DNA diagnosis of pyruvate dehydrogenase deficiency in female patients with congenital lactic acidaemia

The diagnosis of pyruvate dehydrogenase (PDH) E1 alpha deficiency, which is an X-linked inborn error of metabolism, is usually established by the measurement of PDH complex activity in cultured cells. However, heterozygous female patients with PDH E1 alpha deficiency may be misdiagnosed when the normal X chromosome is predominantly expressed in the cultured cells. Therefore, in female patients with convincing clinical presentations of PDH E1 alpha deficiency and the normal enzyme activity, the X-inactivation pattern should be analysed and the PDH E1 alpha gene screened for mutations. For this screening, we applied the method of single-strand conformational polymorphism (SSCP) and DNA sequencing and examined 11 female patients with congenital lactic acidaemia whose PDH complex activity was normal in cultured cells. In 2 of the 11 female patients, we found distinct pathogenic missense mutations in the PDH E1 alpha gene (G89S and G291R). Both affected patients showed a similar clinical presentation and had been diagnosed as West syndrome. In 3 of the 11 patients, we found a polymorphic base-pair substitution in exon 9 of the PDH E1 alpha gene which resulted in a changed amino acid residue (M282L). We conclude that PCR-SSCP analysis of the PDH E1 alpha gene, followed by DNA sequencing, is a useful method to screen for mutations of the PDH E1 alpha gene in female patients with congenital lactic acidaemia who have normal enzyme activities in available samples, normal ratio of lactate to pyruvate, and predominantly raised lactate concentration in cerebrospinal fluid.

Characterization of the myosin-binding subunit of smooth muscle myosin phosphatase

A myosin phosphatase was purified from chicken gizzard smooth muscle. The holoenzyme is a trimer and consists of 130,000-, 38,000-, and 20,000-Da subunits (in agreement with the results of Alessi et al.: Alessi, D., MacDougall, L. K., Sola, M. M., Ikebe, M., and Cohen, P. (1992) Eur. J. Biochem. 210, 1023-1035). The catalytic subunit, 38,000 Da, is the type 1 delta isoform, and its derived amino acid sequence is identical to the rat isoform. The larger subunit bound to myosin and also interacted with the catalytic subunit. cDNA clones encoding the large subunit were isolated from chicken gizzard cDNA libraries. Overlapping clones indicated the presence of two isoforms, and open reading frames of 2889 and 3012 bases were obtained. These encoded proteins of 963 and 1004 amino acids, with masses of 106,700 and 111,600 Da, respectively. The insert in the larger isoform is in the center of the molecule, at residues 512-552. The N-terminal third of the molecule is composed of eight repeat sequences, similar to the cdc10/SWI6 or ankyrin repeat. Myosin binding and binding to the catalytic subunit are properties of a 58,000-Da fragment that represents the N-terminal part of the molecule.

Consecutive cerebral MRI findings of acute relapsing disseminated encephalomyelitis

A seven year old girl with acute relapsing disseminated encephalomyelitis (ARDEM) was observed with serial magnetic resonance imaging (MRI) examination. She had the first encephalomyelitis episode at the age of 2 years 9 months. She entered remission with steroid therapy. She suffered a recurrence at the age of 7. Steroid therapy was instituted and consecutive magnetic resonance imaging (MRI) was performed. In spite of rapid improvement of neurological abnormality with steroid and steroid pulse therapy, disseminated high intensity lesions in T2-weighted imaging which were considered as demyelination remained for a long time. Magnetic resonance imaging seems to be most suitable for evaluating the clinical condition and long-term follow-up of ARDEM.

Synthesis of 9E- and 9Z-locked retinoic acid analogs as ligands for RAR and RXR

New retinoic acid (RA) analogs 9E-locked-RA 3 and 9Z-locked-RA 4 were synthesized from dithiane 6 and beta-cyclocitral 13, respectively. Both analogs behaved as agonistic ligands for a mixture of retinoic acid receptor (RAR) and retinoid X receptor (RXR).

