Genotyping human papillomavirus type 16 isolates from persistently infected promiscuous individuals and cervical neoplasia patients

Nucleotide sequence variation in the noncoding region of the genome of human papillomavirus type 16 (HPV16) was determined by direct sequencing and single-strand conformation polymorphism analysis of DNA fragments amplified by PCR. Individuals of diverse sexual promiscuity and/or cervicopathology were studied. In a group of 14 healthy, monogamous HPV16-positive females, only two HPV16 sequence variants could be documented. Among 17 females and 3 males with multiple sex partners and living in the same geographical region, nine sequence variants were found, whereas among 7 patients with cervical neoplasia from another region, five variants were detected. Although numbers are limited, in the group of individuals at high risk of acquiring a sexually transmitted disease or with cervical neoplasia, a larger number of HPV16 sequence variants was encountered (two types among 14 individuals versus nine types among 20; Fisher's exact test, P = 0.07). Seven of the individuals were sampled repeatedly over time. For these persistently infected women, no differences in HPV16 sequences were detected, irrespective of promiscuity, and persistence of a single viral variant, spread over multiple anatomic sites, for more than 2 years could be demonstrated. This indicates that viral persistence may be a common feature and that successful superinfection with a new variant may be rare, despite a potentially high frequency of viral reinoculation.

[Herpes gestationis. Clinical spectrum and diagnostic possibilities]

Herpes gestationis (HG) is a rare autoimmune disease of pregnancy. We report on five patients in whom the clinical diagnosis was confirmed by histology, immunofluorescence and immunoblot studies. The time of onset ranged from the 8th week of pregnancy to the 1st day post partum. In one patient erosions and ulcerations of the oral cavity predominated while the remainder of the skin was nearly unaffected. One patient had intense pruritus without any skin eruptions during the final 8 weeks of her pregnancy, developing bullous lesions on the 1st day post partum. The other patients initially suffered from pruritic polymorphic skin lesions, followed by vesiculae and bullae. In the serum of all patients, the complement-fixing HG factor was found. Immunoblot studies with epidermal and dermal extracts demonstrated the binding of the antibodies to a 180-kD protein of the epidermis. All patients improved markedly with medium dosages of systemic corticosteroids. In four cases the newborns were healthy and mature, and in one case, the infant met all criteria for a "small-for-dates" baby. We discuss both clinical spectrum and diagnostic options of HG and review new aspects related to the pathogenesis of this disease.

[Pemphigus foliaceus caused by penicillamine]

We report the case of an 80-year-old woman who developed pemphigus foliaceus while taking penicillamine for rheumatoid arthritis. On the basis of this new case, we discuss fresh insights into the pathogenesis of drug-induced pemphigus. In addition, having reviewed the literature, we give a list of drugs that have been reported to induce this disease.

[A case of adult Gaucher disease]

The authors describe a case of an adult patient having Gaucher's disease, who had hepatosplenomegaly and pancytopenia. The diagnosis was established by the low level of leukocyte beta-glucosidase and by histology of bone marrow, liver and spleen. The patient had no bone pain, but MRI described characteristic lesions of the femur. Serum acid phosphatase was characteristically elevated. The hypersplenism was reduced after splenectomy. The patient has a daughter with central nervous system dysfunction. Her chromosome examination is normal, but she has lower leukocyte beta-glucosidase activity too. She may have a Gaucher's disease of type II, the acute neuropathic form.

Soluble interleukin-2 receptors inhibit interleukin 2-dependent proliferation and cytotoxicity: explanation for diminished natural killer cell activity in cutaneous T-cell lymphomas in vivo?

In patients with cutaneous T-cell lymphomas (CTCL), soluble interleukin-2 receptor serum levels (sIL-2R) were determined by ELISA technique, and natural killer cell (NK) activity, by a 4-h chromium-51 release assay. Decrease of NK activity correlated with the augmentation of serum sIL-2R. After a 4-d stimulation with interleukin 2 CTCL patients' peripheral mononuclear cells (PMC) showed an increase of cytotoxic activity similar to that in healthy donors' PMC. Normal donors' PMC demonstrated a diminished IL-2-induced cytotoxic activity in 25% CTCL serum (sIL-2R of 3000, 7330, and 10700 U/ml, respectively) compared to control serum (sIL-2R of 400, 340, and 420 U/ml, respectively). IL-2-dependent proliferation of 2-d phytohemagglutinin (PHA) blasts was lower in CTCL serum than in control serum. sIL-2R was enriched from one CTCL patient's serum by IL-2 affinity chromatography. Transfection of the Tac gene into NIH/3T3 fibroblasts resulted in the production of a recombinant sIL-2R. The presence of enriched native or recombinant sIL-2R inhibited interleukin-2-dependent generation of cytotoxic activity and PHA blast proliferation. We suggest that elevated sIL-2R levels account for diminished NK activity by neutralizing interleukin 2 in CTCL patients.

