Mutations in the SDHB gene are associated with extra-adrenal and/or malignant phaeochromocytomas

Germ-line mutations in the genes encoding succinate dehydrogenase complex subunits B (SDHB) and D (SDHD) have been reported in familial paragangliomas and apparently sporadic phaeochromocytomas (ASP), but the genotype-phenotype relationships of these mutations are unknown. Eighty-four patients (all but 2 followed up for 8.8 +/- 5.7 years) with ASP (57 with adrenal tumors, 27 with extra-adrenal, multiple, malignant, or recurrent tumors) were screened for the major susceptibility genes for phaeochromocytoma (RET, VHL, SDHD, and SDHB). Thirty-three tumors were available for molecular analysis, enzyme assays, and immunohistochemistry. No (0%) RET and 2 (2.4%) VHL mutations were detected. Only two coding single nucleotide polymorphisms in the SDHD gene (G12S and H50R) were found in 6 patients (7%). Conversely, six deleterious mutations in the SDHB gene were identified in 8 patients (9.5%). Ectopic site and recurrence or malignancy were strongly associated with SDHB mutations (7 of 8, 87%, versus 20 of 76, 26%; P = 0.001). Somatic DNA analysis indicated a loss of heterozygosity at chromosome 1p36 (SDHB locus) in 16 of 33 cases (48%). A loss of heterozygosity at the SDHB locus was found in all tumors with SDHB mutation, and assays of respiratory chain enzymes showed a complete loss of complex II catalytic activity. The vascular architecture of tumors with SDHB mutations displayed features typical of malignancy. These data strongly suggest that SDHB gene is a tumor suppressor gene and that the identification of germ-line mutations in SDHB gene in patients with ASPs should be considered as a high-risk factor for malignancy or recurrence.     

Posttranslational processing and identification of a neutralization domain of the GP4 protein encoded by ORF4 of Lelystad virus

GP4 is a minor structural glycoprotein encoded by ORF4 of Lelystad virus (LV). When it was immunoprecipitated from cell lysates and extracellular virus of CL2621 cells infected with LV, it was shown to have an apparent molecular mass of approximately 28 and 31 kDa, respectively. This difference in size occurred because its core N-glycans were modified to complex type N-glycans during the transport of the protein through the endoplasmic reticulum and Golgi compartment. A panel of 15 neutralizing monoclonal antibodies (MAbs) reacted with the native GP4 protein expressed by LV and the recombinant GP4 protein expressed in a Semliki Forest virus expression system. However, these MAbs did not react with the GP4 protein of U.S. isolate VR2332. To map the binding site of the MAbs, chimeric constructs composed of ORF4 of LV and VR2332 were generated. The reactivity of these constructs indicated that all the MAbs were directed against a region spanning amino acids 40 to 79 of the GP4 protein of LV. Six MAbs reacted with solid-phase synthetic dodecapeptides. The core of this site consists of amino acids 59 to 67 (SAAQEKISF). Comparison of the amino acid sequences of GP4 proteins from various European and North American isolates indicated that the neutralization domain spanning amino acids 40 to 79 is the most variable region of GP4. The neutralization domain of GP4, described here, is the first identified for LV.     

Simultaneous occurrence of a supra- and an infratentorial glioma in a patient with Ollier's disease: more evidence for non-mesodermal tumor predisposition in multiple enchondromatosis

A case is presented in which two neuro-ectodermal tumors, an infra- and a supratentorial glioma, developed in a young man with multiple enchondromatosis of Ollier's disease. This is the third such case of multifocal low-grade glioma in Ollier's disease, suggesting a predisposition for non-mesodermal tumors in Ollier's disease. The related condition of multiple enchondromatosis and hemangiomas (Maffucci's syndrome) is well known for its malignant potential, developing both mesodermal and non-mesodermal tumors. Along with other authors, we support the concept of two variants of the same disease with a predisposition to development of tumors from various germ layers.     

Botulinum toxin in the management of the lower limb in cerebral palsy

The role of intramuscular botulinum toxin A in the treatment of 26 children with cerebral palsy was evaluated. The indication for injection was the presence of a dynamic contracture of lower-limb muscles interfering with positioning or walking. Spastic target muscles were identified by clinical examination and, in ambulant children, by gait analysis. Between 50 and 320 units of botulinum toxin were injected into each muscle group to a total dose of 100 to 400 units per child. The effects of injection were monitored by repeated clinical examination and gait analysis. There were no clinically detectable systemic side-effects, and all but one patient had a reduction in tone, which occurred within three days and persisted for two to four months. There were significant improvements in ambulatory status and in sagittal-plane kinematics. In some cases these gains persisted after the tone-reducing effects of the toxin had worn off.     

