Schwannoma of infratemporal fossa in a young child

Schwannomas in children are rare. A nine-year-old boy presented with swelling right side of face and proptosis for 4 months. CT scan showed a heterogenous mass in the right infratemporal fossa and extending to the posterior ethmoid. There was erosion of the bony walls of the infratemporal fossa. A biopsy through the sublabial approach was reported as schwannoma. The tumour was approached by Weber-Ferguson approach and excised in toto with complete relief of symptoms.

Inhibition of vesicular stomatitis virus in cells constitutively expressing an antisense RNA targeted against the virus RNA polymerase gene

To study the effect of virus-specific antisense RNA expression on vesicular stomatitis virus (VSV) infectivity in cultured cells, a HeLaS3 cell line constitutively expressing antisense RNA complimentary to a portion of the VSV large RNA-dependent RNA polymerase gene (L) was established (HeAntiL). At an m.o.i. of 0.01 or 0.1, the HeAntiL cell line was able to reduce virus titre and delay virus-induced cell death by 9 or 5 h, respectively, when compared to a HeLa cell line stably transfected with the expression vector devoid of antisense sequence. Ribonuclease protection experiments showed a 10-20-fold reduction of hybridizable virus L mRNA in infected HeAntiL cells compared to infected control cells at various times before cell death. These results indicate that the antisense RNA approach can significantly reduce VSV mRNA transcription and virus production for a reasonable period of time. The robust growth rate of VSV eventually overwhelms the available antisense RNA and leads to delayed cell death.

T cell rich and histiocyte rich B cell lymphoma--a case report

We report one case of Non Hodgkin's Lymphoma which was classified as Histiocyte Rich B cell lymphoma on immunocytochemistry. The diagnosis was difficult on fine needle aspiration cytology and routine histopathological examination as the infiltrate was composed of reactive lymphocytes and numerous histiocytes obscuring the lymphoma cell population. The neoplastic cells were positive for CD20(L26-A Pan B marker) and negative for CD15(Leu M1), CD3(Ber H2) and pan T cell markers. The histiocytes were positive for CD3(UCHL-1). The patient had a rapid downhill course and died. The autopsy showed infiltration in the axillary, cervical, mesenteric, para aortic, peri pancreatic and hilar lymph nodes. The liver, spleen, bone marrow and kidney also showed lymphomatous infiltration.

Prediction of optimum dimensions of colonic pouch reservoir

PURPOSE

A mathematic model was developed to quantify colonic reservoir pouch capacity and to allow comparison with capacity of the parent colonic segment from which the pouch was fashioned.

METHODS

Using geometry, pouch capacity was calculated and various capacities were enumerated.

RESULTS

From this model, ideal pouch dimensions can be predicted, which are 6 to 7 cm of undistended bowel circumference with limb lengths of 8 to 10 cm.

CONCLUSIONS

Such a pouch maximizes the pouch colon capacity ratio and has a calculated undistended capacity between 60 and 105 ml.

Follow-up results of balloon angioplasty for native coarctation of aorta

Balloon angioplasty of native discrete (< 1 cm) coarctation of thoracic aorta was performed in 29 patients [aged 13 to 31 years (mean 21.5 +/- 5.8 years), 22 males and 7 females], from March 1993 to December 1995. The patients were followed up for two years. After angioplasty, peak systolic arterial pressure (PSAP) decreased from 173.5 +/- 18.1 mm Hg to 122.5 +/- 9.9 mm Hg (p < 0.001), peak systolic pressure gradient (PSG) decreased by 90.9 percent from 86.2 +/- 15.77 to 7.77 +/- 3.8 mm Hg (p < 0.001) and the coarcted segment diameter increased about three times from 3.7 +/- 1.6 to 10.9 +/- 3.3 mm (p < 0.001). PSG decreased to < 10 mm Hg in 27 patients (93%) whereas in the other two patients PSG was 17 and 13 mm Hg. Restenosis appeared in 2 patients (6.8%); aneurysm in one patient (3.4%) which remained static even after 1.3 years of follow-up; mild dissection in 3 patients (10.3%); temporary femoral artery occlusion in 2 (6.8%) patients who recovered with heparin injection. Though hypertension disappeared after balloon dilatation in all patients, it reappeared in 3 patients (10.3%) within 7 days and in 10 patients (34.5%) within 6 months. In conclusion, balloon angioplasty of CoA is a good alternative to surgical correction.

