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Sample records for receiving tacrolimus fk

  1. Synergistic Antitumor Effect of Doxorubicin and Tacrolimus (FK506 on Hepatocellular Carcinoma Cell Lines

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    Francesca Capone

    2014-01-01

    Full Text Available Hepatocellular carcinoma is the fifth most common cancer worldwide and shows a complex clinical course, poor response to pharmacological treatment, and a severe prognosis. Thus, the aim of this study was to investigate whether tacrolimus (FK506 has synergistic antitumor effects with doxorubicin on two human hepatocellular carcinoma cell lines, Huh7 and HepG2. Cell viability was analyzed by Sulforhodamine B assay and synergic effect was evaluated by the software CalcuSyn. Cell apoptosis was evaluated using Annexin V and Dead Cell assay. Apoptosis-related protein PARP-1 cleaved and autophagy-related protein expressions (Beclin-1 and LC3B were measured by western blotting analysis. Cytokines concentration in cellular supernatants after treatments was studied by Bio-Plex assay. Interestingly the formulation with doxorubicin and tacrolimus induced higher cytotoxicity level on tumor cells than single treatment. Moreover, our results showed that the mechanisms involved were (i a strong cell apoptosis induction, (ii contemporaneous decrease of autophagy activation, understood as prosurvival process, and (iii downregulation of proinflammatory cytokines. In conclusion, future studies could relate to the doxorubicin/tacrolimus combination effects in mice models bearing HCC in order to see if this formulation could be useful in HCC treatment.

  2. Central pontine myelinolysis (CPM) associated with tacrolimus (FK506) after liver transplantation.

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    Fukazawa, Kyota; Nishida, Seigo; Aguina, Luz; Pretto, Ernesto

    2011-01-01

    Central pontine myelinolysis (CPM) is the most detrimental neurologic complication after liver transplantation. The incidence of CPM after liver transplantation ascends to 17%. Although the precise etiology and pathogenesis of CPM is largely unknown, a growing literature implicates a possible role of immunosuppressive agents, such as Cyclosporine (incidence 30%) on its development. Other immunosuppressive agents also can cause CPM but the frequency of these cases is less compared to Cyclosporine. There is only one case report for Tacrolimus (FK506)-associated speech disorder, which might be an atypical presentation of CPM, and no case reports for Rapamycin. We present a case of Tacrolimus induced CPM. A 62-year-old woman who underwent liver transplantation developed clinical symptoms with radiologic evidence consistent with CPM 7 days after liver transplant. Since the electrolytes in this patient remained normal from her admission, the hypothesis of inmunossupressor neurotoxicity was established and the therapy was switched, resulting in an evident clinical and radiological improvement of her condition in the following days. Five months later, the patient's only neurological deficit was slight dysarthria and a follow-up MRI showed no abnormalities. This case provides evidence of Tacrolimus-associated CPM after transplantation, which presented with a classic "lock-in syndrome" with radiographic confirmation.

  3. MRI in seven cases of tacrolimus (FK-506) encephalopathy: utility of FLAIR and diffusion-weighted imaging

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    Furukawa, M. [Dept. of Radiology, Yamaguchi University School of Medicine, Ube (Japan); Dept. of Radiology, Hokkaido University School of Medicine, Sapporo (Japan); Terae, S.; Chu, B.C.; Kaneko, K.; Kamada, H.; Miyasaka, K. [Dept. of Radiology, Hokkaido University School of Medicine, Sapporo (Japan)

    2001-08-01

    We assessed the utility of fluid-attenuated inversion-recovery (FLAIR) and diffusion-weighted (DWI) images in investigation of tacrolimus (FK-506) encephalopathy, and to see whether we could predict its cause from clinical and imaging data. In seven patients with presumed FK-506 toxicity the areas involved on MRI were similar to those in cyclosporin A (CsA) toxicity. The abnormal signal was most evident on FLAIR in all cases. In three of four patients who underwent DWI, no diffusion abnormalities were detected; in the remaining patient, increased diffusion was seen in the deep white matter bilaterally on the apparent diffusion coefficient map, consistent with the findings on T2-weighted spin-echo and FLAIR images. Five of the six patients for whom we had clinical data showed sudden changes in electrolyte or fluid equilibrium due to diarrhoea, a polyuria or oliguria one day before or on the day of onset of the central nervous system disturbances. We speculate that FK-506 encephalopathy is triggered by the disturbance of the electrolyte and/or fluid equilibrium, given a certain serum level of FK-506. (orig.)

  4. MRI in seven cases of tacrolimus (FK-506) encephalopathy: utility of FLAIR and diffusion-weighted imaging

    International Nuclear Information System (INIS)

    Furukawa, M.; Terae, S.; Chu, B.C.; Kaneko, K.; Kamada, H.; Miyasaka, K.

    2001-01-01

    We assessed the utility of fluid-attenuated inversion-recovery (FLAIR) and diffusion-weighted (DWI) images in investigation of tacrolimus (FK-506) encephalopathy, and to see whether we could predict its cause from clinical and imaging data. In seven patients with presumed FK-506 toxicity the areas involved on MRI were similar to those in cyclosporin A (CsA) toxicity. The abnormal signal was most evident on FLAIR in all cases. In three of four patients who underwent DWI, no diffusion abnormalities were detected; in the remaining patient, increased diffusion was seen in the deep white matter bilaterally on the apparent diffusion coefficient map, consistent with the findings on T2-weighted spin-echo and FLAIR images. Five of the six patients for whom we had clinical data showed sudden changes in electrolyte or fluid equilibrium due to diarrhoea, a polyuria or oliguria one day before or on the day of onset of the central nervous system disturbances. We speculate that FK-506 encephalopathy is triggered by the disturbance of the electrolyte and/or fluid equilibrium, given a certain serum level of FK-506. (orig.)

  5. Tacrolimus (FK506 suppresses TREM-1 expression at an early but not at a late stage in a murine model of fungal keratitis.

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    Weilan Huang

    Full Text Available To investigate the efficacy and mechanism of tacrolimus(FK506, which is a novel macrolide immunosuppressant, in inhibiting triggering receptor expressed on myeloid cells-1 (TREM-1 expression in a murine keratitis model induced by Aspergillus fumigatus.TREM-1 was detected in 11 fungus-infected human corneas by quantitative real-time PCR (qRT-PCR. RAW264.7 macrophages were divided into four groups, which received treatment with zymosan (100 µg/ml, zymosan (100 µg/ml + mTREM-1/Fc protein (1 µg/ml, or zymosan (100 µg/ml + FK506 (20 µM or negative-control treatment. After this treatment, the expression of TREM-1, interleukin-1β (IL-1β and tumor necrosis factor α (TNFα was assayed using qRT-PCR and ELISA. The mouse model of fungal keratitis was created by intrastromal injection with Aspergillus fumigatus, and the mice were divided into 2 groups: group A received vehicle eye drops 4 times each day, and group B received 4 doses of FK506 eye drops each day. Corneal damage was evaluated by clinical scoring and histologic examination,and myeloperoxidase (MPO protein levels were also detected by ELISA. The expression of TREM-1, IL-1β and TNFα was then determined at different time points using qRT-PCR and ELISA.TREM-1 expression dramatically increased in the human corneas with fungal keratitis. In contrast, FK506 reduced the expression of TREM-1, IL-1β and TNFα in RAW264.7 macrophages stimulated with zymosan. In the mouse model, at day 1 post-infection, the corneal score of the FK506-treated group was lower than that of the control, and polymorphonuclear neutrophil (PMN infiltration was diminished. TREM-1, IL-1β and TNFα expression was significantly reduced at the same time point. However, the statistically significant differences in cytokine expression, clinical scores and infiltration disappeared at 5 days post-infection.FK506 may inhibit the inflammation induced by fungi and alleviate the severity of corneal damage at an early stage of

  6. The Treatment of Tacrolimus (FK506 for Psoriasis: One Case Report and Literature Analysis

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    Cao Wei-gang

    2013-12-01

    Full Text Available Psoriasis is a chronic recurrent inflammatory dermatosis, which is characterized by epidermal proliferation and erythema scales. Its etiology and pathogenesis are still unknown and treatment is difficult. The concentration of tacrolimus for the treatment of psoriasis has not been reported at home and abroad. In this report, we detected the tacrolimus plasma concentration and hope to provide a certain reference value for the clinical treatment of psoriasis.

  7. Pharmacological evaluation of tacrolimus (FK-506 on ischemia reperfusion induced vasculatic neuropathic pain in rats

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    Sood Shailja

    2010-06-01

    Full Text Available Abstract Background Ischemia reperfusion (I/R is common in various pathological conditions like diabetic complication, rheumatic arthritis, necrotizing vascular occlusive disease and trauma. Methods We have evaluated the effect of tacrolimus (1, 2 and 3 mg/kg, p.o. for 10 consecutive days on femoral arterial ischemic reperfusion (I/R induced neuropathic pain in rats. Behavioral parameters (i.e. hot plate, radiant heat, acetone drop, tail heat hyperalgesia, tail flick and tail cold allodynia tests were assessed at different time intervals (i.e. 0, 1, 4, 7, 10, 13 and 16th day and biochemical analysis in serum and tissue samples were also performed along with histopathological studies. Results Behavioral pain assessment revealed increase in the paw and tail withdrawal threshold in tacrolimus treated groups against hyperalgesic and allodynic stimuli as compared to the sham control group. We observed a decrease in the serum nitrate and thiobarbituric acid reactive substance (TBARS levels along with reduction in tissue myeloperoxidase (MPO and total calcium levels, whereas, rise in tissue reduced glutathione levels in tacrolimus treated groups. However, significant results were obtained in medium and high dose treated group as compared to sham control group. Histopathological study had revealed the increase in the neuronal edema and axonal degeneration in the I/R group whereas, tacrolimus ameliorate these effects. Conclusion Our results indicate the anti-oxidative, anti-inflammatory and calcium modulatory actions of tacrolimus. Therefore, it can be used as a therapeutic agent for the treatment of vascular inflammatory related neuropathic pain.

  8. Tacrolimus

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    ... unusual bleeding or bruising seizures coma (loss of consciousness for a period of time) Tacrolimus may cause ... for more information if you do not have access to a take-back program.It is important ...

  9. Primary tacrolimus (FK506) therapy and the long-term risk of post-transplant lymphoproliferative disease in pediatric liver transplant recipients.

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    Cacciarelli, T V; Reyes, J; Jaffe, R; Mazariegos, G V; Jain, A; Fung, J J; Green, M

    2001-10-01

    While the overall incidence of post-transplant lymphoproliferative disease (PTLD) in pediatric liver transplant recipients has been reported to be 4-11%, the long-term risk of PTLD associated with primary tacrolimus therapy is unknown. Therefore, in order to determine the incidence and long-term risk of PTLD, the present study examined 131 pediatric recipients who underwent liver transplantation (LTx) between October 1989 and December 1991 and received primary tacrolimus therapy. This cohort of children was evaluated over an extended time-period (until December 31 1996) with a mean follow-up of 6.3 yr. Actuarial Kaplan-Meier analysis was utilized to determine the risk of PTLD over time. The overall incidence of PTLD was 13% (17/131) with an average age of 4.3 +/- 0.75 yr at diagnosis. Pretransplant Epstein-Barr virus (EBV) serologies were negative in 82%, positive in 12%, and not available in 6% of the patients. The median time to diagnosis of PTLD post-Tx was 11.9 months (mean 16.4 +/- 3.9, range 1.7-63.0 months). Mean tacrolimus dose and plasma trough level (as evaluated by enzyme-linked immunosorbent assay [ELISA]) at the time of diagnosis was 0.32 +/- 0.06 mg/kg/day and 1.3 +/- 0.3 ng/mL, respectively. The cumulative long-term risk of PTLD was found to increase over time: 3% at 6 months, 8% at 1 yr, 12% at 2 yr, 14% at 3 yr, and 15% at 4 and 5 yr. Mortality from PTLD was 12% (two of 17 patients). Primary tacrolimus use in pediatric LTx has a long-term risk of PTLD approaching 15%, with the majority of episodes (78%) occurring in the first 2 yr, suggesting that intense EBV surveillance should occur early post-transplantation.

  10. A short-term trial of tacrolimus ointment for atopic dermatitis. European Tacrolimus Multicenter Atopic Dermatitis Study Group

    NARCIS (Netherlands)

    Ruzicka, T.; Bieber, T.; Schöpf, E.; Rubins, A.; Dobozy, A.; Bos, J. D.; Jablonska, S.; Ahmed, I.; Thestrup-Pedersen, K.; Daniel, F.; Finzi, A.; Reitamo, S.

    1997-01-01

    Tacrolimus (FK 506) is an effective immunosuppressant drug for the prevention of rejection after organ transplantation, and preliminary studies suggest that topical application of tacrolimus is effective in the treatment of atopic dermatitis. We conducted a randomized, doubleblind, multicenter study

  11. Evaluation of Flexible Tacrolimus Drug Concentration Monitoring Approach in Patients Receiving Extended-Release Once-Daily Tacrolimus Tablets.

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    Philosophe, Benjamin; Leca, Nicolae; West-Thielke, Patricia M; Horwedel, Timothy; Culkin-Gemmell, Christine; Kistler, Kristin; Stevens, Daniel R

    2018-02-20

    The majority of United States kidney transplant patients are treated with tacrolimus, a drug effective in preventing graft rejection, but with a narrow therapeutic range, necessitating close monitoring to avoid increased risks of transplant rejection or toxicity if the tacrolimus concentration is too low or too high, respectively. The trough drug concentration tests are time sensitive; patients treated on a twice-daily basis have blood draws exactly 12 hours after their previous dose. The schedule's rigidity causes problems for both patients and health care providers. Novel once-daily tacrolimus formulations such as LCPT (an extended-release tablet by Veloxis Pharmaceuticals, Inc., Cary, North Carolina) have allowed for blood draws on a once-daily basis; however, even that schedule can be restrictive. Results from tests taken either before or after that 24-hour target time may be discarded, or worse, may lead to inappropriate dose changes. Data from ASTCOFF, a phase 3B pharmacokinetic clinical trial (NCT02339246), demonstrated that the unique pharmacokinetic curve of LCPT may allow for a therapeutic monitoring window that extends for 3 hours before or after the 24-hour monitoring target. Furthermore, important tools to help clinicians interpret these levels, such as formulas to estimate the 24-hour trough level if an alternative monitoring time is used, were constructed from these data. These study results give treating clinicians access to data that allow them to safely use and monitor LCPT in their patients and expand the body of evidence surrounding differentiation and practical application of the novel LCPT tacrolimus formulation. © 2018, The Authors. The Journal of Clinical Pharmacology published by Wiley Periodicals, Inc. on behalf of American College of Clinical Pharmacology.

  12. Sirolimus for rescue and primary immunosuppression in transplanted children receiving tacrolimus.

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    Sindhi, R; Webber, S; Venkataramanan, R; McGhee, W; Phillips, S; Smith, A; Baird, C; Iurlano, K; Mazariegos, G; Cooperstone, B; Holt, D W; Zeevi, A; Fung, J J; Reyes, J

    2001-09-15

    The role of sirolimus (SRL) as a rescue agent (n=42) and as a component of primary immunosuppression (n=8) was evaluated in a mixed population of 50 transplanted children receiving tacrolimus (liver: 26, heart: 5, intestinal: 5, liver-intestine: 9, lung: 1, bone marrow: 1, liver-kidney: 1, multivisceral: 1). Rescue indications for tacrolimus (TAC) failure were recurrent acute rejection and acute rejection complicating withdrawal of immunosuppression in posttransplant lymphoproliferative disorder (PTLD). Rescue indications for TAC toxicity were nephrotoxicity, pancreatitis, seizures, hypertrophic cardiomyopathy, and graft-versus-host disease. Mean age at rescue was 11.5 years and mean follow-up was 204 (range 18-800) days. As primary immunosuppression, SRL+TAC prevented early acute rejection in 7/8 children. The indication for rescue resolved in 33/42 children. In children with TAC toxicity, this was associated with decrease in TAC doses by 50%, significant improvements in renal function, and continuing decline in Epstein-Barr virus (EBV) viral load in PTLD patients. Serious adverse events led to discontinuation of SRL in 9/42 rescue patients, 3 of them also experienced acute rejection. Three additional children also experienced acute rejection on SRL therapy (overall incidence 6/50, 12%). Pharmacokinetic analysis in the first week of SRL administration suggested a short half-life (11.8+/-5.5 hr, n=21). SRL and reduced-dose TAC may achieve adequate immunosuppression without compromising renal function or enhancing EBV viremia significantly.

  13. Sarcoma de Kaposi em paciente transplantada renal em uso de Fk-506 Kaposi's Sarcoma in a renal transplant patient receiving Fk-506

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    Jorge David Rocha Zanol

    2002-12-01

    Full Text Available O Sarcoma de Kaposi (SK é neoplasia maligna multicêntrica, cutânea e extracutânea, que tem sido descrita em pacientes transplantados renais que recebem terapia imunossupressora clássica. Este estudo descreve um caso de sarcoma de Kaposi em paciente transplantada renal recebendo FK-506, que surgiu 10 meses após o transplante.Kaposi's sarcoma is a cutaneous and extra cutaneous multicentric malignancy that has been widely described in renal-transplant patients under classic immunosuppressive therapy. This study describes a renal-transplant patient under immunosuppressive therapy with FK-506 who presented Kaposi's sarcoma 10 months after the transplantation.

  14. Tacrolimus Topical

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    ... or lymphoma (cancer in a part of the immune system). There is not enough information available to tell whether tacrolimus ointment caused these patients to develop cancer. Studies of transplant patients and laboratory animals and an understanding of the way tacrolimus works ...

  15. A tacrolimus-related immunosuppressant with reduced toxicity.

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    Dumont, F J; Koprak, S; Staruch, M J; Talento, A; Koo, G; DaSilva, C; Sinclair, P J; Wong, F; Woods, J; Barker, J; Pivnichny, J; Singer, I; Sigal, N H; Williamson, A R; Parsons, W H; Wyvratt, M

    1998-01-15

    Tacrolimus (FK506) has potent immunosuppressive properties reflecting its ability to block the transcription of lymphokine genes in activated T cells through formation of a complex with FK506 binding protein-12, which inhibits the phosphatase activity of calcineurin. The clinical usefulness of tacrolimus is limited, however, by severe adverse effects, including neurotoxicity and nephrotoxicity. Although this toxicity, like immunosuppression, appears mechanistically related to the calcineurin inhibitory action of the drug, a large chemistry effort has been devoted to search for tacrolimus analogs with reduced toxicity but preserved immunosuppressive activity that might have enhanced therapeutic utility. Here, we report on the identification of such an analog, which was synthetically derived from ascomycin (ASC), the C21 ethyl analog of tacrolimus, by introducing an indole group at the C32 position. The profile of biological activity of indolyl-ASC was characterized in rodent models of immunosuppression and toxicity. Indolyl-ASC was found to exhibit an immunosuppressive potency equivalent to that of tacrolimus in T-cell activation in vitro and in murine transplant models, even though indolyl-ASC bound about 10 times less to intracellular FK506 binding protein-12 than tacrolimus or ASC. Further evaluation of indolyl-ASC revealed that it is threefold less potent than tacrolimus in inducing hypothermia, a response that may reflect neurotoxicity, and in causing gastrointestinal transit alterations in mice. Moreover, indolyl-ASC was at least twofold less nephrotoxic than tacrolimus upon 3-week oral treatment in rats. Altogether, these data indicate a modest but definite improvement in the therapeutic index for indolyl-ASC compared with tacrolimus in rodent models.

  16. FK concentrator outdoor measurements

    OpenAIRE

    Hernández Sanz, Maikel; Vilaplana, J., J.; Benitez Gimenez, Pablo; Mohedano,, Rubén; Zamora Herranz, Pablo; Miñano Dominguez, Juan Carlos; Mendes Lopes, Joao

    2013-01-01

    The FK is a two-stage optical concentrator for CPV, composed by a Fresnel lens working as POE and a refractive element working as SOE. Both elements perform Köhler integration, for uniform irradiance purposes. The FK has demonstrated that compares very well with other Fresnel-based concentrator optics. Recent on-sun measurements carried out on an FK mono-module prototype have already shown outstanding results, achieving electrical efficiencies over 34%. Further optimization of optical design ...

  17. Cyclosporin versus tacrolimus for liver transplanted patients

    DEFF Research Database (Denmark)

    Haddad, E M; McAlister, V C; Renouf, E

    2006-01-01

    Most liver transplant recipients receive either cyclosporin or tacrolimus to prevent rejection. Both drugs inhibit calcineurin phosphatase which is thought to be the mechanism of their anti-rejection effect and principle toxicities. The drugs have different pharmacokinetic profiles and potencies....... Several randomised clinical trials have compared cyclosporin and tacrolimus in liver transplant recipients, but it remains unclear which is superior....

  18. PET measurement of FK506 concentration in a monkey model of stroke

    International Nuclear Information System (INIS)

    Murakami, Yoshihiro; Takamatsu, Hiroyuki; Noda, Akihiro; Osoda, Kazuhiko; Nishimura, Shintaro

    2007-01-01

    Introduction: The immunosuppressive agent FK506 (tacrolimus) has neuroprotective properties in an experimental model of cerebral ischemia. To improve the accuracy of clinical studies in acute stroke, a clinical dose setting should be based on the brain concentration, but not on the blood concentration of agents in humans. We have already established a measurement method using PET for FK506 concentration in the normal monkey brain, which could be applicable for human study; however, under ischemic conditions, in this study, we aimed to examine the brain concentration of FK506 in a monkey model of stroke. Methods: Studies were performed on six male cynomolgus monkeys (Macaca fascicularis) and a middle cerebral artery (MCA) occlusion model was used. Regional cerebral blood flow (rCBF) was measured by an intravenous injection of [ 15 O]H 2 O 165 min after MCA occlusion. FK506 (0.1 mg/kg) containing [ 11 C]FK506 was intravenously injected into the monkeys 180 min after MCA occlusion, and dynamic PET images were acquired for 30 min after administration. FK506 concentrations in the brain were calculated in moles per liter (M) units using the specific activity of injected FK506. Results: MCA occlusion produced ischemia, confirmed by rCBF measurement before the administration of [ 11 C]FK506. Fifteen minutes after FK506 (0.1 mg/kg) administration, the concentrations in the contralateral and ipsilateral cortex were 22.4±6.4 and 19.7±4.0 ng/g, respectively. Conclusion: We successfully measured the brain concentration of FK506 in a monkey model of stroke. The difference between the contralateral and ipsilateral concentrations of FK506 was not significant. This characteristic that FK506 readily penetrates ischemic tissue as well as normal tissue might explain the neuroprotective effect of FK506 in the ischemic brain and is suitable for the treatment of stroke patients

  19. The calcineurin activity profiles of cyclosporin and tacrolimus are different in stable renal transplant patients

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    Koefoed-Nielsen, PB; Karamperis, N; Hojskov, C

    2006-01-01

    Cyclosporin and tacrolimus remain the cornerstone immunosuppressive drugs in organ transplantation. Dosing and monitoring these drugs is based on pharmacokinetic protocols, but measuring a pharmacodynamic parameter, calcineurin phosphatase (CaN) activity, could be a valuable supplement...... in determining optimal doses. Forty stable renal transplant patients were investigated three times in a 6-month period. Blood samples were drawn at 0, 1, 2, 3 and 4 h after oral intake of tacrolimus (FK) or cyclosporin at days 1 and 180. At day 90, one blood sample at trough level (FK) or C2 level (cyclosporin A...... at days 1 and 180 were the same for both drugs. Furthermore, we found that patients treated with tacrolimus or cyclosporin displayed different calcineurin activity profiles. We found that cyclosporin displayed greater calcineurin inhibition than tacrolimus. We have demonstrated that the two drugs exert...

  20. Incidence of Posttransplantation Diabetes Mellitus in De Novo Kidney Transplant Recipients Receiving Prolonged-Release Tacrolimus-Based Immunosuppression With 2 Different Corticosteroid Minimization Strategies: ADVANCE, A Randomized Controlled Trial.

    Science.gov (United States)

    Mourad, Georges; Glyda, Maciej; Albano, Laetitia; Viklický, Ondrej; Merville, Pierre; Tydén, Gunnar; Mourad, Michel; Lõhmus, Aleksander; Witzke, Oliver; Christiaans, Maarten H L; Brown, Malcolm W; Undre, Nasrullah; Kazeem, Gbenga; Kuypers, Dirk R J

    2017-08-01

    ADVANCE (NCT01304836) was a phase 4, multicenter, prospectively randomized, open-label, 24-week study comparing the incidence of posttransplantation diabetes mellitus (PTDM) with 2 prolonged-release tacrolimus corticosteroid minimization regimens. All patients received prolonged-release tacrolimus, basiliximab, mycophenolate mofetil and 1 bolus of intraoperative corticosteroids (0-1000 mg) as per center policy. Patients in arm 1 received tapered corticosteroids, stopped after day 10, whereas patients in arm 2 received no steroids after the intraoperative bolus. The primary efficacy variable was the diagnosis of PTDM as per American Diabetes Association criteria (2010) at any point up to 24 weeks postkidney transplantation. Secondary efficacy variables included incidence of composite efficacy failure (graft loss, biopsy-proven acute rejection or severe graft dysfunction: estimated glomerular filtration rate (Modification of Diet in Renal Disease-4) <30 mL/min per 1.73 m), acute rejection and graft and patient survival. The full-analysis set included 1081 patients (arm 1: n = 528, arm 2: n = 553). Baseline characteristics and mean tacrolimus trough levels were comparable between arms. Week 24 Kaplan-Meier estimates of PTDM were similar for arm 1 versus arm 2 (17.4% vs 16.6%; P = 0.579). Incidence of composite efficacy failure, graft and patient survival, and mean estimated glomerular filtration rate were also comparable between arms. Biopsy-proven acute rejection and acute rejection were significantly higher in arm 2 versus arm 1 (13.6% vs 8.7%, P = 0.006 and 25.9% vs 18.2%, P = 0.001, respectively). Tolerability profiles were comparable between arms. A prolonged-release tacrolimus, basiliximab, and mycophenolate mofetil immunosuppressive regimen is efficacious, with a low incidence of PTDM and a manageable tolerability profile over 24 weeks of treatment. A lower incidence of biopsy-proven acute rejection was seen in patients receiving corticosteroids tapered over 10

  1. TACROLIMUS OINTMENT FOR TREATMENT OF VKC

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    Navin Chandra

    2017-05-01

    Full Text Available BACKGROUND Vernal Keratoconjunctivitis (VKC is a bilateral recurrent chronic allergy inflammatory disorder of ocular surface, which is seasonally exacerbated mostly involving tarsal and bulbar conjunctiva in chronic and severe cases involves cornea as well. Affects mostly children and young adults with male predominance. Tacrolimus (FK-506 is a highly potent immune modulatory agent produced by the fungus Streptomyces tsukubaensis. MATERIALS AND METHODS This prospective, nonrandomised case series enrolled 20 patients (40 eyes with severe VKC who were treated with tacrolimus 0.1% ointment. The mean age of the patients was 18.25 ± 4.2 years (range, 9-31 years. Each patient completed a follow-up period of at least 12 months. The main outcome measure was the clinical response to treatment. RESULTS Significant improvements in clinical signs and symptoms were achieved in all patients 6 weeks after starting treatment with topical tacrolimus. Treatment was gradually reduced with increasing intervals between applications. VKC recurred in all patients who attempted to discontinue treatment. No additional medications were required and no significant changes in visual acuity or refraction were documented. Five patients discontinued treatment due to a severe burning sensation and were excluded from the study. CONCLUSION Tacrolimus 0.1% ointment is a safe and effective treatment for VKC refractory to standard treatment and maybe used as a substitute for steroid treatments used to controlled-disease activity. However, adverse effects could cause poor patient compliance.

  2. Molecular mechanisms of FK506-induced hypertension in solid organ transplantation patients

    Institute of Scientific and Technical Information of China (English)

    Wang Jianglin; Guo Ren; Liu Shikun; Chen Qingjie; Zuo Shanru; Yang Meng; Zuo Xiaocong

    2014-01-01

    Objective Tacrolimus (FK506) is an immunosuppressive drug,which is widely used to prevent rejection of transplanted organs.However,chronic administration of FK506 leads to hypertension in solid organ transplantation patients,and its molecular mechanisms are much more complicated.In this review,we will discuss the above-mentioned molecular mechanisms of FK506-induced hypertension in solid organ transplantation subjects.Data sources The data analyzed in this review were mainly from relevant articles without restriction on the publication date reported in PubMed.The terms "FK506" or "tacrolimus" and "hypertension"were used for the literature search.Study selection Original articles with no limitation of research design and critical reviews containing data relevant to FK506-induced hypertension and its molecular mechanisms were retrieved,reviewed and analyzed.Results There are several molecular mechanisms attributed to FK506-induced hypertension in solid organ transplantation subjects.First,FK506 binds FK506 binding protein 12 and its related isoform 12.6 (FKBP12/12.6) and removes them from intracellular ryanodine receptors that induce a calcium ion leakage from the endoplasmic/sarcoplasmic reticulum.The conventional protein kinase C beta II (cPKCβⅡ)-mediated phosphorylation of endothelial nitric oxide (NO) synthase at Thr495,which reduces the production of NO,was activated by calcium ion leakage.Second,transforming growth factor receptor/SMAD2/3 signaling activation plays an important role in Treg/Th17 cell imbalance in T cells which toget converge to cause inflammation,endothelial dysfunction,and hypertension following tacrolimus treatment.Third,the activation of with-no-K(Lys) kinases/STE20/SPS1-related proline/alanine-rich kinase/thiazide-sensitive sodium chloride co-transporter (WNKs/SPAK/NCC) pathway has a central role in tacrolimus-induced hypertension.Finally,the enhanced activity of renal renin-angiotensin-aldosterone system seems to play a crucial role in

  3. Pharmacokinetic interaction between corticosteroids and tacrolimus after renal transplantation.

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    Anglicheau, Dany; Flamant, Martin; Schlageter, Marie Hélène; Martinez, Frank; Cassinat, Bruno; Beaune, Philippe; Legendre, Christophe; Thervet, Eric

    2003-11-01

    Tacrolimus is an immunosuppressive drug that is a substrate of cytochrome P450 3A (CYP3A) enzymes and P-glycoprotein (P-gp). After transplantation, many pharmacological interactions have been described. Corticosteroids induce both CYP3A and P-gp activity. This study was designed to investigate the presence of a clinically significant interaction between steroids and tacrolimus after renal transplantation. We studied 83 renal transplant recipients receiving tacrolimus after transplantation. Patients were divided into three groups, according to steroid dose (low: 0-0.15 mg/kg/day; intermediate: 0.16-0.25 mg/kg/day; and high: >0.25 mg/kg/day). All other medications, including those known to interact with CYP3A and/or P-gp, were recorded. Steroid dosage, tacrolimus dosage, tacrolimus trough concentration (C0) and tacrolimus concentration/dose ratio [C0 divided by the 24 h dosage (mg/kg)] were assessed for each dosage group after 1 and 3 months of tacrolimus treatment. The three groups were not different as regards the use of non-immunosuppressive treatments or clinical events. At 1 and 3 months, the tacrolimus doses and concentration/dose ratios differed significantly in the three steroid dosage groups. With the higher doses, higher tacrolimus doses were needed to achieve the blood tacrolimus targeted trough level. We demonstrated that pharmacokinetic interaction occurs between steroids and tacrolimus in renal transplant patients. The higher the steroid dosage, the higher the dosage of tacrolimus needed to achieve target trough levels in these patients. The most likely interaction mechanism is specific enzymatic induction of CYP3A and/or P-gp. Interaction is present, even when the steroid dosage is low. The clinical events liable to occur during steroid sparing or tapering must be taken into account because it may be associated with episodes of tacrolimus-related nephrotoxicity.

  4. The calcineurin activity profiles of cyclosporin and tacrolimus are different in stable renal transplant patients

    DEFF Research Database (Denmark)

    Koefoed-Nielsen, Pernille Bundgaard; Karamperis, Nikolaos; Jørgensen, Kaj Anker

    2006-01-01

    in determining optimal doses. Forty stable renal transplant patients were investigated three times in a 6-month period. Blood samples were drawn at 0, 1, 2, 3 and 4 h after oral intake of tacrolimus (FK) or cyclosporin at days 1 and 180. At day 90, one blood sample at trough level (FK) or C2 level (cyclosporin A...... significantly different effects on calcineurin activity in renal transplant patients with stable, well-functioning grafts and that tacrolimus-treated patients can maintain good, stable graft function with minimal CaN inhibition.......Cyclosporin and tacrolimus remain the cornerstone immunosuppressive drugs in organ transplantation. Dosing and monitoring these drugs is based on pharmacokinetic protocols, but measuring a pharmacodynamic parameter, calcineurin phosphatase (CaN) activity, could be a valuable supplement...

  5. Analyses of marketplace tacrolimus drug product quality: bioactivity, NMR and LC-MS.

    Science.gov (United States)

    Sommers, Cynthia D; Pang, Eric S; Ghasriani, Houman; Berendt, Robert T; Vilker, Vincent L; Keire, David A; Boyne, Michael T

    2013-11-01

    Tacrolimus (FK506) is a potent, narrow therapeutic index, immunosuppressive drug used to avoid organ rejection in patients that have undergone organ transplantation. Recent clinical reports suggested a significant reduction in the tacrolimus concentration/dose ratio in the plasma of liver and kidney recipients when the reference listed drug was substituted with a generic drug. In response to these concerns about switching between tacrolimus from different approved manufacturers during treatment, the FDA initiated purity, potency and quality studies of the innovator and generic tacrolimus products available in the US marketplace. A combination of analytical methods, including mass spectrometry (LC-MS), nuclear magnetic resonance (NMR) and bioactivity assay were developed and validated to assess the quality of tacrolimus. These tests measured the identity, impurities and activity of tacrolimus from active pharmaceutical ingredient (API) sources and with formulated drug product from five different approved manufactures. In addition, some testing was performed on tacrolimus capsules obtained from a non US approved Indian source. The data obtained showed no discernible difference in the impurity profiles and potency between the generic and innovator tacrolimus products. Copyright © 2013. Published by Elsevier B.V.

  6. FK506 biosynthesis is regulated by two positive regulatory elements in Streptomyces tsukubaensis

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    Goranovič Dušan

    2012-10-01

    Full Text Available Abstract Background FK506 (Tacrolimus is an important immunosuppressant, produced by industrial biosynthetic processes using various Streptomyces species. Considering the complex structure of FK506, it is reasonable to expect complex regulatory networks controlling its biosynthesis. Regulatory elements, present in gene clusters can have a profound influence on the final yield of target product and can play an important role in development of industrial bioprocesses. Results Three putative regulatory elements, namely fkbR, belonging to the LysR-type family, fkbN, a large ATP-binding regulator of the LuxR family (LAL-type and allN, a homologue of AsnC family regulatory proteins, were identified in the FK506 gene cluster from Streptomyces tsukubaensis NRRL 18488, a progenitor of industrial strains used for production of FK506. Inactivation of fkbN caused a complete disruption of FK506 biosynthesis, while inactivation of fkbR resulted in about 80% reduction of FK506 yield. No functional role in the regulation of the FK506 gene cluster has been observed for the allN gene. Using RT-PCR and a reporter system based on a chalcone synthase rppA, we demonstrated, that in the wild type as well as in fkbN- and fkbR-inactivated strains, fkbR is transcribed in all stages of cultivation, even before the onset of FK506 production, whereas fkbN expression is initiated approximately with the initiation of FK506 production. Surprisingly, inactivation of fkbN (or fkbR does not abolish the transcription of the genes in the FK506 gene cluster in general, but may reduce expression of some of the tested biosynthetic genes. Finally, introduction of a second copy of the fkbR or fkbN genes under the control of the strong ermE* promoter into the wild type strain resulted in 30% and 55% of yield improvement, respectively. Conclusions Our results clearly demonstrate the positive regulatory role of fkbR and fkbN genes in FK506 biosynthesis in S. tsukubaensis NRRL 18488. We

  7. Proximal Tubular Injury in Medullary Rays Is an Early Sign of Acute Tacrolimus Nephrotoxicity

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    Diane Cosner

    2015-01-01

    Full Text Available Tacrolimus (FK506 is one of the principal immunosuppressive agents used after solid organ transplantations to prevent allograft rejection. Chronic renal injury induced by tacrolimus is characterized by linear fibrosis in the medullary rays; however, the early morphologic findings of acute tacrolimus nephrotoxicity are not well characterized. Kidney injury molecule-1 (KIM-1 is a specific injury biomarker that has been proven to be useful in the diagnosis of mild to severe acute tubular injury on renal biopsies. This study was motivated by a patient with acute kidney injury associated with elevated serum tacrolimus levels in whom KIM-1 staining was present only in proximal tubules located in the medullary rays in the setting of otherwise normal light, immunofluorescent, and electron microscopy. We subsequently evaluated KIM-1 expression in 45 protocol and 39 indicated renal transplant biopsies to determine whether higher serum levels of tacrolimus were associated with acute segment specific injury to the proximal tubule, as reflected by KIM-1 staining in the proximal tubules of the cortical medullary rays. The data suggest that tacrolimus toxicity preferentially affects proximal tubules in medullary rays and that this targeted injury is a precursor lesion for the linear fibrosis seen in chronic tacrolimus toxicity.

  8. Combination of hydrotropic nicotinamide with nanoparticles for enhancing tacrolimus percutaneous delivery

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    Pan W

    2016-08-01

    Full Text Available Wenhui Pan, Mengyao Qin, Guoguang Zhang, Yueming Long, Wenyi Ruan, Jingtong Pan, Zushuai Wu, Tao Wan, Chuanbin Wu, Yuehong Xu Department of Pharmaceutics, School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, People’s Republic of China Abstract: Tacrolimus (FK506, an effective immunosuppressant for treating inflammatory skin diseases, hardly penetrates into and through the skin owing to its high hydrophobicity and molecular weight. The aim of this study was to develop a hybrid system based on nicotinamide (NIC and nanoparticles (NPs encapsulating FK506, such as FK506–NPs–NIC, for facilitating percutaneous delivery, which exploited virtues of both NIC and NPs to obtain the synergetic effect. Solubility and percutaneous permeation studies were carried out. The results showed that NIC could increase the solubility and permeability of FK506 and that 20% (w/v NIC presented higher FK506 permeability and was thus chosen as the hydrotropic solution to solubilize FK506 and prepare FK506–NPs–NIC. Hyaluronic acid (HA was chemically conjugated with cholesterol (Chol to obtain amphiphilic conjugate of HA–Chol, which self-assembled NPs in 20% NIC solution containing FK506. The particle size, zeta potential, and morphology of NPs were characterized. The encapsulation efficiency and in vitro percutaneous permeation of NPs were evaluated in the presence and absence of NIC. The results demonstrated that hydrotropic solubilizing FK506 was readily encapsulated into NPs with a higher encapsulation efficiency of 79.2%±4.2%, and the combination of NPs with NIC exhibited a significantly synergistic effect on FK506 deposition within the skin (2.39±0.53 µg/cm2 and penetration through the skin (13.38±2.26 µg/cm2. The effect of the combination of NPs with NIC on drug permeation was further visualized by confocal laser scanning microscope through in vivo permeation studies, and the results confirmed that NPs–NIC synergistically enhanced

  9. FK506 protects against articular cartilage collagenous extra-cellular matrix degradation.

    Science.gov (United States)

    Siebelt, M; van der Windt, A E; Groen, H C; Sandker, M; Waarsing, J H; Müller, C; de Jong, M; Jahr, H; Weinans, H

    2014-04-01

    Osteoarthritis (OA) is a non-rheumatologic joint disease characterized by progressive degeneration of the cartilage extra-cellular matrix (ECM), enhanced subchondral bone remodeling, activation of synovial macrophages and osteophyte growth. Inhibition of calcineurin (Cn) activity through tacrolimus (FK506) in in vitro monolayer chondrocytes exerts positive effects on ECM marker expression. This study therefore investigated the effects of FK506 on anabolic and catabolic markers of osteoarthritic chondrocytes in 2D and 3D in vitro cultures, and its therapeutic effects in an in vivo rat model of OA. Effects of high and low doses of FK506 on anabolic (QPCR/histochemistry) and catabolic (QPCR) markers were evaluated in vitro on isolated (2D) and ECM-embedded chondrocytes (explants, 3D pellets). Severe cartilage damage was induced unilaterally in rat knees using papain injections in combination with a moderate running protocol. Twenty rats were treated with FK506 orally and compared to twenty untreated controls. Subchondral cortical and trabecular bone changes (longitudinal microCT) and macrophage activation (SPECT/CT) were measured. Articular cartilage was analyzed ex vivo using contrast enhanced microCT and histology. FK506 treatment of osteoarthritic chondrocytes in vitro induced anabolic (mainly collagens) and reduced catabolic ECM marker expression. In line with this, FK506 treatment clearly protected ECM integrity in vivo by markedly decreasing subchondral sclerosis, less development of subchondral pores, depletion of synovial macrophage activation and lower osteophyte growth. FK506 protected cartilage matrix integrity in vitro and in vivo. Additionally, FK506 treatment in vivo reduced OA-like responses in different articular joint tissues and thereby makes Cn an interesting target for therapeutic intervention of OA. Copyright © 2014 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  10. Efeito renoprotetor dos flavonoides do vinho na nefrotoxicidade do imunossupressor Tacrolimus Efecto renoprotector de los flavonoides del vino en la nefrotoxicidad del inmunosupresor Tacrolimus Renoprotective effects of wine flavonoids in nephrotoxicity of the immunosuppressant Tacrolimus

    Directory of Open Access Journals (Sweden)

    Wanessa Teixeira Silva

    2011-01-01

    Full Text Available OBJETIVO: Verificar o efeito renoprotetor do extrato de Vitis vinifera L na nefrotoxicidade induzida pelo Tacrolimus em estudos experimentais com ratos. MÉTODOS: Pesquisa quantitativa com modelo experimental, na qual foram utilizados ratos Wistar, machos, adultos, pesando entre 250g - 300g, tratados uma vez ao dia por cincodias, por gavagem, conforme segue: Salina (controle, cloreto de sódio 0,1ml; Vitis (Vitis vinifera L 3mg/kg, FK (0,5mg/kg e FK+Vitis (0,5mg/kg + 3mg/kg, respectivamente . A função renal foi avaliada por meio do clearance de creatinina (Clcr/ 100g, método Jaffé e a peroxidação lipídica pela mensuração de peróxidos urinários (PU, FOX-2. RESULTADOS: A administração de FK elevou a excreção de peróxidos e reduziu o clearance de creatinina, e a administração simultânea com Vitis vinifera L protegeu a função renal nesses parâmetros. CONCLUSÃO: Os dados confirmaram a lesão nefrotóxica induzida pelo Tacrolimus e demonstraram o efeito renoprotetor do Vitis Vinifera L.OBJETIVO: Verificar el efecto renoprotector del extracto de Vitis vinifera L en la nefrotoxicidad inducida por el Tacrolimus en estudios experimentales con ratas. MÉTODOS: Investigación cuantitativa con modelo experimental, en la cual fueron utilizadas ratas Wistar, machos, adultos, que pesaban entre 250g - 300g, tratados una vez al dia por cinco días, por alimentación forzada, conforme sigue: Salina (control, cloreto de sodio 0,1ml; Vitis (Vitis vinifera L 3mg/kg, FK (0,5mg/kg e FK+Vitis (0,5mg/kg + 3mg/kg, respectivamente . La función renal fue evaluada por medio del clearance de creatinina (Clcr/ 100g, método Jaffé y la peroxidación lipídica por la mensuración de peróxidos urinarios (PU, FOX-2. RESULTADOS: La administración de FK elevó la excreción de peróxidos y redujo el clearance de creatinina, y la administración simultánea con Vitis vinifera L protegió la función renal en esos parámetros. CONCLUSIÓN: Los datos

  11. Therapeutic drug monitoring of tacrolimus in pancreas transplantation at São Lucas Hospital Monitoramento terapêutico de tacrolimus em transplante de pâncreas no Hospital São Lucas

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    Luciana Mello de Oliveira

    2007-10-01

    Full Text Available Tacrolimus (FK 506, a potent immunosuppressive drug used in prevention and treatment of rejection of transplanted organs, exhibits efficacy related to its blood levels and has a narrow therapeutic index. These factors require frequent monitoring of patients blood levels, in attempt to adjust the dose to reach the best drug concentration with minimum side effects. In this historic study, the authors evaluated tacrolimus blood profile in patients submitted to pancreas transplantation between June 2002 and March 2004. The results show that blood levels were, mostly, within subtherapeutic (39.1% and toxic (43.4% ranges. Considering post-transplantation period, subtherapeutic levels were more frequent until three months after the graft receiving (51.1% and between three and six months (41.9%, whereas toxic levels were more common six months after the transplantation (63%. Patients who received pancreas/kidney transplantation showed a tendency to present toxic levels. The same did not happen with the patients who received isolated pancreas and pancreas after kidney; these patients presented subtherapeutic blood levels in all post-transplantation periods. The results found in this study reassure the importance of therapeutic monitoring to achieve the adequate blood levels of tacrolimus following pancreas transplantation.O tacrolimus (FK506, um potente imunossupressor utilizado na profilaxia e no tratamento de rejeições pós-transplante, exibe eficácia relacionada com sua concentração sangüínea e possui estreita janela terapêutica. Esses fatores requerem o freqüente monitoramento dos níveis sangüíneos em pacientes que fazem uso do fármaco, tendo como objetivo o ajuste de dose para uma concentração terapêutica ótima com efeitos colaterais mínimos. Este estudo retrospectivo foi realizado através do acesso à base de dados do Laboratório de Patologia Clínica do Hospital São Lucas, da Pontifícia Universidade Católica do Rio Grande do

  12. Synergistic effects of tacrolimus and azole antifungal compounds in fluconazole-susceptible and fluconazole-resistant Candida glabrata isolates

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    Laura Bedin Denardi

    2015-03-01

    Full Text Available In vitro interaction between tacrolimus (FK506 and four azoles (fluconazole, ketoconazole, itraconazole and voriconazole against thirty clinical isolates of both fluconazole susceptible and -resistant Candida glabrata were evaluated by the checkerboard microdilution method. Synergistic, indifferent or antagonism interactions were found for combinations of the antifungal agents and FK506. A larger synergistic effect was observed for the combinations of FK506 with itraconazole and voriconazole (43%, followed by that of the combination with ketoconazole (37%, against fluconazole-susceptible isolates. For fluconazole-resistant C. glabrata, a higher synergistic effect was obtained from FK506 combined with ketoconazole (77%, itraconazole (73%, voriconazole (63% and fluconazole (60%. The synergisms that we observed in vitro, notably against fluconazole-resistant C. glabrata isolates, are promising and warrant further analysis of their applications in experimental in vivo studies.

  13. A possible simplification for the estimation of area under the curve (AUC₀₋₁₂) of enteric-coated mycophenolate sodium in renal transplant patients receiving tacrolimus.

    Science.gov (United States)

    Fleming, Denise H; Mathew, Binu S; Prasanna, Samuel; Annapandian, Vellaichamy M; John, George T

    2011-04-01

    Enteric-coated mycophenolate sodium (EC-MPS) is widely used in renal transplantation. With a delayed absorption profile, it has not been possible to develop limited sampling strategies to estimate area under the curve (mycophenolic acid [MPA] AUC₀₋₁₂), which have limited time points and are completed in 2 hours. We developed and validated simplified strategies to estimate MPA AUC₀₋₁₂ in an Indian renal transplant population prescribed EC-MPS together with prednisolone and tacrolimus. Intensive pharmacokinetic sampling (17 samples each) was performed in 18 patients to measure MPA AUC₀₋₁₂. The profiles at 1 month were used to develop the simplified strategies and those at 5.5 months used for validation. We followed two approaches. In one, the AUC was calculated using the trapezoidal rule with fewer time points followed by an extrapolation. In the second approach, by stepwise multiple regression analysis, models with different time points were identified and linear regression analysis performed. Using the trapezoidal rule, two equations were developed with six time points and sampling to 6 or 8 hours (8hrAUC[₀₋₁₂exp]) after the EC-MPS dose. On validation, the 8hrAUC(₀₋₁₂exp) compared with total measured AUC₀₋₁₂ had a coefficient of correlation (r²) of 0.872 with a bias and precision (95% confidence interval) of 0.54% (-6.07-7.15) and 9.73% (5.37-14.09), respectively. Second, limited sampling strategies were developed with four, five, six, seven, and eight time points and completion within 2 hours, 4 hours, 6 hours, and 8 hours after the EC-MPS dose. On validation, six, seven, and eight time point equations, all with sampling to 8 hours, had an acceptable r with the total measured MPA AUC₀₋₁₂ (0.817-0.927). In the six, seven, and eight time points, the bias (95% confidence interval) was 3.00% (-4.59 to 10.59), 0.29% (-5.4 to 5.97), and -0.72% (-5.34 to 3.89) and the precision (95% confidence interval) was 10

  14. Pharmacokinetics of prolonged-release tacrolimus and implications for use in solid organ transplant recipients.

    Science.gov (United States)

    Tanzi, Maria G; Undre, Nasrullah; Keirns, James; Fitzsimmons, William E; Brown, Malcolm; First, M Roy

    2016-08-01

    Prolonged-release tacrolimus was developed as a once-daily formulation with ethylcellulose as the excipient, resulting in slower release and reduction in peak concentration (Cmax ) for a given dose compared with immediate-release tacrolimus, which is administered twice daily. This manuscript reviews pharmacokinetic information on prolonged-release tacrolimus in healthy subjects, in transplant recipients converted from immediate-release tacrolimus, and in de novo kidney and liver transplant recipients. As with the immediate-release formulation, prolonged-release tacrolimus shows a strong correlation between trough concentration (Cmin ) and area under the 24-hour time-concentration curve (AUC24 ), indicating that trough whole blood concentrations provide an accurate measure of drug exposure. We present the pharmacokinetic similarities and differences between the two formulations, so that prescribing physicians will have a better understanding of therapeutic drug monitoring in patients receiving prolonged-release tacrolimus. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  15. Diabetic ketoacidosis associated with tacrolimus in solid organ transplant recipients

    International Nuclear Information System (INIS)

    Maqsood, M.Q.; Rabbani, M.; Habib, M.; Saleem, T.

    2011-01-01

    Diabetic ketoacidosis in patients receiving tacrolimus in the post-transplant setting is rare. We describe two such cases in solid-organ transplant recipients. The first patient, a 17-year-old male, presented with severe diabetic ketoacidosis and was managed with intravenous fluids and insulin infusion. He was a known case of Laurence-Moon-Bardet-Biedl syndrome and had received a renal transplant 2 years ago and was receiving tacrolimus since then. Although diabetic ketoacidosis resolved in 24 hours, large doses of subcutaneous insulin (unto 130 units per day) were needed to keep serum glucose within the normal range. Substitution of tacrolimus with cyclosporine obviated the need for insulin or oral hypoglycaemics. The second patient, a 55-year-old woman, presented with a history of polyuria for 3 days. She had received a hepatic transplant 2 years ago and tacrolimus was being used since then. Mild diabetic ketoacidosis was managed with fluid resuscitation and subcutaneous insulin. Her insulin requirement after an uneventful recovery has been 54 - 70 units per day. Clinicians should be cognizant of the possibility of hyperglycaemic crisis presenting as sudden onset of diabetic ketoacidosis in patients receiving tacrolimus. Use of an alternative calcineurin inhibitor may provide a safer solution to minimize future morbidity in such patients. (author)

  16. Comparative proteomic and metabolomic analysis of Streptomyces tsukubaensis reveals the metabolic mechanism of FK506 overproduction by feeding soybean oil.

    Science.gov (United States)

    Wang, Jun; Liu, Huanhuan; Huang, Di; Jin, Lina; Wang, Cheng; Wen, Jianping

    2017-03-01

    FK506 (tacrolimus) is a 23-membered polyketide macrolide that possesses powerful immunosuppressant activity. In this study, feeding soybean oil into the fermentation culture of Streptomyces tsukubaensis improved FK506 production by 88.8%. To decipher the overproduction mechanism, comparative proteomic and metabolomic analysis was carried out. A total of 72 protein spots with differential expression in the two-dimensional gel electrophoresis (2-DE) were identified by matrix-assisted laser desorption/ionization time-of-flight/time-of-flight mass spectrometry (MALDI-TOF/TOF-MS), and 66 intracellular metabolites were measured by gas chromatography-mass spectrometer (GC-MS). The analysis of proteome and metabolome indicated that feeding soybean oil as a supplementary carbon source could not only strengthen the FK506 precursor metabolism and energy metabolism but also tune the pathways related to transcriptional regulation, translation, and stress response, suggesting a better intracellular metabolic environment for the synthesis of FK506. Based on these analyses, 20 key metabolites and precursors of FK506 were supplemented into the soybean oil medium. Among them, lysine, citric acid, shikimic acid, and malonic acid performed excellently for promoting the FK506 production and biomass. Especially, the addition of malonic acid achieved the highest FK506 production, which was 1.56-fold of that in soybean oil medium and 3.05-fold of that in initial medium. This report represented the first comprehensive study on the comparative proteomics and metabolomics applied in S. tsukubaensis, and it would be a rational guidance to further strengthen the FK506 production.

  17. Label-free quantification of Tacrolimus in biological samples by atomic force microscopy

    International Nuclear Information System (INIS)

    Menotta, Michele; Biagiotti, Sara; Streppa, Laura; Rossi, Luigia; Magnani, Mauro

    2015-01-01

    Highlights: • Tacrolimus is a potent immunosuppressant drug that has to be continually monitored. • We present an atomic force microscope approach for quantification of Tacrolimus in blood samples. • Detection and quantification have been successfully achieved. - Abstract: In the present paper we describe an atomic force microscopy (AFM)-based method for the quantitative analysis of FK506 (Tacrolimus) in whole blood (WB) samples. Current reference methods used to quantify this immunosuppressive drug are based on mass spectrometry. In addition, an immunoenzymatic assay (ELISA) has been developed and is widely used in clinic, even though it shows a small but consistent overestimation of the actual drug concentration when compared with the mass spectrometry method. The AFM biosensor presented herein utilises the endogen drug receptor, FKBP12, to quantify Tacrolimus levels. The biosensor was first assayed to detect the free drug in solution, and subsequently used for the detection of Tacrolimus in blood samples. The sensor was suitable to generate a dose–response curve in the full range of clinical drug monitoring. A comparison with the clinically tested ELISA assay is also reported

  18. Label-free quantification of Tacrolimus in biological samples by atomic force microscopy

    Energy Technology Data Exchange (ETDEWEB)

    Menotta, Michele, E-mail: michele.menotta@uniurb.it [Department of Biomolecular Sciences, University of Urbino “Carlo Bo” via Saffi 2, Urbino (Italy); Biagiotti, Sara [Department of Biomolecular Sciences, University of Urbino “Carlo Bo” via Saffi 2, Urbino (Italy); Streppa, Laura [Physics Laboratory, CNRS-ENS, UMR 5672, Lyon (France); Cell and Molecular Biology Laboratory, CNRS-ENS Lyon, UMR 5239, IFR128, Lyon (France); Rossi, Luigia; Magnani, Mauro [Department of Biomolecular Sciences, University of Urbino “Carlo Bo” via Saffi 2, Urbino (Italy)

    2015-07-16

    Highlights: • Tacrolimus is a potent immunosuppressant drug that has to be continually monitored. • We present an atomic force microscope approach for quantification of Tacrolimus in blood samples. • Detection and quantification have been successfully achieved. - Abstract: In the present paper we describe an atomic force microscopy (AFM)-based method for the quantitative analysis of FK506 (Tacrolimus) in whole blood (WB) samples. Current reference methods used to quantify this immunosuppressive drug are based on mass spectrometry. In addition, an immunoenzymatic assay (ELISA) has been developed and is widely used in clinic, even though it shows a small but consistent overestimation of the actual drug concentration when compared with the mass spectrometry method. The AFM biosensor presented herein utilises the endogen drug receptor, FKBP12, to quantify Tacrolimus levels. The biosensor was first assayed to detect the free drug in solution, and subsequently used for the detection of Tacrolimus in blood samples. The sensor was suitable to generate a dose–response curve in the full range of clinical drug monitoring. A comparison with the clinically tested ELISA assay is also reported.

  19. Improved oral absorption of tacrolimus by a solid dispersion with hypromellose and sodium lauryl sulfate.

    Science.gov (United States)

    Jung, Hyuck Jun; Ahn, Hye In; Park, Ji Yeon; Ho, Myoung Jin; Lee, Dae Ro; Cho, Ha Ra; Park, Jun Seo; Choi, Yong Seok; Kang, Myung Joo

    2016-02-01

    A novel surfactant-incorporated hydroxypropyl methylcellulose (HPMC) solid dispersion (SD) system was constructed in order to facilitate the release rate and oral absorption of tacrolimus (FK506), a poorly water-soluble immunosuppressant. Several emulsifiers including sodium lauryl sulfate (SLS), as drug release promotors, were employed with HPMC to fabricate SD using the solvent wetting method. The solid state characteristics using differential scanning calorimetry and X-ray powder diffraction, revealed that FK506 was molecularly distributed within all dispersions in amorphous form. The dissolution rates of FK506 in SLS-incorporated SDs were much higher than those in SDs prepared with HPMC alone, and even with stearoyl polyoxyl-32 glycerides or tocopheryl polyethylene glycol 1000 succinate. In particular, the greatest dissolution enhancement was obtained from the SD consisting of the drug, HPMC, and SLS in a weight ratio of 1:1:3, providing a 50-fold higher drug concentration within 15 min, compared with HPMC SD. In vivo absorption study in rats demonstrates that the optimized formula remarkably increased the oral absorption of FK506, providing about 4.0-fold greater bioavailability (p<0.05) compared with the marketed product (Prograf®, Astellas Pharma). These data suggest that a novel SLS/HPMC SD may be an advantageous dosage form of FK506, boosting the dissolution and absorption in gastrointestinal tract. Copyright © 2015 Elsevier B.V. All rights reserved.

  20. Progressive necrotic encephalopathy following tacrolimus therapy for liver transplantation.

    Science.gov (United States)

    Aridon, Paolo; Ragonese, Paolo; Di Benedetto, Norma; Grasso, Giovanni; Conaldi, Pier Giulio; D'Amelio, Marco; Savettieri, Giovanni

    2009-12-01

    Previously described neurologic damage induced by immunosuppressive treatments includes transient or reversible central nervous system involvement. We describe a 57-year-old man who underwent liver transplantation and was started on immunosuppressive therapy with tacrolimus (FK506). Six months later, he started complaining of a progressive motor and sensory impairment of the left side, together with cognitive impairment. Brain MRI showed an enlarging lesion of the white matter with peripheral contrast enhancement. PET study indicated severe hypometabolism in the right hemisphere and spectroscopic MRI showed a peak of choline and relative reduction of other metabolites. Findings of CSF examinations and cultures, serology, and molecular techniques were normal. Tacrolimus treatment was stopped. A cerebral biopsy of the lesion showed a sub acute necrotizing process. In the following months, cognitive status of the patient tended to improve although he remained hemiplegic, while serial MRI confirmed the tendency to the recovery of the lesion that was still present 1 year after. The present observation describes a progressive encephalopathy associated with immune suppression with an unusual feature and permanent brain damage.

  1. Differences in Peripheral Blood Lymphocytes between Brand-Name and Generic Tacrolimus Used in Stable Liver Transplant Recipients.

    Science.gov (United States)

    Kim, Jong Man; Kwon, Choon Hyuck David; Joh, Jae-Won; Sinn, Dong Hyun; Choi, Gyu-Seong; Park, Jae Berm; Kang, Eun-Suk; Lee, Suk-Koo

    2017-01-01

    In this study, peripheral blood lymphocytes were compared between a brand-name and a generic tacrolimus group in stable liver transplant recipients. Sixteen patients who underwent ABO-compatible living donor liver transplants between 2012 and 2013 and had stable graft function were included in this study. Ten patients received brand-name tacrolimus and 6 patients received generic tacrolimus. CD3, CD4, CD8, γδ, CD4+FoxP3+, and CD3-CD56+ T cells were analyzed in peripheral blood obtained preoperatively and 4, 8, 12, and 24 weeks after liver transplantation. Categorical variables were compared using a χ2 test or Fisher exact test, and continuous variables were compared using the Mann-Whitney U test. Regarding the baseline and perioperative characteristics, there were no statistically significant differences between the 2 groups. Immunosuppression also was not different. Subtype analysis of T-cell populations carried out in parallel showed similar levels of CD3, CD4, CD8, and γδT cells with brand-name tacrolimus and generic tacrolimus in stable liver transplant recipients. However, the levels of CD4+Foxp3+ and CD3-CD56+ T cells were higher in the brand-name tacrolimus group than in the generic tacrolimus group 8 weeks after transplantation (p brand-name tacrolimus group than in the generic tacrolimus group after transplantation. This finding showed that brand-name tacrolimus could have more potential immunosuppressive activity than generic tacrolimus regarding the contribution of CD4+Foxp3+ T cells to graft tolerance in liver transplant recipients. © 2017 S. Karger AG, Basel.

  2. Topical tacrolimus for atopic dermatitis.

    Science.gov (United States)

    Cury Martins, Jade; Martins, Ciro; Aoki, Valeria; Gois, Aecio F T; Ishii, Henrique A; da Silva, Edina M K

    2015-07-01

    Atopic dermatitis (AD) (or atopic eczema) is a chronic inflammatory skin condition that affects children and adults and has an important impact on quality of life. Topical corticosteroids (TCS) are the first-line therapy for this condition; however, they can be associated with significant adverse effects when used chronically. Tacrolimus ointment (in its 2 manufactured strengths of 0.1% and 0.03%) might be an alternative treatment. Tacrolimus, together with pimecrolimus, are drugs called topical calcineurin inhibitors (TCIs). To assess the efficacy and safety of topical tacrolimus for moderate and severe atopic dermatitis compared with other active treatments. We searched the following databases up to 3 June 2015: the Cochrane Skin Group Specialised Register, CENTRAL in the Cochrane Library (Issue 5, 2015), MEDLINE (from 1946), EMBASE (from 1974), LILACS (from 1982), and the Global Resource of Eczema Trials (GREAT database). We searched six trials registers and checked the bibliographies of included studies for further references to relevant trials. We contacted specialists in the field for unpublished data.A separate search for adverse effects of topical tacrolimus was undertaken in MEDLINE and EMBASE on 30 July 2013. We also scrutinised the U.S. Food and Drug Administration (FDA) websites for adverse effects information. All randomised controlled trials (RCTs) of participants with moderate to severe atopic dermatitis (both children and adults) using topical tacrolimus at any dose, course duration, and follow-up time compared with other active treatments. Two authors independently screened and examined the full text of selected studies for compliance with eligibility criteria, risk of bias, and data extraction. Our three prespecified primary outcomes were physician's assessment, participant's self-assessment of improvement, and adverse effects. Our secondary outcomes included assessment of improvement of the disease by validated or objective measures, such as

  3. Effect of cyclosporine, tacrolimus and sirolimus on cellular senescence in renal epithelial cells.

    Science.gov (United States)

    Koppelstaetter, Christian; Kern, Georg; Leierer, Gisela; Mair, Sabine Maria; Mayer, Gert; Leierer, Johannes

    2018-04-01

    In transplantation medicine calcineurin inhibitors (CNI) still represent the backbone of immunosuppressive therapy. The nephrotoxic potential of the CNI Cyclosporine A (CsA) and Tacrolimus (FK506) is well recognized and CNI not only have been linked with toxicity, but also with cellular senescence which hinders parenchymal tissue regeneration and thus may prime kidneys for subsequent insults. To minimize pathological effects on kidney grafts, alternative immunosuppressive agents like mTOR inhibitors or the T-cell co-stimulation blocker Belatacept have been introduced. We compared the effects of CsA, FK506 and Sirolimus on the process of cellular senescence in different human renal tubule cell types (HK2, RPTEC). Telomere length (by real time PCR), DNA synthesis (by BrdU incorporation), cell viability (by Resazurin conversion), gene expression (by RT-PCR), protein (by western blotting), Immuncytochemistry and H 2 O 2 production (by Amplex Red® conversion) were evaluated. DNA synthesis was significantly reduced when cells were treated with cyclosporine but not with tacrolimus and sirolimus. Resazurin conversion was not altered by all three immunosuppressive agents. The gene expression as well as protein production of the cell cycle inhibitor p21 (CDKN1A) but not p16 (CDKN2A) was significantly induced by cyclosporine compared to the other two immunosuppressive agents when determined by western blotting an immuncytochemistry. Relative telomere length was reduced and hydrogen peroxide production increased after treatment with CsA but not with FK506 or sirolimus. In summary, renal tubule cells exposed to CsA show clear signs of cellular senescence where on the contrary the second calcineurin inhibitor FK506 and the mTOR inhibitor sirolimus are not involved in such mechanisms. Chronic renal allograft dysfunction could be in part triggered by cellular senescence induced by immunosuppressive medication and the choice of drug could therefore influence long term outcome

  4. Synergistic effects of Isatis tinctoria L. and tacrolimus in the prevention of acute heart rejection in mice.

    Science.gov (United States)

    Wang, Yongzhi; Qin, Qing; Chen, Jibing; Kuang, Xiaocong; Xia, Junjie; Xie, Baiyi; Wang, Feng; Liang, Hua; Qi, Zhongquan

    2009-12-01

    Although immunosuppressive treatments are available for acute cardiac rejection no viable treatment exists for long-term cardiac graft failure. Moreover, the extended use of calcineurin inhibitor immunosuppressants, the mainstay of current treatment for cardiac transplantation, leads to significant side effects such as nephrotoxicity and an increased risk of cardiac disease. Because some agents used in Traditional Chinese Medicine (TCM) have strong immunosuppressive effects coupled with low toxicity, we investigated the effect of Compound K (K), the synthesized analogue of highly unsaturated fatty acids from Isatis tinctoria L., either as a single treatment or combined with tacrolimus (FK-506) on acute cardiac allograft rejection. We compared the ability of K alone, or in combination with FK-506, to inhibit acute heart transplant rejection both in vitro and in vivo. We found that the inhibition of lymphocyte proliferation was positively correlated with K concentration. K significantly reduced IL-2 and IFN-gamma expression levels and significantly inhibited lymphocyte proliferation in both a lymphocyte transformation test and a mixed lymphocyte reaction (MLR). We also found that the inhibitory effect of a combination of K and a sub-therapeutic dose of FK-506 (SubFK-506) was stronger than that of full-dose FK-506 alone. Oral administration of K reduced acute cardiac allograft rejection in mice and had no apparent toxicity. In vivo, the immunosuppressive effect of K combined with a half-dose of FK-506 was equivalent to that of a full-dose of FK-506 alone. K combined with a half-dose of FK-506 reduced the expression levels of IL-2 and IFN-gamma (both within the graft and in the recipients' serum) more effectively than a full-dose of FK-506. These results show that K has significant immunosuppressive effects both in vitro and in vivo. When used as a combination therapy with FK-506 we see a powerful inhibition of rejection with no obvious toxic side effects. The

  5. FK Comae Berenices, King of Spin

    DEFF Research Database (Denmark)

    Ayres, Thomas R.; Kashyap, V.; Saar, S.

    2016-01-01

    COCOA-PUFS is an energy-diverse, time-domain study of the ultra-fast spinning, heavily spotted, yellow giant FK Comae Berenices (FK Com: HD117555; G4 III). This single star is thought to be a recent binary merger, and is exceptionally active by measure of its intense ultraviolet (UV) and X......-ray emissions, and proclivity to flare. COCOA-PUFS was carried out with the Hubble Space Telescope in the UV (1200-3000 Å), using mainly its high-performance Cosmic Origins Spectrograph, but also high precision Space Telescope Imaging Spectrograph; Chandra X-ray Observatory in the soft X-rays (0.5-10 ke......V), utilizing its High-Energy Transmission Grating Spectrometer; together with supporting photometry and spectropolarimetry in the visible from the ground. This is an introductory report on the project. FK Com displayed variability on a wide range of timescales over all wavelengths during the week-long main...

  6. FK228 from Burkholderia thailandensis MSMB43

    Directory of Open Access Journals (Sweden)

    Xiang-Yang Liu

    2012-09-01

    Full Text Available FK228 [systematic name: (1S,4S,7Z,10S,16E,21R-7-ethylidene-4,21-di(propan-2-yl-2-oxa-12,13-dithia-5,8,20,23-tetrazabicyclo[8.7.6]tricos-16-ene-3,6,9,19,22-pentone], C24H36N4O6S2, also known as FR901228, depsipeptide, NSC 630176, romidepsin, and marketed as Istodax by Celgene Corporation, is crystallized from ethyl acetate in P21 as compared to the absolute configuration of FK228, first crystallized from methanol in P212121 [Shigematsu et al. (1994. J. Antibiot. 47, 311–314]. A slight difference is observed between the absolute configuration of FK228 and the present structure. The molecular structure is stabilized by intramolecular N—H...O hydrogen bonds. In the crystal, molecules are linked via N—H...O hydrogen bonds.

  7. Open-Label, Randomized Study of Transition From Tacrolimus to Sirolimus Immunosuppression in Renal Allograft Recipients

    Science.gov (United States)

    Tedesco-Silva, Helio; Peddi, V. Ram; Sánchez-Fructuoso, Ana; Marder, Brad A.; Russ, Graeme R.; Diekmann, Fritz; Flynn, Alison; Hahn, Carolyn M.; Li, Huihua; Tortorici, Michael A.; Schulman, Seth L.

    2016-01-01

    Background Calcineurin inhibitor–associated nephrotoxicity and other adverse events have prompted efforts to minimize/eliminate calcineurin inhibitor use in kidney transplant recipients. Methods This open-label, randomized, multinational study evaluated the effect of planned transition from tacrolimus to sirolimus on kidney function in renal allograft recipients. Patients received tacrolimus-based immunosuppression and then were randomized 3 to 5 months posttransplantation to transition to sirolimus or continue tacrolimus. The primary end point was percentage of patients with 5 mL/min per 1.73 m2 or greater improvement in estimated glomerular filtration rate from randomization to month 24. Results The on-therapy population included 195 patients (sirolimus, 86; tacrolimus, 109). No between-group difference was noted in percentage of patients with 5 mL/min per 1.73 m2 or greater estimated glomerular filtration rate improvement (sirolimus, 34%; tacrolimus, 42%; P = 0.239) at month 24. Sirolimus patients had higher rates of biopsy-confirmed acute rejection (8% vs 2%; P = 0.02), treatment discontinuation attributed to adverse events (21% vs 3%; P renal function improvement at 24 months is similar for patients with early conversion to sirolimus after kidney transplantation versus those remaining on tacrolimus. PMID:27500260

  8. Tacrolimus Modulates TGF-β Signaling to Induce Epithelial-Mesenchymal Transition in Human Renal Proximal Tubule Epithelial Cells

    Directory of Open Access Journals (Sweden)

    Jason Bennett

    2016-04-01

    Full Text Available Epithelial-mesenchymal transition (EMT, a process which describes the trans-differentiation of epithelial cells into motile mesenchymal cells, is pivotal in stem cell behavior, development and wound healing, as well as contributing to disease processes including fibrosis and cancer progression. Maintenance immunosuppression with calcineurin inhibitors (CNIs has become routine management for renal transplant patient, but unfortunately the nephrotoxicity of these drugs has been well documented. HK-2 cells were exposed to Tacrolimus (FK506 and EMT markers were assessed by RT PCR and western blot. FK506 effects on TGF-β mRNA were assessed by RT PCR and TGF-β secretion was measured by ELISA. The impact of increased TGF-β secretion on Smad signaling pathways was investigated. The impact of inhibition of TGF-β signaling on EMT processes was assessed by scratch-wound assay. The results presented in this study suggest that FK506 initiates EMT processes in the HK-2 cell line, with altered expression of epithelial and myofibroblast markers evident. Additionally, the study demonstrates that FK506 activation of the TGF-β/ SMAD pathways is an essential step in the EMT process. Overall the results demonstrate that EMT is heavily involved in renal fibrosis associated with CNI nephrotoxicity.

  9. A multicenter experience with generic tacrolimus conversion.

    Science.gov (United States)

    McDevitt-Potter, Lisa M; Sadaka, Basma; Tichy, Eric M; Rogers, Christin C; Gabardi, Steven

    2011-09-27

    The first generic tacrolimus product gained Food and Drug Administration approval in August 2009. This prospective, observational trial sought to determine the need for dose titrations and measure drug cost savings on conversion to generic tacrolimus. Transplant recipients on stable tacrolimus doses were converted from brand to generic tacrolimus on a mg:mg basis. Data were collected at the time of generic conversion (study arm) and at a time point exactly 6 months before conversion (control arm) for all subjects. Seventy conversions from four centers are reported. Subjects were a mean of 70 months after kidney (n=37), liver (n=28), or multiorgan (n=5) transplant. In the study arm, mean tacrolimus doses were 4.4 and 4.5 mg/d and mean tacrolimus trough concentrations were 5.8 and 5.9 ng/mL before and after conversion, respectively. In the control arm, mean tacrolimus doses were 4.6 and 4.6 mg/d and mean tacrolimus trough concentrations were 6.1 and 5.9 ng/mL before and after the control time point, respectively. Dose titrations occurred in five patients (7%) in the control arm and 15 patients (21%) in the study arm (P=0.028). Mean monthly drug costs were $645 for brand, $593 for generic, and $595 for generic after dose titrations. Mean monthly patient copays were $38 for brand and $15 for generic. These cumulative data show that dose requirements and trough levels are similar between brand and generic tacrolimus and that generic substitution allows for savings. However, postconversion monitoring is prudent as patients may require dose titration.

  10. Flip-flops of FK Comae Berenices

    DEFF Research Database (Denmark)

    Hackman, T.; Pelt, J.; Mantere, M. J.

    2013-01-01

    Context.FK Comae Berenices is a rapidly rotating magnetically active star, the light curve of which is modulated by cool spots on its surface. It was the first star where the "flip-flop" phenomenon was discovered. Since then, flip-flops in the spot activity have been reported in many other stars....... Follow-up studies with increasing length have shown, however, that the phenomenon is more complex than was thought right after its discovery. Aims. Therefore, it is of interest to perform a more thorough study of the evolution of the spot activity in FK Com. In this study, we analyse 15 years......-flop cannot be interpreted as a single phenomenon, where the main activity jumps from one active longitude to another. In some of our cases the phase shifts can be explained by differential rotation: two spot regions move with different angular velocity and even pass each other. Comparison between the methods...

  11. Erratic tacrolimus exposure, assessed using the standard deviation of trough blood levels, predicts chronic lung allograft dysfunction and survival.

    Science.gov (United States)

    Gallagher, Harry M; Sarwar, Ghulam; Tse, Tracy; Sladden, Timothy M; Hii, Esmond; Yerkovich, Stephanie T; Hopkins, Peter M; Chambers, Daniel C

    2015-11-01

    Erratic tacrolimus blood levels are associated with liver and kidney graft failure. We hypothesized that erratic tacrolimus exposure would similarly compromise lung transplant outcomes. This study assessed the effect of tacrolimus mean and standard deviation (SD) levels on the risk of chronic lung allograft dysfunction (CLAD) and death after lung transplantation. We retrospectively reviewed 110 lung transplant recipients who received tacrolimus-based immunosuppression. Cox proportional hazard modeling was used to investigate the effect of tacrolimus mean and SD levels on survival and CLAD. At census, 48 patients (44%) had developed CLAD and 37 (34%) had died. Tacrolimus SD was highest for the first 6 post-transplant months (median, 4.01; interquartile range [IQR], 3.04-4.98 months) before stabilizing at 2.84 μg/liter (IQR, 2.16-4.13 μg/liter) between 6 and 12 months. The SD then remained the same (median, 2.85; IQR, 2.00-3.77 μg/liter) between 12 and 24 months. A high mean tacrolimus level 6 to 12 months post-transplant independently reduced the risk of CLAD (hazard ratio [HR], 0.74; 95% confidence interval [CI], 0.63-0.86; p < 0.001) but not death (HR, 0.96; 95% CI, 0.83-1.12; p = 0.65). In contrast, a high tacrolimus SD between 6 and 12 months independently increased the risk of CLAD (HR, 1.46; 95% CI, 1.23-1.73; p < 0.001) and death (HR, 1.27; 95% CI, 1.08-1.51; p = 0.005). Erratic tacrolimus levels are a risk factor for poor lung transplant outcomes. Identifying and modifying factors that contribute to this variability may significantly improve outcomes. Copyright © 2015 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  12. Comparison of Semen Analysis Parametes Changes after Priscription of Two Immunosuppresive Drugs, Tacrolimus and Cyclosporine in Men Undergoing Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Ali Ramouz

    2017-02-01

    Full Text Available Background & Objective: The research objective was to investigate the prevalence of infertility in renal transplant patients receiving immunosuppressive agents and compare the impact of tacrolimus (target of Rapamycin inhibitors (TOR-I and Cyclosporine on spermogram parameters after the transplantation. Material & Methods: In this prospective study, from March 2013 to March 2014, all male patient who underwent renal transplantation and were treated with Tacrolimus or Cyclosporine, were included. Patients’ spermogram was analyzed in terms of sperm count and motility. Results: Average sperm count in patients receiving cyclosporine and tacrolimus before the transplantation was 1.73 × 106 and 2.08 × 106 and after the transplantation was 1.2 × 106 and 1.22 × 106, respectively (P=0.008(P=0.002. Average percentage of the motile sperms of patients treated with Cyclosporine, before the transplantation and start of immunosuppressive course was 45.10%, which decreased to 40.50% at the end of the course. The analysis indicated a significant reduction in sperm motility (P=0.001. Average percentage of the motile sperms of patients receiving Tacrolimus, before the transplantation and start of treatment was 46% that decreased to 38% after the transplantation. This finding presents the significantly reduced sperm motility (P=0.002. Finally, the effective sperm motility in patients treated with Cyclosporine was significantly higher than patients treated with Tacrolimus. Conclusion: Tacrolimus reduces sperms’ motility in renal transplant patients significantly higher than Cyclosporine.

