Identification and characterization of the first mutation (Arg776Cys) in the C-terminal domain of the Human Molybdenum Cofactor Sulfurase (HMCS) associated with type II classical xanthinuria

Classical xanthinuria type II is an autosomal recessive disorder characterized by deficiency of xanthine dehydrogenase and aldehyde oxidase activities due to lack of a common sulfido-olybdenum cofactor (MoCo). Two mutations, both in the N-terminal domain of the Human Molybdenum Cofactor Sulfurase (HMCS), were reported in patients with type II xanthinuria. Whereas the N-terminal domain of HMCS was demonstrated to have cysteine desulfurase activity, the C-terminal domain hypothetically transfers the sulfur to the MoCo. We describe the first mutation in the C-terminal domain of HMCS identified in a Bedouin-Arab child presenting with urolithiasis and in an asymptomatic Jewish female. Patients were diagnosed with type II xanthinuria by homozygosity mapping and/or allopurinol loading test. The Bedouin-Arab child was homozygous for a c.2326C>T (p.Arg776Cys) mutation, while the female patient was compound heterozygous for this and a novel c.1034insA (p.Gln347fsStop379) mutation in the N-terminal domain of HMCS. Cosegregation of the homozygous mutant genotype with hypouricemia and hypouricosuria was demonstrated in the Bedouin family. Haplotype analysis indicated that p.Arg776Cys is a recurrent mutation. Arg776 together with six surrounding amino acid residues were found fully conserved and predicted to be buried in homologous eukaryotic MoCo sulfurases. Moreover, Arg776 is conserved in a diversity of eukaryotic and prokaryotic proteins that posses a domain homologous to the C-terminal domain of HMCS. Our findings suggest that Arg776 is essential for a core structure of the C-terminal domain of the HMCS and identification of a mutation at this site may contribute clarifying the mechanism of MoCo sulfuration.

Economic aspects of the rehabilitation of the Hiriya landfill

The Hiriya landfill, Israel's largest, operated from 1952 to 1998. The landfill, located in the heart of the Dan Region, developed over the years into a major landscape nuisance and environmental hazard. In 1998, the Israeli government decided to close the landfill, and in 2001 rehabilitation activities began at the site, including site investigations, engineering and scientific evaluations, and end-use planning. The purpose of the present research is to perform a cost-benefit analysis of engineering and architectural-landscape rehabilitation projects considered for the site. An engineering rehabilitation project is required for the reduction of environmental impacts such as greenhouse gas emissions, slope instability and leachate formation. An architectural-landscape rehabilitation project would consider improvements to the site to make it suitable for future end uses such as a public park. The findings reveal that reclamation is worthwhile only in the case of architectural-landscape rehabilitation of the landfill, converting it into a public park. Engineering rehabilitation alone was found to be unjustified, but is essential to enable the development of a public park.

What picture is worth a thousand words? A comparative evaluation of a burn prevention programme by type of medium in Israel

Burns are associated with longer hospital stay, permanent disfigurement and emotional stress disorders, and represent a health problem, especially among economically and socially deprived populations, such as the Bedouin population in Israel, hence the importance of intervention programmes. The objective of this research was to examine the extent to which the effect of a visual one-session burn prevention programme was determined by the type of medium used. We also examined the possibility that fear motivates action only when someone feels confident in his/her ability to control the threat. Data were based on the pre-/post-programme self-report questionnaires administered to a randomly selected three-group sample of 12- to 13-year-old Bedouin children (n=179). All three sessions were identical, but differed in the type of medium used: slides (S), video (V), or slides and video consecutively (S + V). We measured health beliefs (perceived threat, internal/external control, self-efficacy) and sense of coherence (SOC), both before and 2 months after completion of the intervention. We also measured post-programme fear reaction and the improvement in burn-related knowledge, understanding and safety behaviour as the outcome measure. No significant post-programme differences between intervention groups were found, either in terms of outcome measure or in terms of health beliefs and SOC. However, within- person analysis indicated that the S group participants had the highest level of post-exposure fear and a decrease in luck control over injuries. The S + V group demonstrated the lowest within change. The hierarchical regression analysis revealed that self-efficacy, fear, higher socio-economic status and female gender predicted improvement. As hypothesized, the interaction between fear and self-efficacy added significantly to prediction. It seems that health beliefs and demographic characteristics were more powerful in predicting the effect of the intervention than the choice of medium per se. A multifaceted approach and more comprehensive interventions are needed in order to promote health among disadvantaged populations.