An investigation into the relationship between anaerobic work capacity, percentage body fat and the grade of asthma in asthmatics and a healthy control group

The goal of this study was to compare the anaerobic working capacity of asthmatic children to that of a healthy control group and to ascertain the relationship between the degree of asthma, anaerobic exercise and percentage body fat. A total of 41 children, 21 asthmatics and 20 healthy children (13-18 years) were tested. Three variables - percentage body fat, pulmonary function and fitness - were measured. It was found that there is very little difference between the asthmatic and the healthy child, with regard to anthropometric measurements, fitness and anaerobic working capacity. A poor correlation was found between percentage body fat, pulmonary function and anaerobic working capacity. The results further showed that there is a slight correlation between the percentage body fat and anaerobic working capacity. This tendency can only be confirmed with a larger random sample of children.The researchers conclude that asthmatics, irrespective of the degree of asthma, are not restricted as far as anaerobic activities are concerned. They can  therefore lead a normal healthy life and, as far as anaerobic exercise is  concerned, can compete on equal terms with healthy children.

Triple-phase bone image abnormalities in Lyme arthritis

Arthritis is a frequent manifestation of Lyme disease. Limited triple-phase Tc-99m MDP bone imaging of the wrists and hands with delayed whole-body images was performed in a patient with Lyme arthritis. This demonstrated abnormal joint uptake in the wrists and hands in all three phases, with increased activity seen in other affected joints on delayed whole-body images. These findings are nonspecific and have been previously described in a variety of rheumatologic conditions, but not in Lyme disease. Lyme disease should be considered in the differential diagnosis of articular and periarticular bone scan abnormalities.

Stimulation of thymus cells by the calcium ionophore A23187 in the presence of LPS and 2-ME: on the mode of action of A23187 and 2-ME

The stimulation of murine spleen and thymus cells by the calcium ionophore A23187 was studied using a serum-free culture technique. In cultures of spleen cells, rabbit IgG was capable of replacing A23187 in bringing about the stimulation of cells. Low concentrations of A23187 were inhibitory to proliferating B lymphocytes. In cultures of thymus cells a stimulating activity of A23187 was observed only if LPS was present in the medium.

Mitogen-responsive S6 kinase

Many cell lines respond to mitogenic stimuli (serum, growth factors) with rapid phosphorylation of the ribosomal protein S6 at several serine sites. We have tried to identify the protein kinase(s) mediating this effect of growth stimuli. Examining post-DEAE chromatography fractions of S49 kin- cell extracts, we could detect a highly active effector-independent S6 kinase with specificity for serine residues. The study was extended to the presumably homologous human enzyme, using HeLa S3 cells as model system. Activity yields increased up to sevenfold when exhausted HeLa cells were supplied with fresh medium plus serum. The enzyme uses ATP, not GTP, as cosubstrate, 40-S or 80-S (reassociated from subunits) ribosomal particles being substrate. The optimal K+ concentration, measured at 3 mM Mg2+, is 35 mM. Under optimized assay conditions S6 phosphorylation proceeded faster in vitro than it appeared to do in vivo. The apparent Mr of the enzyme, as estimated by gel filtration on Sephadex G-100, is 56,000 (determination in the presence of 200 mM KCl in 25 mM phosphate buffer). Tighter binding to DEAE-Sephacel and higher specificity for S6 distinguishes this enzyme from the following S6-phosphorylating protein kinases: protein kinase C, protease-activated kinase II, histone-4 phosphotransferase and an enzyme with the properties of casein kinase I. In published summaries of observations shown here and in a follow-up study with chick embryo fibroblasts, the enzyme(s) has been referred to as mitogen-responsive S6 kinase(s) [Martini, O. H. W. and Lawen, A. (1985) in Hormones and cell regulation (Dumont, J. E., Hamprecht, B. and Nunez, J., eds) vol. 9, pp. 411-412, Elsevier Company, North-Holland, Amsterdam; Lawen, A. and Martini, O. H. W. (1985) FEBS Lett. 185, 272-276].

