Triple paternal contribution to a normal/complete molar chimeric singleton placenta.

A comprehensive study of unusual cases of placental pathology may provide insight into mechanisms of normal human fertilization and early embryonic development by examining the exception to the rule. A gravida three para two 39-year-old woman was monitored by ultrasound from 16 weeks of gestation for cystic placenta. A female newborn was born at 36 weeks gestation. Pathologic examination of the partially cystic placenta revealed a singleton placenta comprised of 2/3 normal placenta and 1/3 complete hydatidiform mole, largely degenerated. Immunostaining for p57 was negative in stromal cells of the molar villi. Chromogenic in-situ hybridization revealed diploidy in both normal and molar parts. A total of 16 microsatellites were studied by short tandem repeat analysis, 11 of which were informative. The analysis revealed bipaternal molar tissue of dispermic origin. The paternal monospermic contribution to the normal part was different from that in the molar part, thus resulting in tripaternal contribution to the conceptus. A chimera is a single organism composed of two or more different populations of genetically distinct cells that originated from different zygotes (tetragametic) whereas mosaic is a mixture of two cell lines in one organism originating from one zygote. The possible mechanisms leading to the formation of chimeric/mosaic placenta in our case (one of the components being complete hydatidiform mole), including twinning, fusion at an early embryonic stage and diploidization of triploids, are discussed.

Living related liver transplant following bone marrow transplantation from same donor: long-term survival without immunosuppression.

We report long-term (seven yr) immunological tolerance in a 16-yr-old boy, to a liver allograft donated by his father following a bone marrow transplant at age 2.5 yr from the same donor. The bone marrow transplant was complicated by severe GVHD leading to liver failure and the ensuing need for a liver transplant, performed under planned avoidance of immunosuppression. At one wk post-transplant, although a liver biopsy was histologically compatible with acute rejection, favorable clinical and biochemical evolution precluded initiating immunosuppressive therapy, thus highlighting the need for caution when interpreting early histological changes so that administration of unnecessary immunosuppression can be avoided. Induction of tolerance in transplant recipients remains an elusive goal. In those patients who had received conventional bone marrow transplants and had endured the consequences of GVHD, development of macrochimerism may allow immunosuppression-free solid organ transplantation from the same donor.

A mutation analysis of the phenylalanine hydroxylase (PAH) gene in the Israeli population.

Hyperphenylalaninemia (HPA) is a group of diseases characterized by a persistent elevation of phenylalanine levels in tissues and biological fluids. The most frequent form is phenylalanine hydroxylase deficiency, causing phenylketonuria (PKU). Among 159 Israeli patients (Jews, Muslim and Christian Arabs and Druze) with HPA, in whom at least one of the mutations was characterized, a total of 43 different mutations were detected, including seven novel ones. PKU was very rare among Ashkenazi Jews and relatively frequent among Jews from Yemen, the Caucasian Mountains, Bukhara and Tunisia. The mutations responsible for the high frequency were: exon3del (Yemenite Jews), L48S (Tunisian Jews) and E178G, P281L and L48S (Jews from the Caucasian Mountains and Bukhara). Among the non-Jewish Israeli citizens, the disease was relatively frequent in the Negev and in the Nazareth vicinity, and in many localities a unique mutation was detected, often in a single family. While marked genetic heterogeneity was observed in the Arab and Jewish populations, only one mutation A300S, was frequent in all of the communities. Several of the other frequent mutations were shared by the non-Ashkenazi Jews and Arabs; none were mutual to Ashkenazi Jews and Arabs.

HLA-G levels in serum and plasma.

Soluble human leukocyte antigen (HLA)-G levels are in most cases higher in the plasma than in the serum obtained from the same individual. This is probably due to trapping of the protein during clot formation. In studies where soluble HLA-G is quantified, it is therefore recommended that plasma or serum levels should be compared with the same blood product, namely, serum to serum and plasma to plasma. Because of possible gender differences in HLA-G levels it is also recommended that this should be considered in the construction of a control group especially in studies where there is a preponderance of one of the sexes.

