A phase III, multicenter, randomized, double-blind, active comparator-controlled study to evaluate the safety, tolerability, and immunogenicity of catch-up vaccination regimens of V114, a 15-valent pneumococcal conjugate vaccine, in healthy infants, children, and adolescents (PNEU-PLAN)

BACKGROUND

Despite widespread use of pneumococcal conjugate vaccines (PCVs) in children, morbidity and mortality caused by pneumococcal disease (PD) remain high. In addition, many children do not complete their PCV course on schedule. V114 is a 15-valent PCV that contains two epidemiologically important serotypes, 22F and 33F, in addition to the 13 serotypes present in PCV13, the licensed 13-valent PCV.

METHODS

This phase III descriptive study evaluated safety and immunogenicity of catch-up vaccination with V114 or PCV13 in healthy children 7 months-17 years of age who were either pneumococcal vaccine-naïve or previously immunized with lower valency PCVs (NCT03885934). Overall, 606 healthy children were randomized to receive V114 (n = 303) or PCV13 (n = 303) via age-appropriate catch-up vaccination schedules in three age cohorts (7-11 months, 12-23 months, or 2-17 years).

RESULTS

Similar proportions of children 7-11 months and 2-17 years of age reported adverse events (AEs) in the V114 and PCV13 groups. A numerically greater proportion of children 12-23 months of age reported AEs in the V114 group (79.0%) than the PCV13 group (59.4%). The proportions of children who reported serious AEs varied between different age cohorts but were generally comparable between vaccination groups. No vaccine-related serious AEs were reported, and no deaths occurred. At 30 days after the last PCV dose, serotype-specific immunoglobulin G geometric mean concentrations were comparable between vaccination groups for the 13 shared serotypes and higher in the V114 group for 22F and 33F.

CONCLUSIONS

Catch-up vaccination with V114 in healthy individuals 7 months-17 years of age was generally well tolerated and immunogenic for all 15 serotypes, including those not contained in PCV13, regardless of prior pneumococcal vaccination. These results support V114 catch-up vaccination in children with incomplete or no PCV immunization per the recommended schedule.

1174. Phase 3 Study to Evaluate the Safety, Tolerability, and Immunogenicity of Catch-up Vaccination Regimens of V114 in Healthy Infants, Children, and Adolescents (PNEU–PLAN)

Background

Despite widespread use of pneumococcal conjugate vaccines (PCVs) in children, morbidity and mortality caused by pneumococcal disease (PD) remain high, in part due to the emergence of disease caused by non-vaccine serotypes (STs). In addition, many children do not receive the recommended number of PCVs on schedule and, therefore, are at risk for PD. V114 is an investigational 15-valent PCV that contains two epidemiologically important STs, 22F and 33F, in addition to the 13 STs present in the licensed 13-valent PCV (PCV13; Prevnar 13^™). This Phase 3 descriptive study evaluated the safety and immunogenicity of V114 and PCV13 when given as catch-up vaccination in children who are pneumococcal vaccine-naïve or previously immunized with lower valency PCVs.

Methods

Solicited adverse events (AEs) were collected for 14 days after each vaccination. Serious adverse events (SAEs) were collected throughout study participation. Immunogenicity was evaluated by anti-pneumococcal polysaccharide ST-specific immunoglobulin G (IgG) geometric mean concentrations (GMCs) at 30 days post-last vaccination.

Results

606 healthy children, aged 7 months through 17 years, were randomized (double-blind) to receive V114 (n=303) or PCV13 (n=303) via age-appropriate catch-up vaccination schedules (Table 1). V114 had an acceptable safety profile and was well tolerated. Similar proportions of children aged 7–11 months and 2–17 years reported AEs in the V114 and PCV13 groups. A larger proportion of children aged 12–23 months reported AEs in the V114 group (79%) than the PCV13 group (59%). The proportion of children who reported SAEs was comparable among vaccination groups (V114 and PCV13, respectively, 7–11 months: 10.9%, 7.8%; 12–23 months: 6.5%, 6.3%; 2–17 years: 2.3%, 2.3%). No SAEs were reported to be vaccine-related, and no deaths occurred. At 30 days after the last PCV dose, ST-specific IgG GMCs were comparable for the 13 shared STs and were higher in the V114 group for 22F and 33F.

Table 1. Catch-up vaccination schedules in V114-024

Conclusion

Catch-up vaccination with V114 in healthy children aged 7 months through 17 years had an acceptable safety profile, was well tolerated, and provided comparable immune responses to the 13 serotypes shared with PCV13, and higher immune responses to serotypes 22F and 33F.

Disclosures

Natalie Banniettis, MD, Merck Sharp and Dohme (Employee, Shareholder) Jacek Wysocki, MD, PhD, GlaxoSmithKline (Scientific Research Study Investigator, Advisor or Review Panel member, Research Grant or Support)MSD (Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member)Pfizer (Scientific Research Study Investigator, Advisor or Review Panel member, Research Grant or Support) Mika Rämet, MD, PhD, MSD (Scientific Research Study Investigator) Ron Dagan, MD, Medimmune/AstraZeneca (Grant/Research Support, Scientific Research Study Investigator, Research Grant or Support)MSD (Consultant, Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau)Pfizer (Consultant, Grant/Research Support, Scientific Research Study Investigator, Advisor or Review Panel member, Research Grant or Support, Speaker’s Bureau) Lori Good, B.S., Merck & Co., Inc (Employee) Melanie Papa, BA, Merck Sharp and Dohme (Employee, Shareholder) Yaru Shi, PhD, Merck & Co., Inc (Employee) Luwy Musey, MD, Merck & Co., Inc. (Employee) Kara Bickham, MD, Merck Sharp and Dohme (Employee, Shareholder) Gretchen Tamms, B.S., Merck Sharp and Dohme (Employee, Shareholder) Richard McFetridge, B.S., Merck & Co., Inc (Employee) Robert Lupinacci, M.S, Merck & Co., Inc (Employee, Shareholder)

Antimicrobial activity of polyhexamethylene biguanide nanoparticles against mastitis-causing Staphylococcus aureus

Postmilking teat disinfection is one of the main measures used to prevent mastitis caused by contagious pathogens, such as Staphylococcus aureus. The present study evaluated the antimicrobial activity of polyhexamethylene biguanide (PHMB) and PHMB nanoparticles (NP) against mastitis-causing Staph. aureus using a microdilution assay methodology. A total of 20 mastitis-causing Staph. aureus isolates were used to determine the minimum inhibitory concentrations (MIC) of PHMB and PHMB NP compared with 3 disinfectants commonly used for teat disinfection (chlorhexidine digluconate, povidone-iodine, and sodium dichloroisocyanurate). The MIC₉₀ was defined at the concentrations required to inhibit the growth of 90% of Staph. aureus. Our results indicated that PHMB NP presented the lowest MIC value (<0.03 µg/mL) to inhibit 90% of Staph. aureus, followed by chlorhexidine digluconate (≥0.25 µg/mL) and PHMB (≥0.5 µg/mL). On the other hand, sodium dichloroisocyanurate (≥500 µg/mL) and povidone-iodine (≥8,000 µg/mL) presented the highest concentrations to inhibit the growth of most Staph. aureus. Our preliminary results suggested that both PHMB and PHMB NP have antimicrobial activity against mastitis-causing Staph. aureus, which indicates the potential for both to be used as a teat-dip disinfectant to prevent bovine mastitis.

Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) 2015: A national survey of sharps injuries and mucocutaneous blood exposures among health care workers in US hospitals

BACKGROUND

National blood exposure (BE) surveys are valuable to health care facilities striving to reduce percutaneous sharps injuries (SIs) or mucocutaneous (MC) exposures among their health care workers (HCWs). In the Exposure Survey of Trends in Occupational Practice (EXPO-S.T.O.P.) 2015 we surveyed hospital BE incidence among members of the Association of Occupational Health Professionals in Healthcare.

METHODS

A 23-item electronic survey requested 2015 data on total SI and MC; SI in nurses, doctors, and surgery; staffed beds; teaching status; full time equivalent staff (FTE), nurse FTE, average daily census (ADC), and adjusted patient days (APD).

RESULTS

One hundred eighty-one hospitals in 34 states reported 9,343 BE (71% SI and 29% MC exposures). SI rates were 25.2/100 ADC (17.5 in nonteaching hospitals and 30.4 in teaching hospitals), 2.1/100 FTE (significantly less than that in 2001), 3.2/100 nurse FTE, 0.36/1,000 APD, and 38% occurred during surgery. MC exposure incidence rates were 10.5/100 ADC (8.6 in nonteaching hospitals and 11.7 in teaching hospitals), 0.86/100 FTE, and 0.14/1000 APD.

CONCLUSIONS

BE incidence rates have fallen slowly but significantly since 2001, but the reduction is far less than hoped. Occupied beds (ie, ADC) has become a less-useful denominator. We estimate more than 300,000 HCWs sustain SIs annually in hospital and nonhospital settings. Greater resources are needed for more frequent and correct use of safety devices, training to competency, and root-cause investigation of all SIs.

Towards an integrated food safety surveillance system: a simulation study to explore the potential of combining genomic and epidemiological metadata

Foodborne infection is a result of exposure to complex, dynamic food systems. The efficiency of foodborne infection is driven by ongoing shifts in genetic machinery. Next-generation sequencing technologies can provide high-fidelity data about the genetics of a pathogen. However, food safety surveillance systems do not currently provide similar high-fidelity epidemiological metadata to associate with genetic data. As a consequence, it is rarely possible to transform genetic data into actionable knowledge that can be used to genuinely inform risk assessment or prevent outbreaks. Big data approaches are touted as a revolution in decision support, and pose a potentially attractive method for closing the gap between the fidelity of genetic and epidemiological metadata for food safety surveillance. We therefore developed a simple food chain model to investigate the potential benefits of combining 'big' data sources, including both genetic and high-fidelity epidemiological metadata. Our results suggest that, as for any surveillance system, the collected data must be relevant and characterize the important dynamics of a system if we are to properly understand risk: this suggests the need to carefully consider data curation, rather than the more ambitious claims of big data proponents that unstructured and unrelated data sources can be combined to generate consistent insight. Of interest is that the biggest influencers of foodborne infection risk were contamination load and processing temperature, not genotype. This suggests that understanding food chain dynamics would probably more effectively generate insight into foodborne risk than prescribing the hazard in ever more detail in terms of genotype.

Validation of a haemoglobin dilution method for estimation of blood loss

BACKGROUND AND OBJECTIVES

Analysis of haemoglobin (Hb) dilution after bleeding is a simple, inexpensive and non-invasive method to estimate blood loss. Blood volume is estimated, taking sex, weight and height into account. The Hb concentration before and after blood loss is analysed and, from the difference, the blood loss volume can be calculated assuming a normovolemic subject. Although widely used this method has never been validated.

MATERIAL AND METHODS

The Hb concentration of 21 blood donors was analysed before and up to 4 days after a standard blood donation and in another 18 blood donors the Hb concentration was analysed before and on day 4, 6, 8, 11 and 14 after blood donation. The blood volume of each donor was calculated and the donated blood volume was estimated by weighing. We calculated the blood loss by the Hb dilution method and compared the calculated value with the donated blood volume.

RESULTS

The mean donated blood volume was 442 +/- 10 ml, whereas the mean calculated blood loss was 152 +/- 214 ml using the Hb concentration of the first day after donation and 301 +/- 145 ml with the Hb concentration of day 6 after blood donation after which no further Hb decrease was observed. The directly measured Hb concentration was always higher than the calculated/expected Hb concentration based on the blood donation volume.

CONCLUSIONS

The Hb dilution method underestimates the true blood loss by more than 30% after a moderate blood loss of approximately 10% of the total blood volume.

Long-term results after primary repair or non-surgical treatment of anterior cruciate ligament rupture: a randomized study with a 15-year follow-up

We investigated the long-term outcome of 100 patients 15 years after having been randomly allocated to primary repair (augmented or non-augmented) or non-surgical treatment of an anterior cruciate ligament (ACL) rupture. The subjective outcome was similar between the groups, with no difference regarding activity level and knee-injury and osteoarthritis outcome score but with a slightly lower Lysholm score for the non-surgically treated group. This difference was attributed to more instability symptoms. The radiological osteoarthritis (OA) frequency did not differ between surgically or non-surgically treated patients, but if a meniscectomy was performed, two-thirds of the patients showed OA changes regardless of initial treatment of the ACL. There were significantly more meniscus injuries in patients initially treated non-surgically. One-third of the patients in the non-surgically treated group underwent secondary ACL reconstruction due to instability problems. In this study, ACL repair itself could not reduce the risk of OA nor increase the subjective outcome scores. However, one-third of the non-surgical treated patients were later ACL reconstructed due to instability. The status of the menisci was found to be the most important predictor of developing OA. Early ACL repair and also ACL reconstruction can reduce the risk of secondary meniscus tears. Indirectly this supports the hypothesis that early stabilization of the knee after ACL injury is advantageous for the long-term outcome.

Does everything now make (anti)sense?

The data generated by the FANTOM (Functional Annotation of Mouse) consortium, Compugen and Affymetrix have collectively provided evidence that most of the mammalian genomes are actively transcribed. The emergence of an antisense RNA world brings new practical complexities to the study and detection of gene expression. However, we also need to address the fundamental questions regarding the functional importance of these molecules. In this brief paper, we focus on non-coding natural antisense transcription, as it appears to be a potentially powerful mechanism for extending the complexity of the protein coding genome, which is currently unable to explain inter-species diversification.

