[Assessment of effect and quality control for parasitological tests in national schistosomiasis surveillance sites]

OBJECTIVE

To understand the ability of pathogenic diagnosis for schistosomiasis japonica in the national surveillance sites and evaluate the effect of stool hatching method in the field, so as to provide the evidence for establishing a quality control system of pathogenic diagnosis of schistosomiasis in the surveillance sites.

METHODS

The data pertaining to the parasitological diagnosis of the residents with positive serological tests were collected in 81 national surveillance sites of 12 provinces in 2011, and the effects of the Kato-Katz technique and stool hatching method were evaluated and compared. The incubation quality control samples made by the national schistosomiasis diagnosis reference laboratory were detected by both Kato-Katz technique and stool hatching method using the single-blind method, and the results were analyzed and compared for the coincidence rate, misdiagnosis rate and missing diagnosis rate in all the county laboratories in 2012.

RESULTS

A total of 3 780 sero-positive residents were tested by using the Kato-Katz technique and stool hatching method in the 81 national surveillance sites in 2011, 127 persons were double egg-positive, 3 513 persons were double egg-negative, and the total coincidence rate was 96.30%. Totally 173 infected people were diagnosed by using the Kato-Katz technique and the positive detection rate was 4.58%; 221 infected people were diagnosed by using the stool hatching method and the positive detection rate was 5.85%. A total of 267 positive people were diagnosed by the Kato-Katz technique or the stool hatching method or both and the total positive detection rate was 7.06%, which was higher by 54.15% than that by using the single Kato-Katz technique (chi2 = 21.32, P < 0.01). In 2012, of 240 standard incubation quality control samples (160 positives, 80 negatives) detected by the technicians from the 80 surveillance sites, 105 samples were positive and 67 samples were negative, with a total coincidence rate of 71.67% (172/240) and a total missing diagnosis rate of 34.38% (55/160). Among them, the missing rate of the strong positive samples was 32.50% (26/80), the missing rate of the weakly positive samples was 36.25% (29/80), and the misdiagnosis rate of the negative samples was 16.25% (13/80). The detection rates of the incubation quality control samples were 61.11%, 80.00%, 77.08%, 90.48%, 58.33% and 59.26% in the surveillance sites of six provinces, including Anhui, Hubei, Hunan, Jiangsu, Jiangxi and Sichuan provinces, respectively, and a significant difference was found (chi2 = 14.27, P < 0.05).

CONCLUSIONS

The detection efficiency of the stool hatching method is superior to that of the Kato-Katz technique in the field. However, the levels of the technical personnel for the stool hatching method are relatively low in most of the surveillance sites. Therefore, the technical training should be strengthened.

The healing of dental extraction sockets in patients with Type 2 diabetes on oral hypoglycaemics: a prospective cohort

BACKGROUND

The aim of this study was to determine whether there is a difference in delayed healing following dental extractions for Type 2 diabetics on oral hypoglycaemics and non-diabetic patients.

METHODS

Prospective patients referred for dental extractions were recruited into two groups: known diabetics and non-diabetics with no conditions associated with poor healing. All had a random blood glucose level (BGL). Extractions were performed using local anaesthesia. Delayed healing cases were identified and statistical evaluation performed to identify risk factors.

RESULTS

There were 224 Type 2 diabetics on oral hypoglycaemics (BGL 7.51, range 4.1-17.4) and 232 non-diabetics. The diabetic group were older, more males and less smokers than the control group. Twenty-eight patients, 12 (5%) diabetic and 16 (7%) control group, had socket healing delayed for more than one week but all healed in four weeks. There were no statistical differences between delayed healing and age, gender, diabetic state, BGL or smoking. The younger control group had more healing problems.

CONCLUSIONS

The traditional view that diabetics have increased delayed healing was not supported. Type 2 diabetics on oral hypoglycaemics should be treated the same as non-diabetic patients for extractions.

