Reduction in Obsessive Compulsive Disorder and Self-Injurious Behavior With Saccharomyces boulardii in a Child with Autism: A Case Report

This case report describes the effective use of Saccharomyces boulardii in a boy with autism spectrum disorder, obsessive compulsive disorder (OCD), and self-injurious behavior (SIB). Gastrointestinal dysfunction and OCD are frequent comorbidities in autism, which may share a common etiology resulting from a disturbance in normal gut microbiota. Alterations in microbial diversity influence neuroinflammation and are linked to mood disorders, abdominal pain, and SIB. S boulardii is a nonpathogenic probiotic yeast that supports a healthy microbiome, enhances immune function, and reduces diarrhea. Treatment with S boulardii successfully reduced OCD and SIB symptoms in this child.

Secular trend of sex ratio and symptom patterns among children with autism spectrum disorders

An information technology invention embodied in a website serving the interests of the autism community was designed to "let the data talk." By its use, the authors have detected a downward temporal trend in 2013 in the sex ratio of 2431 members of Autism360.org from a yearly average between 2010 and 2012 of 4.24 to 3.01 in 2013. As of the first two months of 2014, the average sex ratio is 2.69. We report contemporaneous changes in previously reported male vs female symptom patterns. Such changes suggest a convergence in which distinctive severity of certain grouped central nervous, emotional, and immune profile items in females have diminished toward that of males. The data also show correlations among these profile items that add further credence to the sex ratio findings. A wider dispersion of the female data as compared with the male data was found in the year preceding the downward trend in the mean sex ratio. The authors suggest that such a trend toward an increase in the variance of the data points to instability in the biological system-the autism spectrum. We conclude that public policy would be better served by monitoring changes in the standard deviation as compared with the mean in large data sets to better anticipate changes. The findings we report raise questions based on known sex differences in detoxification chemistry. One such question would be whether maternal, fetal, or individual exposure to a novel environmental factor may have breached the taller fence of female protection from toxins.

Gender differences among children with autism spectrum disorder: differential symptom patterns

The gender ratio among children in the autism spectrum of more than four boys to every girl is widely recognized. The authors present an analysis of gender differences among 79 482 symptoms and strengths in 1495 boys and 336 girls aged 2 to 18 years from parent-identified autistic children reported to a structurally novel anonymous parent-entered online database, Autism360. The data reveal differences that provide previously undetected clues to gender differences in immune and central nervous system and gastrointestinal functional disturbances. Together with published observations of male/female differences in inflammation, oxidative stress, and detoxication, these findings open doors to research focusing on gender physiology as clues to etiologic factors in autism. This study exemplifies a research method based on a large, detailed, patient-entered, structured data set in which patterns of individual illness and healing may answer collective questions about prevention and treatment.

Scientific narratives in autism spectrum disorder

Autism spectrum disorder (ASD) has increased in prevalence in the United States from one in 10 000 in the 1950s to one in 88 today. And in South Korea, the prevalence is now one in 44.(1) If the current rate of increase in the incidence of ASD continues, it could become the norm in children in 30 years. Scientific research continues to reveal potential connections between ASD and the gut microbiome or cancer gene mutations. It occurs in all socioeconomic and ethnic groups and is almost five times more common in boys than in girls. The costs to families and society is high-Medicaid costs for children with ASD are almost five times higher than for children without a diagnosis of ASD. And these costs do not begin to include those of intensive behavioral intervention.(2) Why is the prevalence of this condition increasing, and can a systems-oriented approach be used to resolve this pressing health challenge?

Learning about Autism

A medical essay written in 1923 pointed out the fallacy of blaming a chronic illness on the name of a disease. The focus of treatment should be the individual, not the disease. With a focus on options based on the individuality of each patient, I ask a simple two-part question: Does my patient need to avoid or be rid of substances and/or to be provided with substances that would favor nature's impulse toward healing?

In my academic training as a physician, I learned that a clinically effective stance favored an optimistic intent combined with the objective application of my skills—refined though the practice of listening, prescribing, and observing outcome. My understanding of autism has rested on a foundation of the individuality of every living thing, the rhythmicity of life, and the balance that characterizes healthy systems. The first autistic child I examined struck me with a nonverbal message: “I am in here; see me.”

The recognition of the role of bacterial toxins amplified my notion that a general disorder of the microbiome underlies the loss of immune tolerance that accompanies the global state of sensitivity found in individuals in the autism spectrum. Depletion of organisms that have populated the human gut since before the dawn of our species arises as the most recent elevation of my learning curve.

Morphological features of coronary arteries and lesions in hearts from five species of sharks collected from the northwestern Atlantic Ocean

Morphological features of coronary arteries and incidental lesions are reported from hearts in five species of sharks, the shortfin mako shark, Isurus oxyrhinchus Rafinesque, thresher shark Alopias vulpinus (Bonaterre), blue shark, Prionace glauca L., the smooth dogfish, Mustelus canis (Mitchill), and spiny dogfish, Squalus acanthias L. Sharks were collected from the northwestern Atlantic between June and August from 1996 to 2010. They were necropsied dockside and the hearts were preserved in buffered formalin. Routine sections including ventricle/conus arteriosus and the atrio-ventricular junctions were embedded in paraffin, stained with common histological and immunohistochemical methods and examined by brightfield microscopy. Myointimal hyperplasia, medial myo-myxomatous hyperplasia and bifurcation pads were observed commonly, and medial muscle reorientation and epicardial myeloid tissues were rare. All the above features differed in severity, prevalence and distribution depending on anatomical site and shark species/size. Morphometric analysis indicated that myomyxomatous hyperplasia is associated with luminal narrowing of blood vessels. As suggested previously, the described morphological features are most likely physiological responses to blood flow characteristics. Vascular and cardiac lesions were uncommon and included, granulomatous proliferative epicarditis with fibroepitheliomas, myxomatous epicardial expansions, medial arterial vacuolation, myocardial fibrosis, acute ventricular emboli and parasitic granulomas. The lesions of embolism, proliferative and granulomatous epicarditis and myocardial fibrosis were in all sharks associated with capture events including retained fishing hooks. The significance and aetiopathogenesis of medial vacuolation and epicardial myxomatous expansions remains unclear.

