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Guineaworm in kwara state nigeria ii. immunological studies on naturally infected subjects
Aiyedun, B.A.; Browning, M.J.; Edungbola, L.D.1985East African Medical Journal 62(7): 459-465Guineaworm in kwara state nigeria ii. immunological studies on naturally infected subjects
A study was carried out to examine the immune response to Dracunculus medinensis in the human host, and to evaluate its potential in the diagnosis of infection with the parasite. The immune response was found to be largely IgE mediated, as demonstrated by both a marked elevation in serum levels of IgE, and a high incidence of immediate hypersensitivity reactions to parasite antigen. A lesser but significant increase in serum levels of IgM IgG levels of patients and controls was not significantly different. The absence of delayed hypersensitivity reactions to the parasite suggested little or no role for cell mediated immunity in the immune response. Standard immunological techniques of immunodiffusion and haemagglutination using a phosphate buffered extract of dried worms as antigen were found to be of little use as diagnostic indicators of infection. Skin testing, although giving a high incidence of positive results in infected patients, was found to have an unacceptably high incidence of false positives.
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Related referencesBoLA-Ⅰ外显子2、3在亲本和子代奶牛中同源性研究--《华中农业大学》2012年硕士论文
BoLA-Ⅰ外显子2、3在亲本和子代奶牛中同源性研究
【摘要】：奶牛在人们日常生活中扮演着越来越重要的作用,而奶牛繁殖力低下一直是制约奶牛产业发展的一个瓶颈。哺乳动物和人类的妊娠过程是自然界中存在的同种半异体移植免疫耐受的天然模型。
主要组织相容性复合体(major histocompatibility complex, MHC)在妊娠维持中起着重要的作用。牛的MHC又称为牛白细胞抗原(Bovine leucocyte antigen, BoLA),其基因位于第23号染色体上。按照MHC异源性解释,双亲BoLA-Ia基因越相似,妊娠排斥越小,而BoLA-Ia又具有高度的多态性。相反地,BoLA-Ib的表达有利于保护胚胎免受母体免疫侵害,但多态性不高。按照这一推理,BoLA-Ib在胎儿和母体的差异越小或表达水平越低,排斥得越严重。
根据本实验室已经得出的部分实验结果,选取与妊娠相关的一个BoLA-Ia基因(BoLA-A)和一个BoLA-Ib基因(BoLA-NC1),根据MHC异源性引起妊娠排斥的相关理论,取正常妊娠母牛PBMC、配种公牛精液和胎儿体细胞,从中提取DNA,设计引物扩增相应的BoLA-I相关基因,比较这两个基因的外显子2、3在六组样本里父本、母本和子代中的同源性,确定其同源性规律,从而进一步推出其同源性与正常妊娠维持的关系,并探讨其对妊娠的可能性影响。
实验结果发现,父本、母本、子代同源性差异普遍存在,且与NCBI上公布的相对应的BoLA序列并不完全一致,可见BoLA多态性明显,而且其多态性不仅存在于种间,还存在于种内。从亲本与子代同源性数据我们可以看出,BoLA-A基因和BoLA-NC1基因更多的是遗传于父本(58.33%和55.56%),可见父本这两个基因对子代的影响力更大。本实验样本为正常妊娠的母牛和正常生产的仔牛,虽然其在外显子2、3上存在一些序列差异,但两个基因的差异都比较小,根据实验结果推测,要维持正常妊娠,BoLA-A亲本外显子2同源性应大于99.75%,外显子3同源性应大于99.69%；BoLA-NC1亲本外显子2同源性应小于99.57%,外显子3同源性应小于98.73%,但是由于缺乏由亲本同源性差异而引起的非正常妊娠样本,我们无法推测BoLA-I亲本同源性阈值。
在同一样本组中,BoLA-A与BoLA-NC1的同源性大小有一定差异,但是这种差异并不明显(P0.05)。本研究六组样本中外显子2、3与NCBI上序列信息对比分析,发现均存在单核苷酸突变,发现了BoLA-A外显子2上有4个突变位点,外显子3上有4个突变位点；BoLA-NC1外显子2上有10个突变位点,外显子3上有11个突变位点。这些突变位点有一部分为同义突变,但大部分都造成了编码的氨基酸的改变,而且在同组不同样本中存在相同的突变位点,但是因为样本数量有限,以上并不能全面概括BoLA在外显子2、3上的SNPs。
本研究比较了BoLA-A和BoLA-NC1基因在六组样本中亲本和子代中的同源性,其差异性普遍存在,而且父本这两个基因对子代的影响力更大；并根据结果推测出要维持正常妊娠,这两个基因的同源性范围；另外,在六组样本中六组样本中共发现了29个突变位点,有一些为同义突变,但大多数突变都引起了编码的氨基酸改变,而且在同组不同样本中存在相同的突变位点。
【学位授予单位】：华中农业大学【学位级别】：硕士【学位授予年份】：2012【分类号】：S823
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400-819-9993牛主要组织相容性复合体的研究--《草食家畜》1987年02期
牛主要组织相容性复合体的研究
【摘要】：正主要组织相容性复合作(MHC)是脊椎动物中普遍存在的一个紧密连锁的基因复合体。主要组织相容性抗原是能引起强烈移植反应的一组抗原,编码该抗原的基因也是一组基因,遗传学上把这一连锁群称为主要组织相容性系统(MHS)。七十年代初不少研究者相继报道了特异性牛淋巴细胞抗原的存在,但直至1977年人们才找到牛淋巴细胞抗原(BOLA)是受遗传控制且具有多态性的证据。随后Amorena等(1978)发现BOLA是牛MHC的一部分。 Antczak(1982)认为MHC的研究仅
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400-819-9993四川西门塔尔牛主要组织相容性抗原(BOLA)的研究
西门塔尔牛与黑白花奶牛抗原(BCLA)的差异--《四川畜牧兽医》1988年01期
四川西门塔尔牛主要组织相容性抗原(BOLA)的研究
西门塔尔牛与黑白花奶牛抗原(BCLA)的差异
【摘要】：正 1979年Caldwell报道了牛的主要组织相容性抗原(BOLA)特异性在不同品种牛中的差异。我们利用自制BOLA分型血清分别对四川省61头西门塔尔牛和北京地区61头黑白花奶牛进行了抗原特异性的检测。经显著性检验,发现BOLA—w_2,w_4型在两个品种间差异极显著,其它各型差异不显著。组织相容性抗原系统是目前较为理想的遗传标记,因为它有
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400-819-9993PMCID: PMC3992089Recurrent pelvic organ prolapse (POP) following traditional vaginal hysterectomy with or without colporrhaphy in an Irish population,1 ,2 ,3 and
22Antrim Area Hospital 45 Bush Road Antrim Area Hospital Services Yard, BT41 2RL3NI Clinical Research Support Centre, Elliott Dines Building, Royal Hospitals, Grosvenor Road, Belfast, BT12 6BACorrespondence to Dr Costa ; Email:
