Suspected Brazilian purpuric fever in a toddler with overwhelming Epstein-Barr virus infection

We describe a toddler from Connecticut who developed purulent conjunctivitis, fever, and a morbilliform rash. Blood cultures were positive for Haemophilus influenzae biogroup aegyptius; further investigation was performed to assess the possibility that the illness was consistent with Brazilian purpuric fever, which, to our knowledge, has not been reported in the United States. This isolate shared morphological and some biochemical characteristics with previously studied H. influenzae biogroup aegyptius strains but differed according to slide agglutination testing, plasmid characterization, and ribotyping. Blood and tissue samples obtained during his hospitalization were also positive for Epstein-Barr virus. The child died 8 days after hospitalization. Fifty other cases of invasive H. influenzae infection were identified by active surveillance studies. Of the 49 viable surveillance isolates, 10 were biotype III (two of which had the same ribotype as the strain from our case.

Sustained gene expression in retrovirally transduced, engrafting human hematopoietic stem cells and their lympho-myeloid progeny

Inefficient retroviral-mediated gene transfer to human hematopoietic stem cells (HSC) and insufficient gene expression in progeny cells derived from transduced HSC are two major problems associated with HSC-based gene therapy. In this study we evaluated the ability of a murine stem cell virus (MSCV)-based retroviral vector carrying the low-affinity human nerve growth factor receptor (NGFR) gene as reporter to maintain gene expression in transduced human hematopoietic cells. CD34(+) cells lacking lineage differentiation markers (CD34(+)Lin-) isolated from human bone marrow and mobilized peripheral blood were transduced using an optimized clinically applicable protocol. Under the conditions used, greater than 75% of the CD34(+) cell population retained the Lin- phenotype after 4 days in culture and at least 30% of these expressed a high level of NGFR (NGFR+) as assessed by fluorescence-activated cell sorter analysis. When these CD34(+)Lin-NGFR+ cells sorted 2 days posttransduction were assayed in vitro in clonogenic and long-term stromal cultures, sustained reporter expression was observed in differentiated erythroid and myeloid cells derived from transduced progenitors, and in differentiated B-lineage cells after 6 weeks. Moreover, when these transduced CD34(+)Lin-NGFR+ cells were used to repopulate human bone grafts implanted in severe combined immunodeficient mice, MSCV-directed NGFR expression could be detected on 37% +/- 6% (n = 5) of the donor-type human cells recovered 9 weeks postinjection. These findings suggest potential utility of the MSCV retroviral vector in the development of effective therapies involving gene-modified HSC.

CDC group O-3: phenotypic characteristics, fatty acid composition, isoprenoid quinone content, and in vitro antimicrobic susceptibilities of an unusual gram-negative bacterium isolated from clinical specimens

Between 1983 and 1994, 13 phenotypically similar unidentified clinical isolates were received by the Special Bacteriology Reference Laboratory, Centers for Disease Control and Prevention (CDC). Sources included blood (four strains), lung (three strains), knee fluid and duodenal tissue (one strain each), bone, and lymph node tissue (two strains each). All were aerobic glucose-oxidizing, slender, long, curved gram-negative rods that utilized xylose, sucrose, and maltose; did not grow on MacConkey agar in 1 to 2 days; were oxidase positive; hydrolyzed esculin; and grew on Campylobacter selective medium. All were negative for urease, indole, nitrate reduction, and gelatin hydrolysis. All were motile by means of a single polar flagellum with a noticeably short wavelength; however, motility was sometimes difficult to demonstrate. The cellular fatty acid compositions of these strains, as analyzed by gas-liquid chromatography, were unique, characterized by relatively large amounts of 16:1omega7c, 16:0, and 18:1omega7c with smaller amounts of 12:0, 3-OH-12:1, 14:0, 15:0, 18:0, Br-19:1, and 19:0cyc11-12. High-performance liquid chromatography and mass spectrometry of the quinone extracts of three representative strains showed ubiquinone-10 as the major component. Based on the breakpoints for the family Enterobacteriaceae, all the strains were susceptible in vitro to aminoglycosides, sulfamethoxazole-trimethoprim, and chloramphenicol but were resistant to most beta-lactams except imipenem. The MICs of amoxicillin-clavulanate and ciprofloxacin for these strains clustered around the breakpoints, which makes it difficult to predict the strains' response in vivo to these agents. This group has been designated CDC oxidizer group 3 (O-3).