TGF-beta/extracellular matrix interactions in dentin matrix: a role in regulating sequestration and protection of bioactivity

TGF-beta isoforms sequestrated in dentin matrix potentially provide a reservoir of bioactive molecules that may influence cell behavior in the dentin-pulp complex following tissue injury. The association of these growth factors with dentin matrix and the influence of such associations on the bioactivity of growth factors are still unclear. We used surface plasmon resonance technology in the BIAcore 3000 system to investigate the binding of TGF-beta isoforms 1 and 3 to purified decorin, biglycan, and EDTA soluble dentin matrix components. TGF-beta isoforms 1 and 3 were immobilized on sensorchips CM4 through amine coupling. For kinetic studies of protein binding, purified decorin and biglycan, isolated EDTA soluble dentin matrix, and dentin matrix immunodepleted of decorin and/or biglycan were injected over TGF-beta isoforms and allowed to interact. Programmed kinetic analysis software provided sensorgrams for each concentration of proteoglycan or dentin matrix extract injected. Purified decorin and biglycan and dentin matrix extract bound to the TGF-beta isoforms. However, the association with TGF-beta3 was much weaker than that with TGF-beta1. After immunoaffinity depletion of the dentin matrix extract, the level of interaction between the dentin matrix extract and TGF-beta was significantly reduced. These results suggest isoform-specific interactions between decorin/biglycan and TGF-beta isoforms 1 and 3, which may explain why TGF-beta3 is not detected in the dentin matrix despite being expressed at higher levels than TGF-beta1 in odontoblasts. These proteoglycans appear to play a significant role in TGF-beta/extracellular matrix interactions and may be important in the sequestration of these growth factors in the dentin matrix.

Metabolic endophenotype and related genotypes are associated with oxidative stress in children with autism

Autism is a behaviorally defined neurodevelopmental disorder usually diagnosed in early childhood that is characterized by impairment in reciprocal communication and speech, repetitive behaviors, and social withdrawal. Although both genetic and environmental factors are thought to be involved, none have been reproducibly identified. The metabolic phenotype of an individual reflects the influence of endogenous and exogenous factors on genotype. As such, it provides a window through which the interactive impact of genes and environment may be viewed and relevant susceptibility factors identified. Although abnormal methionine metabolism has been associated with other neurologic disorders, these pathways and related polymorphisms have not been evaluated in autistic children. Plasma levels of metabolites in methionine transmethylation and transsulfuration pathways were measured in 80 autistic and 73 control children. In addition, common polymorphic variants known to modulate these metabolic pathways were evaluated in 360 autistic children and 205 controls. The metabolic results indicated that plasma methionine and the ratio of S-adenosylmethionine (SAM) to S-adenosylhomocysteine (SAH), an indicator of methylation capacity, were significantly decreased in the autistic children relative to age-matched controls. In addition, plasma levels of cysteine, glutathione, and the ratio of reduced to oxidized glutathione, an indication of antioxidant capacity and redox homeostasis, were significantly decreased. Differences in allele frequency and/or significant gene-gene interactions were found for relevant genes encoding the reduced folate carrier (RFC 80G > A), transcobalamin II (TCN2 776G > C), catechol-O-methyltransferase (COMT 472G > A), methylenetetrahydrofolate reductase (MTHFR 677C > T and 1298A > C), and glutathione-S-transferase (GST M1). We propose that an increased vulnerability to oxidative stress (endogenous or environmental) may contribute to the development and clinical manifestations of autism.

Two-dimensional self-assembly in diblock copolymers

Diblock copolymers confined to a two-dimensional surface may produce uniform features of macromolecular dimensions (approximately 10-100 nm). We present a mathematical model for nanoscale pattern formation in such polymers that captures the dynamic evolution of a solution of poly(styrene)-b-poly(ethylene oxide), PS-b-PEO, in solvent at an air-water interface. The model has no fitting parameters and incorporates the effects of surface tension gradients, entanglement or vitrification, and diffusion. The resultant morphologies are quantitatively compared with experimental data.

Interaction of DNA polymerase beta with GRIP1 during meiosis

DNA polymerase beta (pol beta) is an essential enzyme that has been shown to localize as discrete foci to the synaptonemal complex during meiosis in the mouse. To identify proteins that associate with pol beta during meiosis, we employed the yeast two-hybrid screen. Here we show that a multiple PDZ domain-containing protein, the glutamate receptor interacting protein 1 (GRIP1), interacts specifically with pol beta. The PDZ domain-containing proteins, including GRIP1, act as scaffolds to promote rapid and localized biochemical events that require the interaction of multiple proteins. GRIP1 localizes to discrete foci on meiotic bivalents of both spermatocyte and oocyte nuclei, and colocalizes with pol beta. Together, these findings provide evidence that GRIP1 interacts with pol beta during meiosis. Our findings are consistent with the possibility that GRIP1 acts as a scaffold to promote interaction between proteins that function during meiosis.

Patient participation in physical therapy goal setting

BACKGROUND AND PURPOSE

An important part of treatment planning in physical therapy is effective goal setting. The Guide to Physical Therapist Practice recommends that therapists should identify the patient's goals and objectives during the initial examination in order to maximize outcomes. The purpose of this study was to examine whether therapists seek to involve patients in goal setting and, if so, what methods they use. Therapists' attitudes toward participation and patient satisfaction with the examination were also examined.

SUBJECTS AND METHODS

Twenty-two physical therapists audiotaped the initial examination of 73 elderly patients (mean of 76.4 years of age, SD = 7.1, range = 65-94). The audiotaped examinations were then scored using the Participation Method Assessment Instrument (PMAI) to determine the frequency of attempts made by therapists to involve patients in goal setting. Therapists and patients completed surveys following the examinations.

