Assessment of brain growth in early childhood using deformation-based morphometry.

We present methods for the quantitative analysis of brain growth based on the registration of longitudinal MR image data with the use of Jacobian determinant maps to characterise neuroanatomical changes. The individual anatomies, growth maps and tissue classes are also spatially normalised in an 'average space' and aggregated to provide atlases for the population at each timepoint. The average space representation is obtained using the average intersubject transformation within each timepoint. In an exemplar study, this approach is used to assess brain development in 25 infants between 1 and 2 years, and we show consistency in growth estimates between registration and segmentation approaches.

The study of temporal and spatial trends of water qulity of river Kshipra using water quality index.

Water quality index (WQI) plays an important role in interpreting the information on water quality trends of a water body. In the present study, an attempt has been made to study the spatial and temporal water quality trends of one of the pristine river Kshipra (Madhya Pradesh) using water quality index. The importance of existing sampling sites has also been discussed.

Seroprevalence of human T-lymphotropic virus type 1 in Papua New Guinea and Irian Jaya measured using different western blot criteria.

BACKGROUND: Endemic foci of HTLV-1 carriers have been found in the world, however, the origin of HTLV-1 in humans is still unclear. Since a distinct type of virus strain was isolated from the Solomon Islands, detailed surveys on HTLV-1 prevalence in New Guinea are important to shed light on its history of dissemination. OBJECTIVE: To clarify the seroprevalence of HTLV-1 in different regions of New Guinea Island. STUDY DESIGN: Sera from 1221 individuals (649 males, 454 females and 118 unknown) in New Guinea Island were studied for the presence of antibodies to HTLV-1 by a particle agglutination and the Western blot (WB) tests. Two different sets of criteria, proposed by WHO and Kiyokawa et al., were employed to interpret the WB test. Since the latter seemed to lack adequate specificity, the WHO criteria was used for the evaluation of the seroprevalence throughout the study. RESULTS: Seroprevalence of HTLV-1 differed by the WB criteria. By the more stringent criteria, HTLV-1 carriers were found in Madang, Chimbu and one hinterland province, Enga, in Papua New Guinea. An overall seroprevalence rate in different regions ranged from 0 to 14.6%. No seropositive individuals were found in Irian Jaya. CONCLUSIONS: To avoid overestimating the seropositivity rates, the WHO criteria would be more appropriate to employ for WB test by using the samples obtained from tropical and/or malaria endemic areas. This study is the first to show HTLV-1 infected individuals in the hinterland of New Guinea Island.

Occurrence of the erythrocyte band 3 (AE1) gene deletion in relation to malaria endemicity in Papua New Guinea.

South-east Asian ovalocytosis status was determined in 1629 individuals originating from 12 different geographical areas of Papua New Guinea, representing different ethnic groups and degrees of malaria endemicity. This was achieved by using polymerase chain reaction amplification to demonstrate a 27 base pair deletion in the erythrocyte band 3 (AE1) gene. By using this method, the prevalence of erythrocyte band 3 gene deletion was determined to range from zero in both the lowland inland area of Wosera, East Sepik Province and the highland region of Goroka, Eastern Highlands Province to 35% on the north coast of Madang Province. In general, the prevalence correlated well with altitude, being highest on the coast where malaria transmission is high, intermediate in the lowlands, and lowest in the non-malarious highlands. However, Wosera, a lowland area in the Sepik River Plains, which is hyperendemic for malaria, was an exception in that no ovalocytosis was detected. These results largely confirm the prevalence rates that have been reported in the past using microscopy. In keeping with the autosomal dominant mode of inheritance, the male:female ratio was 1.02 and no homozygote was detected, indicating that homozygosity for the ovalocytosis band 3 gene deletion is lethal.

Class I HLA antigens in two long-separated populations: Melanesians and South Amerinds.

Class I HLA antigens have been compared in 5,835 Melanesians of Papua New Guinea and 2,028 Amerindians of South America. The sample includes 50 PNGMel ethnolinguistic groups and 22 SAmInd groups. Both carry 15 serologically defined antigens and an undefined C allele. Except for A2 in Papua New Guinea and Cw1 in South America, these antigens are widely distributed in their respective populations. Nine (A2 and A24, B39, B60 and B62, and Cw1, Cw3, Cw4, and Cw7) are common to both. This commonality suggests that these two populations derive from an ancestral population with less polymorphism than modern East Asians. In both populations several theoretically possible haplotypes were absent, and other haplotypes were in positive disequilibrium in both. The parallels in disequilibria suggest that haplotypes are subject to selective forces acting on the level of allelic interaction. Based on three locus haplotype frequencies, the PNGMel groups form five clusters with internally typical linguistic and geographic characteristics and miscellaneous category, but SAmInd groups show no cluster.