A diagnostic approach to chest pain based on history and ancillary evaluation

Pain is a major reason patients seek health care. Chest pain, in particular, is a serious concern for patients and clinicians because of its potentially life-threatening implications--misdiagnosis can be fatal. Diagnosis of chest pain is complicated by shared neurologic pathways for thoracic and abdominal visceral organs. The importance of a medical history in the differential diagnosis is discussed. A helpful mnemonic is offered both as an organizational guide for novice practitioners and as a reminder for the seasoned clinician. Included are detailed discussions regarding the neuroanatomy of chest pain, followed by common historical presentations and physical findings related to selected cardiovascular and noncardiovascular etiologies of the condition. A brief discussion of confirmatory laboratory evaluations is included. Several etiologies not discussed in detail are presented in table format.

An investigation into lung correction for tangential breast irradiation

A solid water breast phantom with a lung equivalent material was constructed to investigate interface effects of 6 MV tangential photon fields. The phantom was built so that Thermo-luminescence Dosimeters (TLD) could be used for comparison to a pencil beam and Equivalent Tissue-Air-Ratio (ETAR) algorithms. The investigation highlighted the limitations in both of these algorithms under clinically anatomical conditions. At the lung/tissue interface both algorithms showed errors between 3-12% depending on the position of the TLD. In tissue greater than 1 cm from the interface region the errors on average were within +/- 5%. Dose comparisons in lung tissue showed similar results to the interface region. These results indicate that normalisation of Reference Dose in the interface region for tangential breast treatments cause over or under estimates of dose.

Hematopoietic progenitor cells of lymphocytes and dendritic cells

Lymphocytes and dendritic cells (DCs) are critical for immune responses, yet how they develop from pluripotent hematopoietic stem cells is poorly defined. In humans and mice, it is possible to isolate phenotypically defined subsets of bone marrow (BM) cells that represent intermediate progenitors without long-term repopulating characteristics but with specific lineage differentiation properties. For instance, murine BM CD34+ CD45RA+ cells are progenitors for B and T lymphocytes with no in vivo repopulation activity. In human BM, a small subset (5%) of cells having the phenotype CD34+ Lin- CD10+ CD45RA+ CD38+ Thy-1- c-kit- represents a new class of hematopoietic progenitor cells that gives rise to lymphocytes [T, B, and natural killer (NK) cells] and to DCs but does not produce myeloid or erythroid cells. The identification of such progenitor cells provides the opportunity to define the differentiation and growth requirements for the production of lymphocytes and DCs. Genes involved in lineage specification can also be studied. Altogether, these studies have fundamental implications for understanding the biology of pivotal lineages of immune cells. This understanding could be used to treat a variety of immunodeficiencies and to design novel immunotherapies particularly in the context of hematopoietic cell transplantation.

Older people's lives in the inner city: hazardous or rewarding?

An exploratory, qualitative study was used to investigate the social health needs of older residents of a low-income inner-Sydney area characterised by multiple social and environmental hazards. The research was conducted to inform the development by the South Eastern Sydney Area Health Promotion Unit of a strategy to promote the health, wellbeing and independence of older people. As part of a needs assessment process, the investigation focused on specific subgroups of the population believed to be highly disadvantaged and neglected. In-depth interviews were conducted with 40 residents aged 60 to 86 years who were recruited through community centres, service providers and neighbours. The interviews were supplemented by observational field notes. We describe key dimensions of the physical and social environment, the many hazards it presented to vulnerable elderly residents and the practices they adopted in meeting their everyday needs in relation to shopping, meals, mobility outside the home and social participation. The description is from the perspectives of residents themselves. Key factors discussed include the neighbourhood, housing, activities of daily living, safety and security, and social participation. We explore the implications of our findings for the development of effective public health practice. The environmental hazards, such as pedestrian safety and traffic management, affect the whole population and require interventions at government level. Others, such as inadequate hygiene and food storage facilities in rented premises, also require an approach at the level of public policy and environmental change, but need to be carefully targetted and implemented.

