Mutations in human TBX3 alter limb, apocrine and genital development in ulnar-mammary syndrome.

Ulnar-mammary syndrome is a rare pleiotropic disorder affecting limb, apocrine gland, tooth and genital development. We demonstrate that mutations in human TBX3, a member of the T-box gene family, cause ulnar-mammary syndrome in two families. Each mutation (a single nucleotide deletion and a splice-site mutation) is predicted to cause haploinsufficiency of TBX3, implying that critical levels of this transcription factor are required for morphogenesis of several organs. Limb abnormalities of ulnar-mammary syndrome involve posterior elements. Mutations in TBX5, a related and linked gene, cause anterior limb abnormalities in Holt-Oram syndrome. We suggest that during the evolution of TBX3 and TBX5 from a common ancestral gene, each has acquired specific yet complementary roles in patterning the mammalian upper limb.

Holt-Oram syndrome is caused by mutations in TBX5, a member of the Brachyury (T) gene family.

Holt-Oram syndrome is a developmental disorder affecting the heart and upper limb, the gene for which was mapped to chromosome 12 two years ago. We have now identified a gene for this disorder (HOS1). The gene (TBX5) is a member of the Brachyury (T) family corresponding to the mouse Tbx5 gene. We have identified six mutations, three in HOS families and three in sporadic HOS cases. Each of the mutations introduces a premature stop codon in the TBX5 gene product. Tissue in situ hybridization studies on human embryos from days 26 to 52 of gestation reveal expression of TBX5 in heart and limb, consistent with a role in human embryonic development.

Myofibrils bear most of the resting tension in frog skeletal muscle.

The tension that develops when relaxed muscles are stretched is the resting (or passive) tension. It has recently been shown that the resting tension of intact skeletal muscle fibers is equivalent to that of mechanically skinned skeletal muscle fibers. Laser diffraction measurements of sarcomere length have now been used to show that the exponential relation between resting tension and sarcomere length for whole frog semitendinosus muscle is similar to that of single fibers. Slack sarcomere lengths and the rates of stress relaxation in these muscles were similar to those in skinned fibers, and sarcomere length remained unchanged during stress relaxation, as in skinned fibers. Thus, in intact semitendinosus muscle of the frog up to a sarcomere length of about 3.8 micrometers, resting tension arises, not in the connective tissue as is commonly thought, but in the elastic resistance of the myofibrils.

Concerted nonsyntenic allelic loss in human colorectal carcinoma.

Familial polyposis coli (FPC) is caused by an autosomal dominant gene on chromosome 5, and it has been proposed that colorectal cancer in the general population arises from loss or inactivation of the FPC gene, analogous to recessive tumor genes in retinoblastoma and Wilms' tumor. Since allelic loss can be erroneously scored in nonhomogeneous samples, tumor cell populations were first microdissected from 24 colorectal carcinomas, an additional nine cancers were engrafted in nude mice, and nuclei were flow-sorted from an additional two. Of 31 cancers informative for chromosome 5 markers, only 6 (19%) showed loss of heterozygosity of chromosome 5 alleles, compared to 19 of 34 (56%) on chromosome 17, and 17 of 33 (52%) on chromosome 18. Therefore, it appears that (i) FPC is a true dominant for adenomatosis but not a common recessive gene for colon cancer; and (ii) simple Mendelian models involving loss of alleles at a single locus may be inappropriate for understanding common human solid tumors.

Tissue, developmental, and tumor-specific expression of divergent transcripts in Wilms tumor.

The Wilms tumor locus on chromosome 11p13 has been mapped to a region defined by overlapping, tumor-specific deletions. Complementary DNA clones representing transcripts of 2.5 (WIT-1) and 3.5 kb (WIT-2) mapping to this region were isolated from a kidney complementary DNA library. Expression of WIT-1 and WIT-2 was restricted to kidney and spleen. RNase protection revealed divergent transcription of WIT-1 and WIT-2, originating from a DNA region of less than 600 bp. Both transcripts were present at high concentrations in fetal kidney and at much reduced amounts in 5-year-old and adult kidneys. Eleven of 12 Wilms tumors classified as histopathologically heterogeneous exhibited absent or reduced expression of WIT-2, whereas only 4 of 14 histopathologically homogeneous tumors showed reduced expression. These data demonstrate a molecular basis for the pathogenetic heterogeneity in Wilms tumorigenesis.

Wilms tumor locus on 11p13 defined by multiple CpG island-associated transcripts.

Wilms tumor is an embryonal kidney tumor involving complex pathology and genetics. The Wilms tumor locus on chromosome 11p13 is defined by the region of overlap of constitutional and tumor-associated deletions. Chromosome walking and yeast artificial chromosome (YAC) cloning were used to clone and map 850 kilobases of DNA. Nine CpG islands, constituting a "CpG island archipelago," were identified, including three islands that were not apparent by conventional pulsed-field mapping, and thus were at least partially methylated. Three distinct transcriptional units were found closely associated with a CpG island within the boundaries of a homozygous DNA deletion in a Wilms tumor.

