Liver transplantation for pediatric metabolic disease

Liver transplantation (LTx) was initially developed as a therapy for liver diseases known to be associated with a high risk of near-term mortality but is based upon a different set of paradigms for inborn metabolic diseases. As overall outcomes for the procedure have improved, LTx has evolved into an attractive approach for a growing number of metabolic diseases in a variety of clinical situations. No longer simply life-saving, the procedure can lead to a better quality of life even if not all symptoms of the primary disorder are eliminated. Juggling the risk-benefit ratio thus has become more complicated as the list of potential disorders amenable to treatment with LTx has increased. This review summarizes presentations from a recent conference on metabolic liver transplantation held at the Children's Hospital of Pittsburgh of UPMC on the role of liver or hepatocyte transplantation in the treatment of metabolic liver disease.

Acute noncrescentic poststreptococcal glomerulonephritis presenting with pulmonary hemorrhage

We report a child with acute poststreptococcal noncrescentic glomerulonephritis and pulmonary hemorrhage. This patient demonstrates that: (1) poststreptococcal noncrescentic glomerulonephritis in children can be associated with pulmonary hemorrhage, (2) an expeditious renal biopsy in patients with acute or rapidly progressive glomerulonephritis and pulmonary hemorrhage can establish an early diagnosis and provide timely guidance for treatment, and (3) although not proven by controlled studies, the intravenous administration of methylprednisolone in our patient may have been effective in the treatment of pulmonary hemorrhage.

Bar codes and the clinical laboratory: adaptation perspectives

This paper provides an overview of the functional capabilities of bar-code technology within the laboratory environment and assesses the problems and solutions encountered during its introduction in our laboratory. An idea of the potential costs and personnel savings is offered, demonstrating that we have saved an entire full-time equivalent (FTE) medical technologist in clinical chemistry with an associated improvement in the accuracy of patient identification and a marked improvement in turnaround time for both chemistry and hematology routine procedures. We have estimated the savings of two FTE medical technologists while improving service and accuracy. Hardware costs should be recovered in 2 years.

Purification and properties of the major nuclease from mitochondria of Saccharomyces cerevisiae

The vast majority of nuclease activity in yeast mitochondria is due to a single polypeptide with an apparent molecular weight of 38,000. The enzyme is located in the mitochondrial inner membrane and requires non-ionic detergents for solubilization and activity. A combination of heparin-agarose and Cibacron blue-agarose chromatography was employed to purify the nuclease to approximately 90% homogeneity. The purified enzyme shows multiple activities: 1) RNase activity on single-stranded, but not double-stranded RNA, 2) endonuclease activity on single- and double-stranded DNA, and 3) a 5'-exonuclease activity on double-stranded DNA. Digestion products with DNA contain 5'-phosphorylated termini. Antibody raised against an analogous enzyme purified from Neurospora crassa (Chow, T. Y. K., and Fraser, M. (1983) J. Biol. Chem. 258, 12010-12018) inhibits and immunoprecipitates the yeast enzyme. This antibody inhibits 90-95% of all nuclease activity present in solubilized mitochondria, indicating that the purified nuclease accounts for the bulk of mitochondrial nucleolytic activity. Analysis of a mutant strain in which the gene for the nuclease has been disrupted supports this conclusion and shows that all detectable DNase activity and most nonspecific RNase activity in the mitochondria is due to this single enzyme.

Garlic burns: a naturopathic remedy gone awry

We report the case of a child who sustained partial thickness burns from a garlic-petroleum jelly plaster, which had been applied at the direction of a naturopathic physician. A review of the literature reveals that "garlic burns" have not previously been reported, although medicinal properties of garlic have been investigated by physicians and biochemists. The pediatrician caring for children in an area where naturopathic medicine is routinely practiced should be aware of the potential side effects of plasters, poultices, and other "natural" remedies in children.

Epinephrine accumulation in rat brain after chronic administration of pargyline and LY 51641--comparison with other brain amines

Concentrations of biogenic amines and metabolites were measured in regions of rat brain following administration of monoamine oxidase (MAO) inhibitors for 21 days. Epinephrine concentrations were increased from 350 to 500% following chronic administration of LY 51641, a selective inhibitor of MAO type A. Norepinephrine, dopamine and serotonin showed much less relative accumulation. The marked relative accumulation of epinephrine may be related to the efficacy of inhibitors of MAO type A in the treatment of depression.

Transfer-deficient cointegrates of Flac and lambda prophage

Twelve transfer-deficient mutants of the plasmid Flac were obtained by insertion of prophage lambda into secondary attachment sites within the transfer region. Insertions into eight different tra genes were identified. These mutations were strongly polar on expression of tra genes previously mapped "downstream", and thus confirmed that the genes traA through traD form a single operon. However, some continued expression of traI suggested that this was transcribed in part from a promoter located between traD and traI, and in part from the transfer operon promoter. One insertion early in the transfer operon produced a plasmid-specific tra mutation not complemented by R100-1 or R1-19: this insertion was into a new gene (traY), located before traA as the first member of the transfer operon. Partial tra deletion mutants were obtained as 42 degrees C--survivors from several of the Flac tra::ED lambda 4 plasmids, and their properties are described.

Plasmid cointegrates of Flac and lambda prophage

Fifteen cointegrates of the plasmid Flac and prophage lambda that had suffered no detectable change in plasmid phenotype were isolated and characterized. The locations of the prophage insertions were determined by genetic analysis of deletion mutants obtained from each cointegrate as survivors of growth at 42 degrees C. In 11 cointegrates, the prophage was inserted between traI and lac, although probably in more than one location; in 3 others, it was on one side or the other of lac; and in 1 it was between lac and pif. Deletions covering all or part of the transfer region, as well as of lac and of pif, were obtained in the course of this analysis. Deletion mutants that had lost all known transfer genes were also oriT, but they retained the capacity to recircularize after transfer. Attempts were made to isolate lambda transducing phages for nearby plasmid genes from the cointegrates, and lambdaptraGD, lambdaptraD, lambdaptraI, and lambdadtraDI phages were obtained.

The genetic locations of traO, finP and tra-4 on the E. coli K12 sex factor F

Using a series of Hfr and F prime deletion strains, the F transfer inhibition genefinPhas been mapped betweenoriandtraJ. Marker rescue experiments with the Hfr deletion strains further showed thattraO, the site of action of the transfer inhibitor, is located immediately to the left of, or possibly within,traJ, and that the polar mutationtra-4lies intraK.