A comparison of duplex Doppler ultrasonography and intrarenal manometry in the diagnosis of acute renal transplant rejection

Renal transplant rejection is frequently difficult to differentiate from other causes of renal dysfunction. This study examined the use of duplex Doppler ultrasound and intrarenal manometry in a consecutive series of 73 patients who underwent renal transplantation. Altogether 327 duplex scans were analyzed and, for each, a resistive index (RI) was calculated. A raised RI predicted rejection in patients with grafts that functioned immediately, but not in those that had delayed function. A rise in intrarenal pressure ( greater than or equal to 40 mmHg) indicated the presence of rejection in both groups. However, neither test had a sensitivity of more than 71% and this was not improved by combining the results of the two tests for each patient. Although both tests have a place in transplantation, renal biopsies may still be required to confirm rejection.     

Molecular epidemiology of human rotaviruses in Manipur: genome analysis of rotaviruses of long electropherotype and subgroup I

Summary cDNA complementary to the 3-terminal half of RNA 1 of wheat spindle streak mosaic virus (WSSMV) from Southern France has been cloned and sequenced. One large open reading frame (ORF) of 4 410 nucleotides and a nontranslated region (NTR) of 213 nucleotides at the 3-end excluding the poly(A)-tail were found. Because of the amino acid sequence homology to the polyprotein of barley yellow mosaic virus (BaYMV) RNA 1, the encoded polyprotein of the sequenced region of WSSMV is supposed to comprise the C-terminal part of the putative cytoplasmic inclusion (CI) protein, the nuclear inclusion a (NIa) proteinase, the (NIb) RNA-polymerase and the capsid protein. The first 19 N-terminal amino acids of the capsid protein were determined by direct sequencing of proteins of purified WSSMV particles and confirmed this hypothesis. The deduced capsid protein has 294 amino acids and shows 74% identity with the BaYMV capsid protein sequence. This high sequence homology with BaYMV, in addition to the significant identities with barley mild mosaic virus (BaMMV, 35%) and its marginal homology to capsid protein sequences of aphid and mite-borne potyviruses (22–24%), supports the classification of WSSMV as a distinct member of the genusBaymovirus, familyPotyviridae.     

Compliance with OSHA's respiratory protection standard in hospitals

This study examined the incidence of violations of occupational safety and health standards for respiratory protection in hospitals. Data from Occupational Safety and Health Administration inspections that occurred in hospitals and resulted in violations of the respiratory protection standards were examined. From July 1, 1990, to June 30, 1995, the complaint rates for hazards in the workplace significantly increased. During 1990-1991, tuberculosis hazard complaint inspections rates were approximately 5 complaints per 1000 complaint inspections conducted. During 1994-1995, tuberculosis hazard complaint inspections rates were approximately 76 complaints per 1000 complaint inspections conducted, representing an increase of over 15 times. During this same period, the percentage of respiratory protection violations in relation to all violations doubled. Increased employee awareness of the hazards and current safety laws could have contributed to the increased frequency of employee complaints, leading to increases in inspections, violations, and fines. Employers must adhere to the current safety and health requirements specifically as they pertain to respiratory hazards and tuberculosis.     

Post traumatic rupture of the right main bronchus: a rare clinical entity?

Tracheobronchial disruption is an uncommon injury usually associated with severe blunt thoracic trauma and rarely occurs in isolation. We report a case of isolated rupture of the right main bronchus occurring after a crush injury without an associated pneumothorax. Difficulties in the diagnosis of this condition are briefly discussed and an algorithm of management presented.     

Two mutations identified in the androgen receptor of the new human prostate cancer cell line MDA PCa 2a