RESULTS

Therapists' use of participation methods during examinations ranged from a minimum of 1 to a maximum of 19 out of 21 possible items on the PMAI. The therapists stated that they believed that it is important to include patients in goal-setting activities and that outcomes will be improved if patients participate. Patients also indicated that participation is important to them.

DISCUSSION AND CONCLUSION

In most cases, the therapists did not fully take advantage of the potential for patient participation in goal setting. Patient and therapist education is needed regarding methods for patient participation during initial goal-setting activities.

Clinical significance of monitoring early symptom change to predict outcome

Even with efforts to develop medication algorithms for the treatment of psychiatric illnesses, there is no single authoritative method that can be used to incorporate multiple factors in the treatment decision process. For this reason, physicians are faced with the often daunting task of sifting through the numerous treatment options for psychiatric illness to develop an approach that will prove the most successful for their patients. Investigating patient patterns of response, particularly during the acute phase of treatment, and bearing them in mind when developing treatment protocols may assist clinicians in optimally managing the degree and course of symptom response. We present here a consideration of the timing and nature of response as well as individual patient predictors, which may impact therapy decisions. Furthermore, we explore the clinical significance of integrating response patterns into the treatment approach. We believe that an analysis of response patterns, in conjunction with the use of other practice guidelines, is a viable method to more effectively navigate critical decision points in the treatment process and ultimately have a dramatic effect on patient outcome.

Particle transport in the zebra mussel, Dreissena polymorpha (Pallas)

The capture, transport, and sorting of particles by the gills and labial palps of the freshwater mussel Dreissena polymorpha were examined by endoscopy and video image analysis. More specifically, the morphology of the feeding organs in living zebra mussels was described; the mode and speeds of particle transport on the feeding organs was measured; and the sites of particle selection in the pallial cavity were identified. Particle velocities (outer demibranch lamellae, 90 microm s(-1); inner demibranch lamellae, 129 microm s(-1); marginal food groove of inner demibranchs, 156 microm s(-1); dorsal ciliated tracts, 152 microm s(-1)), as well as the movement of particles on the ctenidia and labial palps of D. polymorpha, are consistent with mucociliary, rather than hydrodynamic, transport. Particles can be sorted on the ctenidia of zebra mussels, resulting in a two-layer transport at the marginal food groove of the inner demibranch. That is: preferred particles are transported inside the marginal groove proper, whereas particles destined for rejection are carried superficially in a string of mucus. Sorting also occurs at the ventral margin of the outer demibranch; desirable particles are retained on the outer demibranch, whereas unacceptable particles are transferred to the inner demibranch and ultimately excluded from ingestion. We suggest that the structure of homorhabdic ctenidia does not preclude particle sorting, and that some ecosystem modifications attributed to zebra mussels may ultimately be due to ctenidial sorting mechanisms.

Polarization dynamics of solitons in birefringent fibers

We study the dynamics of uniformly polarized pulses in a birefringent optical fiber. By considering the Hamiltonian structure, symmetries, and the momentum map of the underlying equations, we obtain a self-consistent set of equations for the polarization state alone. In the autonomous case, we find the bifurcation curve of this system, and discuss how the orbits change in the neighborhood of this curve. We calculate the orbits explicitly. An extension to nonautonomous underlying equations is also possible. We further briefly discuss the effect of radiation emission from solitons as their polarization state changes.

Computerizing medication algorithms and decision support systems for major psychiatric disorders

In this article, the authors discuss the rationale for the use of computerized medication algorithms and decision support systems in the treatment of major psychiatric disorders. The field of psychopharmacology has advanced tremendously in the last two decades, with the resulting vast array of new information yielding a marked disparity between actual practice and what is commonly called "best practice." As a remedy, clinical practice guidelines and algorithms have been widely developed. These algorithms are used to disseminate up-to-date information, effect change in physician behavior, and reduce untoward variation in care. Review of the literature reveals advantages and limitations in trying to implement these paper and pencil guidelines and algorithms. Available research also suggests that computerized decision support systems have the potential to overcome such limitations, increase the use of treatment guidelines and algorithms, and improve physician adherence to recommended practices. The advantages of computerized medication algorithms and decision support systems are discussed. Finally, the computer platform elements that are necessary to make such systems effective and user-friendly are described.

Mlh1 deficiency enhances several phenotypes of Apc(Min)/+ mice

Defects in APC and DNA mismatch repair genes are associated with a strong predisposition to colon cancer in humans, and numerous mouse strains with mutations in these genes have been generated. In this report we describe the phenotype of Min/+ Mlh1-/- mice. We find that these doubly mutant mice develop more than three times the number of intestinal adenomas compared to Min/+ Mlh1+/+ or +/- mice but that these tumors do not show advanced progression in terms of tumor size or histological appearance. Full length Apc protein was not detected in the tumor cells from Min/+ Mlh1-/- mice. Molecular analyses indicated that in many tumors from Min/+ Mlh1-/- mice, Apc was inactivated by intragenic mutation. Mlh1 deficiency in Min/+ mice also led to an increase in cystic intestinal crypt multiplicity as well as enhancing desmoid tumorigenesis and epidermoid cyst development. Thus, Mlh1 deficiency influences the somatic events involved in the development of most of the phenotypes associated with the Min mutation. Oncogene (2000).

Mammalian DNA mismatch repair

DNA mismatch repair (MMR) is one of multiple replication, repair, and recombination processes that are required to maintain genomic stability in prokaryotes and eukaryotes. In the wake of the discoveries that hereditary nonpolyposis colorectal cancer (HNPCC) and other human cancers are associated with mutations in MMR genes, intensive efforts are under way to elucidate the biochemical functions of mammalian MutS and MutL homologs, and the consequences of defects in these genes. Genetic studies in cultured mammalian cells and mice are proving to be instrumental in defining the relationship between the functions of MMR in mutation and tumor avoidance. Furthermore, these approaches have raised awareness that MMR homologs contribute to DNA damage surveillance, transcription-coupled repair, and recombinogenic and meiotic processes.