Specific interaction in vitro and in vivo of glyceraldehyde-3-phosphate dehydrogenase and LA protein with cis-acting RNAs of human parainfluenza virus type 3

Human parainfluenza virus type 3 (HPIV3) genome RNA is transcribed and replicated by the virus-encoded RNA-dependent RNA polymerase, and specific cellular proteins play a regulatory role in these processes. To search for cellular proteins potentially interacting with HPIV3 cis-acting regulatory RNAs, a gel mobility shift assay was used. Two cellular proteins specifically interacted with the viral cis-acting RNAs containing the genomic 3'-noncoding region and the plus-sense leader sequence region. Surprisingly, by biochemical and immunological analyses, one of the cellular proteins was identified as the key glycolytic enzyme, glyceraldehyde-3-phosphate dehydrogenase (GAPDH). The other protein was characterized as the autoantigen, LA protein. Both GAPDH and LA protein also interacted with the same cis-acting RNA sequences in vivo and were found to be associated with the HPIV3 ribonucleoprotein complex in the infected cells. By double immunofluorescent labeling, GAPDH was found to be co-localized with viral ribonucleoprotein in the perinuclear region. These observations strongly suggest that cellular GAPDH and LA Protein participate in the regulation of HPIV3 gene expression.

Caring for the elderly: problems and priorities

In view of the projected massive increase in the number of the very aged, all health-care agencies, professionals and the government must develop an acceptable strategy of care. With a positive attitude towards aging based on facts and knowledge, the burden of such a demographic change can be minimized. Perhaps a dedicated government department or even a separate ministry may be useful.

Digoxin therapy and survival in heart failure in sinus rhythm

The effect of digoxin therapy on the survival of heart failure patients in sinus rhythm was assessed using a retrospective case control study. Patients with an acute exacerbation of chronic heart failure secondary to ischemic heart disease were selected. All were in sinus rhythm and all were treated with digoxin. Case-matched controls were identified for all digoxin-treated patients. Long-term survival was ascertained for all 18 digoxin-treated patients and 18 controls who formed the study population. The relative risk of death was 6.4 for digoxin-treated patients (95% confidence interval 0-36) during the period of hospitalization. Te increased risk of death among digoxin-treated patients persisted up to 1 year following discharge from hospital. The results raise further concern regarding the safety of digoxin therapy in managing heart failure exacerbation, when the patients are in sinus rhythm.

Low-dose amiodarone in severe chronic heart failure

Sudden cardiac death is a common cause of mortality in patients with congestive heart failure. Asymptomatic ventricular arrhythmia has been attributed as the cause for increased overall mortality in such patients. We conducted a prospective randomised single-blind placebo-controlled trial with low-dose amiodarone to assess its efficacy in reducing mortality in severe congestive heart failure and its effect on exercise tolerance, left ventricular systolic function and ventricular ectopic activity. Patients were randomised to receive amiodarone (n = 36) 400 mg/day orally for one month followed by a maintenance dose of 200 mg/day, or to a standard treatment (n = 40) according to intention-to-treat principle. There were 10 cardiac deaths in the amiodarone-treated group and 16 in the control group. Significant improvement was noted in exercise time in the treadmill test (modified Bruce Protocol) among patients in the amiodarone-treated group while no such statistical difference was detectable in the placebo group. Side-effects in the amiodarone group included asymptomatic rise in hepatic enzymes (three-fold) in 6 percent and proarrhythmia in 3 percent of patients. Nausea was reported in one patient and rash in one. Though low-dose amiodarone proved to be an effective antiarrhythmic agent, it failed to live up to the expectation of improving sudden cardiac death in patients with severe chronic heart failure and asymptomatic ventricular ectopy.

