Demographics and outcome of elective cerclage in a multi-ethnic London district general hospital

Elective cerclage is a rare procedure, but is reported to be relatively more common in developing countries. This variation in rate may be reflected in a multi-ethnic population as seen in London. Our study analysed the epidemiology and rate of elective cerclage performed in a London district general hospital. Factors contributing to the outcome of the procedures were also reviewed. A total of 41 elective cerclages were performed in the hospital between 2000 and 2007. Data from these were collected retrospectively, including maternal history, operative details, and gestational age at delivery. Fisher's exact test was used for statistical analysis. Of the 41 cases, 19 pregnancies were carried to term (>or=37 weeks' gestation), nine were pre-term (24-36 weeks' gestation) and seven miscarried (<24 weeks' gestation); six cases had not yet delivered. All of the patients were immigrants from developing countries but ethnicity did not affect the operative outcome (p = 0.89, Fisher's exact). The other factors studied were also noted to have no significant impact on success. These included cervical length at insertion (p = 1.00, Fisher's exact), type of suture (p = 0.90, Fisher's exact) and average gestation at insertion (p = 0.20, Fisher's exact). In conclusion, all patients requiring intervention in this study originated from developing countries. This is a disproportionately high figure relative to the demographic breakdown of the study population. Such a finding may be due to geographical variation of risk factors for cervical incompetence but may also be influenced by observer bias. Additional studies are needed to further investigate the influence of ethnicity on the rate of elective cerclage. None of the variables analysed in this study significantly affected the outcome of the procedure.

Flavin-protein interactions in flavocytochrome b2 as studied by NMR after reconstitution of the enzyme with 13C- and 15N-labelled flavin

A new procedure was devised for reversibly removing the flavin from flavocytochrome b2. It allowed reconstitution with selectively enriched 13C- and 15N-labelled FMN for an NMR analysis of the chemical shifts of the enriched positions as well as that of 31P. From these measurements, it was possible to deduce information about the hydrogen-bonding pattern of FMN in the protein, the hybridization states of the nitrogen atoms and (in part) the pi-electron distribution. The carbonyl groups at C(2) and C(4) and the nitrogen atoms N(1) and N(5) form hydrogen bonds to the apoenzyme in both redox states. Nevertheless, according to 15N-chemical shifts, the bond from the protein to N(3) is very weak in both redox states, whereas that to N(5) is strong for the oxidized state, and is weakened upon flavin reduction. On the other hand, the 13C-NMR results indicate that the C(2) and C(4) carbonyl oxygens form stronger hydrogen bonds with the enzyme than most other flavoproteins in both redox states. From coupling constant measurements it is shown that the N(3) proton is not solvent accessible. Although no N-H coupling constant could be measured for N(5) in the reduced state due to lack of resolution, N(5) is clearly protonated in flavocytochrome b2 as in all other known flavoproteins. With respect to N(10), it is more sp3-hybridized in the oxidized state than in free FMN, whereas the other nitrogen atoms show a nearly planar structure. In the reduced state, N(5) and N(10) in bound FMN are both more sp3-hybridized than in free FMN, but N(5) exhibits a higher degree of sp3-hybridization than N(10), which is only slightly shifted out of the isoalloxazine plane. In addition, two-electron reduction of the enzyme leads to anion formation on N(1), as indicated by its 15N-chemical shift of N(1) and characteristic upfield shifts of the resonances of C(2), C(4) and C(4a) compared to the oxidized state, as observed for most flavoproteins. 31P-NMR measurements show that the phosphate geometry has changed in enzyme bound FMN compared to the free flavin in water, indicating a strong interaction of the phosphate group with the apoenzyme.