Prevalence of parkinsonism and relationship to exposure in a large sample of Alabama welders

OBJECTIVE

To estimate the prevalence of parkinsonism in welders in Alabama and to compare this prevalence with that in a general population sample.

METHODS

The authors screened 1,423 welders from Alabama who were referred for medical-legal evaluation for Parkinson disease (PD). Standardized videotaped assessments using the Unified Parkinson's Disease Rating Scale motor subsection 3 (UPDRS3) were obtained. Patients provided information regarding exposure to welding fumes and job titles. Job titles were matched with Department of Labor Standard Occupational Codes (SOCs). Diagnoses were assigned based on quantitative criteria for the diagnosis of PD using two thresholds for diagnosis. With use of the number of active welders in this screening with parkinsonism as the numerator and the age-adjusted number of welders in each SOC as the denominator, the prevalence of parkinsonism in Alabama welders was estimated using conservative assumptions and compared with general population data from Copiah County, MS.

RESULTS

With use of conservative and liberal case definitions of parkinsonism, the estimated prevalence of parkinsonism among active male welders age 40 to 69 statewide was 977 to 1,336 cases/100,000 population. The prevalence of parkinsonism was higher among welders vs age-standardized data for the general population (prevalence ratio = 10.19, 95% CI 4.43 to 23.43).

CONCLUSION

The estimated prevalence of parkinsonism was higher within a sample of male Alabama welders vs the general population of male residents of Copiah County, MS.

Tranexamic acid decreases external blood loss but not hidden blood loss in total knee replacement

BACKGROUND

Total knee arthroplasty (TKA) is often carried out using a tourniquet and shed blood is collected in drains. Tranexamic acid decreases the external blood loss. Some blood loss may be concealed, and the overall effect of tranexamic acid on the haemoglobin (Hb) balance is not known.

METHODS

Patients with osteoarthrosis had unilateral cemented TKA using spinal anaesthesia. In a double-blind fashion, they received either placebo (n=24) or tranexamic acid 10 mg kg(-1) (n=27) i.v. just before tourniquet release and 3 h later. The decrease in circulating Hb on the fifth day after surgery, after correction for Hb transfused, was used to calculate the loss of Hb in grams. This value was then expressed as ml of blood loss.

RESULTS

The groups had similar characteristics. The median volume of drainage fluid after placebo was 845 (interquartile range 523-990) ml and after tranexamic acid was 385 (331-586) ml (P<0.001). Placebo patients received 2 (0-2) units and tranexamic acid patients 0 (0-0) units of packed red cells (P<0.001). The estimated blood loss was 1426 (1135-1977) ml and 1045 (792-1292) ml, respectively (P<0.001). The hidden loss of blood (calculated as loss minus drainage volume) was 618 (330-1347) ml and 524 (330-9620) ml, respectively (P=0.41). Two patients in each group developed deep vein thrombosis.

CONCLUSIONS

Tranexamic acid decreased total blood loss by nearly 30%, drainage volume by approximately 50% and drastically reduced transfusion. However, concealed loss was only marginally influenced by tranexamic acid and was at least as large as the drainage volume.

Translation repression by antisense sequences

Antisense sequences that hybridize to messenger RNA can inhibit target gene expression in a variety of ways. The best-known antisense mechanisms trigger messenger RNA (mRNA) degradation; however, translation repression by ribosome interference is a common natural antisense mechanism. In bacteria, there are fascinating examples of cis-encoded and trans-encoded antisense sequences that reversibly repress translation. In eukaryotes, microRNAs that bind 3'UTR target sequences also repress translation, although the mechanism is unclear. An important feature of translation repression is that the mRNA can remain intact during periods of repression, and rapid expression switching can occur in response to cellular and environmental signals. Recent genome analyses indicate many new short noncoding RNAs with predicted antisense activities. Therefore, translation repression by antisense sequences is likely to be a common and important form of posttranscriptional gene control, and such natural mechanisms provide a basis for the development of synthetic antisense gene control in research and drug development.

Ptosis as a remote effect of therapeutic botulinum toxin B injection

The authors report a patient with cervical dystonia, previously treated with botulinum toxin A (BTX-A), who developed bilateral ptosis and difficulty with accommodation only after botulinum toxin B (BTX-B). High-frequency repetitive nerve stimulation of the abductor digiti minimi demonstrated a 34% increment in compound muscle action potential. No increment in 20 people injected with BTX-A and no cases of ptosis in a chart review of 1,606 BTX-A injections for cervical dystonia were found. The authors conclude that systemic spread of BTX-B can cause symptomatic involvement of autonomic neurons.

Range of motion training in brace vs. plaster immobilization after anterior cruciate ligament reconstruction: a prospective randomized comparison with a 2-year follow-up

The purpose of this prospective and randomized study was to compare rehabilitation with early range of motion (ROM) training vs immobilization following anterior cruciate ligament (ACL) reconstruction. Fifty patients, undergoing an ACL reconstruction with a bone-patellar tendon-bone graft, were postoperatively allocated randomly to either a plaster cast or a brace for 5 weeks. The brace group had ROM exercises from postoperative day 7. The commencement of ROM exercises was postponed 4 weeks for the plaster group compared to the brace group, but progressed subsequently with equal speed. There was no difference between the groups in the ROM of flexion or extension 20 weeks after the ACL reconstruction and later. Twenty-four months after surgery, the muscle strength deficit in the hamstring muscles (isokinetic measurements; percent difference, injured vs uninjured) was significantly larger in the brace group (mean +/- SD: 5.9 +/- 7.8%, P < 0.01) than in the plaster group (- 0.9 +/- 11.8%, NS) (brace vs plaster group, P < 0.05). Furthermore, there was also a tendency in the brace group to a larger strength deficit in the quadriceps muscle (brace: 11.1 +/- 13.2%, P < 0.001; plaster: 3.8 +/- 12.9%, NS) (brace vs plaster group, P= 0.07). There was no difference between the groups in the total sagittal knee laxity, as measured with an arthrometer, or in the subjective knee function or activity level (Lysholm score together with the Tegner activity level) between the groups. It is concluded that the postoperative treatment with early range of motion training after ACL reconstruction gave as good ROM, knee stability, subjective knee function and activity level as the treatment with immobilization. It is hypothesized that the larger strength deficit observed after rehabilitation with early range of motion training is secondary to the more intensive training and physical therapist involvement that was demanded in order to achieve full ROM following immobilization.

