In vitro processing at the 3'-terminal region of pre-18S rRNA by a nucleolar endoribonuclease

In an investigation of the possible involvement of a highly purified nucleolar endoribonuclease in processing of pre-rRNA at the 3' end of the 18S rRNA sequence, an in vitro synthesized pre-18S rRNA transcript containing the 3' end region of 18S rRNA and the 5' region of the first internal transcribed spacer (ITS1) was used as a substrate for the enzyme. Cleavages generated by the nucleolar RNase were localized by S1 nuclease protection analysis and by the direct release of labeled rRNA products. Precise determination of the specificity of cleavage was achieved by RNA sequence analysis with end-labeled rRNA transcripts. These data demonstrated that the purified nucleolar RNase cleaved the pre-18S rRNA transcript at three specific sites relative to the 3' region of 18S rRNA. The first two sites included the mature 3'-end 18S rRNA sequence and a site approximately 55 nucleotides downstream of the 3'-end 18S rRNA sequence, both of which corresponded directly to recent results (Raziuddin, R. D. Little, T. Labella, and D. Schlessinger, Mol. Cell. Biol. 9:1667-1671, 1989) obtained with transfected mouse rDNA in hamster cells. The other cleavage occurred approximately 35 nucleotides upstream from the mature 3' end in the 18S rRNA sequence. The results from this study mimic the results obtained from in vivo studies for processing in the 3' region of pre-18S rRNA, supporting the proposed involvement of this nucleolar endoribonuclease in rRNA maturation.

The value of early third-trimester maternal serum alpha-fetoprotein determination

The value of determination of maternal serum of alpha-fetoprotein (MSAFP) concentration in the second trimester is well established. In addition to open neural tube defects, pregnancies associated with elevated second-trimester MSAFP have been shown to be at increased risk for a variety of problems, including low birth weight, preterm delivery, and pregnancy-induced hypertension (PIH). We evaluated the potential usefulness of MSAFP in the early third trimester. MSAFP concentration was determined in over 200 women at the time of glucose screening. Results were analysed with regard to gestational age at sampling, maternal weight, race, diabetes, and presence of twins. MSAFP was twice as high in twin gestation, but not affected by race or the presence of diabetes. In contrast to levels in early gestation, third-trimester MSAFP does not appear to be predictive of preterm delivery, low birth weight, or PIH.

Viral lower respiratory tract infections in Filipino children

Viral causes of acute lower respiratory tract infection were studied prospectively between 15 June and 31 October 1984 in 312 Filipino children less than 5 years old living in periurban slums and middle-class housing. The cause was based on viral antigen detection, virus isolation, and antibody assays. There were 131 children (41.2%) who were admitted to the hospital, and 150 (47%) had an infiltrate on chest radiograph. A total of 198 viral infections were confirmed in 162 patients (51.9%), 42.3% with single viral infection and 9.6% with mixed (two or more) infection. The infections were measles (21.4%), influenza A (15.9%), parainfluenza types 1, 2, and 3 (8.8%), respiratory syncytial virus (7.1%), influenza B (5.8%), enteroviruses (5.1%), adenoviruses (3.9%), herpes simplex virus (1.6%), and cytomegalovirus (1.3%). Viral infections other than measles were seen in 39.7% of the cases. The presence of viral infection correlated with better nutritional status. Influenza A or B diagnosis was associated with mild forms of acute respiratory tract infection, measles and a preceding rash with severe disease.

Serological diagnosis of neurobrucellosis

The presence of antibodies was determined in the serum and cerebrospinal fluid in six patients with neurobrucellosis using the Rose Bengal test, the microdilution agglutination test, and the Coombs' test. Four of the patients were followed up for more than three months. The Rose Bengal test and the microagglutination test were positive in cerebrospinal fluid in five of the six cases at some stage. The Coombs' test was positive in cerebrospinal fluid in every patient and in one was the only positive serological test. Cerebrospinal fluid positivity is not excluded by low titres or negative results of antibodies in the serum for any of the three methods. A Coombs' test or some equivalent must always be made on the cerebrospinal fluid to diagnose neurobrucellosis.