PURPOSE: We have characterized the androgen receptor (AR) in a new human prostate cancer cell line, MDA PCa 2a, that has recently been established from a bone metastasis of a patient whose cancer exhibited androgen-independent growth. MATERIALS AND METHODS: Androgen responsiveness of these cells was assessed by measuring the effect of DHT and R1881 on cell growth and PSA secretion. Scatchard analysis was used to characterize the affinity and abundance of AR protein. Using a PCR based strategy, genomic DNA of the entire coding region of AR gene was sequenced to identify possible mutations. RESULTS: These cells express abundant AR (Nmax = 685 +/- 149 fmol./mg. protein), but the AR binding affinity (Kd) for DHT is only 25 nM, approximately 50-fold lower affinity than the mutated AR in LNCaP prostate cancer cells (Kd = 0.5 nM) or the wildtype AR in MCF-7 breast cancer cells (Kd = 0.4 nM). Two mutations, L701H and T877A, were identified in the ligand binding domain of the AR gene. Compared with LNCaP cells, the new cell line is significantly less responsive to DHT and R1881 as well as to other androgens such as testosterone, androstenedione, and DHEA. Similar to LNCaP cells, the ligand specificity of the AR in MDA PCa 2a cells appears to be relaxed and non-androgens such as progesterone and estradiol act as agonists although with less potency than in LNCaP cells. Interestingly, in the absence of androgens, the new cell line expresses 15-fold higher baseline levels of PSA than LNCaP. CONCLUSIONS: Two mutations were identified in the AR gene of the MDA PCa 2a cell line that are likely responsible for the decreased androgen sensitivity and altered ligand specificity observed in these cells. Thus, this new cell line with partial androgen responsiveness and PSA expression can serve as a functionally relevant model system of bone metastatic prostate cancer, and can be used to investigate the role of AR mutations in prostate cancer and its progression to androgen independence.     

Characterisation of a myofibroblast-like cell line from an angiosarcoma

We have isolated a cell line (ASMM) by serial passage of cells from explant cultures of an angiosarcoma resected from the calf of a 62 year old female. ASMM has been in continuous culture for over eighteen months (>150 population doublings) and has a Fibroblast-like morphology with a doubling time of approximately 72 h. ASMM has a normal diploid karyology and is unable to generate tumors in nude mice or produce colonies in soft agar. Examination of the cytoskeletal proteins shows both desmin and vimentin and a low level of alpha-smooth muscle actin, which can be upregulated by treatment with TGF beta. Low levels of basal VCAM-1 are significantly upregulated with TNF alpha and reduced by the presence of TCF beta. Basal ICAM-1 is also upregulated with TNF alpha and we show an additional upregulation through TGF beta. ASMM expresses high levels of the hyaluronate receptor CD44, including the variant exons 6, 8 and 10. In addition, ASMM synthesises high levels of hyaluronate (HA), as did the original tumor. Unlike human umbilical vein endothelial cells (HUVECs) these cells were unable to generate capillary-like tubes when seeded onto basement membrane gels, and generated cords of cells containing many synthetic organelles and intermediate filaments. We were unable to detect the expression of factor VIII-related antigen, von Willebrand factor (vWF), CD31 or CD34, and were not able to induce expression of E-selectin after TNF alpha stimulation. In conclusion, this cell line represents a partially transformed population of cells which show characteristics consistent with myofibroblast-like cells. The production of high levels of HA and expression of CD44 may help to explain the high degree of agressiveness of the tumor from which ASMM was derived, as these molecules have been shown to play a role in cell motility and adhesion.     

Characterization of bound phenthoate residues in citrus

The metabolism and fate of phenyl ring-labeled¹⁴C-phenthoate {O,O- dimethylS-[-(carboethoxy)benzyl] phosphorodithioate} was examined in the Valencia orange fruit with emphasis on the characterization of bound phenthoate residues in the fruit peel. The products recovered from the citrus fruit wash were unchanged phenthoate, phenthoate oxon, demethyl phenthoate, phenthoate acid, ethyl mandelate, and mandelic acid. The same products, with the exception of phenthoate oxon, were found in the acetone extract of the fruit peel. Enzymatic hydrolysis of the bound residue in the peel with-glucosidase, followed by acidic and basic hydrolysis gave ethyl mandelate as the major product, followed by mandelic acid, demethyl phenthoate and phenthoate acid. Phenthoate was metabolized and conjugated in citrus fruits into detoxication products.     

Radiographic findings in tuberculosis of the calvarium

We reviewed the pattern of involvement of the calvarium by tuberculosis (TB) in five patients and the role of imaging in its management. Four patients presented with localised scalp swelling and one with generalized seizures. Radiographs revealed lucent lesions with minimal surrounding sclerosis in the frontal (2), parietal (2) and occipital (1) bones. CT showed lesions involving the entire thickness of the calvarium and accompanying contrast-enhancing soft tissue. The patient presenting with seizures had a ring-enhancing lesion in the parietal lobe in addition to the extra-axial lesions. Although radiographs in all cases demonstrated calvarial TB, CT showed the extent of the defect, involvement of adjacent soft tissues, and in one case an intra-axial lesion. Radiographs suffice for follow-up of these patients. Received: 23 July 1999 Accepted: 20 September 1999