Pelvic organ prolapse (POP) is a highly prevalent condition affecting about 50% of parous women, . There is a lifetime risk of 11.9% of undergoing an operation for its surgical correction, . Vaginal hysterectomy with or without colporrhaphy is the most common primary operation performed for POP, which is claimed to have a long-term recurrence rate of 29 - 30%-.The aetiology of POP is not well understood, but it is thought to be multifactorial. Weakening of the pelvic floor as a result of injury to levator ani muscles is widely accepted as an underlying factor. Vakili et al. reported that women with diminished levator ani contraction strength and a widened genital hiatus are more likely to develop recurrent POP following a primary procedure. Several other factors such as age, obesity, high parity and advanced stage of an initial prolapse have been reported to be associated with recurrent POP, , . It has also been suggested that the recurrence of POP may be due to persistent unrecognised support defects. Alternatively, new defects may occur in a different compartment predisposed to recurrence due to the redistribution of forces following a primary operation[, , ].Most importantly, only a proportion of POPs and recurrent POPs are symptomatic. Olsen et al. reported that only 10-20% of women seek medical treatment for their symptoms, although an estimated 50% of parous women lose pelvic floor support resulting in POP. Recent studies by Miedel et al. and Diez-Itza et al. demonstrated the same situation with recurrent POPs, with only one third or less of them being symptomatic. Hence, it is debateable whether clinicians should embark on aggressive primary procedures to prevent recurrent POPs, which may not be symptomatic.Almost all studies quoting the rate and nature of recurrence have been carried out on North American populations and so data may not be applicable to other populations with different characteristics and expectations. The primary objective of our study was to estimate the incidence of recurrent POPs following traditional vaginal hysterectomy with or without colporraphy as a primary procedure in an Irish population. Our secondary objective was to explore the nature of recurrent POP.This is a retrospective cohort study of 114 women who had surgery between January 1998 and December 2003 in a teaching hospital in Northern Ireland. The operations were performed by or under the direct supervision of two consultant gynaecologists. Through the hospital's surgical register, 189 consecutive patients who had vaginal hysterectomies with or without colporrhaphy were identified. Only 152 patients were eligible for the study, after patients who had concomitant or previous prolapse surgery were excluded. Nine patients had deceased, leaving a sample of 143 patients who had vaginal hysterectomy with or without colporrhaphy as a primary procedure.In the first phase of the study, in addition to the review of inpatient and outpatient notes, a short questionnaire, modified from ICIQ-VS, was used to identify patients who may not have presented to the hospital with symptomatic recurrences. The questionnaire focused on prolapse. Barber et al.11 reported that the following question is the single most sensitive one for screening POP without examination: ‘Do you usually have a bulge or something falling out that you can see or feel in your vaginal area?’. Questions number 5 and 6 in ICQI-VS are similar to this question and were included in our questionnaire. A total of 143 questionnaires were sent out with a request for consent to participate in the study. In the first instance 61 replied with consent and 53 replied with consent in the second round of questionnaires, resulting in a sample of 114 patients.Case notes of the 114 patients were analysed in detail to extract demographic data, severity of index of prolapse and details of the index operation, post-operative review appointments and any new presentations. Further details of patients who reported a recurrence of the symptoms of prolapse and had not presented to the hospital were obtained from general practitioners.The