other OMTs. Chalcone OMT is encoded by a small gene family in alfalfa and related sequences are present in other legumes. The chalcone OMT gene is expressed primarily in alfalfa roots; transcript levels were highest during the first 2 weeks of development. The OMT transcript was also detected, to a much lesser extent, in root nodules. In contrast, chalcone isomerase (CHI), although expressed at high levels in roots, was found in all plant organs and had a somewhat different developmental expression pattern. Chalcone OMT transcripts were localized primarily to epidermal and cortical cells starting 1.5-2.0 mm behind the root tip, whereas CHI transcripts were present at approximately equal levels in epidermal, cortical and vascular tissues, both at the root tip and throughout the root. Chalcone OMT transcripts were elicitor-inducible in alfalfa cell suspension cultures, although only low levels of methoxychalcone accumulated. The implications of these results for plant-microorganism interactions are discussed.