Elevated blood serotonin in autistic probands and their first-degree relatives

Whole blood serotonin levels and platelet counts were studied in 14 families, representing 57 family members and 15 probands who met DSM III criteria for infantile autism. High serotonin appeared to segregate in families. When two parents had high serotonin, the serotonin level in their offspring was twice the parental level. When one parent had high serotonin, the serotonin level in the offspring approximated the level of serotonin in either the high serotonin parent or the low serotonin parent. For the case where both parents had low serotonin, in one family the children had low serotonin and in a second family, high serotonin levels were present in the autistic proband, and a sibling with severe mental retardation. Mean serotonin levels were higher for both male and female, autistics and family members, in the four black families than in the 10 Caucasian families.

Clinical efficacy of 99mtechnetium mercaptoacetylglycine kit formulation in routine renal scintigraphy

99mTechnetium mercaptoacetylglycine is a promising new renal radiopharmaceutical undergoing phase III trials in the United States. In a preliminary investigation of the efficacy and safety of mercaptoacetylglycine in 30 adult patients with suspected renal disease we used simultaneous imaging with orthoiodohippurate as the physiological "gold standard". Of these patients 11 had undergone renal transplantation. Factors, such as time to peak renal activity, clearance half-life and regional functional comparison, were similar by orthoiodohippurate and mercaptoacetylglycine imaging. Visual and quantitative analysis of angiograms and renograms was markedly facilitated with the use of mercaptoacetylglycine. Several morphological abnormalities were apparent only during mercaptoacetylglycine evaluation. No adverse effects, changes in vital signs or significant changes in clinical laboratory status were encountered. Since mercaptoacetylglycine combined an excellent technetium image with the pharmacokinetics of orthoiodohippurate, mercaptoacetylglycine may supplant all other agents for routine clinical use.

Management of screen detected ductal carcinoma in situ of the female breast

Thirty eight ductal carcinomas in situ of the female breast detected during the first 7 years of screening by the Guildford Breast Screening Unit have been treated by one surgeon. Twenty-eight cases were treated conservatively and ten by mastectomy. In the group treated conservatively there have been five local recurrences: four as ductal carcinoma in situ and one as node negative microinvasive carcinoma. There were no clinical or pathological features that predicted local recurrence, which was detected only by follow-up mammography. Based on these early results, an initially conservative approach to screen detected ductal carcinoma in situ is advocated.

A chromosome rearrangement suggests that donor and recipient sites are associated during Tam3 transposition in Antirrhinum majus

We describe the structure of a chromosome rearrangement which changes the spatial pattern of expression of the pallida gene of Antirrhinum majus. The rearrangement involves a chromosome inversion of ~6 map units with one breakpoint at the end of a copy of the transposable element Tam3 located in the promoter region of the pallida locus. The sequence at the breakpoints shows that 5-7 bp, present once in the progenitor, has been duplicated and flanks both ends of the inversion. We propose that this structure arose from an aberrant Tam3 transposition, suggesting a model for normal transposition which involves physical association between donor and recipient sites. This may explain why transposition of plant transposable elements such as Ac in maize occurs preferentially to recipient sites closely linked to the donor site. Excision of the Tam3 copy located at the end of the chromosome inversion, results in a unique spatial pattern of pallida gene expression as a consequence of replacing all sequence 70 bp upstream of transcription by a new sequence. This pattern may be the result of deleting specific upstream components which regulate pallida expression and/or of changing the relative chromosome position of the pallida gene.

Occlusal considerations for partially or completely edentulous skeletal Class II patients. Part II: Treatment concepts

Four basic concepts must be considered when developing the prosthetic occlusion for skeletal class II patients: (1) Centric relation must be used as a reference position to relate the mandible to the maxillae; (2) the posterior denture teeth must be positioned close to their former positions; (3) freedom of movement must be created in eccentric movements; and (4) multiple occlusal contacts must be provided in centric and eccentric positions. We have described a method that incorporates these basic concepts and provides a harmonious occlusal arrangement for both edentulous and partially edentulous class II patients.

