Apolipoprotein E gene polymorphism and dyslipidaemia in adult Asian Indians: A population based study from Calcutta, India

AIM:

The study was aimed to determine the association of Apolipoprotein E (apo E) gene polymorphisms on lipid levels in Asian Indian population.

METHODS:

A total of 350 (184 males and 166 females) adult (30 years and above) Asian Indians of Calcutta and suburb participated in the study. Anthropometric measures, lipids profiles, and blood glucose measures were collected. Out of 350 subjects, a sample of 70 individuals was selected randomly for genotyping after adjusting for age and sex. The apo E gene polymorphisms were determined by agarose gel electrophoresis.

RESULTS:

The apo E polymorphism showed significant association with dyslipidaemia (P=0.0135) with ε3/4 combination has had the highest occurrence of dyslipidaemia and metabolic syndrome (MS) followed by ε4/4 <ε3/3 <ε2/4 <ε2/3 in decreasing order.

CONCLUSIONS:

The ε4 allele of apo E gene independent of other risk factors is associated with dyslipidaemia in particular with low HDLc and high TC: HDLc ratio.

Potential allergens of green gram (Vigna radiata L. Millsp) identified as members of cupin superfamily and seed albumin

BACKGROUND

No systematic study on allergenicity of green gram seed proteins have been performed so far, although incidences of IgE-mediated reaction to green gram seedlings have been reported.

OBJECTIVE

We sought to investigate the allergenic potential of green gram, followed by identification and characterization of its relevant allergens using proteomic approaches.

METHODS

BALB/c mice were sensitized intraperitoneally with green gram proteins, and levels of specific Igs, Th2 cytokines, histamine, anaphylactic symptoms and histopathological responses were studied. Twelve naso-bronchial allergic patients with a history of sensitization to green gram were selected on the basis of positive skin prick test and elevated specific IgE levels. Green gram allergens were identified and characterized by their ability to endure pepsin, by IgE immunoblot of two-dimensional (2D) gels in combination with mass spectrometry and by bioinformatics approaches.

RESULTS

Increased specific IgE, IgG1, Th2 cytokine and histamine levels, high anaphylactic scores and histological changes in lungs and spleen of green gram crude protein extract-treated mice are indicative of its sensitization ability. Four proteins (molecular weights: 52, 50, 30 and 18 kDa) showed pepsin resistance and IgE-binding capability with sensitized human and mice sera. The four proteins tentatively named as Vig r2 (52 kDa, pI 5.7), Vig r3 (50 kDa, pI 5.8), Vig r4 (30 kDa, pI 6.6) and Vig r5 (18 kDa, pI 5.5) showed significant sequence similarity with known allergens of soybean, lentil, pea, lupin, etc. Mass spectrometric analysis identified Vig r2 as 8S globulin β-isoform precursor, Vig r3 as 8S globulin α-isoform precursor and Vig r4 as seed albumin.

CONCLUSION AND CLINICAL RELEVANCE

Green gram seeds contain at least four clinically relevant allergenic proteins, namely Vig r2, Vig r3, Vig r4 and Vig r5 that were capable of inducing strong IgE-mediated reactions. One of the most important steps towards diagnostic and therapeutic approaches to deal effectively with food allergy is continued identification of newer food allergens and their characterization. The significance of this study can be enormous as the data generated may work as basic biology data in developing a green gram species modified genetically that may have reduced allergenicity.

