HLA-DR ALLELES IN PATIENTS WITH SJOGREN'S SYNDROME OVER-REPRESENTING V{beta}2 AND V{beta}13 GENES IN THE LABIAL SALIVARY GLANDS

To identify genetic factors that play a role in the pathogenesisof patients with SS over-representing Vß2 and Vß13genes in the lips, HLA-DR and -DQ alleles of 10 primary SS patientswith predominant expression of Vß2 and Vß13genes in the lips were analysed, using the polymerase chainreaction (PCR) and sequence specific oligonucleotide probes.The CDR3 amino acid sequences of cDNA clones encoding Vß2and Vß3 genes were also determined by PCR. The resultsshowed that the DRB4^*0101 allele was significantly increased(80%) and that the frequency of DRB3 allele was decreased (0%)when compared to findings in healthy subjects (35.6 and 26%,respectively). Sequencing analyses demonstrated that 75% ofVß2 cDNA clones and 87% of Vß13 cDNA cloneshad a glutamine residue at position 106, in the CDR13 region.Moreover, the conserved sequences (Y^*TLRNEQ) in the CDR3 ofVß13-positive T cell were detected in two differentclones (27%) from the two individual SS patients. These findingssuggest that the decreased DRB3 and increased DRB4^*0101 allelesmay be associated with the antigens recognized by Vß2-and Vß13-positive T cells. KEY WORDS: HLA, Sjögren's syndrome, TCR Vß, CDR3 region     

High‐dose unfractionated heparin therapy in a pregnant patient with antiphospholipid syndrome: a case report

A case of a 37‐year‐old pregnant patient with antiphospholipid syndrome (APS), who has a medical history of both thrombosis and recurrent fetal loss, is presented. She was treated with predonisolone and fixed‐dose unfractionated heparin (UFH) infusion, followed by plasmaphereses and fixed‐dose low‐molecular‐weight heparin infusion during her fourth pregnancy. Unfortunately, this treatment did not have beneficial effects, resulting in intrauterine growth restriction and finally neonatal death. Continuous intravenous UFH infusion and low‐dose aspirin were administrated under the monitoring of the activated partial thromboplastin time to achieve a target level of 120 s during her fifth pregnancy. A healthy baby weighing 1818 g at birth was delivered by Cesarean section at the 34th week of pregnancy. High‐dose UFH infusion may be considered to be one of the preferable options to manage pregnant patients with refractory APS.     

Effects of Serum to Cushion Mesenchymal Cell Migration of the Developing Chick Heart in Vitro

Summary Migration of cardiac mesenchymal cells of chick embryos was examined in vitro . The conotruncal cushion and atrioventricular cushion cells of 6-day-old chick embryos were cultured on collagen gel in Dulbecco's modified Eagle's medium with chicken serum of calf serum, or no serum. After 48 hr of incubation, the culture was fixed with 4% formaldehyde, and photographed. The migration area of mesenchymal cells spread from the transplanted tissue was measured by digitizing the photographs. Then, the migration distance of mesenchymal cells was computed from the area with a personal computer.
Mesenchymal cells cultured with chicken serum migrated a significantly longer distance than those with calf serum or no serum. Under the designed conditions, the migration distance of the mesenchymal cells of the conotruncal cushion was longer than that of the atrioventricular cushion.
These results show that certain factor(s) in serum stimulates migration activity of cardiac mesenchymal cells, but the mammalian factor(s) is not cross-reactive to cardiac mesenchymal cells of birds. Different effects of the serum from different species on the migration activity of chick cardiac mesenchymal cells were shown in the present results. At the same time, it was revealed that migration activity of mesenchymal cells of the conotruncal cushion is different from that of the atrioventricular cushion.     

Water fluoridation in 40 Brazilian cities: 7 year analysis

Objectives:

Fluoride levels in the public water supplies of 40 Brazilian cities were analyzed and classified on the basis of risk/benefit balance.

Material and Methods:

Samples were collected monthly over a seven-year period from three sites for each water supply source. The samples were analyzed in duplicate in the laboratory of the Center for Research in Public Health - UNESP using an ion analyzer coupled to a fluoride-specific electrode.

