Multiple intracranial space-occupying lesions in a renal transplant recipient from an area endemic for tuberculosis (TB): TB vs. toxoplasmosis

Renal transplant recipients may present with intracranial space-occupying lesions (SOLs) due to infections as well as a post-transplant lymphoproliferative disorder (PTLD). Here, we discuss a renal transplant recipient who presented with neurologic symptoms and magnetic resonance imaging (MRI) of the brain showed multiple focal SOLs. Tuberculosis (TB), toxoplasmosis, nocardiosis, fungal infections, and PTLD were considered in the differential diagnosis. MRI spectroscopy was suggestive of an infectious cause, such as toxoplasmosis or TB. Serologic tests using Toxoplasma were negative. A brain biopsy followed by immunohistochemical staining using Toxoplasma antibody demonstrated multiple intravascular cysts of toxoplasma. This case highlights the diagnostic dilemma in an immunocompromised patient with multiple focal brain lesions, especially in areas where TB is endemic.

Type II natural killer T cells foster the antitumor activity of CpG-oligodeoxynucleotides

Type II natural killer T (NKT) cells in cancer immunity are typically associated with suppression of tumor immunosurveillance through secretion of IL-13. We previously demonstrated that CpG oligonucleotide therapy activated Type II NKT cells to produce T helper type 1 (Th1) rather than T helper type 2 (Th2) cytokines. This cytokine skewing may manifest in Type II NKT cell antitumor properties in an immunotherapeutic setting.

Pattern and Determinants of Overweight and Obesity Among Future Physicians

Background   Overweight including obesity is a leading cause of present day morbidity and kills more people than underweight. Keeping this background in mind this study had been conducted to establish the pattern of overweight and obesity in the midst of undergraduate medical group and to find out the association of overweight (plump) and obesity with probable hazardous factors. Materials and Methods This descriptive observational study had been conducted among undergraduate medical group for the duration of May to June 2011. Simple random sampling was adopted to select the students under study. A pretested, predesigned self-administered questionnaire was utilized for data collection. Body Mass Index (BMI) was assessed through weight and height and acted as forecaster of heavy figure and or obesity. Overweight and or obesity were analyzed to see the association with certain socio-demographic variables, dietary habits, family history of overweight and or obesity, life style issues, computer use etc. After collection of data, these were analyzed using tabulation, proportion and Chi square through Epi-Info software. Results The study subjects were young adults. The general pattern of overweight (plump) and obesity was 18.0 percent and 4.0 percent respectively. Overweight and or obesity was found significantly high among male students, fast food and soft drinks takers, low takers of fruits and vegetables, alcohol consumers, students with lack of exercise and family history of obesity. Overweight and obesity were not found associated with type of diet (vegetarian or non-vegetarian) and smoking. Conclusion Presence of probable associated factors with regard to overweight (plump) and obesity exists amid medical undergraduate pupils.DOI: http://dx.doi.org/10.3126/nje.v4i1.10134 Nepal Journal of Epidemiology 2014;4 (1): 323-329

Characterization of polyclonal type II NKT cells and their role in CpG oligodeoxynucleotides-mediated anti-tumor response (P2112)

CD1d-restricted NKT cells are innate-like T cells with potent immunomodulatory function via rapid production of both Th1 and Th2 cytokines. NKT cells comprise well-characterized type I NKT cells which can be detected by α-GalCer (α-galactosylceramide) loaded CD1d tetramer and less-studied type II NKT cells which do not recognize α-GalCer. Here we characterized type II NKT cells on a polyclonal level by using an IL-4 reporter mouse model. We found type II NKT cells, like type I NKT cells, exhibit an activated phenotype and are dependent on the transcriptional regulator PLZF (promyelocytic leukemia zinc finger) and the adaptor molecule SAP (signaling lymphocyte activation molecule-associated protein) for their development. Compared to type I NKT cells, type II NKT cells produce lower levels of IFN-γ but comparable amounts of IL-13 in response to polyclonal TCR stimulation, suggesting they may play different roles in regulating immune responses. However, type II NKT cells can be activated by CpG oligodeoxynucletides to produce IFN-γ, but not IL-4 or IL-13. Importantly, CpG-activated type II NKT cells contribute to the anti-tumor effect of CpG in the B16 melanoma model. Taken together, our data reveal the characteristics of polyclonal type II NKT cells and their potential role in anti-tumor immunotherapy.

