A de novo unequal cross-over mutation between CYP11B1 and CYP11B2 genes causes familial hyperaldosteronism type I.

UNLABELLED: Familial hyperaldosteronism type I (FH-I) is an autosomal dominant disorder caused by an unequal cross-over of the gene encoding steroid 11ß-hydroxylase (CYP11B1) and aldosterone synthase (CYP11B2), giving rise to a chimeric CYP11B1/CYP11B2 gene that displays aldosterone synthase activity regulated by ACTH instead of angiotensin II. AIM: To report an unprecedented case of a de novo unequal crossover mutation between CYP11B1 and CYP11B2 genes causing FH-I. PATIENTS AND METHODS: The index case is a 45-yr-old Chilean male diagnosed with primary aldosteronism (PA). All family members were also studied: his biological parents, 1 brother, 6 sisters, 2 daughters, and 1 son. Plasma renin activity, serum aldosterone, and its ratio were measured in all patients. Genetic analyses were performed using long-extension PCR (XL-PCR), DNA sequencing and Southern blot methods. RESULTS: PA was diagnosed for the index case, 1 of his daughters, his son but not for his parents or siblings. XLPCR and Southern blotting demonstrated the presence of the chimeric CYP11B1/CYP11B2 gene solely in PA-affected subjects, suggesting a case of a de novo mutation. Sequence analysis showed the unequal cross-over CYP11B1/CYP11B2 at intron 2 (c.2600-273 CYP11B2). We also identified a polymorphism at the same intron (c.2600-145C>A CYP11B2) in the genome of the index case's father. CONCLUSION: We describe an unprecedented case of unequal cross-over mutation for the chimeric CYP11B1/CYP11B2 gene causing FH-I, which may be linked to a polymorphism in the index case's father germ line.

Primary aldosteronism can alter peripheral levels of transforming growth factor beta and tumor necrosis factor alpha.

UNLABELLED: Primary aldosteronism (PA) is the most common secondary cause of hypertension that has recently been implicated in alterations of the immune system and progression of cardiovascular disease. OBJECTIVE: To study the cytokines transforming growth factor beta1 (TGF-beta1), tumor necrosis factor alpha (TNF-alpha), and interleukin 10 (IL-10) in patients with PA and essential hypertensives (EH) and evaluate its association with the renin-angiotensin-aldosterone system. PATIENTS AND METHODS: We studied 26 PA and 52 EH patients as controls, adjusted by their blood pressure, body mass index, age, and gender. In both groups, PA and EH, we measured serum aldosterone (SA), plasma renin activity (PRA), and cytokines TGF- beta1, TNF-alpha, and IL-10. In addition, 17 PA patients were treated for 6 months with spironolactone, a mineralocorticoid receptor (MR) antagonist. RESULTS: PA patients had lower levels of TGF-beta1 (17.6+/-4.1 vs 34.5+/-20.5 pg/ml, p<0.001) and TNF-alpha (17.0+/-4.4 vs 35.6+/-21.7 pg/ml, p<0.001) and similar IL-10 levels (99.7+/-18.7 vs 89.4+/-49.5 pg/ml, p: ns), as compared with EH controls. TGF-beta1 and TNF-alpha levels showed a remarkable correlation with SA/PRA ratio in the total group (PA+EH). The treatment of PA patients with spironolactone increased the TGF-beta1 levels (18.3+/-5.9 to 28.4+/-6.3 pg/ml, p<0.001), while TNF-alpha, and IL-10 remained unchanged. CONCLUSION: Our results showed that PA patients have lower TGF-beta1 and TNF-alpha cytokine serum levels than EH. TGF-beta1 levels were restored with spironolactone, showing a MR-dependent regulation. In this way, the chronic aldosterone excess modifies the TGF-beta1 levels, which could produce an imbalance in the immune system homeostasis that may promote an early proinflammatory cardiovascular phenotype.

Status of the PCDD and PCDF contamination of commercial milk caused by milk cartons.

