A tree girdling beetle in Korogwe District: its potential risk to ...

African Journals Online (AJOL)

A study was conducted to identify and assess damage of an insect pest girdling young Eucalypts in Korogwe Forest Plantation, Tanga. Purposive sampling was employed to establish 10 plots of 10m by 10m. A total of 90 trees were sampled. Insect pest specimens were collected and girdled trees counted in each plot. The

Bacteria Localization and Chorion Thinning among Preterm Premature Rupture of Membranes

Science.gov (United States)

Fortner, Kimberly B.; Grotegut, Chad A.; Ransom, Carla E.; Bentley, Rex C.; Feng, Liping; Lan, Lan; Heine, R. Phillips; Seed, Patrick C.; Murtha, Amy P.

2014-01-01

Objective Bacterial colonization of the fetal membranes and its role in pathogenesis of membrane rupture is poorly understood. Prior retrospective work revealed chorion layer thinning in preterm premature rupture of membranes (PPROM) subjects. Our objective was to prospectively examine fetal membrane chorion thinning and to correlate to bacterial presence in PPROM, preterm, and term subjects. Study Design Paired membrane samples (membrane rupture and membrane distant) were prospectively collected from: PPROM = 14, preterm labor (PTL = 8), preterm no labor (PTNL = 8), term labor (TL = 10), and term no labor (TNL = 8), subjects. Sections were probed with cytokeratin to identify fetal trophoblast layer of the chorion using immunohistochemistry. Fluorescence in situ hybridization was performed using broad range 16 s ribosomal RNA probe. Images were evaluated, chorion and choriodecidua were measured, and bacterial fluorescence scored. Chorion thinning and bacterial presence were compared among and between groups using Student's t-test, linear mixed effect model, and Poisson regression model (SAS Cary, NC). Results In all groups, the fetal chorion cellular layer was thinner at rupture compared to distant site (147.2 vs. 253.7 µm, prupture site compared to distant sites. In PPROM fetal chorion, we demonstrated pronounced global thinning. Although cause or consequence is uncertain, bacterial presence is greatest and inversely correlated with chorion thinning among PPROM subjects. PMID:24421883

On the homology of the shoulder girdle in turtles.

Science.gov (United States)

Nagashima, Hiroshi; Sugahara, Fumiaki; Takechi, Masaki; Sato, Noboru; Kuratani, Shigeru

2015-05-01

The shoulder girdle in turtles is encapsulated in the shell and has a triradiate morphology. Due to its unique configuration among amniotes, many theories have been proposed about the skeletal identities of the projections for the past two centuries. Although the dorsal ramus represents the scapular blade, the ventral two rami remain uncertain. In particular, the ventrorostral process has been compared to a clavicle, an acromion, and a procoracoid based on its morphology, its connectivity to the rest of the skeleton and to muscles, as well as with its ossification center, cell lineage, and gene expression. In making these comparisons, the shoulder girdle skeleton of anurans has often been used as a reference. This review traces the history of the debate on the homology of the shoulder girdle in turtles. And based on the integrative aspects of developmental biology, comparative morphology, and paleontology, we suggest acromion and procoracoid identities for the two ventral processes. © 2014 Wiley Periodicals, Inc.

Physiological girdling of pine trees via phloem chilling: proof of concept

Science.gov (United States)

Kurt Johnsen; Chris Maier; Felipe Sanchez; Peter Anderson; John Butnor; Richard Waring; Sune Linder

2007-01-01

Quantifying below-ground carbon (C) allocation is particularly difficult as methods usually disturb the root– mycorrhizal–soil continuum. We reduced C allocation below ground of loblolly pine trees by: (1) physically girdling trees and (2) physiologically girdling pine trees by chilling the phloem. Chilling reduced cambium temperatures by approximately 18 °C. Both...

Optimizing Use of Girdled Ash Trees for Management of Low-Density Emerald Ash Borer (Coleoptera: Buprestidae) Populations.

Science.gov (United States)

Siegert, Nathan W; McCullough, Deborah G; Poland, Therese M; Heyd, Robert L

2017-06-01

Effective survey methods to detect and monitor recently established, low-density infestations of emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), remain a high priority because they provide land managers and property owners with time to implement tactics to slow emerald ash borer population growth and the progression of ash mortality. We evaluated options for using girdled ash (Fraxinus spp.) trees for emerald ash borer detection and management in a low-density infestation in a forested area with abundant green ash (F. pennsylvanica). Across replicated 4-ha plots, we compared detection efficiency of 4 versus 16 evenly distributed girdled ash trees and between clusters of 3 versus 12 girdled trees. We also examined within-tree larval distribution in 208 girdled and nongirdled trees and assessed adult emerald ash borer emergence from detection trees felled 11 mo after girdling and left on site. Overall, current-year larvae were present in 85-97% of girdled trees and 57-72% of nongirdled trees, and larval density was 2-5 times greater on girdled than nongirdled trees. Low-density emerald ash borer infestations were readily detected with four girdled trees per 4-ha, and 3-tree clusters were as effective as 12-tree clusters. Larval densities were greatest 0.5 ± 0.4 m below the base of the canopy in girdled trees and 1.3 ± 0.7 m above the canopy base in nongirdled trees. Relatively few adult emerald ash borer emerged from trees felled 11 mo after girdling and left on site through the following summer, suggesting removal or destruction of girdled ash trees may be unnecessary. This could potentially reduce survey costs, particularly in forested areas with poor accessibility. Published by Oxford University Press on behalf of Entomological Society of America 2017. This work is written by US Government employees and is in the public domain in the US.

Clinical and laboratory experience of chorionic villous sampling in ...

African Journals Online (AJOL)

Background: Chorionic villous sampling is a first trimester invasive diagnosis procedure that was introduced in Nigeria <2 decades ago. Objective: The objective of the following study is to review experience with chorionic villous sampling in relation to clinical and laboratory procedures, including general characteristics of ...

Review of chorionic Villus sampling in prenatal diagnosis | Oloyede ...

African Journals Online (AJOL)

Invasive prenatal diagnosis continues to be gold standard in pregnancies at increased risk of congenital abnormalities with chorionic villus sampling being one of the principal methods of prenatal diagnosis. Although not widely available in most developing countries, chorionic villus sampling is the procedure of choice for ...

Dual function of the pectoral girdle for feeding and locomotion in white-spotted bamboo sharks.

Science.gov (United States)

Camp, Ariel L; Scott, Bradley; Brainerd, Elizabeth L; Wilga, Cheryl D

2017-07-26

Positioned at the intersection of the head, body and forelimb, the pectoral girdle has the potential to function in both feeding and locomotor behaviours-although the latter has been studied far more. In ray-finned fishes, the pectoral girdle attaches directly to the skull and is retracted during suction feeding, enabling the ventral body muscles to power rapid mouth expansion. However, in sharks, the pectoral girdle is displaced caudally and entirely separate from the skull (as in tetrapods), raising the question of whether it is mobile during suction feeding and contributing to suction expansion. We measured three-dimensional kinematics of the pectoral girdle in white-spotted bamboo sharks during suction feeding with X-ray reconstruction of moving morphology, and found the pectoral girdle consistently retracted about 11° by rotating caudoventrally about the dorsal scapular processes. This motion occurred mostly after peak gape, so it likely contributed more to accelerating captured prey through the oral cavity and pharynx, than to prey capture as in ray-finned fishes. Our results emphasize the multiple roles of the pectoral girdle in feeding and locomotion, both of which should be considered in studying the functional and evolutionary morphology of this structure. © 2017 The Author(s).

Carbohydrate regulation of photosynthesis and respiration from branch girdling in four species of wet tropical rain forest trees.

Science.gov (United States)

Asao, Shinichi; Ryan, Michael G

2015-06-01

How trees sense source-sink carbon balance remains unclear. One potential mechanism is a feedback from non-structural carbohydrates regulating photosynthesis and removing excess as waste respiration when the balance of photosynthesis against growth and metabolic activity changes. We tested this carbohydrate regulation of photosynthesis and respiration using branch girdling in four tree species in a wet tropical rainforest in Costa Rica. Because girdling severs phloem to stop carbohydrate export while leaving xylem intact to allow photosynthesis, we expected carbohydrates to accumulate in leaves to simulate a carbon imbalance. We varied girdling intensity by removing phloem in increments of one-quarter of the circumference (zero, one--quarter, half, three-quarters, full) and surrounded a target branch with fully girdled ones to create a gradient in leaf carbohydrate content. Light saturated photosynthesis rate was measured in situ, and foliar respiration rate and leaf carbohydrate content were measured after destructive harvest at the end of the treatment. Girdling intensity created no consistent or strong responses in leaf carbohydrates. Glucose and fructose slightly increased in all species by 3.4% per one-quarter girdle, total carbon content and leaf mass per area increased only in one species by 5.4 and 5.5% per one-quarter girdle, and starch did not change. Only full girdling lowered photosynthesis in three of four species by 59-69%, but the decrease in photosynthesis was unrelated to the increase in glucose and fructose content. Girdling did not affect respiration. The results suggest that leaf carbohydrate content remains relatively constant under carbon imbalance, and any changes are unlikely to regulate photosynthesis or respiration. Because girdling also stops the export of hormones and reactive oxygen species, girdling may induce physiological changes unrelated to carbohydrate accumulation and may not be an effective method to study carbohydrate feedback

Clinical and molecular characterization of limb-girdle muscular dystrophy due to LAMA2 mutations

DEFF Research Database (Denmark)

Gavassini, Bruno F; Carboni, Nicola; Nielsen, Jørgen E

2011-01-01

In this study we describe the clinical and molecular characteristics of limb-girdle muscular dystrophy (LGMD) due to LAMA2 mutations.......In this study we describe the clinical and molecular characteristics of limb-girdle muscular dystrophy (LGMD) due to LAMA2 mutations....

Human chorionic gonadotropin, angiogenic factors, and preeclampsia risk: a nested case-control study.

Science.gov (United States)

Asvold, Bjørn O; Eskild, Anne; Vatten, Lars J

2014-05-01

To study whether human chorionic gonadotropin concentrations during pregnancy or combinations of human chorionic gonadotropin and other angiogenic factors, soluble fms-like tyrosine kinase 1 and placental growth factor (PlGF), are associated with preeclampsia risk. Nested case-control study. Population cohort of pregnant women. A total of 121 cases of preterm (cases of term preeclampsia (≥37 weeks of gestation) and 356 women without preeclampsia (controls). Women with preeclampsia were identified by linkage to the Medical Birth Registry of Norway. Concentrations of human chorionic gonadotropin, soluble fms-like tyrosine kinase 1 and PlGF were measured in maternal serum samples collected in each trimester of pregnancy. Odds ratios of preterm and term preeclampsia. High human chorionic gonadotropin concentrations (highest quartile) in the first trimester were associated with reduced risk for preterm preeclampsia (OR 0.3, 95% CI 0.1-0.9), compared with low human chorionic gonadotropin (lowest quartile), whereas high human chorionic gonadotropin concentrations in the second trimester were associated with increased risk for preterm preeclampsia (OR 4.0, 95% CI 1.8-8.9). High human chorionic gonadotropin concentrations in the third trimester were associated with increased risk for term preeclampsia (OR 4.8, 95% CI 1.8-13.3). Concentrations of human chorionic gonadotropin above the median value combined with PlGF below the median in the second trimester were associated with very high risk for preterm preeclampsia (OR 36.9, 95% CI 8.2-165.8). The results suggest an important role of human chorionic gonadotropin in the pathophysiological processes that lead to preeclampsia. The combined association of human chorionic gonadotropin and PlGF indicates a possible synergism between underlying biological pathways. © 2014 Nordic Federation of Societies of Obstetrics and Gynecology.

Preliminary diffusion tensor imaging studies in limb-girdle muscular dystrophies

Science.gov (United States)

Hidalgo-Tobon, S.; Hernandez-Salazar, G.; Vargas-Cañas, S.; Marrufo-Melendez, O.; Solis-Najera, S.; Taboada-Barajas, J.; Rodriguez, A. O.; Delgado-Hernandez, R.

2012-10-01

Limb-girdle muscular dystrophies (LGMD) are a group of autosomal dominantly or recessively inherited muscular dystrophies that also present with primary proximal (limb-girdle) muscle weakness. This type of dystrophy involves the shoulder and pelvic girdles, distinct phenotypic or clinical characteristics are recognized. Imaging experiments were conducted on a 1.5T GE scanner (General Electric Medical Systems. Milwaukee. USA), using a combination of two eight-channel coil array. Diffusion Tensor Imaging (DTI) data were acquired using a SE-EPI sequence, diffusion weighted gradients were applied along 30 non-collinear directions with a b-value=550 s/mm2. The connective tissue content does not appear to have a significant effect on the directionality of the diffusion, as assessed by fractional anisotropy. The fibers of the Sartorius muscle and gracilis showed decreased number of tracts, secondary to fatty infiltration and replacement of connective tissue and muscle mass loss characteristic of the underlying pathology. Our results demonstrated the utility of non-invasive MRI techniques to characterize the muscle pathology, through quantitative and qualitative methods such as the FA values and tractrography.

DNA Extraction from Chorionic Villi for Prenatal Diagnosis of Foetal ...

African Journals Online (AJOL)

BACKGROUND: Extraction of DNA from the chorionic villi is the first major step in the molecular determination of foetal haemoglobin genotype. There are few reports on DNA extraction from the chorionic villi. A desired method should be simple to conduct, reliable and cost effective. OBJECTIVE: The aim of the study was to ...

Effects of cane girdling on yield, fruit quality and maturation of (Vitis vinifera L. cv. Flame Seedless

Directory of Open Access Journals (Sweden)

Soltekin Oguzhan

2016-01-01

Full Text Available This study was carried out to determine the effects of cane girdling on coloration, maturation, yield and some quality characteristics of Vitis vinifera L. cv. Flame Seedless table grape variety. Cane girdling practices were treated at pea-size stage (G2 and veraison period (G1 over two growing seasons, 2013–2014, at the facility of Manisa Viticultural Research Institute in Turkey. Cane girdling was performed on the canes after first shoot was left from the bottom and 4 mm-wide ring of bark was completely removed with a doubleded knife. On the other hand control vines were left untouched. Statistical analyses showed that TSS, berry length, colour parameters, CIRG index and anthocyanin content of Flame Seedless was significantly affected by the cane girdling treatments in both years, 2013 and 2014. In addition it was detected that any effect of girdling treatments cannot be determined statistically significant on total yield, marketable yield, titrable acidity and 50 berry weight. Total and marketable yields of girdled vines had higher value than control vines although they were not statistically significant. Furthermore it was observed 9 and 12 days earliness with G2 treatments compare to the control vines in 2013 and 2014, respectively.

Anabolic steroid induced hypogonadism treated with human chorionic gonadotropin.

OpenAIRE

Gill, G. V.

1998-01-01

A case is presented of a young competitive body-builder who abused anabolic steroid drugs and developed profound symptomatic hypogonadotrophic hypogonadism. With the help of prescribed testosterone (Sustanon) he stopped taking anabolic drugs, and later stopped Sustanon also. Hypogonadism returned, but was successfully treated with weekly injections of human chorionic gonadotropin for three months. Testicular function remained normal thereafter on no treatment. The use of human chorionic gonad...

Myocytes of chorionic vessels from placentas with meconium-associated vascular necrosis exhibit apoptotic markers.

Science.gov (United States)

King, Erin L; Redline, Raymond W; Smith, Steven D; Kraus, Frederick T; Sadovsky, Yoel; Nelson, D Michael

2004-04-01

Meconium-associated vascular necrosis (MAVN) is a histological abnormality of human placental chorionic vessels that is associated with poor neonatal outcome. We tested the hypothesis that MAVN shows apoptosis in the walls of chorionic vessels. Archival placental specimens with MAVN (n = 5) were compared with specimens from uncomplicated pregnancies at term (n = 5) and from placentas with intense chorionic vasculitis associated with acute chorioamnionitis with (n = 5) or without (n = 5) a clinical history of meconium in the amniotic fluid. Sections from all placentas were processed by the TUNEL method, and 2 observers who were blinded to specimen diagnosis quantified the immunofluorescent TUNEL staining in both the amnion-facing and villous-facing walls of the larger chorionic vessels in each specimen. Compared with the other 3 groups, only the amnion-facing wall of chorionic vessels in MAVN showed a significantly greater number of apoptotic cells. This was verified by morphological criteria and caspase 3 staining. There were limited or no detectable TUNEL-stained cells in either the villous-facing walls of vessels in the MAVN specimens or in any of the vessels of the placentas from uncomplicated pregnancies. There was a negligible level of apoptosis in chorionic vessels of placentas with intense chorionic vasculitis, with or without meconium, despite the inflammatory response or presence of meconium. We conclude that apoptosis contributes to the pathophysiology of MAVN.

Bethlem myopathy is not allelic to limb-girdle muscular dystrophy type 1A

Energy Technology Data Exchange (ETDEWEB)

Speer, M.C.; Yamaoka, L.H.; Stajich, J.; Lewis, K. [and others

1995-08-28

The Bethlem myopathy, an autosomal-dominant myopathy, shows a distribution of proximal muscle weakness similar to that observed in dominant limb-girdle muscular dystrophy (LGMD). Yet the Bethlem myopathy differs from most limb-girdle dystrophies in two important regards. First, the Bethlem myopathy presents with joint contractures most commonly observed at the elbows, ankles, and neck. Secondly, disease onset in the Bethlem myopathy is in early childhood, while most dominant LGMDs present with adult onset. 6 refs., 1 fig.

Women's experiences of pregnancy related pelvic girdle pain: A systematic review.

Science.gov (United States)

Mackenzie, Jo; Murray, Esther; Lusher, Joanne

2018-01-01

to systematically review the available studies which relay the experience of pregnancy related pelvic girdle pain and how this affects women psychologically and emotionally. a systematic review and meta-synthesis of the experiences of pregnancy related pelvic girdle pain was conducted for qualitative studies dated between 2005 and 2016. Predefined terms were used to search nine central databases and hand searches of two reference lists of identified studies were carried out. 614 records were identified, eight studies met the inclusion criteria for review. Pain from pelvic girdle pain impacted on women's daily lives both at home and the workplace. This had a negative emotional and psychological impact on women as it took away their feeling of independence. Women reported feelings of frustration, guilt, irritability and upset at being unable to carry out their normal roles. Pelvic girdle pain also affected the women's sense of identity and ability to care for their children. Health professionals working with pregnant and postnatal women need to be aware of the anger, frustration and negative emotions resulting from PGP. These women may become socially isolated and there is a risk they could abuse analgesics in attempt to manage the pain especially if they do not have the social support. For women with young children, it is important to be aware of safety issues they face with carrying babies and controlling toddlers. It is therefore important that health professionals recognise PGP as a serious health issue, approach this condition sensitively and refer to appropriate treatment as soon as PGP is suspected. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

[Chorionicity and adverse perinatal outcome].

Science.gov (United States)

Ferreira, Isabel; Laureano, Carla; Branco, Miguel; Nordeste, Ana; Fonseca, Margarida; Pinheiro, Adelaide; Silva, Maria Isabel; Almeida, Maria Céu

2005-01-01

Considering the highest rate of morbidity and mortality in diamniotic monochorionic twins, the authors evaluated and compared the adverse obstetric and perinatal outcome in twin pregnancies according to chorionicity. A retrospective study was conducted in all twin deliveries that occurred in the Obstetric Unit of Maternidade Bissaya-Barreto, for a period of tree years (from the 1st of January 1999 until the 31st of December 2001). From de 140 diamniotic twin pregnancies studied, we considered two groups according to the chorionicity: monochorionic and dichorionic. We compared multiple parameters as, epidemiologic data, adverse obstetric outcome, gestacional delivery age, type of delivery and the morbidity, the mortality and the follow-up of the newborn. The statistic tests used were the X2 and the t student. From the 140 twin pregnancies included in the study, 66% (92 cases) presented dichorionic placentation and 34% (48 cases) were monochorionic. In the group of monochorionic pregnancies, we observed highly difference related to pathology of amniotic fluid (14.5% vs 2.2%), discordant fetal growth (41.6% vs 22.8%) and rate of preterm delivery (66.6% vs 32.6%). Related to the newborn we verified that they had a lower average birth weight (1988g vs 2295g), a highly rate of weight discordancy (23% vs 15.3%), intraventricular haemorrhage (2.2% vs 0%) and IUGR (6.6% vs 1.6%), statistically significant in the monochorionic group. Also the perinatal mortality rate was significantly higher in the monochorionic pregnancies (93.7 per thousand vs 21.7 per thousand). The high rate of morbidity and mortality related to the monochorionic twin pregnancies, implies the need of a correct identification of the type of chorionicity and also a high standard of prenatal surveillance in prenatal specialised health centers.

Pengaruh Penambahan Chorionic Gonadotrophin pada Medium Maturasi terhadap Kemampuan Maturasi, Fertilisasi, dan Perkembangan Embrio secara In Vitro Kambing Peranakan Ettawa (The Effect of Chorionic Gonadotrophin Addition Into Maturation Medium on The Abili

Directory of Open Access Journals (Sweden)

Nurvina Septi Adifa

2012-02-01

the values of 40.8%, 11.4%, and 12.2% respectively. Based on the result it could be concluded that chorionic gonadotrophin addition into maturation medium had not increased ettawa crossbred oocytes maturation, fertilization, and in vitro cleavage rate. The best maturation, fertilization, and in vitro cleavage rate were found using maturation medium without any addition of chorionic gonadotrophin. (Key words: Does oocyte, Chorionic gonadotrophin, In vitro maturation, In vitro fertilization, In vitro embryo development

Cone and seed production of western larch in response to girdling and nitrogen fertilization - an update

Science.gov (United States)

Russell T. Graham; Jonalea R. Tonn; Theresa B. Jain

1995-01-01

Western larch (Larix occidentalis Nutt.) is a sporadic cone and seed producer. Because the species is such an important component of the -Northern Rocky Mountain forests, methods of increasing seed production are needed. Girdling, fertilizing, and a combination of the two were used on 75-year-old western larch in northern Idaho. Girdling at the base of the live crown...

Stem girdling evidences a trade-off between cambial activity and sprouting and dramatically reduces plant transpiration due to feedback inhibition of photosynthesis and hormone signaling.

Science.gov (United States)

López, Rosana; Brossa, Ricard; Gil, Luis; Pita, Pilar

2015-01-01

The photosynthesis source-sink relationship in young Pinus canariensis seedlings was modified by stem girdling to investigate sprouting and cambial activity, feedback inhibition of photosynthesis, and stem and root hydraulic capacity. Removal of bark tissue showed a trade-off between sprouting and diameter growth. Above the girdle, growth was accelerated but the number of sprouts was almost negligible, whereas below the girdle the response was reversed. Girdling resulted in a sharp decrease in whole plant transpiration and root hydraulic conductance. The reduction of leaf area after girdling was strengthened by the high levels of abscisic acid found in buds which pointed to stronger bud dormancy, preventing a new needle flush. Accumulation of sugars in leaves led to a coordinated reduction in net photosynthesis (AN) and stomatal conductance (gS) in the short term, but later (gS below 0.07 mol m(-2) s(-1)) AN decreased faster. The decrease in maximal efficiency of photosystem II (FV/FM) and the operating quantum efficiency of photosystem II (ΦPSII) in girdled plants could suggest photoprotection of leaves, as shown by the vigorous recovery of AN and ΦPSII after reconnection of the phloem. Stem girdling did not affect xylem embolism but increased stem hydraulic conductance above the girdle. This study shows that stem girdling affects not only the carbon balance, but also the water status of the plant.

Stem girdling evidences a trade-off between cambial activity and sprouting and dramatically reduces plant transpiration due to feedback inhibition of photosynthesis and hormone signaling

Directory of Open Access Journals (Sweden)

Rosana eLópez

2015-04-01

Full Text Available The photosynthesis source-sink relationship in young Pinus canariensis seedlings was modified by stem girdling to investigate sprouting and cambial activity, feedback inhibition of photosynthesis, and stem and root hydraulic capacity. Removal of bark tissue showed a trade-off between sprouting and diameter growth. Above the girdle, growth was accelerated but the number of sprouts was almost negligible, whereas below the girdle the response was reversed. Girdling resulted in a sharp decrease in whole plant transpiration and root hydraulic conductance. The reduction of leaf area after girdling was strengthened by the high levels of ABA found in buds which pointed to stronger bud dormancy, preventing a new needle flush. Accumulation of sugars in leaves led to a coordinated reduction in net photosynthesis (AN and stomatal conductance (gS in the short term, but later (gS below 0.07 mol m-2 s-1 AN decreased faster. The decrease in maximal efficiency of photosystem II (FV/FM and the operating quantum efficiency of photosystem II (ΦPSII in girdled plants could suggest photoprotection of leaves, as shown by the vigorous recovery of AN and ΦPSII after reconnection of the phloem. Stem girdling did not affect xylem embolism but increased stem hydraulic conductance above the girdle. This study shows that stem girdling affects not only the carbon balance, but also the water status of the plant.

Mesenchymal stem cells in human placental chorionic villi reside in a vascular Niche

NARCIS (Netherlands)

Castrechini, N. M.; Murthi, P.; Gude, N. M.; Erwich, J. J. H. M.; Gronthos, S.; Zannettino, A.; Brennecke, S. R.; Kalionis, B.; Brennecke, S.P.

The chorionic villi of human term placentae are a rich source of mesenchymal stem cells (PMSCs) The stem cell "niche" within the chorionic villi regulates how PMSCs participate in placental tissue generation, maintenance and repair, but the anatomic location of the niche has not been defined A

Pattern of human chorionic gonadotropin binding in the polycystic ovary

International Nuclear Information System (INIS)

Brawer, J.; Richard, M.; Farookhi, R.

