[Traumatic enucleation. Accident or self-mutilation?]. / Traumatische Enukleation. Unfall oder Selbstverletzung?

A 52-year-old woman was admitted for emergency treatment after traumatic enucleation. Because of the position of the avulsed eye and the acute mental condition of the patient a trauma caused by self-mutilation could not be excluded. There was even the suspicion of self-enucleation in a second case and in both cases a psychiatrist was consulted but ultimately a disastrous accident was clearly verified for both patients. Nevertheless, an interdisciplinary evaluation should be initiated in cases of patients with a suspicious traumatic injury as in cases of self-mutilation the danger of relapse is high in the first hours and weeks after the primary event.

Description of an ectothermic TCR coreceptor, CD8 alpha, in rainbow trout.

We have cloned the first CD8 alpha gene from an ectothermic source using a degenerate primer for Ig superfamily V domains. Similar to homologues in higher vertebrates, the rainbow trout CD8 alpha gene encodes a 204-aa mature protein composed of two extracellular domains including an Ig superfamily V domain and hinge region. Differing from mammalian CD8 alpha V domains, lower vertebrate (trout and chicken) sequences do not contain the extra cysteine residue (C strand) involved in the abnormal intrachain disulfide bridging within the CD8 alpha V domain of mice and rats. The trout membrane proximal hinge region contains the two essential cysteine residues involved in CD8 dimerization (alpha alpha or alpha beta) and threonine, serine, and proline residues which may be involved in multiple O-linked glycosylation events. Although the transmembrane region is well conserved in all CD8 alpha sequences analyzed to date, the putative trout cytoplasmic region differs and, in fact, lacks the consensus p56lck motif common to other CD8 alpha sequences. We then determined that the trout CD8 alpha genomic structure is similar to that of humans (six exons) but differs from that of mice (five exons). Additionally, Northern blotting and RT-PCR demonstrate that trout CD8 alpha is expressed at high levels within the thymus and at weaker levels in the spleen, kidney, intestine, and peripheral blood leukocytes. Finally, we show that trout CD8 alpha can be expressed on the surface of cells via transfection. Together, our results demonstrate that the basic structure and expression of CD8 alpha has been maintained for more than 400 million years of evolution.

Expression, linkage, and polymorphism of MHC-related genes in rainbow trout, Oncorhynchus mykiss.

The architecture of the MHC in teleost fish, which display a lack of linkage between class I and II genes, differs from all other vertebrates. Because rainbow trout have been examined for a variety of immunologically relevant genes, they present a good teleost model for examining both the expression and organization of MHC-related genes. Full-length cDNA and partial gDNA clones for proteasome delta, low molecular mass polypeptide (LMP) 2, TAP1, TAP2A, TAP2B, class Ia, and class IIB were isolated for this study. Aside from the expected polymorphisms associated with class I genes, LMP2 and TAP2 are polygenic. More specifically, we found a unique lineage of LMP2 (LMP2/delta) that shares identity to both LMP2 and delta but is expressed like the standard LMP2. Additionally, two very different TAP2 loci were found, one of which encodes polymorphic alleles. In general, the class I pathway genes are expressed in most tissues, with highest levels in lymphoid tissue. We then analyzed the basic genomic organization of the trout MHC in an isogenic backcross. The main class Ia region does not cosegregate with the class IIB locus, but LMP2, LMP2/delta, TAP1A, and TAP2B are linked to the class Ia locus. Interestingly, TAP2A (second TAP2 locus) is a unique lineage in sequence composition that appears not to be linked to this cluster or to class IIB. These results support and extend the recent findings of nonlinkage between class I and II in a different teleost order (cyprinids), suggesting that this unique arrangement is common to all teleosts.

Conservation of a master hematopoietic switch gene during vertebrate evolution: isolation and characterization of Ikaros from teleost and amphibian species.

The generation of T, B and NK lymphocyte lineages from pluripotent hematopoietic stem cells is dependent upon the early expression of the Ikaros locus which by means of alternative splicing produces a variety of zinc finger DNA binding transcription factors. We assessed the general biological importance of Ikaros by studying its conservation and expression in teleost fish and amphibians. Portions of Ikaros cDNA from rainbow trout and Xenopus were amplified by reverse transcription-polymerase chain reaction (RT-PCR). They show roughly 75% conservation of the amino acid sequence with mammalian Ikaros. The trout fragment was then used to isolate full-length Ikaros clones from a trout thymocyte cDNA library. In mice and humans, Ikaros produces six alternatively spliced isoforms, but in trout two additional novel splice variants designated Ik-7 and Ik-8 were also found. Ik-7 is expressed in a similar fashion to Ik-1 and Ik-2, the predominant isoforms expressed in mammalian lymphocytes. In trout and zebrafish, as in mammals, Ikaros is a single-copy gene, but in Xenopus segregation analysis demonstrates that Ikaros has been duplicated, most likely a result of polyploidization. We then examined the expression of Ikaros in trout and Xenopus tumor T cell lines via Northern blot, RT-PCR, immunofluorescence and Western blot analysis. Overall, Ikaros is expressed in a lymphoid-specific fashion similar to that found in mice and humans. In addition Ikaros is expressed early in trout ontogeny, beginning roughly at days 3-4 in the yolk sac and at day 5-6 in the embryo proper. The conservation of Ikaros structure and expression confirms it as a master switch of hematopoiesis.

