Abnormal ossification in thanatophoric dysplasia

Thanatophoric dysplasia (TD) is a lethal human bone dysplasia characterized by severe dwarfism. It pathogenesis is thought to involve an abnormal ossifying fibrous tissue that disrupts the skeletal growth plate. We employed a combined morphologic, immunohistochemical and biochemical approach to better define the nature of this tissue in growth plate cartilage from 15 TD fetuses and infants in whom the abnormality was observed. The tissue was organized into tufts comprised of a cap of interstitial connective tissue, a transition region containing preosteoblastic cells near the cap and osteoblastic cells near the base, and a mineralized base which formed the subchondral bone trabeculae. The morphology of the cells and the presence of type I collagen in all regions of the tufts suggested that they were foci of membraneous ossification. However, elements of cartilage matrix (type II collagen, proteoglycan, link protein) were identified in the pericellular matrix of the osteoblastic cells and adjacent osteocytic cells. These observations suggest that a peculiar form of ossification occurs in the TD growth plate and may be involved in the pathogenesis of the disorder.

Comparability of results obtained by two-week home maintained diarrhoeal calendar with two-week diarrhoeal recall

Many community based studies of diarrhoea in the developing world employ face-to-face interviews to obtain diarrhoeal histories. An alternative recording device that preserved the accuracy but avoided the expense and time commitment of the interview would be extremely valuable. To evaluate the comparability of episodes of diarrhoea obtained from a home-maintained two-week calendar with those histories given in response to a two-week health recall interview in a largely uneducated population, we studied approximately 1500 families for six months in Dhaka, Bangladesh. The diarrhoea records obtained for children by the two methods were highly comparable (Kappa value 0.83). The comparability was not impaired either by lack of maternal education nor by increased numbers of children in the household. We conclude that the two-week home maintained diarrhoea calendar offers comparable results with the two-week recall and in certain situations could be a useful substitute.

Urinary undiversion in 35 patients with neurogenic bladder and an ileal conduit

Urinary undiversion was performed in 21 male and 14 female patients with neurogenic bladder and an ileal conduit urinary diversion, 3-17 years after the original operation. Twenty-six patients had surgery for ileal conduit complications but nine had an elective undiversion. In 24 patients, reconstruction was achieved by ureteroureteric anastomoses, in six by ureteroneocystotomy and in five by primary enterocystoplasty. Transureteroureterostomy (TUU) was an essential part of almost all the reconstructive procedures. Secondary operations were necessary in 10 patients, seven of whom had an enterocystoplasty. Improvement or stabilization of the upper urinary tract was eventually achieved in all patients. Twelve male patients void normally with complete urinary control in eleven and incontinence in one. Eight male and all 14 female patients are managed by clean intermittent catheterization (CIC) with complete urinary control in 12, acceptable dampness in eight and incontinence in two. One male patient is managed by an indwelling urethral catheter. All patients showed an improved physical and emotional status and preferred life without a urinary stoma. Urinary undiversion should be considered in all patients with ileal conduit complications and in selected patients with an uncomplicated ileal conduit.

Management of double system ureterocele

Thirty eight patients with double system ureterocele are reviewed. More than half presented in infancy, urinary infection being the commonest clinical feature. Urinary tract ultrasound (US) and renal nuclide scan (RNS) were found to be the most useful diagnostic investigations. Whereas there are various surgical options available, an analysis of the results indicates that the primary operation should usually be an upper pole heminephrourterectomy, particularly in infancy. Secondary bladder surgery will be necessary in many infants but in children with disease confined to the ureterocele segment only, bladder surgery may be avoided. In selected cases, usually beyond infancy, total one stage reconstruction with upper pole heminephroureterectomy and bladder surgery may be justified.

OKB7 recognizes antigen on T-cell malignancies

This article describes the pattern of OKB7 positivity in 49 cases of lymphoid malignancies (31 ALL, 17 chronic lymphocytic leukemia (CLL), 1 HCL). The authors have observed that it reacted with 4 out of 5 cases of T-ALL and 8 out of 17 cases of B-CLL. Incidentally all cases of OKB7+ T-ALL were also CALLA+. One case of HCL and 26 cases of non-T-ALL did not react with this antibody. The authors suggest that OKB7 is not specific for B-lineage and many cases of T-ALL may cross-react with it. However, it may be useful for identification of peculiar T-ALL phenotypes (T+, OKB7+, and CALLA+).

