[The significance of the family anamnesis in women with breast carcinoma]

A cancer-related family history was ascertained in 600 women with breast cancer. Prevalence data in the families were compared to the data of the population-based Basel cancer registry. Breast cancer occurrence was increased in first degree female relatives (relative risk: 1.7; 95% confidence interval: 1.4-1.9; p less than 0.0001). Breast cancer risk in relatives decreased with increasing age of the probands. Women at elevated breast cancer risk can be identified by obtaining a family history of breast cancer patients.

Effect of AWD 52-39 on vasoconstriction induced by noradrenaline and 5-hydroxytryptamine in vitro and in vivo in rats

The vascular effect of the potential nootropic AWD 52-39 (1; N,N-diacetoxyethyl-9,10-dihydrolysergic acid amide) as well as its influence on noradrenaline- or 5-HT-induced vasoconstriction were studied in the isolated rat aorta and in anesthetized normotensive and pithed rats. Vasoconstriction was determined by measuring the increase in mean arterial pressure (MAP). Both in vitro and in pithed rats, 1 caused a slight vasoconstriction, whereas a dose-dependent short-lasting decrease in mean arterial pressure was found in normotensive rats. In vitro and in pithed rats, 1 exerted no influence on the noradrenaline-induced vasoconstriction, while the 5-HT-induced contractile response was significantly inhibited. These findings characterize 1 as a competitive antagonist at vascular 5-HT2 receptors without any alpha-adrenolytic effect.

Biogenesis of the yeast vacuole (lysosome). Mutation in the active site of the vacuolar serine proteinase yscB abolishes proteolytic maturation of its 73-kDa precursor to the 41.5-kDa pro-enzyme and a newly detected 41-kDa peptide

The codon of the catalytic serine in the active site of the vacuolar serine proteinase yscB (PrB) was changed to alanine, yielding the mutant gene prb1-Ala519. Following replacement of the wild-type PRB1 allele with prb1-Ala519, only a 73-kDa molecule was detected by immunoprecipitation with PrB-specific antiserum. The size of the mutant molecule corresponds to the unprocessed cytoplasmic precursor (pre-super-pro-PrB), as detected in sec61 mutants, when translocation into the endoplasmic reticulum is blocked. However, the mutant molecule is completely translocated into the secretory pathway, as indicated by protection from proteinase K digestion in spheroplast lysates in the absence of detergent. When N-glycosylation was inhibited in prb1-Ala519 mutant cells by tunicamycin, a smaller molecule of about 71 kDa appeared consistent with single N-glycosylation and signal-sequence cleavage of the translocated mutant PrB molecule in the endoplasmic reticulum. Thus, the active-site mutation prevents the wild-type processing of the N-glycosylated 73-kDa precursor of PrB to the 41.5 kDa pro-PrB in the endoplasmic reticulum. In order to characterize the processing of wild-type super-pro-PrB in more detail, we generated antibodies against the non-enzymatic superpeptide domain of the 73-kDa precursor expressed in Escherichia coli. We find that, in addition to pro-PrB, a distinct protein (superpeptide) with a mobility of about 41 kDa in SDS/PAGE is generated in the endoplasmic reticulum. Pulse-chase experiments indicate rapid degradation of the 41-kDa superpeptide in wild-type cells. Correspondingly, the superpeptide was virtually undetectable by immunoblotting wild-type cell extracts. In contrast, no degradation of radioactively labeled 41-kDa superpeptide was observed within 60 min in mutant strains deficient in the vacuolar proteinase yscA (PrA), in which maturation of vacuolar pro-PrB to active PrB is blocked. Accordingly, superpeptide antigenic material was readily detected by immunoblotting cell extracts and enriched in vacuolar preparations of PrA deficient mutant cells. These results indicate that the superpeptide and pro-PrB travel to the vacuole, where the superpeptide is rapidly degraded upon pro-PrB activation to PrB. Using purified vacuoles, rapid degradation of the superpeptide was reconstituted in vitro by addition of either mature PrA or mature PrB. However, the PrA-triggered in vitro degradation of the superpeptide required PrB activity, as this process was inhibited in the presence of the PrB inhibitor chymostatin.(ABSTRACT TRUNCATED AT 400 WORDS)

