Development of three multiplex RT-PCR assays for the detection of 12 respiratory RNA viruses

Three multiplex hemi-nested RT-PCR assays were developed to detect simultaneously 12 RNA respiratory viruses: influenza viruses A, B and C, human respiratory syncytial virus (hRSV), human metapneumovirus (hMPV), parainfluenza virus types 1-4 (PIV-1, -2, -3 and -4), human coronavirus OC43 and 229E (HCoV) and rhinovirus (hRV). An internal amplification control was included in one of the RT-PCR assays. The RT-PCR multiplex 1 and the hemi-nested multiplex 1 detected 1 and 0.1 TCID50 of RSV A, respectively, and 0.01 and 0.001 TCID50 of influenza virus A/H3N2, respectively. Two hundred and three nasal aspirates from hospitalised children were retrospectively tested in comparison with two conventional methods: direct immunofluorescence assay and viral isolation technique. Almost all samples (89/91) that were positive by immunofluorescence assay and/or viral isolation technique were detected by the multiplex assay. This method also detected an additional 85 viruses and 33 co-infections. The overall sensitivity (98%), rapidity and enhanced efficiency of these multiplex hemi-nested RT-PCR assays suggest that they would be a significant improvement over conventional methods for the detection of a broad spectrum of respiratory viruses.

[Acute respiratory tract infections due to a human metapneumovirus in children: descriptive study and comparison with respiratory syncytial virus infections]

BACKGROUND

A new paramyxovirus, the human metapneumovirus was recently isolated. We report the first French cases collected between 2000 and 2002.

MATERIAL AND METHODS

Samples were obtained from nasopharyngeal aspirates from children hospitalised for acute respiratory tract infection in hospitals of Caen and Flers in Basse-Normandie. Human metapneumovirus was studied by polymerase chain reaction on negative samples for respiratory syncytial virus, influenza A and B virus, parainfluenza (1, 2 and 3) virus, adenovirus, coronavirus and rhinovirus. Comparison between metapneumovirus virus and respiratory syncytial virus infections was done after matching sex, age and infection month.

RESULTS

Twenty-six human metapneumovirus infections were identified. A comparative study of a matched group of children infected by respiratory syncytial virus found no significative difference for hospitalisation motive, clinical criteria and treatment.

CONCLUSION

The human metapneumovirus is responsible for typical acute bronchiolitis in children.

Two polymorphs of lysozyme nitrate: temperature dependence of their solubility

Two crystallographic forms of lysozyme nitrate are known, namely monoclinic and triclinic. Having previously determined the temperature dependence of the solubility of the monoclinic form (0.2 M NaNO (3) solutions at pH = 4.5) [Legrand et al. (2001). J. Crystal Growth 232, 244-249], we focus here on the solubility of the triclinic form. The temperature dependence of the solubility of this crystallographic form has been measured with a static light device developed in our laboratory. This device allows to observe of the dissolution of one phase and/or the occurrence of a new one by varying the temperature with a sweep rate as low as 0.6 degree/hour. The new solubility data are complemented with crystallographic data of the triclinic form for the sake of completeness. The faces of a triclinic crystal are indexed. The crystallisation enthalpy of the triclinic form is deduced from these new results. These new solubility data allow us now to discuss (1). the published protocols used to obtain the monoclinic and triclinic forms of lysozyme nitrate and (2). the phase transformation.

A 3-D marker-free system for the analysis of movement disabilities--an application to the legs

The aim of this paper is to describe an approach allowing the analysis of human motion in three-dimensional (3-D) space. The system that we developed is composed of three charge-coupled-device cameras that capture synchronized image sequences of a human body in motion without the use of markers. Characteristic points belonging to the boundaries of the body in motion are first extracted from the initial images. Two-dimensional superquadrics are then adjusted on these points by a fuzzy clustering process. After that, the position of a 3-D model based on a set of articulated superquadrics, each of them describing a part of the human body, is reconstructed. An optical flow process allows the prediction of the position of the model from its position at the previous time, and gives initial values for the fuzzy classification. The results that we present concern more specifically the analysis of movement disabilities of a human leg during gait. They are improved by using articulation-based constraints. The methodology can be used in human motion analysis for clinical applications.

