Antibody landscapes after influenza virus infection or vaccination.

We introduce the antibody landscape, a method for the quantitative analysis of antibody-mediated immunity to antigenically variable pathogens, achieved by accounting for antigenic variation among pathogen strains. We generated antibody landscapes to study immune profiles covering 43 years of influenza A/H3N2 virus evolution for 69 individuals monitored for infection over 6 years and for 225 individuals pre- and postvaccination. Upon infection and vaccination, titers increased broadly, including previously encountered viruses far beyond the extent of cross-reactivity observed after a primary infection. We explored implications for vaccination and found that the use of an antigenically advanced virus had the dual benefit of inducing antibodies against both advanced and previous antigenic clusters. These results indicate that preemptive vaccine updates may improve influenza vaccine efficacy in previously exposed individuals.

Scintigraphic changes of osteoarthritis: An analysis of findings during routine bone scans to evaluate the incidence in an Indian population.

AIMS: The reported prevalence of osteoarthritis (OA) varies according to the method that is used to detect it. X-rays are commonly used in the diagnosis of OA. However, marked osteoarthritic damage must be present to detect characteristic changes with radiologic imaging. Our intention was to evaluate bone scans (1) he occurrence of such changes, (2) he incidence of OA (single or multiple joints) in the general population (a mixture of urban and rural) who were asymptomatic. Data on OA incidence in India is sketchy and sparse as against more detailed information obtained from USA and European nations. Also, clinical rheumatologists are not well-versed with the potential application of bone scans in the management of arthritides. MATERIALS AND METHODS: Two hundred and eighty nine planar images of routine bone scans were randomly evaluated by two trained nuclear medicine physicians. The ages of the patients ranged from 20 to over 80 years. RESULTS: It is observed that as the age increases, the incidence of joint involvement increases. However, it is worth noting that even in the age group of 20-40 years, as many as 34% of asymptomatic persons have involvement of the joints. In this age group, as the manifestation is probably in the inception stage, there is a tendency for single joint involvement as against multiple joints seen in the older age groups. Another point to note is that the incidence of joint involvement was not affected by weight. In our patient population, gross obesity was not seen. The predominant joints involved are the knees and hips, followed by the shoulders and ankles. Females show a higher incidence than males. Some patients would be having only a single site or multiple site involvement. This observation is important as in a single, simple test whole body survey gives more information with low radiation burden. CONCLUSION: Scintigraphic prevalence of OA is higher than reported in US, Europe, and Asia as this test is more sensitive in detecting early changes as compared to radiological changes. These findings on scintigraphy in asymptomatic cases have not been described to the best of our knowledge. Epidemiological demography in published reports is based on clinical or radiological changes observed in single joints which are predominantly symptomatic and multiple joint involvement is rarely recorded. The sensitivity of scintigraphy to show early changes in bone homeostasis and remodeling needs to be exploited.

Molecular analysis of human leukocyte antigen class I and class II allele frequencies and haplotype distribution in Pakistani population.

AIM: Distribution of HLA class I and II alleles and haplotype was studied in Pakistani population and compared with the data reported for Caucasoid, Africans, Orientals and Arab populations. MATERIALS AND METHODS: HLA class I and II polymorphisms in 1000 unrelated Pakistani individuals was studied using sequence-specific primers and polymerase chain reaction and assay. RESULTS: The most frequent class I alleles observed were A*02, B*35 and CW*07, with frequencies of 19.2, 13.7 and 20%, respectively. Fifteen distinct HLA-DRB1 alleles and eight HLA-DQB1 alleles were recognized. The most frequently observed DRB1 alleles which represented more than 60% of the subjects were DRB1 *03, *07, *11 and *15. The rare DRB1 alleles detected in this study were HLADRB1 *08 and *09, having frequencies of 0.9 and 1.7%, respectively. In addition, at DRB1-DQB1 loci there were 179 different haplotypes and 285 unique genotypes and the most common haplotype was DRB1*15-DQB1*06 which represented 17% of the total DRB1-DQB1 haplotypes. In our population, haplotype A*33-B*58-Cw*03 comprised 2.8% of the total class I haplotypes observed. This haplotype was seen only in the oriental populations and has not been reported in the African or European Caucasoid. CONCLUSION: Our study showed a close similarity of HLA class I and II alleles with that of European Caucasoid and Orientals. In Pakistani population, two rare loci and three haplotypes were identified, whereas haplotypes characteristic of Caucasians, Africans and Orientals were also found, suggesting an admixture of different races due to migration to and from this region.

