Kinetics of enteroendocrine cells with implications for their origin: a study of the cholecystokinin and gastrin subpopulations combining tritiated thymidine labelling with immunocytochemistry in the mouse

Evidence for a common endodermal stem cell has been derived from kinetic studies in mouse small intestine which indicate that the turnover characteristics of endocrine cells are similar to those of other cell lineages (columnar and goblet cells). We have used continuous tritiated thymidine labelling and peptide immunocytochemistry on resin embedded semithin sections, a combination of techniques which have not been used before in the small intestine. Our data show that the turnover time for endocrine cells in the small intestine is 10 days, considerably longer than the four days suggested by previous studies, although for columnar and mucous cell lineages, turnover rates are similar to the published literature. In the stomach, the turnover time was very slow indeed (of the order of 45-60 days). These results show that endocrine cells do not share turnover characteristics with the other cell types and suggest that they constitute a kinetically distinct cell population independent of the other cell lineages. These data are not consistent with a common stem cell origin for gut endocrine cells.

Cloning and expression of cDNA for the luciferase from the marine ostracod Vargula hilgendorfii

The marine ostracod Vargula hilgendorfii ejects luciferin and luciferase into seawater to produce a bright luminous cloud. The light is due to the oxidation of luciferin, an imidazopyrazine compound, by molecular oxygen, catalyzed by luciferase. The mechanism of the reaction has been studied extensively and the 60 kcal/mol required for the blue emission have been shown to be derived from the oxidation of luciferin via a dioxetanone intermediate, in which the excited state oxyluciferin bound to luciferase is the emitter. However, only limited information is available regarding the properties of the enzyme. This paper reports the cloning and sequence analysis of the cDNA for Vargula luciferase and the expression of the cDNA in a mammalian cell system. The primary structure, deduced from the nucleotide sequence, consists of 555 amino acid residues in a single polypeptide chain with a molecular weight of 62,171. Two regions of the enzyme show significant amino acid sequence homology with an N-terminal segment of the photoprotein aequorin. The Vargula luciferase gene, which contains a signal sequence for secretion, should be well suited as a reporter in studies of gene expression.

Kyphomelic dysplasia

A case of kyphomelic dysplasia is reported in a boy followed up over three years. The most striking feature of this recessively inherited generalised bone dysplasia is marked angulation of the femora, associated with short stature, bowing and shortening of other long bones, metaphyseal changes in infancy, flared ribs, small thoracic cage, and platyspondyly. The good prognosis regarding motor and intellectual development in this condition is stressed and the association with cleft lip and palate is described for the first time.

X linked mental retardation: a family with a separate syndrome?

Four males with X linked mental retardation are described. Manifestations similar to those seen in the FG syndrome include severe constipation, tall, broad foreheads, hypotonia, and cowlicks of the hair line, but no individual patient had all the features of the syndrome and none had macrocephaly. The facial appearance was distinctive but different from that seen in the FG syndrome. The cases are presented in order to discuss the phenotypic limits of the FG syndrome and to consider the need to separate other distinct but similar entities.

Another family with the 'Habsburg jaw'

We report a three generation family with similar facial characteristics to those of the Royal Habsburgs, including mandibular prognathism, thickened lower lip, prominent, often misshapen nose, flat malar areas, and mildly everted lower eyelids. One child had craniosynostosis which may be part of the syndrome.

A child with sclerocornea, short limbs, short stature, and distinct facial appearance

We describe a boy with sclerocornea, short limbs, short stature and a distinct facial appearance. The resemblance to other reports of affected sibs suggests that this is a newly recognised, autosomal recessive syndrome.