Inhibition of human parainfluenza virus-3 replication by interferon and human MxA

We have investigated the IFN-mediated inhibition of human parainfluenza virus-3 (HPIV-3) replication in cultured human A549 cells. IFN-alpha inhibited the virus yield significantly with concomitant reduction of viral RNA accumulation by more than 90%. Further studies indicated that the inhibitory action of IFN was at the level of primary transcription of HPIV3 replication. Since the IFN-inducible protein, MxA, has been shown to inhibit virus replication in several RNA viruses, we examined the role of MxA in HPIV-3 replication using a stably transfected human glioblastoma cell line expressing MxA. In these cells HPIV-3 replication was decreased by more than 100-fold depending on the virus dosage used with concomitant inhibition of viral RNA synthesis by about 80%. However, the viral primary transcription was not affected in this MxA-producing cell line. In contrast, in the parental cell line IFN-mediated inhibition occurred at the primary transcription step of HPIV-3 replication. These data suggest that in addition to MxA, other IFN-inducible proteins are involved in the anti-HPIV-3 effect of IFN in both the cell lines used.

Expression of the human MxA protein is associated with hyperphosphorylation of VSV P protein in human neural Cells

Constitutive expression of the type I interferon-inducible human cytoplasmic MxA protein has been shown to interfere with primary transcription of vesicular stomatitis virus (VSV) in tissue culture cells. As phosphorylation of the VSV P protein has been linked to its ability to stimulate viral transcription, we analyzed the phosphorylation status of this protein in human brain cells (U-87) stably transfected with MxA. We observed a general increase in cellular kinase activity in the presence of MxA, affecting both cellular proteins and VSV P protein. Phosphorylation of the latter was up to threefold higher both in vivo and in vitro. In vitro phosphorylation of recombinant VSV P protein could be enhanced in MxA-negative cell extracts after exogenous addition of recombinant His-MxA. Biochemical evidence and phosphorylation of a mutant P protein lacking the recognized casein kinase II (CKII) sites suggested that hyperphosphorylation of VSV P protein was not due to a stimulation of CKII. We thus propose that expression of MxA in human brain cells is associated with the stimulation of a cellular kinase that is active in phosphorylating both cellular target proteins and VSV P protein.

Aseptic cerebral venous thrombosis associated with idiopathic ulcerative colitis: a report of two cases

Two cases of cerebral venous thrombosis with ulcerative colitis with complete autopsy findings are reported. The diagnosis of cerebral venous thrombosis with ulcerative colitis was made during life in one case and at autopsy showed active chronic ulcerative colitis with recent cerebral venous thrombosis with cerebral infarction. In the other case active chronic ulcerative colitis and old cerebral venous thrombosis with cerebral infarction were diagnosed at autopsy. Although rare the importance of recognising cerebral venous thrombosis as a complication of ulcerative colitis has been emphasised in view of the high mortality of this complication.

Expression of L protein of vesicular stomatitis virus Indiana serotype from recombinant baculovirus in insect cells: requirement of a host factor(s) for its biological activity in vitro

The 241-kDa large (L) protein of vesicular stomatitis virus (VSV) Indiana serotype, a multifunctional catalytic subunit of the viral RNA polymerase, has been expressed in Spodoptera frugiperda cells infected with recombinant baculovirus BacPAK6-L containing the L gene under the control of a polyhedrin promoter. The recombinant L protein was biologically active and supported viral mRNA synthesis in vitro. When the expressed L protein was purified by phosphocellulose column chromatography, it eluted in two peaks, one at 0.4 M NaCl (peak I) and the second at 0.75 M NaCl (peak II). The L protein in peak I showed significant transcriptional activity in an in vitro transcription reconstitution experiment, whereas the L protein in peak II was inactive. Interestingly, the addition of cytoplasmic extract from uninfected Sf21 cells to peak II completely restored transcription in vitro, indicating the requirement of a host factor(s) for the activity of the L protein. This factor is relatively heat stable and is dissociable from the recombinant L protein. It is also present in BHK, COS, and HeLa cells in detectable levels. The role of the putative host protein(s) in the activation of the L protein is discussed.