A third Wilms' tumor locus on chromosome 16q.

Loss of heterozygosity studies have been used to identify chromosomal regions which are frequently deleted and thus indicate areas which may harbor tumor suppressor genes. As a result, both the WT1 gene located in chromosome 11p13 and an unidentified gene(s) within chromosome 11p15 have been implicated in Wilms' tumorigenesis. Cytogenetic and linkage studies suggest that additional non-chromosome 11 sites are involved in Wilms' tumor. Because these sites may also involve loss of heterozygosity, loci on 33 autosomal arms were screened for allele loss in a series of Wilms' tumors. We found that in addition to loss on chromosome 11p (11 of 25 informative tumors) there was significant loss on chromosome 16q (9 of 45 informative tumors), while the total frequency of allele loss excluding these loci was low (9 of 426 total informative loci). These data indicate that losses of both chromosome 11p and 16q alleles are nonrandom events and suggest that 16q is the location of a third tumor suppressor gene underlying Wilms' tumorigenesis. The parental origin of the lost chromosome 16q allele was determined in eight sporadic tumors. Alleles of paternal and of maternal origin were each lost in four sporadic tumors indicating that, unlike chromosome 11p, alleles of either parental origin are lost on 16q.

Identification of a putative collagen-binding protein from chicken skeletal muscle as glycogen phosphorylase.

We have purified and generated antisera to a 95 kDa skeletal muscle protein that constitutes the largest mass fraction of gelatin-agarose binding proteins in skeletal muscle. Preliminary results indicated that this 95 kDa chicken skeletal muscle protein bound strongly to gelatin-agarose and type IV collagen-agarose, suggesting a possible function in muscle cell adhesion to collagen. However, N-terminal sequencing of proteolytic fragments of the 95 kDa protein indicates that it is the chicken skeletal muscle form of glycogen phosphorylase, the binding of which to gelatin-agarose is unlikely to be biologically relevant. Further characterization showed that the skeletal muscle form of glycogen phosphorylase is immunologically distinct from the liver and brain forms in the chicken, and suggests that, unlike mammalian skeletal muscle, chicken skeletal muscle may have two phosphorylase isoforms. Furthermore, immunolocalization data and solubility characteristics of glycogen phosphorylase in muscle extraction experiments suggest the enzyme may interact strongly with an unidentified component of the muscle cytoskeleton. Thus, this study yields a novel purification technique for skeletal muscle glycogen phosphorylase, provides new information on the distribution and isoforms of glycogen phosphorylase, and provides a caveat for using gelatin affinity chromatography as a primary step in purifying collagen-binding proteins from skeletal muscle.

Highly sensitive and rapid gene mapping using miniaturized blot hybridization: application to prenatal diagnosis.

We have developed a protocol for the preparation and analysis of amniocyte DNA which permits more sensitive and more rapid antenatal detection of sickle-cell anemia (SCA) than previously has been possible. After rapid extraction of DNA from amniotic cells, only 50 ng of MstII-digested DNA need be analyzed by mini-gel electrophoresis and hybridization detection to determine reliably the fetal genotype. Under these conditions, the entire gene-mapping procedure can be performed within 5 days. When larger amounts of DNA (greater than 500 ng) are analyzed, the minimal diagnosis time is reduced to 2 days. The resolution of restriction fragments on mini-gels is comparable to that obtained with larger gels. The 1.15-kb betaA and 1.35-kb betaS MstII fragments are well separated. The technique is useful whenever rapid and sensitive analysis of genomic DNA is desired.

Factors affecting the incidence of postoperative wound infection.

A prospective study of postoperative wounds was carried out in West Dorset to determine the incidence of infection, describe the time distribution of presentation before and after discharge from hospital and identify possible contributory factors. There were 702 consecutive patients admitted to the study (600 in-patients and 102 day cases). Fifty one became infected (47 in-patients and 4 day cases), corresponding to an overall infection rate of 7.3%. Over 50% of infections presented during the first week after operation, and almost 90% were diagnosed within 2 weeks of surgery Twenty-eight (55%) wounds that became infected presented after hospital discharge. Of 23 specific aetiological variables studied, four (age, preoperative stay, shaving and the surgeon) were shown to have a statistically significant association with the development of wound infection. A strong association between the individual surgeon and the development of a wound infection was demonstrated and this supports the need for routine surgical audit.

Perceptual and cognitive factors governing performance in comparative arrival-time judgments.

