Temporal lobe and hypothalamic-pituitary dysfunctions after radiotherapy for nasopharyngeal carcinoma: a distinct clinical syndrome

Eleven patients with combined neurological and endocrine complications after external radiotherapy for nasopharyngeal carcinoma are described. Neurologically, memory disturbance, complex partial seizures and hypodense areas in one or both temporal lobes on CT were typical features. Endocrinologically, hypopituitarism was the prominent manifestation. This constellation of clinical features in a patient with previous radiotherapy to the nasopharynx characterises radiation injury to the inferomedial aspects of the temporal lobes and the hypothalamic-pituitary axis. While the parenchymal brain lesions may mimic metastases or glioma on CT, the associated endocrine disturbance would betray the correct diagnosis. The importance of recognising the hypopituitarism which may be clinically asymptomatic and which is amenable to therapy is emphasised, as is the need for a proper fractionation of the radiation dose to minimise the incidence of these disabling complications.

Giardia lamblia in patients undergoing endoscopy: lack of evidence for a role in nonulcer dyspepsia

Previous studies have suggested that Giardia lamblia may cause nonulcer dyspepsia as the sole manifestation of infection. To explore this premise, duodenal aspirates from patients undergoing upper endoscopy were examined for Giardia and results were correlated with endoscopic findings and symptoms. Of 155 patients, 15.5% had Giardia. Patients with dyspepsia, with or without obvious lesions at endoscopy, had a similar prevalence. Patients with vomiting and diarrhea had an increased prevalence (38.5%) (p less than 0.05). The prevalence of Giardia lamblia in this patient population is surprisingly high. This study suggests that Giardia lamblia infection is not a major cause of nonulcer dyspepsia.

Yeast activators stimulate plant gene expression

GAL4 is a transcriptional activator found in yeast. Two distinct functions of the protein are required for its activity: one directs sequence-specific DNA binding, and another interacts with some other component of the transcriptional machinery, for example, RNA polymerase II or a TATA-binding protein. Two short regions of GAL4 function as 'activating sequences' when attached to the DNA-binding portion of GAL4 and these regions can be replaced by a large number of peptides encoded by Escherichia coli genomic DNA fragments or by a synthetic peptide designed to form an amphiphilic alpha-helix. All of these activating sequences, like that found in another yeast activator, GCN4 bear an excess negative charge. GAL4 and its derivatives that are active in yeast stimulate transcription in mammalian cells when GAL4 binding sites are introduced upstream of a mammalian gene; similarly, GAL4 activates transcription in Drosophila cells. Here we show that GAL4 derivatives stimulate gene expression in plant cells.

Virulence properties and protective efficacy of the capsular polymer of Haemophilus (Actinobacillus) pleuropneumoniae serotype 5

The role of the capsule of Haemophilus (Actinobacillus) pleuropneumoniae serotype 5 in bacterial virulence, and the protective efficacy of antibody to serotype 5 capsule was investigated. Encapsulated H. pleuropneumoniae serotype 5 were resistant to killing by complement and antibody to capsule or somatic antigens, whereas a noncapsulated mutant was sensitive to killing by the alternative complement pathway alone. Antiserum to whole H. pleuropneumoniae serotype 5 bacteria or monospecific antiserum to capsule was capable of opsonizing bacteria of the homologous serotype for phagocytosis by swine polymorphonuclear leukocytes but was not opsonic for a heterologous serotype. An immunoglobulin M monoclonal antibody to the serotype 5 capsule was not opsonic for any serotype. Mice were protected against lethal, intranasal challenge with the homologous or heterologous serotype after immunization with live encapsulated or noncapsulated bacteria, but not after immunization with killed bacteria, lipopolysaccharide, or a capsule-protein conjugate vaccine. The protection induced by immunization with live bacteria was transferred to nonimmune, syngeneic mice by serum but not by spleen cells. Nonimmune pigs passively immunized with monospecific swine serum to capsule were protected from lethal infection but not from development of hemorrhagic lung lesions, whereas pigs passively immunized with swine antiserum to live bacteria did not develop severe respiratory lesions. Thus, the capsule of H. pleuropneumoniae serotype 5 was inhibitory to the bactericidal activity of serum and was antiphagocytic. Antibody to the capsule was opsonic but was not fully protective.

Glomerulonephropathy of Laurence-Moon-Biedl syndrome

A patient with Laurence-Moon-Biedl syndrome and nephrotic range proteinuria is presented. Radiological investigation of the urinary tract revealed clubbed calyces but no evidence of obstruction or vesicoureteric reflux. Renal biopsy revealed occasional sclerotic glomeruli, extensive foot-process fusion and segmental glomerular basement membrane abnormalities with negative immunofluorescence for immunoglobulins and complement. Nephrotic proteinuria responded to steroid therapy but mild proteinuria persisted. The findings were consistent with minimal change nephropathy superimposed on the glomerular lesions of Lawrence-Moon-Biedl syndrome.

