Flare-up of genital tuberculosis following endometrial aspiration in a patient of generalized miliary tuberculosis

INTRODUCTION

Genital tuberculosis is often neglected by health-care providers, but is an important cause of significant morbidity for the affected women.

CASE REPORT

We report a rare case of tuberculosis (TB) flare in a 28-year-old nulliparous woman following endometrial aspiration (EA), which drained 30 ml pus. Following this, she developed high-grade fever with pain abdomen, guarding and rigidity. PCR was positive for mycobacterium and histopathology showed necrotizing granulomatous endometritis. She also showed features of genitourinary TB and chronic tubercular meningitis and was started on antitubercular therapy.

CONCLUSION

To conclude, EA requires concern and a higher precision in the diagnosis of this insidious disease that primarily necessitates a clinical awareness of this serious health problem, to prevent such flare-up of TB. The clinician should be aware that isolation of TB requires special methods and this diagnosis should be considered while dealing with patients born in countries with high prevalence of TB.

Observation of two-source interference in the photoproduction reaction AuAu --> AuAurho0

In ultraperipheral relativistic heavy-ion collisions, a photon from the electromagnetic field of one nucleus can fluctuate to a quark-antiquark pair and scatter from the other nucleus, emerging as a rho{0}. The rho{0} production occurs in two well-separated (median impact parameters of 20 and 40 F for the cases considered here) nuclei, so the system forms a two-source interferometer. At low transverse momenta, the two amplitudes interfere destructively, suppressing rho{0} production. Since the rho{0} decays before the production amplitudes from the two sources can overlap, the two-pion system can only be described with an entangled nonlocal wave function, and is thus an example of the Einstein-Podolsky-Rosen paradox. We observe this suppression in 200 GeV per nucleon-pair gold-gold collisions. The interference is 87%+/-5%(stat.)+/-8%(syst.) of the expected level. This translates into a limit on decoherence due to wave function collapse or other factors of 23% at the 90% confidence level.

Indications of conical emission of charged hadrons at the BNL relativistic heavy ion collider

Three-particle azimuthal correlation measurements with a high transverse momentum trigger particle are reported for pp, d+Au, and Au+Au collisions at sqrt[s_{NN}]=200 GeV by the STAR experiment. Dijet structures are observed in pp, d+Au and peripheral Au+Au collisions. An additional structure is observed in central Au+Au data, signaling conical emission of correlated charged hadrons. The conical emission angle is found to be theta=1.37+/-0.02(stat)-0.07+0.06(syst), independent of p_{ perpendicular}.

192 EFFECT OF DIFFERENT CULTURE MEDIUM ON THE PRODUCTION OF GRANULOSA SCNT EMBRYOS IN WATER BUFFALO (BUBALUS BUBALIS) AND THEIR mRNA TRANSCRIPT ANALYSIS AT DEVELOPMENTAL STAGES IN COMPARISON WITH IN VITRO FERTILIZATION-PRODUCED EMBRYOS

Success of NT is as low as 0.2 to 3.4% in cloned offspring, and many cloned embryos arrest development before implantation. Expression patterns of mRNA in NT embryos at critical time points play an important role in epigenetic reprogramming and are affected by external factors (Dean et al. 2001 PNAS 98, 13 734–13 738). Embryo culture system can affect the silencing or activations of a particular gene at fetal development stages (Wrenzycki et al. 2001 Hum. Reprod. 16, 893–901). The study was aimed to analyze the expression of genes responsible for growth and embryogenesis (IGF1, IGF2, IGF1R & IGF2R), cellular metabolism (Glut1), gap junction (Cx43) with internal standard (GAPDH) in SCNT embryos in TCM199+FBS, TCM199+PVA and CR1aa+BSA culture media. Passage-5 granulosa cells were used as donor cells after analyzing their proliferation, senescence and ploidy levels. IVM oocytes after nuclear transfer were activated electrically (1.5 kV cm–2, 15 μs) and chemically (ionomycin, 6DMAP, CHX & CytoB) and were cultured up to blastocyst stage. For control IVM oocytes were fertilized with BO medium capacitated frozen semen in TCM199+10%FBS. The cDNA was prepared from single 2, 4, 8, 16-cell, morula and blastocyst embryos using cell to cDNA kit (Ambion). Relative expression of candidate genes was quantified using real-time PCR with ΔΔCT method. Data was analyzed for one-way ANOVA and Post-Hoc Duncan multiple range tests at P ≤ 0.05 level of significance. Blastocyst production was significantly different among groups with the greatest rate (22.36%) in TCM199+FBS than in TCM199+PVA (15.6%) & CR1aa+BSA (19.21%). Cx43 expression was normal in TCM199+FBS as compared with other media. This could be related to modifications in intercellular communication between other connexin proteins in serum. Glut1 level was abnormal in all NT embryo culture groups. Glucose transport efficiency increased in response to glucose starvation in mediums and can be related to greater Glut1 expression (Gardner and Kaye 1995 Reprod. Fertil. Dev. 7, 41–50). IGF1 & IGF2 were up regulated and IGF1R & IGF2R were down regulated in all NT embryo culture groups than in IVF. The temporal and spatial expression of these transcripts determined by real-time software (Stratagene) was significantly affected by the presence of exogenous protein in medium. IGF1R & IGF2R transcripts showed aberrant reprogramming of donor cells, which affect chromatin remodeling, and is highly correlated to imprinted genes (Giraldo et al. 2008 Biol. Reprod. 78, 832–840). In TCM199+PVA & CR1aa+BSA regulation of all transcripts was more aberrant than TCM199+BSA as compared with IVF embryos. Altered mRNA levels in NT embryos at certain stages are indicative of their vulnerability to grow probably due to suboptimal culture conditions. To improve the efficiency and production of healthy clones, expression analysis of important gene in preimplantation embryos can be correlated with developmental competence of SCNT embryos before transfer in surrogates.