The effects of hydraulic retention time and feed COD concentration on the rate of hydrolysis of primary sewage sludge under methanogenic conditions.

A series of completely mixed methanogenic anaerobic digesters have been operated to determine the rate of hydrolysis of primary sewage sludge. The hydraulic retention time was reduced from 60 d to when the system failed (approximately 5 d), while the feed COD concentration was 40, 25, 13 and 2 gCOD/L. A steady state model based on first order kinetics was developed to simulate the hydrolysis rate at each retention time and feed concentration. With the mean value for the hydrolysis rate constant (0.992 +/- 0.492 d(-1)), this model was able to accurately predict the effluent COD for all steady state operating conditions. However, the effluent COD concentration was relatively insensitive to the exact value for this constant. The model provides a framework for analysis of anaerobic digestion experimental data, to enable meaningful comparisons.

Integrated chemical, physical and biological processes modelling of anaerobic digestion of sewage sludge.

The biological kinetic processes for anaerobic digestion (AD) are integrated into a two phase subset of a three phase mixed weak acid/base chemistry kinetic model. The approach of characterising sewage sludge into carbohydrates, lipids and proteins, as is done in the International Water Association (IWA) AD model No 1 (ADM1), requires measurements that are not routinely available on sewage sludges. Instead, the sewage sludge is characterised with the COD, carbon, hydrogen, oxygen and nitrogen (CHON) composition and is formulated in mole units, based on conservation of C, N, O, H and COD. The model is calibrated and validated with data from laboratory mesophilic anaerobic digesters operating from 7 to 20 d sludge age and fed a sewage primary and humus sludge mixture. These digesters yielded COD mass balances between 107-109% and N mass balances between 91-99%, and hence the experimental data is accepted as reasonable. The sewage sludge COD is found to be 32-36% unbiodegradable (depending on the kinetic formulation selected for the hydrolysis process) and to have a C3.5H7O2N0.196 composition. For the selected hydrolysis kinetics of surface mediated reaction (Contois), with a single set of kinetic and stoichiometric constants, for all retention times good correlation is obtained between predicted and measured results for: (i) COD; (ii) free and saline ammonia (FSA); (iii) short chain fatty acids (SCFA); (iv) H2CO3 * alkalinity; (v) pH of the effluent stream; (vi) CO2; and (vii) CH4 gases in the gas stream. The measured composition of primary sludge from two local wastewater treatment plants ranged between C3.38H7O1.91 N0.21 and C3.91H7O2.04N0.16. The predicted composition based on mass balances is therefore within 5% of the average measured composition providing persuasive validation of the model.

Integrated chemical--physical processes kinetic modelling of multiple mineral precipitation problems.

A three-phase (aqueous/gas/solid) mixed weak acid/base chemistry kinetic model is applied to evaluate the processes operative in the aeration treatment of swine wastewater (SWW) and sewage sludge anaerobic digester liquor (ADL). In both applications, with a single set of constants (except for the aeration rates which are situation specific), close correlation could be obtained between predicted and measured data, except for the Ca concentration-time profile in the SWW. For this wastewater, the model application highlighted an inconsistency in the measured Ca data which could not be resolved; this illustrates the value of a mass balance-based model in evaluating experimental data. From the model applications, in both wastewaters the dominant minerals precipitating are struvite and amorphous calcium phosphate (ACP), which precipitate simultaneously competing for the same species, P. The absolute and relative masses of the two precipitants are governed by the initial solution state (e.g. total inorganic C (C(T)), Mg, Ca and P concentrations), their relative precipitation rates (struvite > ACP) and the system conditions imposed (aeration rates and time applied). It is concluded that the kinetic model is able to predict correctly the time-dependent weak acid/base chemistry reactions and final equilibrium state for situations where multiple minerals competing for the same species precipitate simultaneously or sequentially, a deficiency in traditional equilibrium chemistry-based algebraic models.