Short-term efficacy and long-term outcome of cyclosporine treatment in patients with severe ulcerative colitis

Cyclosporine A (CyA) has been recommended for the treatment of severe steroid-resistant ulcerative colitis, however, long-term results are scarce. We prospectively followed a treatment plan in 14 patients with severe ulcerative colitis receiving intravenous CyA after failure to respond to at least eight days of standard therapy with prednisolone (1-1.5 mg/kg/day). CyA was delivered in a daily dose of 5 mg/kg i.v. for a mean of 14 days (range 7-28) in addition to ongoing medical therapy. CyA whole blood levels were monitored by HPLC and maintained between 100 ng/ml and 400 ng/ml. Responders were switched to oral CyA (5-7.5 mg/kg/day) for a mean of two months, and steroids were gradually tapered. Eleven patients (79%) initially responded to i.v. CyA, three patients failed to respond and underwent urgent colectomy. Time until response averaged seven days (range 3-13). Four of the eleven responders underwent colectomy because of severe relapse after one, eleven, twelve and 13 months of follow-up. The remaining seven patients were followed for a median of 48 months. During the first year of follow-up three out of seven had a severe relapse and responded to steroids (two patients) or to a further course of i.v. CyA (one patient). During CyA therapy one patient developed staphylococcal sepsis, other adverse events were mild and reversible. The results confirm that CyA is effective in severe steroid-refractory ulcerative colitis. Severe relapse and colectomy are uncommon after the first year of follow-up and the colon preserving effect of CyA can be maintained in up to 50% of patients over a period of four years.

Spiral CT evaluation of deep venous thrombosis

Spiral CT venography is a technical innovation in vascular imaging that can optimize vessel contrast in the deep venous system and, therefore, is an accurate diagnostic tool to detect deep venous thrombosis. Compared with conventional venography, the amount of contrast material can be reduced by 80%. While using spiral CT as the primary imaging technique for the detection of pulmonary embolism, the cause of embolism can be evaluated within a short period of additional imaging time without further patient mobilization. This review outlines fundamental techniques in spiral CT venography and summarizes our clinical experience at Vienna University Medical Center.

Genistein, a dietary-derived inhibitor of in vitro angiogenesis

Consumption of a plant-based diet can prevent the development and progression of chronic diseases that are associated with extensive neovascularization; however, little is known about the mechanisms. To determine whether prevention might be associated with dietary-derived angiogenesis inhibitors, we have fractionated urine of healthy human subjects consuming a plant-based diet and examined the fractions for their abilities to inhibit the proliferation of vascular endothelial cells. Using gas chromatography-mass spectrometry, we showed that one of the most potent fractions contained several isoflavonoids, which we subsequently synthesized. Of all synthetic compounds, the isoflavonoid genistein was the most potent and inhibited endothelial cell proliferation and in vitro angiogenesis at concentrations giving half-maximal inhibition of 5 and 150 microM, respectively. As we have previously demonstrated, genistein concentrations in urine of subjects consuming a plant-based diet are in the micromolar range, while those of subjects consuming a traditional Western diet are lower by a factor of > 30. The high excretion of genistein in urine of vegetarians and our present results suggest that genistein may contribute to the preventive effect of a plant-based diet on chronic diseases, including solid tumors, by inhibiting neovascularization. Thus, genistein may represent a member of a new class of dietary-derived anti-angiogenic compounds.

Identification in human urine of a natural growth inhibitor for cells derived from solid paediatric tumours

Partially purified urine of healthy human subjects contains several fractions able to inhibit the proliferation of cultured human neuroblastoma cells. One of the most active fractions was further analysed by gas chromatography-mass spectrometry and shown to contain genistein, a substance formed in the human body from precursors obtained by diet. Synthetic genistein was able to inhibit the proliferation of human neuroblastoma cells with a half-maximal effect at 5-10 mumol l-1 concentrations. Genistein displayed similar potencies in inhibiting the proliferation of cells derived from various other solid pediatric tumours. Our results suggest that genistein is a natural antineoplastic agent present in diet and that it could be useful for the therapy of paediatric tumours.