Treatment of wastewater from a low-temperature carbonization process industry through biological and chemical oxidation processes for recycle/reuse: a case study

Low-temperature carbonization (LTC) of coal generates highly complex wastewater warranting stringent treatment. Developing a techno-economically viable treatment facility for such wastewaters is a challenging task. The paper discusses a case study pertaining to an existing non-performing effluent treatment plant (ETP). The existing ETP comprising an ammonia stripper followed by a single stage biological oxidation was unable to treat 1,050 m(3)/d of effluent as per the stipulated discharge norms. The treated effluent from the existing ETP was characterized with high concentrations of ammonia (75-345 mg N/l), COD (313-1,422 mg/l) and cyanide (0.5-4 mg/l). Studies were undertaken to facilitate recycling/reuse of the treated effluent within the plant. A second stage biooxidation process was investigated at pilot scale for the treatment of the effluent from the ETP. This was further subjected to tertiary treatment with 0.5% dose of 4% hypochlorite which resulted in effluent with pH: 6.6-6.8, COD: 73-121 mg/l, and BOD(5):<10 mg/l. Phenol, cyanide and ammonia were below detectable limits and the colourless effluent was suitable for recycle and reuse. Thus, a modified treatment scheme comprising ammonia pre-stripping followed by two-stage biooxidation process and a chemical oxidation step with hypochlorite at tertiary stage was proposed for recycle/reuse of LTC wastewater.

Birth weight discordance in multiple gestations: Occurrence and outcomes

This paper reviews the patterns of occurrence, measurement and the effect of birth weight discordance on fetal and neonatal mortality in multiple pregnancies (twins and triplets). Birth weight discordance is fairly common among multiple pregnancies, and about one-quarter of the twin deliveries are affected by a birth weight discordance of 15%, while nearly 5% of twin gestations experience severe discordance (>or= 35%). Factors influencing birth weight discordance are exaggerated in triplet deliveries. Approximately 20% of triplet sets experience a birth weight discordance of 25 - 35% and nearly 10% experience severe forms of discordance. Frequencies of discordant sets at >25% discordance along the range of birth weight deciles show an inverse logarithmic relationship in twins, while the best-fit function in triplets is polynomial. Birth weight discordance is significantly associated with both fetal and neonatal mortality. Neonatal demise among the severely discordant smaller twin is significantly more frequent than in a non-discordant smaller twin. The magnitude of the effect is greater when one or both of the discordant twins are concomitantly small for gestational age.

Proliferation defects and genome instability in cells lacking Cul4A

The Cul4A gene, which encodes a core component of a cullin-based E3 ubiquitin ligase complex, is over-expressed in breast and hepatocellular cancers. In breast cancers, over-expression of Cul4A strongly correlates with poor prognosis. Also, Cul4A is required for early embryonic development. Early lethality of mouse embryos prevented a detailed analysis of the functions of Cul4A. Here, we used a strain of mice carrying floxed alleles of Cul4A to study its role in cell division, in vitro and in vivo. Embryonic fibroblasts exhibit a severe deficiency in cell proliferation following deletion of Cul4A. We observed that the Cul4A protein is abundantly expressed in brain, liver and in the mammary tissue of pregnant mice. Deletion of Cul4A in liver impairs hepatocyte proliferation during regeneration following carbon tetrachloride induced injury. The Cul4A-deleted cells are slow in entering S phase, and are deficient in progressing through early M phase. Several cell cycle regulators, including p53 and p27Kip1, are de-regulated in the Cul4A-deleted cells. Expression of a dominant negative mutant of p53 causes significant reversal of the proliferation defects in Cul4A-deleted cells. The Cul4A-deleted cells exhibit aberrant number of centrosome, multipolar spindles and micronuclei formation. Furthermore, those cells are sensitive to UV irradiation and exhibit reduced levels of unscheduled DNA synthesis. Together, our observations indicate that Cul4A is required for efficient cell proliferation, control of the centrosome amplification and genome stability.

Acute osteomyelitis in congenital hypofibrinogenemia

A 10-month-old female child presented with intermittent high grade fever, pain and diffuse swelling in the left knee joint with history of ecchymosis in different areas of the body. There was radiological features of acute osteomyelitis, low fibrinogen level and bacteremia due to the presence of coagulase positive staphylococcus aureus. The child responded nicely to the treatment for acute osteomyelitis and congenital hypofibrinogenemia. So, in congenital hypofibrinogenemia, a joint swelling might be a resultant of an acute osteomyelitis, not mere hemarthrosis.

Study of KAP of the private medical practitioners about national disease control programmes

This study was carried out among the Private Allopathic Medical Practitioners (PMPs) at Khardah Municipal area (West Bengal) to find out their perception & practice about management protocol of diseases like acute respiratory infections and diarrhoel diseases in children, malaria and tuberculosis. Data was collected by interviewing the PMPs with pre-designed open-ended questionnaire. It was supplemented by analysing sample prescriptions of the same diseases. The study revealed that PMPs knowledge and practice were not at par with national guidelines. The need for periodic sensitization of PMPs regarding national disease control programme was emphasized.

