RESUMEN
The presence of p24 protein was studied in lymph nodes from human immunodeficiency virus (HIV)-positive patients affected by persistent generalized lymphadenopathy. Paraffin-embedded lymph node sections from 50 HIV-1 subtype E-infected lymph nodes from patients in Thailand and 25 HIV-1 presumably subtype B-infected lymph nodes from patients in the United States were immunostained with p24 HIV major core and capsid monoclonal antibodies using the streptavidin-biotin immunoperoxidase technique. Positivity for HIV p24 protein was detected in 20 of 22 HIV-1 subtype B infected nodes in which lymphoid follicles were present, with p24 staining demonstrating a reticular pattern within the germinal centers. Interestingly, no case from 50 clade E-infected lymph nodes containing lymphoid follicles had such a reticular pattern in the germinal centers. This difference could be explained by differential infection of subsets of dendritic cells by the two HIV-1 clades, or perhaps by different routes of initial HIV-1 transmission.
Asunto(s)
Células Dendríticas/virología , Seropositividad para VIH/patología , VIH-1/clasificación , Ganglios Linfáticos/virología , Biopsia , Estudios de Casos y Controles , Células Dendríticas Foliculares/virología , Femenino , Centro Germinal/patología , Centro Germinal/virología , Proteína p24 del Núcleo del VIH/análisis , Humanos , Ganglios Linfáticos/patología , Masculino , Estudios Retrospectivos , Tailandia , Estados UnidosRESUMEN
In Thailand, the predominant HIV subtype is E, rather than Subtype B as in North America and Europe, and the predominant mode of transmission is heterosexual contact. Subtype E has the ability to replicate in vitro in Langerhans cells. We hypothesized that this cell type might constitute a reservoir for the HIV virus in vaginal mucosa of asymptomatic carriers. To examine this hypothesis, we compared vaginal tissue histology in HIV-1-seropositive cases with seronegative cases and determined the immunophenotype of HIV-1-infected cells, their numbers, and their distribution in vaginal mucosa. Vaginal biopsies were performed at four different sites from six asymptomatic HIV-1 Subtype E-infected persons and from six seronegative cases at necropsy and examined histologically. Immunophenotyping was performed using immunoperoxidase for Gag p24 HIV, CD3, CD20, CD68, CD1a, S-100 and p55 antigens and by double labeling, combining immunoperoxidase with alkaline phosphatase using pairs of the above antigens. Twenty of twenty-four vaginal biopsies (83.3%) from HIV-seropositive cases showed definite inflammation compared to five of twenty-four vaginal necropsies (20.8%) from HIV-seronegative cases. One third of HIV-seropositive biopsies (8/24) demonstrated p24-positive cells in the epithelium, whereas three-fourths (18/24) of the biopsies revealed p24-positive cells in the lamina propria. All seropositive patients showed positive cells in at least one biopsy, but not all biopsies contained positive cells. Infected cells were more frequently observed at sites of greater inflammation. The dendritic cell count in HIV-seropositive vaginal epithelium was significantly higher than that observed in the seronegative cases (P =.004). The majority of p24-positive cells in the vaginal epithelium were Langerhans cells (CD1a+/S-100+), whereas in the lamina propria, about half of p24-positive cells were Langerhans-related dendritic cells (p55+ and S-100+) and half were T lymphocytes. In conclusion, the increased propensity for heterosexual transmission of Subtype E may be related to vaginal inflammation, leading to the accumulation of Langerhans cells and related dendritic cells which, once infected with HIV, can act as a reservoir for further virus transmission.
Asunto(s)
Síndrome de Inmunodeficiencia Adquirida/patología , Reservorios de Enfermedades , VIH-1/crecimiento & desarrollo , Células de Langerhans/patología , Vagina/patología , Síndrome de Inmunodeficiencia Adquirida/inmunología , Síndrome de Inmunodeficiencia Adquirida/transmisión , Síndrome de Inmunodeficiencia Adquirida/virología , Antígenos CD/análisis , Biomarcadores/análisis , Recuento de Células , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Proteína p24 del Núcleo del VIH/análisis , Seropositividad para VIH , VIH-1/clasificación , VIH-1/genética , VIH-1/aislamiento & purificación , Humanos , Técnicas para Inmunoenzimas , Inmunofenotipificación , Células de Langerhans/inmunología , Células de Langerhans/virología , Membrana Mucosa/inmunología , Membrana Mucosa/patología , Membrana Mucosa/virología , Tailandia , Vagina/inmunología , Vagina/virología , Vaginitis/inmunología , Vaginitis/patología , Vaginitis/virologíaRESUMEN
The DIS80 and VWA loci were studied in a Karen population from Northern Thailand by the polymerase chain reaction and polyacrylamide gel electrophoresis. Twelve DIS80 and six VWA alleles were found. No deviations from the Hardy-Weinberg and linkage equilibrium were observed. The power of exclusion (PE) from the analysis of the DIS80 and VWA locus is 0.67 and 0.45, respectively, the power of discrimination (PD) is 0.95 and 0.85, respectively, with a combined PD of 0.99 and PE of 0.82.