Assessment of the humoral and cell-mediated immunity against the Plasmodium falciparum vaccine candidates circumsporozoite protein and SPf66 in adults living in highly endemic malarious areas of Papua New Guinea.

To assess natural immunity against the circumsporozoite (CS) protein and the synthetic vaccine SPf66, immunologic studies were carried out in a highly endemic malarious area of Papua New Guinea. Antibody prevalence, antibody titers, and T cell proliferation against both antigens were measured in 214 adults. Immunologic data were analyzed with respect to longitudinal malariologic and morbidity data. Evidence of genetic traits such as glucose-6-phosphate dehydrogenase deficiency and ovalocytosis was analyzed. Antibody prevalence was high, with 79% and 84% for CS protein and SPf66, respectively, while T cell proliferation was infrequent and low, with 14% and 12% responders, respectively. Anti-CS protein antibodies increased with age but showed no association to malaria indices or morbidity. No protective value was observed with T cell responses or with humoral response to SPf66. These results provide a first description of naturally developed immunity against SPf66 and suggest further studies in to fully understand the mechanism of immunity against this antigen.

The Malaria Vaccine Epidemiology and Evaluation Project of Papua New Guinea: rationale and baseline studies.

The range of possible malaria vaccines, against different species of Plasmodium and various stages in the life cycle of the parasite in both human host and mosquito vector, is reviewed. The importance, in a malaria-endemic area, of protection by a malaria vaccine against disease rather than infection is emphasized, and the ways by which disease prevention may be achieved are discussed. Mechanisms of production and presentation of vaccines are considered, including the importance of appropriate and more effective adjuvants. The variety of immune responses to malaria is set out and linked to both human and plasmodial genetic factors. Host genetics may also modify susceptibility to malaria through mechanisms which are not immunological. There is a need for entomological studies of the Anopheles vectors, especially but not only in preparation for transmission-blocking vaccines. This overall complexity justifies a multidimensional approach to epidemiology and field-site preparation. An iterative procedure is proposed for initial field evaluation, through adult male volunteers to community studies in immune adults and then to semi-immune school children, before evaluation in the principal target population of nonimmune young children. The outcome variables for epidemiological evaluation are specified. After this brief review of malaria vaccines, the baseline studies being undertaken by the Malaria Vaccine Epidemiology and Evaluation Project of the Papua New Guinea Institute of Medical Research in the Wosera area of East Sepik Province are discussed in some detail, and their rationale linked to the range and complexity of the malaria vaccines that have been reviewed. These studies are described under the headings of their principal components of epidemiology, parasitology, immunology, genetics and entomology.

Multiple glomangiomas of lower limb.

A young man with multiple painful nodules on the left lower limb is presented. Histology of one of the nodules proved the diagnosis of glomangioma.

Albumin--vitamin D-binding protein haplotypes in Asian-Pacific populations.

We have determined the various haplotypic combinations between alleles as well as restriction fragment length polymorphisms of two linked genetic markers, albumin and vitamin D-binding protein or group-specific component, in a number of Asian-Pacific populations. Using the partial maximum likelihood method, we constructed a phylogenetic network from the haplotype frequencies to assess relationships among the populations sampled. No systematic linkage disequilibrium was detected between most of the combinations, suggesting a lack of operation of any selection pressure at the two loci. The phylogenetic analysis confirmed the known interrelationships among various populations in the Asian-Pacific region. The Australian aborigines clustered closely with the non-Austronesian-speaking highlanders from Papua New Guinea, as expected. Similarly, the Austronesian-speaking Polynesians, Micronesians, and the Southeast Asians branched off together as a separate group. The position of the Austronesian-speaking Tolais from New Britain with respect to other populations from the Southwest Pacific was anomalous. The Tolais revealed a strong affinity with the Australian aborigines, which is inexplicable. The populations from China formed a tight cluster with other populations from the Asian-Pacific region. Genetic interrelationships of these populations with the white Australians were remote, which is in accordance with the known affinities of various human racial groups.

