A new autosomal recessive syndrome of characteristic facies, joint contractures, skeletal abnormalities, and normal development: second report with further clinical delineation

We describe a girl of Pakistani origin, born to consanguineous parents, with a multiple congenital anomaly (MCA) syndrome. This is the second report confirming an apparently new autosomal recessive syndrome reported earlier by van den Ende et al in 1992. The hallmarks of this MCA syndrome include characteristic facies with blepharophimosis, narrow, beaked nose, hypoplastic maxilla with or without cleft palate and everted lower lip, arachnodactyly, self-limiting congenital joint contractures, peculiar skeletal abnormalities, and normal growth and development. Further clinical and radiological delineation of the syndrome in this report suggests that the term “Marden-Walker-like syndrome without psychomotor retardation”, used in the first report to describe this condition, does not accurately reflect its clinical picture. The overall prognosis in this syndrome seems good.     

Identification of an antigenic determinant of mouse lactate dehydrogenase C4

A peptide bearing an antigenic determinant of the sperm-specific lactate dehydrogenase C₄ isozyme (LDH-C₄) has been isolated from a tryptic digest of the whole protein. This peptide, comprising residues 152–159 (MC_152–159), reacts with rabbit anti-mouse LDH-C₄. Immunization of rabbits with synthetic MC_152–159 conjugated to bovine serum albumin induces an immune response which is specific for the peptide. Anti-MC_152–159 IgG binds ¹²⁵I-labeled mouse LDH-C₄ and competition experiments demonstrate the specificity of this antigen-antibody reaction.     

Increased numbers of cytokeratin-positive interstitial reticulum cells (CIRC) in reactive,inflammatory and neoplastic lymphadenopathies: hyperplasia or induced expression?

A total of 291 enlarged lymph nodes showing a range of reactive-inflammatory processes, primary and metastatic neoplasms were studied to determine the distribution and immunoprofile of their cytokeratin-positive interstitial reticulum cells (CIRC) in comparison with normal nodes. In 258/291 nodes (89%), CIRC numbers were distinctly increased in the subcapsular, paracortical and, occasionally, in the medullary zones; often, these increased CIRC formed networks around follicles, sinuses and vessels. CIRC had comparatively small, irregularly shaped bodies and dendritic processes; occasionally, giant forms were noted. CIRC contained cytokeratins (CK) 8 and 18 but not 19, as shown by immunohistochemistry, and by gel electrophoresis with subsequent immunoblotting. They co-expressed vimentin consistently, alpha-smooth-muscle actin frequently, and desmin less frequently. They did not contain desmoplakins, Factor VIII, S-100, LCA, B and T lymphocyte- and macrophage-associated antigens, chromogranin A, synaptophysin or the A-80 glycoprotein. We found no clear correlation between the increased CIRC and given nodal disease processes. However, CIRC were most abundant in nodes free of but draining malignant tumours; bizarre CIRC assemblies were noted in HIV lymphadenopathy. CIRC appear to represent a subset of the so-called fibroblastic reticulum cells of lymph nodes. Their function remains undetermined; their increase in diverse lymphadenopathies suggests that they partake in nodal reactions to injury. It remains unclear whether the increase in CIRC relative number is due to proliferation or to CK gene induction processes but their presence and potential capability to undergo hyperplasia with dysplastic forms should alert pathologists to possible diagnostic pitfalls. In addition, we discuss that CIRC may undergo transformation and represent the cell of origin of certain CK-positive tumours restricted to lymph nodes.     

A new syndrome of triphalangeal thumbs and brachy-ectrodactyly

Two Mexican families in which a total of 17 persons exhibited the same pattern of limb malformations are described. The syndrome is characterized by triphalangeal thumbs and brachydactyly affecting the index fingers and the third toes. The clinical findings are variable and the inheritance is autosomal dominant. The syndrome, to the best of our knowledge, has not been described before.     