Overcoming Nonlinear Partial Volume Effects in Known-Component Reconstruction of Cochlear Implants

Nonlinear partial volume (NLPV) effects can be significant for objects with large attenuation differences and fine detail structures near the spatial resolution limits of a tomographic system. This is particularly true for small metal devices like cochlear implants. While traditional model-based approaches might alleviate these artifacts through very fine sampling of the image volume and subsampling of rays to each detector element, such solutions can be extremely burdensome in terms of memory and computational requirements. The work presented in this paper leverages the model-based approach called "known-component reconstruction" (KCR) where prior knowledge of a surgical device is integrated into the estimation. In KCR, the parameterization of the object separates the volume into an unknown background anatomy and a known component with unknown registration. Thus, one can model projections of an implant at very high spatial resolution while limiting the spatial resolution of the anatomy - in effect, modeling NLPV effects where they are most significant. We present modifications of the KCR approach that can be used to largely eliminate NLPV artifacts, and demonstrate the efficacy of the modified technique (with improved image quality and accurate implant position estimates) for the cochlear implant imaging scenario.

[Risk evaluation of Schistosomiasis japonica in potential endemic areas in China]

OBJECTIVE

To analyze the impact of large hydraulic projects on schistosomiasis transmission and evaluate the transmission risk in potential endemic areas.

METHODS

During 2008-2010, surveillance on risk factors related to schistosomiasis transmission and risk assessment were carried out in potential endemic sites in counties of Xuyu, Hongze, Jinhu, and Gaoyou in Jiangsu Province, Weishan County in Shangdong, Qianjiang City and Yiling District of Yichang City in Hubei, Juchao District of Chaohu City in Anhui Province, Wanzhou and Kaixian in Chongqing in Three Gorges Dam region or passed by South-to-North Water Diversion Project and Zhangjiagang City in Jiangsu Province located in lower reach of Yangtze River. At least one fixed and three temporary monitoring sites were set in each county (city or district). Local inhabitants aged 6-65 years old were screened by indirect haemagglutination assay (IHA) or ELISA, and the sero-positives were tested by Kato-Katz or miracidium hatching techniques to investigate possible infection in 2008. The endemic status of schistosomiasis in mobile population was surveyed every year during 2008-2010. Infection status in livestocks was surveyed in Juchao, Qianjiang, Gaoyou and Wanzhou Counties in 2008-2010. Oncomelania hupensis distribution was investigated in risky and suspicious areas. Snail spreading investigation was conducted through salvaging floater and snails-inducing by straw curtains in rivers connected with Yangtze River.

RESULTS

8 256 local inhabitants were investigated by serological tests with a positive rate of 0.7% (60/8 256). Among the 60 serologically positive subjects, 55 individuals were examined by stool examination but none of them was egg positive. The antibody prevalence rate of migrating population in 2008-2010 was 2.0%, 1.4%, and 1.7%, respectively, with no significant difference (chi2 = 3.57, P > 0.05). Among the serologically positive subjects, egg-positive cases were found in migrating population in Juchao District each year and one case was found in Jinhu County in 2010. Oncomelania snails were only found in in Jinhu and Gaoyou without infected ones. A lot of aquatic shell-fish and snails were collected in the water floater and straw curtain without Oncomelania snails.

CONCLUSION

Schistosomiasis is not endemic in the original nonendemic areas in Three Gorges Dam region and areas passed by South-to-North Water Diversion Project until now, but potential risk of transmission exists. Long term surveillance scheme on schistosomiasis should be established with varied monitoring factors in different category areas.

