The denaturation of alpha, beta and psi bovine trypsin at pH 3.0: evidence of intermediates

The conformational stability and the folding process of alpha, beta and Psi bovine trypsin at pH 3.0 followed by circular dichroism (CD) and size exclusion in HPLC have been analyzed as a function of urea concentration. The thermodynamic stability for a and b are deltaG = 15.91 +/- 0.28 kcal/mol, deltaG = 15.54 +/- 2.39 kcal/mol. respectively, and y trypsin is deltaG = 16.10 +/- 2.51 kcal/mol. The transition curves for alpha, beta and Psi forms suggest a molten globule state.

QTL mapping and introgression of yield-related traits from Oryza glumaepatula to cultivated rice ( Oryza sativa) using microsatellite markers

Rice ( Oryza sativa) cultivar development currently faces the task of overcoming yield plateaus, which is difficult due to the narrow genetic base of breeding programs. Oryza glumaepatula is a diploid wild relative of cultivated rice, native to Central and South America, and is therefore a potential source of alleles of agronomic importance to rice breeding programs. We studied 11 agronomic traits in BC(2)F(2) families of the interspecific cross Oryza sativa x O. glumaepatula. Transgressive lines which are almost isogenic to the elite recurrent O. sativa parent were identified for most of these traits. Quantitative trait locus (QTL) analysis was performed by single-point and interval mapping using a molecular map based on 157 microsatellite and STS markers. Marker regions accounting for 14.5 to 72.9% of a phenotypic variation trait were identified in 9 of the 12 rice chromosomes. Positive QTL effects from O. glumaepatula were observed in chromosomal regions associated with tillering and panicle-number traits.

Prevalence of insomnia symptoms in patients with sleep-disordered breathing

OBJECTIVE

To assess the prevalence of insomnia symptoms in patients with objectively diagnosed sleep-disordered breathing (SDB).

DESIGN

Retrospective medical chart review of a representative sample of patients with SDB.

SETTING

University sleep-disorders clinic and laboratory.

PATIENTS

Two hundred thirty-one patients with SDB were selected from a pool of approximately 2,000 patients with sleep disorders.

MEASUREMENTS

Data were extracted from intake questionnaires and polysomnographic studies.

RESULTS

Of 231 patients with SDB diagnoses, 115 patients reported no insomnia complaints (SDB-only patients) and 116 patients reported clinically meaningful insomnia complaints (SDB-plus patients). Compared to SDB-only patients, SDB-plus patients reported significantly worse mean sleep characteristics consistent with insomnia, including sleep latency (17 min vs 65 min), total sleep time (7.2 h vs 5.6 h), and sleep efficiency (92% vs 75%). SDB-plus patients experienced significantly more psychiatric disorders, cognitive-emotional symptoms, and physical and mental symptoms that disrupted or prevented sleep. SDB-plus patients also reported greater use of sedative and psychotropic medications and had significantly more primary complaints of insomnia, restless legs or leg jerks, and poor sleep quality despite having relatively similar referral rates for sleep apnea or complaints of loud snoring.

CONCLUSIONS

Problematic insomnia symptoms were reported by 50% of a representative sample of patients with objectively diagnosed SDB. Research is needed to determine the degree to which insomnia and related symptoms and behaviors interfere with SDB treatment.

Visceral leishmaniasis in a Brazilian child infected perinatally with human immunodeficiency virus

This report describes a Brazilian child perinatally infected by HIV who presented visceral leishmaniasis. She showed the classic clinical features, and diagnosis was made by demonstration of amastigote forms of Leishmania in bone marrow aspirate. She responded well to traditional treatment with meglubine.

[Prevalence of cutaneous lesions in Freixo de Espada à Cinta]

