Potential drug-drug interactions among hospitalised TB patients

BACKGROUND: Hospitalised TB patients are at heightened risk for developing drug-drug interactions (DDIs) due to overlapping CYP450 enzyme and/or drug transporter biotransformation of anti-TB drugs and co-medications given for treating TB-associated comorbidities. We aimed to compare the occurrence, characterisation and determinants of database identified potential DDIs (pDDIs) associated with first-line anti-TB drugs and other co-medications using a subscription and free access drug information database.METHOD: This was a single-centre retrospective study to assess pDDIs between first-line anti-TB drugs and other medications for comorbidities among hospitalised TB patients using IBM Micromedex^® and Drugs.com.RESULTS: On multivariate regression analysis, hospitalised TB patients with comorbidities such as diabetes mellitus, HIV infection and hypertension, longer hospitalisation, and patients administered with more than seven drugs during their hospital stay were associated with increased risk for the occurrence of pDDIs. Significant discrepancies were observed in the detection and severity of pDDIs between IBM Micromedex and Drugs.com.CONCLUSION: We recommend using free access drug information database to a subscription drug information database in drug interaction screening protocols in clinics for enhanced identification of pDDIs and reducing monetary burden in resource-limited settings.

Erratum: Frequency of heavy vehicle traffic and association with DNA methylation at age 18 years in a subset of the Isle of Wight birth cohort

[This corrects the article DOI: 10.1093/eep/dvy028.][This corrects the article DOI: 10.1093/eep/dvy028.].

Frequency of heavy vehicle traffic and association with DNA methylation at age 18 years in a subset of the Isle of Wight birth cohort

Assessment of changes in DNA methylation (DNA-m) has the potential to identify adverse environmental exposures. To examine DNA-m among a subset of participants (n = 369) in the Isle of Wight birth cohort who reported variable near resident traffic frequencies. We used self-reported frequencies of heavy vehicles passing by the homes of study subjects as a proxy measure for TRAP, which were: never, seldom, 10 per day, 1-9 per hour and >10 per hour. Methylation of cytosine-phosphate-guanine (CpG) dinucleotide sequences in the DNA was assessed from blood samples collected at age 18 years (n = 369) in the F1 generation. We conducted an epigenome wide association study to examine CpGs related to the frequency of heavy vehicles passing by subjects' homes, and employed multiple linear regression models to assess potential associations. We repeated some of these analysis in the F2 generation (n = 140). Thirty-five CpG sites were associated with heavy vehicular traffic. After adjusting for confounders, we found 23 CpGs that were more methylated, and 11 CpGs that were less methylated with increasing heavy vehicular traffic frequency among all subjects. In the F2 generation, 2 of 31 CpGs were associated with traffic frequencies and the direction of the effect was the same as in the F1 subset while differential methylation of 7 of 31 CpG sites correlated with gene expression. Our findings reveal differences in DNA-m in participants who reported higher heavy vehicular traffic frequencies when compared to participants who reported lower frequencies.

Green silver nanoparticles for drug transport, bioactivities and a bacterium (Bacillus subtilis)-mediated comparative nano-patterning feature

Supramolecular hydrogel-capped non-toxic Ag NPs are effective for cellular drug transport and are potentially bioactive, which also leads to the formation of novel silver nanoparticles.

A supramolecular hydrogel for generation of a benign DNA-hydrogel

A DNA-hydrogel, produced using calf-thymus DNA and a 2′,4′,6′-tri(4-pyridyl)pyridine based luminescent supramolecular hydrogel, can stabilize sunray mediated photochemically synthesized bio-compatible, luminous Ag-NPs.