  13. Cool covered sky-splitting spectrum-splitting FK

    Energy Technology Data Exchange (ETDEWEB)

    Mohedano, Rubén; Chaves, Julio; Falicoff, Waqidi; Hernandez, Maikel; Sorgato, Simone [LPI, Altadena, CA, USA and Madrid (Spain); Miñano, Juan C.; Benitez, Pablo [LPI, Altadena, CA, USA and Madrid, Spain and Universidad Politécnica de Madrid (UPM), Madrid (Spain); Buljan, Marina [Universidad Politécnica de Madrid (UPM), Madrid (Spain)

    2014-09-26

    Placing a plane mirror between the primary lens and the receiver in a Fresnel Köhler (FK) concentrator gives birth to a quite different CPV system where all the high-tech components sit on a common plane, that of the primary lens panels. The idea enables not only a thinner device (a half of the original) but also a low cost 1-step manufacturing process for the optics, automatic alignment of primary and secondary lenses, and cell/wiring protection. The concept is also compatible with two different techniques to increase the module efficiency: spectrum splitting between a 3J and a BPC Silicon cell for better usage of Direct Normal Irradiance DNI, and sky splitting to harvest the energy of the diffuse radiation and higher energy production throughout the year. Simple calculations forecast the module would convert 45% of the DNI into electricity.

  14. Successful treatment of dry eye in two patients with chronic graft-versus-host disease with systemic administration of FK506 and corticosteroids.

    Science.gov (United States)

    Ogawa, Y; Okamoto, S; Kuwana, M; Mori, T; Watanabe, R; Nakajima, T; Yamada, M; Mashima, Y; Tsubota, K; Oguchi, Y

    2001-05-01

    We present two cases of severe dry eye in patients with chronic graft-versus-host disease (CGVHD) after hematopoietic stem cell transplantation (SCT) who were successfully treated by the systemic administration of FK506 and corticosteroids. A 29-year-old man with chronic myelogenous leukemia underwent SCT. Oral and lung CGVHD developed on approximately day 130, and dry eye associated with CGVHD was diagnosed on day 168. The patient began receiving cyclosporin A (150 mg/d) for the treatment of oral and lung CGVHD. Treatment with prednisolone (1 mg/kg/d) began on approximately day 300. Oral and lung GVHD improved slightly, but worsened again although systemic administration of cyclosporin A and prednisolone were continued. Cyclosporin A was discontinued, and systemic administration of FK506 was started on day 376. Forty-four days later, marked improvement in the ocular surface and other organs was observed. However, the dry eye worsened while tapering FK506, with no flare of other affected organs. A 43-year-old woman with myelodysplastic syndrome underwent SCT. She received FK506 for prophylaxis of CGVHD. She had mild dry eye before SCT. Oral and intestinal CGVHD developed, and the dry eye worsened significantly on approximately day 150 while tapering FK506. Treatment with prednisolone (1 mg/kg/d) began, and the dose of FK506 was increased. By day 240, the symptoms of dry eye and the findings of the ocular surface markedly improved, and CGVHD in other organs was completely resolved. However, the improvement in the dry eye was lost when FK506 was tapered for the second time. Systemic administration of FK506 with corticosteroids is an effective treatment of severe dry eye in patients with CGVHD, but long-term administration may be required to achieve a lasting response. These cases also suggest that further investigation into the use of topical FK506 and prednisolone as a maintenance therapy should be pursued.

  15. Effectiveness of minocycline and FK506 alone and in combination on enhanced behavioral and biochemical recovery from spinal cord injury in rats.

    Science.gov (United States)

    Ahmad, Mohammad; Zakaria, Abdulrahim; Almutairi, Khalid M

    2016-06-01

    Injury to the spinal cord results in immediate physical damage (primary injury) followed by a prolonged posttraumatic inflammatory disorder (secondary injury). The present study aimed to investigate the neuroprotective effects of minocycline and FK506 (Tacrolimus) individually and in combination on recovery from experimental spinal cord injury (SCI). Young adult male rats were subjected to experimental SCI by weight compression method. Minocycline (50mg/kg) and FK506 (1mg/kg) were administered orally in combination and individually to the SCI group daily for three weeks. During these three weeks, the recovery was measured using behavioral motor parameters (including BBB, Tarlov and other scorings) every other day for 29days after SCI. Thereafter, the animals were sacrificed and the segment of the spinal cord centered at the injury site was removed for the histopathological studies as well as for biochemical analysis of monoamines such as 5-hydroxytryptamine (5-HT) and 5-hydroxy-indolacetic acid (5-HIAA) and some oxidative stress indices, such as thiobarbituric acid-reactive substances (TBARS), total glutathione (GSH) and myeloperoxidase (MPO). All behavioral results indicated that both drugs induced significant recovery from SCI with respect to time. The biochemical and histopathological results supported the behavioral findings, revealing significant recovery in the regeneration of the injured spinal tissues, the monoamine levels, and the oxidative stress indices. Overall, the effects of the tested drugs for SCI recovery were as follows: FK506+minocycline>minocycline>FK506 in all studied parameters. Thus, minocycline and FK506 may prove to be a potential therapy cocktail to treat acute SCI. However, further studies are warranted. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Dyslipidaemia among renal transplant recipients: cyclosporine versus tacrolimus.

    Science.gov (United States)

    Fazal, Muhammad Asim; Idrees, Muhammad Khalid; Akhtar, Syed Fazal

    2014-05-01

    To compare new onset dyslipidaemia in live-related renal transplant recipients taking cyclosporine versus tacrolimus after 3 months of therapy. The randomised controlled trial was conducted at the Sindh Institute of Urology and Transplantation (SIUT) Karachi, from September 2010 to April 2011, and included 182 End Stage Renal Disease patients on maintenance haemodialysis with pre-transplant normal lipid profile. The patients, who had live-related renal transplant, were randomly allocated to two equal groups using lottery. Group A received cyclosporine (3 mg/kg) and group B was treated with tacrolimus (0.1 mg/kg). All patients had pre-transplant fasting lipid profile checked when they were on maintenance haemodialysis and 3 months after renal transplantation. Serum fasting lipid profile was collected by taking 5 ml blood by venipuncture after an overnight fast of 9-12 hours. SPSS 10 was used for statistical analyses. Of the 182 patients, 144 (79.1%) were males and 38 (20.9%) were females. The overall mean age was 30.18 +/- 9.57 years, and the mean weight was 54.41 +/- 11.144 kg. Significant difference was not observed between the two groups regarding age and weight of the patients. Dyslipidaemia was found in 115(63.2%) subjects; 61(67%) in group A and 54 (59.3%) in group B. There was no statistical difference (p=0.28) when comparison was done after 3 months of therapy. The occurrence of new onset hyperlipidaemia is similar in renal transplant recipients receiving either cyclosporine or tacrolimus in first 3 months post-transplant, but there is room for more research in this field as dyslipidaemia following successful renal transplantation is a frequent and persistent complication.

  17. Dyslipidaemia among renal transplant recipients: cyclosporine versus tacrolimus

    International Nuclear Information System (INIS)

    Fazal, M. A.; Idrees, M. K.; Akhtar, S. F.

    2014-01-01

    Objectives: To compare new onset dyslipidaemia in live-related renal transplant recipients taking cyclosporine versus tacrolimus after 3 months of therapy. Methods: The randomised controlled trial was conducted at the Sindh Institute of Urology and Transplantation (SIUT) Karachi, from September 2010 to April 2011, and included 182 End Stage Renal Disease patients on maintenance haemodialysis with pre-transplant normal lipid profile. The patients, who had live-related renal transplant, were randomly allocated to two equal groups using lottery. Group A received cyclosporine (3mg/kg) and group B was treated with tacrolimus (0.1mg/kg). All patients had pre-transplant fasting lipid profile checked when they were on maintenance haemodialysis and 3 months after renal transplantation. Serum fasting lipid profile was collected by taking 5ml blood by venipuncture after an overnight fast of 9-12 hours. SPSS 10 was used for statistical analyses. Results: Of the 182 patients, 144(79.1%) were males and 38(20.9%) were females. The overall mean age was 30.18+-9.57 years, and the mean weight was 54.41+- 11.144kg. Significant difference was not observed between the two groups regarding age and weight of the patients. Dyslipidaemia was found in 115(63.2%) subjects; 61(67%) in group A and 54(59.3%) in group B. There was no statistical difference (p=0.28) when comparison was done after 3 months of therapy. Conclusions: The occurrence of new onset hyperlipidaemia is similar in renal transplant recipients receiving either cyclosporine or tacrolimus in first 3 months post-transplant, but there is room for more research in this field as dyslipidaemia following successful renal transplantation is a frequent and persistent complication. (author)

  18. The Spinning Corona of FK Comae

    Science.gov (United States)

    Kashyap, Vinay

    2010-09-01

    FK Comae is an ultra-fast rotating, single yellow giant, product of a recent W UMa merger. Extraordinary levels of FUV and X-ray emission rate FK Comae a coronal powerhouse on par with the most extreme of the better known activity heavyweights: short-period RS CVn binaries. As a single star, FK Comae has clear advantages as a laboratory for exploring the outer limits of magnetospheric activity among the coronal cool stars. FK Comae has a long history of attention at optical and X-ray wavelengths, thanks to its generously spotted surface, and proclivity to flare regularly at high energies. FUSE discovered ultra-broad, redshifted profiles of OVI and CIII, but unfortunately the singular observation could not be repeated, thanks to the satellite's flaky attitude system. The remarkable FUV spectrum was taken just a few months before STIS failed in 2004, so there was no opportunity to turn the more powerful gaze of Hubble to the task. Now, finally, the amazing sensitivity of Cosmic Origins Spectrograph can be brought to bear: a single orbit can capture an FUV spectrum of FK Comae with S/N at instrumental limits for bright lines, and digging down to faint FeXXI 1354 {bridge to the coordinated Chandra HETGS pointing we are carrying out}.We will trace how the bright FUV regions relate spatially to the photospheric dark spots, to inform ideas of coronal structure and heating in these advanced objects. We will probe whether a global magnetosphere exists, and whether the field lines are loaded with hot coronal gas {>10 MK}, as well as the cooler 0.3 MK material already suggested by highly broadened FUSE OVI. Further, we will test whether the striking 100 km/s redshifts of the FUV lines, and similar shifts seen in NeX by Chandra HETGS, are caused by persistent coronal flows {outflows, perhaps implicated in magnetic braking; or inflows, like "coronal rain" on the Sun}. Our method is to exploit, on the one hand, emission-line "Doppler imaging," whereby bright surface regions are

  19. Stability of tacrolimus solutions in polyolefin containers.

    Science.gov (United States)

    Lee, Jun H; Goldspiel, Barry R; Ryu, Sujung; Potti, Gopal K

    2016-02-01

    Results of a study to determine the stability of tacrolimus solutions stored in polyolefin containers under various temperature conditions are reported. Triplicate solutions of tacrolimus (0.001, 0.01, and 0.1 mg/mL) in 0.9% sodium chloride injection or 5% dextrose injection were prepared in polyolefin containers. Some samples were stored at room temperature (20-25 °C); others were refrigerated (2-8 °C) for 20 hours and then stored at room temperature for up to 28 hours. The solutions were analyzed by stability-indicating high-performance liquid chromatography (HPLC) assay at specified time points over 48 hours. Solution pH was measured and containers were visually inspected at each time point. Stability was defined as retention of at least 90% of the initial tacrolimus concentration. All tested solutions retained over 90% of the initial tacrolimus concentration at all time points, with the exception of the 0.001-mg/mL solution prepared in 0.9% sodium chloride injection, which was deemed unstable beyond 24 hours. At all evaluated concentrations, mean solution pH values did not change significantly over 48 hours; no particle formation was detected. During storage in polyolefin bags at room temperature, a 0.001-mg/mL solution of tacrolimus was stable for 24 hours when prepared in 0.9% sodium chloride injection and for at least 48 hours when prepared in 5% dextrose injection. Solutions of 0.01 and 0.1 mg/mL prepared in either diluent were stable for at least 48 hours, and the 0.01-mg/mL tacrolimus solution was also found to be stable throughout a sequential temperature protocol. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  20. Generic tacrolimus in solid organ transplantation

    DEFF Research Database (Denmark)

    Taube, D; Jones, G; O'Beirne, J

    2014-01-01

    The availability of a wide range of immunosuppressive therapies has revolutionized the management of patients who have undergone solid organ transplantation (SOT). However, the cost of immunosuppressive drugs remains high. This situation has led to the development of generic equivalents, which...... innovator tacrolimus drug (Prograf) in both healthy volunteers and kidney transplant patients. Clinical experience with this generic tacrolimus formulation has also been established in both de novo and conversion patients who have undergone kidney and liver transplantation, as well as in conversion of other...

  1. Tacrolimus interaction with nafcillin resulting in significant decreases in tacrolimus concentrations: A case report.

    Science.gov (United States)

    Wungwattana, Minkey; Savic, Marizela

    2017-04-01

    Tacrolimus (TAC) is subject to many drug interactions as a result of its metabolism primarily via CYP450 isoenzyme 3A4. Numerous case reports of TAC and CYP3A4 inducers and inhibitors have been described including antimicrobials, calcium channel antagonists, and antiepileptic drugs. We present the case of a 13-year-old patient with cystic fibrosis and a history of liver transplantation, where subtherapeutic TAC concentrations were suspected to be a result of concomitant TAC and nafcillin (NAF) therapy. The observed drug interaction occurred on two separate hospital admissions, during both of which the patient exhibited therapeutic TAC concentrations prior to exposure to NAF, a CYP3A4 inducer. Upon discontinuation of NAF, TAC concentrations recovered in both instances. This case represents a drug-drug interaction between TAC and NAF that has not previously been reported to our knowledge. Despite the lack of existing reports of interaction between these two agents, this case highlights the importance of therapeutic drug monitoring and assessing for any potential drug-drug or drug-food interactions in patients receiving TAC therapy. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  2. Probable tacrolimus toxicity from tibolone co-administration in a woman: a case report

    Directory of Open Access Journals (Sweden)

    Clark Carolyn J

    2010-08-01

    Full Text Available Abstract Introduction Tibolone is a synthetic steroid, used with increasing frequency to treat symptoms of menopause, including patients with solid-organ transplants who are taking concurrent immune suppression. To the best of our knowledge, there are no reported drug interactions between tibolone and tacrolimus, one of the principal immune suppressants used in kidney transplantation. Case presentation We report the case of a 49-year-old Caucasian woman who had received a kidney transplant and who developed acute kidney injury secondary to tacrolimus toxicity 10 days after starting tibolone therapy. No alternative causes were found. Tibolone is known to be a weak competitive inhibitor of CYP3A4, which is involved in tacrolimus metabolism. Conclusions Despite a careful evaluation, no alternative reason was found for the acute kidney injury, and her kidney function returned to the previous baseline within several days of cessation of the medication, and with no other specific treatment. Using the Drug Interaction Probability Scale we conclude that she experienced a probable drug interaction. We believe that transplant clinicians should utilise frequent therapeutic drug monitoring of tacrolimus in patients starting or stopping tibolone therapy.

  3. Public relations 1. FK Příbram

    OpenAIRE

    Bauerová, Eva

    2015-01-01

    Title: Public relations 1. FK Příbram Objectives: The objective is analysis and assessment tools and activities Public Relations, which football club 1. FK Pribram uses, both in communication with fans and interact with their partners. Based on the analysis tool will suggest scheme so that communication by Public relations have been effective and successful. Methods: To acheave goals was chosen the case study method, which helped to get detail information. Data collection was performed using ...

  4. Marketingová komunikace FK Mladá Boleslav

    OpenAIRE

    Fanta, Jan

    2014-01-01

    Title: Marketing communications FK Mladá Boleslav Objectives: The main objective of this bachelor thesis is to analyze the current state of marketing communication with the audience FK Mladá Boleslav, identify deficiencies and submit a proposal to improve the marketing communication strategy with fans of this club. Methods: In this thesis were used methods of analysis of relevant documents and texts. Another used method was structured interview with the staff of the marketing department, the ...

  5. Frequency-Wavenumber (FK)-Based Data Selection in High-Frequency Passive Surface Wave Survey

    Science.gov (United States)

    Cheng, Feng; Xia, Jianghai; Xu, Zongbo; Hu, Yue; Mi, Binbin

    2018-04-01

    Passive surface wave methods have gained much attention from geophysical and civil engineering communities because of the limited application of traditional seismic surveys in highly populated urban areas. Considering that they can provide high-frequency phase velocity information up to several tens of Hz, the active surface wave survey would be omitted and the amount of field work could be dramatically reduced. However, the measured dispersion energy image in the passive surface wave survey would usually be polluted by a type of "crossed" artifacts at high frequencies. It is common in the bidirectional noise distribution case with a linear receiver array deployed along roads or railways. We review several frequently used passive surface wave methods and derive the underlying physics for the existence of the "crossed" artifacts. We prove that the "crossed" artifacts would cross the true surface wave energy at fixed points in the f-v domain and propose a FK-based data selection technique to attenuate the artifacts in order to retrieve the high-frequency information. Numerical tests further demonstrate the existence of the "crossed" artifacts and indicate that the well-known wave field separation method, FK filter, does not work for the selection of directional noise data. Real-world applications manifest the feasibility of the proposed FK-based technique to improve passive surface wave methods by a priori data selection. Finally, we discuss the applicability of our approach.

  6. Frequency-Wavenumber (FK)-Based Data Selection in High-Frequency Passive Surface Wave Survey

    Science.gov (United States)

    Cheng, Feng; Xia, Jianghai; Xu, Zongbo; Hu, Yue; Mi, Binbin

    2018-07-01

    Passive surface wave methods have gained much attention from geophysical and civil engineering communities because of the limited application of traditional seismic surveys in highly populated urban areas. Considering that they can provide high-frequency phase velocity information up to several tens of Hz, the active surface wave survey would be omitted and the amount of field work could be dramatically reduced. However, the measured dispersion energy image in the passive surface wave survey would usually be polluted by a type of "crossed" artifacts at high frequencies. It is common in the bidirectional noise distribution case with a linear receiver array deployed along roads or railways. We review several frequently used passive surface wave methods and derive the underlying physics for the existence of the "crossed" artifacts. We prove that the "crossed" artifacts would cross the true surface wave energy at fixed points in the f- v domain and propose a FK-based data selection technique to attenuate the artifacts in order to retrieve the high-frequency information. Numerical tests further demonstrate the existence of the "crossed" artifacts and indicate that the well-known wave field separation method, FK filter, does not work for the selection of directional noise data. Real-world applications manifest the feasibility of the proposed FK-based technique to improve passive surface wave methods by a priori data selection. Finally, we discuss the applicability of our approach.

  7. Betel Nut Chewing Is Associated With Reduced Tacrolimus Concentration in Taiwanese Liver Transplant Recipients.

    Science.gov (United States)

    Chen, W-Y; Lee, C-Y; Lin, P-Y; Hsieh, C-E; Ko, C-J; Lin, K-H; Lin, C-C; Ming, Y-Z; Chen, Y-L

    2017-03-01

    Studies have shown that arecoline, the major alkaloid component of betel nuts, alters the activity of enzymes in the cytochrome P450 (CYP-450) family. Tacrolimus, an immunosuppressant that protects against organ rejection in transplant recipients, not only is mainly metabolized by CYP3A enzymes but also has a narrow therapeutic range. We aimed to investigate whether dose-adjusted blood trough levels of tacrolimus differed over time between betel nut-chewing and non-betel nut-chewing liver transplant recipients. In this retrospective case-control study, 14 active betel nut-using liver recipients were matched at a 1:2 ratio to 28 non-betel nut-using liver recipients by sex, age, graft source, duration of follow-up after liver transplantation, and estimated glomerular filtration rate. Differences in liver function index, renal function index, and dose-adjusted blood trough levels of tacrolimus over an 18-month period were compared between the 2 groups by using the Generalized Estimating Equation approach. Dose-adjusted blood trough levels of tacrolimus tended to be significantly (P = .04) lower in betel nut chewers (mean = 0.81, medium = 0.7, 95% confidence interval [CI] = 0.73 to 0.90) than in nonchewers (mean = 1.12, medium = 0.88, 95% CI = 1.03 to 1.22) during the 18-month study period. However, there was no significant difference in renal and liver function index between the 2 groups. Liver transplant recipients receiving tacrolimus tend to have lower blood trough levels of the drug over time if they chew betel nuts. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Sirolimus Associated with Tacrolimus at Low Doses in Elderly Kidney Transplant Patients: A Prospective Randomized Controlled Trial.

    Science.gov (United States)

    Kojima, Cristiane Akemi; Nga, Hong Si; Takase, Henrique Mochida; Bravin, Ariane Moyses; Martinez Garcia, Márcia de Fátima Faraldo; Garcia, Paula Dalsoglio; Contti, Mariana Moraes; de Andrade, Luis Gustavo Modelli

    2018-06-01

    There is no consensus on the best immunosuppressive regimen for elderly renal transplant recipients. The objective of this study was to assess cytomegalovirus infection incidence and kidney transplant outcomes in elderly recipients treated with mammalian target of rapamycin inhibitors sirolimus/ tacrolimus at low doses compared with those receiving tacrolimus/mycophenolate sodium. In this single-center prospective randomized study (Trial Registration No. NCT02683291), kidney transplant recipients over 60 years of age were randomly allocated into 2 groups: tacrolimus-sirolimus (21 patients) and tacrolimus-mycophenolate (23 patients). Cytomegalovirus infection rate and patient survival, biopsy-proven acute rejection, and renal function at 12 months were assessed. Cytomegalovirus infection rate was higher in the mycophenolate group (60.9%) than in the sirolimus group (16.7%; P = .004). The rates of biopsy-proven acute rejection, patient survival, graft survival, and estimated glomerular filtration rate over 12 months did not significantly differ between groups. The incidence of cytomegalovirus infection was significantly lower in the sirolimus group. The use of tacrolimus combined with sirolimus in elderly kidney transplant recipients is safe.

  9. Tacrolimus increases Nox4 expression in human renal fibroblasts and induces fibrosis-related genes by aberrant TGF-beta receptor signalling.

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    Georg Kern

    Full Text Available Chronic nephrotoxicity of immunosuppressives is one of the main limiting factors in the long-term outcome of kidney transplants, leading to tissue fibrosis and ultimate organ failure. The cytokine TGF-β is considered a key factor in this process. In the human renal fibroblast cell line TK-173, the macrolide calcineurin inhibitor tacrolimus (FK-506 induced TGF-β-like effects, manifested by increased expression of NAD(PH-oxidase 4 (Nox4, transgelin, tropomyosin 1, and procollagen α1(V mRNA after three days. The macrolide mTOR inhibitor rapamycin had similar effects, while cyclosporine A did not induce fibrose-related genes. Concentration dependence curves were sigmoid, where mRNA expression was induced already at low nanomolar levels of tacrolimus, and reached saturation at 100-300 nM. The effects were independent of extracellular TGF-β as confirmed by the use of neutralizing antibodies, and thus most likely caused by aberrant TGF-β receptor signaling, where binding of tacrolimus to the regulatory FKBP12 protein results in a "leaky" TGF-β receptor. The myofibroblast marker α-smooth muscle actin was neither induced by tacrolimus nor by TGF-β1, indicating an incomplete activation of TK-173 fibroblasts under culture conditions. Tacrolimus- and TGF-β1-induced Nox4 protein upregulation was confirmed by Western blotting, and was accompanied by a rise in intracellular H2O2 concentration. Si-RNA mediated knock-down of Nox4 expression prevented up-regulation of procollagen α1(V mRNA in tacrolimus-treated cells, but induced procollagen α1(V expression in control cells. Nox4 knock-down had no significant effect on the other genes tested. TGF-β is a key molecule in fibrosis, and the constant activation of aberrant receptor signaling by tacrolimus might contribute to the long-term development of interstitial kidney fibrosis in immunosuppressed patients. Nox4 levels possibly play a regulatory role in these processes.

  10. Probable tacrolimus toxicity from tibolone co-administration in a woman: a case report

    OpenAIRE

    Clark Carolyn J; Hawley Carmel M; Mudge David W

    2010-01-01

    Abstract Introduction Tibolone is a synthetic steroid, used with increasing frequency to treat symptoms of menopause, including patients with solid-organ transplants who are taking concurrent immune suppression. To the best of our knowledge, there are no reported drug interactions between tibolone and tacrolimus, one of the principal immune suppressants used in kidney transplantation. Case presentation We report the case of a 49-year-old Caucasian woman who had received a kidney transplant an...

  11. HEPATOTROPHIC EFFECTS OF FK506 IN DOGS1

    Science.gov (United States)

    Starzl, Thomas E.; Porter, Kendrick A.; Mazzaferro, Vincenzo; Todo, Satoru; Fung, John; Francavilla, Antonio

    2010-01-01

    Portacaval shunt (Eck fistula) in dogs causes hepatocyte atrophy and organelle disruption, as well as tripling of hepatocyte mitoses. After submitting dogs to this procedure, FK506 was infused into the tied-off left portal vein. The size, anatomic quality, and replication of hepatocytes were enhanced in the portion of liver infused with FK506, with a significant spillover effect in the noninfused portion. These hepatotrophic qualities of FK506 may explain part of FK506’s efficacy for the treatment of chronic liver rejection. Also, the observations support a trial with this drug for the treatment of autoimmune liver diseases because, in addition to turning off the immunologic genesis of such disorders, repair and regeneration of the damaged liver may be augmented. Finally, these hepatrophic qualities are part of an emerging spectrum of biologic effects caused by drugs that may modulate the enzyme cis-trans peptidyl-prolyl isomerase (PPIase), the principal constituent of the cytosolic binding sites of FK506, repamycin, cyclosporine, and presumably other immunosuppressive drugs as yet undiscovered. PMID:1702912

  12. Cosine problem in EPRL/FK spinfoam model

    Science.gov (United States)

    Vojinović, Marko

    2014-01-01

    We calculate the classical limit effective action of the EPRL/FK spinfoam model of quantum gravity coupled to matter fields. By employing the standard QFT background field method adapted to the spinfoam setting, we find that the model has many different classical effective actions. Most notably, these include the ordinary Einstein-Hilbert action coupled to matter, but also an action which describes antigravity. All those multiple classical limits appear as a consequence of the fact that the EPRL/FK vertex amplitude has cosine-like large spin asymptotics. We discuss some possible ways to eliminate the unwanted classical limits.

  13. In Silico Ocular Pharmacokinetic Modeling: Delivery of Topical FK962 to Retina.

    Science.gov (United States)

    Mori, Ayumi; Yabuta, Chiho; Kishimoto, Yayoi; Kozai, Seiko; Ohtori, Akira; Shearer, Thomas R; Azuma, Mitsuyoshi

    2017-09-01

    To establish the in silico ocular pharmacokinetic modeling for eye drops, and to simulate the dose regimen for FK962 in human choroid/retinal diseases. Pharmacokinetics for FK962 in vivo was performed by a single instillation of drops containing 0.1% 14 C-FK962 in rabbit eyes. Permeation of FK962 across the cornea, sclera, and choroid/retina was measured in vitro. Neurite elongation by FK962 was measured in cultured rat retinal ganglion cells. Parameters from the experimental data were used in an improved in silico model of ocular pharmacokinetics of FK962 in man. The mean concentration of FK962 in ocular tissues predicted by in silico modeling was consistent with in vivo results, validating the in silico model. FK962 rapidly penetrated into the anterior and posterior segments of the eye and then diffused into the vitreous body. The in silico pharmacokinetic modeling also predicted that a dose regimen of 0.0054% FK962 twice per day would produce biologically effective concentrations of FK962 in the choroid/retina, where FK962 facilitates rat neurite elongation. Our in silico model for ocular pharmacokinetics is useful (1) for predicting drug concentrations in specific ocular tissues after topical instillation, and (2) for suggesting the optimal dose regimens for eye drops. The pharmacodynamics for FK962 produced by this model may be useful for clinical trials against retinal neuropathy.

  14. Effects of Storage Temperature and Time on Stability of Serum Tacrolimus and Cyclosporine A Levels in Whole Blood by LC-MS/MS

    Directory of Open Access Journals (Sweden)

    İbrahim Kaplan

    2015-01-01

    Full Text Available Tacrolimus and cyclosporine A are immunosuppressant drugs with narrow therapeutic windows. The aim of this study was to investigate the stability of tacrolimus and cyclosporin A levels in whole blood samples under different storage conditions. Whole blood samples were obtained from 15 patients receiving tacrolimus and 15 patients receiving cyclosporine A. Samples were immediately analyzed and then stored at different conditions (room temperature (24°C−26°C for 24 hours, +4°C for 24 and 48 hours, and −20°C for one month and then analyzed again. For tacrolimus, there was a significant difference between samples analyzed immediately and those kept 24 hours at room temperature (P=0.005 (percent change 32.89%. However, there were no significant differences between the other groups. For cyclosporine A, there was a significant difference between samples analyzed immediately and those kept 24 hours (P=0.003 (percent change 19.47% and 48 hours (P=0.002 (percent change 15.38% at +4°C and those kept 24 hours at room temperature (P=0.011 (percent change 9.71%. Samples of tacrolimus should be analyzed immediately or stored at either +4°C or −20°C, while samples of cyclosporine A should be analyzed immediately or stored at −20°C.

  15. 15 year experience of tacrolimus application in medical practice

    Directory of Open Access Journals (Sweden)

    Y. S. Kondratyeva

    2016-01-01

    Full Text Available The review presents modern literature data on the use of tacrolimus in medical practice. The results of national and international research on the effectiveness and safety of the drug at various dermatoses are presented.

  16. Mechanisms of lower maintenance dose of tacrolimus in obese patients.

    Science.gov (United States)

    Sawamoto, Kazuki; Huong, Tran T; Sugimoto, Natsumi; Mizutani, Yuka; Sai, Yoshimichi; Miyamoto, Ken-ichi

    2014-01-01

    A retrospective analysis suggested that blood tacrolimus concentrations were consistent among patients with a body mass index (BMI) that was lean (maintenance dose of tacrolimus in patients with BMI ≥ 25 was significantly lower compared with that in patients with a BMI of less than 25. Lean and obese Zucker rats fed a normal diet were given tacrolimus intravenously or orally. The blood concentrations of tacrolimus in obese rats were significantly higher than those in lean rats after administration via both routes. The moment analysis has suggested that CLtot and Vdss of tacrolimus were not significantly different between lean and obese rats. The bioavailability was higher in obese rats, compared with that in lean rats. The protein expression of Cyp3a2 in the liver was significantly decreased in obese rats, compared with lean rats, while P-gp in the small intestine was also significantly decreased in obese rats. These results suggested that the steady-state trough concentration of tacrolimus in obese patients was well maintained by a relatively low dose compared with that in normal and lean patients, presumably due to increased bioavailability.

  17. Olmesartan Attenuates Tacrolimus-Induced Biochemical and Ultrastructural Changes in Rat Kidney Tissue

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    Naif O. Al-Harbi

    2014-01-01

    Full Text Available Tacrolimus, a calcineurin inhibitor, is clinically used as an immunosuppressive agent in organ transplantation, but its use is limited due to its marked nephrotoxicity. The present study investigated the effect of olmesartan (angiotensin receptor blocker on tacrolimus-induced nephrotoxicity in rats. A total of 24 rats were divided into four groups, which included control, tacrolimus, tacrolimus + olmesartan, and olmesartan groups. Tacrolimus-induced nephrotoxicity was assessed biochemically and histopathologically. Tacrolimus significantly increased BUN and creatinine level. Treatment with olmesartan reversed tacrolimus-induced changes in the biochemical markers (BUN and creatinine of nephrotoxicity. Tacrolimus significantly decreased GSH level and catalase activity while increasing MDA level. Olmesartan also attenuated the effects of tacrolimus on MDA, GSH, and catalase. In tacrolimus group histological examination showed marked changes in renal tubule, mitochondria, and podocyte processes. Histopathological and ultrastructural studies showed that treatment with olmesartan prevented tacrolimus-induced renal damage. These results suggest that olmesartan has protective effects on tacrolimus-induced nephrotoxicity, implying that RAS might be playing role in tacrolimus-induced nephrotoxicity.

  18. Test characteristics of two rapid antigen detection tests (SD FK50 and SD FK60 for the diagnosis of malaria in returned travellers

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    Van Esbroeck Marjan

    2009-05-01

    Full Text Available Abstract Background Two malaria rapid diagnostic tests were evaluated in a travel clinic setting: the SD FK50 Malaria Ag Plasmodium falciparum test (a two-band test and the SD FK60 Malaria Ag P. falciparum/Pan test (a three-band test. Methods A panel of stored whole blood samples (n = 452 and n = 614 for FK50 and FK60, respectively from returned travellers was used. The reference method was microscopy with PCR in case of discordant results. Results For both tests, overall sensitivity for the detection of P. falciparum was 93.5%, reaching 97.6% and 100% at parasite densities above 100 and 1,000/μl respectively. Overall sensitivities for Plasmodium vivax, Plasmodium ovale and Plasmodium malariae for the FK60 test were 87.5%, 76.3% and 45.2%, but they reached 92.6% and 90.5% for P. vivax and P. ovale at parasite densities above 500/μl. Specificities were above 95% for all species and both tests when corrected by PCR, with visible histidine-rich protein-2 lines for P. malariae (n = 3 and P. vivax and P. ovale (1 sample each. Line intensities were reproducible and correlated to parasite densities. The FK60 tests provided clues to estimate parasite densities for P. falciparum below or above 1,000/μl. Conclusion Both the FK50 and FK60 performed well for the diagnosis of P. falciparum in the present setting, and the FK60 for the diagnosis of P. vivax and P. ovale at parasite densities > 500/μl. The potential use of the FK60 as a semi-quantitative estimation of parasite density needs to be further explored.

  19. Effect of concomitant administration of nifedipine and tacrolimus on the development of gingival overgrowth in rats

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    Sheng-Yi Chen

    2015-03-01

    Conclusion: Gingival overgrowth could be induced either by nifedipine or by tacrolimus, although the extent of gingival overgrowth induced by tacrolimus would be less than that by nifedipine. However, a concomitant administration of nifedipine and tacrolimus did not aggravate the induced gingival overgrowth.

  20. Targeted Therapy for Acute Autoimmune Myocarditis with Nano-Sized Liposomal FK506 in Rats.

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    Keiji Okuda

    Full Text Available Immunosuppressive agents are used for the treatment of immune-mediated myocarditis; however, the need to develop a more effective therapeutic approach remains. Nano-sized liposomes may accumulate in and selectively deliver drugs to an inflammatory lesion with enhanced vascular permeability. The aims of this study were to investigate the distribution of liposomal FK506, an immunosuppressive drug encapsulated within liposomes, and the drug's effects on cardiac function in a rat experimental autoimmune myocarditis (EAM model. We prepared polyethylene glycol-modified liposomal FK506 (mean diameter: 109.5 ± 4.4 nm. We induced EAM by immunization with porcine myosin and assessed the tissue distribution of the nano-sized beads and liposomal FK506 in this model. After liposomal or free FK506 was administered on days 14 and 17 after immunization, the cytokine expression in the rat hearts along with the histological findings and hemodynamic parameters were determined on day 21. Ex vivo fluorescent imaging revealed that intravenously administered fluorescent-labeled nano-sized beads had accumulated in myocarditic but not normal hearts on day 14 after immunization and thereafter. Compared to the administration of free FK506, FK506 levels were increased in both the plasma and hearts of EAM rats when liposomal FK506 was administered. The administration of liposomal FK506 markedly suppressed the expression of cytokines, such as interferon-γ and tumor necrosis factor-α, and reduced inflammation and fibrosis in the myocardium on day 21 compared to free FK506. The administration of liposomal FK506 also markedly ameliorated cardiac dysfunction on day 21 compared to free FK506. Nano-sized liposomes may be a promising drug delivery system for targeting myocarditic hearts with cardioprotective agents.

  1. Targeted Therapy for Acute Autoimmune Myocarditis with Nano-Sized Liposomal FK506 in Rats.

    Science.gov (United States)

    Okuda, Keiji; Fu, Hai Ying; Matsuzaki, Takashi; Araki, Ryo; Tsuchida, Shota; Thanikachalam, Punniyakoti V; Fukuta, Tatsuya; Asai, Tomohiro; Yamato, Masaki; Sanada, Shoji; Asanuma, Hiroshi; Asano, Yoshihiro; Asakura, Masanori; Hanawa, Haruo; Hao, Hiroyuki; Oku, Naoto; Takashima, Seiji; Kitakaze, Masafumi; Sakata, Yasushi; Minamino, Tetsuo

    2016-01-01

    Immunosuppressive agents are used for the treatment of immune-mediated myocarditis; however, the need to develop a more effective therapeutic approach remains. Nano-sized liposomes may accumulate in and selectively deliver drugs to an inflammatory lesion with enhanced vascular permeability. The aims of this study were to investigate the distribution of liposomal FK506, an immunosuppressive drug encapsulated within liposomes, and the drug's effects on cardiac function in a rat experimental autoimmune myocarditis (EAM) model. We prepared polyethylene glycol-modified liposomal FK506 (mean diameter: 109.5 ± 4.4 nm). We induced EAM by immunization with porcine myosin and assessed the tissue distribution of the nano-sized beads and liposomal FK506 in this model. After liposomal or free FK506 was administered on days 14 and 17 after immunization, the cytokine expression in the rat hearts along with the histological findings and hemodynamic parameters were determined on day 21. Ex vivo fluorescent imaging revealed that intravenously administered fluorescent-labeled nano-sized beads had accumulated in myocarditic but not normal hearts on day 14 after immunization and thereafter. Compared to the administration of free FK506, FK506 levels were increased in both the plasma and hearts of EAM rats when liposomal FK506 was administered. The administration of liposomal FK506 markedly suppressed the expression of cytokines, such as interferon-γ and tumor necrosis factor-α, and reduced inflammation and fibrosis in the myocardium on day 21 compared to free FK506. The administration of liposomal FK506 also markedly ameliorated cardiac dysfunction on day 21 compared to free FK506. Nano-sized liposomes may be a promising drug delivery system for targeting myocarditic hearts with cardioprotective agents.

  2. Assessment of nerve regeneration across nerve allografts treated with tacrolimus.

    Science.gov (United States)

    Haisheng, Han; Songjie, Zuo; Xin, Li

    2008-01-01

    Although regeneration of nerve allotransplant is a major concern in the clinic, there have been few papers quantitatively assessing functional recovery of animals' nerve allografts in the long term. In this study, functional recovery, histopathological study, and immunohistochemistry changes of rat nerve allograft with FK506 were investigated up to 12 weeks without slaughtering. C57 and SD rats were used for transplantation. The donor's nerve was sliced and transplanted into the recipient. The sciatic nerve was epineurally sutured with 10-0 nylon. In total, 30 models of transplantation were performed and divided into 3 groups that were either treated with FK506 or not. Functional recovery of the grafted nerve was serially assessed by the pin click test, walking track analysis and electrophysiological evaluations. A histopathological study and immunohistochemistry study were done in the all of the models. Nerve allografts treated with FK506 have no immune rejection through 12 weeks. Sensibility had similarly improved in both isografts and allografts. There has been no difference in each graft. Walk track analysis demonstrates significant recovery of motor function of the nerve graft. No histological results of difference were found up to 12 weeks in each graft. In the rodent nerve graft model, FK506 prevented nerve allograft rejection across a major histocompatibility barrier. Sensory recovery seems to be superior to motor function. Nerve isograft and allograft treated with FK506 have no significant difference in function recovery, histopathological result, and immunohistochemistry changes.

  3. Tacrolimus inhibits the revascularization of isolated pancreatic islets.

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    Ryuichi Nishimura

    Full Text Available AIMS: Immunosuppressive drugs could be crucial factors for a poor outcome after islet allotransplantation. Unlike rapamycin, the effects of tacrolimus, the current standard immunosuppressant used in islet transplantation, on graft revascularization remain unclear. We examined the effects of tacrolimus on islet revascularization using a highly sensitive imaging system, and analyzed the gene expression in transplanted islets by introducing laser microdissection techniques. METHODS: Islets isolated from C57BL/6-Tg (CAG-EGFP mice were transplanted into the nonmetallic dorsal skinfold chamber on the recipients. Balb/c athymic mice were used as recipients and were divided into two groups: including a control group (n = 9 and tacrolimus-treated group (n = 7. The changes in the newly-formed vessels surrounding the islet grafts were imaged and semi-quantified using multi-photon laser-scanning microscopy and a Volocity system. Gene expression in transplanted islets was analyzed by the BioMark dynamic system. RESULTS: The revascularization process was completed within 14 days after pancreatic islet transplantation at subcutaneous sites. The newly-formed vascular volume surrounding the transplanted islets in the tacrolimus-treated group was significantly less than that in the control group (p<0.05. Although the expression of Vegfa (p<0.05 and Ccnd1 (p<0.05 was significantly upregulated in the tacrolimus-treated group compared with that of the control group, no differences were observed between the groups in terms of other types of gene expression. CONCLUSIONS: The present study demonstrates that tacrolimus inhibits the revascularization of isolated pancreatic islets without affecting the characteristics of the transplanted grafts. Further refinements of this immunosuppressive regimen, especially regarding the revascularization of islet grafts, could improve the outcome of islet allotransplantation.

  4. The Comparison of Efficacy of Adcortyl Ointment and Topical Tacrolimus in Treatment of Erosive Oral Lichen Planus

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    Arash Azizi

    2007-12-01

    Full Text Available

    Background and aims. Oral lichen planus (OLP is a common chronic mucocutaneous disease. Patients with atrophic and erosive lichen planus often have symptoms of soreness and need proper treatment. The main therapy of OLP has been the administration of topical or systemic corticosteroids. Potent topical corticosteroids have been increasingly prescribed in the treatment of erosive lichen planus. The purpose of this study was to compare the efficacy of adcortyl ointment (triamcinolone in orabase with topical tacrolimus for the treatment of erosive oral lichen planus.

    Materials and methods. Sixty Patients with histopathologically confirmed oral lichen planus were enrolled in the study. The severity of lesions was scored from 0 to 5 according to the criteria described in a previous study. Patients were randomly given adcortyl (group A and topical tacrolimus ointment (group B and asked to apply the medication on dried lesions 4 times a day. The lesions were evaluated after 4 weeks of treatment. Visual analogue scale was used to assess the severity of pain before and after treatment. The severity scores were analyzed using the Kruskal-Wallis k-sample test.

    Results. The average score of lesions improved from 3.4 to 1.5 in patients who received adcortyl ointment and from 3.2 to 1.2 in patients who received topical tacrolimus ointment. The differences between the improvements in scores were not statistically significant in the two groups. The average pain severity in A and B groups was 8.2 and 7.8 at the beginning of treatment, and 3.5 and 3.2 at the end of treatment, respectively. There was a statistically significant reduction in pain severity in both groups.

    Conclusion. Topical tacrolimus is a safe and effective alternative therapy in the treatment of oral lichen planus.

  5. Renal Tubular Acidosis Secondary to FK506 in Living Donor Liver Transplantation: A Case Report

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    Keiko Ogita

    2003-10-01

    Full Text Available FK506 is an immunosuppressant that is thought to be less nephrotoxic than cyclosporine A. However, complications due to renal tubular acidosis (RTA have recently been reported. We report a case of RTA secondary to FK506 administration in liver transplantation. A 6-month-old girl was treated with FK506 after undergoing living donor liver transplantation for fulminant hepatitis. On postoperative day 17, she demonstrated hyperkalaemia and metabolic acidosis; she was diagnosed to have hyperkalaemic distal RTA with aldosterone deficiency (type IV. Intravenous sodium bicarbonate and furosemide, and intrarectal calcium polystyrenesulfonate were administered to correct the acidosis and promote potassium secretion. Thereafter, the FK506 concentration in whole blood gradually decreased, and the hyperkalaemia and metabolic acidosis following RTA improved. RTA is one type of nephrotoxicity induced by FK506, and it is reversible in mild cases when appropriately treated. The mechanism of RTA induced by FK506 has not yet been clearly elucidated. Surgeons and physicians should therefore be aware of the potential for RTA to occur with FK506 after any organ transplantation. The treatment for acidosis and hyperkalaemia should be started as soon as RTA is diagnosed, and the dosage of FK506 should also be reduced if possible.

  6. Therapeutic equivalence and pharmacokinetics of generic tacrolimus formulation in de novo kidney transplant patients.

    Science.gov (United States)

    Min, Sang-Il; Ha, Jongwon; Kim, Yon Su; Ahn, Sang Hyun; Park, Taejin; Park, Dae Do; Kim, Suh Min; Min, Seung-Kee; Hong, Hyejin; Ahn, Curie; Kim, Sang Joon

    2013-12-01

    There is a growing concern about the therapeutic equivalence of the generic tacrolimus formulation (GEN Tacrolimus) to the reference tacrolimus (REF Tacrolimus) in solid organ transplantation. A prospective, randomized study of 126 de novo renal transplant patients was conducted to compare the efficacy, safety and pharmacokinetic (PK) profiles between GEN tacrolimus (n = 63) and REF tacrolimus (n = 63). The PK of tacrolimus was evaluated on Day 10 and 6 months under steady-state condition. Crossover study was carried out in 66 patients at 6 months. On Day 10, 117 patients completed PK profiles (54 GEN tacrolimus and 63 REF tacrolimus) and GEN tacrolimus showed comparable C(0) (9.8 ± 2.5 versus 9.7 ± 3.0 ng/mL, P = 0.80) but significantly higher dose-normalized C(max) (309.1 ± 191.9 versus 192.5 ± 95.2 ng/mL/mg/kg, P PK profiles evaluated at 9 months showed that generic substitution also resulted in an 'early and high C(max)'. Efficacy and safety data were comparable over the 9-month study period. Therapeutic equivalence and the PK of GEN tacrolimus should be evaluated in patients undergoing de novo renal transplantation.

  7. Topical tacrolimus solution in autoimmune polyglandular syndrome-1-associated keratitis.

    Science.gov (United States)

    Shoughy, Samir S; Tabbara, Khalid F

    2017-09-01

    To evaluate the efficacy of topical tacrloimus eye drops in the treatment of keratitis associated with autoimmune polyglandular syndrome (APS)-1. This is a retrospective review of 10 patients with APS-1. The patients were treated with topical tacrolimus 0.01% solution at The Eye Center, between 1 March 2012 and 30 April 2016. The outcome measures included improvement in visual acuity, photophobia and keratitis following treatment. Clinical assessment was carried out before, during and on the last visit following initiation of therapy. A total of 10 patients were included. There were five male and five female patients. The mean age was 11 years with age range of 3-42 years. The mean duration of treatment with topical tacrolimus was 26 months (range 8-46 months). There was improvement of photophobia in 7 out of 10 patients following therapy with topical tacrolimus. In three patients, the photophobia was persistent. There was no clinically detectable improvement in the severity of keratitis in all patients. The mean best corrected visual acuity was 0.1 before and following therapy. Topical tacrolimus is effective in reducing the photophobia in patients with APS-1-associated keratitis, but showed no effects on the severity of keratitis. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  8. Tacrolimus versus cyclosporin as primary immunosuppression for lung transplant recipients

    DEFF Research Database (Denmark)

    Penninga, Luit; Penninga, Ida Elisabeth Irene; Møller, Christian H

    2013-01-01

    Lung transplantation is a well-accepted treatment for people with most end-stage lung diseases. Although both tacrolimus and cyclosporin are used as primary immunosuppressive agents in lung transplant recipients, it is unclear which of these drugs is better in reducing rejection and death without...

  9. Atopic dermatitis: tacrolimus vs. topical corticosteroid use | Langa ...

    African Journals Online (AJOL)

    Despite this, the US Food and Drug Administration (FDA) black box warning of possible malignancies has resulted in much debate among experts. The main focus of this article is to compare the safety and efficacy of topical corticosteroids to calcineurin inhibitors, particularly tacrolimus. Furthermore, the aim is to evaluate ...

  10. Gut microbiota and tacrolimus dosing in kidney transplantation.

    Directory of Open Access Journals (Sweden)

    John R Lee

    Full Text Available Tacrolimus dosing to establish therapeutic levels in recipients of organ transplants is a challenging task because of much interpatient and intrapatient variability in drug absorption, metabolism, and disposition. In view of the reported impact of gut microbial species on drug metabolism, we investigated the relationship between the gut microbiota and tacrolimus dosing requirements in this pilot study of adult kidney transplant recipients. Serial fecal specimens were collected during the first month of transplantation from 19 kidney transplant recipients who either required a 50% increase from initial tacrolimus dosing during the first month of transplantation (Dose Escalation Group, n=5 or did not require such an increase (Dose Stable Group, n=14. We characterized bacterial composition in the fecal specimens by deep sequencing of the PCR amplified 16S rRNA V4-V5 region and we investigated the hypothesis that gut microbial composition is associated with tacrolimus dosing requirements. Initial tacrolimus dosing was similar in the Dose Escalation Group and in the Stable Group (4.2 ± 1.1 mg/day vs. 3.8 ± 0.8 mg/day, respectively, P=0.61, two-way between-group ANOVA using contrasts but became higher in the Dose Escalation Group than in the Dose Stable Group by the end of the first transplantation month (9.6 ± 2.4 mg/day vs. 3.3 ± 1.5 mg/day, respectively, P<0.001. Our systematic characterization of the gut microbial composition identified that fecal Faecalibacterium prausnitzii abundance in the first week of transplantation was 11.8% in the Dose Escalation Group and 0.8% in the Dose Stable Group (P=0.002, Wilcoxon Rank Sum test, P<0.05 after Benjamini-Hochberg correction for multiple hypotheses. Fecal Faecalibacterium prausnitzii abundance in the first week of transplantation was positively correlated with future tacrolimus dosing at 1 month (R=0.57, P=0.01 and had a coefficient ± standard error of 1.0 ± 0.6 (P=0.08 after multivariable linear

  11. Treatment of Sjögren's syndrome dry eye using 0.03% tacrolimus eye drop: Prospective double-blind randomized study.

    Science.gov (United States)

    Moscovici, Bernardo Kaplan; Holzchuh, Ricardo; Sakassegawa-Naves, Fernando Eiji; Hoshino-Ruiz, Diego Ricardo; Albers, Marcos Bottene Villa; Santo, Ruth Miyuki; Hida, Richard Yudi

    2015-10-01

    To describe the clinical efficacy of the treatment of Sjögren's syndrome dry eye using 0.03% tacrolimus eye drop. Prospective double-blind randomized study. Institutional outpatient clinic. Forty-eight eyes of twenty-four patients with dry eye related to Sjögren syndrome were enrolled in this study. The patients were randomized in 2 groups: tacrolimus (n=14) and vehicle (n=10) group. The tacrolimus group received a vial containing tacrolimus 0.03% (almond oil as vehicle) and the other group received the almond oil vehicle. All patients were instructed to use the eye drops every 12h in the lower conjunctival sac. Schirmer I test, break-up-time (BUT), corneal fluorescein and Rose Bengal staining scores were evaluated in all patients one day before the treatment (baseline), 7, 14, 28 and 90 days after treatment with the eye drops. The average fluorescein and Rose Bengal scores improved statistically after 7 days of treatment and even more after 90 days. The average Schirmer I and BUT values were unchanged after 7, 14 and 21 days but did show an improvement relative to baseline after 28 days of treatment. Schirmer I, BUT, fluorescein and Rose Bengal did not show any statistical significance in the vehicle group. Topical 0.03% tacrolimus eye drop improved tear stability and ocular surface status in cases of inflammatory or SS-related dry eye. ClinicalTrials.gov Identifier: NCT01850979. Copyright © 2015 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  12. The incidence of post-transplant cancer among kidney transplant recipients is associated with the level of tacrolimus exposure during the first year after transplantation.

    Science.gov (United States)

    Lichtenberg, Shelly; Rahamimov, Ruth; Green, Hefziba; Fox, Benjamin D; Mor, Eytan; Gafter, Uzi; Chagnac, Avry; Rozen-Zvi, Benaya

    2017-07-01

    Immunosuppressive therapy plays a major role in the development of post-transplant cancer. In this nested case-control study of kidney transplant recipients (KTRs), we investigated whether the incidence of post-transplant cancer is associated with the level of tacrolimus exposure over time. We screened the Rabin Medical Center database for adults who received kidney transplants between 2001 and 2014 and developed post-transplant cancer (excluding basal and squamous cell skin cancers). They were matched against KTRs without cancer. All patients received a maintenance immunosuppressive treatment with tacrolimus, mycophenolate mofetil and corticosteroids. The degree of exposure to tacrolimus was estimated as the time-weighted average (tTWA) value of tacrolimus blood levels. The tTWA was calculated as the area under the curve divided by time at 1, 6, and 12 months after transplantation and at time of cancer diagnosis. Thirty-two cases were matched against 64 controls. tTWA values above 11 ng/mL at 6 and 12 months after transplantation were associated with odds ratio (OR) of 3.1 (95% CI 1.1-9) and 11.7 (95% CI = 1.3-106), respectively, for post-transplant cancer; and with OR of 5.2 (95% CI 1.3-20.5) and 14.1 (95% CI = 1.5-134.3), respectively, for cancer diagnosed more than 3 years after transplantation. Exposure to a tacrolimus time-weighted average level above 11 ng/mL at 6 or 12 months after kidney transplantation is associated with an increased risk of developing cancer.

  13. Differential Antitumoral Properties and Renal-Associated Tissue Damage Induced by Tacrolimus and Mammalian Target of Rapamycin Inhibitors in Hepatocarcinoma: In Vitro and In Vivo Studies.

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    Elena Navarro-Villarán

    Full Text Available Orthotopic liver transplantation (OLT is the recommended treatment for patients at early stages of hepatocarcinoma (HCC with potential portal hypertension and/or bilirubinemia, but without vascular-associated diseases. The patients are receiving immunosuppressive therapy to reduce graft rejection, but differential side effects have been related to calcineurin and mTOR inhibitor administration regarding tumor recurrence and nephrotoxicity. The in vitro studies showed that Tacrolimus exerted a more potent pro-apoptotic effect than Everolimus (Huh 7>Hep 3B>HepG2, being sirolimus only active in Hep3B cell line. Tacrolimus and Everolimus exerted potent antiproliferative properties in Huh 7 and Hep3B in which cells Sirolimus was inactive. Interestingly, Tacrolimus- and Everolimus-dependent G0/G1 cell accumulation occurred as a consequence of drastic reduction in S, as well as in S and G2+M phases, respectively. The in vivo studies support data on the more effective antitumoral properties of Everolimus, eventual risk of pro-angiogenic tumoral properties and nephrotoxicity of Tacrolimus, and pro-proliferative properties of Sirolimus in tumors developed in nude mice.

  14. In vitro activity of FK037, a new parenteral cephalosporin, against anaerobic bacteria.

    Science.gov (United States)

    Kato, N; Kato, H; Tanaka, Y; Bando, K; Watanabe, K; Ueno, K

    1993-01-01

    The activity of FK037, a new parenteral cephalosporin, was compared with those of cefpirome, ceftazidime, and flomoxef against 322 recent clinical isolates of anaerobic bacteria. A fastidious facultative anaerobe, Gardnerella vaginalis, was also studied. FK037 inhibited 90% of isolates of Peptostreptococcus anaerobius, Peptostreptococcus asaccharolyticus, Clostridium perfringens, Mobiluncus spp., G. vaginalis, and Porphyromonas gingivalis at 200 micrograms/ml, respectively; the activity of FK037 was comparable to those of cefpirome and ceftazidime but lower than that of flomoxef. The activity of FK037 against Fusobacterium nucleatum, Fusobacterium varium, and Bilophila wadsworthia decreased when inoculum size was increased from 10(6) to 10(8) CFU/ml. Little influence of inoculum size on the activity of FK037 was observed for other isolates tested. Medium pH affected the activity of FK037 against F. varium (MICs at pHs 5 and 7, 3.13 and 100 micrograms/ml, respectively) and Bacteroides gracilis (MICs at pHs 5 and 7, 12.5 and 1.56 micrograms/ml, respectively) but not against other organisms tested. FK037 was less resistant than flomoxef to hydrolysis by beta-lactamase group 2e derived from B. fragilis GAI 0558 and GAI 10150. PMID:8517721

  15. Preparation of 0.05% FK506 suspension eyedrops and its pharmacokinetics after topical ocular administration.

    Science.gov (United States)

    Yuan, Jin; Zhai, Jia-jie; Chen, Jia-qi; Ye, Cheng-tian; Zhou, Shi-you

    2009-08-01

    To investigate the stability of FK506 eye suspension and its pharmacokinetics in rabbit aqueous humor, as well as its distribution in eye tissues. Sedimentation rate, flocculation value, redispersion time, rheological study, and accelerated experiment were determined for evaluating the stability of FK506 suspension. In a single-dose pharmacokinetic study, six rabbits were instilled a 25-microL drop of 0.05% FK506 suspension and aqueous humor samples were collected at different intervals after administration. In a multiple-dose pharmacokinetic study, a 25-microL drop of FK506 suspension was instilled into the right eye of six rabbits four times a day for 7 days. On the eighth day, aqueous humor samples were collected before the administration of the first, second, third dose, and at different checkpoints after the third dose. For tissue distribution study, six eyes per time points (18 rabbits in total) were treated with single dose of FK506 suspension, and the eyes were enucleated at 60, 100, and 240 min after treatment, then eye tissues were collected. The concentrations of FK506 in all samples were determined by LC-MS/MS. The preliminary results indicated that the stability of FK506 suspension was in accord with the standards of Chinese pharmacopoeia. The maximum concentrations of aqueous humor after single dose and multiple dose administrations were 31.40 +/- 9.32 ng/mL and 37.73 +/- 11.25 ng/mL, respectively. The concentration of FK506 in cornea at 60, 100, and 240 min after a single dose were 402.0 +/- 96.8 ng/g, 363.8 +/- 84.5 ng/g, and 220 +/- 62.3 ng/g, respectively. Determination of pharmacokinetic parameters of single-dose and multiple-dose administration, as well as the FK506 concentrations in eye tissues, showed that the FK506 formulation and the dosing regimen ensured the therapeutic concentration of FK506 for treating corneal allograft rejection. Based on the stability, single-dose and multiple-dose pharmacokinetics, and tissue distribution, FK506

  16. Tacrolimus in the treatment of myasthenia gravis in patients with an inadequate response to glucocorticoid therapy: randomized, double-blind, placebo-controlled study conducted in China.

    Science.gov (United States)

    Zhou, Lei; Liu, Weibin; Li, Wei; Li, Haifeng; Zhang, Xu; Shang, Huifang; Zhang, Xu; Bu, Bitao; Deng, Hui; Fang, Qi; Li, Jimei; Zhang, Hua; Song, Zhi; Ou, Changyi; Yan, Chuanzhu; Liu, Tao; Zhou, Hongyu; Bao, Jianhong; Lu, Jiahong; Shi, Huawei; Zhao, Chongbo

    2017-09-01

    To determine the efficacy of low-dose, immediate-release tacrolimus in patients with myasthenia gravis (MG) with inadequate response to glucocorticoid therapy in a randomized, double-blind, placebo-controlled study. Eligible patients had inadequate response to glucocorticoids (GCs) after ⩾6 weeks of treatment with prednisone ⩾0.75 mg/kg/day or 60-100 mg/day. Patients were randomized to receive 3 mg tacrolimus or placebo daily (orally) for 24 weeks. Concomitant glucocorticoids and pyridostigmine were allowed. Patients continued GC therapy from weeks 1-4; from week 5, the dose was decreased at the discretion of the investigator. The primary efficacy outcome measure was a reduction, relative to baseline, in quantitative myasthenia gravis (QMG) score assessed using a generalized linear model; supportive analyses used alternative models. Of 138 patients screened, 83 [tacrolimus ( n = 45); placebo ( n = 38)] were enrolled and treated. The change in adjusted mean QMG score from baseline to week 24 was -4.9 for tacrolimus and -3.3 for placebo (least squares mean difference: -1.7, 95% confidence interval: -3.5, -0.1; p = 0.067). A post-hoc analysis demonstrated a statistically significant difference for QMG score reduction of ⩾4 points in the tacrolimus group (68.2%) versus the placebo group (44.7%; p = 0.044). Adverse event profiles were similar between treatment groups. Tacrolimus 3 mg treatment for patients with MG and inadequate response to GCs did not demonstrate a statistically significant improvement in the primary endpoint versus placebo over 24 weeks; however, a post-hoc analysis demonstrated a statistically significant difference for QMG score reduction of ⩾4 points in the tacrolimus group versus the placebo group. This study was limited by the low number of patients, the absence of testing for acetylcholine receptor antibody and the absence of stratification by disease duration (which led to a disparity between the two groups). Clinical

  17. Efficacy and safety of tacrolimus treatment for rheumatoid arthritis patients undergoing hemodialysis.

    Science.gov (United States)

    Yamashita, Misuzu; Natsumeda, Masamitsu; Takasugi, Koji; Ueno, Akiko; Ezawa, Kayo; Ezawa, Kazuhiko

    2008-01-01

    Rheumatoid arthritis (RA) is an autoimmune disorder characterized by progressive joint destruction that requires aggressive treatment using appropriate disease-modifying antirheumatic drugs (DMARDs). RA patients with renal failure, however, are intolerant to most DMARDs due to the potential toxicity. In Japan, tacrolimus was approved for the treatment of RA in 2005. Based on its pharmacokinetics, tacrolimus may be administered to the patients undergoing hemodialysis. We report two cases of RA patients on hemodialysis treated effectively and safely with tacrolimus.

  18. Tacrolimus in preventing transplant rejection in Chinese patients – optimizing use

    Directory of Open Access Journals (Sweden)

    Li CJ

    2015-01-01

    Full Text Available Chuan-Jiang Li,1,* Liang Li2,* 1Department of Surgery, Nanfang Hospital, 2Department of Medical Genetics, School of Basic Medical Sciences, Southern Medical University, Guangzhou, People’s Republic of China *The authors contributed equally to this work Abstract: Tacrolimus is a product of fermentation of Streptomyces, and belongs to the family of calcineurin inhibitors. It is a widely used immunosuppressive drug for preventing solid-organ transplant rejection. Compared to cyclosporine, tacrolimus has greater immunosuppressive potency and a lower incidence of side effects. It has been accepted as first-line treatment after liver and kidney transplantation. Tacrolimus has specific features in Chinese transplant patients; its in vivo pharmacokinetics, treatment regimen, dose and administration, and adverse-effect profile are influenced by multiple factors, such as genetics and the spectrum of primary diseases in the Chinese population. We reviewed the clinical experience of tacrolimus use in Chinese liver- and kidney-transplant patients, including the pharmacology of tacrolimus, the immunosuppressive effects of tacrolimus versus cyclosporine, effects of different factors on tacrolimus metabolism on Chinese patients, personalized medicine, clinical safety profile, and patient satisfaction and adherence. This article provides guidance for the rational and efficient use of tacrolimus in Chinese organ-transplant patients. Keywords: tacrolimus, liver transplantation, kidney transplant, Chinese, personalized medicine

  19. Effects of tacrolimus on action potential configuration and transmembrane ion currents in canine ventricular cells.

    Science.gov (United States)

    Szabó, László; Szentandrássy, Norbert; Kistamás, Kornél; Hegyi, Bence; Ruzsnavszky, Ferenc; Váczi, Krisztina; Horváth, Balázs; Magyar, János; Bányász, Tamás; Pál, Balázs; Nánási, Péter P

    2013-03-01

    Tacrolimus is a commonly used immunosuppressive agent which causes cardiovascular complications, e.g., hypertension and hypertrophic cardiomyopathy. In spite of it, there is little information on the cellular cardiac effects of the immunosuppressive agent tacrolimus in larger mammals. In the present study, therefore, the concentration-dependent effects of tacrolimus on action potential morphology and the underlying ion currents were studied in canine ventricular cardiomyocytes. Standard microelectrode, conventional whole cell patch clamp, and action potential voltage clamp techniques were applied in myocytes enzymatically dispersed from canine ventricular myocardium. Tacrolimus (3-30 μM) caused a concentration-dependent reduction of maximum velocity of depolarization and repolarization, action potential amplitude, phase-1 repolarization, action potential duration, and plateau potential, while no significant change in the resting membrane potential was observed. Conventional voltage clamp experiments revealed that tacrolimus concentrations ≥3 μM blocked a variety of ion currents, including I(Ca), I(to), I(K1), I(Kr), and I(Ks). Similar results were obtained under action potential voltage clamp conditions. These effects of tacrolimus developed rapidly and were fully reversible upon washout. The blockade of inward currents with the concomitant shortening of action potential duration in canine myocytes is the opposite of those observed previously with tacrolimus in small rodents. It is concluded that although tacrolimus blocks several ion channels at higher concentrations, there is no risk of direct interaction with cardiac ion channels when applying tacrolimus in therapeutic concentrations.

  20. Relative bioavailability of single doses of prolonged-release tacrolimus administered as a suspension, orally or via a nasogastric tube, compared with intact capsules: a phase 1 study in healthy participants.

    Science.gov (United States)

    Undre, Nasrullah; Dickinson, James

    2017-04-04

    Tacrolimus, an immunosuppressant widely used in solid organ transplantation, is available as a prolonged-release capsule for once-daily oral administration. In the immediate postsurgical period, if patients cannot take intact capsules orally, tacrolimus therapy is often initiated as a suspension of the capsule contents, delivered orally or via a nasogastric tube. This study evaluated the relative bioavailability of prolonged-release tacrolimus suspension versus intact capsules in healthy participants. A phase 1, open-label, single-dose, cross-over study. A single clinical research unit. In total, 20 male participants, 18-55 years old, entered and completed the study. All participants received nasogastric administration of tacrolimus 10 mg suspension in treatment period 1, with randomisation to oral administration of suspension or intact capsules in periods 2 and 3. Blood concentration-time profile over 144 hours was used to estimate pharmacokinetic parameters. Primary end point: relative bioavailability of prolonged-release intact capsule versus oral or nasogastric administration of prolonged-release tacrolimus suspension (area under the concentration-time curve (AUC) from time 0 to infinity post-tacrolimus dose (AUC 0-∞ ); AUC measured until the last quantifiable concentration (AUC 0-tz ); maximum observed concentration (C max ); time to C max (T max )). Tolerability was assessed throughout the study. Relative bioavailability of prolonged-release tacrolimus suspension administered orally was similar to intact capsules, with a ratio of least-square means for AUC 0-tz and AUC 0-∞ of 1.05 (90% CI 0.96 to 1.14). Bioavailability was lower with suspension administered via a nasogastric tube versus intact capsules (17%; ratio 0.83; CI 0.76 to 0.92). C max was higher for oral and nasogastric suspension (30% and 28%, respectively), and median T max was shorter (difference 1.0 and 1.5 hours postdose, respectively) versus intact capsules (2.0 hours). Single 10

  1. A case of tacrolimus-induced encephalopathy after kidney transplantation

    Directory of Open Access Journals (Sweden)

    Myoung Uk Kim

    2011-01-01

    Full Text Available We present a case of tacrolimus-induced encephalopathy after successful kidney transplantation. An 11-year-old girl presented with sudden onset of neurologic symptoms, hypertension, and psychiatric symptoms, with normal kidney function, after kidney transplantation. The symptoms improved after cessation of tacrolimus. Magnetic resonance imaging (MRI showed acute infarction of the middle cerebral artery (MCA territory in the right frontal lobe. Three days later, she had normal mental function and maintained normal blood pressure with left hemiparesis. Follow-up MRI was performed on D19, showing new infarct lesions at both cerebral hemispheres. Ten days later, MRI showed further improvement, but brain single photon emission computed tomography (SPECT showed mild reduction of uptake in both the anterior cingulate gyrus and the left thalamus. One month after onset of symptoms, angiography showed complete resolution of stenosis. However, presenting as a mild fine motor disability of both hands and mild dysarthria, what had been atrophy at both centrum semiovale at 4 months now showed progression to encephalomalacia. There are two points of interest in this case. First, encephalopathy occurred after administration of tacrolimus and improved after discontinuation of the drug. Second, the development of right-side hemiplegia could not be explained by conventional MRI; but through diffusion tensor imaging (DTI and diffusion tensor tractography (DTT of white matter tract, visualization was possible.

  2. Tacrolimus treatment of atopic eczema/dermatitis syndrome.

    Science.gov (United States)

    Thestrup-Pedersen, Kristian

    2003-10-01

    Atopic dermatitis is today the most common chronic disease of children in Europe, the US and Japan. The 'golden standard' of therapy is topical glucocorticosteroids and emollients. The steroids have been on the market for four decades, are efficacious, but only advised for short-term treatment due to their risks of side effects. More than 16,000 persons suffering from atopic dermatitis have been enrolled in clinical studies of tacrolimus. One third of patients with moderate to severe atopic dermatitis experience over 90% improvement in their disease over a 12-week treatment period and up to 70% of patients have over 50% improvement. A 1-year treatment leads to more than 90% improvement in 75% of patients. The most pronounced side effect is a burning sensation occurring in up to 60% of patients. Atopic dermatitis is a chronic skin disease leading to a demand for long-term treatment control. Such treatment options have not previously been available--except for emollients which are not efficacious for controlling skin inflammation. Tacrolimus and pimecrolimus are new treatment options, free from the potential side effects of topical steroids, which are known for their efficacy in short-term treatment. The new treatment modalities prevent the eczema from relapsing and at the same time they control active eczema. The future will see a shift towards the long-term use of tacrolimus which is able to control the skin inflammation and, hopefully, shorten the course of the eczema.

  3. Tacrolimus is a class II low-solubility high-permeability drug: the effect of P-glycoprotein efflux on regional permeability of tacrolimus in rats.

    Science.gov (United States)

    Tamura, Shigeki; Ohike, Atsuo; Ibuki, Rinta; Amidon, Gordon L; Yamashita, Shinji

    2002-03-01

    The objective of this study is to investigate the role of P-glycoprotein (P-gp), a membrane efflux pump associated with multidrug resistance (MDR) and a known substrate for tacrolimus, in determining the regional intestinal permeability of tacrolimus in rats. Thus, isolated segments of rat jejunum, ileum, or colon were perfused with tacrolimus solutions containing polyethoxylated hydrogenated castor oil 60 surfactant, and with or without verapamil, a P-gp substrate used to reverse the MDR phenotype. The results indicated that the intrinsic permeability of tacrolimus in the jejunum, calculated on the basis of the concentration of non-micellized free tacrolimus, was quite high ( approximately 1.4 x 10(-4) cm/s). The apparent permeability (P(app)) in the jejunum was unaffected by the presence of verapamil; however, the P(app) in the ileum and the colon increased significantly in the presence of verapamil and were similar to the values observed in the jejunum. The results suggest that systemic absorption of tacrolimus from the gastrointestinal tract could be significantly affected by P-gp efflux mechanisms. It is also possible that differences in P-gp function at various intestinal sites in a subject or at a given intestinal site in various subjects could lead to large intra- and interindividual variability in bioavailability of tacrolimus following oral administration. Copyright 2002 Wiley-Liss, Inc. and the American Pharmaceutical Association .

  4. Action of tacrolimus on Wistar rat kidneys implanted with Walker 256 carcinosarcoma Estudo da ação do tacrolimus em rins de ratos Wistar implantados com carcinossarcoma de Walker

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    Cristiano Machado Inácio

    2010-02-01

    Full Text Available PURPOSE: To evaluate the development of Walker 256 tumor in male Wistar rats treated with tacrolimus using an experimental kidney tumor model. METHODS: 40 male Wistar rats were divided into four groups: Tumor group (TU (n=10, Tacrolimus-Tumor group (TT (n=10, Tacrolimus group (TC (n=10 and Control group (C (n=10. Treatment with tacrolimus was performed in groups TT and TC. Under anesthesia, the right kidney of each animal of TU and TT was accessed through a supraumbilical incision and inoculated with a 0.1mL solution containing 2x10(6 tumor cells (Walker 256 carcinosarcoma tumor cells. Group TC was treated with a saline solution. All the animals of groups TC and TT were treated with tacrolimus (5mg/kg/day by gavage for 15 days. TU group animals received saline by gavage for 15 days. On the 15th postoperative day, all animals were submitted to euthanasia and blood sampling for analysis of serum creatinine (Cr and blood urea nitrogen (BUN. Abdominal gross examination was performed, the right kidney removed and prepared for histological analysis by hematoxylin-eosin staining. The resulting data were submitted to statistical analysis by ANOVA. RESULTS: Statistical significance was found when comparing creatinine level between groups TU, TT and TC -TT group culminated with a marked increased in creatinine levels (Cr=1.013 ± 0.3028 mg/mL, TU group (Cr=0.5670 ± 0.03536 mg/dL P=0.00256, TC group (Cr =0.711 ± 0.1653 mg/mL P= 0.02832. Statistical significance was found when comparing BUN levels in TT group (71.32 ± 17.14 mg/mL, compared with TU group (45.83 ± 5.046 mg/dL, P=0.000318. There were no statistically significant differences between groups TT and TC (61.23 ± 9.503 mg/mL P=0.7242. Histological analysis showed a poor evolution in TT group with multiple foci of hemorrhage and cortical invasion by the Walker tumor. CONCLUSION: The Tacrolimus-treated group developed a more aggressive tumor and a drug-related nephrotoxic effect.OBJETIVO: Avaliar

  5. EPRL/FK asymptotics and the flatness problem

    Science.gov (United States)

    Oliveira, José Ricardo

    2018-05-01

    Spin foam models are an approach to quantum gravity based on the concept of sum over states, which aims to describe quantum spacetime dynamics in a way that its parent framework, loop quantum gravity, has not as of yet succeeded. Since these models’ relation to classical Einstein gravity is not explicit, an important test of their viabilitiy is the study of asymptotics—the classical theory should be obtained in a limit where quantum effects are negligible, taken to be the limit of large triangle areas in a triangulated manifold with boundary. In this paper we will briefly introduce the EPRL/FK spin foam model and known results about its asymptotics, proceeding then to describe a practical computation of spin foam and semiclassical geometric data for a simple triangulation with only one interior triangle. The results are used to comment on the ‘flatness problem’—a hypothesis raised by Bonzom (2009 Phys. Rev. D 80 064028) suggesting that EPRL/FK’s classical limit only describes flat geometries in vacuum.

  6. Systematic Review and Meta-Analysis of Tacrolimus versus Ciclosporin as Primary Immunosuppression After Liver Transplant.

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    Gorden Muduma

    Full Text Available Several meta-analyses comparing ciclosporin with tacrolimus have been conducted since the 1994 publication of the tacrolimus registration trials, but most captured data from randomized controlled trials (RCTs predating recent improvements in waiting list prioritization, induction protocols and concomitant medications. The present study comprised a systematic review and meta-analysis of ciclosporin and tacrolimus in liver transplant recipients using studies published since January 2000.Searches of PubMed, the Cochrane Library and EMBASE identified RCTs of tacrolimus and ciclosporin as the immunosuppressant in adult primary liver transplant recipients, published between January 2000 and August 6, 2014. A random effects meta-analysis was conducted to evaluate the relative risk of death, graft loss, acute rejection (AR, new-onset diabetes after transplantation (NODAT and hypertension with tacrolimus relative to ciclosporin at 12 months.The literature search identified 11 RCTs comparing ciclosporin with tacrolimus. Relative to ciclosporin, tacrolimus was associated with significantly improved outcomes in terms of patient mortality (risk ratio [RR] with ciclosporin of 1.26; 95% confidence interval [95%CI] 1.01-1.58. Tacrolimus was superior to ciclosporin in terms of hypertension (RR with ciclosporin 1.26; 95%CI 1.07-1.47, but inferior in terms of NODAT (RR with ciclosporin 0.60; 95%CI 0.47-0.77. There were no significant differences between ciclosporin and tacrolimus in terms of graft loss or AR.Meta-analysis of RCTs published since 2000 showed tacrolimus to be superior to ciclosporin in terms of patient mortality and hypertension, while ciclosporin was superior in terms of NODAT. No significant differences were identified in terms of graft loss or AR. These findings provide further evidence supporting the use of tacrolimus as the cornerstone of immunosuppressive therapy in liver transplant recipients.