Incidence or prevalence studies on cutaneous lesions in general populations are not available. The community observed by the authors (Freixo de Espada à Cinta, North-Eastern Portugal) is relatively closed. A pre-tested questionnaire for socio-demographic and clinical information was used and a physical observation was conducted in January and February 1994 by the Dermatology Team of Santo António General Hospital, Oporto. The analysis was supported by independent tests (Pearson and Fisher chi 2, Student-t, Mann-Whitney and Kruskall-Wallis). The Spearman correlation coefficient was also used. The results indicated that 51.9% of 1000 subjects analysed were in phototype III. Concerning specific pathologies, the following percentages were observed: melanocytic nevi 81.2; hemangiomas 26.5; androgenetic alopecia 20.5; deshydrotic eczema 12.7; seborrheic keratosis 11; solar keratosis 9.6; acne vulgaris 9.5; seborrheic dermatitis 6.9; superficial mycosis 6.4; other dermatitis 5.5; vascular spiders 4.4; vulgar psoriasis 1.9; vulgar warts 1.5; pediculosis and scabiosis 1.2.; herpes simplex 0.9; impetigo 0.7; tumours (neoplasias) 0.7; dysplastic nevi 0.6; urticaria 0.3. More than nine nevi were counted in 50% of the subjects observed. A difference was observed (p < 0.05) concerning the presence of nevi, mycosis, hemangiomas, non-specific dermatitis, vascular spider and solar keratosis according to sex. The females had more nevi in number than males (Mann-Whitney, p = 0.03). According to age there was a difference concerning the presence of nevi, superficial mycosis, deshydrotic eczema, seborrheic dermatitis, acne, psoriasis, tumours, hemangiomas, non-specific dermatitis, vascular spider, solar keratosis (with linear augmentation by age) and seborrheic keratosis. Nevi increased with ageing (Rs = 0.10 p < 0.001) and a greater number were observed in age groups 0-9 and 60 or more years. Acne was observed in 9.4% of the females and 9.7% of the males, 46.2% in the 15-29 year-old age group. This study indicated that the population had a mean of nine nevi. Psoriasis was similar to that mentioned in other studies: about 1% in the United States of America. Atopic dermatitis (5.5%) is below the values for the northern population (> = 15%), but above that indicated for the English and American population. Nevertheless, the values of the present study were higher than those in the latter populations, when children until seven years old were considered. The Freixo de Espada à Cinta population above 60 years had solar keratosis in 30.6%, a value three times higher than the previous decade (10.9%); reference values were not found. Contrary to the literature, an association was not established between phototype and solar keratosis. Cutaneous tumours were observed in 0.7% of the cases.

[Analysis of proxemic factors in the communication with laryngectomized patients]

The present study analyzed the proxemic factors of interactions between health professionals and laryngotomized patients in mediate post-surgery. We used the non-participant observation technique with pre-established guidelines. Data were analyzed according to Hall's theoretical framework. The speakers' sex or color did not influence the distance maintained in the interactions; the nursing technical care category was predominant; the attitude adopted was compatible with the meeting goals; instrumental touch with visual contact was predominant, voice tone was adequate to the distances maintained and the authors observed the presence of obstacles in some interactions, which demonstrated that communication was impaired.

Analysis of cost of dressings in the care of burn patients

This study aimed at analyzing the costs of material used in the occlusive dressings of burn patients. The subjects of the study were patients over the age of 18 years who were admitted to the Burns Unit of the Ribeirão Preto Medical School Clinical Hospital, University of São Paulo-Brazil, from 15 January to 11 September 1998. Data were collected concerning the costs and duration of bathing and dressing of these patients. We concluded that there was a positive relation between the real costs of the materials used and the percentage of the body surface burned. In addition, there was a positive correlation between the number of staff involved in care and the size of the burns. There was no significant difference between the cost of materials used in dressings for burns of different depths.

Human chromosomal localization, tissue/tumor expression, and regulatory function of the ets family gene EHF

Ets factors are members of an ancient multigene family of transcription factors including oncoproteins and possibly tumor suppressors. We previously characterized a novel divergent ets gene, Ehf (ets homologous factor) in mice. Here we report the cDNA sequence, chromosomal location, and tissue/tumor expression patterns of the human EHF gene and the regulatory activity of the EHF protein. EHF maps to 11p12, which is deleted in many prostate, breast, and lung carcinomas and is a hot spot for inherited deletion- or amplification-associated developmental defects. EHF is differentially expressed in normal tissues and carcinomas and between tumor stages and is most highly expressed in the organs known to form carcinomas upon 11p12 deletion. EHF protein represses the ETS-2 induced activity of both stromelysin-1 and collagenase-1 promoters. These data suggest that EHF may contribute to human development and carcinogenesis and is a candidate for the 11p12 tumor suppressor gene.

