Changes in En(a-) human red blood cell membranes during in vivo ageing.

The human red blood cells with phenotype En(a-) were characterized by the lack of MN antigens. The red blood cells with phenotype En(a-) which were found in a Japanese family were tested to clarify the changes in membrane surfaces of the red blood cells during in vivo ageing. The contents of sialic acid, glucose, mannose, galactose, fucose, N-acetylglucosamine and N-acetylgalactosamine of the red blood cell membranes obtained from the old red blood cells with phenotype En(a-) were significantly lower than those of the young red blood cell membranes. Neither the young nor the old red blood cells with phenotype En(a-) showed the agglutination with Arachis hypogaea (PNA) which was capable of binding to T agglutinogen. It is presumed that En(a-) red blood cells are not exposed to sialidase in vivo. In comparison with the young En(a-) red blood cell membranes, the number and the distribution density of lectin receptor sites on the old ones for Limulus polyphemus (LPA), Canavalia ensiformis (Con A), Triticum vulgaris (WGA) and Bauhinia purpurea (BPA) were significantly lower. It is thought that En(a-) red blood cell ageing is accompanied by elimination of some sialoglycoconjugates which have affinity for LPA, Con A, WGA and BPA, whereas En(a-) red blood cells lack glycophorin A.

Suppressed antidonor MLC responses in renal transplant candidates conditioned with donor-specific transfusions that carry the recipient's noninherited maternal HLA haplotype.

Forty-seven patients with end-stage renal disease were entered into a donor-specific transfusion protocol consisting of three infusions of whole blood every two weeks prior to transplantation. Fourteen of the patients became sensitized following transfusion and were not transplanted. Thirty-one patients received a transplant from the DST donor and have an estimated two-year graft survival of 97%, three-year survival of 88%, and four-year survival of 69%. Cells of eleven of the 36 recipients tested in one-way MLC before and two weeks after completion of DST exhibited a significantly decreased antidonor MLC response. Deletion of CD8+ positive lymphocytes from suppressed MLCs resulted in restoration of antidonor MLC reactivity in four of six patients. An analysis of the family HLA profile in patients exhibiting a decreased donor-directed MLC response revealed a significant (P less than 0.02) association between decreased MLC reactivity following DST and the expression of noninherited maternal HLA antigens by cells of the transfusion donor. These alterations in cellular immune responses noted in some patients following DST are consistent with the appearance of specific antidonor T suppressor cells as a result of donor-specific transfusion.

Number and distribution density of ABH and MN antigen sites on young and old human erythrocyte surfaces.

There were no differences in the number of A and M antigen sites between young and old human erythrocyte surfaces. No essential differences in the number of A1, N and Vicia graminea N antigen sites could be observed between young and old erythrocytes. The number of B and H antigen sites on cell surface was significantly higher in young erythrocytes than in old ones. The distribution density of A and M antigen sites on young erythrocyte was remarkably higher than that on old ones. Compared with young erythrocytes, significant increases in the distribution density of A1, B, H, N and Vicia graminea N antigen sites were observed in aged erythrocytes. It is suggested from these and other observations that human erythrocyte aging is accompanied by elimination of a small amount of B and H antigens from cell membranes, while A, A1, M, N and Vicia graminea N antigens are not released from cell membranes during in vivo aging.

Determination of ester-type local anesthetic drugs (procaine, tetracaine, and T-caine) in human serum by wide-bore capillary gas chromatography with nitrogen-phosphorus detection.

A sensitive method for simultaneous determination of ester-type local anesthetic drugs (procaine, tetracaine, and T-caine) has been developed using wide-bore capillary gas chromatography with nitrogen-phosphorus detection (GC-NPD). The extraction procedure, the experimental conditions for heptafluorobutyryl (HFB) derivative formation, and the percentage of the ester-type local anesthetic drugs from the human serum are described. The HFB derivatives of ester-type local anesthetic drugs showed sensitivity of approximately 2-3 fold higher than that without derivatization. The detection limits of HFB derivatives of the ester-type local anesthetic drugs were approximately 60-70 pg on column. Recoveries from the human serum were 85-94%. This method could be used to determine concentrations as low as 24-28 ng/mliters of the ester-type local anesthetic drugs.

A case of homicidal choking mistaken for suicide.