A marker-free system for the analysis of movement disabilities

A major step toward improving the treatments of disabled persons may be achieved by using motion analysis equipment. We are developing such a system. It allows the analysis of plane human motion (e.g. gait) without using the tracking of markers. The system is composed of one fixed camera which acquires an image sequence of a human in motion. Then the treatment is divided into two steps: first, a large number of pixels belonging to the boundaries of the human body are extracted at each acquisition time. Secondly, a two-dimensional model of the human body, based on tapered superquadrics, is successively matched with the sets of pixels previously extracted; a specific fuzzy clustering process is used for this purpose. Moreover, an optical flow procedure gives a prediction of the model location at each acquisition time from its location at the previous time. Finally we present some results of this process applied to a leg in motion.

Automatic detection of left ventricular contours from cardiac cine magnetic resonance imaging using fuzzy logic

RATIONALE AND OBJECTIVES

Gated cardiac cine magnetic resonance imaging provides accurate dynamic data of the left ventricular function. However, the manual extraction of important physiologic parameters such as myocardium wall thickness and left ventricular volumes is invariably time consuming and subjective. To reduce the variability and time constraints inherent in observer contour tracing, the authors developed an automatic left ventricle contour-detection method.

METHODS

The purpose was to apply fuzzy logic-based automatic contour detection to identification of endocardial and epicardial borders in short-axis magnetic resonance images. The automatic contouring was compared with manual tracing using the calculated ejection fraction as the comparison criterion.

RESULTS

A good correlation was found between the two approaches (r2 = 0.98).

CONCLUSIONS

The ejection fraction can be obtained using this automatic contouring method.

Automatic detection of cardiac contours on MR images using fuzzy logic and dynamic programming

This paper deals with the use of fuzzy logic and dynamic programming in the detection of cardiac contours in MR Images. The definition of two parameters for each pixel allows the construction of the fuzzy set of the cardiac contour points. The first parameter takes into account the grey level, and the second the presence of an edge. A corresponding fuzzy matrix is derived from the initial image. Finally, a dynamic programming with graph searching is performed on this fuzzy matrix. The method has been tested on several MR images and the results of the contouring were validated by an expert in the domain. This preliminary work clearly demonstrates the interest of this method, although a formal evaluation has to be done.

Raman Study of Aluminum Chloride-Dimethylsulfone Solutions

The Raman spectra of AlCl(3)-LiCl-dimethylsulfone mixtures with different molar compositions have been recorded as a solid (300 K) and as a melt (400 K). In any case, only AlCl(4)(-) ion lines at 120, 179, and 347 cm(-)(1) were observed; we were unable to detect any other chloroaluminate species. Furthermore, some bands assigned to the Al[(CH(3))(2)SO(2)](3)(3+) octahedral coordination compound are evidence for a high AlCl(3) content.

Percutaneous transluminal angioplasty without anticoagulation

This paper presents the results of a retrospective study of 110 percutaneous transluminal angioplasties done over a period of two years on 110 consecutive patients. Anticoagulation or antiplatelet drugs were not used during or after percutaneous transluminal angioplasty. Life-table analysis was used to calculate success rates at one and three months following the procedure. Success rates were determined using three criteria: clinical improvement, pre- and post-percutaneous transluminal angioplasty Doppler studies, and radiographic appearance. Claudication was present in 87 (79%) patients and severe ischemia in 23 (21%) patients. Sixty-eight (62%) PCTAs were done in the iliac arteries, 35 (32%) in the femoral arteries, and 7 (6%) in the popliteal artery. The majority of patients (61%) had 50%-75% arterial stenosis and only 18% had complete occlusion. Percutaneous transluminal angioplasty in the iliac arteries had the best results with cumulative success rates of 90% and 85% at one and three months, respectively. Success rates in the femoral arteries were 83% and 79% and in the popliteal artery 71% and 57% at one and three months, respectively. None of our patients required amputation. Ten patients (9.1%) suffered the following complications within 30 days of percutaneous transluminal angioplasty: death (2), thrombosis (2), perforation (3), minor hematoma (2), and false aneurysm (1). In conclusion, we have shown that percutaneous transluminal angioplasty can be performed safely and effectively without the use of anticoagulation and its associated risks.