Population genetics and paternity in Rasa Aragonesa sheep using DNA fingerprinting

DNA fingerprinting was used to study the population genetics and paternity of the Rasa Aragonesa sheep (Ovis aries). Using a combination of Hae III and the M13 derived probe pV47, the mean number of bands per individual (5.422 +/- 0.309), the background band sharing coefficient (0.347), the mean population frequency of alleles (0.192) and the mean heterozygosity for bands (0.893) were calculated for 45 individuals from eight different farms in Aragon, northern Spain. Therefore, the estimated probability of missing a wrong paternity was 0.126 for unrelated males, and this probability was 0.438 for full-sibs males. In addition, in a field trial of this technique, paternity was assigned for three ewe-lamb pairs with a probability of 97 per cent in two cases and 77 per cent in one case.

p300/cAMP-responsive element-binding protein interactions with ets-1 and ets-2 in the transcriptional activation of the human stromelysin promoter

In this paper we show that transcription factors Ets-1 and Ets-2 recruit transcription adapter proteins p300 and CBP (cAMP-responsive element-binding protein) during the transcriptional activation of the human stromelysin promoter, which contains palindromic Ets-binding sites. Ets-2 and p300/CBP exist as a complex in vivo. Two regions of p300/CBP between amino acids (a.a.) 328 and 596 and a. a. 1678 and 2370 independently can interact with Ets-1 and Ets-2 in vitro and in vivo. Both these regions of p300/CBP bind to the transactivation domain of Ets-2, whereas the C-terminal region binds only to the DNA binding domain of Ets-2. The N- and the C-terminal regions of CBP (a.a. 1-1097 and 1678-2442, respectively) which lack histone acetylation activity independently are capable of coactivating Ets-2. Other Ets family transcription factors failed to cooperate with p300/CBP in stimulating the stromelysin promoter. The LXXLL sequence, reported to be important in receptor-coactivator interactions, does not appear to play a role in the interaction of Ets-2 with p300/CBP. Previous studies have shown that the stimulation of transcriptional activation activity of Ets-2 requires phosphorylation of threonine 72 by the Ras/mitogen-activated protein kinase signaling pathway. We show that mutation of this site does not affect its capacity to bind to and to cooperate with p300/CBP.

Factors associated with outcome after cord blood transplantation in children with acute leukemia. Eurocord-Cord Blood Transplant Group

We have analyzed factors influencing the outcome of 102 children with acute leukemia given a cord blood transplantation (CBT) and reported to the Eurocord Registry. Seventy patients with acute lymphoblastic and 32 with acute myeloid leukemia were given either a related (n = 42) or an unrelated (n = 60) CBT. Children given CBT during first or second complete remission were considered as belonging to the good-risk group (n = 66), whereas those who received a transplant in a more advanced stage of disease were assigned to the poor-risk group (n = 36). In the related group (RCBT), 12 of 42 patients received transplantation from an HLA-disparate donor, whereas in the unrelated group (UCBT) 54 of 60 received an HLA mismatched CBT. Kaplan-Meier estimates for neutrophil recovery at day 60 were 84% +/- 7% in RCBT and 79 +/- 6% in UCBT (P =.16). In multivariate analysis, the most important factor influencing neutrophil engraftment in UCBT was a nucleated cell dose infused greater than 3.7 x 10(7)/kg (P =.05, relative risk [RR] of 1.85, 95% confidence interval [CI]: 0.98-3.4). The incidence of grade II through IV acute graft-versus-host disease was 41% +/- 8% in the RCBT group and 37% +/- 6% in the UCBT group (P =.59). Kaplan-Meier estimates of 2-year event-free survival (EFS) after RCBT or UCBT were 39% +/- 8% and 30% +/- 7%, respectively (P =.19). In multivariate analysis, the most important factor influencing EFS was disease status at time of transplantation: good-risk patients had a 2-year EFS of 49% +/- 7% as compared to 8% +/- 5% in patients with more advanced disease (P =.0003, RR: 0.40, 95% CI: 0.24 to 0. 65). This was a consequence of both an increased 1-year transplant related mortality and a higher 2-year relapse rate in the poor-risk group (65% +/- 9% and 77% +/- 14%, respectively), as compared with good risk patients (34% +/- 6% and 31% +/- 9%, respectively). These data confirm that allogeneic CBT from either a related or an unrelated donor is a feasible procedure able to cure a significant proportion of children with acute leukemia, especially if transplanted in a favorable phase of disease.