Mechanisms of follicle selection and development

Follicle recruitment and selection, the process that gives rise to the dominant follicle (DF) and the physiological state of the DF are important areas of research. The selection of a single ovarian follicle for further differentiation and finally ovulation is a shared phenomenon in monovulatory species including humans. The DF is different from other follicles because it can escape atresia (the fate of all other follicles). The DF cells develop corpus luteum if exposed to the luteinizing hormone (LH) surge. Several mechanisms for DF selection have been proposed. Rising follicle stimulating hormone (FSH) concentrations induce the emergence of a follicle wave and cohort attrition occurs during declining FSH concentrations, resulting in DF selection. Cohort secretions are initially responsible for the decline in FSH, which is subsequently suppressed by the selected DF lowering it below the threshold of FSH requirements of all other cohort follicles. The DF acquires relative FSH-independence in order to continue growth and differentiation during further declining FSH concentrations. A transition from FSH- to LH-dependence is postulated as the mechanism for the continued development of the selected DF. In addition, FSH and insulin-like-growth factor (IGF) enhance each other's ability to stimulate follicle cell function. Access of IGF II to their receptors is regulated by IGF binding proteins that are in turn regulated by specific proteases; all of which have been ascribed a role in DF development. One other shared mechanism recently proposed for DF selection is the possible differential regulation of blood vessel formation. Anti-Müllerian hormone (AMH) also plays a critical role in selection of the DF. AMH levels decline as the size of the follicle increases. Once follicles reach a size at which they are dominant, it has largely disappeared. From the time a follicle has been selected, the follicle destined to ovulate greatly enlarges and shows marked changes in its steroidogenic activity. LH surge causes a significant decline in gap junctions leading to dissociation of mural granulosa cells (GC) and expansion of the cumulus-oocyte complex (COC). The oocyte resumes its meiosis and progresses from prophase 1 to metaphase 2 at the time of ovulation. The concept of DF selection could be applied to the in-vitro maturation (IVM) program. Understanding the mechanism of DF selection in menstrual cycles is the key to planning the optimal timing of oocyte retrieval in order to obtain competent oocytes and embryos. Although the timing of oocyte retrieval is still open to debate, there is evidence to suggest that it may be better to retrieve oocytes before the small cohort follicles complete the process of atresia following selection of the DF.

Complications of misuse of Bacillus Calmette-Guerin

Intravesical BCG is a good treatment choice for vesical carcinomas. Nevertheless, it can also become a mortal toxin when applied in a wrong way. The application routes of the prescribed drug should be rigorously described to patients and detailed instructions regarding the ways of application such as intravesical application should be given to the persons taking this medicine (Ref. 9).

Phage types of Vibrio cholerae O1 and O139 in the past decade in India

Cholera has been a prevalent disease worldwide since the early 19th century. Vibrio cholerae O1 and O139 are the two serogroups that have been mainly implicated in causing cholera. This study reports the results of biotyping, serotyping and phage typing of V. cholerae O1 and O139 (1998-2007) strains received from different parts of India for the identification of the trends in the occurrence and spread of cholera in the country. However, there has been a notable steep decline in the occurrence of V. cholerae O139 strains over the past few years resulting in no strain of V. cholerae O139 being received from any part of India in 2007 and 2008. Of the total strains received, 79.1% were serotyped as Ogawa and the remaining 20.9% were found to be Inaba, which indicates that Ogawa was the predominant serotype. Almost 100% typeability was observed with the new scheme of V. cholerae O1, with type 27 being the dominant phage type and V. cholerae O139 strains were clustered into the predominant phage type T-1. From the phage typing and serotyping results, it can be concluded that V. cholerae O1 (T-27) and O139 (T-1) strains circulate throughout the country at any given time.

Functional MR imaging in patients with carotid artery stenosis before and after revascularization

BACKGROUND AND PURPOSE

Significant extracranial stenosis of the ICA is a known risk factor for future stroke and it has been shown that revascularization reduces the risk of future stroke. We applied BOLD fMRI in patients with carotid artery stenosis before and after CEA. Our purpose was to determine whether fMRI is able to demonstrate impaired CVR and to identify patient parameters that are associated with postoperative changes of cerebral hemodynamics.

MATERIALS AND METHODS

Nineteen consecutive patients with symptomatic (n = 13) and asymptomatic (n = 6) stenosis of the ICA were prospectively recruited (male/female ratio = 16:3; age, 69 ± 8,1 years). fMRI using a simple bilateral motor task was performed immediately before and after CEA.

RESULTS

Mean BOLD MSC was significantly increased postoperatively (MSC, 0.13 ± 0.66; P = 0.0002). Patients with a stenosis of <80% demonstrated an increase in MSC (MSC, 0.32 ± 0.59; P ≤ .0001). Patients with previous ischemic stroke showed a larger MSC than patients with TIAs (stroke: MSC, 0.55 ± 0.65; P ≤ .0001; TIA: MSC, 0.05 ± 0.26; P = 0.054). Patients older than 70 years had a significantly larger MSC following surgery (≤70 years: MSC, -0.01 ± 0.39; P = .429; >70 years: MSC, 0.29 ± 0.48; P ≤ .0001).

