Outcomes of transfemoral-transcatheter aortic valve replacement with Sapien-3 valve in liver cirrhosis patients

Background

Little is known about the outcomes of liver cirrhosis patients with severe aortic stenosis (AS) who undergo transcatheter aortic valve replacement (TAVR).

Methods

We undertook a retrospective analysis of consecutive patients with severe symptomatic AS who underwent transfemoral-TAVR with Sapien-3 valve at our Clinic between April 2015 and December 2018, yielding 32 patients with liver cirrhosis on imaging including ultrasound and/or computed tomography. Their baseline characteristics, procedural and long-term outcomes after TAVR with the non-cirrhotic group were compared, along with their management strategies as per the hepatology team.

Results

Among 1028 patients, 32 were assigned to the cirrhosis, and 996 were assigned to the non-cirrhosis (control) group. Compared with the control group cirrhotic patients were slightly younger in age (74.5 vs 81.2 years), had a slightly higher BMI (31.3 vs 29.3), and had a higher incidence of prior history of myocardial infarction (38% vs 33%). Baseline variables including the history of smoking, hypertension, diabetes, and atrial fibrillation were comparable in both groups. Among cirrhotic patients (n=32), the most common etiologies were non-alcoholic steatohepatitis (NASH) (37.5%), Alcoholism (18.75%), and Hepatitis C (12.5%). The mean MELD-NA score was 11.8 and 67% of patients were Child PUGH Class A and 33% were Child PUGH Class B and all patients had a Child PUGH score of ≥5. 53% of patients (n=17) in the cirrhosis group were evaluated by Hepatology and 12.5% (n=4) were evaluated for a liver transplant but only 1 patient had a liver transplant post-TAVR. Compared with the control group cirrhotic patients had similar 1-year mortality (12% vs 12%, p=1), had a lower rate of 30-day new pacemaker post tavr (6% vs 9% p=0.85), had a higher rate of 1-year readmission for heart failure (12% vs 5% p=0.12) and similar 1-year major adverse cardiac and cerebrovascular event (MACCE) rate (15% vs 14% p=0.98)

Conclusion

Patients with severe AS undergoing TAVR with concomitant liver cirrhosis demonstrate comparable outcomes compared with their non- cirrhotic counterparts. NASH followed by alcoholic cirrhosis was found to be most common etiology.

Funding Acknowledgement

Type of funding sources: None. Figure 1Figure 2

Development of eco-friendly, self-cleaning, antibacterial membrane for the elimination of chromium (VI) from tannery wastewater

Hydrophobic polyvinylidene fluoride membrane was reformed to the hydrophilic membrane by incorporating synthesized titanium dioxide nanoparticles using Cajanus cajan seed extract. Spectroscopic and microscopic techniques characterized the composite membrane. The X-ray diffraction confirms the anatase phase of titanium dioxide nanoparticles of crystalline size 15.89 nm. The effect of titanium dioxide concentration on the thermodynamical and rheological properties on the polyvinylidene fluoride casting solution was investigated by the triangle phase diagram and viscosity measurement. It was concluded that titanium dioxide introduction caused thermodynamic enhancement, but the impact of rheological hinderance was higher at high concentrations. The polyvinylidene fluoride/titanium dioxide membranes were used as a bi-functional membrane to evaluate the rejection of chromium (VI) from wastewater; then, they were applied as sunlight-active catalyst membrane to reduce the concentrated chromium (VI) to chromium (III) by reduction. It was concluded that at 0.02 wt% of titanium dioxide, the maximum rejection of 85.59% and a% reduction of 92% was achieved with enhanced flux.

Safety and Immunogenicity of MF59-Adjuvanted Cell Culture-Derived A/H5N1 Subunit Influenza Virus Vaccine: Dose-Finding Clinical Trials in Adults and the Elderly

Background

A/H5N1 influenza viruses have high pandemic potential; consequently, vaccines need to be produced rapidly. MF59® adjuvant reduces the antigen required per dose, allowing for dose sparing and more rapid vaccine availability.