[Characteristics of 11 patients with acute myeloid leukemia accompanied with karyotype aberration t(6;9)]

This study was aimed to investigate the characteristics of 11 patients with acute myeloid leukemia (AML) accompanying with karyotype t(6;9). The laboratorial and clinical data were analyzed retrospectively, including immunophenotype analysis and result analysis of real-time quantitative PCR detection. The results showed that a high prevalence of M2 was observed. Among 11 cases, 6 of M2, 2 of M4, 2 of M5 and 1 of MDS-RAEBT were found according to FAB criteria. Ten patients had high counts of peripheral white blood cells. Bone marrow dysplasia was seen in only 2 cases, and basophilia occurred in 4 cases. Six patients carried additional cytogenetic aberrations apart from t(6;9). Immunophenotypic analysis showed that all patients were positive for CD117, CD33, CD13, HLA-DR, CD38 and CD123. No NPM1 mutation was observed in all patients and a high level of WT1 was detected in all patients (7/7), out of 7 patients FLT3-ITD mutation was detected in only 3 patients. Follow-up details were available for 7 patients, one of whom died before chemotherapy, and the remaining 6 patients all had no response to IA or DA regimen. Among the 6 patients, 3 did not response to subsequently chemotherapy and all died from infections in a short period after diagnosis, the other 3 patients achieved a complete remission after alternative chemotherapy, but 2 relapsed in a short time and died. It is concluded that AML with cytogenetic aberration of t(6,9) is a distinct disease with a very poor prognosis. The first line chemotherapy such as IA or DA regimen is not effective to such patients, and the effective treatment needs further study.

Robust methods for automatic image-to-world registration in cone-beam CT interventional guidance

PURPOSE

Real-time surgical navigation relies on accurate image-to-world registration to align the coordinate systems of the image and patient. Conventional manual registration can present a workflow bottleneck and is prone to manual error and intraoperator variability. This work reports alternative means of automatic image-to-world registration, each method involving an automatic registration marker (ARM) used in conjunction with C-arm cone-beam CT (CBCT). The first involves a Known-Model registration method in which the ARM is a predefined tool, and the second is a Free-Form method in which the ARM is freely configurable.

METHODS

Studies were performed using a prototype C-arm for CBCT and a surgical tracking system. A simple ARM was designed with markers comprising a tungsten sphere within infrared reflectors to permit detection of markers in both x-ray projections and by an infrared tracker. The Known-Model method exercised a predefined specification of the ARM in combination with 3D-2D registration to estimate the transformation that yields the optimal match between forward projection of the ARM and the measured projection images. The Free-Form method localizes markers individually in projection data by a robust Hough transform approach extended from previous work, backprojected to 3D image coordinates based on C-arm geometric calibration. Image-domain point sets were transformed to world coordinates by rigid-body point-based registration. The robustness and registration accuracy of each method was tested in comparison to manual registration across a range of body sites (head, thorax, and abdomen) of interest in CBCT-guided surgery, including cases with interventional tools in the radiographic scene.

RESULTS

The automatic methods exhibited similar target registration error (TRE) and were comparable or superior to manual registration for placement of the ARM within ∼200 mm of C-arm isocenter. Marker localization in projection data was robust across all anatomical sites, including challenging scenarios involving the presence of interventional tools. The reprojection error of marker localization was independent of the distance of the ARM from isocenter, and the overall TRE was dominated by the configuration of individual fiducials and distance from the target as predicted by theory. The median TRE increased with greater ARM-to-isocenter distance (e.g., for the Free-Form method, TRE increasing from 0.78 mm to 2.04 mm at distances of ∼75 mm and 370 mm, respectively). The median TRE within ∼200 mm distance was consistently lower than that of the manual method (TRE = 0.82 mm). Registration performance was independent of anatomical site (head, thorax, and abdomen). The Free-Form method demonstrated a statistically significant improvement (p = 0.0044) in reproducibility compared to manual registration (0.22 mm versus 0.30 mm, respectively).

CONCLUSIONS

Automatic image-to-world registration methods demonstrate the potential for improved accuracy, reproducibility, and workflow in CBCT-guided procedures. A Free-Form method was shown to exhibit robustness against anatomical site, with comparable or improved TRE compared to manual registration. It was also comparable or superior in performance to a Known-Model method in which the ARM configuration is specified as a predefined tool, thereby allowing configuration of fiducials on the fly or attachment to the patient.

