Engineering the Berreman mode in mid-infrared polar materials

We demonstrate coupling to and control over the broadening and dispersion of a mid-infrared leaky mode, known as the Berreman mode, in samples with different dielectric environments. We fabricate subwavelength films of AlN, a mid-infrared epsilon-near-zero material that supports the Berreman mode, on materials with a weakly negative permittivity, strongly negative permittivity, and positive permittivity. Additionally, we incorporate ultra-thin AlN layers into a GaN/AlN heterostructure, engineering the dielectric environment above and below the AlN. In each of the samples, coupling to the Berreman mode is observed in angle-dependent reflection measurements at wavelengths near the longitudinal optical phonon energy. The measured dispersion of the Berreman mode agrees well with numerical modes. Differences in the dispersion and broadening for the different materials is quantified, including a 13 cm^-1 red-shift in the energy of the Berreman mode for the heterostructure sample.

May Measurement Month 2017: an analysis of blood pressure screening results from Australia-South-East Asia and Australasia

Increased blood pressure (BP) is the single biggest contributing risk factor to the global disease burden. May Measurement Month (MMM) is a global initiative of the International Society of Hypertension aimed at raising awareness of high BP. In Australia, hypertension affects around six million adults and continues to remain the greatest attributable cause of cardiovascular mortality and morbidity (48.3%), stroke deaths (28%), and kidney disease (14%). An opportunistic cross-sectional survey was carried out during May 2017 predominantly in capital cities across Australia which included adult volunteers. Blood pressure measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Additional information obtained included anthropometric data and responses to questionnaires on demographic, lifestyle, and environmental factors. Data were collected from 3817 individuals. After multiple imputation, of the 3758 individuals for whom a mean of the second and third BP reading was available, 1188 (31.2%) had hypertension. Of 3213 individuals not receiving antihypertensive treatment, 591 (18.4%) were hypertensive, and 239 (40.1%) of the 596 individuals receiving treatment had uncontrolled BP. Adjusted BP was higher in association with antihypertensive medication, cerebrovascular disease, smoking, and alcohol consumption. Blood pressure was higher when measured on the right arm and on Tuesdays. MMM17 was one of the largest BP screening campaigns undertaken in Australia using standardized BP measurements. In line with previous surveys, around one-third of screened adults had hypertension and approximately 40% of treated individuals remained uncontrolled. These results suggest that opportunistic screening can identify significant numbers with raised BP.

Conjoined twins with single heart and liver - a case report

Twin pregnancy is common but conjoined twins are an extremely rare congenital malformation without any known genetic predisposition. The incidence of conjoined twins is estimated to be around 1 in 250,000 live births with a female predilection. We presented an extremely rare case of abdomino-thoracopagus with single heart and liver. In this paper, the imaging of conjoined twins both antenatally and postnatally is reviewed, in particular taking into consideration recent advances with gray scale and color Doppler ultrasound. This case is of particular interest because of the rarity of abdomino-thoracopagus twins with single heart and liver, in literature.

Wandering biliary ascariasis with hepatic abscess in a postmenopausal woman

Hepatobiliary ascariasis is common in developing countries where there is a low standard of public health and hygiene. We are reporting a rare case of ascariasis which induced multiple liver abscesses in a post menopausal woman who presented with fever, anorexia, nausea, vomiting and mild hepatomegaly. Ultrasonography revealed biliary ascariasis with multiple hepatic abscesses. Laparoscopic drainage of hepatic abscesses was done and microscopic examination of drainage materials showed decorticated eggs of Ascaris Lumbricoides. The post operative recovery of the patient was uneventful. Ultrasonography is a reliable modality to diagnose and follow up of such cases.

Color Doppler sonography and resistivity index in the differential diagnosis of hepatic neoplasm