  7. Effect of Topical Tacrolimus on Vitiligo in Children

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    Mohammed Ziaur Rahman Bhuiyan

    2016-01-01

    Full Text Available Background: Considering safe treatment modalities for children with vitiligo, search for newer therapeutic agents continues. Hence, new immunomodulatory agents such as calcineurinantagonists, frequently referred to as topical immunomodulators (TIMs have recently been introduced as new promising tools to treat acquired hypopigmentary disorders. Tacrolimus is safe in treating children due to lack of skin atrophy and less data are available on effect of topical tacrolimus on vitiligo. Objective: To see the effect of topical tacrolimus on vitiligo in children. Materials and Methods: This prospective study was done in outpatient department of Dermatology and Venereology, Chittagong Medical College Hospital (CMCH, Bangladesh. Clinically diagnosed vitiligo patients of up to 12 years age visiting Skin & VD OPD, CMCH during study period were the study population (total 30. The study was carried out from November 2007 to April 2008. Results: A total of 30 patients, 13 (43.33% males and 17 (56.66% females with focal, segmental or generalized vitiligo were studied. Seventy percent of study subjects were from 7–12 years of age. Topical tacrolimus 0.03% ointment was administered twice daily for 12 weeks to each patient. Repigmentation was complete (>75% in 43.33% cases (13/30, was moderate (50–75% in 33.33% (10/30, mild (<50% in 13.33% (4/30. Clinical adverse effects were noted in 6.67% (2/30 of cases where pruritus was in 3.33% (1/30 and burning in 3.33% (1/30. None of the reactions was severe, all were mild and well-tolerated and most occurred within the first month of initiation of treatment and resolved with continued use of drug and completely cured after the treatment completed. Nobody had to discontinue the therapy for side effects. Conclusion: In conclusion, tacrolimus ointment may be a rapidly efficacious and safe option for the treatment of vitiligo in children. The ease of topical self-administration with minimal side effects makes this novel

  8. FK866-induced NAMPT inhibition activates AMPK and downregulates mTOR signaling in hepatocarcinoma cells

    Energy Technology Data Exchange (ETDEWEB)

    Schuster, Susanne, E-mail: Susanne.Schuster@medizin.uni-leipzig.de [Center for Pediatric Research Leipzig, University Hospital for Children and Adolescents, Faculty of Medicine, University of Leipzig, Liebigstr. 21, 04103 Leipzig (Germany); Penke, Melanie; Gorski, Theresa [Center for Pediatric Research Leipzig, University Hospital for Children and Adolescents, Faculty of Medicine, University of Leipzig, Liebigstr. 21, 04103 Leipzig (Germany); Gebhardt, Rolf [Institute of Biochemistry, Faculty of Medicine, University of Leipzig, Johannisallee 30, 04103 Leipzig (Germany); Weiss, Thomas S. [Children' s University Hospital, University of Regensburg, Franz-Josef-Strauss-Allee 11, 93053 Regensburg (Germany); Kiess, Wieland; Garten, Antje [Center for Pediatric Research Leipzig, University Hospital for Children and Adolescents, Faculty of Medicine, University of Leipzig, Liebigstr. 21, 04103 Leipzig (Germany)

    2015-03-06

    Background: Nicotinamide phosphoribosyltransferase (NAMPT) is the key enzyme of the NAD salvage pathway starting from nicotinamide. Cancer cells have an increased demand for NAD due to their high proliferation and DNA repair rate. Consequently, NAMPT is considered as a putative target for anti-cancer therapies. There is evidence that AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (mTOR) become dysregulated during the development of hepatocellular carcinoma (HCC). Here, we investigated the effects of NAMPT inhibition by its specific inhibitor FK866 on the viability of hepatocarcinoma cells and analyzed the effects of FK866 on the nutrient sensor AMPK and mTOR complex1 (mTORC1) signaling. Results: FK866 markedly decreased NAMPT activity and NAD content in hepatocarcinoma cells (Huh7 cells, Hep3B cells) and led to delayed ATP reduction which was associated with increased cell death. These effects could be abrogated by administration of nicotinamide mononucleotide (NMN), the enzyme product of NAMPT. Our results demonstrated a dysregulation of the AMPK/mTOR pathway in hepatocarcinoma cells compared to non-cancerous hepatocytes with a higher expression of mTOR and a lower AMPKα activation in hepatocarcinoma cells. We found that NAMPT inhibition by FK866 significantly activated AMPKα and inhibited the activation of mTOR and its downstream targets p70S6 kinase and 4E-BP1 in hepatocarcinoma cells. Non-cancerous hepatocytes were less sensitive to FK866 and did not show changes in AMPK/mTOR signaling after FK866 treatment. Conclusion: Taken together, these findings reveal an important role of the NAMPT-mediated NAD salvage pathway in the energy homeostasis of hepatocarcinoma cells and suggest NAMPT inhibition as a potential treatment option for HCC. - Highlights: • FK866 increases cell death in p53-deficient hepatocarcinoma cells. • AMPK/mTOR signaling is dysregulated in hepatocarcinoma cells. • FK866-induced NAMPT inhibition activates AMPK

  9. FK866-induced NAMPT inhibition activates AMPK and downregulates mTOR signaling in hepatocarcinoma cells

    International Nuclear Information System (INIS)

    Schuster, Susanne; Penke, Melanie; Gorski, Theresa; Gebhardt, Rolf; Weiss, Thomas S.; Kiess, Wieland; Garten, Antje

    2015-01-01

    Background: Nicotinamide phosphoribosyltransferase (NAMPT) is the key enzyme of the NAD salvage pathway starting from nicotinamide. Cancer cells have an increased demand for NAD due to their high proliferation and DNA repair rate. Consequently, NAMPT is considered as a putative target for anti-cancer therapies. There is evidence that AMP-activated protein kinase (AMPK) and mammalian target of rapamycin (mTOR) become dysregulated during the development of hepatocellular carcinoma (HCC). Here, we investigated the effects of NAMPT inhibition by its specific inhibitor FK866 on the viability of hepatocarcinoma cells and analyzed the effects of FK866 on the nutrient sensor AMPK and mTOR complex1 (mTORC1) signaling. Results: FK866 markedly decreased NAMPT activity and NAD content in hepatocarcinoma cells (Huh7 cells, Hep3B cells) and led to delayed ATP reduction which was associated with increased cell death. These effects could be abrogated by administration of nicotinamide mononucleotide (NMN), the enzyme product of NAMPT. Our results demonstrated a dysregulation of the AMPK/mTOR pathway in hepatocarcinoma cells compared to non-cancerous hepatocytes with a higher expression of mTOR and a lower AMPKα activation in hepatocarcinoma cells. We found that NAMPT inhibition by FK866 significantly activated AMPKα and inhibited the activation of mTOR and its downstream targets p70S6 kinase and 4E-BP1 in hepatocarcinoma cells. Non-cancerous hepatocytes were less sensitive to FK866 and did not show changes in AMPK/mTOR signaling after FK866 treatment. Conclusion: Taken together, these findings reveal an important role of the NAMPT-mediated NAD salvage pathway in the energy homeostasis of hepatocarcinoma cells and suggest NAMPT inhibition as a potential treatment option for HCC. - Highlights: • FK866 increases cell death in p53-deficient hepatocarcinoma cells. • AMPK/mTOR signaling is dysregulated in hepatocarcinoma cells. • FK866-induced NAMPT inhibition activates AMPK

  10. Local Tacrolimus (FK506) Delivery for Prevention of Acute Rejection in the Nonhuman Primate Delayed Mixed Chimerism Vascularized Composite Allograft Tolerance Induction Protocol

    Science.gov (United States)

    2016-10-01

    diligently to overcome the delays caused by contractual issues and personnel changes. To this end, the Rutgers Team requests the addition of 6 months to...Carmine Iovine Scientist 1.90 Worked on Polymer design, synthesis & experimental design Ritu Goyal Post-doc 0.90 Worked on drug encapsulation

  11. Different Influences on Tacrolimus Pharmacokinetics by Coadministrations of Zhi Ke and Zhi Shi in Rats

    Directory of Open Access Journals (Sweden)

    Shiuan-Pey Lin

    2011-01-01

    Full Text Available Tacrolimus, an immunosuppressant with narrow therapeutic window, has been used widely in transplant patients. Grapefruit juice and pomelo have been reported to increase the blood levels of tacrolimus. Zhi Ke and Zhi Shi, the ripe peels and unripe fruits of Citrus aurantium which is chemotaxonomically related to grapefruit and pomelo, are in wide use in clinical Chinese medicine. To investigate the possible interaction of these two Citrus herbs with tacrolimus, male Sprague-Dawley rats were orally given tacrolimus (1.5 mg/kg with and without Zhi Ke and Zhi Shi decoctions in a cross-over design. Blood samples were withdrawn via cardiopuncture at specific time and quantitated by a microparticle enzyme immunoassay. In addition, to explore the mechanism of interaction, LS 180 cell line was used for the transport study of rhodamine 123, a typical substrate of P-glycoprotein (P-gp. The results showed that Zhi Shi significantly decreased the Cmax⁡ and AUC0-t of tacrolimus by 72.4% and 72.0%, respectively, whereas Zhi Ke did not affect tacrolimus pharmacokinetics. LS 180 cell line study indicated that Zhi Shi increased the efflux activity of P-gp, enabling us to explain the decreased oral bioavailability of tacrolimus caused by Zhi Shi. Hence, we suggest that Zhi Shi be contraindicated for transplant patients treated with tacrolimus to reduce the risk of allograft rejection.

  12. Treatment of Acute Tacrolimus Toxicity with Phenytoin in Solid Organ Transplant Recipients

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    Arin S. Jantz

    2013-01-01

    Full Text Available The pharmacokinetics of tacrolimus are influenced by many factors, including genetic variability, acute infections, liver dysfunction, and interacting medications, which can result in elevated concentrations. The most appropriate management of acute tacrolimus toxicity has not been defined though case reports exist describing the therapeutic use of enzyme inducers to increase tacrolimus metabolism and decrease concentrations. We are reporting on the utilization of phenytoin to assist in decreasing tacrolimus concentrations in a case series of four solid organ transplant recipients with acute, symptomatic tacrolimus toxicity presenting with elevated serum creatinine, potassium, and tacrolimus trough concentrations greater than 30 ng/mL. All four patients had the potential causative agents stopped or temporarily held and were given 300 to 400 mg/day of phenytoin for two to three days. Within three days of beginning phenytoin, all four patients had a decrease in tacrolimus concentration to less than 15 ng/mL, a return to or near baseline creatinine concentration, and lack of phenytoin-related side effects. Therefore, phenytoin appears to be a safe and potentially beneficial treatment option in patients with symptomatic tacrolimus toxicity.

  13. Different Influences on Tacrolimus Pharmacokinetics by Coadministrations of Zhi Ke and Zhi Shi in Rats

    Science.gov (United States)

    Lin, Shiuan-Pey; Wu, Ping-Ping; Hou, Yu-Chi; Tsai, Shang-Yuan; Wang, Meng-Ju; Fang, Shih-Hua; Chao, Pei-Dawn Lee

    2011-01-01

    Tacrolimus, an immunosuppressant with narrow therapeutic window, has been used widely in transplant patients. Grapefruit juice and pomelo have been reported to increase the blood levels of tacrolimus. Zhi Ke and Zhi Shi, the ripe peels and unripe fruits of Citrus aurantium which is chemotaxonomically related to grapefruit and pomelo, are in wide use in clinical Chinese medicine. To investigate the possible interaction of these two Citrus herbs with tacrolimus, male Sprague-Dawley rats were orally given tacrolimus (1.5 mg/kg) with and without Zhi Ke and Zhi Shi decoctions in a cross-over design. Blood samples were withdrawn via cardiopuncture at specific time and quantitated by a microparticle enzyme immunoassay. In addition, to explore the mechanism of interaction, LS 180 cell line was used for the transport study of rhodamine 123, a typical substrate of P-glycoprotein (P-gp). The results showed that Zhi Shi significantly decreased the C max and AUC0−t of tacrolimus by 72.4% and 72.0%, respectively, whereas Zhi Ke did not affect tacrolimus pharmacokinetics. LS 180 cell line study indicated that Zhi Shi increased the efflux activity of P-gp, enabling us to explain the decreased oral bioavailability of tacrolimus caused by Zhi Shi. Hence, we suggest that Zhi Shi be contraindicated for transplant patients treated with tacrolimus to reduce the risk of allograft rejection. PMID:21318106

  14. Topical tacrolimus in combination with simulated solar radiation does not enhance photocarcinogenesis in hairless mice

    DEFF Research Database (Denmark)

    Lerche, C.M.; Philipsen, P.A.; Poulsen, T.

    2008-01-01

    tacrolimus ointment on squamous cell carcinoma formation in hairless female C3.Cg/TifBomTac immunocompetent mice exposed to solar simulated radiation (SSR). In a first experiment, mice (n = 200) had tacrolimus applied on their dorsal skin three times weekly followed by SSR (2, 4 or 6 standard erythema doses...

  15. Tacrolimus-related hypertrophic cardiomyopathy in an adult cardiac transplant patient

    Institute of Scientific and Technical Information of China (English)

    LIU Tong; DONG Jian-zeng; GAO Yun; GAO Yu-long; CHENG Yu-tong; WANG Su; LI Zhi-zhong; ZHANG Hai-bo; MENG Xu; MA Chang-sheng

    2012-01-01

    Left ventricular hypertrophy associated with the use of tacrolimus is a rare complication of solid organ transplantation in adult recipients.We present a cardiac transplant recipient who developed severe concentric left ventricular hypertrophy with congestive heart failure related to myocardial hypertrophy on tacrolimus.Hypertrophy improved when the drug was discontinued and replaced with sirolimus.

  16. The Pharmacogenetics of Tacrolimus in Corticosteroid-Sparse Pediatric and Adult Kidney Transplant Recipients

    DEFF Research Database (Denmark)

    Juul Madsen, Mads; Bergmann, Troels K; Brøsen, Kim

    2017-01-01

    INTRODUCTION: Tacrolimus is a calcineurin inhibitor used as an immunosuppressant drug in solid organ transplantation, and is mainly metabolized by cytochrome P450 (CYP) 3A4 and CYP3A5. Studies have shown an association between the CYP3A5 genotype and tacrolimus dose-adjusted trough concentrations...

  17. Process optimization by use of design of experiments: Application for liposomalization of FK506.

    Science.gov (United States)

    Toyota, Hiroyasu; Asai, Tomohiro; Oku, Naoto

    2017-05-01

    Design of experiments (DoE) can accelerate the optimization of drug formulations, especially complexed formulas such as those of drugs, using delivery systems. Administration of FK506 encapsulated in liposomes (FK506 liposomes) is an effective approach to treat acute stroke in animal studies. To provide FK506 liposomes as a brain protective agent, it is necessary to manufacture these liposomes with good reproducibility. The objective of this study was to confirm the usefulness of DoE for the process-optimization study of FK506 liposomes. The Box-Behnken design was used to evaluate the effect of the process parameters on the properties of FK506 liposomes. The results of multiple regression analysis showed that there was interaction between the hydration temperature and the freeze-thaw cycle on both the particle size and encapsulation efficiency. An increase in the PBS hydration volume resulted in an increase in encapsulation efficiency. Process parameters had no effect on the ζ-potential. The multiple regression equation showed good predictability of the particle size and the encapsulation efficiency. These results indicated that manufacturing conditions must be taken into consideration to prepare liposomes with desirable properties. DoE would thus be promising approach to optimize the conditions for the manufacturing of liposomes. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. César Augusto Restrepo Valencia, Consuelo Vélez Álvarez Abstract Objective. To evaluate the effectiveness of calcineurin ciclosporin and tacrolimus inhibitors to induce remission in patients with refractory lupus nephritis. Patients, materials and methods. Patients with lupus nephritis class IV-G who despite receiving therapy with high doses of steroid and with a cytostatic (cyclophosphamide or mycophenolate for 3 months had not been able to induce some kind of remission.The exclusion criteria were creatinine levels greater than 3 mg / dl, pregnancy, previous history of exposure to calcineurin inhibitors, cancer, active infections, uncontrolled hypertension, and negligence with medication intake. The recommended dose of cyclosporine was 3 mg / kg / day and tacrolimus 0.1 mg / kg / day, in joint with prednisone 0.3 mg / kg / day, cyclophosphamide 1 mg / kg / day or mycophenolate mofetil 1 gram every 12 hours. The cyclophosphamide was administered only during 6 months, after which it was changed to azathioprine at doses of 1 mg / kg / day. Still, mycophenolate was continued at the same dose. All patients completed a minimum period of 12 months follow-up, it was considered that patients achieved partial remission when proteinuria decreased by 50% of the baseline value or its value decreased to less than 1 gram in 24 hours, decrease of leukocytes count and red blood cells in urine of 50%, and creatinine values were stable. A complete remission was considered when there was a reduction in proteinuria in a value less than 300 mg per 24 hours, urinary sediment with less than 3 red blood cells, less than 5 leukocyte for each high power microscopic field, and a creatinine value reduction by 50% or reaching a normal value. Results. Twelve patients met the inclusion criteria and initiated the calcineurin inhibitor protocol. Two presented accelerated deterioration in their function and required chronic dialysis therapy. Ten patients with active treatment completed 12 months

    Directory of Open Access Journals (Sweden)

    César Augusto Restrepo Valencia

    2014-10-01

    Full Text Available Objective: To evaluate the effectiveness of calcineurin ciclosporin and tacrolimus inhibitors to induce remission in patients with refractory lupus nephritis. Patients, materials and methods: Patients with lupus nephritis class IV-G who despite receiving the rapy with high doses of steroid and with a cytostatic (cyclophosphamide or mycophenolate for 3 months had not been able to induce some kind of remission.The exclusion criteria were creatinine levels greater than 3 mg / dl, pregnancy, previous history of exposure to calcineurin inhibitors, cancer, active infections, uncontrolled hypertension, and negligence with medication intake. The recommended dose of cyclosporine was 3 mg / kg / day and tacrolimus 0.1 mg / kg / day, in joint with prednisone 0.3 mg / kg / day, cyclophosphamide 1 mg / kg / day or mycophenolate mofetil 1 gram every 12 hours. The cyclophosphamide was administered only during 6 months, after which it was changed to azathioprine at doses of 1 mg / kg / day. Still, mycophenolate was continued at the same dose. All patients completed a minimum period of 12 months follow-up, it was considered that patients achieved partial remission when proteinuria decreased by 50% of the baseline value or its value decreased to less than 1 gram in 24 hours, decrease of leukocytes count and red blood cells in urine of 50%, and creatinine values were stable. A complete remission was considered when there was a reduction in proteinuria in a value less than 300 mg per 24 hours, urinary sediment with less than 3 red blood cells, less than 5 leukocyte for each high power microscopic field, and a creatinine value reduction by 50% or reaching a normal value. Results: Twelve patients met the inclusion criteria and initiated the calcineurin inhibitor protocol. Two presented accelerated deterioration in their function and required chronic dialysis therapy. Ten patients with active treatment completed 12 months of followup, of which 4 (40% had partial

  19. LL-37-derived membrane-active FK-13 analogs possessing cell selectivity, anti-biofilm activity and synergy with chloramphenicol and anti-inflammatory activity.

    Science.gov (United States)

    Rajasekaran, Ganesan; Kim, Eun Young; Shin, Song Yub

    2017-05-01

    Although the human-derived antimicrobial peptide (AMP) LL-37 has potent antimicrobial and anti-inflammatory activities, its therapeutic application is limited by its low cell selectivity and high production cost due to its large size. To overcome these problems, we tried to develop novel LL-37-derived short α-helical AMPs with improved cell selectivity and without a significant loss of anti-inflammatory activity relative to that of parental LL-37. Using amino acid substitution, we designed and synthesized a series of FK13 analogs based on the sequence of the 13-meric short FK13 peptide (residues 17-29 of LL-37) that has been identified as the region responsible for the antimicrobial activity of LL-37. Among the designed FK13 analogs, FK-13-a1 and FK-13-a7 showed high cell selectivity and retained the anti-inflammatory activity. The therapeutic index (a measure of cell selectivity) of FK-13-a1 and FK-13-a7 was 6.3- and 2.3-fold that of parental LL-37, respectively. Furthermore, FK-13-a1 and FK-13-a7 displayed more potent antimicrobial activity against antibiotic-resistant bacteria including MRSA, MDRPA, and VREF, than did LL-37. In addition, FK-13-a1 and FK-13-a7 exhibited greater synergistic effects with chloramphenicol against MRSA and MDRPA and were more effective anti-biofilm agents against MDRPA than LL-37 was. Moreover, FK-13-a1 and FK-13-a7 maintained their activities in the presence of physiological salts and human serum. SYTOX green uptake, membrane depolarization and killing kinetics revealed that FK13-a1 and FK13-a7 kills microbial cells by permeabilizing the cell membrane and damaging membrane integrity. Taken together, our results suggest that FK13-a1 and FK13-a7 can be developed as novel antimicrobial/anti-inflammatory agents. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Assessment of modern spectral analysis methods to improve wavenumber resolution of F-K spectra

    International Nuclear Information System (INIS)

    Shirley, T.E.; Laster, S.J.; Meek, R.A.

    1987-01-01

    The improvement in wavenumber spectra obtained by using high resolution spectral estimators is examined. Three modern spectral estimators were tested, namely the Autoregressive/Maximum Entropy (AR/ME) method, the Extended Prony method, and an eigenstructure method. They were combined with the conventional Fourier method by first transforming each trace with a Fast Fourier Transform (FFT). A high resolution spectral estimator was applied to the resulting complex spatial sequence for each frequency. The collection of wavenumber spectra thus computed comprises a hybrid f-k spectrum with high wavenumber resolution and less spectral ringing. Synthetic and real data records containing 25 traces were analyzed by using the hybrid f-k method. The results show an FFT-AR/ME f-k spectrum has noticeably better wavenumber resolution and more spectral dynamic range than conventional spectra when the number of channels is small. The observed improvement suggests the hybrid technique is potentially valuable in seismic data analysis

  1. Rapidly rotating single late-type giants: New FK Comae stars?

    Science.gov (United States)

    Fekel, Francis C.

    1986-01-01

    A group of rapidly rotating single late-type giants was found from surveys of chromospherically active stars. These stars have V sin I's ranging from 6 to 46 km/sec, modest ultraviolet emission line fluxes, and strong H alpha absorption lines. Although certainly chromospherically active, their characteristics are much less extreme than those of FK Com and one or two other similar systems. One possible explanation for the newly identified systems is that they have evolved from stars similar to FK Com. The chromospheric activity and rotation of single giant stars like FK Com would be expected to decrease with time as they do in single dwarfs. Alternatively, this newly identified group may have evolved from single rapidly rotating A, or early F stars.

  2. On the kinematics of visual binary and multiple stars of the FK4 cataloque

    International Nuclear Information System (INIS)

    Starikova, G.A.

    1981-01-01

    Kinematic features of single, binary and multiple stars are considered. To compare kinematics of such stars with the kinematics of single stars the data on positions and proper motions of those stars which are given in the basic catalogue FK4. Single as well as visual binary and multiple stars united because of their limited content in FK4 have been subdivided by spectra and classes of luminosity into groups with account for known kinematic peculiarities of various spectral groups. Kinematic features for the studied spectral groups are given. By the stars of the FK4 catalogue for various spectral classes the difference of kinematic features of single, visual binary and multiple stars is obtained. However the values of these differences need to be specified due to small number of stars included in five of six groups considered

  3. Sirolimus Versus Tacrolimus as Primary Immunosuppressant After Renal Transplantation: A Meta-Analysis and Economics Evaluation.

    Science.gov (United States)

    Liu, Jin-Yu; Song, Ming; Guo, Min; Huang, Feng; Ma, Bing-Jun; Zhu, Lan; Xu, Gang; Li, Juan; You, Ru-Xu

    Sirolimus and tacrolimus are the major immunosuppressants for renal transplantation. Several studies have compared these 2 drugs, but the outcomes were not consistent. The aim of this study was to evaluate the efficacy, safety, and pharmacoeconomics of sirolimus and tacrolimus in the treatment of renal transplantation and provide evidence for the selection of essential drugs. Trials were identified through a computerized literature search of PubMed, EMBASE, Cochrane controlled trials register, Cochrane Renal Group Specialized Register of randomized controlled trials, and Chinese Biomedical database. Two independent reviewers assessed trials for eligibility and quality and then extracted data. Data were extracted for patient and graft mortality, acute rejection (AR), and adverse events. Dichotomous outcomes were reported as relative risk with 95% confidence intervals. A decision tree model was populated with data from a literature review and used to estimate costs and QALYs gained and incremental cost-effectiveness. Altogether, 1189 patients from 8 randomized controlled trials were included. The results of our analysis were that tacrolimus reduced the risks after renal transplantation of AR and patient withdrawn. Nevertheless, tacrolimus increased the risk of infection. Pharmacoeconomic analysis showed that tacrolimus represented a more cost-effective treatment than does cyclosporine for the prevention of adverse events after renal transplant. Tacrolimus is an effective and safe immunosuppressive agent, and it may be more cost-effective than cyclosporine for the primary prevention of AR in renal transplant recipients. However, it should be noted that such superiority was reversal when the cost of sirolimus and tacrolimus changed.

  4. Successful treatment with tacrolimus in TAFRO syndrome: two case reports and literature review.

    Science.gov (United States)

    Shirai, Taiichiro; Onishi, Akira; Waki, Daisuke; Saegusa, Jun; Morinobu, Akio

    2018-06-01

    TAFRO syndrome is a systemic inflammatory disorder characterized by thrombocytopenia, anasarca, fever, reticulin fibrosis, renal dysfunction, and organomegaly. In contrast to that in multicentric Castleman disease, interleukin-6 targeting strategies seem ineffective in some TAFRO syndrome cases; however, the optimal treatment remains unclear. Here, we report 2 cases of TAFRO syndrome, where 1 with cardiomyopathy, successfully treated with tacrolimus. This is the first case report of successful treatment with tacrolimus in TAFRO syndrome. Both patients (cases 1 and 2) developed fever, anasarca, thrombocytopenia, renal dysfunction, and mild hepatosplenomegaly. In both patients, lymph node pathology revealed mixed type Castleman disease-like features, and bone marrow showed reticulin myelofibrosis. TAFRO syndrome was diagnosed based on the patients' laboratory, clinical, and pathologic findings. In case 2, we observed a rare complication of cardiomyopathy with no evidence of takotsubo cardiomyopathy or viral myocarditis. In case 1, tocilizumab combined with glucocorticoids was ineffective and caused septic shock; additionally, cyclosporine A was discontinued because of hepatotoxicity. However, tacrolimus was effective in resolving TAFRO syndrome without any adverse events. In case 2, tacrolimus completely reversed TAFRO syndrome and was also effective in cardiomyopathy. This report suggests that tacrolimus is potentially effective and safe as an initial treatment and a glucocorticoid-sparing agent. Our literature review shows that calcineurin inhibitors, including tacrolimus, may be effective in TAFRO syndrome. Since previous studies indicate a role of Th1 inflammation in TAFRO syndrome pathogenesis, tacrolimus may, therefore, be effective in treating TAFRO syndrome.

  5. Clinical analysis on hyperpotassemia induced by pharmacologic interaction between tacrolimus and other drugs in 10 renal ;transplant recipients%他克莫司与其它药物相互作用致肾移植受者高钾血症10例临床分析

    Institute of Scientific and Technical Information of China (English)

    邱春燕; 隋雨荧; 于立新; 邓文锋; 苗芸; 刘如敏; 叶桂荣

    2017-01-01

    Objective To investigate the therapeutic methods of hyperpotassemia induced by excessively high blood concentration of tacrolimus (FK506) caused by drug use after renal transplantation. Methods Clinical data of 10 patients diagnosed with hyperpotassemia induced by excessively high blood concentration of FK506 after administration of antifunga l medication following renal transplantation were collected and retrospectively analyzed. Results At 1-2 months after renal transplantation, 10 patients suffered from pulmonary infectiono r pneumonia complicated with pulmonary fungal infection . An appropriate dose of compound sulfamethoxazole, micafungin, cefoperazone sodium-sulbactam sodium and moxifloxacin was administered for antifungal infection. After potassium-lowering therapy, termination of antifungal medication and FK506 dose adjustment (replaced by cyclosporin for certain cases), the serum level of potassium was declined and maintained within normal range for 10 cases. The serum concentration of FK506 was within normal range. No sign of excessively high level of potassium was observed without any potassium-lowering intervention. Conclusions Postoperative administration of drugs is likely to cause excessively high level of FK506 and hyperpotasesmia. Potassium-lowering therapy, termination of drug use and adjustment of immunosuppressive agents should be adopted to avoid the incidence of adverse pharmacologic interaction.%目的:探讨肾移植术后用药导致他克莫司(FK506)血药浓度过高引起高钾血症的处理方法。方法对肾移植术后服用抗真菌药物致FK506血药浓度过高而引起的高钾血症10例患者的临床资料进行归纳和分析。结果10例患者术后1~2个月内出现肺部感染或肺炎合并肺部真菌感染等,对症选用相应剂量的复方磺胺甲唑、米卡芬净、头孢哌酮钠-舒巴坦钠和莫西沙星等药物进行抗真菌感染治疗。经过降钾治疗及停用抗真菌药物、调整FK506

  6. CYP3A5 polymorphisms in renal transplant recipients: influence on tacrolimus treatment

    Directory of Open Access Journals (Sweden)

    Chen L

    2018-03-01

    Full Text Available Lucy Chen,1 G V Ramesh Prasad2 1Kidney Transplant Program, St Michael’s Hospital, Toronto, ON, Canada; 2Division of Nephrology, St Michael’s Hospital, Toronto, ON, Canada Abstract: Tacrolimus is a commonly used immunosuppressant after kidney transplantation. It has a narrow therapeutic range and demonstrates wide interindividual variability in pharmacokinetics, leading to potential underimmunosuppression or toxicity. Genetic polymorphism in CYP3A5 enzyme expression contributes to differences in tacrolimus bioavailability between individuals. Individuals carrying one or more copies of the wild-type allele *1 express CYP3A5, which increases tacrolimus clearance. CYP3A5 expressers require 1.5 to 2-fold higher tacrolimus doses compared to usual dosing to achieve therapeutic blood concentrations. Individuals with homozygous *3/*3 genotype are CYP3A5 nonexpressers. CYP3A5 nonexpression is the most frequent phenotype in most ethnic populations, except blacks. Differences between CYP3A5 genotypes in tacrolimus disposition have not translated into differences in clinical outcomes, such as acute rejection and graft survival. Therefore, although genotype-based dosing may improve achievement of therapeutic drug concentrations with empiric dosing, its role in clinical practice is unclear. CYP3A5 genotype may predict differences in absorption of extended-release and immediate-release oral formulations of tacrolimus. Two studies found that CYP3A5 expressers require higher doses of tacrolimus in the extended-release formulation compared to immediate release. CYP3A5 genotype plays a role in determining the impact of interacting drugs, such as fluconazole, on tacrolimus pharmacokinetics. Evidence conflicts regarding the impact of CYP3A5 genotype on risk of nephrotoxicity associated with tacrolimus. Further study is required. Keywords: calcineurin inhibitor, graft, pharmacogenomics, kidney, genotype

  7. The carcinogenic potential of tacrolimus ointment beyond immune suppression: a hypothesis creating case report.

    Science.gov (United States)

    Becker, Jürgen C; Houben, Roland; Vetter, Claudia S; Bröcker, Eva B

    2006-01-11

    Since tacrolimus ointment was approved by the U.S. Food and Drug Administration (FDA) as a promising treatment for atopic dermatitis, it has been approved in more than 30 additional countries, including numerous European Union member nations. Moreover, in the current clinical routine the use of this drug is no longer restricted to the approved indication, but has been extended to a wide variety of inflammatory skin diseases including some with the potential of malignant transformation. So far, the side-effects reported from the topical use of tacrolimus have been relatively minor (e.g. burning, pruritus, erythema). Recently, however, the FDA reviewed the safety of topical tacrolimus, which resulted in a warning that the use of calcineurin inhibitors may be associated with an increased risk of cancer. Oral lichen planus (OLP) was diagnosed in a 56-year-old women in February 1999. After several ineffective local and systemic therapeutic measures an off-label treatment of this recalcitrant condition using Tacrolimus 0.1% ointment was initiated in May 2002. After a few weeks of treatment most of the lesions ameliorated, with the exception of the plaques on the sides of the tongue. Nevertheless, the patient became free of symptoms which, however, reoccurred once tacrolimus was weaned, as a consequence treatment was maintained. In April 2005, the plaques on the left side of the tongue appeared increasingly compact and a biopsy specimen confirmed the suspected diagnosis of an oral squamous cell carcinoma. The suspected causal relationship between topical use of tacrolimus and the development of a squamous cell carcinoma prompted us to test the notion that the carcinogenicity of tacrolimus may go beyond mere immune suppression. To this end, tacrolimus has been shown to have an impact on cancer signalling pathways such as the MAPK and the p53 pathway. In the given case, we were able to demonstrate that these pathways had also been altered subsequent to tacrolimus therapy.

  8. The carcinogenic potential of tacrolimus ointment beyond immune suppression: a hypothesis creating case report

    Directory of Open Access Journals (Sweden)

    Vetter Claudia S

    2006-01-01

    Full Text Available Abstract Background Since tacrolimus ointment was approved by the U.S. Food and Drug Administration (FDA as a promising treatment for atopic dermatitis, it has been approved in more than 30 additional countries, including numerous European Union member nations. Moreover, in the current clinical routine the use of this drug is no longer restricted to the approved indication, but has been extended to a wide variety of inflammatory skin diseases including some with the potential of malignant transformation. So far, the side-effects reported from the topical use of tacrolimus have been relatively minor (e.g. burning, pruritus, erythema. Recently, however, the FDA reviewed the safety of topical tacrolimus, which resulted in a warning that the use of calcineurin inhibitors may be associated with an increased risk of cancer. Case presentation Oral lichen planus (OLP was diagnosed in a 56-year-old women in February 1999. After several ineffective local and systemic therapeutic measures an off-label treatment of this recalcitrant condition using Tacrolimus 0.1% ointment was initiated in May 2002. After a few weeks of treatment most of the lesions ameliorated, with the exception of the plaques on the sides of the tongue. Nevertheless, the patient became free of symptoms which, however, reoccurred once tacrolimus was weaned, as a consequence treatment was maintained. In April 2005, the plaques on the left side of the tongue appeared increasingly compact and a biopsy specimen confirmed the suspected diagnosis of an oral squamous cell carcinoma. Conclusion The suspected causal relationship between topical use of tacrolimus and the development of a squamous cell carcinoma prompted us to test the notion that the carcinogenicity of tacrolimus may go beyond mere immune suppression. To this end, tacrolimus has been shown to have an impact on cancer signalling pathways such as the MAPK and the p53 pathway. In the given case, we were able to demonstrate that these

  9. The carcinogenic potential of tacrolimus ointment beyond immune suppression: a hypothesis creating case report

    International Nuclear Information System (INIS)

    Becker, Jürgen C; Houben, Roland; Vetter, Claudia S; Bröcker, Eva B

    2006-01-01

    Since tacrolimus ointment was approved by the U.S. Food and Drug Administration (FDA) as a promising treatment for atopic dermatitis, it has been approved in more than 30 additional countries, including numerous European Union member nations. Moreover, in the current clinical routine the use of this drug is no longer restricted to the approved indication, but has been extended to a wide variety of inflammatory skin diseases including some with the potential of malignant transformation. So far, the side-effects reported from the topical use of tacrolimus have been relatively minor (e.g. burning, pruritus, erythema). Recently, however, the FDA reviewed the safety of topical tacrolimus, which resulted in a warning that the use of calcineurin inhibitors may be associated with an increased risk of cancer. Oral lichen planus (OLP) was diagnosed in a 56-year-old women in February 1999. After several ineffective local and systemic therapeutic measures an off-label treatment of this recalcitrant condition using Tacrolimus 0.1% ointment was initiated in May 2002. After a few weeks of treatment most of the lesions ameliorated, with the exception of the plaques on the sides of the tongue. Nevertheless, the patient became free of symptoms which, however, reoccurred once tacrolimus was weaned, as a consequence treatment was maintained. In April 2005, the plaques on the left side of the tongue appeared increasingly compact and a biopsy specimen confirmed the suspected diagnosis of an oral squamous cell carcinoma. The suspected causal relationship between topical use of tacrolimus and the development of a squamous cell carcinoma prompted us to test the notion that the carcinogenicity of tacrolimus may go beyond mere immune suppression. To this end, tacrolimus has been shown to have an impact on cancer signalling pathways such as the MAPK and the p53 pathway. In the given case, we were able to demonstrate that these pathways had also been altered subsequent to tacrolimus therapy

  10. Tacrolimus and mycophenolate mofetil after nonmyeloablative matched-sibling donor allogeneic stem-cell transplantations conditioned with fludarabine and low-dose total body irradiation.

    Science.gov (United States)

    Nieto, Yago; Patton, Nigel; Hawkins, Timothy; Spearing, Ruth; Bearman, Scott I; Jones, Roy B; Shpall, Elizabeth J; Rabinovitch, Rachel; Zeng, Chan; Barón, Anna; McSweeney, Peter A

    2006-02-01

    We evaluated tacrolimus/mycophenolate mofetil (MMF) for graft-versus-host disease (GVHD) prophylaxis after a nonmyeloablative stem cell transplantation (NST) from a matched sibling donor (MSD). Thirty-two patients (median age, 57 years) with advanced hematologic malignancies, who were poor candidates for a conventional myeloablative transplantation, received fludarabine (30 mg/m(2), day -4 to day -2), total-body irradiation (TBI) (200 cGy, day 0), infusion of donor peripheral blood progenitor cells (day 0), oral tacrolimus 0.06 mg/kg twice daily (from day 3), and oral MMF at 15 mg/kg twice daily (days 0-+27). Tacrolimus was tapered from day +100 to day +180 in those patients with indolent malignancies (n = 25), and from day +35 to day +56 in those with aggressive tumors (n = 7). Regimen toxicities and myelosuppression were mild, allowing 75% of patients to have entirely outpatient transplantations. One patient (3%) experienced a nonfatal graft rejection. Rates of grades II-IV and III-IV acute GVHD were 15.6% and 3%, respectively. Acute GVHD was diagnosed at median day +78 (range, days +31-+84). Extensive chronic GVHD was observed in 10 of 24 evaluable patients (41.6%) at a median onset of day +198 (range, days +128-+277), either spontaneously (n = 5) or elicited after tumor progression (n = 5). Five patients experienced transplantation-related mortality (TRM) (15.6%) from either acute GVHD-related multiorgan failure (MOF) (n = 3) or infectious complications (n = 2). At median follow-up of 19 months (range, 2-41 months), the overall survival, progression-free survival, and disease-free survival rates are 62.5%, 50%, and 40%, respectively. In conclusion, the use of tacrolimus/MMF after MSD NST is associated with encouraging rates of GVHD control.

  11. Manic-Like Psychosis Associated with Elevated Trough Tacrolimus Blood Concentrations 17 Years after Kidney Transplant

    Directory of Open Access Journals (Sweden)

    Giuseppe Bersani

    2013-01-01

    Full Text Available Several neurological side effects induced by tacrolimus are described in the scientific literature, ranging from mild neurological symptoms to delirium and psychosis. We report the case of a 46-year-old man with no prior psychiatric history who suddenly manifested manic-like psychosis associated with elevated trough tacrolimus blood concentrations 17 years after kidney transplant. The use of antipsychotics may improve the severity of symptoms; but in order to obtain a complete remission, the reduction in the dose of tacrolimus, or its replacement with alternative immunosuppressant therapies, is recommended.

  12. Bioequivalence between innovator and generic tacrolimus in liver and kidney transplant recipients: A randomized, crossover clinical trial.

    Directory of Open Access Journals (Sweden)

    Rita R Alloway

    2017-11-01

    allow for the impact of nonadherence or feeding on the possible pharmacokinetic differences. Generic Hi and Lo were selected based upon bioequivalence data in healthy volunteers because no pharmacokinetic data in recipients were available for all products. The safety data should be interpreted in light of the small number of participants and the short observation periods. Lastly, only the 1 mg tacrolimus strength was utilized in this study.Using an innovative, controlled bioequivalence study design, we observed equivalence between tacrolimus innovator and 2 generic products as well as between 2 generic products in individuals after kidney or liver transplantation following current FDA bioequivalence metrics. These results support the position that bioequivalence for the narrow therapeutic index drug tacrolimus translates from healthy volunteers to individuals receiving a kidney or liver transplant and provides evidence that generic products that are bioequivalent with the innovator product are also bioequivalent to each other.ClinicalTrials.gov NCT01889758.

  13. 1.8. Brand*, HA Badenhorst, FK 8iebrits and EH Kemm JP Hayes et ...

    African Journals Online (AJOL)

    Brand*, H.A. Badenhorst, F.K. 8iebrits and E.H. Kemm. Animal and Dairy Science Research Institute, Private Bag X2, Irene 1675, Republic of South Africa. J.P. Hayes. Department of Poultry Science, University of Stellenbosch, Stellenbosch 7600, Republic of South Africa. The experiment was conducted to compare the ...

  14. Effectiveness and safety of topical tacrolimus in treatment of vitiligo

    Directory of Open Access Journals (Sweden)

    Ghasem Rahmatpour Rokni

    2017-01-01

    Full Text Available Vitiligo is one of the most primitive well-known dermatoid disorders with different suggested therapies. Therefore, this study investigated the efficiency and safety of topical tacrolimus in treatment of patients with vitiligo. This study was a clinical randomized designed study pre- post-test method, has been conducted on thirty cases with vitiligo who have referred to polyclinic and dermatology clinic. Participant′s evaluated and demographic information recorded in designed checklist. In the next stage, the disease activity scored by vitiligo index disease activity system. Photography and depigmentation percent has recorded before treatment and further in 4 th , 8 th , 12 th , 16 th , 20 th , and 24 th weeks. Finally, gathered data compared through SPSS-20 software. The final sample comprised 30 persons including: 12 men (40% and 18 women (60%. The average of patient′s age in this study was 26/13 ΁ 18/20 (2-76-year-old. Eleven persons was ≤15 years old and rest was older than 15. Sixty-six lesions have funded in patients that maximum has accrued on face and neck (37/87% and trunk (21/21%. In addition, minimum of lesions is related to genitalia (9/09%. In the in 4 th , 8 th , 12 th , 16 th weeks, improvement in face and neck had increased significantly, into the past weeks. In the 20 th and 24 th weeks, the improvement has increased although it was not significant enhancement. Also about trunk, in the 4 th week the improvement does not have significant increasing in compare to the past week. In the eighth, 12 th , 16 th , 20 th , and 24 th weeks the improvement has been increased significantly in compare to the past weeks. Although in the case of limbs and genitalia, the improvement was lower. There was no significant difference between male and females and age. Although the improvement was, slow in older persons. Study results, has presented applying topical tacrolimus in vitiligo, particularly in face and neck, could be effective and

  15. Tacrolimus drug level and response to treatment in idiopathic childhood steroid resistant nephrotic syndrome

    International Nuclear Information System (INIS)

    Shah, S.S.; Hafeez, F.; Akhtar, N.

    2015-01-01

    The management of Steroid Resistant Nephrotic Syndrome (SRNS) is an uphill task for paediatric nephrologists as immunosuppressive agents are the mainstay of treatment in these patients. Tacrolimus is used along with steroids. This study is conducted to see the relationship between the tacrolimus dose, drug level and response in the management of SRNS. Methods: This quasi experimental study was conducted at The Childrens Hospital Lahore over a period of one year. Patients with SRNS of either sex and 1-10 years of age were included and those with secondary nephrotic syndrome were excluded. Tacrolimus was given at a dose of 0.05-0.1 mg/kg/day in 2 divided doses along with steroids. The follow-up was done for six months with proteinuria monitoring and tacrolimus drug levels done two weeks after initiation of treatment. Results: Out of 42 patients, 27 (64.3%) were males and 15 (35.7%) were females. The most common histological diagnosis observed was mesangio-proliferative glomerulonephritis in 30 (71.4%) patients. The tacrolimus trough level range was 0.5-15.20 ng/ml with a mean value of 4.68 ng/ml±2.85. Forty-one (97.6%) children showed complete response to treatment while one patient showed partial response. Conclusion: This study suggests that tacrolimus is an effective drug for treatment of SRNS in paediatric patients and there is no linear relationship between the drug dose, response and drug level. (author)

  16. Prevention of organ rejection in renal and liver transplantation with extended release tacrolimus

    Directory of Open Access Journals (Sweden)

    Reschen ME

    2014-09-01

    Full Text Available Michael E Reschen, Christopher A O’Callaghan Henry Wellcome Building, Nuffield Department of Medicine, University of Oxford, Oxford, United Kingdom Abstract: Tacrolimus is the key immunosuppressant used to prevent allograft rejection in kidney and liver transplant recipients. Despite the efficacy of tacrolimus and adjunctive immunosuppressants, a substantial number of patients experience episodes of acute rejection and late graft loss. Nonadherence is an etiological factor in both acute rejection and graft loss. In 2007, a prolonged release version of tacrolimus became available that allows once daily administration, thus halving the pill burden compared to the standard twice-daily tacrolimus. An increasing number of studies in de novo transplantation and in treatment conversion have evaluated the pharmacokinetic profile, efficacy, and safety of prolonged-release tacrolimus. We have reviewed the literature on the use of prolonged-release tacrolimus and hope that this will be of value in the design of protocols for transplant immunosuppression.Keywords: immunosuppression, kidney, hepatic, allograft, adherence

  17. FK506: therapeutic effects on lupus dermatoses in autoimmune-prone MRL/Mp-lpr/lpr mice.

    Science.gov (United States)

    Furukawa, F; Imamura, S; Takigawa, M

    1995-01-01

    The effects of FK506, a new immunosuppressive agent, on the development of lupus dermatoses were investigated in the autoimmune-prone MRL/Mp-lpr/lpr (MRL/lpr) mouse, which is an animal model for the spontaneous development of skin lesions similar to those of human lupus erythematosus (LE). FK506 reduced the incidence of skin lesions, lupus nephritis, the titre of serum anti-double-stranded DNA antibodies and the massive T cell proliferation. The incidence and magnitude of IgG deposition at the dermoepidermal junction were not changed. These results suggest that FK506 is a promising immunosuppressive agent for the control of autoimmune skin diseases.

  18. A Low Concentration of Tacrolimus/Semifluorinated Alkane (SFA) Eyedrop Suppresses Intraocular Inflammation in Experimental Models of Uveitis.

    Science.gov (United States)

    De Majumdar, S; Subinya, M; Korward, J; Pettigrew, A; Scherer, D; Xu, H

    2017-01-01

    Corticosteroids remain the mainstay therapy for uveitis, a major cause of blindness in the working age population. However, a substantial number of patients cannot benefit from the therapy due to steroids resistance or intolerance. Tacrolimus has been used to treat refractory uveitis through systemic administration. The aim of this study was to evaluate the therapeutic potential of 0.03% tacrolimus eyedrop in mouse models of uveitis. 0.03% tacrolimus in perfluorobutylpentane (F4H5) (0.03% Tacrolimus/SFA) was formulated using a previously published protocol. Tacrolimus suspended in PBS (0.03% Tacrolimus/PBS) was used as a control. In addition, 0.1% dexamethasone (0.1% DXM) was used as a standard therapy control. Endotoxin-induced uveitis (EIU) and experimental autoimmune uveoretinitis (EAU) were induced in adult C57BL/6 mice using protocols described previously. Mice were treated with eyedrops three times/day immediately after EIU induction for 48 h or from day 14 to day 25 post-immunization (for EAU). Clinical and histological examinations were conducted at the end of the experiment. Pharmacokinetics study was conducted in mice with and without EIU. At different times after eyedrop treatment, ocular tissues were collected for tacrolimus measurement. The 0.03% Tacrolimus/SFA eyedrop treatment reduced the clinical scores and histological scores of intraocular inflammation in both EIU and EAU to the levels similar to 0.1% DXM eyedrop treatment. The 0.03% Tacrolimus/PBS did not show any suppressive effect in EIU and EAU. Pharmacokinetic studies showed that 15 min after topical administration of 0.03% Tacrolimus/SFA, low levels of tacrolimus were detected in the retina (48 ng/g tissue) and vitreous (2.5 ng/ml) in normal mouse eyes, and the levels were significantly higher in EIU eyes (102 ng/g tissue in the retina and 24 ng/ml in the vitreous). Tacrolimus remained detectable in intraocular tissues of EIU eyes 6 h after topical administration (68 ng/g retinal tissue, 10

  19. TSOS and TSOS-FK hybrid methods for modelling the propagation of seismic waves

    Science.gov (United States)

    Ma, Jian; Yang, Dinghui; Tong, Ping; Ma, Xiao

    2018-05-01

    We develop a new time-space optimized symplectic (TSOS) method for numerically solving elastic wave equations in heterogeneous isotropic media. We use the phase-preserving symplectic partitioned Runge-Kutta method to evaluate the time derivatives and optimized explicit finite-difference (FD) schemes to discretize the space derivatives. We introduce the averaged medium scheme into the TSOS method to further increase its capability of dealing with heterogeneous media and match the boundary-modified scheme for implementing free-surface boundary conditions and the auxiliary differential equation complex frequency-shifted perfectly matched layer (ADE CFS-PML) non-reflecting boundaries with the TSOS method. A comparison of the TSOS method with analytical solutions and standard FD schemes indicates that the waveform generated by the TSOS method is more similar to the analytic solution and has a smaller error than other FD methods, which illustrates the efficiency and accuracy of the TSOS method. Subsequently, we focus on the calculation of synthetic seismograms for teleseismic P- or S-waves entering and propagating in the local heterogeneous region of interest. To improve the computational efficiency, we successfully combine the TSOS method with the frequency-wavenumber (FK) method and apply the ADE CFS-PML to absorb the scattered waves caused by the regional heterogeneity. The TSOS-FK hybrid method is benchmarked against semi-analytical solutions provided by the FK method for a 1-D layered model. Several numerical experiments, including a vertical cross-section of the Chinese capital area crustal model, illustrate that the TSOS-FK hybrid method works well for modelling waves propagating in complex heterogeneous media and remains stable for long-time computation. These numerical examples also show that the TSOS-FK method can tackle the converted and scattered waves of the teleseismic plane waves caused by local heterogeneity. Thus, the TSOS and TSOS-FK methods proposed in

  20. Coronal Abundances In Xi Boo A, Abundances in the Corona of FK Aqr and the Origin of Cosmic Ray

    Science.gov (United States)

    Drake, Jeremy; Oliversen, Ronald J. (Technical Monitor)

    2002-01-01

    Both Xi Boo A and FK Agr observations have been acquired, reduced and analysed. The results of the Xi Boo A study were published in ApJ (Drake, J.J., Kashyap, V., 2001, Up, 547, 428). Work is ongoing to determine the coronet metallicity of FK Aqr based on EUVE spectra and DO photometer data, using the techniques developed in the Drake & Kashyap paper. Preliminary synthetic spectra for FK Aqr have been developed, and further work to heap define the hot plasma emission measure distribution is underway. Progress on spectral analysis has been hampered following the post-doctoral scientist, Vinay Kashyap, taking up new position. A suitable replacement has been difficult to find, but new hire is expected shortly. However, good progress has been made on analysis of DO photometric variations in FK Age, with a publication now ready (Kashyap, V., Drake, J.J., Guedel, M., Audard, M.) for submission to a mainstream astrophysical journal.

  1. Multi-site analytical evaluation of the Abbott ARCHITECT tacrolimus assay.

    Science.gov (United States)

    Wallemacq, Pierre; Goffinet, Jean-Sebastien; O'Morchoe, Susan; Rosiere, Thomas; Maine, Gregory T; Labalette, Myriam; Aimo, Giuseppe; Dickson, Diana; Schmidt, Ed; Schwinzer, Reinhard; Schmid, Rainer W

    2009-04-01

    The objective of this study was to evaluate the analytical performance of the Abbott ARCHITECT Tacrolimus immunoassay. Proficiency panels and specimens from a population of organ transplant recipients were analyzed in 6 clinical laboratories in Europe and the United States, and the results were compared with other methods. The ARCHITECT assay requires a whole blood specimen pretreatment step with methanol/zinc sulfate to precipitate protein and extract the drug, followed by a 30-minute immunoassay using anti-tacrolimus antibody-coated paramagnetic microparticles and an acridinium-tacrolimus tracer. The assay was free from hematocrit interference in the range 25%-55% and from interference by extremes of cholesterol, triglycerides, bilirubin, total protein, and uric acid. The total percent of coefficient of variations of the assay were 4.9%-7.6% at 3 ng/mL, 2.9%-4.6% at 8.6 ng/mL, and 3.1%-8.2% at 15.5 ng/mL. Limit of detection was Abbott IMx Tacrolimus II immunoassay (4 sites) yielded average biases between -0.94 and +0.26 ng/mL; ARCHITECT assay versus the Dade Dimension Tacrolimus immunoassay (2 sites) yielded average biases of -0.46 and +0.11 ng/mL; and ARCHITECT assay versus LC-MSMS methods at 2 sites yielded average biases of +0.51 and +1.63 ng/mL. Spearman correlation coefficients were >/=0.90 on all method comparisons. The ARCHITECT Tacrolimus assay is a semiautomated, robust, and highly sensitive immunoassay, representing an alternative approach for laboratories not equipped with LC-MSMS, and meets the 1 ng/mL recommendation of LOQ by the European Consensus Conference on Tacrolimus Optimization.

  2. Vorinostat plus tacrolimus/methotrexate to prevent GVHD after myeloablative conditioning, unrelated donor HCT.

    Science.gov (United States)

    Choi, Sung Won; Braun, Thomas; Henig, Israel; Gatza, Erin; Magenau, John; Parkin, Brian; Pawarode, Attaphol; Riwes, Mary; Yanik, Greg; Dinarello, Charles A; Reddy, Pavan

    2017-10-12

    The oral histone deacetylase (HDAC) inhibitor (vorinostat) is safe and results in low incidence of acute graft-versus-host disease (GVHD) after reduced-intensity conditioning, related donor hematopoietic cell transplantation (HCT). However, its safety and efficacy in preventing acute GVHD in settings of heightened clinical risk that use myeloablative conditioning, unrelated donor (URD), and methotrexate are not known. We conducted a prospective, phase 2 study in this higher-risk setting. We enrolled 37 patients to provide 80% power to detect a significant difference in grade 2 to 4 acute GVHD of 50% compared with a reduction in target to 28%. Eligibility included adults with a hematological malignancy to receive myeloablative HCT from an available 8/8-HLA matched URD. Patients received GVHD prophylaxis with tacrolimus and methotrexate. Vorinostat (100 mg twice daily) was started on day -10 and continued through day +100 post-HCT. Median age was 56 years (range, 18-69 years), and 95% had acute myelogenous leukemia or high-risk myelodysplastic syndrome. Vorinostat was safe and tolerable. The cumulative incidence of grade 2 to 4 acute GVHD at day 100 was 22%, and for grade 3 to 4 it was 8%. The cumulative incidence of chronic GVHD was 29%; relapse, nonrelapse mortality, GVHD-free relapse-free survival, and overall survival at 1 year were 19%, 16%, 47%, and 76%, respectively. Correlative analyses showed enhanced histone (H3) acetylation in peripheral blood mononuclear cells and reduced interleukin 6 ( P = .028) and GVHD biomarkers (Reg3, P = .041; ST2, P = .002) at day 30 post-HCT in vorinostat-treated subjects compared with similarly treated patients who did not receive vorinostat. Vorinostat for GVHD prevention is an effective strategy that should be confirmed in a randomized phase 3 study. This trial was registered at www.clinicaltrials.gov as #NCT01790568. © 2017 by The American Society of Hematology.

  3. An observational study evaluating tacrolimus dose, exposure, and medication adherence after conversion from twice- to once-daily tacrolimus in liver and kidney transplant recipients.

    Science.gov (United States)

    Bäckman, Lars; Persson, Carl-Axel

    2014-03-17

    Immunosuppression regimens in transplantation medicine are complex. Drugs with extended release action have simplified medication dosing without affecting efficacy. This prospective, observational, multicenter study, conducted in a routine medical practice setting, evaluated changes in tacrolimus daily dose and trough levels and patient-reported medication adherence at day 90 after 1:1 (mg: mg) conversion to once-daily tacrolimus in adult liver and kidney transplant recipients. Data from 224 recipients of a liver (n=19) or kidney (n=205) transplant, average age 51±14.5 years, were evaluated. The mean change in tacrolimus daily dose was +0.04 mg/day. Dose remained stable after conversion in 62.5%, was lower in 15.6%, and higher in 22% of patients. Trough level after conversion was lower in 62.6% and higher in 36.5%; generally, levels were 12.8% lower than pre-conversion levels. No acute rejection, graft loss, or serious safety events were observed. Two deaths occurred due to myocardial infarction. Conversion helped 19% to less frequently forget medications and 55% reported no difference in remembering to take the once-daily dose after conversion. The change in dosing frequency was identified as "better" for 55%. Tacrolimus daily dose remained stable while trough levels were significantly lower after conversion to once-daily dosing. Safety and efficacy were maintained; reduced dosing frequency had no apparent influence on patient-reported medication adherence.

  4. A Nampt inhibitor FK866 mimics vitamin B3 deficiency by causing senescence of human fibroblastic Hs68 cells via attenuation of NAD(+)-SIRT1 signaling.

    Science.gov (United States)

    Song, Tuzz-Ying; Yeh, Shu-Lan; Hu, Miao-Lin; Chen, Mei-Yau; Yang, Nae-Cherng

    2015-12-01

    Vitamin B3 (niacin) deficiency can cause pellagra with symptoms of dermatitis, diarrhea and dementia. However, it is unclear whether the vitamin B3 deficiency causes human aging. FK866 (a Nampt inhibitor) can reduce intracellular NAD(+) level and induce senescence of human Hs68 cells. However, the mechanisms underlying FK866-induced senescence of Hs68 cells are unclear. In this study, we used FK866 to mimic the effects of vitamin B3 deficiency to reduce the NAD(+) level and investigated the mechanisms of FK866-induced senescence of Hs68 cells. We hypothesized that FK866 induced the senescence of Hs68 cells via an attenuation of NAD(+)-silent information regulator T1 (SIRT1) signaling. We found that FK866 induced cell senescence and diminished cellular NAD(+) levels and SIRT1 activity (detected by acetylation of p53), and these effects were dramatically antagonized by co-treatment with nicotinic acid, nicotinamide, or NAD(+). In contrast, the protein expression of SIRT1, AMP-activated protein kinase, mammalian target of rapamycin, and nicotinamide phosphoribosyltransferase (Nampt) was not affected by FK866. In addition, the role of GSH in the FK866-induced cells senescence may be limited, as N-acetylcysteine did not antagonize FK866-induced cell senescence. These results suggest that FK866 induces cell senescence via attenuation of NAD(+)-SIRT1 signaling. The effects of vitamin B3 deficiency on human aging warrant further investigation.

  5. The NAMPT inhibitor FK866 reverts the damage in spinal cord injury

    Directory of Open Access Journals (Sweden)

    Esposito Emanuela

    2012-04-01

    Full Text Available Abstract Background Emerging data implicate nicotinamide phosphoribosyl transferase (NAMPT in the pathogenesis of cancer and inflammation. NAMPT inhibitors have proven beneficial in inflammatory animal models of arthritis and endotoxic shock as well as in autoimmune encephalitis. Given the role of inflammatory responses in spinal cord injury (SCI, the effect of NAMPT inhibitors was examined in this setting. Methods We investigated the effects of the NAMPT inhibitor FK866 in an experimental compression model of SCI. Results Twenty-four hr following induction of SCI, a significant functional deficit accompanied widespread edema, demyelination, neuron loss and a substantial increase in TNF-α, IL-1β, PAR, NAMPT, Bax, MPO activity, NF-κB activation, astrogliosis and microglial activation was observed. Meanwhile, the expression of neurotrophins BDNF, GDNF, NT3 and anti-apoptotic Bcl-2 decreased significantly. Treatment with FK866 (10 mg/kg, the best known and characterized NAMPT inhibitor, at 1 h and 6 h after SCI rescued motor function, preserved perilesional gray and white matter, restored anti-apoptotic and neurotrophic factors, prevented the activation of neutrophils, microglia and astrocytes and inhibited the elevation of NAMPT, PAR, TNF-α, IL-1β, Bax expression and NF-κB activity. We show for the first time that FK866, a specific inhibitor of NAMPT, administered after SCI, is capable of reducing the secondary inflammatory injury and partly reduce permanent damage. We also show that NAMPT protein levels are increased upon SCI in the perilesional area which can be corrected by administration of FK866. Conclusions Our findings suggest that the inflammatory component associated to SCI is the primary target of these inhibitors.

  6. Effects of FK506 on Hippocampal CA1 Cells Following Transient Global Ischemia/Reperfusion in Wistar Rat

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    Zahra-Nadia Sharifi

    2012-01-01

    Full Text Available Transient global cerebral ischemia causes loss of pyramidal cells in CA1 region of hippocampus. In this study, we investigated the neurotrophic effect of the immunosuppressant agent FK506 in rat after global cerebral ischemia. Both common carotid arteries were occluded for 20 minutes followed by reperfusion. In experimental group 1, FK506 (6 mg/kg was given as a single dose exactly at the time of reperfusion. In the second group, FK506 was administered at the beginning of reperfusion, followed by its administration intraperitoneally (IP 6, 24, 48, and 72 hours after reperfusion. FK506 failed to show neurotrophic effects on CA1 region when applied as a single dose of 6 mg/kg. The cell number and size of the CA1 pyramidal cells were increased, also the number of cell death decreased in this region when FK506 was administrated 48 h after reperfusion. This work supports the possible use of FK506 in treatment of ischemic brain damage.

  7. Conversion From Twice-Daily Tacrolimus Capsules to Once-Daily Extended-Release Tacrolimus (LCPT): A Phase 2 Trial of Stable Renal Transplant Recipients

    Science.gov (United States)

    Gaber, A. Osama; Alloway, Rita R.; Bodziak, Kenneth; Kaplan, Bruce; Bunnapradist, Suphamai

    2013-01-01

    Background LCP-Tacro is an extended-release formulation of tacrolimus designed for once-daily dosing. Phase 1 studies demonstrated greater bioavailability to twice-daily tacrolimus capsules and no new safety concerns. Methods In this phase 2 study, adult stable kidney transplant patients on tacrolimus capsules (Prograf) twice-daily were converted to tacrolimus tablets (LCP-Tacro) once-daily; patients continued on LCP-Tacro once-daily for days 8 to 21; trough levels were to be maintained between 5 and 15 ng/mL; 24-hr pharmacokinetic assessments were done on days 7 (baseline pre-switch), 14, and 21. Results Forty-seven patients completed LCP-Tacro dosing per protocol. The mean conversion ratio was 0.71. Pharmacokinetic data demonstrated consistent exposure (AUC) at the lower conversion dose. Cmax (P=0.0001), Cmax/Cmin ratio (P<0.001), percent fluctuation (P<0.0001), and swing (P=0.0004) were significantly lower and Tmax significantly (P<0.001) longer for LCP-Tacro versus Prograf. AUC24 and Cmin correlation coefficients after 7 and 14 days of therapy were 0.86 or more, demonstrating a robust correlation between LCP-Tacro tacrolimus exposure and trough levels. There were three serious adverse events; none were related to study drug and all were resolved. Conclusions Stable kidney transplant patients can be safely converted from Prograf twice-daily to LCP-Tacro. The greater bioavailability of LCP-Tacro allows for once-daily dosing and similar (AUC) exposure at a dose approximately 30% less than the total daily dose of Prograf. LCP-Tacro displays flatter kinetics characterized by significantly lower peak-trough fluctuations. PMID:23715050

  8. Síndrome de encefalopatía posterior reversible secundaria a tacrolimus

    Directory of Open Access Journals (Sweden)

    María J. Rodríguez-González

    2016-01-01

    Full Text Available Los inhibidores de la calcineurina, la ciclosporina y el tacrolimus han jugado un papel preponderante en la prevención de los episodios de rechazo y de la enfermedad de injerto contra el huésped en pacientes tratados mediante el trasplante de órgano sólido y de la médula ósea. No obstante, el tacrolimus presenta efectos adversos relacionados con la neurotoxicidad, siendo el síndrome de encefalopatía posterior reversible la consecuencia más severa de dicha neurotoxicidad. El reporte de nuestro caso es de una mujer de 30 años de edad, con 2 días de evolución de cefalea intensa en la frente, náuseas, emesis, hiporexia y epigastralgia, afebril. Antecedente de un trasplante cardiaco 45 días antes, en tratamiento inmunosupresor con tacrolimus y micofenolato mofetilo. Se documentan niveles de tacrolimus adecuados (12,1 ng/ml, los estudios imagenológicos normales y los resultados de laboratorio negativos para infección, lo que permite descartar las causas vasculares e infecciosas y la neurotoxicidad por el tacrolimus. Sin embargo, ante el desarrollo de alteraciones neuropsiquiátricas, y a pesar de niveles de tacrolimus < 5,5 ng/ml, se realiza nueva resonancia nuclear magnética cerebral con hallazgos que indican síndrome de leucoencefalopatía posterior reversible. Se suspende el tacrolimus y se inicia tratamiento con everolimus, lográndose remisión total. Este sería el primer caso reportado en el cual las alteraciones imagenológicas asociadas al síndrome de encefalopatía posterior reversible se desarrollaron en una paciente intervenida de trasplante cardiaco con niveles de tacrolimus < 10 ng/ml. El reporte de este caso permitirá a los grupos médicos tratantes considerar este diagnóstico a pesar de niveles de tacrolimus en rango terapéutico, de manera que se realice un reconocimiento y tratamiento oportuno, evitando así el desarrollo de complicaciones o secuelas neurológicas.

  9. Tacrolimus-induced thrombotic microangiopathy in orthotopic liver transplant patients: case series of four patients.

    Science.gov (United States)

    Nwaba, A; MacQuillan, G; Adams, L A; Garas, G; Delriviere, L; Augustson, B; DeBoer, B; Moody, H; Jeffrey, G P

    2013-03-01

    Thrombotic microangiopathy (TMA) is a potentially fatal complication in solid organ and bone marrow transplant patients, with reported incidence of 0.5-3% and mortality of about 75%. To emphasise the importance of early diagnosis and prompt commencement of therapy results in improved clinical outcomes. A retrospective study of all patients who underwent orthotopic liver transplantation (OLTX) at the Western Australian Liver Transplantation Service from May 1994 to December 2010 was conducted to identify patients who developed tacrolimus-induced TMA. We identified four patients with tacrolimus-induced TMA post-OLTX, derived from a cohort of 104 patients treated with tacrolimus in our institution. The mean age at diagnosis was 40 years, and the mean time of onset was 63 ± 7.5 weeks after OLTX. The indications for OLTX in the four patients were fulminant hepatic failure in three (Wilson disease, paracetamol overdose and post-partum thrombotic thrombocytopenic purpura) and hepatitis C virus-related cirrhosis. All patients had tacrolimus post-OLTX. At diagnosis, tacrolimus was discontinued in all patients, and three of the four patients underwent plasma exchange and all patients improved clinically. Mean duration of follow up was 15 ± 7.5 months. There was no mortality 6 months post-TMA. Early diagnosis with immediate discontinuation or conversion of calcineurin inhibitors and plasma exchange should be offered to OLTX patients with TMA as it results in good outcomes. © 2013 The Authors; Internal Medicine Journal © 2013 Royal Australasian College of Physicians.

  10. HEMOFILTRATION AND COUPLED PLASMA FILTRATION ADSORPTION IMPACT ON TACROLIMUS BLOOD CONCENTRATION IN RENAL TRANSPLANT RECIPIENTS

    Directory of Open Access Journals (Sweden)

    A.V. Vatazin

    2014-01-01

    Full Text Available Aim. To study the effect of hemofi ltration and coupled plasma fi ltration adsorption on tacrolimus blood concentration in renal transplant recipients.Methods and results. The study included 8 renal transplant recipients. In these patients immediately after the operation was performed the coupled plasma fi ltration adsorption with hemofiltration using a cartridge Mediasorb to reduce the severity of reperfusion injury. We have found that during this extracorporeal blood correction procedure there was statistically not signifi cant decrease of tacrolimus blood concentration. However, concentration of tacrolimus remained in the therapeutic range even after the procedure and it was not signifi cantly different from the control point С0.Conclusion. Coupled plasma fi ltration adsorption is safe in renal transplant recipients and has no signifi cant impact on tacrolimus blood concentration. However, the downward trend in the concentration of tacrolimus in the course of these procedures, especially in continuous or semicontinuous mode, as well as in patients with low hematocrit and hypoalbuminemia, requires individual monitoring.

  11. Efficacy and safety of tacrolimus ointment compared with that of hydrocortisone acetate ointment in children with atopic dermatitis

    NARCIS (Netherlands)

    Reitamo, Sakari; van Leent, Edwin J. M.; Ho, Vincent; Harper, John; Ruzicka, Thomas; Kalimo, Kirsti; Cambazard, Frédéric; Rustin, Malcolm; Taïeb, Alain; Gratton, David; Sauder, Daniel; Sharpe, Graham; Smith, Catherine; Jünger, Michael; de Prost, Yves

    2002-01-01

    Vehicle-controlled studies have demonstrated the efficacy and safety of tacrolimus ointment in the treatment of patients with atopic dermatitis (AD). This study was undertaken to compare 0.03% and 0.1% tacrolimus ointment with 1% hydrocortisone acetate ointment in children 2 to 15 years of age with

  12. Conservation of small-airway function by tacrolimus/cyclosporine conversion in the management of bronchiolitis obliterans following lung transplantation.

    Science.gov (United States)

    Revell, M P; Lewis, M E; Llewellyn-Jones, C G; Wilson, I C; Bonser, R S

    2000-12-01

    We studied serial lung function in 11 patients with bronchiolitis obliterans syndrome who were treated with tacrolimus conversion following lung or heart-lung transplantation. Our results show that tacrolimus conversion slows the decline of lung function in bronchiolitis obliterans syndrome. The attenuation continues for at least 1 year following conversion.

  13. Age-Dependent Metabolic and Immunosuppressive Effects of Tacrolimus.

    Science.gov (United States)

    Krenzien, F; Quante, M; Heinbokel, T; Seyda, M; Minami, K; Uehara, H; Biefer, H R C; Schuitenmaker, J M; Gabardi, S; Splith, K; Schmelzle, M; Petrides, A K; Azuma, H; Pratschke, J; Li, X C; ElKhal, A; Tullius, S G

    2017-05-01

    Immunosuppression in elderly recipients has been underappreciated in clinical trials. Here, we assessed age-specific effects of the calcineurin inhibitor tacrolimus (TAC) in a murine transplant model and assessed its clinical relevance on human T cells. Old recipient mice exhibited prolonged skin graft survival compared with young animals after TAC administration. More important, half of the TAC dose was sufficient in old mice to achieve comparable systemic trough levels. TAC administration was able to reduce proinflammatory interferon-γ cytokine production and promote interleukin-10 production in old CD4 + T cells. In addition, TAC administration decreased interleukin-2 secretion in old CD4 + T cells more effectively while inhibiting the proliferation of CD4 + T cells in old mice. Both TAC-treated murine and human CD4 + T cells demonstrated an age-specific suppression of intracellular calcineurin levels and Ca 2+ influx, two critical pathways in T cell activation. Of note, depletion of CD8 + T cells did not alter allograft survival outcome in old TAC-treated mice, suggesting that TAC age-specific effects were mainly CD4 + T cell mediated. Collectively, our study demonstrates age-specific immunosuppressive capacities of TAC that are CD4 + T cell mediated. The suppression of calcineurin levels and Ca 2+ influx in both old murine and human T cells emphasizes the clinical relevance of age-specific effects when using TAC. © 2016 The American Society of Transplantation and the American Society of Transplant Surgeons.

  14. Tacrolimus concentration/dose ratio as a therapeutic drug monitoring strategy: The influence of gender and comedication

    Directory of Open Access Journals (Sweden)

    Rančić Nemanja

    2015-01-01

    Full Text Available Background/Aim. A combination of tacrolimus and other drugs such as corticosteroids has been commonly used immunosuppresive regimens. On the other hand, there is a growing body of evidence that male and female may differ in their response to the equal drug treatment. The aim of the study was to estimated the use of tacrolimus concentration/dose (C/D ratio for the assessment of the influence of gender differences and comedication on tacrolimus exposure in renal transplant recipients. Methods. This prospective case series study included 54 patients, in which the unit of monitoring was outpatient examination (1,872 of the renal transplant patients. The patients were monitored in the period 2010-2014, starting one month after the transplantation. Tacrolimus trough concentrations (TTC were measured by chemiluminescence microparticles immunoassay. Results. TTC and the tacrolimus C/D ratio were significantly lower in the females comparing with the males. Contrary to the males, in the females a significant increase of the tacrolimus daily dose (TDD per body weight and TTC, along with the corticosteroid dose increase, was not accompanied by any significant changes in the tacrolimus C/D ratio; in different corticosteroid doses faster elimination of tacrolimus was found with the exception of the doses > 0.25 mg/kg. In the patients treated with proton pump inhibitors, mainly with pantoprazole TDD per body weight and TTC were significantly higher, while the tacrolimus C/D ratio was significantly lower compared to the patients without this treatment. In the patients treated with calcium channel blockers, TDD per body weight was significantly lower (particularly with amlodipine while the tacrolimus C/D ratio was higher compared to the patients who were not treated by them. Conclusion. A lower tacrolimus exposure was detected in females in comparison to males. When gender differences were considered in the context of different corticosteroid doses, faster

  15. The onset risk of carcinoma in patients continuing tacrolimus topical treatment for oral lichen planus: a case report.

    Science.gov (United States)

    Morita, Mayu; Asoda, Seiji; Tsunoda, Kazuyuki; Soma, Tomoya; Nakagawa, Taneaki; Shirakawa, Masayori; Shoji, Hirofumi; Yagishita, Hisao; Nishikawa, Takeji; Kawana, Hiromasa

    2017-04-01

    Oral lichen planus is a chronic inflammatory mucocutaneous disease. Topical use of steroids and other immuno-modulating therapies have been tried for this intractable condition. Nowadays, tacrolimus ointment is used more commonly as a choice for treatment. However, a number of discussions have taken place after tacrolimus was reported to be carcinogenic. This report describes a patient who applied tacrolimus ointment to the lower lip after being diagnosed with oral lichen planus in 2008, and whose lesion developed squamous cell carcinoma in 2010. Since the relationship between tacrolimus and cancer development has been reported in only a few cases, including this case report, the clinician must be careful selecting tacrolimus as a second-line treatment for oral lichen planus.

  16. [The therapeutic drug monitoring network server of tacrolimus for Chinese renal transplant patients].

    Science.gov (United States)

    Deng, Chen-Hui; Zhang, Guan-Min; Bi, Shan-Shan; Zhou, Tian-Yan; Lu, Wei

    2011-07-01

    This study is to develop a therapeutic drug monitoring (TDM) network server of tacrolimus for Chinese renal transplant patients, which can facilitate doctor to manage patients' information and provide three levels of predictions. Database management system MySQL was employed to build and manage the database of patients and doctors' information, and hypertext mark-up language (HTML) and Java server pages (JSP) technology were employed to construct network server for database management. Based on the population pharmacokinetic model of tacrolimus for Chinese renal transplant patients, above program languages were used to construct the population prediction and subpopulation prediction modules. Based on Bayesian principle and maximization of the posterior probability function, an objective function was established, and minimized by an optimization algorithm to estimate patient's individual pharmacokinetic parameters. It is proved that the network server has the basic functions for database management and three levels of prediction to aid doctor to optimize the regimen of tacrolimus for Chinese renal transplant patients.

  17. Association of the multidrug resistance-1 gene single-nucleotide polymorphisms with the tacrolimus dose requirements in renal transplant recipients.

    Science.gov (United States)

    Anglicheau, Dany; Verstuyft, Céline; Laurent-Puig, Pierre; Becquemont, Laurent; Schlageter, Marie-Hélène; Cassinat, Bruno; Beaune, Philippe; Legendre, Christophe; Thervet, Eric

    2003-07-01

    The immunosuppressive drug tacrolimus, whose pharmacokinetic characteristics display large interindividual variations, is a substrate for P-glycoprotein (P-gp), the product of the multidrug resistance-1 (MDR1) gene. Some of the single nucleotide polymorphisms (SNP) of MDR1 reported correlated with the in vivo activity of P-gp. Because P-gp is known to control tacrolimus intestinal absorption, it was postulated that these polymorphisms are associated with tacrolimus pharmacokinetic variations in renal transplant recipients. The objective of this study was to evaluate in a retrospective study of 81 renal transplant recipients the effect on tacrolimus dosages and concentration/dose ratio of four frequent MDR1 SNP possibly associated with P-gp function (T-129C in exon 1b, 1236C>T in exon 12, 2677G>T,A in exon 21, and 3435C>T in exon 26). As in the general population, the SNP in exons 12, 21, and 26 were frequent (16, 17.3, and 22.2% for the variant homozygous genotype, respectively) and exhibited incomplete linkage disequilibrium. One month after tacrolimus introduction, exon 21 SNP correlated significantly with the daily tacrolimus dose (P < or = 0.05) and the concentration/dose ratio (P < or = 0.02). Tacrolimus dose requirements were 40% higher in homozygous than wild-type patients for this SNP. The concentration/dose ratio was 36% lower in the wild-type patients, suggesting that, for a given dose, their tacrolimus blood concentration is lower. Haplotype analysis substantiated these results and suggested that exons 26 and 21 SNP may be associated with tacrolimus dose requirements. Genotype monitoring of the MDR1 gene reliably predicts the optimal dose of tacrolimus in renal transplant recipients and may predict the initial daily dose needed by individual patients to obtain adequate immunosuppression.

  18. Tacrolimus Versus Cyclosporine as Primary Immunosuppressant After Renal Transplantation: A Meta-Analysis and Economics Evaluation.

    Science.gov (United States)

    Liu, Jin-Yu; You, Ru-Xu; Guo, Min; Zeng, Lu; Zhou, Pu; Zhu, Lan; Xu, Gang; Li, Juan; Liu, Dong

    2016-01-01

    Tacrolimus and cyclosporine are the major immunosuppressants for renal transplantation. Several studies have compared these 2 drugs, but the outcomes were not consistent. The aim of this study was to evaluate the efficacy, safety, and pharmacoeconomics of cyclosporine and tacrolimus in the treatment of renal transplantation and provide evidence for the selection of essential drugs. Trials were identified through a computerized literature search of PubMed, EMBASE, Cochrane Controlled Trials Register, Cochrane Renal Group Specialized Register of randomized controlled trials, and Chinese Biomedical database. Two independent reviewers assessed trials for eligibility and quality and then extracted data. Data were extracted for patient and graft mortality, acute rejection, and adverse events. Dichotomous outcomes were reported as relative risk with 95% confidence intervals. A decision tree model was populated with data from a literature review and used to estimate costs and quality-adjusted life years gained and incremental cost-effectiveness. Altogether, 6137 patients from 27 randomized controlled trials were included. The results of our analysis were that tacrolimus reduced the risks after renal transplantation of patient mortality, graft loss, acute rejection, and hypercholesterolemia. Nevertheless, tacrolimus increased the risk of new-onset diabetes. Pharmacoeconomic analysis showed that tacrolimus represented a more cost-effective treatment than does cyclosporine for the prevention of adverse events following renal transplant. Tacrolimus is an effective and safe immunosuppressive agent and it may be more cost-effective than cyclosporine for the primary prevention of graft rejection in renal transplant recipients. However, new-onset diabetes should be closely monitored during the medication period.

