Plant cyclins: a unified nomenclature for plant A-, B- and D-type cyclins based on sequence organization

The comparative analysis of a large number of plant cyclins of the A/B family has recently revealed that plants possess two distinct B-type groups and three distinct A-type groups of cyclins. Despite earlier uncertainties, this large-scale comparative analysis has allowed an unequivocal definition of plant cyclins into either A or B classes. We present here the most important results obtained in this study, and extend them to the case of plant D-type cyclins, in which three groups are identified. For each of the plant cyclin groups, consensus sequences have been established and a new, rational, plant-wide naming system is proposed in accordance with the guidelines of the Commission on Plant Gene Nomenclature. This nomenclature is based on the animal system indicating cyclin classes by an upper-case roman letter, and distinct groups within these classes by an arabic numeral suffix. The naming of plant cyclin classes is chosen to indicate homology to their closest animal class. The revised nomenclature of all described plant cyclins is presented, with their classification into groups CycA1, CycA2, CycA3, CycB1, CycB2, CycD1, CycD2 and CycD3.

Uvulopalatopharyngoplasty may compromise nasal CPAP therapy in sleep apnea syndrome

Uvulopalatopharyngoplasty (U3P) has been advocated for treatment of snoring and sleep apnea/hypopnea syndrome (SAHS), but often it does not effect a cure, so that other therapy (CPAP) is often required. We hypothesized that patients with U3P will have increased mouth air leak during CPAP because of loss of the soft palatal seal. This may result in decreased tolerance and compliance if CPAP therapy is required after U3P. We have therefore compared CPAP tolerance in 13 awake normal male subjects, 13 male patients with SAHS and 13 male patients treated with U3P, all naive to CPAP and matched for age and body mass index. All normal subjects and patients with SAHS were able to tolerate pressures of at least 20 cm H2O without mouth air leak or appreciable discomfort. In contrast male U3P patients started to leak air via the mouth at a mean CPAP pressure of 6.8 (SD, 2.4) cm H2O and were able to tolerate a mean maximal pressure of only 14.5 (SD, 2.6) cm H2O, which was significantly less than that in the other two groups (p < 0.001). We also examined nasal CPAP compliance (machine run time) in eight patients with SAHS who had previous U3P compared with 16 patients with SAHS without U3P. Both groups were matched for age, body mass index, and apnea/hypopnea index. Patients with U3P had significantly lower compliance (mean, 3.5 h/night) compared with patients without U3P (mean, 5.7 h/night), p = 0.01. We conclude that U3P may compromise nasal CPAP therapy by increasing mouth air leak and reducing the maximal level of pressure that can be tolerated.

One for tea, not two

This case report illustrates a potentially common cause for the inhibition of iron absorption that can be overlooked at the initial consultation and may lead to extensive investigation of a patient with iron deficiency. The case shows that early questioning of the patient regarding their beverage intake can lead to a positive outcome and avoid unnecessary investigation or treatment.

An Escherichia coli system for assay of F1p site-specific recombination on substrate plasmids

We have developed an Escherichia coli system for testing the behaviour of plasmids carrying target sites for the F1p site-specific recombinase. The E. coli strain BL-FLP is described, which carries a chromosomally integrated bacteriophage T7 RNA polymerase gene expressed from a lac promoter, and harbours the plasmid pMS40.pMS40 has the features: (i) it carries the FLP recombinase gene under the control of a bacteriophage T7 promoter, (ii) it confers kanamycin resistance, and (iii) it uses an R6K origin of replication; these two latter features make it compatible with most conventional cloning vectors. Substrate plasmids carrying F1p-recognition targets (FRT) are transformed into BL-FLP, and the consequences of F1p-mediated recombination can be analysed after subsequent extraction of plasmid DNA. We show that this system is capable of base-perfect F1p-mediated recombination on plasmid substrates. We also present a corrected sequence of the commonly used F1p substrate plasmid, pNEO beta GAL (O'Gorman et al. (1991) Science 251, 1351-1355).

Conventional and dedifferentiated parosteal osteosarcoma. Diagnosis, treatment, and outcome

BACKGROUND

Dedifferentiated parosteal osteosarcoma (dd-POS) designates high grade transformation, of conventional low grade parosteal osteosarcoma (c-POS). The paradigm of preoperative diagnosis, neoadjuvant chemotherapy, and wide local excision has not been adequately evaluated for dd-POS, as it has been for conventional high grade intramedullary osteosarcoma.

METHODS

A retrospective review was conducted of 28 patients treated at the authors' institution between January 1980 and December 1992 for an osteosarcoma arising on the surface of the bone diagnosed as either c-POS or dd-POS. The clinicopathologic features, diagnosis, treatment, and patient outcome were analyzed.