CONCLUSIONS

BOLD fMRI can demonstrate changes in cerebral hemodynamics before and after CEA, indicative of an ameliorated CVR. This response is dependent on the age of the patient, the degree of preoperative stenosis, and the patient's symptoms.

Association of metabolic syndrome with obesity measures, metabolic profiles, and intake of dietary fatty acids in people of Asian Indian origin

OBJECTIVE

The present community-based cross-sectional study was aimed to examine the association of metabolic syndrome (MS) with obesity measures, metabolic profiles, and intake of dietary fatty acids in Asian Indian population.

PATIENTS AND METHODS

A total of 350 adult (30 years and above) individuals (184 males and 166 females) inhabiting in and around Kolkata, India participated in this study. MS was defined using the protocol specifically designed for Asian Indian population.

RESULTS

The prevalence of MS in the study was 31.4%. The prevalence was significantly higher (P < 0.01) in females (48.2%) as compared to males (16.3%). It was observed that males without MS had significantly higher mean waist circumference (WC P < 0.05); waist-hip ratio (WHR; P < 0.001); triglyceride (TG; P < 0.05); very low density lipoprotein cholesterol (VLDLc; P < 0.05) and fasting blood glucose (FBG; P < 0.01) as compared to females without MS. Significant differences were also observed for dietary intake of total fatty acids (TFA; P < 0.001); saturated fatty acids (SFA; P < 0.001) and polyunsaturated fatty acids (PUFA; P < 0.001) between individuals with and without MS. However, no significant association was observed in individuals with MS after controlling for age and sex. On the other, WC and body mass index (BMI) had significant correlation with SFA: mono unsaturated fatty acids (MUFA; P < 0.01) in individuals without MS even after controlling for age and sex.

CONCLUSION

It seem reasonable to argue that while dealing with MS in Asian Indians, clinicians should consider obesity measures, metabolic profiles and dietary fatty acids simultaneously.

Early control of distal internal carotid artery during carotid endarterectomy: does it reduce cerebral microemboli?

AIM

According to the results of the large trials on carotid endarterectomy (CEA), this type of surgery is only warranted if perioperative mortality and morbidity are kept considerably low. Less attention has been paid to methods of cerebral protection during CEA, although intraoperative transcranial Doppler (TCD) can visualise intracerebral microemboli (MES) during routine carotid dissection, although MES occur throughout the CEA, only those during dissection are related to neurological outcome. Prevention of MES by means of early control of the distal internal carotid artery dislodging from the carotid artery plaque during dissection is very likely the mechanism behind an eventual benefit from this approach. Hence, the amount of MES might serve as a surrogate parameter for the risk of periprocedural neurological events. So, the aim of the present study was to evaluate whether early control of the distal carotid artery during CEA is capable of reducing the number of MES by means of a prospective randomised trial.

METHODS

Twenty-eight patients (29 procedures) could be prospectively included in our study. Before surgery we randomly assigned the patients to two groups: group A (N.=12): CEA by means of early control of the distal internal carotid artery; group B (N.=17): CEA with dissection of the total carotid bifurcation before clamping the arteries. Periprocedurally, we continuously monitored the cerebral blood flow in the ipsilateral middle cerebral artery by means of TCD. Pre- and postoperative morbidity were independently verified by a neurologist <2 days before and not later than five days after the procedure. Values of microembolic signs during dissection were summarised with arithmetic means and standard deviations. For further analysis non parametric Wilcoxon test was performed between both methods. P-values <0.05 were considered as statistically significant. Wilcoxon test was performed to compare both methods concerning clamp- and procedure times.

RESULTS

We performed EEA 26 times, in three patients a longitudinal arteriotomy with endarterectomy and patchplasty was performed, in one of these patients a shunt was necessary. In 12 twelve patients MES occurred during the dissection before clamping. Eight of these patients belonged to group B and four patients to group A. The mean number of MES during dissection for group A was 2.4 (SD 4.6; 5-15) and for group B 3.9 (SD 7.1; 2-28). There is no statistically significant difference in the Wilcoxon-test; P=0.4375. There was no patient showing reperfusion syndrom or clinical signs of a new cerebral infarction or any other neurological deficit. There were no other major complications like myocardial infarction or death as well as no minor complications like periphereal nerve lesions, bleeding or wound healing disturbance.

