Staphylococcal Protein A and Human IgG Subclasses and Allotypes

Staphylocoecal protein A binds molecules belonging to the IgGl, IgG2, and IgG4 sub-classes. IgG3 proteins generally do not bind, except for those coded by the two γ3 alleles, which are G3m(u⁻): G3m(b⁰,b³,b⁵,s,v) and G3m(b⁰,b³,b⁵,s,t,v). G3m(u) is located in the C_H2 domain. The difference between G3m(u⁻) and G3m(u⁺) IgG3 proteins correlates with the sequence at position 339 in the C_H2 domain—Ala and Thr respectively. There is another structural difference in the CH3 domain which correlates with protein A binding and non-binding: all IgG proteins that bind protein A have His at position 435, whereas those that do not, have Arg at that position.     

Fusarium endocarditis involving aortic valve following coronary artery surgery

This article describes a case of infective aortic valve endocarditisdue to Fusarium oxysporum occurring 4 years after coronary arterybypass grafting. It is the first reported case of endocarditiscaused by Fusarium.     

CHANGES IN RESISTANCE TO MOUTH OPENING INDUCED BY DEPOLARIZING AND NON-DEPOLARIZING NEUROMUSCULAR RELAXANTS

Mouth opening was measured in 43 children anaesthetized withisoflurane and paralysed with vecuronium or suxamethonium. Measurementsof mouth opening were made for up to 10 min after loss of theadductor pollicis twitch and cessation of muscle fasciculations.In 22 patients receiving suxamethonium, a significant (P <0.001) reduction in mean mouth opening occurred in the 60 safter loss of twitch and cessation of fasciculations. Mouthopening reductions could last for up to 10 min after the lossof twitch, beyond the return of the twitch. One patient experienced"masseter spasm"; he did not develop malignant hyperpyrexiaduring 2.5 h of isoflurane anaesthesia. Patients receiving vecuroniumshowed a significant (P < 0.0006) increase in mouth opening.In 20 subjects, mouth opening was generated with a small (1.67N) and a larger (4.32 N) force. Proportionally equal reductionsin mouth opening were obtained with either force after suxamethoniumadministration. Relatively equal increases with either forcefollowed vecuronium administration. Isolated masseter spasmis not pathognomonic for malignant hyperpyrexia. If the diagnosisof malignant hyperpyrexia is contemplated, signs of hypermetabolism,such as increases in end-tidal carbon dioxide concentrationduring constant minute ventilation, should be sought.     

EARLY AGALACTOSYLATION OF IgG IS ASSOCIATED WITH A MORE PROGRESSIVE DISEASE COURSE IN PATIENTS WITH RHEUMATOID ARTHRITIS: RESULTS OF A FOLLOW-UP STUDY

The clinical significance of the percentage agalactosyl IgGoligosaccharides [%G(O)] was investigated in serum of a well-characterizedcohort of 127 female RA patients who were followed for a meanduration of 6 yr. The %G(O) was determined in the first availableserum sample which was obtained at a mean of 3.4 yr after symptomonset. It could be shown that patients with a %G(O) more than2 S.D. above the mean level of controls (n = 34), had significantlymore erosions, disease activity, and were treated with moresecond-line drugs, than patients without an increased %G(O)(n = 93), both at the time the serum sample was obtained, andduring follow-up. These findings suggest that G(O) may serveas an indicator for the disease course in patients with RA. KEY WORDS: Agalactosyl IgG, Prognosis, Outcome     

Determination of left ventricular volume by two-dimensional echocardiography: comparison with magnetic resonance imaging