Mortality and cardiovascular disease among older live kidney donors

Over the past two decades, live kidney donation by older individuals (≥55 years) has become more common. Given the strong associations of older age with cardiovascular disease (CVD), nephrectomy could make older donors vulnerable to death and cardiovascular events. We performed a cohort study among older live kidney donors who were matched to healthy older individuals in the Health and Retirement Study. The primary outcome was mortality ascertained through national death registries. Secondary outcomes ascertained among pairs with Medicare coverage included death or CVD ascertained through Medicare claims data. During the period from 1996 to 2006, there were 5717 older donors in the United States. We matched 3368 donors 1:1 to older healthy nondonors. Among donors and matched pairs, the mean age was 59 years; 41% were male and 7% were black race. In median follow-up of 7.8 years, mortality was not different between donors and matched pairs (p = 0.21). Among donors with Medicare, the combined outcome of death/CVD (p = 0.70) was also not different between donors and nondonors. In summary, carefully selected older kidney donors do not face a higher risk of death or CVD. These findings should be provided to older individuals considering live kidney donation.

BRCA1 protein expression and its correlation with ER/PR status in sporadic and familial breast cancer in Eastern Indian patients--a hospital based study

BRCA1 gene expression in familial breast cancer is mainly focused on mutational analysis. However in sporadic cancers BRCA1 protein expression is the main area of interest because somatic inactivation of one allele of the gene is likely to occur during the oestrogen mediated proliferation at puberty and subsequent tumourigenic events take place in the same cell. Standard immunohistochemical analysis was used to assess BRCA1 and oestrogen/progesterone receptor (ER/PR) status in familial and sporadic breast cancer patients and correlation of BRCA1 protein expression with histopathological features ER/PR status was studied in these tumours. One hundred and seventy-seven sporadic tumours (group A) and 28 familial tumours (patients with history of breast cancer in first or second degree relative ie, group B) were studied. In group A, 61 tumours had absent/reduced BRCA 1 protein expression; 30 (49%) out of these were negative for ER/PR receptors. In group B, 18 patients had absent/reduced BRCA1 protein expression, and 10 (55.6%) out of these, were ER/PR negative. Overall in 2 groups, 82 tumours were of grade 1, 61 tumours of grade 2 and 62 tumours were of grade 3 differentiation. Test of proportion showed that percentage of ER/PR negativity is significantly higher than ER/PR positivity in sporadic as well as in familial tumours with absent/ reduced BRCA 1 protein expression (p < 0.05). Sporadic tumours with deranged BRCA1 protein expression like familial tumours have more unfavourable histopathological characteristics and are likely to be of higher grade and oestrogen receptor negative

The complex global pattern of genetic variation and linkage disequilibrium at catechol-O-methyltransferase

Genetic variation at the catechol-O-methyltransferase (COMT) gene has been significantly associated with risk for various neuropsychiatric conditions such as schizophrenia, panic disorder, bipolar disorders, anorexia nervosa and others. It has also been associated with nicotine dependence, sensitivity to pain and cognitive dysfunctions especially in schizophrenia. The non-synonymous single nucleotide polymorphism (SNP) in exon 4--Val108/158Met--is the most studied SNP at COMT and is the basis for most associations. It is not, however, the only variation in the gene; several haplotypes exist across the gene. Some studies indicate that the haplotypic combinations of alleles at the Val108/158Met SNP with those in the promoter region and in the 3'-untranslated region are responsible for the associations with disorders and not the non-synonymous SNP by itself. We have now studied DNA samples from 45 populations for 63 SNPs in a region of 172 kb across the region of 22q11.2 encompassing the COMT gene. We focused on 28 SNPs spanning the COMT-coding region and immediately flanking DNA, and found that the haplotypes are from diverse evolutionary lineages that could harbor as yet undetected variants with functional consequences. Future association studies should be based on SNPs that define the common haplotypes in the population(s) being studied.

Audit of the safety and effectiveness of ketamine for procedural sedation in the emergency department

AIM

To examine the effectiveness and safety of the sedative agents used in the emergency department following the introduction of ketamine as an agent for procedural sedation

METHODS

A 2-year prospective audit of sedation practice was undertaken. This specifically examined the rationale behind a doctor's choice of sedative agent, the depth of sedation achieved, adverse events and the time taken to regain full orientation.