Peptide nucleic acid (PNA) antisense effects in Escherichia coli

Antisense peptide nucleic acid (PNA) can be used to control cell growth, gene expression and growth phenotypes in the bacteria Escherichia coli. PNAs targeted to the RNA components of the ribosome can inhibit translation and cell growth, and PNAs targeted to mRNA can limit gene expression with gene and sequence specificity. In an E. coli cell extract, efficient inhibition is observed when using PNA concentrations in the nanomolar range, whereas micromolar concentrations are required for inhibition in growing cells. A mutant strain of E. coli that is more permeable to antibiotics also is more susceptible to antisense PNAs than the wild type. This chapter details methods for testing the antisense activities of PNA in E. coli. As an example of the specific antisense inhibition possible, we show the effects of an anti-beta-galactosidase PNA in comparison to control PNAs. With improvements in cell uptake, antisense PNAs may find applications as antimicrobial agents and as tools for microbial functional genomics.

Postural control after anterior cruciate ligament reconstruction and functional rehabilitation

Total sagittal knee laxity and postural control in the sagittal and frontal planes were measured in 25 patients at a mean of 36 months (range, 27 to 44) after anterior cruciate ligament reconstruction and in a control group consisting of 20 uninjured age- and activity-matched subjects. Body sway was measured in the sagittal plane on a stable and on a sway-referenced force plate in single-legged stance, double-legged stance, or both, with the eyes open and closed. Postural reactions to perturbations in the sagittal and frontal planes were recorded in the single-legged stance with the eyes open. Total sagittal plane laxity was significantly greater in the anterior cruciate ligament-reconstructed knee (11.2 mm; range, 6 to 15) than in the uninjured knee (8.9 mm; range, 6 to 12) or in the control group (6.0 mm; range, 5 to 8). In spite of this, the patients, in comparison with the controls, exhibited normal postural control except in two variables-the reaction time and the latency between the start of force movement to maximal sway in the sagittal plane perturbations. This supports the hypothesis that rehabilitation, with proprioceptive and agility training, is an important component in restoring the functional stability in the anterior cruciate ligament-reconstructed knee.

Bactericidal antisense effects of peptide-PNA conjugates

Antisense peptide nucleic acids (PNAs) can specifically inhibit Escherichia coli gene expression and growth and hold promise as anti-infective agents and as tools for microbial functional genomics. Here we demonstrate that chemical modification improves the potency of standard PNAs. We show that 9- to 12-mer PNAs, especially when attached to the cell wall/membrane-active peptide KFFKFFKFFK, provide improvements in antisense potency in E. coli amounting to two orders of magnitude while retaining target specificity. Peptide-PNA conjugates targeted to ribosomal RNA (rRNA) and to messenger RNA (mRNA) encoding the essential fatty acid biosynthesis protein Acp prevented cell growth. The anti-acpP PNA at 2 microM concentration cured HeLa cell cultures noninvasively infected with E. coli K12 without any apparent toxicity to the human cells. These results indicate that peptides can be used to carry antisense PNA agents into bacteria. Such peptide-PNA conjugates open exciting possibilities for anti-infective drug development and provide new tools for microbial genetics.

Activation of I-kappaB kinase by the HTLV type 1 Tax protein: mechanistic insights into the adaptor function of IKKgamma

The Tax protein encoded by human T cell leukemia virus type 1 (HTLV-1) induces constitutive nuclear expression of the transcription factor NF-kappaB, causing aberrant expression of a large array of cellular genes. Tax activates NF-kappaB by stimulating the activity of the I-kappaB kinase (IKK), which in turn leads to phosphorylation and degradation of the NF-kappaB inhibitor I-kappaBalpha. In normal T cells, IKK activation occurs transiently on cellular stimulation through the T cell receptor (TCR) and the CD28 costimulatory molecule. However, this inducible kinase is constitutively activated in Tax-expressing and HTLV-1-infected T cells, which contributes to the deregulated nuclear expression of NF-kappaB. As a genetic approach to dissect the pathways mediating IKK activation by Tax and T cell activation signals, somatic cell mutagenesis was performed to isolate signaling-defective mutant Jurkat T cell lines. One of the mutant cell lines was shown to have a defect in NF-kappaB activation by both T cell mitogens and Tax. Interestingly, this mutant cell line lacks expression of the IKK regulatory protein, IKKgamma. Expression of exogenous IKKgamma in the mutant cells restored NF-kappaB activation, thus confirming the essential role of this regulatory factor in IKK activation by the cellular and viral stimuli. Mechanistic studies have shown that Tax physically interacts with IKKgamma via specific domains, including two homologous leucine zipper motifs present in IKKgamma. The Tax/IKKgamma interaction serves to recruit Tax to the IKK catalytic subunits, IKKalpha and IKKbeta, and this recruitment appears to be an essential mechanism by which Tax stimulates the activity of IKK.

Potent and nontoxic antisense oligonucleotides containing locked nucleic acids

Insufficient efficacy and/or specificity of antisense oligonucleotides limit their in vivo usefulness. We demonstrate here that a high-affinity DNA analog, locked nucleic acid (LNA), confers several desired properties to antisense agents. Unlike DNA, LNA/DNA copolymers were not degraded readily in blood serum and cell extracts. However, like DNA, the LNA/DNA copolymers were capable of activating RNase H, an important antisense mechanism of action. In contrast to phosphorothioate-containing oligonucleotides, isosequential LNA analogs did not cause detectable toxic reactions in rat brain. LNA/DNA copolymers exhibited potent antisense activity on assay systems as disparate as a G-protein-coupled receptor in living rat brain and an Escherichia coli reporter gene. LNA-containing oligonucleotides will likely be useful for many antisense applications.

Somatic mutagenesis studies of NF-kappa B signaling in human T cells: evidence for an essential role of IKK gamma in NF-kappa B activation by T-cell costimulatory signals and HTLV-I Tax protein

NF-kappa B plays a pivotal role in normal T-cell activation and may also mediate human T-cell leukemia virus (HTLV)-induced T-cell transformation. Activation of NF-kappa B by both T-cell costimulatory signals and the HTLV Tax protein involves stimulation of I kappa B kinase (IKK). As a genetic approach to dissect the intermediate steps involved in NF-kappa B activation in human T cells, we performed somatic cell mutagenesis to isolate signaling-defective mutant Jurkat T-cell lines. One of the mutant cell lines was shown to have a specific blockade in the IKK signaling pathway but remained competent in the c-Jun N-terminal kinase and MAP kinase pathways. Interestingly, this mutant cell line lacks expression of IKK gamma, a non-catalytic component of the IKK complex. Expression of exogenous IKK gamma in the mutant cells restored NF-kappa B activation by both the T-cell costimulation agents and Tax. These findings provide genetic evidence for the requirement of IKK gamma in NF-kappa B signaling triggered by both T-cell costimulatory signals and HTLV-I Tax protein.

