Vaults are up-regulated in multidrug-resistant cancer cell lines

Vaults are 13-MDa ribonucleoprotein particles composed largely of a 104-kDa protein, termed major vault protein or MVP, and a small vault RNA, vRNA. While MVP levels have been found to increase up to 15-fold in non-P-glycoprotein multidrug-resistant cell lines, the levels of vault particles have not been investigated. As both the function of vault particles and the mechanism of drug resistance in non-P-glycoprotein cells are unknown, we decided to determine whether vault synthesis was coupled to MDR. By cloning the human gene for vRNA and careful quantitation of the MVP and vRNA levels in MDR cells, we find that vRNA is in considerable excess to MVP. Sedimentation measurements of vault particles in multidrug resistance cells have indeed revealed up to a 15-fold increase in vault synthesis, coupled with a comparable shift of associated vRNA, demonstrating that vault formation is limited by expression of MVP or the minor vault proteins. The observation that vault synthesis is linked directly to multidrug resistance supports a direct role for vaults in drug resistance.     

Epidemiology of bluetongue in Central America and the Caribbean: initial entomological findings. Regional Bluetongue Team

Forty-four species of Culicoides (Diptera: Ceratopogonidae) were caught in insect light traps during the first 2 years of studies on the epidemiology of bluetongue virus in the Caribbean and Central America. Traps were operated near sentinel ruminants which were bled monthly for serologic evaluation and then virus isolation. More than 570,000 individuals were identified. Culicoides insignis Lutz accounted for 90% of the catch, C. filarifer Hoffman/C. ocumarensis Ortiz 5%, C. furens Poey 3% and C. pusillus Lutz 2%. Other species accounted for less than 1% of the total catch. Sentinel ruminants became seropositive when C. insignis populations were high at many study sites. At a few sites C. pusillus and C. filarifer/C. ocumarensis were predominant or were present in large numbers during seroconversions of sentinels. Virus isolations were obtained from sentinel ruminants during times when these same species were present in large populations.     

Prevalence and correlates of lower extremity arterial disease in elderly women

1. The neuroantibody approach, based on the expression of selected monoclonal antibodies by cells of the nervous system, has recently been described (Cattaneo and Neuberger, 1987; Piccioli et al., 1991). In order to apply this experimental strategy to study the role of nerve growth factor (NGF) in the central nervous system (CNS), we exploited the monoclonal antibody (mAb), alpha D11, which neutralizes very efficiently the biological activity of NGF, both in vitro and in vivo (Cattaneo et al., 1988). 2. The alpha D11 antibody chains were cloned and expressed in COS cells as rat/human chimaeric proteins. The cloned antibody was shown to display all the properties of the parental alpha D11 antibody, including its ability to neutralize NGF biological activity. 3. This will allow us to engineer the expression of recombinant alpha D11 antibodies in the CNS, to study the role of NGF in the developing and adult nervous system. This approach can be extended to other neurotrophic factors for which neutralizing monoclonal antibodies are available.     

The appropriateness of use of percutaneous transluminal coronary angioplasty in New York State

Between 1974 and 1989 we prospectively observed 530 patients with brucellosis. The findings for 62 patients (42 males and 20 females; mean age, 34.7 years) with 63 episodes in which the sacroiliac joint was involved (the most frequent osteoarticular location [11.7%]) were analyzed. Ten of the older patients (mean age, 55.3 years) had concomitant spondylitis. Systemic symptoms were usually important, and characteristic pain and findings of sacroiliitis were observed in approximately 75% of cases. Blood cultures were positive for Brucella melitensis for 44 patients. The most frequent radiographic findings were blurring of articular margins (42 cases) and widening of the sacroiliac space (20 cases). No radiographic anomalies were detected in 13 cases. Results of 99mTc and gallium-67 bone scans were abnormal in approximately 90% of cases (abnormalities were often mild). Overall, clinical, radiographic, and isotopic bone scan findings were sensitive and useful, although they were occasionally minimal or difficult to evaluate, making diagnostic findings confusing or misleading. Brucellar sacroiliitis is a mild disease associated with a good outcome similar to that observed for patients with uncomplicated brucellosis.     