Purified ryanodine receptor from rabbit skeletal muscle is the calcium-release channel of sarcoplasmic reticulum

The ryanodine receptor of rabbit skeletal muscle sarcoplasmic reticulum was purified as a single 450,000-dalton polypeptide from CHAPS-solubilized triads using immunoaffinity chromatography. The purified receptor had a [3H]ryanodine-binding capacity (Bmax) of 490 pmol/mg and a binding affinity (Kd) of 7.0 nM. Using planar bilayer recording techniques, we show that the purified receptor forms cationic channels selective for divalent ions. Ryanodine receptor channels were identical to the Ca-release channels described in native sarcoplasmic reticulum using the same techniques. In the present work, four criteria were used to establish this identity: (a) activation of channels by micromolar Ca and millimolar ATP and inhibition by micromolar ruthenium red, (b) a main channel conductance of 110 +/- 10 pS in 54 mM trans Ca, (c) a long-term open state of lower unitary conductance induced by ryanodine concentrations as low as 20 nM, and (d) a permeability ratio PCa/PTris approximately equal to 14. In addition, we show that the purified ryanodine receptor channel displays a saturable conductance in both monovalent and divalent cation solutions (gamma max for K and Ca = 1 nS and 172 pS, respectively). In the absence of Ca, channels had a broad selectivity for monovalent cations, but in the presence of Ca, they were selectively permeable to Ca against K by a permeability ratio PCa/PK approximately equal to 6. Receptor channels displayed several equivalent conductance levels, which suggest an oligomeric pore structure. We conclude that the 450,000-dalton polypeptide ryanodine receptor is the Ca-release channel of the sarcoplasmic reticulum and is the target site of ruthenium red and ryanodine.

Intestinal mucin antigens in ulcerative colitis and their relationship with malignancy

The expression of two intestinal mucin-associated antigens large intestine mucin antigen (LIMA) and small intestine mucin antigen (SIMA) were investigated by indirect immunoperoxidase staining of rectal mucosa from patients suffering from ulcerative colitis with (n = 6) and without (n = 31) associated carcinoma and in noncolitic controls (n = 40). The aim was to assess the relationship between antigen patterns and malignant change. SIMA, which is localised predominantly in the small intestine, is virtually undetectable in the normal adult colonic mucosa. However, this antigen is present in the foetal colon and colonic carcinoma. LIMA is expressed in normal colonic mucosa, but absent from the small intestine. LIMA staining patterns were not significantly different among the three groups. In contrast, expression of SIMA was significantly higher in the patients who had developed carcinoma (6/6) than in the noncancer group (7/71) (P less than 0.001). The presence of SIMA was also significantly related to areas of dysplasia compared to normal (P = .03) or inflammation (P less than .05), but it did not differ from mucosa showing "indefinite" atypia. The finding of 31% SIMA-positive biopsies associated with severe inflammation in colitis with active disease, but no evidence of malignancy, is difficult to explain at the present stage. A followup study would be necessary to determine its significance. Perhaps the most important finding is the increased frequency of SIMA-positive foci in histologically normal mucosa in carcinoma patients compared with the noncancer group (P less than .001), suggesting a field change. These observations may be prove useful for the identification of patients who may be at risk of developing carcinoma.

No strict alignment is required between a transcriptional activator binding site and the "TATA box" of a yeast gene

GAL4 is a transcriptional activator of the galactose metabolism genes in the yeast Saccharomyces cerevisiae. We show that GAL4 expressed in yeast activated transcription equally well when a single GAL4 binding site was placed at any of nine positions upstream of the GAL1 (galactokinase gene) "TATA box." We chose a sufficient number of positions for the binding site to ensure that, in several of these positions, GAL4 was on the opposite side of the DNA helix with respect to the TATA box. Smaller GAL4 derivatives were similar to wild-type GAL4 in that they also activated transcription in a manner independent of the side of the DNA helix they bound with respect to the TATA box. Unlike wild-type GAL4, however, these smaller GAL4 derivatives activated transcription better when we placed a binding site progressively closer to the TATA box over a distance of 34 base pairs.

Heterogeneity of conductance states in calcium channels of skeletal muscle

The single channel conductance of the dihydropyridine (DHP)-sensitive calcium channel from rabbit skeletal muscle transverse tubules was analyzed in detail using the planar bilayer recording technique. With 0.1 M BaCl2 on both sides of the channel (symmetrical solutions), the most frequent conductance is 12 pS, which is independent of holding potential in the range of -80 to +80 mV. This conductance accounts for approximately 80% of all openings analyzed close to 0 mV. Two additional channels of conductance 9 and 3 pS are also present at all positive potentials, but their relative occurrence close to 0 mV is low. All channels depend on the presence of agonist Bay K 8644 and are inhibited by the antagonist nitrendipine. The relative occurrence of 9 and 3 pS can be increased, and that of 12 pS decreased, by several interventions such as external addition of cholesterol, lectin (wheat germ agglutinin), or calmodulin inhibitor R24571 (calmidazolium). The 9- and 3-pS channels are also conspicuous at positive potentials larger than +40 mV. We suggest that 9- and 3-pS channels are two elementary conductances of the same DHP-sensitive Ca channel. Under most circumstances, these two conductances are gated in a coupled way to generate a channel with a unitary conductance of 12 pS. Interventions tested, including large depolarizations, probably decompose or uncouple the 12-pS channel into 9 and 3 pS.