Improving cancer radiotherapy with 2-deoxy-D-glucose: phase I/II clinical trials on human cerebral gliomas

PURPOSE

Evaluation of tolerance, toxicity, and feasibility of combining large fraction (5 Gy) radiotherapy with 2-deoxy-D-glucose (2DG), an inhibitor of glucose transport and glycolysis, which has been shown to differentially inhibit repair of radiation damage in cancer cells.

METHODS AND MATERIALS

Twenty patients with supratentorial glioma (Grade 3/4), following surgery were treated with four weekly fractions of oral 2DG (200 mg/kg body weight) followed by whole brain irradiation (5 Gy). Two weeks later, supplement focal radiation to the tumor (14 Gy/7 fractions) was given. Routine clinical evaluation, x-ray computerized tomography (CT), and magnetic resonance (MR) imaging were carried out to study the acute and late radiation effects.

RESULTS

All the 20 patients completed the treatment without any interruption. The vital parameters were within normal limits during the treatment. None reported headache during the treatment. Mild to moderate nausea and vomiting were observed during the days of combined therapy (2DG + RT) in 10 patients. No significant deterioration of the neurological status was observed during the treatment period. Seven patients were alive at 63, 43, 36, 28, 27, 19, and 18 months of follow-up. In these patients, the clinical and MR imaging studies did not reveal any late radiation effects.

CONCLUSIONS

Feasibility of administering the treatment (2DG + 5 Gy) is demonstrated by the excellent tolerance observed in all 20 patients. Further, the clinical and MR studies also show the absence of any brain parenchymal damage.

Reflux oesophagitis and Helicobacter pylori infection in elderly patients

Helicobacter pylori is associated with gastritis, peptic ulcers and gastric malignancies. Little attention has been paid to the possibility that it may also have a role in the pathogenesis of reflux oesophagitis. This is especially true in elderly patients who have life-long infection and provide an ideal group to study the mucosal changes associated with the organism. The aim of this study was to determine if H pylori is associated with reflux oesophagitis in elderly patients. Consecutive gastroscopy patients were recruited. Multiple biopsies were taken from oesophagus, stomach, antrum and duodenum for histology and rapid urease tests. Patients also had IgG ELISA antibodies and 13C-urea breath tests performed. Patients with macroscopic or microscopic evidence of reflux oesophagitis were compared to patients with macroscopically normal upper gastrointestinal tracts and no microscopic evidence of reflux. A total of 114 patients were recruited, average age 78.9 years (+/- 5.4). There were 37 refluxers and 33 non-refluxers. We found no evidence for an association between the presence of H pylori and reflux oesophagitis in elderly patients. The high prevalence of H pylori in patients with reflux oesophagitis can be explained by the presence of incidental gastritis.

Prospective study of the proctographic and functional consequences of transanal endoscopic microsurgery

A prospective study of clinical, manometric and proctographic results in 36 patients presenting for transanal endoscopic microsurgery was performed. Anorectal manometry showed no difference in maximal squeeze pressure before and 12 months after operation, but resting pressures were lower after surgery (mean(s.e.m.) preoperative 86.1(27.6) mmHg versus postoperative 67.2(23.2) mmHg, P < 0.05). The rectoanal inhibitory reflex was lost in a significant group of patients (reflex present in 34 of 36 patients before operation and in 27 of 36 12 months after operation, P < 0.05). Proctography, manometry and questionnaire showed preserved function of most modalities 12 months after operation such that if objective function was impaired clinical function was adequate.