Benzodiazepine withdrawal reaction in two children following discontinuation of sedation with midazolam

OBJECTIVE: To report the occurrence of recurrent benzodiazepine withdrawal reactions in two very young children following discontinuation of sedation with midazolam. CASE SUMMARY: A 15-month-old boy with apneic episodes was sedated with midazolam for 12 days with constant infusion. Half a day after discontinuation of the midazolam the boy became restless, tachycardic, and hyperpyrexic. When midazolam was readministered, all symptoms disappeared. Four days later midazolam was again discontinued and within 12 hours the same signs and symptoms reappeared. Midazolam infusion was restarted, and the signs and symptoms disappeared for the second time. After thoracotomy, a 14-day-old boy received intravenous midazolam for sedation for 29 days. Within 12 hours after discontinuation of midazolam he became restless, developed a bulging stomach secondary to aerophagia, and was vomiting. Midazolam therapy was reinstituted and continued for another 2 months by constant infusion. Thereafter, the boy was successfully weaned from artificial ventilation in 5 days under sedation with midazolam. About 12 hours after discontinuation of midazolam the boy became restless, tachycardic, again developed a bulging stomach because of aerophagia, and vomited. When the child was sedated with clorazepate by continuous infusion, the signs and symptoms disappeared. DISCUSSION: Case reports describing benzodiazepine withdrawal reaction upon discontinuation of midazolam were reviewed and compared. The symptoms observed in the children we present resemble those mentioned in the three children and two adults reported previously. Unique in the very young children in this article is the occurrence of gastrointestinal symptoms, which most likely are the result of air being swallowed secondary to severe agitation. CONCLUSIONS: Midazolam withdrawal reactions in adults and children, particularly in an intensive care unit, can be significant. Considerable caution must be taken with relatively long-term administration and abrupt discontinuation of midazolam.     

Mothers' perceptions of sibling adjustment and family life in childhood chronic illness

Researchers who study the effects of chronic illness on well siblings have generally focused on individual characteristics and their relationships with psychological adjustment. More recently, researchers suggest that sibling adjustment can be best understood within the context of the family. The purpose of this study was to examine variations in sibling behavioral adjustment in relation to mothers' perceptions of the illness experience and family life. Based on mothers' ratings on the behavior problem scale of the Child Behavior Checklist (CBCL), five siblings considered poorly adjusted and five very well-adjusted siblings were compared with respect to mothers' reports of individual family member's response to illness, illness management, parenting philosophy, presence of other stressors, availability of social supports, and impact of illness on family members and family life. Two major differences were found between mothers who rated healthy siblings either poorly or very well adjusted: (a) effects of illness on the healthy sibling, the ill child, and the marital relationship and (b) perceived controllability of the chronic illness. Devising ways of helping mothers feel confident in managing their child's illness is integral to creating an environment that promotes optimal development of their ill child and the child's siblings.     

Synthesis of lactosyl phosphate diester derivatives of nucleosides

It has been postulated that some arthroscopic shoulder stabilization failures may be due to knot slippage. In an effort to improve arthroscopic technique, we performed tensile testing on four arthroscopically tied knots with two commonly used suture materials. Handtied square knots served as controls. Sutures of No. 1 Maxon and No. 1 Ticron were used. Four types of sliding knot configurations were tested: the overhand loop, the Duncan loop, the Roeder knot, and the Snyder knot. Knots were tied via a knot pusher, and testing was performed in a normal saline-filled thermoplastic chamber. Knots were tied around two rings connected to a Bionix 858 materials testing apparatus. The knots were tested under conditions of cyclic loading and loading to failure. Results of the testing revealed that the most important factor in knot security was the type of suture material, although there were differences with the type of knot. With the Maxon suture, there was significantly decreased ultimate failure load of all of the arthroscopically tied knots compared with handtied square knots. Knots tied with Ticron were similar in strength for both arthroscopically and handtied groups. The surgeon who chooses a monofilament absorbable suture should be aware that a high percentage of knots fail under low load cyclic testing, and that all of these knots were inferior to handtied square knot controls in testing to failure.