Idiopathic thrombocytopenic purpura with isolated tuberculous splenic abscess

We present a 14-year-old boy, a known case of idiopathic thrombocytopenic purpura (ITP) for five years, and was treated with intermittent oral steroids. He presented with left upper abdominal pain of three months' duration. The pain was dull, aching and non-radiating. There were no other associated features. Before this presentation, he was receiving oral steroids for a month. The patient had been hospitalised in the past for ITP-related bleeding. The patient was managed with anti-tuberculous therapy alone, and after nine months, his splenic abscess regressed significantly in size. Tuberculous splenic abscesses are rare, and in particular, isolated tuberculous splenic abscesses are extremely rare with only three cases reported to date. This may be the first case report of tuberculous splenic abscess in ITP. It is noteworthy that this abscess was minimally symptomatic, with no fever or constitutional symptoms.

245 CONNEXIN 43 mRNA EXPRESSION AT DIFFERENT TIME POINT IN IN VITRO MATURATION OF BUFFALO OOCYTES

In advanced technologies of ART, the basic requirement is the production of in vitro-matured oocytes, and embryo production efficiency depends on healthy, matured oocytes. Oocyte growth and development depends on the ability of oocytes and their surrounding cumulus granulosa cells (Eppig et al. 1979 J. Exp. Zool. 208, 111–120). Cumulus cells provide carbohydrate precursors, amino acids, and nucleotides to the oocytes (Brower and Schultz 1982 Dev. Biol. 90, 144–153). Oocytes and cumulus cell gap junctions are required for the coordination of cytoplasmic and nuclear maturation (Carabatsos et al. 2002 Dev. Biol. 226, 167–179). In bovine COC, functional gap junctions are required for the progression of oocyte maturation. Gap junctions allow for metabolic coupling between adjacent granulosa cells. Disruption in the integrity of the gap junction inhibits oocyte maturation (Anderson and Albertini 1976 J. Cell Biol. 71, 680–686). The aim of this study was to analyze the trend of Cx43 mRNA transcript in in vitro-matured oocytes at different times of maturation in the Indian water buffalo to estimate the correlation with expression level. Oocytes collected from slaughterhouse ovaries were matured in TCM-199 medium supplemented with 2.5 mm pyruvate, gentamycin sulfate (10 mg mL–1), β-estradiol (1000 ng mL–1), FSH (500 ng mL–1), LH (500 ng mL–1), and 10% FBS at 38.5°C in 5% CO2 in air. Cumulus–oocyte complexes were used after 0, 6, 12, 18, and 24 h of maturation for the cDNA preparation with cells of a cDNA II Kit. Expression of the Cx43 gene was quantified at different time intervals for maturation with real-time PCR. Statistical analysis was performed with one-way ANOVA, followed by Duncan’s multiple pair-wise comparison. Our results showed that Cx43 mRNA abundance was affected by time of maturation. The expression of Cx43 was significantly higher at 6 h than at 18 and 24 h, whereas the 12-h value was intermediate. Our results are in agreement with decreased Cx43 protein contents in the outer cumulus layers of COC at maturation time points (Calder et al. 2003 Reprod. Biol. Endocrinol. 1, 14) and the expression of Cx43 in oocyte development regulation (Granot et al. 2002 Biol. Reprod. 66, 568–573). When Cx43 expression was compared among immature oocytes, denuded oocytes, cumulus cells, and COC at 6 h, there was no significant difference. However, 6-h-matured COC showed significantly higher expression than other groups. Further, our study supported the role of cumulus cells in COC in Cx43-mediated communication (Vozzi et al. 2001 Reproduction 122, 619–628). Differential expression of Cx43 mRNA among varying COC classes indicates that this gene may be a useful marker for oocyte quality to improve in vitro production or somatic cell nuclear transfer rates. Marker genes that predict developmental competence could be used in the optimization of maturation and culture conditions. Understanding the molecular mechanism involved in in vitro oocyte maturation would be an additional advantage in analyzing this complex biological phenomenon to improve embryo production.