The purpose of this study was to determine the usefulness of color doppler sonography and resistivity index (RI) in differentiating liver tumors. The study was carried out in the Department of Radiology and Imaging, Mymensingh Medical College Hospital, and Institute of Nuclear Medicine and Allied Sciences (INMAS), Mymensingh, Bangladesh, during the period of July 2009 to June 2011. Total 50 consecutive cases were studied. Among them 27 were hepatocellular carcinomas, 19 were metastatic tumors, 03 were hemangiomas and 01 was hepatic adenoma. Doppler sonographic findings were then correlated, case by case, with final diagnosis- either pathologically by USG guided Fine-needle aspiration or by other imaging modalities (e.g., CT scan and RBC liver scan for hepatic hemangioma). The RI value of hepatocellular carcinoma was 0.69±0.096 and in metastatic tumors 0.73±0.079. The results showed no significant difference between the RI of hepatocellular carcinomas and metastatic liver tumors but it was significantly higher than benign lesions (p<0.05). RI of hemangiomas was 0.49±0.64 and in one hepatic adenoma was 0.65. When RI was <0.6 for benign liver tumors and ≥0.6 for malignant tumors we calculated a sensitivity of 89.14%, specificity of 66.7%, accuracy of 85.71% positive predictive value of 97.62% and negative predictive value of 28.57% in differentiating benign and malignant tumors. Thirty four of 46(73.9%) malignant lesions had intratumoral flow and 25% of benign lesions also showed intratumoral flow. The difference of intratumoral flow between malignant and benign lesions was significant (p<0.01). Two of 4 benign lesions (50%) had peritumoral vascularity where 6% of the malignant tumors showed peritumoral vascularity. In conclusion, combined studies of the type of intra-and peri-tumoral flow signals in CDFI and the parameter of RI would be more helpful in the differential diagnosis of benign and malignant liver tumors.

Ultrasound evaluation of traumatic patient in a tertiary level hospital

This study was designed to assess the use of ultrasonography in evaluation of trauma patients to see any intraperitoneal collection, collection in pleural cavity, any vital organ injury or any localized collection in blunt trauma to abdomen. This cross sectional study was performed in patient having history of trauma who attended the Centre for Nuclear Medicine & Ultrasound (CNM&U), Mymensingh for ultrasonic evaluation. Ultrasonography scanning was done to see any intraperitoneal collection, pleural collection or vital organ injury. Vulnerable age, causes of trauma, types of organ injury and relation between ages & types of organ involved were also evaluated. Fifty patients were evaluated among those 44(88%) were male & 6(12%) were female. Ultrasonographic examination detected 26(52%) patients with intraperitoneal collection, 13(26%) patients with intraabdominal organ injury, 5(10%) patients with pleural collection. Liver (30%) is the mostly affected organ. It was also found that the most vulnerable age having trauma to abdomen was 11 to 30 (54%) years. The most common cause of trauma was road traffic accident (46%). Younger people were more vulnerable to liver and pancreatic injury, older people to splenic injury and middle aged to renal injury. Ultrasonography is a useful primary tool for evaluating traumatic patient specially to detect intraperitoneal collection and organ injury in country like Bangladesh where accidental injury is very common.

Giant penoscrotal filariasis

A 42 year old male individual having a hugely distended scrotum and barely perceptible penis, unable to maintain his livelihood on account of his handicap and socially withdrawn for the fear of humiliation, got admitted into the Surgery department of Mymensingh Medical College Hospital in August 5, 2007. The person had been carrying the so called curse for the last four years. On the basis of clinical, serological and haematological examinations, diagnosis was established as lymphatic filariasis causing elephantiasis of the scrotum. After assessment for operative feasibility, the patient underwent an operation in August 20, 2007 during which, ligation of both the spermatic cords, excision of the scrotum along with the testicles and reposition of the penile shaft into the anterior pelvic wall in the subcutaneous plane (Fleying procedure) was performed. The scrotum measured about 36 inches in diameter and weighed 40 kgs after excision. Histopathological examination of the scrotal skin confirmed the diagnosis. The patient was released without any complication, on the 11th post operative day after removal of stitches, with indwelling urethral catheter. He was prescribed Doxicycline for the next 8 weeks, a drug which has been found to be effective in treating filariasis in a number of studies, and acts by killing a symbiotic bacteria necessary for the survival of the worm. Follow up after 3 months was uneventful.

High resolution ultrasound of ophthalmic patients in a tertiary hospital

The study was done to find out pathologic processes in ophthalmic patients in different age group to understand the use, role and limitations of ultrasonography in the diagnosis of ocular pathology in this locality. A prospective study was done on total 143 patients from September 2004 to January 2006 who attended Centre for Nuclear Medicine & Ultrasound, Mymensingh for ultrasound evaluation of eye. Total 100 (69.93%, n=100) cases were male and 43 (30.06%, n=43) cases were female. The age ranges were 2 months to 80 years. A variety of ocular pathology was diagnosed with the help of high resolution ultrasound (HRUS) with unique ultrasound appearance. Bulk of the referral patients had history of ocular trauma (38.46 %, n= 38) and most commonly detected pathology in these group are vitreous hemorrhage (34.44%, n=34) and cataract formation (28.28%, n=28). Almost all of the patients did not have conclusive diagnosis clinically and by conventional means available before ultrasonography were performed. High resolution sonography may be used as a valuable tool for evaluation of ophthalmic pathology as a well suited, noninvasive method, and only practical imaging modality for assessing those cases particularly when light conducting media are opaque.

