Primary T-cell-based delivery platform for in vivo synthesis of engineered proteins

Primary T cell has been transformed into a cell-based delivery platform that synthesizes complex biologics at the disease site with spatiotemporal resolution. This broadly applicable technology can circumvent toxicities due to systemic administration of biologics that necessitates the use of high doses and may diffuse to the healthy tissues. Its clinical translation, however, has been impeded by manufacturing bottlenecks. In this work, a range of process parameters were investigated for increasing the production yield of the primary T cells engineered for delivery function. Compared to the common spinoculation-based method, the transduction yield was enhanced ~2.5-fold by restricting the transduction reaction volume for maximizing the lentivector-to-T-cell contact. Cell density and cytokines used in the expansion process were adjusted to achieve >100-fold expansion of the T-cell-based delivery platform in 14 days, and the function of these cells was validated in vivo using intraperitoneally implanted tumor cells. The primary T-cell-based delivery platform has human applications because it can be scaled and administrated to express a broad range of therapeutic proteins (e.g., cytokines, interferons, enzymes, agonists, and antagonists) at the disease site, obviating the need for systemic delivery of large doses of these proteins.

Genetically engineered pair of cells for serological testing and its application for SARS-CoV-2

We have developed a serology test platform for identifying individuals with prior exposure to specific viral infections and provide data to help reduce public health risks. The serology test composed of a pair of cell lines engineered to express either a viral envelop protein (Target Cell) or a receptor to recognize the Fc region of an antibody (Reporter Cell), that is, Diagnostic-Cell-Complex (DxCell-Complex). The formation of an immune synapse, facilitated by the analyte antibody, resulted into a dual-reporter protein expression by the Reporter Cell. We validated it with human serum with confirmed history of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. No signal amplification steps were necessary. The DxCell-Complex quantitatively detected the target-specific immunoglobulin G (IgG) within 1 h. Validation with clinical human serum containing SARS-CoV-2 IgG antibodies confirmed 97.04% sensitivity and 93.33% specificity. The platform can be redirected against other antibodies. Self-replication and activation-induced cell signaling, two attributes of the cell, will enable rapid and cost-effective manufacturing and its operation in healthcare facilities without requiring time-consuming signal amplification steps.

Electrically regulated cell-based intervention for viral infections

This work reports on an engineered cell that-when electrically stimulated-synthesizes a desired protein, that is, ES-Biofactory. The platform has been used to express interferon (IFN)-β as a universal antiviral protein. Compelling evidence indicates the inevitability of new pandemics and drives the need for a pan-viral intervention that may be quickly deployed while more specific vaccines are in development. Toward this goal, a fast-growing mammalian cell (Chassis) has been engineered with multiple synthetic elements. These include-(1) a voltage-gated Ca²⁺ channel (Voltage-Sensor) that, upon sensing the electric field, activates the (2) Ca²⁺-mediated signaling pathway (Actuator) to upregulate (3) IFN-β, via an engineered antiviral transgene (Effector), that is, ES-Biofactory➔IFN-β. The antiviral effects of the ES-Biofactory➔IFN-β have been validated on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected cells. The irradiated ES-Biofactory, that does not exhibit oncogenic capacity, continues to exert antiviral effect. The resulting ES-Biofactory➔IFN-β uses a novel signaling pathway that, unlike the natural IFN synthesis pathway, is not subject to viral interference. Once clinically validated, the ES-Biofactory will be a universal antiviral cell therapy that can be immediately deployed in the event of an outbreak. The platform may also be useful in treating other diseases including cancer and autoimmune disorders.

NK-Cell Biofactory as an Off-the-Shelf Cell-based Vector for Targeted In Situ Synthesis of Engineered Proteins

The NK-92MI, a fast-growing cytolytic cell line with a track record of exerting clinical efficacy, is transformed into a vector for synthesizing calibrated amounts of desired engineered proteins at our disease site, that is, NK-cell Biofactory. This provides an allogeneic option to the previously published T-cell-based living vector that is limited by high manufacturing cost and product variability. The modularity of this pathway, which combines a "target" receptor with an "effector" function, enables reprogramming of the NK-cell Biofactory to target diseases with specific molecular biomarkers, such as cancer, viral infections, or auto-immune disorders, and overcome barriers that may affect the advancement of NK-cell therapies.

A study on patterns of use of mobile phone and nomophobia in medical undergraduate students during a COVID-19 pandemic lockdown

Introduction

The governments of various countries enforced a lockdown to contain the COVID -19 pandemic. As the colleges remain closed, the academic teachings for students was conducted online. The mobile phone remained the main source for academics and entertainment during this period.

Objectives

To assess patterns of use of mobile phone by Medical Undergraduate students prior to and during the COVID-19 lockdown. To assess Nomophobia among same participants.