1989-01-01

The histologic evolution of polycystic ovaries in the estradiol valerate-treated rat coincides with the development of a unique plasma pattern of luteinizing hormone. To assess the role of luteinizing hormone in polycystic ovaries, it is necessary to evaluate the luteinizing hormone sensitivity of the specific tissues in the polycystic ovary. Therefore, we examined the pattern of luteinizing hormone binding sites in polycystic ovaries. Rats at 4 or 8 weeks after estradiol valerate treatment each received an intrajugular injection of iodine 125-labeled human chorionic gonadotropin. Some rats also received a 1000-fold excess of unlabeled human chorionic gonadotropin in the same injection. Ovaries were prepared for autoradiography. Dense accumulations of grains occurred over the theca of normal and atretic secondary follicles in all ovaries and over clusters of secondary interstitial cells. The iodine label was variable over the typically hypertrophied theca of precystic follicles. The theca of definitive cysts showed little or no label. These results indicate that cyst formation coincides with the loss of luteinizing hormone/human chorionic gonadotropin binding to the affected follicles

Pattern of human chorionic gonadotropin binding in the polycystic ovary

Energy Technology Data Exchange (ETDEWEB)

Brawer, J.; Richard, M.; Farookhi, R. (McGill Univ., Montreal, Quebec (Canada))

1989-08-01

The histologic evolution of polycystic ovaries in the estradiol valerate-treated rat coincides with the development of a unique plasma pattern of luteinizing hormone. To assess the role of luteinizing hormone in polycystic ovaries, it is necessary to evaluate the luteinizing hormone sensitivity of the specific tissues in the polycystic ovary. Therefore, we examined the pattern of luteinizing hormone binding sites in polycystic ovaries. Rats at 4 or 8 weeks after estradiol valerate treatment each received an intrajugular injection of iodine 125-labeled human chorionic gonadotropin. Some rats also received a 1000-fold excess of unlabeled human chorionic gonadotropin in the same injection. Ovaries were prepared for autoradiography. Dense accumulations of grains occurred over the theca of normal and atretic secondary follicles in all ovaries and over clusters of secondary interstitial cells. The iodine label was variable over the typically hypertrophied theca of precystic follicles. The theca of definitive cysts showed little or no label. These results indicate that cyst formation coincides with the loss of luteinizing hormone/human chorionic gonadotropin binding to the affected follicles.

Etiology and prognosis of pregnancy-related pelvic girdle pain; design of a longitudinal study

Directory of Open Access Journals (Sweden)

Kroese Mariëlle EAL

2005-01-01

Full Text Available Abstract Background Absence of knowledge of pregnancy-related pelvic girdle pain (PPGP has prompted the start of a large cohort study in the Netherlands. The objective of this study was to investigate the prevalence and incidence of PPGP, to identify risk factors involved in the onset and to determine the prognosis of pregnancy-related pelvic girdle pain. Methods/design 7,526 pregnant women of the southeast of the Netherlands participated in a prospective cohort study. During a 2-year period, they were recruited by midwives and gynecologists at 14 weeks of pregnancy. Participants completed a questionnaire at baseline, at 30 weeks of pregnancy, at 2 weeks after delivery, at 6 months after delivery and at 1 year after delivery. The study uses extensive questionnaires with questions ranging from physical complaints, limitations in activities, restriction in participation, work situation, demographics, lifestyle, pregnancy-related factors and psychosocial factors. Discussion This large-scale prospective cohort study will provide reliable insights in incidence, prevalence and factors related to etiology and prognosis of pregnancy-related pelvic girdle pain.

Increasing Human Neural Stem Cell Transplantation Dose Alters Oligodendroglial and Neuronal Differentiation after Spinal Cord Injury

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Katja M. Piltti

2017-06-01

Full Text Available Multipotent human central nervous system-derived neural stem cells transplanted at doses ranging from 10,000 (low to 500,000 (very high cells differentiated predominantly into the oligodendroglial lineage. However, while the number of engrafted cells increased linearly in relationship to increasing dose, the proportion of oligodendrocytic cells declined. Increasing dose resulted in a plateau of engraftment, enhanced neuronal differentiation, and increased distal migration caudal to the transplantation sites. Dose had no effect on terminal sensory recovery or open-field locomotor scores. However, total human cell number and decreased oligodendroglial proportion were correlated with hindlimb girdle coupling errors. Conversely, greater oligodendroglial proportion was correlated with increased Ab step pattern, decreased swing speed, and increased paw intensity, consistent with improved recovery. These data suggest that transplant dose, and/or target niche parameters can regulate donor cell engraftment, differentiation/maturation, and lineage-specific migration profiles.

Limb girdle muscular dystrophies

DEFF Research Database (Denmark)

Vissing, John

2016-01-01

PURPOSE OF REVIEW: The aim of the study was to describe the clinical spectrum of limb girdle muscular dystrophies (LGMDs), the pitfalls of the current classification system for LGMDs, and emerging therapies for these conditions. RECENT FINDINGS: Close to half of all LGMD subtypes have been...... or are registered in other classification systems for muscle disease. On the contrary, diseases that fulfill classical criteria for LGMD have found no place in the LGMD classification system. These shortcomings call for revision/creation of a new classification system for LGMD. The rapidly expanding gene sequencing...... capabilities have helped to speed up new LGMD discoveries, and unveiled pheno-/genotype relations. Parallel to this progress in identifying new LGMD subtypes, emerging therapies for LGMDs are under way, but no disease-specific treatment is yet available for nonexperimental use. SUMMARY: The field of LGMD...

The girdles of the oldest fossil turtle, Proterochersis robusta, and the age of the turtle crown

OpenAIRE

Joyce, Walter G; Schoch, Rainer R; Lyson, Tyler R

2013-01-01

Background: Proterochersis robusta from the Late Triassic (Middle Norian) of Germany is the oldest known fossil turtle (i.e. amniote with a fully formed turtle shell), but little is known about its anatomy. A newly prepared, historic specimen provides novel insights into the morphology of the girdles and vertebral column of this taxon and the opportunity to reassess its phylogenetic position.Results: The anatomy of the pectoral girdle of P. robusta is similar to that of other primitive turtle...

Limb girdle muscular dystrophy due to mutations in POMT2

DEFF Research Database (Denmark)

Østergaard, Sofie Thurø; Johnson, Katherine; Stojkovic, Tanya

2018-01-01

BACKGROUND: Mutations in the gene coding for protein O-mannosyl-transferase 2 (POMT2) are known to cause severe congenital muscular dystrophy, and recently, mutations in POMT2 have also been linked to a milder limb-girdle muscular dystrophy (LGMD) phenotype, named LGMD type 2N (LGMD2N). Only four...

Effect of giberellic acid (GA4/7) and girdling on induction of reproductive structures in Pinus patula

Energy Technology Data Exchange (ETDEWEB)

Vargas-Hernandez, J.J.; Vargas-Abonce, J.I.

2016-07-01

Aim of the study. Seed production in forest tree species commonly takes a long time due to the length of the juvenile stage. Even though several treatments have been used to induce early flowering in conifer species, experience on their use in subtropical Pinus species is limited. This study aimed to evaluate the effect of GA4/7 dose (0, 1.27 and 2.54 mg cm-2) and application time (July-October), alone or in combination with partial stem girdling, on male and female strobili production in young Pinus patula Schiede ex Schltdl. et Cham. clones. Area of study: Nine clones with different flowering background of high-elevation Pinus patula growing in a six-year old seed orchard established in Central México (Aquixtla, Puebla) at 2,800 m elevation. Material and methods: Two independent flowering trials (FT1 and FT2) were carried out in the seed orchard during the 2009 and 2010 flowering cycles; similar factors were evaluated at both trials but time of application, clones tested, and experimental design used varied for each of them. Partial stem girdling was done at the base of the trunk and the GA4/7 solution was injected into the xylem above the point of girdling. The following spring, the percentage of trees with strobili and the number of strobili per tree were determined for both male and female structures. Main results: Significant differences (p ≤ 0.05) among clones in flowering capacity were found at both trials. None of the treatments applied in FT1 resulted in an increase of strobili formation, most probably because they were applied too late in the growing season. In FT2, however, application of GA4/7 combined with partial stem girdling increased the percentage of trees with strobili and the number of strobili of both sexes, particularly when applied in early July. Partial stem girdling was more effective on promoting male strobili than female ones in gibberellin-treated grafts. Research highlights: Timing of GA4/7 application and stem girdling was

A newly recognized autosomal dominant limb girdle muscular dystrophy with cardiac involvement

NARCIS (Netherlands)

van der Kooi, A. J.; Ledderhof, T. M.; de Voogt, W. G.; Res, C. J.; Bouwsma, G.; Troost, D.; Busch, H. F.; Becker, A. E.; de Visser, M.

1996-01-01

Sixty-five members of three families with limb girdle muscular dystrophy (LGMD) underwent neurological, cardiological, and ancillary investigations. Thirty-five individuals were diagnosed as having slowly progressive autosomal dominant LGMD. Symmetrical weakness started in the proximal lower limb

Muscle MRI findings in patients with limb girdle muscular dystrophy with calpain 3 deficiency (LGMD2A) and early contractures.

Science.gov (United States)

Mercuri, Eugenio; Bushby, Kate; Ricci, Enzo; Birchall, Daniel; Pane, Marika; Kinali, Maria; Allsop, Joanna; Nigro, Vincenzo; Sáenz, Amets; Nascimbeni, Annachiara; Fulizio, Luigi; Angelini, Corrado; Muntoni, Francesco

2005-02-01

Limb girdle muscular dystrophy 2A is a common variant secondary to mutations in the calpain 3 gene. A proportion of patients has early and severe contractures, which can cause diagnostic difficulties with other conditions. We report clinical and muscle magnetic resonance imaging findings in seven limb girdle muscular dystrophy 2A patients (four sporadic and three familial) who had prominent and early contractures. All patients showed a striking involvement of the posterior thigh muscles. The involvement of the other thigh muscles was variable and was related to clinical severity. Young patients with minimal functional motor impairment showed a predominant involvement of the adductors and semimembranosus muscles while patients with restricted ambulation had a more diffuse involvement of the posterolateral muscles of the thigh and of the vastus intermedius with relative sparing of the vastus lateralis, sartorius and gracilis. At calf level all patients showed involvement of the soleus muscle and of the medial head of the gastrocnemius with relative sparing of the lateral head. MRI findings were correlated to those found in two patients with the phenotype of limb girdle muscular dystrophy 2A without early contractures and the pattern observed was quite similar. However, the pattern observed in limb girdle muscular dystrophy 2A is different from that reported in other muscle diseases such as Emery-Dreifuss muscular dystrophy and Bethlem myopathy which have a significant clinical overlap with limb girdle muscular dystrophy 2A once early contractures are present. Our results suggest that muscle MRI may help in recognising patients with limb girdle muscular dystrophy 2A even when the clinical presentation overlaps with other conditions, and may therefore, be used as an additional investigation to target the appropriate biochemical and genetic tests.

Complex surgery for locally advanced bone and soft tissue sarcomas of the shoulder girdle.

Science.gov (United States)

Lesenský, Jan; Mavrogenis, Andreas F; Igoumenou, Vasilios G; Matejovsky, Zdenek; Nemec, Karel; Papagelopoulos, Panayiotis J; Fabbri, Nicola

2017-08-01

Surgical management of primary musculoskeletal tumors of the shoulder girdle is cognitively and technically demanding. Over the last decades, advances in the medical treatments, imaging and surgical techniques have fostered limb salvage surgery and reduced the need for amputation. Despite well-accepted general principles, an individualized approach is often necessary to accommodate tumor extension, anatomical challenges and patient characteristics. A combination of techniques is often required to achieve optimal oncologic and durable functional outcome. Goal of this article is to review approach and management of patients with locally advanced sarcomas of the shoulder girdle requiring major tumor surgery, to illustrate principles of surgical strategy, outcome and complications, and to provide useful guidelines for the treating physicians.

Variation in the pelvic and pectoral girdles of Australian Oligo–Miocene mekosuchine crocodiles with implications for locomotion and habitus

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Michael D. Stein

2017-06-01

Full Text Available Australian Oligo–Miocene mekosuchines (Crocodylia; Crocodyloidea display wide diversity in cranial shape and inferred hunting strategies. Terrestrial habitus has been inferred for these distinctive predators. A direct morphological signal for locomotion can be expected in the postcrania, particularly the pelvic and pectoral girdles. Here we describe fossil materials of the girdles, which chart their morphological variation in the subfamily from Eocene through to Middle Miocene. Over this period, both girdles undergo significant morphological changes. Notably, an enclosed, ventrally orientated acetabulum in the ilium is developed in one lineage. This recapitulates the erect parasagittal configuration of the pelvic limb seen in many Mesozoic crocodylomorph lineages, suggesting consistent use of erect high-walking in these mekosuchines. Other pelves from the same Oligo–Miocene deposits display morphology closer to modern crocodilians, suggesting a partitioning of locomotory strategy among sympatric mekosuchines. Plesiomorphic and derived pelvic girdles are distinguishable by parsimony analysis, and the earliest examples of the mekosuchine pelvis more closely resemble gavialids and alligatorids while latter forms converge on crown group crocodylids in the morphology of the iliac crest. This suggests that a revaluation of the base relationship of Mekosuchinae within Eusuchia is necessary.

MR Imaging of Brachial Plexus and Limb-Girdle Muscles in Patients with Amyotrophic Lateral Sclerosis.

Science.gov (United States)

Gerevini, Simonetta; Agosta, Federica; Riva, Nilo; Spinelli, Edoardo G; Pagani, Elisabetta; Caliendo, Giandomenico; Chaabane, Linda; Copetti, Massimiliano; Quattrini, Angelo; Comi, Giancarlo; Falini, Andrea; Filippi, Massimo

2016-05-01

To assess brachial plexus magnetic resonance (MR) imaging features and limb-girdle muscle abnormalities as signs of muscle denervation in patients with amyotrophic lateral sclerosis (ALS). This study was approved by the local ethical committees on human studies, and written informed consent was obtained from all subjects before enrollment. By using an optimized protocol of brachial plexus MR imaging, brachial plexus and limb-girdle muscle abnormalities were evaluated in 23 patients with ALS and clinical and neurophysiologically active involvement of the upper limbs and were compared with MR images in 12 age-matched healthy individuals. Nerve root and limb-girdle muscle abnormalities were visually evaluated by two experienced observers. A region of interest-based analysis was performed to measure nerve root volume and T2 signal intensity. Measures obtained at visual inspection were analyzed by using the Wald χ(2) test. Mean T2 signal intensity and volume values of the regions of interest were compared between groups by using a hierarchical linear model, accounting for the repeated measurement design. The level of interrater agreement was very strong (κ = 0.77-1). T2 hyperintensity and volume alterations of C5, C6, and C7 nerve roots were observed in patients with ALS (P < .001 to .03). Increased T2 signal intensity of nerve roots was associated with faster disease progression (upper-limb Medical Research Council scale progression rate, r = 0.40; 95% confidence interval: 0.001, 0.73). Limb-girdle muscle alterations (ie, T2 signal intensity alteration, edema, atrophy) and fat infiltration also were found, in particular, in the supraspinatus muscle, showing more frequent T2 signal intensity alterations and edema (P = .01) relative to the subscapularis and infraspinatus muscles. Increased T2 signal intensity and volume of brachial nerve roots do not exclude a diagnosis of ALS and suggest involvement of the peripheral nervous system in the ALS pathogenetic cascade. MR

Transcriptomes of Arbuscular Mycorrhizal Fungi and Litchi Host Interaction after Tree Girdling.

Science.gov (United States)

Shu, Bo; Li, Weicai; Liu, Liqin; Wei, Yongzan; Shi, Shengyou

2016-01-01

Trunk girdling can increase carbohydrate content above the girdling site and is an important strategy for inhibiting new shoot growth to promote flowering in cultivated litchi (Litchi chinensis Sonn.). However, girdling inhibits carbohydrate transport to the root in nearly all of the fruit development periods and consequently decreases root absorption. The mechanism through which carbohydrates regulate root development in arbuscular mycorrhiza (AM) remains largely unknown. Carbohydrate content, AM colonization, and transcriptome in the roots were analyzed to elucidate the interaction between host litchi and AM fungi when carbohydrate content decreases. Girdling decreased glucose, fructose, sucrose, quebrachitol, and starch contents in the litchi mycorrhizal roots, thereby reducing AM colonization. RNA-seq achieved approximately 60 million reads of each sample, with an average length of reads reaching 100 bp. Assembly of all the reads of the 30 samples produced 671,316 transcripts and 381,429 unigenes, with average lengths of 780 and 643 bp, respectively. Litchi (54,100 unigenes) and AM fungi unigenes (33,120 unigenes) were achieved through sequence annotation during decreased carbohydrate content. Analysis of differentially expressed genes (DEG) showed that flavonoids, alpha-linolenic acid, and linoleic acid are the main factors that regulate AM colonization in litchi. However, flavonoids may play a role in detecting the stage at which carbohydrate content decreases; alpha-linolenic acid or linoleic acid may affect AM formation under the adaptation process. Litchi trees stimulated the expression of defense-related genes and downregulated symbiosis signal-transduction genes to inhibit new AM colonization. Moreover, transcription factors of the AP2, ERF, Myb, WRKY, bHLH families, and lectin genes altered maintenance of litchi mycorrhizal roots in the post-symbiotic stage for carbohydrate starvation. Similar to those of the litchi host, the E3 ubiquitin ligase complex

Effect of Mifepristone on the Telomerase Activity in Chorion and Decidua during Early Pregnancy

Institute of Scientific and Technical Information of China (English)

Ge-qing XIA; Ya-li XIONG; Yong-hong SUN

2004-01-01

Objective To investigate telomerase activity in chorion and decidua from abortion induced by mifepristone incorporated with misoprostol at early pregnancy Methods TRAP-SYBR Green assay was used to detect the expression of telomerase. Forty specimen were obtained from medicinal abortion (experiment group) and forty were from normal induced abortion (control group).Results Positive expression, of chorion telomerase was significantly different between the experimental group (28％, 11/40) and the control group (73％, 29/40) (P＜0. 05).While in decidua, the positive rate was 28％ (11/40) in the experimental group and 20％ (9/40) in the control group, there was no significant difference (P＞0. 05).Conclusion It is suggested that miferistone may significantly decrease the telomerase activity in chorion but not in decidua.

Gene expression in Citrus sinensis fruit tissues harvested from huanglongbing-infected trees: comparison with girdled fruit.

Science.gov (United States)

Liao, Hui-Ling; Burns, Jacqueline K

2012-05-01

Distribution of viable Candidatus Liberibacter asiaticus (CaLas) in sweet orange fruit and leaves ('Hamlin' and 'Valencia') and transcriptomic changes associated with huanglongbing (HLB) infection in fruit tissues are reported. Viable CaLas was present in most fruit tissues tested in HLB trees, with the highest titre detected in vascular tissue near the calyx abscission zone. Transcriptomic changes associated with HLB infection were analysed in flavedo (FF), vascular tissue (VT), and juice vesicles (JV) from symptomatic (SY), asymptomatic (AS), and healthy (H) fruit. In SY 'Hamlin', HLB altered the expression of more genes in FF and VT than in JV, whereas in SY 'Valencia', the number of genes whose expression was changed by HLB was similar in these tissues. The expression of more genes was altered in SY 'Valencia' JV than in SY 'Hamlin' JV. More genes were also affected in AS 'Valencia' FF and VT than in AS 'Valencia' JV. Most genes whose expression was changed by HLB were classified as transporters or involved in carbohydrate metabolism. Physiological characteristics of HLB-infected and girdled fruit were compared to differentiate between HLB-specific and carbohydrate metabolism-related symptoms. SY and girdled fruit were smaller than H and ungirdled fruit, respectively, with poor juice quality. However, girdling did not cause misshapen fruit or differential peel coloration. Quantitative PCR analysis indicated that many selected genes changed their expression significantly in SY flavedo but not in girdled flavedo. Mechanisms regulating development of HLB symptoms may lie in the host disease response rather than being a direct consequence of carbohydrate starvation.

Radioimmunoassay of β sub unit HCG following hydatidiform mole or chorionic carcinoma

International Nuclear Information System (INIS)

Tscherne, G.; Puerstner, P.

1979-01-01

The radioimmunoassay of Beta Sub Unit HCG in the serum heralds a marked improvement in the diagnosis of gestational trophoblastic disease. In nine cases of hydatidiform mole and three cases of chorionic carcinoma serial examinations of the Beta Sub Unit HCG were performed. When the immunologic pregnancy test became negative following a hydatidiform mole or following treatment of chorionic carcinoma, the HCG excretion remained above detectable values for several more weeks. The decrease of Beta Sub Unit serum HCG was either linear or in fluctuations. The detection of fluctuations or a secondary rise in the Beta Sub Unit HCG titre permits the early diagnosis of invasive trophoblastic disease following hydatidiform mole or of insufficient treatment or recurrence in cases of chorionic carcinoma. Our results suggest that the optimal follow-up with Beta Sub Unit serum HCG is by weekly determinations until four consecutive determinations remained negative. This is followed by two determinations at bi-weekly intervals and thereafter monthly follow-up examinations. (orig.) 891 AJ/orig. 892 BRE [de

Clinical and genetic spectrum in limb-girdle muscular dystrophy type 2E

DEFF Research Database (Denmark)

Semplicini, Claudio; Vissing, John; Dahlqvist, Julia R

2015-01-01

OBJECTIVE: To determine the clinical spectrum of limb-girdle muscular dystrophy 2E (LGMD2E) and to investigate whether genetic or biochemical features can predict the phenotype of the disease. METHODS: All LGMD2E patients followed in participating centers were included. A specific clinical protoc...

Exercise level before pregnancy and engaging in high-impact sports reduce the risk of pelvic girdle pain: a population-based cohort study of 39 184 women.

Science.gov (United States)

Owe, Katrine Mari; Bjelland, Elisabeth K; Stuge, Britt; Orsini, Nicola; Eberhard-Gran, Malin; Vangen, Siri

2016-07-01

To examine whether an association exists between exercise levels pre-pregnancy and pelvic girdle pain in pregnancy. Pelvic girdle pain in pregnancy has been associated with physical inactivity, a risk factor for adverse pregnancy outcomes. We used data from a population-based cohort study including 39 184 nulliparous women with a singleton pregnancy enrolled in the Norwegian Mother and Child Cohort study. Pre-pregnancy exercise frequency and types were assessed by questionnaire in pregnancy week 17. Pelvic girdle pain, defined as combined pain in the anterior pelvis and in the posterior pelvis bilaterally, was self-reported in pregnancy week 30. Multivariable Poisson regression estimated risks of pelvic girdle pain associated with pre-pregnancy exercise. We examined a dose-response association of prepregnancy exercise frequency using restricted cubic splines. A test for non-linearity was also conducted. Final models were adjusted for pre-pregnancy BMI, age, education, history of low back pain and history of depression. 4069 women (10.4%) reported pelvic girdle pain in pregnancy and the prevalence among women who were non-exercisers prepregnancy was 12.5%. There was a non-linear association for pre-pregnancy exercise and risk of pelvic girdle pain (test for non-linearity, p=0.003). Compared to non-exercisers, women exercising 3-5 times weekly pre-pregnancy had a 14% lower risk of developing pelvic girdle pain in pregnancy (aRR 0.86, 95% CI 0.77 to 0.96). Taking part in high-impact exercises such as running, jogging, orienteering, ballgames, netball games and high-impact aerobics were associated with less risk of pelvic girdle pain. Women who exercise regularly and engage in high-impact exercises before the first pregnancy may have a reduced risk of pelvic girdle pain in pregnancy. 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/

Body weight-supported training in Becker and Limb Girdle 2I muscular dystrophy

DEFF Research Database (Denmark)

Jensen, Bente Rona; Berthelsen, Martin Peter; Husu, Edith

2016-01-01

INTRODUCTION: We studied the functional effects of combined strength and aerobic anti-gravity training in severely affected patients with Becker and Limb-Girdle muscular dystrophies. METHODS: Eight patients performed 10-week progressive combined strength (squats, calf raises, lunges) and aerobic...

Function and failure of the fetal membrane: Modelling the mechanics of the chorion and amnion.

Directory of Open Access Journals (Sweden)

Stefaan W Verbruggen

Full Text Available The fetal membrane surrounds the fetus during pregnancy and is a thin tissue composed of two layers, the chorion and the amnion. While rupture of this membrane normally occurs at term, preterm rupture can result in increased risk of fetal mortality and morbidity, as well as danger of infection in the mother. Although structural changes have been observed in the membrane in such cases, the mechanical behaviour of the human fetal membrane in vivo remains poorly understood and is challenging to investigate experimentally. Therefore, the objective of this study was to develop simplified finite element models to investigate the mechanical behaviour and rupture of the fetal membrane, particularly its constituent layers, under various physiological conditions. It was found that modelling the chorion and amnion as a single layer predicts remarkably different behaviour compared with a more anatomically-accurate bilayer, significantly underestimating stress in the amnion and under-predicting the risk of membrane rupture. Additionally, reductions in chorion-amnion interface lubrication and chorion thickness (reported in cases of preterm rupture both resulted in increased membrane stress. Interestingly, the inclusion of a weak zone in the fetal membrane that has been observed to develop overlying the cervix would likely cause it to fail at term, during labour. Finally, these findings support the theory that the amnion is the dominant structural component of the fetal membrane and is required to maintain its integrity. The results provide a novel insight into the mechanical effect of structural changes in the chorion and amnion, in cases of both normal and preterm rupture.

