351 research outputs found

    Leishmania isoenzyme polymorphisms in Ecuador: Relationships with geographic distribution and clinical presentation

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    Background: Determinants of the clinical presentation of the leishmaniases are poorly understood but Leishmania species and strain differences are important. To examine the relationship between clinical presentation, species and isoenzyme polymorphisms, 56 Leishmania isolates from distinct presentations of American tegumentary leishmaniasis (ATL) from Ecuador were analyzed. Methods: Isolates were characterized by multilocus enzyme electrophoresis for polymorphisms of 11 isoenzymes. Patients were infected in four different ecologic regions: highland and lowland jungle of the Pacific coast, Amazonian lowlands and Andean highlands. Results: Six Leishmania species constituting 21 zymodemes were identified: L. (Viannia) panamensis (21 isolates, 7 zymodemes), L. (V.) guyanensis (7 isolates, 4 zymodemes), L. (V.) braziliensis (5 isolates, 3 zymodemes), L. (Leishmania) mexicana (11 isolates, 4 zymodemes), L. (L.) amazonensis (10 isolates, 2 zymodemes) and L. (L.) major (2 isolates, 1 zymodeme). L. panamensis was the species most frequently identified in the Pacific region and was associated with several clinical variants of cutaneous disease (CL); eight cases of leishmaniasis recidiva cutis (LRC) found in the Pacific highlands were associated with 3 zymodemes of this species. Mucocutaneous leishmaniasis found only in the Amazonian focus was associated with 3 zymodemes of L. braziliensis. The papular variant of CL, Uta, found in the Andean highlands was related predominantly with a single zymodeme of L. mexicana. Conclusion: Our data show a high degree of phenotypic variation within species, and some evidence for associations between specific variants of ATL (i.e. Uta and LRC) and specific Leishmania zymodemes. This study further defines the geographic distribution of Leishmania species and clinical variants of ATL in Ecuador

    Extended Hemi-Hepatectomy with Portal Vein Reconstruction in a Patient with Situs Ambiguous

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    We report a case of far-advanced hepatocellular carcinoma (HCC) with situs ambiguous, complex visceral and vascular anomalies, who was successfully managed by extended hemi-hepatectomy. A 67-year-old man was referred to our hospital with a large liver mass. Abdominal ultrasonography, computed tomography and angiography revealed HCC with a diameter of 10 cm, with tumor thrombus in the main and first branch of the portal vein. Multiple complex anomalies in the abdomen were determined preoperatively. He had right-sided spleens-stomach-duodenum, liver at midline, inferior vena cava interruption with azygous continuation, and hepatic arterial anomaly. Extended left lobectomy of the liver with reconstruction of the portal vein was performed. Postoperatively, the patient recovered without major complications, and he was discharged on postoperative day 21. We report the first successful extended hepatectomy with portal vein reconstruction for HCC in a patient with rare situs anomalies

    New susceptibility and resistance HLA-DP alleles to HBV-related diseases identified by a trans-ethnic association study in Asia

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    Previous studies have revealed the association between SNPs located on human leukocyte antigen (HLA) class II genes, including HLA-DP and HLA-DQ, and chronic hepatitis B virus (HBV) infection, mainly in Asian populations. HLA-DP alleles or haplotypes associated with chronic HBV infection or disease progression have not been fully identified in Asian populations. We performed trans-ethnic association analyses of HLA-DPA1, HLA-DPB1 alleles and haplotypes with hepatitis B virus infection and disease progression among Asian populations comprising Japanese, Korean, Hong Kong, and Thai subjects. To assess the association between HLA-DP and chronic HBV infection and disease progression, we conducted high-resolution (4-digit) HLA-DPA1 and HLA-DPB1 genotyping in a total of 3,167 samples, including HBV patients, HBV-resolved individuals and healthy controls. Trans-ethnic association analyses among Asian populations identified a new risk allele HLA-DPB1*09 ratio 01 (P = 1.36 x 10(-6); OR= 1.97; 95% CI, 1.50-2.59) and a new protective allele DPB1*02 ratio 01 (P = 5.22 x 10(-6); OR = 0.68; 95% CI, 0.58-0.81) to chronic HBV infection, in addition to the previously reported alleles. Moreover, DPB1*02 ratio 01 was also associated with a decreased risk of disease progression in chronic HBV patients among Asian populations (P = 1.55 x 10(-7); OR = 0.50; 95% CI, 0.39-0.65). Trans-ethnic association analyses identified Asian-specific associations of HLA-DP alleles and haplotypes with HBV infection or disease progression. The present findings will serve as a base for future functional studies of HLA-DP molecules in order to understand the pathogenesis of HBV infection and the development of hepatocellular carcinoma.published_or_final_versio