Nanostructures, local fields, and enhanced absorption in intense light-matter interaction

Recent literature has reported impressive enhancements in hard-x-ray emission from short-lived solid plasmas by modulation of the interacting surface with nanostructures. We show that the modification of local electric fields near surface structures results in excessive absorption and enhanced x-ray production. A simple model based on local field variations explains the observed x-ray enhancements quantitatively.

Microencapsulation of beta-galactosidase with Eudragit L-100

Microcapsules containing beta-galactosidase (lactase) were prepared by solvent evaporation using the pH sensitive polymer, Eudragit L-100. Formulations were prepared using various polymer-enzyme ratios with total solids content of the internal phase using sucrose stearate as a droplet stabilizer. Particle size distributions were invariant to relative proportion of ingredients but were dependent on stirring conditions. Although sucrose stearate had no effect on particle size distribution, release rate or encapsulation efficiency, its presence at a minimum 2% level was necessary to ensure intact microcapsules. Encapsulation efficiencies were higher for formulations prepared with 15% compared to 10% total solid content. DSC results revealed an interaction between encapsulated Eudragit L-100-enzyme-sucrose stearate vs their physical mixtures. The enzyme activities of the freshly prepared product vs those stored under stressed condition (40 degrees C and 75% RH) were 68 and 40% of their pre-processing activity, respectively. In vitro dissolution showed no enzyme release at 1 h in acidic media but 80% of the lactase was released from the microcapsules over 2.5 h in pH 6.8 media, thus establishing the feasibility of lactase microencapsulation to retard enzyme release in an acidic environment and ensuring release at intestinal pH.

Computerised tomographic study of tuberculous meningitis in children

Twenty-one patients with clinical and laboratory diagnosis of tuberculous meningitis were studied at the paediatric department and neuroradiology unit of Bangur Institute of Neurology, both attached to IPGME & R, Kolkata, during the period from 1st February, 1996 to 31 st July, 1996. The age group of the patients were between 1 and 8 years. It clearly appears that CT is an extremely powerful investigative modality for the diagnosis, management and follow-up assessment of development of any complications like hydrocephalus, cerebral infarction, etc. CT examination also can predict the prognosis of the patients.

Both Rb and E7 are regulated by the ubiquitin proteasome pathway in HPV-containing cervical tumor cells

High-risk human papillomaviruses (HPVs) are etiologically linked to human cervical and oral cancers. The E6 and E7 oncoproteins encoded by HPV target host cell tumor suppressor proteins. E6 induces proteolysis of p53 through the ubiquitin-proteasome pathway. Recent studies showed that overexpression of E7 caused proteolytic degradation of the tumor suppressor Rb. However, unlike p53, Rb is not regulated by proteolysis in normal cells. In addition, it was unclear whether in its natural context E7 regulates Rb through the ubiquitin-proteasome pathway. Therefore, we sought to determine whether Rb is regulated by the ubiquitin-proteasome pathway in HPV-containing tumor cells. We carried out a detailed analysis in Caski cells, that are derived from HPV-containing cervical cancer tissues. Studies with various protease inhibitors revealed that Rb is regulated specifically by the ubiquitin-proteasome pathway in HPV-containing cervical tumor cells. Several inhibitors of the 26S proteasome significantly increased the level of Rb in the Caski cells. Rb controls cell growth by forming complexes with the E2F-family transcription factors. Surprisingly, in spite of a significant accumulation of the hypophosphorylated form of Rb, no Rb/E2F complex was detectable in the proteasome inhibitor treated cells. Further analysis revealed that there was an increased accumulation of the E7 oncoprotein. We showed that the proteasome inhibitors simultaneously blocked the proteolysis of E7 and Rb, suggesting that E7 is also regulated by the ubiquitin-dependent proteolysis in cervical cancer cells. Taken together, this study suggests that targeted inhibition of Rb proteolysis will be required for restoring Rb function in HPV-containing cervical cancer cells.

The p48 subunit of the damaged-DNA binding protein DDB associates with the CBP/p300 family of histone acetyltransferase

DDB has been implicated in DNA repair as well as transcription. Mutations in DDB have been correlated with the repair-deficiency disease, xeroderma pigmentosum group E (XP-E). The XP-E cells exhibit deficiencies in global genomic repair, suggesting a role for DDB in that process. DDB also possesses a transcription stimulatory activity. We showed that DDB could function as a transcriptional partner of E2F1. But the mechanism by which DDB stimulates E2F-regulated transcription or carry out its DNA repair function is not understood. To investigate the mechanisms, we looked for nuclear proteins that interact with DDB. Here we show that DDB associates with the CBP/p300 family of proteins, in vivo and in vitro. We suggest that DDB participates in global genomic repair by recruiting CBP/p300 to the damaged-chromatin. It is possible that the histone acetyltransferase activities of the CBP/p300 proteins induce chromatin remodeling at the damaged-sites to allow recruitment of the repair complexes. The observation offers insights into both transcription and repair functions of DDB.