CONCLUSION

In this prospective, randomised trial early control of the distal internal carotid artery did not reduce the occurrence of MES during dissection of the carotid bifurcation. Also, the total number of MES throughout the procedure and postoperatively was comparable between both groups. The procedure related times as well as the clinical outcome did not differ significantly. Thus, early control of the distal internal carotid artery has got no advantage but also no disadvantage as compared to the traditional CEA technique. However, a limitation of the study is the small number of patients included.

Prevalence of cardiovascular disease risk factors in people of Asian Indian origin: Age and sex variation

BACKGROUND

No study has been undertaken on people of Asian Indian origin to investigate the age and sex variation in the prevalence of cardiovascular disease (CVD) risk factors.

OBJECTIVES

To investigate the age and sex variation in the prevalence of CVD risk factors among the people of Asian Indian origin.

MATERIALS AND METHODS

A total of 682 (302 males and 380 females) participants aged 25-85 years took part in the study. The subjects were categorized into 4 groups, namely, Group I (25-34 years), Group II (35-44 years), Group III (45-54 years), and Group IV (55 years and above). Height, weight, and the circumferences of minimum waist (MWC) and maximum hip were collected using standard techniques. Waist-hip ratio (WHR) was then calculated. Percentage of body fat (%BF) and body mass index (BMI) were measured using an Omron body fat analyzer. Left arm systolic (SBP) and diastolic (DBP) blood pressure were taken from each participant with the help of an Omron MI digital electronic blood/pulse monitor. Metabolic profiles, namely, total cholesterol (TC), triglyceride (TG), high (HDL), low (LDL), very low-density lipoprotein (VLDL), and fasting blood glucose (FBG) were also measured using an autoanalyzer.

RESULTS

One-way analysis of variance revealed significant differences for age, BMI, MWC, WHR, SBP, DBP, TC, TG, LDL, VLDL, and TC:HDL and TG:HDL ratios across the groups. It was observed that there were significant sex-specific group differences (male [χ(2) (12)] =29.22, P < 0.01 and female [χ(2) (12)] =56.69, P < 0.001) for obesity, high BP, high TC, high TG, and high FBG. But no significant group-specific sex difference was evident for either of the risk factors, except for Group IV.

CONCLUSION

Age irrespective of sex modulates CVD risk factors and warranted prevention as early as middle age.

Factor analysis of risk variables associated with metabolic syndrome in adult Asian Indians

BACKGROUND

Several studies hinted about the clustering of risk variables of the metabolic syndrome (MS) and suggested that the underlying genetic polymorphisms could be responsible for the increasing incidence of coronary heart disease (CHD) in people of Indian origin. Therefore, identification of the components of the MS along with the genetic factors could be one of the aspects to make an attempt to prevent the increasing incidence of CHD.

MATERIALS AND METHODS

Principal component factor analysis (PCFA) was undertaken to identify the components or factors of the MS among the adult (≥30 years) Asian Indians living in and around Calcutta, India. The study comprised 350 adult Asian Indians. Anthropometric measurements were taken, and lipid profiles, blood pressure and fasting blood glucose were measured for each participant. Two genetic polymorphisms, namely, angiotensin converting enzyme (ACE) gene polymorphism (insertion/deletion [I/D]) or ACE (I/D) and apolipoproteinE (Hha I) were also studied.

RESULTS

PCFA revealed 3 factors that cumulatively explained 65.39% of the observed variance of the MS by measured variables. The 3 factors identified were lipids and lipoprotein (Factor 1), centripetal fat and blood pressure (Factor 2), and ACE (I/D) polymorphism with blood pressure (Factor 3). Moreover, the first 2 factors, that is, lipids, lipoprotein, centripetal fat, and blood pressures cumulatively explained ~46% (45.94%) of the observed variance of MS in this population.