Occurrence and Potential Diagnostic Applications of Serological Cross-Reactivities between Brucella and Other Alpha-Proteobacteria

Agrobacterium, Sinorhizobium, and Ochrobactrum are genera closely related to Brucella but, in contrast to the latter, are not pathogenic for humans and animals. We studied by an indirect enzyme-linked immunosorbent assay (ELISA) the reactivities of brucellosis sera against cytosolic (CYT) and membrane (MA) antigens from these nonpathogenic bacteria, and we evaluated the potential usefulness of these cross-reactions for the diagnosis of brucellosis in humans, sheep, cows, and dogs. Canine infection by Brucella canis was detected with high specificity by CYT antigen-based ELISAs (96% for Agrobacterium, 96% for Sinorhizobium, and 91% for Ochrobactrum), while sensitivity was variable (58% for Agrobacterium, 88% for Sinorhizobium, and 84% for Ochrobactrum). In addition, it was possible to diagnose canine disease shortly after exposure to the pathogen (15 days). Similar results for canine brucellosis were obtained with MA antigens. In contrast, normal sera from humans, sheep, and cattle reacted strongly with all the antigens (CYT and MA antigens from the three bacteria), producing high cutoff values and, consequently, low sensitivities. While for some host species the reactivity patterns of normal sera by Western blotting were similar to those produced with sera from infected individuals, the reactivity pattern of bovine sera against Sinorhizobium meliloti antigens exhibited some differential bands for the two groups of sera. These results show that crude fractions from nonpathogenic alpha-proteobacteria can be used to diagnose canine brucellosis but may need to be further separated into simpler fractions to have diagnostic usefulness in ovine, bovine, or human infection. By reducing the biosafety requirements, the use of antigens derived from these nonpathogenic bacteria would simplify the production of diagnostic kits for brucellosis, especially in settings where biosafety level-3 facilities are scarce or absent.     

The diffusion of carbon dioxide in erythrocytes and hemoglobin solutions

Summary The CO₂ diffusion constant (Krogh's diffusion constant) has been estimated from the CO₂ flux across layers with defined thickness under steady state conditions.At 22°C and in hemoglobin solutions with a concentration of 33 g% the diffusion constant for CO₂ was found to be 3.3×10^–4 cm² min^–1 atm^–1. This value is about 40% of the diffusion constant for CO₂ in water. The relationship between the diffusion constant and the hemoglobin concentration was approximately linear in a concentration range of 10–40 g%. The temperature coefficient of the diffusion constant was –0.5%/°C both in water and hemoglobin solutions. At 38°C and in a hemoglobin solution with a concentration of 33 g%, the diffusion constant for CO₂ was therefore 3.0×10^–4 cm² min^–1 atm^–1, the diffusion coefficient 11×10^–6 cm² s^–1.A general theory for the diffusion of CO₂ in hemoglobin solutions has been derived. According to this theory the diminution of the CO₂ diffusion in hemoglobin solutions in comparison to water can be explained quantitatively by a reduction of the water space by the hemoglobin molecules.The diffusion constant for CO₂ in layers of erythrocytes was insignificantly (0–3%) smaller than in hemoglobin solutions with the same hemoglobin concentration. It is concluded that the erythrocyte membrane does not offer a considerable resistance for the CO₂ diffusion.     

Localization of vasoactive intestinal polypeptide in penile erectile tissue and in the major pelvic ganglion of the rat

Vasoactive intestinal polypeptide was localized by immunocytochemical techniques in the major pelvic ganglion and penile erectile tissue of the rat. Vasoactive intestinal polypeptide fibers were concentrated in penile crura with the density of innervation decreasing distally. The helicine arteries were very densely innervated while fewer fibers surrounded the deep artery of the penis. Intrinsic smooth muscle of the cavernous bodies received a moderate supply of vasoactive intestinal polypeptide immunoreactive fibers. Dorsal vascular structures, including the deep dorsal vein were innervated by vasoactive intestinal polypeptide fibers. Vasoactive intestinal polypeptide immunoreactive cell bodies were found in the major pelvic ganglion, concentrated on one end of the ganglion. Rectrograde studies with a dye injected into the penile crura indicated that neurons in major pelvic ganglion projected to the penis. Combined dye and immunofluorescent studies showed that all the dye-labeled neurons were immunoreactive for vasoactive intestinal polypeptide.

It is concluded that all vascular beds in the penis of the rat are innervated by vasoactive intestinal polypeptide fibers and that the extent of the innervation is related to the occurrence of smooth muscle. Neurons in the major pelvic ganglion probably are the main source of vasoactive intestinal polypeptide fibers to the penis.     