Insulin-induced S6 kinase activation in HeLa cells and its reversal by hyperthermic stress

Insulin treatment of HeLa S3 cells activates an S6-phosphorylating protein kinase. Although this enzyme has chromatographic properties resembling those of described proteolytic fragments of other protein kinases, namely protein kinase C, protease-activated kinase II and histone-4 protein kinase, and although insulin has been proposed by others to cause S6 phosphorylation via proteolytic protein kinase activation, the insulin-induced increase in S6-kinase activity described here is probably not due to proteolysis. Rather, the activity indicates the existence, in HeLa cells, of an interconvertible S6 kinase, since the insulin-induced activity increase was rapidly reversed under hyperthermic stress, and since this effect of hyperthermia was itself reversible. The S6-kinase activities from serum- and from insulin-stimulated HeLa cells resemble each other closely and are likely to represent the same enzyme. The enzyme may therefore mediate both signals delivered by mitogens and the insulin signal. Analysed at an in vitro transfer of 1 mol phosphate/mol S6, this S6 kinase activity does not phosphorylate the (principal) S6 site recognized by the cAMP-dependent protein kinase.

Increased detection rate of human papillomavirus in cervical scrapes by the polymerase chain reaction as compared to modified FISH and southern-blot analysis

Cervical scrapes from 80 women with a positive cytology result were tested for the presence of human papillomavirus (HPV) using the polymerase chain reaction (PCR) and compared to the results obtained with the modified filter in situ hybridisation (FISH) and the Southern-blot techniques. The sensitivity of the modified FISH and the Southern-blot was similar, and HPV was detected in 46% of the patients. The sensitivity of the PCR appeared to be higher, and HPV was detected in 70% of the patients. HPV-DNA could be detected in 46 of the 68 patients with mild dysplasia, in 6 of the 8 patients with severe dysplasia, and in all 4 patients with carcinoma in situ. In 18 patients (21%) more than one HPV type could be detected by the PCR. The control group consisted of 100 women involved in a triennial checkup programme, who had normal smear results and no history of cervical lesions. HPV was detected in 5% of the women by the PCR. The PCR technique detected HPV in a high proportion of the cervical scrapes from women with a positive cytology result. These results give further evidence for an important role of HPV in the pathogenesis of cervical cancer.

Why I chose an HMO

The advantages of family practice in an HMO are fixed hours, excellent call coverage, and immediate, steady outcome. Its disadvantages are less control over administrative decisions, less continuity of coverage than in solo practice, and great sensitivity to economic pressures. The author discusses how he came to his decision to practice family medicine in an HMO.

Acute immune hemolysis induced by a degradation product of amphotericin B

We report here on an eight-year-old boy who first developed acute intravascular hemolysis following therapy with amphotericin B (AmB) and subsequently a delayed hemolytic transfusion reaction due to alloantibodies. Although there is as yet no evidence for metabolism of AmB in vivo, the hemolysis appeared to be the result of sensitization against a degradation product of the drug. The patient's serum contained a hemagglutinating IgM antibody that reacted with all red blood cells (RBC) tested in the presence of plasma obtained from patients receiving AmB (ex vivo antigen), but not in the presence of their urine, AmB itself, or with AmB-pretreated RBC. These findings indicate that the antibody was directed against a degradation product of AmB, presumably a trace metabolite, that has not yet been identified.

Interplay between extracellular -SH groups and Ca2+ in their mitogenic action on murine lymphocytes: the role of SiO2

Murine spleen lymphocytes, cultured under serum-free conditions and stimulated with concanavalin A (Con A), showed an increased demand for supplemental concentrations of Ca2+ when 2-mercaptoethanol (2-ME) or L-cysteine were also present in the culture medium. The requirement for additional Ca2+ ions was particularly evident at high cell concentrations. The addition of SiO2 (Aerosil 200), in concentrations depending on the original level of Ca2+ in the culture medium, could substitute for the increased demand on calcium ions. This dependency of SiO2 effects on calcium levels in the medium was also evident when supraoptimal, i.e. inhibitory concentrations of silica were tested. Results of experiments with 45Ca suggest that silica particles may act as intercellular carriers of calcium. In contrast to spleen lymphocytes, Con A-stimulated thymus cells exhibited neither a need for an increase in the concentration of Ca2+ nor a dependency on the presence of 2-ME in the medium.

Stimulation of proliferation of murine lymphocytes by the calcium ionophore A 23187 in the absence of serum: the requirement for thiols

The proliferation of mouse spleen cells and T-lymphocytes, initiated by the calcium ionophore A 23187 was studied by a serum-free culture technique. In contrast to Con A, A 23187 was capable of stimulating cells only if 2-mercaptoethanol, cysteine and glutathione (reduced form), respectively, were present in the culture medium. In the absence of one of these compounds a stimulating activity of A 23187 was observed only with high concentrations of cells (i.e., 10(7)/ml). With glutathione present, the cells could be stimulated only at concentrations of A 23187 which were found to be suboptimal in cultures with 2-mercaptoethanol. Human serum, fetal calf serum and bovine serum albumin shifted the active and optimally stimulating concentrations of A 23187 to higher values. A similar effect was observed with sera- and Con A-treated cells. The effect of sera and albumin was paralleled by a protecting effect of cells against high concentrations of A 23187.