Placenta previa and it's relation with maternal age, gravidity and cesarean section

The placenta provides the essential connection between the mother and the developing fetus. Placental position were routinely mentioned in an ultrasound report starting from early second trimester to the end of third trimester when asked for pregnancy evaluation. The aim of this study was to see the prevalence of lower segment placenta (placenta previa) and its relations with previous cesarean section delivery, parity and maternal age. The study conducted in Centre for Nuclear Medicine and Ultrasound (CNMU) Mymensingh in a period from January 2001 to December 2002. About 2536 pregnant women (those included in this study) underwent ultrasound examination during pregnancy at third trimester. The prevalence of lower segment placenta was 1.34%. The highest prevalence of placenta previa (2.58%) was seen in 3rd and higher gravida group. Also the highest prevalence were seen 30 yr. and above age group in compare to below 30 yr. age group. No increased prevalence of placenta previa were seen in previous cesarean section (C / S) delivery group (0.65%) in compare to normal delivery group (1.97%). From our study it was seen that development of lower segment placenta has relation with increased number of gravidity and maternal age but no increased prevalence were seen in subjects with previously done cesarean section

Ultrasound guided fine needle aspiration cytology for diagnosis of mass lesions of liver

The therapeutic and prognostic evaluation of malignant neoplasia of liver depends mostly on morphologic diagnosis. Ultrasound guided fine needle aspiration cytology (FNAC) of liver has been proved to be a rapid, reliable and cost-effective method for cytological diagnosis of hepatic mass lesions. This study was undertaken to find out the frequency of different benign and malignant space occupying lesions (SOL) of liver from patients attending for FNAC in Mymensingh. Ultrasound guided FNAC was performed on 108 patients with hepatic mass lesions from September 2, 2001 to August 19, 2003. There were 67 (62.0%) males and 41 (37.96%) females with a mean age 53 year (SD +/- 14) ranging from 2 to 83 years. Samples were adequate in 101 (93.5%) and inadequate in 7 (6.5%). Out of 101 adequate samples only one was benign (liver abscess) and 100 were malignant. Of the malignant lesions hepatoblastoma was in 1 (1%), hepatocellular carcinomas in 8 (8%), metastatic adenocarcinomas in 73 (73%) and unclassified malignancies were in 18 (18%). Most of the hepatocellular carcinomas occurred in males (7 in 8). The frequency of metastatic adenocarcinoma was more in males (39 vs. 34) but the difference is not significant (p > 0.05). Ultrasound guided FNAC of liver is a rapid, reliable and cost-effective diagnostic method. It can be practice in any centres where ultrasound facility and specialist pathologists are available.

Gall stone in pregnancy

Gallbladder disease is four times as common in women as in men, and pregnancy appears to contribute to the development of gallstones. During pregnancy, most women receive ultrasound scans, which are highly sensitive in detecting gallstones. The study was undertaken to evaluate the prevalence of gallstones among the pregnant woman. The aim was to determine any significant difference in the prevalence of gallstone among the pregnant woman compared to the generalized prevalence of gallstone in our community.

METHODS

The maternal gallbladder was examined in 1336 consecutive obstetric ultrasound scans performed for medical indications at 3rd trimester of pregnancy. The study was conducted in Centre for Nuclear Medicine and Ultrasond (CNMU) Mymensingh on randomly selected subjects, among those who came here for ultrasound evaluation of pregnancy. 500 control were taken from age group between 20-30 yrs who came here for ultrasound examination of lower abdomen other than pregnancy.

RESULTS

Gallstone were found in total one hundred eight cases. Prevalence of gallstone in pregnant woman was 8.08% (n=108). The age ranges were 20 to 45 yrs with mean age of 28.21 +/- 4.95 (mean +/- SD) yrs. The highest prevalence (12.71%) were seen in 3rd or higher gravida group with mean age of 30.32 +/- 4.74 yrs. Significantly higher cases of gallstone were found in multiparity compared to control population of same age group. CONCLUSIONS. Repeated pregnancy causes increased gallstone formation due to changes in gallbladder kinetics leading to stasis and stone formation.