Methods

This study was done by an online survey method after obtaining approval from the Institutional Ethics Committee. A validated questionnaire on patterns of mobile phone use and the Nomophobia Questionnaire(NMP-Q) was completed by the medical students (n=187) who consented to participate in the study

Results

Prior to the pandemic lockdown, 52.9% of the participants used the mobile phones for 2-4 hours per day with 78% of the usage in social media. During lockdown, 89.3% of the participants reported an increase in the usage of mobile phones. 35.65% reported an increase in use by 2-4 hours everyday. About 30.5 % used the mobile phone for 6-8 hours per day. 80.2 % reported a maximum usage for social media. 59.45% reported a maximum usage for online academics. 33.7% frequently checked their phones once in 15 minutes. About 60.43% of the participants were in the moderate and 21.4% in the severe category of nomophobia.

Conclusions

There is an increase in mobile phone usage during the lockdown with a significant proportion of students in the moderate and severe category of nomophobia.

Disclosure

No significant relationships.

Lentivirus Manufacturing Process for Primary T-Cell Biofactory Production

A process for maximizing the titer of lentivirus particles, deemed to be a necessity for transducing primary cells, is developed. Lentivirus particles, with a set of transgenes encoding an artificial cell-signaling pathway, are used to transform primary T cells as vectors for calibrated synthesis of desired proteins in situ, that is, T-cell biofactory cells. The process is also used to generate primary T cells expressing antigen-specific chimeric antigen receptors, that is, CAR T cells. The two differently engineered primary T cells are expanded and validated for their respective functions, that is, calibrated synthesis of desired proteins upon engaging the target cells, which is specific for the T-cell biofactory cells, and cytolysis of the target cells common to both types of cells. The process is compliant with current Good Manufacturing Practices and can be used to support the scale-up for clinical translation.

Engineered Ovarian Cancer Cell Lines for Validation of CAR T Cell Function

A set of genetically engineered isogenic cell lines is developed to express either folate receptor alpha or mesothelin, and a control cell line negative for both antigens. These cell lines also express fluorescent and bioluminescent reporter transgenes. The cell lines are used to authenticate specificity and function of a T-cell biofactory, a living vector that is developed to express proportionate amounts of engineered proteins upon engaging with disease cells through their specific antigenic biomarkers. The engineered cell lines are also used to assess the cytolytic function and specificity of primary T cells engineered with chimeric antigen receptors; and the specificity of monoclonal antibodies. The strategy described can be used to generate other cell lines to present different disease-specific biomarkers for use as quality control tools.

Brain pseudotumour secondary to Behçet's disease

Neuro-Behçet's disease (NBD) is a serious manifestation of Behçet's disease (BD) and can affect either the central or peripheral nervous systems, or both. It occurs in 10-50% of patients with BD. We report on a patient with an unusual intraparenchymal lesion, initially thought to be a brain tumour. Histological examination revealed vasculitis consistent with BD. Clinicians should include NBD as a differential diagnosis when considering an isolated inflammatory intracranial lesion.

Modular Antigen-Specific T-cell Biofactories for Calibrated In Vivo Synthesis of Engineered Proteins

An artificial cell-signaling pathway is developed that capitalizes on the T-cell's innate extravasation ability and transforms it into a vector (T-cell Biofactory) for synthesizing calibrated amounts of engineered proteins in vivo. The modularity of this pathway enables reprogramming of the T-cell Biofactory to target biomarkers on different disease cells, e.g. cancer, viral infections, autoimmune disorders. It can be expected that the T-cell Biofactory leads to a "living drug" that extravasates to the disease sites, assesses the disease burden, synthesizes the calibrated amount of engineered therapeutic proteins upon stimulation by the diseased cells, and reduces targeting of normal cells.

Abstract 2557: Assessing the therapeutic efficacy of disease-specific T-cell biofactories

Current protein-based cancer therapies have several disadvantages, which include general toxicity, lack of response at the administered dose and differing responses from patients to patient. To circumvent these issues, we propose a platform in which engineered T-cells specifically recognize tumors and secrete therapeutic peptides directly at the disease site leading to targeted cancer cell killing. This approach will increase the specificity of the therapy and decrease toxicity to healthy cells.

We transformed acute T-cell lymphoma cells into biofactories for site-specific synthesis of therapeutic proteins upon stimulation by antigen-presenting disease cells. The effector T-cell line was engineered by stably introducing a chimeric T-cell receptor to recognize Folate-Receptor alpha (FRα) or Mesothelin (MSLN) protein. Upon binding of the effector T-cells to the receptor, an intracellular cascade directed expression of non-human proteins is induced. Specific T-cell binding to human ovarian cancer cell lines and signaling was measured by in vitro co-culture using luciferase production as a surrogate for therapeutic peptide secretion.

