INTRA-AORTIC BALLOON RUPTURE CAUSING FEMORAL ENTRAPMENT

Rupture of an intra-aortic balloon counterpulsator (IABCP) demands immediate removal. We report a case of thrombus formation within a Datascope IABCP secondary to IABCP rupture, necessitating surgical exploration for removal. There is a disturbing pattern of balloon ruptures with this type of IABCP.     

PJA-BP expression and TCR delta deletion during human T cell differentiation

Recombination of deltaRec to psiJalpha will delete the TCR delta gene, which is thought to play an important role in the bifurcation of the TCR alphabeta versus TCR gammadelta differentiation lineages. We recently detected a DNA-binding protein in human thymocytes, the so- called PJA-BP, which recognizes the psiJalpha gene segment and might be one of the factors involved in the regulation of preferential deltaRec- psiJalpha rearrangements. We now investigate PJA-BP expression and its correlation with TCR delta gene deletion in thymocytes. Our electrophoretic mobility shift assay experiments showed that the PJA-BP is evolutionary conserved in human, murine and simian thymocytes. Using a large series of human hematopoietic malignancies (n = 30), we conclude that PJA-BP expression is thymocyte specific and seems to be restricted to thymocytes committed to the TCR alphabeta lineage. Analysis of seven well-defined human thymocyte subpopulations showed that preferential deltaRec-psiJalpha rearrangements as well as PJA-BP expression can be detected from the immature CD34-/CD1+/CD3- /CD4+/CD8alpha+beta- thymocyte differentiation stage onwards. These experiments indicate that expression of PJA-BP in human thymocytes starts simultaneously with preferential deltaRec-psiJalpha rearrangements, which supports our hypothesis that PJA-BP is one of the factors involved in the preferential recombination of deltaRec to psiJalpha.      

Circulating antibodies to peripheral nerve in American trypanosomiasis (Chagas' disease).

An antibody reacting with Schwann sheaths of myelinated somatic and unmyelinated autonomic peripheral nerve was found in sixty-one out of seventy-one chronic, and nine out of ten acute, Chagas' disease sera. Indirect immunofluorescence (IFL) was carried out on rat, mouse and human somatic nerves and rat sympathetic nerves with initial serum dilutions of 1 : 10, and the staining reached a final titre of 1 : 320 in some cases. The antibodies fixed complement and were absorbed out by lyophilized epimastigotes of T. cruzi. Lipid extraction of the tissue sections enhanced the staining of myelinated nerve, whereas unfixed unmyelinated sympathetic nerve was strongly reactive. Central nervous tissue did not display any positive staining on neurons, glial cells or periaxonal sheaths. Furthermore, by using a double-labelled IFL technique, it was possible to show that a rabbit antiserum raised against guinea-pig spinal cord and the chagasic anti-nerve antibodies reacted with different structures in the rat sciatic nerve. These findings suggest that the reactive antigen(s) could be located on Schwann cells. The majority, but not all, of the chagasic individuals with anti-nerve antibodies also showed the sarcolemmal and endothelial staining (EVI) previously described in Chagas' disease. The possible recognition of Schwann cell antigens by circulating antibodies in Chagas' disease could be relevant, since an autonomic denervation has been postulated as a pathogenic mechanism of cardiomyopathy and megaviscera in this condition.     

Missense mutation in a von Willebrand factor type A domain of the alpha 3(VI) collagen gene (COL6A3) in a family with Bethlem myopathy

The Bethlem myopathy is a rare autosomal dominant proximal myopathy characterized by early childhood onset and joint contractures. Evidence for linkage and genetic heterogeneity has been established, with the majority of families linked to 21q22.3 and one large family linked to 2q37, implicating the three type VI collagen subunit genes, COL6A1 (chromosome 21), COL6A2 (chromosome 21) and COL6A3 (chromosome 2) as candidate genes. Mutations of the invariant glycine residues in the triple-helical domain-coding region of COL6A1 and COL6A2 have been reported previously in the chromosome 21-linked families. We report here the identification of a G-->A mutation in the N-terminal globular domain-coding region of COL6A3 in a large American pedigree (19 affected, 12 unaffected), leading to the substitution of glycine by glutamic acid in the N2 motif, which is homologous to the type A domains of the von Willebrand factor. This mutation segregated to all affected family members, to no unaffected family members, and was not identified in 338 unrelated Caucasian control chromosomes. Thus mutations in either the triple-helical domain or the globular domain of type VI collagen appear to cause Bethlem myopathy.