[Multiple myeloma with numb chin syndrome as the initial manifestation].

The numb chin syndrome (NCS) is characterized by chin or lower lip numbness restricted to the distribution of the mental nerve (the distal trigeminal nerve). A case of multiple myeloma with polycythemia vera was diagnosed with NCS as the initial manifestation. A 73-year-old Japanese male was admitted to our hospital in April, 1993, because of paresthesia around the chin and lower lip. X-ray film showed multiple osteolytic lesions. According to serum and urine immunoelectrophoresis, lambda type Bence Jones protein was demonstrated. The bone marrow aspiration showed the normocellular marrow with 14.1% myeloma cells. He was diagnosed a suffering from multiple myeloma and was treated with melphalan and prednisolone. He is alive at present with resolution of NCS. We discussed pathogenesis, diagnosis, and treatment of NCS.

A phosphatidylinositol kinase in rat mast cell granules.

Intact granules were isolated from sonicated purified rat serosal mast cells on a Percoll gradient. The granules were shown to contain a highly active phosphatidylinositol kinase that catalyzes the formation of diphosphoinositide from endogenous phosphatidylinositol in the granule membrane. The enzyme requires ATP and Mg2+ or Mn2+ for activity; Ca2+, fluoride and cyclic AMP are inhibitory. The Km for ATP is 25 microM. The initial reaction is rapid, but the response ceases within a few minutes. A comparison of the rate of phosphorylation of intact and broken membrane granules suggests that the phosphorylation occurs on the outer (cytoplasmic) surface of the granules.

Helicobacter pylori infection among Japanese children.

BACKGROUND: In Japan, there are few reports describing Helicobacter pylori infection among young children. The aim of the present study was to identify risk factors associated with H. pylori in school-aged children. METHODS: Subjects were first-grade students of three elementary schools (n = 310) and second-grade students of a junior high school (n = 300). Personal information, such as student's medical history, parent's history, family size, sibshipsize and household pets, was collected from guardians using a questionnaire. Saliva samples and personal information were collected twice (1995 and 1996). By using the saliva samples, H. pylori IgG antibody was measured using a commercial kit. To analyze the risk factors for H. pylori infection, sex- and age-adjusted odds ratios (OR) were calculated using a multiple logistic model. RESULTS: Among the children, factors related to Helicobacter antibody in saliva included spending a longer period of time in a nursery school or kindergarten (OR = 4.0) and a maternal history of stomach disease (OR = 2.8). Birth order (OR = 2.2), sleeping situation (OR = 2.3) and sibshipsize (OR = 1.6) were not factors that were significantly related to Helicobacter antibody in the saliva. Chewing food for the infant, family size, rooms in the household, sharing a bedroom during childhood, pets, a past history and a paternal history were not related to positivity. CONCLUSIONS: The results indicate that transmission is person-to-person, mainly through close contact with other children and intrafamilial infection. Helicobacter pylori infection seems to occur frequently early in life, probably before 6 years of age.

Immune tolerance induced by polyethylene glycol-conjugate of protein antigen: clonal deletion of antigen-specific Th-cells in the thymus.

Polyethylene glycol (PEG) conjugates of protein antigens induce antigen-specific immune tolerance of helper T (Th)-cells. However, the mechanism of this Th-cell tolerance has remained unelucidated. Using transgenic mice with ovalbumin (OVA)-specific T-cell receptor (TCR) genes, we examined the response of OVA-specific Th-cells towards tolerogenic PEG-conjugate of OVA in vitro and in vivo. When stimulated with PEG--OVA in vitro, transgenic OVA-specific Th-cells proliferated and produced interleukin 2, the levels of which were comparable to those induced by unmodified OVA. In contrast, PEG--OVA administered into the circulation of transgenic mice induced unresponsiveness in peripheral OVA-specific Th-cells. Moreover, in the thymus of these transgenic mice, the frequency of immature CD4+CD8+ (double positive) thymocytes was reduced. A similar phenomenon was not observed in transgenic mice treated with unmodified OVA. As autoreactive T-cells are known to be clonally deleted at the immature double positive stage in the thymus. Th-cell tolerance induced by PEG--protein antigens is at least in part mediated by central tolerance in the thymus, and is likely caused by the markedly enhanced stability of PEG--protein conjugates in the circulatory system.