Chromosomal influence on meiotic spindle assembly: abnormal meiosis I in female Mlh1 mutant mice

In mouse oocytes, the first meiotic spindle is formed through the action of multiple microtubule organizing centers rather than a pair of centrosomes. Although the chromosomes are thought to play a major role in organizing the meiotic spindle, it remains unclear how a stable bipolar spindle is established. We have studied the formation of the first meiotic spindle in murine oocytes from mice homozygous for a targeted disruption of the DNA mismatch repair gene, Mlh1. In the absence of the MLH1 protein meiotic recombination is dramatically reduced and, as a result, the vast majority of chromosomes are present as unpaired univalents at the first meiotic division. The orientation of these univalent chromosomes at prometaphase suggests that they are unable to establish stable bipolar spindle attachments, presumably due to the inability to differentiate functional kinetochore domains on individual sister chromatids. In the presence of this aberrant chromosome behavior a stable first meiotic spindle is not formed, the spindle poles continue to elongate, and the vast majority of cells never initiate anaphase. These results suggest that, in female meiotic systems in which spindle formation is based on the action of multiple microtubule organizing centers, the chromosomes not only promote microtubule polymerization and organization but their attachment to opposite spindle poles acts to stabilize the forming spindle poles.

Different mutator phenotypes in Mlh1- versus Pms2-deficient mice

Deficiencies in DNA mismatch repair (MMR) result in increased mutation rates and cancer risk in both humans and mice. Mouse strains homozygous for knockouts of either the Pms2 or Mlh1 MMR gene develop cancer but exhibit very different tumor spectra; only Mlh1(-/-) animals develop intestinal tumors. We carried out a detailed study of the microsatellite mutation spectra in each knockout strain. Five mononucleotide repeat tracts at four different chromosomal locations were studied by using single-molecule PCR or an in vivo forward mutation assay. Three dinucleotide repeat loci also were examined. Surprisingly, the mononucleotide repeat mutation frequency in Mlh1(-/-) mice was 2- to 3-fold higher than in Pms2(-/-) animals. The higher mutation frequency in Mlh1(-/-) mice may be a consequence of some residual DNA repair capacity in the Pms2(-/-) animals. Relevant to this idea, we observed that Pms2(-/-) mice exhibit almost normal levels of Mlh1p, whereas Mlh1(-/-) animals lack both Mlh1p and Pms2p. Comparison between Mlh1(-/-) animals and Mlh1(-/-) and Pms2(-/-) double knockout mice revealed little difference in mutator phenotype, suggesting that Mlh1 nullizygosity is sufficient to inactivate MMR completely. The findings may provide a basis for understanding the greater predisposition to intestinal cancer of Mlh1(-/-) mice. Small differences (2- to 3-fold) in mononucleotide repeat mutation rates may have dramatic effects on tumor development, requiring multiple genetic alterations in coding regions. Alternatively, this strain difference in tumor spectra also may be related to the consequences of the absence of Pms2p compared with the absence of both Pms2p and Mlh1p on as yet little understood cellular processes.

The human MLH1 cDNA complements DNA mismatch repair defects in Mlh1-deficient mouse embryonic fibroblasts

The DNA mismatch repair gene hMLH1 is reported to function in mutation avoidance, cell cycle checkpoint control, the cytotoxicity of various DNA-damaging agents, and transcription-coupled nucleotide excision repair. Formal proof of the involvement of hMLH1 in these processes requires single gene complementation. We have stably expressed hMLH1 from a transfected cDNA in Mlh1-deficient mouse embryonic fibroblasts. Expression of hMLH1 restored normal levels of mPMS2 protein, reduced spontaneous base substitution and microsatellite mutations, increased sensitivity to the toxic effects of 6-thioguanine (6-TG), and restored 6-TG-induced cell cycle arrest. Our studies confirm that hMLH1 has an essential role in the maintenance of genomic stability and the potentiation of 6-TG cytotoxicity and provide a system for detailed structure/function analysis of the hMLH1 protein.

Altered spectra of hypermutation in antibodies from mice deficient for the DNA mismatch repair protein PMS2

Mutations are introduced into rearranged Ig variable genes at a frequency of 10(-2) mutations per base pair by an unknown mechanism. Assuming that DNA repair pathways generate or remove mutations, the frequency and pattern of mutation will be different in variable genes from mice defective in repair. Therefore, hypermutation was studied in mice deficient for either the DNA nucleotide excision repair gene Xpa or the mismatch repair gene Pms2. High levels of mutation were found in variable genes from XPA-deficient and PMS2-deficient mice, indicating that neither nucleotide excision repair nor mismatch repair pathways generate hypermutation. However, variable genes from PMS2-deficient mice had significantly more adjacent base substitutions than genes from wild-type or XPA-deficient mice. By using a biochemical assay, we confirmed that tandem mispairs were repaired by wild-type cells but not by Pms2(-/-) human or murine cells. The data indicate that tandem substitutions are produced by the hypermutation mechanism and then processed by a PMS2-dependent pathway.

Enhanced intestinal adenomatous polyp formation in Pms2-/-;Min mice

Analysis of two human familial cancer syndromes, hereditary nonpolyposis colorectal cancer and familial adenomatous polyposis, indicates that mutations in either one of four DNA mismatch repair gene homologues or the adenomatous polyposis coli (APC) gene, respectively, are important for the development of colorectal cancer. To further investigate the role of DNA mismatch repair in intestinal tumorigenesis, we generated mice with mutations in both Apc and the DNA mismatch repair gene, Pms2. Whereas Pms2-deficient mice do not develop intestinal tumors, mice deficient in Pms2 and heterozygous for Min, an allele of Apc, develop approximately three times the number of small intestinal adenomas and four times the number of colon adenomas relative to Min and Pms2+/-;Min mice. Although Pms2 deficiency clearly increases adenoma formation in the Min background, histological analysis indicated no clear evidence for progression to carcinoma.