This report presents an autopsy case of the homicidal choking of an adult, who died as a result of tissue paper being thrust into his mouth. An in-patient (a 29-year-old Japanese man) at a mental hospital was choked to death by another male in-patient, his roommate, who thrust a large amount of tissue paper into his mouth after rendering him slightly unconscious by cervical compression. At the time of discovery, this mental patient was believed to have committed suicide by inserting tissue paper into his own mouth. Autopsy findings and re-investigation of the case revealed that the subject had been murdered. This is a very rare case of choking used as a method of homicide.

Coronary aneurysms in a young adult: report of a case suspected of Kawasaki disease.

An autopsy case of coronary aneurysm was reported. The patient, a 23-year-old Japanese man, suddenly fell unconscious during a karate match and died an hour later. The autopsy revealed coronary aneurysms, one of which was accompanied by thrombosis. Histologically, the aneurysmal walls showed marked scar formation and intimal thickening and the state was regarded as healed arteritis. By taking a precise history from his parents, Kawasaki disease was thought to be the probable cause of the coronary aneurysms.

[Some chemical and serological properties of non-dialysable fractions of human seminal plasmas].

Some chemical and serological properties of water-soluble and undialysable fraction (WSF) and water-insoluble and undialysable fraction (WISF) of human seminal plasmas were studied. Both of the fractions contained proteins as the main components and also carbohydrates as minor components, and each fraction gave 9 bands which were stained with the Periodate-Schiff and/or Coomassie brilliant blue reagents on sodium dodecyl sulfate-polyacrylamide slub gel electrophoresis. WSF reacted with 17 of 19 hemagglutinins, whereas WISF reacted with 12 of them. Although WSF and WISF did not react with anti-M and -N sera respectively, both of the fractions reacted with the anti-N lectins of Vicia graminea and V. unijuga and also with Arachis hypogaea anti-T (Thomsen-Friedenreich) lectin. Perchloric acid-soluble fractions separated from a large number of human intact organ tissues and serum did not react with the above-mentioned 5 hemagglutinins. In double immuno-diffusion, both of the fractions interacted with rabbit anti-WSF serum to form 4 precipitation lines.

[Problems of the medicolegal system for unnatural or unexpected deaths in Japan].

Each area in Japan has its own system for postmortem examination of unnatural death or sudden unexpected death. Large cities like Tokyo, Yokohama, Osaka and Kobe have the medical examiner system. In the areas autopsies are performed for the unknown cause of death and for other reasons. Kyoto and Nagoya used to have the system but it was repealed in 1985. In the most part of Japan, the areas without the system, the causes of death are estimated by external examination without autopsy. Medical Examiner's Office, Tokyo Metropolitan Government, examines approximately 7,000 corpses for a year. This number accounts for 15% of total number of death in the area concerned. The author has been a medical examiner since 1969. He has examined 6,084 corpses for 21 years. The 38.4% out of his cases were autopsied. The causes of death suspected at the external medicolegal examinations and the causes determined by autopsies were compared. Not a few diagnoses had serious errors: some extrinsic death was primarily diagnosed as intrinsic diseases, and vice versa. In conclusion, the proportion of cases with serious errors was 15.5% of the total cases of his external examinations. It is extremely difficult to determine the cause of unnatural or unexpected death without autopsy. An error in the postmortem examination infringes on the right of the deceased and his or her family. It still exert a baneful influence upon the public health, social security, life insurance and other related matters. The author insists on the need for medical examiner system all over Japan. This is already asserted by Prof. Kuniyoshi Katayama in 1889. However, it was not until 1946 that the system was applied only to above mentioned areas, and no more than that still now.

A case of suicide by drowning with hesitation marks on the back.

A case of a 78-year-old woman suspected of committing suicide is reported; an analysis of the evidence suggesting that she threw herself into the river after stabbing and cutting her neck, left forearm, abdomen and back. Hesitation marks on the back are relatively rare in cases of suicide. We discuss the manner of death and assume the mode in which her injuries were inflicted.

Serological and biochemical studies on En(a-) human erythrocytes in a Japanese family.