Mucus clearance, MyD88-dependent and MyD88-independent immunity modulate lung susceptibility to spontaneous bacterial infection and inflammation

It has been postulated that mucus stasis is central to the pathogenesis of obstructive lung diseases. In Scnn1b-transgenic (Scnn1b-Tg⁺ mice, airway-targeted overexpression of the epithelial Na⁺ channel β subunit causes airway surface dehydration, which results in mucus stasis and inflammation. Bronchoalveolar lavage from neonatal Scnn1b-Tg⁺ mice, but not wild-type littermates, contained increased mucus, bacteria, and neutrophils, which declined with age. Scnn1b-Tg⁺ mice lung bacterial flora included environmental and oropharyngeal species, suggesting inhalation and/or aspiration as routes of entry. Genetic deletion of the Toll-interleukin-1 receptor adapter molecule MyD88 in Scnn1b-Tg⁺ mice did not modify airway mucus obstruction, but caused defective neutrophil recruitment and increased bacterial infection, which persisted into adulthood. Scnn1b-Tg⁺ mice derived into germ-free conditions exhibited mucus obstruction similar to conventional Scnn1b-Tg⁺ mice and sterile inflammation. Collectively, these data suggest that dehydration-induced mucus stasis promotes infection, compounds defects in other immune mechanisms, and alone is sufficient to trigger airway inflammation.

Abstract P6-04-10: Genetic Discrimination of Aggressive from Indolent DCIS

Background: Treatment options for DCIS vary from surgical excision with or without radiation and/or chemopreventive therapy, or mastectomy. Intuitively, more aggressive treatment options should lead to improved survival rates, however, studies have shown no difference in breast cancer mortality between women treated with wide excision only versus those with excision plus radiation and treatments can be costly, lengthy and associated with side effects. To avoid over-treating women with indolent disease, while intensively treating women with aggressive disease, new molecular tools must be developed to supplement pathological information to classify DCIS lesions and predict clinical outcome.

Methods: Formalin-fixed paraffin-embedded (FFPE) pure DCIS biopsy specimens were collected from the pathology archives of the Anne Arundel Medical Center. Samples included those with poor prognosis characterized by either recurrence of DCIS or progression to invasive cancer (n=7) and those good prognosis, having ≥5-year disease-free survival (n=10). RNA was isolated after laser-microdissection of pure tumor cells and hybridized to Breast Cancer DSA™ microarrays (Almac Diagnostics). S-way ANOVA was used to account for batch effects and then Support Vector Machine (SVM) was used to identify candidate genes effective at discriminating good from poor prognosis DCIS. Pathway analysis was performed using MetaCore (GeneGeo).

Results: 328 genes were found to be differentially expressed between good and poor prognosis specimens (P&lt;0.01). Preliminary analysis with SVM found that a 70-gene candidate signature from these 328 genes wasoptimal under the tested conditions for discriminating favorable from poor prognosis DCIS. This candidate signature included genes such as MEF2C, PTK2 and ZBTB2. Pathway analysis revealed that genes involved in cytoskeleton modeling, apoptosis and survival, DNA damage repair and cell adhesion are expressed at lower levels in poor prognosis DCIS while those involved in cell cycle, immune response and cell proliferation are expressed at higher levels.

Conclusions: While studies have attempted to identify molecular profiles associated with aggressive DCIS by comparing DCIS co-occurring with invasive disease to pure DCIS, to our knowledge, this is the first study that identified a candidate molecular signature of prognosis in pure DCIS. Although many of the 70 genes found to differ between favorable and poor prognosis DCIS have not been previously associated with breast cancer or have unknown function, MEF2C and PTK2 have been implicated in invasion and migration, while ZBTB2 is a master regulator of p53 and stimulates cellular proliferation. These data demonstrate aggressive DCIS do differ from indolent DCIS at the genetic level and that these differences may be useful in developing molecular tools to classify DCIS lesions and guide appropriate treatment.

Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P6-04-10.

Identification of a globally distributed clinical streptomycin-resistance plasmid and other resistance determinants in a coastal bay of China

AIMS

To study streptomycin-resistant bacteria isolated from Jiaozhou Bay and their molecular determinants of resistance.

METHODS AND RESULTS

Twenty-seven tetracycline-resistant and 49 chloramphenicol-resistant bacterial isolates from surface seawater of Jiaozhou Bay were selected for investigation. More than 88% of these isolates were resistant to streptomycin. Half of the streptomycin-resistant bacteria harboured the strA-strB gene pair, and six isolates carried Tn5393-like transposons by PCR detection. The p9123-related plasmids containing the sul2-strA-strB gene cluster were characterized in two environmental Escherichia coli isolates. Transposon Tn5393 was first identified on a Klebsiella pneumoniae plasmid, which also carried Tn1721, estP and umu genes responsible for antimicrobial and insecticide resistance.

CONCLUSIONS

Coresistance to streptomycin and tetracycline or chloramphenicol was found with high frequency. p9123-related plasmid and Tn5393 transposon may contribute to the wide distribution and spread of the strA-strB gene pair in Jiaozhou Bay. The detection of streptomycin-resistance plasmid pQ1-1 from Jiaozhou Bay seawater bacteria and human bacterial pathogens from USA indicates its global dissemination and transmission, across different components of the microbiota on earth.

SIGNIFICANCE AND IMPACT OF THE STUDY

Streptomycin resistance can be recognized as an important bioindicator of environmental quality, owing to its association with anthropogenic pollution and the multidrug-resistant microbiota.

[Laboratory study on a rare case of chronic myeloid leukemia with ins(22;9)t(9;13) and Ph-negative]

The study aimed to examine a rare case of Philadelphia (Ph)-negative chronic myeloid leukemia (CML) with t(9;13). Chromosome samples were prepared after culture of bone marrow cells for 24 hours, the karyotypes were analyzed by G banding technique. Chromosome painting analysis was performed by using whole chromosome paints for chromosomes 9 and 22. Fluorescence in situ hybridization (FISH) was done with dual color dual fusion LSI bcr/abl probe. Bcr/abl transcripts were detected by real time fluorescence quantitative polymerase chain reaction (RQ-PCR). As a result, G banding analysis showed a karyotype of 45, XX, der(9)t(9;13)(q34;q10), -13[20]. FISH assay using LSI bcr/abl DNA probe showed a red abl signal inserted into der(22) and a fusion signal of bcr/abl rearrangement was discovered. RQ-PCR detected high copies of bcr/abl transcripts. In conclusion, insertion of bcr/abl rearrangement was a rare variant t(9;22) and could be well detected by molecular techniques, however, regular cytogenetic banding technique and whole chromosome paintings may probably lead a misdiagnosis to such cases.

[Detection of bcr/abl fusion gene and its derivative chromosome 9 deletions in CML by using home-made bcr/abl extra-signal probe]

This study was aimed to verify the efficacy of home-made LSI bcr/abl ES probe for detection of bcr/abl fusion gene and derivative chromosome 9 deletions in chronic myeloid leukemia (CML). Fluorescence in situ hybridization (FISH) was carried out with dual color bcr/abl extra signal (ES) probe in 97 cases of CML based on morphology and cytogenetic karyotype and 129 cases of non-hematological malignancies/non-myeloproliferative diseases with normal cytogenetic karyotype. For the patients with signals of 1R1G1F indicating der(9) deletions, FISH were done using ASS DNA probe. The results showed that 91 cases with standard t(9;22) and 6 cases with variant translocation of t(9;22) were detected by conventional G banding technique. All of the 97 patients displayed bcr/abl fusion gene by ES-FISH, including 16 cases with signal patterns of 1R1G1F showing der(9) deletions. Among the 16 cases with der(9) deletions, 13 cases were detected to have deletions of ASS gene. Meanwhile, none of the 129 cases of negative control showed bcr/abl fusion gene by ES-FISH. It is concluded that home-made LSI bcr/abl ES probe is effective to identify the bcr/abl fusion gene and der(9) deletions in CML, and the ES-FISH results are consistent with conventional cytogenetic karyotype.