  19. Evaluation of adherence and tolerability of prolonged-release tacrolimus (Advagraf™) in kidney transplant patients in Germany: A multicenter, noninterventional study.

    Science.gov (United States)

    Lehner, Lukas J; Reinke, Petra; Hörstrup, Jan H; Rath, Thomas; Suwelack, Barbara; Krämer, Bernhard K; Budde, Klemens; Banas, Bernhard

    2018-01-01

    This study assessed adherence to prolonged-release tacrolimus (PR-T)-based immunosuppression during routine maintenance of renal transplant recipients in Germany. Patients had received PR-T for ≥1 month at inclusion. Data were collected during four visits (V): baseline (V1), 6 (V2), 12 (V3), and 18 (V4) months. Composite primary endpoint: nonadherence at V4, defined as self-reported nonadherence on the Basel Assessment of Adherence with Immunosuppressive Medication Scale (BAASIS © ), investigator-rated nonadherence, and/or V4 tacrolimus trough level outside a predefined range. Secondary endpoints: individual BAASIS items, incidence of rejection, kidney function, and safety. Overall, 153 adult kidney recipients (mean [standard deviation] time post-transplant 5.8 [4.6] years) were included. Nonadherence was high at V4 (67.7% [95% confidence interval 58.9%, 75.6%]). Medication-taking adherence was 86.9% and 91.3% at V1 and V4, respectively; adherence to timing of medication intake was 58.2% and 58.3%, with little evidence of missed doses/drug holidays. Investigators rated adherence "good" in 85.6% of patients (V4). Two (1.3%) patients had acute rejection episodes. Kidney function remained stable (mean creatinine clearance, V1: 62.1 mL/min; V4: 65.3 mL/min). Investigators rated effectiveness of PR-T as "very good"/"good" in 91.5% of patients. Most patients (94.7%) found PR-T dosing more convenient than immediate-release tacrolimus. PR-T was well tolerated with high medication persistence. © 2017 The Authors. Clinical Transplantation Published by John Wiley & Sons Ltd.

  20. FK Comae Berenices, King of Spin: The COCOA-PUFS Project

    Science.gov (United States)

    Ayres, Thomas R.; Kashyap, V.; Saar, S.; Huenemoerder, D.; Korhonen, H.; Drake, J. J.; Testa, P.; Cohen, O.; Garraffo, C.; Granzer, T.; Strassmeier, K.

    2016-03-01

    COCOA-PUFS is an energy-diverse, time-domain study of the ultra-fast spinning, heavily spotted, yellow giant FK Comae Berenices (FK Com: HD117555; G4 III). This single star is thought to be a recent binary merger, and is exceptionally active by measure of its intense ultraviolet (UV) and X-ray emissions, and proclivity to flare. COCOA-PUFS was carried out with the Hubble Space Telescope in the UV (1200-3000 Å), using mainly its high-performance Cosmic Origins Spectrograph, but also high precision Space Telescope Imaging Spectrograph; Chandra X-ray Observatory in the soft X-rays (0.5-10 keV), utilizing its High-Energy Transmission Grating Spectrometer; together with supporting photometry and spectropolarimetry in the visible from the ground. This is an introductory report on the project. FK Com displayed variability on a wide range of timescales over all wavelengths during the week-long main campaign, including a large X-ray flare; “super-rotational broadening” of the far-ultraviolet “hot lines” (e.g., Si IV 1393 Å 8 × 104 K) together with chromospheric Mg II 2800 Å and C II 1335 Å (1-3 × 104 K); large Doppler swings suggestive of bright regions alternately on advancing and retreating limbs of the star; and substantial redshifts of the epoch-average emission profiles. These behaviors paint a picture of a highly extended, dynamic, hot (˜10 MK) coronal magnetosphere around the star, threaded by cooler structures perhaps analogous to solar prominences and replenished continually by surface activity and flares. Suppression of angular momentum loss by the confining magnetosphere could temporarily postpone the inevitable stellar spindown, thereby lengthening this highly volatile stage of coronal evolution. COordinated Campaign of Observations and Analysis, Photosphere to Upper Atmosphere, of a Fast-rotating Star.

  1. FK COMAE BERENICES, KING OF SPIN: THE COCOA-PUFS PROJECT

    Energy Technology Data Exchange (ETDEWEB)

    Ayres, Thomas R. [Center for Astrophysics and Space Astronomy, 389 UCB, University of Colorado, Boulder, CO 80309 (United States); Kashyap, V.; Saar, S.; Drake, J. J.; Testa, P.; Cohen, O.; Garraffo, C. [Harvard-Smithsonian Center for Astrophysics, Cambridge, MA (United States); Huenemoerder, D. [Massachusetts Institute of Technology, Cambridge, MA (United States); Korhonen, H. [Finnish Centre for Astronomy with ESO (FINCA), University of Turku, Väisäläntie 20, FI-21500 Piikkiö (Finland); Granzer, T.; Strassmeier, K., E-mail: Thomas.Ayres@Colorado.edu [Leibniz-Institut für Astrophysik Potsdam (AIP), An der Sternwarte 16, D-14482 Potsdam (Germany)

    2016-03-15

    COCOA-PUFS is an energy-diverse, time-domain study of the ultra-fast spinning, heavily spotted, yellow giant FK Comae Berenices (FK Com: HD117555; G4 III). This single star is thought to be a recent binary merger, and is exceptionally active by measure of its intense ultraviolet (UV) and X-ray emissions, and proclivity to flare. COCOA-PUFS was carried out with the Hubble Space Telescope in the UV (1200–3000 Å), using mainly its high-performance Cosmic Origins Spectrograph, but also high precision Space Telescope Imaging Spectrograph; Chandra X-ray Observatory in the soft X-rays (0.5–10 keV), utilizing its High-Energy Transmission Grating Spectrometer; together with supporting photometry and spectropolarimetry in the visible from the ground. This is an introductory report on the project. FK Com displayed variability on a wide range of timescales over all wavelengths during the week-long main campaign, including a large X-ray flare; “super-rotational broadening” of the far-ultraviolet “hot lines” (e.g., Si iv 1393 Å; 8 × 10{sup 4} K) together with chromospheric Mg ii 2800 Å and C ii 1335 Å (1–3 × 10{sup 4} K); large Doppler swings suggestive of bright regions alternately on advancing and retreating limbs of the star; and substantial redshifts of the epoch-average emission profiles. These behaviors paint a picture of a highly extended, dynamic, hot (∼10 MK) coronal magnetosphere around the star, threaded by cooler structures perhaps analogous to solar prominences and replenished continually by surface activity and flares. Suppression of angular momentum loss by the confining magnetosphere could temporarily postpone the inevitable stellar spindown, thereby lengthening this highly volatile stage of coronal evolution.

  2. FK COMAE BERENICES, KING OF SPIN: THE COCOA-PUFS PROJECT

    International Nuclear Information System (INIS)

    Ayres, Thomas R.; Kashyap, V.; Saar, S.; Drake, J. J.; Testa, P.; Cohen, O.; Garraffo, C.; Huenemoerder, D.; Korhonen, H.; Granzer, T.; Strassmeier, K.

    2016-01-01

    COCOA-PUFS is an energy-diverse, time-domain study of the ultra-fast spinning, heavily spotted, yellow giant FK Comae Berenices (FK Com: HD117555; G4 III). This single star is thought to be a recent binary merger, and is exceptionally active by measure of its intense ultraviolet (UV) and X-ray emissions, and proclivity to flare. COCOA-PUFS was carried out with the Hubble Space Telescope in the UV (1200–3000 Å), using mainly its high-performance Cosmic Origins Spectrograph, but also high precision Space Telescope Imaging Spectrograph; Chandra X-ray Observatory in the soft X-rays (0.5–10 keV), utilizing its High-Energy Transmission Grating Spectrometer; together with supporting photometry and spectropolarimetry in the visible from the ground. This is an introductory report on the project. FK Com displayed variability on a wide range of timescales over all wavelengths during the week-long main campaign, including a large X-ray flare; “super-rotational broadening” of the far-ultraviolet “hot lines” (e.g., Si iv 1393 Å; 8 × 10 4 K) together with chromospheric Mg ii 2800 Å and C ii 1335 Å (1–3 × 10 4 K); large Doppler swings suggestive of bright regions alternately on advancing and retreating limbs of the star; and substantial redshifts of the epoch-average emission profiles. These behaviors paint a picture of a highly extended, dynamic, hot (∼10 MK) coronal magnetosphere around the star, threaded by cooler structures perhaps analogous to solar prominences and replenished continually by surface activity and flares. Suppression of angular momentum loss by the confining magnetosphere could temporarily postpone the inevitable stellar spindown, thereby lengthening this highly volatile stage of coronal evolution

  3. Cochlearoids F-K: Phenolic meroterpenoids from the fungus Ganoderma cochlear and their renoprotective activity.

    Science.gov (United States)

    Wang, Xin-Long; Zhou, Feng-Jiao; Dou, Man; Yan, Yong-Ming; Wang, Shu-Mei; Di, Lei; Cheng, Yong-Xian

    2016-11-15

    Ganoderma mushrooms are of great nutritious and medicinal values. This study was designed to characterize compounds from the fruiting bodies of Ganoderma cochlear and investigate their protective effects against kidney disorders. Six novel meroterpenoids cochlearoids F-K (1-6) were isolated by utilizing phytochemical approaches. Their structures were identified on the basis of extensive spectroscopic data and calculation methods. Biological evaluation shows that compounds 1-4 and 6 exhibit potent inhibitory activity on fibronectin overproduction in TGF-β1-induced HKC-8 cells. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. ATG-Fresenius treatment and low-dose tacrolimus: results of a randomized controlled trial in liver transplantation.

    Science.gov (United States)

    Benítez, C E; Puig-Pey, I; López, M; Martínez-Llordella, M; Lozano, J J; Bohne, F; Londoño, M C; García-Valdecasas, J C; Bruguera, M; Navasa, M; Rimola, A; Sánchez-Fueyo, A

    2010-10-01

    We report the results of a prospective randomized controlled trial in liver transplantation assessing the efficacy and safety of antithymocyte globulin (ATG-Fresenius) plus tacrolimus monotherapy at gradually decreasing doses. Patients were randomized to either: (a) standard-dose tacrolimus plus steroids;or (b) peritransplant ATG-Fresenius plus reduced-dose tacrolimus monotherapy followed by weaning of tacrolimus starting 3 months after transplantation. The primary end-point was the achievement of very low-dose tacrolimus (every-other-day or once daily dose with Fresenius group but no benefits in terms of improved renal function, lower metabolic complications or increased prevalence of tolerance-related biomarkers were observed. In conclusion, the use of ATG-Fresenius and tacrolimus at gradually decreasing doses was associated with a high rate of rejection, did not allow for the administration of very low doses of tacrolimus and failed to provide detectable clinical benefits. ClinicalTrials.gov identifier: NCT00436722. © 2010 The Authors Journal compilation © 2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

  5. Comparison between the efficacy of microneedling combined with 5-fluorouracil vs microneedling with tacrolimus in the treatment of vitiligo.

    Science.gov (United States)

    Mina, Mary; Elgarhy, Lamia; Al-Saeid, Hanan; Ibrahim, Zeinab

    2018-03-12

    Several treatment modalities had been used for the treatment of vitiligo, but the optimal treatment has not yet been identified. To study the efficacy of microneedling with 5-flurouracil vs its efficacy with tacrolimus in the treatment of vitiligo. Twenty-five patients with vitiligo were subjected to microneedling of 2 patches of vitiligo with dermapen, then application of 5-fluorouracil to 1 patch and tacrolimus on the other patch. This procedure was repeated every 2 weeks for every patient for maximum 6 months (12 sessions). The patients were followed up for 3 months after the last session. The overall repigmentation was significantly higher in 5-fluorouracil-treated patches compared with tacrolimus. Excellent improvement occurred in 48% of 5- flurouracil-treated patches while only in 16% of tacrolimus-treated patches. In the acral parts, 40% of the patches treated with 5-fluorouracil achieved excellent improvement (repigmentation >75%), while no patch in the acral parts achieved excellent improvement with tacrolimus. However, there was significant difference between the 2 drugs,regarding inflammation, ulceration, and hyperpigmentation which occurred with 5-fluorouracil. Microneedling combined with 5-fluorouracil or tacrolimus is safe and effective treatment of vitiligo. However, 5-fluorouracil achieved a greater percentage of repigmentation than tacrolimus particularly in the acral parts. © 2018 Wiley Periodicals, Inc.

  6. COMPARATIVE ANALYSIS OF SOLUBLE OF CD40 LIGAND LEVELS IN HEART RECIPIENTS TREATED WITH CYCLOSPORINE A AND TACROLIMUS

    Directory of Open Access Journals (Sweden)

    O. P. Shevchenko

    2012-01-01

    Full Text Available Soluble form of CD40L is platelet activating factor, which is a marker of inflammation and thrombosis. Elevated levels of sCD40L before the heart transplantation are associated with the risk of early development of cardiova- scular complications. The study included 54 patients who had received heart transplants. All recipients received a triple heart immu- nosuppressive therapy, including methylprednisolone, mycophenolate mofetil and cyclosporine A (20 recipients or methylprednisolone, mycophenolate mofetil and tacrolimus (34 recipients. Patients were not differed by age, gender, etiology of heart failure before heart transplantation (p > 0,05. In the first group of transplant recipients, the relative risk of cardiovascular events with high sCD40L levels before transplantation was 3 2 (95% CI 1,4; 12,0. In the second group of recipients, respectively, 2.69 (95% CI 1,1; 8,5. SCD40L level after heart transplan- tation was significantly higher for patients receiving cyclosporine (P < 0.05. Increasing concentrations of sCD40L are associated with a higher incidence of cardiovascular complications. 

  7. Development and Improvement of Simple Colonic Mucosal Ulcer during Treatment of Severe Ulcerative Colitis with Tacrolimus

    Directory of Open Access Journals (Sweden)

    Ayumi Ito

    2017-03-01

    Full Text Available Diarrhea, melena, and lower abdominal pain developed in a male in his 20s and colonoscopy showed pancolitis-type severe ulcerative colitis (UC. Treatment was initiated with 4,000 mg of 5-aminosalicylic acid and 60 mg/day of prednisolone, but the symptoms and inflammatory reaction worsened with prednisolone dose reduction. Tacrolimus was added to the treatment, which subsequently induced remission. Serial colonoscopies during the treatment showed improvement in ulcer and mucosal edema throughout the entire large intestine, but a new solitary round ulcer appeared at the end of the ileum. Since no signs of Behçet’s disease were noted, it was considered as a simple ulcer, a complication of UC. Tacrolimus treatment was continued based on continued improvement in clinical features and colonic mucosa, excluding the end of the ileum. Colonoscopy at 6 months after initiation of tacrolimus showed healing of the large intestinal mucosa, although mild congestion was still noted. The solitary round ulcer at the end of the ileum improved to a small erosion. We report the improvement of a simple ulcer that developed during tacrolimus treatment.

  8. Which genetic determinants should be considered for tacrolimus dose optimization in kidney transplantation?

    DEFF Research Database (Denmark)

    Bruckmueller, H; Werk, Anneke Nina; Renders, Lutz

    2014-01-01

    ). In addition, there are further polymorphic genes, possibly influencing CYP3A activity (pregnan x receptor NR1I2, P450 oxidoreductase POR and peroxisome proliferator-activator receptor alpha PPRA). We aimed to investigate combined effects of these gene variants on tacrolimus maintenance dose and PK in stable...

  9. Tacrolimus Therapy for Three Patients with Elderly-Onset Ulcerative Colitis: Report of Three Cases

    Directory of Open Access Journals (Sweden)

    Rumiko Kobayashi

    2016-07-01

    Full Text Available In recent years, cases of elderly-onset ulcerative colitis (UC have been increasing in number and are currently reported to account for 10–15% of all cases of UC. Although the treatment of UC is essentially similar between older and younger patients, evidence of the therapeutic efficacy of tacrolimus in elderly-onset UC patients is still limited. Herein, we report our attempt to induce remission using tacrolimus in three patients with elderly-onset UC. A 75-year-old Japanese woman, a 71-year-old Japanese man and a 76-year-old Japanese woman with severe elderly-onset UC of the pancolitis type were treated with tacrolimus. Although all three patients showed response to the drug, the eventual outcome was poor in the first patient, who developed toxic megacolon, underwent surgery, and suffered from recurrent infections and hemorrhage after the surgery. However, clinical remission was successfully achieved in the second and third patient. Tacrolimus shows some indication of effectiveness in the treatment of elderly-onset UC. However, in elderly-onset UC patients, it is necessary to keep in mind the higher risk of adverse effects of medical therapy and postoperative complications because of the high comorbidity rates. Moreover, in situations where surgery needs to be considered, it is important to ensure appropriate timing of the surgery.

  10. Cyclosporine versus tacrolimus: cost-effectiveness analysis for renal transplantation in Brazil

    Science.gov (United States)

    Guerra, Augusto Afonso; Silva, Grazielle Dias; Andrade, Eli Iola Gurgel; Cherchiglia, Mariângela Leal; Costa, Juliana de Oliveira; Almeida, Alessandra Maciel; Acurcio, Francisco de Assis

    2015-01-01

    OBJECTIVE To analyze the cost-effectiveness of treatment regimens with cyclosporine or tacrolimus, five years after renal transplantation. METHODS This cost-effectiveness analysis was based on historical cohort data obtained between 2000 and 2004 and involved 2,022 patients treated with cyclosporine or tacrolimus, matched 1:1 for gender, age, and type and year of transplantation. Graft survival and the direct costs of medical care obtained from the National Health System (SUS) databases were used as outcome results. RESULTS Most of the patients were women, with a mean age of 36.6 years. The most frequent diagnosis of chronic renal failure was glomerulonephritis/nephritis (27.7%). In five years, the tacrolimus group had an average life expectancy gain of 3.96 years at an annual cost of R$78,360.57 compared with the cyclosporine group with a gain of 4.05 years and an annual cost of R$61,350.44. CONCLUSIONS After matching, the study indicated better survival of patients treated with regimens using tacrolimus. However, regimens containing cyclosporine were more cost-effective. PMID:25741648

  11. Effects of Topical Corticosteroid and Tacrolimus on Ceramides and Irritancy to Sodium Lauryl Sulphate in Healthy Skin

    DEFF Research Database (Denmark)

    Jungersted, Jakob Mutanu; Høgh, Julie Kaae; Hellgren, Lars

    2011-01-01

    twice daily for one week with betamethasone, tacrolimus, emollient, or left untreated, respectively. After one week each area was challenged with a 24 h sodium lauryl sulphate patch test. The lipids were collected using the cyanoacrylate method and evaluated by high performance thin layer chromatography...... found between treatment regimes. Pretreatment with betamethasone (p = 0.01) or with tacrolimus (p = 0.001) causes a decreased inflammatory response to sodium lauryl sulphate compared with emollient. In conclusion, treatment with betamethasone and tacrolimus has a positive effect on the ceramide...

  12. Aerobic degradation of 4-nitroaniline (4-NA) via novel degradation intermediates by Rhodococcus sp. strain FK48

    Energy Technology Data Exchange (ETDEWEB)

    Khan, Fazlurrahman; Pandey, Janmejay; Vikram, Surendra; Pal, Deepika; Cameotra, Swaranjit Singh, E-mail: ssc@imtech.res.in

    2013-06-15

    Highlights: • This study reports isolation of a novel bacterium capable of mineralizing 4-nitroaniline (4-NA). • This bacterium has been identified as Rhodococcus sp. strain FK48. • Strain FK48 degrades 4-NA via a novel aerobic degradation pathway that involves 4-AP and 1,2,4-BT. • Subsequent degradation proceeds via ring fission and formation of maleylacetate. • This is the first report showing elucidation of catabolic pathway for microbial degradation 4-NA. -- Abstract: An aerobic strain, Rhodococcus sp. strain FK48, capable of growing on 4-nitroaniline (4-NA) as the sole source of carbon, nitrogen, and energy has been isolated from enrichment cultures originating from contaminated soil samples. During growth studies with non- induced cells of FK48 catalyzed sequential denitrification (release of NO{sub 2} substituent) and deamination (release of NH{sub 2} substituent) of 4-NA. However, none of the degradation intermediates could be identified with growth studies. During resting cell studies, 4-NA-induced cells of strain FK48 transformed 4-NA via a previously unknown pathway which involved oxidative hydroxylation leading to formation of 4-aminophenol (4-AP). Subsequent degradation involved oxidated deamination of 4-AP and formation of 1,2,4-benzenetriol (BT) as the major identified terminal aromatic intermediate. Identification of these intermediates was ascertained by HPLC, and GC–MS analyses of the culture supernatants. 4-NA-induced cells of strain FK48 showed positive activity for 1,2,4-benzenetriol dioxygenase in spectrophotometric assay. This is the first conclusive study on aerobic microbial degradation of 4-NA and elucidation of corresponding metabolic pathway.

  13. Aerobic degradation of 4-nitroaniline (4-NA) via novel degradation intermediates by Rhodococcus sp. strain FK48

    International Nuclear Information System (INIS)

    Khan, Fazlurrahman; Pandey, Janmejay; Vikram, Surendra; Pal, Deepika; Cameotra, Swaranjit Singh

    2013-01-01

    Highlights: • This study reports isolation of a novel bacterium capable of mineralizing 4-nitroaniline (4-NA). • This bacterium has been identified as Rhodococcus sp. strain FK48. • Strain FK48 degrades 4-NA via a novel aerobic degradation pathway that involves 4-AP and 1,2,4-BT. • Subsequent degradation proceeds via ring fission and formation of maleylacetate. • This is the first report showing elucidation of catabolic pathway for microbial degradation 4-NA. -- Abstract: An aerobic strain, Rhodococcus sp. strain FK48, capable of growing on 4-nitroaniline (4-NA) as the sole source of carbon, nitrogen, and energy has been isolated from enrichment cultures originating from contaminated soil samples. During growth studies with non- induced cells of FK48 catalyzed sequential denitrification (release of NO 2 substituent) and deamination (release of NH 2 substituent) of 4-NA. However, none of the degradation intermediates could be identified with growth studies. During resting cell studies, 4-NA-induced cells of strain FK48 transformed 4-NA via a previously unknown pathway which involved oxidative hydroxylation leading to formation of 4-aminophenol (4-AP). Subsequent degradation involved oxidated deamination of 4-AP and formation of 1,2,4-benzenetriol (BT) as the major identified terminal aromatic intermediate. Identification of these intermediates was ascertained by HPLC, and GC–MS analyses of the culture supernatants. 4-NA-induced cells of strain FK48 showed positive activity for 1,2,4-benzenetriol dioxygenase in spectrophotometric assay. This is the first conclusive study on aerobic microbial degradation of 4-NA and elucidation of corresponding metabolic pathway

  14. Artificial neural network model for predicting the bioavailability of tacrolimus in patients with renal transplantation

    Science.gov (United States)

    Thishya, Kalluri; Vattam, Kiran Kumar; Naushad, Shaik Mohammad; Raju, Shree Bhushan

    2018-01-01

    The objective of the current study was to explore the role of ABCB1 and CYP3A5 genetic polymorphisms in predicting the bioavailability of tacrolimus and the risk for post-transplant diabetes. Artificial neural network (ANN) and logistic regression (LR) models were used to predict the bioavailability of tacrolimus and risk for post-transplant diabetes, respectively. The five-fold cross-validation of ANN model showed good correlation with the experimental data of bioavailability (r2 = 0.93–0.96). Younger age, male gender, optimal body mass index were shown to exhibit lower bioavailability of tacrolimus. ABCB1 1236 C>T and 2677G>T/A showed inverse association while CYP3A5*3 showed a positive association with the bioavailability of tacrolimus. Gender bias was observed in the association with ABCB1 3435 C>T polymorphism. CYP3A5*3 was shown to interact synergistically in increasing the bioavailability in combination with ABCB1 1236 TT or 2677GG genotypes. LR model showed an independent association of ABCB1 2677 G>T/A with post transplant diabetes (OR: 4.83, 95% CI: 1.22–19.03). Multifactor dimensionality reduction analysis (MDR) revealed that synergistic interactions between CYP3A5*3 and ABCB1 2677 G>T/A as the determinants of risk for post-transplant diabetes. To conclude, the ANN and MDR models explore both individual and synergistic effects of variables in modulating the bioavailability of tacrolimus and risk for post-transplant diabetes. PMID:29621269

  15. Fifth Fundamental Catalogue (FK5). Part 1: Basic fundamental stars (Fricke, Schwan, and Lederle 1988): Documentation for the machine-readable version

    Science.gov (United States)

    Warren, Wayne H., Jr.

    1990-01-01

    The machine-readable version of the catalog, as it is currently being distributed from the Astronomical Data Center, is described. The Basic FK5 provides improved mean positions and proper motions for the 1535 classical fundamental stars that had been included in the FK3 and FK4 catalogs. The machine version of the catalog contains the positions and proper motions of the Basic FK5 stars for the epochs and equinoxes J2000.0 and B1950.0, the mean epochs of individual observed right ascensions and declinations used to determine the final positions, and the mean errors of the final positions and proper motions for the reported epochs. The cross identifications to other designations used for the FK5 stars that are given in the published catalog were not included in the original machine versions, but the Durchmusterung numbers have been added at the Astronomical Data Center.

  16. A search for new CYP3A4 variants as determinants of tacrolimus dose requirements in renal-transplanted patients.

    Science.gov (United States)

    Tavira, Beatriz; Coto, Eliecer; Diaz-Corte, Carmen; Alvarez, Victoria; López-Larrea, Carlos; Ortega, Francisco

    2013-08-01

    The CYP3A5*3 and CYP3A4*1B alleles have been related with tacrolimus (Tac) dose requirements. The rare CYP3A4*22 variant has also been associated with a significantly lower Tac dose. We genotyped the three single-nucleotide polymorphisms in 206 kidney-transplanted patients who received Tac as the primary immunosuppressor. CYP3A5*1 and CYP3A4*1B allele carriers received a significantly higher Tac dose (PCYP3A4*22 genotypes, either nominally or according to the CYP3A5 genotype (expressers vs. nonexpressers). Sequencing of CYP3A4 coding exons in a total of 15 patients revealed only one nonreported missense change (p.P227>T) in one patient. We concluded that CYP3A5*3 and CYP3A4*1B were the main determinants of the Tac dose-adjusted blood concentration in our cohort of renal-transplanted patients.

  17. Distinct deleterious effects of cyclosporine and tacrolimus and combined tacrolimus-sirolimus on endothelial cells: protective effect of defibrotide.

    Science.gov (United States)

    Carmona, Alba; Díaz-Ricart, Maribel; Palomo, Marta; Molina, Patricia; Pino, Marc; Rovira, Montserrat; Escolar, Ginés; Carreras, Enric

    2013-10-01

    Endothelial dysfunction seems to be a key factor in the development of several complications observed early after hematopoietic stem cell transplantation (HSCT). The conditioning regimen and many other factors associated with the procedure are responsible for this endothelial damage. The effects of immunosuppressive agents on endothelial function have not been explored in detail. We evaluated the effects of 3 drugs commonly used in HSCT: 2 calcineurin inhibitors, cyclosporine A (CSA) and tacrolimus (TAC), and an inhibitor of mTOR, sirolimus (SIR). We also evaluated the effect of the combination of TAC and SIR (TAC+SIR), which is used increasingly in clinical practice. Microvascular endothelial cells (HMEC-1) were exposed to these drugs to evaluate changes in (1) intercellular adhesion molecule (ICAM)-1 expression on the cell surface, assessed by immunofluorescence labeling and expressed as the mean gray value (MGV); (2) reactivity of the extracellular matrix (ECM) toward platelets, upon exposure of the ECM to circulating blood; and (3) whole-blood clot formation, assessed by thromboelastometry. Studies were conducted in the absence and presence of defibrotide (DF) to assess its possible protective effect. The exposure of HMEC-1 to CSA and TAC+SIR significantly increased the expression of ICAM-1 (157.5 ± 11.6 and 153.4 ± 9.5 MGV, respectively, versus 105.7 ± 6.5 MGV in controls [both P < .05]). TAC applied alone increased ICAM-1 slightly (120.3 ± 8.2 MGV), and SIR had no effect (108.9 ± 7.4 MGV). ECM reactivity increased significantly only in response to CSA (surface covered by platelets of 41.2% ± 5.4% versus 30.1% ± 2.0%, P < .05). DF attenuated all these changes. No significant changes in the viscoelastic properties of clot formation were observed in any condition with blood samples incubated in vitro. In conclusion, CSA and TAC+SIR had a proinflammatory effect, but only CSA exhibited an additional prothrombotic effect. Interestingly, DF exerted clear

  18. Efficacy of topical tacrolimus 0.1% in active plaque morphea: randomized, double-blind, emollient-controlled pilot study.

    NARCIS (Netherlands)

    Kroft, Ilse; Groeneveld, T.J.; Seyger, M.M.B.; Jong, E.M.G.J. de

    2009-01-01

    BACKGROUND: Tacrolimus, a calcineurin inhibitor, is an immunomodulating and anti-inflammatory drug that inhibits T-cell activation and production of cytokines. The elevated level of cytokines in morphea causes fibroblast proliferation and subsequent overproduction of collagen. Theoretically,

  19. High Intrapatient Variability of Tacrolimus Levels and Outpatient Clinic Nonattendance Are Associated With Inferior Outcomes in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Dawn L. Goodall, MSc

    2017-08-01

    Conclusions. This study shows that high tacrolimus IPV and clinic nonattendance are associated with inferior allograft survival. Interventions to minimize the causes of high variability, particularly nonadherence are essential to improve long-term allograft outcomes.

  20. A Comparative Evaluation of Efficacy of Tacrolimus and Triamcinolone Acetonide in the Management of Symptomatic Oral Lichen Planus

    Directory of Open Access Journals (Sweden)

    Y M Swarna

    2011-01-01

    Interpretation and conclusion Topical tacrolimus 0.03% ointment induced better initial therapeutic response than triamcinolone acetonide 0.1 % ointment. However, relapses occurred in two subjects in group ′A′ and three subjects in group ′B′ after the cessation of the respective treatments. Nevertheless, at present topical tacrolimus may be a valuable addition to the already existing therapeutic modalities for treating subjects with OLP.

  1. Hubungan Kejadian Internet Addiction dengan Prestasi Belajar pada Mahasiswa FK Unand

    Directory of Open Access Journals (Sweden)

    Rizky Erizka

    2016-09-01

    Full Text Available AbstrakTeknologi internet berkembang sangat pesat dalam beberapa tahun terakhir dengan berbagai manfaat positif dan negatifnya. Internet addiction merupakan salah satu dampak negatif yang ditimbulkan. Dalam beberapa penelitian disebutkan pengaruh internet addiction terhadap beberapa aspek termasuk pendidikan. Tujuan penelitian ini adalah mengetahui angka kejadian internet addiction dan mempelajari hubungannya dengan prestasi belajar pada mahasiswa Fakultas Kedokteran Unand. Metode studi cross sectional dilakukan terhadap mahasiswa FK Unand angkatan 2011. Hasil penelitian diolah dengan menggunakan uji chi-square. Hasil penelitian menunjukkan kejadian internet addiction mempengaruhi prestasi belajar pada mahasiswa FK Unand. Sebanyak 1,1% subjek mengalami internet addiction berat, 34,4% sedang dan 37,7% ringan. Berdasarkan jenis kelamin perempuan lebih banyak mengalami internet addiction daripada laki laki karena  perempuan yang lebih banyak. Klasifikasi yang terbanyak adalah cyber-relationship dan metode paling banyak yang digunakan untuk mengakses internet adalah dengan menggunakan smartphone. Hasil lain yang didapatkan adalah kebutuhan dasar dan ibadah adalah kegiatan paling dominan yang dapat menghentikan responden dari mengakses internet. Disimpulkan bahwa kejadian internet addiction mempengaruhi prestasi belajar pada mahasiswa FK Unand.Kata kunci: cyber-relationship, internet, internet addiction, prestasi belajar AbstractThe internet technology grow very fast in recent years bringing many positive and negative effects. Internet addiction is one of the negative effect. Several research confirm some negative effect of internet addiction including  academic problem. The objective of this study was to know frequency and it’s relation with academic achievement in Medical Faculty of Andalas university’s students. This was a cross-sectional study on Medical Faculty of Andalas University’s students. The result were analyzed by chi

  2. Books Received

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education. Books Received. Articles in Resonance – Journal of Science Education. Volume 1 Issue 1 January 1996 pp 118-118 Books Received. Books Received · More Details Fulltext PDF. Volume 1 Issue 2 February 1996 pp 120-120 Books Received. Books Received.

  3. Post-Transplant Cyclophosphamide and Tacrolimus-Mycophenolate Mofetil Combination Prevents Graft-versus-Host Disease in Allogeneic Peripheral Blood Hematopoietic Cell Transplantation from HLA-Matched Donors.

    Science.gov (United States)

    Carnevale-Schianca, Fabrizio; Caravelli, Daniela; Gallo, Susanna; Coha, Valentina; D'Ambrosio, Lorenzo; Vassallo, Elena; Fizzotti, Marco; Nesi, Francesca; Gioeni, Luisa; Berger, Massimo; Polo, Alessandra; Gammaitoni, Loretta; Becco, Paolo; Giraudo, Lidia; Mangioni, Monica; Sangiolo, Dario; Grignani, Giovanni; Rota-Scalabrini, Delia; Sottile, Antonino; Fagioli, Franca; Aglietta, Massimo

    2017-03-01

    Allogeneic hematopoietic cell transplant (HCT) remains the only curative therapy for many hematologic malignancies but it is limited by high nonrelapse mortality (NRM), primarily from unpredictable control of graft-versus-host disease (GVHD). Recently, post-transplant cyclophosphamide demonstrated improved GVHD control in allogeneic bone marrow HCT. Here we explore cyclophosphamide in allogeneic peripheral blood stem cell transplantation (alloPBSCT). Patients with high-risk hematologic malignancies received alloPBSCT from HLA-matched unrelated/related donors. GVHD prophylaxis included combination post-HCT cyclophosphamide 50 mg/kg (days +3 and +4) and tacrolimus/mofetil mycophenolate (T/MMF) (day +5 forward). The primary objective was the cumulative incidence of acute and chronic GVHD. Between March 2011 and May 2015, 35 consecutive patients received the proposed regimen. MMF was stopped in all patients at day +28; the median discontinuation of tacrolimus was day +113. Acute and chronic GVHD cumulative incidences were 17% and 7%, respectively, with no grade IV GVHD events, only 2 patients requiring chronic GVHD immunosuppression control, and no deaths from GVHD. Two-year NRM, overall survival, event-free survival, and chronic GVHD event-free survival rates were 3%, 77%, 54%, and 49%, respectively. The graft-versus-tumor effect was maintained as 5 of 15 patients (33%) who received HCT with evidence of disease experienced further disease response. A post-transplant cyclophosphamide + T/MMF combination strategy effectively prevented acute and chronic GVHD after alloPBSCT from HLA-matched donors and achieved an unprecedented low NRM without losing efficacy in disease control or impaired development of the graft-versus-tumor effect. This trial is registered at clinicaltrials.gov as NCT02300571. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  4. Conversion from tacrolimus-mycophenolate mofetil to tacrolimus-mTOR immunosuppression after kidney-pancreas transplantation reduces the incidence of both BK and CMV viremia.

    Science.gov (United States)

    Knight, Richard J; Graviss, Edward A; Nguyen, Duc T; Kuten, Samantha A; Patel, Samir J; Gaber, Lillian; Gaber, A Osama

    2018-04-19

    We sought to determine whether conversion from tacrolimus/mycophenolate mofetil (TAC-MMF) into tacrolimus/mTOR inhibitor (TAC-mTOR) immunosuppression would reduce the incidences of BK and CMV viremia after kidney/pancreas (KP) transplantation. In this single-center review, the TAC-mTOR cohort (n = 39) was converted at 1 month post-transplant to an mTOR inhibitor and reduced-dose tacrolimus. Outcomes were compared to a cohort of KP recipients (n = 40) maintained on TAC-MMF. At 3 years post-transplant, KP survivals and incidences of kidney/pancreas rejection were equivalent between mTOR and MMF-treated cohorts. (P = ns). BK viremia-free survival was better for the mTOR vs MMF-treated group (P = .004). In multivariate analysis, MMF vs mTOR immunosuppression was an independent risk factor for BK viremia (hazard ratio 12.27, P = .02). Similarly, mTOR-treated recipients displayed better CMV infection-free survival compared to the MMF-treated cohort (P = .01). MMF vs mTOR immunosuppression (hazard ratio 18.77, P = .001) and older recipient age (hazard ratio 1.13 per year, P = .006) were independent risk factors for CMV viremia. Mean estimated GFR and HgbA1c levels were equivalent between groups at 1, 2, and 3 years post-transplantation. Conversion from TAC/MMF into TAC/mTOR immunosuppression after KP transplantation reduced the incidences of BK and CMV viremia with an equivalent risk of acute rejection and similar renal/pancreas function. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  5. CD73 Protein as a Source of Extracellular Precursors for Sustained NAD+ Biosynthesis in FK866-treated Tumor Cells*

    Science.gov (United States)

    Grozio, Alessia; Sociali, Giovanna; Sturla, Laura; Caffa, Irene; Soncini, Debora; Salis, Annalisa; Raffaelli, Nadia; De Flora, Antonio; Nencioni, Alessio; Bruzzone, Santina

    2013-01-01

    NAD+ is mainly synthesized in human cells via the “salvage” pathways starting from nicotinamide, nicotinic acid, or nicotinamide riboside (NR). The inhibition with FK866 of the enzyme nicotinamide phosphoribosyltransferase (NAMPT), catalyzing the first reaction in the “salvage” pathway from nicotinamide, showed potent antitumor activity in several preclinical models of solid and hematologic cancers. In the clinical studies performed with FK866, however, no tumor remission was observed. Here we demonstrate that low micromolar concentrations of extracellular NAD+ or NAD+ precursors, nicotinamide mononucleotide (NMN) and NR, can reverse the FK866-induced cell death, this representing a plausible explanation for the failure of NAMPT inhibition as an anti-cancer therapy. NMN is a substrate of both ectoenzymes CD38 and CD73, with generation of NAM and NR, respectively. In this study, we investigated the roles of CD38 and CD73 in providing ectocellular NAD+ precursors for NAD+ biosynthesis and in modulating cell susceptibility to FK866. By specifically silencing or overexpressing CD38 and CD73, we demonstrated that endogenous CD73 enables, whereas CD38 impairs, the conversion of extracellular NMN to NR as a precursor for intracellular NAD+ biosynthesis in human cells. Moreover, cell viability in FK866-treated cells supplemented with extracellular NMN was strongly reduced in tumor cells, upon pharmacological inhibition or specific down-regulation of CD73. Thus, our study suggests that genetic or pharmacologic interventions interfering with CD73 activity may prove useful to increase cancer cell sensitivity to NAMPT inhibitors. PMID:23880765

  6. Plaque-Like Sclerodermiform Localized Mucinosis Rapidly Responsive to Topical Tacrolimus

    Directory of Open Access Journals (Sweden)

    R. Schmaltz

    2010-08-01

    Full Text Available We report the successful treatment of plaque-like sclerodermiform mucinosis using tacrolimus ointment topically. We present a 70-year-old male with a large chronic erythema and hardening of the nuchal skin and shoulder area. Subjective symptoms were a moderate pruritus and a rather disabling stiffness. A biopsy specimen revealed typical features of lichen myxedematosus. In a subsequent clinical examination, no associated illnesses such as hypothyroidism or gammopathy were found. Since no established therapy exists for this condition, and as there was a lack of response to potent topical glucocorticosteroids, tacrolimus 0.03% ointment was used off-label twice daily. Surprisingly, this resulted in a rapid, almost complete clearance of the skin within three weeks of treatment.

  7. Investigation on biological properties of tacrolimus-loaded poly(1,3-trimethylene carbonate) in vitro

    Science.gov (United States)

    Hou, Ruixia; Wu, Leigang; Wang, Jin; Huang, Nan

    2010-06-01

    The drug-eluting stents have been regarded as a milestone in inhibiting the restenosis of coronary arteries. However, adverse reactions caused by bare-metal stents and non-biodegradable polymer coatings may result in some clinical problems. In this study, a new tacrolimus-eluting stent coated with biodegradable poly(1,3-trimethylene carbonate) (PTMC) is developed. The structures are characterized by Fourier transform infrared (FTIR) analysis, and the wettability is measured by contact angle assay. The biological behaviors are evaluated by the in vitro platelets adhesion test, APTT test, the human umbilical cord artery smooth muscle cells (HUCASMCs), 4',6-diamidine-2-phenylindole (DAPI) and actin immunofluorescence staining, MTT colorimetric assay. These results show that after blending tacrolimus into PTMC, the anticoagulant behavior is improved, and the adhesion and proliferation of HUCASMCs on samples are inhibited. This work aims to find one kind of surface erosion biodegradable polymers that can be applied as drug-eluting stent coatings.

  8. Ação do tacrolimus na pancreatite aguda experimental induzida pela arginina

    Directory of Open Access Journals (Sweden)

    Marlus Moreira

    Full Text Available OBJETIVO: verificar se o tacrolimus administrado em ratos, em vigência de pancreatite induzida pela L-Arginina, interfere nos níveis séricos da amilase e glicose e no padrão histológico do parênquima pancreático. MÉTODOS: quarenta ratos Wistar foram distribuídos em quatro grupos com 10 ratos cada. Grupo controle (C, grupo tacrolimus (T, grupo pancreatite (P e grupo pancreatite-tacrolimus (PT. Foram avaliados os níveis séricos de amilase, glicose e tacrolimus e feitas avaliações histológicas do pâncreas, A indução de pancreatite foi feita pela inoculação de L-Arginina na dose de 500mg/100g de peso corporal por via intraperitoneal e o tratamento com tacrolimus na dose de 1ìg/kg por via subcutânea durante quatro dias. RESULTADOS: a amilasemia estava mais elevada (p=0,0000 nos grupos PT, T e P do que no grupo controle. A média do grupo PT foi maior (p=0,0009 que a do grupo T, mas não diferiu (p=0,6802 da média do grupo P. Entre os grupos P e T não houve diferença (p=0,2568. Não houve diferença nas médias de glicemia entre os grupos (p=0,4920 e os níveis séricos de tacrolimus foram similares nos grupos PT e T (p=0,7112. Não ocorreram alterações histológicas nos grupos T e C e não ocorreu hemorragia no pâncreas dos ratos dos grupos P e PT. No grupo P, em 30% não se observou edema, em 20% observou-se a forma leve e em 50%, a moderada; quanto à infiltração inflamatória, em 80% moderada e em 20% não ocorreu, e a atrofia do parênquima foi de 60% moderada e 40% acentuada. No grupo PT, houve ocorrência de edema, infiltração inflamatória e atrofia do pâncreas em todos os ratos. CONCLUSÃO: o tratamento pelo tacrolimus induziu aumento nos níveis séricos de amilase em ratos normais, não alterou a glicemia nem o padrão histológico do parênquima pancreático. Na vigência de pancreatite induzida pela L-Arginina o tacrolimus induziu edema, infiltração inflamatória e atrofia com maior gravidade no par

  9. Post-marketing surveillance of the safety and effectiveness of tacrolimus in 3,267 Japanese patients with rheumatoid arthritis.

    Science.gov (United States)

    Takeuchi, Tsutomu; Kawai, Shinichi; Yamamoto, Kazuhiko; Harigai, Masayoshi; Ishida, Kota; Miyasaka, Nobuyuki

    2014-01-01

    A post-marketing surveillance (PMS) program was implemented to assess the safety and effectiveness of tacrolimus (TAC) in Japanese rheumatoid arthritis (RA) patients and to identify risk factors related to adverse drug reactions (ADRs). Patients were registered centrally and monitored for all adverse events (AEs) for 24 weeks. Effectiveness was evaluated using the Disease Activity Score 28-CRP (DAS28-CRP). Data from 3,172 patients (mean age 62.2 years) were evaluated in the safety analysis. Of the safety population, 78.5 %were female and 25.9 % were in Steinbrocker's functional class 3 or 4. TAC was prescribed as monotherapy in 52.5 % and the most common concomitant disease modifying antirheumatic drug (DMARD) was methotrexate, used in 28.9 % of the patients. The incidence of AEs, serious AEs (SAEs), ADRs and serious ADRs were 41.2, 6.4, 36.0, and 4.9 %, respectively. The most frequent serious ADR category was infections and infestations. Age ≥ 65 years, concurrent renal dysfunction, and concurrent diabetes mellitus were identified as significant risk factors for ADR. Based on EULAR response criteria, 65.4 % of the patients showed moderate or good response. The results demonstrate that TAC is well tolerated by Japanese patients with active RA, including those receiving concomitant methotrexate, in the real world.

  10. The effects of FK1706 on nerve regeneration and bladder function recovery following an end-to-side neurorrhaphy in rats.

    Science.gov (United States)

    Gao, Wansheng; He, Xiangfei; Li, Yunlong; Wen, Jianguo

    2017-11-07

    Immunophilin ligands are neuroregenerative agents binding to FK506 binding proteins, by which stimulate recovery of neurons in a variety of injury nerves. FK1706 is a novel immunophilin ligand which has neuroprotective and neuroregenerative effects but without immunosuppressive activity. At present, most reports about FK1706 in ameliorating nerve injury and functional recovery are limited to cavernous nerve injury and erectile function recovery. This study aimed to demonstrate the effects of FK1706 on nerve regeneration and bladder function recovery following an end-to-side neurorrhaphy in rat models. The numbers of regenerated myelinated axons of the pelvic parasympathetic nerve (PPN) in the three groups' rats (FK1706 + ETS, ETS and control groups) were evaluated. Their intravesical pressure (IVP), S100β and growth associated protein 43 (GAP43) expressions were also compared. In FK1706 + ETS group, 90% the rats showed that the frequency of FG labeled neurons was larger than the 3.5 cutoff value, 100% the rats showed that the frequency of FG-FB double-labeled neurons was larger than the 5.5 cutoff value. The average maximum of IVP in FK1706 + ETS group reached 76.3% of the value in control group. Their average number of myelinated axons of regenerated PPN reached 80% of the amount in control group. The nerve regeneration-associated markers data indicated that the expression level of S100β and GAP43 in FK1706 + ETS group was approximately 2-fold higher than that of ETS group (P side neurorrhaphy, FK1706 effectively enhanced the nerve regeneration and bladder function recovery.

  11. Efficacy and safety of low-dose topical tacrolimus in vernal keratoconjunctivitis.

    Science.gov (United States)

    Shoughy, Samir S; Jaroudi, Mahmoud O; Tabbara, Khalid F

    2016-01-01

    The objective of this study was to evaluate the efficacy and safety of topical low-dose tacrolimus (0.01%) solution in patients with vernal keratoconjunctivitis (VKC). A total of 62 consecutive patients with VKC refractory to conventional treatment were included retrospectively. Tacrolimus 0.01% ophthalmic solution was administered to patients twice daily after discontinuation of all previous topical medications. The duration of treatment ranged from 1 month to 29 months. The clinical symptoms of itching, redness, foreign body sensation, and discharge and the clinical signs of conjunctival hyperemia, conjunctival papillary hypertrophy, limbal infiltration, Trantas dots, and superficial punctate keratopathy were graded as 0 (normal), 1+ (mild), 2+ (moderate), or 3+ (severe). Assessment was carried out before initiation of therapy and on the last visit after treatment. There were 62 patients with VKC comprising 49 male and 13 female patients. The median age was 12 years (range: 5-47 years). The mean visual acuity improved from 20/30 to 20/25 following treatment. There was statistically significant improvement in symptoms of itching (P<0.001), redness (P<0.001), foreign body sensation (P<0.001), and discharge (P<0.001). Statistically significant improvement was also observed in clinical signs of conjunctival hyperemia (P<0.001), limbal infiltration (P<0.001), Trantas dots (P<0.001), superficial punctate keratopathy (P<0.001), and conjunctival papillary hypertrophy (P<0.001). The solution form of tacrolimus was well tolerated. None of the patients developed elevation of intraocular pressure, cataract, or infectious keratitis. Low-dose topical tacrolimus 0.01% solution is effective and safe in the management of patients with refractory VKC.

  12. An analysis of tacrolimus-related complications in the first 30 days after liver transplantation

    Directory of Open Access Journals (Sweden)

    Lucas Souto Nacif

    2014-11-01

    Full Text Available OBJECTIVES: Orthotopic liver transplantation has improved survival in patients with end-stage liver disease; however, therapeutic strategies that achieve ideal immunosuppression and avoid early complications are lacking. To correlate the dose and level of Tacrolimus with early complications, e.g., rejection, infection and renal impairment, after liver transplantation. From November 2011 to May 2013, 44 adult liver transplant recipients were studied in this retrospective comparative study. RESULTS: The most frequent indication for liver transplantation was hepatitis C cirrhosis (47.7%, with a higher prevalence observed in male patients (68.18%. The ages of the subjects ranged from 19-71 and the median age was 55.5 years. The mean length of the hospital stay was 16.1±9.32 days and the mean Model for End-stage Liver Disease score was 26.18±4.28. There were five cases of acute cellular rejection (11.37% and 16 cases of infection (36.37%. The blood samples that were collected and analyzed over time showed a significant correlation between the Tacrolimus blood level and the deterioration of glomerular filtration rate and serum creatinine (p<0.05. Patients with infections had a higher serum level of Tacrolimus (p = 0.012. The dose and presence of rejection were significantly different (p = 0.048 and the mean glomerular filtration rate was impaired in patients who underwent rejection compared with patients who did not undergo rejection (p = 0.0084. CONCLUSION: Blood Tacrolimus levels greater than 10 ng/ml were correlated with impaired renal function. Doses greater than 0.15 mg/kg/day were associated with the prevention of acute cellular rejection but predisposed patients to infectious disease.

  13. Pharmacokinetics of a self-microemulsifying drug delivery system of tacrolimus.

    Science.gov (United States)

    von Suesskind-Schwendi, Marietta; Gruber, Michael; Touraud, Didier; Kunz, Werner; Schmid, Christof; Hirt, Stephan W; Lehle, Karla

    2013-07-01

    This study evaluated the pharmacokinetics of tacrolimus (Tac) in a novel self-microemulsifying drug delivery system (SMEDDS) for improved oral administration. SMEDDS Tac consisted of ethyl oleate as the oily phase, Solutol HS 15 as the surfactant and glycofurol as the co-surfactant and contained 0.5mg/mL tacrolimus. Blood and tissue concentrations of tacrolimus from two study groups (oral application of SMEDDS Tac and Prograf®) were determined using ELISA technique following tacrolimus administration in rats. There was no difference between area under the whole blood concentration-time curve in the SEDDM Tac group and the Prograf® group. Maximum concentrations of the drug were three times higher (P<0.05) in the SEDDM Tac group accompanied by a 3-fold earlier peak time. Elimination half-life was significantly lower in the SEDDM Tac group. Application of SMEDDS Tac increased tissue accumulation. Already after 15 min, Tac levels of small intestine, liver, kidney, spleen, heart and bone marrow were significantly higher in the SMEDDS Tac group than in the Prograf® group (P<0.05). However, the Tac concentration in the kidney was significantly lower in the SMEDDS Tac group. Formulation of SMEDDS did not affect blood-brain barrier function. The SMEDDS is a potentially useful method for a local delivery of Tac to target organs. The selection of the optimum SMEDDS Tac composition might have advantage as an alternative oral dosage form for Tac. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  14. STUDY OF THERAPEUTIC COMPARISON OF TACROLIMUS 0.1% AND MINOXIDIL 2% IN ALOPECIA AREATA

    Directory of Open Access Journals (Sweden)

    Kallappa C. Herkal

    2013-07-01

    Full Text Available Introduction: Alopecia areata is a unique, idiopathic disease in which there is patchy hair loss. The variable and uncertain natural history of alopecia areata is accounting for the multiplicity of uncritical claims for a large variety of therapeutic procedures. Aim: to find the therapeutic comparison between tacrolimus 0.1% ointment and minoxidil 2% solution. Material and Methods: Patients attending skin out patient department in Navodaya medical college hospital and research centre, Raichur were screened and the consenting consecutive cases of Aopecia Areata (AA from December 2010 to November 2011 were chosen for study. There were 75 patients in the study. It is a randomized, single blind, intension to treat study. The eligible patients for the study were randomly allocated into two groups-Group A and Group B (38 in Group A and 37 in Group B. Patients in Group A were treated with 2% Minoxidi solution to be applied twice daily over the alopecia patch, where as Patients in Group B were treated with Tacrolimus 0.1% ointment applied twice daily. Patients were followed up at 2, 4, 6, 8, 10 and 12 weeks. Alopecia Grading Score (AGS was calculated at baseline and 12 weeks. Regrowth Score (RGS was calculated at 12 weeks. Results: Total 69 patients completed the study (35 in Group A and 34 in Group B. In our study RGS ≥ 3 was observed in 65.71% of patients treated with Tinoxidil 2% solution and 44.12% of patients treated with Tacrolimus 0.1% ointment. Conclusion: In our study Minoxidil 2% solution had better stimulatory effect on hair growth compared to Tacrolimus 0.1% ointment in the treatment of mild to moderate patchy alopecia areata. The combination treatment may yield a better clinical response than either of the agents used singly.

  15. Different top-down approaches to estimate measurement uncertainty of whole blood tacrolimus mass concentration values.

    Science.gov (United States)

    Rigo-Bonnin, Raül; Blanco-Font, Aurora; Canalias, Francesca

    2018-05-08

    Values of mass concentration of tacrolimus in whole blood are commonly used by the clinicians for monitoring the status of a transplant patient and for checking whether the administered dose of tacrolimus is effective. So, clinical laboratories must provide results as accurately as possible. Measurement uncertainty can allow ensuring reliability of these results. The aim of this study was to estimate measurement uncertainty of whole blood mass concentration tacrolimus values obtained by UHPLC-MS/MS using two top-down approaches: the single laboratory validation approach and the proficiency testing approach. For the single laboratory validation approach, we estimated the uncertainties associated to the intermediate imprecision (using long-term internal quality control data) and the bias (utilizing a certified reference material). Next, we combined them together with the uncertainties related to the calibrators-assigned values to obtain a combined uncertainty for, finally, to calculate the expanded uncertainty. For the proficiency testing approach, the uncertainty was estimated in a similar way that the single laboratory validation approach but considering data from internal and external quality control schemes to estimate the uncertainty related to the bias. The estimated expanded uncertainty for single laboratory validation, proficiency testing using internal and external quality control schemes were 11.8%, 13.2%, and 13.0%, respectively. After performing the two top-down approaches, we observed that their uncertainty results were quite similar. This fact would confirm that either two approaches could be used to estimate the measurement uncertainty of whole blood mass concentration tacrolimus values in clinical laboratories. Copyright © 2018 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  16. Physicochemical characterization of tacrolimus-loaded solid dispersion with sodium carboxylmethyl cellulose and sodium lauryl sulfate.

    Science.gov (United States)

    Park, Young-Joon; Ryu, Dong-Sung; Li, Dong Xun; Quan, Qi Zhe; Oh, Dong Hoon; Kim, Jong Oh; Seo, Youn Gee; Lee, Young-Im; Yong, Chul Soon; Woo, Jong Soo; Choi, Han-Gon

    2009-06-01

    To develop a novel tacrolimus-loaded solid dispersion with improved solubility, various solid dispersions were prepared with various ratios of water, sodium lauryl sulfate, citric acid and carboxylmethylcellulose-Na using spray drying technique. The physicochemical properties of solid dispersions were investigated using scanning electron microscopy, differential scanning calorimetery and powder X-ray diffraction. Furthermore, their solubility and dissolution were evaluated compared to drug powder. The solid dispersion at the tacrolimus/CMC-Na/sodium lauryl sulfate/citric acid ratio of 3/24/3/0.2 significantly improved the drug solubility and dissolution compared to powder. The scanning electron microscopy result suggested that carriers might be attached to the surface of drug in this solid dispersion. Unlike traditional solid dispersion systems, the crystal form of drug in this solid dispersion could not be converted to amorphous form, which was confirmed by the analysis of DSC and powder X-ray diffraction. Thus, the solid dispersion system with water, sodium lauryl sulfate, citric acid and CMC-Na should be a potential candidate for delivering a poorly water-soluble tacrolimus with enhanced solubility and no convertible crystalline.

  17. Clinical study of double dose of valsartan combined with tacrolimus in treatment of diabetic nephropathy.

    Science.gov (United States)

    Jin, H; Zhang, H-N; Hou, X-L; Zhang, B; Wu, J; Zhang, H-B

    2016-01-01

    To investigate the clinical effect of double dose of valsartan combined with tacrolimus in the treatment of diabetic nephropathy (DN). HA total of 86 cases diagnosed with DN were selected from October 2013 to October 2014 in Zaozhuang Municipal Hospital, China. The study was approved by our hospital Ethics Committee and written consent was obtained from patients and their family members. Patients were randomly divided into three groups according to the sequence of admission, group A (conventional dose of valsartan group, n = 28 cases), group B (double dose of valsartan group, n = 29 cases) and group C (double dose of valsartan combined with tacrolimus group, n = 29). Clinical effects were compared by analyzing the renal function tests after 8 weeks. 24h urine protein, serum creatinine level of patients in group B and group C were significantly lower than that of group A. Those in group C was much lower. The glomerular filtration rates were significantly higher for group B and C than that of group A, and those in group C were much higher. The difference is statistically significant (p valsartan combined with tacrolimus treatment of DN patients can improve clinical symptoms, reducing inflammation, inhibiting or even reversing the interstitial fibrosis, which will improve the curative effect and reduce the recurrence, as to provide a new theoretical basis for the clinical treatment of the disease.

  18. Application of Machine-Learning Models to Predict Tacrolimus Stable Dose in Renal Transplant Recipients

    Science.gov (United States)

    Tang, Jie; Liu, Rong; Zhang, Yue-Li; Liu, Mou-Ze; Hu, Yong-Fang; Shao, Ming-Jie; Zhu, Li-Jun; Xin, Hua-Wen; Feng, Gui-Wen; Shang, Wen-Jun; Meng, Xiang-Guang; Zhang, Li-Rong; Ming, Ying-Zi; Zhang, Wei

    2017-02-01

    Tacrolimus has a narrow therapeutic window and considerable variability in clinical use. Our goal was to compare the performance of multiple linear regression (MLR) and eight machine learning techniques in pharmacogenetic algorithm-based prediction of tacrolimus stable dose (TSD) in a large Chinese cohort. A total of 1,045 renal transplant patients were recruited, 80% of which were randomly selected as the “derivation cohort” to develop dose-prediction algorithm, while the remaining 20% constituted the “validation cohort” to test the final selected algorithm. MLR, artificial neural network (ANN), regression tree (RT), multivariate adaptive regression splines (MARS), boosted regression tree (BRT), support vector regression (SVR), random forest regression (RFR), lasso regression (LAR) and Bayesian additive regression trees (BART) were applied and their performances were compared in this work. Among all the machine learning models, RT performed best in both derivation [0.71 (0.67-0.76)] and validation cohorts [0.73 (0.63-0.82)]. In addition, the ideal rate of RT was 4% higher than that of MLR. To our knowledge, this is the first study to use machine learning models to predict TSD, which will further facilitate personalized medicine in tacrolimus administration in the future.

  19. Tacrolimus Improves Symptoms of Children With Myasthenia Gravis Refractory to Prednisone.

    Science.gov (United States)

    Liu, Chanchan; Gui, Mengcui; Cao, Yayun; Lin, Jing; Li, Yue; Ji, Suqiong; Bu, Bitao

    2017-12-01

    Myasthenia gravis tends to affect children in China. Oral pyridostigmine and prednisone could effectively improve the symptoms, but multiple side effects become a major concern after long-term oral prednisone. To avoid the long-term complications of prednisone therapy and to obtain more satisfactory improvement, we tested the efficacy and safety of tacrolimus in children with myasthenia gravis. Children with myasthenia gravis who had not achieved satisfactory improvement or who experienced severe side effects after prednisone therapy were recruited between January 2015 and December 2016 at Tongji Hospital. All the children were treated with tacrolimus 1 mg to 2 mg daily and the dose was adjusted on the basis of the clinical response and the serum concentration. The dosage of prednisone, the severity of symptoms, blood samples, the serum concentration of tacrolimus, and titers of antiacetylcholine receptor antibodies were evaluated every four weeks. Fourteen children were enrolled. One child withdrew two weeks after the enrollment. Thirteen children have completed the therapy for one year. At the end point, the dosage of prednisone was significantly decreased (P myasthenia gravis score, and myasthenia gravis-specific manual muscle testing and myasthenia gravis-activities of daily living scores were significantly improved (P myasthenia gravis. Randomized clinical trials are needed to confirm the observation. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Efficacy and safety of low-dose topical tacrolimus in vernal keratoconjunctivitis

    Directory of Open Access Journals (Sweden)

    Shoughy SS

    2016-04-01

    Full Text Available Samir S Shoughy,1 Mahmoud O Jaroudi,1 Khalid F Tabbara1–3 1The Eye Center and The Eye Foundation for Research in Ophthalmology, 2Department of Ophthalmology, College of Medicine, King Saud University, Riyadh, Saudi Arabia; 3Wilmer Ophthalmological Institute of the Johns Hopkins University School of Medicine, Baltimore, MD, USA Objective: The objective of this study was to evaluate the efficacy and safety of topical low-dose tacrolimus (0.01% solution in patients with vernal keratoconjunctivitis (VKC. Patients and methods: A total of 62 consecutive patients with VKC refractory to conventional treatment were included retrospectively. Tacrolimus 0.01% ophthalmic solution was administered to patients twice daily after discontinuation of all previous topical medications. The duration of treatment ranged from 1 month to 29 months. The clinical symptoms of itching, redness, foreign body sensation, and discharge and the clinical signs of conjunctival hyperemia, conjunctival papillary hypertrophy, limbal infiltration, Trantas dots, and superficial punctate keratopathy were graded as 0 (normal, 1+ (mild, 2+ (moderate, or 3+ (severe. Assessment was carried out before initiation of therapy and on the last visit after treatment. Results: There were 62 patients with VKC comprising 49 male and 13 female patients. The median age was 12 years (range: 5–47 years. The mean visual acuity improved from 20/30 to 20/25 following treatment. There was statistically significant improvement in symptoms of itching (P<0.001, redness (P<0.001, foreign body sensation (P<0.001, and discharge (P<0.001. Statistically significant improvement was also observed in clinical signs of conjunctival hyperemia (P<0.001, limbal infiltration (P<0.001, Trantas dots (P<0.001, superficial punctate keratopathy (P<0.001, and conjunctival papillary hypertrophy (P<0.001. The solution form of tacrolimus was well tolerated. None of the patients developed elevation of intraocular pressure

  1. Nur77 nuclear import and its NBRE-binding activity in thymic lymphoma cells are regulated by different mechanisms sensitive to FK506 or HA1004

    International Nuclear Information System (INIS)

    Kochel, Izabela; Rapak, Andrzej; Ziolo, Ewa; Strzadala, Leon

    2005-01-01

    Thymic lymphoma cells restore their sensitivity to ionomycin-induced apoptosis when treated with FK506 or HA1004. In apoptosis-resistant cells, ionomycin-induced Nur77 strongly binds DNA during the first 2 h of response, in contrast to lymphoma cells treated with ionomycin together with FK506 or HA1004, which undergo massive apoptosis. We show that Nur77 could discriminate between calcium signals sensitive to FK506 and those sensitive to HA1004, as the inhibitors differentially regulate the kinetics of Nur77 nuclear import, and FK506, unlike HA1004, inhibits Nur77 DNA-binding activity. In the presence of HA1004, NBRE binding by Nur77 protein increases with time (6 h vs 2 h), whereas the final outcome of both inhibitors is apoptosis of thymic lymphoma cells

  2. Impact of the CYP3A5*1 Allele on the Pharmacokinetics of Tacrolimus in Japanese Heart Transplant Patients.

    Science.gov (United States)

    Uno, Takaya; Wada, Kyoichi; Matsuda, Sachi; Terada, Yuka; Oita, Akira; Kawase, Atsushi; Takada, Mitsutaka

    2018-04-24

    Tacrolimus, a major immunosuppressant used after transplantation, is associated with large interindividual variation involving genetic polymorphisms in metabolic processes. A common variant of the cytochrome P450 (CYP) 3A5 gene, CYP3A5*3, affects blood concentrations of tacrolimus. However, tacrolimus pharmacokinetics at the early stage of transplantation have not been adequately studied in heart transplantation. We retrospectively examined the impact of the CYP3A5 genotype on tacrolimus pharmacokinetics at the early stage of heart transplantation. The tacrolimus pharmacokinetic profile was obtained from 65 patients during the first 5 weeks after heart transplantation. Differences in the patients' characteristics and tacrolimus pharmacokinetic parameters between the CYP3A5 expresser (*1/*1 or *1/*3 genotypes) and non-expresser (*3/*3 genotype) groups were assessed by the Chi-square test, Student's t test, or Mann-Whitney U test. The CYP3A5 *1/*1, *1/*3, and *3/*3 genotypes were detected in 5, 22, and 38 patients, respectively. All patients started clotrimazole therapy approximately 1 week after starting tacrolimus. Apparent clearance and dose/weight to reach the target trough concentration (C 0 ) were significantly higher in the expresser group than in the non-expresser group (0.32 vs. 0.19 L/h/kg, p = 0.0003; 0.052 vs. 0.034 mg/kg/day, p = 0.0002); there were no significant differences in the area under the concentration-time curve from 0 to 12 h (AUC 0-12 ) and concentrations at any sampling time point between the two groups. Similar concentration-time curves for tacrolimus were obtained in the expresser and non-expresser groups by dose adjustment based on therapeutic drug monitoring. These results demonstrate the importance of the CYP3A5 genotype in tacrolimus dose optimization based on therapeutic drug monitoring after heart transplantation.

  3. The calcineurin inhibitor tacrolimus reduces proteinuria in membranous nephropathy accompanied by a decrease in angiopoietin-like-4.

    Directory of Open Access Journals (Sweden)

    Lei Peng

    Full Text Available Tacrolimus is an anticalcineurinic agent with potent immunosuppressive activity that has recently been shown to have the added benefit of reducing proteinuria in membranous nephropathy (MN patients. However, its potential mechanisms remain unknown. To reveal the mechanism, rat cohorts were administered tacrolimus or vehicle from days 7 to 28 after the induction of passive Heymann nephritis (PHN. PHN induction resulted in heavy proteinuria and increased expression of desmin, a marker of injured podocytes. We also showed that the glomerular expression of angiopoietin-like-4 (Angptl4 was markedly upregulated in PHN rats and human MN followed by an increase in urine Angptl4 excretion. In addition, increased Angptl4 expression may be related to podocyte injury and proteinuria. Furthermore, upregulated Angptl4 expression primarily colocalized with podocytes rather than endothelial or mesangial cells, indicating that podocytes may be the source of Angptl4, which then gradually migrated to the glomerular basement membrane over time. However, tacrolimus treatment markedly reduced glomerular and urinary Angptl4, accompanied by a reduction in the established proteinuria and the promotion of podocyte repair. Additionally, glomerular immune deposits and circulating IgG levels induced by PHN clearly decreased following tacrolimus treatment. In conclusion, this is the first demonstration that the calcineurin inhibitor tacrolimus can reduce Angptl4 in podocytes accompanied by a decrease in established proteinuria and promotion of podocyte repair in MN.

  4. Tacrolimus loaded biocompatible lecithin-based microemulsions with improved skin penetration: Structure characterization and in vitro/in vivo performances.

    Science.gov (United States)

    Savić, Vedrana; Todosijević, Marija; Ilić, Tanja; Lukić, Milica; Mitsou, Evgenia; Papadimitriou, Vassiliki; Avramiotis, Spyridon; Marković, Bojan; Cekić, Nebojša; Savić, Snežana

    2017-08-30

    In order to improve skin penetration of tacrolimus we aimed to develop potentially non-irritant, lecithin-based microemulsions containing ethanol, isopropanol and/or propylene glycol as cosurfactants, varying caprylic/capric triglycerides and propylene glycol monocaprylate as oil phase. The influence of excipients on the size of microemulsion region in pseudo-ternary phase diagrams and their ability to form different types of microemulsions was evaluated. The comprehensive physicochemical characterization of microemulsions and the evaluation of their structure was performed, while the localization of tacrolimus in microemulsions was further investigated using electron paramagnetic resonance spectroscopy. Moreover, stability studies proved no change in tacrolimus content during one year of storage at room temperature. In addition, in vivo skin performance indicated no skin irritation potential of blank microemulsions, whereas in vitro release testing using Franz diffusion cells showed superior release rate of tacrolimus from microemulsions (0.98±0.10 and 0.92±0.11μg/cm 2 /h for two bicontinuous and 1.00±0.24μg/cm 2 /h for oil-in-water microemulsion) compared to referent Protopic ointment (0.15±0.08μg/cm 2 /h). Furthermore, ex vivo penetration assessed through porcine ear skin using tape stripping, confirmed superiority of two microemulsions related to the reference, implying developed microemulsions as promising carriers for dermal delivery of tacrolimus. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Once-Daily Tacrolimus Extended-Release Formulation: 1 Year after Conversion in Stable Pediatric Kidney Transplant Recipients

    Directory of Open Access Journals (Sweden)

    Lars Pape

    2011-01-01

    Full Text Available It is speculated that a once-daily dosage of immunosuppression can increase adherence and thereby graft survival. Until now, there have been no studies on once-daily use of Tacrolimus extended-release formulation (TAC-ER in children following pediatric kidney transplantation. In 11 stable pediatric kidney recipients >10 years, efficacy, safety, and tolerability of a switch to TAC-ER were observed over one year. Adherence was determined by use of the BAASIS-Scale Interview and comparison of individual variability of Tacrolimus trough levels. Over the observation period, two acute rejections were observed in one girl with nonadherence and repeated Tacrolimus trough levels of 0 ng/m. Beside this, there were no acute rejections in this trial. TAC dose was increased in 3/11 patients and decreased in 2/11 patients within the course of the study. Six patients did not require a dose adjustment. All but one patient had a maximum of 1 dose change during therapy. Mean Tacrolimus dose, trough levels, and Glomerular filtration rates were also stable. Adherence, as measured by BAASIS-Scale Interview and coefficient of variation of Tacrolimus trough levels, was good at all times. It is concluded that conversion to Tac-ER is safe in low-risk children following pediatric kidney transplantation.

  6. Cyclosporine A, FK506, and NIM811 ameliorate prolonged CBF reduction and impaired neurovascular coupling after cortical spreading depression

    DEFF Research Database (Denmark)

    Hansen, Henning Piilgaard; Witgen, Brent Marvin; Rasmussen, Peter

    2011-01-01

    Cortical spreading depression (CSD) is associated with mitochondrial depolarization, increasing intracellular Ca(2+), and the release of free fatty acids, which favor opening of the mitochondrial permeability transition pore (mPTP) and activation of calcineurin (CaN). Here, we test the hypothesis...... and the specific CaN blocker FK506. Cortical spreading depression was induced in rat frontal cortex. Electrocortical activity was recorded by glass microelectrodes, CBF by laser Doppler flowmetry, and tissue oxygen tension with polarographic microelectrodes. Electrocortical activity, basal CBF, CMRO(2......), and neurovascular and neurometabolic coupling were unaffected by all three drugs under control conditions. NIM811 augmented the rise in CBF observed during CSD. Cyclosporine A and FK506 ameliorated the persistent decrease in CBF after CSD. All three drugs prevented disruption of neurovascular coupling after CSD...

  7. Low-dose tacrolimus combined with donor-derived mesenchymal stem cells after renal transplantation: a prospective, non-randomized study

    OpenAIRE

    Pan, Guang-hui; Chen, Zheng; Xu, Lu; Zhu, Jing-hui; Xiang, Peng; Ma, Jun-jie; Peng, Yan-wen; Li, Guang-hui; Chen, Xiao-yong; Fang, Jia-li; Guo, Yu-he; Zhang, Lei; Liu, Long-shan

    2016-01-01

    Calcineurin inhibitors, including tacrolimus, are largely responsible for advances in allotransplantation. However, the nephrotoxicity associated with these immunosuppressants impairs patients' long-term survival after renal allograft. Therefore, novel regimens that minimize or even eliminate calcineurin inhibitors could improve transplantation outcomes. In this pilot study, we investigated the use of low-dose tacrolimus in combination with mesenchymal stem cells (MSCs), which are immunosuppr...

  8. Conformational Entropy of FK506 Binding to FKBP12 Determined by Nuclear Magnetic Resonance Relaxation and Molecular Dynamics Simulations.

    Science.gov (United States)

    Solomentsev, Gleb; Diehl, Carl; Akke, Mikael

    2018-03-06

    FKBP12 (FK506 binding protein 12 kDa) is an important drug target. Nuclear magnetic resonance (NMR) order parameters, describing amplitudes of motion on the pico- to nanosecond time scale, can provide estimates of changes in conformational entropy upon ligand binding. Here we report backbone and methyl-axis order parameters of the apo and FK506-bound forms of FKBP12, based on 15 N and 2 H NMR relaxation. Binding of FK506 to FKBP12 results in localized changes in order parameters, notably for the backbone of residues E54 and I56 and the side chains of I56, I90, and I91, all positioned in the binding site. The order parameters increase slightly upon FK506 binding, indicating an unfavorable entropic contribution to binding of TΔ S = -18 ± 2 kJ/mol at 293 K. Molecular dynamics simulations indicate a change in conformational entropy, associated with all dihedral angles, of TΔ S = -26 ± 9 kJ/mol. Both these values are significant compared to the total entropy of binding determined by isothermal titration calorimetry and referenced to a reactant concentration of 1 mM ( TΔ S = -29 ± 1 kJ/mol). Our results reveal subtle differences in the response to ligand binding compared to that of the previously studied rapamycin-FKBP12 complex, despite the high degree of structural homology between the two complexes and their nearly identical ligand-FKBP12 interactions. These results highlight the delicate dependence of protein dynamics on drug interactions, which goes beyond the view provided by static structures, and reinforce the notion that protein conformational entropy can make important contributions to the free energy of ligand binding.

  9. Tolerogenic β2-glycoprotein I DNA vaccine and FK506 as an adjuvant attenuates experimental obstetric antiphospholipid syndrome.

    Science.gov (United States)

    Chao, Ya-Hsuan; Chen, Der-Yuan; Lan, Joung-Liang; Tang, Kuo-Tung; Lin, Chi-Chien

    2018-01-01

    DNA vaccines have recently emerged as a therapeutic agent for treating autoimmune diseases, such as multiple sclerosis. Antiphospholipid antibody syndrome (APS) is an autoimmune disease characterized by β2-glycoprotein I (β2-GPI)-targeting antiphospholipid antibodies (APAs) and vascular thrombosis or obstetrical complications. To examine the therapeutic potential of a β2-GPI DNA vaccine, we administered a vaccine mixed with FK506 as an adjuvant to a mouse model of obstetric APS. First, the pCMV3-β2-GPI DNA vaccine, which encodes the full-length human β2-GPI gene, was constructed. Then, we administered the β2-GPI DNA vaccine in 0.1 ml of saline, mixed with or without 100 μg of FK506, intramuscularly to the mice on days 28, 35 and 42. Blood titers of the anti-β2-GPI antibody, platelet counts, activated partial thromboplastin times (aPTTs), and the percentage of fetal loss were measured. We also stimulated murine splenic T cells ex vivo with β2-GPI and determined the T helper cell proportion and cytokine secretion. The administration of the β2-GPI DNA vaccine mixed with FK506 reduced the blood IgG anti-β2-GPI antibody titers and suppressed APS manifestations in mice. The combination also suppressed interferon-γ and interleukin (IL)-17A secretion but increased the Treg cell proportion and IL-10 secretion in murine splenic T cells following ex vivo stimulation with β2-GPI. Our results demonstrated the therapeutic efficacy of a β2-GPI DNA vaccine and FK506 as an adjuvant in a murine model of obstetric APS. Possible mechanisms include the inhibition of Th1 and Th17 responses and the up-regulation of Treg cells.

  10. The effect of the immunophilin ligands rapamycin and FK506 on proliferation of mast cells and other hematopoietic cell lines.

    OpenAIRE

    Hultsch, T; Martin, R; Hohman, R J

    1992-01-01

    The immunosuppressive drugs FK506 and cyclosporin A have an identical spectrum of activities with respect to IgE receptor (Fc epsilon RI)-mediated exocytosis from mast cells and T cell receptor-mediated transcription of IL-2. These findings suggest a common step in receptor-mediated signal transduction leading to exocytosis and transcription and imply that immunosuppressive drugs target specific signal transduction pathways, rather than specific cell types. This hypothesis is supported by stu...

  11. Marketingový mix FK Pardubice a návrhy na jeho zlepšení

    OpenAIRE

    Šejvl, Martin

    2016-01-01

    Title: Marketing mix of FK Pardubice and proposals for its improvement. Targets: Analysis of various marketing instruments that form the marketing mix sports club. Determine the views of fans for marketing the club and then suggest ways to improve the quality of marketing mix, which would lead to higher customer satisfaction and attendance of matches. Methods: Analysis of literature in the field of sports marketing, implementation and evaluation of the questionnaire, informal interviews, part...

  12. Age and Early Graft Function Relate With Risk-Benefit Ratio of Allogenic Islet Transplantation Under Antithymocyte Globulin-Mycophenolate Mofetil-Tacrolimus Immune Suppression.