Functional and phenotypic characterization of cord blood and bone marrow subsets expressing FLT3 (CD135) receptor tyrosine kinase

The class III receptor tyrosine kinase FLT3/FLK2 (FLT3; CD135) represents an important molecule involved in early steps of hematopoiesis. Here we compare cell-surface expression of FLT3 on bone marrow (BM) and cord blood (CB) cells using monoclonal antibodies (MoAbs) specific for the extracellular domain of human FLT3. Flow cytometric analysis of MACS-purified BM and CB cells showed that 63% to 82% of BM CD34+ and 88% to 95% of the CB CD34+ cells coexpress FLT3. Clonogenic assays and morphological characterization of FACS-sorted BM CD34+ cells demonstrate that colony-forming unit-granulocyte-macrophage (CFU-GM) and immature myelo-monocytic precursor cells are enriched in the subpopulation staining most brightly with the FLT3 MoAb whereas the majority of the burst-forming units-erythroid (BTU-E) and small cells with lymphoid morphology are found in the FLT3- population. In contrast, statistically indistinguishable proportions of CFU-granulocyte-erythrocyte-megakaryocyte-macrophage (CFU-GEMM) and more primitive cobblestone area forming cells (CAFC) were detected in both fractions, albeit the FLT3+ fraction consistently showed more CAFC activity than the FLT3- fraction. Although in both, BM and CB the majority of CD34+CD117+ (KIT+), CD34+CD90+ (Thy-1+), and CD34+CD109+ cells coexpress FLT3, three-color phenotypic analyses are consistent with the functional findings and suggest that the most primitive cells defined as CD34+CD38-, CD34+CD71low, CD34+HLA-DR-, CD34+CD117low, CD34+CD90+, and CD34+CD109+ express low levels of cell-surface FLT3 and were therefore not enriched to a statistically significant extent with the bright versus negative sorting scheme. Thus, clear segregation of the most primitive progenitors from BM CD34+ cells was confounded by low apparent levels of FLT3 cell-surface expression on these cells, whereas myeloid progenitors unambiguously segregated with the FLT3 brightest cells and erythroid progenitors with the FLT3 dimmest. Additional phenotypic analyses using MoAbs against progenitor/stem cell markers including the mucinlike molecule MGC-24v (CD164), the receptor tyrosine kinases TIE, FMS (CD115), and KIT (CD117) further illustrate the differences in surface antigen expression profiles of BM and CB CD34+ cells. Notably, CD115 is rarely detected on CB CD34+ cells, whereas 20% to 25% of the BM CD34+FLT3+ cells are CD115+. Furthermore, 80% to 95% of the CB CD34+CD117+ but only 60% to 75% of the BM CD34+CD117+ cells coexpress FLT3. Only a negligible amount of CD34+CD19+ are detected in CB, while in BM 20% to 30% of CD34+CD19+ presumed pro/pre-B cells coexpress FLT3. In contrast, the majority of the CD34+CD164+ and CD34+TIE+ subsets in both CB and BM coexpress FLT3. Analysis of unseparated cells showed that FLT3 expression is not restricted to CD34+ subsets. About 65% to 70% of lymphocyte-gated BM CD34-FLT3+ cells are positive for the monocytic marker CD115 whereas 25% to 30% of these cells consist of CD10 expressing B-cell precursors. Finally, CD34- monocytes in BM, CB, and PB express FLT3 whereas granulocytes are FLT3-. Our data show that detectable FLT3 appears first at low levels on the surface of primitive multilineage progenitor cells and disappears during defined stages of B-cell development, but is upregulated and maintained during monocytic maturation.

Effects of hibernation on neural and endothelial control of mesenteric arteries of the golden hamster

The effects of hibernation on mesenteric arterial innervation and function were examined using pharmacological and immunohistochemical techniques in age-matched controls, cold-exposed controls, and 4-wk-hibernated golden hamsters. Electrical field stimulation of the isolated mesenteric arterial bed elicited frequency-dependent vasoconstriction. The sensitivity of responses was significantly increased in tissues from hibernating animals compared with cold-exposed controls. Vasoconstrictor responses to exogenous norepinephrine were also increased in hibernation. However, there was a significant decrease in sensitivity of vasoconstriction to ATP in hibernated and cold-exposed tissue compared with age-matched controls. In preparations preconstricted with methoxamine, endothelium-dependent vasodilator responses to acetylcholine and ATP were similar among the groups. Immunohistochemical investigation of mesenteric arteries revealed no differences among the groups in density of innervation by nerves immunoreactive for tyrosine hydroxylase, neuropeptide Y, and calcitonin gene-related peptide. Postjunctional changes appear to occur in hibernation, leading to augmentation of sympathetic vasoconstriction, which is consistent with the increase in peripheral vascular resistance in hibernation. Endothelium-dependent vasodilatation is not significantly changed in hibernation in the hamster mesenteric arterial bed.

[Inhibitors of Ras farnesylation: tomorrow's anticancer agents?]