We demonstrated that T-cells can be genetically programed to synthesize and secrete proportionate amounts of engineered proteins upon engaging the tumor-associated antigens (FRα or MSLN) on a human ovarian cancer cell line, OVCAR3 (FRα+MSLN+). A FRα-MSLN- ovarian cancer cell line, A2780cis, was used as the non-targeted negative control. The difference in protein secretion following stimulation by the two cell lines, as measured by luciferase activity, was statistically significant within 1 hour. It reached ~35-fold within 1 to 3 days, and we observed stable expression for at least 10 days. The luminescent signal was proportionate to the number of OVCAR3 cells. To further validate the specificity of target engagement, we generated A2780cis-FRα positive and A2780cis-MSLN positive cell lines and demonstrated selective binding and activation of the corresponding effector cells in co-culture assays. No binding was detected to the A2780cis-vector control cells. In vivo results for T-cell biofactories targeting OVCAR3 tumors 24 hours post-stimulation validated the in vitro results. Currently, we are engineering T-cell biofactories to release cytotoxic peptides and are assessing their therapeutic efficacy against cancer cells in vitro using co-culture assays and supernatant transfer.

Our results show that T-cells can be genetically reprogrammed to serve as biofactories for the synthesis of therapeutic proteins upon stimulation by antigen-presenting disease cells. Importantly, these studies demonstrate the feasibility of developing the next generation of adoptively transferred T-cell therapies to target tumors that express FRα (e.g., ovarian, breast, lung) and/or MSLN (e.g. ovarian, lung, pancreatic) on their cell surfaces for cancer therapy.

Citation Format: Claire E. Repellin, Puja Patel, Lucia Beviglia, Harold Javitz, Lidia C. Sambucetti, Parijat Bhatnagar. Assessing the therapeutic efficacy of disease-specific T-cell biofactories [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 2557.

Effects of Microwave Absorption on Long and Short Single-Walled Carbon Nanotubes at 10-6 Torr

Carbon nanotubes have been observed to emit ultraviolet, visible and infrared radiation when exposed to microwaves. We have performed experiments in which both short (0.5 μm–2 μm) and long (5 μm–30 μm) single and double-walled carbon nanotubes were exposed to 2.46 GHz microwaves at a pressure of ~ 10-6 Torr. Structural modifications of the carbon nanotubes due to microwave absorption have been studied using the Raman spectroscopy G-band and D-band intensities, which suggest that microwave irradiation at relatively low pressure results in an increase in nanotube defects, especially in the case of the long nanotubes. Furthermore, a comparison of the spectra of the radiation emitted from the nanotubes suggests that the longer nanotubes emitted radiation of much greater intensity than the shorter nanotubes. Based on the results of the experiments and results described in previous reports, the ultraviolet, visible and infrared radiation emitted as the result of microwave absorption by carbon nanotubes seems to be primarily blackbody radiation emitted due to Joule heating. However, the presence of several broad photopeaks in the spectra of the emitted radiation (which do not seem to be related to gases absorbed by the nanotubes or the presence of catalyst particles) suggest that emissions are not the result of Joule heating alone.

Monitoring hospital wastewaters for their probable genotoxicity and mutagenicity

Cancer is a leading cause of death worldwide. Excluding the genetic factors, environmental factors, mainly the pollutants, have been implicated in the causation of the majority of cancers. Wastewater originated from health-care sectors such as hospitals may carry vast amounts of carcinogenic and genotoxic chemicals to surface waters or any other source of drinking water, if discharged untreated. Humans get exposed to such contaminants through a variety of ways including drinking water. The aim of the present study was, thus, to monitor the genotoxic and mutagenic potential of wastewaters from three big hospitals located in Jaipur (Rajasthan), India. One of them was operating an effluent treatment plant (ETP) for treatment of its wastewater and therefore both the untreated and treated effluents from this hospital were studied for their genotoxicity. Two short-term bacterial bioassays namely the Salmonella fluctuation assay and the SOS chromotest were used for the purpose. Results of fluctuation assay revealed the highly genotoxic nature of all untreated effluent samples with mutagenicity ratios (MR) up to 23.13 ± 0.18 and 42.25 ± 0.35 as measured with Salmonella typhimurium strains TA98 and TA100, respectively. As determined with the chromotest, all untreated effluents produced significant induction factors (IF) ranging from 3.29 ± 1.11 to 13.35 ± 3.58 at higher concentrations. In contrast, treated effluent samples were found to be slightly genotoxic in fluctuation test only with an MR = 3.75 ± 0.35 for TA100 at 10 % concentration. Overall, the results indicated that proper treatment of hospital wastewaters may render the effluents safe for disposal contrary to the untreated ones, possessing high genotoxic potential.

Comparative oxidative stress, metallothionein induction and organ toxicity following chronic exposure to arsenic, lead and mercury in rats