The mechanism of SiO2 (Aerosil)-mediated enhancement of the proliferative response of mouse spleen lymphocytes to antigen and mitogens in a serum-free system

SiO2 particles enhanced the in vitro proliferation of splenic B cells obtained from BALB/c mice immunized with sheep erythrocytes. T cells from immunized animals were capable of replacing SiO2 with regard to the enhancement of both in vitro proliferation and the primary immune response. In addition, the stimulating effect of IgG, phytohemagglutinin (PHA) and concanavalin A (Con A) on spleen lymphocytes was also augmented by SiO2. The enhancing effect of SiO2 was higher at suboptimal than at supraoptimal concentrations of Con A. SiO2 is capable of binding Con A. The SiO2-bound lectin retained its mitogenic effect on spleen cells and, under certain conditions, SiO2-bound Con A was considerably more active in this respect than the free substance.

Enzymic properties of an N-acetylglucosaminide 3-alpha-L-fucosyltransferase of a wheat-germ agglutinin-resistant melanoma clone

A fucosyltransferase was solubilized by extraction with Triton CF-54 from a wheat-germ agglutinin-resistant variant of mouse B16 melanoma. Through affinity chromatography on GDP hexanolamine--Sepharose a 44-fold enrichment of its specific activity was obtained. Analysis of its specificity indicated that the enzyme is an N-acetylglucosaminide 3-alpha-L-fucosyltransferase, which is able to transfer fucose to oligosaccharides containing Gal(beta 1-4)GlcNAc and Gal(beta 1-4)Glc structures. The enzyme is activated by divalent cations and has a maximum of activity at pH 5. It is unable to transfer fucose to sialylated glycoproteins, 6-alpha-sialyllactose or 3-alpha-sialyllactose. As suggested by its precipitation in the presence of antibodies raised in rabbit against a soluble human milk N-acetylglucosaminide 3-alpha-L-fucosyltransferase, these two enzymes seem to be structurally related.

[Aniridia caused by contusion-related rupture of a bleb following Elliot's trepanation]

This case report deals with a 68-year-old man in whom a contusion resulted in a complete loss of the iris through an Elliot fistula. The abrupt increase in intraocular pressure caused the iris to be extruded through the fistula and the ruptured conjunctiva. A functional drainage bleb was reconstructed by pulling and suturing subconjunctival tissue underneath the ruptured conjunctiva.

Radioimmunoassay for vasoactive intestinal polypeptide (VIP) in plasma before and during endoscopic examinations

A specific and sensitive radioimmunoassay of human vasoactive intestinal polypeptide using synthetic VIP as standard preparation and antiserum to synthetic VIP R 502 (Yanaihara et al. 15) is described. No crossreactions with a number of other gastrointestinal hormones such as glucagon, secretin, GIP, HPP or substance P was detected. Aprotinin (Trasylol, Bayer) or heparin had no influence on the antigen--antibody reaction. High concentrations of sodium or potassium chloride in plasma, or hyperlipoproteinemia, did not interfere with the antiserum in the described system. Basal plasma concentration of VIP in 18 females (means +/- sem = 24.05 +/- 1.79 VIP/l) and 20 males (means +/- sem = 24.11 +/- 1.91 pmol/l VIP) showed no sex specific variations. During gastroscopy plasma VIP levels were significantly higher than basal values, showing a peak secretion when the gastric antrum was inspected. During the entire colonoscopic examination, VIP levels were significantly higher than basal values. Endoscopic examination may possibly liberate VIP from the VIP containing cells which can be found throughout the gastrointestinal tract.

The role of 2-mercaptoethanol in the stimulation of spleen cell cultures: increased uptake of cystine into the TCA-soluble pool

A sensitive system for the study of the mechanism of action 2-mercaptoethanol in stimulating of mouse spleen cell cultures is described. In this system the triggering of stimulation of cells by a mitogen or antigen was dependent on the presence of 2-mercaptoethanol (2-ME) in the medium. To obtain a similar stimulatory effect, 2-ME could be replaced by L-cystine or L-cysteine in the presence or absence of a mitogen. In the presence of a mitogen and below the saturation level, cystine was more effective than cysteine. By increasing in this system, the cystine concentration, to the double of that of the basal medium, a strong stimulation of cells was produced. Conversely, in the absence of mitogen, cysteine was significantly more effective than cystine. Addition of 2-ME led to an increased entry of [14C]L-cystine into the TCA-soluble pool of cells while the thiol had no influence on the uptake of a mixture of different amino acids. We conclude that in this system the role of 2-ME is to enable the utilization of otherwise ineffectively low concentrations of cystine by enhancing the entry of this amino acid into the amino acid pool of the cells.

