RasGRP1 overexpression in T-ALL increases basal nucleotide exchange on Ras rendering the Ras/PI3K/Akt pathway responsive to protumorigenic cytokines.

Ras GTPases are activated by RasGEFs and inactivated by RasGAPs, which stimulate the hydrolysis of RasGTP to inactive RasGDP. GTPase-impairing somatic mutations in RAS genes, such as KRAS(G12D), are among the most common oncogenic events in metastatic cancer. A different type of cancer Ras signal, driven by overexpression of the RasGEF RasGRP1 (Ras guanine nucleotide-releasing protein 1), was recently implicated in pediatric T-cell acute lymphoblastic leukemia (T-ALL) patients and murine models, in which RasGRP1 T-ALLs expand in response to treatment with interleukins (ILs) 2, 7 and 9. Here, we demonstrate that IL-2/7/9 stimulation activates Erk and Akt pathways downstream of Ras in RasGRP1 T-ALL but not in normal thymocytes. In normal lymphocytes, RasGRP1 is recruited to the membrane by diacylglycerol (DAG) in a phospholipase C-γ (PLCγ)-dependent manner. Surprisingly, we find that leukemic RasGRP1-triggered Ras-Akt signals do not depend on acute activation of PLCγ to generate DAG but rely on baseline DAG levels instead. In agreement, using three distinct assays that measure different aspects of the RasGTP/GDP cycle, we established that overexpression of RasGRP1 in T-ALLs results in a constitutively high GTP-loading rate of Ras, which is constantly counterbalanced by hydrolysis of RasGTP. KRAS(G12D) T-ALLs do not show constitutive GTP loading of Ras. Thus, we reveal an entirely novel type of leukemogenic Ras signals that is based on a RasGRP1-driven increased in flux through the RasGTP/GDP cycle, which is mechanistically very different from KRAS(G12D) signals. Our studies highlight the dynamic balance between RasGEF and RasGAP in these T-ALLs and put forth a new model in which IL-2/7/9 decrease RasGAP activity.

Managing latex allergy in patients and health care workers.

The new and important problem of latex allergy deserves the attention of all health care professionals and institutions. Latex products we use every day may cause serious consequences for patients and coworkers. All providers must develop a plan for protecting allergic patients and staff from latex exposure, and for managing allergic reactions should they occur.

Current trends in removable prosthodontics.

BACKGROUND: This article discusses trends in the demographics and treatment of the edentulous patient. It is clear that there still is a tremendous need for removable-prosthodontic services today. While the basic process of making dentures has changed little over the past several decades, new materials and techniques can help laboratories and clinicians provide functional, esthetic restorations that offer exceptional value to patients. Implant treatment is a tremendous adjunct to removable prosthodontics in the treatment of edentulous patients, but it is not within the financial reach of all dental patients. CLINICAL IMPLICATIONS: The clinical skills required to deliver excellent complete denture care are also paramount to successful implant prosthodontics (fixed and removable) and esthetic dentistry. Even so, the opportunities to develop these skills and the interest appear to be decreasing at the same time that the need is projected to increase. In service to our patients, the profession must examine this trend closely.

Latex hypersensitivity: its prevalence among dental professionals.

Reports of hypersensitivity to latex are growing among oral health care workers, who have a high degree of exposure to latex products. The authors undertook a study to determine the prevalence of latex hypersensitivity among oral health care workers in a hospital dental practice. Among the 34 people who participated in the study, 12 percent had positive results in a skin prick test for latex. This suggests that the true prevalence rate of immediate hypersensitivity to latex in this group of oral health care workers is similar to that in other health care workers who use latex gloves frequently.

Continuous fiberoptic PCO2 monitoring indicates poorer gastric perfusion during supraceliac aortic clamping than conventional gastric tonometry in humans: a pilot study.

OBJECTIVE: To compare two monitors of gastric perfusion intraoperatively--continuous fiberoptic carbon dioxide partial pressure (PCO2) sensor and conventional gastric tonometer. DESIGN: Prospective, unblinded study. SETTING: University teaching hospital. PARTICIPANTS: Adult patients undergoing major abdominal surgery. INTERVENTIONS: A fiberoptic probe (Biomedical Sensors, Pfizer, High Wycombe, England) capable of continuous PCO2 measurement and adapted to fit into the saline-filled balloon of a tonometric orogastric tube (Tonometrics, Instrumentarium Corp, Helsinki, Finland) was placed in the patients. The fiberoptic probe was attached to a Paratrend 7 machine (Biomedical Sensors, Pfizer) providing continuous intragastric PCO2 data. A second tonometric orogastric tube was passed and used according to the manufacturer's instructions, yielding intermittent PCO2 values. MEASUREMENTS AND MAIN RESULTS: Twelve patients provided 79 data pairs: 33 without aortic clamp, 23 infraceliac aortic clamp, and 23 supraceliac aortic clamp. Data are presented as mean +/- SD, and analysis of variance was used for comparison (p < 0.01); bias and precision were also calculated. Intramusosal PCO2 and PCO2 gradient were significantly higher, and intramucosal pH was significantly lower from continuous fiberoptic measurement in the supraceliac clamp group. In the no-clamp and infraceliac clamp groups, the differences between the 2 methods of measurement were not significant. CONCLUSION: Conventional gastric tonometry overestimated perfusion during conditions of compromised gastric blood flow (supraceliac aortic clamp).