[Fluoride content of tea and amount ingested by children]

The fluoride concentration on their respective infusions was determined in the twelve most popular brand of tea which can be obtained in Valparaiso, Chile. Fluoride concentration was measured 5, 45 and 180 minutes after tea preparation, by using an specific fluoride electrode. The amount of ingestion of tea in children was estimated by means of a survey on 303 children from a sample of 7,690 boys and girls living in a fluoridated area. The data revealed a large variability in fluoride concentration depending on the brand of tea. Mean fluoride concentration was 2.36 mg F/l. at the five first minutes. Sixty eight per cent of children drinking tea as usual beverage, therefore it was estimated that about 22.1% of this sample have risk of dental fluorosis.

The association between apolipoprotein A-I and prostacyclin binding in human serum

The stability of Prostacyclin in human blood is dependent upon binding to circulating proteins. Although this binding has been considered to be primarily due to albumin, a recent report has suggested that apolipoprotein A-I is responsible. We compared prostacyclin binding to the concentration of albumin and apolipoprotein A-I in several groups of sera with known differences in the ability to bind prostacyclin. Our results indicate a strong correlation with albumin concentration but no correlation between binding and the concentration of apolipoprotein A-I. It appears that in the human circulation albumin concentration is the most important determinant of prostacyclin binding.

Physostigmine enhances blood flow-metabolism ratio in neocortex

Inhibition of central nervous system cholinesterase with a single pulse of physostigmine induces a pronounced increase of blood flow in the neocortex, cingulate gyrus, claustrum, and amygdala. This phenomenon is not accompanied by an increase in energy metabolism and may help explain the effect of this drug on memory in normal humans and patients with Alzheimer's disease, as well as other conditions. In contrast, a parallel increase of blood flow and metabolism was observed in the superior colliculus, a component of the visual pathways. Prolonged administration of physostigmine lead to persistent vasodilatation in the neocortex, a lessening of this effect in cingulate gyrus, claustrum and amygdala, and an increase in primary olfactory cortex and hippocampus when compared with single pulse administration. Effects of physostigmine on glucose utilization remained essentially the same as with pulse administration.

[Non-Hodgkin's lymphoma and emergency surgery. Apropos of 12 cases]

From 1972 to 1986, a total of 46 children with the histological diagnosis of Non-Hodgkin's lymphoma were treated in our hospital. Twelve had emergency surgery. Nine of them presented with an acute abdominal condition and three bowel perforation during treatment for childhood Non-Hodgkin's lymphoma. Survival rate was 58%.

[Kidney injuries in children]

From 1972 to 1985 blunt renal injuries were recorded in 58 children up to the age of 14 years. Early evaluation and treatment of these children is essential in order to preserve maximum renal function. The majority responded well to careful conservative, nonoperative management. Some of those requiring surgical intervention, responded well to initial conservative treatment followed by surgical intervention conducted as an delayed procedure. The critical injuries need early operative intervention.

Management of low-grade gliomas of the optic nerve and chiasm

Thirty-six patients were evaluated between 1965 and 1983 for glioma of the optic nerves and/or chiasm. Median follow-up was 10.2 years. Pathologic verification was obtained in 32 patients. Tumor initially confined to the optic nerve recurred in one of five patients after complete resection. The actuarial survival for 25 patients irradiated for biopsy-proven glioma of the optic chiasm was 96%, 90%, and 90% at 5, 10, and 15 years, respectively, and the progression-free survival was 87% at 5, 10, and 15 years. Vision stabilized or improved in 86% of patients after radiotherapy. Patients irradiated to a dose greater than a NSD of 1385 ret had a significantly improved progression-free survival (P = 0.015). One serious complication occurred after a dose of 1533 ret. The recommended radiation dose for optic glioma is 45 to 50 Gy with 1.8 Gy fractions.

