Three new families with arterial tortuosity syndrome

Arterial tortuosity syndrome (ATS) is a rare condition with autosomal recessive inheritance characterized by connective tissue abnormalities. The most specific clinical findings are cardiovascular anomalies including tortuosity, lengthening, aneurysm, and stenosis formation of major arteries. Also ventricular hypertrophy is frequently present. Other anomalies are skin hyperextensibility and cutis laxa, joint laxity or contractures of the joints, and inguinal herniae. Histology shows disruption of elastic fibers of the media. These features suggest that ATS is a connective tissue disorder. A biochemical or molecular defect has not yet been identified. We describe here nine additional ATS patients from three consanguineous Moroccan families and review a total of 35 patients with this uncommon condition.     

Frequent carriage of Panton-Valentine leucocidin genes by Staphylococcus aureus isolates from surgically drained abscesses

Between 1 February and 15 April 2002, 95 patients were admitted to Gaston Bourret Territorial Hospital (New Caledonia, France) for drainage of community-acquired soft tissue abscesses. Staphylococcus aureus was detected in 68 cases (72%). Two-thirds of the patients with S. aureus infection had furuncles, which were located on the limbs in 82% of cases. The median interval between symptom onset and hospital admission was 5.7 days. Three-quarters of the patients were Melanesians living in tribes. Fifty-four S. aureus isolates were screened for toxin genes. Panton-Valentine leucocidin (PVL) genes were detected in 48 isolates (89%), the exfoliative toxin A gene was detected in 1 isolate, and no toxin genes were detected in 4 isolates. S. aureus nasal carriage was detected in 39.7% of patients with S. aureus infections. Two infecting S. aureus strains and two nasal carriage strains were resistant to methicillin. Comparative pulsed-field gel electrophoresis, performed in 16 cases, showed that five of six patients with PVL-positive nasal carriage strains were infected by the same strains. In contrast, 8 of 10 patients with PVL-negative nasal carriage strains were infected by PVL-positive strains. PVL genes thus appear to be a major virulence factor in both primary and secondary S. aureus skin infections.     

Recurrent Bacteremia Caused by a “Flexispira”-Like Organism in a Patient with X-Linked (Bruton’s) Agammaglobulinemia

Helicobacter spp., except for Helicobacter cinaedi, have only rarely been reported in cases of septicemia. A patient with X-linked (Bruton's) agammaglobulinemia was found to have persistent sepsis with a Helicobacter-like organism despite multiple courses of antibiotics. His periods of sepsis were associated with leg swelling thought to be consistent with cellulitis. The organism was fastidious and required a microaerophilic environment containing H(2) for growth. Optimal growth was observed at 35 to 37 degrees C on sheep blood, CDC anaerobe, and Bordet-Gengou agars. Serial subcultures every 4 to 5 days were required to maintain viability. The organism was strongly urease positive and showed highest relatedness to Helicobacter-like organisms with the vernacular name "Flexispira rappini" by 16S rRNA gene sequence analysis. Genomic DNA hybridization studies, however, found 24 to 37% relatedness to "F. rappini" and even less to other Helicobacter spp. Although the organism phenotypically resembles "Flexispira" and Helicobacter, it is thought to represent a new taxon. The patient's infection was eventually cleared with a prolonged (5-month) course of intravenous imipenem and gentamicin.     

Lipoteichoic acids from Lactobacillus johnsonii strain La1 and Lactobacillus acidophilus strain La10 antagonize the responsiveness of human intestinal epithelial HT29 cells to lipopolysaccharide and gram-negative bacteria

Intestinal epithelial cells (IECs) respond to lipopolysaccharide (LPS) from gram-negative bacteria in the presence of the soluble form of CD14 (sCD14), a major endotoxin receptor. Since sCD14 is also known to interact with gram-positive bacteria and their components, we looked at whether sCD14 could mediate their effects on human IECs. To this end, we examined the production of proinflammatory cytokines following exposure of the IECs to specific gram-positive bacteria or their lipoteichoic acids (LTAs) in the absence and presence of human milk as a source of sCD14. In contrast to LPS from Escherichia coli or Salmonella enteritidis, neither the gram-positive bacteria Lactobacillus johnsonii strain La1 and Lactobacillus acidophilus strain La10 nor their LTAs stimulated IECs, even in the presence of sCD14. However, both LTAs inhibited the sCD14-mediated LPS responsiveness of IECs. We have previously hypothesized that sCD14 in human milk is a means by which the neonate gauges the bacterial load in the intestinal lumen and liberates protective proinflammatory cytokines from IECs. The present observations suggest that gram-positive organisms, via their LTAs, temper this response and prevent an exaggerated inflammatory response.     