Afferent axons and their relations with neurons in the nucleus lateralis of the cerebellum: A light microscopic study

Summary The axons of Purkinje cells are the sole corticonuclear afferents to the lateral nucleus. The terminal arborizations of these axons consist of many (30–50) varicose branchlets, which issue from a thick, myelinated parent axon. Each terminal plexus fills a conical field which penetrates the lateral nucleus radially encompassing the cell bodies and parts of the dendritic trees of approximately 40 neurons. The fields of neighboring Purkinje axons overlap considerably. The non-cortical axons are simple, usally unbranched varicose fibers of three sizes: (1) thick, with large varicosities, (2) medium sized with smaller varicosities, or (3) fine, delicate threads with beadlike varicosities. These axons cross the dendritic trees of successive neurons as they penetrate into the nucleus in a radial fashion.The configuration of the dendritic trees of neurons in the various parts of the nucleus—the multipolar neurons and the columnar neurons—can be related to the conical shape of the Purkinje axonal plexus. It is suggested that the organization of converging Purkinje cell axonal fields determines the pattern of input to the cells of the lateral nucleus, rather than the topographical arrangement of Purkinje cells in the cortex. The terminal arborizations of Purkinje cell axons adjacent to one another in the lateral nucleus need not necessarily arise from neighboring Purkinje cells in the cerebellar cortex.The relationships between neurons in the central columnar zone and in the swirled zones of the lateral nucleus with the two classes of afferents are discussed. It is suggested that by virtue of their slender profiles, each of the large columnar neurons falls into the field of one Purkinje cell axonal cone whereas elsewhere, the multipolar neurons tend to share their well spread dendrites with neighboring Purkinje axonal fields. The small neurons that span columns in the central zone are oriented to sample larger numbers of axonal inputs than are adjacent columnar neurons.Supported in part by U.S. Public Health Service Research Grants NS10536, NS03659, Training Grant NS 05591 from the National Institute of Neurological Diseases and Stroke, and a William F. Milton Fund Award from Harvard University.     

Stage, survival and delays in lung, colorectal, prostate and ovarian cancer: comparison between diagnostic routes

BACKGROUND: Very few studies have reported cancer outcomes of patients referred through different routes, despite the prominence of current UK cancer urgent referral guidance. AIM: This study aimed to compare outcomes of cancer patients referred through the urgent referral guidance with those who were not, with respect to stage at diagnosis, survival, and delays in diagnosis. Design of study: Analysis of hospital records. SETTING: One hospital trust in England. METHOD: The records of 889 patients diagnosed in 2000-2001 with one of four types of cancer were analysed: 409 with lung cancer; 239 with colorectal cancer; 146 with prostate cancer; and 95 with ovarian cancer. Outcome measures were diagnostic stage, survival, referral and secondary care delays. RESULTS: For lung cancer, urgent referrals had more advanced TNM (tumor, node, metastasis) stage than patients diagnosed through other routes (P = 0.035) and poorer survival (P = 0.020). There was no difference in stage or survival for the other cancers. For each cancer, a higher proportion of urgent referrals was seen within 2 weeks. Secondary care delays for lung and colorectal cancer were shorter for inter-specialty referrals. CONCLUSION: For patients with lung cancer, the guidance appears to be prioritising those in the more advanced stages of disease. This was not the case for the other three cancers. Referral delays were shorter for patients urgently referred, as is the intention of the guidance. The avoidance of delays in outpatient diagnostics probably accounts for shorter secondary care delays for inter-specialty referrals.     

Immunogenicity and T cell recognition in swine of foot-and-mouth disease virus polymerase 3D

Immunization of domestic pigs with a vaccinia virus (VV) recombinant expressing foot-and-mouth disease virus (FMDV) 3D protein conferred partial protection against challenge with infectious virus. The severity reduction of the clinical symptoms developed by the challenged animals occurred in the absence of significant levels of anti-3D circulating antibodies. This observation suggested that the partial protection observed was mediated by the induction of a 3D-specific cellular immune response. To gain information on the T cell recognition of FMDV 3D protein, we conducted in vitro proliferative assays using lymphocytes from outbred pigs experimentally infected with FMDV and 90 overlapping peptides spanning the complete 3D sequence. The use of pools of two to three peptides allowed the identification of T cell epitopes that were efficiently recognized by lymphocytes from at least four of the five animals analyzed. This recognition was heterotypic because anti-peptide responses increased upon reinfection of animals with a FMDV isolate from a different serotype. The results obtained with individual peptides confirmed the antigenicity observed with peptide pools. Detection of cytokine mRNAs by RT-PCR in lymphocytes stimulated in vitro by individual 3D peptides revealed that IFN-gamma mRNA was the most consistently induced, suggesting that the activated T cells belong to the Th 1 subset. These results indicate that 3D protein contains epitopes that can be efficiently recognized by porcine T lymphocytes from different infected animals, both upon primary and secondary (heterotypic) FMDV infection. These epitopes can extend the repertoire of viral T cell epitopes to be included in subunit and synthetic FMD vaccines.