208 PRODUCTION OF TRANSGENIC CLONED BUFFALO (BUBALUS BUBALIS) EMBRYOS CONTAINING HUMAN INSULIN GENE THROUGH HAND-GUIDED CLONING

Diabetes is a growing disease worldwide and has emerged as a major healthcare problem in India. Insulin is an essential medicine for the treatment of diabetes. Large dairy animals, such as buffaloes and cows, may be used as bioreactors for cost-effective production of human insulin. The present study was aimed to produce transgenic buffalo embryos containing the human insulin gene through hand-guided cloning for production of transgenic animals. Buffalo female fetal fibroblast cells at passage number 3 were transfected using mammary gland- specific expression vector containing the human insulin gene under buffalo β-lactoglobulin promoter by nucleofection method and cultured with G418 drug for 3 weeks to obtain positive transgenic cell clones. Transgene integration into buffalo female fetal fibroblast genome was confirmed by PCR and Southern blotting. Nontransfected and transgene integrated cells were used as nuclear donors to produce embryos by the hand-guided cloning technique. The developmental competence and quality of embryos as judged by total cell number and TUNEL assay were compared among transgenic and nontransgenic (control) embryos. The blastocyst rate was lower (P < 0.05) for transgenic embryos than that of nontransgenic cloned embryos (35.97 ± 2.16 v. 45.80 ± 4.11, respectively). The apoptotic index was found to be lower (P < 0.05) for control blastocysts than that for transgenic blastocysts. However, the total cell number was similar (P < 0.05) among transgenic and control cloned blastocysts. Thus, transgenic cells, and subsequently transgenic embryos containing the human insulin gene, were successfully produced and transferred in recipients. In the future, these may be used for production of transgenic buffalo expressing human insulin in its milk and thus can be further utilised in large-scale production of human insulin.

Phenotypic and antibiogram pattern of V. cholerae isolates from a tertiary care hospital in Mumbai during 2004-2013: a retrospective cross-sectional study

OBJECTIVES

Cholera is a major gastroenteric disease with reports on fluctuation and resistance. Hence, the objective is to determine the trend in seasonality, resistance pattern, prevalent biotypes, serotypes and phage types between 2004 and 2013 among Vibrio cholerae isolates.

DESIGN

A retrospective cross-sectional study.

SETTINGS

A single-centre study was carried out at a tertiary care hospital in a metropolitan city (Mumbai) of a developing country (India).

METHODS

Records of stool specimen cultures of patients with suspected cholera from January 2004 to December 2013 were analysed. The organisms were identified as per standard protocol. Antimicrobial susceptibility testing was performed as per Clinical Laboratory Standard Institute. Biotyping, serotyping and phage typing were carried out. From the confirmed cases of cholera, demographic and laboratory details were noted. Descriptive analysis was used and the data were presented in the form of percentages.

RESULTS

Vibrio cholerae was predominant in males and was isolated from 9.41% (439/4664) of stool specimens. Variability was found in terms of the gross appearance of stool specimens, seasonal trend and antibiotic resistance pattern. The antimicrobial susceptibility showed a waxing and waning pattern for most of the antibiotics (ampicillin, cefuroxime, chloramphenicol, tetracycline) tested, while for a few others the strains were either uniformly sensitive (gentamicin, norfloxacin) or resistant (trimethoprim-sulfamethoxazole, nalidixic acid). All isolates belonged to subgroup O1 and biotype El Tor. The most common serotype was Ogawa. The predominant phage type was T2 (old scheme) and T27 (new scheme).

CONCLUSIONS

The predominant biotype, serotype and phage type were El Tor, Ogawa and T27 phage, respectively. The changing trends in antimicrobial resistance pattern over the years necessitate continued epidemiological and microbiological surveillance of the disease.

Genotypes of CYP1A1, SULT1A1 and SULT1A2 and risk of squamous cell carcinoma of esophagus: outcome of a case-control study from Kashmir, India