Enhanced MYCN oncogene expression in human neuroblastoma cells is associated with altered FGF receptor expression and cellular growth response to basic FGF

We have examined the effect of human basic fibroblast growth factor (bFGF) on the proliferation of human neuroblastoma cells with normal and enhanced MYCN oncogene expression. bFGF stimulated the proliferation of the neuroblastoma cells with enhanced, but not normal, MYCN expression. Both cell species express FGFR-1, but not FGFR-2, receptors and both harbor FGF receptor species of Mr 145.000, but they differ in their pattern of lower and higher-molecular weight FGF receptor species. Our results demonstrate that enhanced MYCN expression confers to neuroblastoma cells the ability to respond to bFGF, possibly by inducing functional FGF receptors. This mechanism may contribute to the advanced malignant phenotype of human neuroblastomas with enhanced MYCN expression.

Isolation and distribution of a Drosophila protein preferentially associated with active regions of the genome

A non-histone chromosomal protein of Mr = 75,000 was isolated from Drosophila embryos. The distribution pattern of this protein was determined by indirect immunofluorescence on salivary gland chromosomes of Drosophila melanogaster third instar larvae and compared with the distribution pattern of RNA polymerase II. Despite its preferential association with transcriptionally active regions of the chromosomes there was in many cases an almost inverse correlation with the RNA polymerase II content of a given locus. We postulate a function of the Mr = 75,000 protein in posttranscriptional regulation of gene expression by storing the newly synthesized RNA.

Isolation and distribution of a Drosophila protein preferentially associated with inactive regions of the genome

The distribution patterns of chromosomal proteins from Drosophila can be observed by immunofluorescent staining of the polytene chromosomes from larval salivary glands. We have purified a non-histone chromosomal protein of Mr = 69,000 molecular weight which has a high affinity for DNA with little sequence specificity. Immunofluorescent staining indicates that this protein is preferentially associated with the inactive portions of the genome, including the centric heterochromatin and the condensed bands within the euchromatic arms of the chromosomes. Observation of both the heat shock loci 87A and 87C and the developmentally regulated loci 74EF and 75B shows an inverse correlation between immunofluorescent staining for the Mr = 69,000 protein and for RNA polymerase. The presence of this protein appears to be correlated with the packaging of the chromatin in an inactive form.

Isolation, resolution and partial characterization of two Robinia pseudoacacia seed lectins

Two lectins from the seeds of Robinia pseudoacacia were isolated and resolved in a single affinity chromatography run using immobilized ovomucoid by successive elution with different buffers. The lectins were characterized by their subunit sizes, total molecular masses and isoelectric points as well as by their ability to bind to ConA-Sepharose and to stimulate mitosis in murine lymphocytes.

Interactions between lectins and other components of leguminous protein bodies

Previous work from this laboratory had shown that Leguminosa seed extracts contain lectin-bound proteins. In the present paper, the isolation of protein bodies from the seeds of 7 Leguminosa species (Canavalia ensiformis, Lens culinaris, Pisum sativum, Glycine max, Sophora japonica, Wisteria floribunda and Phaseolus vulgaris) is described. Protein bodies were characterized microscopically and by their constituents, storage proteins, lectins and some glycosidases. From the protein bodies, lectin-bound proteins were isolated and were shown to be identical with those from whole seed extracts. This indicates a common localization of lectin-bound proteins and of lectins. Lectin-bound proteins belong to the storage proteins and to the proteins with glycosidase activity. The common localization of these proteins and interactions between them suggest a biological role of seed lectins: during maturation they may act as a packaging aid for storage proteins and enzymes into developing protein bodies. Lectins thus may contribute to an ordered construction and degradation of protein bodies.

Affinity chromatography on immobilized hog gastric mucin and ovomucoid. A general method for isolation of lectins

Two affinity adsorbents of general applicability for isolating of plant lectins are presented. The isolation of 30 lectins from 27 plants is described. The method works quickly and is inexpensive. In particular, mixtures of different lectins occurring in some plants may be resolved in one run.