RESULTS

A dedifferentiated component was identified in 12 of 28 tumors (43%). Neither the presence of radiolucencies (77% in c-POS and 100% in dd-POS, P = 0.06) nor medullary invasion (42% in c-POS and 50% in dd-POS, P = 0.28) distinguished dd-POS from c-POS. However, all patients who presented with focal hypervascularity on an arteriogram defined the high grade component of dd-POS that was confirmed by selective needle biopsy. This differed significantly (P = 0.00003) from c-POS. None of the patients with c-POS died of the disease (median survival duration, 77 months; range, 16-152 months). Six patients (35%) developed a local recurrence, but five were treated successfully with further surgery. In the dd-POS group, 7 of the 12 patients died of the disease. Ten patients with dd-POS received preoperative chemotherapy (IA cis-diamminedichloroplatinum, IV doxorubicin), and a good response (> 90% necrosis of high grade component) was observed in four. Among patients whose disease was localized, continuous disease free survival was prolonged significantly (P = 0.03) in patients with a good response (median, 75 months) compared with those who responded poorly (median, 13 months). Five patients remained continuously disease free (median, 66 months, range, 29-95 months).

CONCLUSIONS

Wide surgical excision alone is adequate treatment for patients with c-POS. Recognition of dedifferentiated areas with angiography and percutaneous biopsy of hypervascular areas should prompt the administration of chemotherapy and wide local excision to optimize patient outcome.

Modulation of cyclin transcript levels in cultured cells of Arabidopsis thaliana

Previous studies on the cell cycle of Arabidopsis thaliana have been hindered by the lack of synchronous cell culture systems. We have used liquid callus cultures and a cycloheximide-synchronized suspension culture of Arabidopsis to investigate changes in cyclin transcript levels in response to exogenous auxin, cytokinin, and nutrients, and during the cell cycle. CYCD1 (delta 1) transcript was virtually undetectable in liquid-cultured callus or suspension-culture cells. CYCD2 (delta 2) transcript levels were largely unaffected by the readdition of phytohormones or nitrate to the growth medium, and remained constant throughout the cell cycle in suspension-culture cells. CYCD3 (delta 3) transcript levels were strongly dependent on nitrate, and were induced at the G1/S transition following phytohormone readdition. In synchronized suspension-culture cells, CYCD3 transcript accumulated during the S phase, and remained constant thereafter. These results support the hypothesis that D cyclins function as part of the cellular machinery that integrates diverse signals impinging upon commitment to cell division. In synchronized cells transcripts of the mitotic cyclins CYC1, CYC2, and CYC3 reached a maximum with peak mitotic index, but CYC3 transcript levels increased earlier than those of CYC1 or CYC2. The kinetics of accumulation of CYC transcript levels support their classification as A-type (CYC3) and B-type (CYC1 and CYC2) cyclins, respectively.

Early physiologic patterns in acute illness and accidents: toward a concept of circulatory dysfunction and shock based on invasive and noninvasive hemodynamic monitoring

The aim of the present study was to explore methods, concepts, and techniques that provide recognition of circulatory deficiencies at the earliest possible time in the patient's illness. We used both the standard invasive pulmonary artery thermodilution catheter and noninvasive hemodynamic monitoring systems consisting of a new bioimpedance cardiac output device, pulse oximetry, transcutaneous oxygen (PtCO2) and carbon dioxide tensions as well as the transcutaneous oxygen tension/fraction of inspired oxygen ratio (PtCO2/FIO2). These three noninvasive systems were used to evaluate cardiac function, pulmonary function, and tissue perfusion, respectively. This approach to early noninvasive monitoring is based on recent evidence suggesting that poor tissue perfusion and oxygenation initiate circulatory dysfunction that leads to shock and organ failure. We studied 303 acute episodes of circulatory dysfunction and shock in 261 patients in a university-run county hospital; 75 were acute traumatic injuries and 109 acute nontrauma medical emergencies on admission to the emergency department, and 77 ICU patients with an acute illness or exacerbation of their current illness. The study was a prospective, descriptive study to identify early abnormal circulatory patterns reflecting the cardiac, pulmonary, and perfusion functions associated with death and with survival. We described noninvasively monitored patterns in individual illustrative cases, in common etiologic groups, and in physiologic categories representing various abnormal functional patterns. We found that hypotensive shock usually was preceded by episodes of high flow followed by low flow and inadequate tissue perfusion indicated by reduced PtCO2; this frequent pattern was modified by associated co-morbid conditions, especially hypovolemia, limited cardiac reserve capacity, age, hypertensive states, and increased body metabolism from infection, trauma, stress, exercise, temperature, and endocrine disorders. Reduced pulmonary function occurred in 18% of emergency patients; these were usually patients with thoracic trauma, severe hypovolemia, head injuries, chronic obstructive pulmonary disease, asthma, drug overdose, and central nervous system failure (massive stroke and coma). We concluded that noninvasive measurements identify early circulatory problems reliably and provide objective criteria for physiologic analysis as well as for definition of therapeutic goals and titration of therapy.