Calibration and application of an intra-articular force transducer for the measurement of patellar tendon graft forces: an in situ evaluation

The objective of this study was to evaluate two calibration methods for the "Arthroscopically Implantable Force Probe" (AIFP) that are potentially suitable for in vivo use: (1) a direct, experimentally based method performed by applying a tensile load directly to the graft after it is harvested but prior to implantation (the "pre-implantation" technique), and (2) an indirect method that utilizes cadaver-based analytical expressions to transform the AIFP output versus anterior shear load relationship, which may be established in vivo, to resultant graft load (the "post-implantation" technique). The AIFP outputs during anterior shear loading of the knee joint using these two calibration methods were compared directly to graft force measurements using a ligament cutting protocol and a 6 DOF load cell. The mean percent error (actual-measured)/(actual)* 100) associated with the pre-implantation calibration ranged between 85 and 175 percent, and was dependent on the knee flexion angle tested. The percent error associated with the post-implantation technique was evaluated in two load ranges: loads less than 40 N, and loads greater than 40 N. For graft force values greater than 40 N, the mean percent errors inherent to the post-implantation calibration method ranged between 20 and 29 percent, depending on the knee flexion angle tested. Below 40 N, these errors were substantially greater. Of the two calibration methods evaluated, the post-implantation approach provided a better estimate of the ACL graft force than the pre-implantation technique. However, the errors for the post-implantation approach were still high and suggested that caution should be employed when using implantable force probes for in vivo measurement of ACL graft forces.

Joint position sense is not changed after acute disruption of the anterior cruciate ligament

We evaluated the impact of acute, isolated ACL disruption on knee joint proprioception by means of passive-active and active-active joint position sense (JPS) measurement techniques. 18 subjects with acute, isolated and unilateral ACL disruption were tested for JPS in a standing position. The test protocol included 6 trials for each leg. In each trial, the lower leg was passively positioned to an index angle approximating either 30 degrees or 70 degrees, followed by 5 active repetitions of the index angle where the subjects attempted to reproduce the index angle to the best of their ability. The errors from the exact index angle reproduction were calculated as both real (showing both magnitude and direction) and absolute values (only magnitude). All subjects had a tendency to reproduce the index angle with both the injured and normal knees in a more flexed position (overestimation). Only the absolute error produced by the active-active test at flexion angles greater than 45 degrees produced a significant difference with a larger error for the normal knee. In all other comparisons between the injured and the normal knee no differences were found. We conclude that the afferent signals which are compromised by an acute tear of the ACL are insignificant compared to afferent signals from the other joint and muscle receptors.

Antisense oligonucleotides - the way forward

Antisense oligonucleotides provide attractive possibilities for developing a new class of drugs and the design principle involves straightforward base-pairing rules. The approach has already been useful in many functional genomics efforts and there has also been recent clinical success. With this progress in place, it now is appropriate to thoroughly address design uncertainties and unforeseen effects that have emerged. The key objective has long been, and remains to be, the identification of novel oligonucleotide analogs providing the possibility of achieving high in vivo efficacy in the absence of significant toxicity; such compounds are not at hand today but certain advances have been made in recent years. There is also a need for more expertise in target site selection and for improving delivery and/or bioavailability properties. Immediately achievable goals in the field implicate use of improved in vitro and in vivo assays and, importantly, a set of standard controls, uniform between laboratories, such that results can be compared in a rational manner. In turn, this should lead to the emergence of antisense agents that are useful for a wide range of research and therapeutic applications.

Essential structural features in the Schizosaccharomyces pombe pre-rRNA 5' external transcribed spacer

The proximal region in the 5' external transcribed spacer (5'ETS) of the genes encoding ribosomal RNAs in Schizosaccharomyces pombe was examined with respect to structural features which underlie rRNA maturation. Computer analyses and partial digestion with nuclease probes indicate a crucifix-like structure composed primarily of three extended hairpins which are more highly ordered than previously proposed in Saccharomyces cerevisiae. A re-evaluation of the same region in S. cerevisiae indicates a conserved core structure, including the U3 snoRNA binding site within this higher-order structure. The sequences encoding the individual hairpins were deleted by PCR-mediated mutagenesis and the mutant rDNAs were expressed in vivo to determine the effect of these features on rRNA maturation. Quantitative hybridization analyses indicate that the first hairpin only has modest effects on 18 S rRNA maturation, but the other two regions are critical and no mature 18 S rRNA was observed. When smaller changes were systematically introduced into the critical regions, strong correlations were observed with known or putative events in rRNA maturation. Changes associated with an intermediate cleavage site in helix II and with the putative U3 snoRNA binding site were again critical to 18 S rRNA production. In each case, the effects were sequence dependent and not simply the result of disrupted structure. Further analyses of the 5.8 S rRNA indicate that the large ribosomal subunit RNA can be properly processed in each case but the efficiency is reduced by as much as 60 %, an observation which provides new evidence of interdependency in the maturation process. The results illustrate that rRNA processing is more critically dependent on the 5'ETS than previously believed.

Gene expression profiles in HTLV-I-immortalized T cells: deregulated expression of genes involved in apoptosis regulation

Human T-cell leukemia virus type I (HTLV-I) is the etiologic agent of adult T-cell leukemia, an acute and often fatal T-cell malignancy. A key step in HTLV-I-induced leukemigenesis is induction of abnormal T-cell growth and survival. Unlike antigen-stimulated T cells, which cease proliferation after a finite number of cell division, HTLV-I-infected T cells proliferate indefinitely (immortalized), thus facilitating occurrence of secondary genetic changes leading to malignant transformation. To explore the molecular basis of HTLV-I-induced abnormal T-cell survival, we compared the gene expression profiles of normal and HTLV-I-immortalized T cells using 'gene array'. These studies revealed a strikingly altered expression pattern of a large number of genes along with HTLV-I-mediated T-cell immortalization. Interestingly, many of these deregulated genes are involved in the control of programmed cell death or apoptosis. These findings indicate that disruption of the cellular apoptosis-regulatory network may play a role in the HTLV-I-mediated oncogenesis.

Postural control--a comparison between patients with chronic anterior cruciate ligament insufficiency and healthy individuals

Postural control in the sagittal plane was evaluated in 22 patients with chronic anterior cruciate ligament (ACL) deficiency and the result was compared to that of a control group of 20 uninjured subjects. Measurement of the body sway was done on a fixed and sway-referenced force plate in both single-limb and two-limb stance, with the eyes open and closed, respectively. Further, an analysis of the postural reactions to perturbations backwards and forwards, respectively, was made in single-limb stance. The results demonstrated statistically significant deficits of the postural control in the patient group compared to the control group, but also within the patient group. There was a significantly higher body sway within the patient group when standing on a stable support surface on the injured limb than standing on the uninjured limb with the eyes open, but no difference with the eyes closed. When standing on a stable support surface, there was a significantly higher body sway in the patient group standing on the injured leg than in the control group, both with eyes open and closed. The patient group also showed a significantly impaired postural control compared to the control group when standing on the uninjured leg with the eyes closed. There was no difference between the groups in the two-limb stance. When standing on the sway-referenced support surface, the patient group had a significantly larger body sway than the control group when the eyes were open, but there was no significant difference between the groups with the eyes closed. The measurement of the postural corrective responses to perturbations backwards and forwards showed that the reaction time measured from the initiation of the force plate translation, and the amplitude of the body sway was significantly greater in the patient group than in the control group. We conclude that patients with a continuing chronic ACL insufficiency several years after injury have an impaired postural control in the antero-posterior direction in single-limb stance on their injured leg. They also show a greater body sway and a prolonged reaction time when subjected to antero-posterior perturbations when standing on their injured leg.