A one-step procedure for isolation and resolution of the Phaseolus vulgaris isolectins by affinity chromatography

A new fast-working one-step method for the resolution of the Phaseolus vulgaris isolectins is described which requires inexpensive materials.

[Diagnosis and therapy of laryngeal sarcoidosis]

The larynx may be involved in patients with systemic sarcoidosis or may be the first or only manifestation of the disease. The symptoms depend on the degree of involvement of the larynx, and include a sensation of lump in the throat, dysphagia, hoarseness, cough, stridor and dyspnea. The supraglottis is the most frequently affected area. There are pale pink, edematous, diffuse hypertrophy of the supraglottic structures or granular areas of the glottic and subglottic region. The diagnosis is made by the characteristic appearance of the larynx, histologic and laboratory findings and exclusion of other granulomatous diseases. Laryngeal sarcoidosis may cause life-threatening upper airway obstruction. Systemic corticosteroid therapy is the treatment of choice in most cases, but surgical excision or local steroid injections are useful in selected cases.

Drosophila DNA topoisomerase I is associated with transcriptionally active regions of the genome

The distribution of DNA topoisomerase I within Drosophila polytene chromosomes was observed by immunofluorescent staining with affinity-purified antibodies. The enzyme is preferentially associated with active loci, as shown by prominent staining of puffs. The heat shock loci 87A-87C are stained after, but not before, heat shock induction. A detailed comparison of the distribution of topoisomerase I with that of RNA polymerase II reveals a similar, although not identical, pattern of association. Topoisomerase I is also found in association with the nucleolus, the site of transcription by RNA polymerase I.

Photoaffinity labeling of steroid binding proteins with unmodified ligands

Photoactivation of the alpha,beta-unsaturated ketones of natural and synthetic steroid molecules by light of lambda greater than or equal to 330 nm allows their covalent attachment to steroid-binding proteins. The general validity of this method is demonstrated with two steroid hormone receptors and the steroid-binding protein uteroglobin. Progesterone can be covalently attached to the partially purified progesterone receptor and to uteroglobin, and comigrates with the binding proteins upon electrophoresis in polyacrylamide gels containing sodium dodecyl sulfate. Similarly the synthetic glucocorticoid triamcinolone acetonide can be covalently bound to the partially purified glucocorticoid of rat liver. This method allows the identification of steroid hormone receptors after electrophoresis in polyacrylamide gels containing sodium dodecyl sulfate. Labeling with radioactive steroids is specific since it can be prevented by the addition of an excess of non-radioactive ligand. Digestion of the labeled binding proteins with trypsin or chymotrypsin yields a defined pattern of radioactive peptides, demonstrating that covalent attachment takes place at specific binding sites.

Activation of the progesterone receptor of rabbit uterus

The influence of several parameters on the kinetics of activation of the progesterone receptor in the cytosol of rabbit uterus is described. The estimation of the proportion of activated receptor is based on the differential affinity of the activated and non-activated forms of the receptor for phosphocellulose. Under appropriate conditions binding to phosphocellulose can be used as a test of activation and gives results similar to those obtained with DNA--cellulose, or isolated cell nuclei. The kinetics of receptor activation is temperature-dependent and compatible with a first-order reaction at all temperatures tested. The thermodynamic activation energy of this reaction is 67.8 kcal mol-1. The progesterone receptor can be activated to various extents by increased ionic strength or by dilution of the cytosol with buffers of low ionic strength, and in all cases the activation follows apparent first order kinetics. At a concentration of 0.4 M NaCl, 70--80% of the receptor can be converted into the activated form. The activated and non-activated forms of the receptor appear to be in equilibrium. Salt-activated and heat-activated receptor can be transformed to a non-activated form by decreasing either the salt concentration, or the temperature of incubation. The rate of dissociation of the steroid from the activated form of the receptor is indistinguishable from that observed with the non-activated form, but the activated receptor is more thermolabile. Upon centrifugation on sucrose gradients there are no major differences in the sedimentation behaviour of the two forms of the receptor.