Occlusal considerations for partially or completely edentulous skeletal class II patients. Part I: Background information

Although approximately 15% of the population may be classified as having the skeletal class II relationship, this group of patients is far from homogeneous. Two prototypes were used to delineate various problems in the prosthodontic occlusion that dentists may encounter with these patients. A satisfactory occlusion is difficult to achieve because of skeletal discrepancies, limited space for occlusal contact, steep guidance factors, and the necessity for multiple eccentric occlusal contacts because of the significant range of mandibular motion.

Large-scale chromosomal restructuring is induced by the transposable element tam3 at the nivea locus of antirrhinum majus

The transposable element, Tam3, gives rise to large-scale (greater than 1 kb) chromosomal rearrangements at a low frequency, when it is inserted at the nivea locus of Antirrhinum majus. Although some deletions may result from imprecise excision of Tam3, rearrangements involving deletion, dispersion and inverted duplication of flanking sequences, where Tam3 remains in situ, have also been identified. These rearrangements have been mapped at the molecular level, and the behavior of Tam3 following rearrangement has been observed. It is clear that Tam3 has enormous potential to restructure chromosomes through successive rounds of large-scale rearrangements. The mechanisms by which such rearrangements might arise are discussed.

A semi-dominant allele, niv-525, acts in trans to inhibit expression of its wild-type homologue in Antirrhinum majus

Niv-525 is a semi-dominant allele of the nivea locus, which encodes the enzyme chalcone synthase required for flower pigment biosynthesis in Antirrhinum majus. Plants heterozygous for niv-525 and wild-type (Niv+) allele, have flowers with a reduced intensity and novel spatial pattern of pigmentation compared with Niv+ homozygotes. In heterozygotes, niv-525 acts in trans to reduce the steady-state level of nivea transcript produced by its Niv+ homologue and hence the quantity of chalcone synthase protein. Niv-525 carries an inverted duplication of 207 bp in its promoter region which has arisen following excision of the transposable element Tam 3. This structure can be explained by a model of plant transposable element excision that involves resolution of two hairpin DNA molecules. Possible mechanisms for the trans-acting effect of niv-525 and its relationship to other examples of allelic interactions, such as transvection in Drosophila melanogaster, are discussed.

Importance of cellular DNA content in pre-malignant breast disease and pre-invasive carcinoma of the female breast

The risk of malignant change in pre-invasive breast disease such as proliferative atypia (PA) or the risk of invasive carcinoma arising from ductal carcinoma in situ (DCIS) remains uncertain in individual women because of the absence of any prognostic criteria. In order to clarify this, the cellular DNA content (ploidy) of 51 screen-detected lesions has been investigated. Cellular DNA measurements were made by static cytometry following Feulgen staining of disaggregated tissue sections and the resulting histograms classified as either diploid or aneuploid. Thirteen cases of PA and twelve of DCIS were compared with twenty-six biopsies showing DCIS with adjacent invasive carcinoma (DCIS + Ca). In the latter group, ploidy of the invasive carcinoma was compared with the associated DCIS in 16 cases. Aneuploid cells were found in approximately 30 per cent of PA and DCIS lesions but in 23 of 26 cases of DCIS + Ca. Of 16 assessable cases of co-existing DCIS and micro-invasive carcinoma both were aneuploid in 11, both diploid in 1, and in 4 cases the DCIS was aneuploid whereas the invasive carcinoma was diploid. These results suggest that aneuploidy may be of value in predicting the most biologically aggressive of these pre-invasive lesions.

Transposable elements generate novel spatial patterns of gene expression in Antirrhinum majus

The pallida gene of A. majus encodes a product required for the synthesis of red flower pigment. We have shown that the unstable pallida(recurrens) mutation is due to the insertion of the Tam3 transposable element near the promoter of the gene. Imprecise excision of Tam3 alters pallida gene expression and generates new spatial patterns or different intensities of flower pigmentation. Distinct spatial patterns may also result from rearrangements induced by Tam3 that alter the relative position of the pallida gene. Changes in Tam3 structure or position result in new unstable phenotypes. These findings suggest that genes may be rendered genetically hypervariable as a consequence of transposable element insertion and excision.