Globally, arsenic, mercury and lead constitutes as the three most hazardous environmental toxicants perturbing imbalance in pro—oxidant and antioxidant homeostasis. Individual toxicity of these environmental toxicants is well known but there is lack of comparative data on variables indicative of oxidative stress. We thus investigated the effects of chronic exposure to sodium arsenite, mercuric chloride and lead acetate on blood and tissue oxidative stress, metal concentration and metallothionein (MT) contents. Male rats were exposed to sodium arsenite, mercuric chloride and lead acetate (0.05 mg/kg each, orally, once daily) for 6 months. Arsenic, mercury and lead exposure led to a significant inhibition of blood δ—aminolevulinic acid dehydratase (ALAD) activity and glutathione level supported by increased thiobarbituric acid reactive substance (TBARS). The level of inhibition was more pronounced in case of lead followed by mercury and arsenic. These metals/ metalloid significantly increased reactive oxygen species (ROS), thiobarbituric acid reactive substances (TBARS) and glutathione peroxidase (GPx) activity accompanied by a decreased superoxide dismutase (SOD), catalase and reduced and oxidized glutathione (GSH and GSSG) levels in blood and tissues. Mercury alone produced a significant induction of hepatic and renal MT concentrations. Serum transaminases, lactate dehydrogenase and alkaline phosphatase activities increased significantly on exposure to arsenic and mercury exposure suggesting liver injury which was less pronounced in case of lead exposure. These biochemical alterations were supported by increased arsenic, mercury and lead concentrations in blood and soft tissues. The present study suggests that exposure to sodium arsenite and mercuric chloride lead to more pronounced oxidative stress and hepatotoxicity while lead acetate caused significant alterations in haem synthesis pathway compared to two other thiol binding metal/metalloid.

Health care industries: potential generators of genotoxic waste

Health care waste includes all the waste generated by health care establishments, research facilities, and laboratories. This constitutes a variety of chemical substances, such as pharmaceuticals, radionuclides, solvents, and disinfectants. Recently, scientists and environmentalists have discovered that wastewater produced by hospitals possesses toxic properties due to various toxic chemicals and pharmaceuticals capable of causing environmental impacts and even lethal effects to organisms in aquatic ecosystems. Many of these compounds resist normal wastewater treatment and end up in surface waters. Besides aquatic organisms, humans can be exposed through drinking water produced from contaminated surface water. Indeed, some of the substances found in wastewaters are genotoxic and are suspected to be potential contributors to certain cancers. The aim of this study was to evaluate the genotoxic and cytotoxic potential of wastewaters from two hospitals and three clinical diagnostic centers located in Jaipur (Rajasthan State), India using the prokaryotic Salmonella mutagenicity assay (Ames assay) and the eukaryotic Saccharomyces cerevisiae respiration inhibition assay. In the Ames assay, untreated wastewaters from both of the health care sectors resulted in significantly increased numbers of revertant colonies up to 1,000-4,050 as measured by the Salmonella typhimurium TA98 and TA100 strains (with and without metabolic activation) after exposure to undiluted samples, which indicated the highly genotoxic nature of these wastewaters. Furthermore, both hospital and diagnostic samples were found to be highly cytotoxic. Effective concentrations at which 20 % (EC20) and 50 % (EC50) inhibition of the respiration rate of the cells occurred ranged between ~0.00 and 0.52 % and between 0.005 and 41.30 % (calculated with the help of the MS excel software XLSTAT 2012.1.01; Addinsoft), respectively, as determined by the S. cerevisiae assay. The results indicated that hospital wastewaters contain genotoxic and cytotoxic components. In addition, diagnostic centers also represent small but significant sources of genotoxic and cytotoxic wastes.

Imaging of genetically engineered T cells by PET using gold nanoparticles complexed to Copper-64

Adoptive transfer of primary T cells genetically modified to have desired specificity can exert an anti-tumor response in some patients. To improve our understanding of their therapeutic potential we have developed a clinically-appealing approach to reveal their in vivo biodistribution using nanoparticles that serve as a radiotracer for imaging by positron emission tomography (PET). T cells electroporated with DNA plasmids from the Sleeping Beauty transposon-transposase system to co-express a chimeric antigen receptor (CAR) specific for CD19 and Firefly luciferase (ffLuc) were propagated on CD19(+) K562-derived artificial antigen presenting cells. The approach to generating our clinical-grade CAR(+) T cells was adapted for electro-transfer of gold nanoparticles (GNPs) functionalized with (64)Cu(2+) using the macrocyclic chelator (1,4,7,10-tetraazacyclododecane-1,4,7,10-tetraacetic acid, DOTA) and polyethyleneglycol (GNP-(64)Cu/PEG2000). MicroPET/CT was used to visualize CAR(+)EGFPffLucHyTK(+)GNP-(64)Cu/PEG2000(+) T cells and correlated with bioluminescence imaging. These data demonstrate that GNPs conjugated with (64)Cu(2+) can be prepared as a radiotracer for PET and used to image T cells using an approach that has translational implications.

Evaluation of the sensitivity of scout radiographs on unenhanced helical CT in identifying ureteric calculi: a large UK tertiary referral centre experience

OBJECTIVE

Unenhanced helical CT for kidney, ureter and bladder (CT KUB) has become the standard investigation for renal colic. This study aims to determine the sensitivity of scout radiographs in detecting ureteric calculi using CT KUB as a standard reference.

METHODS

A retrospective review of consecutive patients who presented with acute flank pain and were investigated using CT KUB. 201 patients with positive ureteric calculi were included. Two radiologists independently reviewed the scout radiographs with access to CT KUB images. Each observer recorded the presence or absence of calculi, location, size and mean Hounsfield units of each calculus.

