Phaeochromocytoma: experience from a referral hospital in southern India

BACKGROUND

Phaeochromocytoma has been traditionally called the 'Tumour of Tens'. Many investigators have reported the prevalence of extra-adrenal phaeochromocytoma to be more than 10%.

METHODS

All consecutive adult patients diagnosed to have phaeochromocytoma by the departments of endocrinology and surgical endocrinology of the Christian Medical Hospital, India, over a period of 10 years from 1988 to 1998, were included in the study.

RESULTS

A total of 30 patients were diagnosed to have phaeochromocytoma. Extra-adrenal phaeochromocytoma accounted for 26.6% of cases, Ten per cent of cases were bilateral, 6.6% were malignant and one patient had a familial tumour (multiple endocrine neoplasia IIB). The tumours were localized pre-operatively in all patients. Multicentric extra-adrenal tumours were not found in this series. All patients except one were explored by the anterior transperitoneal approach. Persistent hypertension was noted in 30% of patients.

CONCLUSIONS

Our series shows a higher prevalence (26.6%) of extra-adrenal tumours than the traditionally described 10%. With accurate pre-operative localization, a transperitoneal approach may not be necessary. The laparoscopic approach needs to be evaluated in light of these findings.

Early results from indirect drug susceptibility test for tubercle bacilli

The indirect susceptibility test results on L-J medium for tubercle bacilli against streptomycin, isoniazid and rifampicin were read at the end of 2 wk and compared with the results at 4 wk. It was found that drug resistance could be correctly predicted in over 70 per cent of cultures including multi-drug resistant tuberculosis (MDR TB) strains at the end of 2 wk. The susceptibility to para-nitrobenzoic acid (PNB) read at 2 wk was able to distinguish non-tuberculous mycobacteria from Mycobacterium tuberculosis cultures. The early detection of resistance by this procedure requires only minimum inputs, and can benefit the majority of patients harbouring drug resistant tubercle bacilli.

Identification of a novel cardiac lineage-associated protein(cCLP-1): A candidate regulator of cardiogenesis

We describe the isolation and characterization of a cDNA clone, called cCLP-1, that is a candidate for the previously described early cardiac-specific transcription factor BBF-1. BBF-1 binds the MEF2 (or element B) binding site within the cardiac myosin light chain 2 (MLC2) gene promoter. We used the element B sequence as a probe to screen an expression library constructed from mRNA obtained from the presumptive heart-forming regions of stage 6 chicken embryos. This yielded the cCLP-1 cDNA clone. Gel-shift analysis of stage 6 embryonic chicken protein extracts suggests that a protein that is recognized by the anti-cCLP-1 antibody binds to the same element B binding site to which BBF-1 binds. cCLP-1 mRNA was detected early in chicken development, prior to cardiac fate assignment at stage 4. The expression pattern of cCLP-1, based on whole mount in situ hybridization, coincides remarkably well with the established morphogenetic field of early heart formation. The nuclear localization of cCLP-1 is phosphorylation-dependent, suggesting that cCLP-1 may be a member of that class of transcription factors whose activity is regulated by cytoplasm to nucleus transport. Taken together, these data suggest that cCLP-1 may encode a novel transcription factor whose expression pattern is in agreement with that of the cardiogenic precursor cells of the early chicken embryo.

Surgical presentation of melioidosis in India

BACKGROUND

Melioidosis, the disease caused by Burkholderia pseudomallei, is common in Southeast Asia. It has also been reported from India, where some investigators feel it is under-diagnosed and under-reported. We report our experience with melioidosis presenting as abscesses at unusual sites.

METHODS

All consecutive patients with culture proven B. pseudomallei, who presented to a single surgical unit between 1995 and 1998, were evaluated.

RESULTS

Three patients presented with splenic abscesses and one with a soft tissue abscess in the neck. One patient developed septicaemia. All patients responded favourably to ceftazidime and/or co-trimoxazole which was started as soon as the diagnosis was confirmed.

CONCLUSION

Melioidosis is under-diagnosed in India, probably due to a low index of suspicion of this disease among clinicians. It should be considered as a possibility when abscesses are encountered at unusual sites. The pus must then be cultured to identify the causative agent.

Reduced folate carrier expression in acute lymphoblastic leukemia: a mechanism for ploidy but not lineage differences in methotrexate accumulation

Methotrexate (MTX) is one of the most active and widely used agents for the treatment of acute lymphoblastic leukemia (ALL). To elucidate the mechanism for higher accumulation of MTX polyglutamates (MTX-PG) in hyperdiploid ALL and lower accumulation in T-lineage ALL, expression of the reduced folate carrier (RFC) was assessed by reverse transcription-polymerase chain reaction in ALL blasts isolated from newly diagnosed patients. RFC expression exhibited a 60-fold range among 29 children, with significantly higher expression in hyperdiploid B-lineage ALL (median, 11.3) compared with nonhyperdiploid ALL (median, 2.1; P <.0006), but no significant difference between nonhyperdiploid B-lineage and T-lineage ALL. Furthermore, mRNA levels of RFC (mapped by FISH to chromosome 21) were significantly related to chromosome 21 copy number (P =.0013), with the highest expression in hyperdiploid ALL blasts with 4 copies of chromosome 21. To assess the functional significance of gene copy number, MTX-PG accumulation was compared in ALL blasts isolated from 121 patients treated with either low-dose MTX (LDMTX; n = 60) or high-dose MTX (HDMTX; n = 61). After LDMTX, MTX-PG accumulation was highest in hyperdiploid B-lineage ALL with 4 copies of chromosome 21 (P =.011), but MTX-PG accumulation was not significantly related to chromosome 21 copy number after HDMTX (P =.24). These data show higher RFC expression as a mechanism for greater MTX accumulation in hyperdiploid B-lineage ALL and indicate that lineage differences in MTX-PG accumulation are not due to lower RFC expression in T-lineage ALL.