Cushing's syndrome resulting from primary pigmented nodular adrenocortical disease

In a 10-year-old boy with Cushing's syndrome, the dexamethasone suppression test, the metyrapone test, and both basal and corticotropin-releasing factor-stimulated corticotropin levels all indicated a primary adrenal disorder. However, a computed tomographic scan failed to detect an adrenal tumor. At surgery, the adrenal glands were not enlarged but were studded with small pigmented nodules composed of enlarged nonmalignant adrenocortical cells. This unusual abnormality, referred to as primary pigmented nodular adrenocortical disease, is associated with autonomous hypersecretion of cortisol primarily in children and young adults. Our patient was cured by total bilateral adrenalectomy and corticosteroid replacement therapy, the treatment of choice for this condition.

Effect of nitrendipine, diltiazem, trifluoperazine and pimozide on serotonin2 (5-HT2) receptor activation in the rat uterus and jugular vein

The present study explored the calcium source used in serotonin (5-HT)-induced contractions mediated by 5-HT2 receptor activation in the rat uterus and jugular vein in vitro. In the rat uterus, the calcium channel antagonists, nitrendipine and diltiazem, and the neuroleptic agents, trifluoperazine (TFP) and pimozide, antagonized potently and noncompetitively 5-HT-induced contractions. These data are compatible with the contention that 5-HT-induced contractions in uterine smooth muscle require extracellular sources of calcium. In contrast, neither diltiazem nor nitrendipine inhibited the contractile response to 5-HT in the rat jugular vein although 5-HT-induced contractions in the jugular vein required the presence of extracellular calcium. This difference in sensitivity to calcium channel antagonists between the uterus and jugular vein was not related to differences in the receptor occupancy-response curves for 5-HT as these were similar in the rat uterus and jugular vein. Furthermore, in the jugular vein, neither diltiazem nor nitrendipine were markedly effective in blocking contractions produced by potassium chloride, an agent that activates voltage-dependent calcium channels, suggesting that this tissue lacks calcium channels susceptible to blockade by conventional calcium channel antagonists. Although responses to 5-HT in the jugular vein were only affected marginally by calcium channel antagonists, TFP and pimozide produced concentration-dependent rightward parallel shifts of 5-HT-induced contractions in the jugular vein. Furthermore, both TFP and pimozide showed high affinity at 5-HT2 binding sites in rat brain cortical membranes and the apparent dissociation constant at 5-HT2 receptors in the jugular vein was 38 and 31 nM, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Polymorphonuclear leukocytes, complement, and Trichophyton rubrum

Trichophyton rubrum can activate complement. In order to assess the role of complement in host defense, fresh human serum was incubated with fungus. Factors were produced which were chemotactic for polymorphonuclear leukocytes (PMNL), but only if complement activation was allowed. This suggests that the chemotactic factor or factors were derived from complement. Incubation of T. rubrum with fresh serum did not prevent fungal growth on subsequent culture, but did inhibit incorporation of radiolabeled N-acetylglucosoamine. The interaction of PMNL and fungi was studied, and the role of complement as a mediator was assessed. PMNL adhered well to fungi provided that the fungal hyphae had been preincubated with fresh human serum to provide complement opsonins. Opsonized and unopsonized fungi both stimulated a respiratory burst in normal PMNL as measured by chemiluminescence, but the burst was generated much faster with opsonized hyphae. Although hyphae with adherent PMNL subsequently proliferated in culture, the incorporation of N-acetylglucosoamine was inhibited 96% when the hyphae were opsonized with fresh serum and then incubated with PMNL. Inhibition was also observed with unopsonized fungi, but to a lesser degree. Varying the ratio of PMNL to hyphae showed that inhibition by PMNL was far more efficient if hyphae were opsonized. In contrast to hyphae, opsonized fungal spores were killed by PMNL so that no growth was observed in subsequent cultures. This killing was not observed if PMNL were omitted or if spores were preincubated with heat-inactivated serum rather than fresh serum. Activation of complement apparently opsonizes the spores so that they can be ingested and killed by viable PMNL. Contents of disrupted PMNL failed to inhibit fungal growth. Complement and PMNL may aid the host in defending itself against infection by dermatophytes.