    Science.gov (United States)

    Lee, DaHae; Keymeulen, Bart; Hilbrands, Robert; Ling, Zhidong; Van de Velde, Ursule; Jacobs-Tulleneers-Thevissen, Daniel; Maleux, Geert; Lapauw, Bruno; Crenier, Laurent; De Block, Christophe; Mathieu, Chantal; Pipeleers, Daniel; Gillard, Pieter

    2017-09-01

    Induction therapy with a T cell-depleting agent followed by mycophenolate mofetil and tacrolimus is presently the most frequently used immune suppression (IS) regimen in islet transplantation. This study assesses its safety and tolerability in nonuremic type 1 diabetic recipients. Fifty-one patients (age, between 29 and 63 years) with high glycemic variability and problematic hypoglycemia received intraportal islet grafts under anti-thymocyte globulin-mycophenolate mofetil-tacrolimus protocol. They were followed up for over 48 months for function of the implant and adverse events. Severe hypoglycemia and diabetic ketoacidosis were absent in patients with functioning graft. Immune suppressive therapy was maintained for 48 months in 29 recipients with sustained function (group A), whereas 16 patients stopped earlier due to graft failure (group B) and in 6 for other reasons. Group A was significantly older at the time of implantation and achieved higher graft function at posttransplantation month 6 under similar dose of IS. Prevalence of IS-related side effects was similar in groups A and B, occurring predominantly during the first year posttransplantation. IS-related serious adverse events (SAE) were reported in 47% of patients, with 4 presenting with cytomegalovirus infection and 4 (age, 42-59 years) diagnosed with cancer. Except in 1 patient with cancer, all SAEs resolved after appropriate treatment. These risk/benefit data serve as a basis for clinical decision-making before entering an intraportal islet transplantation protocol. A longer benefit is observed in recipients of higher age (≥40 years), but it is not associated with more side effects and SAE.

  13. The effect of the immunophilin ligands rapamycin and FK506 on proliferation of mast cells and other hematopoietic cell lines.

    Science.gov (United States)

    Hultsch, T; Martin, R; Hohman, R J

    1992-01-01

    The immunosuppressive drugs FK506 and cyclosporin A have an identical spectrum of activities with respect to IgE receptor (Fc epsilon RI)-mediated exocytosis from mast cells and T cell receptor-mediated transcription of IL-2. These findings suggest a common step in receptor-mediated signal transduction leading to exocytosis and transcription and imply that immunosuppressive drugs target specific signal transduction pathways, rather than specific cell types. This hypothesis is supported by studies on the effect of rapamycin on IL-3 dependent proliferation of the rodent mast cell line PT18. Rapamycin inhibits proliferation of PT18 cells, achieving a plateau of 80% inhibition at 1 nM. This inhibition is prevented in a competitive manner by FK506, a structural analogue of rapamycin. Proliferation of rat basophilic leukemia cells and WEHI-3 cells was also inhibited, at doses comparable to those shown previously to inhibit IL-2-dependent proliferation of cytotoxic T lymphocyte line (CTLL) cells. In contrast, proliferation of A-431 cells, a epidermoid cell line, was not affected by rapamycin. DNA histograms indicate that complexes formed between the rapamycin-FK506-binding protein (FKBP) and rapamycin arrest-proliferating PT18 cells in the G0/G1-phase. It is concluded that FKBP-rapamycin complexes may inhibit proliferative signals emanating from IL-3 receptors, resulting in growth arrest of cytokine-dependent, hematopoietic cells. PMID:1384815

  14. Direct evidence that FK506 inhibition of FcepsilonRI-mediated exocytosis from RBL mast cells involves calcineurin.

    Science.gov (United States)

    Hultsch, T; Brand, P; Lohmann, S; Saloga, J; Kincaid, R L; Knop, J

    1998-05-01

    FcepsilonRI-mediated exocytosis of preformed mediators from mast cells and basophils (e.g. histamine, serotonin, beta-hexosaminidase) is sensitive to the immunosuppressants cyclosporin A and FK506 (IC50 200 and 4 nM, respectively) but not rapamycin. The mechanism of inhibition does not appear to involve tyrosine phosphorylation, hydrolysis of inositol phosphates or calcium flux. Here we report experiments using a molecular approach to assess the role of calcineurin, a serine/threonine phosphatase thought to be the primary pharmacological target of these drugs. Calcineurin's activity requires association of its catalytic (A) subunit with an intrinsic regulatory (B) subunit. We hypothesized that calcineurin-sensitive signalling events should be affected by the depletion of calcineurin B subunits, thereby reducing the number of active A:B complexes. We therefore transfected rat basophilic leukemia (RBL) cells with an inhibitory (dominant negative) form of the calcineurin A subunit, which binds the calcineurin B subunit with high affinity but does not possess catalytic activity (B subunit knock-out, BKO). In these transfected cells, the dose-response curve for the inhibition of FcepsilonRI-mediated exocytosis by FK506 was shifted to the left, indicating an increased drug sensitivity of BKO-transfected cells. We conclude that FK506 inhibition of FcepsilonRI-mediated exocytosis in mast cells specifically targets calcineurin activity.

  15. False Elevation of the Blood Tacrolimus Concentration, as Assessed by an Affinity Column-mediated Immunoassay (ACMIA), Led to Acute T Cell-mediated Rejection after Kidney Transplantation.

    Science.gov (United States)

    Kono, Momoko; Hasegawa, Jumpei; Ogawa, Hina; Yoshikawa, Kanae; Ishiwatari, Ayumi; Wakai, Sachiko; Tanabe, Kazunari; Shirakawa, Hiroki

    2018-05-01

    Tacrolimus is the most commonly used immunosuppressant. Because of its narrow therapeutic range, it is necessary to frequently monitor its concentration. We report the case of a 25-year-old man who underwent kidney transplantation whose tacrolimus concentrations, as measured by an affinity column-mediated immunoassay, were falsely elevated. As we reduced the dose of tacrolimus, the recipient developed T cell-mediated rejection. Using the same blood samples, an enzyme-multiplied immunoassay technique showed that the patient's levels of tacrolimus were extremely low. A further examination indicated that the false increase in the tacrolimus concentration was likely due to an unknown interfering substance. We administered methylprednisolone and antithymocyte-globulin. The patient's serum creatinine level decreased and remained stable after these treatments.

  16. Stability of tacrolimus injection diluted in 0.9% sodium chloride injection and stored in Excel bags.

    Science.gov (United States)

    Myers, Alan L; Zhang, Yanping; Kawedia, Jitesh D; Shank, Brandon R; Deaver, Melissa A; Kramer, Mark A

    2016-12-15

    The chemical stability and physical compatibility of tacrolimus i.v. infusion solutions prepared in Excel bags and stored at 23 or 4 °C for up to nine days were studied. Tacrolimus admixtures (2, 4, and 8 μg/mL) were prepared in Excel bags using 0.9% sodium chloride injection and stored at 23 °C without protection from light or at 4 °C in the dark. Test samples were withdrawn from triplicate bag solutions immediately after preparation and at predetermined time intervals (1, 3, 5, 7, and 9 days). Chemical stability was assessed by measuring tacrolimus concentrations using a validated stability-indicating high-performance liquid chromatography assay. The physical stability of the admixtures was assessed by visual examination and by measuring turbidity, particle size, and drug content. All test solutions stored at 23 or 4 °C had a no greater than 6% loss of the initial tacrolimus concentration throughout the nine-day study period. All test samples of tacrolimus admixtures, under both storage conditions, were without precipitation and remained clear initially and throughout the nine-day observation period. Changes in turbidities were minor; measured particulates remained few in number in all samples throughout the study. Extemporaneously prepared infusion solutions of tacrolimus 2, 4, and 8 μg/mL in 0.9% sodium chloride injection in Excel bags were chemically and physically stable for at least nine days when stored at room temperature (23 °C) without protection from light and when stored in a refrigerator (4 °C) in the dark. Copyright © 2016 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  17. Diversity receiver

    NARCIS (Netherlands)

    2005-01-01

    The invention is directed to the reception of high rate radio signals (for example DVB-T signals) while the receiver is moving at a high speed (for example in or with a car). Two or more antennas (12, 16) are closely spaced and arranged behind each other in the direction of motion (v) for receiving

  18. Update on the clinical utility of once-daily tacrolimus in the management of transplantation

    Directory of Open Access Journals (Sweden)

    Revollo J

    2015-05-01

    Full Text Available Jane Revollo Department of Pharmacy, Jackson Memorial Hospital, University of Miami Leonard M Miller School of Medicine Miami, FL, USAThe review by Posadas Salas and Srinivas of the clinical utility of once-daily tacrolimus formulations in the management of transplant patients1 was timely and relevant. It is worth noting, however, the data were presented in a way that overlooked several key differences between two distinct once-daily tacrolimus formulations. These formulations differ in bioavailability, Cmax, Tmax, dose required to achieve target trough levels, and time to reach target trough. The specific formulation and dosing information of one product was detailed in this review (described as modified release 4 [MR-4]; Astagraf®, Astellas Pharma Inc., Tokyo, Japan, but no formulation or dosing details were provided for a very different once-daily tacrolimus formulation (LCP-Tacro™; Veloxis Pharmaceuticals A/S, Hørsholm, Denmark for which a thorough review was recently published.2 The latter product is currently approved in Europe and under review by the US Food and Drug Administration in the US. In presenting data in this review, the authors did not identify which product was investigated in each of the studies discussed. This could easily lead to misinterpretation of results or erroneous conclusions, ie, that both once-daily formulations are the same. In fact, a careful parsing of the data clearly demonstrates that they are not equivalent. Misunderstanding of this point could have a potentially serious impact on appropriate dosing, safety, and patient management in the post-transplant setting. Differentiation between the two products is needed to clarify what appear to be conflicting results of the studies presented in this review.View original paper by Posadas Salas and Srinivas

  19. Tumid lupus erythematosus: An intriguing dermatopathological connotation treated successfully with topical tacrolimus and hydroxyxhloroquine combination

    Directory of Open Access Journals (Sweden)

    Prashant Verma

    2014-01-01

    Full Text Available Tumid lupus erythematosus (LE is a rare variant of lupus erythematosus, which often follows a favorable course. A case of a young woman is illustrated, who presented with an asymptomatic erythematous, solitary plaque over her face. Histopathological and direct immunofluorescence examination established a diagnosis of tumid lupus erythematosus. She responded slowly and near-completely to hydroxychloroquine sulfate; however, a flare up occurred a month later. Addition of topical tacrolimus 0.1% resulted in complete regression without leaving any residual changes. No recurrence was seen subsequently.

  20. Tumid Lupus Erythematosus: An Intriguing Dermatopathological Connotation Treated Successfully with Topical Tacrolimus and Hydroxyxhloroquine Combination

    Science.gov (United States)

    Verma, Prashant; Sharma, Sonal; Yadav, Pravesh; Namdeo, Chaitanya; Mahajan, Garima

    2014-01-01

    Tumid lupus erythematosus (LE) is a rare variant of lupus erythematosus, which often follows a favorable course. A case of a young woman is illustrated, who presented with an asymptomatic erythematous, solitary plaque over her face. Histopathological and direct immunofluorescence examination established a diagnosis of tumid lupus erythematosus. She responded slowly and near-completely to hydroxychloroquine sulfate; however, a flare up occurred a month later. Addition of topical tacrolimus 0.1% resulted in complete regression without leaving any residual changes. No recurrence was seen subsequently. PMID:24700961

  1. FK506-binding protein 10 (FKBP10) regulates lung fibroblast migration via collagen VI synthesis.

    Science.gov (United States)

    Knüppel, Larissa; Heinzelmann, Katharina; Lindner, Michael; Hatz, Rudolf; Behr, Jürgen; Eickelberg, Oliver; Staab-Weijnitz, Claudia A

    2018-04-19

    In idiopathic pulmonary fibrosis (IPF), fibroblasts gain a more migratory phenotype and excessively secrete extracellular matrix (ECM), ultimately leading to alveolar scarring and progressive dyspnea. Here, we analyzed the effects of deficiency of FK506-binding protein 10 (FKBP10), a potential IPF drug target, on primary human lung fibroblast (phLF) adhesion and migration. Using siRNA, FKBP10 expression was inhibited in phLF in absence or presence of 2ng/ml transforming growth factor-β1 (TGF-β1) and 0.1mM 2-phosphoascorbate. Effects on cell adhesion and migration were monitored by an immunofluorescence (IF)-based attachment assay, a conventional scratch assay, and single cell tracking by time-lapse microscopy. Effects on expression of key players in adhesion dynamics and migration were analyzed by qPCR and Western Blot. Colocalization was evaluated by IF microscopy and by proximity ligation assays. FKBP10 knockdown significantly attenuated adhesion and migration of phLF. Expression of collagen VI was decreased, while expression of key components of the focal adhesion complex was mostly upregulated. The effects on migration were 2-phosphoascorbate-dependent, suggesting collagen synthesis as the underlying mechanism. FKBP10 colocalized with collagen VI and coating culture dishes with collagen VI, and to a lesser extent with collagen I, abolished the effect of FKBP10 deficiency on migration. These findings show, to our knowledge for the first time, that FKBP10 interacts with collagen VI and that deficiency of FKBP10 reduces phLF migration mainly by downregulation of collagen VI synthesis. The results strengthen FKBP10 as an important intracellular regulator of ECM remodeling and support the concept of FKBP10 as drug target in IPF.

  2. A Comparison of Short- and Long-Term Therapeutic Outcomes of Infliximab- versus Tacrolimus-Based Strategies for Steroid-Refractory Ulcerative Colitis

    Directory of Open Access Journals (Sweden)

    Katsuya Endo

    2016-01-01

    Full Text Available Background/Aims. Antitumor necrosis factor antibodies and calcineurin inhibitors have shown good therapeutic efficacy for steroid-refractory ulcerative colitis (UC. Although some studies have compared the efficacy of infliximab (IFX and cyclosporin A, there are no published studies comparing IFX and tacrolimus (Tac. This study aimed to compare therapeutic efficacies between IFX- and Tac-based strategies for steroid-refractory UC. Methods. Between July 2009 and August 2013, 95 patients with steroid-refractory UC received either IFX (n=48 or Tac (n=47 in our hospital. In the IFX group, the patients continued to receive maintenance treatment with IFX. In the Tac group, patients discontinued Tac treatment up to 3 months and subsequently received thiopurine. We retrospectively compared the therapeutic outcomes between the groups. Results. There was no significant difference in the colectomy-free rate, clinical remission rate, and clinical response rate at 2 months between the groups. However, relapse-free survival was significantly higher in the IFX group than in the Tac group (p<0.001; log-rank test. The proportions of serious adverse events did not differ between the groups. Conclusion. The findings of our study showed that IFX and Tac have similar short-term therapeutic efficacy for steroid-refractory UC. Maintenance treatment with IFX, however, yields better long-term outcomes than Tac-thiopurine bridging treatment.

  3. [Application of Fourier amplitude sensitivity test in Chinese healthy volunteer population pharmacokinetic model of tacrolimus].

    Science.gov (United States)

    Guan, Zheng; Zhang, Guan-min; Ma, Ping; Liu, Li-hong; Zhou, Tian-yan; Lu, Wei

    2010-07-01

    In this study, we evaluated the influence of different variance from each of the parameters on the output of tacrolimus population pharmacokinetic (PopPK) model in Chinese healthy volunteers, using Fourier amplitude sensitivity test (FAST). Besides, we estimated the index of sensitivity within whole course of blood sampling, designed different sampling times, and evaluated the quality of parameters' and the efficiency of prediction. It was observed that besides CL1/F, the index of sensitivity for all of the other four parameters (V1/F, V2/F, CL2/F and k(a)) in tacrolimus PopPK model showed relatively high level and changed fast with the time passing. With the increase of the variance of k(a), its indices of sensitivity increased obviously, associated with significant decrease in sensitivity index for the other parameters, and obvious change in peak time as well. According to the simulation of NONMEM and the comparison among different fitting results, we found that the sampling time points designed according to FAST surpassed the other time points. It suggests that FAST can access the sensitivities of model parameters effectively, and assist the design of clinical sampling times and the construction of PopPK model.

  4. PRES (posterior reversible encephalopathy syndrome), a rare complication of tacrolimus therapy.

    LENUS (Irish Health Repository)

    Hodnett, P

    2009-11-01

    With increasing numbers of solid organ and hematopoietic stem cell transplantations being performed, there have been significant increases in the use of immunosuppressive agents such as cyclosporine and tacrolimus. Posterior reversible encephalopathy syndrome (PRES) is a serious complication of immunosuppressive therapy use following solid organ or stem cell transplants. Clinical findings including headache, mental status changes, focal neurological deficits, and\\/or visual disturbances. Associated with these are characteristic imaging features of subcortical white matter lesions on computed tomography (CT) or magnetic resonance imaging (MRI). The changes in the subcortical white matter are secondary to potentially reversible vasogenic edema, although conversion to irreversible cytotoxic edema has been described. These imaging findings predominate in the territory of the posterior cerebral artery. Many studies have shown that the neurotoxicity associated with tacrolimus may occur at therapeutic levels. In most cases of PRES, the symptom complex is reversible by reducing the dosage or withholding the drug for a few days. While PRES is an uncommon complication, it is associated with significant morbidity and mortality if it is not expeditiously recognized. MRI represents the most sensitive imaging technique for recognizing PRES. This report highlights the value of MRI in prompt recognition of this entity, which offers the best chance of avoiding long-term sequelae.

  5. Dried blood spot measurement: application in tacrolimus monitoring using limited sampling strategy and abbreviated AUC estimation.

    Science.gov (United States)

    Cheung, Chi Yuen; van der Heijden, Jaques; Hoogtanders, Karin; Christiaans, Maarten; Liu, Yan Lun; Chan, Yiu Han; Choi, Koon Shing; van de Plas, Afke; Shek, Chi Chung; Chau, Ka Foon; Li, Chun Sang; van Hooff, Johannes; Stolk, Leo

    2008-02-01

    Dried blood spot (DBS) sampling and high-performance liquid chromatography tandem-mass spectrometry have been developed in monitoring tacrolimus levels. Our center favors the use of limited sampling strategy and abbreviated formula to estimate the area under concentration-time curve (AUC(0-12)). However, it is inconvenient for patients because they have to wait in the center for blood sampling. We investigated the application of DBS method in tacrolimus level monitoring using limited sampling strategy and abbreviated AUC estimation approach. Duplicate venous samples were obtained at each time point (C(0), C(2), and C(4)). To determine the stability of blood samples, one venous sample was sent to our laboratory immediately. The other duplicate venous samples, together with simultaneous fingerprick blood samples, were sent to the University of Maastricht in the Netherlands. Thirty six patients were recruited and 108 sets of blood samples were collected. There was a highly significant relationship between AUC(0-12), estimated from venous blood samples, and fingerprick blood samples (r(2) = 0.96, P AUC(0-12) strategy as drug monitoring.

  6. Topical pimecrolimus and tacrolimus do not accelerate photocarcinogenesis in hairless mice after UVA or simulated solar radiation

    DEFF Research Database (Denmark)

    Lerche, C.M.; Philipsen, P.A.; Poulsen, T.

    2009-01-01

    in combination with UVA. We used 11 groups of 25 hairless female C3.Cg/TifBomTac immunocompetent mice (n = 275). Pimecrolimus cream or tacrolimus ointment was applied on their dorsal skin three times weekly followed by SSR (2, 4, or 6 standard erythema doses, SED) or UVA (25 J/cm(2)) 3-4 h later. This was done...

  7. Tacrolimus concentration to dose ratio in solid organ transplant patients treated with fecal microbiota transplantation for recurrent Clostridium difficile infection.

    Science.gov (United States)

    Woodworth, Michael H; Kraft, Colleen S; Meredith, Erika J; Mehta, Aneesh K; Wang, Tiffany; Mamo, Yafet T; Dhere, Tanvi; Sitchenko, Kaitlin L; Patzer, Rachel E; Friedman-Moraco, Rachel J

    2018-04-01

    Fecal microbiota transplantation (FMT) is increasingly being performed for Clostridium difficile infection in solid organ transplant (SOT) patients; however, little is known about the potential pharmacokinetic or pharmacomicrobial effects this may have on tacrolimus levels. We reviewed the medical records of 10 SOT patients from September 2012-December 2016 who were taking tacrolimus at time of FMT for recurrent C. difficile infection. We compared the differences in tacrolimus concentration/dose ratio (C/D ratio) 3 months prior to FMT vs 3 months after FMT. The mean of the differences in C/D ratio calculated as (ng/mL)/(mg/kg/d) was -17.65 (95% CI -1.25 to 0.58) (ng/mL)/(mg/kg/d), P-value .43 by Wilcoxon signed-rank test. The mean of the differences in C/D ratio calculated as (ng/mL)/(mg/d) was -0.33 (95% CI -1.25 to 0.58) (ng/mL)/(mg/d), P-value .28 by Wilcoxon signed-rank test. Of these patients, 2/10 underwent allograft biopsy for allograft dysfunction in the year after FMT, with no evidence of allograft rejection on pathology. These preliminary data suggest that FMT may not predictably alter tacrolimus levels and support its safety for SOT patients however further study in randomized trials is needed. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. The Effects of Tacrolimus on T-Cell Proliferation Are Short-Lived: A Pilot Analysis of Immune Function Testing

    Directory of Open Access Journals (Sweden)

    Benjamin L. Laskin, MD, MS

    2017-08-01

    Conclusions. T-cell proliferation is currently not suitable to measure immunosuppression because sample processing diminishes observable effects. Future immune function testing should focus on fresh samples with minimal washing steps. Our results also emphasize the importance of adherence to immunosuppressive treatment, because T-cell proliferation recovered substantially after even brief discontinuation of tacrolimus.

  9. The relationship between tacrolimus concentration-dose ratio and genetic polymorphism in patients subjected to renal transplantation

    Directory of Open Access Journals (Sweden)

    Rančić Nemanja

    2018-01-01

    Full Text Available Background/Aim. Tacrolimus concentration-dose ratio as a potential therapeutic drug monitoring strategy was suggested to be used for the patients subjected to renal transplantation. The aim of this study was examining the relationship between tacrolimus concentration-dose ratio, suggested to be used as a therapeutic drug monitoring strategy and the polymorphisms of genes encoding the most important enzymes, such as CYP3A5 and CYP3A4, as well as the transporter P-glycoprotein, for its metabolism and elimination. Methods. The study was designed as a prospective case series study, in which the unit of monitoring was the outpatient examination of 54 patients subjected to renal transplantation. Genotyping was performed by 7500 Real- Time PCR System by assessing allelic discrimination based on TaqMan® methodology. Results. Patients (n = 13 who were treated with less than 2 mg of tacrolimus/day (0.024 ± 0.006 mg/kg/day had the tacrolimus concentration-dose ratio larger than 150 ng/mL/mg/kg. In this group, 84.62% patients had CYP3А5 *3*3 allele. All of these patients had CYP3А4 *1*1/*1*1B allele. Regarding ABCB1 C3435T gene, 30.77% of patients had the TT gene variant, while 69.23% of our patients had CC and CT gene variants. Conclusion. Tacrolimus concentration-dose ratio greater than 150 ng/mL/mg/kg is cut-off value in patients subjected to renal transplantation which might point to patients who are poor CYP3A5 metabolizers and/or with dysfunctional P-glycoprotein.

  10. The immunosuppressives FK 506 and cyclosporin A inhibit the generation of protein factors binding to the two purine boxes of the interleukin 2 enhancer.

    Science.gov (United States)

    Brabletz, T; Pietrowski, I; Serfling, E

    1991-01-11

    Like Cyclosporin A (CsA), the macrolide FK 506 is a potent immunosuppressive that inhibits early steps of T cell activation, including the synthesis of Interleukin 2 (II-2) and numerous other lymphokines. The block of II-2 synthesis occurs at the transcriptional level. At concentrations that block T cell activation, FK 506 and CsA inhibit the proto-enhancer activity of Purine boxes of the II-2 promoter and the generation of lymphocyte-specific factors binding to the Purine boxes. Under the same conditions, the DNA binding of other II-2 enhancer factors remains unaffected by both compounds. These results support the view that FK 506 and CsA, which both inhibit the activity of peptidylprolyl cis/trans isomerases, suppress T cell activation by a similar, if not identical mechanism.

  11. Safety of reduced dose of mycophenolate mofetil combined with tacrolimus in living-donor liver transplantation

    Directory of Open Access Journals (Sweden)

    Hyeyoung Kim

    2014-09-01

    Full Text Available Background/AimsThe dose of mycophenolate mofetil (MMF has been reduced in Asia due to side effects associated with the conventional fixed dose of 2-3 g/day. We aimed to determine the pharmacokinetics of a reduced dose of MMF and to validate its feasibility in combination with tacrolimus in living-donor liver transplantation (LDLT.MethodsTwo sequential studies were performed in adult LDLT between October 2009 and 2011. First, we performed a prospective pharmacokinetic study in 15 recipients. We measured the area under the curve from 0 to 12 hours (AUC0-12 for mycophenolic acid at postoperative days 7 and 14, and we performed a protocol biopsy before discharge. Second, among 215 recipients, we reviewed 74 patients who were initially administered a reduced dose of MMF (1.0 g/day with tacrolimus (trough, 8-12 ng/mL during the first month, and 5-8 ng/mL thereafter, with a 1-year follow-up. We performed protocol biopsies at 2 weeks and 1 year post-LDLT.ResultsIn the first part of study, AUC0-12 was less than 30 mgh/L in 93.3% of cases. In the second, validating study, 41.9% of the recipients needed dose reduction or cessation due to side effects within the first year after LDLT. At 12 months post-LDLT, 17.6% of the recipients were administered a lower dose of MMF (0.5 g/day, and 16.2% needed permanent cessation due to side effects. The 1- and 12-month rejection-free survival rates were 98.6% and 97.3%, respectively.ConclusionsA reduced dose of MMF was associated with low blood levels compared to the existing recommended therapeutic range. However, reducing the dose of MMF combined with a low level of tacrolimus was feasible clinically, with an excellent short-term outcome in LDLT.

  12. Posaconazole exhibits in vitro and in vivo synergistic antifungal activity with caspofungin or FK506 against Candida albicans.

    Directory of Open Access Journals (Sweden)

    Ying-Lien Chen

    Full Text Available The object of this study was to test whether posaconazole, a broad-spectrum antifungal agent inhibiting ergosterol biosynthesis, exhibits synergy with the β-1,3 glucan synthase inhibitor caspofungin or the calcineurin inhibitor FK506 against the human fungal pathogen Candida albicans. Although current drug treatments for Candida infection are often efficacious, the available antifungal armamentarium may not be keeping pace with the increasing incidence of drug resistant strains. The development of drug combinations or novel antifungal drugs to address emerging drug resistance is therefore of general importance. Combination drug therapies are employed to treat patients with HIV, cancer, or tuberculosis, and has considerable promise in the treatment of fungal infections like cryptococcal meningitis and C. albicans infections. Our studies reported here demonstrate that posaconazole exhibits in vitro synergy with caspofungin or FK506 against drug susceptible or resistant C. albicans strains. Furthermore, these combinations also show in vivo synergy against C. albicans strain SC5314 and its derived echinocandin-resistant mutants, which harbor an S645Y mutation in the CaFks1 β-1,3 glucan synthase drug target, suggesting potential therapeutic applicability for these combinations in the future.

  13. A Markov chain model to evaluate the effect of CYP3A5 and ABCB1 polymorphisms on adverse events associated with tacrolimus in pediatric renal transplantation.

    Science.gov (United States)

    Sy, Sherwin K B; Heuberger, Jules; Shilbayeh, Sireen; Conrado, Daniela J; Derendorf, Hartmut

    2013-10-01

    The SNP A6986G of the CYP3A5 gene (*3) results in a non-functional protein due to a splicing defect whereas the C3435T was associated with variable expression of the ABCB1 gene, due to protein instability. Part of the large interindividual variability in tacrolimus efficacy and toxicity can be accounted for by these genetic factors. Seventy-two individuals were examined for A6986G and C3435T polymorphism using a PCR-RFLP-based technique to estimate genotype and allele frequencies in the Jordanian population. The association of age, hematocrit, platelet count, CYP3A5, and ABCB1 polymorphisms with tacrolimus dose- and body-weight-normalized levels in the subset of 38 pediatric renal transplant patients was evaluated. A Markov model was used to evaluate the time-dependent probability of an adverse event occurrence by CYP3A5 phenotypes and ABCB1 genotypes. The time-dependent probability of adverse event was about double in CYP3A5 non-expressors compared to the expressors for the first 12 months of therapy. The CYP3A5 non-expressors had higher corresponding normalized tacrolimus levels compared to the expressors in the first 3 months. The correlation trend between probability of adverse events and normalized tacrolimus concentrations for the two CYP3A5 phenotypes persisted for the first 9 months of therapy. The differences among ABCB1 genotypes in terms of adverse events and normalized tacrolimus levels were only observed in the first 3 months of therapy. The information on CYP3A5 genotypes and tacrolimus dose requirement is important in designing effective programs toward management of tacrolimus side effects particularly for the initial dose when tacrolimus blood levels are not available for therapeutic drug monitoring.

  14. Analysis of tacrolimus and creatinine from a single dried blood spot using liquid chromatography tandem mass spectrometry.

    Science.gov (United States)

    Koop, Dennis R; Bleyle, Lisa A; Munar, Myrna; Cherala, Ganesh; Al-Uzri, Amira

    2013-05-01

    Long term therapeutic drug monitoring and assessment of renal function are required in renal transplant recipients on immunosuppressant therapy such as tacrolimus. Dry blood spots (DBS) have been used successfully in the clinic for many years and offers a convenient, simple and non-invasive method for repeated blood tests. We developed and performed a preliminary validation of a method for the analysis of tacrolimus and creatinine from a single DBS using liquid chromatography-tandem mass spectrometric (LC-MS/MS). Tacrolimus and creatinine were extracted from a 6mm punch with a mixture of methanol/acetonitrile containing ascomycin and deuterated creatinine as internal standards. A 10 μl aliquot of the extract was analyzed directly after dilution for creatinine with normal phase high performance liquid chromatography and multiple reaction monitoring. The remainder of the extract was processed and analyzed for tacrolimus. The lower limit of quantification for tacrolimus was 1 ng/ml with accuracy of 0.34% bias and precision (CV) of 11.1%. The precision ranged from 1.33% to 7.68% and accuracy from -4.44% to 11.6% bias for the intra- and inter-day analysis. The lower limit of quantification of creatinine was 0.01 mg/dL with precision of 7.94%. Accuracy was based on recovery of additional creatinine spiked into whole blood samples and ranged from -2.45% bias at 5 mg/dL to 3.75% bias at 0.5 mg/dL. Intra- and inter-day precision was from 3.48 to 4.11%. The assay was further validated with DBS prepared from pediatric renal transplant recipients. There was excellent correlation between the levels of tacrolimus and creatinine obtained from the clinical laboratory and the DBS method developed. After additional validation, this assay may have a significant impact on compliance with medication intake as well as potentially lowering the cost associated with intravenous blood draws in clinical laboratories. Copyright © 2013 Elsevier B.V. All rights reserved.

  15. Association of the PPP3CA c.249G>A variant with clinical outcomes of tacrolimus-based therapy in kidney transplant recipients

    Directory of Open Access Journals (Sweden)

    Salgado PC

    2017-03-01

    Full Text Available Patricia C Salgado,1 Fabiana DV Genvigir,1 Claudia R Felipe,2 Helio Tedesco-Silva Jr,2 Jose O Medina-Pestana,2 Sonia Q Doi,3 Mario H Hirata,1 Rosario DC Hirata1 1Department of Clinical and Toxicological Analysis, School of Pharmaceutical Sciences, University of Sao Paulo, 2Division of Nephrology, Hospital do Rim, Federal University of Sao Paulo, Sao Paulo, Brazil; 3School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA Background: The effects of genetic variants related to the pharmacodynamic mechanisms of immunosuppressive drugs on their therapeutic efficacy and safety have been poorly explored. This study was performed to investigate the influence of the PPP3CA c.249G>A variant on the clinical outcomes of kidney transplant recipients. Patients and methods: A total of 148 Brazilian patients received tacrolimus (TAC-based immunosuppressive therapy for 90 days post-kidney transplantation. The PPP3CA rs3730251 (c.249G>A polymorphism was determined by real-time polymerase chain reaction. Single-nucleotide polymorphism (SNP data for CYP3A5 rs776746 (CYP3A5*3C; g.6986A>G were used to eliminate the confounding effects of this variant. Results: The PPP3CA c.249G>A SNP did not influence early TAC exposure, renal function, or other laboratory parameters, including levels of urea, creatinine, glucose, and lipids, and blood counts. This variant also did not account for the cumulative incidence of biopsy-confirmed acute rejection or delayed graft function. Regarding adverse events, PPP3CA c.249A allele carriers initially had a 3.05-fold increased probability of treatment-induced blood and lymphatic system disorders compared with c.249GG genotype individuals (95% confidence interval: 1.10–8.48, p=0.032. However, this result was not maintained after adjusting for body weight and CYP3A5*3C SNP status (p=0.086. Conclusion: The PPP3CA c.249G>A variant does not influence the clinical outcomes of Brazilian patients in the

  16. Topical tacrolimus and periodontal therapy in the management of a case of oral chronic GVHD characterized by specific gingival localization.

    Science.gov (United States)

    Conrotto, Davide; Broccoletti, Roberto; Carcieri, Paola; Giaccone, Luisa; Arduino, Paolo G

    2014-01-01

    Background. Chronic graft versus host disease (cGVHD) is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement.

  17. Topical Tacrolimus and Periodontal Therapy in the Management of a Case of Oral Chronic GVHD Characterized by Specific Gingival Localization

    Directory of Open Access Journals (Sweden)

    Davide Conrotto

    2014-01-01

    Full Text Available Background. Chronic graft versus host disease (cGVHD is a complication following bone marrow transplantation. The oral lesions are difficult to control with a systemic pharmacological therapy. Case Description. A 63-year-old female patient, who underwent an allogeniec transplantation for acute myeloid leukemia, developed a chronic oral and cutaneous GVHD. The patient was treated with topical tacrolimus 0.1%, twice daily for two months, and underwent a protocol of oral hygiene characterized by 3 appointments of scaling, root planning, and daily oral hygiene instructions. The patient showed marked resolution of gingival lesions and a significant improvement of related pain and gingival inflammatory indexes. Clinical Implications. This case report suggests that treatment with topical tacrolimus and professional oral hygiene may be helpful in the management of chronic oral GVHD with severe gingival involvement.

  18. C2 (2-h) levels are not superior to trough levels as estimates of the area under the curve in tacrolimus-treated renal-transplant patients

    DEFF Research Database (Denmark)

    Jørgensen, Kaj; Povlsen, Johan; Madsen, Søren

    2002-01-01

    and AUC by Pearson's correlation coefficient, and pairs of correlation coefficients were compared by an asymptotic Wald-type test. RESULTS: AUC varied five-fold despite near-equal dosing. Pearson's correlation coefficient for trough level, 1, 2, 3, 4, and 6 h were 0.84, 0.60, 0.81, 0.95, 0.95, and 0.......94 on day 3 and 0.94, 0.69, 0.92, 0.96, 0.94, 0.92 on day 14. Three-, 4- and 6-h levels had significantly higher correlation coefficients compared to trough, 1- and 2-h levels. One-hour samples had significantly lower correlation coefficients compared to all other sampling times on day 14. The patient...... with the highest AUC developed nephrotoxicity despite trough levels in the desired range. CONCLUSIONS: Two-hour levels are not superior to trough levels in tacrolimus-treated renal transplant patients. Despite good correlation between trough level and AUC, some patients may still receive nephrotoxic doses despite...

  19. A case of vesicular cutaneous lupus erythematosus in a Border collie successfully treated with topical tacrolimus and nicotinamide-tetracycline.

    Science.gov (United States)

    Lehner, Georg M; Linek, Monika

    2013-12-01

    Canine vesicular cutaneous lupus erythematosus (VCLE) is an autoimmune skin disease of the Shetland sheepdog and rough collie, which manifests as an erosive dermatitis of sparsely haired skin of the ventrum and concave pinnae. Reported treatment consists of immunosuppression with glucocorticoids alone or in combination with azathioprine, but successful treatment is unpredictable. To report on the treatment of VCLE in a Border collie dog with topical 0.1% tacrolimus and nicotinamide in combination with tetracycline. An 8-year-old male neutered Border collie was presented with multiple coalescing erosions on the ventral abdomen, groin and axillae and ulceration on the oral commissures. Clinical presentation, routine diagnostics, histology and immunohistochemistry were consistent with VCLE. Remission was achieved with topical 0.1% tacrolimus and combination therapy of nicotinamide and tetracycline. This dog responded well to treatment with topical 0.1% tacrolimus, nicotinamide-tetracycline and sun avoidance. Complete remission was achieved after 2.5 months, and the dog was lesion free during a 1 year follow-up period. © 2013 ESVD and ACVD.

  20. Traumatic brain injury causes an FK506-sensitive loss and an overgrowth of dendritic spines in rat forebrain.

    Science.gov (United States)

    Campbell, John N; Register, David; Churn, Severn B

    2012-01-20

    Traumatic brain injury (TBI) causes both an acute loss of tissue and a progressive injury through reactive processes such as excitotoxicity and inflammation. These processes may worsen neural dysfunction by altering neuronal circuitry beyond the focally-damaged tissue. One means of circuit alteration may involve dendritic spines, micron-sized protuberances of dendritic membrane that support most of the excitatory synapses in the brain. This study used a modified Golgi-Cox technique to track changes in spine density on the proximal dendrites of principal cells in rat forebrain regions. Spine density was assessed at 1 h, 24 h, and 1 week after a lateral fluid percussion TBI of moderate severity. At 1 h after TBI, no changes in spine density were observed in any of the brain regions examined. By 24 h after TBI, however, spine density had decreased in ipsilateral neocortex in layer II and III and dorsal dentate gyrus (dDG). This apparent loss of spines was prevented by a single, post-injury administration of the calcineurin inhibitor FK506. These results, together with those of a companion study, indicate an FK506-sensitive mechanism of dendritic spine loss in the TBI model. Furthermore, by 1 week after TBI, spine density had increased substantially above control levels, bilaterally in CA1 and CA3 and ipsilaterally in dDG. The apparent overgrowth of spines in CA1 is of particular interest, as it may explain previous reports of abnormal and potentially epileptogenic activity in this brain region.

  1. Co-existence of Fisheries and Marine Renewable Energy: The Spotlight on Fishers and Fishers' Knowledge (FK)

    Science.gov (United States)

    Campbell, M. S.; Ashley, M.; De Groot, J.; Rodwell, L.

    2016-02-01

    As an emerging industry, Marine Renewable Energy (MRE) is expected to play a major contributory role if the UK is to successfully reach it's desired target of renewable energy production by 2020. However, due to the competing objectives and priorities of MRE and other industries, for example fisheries, and in the delivering of conservation measures, the demand for space within our marine landscape is increasing, and interactions are inevitable. A semi structured interview was conducted with forty fishers across the UK to elicit further information on the challenges, barriers to progress and priority issues these fishers face in relation to MRE development. The questionnaire also included a fisher assessment of the mitigation agenda developed by de Groot et al. (2014) under the Natural Environment Research Council Marine Renewable Energy Knowledge Exchange Programme ( NERC MREKEP). Qualitative data were extracted and analysed using the text analysis software NVivo8. Fishers identified barriers to progress, and in order of the most important themes included; policy, consultation, trust, lack of knowledge, true representation of all fishers, science vs. fisher observation mismatch and timescales. Priority issues identified in order of importance were; displacement or loss of access, cable disturbance, timings of installation/repairs, effects on the seabed and specifically offshore windfarm (OWF) sitting. The consultation process caused discontent among all fishers interviewed. In relation to working towards a collaborative mitigation agenda, fishers highlighted issues of trust in relation to; trans-boundary management, data management and the consultation process. At all stages of the research, the response rate of the importance of gathering fishers' knowledge (FK) was high. Fishers underlined the importance of this data source in assessing the impacts of MRE on the sectors of the UK fleet. Thus, although at an early stage of development, an initial framework for the

  2. Use of tacrolimus in rescue therapy of acute and chronic rejection in liver transplantation Uso de tacrolimus na terapia de resgate de rejeições agudas e crônicas no transplante de fígado

    Directory of Open Access Journals (Sweden)

    Fabricio Ferreira Coelho

    2003-01-01

    Full Text Available PURPOSE: To study the indications and results of tacrolimus as rescue therapy for acute cellular or chronic rejection in liver transplantation. PATIENTS AND METHODS: Eighteen liver transplant recipients who underwent rescue therapy with tacrolimus between March 1995 and August 1999 were retrospectively studied. The treatment indication, patients, and graft situation were recorded as of October 31st, 1999. The response to tacrolimus was defined as patient survival with a functional graft and histological reversal of acute cellular, or for chronic rejection, bilirubin serum levels decreasing to up to twice the upper normal limit. RESULTS: Fourteen cases (77.8% presented a good response. The response rate for the different indications was: (1 acute cellular + sepsis - 0/1 case; (2 recurrent acute cellular - 1/1 case; (3 OKT3-resistant acute cellular - 2/2 cases; (4 steroid-resistant acute cellular + active viral infection - 3/3 cases; (5 chronic rejection - 8/11 cases (72.7% response rate. The 4 patients who did not respond died. CONCLUSION: Tacrolimus rescue therapy was successful in most cases of acute cellular and chronic rejection in liver transplantation.OBJETIVO: Estudar os critérios de indicação e o resultado do uso de tacrolimus na terapia de resgate de rejeições agudas ou crônicas no transplante de fígado. CASUÍSTICA E MÉTODO: Foram estudados 18 pacientes transplantados de fígado, submetidos a terapia de resgate com tacrolimus entre março de 1995 e agosto de 1999. Foram registradas a indicação do tratamento e a situação de pacientes e enxertos em 31/10/1999. Considerou-se "respondendores" pacientes vivos, com enxerto funcionante e regressão histológica da terapia de resgate de rejeições agudas, ou com bilirrubina até 2 vezes o valor normal, no caso de terapia de resgate de rejeições crônicas. RESULTADO: Observou-se resposta em 14 casos (77,8%. A taxa de resposta nas diferentes indicações foi: (1 terapia de resgate

  3. Comparable Renal Function at 6 Months with Tacrolimus Combined with Fixed-Dose Sirolimus or MMF: Results of a Randomized Multicenter Trial in Renal Transplantation

    Directory of Open Access Journals (Sweden)

    Eveline Van Gurp

    2010-01-01

    Full Text Available In a multicenter trial, renal transplant recipients were randomized to tacrolimus with fixed-dose sirolimus (Tac/SRL, N = 318 or tacrolimus with MMF (Tac/MMF, N = 316. Targeted tacrolimus trough levels were lower in the Tac/SRL group after day 14. The primary endpoint was renal function at 6 months using creatinine clearance (Cockcroft-Gault and was comparable at 66.4 mL/min (SE 1.4 with Tac/SRL and at 65.2mL/min (SE 1.3 with Tac/MMF (completers. Biopsy-confirmed acute rejection was 15.1% (Tac/SRL and 12.3% (Tac/MMF. In both groups, graft survival was 93% and patient survival was 99.0%. Premature withdrawal due to an adverse event was twice as high in the Tac/SRL group, 15.1% versus 6.3%. Hypercholesterolemia incidence was higher with Tac/SRL (P30 consecutive days in previously nondiabetic patients was 17.8%, Tac/SRL, and 24.8%, Tac/MMF. Evaluation at 6 months showed comparable renal function using tacrolimus/sirolimus and tacrolimus/MMF regimens.

  4. Impact of cytochrome p450 3A5 genetic polymorphism on tacrolimus doses and concentration-to-dose ratio in renal transplant recipients.

    Science.gov (United States)

    Thervet, Eric; Anglicheau, Dany; King, Barry; Schlageter, Marie-Hélène; Cassinat, Bruno; Beaune, Philippe; Legendre, Christophe; Daly, Ann K

    2003-10-27

    Tacrolimus pharmacokinetic characteristics vary greatly among individuals. Tacrolimus is a substrate of cytochrome p450 (CYP), of subfamily CYP3A. CYP3A activity is the sum of the activities of the family of CYP3A genes, including CYP3A5. Subjects with the CYP3A5*1/*1 genotype express large amounts of CYP3A5. Heterozygotes (genotype CYP3A5*1/*3) also express the enzyme. We postulated that CYP3A5 polymorphism is associated with tacrolimus pharmacokinetic variations. CYP3A5 genotype was evaluated in 80 renal transplant recipients and correlated with the daily tacrolimus dose and concentration-to-dose ratio. The frequency of the homozygous CYP3A5*1 genotype (CYP3A5*1/*1) was 5%, and 11% of subjects were heterozygous (CYP3A5*1/*3). The mean doses required to obtain the targeted concentration-to-dose ratio were significantly lower in patients with the CYP3A5*1/*1 genotype. Determination of CYP3A5 genotype is predictive of the dose of tacrolimus in renal transplant recipients and may help to determine the initial daily dose needed by individual patients for adequate immunosuppression without excess nephrotoxicity.

  5. Differing manifestations of hepatitis C and tacrolimus on hospitalized diabetes mellitus occurring after kidney transplantation.

    Science.gov (United States)

    Abbott, Kevin C; Bernet, Victor J; Agodoa, Lawrence Y; Yuan, Christina M

    2005-09-01

    Previous studies suggest the association of recipient hepatitis C seropositivity (HCV+) and use of tacrolimus (TAC) with post-transplant diabetes mellitus (PTDM) may differ by manifestations of type I or type II diabetes, but this has not been assessed in the era of current immunosuppression. We performed a retrospective cohort study of 10,342 Medicare primary renal transplantation recipients without evidence of diabetes at the time of listing in the United States Renal Data System between January 1, 1998 and July 31, 2000, followed until December 31, 2000. Outcomes were hospitalizations for a primary diagnosis of diabetic ketoacidosis (DKA) or hyperglycemic hyperosmolar syndrome (HHS). Cox regression analysis was used to calculate adjusted hazard ratios (AHR) for time to DKA or HHS, stratified by diabetes status at the time of transplant. In Cox regression analysis, use of TAC at discharge was independently associated with shorter time to DKA (AHR, 1.88; 95% CI, 1.05-3.37, p=0.034) but not HHS. In contrast, recipient HCV+ was independently associated with shorter time to HHS (AHR, 3.90; 1.59-9.60, p=.003), but not DKA. There was no interaction between TAC and HCV+ for either outcome. These results confirm earlier findings that TAC and HCV+ may mediate the risk of PTDM through different mechanisms, even in the modern era.

  6. Comparison of sirolimus plus tacrolimus versus sirolimus plus cyclosporine in high-risk renal allograft recipients: results from an open-label, randomized trial.

    Science.gov (United States)

    Gaber, A Osama; Kahan, Barry D; Van Buren, Charles; Schulman, Seth L; Scarola, Joseph; Neylan, John F

    2008-11-15

    The efficacy and safety of sirolimus (SRL) plus tacrolimus (TAC) versus SRL plus cyclosporine (CsA) were compared in high-risk renal allograft recipients. Evaluable patients (448) were randomly assigned (1:1) before transplant to receive SRL+TAC or SRL+CsA with corticosteroids. Eligible patients were black and/or repeat transplant recipients, and/or those with high titer of panel-reactive antibodies. Demographics were similar between groups. Both treatments demonstrated equivalent efficacy of the composite endpoint at 12 months with efficacy failure rates of 21.9% vs. 23.2% (SRL+TAC vs. SRL+CsA, respectively, 95% CI -10.0 to 7.1, P=0.737). Biopsy-confirmed acute rejection rate (13.8% vs. 17.4%) and graft survival rate (89.7% vs. 90.2%) were similar (SRL+TAC vs. SRL+CsA, respectively). In evaluable patients (received at least 1 dose of study drug), renal function (calculated Nankivell glomerular filtration rate) was not superior in SRL+TAC versus SRL+CsA (54.5 vs. 52.6 mL/min, P=0.466); however, in on-therapy patients, glomerular filtration rate was significantly higher in SRL+TAC at most time points. At 12 months, there were no significant differences in rates of death, discontinuation because of adverse events, hypercholesterolemia, hyperlipemia, or proteinuria. Diarrhea and herpes simplex infections occurred significantly more often in SRL+TAC patients. Hypertension, cardiomegaly, increased creatinine, overdose (primarily calcineurin inhibitor toxicity), acne, urinary tract disorders, lymphocele, and ovarian cysts occurred significantly more often in SRL+CsA patients. This study demonstrated that SRL-based therapy was efficacious in high-risk renal allograft recipients in the first year after transplant, providing equivalent efficacy with CsA or TAC, similar graft survival, low biopsy-confirmed acute rejection rates, excellent renal function, and an acceptable safety profile.

  7. Improvement of FK506 Production in the High-Yielding Strain Streptomyces sp. RM7011 by Engineering the Supply of Allylmalonyl-CoA Through a Combination of Genetic and Chemical Approach.

    Science.gov (United States)

    Mo, SangJoon; Lee, Sung-Kwon; Jin, Ying-Yu; Suh, Joo-Won

    2016-02-01

    FK506, a widely used immunosuppressant, is a 23-membered polyketide macrolide that is produced by several Streptomyces species. FK506 high-yielding strain Streptomyces sp. RM7011 was developed from the discovered Streptomyces sp. KCCM 11116P by random mutagenesis in our previous study. The results of transcript expression analysis showed that the transcription levels of tcsA, B, C, and D were increased in Streptomyces sp. RM7011 by 2.1-, 3.1-, 3.3-, and 4.1- fold, respectively, compared with Streptomyces sp. KCCM 11116P. The overexpression of tcsABCD genes in Streptomyces sp. RM7011 gave rise to approximately 2.5-fold (238.1 μg/ml) increase in the level of FK506 production compared with that of Streptomyces sp. RM7011. When vinyl pentanoate was added into the culture broth of Streptomyces sp. RM7011, the level of FK506 production was approximately 2.2-fold (207.7 μg/ml) higher than that of the unsupplemented fermentation. Furthermore, supplementing the culture broth of Streptomyces sp. RM7011 expressing tcsABCD genes with vinyl pentanoate resulted in an additional 1.7-fold improvement in the FK506 titer (498.1 μg/ml) compared with that observed under nonsupplemented condition. Overall, the level of FK506 production was increased approximately 5.2-fold by engineering the supply of allylmalonyl-CoA in the high-yielding strain Streptomyces sp. RM7011, using a combination of overexpressing tcsABCD genes and adding vinyl pentanoate, as compared with Streptomyces sp. RM7011 (95.3 μg/ml). Moreover, among the three precursors analyzed, pentanoate was the most effective precursor, supporting the highest titer of FK506 in the FK506 high-yielding strain Streptomyces sp. RM7011.

  8. Shearlet transform in aliased ground roll attenuation and its comparison with f-k filtering and curvelet transform

    Science.gov (United States)

    Abolfazl Hosseini, Seyed; Javaherian, Abdolrahim; Hassani, Hossien; Torabi, Siyavash; Sadri, Maryam

    2015-06-01

    Ground roll, which is a Rayleigh surface wave that exists in land seismic data, may mask reflections. Sometimes ground roll is spatially aliased. Attenuation of aliased ground roll is of importance in seismic data processing. Different methods have been developed to attenuate ground roll. The shearlet transform is a directional and multidimensional transform that generates subimages of an input image in different directions and scales. Events with different dips are separated in these subimages. In this study, the shearlet transform is used to attenuate the aliased ground roll. To do this, a shot record is divided into several segments, and the appropriate mute zone is defined for all segments. The shearlet transform is applied to each segment. The subimages related to the non-aliased and aliased ground roll are identified by plotting the energy distributions of subimages with visual checking. Then, muting filters are used on selected subimages. The inverse shearlet transform is applied to the filtered segment. This procedure is repeated for all segments. Finally, all filtered segments are merged using the Hanning window. This method of aliased ground roll attenuation was tested on a synthetic dataset and a field shot record from the west of Iran. The synthetic shot record included strong aliased ground roll, whereas the field shot record did not. To produce the strong aliased ground roll on the field shot record, the data were resampled in the offset direction from 30 to 60 m. To show the performance of the shearlet transform in attenuating the aliased ground roll, we compared the shearlet transform with the f-k filtering and curvelet transform. We showed that the performance of the shearlet transform in the aliased ground roll attenuation is better than that of the f-k filtering and curvelet transform in both the synthetic and field shot records. However, when the dip and frequency content of the aliased ground roll are the same as the reflections, ability of

  9. New tablet formulation of tacrolimus with smaller interindividual variability may become a better treatment option than the conventional capsule formulation in organ transplant patients

    Directory of Open Access Journals (Sweden)

    Kim YK

    2017-09-01

    Full Text Available Yu Kyong Kim,1 Anhye Kim,1,2 Shin Jung Park,3 Howard Lee1,4 1Department of Clinical Pharmacology and Therapeutics, Seoul National University College of Medicine and Hospital, Seoul, 2Clinical Trial Center, Ajou University Medical Center, Suwon, 3Research Institute, Chong Kun Dang Pharmaceutical Corp, Yongin, 4Department of Transdisciplinary Studies, Graduate School of Convergence Science and Technology, Seoul National University, Suwon, Republic of Korea Abstract: To evaluate the pharmacokinetic (PK and tolerability profiles of a new tablet formulation of tacrolimus and its interindividual variability (IIV in the systemic exposure, and to compare them with those of the conventional capsule formulation, a randomized, open-label, two-treatment, two-period, two-sequence, crossover study was performed in 47 healthy males. The capsule or tablet formulation of tacrolimus was orally administered, and serial blood samples were collected up to 96 hours after dosing. Whole-blood tacrolimus concentration was determined using liquid chromatography–tandem mass spectrometry. The maximum whole-blood tacrolimus concentration (Cmax and the area under the whole-blood tacrolimus concentration–time curve from 0 hour to the last quantifiable concentration (AUClast were compared between the two formulations. The similarity factor (f2 of the in vitro dissolution profiles was calculated. The geometric mean ratio (90% confidence interval of tablet to capsule was 0.9680 (0.8873–1.0560 and 1.0322 (0.9359–1.1385 for Cmax and AUClast, respectively. The IIV of Cmax and AUClast of the tablet was smaller than the capsule. The f2 values were >50 in all media. Both formulations were well tolerated. Thus, the tablet formulation of tacrolimus has smaller IIV in the systemic exposure than capsule, while having comparable PK and tolerability profiles, which may render it as a better treatment option for organ transplant patients. Keywords: new formulation, incrementally

  10. Analýza marketingového mixu FK Dukla Praha a návrhy na jeho zlepšení

    OpenAIRE

    Bittengel, Günter

    2011-01-01

    FK DUKLA PRAGUE MARKETING MIX ANALYSIS AND PROPOSALS FOR ITS IMPROVEMENT Targets: The analysis of particular marketing aspects, which compose the complete marketing mix. Communication with club fans and investigating their position on marketing. Consequent proposals of appropriate recommendations in marketing field to improve the club's present image. Methods: There will be an example study and SWOT analysis used to analyze current marketing mix. These will determine strong and weak points of...

  11. Efficacy of topical application of 0.03% tacrolimus eye ointment in the management of allergic conjunctivitis.

    Science.gov (United States)

    Hazarika, Ajit Kumar; Singh, Prodip Kumar

    2015-08-01

    Allergic conjunctivitis is commonly observed eye diseases in Sikkim, India due to the abundance of seasonal pollens, environmental pollutants, and house dust. We evaluated the efficacy of topical 0.03% tacrolimus eye ointment in the management of simple allergic conjunctivitis. A prospective observational study was designed consisting of 41 patients with refractory simple allergic conjunctivitis, whose condition responded very poorly to conventional anti-allergic eye drops (azelastine, olopatadine, chlorpheniramine maleate, sodium chromoglycate). Simple allergic conjunctivitis cases were diagnosed and followed up evaluating both subjective and objective findings (itching, photophobia, tearing, chemosis, conjunctival congestion, tarsal papilla, and eyelid edema). Existing ocular treatment was discontinued at enrolment and 0.03% tacrolimus ointment was applied into the conjunctival sac of the affected eyes twice daily for 4 weeks followed by a 2 weeks washout period. Patients were followed up at the end of 1(st) week, 4(th) week, and at 7(th) week (2 weeks washout period). Symptoms of simple allergic conjunctivitis (itching, tearing and photophobia) were significantly reduced at the end of 1(st) week. Signs such as conjunctival chemosis, congestion, tarsal papillae, and eyelid edema were effectively treated in all cases at the end of 1(st) week. At the end of 4(th) week, all cases were fully cured and none of the patient had any recurrences up to 7(th) week. Mean score at 1(st) day (9.6 ± 3.27) was significantly (P < 0.0001) reduced by 7(th) day (1.35 ± 1.19) of treatment. Topical application of tacrolimus ointment is an excellent alternative to anti-allergic and steroids eye drops for the treatment of simple allergic conjunctivitis as it significantly reduces recurrences.

  12. Decreased calcineurin immunoreactivity in the postmortem brain of a patient with schizophrenia who had been prescribed the calcineurin inhibitor, tacrolimus, for leukemia

    Directory of Open Access Journals (Sweden)

    Wada A

    2016-07-01

    Full Text Available Akira Wada,1,2 Yasuto Kunii,1 Jyunya Matsumoto,1 Mizuki Hino,1 Atsuko Nagaoka,1 Shin-ichi Niwa,3 Hirooki Yabe1 1Department of Neuropsychiatry, Fukushima Medical University School of Medicine, Fukushima City, Fukushima, 2Department of Neuropsychiatry, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, 3Department of Psychiatry, Aizu Medical Center, Fukushima Medical University, Aizuwakamatsu City, Fukushima, Japan Background: The calcineurin (CaN inhibitor, tacrolimus, is widely used in patients undergoing allogeneic organ transplantation and in those with certain allergic diseases. Recently, several reports have suggested that CaN is also associated with schizophrenia. However, little data are currently available on the direct effect of tacrolimus on the human brain.Case: A 23-year-old Japanese female experienced severe delusion of persecution, delusional mood, suspiciousness, aggression, and excitement. She visited our hospital and was diagnosed with schizophrenia. When she was 27 years old, she had severe general fatigue, persistent fever, systemic joint pain, gingival bleeding, and breathlessness and was diagnosed with acute myelomonocytic leukemia. Later she underwent bone marrow transplantation (BMT, she was administered methotrexate and cyclosporin A to prevent graft versus host disease (GVHD. Three weeks after BMT, she showed initial symptoms of GVHD and was prescribed tacrolimus instead of cyclosporin A. Seven months after BMT at the age of 31 years, she died of progression of GVHD. Pathological anatomy was examined after her death, including immunohistochemical analysis of her brain using anti-CaN antibodies. For comparison, we used our previous data from both a schizophrenia group and a healthy control group. No significant differences were observed in the percentage of CaN-immunoreactive neurons among the schizophrenia group, healthy control group, and the tacrolimus case (all P>0.5, analysis of covariance. Compared with the

  13. COMPARATIVE STUDY OF TOPICAL MOMETASONE FUROATE 0.1%, TOPICAL 0.03% TACROLIMUS, TOPICAL BASIC FIBROBLAST GROWTH FACTOR (bFGF IN CHILDHOOD VITILIGO

    Directory of Open Access Journals (Sweden)

    Kavitha S. B

    2017-08-01

    Full Text Available BACKGROUND Vitiligo, the commonest of all pigmentary disorders, is an idiopathic, acquired cutaneous achromia, characterised by circumscribed, chalky white macules. It may also involve the pigment epithelium of the eyes, the inner ear and the leptomeninges. Although, vitiligo can begin at any age, it develops before the age of 20 years in 50% of the patients and before the age of 10 years in 25% of patients. MATERIALS AND METHODS The study was conducted for a period of one year with 6 months active intervention. A group of 60 consecutive children attending the outpatient Department of Dermatology were included in this study. The same patients were acting as controls. RESULTS Grade 4 response was seen in 12 cases (60% who were on mometasone (VV-20%, focal-30%, segmental-10%, in 10 cases (50% on tacrolimus (VV-20%, focal-30% and in 4 cases (20% on bFGF (focal. Lesions on the face and neck showed grade 4 response in 16 cases (mometasone-8, tacrolimus-6 and bFGF-2, extremities in 6 cases. On the whole grade, 4 response was observed more with mometasone (60% followed by tacrolimus (50%. Grade 3 response was observed with bFGF (30%. CONCLUSION Topical mometasone was very effective among the 3 drugs used in childhood vitiligo showing grade 4 repigmentation in all types of vitiligo except mucosal vitiligo. Tacrolimus proved almost as effective as mometasone to restore skin colour in lesions of vitiligo in children. Because it does not produce atrophy or other adverse effects, tacrolimus may be very useful for younger patients, and for sensitive areas of the skin such as eyelids, it should be considered in other skin disorders currently treated with topical steroids for prolonged periods. Topical basic fibroblast growth factor though less effective than mometasone and tacrolimus, but can be tried as initial therapy in resistant cases such as segmental vitiligo as initial therapy of small vitiligo patches when physicians may not like to initiate high risk

  14. Experimental research on end-to-side anastomosis of peripheral nerves and effect of FK506 on end-to-side anastomosis.

    Science.gov (United States)

    Yang, L M; Wu, Y X; Zhang, X P; Li, X H

    2014-01-01

    To study the effects of end-to-side anastomosis of initially-denatured nerves at different times. 60 male Wistar albino rats were used to fabricate animal models for the experiment on end-to-side anastomosis of peripheral nerves and 50 female Wistar albino rats were used to fabricate animal models for the experiment on the effect of FK506 on end-to-side anastomosis. Bilateral common peroneal nerve, tibialis anterior muscle electrophysiological and histological examinations, tibialis anterior muscle wet muscle weight determination, and motor end plate examination were performed 3 months after operation. All recovery rates of action potential, single muscle contraction force and tetanic contraction force of the FK506 experimental group are significantly higher than those of the control group and the sectional area of muscle fiber is also higher than that of the control group of normal saline. The best time for end-to-side anastomosis of nerves should be controlled within 2 weeks and the effect of end-to-side anastomosis of nerves will gradually become unsatisfactory. FK506 plays a role in promoting functional rehabilitation following nerve end-to-side anastomosis (Tab. 7, Fig. 4, Ref. 31).

  15. Effects of topical corticosteroid and tacrolimus on ceramides and irritancy to sodium lauryl sulphate in healthy skin

    DEFF Research Database (Denmark)

    Jungersted, Jakob Mutanu; Høgh, Julie Kaae; Hellegren, Lars I

    2011-01-01

    twice daily for one week with betamethasone, tacrolimus, emollient, or left untreated, respectively. After one week each area was challenged with a 24 h sodium lauryl sulphate patch test. The lipids were collected using the cyanoacrylate method and evaluated by high performance thin layer chromatography......The skin barrier, located in the stratum corneum, is influenced mainly by the lipid and protein composition of this layer. In eczematous diseases impairment of the skin barrier is thought to be of prime importance. Topical anti-inflammatory drugs and emollients are the most widely used eczema...

  16. Determination of parameter Vs30 using FK and SPAC techniques in the Bahia de Cadiz (South of Espana)

    International Nuclear Information System (INIS)

    Schmidt Diaz, Victor

    2012-01-01

    A measurement campaign of ambient vibrations was carried out in April 2008 in the Bahia de Cadiz (southern of Espana). The H / V techniques and array of sensors placed in series have been applied in order to classify soils according to the Vs30 parameter in six nearby towns: Cadiz, Chiclana, Rota, Puerto Real, San Fernando and El Puerto de Santa Maria. The H/V technique has confirmed that in the towns of Cadiz, Chiclana and El Puerto de Santa Maria, the medium is heterogeneous and with horizontal layering which allows to observe the dispersion phenomena. The soil profile in Puerto Real has been horizontal but homogeneous and in Rota and San Fernando have been significant changes in a short distance, according to the differences observed in the H / V obtained in two sites 50 m apart, therefore the profile is without be horizontal. The array technique in series has showed clear definition of dispersion curve and well defined soil profile (models with less error) in Cadiz, Chiclana and El puerto de Santa Maria but the results are inconclusive for Rota and San Fernando, due to unclear dispersion curves obtained. In general, the soil types that predominate in the area can be classified as B and C according to Eurocode 8, based on the values of Vs30 obtained using FK and SPAC techniques. (author) [es

  17. Developmental pathways from child maltreatment to adolescent marijuana dependence: Examining moderation by FK506 binding protein 5 gene (FKBP5).

    Science.gov (United States)

    Handley, Elizabeth D; Rogosch, Fred A; Cicchetti, Dante

    2015-11-01

    The current study examined the prospective association between child maltreatment and the development of substance use disorder in adolescence with the aim of investigating pathways underlying this relation, as well as genetic moderation of these developmental mechanisms. Specifically, we tested whether youth who experienced maltreatment prior to age 8 were at risk for the development of marijuana dependence in adolescence by way of a childhood externalizing pathway and a childhood internalizing pathway. Moreover, we tested whether variation in FK506 binding protein 5 gene (FKBP5) CATT haplotype moderated these pathways. The participants were 326 children (n =179 maltreated; n = 147 nonmaltreated) assessed across two waves of data collection (childhood: ages 7-9 and adolescence: ages 15-18). Results indicated that higher levels of child externalizing symptoms significantly mediated the effect of child maltreatment on adolescent marijuana dependence symptoms for individuals with one or two copies of the FKBP5 CATT haplotype only. We did not find support for an internalizing pathway from child maltreatment to adolescent marijuana dependence, nor did we find evidence of moderation of the internalizing pathway by FKBP5 haplotype variation. Findings extend previous research by demonstrating that whether a maltreated child will traverse an externalizing pathway toward substance use disorder in adolescence is dependent on FKBP5 genetic variation.

  18. Tomato FK506 Binding Protein 12KD (FKBP12 mediates the interaction between rapamycin and Target of Rapamycin (TOR

    Directory of Open Access Journals (Sweden)

    Fangjie Xiong

    2016-11-01

    Full Text Available Target of Rapamycin (TOR signaling is an important regulator in multiple organisms including yeast, plants and animals. However, the TOR signaling in plants is much less understood as compared to that in yeast and animals. TOR kinase can be efficiently suppressed by rapamycin in the presence of functional FK506 Binding Protein 12KD (FKBP12 in yeast and animals. In most examined higher plants rapamycin fails to inhibit TOR kinase due to the non-functional FKBP12. Here we find that tomato plants showed obvious growth inhibition when treated with rapamycin and the inhibitory phenotype is similar to suppression of TOR causing by active-site TOR inhibitors (asTORis such as KU63794, AZD8055 and Torin1. The chemical genetic assays using TOR inhibitors and heterologous expressing SlFKBP12 in Arabidopsis indicated that the TOR signaling is functional in tomato. The protein gel shifting and TOR inhibitors combination assays showed that SlFKBP12 can mediate the interaction between rapamycin and TOR. Furthermore, comparative expression profiling analysis between treatments with rapamycin and KU63794 identified highly overlapped Differentially Expressed Genes (DEGs which are involved in many anabolic and catabolic processes, such as photosynthesis, cell wall restructuring, and senescence in tomato. These observations suggest that SlFFBP12 is functional in tomato. The results provided basic information of TOR signaling in tomato, and also some new insights into how TOR controls plant growth and development through reprogramming the transcription profiles

  19. Tomato FK506 Binding Protein 12KD (FKBP12) Mediates the Interaction between Rapamycin and Target of Rapamycin (TOR).

    Science.gov (United States)

    Xiong, Fangjie; Dong, Pan; Liu, Mei; Xie, Gengxin; Wang, Kai; Zhuo, Fengping; Feng, Li; Yang, Lu; Li, Zhengguo; Ren, Maozhi

    2016-01-01

    Target of Rapamycin (TOR) signaling is an important regulator in multiple organisms including yeast, plants, and animals. However, the TOR signaling in plants is much less understood as compared to that in yeast and animals. TOR kinase can be efficiently suppressed by rapamycin in the presence of functional FK506 Binding Protein 12 KD (FKBP12) in yeast and animals. In most examined higher plants rapamycin fails to inhibit TOR kinase due to the non-functional FKBP12. Here we find that tomato plants showed obvious growth inhibition when treated with rapamycin and the inhibitory phenotype is similar to suppression of TOR causing by active-site TOR inhibitors (asTORis) such as KU63794, AZD8055, and Torin1. The chemical genetic assays using TOR inhibitors and heterologous expressing SlFKBP12 in Arabidopsis indicated that the TOR signaling is functional in tomato. The protein gel shifting and TOR inhibitors combination assays showed that SlFKBP12 can mediate the interaction between rapamycin and TOR. Furthermore, comparative expression profile analysis between treatments with rapamycin and KU63794 identified highly overlapped Differentially Expressed Genes (DEGs) which are involved in many anabolic and catabolic processes, such as photosynthesis, cell wall restructuring, and senescence in tomato. These observations suggest that SlFFBP12 is functional in tomato. The results provided basic information of TOR signaling in tomato, and also some new insights into how TOR controls plant growth and development through reprogramming the transcription profiles.

  20. Characteristic features of tacrolimus-induced lung disease in rheumatoid arthritis patients.

    Science.gov (United States)

    Sasaki, Takanori; Nakamura, Wataru; Inokuma, Shigeko; Matsubara, Erika

    2016-02-01

    This paper aims to study the background and clinical characteristics of tacrolimus (TAC)-induced lung disease. A case of a rheumatoid arthritis (RA) patient who developed TAC-induced interstitial lung disease (TAC-ILD) is reported. The Japanese Pharmaceuticals and Medical Devices Agency (PMDA) website was searched for cases of TAC-ILD and its prevalence among all cases of TAC-related adverse events. As for cases of TAC-ILD, its underlying disease, preexisting lung diseases, and fatal outcome were also searched. Literature review of TAC-ILD cases was added. A 65-year-old female RA patient with preexisting bronchiectasis developed near-fatal TAC-ILD. Amelioration of RA, ground-glass opacities in the upper, anterior, and central lung fields, and decrease in peripheral blood lymphocyte count were the major findings in this patient. A search of the PMDA website revealed the following: the prevalence of TAC-ILD was 3 % of all cases of TAC-related adverse events, 56 out of 85 RA cases (66 %), and one out of 15 other cases had a preexisting lung disease; the prevalences of fatal outcome in RA and other cases were 24 and 38 %, respectively. A few cases in the literature had preexisting ILD and developed diffuse alveolar damage. In our case, preexisting bronchiectasis, arthritis remission, newly developed ground-glass opacities (GGOs) in the upper, anterior, and central lung fields, and decrease in peripheral blood lymphocyte count were the major findings. From the search of the PMDA website, about one fourth of the cases with TAC-related lung injury had a fatal outcome, and among RA patients, two thirds had preexisting lung diseases.

  1. The calcineurin pathway inhibitor tacrolimus enhances the in vitro activity of azoles against Mucorales via apoptosis.

    Science.gov (United States)

    Shirazi, F; Kontoyiannis, D P

    2013-09-01

    The calcineurin pathway regulates antifungal drug resistance and the virulence of several major human-pathogenic fungi, including the recalcitrant Mucorales. We hypothesized that the fungistatic triazoles posaconazole (PCZ) and itraconazole (ICZ) become fungicidal in the setting of the calcineurin inhibitor tacrolimus (TCR) and that such an effect is mediated through apoptosis. Fungicidal activity and apoptosis were studied using standard microbiological techniques and hyphal metabolic and vital dye reduction assays at 37°C in RPMI 1640. Apoptosis was characterized by detecting intracellular Ca(2+), phosphatidylserine (PS) externalization, DNA fragmentation, plasma membrane integrity, chromatin condensation, reactive oxygen species (ROS) generation, caspase-like activity, ATP, and cytochrome c release. MICs for PCZ and ICZ alone were significantly higher (8 to 128 μg/ml) than those of PCZ or ICZ plus TCR (0.25 to 4 μg/ml) for Rhizopus oryzae, Cunninghamella bertholletiae, and Mucor circinelloides. Both PCZ and ICZ in combination with TCR became fungicidal, and their activity was mediated through increased apoptotic cell death of R. oryzae (10 to 50%), C. bertholletiae (5 to 50%), and M. circinelloides (5 to 55%) germlings, with morphological apoptotic changes characterized by externalization of PS, nuclear condensation, and DNA fragmentation. Moreover, activation of the caspase-like activity was correlated with cell death induced by TCR plus PCZ or ICZ. These changes correlated with elevated intracellular Ca(2+) and ROS levels and disturbance of mitochondrial potential. We found that PCZ or ICZ in combination with TCR renders Mucorales sensitive to triazoles via apoptotic death. These observations could serve as a new paradigm for the development of new therapeutic strategies.

  2. Differential Effects of Tacrolimus versus Sirolimus on the Proliferation, Activation and Differentiation of Human B Cells.

    Directory of Open Access Journals (Sweden)

    Opas Traitanon

    Full Text Available The direct effect of immunosuppressive drugs calcineurin inhibitor (Tacrolimus, TAC and mTOR inhibitor (Sirolimus, SRL on B cell activation, differentiation and proliferation is not well documented. Purified human B cells from healthy volunteers were stimulated through the B Cell Receptor with Anti-IgM + anti-CD40 + IL21 in the absence / presence of TAC or SRL. A variety of parameters of B cell activity including activation, differentiation, cytokine productions and proliferation were monitored by flow cytometry. SRL at clinically relevant concentrations (6 ng/ml profoundly inhibited CD19(+ B cell proliferation compared to controls whereas TAC at similar concentrations had a minimal effect. CD27(+ memory B cells were affected more by SRL than naïve CD27- B cells. SRL effectively blocked B cell differentiation into plasma cells (CD19(+CD138(+ and Blimp1(+/Pax5(low cells even at low dose (2 ng/ml, and totally eliminated them at 6 ng/ml. SRL decreased absolute B cell counts, but the residual responding cells acquired an activated phenotype (CD25(+/CD69(+ and increased the expression of HLA-DR. SRL-treated stimulated B cells on a per cell basis were able to enhance the proliferation of allogeneic CD4(+CD25(- T cells and induce a shift toward the Th1 phenotype. Thus, SRL and TAC have different effects on B lymphocytes. These data may provide insights into the clinical use of these two agents in recipients of solid organ transplants.

  3. Topical tacrolimus for the treatment of severe allergic keratoconjunctivitis in children

    Directory of Open Access Journals (Sweden)

    Vera Lucia Liendo

    Full Text Available ABSTRACT Purpose: Administration of eye drops containing antihistamines or sodium cromoglycate and its derivatives for the treatment of allergic keratoconjunctivitis is often insufficient and usually requires the addition of corticosteroids. However, the risk of complications, such as glaucoma and cataract, limits the use of corticosteroids to short courses, resulting in inadequate long-term treatment response. Immunosuppressive drugs have been considered as a valid alternative to steroids for atopic keratoconjunctivitis and vernal keratoconjunctivitis. This study aimed to evaluate the use of topical tacrolimus (TCL in improving the clinical signs of severe allergic keratoconjuctivitis in children. Methods: Patients with severe allergic keratoconjunctivitis associated with corneal epitheliopathy, gelatinous limbal infiltrates, and/or papillary reaction, along with a history of recurrences and resistance to conventional topical anti-allergy agents, were included in this open clinical trial. Patients were treated with 0.03% TCL ointment for ocular use. A severity score ranging from 0 to 9, with 9 being the highest and 0 being the lowest, was assigned based on signs observed on biomicroscopy prior to and following TCL treatment. Results: Analyses included 66 eyes of 33 patients. After a mean follow-up period of 13 months (range, 12-29 months, TCL treatment significantly decreased the mean symptom score severity for the right (from 5.56 ± 1.18 to 2.76 ± 1.5; p<0.001 and left (from 5.94 ± 1.16 to 2.86 ± 1.64; p<0.001. Conclusion: Topical TCL was effective and significantly improved the clinical signs of allergic keratoconjuctivitis in children. Thus, it is a potential new option for severe and challenging cases of ocular allergy.

  4. Electronic warfare receivers and receiving systems

    CERN Document Server

    Poisel, Richard A

    2014-01-01

    Receivers systems are considered the core of electronic warfare (EW) intercept systems. Without them, the fundamental purpose of such systems is null and void. This book considers the major elements that make up receiver systems and the receivers that go in them.This resource provides system design engineers with techniques for design and development of EW receivers for modern modulations (spread spectrum) in addition to receivers for older, common modulation formats. Each major module in these receivers is considered in detail. Design information is included as well as performance tradeoffs o

  5. CYP3A5 genotyping may reduce the cost of care and guide dosing in paediatric renal transplant recipients treated with tacrolimus: A report of two paediatric renal transplant cases

    Directory of Open Access Journals (Sweden)

    Stephen M. Roper

    2017-05-01

    Full Text Available Therapeutic tacrolimus blood levels are often difficult to achieve immediately after transplant. Pharmacogenetic testing is an option to predict the metabolism of tacrolimus; however the clinical benefits of this approach have not been extensively studied. We describe two paediatric renal transplant recipients who were initially treated with a standard dosing equation for tacrolimus, but required increased frequency of therapeutic drug monitoring and multiple dose adjustments leading to increased cost of hospitalization. A novel perspective is that pharmacogenetic testing is appropriate to reduce length of hospitalization and the total cost of care.

  6. Aerobic degradation of N-methyl-4-nitroaniline (MNA by Pseudomonas sp. strain FK357 isolated from soil.

    Directory of Open Access Journals (Sweden)

    Fazlurrahman Khan

    Full Text Available N-Methyl-4-nitroaniline (MNA is used as an additive to lower the melting temperature of energetic materials in the synthesis of insensitive explosives. Although the biotransformation of MNA under anaerobic condition has been reported, its aerobic microbial degradation has not been documented yet. A soil microcosms study showed the efficient aerobic degradation of MNA by the inhabitant soil microorganisms. An aerobic bacterium, Pseudomonas sp. strain FK357, able to utilize MNA as the sole carbon, nitrogen, and energy source, was isolated from soil microcosms. HPLC and GC-MS analysis of the samples obtained from growth and resting cell studies showed the formation of 4-nitroaniline (4-NA, 4-aminophenol (4-AP, and 1, 2, 4-benzenetriol (BT as major metabolic intermediates in the MNA degradation pathway. Enzymatic assay carried out on cell-free lysates of MNA grown cells confirmed N-demethylation reaction is the first step of MNA degradation with the formation of 4-NA and formaldehyde products. Flavin-dependent transformation of 4-NA to 4-AP in cell extracts demonstrated that the second step of MNA degradation is a monooxygenation. Furthermore, conversion of 4-AP to BT by MNA grown cells indicates the involvement of oxidative deamination (release of NH2 substituent reaction in third step of MNA degradation. Subsequent degradation of BT occurs by the action of benzenetriol 1, 2-dioxygenase as reported for the degradation of 4-nitrophenol. This is the first report on aerobic degradation of MNA by a single bacterium along with elucidation of metabolic pathway.