Increasing evidence implicates a critical role for aberrant Ras function in promoting the development of human tumours and has provided the impetus for identifying anti-Ras drugs for therapy. In order to be active the protooncogene ras must be associated with the plasma membrane. This feature depends crucially upon its farnesylation (addition of a 15 carbon moiety) by the enzyme farnesyl protein transferase. In the search for new anticancer strategies and agents, potent and selective inhibitors of this enzyme have been designed. The more recent of these compounds have produced impressive results in vivo against human tumours xenografted onto nude mice, without notable toxicity, making them promising candidates for clinical evaluation.

Delineation of the human hematolymphoid system: potential applications of defined cell populations in cellular therapy

Hematopoietic stem cells (HSC) have the capacity to reconstitute all the blood cells in the body. HSC are rare, representing on average 0.05% of the mononuclear cells present in healthy human bone marrow. Due to their capacity for self-renewal and their pluripotent, long-term reconstituting potential, HSC are considered ideal for transplantation to reconstitute the hematopoietic system after treatment for various hematologic disorders or as a target for the delivery of therapeutic genes. Human HSC also have potential applications in restoring the immune system in autoimmune diseases and in the induction of tolerance for allogeneic solid organ transplantation. With the increased interest in human HSC for clinical applications, technology for the isolation of candidate HSC and knowledge of human hematopoiesis have been growing rapidly. In this article, we discuss the functional characterization of a human CD34+Thy-1+ HSC population which is essentially free of residual disease, our efforts to generate alternate monoclonal antibodies for the isolation of clinically useful stem or progenitor cell populations, and the identification of a novel lymphoid progenitor as part of an exploration towards defining progenitors with potential application as adjuncts to HSC-based cellular therapy.

Reduction in blood culture contamination rate by feedback to phlebotomists

OBJECTIVE

To determine whether monitoring and feedback of blood culture contamination rates to phlebotomists would reduce the overall contamination rate.

DESIGN

Before and after interventional study.

SETTING

Blood cultures collected by venipuncture by phlebotomists at Foothills Hospital, Calgary, a tertiary care teaching hospital.

INTERVENTION

Feedback of contamination rates calculated from a laboratory definition of blood culture contamination. The definition was based on isolation of typical skin organisms from a single blood sample when two samples were obtained.

MAIN OUTCOME MEASURE

Reduction in the laboratory-defined contamination rate in the second year.

RESULTS

Of 8462 cultures collected by phlebotomists in the prefeedback year, 224 (2.6%) were contaminated, compared to 131 (1.4%) of 9282 cultures in the postfeedback year. There was a rise in the total number of positive cultures regarded as significant but a fall in the number of coagulase-negative staphylococci that were regarded as significant by our definition. The rate of contamination in blood cultures collected by nonphlebotomists did not change.

CONCLUSIONS

The contamination rate decreased after feedback. Our definition of contamination was imperfect and could be improved, but it was valuable in achieving a real reduction in blood culture contamination.

The characterization, molecular cloning, and expression of a novel hematopoietic cell antigen from CD34+ human bone marrow cells

The adhesion molecule BEN/SC1/DM-GRASP (BEN) is a marker in the developing chicken nervous system that is also expressed on the surface of embryonic and adult hematopoietic cells such as immature thymocytes, myeloid progenitors, and erythroid progenitors. F84.1 and KG-CAM, two monoclonal antibodies to rat neuronal glycoproteins with similarity to BEN, cross-react with an antigen on rat hematopoietic progenitors, but F84.1 only also recognizes human blood cell progenitors. We have defined the antigen recognized by F84.1 as the hematopoietic cell antigen (HCA). HCA expression was detected on 40% to 70% of CD34+ fetal and adult bone marrow cells and mobilized peripheral blood cells. Precursor cell activity for long-term in vitro bone marrow cell culture was confined to the subset of CD34+ cells that coexpress HCA. HCA is expressed by the most primitive subsets of CD34+ cells, including all rhodamine 123(lo), Thy-1+, and CD38(-/lo) CD34+ adult bone marrow cells. HCA was also detected on myeloid progenitors but not on early B-cell progenitors. We also describe here the cloning and characterization of cDNAs encoding two variants of the human HCA antigen (huHCA-1 and huHCA-2) and of a cDNA clone encoding rat HCA (raHCA). The deduced amino acid sequences of huHCA and raHCA are homologous to that of chicken BEN. Recombinant proteins produced from either human or rat HCA cDNAs were recognized by F84.1, whereas rat HCA but not human HCA was recognized by antirat KG-CAM. Expression of either form of huHCA in CHO cells conferred homophilic adhesion that could be competed with soluble recombinant huHCA-Fc. The molecular cloning of HCA and the availability of recombinant HCA should permit further evaluation of its role in human and rodent hematopoiesis.