Implicit memory for phonological processes in visual stem completion

Four experiments were conducted investigating the role of phonology in repetition priming. Experiment 1 used a cross-modal priming paradigm in which participants made semantic judgments about spoken words and then performed a visual stem completion task. In Experiments 2-4, both the primes and the test stems were presented visually. The results of the first three experiments revealed that priming transfers across interpretations of a homophone. That is, seeing or hearing week primes both week and weak. The results of Experiment 4 showed that homophone priming cannot be attributed to the orthographic similarity of homophonic words. Together, these results indicate that repetition priming on a visual word completion task includes a phonological component.

Composition of gallstones in Coimbatore District of Tamil Nadu State

BACKGROUND

Gallstones in northern India are predominantly of the cholesterol type; such information on gallstones in southern India is scant.

AIM

To analyze the composition of gallstones from patients residing in Coimbatore District in Tamil Nadu State.

METHODS

The stones were classified using the Bernhoft criteria and was correlated with the morphological characteristics.

RESULTS

Of the 105 gallstones analyzed, 67 (63.8%) were of the pigment variety and 36 (34.8%) of the intermediate/mixed type. There were only two cholesterol stones. The mean proportions of cholesterol, bilirubin and calcium in the pigment and intermediate stones were 7.1%, 26.1% and 7.8% and 30.2%, 18.4% and 6.3%, respectively. The mean proportion of bilirubin in the pigment stones was higher than in the intermediate type. Morphologically, pigment stones were black in 55% and amorphous in 63%; the intermediate stones were hard in 50% and of variegated color ranging from yellow to ivory white in 61%; both cholesterol stones were multiple, hard and brown.

CONCLUSIONS

There is a predominance of pigment and intermediate gallstones (98%) in this district. These stones have reduced cholesterol and an increase in bilirubin and calcium proportions.

Modulation of biochemical activity of hepatocytes in culture by matrix substratum

The influence of extra cellular matrix on the biochemical activity of hepatocytes was studied by maintaining rat hepatocytes in primary culture in a serum free medium on different matrix protein substrata or biomatrices prepared from liver, aorta or mammary gland. There was significant difference in the individual protein synthesis and distribution by cells maintained on different substrata. Comparison of the kinetics of synthesis and secretion of albumin by cells maintained on different tissue biomatrix showed that those maintained on hepatic biomatrix synthesized more albumin and retained more of albumin synthetic capacity, when compared to those maintained on aortic and mammary gland biomatrix. Similarly, hepatocytes maintained on hepatic biomatrix synthesized significantly more apo B, the major apo protein of VLDL, than those maintained on heterologous tissue matrix. Induction of tyrosine aminotransferase by dexamethasone and the uptake of [14C]-amino isobutyric acid were found to be maximum in cells maintained on liver biomatrix than the heterologous biomatrix. But cells maintained on hepatic biomatrix incorporated less amounts of radioactivity into total cytoskeletal proteins as well as the individual proteins such as actin and the cytokeratins C8 and C18 while that by cells maintained on aortic biomatrix was significantly high. Quantitative analysis of the relative incorporation of radioactivity into individual cytoskeletal proteins and albumin in pulse labelling studies with cells maintained in culture on different matrix for different lengths of time revealed a reciprocal relationship between these two activities. These results indicate that the substrata with which the cells are in contact influence on a selective basis, the biochemical activity of hepatocytes in primary culture.

A human lymphoid leukemia cell line with a V(D)J recombinase-mediated deletion of hprt

Large deletions of exons 2 and 3 of the hprt gene are the most common type of hprt mutation in lymphocytes of newborn infants, and their frequency increases in cultured human T-lymphoid cells as a result of exposure to etoposide. Sequenced PCR products for these deletions are consistent with a V(D)J recombinase-mediated mechanism underlying their genesis. Herein, we describe the isolation and characterization of an etoposide-induced mutant CEM cell line that is clonal for a V(D)J recombinase-mediated exon 2 + 3 deletion. Human CCRF-CEM cells were exposed to 5 muM etoposide for 4 h, selected in 6-thioguanine, and an exon 2 + 3 deletion mutant was isolated through serial limiting dilution, using a PCR-based assay for detection of the exon 2 + 3 deletion. Untreated CEM cells and cells treated with 6-thioguanine alone were similarly subcultured. The exon 2 + 3 deletion-containing line was termed SJCEM808 and had a slightly longer doubling time than the control lines, tended to clump in suspension, and was characterized by cell membrane blebbing. Compared to the parent line, SJCEM808 had similar cytogenetic abnormalities, lower CD2, CD1, and CD10 expression, and negligible RAG-1 expression. However, RAG-1 expression was down-regulated in some untreated parental subclones following similar subculturing. The sequence of the exon 2 + 3 deletion mutation exhibited nucleotide insertions, and the breakpoints were adjacent to heptamer signal recognition sequences in intact hprt, consistent with a V(D)J recombinase-mediated mechanism underlying its genesis. There were no MLL gene or interlocus T-cell receptor (TCR) rearrangements. These results indicate that non-homologous recombination following etoposide treatment is neither necessarily accompanied by other large DNA rearrangements nor simply a pre-lethal event, and this cell line may serve as a useful tool for studying illegitimate V(D)J recombinase-mediated deletions.

Spontaneous retromammary haemorrhage during warfarin therapy

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Pentoxifylline potentiates in vitro lymphocyte suppression by glucocorticoids and immunosuppressive drugs

Pentoxifylline, which has immunomodulatory effects in addition to its better known rheologic effects, might potentiate the effectiveness of traditional immunosuppressive drugs. We therefore studied the suppressive effect of pentoxifylline in combination with clinically relevant concentrations of prednisolone, methylprednisolone, cyclosporine, tacrolimus, rapamycin, and mycophenolic acid on mitogen-stimulated lymphocytes from 29 patients with glomerular diseases. Inhibition of lymphocyte proliferation obtained with 10(-7) and 10(-8) mol/L concentrations of the glucocorticoids and with 300 ng/mL cyclosporine was significantly increased when each was combined with 5, 25, or 50 microg/mL of pentoxifylline. The additive inhibitory effect of pentoxifylline in combination with 10(-7) mol/L glucocorticoids was inversely proportional to the inhibitory effect of the 10(-7) mol/L concentration of glucocorticoid alone, suggesting that the less sensitive the patient's cells, the greater the potentiation by pentoxifylline. The greatest degree of potentiation by pentoxifylline occurred when combined with the lower (10(-8) mol/L) concentration of glucocorticoids. Pentoxifylline also significantly increased lymphocyte suppression in combination with 150 and 300 ng/mL concentrations of cyclosporine, 5 ng/mL of tacrolimus, 2.5 x 10(-7) mol/L mycophenolic acid, and 10 ng/mL of rapamycin. These in vitro results suggest that pentoxifylline might have steroid-sparing effects and contribute to improved clinical outcomes from immunosuppressive treatment of renal diseases.

