Blood Chimeric Twins

A man and his twin sister were found to have two types of circulating red cells. The man had 89% A1 cells of his own and 11% A1B cells derived from his sister. The woman had 12% A1B cells of her own and 88% A1 cells derived from her brother. The two lines of red cells also had different Duffy and Kidd groups. The lymphocyte karyotype in the brother was 68% XY and 32% XX, and that in the sister was 60% XX and 40% XY. The possible mechanisms for producing different proportions of red cells and lymphocytes are discussed.     

Urinary mercury excretion and body weight on workers exposed to mercury vapour

Summary From the 5-year record of health checks including urinary mercury levels and body weights on 33 workers exposed to mercury vapour in a tungsten rod manufacturing factory, the relationships between the level of urinary mercury and the body weight, and between the change of urinary mercury levels and that of body weights, were analysed. Except for the workers with the short period of exposure, on whom no significant correlation was found, correlations between the changes; urinary mercury and body weight, were much stronger than those between the levels. In contrast to the significant negative correlations in the mentioned relationships on the workers with the long period of continuous exposure at atmospheric concentrations below 0.2 mg/m³, there was significant positive correlations on the workers with occasional, short-period exposures at much lower concentrations of mercury. The importance of analysis on the change of exposure and its relation to the effect was emphasized, and possible effects of mercury to the regulation of body weight was discussed.     

Acute subdural hygroma in the posterior fossa (author's transl)]

Four cases of acute or subacute subdural hygromas in the posterior fossa were reported. All showed suboccipital skull fractures radiologically. Two cases of acute subdural hygromas were encounteded during the fiscal year from 1972 to 1973 at Toritsu Toshima Hospital. In the same period 254 patients with head injuries were admitted here and 106 demonstrated skull fractures. Among these 24 exhibited fractures in the suboccipital region. Among these 24 cases 8 showed signs and symptoms of space-occupying lesions in the posterior fossa and were confirmed later surgically (7 cases) or by autopsy (1 case), namely; three extradural hematomas, two acute subdural hygromas as mentioned above, three subdural hematomas with cerebellar contusions. Preoperative courses in these three acute subdural hygomas as well as three subdural hematomas were summarized as follows:lucid interval was followed by severe nuchal pain and rapid downhill course and finally by coma and panea. Retrograde brachial angiographies were performed in cases. The findings were not contributary to locate mass lesions, in three cases, partly because of delayed or faint filling of vessels caused by compression with hematoma or acute subdural hygroma. In short, differential diagnosis between subdural hematoma and subdural hygroma was difficult preoperating. Postoperatively, courses of subdural hematomas were poor or even fatal. On the contrary, patients of acute subdural hygromas showed rapid clinical improvement after evacuation of xanthochromic fluid. The authors stressed that suboccipital craniectomy should be performed as soon as possible to the patients with sugoccipital fractures when vital signs became progressively worse even if little findings were obtained by carotid angiographies. Subdural hygromas in the posterior fossa may have been present in those fatal cases where autopsy finds neither contusion nor hemorrhage but only brain edema or swelling.     

Nasal Application of Inactivated Influenza Vaccine

Intranasally- rpplied inactivated influenza vaccines, which have been made for subcutaneous use, induced local production of specific IgA antibodies. There is a good prospect of practical use of inactivated influenza vaccines applied intranasally.     

Stress-induced production of chemokines by hair follicles regulates the trafficking of dendritic cells in skin

Langerhans cells (LCs) are epidermal dendritic cells with incompletely understood origins that associate with hair follicles for unknown reasons. Here we show that in response to external stress, mouse hair follicles recruited Gr-1(hi) monocyte-derived precursors of LCs whose epidermal entry was dependent on the chemokine receptors CCR2 and CCR6, whereas the chemokine receptor CCR8 inhibited the recruitment of LCs. Distinct hair-follicle regions had differences in their expression of ligands for CCR2 and CCR6. The isthmus expressed the chemokine CCL2; the infundibulum expressed the chemokine CCL20; and keratinocytes in the bulge produced the chemokine CCL8, which is the ligand for CCR8. Thus, distinct hair-follicle keratinocyte subpopulations promoted or inhibited repopulation with LCs via differences in chemokine production, a feature also noted in humans. Pre-LCs failed to enter hairless skin in mice or humans, which establishes hair follicles as portals for LCs.     

T cell receptor-interacting molecule acts as a chaperone to modulate surface expression of the CTLA-4 coreceptor

The costimulatory molecule CTLA-4 is a potent downregulator of T cell responses. Although localized mostly in intracellular compartments, little is understood regarding the mechanism that regulates its transport to the cell surface. In this study, we demonstrated that the adaptor TRIM (T cell receptor-interacting molecule) bound to CTLA-4 in the trans Golgi network (TGN) and promoted transport of CTLA-4 to the surface of T cells. Increased TRIM expression augmented surface CTLA-4 expression, and pulse-chase analysis showed a more rapid transport of CTLA-4 to the cell surface. A reduction of TRIM expression by small hairpin RNAs reduced the expression of surface CTLA-4. This resulted in a more localized pattern of CTLA-4 in the TGN. Altered CTLA-4 expression by TRIM was accompanied by corresponding changes in coreceptor-mediated effects on cytokine production and proliferation. Our findings identify a role for TRIM as a chaperone in regulating CTLA-4 expression and function by enhancing CTLA-4 transport to the surface of T cells.     

An appropriate indication for the initiation of beta-blocker therapy in dilated cardiomyopathy

BACKGROUNDS: Although long-term treatment with beta-blockers has been shown to improve morbidity and mortality in dilated cardiomyopathy (DCM), patient responses are heterogeneous. METHODS: To establish the appropriate indication for the initiation of beta-blocker therapy, we retrospectively analyzed 38 DCM patients treated with beta-blockers (metoprolol or carvedilol) and examined differences in baseline profiles between patients who could continue the therapy (responders) and those who could not (non-responders). RESULTS: In 13 non-responders, the duration from onset of symptoms to beta-blocker initiation was longer (p < 0.05), systolic blood pressure was lower (p < 0.001), serum sodium concentration was lower (p < 0.05), left ventricular posterior wall thickness was thinner (p < 0.05), left ventricular end-diastolic pressure was higher (p < 0.05) and left ventricular wall stress was lower (p < 0.05) than in 25 responders. In 19 patients receiving carvedilol, 5 non-responders showed higher levels of human atrial natriuretic peptide (p < 0.05) and brain natriuretic peptide (p < 0.01) than 13 responders. Discriminant analysis with a linear discriminant function showed the following equation predicted response to beta-blocker therapy: h = 0.004 x systolic blood pressure - 0.002 x brain natriuretic peptide + 0.667 (R2 = 0.67, p < 0.001). The probability of predicting the response was 94.1% with h > or = 0.5. CONCLUSION: We conclude that h > or = 0.5 is the appropriate indication for the initiation of beta-blocker therapy in DCM.