Effect of phospholipases and lysophosphatides on partially purified steroid hormone receptors

Treatment with phospholipase A2 of crude or partially purified preparations of the glucocorticoid receptor of rat liver results in an inactivation of the receptor, which cannot be attributed to contaminating proteases. Similar enzymatic treatment of the progesterone receptor of rabbit uterus does not affect its steroid-binding activity. At various stages during purification the preparations of glucocorticoid receptor contain 10 to 50-fold higher concentrations of lipid phosphate than the corresponding preparations of progesterone receptor, suggesting that the effect of phospholipase A2 on the hepatic receptor could be mediated by lysophosphatides produced during hydrolysis of endogeneous phospholipids. In fact, mixing experiments show that in the presence of the glucocorticoid receptor, phospholipase A2 also inactivated the progesterone receptor. Both partially purified receptors are inactivated by similar concentrations of added lysophosphatides but are not affected by incubation with phospholipase C, which does not produce ionic detergents. In addition, the effects of phospholipase A2 and of added lysophosphatides can be overcome by an excess of bovine serum albumin, indicating that free lysophosphatides are involved in receptor inactivation, possibly due to their strong detergent properties.

Notes on the habitat and distribution of Avena species in the Mediterranean and Middle East

Brief descriptions of the habitats and distributions of Avena species in the Mediterranean and Near East areas are given. These are based on observations made by the authors in three expeditions undertaken during the last decade.Avena pilosa, at its highest distributional density, is a primary component of the Quercus brantii climax area. The main concentration of A. clauda is in the Pistacia–Amygdalus steppe forest which is usually adjacent to the former species. Avena clauda is also a weed in some places in Iran. Both A. pilosa and A. clauda form large populations in Turkish and Iraqui Kurdistan and Iran but small and scattered populations in the Mediterranean region. Avena ventricosa is a rare and scattered species; it is probably of a relic nature and is found only in undisturbed habitats. Avena longiglumis is primarily a Mediterranean species and prefers light or sandy soil. The aggregate A. hirtula–wiestii is Arabo–Nubian–Mediterranean, and forms dense colonies. Avena barbata is Mediterranean – West Irano – Turanian and it is a common weed in all of the Mediterranean area. Avena sterilis is the most common species, and is also the most aggressive weed among oat species from Afghanistan to the Atlantic coast. Avena sterilis is a component of many East Mediterranean – West Irano – Turanian associations with oaks, or shrubs such as Poterietum spinosum. Avena fatua is rare in the areas explored by the authors, but it did occur as a weed of cultivation in areas under strong steppical or continental conditions, such as in northwestern Iran or eastern Turkey. Avena sativa–byzantina aggr. is a weed of cereals in the Mediterranean area, and it is grown as a cereal in northwestern Turkey and northwestern Iran.

INHERITANCE OF CROWN RUST RESISTANCE GENES IN AVENA STERILIS COLLECTIONS FROM ISRAEL, PORTUGAL, AND TUNISIA

The inheritance of genes in three collections of Avena sterilis wild oats conferring resistance to races 216, 264, 295, 305, 326, 330, 332, and 446 of crown rust, Puccinia coronata avenae, was investigated. C. I. 8081 from Portugal contained a partially dominant gene, designated Pc47, which conferred resistance to all eight races. CW486 from Tunisia had a dominant gene, designated Pc50, which gave resistance to all races except 295, 326, and 446. F158 from Israel had two dominant genes; one, designated Pc48, conferred resistance to all the races but 305, while the second, designated Pc49, conferred resistance to races 216, 326, 330, 332, and 446. Genes Pc47, Pc48, Pc49, and Pc50 were inherited independently of each other and of those genes previously isolated from A. sterilis.