Induction of Bioluminescence Capability in the Marine Fish, Porichthys Notatus, by Vargula (Crustacean) [14C]luciferin and Unlabelled Analogues

Along the Pacific coast of North America, the marine fish, Porichthys notatus, is distributed as a northern nonluminescent population and a southern luminescent one. Bioluminescence capability is inducible in nonluminescent P. notatus by a single oral or intraperitoneal administration of a small amount of luciferin, a compound used by the marine ostracod crustacean, Vargula, as substrate for light emission. Once induced, the fish is capable of luminescing for more than 2 years. The results of the present study show that: (1) P. notatus photophores incorporate 14C-labelled Vargula luciferin: (2) the specific activity of the incorporated label is undiluted when recovered from the photophores 7 weeks later; (3) two chemical analogues of Vargula luciferin do not induce bioluminescence capability in the fish; (4) luciferinol, another close analogue of Vargula luciferin, induces a very weak bioluminescent capability in the fish; and (5) two key intermediates in the degradation of Vargula luciferin, oxyluciferin and etioluciferin, are ineffective in inducing bioluminescence capability. The conclusions to be drawn from this study are that P. notatus recycles luciferin and that, in the uninduced fish, the recycling does not involve the resynthesis of luciferin from oxyluciferin or etioluciferin.

Sorsby syndrome: a report on further generations of the original family

Sorsby syndrome is a dominantly inherited combination of bilateral macular colobomas and apical dystrophy of the hands and feet (brachydactyly type B). We report on a further three affected members of the family originally described by Sorsby. Two of these have a single kidney, two have hearing loss, and one has a uterine anomaly.

Multiple pterygium syndrome: evolution of the phenotype

The clinical features of the multiple pterygium syndrome are multiple congenital joint contractures, multiple skin webs, camptodactyly, vertebral anomalies, short stature, ptosis, and antimongoloid eye slant. We present 11 new cases to show the evolution of the full phenotype from birth and to confirm autosomal recessive inheritance. We emphasise morbidity secondary to respiratory impairment and that conductive deafness may be part of the syndrome.

Recurrence risks and prognosis in severe sporadic osteogenesis imperfecta

A study was carried out in the United Kingdom of patients with severe osteogenesis imperfecta (OI), born with fractures to normal parents, in order to determine recurrence risks. A total of 105 cases from 98 families survived the perinatal period and 60 cases from 57 families were stillborn or died during the first week of life. The majority of the perinatal survivors correspond to the overlapping group of Sillence type III and sporadic type IV OI. In 40 of these, the radiograph at birth was available and in 37 it showed a characteristic appearance similar to that described previously for type III OI. The other three cases had radiological type IIB OI at birth and died before 26 months of age. The patients with perinatally lethal OI were subdivided on radiological appearance into Sillence type IIA (30 cases, described in the previous paper), type IIB (12 cases from 11 families), and type IIC (three cases from three families), and in five cases from three families the radiological appearance was the same as that of the 37 perinatal survivors described above. Ten cases from 10 families were not classified because their radiographs were unavailable. To analyse the empirical recurrence risks, patients were grouped according to radiological appearance at birth. Those with a type III-like pattern numbered 42 cases and they were grouped with the other cases of severe deforming OI who survived the perinatal period, for whom no x ray at birth was available, making a total of 107 cases. Taking one affected child per family as the proband, there were 98 probands. They had 146 sibs, of whom 10 were affected, giving an empirical recurrence risk of 6.9%. This is consistent with the disease arising as a new dominant mutation in about three quarters of families and as a recessive in about one quarter in this heterogeneous group. It is reasonable to give a recurrence risk of up to 25% in cases with parental consanguinity and a risk of 4.4% in cases with unrelated parents. Fifteen patients (14 probands) with Sillence type IIB OI had 13 sibs, one affected, giving an empirical recurrence risk of 7.7%. The parents were consanguineous in three families and the evidence for autosomal recessive inheritance for the majority in this group is probably stronger. The three patients with type IIC OI had three healthy sibs and the 10 unclassifiable perinatally lethal cases had 22 sibs, all normal. The radiological appearance at birth predicts prognosis to some extent; essentially, the better the bone morphology and mineralisation the longer the survival.

Osteogenesis imperfecta type IIA: evidence for dominant inheritance

Thirty cases of radiologically proven type IIA osteogenesis imperfecta (OI) have been ascertained. All were isolated with 19 unaffected foreborn and 19 unaffected afterborn sibs. Two sets of parents, both Asian, were consanguineous. There was a significant parental age effect, most marked for paternal age. It is concluded that most cases of type IIA OI result from new dominant mutations.