POP-Q technique was not well established during the index time period. Wide variation existed in the terms used to describe the index of prolapse in the hospital case notes. For this reason, the system developed by Olsen et al. was used to classify the degree of index of prolapse.In the second phase of the study, we invited 107 of the 114 patients to attend for a gynaecological assessment. Seven patients who had undergone a second procedure for recurrent POP during the follow up period were excluded. The review appointment was attended by 58 patients, including nine who claimed to be symptomatic for the recurrence of POP since the index operation. A single examiner performed a gynaecological examination including a POP-Q examination at maximal strain. POP-Q =/>2 at any compartment was considered to be a recurrence.All patients gave their informed consent for the information to be used in the study as well as for the gynecological examination.Data were analysed using IBM SPSS statistics version 19. Fisher's Exact Test was used to analyse categorical variables, while an independent T test was used to analyse continuous data.The study was categorized under service evaluation and deemed exempt from ethical approval.As shown in , the sample of 114 comprised predominantly Caucasian, parous and middle-aged women, representing the characteristics of the average Irish population.The majority of the women were healthy with no significant co-morbidities. In 12.28% of women the indication for index surgery was not prolapse symptoms (menorrhagia) althouogh the surgery was carried out through vaginal route indicating the presence of some degree of asymptomatic prolapse at the time of the surgery.Cohort characteristics at the time of index surgeryOut of the 114, 23.68% of women underwent vaginal hysterectomy alone, 28.95% had anterior colporrhaphy, 7.89% had posterior colporrhaphy, while 39.47% had both anterior and posterior colporrhaphy with vaginal hysterectomy, indicating that the majority of the index prolapse would have been at the apex and anterior compartmentThis is apparent from , which shows the severity of the index prolapse using the classification system developed by Olsen et al.. This shows that 58.76% of women had a grade 2 or higher prolapse at the apex, 57.01% of the women had a similar grade prolapse in the anterior compartment, while only 28.95% had a similar grade prolapse in the posterior compartment. Thus the majority of women in the sample had a vaginal hysterectomy alone or with anterior colporrhaphy to correct apical or anterior wall prolapse.Preoperative prolapse severity according to the site involvedOut of the 114 women, 18 were symptomatic of recurrent POP or had a repeat procedure for recurrent POP. This represents a subjective recurrence rate of 16% (95% CI 10%-24%) for the mean follow up period of 9.18 (1.85) years. Out of these 18 patients, seven patients had a repeat operation for prolapse. The reoperation rate was thus 6.14% for our sample. Four (3.5%) patients who were symptomatic were using ring pessaries, while seven (6.14%) patients decided against further treatment shows the nature of recurrences and the mean time interval between the index operation and subjective recurrence in 18 patients. Almost one third of recurrences were in a new site, while six out of 16 (37.5%) same site recurrences occurred in the apex and the anterior compartment. This demonstrates that apical recurrences were the earliest to be symptomatic (3.5yrs), followed by those in the anterior compartment (4.3yrs), and finally the posterior compartment (5.12yrs).Nature of recurrent POP (subjective) according to the site and time to appear compares some of the characteristics of patients with and without subjective recurrent POP.The recurrent group contained more post menopausal women (67% vs. 60%), more women who had an index operation for prolapse only (72% vs. 48%) and more women who had an index operation in all three compartments (50% vs. 38%). However, these differences were not statistically significant.Comparison