SUMMARYHuman genital infection caused by C hlamydia trachomatis is thought to be immunologically mediated, resulting in local recruitment of lymphocyte subsets and inducing the production of cytokines. Little information is available about the role of lymphocyte recruitment and the regulation of cytokine production in the genital tract of C. trachomatis positive infertile women. We have evaluated the recruitment of lymphocyte subsets in the genital tract and production of Th1/Th2 cytokines in cervical secretions and laparoscopic specimens from the fallopian tubes of C. trachomatis positive infertile women ( n = 17) and compared them with controls, viz. C. trachomatis negative infertile women ( n = 20) using ELISA and flow cytometry. None of these patients were found to be infected either with Candida sps., bacterial vaginosis, Trichomonas vaginalis , Neisseria gonorrhoeae, Mycoplasma hominis or Ureaplasma urealyticum in the cervix. Flow cytometric analysis of cervical secretions in Chlamydia positive women revealed recruitment of both CD4 and CD8 lymphocytes to the genital tract was up-regulated and a variation in the production rates of different cytokines in cervical secretions and fallopian tube was observed. We found that the immune responses in cervical secretions were of Th0 type, since all the analysed cytokines, viz. IFN-g , TNF-a , IL-10 and IL-12 were up-regulated. As, both CD4 and CD8 cells contribute to the production of IFN-g and IL-10, these results suggest that along with CD4 cells, CD8 lymphocytes also may be important for local regulation of Th1/Th2 responses in the genital tract during C. trachomatis infection.
Purpose:To evaluate the spectrum of celiac axis, common hepatic artery (CHA), right, left, middle hepatic artery and gastroduodenal artery variations by using spiral computed tomography (CT).Materials and Methods:A retrospective review of Multidetector CT (MDCT) abdominal angiography scans was performed in patients sent for various liver and other abdominal pathologies between January 2012 and February 2013. A total of 600 patients were evaluated. Definitions of CHA, ambiguous celiac axis, course and division patterns of CHA, replaced hepatic artery, accessory hepatic artery and middle hepatic artery were used as proposed by Song et al., Covey et al., and Wang et al. The pattern of the aortic origin of branches of celiac axis, common hepatic artery and its branches was analyzed.Results:Six types of celiac axis anatomic variations were identified in our study. A total of 546 of the 600 patients had a normal celiac axis anatomy. Anatomic variations were seen in 5.5% of patients. Ambiguous anatomy was seen in 3.5% of the patients. CHA originated from celiac axis in 95.83% of the patients. Variations in anatomic origin of CHA were seen in 8 patients. Ambiguous dual pathway was seen in 4 patients. Normal Sp-preportal course of CHA was identified in 97.78% of cases, Sp-retroportal course in 7 patients, Tp-preportal course in 2, Tp-retroportal in 1, Ip-preportal in 1 and through Ligamentum venosum in 2 patients. Normal origin of RHA from HAP was seen in 79.6% patients. Replaced origin of RHA was seen in 15.16% cases and Accessory origin of RHA was seen in 5.16% cases. LHA originated from HAP in 81.5% patients. Replaced LHA origin was seen in 10.8% cases and Accessory LHA origin seen in 7.6% cases. MHA originated from RHA in 41.3% patients, LHA in 27.83% and from CHA in 4.5% cases. Origin of MHA could not be defined in 26.3% of patients. GDA originated from CHA in 97.6% of patients, from celiac axis in 1.6%, from RHA in 0.33% in patients. Trifurcation of CHA was seen in 7.16% and quadrifurcation of CHA in 2.16%.Conclusion:CT Angiography is a safe and highly sensitive and accurate modality for evaluation of arterial anatomy and its variants.
Screening for Chlamydia trachomatis was done for 280 endocervical swab samples by PCR specific for endogenous plasmid. Age dependency was seen in symptomatic patients, with a high chlamydial prevalence rate (28%) found in younger women. Genotyping by restriction fragment length polymorphism analysis of omp1 PCR-positive samples showed serovars D, E, and F to be the most prevalent.Chlamydia trachomatis is a major cause of sexually transmitted disease (16). Serovars D to K are chiefly responsible for urogenital infections; of these serovars, E, F, and D account for up to 60 to 70% of these infections (1,5,14,20). Epidemiological studies of C. trachomatis infections in sexual contacts have been few to date, which hampers the study of chlamydial transmission, its route of spread in a population, its virulence factors, and the associated risk factors of C. trachomatis infections (12,19). Compared with immunotyping, the genotyping methods, particularly omp1 are more sensitive and precise in revealing C. trachomatis variants within serovars as well as in potential recombinants among serovars (13,15,18). The present study was undertaken to understand the occurrence of C. trachomatis serovars in the genital tracts of infected women, which will help in devising an effective screening program for routine diagnosis of chlamydial infections, understanding the immunopathogenesis, and developing an effective chlamydial control program.Reference C. trachomatis standard serovars were kindly provided by T. Ossewaarde (National Institute of Public Health and Environment Protection, Bilthoven, The Netherlands). Cervical swabs (n ϭ 280) were obtained from patients (17) attending the gynecology outpatient clinic for various gynecological reasons (abnormal vaginal discharge and pelvic pain) at Safdarjang Hospital, New Delhi, India. Chlamydial DNA was extracted from the clinical specimens by the alkali lysis method (2). The study protocol was approved by the committee responsible for the evaluation of work involving human subjects. Prior consent was obtained in all cases.The clinical samples were first screened by a PCR specific for the human -globin gene. The primers used for the human -globin PCR were P1 (sense, 5Ј ACA CAA CTG TGT TCA CTA GC) and P2 (antisense, 5Ј GAA ACC CAA GAG TCT TCT CT). Samples positive in the -globin PCR were used for C. trachomatis detection by using a plasmid PCR performed as described previously. The plasmid primers P3 (sense, 5ЈGAA CAA ATC GTA TCT CGG) and P4 (antisense, 5ЈGAA ACC AAC TCT ACG TCG) generated a fragment of 517 bp in the C. trachomatis-positive samples. The omp1 gene was amplified by primers selected from the published sequences of the omp1 gene of C. trachomatis (L 2 ) (21). The PCR mixture contained 25 pmol of each of the forward and reverse primers, 200 M concentrations of each of the deoxynucleoside triphosphates (dATP, dTTP, dGTP, and dCTP), 10ϫ PCR buffer (containing 10 mM Tris HCl [pH 8.3], 50 mM KCl, 2.5 mM MgCl 2 , 0.01% gelatin), and 0.1 U of Taq DNA polymerase (Gibco-BRL). PCR w...
This is the first PCR estimate of genital chlamydial (50%) and HPV 16 (30%) infection in STD patients and women with precancerous and cancerous lesions of the uterine cervix in India. The PCR method seems to be a good alternative to tissue culture.
Our findings suggest that routine screening and treatment of C. trachomatis infection in pregnant women, especially those in high risk groups, should be mandatory to reduce the adverse effects on obstetric outcome.
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