A CD14 gene polymorphism is associated with the IgE level for Dermatophagoides pteronyssinus

CONCLUSION: CD14/-159 plays a role in sensitization to Dermatophagoides pteronyssinus in Japanese patients with allergic rhinitis. OBJECTIVE: An association between a polymorphism in the 5'-flanking region of the CD14 gene and atopic phenotypes has been identified in a pediatric American population and an adult Dutch population. The aim of this study was to determine whether the CD14/-159 polymorphism is associated with specific IgE levels in allergic rhinitis patients in a Japanese population. MATERIAL AND METHODS: The CD14/-159 genotypes of 81 unrelated patients with allergic rhinitis and 78 healthy subjects were determined and compared. The total IgE level and the specific IgE levels for three aeroallergens were determined. The IgE levels for each genotype were compared. RESULTS: The frequencies of CD14/-159 genotypes did not differ between the two groups. Among the allergic rhinitis patients, TT homozygotes had significantly fewer positive CAP-radioallergosorbent tests (CAP-RASTs) than CC homozygotes and CT heterozygotes, suggesting that the C allele is dominant. TT homozygotes also had significantly lower CAP-RAST scores for Dermatophagoides pteronyssinus, but not for Cryptomeria japonica or Dactylis glomerata, than CC homozygotes and CT heterozygotes. There was no significant association between total serum IgE levels and CD14/-159 genotypes in the allergic rhinitis patients.     

Newly diagnosed acute aortic dissection: characteristics, treatment modifications, and outcomes

The objective of the present study was to examine cases of acute aortic dissection in order to analyze the clinical and diagnostic findings, and to summarize their treatment modalities, as well as their hospital outcomes. Between July 1998 and June 1999, we prospectively studied patients who were newly diagnosed as having acute aortic dissection at 25 hospitals in Mie prefecture. These cases were examined for their demographics, the characteristics of the clinical findings, diagnostic methods, treatment modalities according to the type of aortic dissection, and the early morbidity and mortality of the hospital outcomes. Of 66 newly diagnosed aortic dissections (43 males), 30 were type A and 36 were type B. Seventy-six percent of the cases arrived at a medical facility within 6 hours from the onset of symptoms. Frequent initial symptoms and clinical findings were pain in 95.5%, cardiac arrest and/or hypotension in 21%, pericardial effusion in 29%, pleural effusion in 25%, and neurological signs in 30%. Twenty-one patients underwent surgical repair, 36 were treated medically, and 5 underwent endovascular stenting. Overall early mortality was 12.1%, which included 2 DOA. Fifty percent of these deaths occurred within 48 hours, and 63% by 72 hours of the initial event. In spite of the relatively rare incidence of acute aortic dissection in our study, the calculated incidence was 4.0/100,000/year. The overall mortality rate was relatively low compared to the figures reported in the literature, suggesting the earliest possible diagnosis and timely intervention are critically important to attain successful outcomes.     

Tetralogy of Fallot with Anomalous Origin of the Right Pulmonary Artery from the Ascending Aorta and Hypoplastic Left Pulmonary Artery

A case of tetralogy of Fallot associated with anomalous origin of the right pulmonary artery from the ascending aorta and hypoplastic left pulmonary artery was successfully repaired. Following the simultaneous procedure with banding of the right pulmonary artery and replacement of modified Blalock-Taussig shunt to the left pulmonary artery at 34 days of age, the intracardiac repair was performed successfully at 1 year and 10 months of age. The patient was well 6 months postoperatively, without unilateral pulmonary hypertension.     

Clinical significance of anti-phosphatidylserine-prothrombin complex antibodies in antiphospholipid syndrome

We clarified the clinical significance of IgG anti-phosphatidylserine-prothrombin complex (PS-PT) antibodies in the antiphospholipid syndrome (APS). The study population consisted of 122 patients with SLE and lupus-like disease. IgG anti-PS-PT antibodies were detected in 44% of 59 patients according to the diagnostic criteria by Harris and Hughes. This frequency was significantly (p < 0.005) higher than the 14% seen in patients without APS. IgG anti-PS-PT antibodies were strongly (p < 0.005) associated with thrombosis. In addition, IgG anti-PS-PT antibodies were positive in 64% of IgG beta2-GPI dependent anti-cardiolipin antibody negative APS patients under the Sapporo criteria. The above findings indicate that IgG anti-PS-PT antibodies as well as beta2,-GPI dependent anti-cardiolipin antibodies should be examined in the diagnosis of APS.     

Implanted cannula-mediated repetitive administration of Abeta25-35 into the mouse cerebral ventricle effectively impairs spatial working memory

Amyloid beta (Abeta) is closely related to the onset of Alzheimer's disease (AD). To construct AD animal models, a bolus administration of a large dose of toxic Abeta into the cerebral ventricles of rodents has been performed in earlier studies. In parallel, a continuous infusion system via an osmotic pump into the cerebral ventricle has been developed to make a rat AD model. In this study, we developed a mouse AD model by repetitive administration of Abeta25-35 via a cannula implanted into the cerebral ventricle. Using this administration system, we reproducibly constructed a mouse with impaired spatial working memory. In accordance with the occurrence of the abnormal mouse behavior, we found that the number of choline acetyltransferase (ChAT)-positive neurons was reduced in paraventricular regions of brains of Abeta25-35-administered mice in a dose-dependent manner. Considering that the repetitive administration of a small dose of toxic Abeta via an implanted cannula leads to a brain status more resembling that of the AD patients than a bolus injection of a large dose of Abeta, and therapeutic as well as toxic agents are able to be repeatedly and reliably administered via an implanted cannula, we concluded that the implanted cannula-bearing AD mouse model is useful for development of new AD therapy.