Atelectasis in children

BACKGROUND

In children with lower respiratory tract symptoms, the elicited signs are not enough to distinguish common diagnosis like pneumonic consolidation, foreign body aspiration and atelectasis. Radiology and bronchoscopy would identify the true nature of the etiology.

DESIGN

Prospective study.

SUBJECTS

Thirty five children with both acute and chronic lower respiratory tract symptomatology, were analyzed for clinical and radiological signs of atelectasis.

RESULTS

There were 23 cases in the acute group and 12 in chronic group. Acute group included cases of pneumonia, foreign body aspiration and mucus plug syndrome. Chronic group included cases of congenital heart disease, endobronchial tuberculosis and bronchial stenosis. Clinical recognition of atelectasis on the basis of localized loss of breath sounds and mediastinal shift was seen only in a minority of cases (8/35). The presence of atelectasis in children with pneumonia, missed clinically were diagnosed by the presence of tracheal shift, elevated hemidiaphragm and silhouette sign. In 21 cases, silhouette sign was positive making it an important radiological sign. Twenty one children underwent either diagnostic or/and therapeutic bronchoscopy. Findings included foreign bodies (n = 5), mucus plugs (n = 4), narrowing of main bronchus (n = 4) and inflammatory mucoid secretions and narrowing of lumen (n = 8). There were no major complications.

CONCLUSION

The diagnosis of atelectasis in children may pose difficulties and there is a need to have a high index of suspicion to exclude atelectasis in children with either acute or chronic respiratory tract symptomatology.

Alterations in total and differential counts of WBC during ochratoxicosis in rabbits

Consumption of ochratoxin-contaminated feed (10 mg/kg) by young rabbits for 90 days altered total and differential counts of WBC. Time dependent decline in WBC count indicates occurrence of cumulative toxicity.

Role of pinaverium bromide in south Indian patients with irritable bowel syndrome

The effect of pinaverium bromide in controlling gastrointestinal symptoms in 61 patients with irritable bowel syndrome was studied, as an open trial. Individually, there was significant relief in abdominal discomfort/pain as well as in bowel symptoms in most of the patients. Abdominal pain was reduced in 49%, stool consistency improved in 74%, straining and urgency decreased in 71% and mucus decreased in 64%. Tolerance to the drug administered was good and side-effects reported were few.

Is vegetarianism a precipitating factor for gallstones in cirrhotics?

AIM

To study the association of factors such as alcohol, smoking and vegetarianism with presence of gallstones amongst cirrhotics.

PATIENTS AND METHODS

Data on alcoholism, smoking and vegetarianism was collected from the case records of 669 cirrhotics with (76) or without gallstones (593) retrospectively. Relative risk for the factors was computed individually and in combination controlling for the effects of alcoholism and smoking on vegetarianism.

RESULTS

Alcoholism and smoking were of low relative risk [R.R-1.27 (95% CI 0.82 to 1.96), and 1.02 (95% CI 0.65 to 1.61) respectively] while vegetarianism was associated with high risk for gallstone formation in cirrhotics [R.R 2.74 (95% CI 1.65-4.53)]. Vegetarian men had a relative risk of 3.02 (95% CI 1.75-5.22) irrespective of their alcoholic status. If women were alcoholic the relative risk increased to 7.03 (95% CI 3.26-15.12). Controlling for effects of gender and alcoholism, vegetarian cirrhotics had a 3 times greater risk for gallstone formation [Mantel Haenszel Relative Risk 3.18 (95% CI MHRR 1.82-5.56)].

CONCLUSIONS

Cirrhotic, vegetarian women in South India have a much higher risk for gallstones, if they are alcoholic. Alcoholic men who are vegetarians are at a greater risk for gallstone disease.

12p abnormalities and the TEL gene (ETV6) in childhood acute lymphoblastic leukemia

Although abnormalities involving the short arm of chromosome 12 (12p) are one of the most frequently observed rearrangements in childhood acute lymphoblastic leukemia (ALL), little is known about the frequency of different structural abnormalities and their relationship to the status of the ETV6 (also named TEL) gene in this region. Of 815 children with newly diagnosed ALL, 94 (11.5%) had a total of 104 cytogenetic 12p abnormalities. Loss of genetic material was observed in 67 (64%) of these abnormalities. Cases with 12p alterations had a much lower frequency of hyperdiploidy greater than 50 (7%) than did the ALL population in general, but these cases had a similar distribution of immunophenotype and similar 5-year event-free survival (70% +/- 5% SE v 64% +/- 2%, P = .64). Rearrangement of the ETV6 gene was identified in 36 (56%) of 64 cases evaluated. The ETV6-CBFA2 (TEL-AML1) fusion transcript was found in 25 (66%) of 38 cases evaluated, and all but one of these showed ETV6 rearrangement. Importantly, ETV6 rearrangement was associated with a favorable prognosis (5-year event-free survival: 89% +/- 6% v 60% +/- 1%, P < .01). We conclude that most but not all 12p cytogenetic abnormalities in childhood ALL involve ETV6, and that rearrangement of ETV6 is associated with a favorable treatment outcome.