Rapid changes in the phospholipid composition of gill membranes during thermal acclimation of the rainbow trout, Salmo gairdneri

The phospholipid composition of gill tissue was determined in rainbow trout (Salmo gairdneri) undergoing thermal acclimation between 5 degrees C and 20 degrees C for a period of up to 28 days. Proportions of phosphatidylethanolamine (PE) and cardiolipin (CL) increased during cold acclimation and decreased during warm acclimation; proportions of phosphatidylcholine (PC) changed in the opposite direction (i.e., decreased during cold acclimation). In contrast, levels of phosphatidylserine, -inositol, and sphingomyelin did not vary significantly. Thermal modulation of headgroup composition occurred rapidly as reflected by changes in the ratio of PC-to-PE, which rose significantly from 2.40 +/- 0.09 to 2.92 +/- 0.09 within 72 h of transfer from 5 to 20 degrees C; adaptation to 5 degrees C was equally rapid. Proportions of PE changed more rapidly than those of PC during cold adaptation, whereas the opposite was true during warm acclimation. Both the time course and the direction of the observed changes in phospholipid composition suggest that such adjustments may contribute to the homeoviscous regulation of membrane properties, particularly during the initial stages of thermal adaptation.

Molecular analysis of instability in flower pigmentation of Antirrhinum majus , following isolation of the pallida locus by transposon tagging

The pal locus of Antirrhinum majus was cloned using the transposable element, Tam 3, as a probe. The pal clone was used to examine, at the molecular level, those aspects of instability previously observed phenotypically and genetically. The effects of temperature and of genetic background on excision of the element at pal are considered, and related quantitatively to the phenotype. We describe the identification of the transcript of the pal locus and show that insertion of Tam 3 blocks the production of a normal pal transcript in developing flower buds.

Membrane attack complex of complement in dermatitis herpetiformis

The assembly of membrane attack complex (MAC) of complement implies activation of complement to the attachment of C9 and the presence of MAC on tissue suggests a possible pathogenic role for complement in disease since MAC is able to damage membranes. We examined normal skin of five patients with dermatitis herpetiformis for the presence of MAC using a monoclonal antibody (poly C9-MA) that recognizes a neoantigen of C9 that is not present on monomeric C9 but is common to both isolated MAC and to polymerized C9. Granular deposits of polymerized C9 were found at the sites of IgA deposition in the dermal papillae of normal skin from all patients. The pathologic importance of this finding is uncertain.

Deposition of the membrane attack complex of complement in bullous pemphigoid

Bullous pemphigoid is associated with deposition of IgG and C3 at the dermal-epidermal junction. In order to see whether complement activation in bullous pemphigoid resulted in deposition of membrane attack complex (MAC) at the basement membrane zone, skin biopsies from patients with bullous pemphigoid were examined using a direct immunofluorescence technique. By employing a monoclonal antibody to a neoantigen of C9, the MAC was demonstrated in linear pattern at the basement membrane zone. These deposits were seen in both involved and uninvolved skin but the amount of MAC was greater in involved skin as judged by intensity of staining. Stippled deposits of MAC were also present in or around epidermal basal cells. The MAC could be generated in vitro by reaction of normal plasma with antibasement membrane antibody bound to sections of monkey esophagus. The IgG antibody activated complement and this complement activation proceeded all the way to the terminal step.

