bluuebunny/crossref_metadata_2025_split huggingface dataset:
Ezrin, Maspin, Peroxiredoxin 2, and Heat Shock Protein 27: Potential Targets of a Streptococcal-Induced Autoimmune Response in Psoriasis
Authors: Besgen Petra , Trommler Paul , Vollmer Sigrid , Prinz Joerg Christoph 
Published: April 2010

Abstract
Psoriasis is an HLA-Cw6–associated T cell-mediated autoimmune disease of the skin that is often triggered by streptococcal angina. To identify keratinocyte proteins, which may become psoriatic autoantigens as the result of an immune response against streptococci, rabbits were immunized with heat-killed Streptococcus pyogenes. Streptococcal immunization induced Ab formation against various human keratinocyte proteins. Sera from psoriasis patients reacted against several of these proteins as well. Common serologic reactivities of rabbits and patients included the proteins ezrin, maspin, peroxiredoxin 2 (PRDX2), heat shock protein (hsp)27, and keratin 6. When used for stimulation of blood lymphocytes, ezrin, maspin, PRDX2, and hsp27 induced increased T cell activation in psoriasis patients, which was particularly evident for HLA-Cw6+ individuals. Ag-specific T cell lines generated with these proteins consisted predominantly of CD8+ T cells and used TCR β-chain rearrangements, which were highly homologous to those expanded within the corresponding skin lesion. Several immunodominant epitopes on the different proteins could be defined according to sequence alignments with the whole genome of S. pyogenes. Our data indicate that maspin, ezrin, PRDX2, hsp27, and potentially keratin 6 could act as autoantigens of a streptococcal-induced autoimmune response and represent targets of the exaggerated T cell response in psoriasis. Additionally, ezrin and hsp27 might constitute antigenic links between psoriasis and inflammatory bowel disease, uveitis, or arteriosclerosis, which are clinically associated.
Nonobese Diabetic Congenic Strain Analysis of Autoimmune Diabetes Reveals Genetic Complexity of the Idd18 Locus and Identifies Vav3 as a Candidate Gene
Authors: Fraser Heather I. , Dendrou Calliope A. , Healy Barry , Rainbow Daniel B. , Howlett Sarah , Smink Luc J. , Gregory Simon , Steward Charles A. , Todd John A. , Peterson Laurence B. , Wicker Linda S. 
Published: April 2010

Abstract
We have used the public sequencing and annotation of the mouse genome to delimit the previously resolved type 1 diabetes (T1D) insulin-dependent diabetes (Idd)18 interval to a region on chromosome 3 that includes the immunologically relevant candidate gene, Vav3. To test the candidacy of Vav3, we developed a novel congenic strain that enabled the resolution of Idd18 to a 604-kb interval, designated Idd18.1, which contains only two annotated genes: the complete sequence of Vav3 and the last exon of the gene encoding NETRIN G1, Ntng1. Targeted sequencing of Idd18.1 in the NOD mouse strain revealed that allelic variation between NOD and C57BL/6J (B6) occurs in noncoding regions with 138 single nucleotide polymorphisms concentrated in the introns between exons 20 and 27 and immediately after the 3′ untranslated region. We observed differential expression of VAV3 RNA transcripts in thymocytes when comparing congenic mouse strains with B6 or NOD alleles at Idd18.1. The T1D protection associated with B6 alleles of Idd18.1/Vav3 requires the presence of B6 protective alleles at Idd3, which are correlated with increased IL-2 production and regulatory T cell function. In the absence of B6 protective alleles at Idd3, we detected a second T1D protective B6 locus, Idd18.3, which is closely linked to, but distinct from, Idd18.1. Therefore, genetic mapping, sequencing, and gene expression evidence indicate that alteration of VAV3 expression is an etiological factor in the development of autoimmune β-cell destruction in NOD mice. This study also demonstrates that a congenic strain mapping approach can isolate closely linked susceptibility genes.
Cutting Edge: IL-21 and TLR Signaling Regulate Germinal Center Responses in a B Cell-Intrinsic Manner
Authors: Bessa Juliana , Kopf Manfred , Bachmann Martin F. 
Published: April 2010