Evidence for blood chimerism in dizygotic spontaneous twin pregnancy discordant for Down syndrome.

BACKGROUND: A monochorionic-diamniotic placenta (MCDAP) is rare in dizygotic (DZ) twinning. All reported cases have been documented in pregnancies achieved by the induction of ovulation alone or during the IVF cycle. METHODS AND RESULTS: We report a spontaneous pregnancy in a 39-year-old patient with evidence of MCDAP in DZ twins, discordant for trisomy 21. The first and second-trimester sonographic scans indicated male twins with MCDAP. Amniocentesis, performed because of advanced maternal age, revealed a normal karyotype in one fetus, and trisomy 21 in the other. Molecular studies, performed in order to confirm the zygosity and chorionicity, demonstrated that the fetuses were DZ. In order to identity the affected twin, a detailed sonographic examination was repeated, but no abnormal findings associated with Down syndrome were demonstrated in any of the fetuses. Therefore, umbilical cord blood samples were obtained from both fetuses. Chromosomal analysis revealed in both fetuses two cell lines: a normal cell line of 46,XY and a 47,XY,+ 21 cell line, in 65 and 80% of the cells, respectively. This result was independently confirmed by both FISH and G-banding. DNA extracted from both cord blood samples demonstrated an admixture of two distinct genotypes in each sample. CONCLUSIONS: We propose that this case represents a monochorionic-dizygotic twin pregnancy with blood chimerism. The most plausible mechanism underlying this phenomenon is placental fusion early in pregnancy, resulting in an architecturally single placenta originating from two distinct zygotes. The newly formed blood vessels created anastomoses between the DZ twins and allowed reciprocal blood chimerism between the normal and the trisomic twin.

HLA-G levels in serum and plasma.

HLA-G belongs to the non-classical HLA class-I family of genes presently designated as class-Ib genes. There are four membrane-bound (HLA-G1 to -G4) and three soluble forms (HLA-G5 to -G7) generated by alternative splicing of the primary transcript. HLA-G in the soluble form is found in the plasma, amniotic fluid, and cord blood of healthy individuals. Quantitative determination suggested that HLA-G levels are genetically controlled. While quantifying soluble HLA-G by ELISA, we observed that when plasma and serum levels were measured for the same individual, HLA-G plasma values were almost invariably higher than those from serum. Our results suggest that HLA-G is trapped and/or consumed during clot formation. The amount trapped within the clot is variable and inconsistent. To obtain values which reflect the true biological levels, it is therefore recommended that HLA-G should be determined in the plasma. If serum levels are determined, they should be compared with matched control sera. It should always be borne in mind that conclusions concerning sera levels might be erroneous, because the true plasma level of the protein can be significantly higher.

Advances in seeded ambient temperature ferrite formation for treatment of acid mine drainage.

Advances in the seeded ambient temperature ferrite process for treatment of acid mine drainage (AMD) are described. Magnetite formation requires that the oxidation rate of ferrous to ferric does not exceed the rate at which ferrous iron is incorporated into the crystal structure (dehydroxylation-crystallization). If the oxidation rate is too high, then ferric-only oxides form, an effect exacerbated by the presence of calcium. NaOH was used to raise the pH of simulated AMD, which also contained calcium so as to simulate the use of lime (i.e., the dissolved Ca/ Fe2+ concentration was maintained at 1:1 bythe coaddition of CaCl2 because this is the Ca/Fe ratio that occurs when pH is elevated by the dissolution of lime). Raising the pH to 10.5 causes Fe2+ to precipitate as "ferrous intermediate" (FI), which is then partially oxidized to magnetite (Fe2+Fe3+2O4). The inhibitory effect of calcium is overcome by a combination of magnetite seed particles, high FI concentrations, and aging. High FI concentrations are easily obtained, even from AMD low in Fe2+, by a contact stabilization reactor-settler sequence. Results for simultaneous removal of cobalt, a metal found in significant concentrations in South African AMD, are also presented.