RESULTS

210 patients were included of whom 85 (40%) were given ketamine, 107 (51%) midazolam and 18 (9%) propofol. The median time to full orientation was 25 min for ketamine, 30 min for midazolam and 10 min for propofol. Complications occurred in 15.9% of sedations overall (14.6% of those given ketamine, 15.8% given midazolam and 22.2% given propofol). Apnoea and hypoxia most often occurred with midazolam and propofol, while hypertension and hypertonicity were encountered more frequently with ketamine. In addition, 19.5% of patients given ketamine suffered the re-emergence phenomenon. The association between deep sedation with no response to pain and adverse events encountered with midazolam does not occur with ketamine.

CONCLUSIONS

Ketamine is both safe and effective and compares favourably with midazolam as an agent for procedural sedation in the emergency department. Although the re-emergence phenomenon occurred, no psychological sequelae were encountered after return to full orientation. Ketamine may be particularly useful in groups of patients at high risk of adverse effects with midazolam.

H5N1 influenza questionnaire: are Scottish emergency departments ready to isolate and treat a possible index case?

H5N1 has emerged as a highly pathogenic strain of avian flu. Cases of bird-to-human transmission have occurred and raised concerns that human-to-human transmission may be possible. Therefore, it is vitally important to isolate any index case arising from bird-to-human transmission. Questionnaires were sent out to emergency departments throughout Scotland seeking information on the availability of facilities and supplies necessary to treat and prevent onward infection from a suspected index case of human H5N1 infection. They were specifically asked about side rooms for isolation and supplies of FFP3 masks, lysis buffer and oseltamivir (Tamiflu).

Galvanic deposition of nanocrystalline ZnO thin films from a ZnO-Zn(OH)(2) mixed phase precursor on p-Si substrate

A galvanic technique for the deposition of ZnO thin films is reported. The depositions were carried out on p-type single-crystal silicon substrates at room temperature, from a solution of ZnSO(4), where the Zn rod acted as a sacrificing anode and p-Si was the cathode. The deposition of ZnO by this method is pH sensitive, and a pH between 4 and 5 is found to be optimum for film deposition. This deposition technique is simple, inexpensive and can be carried out at room temperature. X-ray diffraction (XRD), scanning electron microscopy (SEM) and atomic force microscopy (AFM) studies revealed the nanocrystalline structure of the films. The resistivity of the annealed ZnO films was determined by the Van der Pauw measurement technique.

Vitrification of tissue engineered pancreatic substitute

Despite significant advances, some critical issues remain for the long-term storage of an engineered pancreas. In this study we employed a tissue engineered pancreatic substitute model-insulin-secreting betaTC3 cells entrapped in calcium alginate/poly-L-lysine/alginate beads-to demonstrate that a prototype vitrification method can prevent ice formation and maintain cell viability/function. The results showed that the structure of the frozen samples was distorted by ice crystals throughout the matrix. In marked contrast, the vitrified samples appeared to be free of ice. Morphologic studies demonstrated extensive fractures and vacuolation in frozen specimens while there were no fractures in vitrified TEPSs. Both vitrified and frozen constructs showed some vacuolization compared to the control samples. Frozen beads showed a significantly decreased viability compared to fresh controls and the VS55 group (P < .001). There was no significant difference between the vitrified and fresh samples. Vitrification using the VS55 protocol shows similar viability and secretion properties to the control group of fresh beads. Vitrification using the PEG 400 protocol resulted in slightly lower viability and secretion properties relative to the control group; conventional freezing resulted in even significantly lower viability and secretion properties. These results combine to demonstrate feasibility of vitrification as a storage method for a tissue engineered pancreas.

Excess male chronic energy deficiency among adolescents: a cross-sectional study in the context of patrilineal and matrilineal societies in Northeast India

OBJECTIVE

To determine the sex differences in chronic energy deficiency (CED) among adolescents in the context of patrilineal and matrilineal societies in Northeast India.