Improved thermostability of the North American firefly luciferase: saturation mutagenesis at position 354

We have used random chemical mutagenesis and a simple genetic screen to generate and isolate a thermostable mutant of luciferase from the North American firefly (Photinus pyralis). A single G-to-A transition mutation, resulting in the substitution of a glutamate for a lysine residue at position 354 in the protein sequence, was shown to be responsible for this enhanced thermostability. Replacement of Glu-354 with all possible amino acid residues was achieved using directed mutagenesis, and produced mutant enzymes with a range of thermostabilities. The mutations E354K and E354R conferred the largest increases in thermostability, suggesting that side-chain size and hydrophobicity, as well as charge, may also be important contributors to the overall thermostability of the polypeptide chain at this position. Unusually for such mutations, biochemical studies suggest that this position is on the surface of the protein and exposed to solvent.

Day case tonsillectomy in adults: how many are suitable?

Day case surgery is increasing to improve health care cost efficiency. The economic benefits of day surgery depend on how many patients are suitable. Adult tonsillectomy is a common operation. This study aims to define what proportion of adults undergoing tonsillectomy are suitable for day case surgery. One hundred consecutive adults undergoing elective in-patient tonsillectomy were studied prospectively. Patients were questioned, examined and investigated for any general medical or social contra-indications to day surgery as specified by the Royal College of Surgeons of England. They were also questioned about specific contra-indications to day case tonsillectomy, including NSAID contra-indications and tonsillectomy indicated for biopsy, quinsy or with another procedure. Seventy-six per cent patients satisfied the requirements. The most common reasons for failure were social. A high proportion of adults are suitable for day case tonsillectomy and therefore significant economic benefits are possible. However, prior to such surgery further work on operation suitability is required.

Chondrosarcoma of the pelvis. Prognostic factors for 67 patients treated with definitive surgery

BACKGROUND

Chondrosarcoma (CS) most commonly involves the pelvis. Local and systemic failures often result in poor outcome. Prognostic factors that determine patient outcome remain ill-defined.

METHODS

We retrospectively analyzed 67 patients with CS of the pelvis treated by definitive surgery from January 1970 to December 1992. All patients had localized disease including Grade 1 (19 patients), Grade 2 (18 patients), Grade 3 (17 patients), and dedifferentiated (13 patients) tumors. Thirty-two patients underwent a limb-sparing surgical resection and 35 patients underwent hemipelvectomy. Follow-up was available for all patients. The median duration of follow-up for the survivors was 115 months (range, 24-288 months).

RESULTS

At last follow-up, 52% of the patients were disease free, 8% were alive with disease, 36% died of disease, and 4% died of other causes. Nineteen patients (28%) had developed a local recurrence (LR). The median time to LR was 23 months (range, 1-111 months). Independent variables in a multivariate analysis associated with increased risk of LR included inadequate surgical margin, tumor epicenter in the pubis, and high grade histology. LR did not influence overall patient survival. Twenty-three patients (36%) developed distant metastases at a median time of 9 months (range, 1-111 months) postoperatively. Metastases developed in 0% of the patients with Grade 1, 20% of the patients with Grade 2 60% of the patients with Grade 3 and 75% of patients with dedifferentiated CS. On multivariate analysis, histologic high grade was the only significant predictive variable for distant relapse (P = 0.005).

CONCLUSIONS

The critical issue for a favorable outcome in low grade CS of the pelvis is adequate surgical excision (i.e., negative surgical margin). The high rate of systemic failure in high grade and dedifferentiated CS, despite adequate surgery, emphasizes the need for more effective systemic therapy.

The benevolent overreaction: nursing assessment and intervention in families coping with seizure disorder

Boone and Hartman identified the phenomenon of benevolent overreaction to describe the enmeshment seen in parents and their chronically ill children. The cylce of the benevolent overreaction begins with the child's diagnosis with a chronic illness and the subsequent natural protective behaviors of the parents. However, overprotection may become pathologic if these protective behaviors persist and delay or prevent the child's achieving developmental goals. This ego boundary deficit is one of the most frequently seen phenomena in families with chronically ill children. On the Comprehensive Epilepsy Unit this phenomenon was repeatedly observed. The purpose of this investigation was to ascertain the frequency of benevolent overreaction seen on the unit, and to identify the nursing interventions used to address this issue. A chart review was used to identify the frequency of the phenomenon during the past year, the discipline first identifying the phenomenon and nursing interventions applied to the phenomenon. Nursing staff interviews were then conducted, using unit census records of the past year, to identify staff recall of the phenomenon. Nursing staff frequently identified the components of benevolent overreaction in the inpatient population, however, consistent intervention for the phenomenon was less frequently seen. Autonomy, empowerment and self-advocacy for families are goals of the Comprehensive Epilepsy Unit. Consistent application of the nursing process to this phenomenon is vital to providing quality patient care.