CONCLUSIONS

Since more than 1 factor was identified for the MS phenotype, more than 1 physiogenetic mechanism could be accounted for MS in the Asian Indian population.

Sarcoptic mange infestation in pigs in a hilly region of Meghalaya

Skin lesions were collected from 15 adult crossbred pigs maintained at the pig farm of ICAR Research Complex for the North-Eastern Hill Region, Umiam, a hilly region of the state of Meghalaya, India. Skin scrapings of these 15 animals were examined by KOH digestion method. Presence of mites were detected in five animals which were indistinguishable from Sarcoptes scabiei var. suis. Infected pigs were treated with a single dose of Ivermectin at 200 ug/kg body weight, subcutaneously. No mites were recovered from treated pigs after a period of 10 days of post-treatment. The presence of S. scabiei var. suis in pigs from this part of the country has never been reported. This infestation has great significance because it affects the growth rate and feed conversion significantly, specially to the grower and weaned pigs. It can be concluded that S. scabiei var. suis infestation is prevalent in hilly region of Meghalaya. The pig producers are generally unaware about the severity of the problem of mite infestation, so precaution should be taken to prevent their valuable pigs from S. scabiei var. suis infestation.

Synergistic effects of ACE (I/D) and ApoE (HhaI) gene polymorphisms among the adult Asian Indians with and without metabolic syndrome

A total of 350 (184 males and 166 females) adults participated in the study. A sample of 138 individuals was selected randomly for genotyping. The synergistic effect of ACE (I/D) and ApoE (HhaI) on metabolic syndrome (MS) showed that individuals with e4/4+D/D combination had the highest occurrence of metabolic abnormalities.

Non-endoscopic screening biomarkers for Barrett's oesophagus: from microarray analysis to the clinic

BACKGROUND AND AIMS

Barrett's oesophagus predisposes to oesophageal adenocarcinoma but the majority of patients are undiagnosed. A novel non-endoscopic cytological screening device, called a capsule sponge, makes population-based screening for the disease a feasible option. However, due to the mixed cell population retrieved by the capsule sponge, biomarkers specific for Barrett's oesophagus are required.

METHODS

Three publically available microarray datasets were used to identify putative biomarkers present in Barrett's oesophagus but absent from normal oesophagus and gastric mucosa. Validation was performed by qPCR (n = 10 each of normal oesophagus, Barrett's oesophagus, gastric mucosa) and immunohistochemistry (normal oesophagus, n = 20; Barrett's oesophagus, n = 21; gastric mucosa, n = 24; duodenum, n = 18). The biomarker was then prospectively evaluated on capsule sponge specimens from 47 patients with Barrett's oesophagus and 99 healthy controls.

RESULTS

2/14 genes identified, dopa decarboxylase (DDC) and Trefoil factor 3 (TFF3), were confirmed by qPCR to be upregulated in Barrett's oesophagus compared to normal oesophagus (p<0.01) and gastric mucosa (p<0.01 and p<0.05, respectively). Immunohistochemistry confirmed that DDC protein expression was restricted to Barrett's oesophagus but was confined to <1% of the cells within the crypt compartment. TFF3 protein was expressed to high levels at the luminal surface of Barrett's oesophagus compared to absent expression in normal oesophagus and gastric mucosa (p<0.001). Using the capsule sponge 36/46 patients with Barrett's oesophagus (one inadequate sample) and 6/96 controls were positive for TFF3 giving a sensitivity of 78% and a specificity of 94%.

CONCLUSIONS

TFF3 is a promising marker for Barrett's oesophagus screening since it is expressed at the luminal surface of Barrett's oesophagus but not in adjacent tissue types and may be applied to a non-endoscopic screening device.

Carotid plaque analysis: comparison of dual-source computed tomography (CT) findings and histopathological correlation

PURPOSE

Plaque morphology is an important predictor of stroke risk and may also be a predictor of postoperative outcome after carotid endarterectomy (CEA). Thus, the purpose of our study was to evaluate the findings of preoperative dual-source computed tomography (DSCT) of carotid plaque morphology and correlate these findings with histopathological findings.

