Correlation of fetal kidney and testis congenic graft survival with reduced major histocompatibility complex burden

Prolonged survival was enjoyed by fetal and postnatal testis and midgestational renal grafts transplanted beneath the renal capsule of adult congenic mice, confirming previous findings in nonimmunosuppressed outbred rats (3,5). The strategies that enable immature tissues to escape rejection in a graft survival assay were studied by comparing expression of major histocompatibility class I and class II protein and messenger ribonucleic acid (mRNA) in each tissue at different ages. In general, graft survival was best when class I and II expression was low. After transplantation, surviving kidney and testis grafts both showed marked induction of class I and II mRNA measured using donor and recipient-specific oligonucleotide probes. Immunohistochemically detected protein of both classes, however, could not be found in the kidney and was minimal in the testis. Fetal tissues appear to express lower levels of protein and mRNA--and, although invading lymphocytes may induce expression of class I and II mRNA after transplantation, protein was not inducible. The failure of these tissues to express significant levels of transplantation antigens may explain the prolonged survival of these immature grafts.     

Corticosteroid-responsive pure red cell aplasia in chronic lymphatic leukemia

Acquired pure red cell aplasia characterized by selective failure of erythropoiesis was seen in a 37-yr-old female patient with a diagnosis of chronic lymphatic leukemia (CLL). Though different immunosuppressive therapies have been tried in the past with variable response, there has been no case report of such favorable response to corticosteroids alone. We report this rare and unusual case of PRCA associated with CLL who responded to steroid therapy.     

Mohs micrographic surgery for mucocutaneous malignancies

Mohs' micrographic surgery is a surgical technique developed for removal of mucocutaneous malignancies. The surgeon integrates the responsibilities of surgery, specimen orientation and preparation, and microscopic interpretation to determine tumor-free margins. It has the lowest recurrence rate of all surgical techniques while conserving the most tumor-free skin. In selected cases it is the preferred method for treating carcinomas.     

Two Novel Missense Mutations and a 5bp Deletion in the Erythroid‐Specific Promoter of the PKLR Gene in Two Unrelated Patients With Pyruvate Kinase Deficient Transfusion‐Dependent Chronic Nonspherocytic Hemolytic Anemia

We report two children with severe chronic hemolytic anemia, the cause of which was difficult to establish because of transfusion dependency. Reduced erythrocyte pyruvate kinase activity in their asymptomatic parents provided the diagnostic clues for mutation screening of the PKLR gene and revealed that one child was a compound heterozygote of a novel paternally derived 5‐bp deletion in the promoter region (c.‐88_‐84delTCTCT) and a maternally derived missense mutation in exon nine (c.1174G>A; p.Ala392Thr). The second child was a compound heterozygote of two novel missense mutations, namely a paternally derived exon ten c.1381G>A (p.Glu461Lys) and a maternally derived exon seven c.907‐908delCC (p.Pro303GlyfsX12) variant.