Lack of association between helicobacter pylori and gastric atrophy or intestinal metaplasia in elderly patients

Helicobacter pylori (Hp) is associated with gastritis and peptic ulcers. It may also induce gastric atrophy (GA) and intestinal metaplasia (IM), and these changes may be the precursors of gastric carcinoma. The aim of this study was to determine if GA or IM is associated with Hp infection in elderly patients. Consecutive patients admitted for gastroscopy were recruited. Multiple biopsies were taken for histology and rapid urease (CLO) tests along with IgG enzyme-linked immunosorbent assay antibodies and (13)C-urea breath tests. Statistical analysis was by chi(2) tests. 114 patients were recruited, the average age was 78.9 + or - 5.4 years. Histology was available on 105 patients, 80 (76.2%) had gastritis, and 61/80 (76.25%) had evidence of definite current Hp infection. Seven patients had reflux gastritis, and these were excluded from the analysis described below. 20 patients had GA and 24 IM. The relationship between Hp and GA or IM was investigated by dividing patients into four groups: Group 1 patients (n = 57) were taken to be definitely currently infected (GA 7 patients, IM 11, both 1). Group 2 patients (n = 18) had old infection (GA 2, IM 4, both 3). Group 3 patients (n = 16) have never been infected previously (GA 1, IM 1, both 3). Group 4 patients (n = 4) had a poor immunological response to Hp (GA 1, IM 1, both 0). There were no significant differences in the numbers of patients with GA or IM in any group as compared with any other, with the exception of less patients with histological evidence of combined GA and IM among patients with definite current infection as compared with those with either previous infection (p = 0.04) or 'never' infection (p = 0.03). We conclude that the mucosal changes of GA or IM are not consistently associated with Hp infection in the elderly.

Eye changes in non-specific aorto-arteritis

Non-specific aorto-arteritis or Takayasu's arteritis is fairly common and has been reported from all parts of India. The disease presents with various eye symptoms such as transient or permanent blindness, headache and signs including neovascularisation, retinal anastomosis, rubeosis iridis, cataracts. Eye manifestations depend on stage of disease and degree of involvement of cervical arteries. This review consists of an indepth impression of eye involvement in non-specific aorto-arteritis.

Primary pulmonary malignant teratoma with yolk sac element associated with hematologic neoplasia

We describe the unique case of a primary pulmonary malignant teratoma with yolk sac elements, associated with hematologic neoplasia. This 20-year-old male was admitted with complaints of fever, right-sided chest pain, dry cough, and hemoptysis. Necropsy revealed a mass in the right middle and upper lobe which microscopically was a malignant teratoma with yolk sac element. The associated hematologic neoplasia was a myelofibrosis, cellular phase, with myeloid metaplasia in liver, spleen, hilar lymph nodes, left adrenal gland, and lower lobe of the right lung.

Role of cellular casein kinase II in the function of the phosphoprotein (P) subunit of RNA polymerase of vesicular stomatitis virus

The phosphorylation of the P protein of vesicular stomatitis virus by cellular casein kinase II (CKII) is essential for its activity in viral transcription. Recent in vitro studies have demonstrated that CKII converts the inactive unphosphorylated form of P (P0) to an active phosphorylated form P1, after phosphorylation at two serine residues, Ser-59 and Ser-61. To gain insight into the role of CKII-mediated phosphorylation in the structure and function of the P protein, we have carried out circular dichroism (CD) and biochemical analyses of both P0 and P1. The results of CD analyses reveal that phosphorylation of P0 to P1 significantly increases the predicted alpha-helical structure of the P1 protein from 27 to 48%. The phosphorylation defective double serine mutant (P59/61), which is transcriptionally inactive, possesses a secondary structure similar to that of P0. P1, at a protein concentration of 50 micrograms/ml, elutes from a gel filtration column apparently as a dimer, whereas both P0 and the double serine mutant elute as a monomer at the same concentration. Interestingly, unlike wild-type P1 protein, the P mutants in which either Ser-59 or Ser-61 is altered to alanine required a high concentration of CKII for optimal phosphorylation. We demonstrate here that phosphorylation of either Ser-59 or Ser-61 is necessary and sufficient to transactivate L polymerase although alteration of one serine residue significantly decreases its affinity for CKII. We have also shown that P1 binds to the N-RNA template more efficiently than P0 and the formation of P1 is a prerequisite for the subsequent phosphorylation by L protein-associated kinase. In addition, mutant P59/61 acts as a transdominant negative mutant when used in a transcription reconstitution assay in the presence of wild-type P protein.