Activated macrophages for treating skin ulceration: gene expression in human monocytes after hypo-osmotic shock

Macrophages play a major role in almost all stages of the complex process of wound healing. It has been previously shown that the incorporation of a hypo-osmotic shock step, in the process of monocyte-concentrate preparation from a blood unit, induces monocyte/macrophage activation. As the macrophages are produced using a unique, closed and sterile system, they are suitable for local application on ulcers in elderly and paraplegic patients. Enhanced phagocytosis by the activated cells, as well as increased secretion of cytokines such as IL-1, IL-6, were detected in a recent study which are in accord with the very encouraging clinical results. In the present study, we used DNA microarrays to analyse the differential gene expressions of the hypo-osmotic shock-activated monocytes/macrophages and compare them to non-treated cells. Of the genes that exhibited differences of expression in the activated cell population, 94% (68/72) displayed increased activity. The mRNA levels of 43/68 of these genes (63%) were found to be 1.5-fold or higher (1.5-7.98) in the activated macrophages cell population as compared to the non-treated cells. Only four genes were found to have lower mRNA levels in the activated cells, with ratios of expression of 0.62-0.8, which may suggest that the changes are insignificant. A significant number of the genes that showed increased levels of expression is known to be directly involved in macrophage function and wound healing. This may correlate with the increased secretion of different cytokines by the activated macrophages depicted previously. Other groups of genes expressed are known to be involved in important pathways such as neuronal growth and function, developmental defects and cancer. The hypo-osmotic shock induces a gene expression profile of cytokines and receptors in the activated cells. These may evoke potential abilities to produce a variety of protein products needed in the wound healing process and may bring to light possibilities for other therapeutic applications of these cells.

Activation of human monocytes/macrophages by hypo-osmotic shock

Phagocytosis and secretion of interleukins and growth factors put the macrophage in the centre of the wound healing process. For the last four years over 400 human ulcers have been treated in elderly and paraplegic patients by local application of monocytes prepared from a blood unit, in a unique, closed, sterile system. The process of preparation includes a step of hypo-osmotic shock, which induces monocyte/macrophage activation. This is different from any other known method of activation. In the present study we evaluated the efficacy of the hypo-osmotic shock. We found enhanced levels of IL-1 (P = 0.004) and IL-6 (P = 0.001) in the incubation medium (100% autologous serum) of the activated cells, as compared with controls, prepared in the same system. The IL-1 reached a plateau after 6 and 12 h incubation at 37 degrees C, in both experimental and control incubation medium. The level of IL-6 was further elevated after 12 and 24 h incubation in experimental and control incubation mediums (P = 0.001). The phagocytosis of fluorescent beads was markedly enhanced after hypo-osmotic shock (P = 0.005). The osmotic shock induced macrophages were compared to those stimulated with LPS, and osmotic shock was proved to be at least as efficient method of stimulation as LPS.

A graded work site intervention program to improve sun protection and skin cancer awareness in outdoor workers in Israel

OBJECTIVES

A graded worksite intervention program to improve sun protection and skin cancer awareness of outdoor workers was implemented and evaluated longitudinally over a period of 20 months.

METHODS

Outdoor male workers (144/213 recruits) from geographically separated units of the Israel National Water Company were allocated to complete (n = 37), partial (n = 72) or minimal (n = 35) intervention groups. Subsequent to the assignment and training of local safety officers, an educational and medical screening package was provided to the corresponding groups either once, or repeatedly a year later. Personal sun protective gear was provided upon repeated intervention. Outcome measures were evaluated through self-response questionnaires administered prior to the first intervention pulse, and 8 months after the first and second interventions.

RESULTS

A 15-61% improvement in sun-protection habits was noted in the entire study population 8 months after initialization, compared to no sunscreen use, 20% sun-exposed skin area and highest mean occupational exposure dose of 1.68 MED/day at pre-test. An even greater use of sunscreen was evident 1 year later in the complete and partial intervention groups, + 80% and + 52%, respectively. The baseline rate of self-examination of the skin in the same two groups (49%) increased significantly at post-test (+ 71% and + 53%, respectively).

