Molecular characterization of serotype G2 and G3 human rotavirus strains that have an apparently identical electropherotype of the short RNA pattern

The literature is conflicting whether or not rotavirus strains with different G serotype have an identical electropherotype. This is a contentious but an important issue because large parts of molecular epidemiological studies of rotaviruses have been based on the conception that a single strain of rotavirus can be defined by a single electropherotype. Here, we examined in detail by reverse-transcription PCR genotyping, electropherotyping, sequencing, and genogrouping using RNA--RNA hybridization three human rotavirus strains isolated in India that had apparently identical electropherotypes although one strain was typed as P[4], G3 while the other two typed as P[4], G2. These three strains showed an identical electropherotype on 7.5% and 12.5% polyacrylamide gels, but co-electrophoresis on a 10% gel demonstrated that segment 8 of the P[4], G3 strain migrated more slowly than the cognate segment of the P[4], G2 strains. Genogrouping assay and nucleotide sequencing provided evidence for the hypothesis that the P[4], G3 stain was an intergenogroup reassortant in which a P[4], G2 strain of the DS-1 genogroup had acquired the VP7 gene from an yet-unidentified concurrently circulating G3 strain. While electropherotyping remains a valuable asset for molecular epidemiology of rotaviruses, this study underscores the importance of co-electrophoresis under different electrophoretic conditions when pinpointing subtle differences.

Evaluation of ventilator-associated lower respiratory tract infection and tracheobronchial aspiration of gastrointestinal contents

STUDY OBJECTIVE

Ventilator-associated lower respiratory tract infection (LRTI) in a set up of respiratory intensive care unit was evaluated. Also the incidence of tracheobronchial aspiration of gastrointestinal contents was explored among these patients.

DESIGN

Twenty eight patients admitted in the respiratory intensive care unit of referral teaching hospital were studied. All patients were evaluated for tracheobronchial aspiration of gastrointestinal contents in the initial 48 hours of initiating mechanical ventilation using methylene blue as marker and glucostix reagent strip. Protected endotracheal aspirate was secured after 48 hours of beginning of mechanical ventilation and was submitted for microbiological assay.

RESULTS

Of the 28 mechanically ventilated patients, 82% were found to have developed LRTI. Aerobic gram-negative bacilli accounted for 79% of the infections, Klesiella responsible for 39% while Pseudomonas and Escherichia accounted for 18% each. The remaining 4% were caused by Acinetobacter. Gram-positive cocci were responsible for 21% of infection with Staphylococcus and enterococci 14% and 7% respectively. Tracheobronchial aspiration of GI contents was found to be present in 72% of the patients which was significantly correlated with the incidence of LRTI (p=0.014). Significant association was also found between the incidence of LRTI and mortality (p=0.05).

CONCLUSION

The incidence of gastrointestinal aspiration was found to be high and correlation with LRTI was significant. Both glucostix reagent strip and methylene blue were observed to have same positivity rate.

Comparative analysis of knowledge, attitudes and perceptions about induced abortions among medical and non-medical students of Karachi

OBJECTIVE

To determine the knowledge, attitudes and perceptions regarding induced abortions among university students of Karachi and compare these aspects among medical and non-medical students.

STUDY DESIGN

Cross sectional opinion survey.

METHODS

The study is a cross sectional opinion survey of medical and non-medical students from four educational institutions of Karachi using a pretested questionnaire.

RESULTS

Of the 381 students interviewed, 201 were medical and 180 were non-medical. More medical students were aware of the correct definition of induced abortion. An encouraging finding was the awareness of our study population about the only legally acceptable circumstance for induced abortion in Pakistan, that is, if conceptus is a risk to maternal health (p<0.001). More medical students cited complications that were technical like uterine perforation (p<0.001), cervical trauma (p<0.001), DIC (p<0.001), and sepsis (p<0.001). More medical students thought induced abortion to be a health issue (p=0.001) as compared to non-medical students. Most of the medical students felt the need to modify Pakistan's law regarding abortion (p=0.008) especially for fetal anomalies (13.9%) and rape (7%).

CONCLUSION

Though medical students were more knowledgeable about induced abortions as compared to the non-medical population, there is a need to improve awareness regarding induced and unsafe abortions and their consequences.

Quantitative structure-activity relationship study on N-(pyridin-4-yl)-(indol-3-yl) alkylamides as antiallergic agents

The antihistamine activity of N-(pyridin-4-yl)-(indol-3-yl) alkylamides has been analyzed using Fujita-Ban and Hansch approaches. The analyses have helped to ascertain the role of different substituents in explaining the antiallergic actions of these analogues. From both approaches it is revealed that the small size substituents at R and R2 and non-hydrogen bond acceptor substituent at R improve histamine antagonist activity of a compound. Likewise, a small incision such as -CH2CONH-serving as the spacer between pyridinyl and indolyl rings and a bigger substituent like 4-FBn at R1 are also desirable for inhibitory activity.