Modulation of Masseteric Reflexes by Simulated Mastication

It is well-known that limb muscle reflexes are modulated during human movements. However, little is known about the existence of equivalent masticatory muscle reflex modulation. We hypothesized that masticatory reflexes would be modulated during chewing so that smooth masticatory movements occur. To examine this hypothesis, we studied the modulation of inhibitory reflexes evoked by periodontal mechanoreceptor activation and of excitatory reflexes evoked by muscle spindle activation during simulated mastication. In 28 participants, 1- and 2-N mechanical taps were delivered to the incisor. Reflex responses to these taps were examined in the average masseteric electromyogram. To differentiate between periodontal mechanoreceptor- and muscle-spindle-mediated reflex components, we performed experiments prior to, and in the presence of, periodontal anesthesia. Both periodontal mechanoreceptor and muscle spindle reflexes were reduced during simulated masticatory movements.

Epidemiological survey on gastro-intestinal and blood-borne helminths of dogs in north-east Gabon

A survey of helminth parasites was carried out on 198 dogs living in almost complete liberty in villages in the northeast of Gabon. Faeces and blood samples were collected and analysed. Dirofilaria immitis antigen was detected in 13.6% of dogs using the SNAP 3Dx test, a commercially available enzyme-linked immunosorbent assay (ELISA). Faecal examination revealed that 91.4% of dogs were infected by intestinal helminths. Ascarids were found in 58.5% of the samples. Trichuris vulpis was observed in 49.5% of cases, and Uncinaria spp. and Ancylostoma spp. in 34.8%, Spirocerca lupi in 25.3% and Capillaria spp. in 10.6%. Cestode embryophores were found in 8.6% of the samples.

Diversity and spatial distribution of amoA-encoding archaea in the deep-sea sediments of the tropical West Pacific Continental Margin

AIMS

The ecological characteristics of the deep-sea amoA-encoding archaea (AEA) are largely unsolved. Our aim was to study the diversity, structure and distribution of the AEA community in the sediments of the tropical West Pacific Continental Margin, to develop a general view of the AEA biogeography in the deep-sea extreme environment.

METHODS AND RESULTS

Archaeal amoA clone libraries were constructed. Diverse and novel amoA sequences were identified, with the Bohol Sea, Bashi Strait and Sibuyan Sea harbouring the highest and the Bicol Shelf the lowest AEA diversity. Phylogenetic and statistical analyses illustrate a heterogeneous distribution of the AEA community, probably caused by the differential distribution of the terrestrial or estuarine AEA in the various sampling sites.

CONCLUSIONS

The deep-sea sedimentary environments potentially harbour diverse and novel AEA in the tropical West Pacific Continental Margin. The stations in the Philippine inland seas (including station 3043) may represent AEA assemblages with various terrestrial influences and the stations connected directly to the open Philippine Sea may represent marine environment-dominant AEA assemblages.

SIGNIFICANCE AND IMPACT OF STUDY

Our study indicates the potential importance of geological and climatic events in the transport of terrestrial micro-organisms to the deep-sea sedimentary environments, almost totally neglected previously.