RESULTS

203 ureteric calculi were analysed from 201 patients. The overall sensitivity of scout radiographs for Observer A was 42.3% and for Observer B 52.2%, with an interobserver reliability κ-value of 0.78. The significance of mean Hounsfield units and size between two groups of patients with visible stones and those not visible were tested; the p-value for both variables was <0.0001, which is statistically significant. The study found that calculi in the upper ureter and larger than 4 mm are more likely to be seen on the scout radiograph.

CONCLUSIONS

Usage of CT scout radiography should be encouraged and reported routinely in conjunction with CT KUB as a baseline for treatment follow-up.

Perinatal toxicity of cyfluthrin in mice: Developmental and behavioral effects

The present study was undertaken to evaluate the teratogenic and behavioral effects of perinatal exposure to cyfluthrin (Synthetic Pyrethroid) on mice offspring. Humans are exposed to this compound as it is widely used in various household insecticide formulations and in public health programmes. Pregnant females were exposed to 16 mg/kg (low dose) and 32 mg/kg (high dose) body weight cyfluthrin daily by oral intubation from gestation day 14 through parturition and lactation up to weaning. On 18th day of gestation, 50% females were euthanized for teratological studies and the remaining were allowed to deliver their pups normally. The fetuses were weighed and observed for gross external malformations and routine teratological examination was done. The neonates were observed for neuromotor reflexes (surface righting, tail hang reflex and pivoting) from day 1 up to day 7 after birth. Movement and exploratory behavior of weanlings were observed using ‘open-field’ and ‘hole-board.’ The fetuses did not show any external malformation. Skeletal aberrations observed included poor ossification of the skull and phalanges and short ribs. Surface righting and pivoting were significantly affected by the high dose. Both doses produced significant changes in the locomotion, exploration, and rearing frequencies in the open-field. The study indicates that cyfluthrin when administered at the above-mentioned doses did not elicit significant teratogenicity but both the doses caused significant difference in behavioral activities.

Chloroplast coupling factor 1: A species-specific receptor for tentoxin

Tentoxin, a cyclic tetrapeptide, induces chlorosis in certain plant species. It inactivated photophosphorylation and coupling factor 1 (CF(1)) ATPase in lettuce, a sensitive species. This effect was due to binding of tentoxin with CF(1) at a single site (affinity constant 1.3 to 20 x 10(7) M(-1)). Neither AMP nor adenyl-5'-yl imidodiphosphate appeared to bind to this site. In radish, an insensitive species, 20 times more tentoxin was required for 50% inhibition of photophosphorylation. In this species CF(1) ATPase was unaffected by tentoxin, and its CF(1) bound tentoxin only weakly (affinity constant less than 1 x 10(4) M(-1)). Sensitivity of photophosphorylation to tentoxin was correlated with chlorosis sensitivity in six other species examined.

Providing monovalent oral polio vaccine type 1 to newborns: findings from a pilot birth-dose project in Moradabad district, India

PROBLEM

Poliovirus transmission remained a public health challenge in western Uttar Pradesh, India in late 2005 and early 2006. In 2006, the India Expert Advisory Group for Polio Eradication concluded that, given the peak incidence of polio among children 6 to 12 months of age, a targeted birth dose of oral polio vaccine may be necessary to interrupt intense poliovirus transmission in high risk areas.

APPROACH

The Government of Uttar Pradesh, the National Polio Surveillance Project and the United Nations Children's Fund (UNICEF) implemented a pilot birth-dose project aimed at identifying and vaccinating all newborns with a dose of oral polio vaccine within 72 hours of birth in an effort to evaluate operational feasibility and potential impact on population immunity.

LOCAL SETTING

The project was piloted in Moradabad district: zone 7 in Moradabad City (urban setting), Kunderki block (rural setting) and in select birthing hospitals.

RELEVANT CHANGES

Between July 2006 and February 2007, 9740 newborns were identified, of which 6369 (65%) were vaccinated by project personnel within 72 hours of birth. Project coverage (for total newborns vaccinated) ranged from 39% (in zone 7) to 76% (in Kunderki block) of the estimated number of newborns vaccinated during previous supplemental immunization activities.

LESSONS LEARNED

Birth-dose coverage among newborns was lower than expected. Expansion costs were estimated to be high, with marginal impact. The project, however, provided opportunities to strengthen newborn tracking systems which have increased the number of newborns and young infants vaccinated during supplemental immunization activities and enrolled in routine programmes.

Genotoxicity evaluation of hospital wastewaters

In hospitals a large variety of substances are in use for medical purposes such as diagnostics and research. After application, diagnostic agents, disinfectants and excreted non-metabolized pharmaceuticals by patients reach the wastewater. Indeed, some of the substances found in wastewaters are genotoxic and are suspected to be a possible cause of the cancers observed in the last decades. Genotoxicity tests are an excellent means to study the toxicity and the risk associated with these releases. This paper points out the areas of concern for hospital wastewater disposal and reports the findings of genotoxicity tests for hospital effluents from 3 major hospitals in Delhi, namely All India Institute of Medical Sciences, Apollo and Escorts. Mutagenicity of hospital wastewaters from effluent treatment plants (before and after treatment) was studied. The results of this study show that the genotoxicity of hospital wastewaters is highly reduced after the treatment process. This study calls for establishment of advanced and effective effluent treatment plants in the hospitals, which are merely dumping the wastewaters in the municipal sewerage system. The results of this study call for further detailed study in this area.

