Inactivation of the gene for anticoagulant protein C causes lethal perinatal consumptive coagulopathy in mice

Matings of mice heterozygous for a protein C (PC) deficient allele, produced by targeted PC gene inactivation, yielded the expected Mendelian distribution of PC genotypes. Pups with a total deficiency of PC (PC-/-), obtained at embryonic day (E) 17.5 and at birth, appeared to develop normally macroscopically, but possessed obvious signs of bleeding and thrombosis and did not survive beyond 24 h after delivery. Microscopic examination of tissues and blood vessels of E17.5 PC-/- mice revealed their normal development, but scattered microvascular thrombosis in the brain combined with focal necrosis in the liver was observed. In addition, bleeding was noted in the brain near sites of fibrin deposition. The severity of these pathologies was exaggerated in PC-/- neonates. Plasma clottable fibrinogen was not detectable in coagulation assays in PC-/- neonatal mice, suggestive of fibrinogen depletion and secondary consumptive coagulopathy. Thus, while total PC deficiency did not affect the anatomic development of the embryo, severe perinatal consumptive coagulopathy occurred in the brain and liver of PC-/- mice, suggesting that a total PC deficiency is inconsistent with short-term survival.     

Imaging of closed head injury

The endocrinology of late gestation and parturition in the mare has been described, but unlike other domestic animal species, the factors that initiate parturition in the mare have not been elucidated. In contrast to ruminant species, maternal estrogen and progesterone concentrations do not change markedly, and a well-defined fetal cortisol surge is not observed just prior to parturition in the mare. Parturition is associated with large increases in prostaglandin and oxytocin concentrations, which induce uterine contractions and delivery of the foal. There are many methods of inducing parturition in term mares, but the most popular and safest method is through the administration of low-dose oxytocin.     

Prevalence of impairments 5 years after a head injury, and their relationship with disabilities and outcome

To determine what consequences cognitive, behavioural or somatic impairments had on disabilities and recovery after a head injury (HI), a population-based sample of 231 adult patients was studied 5 years after an HI. Eighty lower-limb-injured (LLI) patients were considered as controls. Sixty-four LLI and 176 HI patients were reviewed (114 minor, 35 moderate, and 27 severe HI). Prevalence values of headaches (44-54%), dizziness (26-37%), and anxiety (47-63%) were not significantly different in the three HI severity groups, but were significantly lower in patients with an isolated limb injury (12-15%). Memory problems and depressive mood increased with injury severity. Mental impairments were frequent in severe HI patients (18-40% of patients). In minor and moderate HI patients, most disabilities were related to associated injuries. According to the Glasgow Outcome Scale (GOS), recovery was not considered as good because of somatic, behavioural or cognitive complaints in 2.5%, 5.7% and 59.2% of surviving patients in each of the above HI groups. Somatic or behavioural complaints may have considerable consequences in some minor HI patients, and the long-term management of certain patients needs improvement because these impairments are misunderstood.     

Transmission of Leptospira interrogans serovar Balcanica infection among socially housed brushtail possums in New Zealand

We report a rare case of Erdheim-Chester disease (ECD) presenting as a progressive cerebellar syndrome and diabetes insipidus. On magnetic resonance imaging, a 7-mm extraaxial, enhancing mass was seen enveloping the right vertebral artery and was confirmed at autopsy to represent an adventitial xanthoma with lipid-laden, foamy histiocytes. The cerebellar syndrome most likely resulted from extensive histiocytic infiltration of the pons, particularly the basis pontis and middle cerebellar peduncles.     

Response of lymphoepithelial parotid cysts to antiretroviral treatment in HIV-infected adults

Authors have presented results of vibratory stimulation in 20 anejaculatory spinal cord injury men. In 17 of 20 patients who had not ejaculated since their injuries, application of a vibrator to the penis caused ejaculation. Three of them had retrograde ejaculation. All patients with upper thoracic lesions received nifedipin. Side effects of vibratory stimulation were not reported. Semen can be used for assisted reproductive techniques.     

Differential activation of T cells by natural antigen peptide analogues: influence on autoimmune and alloimmune in vivo T cell responses

Recent studies using synthetic altered peptide ligands (Analogues) have led to the fine dissection of TCR-mediated T cell functions elicited by Ag recognition. Certain Analogues behave as full agonists of the antigenic peptide while others are partial agonists in that they only trigger selected T cell functions. Additionally, peptide Analogues can behave as antagonists by inhibiting functions of T cell clones when coincubated with the wild-type peptide. In fetal thymic organ cultures, synthetic altered peptide ligands can impact T cell repertoire selection. However, the influence of naturally occurring peptide Analogues on T cell immunity in vivo remains hypothetical. We previously reported that, in B10.A mice, immunogenicity and tolerogenicity of the self-MHC class I peptide, Ld 61-80, were influenced by the presentation of a cross-reactive self-peptide, Kk 61-80. Here, we show that Kk 61-80 self-peptide represents a partial agonist of Ld 61-80 in that it induced the proliferation but not the lymphokine production of Ld 61-80-primed T cells. Next, we showed that presentation of Kk 61-80 Analogue peptide mediated T cell tolerance toward Ld 61-80 self-peptide. Alternatively, when Ld protein represented an alloantigen displayed on transplanted cells, immunization with Kk 61-80 Analogue sensitized recipient mice to Ld 61-80 peptide, thus inducing potent immune responses to donor cells. These results show that the presentation of natural Analogue peptides may represent an essential component of T cell responses involved in autoimmunity and transplant rejection.     

Chemical lumbar sympathectomy

The technique of injection and the results of a series of 124 chemical lumbar sympathectomies, performed on 97 patients, are described. Sixty-eight patients, over 60 years of age, had their sympathectomy because of peripheral arteriosclerotic disease. Fifty-two of these patients benefited in terms of pain relief and only one required amputation. Sixteen patients, under 60 years of age, had their sympathectomy because of peripheral arteriosclerotic disease. Ten of these patients benefited but it is recommended that, where possible, other methods of treatment should be used in this younger age group. Thirteen patients, mostly elderly, had their sympathectomy because of diabetic ischaemic disease. Six only of these patients benefited, but it is felt that chemical sympathectomy can be recommended as a way of helping some of these patients who would otherwise have amputation.     

Designing a mental health center to replace a county hospital

An architectural team worked closely with a county building committee and the administrative staff of a Wisconsin county hospital to design a new active-treatment facility. The goals included changing the hospital's negative image in the community, fostering a close relationship between all programs and all groups of users, and encouraging inpatients to make the best possible use of various treatment areas. Planning was interrupted by a community-wide controversy over the location, and the facility was eventually built on a compromise site. The new facility, a community mental health center serving two counties, has an open, split-level design accommodating six inpatient programs and a day hospital. An informal evaluation of the environment was made a year after the center was occupied.