NF-kappaB-inducing kinase and IkappaB kinase participate in human T-cell leukemia virus I Tax-mediated NF-kappaB activation

The tax gene product of human T-cell leukemia virus I induces aberrant expression of various cellular genes, which contributes to transformation of host cells. Induction of many Tax target genes is mediated through transcription factor NF-kappaB. Here we show that Tax triggers activation of cellular protein kinases, IkappaB kinase alpha (IKKalpha) and IKKbeta, which phosphorylate the NF-kappaB inhibitory protein IkappaB alpha, resulting in its degradation and NF-kappaB activation. Constitutive IKK activation occurs in both Tax-transfected and human T-cell leukemia virus I-infected T cells. We further demonstrate that Tax-mediated NF-kappaB signaling also requires the NF-kappaB-inducing kinase (NIK). Consistently, inactive forms of either IKKs or NIK attenuate Tax-mediated NF-kappaB activation. Therefore, Tax activates NF-kappaB by targeting cellular signaling molecules, including both IKKs and NIK.

Antisense inhibition of gene expression in bacteria by PNA targeted to mRNA

Peptide nucleic acid (PNA) is a DNA mimic with attractive properties for developing improved gene-targeted antisense agents. To test this potential of PNA in bacteria, PNAs were designed to target the start codon regions of the Escherichia coli beta-galactosidase and beta-lactamase genes. Dose-dependent and specific gene inhibition was observed in vitro using low nanomolar PNA concentrations and in vivo using low micromolar concentrations. Inhibition was more efficient for a permeable E. coli strain relative to wild-type K-12. The potency of the anti-beta-lactamase PNAs was abolished by a six base substitution, and inhibition could be re-established using a PNA with compensating base changes. Antisense inhibition of the beta-lactamase gene was sufficient to sensitize resistant cells to the antibiotic ampicillin. The results demonstrate gene- and sequence-specific antisense inhibition in E. coli and open possibilities for antisense antibacterial drugs and gene function analyses in bacteria.

Inhibition of translation and bacterial growth by peptide nucleic acid targeted to ribosomal RNA

Peptide nucleic acid (PNA) is a DNA mimic that has shown considerable promise as a lead compound for developing gene therapeutic drugs. We report that PNAs targeted to functional and accessible sites in ribosomal RNA can inhibit translation in an Escherichia coli cell-free transcription/translation system, with 50% reductions caused by nanomolar PNA concentrations. The effect in vitro is quantitatively similar to that of the known translation inhibitor and antibiotic tetracycline. Also, the targeted PNAs inhibited bacterial growth on agar plates and in liquid culture. A strain of E. coli (AS19) that is more permeable to antibiotics was approximately 10-fold more sensitive to the active PNAs, suggesting that the effect on growth indeed was caused by PNAs that entered cells. Inhibition was not observed when using control PNAs of similar composition but with an unrelated or mismatched sequence. The results demonstrate that ribosomal RNA is a possible target for sequence-designed novel antibiotics based on DNA analogues or mimics.

Interdependence in the processing of ribosomal RNAs in Schizosaccharomyces pombe

Eukaryotic rRNAs are produced by cleavage of a large 35 to 45 S pre-rRNA transcript which initially must be fully transcribed and assembled into an 80 to 90 S nucleolar ribonucleoprotein particle. Despite this need for a completed transcript, several investigations have reported a split processing scheme for independent maturation of the large and small subunit rRNAs. Here, an efficiently expressed rDNA plasmid was used to quantitatively analyze the effects of mutations in the internal transcribed spacer (ITS) region in the yeast, Schizosaccharomyces pombe. The results show that substitution of ITS regions inhibits the processing of distant external transcribed spacers (ETS) and that deletion of the ITS2 spacer not only prevents the maturation of the large subunit, but severely affects maturation of the small subunit rRNA. This indicates that the processing mechanisms are not fully split and, when taken together with other evidence of interdependences in rRNA maturation, the results suggest that the interdependences act as a quality control mechanism to help ensure that only functional rRNA is incorporated into ribosomes.

Progress in developing PNA as a gene-targeted drug

Peptide nucleic acid (PNA) is a DNA mimic in which the nucleobases are attached to a pseudopeptide backbone. This achiral, uncharged, and rather flexible peptide backbone permits more stable hybridization to DNA and RNA oligomers with uncompromised or even improved sequence selectivity. Additional advantages of PNA are stability against nucleases and proteases and convenient solid phase synthesis. At the RNA level, PNA can be targeted to mRNA to block protein synthesis in an antisense strategy. PNA can also be targeted to the RNA component of ribonucleoproteins (RNPs) to inhibit their enzymatic activities. At the DNA level, the unique ability of PNA to bind DNA by duplex invasion can be used to arrest transcription within a gene sequence or to provide an artificial open complex to promote transcription. This review focuses on recent progress toward the development of PNA as a sequence-targeted drug.

The ribosomal-RNA-processing pathway in Schizosaccharomyces pombe

In all cells, a long precursor RNA is processed into mature rRNAs for ribosome biogenesis. In eukaryotes, the complexity and speed of the overall process often has made it difficult to establish finer details of the maturation pathway. Since phylogenetic comparisons can provide evidence for critical events, the major rRNA processing pathway for the yeast Schizosaccharomyces pombe was determined using primer extension, nuclease protection and Northern-hybridisational analyses. Transcript mapping of the 5' external transcribed spacer revealed six cleavage sites which occur upstream of the mature 18S termini. Two of these sites as well as a site adjacent to the 18S termini are complementary to conserved Box sequences in the S. pombe U3 small nucleolar RNA. Transcript mapping of the internal transcribed spacers (1 and 2) suggest similar maturation schemes for the two spacers, in which an initial endonuclease cleavage is followed by processing to the mature termini. The mature 5' termini of 25S rRNA appear to be heterogeneous in S. pombe, as has been demonstrated for 5.8S rRNA, suggesting an essential limiting structure in the ribosome-integrated mature RNA. Together with our previous analysis of the 3' external spacer region, the results reveal the major processing pathway for S. pombe and further support a maturation process which acts as a quality assurance mechanism.