HLA haplotypes in non-familial rheumatoid arthritis

The frequencies of HLA-A, B, C, DR, and BF haplotypes in 44 unrelated Caucasian patients with definite seropositive rheumatoid arthritis (RA) were compared with haplotype frequencies in controls. Overall, the patients had an increased risk for HLA-DR4, DR3, and DR2 antigens, but frequencies of certain DR4 or DR3 haplotypes were not increased, suggesting the importance of other HLA loci for the evaluation of risk. The presence of DR4 alone was not found to produce an increased risk for RA since the frequencies of certain DR4 haplotypes were similar in patients and controls. Increased frequencies of HLA-B18, DR4, HLA-B15, DR4, and HLA-A1, B8, Cw7, DR3 haplotypes were found in patients. RA susceptibility has been found to be associated with the last two haplotypes in some studies of multiple case families, suggesting that similar genetic mechanisms may underlie the disease in familial and sporadic forms.

Combined influences of Gm and HLA phenotypes upon multiple sclerosis susceptibility and severity

In some Caucasian populations, multiple sclerosis (MS) susceptibility has been independently related to given alleles of HLA or Gm systems that respectively code for major histocompatibility complex class I and II antigens or immunoglobulin G heavy chains. Whether given combinations of alleles at both series of loci simultaneously influence MS susceptibility and/or severity was investigated by comparing 147 French MS patients and 226 geographically-matched healthy controls. The G2m(-23)/HLA-B35 phenotype and G1m(-1)/HLA-B7(-)/HLA-DR2 phenotype were respectively associated with significant protection against (relative risk = 0.05) and susceptibility to (relative risk = 4.3) MS. When considering MS severity, the presence of HLA-B7 antigen correlated with a more severe disease in Gm1/Gm3 heterozygous patients, but not in Gm3/Gm3 homozygous patients. Conversely, an HLA-B12-associated milder disease was restricted to Gm3/Gm3 homozygotes. These results demonstrate the combined influence on MS of genetic loci that are unlinked but immune response-associated. Combined Gm and HLA typing is very likely able to serve as a prognostic indicator in this disease.

Delay in diagnosing gastrointestinal injury after blunt abdominal trauma in children

Intestinal perforation after blunt abdominal trauma in children is rare and thus the diagnosis may be delayed. For this reason the authors reviewed their experience with 12 children to recommend a protocol for investigation that would reduce the delay in diagnosis. Of the 12 perforations, 2 were gastric, 2 duodenal, 7 jejunal and 1 colonic. The diagnosis of jejunal perforation, in particular, was usually delayed because free air was not seen radiologically in the first few hours after injury. This may be because of delayed rupture or spasm of the injured intestine. Serial films were valuable in aiding the diagnosis and are recommended, together with assessment of solid organ injury by radionuclide scanning. In this series peritoneal lavage was not used. No child died.

HLA antigens and seronegative rheumatoid arthritis

HLA antigens and clinical features in a series of 46 Caucasian patients (40 females, 6 males) and definite repeatedly seronegative rheumatoid arthritis (RA) of more than two years' duration (mean 11.6 years) were compared with those in 77 seropositive RA patients and 110 controls of the same ethnic and geographic origin. Seronegative RA appeared to be less often erosive than seropositive RA, and seronegative patients had fewer extra-articular features. The frequency of the HLA antigen DR1 was raised in seronegative patients as compared with controls (p = 0.006, relative risk = 3) and with seropositive patients (p less than 0.05). HLA-DR4 was slightly increased in seronegative patients compared with controls (p less than 0.05) but was clearly less so than in seropositive patients (p less than 0.005). Early onset of disease was very significantly associated with HLA-DR1 in seronegative patients (p = 0.007), whereas HLA-DR4 was present more frequently in seropositive patients with onset prior to age 35 (p less than 0.05). No correlation between HLA antigens and intolerance to drugs was found in seronegative patients, whereas in seropositive patients side effects to gold salts were associated with DR3. These results suggest that seropositive and seronegative RA have distinct HLA-DR associations, especially in disease of early onset, in addition to well established clinical differences.

