Anterior sacroiliac dislocation.

Although much has been written on the evaluation and management of pelvic ring injuries, only a single case of anterior sacroiliac joint dislocation exists in the literature and was reported in 1976. This article describes 2 additional cases, 1 of a pure anterior sacroiliac dislocation in a 25-year-old man, and 1 of an anterior sacroiliac fracture-dislocation in an 18-year-old man, each treated by a different orthopedic traumatologist at neighboring trauma centers. Both cases were the result of high-energy trauma, and both patients had significant complications resulting from severity of their injuries, including wound dehiscence and causalgia in 1 case and persistent L5-S1 paresthesias and paresis in the other. Closed reduction can be attempted, but in our experience was unsuccessful even with the use of external fixation pins for leverage. We recommend open reduction by an orthopedic traumatologist who will perform definitive fixation. The decision to use an anterior external fixation frame to assist during the patient's resuscitation should be based on the patient's hemodynamic status and concomitant injuries. Despite a high complication rate, operative intervention can return patients to a functional level with minimal residual pain.

The selectivity of inclusion and exclusion criteria in bulimia nervosa treatment studies.

OBJECTIVE: To examine the rates of exclusion and inclusion in various research studies for a series of 51 treatment-seeking patients. METHOD: The inclusion and exclusion criteria employed in a sample of 41 studies were applied to a series of 51 treatment-seeking bulimia nervosa patients. RESULTS: Of the sample of 51, 11, (21.6%) would have been excluded from 16 (39%) of the studies because of an age greater than 30; 13 (32%) of the studies would have excluded 8 (16%) of our patients because of weight > 110% ideal body weight. Thirteen (26%) would have been excluded from 22 (54%) of the studies because of active psychotropic drug use, despite the lack of response. DISCUSSION: Some of the patients who may be most difficult to work with may be excluded from treatment studies.

Mutations in POL1 increase the mitotic instability of tandem inverted repeats in Saccharomyces cerevisiae.

Tandem inverted repeats (TIRs or hairpins) of 30 and 80 base-pair unit lengths are unstable mitotically in yeast (Saccharomyces cerevisiae). TIR instability results from deletions that remove part or all of the presumed hairpin structure from the chromosome. At least one deletion endpoint is always at or near the base of the hairpin, and almost all of the repaired junctions occur within short direct sequence repeats of 4 to 9 base pairs. The frequency of this event, which we call "hairpin excision," is influenced by chromosomal position, length of the inverted repeats, and the distance separating the repeat units; increasing the distance between the inverted repeats as little as 25 base pairs increases their chromosomal stability. The frequency of excision is not affected by representative rad mutations, but is influenced by mutations in certain genes affecting DNA synthesis. In particular, mutations in POL1/CDC17, the gene that encodes the large subunit of DNA polymerase I, increase the frequency of hairpin deletions significantly, implicating this protein in the normal maintainance of genomic TIRs.

A factor, U2AF, is required for U2 snRNP binding and splicing complex assembly.

Pre-mRNA splicing complex assembly is mediated by two specific pre-mRNA-snRNP interactions: U1 snRNP binds to the 5' splice site and U2 snRNP binds to the branch point. Here we show that unlike a purified U1 snRNP, which can bind to a 5' splice site, a partially purified U2 snRNP cannot interact with its target pre-mRNA sequence. We identify a previously uncharacterized activity, U2AF, that is required for the U2 snRNP-branch point interaction and splicing complex formation. Using RNA substrate exclusion and competition assays, we demonstrate that U2AF binds to the 3' splice site region prior to the U2 snRNP-branch point interaction. This provides an explanation for the necessity of the 3' splice site region in U2 snRNP binding and, hence, the first step of splicing.

Alternative branch points are selected during splicing of a yeast pre-mRNA in mammalian and yeast extracts.