Characterisation of non-transferrin-bound iron (ferric citrate) uptake by rat hepatocytes in culture

Under conditions of iron overload plasma transferrin can be fully saturated and the plasma can transport non-transferrin-bound Fe which is rapidly cleared by the liver. Much of this Fe is complexed by citrate. The aim of the present work was to characterise the mechanisms by which Fe-citrate is taken up by hepatocytes using a rat hepatocyte cell culture model. The cells, after one day in culture, were incubated with 59Fe-labelled Fe-citrate for varying time periods, then washed and Fe uptake to the membrane and intracellular compartments of the cell was determined by radioactivity measurements. Maximal rates of internalisation of Fe occurred at a Fe:citrate molar ratio of 1:100 or greater, a pH of approximately 7.4 and an extracellular Ca2+ concentration of 1.0 mM. Fe uptake showed Michaelis-Menten kinetics and was a temperature-dependent process. The K(m) and Vmax for Fe internalisation by the cells at 37 degrees C were approximately 7 microM and 2 nmol/mg DNA/min (25 x 10(6) atoms/cell/min), respectively; and the Arrhenius activation energy was 35 kJ/mol. The transition metals, Zn2+, Co2+ and Ni2+, inhibited Fe uptake when used at 10 and 100 times the concentration of Fe. The rate of Fe internalisation from Fe-citrate was found to be approximately 20 times as great as that from Fe-transferrin with Fe concentrations of 1 and 2.5 microM for both forms of Fe. The rate of Fe uptake by iron-loaded hepatocytes obtained from rats which had been fed carbonyl Fe was not significantly different from that by normal hepatocytes. These experiments show that rat hepatocytes in primary culture have a high capacity to take up non-transferrin-bound Fe in the form of Fe-citrate and that uptake occurs by facilitated diffusion. The iron transport process does not appear to be regulated by cellular Fe levels.

Tumour susceptibility and spontaneous mutation in mice deficient in Mlh1, Pms1 and Pms2 DNA mismatch repair

Germline mutations in the human MSH2, MLH1, PMS2 and PMS1 DNA mismatch repair (MMR) gene homologues appear to be responsible for most cases of hereditary non-polyposis colorectal cancer (HNPCC; refs 1-5). An important role for DNA replication errors in colorectal tumorigenesis has been suggested by the finding of frequent alterations in the length of specific mononucleotide tracts within genes controlling cell growth, including TGF-beta receptor type II (ref. 6), BAX (ref. 7) and APC (ref. 8). A broader role for MMR deficiency in human tumorigenesis is implicated by microsatellite instability in a fraction of sporadic tumours, including gastric, endometrial and colorectal malignancies. To better define the role of individual MMR genes in cancer susceptibility and MMR functions, we have generated mice deficient for the murine homologues of the human genes MLH1, PMS1 and PMS2. Surprisingly, we find that these mice show different tumour susceptibilities, most notably, to intestinal adenomas and adenocarcinomas, and different mutational spectra. Our results suggest that a general increase in replication errors may not be sufficient for intestinal tumour formation and that these genes share overlapping, but not identical functions.

Characterization of protease-activated receptor-2 immunoreactivity in normal human tissues

PAR-2 is a second member of a novel family of G-protein-coupled receptors characterized by a proteolytic cleavage of the amino terminus, thus exposing a tethered peptide ligand that autoactivates the receptor. The physiological and/or pathological role(s) of PAR-2 are still unknown. This study provides tissue-specific cellular localization of PAR-2 in normal human tissues by immunohistochemical techniques. A polyclonal antibody, PAR-2C, was raised against a peptide corresponding to the amino terminal sequence SLIGKVDGTSHVTGKGV of human PAR-2. Significant PAR-2 immunoreactivity was detected in smooth muscle of vascular and nonvascular origin and stromal cells from a variety of tissues. PAR-2 was also present in endothelial and epithelial cells independent of tissue type. Strong immunolabeling was observed throughout the gastrointestinal tract, indicating a possible function for PAR-2 in this system. In the CNS, PAR-2 was localized to many astrocytes and neurons, suggesting involvement of PAR-2 in neuronal function. A role for PAR-2 in the skin was further supported by its immunolocalization in the epidermis. PAR-2C antibody exemplifies an important tool to address the physiological role(s) of PAR-2.

Role of DNA mismatch repair in the cytotoxicity of ionizing radiation

The DNA mismatch repair (MMR) system in mammalian cells not only serves to correct base mispairs and other replication errors, but it also influences the cellular response to certain forms of DNA damage. Cells that are deficient in MMR are relatively resistant to alkylation damage because, in wild-type cells, the MMR system is thought to promote toxicity via futile repair of alkylated mispairs. Conversely, MMR-deficient cells are sensitive to UV light, possibly due to the requirement for MMR factors in transcription-coupled repair of active genes. MMR deficiency has been associated with familial and sporadic carcinomas of the colon and other sites, and so, we sought to determine the influence of MMR status on cellular response to ionizing radiation, an agent commonly used for cancer therapy. Fibroblast cell lines were established from transgenic mice carrying targeted disruptions of one of three MMR genes in mammalian cells: Pms2, Mlh1, or Msh2. In comparison to wild-type cell lines from related mice, the Pms2-, Mlh1-, or Msh2-nullizygous cell lines were found to exhibit higher levels of clonogenic survival following exposure to ionizing radiation. Because ionizing radiation generates a variety of lesions in DNA, the differences in survival may reflect a role for MMR in processing a subset of these lesions, such as damaged bases. These results both identify a new class of DNA-damaging agents whose effects are modulated by the MMR system and may help to elucidate pathways of radiation response in cancer cells.