Four experiments were conducted to investigate factors affecting relative arrival-time judgments in the transverse plane. Across experiments, results indicated an overreliance on relative distance information. The levels of relative velocity and distance used in the arrival-time task were proved discriminable, and performance in both relative velocity and distance judgments predicted performance in the relative arrival-time task. Despite the distance bias, an attempt to integrate relative velocity and distance information was also evidenced. The distance bias appears to have resulted from resource limitations on the concurrent processing of relative velocity and distance information, causing relative velocity information to become resource limited. The final experiment assessed the stability of performance in each of the tasks over time and provided evidence of individual differences in the ability to coordinate information from multiple sources.

Surgical audit: variations in wound infection rates according to definition.

A prospective study of 702 postoperative surgical patients was undertaken to determine whether clinicians showed consistency in their interpretation of signs of infection in wounds. In the 62 cases where symptoms suggestive of such infection were noted, clinical signs were recorded, as were the clinicians' subjective impressions. The application of different criteria would have resulted in a substantial variation in the apparent rates of infection, which raises questions about the need for an agreed definition of the term 'wound infection'. The lack of a specific definition has implications for surgical audit.

Wound infection: the surgeon's responsibility.

Surgical audit has two main purposes: the pursuit of efficiency through the review of clinical workload and the pursuit of quality by reviewing clinical outcomes. In-house quality control is an important aspect of surgical practice. This prospective study aimed to determine the incidence of infection, describe the time distribution of presentation and identify contributory factors. There were 1 242 consecutive patients in the survey (1 086 inpatients and 156 day cases), of whom 83 became infected (79 in-patients and four day cases) - an overall infection rate of 6.7%. Over 55% presented during the first week and 89% within the first two weeks. Of 23 specific aetiological variables studied, four - age, preoperative stay, shaving and the surgeon - were shown to have a statistically significant association with the development of wound infection. A strong association between the surgeon and the development of wound infection was demonstrated. In addition to obvious strong resource implications, it supports the need for routine audit supervision and training of junior staff and peer review for senior clinicians.

The importance of surveillance after discharge from hospital in the diagnosis of postoperative wound infection.

A prospective survey was carried out in West Dorset to determine the incidence of postoperative wound infection. A total of 1242 patients were included in the survey (1086 inpatients and 156 day cases). The overall infection rate was 6.7%. Although the incidence of infection was consistent with that reported by other studies, the infection rate in the 'clean' surgical category was higher than in most other published reports. Careful surveillance after discharge from hospital may have been responsible for identifying cases of wound infection which otherwise might not have come to the attention of the study. Of patients whose wounds became infected, 34 (41%) cases were diagnosed in hospital and 49 (59%) cases were diagnosed in the community. Failure to pursue patients after discharge would have resulted in a substantial underestimation of the true wound infection rate.

Ultrastructural comparison of slack and stretched myotendinous junctions, based on a three-dimensional model of the connecting domain.

The vertebrate myotendinous junction contains junctional microfibrils, located in the lamina lucida of the basement membrane. The junctional microfibrils are thought to transmit muscular force across the junctional lamina lucida, also called the connecting domain. If true, deformation of the terminal muscle cell processes and connecting domain during force transmission would be detected as a change in spacing and/or orientation of the junctional microfibrils. This study compared connecting domain morphology in frog semitendinosus muscles fixed in two extremes of resting tension, to elucidate the mechanical properties of the myotendinous junction. An initial study of connecting domain ultrastructure revealed that junctional microfibrils are punctate or spinelike in shape, and that they are distributed in a linear, helically-oriented array on the muscle cell surface. The rows in the surface lattice are 10-15 nm in thickness, have a centre-to-centre distance between rows of approximately 24 nm, and are oriented at approximately 41 degrees with respect of the long axis of the muscle fibre. Comparison of slack and highly stretched myotendinous junctions shows no significant changes in spacing or orientation of either individual junctional microfibrils or rows in the helical surface lattice. Thus, both the connecting domain and terminal cell processes at the myotendinous junction are essentially inextensible under the loading conditions used in this study.

Dystrophin deficiency is associated with myotendinous junction defects in prenecrotic and fully regenerated skeletal muscle.