Within the scope of this study, possible migration of polychlorinated dibenzodioxins and -furans (PCDDs/PCDFs) from cartons (produced using bleached cardboard) into cow's milk was investigated. Three different types of carton were examined. The milk samples were taken at different times of storage and analysed for PCDDs/PCDFs. In contrast to a similar study carried out in 1990, the I-TEQ-results of all cartons analysed may be considered very low. No significant migration of toxic (2,3,7,8-chlorine-substituted) PCDDs/PCDFs could be observed. This is due to the very low PCDD/PCDF concentrations in modern cardboards as a result of the elemental chlorine-free (ECF) bleaching processes used. As far as the milk samples are concerned, no influence of the cardboards (according to the I-TEQ data) could be ascertained. I-TEQ concentrations in milk did not noticeably change during storage times of three, six and eight days. The I-TEQ-data obtained for all milk samples was found to be in the range typical of background concentrations in cow's milk in Germany. Although 1,2,7,8-TCDF is not included in the calculation of the TEQ (no 2,3,7,8-chlorine-substitution), analysis of this congener in cardboard samples was also carried out as a matter of general interest for cardboard investigations and an indicator of pulp bleaching with free chlorine.

Hydropic vacuolation in the liver of three species of fish from the U.S. West Coast: lesion description and risk assessment associated with contaminant exposure.

Hydropic vacuolation (HydVac) of biliary epithelial cells and hepatocytes is described for 3 species of U.S. West Coast bottom fishes. Risk assessment analyses are also conducted to determine if the prevalence of this lesion increases in association with contaminant exposure and site of capture. The morphology of HydVac in starry flounder Platichthys stellatus, white croaker Genyonemus lineatus and rock sole Lepidopsetta bilineata was similar to that described in winter flounder Pleuronectes americanus from the U.S. Atlantic Coast, especially in that HydVac most commonly affected biliary epithelial cells. Hydropic vacuolation was the most prevalent liver lesion in starry flounder and white croaker captured from contaminated environments. Risk assessment analyses confirmed that the relative risk for HydVac increased with the presence of aromatic and chlorinated hydrocarbons in sediment, fish bile, and fish liver for these species. Hydropic vacuolation also frequently occurred in rock sole, but the lesion showed no clear association with contaminant exposure in this species. The types of liver lesions that were useful biomarkers of contaminant effects in fish depended on the species and this factor must be taken into account when evaluating histopathological biomarkers of response to contaminant exposure.

Relationships between toxicopathic hepatic lesions and exposure to chemical contaminants in English sole (Pleuronectes vetulus), starry flounder (Platichthys stellatus), and white croaker (Genyonemus lineatus) from selected marine sites on the Pacific Coast, USA.

Relationships between hepatic lesions and chemical contaminant concentrations in sediments, stomach contents, liver tissue, and bile were statistically evaluated in three species of bottomfish, English sole (Pleuronectes vetulus), starry flounder (Platichthys stellatus), and white croaker (Genyonemus lineatus), captured from 27 urban and nonurban sites on the Pacific Coast from Alaska to southern California. Lesions detected were neoplasms, preneoplastic foci of cellular alteration, nonneoplastic proliferative lesions, unique or specific degenerative/necrotic lesions, nonspecific degenerative/necrotic lesions, and hydropic vacuolation of biliary epithelial cells and hepatocytes. In general, lesion prevalences were significantly higher in all three species captured at chemically contaminated urban sites, and certain lesions had significantly higher relative risks of occurrence at urban sites in Puget Sound, San Francisco Bay, the vicinity of Los Angeles, and San Diego Bay. Concentrations of polycyclic aromatic hydrocarbons, polychlorinated biphenyls, DDT and its derivatives, and chlordanes and dieldrin in sediment, stomach contents, liver, and fluorescent aromatic compounds in bile were significant risk factors for the occurrence of neoplastic, preneoplastic, nonneoplastic proliferative, and specific degenerative/necrotic lesions, as well as hydropic vacuolation. Fish age also had a significant influence on occurrence of several hepatic lesions, but gender was rarely a significant risk factor. These relationships provide strong evidence for the involvement of environmental contaminants in the etiology of hepatic lesions in several marine bottomfish species and clearly indicate the utility of these lesions as biomarkers of contaminant-induced effects in wild fish.