Staged chest closure in pediatric cardiac surgery preventing typical and atypical cardiac tamponade

Chest closure after cardiac surgery occasionally results in cardiac compression leading to circulatory failure. In shunt-dependent circulation, the arterial oxygen saturation may decrease significantly due to the increase in pulmonary vascular resistance caused by chest closure. Temporary patch implantation with delayed sternal closure facilitates circulatory and/or pulmonary stabilization (temporary chest wall patch plasty, TCWPP). Between July 1986 and June 1991, 42 patients underwent staged chest closure (TCWPP) after open heart surgery for congenital lesions (4.9% of 854 patients). TCWPP was performed when either primary hemodynamic deterioration or an increase in cyanosis (palliative procedures only) followed by hemodynamic deterioration occurred during attempted or shortly after sternal closure. Overall mortality was 40.4% (17/42). It was 32.3% (11/34) when the patch was inserted primarily at the end of the operation. If the patch was inserted emergently 4-24 h postoperatively, mortality was 75% (6/8). Definite chest closure was performed from 4 h to 6 days (mean 72 h) postoperatively. In 2 patients closure had to be performed emergently (single ventricles); 7 patients died before chest closure. One mediastinal microbiology examination was positive. Deep sternal infection necessitating operative revision occurred in one other patient. In conclusion, TCWPP may considerably lower mortality of the illest patients after surgery for complex congenital heart disease. A timely decision as to the performance of staged chest closure is mandatory. This procedure rarely causes infection. We now apply this technique liberally, by cardio-mediastinal size judgement in over 30% of our TCWPP candidates even without a prior trial of primary closure.

[The significance of the structural characteristics of the agent for the problems of immunization against blue tongue]

Bluetongue virus (BTV), an arthropod-borne virus, is transmitted primarily by biting midges of the genus Culicoides. Some insect species, which might serve as a potential vector, are prevalent in Central Europe. In sheep, bluetongue is acute and mortality is high, whereas in cattle, goats and most wild ruminants the infection is usually clinically inapparent. Viremia is of short duration in sheep, but cattle experience a prolonged viremia and provide a reservoir for the dissemination of BTV. At least 24 different BTV serotypes have been identified. Antigenic variations occur in the polypeptides of the outer viral capsid and the segmented nature of the viral genome provides the potential for evolution of the virus by a mechanism of reassortment. This renders the use of polyvalent vaccines inefficient and emphasizes the significance of import/export restrictions on ruminants from BTV endemic areas.

Seasonal succession of ciliates in lake constance

We found a recurrent seasonal pattern in abundance and composition of planktonic ciliates in Lake Constance, FRG, over a three-year period. Abundance peaks occurred in early spring and summer/autumn, while ciliate numbers were low in late spring (clear-water phase) and winter. Prostomatida and Oligotrichida dominated in early spring. They responded immediately to the phytoplankton spring bloom, while Haptorida, Peritrichida, and large Scuticociliatida (Histiobalantium) were delayed by 1 to 2 weeks. The spring community broke down at the onset of the clear-water phase.Pelagohalteria viridis containing symbiontic algae appeared shortly after this event. A highly diverse community was recorded in summer/autumn. Peritrichida, small Oligotrichida, and large Scuticociliatida reached their maxima during this season. Small Scuticociliatida were rare throughout the year and contributed moderately to total ciliate numbers only during the cold season. The observed seasonal sequence of pelagic ciliates in Lake Constance is discussed in relation to simultaneously collected data on potential food organisms and grazers.

[Principles of gene technology and potentials of DNA diagnosis]