Bone anatomy of the pelvic girdle, the thigh and the leg of Myrmecophaga tridactyla (Myrmecophagidae: Pilosa

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Lucas de Assis Ribeiro

2013-11-01

Full Text Available The giant anteater (Myrmecophaga tridactyla is the largest anteater species in the world. It is an animal of terrestrial habits, however, it has some ability to climb tall trees and termite mounds. The hard skeletal structures are of crucial importance, since they join and protect the soft organs and help support the body, shape, and get involved in movement. The appendicular skeleton is an important part of the locomotor apparatus, whose anatomical information in wild species is scarce, making it difficult to interpret data on these bones. This paper aims to describe the pelvic girdle, the thigh, and the leg skeleton in the giant anteater. We used two specimens of Myrmecophaga tridactyla Linnaeus (1758, fixed in a 3.7% aqueous formaldehyde solution. At first, the limbs were disjointed and we removed the skin, viscera, and muscles associated to the bones of the pelvic girdle, the thigh, and the leg in the specimens. Then, they were macerated in boiling water, and, subsequently, placed in a hydrogen peroxide solution. Once clean and dry, the bones were identified and described. The pelvic girdle skeleton in the giant anteater consists of the hip bone, formed by the ilium, pubis, and ischium bones; the thigh consists of the femur bone, and the leg consists of the tibia and fibula bones. In the knee joint region there is the patella, a relatively small sesamoid bone, considering the large size of this animal. The giant anteater have osteological features of the pelvic girdle, the thigh, and the leg similar to those in domestic carnivores, however, some morphological differences are made evident, something which may reflect differences in locomotor patterns.

Glu20Ter Variant in PLEC 1f Isoform Causes Limb-Girdle Muscle Dystrophy with Lung Injury

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Roman V. Deev

2017-07-01

Full Text Available Plectinopathies are orphan diseases caused by PLEC gene mutations. PLEC is encoding the protein plectin, playing a role in linking cytoskeleton components in various tissues. In this study, we describe the clinical case of a 26-year-old patient with an early onset plectinopathy variant “limb-girdle muscle dystrophy type 2Q,” report histopathological and ultrastructural findings in m. vastus lateralis biopsy and a novel homozygous likely pathogenic variant (NM_201378.3:c.58G>T, NP_958780.1:p.Glu20Ter in isoform 1f of the gene PLEC. The patient had an early childhood onset with retarded physical development, moderate weakness in pelvic girdle muscles, progressive weakening of limb-girdle muscles after the age of 21, pronounced atrophy of axial muscles, and hypertrophy of the gastrocnemius, deltoid, and triceps muscles, intermittent dyspnea, and no skin involvement. Findings included: non-infectious bronchiolitis and atelectasis signs, biopsy revealed myodystrophal pattern without macrophage infiltration, muscle fiber cytoskeleton disorganization resulted from the plectin loss, incomplete reparative rhabdomyogenesis, and moderate endomysial fibrosis. We have determined a novel likely pathogenic variant in PLEC 1f isoform that causes limb-girdle muscle dystrophy type 2Q and described the third case concerning an isolated myodystrophic phenotype of LGMD2Q with the likely pathogenic variant in PLEC 1f isoform. In addition, we have demonstrated the presence of severe lung injury in a patient and his siblings with the same myodystrophic phenotype and discussed the possible role of plectin deficiency in its pathogenesis.

Interactive influence of leaf age, light intensity, and girdling on green ash foliar chemistry and emerald ash borer development.

Science.gov (United States)

Chen, Yigen; Poland, Therese M

2009-07-01

Biotic and abiotic environmental factors affect plant nutritional quality and defensive compounds that confer plant resistance to herbivory. Influence of leaf age, light availability, and girdling on foliar nutrition and defense of green ash (Fraxinus pennsylvanica Marsh) was examined in this study. Longevity of the emerald ash borer, Agrilus planipennis Fairmaire (Coleoptera: Buprestidae), adults reared on green ash foliage subjected to these factors was assayed. Mature leaves generally were more nutritious with greater amino acids and a greater ratio of protein to non-structural carbohydrate (P:C) than young leaves, in particular when trees were grown in shade. On the other hand, mature leaves had lower amounts of trypsin and chymotrypsin inhibitors, and total phenolics compared to young leaves. Lower defense of mature leaves alone, or along with higher nutritional quality may lead to increased survival and longevity of emerald ash borer feeding on mature leaves. Sunlight reduced amino acids and P:C ratio, irrespective of leaf age and girdling, and elevated total protein of young foliage, but not protein of mature leaves. Sunlight also dramatically increased all investigated defensive compounds of young, but not mature leaves. Girdling reduced green ash foliar nutrition, especially, of young leaves grown in shade and of mature leaves grown in sun. However emerald ash borer performance did not differ when fed leaves from trees grown in sun or shade, or from girdled or control trees. One explanation is that emerald ash borer reared on lower nutritional quality food may compensate for nutrient deficiency by increasing its consumption rate. The strong interactions among leaf age, light intensity, and girdling on nutrition and defense highlight the need for caution when interpreting data without considering possible interactions.

Effect of high doses of equine chorionic gonadotrophin (eCG ...

African Journals Online (AJOL)

SAM

2014-03-19

Mar 19, 2014 ... Key words: Equine chorionic gonadotrophin, follicular, ovulation, pregnancy, estrus synchronization, goat. ... This requires that the management practices take into account .... MOET, multiple ovulation and embryo transfer; PASW®, predictive analytics software; PMSG, pregnant mare serum gonadotropin.

The effect of smoking on early chorionic villous vascularisation

NARCIS (Netherlands)

van Oppenraaij, R. H. F.; Koning, A. H. J.; van den Hoff, M. J. B.; van der Spek, P. J.; Steegers, E. A. P.; Exalto, N.

2012-01-01

The aim aim of the study was to investigate whether first trimester chorionic villous vascularisation is different in women who smoked cigarettes before and during pregnancy in comparison with women who did not smoke. Placentas of smoking (>10 cigarettes/day, n = 13) and non-smoking women (n = 13),

A new mutation of the fukutin gene causing late-onset limb girdle muscular dystrophy

DEFF Research Database (Denmark)

Riisager, Maria; Duno, M; Hansen, Flemming Juul

2013-01-01

to aberrations of FKTN is rare, with only eight reported cases of limb girdle phenotype (LGMD2M). We describe the mildest affected patient outside Japan with genetically confirmed LGMD2M and onset of symptoms at age 14. She was brought to medical attention at age 12, not because of muscle weakness, but due...... to episodes of tachycardia caused by Wolff-Parkinson-White syndrome. On examination, she had rigid spine syndrome, a typical limb girdle dystrophy pattern of muscle weakness, cardiomyopathy, and serum CK levels >2000 IU/L (normal G; p.Y306C mutation in the FKTN gene was found. The case confirms FKTN mutations...... as a cause of LGMD2M without mental retardation and expands the phenotypic spectrum for LGMD2M to include cardiomyopathy and rigid spine syndrome in the mildest affected non-Japanese patient reported so far....

Tissue-specific expression of silkmoth chorion genes in vivo using Bombyx mori nuclear polyhedrosis virus as a transducing vector.

Science.gov (United States)

Iatrou, K; Meidinger, R G

1990-01-01

A pair of silkmoth chorion chromosomal genes, HcA.12-HcB.12, was inserted into a baculovirus transfer vector, pBmp2, derived from the nuclear polyhedrosis virus of Bombyx mori. This vector, which permits the insertion of foreign genetic material in the vicinity of a mutationally inactivated polyhedrin gene, was used to acquire the corresponding recombinant virus. Injection of mutant silkmoth pupae that lack all Hc chorion genes with the recombinant virus resulted in the infection of all internal organs including follicular tissue. Analysis of RNA from infected tissues has demonstrated that the two chorion genes present in the viral genome are correctly transcribed under the control of their own promoter in follicular cells, the tissue in which chorion genes are normally expressed. The chorion primary transcripts are also correctly processed in the infected follicular cells and yield mature mRNAs indistinguishable from authentic chorion mRNAs present in wild-type follicles. These results demonstrate that recombinant nuclear polyhedrosis viruses can be used as transducing vectors for introducing genetic material of host origin into the cells of the organism and that the transduced genes are transiently expressed in a tissue-specific manner under the control of their resident regulatory sequences. Thus we show the in vivo expression of cloned genes under cellular promoter control in an insect other than Drosophila melanogaster. The approach should be applicable to all insect systems that are subject to nuclear polyhedrosis virus infection. Images PMID:2187186

Use of a caudoventral-craniodorsal oblique radiographic view made at 45° to the frontal plane to evaluate the pectoral girdle in raptors.

Science.gov (United States)

Visser, Marike; Hespel, Adrien-Maxence; de Swarte, Marie; Bellah, Jamie R

2015-11-01

To evaluate use of a caudoventral-craniodorsal oblique radiographic view made at 45° to the frontal plane (H view) for assessment of the pectoral (thoracic) girdle in raptors. Retrospective cross-sectional analysis. 24 raptors suspected to have a fracture of the thoracic girdle. Standard ventrodorsal and H views were obtained for all birds. Radiographs were evaluated twice by a radiologist blinded to the final diagnosis, with each view first evaluated independently and views then evaluated in combination. Sensitivity, specificity, positive predictive value, and negative predictive value were calculated, with results of surgery or necropsy used as the gold standard. 9 birds had thoracic girdle fractures; fractures were correctly identified in 8 of these 9 birds on the ventrodorsal view alone, 7 of these 9 birds on the H view alone, and all 9 birds on the 2 views in combination. Fifteen birds did not have thoracic girdle fractures; radiographs were correctly classified in 12 of these 15 birds when the ventrodorsal view was evaluated alone, all 15 birds when the H view was evaluated alone, and 14 of these 15 birds when the 2 views were evaluated in combination. Results suggested that the H view or the addition of the H view to the VD view could be useful in raptors suspected to have fractures of the thoracic girdle. Agreement with the gold standard (ie, fracture present or absent) was higher with the H view and combination of views than with the ventrodorsal view alone.

Fertility Rates of Ewes Treated with Medroxyprogesterone and Injected with Equine Chorionic Gonadotropin plus Human Chorionic Gonadotropin in Anoestrous Season

Directory of Open Access Journals (Sweden)

I. W. Santos

2010-01-01

Full Text Available The aim of the present paper was to investigate the efficiency of the equine chorionic gonadotropin (eCG plus human chorionic gonadotropin (hCG associated with medroxyprogesterone acetate (MAP to estrous ewes synchronization. Ninety Texel ewes were investigated during seasonal anoestrous. The ewes received intravaginal sponges containing MAP (60 mg for nine days. At the time of sponges' withdrawal, the ewes were divided into three groups (G: (1 receiving 2 mL of saline i.m. (n=30, (2 receiving eCG 400 IU i.m. (n=30, and (3 receiving eCG 400 IU plus hCG 200 IU i.m. (n=30. Twelve h after sponges' removal, teaser rams were used to estrus check and remained with the ewes for 96 h. The artificial insemination was made with fresh semen 10 h after estrus detection. The effect of the treatment was not significant for the estrous rates among the groups: 73%, 90%, and 86%, respectively. The main effect was observed in the pregnancy and lambing rates among the groups: 70%, 86%, 56%, and 80%, 120%, 56%, respectively. Based on these results from our study, the use of the MAP—eCG is the best choice to improve the fertility rate on ewes.

Effect of human chorionic gonadotropin (hCG) on in vitro oocyte ...

African Journals Online (AJOL)

use

2011-11-23

Nov 23, 2011 ... In vitro exposure of Barilius vagra ovarian follicles to human chorionic gonadotropin (hCG) .... breakdown (GVBD) by treating them with egg clearing solution ..... trihydroxy-5Я-pregnen-20-one, in female plaice (Pleuronectes.

[Transabdominal chorionic villus sampling using biopsy forceps or needle: pregnancy outcomes by technique used].

Science.gov (United States)

Spallina, J; Anselem, O; Haddad, B; Touboul, C; Tsatsaris, V; Le Ray, C

2014-11-01

To compare pregnancy outcomes after transabdominal chorionic villus sampling using biopsy forceps or needle. Retrospective bicentric study including all women who had a transabdominal chorionic villus sampling between 2005 and 2009 (172 using biopsy forceps and 160 using needle). The primary endpoint was the rate of fetal loss, after excluding medical abortion due to the result of the biopsy. The secondary endpoint was the rate of premature rupture of the membrane. All cases were reviewed to try to determine the responsibility of the biopsy. The pregnancy outcomes were not different between the two groups: 4 (4.4%) fetal losses in the biopsy forceps group and 6 (7.4%) in the needle group (P=0.52). Only one case (1.2%) of fetal loss can be attributed to the biopsy, using a needle, and none (0%) following a forceps biospy (P=0.29). The rate of premature rupture of the membrane was comparable in the two groups. The pregnancy outcomes following chorionic villus sampling using a biopsy forceps or a needle seem comparable. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

HEMIPELVECTOMY AND INTRAOPERATIVE RADIOTHERAPY FOR BONE AND SOFT-TISSUE SARCOMAS OF THE PELVIC GIRDLE

NARCIS (Netherlands)

HOEKSTRA, HJ; SINDELAR, WF; SZABO, BG; KINSELLA, TJ

1995-01-01

Current treatment of locally advanced bone and soft tissue sarcomas of the pelvic girdle are associated with a high local and distant failure rate, and local tumor control after hemipelvectomy can be a significant problem. IORT has been used in conjunction with hemipelvectomy, both conventional

Fractures due to insufficient pelvic girdle

International Nuclear Information System (INIS)

Garcia Aguayo, F.J.; Martinez Almagro, A.

1995-01-01

Eleven cases are presented of postmenopausal women with a total of 37 fractures due to insufficient pelvic girdle: 15 located in sacrum, ten in the pubic rami, four in ilium proximal to the sacroiliac joint, three in iliac fossa, two in iliac tuberosity and three in the public body. Eight of the patients were diagnosed over a period of six years when seeking medical attention for bone pain. The other three were diagnosed retrospectively among a group of 33 cancer patients (the majority having having breast cancer) who presented positive pelvic radionuclide bone scan. CT was superior to conventional radiology in detecting fractures of this type, especially those of sacrum and ilium. Radionuclide bone scan was highly sensitive but its specificity was low, requiring back-up radiology and above all CT to establish the differential diagnosis with respect to other types of lesions, especially metastases. (Author) 14 refs

Predictors for postpartum pelvic girdle pain in working women: the Mom@Work cohort study

NARCIS (Netherlands)

Stomp-van den Berg, G.M.; Hendriksen, I.J.M.; Bruinvels, D.J.; Twisk, J.W.R.; Mechelen, W. van; Poppel, M.N.M. van

2012-01-01

The objective of this study was to examine which factors during pregnancy and postpartum predict pelvic girdle pain (PGP) at 12 weeks postpartum among working women. A total of 548 Dutch pregnant employees were recruited in 15 companies, mainly health care, child care, and supermarkets. The

The health-seeking behaviours of first-time mothers with persistent pelvic girdle pain after childbirth in Ireland: A descriptive qualitative study.

Science.gov (United States)

Wuytack, Francesca; Curtis, Elizabeth; Begley, Cecily

2015-11-01

to explore the health-seeking behaviours of primiparous women with pelvic girdle pain persisting for more than three months post partum. a descriptive qualitative design involving face-to-face semi-structured interviews following institutional ethical approval. Transcripts were analysed using thematic analysis. an urban hospital in Ireland. a purposive sample of 23 consenting first-time mothers with pelvic girdle pain persisting for at least three months post partum. 'they didn't ask, I didn't tell' was a key theme, which included emerging categories of a perceived lack of follow-up post partum, and feeling ignored by healthcare professionals. The theme 'Seeking advice and support' describes women's role of talking to others, and triggers and barriers to getting help. 'Coping strategies' was the third theme emerging from the interviews, whereby participants described different strategies they used to deal with their symptoms, although many expressed uncertainty about what to do or who to see. our findings show the importance of appropriate information and follow-up care for women with pelvic girdle pain and highlight barriers they encounter in seeking help. They also question the duration of postnatal care as participants felt that postnatal care was stopped too early. The findings may assist maternity care providers in addressing mothers' expectations and needs related to persistent pelvic girdle pain. Copyright © 2015 Elsevier Ltd. All rights reserved.

CLINICAL TESTS FOR THE ASSESSMENT OF THE PELVIC GIRDLE PAIN IN PREGNANCY AND POSTPARTUM

Directory of Open Access Journals (Sweden)

Darija Šćepanović

2018-02-01

Full Text Available Background: Pregnancy-related pelvic girdle pain (PGP refers to the pain in the lumbosacral region, the sacroiliac joints and the symphysis pubis joint. The results of the high methodological quality studies indicate that the point prevalence of pregnant women suffering from PGP is about 20 %. Pregnancy-related PGP requires a comprehensive physiotherapy assessment in order to make or confirm a diagnosis, plan the treatment and evaluate the patient’s condi- tion. Physiotherapy assessment includes clinical diagnostic tests which should satisfy the criteria of safety, feasibility, reliability, sensitivity, specificity and validity. The aim of the present paper was to systematically review the literature on clinical diagnostic tests of PGP in order to determine which clinical tests meet the necessary criteria and are appropriate for clinical examination of PGP in pregnancy and postpartum. Methods: PubMed, Cinahl, Embase, Index Medicus databases and the Cochrane controlled trials reg- ister from 1980 to 2008 were searched using the key words, pregnancy/pelvic girdle pain, pregnancy/clinical tests/sacroiliac joint/symphysis pubis. Only the articles/texts in English and Slovene were reviewed unless translated abstract was available. Additional manual searches of the reference lists in books and review articles were undertaken. Along with the randomized clinical studies the literature search encompassed also the basic studies. Results: Nine studies evaluating the tests for clinical examination of the pregnancy-related PGP met the criteria for inclusion in this review. The studies evaluated and analysed six provocation tests for the sacroiliac joint, namely, the Posterior pelvic pain provocation test (P4, Patrick’s Faber test, palpation of the long dorsal ligament, compression test, separation test, Menell’s test as well as two provocation tests for the symphysis pubis joint (pain palpation and a modified Trendelenburg test and one functional

Progressive dysphagia in limb-girdle muscular dystrophy type 2B.

LENUS (Irish Health Repository)

Walsh, Richard

2012-02-01

Dysphagia has not been reported in genetically confirmed limb-girdle muscular dystrophy type 2B (LGMD2B). A 40-year-old woman reported exercise-induced calf pain at age 34, followed by progressive lower and upper limb weakness. At age 38, progressive dysphagia for solids, and subsequently liquids, ensued. Endoscopic and videofluoroscopic-radiological findings indicated a myopathic swallowing disorder. Molecular genetic analysis confirmed two dysferlin gene mutations consistent with a compound heterozygote state. Progressive dysphagia should be considered as part of the expanding dysferlinopathy phenotype.

Primary pulmonary choriocarcinoma after human chorionic gonadotropin normalization following hydatidiform mole

DEFF Research Database (Denmark)

Maestá, Izildinha; Leite, Fábio Vicente; Michelin, Odair Carlito

2010-01-01

BACKGROUND: Primary pulmonary choriocarcinoma (PPC) is rare and frequently leads to death. CASES: Two young patients presented with previous molar pregnancy and spontaneous serum human chorionic gonadotropin (hCG) normalization. Patient 1 was referred to our center after partial response to chemo...

[The diagnostic value of human chorionic gonadotrophin ratio compared to single measurements of S-human chorionic gonadotrophin on the outcome of pregnancy of unknown location].

Science.gov (United States)

Majeed, Huda Galib; Lyngsø, Julie; Bor, Pinar

2014-10-13

Pregnancy of unknown location is defined by a positive pregnancy test, without visualizing of the intrauterine or extrauterine pregnancy by transvaginal sonography. We present the advantages of using human chorionic gonadotrophin (hCG) ratio instead of single measurements of S-hCG for predicting the outcomes of pregnancies of unknown location.

External and internal hemipelvectomy for sarcomas of the pelvic girdle : consequences of limb-salvage treatment

NARCIS (Netherlands)

Ham, SJ; Veth, RPH; van Horn, [No Value; Eisma, WH; Hoekstra, HJ; Schraffordt Koops, H.

1997-01-01

The outcome of different Limb-saving treatment modalities for pelvic girdle sarcoma is controversial. The oncological and functional results after 11 external and 10 internal hemipelvectomies and the consequences of limb-salvage treatment were studied in 21 consecutive patients with primary bone (19

Changes of serum and chorion-villi contents of EGF in early pregnant women undergone artificial abortion

International Nuclear Information System (INIS)

Li Suping; Wu Xiaohua; Li Hui

2008-01-01

Objective: To investigate the changes of serum and chorion-villi contents of EGF in pregnant women undergone artificial abortion with drug (mifepristone) or surgery (curettage). Methods: Serum epidermal growth factor (EGF), E 2 , progesterone levels changes as well as chorion-villi EGF contents were measured with RIA in 36 pregnant women with drug abortion (before and after mifepristone 25mg bid x 3 days), 30 pregnant women undergone curettage (determined twice, 3 days apart) and 32 controls (serum only). Results: Serum EGF, E 2 , and progesterone contents in all pregnant women were significantly higher than those in controls (P<0.01). The chorion-villi contents of EGF in patients undergone drug abortion were significantly lower than those in patients undergone curettage (P<0.05). Both serum EGF and progesterone contents dropped after 3 days treatment with mifepristone (vs those in curettage group, P<0.05). Conclusion: Mifepristone might exert the effect of abortion through decrease of EGF levels, which was detrimental to fetus growth. (authors)

Cardiac involvement in patients with limb-girdle muscular dystrophy type 2 and Becker muscular dystrophy

DEFF Research Database (Denmark)

Sveen, Marie-Louise; Thune, Jens Jakob; Køber, Lars

2008-01-01

OBJECTIVE: To investigate the extent of cardiac involvement in patients with 1 of the 12 groups of recessively inherited limb-girdle muscular dystrophy type 2 (LGMD2A-L) and Becker muscular dystrophy (BMD). DESIGN: Prospective screening. SETTING: Neuromuscular Clinic and Department of Cardiology...

The Influence of Chorion Type on Health Measures at Birth and Dental Development in Australian and Dutch Twins: A Comparative Study

NARCIS (Netherlands)

Mihailidis, S.; Bockmann, M.; McConnell, E.; Hughes, T.; van Beijsterveldt, C.E.M.; Boomsma, D.I.; McMaster, M.T.; Townsend, G.

2015-01-01

Chorion type may significantly influence the prenatal environment of twins. This study explored the associations between chorion type and gestational age, birth weight, birth length, and the timing of emergence of the first primary tooth in two populations of twins, Australian and Dutch.

CT findings of muscular dystrophy; Limb girdle type (LG), myotonic type (MYD) and Duchenne type (DMD)

Energy Technology Data Exchange (ETDEWEB)

Saitoh, Hiroshi (Tokushima Univ. (Japan). School of Medicine)

1991-07-01

CT scans of muscles in patients with limb girdle type (LG), myotonic type (MYD) and Duchenne type (DMD) dystrophies were obtained at five different body levels: the neck, L3 vertebral body, pelvic girdle, thigh and lower leg. CT numbers, cross sectional areas (CSA) and %CSA of muscle or fat were evaluated in each muscle. The characteristic CT patterns for each type of muscular dystrophy were obtained. Compared with DMD, the gracilis and soleus were more severely damaged in LG and the biceps femoris remained relatively preserved among the hamstrings. In addition, the multifidus of the neck and sternocleidomastoid also were more severely damaged in MYD. This study suggests that CT scan will be useful in the differential diagnosis of these types of muscular dystrophy as well as in planning appropriate rehabilitation and detecting damaged muscles. (author).

Influence of Human Chorionic Gonadotropin on the Fertility Rate in ...

African Journals Online (AJOL)

An experiment was carried out on the influence of human chorionic gonadotropin hormone (hCG) on the fertility rate of rabbit does under artificial insemination. The rabbit does (7-8 months old) were used for the trial. The hCG was administered to the rabbit does at varying doses: 0, 50, 100 and 150 I.U representing ...

Progression of cardiac involvement in patients with limb-girdle type 2 and Becker muscular dystrophies

DEFF Research Database (Denmark)

Petri, Helle; Sveen, Marie-Louise; Thune, Jens Jakob

2015-01-01

AIM: To assess the degree and progression of cardiac involvement in patients with limb-girdle type 2 (LGMD2) and Becker muscular dystrophies (BMD). METHODS: A follow-up study of 100 LGMD2 (types A-L) and 30 BMD patients assessed by electrocardiogram (ECG) and echocardiography, supplemented...

Syndecan expressions in the human amnion and chorionic plate

Directory of Open Access Journals (Sweden)

T. Lorenzi

2010-10-01

Full Text Available The syndecan family consists of four distinct membrane glycoproteins in mammals. Syndecans control cell proliferation, differentiation, adhesion and migration through participation in cell-cell interactions, anchorage of cells to the extracellular environment, and modulation of multiple growth factors. Therefore, syndecans may play a pivotal role in the regulation of cell behaviour depending on the cellular microenvironment. Here, we demonstrate that syndecan-1, syndecan-2 and syndecan-4 are expressed in fetal membrane tissue with different immunolocalizations. Syndecan-1 is expressed in the amniotic epithelium, localizing at basolateral cell surfaces. Syndecan-2 and syndecan-4, in contrast, are mostly localized in intracellular compartments, in the extravillous cytotrophoblastic cells and in some fibroblasts of the chorionic plate as well as in the amniotic epithelial cells. In the latter, syndecan-4 is mainly localized in the apical part of the cells. Our results strongly suggest a key role of syndecan-1, syndecan-2 and syndecan-4 in the determination of structural and functional characteristics of human amnion and chorionic plate. Since the solute exchanges between fetus and mother take place in fetal membranes, our data suggest that syndecans are important players in the placenta for the establishment of the fetal-maternal inter-communication.