[Characteristics of cases with chromosome 3q21q26 aberrations]

To investigate the cytogenetic and clinical characteristics of inv(3q) (q21q26) and t(3;3) (q21; q26) aberrations as well as prognosis, cases were collected and chromosome specimens of bone marrow cells were prepared by 24-hour culture, while G-banding technique was used to perform karyotyping. The results showed that the simple inv(3q) and t(3; 3) aberrations were rare, they commonly combined with other chromosome aberrations such as -7/7q- and t (9; 22). The involved diseases included myelodysplastic syndromes, acute myeloid leukemia and chronic myelogenous leukemia in blast crisis. Out of 24 patients, 2 patients diagnosed with M(5) subtype did not achieve complete remission after multiple chemotherapy; 2 patients received allogenic stem cell transplantation relapsed. It is concluded that 3q21q26 aberration commonly combined with chromosome aberration 7/7q-, for these patients the efficacy of chemical therapy is poor, the efficacy of bone marrow transplant is too poor, these patients with inv(3q) and t(3; 3) aberrations have poor prognosis and short overall survival.

Spatio-temporal correlation between human and bovine schistosomiasis in China: insight from three national sampling surveys

Insight into the spatial and temporal contamination of the environment by bovine faeces in China can provide important information on the significance of bovines in the transmission of human schistosomiasis. This insight will be useful for the new evidence-based strategy of the Chinese national schistosomiasis control programme. To enhance our understanding of the spatio-temporal relationship between the prevalence of human and bovine schistosomiasis, we performed correlation and regression analyses using data from three national sampling surveys on schistosomiasis, carried out in 1989, 1995 and 2004. In addition, we established a geographical information system and performed spatial analyses to identify the high-risk areas of the disease. We found that schistosomiasis is mainly concentrated in the marshlands along the Yangtze River. It was also noted that, although the human prevalence and force of transmission in highly endemic areas has been reduced since 1989, the relative importance of bovine schistosomiasis has increased. This is seen in a declining Spearman correlation coefficient between the infection prevalence in humans and in bovines over time (0.812 in 1989, 0.754 in 1995 and 0.376 in 2004). In parallel, the slope of the linear regression decreased from 0.395 in 1989 to 0.215 in 2004. Our data therefore suggest that future schistosomiasis control efforts in China should more vigorously address the important role of bovines in the transmission of human schistosomiasis, and to reduce the environmental contamination of Schistosoma japonicum eggs by bovines.

Epidemiology of schistosomiasis in the People's Republic of China, 2004

Results from the third nationwide cluster sampling survey on the epidemiology of schistosomiasis in the People's Republic of China, conducted by the Ministry of Health in 2004, are presented. A stratified cluster random sampling technique was used, and 239 villages were selected in 7 provinces where Schistosoma japonicum remains endemic. A total of 250,987 residents 6-65 years of age were included in the survey. Estimated prevalence rates in the provinces of Hunan, Hubei, Jiangxi, Anhui, Yunnan, Sichuan, and Jiangsu were 4.2%, 3.8%, 3.1%, 2.2%, 1.7%, 0.9%, and 0.3%, respectively. The highest prevalence rates were in the lake and marshland region (3.8%) and the lowest rates were in the plain region with waterway networks (0.06%). Extrapolation to all residents in schistosome-endemic areas indicated 726,112 infections. This indicates a reduction of 16.1% compared with a nationwide survey conducted in 1995. However, human infection rates increased by 3.9% in settings where transmission is ongoing.

[Cytogenetic study on eosinophilia]

The aim of study was to investigate the importance of chromosome aberration in differential diagnosis of eosinophilia and the chromosomal aberrations involved in patients with clonal eosinophilia. 65 cases of eosinophilia were collected and chromosome specimens of bone marrow cells were prepared by 24-hour culture, and G-banding technique was used for karyotyping. The results showed that out of 65 cases, chromosome 16 inversion was detected in 9 patients suspected as M(4Eo), and among the other 56 cases, 5 were detected with chromosomal aberrations (8.9%). Combining clinical, hematological and cytogenetical data, the 5 patients were diagnosed as acute myeloid leukemia with eosinophilia, chronic eosinophilic leukemia, 8p11 myeloproliferative syndrome, chronic myeloid leukemia in acute phase and acute myeloid leukemia-M(4Eo) respectively. The detected chromosomal aberrations were +14, t (5; 12) (q31; p13), t (8; 9) (p11; q32), t (9; 22) (q34; q11) and inv (16) (p13 q22). In conclusion, cytogenetical detection is very important in differential diagnosis of clonal eosinophilic disorders and chronic eosinophilic leukemia, which is suggested to be done routinely in clinic.