Gene technology offers new potentialities for medicine in the diagnosis, treatment and also prevention of disease. DNA diagnostic procedures are already a cornerstone of genetic counselling. The number of mutated genes identified and, as a consequence, the number of disorders diagnosable with a molecular genetic approach, is steadily increasing. Since a given gene is present in practically all somatic cells, it can, irrespective of its expression, be analyzed using white blood cells or chorionic vili as a source of DNA. This results in an extension of disorders diagnosable before birth (prenatal diagnosis) or before its clinical manifestation (presymptomatic diagnosis) as well as in the reliable recognition of clinically healthy carriers of defective genes. DNA diagnostic procedures have already gained practical application in oncology, immunology or forensic medicine. The methodology of molecular biology allows the analysis of infectious agents in tissues or body fluids that are only present in a latent state. We are only at the dawn of the century of molecular medicine. However, our knowledge of the cause and the nature not only of rare single genetic diseases but also of common multifactorial disorders, such as cardiovascular diseases, cancer or autoimmune diseases, is increasing through gene technology. Therefore, on the one hand the new genetics holds out numerous promises and hopes, while on the other hand, a future characterized by exorbitant genetic testing increases an irrational fear of this technology in the public. Members of the medical profession must interest themselves in molecular genetics in order to be able to follow the development of modern medicine but also to inform their patients and the general public about the new possibilities and limitations, as well as any risks, of genetic testing. This is the only way to ensure proper use of gene technology in medicine without irrational legal restrictions imposed by an ill informed public.

Interferon-alpha-2-induced stimulation of ACTH and cortisol secretion in man

Short-term effects of interferon-alpha 2 on plasma concentrations of adrenocorticotrophic hormone (ACTH) and cortisol were measured in man in relation to interferon absorption. Interferon-alpha 2 was given subcutaneously at a dose of 3 x 10(6) IU at 17.00 h to 2 female and 5 male patients who suffered from chronic hepatitis B infection and who had not previously been treated with interferon. Plasma levels of ACTH, cortisol and interferon-alpha were determined at 30-min intervals between 16.00 and 24.00 h. In each patient a similar cortisol, ACTH and interferon-alpha profile was determined on a day, when no interferon-alpha treatment was given. Interferon-alpha plasma levels peaked around 21.30 h, i.e. 4.7 h after injection. In each patient ACTH and cortisol levels were increased. As calculated from the areas under the curves, ACTH release was increased by an average of 332% (maxima at about 22.00 h, i.e. 5.2 h post injection); cortisol release was increased by an average of 311% (maxima at about 23.00 h, 5.8 h post injection). These actions were not related to side effects like fever or other flu-like symptoms. Our findings confirm that in man as in animals interferon-alpha 2 can act as a mediator between the immune and endocrine system.

[Continuous peridural application of sufentanil for postoperative analgesia]

Efficacy and side effects of a continuous infusion of sufentanil following epidural administration of a single dose of 30 micrograms of the opioid were studied in 28 patients undergoing laparotomy. Patients were divided into two groups treated with either 10 micrograms/h (n = 13) or 15 micrograms/h (n = 15) and compared with regard to sufentanil plasma levels, side effects and changes in blood gases. The analgesic effect of 15 micrograms/h was slightly better than that of 10 micrograms/h. There were few side effects during continuous administration of the high- or low-dose sufentanil: in some cases nausea (4/13 and 1/15) and vomiting (3/13 and 1/15) occurred. After the injection of a bolus of 30 micrograms sufentanil, a dose chosen according to current recommendations, a quick onset of analgesia was noted, but also sedation and respiratory depression with apneic intervals lasting up to 30 s, demonstrating both the efficacy and the possibility of unwanted and even harmful side effects associated with this kind of administration. During long-term infusion, after about 20 h PaCO2 and respiratory rate were significantly different between the two groups, which could be explained by differences in sufentanil plasma levels and a somewhat higher level of postoperative pain in the group receiving 10 micrograms/h.

Examination of Chinese NiTi wire by a combined clinical and laboratory approach

Chinese NiTi wire was compared with Nitinol and stainless steel wires in a combined laboratory and clinical examination. In the laboratory test, the loading and unloading-deflection properties of the wires were determined in a three-point bending test and their surface properties were studied in a scanning electron microscope. This test attempts to simulate a common clinical situation. The NiTi material showed a non-linear force-deflection relationship. The increase in force from 1 mm deflection and onwards was very slow and the force delivered during unloading from large deflections was almost constant. This behaviour was somewhat different for smaller downward deflections of NiTi wires. Plastic deformation was insignificant. The clinical study confirmed the laboratory results obtained, characterizing a wire material much superior to stainless steel and even superior to Nitinol for alignment purposes. In clinical use, however, the rate of fractures of NiTi wires turned out to be unsatisfactorily high. This disadvantage was not predicted by the three-point bending test. Scanning electron microscopy revealed surface defects and non-metallic inclusions in fractured NiTi wires. A combination of a bending test simulating a clinical situation and surface examination is recommended when new wire materials are to be tested.