Constitutive dephosphorylation and activation of a member of the nuclear factor of activated T cells, NF-AT1, in Tax-expressing and type I human T-cell leukemia virus-infected human T cells

The tax gene product of the type I human T-cell leukemia virus (HTLV-I) transactivates interleukin-2 (IL-2) gene through activation of an enhancer termed CD28 responsive element (CD28RE). Tax activation of the CD28RE is partially mediated by a member of the nuclear factor of activated T cells, NF-AT1. We have previously shown that NF-AT1 is constitutively active in Jurkat T cells stably transfected with the Tax cDNA, although the underlying molecular mechanism and physiological relevance of this finding remain unclear. In this report, we demonstrate that the active form of NF-AT1 is also present in the nuclei of HTLV-I-transformed T cells that express the Tax protein. Interestingly, the constitutive activation of NF-AT1 in these T cells is associated with its dephosphorylation. Furthermore, the dephosphorylated NF-AT1 can be rapidly rephosphorylated when the cells are incubated with cyclosporin A, an immunosuppressant inhibiting the serine/threonine phosphatase calcineurin. These results suggest that activation of NF-AT1 in Tax-expressing and HTLV-I-transformed T cells results from its dephosphorylation, which in turn may be due to deregulation of calcineurin.

CD28 mediates a potent costimulatory signal for rapid degradation of IkappaBbeta which is associated with accelerated activation of various NF-kappaB/Rel heterodimers

Optimal activation of T cells requires at least two signals delivered by the T-cell receptor complex and costimulatory molecules such as CD28. The CD28 signaling participates in the transcription of the interleukin-2 gene through activation of an enhancer termed the CD28-responsive element (CD28RE). Stimulation of CD28 enhances mitogen-mediated induction of CD28RE-binding proteins including members of the NF-kappaB/Rel transcription factor family, although the underlying mechanism remains elusive. In this report, we show that CD28 costimulation leads to biphasic induction of NF-kappaB/Rel heterodimers, including early-phase induction of p50/RelA and c-Rel/RelA and late-phase induction of p50/c-Rel. Interestingly, activation of these NF-kappaB/Rel complexes by the CD28 signal is associated with the rapid degradation of both IkappaBalpha and IkappaBbeta, two major cytoplasmic inhibitors of NF-kappaB/Rel. Although IkappaBalpha degradation can be induced by phorbol ester alone, degradation of IkappaBbeta is largely dependent on the CD28 costimulatory signal. We further demonstrate that CD28-mediated transactivation of the CD28RE enhancer is potently inhibited by an N-terminal truncation mutant of IkappaBbeta that is incapable of responding to the degradation signals. Together, these results suggest that the CD28 costimulatory signal augments activation of NF-kappaB/Rel by promoting degradation of IkappaBbeta as well as enhancing degradation of IkappaBalpha and that induction of NF-kappaB/Rel serves as an essential step in the signal-mediated activation of the CD28RE enhancer.

Regulation of dihydrofolate reductase gene expression and E2F components in human diploid fibroblasts during growth and senescence

The induction of dihydrofolate reductase (DHFR), a key enzyme in DNA biosynthesis that is induced just before the onset of S phase, is markedly attenuated in senescent human fibroblasts (Pang and Chen, 1994, J. Cell. Physiol., 160:531-538). Footprinting analysis of the 365 bp promoter region of the human DHFR gene (-381 to -17) indicated that nuclear proteins bind to a cluster of cis-elements, including two overlapping E2F binding sequences, two Sp1 sites, and one Yi sequence. Gel mobility shift assays were performed to assess the role of each cis-element in the regulation of DHFR gene expression. We found that 1) Sp1 binding activity was constitutively expressed throughout the cell cycle in early passage and senescent cells; 2) Yi binding activity was undetectable in both early passage and senescent cells; and 3) E2F binding activity was serum-inducible, senescence-dependent, and prominent in presenescent cells but strikingly diminished in senescent cells. Northern blot analysis of the expression of E2F and DP family members showed that the E2F-1, E2F-4, and E2F-5 mRNA was growth- and senescence-dependent, whereas E2F-3, DP-1, and DP-2 expression was constitutive and senescence-independent. In contrast, E2F-2 mRNA was not detectable in IMR-90 or WI-38 human fibroblasts. Western blot analysis showed that among the E2F-associated proteins, the expression of E2F-1, cyclin A, and cyclin B but not p107 was cell cycle- and senescence-dependent. A nuclear extract mixing experiment suggested that an inhibitory factor may further reduce E2F binding activity in senescent cells.

Activation of the IL-2 gene promoter by HTLV-I tax involves induction of NF-AT complexes bound to the CD28-responsive element

The tax gene product of the type I human T-cell leukemia virus (HTLV-I) is a potent transcriptional activator of various growth-related cellular genes, including that encoding interleukin-2 (IL-2). Tax activation of many of these target genes appears to be mediated by the NF-kappa B/Rel and CREB/ATF family of cellular transcription factors. However, the mechanism by which Tax transactivates the IL-2 gene remains unclear. In the present study, we demonstrate that neither NF-kappa B/Rel nor CREB/ATF is sufficient for Tax-mediated activation of the IL-2 promoter. Two novel nuclear protein complexes are induced by Tax and specifically bind to an IL-2 gene enhancer, the CD28-responsive element (CD28RE). Immunobiochemical analyses suggest that these DNA binding complexes contain at least two members of the nuclear factor of activated T cells, NF-ATp and NF-ATc. However, the CD28 binding NF-AT complexes do not contain Jun and Fos family proteins that have been proposed to serve as NF-AT partners in the activation of the IL-2 NF-AT motif. Transient transfection studies demonstrate that the in vivo expressed NF-ATp binds to the CD28RE probe and enhances Tax-mediated activation of this critical IL-2 enhancer. We demonstrate further that binding of NF-AT to CD28RE is critical for Tax activation of the IL-2 promoter. Together, these results suggest a novel mechanism of Tax-mediated activation of the IL-2 gene, which involves the induction of NF-AT-containing CD28RE binding complexes.

Persistent activation of NF-kappa B/Rel by human T-cell leukemia virus type 1 tax involves degradation of I kappa B beta

Activation of the eukaryotic NF-kappaB/Rel transcription factors by various cytokines and mitogens is a transient event, reflecting the fact that these inducers trigger the degradation and resynthesis of the dynamic NF-kappaB/Rel inhibitor IkappaBalpha. However, the tax gene product of the human T-cell leukemia virus type 1 (HTLV-1) is known to induce the persistent nuclear expression of various NF-kappaB/Rel factors, especially the c-Rel proto-oncoprotein, although the underlying mechanism remains unclear. In the present study, we demonstrate that Tax induces the degradation Of IkappaBbeta, another NF-kappaB/Rel cytoplasmic inhibitor that differs from IkappaBalpha in signal responses. Unlike that observed with IkappaBalpha, the degradation Of IkappaBbeta is not associated with its rapid resynthesis, apparently because of the failure of Tax to stimulate IkappaBbeta gene transcription. Thus, expression of Tax in Jurkat T cells leads to the gradual depletion of IkappaBbeta, which is correlated with the induction of c-Rel-containing kappaB binding complexes. Remarkably, in the three HTLV-1-infected T-cell lines investigated, little or no detectable amount of IkappaBbeta was found. We further demonstrate that Tax is able to override the cytoplasmic retention of c-Rel by 1kappaBbeta in transiently transfected cells. Together, these studies suggest that Tax-mediated inactivation Of IkappaBbeta may play a role in the persistent nuclear expression of c-Rel induced by HTLV-I infection.