High-content aminoglycoside disks for determining aminoglycoside-penicillin synergy against Enterococcus faecalis

We investigated the use of high-content aminoglycoside disks for determining Enterococcus faecalis susceptibility to aminoglycoside-penicillin synergy. The susceptibility of the organisms to synergy was established by 24-h time-kill studies performed with streptomycin, kanamycin, amikacin, gentamicin, and tobramycin, alone and in combination with penicillin. A total of 20 isolates that were susceptible to all drug combinations and 20 strains that were resistant to each aminoglycoside-penicillin combination were selected for testing against high-content disks. Disk-agar diffusion was performed on Mueller-Hinton agar, with and without 5% sheep blood, by using disks that contained either 300 or 2,000 micrograms of streptomycin and either 120 or 2,000 micrograms of kanamycin, amikacin, tobramycin, or gentamicin. Zone size results obtained for each aminoglycoside, except amikacin, could be used to differentiate between synergy-susceptible and -resistant isolates. No overlap occurred between the zone sizes of susceptible and resistant strains. Susceptibility to amikacin-penicillin synergy could reliably be tested with kanamycin, but not amikacin, disks. When the disks containing 120 micrograms were tested, a narrow zone size range of 6 to 7 mm could be used to identify all resistant strains. In contrast, when the disks containing 2,000 micrograms were used, the zone size ranges for resistant isolates varied widely with the aminoglycoside being tested. The presence of blood in the medium did not appreciably affect the disk test results. To detect resistance to every aminoglycoside-penicillin combination that may be considered for therapy, E. faecalis isolates need to be tested against a maximum of three different high-content disks (i.e., streptomycin, gentamicin, kanamycin). The disk-agar diffusion test performed with high-content aminoglycoside disks can provide laboratories with a convenient and reliable method for detecting E. faecalis isolates that are resistant to aminoglycoside-penicillin synergy.

Effects of medium and inoculum variations on screening for high-level aminoglycoside resistance in Enterococcus faecalis

Enterococcus faecalis isolates that are refractory to aminoglycoside-penicillin synergy can be detected by their ability to grow in the presence of high concentrations of aminoglycoside (2,000 micrograms/ml). In past studies investigators have used a variety of media and inoculum sizes to perform high-level aminoglycoside resistance screens, but little is known about how these variations affect test accuracy. We screened 63 E. faecalis strains on different media by using various inoculum sizes and correlated the results with synergy test results obtained by time-kill studies. Screens were done with dextrose-phosphate agar, brain heart infusion agar, Trypticase soy agar with 5% sheep blood, Mueller-Hinton agar with 5% sheep blood, dextrose-phosphate broth, and Mueller-Hinton broth. Agar screens were inoculated with 10(2), 10(4), and 10(6) CFU; and broth screens contained a final inoculum of 10(5) CFU/ml. The E. faecalis isolates were tested for high-level resistance to streptomycin, kanamycin, amikacin, gentamicin, and tobramycin. Of the 63 isolates tested, 21 did not show high-level resistance to any of the aminoglycosides tested, and 42 demonstrated high-level resistance to one or more drugs. The sensitivity of most screens was greater than or equal to 90%. Regardless of the inoculum size or medium used, false-resistance results were seldom encountered. Screen specificity, which was used as the indicator of false susceptibility, was markedly influenced by both the inoculum size and the drug being tested. Specificity was low whenever a 10(2)-CFU inoculum was used, when amikacin was tested with any inoculum, and when tobramycin was tested in broth media. Data for kanamycin could be used to predict amikacin-penicillin synergy, and the highly accurate gentamicin screen obviated the need for the testing of tobramycin. We recommend a 10(6) -CFU inoculum for agar screens and a 10(5) -CFU/ml inoculum for broth screens. The type of medium used did not substantially influence screen accuracy. Among the aminoglycosides, only streptomycin, gentamicin, and occasionally, kanamycin need to be used to screen E. faecalis isolates for aminoglycoside-penicillin synergy.

[Non-Hodgkin's lymphoma as a cause of intussusception in children]

From 1972 to 1985, a total of 35 children with histological diagnosis of non-Hodgkin's lymphoma were treated. A previously undiagnosed abdominal non-Hodgkin's lymphoma produced intussusception in three of these children between 5 and 10 years of age. Our experience indicates that any child around 6 years of age with abdominal pain, bloody stools and a palpable mass plus radiographic evidence of intussusception should be considered to have an intestinal wall lymphoma until proven otherwise. Inadequate surgical treatment may result from failure to recognize relationship between intussusception and lymphoma in older child.