Antioxidant activity of Tinospora cordifolia and its usefulness in the amelioration of cyclophosphamide induced toxicity

Extract of Tinospora cordifolia has been shown to inhibit the lipid peroxidation and superoxide and hydroxyl radicals in vitro. Concentration needed for 50% inhibition was 6 mg and 12.5 mg/ml, respectively. The extract was also found to reduce the toxic side effects of cyclophosphamide administration (25 mg/kg b.wt, 10 days) in mice hematological system by the free radical formation as seen from total white blood cell count, bone marrow cellularity and alpha-esterase positive cells. Moreover, administration of the extract partially reduced the elevated lipid peroxides in serum and liver as well as alkaline phosphatase and glutamine pyruvate transaminase. This indicates the use of Tinospora extract in reducing the chemotoxicity induced by free radical forming chemicals.

Classically conditioned changes in plasma cortisol levels induced by dexamethasone in healthy men

Animal research has indicated that the activity of the hypothalamic-pituitary-adrenal axis can be influenced by classical (Pavlovian) conditioning procedures. To test the hypothesis that alterations in plasma cortisol levels can be conditioned in humans, the present study used a prospective, randomized, double-blind, placebo-controlled design in which a distinctively flavored beverage was paired with p.o. administration of dexamethasone. Twenty-five healthy men were randomly assigned to one of two groups. During the conditioning phase of the study, subjects in the experimental group received three conditioning trials (pairings of a distinctively flavored beverage with a capsule containing 5 mg dexamethasone) separated by 1 wk recovery periods. Subjects in the control group were treated identically, except that the capsule contained a placebo. During the test phase, all subjects underwent a test day (reexposure to the distinctively flavored beverage before receiving a placebo capsule) and a comparison day (no exposure to the beverage or the capsule). Plasma cortisol was assessed repetitively before and after administration of the beverage and capsule, as were possible confounding factors, including: behavioral variables, psychological distress, aversive reactions to the beverage, and expectations of treatment. After reexposure to the beverage and administration of a placebo capsule (conditioned stimuli), the experimental group had significantly higher levels of plasma cortisol than the control group, after controlling for variability in baseline levels of cortisol (F(5,60)=3.09; P=0.015) that could not be explained by differences in other study variables. No differences in cortisol levels were found on the comparison day. These results support the study hypothesis that changes in plasma cortisol levels can be classically conditioned in humans by pairing a distinctive beverage with p.o. administration of dexamethasone.

Parotid fine-needle aspiration: a cytologic study of pediatric lesions

Fine-needle aspiration (FNA) of parotid lesions in the pediatric age group presents interesting diagnostic problems. There is limited cytologic literature available on the subject. We studied the cytologic findings on FNA of parotid masses in seven such cases. Patients ranged in age from 1 to 17 years (mean = 10.4). Diagnoses included lymphoepithelial cyst (n = 1), mucoepidermoid carcinoma (n = 2), pilomatrixoma (n = 1), acinic-cell carcinoma (n = 1), rhabdomyosarcoma (n = 1), and Ewing's sarcoma (n = 1). Six cases were confirmed by subsequent histologic examination. The study elaborates on the cytologic features of each lesion and discusses the differential diagnosis of closely related entities peculiar to this age group. It highlights the role of FNA as the diagnostic modality of choice in dealing with pediatric parotid masses.

Ameloblastoma. Cytologic findings and literature review

OBJECTIVE

To define and elaborate the cytomorphologic features of primary and metastatic ameloblastoma (ABL) on fine needle aspiration (FNA) and to discuss the differential diagnosis with closely related entities and review the cytologic literature on the subject.

STUDY DESIGN

A retrospective study consisting of five cases of ameloblastomas, primary in the mandible (n = 3) and metastases (n = 2), diagnosed by FNA cytology with appropriate cytohistologic correlation, was done. Smears were stained with the Diff-Quik and Papanicolaou methods. Hematoxylin and eosin-stained sections of paraffin block as well as sections from the surgically resected specimens were also reviewed.

RESULTS

The smears were hypercellular and occasionally showed tissue fragments of basaloid cells with peripheral palisading. A distinct, two-cell population was seen, consisting of small, hyperchromatic, basaloid-type cells and scattered larger cells with more open chromatin. Occasional fragments of mesenchymal cells with more elongated nuclei and ample, clear cytoplasm were also noted. Malignant cases that metastasized showed prominent cytologic pleomorphism, cellular crowding with molding and a high mitotic/karyorrhectic index.

CONCLUSION

In the right clinical setting and with proper radiologic evidence, the cytologic features of primary and metastatic ameloblastoma are unique. Diagnostic problems may arise when these lesions are pleomorphic and frankly malignant, especially at metastatic sites, such as the lung. FNA, therefore, is a valuable diagnostic tool in the initial diagnosis and follow-up of patients with a history of ameloblastoma.

Significance of peritoneal washings in gynecologic oncology. The experience with 901 intraoperative washings at an academic medical center

OBJECTIVE

Peritoneal washings are routinely performed during gynecologic surgery. The presence or absence of malignant cells in washings helps determine the stage of the malignancy. However, the efficacy of this procedure has not been studied recently.

DESIGN

All intraoperative washings for gynecologic disease at our hospital from 1992 through 1994 (901 cases) were reviewed. Of these, 380 were gynecologic malignancies that were reviewed for changes in staging based on the presence of malignant cells.

RESULTS

Histologically, 380 cases were gynecologic malignancies, 521 benign, 79 nongynecologic, and 25 had no accompanying surgical pathology. Of the malignancies, 125 had a diagnosis of cancer on washings. In 12 cases (3.1%), a change in stage resulted.

CONCLUSIONS

In a small but significant number of cases, malignant cells in the washings changed postoperative staging, impacting therapeutic measures and prognosis for these patients greatly. Peritoneal washings remain a simple yet effective tool in the evaluation and management of gynecologic malignancies.