of characteristic between subjective recurrence (n=18) and no subjective recurrence (n=96)In the second phase of the study, 58 patients including nine who were symptomatic of POP recurrence attended for a POP-Q assessment. All nine symptomatic patients and 10 asymptomatic patients were found to have POP-Q =/>2 in one or more compartments, resulting in an anatomical recurrence rate of 32.76% (95% CI 32.76%-22.08%) for this group of 58 patients. compares some characteristics of 19 patients with objective recurrent POP and of 39 patients with no objective recurrence. There was a statistically significant difference in the mean age and menopausal status at index operation, between the patients who had objective recurrence and the remaining patients who attended for POP-Q examination. No objective recurrences occurred in the patients who had vaginal hysterectomy for non-prolapse indications and only two patients who underwent vaginal hysterectomy alone had objective recurrences compared to 17 of those who had vaginal hysterectomy with colporrhaphy.Characteristics of patients with objective recurrence (n=19)compared with no objective recurrence (n=39)This study was undertaken to estimate the incidence and nature of recurrent POP following traditional vaginal hysterectomy with or without colporrhaphy as the primary procedure. The subjective recurrence rate was 16% for the mean follow up period of 9.18 years. In the group of 58 of the 114 patients who attended for POP-Q assessment the objective recurrence rate was 33%.In total, 14 women had a primary operation for non-prolapse indications such as menorrhagia, and none of them had subjective recurrences. These findings agree with those of Mant et al. who reported that the risk of recurrent POP following hysterectomy was 5.5 times higher in women whose initial hysterectomy was for prolapse symptoms than in those with other conditions. Blandon et al. reported that recurrent POPs were of a higher incidence among women who had combined procedures than those who had hysterectomy alone. This supports the concept that underlying connective tissue and neuromuscular defects at the time of the index operation may play a significant role in the recurrence of POP.Vaginal hysterectomy for non-prolapse indications may have been a contributory factor to the low subjective recurrence rate in our sample. When these 14 women were excluded from the analysis the subjective recurrence rate increased from 16% to18%. Similarly, amongst the 58 patients who attended for POP-Q assessments, six patients had the primary operation for similar indications and there were no objective recurrences. The objective recurrence rate increased from 33% to 36.54% when these six patients were excluded from the analysis.Approximately one third (36%) of subjective recurrences and 43.47% of objective (anatomical) recurrences occurred in a new compartment. These findings are similar to those reported by Price et al.[] who reported that 61.5% of repeat procedures for recurrent POP were in a different compartment. This supports the concept, previously described, of the redistribution of forces associated with the primary operation[, , ], which may predispose new compartments to prolapse. Thus recurrent POP may not be solely due to the failure of the primary operation.Inadequate suspension of the vaginal apex contributes to 33% of post hysterectomy vaginal eversion [16]; 24% of subjective recurrences were at the apex and they were the earliest to be symptomatic (3.5 years). None of the asymptomatic objective recurrences were at the apex. This suggests that apical recurrence has a major role to play in patient symptomatology and that the restoring of apical support intra-operatively is of importance[].Several previous studies have demonstrated an association between age, vaginal parity, body weight, hormone replacement therapy and severity of the index of prolapse with recurrent POP[, ]. In the present study a statistically significant difference existed in both the ages and the menopausal status of women who had experienced and had not experienced objective recurrences (). No significant difference was demonstrable between the parity or body weight of the two groups.In the second phase of this study results indicated that the incidence of subjective recurrence (16%) was half that of objective recurrence (32.76%). Symptoms of POP are not always related to the severity of the condition[] and, as demonstrated in this study, many patients are asymptomatic[]. The incidence of symptomatic prolapse has been reported to be as low as 7.4% when the anatomical recurrence rate was 31.3%[]. Miedel et al.