Malaria parasite clag3 genes determine channel-mediated nutrient uptake by infected red blood cells

Development of malaria parasites within vertebrate erythrocytes requires nutrient uptake at the host cell membrane. The plasmodial surface anion channel (PSAC) mediates this transport and is an antimalarial target, but its molecular basis is unknown. We report a parasite gene family responsible for PSAC activity. We used high-throughput screening for nutrient uptake inhibitors to identify a compound highly specific for channels from the Dd2 line of the human pathogen P. falciparum. Inheritance of this compound's affinity in a Dd2 × HB3 genetic cross maps to a single parasite locus on chromosome 3. DNA transfection and in vitro selections indicate that PSAC-inhibitor interactions are encoded by two clag3 genes previously assumed to function in cytoadherence. These genes are conserved in plasmodia, exhibit expression switching, and encode an integral protein on the host membrane, as predicted by functional studies. This protein increases host cell permeability to diverse solutes.

The consequences of punching glass

We carried out a retrospective and prospective study of 67 patients who had sustained hand injuries from punching glass over a period of 33 months. All had consumed alcohol and had argued with a partner. The mean age was 25 years, 90% were male and 56% were unemployed. Seventy per cent of injuries occurred between 23.00 and 04.00 hours. Total damage included division of 149 tendons, 33 nerves and nine arteries. Fifty-two per cent of patients required admission for more than 1 day. The mean number of follow-up visits was 3.6 and the majority needed hand therapy and occupational therapy services. Cost per injury was estimated as 1,120 pounds. Such injuries cause major disability in an already disadvantaged section of society. The challenge is to educate the susceptible patient group.

Isolated coronal urethral duplication in an adolescent presenting with enuresis

This report describes an isolated urethral duplication in the coronal plane in a child referred with primary 'enuresis'. This presentation is unique because duplications usually occur in the sagittal plane. In patients with suspected urethral duplication, magnetic resonance imaging in conjunction with catheterisation of the distal duplicate opening accurately delineates the abnormality, so that individualised treatment strategies can be considered.