The myotendinous junction (MTJ) is the major site of force transmission from myofibrils across the muscle cell membrane to the extracellular matrix. The MTJ is thus an appropriate model system in which to test the hypothesis that dystrophin, the gene product absent in Duchenne muscular dystrophy, functions as a structural link between the muscle cytoskeleton and the cell membrane. We studied changes in MTJ structure in dystrophin-deficient mdx mice during periods of growth and aging that spanned prenecrotic, necrotic, and regenerative phases of postnatal muscle development in mdx mice. Prenecrotic animals were found to exhibit structural defects at MTJs that were similar to those described previously in animals at the peak of necrosis, including a reduction in lateral associations between thin filaments and the MTJ membrane. These defects therefore occur before necrosis and may be directly related to the absence of dystrophin. Observations of regenerating and fully regenerated MTJs in adult animals show that the defects are still present, indicating that normal thin filament-membrane associations are never formed in dystrophin-deficient muscle. However, in prenecrotic as well as regenerated adult mdx muscle, the MTJ membrane is only slightly less folded than in age-matched controls. This indicates that mdx muscle possesses some dystrophin-independent mechanism that allows for the initial formation of MTJs, despite the absence of dystrophin. The presence of the defect in normal, lateral, thin filament-membrane associations in mdx muscle, regardless of age, supports the hypothesis that dystrophin functions as a structural link between thin filaments and the membrane.

Dystrophin is required for normal thin filament-membrane associations at myotendinous junctions.

Dystrophin, the deficient gene product in Duchenne muscular dystrophy, is located subjacent to the muscle cell membrane at myotendinous junctions, as well as along the entire muscle cell. Myotendinous junctions are sites at which thin filaments normally are linked to one another and to the cell membrane, by both lateral and end-on associations between the thin filaments and membrane. The cell membrane at these sites in normal muscle is folded extensively. Dystrophic junctions display normal contacts between the ends of thin filaments and subsarcolemmal densities. However dystrophic junctions are deficient in lateral associations between thin filaments and the membrane and display less membrane folding than controls. These structural defects would result in stress concentrations at sites of thin filament attachment to the membrane, which can cause membrane tearing during muscle activation, especially in large-diameter and mature muscle cells. This deficiency in dystrophic myotendinous junction structure may contribute to our understanding of previously unaccountable aspects of the etiology of Duchenne muscular dystrophy.

Divalent cation-dependent adhesion at the myotendinous junction: ultrastructure and mechanics of failure.

Junctional microfibrils, which span the lamina lucida of the vertebrate myotendinous junction, are thought to function in force transmission at the junction. This hypothesis has been tested by disrupting junctional microfibrils through elimination of extracellular divalent cations, and determining the effects of this treatment on the ultrastructure and mechanics of whole frog skeletal muscles passively stretched to failure. Muscles incubated in divalent cation-free solution failed exclusively in the lamina lucida of the myotendinous junction, while control muscles all failed within the muscle fibres, several millimetres away from the junction. Failure sites from divalent cation-free muscles incubated with antibodies against collagen type IV, laminin, and tenascin showed no labelling of the avulsed ends of the muscle fibres, indicating that remnants of junctional microfibrils observed on the cell surface are not composed of any of these extracellular proteins. All three proteins were present on the tendon side of the failure site, confirming that the lamina densa remains attached to the tendon. Breaking stress for control muscles was 3.47 x 10(5) N m-2, and for divalent cation-free muscles, 1.84 x 10(5) N m-2, or approximately half the control value. Breaking strain averaged 1.17 for divalent cation-free muscles and 1.39 for controls, although the difference was not significant. We conclude that junctional microfibrils are components of a divalent cation-dependent adhesion mechanism at the myotendinous junction. In addition, ultrastructural analysis of divalent cation-free fibres stretched just short of failure suggests that a second, divalent cation-independent mechanism persists along the non-junctional cell surface, and can transmit substantial passive tension from myofibrils laterally to the extracellular matrix, bypassing the failed myotendinous junction.

Developmental regulation of laccase levels in Aspergillus nidulans.

Asexual spores (conidia) of Aspergillus nidulans contain a dark green pigment which is not present in other cell types. Synthesis of this pigment is catalyzed, in part, by a developmentally controlled p-diphenol oxidase, or laccase, encoded at the gamma A genetic locus (A. J. Clutterbuck, J. Gen. Microbiol. 70:423-435, 1972). We have investigated the mechanisms regulating expression of the gamma A gene of A. nidulans. Vegetative hyphae grown in submerged culture lacked detectable laccase enzyme activity and neither contained nor synthesized immunoprecipitable laccase protein. When such cultures were induced to conidiate by harvesting the cells onto filter papers and aerating them, laccase levels began to increase after 10 to 16 h, reached a peak at 20 to 36 h, and then declined slowly. Immunological assays showed that increases in laccase enzyme activity were (i) proceded by a transient rise in the relative rate of laccase protein synthesis and (ii) closely paralleled by increases in the amount of laccase protein. Addition of cycloheximide to cultures at any time after inducing conidiation inhibited further accumulation of laccase enzyme activity. These data are most consistent with increases in laccase levels being due to regulated, de novo synthesis of laccase protein. Addition of inhibitors of ribonucleic acid synthesis to conidiating cultures also inhibited further accumulation of laccase, suggesting that laccase expression is regulated by alterations in the transcriptional activity of the gamma A locus.