[Cytogenetic study of multiple myeloma]

To investigate the cytogenetic characteristics of multiple myeloma and its relationship with clinical prognosis, 68 cases were collected and chromosome specimens of bone marrow cells were prepared by 24-hour culture, and G-banding technique was used for karyotype analysis. The results showed that the detected chromosome aberration rate was 19.1% (13/68). The abnormal clones existed mosaically with normal clones. Numerous aberrations were manifested by aneuploidy, mainly by hyperdiploidy or hypodiploidy. Structural aberrations involved t (11; 14), chromosome 1 and various kinds of marker chromosomes. Cases which had very complex aberrations revealed poor prognosis. It is concluded that chromosome complex aberration is the mainly cytogenetic characteristics of multiple myeloma, and multiple numerous and structural aberrations are involved. Cytogenetic detection should be performed both at diagnosis and at disease progression so as to evaluate prognosis.

The postnatal maternal environment influences diabetes development in nonobese diabetic mice

When nonobese-diabetic (NOD) mouse embryos were implanted into pseudopregnant mothers of a nonautoimmune mouse strain, the progeny had a reduced type 1 diabetes (T1D) incidence, suggesting that transmission of maternal autoantibodies is important for T1D development. Whether eliminating islet autoantibody transmission in utero, or postnatally (through milk), prevented T1D is unknown. Herein, we show that fostering newborn NOD mice on B-cell deficient NOD.Igmu-/- dams does not prevent T1D, demonstrating that postnatally transmitted islet autoantibodies are not required for disease pathogenesis. Additionally, NOD.Igmu-/- mice reared on NOD dams did not develop T1D, indicating that autoantibody transmission to B-cell deficient NOD neonates is insufficient to trigger T1D. Interestingly, newborn NOD mice that were reared by ICR (but not NOD or C57BL/6) dams had reduced T1D incidence, although not as reduced as that reported after embryo transfer to ICR mice, suggesting that both prenatal and postnatal factors contribute to the observed reduction in T1D incidence. Thus, NOD mice have different risks for developing T1D depending on the strain of their foster mother, and both prenatal and postnatal maternal factors, other than islet autoantibodies, influence their T1D incidence. The results may be relevant for understanding the increasing incidence of T1D and designing interventions.

Identification of distal KIR promoters and transcripts

A more complete understanding of the transcriptional control of the human and murine class I MHC receptors will help to shed light on the mechanism of selective, stochastic, gene activation that operates in these gene families. Studies of the murine Ly49 class I MHC receptor genes have revealed an important role for distal transcripts originating upstream of the proximal promoter. To date, there have been no reports of distal promoters within the functionally analogous human KIR family of class I MHC receptors. In the current study, reverse transcriptase-polymerase chain reaction (RT-PCR) and RNase protection assays were used to reveal the presence of distal KIR transcripts initiating upstream of the previously characterized proximal KIR promoter. The intergenic promoter elements detected were associated with repetitive elements of the Alu and L1 families. Unlike the proximal KIR promoter, the distal promoter regions were not NK cell-specific. KIR genes expressed in a variegated manner produced a low level of distal transcripts containing a large 5' untranslated region. In contrast, the highly expressed KIR2DL4 gene possessed a higher level of spliced distal transcripts that were capable of producing KIR2DL4 protein. The identification of distal KIR promoter elements suggests that intergenic transcripts may influence the expression of KIR genes.