The ultrastructure and histology of cholangiocellular carcinomas in English sole (Parophrys vetulus) from Puget Sound, Washington.

The ultrastructure and histology of cholangiocellular carcinomas from feral English sole (Parophyrs vetulus) living in polluted waterways of Puget Sound, WA. are described. Electron microscopy confirmed that biliary epithelial cells were the main proliferative cell type composing this variety of neoplasm. The arrangement of these cells varied from well-organized multiple bile duct-like structures to disorganized multilayered sheets of poorly differentiated biliary epithelial cells. A fibrous stroma consisting of multiple layers of collagen fibers and fibroblasts, with macrophages and various blood cell types scattered among these layers occurred between bile duct-like structures or aggregates of biliary epithelial cells. Hepatocytes were not apparent in these neoplasms except within small necrotic regions surrounded by neoplastic biliary epithelial cells. No virus-like particles were observed among the cases examined in this study.

[Antibiotic pharmacokinetics in patients with mucoviscidosis]. / Antibiotika-Pharmakokinetik bei Patienten mit Mukoviszidose.

In this review we summarize the available literature on the pharmacokinetics of antibacterials in cystic fibrosis. A special impact is given on the results of our group which will be put in perspective with the results of other authors. The homogeneity of our patient population allows a valid comparison between patient and volunteer data. We do not confirm the previously suggested strongly enhanced elimination of antibacterials in CF. Our findings have recently been confirmed by other investigators. However, since in the clinical situation a more heterogeneous group of patients is treated it seems rational to increase the dose of the antibacterials by about 20-30%.

The ultrastructure and histology of hepatocellular carcinomas of English sole (Parophrys vetulus) from Puget Sound, Washington.

The cellular and subcellular morphology of hepatocellular carcinomas (HCs) from feral English sole (Parophrys vetulus) living in contaminated waterways of Puget Sound was compared with normal-appearing liver from English sole inhabiting reference sites in Puget Sound. The most distinctive feature of English sole HCs was the occurrence of large dilations of RER containing densely packed microfilamentous-like material that was often arranged in complex branching arrays that nearly filled the cytoplasm of affected hepatocytes. These arrays have not previously been reported in HCs of any other fishes. Several other characteristics also distinguished HCs from reference liver, including: the apparent proliferation of Golgi complexes and mitochondria; occurrence of torus-shaped mitochondria; elongation and/or proliferation of perisinusoidal cells; and inclusion of large intraheptocellular vacuoles.

High dose treatment with antibiotics in cystic fibrosis--a reappraisal with special reference to the pharmacokinetics of beta-lactams and new fluoroquinolones in adult CF-patients.

In this review we analyzed the pharmacokinetic basis for high dose treatment with antibiotics of patients with cystic fibrosis. Both our results and those from other well designed pharmacokinetic studies do not support the view that low blood levels of antibacterials are a common feature of CF. We were unable to detect a decrease in absorption, nor could we find evidence for enhanced elimination of antibacterials in CF. Both these factors have been considered responsible for reducing the plasma (and tissue) levels of antibiotics. Most recent studies on kidney function are in agreement with these findings, since neither inulin nor creatinine clearance differ between CF-patients and healthy volunteers. In contrast to previous discussion, the volume of distribution (Vdss) was not elevated for any compound. The rational of weight correction of volume terms like Vdss or total clearance has never been clearly demonstrated and should therefore not be used without prior proof of relevance. Since the variability of pharmacokinetic parameters of antibiotics in CF-patients may be considerable, we suggest that a dose increase of 20-30% may be justified, but cannot agree with two to fourfold increases in dosage as previously proposed and applied in many CF-centers. Until more findings become available for non-adult CF-patients, these conclusions are only valid for adult CF-patients.