Left ventricular volume was determined in 12 healthy volunteersusing a newly developed two-dimensional echocardio-graphic delineationmethod. The results were compared with those of magnetic resonanceimaging, which served as the method of reference. Left ventricularend-diastolic volume was 123 ± 12 ml, echocardiographicallydefined, and 121 ± 12 ml calculated with magnetic resonanceimaging. End-systolic volume was 41 ± 7 ml on echocardiographyand 37±6 ml on magnetic resonance imaging. Left ventricularejection fraction was 67 ± 4%, echocardiographicallydefined, and 70 ± 5%, calculated with magnetic resonanceimaging. There was no statistical difference for any of themeasured parameters. Interstudy and inter-observer variabilitywas minimal. In conclusion, in healthy volunteers left ventricularvolume was accurately defined, using this newly developed two-dimensionalechocardiographic delineation method. During endocardial delineationa dynamic display is continuously available on a second window,allowing precise visual edge-detection. Moreover, correctionscan be made easily and quickly. These two advantages enhancethe accuracy of the method, even in cases of poor echogenicity.     

Deuterium Isotope Effect on the Metabolism of the Flame Retardant Tris(2,3-dibromopropyl) Phosphate in the Isolated Perfused Rat Liver

The metabolism of tris(2,3-dibromopropyl) phosphate (Tris-BP)was compared with that of completely deuterated Tris-BP (D15-Tris-BP)in an isolated, recirculating rat liver perfusion system inorder to determine the relative quantitative importance of twodifferent biotransformation pathways of Tris-BP: (i) cytochromeP450-mediated metabolism and (ii) GSH S-transferase-mediatedmetabolism. To accomplish this we quantitated the biliary excretionof S-(3-hydroxypropyl)glutathione (GSOH) as a marker metabolitefor cytochrome P450-mediated metabolism and that of S-(2,3-dihydroxypropyl)glutathione (GSOHOH) as a marker metabolite for GSH S-transferase-mediatedmetabolism. Completedeuterium substitution of Tris-BP significantlydecreased the formation of GSOH, whereas there was no effecton the formation of GSOHOH. Because our previous studies showeda large decrease in genotoxicity of D15-Tris-BP compared toTris-BP, the present results support our hypothesis that cytochromeP450-mediated metabolism is responsible for the genotoxic effectsof Tris BP in the rat liver.     

A PHARMACODYNAMIC MODEL FOR PANCURONIUM

It has been demonstrated that a simple two-compartment kineticmodel may account for the changes in plasma concentration ofpancuronium after i.v. administration. However, it can be shownthat this simple model does not account satisfactorily for theobserved changes in muscle twitch response. By the additionof a receptor (biophase) compartment, twitch response can bereconciled with model behaviour and the characteristics resemblethose predicted by animal studies. The complete model is appliedto the problem of total renal failure, and shows that patientswith this condition are likely to be marginally resistant tosmall doses of pancuronium, with a normal rate of recovery.However, larger doses are likely to result in delayed recovery,the duration of effect increasing in a dose-dependent manner. Communications to C. J. Hull.     

Yellow nail syndrome in infancy

Abstract: This report describes an infant with clinical features consistent with the yellow nail syndrome (YNS), a rare autosomal dominant disorder. He presented at birth with congenital lymphoedema and was referred at 6 months of age for investigation of recurrent cough and wheeze. He had clinical and radiological evidence of bilateral pleural effusions and a pericardial effusion. Following a lung biopsy and pericardial window these were shown to be manifestations of his lymphatic abnormality. He also had persisting middle ear effusions causing conductive deafness requiring hearing aids and secondary immunodeficiency requiring regular immunoglobulin infusions.     

Prognostic factors of neck node metastasis

A retrospective clinico-pathological study has been carried out in a series of 405 patients with squamous cell carcinoma of the head and neck who underwent a total of 484 radical neck dissections. The recurrence rate in the neck in 327 patients who had histological positive nodes was 21.1%, Recurrence in the neck after a standard radical neck dissection almost invariably proved fatal. A statistical analysis has been carried out to evaluate the clinical and pathological factors which are of importance in regards to recurrence in the neck. Histological factors such as extra-nodal spread and the number of histological positive nodes have been shown to be of much more prognostic importance than clinical parameters. When corrections are made for interdependencies between variables, histological extra-nodal spread proved to be the most important single prognostic factor (P < 10^?7).