Experiences with fine needle aspiration cytology as a diagnostic procedure for breast lesions in a Calcutta Hospital

Nine hundred and forty cases of breast lesions were subjected to fine needle aspiration. Nine hundred twenty-four of them were females and sixteen were males. Smears from the 60 female cases were rejected as unsatisfactory. Of the remaining 864 female cases (aged 15 to 72 years) 704 (81.4%) were benign. Histopathological correlations were done in 448 cases with diagnostic accuracy of 97.3%. One hundred and sixty (18.5%) out of 864 females were malignant and cytohistological correlation was done in 142 cases with 98.6% corroboration. Ten of the 16 male cases were histologically examined with full corroboration. Overall accuracy considering both males and females was 98.6%. Though there was underdiagnosis involving 12 cases of infiltrating ductal carcinoma when the lesions were small and deeply situated there was no overdiagnosis in this study.

Local excision of rectal tumours

Local excision of colorectal tumour may be palliative or curative. Recent advances in minimal access techniques have allowed curative excision to be offered to a wider range of patients. Absolute indications for potentially curative local excision include mobile tumours, T1 tumours (assessed by ultrasonography), well or moderately differentiated histology (determined by biopsy) and tumour size less than 3 cm. Relative indications include T2 and T3 tumours (by ultrasonography), poorly differentiated histology (by biopsy) and tumour size greater than 3 cm depending on patient fitness. The rationale for these recommendations is described in detail.

Human parainfluenza virus type 3 phosphoprotein: identification of serine 333 as the major site for PKC zeta phosphorylation

The human parainfluenza virus type 3 P protein is an RNA polymerase subunit involved in both transcription and replication during the life cycle of the virus. Our laboratory has recently shown that the P protein is phosphorylated both in vitro and in vivo by the cellular protein kinase C (PKC) isoform zeta and that this phosphorylation is essential for viral replication. To identify the site(s) of phosphorylation, we have used CNBr cleavage, phosphoamino acid analysis, and two-dimensional tryptic peptide mapping of the in vitro and in vivo phosphorylated P protein. We demonstrate that when bacterially expressed unphosphorylated P is labeled in vitro with either commercial PKC or purified recombinant PKC zeta P protein has one major phosphorylation site. By site-directed mutagenesis of PKC consensus sites in the P protein, the primary phosphorylation site is found to be Ser 333. The same site appeared to be modified when viral P protein was phosphorylated in vitro by the PKC packaged within the virion and in the P protein of progeny virion labeled in vivo.

Involvement of cellular casein kinase II in the phosphorylation of measles virus P protein: identification of phosphorylation sites

The phosphoprotein P gene of measles virus (Edmonston strain) has been cloned in the Escherichia coli expression vector pET-3a with a histidine tag at the C-terminal end. The expressed protein was soluble, unphosphorylated, and constituted 10 to 20% of total cellular protein. Recombinant P protein purified by Ni-affinity chromatography was found to be efficiently phosphorylated in vitro by recombinant casein kinase II (CKII) or by the CKII activity present in the uninfected cell extract. A comparison of phosphopeptide analyses between the in vivo- and the in vitro-32P-labeled P proteins revealed that both proteins share common phosphorylation sites. In an attempt to identify the exact site of the CKII-mediated phosphorylation, we altered specific serine residues located within the CKII consensus motif to alanine by site-directed mutagenesis. The results indicate that Ser 86, Ser 151, and Ser 180 located within the N-terminal half of the P protein are involved in the CKII-mediated phosphorylation of the P protein.