  7. Deficiency of FK506-binding protein (FKBP) 51 alters sleep architecture and recovery sleep responses to stress in mice.

    Science.gov (United States)

    Albu, Stefana; Romanowski, Christoph P N; Letizia Curzi, M; Jakubcakova, Vladimira; Flachskamm, Cornelia; Gassen, Nils C; Hartmann, Jakob; Schmidt, Mathias V; Schmidt, Ulrike; Rein, Theo; Holsboer, Florian; Hausch, Felix; Paez-Pereda, Marcelo; Kimura, Mayumi

    2014-04-01

    FK506-binding protein 51 (FKBP51) is a co-chaperone of the glucocorticoid receptor, functionally linked to its activity via an ultra-short negative feedback loop. Thus, FKBP51 plays an important regulatory role in the hypothalamic-pituitary-adrenocortical (HPA) axis necessary for stress adaptation and recovery. Previous investigations illustrated that HPA functionality is influenced by polymorphisms in the gene encoding FKBP51, which are associated with both increased protein levels and depressive episodes. Because FKBP51 is a key molecule in stress responses, we hypothesized that its deletion impacts sleep. To study FKBP51-involved changes in sleep, polysomnograms of FKBP51 knockout (KO) mice and wild-type (WT) littermates were compared at baseline and in the recovery phase after 6-h sleep deprivation (SD) and 1-h restraint stress (RS). Using another set of animals, the 24-h profiles of hippocampal free corticosterone levels were also determined. The most dominant effect of FKBP51 deletion appeared as increased nocturnal wake, where the bout length was significantly extended while non-rapid eye movement sleep (NREMS) and rapid eye movement sleep were rather suppressed. After both SD and RS, FKBP51KO mice exhibited less recovery or rebound sleep than WTs, although slow-wave activity during NREMS was higher in KOs, particularly after SD. Sleep compositions of KOs were nearly opposite to sleep profiles observed in human depression. This might result from lower levels of free corticosterone in FKBP51KO mice, confirming reduced HPA reactivity. The results indicate that an FKBP51 deletion yields a pro-resilience sleep phenotype. FKBP51 could therefore be a therapeutic target for stress-induced mood and sleep disorders. © 2013 European Sleep Research Society.

  8. Minimizing tacrolimus decreases the risk of new-onset diabetes mellitus after liver transplantation.

    Science.gov (United States)

    Song, Jiu-Lin; Gao, Wei; Zhong, Yan; Yan, Lu-Nan; Yang, Jia-Yin; Wen, Tian-Fu; Li, Bo; Wang, Wen-Tao; Wu, Hong; Xu, Ming-Qing; Chen, Zhe-Yu; Wei, Yong-Gang; Jiang, Li; Yang, Jian

    2016-02-14

    To investigate the impact of minimum tacrolimus (TAC) on new-onset diabetes mellitus (NODM) after liver transplantation (LT). We retrospectively analyzed the data of 973 liver transplant recipients between March 1999 and September 2014 in West China Hospital Liver Transplantation Center. Following the exclusion of ineligible recipients, 528 recipients with a TAC-dominant regimen were included in our study. We calculated and determined the mean trough concentration of TAC (cTAC) in the year of diabetes diagnosis in NODM recipients or in the last year of the follow-up in non-NODM recipients. A cutoff of mean cTAC value for predicting NODM 6 mo after LT was identified using a receptor operating characteristic curve. TAC-related complications after LT was evaluated by χ(2) test, and the overall and allograft survival was evaluated using the Kaplan-Meier method. Risk factors for NODM after LT were examined by univariate and multivariate Cox regression. Of the 528 transplant recipients, 131 (24.8%) developed NODM after 6 mo after LT, and the cumulative incidence of NODM progressively increased. The mean cTAC of NODM group recipients was significantly higher than that of recipients in the non-NODM group (7.66 ± 3.41 ng/mL vs 4.47 ± 2.22 ng/mL, P 50 years), hypertension pre-LT, and high mean cTAC (≥ 5.89 ng/mL) after 6 mo after LT were independent risk factors for developing NODM. Concurrently, recipients with a low cTAC (< 5.89 ng/mL) were less likely to become obese (21.3% vs 30.2%, P < 0.05) or to develop dyslipidemia (27.5% vs 44.8%, P <0.05), chronic kidney dysfunction (14.6% vs 22.7%, P < 0.05), and moderate to severe infection (24.7% vs 33.1%, P < 0.05) after LT than recipients in the high mean cTAC group. However, the two groups showed no significant difference in the incidence of acute and chronic rejection, hypertension, cardiovascular events and new-onset malignancy. A minimal TAC regimen can decrease the risk of long-term NODM after LT. Maintaining a c

  9. Time to reach tacrolimus maximum blood concentration,mean residence time, and acute renal allograft rejection: an open-label, prospective, pharmacokinetic study in adult recipients.

    Science.gov (United States)

    Kuypers, Dirk R J; Vanrenterghem, Yves

    2004-11-01

    The aims of this study were to determine whether disposition-related pharmacokinetic parameters such as T(max) and mean residence time (MRT) could be used as predictors of clinical efficacy of tacrolimus in renal transplant recipients, and to what extent these parameters would be influenced by clinical variables. We previously demonstrated, in a prospective pharmacokinetic study in de novo renal allograft recipients, that patients who experienced early acute rejection did not differ from patients free from rejection in terms of tacrolimus pharmacokinetic exposure parameters (dose interval AUC, preadministration trough blood concentration, C(max), dose). However, recipients with acute rejection reached mean (SD) tacrolimus T(max) significantly faster than those who were free from rejection (0.96 [0.56] hour vs 1.77 [1.06] hours; P clearance nor T(1/2) could explain this unusual finding, we used data from the previous study to calculate MRT from the concentration-time curves. As part of the previous study, 100 patients (59 male, 41 female; mean [SD] age, 51.4 [13.8] years;age range, 20-75 years) were enrolled in the study The calculated MRT was significantly shorter in recipients with acute allograft rejection (11.32 [031] hours vs 11.52 [028] hours; P = 0.02), just like T(max) was an independent risk factor for acute rejection in a multivariate logistic regression model (odds ratio, 0.092 [95% CI, 0.014-0.629]; P = 0.01). Analyzing the impact of demographic, transplantation-related, and biochemical variables on MRT, we found that increasing serum albumin and hematocrit concentrations were associated with a prolonged MRT (P calculated MRT were associated with a higher incidence of early acute graft rejection. These findings suggest that a shorter transit time of tacrolimus in certain tissue compartments, rather than failure to obtain a maximum absolute tacrolimus blood concentration, might lead to inadequate immunosuppression early after transplantation.

  10. Adherence to and Acceptance of Once-Daily Tacrolimus After Kidney and Liver Transplant: Results From OSIRIS, a French Observational Study.

    Science.gov (United States)

    Cassuto, Elisabeth; Pageaux, Georges P; Cantarovich, Diego; Rostaing, Lionel; Loupy, Alexandre; Roche, Bruno; Duvoux, Christophe; Moreau, Karine; Thervet, Eric; Mazouz, Hakim; Bourhis, Yann; Dharancy, Sébastien; Kessler, Michèle

    2016-10-01

    Adherence to immunosuppressive treatments is a major concern in transplanted patients. This 6-month French observational, longitudinal, prospective study aimed to assess patient adherence to and acceptance of once-daily tacrolimus (Advagraf) initiation in kidney and liver transplant recipients. Data from 1106 patients initiating once-daily tacrolimus during posttransplant follow-up were analyzed. Adherence and acceptance were assessed using self-administered questionnaires at inclusion and at 3 and 6 months. Mean age was 52.4 ± 13.2 years, 61.5% were men. For 94.9% of patients, once-daily tacrolimus was prescribed after switching from twice-daily tacrolimus. At inclusion, 20.9% of patients reported good treatment adherence, 72.0% minor nonadherence, and 7.1% were nonadherent. Mean general acceptance score (range, 0-100) was 77.7 (±24.7). At 3 months, adherence was improved in 21.1%, unchanged in 69.2%, and worsened in 9.7% of patients. Mean general acceptance score was 75.4 (±26.5). General acceptance score was improved in 28.0%, unchanged in 39.4%, and worsened in 32.7% of patients. At 6 months, similar changes in adherence and acceptance were observed. Higher general acceptance score at month 3 was significantly associated with better adherence at month 6. Conversion to once-daily tacrolimus led to an improved rate of adherence at month 3 in more than 20% of patients and a worsened rate of adherence in less than 10% of patients.

  11. Improvement of FK506 Production in Streptomyces tsukubaensis by Genetic Enhancement of the Supply of Unusual Polyketide Extender Units via Utilization of Two Distinct Site-Specific Recombination Systems

    Science.gov (United States)

    Chen, Dandan; Zhang, Qi; Zhang, Qinglin; Cen, Peilin

    2012-01-01

    FK506 is a potent immunosuppressant that has a wide range of clinical applications. Its 23-member macrocyclic scaffold, mainly with a polyketide origin, features two methoxy groups at C-13 and C-15 and one allyl side chain at C-21, due to the region-specific incorporation of two unusual extender units derived from methoxymalonyl-acyl carrier protein (ACP) and allylmalonyl-coenzyme A (CoA), respectively. Whether their intracellular formations can be a bottleneck for FK506 production remains elusive. In this study, we report the improvement of FK506 yield in the producing strain Streptomyces tsukubaensis by the duplication of two sets of pathway-specific genes individually encoding the biosyntheses of these two extender units, thereby providing a promising approach to generate high-FK506-producing strains via genetic manipulation. Taking advantage of the fact that S. tsukubaensis is amenable to two actinophage (ΦC31 and VWB) integrase-mediated recombination systems, we genetically enhanced the biosyntheses of methoxymalonyl-ACP and allylmalonyl-CoA, as indicated by transcriptional analysis. Together with the optimization of glucose supplementation, the maximal FK506 titer eventually increased by approximately 150% in comparison with that of the original strain. The strategy of engineering the biosynthesis of unusual extender units described here may be applicable to improving the production of other polyketide or nonribosomal peptide natural products that contain pathway-specific building blocks. PMID:22582065

  12. Receiver Test Selection Criteria

    Science.gov (United States)

    2015-03-12

    The DOT requests that GPS manufacturers submit receivers for test in the following TWG categories: - Aviation (non-certified), cellular, general location/navigation, high precision, timing, networks, and space-based receivers - Each receiver should b...

  13. Efficacy and safety of early tacrolimus conversion to sirolimus after kidney transplantation: Long-term results of a prospective randomized study

    Directory of Open Access Journals (Sweden)

    A E El-Agroudy

    2017-01-01

    Full Text Available We report a prospective, open-label, randomized study to evaluate the safety and efficacy of converting patients with a stable renal function from tacrolimus (Tac-based regimen to a sirolimus (SRL-based regimen after kidney transplantation. Fifty-eight low-risk renal allograft recipients who receiving Tac 6 months posttransplant, were randomly assigned to continue Tac (n = 29 or convert to SRL (n = 29. We evaluated the 3-year outcomes including patient and graft survival, graft function, and safety profile. Three-year patient and graft survival in SRL and Tac groups were 93.1% versus 100% (P = 0.32, and 89.7% versus 100% (P = 0.11, respectively. However, the SRL group had a significantly better renal function, from the 2nd year posttransplant until the last follow-up. Four (13.8% patients in the SRL group and 3 (10.3% in the Tac group (P = 0.5 developed biopsy-proven acute rejection. Mean urinary protein excretion increased significantly after SRL conversion. Diastolic blood pressure was significantly lower at the end of the study in patients who eliminated Tac (80.4 vs. 75.6 mmHg in Tac and SRL group, respectively (P = 0.03. Mean hemoglobin concentrations decreased after SRL conversion and remained significantly lower from 12 months to 36 months (P = 0.01. The mean serum cholesterol (540 ± 44 mg/dl and triglyceride (177 ± 27 mg/dl increased significantly in the SRL group, compared to Tac group (487 ± 62 mg/dl (P = 0.03 and (141 ± 26 mg/dl (P = 0.04. Our experience demonstrates that conversion to SRL from calcineurin inhibitors-based therapy may result in better renal function and blood pressure control in renal transplant recipients without an increased risk of acute rejection. However, these benefits have not resulted in a growing advantage in graft or patient survival.

  14. Clinical research of FK506 therapeutic window concentration in renal transplant recipients%肾移植受者应用他克莫司治疗窗浓度的探讨

    Institute of Scientific and Technical Information of China (English)

    王立明; 闵志廉; 朱有华; 高春芳; 陆慧琦; 周梅生; 姚亚成

    2000-01-01

    目的 寻求适合国人肾移植受者他克莫司(FK506)理想治疗窗浓度范围.方法 应用微粒子酶免疫分析法测定58例肾移植患者口服FK506后12 h的血药谷浓度,并观察排斥反应的发生及药物的肾毒性.结果 FK506的血药浓度,术后1个月为(13.0±2.1)μg/L,2~3个月为(9.4±1.6)μg/L,3个月以后为(6.5±1.3)μg/L,比较各时期全血FK506谷浓度,差异均有极显著性(P<0.01);术后发生急性排斥反应3例次,肾毒性4例次.结论 FK506具有良好的免疫抑制效果,其治疗窗浓度范围,术后第1个月为11~15μg/L,第2~3个月为8~11μg/L;第3个月后为5~8μg/L,此浓度范围既能达到满意的免疫抑制效果,又能减少FK506的肾毒性.%Objective In order to search for the proper therapeutic window concentration of FK506 in Chinese renal transplant recipients.Methods The FK506 trough level 12 h after oral administration in 58 renal transplantation patients was assayed by means of MEIA.The occurrence of rejection and the drug toxicity were observed.Results The blood FK506 trough level was(13.0±2.1)μg/L within the first month,(9.4±1.6)μg/L within second to third months,and(6.5±1.3)μg/L from the third month after transplantation with the difference among the different intervals being very significant(P<0.01).There were 3 case-times of acute rejection and 4 case-times of renal toxicity.Conclusions The whole blood FK506 trough level was 11~15μg/L within the first month,8~11μg/L within the second and third month,5~8μg/L from the fourth month after transplantation.This range of therapeutic window concentration of FK506 trough levels was ideal for Chinese renal transplant recipients with less acute rejection and toxicity effects on kidney.

  15. Tacrolimus Updated Guidelines through popPK Modeling: How to Benefit More from CYP3A Pre-emptive Genotyping Prior to Kidney Transplantation

    Directory of Open Access Journals (Sweden)

    Jean-Baptiste Woillard

    2017-06-01

    Full Text Available Tacrolimus (Tac is a profoundly effective immunosuppressant that reduces the risk of rejection after solid organ transplantation. However, its use is hampered by its narrow therapeutic window along with its highly variable pharmacological (pharmacokinetic [PK] and pharmacodynamic [PD] profile. Part of this variability is explained by genetic polymorphisms affecting the metabolic pathway. The integration of CYP3A4 and CY3A5 genotype in tacrolimus population-based PK (PopPK modeling approaches has been proven to accurately predict the dose requirement to reach the therapeutic window. The objective of the present study was to develop an accurate PopPK model in a cohort of 59 kidney transplant patients to deliver this information to clinicians in a clear and actionable manner. We conducted a non-parametric non-linear effects PopPK modeling analysis in Pmetrics®. Patients were genotyped for the CYP3A4∗22 and CYP3A5∗3 alleles and were classified into 3 different categories [poor-metabolizers (PM, Intermediate-metabolizers (IM or extensive-metabolizers (EM]. A one-compartment model with double gamma absorption route described very accurately the tacrolimus PK. In covariate analysis, only CYP3A genotype was retained in the final model (Δ-2LL = -73. Our model estimated that tacrolimus concentrations were 33% IC95%[20–26%], 41% IC95%[36–45%] lower in CYP3A IM and EM when compared to PM, respectively. Virtually, we proved that defining different starting doses for PM, IM and EM would be beneficial by ensuring better probability of target concentrations attainment allowing us to define new dosage recommendations according to patient CYP3A genetic profile.

  16. A simple and highly sensitive on-line column extraction liquid chromatography-tandem mass spectrometry method for the determination of protein-unbound tacrolimus in human plasma samples.

    Science.gov (United States)

    Bittersohl, Heike; Schniedewind, Björn; Christians, Uwe; Luppa, Peter B

    2018-04-27

    Therapeutic drug monitoring (TDM) of the immunosuppressive drug tacrolimus is essential to avoid side effects and rejection of the allograft after transplantation. In the blood circulation, tacrolimus is largely located inside erythrocytes or bound to plasma proteins and less than 0.1% is protein-unbound (free). One basic principle of clinical pharmacology is that only free drug is pharmacologically active and monitoring this portion has the potential to better reflect the drug effect than conventional measurements of total tacrolimus in whole blood. To address this, a highly sensitive and straightforward on-line liquid chromatography-tandem mass spectrometry (LC-MS/MS) method was developed, validated and applied to patient plasma samples. The sample preparation included ultracentrifugation and addition of the stable isotope labeled drug analogue D2,13C-tacrolimus, followed by on-line sample extraction and measurement using a Sciex QTRAP ® 6500 in the multiple reaction monitoring mode. Due to very low concentrations of protein-unbound tacrolimus, it was important to develop a highly sensitive, precise and accurate assay. Here, we first report the efficient formation of tacrolimus lithium adduct ions, which greatly increased assay sensitivity. A lower limit of quantification (LLOQ) of 1 pg/mL (10 fg on column) was achieved and the assay was linear between 1 and 200 pg/mL. There was no carry-over detected. The inaccuracy ranged from -9.8 to 7.4% and the greatest imprecision was 7.5%. The matrix factor was found to be smaller than 1.1%. In summary, this method represents a suitable tool to investigate the potential clinical value of free tacrolimus monitoring in organ transplant recipients. Copyright © 2018 Elsevier B.V. All rights reserved.

  17. A flexible WLAN receiver

    NARCIS (Netherlands)

    Schiphorst, Roelof; Hoeksema, F.W.; Slump, Cornelis H.

    2003-01-01

    Flexible radio receivers are also called Software Defined Radios (SDRs) [1], [2]. The focus of our SDR project [3] is on designing the front end, from antenna to demodulation in bits, of a °exible, multi-standard WLAN receiver. We try to combine an instance of a (G)FSK receiver (Bluetooth) with an

  18. Gene Expression ‏‏‏‏Profiles of BAD and Bcl-xL in the CA1 Region of the Hippocampus Following Global Ischemic/Reperfusion and FK-506 Administration.

    Science.gov (United States)

    Badr, Ramak; Hashemi, Mehrdad; Javadi, Gholamreza; Movafagh, Abolfazl; Mahdian, Reza

    2015-12-01

    The hippocampus is a tiny nub in the mammalian brain that is involved in forming, organizing, and storing memories. Global cerebral ischemia (GCI) and reperfusion induced apoptosis lead to cell injury and death. FK-506 is a strong immunosuppressant drug that has neuroprotective effects on the hypoxic-ischemic effects of brain damage. BAD and Bcl-xL are pro-apoptotic and anti-apoptotic genes, respectively. These genes belong to The B-cell lymphoma-2 (Bcl-2) family. In this study, we assessed the neurotrophic properties of FK-506 on expression of the BAD and Bcl-xL genes in the hippocampus following global ischemia and reperfusion. In the present experimental study, adult male Wistar rats were obtained and housed under standard conditions in the Tehran University of Medical Science in Iran. Rats were equally distributed in groups of three among the following groups: normal control, treated-1 (ischemia/reperfusion), and treated-2 (ischemia/reperfusion followed by FK-506). Global ischemia was induced for animals in the treated-1 and treated-2 groups. In treated-2, two doses of FK-506 were injected: one dose as an IV injection immediately after reperfusion and another as an intra-peritoneal (IP) injection after 48 hours. Then, the hippocampus tissue was removed after anaesthetizing the rats. RNA was isolated, cDNA was synthesized, and real-time PCR was performed. Finally, the obtained data were analyzed statistically (P value ˂ 0.05). The quantitative results of real-time PCR show that the mRNA expression ratio of Bcl-xL down-regulated was 0.75 ± 0.06 in the ischemia/reperfusion group versus 1.57 ± 0.09 in the control group (P value BAD up-regulated in the ischemia/reperfusion + FK506 group was 3.65 ± 0.49 compared to Normal control (1.39 ± 0.09) and Ischemia/reperfusion + FK506 was 1.09 ± 0.20 (P value BAD /Bcl-xL) confirmed that expression of the pro-apoptotic gene significantly decreased (P value ˂ 0.001) under the ischemia/reperfusion condition. In contrast

  19. Highly Sensitive Optical Receivers

    CERN Document Server

    Schneider, Kerstin

    2006-01-01

    Highly Sensitive Optical Receivers primarily treats the circuit design of optical receivers with external photodiodes. Continuous-mode and burst-mode receivers are compared. The monograph first summarizes the basics of III/V photodetectors, transistor and noise models, bit-error rate, sensitivity and analog circuit design, thus enabling readers to understand the circuits described in the main part of the book. In order to cover the topic comprehensively, detailed descriptions of receivers for optical data communication in general and, in particular, optical burst-mode receivers in deep-sub-µm CMOS are presented. Numerous detailed and elaborate illustrations facilitate better understanding.

  20. Imp2, the PSTPIP homolog in fission yeast, affects sensitivity to the immunosuppressant FK506 and membrane trafficking in fission yeast

    International Nuclear Information System (INIS)

    Kita, Ayako; Higa, Mari; Doi, Akira; Satoh, Ryosuke; Sugiura, Reiko

    2015-01-01

    Cytokinesis is a highly ordered process that divides one cell into two cells, which is functionally linked to the dynamic remodeling of the plasma membrane coordinately with various events such as membrane trafficking. Calcineurin is a highly conserved serine/threonine protein phosphatase, which regulates multiple biological functions, such as membrane trafficking and cytokinesis. Here, we isolated imp2-c3, a mutant allele of the imp2 + gene, encoding a homolog of the mouse PSTPIP1 (proline-serine-threonine phosphatase interacting protein 1), using a genetic screen for mutations that are synthetically lethal with calcineurin deletion in fission yeast. The imp2-c3 mutants showed a defect in cytokinesis with multi-septated phenotypes, which was further enhanced upon treatment with the calcineurin inhibitor FK506. Notably, electron micrographs revealed that the imp2-c3 mutant cells accumulated aberrant multi-lamella Golgi structures and putative post-Golgi secretory vesicles, and exhibited fragmented vacuoles in addition to thickened septa. Consistently, imp2-c3 mutants showed a reduced secretion of acid phosphatase and defects in vacuole fusion. The imp2-c3 mutant cells exhibited a weakened cell wall, similar to the membrane trafficking mutants identified in the same genetic screen such as ypt3-i5. These findings implicate the PSTPIP1 homolog Imp2 in Golgi/vacuole function, thereby affecting various cellular processes, including cytokinesis and cell integrity. - Highlights: • We isolated imp2-c3, in a synthetic lethal screen with calcineurin in fission yeast. • The imp2 + gene encodes a component of the actin contractile ring similar to Cdc15. • The imp2-c3 mutants showed defects in cytokinesis, which were exacerbated by FK506. • The imp2-c3 mutants were defective in membrane trafficking and cell wall integrity. • Our study revealed a novel role for Imp2 in the Golgi/vacuolar membrane trafficking

  1. Imp2, the PSTPIP homolog in fission yeast, affects sensitivity to the immunosuppressant FK506 and membrane trafficking in fission yeast

    Energy Technology Data Exchange (ETDEWEB)

    Kita, Ayako; Higa, Mari [Laboratory of Molecular Pharmacogenomics, School of Pharmaceutical Sciences, Kinki University, 3-4-1 Kowakae, Higashi-Osaka 577-8502 (Japan); Doi, Akira [Laboratory of Molecular Pharmacogenomics, School of Pharmaceutical Sciences, Kinki University, 3-4-1 Kowakae, Higashi-Osaka 577-8502 (Japan); Japan Society for the Promotion of Science, 1-8 Chiyoda-ku, Tokyo 102-8472 (Japan); Satoh, Ryosuke [Laboratory of Molecular Pharmacogenomics, School of Pharmaceutical Sciences, Kinki University, 3-4-1 Kowakae, Higashi-Osaka 577-8502 (Japan); Sugiura, Reiko, E-mail: sugiurar@phar.kindai.ac.jp [Laboratory of Molecular Pharmacogenomics, School of Pharmaceutical Sciences, Kinki University, 3-4-1 Kowakae, Higashi-Osaka 577-8502 (Japan)

    2015-02-13

    Cytokinesis is a highly ordered process that divides one cell into two cells, which is functionally linked to the dynamic remodeling of the plasma membrane coordinately with various events such as membrane trafficking. Calcineurin is a highly conserved serine/threonine protein phosphatase, which regulates multiple biological functions, such as membrane trafficking and cytokinesis. Here, we isolated imp2-c3, a mutant allele of the imp2{sup +} gene, encoding a homolog of the mouse PSTPIP1 (proline-serine-threonine phosphatase interacting protein 1), using a genetic screen for mutations that are synthetically lethal with calcineurin deletion in fission yeast. The imp2-c3 mutants showed a defect in cytokinesis with multi-septated phenotypes, which was further enhanced upon treatment with the calcineurin inhibitor FK506. Notably, electron micrographs revealed that the imp2-c3 mutant cells accumulated aberrant multi-lamella Golgi structures and putative post-Golgi secretory vesicles, and exhibited fragmented vacuoles in addition to thickened septa. Consistently, imp2-c3 mutants showed a reduced secretion of acid phosphatase and defects in vacuole fusion. The imp2-c3 mutant cells exhibited a weakened cell wall, similar to the membrane trafficking mutants identified in the same genetic screen such as ypt3-i5. These findings implicate the PSTPIP1 homolog Imp2 in Golgi/vacuole function, thereby affecting various cellular processes, including cytokinesis and cell integrity. - Highlights: • We isolated imp2-c3, in a synthetic lethal screen with calcineurin in fission yeast. • The imp2{sup +} gene encodes a component of the actin contractile ring similar to Cdc15. • The imp2-c3 mutants showed defects in cytokinesis, which were exacerbated by FK506. • The imp2-c3 mutants were defective in membrane trafficking and cell wall integrity. • Our study revealed a novel role for Imp2 in the Golgi/vacuolar membrane trafficking.

  2. Comparative Effectiveness of Tacrolimus-Based Steroid Sparing versus Steroid Maintenance Regimens in Kidney Transplantation: Results from Discrete Event Simulation.

    Science.gov (United States)

    Desai, Vibha C A; Ferrand, Yann; Cavanaugh, Teresa M; Kelton, Christina M L; Caro, J Jaime; Goebel, Jens; Heaton, Pamela C

    2017-10-01

    Corticosteroids used as immunosuppressants to prevent acute rejection (AR) and graft loss (GL) following kidney transplantation are associated with serious cardiovascular and other adverse events. Evidence from short-term randomized controlled trials suggests that many patients on a tacrolimus-based immunosuppressant regimen can withdraw from steroids without increased AR or GL risk. To measure the long-term tradeoff between GL and adverse events for a heterogeneous-risk population and determine the optimal timing of steroid withdrawal. A discrete event simulation was developed including, as events, AR, GL, myocardial infarction (MI), stroke, cytomegalovirus, and new onset diabetes mellitus (NODM), among others. Data from the United States Renal Data System were used to estimate event-specific parametric regressions, which accounted for steroid-sparing regimen (avoidance, early 7-d withdrawal, 6-mo withdrawal, 12-mo withdrawal, and maintenance) as well as patients' demographics, immunologic risks, and comorbidities. Regression-equation results were used to derive individual time-to-event Weibull distributions, used, in turn, to simulate the course of patients over 20 y. Patients on steroid avoidance or an early-withdrawal regimen were more likely to experience AR (45.9% to 55.0% v. 33.6%, P events and other outcomes with no worsening of AR or GL rates compared with steroid maintenance.

  3. Nephro and neurotoxicity of calcineurin inhibitors and mechanisms of rejections: A review on tacrolimus and cyclosporin in organ transplantation.

    Science.gov (United States)

    Tolou-Ghamari, Zahra

    2012-04-01

    In the meadow of medical sciences substituting a diseased organ with a healthy one from another individual, dead or alive, to allow a human to stay alive could be consider as the most string event. In this article we review the history of transplantation, mechanisms of rejection, nephro-neurotoxicity of tacrolimus and cyclosporin in organ transplantations. Directory of Open Access Journals (DOAJ), Google Scholar, Pubmed (NLM), LISTA (EBSCO) and Web of Science have been searched. The first reference to the concept of organ transplantation and replacement for therapeutic purposes appears to be to Hua-To (136 to 208 A.D), who replaced diseased organs with healthy ones in patients under analgesia induced with a mixture of Indian hemp. In 1936, the first human renal transplant performed by Voronoy in Russia. The first liver transplant in humans was performed on March 1, 1963 by Starzl in Denver, USA. Medawar was the first to assert that rejection was an immunological response, with the inflammatory reaction due to lymphocyte infiltration. Consequently, rational immunosuppressive therapies could inhibit deleterious T-cell responses in an antigen specific manner. Searching related to the history of organ transplantation from mythic to modern times suggests that, to prevent graft rejection, minimize nephro and neuro toxicity monitoring of immunosupressive concentrations could provide an invaluable and essential aid in adjusting dosage to ensure adequate immunosuppression.

  4. High Intrapatient Variability of Tacrolimus Exposure in the Early Period After Liver Transplantation Is Associated With Poorer Outcomes.

    Science.gov (United States)

    Rayar, Michel; Tron, Camille; Jézéquel, Caroline; Beaurepaire, Jean Marie; Petitcollin, Antoine; Houssel-Debry, Pauline; Camus, Christophe; Verdier, Marie Clémence; Dehlawi, Ammar; Lakéhal, Mohamed; Desfourneaux, Véronique; Meunier, Bernard; Sulpice, Laurent; Bellissant, Eric; Boudjema, Karim; Lemaitre, Florian

    2018-03-01

    Tacrolimus (TAC) is the cornerstone of immunosuppressive regimen in liver transplantation (LT). Its pharmacokinetics is characterized by a high interpatient and intrapatient variability (IPV) leading to an unpredictable dose-response relationship. The aim of our study was to evaluate the impact of TAC IPV (IPV) on graft and patient outcomes after LT. We retrospectively analyzed 812 LT recipients treated with TAC. The IPV of TAC concentrations was estimated by calculating the coefficient of variation (CV) of whole blood trough concentrations. Patients were categorized in 2 groups: low IPV (CV < 40%) and high IPV (CV ≥ 40%). There were significantly more neurologic complications (31.2% vs 16.6%, P < 0.001), cardiovascular complications (19.7% vs 9.7%, P < 0.001), and acute renal failure requiring dialysis (8.5% vs 2.2%, P < 0.001) in the high CV group than in the low CV group. Moreover, graft survival was significantly poorer in the high CV group (hazard ratio, 1.42; 95% confidence interval, 1.04-1.95; P = 0.03). A pretransplantation elevated Model for End-Stage Liver Disease score (P < 0.001) and Child-Pugh grade (P < 0.001) were identified as risk factors for presenting a high CV. A high CV of TAC concentrations was found to be predictive of TAC-related toxicity and poorer survival.

  5. Best single time point correlations with AUC for cyclosporine and tacrolimus in HIV-infected kidney and liver transplant recipients.

    Science.gov (United States)

    Frassetto, Lynda A; Tan-Tam, Clara C; Barin, Burc; Browne, Matt; Wolfe, Alan R; Stock, Peter G; Roland, Michelle; Benet, Leslie Z

    2014-03-27

    Interactions between antiretrovirals (ARVs) and transplant immunosuppressant agents (IS) among HIV-infected transplant recipients may lead to lack of efficacy or toxicity. In transplant recipients not infected with HIV, tacrolimus (TAC) trough levels (C0) or cyclosporine (CsA) drawn at C0 or 2 hours after dosing (C2) correlate with drug exposure (area under the curve [AUC]/dose) and outcomes. Because of ARV-IS interactions in HIV-infected individuals, and the high rate of rejection in these subjects, this study investigated the correlations between IS concentrations and exposure to determine the best method to monitor immunosuppressant levels. This study prospectively studied 50 HIV-infected transplant recipients undergoing kidney or liver transplantation evaluating the pharmacokinetics of the IS in 150 studies over time after transplantation (weeks 2 to 4, 12, 28, 52, and 104). IS levels were measured with liquid chromatography-tandem mass spectrometry and AUC calculated using WinNonlin 9.0. Correlation analyses were run on SAS 9.2. CsA concentration at C4 correlated better with AUC than C0 or C2, and over time TAC concentration correlated better at C0 or C2. It is suggested that C0 is acceptable for TAC monitoring, but poor predictability will occur at C0 with CsA. The low correlation of C0 with CsA AUC could be responsible for the higher rejection rates on CsA that has been reported in these subjects.

  6. Simultaneous Determination of Cyclosporine A, Tacrolimus, Sirolimus, and Everolimus in Whole-Blood Samples by LC-MS/MS

    Directory of Open Access Journals (Sweden)

    Mustafa Karapirli

    2012-01-01

    Full Text Available Objectives. Cyclosporine A (CyA, tacrolimus (TRL, sirolimus (SIR, and everolimus (RAD are immunosuppressive drugs frequently used in organ transplantation. Our aim was to confirm a robust sensitive and selective liquid chromatography-tandem mass spectrometry (LC-MS/MS method for determination of CyA, TRL, SIR, and RAD in whole-blood samples. Materials and Methods. We used an integrated online solid-phase extraction-LC-MS/MS system and atmospheric pressure ionization tandem mass spectrometry (API-MS/MS in the multiple reaction monitoring (MRM detection mode. CyA, TRL, SIR, and RAD were simultaneously analyzed in whole blood treated with precipitation reagent taken from transplant patients. Results. System performance parameters were suitable for using this method as a high-throughput technique in clinical practice. The high concentration of one analyte in the sample did not affect the concentration of other analytes. Total analytical time was 2.5 min, and retention times of all analytes were shorter than 2 minutes. Conclusion. This LC-MS/MS method can be preferable for therapeutic drug monitoring of these immunosuppressive drugs (CyA, TRL, SRL, and RAD in whole blood. Sample preparation was too short and simple in this method, and it permits robust, rapid, sensitive, selective, and simultaneous determination of these drugs.

  7. Delphi Accounts Receivable Module -

    Data.gov (United States)

    Department of Transportation — Delphi accounts receivable module contains the following data elements, but are not limited to customer information, cash receipts, line of accounting details, bill...

  8. Solar energy receiver

    Science.gov (United States)

    Schwartz, Jacob

    1978-01-01

    An improved long-life design for solar energy receivers provides for greatly reduced thermally induced stress and permits the utilization of less expensive heat exchanger materials while maintaining receiver efficiencies in excess of 85% without undue expenditure of energy to circulate the working fluid. In one embodiment, the flow index for the receiver is first set as close as practical to a value such that the Graetz number yields the optimal heat transfer coefficient per unit of pumping energy, in this case, 6. The convective index for the receiver is then set as closely as practical to two times the flow index so as to obtain optimal efficiency per unit mass of material.

  9. Cryogenic microwave channelized receiver

    International Nuclear Information System (INIS)

    Rauscher, C.; Pond, J.M.; Tait, G.B.

    1996-01-01

    The channelized receiver being presented demonstrates the use of high temperature superconductor technology in a microwave system setting where superconductor, microwave-monolithic-integrated-circuit, and hybrid-integrated-circuit components are united in one package and cooled to liquid-nitrogen temperatures. The receiver consists of a superconducting X-band four-channel demultiplexer with 100-MHz-wide channels, four commercial monolithically integrated mixers, and four custom-designed hybrid-circuit detectors containing heterostructure ramp diodes. The composite receiver unit has been integrated into the payload of the second-phase NRL high temperature superconductor space experiment (HTSSE-II). Prior to payload assembly, the response characteristics of the receiver were measured as functions of frequency, temperature, and drive levels. The article describes the circuitry, discusses the key issues related to design and implementation, and summarizes the experimental results

  10. Alexandrite Lidar Receiver

    National Research Council Canada - National Science Library

    Wilkerson, Thomas

    2000-01-01

    ...". The chosen vendor, Orca Photonics, In. (Redmond, WA), in close collaboration with USU personnel, built a portable, computerized lidar system that not only is suitable as a receiver for a near IR alexandrite laser, but also contains an independent Nd...

  11. Immunosuppression Adherence in Stable Kidney Transplant Patients Converted From Immediate- to Prolonged-Release Tacrolimus in Clinical Practice: A Norwegian Study.

    Science.gov (United States)

    Abedini, Sadollah; Gøransson, Lasse; Cockburn, Elinor; Kilany, Suzanne; Holdaas, Hallvard

    2018-02-01

    This study investigated medication adherence in kidney transplant patients (KTPs) converted from immediate-release tacrolimus (IR-T) to prolonged-release tacrolimus (PR-T)-based immunosuppression in routine practice. Noninterventional, observational, multicenter study in Norway. Included adult KTPs with stable graft function, converted from IR-T (baseline) to PR-T (1 mg:1 mg) in routine practice. Data were collected at baseline, and months 1, 3, 6, and 12 postconversion. Primary endpoint: adherence using the Basel Assessment of Adherence to Immunosuppressive Medication Scale. Secondary assessments: tacrolimus dose and trough levels (target, 3-7 ng/mL), clinical laboratory parameters (eg, estimated glomerular filtration rate [Modified Diet in Renal Disease]), and adverse events. Ninety-one KTPs (mean ± SD age 47.7 ± 14.3 years) were analyzed. Mean ± SD change in PR-T dose from baseline (4.4 ± 2.4 mg/d) to month 12 was -0.1 ± 0.9 mg/d; mean tacrolimus trough levels remained within target. Overall medication adherence increased from 45.6% at baseline to 58.1% at month 1, but was similar to baseline thereafter; taking and timing adherence followed a similar pattern. Odds ratio (OR) for adherence at month 1 (but not at other time points) was greater versus baseline for overall (OR, 1.71; P = 0.0205), taking (OR, 3.38; P = 0.0004), and timing (OR, 1.77, P = 0.0252) dimensions. Mean ± SD Basel Assessment of Adherence to Immunosuppressive Medication Scale visual analogue scale score at baseline was 96.4 ± 5.5%, and increased postconversion. Estimated glomerular filtration rate remained stable (month 12, 61.6 ± 17.7 mL/min per 1.73 m 2 ), as did other laboratory parameters. Two (2.2%) patients had adverse events considered probably/possibly treatment-related. There was disparity between high, patient-perceived and low, actual adherence. Converting stable KTPs from IR-T to PR-T in routine practice did not impact long-term adherence to immunosuppression; renal

  12. A comparison of the extended-release and standard-release formulations of tacrolimus in de novo kidney transplant recipients: a 12-month outcome study.

    Science.gov (United States)

    Fanous, Helen; Zheng, Rebecca; Campbell, Carolyn; Huang, Michael; Nash, Michelle M; Rapi, Lindita; Zaltzman, Jeffrey S; Prasad, G V Ramesh

    2013-02-01

    BACKGROUND: Limited comparative data are available on the outcomes between extended-release and standard-release tacrolimus when used de novo in kidney transplant recipients (KTRs). METHODS: We identified KTRs transplanted at our institution during 2009-10 routinely prescribed extended-release tacrolimus and compared them with those transplanted during 2008-09 prescribed standard-release tacrolimus. Graft function (eGFR by MDRD-7 equation) at 12 months post-transplant (primary outcome); new-onset diabetes and other cardiovascular risk factors, BK viremia incidence, acute rejection, and graft survival to 12 months (secondary outcomes) were compared by intent-to-treat analysis. Time-to-steady-state concentration and number of dose adjustments required to attain steady state were recorded. RESULTS: There were no important demographic differences between the extended-release (N = 106) and standard-release (N = 95) cohorts. The estimated glomerular filtration rate (eGFR) at 12 months was similar (58.8 ± 17 versus 59.2 ± 18 mL/min/1.73 m(2), P = 0.307). There was no difference in new-onset diabetes (17 versus 20%, P = 0.581), BK viremia (10 versus 7%, P = 0.450), acute rejection (7 versus 16%, P = 0.067) or graft survival (97 versus 95%, P = 0.301). Time-to-steady state was similar (9.2 ± 1.1 versus 8.1 ± 4.7 days, P = 0.490) although extended-release patients required fewer adjustments to attain steady state (1.2 ± 1.7 [0-8] versus 1.7 ± 1.5 [0-7], P = 0.030) but a similar dose (7.2 ± 2.4 [2-17] versus 7 ± 2.7 [2-16] mg/day, P = 0.697). CONCLUSION: De novo KTRs prescribed extended-release or standard-release tacrolimus demonstrate similar 12-month outcomes.

  13. High-performance liquid chromatography-tandem mass spectrometry as a reference for analysis of tacrolimus to assess two immunoassays in patients with liver and renal transplants.

    Science.gov (United States)

    Salm, P; Taylor, P J; Clark, A; Balderson, G A; Grygotis, A; Norris, R L; Lynch, S V; Shaw, L M; Pond, S M

    1997-12-01

    The accuracy and imprecision of three assays used for therapeutic monitoring of tacrolimus were tested using blood-containing weighed-in amounts of the drug, an enzyme-linked immunosorbent assay (ELISA), a microparticle enzyme immunoassay (MEIA I), and a high-performance liquid chromatography-tandem mass spectrometry (HPLC-MS2) assay. Accuracy was acceptable for the HPLC-MS2 assay at all concentrations tested (ELISA at 1.0 and 4.0 microg/l. Accuracy was not acceptable for the ELISA at 15.0 and 50.0 microg/l or for the MEIA I at all concentrations tested. Imprecision was acceptable for the HPLC-MS2 assay at all concentrations tested (coefficient of variation ELISA at 15.0 and 50.0 microg/l, and for the MEIA I at 15.0 and 50.0 microg/l. Imprecision was not acceptable for the ELISA at 1.0 and 4.0 microg/l or for the MEIA I at 1.0 and 4.0 microg/l. This assessment with weighed-in amounts of tacrolimus verified the HPLC-MS2 assay as a reference method. The performance of the two immunoassays with HPLC-MS2 was then compared in the clinical setting using blood from patients with liver (n = 30) and renal (n = 37) transplants. In the liver transplant group (127 samples), the range of tacrolimus concentrations measured by HPLC-MS2, ELISA, and MEIA I was 1.9 to 31.8, 2.1 to 35.0, and less than 0.1 to 36.5 mg/l, respectively. In the renal transplant group (129 samples), the ranges were 1.7 to 26.1, 1.9 to 24.4, and 0.9 to 28.5 microg/l, respectively. Compared with the HPLC-MS2, the ELISA had minimal bias (0.1 to 0.2 microg/l) but unacceptable variability in values (SD > 13%). The MEIA I had unacceptable bias (1.7-1.8 microg/l) and variability (SD > 23%). These data indicated that neither the ELISA nor MEIA I is interchangeable with HPLC-MS2. Moreover, in view of the current trend to reduce the therapeutic dose of tacrolimus, quantitative results using the MEIA I would not be obtainable during therapeutic drug monitoring in some patients in whom effective therapeutic

  14. Receiver Gain Modulation Circuit

    Science.gov (United States)

    Jones, Hollis; Racette, Paul; Walker, David; Gu, Dazhen

    2011-01-01

    A receiver gain modulation circuit (RGMC) was developed that modulates the power gain of the output of a radiometer receiver with a test signal. As the radiometer receiver switches between calibration noise references, the test signal is mixed with the calibrated noise and thus produces an ensemble set of measurements from which ensemble statistical analysis can be used to extract statistical information about the test signal. The RGMC is an enabling technology of the ensemble detector. As a key component for achieving ensemble detection and analysis, the RGMC has broad aeronautical and space applications. The RGMC can be used to test and develop new calibration algorithms, for example, to detect gain anomalies, and/or correct for slow drifts that affect climate-quality measurements over an accelerated time scale. A generalized approach to analyzing radiometer system designs yields a mathematical treatment of noise reference measurements in calibration algorithms. By treating the measurements from the different noise references as ensemble samples of the receiver state, i.e. receiver gain, a quantitative description of the non-stationary properties of the underlying receiver fluctuations can be derived. Excellent agreement has been obtained between model calculations and radiometric measurements. The mathematical formulation is equivalent to modulating the gain of a stable receiver with an externally generated signal and is the basis for ensemble detection and analysis (EDA). The concept of generating ensemble data sets using an ensemble detector is similar to the ensemble data sets generated as part of ensemble empirical mode decomposition (EEMD) with exception of a key distinguishing factor. EEMD adds noise to the signal under study whereas EDA mixes the signal with calibrated noise. It is mixing with calibrated noise that permits the measurement of temporal-functional variability of uncertainty in the underlying process. The RGMC permits the evaluation of EDA by

  15. Clinical Validation of Simultaneous Analysis of Tacrolimus, Cyclosporine A, and Creatinine in Dried Blood Spots in Kidney Transplant Patients.

    Science.gov (United States)

    Veenhof, Herman; Koster, Remco A; Alffenaar, Jan-Willem C; Berger, Stefan P; Bakker, Stephan J L; Touw, Daan J

    2017-07-01

    Monitoring of creatinine and immunosuppressive drug concentrations, such as tacrolimus (TaC) and cyclosporin A (CsA), is important in the outpatient follow-up of kidney transplant recipients. Monitoring by dried blood spot (DBS) provides patients the opportunity to sample a drop of blood from a fingerprick at home, which can be sent to the laboratory by mail. We performed a clinical validation in which we compared measurements from whole-blood samples obtained by venapuncture with measurements from DBS samples simultaneously obtained by fingerprick. After exclusion of 10 DBS for poor quality, and 2 for other reasons, 199, 104, and 58 samples from a total of 172 patients were available for validation of creatinine, TaC and CsA, respectively. Validation was performed by means of Passing & Bablok regression, and bias was assessed by Bland-Altman analysis. For creatinine, we found y = 0.73x - 1.55 (95% confidence interval [95% CI] slope, 0.71-0.76), giving the conversion formula: (creatinine plasma concentration in μmol/L) = (creatinine concentration in DBS in μmol/L)/0.73, with a nonclinically relevant bias of -2.1 μmol/L (95% CI, -3.7 to -0.5 μmol/L). For TaC, we found y = 1.00x - 0.23 (95% CI slope, 0.91-1.08), with a nonclinically relevant bias of -0.28 μg/L (95% CI, -0.45 to -0.12 μg/L). For CsA, we found y = 0.99x - 1.86 (95% CI slope, 0.91-1.08) and no significant bias. Therefore, for neither TaC nor CsA, a conversion formula is required. DBS sampling for the simultaneous analysis of immunosuppressants and creatinine can replace conventional venous sampling in daily routine.

  16. The ORION study: comparison of two sirolimus-based regimens versus tacrolimus and mycophenolate mofetil in renal allograft recipients.

    Science.gov (United States)

    Flechner, S M; Glyda, M; Cockfield, S; Grinyó, J; Legendre, Ch; Russ, G; Steinberg, S; Wissing, K M; Tai, S S

    2011-08-01

    Safety and efficacy of two sirolimus (SRL)-based regimens were compared with tacrolimus (TAC) and mycophenolate mofetil (MMF). Renal transplantation recipients were randomized to Group 1 (SRL+TAC; week 13 TAC elimination [n = 152]), Group 2 (SRL + MMF [n = 152]) or Group 3 (TAC + MMF [n = 139]). Group 2, with higher-than-expected biopsy-confirmed acute rejections (BCARs), was sponsor-terminated; therefore, Group 2 two-year data were limited. At 1 and 2 years, respectively, graft (Group 1: 92.8%, 88.5%; Group 2: 90.6%, 89.9%; Group 3: 96.2%, 95.4%) and patient (Group 1: 97.3%, 94.4%; Group 2: 95.2%, 94.5%; Group 3: 97.0%, 97.0%) survival rates were similar. One- and 2-year BCAR incidence was: Group 1, 15.2%, 17.4%; Group 2, 31.3%, 32.8%; Group 3, 8.2%, 12.3% (Group 2 vs. 3, p < 0.001). Mean 1- and 2-year modified intent-to-treat glomerular filtration rates (mL/min) were similar. Primary reason for discontinuation was adverse events (Group 1, 34.2%; Group 2, 33.6%; Group 3, 22.3%; p < 0.05). In Groups 1 and 2, delayed wound healing and hyperlipidemia were more frequent. One-year post hoc analysis of new-onset diabetes posttransplantation was greater in TAC recipients (Groups 1 and 3 vs. 2, 17% vs. 6%; p = 0.004). Between-group malignancy rates were similar. The SRL-based regimens were not associated with improved outcomes for kidney transplantation patients. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

  17. 'Chaos' in superregenerative receivers

    International Nuclear Information System (INIS)

    Commercon, Jean-Claude; Badard, Robert

    2005-01-01

    The superregenerative principle has been known since the early 1920s. The circuit is extremely simple and extremely sensitive. Today, superheterodyne receivers generally supplant superregenerative receivers in most applications because there are several undesirable characteristics: poor selectivity, reradiation, etc. Superregenerative receivers undergo a revival in recent papers for wireless systems, where low cost and very low power consumption are relevant: house/building meters (such as water, energy, gas counter), personal computer environment (keyboard, mouse), etc. Another drawback is the noise level which is higher than that of a well-designed superheterodyne receiver; without an antenna input signal, the output of the receiver hears in an earphone as a waterfall noise; this sound principally is the inherent input noise amplified and detected by the circuit; however, when the input noise is negligible with respect of an antenna input signal, we are faced to an other source of 'noise' self-generated by the superregenerative working. The main objective of this paper concerns this self-generated noise coming from an exponential growing followed by a re-injection process for which the final state is a function of the phase of the input signal

  18. Recombinant Protein Truncation Strategy for Inducing Bactericidal Antibodies to the Macrophage Infectivity Potentiator Protein of Neisseria meningitidis and Circumventing Potential Cross-Reactivity with Human FK506-Binding Proteins

    OpenAIRE

    Bielecka, Magdalena K.; Devos, Nathalie; Gilbert, Mélanie; Hung, Miao-Chiu; Weynants, Vincent; Heckels, John E.; Christodoulides, Myron

    2014-01-01

    A recombinant macrophage infectivity potentiator (rMIP) protein of Neisseria meningitidis induces significant serum bactericidal antibody production in mice and is a candidate meningococcal vaccine antigen. However, bioinformatics analysis of MIP showed some amino acid sequence similarity to human FK506-binding proteins (FKBPs) in residues 166 to 252 located in the globular domain of the protein. To circumvent the potential concern over generating antibodies that could recognize human protein...

  19. Solar thermal central receivers

    International Nuclear Information System (INIS)

    Vant-Hull, L.L.

    1993-01-01

    Market issues, environmental impact, and technology issues related to the Solar Central Receiver concept are addressed. The rationale for selection of the preferred configuration and working fluid are presented as the result of a joint utility-industry analysis. A $30 million conversion of Solar One to an external molten salt receiver would provide the intermediate step to a commercial demonstration plant. The first plant in this series could produce electricity at 11.2 cents/kWhr and the seventh at 8.2 cents/kWhr, completely competitive with projected costs of new utility plants in 1992

  20. Wideband CMOS receivers

    CERN Document Server

    Oliveira, Luis

    2015-01-01

    This book demonstrates how to design a wideband receiver operating in current mode, in which the noise and non-linearity are reduced, implemented in a low cost single chip, using standard CMOS technology.  The authors present a solution to remove the transimpedance amplifier (TIA) block and connect directly the mixer’s output to a passive second-order continuous-time Σ∆ analog to digital converter (ADC), which operates in current-mode. These techniques enable the reduction of area, power consumption, and cost in modern CMOS receivers.

  1. Receiver gain function: the actual NMR receiver gain

    OpenAIRE

    Mo, Huaping; Harwood, John S.; Raftery, Daniel

    2010-01-01

    The observed NMR signal size depends on the receiver gain parameter. We propose a receiver gain function to characterize how much the raw FID is amplified by the receiver as a function of the receiver gain setting. Although the receiver is linear for a fixed gain setting, the actual gain of the receiver may differ from what the gain setting suggests. Nevertheless, for a given receiver, we demonstrate that the receiver gain function can be calibrated. Such a calibration enables accurate compar...

  2. F.K. Trailin’s “Kazachy Vestnik” on the protection of old Cossacks living principles: to the typological features of the conservative Cossacks’ newspapers

    Directory of Open Access Journals (Sweden)

    Abramovich Tatyana Sergeevna

    2015-12-01

    Full Text Available At the end of the 19th century the issue of Cossacks’ self-identification divided into two camps already exfoliated class. Liberal-minded Cossacks fought for the destruction of the “great Chinese wall” between the Don and the rest of Russia, the Cossacks, the Conservatives tried to preserve their distinctive way of life. This opposition is directly reflected in the Don journalism. On the example of F.K. Trailin’s “Kazachy Vestnik” the article describes typological features of Cossack-oriented newspapers of the period, and the relevant date for the publication of Cossack associations. It is justified the conclusion that the typological features of Cossack Conservatives newspaper were caused by combining some typological features borrowed from existing at the time of publications in the Don journalism. So, from a universal privately owned newspaper Cossack-oriented one adopted a broad program that determined the broad area of information attention, as well as many typological attributes: genre, format, frequency, design, volume. From specialized journals it was taken narrowly defined thematic focus, from national - the use of the national language - dialect, which are actively used in materials by authors Cossacks. However, a leading typology characterizing factor for the newspaper of the Cossack conservatives - publisher-Cossack-specialist - was new for the system of Don periodicals, since the creation of its organ was guided only by the principles dictated by the class origin to the Cossack class.

  3. Campus Projects Receiving "Earmarks."

    Science.gov (United States)

    Schonberger, Benjamin

    1991-01-01

    Specific campus projects that Congress has directed federal agencies to support this year at over 120 colleges and universities are listed. The agencies neither requested support nor sponsored merit-based competitions for the awards. In some cases, the institutions have a history of receiving special federal treatment. (MSE)

  4. Digital Receiver Phase Meter

    Science.gov (United States)

    Marcin, Martin; Abramovici, Alexander

    2008-01-01

    The software of a commercially available digital radio receiver has been modified to make the receiver function as a two-channel low-noise phase meter. This phase meter is a prototype in the continuing development of a phase meter for a system in which radiofrequency (RF) signals in the two channels would be outputs of a spaceborne heterodyne laser interferometer for detecting gravitational waves. The frequencies of the signals could include a common Doppler-shift component of as much as 15 MHz. The phase meter is required to measure the relative phases of the signals in the two channels at a sampling rate of 10 Hz at a root power spectral density measurements in laser metrology of moving bodies. To illustrate part of the principle of operation of the phase meter, the figure includes a simplified block diagram of a basic singlechannel digital receiver. The input RF signal is first fed to the input terminal of an analog-to-digital converter (ADC). To prevent aliasing errors in the ADC, the sampling rate must be at least twice the input signal frequency. The sampling rate of the ADC is governed by a sampling clock, which also drives a digital local oscillator (DLO), which is a direct digital frequency synthesizer. The DLO produces samples of sine and cosine signals at a programmed tuning frequency. The sine and cosine samples are mixed with (that is, multiplied by) the samples from the ADC, then low-pass filtered to obtain in-phase (I) and quadrature (Q) signal components. A digital signal processor (DSP) computes the ratio between the Q and I components, computes the phase of the RF signal (relative to that of the DLO signal) as the arctangent of this ratio, and then averages successive such phase values over a time interval specified by the user.

  5. Mycophenolic acid AUC in Thai kidney transplant recipients receiving low dose mycophenolate and its association with UGT2B7 polymorphisms.

    Science.gov (United States)

    Pithukpakorn, Manop; Tiwawanwong, Tiwat; Lalerd, Yupaporn; Assawamakin, Anunchai; Premasathian, Nalinee; Tasanarong, Adis; Thongnoppakhun, Wanna; Vongwiwatana, Attapong

    2014-01-01

    Despite use of a lower mycophenolate dose in Thai kidney transplant patients, acceptable graft and patient outcomes can be achieved. We therefore examined the pharmacokinetics of mycophenolic acid (MPA) by area under the curve (AUC) and investigated genetic contribution in mycophenolate metabolism in this population. Kidney transplant recipients with stable graft function who were receiving mycophenolate mofetil 1,000 mg/d in combination with either cyclosporine or tacrolimus, and prednisolone were studied. The MPA concentration was measured by fluorescence polarization immunoassay (FPIA), at predose and 1, 1.5, 2, 4, 6, 8, 10, and 12 hours after dosing. Genetic polymorphisms in UGT1A8, UGT1A9, and UGT2B7 were examined by denaturing high-performance liquid chromatography (DHPLC)-based single-base extension (SBE) analysis. A total 138 patients were included in study. The mean AUC was 39.49 mg-h/L (28.39-89.58 mg-h/L), which was in the therapeutic range. The correlation between the predose MPA concentration and AUC was poor. The mean AUC in the tacrolimus group was higher than that in the cyclosporine group. Polymorphisms in UGT2B7 showed significant association with AUC. Most of our patients with reduced mycophenolate dose had the AUC within the therapeutic range. Genetic polymorphisms in UGT2B7 may play a role in MPA metabolism in Thai kidney transplant patients.

  6. Brain-derived neurotrophic factor/FK506-binding protein 5 genotype by childhood trauma interactions do not impact on hippocampal volume and cognitive performance.

    Directory of Open Access Journals (Sweden)

    Dennis Hernaus

    Full Text Available In the development of psychotic symptoms, environmental and genetic factors may both play a role. The reported association between childhood trauma and psychotic symptoms could therefore be moderated by single nucleotide polymorphisms (SNPs associated with the stress response, such as FK506-binding protein 5 (FKBP5 and brain-derived neurotrophic factor (BDNF. Recent studies investigating childhood trauma by SNP interactions have inconsistently found the hippocampus to be a potential target underlying these interactions. Therefore, more detailed modelling of these effects, using appropriate covariates, is required. We examined whether BDNF/FKBP5 and childhood trauma interactions affected two proxies of hippocampal integrity: (i hippocampal volume and (ii cognitive performance on a block design (BD and delayed auditory verbal task (AVLT. We also investigated whether the putative interaction was different for patients with a psychotic disorder (n = 89 compared to their non-psychotic siblings (n = 95, in order to elicit possible group-specific protective/vulnerability effects. SNPs were rs9296158, rs4713916, rs992105, rs3800373 (FKBP5 and rs6265 (BDNF. In the combined sample, no BDNF/FKBP5 by childhood trauma interactions were apparent for either outcome, and BDNF/FKBP5 by childhood trauma interactions were not different for patients and siblings. The omission of drug use and alcohol consumption sometimes yielded false positives, greatly affected explained error and influenced p-values. The consistent absence of any significant BDNF/FKBP5 by childhood trauma interactions on assessments of hippocampal integrity suggests that the effect of these interactions on psychotic symptoms is not mediated by hippocampal integrity. The importance of appropriate statistical designs and inclusion of relevant covariates should be carefully considered.

  7. FK506 Binding Protein Mediates Glioma Cell Growth and Sensitivity to Rapamycin Treatment by Regulating NF-κB Signaling Pathway

    Directory of Open Access Journals (Sweden)

    Wei Jiang

    2008-03-01

    Full Text Available FK506 binding protein 5 (FKBP5 belongs to a family of immunophilins named for their ability to bind immunosuppressive drugs, also known as peptidyl-prolyl cis-trans isomerases, and also with chaperones to help protein folding. Using glioma cDNA microarray analysis, we found that FKBP5 was overexpressed in glioma tumors. This finding was further validated by real-time reverse transcription-polymerase chain reaction and Western blot analysis. The roles of FKBP5 in glioma cells were then examined. We found that cell growth was suppressed after FKBP5 expression was inhibited by short interfering RNA transfection and enhanced by FKBP5 overexpression. Electrophoretic mobility shift assay showed that nuclear factor-kappa B (NF-κB and DNA binding was enhanced by FKBP5 overexpression. The expression level of I-kappa B alpha and phosphorylated NF-κB was regulated by the expression of FKBP5. These data suggest that FKBP5 is involved in NF-κB pathway activation in glioma cells. In addition, FKBP5 overexpression in rapamycin-sensitive U87 cells blocked the cells' response to rapamycin treatment, whereas rapamycin-resistant glioma cells, both PTEN-positive and -negative, were synergistically sensitive to rapamycin after FKBP5 was knocked down, suggesting that the FKBP5 regulates glioma cell response to rapamycin treatment. In conclusion, our study demonstrates that FKBP5 plays an important role in glioma growth and chemoresistance through regulating signal transduction of the NF-κB pathway.

  8. Pressure difference receiving ears

    DEFF Research Database (Denmark)

    Michelsen, Axel; Larsen, Ole Næsbye

    2007-01-01

    Directional sound receivers are useful for locating sound sources, and they can also partly compensate for the signal degradations caused by noise and reverberations. Ears may become inherently directional if sound can reach both surfaces of the eardrum. Attempts to understand the physics...... of the eardrum. The mere existence of sound transmission to the inner surface does not ensure a useful directional hearing, since a proper amplitude and phase relationship must exist between the sounds acting on the two surfaces of the eardrum. The gain of the sound pathway must match the amplitude and phase...... of the sounds at the outer surfaces of the eardrums, which are determined by diffraction and by the arrival time of the sound, that is by the size and shape of the animal and by the frequency of sound. Many users of hearing aids do not obtain a satisfactory improvement of their ability to localize sound sources...

  9. Solar thermal energy receiver

    Science.gov (United States)

    Baker, Karl W. (Inventor); Dustin, Miles O. (Inventor)

    1992-01-01

    A plurality of heat pipes in a shell receive concentrated solar energy and transfer the energy to a heat activated system. To provide for even distribution of the energy despite uneven impingement of solar energy on the heat pipes, absence of solar energy at times, or failure of one or more of the heat pipes, energy storage means are disposed on the heat pipes which extend through a heat pipe thermal coupling means into the heat activated device. To enhance energy transfer to the heat activated device, the heat pipe coupling cavity means may be provided with extensions into the device. For use with a Stirling engine having passages for working gas, heat transfer members may be positioned to contact the gas and the heat pipes. The shell may be divided into sections by transverse walls. To prevent cavity working fluid from collecting in the extensions, a porous body is positioned in the cavity.

  10. Analytical performance evaluation of the Elecsys® Cyclosporine and Elecsys® Tacrolimus assays on the cobas e411 analyzer

    Directory of Open Access Journals (Sweden)

    Maki Sasano

    2017-08-01

    Full Text Available Background: Cyclosporine (CsA and tacrolimus (TAC are immunosuppressant drugs that are often used to treat autoimmune diseases and as transplantation therapy; therefore, their concentrations need to be monitored carefully. We herein evaluated the analytical performance of the Elecsys® Cyclosporine and Elecsys® Tacrolimus assay kits, which have been newly developed to measure CsA and TAC concentrations in the whole blood. Methods: We used residual whole blood samples from autoimmune disease and transplantation patients who were being treated with CsA or TAC. CsA concentrations were measured using an affinity chrome-mediated immunoassay (ACMIA and an electrochemiluminescence immunoassay (ECLIA. TAC concentrations were measured using a chemiluminescence immunoassay (CLIA and ECLIA. We investigated assay precision, linearity, lower limit of quantitation (LOQ, stability of calibration, influence of interference substances and the hematocrit, correlation of ACMIA with ECLIA, and correlation of CLIA with ECLIA. Results: Within-assay coefficients of variation were 1.8−3.6% (CsA: 94−1238 ng/mL and 2.9−3.9% (TAC: 2.1−17.8 ng/mL, whereas day-to-day coefficients of variation ranged between 3.0−4.1% (CsA and 2.8−3.9% (TAC. The limits of quantitation were defined as the concentration at which the CV was approximately 10%. Each lower LOQ obtained was 16 ng/mL (CsA, and 0.95 ng/mL (TAC. CsA and TAC calibrations were stable for at least 21 days. Neither the presence of conjugated bilirubin, unconjugated bilirubin, chyle, and rheumatoid factor nor the hematocrit affected these assays. A method comparison using a standardized major axis regression analysis of ACMIA and ECLIA was r=0.995, y=0.924x −1.175, n=200 (CsA, while that of CLIA and ECLIA was r=0.994, y=1.080x −0.197, n=200 (TAC. Conclusions: The analytical performances of the Elecsys® Cyclosporine and Elecsys®Tacrolimus assays were acceptable

  11. CERN apprentice receives award

    CERN Multimedia

    2008-01-01

    Another CERN apprentice has received an award for the quality of his work. Stéphane Küng (centre), at the UIG ceremony last November, presided over by Geneva State Councillor Pierre-François Unger, Head of the Department of Economics and Health. Electronics technician Stéphane Küng was honoured in November by the Social Foundation of the Union Industrielle Genevoise (UIG) as one of Geneva’s eight best apprentices in the field of mechatronics. The 20-year-old Genevan obtained his Federal apprentice’s certificate (Certificat fédéral de capacité - CFC) in June 2007, achieving excellent marks in his written tests at the Centre d’Enseignement Professionnel Technique et Artisanal (CEPTA). Like more than 200 youngsters before him, Stéphane Küng spent part of his four-year sandwich course working at CERN, where he followed many practical training courses and gained valuable hands-on experience in various technical groups and labs. "It’ always very gr...

  12. GNSS Software Receiver for UAVs

    DEFF Research Database (Denmark)

    Olesen, Daniel Madelung; Jakobsen, Jakob; von Benzon, Hans-Henrik

    2016-01-01

    This paper describes the current activities of GPS/GNSS Software receiver development at DTU Space. GNSS Software receivers have received a great deal of attention in the last two decades and numerous implementations have already been presented. DTU Space has just recently started development of ...... of our own GNSS software-receiver targeted for mini UAV applications, and we will in in this paper present our current progress and briefly discuss the benefits of Software Receivers in relation to our research interests....

  13. A cohort study on the risk of lymphoma and skin cancer in users of topical tacrolimus, pimecrolimus, and corticosteroids (Joint European Longitudinal Lymphoma and Skin Cancer Evaluation – JOELLE study

    Directory of Open Access Journals (Sweden)

    Castellsague J

    2018-03-01

    Full Text Available Jordi Castellsague,1 Josephina G Kuiper,2 Anton Pottegård,3 Ingegärd Anveden Berglind,4 Daniel Dedman,5 Lia Gutierrez,1 Brian Calingaert,6 Myrthe PP van Herk-Sukel,2 Jesper Hallas,3 Anders Sundström,4 Arlene M Gallagher,5 James A Kaye,7 Carolina Pardo,8 Kenneth J Rothman,7 Susana Perez-Gutthann1 1Department of Epidemiology, RTI Health Solutions, Barcelona, Spain; 2Department Research, PHARMO Institute for Drug Outcomes Research, Utrecht, the Netherlands; 3Clinical Pharmacology and Pharmacy, Department of Public Health, University of Southern Denmark, Odense, Denmark; 4Centre for Pharmacoepidemiology, Unit of Clinical Epidemiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden; 5Clinical Practice Research Datalink, Medicines and Healthcare products Regulatory Agency, London, UK; 6Department Epidemiology, RTI Health Solutions, Research Triangle Park, NC, 7Department of Epidemiology, RTI Health Solutions, Waltham, MA, USA; 8Pharmacovigilance Department, Astellas Pharma Europe B.V., Leiden, the Netherlands Background: There is a concern that topical tacrolimus and pimecrolimus, indicated for second-line treatment of atopic dermatitis, may increase the risk of lymphoma and skin cancer, particularly in children.Objective: The aim of this study was to compare incidence rates (IRs of lymphoma and skin cancer between new users of topical tacrolimus or pimecrolimus and users of moderate- to high-potency topical corticosteroids (TCSs and untreated subjects.Methods: This is a multicenter cohort study with frequency matching by strata of propensity scores in population databases in the Netherlands, Denmark, Sweden, and the UK. IR ratios (IRRs were estimated using Mantel–Haenszel methods for stratified analysis.Results: We included 19,948 children and 66,127 adults initiating tacrolimus, 23,840 children and 37,417 adults initiating pimecrolimus, 584,121 users of TCSs, and 257,074 untreated subjects. IRs of lymphoma per 100,000 person

  14. Solar advanced internal film receiver

    International Nuclear Information System (INIS)

    Torre Cabezas, M. de la

    1990-01-01

    In a Solar Central Internal Film Receiver, the heat absorbing fluid (a molten nitrate salt) flows in a thin film down over the non illuminated side of an absorber panel. Since the molten salt working fluid is not contained in complicated tube manifolds, the receiver design is simples than a conventional tube type-receiver resulting in a lower cost and a more reliable receiver. The Internal Film Receiver can be considered as an alternative to the Direct Absorption Receiver, in the event that the current problems of the last one can not be solved. It also describes here the test facility which will be used for its solar test, and the test plans foreseen. (Author) 17 refs

  15. Communications receivers principles and design

    CERN Document Server

    Rohde, Ulrich L; Zahnd, Hans

    2017-01-01

    This thoroughly updated guide offers comprehensive explanations of the science behind today’s radio receivers along with practical guidance on designing, constructing, and maintaining real-world communications systems. You will explore system planning, antennas and antenna coupling, amplifiers and gain control, filters, mixers, demodulation, digital communication, and the latest software defined radio (SDR) technology. Written by a team of telecommunication experts, Communications Receivers: Principles and Design, Fourth Edition, features technical illustrations, schematic diagrams, and detailed examples. Coverage includes: • Basic radio considerations • Radio receiver characteristics • Receiver system planning • Receiver implementation considerations • RF and baseband techniques for Software-Defined Radios • Transceiver SDR considerations • Antennas and antenna coupling • Mixers • Frequency sources and control • Ancillary receiver circuits • Performance measurement

  16. Higher tacrolimus trough levels on days 2-5 post-renal transplant are associated with reduced rates of acute rejection.

    LENUS (Irish Health Repository)

    O'Seaghdha, C M

    2011-04-06

    We analyzed the association between whole-blood trough tacrolimus (TAC) levels in the first days post-kidney transplant and acute cellular rejection (ACR) rates. Four hundred and sixty-four consecutive, deceased-donor kidney transplant recipients were included. All were treated with a combination of TAC, mycophenolate mofetil and prednisolone. Patients were analyzed in four groups based on quartiles of the mean TAC on days 2 and 5 post-transplant: Group 1: median TAC 11 ng\\/mL (n = 122, range 2-13.5 ng\\/mL), Group 2: median 17 ng\\/mL (n = 123, range 14-20 ng\\/mL), Group 3: median 24 ng\\/mL (n = 108, range 20.5-27 ng\\/mL) and Group 4: median 33.5 ng\\/mL (n = 116, range 27.5-77.5 ng\\/mL). A graded reduction in the rates of ACR was observed for each incremental days 2-5 TAC. The one-yr ACR rate was 24.03% (95% CI 17.26-32.88), 22.20% (95% CI 15.78-30.70), 13.41% (95% CI 8.15-21.63) and 8.69% (95% CI 4.77-15.55) for Groups 1-4, respectively (p = 0.003). This study suggests that higher early TACs are associated with reduced rates of ACR at one yr.

  17. Thymoglobulin induction in liver transplant recipients with a tacrolimus, mycophenolate mofetil, and steroid immunosuppressive regimen: a five-year randomized prospective study.

    Science.gov (United States)

    Boillot, Olivier; Seket, Belhassen; Dumortier, Jérôme; Pittau, Gabriella; Boucaud, Catherine; Bouffard, Yves; Scoazec, Jean-Yves

    2009-11-01

    This randomized, comparative study assessed the long-term efficacy and tolerability of thymoglobulin (TMG) induction in 93 liver transplant patients with an initial regimen of tacrolimus (Tac), mycophenolate mofetil (MMF), and steroids. Forty-four patients were randomly allocated to the TMG+ group, and 49 patients were randomly allocated to the TMG- group. In both groups, Tac was given orally at the initial daily dose of 0.075 mg/kg twice daily, and MMF was given at the initial daily dose of 2 g/day. Steroid withdrawal was planned at 3 months after liver transplantation. The results were evaluated with respect to acute rejection incidence, patient and graft survival, graft function, and medical complications until 5 years or death for all patients. No significant differences were found between groups for the incidence of acute rejection at 5 years (11.4% versus 14.3%), 5-year patient survival (77.3% versus 87.8%), graft function, or postoperative renal function. One patient in the TMG- group underwent retransplantation. There was no difference between groups with respect to the incidence of medical complications, excepted for a higher rate of leukopenia in the TMG+ group, during the 5-year follow-up. In conclusion, the results of this prospective randomized study suggest that the addition of TMG to a triple immunosuppressive regimen (Tac, MMF, and steroids) did not modify the incidence of acute rejection episodes or long-term survival and was responsible for increased leukopenia rates.

  18. Early Conversion from Tacrolimus to Belatacept in a Highly Sensitized Renal Allograft Recipient with Calcineurin Inhibitor-Induced de novo Post-Transplant Hemolytic Uremic Syndrome

    Directory of Open Access Journals (Sweden)

    Vasishta S. Tatapudi

    2018-01-01

    Full Text Available Background: Kidney transplantation is the first-line therapy for patients with end-stage renal disease since it offers greater long-term survival and improved quality of life when compared to dialysis. The advent of calcineurin inhibitor (CNI-based maintenance immunosuppression has led to a clinically significant decline in the rate of acute rejection and better short-term graft survival rates. However, these gains have not translated into improvement in long-term graft survival. CNI-related nephrotoxicity and metabolic side effects are thought to be partly responsible for this. Case Presentation: Here, we report the conversion of a highly sensitized renal transplant recipient with pretransplant donor-specific antibodies from tacrolimus to belatacept within 1 week of transplantation. This substitution was necessitated by the diagnosis of CNI-induced de novo post-transplant hemolytic uremic syndrome. Conclusion: Belatacept is a novel costimulation blocker that is devoid of the nephrotoxic properties of CNIs and has been shown to positively impact long-term graft survival and preserve renal allograft function in low-immunologic-risk kidney transplant recipients. Data regarding its use in patients who are broadly sensitized to human leukocyte antigens are scarce, and the increased risk of rejection associated with belatacept has been a deterrent to more widespread use of this immunosuppressive agent. This case serves as an example of a highly sensitized patient that has been successfully converted to a belatacept-based CNI-free regimen.

  19. Stability of heterodyne terahertz receivers

    NARCIS (Netherlands)

    Kooi, J.W.; Baselmans, J.J.A.; Baryshev, A.; Schieder, R.; Hajenius, M.; Gao, J.R.; Klapwijk, T.M.; Voronov, B.; Gol'tsman, G.

    2006-01-01

    In this paper we discuss the stability of heterodyne terahertz receivers based on small volume NbN phonon cooled hot electron bolometers (HEBs). The stability of these receivers can be broken down in two parts: the intrinsic stability of the HEB mixer and the stability of the local oscillator (LO)

  20. High Gain Advanced GPS Receiver

    National Research Council Canada - National Science Library

    Brown, Alison; Zhang, Gengsheng

    2006-01-01

    NAVSYS High Gain Advanced GPS Receiver (HAGR) uses a digital beam-steering antenna array to enable up to eight GPS satellites to be tracked, each with up to 10 dBi of additional antenna gain over a conventional receiver solution...

  1. UWB delay and multiply receiver

    Energy Technology Data Exchange (ETDEWEB)

    Dallum, Gregory E.; Pratt, Garth C.; Haugen, Peter C.; Romero, Carlos E.

    2013-09-10

    An ultra-wideband (UWB) delay and multiply receiver is formed of a receive antenna; a variable gain attenuator connected to the receive antenna; a signal splitter connected to the variable gain attenuator; a multiplier having one input connected to an undelayed signal from the signal splitter and another input connected to a delayed signal from the signal splitter, the delay between the splitter signals being equal to the spacing between pulses from a transmitter whose pulses are being received by the receive antenna; a peak detection circuit connected to the output of the multiplier and connected to the variable gain attenuator to control the variable gain attenuator to maintain a constant amplitude output from the multiplier; and a digital output circuit connected to the output of the multiplier.

  2. Customizable Digital Receivers for Radar

    Science.gov (United States)

    Moller, Delwyn; Heavey, Brandon; Sadowy, Gregory

    2008-01-01

    Compact, highly customizable digital receivers are being developed for the system described in 'Radar Interferometer for Topographic Mapping of Glaciers and Ice Sheets' (NPO-43962), NASA Tech Briefs, Vol. 31, No. 7 (August 2007), page 72. The receivers are required to operate in unison, sampling radar returns received by the antenna elements in a digital beam-forming (DBF) mode. The design of these receivers could also be adapted to commercial radar systems. At the time of reporting the information for this article, there were no commercially available digital receivers capable of satisfying all of the operational requirements and compact enough to be mounted directly on the antenna elements. A provided figure depicts the overall system of which the digital receivers are parts. Each digital receiver includes an analog-to-digital converter (ADC), a demultiplexer (DMUX), and a field-programmable gate array (FPGA). The ADC effects 10-bit band-pass sampling of input signals having frequencies up to 3.5 GHz. The input samples are demultiplexed at a user-selectable rate of 1:2 or 1:4, then buffered in part of the FPGA that functions as a first-in/first-out (FIFO) memory. Another part of the FPGA serves as a controller for the ADC, DMUX, and FIFO memory and as an interface between (1) the rest of the receiver and (2) a front-panel data port (FPDP) bus, which is an industry-standard parallel data bus that has a high data-rate capability and multichannel configuration suitable for DBF. Still other parts of the FPGA in each receiver perform signal-processing functions. The digital receivers can be configured to operate in a stand-alone mode, or in a multichannel mode as needed for DBF. The customizability of the receiver makes it applicable to a broad range of system architectures. The capability for operation of receivers in either a stand-alone or a DBF mode enables the use of the receivers in an unprecedentedly wide variety of radar systems.