The concept of coding in learning-memory theory.

The concept of coding, which refers to what is stored in memory during learning, is defended, as an important and necessary conceptual advance in learning-memory theory during the last decade. It is maintained that the concept covers a wide variety of functionally different coding operations, with many specifics of its operation still to be experimentally determined, and that attempts to restrict its meaning to arbitrary transformational coding, as suggested by Restle, should be rejected. The paper comments on the empirical contributions to coding theory by Johnson, Wickens, Martin, and Postman and Bums in the symposium for which it served a discussant function.

Environmental regulation of expression of virulence determinants in Bordetella pertussis.

The trans-activator vir is required for expression of all virulence-associated genes in Bordetella pertussis. The nature of the global regulation of these factors by vir and environmental signals was examined by Northern blot analysis and with beta-galactosidase transcriptional fusions in five vir-regulated genes. Northern blots suggested that vir regulates at the level of transcription since Vir- organisms did not exhibit detectable mRNA from vir-regulated loci. Environmental signals such as high levels of salts, nicotinic acid, and 6-chloronicotinic acid or growth at low temperatures were examined. Of all of the cations and anions examined, only SO4 ions eliminated transcription of vir-regulated genes and reduced transcription of vir itself, suggesting that global regulation is obtained by modifying expression of the essential component, vir. Organisms grown on 6-chloronicotinic acid or quinaldic acid did not have detectable transcription from vir-regulated loci. Modulation by nicotinic acid, on the other hand, was strain dependent, acting at the level of transcription in strain 18-323 but not in Tohama I derivatives. Growth at lower temperatures reduced, but did not eliminate, transcription from vir-regulated loci. At 28 degrees C the ratio of pertussis toxin mRNA to recA mRNA (a non-vir-regulated factor) was equivalent to that at 37 degrees C, suggesting that transcription at low temperatures is reduced in a proportional manner and need not involve vir.

Electron capture gas-liquid chromatographic study of metabolites produced by some arthritic transudate-associated organisms in vitro and in vivo in rabbit models.

Computerized, frequency-pulsed, modulated electron capture gas-liquid chromatography was used to study the acid metabolites produced in vitro in fetal calf serum and in vivo in an animal chamber model. Several strains of Diplostreptococcus agalactiae, Propionibacterium acnes, Staphylococcus aureus, and Streptococcus serogroups A, B, and G were studied. All of these organisms have been reported to be associated with arthritic transudates in humans. Metabolites were detected by this method from derivatized extracts of both spent fetal calf serum and chamber fluids. Since there was little host response to the organisms cultured in the chambers, it is highly probable that the products detected represent metabolites produced in an in vivo type of environment. The metabolic patterns were reproducible and exhibited many similarities in vitro and in vivo. Production of the acids detected was reproducible, and these acids were useful identification markers. The data support published reports (J. B. Brooks, C. C. Alley, and J. A. Liddle, Anal. Chem. 46: 1930-1934, 1974; J. B. Brooks, G. Choudhary, R. B. Craven, D. Edman, C. C. Alley, and J. A. Liddle, J. Clin. Microbiol. 5:625-628, 1977; J. B. Brooks, R. B. Craven, A. R. Melton, and C. C. Alley, in H. H. Johnson and W. B. Newson, ed., Second International Symposium on Rapid Methods and Automation on Microbiology, 1976; J. B. Brooks, R. B. Craven, D. Schlossberg, C. C. Alley, and F. M. Pitts, J. Clin. Microbiol. 8:203-208, 1978; J. B. Brooks, D. S. Kellogg, C. C. Alley, H. B. Short, and H. H. Handsfield, J. Infect. Dis. 129:660-668, 1974) that bacterial metabolites might be detectable in diseased body fluids. The growth characteristics of the organisms in the animal model and fetal calf serum are discussed, and a moderately priced computer for performing data manipulations is evaluated.

Characterization of environmental regulators of Bordetella pertussis.

Bordetella pertussis suppresses transcription of its virulence genes in response to specific environmental conditions, a response called modulation. The organism responds to high concentrations of SO4 and CIO4 ions, nicotinic acid, and nicotinic acid analogs in vitro; however, the in vivo modulator has not been identified. We investigated which chemical structures of the nicotinic acid molecule are important for modulation by testing various analogs for their ability to modulate. The ring nitrogen of nicotinic acid was not required, since benzoic acid was a modulator. In contrast, the carboxyl group was required, since derivatives like ethylnicotinate, 3-pyridylcarbinol, 3-acetyl pyridine, and 6-chloronicotinamide with altered carboxyl groups were not modulators. The planar ring structure or resonance in the ring was required for modulation, since nipecotic acid failed to modulate. The most potent modulators were nicotinic acid derivatives with electron-withdrawing substituents in the meta or para position relative to the carboxyl group. Relative hydrophilicity of substituents did not appear to contribute to modulation. Although these modulators elicited a clear biological response, the mechanism of modulation remains unclear, because no binding of the modulator 35SO4 or [14C]4-chlorobenzoic acid to whole B. pertussis was detected. However, modulation appears to involve a charge-charge interaction, since the response was blocked by chlorine ions.