Abrupt cessation of immunosuppression in a patient with persistent acute lymphoblastic leukaemia following allogeneic transplantation

A 20-year-old man with acute lymphoblastic leukaemia (ALL) in second complete remission underwent sibling donor transplant. Post-transplant there was haematological and immunophenotypic evidence of persisting disease. Cyclosporine was abruptly discontinued and following this the leukaemic clone disappeared. Discontinuation of immunosuppression may be of benefit in leukaemia which persists following transplant.

Treatment of facial synkinesis and facial asymmetry with botulinum toxin type A following facial nerve palsy

Facial synkinesis and asymmetry commonly impair the outcome of facial nerve palsy. Botulinum toxin type A is a neurotoxin which prevents acetylcholine release at the neuromuscular endplate, paralysing skeletal muscle. This paper examines its use in 24 patients with synkinesis and asymmetry affecting the eye and mouth. Sixty-eight of 72 treatments produced improved cosmesis. Dose-related complications occurred in 26 treatments but were generally mild and transient. The total dosages of toxin used were analysed. The higher dose group compared with the lower dose group had no significant advantage in overall cosmetic improvement but the complication rate was significantly higher in the higher dose group (20/39) compared with the lower dose group (6/33) (chi 2 6.675, P > 0.05).

Function of identified nerves in orientation to water flow in Tritonia diomedea

We determined which sensory and motor nerves mediate orientation to flow in the marine slug Tritonia diomedea, and tested the hypothesis that the slug orients to water flow by comparing the intensities of water flow stimulation on each side of its body. Lesion experiments revealed which nerves carried information necessary for flow orientation. The lateral branches of Cerebral Nerve #2 were the only cerebral nerves necessary for flow orientation. Cutting all cerebral nerves except the lateral branches of Cerebral Nerve #2 did not eliminate flow orientation. Thus, the lateral branches of Cerebral Nerve #2 were both necessary and sufficient (among the cerebral nerves) for flow orientation. Denervation of one side of the head by cutting Cerebral Nerves #1-4 on one side did not eliminate normal flow orientation. We have revised our model of how Tritonia diomedea orients to flow to allow for this unilateral determination of flow direction. Unilaterally cutting Pedal Nerve #3, which contains many pedal motor axons, reduced turning toward that side, but did not affect final orientation to flow. The ability to detect flow direction was not compromised by the inability to initially turn towards flow.

Antioxidant enzymes in intramural nerves of the opossum esophagus

Superoxide radical (O2-.) combines with nitric oxide (NO) to form peroxynitrite, thereby nullifying the biological activity of NO. Superoxide dismutase (SOD) prevents this reaction by converting O2-. to H2O2. We tested the hypotheses that the antioxidant enzymes catalase (CAT), Mn SOD, and Cu/Zn SOD are present in enteric neurons of the opossum esophagus, and that O2-. alters esophageal motor function. Immunostaining demonstrated CAT, Mn SOD, and Cu/Zn SOD immunoreactivity in interganglionic nerve bundles and ganglia of the myenteric and submucosal plexuses. Western blot analysis confirmed the presence of these enzymes in homogenates of esophageal muscularis propria, and enzyme assays demonstrated Cu/Zn SOD and Mn SOD activities of 262 and 73 U/mg protein, respectively. Both diethyldithiocarbamic acid, an inhibitor of Cu/Zn SOD, and xanthine (X) with xanthine oxidase (XO), which generate O2-., shortened the latency of the nerve-mediated contraction of circular esophageal muscle, the off response, by 20.2 and 23.4%, respectively. SOD alone did not affect the latency, but it inhibited the effect of X with XO on the latency. Antioxidant enzymes found in intramural esophageal nerves may play a role in regulating NO-mediated neuromuscular communication in the esophagus.

Multiple cloning sites carrying loxP and FRT recognition sites for the Cre and Flp site-specific recombinases

Plasmids were constructed carrying the loxP and FRT recognition sites for the Cre and Flp site-specific recombinases, respectively, within multiple cloning sites. Vectors carrying single and tandemly repeated targets are available with various flanking restriction enzyme sites. In addition, a series of plasmids carrying both loxP and FRT sites is available. These vectors facilitate construction of target molecules for these site-specific recombinases which are becoming increasingly important tools for the in vivo manipulation of DNA.

Would day-case adult tonsillectomy be safe?

Day-case surgery is increasing to improve health care efficiency. Adult tonsillectomy is performed on an inpatient basis in the UK because of safety concerns regarding primary haemorrhage. This study aims to investigate the likely safety of day-case tonsillectomy in adults, by defining the incidence and timing of primary haemorrhage and therefore to establish a safe time period for same-day discharge. Prospectively recorded data on 2,157 adult tonsillectomies over a five-year period were reviewed. Serious primary haemorrhage was uncommon (0.8 per cent). The 95 per cent reference range of time to primary haemorrhage was within 0 to 6.8 hours of surgery and the 95 per cent confidence interval (C.I.) of its upper limit was 5.2 to 8.4 hours. The results compare favourably with the UK inpatient and US adult day-case literature. We conclude that day-case tonsillectomy would probably be safe in adults if the patients are discharged after 8.4 hours.