Stimulus parameters for induction of long-term depression in in vitro rat Purkinje cells

Long-term depression (LTD) was induced in rat cerebellar slices by conjunctive stimulation of parallel fibers (PFs) and climbing fibers (CFs) under perfusion of 20 microM picrotoxin. LTD was estimated by the reduction in the initial rising slope of EPSPs PF-induced in Purkinje cell dendrites. LTD-inducing efficacy was represented by both the average amount of depression and the probability of inducing depression greater than 25%, both measured at 40 min after the onset of conjunctive stimulation. Using 300 regularly recurring pulses given to both CFs and PFs with 0 ms interval, LTD was optimally induced at 1 Hz, and to lesser degrees at other frequencies. When the number of conjunctive stimuli at 1 Hz with zero CF-PF interval was varied from 50 to 500, 300 stimuli induced LTD most robustly. When CF-PF interval was varied while 300 pulses were given at 0.25-4 Hz, LTD was induced even when PF stimuli were delayed after CF stimuli by as much as 2 s, but it was inhibited when PF stimuli preceded CF stimuli by 10-100 ms. LTD was also induced by applying repeated short pulse trains to both CFs and PFs, but repeated application of a PF stimulus train immediately followed by a CF stimulus train as in classical conditioning was effectless. The present results suggest complex processes leading to LTD as a result of conjunctive CF and PF stimulation.

Cardiorespiratory dynamics during successful and unsuccessful trials of weaning from mechanical ventilation following cardiac surgery

The purpose of this study was to examine the effects of a weaning trial with pressure support ventilation (PSV) on the cardiorespiratory dynamics in 20 cardiac surgery patients. In the patients who failed a weaning trial (failure group,n=6), the mean duration of cardiopulmonary bypass was 270±83 min and the mean postoperative lung-thorax compliance was 38±5 ml·cmH₂O^-1, whereas in successfully weaned patients (success group,n=14) they were 145±30 min and 55±10 ml·cm H₂O^-1 respectively (mean±SD). Significant differences were recognized in those values between the two groups. Preoperative cardiac function, intraoperative blood loss, and postoperative fluid balance were similar in both groups. Cardiac index (CI) increased similarly in both groups. Pao₂/FIo₂ and percentage intrapulmonary shunt were constant in the success group, and these variables worsened in the failure group. Oxygen consumption ([Formula: see text]) increased and mixed venous O₂ tension ([Formula: see text]) decreased in the failure group, whereas[Formula: see text] remained constant and[Formula: see text] increased in the success group. These data suggest that prolonged cardiopulmonary bypass might have produced acute lung injury. Decreased lung compliance may be responsible for rapid shallow breathing and an increase in oxygen consumption during a weaning trial, and may lead to weaning failure from mechanical ventilation.

Construction of a new teichuronopeptide-defective derivative from alkaliphilic Bacillus sp. C-125 by cell fusion

Cell walls of facultative alkaliphilic Bacillus sp. C-125 are composed of peptidoglycan, teichuronic acid, and teichuronopeptide. A mutant lacking teichuronic acid, or defective in both teichuronic acid and teichuronopeptide has been isolated from the organism. We now constructed another type of a cell-wall defective mutant that was defective in teichuronopeptide but had teichuronic acid, by cell fusion using protoplasts prepared from a wild-type strain and a mutant defective in teichuronopeptide and teichuronic acid. This mutant grew more poorly than wild type or a teichuronic acid-defective strain of C-125. The growth, however, was faster than that of the parental strain defective in both teichuronic acid and teichuronopeptide.

Mechanical detachable coil as a therapeutic alternative for cerebral aneurysm

Endovascular treatment for unruptured cerebral aneurysms has been recognized as a useful alternative. Various types of intravascular materials embolizing aneurysms were classified into one of two groups. One was retrievable after the placement, whereas the other was irretrievable. The former which has involved detachable coils is preferred, because it can be repositioned repeatedly, while it forms the most effective arrangement. In this report, we present a compromised patient who was a 68 year-old female suffering angina pectoris and was treated with an interlocking detachable coil. Technical points are discussed here compared with Guglielmi's detachable coil.