Hydrops fetalis: report of 3 cases

Ultrasound is a well recognized imaging modality for prenatal diagnosis of fetal congenital anomalies. Reported cases are hydrops fetalis diagnosed during ultrasonic evaluation of fetal condition in the Center for Nuclear Medicine and ultrasound (CNMU), Mymensingh. Only fetal ascites was detected in one case of 26 +/- 2 wks of gestation, fetal ascites with hydramnios and thick placenta was seen in another case of 28 +/- 2 wks of gestation. In third case, there was fetal ascites, scalp edema, hydrothorax and myelomeningocele with oligohydramnios at 20 +/- 2 wks of gestation; sonographic diagnosis was hydrops fetalis with myelomeningocele. Follow up was advised in first two cases and third case was terminated electively. To decrease the mortality rate and to improve the outcome of hydrops fetalis cases appropriate prenatal investigations and therapy is needed. Recent advances in prenatal ultrasound have made possible the early detection of hydrops fetalis which is helpful for proper management in time.

Abdominal wall defect: a case report and review

Ultrasound is well recognized imaging modality for prenatal diagnosis of fetal congenital anomalies. However, precise diagnosis of fetal anomaly with gray scale ultrasound may not be possible at times. Color Doppler ultrasound compliments gray scale ultrasound in accurately diagnosing fetal anomaly. We report a case of an omphalocele with short lower limbs, diagnosed during 3rd trimester on the basis of color Doppler ultrasound. Gray scale ultrasound failed to diagnose the condition initially. Color Doppler sonography helped in accurate diagnosis. Findings were confirmed after termination of pregnancy.

Incidence of bony secondary at presentation of breast carcinoma in our region

Study is conducted to evaluate the incidence of bony secondary and to evaluate the need for routine bone scintigraphy at the time of presentation of breast carcinoma in this region. Of the total 130 patients evaluated by bone scan, sixty (n = 60, 46.15%) had secondary lesion in bone. Among the 54 preoperative patients, all with positive FNAC, twenty (n = 20, 37.03%) had bony metastases. Of the 76 post-operative patients, forty (n = 40, 52.63%) had secondary bone lesions. Single lesion was seen in only five (n = 5, 8.53%) cases. Rest fifty five (n = 55, 91.67%) had multiple bony secondaries. Most of the postoperative cases (n = 40, 52.63%) were invasive/infiltrative duct cell carcinoma. The very high incidence of bony secondary appears to be due to delayed presentation associated with poor socioeconomic condition, ignorance and also shyness. Bony metastases at the time of presentation suggests poor prognosis. As it can affect therapeutic management of these patients, routine bone scintigraphy at the time of presentation of breast carcinoma patients to a tertiary label hospital is proposed, against conflicting conclusion by papers in the developed countries.

Laser in situ Keratomileusis for the Correction of Hyperopia From +0.50 to +11.50 Diopters With the Keracor 117C Laser

PURPOSE

To evaluate excimer laser in situ keratomileusis (LASIK) for the correction of hyperopia.

METHODS

We reviewed retrospectively the medical records of 46 patients treated with LASIK for hyperopia. All patients had a complete ophthalmologic evaluation. The corneal bed was ablated using the Bausch & Lomb Chiron Keracor 117C excimer laser to create a paracentral annular ablation under a nasally hinged 160-microm corneal flap with the Chiron Automatic Corneal Shaper microkeratome. Follow-up was a minimum of 6 months.

RESULTS

Eighty eyes of 46 patients (23 males and 23 females) were included. Age ranged from 18 to 65 years (mean, 42 yr). The range of preoperative spherical equivalent refraction was +0.50 to +11.50 D (mean, +3.40 D). Mean postoperative spherical equivalent refraction at 6 months was +0.26 D. Six months after surgery, 35 eyes (44%) achieved uncorrected visual acuity of 20/20 or better and 78 eyes (97.5%) achieved 20/40 or better. Forty-six eyes (58%) had a postoperative spherical equivalent refraction within +/-0.50 D of attempted correction, and 67 eyes (84%) were within +/-1.00 D of attempted correction. When using the Bausch & Lomb Chiron Keracor 117C excimer laser to correct hyperopia, eyes with a spherical equivalent refraction less +2.00 D should be overcorrected by 25%, +2.00 to +4.00 D by 30%, and over +4.00 by 40%. The positive cylinder should be overcorrected by 10%.

CONCLUSIONS

LASIK was safe and effective in the treatment of hyperopia from +0.50 to +11.50 D. Regression following LASIK for hyperopia remains a problem. A special nomogram was required to achieve results comparable with those for myopia.