Evolution of extended-spectrum beta-lactam resistance (SHV-8) in a strain of Escherichia coli during multiple episodes of bacteremia

Nine isolates of Escherichia coli were recovered from seven blood cultures over a period of 3 months from a 19-month-old female with aplastic anemia. Initial isolates were susceptible to extended-spectrum cephalosporins, including ceftazidime (MIC, < or = 0.25 microgram/ml), but gradually became resistant to this drug (MICs, > or = 128 micrograms/ml) and other cephalosporins and the monobactam aztreonam. Molecular typing methods, including plasmid profile analysis, pulsed-field gel electrophoresis, and arbitrarily primed PCR, indicated that the nine isolates were derived from a common ancestor. Dot blot hybridization and PCR analysis of total bacterial DNA using blaSHV- and blaTEM-specific DNA probes and primers identified the presence of a blaTEM beta-lactamase gene in all of the isolates and a blaSHV gene in the isolates with elevated ceftazidime MICs. Isoelectric focusing analysis of crude lysates showed that all nine isolates contained an enzyme with a pI of 5.4 corresponding to the TEM-1 beta-lactamase, and those isolates containing an SHV-type beta-lactamase demonstrated an additional band with a pI of 7.6. The first of the ceftazidime-resistant isolates appeared to hyperproduce the SHV enzyme compared to the other resistant isolates. DNA sequencing revealed a blaSHV-1 gene in the first ceftazidime-resistant isolate and a novel blaSHV gene, blaSHV-8, with an Asp-to-Asn substitution at amino acid position 179 in the remaining four isolates. Three of the ceftazidime-resistant isolates also showed a change in porin profile. The patient had received multiple courses of antimicrobial agents during her illness, including multiple courses of ceftazidime. This collection of blood isolates from the same patient appears to represent the in vivo evolution of resistance under selective pressure of treatment with various cephalosporins.

Innervation and nitric oxide modulation of mesenteric arteries of the golden hamster

Immunohistochemical and pharmacological techniques were used to examine perivascular nerves, endothelium and the effects of inhibition of nitric oxide synthesis on responses in mesenteric arteries/perfused mesenteric arterial beds of the Golden hamster. Frequency-dependent vasoconstrictions to electrical field stimulation and dose-dependent vasoconstrictions to noradrenaline were significantly augmented by NG-nitro-L-arginine methyl ester (10(-5) M), an inhibitor of nitric oxide synthase. In preparations with tone raised with methoxamine (10 microM) dose-dependent relaxations to ATP, but not to acetylcholine, were blocked by NG-nitro-L-arginine methyl ester. In the presence of guanethidine (5 microM) to block sympathetic neurotransmission there was no neurogenic relaxation to electrical field stimulation. Furthermore, the sensory neurotoxin capsaicin (0.05-5 nmol) did not elicit relaxation. Immunohistochemical studies demonstrated dense plexuses of fibres immunoreactive for tyrosine hydroxylase and neuropeptide Y, a plexus of moderate density for calcitionin gene-related peptide and an absence of fibres immunoreactive for substance P and vasoactive intestinal polypeptide. Of particular interest is the finding that whereas sympathetic perivascular nerves and nitric oxide regulate the function of hamster mesenteric arteries, there is no apparent motor function of calcitonin gene-related peptide-containing sensory nerves.

Respiratory symptoms and respiratory function in workers exposed to tea fluff

A questionnaire survey of respiratory symptoms was carried out on a group of subjects with exposure to tea fluff in a packaging plant and compared with a group of unexposed workers. The subjects had a higher prevalence of rhinitis, bouts of coughing and chest tightness than the controls. Except in the case of rhinitis however, the differences disappeared when allowance was made for either hay fever or smoking. From the original group of subjects, two smaller groups were chosen, one with and one without symptoms, and peak expiratory flow rates were measured over a 12-day period, including eight working and four non-working days. The mean difference in peak flow was greater on the non-working than on the working days and was not related to age, sex, years of exposure, smoking or atopy. We conclude that there is little evidence to suggest that this group of tea packers shows signs of sensitization but that they are probably exposed to an irritant in the tea fluff.

