High throughput mutation screening of the factor VIII gene (F8C) in hemophilia A: 37 novel mutations and genotype-phenotype correlation

Hemophilia A (HEMA) is an X-linked bleeding disorder caused by mutations in the factor VIII gene (F8C). Molecular genetic testing for the factor VIII gene is challenging due to its large size. Here we present results of high throughput mutation scanning based on Southern blot analysis and direct sequencing of all PCR amplified coding exons and the exon-intron boundaries of the factor VIII gene. The results of mutation analysis on 89 hemophiliac males showed presence of a disease-causing mutation in 80 individuals (90%, 95% CI of 82%-95%). Seven out of nine mutation-negative individuals were severe cases of hemophilia A with < 1% factor VIII protein in the blood. The correlation of phenotype with genotype as observed in this study was not absolute. This finding is supported by similar observations in the international database for hemophilia A mutations (HAMSTeRS). This issue raises the importance of genotypes at other loci that can act as modifiers for the phenotype. Thirty-four novel mutations and three novel substitutions for previously reported amino acid residues were identified in this series of 80 mutations. The mutations cover the full spectrum including rearrangements, deletions, frameshift, and point mutations. The novel missense mutations require careful evaluation. Prediction of a mutation as the disease-causing allele was made from the nature of the substitution and the degree of conservation of the mutated amino acid among species that have diverged in evolution. In some cases segregation analysis of the mutation with disease condition was performed when other family members were available.     

Effect of hydrogen peroxide on amino acid concentrations in bovine retina and vitreous humor, ex vivo

In a previous study, we showed evidence that oxidative stress induced by hydrogen peroxide (H2O2) can inhibit the release of [3H]-D-aspartate from the bovine isolated retina, in vitro. The aim of the present study was to investigate the effect of H2O2 on glutamate and glycine levels in the bovine retina and vitreous humor, ex vivo. Furthermore, we examined whether inhibition of catalase activity with 3-amino-triazole had any effect on the concentrations of these amino acids in the posterior segment of the bovine eye. Whole eye organ cultures were prepared by incubating tissues in oxygenated Krebs solution at 37 masculine C for 30 min. After incubation, H2O2 (1-100 microM) or sterile distilled water was injected intravitreally into each eye. Thirty minutes after injection, the retina and vitreous humor were removed for analysis of glutamate and glycine by high performance liquid chromatography (HPLC) with fluorescence detection. Exogenously applied H2O2 (1-100 microM) caused a concentration-related decrease in both glutamate and glycine levels in the bovine retina. Furthermore, while H2O2 (1-10 microM) caused a concentration-dependent decrease in glycine levels in the vitreous humor, it had no significant effect on glutamate levels. The catalase inhibitor, 3-amino-triazole (10 mM), caused a significant reduction in both glutamate and glycine levels in the bovine retina, ex vivo. Likewise, 3-AT caused an attenuation in both glutamate and glycine concentration in the vitreous humor. We conclude that oxidative stress induced by H2O2 can alter the release and/or availability of amino acids in the posterior segment of bovine eyes.     

Laboratory investigations for rheumatic disease

Laboratory investigations are very important tools in the diagnosis of rheumatic diseases. Nowadays a large number of tests are available. The authors have discussed some important tests of value in day to day practice.     

Trigonella foenum graecum (fenugreek) seed extract as an antineoplastic agent

The antineoplastic effect of Trigonella foenum graecum seed extract has been evaluated in the Ehrlich ascites carcinoma (EAC) model in Balb-C mice. Intra-peritoneal administration of the alcohol extract of the seed both before and after inoculation of EAC cell in mice produced more than 70% inhibition of tumour cell growth with respect to the control. Treatment with the extract was found to enhance both the peritoneal exudate cell and macrophage cell counts. The extract also produced a significant antiinflammatory effect. We report here the antiinflammatory and antineoplastic effects, of Trigonella foenum graecum seed extract.     

Infantile hemangioendothelioma: A case report and discussion

Infantile hepatic hamangioendothelioma type II is similar to angiosarcoma in terms of histomorphology and behavior. Various presentations of this lesion have been reported in the literature, e.g. cases with a hepatic mass, cutaneous hemangiomas, heart failure, etc. We report on a patient, male/2 years, who had two jejunal masses and a hepatic mass accompanied by lower GI bleeding and intestinal obstruction. The two jejunal masses and the hepatic lesion were diagnosed as angiosarcoma histomorphologically (IHHE type II), and were positive for vascular markers (CD31 and CD34) on immunohistochemistry. The patient had no skin lesions. We report this case and provide a literature review because of the unusual presentation and the overall rarity of this entity.     

Factors affecting immunization rate in a cohort of elderly veterans: a retrospective pilot study of influenza vaccine compliance

A survey of aged veterans greater than or equal to 85 years old was undertaken to determine their vaccination behaviour prior to mounting a local education campaign on influenza vaccine. A questionnaire inquiring into circumstances which may have influenced their decision to be immunized against influenza was mailed to all 300 elderly veterans (greater than or equal to 85) obtained from the register at the James A. Haley Veterans' Hospital. Ninety-two persons responded in self addressed stamped envelopes and data were analysed six months following mailing date. The most important reason for not being immunized was lack of information concerning vaccine recommendations and its availability (48%). Fear of 'shots' and side effects was the next most important reason for not taking the vaccine (19%). Amotivation and transportation difficulties played comparatively minimal roles (10%, 13%). These data suggest that health education measures may improve vaccine compliance in the elderly population who suffer from higher death rates and complications from influenza.     

5-Hydroxytryptamine in the phrenic nerve diaphragm: evidence for its existence and release

Evidence is presented for the existence of 5-hydroxytryptamine (5-HT) within the phrenic nerve of the rat and its release following electrical stimulation. Contents of 5-HT and its metabolite, 5-hydroxyindoleacetic acid (5-HIAA) in the phrenic nerve and the indoleamine released into the bathing fluid were estimated fluorimetrically after isolation on Sephadex G-10 and/or solvent-solvent extraction. Bioassays of 5-HT were done on rat fundus strip. The phrenic nerve and the end-plate zone contains high levels of 5-HT (1.9 micrograms/g wet weight) and 5-HIAA (1.5 micrograms/g wet weight). The resting release of around 1 ng 5-HT/diaphragm/min was enhanced by 50% (1.5 ng 5-HT/diaphragm/min) upon supramaximal (2-4 V) electrical stimulation of 5 Hz. Phrenic nerve diaphragm prepared from the denervated and p-chlorophenylalanine (300 mg/kg/day i.p. for 3 days) treated rats failed to release 5-HT confirming the neuronal origin and the identity of the indoleamine respectively. Furthermore, methysergide, an antagonist of 5-HT in rat fundus strip, blocked the response obtained by the sample on it. A modulatory role of 5-HT in the phrenic nerve diaphragm of the rat is envisaged from the present study.