Studies on asexual variation in the virulence of oat crown rust, Puccinia coronata f. sp. avenae, and wheat leaf rust, Puccinia recondita

This study was conducted to determine the nature and extent of variation in cereal leaf rusts. Two different races of oat crown rust, Puccinia coronata f. sp. avenae, were recovered from a mixture of single-spored cultures of races 228 and 393. A further subculturing yielded nine non-parental virulence combinations, which could have resulted from somatic recombination.Single-spore isolates of race 228, avirulent on the oat variety Saia were increased, and screened on Saia. Eighty-seven susceptible infections were obtained from a total of nearly 40 000 infections. This variation could result from a high mutation rate.A unique form of variation was observed when Saia-virulent isolates of race 229 were subcultured. Approximately half the subcultures were virulent and half were avirulent on Saia. Further isolations from the avirulent subcultures were all avirulent. Serial propagation of race 229 continued to give cultures virulent and avirulent on Saia. A stable culture of race 229 virulent on Saia was not obtained. Cytological examination of this race 229 culture showed that most of the spores were dikaryotic. Aneuploidy or cytoplasmic inheritance might account for this variability on Saia.Uredial isolates of wheat leaf rust, Puccinia recondita, differing in virulence and color were also studied for the possible occurrence of recombinants. No recombinants were found in six mixtures, each consisting of two different uredial isolates.

Taxonomic significance of protein patterns of rust species and formae speciales obtained by disc electrophoresis

Soluble uredospore proteins were isolated from physiologic races or isolates of Puccinia graminis f. sp. avenae, P. graminis f. sp. secalis, P. graminis f. sp. tritici, P. recondita f. sp. secalis, P. recondita f. sp. tritici, P. coronata f. sp. avenae, and P. hordei. The protein extracts were subjected to polyacrylamide gel (disc) electrophoresis and the resulting patterns were compared.Patterns were assessed by two methods based on Ef values and by a third method based on subjective assessment of color intensity of stained proteins. Assessments based on Ef values differed for each method and were in almost total disagreement with conclusions derived by the third method.No useful inter-subspecific and interspecific comparisons were possible using Ef-based data because the host on which the rust was grown influenced the patterns. Evidence obtained by the third method of assessment contradicted this conclusion, for the host only appeared to influence color intensity and width of individual bands. Thus, using the color intensity method it was found that the differences between species were greater than between formae speciales, and the latter, with one exception, differed more than physiologic races. Differentiation between most physiologic races or isolates was impossible.The taxonomic significance of the protein patterns is discussed.

THE INHERITANCE OF RESISTANCE TO STEM AND CROWN RUST IN KYTO OATS

The oat variety Kyto possesses a recessive gene, designated pg-12, which confers seedling resistance to all nine races of oat stem rust tested. This gene is inherited independently of the Pg-2, Pg-4 and pg-9 loci for seedling stem rust resistance. Kyto also possesses a dominant gene, Pc-44, for resistance to crown rust of oats. Gene Pc-44 is inherited independently of the Pg-2, Pg-4 and pg-12 loci but is associated with the pg-9 locus. Resistance conferred by genes pg-12 and Pc-44 is not expressed at constant temperatures of 25°C and above.

AN ASSOCIATION OF STEM RUST AND CROWN RUST RESISTANCE IN JOSTRAIN OATS

Rodney backcross lines carrying single genes for stem rust resistance were tested with 10 cultures of crown rust. Lines possessing genes Pg-1, Pg-2, Pg-4 and pg-8 were susceptible to all cultures of crown rust used, whereas the line carrying Pg-3 was highly resistant to several of these cultures. Studies of 51 Victory2 x Jostrain F2 backcross families indicate that gene Pg-3 confers a moderate level of resistance to stem rust. In addition to Pg-3 a number of modifying genes appear to be required to explain the high level of stem rust resistance in Jostrain.Either one gene, Pg-3, or two closely linked genes in the Victory2 x Jostrain backcross families, confer resistance to both stem rust and crown rust. Resistance to both rusts broke down at temperatures of 25 °C and above suggesting that Pg-3 alone is responsible for resistance to both rusts.