The human factor

Defining the core activity of psychiatric nursing is helpful if the discipline seeks professionalization. A definition offers a sense of stability within the current culture of change in care provision. However, core activity may be incongruent with postmodern ideas and practice. The paper attempts to square this circle. It addresses the complexity of describing core activity when this is based on implicit knowledge of practice, based in art rather than science. Using a phenomenological research approach, the research involved encouraging psychiatric nurses within residential schemes to consider the meaning of their concrete activity. Initial findings suggest that the core activity is working with extraordinary people within 'ordinary' relationships, and in 'ordinary' contexts.

Drug resistance

An overview of the current mechanisms identified as associated with the expression of multidrug resistance is provided. The clinical relevance of multidrug resistance associated with the overexpression of the three major drug resistance-associated proteins namely, P-glycoprotein, MRP and/or LRP, is discussed. Alternate forms of multidrug resistance involving the reduced or altered expression of either or both of the topoisomerases is next considered, followed by a short section relating to resistance to the platinum complexes and the contribution of altered DNA repair. For those involved in new drug discovery programmes for cancer chemotherapy, the identification and study of these new major intracellular targets makes this an exciting era.

High-level expression of a novel epitope of CD59 identifies a subset of CD34+ bone marrow cells highly enriched for pluripotent stem cells

To further define the hierarchy of human hematopoietic progenitor cells, we have attempted to identify antibodies to cell-surface molecules expressed on CD34+ progenitor cell subsets. Herein we describe the utility of a new monoclonal antibody, HCC-1, which binds to a novel epitope of CD59 differentially expressed among CD34+ progenitor cells. HCC-1 subdivides the adult marrow CD34+ population into HCC-1high and HCC-1low/- fractions of approximately equal size. Cobblestone area-forming cells (CAFC) in long-term bone marrow culture were enriched 10-30-fold in CD34+HCC-1high cells compared with CD34+HCC1-low/- cells and two-fold compared with CD34+ cells. When injected into fetal human bone fragments implanted in SCID mice, the CD34+HCC-1high population showed potent engrafting activity leading to the production of myeloid, lymphoid, and erythroid elements, as well as the retention of progenitor cell phenotype. These studies demonstrate that the CD34+HCC-1high population contains primitive pluripotent hematopoietic stem cells. No hematopoietic engrafting activity was detected in the CD34+HCC-1low/- population. Consistent with this finding, simultaneous five-color flow cytometric analysis revealed that HCC-1high cells include virtually all CD34+Thy-1+Lin- cells, a cell population previously characterized as highly enriched for primitive pluripotent hematopoietic stem cells. The ability of CD34+ cells divided into subsets by HCC-1 to produce T cells was assessed by transplantation of sorted cells into human fetal thymus implanted into SCID mice. A higher frequency of thymus-engrafting activity was observed in the CD34+HCC-1high than in the CD34+HCC-1low/- population. Consistent with the limited ability to engraft in the SCID-hu thymus model, the CD34+HCC-1low/- population was shown to contain a low frequency of CD34+CD10+ lymphoid progenitor cells. We conclude that the HCC-1 epitope is expressed at high levels on a subset of CD34+ cells that contain virtually all primitive pluripotent hematopoietic stem cells and that the population of CD59 molecules expressed on CD34+ cells is not homogeneous.

Rebuilding the face of George Buchanan (1506-1582)

For many years, controversy has existed as to which of several portraits bore the closest resemblance to George Buchanan, Scottish humanist, historian, churchman, statesman and tutor to James VI of Scotland (later James I of England). It was considered that a formal facial reconstruction from his skull, which is housed in Edinburgh University Anatomy Museum, would help clarify this long standing dilemma. The reconstruction process and its results are described and illustrated.

Regulation of polyamine synthesis and transport by fibroblast growth factor in aortic smooth muscle cells

Basic-FGF (FGF2) is implicated as a regulator of smooth muscle cell proliferation that develops after arterial injury. Polyamines are essential for cell growth and differentiation and may mediate some of the FGF2-elicited responses. To examine this possibility, the effect of FGF2 on polyamine synthesis and uptake was tested on rat arterial smooth muscle cells. Exposure of cells to FGF2 for 24 and 48 h resulted in increased intracellular polyamine content. Ornithine decarboxylase (ODC) activity increased in FGF2-treated cells after 6 h of treatment, whereas no increases were detected in ODC mRNA steady-state levels. Basic-FGF increased maximal polyamine transport rate without changes in Km. Treatment with actinomycin D decreased polyamine transport. The effect of cyclohexamide on polyamine uptake was dose dependent. These studies indicate that treatment of vascular smooth muscle cells with FGF2 results in increases in intracellular polyamine content, polyamine synthetic activity, and polyamine transport.