DESIGN

Cross-sectional, community-based study of the Hmar patrilineal society and the Khasi (War and Khynriam) matrilineal society.

SETTING

Mizoram and Meghalaya in Northeast India.

SUBJECTS

In total, 1733 adolescent boys and girls aged 9-16 y: Khynriam Khasis (n = 1005), War Khasis (n = 305) and Hmars (n = 423).

MEASUREMENTS

Weight, height, and socio-economic characteristics. Body mass index (weight in kg/height in m2) was used for assessing CED relative to the international reference values.

RESULTS

The overall prevalence of CED was significantly greater in boys than in girls. The sex differences in the prevalence of CED were 5, 10 and 6% points in the Khynriam Khasis, War Khasis and Hmars, respectively. Allowing for age and socio-economic variables, the risks of CED were about 1.82 (95% CI 1.14-2.90), 1.83 (95% CI 1.19-3.33) and 1.78 (95% CI 1.10-3.25) times greater in boys than in girls among the Khynriam Khasis, War Khasis and Hmars, respectively. Using logistic regression analysis, the prevalence of CED was negatively associated with family income across study populations. No significant association was found between CED and religion.

CONCLUSION

Patrilineal and matrilineal forms of society were not reflected in the prevalence of CED among adolescents. Subject to further studies of the research problems concerning the nutritional status of adolescents, girls fare better than boys with respect to the prevalence of CED.

DNA sequence variation and haplotype structure of the ICAM1 and TNF genes in 12 ethnic groups of India reveal patterns of importance in designing association studies

We have examined the patterns of DNA sequence variation in and around the genes coding for ICAM1 and TNF, which play functional and correlated roles in inflammatory processes and immune cell responses, in 12 diverse ethnic groups of India. We aimed to (a) quantify the nature and extent of the variation, and (b) analyse the observed patterns of variation in relation to population history and ethnic background. At the ICAM1 and TNF loci, respectively, the total numbers of SNPs that were detected were 28 and 12. Many of these SNPs are not shared across ethnic groups and are unreported in the dbSNP or TSC databases, including two fairly common non-synonymous SNPs at positions 13487 and 13542 in the ICAM1 gene. Conversely, the TNF-376A SNP that is reported to be associated with susceptibility to malaria was not found in our study populations, even though some of the populations inhabit malaria endemic areas. Wide between-population variation in the frequencies of shared SNPs and coefficients of linkage disequilibrium have been observed. These findings have profound implications in case-control association studies.

Microbes: therapeutic targets or therapeutic tools?

Antimicrobial resistance has produced alarming situation worldwide. Use of antibiotics in large scale is one of the common cause for developing microbial resistance. Newer and newer antibiotics are coming for their use and more resistance problem is arising out. A complete new method of treatment by bacterial interference has been evolved. However, a new method of treatment has evolved ie, bacterial interference.

Mapping of the candidate tumor suppressor genes' loci on human chromosome 3 in head and neck squamous cell carcinoma of an Indian patient population

The candidate tumor suppressor genes' (TSG) loci on human chromosome 3 (chr.3) were mapped in six dysplastic lesions and 51 primary squamous cell carcinoma from head and neck region of an Indian patient population by using 20 highly polymorphic microsatellite markers. The two chromosomal regions 3p12-13 and 3p21.2-22 have shown the highest losses of heterozygosity (LOHs) of 34.6-38% and 37-46%, respectively with statistically significant clinical correlation's with tobacco habit, positive lymph node and tumor stages. In addition, high frequencies of microsatellite size alterations (MAs) of 16.2-28.5% and 23.8-28.2% were observed in the chromosomal 3p11-13 and 3p21.2-22 regions, respectively, with significant above-mentioned clinical correlation only in the 3p11-13 region. In the dysplastic lesions, the prevalence of LOHs compared to the MAs had indicated that LOHs might be the early events. Five tumors at stage-III/IV seemed to have lost an entire normal copy of chr.3. It was of particular note that 17% (10/57) of the samples showed rare bi-allelic alterations mainly in and around the high LOHs regions. Thus, (1) the gradual increase of LOHs/MAs during progression of the tumor, (2) high frequencies of MAs, (3) rare bi-allelic alterations in and around high LOHs regions and (4) loss of wild type chr.3 in the later stages of tumor development have suggested that such alterations might provide selective growth advantage to the tumors. Also, we propose from our data that the high LOHs regions (3p12-13 and 3p21.2-22) could harbour putative TSG(s), responsible for the development of head and neck squamous cell carcinoma.