    Lower plate structure and upper plate deformational segmentation at the Sunda-Banda arc transition, Indonesia

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    The Sunda‐Banda arc transition at the eastern termination of the Sunda margin (Indonesia) represents a unique natural laboratory to study the effects of lower plate variability on upper plate deformational segmentation. Neighboring margin segments display a high degree of structural diversity of the incoming plate (transition from an oceanic to a continental lower plate, presence/absence of an oceanic plateau, variability of subducting seafloor morphology) as well as a wide range of corresponding fore‐arc structures, including a large sedimentary basin and an accretionary prism/outer arc high of variable size and shape. Here, we present results of a combined analysis of seismic wide‐angle refraction, multichannel streamer and gravity data recorded in two trench normal corridors located offshore the islands of Lombok (116°E) and Sumba (119°E). On the incoming plate, the results reveal a 8.6–9.0 km thick oceanic crust, which is progressively faulted and altered when approaching the trench, where upper mantle velocities are reduced to ∼7.5 km/s. The outer arc high, located between the trench and the fore‐arc basin, is characterized by sedimentary‐type velocities (Vp < 5.5 km/s) down to the top of the subducting slab (∼13 km depth). The oceanic slab can be traced over 70–100 km distance beneath the fore arc. A shallow serpentinized mantle wedge at ∼16 km depth offshore Lombok is absent offshore Sumba, where our models reveal the transition to the collisional regime farther to the east and to the Sumba block in the north. Our results allow a detailed view into the complex structure of both the deeper and shallower portions of the eastern Sunda margin

    Seismic reflection images of a near-axis melt sill within the lower crust at the Juan de Fuca ridge

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    Author Posting. © The Author(s), 2009. This is the author's version of the work. It is posted here by permission of Nature Publishing Group for personal use, not for redistribution. The definitive version was published in Nature 460 (2009): 89-93, doi:10.1038/nature08095.The oceanic crust extends over two thirds of the Earth’s solid surface and is generated along mid-ocean ridges from melts derived from the upwelling mantle. The upper and mid crust are constructed by dyking and seafloor eruptions originating from magma accumulated in mid-crustal lenses at the spreading axis, but the style of accretion of the lower oceanic crust is actively debated. Models based on geological and petrological data from ophiolites propose that the lower oceanic crust is accreted from melt sills intruded at multiple levels between the Moho transition zone (MTZ) and the mid-crustal lens, consistent with geophysical studies that suggest the presence of melt within the lower crust. However, seismic images of molten sills within the lower crust have been elusive. To date only seismic reflections from mid-crustal melt lenses and sills within the MTZ have been described, suggesting that melt is efficiently transported through the lower crust. Here we report deep crustal seismic reflections off the southern Juan de Fuca Ridge that we interpret as originating from a molten sill presently accreting the lower oceanic crust. The sill sits 5-6 km beneath the seafloor and 850-900 m above the MTZ, and it is located 1.4-3.2 km off thespreading axis. Our results provide evidence for the existence of low permeability barriers to melt migration within the lower section of modern oceanic crust forming at intermediate-to-fast spreading rates, as inferred from ophiolite studies.This research was supported by grants form the US NSF
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