["Dry eye" and artificial tear solutions (author's transl)]

Seventeen patients in whom "dry eye" had been diagnosed each tried four coded commercial artificial tear solutions for one week, in random sequence. The correlation of the function tests (Schirmer test, break-up tie, goblet cell count in conjunctival biopsy) did not permit a grouping of the patients. A tendency to a correlation between break-up time and goblet cell count was noted. It was not possible to show a preference on the part of certain patients for particular products; thus, with the current function tests available, a precise therapeutic classification of "dry eye" patients does not seem possible.

Immunization of mouse spleen cell cultures in the absence of serum and its proteins using SiO2 and 2-mercaptoethanol

High recoveries of plaque-forming cells were obtained in a serum-free medium using 2-mercaptoethanol and SiO2. Under such conditions an increase in the number of plaque-forming cells occurred between the fourth and fifth day of incubation, as compared with cultures with foetal calf serum. The addition of glutathione to the medium had a stimulating effect, it was however not absolutely necessary for a positive response. The recovery of plaque-forming cells was strongly influenced by an interdependence of cell density and amount of SiO2 gel particles.

The in vitro immune response in the absence of serum and its proteins: stimulating activity of zymosan

In the absence of serum and its components, zymosan, together with 2-mercaptoethanol present in the medium, stimulated the in vitro primary immune response. Zymosan was effective at a concentration of as low as 2.5 microgram/ml. Removal of macrophages using iron powder resulted in higher recoveries of plaque-forming cells in the presence of zymosan but not of fetuin. Since insoluble zymosan may be easily removed from the culture, the test system described might be suitable for the identification of specific control factors secreted by cells during the in vitro immune response.

Fibronectin in the developing sea urchin embryo

The presence of fibronectin in developing sea urchin embryos was studied uing immunofluorescence staining. The fluorescence pattern indicates that fibronectin is found on the cell surfaces and between cells in the blastula and gastrula stages, indicating that it plays a role in cell adhesion. Its presence on invaginating cells also suggests its involvement in morphogenesis during early development.

Primary Immune Response of Mouse Spleen Cells in a Serum-Free System: the Role of 2-Mercaptoethanol

The stimulatory effect of the combination of fetuin and 2-mercaptoethanol on the recovery of plaque-forming cells (PFC) in the absence of serum could be mimicked by the use of reduced alkylated fetuin. A correlation was found between the mitogenic and PFC-stimulating activities of reduced alkylated fetuin.

An absolute requirement for 2-mercaptoethanol in the in vitro primary immune response in the absence of serum

Using a serum-free medium, high recoveries of plaque-forming cells (PFCs) were obtained up to 5 days of incubation in the in vitro primary immune response. Under these conditions, the presence in the medium of 2-mercaptoethanol was an absolute requirement. In order to obtain maximal recoveries of PFCs, the antigen and 2-mercaptoethanol had to be present from the start of the culture, while the addition of fetuin could be delayed for 24 h without any loss of PFCs. The 2-mercaptoethanol could be replaced by (dialysed) human serum.

A serum-free medium for the Mishell-Dutton system

A serum-free medium which provides high recoveries of plaque-forming cells in the primary immune response to sheep erythrocytes is described. In this medium the serum was replaced by heated fetuin and by excess of nonessential amino acids. Glycopeptides, obtained by excessive pronase treatment of fetuin were partially capable of replacing the nonhydrolyzed fetuin.

Stimulation of the in vitro immune response by factors present in the human serum

Two distinct factors which stimulate the recovery of plaque-forming cells in the vitro immune response have been found in human serum. One acts in the presence of fetuin and the other augments the recovery of plaque-forming cells in its absence. The molecular weight of the former is higher than 1 X 10(5). The two factors could be separated from each other by ammonium sulphate fractionation. Large differences were found in the amount of these factors in sera obtained from different human donors.

Marked instability of character of cloned epithelial cells

Cell lines derived from 7,12-dimethylbenzanthracene-induced rat mammary carcinomas show a marked drift in properties when cultured in vitro. The following characteristics alter progressively with the number of passages: cloning efficiency, requirement for hydrocortisone, requirement for fetal sera, growth response to conditioning factor(s) and ease of detachment from the culture vessel by trypsinization.