Time trends in the prevalence of hypertension and associated risk factors in Chandigarh

To estimate the changes in the prevalence of hypertension and associated risk factors over a 30 years period a cross-sectional population survey in three randomly selected sectors of Chandigarh city was carried out. Study population consisted of 1181 individuals (570 males and 611 females) aged 35 years and above. A total of 1049 subjects were interviewed using a structured interview schedule, and 937 were examined by a physician. Blood pressure and anthropometric measurements were recorded. Physical activity was graded according to the job performed by the individual. Guidelines of the Fifth Joint National Committee (JNC-V) of USA were used for diagnosis of hypertension. Estimation of body fat from skin fold thickness was done by applying Grande's formula and the method of Pascale et al. Data were compared to that of year 1968 when a similar cross-sectional survey had been carried out in Chandigarh. Age and sex standardised prevalence of hypertension according to JNC-V criteria increased from 26.9 per cent in 1968 to 44.9 per cent in 1996-97. In 1968, 70% of the male population were engaged in sedentary and light physical activity compared to 73.7 per cent in 1996-97. Total body fat has increased in both men and women. High and high middle income groups in males were 61.2% in 1996-97 compared to 37.4% in 1968. Smoking rates, however, remained unchanged, 25.4 per cent men smoked in 1968 compared to 24.6 per cent in 1996-97. The prevalence of hypertension has almost doubled over 30 years in Chandigarh. Unfavourable change in prevalence of hypertension, physical activity and body fat makes this population highly vulnerable to cardiovascular morbidity and mortality.

Suppression of bloodfeeding by Ochlerotatus dorsalis and Ochlerotatus melanimon on cattle treated with python ear tags

Adult mosquitoes were collected by drop traps to compare bloodfeeding rates between cattle treated with 2 Python ear tags (10% zeta-cypermethrin and 20% piperonyl butoxide) per animal and animals that were untreated. Mosquitoes were collected both 2 and 4 wk after application of the ear tags. Bloodfeeding by Ochlerotatus dorsalis was reduced by 79 and 77%, respectively, and bloodfeeding by Ochlerotatus melanimon was reduced by 84 and 81%, respectively, at 2 and 4 wk. Based on chi-square analysis, differences in bloodfeeding rates due to treatment were significant. The effect of the treatment appeared to be repellency, because no mosquito mortality was observed at the time of collection and no mortality was observed among bloodfed mosquitoes that were collected and held for 24 h.

Demonstration of scolex in calcified cysticercus lesion using gradient echo with or without corrected phase imaging and its clinical implications

AIM

This study was performed to determine the magnetic resonance imaging (MRI) sequence that was best suited to demonstrate the scolex in a calcified lesion and to seek the explanation for the appearance of a negative phase in a calcified scolex on corrected gradient refocused echo (GRE) phase imaging.

MATERIALS AND METHODS

Forty-nine patients with single/multiple computed tomography (CT) documented homogeneous calcified lesions and/or calcified scolices in cysts were studied with conventional spin echo and corrected GRE phase imaging. Calcium and different paramagnetic substances from cysticerci scolices of a sample of infected swine muscle were quantified.

RESULTS

The scolex could be demonstrated in 29/39 patients with single calcified lesion. GRE imaging with an echo time of 35ms was the only sequence that demonstrated scolex in all these 29 cases. 15/29 patients with a single calcified lesion, in all 10 patients with multiple calcified lesions and infected swine muscle with multiple cysts and calcified scolex, corrected GRE phase imaging showed negative phase in all these scolices. Estimation of minerals from the calcified scolices from the swine muscle showed by spectroscopic techniques 41.2% of the total mineral contents as paramagnetic substances.

CONCLUSION

We conclude that GRE imaging is the imaging method of choice for demonstration of the scolex in a CT calcified lesion. The negative phase on corrected GRE phase imaging is due to the presence of large amount of paramagnetic substances.

Laparoscopic appendectomy in modern gynecology

Gynecologists frequently manage women with acute or chronic pain in the right iliac fossa. Appendicitis is one of the common conditions encountered in this setting. From the gynecologic perspective, issues regarding the role of laparoscopic appendectomy include radioimaging and laparoscopic diagnosis, operative technique, advantages and disadvantages, and laparoscopic appendectomy in pregnancy and in complicated appendicitis. Most studies are in favor of the procedure, and it seems reasonable to include it in training programs in gynecology.