An audit of fatal acute pancreatitis

Acute pancreatitis has a mortality of about 10%: this figure has not changed over the last 20 years. A retrospective audit of fatal acute pancreatitis was performed in a teaching hospital with a catchment population of about 750,000 patients to examine patient characteristics. Using Hospital Activity Analysis code 577.0, all fatal cases of acute pancreatitis were studied in a six-year period 1987-93. Additionally, all post mortem diagnoses of acute pancreatitis were traced. The overall post mortem rate in Nottingham at the time of the study was about 35%. All available records, X-ray and biochemical data were studied and appropriate information recorded and analysed for 65 fatal cases. Only 15% were post mortem diagnoses, lower than in previous series; 72% had respiratory and 67% had renal complications. Only 34% had been admitted to the intensive care unit. A third of patients had had surgery; 67% of these was some form of external drainage. Of the 14 patients with proven gallstone pancreatitis only three had endoscopic retrograde cholangiopancreatography; 42% of patients had idiopathic disease. Not all the patients diagnosed ante mortem had the full biochemical predicted severity criteria analysed: pO2 and calcium analysis was performed in about 80%. Pre-mortem diagnoses of pancreatitis was achieved more frequently than in other comparable series.

Non-extractive spectrophotometric determination of vanadium(v) in alloys and environmental, biological and soil samples using 5,7-dibromo-8-hydroxyquinoline

An ultra-sensitive and highly selective non-extractive spectrophotometric method is presented for the rapid determination of vanadium(v) at trace levels using 5,7-dibromo-8-hydroxyquinoline (DBHQ) as a new spectrophotometric reagent (lambda max = 400 nm) in slightly acidic solution (0.00015-0.016 mol-1 sulfuric acid). The reaction is instantaneous and the absorbance remains stable for over 48 h. The average molar absorption coefficient and Sandell's sensitivity were found to be 6.1 x 10(3) l mol-1 cm-1 and 0.015 micrograms cm-2 of Vv, respectively. Linear calibration graphs were obtained for 0.1-20 micrograms ml-1 of Vv: the stoichiometric composition of the chelate is 1:3 (V:DBHQ). Large excesses of over 50 cations, anions and complexing agents (e.g., tartrate, oxalate, citrate, phosphate, thio-urea, SCN-) do not interfere in the determination. The method was successfully used in the determination of vanadium in several Standard Reference Materials (alloys and steels) as well as in some environmental waters (potable and polluted), biological samples (human blood and urine), soil samples and complex synthetic mixtures. The method has high precision and accuracy (s = +/- 0.01 for 0.5 micrograms ml-1).

Prevalence of hearing problems, and use of hearing aids among a sample of elderly patients

BACKGROUND

Deterioration of hearing with advancing age is well documented. However, the proportion of elderly people with hearing problems who wear hearing aids is low.

AIM

The aim of this study was to assess the prevalence of hearing disability in a group of elderly patients in hospital and to determine their attitudes to hearing difficulties and the wearing of hearing aids.

METHOD

A random sample of patients who were convalescing were interviewed. A detailed questionnaire was administered to patients regarding their hearing difficulties.

RESULTS

A total of 79 patients were recruited. Twenty two patients were excluded because of low mental test scores, hence 57 patients (72%) were eligible for inclusion into the study. Thirty eight patients were women (mean age 81 years) and 19 were men (mean age 79 years). Thirty patients (53%) reported difficulties with their hearing, of whom 12 had hearing aids. Seventeen patients had consulted their general practitioner about their difficulties, 15 of whom had been referred for audiological examination. Thirteen patients chose not to consult about their hearing problems, to 'suffer in silence'. Of the 12 patients with hearing aids three reported discomfort or pain and five reported problems such as an ill-fitting hearing aid and excessive amplification. Six patients said they wore their hearing aid for less than four hours a day.

CONCLUSION

Almost all patients consulting their general practitioner with hearing problems were referred for audiological examination but subsequent follow up, especially of problems with hearing aids, was poor. Better health education and case finding is indicated and patients with hearing aids must be questioned specifically about problems when they consult health professionals. Proper assessment, screening and follow up has implications for resources and training, especially of practice nurses.

Respiratory failure in acute pancreatitis

There are a number of important pulmonary complications of acute pancreatitis which make a significant contribution to the morbidity and mortality of the condition. The pathophysiology and management guidelines are given for each and approaches towards better treatment in the future are discussed.