Abstract
IL-21 produced by follicular Th (Tfh) cells is an important regulator of Tfh cell development and B cell responses, including germinal center (GC) formation. However, whether defective GC formation and Ab responses are a consequence of impaired Tfh cells development or a B cell-intrinsic defect in IL-21–deficient mice requires clarification. To address this question, we generated chimeric mice lacking IL-21R exclusively on B cells. In this study, we demonstrate that GC reaction and B cell responses induced by immunization with virus-like particles were strongly reduced in both global and B cell-specific IL-21R–deficient mice. Interestingly, the presence of TLR7 ligand within virus-like particles largely restored defective GC reaction and Ab responses in global as well as in B cell-specific IL-21R–deficient mice. Hence, IL-21 acts directly on B cells and cooperates with TLR signaling for optimal B cell responses.
PU.1 Binds to a Distal Regulatory Element That Is Necessary for B Cell-Specific Expression of CIITA
Authors: Yoon Hyesuk , Boss Jeremy M. 
Published: April 2010

Abstract
The transcriptional coactivator CIITA regulates MHC class II genes. In the mouse, CIITA is expressed from three distinct promoters (pI, pIII, and pIV) in a developmental and cell type-specific manner with pIII being responsible for B lymphocyte-specific expression. Although the promoter proximal sequences that regulate CIITA in B cells have been described, nothing is known about additional distal elements that may regulate its expression in B cells. Sequence homology comparisons, DNase I hypersensitivity assays, and histone modification analysis revealed a potential regulatory element located 11 kb upstream of pIII. Deletion of this element, termed hypersensitive site 1 (HSS1), in a bacterial artificial chromosome encoding the entire CIITA locus and surrounding genes, resulted in a complete loss of CIITA expression from the bacterial artificial chromosome following transfection into B cells. HSS1 and pIII displayed open chromatin architecture features in B cell but not in plasma cell lines, which are silenced for CIITA expression. PU.1 was found to bind HSS1 and pIII in B cells but not in plasma cells. Depletion of PU.1 by short hairpin RNA reduced CIITA expression. Chromatin conformation capture assays showed that HSS1 interacted directly with pIII in B cells and that PU.1 was important for this interaction. These results provide evidence that HSS1 is required for B cell-specific expression of CIITA and that HSS1 functions by interacting with pIII, forming a long-distance chromatin loop that is partly mediated through PU.1.
Fas-Activated Serine/Threonine Phosphoprotein Promotes Immune-Mediated Pulmonary Inflammation
Authors: Simarro Maria , Giannattasio Giorgio , De la Fuente Miguel A. , Benarafa Charaf , Subramanian Kulandayan K. , Ishizawar Rumey , Balestrieri Barbara , Andersson Emma M. , Luo Hongbo R. , Orduña Antonio , Boyce Joshua , Anderson Paul 
Published: April 2010

Abstract
We generated Fas-activated serine threonine phosphoprotein (FAST)-deficient mice (FAST−/−) to study the in vivo role of FAST in immune system function. In a model of house dust mite-induced allergic pulmonary inflammation, wild type mice develop a mixed cellular infiltrate composed of eosinophils, lymphocytes, and neutrophils. FAST−/− mice develop airway inflammation that is distinguished by the near absence of neutrophils. Similarly, LPS-induced alveolar neutrophil recruitment is markedly reduced in FAST−/− mice compared with wild type controls. This is accompanied by reduced concentrations of cytokines (TNF-α and IL-6 and -23) and chemoattractants (MIP-2 and keratinocyte chemoattractant) in bronchoalveolar lavage fluids. Because FAST−/− neutrophils exhibit normal chemotaxis and survival, impaired neutrophil recruitment is likely to be due to reduced production of chemoattractants within the pulmonary parenchyma. Studies using bone marrow chimeras implicate lung resident hematopoietic cells (e.g., pulmonary dendritic cells and/or alveolar macrophages) in this process. In conclusion, our results introduce FAST as a proinflammatory factor that modulates the function of lung resident hematopoietic cells to promote neutrophil recruitment and pulmonary inflammation.
Cutting Edge: Critical Role for PYCARD/ASC in the Development of Experimental Autoimmune Encephalomyelitis
Authors: Shaw Patrick J. , Lukens John R. , Burns Samir , Chi Hongbo , McGargill Maureen A. , Kanneganti Thirumala-Devi 
Published: April 2010

Abstract
Multiple sclerosis is an autoimmune disease in which self-reactive T cells attack oligodendrocytes that myelinate axons in the CNS. Experimental autoimmune encephalomyelitis (EAE), an animal model of multiple sclerosis, is dependent on caspase-1; however, the role of Nod-like receptors upstream of caspase-1 is unknown. Danger- and pathogen-associated molecular patterns activate Nod-like receptor 3, which activates caspase-1 through the adaptor protein, apoptosis-associated speck-like protein containing CARD (ASC). We report that the progression of EAE is dependent on ASC and caspase-1 but not Nod-like receptor 3. ASC−/− mice were even more protected from the progression of EAE than were caspase-1−/− mice, suggesting that an inflammasome-independent function of ASC contributes to the progression of EAE. We found that CD4+ T cells deficient in ASC exhibited impaired survival; accordingly, ASC−/− mice had fewer myelin oligodendrocyte glycoprotein–specific T cells in the draining lymph nodes and CNS.
Preterm Labor: A Review
Authors: Dhumale Hema , Bellad MB , Shravage Jyotsna C 
Published: April 2010