High-resolution analysis of Y-chromosomal polymorphisms reveals signatures of population movements from Central Asia and West Asia into India

Linguistic evidence suggests that West Asia and Central Asia have been the two major geographical sources of genes in the contemporary Indian gene pool. To test the nature and extent of similarities in the gene pools of these regions we have collected DNA samples from four ethnic populations of northern India, and have screened these samples for a set of 18 Y-chromosome polymorphic markers (12 unique event polymorphisms and six short tandem repeats). These data from Indian populations have been analysed in conjunction with published data from several West Asian and Central Asian populations. Our analyses have revealed traces of population movement from Central Asia and West Asia into India. Two haplogrops, HG-3 and HG-9, which are known to have arisen in the Central Asian region, are found in reasonably high frequencies (41.7% and 14.3% respectively) in the study populations. The ages estimated for these two haplogroups are less in the Indian populations than those estimated from data on Middle Eastern populations. A neighbour-joining tree based on Y-haplogroup frequencies shows that the North Indians are genetically placed between the West Asian and Central Asian populations. This is consistent with gene flow from West Asia and Central Asia into India.

The enhancement of periosteal chondrogenesis in organ culture by dynamic fluid pressure

Cartilage repair by autologous periosteal arthroplasty is enhanced by continuous passive motion (CPM) of the joint after transplantation of the periosteal graft. However, the mechanisms by which CPM stimulate chondrogenesis are unknown. Based on the observation that an oscillating intra-synovial pressure fluctuation has been reported to occur during CPM (0.6-10 kPa), it was hypothesized that the oscillating pressure experienced by the periosteal graft as a result of CPM has a beneficial effect on the chondrogenic response of the graft. We have developed an in vitro model with which dynamic fluid pressures (DFP) that mimic those during CPM can be applied to periosteal explants while they are cultured in agarose gel suspension. In this study periosteal explants were treated with or without DFP during suspension culture in agarose, which is conducive to chondrogenesis. Different DFP application times (30 min, 4 h, 24 h/day) and pressure magnitudes (13, 103 kPa or stepwise 13 to 54 to 103 kPa) were compared for their effects on periosteal chondrogenesis. Low levels of DFP (13 kPa at 0.3 Hz) significantly enhanced chondrogenesis over controls (34 +/- 7% vs 14 +/- 5%; P < 0.05), while higher pressures (103 kPa at 0.3 Hz) completely inhibited chondrogenesis, as determined from the percentage of tissue that was determined to be cartilage by histomorphometry. Application of low levels of DFP to periosteal explants also resulted in significantly increased concentrations of Collagen Type II protein (43 +/- 8% vs 10 +/- 5%; P < 0.05). New proteoglycan synthesis, as measured by 35S-sulphate uptake was increased by 30% in periosteal explants stimulated with DFP (350 +/- 50 DPM vs 250 +/- 75 DPM of 35S-sulphate uptake/microg total protein), when compared to controls though this difference was not statistically significant. The DFP effect at low levels was dose-dependant for time of application as well, with 4 h/day stimulation causing significantly higher chondrogenesis than just 30 min/day (34 +/- 7 vs 12 +/- 4% cartilage; P < 0.05) and not significantly less than that obtained with 24 h/day of DFP (48 +/- 9% cartilage, P > 0.05). These observations may partially explain the beneficial effect on cartilage repair by CPM. They also validate an in vitro model permitting studies aimed at elucidating the mechanisms of action of mechanical factors regulating chondrogenesis. The fact that these tissues were successfully cultured in a mechanical environment for six weeks makes it possible to study the actions of mechanical factors on the entire chondrogenic pathway, from induction to maturation. Finally, these data support the theoretical predictions regarding the role of hydrostatic compression in fracture healing.