Effect of nitroblue tetrazolium on NO synthase and motor function of opossum esophagus

Nitric oxide mediates neuromuscular events in the opossum esophagus. The NADPH diaphorase stain is used to localize nitric oxide synthase-containing enteric neurons. Cells stain by the NADPH diaphorase technique because they reduce nitroblue tetrazolium to the visible formazan. The effects of nitroblue tetrazolium on neuromuscular function and nitric oxide synthase of esophageal muscle were studied. The NADPH diaphorase stain was performed. Nitroblue tetrazolium inhibited lower esophageal sphincter relaxation, abolished the latency gradient of the off response, and inhibited nitric oxide synthase. The NADPH diaphorase technique stained myenteric plexus nerve cell bodies and nerve processes. Nitroblue tetrazolium is not a nonspecific muscle or nerve toxin, as nerve-mediated cholinergic responses, responses to exogenous nitric oxide, and responses to myogenic stimulation were maintained after nitroblue tetrazolium abolished the off response and lower esophageal sphincter relaxation. Nitroblue tetrazolium inhibits nitric oxide-mediated events and nitric oxide synthase. It stains neurons in the esophageal myenteric plexus.

The effects of recombinant human hemoglobin on esophageal motor functions in humans

BACKGROUND & AIMS

Nitric oxide controls lower esophageal sphincter (LES) relaxation and esophageal peristalsis in opossums, but its role in the control of esophageal motility in humans is not defined. Hemoglobin inactivates NO by binding it. Recombinant human hemoglobin (rHb1.1) was used to test the hypothesis that NO mediates esophageal motor functions in humans.

METHODS

rHb1.1 or human serum albumin was administered intravenously to fasting male volunteers. Esophageal manometric studies were performed before, during, and up to 6 hours after the infusion.

RESULTS

rHb1.1 increased the velocities of peristaltic contractions to produce simultaneous contractions in 6 of 9 subjects. It increased the amplitude and duration of contractile waves in the esophagus. There was no consistent effect on the resting tone of the LES, but LES relaxation was inhibited. Spontaneous, simultaneous high-pressure contractions occurred in 8 of 9 subjects. Lower retrosternal chest pain during swallowing was observed in 4 subjects.

CONCLUSIONS

rHb1.1 interfered with esophageal peristalsis and LES relaxation. It precipitated esophageal spasm in some subjects. These data support the hypothesis that the timing of smooth muscle esophageal peristalsis and LES relaxation are mediated by NO. They suggest that some disorders of esophageal motor function may result from defects in NO neuromuscular communication.

Nitric oxide modulates a calcium-activated potassium current in muscle cells from opossum esophagus

Nitric oxide mediates nerve-induced hyperpolarization of circular smooth muscle of the esophagus. Two mechanisms are proposed to explain this hyperpolarization: an increase in K+ current or a decrease in Cl- current. These studies test the hypothesis that nitric oxide increases a K+ current in esophageal smooth muscle. Three outward K+ currents are present in circular smooth muscle cells from the opossum esophagus. One current is a Ca(2+)-activated K+ current (IKCa2+). This current is inhibited by charybdotoxin. Whole cell currents were recorded from isolated opossum esophageal smooth muscle cells using the whole cell patch-clamp technique. These studies showed that IKCa2+ is activated at potentials more positive than -30 mV. Bath application of S-nitroso-L-cysteine increased IKCa2+ by 50% above control levels throughout the entire activation range of potentials. The enhanced current was reversible on washout. Either charybdotoxin, an inhibitor of IKCa2+, or (R)-p-8-(4-chloropenylthio)-guanosine 3',5'-cyclic monophosphorothioate, an inhibitor of protein kinase G, antagonized the increase in outward current induced by S-nitroso-L-cysteine. These data suggest that nitric oxide activates IKCa2+ via the guanosine 3',5'-cyclic monophosphate-protein kinase G signal transduction pathway.

Re-innervation of facial nerve territory using a composite hypoglossal nerve--muscle autograft--facial nerve bridge. An experimental model in sheep

The hypoglossal nerve has been used both entirely and in part to repair the facial nerve. Using the partial technique it may be difficult to obtain sufficient length and a free interposed graft is then required to extend the hypoglossal element. In six sheep the facial nerve was excised between its emergence from the stylomastoid foramen and its bifurcation in the parotid gland. The hypoglossal nerve was exposed and split longitudinally producing a limb which was reflected towards the distal stump of the facial nerve. This left a gap of 4-5 cm which was bridged with a freeze-thawed coaxially aligned skeletal muscle autograft. The sheep were examined at 8 months. Laser doppler blood-flow studies showed the blood-flow distal to the graft to be about 25% of that at an equivalent site on the normal side. Peak nerve conduction velocities were also reduced on the repaired side but stimulation of the proximal hypoglossal nerve was nevertheless capable of causing adequate contraction of both facial and tongue muscles. Histological comparison of the repaired facial nerves with equivalent sites on the normal side showed a reduction in mean axon and fibre diameters with normal myelin sheath thickness for the regenerated axon sizes. All of these features are to be expected in a regenerated nerve and are consistent with a good level of recovery of function.