Asunto(s)
Etnicidad/genética , Genética de Población , Secuencias Repetidas en Tándem/genética , Alelos , ADN/análisis , Variación Genética , Humanos , Reacción en Cadena de la Polimerasa , Tailandia/etnologíaRESUMEN
To determine if the immunopathologic alterations of HIV-infected lymph nodes have any correlation with clinical stages in the northern Thai patients, we conducted a comparative analysis of immunopathologic features of lymph nodes between 25 HIV-infected patients from various clinical categories and 25 non-HIV individuals of reactive hyperplasia morphology of lymph node biopsies. The risk factors for HIV infection were all heterosexual. The majority of patients in clinical category A (PGL) showed a histopathologic pattern of explosive follicular hyperplasia, while category C (AIDS) patients demonstrated follicular involution and lymphocyte depletion on lymph node sections. Interestingly, weak reactivity for HIV p24 gag protein was detected within the germinal centers and scattering interfollicular lymphocytes in only 20% of the HIV-infected cases. Morphologically, the presence of MGCs was specific for HIV-infected lymph nodes. MGCs (hematoxylin & eosin stain) were found in 64% of the HIV-infected cases, which was significantly different from 4% found in control cases (p = 0.00002). By S-100 immunostaining, MGCs were demonstrated in all HIV-infected lymph node sections, while they were found in 32% of the control lymph nodes. Immunostaining with S-100 protein also revealed the appearance of syncytial ballooning and countable numbers of MGCs. High numbers of MGCs seemed to correlate with histologic and clinical changes. In conclusion, the HIV-infected patients had high numbers of MGCs or syncytia on lymph node sections in early stage and pre-AIDS conditions, which has never been reported before.
Asunto(s)
Infecciones por VIH/metabolismo , Ganglios Linfáticos/química , Adolescente , Adulto , Anciano , Antígenos CD/análisis , Antígenos CD20/análisis , Antígenos de Diferenciación Mielomonocítica/análisis , Complejo CD3/análisis , Antígenos CD4/análisis , Antígenos CD8/análisis , Femenino , Células Gigantes/química , Células Gigantes/virología , Infecciones por VIH/patología , Humanos , Inmunohistoquímica , Antígenos Comunes de Leucocito/análisis , Ganglios Linfáticos/patología , Ganglios Linfáticos/virología , Masculino , Persona de Mediana Edad , Proteínas S100/análisis , TailandiaRESUMEN
The STR locus HUMTH01 was studied in 110 unrelated Thais from the area of Chiang Mai in North Thailand. By using PCR and vertical PAGE, six alleles were identified and the frequencies ranged from 0.005 to 0.400. The allele frequency distribution in this population showed significant differences from a Japanese population and other ethnic populations but was similar to Asians in the USA and Australia. The genotype distribution meets Hardy-Weinberg expectations. The average power of exclusion (in no-parent and one-parent cases) and the discriminating power (DP) were calculated to be 0.3020, 0.4761 and 0.8722 respectively.
Asunto(s)
Frecuencia de los Genes , Polimorfismo Genético , Tirosina 3-Monooxigenasa/genética , Humanos , Reacción en Cadena de la Polimerasa , Secuencias Repetitivas de Ácidos Nucleicos , TailandiaRESUMEN
A population study on the D1S80 locus in 100 northern Thais was performed using polymerase chain reaction (PCR) and high resolution polyacrylamide gel electrophoresis. Sixteen alleles and 39 genotypes were observed with a heterozygosity of 82%. In contrast to other studies, the allele with 31 repeat units was found to be the most common, followed by alleles 24 and 18. Alleles with more than 41 repeat units were also observed in this study. When applying statistical tests for Hardy-Weinberg equilibrium, no significant deviations were found in this Thai population. The average power of exclusion (in no-parent and one-parent cases) and the discriminating power (DP) was calculated to be 0.52, 0.69 and 0.94, respectively.