Ethnic differences in distributions of GSTM1 and GSTT1 homozygous "null" genotypes in India

We estimated the frequencies of GSTM1 and GSTT1 "null" homozygotes in 10 different ethnic populations of India by a genotyping method based on polymerase chain reaction. These populations, inhabiting diverse geographical locations and occupying various positions in the sociocultural hierarchy, were represented by a sample of 299 unrelated individuals. Frequencies of GSTM1 and GSTT1 "null" homozygotes varied from 20% to 79% and 3% to 39%, respectively, across the study populations. Maximum frequencies of GSTM1 and GSTT1 "null" homozygotes (79% and 39%, respectively) have been observed in the same population (Jamatia). Frequencies of homozygous "null" genotypes at the GSTM1 and GSTT1 loci show a significant positive correlation in these populations, which is contrary to expectations. A possible implication is that the two enzymes are working in tandem, instead of working in a complementary way.

Localization of chondrocyte precursors in periosteum

OBJECTIVE

Periosteal chondrogenesis is relevant to cartilage repair and fracture healing. Periosteum contains two distinct layers: a thick, outer fibrous layer and a thin, inner cambium layer which is adjacent to the bone. Specific chondrocyte precursors are known to exist in periosteum but have not yet been identified. In this study, the location of the chondrocyte precursors in periosteum was determined.

METHOD

One hundred and twenty periosteal explants from 30 2-month-old NZ rabbits were cultured for up to 42 days. Histomorphological changes and spatio-temporal localization of Col. II mRNA and protein were analysed.

RESULTS

On day 7, chondrocyte differentiation appeared in the most juxtaosseous region in the cambium layer. Col. II mRNA and protein were also evident in the same region. By day 14, chondrocyte differentiation progressed further into the juxtaosseous cambium layer, as did Col. II mRNA and protein. With growth of the neocartilage, the cambium layer gradually diminished to the extent that by 21-28 days it was no longer evident. Cartilage growth was significant and followed an appositional pattern, growing away from the fibrous layer. The fibrous layer remained essentially unchanged from 0-42 days, without evidence of hypertrophy or atrophy. Col. II mRNA expression was never seen in the fibrous layer.

CONCLUSION

From these data, three conclusions can be drawn concerning chondrogenesis from periosteum: (1) the chondrocyte precursors are located in the cambium layer of periosteum; (2) chondrogenesis commences in the juxtaosseous area in the cambium layer and progresses from the juxtaosseous region to the juxtafibrous region of the cambium layer; (3) neocartilage growth is appositional, which displaces the fibrous layer away from the cartilage already formed, as new cartilage is formed between these two layers. These findings suggest that the least differentiated (stem or reserve) cells are located in the cambium layer furthest from the bone.

CLINICAL RELEVANCE

These findings show that the chondrocyte precursors are located in the cambium layer of periosteum. Preservation of this layer is essential for chondrogenesis. As neocartilage growth is appositional, away from the fibrous layer, it can be expected that the new cartilage deposited in and adjacent to a periosteal graft would be expected to be located on the side of the cambium layer, rather than on the side of the fibrous layer of the graft.

The piezoelectric cochlear implant: concept, feasibility, challenges, and issues

A better understanding of the fundamental phenomena occurring in both the healthy and the artificially stimulated cochlea will greatly aid in the engineering of more effective cochlear implant devices and will, in general, enhance mankind's knowledge of inner ear function. This study was initiated to probe the feasibility of use of artificial piezoelectric transducer devices, both for the understanding of cochlear phenomena and as a possible cochlear implant. Aspects of feasibility of such an implant, the issues involved, the materials science challenges that need to be overcome to fabricate such a device, and results from initial in vivo experiments are discussed.

