Thromboangiitis obliterans (Buerger's disease) in a saphenous vein arterial graft

Thromboangiitis obliterans (Buerger's disease) is an uncommon variety of occlusive peripheral vascular disease, occurring predominantly in young male tobacco smokers. The vascular lesion in the acute stage of thromboangiitis obliterans is distinctive and affects both the arteries and veins. Described here is an unusual case of thromboangiitis obliterans occurring in a saphenous vein used for coronary artery bypass graft in a middle-aged man who, against advice, had continued to smoke after the myocardial revascularization surgery. To the author's knowledge, thromboangiitis obliterans in arterial vein graft has not been reported previously.     

Identification and distribution ofEchinostoma lindoense,E. audyi andE. revolutum (Trematoda; Echinostomatidae)

The closely relatedEchinostoma lindoense, E. audyi andE. revolutum can be differentiated by morphological characteristics of their adults and cercariae. We have foundE. lindoense andE. audyi in Southeast and Southwest Asia and Central Europe and the former species also in South America. However, using the morphological characteristics described by Beaver (1937) forE. revolutum which is assumed to be cosmopolitan, we did not find this species in these regions.     

Genotype effects and epistasis in type 1 diabetes and HLA-DQ trans dimer associations with disease

Alleles of HLA class II genes DQB1, DQA1, and DRB1 in the MHC region are major determinants of genetic predisposition to type 1 diabetes (T1D). Several alleles of each of these three loci are associated with susceptibility or protection from disease. In addition, relative risks for some DR-DQ genotypes are not simply the sum or product of the single haplotype relative risks. For example, the risk of the DRB1*03-DQB1*02/DRB1*0401-DQB1*0302 genotype is often found to be higher than for the individual DRB1*03-DQB1*02 and DRB1*0401-DQB1*0302 homozygous genotypes. It has been hypothesized that this synergy or epistasis occurs through formation of highly susceptible trans-encoded HLA-DQ(alpha 1, beta 1) heterodimers. Here, we evaluated this hypothesis by estimating the disease associations of the range of DR-DQ genotypes and their inferred dimers in a large collection of nuclear families. We determined whether the risk of haplotypes in DRB1*0401-DQB1*0302-positive genotypes relative to the DRB1*03-DQB1*02-positive genotypes is different from that of DRB1*01-DQB1*0501, which we used as a baseline reference. Several haplotypes showed a different risk compared to DRB1*01-DQB1*0501, which correlated with their ability to form certain trans-encoded DQ dimers. This result provides new evidence for the potential importance of trans-encoded HLA DQ molecules in the determination of HLA-associated risk in T1D.     

Haplotype structure,LD blocks,and uneven recombination within the LRP5 gene

Patterns of linkage disequilibrium (LD) in the human genome are beginning to be characterized, with a paucity of haplotype diversity in "LD blocks," interspersed by apparent "hot spots" of recombination. Previously, we cloned and physically characterized the low-density lipoprotein-receptor-related protein 5 (LRP5) gene. Here, we have extensively analysed both LRP5 and its flanking three genes, spanning 269 kb, for single nucleotide polymorphisms (SNPs), and we present a comprehensive SNP map comprising 95 polymorphisms. Analysis revealed high levels of recombination across LRP5, including a hot-spot region from intron 1 to intron 7 of LRP5, where there are 109 recombinants/Mb (4882 meioses), in contrast to flanking regions of 14.6 recombinants/Mb. This region of high recombination could be delineated into three to four hot spots, one within a 601-bp interval. For LRP5, three haplotype blocks were identified, flanked by the hot spots. Each LD block comprised over 80% common haplotypes, concurring with a previous study of 14 genes that showed that common haplotypes account for at least 80% of all haplotypes. The identification of hot spots in between these LD blocks provides additional evidence that LD blocks are separated by areas of higher recombination.     