A family of cyclin D homologs from plants differentially controlled by growth regulators and containing the conserved retinoblastoma protein interaction motif

A new family of three related cyclins has been identified in Arabidopsis by complementation of a yeast strain deficient in G1 cyclins. Individual members show tissue-specific expression and are conserved in other plant species. They form a distinctive group of plant cyclins, which we named delta-type cyclins to indicate their similarities with mammalian D-type cyclins. The sequence relationships between delta and D cyclins include the N-terminal sequence LXCXE. This motif was originally identified in certain viral oncoproteins and is strongly implicated in binding to the retinoblastoma protein pRb. By analogy to mammalian cyclin D, these plant homologs may mediate growth and phytohormonal signals into the plant cell cycle. In support of this hypothesis, we show that, on restimulation of suspension-cultured cells, cyclin delta 3 is rapidly induced by the plant growth regulator cytokinin and cyclin delta 2 is induced by carbon source.

Vasoactive intestinal contractor: localization in the opossum esophagus and effects on motor functions

BACKGROUND/AIMS

Vasoactive intestinal contractor (VIC), an endothelinlike peptide and a putative gastrointestinal hormone, contracts gastrointestinal smooth muscle. The aim was to study VIC in relation to esophageal function.

METHODS

Intramural nerves in opossum esophageal smooth muscle strips were stimulated in the presence of various concentrations of VIC and were stained for VIC immunoreactivity.

RESULTS

VIC caused an atropine-resistant increase in the amplitude of nerve-induced contractions of the circular muscle. VIC alone contracted longitudinal muscle, and this effect was nearly eliminated by 1 mmol/L atropine. VIC caused an atropine-resistant increase in the resting tone of the lower esophageal sphincter muscle, but it did not affect nerve-induced relaxation of that muscle. VIC-immunoreactive nerve fibers occurred in the longitudinal muscle layer, in the muscularis mucosae, and around the ducts of esophageal glands. A few such fibers were found in the circular muscle layer. Nerve fibers and cell bodies of the myenteric plexus showed VIC immunoreactivity. In the stomach, immunoreactive nerve fibers occurred in muscularis mucosae and circular muscle but not in longitudinal muscle.

CONCLUSIONS

VIC is localized in neuronal elements of the opossum esophagus and excites contractions in esophageal smooth muscle.

The effect of fibrin sealant haemostasis on post-operative pain in tonsillectomy

Pain following tonsillectomy is an important problem. It is caused by the surgical trauma of excision and haemostasis. Numerous surgical and pharmacological solutions have been tried, with disappointing results. Fibrin sealant is a widely used atraumatic haemostatic agent. This study aims to determine whether tonsillectomy with fibrin sealant haemostasis results in less post-operative pain than that with the conventional technique of diathermy. Fifty consecutive adult patients undergoing tonsillectomy were prospectively studied. They were randomized to receive either fibrin sealant or diathermy haemostasis. Other pain variables were controlled. Pain was measured by a visual linear analogue scale and inter-incisor distance on both the day of operation and the first post-operative day. The patients and pain measurer were blind to the randomization. The results showed that tonsillectomy with fibrin sealant haemostasis was significantly (P < 0.05) less painful than that with diathermy on both days studied and by both methods of pain measurement.

Roles of Triton X-100 in NADPH-diaphorase histochemistry

Triton X-100 is widely but not universally used in NADPH-diaphorase histochemical staining. We investigated its effect on the staining and examined nitroblue diformazan (NBF) production under the influence of Triton X-100. Exposure of opossum esophagus, intestine, and colon tissues to Triton X-100 before staining enhanced staining of nerve cells and fibers and suppressed staining of non-neural structures. Long exposures and high concentrations nearly abolished the staining of non-neural structures and decreased the staining of nerves. The use of an incubation medium containing Triton X-100 achieved the best staining of nerve cells and fibers. Addition of Triton X-100 to the incubation medium changed its color from yellow to purple; in the presence of tissues, this color change occurred much more quickly. Spectral analysis showed that Triton X-100 increases the rate of NBF formation in the presence of tissue supernatant. Triton X-100 increases it less in the absence of tissue supernatant. Therefore, Triton X-100 improves the histochemical staining, probably by catalyzing the activity of NADPH-diaphorase, by keeping the extracellular NBF in solution and thus suppressing the staining of non-neural structures, and by increasing the permeability of cell membranes.

