988 movement. At 6 15 r.M. his pelvis was raised to allow of the introduction of a bed-pan and almost instantaneous death ensued. At the post-mortem examination a prolonged and careful search failed to reveal any macroscopic change in the brain, its vessels, or the meninges. On opening the pericardium it was found to be filled with blood clot, and on washing this away a laceration about one and a half inches in length was found in the left lateral wall of the left ventricle. The aperture was closed by recent clot. The cavities of the heart were dilated, the walls thin and in an advanced stage of fatty degeneration. No valvular disease was present. The aorta and its main branches were atheromatous. Both lungs contained calcifying tubercle ; the abdomen was loaded with fat; the spleen was soft and friable ; the kidneys were engorged, but otherwise healthy. Although the patient's death followed such a slight movement as that of raising his buttocks, and which was apparently the last straw," he had been able to survive a considerable journey (from Waltham Abbey to Tottenham) in a cab on the previous day. My cordial thanks are due to Dr. Rasch, visiting physician to the hospital, for his permission to publish this interesting case. CASE l.-The patient was a girl aged seven years and six months. On Sept. llth she was said to have had tonsillitis, but to have completely recovered by the 15th. On the evening of Sept. 20th there was copious epistaxis. On the 21&t, on the right side of the uvula and anterior pillar of the fauces, there was a shallow, raw-looking ulcer, and the left nostril was filled with a greyish-white membrane down to the orifice. The pulse was 130 and the temperature 1010 F. The urine contained over 0-05 per cent. albumen.The patient was given perchloride of mercury and lactic acid (one drachm to the ounce) applied locally. On the 22nd with a nasal speculum a white substance could be seen far back in the right nostril. On the 23rd the temperature reached 102 2°, and the child was distinctly worse. On the 24th the urine contained over 0 03 per cent. albumen. At 7 P.M. 0'7 c.c. of Aronson's antitoxin was injected. On the 2S"h the patient could breathe better through the nose. She was very restless in the afternoon and her temperature rose to 103°. On the 26th the ulcer on the uvula was nearly well. No membrane could be seen in the nose, but the temperature was still keeping over 102° and the albumen had increased to 0'2 per cent. ; 1'2 c.c. of antitoxin injected. On the 17th she complained of pain in the legs, and after the most careful examination the knee-jerks could be only doubtfully obtained ; anyway, there was very slight reaction. The fauces and nose looked well, but she complained of ear pain. On the 28th pus issued from the right ear. The patient could not hear the ticking of a watch ou contact, and the tympanum was perforated. On the 30Gh the ear was quite free from discharge, and she heard a watch at three inches. The throat and nose looked well, but the temperature reached 1032&de...

No abstract

The C57BL/6J.YSB consomic males bear a Y chr with a translocation (Yaa) from X bearing TLR7. The translocation reduces susceptibility to EAE, a mouse model of multiple sclerosis. We hypothesized that B6.Yaa mice would also show decreased susceptibility to herpes simplex encephalitis (HSE), another neuroinflammatory condition, compared to the consomic partner, C57BL/6J (B6). Four week-old B6 and B6.Yaa male mice were inoculated with neurovirulent HSV-1. B6.Yaa mice had significantly increased survival (MST = 8 days; 40% survival) compared to B6 (MST = 6 days; 0% survival) by log-rank test. Surprisingly, the brains of the less susceptible B6.Yaa mice had a significantly greater number of viral genome copies than B6 mice (p = 7 x 10-9), as measured by quantitative real-time PCR. We analyzed expression levels of known markers of susceptibility to HSE in the two strains (including cell surface markers, cytokines, and cell-signaling molecules) by real-time PCR assays of RNA from draining lymph nodes and infected tissues. Brains of infected B6.Yaa mice demonstrated significantly increased expression of CD4, IL-1α, IL-1β, IL-6, and TNFα compared to B6 mice on dpi 5. Cluster analysis of expression levels from the 26 transcripts studied (including 21 host transcripts and 5 viral transcripts) in the brains of B6 and B6.Yaa mice demonstrated distinct patterns of gene expression. Thus the Yaa translocation alters the adaptive immune response to HSV-1 and increases survival in these mice.