Evaluation of murine norovirus as a surrogate for human norovirus and hepatitis A virus in heat inactivation studies.

AIMS: To determine the suitability of murine norovirus (MNV) as a surrogate for human norovirus (HuNoV) in heat inactivation studies. METHODS AND RESULTS: MNV, hepatitis A virus (HAV) and HuNoV genogroup I and II (GI and GII) specific real-time quantitative reverse transcription (qRT)-PCR assays were used to determine the effects of heat exposure (63 and 72 degrees C) for up to 10 min in water and milk. Using culture assays, MNV and HAV showed similar reductions in infectivity over time. Both HuNoV GI and GII showed lower log reductions in qRT-PCR titre following heat exposure than either MNV or HAV. No significant protective effect of milk was observed for any virus. CONCLUSIONS: MNV is as suitable a surrogate for HuNoV as HAV. In heat inactivation studies at 63 and 72 degrees C, qRT-PCR results indicate that HuNoV is less susceptible to heat than either HAV or MNV and so neither virus may be an appropriate surrogate for HuNoV. SIGNIFICANCE AND IMPACT OF THE STUDY: Caution should be used when extrapolating surrogate virus data for HuNoV. Although not conclusive, our results suggest that HuNoV may be more resistant to heat than either HAV or MNV.

Spin-glass transition of the three-dimensional Heisenberg spin glass.

It is shown, by means of Monte Carlo simulation and finite size scaling analysis, that the Heisenberg spin glass undergoes a finite-temperature phase transition in three dimensions. There is a single critical temperature, at which both a spin glass and a chiral glass ordering develop. The Monte Carlo algorithm, adapted from lattice gauge theory simulations, makes it possible to thermalize lattices of size L = 32, larger than in any previous spin-glass simulation in three dimensions. High accuracy is reached thanks to the use of the Marenostrum supercomputer. The large range of system sizes studied allows us to consider scaling corrections.

CYP17 genetic polymorphism in patients with endometrial hyperplasia and cancer.

We investigated the association of CYP17 gene polymorphism with the risk of having endometrial cancer and a well-known precursor of it, endometrial hyperplasia. Group A (control group) consisted of 35 patients who had histologically proven normal endometrium. Group B and C consisted of 18 and 30 patients who had endometrial hyperplasia with and without atypia, respectively. Group D consisted of 57 patients who had endometrial cancer. Venous blood samples were collected from patients in groups, and polymerase chain reaction was performed to determine the CYP17 gene polymorphism. Significant increase of A1/A1 and a decrease of A1/A2 genotype frequencies have been determined in patients with endometrial cancer and with atypical endometrial hyperplasia. No significant differences were found between groups in the frequency of A2/A2 genotype. There was no significant difference between the groups in the meaning of allele distributions. CYP17 polymorphism had correlation with endometrial atypia and cancer. Related effects of different types of CYP17 gene variants on the progression of hyperplastic endometrial cells into carcinoma should be evaluated in further studies. Progress in this area would help us modulate preventive treatments used in those actual high-risk group patients.

Glutathione-S-transferase P1 gene polymorphism and susceptibility to endometriosis.

BACKGROUND: Glutathione-S-tranferase (GST) is the part of the key phase II detoxifying enzyme system. Many studies have investigated the role of GSTM1 and GSTT1 gene polymorphisms in endometriosis. Although GSTP1 was found to be one of the most abundant types of GST in genital system, there are insufficient data about the importance of the role of GSTP1 gene polymorphism in endometriosis. METHODS: This case-control study involved 150 patients with endometriosis and 150 controls. The frequency of GSTP1 single nucleotide polymorphisms was evaluated using PCR and melting curve analysis. RESULTS: The proportion of GSTP1 ile/ile tended to be higher in patients with endometriosis than control group, although the difference was not significant [odds ratio (OR)=1.53; 95% confidence interval (CI)=0.95-2.46]. In contrast, GSTP1 val/val was significantly higher in control patients and seems protective for endometriosis (OR=0.10; 95% CI=0.02-0.42). CONCLUSION: The results of this study suggest that GSTP1 polymorphism might modulate the risk of endometriosis with significantly decreased risk for GSTP1 val/val and marginally increased risk for GSTP1 ile/ile. Further studies on not only the disease processes but also normal distribution of the enzyme in female genital tract may provide better understanding about the role of GST types and their polymorphs in endometriosis.

Treatment of viable cesarean scar ectopic pregnancy with suction curettage.