Studies on associations of various polymorphism in xenobiotic metabolizing genes with different cancers including esophageal squamous cell carcinoma (ESCC) are mixed and inconclusive. To evaluate the association of CYP1A1*4, SULT1A1*2 and SULT1A2*2 genotypes with ESCC risk and their modifying effects on different risk factors of ESCC, we conducted a case-control study in Kashmir, India, an area with relative high incidence of ESCC. We recruited 404 histopathologically confirmed ESCC cases, and equal number of controls, individually matched for sex, age and district of residence to respective case. Information was obtained on various dietary, lifestyle and environmental factors in face-to-face interviews, using a structured questionnaire, from each subject. Genotypes were analyzed by polymerase chain reaction, restriction fragment length polymorphism and direct sequencing. Conditional logistic regression models were used to calculate odds ratios (ORs) and 95% confidence intervals (95% CIs). A higher risk was observed in the subjects who harbored variant genotype of CYP1A1*4 (OR = 2.06; 95% CI: 1.28-3.32); and the risk was further enhanced in ever smokers (OR = 3.47; 95% CI: 1.62-7.42), adobe dwellers (OR = 6.71; 95% CI: 3.02-14.89), and biomass fuel users (OR = 5.11; 95% CI: 1.34-19.50). We did not find any significant differences in the polymorphic variants of SULT1A1*2 and SULT1A2*2 between cases and controls. The study indicates that, unlike SULT1A1*2 and SULT1A2*2, the polymorphism of CYP1A1*4 is associated with ESCC risk. However, replicative studies with larger sample size are needed to substantiate our findings.

Subfoveal choroidal thickness as a predictor of central serous chorioretinopathy

PurposeThe purpose of the study was to evaluate the role of subfoveal choroidal thickness (CT) measurements as a predictor for the course of central serous chorioretinopathy (CSC).Patients and methodsThirty-eight eyes of 33 patients with CSC were analyzed retrospectively. Key inclusion criteria were naive (acute or recurrent) CSC; a minimum of 12 months of follow up; and the availability of good quality enhanced depth imaging SD-OCT images at each visit. Eyes with changes suggestive of chronic CSC and history of any treatment were excluded. Collected data included demographic profile, visual acuity, subfoveal CT, central macular thickness (CMT), and treatment details. Univariate and multivariate analyses for association of baseline features with need for treatment were performed. On the basis of results of this analysis, the 38 eyes were divided into two groups: Group A (subfoveal CT≤356 μm) and Group B (subfoveal CT>356 μm).ResultsOn univariate analysis, the need for treatment had significantly positive correlation with duration of symptoms (P=0.02), negative correlation with the baseline CT (P<0.01), and no significant correlation with CMT (P=0.13). On multivariate regression analysis, only baseline CT had a statistically significant association with the need for treatment (odds ratio (OR), 0.989; CI, 0.979-0.999; P=0.048). Group A eyes were more likely to require treatment (Group A: 54.55%, 12 of 22 eyes; Group B: 18.75%, 3 of 16 eyes; OR: 5.2, 95% CI, 1.15-23.54; P=0.04). There was a significant decrease in subfoveal CT in Group B (-105.62±108.91 μm; P=0.002).ConclusionCSC with a subfoveal CT≤356 μm is of chronic nature and is more likely to require treatment rather than observation.

Neurological Symptoms, Not Signs,<br />Are Common in Early HIV Infection

Objective. To examine the cross-sectional prevalence of neurological symptoms and signs in a large cohort of human immunodeficiency virus (HIV)-seropositive men, and determine the relationship of the symptoms to disease stage, immunologic markers, and independent variables from neuropsychological (NP) testing and psychiatric interview.

METHODS

One hundred-nine controls and 386 HIV-infected volunteers enrolled in the HIV Neurobehavioral Research Center (HNRC) longitudinal study. The majority, without acquired immune deficiency syndrome (AIDS), were screened for alcohol/substance abuse; previous diagnosis of HIV-associated dementia; and HIV-unrelated developmental, neurological, medical, and neurobehavioral conditions which potentially impair cognition; and underwent a structured neurological interview and examination, standardized NP testing, and psychiatric interview as part of a more extensive battery. A large subset (N = 377) underwent lumbar puncture for cerebrospinal fluid (CFS) examination. We examined the relationship of sixteen select but independent variables, using stepwise multiple regressions, from demographic/staging, immunological, NP, and psychiatric domains to neurological symptoms in an effort to identify possible predictors of subclinical nervous systems involvement. Results. All categories of neurological symptoms were significantly more prevalent among medically asymptomatic (CDC stage A) subjects than controls, with a further rise in prevalence in those with more advanced stages of infection. The most marked rise was seen in cognitive and sensorimotor complaints. In contrast, significant findings on neurological examination were evident in only the sicker (stage C) subjects. Stage of illness, serum &beta;2-microglobulin, psychiatric indices of depressed mood or anxiety, and NP "motor" performance were the most significant independent variables associated with the presence of neurological symptoms. CSF pleocytosis was seen early (CDC stage A), and may reflect the presence of HIV in the central nervous system (CNS) at the least stages of infection. We also confirmed the value of CSF &beta;2m and neopterin as important markers of advancing disease stage. Whether they predict subclinical CNS involvement is to be determined by longitudinal observations. Conclusion. Neurological complains are common in medically asymptomatic HIV subjects whereas signs are not. The symptoms correlate with commonly determined independent measures of depression, anxiety, NP tests of fine motor speed and strength, as well as indices of disease worsening (CDC stage, serum &beta;2m).