Comparative study of alcohol metabolism in stroke-prone spontaneously hypertensive rats and Wistar-Kyoto rats fed normal or low levels of dietary protein

Our previous experiments have shown that the appetite or preference for alcohol is affected by the rat strain and nutritional status, such as dietary protein levels. To determine the affected factors in alcohol preference, the alcohol metabolism in SHRSP (stroke-prone spontaneously hypertensive rats) and WKY (Wistar-Kyoto) rats fed with the standard level (15%) or low level (5%) purified egg protein diet (PEP) was investigated. The animals were kept on the experimental diets for 4 weeks. After 12 h fasting, a 15% ethanol solution was given in a dose of 100 mg ethanol per 100 g body weight with a gastric probe to all animals and the blood ethanol and acetaldehyde levels were determined. Compared with 15% PEP diet-fed SHRSP, WKY showed higher levels of blood ethanol and acetaldehyde. Furthermore, the same results were also observed in SHRSP and WKY fed with 5% PEP diet. On the other hand, regardless of the rat strain, rats fed a low level protein diet showed higher blood ethanol and acetaldehyde levels. We also found that there was no significant change in alcohol dehydrogenase (ADH) activity and acetaldehyde dehydrogenase (ALDH) activity between SHRSP and WKY. However, both SHRSP and WKY fed a 15% PEP diet showed higher ADH and ALDH activity compared with rats fed the 5% PEP diet. These results suggested that the affected factors of preference for alcohol may be correlated with blood ethanol and acetaldehyde levels after alcohol intake.

Dual energy X-ray absorptiometry of the calcaneus: comparison with other techniques to assess bone density and value in predicting risk of spine fracture

OBJECTIVE

The calcaneus has been proposed as an alternative site for assessment of bone mineral density (BMD) in women with osteoporosis. The objectives of this study were to evaluate the clinical usefulness of dual-energy X-ray absorptiometry (DXA) of the calcaneus for predicting spinal fracture and to compare the predictive value of assessment of BMD by DXA of the calcaneus, quantitative CT or DXA of the lumbar spine, and DXA of the most distal part of the radius.

SUBJECTS AND METHODS

The study group consisted of 399 healthy volunteer women (aged 19-81 years) and 27 women (aged 44-85 years) who had osteoporosis. They had DXA of the calcaneus, quantitative CT and DXA of the lumbar spine, and DXA of the most distal part of the radius. T-score analyses were used to compare decreases in BMD in postmenopausal women with decreases in premenopausal women, and to compare decreases in women with and without osteoporosis.

RESULTS

T-score analysis of age-related changes in BMD in the control subjects showed that densities in the calcaneus, the lumbar spine, and the most distal part of the radius decrease significantly with age in postmenopausal women. In women with osteoporosis (n = 27), BMDs in the calcaneus (DXA, p < .0002), L1-L3 (quantitative CT, p < .0001), L1-L4 (DXA, p < .0005), and the most distal part of the radius (DXA, p < .005) were significantly lower than those in healthy control subjects (n = 77). T-score analysis indicated that in women with osteoporosis, DXA of the calcaneus showed BMD losses greater than those shown by DXA of L1-L4 and the most distal part of the radius and similar to those shown by quantitative CT of L1-L3. Receiver-operating characteristic (ROC) analysis showed that findings on DXA of the calcaneus were as good a predictor of the risk of spinal fracture as findings on DXA of the lumbar spine and not as good as findings on quantitative CT of the lumbar spine.

CONCLUSION

The results suggest that DXA assessment of BMD in the calcaneus is not a useful adjunct to other measurements. However, it can be used to predict the risk of fracture when better measures, such as quantitative CT, are unavailable.