CONCLUSIONS

This integrated intervention program led to significantly improved sun protection and skin cancer awareness. Repeated intervention combined with the supply of sun-protective gear contributed to an even greater impact.

A burn prevention program as a long-term investment: trends in burn injuries among Jews and Bedouin children in Israel

In order to broaden our long-term intervention efforts in elementary schools in Israel (underway since 1988) and to set priorities for further population-specific actions, we compared the pattern of burn injuries among two age groups (0-4; 5-14) of two ethnic groups of Jews and Bedouins admitted to a regional hospital between 1986 and 1995 (n = 1050). The findings indicated a significant downward trend, though somewhat nonlinear, in burn admissions among the older age groups. A relatively less favorable trend was observed for the younger age groups. Consistently across years, burn rates in the younger group of Bedouin children were the highest. For the 10-year period, a significant season by ethnic group variation in burn admissions was observed, with a peak in the spring and in the wintertime for the Jews and Bedouins, respectively. A significant trend of decrease, mostly among older children, in average lengths of hospital stay, was also evident. Yet, regardless of age group and across years, Bedouin children stayed longer in the hospital than Jewish children. The overall leading causes of injury (for 1992-1995) were hot liquids (69%), fire (17%), chemicals (9.5%) and contact (2%). In our view, there is a need to address at-risk populations through environmental, community and family-oriented interventions and to venture beyond the pathogenic factors to the investigation of the salutary factors of health under diverse life conditions.

Are we making an impact? A review of a burn prevention program in Israeli schools

In an attempt to challenge the immense toll of burn and scald injuries among children in Israel, a structured educational program was developed by our university center for plastic surgery in Beer-Sheva. Since 1986, more than 250,000 children and 10,000 teachers, in more than 460 elementary schools nationwide, have been exposed to our program. This article reviews the design of the program, the implementation procedures, and the studies evaluating its effectiveness. The studies revealed significant improvements in children's risk-related knowledge and injury-control beliefs. Both teachers and principals assessed the program as important, and the in-training workshops and intervention activities won high approval. An overall trend of reduction in the number of patients hospitalized with burn injuries in the southern part of Israel was found also. Although it is clear that the project is instructive, further comprehensive efforts are needed to make a dramatic nationwide impact. Some of the efforts already underway target the most vulnerable group of the non-Jewish population in Israel.

[Amplification of protooncogenes and expression of the HER2/neu oncogene in invasive breast cancer]

The protooncogene HER2/neu was analyzed in 27 women with invasive breast cancer and in 26 with benign breast conditions. Gene amplification was found in 3 patients, 1 in stage 3 and 2 in stage 4. In 3 patients in stage 2 overexpression of protein was found. Although amplification of the gene was found to be a significant predictor of clinical outcome (p < 0.05), high expression of the gene did not correlate with prognosis. In women with benign breast conditions there were no alterations of HER2/neu amplification may become a molecular marker in some malignancies. It should be noted that since few tumors show amplification, examination of a small series may not reveal clinical association with these alterations. Therefore, our conclusions require confirmation on a larger scale with long-term clinical follow-up.

The role of age and an expanded Health Belief Model in predicting skin cancer protective behavior

Skin cancer (SC), the most common form of cancer in the US, with a rapidly growing incidence, has become a target for health education. Sun exposure protective behavior (SEPB) is currently believed to be the best means to prevent it. Focusing on age differences, this paper applies an expansion of the Health Belief Model (HBM) to the prediction of engagement in SC protective behaviors in four age-groups, following an intervention program. It is based on data collected by a structured questionnaire completed by 509 members of four kibbutzim in Israel. The results indicate that the proposed model explains the SC-related protective behaviors of the older age-groups (45+) much better than that of the younger groups (15-44). The older age-groups are also more likely to change risky behavior following the intervention. The youngest age-group (15-29), although being highest at risk for SC due to sun exposure habits, is least likely to change them and least likely to participate in the intervention. Beliefs about sun tanning, sun exposure habits (barriers) and degree of exposure to the intervention are the best predictors of the likelihood to engage in SEPB in the younger age-groups, while among the older groups the best predictors are the value of health and appearance. These findings suggest that health education programs should develop different messages for different age-groups. Regarding SC, it seems especially important to focus prevention efforts on adolescents and young adults by recruiting the beauty and fashion industries as well as legislation. The merits of age group analyses in the research of health behavior are discussed.