Methods

Two multicenter, phase II trials were conducted to evaluate the safety and immunogenicity of an MF59-adjuvanted, cell culture–derived, A/H5N1 vaccine (aH5N1c) among 979 adult (18–64 years old) and 1393 elderly (≥65 years old) subjects. Participants were equally randomized to receive 2 full-dose (7.5 μg of hemagglutinin antigen per dose) or 2 half-dose aH5N1c vaccinations 3 weeks apart. Outcomes were based on Center for Biologics Evaluation Research and Review (CBER) and Committee for Medicinal Products for Human Use (CHMP) licensure criteria (titers ≥1:40 and seroconversions on day 43). Solicited reactions and adverse events were assessed (www.clinicaltrials.gov: NCT01776541 and NCT01766921).

Results

CBER and CHMP criteria were met by both age groups. CBER criteria for hemagglutination titers were met for the full-dose formulation. Solicited reaction frequencies tended to be higher in the full-dose group and were of mild to moderate intensity. No vaccine-related serious adverse events occurred.

Conclusions

In adult and elderly participants, the full-dose aH5N1c vaccine formulation was well tolerated and met US and European licensure criteria for pandemic vaccines.

Breadth of coverage against a panel of 110 invasive disease isolates, immunogenicity and safety for 2 and 3 doses of an investigational MenABCWY vaccine in US adolescents - Results from a randomized, controlled, observer-blind phase II study

BACKGROUND

Neisseria meningitidis serogroups A, B, C, W and Y cause most meningococcal disease worldwide. An investigational MenABCWY vaccine combining serogroup B antigens and a meningococcal ACWY CRM₁₉₇-glycoconjugate vaccine (MenACWY-CRM) could provide protection against all 5 serogroups. Complement mediated bactericidal activity induced by MenABCWY was tested against a panel of 110 randomly-selected serogroup B strains causing invasive disease in the US to evaluate the vaccine's breadth of coverage (BoC).

METHODS

We conducted this observer-blind study (NCT02140762) and its extension (NCT02285777) in 8 centers in the US. Adolescents aged 10-18 years were randomized (1:1) to receive either 3 MenABCWY doses (MenABCWY group), on a 0, 2, 6-month (M) schedule or a single MenACWY-CRM dose at M2 and placebo at 0,6-M (Control group). MenABCWY BoC was calculated as (1 - relative risk) × 100 (relative risk = ratio between the percentage of samples seronegative at 1:4 dilution against the selected strains in the MenABCWY vs Control group). BoC was determined at 1 M and 4 M after 2 and 3 doses, using an endogenous complement serum bactericidal assay. Immunogenicity and safety were assessed.

RESULTS

301 and 189 adolescents were vaccinated in the parent and extension study, respectively. At 1 M post-vaccination, the BoC of MenABCWY across the 110 serogroup B strains was 67% (95%CI: 65-69) after 2 doses and 71% (95%CI: 69-73) after 3 doses. BoC decreased to 44% (95%CI: 41-47) and 51% (95%CI: 48-55) at 4 M after 2 and 3 MenABCWY doses, respectively. Robust immune responses to antigen-specific test strains for each serogroup were observed at all timepoints in the MenABCWY group. No reactogenicity or safety concerns arose during the study.

CONCLUSION

Two or 3 doses of MenABCWY showed similar BoC against the panel of invasive US serogroup B isolates and comparable immunogenicity against the antigen-specific test strains, with no safety concerns identified.

Abstract CT123: A phase I study assessing the safety and clinical activity of multiple doses of a NKG2D-based CAR-T therapy, CYAD-01, administered concurrently with the neoadjuvant FOLFOX treatment in patients with potentially resectable liver metastases from colorectal cancer