Anterior uveitis following combined vaccination for measles, mumps and rubella (MMR): a report of two cases

PURPOSE

To describe two children who developed anterior uveitis after vaccination for common childhood diseases.

METHODS

A retrospective study of two Saudi patients who were seen at The Eye Center, Riyadh, Saudi Arabia.

RESULTS

Aged 12 and 14, respectively, the two patients developed anterior non-granulomatous uveitis 6 and 4 weeks after having the combined vaccination for measles, mumps and rubella (MMR). No other definite cause of uveitis was detected from history or from laboratory work up. Both patients responded to traditional regimens of uveitis therapy. However, they required a treatment period of several months.

CONCLUSION

Anterior uveitis may occur following MMR vaccination. Cases of vaccination thus require ophthalmic awareness if visual symptoms or a painful red eye develop.

Coil embolisation for ruptured vertebral artery dissection distal to the origin of the posterior inferior cerebellar artery

Although many surgical or endovascular treatments for ruptured vertebral artery dissection have been reported, the best treatment is controversial. We treated five cases of ruptured vertebral artery dissection distal to the origin of the posterior inferior cerebellar artery (PICA), using retrievable platinum coils packed in the dissection site and the immediately proximal vertebral artery. All patients had a contralateral vertebral artery of the same calibre or larger. All dissections were occluded completely, together with the portion of the vertebral artery distal to the PICA origin. No complications related to the procedure were seen. The purpose of the treatment is to isolate the dissection from the cerebral circulation. Occlusion of the rupture site, preserving perforating arteries arising from the vertebral artery, would be ideal. Short-segment occlusion by retrievable platinum coils is close to the ideal.

Treatment of acute bacterial conjunctivitis with topical lomefloxacin 0.3% compared to topical ofloxacin 0.3%

PURPOSE

The main purpose of this prospective study was to compare the efficacy, local tolerance, and safety of topical lomefloxacin 0.3% and topical ofloxacin 0.3% in the treatment of acute bacterial conjunctivitis.

PATIENTS AND METHODS

Forty patients with acute bacterial conjunctivitis were included in a randomized, prospective, parallel-group study. Twenty patients were assigned to the lomefloxacin group (Okacin, CIBA Vision Ophthalmics) and 20 patients to ofloxacin (Oflox, Allergan). Lomefloxacin 0.3% was given 1 drop every 2 hours during waking hours on the first day then twice daily for one week. Ofloxacin 0.3% eyedrops were given four times daily. All patients underwent eye examination and clinical findings were graded and recorded according to severity of lid hyperemia, lid edema, lid crusting, conjunctival edema and discharge, bulbar conjunctival hyperemia, palpebral conjunctival hyperemia, corneal edema, and ocular discomfort. The score for each clinical sign was recorded before and after treatment. The mean cumulative sum score (CSS) was obtained by adding the scores for signs and symptoms. All conjunctival swabs were cultured and tested for sensitivity. Patients with confirmed bacterial conjunctivitis were included.

RESULTS

There were 10 male and 10 female patients in each group. The age range was from 1 to 78 years, and the mean age was 35 years in the lomefloxacin group. In the ofloxacin group the age range was from 1 to 70 years, and the mean age was 26 years. There was no significant difference between the two groups in relation to age or sex. The causative organisms were Staphylococcus epidermidis in 16 cases (36%), alpha-hemolytic Streptococci in 9 (20%), Haemophilus spp. 6 (13%), Staphylococcus aureus 5 (11%), Streptococcus pneumoniae 4 (9%), Pseudomonas aeruginosa 3 (7%), and other 2 (4%). The mean CSS for conjunctivitis was 12.1 before therapy in the lomefloxacin group and 12.7 in the ofloxacin group. On the 7th day of therapy, the mean CSS was 0.7 in the lomefloxacin group, and 1.6 for ofloxacin. All patients showed improvement, but a total of 18 out of 20 (88%) in the lomefloxacin group showed complete resolution compared to 15 (75%) in the ofloxacin group. The difference was not statistically significant (p = 0.08). Tolerance was excellent in both groups, and no side effects were reported. A burning sensation was noted by two patients, one in each group.

CONCLUSIONS

Lomefloxacin and ofloxacin were equally effective and safe in the treatment of acute bacterial conjunctivitis.

HLA-B27 subtypes and HLA class II alleles in Japanese patients with anterior uveitis

PURPOSE

Some patients with anterior uveitis (AU) have ankylosing spondylitis (AS) and are HLA-B27 class I-positive. The purpose of this study was to investigate whether there are differences in HLA at the allele level among each group of patients with AU.