Homology of the enigmatic nuchal bone reveals novel reorganization of the shoulder girdle in the evolution of the turtle shell.

Science.gov (United States)

Lyson, Tyler R; Bhullar, Bhart-Anjan S; Bever, Gabe S; Joyce, Walter G; de Queiroz, Kevin; Abzhanov, Arhat; Gauthier, Jacques A

2013-01-01

The turtle shell represents a unique modification of the ancestral tetrapod body plan. The homologies of its approximately 50 bones have been the subject of debate for more than 200 years. Although most of those homologies are now firmly established, the evolutionary origin of the dorsal median nuchal bone of the carapace remains unresolved. We propose a novel hypothesis in which the nuchal is derived from the paired, laterally positioned cleithra-dorsal elements of the ancestral tetrapod pectoral girdle that are otherwise retained among extant tetrapods only in frogs. This hypothesis is supported by origin of the nuchal as paired, mesenchymal condensations likely derived from the neural crest followed by a unique two-stage pattern of ossification. Further support is drawn from the establishment of the nuchal as part of a highly conserved "muscle scaffold" wherein the cleithrum (and its evolutionary derivatives) serves as the origin of the Musculus trapezius. Identification of the nuchal as fused cleithra is congruent with its general spatial relationships to other elements of the shoulder girdle in the adult morphology of extant turtles, and it is further supported by patterns of connectivity and transformations documented by critical fossils from the turtle stem group. The cleithral derivation of the nuchal implies an anatomical reorganization of the pectoral girdle in which the dermal portion of the girdle was transformed from a continuous lateral-ventral arc into separate dorsal and ventral components. This transformation involved the reduction and eventual loss of the scapular rami of the clavicles along with the dorsal and superficial migration of the cleithra, which then fused with one another and became incorporated into the carapace. © 2013 Wiley Periodicals, Inc.

Stem girdling affects the quantity of CO2 transported in xylem as well as CO2 efflux from soil.

Science.gov (United States)

Bloemen, Jasper; Agneessens, Laura; Van Meulebroek, Lieven; Aubrey, Doug P; McGuire, Mary Anne; Teskey, Robert O; Steppe, Kathy

2014-02-01

There is recent clear evidence that an important fraction of root-respired CO2 is transported upward in the transpiration stream in tree stems rather than fluxing to the soil. In this study, we aimed to quantify the contribution of root-respired CO2 to both soil CO2 efflux and xylem CO2 transport by manipulating the autotrophic component of belowground respiration. We compared soil CO2 efflux and the flux of root-respired CO2 transported in the transpiration stream in girdled and nongirdled 9-yr-old oak trees (Quercus robur) to assess the impact of a change in the autotrophic component of belowground respiration on both CO2 fluxes. Stem girdling decreased xylem CO2 concentration, indicating that belowground respiration contributes to the aboveground transport of internal CO2 . Girdling also decreased soil CO2 efflux. These results confirmed that root respiration contributes to xylem CO2 transport and that failure to account for this flux results in inaccurate estimates of belowground respiration when efflux-based methods are used. This research adds to the growing body of evidence that efflux-based measurements of belowground respiration underestimate autotrophic contributions. © 2013 The Authors. New Phytologist © 2013 New Phytologist Trust.

Identification of Fetal Inflammatory Cells in Eosinophilic/T-cell Chorionic Vasculitis Using Fluorescent In Situ Hybridization.

Science.gov (United States)

Katzman, Philip J; Li, LiQiong; Wang, Nancy

2015-01-01

Eosinophilic/T-cell chorionic vasculitis (ETCV) is an inflammatory lesion of placental fetal vessels. In contrast to acute chorionic vasculitis, inflammation in ETCV is seen in chorionic vessel walls opposite the amnionic surface. It is not known whether inflammation in ETCV consists of maternal cells from the intervillous space or fetal cells migrating from the vessel. We used fluorescent in situ hybridization (FISH) to differentiate fetal versus maternal cells in ETCV. Placentas with ETCV, previously identified for a published study, were used. Infant sex in each case was identified using the electronic medical record. For male infants, 3-μm sections were cut from archived tissue blocks from placentas involving ETCV and stained with fluorescent X- and Y-chromosome centromeric probes. A consecutive hematoxylin/eosin-stained section was used for correlation. FISH analysis was performed on 400 interphase nuclei at the site of ETCV to determine the proportion of XX, XY, X, and Y cells. Of 31 ETCV cases, 20 were female and 10 were male (1 sex not recorded). Six of 10 cases with male infants had recuts with visible ETCV. In these 6 cases the average percentages (ranges) of XY cells, X-only cells, and Y-only cells in the region of inflammation were 81 (70-90), 11 (6-17), and 8 (2-14), respectively. There was a 2:1 female:male infant ratio in ETCV. Similar to acute chorionic vasculitis, the inflammation in ETCV is of fetal origin. It is still unknown, however, whether the stimulus for ETCV is of fetal or maternal origin.

-Human Chorionic Gonadotropin Production

Directory of Open Access Journals (Sweden)

Michael J. Russell

2008-01-01

Full Text Available Dedifferentiated liposarcomas may display a variety of “heterologous” lines of differentiation, including osseous, vascular, skeletal, and/or smooth muscular. There have been six previously reported examples of leiomyosarcomas associated with high levels of serum human chorionic gonadotropin (hCG production, comprised of cases originating from the retroperitoneum, spermatic cord, small intestine, and uterus. This report describes the first example of a dedifferentiated liposarcoma that combined both of the aforementioned features: extensive heterologous (leiomyosarcomatous differentiation and -hCG production (maximum serum levels 1046 mIU/ml, reference <5 mIU/ml. The tumor, which originated in the retroperitoneum in the region of the right kidney, was rapidly progressive and ultimately fatal within three months of its diagnosis. In addition to characteristic morphologic features, lipogenic and smooth muscle differentiation were confirmed with immunohistochemical stains for MDM2 and smooth muscle actin, respectively. The tumor also displayed diffuse immunoreactivity for -hCG in both primary and metastatic sites. This case further expands the clinicopathologic spectrum of lipogenic tumors.

Attraction of the emerald ash borer to ash trees stressed by girdling, herbicide treatment, or wounding

Science.gov (United States)

Deborah McCullough; Therese Poland; David. Cappaert

2009-01-01

New infestations of emerald ash borer, Agrilus planipennis Fairmaire, an invasive pest native to Asia, are difficult to detect until densities build and symptoms appear on affected ash (Fraxinus spp). We compared the attraction of A. planipennis to ash trees stressed by girdling (bark and phloem removed...

Comparison of different patient positioning strategies to minimize shoulder girdle artifacts in head and neck CT.

Science.gov (United States)

Wirth, Stefan; Meindl, Thomas; Treitl, Marcus; Pfeifer, Klaus-Jürgen; Reiser, Maximilian

2006-08-01

The purpose of this study was to analyze different patient positioning strategies for minimizing artifacts of the shoulder girdle in head and neck CT. Standardized CT examinations of three positioning groups were compared (P: patients pushed their shoulders downwards; D: similar optimization by a pulling device; N: no particular positioning optimization). Parameters analyzed were the length of the cervical spine not being superimposed by the shoulder girdle as well as noise in the supraclavicular space. In groups P and D, the portion of the cervical spine not superimposed was significantly larger than in group N (P: 10.4 cm; D: 10.6 cm; N: 8.5 cm). At the supraclavicular space, noise decreased significantly (P: 12.5 HU; D: 12.1 HU; N: 17.7 HU). No significant differences between the two position-optimized groups (P and D) were detected. Optimized shoulder positioning by the patient increases image quality in CT head and neck imaging. The use of a pulling device offers no additional advantages.

The role of abnormal fetal heart rate in scheduling chorionic villus sampling.

Science.gov (United States)

Yagel, S; Anteby, E; Ron, M; Hochner-Celnikier, D; Achiron, R

1992-09-01

To assess the value of fetal heart rate (FHR) measurements in predicting spontaneous fetal loss in pregnancies scheduled for chorionic villus sampling (CVS). A prospective descriptive study. Two hospital departments of obstetrics and gynaecology in Israel. 114 women between 9 and 11 weeks gestation scheduled for chorionic villus sampling (CVS). Fetal heart rate was measured by transvaginal Doppler ultrasound and compared with a monogram established from 75 fetuses. Whenever a normal FHR was recorded, CVS was performed immediately. 106 women had a normal FHR and underwent CVS; two of these pregnancies ended in miscarriage. In five pregnancies no fetal heart beats could be identified and fetal death was diagnosed. In three pregnancies an abnormal FHR was recorded and CVS was postponed; all three pregnancies ended in miscarriage within 2 weeks. Determination of FHR correlated with crown-rump length could be useful in predicting spontaneous miscarriage before performing any invasive procedure late in the first trimester.

Gene expression profiling in limb-girdle muscular dystrophy 2A.

Directory of Open Access Journals (Sweden)

Amets Sáenz

Full Text Available Limb-girdle muscular dystrophy type 2A (LGMD2A is a recessive genetic disorder caused by mutations in calpain 3 (CAPN3. Calpain 3 plays different roles in muscular cells, but little is known about its functions or in vivo substrates. The aim of this study was to identify the genes showing an altered expression in LGMD2A patients and the possible pathways they are implicated in. Ten muscle samples from LGMD2A patients with in which molecular diagnosis was ascertained were investigated using array technology to analyze gene expression profiling as compared to ten normal muscle samples. Upregulated genes were mostly those related to extracellular matrix (different collagens, cell adhesion (fibronectin, muscle development (myosins and melusin and signal transduction. It is therefore suggested that different proteins located or participating in the costameric region are implicated in processes regulated by calpain 3 during skeletal muscle development. Genes participating in the ubiquitin proteasome degradation pathway were found to be deregulated in LGMD2A patients, suggesting that regulation of this pathway may be under the control of calpain 3 activity. As frizzled-related protein (FRZB is upregulated in LGMD2A muscle samples, it could be hypothesized that beta-catenin regulation is also altered at the Wnt signaling pathway, leading to an incorrect myogenesis. Conversely, expression of most transcription factor genes was downregulated (MYC, FOS and EGR1. Finally, the upregulation of IL-32 and immunoglobulin genes may induce the eosinophil chemoattraction explaining the inflammatory findings observed in presymptomatic stages. The obtained results try to shed some light on identification of novel therapeutic targets for limb-girdle muscular dystrophies.

Effects and mechanisms of action of sildenafil citrate in human chorionic arteries

Directory of Open Access Journals (Sweden)

Lynch Tadhg

2009-04-01

Full Text Available Abstract Objectives Sildenafil citrate, a specific phosphodiesterase-5 inhibitor, is increasingly used for pulmonary hypertension in pregnancy. Sildenafil is also emerging as a potential candidate for the treatment of intra-uterine growth retardation and for premature labor. Its effects in the feto-placental circulation are not known. Our objectives were to determine whether phosphodiesterase-5 is present in the human feto-placental circulation, and to characterize the effects and mechanisms of action of sildenafil citrate in this circulation. Study Design Ex vivo human chorionic plate arterial rings were used in all experiments. The presence of phosphodiesterase-5 in the feto-placental circulation was determined by western blotting and immunohistochemical staining. In a subsequent series of pharmacologic studies, the effects of sildenafil citrate in pre-constricted chorionic plate arterial rings were determined. Additional studies examined the role of cGMP and nitric oxide in mediating the effects of sildenafil. Results Phosphodiesterase-5 mRNA and protein was demonstrated in human chorionic plate arteries. Immunohistochemistry demonstrated phosphodiesterase-5 within the arterial muscle layer. Sildenafil citrate produced dose dependent vasodilatation at concentrations at and greater than 10 nM. Both the direct cGMP inhibitor methylene blue and the cGMP-dependent protein kinase inhibitor Rp-8-Br-PET-cGMPS significantly attenuated the vasodilation produced by sildenafil citrate. Inhibition of NO production with L-NAME did not attenuate the vasodilator effects of sildenafil. In contrast, sildenafil citrate significantly enhanced the vasodilation produced by the NO donor sodium nitroprusside. Conclusion Phosphodiesterase-5 is present in the feto-placental circulation. Sildenafil citrate vasodilates the feto-placental circulation via a cGMP dependent mechanism involving increased responsiveness to NO.

Effects and mechanisms of action of sildenafil citrate in human chorionic arteries.

LENUS (Irish Health Repository)

Maharaj, Chrisen H

2009-01-01

OBJECTIVES: Sildenafil citrate, a specific phosphodiesterase-5 inhibitor, is increasingly used for pulmonary hypertension in pregnancy. Sildenafil is also emerging as a potential candidate for the treatment of intra-uterine growth retardation and for premature labor. Its effects in the feto-placental circulation are not known. Our objectives were to determine whether phosphodiesterase-5 is present in the human feto-placental circulation, and to characterize the effects and mechanisms of action of sildenafil citrate in this circulation. STUDY DESIGN: Ex vivo human chorionic plate arterial rings were used in all experiments. The presence of phosphodiesterase-5 in the feto-placental circulation was determined by western blotting and immunohistochemical staining. In a subsequent series of pharmacologic studies, the effects of sildenafil citrate in pre-constricted chorionic plate arterial rings were determined. Additional studies examined the role of cGMP and nitric oxide in mediating the effects of sildenafil. RESULTS: Phosphodiesterase-5 mRNA and protein was demonstrated in human chorionic plate arteries. Immunohistochemistry demonstrated phosphodiesterase-5 within the arterial muscle layer. Sildenafil citrate produced dose dependent vasodilatation at concentrations at and greater than 10 nM. Both the direct cGMP inhibitor methylene blue and the cGMP-dependent protein kinase inhibitor Rp-8-Br-PET-cGMPS significantly attenuated the vasodilation produced by sildenafil citrate. Inhibition of NO production with L-NAME did not attenuate the vasodilator effects of sildenafil. In contrast, sildenafil citrate significantly enhanced the vasodilation produced by the NO donor sodium nitroprusside. CONCLUSION: Phosphodiesterase-5 is present in the feto-placental circulation. Sildenafil citrate vasodilates the feto-placental circulation via a cGMP dependent mechanism involving increased responsiveness to NO.

Contractile properties are disrupted in Becker muscular dystrophy, but not in limb girdle type 2I

DEFF Research Database (Denmark)

Løkken, Nicoline; Hedermann, Gitte; Thomsen, Carsten

2016-01-01

We investigated whether a linear relationship between muscle strength and cross-sectional area (CSA) is preserved in calf muscles of patients with Becker muscular dystrophy (BMD, n = 14) and limb-girdle type 2I muscular dystrophy (LGMD2I, n = 11), before and after correcting for muscle fat...

Asymmetries of the shoulder and pelvic girdles in girls with scoliosis and scoliotic posture

Directory of Open Access Journals (Sweden)

Jacek Wilczyński

2013-08-01

Full Text Available Aim of the research: To evaluate the asymmetries of the shoulder and pelvic girdles in girls aged 7–18 with scoliosis and scoliotic posture. Material and methods: The children were enrolled at the Międzyszkolny Ośrodek Gimnastyki Korekcyjnej i Kompensacyjnej (Interschool Corrective and Compensatory Gymnastics Centre in Starachowice. The research was carried out in June 2011. 3D digital photogrammetry using the moiré effect was adopted in the research. Depending on the conformity of the variables’ distributions with the normal distribution, and the values of skewness and kurtosis, parametric or non-parametric tests were adopted. The variables were verified in terms of normal distribution with the Shapiro-Wilk test. A screening analysis of the parameters of physiological curvatures of the spine in age groups was also carried out. The relation between the frequency and type of disorders in the frontal plane and age was determined using the χ 2 test. Value of p ≤ 0.05 was assumed as the level of significance. Results: Based on the size of the angle of the curvature of the spine the following were singled out scoliotic posture (1–9° and idiopathic scoliosis (≥ 10°. There were 21 (75% children with the scoliotic posture and 7 (25% with idiopathic scoliosis. The frequency and type of disorders in the frontal plane does not depend on the age of the examined. Asymmetry of the shoulders and shoulder blades was found in all of the examined. The left shoulder along with the left shoulder blade were raised more often. The right side of the pelvis was lowered in most of the examined. Posterior rotation of the left hip bone occurred more often. Conclusions: The values of WBM, WBK and WBC asymmetry coefficients confirm the asymmetry of the shoulder and hip girdles. Analysis of variance did not show any significant relations of asymmetry of the shoulder and hip girdles and the age of the examined.

Morphologic alterations and immunohistochemical analysis of alpha-fetoprotein and CD34 in chorionic villi of anembryonic pregnancy

International Nuclear Information System (INIS)

Aydin, S.; Yenilmez, E.; Yulug, E.; Arvas, H.; Ozeren, M.; Cobanoglu, U.

2006-01-01

To investigate the morphology of chorionic villi using light and electron microscopy, especially the expression of alpha-fetoprotein (AFP) in trophoblastic cells and the process of maturation and margination vasculogenesis proper using CD34 immunohistochemistry in tissues from the first trimester of pregnancy loss due to anembryonic pregnancy in comparison with embryonic pregnancy. The study consisted of 2 groups: 9 patients with anembryonic pregnancies and 9 patients with embryonic pregnancies between 6 and 10 weeks of gestational age registered at the Department of Gynecology and Obstetrics, University Hospital of Karadeniz Technical University, Turkey, from March 2003 to December 2004. We examined the chorionic villi using light and electron microscopy. For immunohistochemical staining, we used AFP and CD 34. Microscopically, pathologic changes were shown in syncytiotrophoblast cells of anembryonic pregnancies and AFP was strongly expressed by villous trophoblastic cells compared to embryonic pregnancies. We determined the CD34 positivity in both groups. In anembryonic pregnancies, vascular elements were much fewer in number compared with embryonic pregnancies (p<0.001) and were located in the formed of hemangioblastic cords. Placental vasculogenesis is a basic feature in all types of pregnancy and a relationship exists between trophoblast cells and vessels in the chorionic villi with the potential to influence each other's functions. Defective chorionic villus vascularization is associated with embryonic death. This study may support the hypothesis, as suggested by previous studies, that anembryonic pregnancy results from early embryonic death and subsequent reabsorption rather than from the nondevelopment of an embryo. (author)

Internal hemipelvectomy with intraoperative and external beam radiotherapy in the limb-sparing treatment of a pelvic girdle chondrosarcoma

NARCIS (Netherlands)

Hoekstra, HJ; Szabo, BG

The case of a patient with an extensive pelvic girdle chondrosarcoma treated with internal hemipelvectomy and intraoperative radiotherapy, followed by adjuvant high-dose external beam radiotherapy, with a successful attempt in achieving long-term local tumor control and limb-sparing treatment is

Anatomy of Shoulder Girdle Muscle Modifications and Walking Adaptation in the Scaly Chinese Pangolin (Manis Pentadactyla Pentadactyla: Pholidota) Compared with the Partially Osteoderm-Clad Armadillos (Dasypodidae).

Science.gov (United States)

Kawashima, Tomokazu; Thorington, Richard W; Bohaska, Paula W; Chen, Yen-Jean; Sato, Fumi

2015-07-01

Because pangolins are unique mammals with a body and limbs almost entirely sheathed in hard keratinous overlapping scales and with digging and climbing abilities, the shoulder girdle muscles may differ significantly from those of other mammals including the partially osteoderm-clad armadillos. Therefore, we conducted a functional anatomical study of the shoulder girdle muscles in Chinese pangolins (Manis pentadactyla pentadactyla, Pholidota) and some armadillo species (Dasypodidae). Our CT scans revealed that the pangolin's overlapping scales are hard structures completely encasing the limbs. The armadillo's limbs, however, are covered with small relatively soft non-overlapping scales embedded in the skin, and articulate completely free of the hard osteodermal carapace. The attachments of some shoulder girdle muscles in the pangolin have moved from the surrounding edges of the scapula to the spine, and they, therefore, fully cover the scapula. In addition, some pangolin shoulder girdle muscles cross the shoulder joint to insert on the distal humerus, but this does not occur in armadillos. We cannot rule out the possibility that these muscle modifications represent adaptations for digging and/or climbing in pangolins. Our results and previous literature do not establish specific links between them and locomotive modes. However, we propose that the Chinese pangolin may use its derived muscular features when walking to move its armor-restricted forelimbs more effectively by swinging its head from side to side. © 2015 Wiley Periodicals, Inc.

Botulinum toxin type a injections for cervical and shoulder girdle myofascial pain using an enriched protocol design.

Science.gov (United States)

Nicol, Andrea L; Wu, Irene I; Ferrante, F Michael

2014-06-01

Myofascial pain syndrome is a regional condition of muscle pain and stiffness and is classically characterized by the presence of trigger points in affected musculature. Botulinum toxin type A (BoNT-A) has been shown to have antinociceptive properties and elicit sustained muscle relaxation, thereby possibly affording even greater relief than traditional strategies. Our goal was to determine whether direct injection of BoNT-A into painful muscle groups is effective for cervical and shoulder girdle myofascial pain. An enriched protocol design was used, wherein 114 patients with cervical and shoulder girdle myofascial pain underwent injection of BoNT-A to determine their response to the drug. Fifty-four responders were then enrolled in a 12-week, randomized, double-blind, placebo-controlled trial. Pain scales and quality of life measures were assessed at baseline and at routine follow-up visits until completion of the study after 26 weeks. Injection of BoNT-A into painful muscle groups improved average visual numerical pain scores in subjects who received a second dose of BoNT-A compared to placebo (P = 0.019 [0.26, 2.78]). Subjects who received a second dose of BoNT-A had a reduced number of headaches per week (P = 0.04 [0.07, 4.55]). Brief Pain Inventory interference scores for general activity and sleep were improved (P = 0.046 [0.038, 3.700] and 0.02 [0.37, 4.33], respectively) in those who received a second dose of BoNT-A. BoNT-A injected directly into painful muscle groups improves average pain scores and certain aspects of quality of life in patients experiencing severe cervical and shoulder girdle myofascial pain.

Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

Energy Technology Data Exchange (ETDEWEB)

Garnon, Julien, E-mail: juliengarnon@gmail.com; Koch, Guillaume, E-mail: Guillaume.koch@gmail.com [University Hospital of Strasbourg, Department of Interventional Radiology (France); Ramamurthy, Nitin, E-mail: Nitin-ramamurthy@hotmail.com [Norfolk and Norwich University Hospital, Department of Radiology (United Kingdom); Caudrelier, Jean, E-mail: caudjean@yahoo.fr [University Hospital of Strasbourg, Department of Interventional Radiology (France); Rao, Pramod, E-mail: pramodrao@me.com [University of Strasbourg, ICube (France); Tsoumakidou, Georgia, E-mail: Georgia.tsoumakidou@chru-strasbourg.fr; Cazzato, Roberto Luigi, E-mail: gigicazzato@hotmail.it; Gangi, Afshin, E-mail: Afshin.gangi@chru-strasbourg.fr [University Hospital of Strasbourg, Department of Interventional Radiology (France)

2016-09-15

ObjectiveTo review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.Materials and MethodsBetween May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment.ResultsFour pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.ConclusionPercutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.

Percutaneous CT and Fluoroscopy-Guided Screw Fixation of Pathological Fractures in the Shoulder Girdle: Technical Report of 3 Cases

International Nuclear Information System (INIS)

Garnon, Julien; Koch, Guillaume; Ramamurthy, Nitin; Caudrelier, Jean; Rao, Pramod; Tsoumakidou, Georgia; Cazzato, Roberto Luigi; Gangi, Afshin

2016-01-01

ObjectiveTo review our initial experience with percutaneous CT and fluoroscopy-guided screw fixation of pathological shoulder-girdle fractures.Materials and MethodsBetween May 2014 and June 2015, three consecutive oncologic patients (mean age 65 years; range 57–75 years) with symptomatic pathological shoulder-girdle fractures unsuitable for surgery and radiotherapy underwent percutaneous image-guided screw fixation. Fractures occurred through metastases (n = 2) or a post-ablation cavity (n = 1). Mechanical properties of osteosynthesis were adjudged superior to stand-alone cementoplasty in each case. Cannulated screws were placed under combined CT and fluoroscopic guidance with complementary radiofrequency ablation or cementoplasty to optimise local palliation and secure screw fixation, respectively, in two cases. Follow-up was undertaken every few weeks until mortality or most recent appointment.ResultsFour pathological fractures were treated in three patients (2 acromion, 1 clavicular, 1 coracoid). Mean size of associated lesion was 2.6 cm (range 1–4.5 cm). Technical success was achieved in all cases (100 %), without complications. Good palliation and restoration of mobility were observed in two cases at 2–3 months; one case could not be followed due to early post-procedural oncologic mortality.ConclusionPercutaneous image-guided shoulder-girdle osteosynthesis appears technically feasible with good short-term efficacy in this complex patient subset. Further studies are warranted to confirm these promising initial results.

Chorionic villi derived mesenchymal like stem cells and expression of embryonic stem cells markers during long-term culturing.