Results:

A total of 19,533 samples were analyzed, of which 18,847 were artificially fluoridated and 686 were not artificially fluoridated. In samples from cities performing water fluoridation, 51.57% (n=9,720) had fluoride levels in the range of 0.55 to 0.84 mg F/L; 30.53% (n=5,754) were below 0.55 mg F/L and 17.90% (n=3,373) were above 0.84 mg F/L (maximum concentration=6.96 mg F/L). Most of the cities performing fluoridation that had a majority of samples with fluoride levels above the recommended parameter had deep wells and more than one source of water supply. There was some variability in the fluoride levels of samples from the same site and between collection sites in the same city.

Conclusions:

The majority of samples from cities performing fluoridation had fluoride levels within the range that provides the best combination of risks and benefits, minimizing the risk of dental fluorosis while preventing dental caries. The conduction of studies about water distribution systems is suggested in cities with high natural fluoride concentrations in order to optimize the use of natural fluoride for fluoridation costs and avoid the risk of dental fluorosis.     

Effects of Bis-diamine to Cardiac Mesenchymal Cell Migration of the Chick Embryo

Summary Bis-diamine is a teratogen which induces conotruncal anomalies in rats and chicks. Bis-diamine induces endocardial cushion defects in rats but it does not induce in chicks. In the present study, we examined effects of bis-diamine to chick embryonic cardiac mesenchymal cells. Chick embryos of 3 days incubation (E3, H. H. stage 17–28) were treated with 100 μg of bis-diamine dissolved in 50 μl dimethylsulfoxide. The conotruncal and atrioventricular cushions of the E6 embryos treated with bis-diamine were cultured with chicken serum. After 48 h of incubation, the culture was fixed with 4% formaldehyde. The area of grown out mesenchymal cells from the transplanted tissue was measured, and then the migration distance of mesenchymal cells was computed from the area.
In the group treated with bis-diamine, the migration distance of conotruncal cushion mesenchymal cells was significantly shorter than that of controls. However, the migration distance of atrioventricular cushion mesenchymal cells was not diminished. By scanning electron microscopy, the superior endocardial cushion of E4.5 or E5 embryos treated with bis-diamine was slightly hypoplastic compared with the inferior endocardial cushion. In spite of hypoplasia of the superior and inferior endocardial cushions, these cushions fused in E6 embryos treated with bis-diamine.
These results have shown that bis-diamine affects migration activity of conotruncal cushion mesenchymal cells but it does not severely affect that of the atrioventricular cushion in chicks. This portionally different effect of bis-diamine can explain that bis-diamine does not frequently induce endocardial cushion defects in chicks.     

Ultrastructure of the Adenohypophysis in a Case of Cyclopia

The adenohypophysis of a newborn with cyclopia was examined by electron microscopy. The hypophysis was normal in size and shape in the present case. Electron microscopy, however, showed degenerating cells in the adenohypophysis. These cells had small number of granules and cytoplasmic organelles, and the concentric membranous structure, but were not considered as necrotic cells. These findings may indicate overproduction of hormones by the damage of the negative feedback system. No remarkable change, however, was observed in the endocrine organs by light microscopy. Thus, the possible disorder of the hormone production might not be severe enough to cause abnormal formation of the endocrine system in the present case.     

Analysis of Atrioventricular Nodal Reentrant Tachycardia with Variable Ventriculoatrial Block: Characteristics of the Upper Common Pathway

Background: The precise nature of the upper turnaround part of atrioventricular nodal reentrant tachycardia (AVNRT) is not entirely understood.
Methods: In nine patients with AVNRT accompanied by variable ventriculoatrial (VA) conduction block, we examined the electrophysiologic characteristics of its upper common pathway.
Results: Tachycardia was induced by atrial burst and/or extrastimulus followed by atrial-His jump, and the earliest atrial electrogram was observed at the His bundle site in all patients. Twelve incidents of VA block: Wenckebach VA block (n = 7), 2:1 VA block (n = 4), and intermittent (n = 1) were observed. In two of seven Wenckebach VA block, the retrograde earliest atrial activation site shifted from the His bundle site to coronary sinus ostium just before VA block. Prolongation of His-His interval occurred during VA block in 11 of 12 incidents. After isoproterenol administration, 1:1 VA conduction resumed in all patients. Catheter ablation at the right inferoparaseptum eliminated antegrade slow pathway conduction and rendered AVNRT noninducible in all patients.
Conclusion: Selective elimination of the slow pathway conduction at the inferoparaseptal right atrium may suggest that the subatrial tissue linking the retrograde fast and antegrade slow pathways forms the upper common pathway in AVNRT with VA block.