Pulmonary artery catheterization: a modified technique

A modified technique for catheterization of the pulmonary artery was developed. It involves the passage of a tapered, movable-core, J-tipped guide wire across the right ventricle into the pulmonary artery followed by the advancement of a straightened Grollman pigtail catheter. The technique was successful in 34 of 34 pulmonary artery catheterizations. The method avoids prolonged catheter manipulation within the right ventricle. In addition, since the catheter does not cross the tricuspid valve until the guide wire has been advanced, the occasional complication of the pigtail "hooking" on a tricuspid valve leaflet or chordae tendineae during catheter withdrawal and manipulation is prevented.     

Giant cell tumor of the scapula

This study reviews the demographic, radiologic, and histologic characteristics of 13 cases of an important primary skeletal neoplasm, giant cell tumor of bone, occurring in an uncommon location, the scapula. that eight of 13 patients presented prior to 20 years of age contrasts significantly with the typical age distribution (between 20–40 years) encountered in giant cell tumors arising in long bones. As it does elsewhere in the skeleton, giant cell tumor of the scapula frequently demonstrates cystic and/or telangiectatic components on histologic examination. The radiologic appearances of giant cell tumor in the scapula and in more typical locations are similar and include: (1) well-defined (geographic) margins, occasionally with a delicate sclerotic rim, (2) prominent trabeculations, (3) expanded bone contour, (4) frequent extension to the subchondral plate, and (5) absence of internal mineralization. Tumor sites within the scapula included: coracoid process, acromion, and body (three cases each); glenoid (two cases); and superior and inferior angles (one case each).The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the Department of the Army, the Department of Defense, or the Uniformed Services University of the Health Sciences.     

PJA-BP expression and TCR delta deletion during human T cell differentiation

Recombination of deltaRec to psiJalpha will delete the TCR delta gene, which is thought to play an important role in the bifurcation of the TCR alphabeta versus TCR gammadelta differentiation lineages. We recently detected a DNA-binding protein in human thymocytes, the so- called PJA-BP, which recognizes the psiJalpha gene segment and might be one of the factors involved in the regulation of preferential deltaRec- psiJalpha rearrangements. We now investigate PJA-BP expression and its correlation with TCR delta gene deletion in thymocytes. Our electrophoretic mobility shift assay experiments showed that the PJA-BP is evolutionary conserved in human, murine and simian thymocytes. Using a large series of human hematopoietic malignancies (n = 30), we conclude that PJA-BP expression is thymocyte specific and seems to be restricted to thymocytes committed to the TCR alphabeta lineage. Analysis of seven well-defined human thymocyte subpopulations showed that preferential deltaRec-psiJalpha rearrangements as well as PJA-BP expression can be detected from the immature CD34-/CD1+/CD3- /CD4+/CD8alpha+beta- thymocyte differentiation stage onwards. These experiments indicate that expression of PJA-BP in human thymocytes starts simultaneously with preferential deltaRec-psiJalpha rearrangements, which supports our hypothesis that PJA-BP is one of the factors involved in the preferential recombination of deltaRec to psiJalpha.      

Change of tubular reabsorption of sodium and water after denervation

1. Renal function was compared in dogs before and after denervation, with normal or reduced glomerular filtration rate (GFR). GFR was reduced by one of two means, aortic clamping or injection of plastic microspheres into one renal artery.

2. The data showed that the tubular rejection fraction of denervated kidneys increased at a time when the same value for the control kidney decreased, indicating that denervation diuresis is not simply a result of increased filtered load of Na and water.

3. Changes in excretion after aortic clamping are not due solely to reduced filtered load. A reduction in renal blood pressure itself appears to have a direct effect on Na transport since Na excretion was significantly decreased before there were any changes in GFR, renal plasma flow and urine volume.

4. When GFR in a denervated kidney was reduced by microsphere injection it was demonstrated that a significant natriuresis (U_Na V) and diuresis (V) occurred when. GFR was reduced by as much as 40%.

5. These experiments support the hypothesis that denervation diuresis does not result solely from increased filtered load, but entails altered Na transport.

     

Temperature and cellular regulation of spontaneous cytotoxicity in the shark

Spontaneous cytolytic activity of shark peripheral blood leukocytes is observed only during periods of decreased environmental temperature (< 23°C). The effector cell is adherent to glass and is phagocytic. Leukocytes tested during warmer periods (26–31°C) exhibit no spontaneous activity; however, glass-adherent cells isolated from those fish are cytotoxic in vitro, indicating that the effector cell is present at all temperatures. During warmer temperatures, nonadherent cells added to adherent cells were shown to inhibit spontaneous cytotoxicity. This inhibition requires viable cells in contact with the spontaneous cytotoxic population. Thus decreased environmental temperature correlated with spontaneous cytotoxicity, and appears to affect a regulatory cell that is glass nonadherent. In addition, the cytotoxic effector cell is more active at 23°C than 30°C in vitro. These data show that by the time of emergence of the nurse shark, a temperature-dependent mechanism had evolved for cellular regulation of at least one immune function, spontaneous cytotoxicity.     

Missense mutation in a von Willebrand factor type A domain of the alpha 3(VI) collagen gene (COL6A3) in a family with Bethlem myopathy

The Bethlem myopathy is a rare autosomal dominant proximal myopathy characterized by early childhood onset and joint contractures. Evidence for linkage and genetic heterogeneity has been established, with the majority of families linked to 21q22.3 and one large family linked to 2q37, implicating the three type VI collagen subunit genes, COL6A1 (chromosome 21), COL6A2 (chromosome 21) and COL6A3 (chromosome 2) as candidate genes. Mutations of the invariant glycine residues in the triple-helical domain-coding region of COL6A1 and COL6A2 have been reported previously in the chromosome 21-linked families. We report here the identification of a G-->A mutation in the N-terminal globular domain-coding region of COL6A3 in a large American pedigree (19 affected, 12 unaffected), leading to the substitution of glycine by glutamic acid in the N2 motif, which is homologous to the type A domains of the von Willebrand factor. This mutation segregated to all affected family members, to no unaffected family members, and was not identified in 338 unrelated Caucasian control chromosomes. Thus mutations in either the triple-helical domain or the globular domain of type VI collagen appear to cause Bethlem myopathy.