HLA-DRB1 and DQB1 polymorphisms in southern France and genetic relationships with other Mediterranean populations

This study presents the results of HLA-DRB1 and DQB1 sequence-specific oligonucleotide probe (SSOP) typing for a population sample of 181 individuals originating from southern France. On the basis of allele and haplotype frequencies, we compared our population with others from the Mediterranean area. Allele frequencies are comparable to those found in other western European populations (France, Portugal, Spain) and indicate neighboring exchanges. The haplotype frequencies showed relationships with North Africans and Jewish populations, as well as the common origin of Moroccan and Lebanese Jews. Therefore, allele frequencies seem to be more able to show recent exchanges while haplotype frequencies might show ancestral relationships. These results may serve as references for future studies of HLA and disease in southern France.     

Anatomy of the arterial vascularization of the lips

Summary The findings from 12 dissections of previously injected facial masks, 8 dissections of the face following intrarterial injection of a red solution of Latex Neoprene, and a corrosion cast specimen allowed us to study the arterial supply of the lips. The arterial supply of the upper lip arises mainly from the superior labial arteries, but also from the subseptal arteries and from the subalar arteries. There is a figure of 8 shaped anastomotic system between these arteries lying on the upper lip. The arterial supply of the lower lip arises from the inferior labial arteries and from branches of the mental artery. A constant inferior labial arterial network was shown at the level of the lower lip arising in a fifth of cases from a T-shaped inferior labial artery. All these recent anatomic findings help us to improve our understanding of plastic surgery of the lips.

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Vascularisation artérielle des lèvres

Résumé Douze dissections de masques faciaux préalablement injectés à la gélatine minium, huit dissections de face après injection artérielle par une solution de latex néoprène rouge, et une injectioncorrosion a permis l'étude de la vascularisation artérielle labiale. La lèvre supérieure reçoit sa vascularisation artérielle des artères labiales supérieures principalement, mais aussi des artères sous-narinaires branches des artères faciales, et des artères de la sous-cloison. Il existe un système d'anastomose fréquent entre les trois artères décrivant un aspect de 8 de chiffre couché au niveau de la lèvre supérieure. La lèvre inférieure est vascularisée par les artères labiales inférieures et par des branches de l'artère mentonnière ; il existe de manière constante au niveau de la lèvre inférieure une arche artérielle labiale inférieure provenant une fois sur cinq d'une artère labiales inférieure en T unique. Toute ces données anatomiques récentes permettent d'envisager dans de meilleures conditions la chirurgie réparatrice des lèvres.

     

Increased and highly stable levels of functional soluble interleukin-6 receptor in sera of patients with monoclonal gammopathy

Soluble human interleukin-6 receptor (sIL-6R) was measured in the serum of 30 healthy individuals, 32 individuals with monoclonal gammopathy of undetermined significance (MGUS), 20 patients with early multiple myeloma (MM) and 54 patients with overt MM. The serum activity recognized by an immunoradiometric assay was determined to be sIL-6R, because of its binding capacity to IL-6 and its molecular mass of 55 kDa. All sera of healthy individuals contained sIL-6R (mean value: 89 ng/ml, range 17-300 ng/ml). Serum sIL-6R levels were increased by 51% in patients with MGUS (mean value: 135 ng/ml, p<0.005), by 44% in patients with early myeloma (mean value: 128 ng/ml, p<0.001) and by 116 % in patients with overt MM (mean value: 193 ng/ml, p<0.001). In patients with MM, a complete lack of correlation (p>0.7) was found between serum sIL-6R levels and other previously recognized prognostic factors in this disease, particularly serum IL-6 levels and those factors related to tumor cell mass. The independence of serum sIL-6R levels on tumor cell mass was directly demonstrated by studying four patients with MM treated with autologous bone marrow transplantation for periods of between 320 and 760 days. These levels were found to be remarkably stable and constant, independent of whether patients relapsed or achieved complete remission. Finally, physiological concentrations of sIL-6R were found to increase by tenfold the sensitivity of human myeloma cell lines to IL-6. These observations suggest a high control of the sIL-6R level in vivo, and, possibly, an important functional role of this circulating protein in patients with monoclonal gammopathies.     