Science.gov (United States)

Katsiani, E; Garas, A; Skentou, C; Tsezou, A; Messini, C I; Dafopoulos, K; Daponte, A; Messinis, I E

2016-09-01

Mesenchymal stem cells (MSCs) can be obtained from a variety of human tissues. MSCs derived from placental chorionic villi of the first trimester are likely to resemble, biologically, embryonic stem cells (ESC), due to the earlier development stage of placenta. In the present study long-term cultures of MSC-like cells were assessed in order to evaluate MSCs multipotent characteristics and molecular features during the period of culture. CV-cells obtained from 10 samples of chorionic villus displayed typical fibroblastoid morphology, undergone 20 passages during a period of 120 days, maintaining a stable karyotype throughout long term expansion. The cells were positive, for CD90, CD73, CD105, CD29, CD44, HLA ABC antigens and negative for CD14, CD34, AC133, and HLA DR antigens as resulted from the flow cytometry analysis. CV-cells were differentiated in adipocytes, osteoblasts, chondrocytes and neuronal cells under specific culture conditions. The expression of the ESC-gene markers POU5F1 (Oct-4) and NANOG was observed at earliest stages (4-12 passages) and not at the late stages (14-20 passages) by RT-PCR analysis. ZFP42 and SOX2 expression were not detected. Moreover, CV-cells were found to express GATA4 but not NES (Nestin). Chorionic villi-derived cells possess multipotent properties, display high proliferation rate and self-renew capacity, share common surface antigens with adult MSCs and express certain embryonics stem cells gene markers. These characteristics highlight chorionic villi as an attractive source of MSCs for the needs of regenerative medicine.

Impact of carbohydrate supply on stem growth, wood and respired CO{sub 2} {delta}{sup 13}C : assessment by experimental girdling

Energy Technology Data Exchange (ETDEWEB)

Maunoury-Danger, F. [Paris-Sud Univ., Orsay Cedex (France). Laboratoire Ecologie, Systematique et Evolution; Centre National de la Recherche Scientifique, Orsay CEDEX (France); AgroParisTech, Paris (France); Paul Verlaine-Metz Univ., Metz (France). Laboratoire des Interactions Ecotoxicologie Biodiversite Ecosystemes; Fresneau, C.; Eglin, T.; Berveiller, D.; Francois, C.; Damesin, C. [Paris-Sud Univ., Orsay Cedex (France). Laboratoire Ecologie, Systematique et Evolution; Centre National de la Recherche Scientifique, Orsay CEDEX (France); AgroParisTech, Paris (France); Lelarge-Trouverie, C. [Paris-Sud Univ., Orsay Cedex (France). Inst. de Biotechnologie des Plantes, Plateforme Metabolisme-Metabolome

2010-07-15

In trees, carbohydrate storage and remobilization may affect the carbon isotope signals of sugars exported from leaves, tree organic matter and respired carbon dioxide (CO{sub 2}). This study characterized the impact of a change in the carbon (C) source used for stem functioning on the {delta}{sup 13} C of stem organic matter and respired CO{sub 2}. Girdling experiments were carried out on 2-year old oaks that consisted in removing the bark and phloem around the stem so that the sap would cease to flow. The stem was therefore forced to use its own C reserves to maintain metabolic activity. Trees were girdled at 3 different periods, notably just after budburst, during stem growth, and just after cessation of stem radial growth. Stem radial growth and respiration rate were measured throughout the year. Other measured variables included {delta}{sup 13} C of respired CO{sub 2} and contents of starch and water-soluble fraction in stems and leaves. The study showed that girdling stopped growth, even early in the growing season, leading to a decrease in stem CO{sub 2} efflux. The study demonstrated that leaf carbohydrate supply versus reserve use could be an important factor controlling stem growth and {delta}{sup 13} C of both ring and stem CO{sub 2} efflux. 69 refs., 3 tabs., 5 figs.

Effect of BAP, ethrel and stem girdling on growth and partitioning of photosynthates in Y-shaped mungbean

International Nuclear Information System (INIS)

Panwar, J.D.S.; Abbas, S.; Sita Ram; Sirohi, G.S.

1988-01-01

During early vegetative growth, pots grown mungbean (Vigna radiata (L) Wilczek cv. Pusa 105) were forced to develop a Y-shaped stem consisting of two symmetrical branches. At preflowering stage, the plants were treated with 6-benzyl amino purine (BAP-20 ppm) and ethrel (500 ppm). Stem girdling was also done just below the junction of the two symmetrical branches and hormonal application (BAP) was done on one of the branches and its effect was observed on other branch of the same plant. Suitable controls were kept. BAP delayed the leaf senescence, enhanced photosynthetic rate and its duration on the treated as well as untreated leaf, whereas ethrel enhanced leaf senescence, reduced photosynthetic rate and its duration. 14 C studies indicated that the translocation of photosynthates was diverted differentially to other plant parts through hormonal application. Girdling on main stem affected the remote effects of hormones and about 98% 14 C remained on the applied branch itself indicating that growth regulators showed their effect on the other branch through roots only. (author). 4 refs., 4 tabs

Generation of iPSC lines from primary human chorionic villi cells

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Björn Lichtner

2015-11-01

Full Text Available Primary human chorionic villi (CV cells were used to generate the iPSC line by retroviral transduction of the four Yamanaka-factors OCT4, SOX2, KLF4 and c-MYC. Pluripotency was confirmed both in vivo and in vitro. The transcriptomes of the CV-derived iPSC lines and the human embryonic stem cell lines—H1 and H9 have a Pearson correlation of 0.929 and 0.943 respectively.

Recessive variants of MuSK are associated with late onset CMS and predominant limb girdle weakness.

Science.gov (United States)

Owen, David; Töpf, Ana; Preethish-Kumar, Veeramani; Lorenzoni, Paulo José; Vroling, Bas; Scola, Rosana Herminia; Dias-Tosta, Elza; Geraldo, Argemiro; Polavarapu, Kiran; Nashi, Saraswati; Cox, Daniel; Evangelista, Teresinha; Dawson, John; Thompson, Rachel; Senderek, Jan; Laurie, Steven; Beltran, Sergi; Gut, Marta; Gut, Ivo; Nalini, Atchayaram; Lochmüller, Hanns

2018-04-28

Congenital myasthenic syndrome (CMS) is a heterogeneous disorder that causes fatigable muscle weakness. CMS has been associated with variants in the MuSK gene and, to date, 16 patients have been reported. MuSK-CMS patients present a different phenotypic pattern of limb girdle weakness. Here, we describe four additional patients and discuss the phenotypic and clinical relationship with those previously reported. Two novel damaging missense variants are described: c.1742T > A; p.I581N found in homozygosis, and c.1634T > C; p.L545P found in compound heterozygosis with p.R166*. The reported patients had predominant limb girdle weakness with symptom onset at 12, 17, 18, and 30 years of age, and the majority exhibited a good clinical response to Salbutamol therapy, but not to esterase inhibitors. Meta-analysis including previously reported variants revealed an increased likelihood of a severe, respiratory phenotype with null alleles. Missense variants exclusively affecting the kinase domain, but not the catalytic site, are associated with late onset. These data refine the phenotype associated with MuSK-related CMS. © 2018 Wiley Periodicals, Inc.

Application of radioreceptor assay for chorionic gonadotropin in diagnosis of normal and disturbed pregnancy

International Nuclear Information System (INIS)

Koch, R.; Schmidt-Gollwitzer, M.; Nevinny-Stickel, J.

1977-01-01

For diagnoses of normal and disturbed pregnancy, a radioreceptor assay (RRA) for the detection of chorionic gonadotropin (HLG) has been developed. The hormone was labelled with 125 I. Compared with biological and immunological methods, the RRA has a higher sensitivity and a shorter evaluation time. (orig./VJ) [de

A mitochondrial tRNA(Met) mutation causing developmental delay, exercise intolerance and limb girdle phenotype with onset in early childhood

DEFF Research Database (Denmark)

Born, Alfred Peter; Duno, Morten; Rafiq, Jabin

2015-01-01

A 10-year-old girl presented with exercise intolerance, learning difficulty, and muscle weakness in a limb girdle distribution. She had delayed achievement of motor milestones and difficulties with social interaction at pre-school age. Muscle biopsy showed no myopathic or dystrophic features...

Physical-chemical and biological characterization of different preparations of equine chorionic gonadotropin

OpenAIRE

Alvarez, Rafael Herrera; Natal, Fabio Luis Nogueira; Ribela, Maria Teresa Carvalho Pinto; de Almeida, Beatriz Elane; de Oliveira, Jo?o Ezequiel; Bartolini, Paolo

2016-01-01

Ovarian stimulation with commercial preparations of equine chorionic gonadotropin (eCG) produces extremely variable responses in domestic animals, ranging from excessive stimulation to practically no stimulation, when applied on the basis of their declared unitage. This study was conducted to analyze four commercial preparations from different manufacturers via reversed-phase HPLC (RP-HPLC) in comparison with a reference preparation and an official International Standard from the World Health...

Effects of human chorionic gonadotropin combined with clomiphene on Serum E2, FSH, LH and PRL levels in patients with polycystic ovarian syndrome.

Science.gov (United States)

Yonggang, Huang; Xiaosheng, Lu; Zhaoxia, Huang; Yilu, Chen; Jiqiang, Lv; Huina, Zhang

2017-02-01

Effects of human chorionic gonadotropin combined with clomiphene on serum E 2 , FSH, LH and PRL levels in patients with polycystic ovarian syndrome were analyzed. 90 patients with polycystic ovarian syndrome treated from January 2015 to March 2016 were randomly and evenly divided into control group and observation group. Patients in the control group were only treated with clomiphene. On the basis of the treatment in control group, human chorionic gonadotropin was added in the treatment of observation group. The changes of E 2 , FSH, LH, PRL levels were compared between two groups before and after the treatment. Clinical curative effects of patients in the two groups was evaluated. Adverse reactions during treatment in two groups were observed and recorded. The incidence of adverse reactions was calculated. Serum E 2 , FSH, LH and PRL levels in the two groups decreased significantly after treatment compared with that before treatment. The difference is statistical significant ( P   0.05). Combined use of human chorionic gonadotropin can significantly reduce serum E 2 , FSH, LH and PRL levels, improve clinical curative effects and reduce the incidence of adverse reactions. Human chorionic gonadotropin has high application value on the treatment of polycystic ovary syndrome.

Effect of a Home Based Exercise Program on Postmenopausal Women’s Shoulder Girdle Muscle Strength for Women with Breast Cancer

Directory of Open Access Journals (Sweden)

M. Akoochakian

2014-10-01

Full Text Available Introduction & Objective: Reducing in muscle strength of the shoulder girdle is a side effect of breast cancer treatment. The aim of this study was to determine the effect of 4 weeks of resistance and mobility training on the shoulder girdle strength of women with breast cancer. Materials & Methods: In this randomized clinical trial study twenty-seven postmenopausal women with breast cancer (mean age, 51±5.96 years, (mean height, 158.08±7.2 cm, (mean weight, 63.08±11.06 kg who underwent surgery, chemotherapy and radiation therapy, were purposefully selected and divided into two groups of intervention and control. Intervention group performed 4 weeks (4 sessions per week of resistance training with flex-band and stretch training at home, but the control group did not participate in any sports or physical program. Muscle strength before and after intervention was measured using a handheld dynamometer. The data were analyzed using ANCOVA. Results: Significant differences were seen between intervention and control groups in shoulder flexion, scapula abduction and upward rotation, shoulder internal rotation, shoulder external rotation, shoulder horizontal adduction and scapula depression and adduction strength, as all strength variables increased after 4 weeks exercise. Conclusion: Since strength plays an important role in ADL performance and shoulder girdle function in breast cancer survivors, it seems that muscle strength improvement following combined home based exercise program can help patients after treatment to easier and faster rehabilitation. (Sci J Hamadan Univ Med Sci 2014; 21 (3: 185-195

Complex shoulder girdle injuries following mountain bike accidents and a review of the literature

Science.gov (United States)

Lea, Matthew Alexander; Makaram, Navnit; Srinivasan, Makaram S

2016-01-01

Background Mountain and road bike accidents are particularly common with the increased popularity of the sport. We reviewed the attendances in our emergency department over a 4-year period looking at cycling injuries to detect the level and grade of these injuries and their outcomes. Method Royal Blackburn Hospital caters for a population of 550 000. A search through the Hospital information system revealed 104 patients with fractures following mountain bike injuries. These were looked at in more detail. We present a series of 5 severe shoulder girdle injuries following mountain bike accidents in this cohort, to highlight the serious level of injury sustained in this sport. We searched MEDLINE and EMBASE databases over the past 10 years using the keywords, mountain, biking and fracture. This yielded 7 papers. We compared our series with the literature. Results 104 fractures following mountain bike accidents between 2008 and 2011. Fractures of the upper limb were the most common (88.5%) with the clavicle being the most commonly fractured bone (28.8%). Conclusions Major scapular injuries with destruction or disruption of the four bar linkage of the shoulder girdle are very common following mountain accidents. Clavicular fractures are the commonest upper limb injury. It is easy to miss a disruption to the four-bar linkage associated with a clavicular injury. This paper highlights the severity of the injuries sustained in mountain bike accidents of the upper limb and requirement of adequate protection in this exhilarating sport. PMID:27900147

Competitive enzyme immunoassay for human chorionic somatomammotropin using the avidin-biotin system

International Nuclear Information System (INIS)

Rappuoli, R.; Leoncini, P.; Tarli, P.; Neri, P.

1981-01-01

Human chorionic somatomammotropin (HCS) is determined by an enzyme immunoassay where HCS competes with biotin-labeled HCS for insolubilized anti-HCS antibodies. Enzyme-labeled avidin is then used to reveal the amount of bound HCS. The system proves to be sensitive (1 ng/ml of HCS can be detected) and results agree with radioimmunoassay determinations (correlation coefficient = 0.979). Kinetics of the avidin-biotin reaction and coating of polystyrene wells are also investigated

Comparative study of P19 EC stem cell differentiation in between conventional hanging drop and the zebrafish chorion as a bio-derived material.

Science.gov (United States)

Dae Seok Na; Lee, Hwang; Sun Uk Kim; Chang Nam Hwang; Sang Ho Lee; Ji Yoon Kang; Jai Kyeong Kim; James Jungho Pak

2008-07-01

Various materials including glass and polymers have been widely used for stem cell culture due to their biocompatibility. However, the roles of these materials are fundamentally limited because they cannot realize or imitate the complex biological functions of living tissues, except in very simple cases. Here, the development of a bio-derived material suitable for stem cell culture and improvement of differentiation efficiency to specific cell lineages with no stimulating agents by using a chorion obtained from a fertilized zebrafish egg through the removal of the yolk and embryonic cell mass from the egg is reported. Mouse P19 EC stem cells introduced into the empty chorion form a uniform embryoid body (EB) without addition of any inducing agent. It is demonstrated that the zebrafish chorion with nanopores improves efficiencies greatly in the EB formation, cell proliferation, and lineage-specific differentiations compared to those of the conventional hanging drop culture method.

Chorion gene activation and repression is dependent on BmC/EBP expression and binding to cognate cis-elements.

Science.gov (United States)

Papantonis, Argyris; Sourmeli, Sissy; Lecanidou, Rena

2008-05-09

From the different cis-elements clustered on silkmoth chorion gene promoters, C/EBP binding sites predominate. Their sequence composition and dispersal vary amongst promoters of diverse developmental specificity. Occupancy of these sites by BmC/EBP was examined through Southwestern and ChIP assays modified to suit ovarian follicular cells. For the genes studied, binding of BmC/EBP coincided with the respective stages of transcriptional activation. However, the factor was reloaded on promoter sequences long after individual gene repression. Furthermore, suppression of BmC/EBP transcription in developing follicles resulted in de-regulation of chorion gene expression. A biphasic function of BmC/EBP, according to which it may act as both an activator and a repressor during silkmoth choriogenesis, is considered under the light of the presented data.

Comparative analysis of phenotypes features in two common genetic variants of limb-girdle muscular dystrophy

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I. V. Sharkova

2015-01-01

Full Text Available The algorithm of differential diagnosis of the two most common genetic variants the limb-girdle muscular dystrophy (LGMD2A and DMD, developed on the basis of a comprehensive survey of 85 patients with a diagnosis specification using techniques of DNA analysis. It is shown that the accurate diagnosis of LGMD genetic types should be based on the results of the clinical and genealogical, biochemical and molecular genetic analysis. The proposed algorithm will significantly reduces the economic and time costs with expensive DNA testing.

Limb-girdle muscular dystrophy type 2A in Brazilian children

Directory of Open Access Journals (Sweden)

Marco Antônio Veloso de Albuquerque

2015-12-01

Full Text Available ABSTRACT Calpainopathy is an autosomal recessive limb girdle muscular dystrophy (LGMD2A caused by mutations in CAPN3 gene. Objective To present clinical and histological findings in six children with a molecular diagnosis of LGMD2A and additionally the MRI findings in two of them. Method We retrospectively assessed medical records of 6 patients with mutation on CAPN3 gene. Results All patients were female (three to 12 years. The mean of age of disease onset was 9 years. All of them showed progressive weakness with predominance in lower limbs. Other findings were scapular winging, joint contractures and calf hypertrophy. One female had a more severe phenotype than her dizygotic twin sister that was confirmed by muscle MRI. Muscle biopsies showed a dystrophic pattern in all patients. Conclusion In this cohort of children with LGMD2A, the clinical aspects were similar to adults with the same disorder.

Prenatal cytogenetic diagnosis after transabdominal chorionic villus sampling in the first trimester

DEFF Research Database (Denmark)

Therkelsen, A J; Jensen, P K; Hertz, Jens Michael

1988-01-01

First trimester prenatal cytogenetic diagnosis was attempted in 350 pregnancies after transabdominal chorionic villus sampling. The cytogenetic investigation was performed using both a short-term method (24 h incubation) and cell culture. Adequate samples were obtained in 99.1 per cent and in all...... of 181 cases where the 24 h incubation revealed a male karyotype. Studies of culture morphology showed that colonies of convoluted cells may serve as a marker for contamination with maternal cells in culture. For the present, we recommend using a short-term method as well as cell culture for cytogenetic...

The girdles of the oldest fossil turtle, Proterochersis robusta, and the age of the turtle crown.

Science.gov (United States)

Joyce, Walter G; Schoch, Rainer R; Lyson, Tyler R

2013-12-06

Proterochersis robusta from the Late Triassic (Middle Norian) of Germany is the oldest known fossil turtle (i.e. amniote with a fully formed turtle shell), but little is known about its anatomy. A newly prepared, historic specimen provides novel insights into the morphology of the girdles and vertebral column of this taxon and the opportunity to reassess its phylogenetic position. The anatomy of the pectoral girdle of P. robusta is similar to that of other primitive turtles, including the Late Triassic (Carnian) Proganochelys quenstedti, in having a vertically oriented scapula, a large coracoid foramen, a short acromion process, and bony ridges that connect the acromion process with the dorsal process, glenoid, and coracoid, and by being able to rotate along a vertical axis. The pelvic elements are expanded distally and suturally attached to the shell, but in contrast to modern pleurodiran turtles the pelvis is associated with the sacral ribs. The primary homology of the character "sutured pelvis" is unproblematic between P. robusta and extant pleurodires. However, integration of all new observations into the most complete phylogenetic analysis that support the pleurodiran nature of P. robusta reveals that this taxon is more parsimoniously placed along the phylogenetic stem of crown Testudines. All current phylogenetic hypotheses therefore support the basal placement of this taxon, imply that the sutured pelvis of this taxon developed independently from that of pleurodires, and conclude that the age of the turtle crown is Middle Jurassic.

Human Chorionic Gonadotrophin as a Possible Mediator of Leiomyoma Growth during Pregnancy: Molecular Mechanisms.

Science.gov (United States)

Sarais, Veronica; Cermisoni, Greta Chiara; Schimberni, Matteo; Alteri, Alessandra; Papaleo, Enrico; Somigliana, Edgardo; Vigano', Paola

2017-09-20

Uterine fibroids are the most common gynecologic benign tumors. Studies supporting a strong pregnancy-related growth of leiomyomas generally claimed a crucial role of sex steroid hormones. However, sex steroids are unlikely the unique actors involved as estrogen and progesterone achieve a pick serum concentration in the last trimester while leiomyomas show a typical increase during the first trimester. Given the rapid exponential raise in serum human Chorionic Gonadotrophin (hCG) at the beginning of gestation, we conducted a review to assess the potential role of hCG in the striking growth of leiomyomas during initial pregnancy. Fibroid growth during initial pregnancy seems to correlate to the similar increase of serum hCG levels until 12 weeks of gestation. The presence of functional Luteinizing Hormone/human Chorionic Gonadotropin (LH/hCG) receptors was demonstrated on leiomyomas. In vitro treatment of leiomyoma cells with hCG determines an up to 500% increase in cell number after three days. Expression of cyclin E and cyclin-dependent kinase 1 was significantly increased in leiomyoma cells by hCG treatment. Moreover, upon binding to the receptor, hCG stimulates prolactin secretion in leiomyoma cells, promoting cell proliferation via the mitogen-activated protein kinase cascade. Fibroid enlargement during initial pregnancy may be regulated by serum hCG.

Diagnosis of tumors in the shoulder girdle by means of MRI

International Nuclear Information System (INIS)

Schlecht, I.; Gaffke, G.; Stroszczynski, C.; Felix, R.

2001-01-01

The aim of the study was to estimate the value of MRI for evaluation of tumors of the shoulder girdle. We diagnosed respectively 13 patients with lesions in the shoulder region. The imaging has been done with a 'Magnetom SP 63' (Siemens, Erlangen, Germany). The protocol consisted of T1- and T2-based SE-sequences in axial slice orientation, T1-based imaging in coronary respectively in sagittal slice orientation as well as T1-based sequences after application of contrast medium. The evaluation of the tumor expansion within the soft tissue was possible. The exact diagnosis in some individual cases - neurinoma, cyst of the synovia - could be found by MRI. Estimation of the dignity in the case of infiltrative growth was possible in most cases. To assess the exact type of tumor was often difficult. Especially the dignity of the cartilaginous tumors could not be precisely described. (orig.) [de

Inhibition of septic shock in mice by an oligopeptide from the beta-chain of human chorionic gonadotrophin hormone

NARCIS (Netherlands)

Khan, N.A.; Khan, A.; Savelkoul, H.F.J.; Benner, R.

2002-01-01

Human chorionic gonadotrophin (hCG) is a heterodimeric placental glycoprotein hormone required in pregnancy. In human pregnancy urine and in commercial hCG preparations (c-hCG) it occurs in a variety of forms, including breakdown products. Several reports have suggested modulation of the immune

Tipo de porta-enxerto e anelamento de ramos no pegamento da enxertia em lichieira (Litchi chinensis Sonn. Evaluation of the performance of grafting in different rootstocks and girdling of litchi (Litchi chinensis Sonn.

Directory of Open Access Journals (Sweden)

ANTONIO BALDO GERALDO MARTINS

2002-04-01

Full Text Available O presente trabalho foi realizado em condições de ripado, com o objetivo de avaliar o desempenho da enxertia a inglês simples, em dois tipos de porta-enxerto (pé-franco e alporquia, em combinação com três tipos de anelamento do ramo (sem anelamento, e ramos anelados duas e quatro semanas antes da retirada do garfo, em lichia. O experimento foi conduzido em delineamento inteiramente casualizado, com seis tratamentos e três repetições. Foi somente observada diferença significativa para o tipo pé-franco, que revelou os melhores resultados.This research work was carried out in the experimental area to evaluate the performance of grafting technique in two types of rootstocks (air layering and seedling with three types of girdling (without girdling and girdling shoot, two and four weeks before grafts retreat in litchi. The experimental design was a complete randomized with six treatments and three replications. There was statistical difference for the type of rootstocks that showed better results.

Intérêt pronostique de l’infiltration du chorion dans les tumeurs vésicales pT1

Directory of Open Access Journals (Sweden)

W. Zakhama

2016-12-01

Conclusion: Le classement des ces tumeurs en fonction de l’importance d’envahissement du chorion et de l’infiltration de la musculaire muqueuse a prouvé son efficacité à travers les taux de récidive et de progression tumorale chez nos malades.

The effect of chorionicity and twin-to-twin delivery time interval on short-term outcome of the second twin

DEFF Research Database (Denmark)

Hjortø, Sofie; Nickelsen, Carsten; Petersen, Janne

2013-01-01

Abstract Objectives: To investigate the effect of chorionicity and twin-to-twin delivery time interval on short-term outcome in the second twin. Additionally, to investigate predictors of adverse outcome in both twins. Methods: Data included vaginally delivered twins (≥ 36 weeks) from Copenhagen ...

Concentration of carcinoembryonic antigen alpha-fetoprotein and beta-subunit of human chorionic gonadotropin in the serum of coke oven workers

Energy Technology Data Exchange (ETDEWEB)

Snit, M. [Silesian Medical Academy, Zabrze (Poland)

1993-01-01

Increased levels of carcinoembryonic antigen and {alpha}-fetoprotein were found in blood serum of coke oven workers, and also to some extent in smokers and in residents of industrial cities. The {beta} subunit of chorionic gonadotropin was barely detectable.

Demand dynamic bio-girdling in heart failure: improved efficacy of dynamic cardiomyoplasty by LD contraction during aortic out-flow.