Adaptive mechanisms induced by long-term estrogen deprivation in breast cancer cells

Clinical observations suggest that human breast tumors can adapt in response to endocrine therapy by developing hypersensitivity to estradiol. To understand the mechanisms responsible, we examined estrogenic stimulation of cell proliferation in a model system and provided evidence that long-term deprivation of estradiol causes adaptive hypersensitivity. The enhanced responses to estradiol do not involve mechanisms acting at the level of transcription of estrogen regulated genes. We found no evidence of hypersensitivity when examining the effects of estradiol on regulation of c-myc, pS2, progesterone receptor, several ER reporter genes or c-myb in hypersensitive cells. On the other hand, deprivation of breast cells long term was found to up-regulate a separate pathway whereby the estrogen receptor co-opts a classical growth factor pathway and induces rapid non-genomic effects. Through this pathway, estradiol caused rapid activation of mitogen-activated protein (MAP) kinase. In exploring the mechanisms mediating this event, we found that estradiol binds to cell membrane associated estrogen receptors and causes phosphorylation of Shc, an adaptor protein usually involved in growth factor signaling pathways. ERalpha was found to complex with Shc under these conditions. In turn, Shc bound Grb-2 and Sos which resulted in the activation of MAP kinase. The pure antiestrogen, ICI 182,780, blocked several steps in the rapidly responding ER alpha, Shc, MAP kinase pathway. These non-genomic effects of estradiol produced biologic effects by activating Elk and by inducing morphologic changes in cell membranes. Using confocal microscopy, we demonstrated that estradiol caused a rapid alteration in membrane ruffling, the formation of pseudopodia and translocation of ER alpha to regions contiguous with the cell membrane. These morphologic effects could be blocked with a pure anti-estrogen. We conclude that long-term estradiol deprived cells utilize both genomic (transcriptional) and rapid, non-genomic estradiol induced pathways. We postulate that synergy between these two pathways acting at the level of the cell cycle is responsible for adaptive hypersensitivity.

Regulation of osteoblast growth by interactions between transforming growth factor-beta and 1alpha,25-dihydroxyvitamin D3

Osteoblast growth and differentiation encompass a series of events including proliferation, changes in cell shape, and expression of the markers specific for osteoblast phenotype. Both transforming growth factor-beta (TGF-beta) and 1alpha,25-dihydroxyvitamin D3 (1alpha,25[OH]2D3) are effective in regulating osteoblast proliferation, differentiation, bone matrix maturation and cell-specific gene expression. Although there is some degree of controversy regarding the influences on osteoblasts in vitro, it is generally agreed that TGF-beta stimulates osteoblast proliferation and growth, and inhibits the expression of the markers characteristic of the osteoblast phenotype such as osteocalcin. In contrast, 1alpha,25(OH)2D3 causes inhibition of the proliferation of osteoblasts, arrests their growth, and stimulates expression of specific markers. In many studies, complex interactions have been demonstrated between TGF-beta and 1alpha,25(OH)2D3 modulating their receptor expression, synthesis, and effects on osteoblast-specific gene expression. The cooperative actions of TGF-beta and 1alpha,25(OH)2D3 can be synergistic or antagonistic. It has recently been established that Smad proteins that transduce signals downstream the TGF-beta stimulation may mediate the crosstalk between TGF-beta and 1alpha,25(OH)2D3 signaling. Future studies should focus on the explanation of the molecular basis of these interactions and the in vivo consequences of the regulation of osteoblast growth and differentiation by TGF-beta and 1alpha,25(OH)2D3.

Allergenic cross-reactivity of Curvularia lunata with other airborne fungal species

BACKGROUND

Curvularia lunata is an important fungus for respiratory allergic disorders. Previous studies indicated cross-reactivity of Curvularia with other fungi. However, the cross-reactive allergenic component (s) were not identified. The present work was carried out to study the shared allergenic components of C. lunata and others.

METHODS

Cross-reactivity studies were performed using pooled hypersensitive patient sera to C. lunata by ELISA, immunoblot, immunoblot inhibition and ELISA inhibition.

RESULTS

Many C. lunata sensitive patients showed positive skin test to five other fungi. Alternaria alternata exhibited maximum (68%) whereas Cladosporium herbarum showed the least (17%) skin reactivity. Immunoblots of fungal extracts with pooled sera showed common proteins. Fusarium solani and C. herbarum showed negligible IgE binding. IgE ELISA inhibition with C. lunata showed 92% inhibition whereas A. alternata and E. nigrum showed 84% and 63%, respectively. Immunoblot inhibition with self protein showed complete loss of IgE-binding activity. Proteins of 26, 31, 38, 45 and 50 kDa of C. lunata were inhibited by A. alternata and E. nigrum, whereas A. fumigatus inhibited 26, 45 and 50 kDa proteins.