Interaction between the nucleocapsid protein and the phosphoprotein of human parainfluenza virus 3. Mapping of the interacting domains using a two-hybrid system

A two-hybrid system was used to study interaction in vivo between the nucleocapsid protein (NP) and the phosphoprotein (P) of human parainfluenza virus type 3 (HPIV-3). Two plasmids, one containing the amino terminus of P fused to the DNA-binding domain of the yeast transactivator, GAL4, and the other containing the amino terminus of NP fused to the herpesvirus transactivator, VP16, were transfected in COS-1 cells along with a chloramphenicol acetyltransferase (CAT) reporter plasmid containing GAL4 DNA-binding sites. A specific and high-affinity interaction between NP and P was observed as measured by the activation of the CAT gene. Mapping of the domains in P (603 amino acids) involved in the association with NP revealed that NH2-terminal 40 and COOH-terminal 20 amino acids are important for such association. Interestingly, a stretch of NH2-terminal amino acids as short as 63-403 interacted with NP more than the wild type, reaching greater than 2.5-fold as measured by the CAT assay. These results suggest that a domain is present in P that negatively regulates its interaction with NP. Deletion of NH2-terminal 40 and COOH-terminal 160 amino acids of NP reduced the CAT activity by more than 95%. These results underscore the important differences between negative strand RNA viruses with respect to interactions between these two viral proteins involved in gene expression.

Cellular protein kinase C isoform zeta regulates human parainfluenza virus type 3 replication

Phosphorylation of the P proteins of nonsegmented negative-strand RNA viruses is critical for their function as transactivators of the viral RNA polymerases. Using unphosphorylated P protein of human parainfluenza virus type 3 (HPIV3) expressed in Escherichia coli, we have shown that the cellular protein kinase that phosphorylates P in vitro is biochemically and immunologically indistinguishable from cellular protein kinase C isoform zeta (PKC-zeta). Further, PKC-zeta is specifically packaged within the progeny HPIV3 virions and remains tightly associated with the ribonucleoprotein complex. The P protein seems also to be phosphorylated intracellularly by PKC-zeta, as shown by the similar protease digestion pattern of the in vitro and in vivo phosphorylated P proteins. The growth of HPIV3 in CV-1 cells is completely abrogated when a PKC-zeta-specific inhibitor pseudosubstrate peptide was delivered into cells. These data indicate that PKC-zeta plays an important role in HPIV3 gene expression by phosphorylating P protein, thus providing an opportunity to develop antiviral agents against an important human pathogen.

Efficient interaction of the vesicular stomatitis virus P protein with the L protein or the N protein in cells expressing the recombinant proteins

Specific in vivo interaction between the phosphoprotein (P) and the large polymerase protein (L) from the Indiana serotype of vesicular stomatitis virus was studied using a two-hybrid system. Transfection of CHO cells with plasmids encoding GALPIND and VPLIND fusion proteins resulted in an easily detectable level of CAT activity, indicating that PIND and LIND associate in vivo in the absence of other viral proteins. Mutational studies of PIND demonstrated that both domains I and II of PIND are important for PIND-LIND association. In addition, casein kinase II (CKII)-mediated phosphorylation within domain I of PIND was necessary for efficient association with LIND. We have also used the two-hybrid system to show PIND interaction with NIND in vivo. PIND and NIND associated more strongly than PIND and LIND. A similar strong association was observed in heterologous interaction studies between Indiana and New Jersey serotype P and N proteins. Mutational studies of PIND demonstrated that, unlike what was found for PNJ-NNJ association, only the C-terminal region of the P protein was important for efficient association with NIND. Like PNJ, CKII-mediated phosphorylation within domain I of PIND was not required for P-N association and, like NNJ, the C-terminal five amino acids of the NIND protein were critical for P association with N. These results demonstrate the importance of phosphorylation and specific domains of the P protein in its interaction with the L and N proteins, which are necessary for viral transcription and replication, respectively.