Science.gov (United States)

Carraro, U; Rigatelli, G; Rossini, K; Barbiero, M; Rigatelli, G

2003-03-01

The value of dynamic cardiomyoplasty has been brought into question by the disappointing results produced by slow contraction-relaxation cycle and possibly degeneration of the latissimus dorsi muscle (LD) secondary to temporary tenotomy and chronic daily electrical stimulation. Objective of our study is to determine whether daily periods of rest introduced by demand stimulation in the continuous contraction protocol produce systolic assistance and improve clinical results. Twelve dynamic cardiomyoplasty patients (mean age 58.2 +/- 5.8 years, M/F=11/1, sinus rhythm/atrial fibrillation=11/1) with dilated myocardiopathy were enrolled in an unrandomized trial of Demand Dynamic Heart Bio-Girdling in a public regional teaching hospital. Periods of LD inactivity, each lasting several hours, were introduced daily on a heart rate-based demand regime. To avoid full transformation of LD, fewer impulses per day were delivered, daily providing the LD with long periods of rest (Demand light stimulation). The contractile properties were measured by transcutaneous non-invasive LD tensiomyogram interrogation (LD tensiomyogram). Bio-Girdle activation was synchronized to heart beat by combining tensiomyogram and echocardiography. Clinical, echocardiographic and hemodynamic records, as well as aortic flow measurements by Doppler aortic flow wire were taken during the follow-up. Mean duration of the demand stimulation follow-up was 40.2+13.8 months. At five years, "Demand stimulation" shows: 1) no operative death; 2) 83% actuarial survival; 3) highly significant 47.4% decrease of the NYHA class (from 3.17 +/- 0.38 to 1.67 +/- 0.77, p=0.0001); 4) 41.6% improvement of LVEF (from 22.6 +/- 4.38 to 32.0 +/- 7.0, p=0.001); 5) 7.5 +/- 3.0% increase in aortic flow velocity peak in assisted vs. unassisted beats, and 6) preservation of LD from slowness (TFF value 33 +/- 7.86 at follow-up versus 15.8 +/- 11.1 Hz just before switching from continuous to demand stimulation, p=0.0001) and muscle

The human chorionic gonadotropin-beta arginine68 to glutamic acid substitution fixes the conformation of the C-terminal peptide

DEFF Research Database (Denmark)

Charrel-Dennis, Marie; Terrazzini, Nadia; McBride, Jeffrey D

2005-01-01

Wild-type human chorionic gonadotropin (hCG) has been used as a contraceptive vaccine. However, extensive sequence homology with LH elicits production of cross-reactive antibodies. Substitution of arginine(68) of the beta-subunit (hCG(beta)) with glutamic acid (R68E) profoundly reduces the cross...

Development of Some Organs Derived from the Three Embryonic Germ Layer in a Degus Ectopic Pregnancy and Presence of a Cytotrophoblast That Mimics Human Chorionic Placenta

Directory of Open Access Journals (Sweden)

C. Bosco

2014-01-01

Full Text Available This report describes a case of abdominal pregnancy in an adult female degu from which we recovered two large tissular masses from the peritoneal cavity. The bigger one showed a number of thin vascular connections to the serosa layer of the small intestine. It was also directly connected to the smaller mass by a thin membranous process. The surface of the bigger mass facing the small intestine wall showed the presence of chorionic villous that resembled a villous human chorionic placenta, rather than the hemomonochorial labyrinthine placenta, characteristic of this species. This unusual finding leads us to postulate that in the degu’s uterus the cytotrophoblast is exposed to a number of factors that will activate cascades of cellular and molecular events that ultimately will be signaling the cytotrophoblast to develop into a labyrinthine hemomonochorial placenta. In absence of the proper uterine environment, as is the case of the abdominal pregnancy in the peritoneal cavity reported here, the lack of signaling will lead the cytotrophoblast to develop into a villous chorionic placenta, similar to that observed in human.

Cardiac involvement of progressive muscular dystrophy (Becker type, Limb-girdle type and Fukuyama type) evaluated by radionuclide method

International Nuclear Information System (INIS)

Nagamachi, Shigeki; Inoue, Kenjiro; Jinnouchi, Seishi; Hoshi, Hiroaki; Ono, Seiji; Ohnishi, Takashi; Futami, Shigemi; Watanabe, Katsushi; Hayashi, Tohru

1994-01-01

Tl-201 SPECT and Tc-99m-Human serum albumin (HSA) multigated radionuclide ventriculography were performed on 11 patients with progressive muscular dystrophy (Becker type 2, Fukuyama type 2, Limb-girdle type 7) to evaluate myocardial involvement. Hypoperfusion was detected in 8 patients on Tl-201 SPECT. Decreases in both systolic function (left ventricular ejection fraction; LVEF) and diastolic function (peak filling rate; PFR) were also seen in these patients. A high incidence of myocardial involvement of these kinds of progressive muscular dystrophy was suggested. (author)

Cardiac involvement of progressive muscular dystrophy (Becker type, Limb-girdle type and Fukuyama type) evaluated by radionuclide method

Energy Technology Data Exchange (ETDEWEB)

Nagamachi, Shigeki; Inoue, Kenjiro; Jinnouchi, Seishi; Hoshi, Hiroaki; Ono, Seiji; Ohnishi, Takashi; Futami, Shigemi; Watanabe, Katsushi; Hayashi, Tohru [Miyazaki Medical Coll., Kiyotake (Japan)

1994-02-01

Tl-201 SPECT and Tc-99m-Human serum albumin (HSA) multigated radionuclide ventriculography were performed on 11 patients with progressive muscular dystrophy (Becker type 2, Fukuyama type 2, Limb-girdle type 7) to evaluate myocardial involvement. Hypoperfusion was detected in 8 patients on Tl-201 SPECT. Decreases in both systolic function (left ventricular ejection fraction; LVEF) and diastolic function (peak filling rate; PFR) were also seen in these patients. A high incidence of myocardial involvement of these kinds of progressive muscular dystrophy was suggested. (author).

Regenerative and Antibacterial Properties of Acellular Fish Skin Grafts and Human Amnion/Chorion Membrane: Implications for Tissue Preservation in Combat Casualty Care.

Science.gov (United States)

Magnusson, Skuli; Baldursson, Baldur Tumi; Kjartansson, Hilmar; Rolfsson, Ottar; Sigurjonsson, Gudmundur Fertram

2017-03-01

Improvised explosive devices and new directed energy weapons are changing warfare injuries from penetrating wounds to large surface area thermal and blast injuries. Acellular fish skin is used for tissue repair and during manufacturing subjected to gentle processing compared to biologic materials derived from mammals. This is due to the absence of viral and prion disease transmission risk, preserving natural structure and composition of the fish skin graft. The aim of this study was to assess properties of acellular fish skin relevant for severe battlefield injuries and to compare those properties with those of dehydrated human amnion/chorion membrane. We evaluated cell ingrowth capabilities of the biological materials with microscopy techniques. Bacterial barrier properties were tested with a 2-chamber model. The microstructure of the acellular fish skin is highly porous, whereas the microstructure of dehydrated human amnion/chorion membrane is mostly nonporous. The fish skin grafts show superior ability to support 3-dimensional ingrowth of cells compared to dehydrated human amnion/chorion membrane (p fish skin is a bacterial barrier for 24 to 48 hours. The unique biomechanical properties of the acellular fish skin graft make it ideal to be used as a conformal cover for severe trauma and burn wounds in the battlefield. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

Transplante de intestino delgado Small intestine transplantation

Directory of Open Access Journals (Sweden)

Flávio Henrique Ferreira Galvão

2003-06-01

Full Text Available RACIONAL: Avanços da biotecnologia e o desenvolvimento de novas drogas imunossupressoras melhoraram os resultados do transplante de intestino delgado. Esse transplante é atualmente indicado para casos especiais da falência intestinal. OBJETIVO: A presente revisão realça os recentes desenvolvimentos na área do transplante de intestino delgado. MATERIAL E MÉTODO: Mais de 600 publicações de transplante de intestino delgado foram revisadas. O desenvolvimento da pesquisa, novas estratégias de imunossupressão, monitorização do enxerto e do receptor, e avanços na técnica cirúrgica são discutidos. RESULTADOS: Realizaram-se cerca de 700 transplante de intestino delgado em 55 centros: 44% intestino-fígado, 41% enxerto intestinal isolado e 15% transplante multivisceral. Rejeição e infecção são as principais limitações desse transplante. Sobrevida de 5 anos na experiência internacional é de 46% para o transplante de intestino isolado, 43% para o intestino-fígado e de cerca de 30% para o transplante multivisceral. Sobrevidas prolongadas são mais freqüentes nos centros com maior experiência. Em série de 165 transplantes intestinais na Universidade de Pittsburgh, PA, EUA, foi relatada sobrevida do paciente maior do que 75% no primeiro ano, 54% em 5 anos e 42% em 10 anos. Mais de 90% desses pacientes assumem dieta oral irrestrita. CONCLUSÃO: O transplante de intestino delgado evoluiu de estratégia experimental para uma alternativa viável no tratamento da falência intestinal permanente. Promover o refinamento da terapia imunossupressora, do manejo e prevenção de infecções, da técnica cirúrgica e da indicação e seleção adequada dos pacientes é crucial para melhorar a sobrevida desse transplante.BACKGROUND: Significant progress has been made in clinical small bowel transplantation over the last decade mainly due advances in biotechnology and new immunosuppressive regiments. This transplantation has now been indicated

Muscle recruitment patterns of the subscapularis, serratus anterior and other shoulder girdle muscles during isokinetic internal and external rotations.

Science.gov (United States)

Gaudet, Sylvain; Tremblay, Jonathan; Begon, Mickael

2018-05-01

The aims of this study were to investigate the differences in peak muscle activity and recruitment patterns during high- and low-velocity, concentric and eccentric, internal and external isokinetic shoulder rotations. Electromyographic activity of the rotator cuff and eight superficial muscles of the shoulder girdle was recorded on 25 healthy adults during isokinetic internal and external shoulder rotation at 60°/s and 240°/s. Peak muscle activity, electromyographic envelopes and peak isokinetic moments were analyzed using three-factor ANOVA and statistical parametric mapping. The subscapularis and serratus anterior showed moderate to high peak activity levels during each conditions, while the middle and posterior deltoids, upper, middle and lower trapezius, infraspinatus and supraspinatus showed higher peak activity levels during external rotations (+36.5% of maximum voluntary activation (MVA)). The pectoralis major and latissimus dorsi were more active during internal rotations (+40% of MVA). Only middle trapezius and pectoralis major electromyographic activity decreased with increasing velocity. Peak muscle activity was similar or lower during eccentric contractions, although the peak isokinetic moment increased by 35% on average. The subscapularis and serratus anterior appear to be important stabilizers of the glenohumeral joint and scapula. Isokinetic eccentric training at high velocities may allow for faster recruitment of the shoulder girdle muscles, which could improve joint stability during shoulder internal and external rotations.

Liver transplant

Science.gov (United States)

Hepatic transplant; Transplant - liver; Orthotopic liver transplant; Liver failure - liver transplant; Cirrhosis - liver transplant ... The donated liver may be from: A donor who has recently died and has not had liver injury. This type of ...

Hair Transplants

Science.gov (United States)

... Search Skin Experts Skin Treatments Hair Transplants Share » HAIR TRANSPLANTS Before (left) and after (right) - front of ... transplant. Photo courtesy of N. Sadick What are hair transplants? In punch transplanting, a plug containing hair ...

Amnion and Chorion Membranes: Potential Stem Cell Reservoir with Wide Applications in Periodontics.

Science.gov (United States)

Gupta, Akanksha; Kedige, Suresh D; Jain, Kanu

2015-01-01

The periodontal therapy usually aims at elimination of disease causing bacteria and resolution of inflammation. It involves either resective or regenerative surgery to resolve the inflammation associated defects. Over the years, several methods have been used for achievement of periodontal regeneration. One of the oldest biomaterials used for scaffolds is the fetal membrane. The amniotic membranes of developing embryo, that is, amnion (innermost lining) and chorion (a layer next to it), have the properties with significant potential uses in dentistry. This paper reviews the properties, mechanism of action, and various applications of these placental membranes in general and specifically in Periodontics.

Immediate re-transplantation following early kidney transplant thrombosis.

LENUS (Irish Health Repository)

Phelan, Paul J

2012-02-01

Allograft thrombosis is a devastating early complication of renal transplantation that ultimately leads to allograft loss. We report here on our experience of nine cases of immediate re-transplantation following early kidney transplant thrombosis at a single centre between January 1990 and June 2009. The mean age was 42.9 years at time of transplant. For seven patients, the allograft thrombosis was their first kidney transplant and seven of the nine cases had a deceased donor transplant. The initial transplants functioned for a mean of 1.67 days and the patients received a second allograft at a mean of 3.1 days after graft failure. All of the re-transplants worked immediately. Four allografts failed after a mean of 52.5 months (2-155 months). Two of these died with a functioning allograft, one failed owing to chronic allograft nephropathy and one owing to persistent acute cellular rejection. The remaining five patients still have a functioning allograft after a mean of 101.8 months (7-187 months). One year allograft and patient survival after re-transplantation were 87.5% and 100% respectively (after 5 years, both were 57%). Immediate re-transplantation following early kidney transplant thrombosis can be a success. It may be considered in selected cases after allograft thrombosis.

Radiosteriometric analysis of movement in the sacroiliac joint during a single-leg stance in patients with long-lasting pelvic girdle pain.

Science.gov (United States)

Kibsgård, Thomas J; Røise, Olav; Sturesson, Bengt; Röhrl, Stephan M; Stuge, Britt

2014-04-01

Chamberlain's projections (anterior-posterior X-ray of the pubic symphysis) have been used to diagnose sacroiliac joint mobility during the single-leg stance test. This study examined the movement in the sacroiliac joint during the single-leg stance test with precise radiostereometric analysis. Under general anesthesia, tantalum markers were inserted into the dorsal sacrum and the ilium of 11 patients with long-lasting and severe pelvic girdle pain. After two to three weeks, a radiostereometric analysis was conducted while the subjects performed a single-leg stance. Small movements were detected in the sacroiliac joint during the single-leg stance. In both the standing- and hanging-leg sacroiliac join, a total of 0.5 degree rotation was observed; however, no translations were detected. There were no differences in total movement between the standing- and hanging-leg sacroiliac joint. The movement in the sacroiliac joint during the single-leg stance is small and almost undetectable by the precise radiostereometric analysis. A complex movement pattern was seen during the test, with a combination of movements in the two joints. The interpretation of the results of this study is that, the Chamberlain examination likely is inadequate in the examination of sacroiliac joint movement in patients with pelvic girdle pain. Copyright © 2014 Elsevier Ltd. All rights reserved.

Immediate re-transplantation following early kidney transplant thrombosis.

LENUS (Irish Health Repository)

Phelan, Paul J

2011-08-01

Allograft thrombosis is a devastating early complication of renal transplantation that ultimately leads to allograft loss. We report here on our experience of nine cases of immediate re-transplantation following early kidney transplant thrombosis at a single centre between January 1990 and June 2009. The mean age was 42.9 years at time of transplant. For seven patients, the allograft thrombosis was their first kidney transplant and seven of the nine cases had a deceased donor transplant. The initial transplants functioned for a mean of 1.67 days and the patients received a second allograft at a mean of 3.1 days after graft failure. All of the re-transplants worked immediately. Four allografts failed after a mean of 52.5 months (2-155 months). Two of these died with a functioning allograft, one failed owing to chronic allograft nephropathy and one owing to persistent acute cellular rejection. The remaining five patients still have a functioning allograft after a mean of 101.8 months (7-187 months). One year allograft and patient survival after re-transplantation were 87.5% and 100% respectively (after 5 years, both were 57%). Immediate re-transplantation following early kidney transplant thrombosis can be a success. It may be considered in selected cases after allograft thrombosis.

Convergent evolution of pregnancy-specific glycoproteins in human and horse.

Science.gov (United States)

Aleksic, Denis; Blaschke, Lisa; Mißbach, Sophie; Hänske, Jana; Weiß, Wiebke; Handler, Johannes; Zimmermann, Wolfgang; Cabrera-Sharp, Victoria; Read, Jordan E; de Mestre, Amanda M; O'Riordan, Ronan; Moore, Tom; Kammerer, Robert

2016-09-01

Pregnancy-specific glycoproteins (PSGs) are members of the carcinoembryonic antigen cell adhesion molecule (CEACAM) family that are secreted by trophoblast cells. PSGs may modulate immune, angiogenic and platelet responses during pregnancy. Until now, PSGs are only found in species that have a highly invasive (hemochorial) placentation including humans, mice and rats. Surprisingly, analyzing the CEACAM gene family of the horse, which has a non-invasive epitheliochorial placenta, with the exception of the transient endometrial cups, we identified equine CEACAM family members that seem to be related to PSGs of rodents and primates. We identified seven genes that encode secreted PSG-like CEACAMs Phylogenetic analyses indicate that they evolved independently from an equine CEACAM1-like ancestor rather than from a common PSG-like ancestor with rodents and primates. Significantly, expression of PSG-like genes (CEACAM44, CEACAM48, CEACAM49 and CEACAM55) was found in non-invasive as well as invasive trophoblast cells such as purified chorionic girdle cells and endometrial cup cells. Chorionic girdle cells are highly invasive trophoblast cells that invade the endometrium of the mare where they form endometrial cups and are in close contact with maternal immune cells. Therefore, the microenvironment of invasive equine trophoblast cells has striking similarities to the microenvironment of trophoblast cells in hemochorial placentas, suggesting that equine PSG-like CEACAMs and rodent and primate PSGs have undergone convergent evolution. This is supported by our finding that equine PSG-like CEACAM49 exhibits similar activity to certain rodent and human PSGs in a functional assay of platelet-fibrinogen binding. Our results have implications for understanding the evolution of PSGs and their functions in maternal-fetal interactions. © 2016 Society for Reproduction and Fertility.

Pre-liver transplant psychosocial evaluation predicts post-transplantation outcomes.

Science.gov (United States)

Benson, Ariel A; Rowe, Mina; Eid, Ahmad; Bluth, Keren; Merhav, Hadar; Khalaileh, Abed; Safadi, Rifaat

2018-08-01

Psychosocial factors greatly impact the course of patients throughout the liver transplantation process. A retrospective chart review was performed of patients who underwent liver transplantation at Hadassah-Hebrew University Medical Center between 2002 and 2012. A composite psychosocial score was computed based on the patient's pre-transplant evaluation. Patients were divided into two groups based on compliance, support and insight: Optimal psychosocial score and Non-optimal psychosocial score. Post-liver transplantation survival and complication rates were evaluated. Out of 100 patients who underwent liver transplantation at the Hadassah-Hebrew University Medical Center between 2002 and 2012, 93% had a complete pre-liver transplant psychosocial evaluation in the medical record performed by professional psychologists and social workers. Post-liver transplantation survival was significantly higher in the Optimal group (85%) as compared to the Non-optimal group (56%, p = .002). Post-liver transplantation rate of renal failure was significantly lower in the Optimal group. No significant differences were observed between the groups in other post-transplant complications. A patient's psychosocial status may impact outcomes following transplantation as inferior psychosocial grades were associated with lower overall survival and increased rates of complications. Pre-liver transplant psychosocial evaluations are an important tool to help predict survival following transplantation.

INCREASED MATERNAL SERUM ALPHA-FETOPROTEIN AND HUMAN CHORIONIC-GONADOTROPIN IN COMPROMISED PREGNANCIES OTHER THAN FOR NEURAL-TUBE DEFECTS OR DOWN-SYNDROME

NARCIS (Netherlands)

BEEKHUIS, [No Value; VANLITH, JMM; DEWOLF, BTHM; MANTINGH, A

Intrauterine fetal death occurred in four women who were 'screen-positive' in a screening programme for neural tube defects (NTDs) and Down syndrome (DS). These women had very high levels of maternal serum alpha-fetoprotein (MSAFP) and maternal serum human chorionic gonadotropin (MShCG). Therefore,

Three-year post-transplant medicare payments in kidney transplant recipients: Associations with pre-transplant comorbidities

Directory of Open Access Journals (Sweden)

Gerardo Machnicki

2011-01-01

Full Text Available Little is known about the influence of pre-transplant comorbidities on post-transplant expenditures. We estimated the associations between pre-transplant comorbidities and post-transplant Medicare costs, using several comorbidity classification systems. We included recipients of first-kidney deceased donor transplants from 1995 through 2002 for whom Medicare was the primary payer for at least one year pre-transplant (N = 25,175. We examined pre-transplant comorbidities as classified by International Classification of Diseases (ICD-9-CM codes from Medicare claims with the Clinical Cla-ssifications Software (CCS and Charlson and Elixhauser algorithms. Post-transplant costs were calcu-lated from payments on Medicare claims. We developed models considering Organ Procurement and Transplantation Network (OPTN variables plus: 1 CCS categories, 2 Charlson, 3 Elixhauser, 4 num-ber of Charlson and 5 number of Elixhauser comorbidities, independently. We applied a novel regression methodology to account for censoring. Costs were estimated at individual and population levels. The comorbidities with the largest impact on mean Medicare payments included cardiovascular disease, ma-lignancies, cerebrovascular disease, mental conditions and functional limitations. Skin ulcers and infec-tions, rheumatic and other connective tissue disease and liver disease also contributed to payments and have not been considered or described previously. A positive graded relationship was found between costs and the number of pre-transplant comorbidities. In conclusion, we showed that expansion beyond the usually considered pre-transplant comorbidities with inclusion of CCS and Charlson or Elixhauser comorbidities increased the knowledge about comorbidities related to augmented Medicare payments. Our expanded methodology can be used by others to assess more accurately the financial implications of renal transplantation to Medicare and individual transplant centers.

Chorionic gonadotropin and uterine dialogue in the primate

Directory of Open Access Journals (Sweden)

Strakova Zuzana

2004-07-01

Full Text Available Abstract Implantation is a complex spatio-temporal interaction between the growing embryo and the mother, where both players need to be highly synchronized to be able to establish an effective communication to ensure a successful pregnancy. Using our in vivo baboon model we have shown that Chorionic Gonadotropin (CG, as the major trophoblast derived signal, not only rescues the corpus luteum but also modulates the uterine environment in preparation for implantation. This response is characterized by an alteration in both the morphological and biochemical activity in the three major cell types: luminal and glandular epithelium and stromal fibroblasts. Furthermore, CG and factors from the ovary have a synergistic effect on the receptive endometrium. Novel local effects of CG which influence the immune system to permit the survival of the fetal allograft and prevent endometrial cell death are also discussed in this review. An alternate extracellular signal-regulated kinase (ERK activation pathway observed in epithelial endometrial cells and the possibility of differential expression of the CG/LH-R isoforms during gestation, open many questions regarding the mechanism of action of CG and its signal transduction pathway within the primate endometrium.

Post-transplant lymphoproliferative disorder following kidney transplantation

DEFF Research Database (Denmark)

Maksten, Eva Futtrup; Vase, Maja Ølholm; Kampmann, Jan

2016-01-01

after long-term post-transplantation follow-up. A retrospective population-based cohort study including all kidney transplant recipients at two Danish centres (1990-2011; population covered 3.1 million; 2175 transplantations in 1906 patients). Pathology reports were reviewed for all patient biopsies...

Monoclonal antibodies to human chorionic gonadotropin and their application to two-site sandwich radioimmunoassay

International Nuclear Information System (INIS)

Mizuchi, A.; Iio, M.; Miyachi, Y.

1984-01-01

Monoclonal antibodies were prepared against human chorionic gonadotropin (HCG). One monoclonal antibody recognized a conformational determinant expressed only on native HCG molecule and another monoclonal antibody had the specificity for the epitopes located on the β-subunit of HCG. Monoclonal antibodies reacting with different antigenic determinants on the HCG molecule were used to develop a simplified 2-site sandwich radioimmunoassay in which one monoclonal antibody was immobilized and another labeled with 125 iodine. This assay was highly specific for HCG and there was no cross-reactivity with α,β-subunit of HCG, luteinizing hormone and follicle stimulating hormone. (Auth.)

Field emission scanning electron microscopy and transmission electron microscopy studies of the chorion, plasma membrane and syncytial layers of the gastrula-stage embryo of the zebrafish Brachydanio rerio : a consideration of the structural and functional relationships with respect to cryoprotectant penetration

NARCIS (Netherlands)

Rawson, DM; Zhang, T; Kalicharan, D; Jongebloed, WL

The structure of the chorion and plasma membranes of gastrula-stage zebrafish Brachydanio rerio embryos were studied using field emission scanning electron microscopy (FE-SEM) and transmission electron microscopy (TEM). These studies confirm the outer chorion membrane complex to be 1.5-2.5 mu m in

Kidney transplant

Science.gov (United States)

... always take your medicine as directed. Alternative Names Renal transplant; Transplant - kidney Patient Instructions Kidney removal - discharge Images Kidney anatomy Kidney - blood and urine flow Kidneys Kidney transplant - ...

Pancreatic Islet Cell Transplantation: A new era in transplantation

OpenAIRE

Warnock, Garth L.; Rajotte, Ray V.

1992-01-01

Transplantation of insulin-producing tissue offers a physiologic approach to restoration of glycemic control. Whereas transplantation of vascularized pancreatic grafts has recently achieved encouraging results, pancreatic islet cell transplantation holds the promise of low morbidity and reduced requirements for agressive immunosuppression for recipients. Islet cell transplantation was recently demonstrated to induce euglycemia with insulin independence.

Growth of the pectoral girdle in a sample of juveniles from the kellis 2 cemetery, Dakhleh Oasis, Egypt.

Science.gov (United States)

Bleuze, Michele M; Wheeler, Sandra M; Williams, Lana J; Dupras, Tosha L

2016-09-10

This study investigates growth patterns in the scapula and clavicle in a cross-sectional juvenile skeletal sample ranging from 20 weeks gestation to 8.5 years of age from the Kellis 2 cemetery, Dakhleh Oasis, Egypt. The primary goal is to quantify growth patterns and growth velocities in the scapula and clavicle to better understand the development of the pectoral girdle. A series of low-order polynomial regression models was used to examine growth curves in clavicle diaphyseal length, scapular height, and scapular width. Incremental growth and relative percent increase were examined among successive age groups as a proxy measure of growth velocity. Scapular body proportions were assessed with the scapular index and compared across age groups using a Kruskal-Wallis test with post-hoc tests. A third-order polynomial best describes growth in clavicle diaphyseal length and scapular height, and a second-order polynomial best describes growth in scapular width. Growth velocity patterns are similar among clavicle diaphyseal length, scapular height, and scapular width particularly from birth until the end of early childhood. Clavicle diaphyseal length decelerates during middle childhood while scapular height and width accelerate during this time. With increasing age, the scapular body proportionately increases more in height than in width. The relatively narrow scapular body characteristic of adult scapulae is first evident during early childhood. Changes in scapular body shape during ontogeny may be a reflection of the greater alterations taking place in the integrated morphology of the pectoral girdle during the biomechanical shift from crawling to bipedalism. Am. J. Hum. Biol. 28:636-645, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Determination of chorionic gonadotrophin. Comparison of biological, immunological and radioimmunological methods

International Nuclear Information System (INIS)

Munier, M.-P.