Formation of Artemisinin in Artemisia annua During One Vegetation Period*,1.

In order to investigate the possibility of isolating greater amounts of the antimalarial compound artemisinin (quinghaosu), plants of ARTEMISIA ANNUA were cultivated and analysed at different stages of development. We found the highest content just before flowering. It was also possible to correlate development of the plants with the maximum content of artemisinin. ARTEMISIA ANNUA plants cultivated from various other sources were also examine for artemisinin content. According to our results, none of these plants contained sufficient amounts of artemisinin to justify an isolation on a technical scale. Furthermore other Artemisia species were tested. We found artemisinin in only one other species. To possibly increase the amount of artemisinin during the growth period of the plant, we tested two hormone-type growth regulators on A. ANNUA strain 811. The results showed that one of them, chlormequat, was able to increase the artemisinin content by 30% over untreated plants. We also found some slight effects of the growth regulators on morphological criteria of glandular trichomes.

Changes in the surface epithelium of the developing olfactory organ in the sand sole (Psettichthys melanastictus) and the rex sole (Glyptocephalus zachirus).

The olfactory organ of the sand sole (Psettichthys melanastictus) and the rex sole (Glyptocephalus zachirus) begins its development as a primary olfactory groove containing a sensory epithelium with two or more cell types. The groove becomes dumbbell shaped as its lateral margins grow towards each other and eventually fuse, resulting in the formation of an olfactory chamber with openings for the anterior and posterior nares. Dimensions of the primary olfactory groove are different between these two species. Fusion of the olfactory bridge occurs about the time of metamorphosis in the sand sole, but before metamorphosis in the rex sole. The sensory epithelium of the sand sole larva contains microvillar cells, ciliated type I cells, and ciliated type II cells at hatching, while the rex sole larva has only microvillar and ciliated type II cells. Ciliated type I cells were observed in rex sole only after the olfactory bridge had fused. The olfactory epithelium in both species is directly exposed to the fish's environment for some length of time before it becomes enclosed within an olfactory chamber.

The comparative ultrastructure of the egg membrane and associated pore structures in the starry flounder, Platichthys stellatus (Pallas), and pink salmon, Oncorhynchus gorbuscha (Walbaum).

Eggs of the starry flounder (Platichthys stellatus) and pink salmon (Oncorhynchus gorbuscha) were examined by scanning and transmission electron microscopy to determine differences in egg membrane structure with reference to contrasting ecological conditions in which the eggs normally develop. The egg membrane of the starry flounder constitutes 0.22--0.50% of the egg's diameter. The zona radiata is composed of 6 continuous horizontal lamellae, covered by a thin triple layered border, and pierced by numerous regularly spaced pore canals. The micropyle canal measures 8 microns at the opening and tapers to 3.6 microns as it penetrates the membrane. In contrast, the thicker membrane of the pink salmon egg forms 0.80--1.0% of the egg's diameter, is composed of numerous short discontinuous lamellae which are pierced by pore canals, and is covered by a coating of irregular thickness. The 15--16 micron micropyle opening is surrounded by an area of protrusions, and the funnel-shaped canal tapers to 2 microns at its terminal aperture. Contrasting environmental conditions during embryogenesis of these two species may be reflected by the thin membrane and simple lamellar structure in the pelagic egg of the starry flounder, and the thick membrane and complex lamellar structure in the demersal egg of the pink salmon.

[Changes in aminophenazone metabolism with acute hepatitis in children (author's transl)]. / Veränderungen des Aminophenazon-Metabolismus bei akuter Hepatitis im Kindesalter.

Serum half-life of aminophenazone was measured in 23 children with acute viral hepatitis and children with normal liver biopsy of matched ages. In acute hepatitis the value was 6.71 +/- 3.34, significantly longer than in the normal controls (2.79 +/- 0.53). Two hours after oral intake of the drug the serum concentration was higher in healthy children than in those with hepatitis, but the difference was not significant. Especially in children with intercurrent acute hepatic disease account must be taken of impaired metabolism during long-term drug treatment.