The propositus erythrocytes with phenotype En(a-), which was found in the first example of a Japanese family, reacted with anti-N serum weaker than the ordinary phenotype N erythrocytes. When the erythrocyte membranes of the propositus were subjected to SDS-PAGE, no glycophorin A was observed on the gel by PAS staining, whereas glycophorin B band was observed. The S and the s antigens of the propositus erythrocytes were appeared to be normal. These results suggested that N activity of the propositus erythrocytes may be derived from glycophorin B components on the erythrocyte membranes. The amounts of bound sialic acid of the erythrocyte membranes were significantly lower in the En(a-) erythrocytes than the ordinary OMN erythrocytes. Neither the OMN nor the En(a-) erythrocytes showed the agglutinability to Arachis hypogaea lectin. The number of lectin receptor sites on the En(a-) erythrocyte membranes was significantly lower than on the OMN erythrocyte membranes for Limulus polyphemus, Triticum vurgaris and Bauhinia purpurea lectins. These results provide further support for the contention that En(a-) cells lack the glycophorin A as major erythrocytes sialoglycoprotein on the membranes.

Suicide by self-stabbing in the city of Tokyo--a review of accumulated data from 1976 to 1995.

Accumulated data of suicide by self-stabbing in the city of Tokyo (population: approx. 8.1 million. 1994) between 1976 and 1995 was reviewed. The overall numbers of suicides for each year were similar (min.: 1178, max.: 1620, 1346.9 on average), while the annual number of unusual death cases increased gradually (5399 in 1976 to 9226 in 1995). The annual number of suicides by self-stabbing fluctuated irregularly, but was generally low (2.3-4.7%) among modes of suicide. A significant difference was observed between the sex ratio in suicidal self-stabbing and that for all suicide; the male/female ratio is higher in suicidal self-stabbing than in suicides overall. The majority of fatally wounded body sites were in the neck, chest, abdomen, wrists and forearms. Marked differences according to sex were observed in terms of the implements employed for self-stabbing; craft knives, swords and recreational knives, fragments of glass, carpenter's tools and surgical knives were used almost exclusively by men, while more than 80% of women used kitchen knives or razors. No influence of psychiatric history on suicide by self-stabbing was proved.

[Reconsideration of organ weight in Japanese (1). Heart].

The heart weight measured at medicolegal autopsies in these days are usually heavier than the data of the mean value of Japanese in textbooks and papers which were surveyed around the Second World War. As it was supposed that some improvement of the nutrition and physique since the end of the war should make the heart weight heavier, the value on 1,399 cases of medicolegal autopsy was measured and analyzed. The results revealed that the heart weight in the late of teens reaches the old value of grown-ups and the mean values of men (360 g) and women (300 g) earned by the present study are far more than those described in the former reports. It was presumed that periodic researches for the standard heart weight are indispensable in the consequence of the present study.

A large-scale study of bacterial contamination of drinking water and its public health impact in Nepal.

Bacterial contamination of drinking water is a major public health in Nepal. A large scale study on contamination of drinking water was done covering all three ecological belts (mountain, hill and Terai) in all five (eastern, central, western, mid-western and far-western) development regions of Nepal during 2009-2011. Of the total 506 water samples studied, one-forth (25.1%; 127/506) were visually turbid. Bacteriologically, 88.5% (448/506) samples were positive for total coliform (TC) whereas 56.5% (286/506) were positive for fecal coliform (FC) (Esch. coli). The TC positive rate ranged from 53.8% in Damak (Jhapa) to 100.0% in different districts. The FC positive rate varied more widely ranging from 10.0% in Bharatpur City (Chitawan) to 100.0% in Baglung Township (Baglung) with over 50.0% in most of the districts (over 75.0% in eight districts). Both TC and FC positive rate were highest in Far-western Development Region (DR). High TC positive rate (96.7%) in Far-western DR was followed by Western DR (93.9%), Eastern DR (89.2%), Central DR (87.0%) and Mid-western DR (74.6%). Highest FC positive rate (65.5%) in Far-western DR was followed by Med-western DR (63.5%), Western DR (55.9%), Central DR (53.2%) and Eastern DR (52.0%). TC positive was highest (90.7%) in hills followed by mountain (89.7%) and Terai (plain) (84.1%) belt. In contrast, FC positive rate was highest (66.2%) in mountain, followed by hills (58.0%) and Terai (49.7%). Of the total 506, 335 were piped tap water, 129 were boring water, 16 natural tap (spout), 16 were well (sallow/deep well) and 10 were mineral/uroguard treated water. TC positive rate was very high (81.2% to 100.0%) in different type water samples (piped tap: 90.1%; boring water: 85.2%; natural spout/tap: 81.2%; well water 100.0% and mineral water/uroguard treated water: 80.0%). FC positive rate ranged from 0.0% in mineral water/uroguard treated water to 93.7% in well water samples. These findings are of serious public health concern with regard to both endemicity and outbreak of waterborne diseases in the country.