30 IN VITRO EXPRESSION OF BAX AND BCL2 GENES IN NUCLEAR DONOR SKIN FIBROBLAST, CUMULUS, AND GRANULOSA CULTURED CELLS DURING CULTURE AND THEIR SOMATIC CELL NUCLEAR TRANSFER-CLONED EMBRYOS IN INDIAN BUFFALOES (BUBALUS BUBALIS)

Somatic cell nuclear transfer (SCNT) involves functional changes in the genome which result in low efficiency for the production of viable and cloned embryos. It is primarily due to incomplete reprogramming of genome of donor cell nuclei in the reconstructed embryos (Vassena et al. 2007 Dev. Biol. 304, 75–89). Expression of BCL2 and Bax can be correlated with apoptosis. BCL2 inhibits apoptosis by regulating the release of cytochrome-c and other proteins from mitochondria (Keep et al. 2007 EMBO J. 26, 825–834). Antiapoptotic BCL2 is antiproliferative by facilitating G0. Bax is proapoptotic and accelerates S-phase progression. The dual functions in apoptosis and cell cycle are coordinately regulated by the BCL2 family and suggest that survival is maintained at the expense of proliferation (Zinkel et al. 2006 Cell Death Differ. 13, 1351–1359). The aim of this study was to estimate the relative expression of BCL2 oncogene and Bax gene in regulating apoptosis, in skin fibroblast, cumulus, and granulosa cells in culture, so that ideal-type donor cell lines are developed for higher success rates in SCNT-derived buffalo cloning. The cell lines up to 25th passage were from all the 3 tissue types by previous method (Gupta et al. 2007 Cell Biol. Int. 31, 1257–1264). The cells between passages 5th to 15th were selected as competent donor cells and transferred into enucleated in vitro-matured oocytes from slaughter ovaries. The couplets were activated electrically (1.5 kV cm–2, 15 μs) and chemically (ionomycin, 6-DMAP, CHX, and Cyto-B) and were cultured up to blastocyst. The cDNA were prepared from the growing cells in culture at 5, 10, and 15 passages from all cell lines and SCNT-cloned blastocysts from these cell lines at respective passages for Bax and BCL2 gene expression analysis. Relative expression of these candidate genes was quantified using real-time PCR. The data was analyzed for 1-way ANOVA and post-hoc Duncan multiple range test at P ≤ 0.05 level of significance. The cell proliferation rate in cultured cells at fifth passage was higher in all the 3 cell lines and declined in subsequent passages (range from 1.06 to 0.67). The relative abundance of Bax mRNA in granulosa cell was comparable with skin fibroblasts but significanly higher than cumulus cells at respective passages. BCL2 mRNA expression was significantly upregulated in cumulus cells as compared to granulosa cells but not with skin fibroblasts. The SCNT blastocyst production rates from granulosa were highest (24.28%) as compared to fibroblast (22.6%) and cumulus (21.4%) at passage 10. Level of Bax and BCL2 mRNA in granulosa and fibroblast SCNT blastocysts was not significantly different from IVF (control), whereas cumulus-derived blastocyst showed abnormal patterns with downregulated expression of Bax mRNA and upregulated expression of BCl2 mRNA. Identification of expressed genes in cells and cloned embryos will help to investigate the causes of developmental abnormality due to deregulation of expression of important gene associated with ART.