Intestinal stem cell division and genetic diversity. A computer and experimental analysis

Somatic mutations are expected to arise with age. This process is accelerated in mice lacking the DNA mismatch repair gene Pms2. The distributions of microsatellite alleles present in small patches of normal Pms2 -/- intestines revealed a general increase in genetic diversity or the number of mutations with age. However, the patterns were complex with different distributions and variances present within a single mouse. Computer simulations indicate that the experimental data are consistent with mutation rates between 0.0020 and 0.0025 mutations per division, nonrandom cell death, and an effective population size of 20 or fewer cells. Small numbers of cells exacerbate the random accumulation of mutations expected of a stochastic mutation process. The computer simulations and experimental data are consistent with known patterns of intestinal development and renewal by small numbers of stem cells and demonstrate relatively high mutation rates in histologically normal epithelium. These findings provide background for the analysis of microsatellite mutations in normal and tumor tissue lacking mismatch repair and further support the hypothesis that microsatellite loci can function as molecular tumor clocks.

The risk of cancer associated with specific mutations of BRCA1 and BRCA2 among Ashkenazi Jews

BACKGROUND

Carriers of germ-line mutations in BRCA1 and BRCA2 from families at high risk for cancer have been estimated to have an 85 percent risk of breast cancer. Since the combined frequency of BRCA1 and BRCA2 mutations exceeds 2 percent among Ashkenazi Jews, we were able to estimate the risk of cancer in a large group of Jewish men and women from the Washington, D.C., area.

METHODS

We collected blood samples from 5318 Jewish subjects who had filled out epidemiologic questionnaires. Carriers of the 185delAG and 5382insC mutations in BRCA1 and the 6174delT mutation in BRCA2 were identified with assays based on the polymerase chain reaction. We estimated the risks of breast and other cancers by comparing the cancer histories of relatives of carriers of the mutations and noncarriers.

RESULTS

One hundred twenty carriers of a BRCA1 or BRCA2 mutation were identified. By the age of 70, the estimated risk of breast cancer among carriers was 56 percent (95 percent confidence interval, 40 to 73 percent); of ovarian cancer, 16 percent (95 percent confidence interval, 6 to 28 percent); and of prostate cancer, 16 percent (95 percent confidence interval, 4 to 30 percent). There were no significant differences in the risk of breast cancer between carriers of BRCA1 mutations and carriers of BRCA2 mutations, and the incidence of colon cancer among the relatives of carriers was not elevated.

CONCLUSIONS

Over 2 percent of Ashkenazi Jews carry mutations in BRCA1 or BRCA2 that confer increased risks of breast, ovarian, and prostate cancer. The risks of breast cancer may be overestimated, but they fall well below previous estimates based on subjects from high-risk families.

Elevated levels of mutation in multiple tissues of mice deficient in the DNA mismatch repair gene Pms2

The Pms2 gene has been implicated in hereditary colon cancer and is one of several mammalian homologs of the Escherichia coli mutL DNA mismatch repair gene. To determine the effect of Pms2 inactivation on genomic integrity in vivo, hybrid transgenic mice were constructed that carry targeted disruptions at the Pms2 loci along with a chromosomally integrated mutation reporter gene. In the absence of any mutagenic treatment, mice nullizygous for Pms2 showed a 100-fold elevation in mutation frequency in all tissues examined compared with both wild-type and heterozygous litter mates. The mutation pattern in the nullizygotes was notable for frequent 1-bp deletions and insertions within mononucleotide repeat sequences, consistent with an essential role for PMS2 in the repair of replication slippage errors. Further, the results demonstrate that high rates of mutagenesis in multiple tissues are compatible with normal development and life and are not necessarily associated with accelerated aging. Also, the finding of genetic instability in all tissues tested contrasts with the limited tissue distribution of cancers in the animals, raising important questions regarding the role of mutagenesis in carcinogenesis.

Altered expression of hMSH2 and hMLH1 in tumors with microsatellite instability and genetic alterations in mismatch repair genes

To date, at least four genes involved in DNA mismatch repair (MMR) have been demonstrated to be altered in the germline of patients with hereditary nonpolyposis colon cancer: hMSH2, hMLH1, hPMS1, and hPMS2. Additionally, loss of MMR function has been demonstrated to lead to the phenomenon of microsatellite instability (MIN) in tumors from these patients. In this study, we have examined the protein expression pattern of hMSH2 and hMLH1 by immunohistochemistry in paraffin-embedded tumors from 7 patients with MIN+ sporadic cancer, 13 patients with familial colorectal cancer, and 12 patients meeting the strict Amsterdam criteria for hereditary nonpolyposis colon cancer. The relationship between the expression of these two gene products, the presence of germline or somatic mutations, and the presence of tumor MIN was examined. Nineteen of the 28 tumors studied demonstrated MIN, whereas mutations in hMLH1 and hMSH2 were detected in 6 and 2 patients, respectively. Of the eight MIN+/mutation+ cases, the absence of protein expression was observed for the corresponding gene product in all but one case (missense mutation in hMLH1). However, seven MIN+/mutation- cases also showed no expression of either hMLH1 (n = 5), hMSH2 (n = 1), or both (n = 1), whereas four MIN+/mutation- cases demonstrated normal expression for both. None of the MIN-/mutation- cases (n = 9) demonstrated an altered expression pattern for either protein. These data suggest that examination of protein expression by immunohistochemistry may be a rapid method for prescreening tumors for mutations in the MMR genes.

Involvement of mouse Mlh1 in DNA mismatch repair and meiotic crossing over

Mice that are deficient in either the Pms2 or Msh2 DNA mismatch repair genes have microsatellite instability and a predisposition to tumours. Interestingly, Pms2-deficient males display sterility associated with abnormal chromosome pairing in meiosis. Here mice deficient in another mismatch repair gene, Mlh1, possess not only microsatellite instability but are also infertile (both males and females). Mlh1-deficient spermatocytes exhibit high levels of prematurely separated chromosomes and arrest in first division meiosis. We also show that Mlh1 appears to localize to sites of crossing over on meiotic chromosomes. Together these findings suggest that Mlh1 is involved in DNA mismatch repair and meiotic crossing over.