Specific sHLA in healthy donors and donor-specific sHLA in renal transplant patients

We studied cadaver kidney transplant recipients to determine if their serum levels of donor-specific class I sHLA correlated with graft outcome. Testing of sHLA was performed by an ELISA sandwich assay using allospecific monoclonal trapping antibodies and anti-beta2-mu detecting antibody. Sufficient sHLA sensitivity (<1 ng/ml) was achieved by using two synergistic trapping antibodies. Suitable antibodies were available for A2 and B7, and data were collected for these two antigens. Stability of these sHLA was determined in plasma and serum as were ranges of normal and background levels. Background levels varied substantially. Five A2- recipients of A2+ grafts and 5 B7- recipients of B7+ grafts were studied with appropriate sHLA levels measured pre-transplant and at intervals post-transplant. Graft outcome was assessed by serum creatinines, renal biopsies and/or therapy for rejection. In the 5 patients (3 A2- and 2 B7-) whose post-transplant donor-specific sHLA never exceeded immunological complications (e.g., post-operative ATN, ureteral obstruction) did not affect the correlation. In the 5 patients with post-transplant levels exceeding pre-transplant levels, subsequent evidence of rejection was observed. Periodic measurement of donor-specific sHLA should be a useful instrument for monitoring renal allograft rejection.

Nitric oxide for ARDS--what is the evidence?

We critically reviewed English-language articles indexed on MEDLINE from 1966-1998 and those cited in indexed articles describing or investigating administration of nitric oxide (NO) in adult respiratory distress syndrome (ARDS). Studies evaluating NO exclusively in the pediatric population and in conditions other than ARDS (chronic obstructive pulmonary disease, asthma, cardiac surgery, pulmonary hypertension) were excluded, as were those published exclusively as abstracts. Of the 22 papers selected, 5 studies were dose-response trials, eight were comparative, and the rest were noncomparative. Dose-dependent decreases in pulmonary artery pressures and increases in arterial oxygenation were observed; however, the minimal effective dose varied. Several short-term noncomparative and small noncomparative prospective trials concluded that NO improves oxygenation and decreases pulmonary vasoconstriction without effects on systemic hemodynamics. However, evidence that NO improves outcomes in patients with ARDS is insufficient because mortality remained high, and the number of subjects in each study was low. Since improvements in oxygenation are not seen in all patients and outcomes or mortality might not be altered, NO should be reserved for selected patients in whom conventional therapy is not sufficient to maintain acceptable oxygenation levels.

Plasma homovanillic acid and prolactin in systemic lupus erythematosus

Prolactin (PRL) is an important immunoregulator and might have a role in the pathogenesis of systemic lupus erythematosus (SLE). The regulation of pituitary prolactin secretion is complex and involves a negative feedback process in the hypothalamus, in which dopamine plays the principal role. However, the main source of serum prolactin in lupus patients is still not clearly established. Since homovanillic acid (HVA), the principal metabolite of dopamine (DA), is removed from the brain into the blood, it would indirectly reflect DA metabolism. It is assumed that the turnover of a neurotransmitter can be determined through an analysis of its metabolites. The objective of this study was to analyse plasma samples from SLE patients to see if there were any alterations in neurally functioning DA through its principal metabolite, HVA. We also measured the levels of PRL and compared HVA and PRL with the clinical activity of the disease. Twenty-four SLE patients and fifteen healthy controls were studied. The investigation was done over a period of 3 months. The results of this study show significantly low levels of HVA in lupus patients compared to controls (P < 0.0001). This corresponds to a decrease in dopamine turnover. Hyperprolactinemia was observed in nine patients, and the average level of prolactin in lupus patients was higher than in healthy controls (P < 0.001). For the duration of the study, a significant percentage of variation was observed in the levels of HVA in the clinically active patients (P < 0.05) compared to inactive patients. When PRL was compared in these groups, throughout the study, no significant percentage of variation was observed. The relationship between HVA and PRL in healthy controls was r = 0.47, P = 0.08, and in patients was r = 0.04, P = 0.84. It is suggested that there is a probable association between plasma levels of HVA and PRL in the healthy controls and not in the SLE patients.