Assessment of teratogenecity and embryotoxicity of sludge from textile industries at Pali (India) in Swiss albino mice exposed during organogenetic period

The present investigation was carried out to assess the teratological effects of in-utero exposure of sludge leachate from textile and dyeing industries located in Pali, Rajasthan. Sludge was collected at the combined effluent treatment plant (CETP). Two groups of 10 pregnant Swiss albino mice each, were given sludge leachate of 1/10 and 1/100 dilutions with water ad libitum from 6th day to 15th day of gestation covering the critical period of organogenesis. Cesarean sections were performed on day 18 of gestation and all foetuses were examined for reproductive and teratological tests. Sludge induced maternal toxicity was evidenced by significant increase in leachate consumption, reduction in body weight gain and reduction in fur of the body. Developmental toxicity was evidenced by a significant decrease in foetal weight per litter increase in the number of resorptions and an increase in total number of foetuses showing bone retardation and skeletal variations (specially of skull, sternebrae and vertebrae). The leachate of the sludge that is being dumped in the open areas of the town Pall seems to elicit teratogenic as well as embryotoxic potential as indicated by the findings of the present investigation.

Is the KUB radiograph redundant for investigating acute ureteric colic in the non-contrast enhanced computed tomography era?

AIM

To establish whether non-contrast enhanced computed tomography (NCCT) renders the kidneys-ureters-bladder (KUB) radiograph redundant as the initial imaging investigation for suspected acute ureteric colic.

MATERIALS AND METHODS

The imaging investigations for 120 patients consecutively admitted to an emergency department-led clinical decisions unit (CDU) with suspected acute ureteric colic were retrospectively reviewed. A multidisciplinary meeting reviewed the findings and recommended that KUB radiographs should not be routinely performed prior to NCCT. Prospective assessment of 116 consecutive patients admitted over a comparable period was then undertaken.

RESULTS

In the retrospective group, 61 (50.8%) patients had calculi to account for symptoms (positive NCCT) and 59 (49.2%) patients did not have stone disease (negative NCCT). Ninety (75%) patients had a KUB radiograph prior to NCCT. However, in 46 (38% of total) of these patients the NCCT was negative for stones, and therefore, they had been subjected to an unnecessary radiographic examination. These results prompted a change in practice. In the subsequent and prospectively studied group, preliminary KUB radiographs were performed in only 6% of the patients, with no significant change in the positive NCCT rate (50.8 versus 51.7%) or the total number of examinations performed (120 versus 116).

CONCLUSION

NCCT should be the initial imaging examination for acute ureteric colic. Up to 50% of patients with clinical suspicion do not have stone disease, and therefore, preliminary KUB radiographs with attendant radiation and cost implications are unjustified. Preliminary KUB radiographs can be omitted from the imaging pathway with no resultant indication creep or increase in demand for NCCT examinations.

Thin film processing using S-layer proteins: Biotemplated assembly of colloidal gold etch masks for fabrication of silicon nanopillar arrays

We explored the bionanofabrication of silicon nanopillar structures using ordered gold nanoparticle arrays generated from microbial surface layer (S-layer) protein templates. The S-layer template used for these thin film processing experiments was isolated from the Gram-positive bacterium Deinococcus radiodurans. In this preliminary work, S-layers preimmobilized onto chemically modified silicon substrates were initially used to template the fabrication of a nanolithographic hard mask pattern comprised of a hexagonally ordered array of 5-nm gold nanoparticles (lattice constant=18 nm). Significantly, the use of the biotemplated gold nanoparticle mask patterns in an inductively coupled plasma (ICP) etching process successfully yielded silicon nanopillar structures. However, it was found that the resultant nanopillars (8-13 nm wide at the tip, 15-20 nm wide at half-height, 20-30 nm wide at the base, and 60-90 nm tall) appeared to lack any significant degree of translational ordering. The results suggest that further studies are needed in order to elucidate the optimal plasma processing parameters that will lead to the generation of long-range ordered arrays of silicon-based nanostructures using S-layer protein templates.

Evidence-based practice in the utilization of knee radiographs--a survey of all members of the British Orthopaedic Association

There has been a debate amongst orthopaedic surgeons about which plain radiographs are required in common knee conditions and this is a 5-year review assessing the influence of recent publications on the use of radiographs. A postal survey of all members of the British Orthopaedic Association was performed. The response rate was 60% (990/1,650). There was a broad agreement on the use of anteroposterior and lateral radiographs. The use of the posteroanterior (PA) weight-bearing radiograph has increased from 82 to 86%. The use of skyline view for suspected arthritis and after knee replacement has increased from 23 to 41%. There is still disparity amongst orthopaedic surgeons regarding the knee flexion angle for skyline and weight-bearing views. After review of the literature we recommend that a single skyline view in 30 degrees flexion is adequate and should be a standard investigation in knee disorders. We also stress the importance of weight-bearing PA radiograph in 30 degrees knee flexion for adequate assessment in all patients with suspected arthritis.