A girl with the Weaver syndrome

A female with the Weaver syndrome is reported. In addition to the characteristic manifestations of overgrowth and advanced bone age, the facies were typical, with a broad forehead, hypertelorism, a long philtrum, micrognathia, and large ears. Like most other patients with Weaver syndrome, she was developmentally delayed, hypertonic, and had a hoarse voice. Other clinical features included prominent finger pads, narrow hyperconvex nails, small and narrow chest, unilateral dislocated distal ulna, and abnormal thoracic vertebrae.

Combination treatment with ranitidine and sodium bicarbonate prior to obstetric anaesthesia

The gastric pH and volume were measured in 175 patients undergoing elective, and 313 undergoing emergency, obstetric procedures. Ranitidine 150 mg was administered orally every 6 hours in labour and at least 2 hours before elective Caesarean section. Patients received 20 ml of 8.4% sodium bicarbonate orally immediately prior to induction of anaesthesia. The combination of ranitidine and sodium bicarbonate produced marked alkalinisation of gastric contents (mean pH 8.9). The administration of sodium bicarbonate pre-operatively in patients who received ranitidine less than 2 hours before operation led to satisfactory elevation of gastric pH. Only four patients had a gastric pH less than 2.5, one patient refused any medication, two received only ranitidine and one patient had a long interval from administration of bicarbonate to aspiration of gastric contents. Gastric volumes were high in labouring patients (mean 84 ml) despite administration of ranitidine. The effectiveness of sodium bicarbonate as a single dose antacid therapy prior to obstetric anaesthesia requires further study.

Necropsy findings in a child with FG syndrome

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A male infant with the Catel-Manzke syndrome and dislocatable knees

A male infant is described with severe micrognathia and bilateral duplication of the proximal phalanges of the index fingers, an association which is characteristic of the Catel-Manzke syndrome. In addition, he had dislocatable knees, which have not been described in this disorder before.

Effect of pretreatment with ranitidine on the hypnotic action of single doses of midazolam, temazepam and zopiclone. A clinical study

Patients receiving midazolam, temazepam or zopiclone by mouth as premedication for minor gynaecological surgery were pretreated with either ranitidine or an inert tablet. Pretreatment with ranitidine was associated with a greater degree of drowsiness at 20 and 40 min after midazolam, and a shorter mean time to peak hypnotic effect than in the non-pretreated group. Ranitidine did not affect the degree of drowsiness in the patients receiving temazepam or zopiclone.

Amniotic bands in connective tissue disorders

Amniotic bands are described in two children with Ehlers-Danlos syndrome type IV and in one with severe osteogenesis imperfecta. Since the basic defect in both of these disorders rests in collagen, which constitutes the main component of the load bearing amnion, it is proposed that these cases provide further insight into the pathogenesis of amniotic bands.

Quantitation in inflammatory bowel disease using computerised interactive image analysis

Objective measurements of various histological features in rectal biopsy material were made using computerised interactive image analysis. Analysis of the resulting data by forward stepwise discriminant analysis showed that biopsies from patients with ulcerative colitis and infective diarrhoea could be distinguished from each other and from normal biopsies; they could not, however, be distinguished from biopsies of patients with Crohn's disease, which behaves as a heterogeneous entity rather than a single disease. The measurements showed that the crypt atrophy described in active ulcerative colitis may be a misnomer, the appearances being due to an increase in mucosal depth and alteration in crypt configuration rather than a true atrophy. Unexpectedly, the ratio of crypt cell height to surface cell height gave the best separation of Crohn's disease from ulcerative colitis.

The FG syndrome: 7 new cases

The X-linked FG syndrome is characterised by mental retardation, congenital hypotonia and constipation (which may both be severe), structural anal anomalies and relative macrocephaly in some, and an unusual and characteristic facial appearance. We describe 7 males from 4 families. One had anal stenosis. Two of the mothers and one sister show probable carrier manifestations. The features of the FG syndrome are individually non-specific. We emphasize that the characteristic combination of features is needed to avoid overdiagnosis.