The YMNM motif that exists in the CD28 cytoplasmic domain is known as a binding site for phosphatidylinositol 3-kinase and Grb-2 and is considered to be important for CD28-mediated costimulation. To address the role of the YMNM motif in CD28 cosignaling in primary T cells, we generated transgenic mice on a CD28 null background that express a CD28 mutant lacking binding ability to phosphatidylinositol 3-kinase and Grb-2. After anti-CD3 and anti-CD28 Ab stimulation in vitro, the initial proliferative response and IL-2 secretion in CD28 Y189F transgenic T cells were severely compromised, while later responses were intact. In contrast to anti-CD3 and anti-CD28 Ab stimulation, PMA and anti-CD28 Ab stimulation failed to induce IL-2 production from CD28 Y189F transgenic T cells at any time point. Using the graft-vs-host reaction system, we assessed the role of the YMNM motif for CD28-mediated costimulation in vivo and found that CD28 Y189F transgenic spleen cells failed to engraft and could not induce acute graft-vs-host reaction. Together, these results suggest that the membrane-proximal tyrosine of CD28 is required for costimulation in vivo. Furthermore, these results indicate that the results from in vitro assays of CD28-mediated costimulation may not always correlate with T cell activation in vivo.
Moyamoya disease is a cerebrovascular stenotic or occlusive disease predominantly seen in Asian countries. Sometimes there are coexisting renal artery lesions in Moyamoya disease patients. A 32-year-old multipara had a cesarean section at 33 gestational weeks due to preeclampsia. One month later, she developed subarachnoid hemorrhage and angiography demonstrated Moyamoya vessels with renal artery stenosis. After conservative therapy, the patient was discharged without any deficits. Our conclusion is that patients with Moyamoya disease carry a risk of cerebrovascular accident during pregnancy and postpartum. In this case, we did not diagnose Moyamoya disease with renal artery stenosis until the patient developed subarachnoid hemorrhage. It is very important to make a careful differential diagnosis of hypertension during pregnancy and the postpartum period.
BackgroundJapan has consistently shown a low fertility rate, which has been lower than the replacement level since 1974, and represents one of the least fertile countries in the world. This study was designed to determine the family size preference of and its effect on Japanese women.MethodsWe conducted a questionnaire survey among women who visited the obstetrics and gynecology department of 18 hospitals and clinics in the Hyogo Prefecture, Japan, between October 2011 and February 2012. All the women were categorized according to age group and area of residence, and the survey results were statistically analyzed using a t test.ResultsA total of 1616 women were included in this study. There was no significant difference between the mean desired and actual marital ages (26.70 and 26.67 years, respectively). The mean desired number of children was 2.55, which was significantly more than the mean actual number of children (1.77) in all generations. The mean desired and actual numbers of children were more in the rural areas (2.73 and 2.09, respectively) than in the urban (2.54 and 1.70, respectively) and semi-urban areas (2.49 and 1.60, respectively). The mean number of family members was significantly greater in the rural areas (3.84) than in the urban (3.25) and semi-urban areas (3.05).The most important concern among women who had never delivered a baby was childbearing itself, followed by the expenses related to pregnancy and childbearing.ConclusionsThe family size preference of the women in our study was higher than the actual numbers of children. The fertility intentions were low among the younger women but high among those living in rural areas with larger families.
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