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A prototype of the Online London Dysmorphology Database is now available for testing purposes. In this paper we describe the new online version of the London Dysmorphology Database (LDDB), which is accessible via the World-Wide Web. The system has been developed primarily to address the information lag associated with the stand-alone version of LDDB (currently 3-15 months) and therefore provides access to the latest data from the master database that resides on a web server. An additional benefit is that, because the Online LDDB is a web-based resource, it will be available to users of both Macintosh and Unix computers as well as PC users.

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Ikaros proteins are required for normal T, B, and NK cell development and are postulated to activate lymphocyte-specific gene expression. Here we examined Ikaros distribution in the nucleus of B lymphocytes using confocal microscopy and a novel immunofluorescence in situ hybridization (immuno-FISH) approach. Unexpectedly, Ikaros localized to discrete heterochromatin-containing foci in interphase nuclei, which comprise clusters of centromeric DNA as defined by gamma-satellite sequences and the abundance of heterochromatin protein-1 (HP-1). Using locus-specific probes for CD2, CD4, CD8alpha, CD19, CD45, and lambda5 genes, we show that transcriptionally inactive but not transcriptionally active genes associate with Ikaros-heterochromatin foci. These findings support a model of organization of the nucleus in which repressed genes are selectively recruited into centromeric domains.

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Endovascular stent placement to prevent restenosis after angioplasty is being increasingly employed. A 63-year-old hemodialysis patient with a right forearm gortex graft developed ipsilateral arm edema, and a right subclavian vein stenosis was diagnosed. This vascular stenosis was presumably secondary to previous placement of temporary access catheters. The subclavian vein stenosis was treated with angioplasty, endovascular stenting, and warfarin, which resulted in resolution of the arm edema. Three weeks after stenting, the patient developed fever to 104 degrees F, chills, and right arm and shoulder edema. All blood cultures grew Staphylococcus aureus, and an Indium-labeled white blood cell scan was positive at the sight of the subclavian stent. Infectious disease consultants recommended urgent removal of the infected stent, but the extensive surgery required posed considerable risk of major morbidity. We elected to conservatively treat the patient. With loss of all upper-extremity access sites, the patient was converted to peritoneal dialysis. Despite the patient's ambulatory status, a femoral venous Hickman catheter was placed and tunneled through the abdominal subcutaneous soft tissue. The patient received 9 weeks of antibiotics by the Hickman catheter with an infusion pump, and warfarin was continued. There has been complete clinical resolution of infection and subclavian thrombosis. Endovascular stents are being used more commonly, and this is the first description, to our knowledge, of a stent infection. The stent infection was successfully managed without surgical removal.

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Stathmin is a cytosolic phosphoprotein that has an important but, as yet, undefined role in cell proliferation and differentiation. Induction of growth arrest and differentiation of HL60 cells to monocytes by phorbol 12-myristate 13-acetate is associated with rapid phosphorylation of the protein. Stathmin phosphorylation was not seen when HL60 cells were induced to differentiate to monocytes, by 1 alpha, 25-dihydroxyvitamin D3, and to neutrophils, by all-trans retinoic acid and granulocyte colony stimulating factor. In all the above instances, stathmin expression was down-regulated. Thus, increased stathmin phosphorylation is not required for cell growth arrest or differentiation or down-regulation of stathmin expression.

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BACKGROUND: Stathmin is a phylogenetically conserved protein which was identified initially as a prominent cytosolic protein in hemopoietic cells, endocrine cells, brain, and testis. In these tissues, it has been suggested that the level of stathmin expression is important in development and cell proliferation. Furthermore, stathmin phosphorylation appears to be involved in the regulation of cell growth arrest, terminal differentiation, and hormone secretion. Elevated levels of expression of stathmin have been described in leukemia and lymphoma cells. The aim of this study was to characterize the distribution of cells that express the stathmin protein in a wide variety of normal human and rodent tissues. EXPERIMENTAL DESIGN: First, antisera against a synthetic stathmin peptide have been raised in rabbits and the specificity of these antisera confirmed by their reactivity with stathmin on 1-dimensional and 2-dimensional Western blots. Second, the most appropriate means of fixing tissues in order to stain stathmin has been investigated. Finally, using the optimized conditions of tissue fixation, the antisera have been used to immunostain sections taken from a wide variety of tissues. RESULTS: Immunopositivity was found in cells of all the lineages studied, with the stained cells present within the proliferating compartment of tissues. Conversely, most nonproliferating mature cells did not stain with the antisera to stathmin. The only nonproliferating cells that appeared to express stathmin were a subpopulation of glial cells, neurons, and anterior pituitary cells. CONCLUSIONS: It is proposed that stathmin is necessary for cell proliferation in most, or all, cell lineages and that its primary function relates to some aspect of cell division.

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A case of intracranial tuberculosis due to Mycobacterium bovis is presented. Computed tomography (CT) identified multiple enhancing lesions which by biopsy proved to be intracranial tuberculomas. The CT appearance, epidemiology and bacteriology as well as pharmacotherapy of this uncommon entity are discussed.

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This research evaluated a stress management, coping skills model of adjustment in the analysis of depression in a sample of Laotian refugees living in the southeastern United States. Stressful events and experiences during emigration and a lack of English proficiency were associated with depressive symptoms, while demographic variables and social support were not. English proficiency also significantly reduced the impact of acculturative stressors on depression, suggesting that language skill may act as a stress buffer in the new cultural environment.

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Isospora belli is an uncommon cause of diarrhea in man. Like the closely related Cryptosporidium, the organism causes disease that may be more severe and chronic in patients with underlying immune deficiency states. We describe three male homosexuals with Isospora enteritis. Each had several months of diarrhea. All three patients had lymphopenia and two had profound T cell helper-suppressor ratio reversal. In addition, two of the patients admitted to oral-anal contact, a practice associated with the acquisition of parasites and other enteric pathogens in the homosexual population. We suggest that Isospora belli may be a sexually transmitted pathogen which should be considered in the diagnosis of homosexual patients with diarrhea.

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