Metatarsal growth during the second trimester: a predictor of gestational age?

Metatarsal growth was studied in 780 human fetal metatarsal bones, crown-rump length ranging from 120 to 260 mm and gestational age ranging from 14 to 23 wk postconception. Total length, diaphyseal length and diameter were measured and statistical analysis performed. Means and standard deviations for each measurement were calculated at 1 wk intervals. These data were correlated with crown-rump length and gestational age and an equation was constructed in an attempt to predict gestational age.

Cord blood transplantation for children with acute leukemia. Eurocord Transplant Group

Over the past decade, allogeneic cord blood transplantation (CBT) has been widely used for treating patients with malignant disorders. However, the reported low incidence of GVHD observed after allogeneic CBT might be a major drawback in leukemic recipients and at present it is not clear whether CBT really predisposes patients to an increased risk of leukemia relapse. In order to further elucidate the role of CBT in children with hematological malignancies, 54 patients with ALL or AML given either a related (31 cases) or an unrelated (23 cases) CBT in 25 centers participating in the Eurocord Registry were analyzed. Overall survival of related and unrelated CBT recipients was substantially similar, the most important factor influencing patients' outcome being disease state at time of transplantation. In fact, due to a markedly increased relapse rate, poor-risk children (ie patients transplanted in more advanced disease) experienced a significantly worse EFS than those given CBT in a more favorable disease phase (ie CR1 or CR2). These data confirm that allogeneic CBT from either a related or an unrelated donor is a feasible procedure able to cure a significant proportion of children with acute leukemia, especially if transplanted in a favorable phase of disease.

[Multicenter study of intracoronary stent implantation in Rio de Janeiro]

PURPOSE

To evaluate retrospectively stent implantation (SI) in patients with coronary artery disease (CAD) performed in 7 hospitals in Rio de Janeiro.

METHODS

From June/94 to December/96 2,220 procedures were performed among which we analyzed 783 SI in 660 (29.7%) patients using coronary angiography without digital subtraction. Several types of stents were used: Palmaz-Schatz (40.9%), Gianturco-Roubin (29.1%) e NIR (22.0%). Indications for SI: 1--de novo lesion (67.9%); 2) restenotic lesion (16.0%); 3) sub-optimal results after PTCA (8.2%); 4) abrupt or threatened closure after PTCA (4.9%); 5) chronic occlusion (3.0%). All stents were implanted using high pressure balloon inflation without intracoronary ultrasound guidance. Sub-acute stent thrombosis prevention, in the majority of patients (87.8%) was done with ticlopidine and aspirin.

RESULTS

Early outcome: a) the success rate of SI in 770 lesions was 98.0% in 646 (97.9%) patients; b) the clinical success rate in 634 patients was 96.0%; c) the major complications were acute myocardial infarction (1.1%); coronary artery bypass graft (1.4%) and death (0.8%); d) vascular complications with surgical correction and/or bleeding occurred in 3.0%. Late outcome: a) the clinical follow-up of 399 (60.4%) and the coronary angiographies of 121 patients (30.3%) showed in-stent lesion in 79 (19.8%); b) other event rates: myocardial infarction (1.5%); coronary bypass (2.3%); death: 1.0% and other PTCA or similar procedure (12.5%).

CONCLUSION

This multicentric study showed that SI for CAD can be performed with safety, high early success rate, few complications and low rate of cardiac events during the late follow-up.

[Intrathecal immunoglobulin synthesis evaluation in bone marrow transplantation]

The central nervous system involvement in chronic graft versus host disease (GVHD) has been suggested. Chronic GVHD resembles auto immune connective tissue disorders. In order to investigate the immunoglobulin intra blood brain barrier (BBB) synthesis during chronic GVHD, and contribute to understanding the pathophysiology of the disease, we studied 33 patients who underwent allogeneic bone marrow transplants (BMT) from HLA identical related donors. Immunoglobulin intra BBB synthesis was investigated quantitative and qualitatively. The samples were collected pre BMT, pos BMT and during chronic GVHD. There were no evidence of immunoglobulin intra BBB synthesis, and no oligoclonal bands were found. Only isolated cases suggested IgO and IgA intra BBB synthesis, and in one case IgM during GVHD.