[] confirmed this, reporting an anatomical recurrence rate of 41.1%, with less than one half of cases symptomatic.The incidence of reoperation for recurrent POP is associated with its symptomatic recurrence. However not all symptomatic patients choose a surgical remedy. The incidence of reoperation in our study (6.14%) is low compared to other reported rates (17%[] 10.8%[]) and this may be due to the majority of our patients with symptomatic recurrent POP (7/9; 77.78%) choosing not to have further surgery. This suggests that the symptoms may not affect the quality of life sufficiently to warrant surgery, although this hypothesis was not tested. It is tempting to presume that differences exist between the Irish and North American populations, although the results obtained from women operated on by two gynaecologists in a single hospital may not be representative of all Irish women. This hypothesis can only be confirmed with further studies including data from all major hospitals in the regionLimitations exist in this study. The severity of the index of prolapse may not be accurate as some of the terms used were difficult to categorise even with use of the technique developed by Olsen et al.[]. This may have resulted in an under or overestimation of the severity of the index of prolapse. Although it was possible to estimate the true subjective recurrence rate from questionnaires, information from general practitioners, and reviewing notes, all eligible patients did not attend for POP-Q assessments. Only 58 women were available for estimating the objective recurrence rate, albeit with an average of nine years between the index procedure and the review. The authors recognize that a modified ICIQ questionnaire was not ideal. It was felt that the inclusion of all questions, particularly those of a sexual nature, would reduce responses from this community, thus questions relating to prolapse symptoms only were included.The findings of this study indicate the importance of having a sound understanding of the expectations of an individual woman together with identifying factors putting her at risk of prolapse recurrence before performing an operation for POP. Women's expectations of pelvic floor surgery are personal and highly subjective[]. Achieving complete anatomical correction may not be necessary to meet patients' expectations. Elkardry et al.[] stated that it is essential to identify and negotiate surgical expectations during pre-operative counselling, particularly when surgery is being performed simply to improve the quality of life. Therefore, this study indicates that anatomical correction does not always prevent recurrent POP in a different compartment and may not even be necessary to meet a patient's expectations. We should concentrate more on measures to reduce symptomatic recurrence as well as achieving patient-selected goals rather than just achieving anatomical correction.The authors would like to thank Dr Robert McMillen for providing access to the operative notes of his patients and the clerical and nursing staff who assisted with the conduct of the study.The authors have no conflict of interest.1. Olsen AL, Smith VJ, Bergstrom JO, Colling JC, Clark AL. Epidemiology of surgically managed pelvic organ prolapse and urinary incontinence. Obstet Gynecol. 1997;89(4):501–6.
[]2. Salvatore S, Athancisiou S, Digesu GA, Soligo M, Sotiropoulou M, Serati M, et al.
Identification of risk factors for genital prolapse recurrence. Neurol Urodyn. 2009;28(4):301–4.