METHODS

Seventy-three patients with AU were studied. They were classified into three groups: 31 with AS-associated AU, 14 with HLA-B27-associated AU, and 28 with idiopathic AU. Three control groups without AU were used: 138 random subjects, 33 HLA-B27-positive healthy subjects, and 19 HLA-B27-positive patients with AS. DRB1 and DQB1 genotyping was performed using polymerase chain reaction (PCR)-single-strand conformation polymorphism (PCR-SSCP) and PCR-restriction fragment length polymorphism. HLA-B27 subtype was determined by PCR-SSCP.

RESULTS

There was no difference in the frequency of any class I antigen except HLA-B27 among the patients studied. The frequencies of HLA-DR12 in AS-associated AU and HLA-DR1 in HLA-B27-associated AU showed an increase. In HLA-B27-associated AU, DRB1*0101 and DQB1*0501 were increased compared with HLA-B27-positive control subjects. When HLA-B27 subtype distribution was compared among the groups, the proportion of B*2704 was significantly lower in HLA-B27-associated AU (P = 0.037), however, such a difference was not present in AS-associated groups.

CONCLUSIONS

These results indicated that B*2704 seemed to be less susceptible to AU compared with B*2705 in Japanese subjects. The increase of HLA-DR12 and HLA-DR1 in AU may be caused by linkage disequilibrium with B*2704 and B*2705, respectively.

Immunogenetics of episcleritis in leprosy

Human leukocyte antigens (HLA) were analyzed among Japanese leprosy patients to identify any possible determinants in the development of episcleritis in leprosy patients. Seventy-nine Japanese leprosy patients (33 patients with history of episcleritis and 46 patients without episcleritis) and 114 healthy control subjects were investigated. Human leukocyte antigen-class I and class II specificities were determined serologically by the standard microcytotoxicity test. The HLA-DRB1, -DRB5, -DQA1, and -DQB1 genotypings were performed by using the polymerase chain reaction (PCR)-single strand conformation polymorphism and PCR-restriction fragment length polymorphism analyses. The frequency of HLA-Cw3 was significantly increased among the patients with episcleritis (66.7%) compared to patients without episcleritis (43.5%; odds ratio = 2.6, P < 0.05). The frequency of HLA-DR4 was significantly decreased among the patients with episcleritis (15.2%) compared to patients without episcleritis (39.1%; odds ratio = 0.28, P < 0.05) and the controls (46.5%; odds ratio = 0.21, P < 0.001). At the genomic level, frequencies of the HLA-DRB1*0405, -DQB1*0401, and -DQB1*0302 alleles were significantly decreased among the patients with episcleritis (0%, 0%, and 6.1%, respectively) compared to patients without episcleritis (15.2%, 13.0%, and 26.1%, respectively; odds ratio = 0.07, 0.09, and 0.18, P < 0.05). HLA-DRB1*0405 and -DQB1*0401 were also significantly decreased among the patients with episcleritis compared to the controls (29.8% and 29.8%; odds ratio = 0.04, P < 0.0001). Our results suggest that HLA-Cw3 antigen confers the susceptibility to the development of episcleritis among Japanese leprosy patients. Concurrently, the DRB1 (the -DBR1*0405), and/or DQB1 (the -DQB1*0401 and -DQB1*0302) alleles might provide protection against leprous episcleritis.

Influences of selected socioeconomic and demographic variables on fertility in Bangladesh

"The data used in this study are from the 1989 Bangladesh Fertility Survey (1989 BFS), which was conducted...by the National Institute of Population Research and Training (NIPORT)....A two-stage probability sample design was used for the survey.... It has been found that female age at marriage has a significant direct negative influence on fertility. Thus, raising the age at marriage by implementing a minimum-age marriage law is likely to lower fertility on a national scale. Duration of breast-feeding is also found to have a significant direct negative effect on fertility....Fetal loss appears to have a significant direct positive effect on fertility...which means that mothers who have experienced fetal loss are found to have higher fertility.... Maternal mortality is also high in Bangladesh. Therefore, it is essential to provide primary health care, particularly maternal and child health care, for surviving children."

HLA class II genes in Vogt-Koyanagi-Harada disease

PURPOSE

Vogt-Koyanagi-Harada disease (VKH) is an autoimmune disorder causing a bilateral diffuse granulomatous uveitis, often with several associated extraocular manifestations. Strong association of human leukocyte antigens (HLA) antigens with the disease has been documented. The details of all HLA class II genotypes were investigated in Japanese patients with VKH to demonstrate the immunogenetic background of the disease.