Asunto(s)
ADN/genética , Frecuencia de los Genes/genética , Repeticiones de Minisatélite/genética , Polimorfismo de Longitud del Fragmento de Restricción , Secuencia de Bases , Análisis Discriminante , Electroforesis en Gel de Poliacrilamida , Tamización de Portadores Genéticos , Genotipo , Humanos , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa , Reproducibilidad de los Resultados , TailandiaRESUMEN
Exit gunshot wounds of the skull generally have external beveling while entrance wounds show internal beveling. With rare exceptions, entrance gunshot wounds show external beveling, usually of two types: the asymmetric 'keyhole' type and the symmetric 'non-keyhole' type. In exit gunshot wounds of the skull, only the keyhole type has been reported. This report shows that symmetric internal beveling from an exit gunshot wound to the skull may confuse medical personnel.
Asunto(s)
Cráneo/patología , Heridas por Arma de Fuego/patología , Humanos , Masculino , Persona de Mediana Edad , Radiografía , Cráneo/diagnóstico por imagen , Cráneo/lesiones , Suicidio , Heridas por Arma de Fuego/diagnóstico por imagenRESUMEN
We report a case of a 28-year-old male who died suddenly on the way from his house to the hospital. He was said to have a gurgling sound in this throat followed by a seizure while sleeping at night. His wife tried to wake him up but he never returned to consciousness. She brought him to the hospital where a doctor in the emergency room pronounced him dead upon arrival. The autopsy revealed various types of mucocutaneous lesions, involving conjunctiva, lips, face, trunk and extremities, compatible with Stevens-Johnson syndrome. The eruptions covered only 1-2% of the total body surface area. The internal examination disclosed severe glossitis, epiglottitis and inflammation of the upper respiratory tract with prominent laryngeal edema. The microscopic sections of some skin lesions confirmed the previous diagnosis, and the cause of sudden death was believed to be acute upper airway obstruction which complicated the disease. This is probably the first report of Stevens-Johnson Syndrome resulting in death prior to disease recognition by medical personnel.
Asunto(s)
Muerte Súbita/etiología , Síndrome de Stevens-Johnson/patología , Adulto , Obstrucción de las Vías Aéreas/patología , Humanos , MasculinoRESUMEN
Focal and confluent areas of periventricular hyperintensity have been reported on magnetic resonance (MR) images in 30% of patients over 60 years of age. In order to better understand the pathologic basis of these lesions, the authors studied 14 formalin-fixed brains with MR imaging. Multiple focal areas of hyperintensity were identified in the periventricular white matter in three of the 14 brains studied (21%). Subsequent gross and microscopic pathologic examination of both hyperintense and normal-intensity areas was performed on 87 tissue sections. The larger lesions were characterized centrally by necrosis, axonal loss, and demyelination and therefore represent true infarcts. Reactive astrocytes oriented along the degenerated axons were identified at distances of up to several centimeters from the central infarct. This is called isomorphic gliosis and is associated with increased intensity on T2-weighted images that increases the apparent size of the central lesion.
Asunto(s)
Infarto Cerebral/patología , Imagen por Resonancia Magnética , Anciano , Encéfalo/patología , Humanos , MasculinoRESUMEN
Zinc is present in high concentration in semen, but in low concentration in vaginal fluid. We evaluated vaginal zinc levels as a marker for intercourse by measuring precoital (greater than 11 h after intercourse) or postcoital (less than 5 h after intercourse) zinc and acid phosphatase levels in 26 specimens of vaginal fluid from 18 women. The approximate 95% reference range for zinc in precoital vaginal fluid was 1.2 to 15 micrograms/mL (mean 4.5), and in postcoital vaginal fluid 4.0 to 135 micrograms/mL (mean 24). There is an overlap between the precoital and postcoital reference ranges. Provided that the vaginal fluid zinc level is less than approximately 4.0 micrograms/mL or greater than approximately 15 micrograms/mL, vaginal fluid zinc concentration may be useful as an indicator of intercourse.