MATERIAL AND METHODS

Thirty patients undergoing CEA due to neurological events and high-grade carotid artery stenosis were evaluated with DSCT for degree of stenosis following the North American Symptomatic Carotid Endarterectomy Trial (NASCET) criteria and for non-invasive plaque morphology prior to CEA. CT protocol was as follows (SOMATOM Definition, Siemens Medical Solutions, Forchheim, Germany): A dual-energy protocol was used with tube A (140 kV, 55 mA) and tube B (80 kV, 230 mA) with 2 x 64 x 0.6-mm collimation, pitch 0.65 and rotation time of 0.33 s. Histopathological work-up was performed on the surgically retrieved tissues. The findings from DSCT and histopathology were compared with respect to image quality and plaque composition (fatty plaque, mixed plaque and calcified plaque), were correlated with histological specimens and classified according to the American Heart Association (AHA) classification of atherosclerotic plaque. Pearson correlation and kappa statistics were performed.

RESULTS

The image quality of DSCT was rated as 'excellent' in all the examinations. The mean degree of stenosis was quantified as 82%. The sensitivity of DSCT for the detection of calcification was 100% (standard deviation (SD) 0%, confidence interval (CI): 99-100). While the sensitivity for the detection of mixed plaques was 89% (SD 12%, CI: 79-98), it was 85% (SD 10%, CI: 76-92) for the detection of low-density fatty plaques. The mean degree of agreement was k=0.81.

CONCLUSION

DSCT angiography of the carotid arteries is feasible and the evaluation of carotid plaque composition allows non-invasive assessment of different plaque components. This may have an impact on the non-invasive differentiation of vulnerable plaques.

Visceral leishmaniasis on the Indian sub-continent: a multi-centre study of the costs of three interventions for the control of the sandfly vector, Phlebotomus argentipes

The sandflies that transmit the parasites causing human visceral leishmaniasis (VL) can be controlled by several methods, including indoor residual spraying (IRS), the use of long-lasting insecticidal nets (LLIN) and ecological vector management (EVM). The financial costs of each of these three methods of sandfly control have recently been assessed and compared, in a multi-centre study based on the Indian sub-continent. In each of the four study sites (two in Nepal and one each in India and Bangladesh), 24 neighbourhoods were randomly selected in districts with high incidences of VL. The costs of the three interventions were then prospectively assessed in each study neighbourhood, in the local currency, and then converted to U.S. dollars at the prevailing exchange rate in the country concerned. The costs of IRS, which ranged from U.S.$2.4-11.7 (mean = U.S.$5.9) per household-year, were greater than those of LLIN (U.S.$3.5-5.1/household-year, with a mean of U. S.$4.5) but less than those of EVM (U. S.$5.0- 14.0/household-year, with a mean of U.S.$8.7). These results indicate that LLIN and IRS may be the cheaper options for the control of sandflies on the Indian sub-continent, and that EVM should perhaps only be taken up as a complimentary and voluntary method. Various combinations of these interventions (based on country-specific social and economic factors) may, however, be the best and most cost-effective choice.

Angiotensin converting enzyme gene polymorphism (insertion/deletion) and hypertension in adult Asian Indians: a population-based study from Calcutta, India

The angiotensin converting enzyme (ACE) gene insertion/deletion polymorphism has been identified as a potential genetic risk factor for essential hypertension. The purpose of the present study is to investigate the association of the insertion/deletion polymorphism of the ACE gene with essential hypertension in adult Asian Indians. Three hundred fifty (184 males and 166 females) adult (30 years and older) Asian Indians of Calcutta and its suburbs participated in this population-based cross-sectional study. Anthropometric measures, lipids profiles, blood glucose, and blood pressure measures were collected from participants. ACE insertion/deletion polymorphism was determined by agarose gel electrophoresis and D/D typing was further reconfirmed using insertion-allele-specific amplification. Essential hypertension was defined as a systolic blood pressure (SBP) greater than 160 mm Hg and/or a diastolic blood pressure (DBP) greater than 90 mm Hg or use of any antihypertensive treatment by participants. Significantly higher SBP, DBP, and mean arterial pressure were recorded in D/D subjects compared to I/I and I/D subjects. We also observed that the odds of being hypertensive were 7.483 (95% CI = 1.746, 30.192) in D/D individuals compared to those carrying one or no D alleles. This finding suggests that ACE insertion/deletion polymorphism is associated with essential hypertension in Asian Indians. Moreover, individuals who are homozygous for the D allele of the ACE gene are more likely to have essential hypertension.