The deltaccr5 mutation conferring protection against HIV-1 in Caucasian populations has a single and recent origin in Northeastern Europe

The chemokine receptor CCR5 is encoded by the CMKBR5 gene located on the p21.3 region of human chromosome 3, and constitutes the major co- receptor for the macrophage-tropic strains of HIV-1. A mutant allele of the CCR5 gene, Delta ccr5 , was shown to provide to homozygotes with a strong resistance against infection by HIV. The frequency of the Delta ccr5 allele was investigated in 18 European populations. A North to South gradient was found, with the highest allele frequencies in Finnish and Mordvinian populations (16%), and the lowest in Sardinia (4%). Highly polymorphic microsatellites (IRI3.1, D3S4579 and IRI3.2, D3S4580 ) located respectively 11 kb upstream and 68 kb downstream of the CCR5 gene deletion were used to determine the haplotype of the chromosomes carrying the Delta ccr5 variant. A strong linkage disequilibrium was found between Delta ccr5 and specific alleles of the IRI3.1 and IRI3.2 microsatellites: >95% of the Delta ccr5 chromosomes carried the IRI3.1-0 allele, while 88% carried the IRI3.2-0 allele. These alleles were found respectively in only 2 or 1.5% of the chromosomes carrying a wild-type CCR5 gene. From these data, it was inferred that most, if not all Delta ccr5 alleles originate from a single mutation event, and that this mutation event probably took place a few thousand years ago in Northeastern Europe. The high frequency of the Delta ccr5 allele in Caucasian populations cannot be explained easily by random genetic drift, suggesting that a selection advantage is or has been associated with homo- or heterozygous carriers of the Delta ccr5 allele.      

Simultaneous screening for HBV DNA and HCV RNA genomes in blood donations using a novel TaqMan PCR assay

The risk of contracting hepatitis from blood transfusions is estimated to be 1 in 63000 in the case of hepatitis B virus (HBV) and 1 in 103000 in the case of hepatitis C virus (HCV). In some countries (Germany, USA and England, for example), molecular protocols are evaluated to detect viral genomes in blood donations in order to reduce the seroconversion period. However, no such method is available currently to screen large series samples for HBV and HCV. While strategies involving the pooling of plasma samples have been proposed and tested in Germany, there is the question of sensitivity. We developed a novel approach to screen for HBV and HCV based on the TaqMan technology that allows for the quantification of an amplified fragment during PCR analysis (Lee et al., 1993). This approach is more sensitive than other quantification methods. As a first step primers and probes were designed to detect the different sub-types of HBV and HCV genomes. We then optimized the reaction conditions in order to screen for the two viruses at the same time. The observed sensitivity is less than 50 molecules per ml for HBV and less than 50 molecules per ml for HCV. This assay is, to our knowledge, the first that allows the simultaneous detection of DNA and RNA viral genomes. In conclusion, this TaqMan approach could be used as a single test to screen for HBV and HCV genomes in a series of 96 samples in less than 5 h. Such an approach is a first step for development of automation allowing a systematic screening of blood donations.     