Dynamic pressure transmission through agarose gels

In biomedical research, agarose gel is widely used in tissue culture systems because it permits growing cells and tissues in a three-dimensional suspension. This is especially important in the application of tissue engineering concepts to cartilage repair because it supports the cartilage phenotype. Mechanical loading, especially compression, plays a fundamental role in the development and repair of cartilage. It would be advantageous to develop a system where cells and tissues could be subjected to compression so that their responses can be studied. There is currently no information on the pressure response of agarose gel when pressure is applied to the gas phase of a culture system. To understand the transmission of pressure through the gel, we set up an apparatus that would mimic an agarose suspension tissue culture system. This consisted of a sealed metal cylinder containing air as well as a layer of agarose submerged in culture medium. Pressure responses were recorded in the air, fluid, gel center, and gel periphery using various frequencies, pressures, gel volumes, and viscosities. Regression analyses show an almost perfect linear relation between gas and gel pressures (r(2) = 0.99987, p < 0.0001, f(x) = 0.9982 x - 0.0286). The pressure transmission was complete and immediate, throughout the range of the applied pressures, frequencies, volumes, and viscosities tested. Applying dynamic pressure to the gas phase results in reproducible pressure in the agarose and, therefore, validates the use of agarose tissue culture systems in studies employing dynamic pressurization in cartilage tissue engineering.

Variation at 4 short tandem repeat loci in 8 population groups of India

We have determined the nature and extent of variation at 4 STR loci (CSF1P0, TPOX, TH01, VWA) in 8 caste and tribal population groups of eastern and northern India. Large differences in allele frequencies among the groups were found. Average heterozygosities in all populations were high (approximately 80%). The overall extent of gene differentiation among the 8 groups was high (GST = 0.04). The nature of genomic affinities based on these 4 STR loci does not completely agree with our earlier finding based on classical genetic markers that geographic proximity of habitat has a greater influence on genetic similarity between populations than sociocultural proximity does.

Human-specific insertion/deletion polymorphisms in Indian populations and their possible evolutionary implications

DNA samples from 396 unrelated individuals belonging to 14 ethnic populations of India, inhabiting various geographical locations and occupying various positions in the socio-cultural hierarchy, were analysed in respect of 8 human-specific polymorphic insertion/deletion loci. All loci, except Alu CD4, were found to be highly polymorphic in all populations. The levels of average heterozygosities were found to be very high in all populations and, in most populations, also higher than those predicted by the island model of population structure. The coefficient of gene differentiation among Indian populations was found to be higher than populations in most other global regions, except Africa. These results are discussed in the light of two possible scenarios of evolution of Indian populations in the broader context of human evolution.

Load sharing between solid and fluid phases in articular cartilage: I--Experimental determination of in situ mechanical conditions in a porcine knee

The in situ mechanical conditions of cartilage in the articulated knee were quantified during joint loading. Six porcine knees were subjected to a 445 N compressive load while cartilage deformations and contact pressures were measured. From roentgenograms, cartilage thickness before and during loading allowed the calculation of tissue deformation on the lateral femoral condyle at different times during the loading process. Contact pressures on the articular surface were measured with miniature fiber-optic pressure transducers. Results showed that the medial side of the lateral femoral condyle had higher contact pressures, as well as deformations. To begin to correlate the pressures and resulting deformations, the intrinsic material properties of the cartilage on the lateral condyle were obtained from indentation tests. Data from four normal control specimens indicated that the aggregate modulus of the medial side was significantly higher than in other areas of the condyle. These experimental measures of the in situ mechanical conditions of articular cartilage can be combined with theoretical modeling to obtain valuable information about the relative contributions of the solid and fluid phases to supporting the applied load on the cartilage surface (see Part II).