Circulatory neurosteroid levels in underweight female adolescent anorexia nervosa inpatients and following weight restoration.

Nineteen female adolescent inpatients diagnosed with anorexia nervosa, restricting type (AN-R) and 16 non-eating disordered (ED) controls were assessed for plasma dehydroepiandrosterone (DHEA), dehydroepiandrosterone-sulphate (DHEA-S), and cortisol levels, and for eating-related and non-eating-related psychopathology. AN-R patients were assessed at admission, 1 month and 4 months following hospitalization. The non-ED controls were assessed once. No baseline between-group differences were found in plasma cortisol, DHEA, and DHEA-S levels, whereas the patient group had a significantly lower Cortisol/DHEA-S ratio and elevated scores on most psychopathological parameters. A significant increase was found in the body mass index of the AN-R patients at 4 months post-hospitalization, accompanied by a decrease in plasma cortisol levels and a trend towards decreased Cortisol/DHEA and Cortisol/DHEA-S ratios, whereas no change occurred in psychopathology. The difference in Cortisol/DHEA-S ratio between AN-R patients and non-ED controls, and the different patterns of change in cortisol vs. DHEA(-S) levels following weight restoration, may in part account for the feeding difficulties in AN, particularly during refeeding.

Feto-feto-fetal transfusion syndrome in monozygotic monochorionic triamniotic triplets: vascular evaluation by a cast model.

A unique cast model of the placenta in a rare case of feto-feto-fetal triplet transfusion syndrome (FFFTTS) allowed the demonstration of why the transfusion syndrome developed in one fetus and not in the other two in that single placenta. The vasculature anatomy of a monochorionic triamniotic triplet placenta with FFFTTS of three healthy infants (one donor, two recipients) born in the 35th week of gestation was cast by means of dental casting materials. After the cast hardened, the tissue was corroded, revealing the cast blood vessels. The diameters and lengths of the chorionic blood and intraplacental vessels of the cast placenta were measured with a digital caliper. The cast revealed two artery-artery (A-A) anastomoses on the chorionic plate between the two recipients and the donor. Seven artery-vein (A-V) deep anastomoses connected only the arteries of the donor and the veins of the two recipients. The blood vessel connections among the fetuses allowed the evaluation of a pathologic case with its own control in a single placenta. From the vascular appearance, we speculate that the A-A anastomoses between the two fetuses protected them from developing blood transfusions, but that the A-V anastomoses contributed to their development.

Common ancestral origin of pemphigus vulgaris in Jews and Spaniards: a study using microsatellite markers.

Pemphigus is a group of autoimmune blistering diseases of the skin and mucous membranes. The association of pemphigus with human leukocyte antigen (HLA) is widely accepted. It was described in many ethnic groups and in most countries of the world. Studies showed that the associated HLA haplotype in Jewish pemphigus vulgaris (PV) patients is HLA-B38, DRB1*0402, and DQB1*0302; or HLA-B35, DRB1*0402, and DQB1*0302. Similar associations with class II genes were found in Spanish non-Jewish PV patients. As Jews lived in Spain for hundreds of years and many converted to Christianity, the presence of the same HLA haplotype in the Jewish and Spanish PV suggests that they may share the same founder. Microsatellite markers which span the entire major histocompatibility complex (MHC) locus were used as genetic probes. They were utilized to dissect the MHC region in the search for possible common haplotypes, besides HLA, which may provide an answer to this question. It was found that in both cohorts, in addition to HLA class II genes, there are probably genes in the class I region which are associated with PV. Alleles belonging to the associated markers were used to construct haplotypes and to estimate genetic distances. The distance between the two PV cohorts is relatively short, but the distance between the Jewish patients and the Jewish controls is greater compared to the distance between Spanish patients and Spanish controls. In both PV populations, the same microsatellite haplotypes in addition to a common class II haplotype were found, suggesting that both patient populations originated from the same genetic stock and, therefore, share the same ancestral disease gene.