[]3. Denman MA, Gregory WT, Boyles SH, Smith V, Edwards SR, Clark AL. Reoperation 10 years after surgically managed pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2008;198(5):e1–e5. 555.
[]4. Fialkow MF, Newton KM, Weiss NS. Incidence of recurrent pelvic organ prolapse 10 years following primary surgical management: a retrospective cohort study. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(11):1483–7.
[]5. Vakili B, Zheng YT, Loesch H, Echols KT, Franco N, Chesson RR. Levator contraction strength and genital hiatus as risk factors for recurrent pelvic organ prolapse. Am J Obstet Gynecol. 2005;192(5):1592–98.
[]6. Whiteside JL, Weber AM, Meyn LA, Walters MD. Risk factors for prolapse recurrence after vaginal repair. Am J Obstet Gynecol. 2004;191(5):.
[]7. Clark AL, Gregory T, Smith VJ, Edwards R. Epidemiologic evaluation of reoperation for surgically treated pelvic organ prolapse and urinary incontinence. Am J Obstet Gynecol. 2003;189(5):1261–7.
[]8. Miedel A, Tegerstedt G, Mörlin B, Hammarström M. A 5-year prospective follow-up study of vaginal surgery for pelvic organ prolapse. Int Urogynecol J Pelvic Floor Dysfunct. 2008;19(12):.
[]9. Diez-Itza I, Aizpitarte I, Becerro A. Risk factors for the recurrence of pelvic organ prolapse after vaginal surgery: a review at 5 years after surgery. Int Urogynecol J Pelvic Floor Dysfunct. 2007;18(11):1317–24.
[]10. Price N, Jackson SR, Avery K, Brookes ST, Abrams P. Development and psychometric evaluation of the ICIQ Vaginal Symptoms Questionnaire: the ICIQ-VS. BJOG. 2006;113(6):700–12.
[]11. Barber MD, Neubauer NL. Klein-Olarte V. Can we screen for pelvic organ prolapse without a physical examination in epidemiologic studies? Am J Obstet Gynecol. 2006;195(4):942–8.
[]12. Mant J, Painter R, Vessey M. Epidemiology of genital prolapse: observations from the Oxford Family Planning Association Study. Br J Obstet Gynecol. 1997;104(5):579–85.
[]13. Blandon RE, Bharucha AE, Melton LJ, Schleck CD, Babalola EO, Zinsmeister AR, et al.
Incidence of pelvic floor repair after hysterectomy: A population-based cohort study. Am J Obstet Gynecol. 2007;197(6):e1–e7. 664. []
[]14. Rooney K, Kenton K, Mueller ER, FitzGerald MP, Brubaker L. Advanced anterior vaginal wall prolapse is highly correlated with apical prolapse. Am J Obstet Gynecol. 2006;195(6):1837–40.
[]15. Price N, Slack A, Jwarah E, Jackson S. The incidence of reoperation for surgically treated pelvic organ prolapse: an 11-year experience. Menopause Int. 2008;14(4):145–8.
[]16. Afifi R, Sayed A. Post hysterectomy vaginal vault prolapse. The Obstet Gynecol. 2005;7(2):89–97.17. Jeon MJ, Chung SM, Jung HJ, Kim SK, Bai SW. Risk factors for the recurrence of pelvic organ prolapse. Gynecol Obstet Invest. 2008;66(4):268–73.
[]18. Kapoor DS, Nemcova M, Pantazis K, Brockman P, Bombieri L, Freeman RM. Reoperation rate for traditional anterior vaginal wall repair: analysis of 207 cases with a median 4-year follow up. Int Urogynecol J. 2010;21(1):27–31.
[]19. Bump RC, Norton PA. Epidemiology and natural history of pelvic floor dysfunction. Obstet Gynecol Clin North Am. 1998;25(4):723–46.
[]20. Elkardry EA, Kenton KS, FitzGerald MP, Shott S, Brubaker L. Patientselected goals: a new perspective on surgical outcome. Am J Obstet Gynecol. 2003;189(6):1551–8.
[]Articles from The Ulster Medical Journal are provided here courtesy of Ulster Medical Society
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