A chalcone synthase/stilbene synthase DNA probe for conifers

A probe for chalcone synthase (CHS) was generated by PCR using chalcone synthase conserved sequences. The cloned PCR product has high similarity to both chalcone synthase and stilbene synthase sequences. The probe was used to examine the organization of chalcone synthase and stilbene synthase genes in Abies procera, Pinus lambertiana, P. monticola, Picea glauca, P. sitchensis, Pseudostuga menziesii, Taxus brevifolia, and Thuja plicata. A large number of hybridizing bands were found in all species except T. plicata which did not cross hybridize. The hybridization patterns are highly polymorphic between the species and are also polymorphic within several of them.

Pertussis toxin export genes are regulated by the ptx promoter and may be required for efficient translation of ptx mRNA in Bordetella pertussis

The gene products from an 8-kb region adjacent to the 3' end of the ptx operon are required by Bordetella pertussis for the export of pertussis holotoxin. At least one of these gene products (PtlC) is specifically required for the export of assembled holotoxin from the periplasmic space. ptlC mutants exhibit a 20-fold reduction in the amount of holotoxin present in the culture supernatant but have no effect upon the assembly or steady-state level of holotoxin present in the periplasmic space. Impaired export of holotoxin from the ptlC strain blocks expression of toxin at a posttranscriptional level, and wild-type levels of ptx mRNA are detected in the mutant strain. The transcription of ptl is subject to modulation by MgSO4 in the same manner as ptx is; however, in B. pertussis strains containing an E. coli tac promoter in place of the native ptx promoter, wild-type levels of ptx mRNA are present and holotoxin is synthesized and exported even in the presence of MgSO4. Promoter mapping of the region extending from the ptxS3 coding region to the ptlC coding region failed to detect the ptl transcription initiation site. Additional RNase protection experiments with ptx promoter deletion and substitution strains indicate that the ptl operon is transcribed from the ptx promoter as part of a > 11-kb mRNA.

Male mice defective in the DNA mismatch repair gene PMS2 exhibit abnormal chromosome synapsis in meiosis

Using gene targeting in embryonic stem cells, we have derived mice with a null mutation in a DNA mismatch repair gene homolog, PMS2. We observed microsatellite instability in the male germline, in tail, and in tumor DNA of PMS2-deficient animals. We therefore conclude that PMS2 is involved in DNA mismatch repair in a variety of tissues. PMS2-deficient animals appear prone to sarcomas and lymphomas. PMS2-deficient males are infertile, producing only abnormal spermatozoa. Analysis of axial element and synaptonemal complex formation during prophase of meiosis I indicates abnormalities in chromosome synapsis. These observations suggest links among mismatch repair, genetic recombination, and chromosome synapsis in meiosis.

Is vernix caseosa a protective material to the newborn? A biochemical approach

Twenty random samples of vernix caseosa were collected from immediately born neonates, in Jamahiriya Hospital, Benghazi. Biochemical studies of these samples revealed presence of lipids (62.5%), proteins (36%) and carbohydrate (1.5%). Also we could observe inhibition of staph. aureus and klebsiella growth on nutrient agar by this vernix. This observation could be explained either by its higher asparagine content or by its elevated lipid component. In addition tripalmitin was found to be the major lipid constituent, responsible for its hydrophobic property. So we recommend leaving this vernix layer on newborn skin until spontaneous drying.

Results of the 1993 survey of the American Association of Academic Chief Residents in Radiology

RATIONALE AND OBJECTIVES

A survey of chief residents of academic radiology programs is conducted annually on behalf of the American Association of Academic Chief Residents in Radiology (A3CR2). Data are obtained to improve the training of diagnostic radiology residents and to increase the understanding of radiologists and their associates about issues of interest to radiologists in training.

METHODS

Questionnaires were mailed to 133 accredited programs in the United States and Canada. A wide variety of demographic and common interest questions were asked. The analysis took into account geographic location of the responders and the size of the residency program. Comparisons were made to the data from prior years.

RESULTS

Completed surveys from 93 programs (70%) were returned. The percentage of women residents is increasing. Important regional and size variations exist in several areas including salary, workload, prior clinical training, resident/fellow ratios, post residency plans, and call schedules. Although many chief residents feel knowledgeable about the health care system, opinions about the future of radiology and medical care are tentative.

CONCLUSIONS

This survey provides important demographic information about academic radiology residency programs. The summary information regarding plans for fellowship training, resident call schedules, and opinions about socioeconomic issues may be useful for chief residents, program directors, and departmental chairmen.

Mutation in the DNA mismatch repair gene homologue hMLH1 is associated with hereditary non-polyposis colon cancer

The human DNA mismatch repair gene homologue hMSH2, on chromosome 2p is involved in hereditary non-polyposis colon cancer (HNPCC). On the basis of linkage data, a second HNPCC locus was assigned to chromosome 3p21-23 (ref. 3). Here we report that a human gene encoding a protein, hMLH1 (human MutL homologue), homologous to the bacterial DNA mismatch repair protein MutL, is located on human chromosome 3p21.3-23. We propose that hMLH1 is the HNPCC gene located on 3p because of the similarity of the hMLH1 gene product to the yeast DNA mismatch repair protein, MLH1, the coincident location of the hMLH1 gene and the HNPCC locus on chromosome 3, and hMLH1 missense mutations in affected individuals from a chromosome 3-linked HNPCC family.

