Ultrasonographic evaluation permits better assessment of the risk of scar complication intrapartum, and could allow for safer management of delivery.

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: Cancer testis antigens are a group of tumor antigens with gene expression restricted to male germ cells in the testis and in various cancerous tissues. Recently, we reported a novel testisspecific sperm-associated antigen 9 (SPAG9) gene, a new member of the c-Jun NH 2 -terminal kinase^interacting protein family, having functional role in sperm-egg fusion and mitogenactivated protein kinase signaling pathway. National Center for Biotechnology Information Blast searches revealed SPAG9 nucleotide sequence similarities with expressed sequence tags of various cancerous tissues. In an effort to examine the clinical utility of SPAG9, we investigated the SPAG9 mRNA and protein expression in epithelial ovarian cancer (EOC). Humoral immune response to SPAG9 was also evaluated in EOC patients. Experimental Design: We determined the expression profile of SPAG9 transcript by reverse transcription-PCR and RNA in situ hybridization and SPAG9 protein expression by immunohistochemistry in EOC specimens and human ovarian cancer cell lines. Using ELISA and Western blotting, we analyzed specific antibodies for SPAG9 in sera from patients with EOC. Results: SPAG9 mRNA and protein expression was detected in 90% of EOC tissues and in all three human ovarian cancer cell lines. Specific SPAG9 antibodies were detected in 67% of EOC patients and not in sera from healthy individuals. Conclusions: Our findings indicate that SPAG9 is highly expressed in EOC and immunogenic in patients. Humoral immune response against SPAG9 in early stages of EOC suggests its important role in early diagnostics.These results collectively suggest that SPAG9, a novel member of cancer testis antigen family, could be a potential target for the development of diagnostic and therapeutic methods in EOC.

Objective:To assess the birth prevalence and pattern of congenital heart disease (CHD) using echocardiography in babies born in a community hospital of North India.Methods:A cross-sectional observational study conducted over a period of 3 years. Newborns born over a specific 8-h period of the day were recruited in the study. They underwent routine clinical examination and pulse oximetry, followed by screening echocardiography for diagnosing a CHD.Results:A total of 20,307 newborns were screened, among which 874 had abnormal echocardiograms; 687 had insignificant CHDs, 164 had significant CHDs, and 24 had other abnormal cardiac findings. The birth prevalence of significant CHDs was 8.07 per 1000 live births; 131 newborns had an acyanotic CHD (79.9%) and 33 a cyanotic CHD (20.1%). Ventricular septal defect (VSD) was the most common acyanotic CHD, present in 116 newborns, giving a prevalence of 5.7/1000 live births. Among the cyanotic CHD, transposition of great arteries was most common (prevalence 0.34/1000 live births).Conclusion:The CHD birth prevalence in our study is similar to the reported worldwide birth prevalence. Acyanotic CHD (mostly VSD) is seen in about three-fourths of babies born with CHD. The more sinister cyanotic CHD is present in remaining 25%.

BACKGROUND: Cervical cancer is the second most common malignancy in women, with nearly half a million new cases diagnosed each year worldwide. The authors' recent studies have suggested an association

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...

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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