We recently developed a novel chimeric antigen receptor (CAR) T-cell therapy, called CYAD-01 (a.k.a. NKR-2), incorporating the full-length human natural killer receptor NKG2D fused with the human CD3 zeta signaling domain, which associates with the adaptor molecule DAP10 to provide co-stimulatory signal upon ligand binding. CYAD-01 is currently evaluated in the ongoing THINK study (NCT03018405) without preconditioning therapy in both hematological and solid indications. Classical CAR-Ts has yet to demonstrate positive results in the context of solid tumors. Underlying reasons for this reduced clinical activity include the need to extravasate from the peripheral circulation, infiltrate into the tumor and overcome the hostile immune suppressive tumor microenvironment (TME) to deliver anti-tumor effector responses. To address the challenge related to the immunosuppressive TME, the SHRINK trial (Standard cHemotherapy Regimen and Immunotherapy with NKR-2) has been developed to assess the safety and clinical activity of multiple infusion CYAD-01 treatment (every 2 weeks x 3 infusions) in patients undergoing standard-of-care FOLFOX (Folinic acid, Fluorouracil (5-FU) and Oxaliplatin) chemotherapy, as neoadjuvant treatment, for the treatment of colorectal metastatic disease with potentially resectable metastases (NCT03310008). The FOLFOX treatment is given every two weeks for six cycles and CYAD-01 cells are infused shortly after chemotherapy on cycles 3, 4 and 5. This concurrent administration of chemotherapy and CYAD-01 treatments would not only (i) favor infiltration into the immunosuppressive TME due to the effect of chemotherapy on TME and cancer cells but also (ii) provide an opportunity for the CYAD-01 cells to better engraft due to the lymphodepletion induced by the standard chemotherapy administration, and likely (iii) increase the NKG2D ligand expression in tumor tissues targeted by CYAD-01, even in patients presenting heterogeneity and/or low ligand expression. The study contains two consecutive segments. The dose escalation segment will enroll 9 patients and will evaluate 3 dose levels of CYAD-01 (1x108, 3x108 and 1x109 CYAD-01 per injection) following a 3+3 design. The expansion segment will then enroll 21 additional patients to further evaluate the safety and potential signs of activity of the CYAD-01 therapy when administered concurrently with chemotherapy. Peripheral blood samples, as well as tumor biopsies from patients at baseline and at resection, will be collected to determine, among others, CYAD-01 persistence, NKG2D ligand expression and systemic cytokine levels in peripheral blood post-infusion.

Citation Format: Caroline Lonez, Alain Hendlisz, Leila Shaza, Philippe Aftimos, Ahmad Awada, Jean-Pascal H. Machiels, Marc Van Den Eynde, Jean-Luc Canon, Javier Carrasco, Bikash Verma, David E. Gilham, Frédéric F. Lehmann. A phase I study assessing the safety and clinical activity of multiple doses of a NKG2D-based CAR-T therapy, CYAD-01, administered concurrently with the neoadjuvant FOLFOX treatment in patients with potentially resectable liver metastases from colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr CT123.

Abstract CT134: A phase I study assessing the safety and clinical activity of multiple hepatic transarterial administrations of a NKG2D-based CAR-T therapy CYAD-01, in patients with unresectable liver metastases from colorectal cancer

We recently developed a novel chimeric antigen receptor (CAR) T-cell therapy, called CYAD-01 (a.k.a. NKR-2), incorporating the full-length human natural killer receptor NKG2D fused with the human CD3 zeta signaling domain, which associates with the adaptor molecule DAP10 to provide co-stimulatory signal upon ligand binding. CYAD-01 is currently evaluated in multiple intravenous administrations in the ongoing THINK study (NCT03018405) in both hematological and solid indications. Classical CAR-Ts has yet to demonstrate positive results in the context of solid tumors. Underlying reasons for this reduced clinical activity include the need to extravasate from the peripheral circulation, infiltrate into the tumor and overcome the hostile immune suppressive tumor microenvironment (TME) to deliver anti-tumor effector responses. To address the challenge related to the difficulty of CAR-T cells to access the site of metastasis, the LINK trial (Locoregional Immunotherapy with NKR-2) has been developed to assess the safety and clinical activity of multiple hepatic transarterial administrations of CYAD-01 treatment (every 2 weeks x 3 infusions) in colorectal cancer patients with unresectable liver metastases (NCT03370198). The hepatic transarterial administration (HTAA) cell therapy may offer the advantage of lower systemic toxicity and higher and more persistent concentration of the infused cells on the TME compared with systemic administration. The difference in blood supply between uninvolved liver parenchyma and metastases may favor CYAD-01 tumor homing. Moreover, based on the potential impact of the CYAD-01 treatment on the host immune system, combined with the tumor antigens spreading induced by its direct anti-cancer cells activity, the CYAD-01 HTAA may boost the adaptive immune response and therefore may control any distant lesion (aboscopal effect). This dose escalation study will use a 3+3 design including 3 dose levels of CYAD-01 (3x108, 1x109 and 3x109 cells per injection) to evaluate the maximum tolerated dose of the CYAD-01 hepatic transarterial administration. Peripheral blood samples, as well as tumor biopsies will be collected to determine systemic CYAD-01 kinetics and within the liver tumor tissues, NKG2D ligand expression and systemic cytokine levels in peripheral blood post-infusion. This study will enroll 12 patients in case of no DLT and is open for recruitment.