Bionanofabrication of metallic and semiconductor nanoparticle arrays using S-layer protein lattices with different lateral spacings and geometries

Two-dimensional (2-D) surface layer (S-layer) protein lattices isolated from the gram-positive bacterium Deinococcus radiodurans and the acidothermophilic archaeon Sulfolobus acidocaldarius were investigated and compared for their ability to biotemplate the formation of self-assembled, ordered arrays of inorganic nanoparticles (NPs). The NPs employed for these studies included citrate-capped gold NPs and various species of CdSe/ZnS core/shell quantum dots (QDs). The QD nanocrystals were functionalized with different types of thiol ligands (negative- or positive-charged/short- or long-chain length) in order to render them hydrophilic and thus water-soluble. Transmission electron microscopy, Fourier transform analyses, and pair correlation function calculations revealed that ordered nanostructured arrays with a range of spacings (approximately 7-22 nm) and different geometrical arrangements could be fabricated through the use of the two types of S-layers. These results demonstrate that it is possible to exploit the physicochemical/structural diversity of prokaryotic S-layer scaffolds to vary the morphological patterning of nanoscale metallic and semiconductor NP arrays.

Variation of a variation: case report of attenuated familial adenomatous polyposis

BACKGROUND

First described in 1988, attenuated familial adenomatous polyposis (AFAP) is a rare autosomal dominant precancerous condition of the gastrointestinal tract. Few reports have described adenocarcinomatous change in the gastroduodenal region thus far.

CASE OUTLINE

We report a case of AFAP presenting with extensive gastric polyposis and ampullary adenocarcinoma in absence of a positive family history of gastrointestinal cancer and a novel mutation.

Assessment of organochlorine pesticide residue levels in dairy milk and buffalo milk from Jaipur City, Rajasthan, India

The widespread application of pesticides in agriculture, public health, and industry and in and around the home can result in the accumulation of pesticides in the environment. Therefore, a survey has been conducted during 1993-1996 to investigate the magnitude of contamination of bovine milk with organochlorine pesticide (OCP) residues from Jaipur City, Rajasthan, India. Milk samples, i.e., dairy (toned and whole) and buffalo milk, were collected seasonally, and pesticide residues were assessed using a gas chromatograph (GC) with an electron capture detector (ECD). The results indicate that all the milk samples were contaminated with dichlorodiphenyltrichloroethane (DDT) and its metabolites (DDE and p,p'-dichlorodiphenyldichloroethane [DDD]), isomers of hexachlorocyclohexane (HCH; alpha, beta, and gamma), heptachlor and its epoxide, and aldrin. Seasonal variations of these pesticide residue levels were also observed in all the milk samples. Samples collected during winter season were found to contain higher residue levels as compared to other seasons.

Transgenic manipulation of the metabolism of polyamines in poplar cells

The metabolism of polyamines (putrescine, spermidine, and spermine) has become the target of genetic manipulation because of their significance in plant development and possibly stress tolerance. We studied the polyamine metabolism in non-transgenic (NT) and transgenic cells of poplar (Populus nigra x maximowiczii) expressing a mouse Orn decarboxylase (odc) cDNA. The transgenic cells showed elevated levels of mouse ODC enzyme activity, severalfold higher amounts of putrescine, a small increase in spermidine, and a small reduction in spermine as compared with NT cells. The conversion of labeled ornithine (Orn) into putrescine was significantly higher in the transgenic than the NT cells. Whereas exogenously supplied Orn caused an increase in cellular putrescine in both cell lines, arginine at high concentrations was inhibitory to putrescine accumulation. The addition of urea and glutamine had no effect on polyamines in either of the cell lines. Inhibition of glutamine synthetase by methionine sulfoximine led to a substantial reduction in putrescine and spermidine in both cell lines. The results show that: (a) Transgenic expression of a heterologous odc gene can be used to modulate putrescine metabolism in plant cells, (b) accumulation of putrescine in high amounts does not affect the native arginine decarboxylase activity, (c) Orn biosynthesis occurs primarily from glutamine/glutamate and not from catabolic breakdown of arginine, (d) Orn biosynthesis may become a limiting factor for putrescine production in the odc transgenic cells, and (e) assimilation of nitrogen into glutamine keeps pace with an increased demand for its use for putrescine production.