A rabies-specific human monoclonal antibody that protects mice against lethal rabies

According to a recommendation from WHO (World Health Organisation) for prevention of a possible rabies infection, active vaccination has to be combined with application of immunoglobulin to get a fast protective effect. At present, preparations of purified human or equine rabies-specific immunoglobulin are used. We have generated a human rabies-specific monoclonal antibody (huMAb) by immortalization of human B-cells with Epstein Barr Virus (EBV), followed by fusion with a mouse myeloma cell. The resulting clone TW-1 secrets an IgG1 lambda huMAb which specifically reacts in ELISA with 5 laboratory rabies virus strains of serotype 1 and DUV3 (Duvenhage, serotype 4). Western Blot analysis revealed fine specificity for the G glycoprotein (gp67) of rabies virus. HuMAb TW-1 neutralizes rabies virus in vitro (RFFIT) as well as in vivo and protects rabies infected mice. Compared to polyclonal human rabies immunoglobulins, huMAb TW-1 is advantageous, because of its defined specificity and the very low amounts of total protein needed for therapeutic effects.

Immuno- and enzymehistochemical characterization of 'plasmacytoid T-cells' in formalin-fixed paraffin-embedded tissue of reactive lymph nodes

In eight (10.4%) of 77 randomly selected cases of lymphadenitis, foci of 'plasmacytoid T-cells' (PTCs) were found. We characterized the PTCs in formalin-fixed paraffin-embedded tissue by immuno- and enzymehistochemical techniques. In each case the PTCs formed nodular and patchy infiltration patterns around the high endothelial venules in the paracortex of the lymph nodes. The PTCs in half of the cases were present near the intermediary peritrabecular sinuses. The PTCs were found to be positive for CD 45 (LCA), CD 45 R (4 KB 5) and CD 43 (MT 1), but not for CD 45 RO (UCHL 1), L 26 (CD 20), myeloperoxidase, naphthol AS-D chloroacetate esterase, Mac 387, alpha-1-antichymotrypsin or S 100 protein and anti-dendritic reticulum cell antibody. Some lysozyme+ PTCs were mingled in and around the foci in each case. In five cases the PTCs showed weaker positive reactions for CD 68 (EBM 11) and HLA-DR than for T-zone macrophages and sinus histiocytes. Related to the degree of desintegration of the nodular PTC-foci increasing numbers of T- and B-lymphocytes, T-zone macrophages and interdigitating reticulum cells with HLA-DR were detected in the foci. In two cases, where there was no HLA-DR expression by PTCs, small amounts of HLA-DR in secondary lymph follicles and a decrease of HLA-DR+ T-zone macrophages and interdigitating reticulum cells were observed. Our results suggest that there is a high degree of interaction between PTCs and other cellular components in the lymph node. The PTC may represent a special type of resident macrophage with secretory capacities.

Endonuclease activity of Escherichia coli DNA helicase I directed against the transfer origin of the F factor

DNA helicase I, the traI gene product of the Escherichia coli F factor, was shown to be associated with endonuclease activity specific for the transfer origin of the F plasmid, oriT. In the presence of Mg2+, the purified enzyme forms a complex, stable in the presence of sodium dodecylsulfate (SDS) with a negatively superhelical chimeric plasmid containing oriT. The enzyme nicks and, after this, apparently binds to the 5' nick terminus when this complex is heated in the presence of SDS and/or EDTA or treated with proteinase K. Dideoxy sequencing locates the nick site in the F DNA strand transferred during bacterial conjugation after nucleotide 138 clockwise of the mid-point of the BglII site at 66.7 kb of the F genetic map. A sequencing stop after nucleotide 137 of this strand (where oriT-nicking seems to occur in vivo) is possibly an artefact caused by helicase I protein attached to the 5' terminal nucleotide. Deletion in the amino-terminal part of the traI polypeptide abolishes the oriT-nicking activity while leaving the strand-separating activity intact. These results confirm the prediction from genetic studies that helicase I is bifunctional with site-specific endonuclease and strand-separating activities.