Abstract P5-17-04: Breast conserving surgery alone for ductal carcinoma in situ: Factors associated with increased risk of local recurrence

Background: There is ongoing debate regarding the added benefit of radiation therapy (RT) for patients with ductal carcinoma in situ (DCIS) believed to be at low risk for recurrence after wide local excision (WLE) alone since RT is costly and can cause significant adverse effects. In this retrospective study we aimed to identify clinicopathological characteristics associated with an increased risk for ipsilateral local recurrence (LR) in patients not undergoing RT.

Methods: All patients with DCIS treated with WLE alone at the Beth Israel Deaconess Medical Center, Boston between 2000 and 2010 were identified. We collected data on demographics, parity, personal or family history of breast cancer, exogenous hormone use, tobacco use, comorbidities, genetic mutation carrier status, imaging interval, and tumor-specific characteristics (size, margins, grade, architectural subtype, presence of necrosis, estrogen receptor status). We analyzed their effects on the risk of LR.

Results: The study cohort included 281 eligible patients (mean age at diagnosis 59 years, range 33-90). Median follow-up time was 8 years (range 0.11-16.59 years); 59 patients were excluded because they were not followed in our institution after undergoing WLE. LR occurred in 19 of 222 patients (9%), with a recurrence rate of 11.3 per 1000 person-years. The median time from excision to LR was 4.2 years (range, 0.8-11.7). The risk of recurrence was lower for the 64 patients with nuclear grade (NG) I tumors than for the 110 patients with a NG II or 20 patients NG III tumors (3%, 9%, and 20%, respectively, p for trend = 0.01). The mean margin width was 1.8 mm in patients experiencing LR, versus 2.5 mm in patients without LR (p=0.4). Patients who had used hormone replacement therapy or oral contraceptives (n=61) or patients with a history of tobacco use (n=41) had higher rates of LR than those who did not, although these did not reach statistical significance (15% versus 6%, p=0.06; and 17% versus 7%, p=0.07 respectively). There was no significant correlation between the use of tamoxifen or aromatase inhibitors and the risk of LR.

Conclusions: Our data indicate that higher nuclear grade, narrower margin width, use of exogenous hormones, and smoking history may be associated with an increased risk of LR. The evaluation of these factors may be helpful when considering whether to use adjuvant RT or not for patients with DCIS.

Citation Format: Recht A, Mele A, Mehta P, Brook A, Slanetz P, Sharma R. Breast conserving surgery alone for ductal carcinoma in situ: Factors associated with increased risk of local recurrence. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-17-04.

Treatment of postherpetic neuralgia using a thoracic transforaminal epidural steroid injection

A 64-year-old male patient with a history of herpes zoster exposure presented with severe, constant, burning pain in the left T10 dermatome consistent with postherpetic neuralgia. Previous treatment included oral and topical medications as well as an intercostal nerve block; however, these treatment options did not provide significant relief. The patient was treated with a single-level T10 thoracic transforaminal epidural steroid injection for refractory postherpetic neuralgia. He reported complete resolution of his symptoms at 2- and 12-week follow-ups. This case illustrates transforaminal epidural steroid injections may be a successful treatment option for postherpetic neuralgia.

Demonstration of an 8-dimensional modulation format with reduced inter-channel nonlinearities in a polarization multiplexed coherent system

We demonstrate a polarization-managed 8-dimensional modulation format that is time domain coded to reduce inter-channel nonlinearity. Simulation results show a 2.3 dB improvement in maximum net system margin (NSM) relative to polarization multiplexed (PM)-BPSK, and a 1.0 dB improvement relative to time interleaved return-to-zero (RZ)-PM-BPSK, for five WDM channels propagating over 1600 km ELEAF with 90% inline optical dispersion compensation. In contrast to the other modulations considered, the new 8-dimensional format has negligible sensitivity to the polarization states of the neighboring WDM channels. High-density WDM (HD-WDM) measurements on a 5000 km dispersion-managed link show a 1.0 dB improvement in net system margin relative to PM-BPSK.