Physical separation of HLA-A alleles by denaturing high-performance liquid chromatography

Genomic typing of polymorphic loci may be hampered by ambiguous typing results. Moreover, robust methods for simultaneous sequencing of two alleles present in a given sample may be difficult to establish. We used denaturing high-performance liquid chromatography (DHPLC) for physical separation of HLA-A alleles before sequence-based genomic typing (SBT). Physical separation was achieved by resolution of heteroduplexes between the sample alleles and a modified reference probe by DHPLC followed by selective reamplification of the sample alleles present in heteroduplexes. Complementary strands of the reference probe and sample alleles for heteroduplex induction were obtained by lambda-exonuclease digestion. HLA-A genotyping of 101 individuals using DHPLC-SBT yielded better typing resolution compared with serological typing and genotyping by the sequence-specific primer-polymerase chain reaction (SSP-PCR) method. Physical separation of alleles using a modified reference probe allows for development of fully automated methods for genomic typing of highly polymorphic loci such as HLA.     

Genetic analysis of the CD28/CTLA4/ICOS (CELIAC3) region in coeliac disease

Abstract:  In order to extend our previous findings of genetic linkage to the CD28/CTLA4/ICOS region on chromosome 2q33 ( CELIAC3 ) in coeliac disease (CD), we have investigated 22 genetic markers in 325 Norwegian/Swedish multiplex and simplex CD families. We found both linkage and association with several markers, primarily in the multiplex material. We observed strong linkage disequilibrium (LD) between SNPs (Single Nucleotide Polymorphisms) within an LD block delimited by MH30 and D2S72. A haplotype of this region marked by the alleles −1147*T: + 49*A:CT60*G:CT61*A was significantly associated with CD, suggesting that one or more polymorphisms of this haplotype, possibly −1147*T, are involved in CD susceptibility. The CT60 SNP, a polymorphism found to be most strongly associated with some other immune-mediated diseases, was not associated with CD, as this SNP was part of both associated and non-associated haplotypes. Moreover, our results suggest that CELIAC3 harbours several independent loci contributing to CD susceptibility.     

Polymorphisms in the gene encoding thymus-specific serine protease in the extended HLA complex: a potential candidate gene for autoimmune and HLA-associated diseases

Positive selection plays a role, together with negative selection, in the prevention of autoimmunity. Thymus-specific serine protease is highly expressed in the thymus and is believed to be involved in positive selection of T cells. The gene encoding thymus-specific serine protease (PRSS16) maps to the extended HLA complex, which harbours several genes predisposing for autoimmune diseases. Here we report the results of scanning the genetic region containing PRSS16 for polymorphisms. Twenty-two polymorphisms were identified, including one missense polymorphism, one deletion leading to elimination of five amino acids, as well as several SNPs in the promoter region.     

Isolated polyarteritis of testis in hairy-cell leukemia

A polyarteritis nodosalike systemic vasculitis in hairy-cell leukemia was first reported in 1979, and since then at least 30 additional cases of this unusual association have been reported in the literature. Reported herein is, to my knowledge, the first known example of hairy-cell leukemia with necrotizing vasculitis limited to the testis only.     

Effect of cyanide on renal metabolic rate and glomerulotubular balance.

Measurements of anesthetized dogs by the heat-accumulation technique showed that cyanide reduced equally the metabolic rates of outer medulla and cortex, whereas combined infusion of ethacrynic acid and chlorothiazide reduced mainly the metabolic rate of the outer medulla. During ethacrynic acid and chlorothiazide infusion, cyanide reduced the remaining sodium reabsorption by an average of 19% and the remaining cortical metabolic rate by 43%, but had no additional effect on the outer medullary metabolism. Metabolic rates remained essentially constant when glomerular filtration rate (GFR) was raised during cyanide infusion from 63 plus or minus 3 to 135 plus or minus 7% of control by carotid constriction or intravenous infusion of angiotensin. Glomerulotubular balance, defined as proportional relationship between sodium reabsorption and GFR during infusion of ethacrynic acid and chlorothiazide, was present only at GFR less than 80% of control in experiments with and without cyanide infusion. We conclude that cyanide inhibits proximal energy-requiring sodium transport which cannot be inhibited by ethacrynic acid and chlorothiazide, but does not alter the range of GFR over which glomerulotubular balance applies.