Control of corrosion and aggression in drinking water systems.

Corrosion and/or aggression are common problems arising in pipelines transporting terrestrial waters. The kinetics and severity of such events depend on both the quality of the water being transported and the material properties of the pipeline. Irrespective of the nature of the problem, its solution (or at least its minimisation) is strongly linked to control of pH, calcium concentration and carbonate chemistry of the water (stabilisation). However, application of such chemistry to water treatment problems is complex and time consuming. Various numerical, graphical and computer techniques have been developed to address this, but these are either of insufficient accuracy, too time consuming or lacking in generality. In this paper algorithms are presented for solving a broad spectrum of problems related to control of mineral precipitation/aggression, pH and chemical dosing in water treatment. These have been incorporated into a computer software package, STASOFT, which offers the requisite framework for use in water treatment. Various stabilisation problems pertinent to water supply are addressed.

Different phenotypic expression in monozygotic twins with Huntington disease.

Monozygotic (MZ), 46-year-old, male twins, carrying the same Huntington disease (HD) mutation, presented with a different clinical course. In one of the twins, the disease process started at the age of 32 years with chorea, dysarthria, and a depressed mood. Over 14 years, the disease progressed to total functional dependence. The second twin presented at age 35 with gait disturbances. His behavior became aggressive with an obsessive pattern, whereas the motor features included hypokinesia, rigidity, gait unsteadiness, and dysarthria. This is the first report of genetic identity associated with different age of disease onset as well as a different motor and behavioral phenotype. Postzygotic events are a likely explanation for the observed differences of phenotype in these genetically identical twins.

NQO2 gene is associated with clozapine-induced agranulocytosis.

Clozapine is a dibenzodiazepine neuroleptic with atypical pharmacological and clinical profiles. Treatment with this drug may be complicated with agranulocytosis (AGR). It is likely that defective oxidative mechanism may be the cause of AGR. A candidate gene, dihydronicotinamide riboside (NRH) quinone oxidoreductase 2 (NQO2), which is involved in detoxification of drugs, was selected. This gene has been mapped to the short arm of chromosome six. The gene was studied by single-strand conformation polymorphism analysis and direct sequencing in 98 schizophrenic patients that were treated with clozapine. Eighteen of these patients developed AGR. Ten polymorphisms in the coding regions, in intron 1, and in the promoter region were found, two of which were novel. Comparisons of the polymorphisms in the first intron in AGR patients and controls suggested that this site might be connected with AGR. Quantitative reverse transcriptase-polymerase chain reaction analysis showed that the level of NQO2 mRNA is low in AGR patients compared with the control group. Such a reduction in message suggests that the NQO2 gene may be involved in the development of clozapine-induced AGR.

Heterotroph anoxic yield in anoxic aerobic activated sludge systems treating municipal wastewater.

As input to the steady state design and kinetic simulation models for the activated sludge system, the correct value for the heterotroph anoxic yield is essential to provide reliable estimates for the system denitrification potential. This paper examines activated sludge anoxic yield values in the literature, and presents experimental data quantifying the value. In the literature, in terms of the structure of ASM1 and similar models, theoretically it has been shown that the anoxic yield should be reduced to approximately 0.79 the value of the aerobic yield. This theoretical value is validated with data from corresponding aerobic OUR and anoxic nitrate time profiles in a batch fed laboratory scale long sludge age activated sludge system treating municipal wastewater. The value also is in close agreement with values in the literature measured with both artificial substrates and municipal wastewater. Thus, it is concluded that, in ASM1 and similar models, for an aerobic yield of 0.67mg COD/mg COD, the anoxic yield should be about 0.53 mg COD/mg COD. Including such a lower anoxic yield in ASM1 and similar models will result in a significant increase in denitrification potential, due to increased denitrification with wastewater RBCOD as substrate. In terms of the structure of ASM3, for the proposed substrate storage yields and the aerobic yield of 0.63 mg COD/mg COD, experimental data indicate that the corresponding anoxic yield should be about 0.42 mg COD/mg COD. This is significantly lower than the proposed value of 0.54 mg COD/mg COD, and requires further investigation.