Mechanisms for cisplatin-FUra synergism and cisplatin resistance in human ovarian carcinoma cells both in vitro and in vivo

Cisplatin and FUra act synergisticly in human carcinomas. An increase in the availability of reduced folates necessary for tight binding of FdUMP to thymidylate synthase (TS) contributes to the enhanced cytotoxicity of this drug combination. The human ovarian A2780 cell line made three-fold resistant to cisplatin has been shown to have a three-fold elevation of m-RNA for dihydrofolate reductase (DHFR) and TS. However, this increase did not result from an amplification of the genes for these two enzymes. In contrast, ovarian carcinoma cells from patients who failed treatment with cisplatin and FUra have been shown to have both enhanced gene expression and increased gene copy number for DHFR and TS.

Expression of intestinal mucin antigens in the gastric epithelium and its relationship with malignancy

The expression of large and small intestinal mucin antigens (LIMA and SIMA) was investigated in 30 gastrectomy specimens of carcinoma and in 11 controls resected for various pathologic conditions. One hundred eighty-five samples of normal mucosa, hyperplasia, intestinal metaplasia (types I, II, and III), dysplasia, and tumor were studied to identify phenotypes indicative of premalignant change. Our results showed LIMA and SIMA were not detected in normal gastric epithelium from either control or carcinoma specimens. SIMA characterized goblet cell mucin in all types of intestinal metaplasia and was not discriminatory between controls and carcinoma groups. On the other hand, LIMA was extensively expressed in columnar and goblet cells in carcinoma-bearing stomachs (97 per cent) but was absent in controls. There was a crescendo intensity and frequency of LIMA staining in an inverse relation to the degree of cell maturation and differentiation from type I intestinal metaplasia (60 per cent) to type II (85 per cent), type III (100 per cent), and dysplasia (100 per cent). In contrast, intestinal metaplasia of any type in controls did not show LIMA. The distribution of LIMA seemed to be intimately related to cell differentiation in the proliferative zone at the base of metaplastic glands. Carcinomas revealed antigenic phenotype heterogenicity. Our data indicate that LIMA sharpens the diagnosis of dysplasia, discriminates between reactive and preneoplastic epithelium (particularly within intestinal metaplasia), and detects abnormal phenotypes that may represent early stages in carcinogenesis.

A new class of yeast transcriptional activators

We describe yeast transcriptional activators encoded by E. coli genomic DNA fragments fused to the coding sequence of the DNA-binding portion of GAL4. All of the new activating sequences that we have analyzed, like those of GAL4 and GCN4, are acidic; most of these sequences show no obvious sequence homology when compared with the identified activating regions of GAL4 and GCN4 or among themselves. We also describe a fusion protein that contains no yeast protein sequence but activates transcription in yeast.

The carboxy-terminal 30 amino acids of GAL4 are recognized by GAL80

In wild-type yeast the action of the transcriptional activator GAL4 is inhibited by GAL80, and galactose relieves this inhibition. We show that deletion mutants of GAL4 lacking 30 amino acids of the carboxyl terminus activate transcription constitutively, whereas other deletion mutants bearing the carboxy-terminal 30 amino acids are inhibited by GAL80. Moreover, GAL4 fragments bearing these 30 amino acids, when expressed from a strong promoter on multicopy plasmids, free the endogenous GAL4 from inhibition by GAL80. These and other results suggest that GAL80 recognizes the carboxy-terminal 30 amino acids of GAL4, forming a complex that, though bound to DNA, does not activate transcription.

Deletion analysis of GAL4 defines two transcriptional activating segments

We describe the activities of a wide array of deletion mutants of GAL4, a yeast transcriptional activator. We identify two short regions of GAL4, each of which activates transcription when fused to the DNA-binding region of the molecule. Very large portions of GAL4 are not required for gene activation.

Is hypereosinophilic syndrome a malignant disease?

A patient with an abdominal mass for 4 years developed hypereosinophilia and weight loss. Bone marrow aspirations and biopsy specimens showed hypercellularity of eosinophils. No cause for hypereosinophilia was found. Biopsy specimens of several organs, including the abdominal mass, showed eosinophilic infiltration with reactive fibrosis in some. Cytogenetic studies of the bone marrow before treatment with cytoxic drugs showed chromosomal abnormalities. Several of these have been reported in association with acute or eosinophilic leukemias. Based upon these findings, the authors believe that the patient had eosinophilic leukemia and that the abdominal mass probably was an eosinophilic chloroma.

A colon cancer cell line (LIM1215) derived from a patient with inherited nonpolyposis colorectal cancer

A new human colon cancer cell line (LIM1215) has been derived from a tumor arising in a member of a family known to have a high incidence of colorectal cancer. The tumor cell line is comprised of small pleomorphic cells that clone in liquid medium and form tumors in immunosuppressed mice. Ultrastructurally, the cells are capable of differentiation, with cells with multiple microvilli and cells resembling goblet cells being present in the one culture. The cells are pseudodiploid and contain a 13p+ marker chromosome.