Ventricular fibrillation following administration of thrombolytic treatment: The EMIP experience

Reperfusion-induced ventricular fibrillation has been dem onstratedin animal models of myocardial ischaemia, but no evidence existsfor this in humans. The European Myocar dial Infarction Projectcompared the efficacy and safety of pre-hospital thrombolytictherapy with that of hospital therapy. The objective of thisstudy was to investigate the occurrence of reperfusion-inducedventricular fibrilla tion in acute myocardial infarction patientsfollowing thrombolytic therapy. In a double-blind multicentre trial, eligible patients wererandomized to receive anistreplase at home followed by placeboin the hospital (A/P group), or placebo followed by anistreplase(P/A group). The occurrence of ventricular fibrillation, andother adverse events were recorded on specific study forms andcould be attributed to defined time intervals. The incidence of ventricular fibrillation in the A/P group wassignificantly higher following the pre-hospital injection thanin the P/A group (2.5% vs 1.6%; P=0.021); the situation wasreversed following the hospital injection (3.6% vs 5.3%; P=0.002).No relationship was found be tween this excess of ventricularfibrillation and the patients condition, with the exceptionof the site of the infarct. These results suggest the existence of reperfusion-induced ventricularfibrillation in patients developing myocardial infarction whoreceive thrombolytic treatment.     

Genetic effects of chlorinated anilines and azobenzenes onSalmonella typhimurium

The mutagenicity of 19 herbicide-derived chlorinated azobenzenes and structurally related chlorinated anilines and nitrobenzenes was assayed towards several strains ofS. typhimurium, using the plate incorporation method and the fluctuation test, in the presence or in the absence of liver post-mitochondrial fractions, in aerobic and anaerobic conditions.Positive results were obtained with 4,4-dichloroazobenzene, 4,4-dichloroazoxybenzene, 3,4-dichloronitrobenzene and, to a much lesser extent, with 3,4,3,4-tetrachloroazobenzene. No mutagenic effect was observed with 2,3,7,8-tetrachlorodibenzo-p-dioxin in any condition.     

Incidence of the morphological aspect on the rate of implantation of embryos obtained by fertilization in vitro]

1350 embryos obtained by In Vitro Fertilization (IVF) have been examined with the reverse microscope before their transfer in utero. Some embryos are "morphologically normal" (34.7%); some others are atypical. It is difficult to determinate the implantation rate by embryo according to morphological aspect because, most of the time we transfer several embryos to only one patient and we do not know, in case of pregnancy, which one or which ones have developed. Nevertheless, we have tried to appreciate, for 500 embryos transfers after IVF, the incidence of morphological aspect according to the presence or absence of "morphologically normal" embryos. The implantation rate is significantly higher in the groups in which you find "morphological normal" embryos than in the group where they are missing. (19.7% and 19.2% vs 10.2%). It seems that the aspect of the embryo when it is transferred, has an incidence on its future development.     

Unusual traumatic rupture of the thoracic aorta with avulsion of the left subclavian artery]

Of the many cases of traumatic rupture of the aorta diagnosed each year at l"H?pital du Sacré-Coeur, Montreal, most patients are already in irreversible shock when seen. However, during the period Oct. 1, 1974 to Sept. 30, 1975, prompt surgical treatment saved six patients. One of these six patients had a complete trans-section of the aortic arch between the left carotid and left subclavian arteries with avulsion and slight retraction of the left subclavian artery. Repair of the aortic arch and left subclavian artery was accomplished without extracorporeal circulation. A sutureless temporary bypass shunt was created by (a) cannulating the ascending and descending aorta, the cannulas being secured with purse-string sutures and joined by a 3/8-inch (94-mm) polyvinyl chloride (PVC) tube connected to a "double T" adapter, and (b) joining two small PVC tubes from the adapter with two straight cannulas, a no. 14 being inserted into the innominate artery and a no. 12 being inserted into the left carotid artery. With this temporary bypass created, the ascending and descending aorta and aortic arch vessels were all clamped. Aortic continuity was re-established with a tubular Dacron graft (diameter, 19 mm) to which was anastomosed a side-arm of knitted Dacron (diameter, 10 mm) to repair the left subclavian artery. Throughout the temporary perfusion the brain, spinal cord and all abdominal viscera were well protected. No sign of ventricular distension was detected. This report is the first in which complete transsection of the aortic arch has been managed by a sutureless bypass shunt allowing perfusion of all aortic arch vessels without extracorporeal circulation.