Citation Format: Nathalie Braun, Alain Hendlisz, Leila Shaza, Michaël Vouche, Vincent Donckier, Philippe Aftimos, Ahmad Awada, Caroline Lonez, Bikash Verma, David E. Gilham, Frédéric F. Lehmann. A phase I study assessing the safety and clinical activity of multiple hepatic transarterial administrations of a NKG2D-based CAR-T therapy CYAD-01, in patients with unresectable liver metastases from colorectal cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr CT134.

Characterization and compositional analysis of highly acidic karanja oil and its potential feedstock for enzymatic synthesis of biodiesel

In the present study, we focused on the synthesis of biodiesel fromPseudomonas cepacia, crude karanja oil by the process of enzymatic transesterification using bio-support materials, such as lipase immobilized on polyvinyl alcohol/AlgNa.

Study protocol for THINK: a multinational open-label phase I study to assess the safety and clinical activity of multiple administrations of NKR-2 in patients with different metastatic tumour types

INTRODUCTION

NKR-2 are autologous T cells genetically modified to express a chimeric antigen receptor (CAR) comprising a fusion of the natural killer group 2D (NKG2D) receptor with the CD3ζ signalling domain, which associates with the adaptor molecule DNAX-activating protein of 10 kDa (DAP10) to provide co-stimulatory signal upon ligand binding. NKG2D binds eight different ligands expressed on the cell surface of many tumour cells and which are normally absent on non-neoplastic cells. In preclinical studies, NKR-2 demonstrated long-term antitumour activity towards a breadth of tumour indications, with maximum efficacy observed after multiple NKR-2 administrations. Importantly, NKR-2 targeted tumour cells and tumour neovasculature and the local tumour immunosuppressive microenvironment and this mechanism of action of NKR-2 was established in the absence of preconditioning.

METHODS AND ANALYSIS

This open-label phase I study will assess the safety and clinical activity of NKR-2 treatment administered three times, with a 2-week interval between each administration in different tumour types. The study will contain two consecutive segments: a dose escalation phase followed by an expansion phase. The dose escalation study involves two arms, one in solid tumours (five specific indications) and one in haematological tumours (two specific indications) and will include three dose levels in each arm: 3×10⁸, 1×10⁹ and 3×10⁹ NKR-2 per injection. On the identification of the recommended dose in the first segment, based on dose-limiting toxicity occurrences, the study will expand to seven different cohorts examining the seven different tumour types separately. Clinical responses will be determined according to standard Response Evaluation Criteria In Solid Tumors (RECIST) criteria for solid tumours or international working group response criteria in haematological tumours.

ETHICS APPROVAL AND DISSEMINATION

Ethical approval has been obtained at all sites. Written informed consent will be taken from all participants. The results of this study will be disseminated through presentation at international scientific conferences and reported in peer-reviewed scientific journals.

TRIAL REGISTRATION NUMBER

NCT03018405, EudraCT 2016-003312-12; Pre-result.