1978-07-01

Three types of analysis were used to quantify chorionic gonadotrophic hormone: biological determination (rana-reaction); immunological determination (simplified pregnosticon test of the Organon Teknika laboratories); radioimmunological determination (Commissariat a l'Energie Atomique - CEA kits). While the immunochemical technique is specially suited to analysis of the urine, the radioimmunological measurement is carried out on the plasma. This method is extremely sensitive; when traditional biological and immunological methods are used the quantity of CGH detectable is of the order of some hundreds or at best a few tens of international units. The radioimmunological method is a thousand times more sensitive and can therefore measure CGH in amounts of the milli-unit order. Until recently it was not specific enough to differentiate between CGH and LH, but not long ago a β CGH-specific antibody was discovered and it is now possible to detect small amounts of CGH in the presence of LH [fr

ABNORMAL LEVELS OF MATERNAL SERUM HUMAN CHORIONIC-GONADOTROPIN AND ALPHA-FETOPROTEIN IN THE 2ND-TRIMESTER - RELATION TO FETAL WEIGHT AND PRETERM DELIVERY

NARCIS (Netherlands)

MORSSINK, LP; KORNMAN, LH; BEEKHUIS, [No Value; DEWOLF, BTHM; MANTINGH, A

The aim of this prospective descriptive cross-sectional study was to examine the clinical significance of abnormal maternal serum human chorionic gonadotropin (MShCG) and alpha-fetoprotein (MSAFP) in the second trimester of pregnancy. The study group comprised 8892 women with a singleton pregnancy,

Intestine Transplant

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... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

Islet alloautotransplantation: Allogeneic pancreas transplantation followed by transplant pancreatectomy and islet transplantation.

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Nijhoff, M F; Dubbeld, J; van Erkel, A R; van der Boog, P J M; Rabelink, T J; Engelse, M A; de Koning, E J P

2018-04-01

Simultaneous pancreas-kidney (SPK) transplantation is an important treatment option for patients with type 1 diabetes (T1D) and end-stage renal disease (ESRD). Due to complications, in up to 10% of patients, allograft pancreatectomy is necessary shortly after transplantation. Usually the donor pancreas is discarded. Here, we report on a novel procedure to rescue endocrine tissue after allograft pancreatectomy. A 39-year-old woman with T1D and ESRD who had undergone SPK transplantation required emergency allograft pancreatectomy due to bleeding at the vascular anastomosis. Islets were isolated from the removed pancreas allograft, and almost 480 000 islet equivalents were infused into the portal vein. The patient recovered fully. After 3 months, near-normal mixed meal test (fasting glucose 7.0 mmol/L, 2-hour glucose 7.5 mmol/L, maximal stimulated C-peptide 3.25 nmol/L, without insulin use in the preceding 36 hours) was achieved. Glycated hemoglobin while taking a low dose of long-acting insulin was 32.7 mmol/mol hemoglobin (5.3%). When a donor pancreas is lost after transplantation, rescue β cell therapy by islet alloautotransplantation enables optimal use of scarce donor pancreata to optimize glycemic control without additional HLA alloantigen exposure. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Human chorionic ganodotropin binding sites in the human endometrium

International Nuclear Information System (INIS)

Bhattacharya, S.; Banerjee, J.; Sen, S.; Manna, P.R.

1993-01-01

The existence of high-affinity and low-capacity specific binding sites for luteinizing hormone/human chorionic gonadotropin (hCG) has been reported in porcine, rabbit and rat uteri. The authors have identified the hCG binding sites in the human endometrium collected from 35-42-year-old ovulatory and anovulatory women. The binding characteristics of hCG to endometrial tissue preparations from ovulatory and anovulatory women showed saturability with high affinity and low capacity. Scatchard plot analysis showed the dissociation constant of specific binding sites in the ovulatory women to be 3.5x10 -10 mol/l and in anovulatory women to be 3.1x10 -10 mol/l. The maximum binding capacity varied considerably between ovulatory and anovulatory endometrium. Among the divalent metal ions tested Zn 2+ effected a remarkable increase in [ 125 I]hCG binding to the endometrium, whereas Mn 2+ showed a marginal increase and other metal ions did not have any effect. Data obtained with human endometrium indicate an influence of the functional state of the ovary on [ 125 I]hCG binding to endometrium. 14 refs., 3 figs

Transplant tourism among kidney transplant patients in Eastern Nigeria.

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Okafor, U H

2017-07-05

Transplant tourism entails movement of recipient, donor or both to a transplant centre outside their country of residence. This has been reported in many countries; and has variously been associated with organ trade. The objective of this study is to determine the frequency and pattern of transplant tourism among transplant patients in Eastern Nigeria. This is a non randomized cross sectional study. All kidney transplant patients who presented at Enugu State University Teaching Hospital Parklane Enugu and Hilton Clinics Port Harcourt in Nigeria were recruited. The clinical parameters including the transplant details of all the patients were documented. The data obtained was analysed using SPSS package. A total of one hundred and twenty six patients were studied, 76.2% were males with M:F ratio of 3.2:1 and mean age of 46.9 ± 13.3 years. Fifty four and 58.7% of the patients were managed in a tertiary hospital and by a nephrologist respectively before referral for kidney transplant. Only 15.8% of the patients had their kidney transplant without delay: finance, lack of donor, logistics including delay in obtaining travelling documents were the common causes of the delay. Ninety percent of the patients had their transplant in India with majority of them using commercial donors. India was also the country with cheapest cost ($18,000.00). 69.8% were unrelated donors, 68.2% were commercial donors and 1.6% of the donors were spouse. All the commercial donors received financial incentives and each commercial donor received mean of 7580 ± 1280 dollars. Also 30.2% of the related donors demanded financial incentive. Transplant tourism is prevalent in eastern Nigeria.

Contractile properties are disrupted in Becker muscular dystrophy, but not in limb girdle type 2I.

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Løkken, Nicoline; Hedermann, Gitte; Thomsen, Carsten; Vissing, John

2016-09-01

We investigated whether a linear relationship between muscle strength and cross-sectional area (CSA) is preserved in calf muscles of patients with Becker muscular dystrophy (BMD, n = 14) and limb-girdle type 2I muscular dystrophy (LGMD2I, n = 11), before and after correcting for muscle fat infiltration. The Dixon magnetic resonance imaging technique was used to quantify fat and calculate a fat-free contractile CSA. Strength was assessed by dynamometry. Muscle strength/CSA relationships were significantly lower in patients versus controls. The strength/contractile-CSA relationship was still severely lowered in BMD, but was almost normalized in LGMD2I. Our findings suggest close to intact contractile properties in LGMD2I, which are severely disrupted in BMD. Ann Neurol 2016;80:466-471. © 2016 American Neurological Association.

Gorham-Stout syndrome of the pelvic girdle treated by radiation therapy. A case report

International Nuclear Information System (INIS)

Heyd, Reinhard; Tselis, Nikolaos; Zamboglou, Nikolaos; Rabeneck, Daniela; Universitaetsklinikum Frankfurt, Frankfurt am Main; Doernenburg, Oliver

2011-01-01

The Gorham-Stout syndrome (GSS) is a rare, benign idiopathic and progressive disorder causing massive osteolysis due to a vascular hyperproliferation replacing the bony structure. Clinical experience concerning the efficacy of radiation therapy (RT) is limited to about 50 of an overall 200 cases reported worldwide. Case Report: A 24-year-old bedridden woman had histologically proven GSS with destruction of the anterior pelvic girdle and received RT for a total dose of 45.0 Gy applied in 5 weekly fractions of 1.8 Gy. In addition, the patient received intravenously 4 mg zoledronic acid once a month. One year after the combined treatment, complete pain relief occurred, and the patient was able to walk without the use of appliances. Imaging studies revealed no progression of the osteolysis but only minimal signs of remineralization. Conclusion: Combined treatment with RT and bisphosphonate administration can prevent the progression of osteolysis in GSS. Total doses of 40-45 Gy are recommended. (orig.)

Gorham-Stout syndrome of the pelvic girdle treated by radiation therapy. A case report

Energy Technology Data Exchange (ETDEWEB)

Heyd, Reinhard; Tselis, Nikolaos; Zamboglou, Nikolaos [Klinikum Offenbach, Offenbach am Main (Germany). Strahlenklinik; Rabeneck, Daniela [Klinikum Offenbach, Offenbach am Main (Germany). Strahlenklinik; Universitaetsklinikum Frankfurt, Frankfurt am Main (Germany). Klinik fuer Strahlentherapie und Onkologie; Doernenburg, Oliver [Klinikum Offenbach, Offenbach am Main (Germany). Inst. fuer Diagnostische und Interventionelle Radiologie

2011-02-15

The Gorham-Stout syndrome (GSS) is a rare, benign idiopathic and progressive disorder causing massive osteolysis due to a vascular hyperproliferation replacing the bony structure. Clinical experience concerning the efficacy of radiation therapy (RT) is limited to about 50 of an overall 200 cases reported worldwide. Case Report: A 24-year-old bedridden woman had histologically proven GSS with destruction of the anterior pelvic girdle and received RT for a total dose of 45.0 Gy applied in 5 weekly fractions of 1.8 Gy. In addition, the patient received intravenously 4 mg zoledronic acid once a month. One year after the combined treatment, complete pain relief occurred, and the patient was able to walk without the use of appliances. Imaging studies revealed no progression of the osteolysis but only minimal signs of remineralization. Conclusion: Combined treatment with RT and bisphosphonate administration can prevent the progression of osteolysis in GSS. Total doses of 40-45 Gy are recommended. (orig.)

Shoulder Girdle Muscles Endurance in Subjects with and without Impingement Syndrome

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Afsoun Nodehi-Moghadam

2011-07-01

Full Text Available Objective: Any minimal alteration in performance and coordination of scapular and glenohumeral muscles has the potential to lead to shoulder joint dysfunction. The impingement syndrome has been reported as is the most common diagnosis of shoulder pain. The purpose of this study was to determine whether endurance deficits could be detected in patients with shoulder impingement. Materials & Methods: By convenient sampling 15 patients with impingement syndrome at average of 45.3 years of age and 15 healthy persons (age 45.8 years through a case–control design participated in the study. Endurance of glenohumeral and scapulothoracic muscles were tested with a hand held dynamometer. Independent t–test was used to statistically analyze different groups. Results: Compared to non–impaired subjects, those with impingement syndrome demonstrated a significantly lower endurance of external rotation, scaption and scapular abduction and upward rotation movements (P<0.05. In impingement syndrome patients, the external–to–internal rotator muscles endurance ratio was significantly lower than the control group (P<0.05. Conclusion: The result of the study suggests that endurance deficit of rotator cuff and scapular upward rotator muscles may be an important aspect of the impingement syndrome. Shoulder girdle muscles endurance should be considered in evaluation and physical therapy of impingement syndrome patients.

Young adults' experiences of living with recessive limb-girdle muscular dystrophy from a salutogenic orientation: an interview study.

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Aho, Anna Carin; Hultsjö, Sally; Hjelm, Katarina

2015-01-01

To describe young adults' experiences of living with recessive limb-girdle muscular dystrophy (LGMD2) from a salutogenic orientation. A qualitative explorative interview study, including 14 participants aged 20-30 years, was performed focusing on comprehensibility, manageability and meaningfulness in daily life. Content analysis was used for data analysis. Living with LGMD2 not only implies learning to live with the disease and the variations between good and bad periods but also means trying to make sense of a progressive disease that brings uncertainty about future health, by striving to make the best of the situation. Disease progression involves practical and mental struggle, trying to maintain control over one's life despite vanished physical functions that require continual adjustments to the body. Restrictions in a double sense were described, not only due to the disease but also due to poor comprehension of the disease in society. Lack of knowledge about LGMD2 among professionals often results in having to fight for the support needed. In order to manage daily life, it is important to be seen and understood as an individual in contacts with professionals and in society in general, to have informal social support and meaningful activities as well as access to personal assistance if necessary. Recessive limb-girdle muscular dystrophy (LGMD2) is a group of progressive disorders, which manifest in physical and psychological consequences for the individual. According to the salutogenic orientation, people need to find life comprehensible, manageable and meaningful, i.e. to achieve a sense of coherence (SOC), but living with LGMD2 may recurrently challenge the individual's SOC. Through the holistic view of the individual's situation that the salutogenic orientation provides, professionals may support the individual to strengthen SOC and thereby facilitate the movement towards health.

Post-transplant lymphoproliferative disease in liver transplant recipients

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Mercedes Rubio-Manzanares-Dorado

Full Text Available Introduction: Post-transplant lymphoproliferative syndrome (PTLD is a rare and potentially life-threatening complication after liver transplantation. The aim of this study was to analyze the clinicopathologic features related to PTLD in a single institution after liver transplantation. Methods: Observational study where we have retrospectively analyzed 851 cases who underwent liver transplantation. Ten cases have developed PTLD. Their clinical-pathological characteristics and the treatment received have been analyzed. Results: PTLD incidence was 1.2% (10/851. The mean time from liver transplantation to PTLD diagnosis was 36 months (range 1.2 to 144 months. PTLD localization was extranodal in all cases, the most frequent location being intestinal. Seven cases showed a monomorphic lymphoma which in all cases was differentiated B cell lymphomas. Fifty per cent of the series were seropositive for Epstein-Barr virus. Five patients were alive at the time of the review. Among these patients, we observed three cases of complete remission and two cases of disease stabilization. The death rate was higher in the first year after diagnosis of PTLD. Conclusion: PTLD is a rare complication after liver transplantation, but it may pose a threat to the life of a liver transplant recipient. It is essential to identify patients at risk, to establish an early diagnosis and treatment that can change the outcome of the disease.

Pre-transplant history of mental health concerns, non-adherence, and post-transplant outcomes in kidney transplant recipients.

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Gumabay, Franz Marie; Novak, Marta; Bansal, Aarushi; Mitchell, Margot; Famure, Olusegun; Kim, S Joseph; Mucsi, Istvan

2018-02-01

The association between pre-transplant mental health concerns and non-adherence and post-transplant outcomes after kidney transplantation is not fully established. We examined the relationship between a pre-transplant history of mental health concerns and non-adherence and post-transplant outcomes among kidney transplant recipients. In this retrospective single center cohort study of adult kidney transplant recipients (n=955) the associations between the history of mental health concerns or non-adherence and the time from kidney transplant to biopsy proven acute rejection; death-censored graft failure and total graft failure were examined using Cox proportional hazards models. Mean (SD) age was 51 (13) years, 61% were male and 27% had a history of diabetes. Twenty-two and 11% of patients had mental health concerns and non-adherence, respectively. Fifteen percent of the patients had acute rejection, 5.6% had death-censored graft failure and 13.0% had total graft failure. The history of mental health concerns was not associated with acute rejection, death-censored graft failure or total graft failure. Patients with versus without a history of non-adherence tended to have higher cumulative incidence of acute rejection (23.3% [95% CI: 16.1, 33.2] vs. 13.6% [95% CI: 11.4, 16.2]) and death-censored graft failure (15.0% [95% CI: 6.9, 30.8] vs. 6.4% [95% CI: 4.7, 8.7]) (log rank p=0.052 and p=0.086, respectively). These trends were not significant after multivariable adjustment. In summary, a history of pre-transplant mental health concerns or non-adherence is not associated with adverse outcomes in patients who completed transplant workup and received a kidney transplant. Copyright © 2018 Elsevier Inc. All rights reserved.

Organ donation and transplantation in Mexico. A transplantation health professionals’ perspective

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Luis Eduardo Hernández-Ibarra

2017-01-01

Full Text Available Objective. We aimed to explore organ donation and transplantation in Mexico from the point of view of transplantation health professionals. Materials and methods. A qualitative study was carried out. Twenty six organ transplantation health professionals from seven states of Mexico participated. Semi-structured face-to-face interviews were conducted mainly in hospital settings. Critical discourse analysis was performed. Results. According to participants, living organ transplantation offers benefits for recipients as well as for donors. Several factors influence the field of transplantation negatively, among them the scarcity of resources that impedes the incorporation of new health personnel, as well as conflicts between transplantation teams with diverse health professionals and authorities. Conclusion. Besides increasing economic resources, transplantation health personnel should be sensitized to find solutions in order to avoid conflicts with different health professionals. Studies on organ donation and transplants also should include other social actors’ viewpoint.

Body weight-supported training in Becker and limb girdle 2I muscular dystrophy.

Science.gov (United States)

Jensen, Bente R; Berthelsen, Martin P; Husu, Edith; Christensen, Sofie B; Prahm, Kira P; Vissing, John

2016-08-01

We studied the functional effects of combined strength and aerobic anti-gravity training in severely affected patients with Becker and Limb-Girdle muscular dystrophies. Eight patients performed 10-week progressive combined strength (squats, calf raises, lunges) and aerobic (walk/run, jogging in place or high knee-lift) training 3 times/week in a lower-body positive pressure environment. Closed-kinetic-chain leg muscle strength, isometric knee strength, rate of force development (RFD), and reaction time were evaluated. Baseline data indicated an intact neural activation pattern but showed compromised muscle contractile properties. Training (compliance 91%) improved functional leg muscle strength. Squat series performance increased 30%, calf raises 45%, and lunges 23%. Anti-gravity training improved closed-kinetic-chain leg muscle strength despite no changes in isometric knee extension strength and absolute RFD. The improved closed-kinetic-chain performance may relate to neural adaptation involving motor learning and/or improved muscle strength of other muscles than the weak knee extensors. Muscle Nerve 54: 239-243, 2016. © 2016 Wiley Periodicals, Inc.

Gorham-Stout disease of the shoulder girdle and cervico-thoracic spine: fatal course in a 65-year-old woman

International Nuclear Information System (INIS)

Bode-Lesniewska, B.; Hochstetter, A. von; Exner, G.U.; Hodler, J.

2002-01-01

A case of Gorham-Stout disease of the shoulder girdle and cervico-thoracic spine in a 65-year-old woman is described. The patient presented with progressive neurologic symptoms, pain, and deformities of the cervico-thoracic spine as well as of her left shoulder following a traumatic shoulder luxation. Since the patient had a history of uterine carcinoma, the current disease was clinically difficult to differentiate from osteolytic metastases. The results of the clinical, radiological and histopathologic examination leading to the diagnosis of Gorham-Stout disease are described. Neither attempted surgery nor radiotherapy produced clinical improvement and the patient died 1 year after the first clinical evaluation. (orig.)

Expression of β human chorionic gonadotropin in the placenta of gestational diabetic mothers: an immunohistochemistry and ultrastructural study.

Science.gov (United States)

Sak, Muhammed Erdal; Deveci, Engin; Evsen, Mehmet Siddik; Kalkanhi, Sevgi; Baran, Ozlem; Ozekinci, Selver; Seker, Uğur

2013-02-01

To investigate morphologic differences of the placenta in pregnancies complicated by gestational diabetes compared to nondiabetic pregnancies. This was a comparative morphological study of the placentas from 20 women with gestational diabetes and 20 healthy pregnancies at 28-35 weeks of gestation. The presence of lesions such as fibrinoid necrosis, villous edema, syncytial knot and vascular lesions like chorangiosis was apparent, mainly in the diabetes group. There was an apparent decrease in the intensity of the human chorionic gonadotropin (hCG) immunostaining in the syncytiotrophoblast from the 28th to 35th weeks of gestation in the placentas of the healthy control group. No hCG immunostaining was observed in the villous or intervillous areas of any of the placentas. In diabetic placentas the expression of hCG was homogeneous with a moderate to intense immunoreactivity in the syncytiotrophoblast. Several syncytiotrophoblast cells showed dilations of both rough and smooth endoplasmic reticulum and loss and alteration of microvilli, and large vacuoles were observed just below the plasma membrane, as well as irregularities in the mitochondria. Syncytial cells play an important role in the placental transition. Increased expression of beta-hCG, deterioration, degeneration of organelles and cell structure and the basal membrane disorder in chorionic vessels were seen in placentas with gestational diabetes. These changes can affect placental transfer. However, further studies are needed to clarify this issue.

Thoracic organ transplantation.

Science.gov (United States)

Pierson, Richard N; Barr, Mark L; McCullough, Keith P; Egan, Thomas; Garrity, Edward; Jessup, Mariell; Murray, Susan

2004-01-01

This article presents an overview of factors associated with thoracic transplantation outcomes over the past decade and provides valuable information regarding the heart, lung, and heart-lung waiting lists and thoracic organ transplant recipients. Waiting list and post-transplant information is used to assess the importance of patient demographics, risk factors, and primary cardiopulmonary disease on outcomes. The time that the typical listed patient has been waiting for a heart, lung, or heart-lung transplant has markedly increased over the past decade, while the number of transplants performed has declined slightly and survival after transplant has plateaued. Waiting list mortality, however, appears to be declining for each organ and for most diseases and high-severity subgroups, perhaps in response to recent changes in organ allocation algorithms. Based on perceived inequity in organ access and in response to a mandate from Health Resources and Services Administration, the lung transplant community is developing a lung allocation system designed to minimize deaths on the waiting list while maximizing the benefit of transplant by incorporating post-transplant survival and quality of life into the algorithm. Areas where improved data collection could inform evolving organ allocation and candidate selection policies are emphasized.

Dialysis Facility Transplant Philosophy and Access to Kidney Transplantation in the Southeast.

Science.gov (United States)

Gander, Jennifer; Browne, Teri; Plantinga, Laura; Pastan, Stephen O; Sauls, Leighann; Krisher, Jenna; Patzer, Rachel E

2015-01-01

Little is known about the impact of dialysis facility treatment philosophy on access to transplant. The aim of our study was to determine the relationship between the dialysis facility transplant philosophy and facility-level access to kidney transplant waitlisting. A 25-item questionnaire administered to Southeastern dialysis facilities (n = 509) in 2012 captured the facility transplant philosophy (categorized as 'transplant is our first choice', 'transplant is a great option for some', and 'transplant is a good option, if the patient is interested'). Facility-level waitlisting and facility characteristics were obtained from the 2008-2011 Dialysis Facility Report. Multivariable logistic regression was used to examine the association between the dialysis facility transplant philosophy and facility waitlisting performance (dichotomized using the national median), where low performance was defined as fewer than 21.7% of dialysis patients waitlisted within a facility. Fewer than 25% (n = 124) of dialysis facilities reported 'transplant is our first option'. A total of 131 (31.4%) dialysis facilities in the Southeast were high-performing facilities with respect to waitlisting. Adjusted analysis showed that facilities who reported 'transplant is our first option' were twice (OR 2.0; 95% CI 1.0-3.9) as likely to have high waitlisting performance compared to facilities who reported that 'transplant is a good option, if the patient is interested'. Facilities with staff who had a more positive transplant philosophy were more likely to have better facility waitlisting performance. Future prospective studies are needed to further investigate if improving the kidney transplant philosophy in dialysis facilities improves access to transplantation.

Chorionic villus sampling for beta-thalassemia: the first report of experience in Iran.

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Akhlaghpoor, Shahram

2006-12-01

Beta-thalassemia is one of the most common hereditary disorders in Iran. The prenatal diagnosis of beta-thalassemia is part of a control program in our country and it began 13 years ago. During the past 8 years the number of procedures has increased significantly as also the legal abortions. This is the first report made on the CVS program in Iran. One thousand six hundred and sixty-one cases of transabdominal Chorionic Villus Sampling (CVS) have been retrospectively evaluated. Among them 1381 cases had inclusion criteria. CVS results, complications and fetal loss rate were evaluated. The distributions of the population at risk were divided between eight regions that have been proposed for beta-thalassemia mapping previously. The mean age of the patients was 26.2 +/- 5.2 years with mean gestational age of 11.4 +/- 1.4 weeks. CVS was successful in all the patients (100%) although 1% required a second procedure. Post CVS fetal loss was 1.45%. Other minor complications were bleeding or spotting (1.81%), amniotic fluid leak (0.5%), small sub-chorionic hematoma (0.58%), severe abdominal pain (0.6%) and severe vasovagal reaction (0.14%). Late complications were seen in 0.21% (oligohydraminos). Approximately 2/3 of the patients were referred from three regions of the country, North (26.8%), South West (22.4%), Central (19.5%) and the remainder (31.3%) were from the other five regions. CVS is a safe and effective method for prenatal diagnosis of beta-thalassemia in countries with a high prevalence as in Iran. The overall complication rate is quite low and acceptable. Fortunately the recent acceptance of legal abortion with respect to Muslim rules has increased the effectiveness of the procedure and made great advances in its application in Iran. Correspondingly, social knowledge has also improved but still there is a gap between the population at risk and the required prenatal diagnosis laboratories and sampling centers. 2006 John Wiley & Sons, Ltd.

Carinal transplantation.