Flies in the group Cyclorrhapha use (3S)-3-hydroxyretinal as a unique visual pigment chromophore

In the class Insecta, retinal and 3-hydroxyretinal are used as chromophores of visual pigments, but the absolute structure of the 3-hydroxyretinal chromophore has yet to be clarified. This study investigates the chirality of 3-hydroxyretinal in the compound eyes of five representative orders of insects. In the orders Odonata, Hemiptera, Neuroptera and Lepidoptera, and suborders Nematocera and Brachycera of the Diptera, only (3R)-3-hydroxyretinal isomers were detected, but dipterans of the suborder Cyclorrhapha (higher flies) had the (3S)-11-cis enantiomer and a mixture of (3R)-all-trans and (3S)-all-trans 3-hydroxyretinal enantiomers; the ratio of the (3R) enantiomer to the sum of both enantiomers of the all-trans isomer was in the range 9-32%. Despite differences in feeding habits, including one species that is a butterfly parasite, all higher flies analysed to date share the same pattern of 3-hydroxyretinal enantiomers, making them a unique group with regard to the nature of the visual pigment chromophore.

Chemopreventive effects of beta-carotene, alpha-tocopherol and five naturally occurring antioxidants on initiation of hepatocarcinogenesis by 2-amino-3-methylimidazo[4,5-f]quinoline in the rat

Inhibitory effects of naturally occurring antioxidants on the initiation stage of hepatocarcinogenesis were studied. Group 1 rats were given a diet containing beta-carotene (beta-CT, 0.02%), alpha-tocopherol (alpha-TP, 1.5%), glutathione (GLT, 5%), vanillin (VNL, 1%), quercetin (QCT, 1%) or ellagic acid (ELA, 1%), or 3 doses of diallyl sulfide (DAS, 200 mg/kg, i.g.) over an 8-day period. On day 7, the animals received a single dose of 2-amino-3-methylimidazo[4,5-f] quinoline (IQ, 100 mg/kg, i.g.), 12 h after two-thirds partial hepatectomy for initiation and 2 weeks thereafter, were placed on promotion regimen comprising phenobarbital (0.05% in diet) and a single dose of D-galactosamine (100 mg/kg, i.p.). Groups 2 and 3 were treated as described for Group 1, but without test material or IQ, respectively. Survivors were killed at week 11 and antioxidant influence was assessed by comparing values for preneoplastic glutathione S-transferase placental form-positive (GST-P+) foci between Groups 1 and 2. All lesions larger than 70 microns in diameter consisting of approximately 5 cells in cross section were counted. Numbers of GST-P+ foci/cm2 in Group 1 were: beta-CT, 7.99; alpha-TP, 8.21; GLT, 9.71; DAS, 10.37; VNL, 10.57; QCT, 11.1; ELA, 12.5 (n = 11-15). All, except ELA, showed a significant decrease as compared with the Group 2 value of 14.54 (n = 15). Only beta-CT showed a significant decrease for the area value. This is the first report to show that beta-CT, alpha-TP, GLT, DAS, VNL, QCT exert inhibitory effects on initiation of hepatocarcinogenesis by the food carcinogen IQ, suggesting that these antioxidants might find application as chemopreventive agents. Furthermore, the current protocol proved practical for the assessment of chemopreventive agents within 11 weeks, a relatively short period.

Vitamin D-dependent rickets type II: regulation of human osteocalcin gene expression in cells with defective vitamin D receptors by 1,25-dihydroxyvitamin D-3, retinoic acid, and triiodothyronine