  3. HIGH-EFFICIENCY INFRARED RECEIVER

    Directory of Open Access Journals (Sweden)

    A. K. Esman

    2016-01-01

    Full Text Available Recent research and development show promising use of high-performance solid-state receivers of the electromagnetic radiation. These receivers are based on the low-barrier Schottky diodes. The approach to the design of the receivers on the basis of delta-doped low-barrier Schottky diodes with beam leads without bias is especially actively developing because for uncooled receivers of the microwave radiation these diodes have virtually no competition. The purpose of this work is to improve the main parameters and characteristics that determine the practical relevance of the receivers of mid-infrared electromagnetic radiation at the operating room temperature by modifying the electrodes configuration of the diode and optimizing the distance between them. Proposed original design solution of the integrated receiver of mid-infrared radiation on the basis of the low-barrier Schottky diodes with beam leads allows to effectively adjust its main parameters and characteristics. Simulation of the electromagnetic characteristics of the proposed receiver by using the software package HFSS with the basic algorithm of a finite element method which implemented to calculate the behavior of electromagnetic fields on an arbitrary geometry with a predetermined material properties have shown that when the inner parts of the electrodes of the low-barrier Schottky diode is performed in the concentric elliptical convex-concave shape, it can be reduce the reflection losses to -57.75 dB and the standing wave ratio to 1.003 while increasing the directivity up to 23 at a wavelength of 6.09 μm. At this time, the rounded radii of the inner parts of the anode and cathode electrodes are equal 212 nm and 318 nm respectively and the gap setting between them is 106 nm. These parameters will improve the efficiency of the developed infrared optical-promising and electronic equipment for various purposes intended for work in the mid-infrared wavelength range. 

  4. Impact of maintenance immunosuppressive therapy on the fecal microbiome of renal transplant recipients: Comparison between an everolimus- and a standard tacrolimus-based regimen.

    Directory of Open Access Journals (Sweden)

    Gianluigi Zaza

    Full Text Available The gut microbiome is the full set of microbes living in the gastrointestinal tract and is emerging as an important dynamic/fluid system that, if altered by environmental, dietetic or pharmacological factors, could considerably influence drug response. However, the immunosuppressive drug-induced modifications of this system are still poorly defined.We employed an innovative bioinformatics approach to assess differences in the whole-gut microbial metagenomic profile of 20 renal transplant recipients undergoing maintenance treatment with two different immunosuppressive protocols. Nine patients were treated with everolimus plus mycophenolate mofetil (EVE+MMF group, and 11 patients were treated with a standard therapy with tacrolimus plus mycophenolate mofetil (TAC+MMF group.A statistical analysis of comparative high-throughput data demonstrated that although similar according to the degree of Shannon diversity (alpha diversity at the taxonomic level, three functional genes clearly discriminated EVE+MMF versus TAC+MMF (cutoff: log2 fold change≥1, FDR≤0.05. Flagellar motor switch protein (fliNY and type IV pilus assembly protein pilM (pilM were significantly enriched in TAC+MMF-treated patients, while macrolide transport system mrsA (msrA was more abundant in patients treated with EVE+MMF. Finally, PERMANOVA revealed that among the variables analyzed and included in our model, only the consumption of sugar significantly influenced beta diversity.Our study, although performed on a relatively small number of patients, showed, for the first time, specific immunosuppressive-related effects on fecal microbiome of renal transplant recipients and it suggested that the analysis of the gut microbes community could represent a new tool to better understand the effects of drugs currently employed in organ transplantations. However, multicenter studies including healthy controls should be undertaken to better address this objective.

  5. Impact of maintenance immunosuppressive therapy on the fecal microbiome of renal transplant recipients: Comparison between an everolimus- and a standard tacrolimus-based regimen.

    Science.gov (United States)

    Zaza, Gianluigi; Dalla Gassa, Alessandra; Felis, Giovanna; Granata, Simona; Torriani, Sandra; Lupo, Antonio

    2017-01-01

    The gut microbiome is the full set of microbes living in the gastrointestinal tract and is emerging as an important dynamic/fluid system that, if altered by environmental, dietetic or pharmacological factors, could considerably influence drug response. However, the immunosuppressive drug-induced modifications of this system are still poorly defined. We employed an innovative bioinformatics approach to assess differences in the whole-gut microbial metagenomic profile of 20 renal transplant recipients undergoing maintenance treatment with two different immunosuppressive protocols. Nine patients were treated with everolimus plus mycophenolate mofetil (EVE+MMF group), and 11 patients were treated with a standard therapy with tacrolimus plus mycophenolate mofetil (TAC+MMF group). A statistical analysis of comparative high-throughput data demonstrated that although similar according to the degree of Shannon diversity (alpha diversity) at the taxonomic level, three functional genes clearly discriminated EVE+MMF versus TAC+MMF (cutoff: log2 fold change≥1, FDR≤0.05). Flagellar motor switch protein (fliNY) and type IV pilus assembly protein pilM (pilM) were significantly enriched in TAC+MMF-treated patients, while macrolide transport system mrsA (msrA) was more abundant in patients treated with EVE+MMF. Finally, PERMANOVA revealed that among the variables analyzed and included in our model, only the consumption of sugar significantly influenced beta diversity. Our study, although performed on a relatively small number of patients, showed, for the first time, specific immunosuppressive-related effects on fecal microbiome of renal transplant recipients and it suggested that the analysis of the gut microbes community could represent a new tool to better understand the effects of drugs currently employed in organ transplantations. However, multicenter studies including healthy controls should be undertaken to better address this objective.

  6. Impact of maintenance immunosuppressive therapy on the fecal microbiome of renal transplant recipients: Comparison between an everolimus- and a standard tacrolimus-based regimen

    Science.gov (United States)

    Dalla Gassa, Alessandra; Felis, Giovanna; Granata, Simona; Torriani, Sandra; Lupo, Antonio

    2017-01-01

    Background The gut microbiome is the full set of microbes living in the gastrointestinal tract and is emerging as an important dynamic/fluid system that, if altered by environmental, dietetic or pharmacological factors, could considerably influence drug response. However, the immunosuppressive drug-induced modifications of this system are still poorly defined. Methods We employed an innovative bioinformatics approach to assess differences in the whole-gut microbial metagenomic profile of 20 renal transplant recipients undergoing maintenance treatment with two different immunosuppressive protocols. Nine patients were treated with everolimus plus mycophenolate mofetil (EVE+MMF group), and 11 patients were treated with a standard therapy with tacrolimus plus mycophenolate mofetil (TAC+MMF group). Results A statistical analysis of comparative high-throughput data demonstrated that although similar according to the degree of Shannon diversity (alpha diversity) at the taxonomic level, three functional genes clearly discriminated EVE+MMF versus TAC+MMF (cutoff: log2 fold change≥1, FDR≤0.05). Flagellar motor switch protein (fliNY) and type IV pilus assembly protein pilM (pilM) were significantly enriched in TAC+MMF-treated patients, while macrolide transport system mrsA (msrA) was more abundant in patients treated with EVE+MMF. Finally, PERMANOVA revealed that among the variables analyzed and included in our model, only the consumption of sugar significantly influenced beta diversity. Conclusions Our study, although performed on a relatively small number of patients, showed, for the first time, specific immunosuppressive-related effects on fecal microbiome of renal transplant recipients and it suggested that the analysis of the gut microbes community could represent a new tool to better understand the effects of drugs currently employed in organ transplantations. However, multicenter studies including healthy controls should be undertaken to better address this

  7. Validation of an LC-MS/MS method to measure tacrolimus in rat kidney and liver tissue and its application to human kidney biopsies.

    Science.gov (United States)

    Noll, Benjamin D; Coller, Janet K; Somogyi, Andrew A; Morris, Raymond G; Russ, Graeme R; Hesselink, Dennis A; Van Gelder, Teun; Sallustio, Benedetta C

    2013-10-01

    Tacrolimus (TAC) has a narrow therapeutic index and high interindividual and intraindividual pharmacokinetic variability, necessitating therapeutic drug monitoring to individualize dosage. Recent evidence suggests that intragraft TAC concentrations may better predict transplant outcomes. This study aimed to develop a method for the quantification of TAC in small biopsy-sized samples of rat kidney and liver tissue, which could be applied to clinical biopsy samples from kidney transplant recipients. Kidneys and livers were harvested from Mrp2-deficient TR- Wistar rats administered TAC (4 mg·kg·d for 14 days, n = 8) or vehicle (n = 10). Tissue samples (0.20-1.00 mg of dry weight) were solubilized enzymatically and underwent liquid-liquid extraction before analysis by liquid chromatography tandem mass spectrometry method. TAC-free tissue was used in the calibrator and quality control samples. Analyte detection was accomplished using positive electrospray ionization (TAC: m/z 821.5 → 768.6; internal standard ascomycin m/z 809.3 → 756.4). Calibration curves (0.04-2.6 μg/L) were linear (R > 0.99, n = 10), with interday and intraday calibrator coefficients of variation and bias <17% at the lower limit of quantification and <15% at all other concentrations (n = 6-10). Extraction efficiencies for TAC and ascomycin were approximately 70%, and matrix effects were minimal. Rat kidney TAC concentrations were higher (range 109-190 pg/mg tissue) than those in the liver (range 22-53 pg/mg of tissue), with median tissue/blood concentrations ratios of 72.0 and 17.6, respectively. In 2 transplant patients, kidney TAC concentrations ranged from 119 to 285 pg/mg of tissue and were approximately 20 times higher than whole blood trough TAC concentrations. The method displayed precision and accuracy suitable for application to TAC measurement in human kidney biopsy tissue.

  8. Diagnostic efficiency of truncated area under the curve from 0 to 2 h (AUC₀₋₂) of mycophenolic acid in kidney transplant recipients receiving mycophenolate mofetil and concomitant tacrolimus.

    Science.gov (United States)

    Lampón, Natalia; Tutor-Crespo, María J; Romero, Rafael; Tutor, José C

    2011-07-01

    Recently, the use of the truncated area under the curve from 0 to 2 h (AUC(0-2)) of mycophenolic acid (MPA) has been proposed for therapeutic monitoring in liver transplant recipients. The aim of our study was the evaluation of the clinical usefulness of truncated AUC(0-2) in kidney transplant patients. Plasma MPA was measured in samples taken before the morning dose of mycophenolate mofetil, and one-half and 2 h post-dose, completing 63 MPA concentration-time profiles from 40 adult kidney transplant recipients. The AUC from 0 to 12 h (AUC(0-12)) was calculated using the validated algorithm of Pawinski et al. The truncated AUC(0-2) was calculated using the linear trapezoidal rule, and extrapolated to 0-12 h (trapezoidal extrapolated AUC(0-12)) as previously described. Algorithm calculated and trapezoidal extrapolated AUC(0-12) values showed high correlation (r=0.995) and acceptable dispersion (ma68=0.71 μg·h/mL), median prediction error (6.6%) and median absolute prediction error (12.6%). The truncated AUC(0-2) had acceptable diagnostic efficiency (87%) in the classification of subtherapeutic, therapeutic or supratherapeutic values with respect to AUC(0-12). However, due to the high inter-individual variation of the drug absorption-rate, the dispersion between both pharmacokinetic variables (ma68=6.9 μg·h/mL) was unacceptable. The substantial dispersion between truncated AUC(0-2) and AUC(0-12) values may be a serious objection for the routine use of MPA AUC(0-2) in clinical practice.

  9. GIVING AND RECEIVING CONSTRUCTIVE FEEDBACK

    Directory of Open Access Journals (Sweden)

    Ірина Олійник

    2015-05-01

    Full Text Available The article scrutinizes the notion of feedback applicable in classrooms where team teaching is provided. The experience of giving and receiving feedback has been a good practice in cooperation between a U.S. Peace Corps volunteer and a Ukrainian counterpart. Giving and receiving feedback is an effective means of classroom observation that provides better insight into the process of teaching a foreign language. The article discusses the stages of feedback and explicates the notion of sharing experience between two teachers working simultaneously in the same classroom. The guidelines for giving and receiving feedback have been provided as well as the most commonly used vocabulary items have been listed. It has been proved that mutual feedback leads to improving teaching methods and using various teaching styles and techniques.

  10. Receiver-exciter controller design

    Science.gov (United States)

    Jansma, P. A.

    1982-01-01

    A description of the general design of both the block 3 and block 4 receiver-exciter controllers for the Deep Space Network (DSN) Mark IV-A System is presented along with the design approach. The controllers are designed to enable the receiver-exciter subsystem (RCV) to be configured, calibrated, initialized and operated from a central location via high level instructions. The RECs are designed to be operated under the control of the DMC subsystem. The instructions are in the form of standard subsystem blocks (SSBs) received via the local area network (LAN). The centralized control provided by RECs and other DSCC controllers in Mark IV-A is intended to reduce DSN operations costs from the Mark III era.

  11. Stability of heterodyne terahertz receivers

    OpenAIRE

    Kooi, J. W.; Baselmans, J. J. A.; Baryshev, A.; Schieder, R.; Hajenius, M.; Gao, J. R.; Klapwijk, T. M.; Voronov, B.; Gol'tsman, G.

    2006-01-01

    In this paper we discuss the stability of heterodyne terahertz receivers based on small volume NbN phonon cooled hot electron bolometers (HEBs). The stability of these receivers can be broken down in two parts: the intrinsic stability of the HEB mixer and the stability of the local oscillator (LO) signal injection scheme. Measurements show that the HEB mixer stability is limited by gain fluctuations with a 1/f spectral distribution. In a 60 MHz noise bandwidth this results in an Allan varian...

  12. A Complicated Case of Tacrolimus-Induced Rapid Remission after Cesarean Section in the Early Third Trimester for Refractory Severe Ulcerative Colitis Flaring in the Initial Period of Gestation

    Directory of Open Access Journals (Sweden)

    Takashi Mizushima

    2011-04-01

    Full Text Available A 36-year-old woman who had been diagnosed with ulcerative colitis at the age of 17 years was referred to our hospital because of severe abdominal pain and repeated bloody diarrhea that persisted during pregnancy despite combination therapy with high-dose corticosteroids and weekly granulocyte and monocyte adsorptive apheresis (GMA. She underwent combination therapy consisting of high-dose corticosteroids, intensive GMA (two sessions per week and vancomycin, which was used to eradicate Clostridium difficile, under total parenteral nutrition control until the estimated weight of her fetus reached 1,000 g. This combination therapy was partially successful, resulting in almost complete disappearance of abdominal pain and a marked decrease in stool frequency. However bloody diarrhea persisted and the patient developed anemia and hypoalbuminemia and was unable to prolong her gestation time. Cesarean section was conducted at 28 weeks of gestation without any congenital abnormalities or neurological defects. Oral administration of tacrolimus was begun 7 days after cesarean section, which was followed by rapid induction of remission. Corticosteroids were then gradually tapered off. Tacrolimus is one therapeutic option after cesarean section in pregnant patients who do not respond well to GMA and high-dose corticosteroids for persistent active ulcerative colitis.

  13. Budget impact of switching from an immediate-release to a prolonged-release formulation of tacrolimus in renal transplant recipients in the UK based on differences in adherence

    Directory of Open Access Journals (Sweden)

    Muduma G

    2014-03-01

    Full Text Available Gorden Muduma,1 Isaac Odeyemi,1 Jayne Smith-Palmer,2 Richard F Pollock21Astellas Pharma Europe, Chertsey, UK; 2Ossian Health Economics and Communications, Basel, SwitzerlandBackground and aims: Advagraf is a once-daily prolonged-release formulation of tacrolimus with proven noninferiority to Prograf, a twice-daily immediate-release formulation of tacrolimus, in biopsy-proven acute rejection, graft survival and patient survival in renal transplant recipients. Advagraf is associated with improved adherence compared with Prograf, which may ultimately improve long-term outcomes. The present study assessed the budget impact of switching patients from Prograf to Advagraf in the UK.Materials and methods: A budget-impact model was constructed based on published data on acute rejection, graft failure, and mortality in the UK setting. Patients were assumed to convert from Prograf to Advagraf on a 1:1 milligram:milligram basis. In a study comparing the adherence rates between once-daily versus twice-daily formulations of tacrolimus, the proportion of patients taking the prescribed number of daily doses was 88.2% in Advagraf patients and 78.8% in Prograf patients. The model applied a relative risk of graft failure of 3.47 to nonadherent patients based on data from a 2004 meta-analysis (based on graft-failure rates of 1.3%–40.0% in adherent patients, compared with 6.1%–100% in nonadherent patients. Cost data were taken from the March 2013 British National Formulary and 2012–2013 National Health Service tariff information. The analysis was performed over a 5-year time horizon and future costs were not discounted, in line with International Society for Pharmacoeconomics and Outcomes Research guidelines.Results: Over a 5-year time horizon, the mean cost per patient (including tacrolimus, concomitant immunosuppressive medications, dialysis after graft failure, and treatment for acute rejection was £29,328 (standard deviation [SD] £2,844 for Advagraf

  14. Femtosecond Photon-Counting Receiver

    Science.gov (United States)

    Krainak, Michael A.; Rambo, Timothy M.; Yang, Guangning; Lu, Wei; Numata, Kenji

    2016-01-01

    An optical correlation receiver is described that provides ultra-precise distance and/or time/pulse-width measurements even for weak (single photons) and short (femtosecond) optical signals. A new type of optical correlation receiver uses a fourth-order (intensity) interferometer to provide micron distance measurements even for weak (single photons) and short (femtosecond) optical signals. The optical correlator uses a low-noise-integrating detector that can resolve photon number. The correlation (range as a function of path delay) is calculated from the variance of the photon number of the difference of the optical signals on the two detectors. Our preliminary proof-of principle data (using a short-pulse diode laser transmitter) demonstrates tens of microns precision.

  15. Scintillation-Hardened GPS Receiver

    Science.gov (United States)

    Stephens, Donald R.

    2015-01-01

    CommLargo, Inc., has developed a scintillation-hardened Global Positioning System (GPS) receiver that improves reliability for low-orbit missions and complies with NASA's Space Telecommunications Radio System (STRS) architecture standards. A software-defined radio (SDR) implementation allows a single hardware element to function as either a conventional radio or as a GPS receiver, providing backup and redundancy for platforms such as the International Space Station (ISS) and high-value remote sensing platforms. The innovation's flexible SDR implementation reduces cost, weight, and power requirements. Scintillation hardening improves mission reliability and variability. In Phase I, CommLargo refactored an open-source GPS software package with Kalman filter-based tracking loops to improve performance during scintillation and also demonstrated improved navigation during a geomagnetic storm. In Phase II, the company generated a new field-programmable gate array (FPGA)-based GPS waveform to demonstrate on NASA's Space Communication and Navigation (SCaN) test bed.

  16. The current burden of cytomegalovirus infection in kidney transplant recipients receiving no pharmacological prophylaxis

    Directory of Open Access Journals (Sweden)

    Claudia Rosso Felipe

    Full Text Available Abstract Cytomegalovirus (CMV infection in kidney transplantation has changed its clinical spectrum, mostly due to the current and more effective immunosuppression. In the absence of preventive strategies it is associated with significant morbi-mortality. Objective: This study evaluated the incidence of CMV events and its effect on outcomes of kidney transplantation in recipients without pharmacological prophylaxis or targeted preemptive treatment. Results: The study cohort comprised 802 recipients of kidney transplants between 04/30/2014 and 04/30/2015. The majority received induction with anti-thymocyte globulin (81.5%, tacrolimus and prednisone in combination with either mycophenolate (46.3% or azathioprine (53.7%. The overall incidence of CMV events was 42% (58.6% infection and 41.4% disease. Patients with CMV showed higher incidence of first treated acute rejection (19 vs. 11%, p = 0,001 compared with those without CMV but no differences in graft loss, death or loss to follow-up. The incidence of delayed graft function was higher (56% vs. 37%, p = 0.000 and the eGFR at 1 (41 ± 21 vs. 54 ± 28 ml/min, p = 0.000 and 12 months (50 ± 19 vs. 61 ± 29 ml/min, p = 0.000 were lower in patients with CMV. Recipients age (OR = 1.03, negative CMV serology (OR = 5.21 and use of mycophenolate (OR = 1.67 were associated with increased risk of CMV. Changes in immunosuppression was more often in patients with CMV (63% vs. 31%, p = 0.000. Conclusion: the incidence of CMV events was high and associated with higher incidence of acute rejection and changes in immunosuppression. Besides traditional risk factors, renal function at 1 month was independently associated with CMV infection.

  17. A comparison of the effects of C2-cyclosporine and C0-tacrolimus on renal function and cardiovascular risk factors in kidney transplant recipients.

    Science.gov (United States)

    Kim, S Joseph; Prasad, G V Ramesh; Huang, Michael; Nash, Michelle M; Famure, Olusegun; Park, Joseph; Thenganatt, Mary Ann; Chowdhury, Nizamuddin; Cole, Edward H; Fenton, Stanley S A; Cattran, Daniel C; Zaltzman, Jeffrey S; Cardella, Carl J

    2006-10-15

    There are few data directly comparing the effects of two-hour postingestion monitored cyclosporine (C2-CsA) vs. trough-monitored tacrolimus (C0-Tac) on renal function and cardiovascular risk factors. We studied 378 (202 C2-CsA vs. 176 C0-Tac) incident kidney transplant recipients in Toronto, Canada, from August 1, 2000 and December 31, 2003. Outcomes included changes in estimated glomerular filtration rate (eGFR at 1 and 6 months by modification of diet in renal disease four-variable equation), mean arterial pressure (MAP), total cholesterol (TC), and new-onset diabetes mellitus (NODM) at six months posttransplant. The independent effect of treatment/monitoring strategies on continuous outcomes and time-to-NODM was modeled using linear and Cox regression, respectively. Mean eGFR was 59.5 vs. 62.9 ml/min at one month and 50.6 vs. 61.2 ml/min at six months for C2-CsA vs. C0-Tac, respectively. Multiple linear regression revealed the slope of eGFR to be 0.93 ml/min/month lower in C2-CsA patients. This was equivalent to an adjusted average eGFR difference of 4.64 ml/min between months one and six posttransplant. There was no significant difference in average MAP and TC. In a stepwise multivariable Cox model and a propensity score analysis, there was no significant association between the type of treatment/monitoring strategy and time-to-NODM. There was a greater decline in eGFR for patients on C2-CsA (vs. C0-Tac) between one and six months posttransplant. However, MAP, TC, and the risk of NODM were comparable in both treatment/monitoring groups. The long-term impact of short-term reductions in eGFR as a function of the type of treatment/monitoring strategy requires further study.

  18. Communication received from South Africa

    International Nuclear Information System (INIS)

    1984-02-01

    The document reproduces the press release with a statement by Dr. J.W.L. de Villiers, Executive Chairman of the Atomic Energy Corporation of South Africa Limited, issued on 31 January 1984 and included in the letter received by the Director General of the IAEA from the Resident Representative of South Africa to the Agency on 31 January 1984. This statement refers to the transfer of nuclear material equipment and technology by South Africa to other countries and the Non-Proliferation Treaty

  19. Absorption Efficiency of Receiving Antennas

    DEFF Research Database (Denmark)

    Andersen, Jørgen Bach; Frandsen, Aksel

    2005-01-01

    A receiving antenna with a matched load will always scatter some power. This paper sets an upper and a lower bound on the absorption efficiency (absorbed power over sum of absorbed and scattered powers), which lies between 0 and 100% depending on the directivities of the antenna and scatter...... patterns. It can approach 100% as closely as desired, although in practice this may not be an attractive solution. An example with a small endfire array of dipoles shows an efficiency of 93%. Several examples of small conical horn antennas are also given, and they all have absorption efficiencies less than...

  20. Solar receiver with integrated optics

    Science.gov (United States)

    Jiang, Lun; Winston, Roland

    2012-10-01

    The current challenge for PV/Thermal (PV/T) systems is the reduction of radiation heat loss. Compared to solar thermal selective coating, the solar cells cannot be used as an efficient thermal absorber due to their large emissivity of the encapsulation material. Many commercial PV/T products therefore require a high concentration (more than 10x) to reach an acceptable thermal efficiency for their receivers. Such a concentration system inevitably has to track or semi-track, which induces additional cost and collects only the direct radiation from the sun. We propose a new PV/T design using a vacuum encapsulated thin film cell to solve this problem. The proposed design also collects the diffuse sun light efficiently by using an external compound parabolic concentrator (XCPC). Since the transparent electrode (TCO) of thin film cell is inherently transparent in visible light and reflective beyond infrared, this design uses this layer instead of the conventional solar cell encapsulation as the outmost heat loss surface. By integrating such a vacuum design with a tube shaped absorber, we reduce the complexity of conducting the heat energy and electricity out of the device. A low concentration standalone non-tracking solar collector is proposed in this paper. We also analyzed the thermosyphon system configuration using heat transfer and ray tracing models. The economics of such a receiver are presented.

  1. Broadband direct RF digitization receivers

    CERN Document Server

    Jamin, Olivier

    2014-01-01

    This book discusses the trade-offs involved in designing direct RF digitization receivers for the radio frequency and digital signal processing domains.  A system-level framework is developed, quantifying the relevant impairments of the signal processing chain, through a comprehensive system-level analysis.  Special focus is given to noise analysis (thermal noise, quantization noise, saturation noise, signal-dependent noise), broadband non-linear distortion analysis, including the impact of the sampling strategy (low-pass, band-pass), analysis of time-interleaved ADC channel mismatches, sampling clock purity and digital channel selection. The system-level framework described is applied to the design of a cable multi-channel RF direct digitization receiver. An optimum RF signal conditioning, and some algorithms (automatic gain control loop, RF front-end amplitude equalization control loop) are used to relax the requirements of a 2.7GHz 11-bit ADC. A two-chip implementation is presented, using BiCMOS and 65nm...

  2. Etiology of New-onset Diabetes Mellitus by Tacrolimus after Transplantation%他克莫司致器官移植后新发糖尿病的发病机制研究进展

    Institute of Scientific and Technical Information of China (English)

    陈凡; 徐彦贵

    2014-01-01

    器官移植术后新发糖尿病是实体器官移植后的一个主要并发症,通常导致住院率和死亡率的升高。免疫抑制剂常被认为是导致器官移植术后新发糖尿病的主要因素,包括糖皮质激素、钙调磷酸酶抑制剂等。其中,钙调磷酸酶抑制剂对血糖的影响最大。他克莫司是从链霉菌属中分离出的发酵产物,是一种强效免疫抑制性大环内酯类抗生素,现广泛用于实体器官移植的免疫抑制剂。他克莫司对细胞免疫有选择性抑制作用,主要通过抑制白介素-2的释放,全面抑制T淋巴细胞的作用。通过查阅了大量的国外文献,本文分别从三个方面综述了他克莫司引起高血糖的机制,包括影响β细胞存活和复制、影响胰岛素分泌、影响外周组织的胰岛素利用。%New-onset diabetes (NODAT) is recognized as a complication after solid organ transplantation, which may increase the risk of morbidity and morality. Immunosuppressive agent is the main risk factor for NODAT after organ transplantation, including glucocorticoids, calcineurin inhibitors etc. Among them, calcineurin inhibitors are most strongly associated with NODAT. Tacrolimus is a macrolide immunosuppressants discovered from the fermentation broth of bacteria streptomyces tsukubaensis which is widely used in organ transplantation. Tacrolimus reduces interleukin-2 (IL-2) production by T-cells. In this review, we will provide a detailed discussion describing potential mechanisms involved in diabetogenic properties of tacrolimus, including effects on β-cell survival and replication, insulin secretion and peripheral insulin action.

  3. CERN physicist receives Einstein Medal

    CERN Multimedia

    2006-01-01

    On 29 June the CERN theorist Gabriele Veneziano was awarded the prestigious Albert Einstein Medal for significant contributions to the understanding of string theory. This award is given by the Albert Einstein Society in Bern to individuals whose scientific contributions relate to the work of Einstein. Former recipients include exceptional physicists such as Murray Gell-Mann last year, but also Stephen Hawking and Victor Weisskopf. Gabriele Veneziano, a member of the integrated CERN Theory Team since 1977, led the Theory Division from 1994 to 1997 and has already received many prestigious prizes for his outstanding work, including the Enrico Fermi Prize (see CERN Courier, November 2005), the Dannie Heineman Prize for mathematical physics of the American Physical Society in 2004 (see Bulletin No. 47/2003), and the I. Ya. Pomeranchuk Prize of the Institute of Theoretical and Experimental Physics (Moscow) in 1999.

  4. Late conversion from tacrolimus to a belatacept-based immuno-suppression regime in kidney transplant recipients improves renal function, acid-base derangement and mineral-bone metabolism.

    Science.gov (United States)

    Schulte, Kevin; Vollmer, Clara; Klasen, Vera; Bräsen, Jan Hinrich; Püchel, Jodok; Borzikowsky, Christoph; Kunzendorf, Ulrich; Feldkamp, Thorsten

    2017-08-01

    Calcineurin inhibitor (CNI)-induced nephrotoxicity and chronic graft dysfunction with deteriorating glomerular filtration rate (GFR) are common problems of kidney transplant recipients. The aim of this study was to analyze the role of belatacept as a rescue therapy in these patients. In this retrospective, observational study we investigated 20 patients (10 females, 10 males) who were switched from a CNI (tacrolimus) to a belatacept-based immunosuppression because of CNI intolerance or marginal transplant function. Patient follow-up was 12 months. Patients were converted to belatacept in mean 28.8 months after transplantation. Reasons for conversion were CNI intolerance (14 patients) or marginal transplant function (6 patients). Mean estimated GFR (eGFR) before conversion was 22.2 ± 9.4 ml/min at baseline and improved significantly to 28.3 ± 10.1 ml/min at 4 weeks and to 32.1 ± 12.6 ml/min at 12 months after conversion. Serum bicarbonate significantly increased from 24.4 ± 3.2 mmol/l at baseline to 28.7 ± 2.6 mmol/l after 12 months. Conversion to belatacept decreased parathyroid hormone and phosphate concentrations significantly, whereas albumin levels significantly increased. In 6 cases an acute rejection preceded clinically relevant CNI toxicity; only two patients suffered from an acute rejection after conversion. Belatacept was well tolerated and there was no increase in infectious or malignant side effects. A late conversion from a tacrolimus-based immunosuppression to belatacept is safe, effective and significantly improves renal function in kidney transplant recipients. Additionally, the conversion to belatacept has a beneficial impact on acid-base balance, mineral-bone and protein metabolism, independently of eGFR.

  5. Recombinant protein truncation strategy for inducing bactericidal antibodies to the macrophage infectivity potentiator protein of Neisseria meningitidis and circumventing potential cross-reactivity with human FK506-binding proteins.

    Science.gov (United States)

    Bielecka, Magdalena K; Devos, Nathalie; Gilbert, Mélanie; Hung, Miao-Chiu; Weynants, Vincent; Heckels, John E; Christodoulides, Myron

    2015-02-01

    A recombinant macrophage infectivity potentiator (rMIP) protein of Neisseria meningitidis induces significant serum bactericidal antibody production in mice and is a candidate meningococcal vaccine antigen. However, bioinformatics analysis of MIP showed some amino acid sequence similarity to human FK506-binding proteins (FKBPs) in residues 166 to 252 located in the globular domain of the protein. To circumvent the potential concern over generating antibodies that could recognize human proteins, we immunized mice with recombinant truncated type I rMIP proteins that lacked the globular domain and the signal leader peptide (LP) signal sequence (amino acids 1 to 22) and contained the His purification tag at either the N or C terminus (C-term). The immunogenicity of truncated rMIP proteins was compared to that of full (i.e., full-length) rMIP proteins (containing the globular domain) with either an N- or C-terminal His tag and with or without the LP sequence. By comparing the functional murine antibody responses to these various constructs, we determined that C-term His truncated rMIP (-LP) delivered in liposomes induced high levels of antibodies that bound to the surface of wild-type but not Δmip mutant meningococci and showed bactericidal activity against homologous type I MIP (median titers of 128 to 256) and heterologous type II and III (median titers of 256 to 512) strains, thereby providing at least 82% serogroup B strain coverage. In contrast, in constructs lacking the LP, placement of the His tag at the N terminus appeared to abrogate bactericidal activity. The strategy used in this study would obviate any potential concerns regarding the use of MIP antigens for inclusion in bacterial vaccines. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  6. Recombinant Protein Truncation Strategy for Inducing Bactericidal Antibodies to the Macrophage Infectivity Potentiator Protein of Neisseria meningitidis and Circumventing Potential Cross-Reactivity with Human FK506-Binding Proteins

    Science.gov (United States)

    Bielecka, Magdalena K.; Devos, Nathalie; Gilbert, Mélanie; Hung, Miao-Chiu; Weynants, Vincent; Heckels, John E.

    2014-01-01

    A recombinant macrophage infectivity potentiator (rMIP) protein of Neisseria meningitidis induces significant serum bactericidal antibody production in mice and is a candidate meningococcal vaccine antigen. However, bioinformatics analysis of MIP showed some amino acid sequence similarity to human FK506-binding proteins (FKBPs) in residues 166 to 252 located in the globular domain of the protein. To circumvent the potential concern over generating antibodies that could recognize human proteins, we immunized mice with recombinant truncated type I rMIP proteins that lacked the globular domain and the signal leader peptide (LP) signal sequence (amino acids 1 to 22) and contained the His purification tag at either the N or C terminus (C-term). The immunogenicity of truncated rMIP proteins was compared to that of full (i.e., full-length) rMIP proteins (containing the globular domain) with either an N- or C-terminal His tag and with or without the LP sequence. By comparing the functional murine antibody responses to these various constructs, we determined that C-term His truncated rMIP (−LP) delivered in liposomes induced high levels of antibodies that bound to the surface of wild-type but not Δmip mutant meningococci and showed bactericidal activity against homologous type I MIP (median titers of 128 to 256) and heterologous type II and III (median titers of 256 to 512) strains, thereby providing at least 82% serogroup B strain coverage. In contrast, in constructs lacking the LP, placement of the His tag at the N terminus appeared to abrogate bactericidal activity. The strategy used in this study would obviate any potential concerns regarding the use of MIP antigens for inclusion in bacterial vaccines. PMID:25452551

  7. Water jacket for solid particle solar receiver

    Science.gov (United States)

    Wasyluk, David T.

    2018-03-20

    A solar receiver includes: water jacket panels each having a light-receiving side and a back side with a watertight sealed plenum defined in-between; light apertures passing through the watertight sealed plenums to receive light from the light-receiving sides of the water jacket panels; a heat transfer medium gap defined between the back sides of the water jacket panels and a cylindrical back plate; and light channeling tubes optically coupled with the light apertures and extending into the heat transfer medium gap. In some embodiments ends of the light apertures at the light receiving side of the water jacket panel are welded together to define at least a portion of the light-receiving side. A cylindrical solar receiver may be constructed using a plurality of such water jacket panels arranged with their light-receiving sides facing outward.

  8. Design of double capacitances infrasonic receiver

    International Nuclear Information System (INIS)

    Wang Changhai; Han Kuixia; Wang Fei

    2003-01-01

    The article introduces the theory of infrasonic generation and reception of nuclear explosion. An idea of the design of double capacitances infrasonic receiver using CPLD technology is given in it. Compare with the single capacitance infrasonic receiver, sensitivity of the improved receiver can be improved scores of times, dynamic range can be improved largely, and the whole performance gets improvement a lots

  9. 29 CFR 1917.155 - Air receivers.

    Science.gov (United States)

    2010-07-01

    .... This section applies to compressed air receivers and equipment used for operations such as cleaning... transportation applications as railways, vehicles or cranes. (b) Gauges and valves. (1) Air receivers shall be... 29 Labor 7 2010-07-01 2010-07-01 false Air receivers. 1917.155 Section 1917.155 Labor Regulations...

  10. 49 CFR 393.88 - Television receivers.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 5 2010-10-01 2010-10-01 false Television receivers. 393.88 Section 393.88... NECESSARY FOR SAFE OPERATION Miscellaneous Parts and Accessories § 393.88 Television receivers. Any motor vehicle equipped with a television viewer, screen or other means of visually receiving a television...

  11. 21 CFR 1020.10 - Television receivers.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Television receivers. 1020.10 Section 1020.10 Food...) RADIOLOGICAL HEALTH PERFORMANCE STANDARDS FOR IONIZING RADIATION EMITTING PRODUCTS § 1020.10 Television receivers. (a) Applicability. The provisions of this section are applicable to television receivers...

  12. More Efficient Solar Thermal-Energy Receiver

    Science.gov (United States)

    Dustin, M. O.

    1987-01-01

    Thermal stresses and reradiation reduced. Improved design for solar thermal-energy receiver overcomes three major deficiencies of solar dynamic receivers described in literature. Concentrator and receiver part of solar-thermal-energy system. Receiver divided into radiation section and storage section. Concentrated solar radiation falls on boiling ends of heat pipes, which transmit heat to thermal-energy-storage medium. Receiver used in number of applications to produce thermal energy directly for use or to store thermal energy for subsequent use in heat engine.

  13. CYP3A5*3 and ABCB1 61A>G Significantly Influence Dose-adjusted Trough Blood Tacrolimus Concentrations in the First Three Months Post-Kidney Transplantation.

    Science.gov (United States)

    Hu, Rong; Barratt, Daniel T; Coller, Janet K; Sallustio, Benedetta C; Somogyi, Andrew A

    2018-03-30

    Tacrolimus (TAC) is a first-line immunosuppressant used to prevent organ rejection after kidney transplantation. There is large inter-individual variability in its pharmacokinetics. Single nucleotide polymorphisms (SNPs) in genes encoding TAC metabolizing enzymes cytochromes P450 3A4/5 (CYP3A4/5), P-glycoprotein efflux transporter (ABCB1), their expression regulator pregnane X receptor (NR1I2) and CYP3A co-factor cytochrome P450 reductase (POR) have been studied for their effects on tacrolimus disposition. However, except for CYP3A5*3, controversies remain about their roles in predicting dose-adjusted trough blood TAC concentrations (C 0 /D). This study aimed to investigate the effects of ABCB1 (61A>G, 1199G>A, 1236C>T, 2677G>T and 3435C>T), CYP3A4*22, CYP3A5*3, NR1I2 (8055C>T, 63396C>T and -25385C>T) and POR*28 SNPs on TAC C 0 /D. In total, 165 kidney transplant recipients were included in this study. SNPs were genotyped by probe-based real-time polymerase chain reaction. Associations between log-transformed whole blood TAC C 0 /D (measured at 1 and 3 months post-transplant) and genotypes/haplotypes were assessed by linear mixed effects analysis, controlling for age, sex and haematocrit. It was observed that CYP3A5 expressors (*1/*1 + *1/*3) (p = 5.5 × 10 -16 ) and ABCB1 61G allele carriers (p = 0.001) had lower log-transformed TAC C 0 /D (56% and 26% lower geometric mean TAC C 0 /D, respectively) and accounted for approximately 30% and 4%, respectively, of log-transformed TAC C 0 /D variability in the first 3 months post-transplant. In conclusion, CYP3A5*3 is a major, and ABCB1 61A>G is a novel, although minor, genetic factor affecting TAC C 0 /D in kidney transplant recipients. © 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  14. Main: 1FK0 [RPSD[Archive

    Lifescience Database Archive (English)

    Full Text Available Molecule: Nonspecific Lipid-Transfer Protein; Chain: A Lipid Transport G.W.Han, J.Y.Lee, H.K.Song, D.H.Shin,...Kim, J.Choe, D.Lim, H.J.Moon, S.W.Suh Structural Basis Of Non-Specific Lipid Binding In Mai...; @=28-120.|PDB; 1MZM; X-ray; @=28-120.|MaizeDB; 25447; -.|InterPro; IPR003612; A

  15. Main: 1FK1 [RPSD[Archive

    Lifescience Database Archive (English)

    Full Text Available Molecule: Non-Specific Lipid Transfer Protein; Chain: A Lipid Transport G.W.Han, J.Y.Lee, H.K.Song, D.H.Shin....Kim, J.Choe, D.Lim, H.J.Moon, S.W.Suh Structural Basis Of Non-Specific Lipid Binding In Mai...y; @=28-120.|PDB; 1MZM; X-ray; @=28-120.|MaizeDB; 25447; -.|InterPro; IPR003612;

  16. Main: 1FK5 [RPSD[Archive

    Lifescience Database Archive (English)

    Full Text Available Molecule: Nonspecific Lipid-Transfer Protein; Chain: A Lipid Transport G.W.Han, J.Y.Lee, H.K.Song, D.H.Shin,...Kim, J.Choe, D.Lim, H.J.Moon, S.W.Suh Structural Basis Of Non-Specific Lipid Binding In Mai...; @=28-120.|PDB; 1MZM; X-ray; @=28-120.|MaizeDB; 25447; -.|InterPro; IPR003612; A

  17. Generalized Fourier transforms Fk,a

    DEFF Research Database (Denmark)

    Salem, Ben Said; Kobayashi, Toshiyuki; Ørsted, Bent

    2009-01-01

    We construct a two-parameter family of actions ωk,a of the Lie algebra by differential-difference operators on . Here, k is a multiplicity-function for the Dunkl operators, and a>0 arises from the interpolation of the Weil representation and the minimal unitary representation of the conformal gro...... of our semigroup Ωk,a provides us with (k,a) -generalized Fourier transforms , which includes the Dunkl transform ( a=2 ) and a new unitary operator ( a=1 ) as a Dunkl-type generalization of the classical Hankel transform....

  18. Concentrated solar power generation using solar receivers

    Science.gov (United States)

    Anderson, Bruce N.; Treece, William Dean; Brown, Dan; Bennhold, Florian; Hilgert, Christoph

    2017-08-08

    Inventive concentrated solar power systems using solar receivers, and related devices and methods, are generally described. Low pressure solar receivers are provided that function to convert solar radiation energy to thermal energy of a working fluid, e.g., a working fluid of a power generation or thermal storage system. In some embodiments, low pressure solar receivers are provided herein that are useful in conjunction with gas turbine based power generation systems.

  19. RF subsystem design for microwave communication receivers

    Science.gov (United States)

    Bickford, W. J.; Brodsky, W. G.

    A system review of the RF subsystems of (IFF) transponders, tropscatter receivers and SATCOM receivers is presented. The quantity potential for S-band and X-band IFF transponders establishes a baseline requirement. From this, the feasibility of a common design for these and other receivers is evaluated. Goals are established for a GaAs MMIC (monolithic microwave integrated circuit) device and related local oscillator preselector and self-test components.

  20. Receiver function estimated by maximum entropy deconvolution

    Institute of Scientific and Technical Information of China (English)

    吴庆举; 田小波; 张乃铃; 李卫平; 曾融生

    2003-01-01

    Maximum entropy deconvolution is presented to estimate receiver function, with the maximum entropy as the rule to determine auto-correlation and cross-correlation functions. The Toeplitz equation and Levinson algorithm are used to calculate the iterative formula of error-predicting filter, and receiver function is then estimated. During extrapolation, reflective coefficient is always less than 1, which keeps maximum entropy deconvolution stable. The maximum entropy of the data outside window increases the resolution of receiver function. Both synthetic and real seismograms show that maximum entropy deconvolution is an effective method to measure receiver function in time-domain.

  1. Effects of Oxytocin Administration on Receiving Help.

    Science.gov (United States)

    Human, Lauren J; Woolley, Joshua D; Mendes, Wendy Berry

    2017-11-27

    Receiving help can be a "mixed blessing." Despite the many psychosocial benefits it can carry, it sometimes has negative psychological consequences, such as loss in self-esteem or enhanced guilt. It is, therefore, important to understand the factors that modify responses to receiving help from others. We explored the role of the hormone oxytocin (OT) on affective and social responses to receiving help, given the putative role of OT in social bonding and attunement. To this end, we manipulated whether help was received from a same-sex interaction partner (confederate) versus a control condition, crossed with a double-blind administration of intranasal OT (vs. placebo), and examined subjective and observer-rated participant responses to help. We observed significant interactions between OT and the help manipulation. In the placebo condition, receiving help from the interaction partner compared with the control condition had negative consequences, such that participants reported greater negative affect and came to view themselves and their interaction partners more negatively after interacting together on several tasks. What is important, however, is that OT administration buffered against these negative subjective responses to receiving help. Further, outside observers rated participants who received OT administration as expressing greater happiness and gratitude in response to help, relative to those who received placebo. In sum, in the context of receiving help from a stranger, oxytocin administration fostered more positive affective and social responses. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Shipping/Receiving and Quality Control

    Data.gov (United States)

    Federal Laboratory Consortium — Shipping receiving, quality control, large and precise inspection and CMM machines. Coordinate Measuring Machines, including "scanning" probes, optical comparators,...

  3. Compressive Sensing for Spread Spectrum Receivers

    DEFF Research Database (Denmark)

    Fyhn, Karsten; Jensen, Tobias Lindstrøm; Larsen, Torben

    2013-01-01

    With the advent of ubiquitous computing there are two design parameters of wireless communication devices that become very important: power efficiency and production cost. Compressive sensing enables the receiver in such devices to sample below the Shannon-Nyquist sampling rate, which may lead...... the bit error rate performance is degraded by the subsampling in the CS-enabled receivers, this may be remedied by including quantization in the receiver model.We also study the computational complexity of the proposed receiver design under different sparsity and measurement ratios. Our work shows...

  4. B cells and immunoglobulin in ABO-incompatible renal transplant patients receiving rituximab and double filtration plasmapheresis

    Directory of Open Access Journals (Sweden)

    Meng-Kun Tsai

    2015-04-01

    Conclusion: With the aid of tacrolimus and mycophenolate mofetil, rituximab resulted in sustained suppression of B cell count and total IgG and IgM. Among the IgG subclasses, IgG3 was less sensitive to rituximab.

  5. Safety and effectiveness of tacrolimus add-on therapy for rheumatoid arthritis patients without an adequate response to biological disease-modifying anti-rheumatic drugs (DMARDs): Post-marketing surveillance in Japan.

    Science.gov (United States)

    Takeuchi, Tsutomu; Ishida, Kota; Shiraki, Katsuhisa; Yoshiyasu, Takashi

    2018-01-01

    Post-marketing surveillance (PMS) was conducted to assess the safety and effectiveness of tacrolimus (TAC) add-on therapy for patients with rheumatoid arthritis (RA) and an inadequate response to biological disease-modifying anti-rheumatic drugs (DMARDs). Patients with RA from 180 medical sites across Japan were registered centrally with an electronic investigation system. The observational period was 24 weeks from the first day of TAC administration concomitantly with biological DMARDs. Safety and effectiveness populations included 624 and 566 patients, respectively. Patients were predominantly female (81.1%), with a mean age of 61.9 years. Overall, 125 adverse drug reactions (ADRs) occurred in 94 patients (15.1%), and 15 serious ADRs occurred in 11 patients (1.8%). These incidences were lower compared with previously reported incidences after TAC treatment in PMS, and all of the observed ADRs were already known. A statistically significant improvement was observed in the primary effectiveness variable of Simplified Disease Activity Index after TAC treatment; 62.7% of patients achieved remission or low disease activity at week 24. TAC is well tolerated and effective when used as an add-on to biological DMARDs in Japanese patients with RA who do not achieve an adequate response to biological DMARDs in a real-world clinical setting.

  6. An SDR based AIS receiver for satellites

    DEFF Research Database (Denmark)

    Larsen, Jesper Abildgaard; Mortensen, Hans Peter; Nielsen, Jens Frederik Dalsgaard

    2011-01-01

    For a few years now, there has been a high interest in monitoring the global ship traffic from space. A few satellite, capable of listening for ship borne AIS transponders have already been launched, and soon the AAUSAT3, carrying two different types of AIS receivers will also be launched. One...... of the AIS receivers onboard AAUSAT3 is an SDR based AIS receiver. This paper serves to describe the background of the AIS system, and how the SDR based receiver has been integrated into the AAUSAT3 satellite. Amongst some of the benefits of using an SDR based receiver is, that due to its versatility, new...... detection algorithms are easily deployed, and it is easily adapted the new proposed AIS transmission channels....

  7. Heat receiving plates in thermonuclear device

    International Nuclear Information System (INIS)

    Kitamura, Kazunori.

    1988-01-01

    Purpose: To obtain a heat receiving plate structure capable of withstanding sputtering wear and retaining the thermal deformation and residual stress low upon junction and available at a reduced cost. Constitution: Junction structures between heat sinks and armours are the same as usual, whereas high melting armour (for example, made of tungsten) are used at the portion on a heat receiving plate where the thermal load and particle load are higher while materials having a heat expansion coefficient similar to that of the heat sink (stainless steel) are used at the portion where the thermal load and particle load are lower on a heat receiving plate depending on the thermal load and particle load distribution. This can reduce the thermal deformation for the entire divertor heat receiving plate to obtain a heat receiving plate of a good surface dimensional accuracy. (Takahashi, M.)

  8. High thermal load receiving heat plate

    International Nuclear Information System (INIS)

    Shibutani, Jun-ichi; Shibayama, Kazuhito; Yamamoto, Keiichi; Uchida, Takaho.

    1993-01-01

    The present invention concerns a high thermal load heat receiving plate such as a divertor plate of a thermonuclear device. The high thermal load heat receiving plate of the present invention has a cooling performance capable of suppressing the temperature of an armour tile to less than a threshold value of the material against high thermal loads applied from plasmas. Spiral polygonal pipes are inserted in cooling pipes at a portion receiving high thermal loads in the high temperature load heat receiving plate of the present invention. Both ends of the polygonal pipes are sealed by lids. An area of the flow channel in the cooling pipes is thus reduced. Heat conductivity on the cooling surface of the cooling pipes is increased in the high thermal load heat receiving plate having such a structure. Accordingly, temperature elevation of the armour tile can be suppressed. (I.S.)

  9. Fundamentals of GPS Receivers A Hardware Approach

    CERN Document Server

    Doberstein, Dan

    2012-01-01

    While much of the current literature on GPS receivers is aimed at those intimately familiar with their workings, this volume summarizes the basic principles using as little mathematics as possible, and details the necessary specifications and circuits for constructing a GPS receiver that is accurate to within 300 meters. Dedicated sections deal with the features of the GPS signal and its data stream, the details of the receiver (using a hybrid design as exemplar), and more advanced receivers and topics including time and frequency measurements. Later segments discuss the Zarlink GPS receiver chip set, as well as providing a thorough examination of the TurboRogue receiver, one of the most accurate yet made. Guiding the reader through the concepts and circuitry, from the antenna to the solution of user position, the book’s deployment of a hybrid receiver as a basis for discussion allows for extrapolation of the core ideas to more complex, and more accurate designs. Digital methods are used, but any analogue c...

  10. GPU Acceleration of DSP for Communication Receivers.

    Science.gov (United States)

    Gunther, Jake; Gunther, Hyrum; Moon, Todd

    2017-09-01

    Graphics processing unit (GPU) implementations of signal processing algorithms can outperform CPU-based implementations. This paper describes the GPU implementation of several algorithms encountered in a wide range of high-data rate communication receivers including filters, multirate filters, numerically controlled oscillators, and multi-stage digital down converters. These structures are tested by processing the 20 MHz wide FM radio band (88-108 MHz). Two receiver structures are explored: a single channel receiver and a filter bank channelizer. Both run in real time on NVIDIA GeForce GTX 1080 graphics card.

  11. Global Positioning System receiver evaluation results

    Energy Technology Data Exchange (ETDEWEB)

    Byrne, R.H.

    1993-09-01

    A Sandia project currently uses an outdated Magnavox 6400 Global Positioning System (GPS) receiver as the core of its navigation system. The goal of this study was to analyze the performance of the current GPS receiver compared to newer, less expensive models and to make recommendations on how to improve the performance of the overall navigation system. This paper discusses the test methodology used to experimentally analyze the performance of different GPS receivers, the test results, and recommendations on how an upgrade should proceed. Appendices contain detailed information regarding the raw data, test hardware, and test software.

  12. Decoding algorithm for vortex communications receiver

    Science.gov (United States)

    Kupferman, Judy; Arnon, Shlomi

    2018-01-01

    Vortex light beams can provide a tremendous alphabet for encoding information. We derive a symbol decoding algorithm for a direct detection matrix detector vortex beam receiver using Laguerre Gauss (LG) modes, and develop a mathematical model of symbol error rate (SER) for this receiver. We compare SER as a function of signal to noise ratio (SNR) for our algorithm and for the Pearson correlation algorithm. To our knowledge, this is the first comprehensive treatment of a decoding algorithm of a matrix detector for an LG receiver.

  13. Exploiting Redundancy in an OFDM SDR Receiver

    Directory of Open Access Journals (Sweden)

    Tomas Palenik

    2009-01-01

    Full Text Available Common OFDM system contains redundancy necessary to mitigate interblock interference and allows computationally effective single-tap frequency domain equalization in receiver. Assuming the system implements an outer error correcting code and channel state information is available in the receiver, we show that it is possible to understand the cyclic prefix insertion as a weak inner ECC encoding and exploit the introduced redundancy to slightly improve error performance of such a system. In this paper, an easy way to implement modification to an existing SDR OFDM receiver is presented. This modification enables the utilization of prefix redundancy, while preserving full compatibility with existing OFDM-based communication standards.

  14. 29 CFR 1926.306 - Air receivers.

    Science.gov (United States)

    2010-07-01

    ... transportation vehicles such as steam railroad cars, electric railway cars, and automotive equipment. (2) New and... manholes therein are easily accessible. Under no circumstances shall an air receiver be buried underground...

  15. 29 CFR 1910.169 - Air receivers.

    Science.gov (United States)

    2010-07-01

    ... and equipment used on transportation vehicles such as steam railroad cars, electric railway cars, and... therein are easily accessible. Under no circumstances shall an air receiver be buried underground or...

  16. 47 CFR 32.1170 - Receivables.

    Science.gov (United States)

    2010-10-01

    ... FOR TELECOMMUNICATIONS COMPANIES Instructions for Balance Sheet Accounts § 32.1170 Receivables. (a... of interest accrued to the date of the balance sheet on bonds, notes, and other commercial paper...

  17. Optical Coherent Receiver Enables THz Wireless Bridge

    DEFF Research Database (Denmark)

    Yu, Xianbin; Liu, Kexin; Zhang, Hangkai

    2016-01-01

    We experimentally demonstrated a 45 Gbit/s 400 GHz photonic wireless communication system enabled by an optical coherent receiver, which has a high potential in fast recovery of high data rate connections, for example, in disaster....

  18. Storage rack for fuel cell receiving shrouds

    International Nuclear Information System (INIS)

    Mollon, L.

    1978-01-01

    Disclosed is a rack for receiving a multiplicity of vertical tubular shrouds or tubes for storing spent nuclear fuel cells. The rack comprises a plurality of horizontally reticulated frames interconnected by tension rods and spacing tubes surrounding the rods

  19. List of Nuclear Materials Licensing Actions Received

    Data.gov (United States)

    Nuclear Regulatory Commission — A catalog of all Materials Licensing Actions received for review. The catalog lists the name of the entity submitting the license application, their city and state,...

  20. Recipient bone marrow-derived stromal cells prolong graft survival in a rat hind limb allotransplantation model.

    Science.gov (United States)

    Ikeguchi, Ryosuke; Kakinoki, Ryosuke; Ohta, Souichi; Oda, Hiroki; Yurie, Hirofumi; Kaizawa, Yukitoshi; Mitsui, Hiroto; Aoyama, Tomoki; Toguchida, Junya; Matsuda, Shuichi

    2017-09-01

    Recent studies have indicated that bone marrow-derived stromal cells (BMSCs) have immunomodulatory properties that suppress the T cell responses that cause graft rejection. The purpose of this study is to evaluate the effect of recipient BMSCs intravenous infusion for immunomodulation in a rat vascularized composite allotransplantation model. A total of nine Wistar (WIS) rats and thirty Lewis (LEW) rats were used. BMSCs were harvested from three LEW rats. Twenty-four LEW rats were used as recipients and divided randomly into four groups: BMSC group, FK group, UT group, and Iso group. In the BMSC group, orthotopic rat hind limb transplantation was performed between WIS donor and LEW recipient rats. Recipient rats were injected intravenously with 2 × 10 6 recipient BMSCs on day 6, and with 0.2 mg/kg/day tacrolimus administered over 7 days (n = 6). In the FK group, recipient rats were treated with tacrolimus alone (n = 6). Rats in the UT group received no immunosuppressive treatment (n = 6). In the Iso group, transplantation was performed from three LEW donor rats to six LEW recipient rats without any immunosuppressive treatment (n = 6). Graft survival was assessed by daily inspection and histology. The immunological reactions of recipients were also evaluated. The graft survival of recipient rats in the BMSC group (24.5 days) was significantly prolonged in comparison with that of the FK group (18 days) (P Recipient rats in the BMSC group had significantly reduced serum IFN-γ cytokine levels (1.571 ± 0.779 pg/ml) in comparison with that of the FK group (7.059 ± 1.522 pg/ml) (P = .001). In in vitro study, BMSCs induce T cell hyporesponsiveness in a mixed lymphocyte reaction. BMSCs induce T cell hyporesponsiveness and prolong graft survival in the rat vascularized composite allotransplantation model. BMSCs exhibit immunomodulatory properties against acute rejection that can be realized without the need for significant recipient

  1. Single-Receiver GPS Phase Bias Resolution

    Science.gov (United States)

    Bertiger, William I.; Haines, Bruce J.; Weiss, Jan P.; Harvey, Nathaniel E.

    2010-01-01

    Existing software has been modified to yield the benefits of integer fixed double-differenced GPS-phased ambiguities when processing data from a single GPS receiver with no access to any other GPS receiver data. When the double-differenced combination of phase biases can be fixed reliably, a significant improvement in solution accuracy is obtained. This innovation uses a large global set of GPS receivers (40 to 80 receivers) to solve for the GPS satellite orbits and clocks (along with any other parameters). In this process, integer ambiguities are fixed and information on the ambiguity constraints is saved. For each GPS transmitter/receiver pair, the process saves the arc start and stop times, the wide-lane average value for the arc, the standard deviation of the wide lane, and the dual-frequency phase bias after bias fixing for the arc. The second step of the process uses the orbit and clock information, the bias information from the global solution, and only data from the single receiver to resolve double-differenced phase combinations. It is called "resolved" instead of "fixed" because constraints are introduced into the problem with a finite data weight to better account for possible errors. A receiver in orbit has much shorter continuous passes of data than a receiver fixed to the Earth. The method has parameters to account for this. In particular, differences in drifting wide-lane values must be handled differently. The first step of the process is automated, using two JPL software sets, Longarc and Gipsy-Oasis. The resulting orbit/clock and bias information files are posted on anonymous ftp for use by any licensed Gipsy-Oasis user. The second step is implemented in the Gipsy-Oasis executable, gd2p.pl, which automates the entire process, including fetching the information from anonymous ftp

  2. Flexible receiver adapter formal design review

    International Nuclear Information System (INIS)

    Krieg, S.A.

    1995-01-01

    This memo summarizes the results of the Formal (90%) Design Review process and meetings held to evaluate the design of the Flexible Receiver Adapters, support platforms, and associated equipment. The equipment is part of the Flexible Receiver System used to remove, transport, and store long length contaminated equipment and components from both the double and single-shell underground storage tanks at the 200 area tank farms

  3. Anatomy of a digital coherent receiver

    DEFF Research Database (Denmark)

    Borkowski, Robert; Zibar, Darko; Tafur Monroy, Idelfonso

    2014-01-01

    , orthonormaliation, chromatic dispersion compensation/nonlinear compensation, resampling a nd timing recovery, polarization demultiplexing and equalization, frequency and phase recovery, digital demodulation. We also describe novel subsystems of a digital coherent receiver: modulation format recognition......Digital coherent receivers have gained significant attention in the last decade. The reason for this is that coherent detection, along with digital signal processing (DSP) allows for substantial increase of the channel capacity by employing advanced detection techniques. In this paper, we first...

  4. Efficient receiver tuning using differential evolution strategies

    Science.gov (United States)

    Wheeler, Caleb H.; Toland, Trevor G.

    2016-08-01

    Differential evolution (DE) is a powerful and computationally inexpensive optimization strategy that can be used to search an entire parameter space or to converge quickly on a solution. The Kilopixel Array Pathfinder Project (KAPPa) is a heterodyne receiver system delivering 5 GHz of instantaneous bandwidth in the tuning range of 645-695 GHz. The fully automated KAPPa receiver test system finds optimal receiver tuning using performance feedback and DE. We present an adaptation of DE for use in rapid receiver characterization. The KAPPa DE algorithm is written in Python 2.7 and is fully integrated with the KAPPa instrument control, data processing, and visualization code. KAPPa develops the technologies needed to realize heterodyne focal plane arrays containing 1000 pixels. Finding optimal receiver tuning by investigating large parameter spaces is one of many challenges facing the characterization phase of KAPPa. This is a difficult task via by-hand techniques. Characterizing or tuning in an automated fashion without need for human intervention is desirable for future large scale arrays. While many optimization strategies exist, DE is ideal for time and performance constraints because it can be set to converge to a solution rapidly with minimal computational overhead. We discuss how DE is utilized in the KAPPa system and discuss its performance and look toward the future of 1000 pixel array receivers and consider how the KAPPa DE system might be applied.

  5. Metabolic differences of tacrolimus between patients with combined liver and kidney transplantation and patients with single liver or single kidney transplantation%他克莫司在肝肾联合移植患者与单纯肝移植及单纯肾移植患者之间代谢的差异

    Institute of Scientific and Technical Information of China (English)

    鲁燕侠; 邹德勇; 王新; 严莲珍

    2017-01-01

    目的 探讨他克莫司在不同器官移植受者间的代谢差异.方法 采用回顾性研究方法,选择武警总医院器官移植中心2002年1月至2012年8月收治的器官移植患者30例,分为肝肾联合移植(SLK)组、单纯肝移植组和单纯肾移植组,每组10例.SLK组与单纯肝移植组两组给药方案相同,术中均给予甲泼尼龙注射液,术后采用他克莫司+吗替麦考酚酯+泼尼松三联免疫抑制治疗方案.术后第1天给予他克莫司,初始剂量0.06 mg·kg-1·d-1,分2次服用,术后第3天开始检测他克莫司全血谷浓度;单纯肾移植组术后2~4 d给予他克莫司,初始剂量为0.15 mg·kg-1·d-1,分2次服用,服药3 d后开始监测他克莫司全血谷浓度.比较3组移植术后1个月内他克莫司的服药剂量和全血谷浓度.结果 术后1个月SLK组口服他克莫司剂量(μg·kg-1·d-1:74.78±32.65比80.62±24.02、85.58±16.78)及血药浓度监测值(μg/L:6.64±2.73比7.50±3.08、7.46±3.20)均低于单纯肝移植组和单纯肾移植组,但组间比较差异无统计学意义(均P>0.05).结论 SLK中移植肝对于移植肾的保护作用可能与术后时间有关.术后1个月内移植肝对于移植肾未显示出保护作用.%Objective To investigate the metabolic differences of Tacrolimus in different transplant recipients. Methods A retrospective study was conducted, 30 patients of the organ transplant admitted to organ transplantation center of General Hospital of Chinese People's Armed Police Forces from January 2002 to August 2012 were enrolled, and they were divided into combined liver and kidney transplant (SLK) group, single liver transplant group and single renal transplant group, 10 cases in each group. The SLK group and the simple liver transplantation group were given the same drug regimen, methylprednisolone injection was given during operation, and tacrolimus+ mycophenolate mofetil+ prednisone triple immunosuppressive therapy was taken after operation, on

  6. ASTRID© - Advanced Solar Tubular ReceIver Design: A powerful tool for receiver design and optimization

    Science.gov (United States)

    Frantz, Cathy; Fritsch, Andreas; Uhlig, Ralf

    2017-06-01

    In solar tower power plants the receiver is one of the critical components. It converts the solar radiation into heat and must withstand high heat flux densities and high daily or even hourly gradients (due to passage of clouds). For this reason, the challenge during receiver design is to find a reasonable compromise between receiver efficiency, reliability, lifetime and cost. There is a strong interaction between the heliostat field, the receiver and the heat transfer fluid. Therefore, a proper receiver design needs to consider these components within the receiver optimization. There are several design and optimization tools for receivers, but most of them focus only on the receiver, ignoring the heliostat field and other parts of the plant. During the last years DLR developed the ASTRIDcode for tubular receiver concept simulation. The code comprises both a high and a low-detail model. The low-detail model utilizes a number of simplifications which allow the user to screen a high number of receiver concepts for optimization purposes. The high-detail model uses a FE model and is able to compute local absorber and salt temperatures with high accuracy. One key strength of the ASTRIDcode is its interface to a ray tracing software which simulates a realistic heat flux distributions on the receiver surface. The results generated by the ASTRIDcode have been validated by CFD simulations and measurement data.

  7. 'Chaos' in superregenerative receivers

    Energy Technology Data Exchange (ETDEWEB)

    Commercon, Jean-Claude [INSA, Department d' Informatiques, Ba-hat t B. Pascal, 20 Avenue Albert Einsten, 69621 Villeurbaune (France)]. E-mail: jean-claude.commercon@insa-lyon.fr; Badard, Robert [INSA, Department d' Informatiques, Bat B. Pascal, 20 Avenue Albert Einsten, 69621 Villeurbaune (France)]. E-mail: robert.badard@insa-lyon.fr

    2005-02-01

    The superregenerative principle has been known since the early 1920s. The circuit is extremely simple and extremely sensitive. Today, superheterodyne receivers generally supplant superregenerative receivers in most applications because there are several undesirable characteristics: poor selectivity, reradiation, etc. Superregenerative receivers undergo a revival in recent papers for wireless systems, where low cost and very low power consumption are relevant: house/building meters (such as water, energy, gas counter), personal computer environment (keyboard, mouse), etc. Another drawback is the noise level which is higher than that of a well-designed superheterodyne receiver; without an antenna input signal, the output of the receiver hears in an earphone as a waterfall noise; this sound principally is the inherent input noise amplified and detected by the circuit; however, when the input noise is negligible with respect of an antenna input signal, we are faced to an other source of 'noise' self-generated by the superregenerative working. The main objective of this paper concerns this self-generated noise coming from an exponential growing followed by a re-injection process for which the final state is a function of the phase of the input signal.

  8. Dish/stirling hybrid-receiver

    Science.gov (United States)

    Mehos, Mark S.; Anselmo, Kenneth M.; Moreno, James B.; Andraka, Charles E.; Rawlinson, K. Scott; Corey, John; Bohn, Mark S.

    2002-01-01

    A hybrid high-temperature solar receiver is provided which comprises a solar heat-pipe-receiver including a front dome having a solar absorber surface for receiving concentrated solar energy, a heat pipe wick, a rear dome, a sidewall joining the front and the rear dome, and a vapor and a return liquid tube connecting to an engine, and a fossil fuel fired combustion system in radial integration with the sidewall for simultaneous operation with the solar heat pipe receiver, the combustion system comprising an air and fuel pre-mixer, an outer cooling jacket for tangentially introducing and cooling the mixture, a recuperator for preheating the mixture, a burner plenum having an inner and an outer wall, a porous cylindrical metal matrix burner firing radially inward facing a sodium vapor sink, the mixture ignited downstream of the matrix forming combustion products, an exhaust plenum, a fossil-fuel heat-input surface having an outer surface covered with a pin-fin array, the combustion products flowing through the array to give up additional heat to the receiver, and an inner surface covered with an extension of the heat-pipe wick, a pin-fin shroud sealed to the burner and exhaust plenums, an end seal, a flue-gas diversion tube and a flue-gas valve for use at off-design conditions to limit the temperature of the pre-heated air and fuel mixture, preventing pre-ignition.

  9. The Communication Between Designer and Design Receiver

    DEFF Research Database (Denmark)

    Dai, Zheng; Dai, Yan

    2009-01-01

    When people think about a product,the first impression always mainly influences the result.Product is the medium of communication between designer and designer receiver.Because both of them have varied different experience and background,the information would be biased during the transferring...... process.The common symbols which can be recognized by both of designer and receiver are the key tools for communication.In some case,the same symbol in one product would be leads to different receiver impression.Generally,impression includes 3 aspects:aesthetics,function, and emotion.Designer needs...... to create an attractive and accurate impression in product from these 3 aspects.For facing the dilemma of communication,some experimental approaches can help designer deal with unique and diversity situations.Solving the detail problem in each step could keep the original meaning of designer....

  10. The ARSQ: the athletes' received support questionnaire.

    Science.gov (United States)

    Freeman, Paul; Coffee, Pete; Moll, Tjerk; Rees, Tim; Sammy, Nadine

    2014-04-01

    To address calls for context-specific measurement of social support, this article reports the development of the Athletes' Received Support Questionnaire (ARSQ) and demonstrates initial evidence for its validity. Across four studies there was support for a four-dimensional structure reflecting emotional, esteem, informational, and tangible received support. There was also support for unidimensional and higher-order models. Further, Study 3 provided some support for convergent validity, with significant correlations between the corresponding dimensions of the ARSQ and the Inventory of Socially Supportive Behaviors. Study 4 provided evidence for the nomological validity of the ARSQ. Emotional and esteem support significantly predicted self-confidence and positive affect, and tangible support significantly moderated the relationship between stress and negative affect. Collectively, these results provide initial evidence for the validity of the ARSQ, and offer researchers flexibility to adopt either a multidimensional or aggregated approach to measuring received support.

  11. Precision Continuum Receivers for Astrophysical Applications

    Science.gov (United States)

    Wollack, Edward J.

    2011-01-01

    Cryogenically cooled HEMT (High Electron Mobility Transistor) amplifiers find widespread use in radioastronomy receivers. In recent years, these devices have also been commonly employed in broadband receivers for precision measurements of the Cosmic Microwave Background (CMB) radiation. In this setting, the combination of ultra-low-noise and low-spectral-resolution observations reinforce the importance achieving suitable control over the device environment to achieve fundamentally limited receiver performance. The influence of the intrinsic amplifier stability at low frequencies on data quality (e.g., achievable noise and residual temporal correlations), observational and calibration strategies, as well as architectural mitigation approaches in this setting will be discussed. The implications of device level 1/f fluctuations reported in the literature on system performance will be reviewed.

  12. Multistandard Receiver Design for Telemedicine Monitoring System

    Directory of Open Access Journals (Sweden)

    Hongmei Wang

    2018-01-01

    Full Text Available In short-distance wireless communications for telemedicine monitoring, different medical data measurement equipment has different wireless transmission modes. A multistandard receiver is designed that can adapt to different medical data measuring equipment. Using a second-order bandpass sampling for the design of antialiasing filters, two aliasing signals can be separated. Simultaneously, constraint conditions for sampling frequency are not as critical. The design is useful for a multistandard receiver in a telemedicine monitoring system and has the advantages such as saving spectrum resources and facilitating spectrum planning.

  13. Analog fourier transform channelizer and OFDM receiver

    OpenAIRE

    2007-01-01

    An OFDM receiver having an analog multiplier based I-Q channelizing filter, samples and holds consecutive analog I-Q samples of an I-Q baseband, the I-Q basebands having OFDM sub-channels. A lattice of analog I-Q multipliers and analog I-Q summers concurrently receives the held analog I-Q samples, performs analog I-Q multiplications and analog I-Q additions to concurrently generate a plurality of analog I-Q output signals, representing an N-point discrete Fourier transform of the held analog ...

  14. Building and Testing a Portable VLF Receiver

    Science.gov (United States)

    McLaughlin, Robert; Krause, L.

    2014-01-01

    Unwanted emissions or signal noise is a major problem for VLF radio receivers. These can occur from man made sources such as power line hum, which can be prevalent for many harmonics after the fundamental 50 or 60 Hz AC source or from VLF radio transmissions such as LORAN, used for navigation and communications. Natural emissions can also be detrimental to the quality of recordings as some of the more interesting natural emissions such as whistlers or auroral chorus may be drowned out by the more common sferic emissions. VLF receivers must selectively filter out unwanted emissions and amplify the filtered signal to a record-able level without degrading the quality.

  15. Billing and accounts receivable: fundamentals for improvement.

    Science.gov (United States)

    Bizon, M M

    1993-07-01

    If a healthcare facility's accounts receivable operation is experiencing problems, the patient accounts manager should survey all areas of his or her responsibility to determine the best method of resolving the difficulties. One effective technique to reduce billing problems is to take a proactive--not reactive--approach. If mistakes can be corrected before they get out of control, and if the patient accounts manager can ensure that claims will not be denied, a healthcare facility's accounts receivable should remain in good condition.

  16. Improved timing recovery in wireless mobile receivers

    CSIR Research Space (South Africa)

    Olwal, TO

    2007-06-01

    Full Text Available are transmitted to the receiver. In the proposed method, the receiver exploits the soft decisions computed at each turbo decoding iteration to provide reliable estimates of a soft timing signal, which in turn, improves the decoding time. The derived method... as ( ) ( )( )1 2 1 2, ,..., , ,...,Q Qk k k k k k k k ka a x x x P a x x xη∗ ∗∈Β= ∑ (29) where ( )1 2, ,..., Qk k kx x x are the Q coded bits in a multilevel symbol modulation scheme [32]. According to [29], the soft information demapper computes posteriori...

  17. Measuring Balance Across Multiple Radar Receiver Channels.

    Energy Technology Data Exchange (ETDEWEB)

    Doerry, Armin W.; Bickel, Douglas L.

    2018-03-01

    When radar receivers employ multiple channels, the general intent is for the receive channels to be as alike as possible, if not as ideal as possible. This is usually done via prudent hardware design, supplemented by system calibration. Towards this end, we require a quality metric for ascertaining the goodness of a radar channel, and the degree of match to sibling channels. We propose a relevant and useable metric to do just that. Acknowledgements This report was the result of an unfunded research and development activity.

  18. Richard W. Ziolkowski Receives Honorary Doctorate

    DEFF Research Database (Denmark)

    Breinbjerg, Olav

    2012-01-01

    At the annual Commemoration of the Technical University of Denmark (DTU) on April 27, 2012, Prof. Richard W. Ziolkowski, University of Arizona (UoA), received DTU's highest academic degree, the Honorary Doctor degree: Doctor Technices Honoris Causa (Figure 1). Prof. Ziolkowski has been a close...

  19. Howard Feiertag receives hospitality industry award

    OpenAIRE

    Ho, Sookhan

    2004-01-01

    Howard Feiertag, of Blacksburg, an instructor in hospitality and tourism management at Virginia Tech's Pamplin College of Business, received the inaugural Excellence in Sales and Marketing Strategy Award at the Hospitality Sales and Marketing Association/New York University Strategy Conference in New York recently.

  20. 7 CFR 966.124 - Approved receiver.

    Science.gov (United States)

    2010-01-01

    ... limited to, the following information: (1) Name, address, contact person, telephone number, and e-mail... 7 Agriculture 8 2010-01-01 2010-01-01 false Approved receiver. 966.124 Section 966.124 Agriculture Regulations of the Department of Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Marketing Agreements...

  1. Optimization of Passive Coherent Receiver System Placement

    Science.gov (United States)

    2013-09-01

    spheroid object with a constant radar cross section (RCS). Additionally, the receiver and transmitters are assumed to be notional isotropic antennae...software- defined radio for equatorial plasma instability studies,” Radio Science, vol. 48, pp. 1–11. Aug. 2013. [2] P. C. Zhang and B. Y. Li, “Passive

  2. A 24GHz Radar Receiver in CMOS

    NARCIS (Netherlands)

    Kwok, K.C.

    2015-01-01

    This thesis investigates the system design and circuit implementation of a 24GHz-band short-range radar receiver in CMOS technology. The propagation and penetration properties of EM wave offer the possibility of non-contact based remote sensing and through-the-wall imaging of distance stationary or

  3. 8. Prevalence of Epistaxis among Patients Receiving ...

    African Journals Online (AJOL)

    user

    The aim of this study was thus to determine the prevalence, aetiology and treatment modalities of epistaxis among patients receiving otorhinolaryngology services at MNH and MOI. Materials and Methods: A cross-sectional, hospital based study was done to 427 patients at Muhimbili. National Hospital (MNH) and Muhimbili.

  4. Receiving Assistance and Local Food System Participation

    Directory of Open Access Journals (Sweden)

    Rebecca L. Som Castellano

    2017-02-01

    Full Text Available A body of literature has noted that local food systems (LFSs may not involve active participation by individuals with lower incomes. This is, in part, a function of racial and class hegemony, as well as physical and financial accessibility of LFSs. LFS institutions, such as farmers’ markets, have been working to facilitate receipt of food assistance programs, such as the Supplemental Nutrition Assistance Program (SNAP. Charitable assistance programs, such as food banks, have also been actively working to engage in LFSs, for example, by making local foods available. However, little research has explored the role that receiving public or charitable assistance can play in influencing LFS participation. In this article, I utilize quantitative and qualitative data collected from across the state of Ohio to examine the relationship between receiving assistance and LFS participation for women, who remain predominately responsible for food provisioning in the U.S., including among those who participate in LFSs. Quantitative results suggest that receiving assistance can increase participation in LFSs. Qualitative data provides more nuanced information about the importance of food assistance for women who want to participate in LFSs, and suggest that it is essential that food cooperatives and farmers’ markets are equipped to receive food assistance programs, such as SNAP, in order for women with lower incomes to participate in LFSs.