HLA-DR genotype risks in seropositive rheumatoid arthritis

We studied the distribution of HLA-A, B, C, and -DR antigens in 77 Caucasian patients with sero-positive rheumatoid arthritis. Forty-four patients were genotyped and compared with the control panel of 110 unrelated Caucasian genotyped donors. The data obtained confirm the association of DR4 with RA, and reveal an increased risk of disease for patients carrying DR1, DR2, and DR3, compared to the risk for those carrying other antigens, such as DR5, DRw6, and DR7. There is a higher risk for DR4/4 homozygotes than for DR4/1, DR4/2, or DR4/3 heterozygotes. DR4/5, DR4/6, and DR4/7 have a lower risk than the previously mentioned genotypes. The genotype risks are compatible with the inheritance of a single, linked genetic determinant of disease susceptibility, but we are unable to distinguish between recessive and dominant inheritance of susceptibility using the "antigen-frequencies-amongst-diseases" method. DR4 seems to be more frequent in patients in whom onset occurs before the age of 35 (79% vs. 54% DR4 positive). A significant excess of DR3 + is observed in patients with toxic complications following treatment with gold salts (X2(1) = 8.96).

HLA system and side effects of gold salts and D-penicillamine treatment of rheumatoid arthritis

Among 67 patients with rheumatoid arthritis treated with gold salts (aurothiopropanol sulphonate) a significant correlation (p less than 10(-2)) was noted between gold toxic reactions, whatever their type, and the HLA antigens A1, B8, Cw7, and DR3. Forty-two patients were genotyped, and a correlation was observed between gold side effects and the haplotype A1 Cw7 B8 DR3 (p less than 10(-2), RR = 8.0). In addition 3 out of 4 cases of renal intolerance to D-penicillamine were observed in patients possessing the Cw7 B8 DR3 haplotype.

HLA-and Gm-linked genes affecting the degradation rate of antigens (sheep red blood cells) endocytized by macrophages

Phagocytosis and catabolism of sheep red blood cells by human peripheral blood phagocytes were studied in 100 normal caucasoid subjects (44 males and 56 females). Both phenomena are highly reproducible, and their indices seem to be biological constants. There is no correlation between these two indices and the indices do not have a correlation with ABO or Rh markers. Further, the phagocytic index has no correlation with HLA and GM markers. However, a low speed of degradation is significantly correlated (p = 0.001) with the HLA-DR3 antigen, and most of the low degraders are significantly correlated (p = 0.006) with both DR3 and Gm 3,23,11 (probably Gm homozygous). Thus the gradient of antigen degradation could be related to an interaction between MHC and Gm immunoglobulin genes, as is found in the mouse [Biozzi's high (H) and low (L) responder strains.

Role of Ia-like products of the main histocompatibility complex in conditioning skin allograft survival in man

This report correlates the survival time of 93 intrafamilial skin allografts performed under conditions of main histocompatibility complex (HLA) haploidentity with donor-recipient compatibility for products of the HLA-A, -B, -C, and -DR, as well as C3 proactivator, Glyoxalase I, and P loci located on the human 6th chromosome. Incompatibilities for HLA-A and -B (and to a lesser extent for HLA-C) and(or) for HLA-DR products exerted a strong influence upon the fate of skin allografts. When HLA-A and -B were considered alone, the most compatible group of grafts had a mean survival time of 15.8 d, as compared with 11.3 d for the most incompatible transplants. HLA-DR compatibility alone was associated with a mean survival time of 15.3 d, whereas HLA-DR-incompatible grafts had a mean survival time of 11.5 d. Incompatibilities for C3 proactivator, Glyoxalase I, and P did not have a significant effect upon graft survival. There was no evidence of an association between donor-recipient incompatibility at HLA-A, -B, or -C or at HLA-DR; such incompatibilities occurred independently of each other, in spite of the state of linkage disequilibrium known to exist between HLA-B and -DR. Incompatibilities for HLA-A, -B, and for HLA-DR exerted a potent additive effect upon graft survival. Skin grafts bearing one, two, or three incompatibilities had a mean survival time of 16.2, 13.7, and 10.7 d, respectively (P <0.0005).The results point to the important role played by the Ia-like products of the HLA complex (HLA-DR) in conditioning skin allograft survival in man. This consideration may be of direct relevance to the potential clinical usefulness of in vitro serological techniques for the detection of donor-recipient compatibility for HLA-DR.