Conservation of an alpha 2 domain within the teleostean world, MHC class I from the rainbow trout Oncorhynchus mykiss.

A full-length cDNA clone (Onmy-UA-C32) encoding a major histocompatibility complex (MHC) class I heavy chain was isolated from a rainbow trout thymus cDNA library. Onmy-UA-C32 alpha I and III extracellular domains were most similar to other salmonids (92 and 86% at the nucleotide and amino acid level) but interestingly the alpha II domain is closer to that of the carp (74 and 73%) and zebrafish (75 and 70%). In addition, Onmy-UA-C32 displays conservation of residues known to be essential for the function and structure of MHC class Ia molecules. Northern blot hybridization with alpha 2 or 2-3 domain probes of Onmy-UA-C32 detected high expression (2.6 kb) of this gene in the spleen, thymus, kidney, heart and intestine with lower levels being observed in the brain and liver. No tissues were found to be negative indicating a ubiquitous pattern of expression for Onmy-UA-C32. Onmy-UA-C32 may therefore represent a MHC class Ia gene in trout as well as providing new insights regarding the evolution of the MHC within teleost species.

[The behavior of C-reactive protein in tumor patients]. / Untersuchungen zum Verhalten des C-reaktiven Proteins bei Tumorpatienten.

Within a standardized therapy programme in 110 tumour patients the concentrations of CRP were investigated in order to allow an estimation of the prognostic value of this parameter. In the group of patients with a bad prognosis under clinical aspects the concentrations of CRP were clearly above the range of reference throughout the period of therapy, whereas the group with a good clinical prognosis showed a continuous falling of the concentrations.

[Possibilities of surgical therapy of metastatic melanoblastoma]. / Möglichkeiten der operativen Therapie des metastasierten Melanoblastoms.

Cryosurgery and large-size excision are therapeutic steps of good palliative effectiveness in the treatment of skinmetastasised melanoblastoma, provided that no visceral metastasation has taken place. Three cases are described with their histories.

[Biochemical and hematological parameters during extracorporeal heterologous perfusion with a porcine liver in acute liver failure]. / Biochemische und hämatologische Parameter während extrakorporaler heterologer Perfusion mit einer Schweineleber beim akuten Leberversagen.

The authors report on biochemical and hematologic investigations during 6 extracorporeal heterologous perfusions by means of porcine livers in 4 patients suffering from acute hepatic failure. The findings stress the functioning of porcine liver in the extracorporeal system. All livers produced bile with higher values of bilirubin and pH than found in serum. At each perfusion the serum levels of bilirubin decreased. Activities of serum enzymes (GOT, GPT, GLDH, gamma-GT, alkaline phosphatase) and the levels of potassium and sodium behaved differently. This could be explained by different damages of the porcine livers during perfusion which always occur. In 3 perfusions decreased leucocyte counts were observed, explicable immunologically. Extracorporeal heterologous perfusion by means of an alien liver is considered a possible way for temporary replacement of liver function and for removing toxins from the host. Success in single cases with reasonable indication are considered possible. The patients endured the perfusions well. After transitory improvement of their general conditions they succumbed from their severe diseases, though.

[Pyruvate and alpha-ketoglutarate levels in the after parenteral fat emulsion (Lipofundin) administration]. / Das Verhalten von Pyruvat, und alpha-Ketoglutarat im Blut nach parenteraler Fettemulsion (Lipofundin)-Gabe.

In various kinds of tests the metabolites pyruvate, lactate, and alpha-ketoglutarate were estimated after a single application of Lipofundin, resp. sorbitol solution. Within 24 hours after infusion significant changes of concentration occurred. The results are discussed. It is emphasized that Lipofundin caused no additional metabolic alterations compared with sorbitol, thus the concentration changes of pyruvate, lactate, and alpha-ketoglutarate after Lipofundin probably being caused by its content of sorbitol. Accordingly, parenteral application of fat during the immediate postoperative period is not necessary. After this period it is indicated in order to meet requirements of essential fatty acids and of energy.