Pulmonary sequestration--a diagnostic pitfall: a case report

Pulmonary sequestration is defined as a congenital malformation of abnormal lung tissue that does not communicate with the airway system and that receives blood supply from anomalous arteries. The majority of these sequestrations are encountered in the pediatric population. Surgical excision is the treatment of choice, with excellent prognosis. We studied a case of an extralobar pulmonary sequestration in a young adult, presenting as an intrathoracic mass; it was aspirated twice, final diagnosis being rendered after surgical resection. The cytologic findings and the accompanying diagnostic difficulties to our knowledge have never been reported.

Synthesis of sulphated proteoglycans by primary cultures of rat hepatocytes--modulation by matrix substratum

Primary cultures of rat hepatocytes maintained on different matrix proteins such as collagen (Co IV) fibronectin (Fn), Laminin (Ln) or different tissue biomatrices were metabolically labelled with 35[S]-SO4 and the synthesis of sulphated proteoglycans was studied. The incorporation of the label into total glycosaminoglycan (GAG) was significantly higher in cells maintained on Co IV compared to those maintained on Fn or Ln. Similarly the incorporation of label was maximum in those cells maintained on the aortic biomatrix compared to liver or mammary gland biomatrix. About 80-95% of the GAG synthesised and secreted by cells maintained on individual matrix proteins and liver biomatrix was heparan sulphate (HS). But in the case of cells maintained on collagen IV aortic or mammary biomatrix in addition to HS, significant amount of chondroitin sulphate (CS) was also found. Nearly 50% of the total 35[S]-GAG was associated with the cell layer after 24 h in culture in the case of cells maintained on individual matrix protein while those maintained on tissue biomatrix, retained about 70% of the 35[S]-labelled proteoglycans (PG) with the cell layer. Analysis of the cell surface 35[S]-labelled proteoglycans isolated from cells maintained on different biomatrix showed that it is a hybrid proteoglycan consisting of CS and HS. While the PG isolated from cells maintained on liver biomatrix consists of HS and CS in the ratio of 3:2 that from cells maintained on aorta or mammary gland matrix was about 2:3 indicating an alteration in the nature of the cell surface PGs produced by cells maintained on different tissue biomatrix. These results indicate that depending on the nature of the matrix substratum with which the cells are in contact, the nature and quantity of sulphated proteoglycans produced by hepatocytes vary.

Promoter of the canine tracheobronchial mucin gene

The mucin gene is up-regulated in diseases such as cystic fibrosis (CF) and asthma. To understand the mechanisms involved in transcriptional regulation of mucin gene expression we have characterized the region of the mucin gene up-stream of the transcriptional start site and analysed the cis-acting elements required for mucin promoter activity. We isolated clones from a dog genomic library containing the promoter region for the tracheobronchial mucin gene (TBM). The authenticity of the promoter was tested by nucleotide sequencing, primer extension analysis, electrophoretic mobility shift assay (EMSA) and reporter gene expression analysis. The canine TBM promoter is different from housekeeping gene promoters (as it is not rich in GC content and contains TATA- and CAAT-like sequences) and different from that of regulatory genes (because it contains many TATA- and CAAT-like sequences and multiple transcriptional initiation sites). Reporter gene analysis using canine TBM promoter-chloramphenicol acetyltransferase (CAT) fusion plasmids established the regions responsible for promoter activity and verified the positions of the major mucin transcriptional initiation sites. Reporter gene analysis also established that a region of the canine TBM promoter and first exon containing all of the transcriptional initiation sites is more active in mucin expressing cells (e.g. CT1 cells-immortalized canine tracheal epithelial cells, human CFT1 cells-immortalized tracheal epithelial cells from a CF subject, or HBE1 cells-immortalized tracheal epithelial cells from non-CF subject) than in mucin non-expressing cells (COS7, 3T3), suggesting cell specificity. The promoter region contained cAMP response element (CRE) sequences, and the TBM gene transcription was enhanced when cAMP analogs were added to transfected cells. EMSA indicated the presence of at least two DNA binding proteins in CT1 cells. This is the first report describing the characterization of a TBM gene promoter. The information obtained in the present studies will be valuable in understanding mucin gene regulation in normal and pathological conditions.

Mediastinal enterogenic cyst presenting as paraplegia--a case report

A rare case of a mediastinal enterogenic cyst with an intraspinal extension through a anterior vertebral defect presenting with paraplegia in a 10 year boy is presented. Laminectomy and the trans-thoracic excision of the cyst resulted in the complete recovery of the neural deficit.

Ochratoxin induced hemolysis in rabbits

A saline suspension of RBC when incubated with an increasing concentration (1 to 10 micrograms/ml) of crude ochratoxin at 37 degrees C for 16 hr showed a marked alteration in morphological characters followed by hemolysis. The effect was more pronounced with higher concentration of toxin. The result suggests extreme cytotoxic effect of ochratoxin on RBC leading to its lysis.

REL proto-oncogene is frequently amplified in extranodal diffuse large cell lymphoma

Comparative genomic hybridization (CGH) analysis of DNA extracted from a diffuse lymphoma with a large cell component (DLLC) that displayed double minute chromosomes upon conventional karyotypic analysis indicated overt amplification of DNA sequences derived from the 2p13-15 region. Southern blot analysis of this tumor DNA with a cDNA probe for the proto-oncogene REL, previously mapped to 2p14-15, indicated a greater than 35-fold amplification of REL. To determine the incidence of REL amplification and possible clinical or histologic association with DLLC, a panel of 111 tumor DNAs from DLLC specimens was screened for REL amplification by Southern blot analysis. A copy number of > or = 4 was noted in 26 cases (23%). Southern blot analysis of these 26 tumor DNAs with a cDNA probe for TGFA, mapped to 2p13, indicated lack of coamplification except in one case. Another member of the Rel/NF-kappa B family of transcriptional activators, RELA/p65 mapped to 11q13, was amplified in five cases as determined by Southern blot analysis using a cDNA probe. Nineteen of the 26 DLLC (73%) with REL amplification were primary extranodal lymphomas. As a group, the tumors with REL amplification demonstrated an increased frequency of chromosomal aberrations previously associated with tumor progression, suggesting an oncogenic effect of amplified REL in B-lymphoid cells that already contained a transforming genetic lesion. Thus, REL amplification is a frequent event in DLLC, and probably constitutes a progression-associated marker of primary extranodal lymphomas. This study shows the usefulness of the CGH technique in identifying chromosomal regions overrepresented in tumors that can point to amplified genes and may be correlated with clinical features of the disease.