Pre-mRNA splicing in yeast and higher eukaryotes proceeds by similar pathways, in which a probable splicing intermediate and the excised intron are in a lariat configuration. To compare the pre-mRNA splicing mechanisms in yeast and higher eukaryotes, we have analyzed the RNA products resulting from in vitro processing of a yeast intron-containing pre-mRNA in HeLa cell and yeast extracts. In yeast, the RNA branch (2'-5' phosphodiester bond) of the RNA lariat forms at the third adenosine of the TACTAAC box in vivo and in vitro. In contrast, in the HeLa cell extract, the yeast pre-mRNA is accurately spliced, but the RNA lariats contain RNA branches located significantly closer to the 3' splice site than the TACTAAC box. In yeast, mutant pre-mRNAs that lack the TACTAAC box are not spliced in vivo or in vitro. However, these same mutant pre-mRNAs are accurately spliced in the HeLa cell extract. Therefore, although pre-mRNA splicing in yeast and higher eukaryotes proceeds by the same basic pathway, there are substantial differences in the specificity of the biochemical components that mediate the formation of the RNA processing products.

Specific and stable intron-factor interactions are established early during in vitro pre-mRNA splicing.

Biochemical components (splicing factors) interact with specific intron regions during pre-mRNA splicing in vitro. The pre-mRNA specifically associates with factors at both the branch point and the 5' splice site and these RNA-factor interactions are maintained in the intron-containing RNA processing products. The first detectable event, the ATP-dependent association of a factor (or factors) with the branch point, is mediated by at least one factor containing an essential nucleic acid component. Mutant RNA substrates that lack either the 5' splice site or the vast majority of exon sequences can still associate with the branch point binding factor(s). However, this branch point-factor interaction does not occur with a mutant RNA substrate that contains the branch point but that lacks the 3' splice site consensus sequence. These results suggest that selection of the 3' splice site accompanied by the association of a factor with the branch point may be the initial step in mammalian pre-mRNA splicing.

Methyl-esterified proteins in a mammalian cell line.

Methyl esterification of carboxylic acid residues in intact mouse S49 lymphoma cells was examined, and at least 24 proteins were found to be modified. Cell fractionation revealed that a distinct set of these proteins could be found in each of the four fractions. Nuclei contained 11 methyl-esterified proteins at 12, 15.5, 18, 19, 39, 41, 45, 70, 90, 105, and 130 kilodaltons (kDa). Five proteins copurified with the plasma membrane/mitochondrial fraction at 13, 24, 25, 27, and 28 kDa. Two proteins at 32 and 56 kDa were in the microsomal fraction, and six were soluble at 16.5, 21, 24, 26, 34, and 36 kDa. Eleven of these proteins were [3H]methyl esterified when cell homogenates were incubated with S-adenosyl-L-[methyl-3H]methionine. The steady-state level of methyl group incorporation into protein in intact cells was approximately 118 pmol/mg of protein. Assuming the average protein is 40 kDa, there appears to be 1 methyl group per 210 proteins. This was compared to phosphorylation which gave approximately one phosphoryl group for every four proteins. Exogenously added L-[methyl-3H]methionine equilibrated with the cellular S-adenosylmethionine pool within 30 min which was sufficiently rapid to allow the rate of methyl group turnover to be determined. Most methyl-esterified proteins demethylated in a pulse--chase experiment with half-lives ranging from 2.6 to 9.3 h. When protein syn thesis was blocked with puromycin, amino acid backbone incorporation of methionine was reduced to 2% of control. Methyl group incorporation, however, was 39% of the control.(ABSTRACT TRUNCATED AT 250 WORDS)

Role of the 3' splice site consensus sequence in mammalian pre-mRNA splicing.

Pre-mRNA splicing has been shown to occur by a two-step pathway. In the first stage, the pre-mRNA is cleaved at the 5' splice site, generating the first exon RNA species and an RNA species composed of the intron and second exon (IVS1-exon 2 RNA species). In the second stage, cleavage at the 3' splice site and ligation of the exons occurs, resulting in the excision of the intact intron. The excised intron and IVS1-exon 2 RNA species are in the form of a lariat in which the 5' end of the intron is joined to an adenosine residue near the 3' end of the intron by a 2'-5' phosphodiester bond. Here we show that although cleavage at the 3' splice site does not occur until the second stage of the splicing reaction, at least a portion of the 3' splice site consensus sequence is necessary for 5' splice site cleavage and lariat formation. Thus, in higher eukaryotes at least three sequence elements participate in the initiation of the splicing reaction: the 5' splice site, 3' splice site consensus sequence and the RNA branchpoint.