An efficiently expressed 5.8S rRNA 'tag' for in vivo studies of yeast rRNA biosynthesis and function

Inefficient expression or detrimental markers have limited mutational analyses of eukaryotic 5.8S rRNA and the associated rDNA transcribed spacers. We have found a neutral, 4-base insertion mutation that effectively tags the 5.8S rRNA for improved studies of rRNA expression, processing and function. Cells expressing the tagged rDNA plasmid contain 50-60% mutant 5.8S rRNA, but show a normal growth rate and polysomal profile and a constant distribution of tagged 5.8S rRNA. The high level of expression also demonstrates that plasmid-associated rDNA is preferentially transcribed over chromosomal copies.

In-vitro correlation between tension and length change in an anterior cruciate ligament substitute

The length change and tension patterns from multiple insertion locations of an anterior cruciate ligament substitute were studied in 10 cadaver knees. Length change was measured with a spring-loaded isometer of low stiffness, and tension was measured with a piezoelectric load cell. In both instances a thin Kevlar test ligament was positioned in five different femoral and two different tibial ligament insertion locations, that were all located within the normal attachments of the anterior cruciate ligament. Differences were found regarding length changes and tension patterns from a simulated active extension between the central, posterior, and anterior femoral locations. All locations showed larger length change and tension values in extension than in flexion. The anterior femoral ligament insertion location showed length change and tension patterns with increasing values in flexion compared to the other femoral locations. The anterior tibial ligament insertion location showed smaller excursions of both length and tension, than did the central one, but the patterns of the curves were similar. A statistically significant correlation was found between length change and tension patterns throughout a 130-0 degrees range of motion. A statistically significant correlation was also found between the maximum length and tension values. No fixed relationship was found between the magnitude of the length and tension values, when different intervals of the range of motion were studied. RELEVANCE: The intraoperative employment of length change measurements of a test ligament in anterior cruciate ligament reconstruction gives information on where high tension can be expected in the range of motion of the knee, and how this can differ depending on the angle of graft fixation. The information gained can also be used to improve drill channel location. However, no predictions on the magnitude of tension can be made, mainly due to large biological variability.

Analysis of sequence-specific binding activity of cis-elements in human thymidine kinase gene promoter during G1/S phase transition

Expression of thymidine kinase (TK) gene in normal human diploid, cells is both cell cycle and age dependent and appears to be transcriptionally regulated. Several studies have indicated that the G1/S control sequence may reside within the region of about 130 bp upstream of the transcription initiation site. We have previously shown that a trans-acting factor, CBP/tk (CCAAT binding protein for TK gene), binds to either one of the two inverted CCAAT boxes in a cell cycle- and age-dependent manner (Pang and Chen, 1993, J. Biol. Chem., 268:2909-2916). An upstream 25 bp fragment (-109/-84), containing both Yi-like and E2F-like binding sites, has recently been proposed to be essential for the G1/S regulation of human TK gene. To assess the contribution of various cis-elements in human TK promoter to the G1/S regulation, we have examined the binding activity of these cis-elements in the nuclear extracts derived from human IMR-90 cells at low passage number. Our results indicated that no binding activity could be detected using either the 25 bp fragment (-109/-94) or the authentic Yi sequence. However, Yi binding activity was observed in SV-40 transformed IMR-90 cells. In contrast, the 28 bp fragment (-91/-64) that contains the distal inverted CCAAT box exhibited a strong binding in serum-stimulated young IMR-90 cells. The binding of CBP/tk to the 28 bp fragment was abolished by a single base mutation in the CCAAT box. The CBP/tk binding of the 28 bp fragment could not be displaced by either the 25 bp fragment or the authentic Yi element. A deletion of the 5'-flanking region of the 28 bp fragment up to 5 bases also abolished the binding activity. The CBP/tk binding in IMR-90 cells was supershifted by antiserum against NF-Ya, but not by antiserum made against p107, pRb, cyclin A, p33cdk2, or p34cdc2. Taken together, our results suggest that the G1/S regulatory cis-element in human TK promoter may be confined only to CBP/tk binding sites.

Tetrahymena ribozyme disrupts rRNA processing in yeast

The intervening sequence (IVS) of Tetrahymena thermophila nucleolar DNA interrupts a highly conserved sequence in the RNA core structure of the large ribosomal subunit. This location in nuclear DNA is unusual as most group I introns are in mitochondrial and chloroplast DNA. To examine the effect of a ribozyme insertion in another nuclear genome, the Tetrahymena IVS was introduced into the analogous position in a cloned Schizosaccharomyces pombe ribosomal gene, and the mutant rDNA was expressed in vivo. RNA analyses indicated that mature 5.8 S rRNA was not formed from the mutant gene transcript and the amount of 27 S nRNA was significantly reduced. In contrast, hybridization analyses indicated that RNA splicing continued, and normal forms of free ribozyme were present. The results show that the IVS sequence can interfere with rRNA processing and suggest that the unusual amplification of a single rDNA repeat may have forced Tetrahymena to accommodate its ribozyme.

Sagittal knee stability after anterior cruciate ligament reconstruction with a patellar tendon strip. A two-year follow-up study

Tibial anteroposterior displacement after anterior cruciate ligament reconstruction with a patellar tendon graft was followed prospectively for 2 years in 24 patients with an arthrometer. The femoral ligament insertion location, in a lateral projection, and the change in intraarticular fixation distance, measured with an isometer, were documented intraoperatively. Two years after surgery, the overall mean injured-noninjured difference in anteroposterior displacement was 2.0 +/- 2.3 mm. All grafts were fixed during surgery at 20 degrees of knee flexion. Patients for whom this angle coincided with the angle of minimum intraarticular fixation distance (Group I), and patients who had a femoral ligament insertion location > 2 mm anterior to the center of the normal anterior cruciate ligament attachment (Group A) showed larger tibial displacement than the other patients. An injured-noninjured difference in tibial anteroposterior displacement > or = 3 mm was classified as failure. Groups I and A failure rates were higher than for the other patients. No correlation was found between anteroposterior displacement and magnitude of the change in intraarticular fixation distance. We conclude that anterior femoral locations lead to larger sagittal play after 2 years than central or posterior locations and that the magnitude of the fixation distance is less important than the pattern.