Prolonged duration of succinylcholine in patients receiving anticonvulsants: evidence for mild up-regulation of acetylcholine receptors?

Succinylcholine (SCh) normally causes a small increase in serum potassium concentration, but certain conditions may predispose to severe hyperkalaemia. This is due to "up-regulation" of skeletal muscle acetylcholine receptors (AChR), which also results in resistance to non-depolarizing muscle relaxants (NDMR). Anticonvulsant therapy causes NDMR resistance because of sub-clinical blockade, and diminished release, of acetylcholine. We studied nine patients chronically receiving anticonvulsants (phenytoin and/or carbamazepine) and nine control patients. Anaesthesia was induced typically with thiopentone or propofol; isoflurane and N2O were used for maintenance. The ulnar nerve was supramaximally stimulated and mechanical twitch height was measured with a force transducer at the adductor pollicis, before and after SCh 1 mg.kg-1, until return to baseline height. Plasma potassium concentration was measured before and at three, five, and ten minutes following SCh. Mean maximum potassium rise was 0.2 mEq.L-1 in each group. The time for return to baseline twitch height was 14.3 +/- 2.3 min (mean +/- SD) in the anticonvulsant group and 10.0 +/- 1.6 min in the control group, P = 0.001. The recovery index (time for 25% to 75% recovery) was 2.6 +/- 0.9 min in the anticonvulsant group and 1.4 +/- 0.3 min in the control group, P < 0.01. The normal potassium response coupled with prolonged duration suggests a hypersensitivity to SCh that is consistent with an anticonvulsant-induced mild up-regulation of AChR.

RhoA/rho-associated kinase mediates fibroblast contractile force generation.

The intracellular signals governing contractile force generation by non-muscle cells remain uncertain. Our aim was to test the hypothesis that the rhoA/rho-associated kinase signaling pathway is a principal mediator of contractile force generation in non-muscle cells. We measured myosin II regulatory light chain (MLC) phosphorylation and directly quantitated force generation by chicken embryo fibroblasts in the absence and presence of selective inhibitors of rhoA, and its downstream effector, rho-associated kinase. Inactivation of rhoA, with C3 transferase, inhibited serum-stimulated MLC phosphorylation and contractile force generation. Y-27632, an inhibitor of rho-associated kinase, reduced basal contractile tension, and inhibited both serum and endothelin-1 stimulated MLC phosphorylation and contractile force generation. The results of this study provide novel evidence indicating that the rhoA/rho-associated kinase signaling pathway is a principal mediator of MLC phosphorylation and consequent contractile force generation by non-muscle cells.

Caffeine- or halothane-induced contractures of masseter muscle are similar to those of vastus muscle in normal humans.

BACKGROUND: Skinned fibers from normal human masseter muscle have greater caffeine and calcium sensitivity than skinned fibers from vastus muscle. We examined sensitivity to caffeine and halothane in fresh, cut muscle bundles (non-skinned) from human masseter muscle. METHODS: Masseter bundles (caffeine, n=25, halothane, n=19) excised from 10 humans under general anesthesia had tension measured in 37 degrees C baths during the addition of caffeine (0.5, 1, 2, 4, 8, 32 mM) or 3% halothane. Results were compared to those of our previous studies (1989, 1997, 25 patients) of vastus bundles (caffeine, n=71, halothane, n=63) using the same protocol, technicians, and equipment. RESULTS: Baseline force in the caffeine test was 2.10+/-1.57 for masseter, and 2.02+/-1.68 and 1.82+/-1.29 respectively for vastus muscle. Force at 32 mM caffeine concentration was 11.2+/-9.9 g for masseter, 11.0+/-5.4 and 13.5+/-7.5 g for vastus. Concentration-response curves were virtually identical. In the halothane group, neither baseline values (masseter 1.47+/-1.30, vastus 1.91+/-1.32 and 2.15+/-1.71) nor contractures in response to 3% halothane were different. Most bundles had no contracture in response to 3% halothane; 3 masseter bundles and 2 vastus bundles (1989) developed contractures of less than 0.05 g. Three vastus bundles (1997) developed contractures >0.2 g. CONCLUSION: Contracture responses of intact cut masseter and vastus bundles (non-skinned) do not differ with respect to caffeine and halothane. Responses of skinned fibers might demonstrate greater sensitivity under certain conditions, but they do not reflect those of intact cut bundles.