METHODS

Human leukocyte antigen tissue typing was performed in 57 Japanese patients with VKH by the modified two-stage complement-dependent microcytotoxicity method. DNA analyses were done by polymerase chain reaction (PCR)-single-strand conformation polymorphism and PCR-restriction fragment-length polymorphism methods.

RESULTS

The frequencies of HLA-DR4 and HLA-DQ4 were 93% and 83% among the patients with VKH, compared with 43% and 32% among the controls, respectively (relative risks, 17.4 and 9.9; Pc < 1.0 x 10(-10)). At the genomic level, all patients had the HLA-DQA1*0301 genotype, which was present in only 67% of the normal controls (relative risk, 56.5; Pc < 1.0 x 10(-5)). With allelic combinations, -DQA1*0301/-DR4 showed the greatest relative risk ratio. Conversely, DQB1*0604 genotype was not detected among the patients.

CONCLUSION

It can be postulated that VKH is a disease of combined allelic predisposition in which DQA1*0301 acts as the primary and HLA-DR4 acts as an additive factor in the development of the disease. Based on the negative association of DQB1*0604, we propose that DQB1*0604 provides considerable protection, possibly by altering other factors in the pathogenesis of VKH in the Japanese.

[Relation between the clinical course of Vogt-Koyanagi-Harada's disease and human leukocyte antigen (HLA)-DR4 subtypes]

Vogt-Koyanagi-Harada's disease (VKH) is an autoimmune disorder affecting melanocyte-containing tissues. VKH is strongly related to human leukocyte antigen (HLA)-DR4, a heterogeneous HLA specificity consisting of at least 12 different genotypes. The disease has two types: prolonged and non-prolonged, depending upon the clinical course. Fifty-four Japanese patients comprising 27 with the prolonged type, 15 with the non-prolonged type, and 12 new cases of VKH were included in this study. Ninety-three percent of the patients with all types had HLA-DR4. All 27 patients with the prolonged type had either the DRB1*0405 or *0410 genotype, and the non-prolonged type included two DR4-negative and four DRB1*0405 and *0410 negative patients. Our results indicate that the clinical course of VKH is determined partly by the patient's HLA genotype.

Influence of HLA-DRB1 gene variation on the clinical course of Vogt-Koyanagi-Harada disease

PURPOSE

To investigate the difference, if any, in the immunogenetic backgrounds between two clinical subtypes of Vogt-Koyanagi-Harada disease (VKH).

METHODS

HLA-DR4 gene variations were investigated in 46 Japanese patients, 28 with the prolonged type and 18 with the nonprolonged type of VKH. HLA-DR4 genes were amplified with polymerase chain reaction (PCR) and then analyzed for its variation with single-strand conformation polymorphism (SSCP) and restriction fragment length polymorphism (RFLP) methods.

RESULTS

Significant differences were found in the DR4 gene variation in the two clinical subtypes. All the patients with the prolonged type had either the DRB1*0405 or DRB1*0410 variant, whereas 39% of the patients with the nonprolonged type had neither of them. This difference in frequency was statistically highly significant (P = 0.00059, Pc = 0.0041). DRB1*0405 was also more frequent in the prolonged type (93%) than in the nonprolonged type (56%) (P = 0.0044, Pc " 0.030). In the prolonged type, relative risk was highest for DRB1*0405/0410 (128), whereas in the nonprolonged type it was highest for DR4 (8.6).

CONCLUSION

This preliminary study showed that DR4 gene variants differed significantly between the two subtypes of VKH, suggesting that the clinical course of VKH is determined partly by the patient's HLA-DR gene variation.

Unique associations between HLA-B and HLA-DRB1*04 gene variants in Japanese

HLA-DRB1*04 gene variants were determined in apparently healthy Japanese with PCR-SSCP and PCR-RFLP, and HLA-B-DRB1*04 haplotype frequencies were estimated statistically. DRB1*0405, which consisted of 60% of the Japanese DRB1*04 gene pool, was associated strongly with HLA-B54. This association was observed only for DRB1*0405, and not for any other DR4 variants. DRB1*0403 and DRB1*0406, which share the same peptide sequence except for amino acid 37, were both associated with B35 and B62. DRB1*0407 was associated exclusively with B35. DRB1*0410 was associated with B60 and B61. B60 and B61, on the other hand, were associated only with DRB1*0410 and DRB1*0405. B35 was associated with all DR4 microvariants. With this possible exception, our calculation suggests that unique B-DR associations were present even for DR4 microvariants. The knowledge of HLA-B and DRB1*04 associations would be useful in clinical settings.