Selection for high and low number of sternopleural bristles in Drosophila ananassae: correlated response in the frequency of chromosome inversions

Directional selection for high and low number of sternopleural bristles in Drosophila ananassae was applied for 13 generations. The selection produced a rapid divergence in the mean number of sternopleural bristles in the replicates high and low lines: i-high (H1 -25.75, H2 -25.69); ii-low (L1 -14.16 L2 -13.55); iii-control (17.21) lines in G13. Regression coefficients for the high and low lines were significantly different from zero. The realized heritability over thirteen generations was 21-23 for the high lines and 14-18 for the low lines. The results suggest that the number of sternopleural bristles in D. ananassae is under polygenic control, with a substantial amount of additive genetic variation. Flies of the base population had three chromosome inversions: AL (2L), ZE (2R) and DE (3L). The comparisons of chromosome arrangement between high and low lines (the G13 generation of selection) indicates significant changes in the inversion frequency during the course of selection, providing evidence for correlation between the bristle number and particular chromosome arrangements.

New technique for exchanging an "over-the-wire" balloon dilatation catheter

We describe here an indigenous technique of "over-the-wire" balloon exchanges that avoids use of an extension guidewire.

Chromosomal assignment of human ID1 and ID2 genes

The Id (inhibitor of DNA binding) proteins regulate transcription during development by interacting with transcription factors. Three human genes, ID1, ID2, and ID3, have been identified that belong to this family of transcription regulators. We show, by somatic cell hybridization and fluorescence in situ hybridization experiments, that ID1 and ID2 are localized at 20q11 and 2p25, respectively.

Vancomycin for controlling contamination of selective Kirchner's liquid medium in the culture of gastric lavage for tubercle bacilli

Gastric lavage (GL) was collected for culture of tubercle bacilli from children too young to expectorate sputum. The selective Kirchner's liquid medium (SKLM), routinely used as one of the media for culture of all extrapulmonary specimens, was found to often get contaminated when cultured with GL. We have shown that vancomycin at a concentration of 10 mg/l successfully reduced the contamination from about 60 to 20 per cent, and enhanced the isolation rate of tubercle bacilli from 3 to 6 per cent. Decontamination of the liquid culture before subculture on solid medium also helped to reduce the contamination rate. Vancomycin was found to be an effective selective drug for use in the Kirchner's liquid medium for culture of tubercle bacilli.

Inversion polymorphism in Drosophila ananassae: persistence of inversions, heterosis and intra- and inter-chromosomal associations in experimental populations of mixed geographic origin

Two experimental populations of D. ananassae were synthesised by making reciprocal crosses among five geographic strains and mixing the hybrids. Each of the two populations of mixed geographic origin was maintained as mass cultures in food bottles. After five generations chromosomal analysis of these two populations was made by squashing a large number of larvae. The results showed that both experimental populations remained polymorphic due to the persistence of AL, (2L), ZE (2R) and DE (3L) inversions in population A and AL, ZE, DE and ET (3R) inversions in population B. Persistence of inversions in considerable frequency and significant deviation from Hardy-Weinberg equilibrium showed that heterosis is associated with these four inversions in D. ananassae. Further, there is non-random association (linkage disequilibrium) between linked inversions in second (AL-ZE) chromosome. However, the inversions of the different chromosomes are associated randomly indicating no interchromosomal interactions in D. ananassae. The results of these studies on population dynamics of inversion polymorphism in experimental populations are attributable to selection, genetic drift and Founder effect.

A direct rifampicin sensitivity test for tubercle bacilli

A direct sensitivity test for rifampicin has been standardised for early detection of resistance for the mycobacterium tuberculosis smear positive sputum samples. Indirect sensitivity tests set up from primary cultures of the same samples served as controls. The direct test showed 95 per cent agreement with the standard indirect test and as such 74 per cent and 90 per cent of the resistant strains were detected by the fourth week and fifth week, respectively, with an overall gain of 4-5 wks time. Resistance could be detected earlier for multibacillary specimens. This direct sensitivity test on Lowenstein Jensen (LJ) medium offers a feasible alternative for laboratories which lack facilities to perform drug susceptibility tests by the rapid but sophisticated and costly BACTEC method. The method is simple to perform, economic, reliable and amenable to confirmation by the indirect test, if needed.

Structure and mapping of the human thymopoietin (TMPO) gene and relationship of human TMPO beta to rat lamin-associated polypeptide 2

Thymopoietins (TMPOs, previously abbreviated TPs) alpha (75 kDa), beta (51 kDa), and gamma (39 kDa) are related nuclear proteins expressed in many or all tissues. TMPO alpha is present diffusely throughout the nucleus, while TMPOs beta and gamma are localized to the nuclear membrane. Here we report the cloning and analysis of a single TMPO gene encoding TMPOs alpha, beta, and gamma, which are produced by alternative mRNA splicing, as previously inferred from cDNA sequences. The eight exons of the TMPO gene are spread over approximately 35 kb. Exon 4, which is spliced into TMPO alpha mRNA, contains sequences that encode a putative basic nuclear localization motif. Exon 8, which is spliced into TMPO beta and gamma mRNAs, encodes a hydrophobic putative membrane-spanning domain that is thought to target TMPOs beta and gamma to the nuclear membrane. TMPO beta appears to be the human homologue of the recently described rat protein LAP2 (lamina-associated polypeptide 2), which is thought to play an important role in the regulation of nuclear architecture by binding lamin B1 and chromosomes in a manner regulated by phosphorylation during mitosis (K. Furukawa and L. Gerace, La Jolla, pers. comm., 22 Nov. 1994). The human TMPO gene maps to chromosome band 12q22.