The GDP-bound form of the small G protein Rac1 p21 is a potent activator of the superoxide-forming NADPH oxidase of macrophages

Phagocytes produce superoxide by the assembly of a multicomponent complex that utilizes NADPH for the reduction of molecular oxygen (NADPH oxidase). The components participating in the assembly are a membrane-bound flavocytochrome and three cytosolic proteins, one of which was shown to be a dimer of the small GTP-binding protein (G protein) Rac1 p21 or Rac2 p21 with GDP dissociation inhibitor for Rho (Rho GDI). We determined the identity and quantity of the nucleotide bound to Rac1 p21 by high performance anion exchange chromatography of extracts prepared from highly purified Rac1 p21-Rho GDI, isolated from guinea pig macrophage cytosol. Rac1 p21 contained only GDP at a ratio of close to 1 mol of GDP per mol of G protein. The GDP-bound form of Rac1 p21 complexed to Rho GDI functioned as a potent activator of NADPH oxidase in a cell-free system that contained no free GTP or ATP. We propose that the GDP-bound form of Rac1 p21 might be the physiological activator of NADPH oxidase in macrophages, following its dissociation from Rho GDI, and that nucleotide exchange or conversion to GTP is not necessarily involved.

Foraging mode in lacertid lizards: variation and correlates

Abstract

Foraging strategy was observed in five species of Israeli lacertid lizards in the field. Acanthodactylus scutellatus is a sit-and-wait strategist, whereas A. boskianus, A. schreiberi, Lacerta laevis and Mesalina guttulata forage widely. However, the actual values differed from those reported by Huey and Pianka (1981) for Kalahari lacertids, possibly indicating the existence of a continuum of foraging modes. Foraging intensity (proportion of time spent moving or frequency of moves) is positively correlated to relative tail length, and negatively correlated to relative clutch mass. Additional possible correlates are discussed, and some cautionary remarks added.

Musculoskeletal manifestations in patients with hypercholesterolemia

Musculoskeletal symptoms were assessed in 33 patients with familial and 36 patients with nonfamilial type IIa hypercholesterolemia and compared to 33 healthy controls. Significant joint pain was reported by 47.8% of the patients with hypercholesterolemia vs 25.8% of the control group. Pain in the hyperlipidemic patients was significantly more prevalent in ankles and feet compared to the control group. The pain was not due to local effects of xanthoma, and was not accompanied by symptoms of inflammation or systemic rheumatic symptoms such as morning stiffness.

Isolation and sequencing of a cDNA coding for the human DF3 breast carcinoma-associated antigen

The murine monoclonal antibody (mAb) DF3 reacts with a high molecular weight glycoprotein detectable in human breast carcinomas. DF3 antigen expression correlates with human breast tumor differentiation, and the detection of a cross-reactive species in human milk has suggested that this antigen might be useful as a marker of differentiated mammary epithelium. To further characterize DF3 antigen expression, we have isolated a cDNA clone from a lambda gt11 library by screening with mAb DF3. The results demonstrate that this 309-base-pair cDNA, designated pDF9.3, codes for the DF3 epitope. Southern blot analyses of EcoRI-digested DNAs from six human tumor cell lines with 32P-labeled pDF9.3 have revealed a restriction fragment length polymorphism. Variations in size of the alleles detected by pDF9.3 were also identified in Pst I, but not in HindIII, DNA digests. Furthermore, hybridization of 32P-labeled pDF9.3 with total cellular RNA from each of these cell lines demonstrated either one or two transcripts that varied from 4.1 to 7.1 kilobases in size. The presence of differently sized transcripts detected by pDF9.3 was also found to correspond with the polymorphic expression of DF3 glycoproteins. Nucleotide sequence analysis of pDF9.3 has revealed a highly conserved (G + C)-rich 60-base-pair tandem repeat. These findings suggest that the variation in size of alleles coding for the polymorphic DF3 glycoprotein may represent different numbers of repeats.

Echocardiographic diagnosis of anatomically corrected malposition of the great arteries

In anatomically corrected malposition of the great arteries, the great arteries are abnormally related to one another and to the ventricles but arise from their normal ventricles. We present here a case in which this diagnosis was made by echocardiography and confirmed by cardiac catheterization.