Socioeconomic and environmental determinants of child survival in Bangladesh

Differentials in child survival in Bangladesh have been examined using a number of socioeconomic and environmental factors on data from the 1989 Bangladesh Fertility Survey. Multivariate analysis reveals that both wife's and husband's education and household electricity show a significant positive association with child survival. The respondent's working status exerts a significant negative influence. Wife's education has a greater influence on child survival in Bangladesh than that of husband's education.

Factors affecting fertility in a rural area of Bangladesh

"The purpose of this paper is to examine the effects of selected socioeconomic and demographic factors on fertility in a rural area of Bangladesh. It has been revealed that age at first marriage and coital frequency have direct significant effects while ever use of contraception and duration of breast-feeding have direct positive significant effects on total parity. Total effects of wife's education and age at first marriage on fertility are found to be negative while those of religion and household income on fertility are found to be positive."

Inhibition of tumor cell adhesion to lymph nodes by laminin-related peptide and neuraminidase

BACKGROUND

Adhesion to lymph nodes, rather than growth stimulation, accounted for preferential colonization of lymph nodes by a metastatic B16 melanoma. We investigated these adhesive interactions.

METHODS

Four classes of molecules were tested for inhibition of melanoma adhesion to cryostat sections of lymph node.

RESULTS

Calcium chelators ethylenediaminetetraacetic acid and ethyleneglycol-bis-(beta-aminoethylether)-N,N,N',N'-tetra ace tic acid completely inhibited adhesion (50% adhesion, half-maximal inhibition, at 1 to 3 mmol/L). Cytochalasin B, which impairs contractile microfilaments, inhibited adhesion (60% adhesion at .001 mmol/L, 28% at .01 mmol/L). Colchicine, which disaggregates microtubules, had a similar effect (20% at .01 mmol/L, lowest dose tested). Trypsin slightly increased adhesion (125% adhesion at 10 micrograms/ml). Neuraminidase, which removed sialic acid residues, inhibited it (50% adhesion at 5 micrograms/ml). Gly-arg-gly-asp-ser, a peptide with a cell binding sequence of fibronectin, did not consistently inhibit adhesion (69% adhesion at 0.1 mg/ml, 83% adhesion at 1 mg/ml) or substantially differ from gly-arg-gly-glu-ser-pro (59% adhesion at 0.1 mg/ml, 90% adhesion at 1 mg/ml). In contrast, a peptide with a cell binding region of laminin (tyr-ile-gly-ser-arg) inhibited adhesion (50% adhesion at .05 mg/ml).

CONCLUSIONS

Tumor cell-lymph node adhesion is a calcium-dependent process, requiring a functional cytoskeleton, that is mediated by both sialic acid moieties and trypsin-resistant, laminin-related, adhesion molecules.

Fertility differentials in rural Bangladesh

"Data from two sources in rural Bangladesh have been used in this study to examine the differentials in fertility by selected socio-economic and demographic factors. Results [indicate] that age at first marriage, education of spouses and availability of electricity in the household...have [an] inverse relationship with fertility. Higher fertility is observed for Muslim women than for non-Muslims. It has been found that fertility is the lowest to those women whose husbands are service holders and the highest for agriculture."

Fertility desires in Bangladesh and Sri Lanka: an application of logit model

"The relationship between fertility desires and some explanatory variables, number of living children, level of education, and age of women are studied by fitting a series of logit models for two developing countries, Bangladesh and Sri Lanka. The model which includes the main effects of all the explanatory variables to predict the fertility desires of women is found to be the most appropriate model for Sri Lanka whereas the best fitting model for predicting fertility desires among Bangladeshi women includes the interaction of age and number of living children as well as the interaction of number of living children and education in addition to the main effects of all the explanatory variables. The single best predictor of future childbearing desires of women is found to be the number of living children, while the weakest predictor is the level of education."

Factor analysis of some socio-economic and demographic variables for Bangladesh

The author carries out an exploratory factor analysis of some socioeconomic and demographic variables for Bangladesh using the classical or common factor approach with the varimax rotation method. The socioeconomic and demographic indicators used in this study include literacy, rate of growth, female employment, economic development, urbanization, population density, childlessness, sex ratio, proportion of women ever married, and fertility. The 18 administrative districts of Bangladesh constitute the unit of analysis. 3 common factors--modernization, fertility, and social progress--are identified in this study to explain the correlations among the set of selected socioeconomic and demographic variables.