Cytogenetics of gastric and esophageal adenocarcinomas. 3q deletion as a possible primary chromosomal change

We report clonal chromosome abnormalities in short term cultures of seven gastric or esophageal adenocarcinomas and two squamous carcinomas of the esophagus and EG junction. The most consistent aberration encountered was a del(3) (q13.2q23) seen in six of nine tumors. This finding, together with a survey of published cytogenetic literature, suggested that del(3q) is the most common cytogenetic abnormality, and hence possibly of primary significance, in these tumors. In addition to del(3q), rearrangements affecting 1p13 (two cases), 6q15-q23 (two cases), 7p22 (two cases), 7q22 (two cases), and 11p11.2-p14 (three cases) were seen. Cytogenetic evidence for gene amplification in the form of homogeneously staining region (hsr) was seen at 9q13 in two cases.

Alternative splicing of a 48-nucleotide exon generates two isoforms of the human calcitonin receptor

A portion of the human calcitonin receptor (hCTR) gene corresponding to the region of the porcine gene at which alternative splicing generates two CTR isoforms was isolated by polymerase chain reaction amplification of placental DNA. In contrast to the porcine CTR gene, in which two acceptor sites in exon 8 are separated by 48 nucleotides, we found a distinct 48-nucleotide exon in the hCTR gene that is present approximately 6400 basepairs from the up-stream exon, which corresponds to porcine exon 7, and approximately 1100 basepairs from the down-stream exon, which corresponds to porcine exon 8. Splicing of this exon accounts for the two isoforms of hCTR, containing or not containing a 16-amino acid insertion in the first putative intracellular loop. A region similar to the intron 7-exon junction in the porcine CTR gene is present in the human gene, but contains four extra nucleotides that shift the reading frame. Using probes derived from these introns in somatic cell and in situ hybridization analyses, we assigned the CTR gene to human chromosome band 7q21.2-q21.3. Thus, human and porcine species have evolved distinct mechanisms to generate two similar CTR isoforms.

p27Kip1: chromosomal mapping to 12p12-12p13.1 and absence of mutations in human tumors

The p27Kip1 gene codes for a cyclin-dependent kinase inhibitor implicated in G1 arrest by transforming growth factor beta, cell-cell contact, agents that elevate cyclic AMP, and the growth-inhibitory drug rapamycin. p27 binds to and inhibits complexes formed by cyclin E-cdk2, cyclin A-cdk2, and cyclin D-cdk4. The involvement of p27 in the negative regulation of cell proliferation suggests that it may also function as a tumor suppressor gene. Using a combination of somatic cell hybrid panels and fluorescence in situ hybridization p27Kip1 has been mapped to the short arm of chromosome 12 at the 12p12-12p13.1 boundary, reported to harbor deletions and rearrangements in leukemia and mesotheliomas. In order to assess potential p27Kip1 gene alterations, we have screened a total of 147 human primary solid tumors and found no detectable cancer-specific mutations. These results argue that the often observed loss of antimitogenic transforming growth factor beta responsiveness in human cancer cells is not due to structural defects in p27Kip1.

Loss of heterozygosity identifies multiple sites of allelic deletions on chromosome 1 in human male germ cell tumors

Cytogenetic analysis of human male germ cell tumors (GCTs) and derived cell lines revealed frequent deletions and rearrangements of chromosome 1. However, no detailed molecular analysis of these aberrations has thus far been performed. We undertook loss of heterozygosity (LOH) analysis utilizing a panel of 48 GCTs at 22 subregionally mapped polymorphic loci on both arms of chromosome 1. Eight probes, for which precise mapping data were unavailable, were subregionally mapped to specific regions by fluorescence in situ hybridization. Allelic losses were observed in 46% of cases on 1p and in 23% of cases on 1q. Teratomas showed higher frequency of allelic losses compared to embryonal carcinomas, yolk sac tumors, and seminomas, consistent with the results of our previous allelotype analysis, which showed overall higher genetic loss in teratomas compared to embryonal carcinomas. Our LOH study of chromosome 1 identified 4 sites of frequent deletions, 3 in the short arm (1p13, 1p22, and 1p31.3-32.2) and 1 in the long arm (1q32). Of these, 38.5% LOH at 1p22 (D1S16) identifies the site of a novel candidate tumor suppressor gene (TSG), possibly associated with GCTs. LOH at the remaining sites (1p13, 1p31.3-32.2, and 1q32) has also been reported in breast carcinomas, suggesting the involvement of TSGs common to both tumor types.

Characterization of the promoter region of the gene for the rat neutral and basic amino acid transporter and chromosomal localization of the human gene

The promoter region of the rat kidney neutral and basic amino acid transporter (NBAT) gene has been isolated and sequenced. The major transcription initiation site was mapped by primer extension. The entire promoter region and a set of 5' deletions within it were expressed at a high level in LLC-PK1 cells using the luciferase indicator gene. Positive and negative regulatory elements in the promoter region were observed. A human genomic clone of the transporter was also obtained and was used to localize the NBAT gene at the p21 region of chromosome 2.

Replication error-type genetic instability at 1q42-43 in human male germ cell tumors

The replication error phenotype, recognized as microsatellite sequence alterations, has recently been suggested to be associated with hereditary nonpolyposis colorectal cancer and other types of sporadic tumors. We examined paired tumor-normal DNAs from 69 human male germ cell tumors for somatic instability at the 1q42-43 region. Analysis of a variable number of tandem repeats marker (D1S74) and 3 (CA)n type microsatellite loci (D1S235, D1S180, and angiotensinogen) revealed genetic alterations in tumor DNAs of 26 (38.2%) cases. The changes observed comprised rearrangements with D1S74 detected by Southern blot analysis in 4 of 55 (7%) cases; replication error-type alterations with D1S235, D1S180, and angiotensinogen in 12 of 66 (18.2%) cases; and loss of heterozygosity in 12 of 67 (17.9%) cases with the same probes. The microsatellite sequence alterations were more common in histological subsets other than teratomas, while the loss of heterozygosity was significantly more frequent in teratomas compared to other histologies. These results suggest that microsatellite instability and loss of heterozygosity at 1q42-43 may be unrelated genetic events which may play a role in germ cell tumor development.