A NKG2D-based CAR-T therapy in a multinational phase I dose escalation and expansion study targeting multiple solid and hematologic tumor types

TPS3093

Background: Chimeric Antigen Receptor (CAR)-T therapy has potentially serious limitations related to target antigen loss, toxicity due to pre-conditioning regimen, and lack of activity in many tumor types. To overcome these limitations, we have developed a novel CAR-T, called NKR-2, incorporating the full-length human natural killer receptor NKG2D fused with the human CD3 zeta signaling domain. When expressed in T-cells, the naturally-expressed DAP10 provides co-stimulatory signals to NKR-2 to produce cytokines and selectively target tumor cells upon recognition of up to 8 different stress-induced NKG2D ligands expressed in many solid and hematologic malignancies. In preclinical studies, NKR-2 demonstrated long-term anti-tumor activity towards a breadth of tumor indications, in the absence of pre-conditioning, whilst simultaneously targeting tumor cells and cells from the local tumor neo-vasculature and suppressive immune environment. In our recently completed First-in-Human Phase 1 study (NCT02203825) in hematologic cancers, a single administration of autologous NKR-2 was safe with initial signs of clinical benefit. Methods: Exploiting the multiple ligand targeting capability and unique mode of action of NKR-2, the THINK trial (THerapeutic Immunotherapy with NKR-2) is an open-label Phase I study that will assess the safety and clinical activity of multiple infusion NKR-2 treatment (every 2 weeks x 3 infusions) in relapse/refractory patients with metastatic or locally advanced CRC, urothelial carcinoma, TNBC, pancreatic cancer, recurrent epithelial ovarian and fallopian tube carcinoma, AML/MDS and MM, post standard treatment. The study contains two consecutive segments. The dose escalation segment will enroll 18 patients in two separate hematologic and solid malignancy arms, and will evaluate 3 dose levels of NKR-2 (3x108, 1x109 and 3x109 per injection) following a 3+3 design. The expansion segment will then enroll 96 additional patients in 7 separate cohorts for each indication with 3 steps of statistical analysis (overall futility, cohort futility and final evaluation). The study is open for recruitment in both EU and US. Clinical trial information: NCT03018405.

A TCRMimic Monoclonal Antibody Generated from a Directly Discovered Epitope of p68 RNA Helicase Dramatically Debulks Large Established Tumors through Recognition of a Specific MHC/Peptide Complex

Debulking large tumors using monoclonal antibodies (mAb) that specifically recognize unique T cell epitopes represents a novel approach to cancer therapy.Using a mAb designated as a TCRm we recently demonstrated the in vivo suppression of tumor growth. The TCRm had specificity for a peptide/MHC class I molecule expressed on the surface of the tumor cells. In this study we use an innovative direct epitope discovery strategy that led to the identification of peptide YLLPAIVHI in the context of HLA-A*0201 (YLL/A2) in human breast carcinoma cell lines. The peptide is derived from the DEAD Box RNA helicase protein p68, a protein overexpressed and highly phosphorylated in malignant cells. A TCRm antibody (RL6A) was generated and characterized for binding specificity, sensitivity and affinity for the YLL/A2 target. The TCRm specifically stained cells that co-expressed HLA-A2 and p68 but not cells lacking expression of p68 protein or HLA-A2 alone. It binds to cognate peptide/HLA-A2 with an affinity constant (KD) of 5.69 x 10-10 M and recognized specifically the YLL/A2 epitope in human breast cancer tissue but not in normal control breast tissue.Mice implanted in the mammary fat pad with human breast tumor cells grew tumors of considerable size, yet when treated with RL6A TCRm there was a marked reduction in tumor size. Examination of frozen tumor tissue sections revealed significantly greater numbers of apoptotic cells in mice treated with RL6A TCRm than with control antibody. Investigation in vitro showed that TCRm engagement of specific YLL/A2 epitope led to the induction of apoptosis providing the first experimental evidence that MHC signaling could directly mediate tumor cell death. Together, these data indicate that TCRm targeting of specific peptide/MHC complexes unique to tumor cells is effective not only in slowing the growth of tumors but also in dramatically reducing the size of established tumors and suggests a possible novel approach to the treatment of cancer.

Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5072.