Rapid-staged strategy for concomitant critical carotid and left main coronary disease with left ventricular dysfunction: IABP use

Fascicle length, pennation angle, and tendon elongation of the human tibialis anterior were measured in vivo by ultrasonography. Subjects (n = 9) were requested to develop isometric dorsiflexion torque gradually up to maximal at the ankle joint angle of 20 degrees plantarflexion from the anatomic position. Fascicle length shortened from 90 +/- 7 to 76 +/- 7 (SE) mm, pennation angle increased from 10 +/- 1 to 12 +/- 1 degrees, and tendon elongation increased up to 15 +/- 2 mm with graded force development up to maximum. The tendon stiffness increased with increasing tendon force from 10 N/mm at 0-20 N to 32 N/mm at 240-260 N. Young's modulus increased from 157 MPa at 0-20 N to 530 MPa at 240-260 N. It can be concluded that, in isometric contractions of a human muscle, mechanical work, some of which is absorbed by the tendinous tissue, is generated by the shortening of muscle fibers and that ultrasonography can be used to determine the stiffness and Young's modulus for human tendons.     

Oligoradionuclidetherapy using radiolabelled antisense oligodeoxynucleotide phosphorothioates

Radiolabelled antisense oligodeoxynucleotides have been used for in vivo biokinetic studies in AIDS and cancer patients. The therapeutic possibilities are still unknown and the major question in therapeutic use of radio-oligonucleotide is the optimal source of radiation. We studied the pharmacokinetics and in vivo tissue distribution for oligodeoxynucleotide phosphorothioates by using the data from three different radionuclides: sulphur-35 (t1/2 = 87.4 days, maximum beta-energy = 167 keV), phosphorus-33 (t1/2 = 24.4 days, maximum beta-energy = 250 keV) and phosphorus-32 (t1/2 = 14.3 days, maximum beta-energy = 2270 keV). The absorbed doses of 32P-, 33P- and 35S-labelled oligonucleotides were estimated using the published biodistribution data for several oligonucleotides in two animal models for both tumour xenografts and AIDS. The local energy absorption of 33P turned out to be higher than that of 32P if the mass was smaller than approximately 300 micrograms, and the local absorption of 35S was higher than that of 32P when the mass was <80 micrograms. In a mouse tumour xenograft model an i.v. injected activity seemed to achieve sufficient radiation doses in the tumour: in a 1 g tumour 4.9 Gy for 32P, 5.1 Gy for 33P and 5.5 Gy for 35S were calculated when the kidney dose was kept as 5 Gy. In the same model in smaller tumours the doses were for a 1 mg tumour 0.73 Gy (32P), 5.1 Gy (33P) and 5.5 Gy (35S), and for a 1 microgram tumour 0.08 Gy (32P), 3.1 Gy (33P) and 3.9 Gy (35S). Thus, 33P and 35S have more beneficial radiotherapeutic characteristics than 32P. Relative advantage factors (33P and 35S versus 32P) for kidney and liver doses using these nuclides varied from 0.997 to 1.001 for a 1 g tumour and there was no difference in the radiation dose to normal organs. Therefore, we conclude that in oligonucleotide radiotherapy tumours >1 g should be treated with 32P, whereas smaller tumours should be treated with 33P or 35S. There is no significant difference between 33P and 35S, and either radionuclide could be selected according to labelling properties.     

Thermodynamic stability of immunoglobulins and allosteric interactions with ferritin and protein A: distinct properties of the two antibodies of IgG2a subclass

The two anti-ferritin monoclonal antibodies of mouse IgG2a subclass, G10 and F11, are described that have similar affinity to human spleen ferritin and identical protein A-binding affinity. Antigen binding was shown to change significantly the protein A-binding parameters of the IgG2a antibodies. Antigen-induced conformational changes result in enhanced protein A-binding affinity of the G10 antibody while reduced affinity of the F11 antibody. Antigen binding does not change inherently low affinity of the anti-ferritin IgG1 antibody C5 to protein A. Differential scanning calorimetry revealed that the enthalpy and Gibbs free energy of denaturation for G10 was respectively by 19 and 29% higher than the corresponding parameters for F11. The lower structural energetics of F11 is associated with the lack of a calorimetrically revealed folding unit that may be responsible for distinct interaction between the antigen-binding and protein A-binding sites. This work provides experimental demonstration of the fact that functionally significant interactions between the two spatially remote recognition sites in antibodies of the same heavy chain isotype can be modulated by relatively small structural variations that also result in different thermodynamic stability.     

Inhibition of antigen-induced cutaneous responses of ponies with insect hypersensitivity by the histamine-1 receptor antagonist chlorpheniramine

A whole-body extract of Culicoides impunctatus induced a biphasic increase in oedema formation in ponies with insect hypersensitivity, with maxima after one and eight hours. The Culicoides antigen did not induce similar responses in ponies with no previous history of the disease. In insect-hypersensitive ponies the local administration of chlorpheniramine (12 micrograms) completely inhibited oedema formation in response to histamine (0.04 microgram) and to Culicoides antigen (0.5 microgram) at one hour, and the response to Culicoides antigen at eight hours was inhibited by 63 per cent. Chlorpheniramine also partially inhibited the accumulation of eosinophils and neutrophils induced by Culicoides antigen after two hours.