Evaluation of Nd:YAG-pumped Raman shifter as a broad-spectrum light source

We have examined the utility of a gas-filled, Nd:YAG-laser-pumped Raman shifter as a possible broad-spectrum light source. Six to nine new output frequencies with pulse energies above 1 µJ are produced when a pure-hydrogen or pure-methane Raman shifter is pumped with 40 mJ of secondharmonic, 20 mJ of third-harmonic, or 11 mJ of fourth-harmonic pump pulse energy. Optimum output occurs at pressures of approximately 10 atm for the pure-gas experiments. We also report the output frequencies and pulse energies of a mixed hydrogen-methane Raman shifter pumped by 20 mJ of the third harmonic of the laser for various proportions of the two gases at pressures up to nearly 20 atm. Depending on composition and pressure, over a dozen new output lines with pulse energies over 1 µJ can be produced. We discuss the nonlinear processes involved, the optimum operating conditions, and the suitability of the source for our application of groundwater monitoring.

Evaluation of a cold staining method for acid-fast bacilli in sputum

Comparison between the Ziehl-Neelsen staining method for acid-fast bacilli, applied with and without heating, was carried out in a controlled investigation using smears prepared from 306 sputum samples collected prior to treatment from suspected cases of pulmonary tuberculosis. Smear and culture positivity were graded and the colour intensity of bacilli recorded. Results showed that the chance corrected agreement (Kappa) between Z-N and cold methods was only 78%. The sensitivity of the Z-N and cold methods were 84% and 77% respectively when compared with culture results. Assuming 10% smear positivity among symptomatics reporting to Peripheral Health Institutions (PHIs), the positive predictive value of the cold method was very low (53%). When compared to culture, the positive predictive value is 71% for the Z-N method and 57% for the cold method for a symptomatic population with 15% culture positivity. In the absence of heating, penetration of the stain was significantly reduced and consequently the number of bacilli detected was less. The inability to take the stain without heating was seen in smears from all grades of culture positive samples; thus even heavy positives were missed by the cold method. The evaluation of the cold method against the standard Z-N method highlights its limitations and demonstrates that it is not as reliable as the standard Z-N method.

Pancreatic lesions and modifications of pancreatic juice in tropical chronic pancreatitis (tropical calcific diabetes)

Seventeen Indian patients from Kerala State and 13 Indian controls were submitted to a dietary inquiry. Indian patients and controls had a low fat intake (40.8 g +/- 12.1 and 34.5 g +/- 11.0 per day, respectively) and a moderately low protein intake (52.8 +/- 9.5 and 47.8 +/- 11.3 g per day); 11 patients and 6 controls did not consume cassava. Pure nonactivated pancreatic juice was collected at endoscopy in 10 Indian patients who presented with tropical calcific diabetes, 12 apparently normal controls from the same area, and 23 apparently normal French controls. The only significant differences between Indian and French controls was a decreased pancreatic protein response to cerulein and an increased calcium concentration in the Indian subjects. The pancreatic juice of Indian patients was characterized by decreased volume, normal bicarbonate concentration, increased protein concentration when the acinar cells were not stimulated, with no response to cerulein, increased calcium concentration, and normal citrate concentration. These changes are very similar to the changes observed in French patients with chronic alcoholic pancreatitis. The lesions of 14 surgical resection pancreatic specimens from South Indian patients presenting with tropical pancreatitis were compared to pancreata from French patients presenting with chronic alcoholic pancreatitis. The only difference was that intraductal plugs, lesions of the duct epithelium, and retention cysts or pseudocysts were less frequent in Indians. These results show that the two nutritional forms of pancreatic lithiasis, alcoholic and tropical, have similar histological lesions and biochemical modifications of pancreatic juice.(ABSTRACT TRUNCATED AT 250 WORDS)

Origin of adult male mediastinal germ-cell tumours

The origin of primary extragonadal germ-cell tumours, especially mediastinal and pineal germ-cell tumours in adult males remains uncertain, although the predominant view is that they originate in misplaced primordial germ cells retained in extra-gonadal sites, in contrast to gonadal germ-cell tumours which are considered to arise in premeiotic spermatocytes. We hypothesised that if mediastinal germ-cell tumours and gonadal germ-cell tumours were derived from precursor cells in different developmental states and in different cellular environments, non-random genetic changes in the two groups would be significantly different. To test this hypothesis, we compared non-random chromosomal abnormalities in mediastinal germ-cell tumours with those in gonadal germ-cell tumours. Our results show that although the two groups differed in the composition of histological subsets, their non-random chromosomal changes were essentially the same. These data suggest gonadal origin of all germ-cell tumours with occasional migration of precursors early in development to extragonadal sites to become established as primary extragonadal germ-cell tumours. Based on a review of cytogenetic data on carcinoma in situ, primary mediastinal and gonadal germ-cell tumours, embryonal migration of primordial germ-cells, and meiotic behaviour of spermatocytes, a model of origin of all germ-cell tumours in males is suggested.

Transforming growth factor receptor gene TGFBR2 maps to human chromosome band 3p22

In this study, we map the chromosomal position of the gene that encodes the type II receptor of TGF-beta (HGM symbol TGFBR2), a multifunctional regulator of cell proliferation and differentiation. Using a full-length cDNA and a genomic probe in Southern blot analysis of a human x rodent somatic cell hybrid panel and by direct fluorescence in situ hybridization to normal metaphase chromosomes, we show that the TGFBR2 gene maps to 3p22.

Confirmation of Duffy blood group antigen locus (FY) at 1q22-->q23 by fluorescence in situ hybridization

The gene for the Duffy blood group antigen (FY) was previously assigned to the chromosome region 1q22-->q23 by linkage analysis. We confirm this localization by fluorescence in situ hybridization.