The structural polypeptide VP3 of infectious bursal disease virus carries group- and serotype-specific epitopes

Two independent non-overlapping epitopes could be demonstrated on the structural protein VP3 of infectious bursal disease virus by non-neutralizing monoclonal antibodies produced against serotypes I and II. Both serotypes have one epitope in common, whereas the second epitope is distinct for serotype I and serotype II.

Influence of endothelium on the vasoconstrictor effect of dihydroergotamine in pithed rats

The aim of the present paper was to investigate whether endothelial damage influences the vasoconstrictor activity of dihydroergotamine in pithed normotensive rats. Intravenous administration of dihydroergotamine caused a dose-dependent increase in mean arterial blood pressure. Endothelial lesions were produced by a bolus injection of homocysteine (100 mg/kg) or methionine (100 mg/kg every 24 hr for 6 days). In these animals, the resting blood pressure was not influenced, while the dihydroergotamine-induced pressor effect was significantly enhanced with an increase in the maximum effect. Pretreatment of the animals with NG-nitro-L-arginine (10 mg/kg), which inhibits the biosynthesis of the endothelium-derived relaxing factor in endothelial cells, markedly enhanced the pressor response to dihydroergotamine accompanied with an increase in the maximum response. Intravenous administration of NG-nitro-L-arginine alone led to a sustained increase in blood pressure by 19 +/- 4 mm Hg. In comparative studies with noradrenaline, the dose-response curve for the pressor effect was shifted to the left after pretreatment of the rats with methionine or NG-nitro-L-arginine, whereas the maximum effect remained unchanged. The results suggest that the impaired basal release of the endothelium-derived relaxing factor accounts for the increased vasoconstrictor activity of dihydroergotamine. This might be an explanation for the vasospastic effects of dihydroergotamine in arterial vessels with endothelial damage.

Heterogeneity of the antigenic site responsible for the induction of neutralizing antibodies in infectious bursal disease virus

Using neutralizing monoclonal antibodies, three categories of escape mutants were selected from a stock of wild-type infectious bursal disease virus (IBDV). Additional mutants were found, where alterations coexisted in two or three of these epitopes. Although each group of mutants had a distinct reaction pattern with neutralizing monoclonal antibodies, all types of mutants were neutralized by convalescent chicken sera to the same extent. In spite of the lack of homogeneity in these antigenic sites located on IBDV structural polypeptide VP2, all neutralizing monoclonal antibodies reacted with epitopes in extracts prepared from the bursa of Fabricius from animals that had died during recent outbreaks of infectious bursal disease in the F.R.G. and Africa. Since binding to VP2 of the escape mutants, demonstrable by immunoprecipitation, correlated with the neutralizing capacity of these antibodies, a combined immunoprecipitation-immunoblotting technique was established as equivalent for a neutralization assay. The results of our experiments indicate that IBDV did not undergo a major antigenic variation in these two areas of Europe and Africa. The significance of protein conformation for the interaction of VP2 with neutralizing antibodies was underlined by the finding that renatured VP2 was capable of binding neutralizing antibodies; the antibodies induced in animals by immunization with this protein, however, were not neutralizing.

Infectious bursal disease--B cell dependent immunodeficiency syndrome in chickens

Infectious bursal disease of chickens can run an acute lethal course, or death can result from a B cell-dependent immunodefect due to destruction of the bursa of Fabricius following infection with infectious bursal disease virus (IBDV). This member of the Birnaviridae has been characterized, the nucleotide sequence and coding capacity of the two genomic segments of dsRNA has been determined, and the functional significance of the four structural proteins has been largely elucidated. The antigenic structure of the two main structural components permits differentiation of two serotypes; the antigenic domain responsible for the induction of neutralizing antibodies resides, in a conformation-dependent fashion, on one of these proteins. Various types of defective particles are formed and various degrees of pathogenicity appear, depending on the host cell in which the virus replicates. B cells in the bursa offer optimal conditions for virus replication. Pathogenic properties of the virus are also influenced by both genomic segments and cannot be attributed to a single gene. Many aspects of practical interest for disease control are briefly discussed.