Inhibition of enriched stem cells in vivo and in vitro by the hemoregulatory peptide SK&F108636

Replacement of the labile sulfhydryl group (-SH) of the hemoregulatory peptide monomer pyroGluGluAspCysLys (HP5b) with an isosteric methylene group yields a chemically stable compound, SK&F108636. In this study, we describe the effects of SK&F108636 on highly enriched Lin-Sca1+ hematopoietic stem cells. SK&F108636 significantly reduced the fraction of cycling progenitor cells, granulocyte macrophage colony-forming cells (GM-CFC), in vitro and in vivo. There was no effect on GM-CFC or Mix-CFC colony formation. SK&F108636 significantly inhibited proliferation of high proliferative potential (HPP)-CFC in semisolid agar cultures stimulated by stem cell factor + interleukin 3 (IL-3) + IL-1, but had no effect in cultures stimulated with M-CSF + IL-3 + IL-1. SK&F108636 was shown to act directly on the stem cells since SK&F108636 inhibited proliferation of Lin-Sca1+ cells in single cell assays. Administration of SK&F108636 to lethally irradiated mice transplanted with 2000 Lin-Sca1+ cells significantly inhibited proliferation/differentiation of cells developing into colony forming units-spleen (CFU-S) (preCFU-S) and the reconstitution of HPP-CFC and GM-CFC. There was no effect of SK&F108636 on CFU-S colony formation or mature cell regeneration in bone marrow, spleen and blood. Hence, the hemoregulatory peptide monomer SK&F108636 is a potent primitive stem cell inhibitor in vivo and in vitro. Inhibition of stem cell proliferation by small specific inhibitors may protect hematopoiesis from myelotoxic side effects during chemotherapy treatment.

Zinc is a possible toxic contaminant of silicone oil in microdrop cultures of preimplantation mouse embryos

A batch of silicone oil (dimethylpolysiloxane) is described which had differential effects on the development of 1- and 2-cell preimplantation mouse embryos in vitro when used as a microdrop overlay over two culture media: CZB and KSOM. A high rate of development into blastocysts was observed when using CZB medium; in contrast, development was strongly inhibited when KSOM was used. Other batches of silicone oil or paraffin oil permitted development from the zygote to the blastocyst of an outbred strain of mouse without arrest at the 2-cell stage. Our results show that the higher concentrations of ethylenediaminetetraacetic acid (EDTA) and bovine serum albumin (BSA) in CZB medium, in comparison with KSOM, protect against the toxic component in the oil. Observations also gave circumstantial evidence that the toxic component in the oil is zinc. The beneficial effect of including EDTA in a medium is usually attributed to its chelating toxic metals introduced as impurities in other components of the medium. Our results now show that EDTA also protects against impurities in the oil overlay.

Interobserver agreement in the diagnosis of cervical smears

The present study was carried out to reveal the magnitude of individual variation in the diagnosis of Pap smears between two cytoscreeners and their compatability with cytopathologists and subsequent final diagnostic comparison with biopsy in 1,17411 cervical smears collected from different hospitals of Delhi during ten-year period. Smears diagnosed as dysplasia at initial level by any one of the cytoscreeners were screened by cytopathologists for confirmation of diagnosis. An overall agreement of 94.9 percent was observed between two screens. 79.5 percent was agreement between screeners and cytopathologists. An agreement between cytology and histology in the diagnosis of dysplasia and malignancy were found to be 61.9 percent and dysplasia and malignancy were found to be 61.9 percent and 40.1 percent respectively. From the above study, it was observed that consistency among the two screeners was fairly acceptable. Keeping this observation in view, we can possibly practice two tier screening in place of three.

CSF-1 and mouse preimplantation development in vitro

The effects of macrophage colony stimulating factor on the development of the zygote to the blastocyst stage of an outbred strain of mouse have been studied in KSOM, an improved medium that supports a high rate of in vitro development. Macrophage colony stimulating factor accelerates the formation of the blastocyst cavity by day 4 (96 hours post-hCG). It also increases overall embryonic cell number through a differential increase in the number of trophoblast cells, with no significant effect on the number of inner cell mass cells. By day 5 of culture (120 hours post-hCG), colony stimulating factor-treated embryos have about 20 more trophoblast cells than control embryos, an increase of about 30 percent of the total number of cells in a control blastocyst. The maximum response of embryos was obtained at a concentration around 540 U ml-1 colony stimulating factor (identical to 918 Stanley units ml-1), and the cytokine can produce the same effects even if it is present in the medium for only part of the culture period. This in vitro stimulation of preimplantation development with macrophage colony stimulating factor is compatible with continued normal fetal development in vivo.

Epidemiologic analysis of Trichomonas vaginalis infection in inflammatory smears

Infections of the lower reproductive tract are common in Indian women of reproductive age. Hospital-based cytologic screening was undertaken on 63,265 women. The smears were examined for the presence of specific infections, such as Candida, herpes simplex virus, human papillomavirus, Trichomonas vaginalis (TV) and Chlamydia. This paper highlights the prevalence of TV infection in inflammatory cervical smears. Among the various infections detected, the rate of TV infection was the highest (5.1%). On further analysis the rate of TV infection showed an increasing trend up to the age of 49 years; an inverse association was observed with the educational status of the women. The prevalence was high in women with clinical signs (vaginitis, 6.9%) and low in those with a prolapsed uterus (1.2%) as compared to a normal cervix. These observations reveal the need for providing proper counseling and education on sexual behavior and genital hygiene besides treatment to control and prevent these infections.