Unilateral blepharospasm and blepharoptosis with bilateral vertical gaze palsy in thalamic hemorrhage

We present here case of a 49-year-old female with unilateral left sided blepharospasm and blepharoptosis, bilateral vertical gaze palsy, right hemiparesis and right seventh nerve supranuclear palsy as a manifestation of left thalamic hemorrhage. To our knowledge this is the first reported case of a combination of unilateral blepharospasm and blepharoptosis with bilateral vertical gaze palsy.

Transfusion transmitted malaria in a non-endemic area

Transfusion transmitted malaria in non-endemic areas is a rare and alarming diagnosis. It deserves a special mention because of its rarity, delay in diagnosis, treatment and serious complications. Shimla, though nonendemic, but being a tourist place, can get malaria transported from other parts of India. We present here a case of transfusion transmitted falciparum malaria in IGMC Shimla. We have discussed the strategies for diagnosis and prevention of transfusion transmitted malaria in endemic and non-endemic regions.

Enalaprilat induced acute parotitis

Drug induced acute parotitis is a very uncommon complication reported with a few drugs only. There is no case of acute bilateral parotitis reported previously with i.v. enalaprilat. We present here a female patient who developed acute bilateral parotitis within minutes of i.v. enalaprilat injection and recovered within 24 hours of stopping the drug and with symptomatic treatment.

A post-mortem study of the upper gastro-intestinal tract in head injury cases

A post-mortem study was conducted to find the incidence, morphological changes and distribution of lesions in the upper gastro-intestinal tract (GIT) in victims of head injury who had survived for 24 hours or longer. The study involved naked eye and microscopic examination of the mucosa of the upper gastro-intestinal tract. In this study all the victims of head injury who had survived one or more days showed definite evidence of damage to the lining of the stomach wall. The severity of the damage increased with survival time. The damage observed was in the form of congestion, mucosal haemorrhage, superficial erosions, and superficial ulcerations accompanied by frank haemorrhage.

A computer-aided diagnosis system for digital mammograms based on fuzzy-neural and feature extraction techniques

An intelligent computer-aided diagnosis system can be very helpful for radiologist in detecting and diagnosing microcalcifications' patterns earlier and faster than typical screening programs. In this paper, we present a system based on fuzzy-neural and feature extraction techniques for detecting and diagnosing microcalcifications' patterns in digital mammograms. We have investigated and analyzed a number of feature extraction techniques and found that a combination of three features, such as entropy, standard deviation, and number of pixels, is the best combination to distinguish a benign microcalcification pattern from one that is malignant. A fuzzy technique in conjunction with three features was used to detect a microcalcification pattern and a neural network to classify it into benign/malignant. The system was developed on a Windows platform. It is an easy to use intelligent system that gives the user options to diagnose, detect, enlarge, zoom, and measure distances of areas in digital mammograms.

Intraosseous access using butterfly needle

Butterfly needle (18 G) was used for intraosseous administration of fluids and drugs in 22 children with shock. All except one patient could be stabilized successfully. Fifteen children had severe dehydration because of diarrhoea. The intraosseous route needs to be popularized as an option for rehydration in areas, where diarrhoeal dehydration continues to be an important cause of child mortality.

Topical pefloxacin in bacterial keratitis

PROBLEM

To evaluate the clinical efficacy and safety of topical pefloxacin 0.3% drops as the sole antibiotic used to treat culture positive bacterial corneal ulcers.

METHODS

Forty two consecutive Gram's smear-positive cases of bacterial corneal ulcers were enrolled for this prospective open labelled clinical trial. All patients underwent a complete clinical and microbiological work up and were put on topical 0.3% pefloxacin drops with supportive cycloplegic, vitamins and antiglaucoma therapy. Of 42 cases, 4 cases of mycotic keratitis and 6 culture negative cases were excluded from the study.

RESULTS

Positive microbiologic cultures were obtained in 84.2% (32 of 38) cases. Staphylococcus aureus (14/32; 43.7%) and coagulase negative Staphylococci (12/32; 37.5%) were the two most common organisms isolated. Resolution of the corneal ulcer was achieved in 31 out of 32 cases (96.9%) with a mean duration of 9.3+/-5.3 days (range 3-21 days). Best corrected visual acuity of 20/200 or better was achieved in 65.6% of cases at 4 weeks post resolution. Corneal deposits were observed in one case which disappeared 8 days following discontinuation of therapy.

