Double-stranded DNA breaks (DSBs) at the IgV region (IgV) genes might be involved in somatic hypermutation and affinity-maturation of the B cell receptor in response to T cell-dependent Ag. By ligation-mediated PCR, we studied IgV DSBs that occurred in mature germinal center B cells in response to nitrophenyl-chicken γ-globulin in a RAG1-independent, Ag-dependent, and IgV-selective manner. We quantified their levels in GANP-deficient B cells that have impaired generation of high-affinity Ab. GANP−/− B cells showed a decreased level of DSBs with blunt ends than control B cells and, on the contrary, the ganp gene transgenic (GANPTg) B cells showed an increased level. These results suggested that the level of IgV DSBs in germinal center B cells is associated with GANP expression, which is presumably required for B cell receptor affinity maturation.
We treated 2-or 3-part proximal humeral unstable fractures with closed intramedullary fixation using Ender nails. Over 5 years (1994-1998), we treated 10 patients consisting of a man and 9 women whose age at operation ranged from 27 to 82 years (average; 61.6 years). 8 cases were 2-part fractures and 2 cases were 3-part. We perfomed fixation using 2 Ender nails from 2 entrance portals at the medial and lateral epicondyle of the distal humerus. Within 2 weeks after surgery, the patient was allowed to begin active and passive range of motion exercise. There were no infections and non-unions. Clinical and radiographical results were acceptable in 8 cases, and poor in 2. One of the nails cutout in 3 patients, requiring reversion or extraction in 2.
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