Radio-active iodine uptake in vitiligo.

Vitiligo and thyroid disease are commonly associated disorders. Twenty-two clinically euthyroid vitiligo patients were studied for functional assessment of thyroid by radioactive iodine uptake assay. Half of them showed abnormal uptake values at 24 hours. Of these patients, 90% had lower values indicating a tendency towards developing hypothyroid state. Subclinical thyroid dysfunction in vitiligo appears to be an adaptive change.

HLA heterozygosity and hyperreactive malarious splenomegaly in the Upper Watut Valley of Papua New Guinea.

Hyperreactive malarious splenomegaly (HMS) represents an abnormal immune response to recurrent malarial infection. In the Upper Watut Valley of Papua New Guinea, where over 80% of adult inhabitants are known to develop the disease, human leucocyte antigen (HLA) studies have demonstrated an association between the antigen DR2 and gross splenomegaly. To test the hypothesis that the magnitude of the individual immune response to malaria is also influenced by the number of different HLA antigens present, we have studied the correlation of the level of observed heterozygosity at HLA-A, -B, -C and -DR loci with the degree of splenomegaly in adult Watut subjects. Heterozygosity per se provides additional antigens for the formation of complexes between HLA and foreign antigenic epitopes, considered crucial to mounting an immune response. Multiply heterozygous individuals were found to exhibit more intense immune responses to recurrent malarial infections than did individuals with low multiple-locus heterozygosity. On the basis of the analysis presented here, we suggest that the degree of immune response to malaria is also influenced by the level of HLA heterozygosity, although the exact mechanisms remain unclear.

Keratoma hereditaria mutilans (Vohwinkel's disease) with congenital alopecia universalis (atrichia congenita).

A family is described in which a boy and two girls had features of keratoma hereditaria mutilans (Vohwinkel's disease) and congenital absence of hair. None of them had any hair at birth or developed any subsequently. They had congenital, nonscarring alopecia universalis. The skin over the palms and soles showed progressive thickening, which led to mutilating deformities of the hands and fingers. Histopathological examination of the scalp skin revealed no changes in the epidermis or dermis with normal sebaceous glands and identify hair structures; the skin on the palms showed a tremendously thickened horny layer. Both conditions remained unresponsive to various topical and systemic remedies used in the past. One of the girls had a meningocoele of the dorsolumbar region and died postoperatively. The simultaneous appearance of two rare hereditary diseases in siblings of one family is being reported for the first time.

Glucose-6-phosphate dehydrogenase deficiency and hereditary ovalocytosis in the Ok Tedi impact region of Papua New Guinea.

We report the distribution of two genetic traits, glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and hereditary ovalocytosis (HO) in a number of populations living in the Ok Tedi impact region of Papua New Guinea. Significant interpopulation heterogeneity in the distributions of G-6-PD deficiency and HO was observed. The highlands populations of the region did not show any G-6-PD deficiency, but in the highlands fringe and lowland populations the trait has achieved polymorphic frequencies. Hereditary ovalocytosis is significantly more common in the region and is present in all the populations studied, including those in the highland valleys. Distribution patterns of the two genetic markers correspond well with the pattern of malaria endemicity in the region, providing support for the hypothesis that relates the distribution of these polymorphisms to that of malaria.

Mycosis Fungoides with Unusual Features.

A case of mycosis fungoides had unusual features such as non- pruritic nodule-ulcerative lesions following a febrile, episode, appearance of many lesions in subsequent episodes in the margins of scars of previous lesions, along with a cyclic course. Higtopathology of the skin and lymph node showed a typical picture, of mycosis fungoides.

Metal Sensitivity in Children.

One hundred children were patch tested with 5% nickel sulphate, 0.5% potassium dichromate, 5% cobalt chloride and pure petrolatum. Seventeen children (11 having eczematous and 6 having non-eczematous dermatoses) showed positive patch test reactions to one or more metals, chromium (13%), nickel (8%) and cobalt (1%). The incidence of metal sensitivity was highger (32.5%) in the older children (8-14 years) as compared to the younger children 7 years of age (2.66%). The female children had a higher incidence of sensitivity as compared to the male children.

Tab Vaccine Causing Erythema Multiforme.

Five members of a family got TAB vaccination and one of them develoled erythema multiforme which progressed to Stevens Johnson syndrome. On recovery she was left with residual bilateral corneal opacities.