OBJECTIVE: Pregnancy in previous cesarean scar is the rarest form of ectopic pregnancy. All reported cases in the literature that were treated with uterine curettage either become unsuccessful or complicated. We aimed to present a case of cesarean scar ectopic pregnancy that was successfully treated with suction curettage without any additional therapy. CASE: A 32-year-old asymptomatic woman, gravida 2, para 1 was referred to our hospital with the possible diagnosis of cervical ectopic pregnancy. Transvaginal and transabdominal sonographic examination revealed the diagnosis of viable ectopic pregnancy in a previous cesarean scar. Suction curettage with carman canulles was performed under transabdominal ultrasonographic guidance. beta-hCG decreased progressively postoperatively. CONCLUSION: Suction curettage under ultrasonography guidance can be used in termination of selected cases (early diagnosed, without symptoms that necessitates emergency intervention) of cesarean scar pregnancy.

Frequency of micronuclei in peripheral blood lymphocytes from subjects occupationally exposed to low levels of ionizing radiation.

The aim of this study was to evaluate the genotoxic effect of low dose of occupational radiation exposure in Nuclear Medicine Department employees, by using cytokinesis-blocked micronucleus assay in peripheral blood lymphocytes. The study included 46 exposed individuals together with 27 from the same area without occupational exposure to radiation which served as controls. The results obtained were evaluated with respect to age, gender, smoking habits, pathological condition and the occupational exposure to radiation of the individuals. The frequency of micronuclei increased significantly with the age of the subjects (P = 0.007). However there were no significant differences in micronucleus frequency with gender, smoking habits and occupational exposure. The frequency of micronuclei was significantly higher in individuals with presence of pathological condition (P < 0.0001) in comparison to healthy population irrespective of their exposure status.

Effect of antioxidants (vitamin C, E and turmeric extract) on methimazole induced hypothyroidism in rats.

The study was to investigate the protective effect of antioxidants against methimazole (MMI) induced hypothyroidism in rats. Male Wistar rats were fed MMI, MMI plus vitamin C, MMI plus vitamin E and MMI plus turmeric extract (TE) supplemented diet. At the end of the experiments, thyroid weights, thyroxine (T4), triiodothyronine (T3) and cholesterol levels were determined. It was observed that MMI treated rats showed increase in thyroid weights, very low levels of circulating T4, T3 and increased levels of total cholesterol as compared to controls (P< 0.001). However, rats which received Vit. C, Vit. E or TE along with MMI showed reduced weights (38-55% less) in thyroid glands (P < 0.01), less suppressed T4 and T3 levels (2-6% and 7-35% respectively) and less increase in total cholesterol levels (19-52%) which are statistically significant. The data suggest the positive effect of antioxidants on thyroid gland which could be due to direct involvement of antioxidants on thyroid gland.

Prevalence, management and outcome in eclampsia.

OBJECTIVE: To review the management of eclampsia in our institution. METHOD: The prevalence, management and outcome of women with eclampsia over a period of 8 years were reviewed at our referral medical center. There were 444 patients with eclampsia among 5757 deliveries (1 in 12.96 deliveries or 7.71% of deliveries). Most of the cases were uneducated and had received no antenatal care. One hundred eighty-one cases were nulliparous (40.77%). High parities of more than five were observed in 27.93% of cases. A standard magnesium sulfate regimen, similar to Prichard's intramuscular regimen, was used. RESULTS: Magnesium sulfate effectively controlled the convulsions. The incidence of abdominal delivery among 397 cases with ante- and intrapartum eclampsia was 50.12%. Perinatal mortality was very high (591.47% 0) for all cases. Maternal complications were serious and led to maternal death in 42 women (9.46%). CONCLUSION: Eclampsia is still a serious obstetric complication particularly in uneducated women who do not receive antenatal care.

Pomeroy tubal ligation by laparoscopy and minilaparotomy.

Pomeroy tubal ligation is a widely-used method for surgical female sterilization. A laparoscopic technique of Pomeroy tubal ligation using endoloop sutures is compared with the conventional technique of Pomeroy tubal ligation by minilaparotomy. Forty-four women requiring sterilization were randomly selected for either laparoscopy (n = 24) or minilaparotomy (n = 20). Mean operative time in the laparoscopy group (18.90 +/- 5.56 with a range of 12-35 minutes) was not significantly different from that in the minilaparotomy (23.12 +/- 8.24 with a range of 15-45 minutes) group. In all women, tubal specimens confirmed tubal histology. Both laparoscopy and minilaparotomy procedures may be performed for Pomeroy tubal ligation with minor morbidity. In clinics with appropriate conditions, Pomeroy tubal ligation by laparoscopy may be preferable to minilaparotomy.