CONCLUSIONS

Topical pefloxacin is effective as a single antibiotic agent for the treatment of bacterial keratitis.

Study on serum sperm agglutination in cases of unexplained infertility

In our study we investigated 100 couples of unexplained infertility in order to detect the presence of anti-spermatozoal antibodies. Both auto-immunity and Iso-immunity have been found responsible in 12.5% of couples of primary infertility & 10% of couples of secondary infertility. As many as, 21% of cases of unexplained infertility were attributed to presence of antibodies in sera of infertile couples. Here, we highlight the importance of anti-spermatozoal antibodies testing in the first instance itself in cases of unexplained infertility.

Plants obtained from the Khair tree (Acacia catechu Willd.) using mature nodal segments

An in vitro method for obtaining plants of Acacia catechu has been developed using nodal explants from mature `elite' trees growing in the field. Maximum shoot bud development (eight to ten) from a single explant was achieved on Murashige and Skoog (MS) medium supplemented with 6-benzylaminopurine (BAP) (4.0 mg/l) and α-naphthaleneacetic acid (0.5 mg/l). Addition of adenine sulphate (25.0 mg/l), ascorbic acid (20.0 mg/l) and glutamine (150.0 mg/l) to the medium was found beneficial for maximum shoot bud induction. The shoot buds developed into healthy and sturdy shoots on MS medium containing BAP and kinetin at 1.0 mg/l. Excised shoots were rooted on 1/4-strength MS medium with indole-3-acetic acid at 3.0 mg/l and 1.5% sucrose to obtain complete plants.

Recognition of rotating images using an automatic feature extraction technique and neural networks

This paper presents a new automatic feature extraction technique and a neural network based classification method for recognition of rotating images. The image processing technique extracts global features of an image and converts a large size image into a one-dimensional small vector. A special advantage of the proposed technique is that the extracted features are the same even if the original image is rotated with rotation angles from 5 to 355 or rotated and a little bit distorted. The proposed technique is based on simple co-ordinate geometry, fuzzy sets and neural networks. The proposed approach is very easy in implementation and it has been developed in C++ on a Sun workstation. The experimental results have demonstrated that the proposed approach performs successfully on a variety of small as well as large scale rotated and distorted images.

Acute ethanol consumption synergizes with trauma to increase monocyte tumor necrosis factor alpha production late postinjury

The hypothesis that acute ethanol uptake plus trauma can synergize to increase immunosuppression was tested. We found that, unlike non-alcohol-exposed patients, patients with acute alcohol use prior to trauma have a transient decrease in monocyte tumor necrosis factor alpha (TNF alpha) production during the very early postinjury (0-3 days) period. However, TNF alpha production by these alcohol-exposed patients' monocytes (M0) became hyperelevated late postinjury (> 9 days). Consequently, these massively elevated M0 TNF alpha levels can contribute to posttrauma immunosuppression after acute alcohol use. We also demonstrate that normal monocyte activation with the superantigen, Staphylococcus enterotoxin B (SEB), results in a preferential induction of cell-associated M0 TNF alpha production, described as characteristic of immunosuppressed trauma patients. Acute in vitro ethanol treatment down-regulated the elevated TNF alpha production by trauma patients' M0 after either SEB, muramyl-dipeptide (MDP), interferon-gamma plus MDP, or lipopolysaccharide (LPS) stimulation. Both SEB- and LPS-induced TNF alpha mRNA induction was inhibited by acute alcohol treatment in normal M0, indicating that ethanol can regulate cytokine gene expression. An additional immunosuppressive effect of acute ethanol's stimulation was suggested by its induction of elevated transforming growth factor beta production in trauma patients' activated M0.