The Edinburgh facial palsy clinic: a review of three years' activity

Patients with facial palsy can present to almost all medical practitioners. From birth to old age the aetiologies of disease affecting the nerve range from congenital to the more common inflammatory, infective, traumatic and neoplastic. This paper reviews the Edinburgh Facial Palsy Clinic, its structure and function over a three year period. The methods of clinical investigation, special investigation and management strategies are discussed. The diversity of pathology seen over a three year period is presented, confirming the need for a team approach to the management of patients with facial palsy.

Acute and chronic diarrhea. How to keep laboratory testing to a minimum

Diagnosing a cause of diarrhea is a challenging undertaking but can be accomplished if a systematic approach is used for evaluation. Pathophysiologic mechanisms of acute diarrhea (eg, Giardia lamblia infection, antibiotic use) are different from those of chronic diarrhea (eg, secretory dysfunction from thyrotoxicosis, lactose or fructose intolerance), so adequate history taking and physical examination are essential in narrowing the diagnosis. Laboratory investigation can then be directed using the information obtained, and the cause of the diarrhea can be established without subjecting the patient to extensive and expensive testing. Undoubtedly, some functional entities that contribute to diarrhea await discovery.

Comparison of charges related to radiotherapy for soft-tissue sarcomas treated by preoperative external-beam irradiation versus interstitial implantation

BACKGROUND

We compared treatment-related charges associated with external beam irradiation and interstitial implantation for soft-tissue sarcoma of the extremity.

METHODS

Charges related to radiotherapy in 35 patients with soft-tissue sarcoma of the extremity were reviewed. Preoperative external beam irradiation (EB) delivering 50 Gy in 25 fractions with 6 MV photons was administered to 12 of the patients evaluated. The remaining 23 patients were treated with interstitial implantation (IR) as the only radiotherapeutic intervention. The anatomic distribution of the sarcomas treated by IR included 14 lower-extremity (LE) and nine upper-extremity (UE) lesions. The average length of iridium wire used for IR was 78 cm. Because LE lesions tend to be larger, the average length equaled 109.5 cm as compared with the 47 cm for UE implants.

RESULTS

The radiotherapeutic approach represented the only difference in treatment-related charges because the operative procedure of wide local excision was performed in each group. No difference in perioperative complications was observed between the two treatment approaches. Charges were stratified according to hospital-based and professional services. Radiotherapy-based hospital charges for the administration of EB averaged $6,515 compared with $4,050 for IR (p < 0.0001). Professional services also were significantly different, totaling $4,390 for EB and $3,240 for IR (p < 0.0001). The total of these charges for radiotherapy procedures and professional fees equaled $10,905 for EB compared with $7,290 for IR (p < 0.0001). Incorporating the necessary operating-room time for implant placement ($750) and five additional hospital days ($1,800), the costs associated with IR totaled $9,840; using chi-square analysis, the cost for IR remained significantly (p < 0.0001) less expensive than the $10,905 associated with EB. Because a large component of the radiotherapy cost for IR is related to the length of iridium 192 wire required, charges were stratified according to the location of the tumor. The total charge for IR of the UE equaled $9,345 compared with $10,335 for LE implants. Chi-square comparison for both UE and LE implants continued to show significant differences (p < 0.0001) when related to EB therapy.

CONCLUSION

Cost-analysis comparison of brachytherapy versus external beam irradiation found lower charges for patients undergoing adjuvant irradiation with brachytherapy for soft-tissue sarcoma. To optimize the cost-benefit ratio, prospective studies are necessary to define the application of these radiotherapeutic approaches based on clinical criteria.

Minimal cross-sectional areas, nasal peak flow and patients' satisfaction in septoplasty and inferior turbinectomy

Changes in minimal cross-sectional areas, measured by acoustic rhinometry as well as nasal peak flow fractions and linear analogue patients' satisfaction scores, were measured in two groups of eight patients each, undergoing septoplasty alone and septoplasty combined with trimming of the inferior turbinates, respectively. Patients who had both procedures performed showed the greatest increase in both minimal cross-sectional areas and peak flow fractions, and both of these parameters were closely correlated with patients' satisfaction, whether the patient was satisfied or not. Pre-operative nasal obstruction was worse in the dual-procedure group, but post-operative satisfaction was significantly greater in these patients. Both acoustic rhinometry and nasal peak flow fractions can be recommended as accurate and easy to perform pre-operative measurements in patients undergoing surgery for nasal obstruction.

The prognostic value of facial electroneurography in Bell's palsy

Twenty six patients with Bell's palsy were studied at presentation using electroneurography. Ninety-four per cent of those who recovered completely could have been predicted by ENoG within 10 days of onset. Of the 18 patients who recovered completely, 13 had a total palsy at presentation.