Cryptic branch point activation allows accurate in vitro splicing of human beta-globin intron mutants.

The excised introns of pre-mRNAs and intron-containing splicing intermediates are in a lariat configuration in which the 5' end of the intron is linked by a 2'-5' phosphodiester bond (RNA branch) to a single adenosine residue near the 3' end of the intron. To determine the role of the specific sequence surrounding the RNA branch, we have mutated the branch point sequence of the human beta-globin IVS1. Pre-mRNAs lacking the authentic branch point sequence are accurately spliced in vitro; processing of the mutant pre-mRNAs generates RNA lariats due to the activation of cryptic branch points within IVS1. The cryptic branch points always occur at adenosine residues, but the sequences surrounding the branched nucleotide vary. Regardless of the type of mutation or the sequences remaining within IVS1, the cryptic branch points are 22 to 37 nucleotides upstream of the 3' splice site. These results suggest that RNA branch point selection is primarily based on a mechanism that measures the distance from the 3' splice site.

An RNA processing activity that debranches RNA lariats.

The excised introns of pre-messenger RNA's (pre-mRNA's) and intron-containing splicing intermediates are in a lariat configuration in which the 5' end of the intron is covalently joined by a 2',5'-phosphodiester bond to a specific adenosine residue near the 3' end of the intron. A 2',5'-phosphodiesterase activity in HeLa cell extracts has been detected that debranches RNA lariats, converting them to linear RNA molecules by specific cleavage of the 2',5'-phosphodiester bond. This lariat debranching activity is distinct from previously reported 2',5'-phosphodiesterases with regard to its biochemical and substrate requirements as well as its stringent cleavage specificity. The debranching activity is observed only if the RNA lariats generated during in vitro processing are deproteinized and added back to the extract. These results suggest that during the normal in vitro splicing reaction the 2',5'-phosphodiester bond of RNA lariats is protected from cleavage by the lariat debranching activity.

Excision of an intact intron as a novel lariat structure during pre-mRNA splicing in vitro.

To study the mechanisms of RNA splicing we have analyzed the products generated by in vitro processing of a truncated 32P-labeled human beta-globin RNA precursor that contains the first two exons and the first intervening sequence (IVS1). Six major RNA products were detected and characterized. The first detectable RNA processing event is cleavage at the 5' GT of IVS1. Subsequently, accurately spliced RNA and the excised, intact IVS1 are simultaneously observed. The IVS1-containing RNA processing products have several unusual properties, which include: anomalous electrophoretic mobilities on polyacrylamide gels; a block to reverse transcription near the 3' end of IVS1; the presence of a nuclease-resistant component within IVS1. The block to reverse transcription and the nuclease-resistant component map to the same site near the 3' end of IVS1. The nuclease-resistant component appears to be a modified adenosine residue that contains an RNA branch. Based upon these and other structural studies we propose that the 5' end of IVS1 is joined by a 2'-5' phosphodiester linkage to the A residue in the RNAase T1 oligonucleotide ACTCTCTCTG located 28-37 nucleotides upstream from the IVS1 3' end. The IVS1 is therefore in the form of a lariat. These results imply that sequences within IVS1 actively participate in splicing.

Normal and mutant human beta-globin pre-mRNAs are faithfully and efficiently spliced in vitro.

Human beta-globin mRNA precursors (pre-mRNAs) synthesized in vitro from a bacteriophage SP6 promoter/beta-globin gene fusion are accurately and efficiently spliced when added to a HeLa cell nuclear extract. Under optimal conditions, the first intervening sequence (IVS 1) is removed by splicing in up to 90% of the input pre-mRNA. Splicing requires ATP and in its absence the pre-mRNA is neither spliced nor cleaved at splice junctions. Splicing does not require that the pre-mRNA contain a correct 5' or 3' end, a 3' poly A tail, or a 5'-terminal cap structure. However, capping of the pre-mRNA significantly affects the specificity of in vitro processing. In the absence of a cap approximately 30%-40% of the pre-mRNA is accurately spliced, and a number of aberrantly cleaved RNAs are also detected. In contrast, capped pre-mRNAs are spliced more efficiently and produce fewer aberrant RNA species. The specificity of splice-site selection in vitro was tested by analyzing pre-mRNAs that contain beta-thalassemia splicing mutations in IVS 1. Remarkably, these mutations cause the same abnormal splicing events in vitro and in vivo. The ability to synthesize mutant pre-mRNAs and study their splicing in a faithful in vitro system provides a powerful approach to determine the mechanisms of RNA splice-site selection.