Seventh allele of the HLA-C series (Cve)

Serum VE reacting with 29.8% of French individuals seemed to define the seventh allele of the HLA-C series as shown by serologic and genetic investigations. The gene frequency of Cve is 0.163.

Regional mapping of the HLA on the short arm of chromosome 6

A detailed gene marker study was performed on a partial 6p trisomic child resulting from a balanced maternal translocation t (2;6) (p 2505; p2105). HLA typing and mixed lymphocyte reaction showed that the breakpoint on chromosome 6 was located within the HLA gene cluster, allowing an accurate location of the D determinants. Localization of the P blood group locus within the region 6 p 2105 to 6 p ter was excluded.

The role of HLA-DR antigens in transplantation--survival of skin allografts in HLA-haploidentical donor-recipient combinations

The results of 79 skin grafts performed in haploidentical donor-recipient pairs are correlated with HLA-A, -B, -C, and -DR compatibility. A strong detrimental effect of DR incompatibilities has been demonstrated. This effect is independent from that exerted by products of the HLA-A, -B, and -C loci. An additive effect of HLA-A, -B, and -DR incompatibilities on allograft survival time has been observed.

A haplotype study of HLA complex with special reference to the HLA-DR series and to Bf. C2 and glyoxalase I polymorphisms

Fifty-three French families were typed for alleles at seven loci of the HLA complex (HLA-A, -B, -C, -DR, -Bf, -C2 and -GLO) and 212 haplotypes were demonstrated. Eleven recombinations were observed (two A/B, two A/C, two B/Bf, one Bf/D and four D/GLO). The linkage disequilibrium was calculated not only between two alleles (delta) but between three, four...seven alleles (D). In order to compare the intensity of D values in the various haplotypes, the influence of the differences in gene frequencies was eliminated by the introduction of the standardized Ds (Ds = D/D max). The number of haplotypes in disequilibrium is relatively limited since most of the significant Ds involved about 17 haplotypes. For some haplotypes, the disequilibrium covered the whole distance from A to GLO but the stronger disequilibrium concerns the C to Bf or C to DR segment. Three hypotheses (isolation, admixture of population and selection) concerning the formation and maintenance of the disequilibria are discussed.

[The Ly-Li system, a new locus of the HLA complex]

Antibodies raised through immunization of volunteers not differing for serologically defined HLA-A, B and C antigens enabled us to define since 1975 a new antigenic system controlled by the HLA complex. These new allo-antigens, designated Ly-Li, are expressed on B lymphocytes but are absent from T lymphocytes, platelets, erythrocytes and fibroblasts. Multiple alleles belong to the Ly-Li differentiation antigen system. The gene frequencies of three alleles thus far detected are 0.1558 for Li2; 0.1867 for Li3 and 0.122 for Li4. Like in the serologically defined HLA antigen systems, "inclusions" were observed also in Ly-Li system, suggesting the existence of private and public specificities. Among 48 families, 23 were informative in showing that the Ly-Li locus segregated with the HLA complex. Data on three families with recombinant haplotypes between HLA-B and D, and between Bf and HLA-D, indicated that the Ly-Li locus was near HLA-D (possibly identical with HLA-D). Anti-Ly-Li antibodies inhibited cellular proliferation in mixed leucocyte culture (MLC) primarily when directed against the antigens of stimulator cells. There was a good correlation between Ly-Li and HLA-D alleles, particularly between Li2 and DW5 (r = 0.70). Usually, HLA-D specificities were "included" in the related Ly-Li specificities, but not vice-versa. In contrast, there was a higher correlation between Ly-Li specificities and those detected by the PLT (primed lymphocyte test). The Ly-Li system seems to be of great importance for the functional characterization of lymphocyte subpopulations, for the selection of the best donor in organ transplantation, and for the investigation of susceptibility genes in diseases associated with HLA-D.