System-size independence of directed flow measured at the BNL relativistic heavy-ion collider

We measure directed flow (v_{1}) for charged particles in Au+Au and Cu+Cu collisions at sqrt[s_{NN}]=200 and 62.4 GeV, as a function of pseudorapidity (eta), transverse momentum (p_{t}), and collision centrality, based on data from the STAR experiment. We find that the directed flow depends on the incident energy but, contrary to all available model implementations, not on the size of the colliding system at a given centrality. We extend the validity of the limiting fragmentation concept to v_{1} in different collision systems, and investigate possible explanations for the observed sign change in v_{1}(p_{t}).

The 2006 dengue outbreak in Delhi, India

Dengue is a worldwide condition spread throughout the tropical and subtropical zones between 30 degrees north and 40 degrees south. It is endemic in South East Asia, the pacific, East and West Africa, the Caribbean and the Americas. Dengue outbreaks are occurring almost every three yearly in Delhi for the last 12 years. The latest outbreak was in the year 2006, which started late in August, peaked in the month of October and lasted till late November. We describe here the clinical, hematological and biochemical data of 70 patients of dengue fever diagnosed as per WHO criteria in Lok Nayak Hospital, New Delhi during this outbreak. Hematological parameters were estimated by automated counter and dengue serology was done by capture ELISA technique. The results displayed widespread effect of dengue fever on hematological and biochemical profile. Some of our patients also had atypical dengue manifestations. These results suggest that dengue fever is a major public health problem which can lead to significant morbidity and can even be fatal at times. All efforts should be made to prevent it.

Forward neutral-pion transverse single-spin asymmetries in p + p collisions at sqrt[s] = 200 GeV

We report precision measurements of the Feynman x (xF) dependence, and first measurements of the transverse momentum (pT) dependence, of transverse single-spin asymmetries for the production of pi0 mesons from polarized proton collisions at sqrt[s] = 200 GeV. The xF dependence of the results is in fair agreement with perturbative QCD model calculations that identify orbital motion of quarks and gluons within the proton as the origin of the spin effects. Results for the pT dependence at fixed xF are not consistent with these same perturbative QCD-based calculations.

Plusoptix Vision Screener: the accuracy and repeatability of refractive measurements using a new autorefractor

BACKGROUND

The Plusoptix Vision Screener (PVS) is a new non-cycloplegic videoretinoscopy autorefractor. Refractive accuracy may affect its performance as a screening tool.

AIMS

Study 1: To determine the intra- and interobserver variability of PVS measurements. Study 2: To compare PVS measurements with gold-standard manual cycloplegic retinoscopy (MCR).

METHODS

Study 1: PVS refraction of 103 children with mean (SD) age 5.5 (0.6) years by two observers. Study 2: PVS and MCR refraction of 126 children with mean (SD) age 5.5 (1.5) years, including 43 children with manifest strabismus >/=5 PD, comparing mean spherical equivalent (MSE) and Jackson cross cylinders J(0) and J(45).

RESULTS

Study 1: Repeatability coefficients (observer 1): MSE: 0.63 D, J(0): 0.24 D, J(45): 0.18 D; those of observer 2 were nearly identical. The mean difference (95% limits of agreement) between the two observers for MSE, J(0) and J(45) were, respectively, 0.03 (-0.62 to 0.68 D), -0.008 (-0.25 to 0.23 D) and 0.013 (-0.18 to 0.20) D. Study 2: MSE tended to be lower on PVS than MCR, with differences of up to 8.00 D. Less than 20% of values were within +/-0.50 D of each other. Agreement was better for J(0) and J(45). Strabismus was associated with an odds ratio of 3.7 (95% CI 1.3 to 10.5) of the PVS failing to obtain a reading.

CONCLUSIONS

The PVS may underestimate children's refractive error.

East Central South African genotype as the causative agent in reemergence of Chikungunya outbreak in India

Chikungunya fever is an important arboviral infection prevalent throughout Africa and Southeast Asia. Recently, in 2006, it has reemerged in many parts of India, affecting more than a million persons. A detail serological, virological, and molecular investigation of this unprecedented outbreak was carried out by collecting and studying 540 samples from all the affected regions of India during this epidemic. An in-depth investigation revealed the presence of anti-Chikungunya antibodies in 68% of the samples and genomic RNA in 49% of them. In addition 32 Chikungunya viruses were isolated from 45 representative polymerase chain reaction-positive samples. The nucleotide sequences of partial E1 gene of 25 representative Chikungunya viruses were deciphered. The sequence analysis indicated that all the isolates of this epidemic belonged to the new Indian Ocean island clade of East Central South (ECS) African genotype. This study conclusively proved the genotype shift from Asian to ECS African as the major factor in the reemergence of Chikungunya in an unprecedented outbreak in India after a gap of 32 years.