Local thermal unpleasantness and discomfort prediction in the vicinity of thermoneutrality

This work emphasizes a better understanding of the origin of human thermal discomfort under heterogeneous but steady environments, in subjects in the vicinity of physiological and sensory thermoneutrality. The knowledge of skin temperatures allows a psychophysiological study aiming at linking the body thermal state (local and global) to thermal sensation (perceptive and affective judgements). By using two driving simulators, 345 subjects were exposed to different thermal environments, modulated by factors such as the air distribution in the automotive cockpit or the clothing insulation (winter or summer). This work shows that consideration of the local thermal state is essential for the evaluation of thermal comfort in the case of non-uniform environments. Our experimental conditions point out that the overall sensation of discomfort is quantitative, with local unpleasantness needing to be felt for a certain number of body surfaces. A local origin is suggested for cold discomfort, in opposition to the global characteristics of warm discomfort.     

Education of medical technologists in North America

The increasing complexity of diseases and advancing medical technologies have recently raised the number of test items and their use. This has caused each department to ask for clinical support by medical technologists, including consultation services on clinical laboratory tests in Japan. Under these circumstances, we think it is necessary to consider a Japanese education system for medical technologists to foster people with advanced ability capable in providing adequate clinical support. It is important that we study medical technologist systems and education systems superior to than ours. Therefore, to investigate the state of the Japanese education system for medical technologists, we conducted a comparison between the medical technologist systems and education systems in foreign countries and those of Japan. The social background in which medical technologists are positioned, their scope of work, and the education systems overseas are different from Japan on many points and we were given many suggestions for what a system in Japan should be like.     

The effect of haemorrhage on venous return and regional blood flow in the anaesthetized cat

1. In cats under pentobarbitone anaesthesia, a venous long-circuit technique was used to measure the blood flows in the superior vena cava and the hepatic, renal and iliac segments of the inferior vena cava. The sum of these flows gave the venous return (minus coronary and bronchial flows).2. In these preparations, the mean venous return was 130 ml./kg. Of this 28% came from the superior vena cava and 37% from the hepatic, 23% from the renal and 12% from the iliac segments of the inferior vena cava.3. After haemorrhage, the flows from all the venae cavae segments decreased. The quantitative changes varied with the particular cat, the degree and duration of the haemorrhage and whether the animal had been subjected to a previous haemorrhage.4. The proportion of the reduced venous return draining from the superior vena cava and the hepatic segment increased, that draining from the renal and iliac segments decreased. Vasoconstriction occurred in all vascular beds, but was greatest in the kidney and hind limbs. Thus the blood flow through the head and liver was partially maintained at the expense of that through the kidneys and hind limbs.5. Autoregulation of blood flow in the kidneys was usually seen immediately after the first removal of blood but with the onset of renal vasoconstriction it was reduced or abolished for the remainder of the experiment.     

Activation and internalization of p56lck upon CD45 triggering of Jurkat cells

Relationships between CD45 and p56^Ick have been suggested by co-immunoprecipitation of both proteins and by dephosphorylation of the p56^lck regulatory site, Tyr 505, by CD45 in vitro. We investigated whether the kinase activity of p56^lck is modulated in T cells triggered via CD45. We showed that incubation of Jurkat cells with a combination of two anti-CD45 monoclonal antibodies (mAb) (MC5/2 + D3/9) induced an increase in p56^lck kinase activity, while a single mAb did not. Under these conditions, p56^lck underwent two consecutive waves of activation. This was accompanied by internalization of the kinase and by a time-dependent increased accessibility of CD45 phosphatase at the plasma membrane. Similarly, activation and internalization of p56^lck were observed using a combination of anti-CD45 (MC5/2) and anti-CD2(T11₂) mAb, suggesting that a functional complex consisting of CD45, CD2 and p56^lck was formed upon cell triggering. Taken together, these results suggests that: (i) CD45 participates in the regulation of p56^lck kinase activity in vivo and that (ii) CD45 could play a mediator role in the stimulation and endocytosis of p56^lck through the CD2 pathway.     

Exercise and skeletal muscle ageing: cellular and molecular mechanisms

As we age, our skeletal muscle becomes smaller and weaker. In addition, the remaining muscle is more susceptible to damage, particularly following exercise, recovery from damage is severely impaired and muscle is unable to adapt rapidly following sequential periods of exercise. The mechanisms by which skeletal muscle damage occurs are poorly understood and the role that an increased production of free radical species plays in this damage is controversial. However, evidence is emerging which suggests that an increased production of free radicals may act as an activator of the adaptive response in skeletal muscle, resulting in the increased production of antioxidant enzymes and heat shock proteins (HSPs). The increased content of these proteins facilitates rapid remodelling of muscle and provides considerable protection against subsequent periods of damaging exercise. There is considerable evidence that the production of free radicals is modified during the ageing process. The aim of this review is to examine the possible effects of this modification on the ability of muscle cells to respond to stress and the functional effect that this may have on our muscles as we age.