Load sharing between solid and fluid phases in articular cartilage: II--Comparison of experimental results and u-p finite element predictions

Experimental measurements in conjunction with theoretical predictions were used to determine the extent of load supported by the fluid phase of cartilage at the articular surface. The u-p finite element model was used to simulate the loading of six separate porcine knee joints and to predict surface deformations of the cartilage layer on the lateral femoral condyle. Representative geometry for the condyle, contact pressures, and intrinsic material properties of the cartilage layer were supplied from experimental measures (see Part I). The u-p finite element predictions for surface deformations of the cartilage layer were obtained for several load partitioning states between the solid and fluid phases of cartilage at the articular surface. These were then compared to actual surface deformations obtained experimentally. It appeared from the comparison that approximately 75 percent of the applied load was borne by the fluid phase at the articular surface under this loading regime. This was qualitatively in agreement with the hypothesis that an applied load to articular joints is partitioned at the surface to the two phases according to the surface area ratios of the solid and fluid phases. It appeared that the solid phase was shielded from the total applied stress on the articular surface by the fluid and could be a reason for the excellent durability of the tissue under the demanding conditions in a diarthrodial joint.

Evaluation of stroke patients with reference to CT scan findings

Eighty patients suffering from stroke were studied on the setting of clinical and computerised tomography (CT) scan findings and were followed up to 6 months. Even though some of the clinical and CT scan findings are found to be important in prediction of outcome of stroke patients, clinical assessment appears to be more important.

Measurement of articular cartilage thickness in the articulated knee

A radiographic and image analysis method was developed and applied in porcine knees for the measurement of articular cartilage thickness in articulated joints. The feasibility of the approach was assessed by implementing the method for the lateral femoral condyle from harvested limbs. Measurement of the undeformed cartilage thickness with this method was found to have a great degree of precision, with approximately a 1.0% (14 microm) mean variation. Accuracy was also high when compared to an optical method for measuring the true cartilage thickness. An excellent linear correlation (r2>0.99) between the thickness determined optically and that obtained from the radiographic images was demonstrated. No significant differences were found between these two measures of cartilage thickness. This method, which minimizes disturbance to the structures of the knee to maintain its physiologic environment, also has promise to measure the changes in cartilage thickness as the tissue is deformed during joint loading. Information about the undeformed and deformed cartilage thicknesses can be combined with finite element models to examine cartilage behavior from both experimental and theoretical perspectives.

Lipid peroxidation of erythrocytes in visceral leishmaniasis

Lipid peroxidation of erythrocytes was studied in kala-azar patients having a considerable degree of anemia. Enhanced formation of oxidative metabolic products was observed in the erythrocytes of these patients. Decreased activities of the protective enzymes suggest impairment of the defense mechanism against peroxidative threat. These may contribute to some extent to the shortened lifespan of red cells in visceral leishmaniasis.

Elevated 2,3-diphosphoglycerate concentrations and alteration of structural integrity in the erythrocytes of Indian cases of visceral leishmaniasis

The visceral leishmaniasis (VL) known as kala-azar in India is characterized by severe anaemia. The anaemia seems to be the result, at least in part, of the relatively short life-time of the erythrocytes, which have weakened cell membranes, possibly because of elevated concentrations of 2,3-diphosphoglycerate (2,3-DPG). There is a negative correlation (r = 0.91; P < 0.01) between erythrocytic 2,3-DPG concentrations and the blood concentration of haemoglobin, and the erythrocytes from infected patients display higher osmotic fragility than those from uninfected controls. Spectrofluorometry, using 1,6-diphenyl 1,3,5-hexatriene as a probe, indicated that fluorescence depolarization and microviscosity are also higher in the erythrocytic membranes from VL cases than in those from the controls. The cholesterol/phospholipid ratio is also relatively high in the membranes from the VL cases and there is degradation of the skeletal components and the major integral protein (band 3). The enhanced concentration of 2,3-DPG may be related to the altered structural integrity of the erythrocytes and this may lead to anisocytosis and the reduction in the erythrocytic half life.