Variability of bacterial translocation in the absence of intestinal mucosal damage following injury and the influence of interleukin-6.

Bacterial translocation and intestinal mucosal damage have been reported as potentially clinically important sequelae of injury. Evidence that endogenous interleukin-6 (IL-6) is able to protect against infection, and that orally administered IL-6 could prevent bacterial translocation and mucosal damage following haemorrhage, led us to evaluate the impact of injury on the intestinal mucosa and the role of endogenous IL-6. Normal and IL-6-deficient (IL-6-/-) mice were subjected to haemorrhage of increasing severity, hind limb ischaemia, or both. Mucosal integrity and bacterial translocation to the liver, spleen and mesenteric lymph nodes (MLN) were examined after 16 h. Bacterial translocation to each of these tissues was observed in unoperated animals. The more severe haemorrhage procedures, and hind limb ischaemia, increased bacterial translocation to the liver significantly in most experiments with normal mice. The IL-6-/- mice survived the most severe haemorrhage procedure less well (p = 0.0015), although increased bacterial translocation was not seen. There was no clear evidence of mucosal damage, or bacterial translocation to spleen and mesenteric lymph nodes, in either normal or IL-6-/- mice. Intestinal IgA concentrations were the same in IL-6-/- mice and controls. These data demonstrate that increased bacterial translocation can be observed following severe injury, but that neither bacterial translocation nor severe injury are inevitably associated with morphological damage to the intestinal mucosa, and endogenous IL-6 is more likely to promote bacterial translocation than protect the gut.

An omphalopagus parasitic twin after intracytoplasmic sperm injection.

OBJECTIVE: To describe a first case of parasitic twin achieved after intracytoplasmic sperm injection (ICSI). DESIGN: Case report. SETTING: Perinatal center at a Japanese university hospital. PATIENT(S): A 30-year-old pregnant Japanese woman with a history of secondary infertility achieved after ICSI was diagnosed with an omphalopagus parasitic twin pregnancy by prenatal ultrasound at 28 weeks of gestation. INTERVENTION(S): A female infant was delivered by scheduled cesarean section at 30 weeks of gestation. The cesarean section was performed for dystocia. MAIN OUTCOME MEASURE(S): Brief review of parasitic twin and malformations in fetuses achieved after ICSI. RESULT(S): Resuscitation was not done because of the poor prognosis for both fetuses. Molecular analysis with informative genetic markers is consistent with monozygotic pregnancy. CONCLUSION(S): A careful ultrasound examination is indicated to detect additional anomalous findings in twin fetuses achieved after ICSI.

Nitric oxide synthase expressions in mice skeletal muscle subjected to ischemia/reperfusion injury.

Nitric oxide synthase (NOS) expressions in skeletal muscle subjected to ischemia/reperfusion (I/R) were studied using a hind limb tourniquet ischemia model in mice. A rubber band was applied to a hind limb for 3 h under isoflurane anesthesia followed by 1 or 4 h of reperfusion. Increased NADPH diaphorase activity and NOS immunoreactivity were histochemically detected in the cells of muscle that had been subjected to I/R. The results of RT-PCR of the muscle subjected to I/R showed that NOS mRNA expressions were not significantly increased until 4 h after the start of reperfusion. Since there was no significant difference between histochemical findings or between water contents of the hind limbs or organs in interleukin (IL)-6-deficient mice and the wild-type mice, IL-6 may not be involved in the early stage of I/R muscle injury such as that in this model. O(2)(-) production in the cells of muscle that had been subjected to I/R was observed using an in situ detection method with hydroethidine, and the O(2)(-) was inhibited by intravenous administration of L-NAME or L-NMMA, but not L-NIL, 30 min before tourniquet release. Further study is needed to evaluate the role of O(2)(-) produced by constitutive NOS in muscle subjected to I/R in the pathophysiology of tourniquet shock.

A novel PCR method for identifying plankton in cases of death by drowning.

We present a new PCR method for identifying plankton in cases of death by drowning. We designed four primer pairs for chlorophyll-related genes of Euglena gracilis (EG) and Skeletonema costatum (SK), which are commonly distributed in water. The primers were selected from sequences coding chloroplast/chlorophyll apoprotein of EG (EG1 and EG2) and fucoxanthin-chlorophyll a/c harvesting protein of SK (SK1 and SK2). With EG1 or EG2, up to 2 fg of EG-DNA was identified, and 0.2 pg of SK-DNA was detectable with SK1 or SK2. No PCR products were amplified from green vegetables (komatsuna, spinach, parsley) or human DNA with the four primer pairs. Regardless of the origin, seawater or fresh water, most diatoms were detectable with primer pairs of EG1 and EG2. With SK1, only Centrales diatoms were identified, and five diatom strains originating from seawater were detectable with SK2. EG1 and EG2 gave rise to PCR products from most water samples. By using Percoll, plankton was easily isolated from human tissue or blood samples and good results of PCR analysis were obtained in cases of death by drowning.

Interleukin-6 deficiency increases blood volume without altering body composition in young mice.

This study was carried out to measure blood volume in interleukin-6 (IL-6) deficient and the wild type mice and to relate any differences to concomitant changes in body composition. Young animals (8-20 weeks of age) were used in this study. The red blood cell (RBC) and plasma volumes were measured by isotope-dilution using Cr(51)-labeled erythrocytes and I(131)-labeled human albumin injected simultaneously in each animal. Red blood cells and plasma volumes and hence total measured blood volume were significantly larger in the IL-6-deficient than in either male or female wild type mice. There were no differences in either whole body hematocrit or Fcells ratio. There were no differences in water, fat, protein and mineral content between the genotypes of either gender. Thus, IL-6-deficient mice at young age have a significantly greater blood volume than the wild type mice without concomitant changes in body composition. We suggest that the changes in blood volume may reflect a role for IL-6 in the regulation of the peripheral circulation.

The mechanism underlying the occurrence of traumatic brainstem lesions in victims of traffic accidents.

Autopsy records and photographs of traffic accident deaths from 1985 to 2000 as well as police reports were reviewed to determine the morbidity and pathological features of traumatic brainstem lesions and to determine the relationship between lesions and forces applied. Of 156 autopsied traffic accident cases, 26 (16.7%) of the victims had gross primary brainstem injury. The 26 victims included 19 pedestrians, five cyclists, one driver and one passenger. There were four cases of upper face impact and two cases of lower face impact in which the direct forces to the head had caused hyperextension of the neck. However, eight of the pedestrians and two of the cyclists had medullary lesions for which the cause could not be explained by the direct impact to the head, suggesting that indirect forces, i.e. the inertia of the head, had caused neck hyperextension at the moment of impact with the car. Based on the findings in this study, it was concluded that when a pedestrian or cyclist is hit by a vehicle travelling at high speed, the traction force due to the inertia of the head is one of the causes of violent hyperextension of the head that result in traumatic brainstem lesions.