Bovine achondrogenesis: evidence for defective chondrocyte differentiation

A survey study of growth cartilage abnormalities in bovine bone dysplasias revealed that a disorder in Holstein cattle called bulldog calf closely resembles human achondrogenesis Type II. Substantial amounts of Type I collagen and other non Type II collagens were detected in the bulldog cartilage which was comprised primarily of extensive vascular canals and cells having the characteristics of hypertrophic and degenerative chondrocytes normally found in the growth plate. It is proposed that chondrocytes throughout the bulldog growth cartilage prematurely differentiate into hypertrophic cells that degenerate and predispose the cartilage to vascular invasion and the formation of cartilage canals. The presence of these canals probably accounts for most of the observed collagen abnormalities.

Amino acid composition of uremic middle and low molecular weight retention products

In order to characterize the spectrum of small peptides retained in chronic renal failure, we carried out high pressure liquid chromatography (HPLC) of serum ultrafiltrates from patients with chronic renal failure (CRF), acute renal failure (ARF), and normal subjects. HPLC patterns in CRF resolved into more than twenty peaks; those in ARF contained fewer peaks and resembled that of normals. We carried out amino acid analysis of HPLC fractions after hydrolysis with 6N HC1 of four patients with CRF, one patient with ARF, and one normal subject. Following hydrolysis each HPLC fraction yielded several amino acids. Glycine, leucine, serine, phosphoserine, glutamic acid, and phenylalanine were found in greatest frequency in the four CRF patients.

Biochemical elucidation and HPLC fractionation of fluorescent peptides in patients with chronic renal failure

We evaluated the biochemical characteristics of endogenous fluorescent substances, Ex 380 nm/Em 440 nm and Ex 400 nm/Em 460 nm, present in sera of patients with chronic renal failure (Clin. Chem. 31:1988, 1985). Sera from 23 patients with chronic renal failure (CRF) and from 10 normal subjects were filtered through ultrafiltration membranes (cutoff limit of 500 Da). Fluorescence intensity of the aforementioned substances was significantly elevated as compared to normals (p less than 0.001). Fluorescence characteristics of these substances remained unaltered after ultrafiltration and treatment with beta-glucuronidase. Extraction of these fluorescent compounds with organic solvents (dichloromethane, ethyl acetate, chloroform:methanol) could not be achieved after ultrafiltrates were subjected to 6N hydrochloric acid (HC1) hydrolysis. In addition, treatment with 6N HC1 enhanced fluorescence intensity without altering fluorescence excitation/emission maxima. Removal of fluorescence could be accomplished in toto by adsorption onto activated charcoal with subsequent recovery from charcoal by treatment with sodium hydroxide, pH 12 (Ex 380 nm: 51.1%, Ex 400 nm: 91.8%). Analysis of alkali-treated specimens by high performance liquid chromatography demonstrated that peptides associated with these fluorescent substances were denatured, although fluorescence at these previously described excitation/emission maxima persisted. Our studies indicate that the unique fluorescence observed in the sera of patients with CRF is not an intrinsic characteristic of a specific peptide or its amino acids, but rather an inherent property of fluorescent molecules which may bind to these peptides.

Surgery of pelviureteric obstruction in 101 children over one year of age

One hundred and one children over 1 year of age have had surgery for pelviureteric obstruction over an 11 year period. The common clinical features were abdominal pain, urinary infection or haematuria, but a number presented as an incidental finding. Less commonly, the patients presented with an abdominal mass or with hypertension. The diagnosis was usually made on intravenous pyelography (IVP) but in the latter part of the series, renal nuclide scan (RNS) and ultrasonography (US) were preferred. Ninety-three patients had a unilateral pyeloplasty, three had bilateral pyeloplasty and five had nephrectomy or heminephrectomy. Whereas initially nephrostomy drainage was used in the majority of patients after pyeloplasty, a trend away from nephrostomy evolved in the latter part of the series. With experience, the incidence of postoperative complications was also reduced and there was a reduction in the period of hospitalization. Clinical results were consistently satisfactory. Postoperative assessment after pyeloplasty was made by IVP and/or RNS and also US. A review of these investigations showed that RNS provided more factual information of the result when compared with the IVP.

Phase II trials of 5-FU, doxorubicin, and cisplatin in advanced, measurable adenocarcinoma of the lung and stomach

A combination of 5-FU (600 mg/m2 on Days 1 and 8), doxorubicin (40 mg/m2 on Day 1), and cisplatin (75 mg/m2 on Day 1) has been used for treatment of 31 patients with advanced measurable adenocarcinoma of the lung and 35 with gastric cancer. The regimen was given every 4 weeks until disease progression to patients who had not received prior chemotherapy. One complete response occurred in the lung cancer group. Ten of the gastric cancer patients (29%) had partial responses. The median duration of response was 5.5 months and the median survival in responding patients was 10.8 months. Toxicity of the regimen was moderate. We conclude that this combination offers no particular advantages over previously described treatments for these diseases.