The vitamin D receptor (VDR) is a nuclear transcription factor which binds to the vitamin D response element (VDRE) of the human osteocalcin gene and regulates its expression. Humans with VDR gene mutations, ever among those with the same point mutation in their VDR gene, demonstrate clinical heterogeneity. In addition, in some patients with these mutations, rickets has not recurred following cessation of therapy during follow-up ranging from 6 to 24 years. While important, it is likely that the VDR protein is not the sole factor in the development of rickets. To try to understand these clinical findings, the complex formed between the VDRE and one or more proteins in the nuclear extracts of cultured skin fibroblasts treated with 1,25-dihydroxyvitamin D-3 (1,25(OH)2D3), retinoic acid (RA), and/or triiodothyronine (T3) was investigated since such complexes are likely to precede the transcription of the VDR gene. Complex formation in the control cells with an intact VDR was increased by treatment with either 0.1 nM, 1 nM, 10 nM 1,25(OH)2D3, 100 nM RA, or 100 nM T3; however, combinations of these compounds did not produce an additive effect. In cells of affected patients, 1,25(OH)2D3, RA, or T3 increased complex formation, while no combination had an additive effect. These results indicate that 1,25(OH)2D3, RA, and T3 play a role in the regulation of bone remodeling through modulating the formation of protein complexes on the VDRE. Therefore, the clinical observations in patients with a VDR mutation might be explained at least in part by the overlapping control of osteocalcin expression by 1,25(OH)2D3, RA and T3.

Anti-human immunodeficiency virus type 1 activity of phosphorothioate analogs of oligodeoxynucleotides: penetration and localization of oligodeoxynucleotides in HIV-1-infected MOLT-4 cells

Phosphorothioate antisense oligodeoxynucleotide against HIV-1 rev (S-ODN-rev) inhibits virus-induced cytopathic effects (CPE) in acute infection and inhibits the expression of HIV-1 core protein, p24, in chronically infected cells in vitro. HIV-1 reverse transcriptase activity was not affected by S-ODN-rev at the high concentrations of 5-25 microM, which were 250-1250 times higher than the concentration required to achieve 100% HIV-1-induced CPE inhibition. [32P]-labeled S-ODN-rev was rapidly uptaken by MOLT-4 cells, whereas [32P]-SO-ODN-rev and [32P]-O-ODN-rev were not. In the observation of FITC-S-ODN-rev-treated MOLT-4 cells by a confocal laser scanning microscope, diffuse fluorescence was apparently observed in the cytoplasm. Interestingly, fluorescence signals were accumulated in the nuclear region of chronically infected MOLT-4/HIV-1 cells 60 min after incubation. FITC-labeled homooligomer, FITC-S-dC20 and FIT-C-S-dT20, also accumulated in the nucleus of MOLT-4/HIV-1 cells, but weak fluorescence was observed on the cell membrane and in the cytoplasm of the FITC-S-random treated MOLT-4/HIV-1 and MOLT-4 cells.

[Five cases of phosphorylase b kinase deficiency affecting muscle or liver: clinical symptoms and diagnosis]

Muscle, erythrocyte and/or leukocyte phosphorylase b kinase (PBK) activities were measured in 5 patients and in 2 families. The relation between phenotype and enzyme deficiency in clinically variable samples based on measurement of erythrocytes, leukocytes or muscle was described. Three patients showed the enzyme deficiency in liver and the disease was transmitted as an X-linked recessive trait. In these cases, our results suggested that carrier detection was more reliable with erythrocytes than leukocytes. Two patients showed enzyme deficiency in muscle, and the mode of inheritance was not clear. In these cases, muscle biopsies were necessary for diagnosis.

Prevention of preeclampsia with calcium supplementation and vitamin D3 in an antenatal protocol

OBJECTIVES

Using an angiotensin sensitivity test we carried out a prospective study in an attempt to predict the possible onset of preeclampsia and to prevent it by calcium supplementation (elemental calcium 156 or 312 mg/day per os) and treatment with vitamin D3 (0.5 micrograms/3 day per os).

METHOD

We used a study design in which 666 singleton pregnant women were managed with conventional antenatal care and 210 singleton pregnant women were managed with a protocol, together with conventional antenatal care.

RESULT

Of the 666 women managed conventionally, 113 (16.9%) developed preeclampsia. However, the incidence of preeclampsia in the 210 women managed on the protocol was lower, at 10.9%.

CONCLUSION

Our findings indicate that this protocol for the prediction and prevention of preeclampsia is useful for pregnant women at high risk of developing preeclampsia.