  5. Reasons Parents Exempt Children from Receiving Immunizations

    Science.gov (United States)

    Luthy, Karlen E.; Beckstrand, Renea L.; Callister, Lynn C.; Cahoon, Spencer

    2012-01-01

    School nurses are on the front lines of educational efforts to promote childhood vaccinations. However, some parents still choose to exempt their children from receiving vaccinations for personal reasons. Studying the beliefs of parents who exempt vaccinations allows health care workers, including school nurses, to better understand parental…

  6. Social effects of migration in receiving countries.

    Science.gov (United States)

    Ohndorf, W

    1989-06-01

    This paper examines the impact of post-1945 migration into Western, Middle, and Northern Europe from Southern Europe, Turkey, and Northern Africa, and migration to the traditional immigration countries by Asian and Latin American immigrants, on the social structures of receiving countries. Between 1955 and 1974, 1) traditional migration to the US and Australia became less important for European countries while traditional receiving countries accepted many immigrants from developing countries; and 2) rapid economic revival in Western and Northern Europe caused a considerable labor shortage which was filled by migrant workers especially from Southern Europe, Turkey, and Northern Africa, who stayed only until they reached their economic goals. Since 1974, job vacancies have declined and unemployment has soared. This employment crisis caused some migrants 1) to return to their countries of origin, 2) to bring the rest of their families to the receiving country, or 3) to lengthen their stay considerably. The number of refugees has also significantly increased since the mid-970s, as has the number of illegal migrants. After the mid-1970s, Europe began to experience integration problems. The different aspects of the impact of migration on social structures include 1) improvement of the housing situation for foreigners, 2) teaching migrants the language of the receiving country, 3) solving the unemployment problem of unskilled migrants, 4) improvement of educational and vocational qualifications of 2nd generation migrants, 5) development of programs to help unemployed wives of migrants to learn the language and meet indigenous women, 6) encouraging migrants to maintain their cultural identity and assisting them with reintegration if they return to their original country, 7) coping with the problems of refugees, and 8) solving the problems of illegal migration. Almost all receiving countries now severely restrict further immigration. [Those policies should result in

  7. CERN Press Office receives award from Euroscience

    CERN Multimedia

    2009-01-01

    The CERN Communication group has received an award for its efforts in communicating the LHC first beam to the media and the public. James Gillies, head of the Communication group was presented the AlphaGalileo Research Public Relations Award on Wednesday, 14 October during the Euroscience Media Award Ceremony in Hannover. "It’s great to receive this recognition," said Gillies. "Of course, we had great material to work with: the LHC is a fantastic story and one that is going to get even better. Angels, Demons and black holes also had their roles to play, but behind the media interest there’s been a lot of hard work by my team. This is for them." The CERN Communication group also works with communication professionals in all the CERN Member States and major physics labs around the world through the European Particle Physics Communication Network, and the InterAction collaboration. "Without them," says Gillies, &am...

  8. Nutritional survey of neoplasm patients receiving radiotherapy

    International Nuclear Information System (INIS)

    Li Xinli; Zhu Shengtao

    2001-01-01

    Objective: In order to know the nutriture of neoplasm patients receiving radiotherapy and give nutritional guidance properly, the authors make the following survey. Methods: A dietary survey of twenty-four-hour retrospective method was used; The patients' activity was recorded and their twenty-four hours caloric consumption was calculated. Results: Of all the patients, the intake of protein is more than recommended, percentage of calorific proportion is about 15%-19% of gross caloric. A larger portion of patients' caloric intake, especially female patients, is lower than caloric consumption. Among all the patients, the intake of vegetables is not enough; The consumption of milk and milky products is lower; it is common and serious that neoplasm patients receiving radiotherapy have vitamine and mineral's scarcity. Conclusions: Nutriture of neoplasm patients is not optimistic, it is imperative to improve their nutriture

  9. Graphene radio frequency receiver integrated circuit.

    Science.gov (United States)

    Han, Shu-Jen; Garcia, Alberto Valdes; Oida, Satoshi; Jenkins, Keith A; Haensch, Wilfried

    2014-01-01

    Graphene has attracted much interest as a future channel material in radio frequency electronics because of its superior electrical properties. Fabrication of a graphene integrated circuit without significantly degrading transistor performance has proven to be challenging, posing one of the major bottlenecks to compete with existing technologies. Here we present a fabrication method fully preserving graphene transistor quality, demonstrated with the implementation of a high-performance three-stage graphene integrated circuit. The circuit operates as a radio frequency receiver performing signal amplification, filtering and downconversion mixing. All circuit components are integrated into 0.6 mm(2) area and fabricated on 200 mm silicon wafers, showing the unprecedented graphene circuit complexity and silicon complementary metal-oxide-semiconductor process compatibility. The demonstrated circuit performance allow us to use graphene integrated circuit to perform practical wireless communication functions, receiving and restoring digital text transmitted on a 4.3-GHz carrier signal.

  10. Hypersensitivity reactions in patients receiving hemodialysis.

    Science.gov (United States)

    Butani, Lavjay; Calogiuri, Gianfranco

    2017-06-01

    To describe hypersensitivity reactions in patients receiving maintenance hemodialysis. PubMed search of articles published during the past 30 years with an emphasis on publications in the past decade. Case reports and review articles describing hypersensitivity reactions in the context of hemodialysis. Pharmacologic agents are the most common identifiable cause of hypersensitivity reactions in patients receiving hemodialysis. These include iron, erythropoietin, and heparin, which can cause anaphylactic or pseudoallergic reactions, and topical antibiotics and anesthetics, which lead to delayed-type hypersensitivity reactions. Many hypersensitivity reactions are triggered by complement activation and increased bradykinin resulting from contact system activation, especially in the context of angiotensin-converting enzyme inhibitor use. Several alternative pharmacologic preparations and dialyzer membranes are available, such that once an etiology for the reaction is established, recurrences can be prevented without affecting the quality of care provided to patients. Although hypersensitivity reactions are uncommon in patients receiving hemodialysis, they can be life-threatening. Moreover, considering the large prevalence of the end-stage renal disease population, the implications of such reactions are enormous. Most reactions are pseudoallergic and not mediated by immunoglobulin E. The multiplicity of potential exposures and the complexity of the environment to which patients on dialysis are exposed make it challenging to identify the precise cause of these reactions. Great diligence is needed to investigate hypersensitivity reactions to avoid recurrence in this high-risk population. Copyright © 2017 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  11. TDRSS S-shuttle unique receiver equipment

    Science.gov (United States)

    Weinberg, A.; Schwartz, J. J.; Spearing, R.

    1985-01-01

    Beginning with STS-9, the Tracking and Date Relay Satellite system (TDRSS) will start providing S- and Ku-band communications and tracking support to the Space Shuttle and its payloads. The most significant element of this support takes place at the TDRSS White Sands Ground Terminal, which processes the Shuttle return link S- and Ku-band signals. While Ku-band hardware available to other TDRSS users is also applied to Ku-Shuttle, stringent S-Shuttle link margins have precluded the application of the standard TDRSS S-band processing equipment to S-Shuttle. It was therfore found necessary to develop a unique S-Shuttle Receiver that embodies state-of-the-art digital technology and processing techniques. This receiver, developed by Motorola, Inc., enhances link margins by 1.5 dB relative to the standard S-band equipment and its bit error rate performance is within a few tenths of a dB of theory. An overview description of the Space Shuttle Receiver Equipment (SSRE) is presented which includes the presentation of block diagrams and salient design features. Selected, measured performance results are also presented.

  12. A Decentralized Receiver in Gaussian Interference

    Directory of Open Access Journals (Sweden)

    Christian D. Chapman

    2018-04-01

    Full Text Available Bounds are developed on the maximum communications rate between a transmitter and a fusion node aided by a cluster of distributed receivers with limited resources for cooperation, all in the presence of an additive Gaussian interferer. The receivers cannot communicate with one another and can only convey processed versions of their observations to the fusion center through a Local Array Network (LAN with limited total throughput. The effectiveness of each bound’s approach for mitigating a strong interferer is assessed over a wide range of channels. It is seen that, if resources are shared effectively, even a simple quantize-and-forward strategy can mitigate an interferer 20 dB stronger than the signal in a diverse range of spatially Ricean channels. Monte-Carlo experiments for the bounds reveal that, while achievable rates are stable when varying the receiver’s observed scattered-path to line-of-sight signal power, the receivers must adapt how they share resources in response to this change. The bounds analyzed are proven to be achievable and are seen to be tight with capacity when LAN resources are either ample or limited.

  13. Multifunction waveform generator for EM receiver testing

    Science.gov (United States)

    Chen, Kai; Jin, Sheng; Deng, Ming

    2018-01-01

    In many electromagnetic (EM) methods - such as magnetotelluric, spectral-induced polarization (SIP), time-domain-induced polarization (TDIP), and controlled-source audio magnetotelluric (CSAMT) methods - it is important to evaluate and test the EM receivers during their development stage. To assess the performance of the developed EM receivers, controlled synthetic data that simulate the observed signals in different modes are required. In CSAMT and SIP mode testing, the waveform generator should use the GPS time as the reference for repeating schedule. Based on our testing, the frequency range, frequency precision, and time synchronization of the currently available function waveform generators on the market are deficient. This paper presents a multifunction waveform generator with three waveforms: (1) a wideband, low-noise electromagnetic field signal to be used for magnetotelluric, audio-magnetotelluric, and long-period magnetotelluric studies; (2) a repeating frequency sweep square waveform for CSAMT and SIP studies; and (3) a positive-zero-negative-zero signal that contains primary and secondary fields for TDIP studies. In this paper, we provide the principles of the above three waveforms along with a hardware design for the generator. Furthermore, testing of the EM receiver was conducted with the waveform generator, and the results of the experiment were compared with those calculated from the simulation and theory in the frequency band of interest.

  14. Russian institute receives CMS Gold Award

    CERN Multimedia

    Patrice Loïez

    2003-01-01

    The Snezhinsk All-Russian Institute of Scientific Research for Technical Physics (VNIITF) of the Russian Federal Nuclear Centre (RFNC) is one of twelve CMS suppliers to receive awards for outstanding performance this year. The CMS Collaboration took the opportunity of the visit to CERN of the Director of VNIITF and his deputy to present the CMS Gold Award, which the institute has received for its exceptional performance in the assembly of steel plates for the CMS forward hadronic calorimeter. This calorimeter consists of two sets of 18 wedge-shaped modules arranged concentrically around the beam-pipe at each end of the CMS detector. Each module consists of steel absorber plates with quartz fibres inserted into them. The institute developed a special welding technique to assemble the absorber plates, enabling a high-quality detector to be produced at relatively low cost.RFNC-VNIITF Director Professor Georgy Rykovanov (right), is seen here receiving the Gold Award from Felicitas Pauss, Vice-Chairman of the CMS ...

  15. Submillimeter heterodyne receiver for the CSO telescope

    International Nuclear Information System (INIS)

    Gulkis, S.

    1988-01-01

    This task is to build a cryogenically cooled 620 to 700 GHz astronomical receiver that will be used as a facility instrument at the CalTech Submillimeter Observatory (CSO) on Mauna Kea, Hawaii. The receiver will have applications as a very high resolution spectrometer to investigate spectral lines in planetary and satellite atmospheres, and comets. The receiver will also be used to make continuum measurements of planets, satellites, and asteroids. During FY88, a scale model (200 GHz) SIS mixer radiometer was built and intrgrated into a cryostat designed for use on the CSO telescope. This system will serve as a model to guide the work on the higher frequency mixer. A solid state local oscillator source that covers two bands in the 600 to 700 GHz has been developed under contract JPL and will be delivered before the end of the year. Work has continued on the SIS materials needed for the 620 to 700 GHz mixer. Test hardware has been developed which allow the 1 to 5 curves for SIS material to be easily measured

  16. Towards Self-Clocked Gated OCDMA Receiver

    Science.gov (United States)

    Idris, S.; Osadola, T.; Glesk, I.

    2013-02-01

    A novel incoherent OCDMA receiver with incorporated all-optical clock recovery for self-synchronization of a time gate for the multi access interferences (MAI) suppression and minimizing the effect of data time jitter in incoherent OCDMA system was successfully developed and demonstrated. The solution was implemented and tested in a multiuser environment in an out of the laboratory OCDMA testbed with two-dimensional wavelength-hopping time-spreading coding scheme and OC-48 (2.5 Gbp/s) data rate. The self-clocked all-optical time gate uses SOA-based fibre ring laser optical clock, recovered all-optically from the received OCDMA traffic to control its switching window for cleaning the autocorrelation peak from the surrounding MAI. A wider eye opening was achieved when the all-optically recovered clock from received data was used for synchronization if compared to a static approach with the RF clock being generated by a RF synthesizer. Clean eye diagram was also achieved when recovered clock is used to drive time gating.

  17. Ground receiving station (GRS) of UMS - receiving and processing the electromagnetic wave data from satellite

    International Nuclear Information System (INIS)

    Mohammad Syahmi Nordin; Fauziah Abdul Aziz

    2007-01-01

    The low resolution Automatic Picture Transmission (APT) data from the National Oceanic and Atmospheric Administration (NOAA) polar-orbiting satellites Advanced Very High Resolution Radiometer (AVHRR) is being received and recorded in real-time mode at ground receiving station in School of Science and Technology, Universiti Malaysia Sabah. The system is suitable for the developing and undeveloped countries in south and Southeast Asia and is said to be acceptable for engineering, agricultural, climatological and environmental applications. The system comprises a personal computer attached with a small APT receiver. The data transmission between the ground receiving station and NOAA satellites is using the electromagnetic wave. The relation for receiving and processing the electromagnetic wave in the transmission will be discussed. (Author)

  18. Superconducting Submm Integrated Receiver for TELIS

    Energy Technology Data Exchange (ETDEWEB)

    Koshelets, V P [Institute of Radio Engineering and Electronics (IREE) (Russian Federation); Ermakov, A B [Institute of Radio Engineering and Electronics (IREE) (Russian Federation); Filippenko, L V [Institute of Radio Engineering and Electronics (IREE) (Russian Federation); Koryukin, O V [Institute of Radio Engineering and Electronics (IREE) (Russian Federation); Khudchenko, A V [Institute of Radio Engineering and Electronics (IREE) (Russian Federation); Sobolev, A S [Institute of Radio Engineering and Electronics (IREE) (Russian Federation); Torgashin, M Yu [Institute of Radio Engineering and Electronics (IREE) (Russian Federation); Yagoubov, P A [SRON National Institute for Space Research (Netherlands); Hoogeveen, R W M [SRON National Institute for Space Research (Netherlands); Vreeling, W J [SRON National Institute for Space Research (Netherlands); Wild, W [SRON National Institute for Space Research (Netherlands); Pylypenko, O M [State Research Center of Superconducting Electronics ' Iceberg' (Ukraine)

    2006-06-01

    In this report we present design and first experimental results for development of the submm superconducting integrated receiver spectrometer for Terahertz Limb Sounder (TELIS). TELIS is a collaborative European project to build up a three-channel heterodyne balloon-based spectrometer for measuring a variety of atmospheric constituents of the stratosphere. The 550 - 650 GHz channel of TELIS is based on a phase-locked Superconducting Integrated Receiver (SIR). SIR is an on-chip combination of a low-noise Superconductor-Insulator-Superconductor (SIS) mixer with quasioptical antenna, a superconducting Flux Flow Oscillator (FFO) acting as Local Oscillator (LO), and SIS harmonic mixer (HM) for FFO phase locking. A number of new solutions were implemented in the new generation of SIR chips. To achieve the wide-band performance of the spectrometer, a side-feed twin-SIS mixer and balanced SIS mixer with 0.8 {mu}m{sup 2} junctions integrated with a double-dipole (or double-slot) antenna is used. An improved design of the FFO for TELIS has been developed and optimized providing a free-running linewidth between 10 and 2 MHz in the frequency range 500 - 700 GHz. It is important to ensure that tuning of a phase-locked (PL) SIR can be performed remotely by telecommand. For this purpose a number of approaches for the PL SIR automatic computer control have been developed. All receiver components (including input optical elements and Martin-Puplett polarization rotating interferometer for single side band operation) will be mounted on a single 4.2 K plate inside a 40 x 180 x 80 mm{sup 3} box. First measurements give an uncorrected double side band (DSB) noise temperature below 250 K measured with the phase-locked FFO; more detailed results are presented at the conference.

  19. Superconducting Submm Integrated Receiver for TELIS

    International Nuclear Information System (INIS)

    Koshelets, V P; Ermakov, A B; Filippenko, L V; Koryukin, O V; Khudchenko, A V; Sobolev, A S; Torgashin, M Yu; Yagoubov, P A; Hoogeveen, R W M; Vreeling, W J; Wild, W; Pylypenko, O M

    2006-01-01

    In this report we present design and first experimental results for development of the submm superconducting integrated receiver spectrometer for Terahertz Limb Sounder (TELIS). TELIS is a collaborative European project to build up a three-channel heterodyne balloon-based spectrometer for measuring a variety of atmospheric constituents of the stratosphere. The 550 - 650 GHz channel of TELIS is based on a phase-locked Superconducting Integrated Receiver (SIR). SIR is an on-chip combination of a low-noise Superconductor-Insulator-Superconductor (SIS) mixer with quasioptical antenna, a superconducting Flux Flow Oscillator (FFO) acting as Local Oscillator (LO), and SIS harmonic mixer (HM) for FFO phase locking. A number of new solutions were implemented in the new generation of SIR chips. To achieve the wide-band performance of the spectrometer, a side-feed twin-SIS mixer and balanced SIS mixer with 0.8 μm 2 junctions integrated with a double-dipole (or double-slot) antenna is used. An improved design of the FFO for TELIS has been developed and optimized providing a free-running linewidth between 10 and 2 MHz in the frequency range 500 - 700 GHz. It is important to ensure that tuning of a phase-locked (PL) SIR can be performed remotely by telecommand. For this purpose a number of approaches for the PL SIR automatic computer control have been developed. All receiver components (including input optical elements and Martin-Puplett polarization rotating interferometer for single side band operation) will be mounted on a single 4.2 K plate inside a 40 x 180 x 80 mm 3 box. First measurements give an uncorrected double side band (DSB) noise temperature below 250 K measured with the phase-locked FFO; more detailed results are presented at the conference

  20. Compressed Sensing-Based Direct Conversion Receiver

    DEFF Research Database (Denmark)

    Pierzchlewski, Jacek; Arildsen, Thomas; Larsen, Torben

    2012-01-01

    Due to the continuously increasing computational power of modern data receivers it is possible to move more and more processing from the analog to the digital domain. This paper presents a compressed sensing approach to relaxing the analog filtering requirements prior to the ADCs in a direct......-converted radio signals. As shown in an experiment presented in the article, when the proposed method is used, it is possible to relax the requirements for the quadrature down-converter filters. A random sampling device and an additional digital signal processing module is the price to pay for these relaxed...

  1. Radiation Doses Received by the Irish Population

    International Nuclear Information System (INIS)

    Colgan, P.A.; Organo, C.; Hone, C.; Fenton, D.

    2008-05-01

    Some chemical elements present in the environment since the Earth was formed are naturally radioactive and exposure to these sources of radiation cannot be avoided. There have also been additions to this natural inventory from artificial sources of radiation that did not exist before the 1940s. Other sources of radiation exposure include cosmic radiation from outer space and the use of radiation in medical diagnosis and treatment. There can be large variability in the dose received by invividual members of the population from any given source. Some sources of radiation expose every member of the population while, in other cases, only selected individuals may be exposed. For example, natural radioactivity is found in all soils and therefore everybody receives some radiation dose from this activity. On the other hand, in the case of medical exposures, only those who undergo a medical procedure using radiation will receive a radiation dose. The Radiological Protection Institute of Ireland (RPII) has undertaken a comprehensive review of the relevant data on radiation exposure in Ireland. Where no national data have been identified, the RPII has either undertaken its own research or has referred to the international literature to provide a best estimate of what the exposure in Ireland might be. This has allowed the relative contribution of each source to be quantified. This new evaluation is the most up-to-date assessment of radiation exposure and updates the assessment previously reported in 2004. The dose quoted for each source is the annual 'per caput' dose calculated on the basis of the most recently available data. This is an average value calculated by adding the doses received by each individual exposed to a given radiation source and dividing the total by the current population of 4.24 million. All figures have been rounded, consistent with the accuracy of the data. In line with accepted international practice, where exposure takes place both indoors and

  2. Dynamic Quantification of Host Schwann Cell Migration into Peripheral Nerve Allografts

    Science.gov (United States)

    Whitlock, Elizabeth L.; Myckatyn, Terence M.; Tong, Alice Y.; Yee, Andrew; Yan, Ying; Magill, Christina K.; Johnson, Philip J.; Mackinnon, Susan E.

    2010-01-01

    Host Schwann cell (SC) migration into nerve allografts is the limiting factor in the duration of immunosuppression following peripheral nerve allotransplantation, and may be affected by different immunosuppressive regimens. Our objective was to compare SC migration patterns between clinical and experimental immunosuppression regimens both over time and at the harvest endpoint. Eighty mice that express GFP under the control of the Schwann cell specific S100 promoter were engrafted with allogeneic, nonfluorescent sciatic nerve grafts. Mice received immunosuppression with either tacrolimus (FK506), or experimental T-cell triple costimulation blockade (CSB), consisting of CTLA4-immunoglobulin fusion protein, anti-CD40 monoclonal antibody, and anti-inducible costimulator monoclonal antibody. Migration of GFP-expressing host SCs into wild-type allografts was assessed in vivo every 3 weeks until 15 weeks postoperatively, and explanted allografts were evaluated for immunohistochemical staining patterns to differentiate graft from host SCs. Immunosuppression with tacrolimus exhibited a plateau of SC migration, characterized by significant early migration (< 3 weeks) followed by a constant level of host SCs in the graft (15 weeks). At the endpoint, graft fluorescence was decreased relative to surrounding host nerve, and donor SCs persisted within the graft. CSB-treated mice displayed gradually increasing migration of host SCs into the graft, without the plateau noted in tacrolimus-treated mice, and also maintained a population of donor SCs at the 15-week endpoint. SC migration patterns are affected by immunosuppressant choice, particularly in the immediate postoperative period, and the use of a single treatment of CSB may allow for gradual population of nerve allografts with host SCs. PMID:20633557

  3. Superconductor Digital-RF Receiver Systems

    Science.gov (United States)

    Mukhanov, Oleg A.; Kirichenko, Dmitri; Vernik, Igor V.; Filippov, Timur V.; Kirichenko, Alexander; Webber, Robert; Dotsenko, Vladimir; Talalaevskii, Andrei; Tang, Jia Cao; Sahu, Anubhav; Shevchenko, Pavel; Miller, Robert; Kaplan, Steven B.; Sarwana, Saad; Gupta, Deepnarayan

    Digital superconductor electronics has been experiencing rapid maturation with the emergence of smaller-scale, lower-cost communications applications which became the major technology drivers. These applications are primarily in the area of wireless communications, radar, and surveillance as well as in imaging and sensor systems. In these areas, the fundamental advantages of superconductivity translate into system benefits through novel Digital-RF architectures with direct digitization of wide band, high frequency radio frequency (RF) signals. At the same time the availability of relatively small 4K cryocoolers has lowered the foremost market barrier for cryogenically-cooled digital electronic systems. Recently, we have achieved a major breakthrough in the development, demonstration, and successful delivery of the cryocooled superconductor digital-RF receivers directly digitizing signals in a broad range from kilohertz to gigahertz. These essentially hybrid-technology systems combine a variety of superconductor and semiconductor technologies packaged with two-stage commercial cryocoolers: cryogenic Nb mixed-signal and digital circuits based on Rapid Single Flux Quantum (RSFQ) technology, room-temperature amplifiers, FPGA processing and control circuitry. The demonstrated cryocooled digital-RF systems are the world's first and fastest directly digitizing receivers operating with live satellite signals in X-band and performing signal acquisition in HF to L-band at ˜30GHz clock frequencies.

  4. Eosinophils increase in animals that received biotherapic

    Directory of Open Access Journals (Sweden)

    Pedro Gilberto Silva Morais

    2012-12-01

    Full Text Available Dairy industry is an important Brazilian economic activity participating of income generation. European breeds cattle aren’t adapted to parasites found in the tropics, like the Rhipicephalus microplus tick. Parasites can acquire resistance to allopathic products, but not to homeopathic products. We evaluate the efficacy of an antiparasiticide biotherapic against the R. microplus tick. The biotherapic was prepared according to the homeopathic pharmacopoeia recommendations from vegetable (Abrotanum and animal products (Rhipicephalus microplus, Amblyomma cajenennense, Haematobia irritans, Musca domestica, Dermatobia hominis, all diluted and vigorous shaken (dynamized in water or alcohol at a ratio of 1:99, in the 12th Centesimal Hahnemann (CH12, with limestone as the carrier. This homeophatic product found in veterinary pharmacies of Ituiutaba’s region, Minas Gerais State, is registered at Ministério da Agricultura, Pecuária e Abastecimento (MAPA. Natural tick infestation was accessed in thirty Girolando (Gir x Holstein cows with 7 to 13 year-old, by monthly counting of tick female bigger than 6 mm, from October/2009 to July/2011. Cows were divided in three groups of 10 similar animals. The treated group (T1 received roughage, concentrate and biotherapic. The placebo group (T2 received roughage, concentrate and limestone and the control group (T3 received only roughage and concentrate. T1 and T2 groups were managed together and remained in the same paddock. T3 group was separed from T1 and T2 by a wire fence. From October 2009 to September 2010 blood cell counts and serum biochemical tests were performed monthly only in T1 and T2, but visual clinical observations were made in all animals. Any group was treated with acaricide when the count’s average reached 50 or more ticks. It was necessary 7 baths with acaricide in T1 and T2, while in T3 group (control group it was necessary 19 acaricide baths to control the cattle tick. We verified

  5. Radioactive contamination in monitors received for calibration

    International Nuclear Information System (INIS)

    Dias, Paulo S.; Santos, Gilvan C. dos; Brunelo, Maria Antonieta G.; Paula, Tiago C. de; Pires, Marina A.; Borges, Jose C.

    2013-01-01

    The Calibration Laboratory - LABCAL, from the Research Center for Metrology and Testing - METROBRAS, MRA Comercio de Instrumentos Eletronicos Ltda., began activities in October 2008 and, in August 2009, decided to establish a procedure for monitoring tests, external and internal, of all packages received from customers, containing instruments for calibration. The aim was to investigate possible contamination radioactive on these instruments. On July 2011, this procedure was extended to packagings of personal thermoluminescent dosemeters - TLD, received by the newly created Laboratory Laboratorio de Dosimetria Pessoal - LDP . In the monitoring procedure were used monitors with external probe, type pancake, MRA brand, models GP - 500 and MIR 7028. During the 37 months in which this investigation was conducted, were detected 42 cases of radioactive contamination, with the following characteristics: 1) just one case was personal dosimeter, TLD type; 2) just one case was not from a packing from nuclear medicine service - was from a mining company; 3) contamination occurred on packs and instruments, located and/or widespread; 4) contamination values ranged from slightly above the level of background radiation to about a thousand fold. Although METROBRAS has facilities for decontamination, in most cases, especially those of higher contamination, the procedure followed was to store the contaminated material in a room used for storage of radioactive sources. Periodically, each package and/or instrument was monitored, being released when the radiation level matched the background radiation. Every contamination detected, the client and/or owner of the instrument was informed. The Brazilian National Energy Commission - CNEN, was informed, during your public consultation for reviewing the standard for nuclear medicine services, held in mid-2012, having received from METROBRAS the statistical data available at the time. The high frequency of contamination detected and the high

  6. Signal Processing for Improved Wireless Receiver Performance

    DEFF Research Database (Denmark)

    Christensen, Lars P.B.

    2007-01-01

    This thesis is concerned with signal processing for improving the performance of wireless communication receivers for well-established cellular networks such as the GSM/EDGE and WCDMA/HSPA systems. The goal of doing so, is to improve the end-user experience and/or provide a higher system capacity...... by allowing an increased reuse of network resources. To achieve this goal, one must first understand the nature of the problem and an introduction is therefore provided. In addition, the concept of graph-based models and approximations for wireless communications is introduced along with various Belief...... Propagation (BP) methods for detecting the transmitted information, including the Turbo principle. Having established a framework for the research, various approximate detection schemes are discussed. First, the general form of linear detection is presented and it is argued that this may be preferable...

  7. The BINP receives its Golden Hadron award

    CERN Multimedia

    2002-01-01

    On Thursday, 14 September, the LHC Project Leader, Lyn Evans, handed over a Golden Hadron award to Alexander Skrinsky of Russia's Budker Institute of Nuclear Physics (BINP). The prize is awarded in recognition of exceptional performances by suppliers and this year prizes were awarded to two firms, Cockerill-Sambre (Belgium) and Wah-Chang (United States), and to the Budker Institute, which was unable to receive the award at the same time as the two other recipients (see Bulletin No 34/2002, of 19 August 2002). The Russian institute has been rewarded for the particularly high-quality production of 360 dipole magnets and 185 quadrupole magnets for the LHC proton beam transfer lines.

  8. Humboldt SK pilot biodigester receives funding

    Energy Technology Data Exchange (ETDEWEB)

    Anon.

    2005-09-30

    The Canada-Saskatchewan Western Economic Partnership Agreement (WEPA) will provide funding for Canada's first pilot-scale biodigester to be built in Humboldt, Saskatchewan. The $208,138 pilot facility will use household garbage as well as agricultural waste such as manure and livestock operations, abattoirs and food processing to create heat or power and fertilizer. Support for this bio-energy facility, which could also reduce greenhouse gases, will come from the Prairie Agricultural Machinery Institute which has received $186,138 from Canada and Saskatchewan in the form of cost-shared federal-provincial funding. The pilot plant will test different combinations of waste material feedstocks and the characteristics of the resulting gas end products. The pilot facility will also provide design information for full-scale biodigester manufacturers in Canada. It is expected that 25 full-scale biodigesters will be constructed in Canada in the near future.

  9. Receiver based PAPR reduction in OFDMA

    KAUST Repository

    Ali, Anum Z.; Al-Zahrani, Ali Y.; Al-Naffouri, Tareq Y.; Naguib, Ayman F.

    2014-01-01

    High peak-to-average power ratio is one of the major drawbacks of orthogonal frequency division multiplexing (OFDM). Clipping is the simplest peak reduction scheme, however, it requires clipping mitigation at the receiver. Recently compressed sensing has been used for clipping mitigation (by exploiting the sparse nature of clipping signal). However, clipping estimation in multi-user scenario (i.e., OFDMA) is not straightforward as clipping distortions overlap in frequency domain and one cannot distinguish between distortions from different users. In this work, a collaborative clipping removal strategy is proposed based on joint estimation of the clipping distortions from all users. Further, an effective data aided channel estimation strategy for clipped OFDM is also outlined. Simulation results are presented to justify the effectiveness of the proposed schemes. © 2014 IEEE.

  10. Fast digitization and digital receiver technology

    International Nuclear Information System (INIS)

    Kimball, Ralph C.

    2002-01-01

    The potentially lucrative wireless market has led to technological advances in mixed signal devices such as high speed, high resolution A/D and D/A converters. This same market has also driven the development of high performance multi-channel digital receiver and digital transmitter ICs. Similarly, advances in semiconductor processes, coupled with the need for reduced time-to-market, has led to the development of large, enhanced performance, in-circuit programmable logic devices. A review of the key characteristics of these mixed-signal, signal processing and programmable logic devices is presented. The application of these devices and technologies to the instrumentation of Accelerators and Storage Rings is discussed and presented by way of examples. Issues relating to the requirements associated with real-time processing, I/O throughput, reconfigurability, reliability, maintainability and packaging requirements are also addressed

  11. Morel Receives 2005 Maurice Ewing Medal

    Science.gov (United States)

    Schrag, Daniel P.; Morel, François M. M.

    2006-02-01

    François M. M. Morel received the Ewing Medal at the AGU Fall Meeting Honors Ceremony, which was held on 7 December 2005, in San Francisco, Calif. The medal is given for significant original contributions to the scientific understanding of the processes in the ocean; for the advancement of oceanographic engineering, technology, and instrumentation; and for outstanding service to marine sciences. François Morel has led the search to understand the role of metals in the ocean, starting with a focus on inorganic processes and aquatic chemistry, and leading to a blend of geochemistry, microbiology, biochemistry, and genetics. His influence comes from his research and from the way he has educated an entire community of scientists with his textbooks, with his teaching, and through his former students and postdocs who hold faculty positions at universities throughout the world.

  12. Receiver operator characteristic (ROC) analysis without truth

    International Nuclear Information System (INIS)

    Henkelman, R.M.; Kay, I.; Bronskill, M.J.

    1990-01-01

    Receiver operator characteristic (ROC) analysis, the preferred method of evaluating diagnostic imaging tests, requires an independent assessment of the true state of disease, which can be difficult to obtain and is often of questionable accuracy. A new method of analysis is described which does not require independent truth data and which can be used when several accurate tests are being compared. This method uses correlative information to estimate the underlying model of multivariate normal distributions of disease-positive and disease-negative patients. The method is shown to give results equivalent to conventional ROC analysis in a comparison of computed tomography, radionuclide scintigraphy, and magnetic resonance imaging for liver metastasis. When independent truth is available, the method can be extended to incorporate truth data or to evaluate the consistency of the truth data with the imaging data

  13. Received View of Addiction, Relapse and Treatment.

    Science.gov (United States)

    Ndasauka, Yamikani; Wei, Zhengde; Zhang, Xiaochu

    2017-01-01

    It is important to highlight that attempts at understanding and explaining addiction have been made for centuries. It is, however, just five decades ago, with the growth of science and technology that more interest has been observed in this field. This chapter examines different views and theories that have been posited to understand and explain addiction. More attention will be given to prominent views that seem to draw consensus among researchers and medical practitioners. The first section of the chapter introduces the addiction debate, the different theories that have been provided to explain it from different perspectives and disciplines such as neurosciences, philosophy and psychology. Then, the chapter discusses different views on the role of relapse and what it entails in understanding addiction. The second section discusses different proposed and used forms of treating addiction. Thus, the chapter discusses the received view of addiction, the understanding of relapse as a critical element in addiction and treatments.

  14. MRI in children receiving total parenteral nutrition

    International Nuclear Information System (INIS)

    Quaghebeur, G.; Taylor, W.J.; Kingsley, D.P.E.; Fell, J.M.E.; Reynolds, A.P.; Milla, P.J.

    1996-01-01

    Cranial MRI was obtained in 13 of a group of 57 children receiving long-term parenteral nutrition, who were being investigated for hypermanganasaemia. Increased signal intensity on T1-weighted images has been reported in adult patients on long-term parenteral nutrition and with encephalopathy following chronic manganese exposure in arc welding. It has been postulated that these changes are due to deposition of the paramagnetic trace element manganese. In excess manganese is hepato- and neurotoxic and we present the correlation of whole blood manganese levels with imaging findings. The age range of our patients was 6 months to 10 years, and the duration of therapy 3 months to 10 years. In 7 children we found characteristic increased signal intensity on T1-weighted images, with no abnormality on T2-weighted images. All patients had elevated whole blood manganese levels, suggesting that the basis for this abnormality is indeed deposition of manganese within the tissues. (orig.). With 3 figs

  15. New Packing Structure of Concentration Solar Receiver

    International Nuclear Information System (INIS)

    Tsai, Shang-Yu; Lee, Yueh-Mu; Shih, Zun-Hao; Hong, Hwen-Fen; Shin, Hwa-Yuh; Kuo, Cherng-Tsong

    2010-01-01

    This paper presents a solution to the temperature issue in High Concentration Photovoltaic (HCPV) module device by using different thermal conductive material and packing structure. In general, the open-circuited voltage of a device reduces with the increase of temperature and therefore degrades its efficiency. The thermal conductive material we use in this paper, silicon, has a high thermal conductive coefficient (149 W/m·K) and steady semiconductor properties which are suitable for the application of solar receiver in HCPV module. Solar cell was soldered on a metal-plated Si substrate with a thicker SiO 2 film which acts as an insulating layer. Then it was mounted on an Al-based plate to obtain a better heat dissipating result.

  16. Receiver based PAPR reduction in OFDMA

    KAUST Repository

    Ali, Anum Z.

    2014-05-01

    High peak-to-average power ratio is one of the major drawbacks of orthogonal frequency division multiplexing (OFDM). Clipping is the simplest peak reduction scheme, however, it requires clipping mitigation at the receiver. Recently compressed sensing has been used for clipping mitigation (by exploiting the sparse nature of clipping signal). However, clipping estimation in multi-user scenario (i.e., OFDMA) is not straightforward as clipping distortions overlap in frequency domain and one cannot distinguish between distortions from different users. In this work, a collaborative clipping removal strategy is proposed based on joint estimation of the clipping distortions from all users. Further, an effective data aided channel estimation strategy for clipped OFDM is also outlined. Simulation results are presented to justify the effectiveness of the proposed schemes. © 2014 IEEE.

  17. IAEA receives Iraq's nuclear-related declaration

    International Nuclear Information System (INIS)

    2002-01-01

    Full text: The Director General of the International Atomic Energy Agency, Mohamed ElBaradei, announced that the IAEA received this evening, Sunday, 8 December 2002, at its Headquarters in Vienna, an approximately 2400 page declaration on Iraq's nuclear programme. The declaration consists of about 2100 pages in English and 300 pages in Arabic. The declaration was submitted by the Government of Iraq in response to paragraph 3 of Security Council resolution 1441 (8 November 2002), which requires Iraq to provide to UNMOVIC, the IAEA and to the Security Council, not later than 30 days of the date of that resolution, with 'currently accurate, full, and complete declaration of all aspects of its programmes to develop chemical, biological, and nuclear weapons, ballistic missiles, and other delivery systems... as well as all other chemical, biological, and nuclear programmes, including any which it claims are for purposes not related to weapon production or material'. 'The IAEA will immediately begin to assess this important new document,' said Mr. ElBaradei, 'including the painstaking and systematic cross-checking of the information provided by Iraq against information which the IAEA already has, information that it expects to receive from other Member States, as contemplated in resolution 1441, and results of past and present Agency verification activities.' Complete assessment of the declaration will be time consuming, particularly in light of the need to translate the 300 pages of Arabic text into English. However, the IAEA expects to be able to provide a preliminary analysis of the document to the Security Council within the next ten days, with a fuller assessment to be provided when it reports to the Council at the end of January. (IAEA)

  18. Transmit-receive eddy current probes

    International Nuclear Information System (INIS)

    Obrutsky, L.S.; Sullivan, S.P.; Cecco, V.S.

    1997-01-01

    In the last two decades, due to increased inspection demands, eddy current instrumentation has advanced from single-frequency, single-output instruments to multifrequency, computer-aided systems. This has significantly increased the scope of eddy current testing, but, unfortunately, it has also increased the cost and complexity of inspections. In addition, this approach has not always improved defect detectability or signal-to-noise. Most eddy current testing applications are still performed with impedance probes, which have well known limitations. However, recent research at AECL has led to improved eddy current inspections through the design and development of transmit-receive (T/R) probes. T/R eddy current probes, with laterally displaced transmit and receive coils, present a number of advantages over impedance probes. They have improved signal-to-noise ratio in the presence of variable lift-off compared to impedance probes. They have strong directional properties, permitting probe optimization for circumferential or axial crack detection, and possess good phase discrimination to surface defects. They can significantly increase the scope of eddy current testing permitting reliable detection and sizing of cracks in heat exchanger tubing as well as in welded areas of both ferritic and non-ferromagnetic components. This presentation will describe the operating principles of T/R probes with the help of computer-derived normalized voltage diagrams. We will discuss their directional properties and analyze the advantages of using single and multiple T/R probes over impedance probes for specific inspection cases. Current applications to surface and tube testing and some typical inspection results will be described. (author)

  19. Full-wave receiver architecture for the homodyne motion sensor

    Science.gov (United States)

    Haugen, Peter C; Dallum, Gregory E; Welsh, Patrick A; Romero, Carlos E

    2013-11-19

    A homodyne motion sensor or detector based on ultra-wideband radar utilizes the entire received waveform through implementation of a voltage boosting receiver. The receiver includes a receiver input and a receiver output. A first diode is connected to the receiver output. A first charge storage capacitor is connected from between the first diode and the receiver output to ground. A second charge storage capacitor is connected between the receiver input and the first diode. A second diode is connected from between the second charge storage capacitor and the first diode to ground. The dual diode receiver performs voltage boosting of a RF signal received at the receiver input, thereby enhancing receiver sensitivity.

  20. Full-wave receiver architecture for the homodyne motion sensor

    Energy Technology Data Exchange (ETDEWEB)

    Haugen, Peter C.; Dallum, Gregory E.; Welsh, Patrick A.; Romero, Carlos E.

    2015-09-29

    A homodyne motion sensor or detector based on ultra-wideband radar utilizes the entire received waveform through implementation of a voltage boosting receiver. The receiver includes a receiver input and a receiver output. A first diode is connected to the receiver output. A first charge storage capacitor is connected from between the first diode and the receiver output to ground. A second charge storage capacitor is connected between the receiver input and the first diode. A second diode is connected from between the second charge storage capacitor and the first diode to ground. The dual diode receiver performs voltage boosting of a RF signal received at the receiver input, thereby enhancing receiver sensitivity.

  1. Phase Noise Tolerant QPSK Receiver Using Phase Sensitive Wavelength Conversion

    DEFF Research Database (Denmark)

    Da Ros, Francesco; Xu, Jing; Lei, Lei

    2013-01-01

    A novel QPSK receiver based on a phase noise reduction pre-stage exploiting PSA in a HNLF and balanced detection is presented. Receiver sensitivity improvement over a conventional balanced receiver is demonstrated.......A novel QPSK receiver based on a phase noise reduction pre-stage exploiting PSA in a HNLF and balanced detection is presented. Receiver sensitivity improvement over a conventional balanced receiver is demonstrated....

  2. The stability of a terahertz receiver based on a superconducting integrated receiver

    International Nuclear Information System (INIS)

    Ozhegov, R V; Gorshkov, K N; Gol'tsman, G N; Kinev, N V; Koshelets, V P

    2011-01-01

    We present the results of stability testing of a terahertz radiometer based on a superconducting receiver with a SIS tunnel junction as the mixer and a flux-flow oscillator as the local oscillator. In the continuum mode, the receiver with a noise temperature of 95 K at 510 GHz measured over the intermediate frequency (IF) passband of 4-8 GHz offered a noise equivalent temperature difference of 10 ± 1 mK at an integration time of 1 s. We offer a method to significantly increase the integration time without the use of complex measurement equipment. The receiver observed a strong signal over a final detection bandwidth of 4 GHz and offered an Allan time of 5 s.

  3. The stability of a terahertz receiver based on a superconducting integrated receiver

    Energy Technology Data Exchange (ETDEWEB)

    Ozhegov, R V; Gorshkov, K N; Gol' tsman, G N [Department of Physics, Moscow State Pedagogical University, Moscow 119992 (Russian Federation); Kinev, N V; Koshelets, V P, E-mail: Ozhegov@rplab.ru [Institute of Radio Engineering and Electronics, 125009 Moscow (Russian Federation)

    2011-03-15

    We present the results of stability testing of a terahertz radiometer based on a superconducting receiver with a SIS tunnel junction as the mixer and a flux-flow oscillator as the local oscillator. In the continuum mode, the receiver with a noise temperature of 95 K at 510 GHz measured over the intermediate frequency (IF) passband of 4-8 GHz offered a noise equivalent temperature difference of 10 {+-} 1 mK at an integration time of 1 s. We offer a method to significantly increase the integration time without the use of complex measurement equipment. The receiver observed a strong signal over a final detection bandwidth of 4 GHz and offered an Allan time of 5 s.

  4. Apparatus for delivering and receiving radioactive gas

    International Nuclear Information System (INIS)

    Dansky, B.; Epifano, L.; Farella, R.

    1980-01-01

    An apparatus for delivering and receiving gas to and from a patient, such as for lung ventilation studies. In accordance with the invention there is provided a restrictive breathing chamber adapted for coupling to the patient's breathing organs. A system, including a first check valve, is provided for coupling the breathing chamber to an inflatable gas receptacle so as to allow flow only toward the inflatable gas receptacle. Active gas input apparatus, including a second check valve, is also coupled to the breathing chamber, the second check valve allowing flow only toward the breathing chamber means. First and second auxiliary tubes and a gas filter are also provided. A system is provided for coupling the first auxiliary tube from the inflatable receptacle through the gas filter and to an ambient air environment. The second auxiliary tube is coupled from the inflatable receptacle to an ambient air environment. Finally, a gas pump is switchably coupled as between the first and second auxiliary tubes and operative to selectively cause gas flow in the first auxiliary tube toward the ambient environment, and in the second auxiliary tube toward the inflatable receptacle. A gas trap structure is also disclosed

  5. Patrick Janot receives the CNRS silver medal

    CERN Multimedia

    2005-01-01

    Patrick Janot during the award ceremony. (Photo Schwemling, Paris) On 25 November, Patrick Janot of the CERN Physics Department received the CNRS silver medal for IN2P3 (Institut national de physique nucléaire et de physique des particules). This prize, one of the most prestigious awarded by the French research centre, is given to scientists for the 'originality, quality and importance of their work, as recognised both nationally and internationally'. Patrick Janot joined the ALEPH collaboration, one of the four experiments at LEP, then under construction, in 1987. First a CERN Fellow, he went on to work for the CNRS at LAL in 1989. Together with his team, he developed innovative algorithms for the reconstruction of events. This work and others earned him the bronze CNRS medal in 1993, which is awarded to scientists for their first achievements. In 1997, he became a permanent physicist at CERN, where he continued to work for ALEPH. He was appointed LEP scientific co-ordinator for the last two years of the ac...

  6. CERN safety expert receives international award

    CERN Multimedia

    2005-01-01

    On 18 December 2004, the President of the Swiss Electro-technical Committee, Martin Reichle (left), presented the award to Helmut Schönbacher. Helmut Schönbacher, of the Safety Commission at CERN, has received, the "1906 Award" of the International Electrotechnical Commission (IEC) for his standardisation work on the influence of ionizing radiation on insulating materials. From 1986 until 2004, Schönbacher was leader of a working group on radiation composed of internationally recognised experts. It edited standards of the IEC 60544 series on the determination of the effects of ionizing radiation on electrical insulating materials. The working group also edited three IEC Technical Reports on the determination of long-term radiation ageing in polymers. This standardisation work and long-term experience from CERN on the radiation ageing of materials also contributed to research coordination programmes of the International Atomic Energy Agency (IAEA). From 1968 until 1988, Schönbacher was a member of the Rad...

  7. Paterson Receives 2004 Walter H. Bucher Medal

    Science.gov (United States)

    Jackson, Ian

    2005-01-01

    Mervyn S. Paterson received the Bucher Medal at the 2004 Fall Meeting Honors Ceremony on 15 December, in San Francisco, California. The medal is given for original contributions to the basic knowledge of the crust and lithosphere. Citation. It is the nature of modern research in the Earth sciences that observations of natural phenomena are often made and interpreted through the prism provided by the enabling sciences and technologies. Thus it has been with Mervyn Paterson's career. His undergraduate training in engineering in Adelaide formed the basis for his Ph.D. study of X-ray line-broadening in cold-worked metals under Orowan at Cambridge. This interest in the deformation of metals was fostered during his employment at the Aeronautical Research Laboratories in Melbourne and by postdoctoral experience at the Institute of Metals at the University of Chicago. Mervyn's general background in engineering and his particular interest in mechanical behavior have underpinned a distinguished career at the Australian National University in the experimental deformation of rocks, providing fundamental new insight into the mechanical behavior of the Earth's crust.

  8. Every second cancer patient receives radiotherapy

    International Nuclear Information System (INIS)

    Ojala, A.

    1996-01-01

    Radiotherapy to treat cancer was given for the first time exactly one hundred years ago. Today, radiotherapy and surgery are the two main modes of treating cancer. One in two cancer patients receives radiotherapy at some point during the course of treatment for the disease. Radiotherapy is applied most commonly in cases where surgery is not possible. Moreover, these two modes of treatment are often used together to supplement each other. About half of new cancer cases detected today can be ordered. The estimate given by the EU for cancers cured is 45 per cent, which is divided between the various treatment modes as follows: surgery 22 %, radiotherapy 12 %, surgery plus radiotherapy 6 %, and drug therapy 6 %. In addition to curative treatment, radiotherapy plays a crucial role in palliative treatment, i.e. treatment that alleviates symptoms. The sensitivity of malignant tumours to radiotherapy varies over a wide range; the same is true for healthy tissues. Radiotherapy can only be used to cure a tumour that is more sensitive to radiation than the surrounding healthy tissue. The tumour must also be sufficiently small in size and limited to a relatively small area. (orig.)

  9. Design and simulation analysis of non-receiver aware and receiver ...

    African Journals Online (AJOL)

    We present multicast extensions to our recently proposed Location Prediction Based Routing (LPBR) protocol, referred to as NR-MLPBR and R-MLPBR, to simultaneously reduce the number of multicast tree discoveries and number of links per tree and/or the hop count per source-receiver path in mobile ad hoc networks ...

  10. Qualification test for the flexible receiver

    International Nuclear Information System (INIS)

    Keller, C.M.

    1994-01-01

    This document provides the test plan and procedures to certify and design verify the 42 inch and 4--6 inch Flexible Receiver (FR) is a safety class 3 system. Verification of the design will be handled in two parts. The first part will be to show that it meets design requirements set forth by documents and the second part will perform test(s) to verify its operational aspects. To qualify the design of the FR systems for field use this test will demonstrate environmentally safe removal of a Tank Farm pump mock-up from a Tank Farm riser mock-up. Testing will also demonstrate the performance of supporting equipment. The FR and the Secondary Bagging (SB) equipment shall be tested to verify successful operation of the equipment to the following criteria: The FR can be placed on a riser and connections made to the supporting equipment; The FR bag can accept equipment and be successfully sealed; The SB system encases the seal of the primary FR bag; The flexible bag(s) do not tear and maintain integrity during the entire test; The FR control system operates in the fail safe forced sequence mode; The FR control system will operate in the manual override mode (out of sequence operations); The CCTV Video system monitors and records the removal of the test item; The spray wash system operates without leaks and effectively provides coverage; The item being removed can be reinserted to a depth of 8 feet and the bag reinstalled onto the vertical bag supports; and The system prohibits momentary mechanical fluctuations due to the application of system power, including power interruptions

  11. Crustal Structure beneath Alaska from Receiver Functions

    Science.gov (United States)

    Zhang, Y.; Li, A.

    2017-12-01

    The crustal structure in Alaska has not been well resolved due to the remote nature of much of the state. The USArray Transportable Array (TA), which is operating in Alaska and northwestern Canada, significantly increases the coverage of broadband seismic stations in the region and allows for a more comprehensive study of the crust. We have analyzed P-receiver functions from earthquake data recorded by 76 stations of the TA and AK networks. Both common conversion point (CCP) and H-K methods are used to estimate the mean crustal thickness. The results from the CCP stacking method show that the Denali fault marks a sharp transition from thick crust in the south to thin crust in the north. The thickest crust up to 52 km is located in the St. Elias Range, which has been formed by oblique collision between the Yakutat microplate and North America. A thick crust of 48 km is also observed beneath the eastern Alaska Range. These observations suggest that high topography in Alaska is largely compensated by the thick crust root. The Moho depth ranges from 28 km to 35 km beneath the northern lowlands and increases to 40-45 km under the Books Range. The preliminary crustal thickness from the H-K method generally agrees with that from the CCP stacking with thicker crust beneath high mountain ranges and thinner crust beneath lowlands and basins. However, the offshore part is not well constrained due to the limited coverage of stations. The mean Vp/Vs ratio is around 1.7 in the Yukon-Tanana terrane and central-northern Alaska. The ratio is about 1.9 in central and southern Alaska with higher values at the Alaska Range, Wrangell Mountains, and St. Elias Range. Further data analyses are needed for obtaining more details of the crustal structure in Alaska to decipher the origin and development of different tectonic terranes.

  12. Hypoglycaemia monitoring in a medical receiving ward.

    Science.gov (United States)

    Ellis, Ryan

    2015-01-01

    It has been suggested that current care for diabetes inpatients remains inadequate and that greater attention is required for high quality management. In this project the aspect of hypoglycaemia was studied in a busy medical receiving ward at the Glasgow Royal Infirmary. A large proportion of inpatients have diabetes and episodes of hypoglycaemia experienced by this population can delay discharge and indeed be detrimental to health. Thus it is important from both an organisational and patient perspective to manage this population well. In this project BM machine data was analysed to identify patients who were hypoglycaemic. These patients were then tracked down to study the subsequent management and compared this against recommended guidance. Following this an intervention was made to promote identification, management, documentation, and prevention of hypoglycaemia. This was deliberately a simple intervention involving discussions with staff and provision of basic documented guidance next to every BM machine. In the first phase 17 patients were identified and in a second and third phase 16 patients each time were further identified. Patients in the study were both type 1 and type 2 diabetics. Initial results in phase I were compared to results in phase II and III respectively. This intervention produced significant improvements in management with correct monitoring of low BMs (i.e. upon identification of low BM repeat within 1 hour) improving from 47% to 100% (for Phase II and III). Also, recording of preventative measures of hypoglycaemia improved from 35% to 88% and 94% with an improvement from 24% to 69% and 75% in recording of treatment given if needed. In conclusion, the study successfully demonstrated that simple measures can significantly improve the quality care of inpatient diabetic patients in relation to hypoglycaemia management.

  13. Investigation of the receivability of VLF standard time and frequency ...

    African Journals Online (AJOL)

    This study is on the receivability of some standard time and frequency signals in the VLF range in Zaria, Nigeria. Signal field strengths of various stations were estimated, and a suitable radio receiving system was set up to receive them. Using the assembled receiver, some of the transmissions, including the Omega W/L at ...

  14. 37 CFR 1.412 - The United States Receiving Office.

    Science.gov (United States)

    2010-07-01

    ... Information § 1.412 The United States Receiving Office. (a) The United States Patent and Trademark Office is a Receiving Office only for applicants who are residents or nationals of the United States of America. (b) The... “United States Receiving Office” or by the abbreviation “RO/US.” (c) The major functions of the Receiving...

  15. Atopic dermatitis: tacrolimus vs. topical corticosteroid use

    African Journals Online (AJOL)

    Atopic dermatitis (AD) is an inflammatory skin disease that is characterised .... effective in the treatment of AD.5. Although ..... original steroid preparations,20 the cost-effectiveness of ... Topical corticosteroids [homepage on the Internet]. c2010.

  16. Superior Coherent Receivers for AF Relaying with Distributed Alamouti Code

    KAUST Repository

    Khan, Fahd Ahmed

    2012-01-01

    Coherent receivers are derived for a pilot-symbol aided distributed Alamouti-coded system with imperfect channel state information. The derived coherent receivers do not perform channel estimation but rather use the received pilot signals for decoding. The derived receiver metrics use the statistics of the channel to give improved performance. The performance is further improved by using the decision history. Simulation results show that a performance gain of up to 1.8 dB can be achieved for the new receivers with decision history as compared with the conventional mismatched coherent receiver. © 2011 IEEE.

  17. FFT Based VLSI Digital One Bit Electronic Warfare Receiver

    National Research Council Canada - National Science Library

    Chien-In, Henry

    1998-01-01

    ... (1 GHz) digital receiver designed for electronic warfare applications. The receiver can process two simultaneous signals and has the potential for fabrication on a single multi-chip module (MCM...

  18. A Correlating Receiver for OFDM at Low SNR

    NARCIS (Netherlands)

    Kokkeler, Andre B.J.; Smit, Gerardus Johannes Maria

    By extending OFDM symbols, acceptable BER performance can be achieved at low SNRs. Two alternative differential receiver architectures are presented, a receiver based on a FX correlator (Fourier transformation before correlation) and based on an XF correlator (correlation before Fourier

  19. Initial results for compressive sensing in electronic support receiver systems

    CSIR Research Space (South Africa)

    Du Plessis, WP

    2011-04-01

    Full Text Available determined by the antenna and microwave system comprising the transmitter and receiver, while the instantaneous bandwidth is mainly determined by the Analog-to-Digital Converter (ADC) in the receiver. A radar can thus operate at any frequency within its... Electronic/Electromagnetic Support Measures (ESM) was used historically [1], [2]. Modern ES receiver systems are based on digital receivers allowing powerful signal processing techniques to be used [3], [4]. Recent developments in sampling technology...

  20. 20 CFR 404.1042 - Wages when paid and received.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Wages when paid and received. 404.1042... DISABILITY INSURANCE (1950- ) Employment, Wages, Self-Employment, and Self-Employment Income Wages § 404.1042 Wages when paid and received. (a) In general. Wages are received by an employee at the time they are...

  1. 5 CFR 551.425 - Time spent receiving medical attention.

    Science.gov (United States)

    2010-01-01

    ... 5 Administrative Personnel 1 2010-01-01 2010-01-01 false Time spent receiving medical attention... Relation to Other Activities § 551.425 Time spent receiving medical attention. (a) Time spent waiting for and receiving medical attention for illness or injury shall be considered hours of work if: (1) The...

  2. THE CORRELATED TRACK RECEIVER OF TONE TRACK CIRCUITS

    Directory of Open Access Journals (Sweden)

    K. V. Goncharov

    2011-05-01

    Full Text Available The work is devoted to further improvement of processing algorithm of checking signals of rail line. The simulation modeling of correlation track receiver of tone rail circuits has been executed; the benchmark analysis of correlation receiver and direct amplifier receiver has been executed.

  3. Noise and intercept point calculation for modern radio receiver planning

    DEFF Research Database (Denmark)

    Iversen, Christian Rye; Kolding, T. E.

    2001-01-01

    The paper presents analytical expressions for determining noise and intercept points for cascaded radio receiver stages. The theory allows for active receiver stages with frequency selectivity and flexible impedance levels. This makes the method highly usable for planning of modem receivers where...

  4. IMPROVEMENT WAYS OF ACCOUNTING AND INTERNAL AUDIT OF ENTERPRISE RECEIVABLES

    Directory of Open Access Journals (Sweden)

    V. D. Zelikman

    2014-06-01

    Full Text Available Purpose. Determination and substantiation of ways to improve accounting and internal audit of receivables at the enterprises. Methodology.The basic principles and ways for improvement of accounting and internal audit systems that should help Ukrainian enterprises to optimize receivables are considered. Findings. It is proved that the receivables optimization is possible on the basis of improving its accounting and internal audit. The basic ways for improvement of accounting and internal audit of receivable are determined. They are: improvement of normative coverage of receivables at the enterprises; providing further harmonization of financial and tax accounting in the part of formation of the doubtful debt receivables, accounting of bad and doubtful receivables and etc. The formation of department for internal audit to control the doubtful and bad debts; providing the timely control of the receivables and payables ratio; determination and support of the optimal value of the receivables at the enterprises. Originality. Improvement of accounting and internal audit of receivables at the enterprises by the way of development of internal audit system and optimization of the receivables size. Practical value. The proposed recommendations will improve the accounting and internal audit system of receivables at the enterprises of Ukraine.

  5. 75 FR 26843 - Petition for Exemption; Summary of Petition Received

    Science.gov (United States)

    2010-05-12

    ...] Petition for Exemption; Summary of Petition Received AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of petition for exemption received. SUMMARY: This notice contains a summary of a petition... the legal status of any petition or its final disposition. DATES: Comments on petitions received must...

  6. Communications Satellite Receiver Systems for Public Schools: A Technical Primer.

    Science.gov (United States)

    Texas Education Agency, Austin.

    Designed to aid school districts contemplating use of some of the telecommunications services now available by satellite, this document contains information on home satellite receiving dishes (Television Receive-Only--TVROs), which can receive radio signals carrying television, sound, and data. This information includes: some factors involved in…

  7. Communications/Electronics Receiver Performance Degradation Handbook (Second Edition)

    Science.gov (United States)

    1975-08-01

    receiver to another in the Rf and IF filter characteristics modify the transfer of inter- forence power through the receiver to the IF output, and so the...modulation system the transmitted and received messages arce in general different bemaus* of small inte, forence or noise perturbations. The probability of

  8. 33 CFR 17.01-10 - Authority to receive gifts.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 1 2010-07-01 2010-07-01 false Authority to receive gifts. 17.01... GENERAL UNITED STATES COAST GUARD GENERAL GIFT FUND General Provisions § 17.01-10 Authority to receive gifts. (a) The Commandant, United States Coast Guard, may accept, receive, hold, or administer gifts...

  9. Sideband ratio in double sideband receivers with a Michelson interferometer

    NARCIS (Netherlands)

    Romanini, M.; Baryshev, A. M.; Hesper, R.; Mena, F. P.; Wild, W.

    2007-01-01

    Terahertz heterodyne receivers typically use double sideband (DSB) mixers. The precise knowledge of the receiver sideband ratio (SBR) is a fundamental requirement for the calibration of the data taken with this type of receivers. At the moment the spectroscopic techniques developed for submillimeter

  10. Tacrolimus binding proteins 5 gene polymorphisms in major depressive disorder%重性抑郁障碍患者他克莫司结合蛋白5基因多态性分析

    Institute of Scientific and Technical Information of China (English)

    杨栋; 赵靖平; 喻妍; 吴仁容; 郭文斌

    2013-01-01

    Objective Tacrolimus binding proteins 5 (FKBP5) gene polymorphisms were analyzed in Chinese Han major depressive disorder (MDD) patients.Methods 263 major depressive disorder (MDD) patients who met the Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-Ⅳ)criterion were given antidepressant drugs for six weeks.The patients were divided into two groups of the responder group and the non-responder group,according to the decreasing rate of score of HAMD ≥ 50%and < 50% respectively.Genomic DNA was extracted from the blood samples,when patients being enrolled.Two polymorphisms (rs3800373 and rs1360780) of FKBP5 gene were genotyped using the ligase detection reaction.Results (1)The distribution frequencies of the SNP of rs3800373 showed no significant differences between responder group (GG + GT 45.7% ; TT 54.3%) and non-responder group (GG + GT47.6% ;T T 52.4%) (x2 =0.051,P > 0.05).The distribution frequencies of the SNP of rs1360780 showed no significant differences between responder group(CC 55.6% ; CT + TF 44.4%) and non-responder group (CC 51.2% ; CT + TT 48.8%) (x2 =0.256,P > 0.05).(2) No significant differences were found in rs3800373-rs1360780 haplotype frequencies between responder group and non-responder group (P > 0.05).(3) There were no significant differences in the incidence rate of total side effect and nausea adverse effect between the patients with different genotypes of rs3800373 and rs1360780 (P > 0.05).Conclusions There may be no significant differences in the genotype frequencies of FKBP5 gene rs3800373 and rs1360780 polymorphisms between responder group and non-responder group in Chinese Han MDD patients.%目的 分析中国汉族重性抑郁障碍患者他克莫司结合蛋白5(FKBP5)基因多态性.方法 对符合《美国诊断与统计手册精神障碍(第4版)》(DSM-Ⅳ)重性抑郁障碍诊断标准的263例患者予以单一抗抑郁药治疗,疗程6周.根据汉密尔顿

  11. BPSK Receiver Based on Recursive Adaptive Filter with Remodulation

    Directory of Open Access Journals (Sweden)

    N. Milosevic

    2011-12-01

    Full Text Available This paper proposes a new binary phase shift keying (BPSK signal receiver intended for reception under conditions of significant carrier frequency offsets. The recursive adaptive filter with least mean squares (LMS adaptation is used. The proposed receiver has a constant, defining the balance between the recursive and the nonrecursive part of the filter, whose proper choice allows a simple construction of the receiver. The correct choice of this parameter could result in unitary length of the filter. The proposed receiver has performance very close to the performance of the BPSK receiver with perfect frequency synchronization, in a wide range of frequency offsets (plus/minus quarter of the signal bandwidth. The results obtained by the software simulation are confirmed by the experimental results measured on the receiver realized with the universal software radio peripheral (USRP, with the baseband signal processing at personal computer (PC.

  12. Solar advanced internal film receiver; Receptor avanzado de pelicular interna

    Energy Technology Data Exchange (ETDEWEB)

    Torre Cabezas, M. de la

    1990-07-01

    In a Solar Central Internal Film Receiver, the heat absorbing fluid (a molten nitrate salt) flows in a thin film down over the non illuminated side of an absorber panel. Since the molten salt working fluid is not contained in complicated tube manifolds, the receiver design is simples than a conventional tube type-receiver resulting in a lower cost and a more reliable receiver. The Internal Film Receiver can be considered as an alternative to the Direct Absorption Receiver, in the event that the current problems of the last one can not be solved. It also describes here the test facility which will be used for its solar test, and the test plans foreseen. (Author) 17 refs.

  13. Ways to rational management of accounts receivable at enterprises

    Directory of Open Access Journals (Sweden)

    Yevtushenko N. O.

    2015-05-01

    Full Text Available This article investigated the principal reasons of management problems an account receivable of enterprises. Credit politics of management is worked out by an account receivable of enterprises. Essence of the stages of construction of rational management an account receivable of enterprises is exposed. In the article are exposed the basic elements of control system for an account receivable such as mission, aims, strategy as politics of management. The basic stages of management politics are described for an account receivable of enterprises: analysis; organization of forming of principles of credit politics, terms of delivery of credit and procedure of collection of accounts receivable; planning of the use of modern forms of refunding, and similarly control.

  14. Ultrabroadband Phased-Array Receivers Based on Optical Techniques

    Science.gov (United States)

    2016-02-26

    bandwidths, and with it receiver noise floors , are unavoidable. Figure 1. SNR of a thermally limited receiver based on Friis equation showing the...techniques for RF and photonic integration based on liquid crystal polymer substrates were pursued that would aid in the realization of potential imaging...These models assumed that sufficient LNA gain was used on the antenna to set the noise floor of the imaging receiver, which necessitated physical

  15. PENENTUAN RECEIVED DATE DENGAN LOAD-ORIENTED MANUFACRURING CONTROL

    Directory of Open Access Journals (Sweden)

    Sri Hartini

    2012-02-01

    Full Text Available Salah satu kunci kompetitif sebuah perusahaan make to order adalah ketepatan dalam pemenuhan waktu penerimaan pesanan pada konsumen yang telah dijanjikan perusahaan ( received date. Penentuan received date yang selama ini dilakukan oleh JI  kurang tepat karena hanya memperkirakan waktu sekitar 10 – 12 minggu tanpa mempertimbangkan faktor produksi. Penelitian ini merancang received date dengan model load-oriented manufacturing control dimana penentuan received date didasarkan pada perhitungan manufacturing lead time yang mempertimbangkan waktu pengiriman order ke konsumen, kapasitas yang tersedia pada tiap stasiun kerja, waktu proses pada stasiun kerja dan aliran produksi di lantai produksi. Hasil validasi perhitungan  penentuan received date order sesuai  dengan sistem produksi PT JI dan lebih valid dibanding sistem awal. Kata kunci : make to order, received date, manufacturing leadtime, load-oriented manufacturing control   One of the competitive key of a make to order company is the accuracy in fulfilling orders which has been promised by the company towards the consumers (received date. Determining received date which has been applied by JI recently is not sufficient because it only predicts 10-12 weeks of time without considering production factors. This research designs received date with load-oriented manufacturing control model where determining received date is based on calculating manufacturing lead time that considers the time needed to deliver orders to the consumer, capacity available for each work station, work station process time, and production flow within the production floor.  Validation results from the calculations for determining received date order is adjusted to PT JI  production system and is more valid than the first system. Keywords : make to order, received date, manufacturing leadtime, load-oriented manufacturing control

  16. Molecular Spectroscopy With a Compact 557-GHz Heterodyne Receiver

    DEFF Research Database (Denmark)

    Neumaier, Philipp F.-X.; Richter, Heiko; Stake, Jan

    2014-01-01

    We report on a heterodyne terahertz spectrometer based on a fully integrated 557-GHz receiver and a digital fast Fourier transform spectrometer. The receiver consists of a chain of multipliers and power amplifiers, followed by a heterostructure barrier varactor tripler that subharmonically pumps...... a membrane GaAs Schottky diode mixer. All sub-components are newly developed and optimized with regard to the overall receiver performance such as noise temperature, power consumption, weight and physical size. The receiver works at room temperature, has a double sideband noise temperature as low as 2000 K...

  17. List of documents received by the INDC Secretariat

    International Nuclear Information System (INIS)

    1987-09-01

    The Nuclear Data Section of the International Atomic Energy Agency receives documents originated by or for the International Nuclear Data Committee for distribution. This list includes all INDC documents received and distributed by the INDC Secretariat during the period January 1984 to March 1986. This list is produced directly from computer printout in two sorts: one ordered by accession number, and the other ordered by document number within each origin series (e.g. listing all INDC(SEC)-documents in one block). In addition to the INDC documents received by the INDC Secretariat for distribution, this document also lists the titles of reports received as single copies for information

  18. Personal monitoring and assessment of doses received by radiation workers

    International Nuclear Information System (INIS)

    Swindon, T.N.; Morris, N.D.

    1981-12-01

    The Personal Radiation Monitoring Service operated by the Australian Radiation Laboratory is outlined and the types of monitors used for assessment of doses received by radiation workers are described. The distribution of doses received by radiation workers in different occupational categories is determined. From these distributions, the average doses received have been assessed and the maximum likely additional increase in cancer deaths in Australia as a result of occupational exposure estimated. This increase is shown to be very small. There is, however, a considerable spread of doses received by individuals within occupational groups

  19. Frequency Estimator Performance for a Software-Based Beacon Receiver

    Science.gov (United States)

    Zemba, Michael J.; Morse, Jacquelynne Rose; Nessel, James A.; Miranda, Felix

    2014-01-01

    As propagation terminals have evolved, their design has trended more toward a software-based approach that facilitates convenient adjustment and customization of the receiver algorithms. One potential improvement is the implementation of a frequency estimation algorithm, through which the primary frequency component of the received signal can be estimated with a much greater resolution than with a simple peak search of the FFT spectrum. To select an estimator for usage in a QV-band beacon receiver, analysis of six frequency estimators was conducted to characterize their effectiveness as they relate to beacon receiver design.

  20. Accounting for Defense Logistics Agency Supply Management Receivables

    National Research Council Canada - National Science Library

    Lane, F

    1998-01-01

    .... For this part of the audit, we determined whether Defense Logistics Agency supply management receivables were accurately accounted for, classified, and reported in the Statement of Financial Position...

  1. Comparison of Attitudes Toward Death Between University Students Who Receive Nursing Education and Who Receive Religious Education.

    Science.gov (United States)

    Bakan, Ayse Berivan; Arli, Senay Karadag

    2018-03-22

    This study aims to compare attitudes toward death between university students who receive nursing education and who receive religious education. This study is cross-sectional in nature. It was conducted with the participation of 197 university students in a university located in the Eastern part of Turkey between June and August, 2017. Data were collected using the socio-demographic form and Turkish form of Death Attitudes Profile-Revised. Of all the students participating in the study, 52.8% received nursing education and 47.2% received religious education. It was found that majority of both groups had no education about death, or found the education they received insufficient. Besides, no significant differences were found between the students who received nursing education and who received religious education in terms of their attitudes toward death (p > 0.05). Results showed that students who received nursing education and who received religious education had similar attitudes toward death. In conclusion, the education given to students about the religious or health aspects of death in accordance with the curriculum seemed to have no effects on students' developing positive attitudes toward death.

  2. 49 CFR 1110.5 - Consideration of comments received.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 8 2010-10-01 2010-10-01 false Consideration of comments received. 1110.5 Section 1110.5 Transportation Other Regulations Relating to Transportation (Continued) SURFACE TRANSPORTATION... PROCEEDINGS § 1110.5 Consideration of comments received. All timely comments will be considered before final...

  3. Qualification test for the Flexible Receiver. Revision 1

    International Nuclear Information System (INIS)

    Keller, C.M.

    1994-01-01

    This document provides the test plan and procedures to certify and design verify the 42 in. and 4 in. -- 6 in. Flexible Receiver as a safety class 3 system. The Flexible Receiver will be used by projects W-151 and W-320 for removing equipment from tanks C-106 and Az-101

  4. Fuel Receiving and Storage Station. License application, amendment 4

    International Nuclear Information System (INIS)

    1975-04-01

    Amendment No. 4 of the application for licensing the Barnwell Fuel Processing Plant is presented. Information is included on: the quantity and characteristics of nuclear fuel assemblies which can be received and stored; specifications limiting the outside washdown of contaminated casks received for unloading; and definition of environmental monitoring program. (U.S.)

  5. Assessment of hospital-based adult triage at emergency receiving ...

    African Journals Online (AJOL)

    The study was conducted in 6 of the 7 hospitals in the region. ... gency department, the rest receive emergency patients/perform triage from .... gional Referral Hospital (government facility) with emer- ... sionals who were involved in daily initial management of ..... for receiving emergency cases can be complex especially.

  6. Qualification test for the flexible receiver. Revision 2

    International Nuclear Information System (INIS)

    Tedeschi, D.J.

    1994-01-01

    This document provides the test plan and procedures to certify and design verify the 42 double-prime and 4 double-prime-6 double-prime Flexible Receiver as a safety class 3 system. The Flexible Receiver will be used by projects W-151 and W-320 for removing equipment from tanks C-106 and AZ-101

  7. Qualification test for the flexible receiver. Revision 2

    Energy Technology Data Exchange (ETDEWEB)

    Tedeschi, D.J.

    1994-12-12

    This document provides the test plan and procedures to certify and design verify the 42{double_prime} and 4{double_prime}-6{double_prime} Flexible Receiver as a safety class 3 system. The Flexible Receiver will be used by projects W-151 and W-320 for removing equipment from tanks C-106 and AZ-101.

  8. Reconfigurable digital receiver design and application for instantaneous polarimetric measurement

    NARCIS (Netherlands)

    Wang, Z.; Krasnov, O.A.; Babur, G.P.; Ligthart, L.P.; Van der Zwan, F.

    2011-01-01

    This paper presents the development of a reconfigurable receiver to undertake challenging signal processing tasks for a novel polarimetric radar system. The field-programmable gate arrays (FPGAs)-based digital receiver samples incoming signals at intermediate frequency (IF) and processes signals

  9. 12 CFR 614.4700 - Financing foreign trade receivables.

    Science.gov (United States)

    2010-01-01

    ... OPERATIONS Banks for Cooperatives and Agricultural Credit Banks Financing International Trade § 614.4700 Financing foreign trade receivables. (a) Banks for cooperatives and agricultural credit banks, under policies adopted by their boards of directors, are authorized to finance foreign trade receivables on...

  10. Hearing Instrument using receivers with different performance characteristics

    DEFF Research Database (Denmark)

    2009-01-01

    The invention regards a signal processing device in a hearing aid, wherein the signal processing device is electrically coupled to a connection socket operable to detachably connect a receiver to the socket and whereby the signal processing device further comprise a detector operable to detect...... a characteristics of the receiver which is connected to the signal processing device through the connection socket....

  11. List of documents received by the INDC secretariat

    International Nuclear Information System (INIS)

    1983-05-01

    The Nuclear Data Section of the International Atomic Energy Agency receives documents originated by or for the International Nuclear Data Committee for distribution. This list includes all INDC documents received and distributed by the INDC secretariat during the last ten years, and supersedes last year's edition of this report

  12. Distributed Iterative Processing for Interference Channels with Receiver Cooperation

    DEFF Research Database (Denmark)

    Badiu, Mihai Alin; Manchón, Carles Navarro; Bota, Vasile

    2012-01-01

    We propose a method for the design and evaluation of distributed iterative algorithms for receiver cooperation in interference-limited wireless systems. Our approach views the processing within and collaboration between receivers as the solution to an inference problem in the probabilistic model...

  13. Gluconeogenesis continues in premature infants receiving total parenteral nutrition

    Science.gov (United States)

    To determine the contribution of total gluconeogenesis, to glucose production in preterm infants receiving total parenteral nutrition (TPN) providing glucose exceeding normal infant glucose turnover rate, eight infants (0.955 +/- 0.066 kg, 26.5 - 0.5 wks, 4-1 d) were studied while receiving routine ...

  14. Autonomous Operation of Super-Regenerative Receiver in BAN

    NARCIS (Netherlands)

    Kalyanasundaram, P.; Huang, L.; Dolmans, G.; Imamura, K.

    2012-01-01

    Super-regenerative receiver is one of the potential candidates to achieve ultra low power wireless communication in body area network (BAN). The main limitations of the super-regenerative receiver include the difficulty in choosing a good quench waveform to optimize its sensitivity and selectivity,

  15. 75 FR 80106 - Petition for Exemption; Summary of Petition Received

    Science.gov (United States)

    2010-12-21

    ... training facilities requirements given the school's use of online training material, as well as the ground...] Petition for Exemption; Summary of Petition Received AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of petition for exemption received. SUMMARY: This notice contains a summary of a petition...

  16. 75 FR 20881 - Petition for Exemption; Summary of Petition Received

    Science.gov (United States)

    2010-04-21

    ...] Petition for Exemption; Summary of Petition Received AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of petition for exemption received. SUMMARY: This notice contains a summary of a petition... the legal status of the petition or its final disposition. DATES: Comments on this petition must...

  17. 76 FR 33807 - Petition for Exemption; Summary of Petition Received

    Science.gov (United States)

    2011-06-09

    ...] Petition for Exemption; Summary of Petition Received AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of petition for exemption received. SUMMARY: This notice contains a summary of a petition... the legal status of the petition or its final disposition. DATES: Comments on this petition must...

  18. 76 FR 39976 - Petition for Exemption; Summary of Petition Received

    Science.gov (United States)

    2011-07-07

    ...] Petition for Exemption; Summary of Petition Received AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of petition for exemption received. SUMMARY: This notice contains a summary of a petition... the legal status of the petition or its final disposition. DATE: Comments on this petition must...

  19. 75 FR 60859 - Petition for Exemption; Summary of Petition Received

    Science.gov (United States)

    2010-10-01

    ...] Petition for Exemption; Summary of Petition Received AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of petition for exemption received. SUMMARY: This notice contains a summary of a petition... the legal status of the petition or its final disposition. DATES: Comments on this petition must...

  20. 77 FR 35103 - Petition for Exemption; Summary of Petition Received

    Science.gov (United States)

    2012-06-12

    ...] Petition for Exemption; Summary of Petition Received AGENCY: Federal Aviation Administration (FAA), DOT. ACTION: Notice of petition for exemption received. SUMMARY: This notice contains a summary of a petition... the legal status of the petition or its final disposition. DATES: Comments on this petition must...