Uncrossed complete ureteral duplication with upper system reflux

We report a case of uncrossed complete ureteral duplication with the orifice of the upper system ureter opening in the cranial and lateral position in the bladder. There was reflux only to the upper system of the duplex kidney, and the patient was treated successfully by conjoint reimplantation of the double ureters.

Free radical reactions with alpha-tocopherol and N-stearoyl tryptophan methyl ester in micellar solutions

The rate constants have been measured for one-electron oxidation by N3. and Br2-. of N-stearoyl tryptophan methyl ester (STME) and alpha-tocopherol (alpha-T) in micelles of sodium dodecyl sulphate (SDS) or tetradecyl trimethyl ammonium bromide (TTAB). Compared with analogous reactions of tryptophan and Trolox C in aqueous solution, the rate constants for oxidation in micellar solution by N3. are reduced by 30-70%. The micellar charge increased the rate of oxidation of STME by Br2-. in TTAB micelles by almost an order of magnitude, compared with the reaction of Br2-. with tryptophan in aqueous solution. In SDS micelles the rate of oxidation of STME by Br2-. was reduced more than 30-fold. Quenching of fluorescence from STME in micelles by acrylamide confirmed the accessibility of the indole ring to the aqueous solvent. The rate of repair of the neutral STME radical by alpha-T in TTAB micelles was found to be accelerated by a factor of at least 27, compared with the similar reaction between Trolox C and tryptophan radicals in aqueous solution.

Fluorescent substances in uremic and normal serum

We measured the fluorescence, at various excitation (Ex) and emission (Em) wavelengths, of serum ultrafiltrates and fractions of serum resolved by chromatography on Sephadex G15, studying both normal subjects and patients in chronic renal failure requiring hemodialysis. We found hitherto undescribed fluorescence at Ex 380 nm/Em 440 nm and Ex 400 nm/Em 460 nm, the intensity being greatly increased in patients with chronic renal failure in comparison with normal subjects (p less than 0.005). This fluorescence persisted unaltered when serum was filtered through membranes having cutoffs ranging from 10 000 to 500 Da. Each serum fraction resolved by gel chromatography demonstrated a characteristic fluorescence, which was generally much more intense in uremics. The most intense fluorescence (Ex 380 nm/Em 440 nm and Ex 400 nm/Em 460 nm) was emitted in the higher-Mr fractions.

Fluorescent substances in uremic and normal serum

We measured the fluorescence, at various excitation (Ex) and emission (Em) wavelengths, of serum ultrafiltrates and fractions of serum resolved by chromatography on Sephadex G15, studying both normal subjects and patients in chronic renal failure requiring hemodialysis. We found hitherto undescribed fluorescence at Ex 380 nm/Em 440 nm and Ex 400 nm/Em 460 nm, the intensity being greatly increased in patients with chronic renal failure in comparison with normal subjects (p less than 0.005). This fluorescence persisted unaltered when serum was filtered through membranes having cutoffs ranging from 10 000 to 500 Da. Each serum fraction resolved by gel chromatography demonstrated a characteristic fluorescence, which was generally much more intense in uremics. The most intense fluorescence (Ex 380 nm/Em 440 nm and Ex 400 nm/Em 460 nm) was emitted in the higher-Mr fractions.

The morphological features of bovine meshwork cells in vitro and their synthetic activities

The morphological characteristics of 3rd-passage cultured bovine meshwork cells were investigated, as were some of their synthetic activities. Growing meshwork cells had the ultrastructural characteristics of metabolically active cells whereas postconfluent cells formed gap junctions at their lateral borders and were closer in their fine structure to meshwork cells in vivo. The incorporation of 3H proline and 3H glucosamine was significantly greater in growing than postconfluent cultures. The normal bovine outflow system was rich in type I collagen but type V collagen and fibronectin was also evident. The 3rd-passage cells were shown to synthesize type I collagen, type V collagen and fibronectin. However, ultrastructural studies of the extracellular matrix which was produced in vitro demonstrated the presence of small fibrils with no distinctive banding pattern, unlike the larger collagen fibrils with a 640 A banding pattern seen in vivo.