ABSTRACTIntroductionPreterm labor (PTL) is one of the leading causes of perinatal morbidity and mortality. It is one of the major public health problems, especially with reference to mortality, disability and health care expenses.IncidenceThe overall incidence of PTL is around 10-15% (6-15% Range)3 (The incidence of PTL in our institute (JNMC) was 10.2% during 2006-2007. Out of all PTL 50% occur spontaneously, 25% following preterm prelabor rupture of membranes (PPROM) and another 25% iatrogenic (Induced due to maternal and/or fetal risks).Risk factorsPrevious history of preterm labor is one of the important risk factor(risk of PTL in subsequent pregnancies is 14.3% and 28% after one and two preterm births. Others include multiple pregnancy, uterine over distension (polyhydramnios, macrosomia and fibroids), uterine anomalies, cervical incompetence, bacterial vaginosis, bleeding in early pregnancy, poor socioeconomic status, elderly and adolescent age group and tobacco use.PredictorsCervical length assessment by USG, fetal fibronectin, vaginal pH are being used.PreventionProgesterone and clindamycin (abnormal vaginal flora) antibiotic is being used with reasonable evidence.TreatmentCorticosteroids and antibiotics help in reducing neonatal morbidity and mortality and tocolytics (nifedepine and atosiban are recommended) helps in allowing the steroids to act.Newer developmentsNew predictors like higher vaginal pH (> 4.5) and Gram stain score of 9 to 10 with Nugent criteria in early pregnancy is increasingly associated with preterm labor. Search for selective and safe tocolytic is also under consideration, specially the prostaglandin synthetase inhibitors and the role of potassium channels in myometrium.ConclusionSuccessful prediction, prevention and treatment of preterm labor has significant influence on the perinatal outcome, health care expenditure and quality of life. As the cause for preterm labor is still an enigma, it is difficult to predict, prevent and treat PTL successfully. At present the treatment of PTL is mainly antibiotics, tocolytics and corticosteroids with varied success.
Fertility Preservation in Female Cancer Patients: A Review
Authors: Talwar Pankaj 
Published: April 2010

ABSTRACT
Cancer ART is one of the fast developing subspecialties in the ever expanding field of Assisted Reproductive Techniques. It is well documented that both chemotherapy and radiotherapy can have a deleterious effect on the gonads. Onco-ART targets this unfortunate population and provides a chance to the patient to produce their biological offspring. Cryopreservation of the ovaries is a step towards this goal. A properly preserved ovarian cortex can be later grafted in the body to enhance fertility. Even though this novel technique is still in its infancy stage, it holds a lot of promise that can be favorably explored.
Uterine Artery Embolization: A Nonsurgical Cure for Fibroids
Authors: Naredi Nikita , Bhattacharyya TK 
Published: April 2010

ABSTRACTUterine leiomyomata commonly known as fibroids are benign tumors of the uterus that are a common cause of heavy menstrual bleeding, pelvic pain and pressure symptoms in women. The traditional method of treatment for these benign tumors has been surgery as long-term medical therapies have not shown to be effective. Uterine artery embolization (UAE) a minimally invasive, interventional radiological technique, wherein complete occlusion of both the uterine arteries with particulate emboli are carried out, has been found to be an effective and safe alternative in the treatment of menorrhagia and other fibroid-related symptoms in women not desiring future fertility or who are poor surgical candidates. This treatment modality available in all major institutions may be instituted as an alternative to hysterectomy in young women wishing to preserve the uterus. UAE a cost-effective modality associated with a short hospital stay has significant advantages over conventional surgeries in the treatment of myomas.
Oral Misoprostol: A Safe and Effective Alternative in Comparison to Conventional Uterotonic Agents in the Active Management of Third Stage of Labor
Authors: Ghazala Mahmud , Nasira Tasnim , Saba Fatima 
Published: April 2010

ABSTRACT

Objective
To determine the efficacy and safety of oral misoprostol with intravenous oxytocin and syntometrine in the active management of third stage of labor.