Regulatory potential of ethanol and retinoic acid on human monocyte functions

Retinoic acid (RA), a metabolic product of vitamin A, has been shown to affect a variety of immune functions, including monocytes. Monocyte functions and mediator production are also modulated by ethanol exposure. This study demonstrates that therapeutic doses of RA (0.1-10 microM) significantly increase transforming growth factor-beta (TGF beta) production both in THP-1, human myelomonocytic cells, and in human peripheral blood monocytes. We have previously reported TGF beta induction by ethanol in human M theta. Combination of RA stimulation with acute in vitro ethanol treatment, however, resulted in significantly lower M theta TGF beta production than TGF beta levels induced by RA alone (p < 0.003). Down-regulation of M theta TGF beta production by ethanol was tested at the concentration range of 25-150 mM and occurred both at high and low RA concentrations (10-0.1 microM). In contrast to its inhibitory effect on RA-induced M theta TGF beta production, ethanol augmented TGF beta production induced by muramyl dipeptide (20 micrograms/ml), suggesting that ethanol can either up- or down-regulate M theta TGF beta production, depending on the costimulatory factors. RA also induced a moderate increase in M theta tumor necrosis factor-alpha (TNF alpha) production, which was down-regulated by ethanol both at the level of secreted and cell-associated TNF alpha. In addition to regulation of cytokine production, both RA and ethanol decreased expression of CD4 on THP-1 cells. The degree of inhibition of CD4 expression by RA was more significant than by ethanol, but RA-induced decrease in CD4 expression was not significantly affected by the combined stimulation with ethanol.(ABSTRACT TRUNCATED AT 250 WORDS)

Selective inhibition of antigen-specific T lymphocyte proliferation by acute ethanol exposure: the role of impaired monocyte antigen presentation capacity and mediator production

Ethanol consumption is associated with impaired immunity. Our data demonstrate that even a single dose of a biologically relevant concentration (25-150 mM) of ethanol can down-regulate antigen-specific T lymphocyte proliferation. In contrast, ethanol augmented mitogen-induced T cell proliferation, suggesting that its inhibitory effect on antigen-specific T cell proliferation was due to its effects on monocytes (m phi s) rather than on T cells. The immunodepressive effects of ethanol on m phi antigen-presenting cell (APC) capacity were manifested whether alcohol treatment was limited to the antigen uptake-processing period only or was present during the entire period of antigen presentation. These inhibitory effects of ethanol were also evident on both the high-antigen-presenting, Fc gamma RI-negative (-31 +/- 17%), and low-antigen-presenting, Fc gamma RI-positive (-42 +/- 15%) m phi subpopulations. Further analysis demonstrated that ethanol inhibits the production of interleukin-1 beta (IL-1 beta) and induces transforming growth factor beta (TGF-beta) and prostaglandin E2 (PGE2), monocyte-derived mediators that can affect T cell proliferation. Ethanol resulted in a dose-dependent down-regulation of secreted and cell-associated IL-1 beta protein as well as IL-1 beta mRNA levels induced by adherence or bacterial stimulation. The causal relationship between decreased m phi IL-1 beta production, elevated TGF-beta levels, and the decreased m phi APC capacity was further substantiated when exogenous IL-1 beta protein or anti-TGF-beta neutralizing antibody prevented the down-regulatory effect of ethanol on antigen-specific T cell proliferation. Utilizing a cyclooxygenase inhibitor, we also demonstrated that the ethanol-induced decrease in m phi APCs is not mediated by enhanced PGE2 production.

Partial purification and characterization of phosphatidylinositol kinase from bovine brain

Purification of Phosphatidylinositol (PI) kinase was attempted from bovine brain. A seven step purification protocol increased the specific activity 100 x but attempts at further purification were unsuccessful. Labeling of the partially purified PI kinase with the ATP analog fluorosulfonylbenzoyl adenosine reproducibly identified three bands on polyacrylamide gel electrophoresis of 76 K, 45 K, and 29 K, one of which likely represents PI kinase. Kinetic studies showed a Km of 17 microM for ATP, 0.02 mg/ml for PI and a Vm of 1830 pmol/min/mg protein for ATP and 820 pmol/min/mg protein for PI.