Humoral and cellular immunity to an encoded protein induced by direct DNA injection

An immunization procedure with naked DNA that generates both humoral and cellular immune responses is described. A mammalian expression vector encoding human factor IX as an example of immunogen was injected into mice three times at 10-day intervals. Three of the 4 mice in which the DNA was injected intramuscularly and 5 of the 9 mice injected subcutaneously produced antibodies to human factor IX. Spleen cells from inoculated mice also showed significant cytotoxic T lymphocyte response to target cells expressing human factor IX. The titers of anti-single-stranded (ss)DNA antibodies were significantly higher in the subsets of genetically inoculated mice than in the control mice, but anti-double-stranded (ds)DNA antibodies were not detected in any serum samples. Thus, intramuscular and subcutaneous injection of plasmid DNA can induce immune responses against the encoded protein without an exposure to virus particles, and this approach may serve as the basis for immunotherapy in the treatment of cancer and infectious diseases in humans.

Contribution of ED-1- and CD-8-positive cells to the development of crescentic-type anti-GBM nephritis in rats

The current studies were designed to identify which mononuclear leukocytes have an important role in the development of glomerular injury using rats with original-type (mild injury) and crescentic-type (severe injury) anti-glomerular basement membrane (GBM) nephritis. 1) Proteinuria was persistent in crescentic-type anti-GBM nephritis compared with original-type anti-GBM nephritis. Macrophages/monocytes (ED-1), cytotoxic/suppressor T cells (CD-8), interleukin-2-receptor (CD-25)-positive cells and Ia-positive cells accumulated remarkably and persisted for longer in crescentic-type nephritic glomeruli. 2) We then performed investigations using immunosuppressants. Cyclosporin A abrogated proteinuria more effectively than azathioprine in crescentic-type nephritis. However, plasma antibody titer and glomerular rat IgG deposition were equally reduced by both azathioprine and cyclosporin A. The increase in the numbers of ED-1-, CD-8- and CD-25-positive cells in nephritic glomeruli was completely inhibited by cyclosporin A, but inhibited only slightly by azathioprine. 3) There was a correlation between the degree of proteinuria and the number of ED-1- and CD-8-positive cells. It is likely that these cells are leukocytes that lead to glomerular injury in nephritis. 4) In additional experiments using monoclonal antibodies against macrophages/monocytes and cytotoxic/suppressor T cells, urinary protein excretion and accumulation of these cells were blunted in nephritic rats treated with these antibodies. These results suggest that ED-1- and CD-8-positive cells are involved in the development of crescentic-type anti-GBM nephritis.

Spatiotemporal distribution of protein kinase and phosphatase activities

Reversible protein phosphorylation plays an essential role in controlling cellular functions. Accumulating evidence indicates that the subcellular distribution of protein kinase and phosphatase activities is organized dynamically. The spatiotemporal dynamics of kinase and phosphatase activities appears to account for the elaborate coordination of the cellular functions achieved by protein phosphorylation and dephosphorylation.

[A resected case of sporadic myxoma of the right ventricle: the diagnosis was supported with DNA flow cytometry]

We report a rare case of a 16-year-old male who had myxoma originating from septal band of the right ventricle. His ECG anomaly was found incidentally upon a physical examination. Subsequently, echocardiography and angiocardiography demonstrated a tumor occupying the right ventricular outflow tract and protruding into the main pulmonary artery in systolic phase. He was operated upon using extracorporeal circulation. By right ventriculotomy the tumor was resected together with septal tissue 5 mm around the stalk, which branched into the myocardium. The defect was closed using mattress sutures with Dacron felt strips. We also analyzed the DNA content of the tumor. The DNA flow cytometry yielded a single cell population with diploid DNA content. This result showed that the tumor is sporadic form of cardiac myxoma. His postoperative course was uneventful. Thirty months after the surgery, patient has no sign of recurrence. The DNA flow cytometry is helpful for detecting clinical behavior of the cardiac myxoma, because microscopic examination can not readily distinguish sporadic myxoma from so-called complex myxoma.