Multi-loop networked process control: a synchronized approach

Modern day process control uses digital controllers which are based on the principle of distributed rather than centralized control. Distributing controllers, sensors and actuators across a plant entails considerable wiring which can be reduced substantially by integrating the components of a control loop over a network. The other advantages include greater flexibility and higher reliability with lower hardware redundancy. The controllers and sensors are on a network and can take over the function of a failed component automatically, without the need of manual reconfiguration, thus eliminating the need of having a redundant component for each and every component. Though elaborate techniques have been developed for Single Input Single Output (SISO) systems, the major challenge lies in extending these ideas to control a practical process plant where de-centralized control is actually achieved through control of individual SISO control loops derived through de-coupling of the original system. Multiple loops increase network load and hence the sampling times associated with the control loops and makes synchronization difficult. This paper presents a methodology by which network based process control can be applied to practical process plants, with a simple direct synchronization mechanism.

Performance evaluation of a computer-aided detection algorithm for solid pulmonary nodules in low-dose and standard-dose MDCT chest examinations and its influence on radiologists

The aim of the study was to evaluate the performance of a computer-aided detection (CAD) algorithm in low-dose and full-dose multidetector-row CT (MDCT) of the thorax and its impact on radiologists' performance. Chest CT examinations of 77 patients were evaluated retrospectively for pulmonary nodules. All patients had undergone a 16-slice MDCT chest examination with a standard acquisition protocol. Artificial image noise was added to the raw data to simulate image acquisition at 10 mAs(eff.) The data were transferred to dedicated lung analysis software (LungCare) with a prototype CAD algorithm (LungCAD). CAD was applied to both dose settings. Images were read by a radiologist and a first-year resident with and without the software at both dose settings. All images were reviewed in consensus by the two radiologists to set the reference standard. Sensitivity results with respect to the reference standard were compared. No statistically significant differences in the detection rate for all pulmonary nodules could be found between low-dose and full-dose settings for the CAD software alone (p = 0.0065). Both radiologists displayed a statistically significant increase in sensitivity with the use of CAD (p<0.0001). In conclusion, CAD is beneficial in both low-dose and standard-dose settings. This may be beneficial in reducing false-negative diagnosis in lung cancer screening, standard chest examinations and the search for metastases.

Rural urban differences of cardiovascular disease risk factors in adult Asian Indians

The prevalence of cardiovascular disease (CVD) risk factors in "People of Indian Origin" (PIO) is exceedingly high and strong relationships among elevated blood pressure, increased levels of lipoproteins, visceral obesity, physical inactivity and subsequent high occurrence of coronary heart disease, type 2 diabetes mellitus etc., were evident in many studies. Increasing urbanization with effective changes in lifestyles could be attributed to explain this exaggerated rate. The present community based cross-sectional investigation was aimed to identify rural-urban differences in prevalence of risk factors of CVD in the adult Asian Indians. A total of 350 adult (30 years and above) individuals (184 males and 166 females) belong to urban (n = 193, males = 104, and females = 89) and rural (n = 157, males = 80, and females = 77) areas participated in the study. Anthropometric measures, lipids profiles, fasting blood glucose and blood pressure measures were obtained from participants. The mean body mass index (kg/m2) for male and female was 22.37 +/- 4.09 and 23.20 +/- 4.37, respectively. There existed significant differences for anthropometric, metabolic, and blood pressure variables between rural and urban areas. Habitat (rural vs. urban) had significant impact on central adiposity, lipids, lipoproteins, and blood pressure measures even after adjusted for age and sex. Overall, 84.3% of females had lower HDL level compared with only 20.1% in males. It was also observed that the prevalence of metabolic syndrome was 56.2% in urban females compared with 36.4% in rural females. Effective urbanization and or modernization seem to influence CVD risk factors and warrants intervention as early as adulthood to check this menace.