An out-patient review of facial palsy in the community

The true psychological morbidity of facial palsy, including Bell's palsy, is not fully understood. This study addresses this problem by a voluntary questionnaire of ENT out-patients. It is not a representative study but indicates that the long-term sequelae of facial palsy is under-estimated by clinicians.

A comparison of glue and a tube as an anastomotic agent to repair the divided buccal branch of the rat facial nerve

The best anastomotic agent to join nerve ends is controversial. This paper describes a controlled trial between a collagen tube wrap and a tissue glue to anastomose the rat facial nerve. There was no difference in the results using photographic, histological and electrophysiological techniques.

Characterization of nitric oxide synthase in the opossum esophagus

BACKGROUND/AIMS

Nitric oxide mediates the nonadrenergic, noncholinergic neural control of esophageal motor function. The purpose of this study was to characterize the NO synthase found in the muscularis propria of the opossum esophagus and determine its distribution along the esophagus.

METHODS

Esophageal muscle was homogenized in HEPES buffer and ultracentrifuged. The supernatant was exposed to [3H]L-arginine. The [3H]L-citrulline produced by NO synthase was separated from [3H]L-arginine with a Dowex AG 50 W-X8 column (Biorad, Hercules, CA). Assays were performed in the presence and absence of Ca2+ or reduced nicotinamide adenine dinucleotide phosphate (NADPH). The distribution of NO synthase activity along the esophagus was determined.

RESULTS

The apparent Michaelis constant and maximum velocity of NO synthase were 7.5 +/- 1.4 mumol/L L-arginine and 76.0 +/- 17.3 pmol.mg protein-1.min-1, respectively. The enzyme required both Ca2+ and NADPH for activity. Smooth muscle tissue from the lower esophageal sphincter and the esophageal body 1-2 cm or 5-6 cm above the lower esophageal sphincter differed little in enzymatic activity, ranging from 0.97 to 1.27 pmol.mg wet wt-1.min-1. Striated muscle had less activity with 0.40 pmol.mg wet wt-1.min-1.

CONCLUSIONS

These data indicate the presence of a constitutive NO synthase in the esophagus of the opossum.

A comparison of epineurial and perineurial sutures for the repair of a divided rat sciatic nerve

Whether epineurial or perineurial nerve repair is superior remains debatable. This paper describes a controlled trial comparing these suture techniques. Both have identical results.

Frequency as a releaser in the courtship song of two crickets, Gryllus bimaculatus (de Geer) and Teleogryllus oceanicus: a neuroethological analysis

1. The courtship behavior of male field crickets, Gryllus bimaculatus (De Geer) and Teleogryllus oceanicus, is a complex, multimodal behavioral act that involves acoustic signals (a courtship song; Fig. 1A, B). The dominant frequency is 4.5 kHz for T. oceanicus song (Fig. 1A) and 13.5 kHz for G. bimaculatus (Fig. 1B). 2. When courting males are deprived of their courtship song by wing amputation, their courtship success declines markedly but is restored when courting is accompanied by tape-recordings of their courtship songs or a synthetic courtship song with only the dominant frequency of the natural song; other naturally occurring frequency components are ineffective for restoring mating success (Figs. 4, 5). 3. It has been suggested that an identified auditory interneuron, AN2, plays a critical role in courtship success. Chronic recordings of AN2 in an intact, tethered female show that AN2's response to the natural courtship song and synthesized songs at 4.5 and 13.5 kHz is similar in T. oceanicus. By contrast, in G. bimaculatus, AN2's response to the natural courtship song and synthesized song at 13.5 kHz, but not at 4.5 kHz, is similar (Fig. 2,3). 4. In behavioral experiments, playback of a 30 kHz synthetic courtship song in G. bimaculatus does not restore courtship success, yet this same stimulus elicits as strong a response from AN2 as does the normal courtship song (Fig. 6). Thus, contrary to earlier work by others, we conclude AN2 is not, by itself, a critical neural link in the courtship behavior of these two species of crickets.

A comparison of absorbable and non-absorbable 10-0 sutures for the repair of a divided rat facial nerve

The use of absorbable sutures to anastomose nerves is controversial. This paper reports on a controlled trial comparing absorbable and non-absorbable sutures for this purpose. No difference between the sutures was found.

Giant solitary synovial chondromatosis

The purpose of this report is to describe giant solitary synovial chondromatosis, a previously unrecognized feature of synovial chondromatosis that may histologically and radiographically mimic a malignant neoplasm. Giant solitary synovial chondroma is an intra- and/or extraarticular lesion measuring over 1 cm in size and sometimes as large as 20 cm. The radiographic appearance is that of a large, well-marginated mass either of irregular feathery calcification from coalescence of multiple small synovial chondromas, or a rounded calcified mass from the growth of a single synovial chondroma. Radiographically, giant solitary synovial chondromatosis may appear similar to chondrosarcoma and parosteal osteosarcoma.