CONCLUSIONS

Significant allergenic cross-reactivity exists among proteins of C. lunata, A. alternata and E. nigrum. Proteins of 26, 31, 38, 45 and 50 kDa are shared allergens in these fungi.

MR imaging and in vivo proton spectroscopy of the brain in neonates with hypoxic ischemic encephalopathy

INTRODUCTION

A number of studies have suggested the potential utility of in vivo proton MR spectroscopy for the evaluation of brain injury in the asphyxiated neonates. We present our initial experience with in vivo proton MR spectroscopy in neonates who were diagnosed as having hypoxic injury on clinical examination and the severity of the insult was graded using Sarnat staging.

METHODS AND MATERIAL

MR imaging and in vivo proton MR spectroscopy was performed in 16 neonates with hypoxic ischemic encephalopathy (HIE) to correlate the imaging and metabolite abnormality with clinical severity of the condition at the time of insult and with outcome at 2 months of age. The ratios of different metabolites were calculated as observed on MR spectroscopy from an 8 ml voxel that included thalami, basal ganglia and part of the ventricular system using spin echo technique with an echo time of 135 ms.

RESULTS AND DISCUSSION

The results of the spectroscopy were compared with imaging abnormalities and Sarnat's clinical staging of HIE. MR Imaging abnormalities included basal ganglia, thalamic and periventricular hemorrhage and periventricular hyperintensities and were noticed in 8/16 neonates with different stages of HIE. Maximum imaging abnormalities were noted in stage II (6/9) followed by stage III (1/2) and stage I (1/5), respectively. The alpha-Glx resonance at 3.76 ppm was seen in 14/16, Glycine at 3.56 ppm (Gly) was seen in 10/16 and Lactate (L) at 1.33 ppm was observed in 4/16 neonates with HIE.

CONCLUSION

MR spectroscopy was more sensitive than imaging in detecting the insult due to HIE and increased concentration of alpha-Glx/Cr and Gly/Cr correlated better with severity of the HIE. The demonstration of L was associated with poor outcome.

Ketamine dependence

Ketamine hydrochloride is a safe and rapid-acting non-opioid, lipid soluble anaesthetic with a short elimination half-life that is used for medical and veterinary purposes. It produces a state of "dissociative anaesthesia", probably from action on N-methyl-D-aspartate (NMDA) receptors. The psychotropic effects of ketamine range from dissociation and depersonalization to psychotic experiences and include a sensation of feeling light, body distortion, absence of time sense, novel experiences of cosmic oneness and out-of-body experiences. Abuse of ketamine has been reported, the typical abuser being an individual who uses multiple drugs and has some contact with medical agencies. This case demonstrates the effects of large doses of ketamine in a person with polysubstance abuse. The case also highlights development of significant tolerance to ketamine without prominent withdrawal symptoms. Caution in use of ketamine is reiterated in light of its abuse liability.

Knowledge and practice pattern of non-allopathic indigenous medical practitioners regarding tuberculosis in a rural area of India

OBJECTIVE

To assess the knowledge and practice patterns of non-allopathic indigenous medical practitioners (IMPs) regarding tuberculosis (TB).

METHODS

Seventy-four IMPs practising in Naraingarh block, a rural area of Haryana State, India, were interviewed using a semi-structured interview schedule.

RESULTS

Fifty-four per cent (40/74) of the IMPs saw two to five TB patients every month. Sixty-one per cent (46/74) reported that they based their diagnosis of TB on symptoms alone, whereas 38% use diagnostic tests such as chest X-ray, erythrocyte sedimentation rate and sputum examination. Forty per cent of the IMPs reported that alcohol was the cause of TB, 36.5% cited smoking and 17.6% reported infection as the cause. Only 34% (25/74) of IMPs reported that they treated TB patients, while the rest said that they referred such cases to nearby hospitals. Anti-tuberculosis drugs used by IMPs were isoniazid, rifampicin and streptomycin, but none of them knew the dosage of the drugs, the duration of treatment or the correct regimen. Sixty-four per cent of the 25 IMPs reported using ayurvedic medicines.

CONCLUSION

Considerable proportions of TB patients seek IMPs for cure of TB, while the knowledge and practice of IMPs is inadequate.