Nosocomial surgical infections: Incidence and cost in a developing country

Eight hundred twenty-nine patients were monitored for nosocomial surgical infections from January to December 1980 at the University Hospital of the West Indies. Two hundred twenty-five patients (27%) had 189 postoperative wound infections (POWI) and 295 other nosocomial infections, with an average of 2.1 infections per infected patient. The incidence of POWI was 22.8%, varying from 7.3% in clean to 82.2% in infected wounds. The most common organisms isolated were gram-negative bacilli and Staphylococcus aureus. The most frequent nosocomial infection other than POWI was urinary tract infection (27.8%). A statistically significant number of urinary tract infections and septicemias were associated with the use of medical devices such as indwelling urethral catheters and central venous pressure lines (p less than 0.001). Septicemia was frequently associated with operations on the lower gastrointestinal and hepatobiliary tracts (p less than 0.001). The postoperative stay of an infected patient was prolonged by an average of 18 days. The total excess cost of hospitalization for the infected patients was U.S. $170,000.

Sonography of fetal urinary tract anomalies

Experience with 13 cases and a review of 41 cases in English literature indicate that anomalous development of the fetal urinary system can be detected in utero using sonography. Anomalies not compatible with extrauterine life (bilateral renal agenesis, infantile polycystic and bilateral multicystic kidney disease) have distinctive sonographic features that can be detected early enough to allow elective termination. Megacystis, either as a primary finding or secondary to urethral obstruction, can be detected and usually portends a poor fetal outcome. Obstruction at the ureterovesical junction has a distinctive sonographic appearance, but ureteropelvic junction obstruction cannot be differentiated from some cystic renal lesions, particularly when it is unilateral. Even when a precise diagnosis cannot be established in utero, the detection of a fetal renal anomaly may significantly affect obstetric and neonatal management of the benefit of both mother and fetus.

Mineral content of reagents used in subtilisin assays

The mineral content of subtilisin Carlsberg and an associated buffer reagent was established by the application of spark source mass spectrometry and atomic absorption spectrometry. The concentrations of the elements detected were too low to contaminate tissue samples that form the bulk of toxicological work in a forensic laboratory.

Hypervascularity of the uterine wall during pregnancy: incidence, sonographic appearance, and obstetric implications

The authors report the incidence (20%) of hypervascularity of the uterine wall (decidual reaction) (1) in 106 pregnant women studied prospectively by ultrasound. An unusual case, which caused problems in diagnosis and management, is reported in detail. The relation between the location and extent of this finding and the location of the placenta is discussed. The authors think that this finding represents dilation of myometrial veins of uncertain etiology, and they conclude that the major implications are that it must be differentiated from pathologic entities that are similar sonographically (1), and that if anterior, it may cause excessive bleeding during invasive procedures.

Relationships between selenium and other parameters in drinking water and blood of subjects from high and low cardiovascular disease rate areas of Georgia

Plasma, erythrocyte and home tap water samples were taken from life-long residents of two counties (Evans-rural and Chatham-urban) in the high cardiovascular disease (CVD) belt of southeastern Georgia and from Habersham County, a rural county of North Georgia which is outside of the CVD belt. One-half of the subjects from each cohort had a serious CVD problem and the remaining half were healthy controls. Water samples were analyzed for hardness, total dissolved solids, pH and selenium (Se) content. Blood samples were analyzed for Se (by neutron activation analysis) and glutathione peroxidase (GSHPx). Se levels in all water samples were less than 0.01 ppb. Water hardness and total dissolved solids levels were higher in the CVD belt counties. There were no significant differences (P greater than 0.05), but water hardness and total dissolved solid levels were inversely correlated (p greater than 0.01) with the activity of erythrocyte GSHPx, a selenium containing enzyme which detoxifies oxidized fats.

Fetal ascites not associated with Rh incompatibility: recognition and management with sonography

Fetal ascites not associated with Rh incompatibility is an uncommon problem that can be detected in utero by sonography. The sonographer should make a systematic search for the cause of ascites in a given case on the basis of well known etiologic possibilities, since this may have a significant effect on the obstetrical management. The use of sonography in the detection, etiologic evaluation, and obstetrical management of nonimmunologic fetal ascites is discussed, and experience with 10 such cases is reported.