Insertion of EGF receptors into target cells in the absence of fusogenic agents

Epidermal growth factor (EGF) receptors can be spontaneously and selectively transferred from donor plasma membranes to recipient receptorless fibroblasts in the absence of any added fusogenic agent. Studies on the time and temperature dependence of this transfer indicate that it is due to preferential insertion of the EGF receptor over the other plasma membrane proteins. The inserted receptor is exceptionally stable to dissociation or damage. The number of receptors inserted increased with increasing amounts of donor membranes and then reached a plateau, which also suggests the existence of saturable receptor 'docking' sites in recipient cells. It is interesting that both human and murine receptors are selectively inserted into the mutant mouse cell membrane. This suggests that the parts of the receptor molecule responsible for insertion are similar in murine and human receptors, and that a 'docking' factor present in the mouse recipient cells may accept both human and murine receptors.

Pediatric multidetector computed tomography using tube current modulation and a patient image gallery

BACKGROUND

Dose reduction is crucial in pediatric multidetector computed tomography (MDCT).

PURPOSE

To perform pediatric 16-slice MDCT using tube current modulations and to adjust prospectively the tube current using a patient image gallery (IG) providing simulated dose-reduced protocols; and to evaluate and compare the image quality of the IG and the clinical MDCT.

MATERIAL AND METHODS

30 examinations (thorax, n = 15; abdomen, n = 8; pelvis, n = 7) in 20 patients (nine male, age 8.05 +/- 7.33 years, weight 29.8 +/- 24.02 kg) were performed according to an IG on a 16-slice MDCT with additional use of online tube current modulation (CARE Dose). Three radiologists visually assessed image quality from the IG and actual 16-slice MDCT scans. For objective analysis, image noise was determined.

RESULTS

Statistical analysis showed moderate concordance in objective (K = 0.68-0.78) and subjective (K = 0.33-0.64) image assessment between the IG and clinical 16-slice MDCT scans. Depending on the weight group and clinical question, no or only minor dose reductions in the chest, but moderate to considerable reductions in the abdominal/pelvic 16-slice MDCT scans compared to previously used pediatric protocols were achieved. Extra dose reduction was achieved due to additional use of CARE Dose depending on age group and scan region (mean 8.6-23.9%).

CONCLUSION

The IG enabled us to prospectively reduce the tube current and adapt the required image quality to the clinical question. Additional dose reduction was achieved with application of CARE Dose; nevertheless, the images are comparable to the simulated images of the IG.

Granulosa cell survival and proliferation are altered in polycystic ovary syndrome

CONTEXT

Polycystic ovary syndrome (PCOS) represents the most common endocrine abnormality in women of reproductive age. The cause of PCOS remains largely unknown, but studies suggest an intrinsic ovarian abnormality.

OBJECTIVE

The objective of the study was to test our hypothesis that differences in granulosa cell proliferation and apoptosis may underlie abnormalities that affect follicular development.

DESIGN

Granulosa cells were prepared from follicular fluid aspirated from 4- to 8-mm follicles of unstimulated ovaries during routine laparoscopy or laparotomy from women with anovulatory PCOS and those with regular ovulatory cycles.

SETTING

The study was conducted at a university hospital.

PATIENTS

Fourteen women with anovulatory PCOS and nine women with regular ovulatory cycles participated in the study.

MAIN OUTCOME MEASURES

Immunocytochemistry on granulosa cells to investigate apoptotic and proliferation rates, together with real-time RT-PCR to analyze gene expression profiles of apoptotic regulators, was measured.

RESULTS

Significantly lower apoptotic rates were found in granulosa cells from patients with PCOS, compared with women with regular ovulatory cycles (P=0.004). Lower apoptotic rates were associated with decreased levels of the apoptotic effector caspase-3 (P=0.001) and increased levels of the anti-apoptotic survival factor cellular inhibitor of apoptosis proteins-2 in the PCOS group that were coupled to higher proliferation rates (P=0.032). Gene expression profiling confirmed the immunocytochemical findings.

CONCLUSIONS

Our findings indicate that there are significant differences in the rate of cell death and proliferation in granulosa cell populations in PCOS patients. These are associated with decreased expression of apoptotic effectors and increased expression of a cell survival factor. These results provide new insights that may be useful in developing specific therapeutic intervention strategies in PCOS.