Open microsurgical autograft of adrenal medulla to the right caudate nucleus in two patients with intractable Parkinson's disease

Recent experimental studies and one clinical case have suggested that grafting tissue from the adrenal medulla into the brain may ameliorate the signs of Parkinson's disease. We describe the treatment of two young patients (35 and 39 years old) with intractable and incapacitating Parkinson's disease, in whom fragments of the adrenal medulla were autotransplanted to the right caudate nucleus. Clinical improvement was noted in both patients at 15 and 6 days (respectively) after implantation and has continued in both. Rigidity and akinesia had virtually disappeared in the first patient at 10 months after surgery, and his tremor was greatly reduced. A similar degree of improvement was present in the second patient at three months. We conclude that autografting of the adrenal medulla to the right caudate nucleus was associated with a marked improvement in the signs of Parkinson's disease in two patients, but our results are preliminary and further work is necessary to see whether this procedure will be applicable over the long term in other types of patients with Parkinson's disease.

[Vesico-urethral injuries in patients with pelvic fractures]

Rupture of the bladder and posterior urethra is a serious complication of pelvis fracture. From 1972 to 1984, 61 patients were admitted for genitourinary injuries. We present a review of 5 cases of bladder and urethral posterior injuries associated with pelvic fractures. We assess some current issues in the treatment and diagnosis.

[Congenital fibrosarcoma. Apropos of 2 cases]

Two cases of congenital fibrosarcoma are presented. Both tumors showed histological features of malignancy, but were successful treated with simple resections. Recurrent tumor does not seem to predispose to metastatic disease. Local excision is the initial treatment of choice for lesions occurring in newborns and infants.

Bulk preparation and crystallization of the Escherichia coli elongation factor Tu-Ts complex

A simple procedure for the preparation of 10-500 mg of the Escherichia coli elongation Tu-Ts complex is described. The protocol is based on the separate purification and quantitation of EF-Tu-GDP and EF-Ts, followed by mixing of equimolar amounts of each protein and removal of the displaced GDP by dialysis. Single crystals grown from the final product have been analyzed by X-ray diffraction techniques. The procedure is also applicable to the bulk preparation and crystallization of the trypsin-modified Tu-Ts complex. Quantitation of the elongation factors by three methods is presented.

Quantitative testing of handgrip strength, myotonia, and fatigue in myotonic dystrophy

An electrically calibrated, isometric hand dynamometer was used to quantitate maximum voluntary contraction (MVC(, relaxation time and fatigue time (at 50% MVC) in 18 normal and 10 myotonic dystrophy subjects. Precise measurements of MVC and fatigue time were obtained in normals and myotonic dystrophy patients. Relaxation times were markedly prolonged and were quite variable in all patients with myotonic dystrophy in contrast to the highly reproducible times in normals. Neither "warm-up" activity nor acetazolamide treatment altered relaxation time.

[Localized pulmonary interstitial emphysema. Therapeutic management of 3 cases]

Persistent localized interstitial emphysema (PLIE) is a severe complication of assisted ventilation in the neonatal period. From january 1980 to may 1982, 156 cases of IRDS where treated in our Intensive Care Unit. Three of these patients developed this type of emphysema. The initial management was conservative. In two cases, when high ventilatory pressures, and oxygen concentrations were needed to maintain normal blood gases, lobectomy was performed. In both of them mechanical ventilation could be withdrawn shortly after surgery. The third case was managed with conservative medical therapy, and the patient died. In conclusion, when PLIE is diagnosed and does not resolve with medical therapy, the patient needs increasingly higher oxygen concentrations and ventilatory pressures, or mechanical ventilation can not be withdrawn, lobectomy should be performed as long as the process is well localized.

A unique case of dysplasia epiphysealis hemimelica of the patella

Dysplasia epiphysealis hemimelica of the patella seems not to have been previously reported. The condition appeared in a five-year-old boy and treatment was excision of the lesion.

Major variations in anatomical origin of the coronary arteries: angiographic observations in 4,250 patients without associated congenital heart disease

In 51 (1.2%) of 4,250 patients studied by selective coronary arteriography, one or more major elements of the coronary arterial system originated from the sinuses of Valsalva in an ectopic manner. The majority of variations involved the left coronary artery. The majority of ectopic ostia were located in the right sinus of Valsalva. Failure to recognize variations in coronary arterial origin can prolong arteriography procedures and lead to errors in interpretation of coronary artery anatomy and pathology. It is concluded from this experience that the incidence and location of major variations in coronary arterial origin are relatively predictable. The data are useful in expeding coronary arteriography procedures and thus improving patient care.