Detection by three cellular immunological techniques of the antigenic determinants of the Ly-Li system, expressed on human B lymphocytes

A clear correlation was observed between the presence of an Ia-like antigenic B-cell system Ly-Li, detected serologically, and three cellular immunological techniques: [1] mixed lymphocyte reaction (MLR) inhibition by an anti-Li antiserum; [2] level of restimulation of anti-Ly-Li in-vitro-primed lymphocytes; and [3] detection of HLA-D alleles by homozygous typing cells. These results suggested that the allelic products detected serologically may be identical to those detected by the first two techniques, namely MLR inhibition and in-vitro-primed lymphocyte typing, and, possibly, HLA-D typing using homozygous typing cells, although the correlation was repeatedly found to be less clear for the last technique.

Demonstration of a human lymphokine which renders macrophages cytotoxic

Incubation of human peritoneal macrophages with cell free supernatants of mixed human lymphocyte cultures (MLC) renders them cytotoxic to labelled target tumour cells. The factor responsible for this effect is found as early as the second day of MLC. The production of this factor in man does not seem to require previous sensitization. In contrast with observations in mice, we have not yet demonstrated in man any clear-cut difference between the macrophage cytotoxicity index observed with supernatants from normal MLC and from MLC between the donor and the recipient of a skin allograft. Human blood monocytes can also be rendered cytotoxic by MLC acellular supernatants, but their cytotoxicity is neither as consistent nor as strong as with macrophages. This human factor does not render mouse macrophages cytotoxic.

[Determination by three technics of cellular immunology of the antigenic determinants of the Ly-Li system expressed on human B lymphocytes]

A clear correlation has been observed between the presence of the antigenic B cell system Ly-Li detected serologically, and 3 cellular immunology techniques: 1. MLR inhibition by anti-Li serum; 2. level of restimulation of anti-Ly-Li in vitro primed lymphocytes; 3. detection of HLA-D alleles by homozygous typing cells. These results suggest that the allelic products detected serologically may be identical to those detected by the first two techniques, namely MLR inhibition and in vitro primed lymphocyte typing, and possibly HLA-D typing using homozygous typing cells, although the correlation was found to be repeatedly less clear for the last technique.

[Localization in the HLA complex of a gene coding for the B lymphocyte system, Ly-Li]

Differentiation antigens can be detected on human B lymphocytes using allo-antibodies. They probably correspond to Mouse Ia antigens. The study of two families with cross-overs between the HLA-B and D loci has shown that one of these B lymphocyte antigens (Ly-Li) is coded by a gene very close (or identical) to the HLA-D locus.

Formal genetics of the HL-A region

The extreme polymorphism of the HL-A system is due to the presence of two (SD1, SD2) and perhaps three linked polyallelic genes. The distinction of "bridging antibodies" (reacting with several HL-A specificities recognizing separate sites on the HL-A molecule) from the main HL-A determinant as it is demonstrated by absorption/inhibition experiments increases this complexity. The HL-A linkage group is composed of other systems: LD1, LD2, PGM3, ADA (?), P, ME1, IPO-B and possibly a "hay fever gene". No gametic or zygotic selection was found in spite of the presence of HL-A antigens on spermatozoa. Mixed lymphocyte reaction (MLR) is principally governed by LD genes. The main (LD2) gene is probably situated outside the interval SD1, SD2, near SD2. Other LD genes (LD1 inside the interval SD1-SD2 and LD3) are suspected. The presence of an immune response gene (Ir) has not yet been demonstrated although several diseases associated with specific SD2 antigens are known. These different genes (SD1, SD2, LD1, LD2, LD3 and Ir) probably form a functional unit in the allo-immunozation.