Nitrification utilizing CaCO3 as the buffering agent.

Nitrification utilizing chalk (calcium carbonate) as the buffering agent was investigated. Three different fluidized bed reactor configurations were examined in order to study the effect of reactor layout on nitrification and concomitant chalk dissolution. The first system consisted of two interconnected columns with high recycle rate, one containing zeolite as the carrier for the nitrifying biomass and the other chalk as the buffering agent. The second reactor system consisted of a single column containing both zeolite and chalk particles. In the third system, nitrification was carried out in a single column where chalk particles were used both as the carrier for the biomass and as the buffer. Results showed that only the reactor with chalk acting as both the buffering agent and the biomass carrier could be operated without external buffer (NaHCO3) addition. This system operated at high ammonium removal rates of up to 2.5 g N l(-1) reactor d(-1) even though the bulk solution of the reactor had a low pH of 5.5. The high nitrification efficiency at this low pH was probably mainly a result of a favorable microenvironment surrounding the nitrifying biomass attached to the chalk.

Prevalence of cystic fibrosis mutations in Israeli Jews.

The aim of this study was to evaluate the screening policies of cystic fibrosis (CF) in the Jewish population. The prevalence of mutations that account for CF in Israel have been defined in the past by determining the frequency of CF mutations in affected individuals. This study is a population-based study and is, therefore, different from previous patient-based studies. We found that the CF mutations D1152H, W1089X, and 405 + IG-->A were present in some ethnic groups in which no CF patients carrying these mutations were reported. These facts necessitate a reevaluation of the screening policy regarding the ethnic groups in Israel. We studied 9,430 healthy Jewish Israeli individuals of 36 countries of origin. The prevalence of CF mutations was 1:19, 1:19, 1:28, and 1:42 for the Ashkenazi, Sephardi, North African, and Eastern Jews, respectively. CF mutations were identified in 374 (4.0%) individuals. These included 173 (46.3%) carriers of the W1282X mutation; 110 (29.4%) found to carry delF508; 23 (6.1%) who carried G542X; 22 (5.9%) who carried 3849 + 10Kb (C-->T; 20 (5.3%) who carried D1152H; 10 (2.7%) who carried N1303K; 11 (2.9%) who carried 405 + IG-->A; 4 (1.1%) who carried W1089X; and one (0.3%) who carried S549R. No carriers were detected for the 1717-1G-->A, G85E, and T360K mutations, which were tested for in 7,383, 1,558, and 41 individuals, respectively.

Identification of new mutations in Israeli patients with X-linked adrenoleukodystrophy.

X-linked adrenoleukodystrophy (ALD) is a peroxisomal disorder characterized by impaired peroxisomal betaoxidation of very-long-chain fatty acids (VLCFAs). This is probably due to reduced activation of the VLCFAs and results in demyelination of the nervous system and adrenocortical insufficiency. The ALD gene is localized on Xq28, has 10 exons and encodes a protein of 745 amino acids with significant homology to the membrane peroxisomal protein PMP70. Characterizing the disease causing mutations is of importance in prenatal diagnosis because 12-20% of women who are obligatory carriers show false-negative results when tested for VLCFA in plasma. We have analyzed DNA from blood samples of 7 Jewish (5 Sephardi and 2 Ashkenazi) and 3 Arab Israeli families suffering from ALD. Five missense-type mutations were identified: R104H, Y174C, L229P, R401Q, and G512C. A single mutation, R464X, was nonsense, and two, Y171 frameshift and E471 frameshift, were frameshift. Interestingly, a single mutation was identified in three families of Moroccan Jewish descent, probably due to a founder effect.