Methodology
325 women were randomly allocated by convenient sampling to receive either 10 IU of intravenous oxytocin or 10 IU of oxytocin with 0.2 mg of Methergine (syntometrine) or 400 mcg of oral misoprostol at the delivery of anterior shoulder. Main outcome measures were estimation of blood loss > 500 ml, drop in hemoglobin/hematocrit levels and adverse effects of drugs.

Results
Estimated blood loss was significantly higher in group misoprostol group (p = 0.016) but comparable to oxytocin group (p = 0.40). Drop in hemoglobin level was comparable in all the three groups (p = 0.106). Drop in hematocrit value was significant for misoprostol and syntometrine (p = 0.022) but comparable to oxytocin. Nausea and vomiting was common in oxytocin and syntometrine group whereas fever and shivering was the leading adverse effect in misoprostol group.

Conclusion
Misoprostol is an effective and safe alternative to intravenous uterotonic agents in the active management of third stage of labor both at tertiary and community level.
Maternal and Perinatal Outcome in Severe Pre-eclampsia and Eclampsia
Authors: LNU Anshu , LNU Deepika 
Published: April 2010

ABSTRACT

Background
Pre-eclampsia is a leading cause of maternal and perinatal morbidity and mortality worldwide. Present study was planned to find the maternal and perinatal outcome in patients of severe pre-eclampsia and eclampsia.

Methodology
It is a prospective study, carried out on 100 pregnant women admitted with severe pre-eclampsia and eclampsia at a tertiary care referral unit. Detailed history and examination was carried out. Investigations like complete hemogram, liver function tests, renal function tests, coagulation profile, fundus and 24 hours urine for protein were done. Obstetric management was done as per existing protocol in the department, magnesium sulphate was the drug of choice for controlling convulsions, and blood pressure was controlled either by oral nefidipene or methyl dopa. Maternal and perinatal complications were noted down.

Results
The majority of the patients was unbooked (82%), belonged to lower socioeconomic status (84%) and had rural background (84%). Headache was the most common antecedent symptom (44%) followed by epigastric pain (20%), oliguria (9%), blurring of vision (8%) and ascitis (5%). There was high incidence of maternal complications like PPH (31%), abruption placentae (11%), renal dysfunction (8%), pulmonary edema (8%), pulmonary embolism (4%), HELLP syndrome (2%) and DIC (2%). Maternal mortality was 8% and the causes were pulmonary embolism in four women, DIC in two, HELLP and pulmonary edema in one each. Perinatal complications were also high 71.43% were low birth weight, 66% had preterm delivery, 52.4% babies had birth asphyxia and 28.57% were still born. Maternal and perinatal outcome was much poorer in eclampsia as compared to severe pre-eclampsia.

Conclusion
There is a very high maternal and perinatal morbidity and mortality and 82% patients had no antenatal care. Good antenatal care could have been prevented severe pre-eclampsia and eclampsia to some extent. Thus it is suggested that developing countries have to go a long way to create awareness about importance of antenatal check ups and take measures for implementation.
Mother to Child Transmission of HIV; Are We Doing Enough?
Authors: Irfan Ahmed , Seiglinde Muller , Firas Saadeh 
Published: April 2010

ABSTRACT

Aim
A retrospective audit was conducted from 1st January 1996 to 31st December 2006 to assess the incidence of mother to child transmission of HIV and to assess changing trends over the last 10 years as well as the ethnicity of the patients.

Methods
All cases of HIV positive women delivered during the time period were considered. Age distribution, marital status women, parity, pregnancy planning, coinfection with Hepatitis B, Hepatitis C and Syphilis, gestational age at delivery, duration of rupture of membranes, mode of delivery and sex of the child were analyzed. Babies were followed up with HIV PCR at 6, 12 and 18 months.

Results
Of a total of 31 cases and 23 mothers, 3 cases were lost to follow-up. From the remaining 28 cases, only one infant tested HIV positive; hence, mother to child transmission rate was 3.6%. Of the 23 mothers, 22 (96%) are of African origin and 1 (4%) is ethnic irish. Most patients were primigravida or para 1.