Dysphoria as a moderator of the relationship between perceived effort and perceived ability

Although Heiderian logic (F. Heider, 1958) proposes an inverse relationship between ability and effort, research has uncovered dramatic individual differences in the judged relationship between the two. Some view ability and effort as positively related; others view them as negatively related. Study 1 explored dysphoria as a moderator of this relationship by gathering dysphoric and nondysphoric individuals' perceptions of their effort and ability on daily activities. Although ability and effort generally were positively related, dysphorics reported lower ability on high effort tasks. In Study 2, Ss rated their effort as high or low. Dysphorics discounted ability when effort was high; nondysphorics reported the greatest ability when they expended the greatest effort. Collectively, there was no support for an inverse relationship between ability and effort. However, dysphorics infer less ability than nondysphorics following high effort.

Hemoglobin Structure and Function in the Rat-Tailed Sea Cucumber, Paracaudina chilensis

The rat-tailed sea cucumber, Paracaudina chilensis, has abundant hemoglobin-filled hemocytes in its perivisceral coelom, water vascular system, and hemal system. The perivisceral oxyhemoglobin consisted of 34 kDa dimers and molecules with an apparent molecular weight of ca. 50 kDa. The perivisceral hemoglobin had a high oxygen affinity with a P50 of 1.5 mm Hg at 15°C. It exhibited cooperative oxygen binding with a Hill coefficient of 1.26 to 1.86. Oxygen affinity appeared to be pH dependent, but the effect was not significant. The heat of oxygenation was -11.2 kcal mol-1. At high hemoglobin concentrations, the perivisceral hemoglobin oxygen affinity was lower and the apparent pH effect and cooperativity were increased. Perivisceral and water vascular hemoglobins had spectral characteristics similar to those of other invertebrate and vertebrate hemoglobins. The perivisceral hemoglobin appeared to be electrophoretically heterogeneous and was structurally distinguishable from water vascular hemoglobin. The oxygen affinity of water vascular hemoglobin was not different from that of the perivisceral hemoglobin in spite of the difference in structure and location in the animal. The exceptionally high oxygen affinity hemoglobin of P. chilensis, a burrowing sea cucumber, may be adaptive to this animal's oxygen-limited habitat.

Color Doppler sonography of ureteral jets in normal volunteers: importance of the relative specific gravity of urine in the ureter and bladder

OBJECTIVE

Sonographic visualization of ureteral jets is a well-recognized phenomenon. In vitro studies have indicated that detection of fluid flow similar to ureteral jets depends on differences in density between the moving and the stationary fluid. This study was undertaken to determine if differences in density between ureteral urine and urine in the bladder could make a significant impact on the sonographic detectability of ureteral jets in vivo.

SUBJECTS AND METHODS

Ten healthy volunteers were vigorously hydrated after an overnight fast. An initial color Doppler sonographic examination of ureteral jets was performed before voiding (while concentrated urine that had accumulated overnight was still in the bladder). A second examination was performed after two cycles of voiding and refilling the bladder (to ensure that dilute urine produced by the hydration was in the bladder).

RESULTS

In all subjects, normal ureteral jets were readily identified on the initial examination. The difference in the estimated specific gravity between bladder urine and ureteral urine during the initial examination ranged from 0.002 to 0.016 (mean, 0.008). This was a statistically significant difference (p less than .05). On the second examination, ureteral jets were not detected from either ureter in any subject. The difference in the estimated specific gravity of bladder urine and ureteral urine during the second examination ranged from 0.000 to 0.002 (mean, 0.001). This was not a statistically significant difference (p greater than .05). There was no statistically significant difference in the diuresis rates throughout the course of the examinations. These ranged from 300 to 1218 ml/hr.

CONCLUSION

These in vivo results support the hypothesis that detection of ureteral jets depends on density differences between ureteral and bladder urine. This is important clinically, because normal ureteral jets may be undetectable, despite adequate hydration and high rates of diuresis, if the patient is allowed to completely void and refill the bladder before the examination.

Effects of Hypoxia and Anoxia on Larval Settlement, Juvenile Growth, and Juvenile Survival of the Oyster Crassostrea virginica

The effects of hypoxia (1.5 mg O2 1-1, 20% of air saturation) and anoxia (<0.07 mg O2 1-1, <1% of air saturation) on oyster (Crassostrea virginica) larval settlement, juvenile growth, and juvenile survival were studied. Settlement was reduced significantly (P < 0.05) in hypoxic treatments, as compared to normoxic treatments (7.3 mg O2 h-1, 100% of air saturation), and almost no settlement took place in anoxic treatments. After 96 h, 38% and 4% of the larvae placed in hypoxic and anoxic treatments had settled, while 79% settled in normoxic treatments. In the first 144 h after settlement, juveniles in hypoxic treatments grew one third as much as those in normoxic treatments, while juveniles in anoxic treatments did not grow at all. Median mortality times of recently settled juveniles in hypoxic and anoxic treatments were 131 h and 84 h, respectively. We conclude that hypoxic and anoxic waters have potentially detrimental effects on oyster settlement and recruitment.

Inducible alkyltransferase DNA repair proteins in the filamentous fungus Aspergillus nidulans

We have investigated the response of the filamentous fungus Aspergillus nidulans to low, non-killing, doses of the alkylating agent MNNG (N-methyl-N'-nitro-N-nitrosoguanidine). Such treatment causes a substantial induction of DNA alkyltransferase activity, with the specific activity in treated cells increasing up to one hundred-fold. Fluorography reveals the two main inducible species as proteins of 18.5 kDa and 21 kDa, both of which have activity primarily against O6-methylguanine (O6-MeG) lesions. In addition, two other alkyltransferase proteins can also be detected. One, of MW 16 kDa, is expressed in non-treated cells, but is not induced to the same extent as the 18.5 and 21 kDa proteins. The other, a protein of 19.5 kDa, is highly inducible and can only be detected in treated cells. Unlike the other three proteins, it acts primarily against methyl-phosphotriester (Me-PT) lesions. This is the first instance in which an MePT alkyltransferase has been detected in a eukaryotic organism and, coupled with the high level of induction of the O6-MeG alkyltransferase enzymes, this indicates that a control system similar to the bacterial adaptive response may be present in filamentous fungi.