Effect of vitamin A supplementation on childhood morbidity and mortality

In a double blind design, 1520 children aged < 10 years were individually randomised in vitamin A and placebo group in slums of Chandigarh. Children > 12, 6-12 and < 6 months of age received 200,000, 100,000, 500,000 I.U. of vitamin A respectively every 4 to 6 months during 15 months trial period. The prevalence of vitamin A deficiency was significantly reduced in vitamin A compared to placebo group during the follow-up period. In vitamin A group, incidence of diarrhoea and measles was significantly reduced but incidence of acute respiratory infections was not significantly different compared to control group. Risk of death was also significantly less in vitamin A group. Therefore, promotion of vitamin A rich diet or supplementation with synthetic vitamin A at 4-6 month interval should be a priority in populations where risk of vitamin A deficiency is high.

Construction of an RAPD linkage map and localization of QTLs for oleic acid level using recombinant inbreds in mustard (Brassica juncea)

RAPD markers were employed for construction of a linkage map and localization of QTLs for oleic acid level using a set of 94 recombinant inbred lines (RILs) of mustard (Brassica juncea L.) as a mapping population. Only 30% of the 235 random primers used were useful in terms of polymorphism detected and the reproducibility of those patterns. Normal Mendelian segregation was observed for the majority of the 130 markers obtained with 71 informative primers; only 13.1% deviated (P < 0.01) from the expected 1:1 ratio. One-hundred and fourteen markers were assigned to 21 linkage groups (LGs) covering a total length of 790.4 cM with an average distance of 6.93 cM between markers. Two quantitative trait loci (QTL) for oleic acid level were mapped to 14- and 10.6-cM marker intervals on two different LGs. Both loci together explained 32.2% of phenotypic variance. One major QTL explained 28.5% of the trait variance observed in this species.

Synthesis and biologic activity of a C-ring analog of vitamin D3: biologic and protein binding properties of 11.alpha.-hydroxyvitamin D3

The influence of C-ring substituents on the biologic activity and protein binding properties of vitamin D3 has not been systematically investigated. To this end, we dehydrogenated cholesta-5,7-dien-3 beta-ol (1) to the 5,7,9(11)-triene. After protection of the 5,7-diene with a 4-phenyl-1,2,4- triazoline -3,5-dione Diels -Alder adduct, oxidation of the unprotected 9(11)-olefin gave epoxide 5. Reverse Diels -Alder and reductive ring opening of epoxide 5 gave cholesta-5,7-diene-3 beta, 11 alpha-diol (6). Photolysis of 6 to the previtamin followed by thermal rearrangement resulted in 11 alpha-hydroxyvitamin D3 (8). We found that vitamin 8 increased calcium transport at a dose of 500 pmol/rat but failed to increase bone calcium mobilization at a dose as high as 50 000 pmol/rat. Under the same conditions, corresponding doses of vitamin D3 and 25-hydroxyvitamin D3 increased bone calcium mobilization and intestinal calcium transport. The new vitamin analogue, 8, was slightly less efficient (B-50 = 6.8 X 10(-8) M) than 25-hydroxyvitamin D3, 24(R),25-dihydroxyvitamin D3, and 25-(S), 26-dihydroxyvitamin D3 (7.1 X 10(-9) M, 7.7 X 10(-9) M, and 7.9 X 10(-9) M, respectively) in displacing radiolabeled 25-hydroxyvitamin D3 from rat plasma vitamin D binding protein. On the other hand, vitamin analogue 8 showed significantly greater binding efficiency than 1 alpha-hydroxyvitamin D3, 1,25-dihydroxyvitamin D3, and vitamin D3 (B-50 = 2.5 X 10(-6) M, 9.84 X 10(-8) M, and 5.46 X 10(-7) M, respectively), under these same conditions.(ABSTRACT TRUNCATED AT 250 WORDS)

Autocrine production and synergistic growth-promoting activity of interleukin-6 and oncostatin M in a new human myeloma cell line TU-1

Human myeloma cell lines are difficult to establish, and they usually originate from patients with extramedullary disease. We describe a new human myeloma cell line, TU-1, which was established from the bone marrow of a patient without extramedullary myeloma. The myeloma cells were initially maintained in a conditioned medium derived from another well-known myeloma cell line U-266. This conditioned medium contained interleukin-6 (IL-6) and oncostatin M (OSM), and possibly other unknown growth factors as well. In 3 months the TU-1 cell line proliferated autonomously and secreted IL-6 and OSM with a synergistic growth response. As we have previously shown the cell line acquired a p53 mutation in vitro, which may be an important factor causing autonomous proliferation. In patients with multiple myeloma OSM is frequently found in the serum and OSM has been associated with serum IL-6 and progressive disease. Our study demonstrates the close relationship of OSM and IL-6 also in vitro.