Conclusion
The known correlation between the longer duration of rupture of membranes and the increased transmission of HIV was evident in the one case where mother to child transmission took place.
Can Early hCG Levels be a Marker for Pregnancy Outcome in ART Cycles?
Authors: Parihar Mandakini 
Published: April 2010

ABSTRACT
With advancing technology of assisted reproduction, physicians today have the ability to achieve conception in many couples who would have been totally incapable doing so only a few years ago. The anxiety and the uncertainty of pregnancy outcomes using ART procedures is widely accepted as one of the main psychological stresses the couples. The ability to predict outcome as soon as possible after assisted conception treatment is important for clinic staff and patients.
The aim of this observational study is to highlight the importance of hCG values in predicting the outcome of ART cycle and counseling the patients in case of adverse result. The ultimate aim is to improve the take home baby rate and initial hCG value can help us counsel our patients towards the ultimate outcome.
Embryo development in early pregnancy follows a preprogrammed-timing schedule and depends mainly on the embryonic age of the healthy, successfully implanted conceptus. The appearance of hCG in maternal serum is used to assess the time of clinically detectable implantation. bhCG has provided the best sensitivity and specificity for detection of normal and pathological pregnancies. After IVF, early pregnancy loss or multiple gestations may be predicted with high sensitivity and specificity by using cut-off values of serum hCG. The median HCG concentration was 116 IU/l in viable pregnancies and 31 IU/l in nonviable pregnancies.
The median hCG concentration in twin pregnancies was almost double that in singleton pregnancies (201 IU/l vs 116 IU/l). Thus we can reassure normally pregnant patients as well as filter and manage those with nonviable outcomes more efficiently.
Teenage Pregnancy: Too Much Too Soon
Authors: Grover Namita , Sandhu Keerat K 
Published: April 2010

ABSTRACT
Teenage pregnancy is a major cause of concern to health professionals. They are high-risk groups because of the pervasive effects of early motherhood on physical and mental health. It is intended in the present study to discuss the obstetric and neonatal outcome in teenage pregnancies vis-a-vis primigravidae aged between 20-29 years. It is undeniable that teenage mothers do not understand the social reality of early pregnancy and do not realize that biologic maturity does not license activating this capacity at will. Responsibility is immense. A concerted effort is needed on the part of the doctors, family and society as a whole to counsel them and to bring down the incidence of this social menace.
Endometrioid Carcinoma and Ectopic Pregnancy Coexisting in an Ovarian Endometrioma
Authors: Rasool Sabahat , Rabbani Tamkin , Akhtar Omar S , Sherwani Rana K 
Published: April 2010

ABSTRACT
A 28 years old female presented to our OPD with the complaints of inability to conceive for the last 13 years and a lump in abdomen for the past month. Perspeculum examination revealed a healthy cervix and vagina and a per-vaginum examination revealed a uterus that was normal in size but a lump was palpable in the right adnexa. There was no cervical motion tenderness. Routine investigations were normal. Ultrasonography showed a complex right-sided adnexal mass of 165 by 78 mm with heterogenous echotexture. Tumor markers were within normal range except serum β-hCG, which was raised. Urine pregnancy test was positive. CT scan reported a welldefined large solid-cystic moderately enhancing pelvic mass with internal septations, seemingly arising from right adnexa. The patient was taken up for a staging laparotomy. Peroperatively, the picture was suggestive of a chronic ectopic pregnancy. Histopathological analysis from the lesion showed an ovarian endometrioid carcinoma and ectopic pregnancy coexisting in the endometrioma complete surgical staging was done, followed by chemotherapy. The patient has responded well to the treatment.
Cardiovascular Collapse Under Spinal Anesthesia
Authors: Puri Randhir , Anand Shankar K , Singh Y 
Published: April 2010

ABSTRACT
A 20 years old ASA I full term primigravida in labor, underwent an emergency lower segment cesarean section under spinal anesthesia, the indication being fetal distress. Immediately following delivery of fetus, she complained of severe breathlessness and suffered a cardiovascular collapse. A presumptive diagnosis of high spinal anesthesia was made and she was managed accordingly. Thirty minutes later she developed angioedema which increased in severity over the next two hours and a diagnosis of anaphylactic reaction was made. The patient responded to intravenous adrenaline and recovered over next 24 hours.
The aim of this case report is to discuss cardiovascular collapse and its etiological factors, such as anaphylaxis, amniotic fluid embolism and high spinal anesthesia during cesarean section.
An Unusual Presentation of Tuberculous Pericardial Effusion
Authors: LNU Shaheen , Sharma Rajyashri , Anjum Parvez , Jayshree Pathak 
Published: April 2010

ABSTRACT
Tuberculosis accounts for upto 4% of acute pericarditis and 7% cases of cardiac tamponade. 19% of women with tuberculosis can present with menorrhagia. Prompt treatment can be life saving but requires accurate diagnosis. We report a case of 25-year-old women who presented with severe bleeding per vaginum for four days. She was in shock. Echocardiography showed moderate pericardial effusion with features of cardiac tamponade. ADA was positive in aspirated pericardial fluid. The patient responded well to antitubercular treatment.