Tryptophan hydroxylase. The role of oxygen, iron, and sulfhydryl groups as determinants of stability and catalytic activity.

Tryptophan hydroxylase (EC 1.14.16.4) from rat mid-brain is inactivated upon exposure to oxygen. The degree of inactivation is dependent both on the temperature and partial pressure of oxygen to which the enzyme is exposed. Furthermore, molecular oxygen, and not an oxygen or hydroxyl radical, is responsible for the inactivation. Sulfhydryl compounds and reductants partially protect the hydroxylase from inactivation by oxygen. Enzyme inhibited by oxygen can be reconstituted by anaerobic incubation in the presence of dithiothreitol and Fe2+ at 25 degrees C and in some experiments the inclusion of inorganic sulfide, in addition to dithiothreitol and Fe2+, led to even greater recoveries of activity. Preincubation of tryptophan hydroxylase with various sulfhydryl reagents or disulfide compounds also produces inactivation which can be rapidly reversed by dithiothreitol. The substrate tryptophan protects the enzyme from inactivation by sulfhydryl reagents and disulfides but not from inactivation by oxygen. Finally, the enzyme was inhibited by a variety of iron chelators. These results suggest that the catalytic activity of tryptophan hydroxylase is dependent on the oxidation-reduction status of--SH groups and iron sites, which are probably located at the catalytic (substrate binding) site of the enzyme.

Spontaneous precipitation of brushite in urine: evidence that brushite is the nidus of renal stones originating as calcium phosphate.

Further evidence that brushite plays a regulatory role in renal stone formation was provided by the identification of brushite as the first precipitate that appears in supersaturated urine by spontaneous precipitation. Calcium chloride was added to induce supersaturation in urine specimens from twelve subjects with and twelve subjects without nephrolithiasis. The first precipitate in all specimens with pH below 6.9 was identified as brushite by x-ray diffraction and shown to have a calcium-phosphorus ratio of approximately 1.0. The activity product of [Ca(2+)] x [HPO(4) (2-)] necessary to produce a precipitate ranged from 2.2 to 3.5 times the solubility product of brushite, but the range and mean were the same for both groups of subjects. The activity product of [Ca(2+)] x [HPO(4) (2-)] in the supernatant (after spontaneous precipitation) was not significantly different from that obtained after incubation of the same urine specimen with synthetic brushite. These results provide conclusive evidence that brushite constitutes the solid phase formed by spontaneous precipitation from acidic urine supersaturated with respect to calcium and phosphorus; they suggest that the nidus for calcium-containing renal stones is brushite as well.

Calcification of collagen by urine in vitro: dependence on the degree of saturation of urine with respect to brushite.

A state of supersaturation of urine with respect to brushite is considered to be important in the formation of renal stones composed of calcium phosphate. 56 supersaturated urine specimens and 44 undersaturated specimens were incubated with collagen (Sigma collagen). Most of the supersaturated specimens calcified the collagen, whereas none of the undersaturated ones did so. Among samples which calcified the collagen, whereas none of the undersaturated ones did so. Among samples which calcified the collagen, the activity product of Ca(++) and HPO(4) (=) after incubation with collagen was essentially the same as that after incubation of the same specimen with brushite; it usually differed from that obtained after incubation with octacalcium phosphate or hydroxyapatite. The molar calcium-to-phosphorus ratio of the solid phase in collagen was approximately 1. These results suggested that the solid phase formed in collagen is brushite. This conclusion was confirmed by the direct identification of brushite in collagen by X-ray diffraction.