Science.gov (United States)

Ueda, H; Shirakusa, T

1992-01-01

BACKGROUND: Current techniques of management of carinal lesions are not always satisfactory. Carinal transplantation, if feasible, would be valuable in certain circumstances. METHODS AND RESULTS: Carinal transplantation experiments were performed in dogs. In early cross transplant experiments there were problems in controlling ventilation and in obtaining satisfactory anastomoses, and the animals failed to live for even a few days. In seven subsequent experiments the carinal graft was removed from one dog and transplanted into a second dog. Two dogs lived for over four months with immunosuppression. CONCLUSION: The results suggest that carinal transplantation can succeed if (1) the calibre of the graft is matched with that of the recipient; (2) there is an abundant blood supply to the graft; (3) appropriate immunosuppression is provided; (4) ventilation is adequate during surgery. Images PMID:1465758

Rosiglitazone attenuates transplant arteriosclerosis after allogeneic aorta transplantation in rats

NARCIS (Netherlands)

Onuta, Geanina; Rienstra, Heleen; de Boer, Jan Freark; Boer, Mark Walther; Roks, Anton J. M.; Klatter, Flip A.; Uges, Donald R. A.; Navis, Gerjan; Rozing, Jan; Hillebrands, Jan-Luuk

2007-01-01

Background. Transplant arteriosclerosis is a leading cause of chronic transplant dysfunction and is characterized by occlusive neointima formation in intragraft arteries. Development of transplant arteriosclerosis is refractory to conventional immunosuppressive drugs and adequate therapy is not

Myocardial Contractile Dysfunction is Present Without Histopathology in a Mouse Model of Limb-Girdle Muscular Dystrophy-2F and is Prevented after Claudin-5 Virotherapy

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Nima Milani-Nejad

2016-12-01

Full Text Available AbstractMutations in several members of the dystrophin glycoprotein complex lead to skeletal and cardiomyopathies. Cardiac care for these muscular dystrophies consists of management of symptoms with standard heart medications after detection of reduced whole heart function. Recent evidence from both Duchenne muscular dystrophy patients and animal models suggests that myocardial dysfunction is present before myocardial damage or deficiencies in whole heart function, and that treatment prior to heart failure symptoms may be beneficial. To determine whether this same early myocardial dysfunction is present in other muscular dystrophy cardiomyopathies, we conducted a physiological assessment of cardiac function at the tissue level in the δ-sarcoglycan null mouse model (Sgcd-/- of Limb-girdle muscular dystrophy type 2F. Baseline cardiac contractile force measurements using ex vivo intact linear muscle preparations, were severely depressed in these mice without the presence of histopathology. Virotherapy with claudin-5 prevents the onset of cardiomyopathy in another muscular dystrophy model. After virotherapy with claudin-5, the cardiac contractile force deficits in Sgcd-/- mice are no longer significant. These studies suggest that screening Limb-girdle muscular dystrophy patients using methods that detect earlier functional changes may provide a longer therapeutic window for cardiac care.

Transplante de bexiga: estudo piloto Bladder transplant: pilot study

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Frederico Teixeira Brandt

2004-08-01

Full Text Available OBJETIVO: Desenvolver um modelo biológico que seja viável para o estudo sistemático do transplante de bexiga. MÉTODOS: Cães mestiços vivos são usados como doadores e receptores do segmento supra-trigonal da bexiga. RESULTADOS: Os pacientes tansplantados só fizeram uso de imunossupressão por 15 dias, estão vivos e sadios com 18 meses de transplante. Desde o primeiro mês de transplante os cães apresentam controle funcional da micção, inclusive sem urina residual importante. CONCLUSÃO: Transplante de bexiga em cães é um modelo viável, fisiológico e simples.PURPOSE: Our aim was to study the feasible of bladder transplants. METHODS: Alive mongrel dogs are being used as trigone bladder segment donators and receptors RESULTS: The transplanted patients had 15 days of immunosuppression and so far an 18-months satisfactory post-operative outcome. Since a month after surgery, the dogs have been presenting full functional control of micturition and the evaluations have been showing normal bladder storage and contraction capacities. CONCLUSION: bladder transplants in dogs its a possible, physiological and simple model.

Differentiation Potential of Human Chorion-Derived Mesenchymal Stem Cells into Motor Neuron-Like Cells in Two- and Three-Dimensional Culture Systems.

Science.gov (United States)

Faghihi, Faezeh; Mirzaei, Esmaeil; Ai, Jafar; Lotfi, Abolfazl; Sayahpour, Forough Azam; Barough, Somayeh Ebrahimi; Joghataei, Mohammad Taghi

2016-04-01

Many people worldwide suffer from motor neuron-related disorders such as amyotrophic lateral sclerosis and spinal cord injuries. Recently, several attempts have been made to recruit stem cells to modulate disease progression in ALS and also regenerate spinal cord injuries. Chorion-derived mesenchymal stem cells (C-MSCs), used to be discarded as postpartum medically waste product, currently represent a class of cells with self renewal property and immunomodulatory capacity. These cells are able to differentiate into mesodermal and nonmesodermal lineages such as neural cells. On the other hand, gelatin, as a simply denatured collagen, is a suitable substrate for cell adhesion and differentiation. It has been shown that electrospinning of scaffolds into fibrous structure better resembles the physiological microenvironment in comparison with two-dimensional (2D) culture system. Since there is no report on potential of human chorion-derived MSCs to differentiate into motor neuron cells in two- and three-dimensional (3D) culture systems, we set out to determine the effect of retinoic acid (RA) and sonic hedgehog (Shh) on differentiation of human C-MSCs into motor neuron-like cells cultured on tissue culture plates (2D) and electrospun nanofibrous gelatin scaffold (3D).

Limb-girdle muscular dystrophy in Brazilian children: clinical, histological and molecular characterization

Directory of Open Access Journals (Sweden)

Marco A. Veloso Albuquerque

2014-06-01

Full Text Available Limb-girdle muscular dystrophies (LGMD are a heterogeneous group of genetic muscular dystrophies, involving 16 autosomal recessive subtypes and eight autosomal dominant subtypes. Autosomal recessive dystrophy is far more common than autosomal dominant dystrophy, particularly in children. The clinical course in this group is characterized by progressive proximal weakness, initially in pelvic and after in shoulder-girdle musculature, varying from very mild to severe degree. Significant overlap of clinical phenotypes, with genetic and clinical heterogeneity, constitutes the rule for this group of diseases. Muscle biopsies are useful for histopathologic and immunolabeling studies, and DNA analysis is the gold standard to establish the specific form of muscular dystrophy. Objectives: The aim of this study was to characterize the clinical, histological and molecular aspects in children with LGMD who attend a big public neuromuscular centre in our country to determine the frequency of different forms. Method: Thirty seven patients were classified as LGMD and included in this analysis. The study period extended from 2009-2012. The female to male ratio was 3:1. The age of onset ranged from two to 13 years, mean 7,5 years. Onset in the first decade was seen in 90%. Results: The initial clinical signs included: frequent falls (22 cases, difficulty in climbing stairs (13 cases, walk on tip toes (2 cases, difficulty in rising from the floor (2 cases and difficulty on walking (1 case. The serum CK levels were high in all cases. Among the 37 patients, 15 (40,5% were classified as sarcoglycanopathies (LGMD2C-F, five (13,5% as dysferlinopathy (LGMD2B, five (13,5% as calpainopathy (LGMD2A. Mutations in LMNA gene (LGMD1B, FKRP gene (LGMDI and caveolin gene (LGMD 1C were identified in two (5,5%, two (5,5% and one patient (2,5%, respectively. In seven of 37 cases (19% it was impossible to determine specific diagnosis. Calf hypertrophy, scapular winging and scoliosis

Evolution of the role of the transplant pharmacist on the multidisciplinary transplant team.

Science.gov (United States)

Alloway, R R; Dupuis, R; Gabardi, S; Kaiser, T E; Taber, D J; Tichy, E M; Weimert-Pilch, N A

2011-08-01

Transplant pharmacists have been recognized as an essential part of the transplant team by their colleagues along with several governing and professional organizations. The specific education, training and responsibilities of the transplant pharmacist have not been clearly delineated in the literature. Various pharmacists across the country have been called upon to serve on the transplant team necessitating standardization of their fundamental and desirable activities. Therefore, the purpose of this manuscript is to describe the training and role of a transplant pharmacist on the patient care team and provide a roadmap to implementation of novel transplant pharmacy services. ©2011 The Authors Journal compilation©2011 The American Society of Transplantation and the American Society of Transplant Surgeons.

A peptide mimic of an antigenic loop of alpha-human chorionic gonadotropin hormone: solution structure and interaction with a llama V-HH domain

NARCIS (Netherlands)

Ferrat, G.; Renisio, J.G.; Morelli, X.; Slootstra, J.W.; Meloen, R.; Cambillau, C.; Darbon, H.

2002-01-01

The X-ray structure of a ternary complex between human chorionic gonadotropin hormone (hCG) and two Fvs recognizing its alpha and beta subunits has been recently determined. The Fvs recognize the elongated hCG molecule by its two ends, one being the Leu-12-Cys-29 loop of the alpha subunit. We have

Pancreatic islet transplantation

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Corrêa-Giannella Maria

2009-09-01

Full Text Available Abstract Background No formulation of exogenous insulin available to date has yet been able to mimic the physiological nictemeral rhythms of this hormone, and despite all engineering advancements, the theoretical proposal of developing a mechanical replacement for pancreatic β cell still has not been reached. Thus, the replacement of β cells through pancreas and pancreatic islet transplantation are the only concrete alternatives for re-establishing the endogenous insulin secretion in type 1 diabetic patients. Since only 1 to 1.5% of the pancreatic mass corresponds to endocrine tissue, pancreatic islets transplantation arises as a natural alternative. Data from the International Islet Transplant Registry (ITR from 1983 to December 2000 document a total of 493 transplants performed around the world, with progressively worse rates of post-transplant insulin independence. In 2000, the "Edmonton Protocol" introduced several modifications to the transplantation procedure, such as the use of a steroid-free immunosuppression regimen and transplantation of a mean islet mass of 11,000 islet equivalents per kilogram, which significantly improved 1-year outcomes. Although the results of a 5-year follow-up in 65 patients demonstrated improvement in glycemic instability in a significant portion of them, only 7.5% of the patients have reached insulin independence, indicating the need of further advances in the preservation of the function of transplanted islet. In addition to the scarcity of organs available for transplantation, islets transplantation still faces major challenges, specially those related to cell loss during the process of islet isolation and the losses related to the graft site, apoptosis, allorejection, autoimmunity, and immunosuppression. The main strategies to optimize islet transplantation aim at improving all these aspects. Conclusion Human islet transplantation should be regarded as an intervention that can decrease the frequency of

Cerebral Post-Transplant Lymphoproliferative Disorder Occurring after Renal Transplantation: A Case Report

Energy Technology Data Exchange (ETDEWEB)

Suh, Jang Ho; Byun, Woo Mok; Kim, Hong Chul; Hwang, Min Su [Dept. of Radiology, Yeungnam University College of Medicine, Daegu (Korea, Republic of)

2012-04-15

Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation and immunosuppression. A 36-year-old woman with a history of renal transplantation visited the hospital complaining of headache and on pathology was diagnosed with cerebral PTLD manifesting as multiple rim enhanced masses in both hemispheres. We report here a case of post-transplant lymphoproliferative disorder involving the cerebrum occurring after renal transplantation, and describe the MRI findings for this patient

Cerebral Post-Transplant Lymphoproliferative Disorder Occurring after Renal Transplantation: A Case Report

International Nuclear Information System (INIS)

Suh, Jang Ho; Byun, Woo Mok; Kim, Hong Chul; Hwang, Min Su

2012-01-01

Post-transplant lymphoproliferative disorder (PTLD) is a complication of organ transplantation and immunosuppression. A 36-year-old woman with a history of renal transplantation visited the hospital complaining of headache and on pathology was diagnosed with cerebral PTLD manifesting as multiple rim enhanced masses in both hemispheres. We report here a case of post-transplant lymphoproliferative disorder involving the cerebrum occurring after renal transplantation, and describe the MRI findings for this patient

CT scan-guided percutaneous osteosynthesis of a complex, multifocal fracture of the pelvic girdle in a 14-year-old adolescent

International Nuclear Information System (INIS)

Gagne, Pierre-Thomas; Bertrand, Anne-Sophie; Caudal, Amandine; El Hayek, Tony; Amoretti, Nicolas

2014-01-01

We report on a 14-year-old girl with minimally displaced pelvic girdle and acetabular roof fracture following motor vehicle trauma, treated percutaneously under CT and C-arm fluoroscopic guidance by an interventional radiologist. After informed consent from the patient's parents, under surgical aseptic conditions and under general anesthesia, three screws were positioned adequately under dual guidance by a radiologist and without immediate or long-term complication. The patient was mobilized 48 h after the procedure and resumed normal activities after 1 month. Even though the technique has been described before on adults, to our knowledge this is the first time it has been described on a pediatric patient. (orig.)

After the Transplant

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... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

Stem Cell Transplant

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... Graft-versus-host disease: A potential risk when stem cells come from donors If you receive a transplant ... medications and blood products into your body. Collecting stem cells for transplant If a transplant using your own ...

Mechanism of Trypanosoma cruzi Placenta Invasion and Infection: The Use of Human Chorionic Villi Explants

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Ricardo E. Fretes

2012-01-01

Full Text Available Congenital Chagas disease, a neglected tropical disease, endemic in Latin America, is associated with premature labor and miscarriage. During vertical transmission the parasite Trypanosoma cruzi (T. cruzi crosses the placental barrier. However, the exact mechanism of the placental infection remains unclear. We review the congenital transmission of T. cruzi, particularly the role of possible local placental factors that contribute to the vertical transmission of the parasite. Additionally, we analyze the different methods available for studying the congenital transmission of the parasite. In that context, the ex vivo infection with T. cruzi trypomastigotes of human placental chorionic villi constitutes an excellent tool for studying parasite infection strategies as well as possible local antiparasitic mechanisms.

Cardiac transplantation in South Carolina: 300 transplants.

Science.gov (United States)

Crumbley, A J; Odom, Sylvia; Van Bakel, Adrian B; Pereira, Naveen; Ikonomidis, John S; Bradley, Scott; Kratz, John M; Sade, Robert M; Uber, Walt; Stroud, Martha R; Crawford, Fred A

2006-02-01

For nearly 20 years, the Medical University's Heart Transplant Program has been providing the citizens of South Carolina with excellent results with a minimum of delay. We present here the results of our first 300 heart transplants, spanning the first 18 years of the Cardiac Transplant Program at the Medical University. Overall survival has been very good, with one, five and ten year survival rates in the adults being 92 +/- 2%, 78 +/- 3%, and 58 +/- 4%. The children's group showed survival rates of 94 +/- 5%, 79 +/- 11%, and 79 +/- 11% over the same lengths of time. Most recently, the federally sponsored Scientific Registry of Transplant Recipients (www.ustransplant.org, July 2005) reports for MUSC a one-year survival of 97.67% and three-year survival of 90.74%; both leading the Southeast. We attribute this success to the dedicated work of health care workers at all levels who believe in attention to detail and that the patient always comes first. It is our hope that we will be able to continue to provide expert, state-of-the-art, cardiac transplant services long into the future, while continuing to expand our heart failure management program as dictated by further developments in this rapidly evolving specialty.

Organ Transplants in Kazakhstan.

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Baigenzhin, Abay; Doskaliyev, Zhaksylyk; Tuganbekova, Saltanat; Zharikov, Serik; Altynova, Sholpan; Gaipov, Abduzhappar

2015-11-01

The Republic of Kazakhstan is one of the fastest developing countries in the world and has a health care system that is unique in Central Asia. Its organ transplant services are also developing rapidly. We aimed to analyze and briefly report on the current status of organ transplant in the Republic of Kazakhstan. We analyzed organ transplant activities in that country for the period 2012 to 2014. All data were collected from the official database of the National Transplant Coordinating Center of the Republic of Kazakhstan. At the end of 2014, the number of transplant centers had increased to 10, three of which could perform multiorgan transplants; during the same period, the number of deceased-donor organ-donating hospitals increased up to 37. By 2013, the transplant activity rate for all centers had reached 9.22 per million population. During the previous 3 years (2012-2014), there was a 3-fold increase in the number of living donors and an 18-fold increase in the number of kidney transplants. Between 2012 and 2014, the number of living-donor liver transplants increased from 17 to 25, and the number of deceased-donor transplants increased from 3 to 7. During the last 3 years (2012-2014), the number of heart transplants increased to 7 cases. During the last 3 years (2012-2014), Kazakhstan achieved a significant improvement in the organization of its transplant services, and a noticeable upward trend in the system continues.

Carinal transplantation.

OpenAIRE

Ueda, H; Shirakusa, T

1992-01-01

BACKGROUND: Current techniques of management of carinal lesions are not always satisfactory. Carinal transplantation, if feasible, would be valuable in certain circumstances. METHODS AND RESULTS: Carinal transplantation experiments were performed in dogs. In early cross transplant experiments there were problems in controlling ventilation and in obtaining satisfactory anastomoses, and the animals failed to live for even a few days. In seven subsequent experiments the carinal graft was removed...

[Transplant Surgeon Meets Nephrologist: Important Nephrological Aspects Before and After Kidney or Liver Transplantation].

Science.gov (United States)

Vondran, F W R; Wintterle, S; Bräsen, J H; Haller, H; Klempnauer, J; Richter, N; Lehner, F; Schiffer, M

2017-04-01

In cases of chronic renal insufficiency, successful kidney transplantation is the method of choice to restore patients' health, well-being and physical fitness. The interdisciplinary collaboration of nephrologists and transplant surgeons has always been a prerequisite for the successful pre-, peri- and post-transplant care of renal transplant patients. The same holds true for liver transplant patients. Here the nephrologist is often involved in cases requiring pre- or post-transplant dialysis as well as in decision making for combined liver-kidney transplantation. This review focuses on nephrological aspects in patient care before and after kidney and liver transplantation. Georg Thieme Verlag KG Stuttgart · New York.

Temporal effects of maternal and pregnancy characteristics on serum pregnancy-associated plasma protein-A and free β-human chorionic gonadotropin at 7-14 weeks' gestation

DEFF Research Database (Denmark)

Ball, S; Ekelund, C; Wright, D

2013-01-01

OBJECTIVE: The aim of this study was to investigate gestational age-dependent effects of racial origin, smoking status and mode of conception on maternal serum levels of free β-human chorionic gonadotropin (β-hCG) and pregnancy-associated plasma protein-A (PAPP-A) at 7-14 weeks' gestation. METHODS...

Too poor for transplant: finance and insurance issues in transplant ethics.

Science.gov (United States)

Laurentine, Kyle Alexander; Bramstedt, Katrina A

2010-06-01

Donor organs are a scarce gift. Additionally, transplantation is very expensive and the United States lacks universal health insurance for all citizens. These facts combine to make personal finance and insurance some of the criteria for wait listing at US transplant centers. Previous research has shown that the poor and the uninsured (as well as women and nonwhites) are less likely to receive a transplant. Living donor candidates are also limited by the US insurance system. To determine the effect of finance and insurance variables on access to transplant and living donation. A qualitative descriptive study of ethics consultation data contained in a research registry approved by the institutional review board at California Pacific Medical Center. This study analyzes research registry data from a large community hospital in Northern California that serves patients from California, Oregon, and Nevada. The registry data are derived from transplant ethics consultations occurring between January 1, 2007, and June 30, 2009. This study explores the restriction of access to transplantation and of participation in living donation. More than a quarter of all transplant ethics consultation reports described the restriction of transplant-related treatment for reasons rooted in finance or insurance. Individuals on the recipient side and on the donor side were hindered with regard to access. Insurance status and personal ability to pay significantly affect access to transplantation in the United States, and this theme is a frequent feature of ethics consultations at California Pacific Medical Center.

History of Lung Transplantation.

Science.gov (United States)

Dabak, Gül; Şenbaklavacı, Ömer

2016-04-01

History of lung transplantation in the world can be traced back to the early years of the 20 th century when experimental vascular anastomotic techniques were developed by Carrel and Guthrie, followed by transplantation of thoracic organs on animal models by Demikhov and finally it was James Hardy who did the first lung transplantation attempt on human. But it was not until the discovery of cyclosporine and development of better surgical techniques that success could be achieved in that field by the Toronto Lung Transplant Group led by Joel Cooper. Up to the present day, over 51.000 lung transplants were performed in the world at different centers. The start of lung transplantation in Turkey has been delayed for various reasons. From 1998 on, there were several attempts but the first successful lung transplant was performed at Sureyyapasa Hospital in 2009. Today there are four lung transplant centers in Turkey; two in Istanbul, one in Ankara and another one in Izmir. Three lung transplant centers from Istanbul which belong to private sector have newly applied for licence from the Ministry of Health.

Perspectives of Older Kidney Transplant Recipients on Kidney Transplantation.

Science.gov (United States)

Pinter, Jule; Hanson, Camilla S; Chapman, Jeremy R; Wong, Germaine; Craig, Jonathan C; Schell, Jane O; Tong, Allison

2017-03-07

Older kidney transplant recipients are susceptible to cognitive impairment, frailty, comorbidities, immunosuppression-related complications, and chronic graft failure, however, there has been limited focus on their concerns and expectations related to transplantation. This study aims to describe the perspectives of older kidney transplant recipients about their experience of kidney transplantation, self-management, and treatment goals to inform strategies and interventions that address their specific needs. Face-to-face semistructured interviews were conducted with 30 kidney transplant recipients aged 65-80 years from five renal units in Australia. Transcripts were analyzed thematically. Six themes were identified: restoring vitality of youth (with subthemes of revived mindset for resilience, embracing enjoyment in life, drive for self-actualization); persisting through prolonged recovery (yielding to aging, accepting functional limitations, pushing the limit, enduring treatment responsibilities); imposing sicknesses (combatting devastating comorbidities, painful restrictions, emerging disillusionment, anxieties about accumulating side effects, consuming treatment burden); prioritizing graft survival (privileged with a miracle, negotiating risks for longevity, enacting a moral duty, preserving the last opportunity); confronting health deterioration (vulnerability and helplessness, narrowing focus to immediate concerns, uncertainty of survival); and value of existence (purpose through autonomy, refusing the burden of futile treatment, staying alive by all means). Older kidney transplant recipients felt able to enjoy life and strived to live at their newly re-established potential and capability, which motivated them to protect their graft. However, some felt constrained by slow recuperation and overwhelmed by unexpected comorbidities, medication-related side effects, and health decline. Our findings suggest the need to prepare and support older recipients for self

Protein and genetic diagnosis of limb girdle muscular dystrophy type 2A: The yield and the pitfalls.

Science.gov (United States)

Fanin, Marina; Angelini, Corrado

2015-08-01

Limb girdle muscular dystrophy type 2A (LGMD2A) is the most frequent form of LGMD worldwide. Comprehensive clinical assessment and laboratory testing is essential for diagnosis of LGMD2A. Muscle immunoblot analysis of calpain-3 is the most useful tool to direct genetic testing, as detection of calpain-3 deficiency has high diagnostic value. However, calpain-3 immunoblot testing lacks sensitivity in about 30% of cases due to gene mutations that inactivate the enzyme. The best diagnostic strategy should be determined on a case-by-case basis, depending on which tissues are available, and which molecular and/or genetic methods are adopted. In this work we survey the current knowledge, advantages, limitations, and pitfalls of protein testing and mutation detection in LGMD2A and provide an update of genetic epidemiology. © 2015 Wiley Periodicals, Inc.

Blood and Bone Marrow Transplant?

Science.gov (United States)

... Topics / Blood and Bone Marrow Transplant Blood and Bone Marrow Transplant Also known as Hematopoietic Stem Cell Transplant , Hematopoietic ... person, called a donor, it is an allogeneic transplant. Blood or bone marrow transplants most commonly are used to treat ...

Adult Neandertal clavicles from the El Sidrón site (Asturias, Spain) in the context of Homo pectoral girdle evolution.

Science.gov (United States)

Rosas, Antonio; Rodriguez-Perez, Francisco Javier; Bastir, Markus; Estalrrich, Almudena; Huguet, Rosa; García-Tabernero, Antonio; Pastor, Juan Francisco; de la Rasilla, Marco

2016-06-01

We undertook a three-dimensional geometric morphometric (3DGM) analysis on 12 new Neandertal clavicle specimens from the El Sidrón site (Spain), dated to 49,000 years ago. The 3DGM methods were applied in a comparative framework in order to improve our understanding of trait polarity in features related to Homo pectoral girdle evolution, using other Neandertals, Homo sapiens, Pan, ATD6-50 (Homo antecessor), and KNM-WT 15000 (Homo ergaster/erectus) in the reference collection. Twenty-nine homologous landmarks were measured for each clavicle. Variation and morphological similarities were assessed through principal component analysis, conducted separately for the complete clavicle and the diaphysis. On average, Neandertal clavicles had significantly larger muscular entheses, double dorsal curvature, clavicle torsion, and cranial orientation of the acromial end than non-Neandertal clavicles; the El Sidrón clavicles fit this pattern. Variation within the samples was large, with extensive overlap between Homo species; only chimpanzee specimens clearly differed from the other specimens in morphometric terms. Taken together, our morphometric analyses are consistent with the following phylogenetic sequence. The primitive condition of the clavicle is manifest in the cranial orientation of both the acromial and sternal ends. The derived condition expressed in the H. sapiens + Neandertal clade is defined by caudal rotation of both the sternal and acromial ends, but with variation in the number of acromia remaining in a certain cranial orientation. Finally, the autapomorphic Neandertal condition is defined by secondarily acquired primitive cranial re-orientation of the acromial end, which varies from individual to individual. These results suggest that the pace of phylogenetic change in the pectoral girdle does not seem to follow that of other postcranial skeletal features. Copyright © 2016 Elsevier Ltd. All rights reserved.

Kaposi's sarcoma in organ transplant recipients. The Collaborative Transplantation Research Group of Ile de France.

Science.gov (United States)

Farge, D

1993-01-01

Kaposi's Sarcoma (KS) is a tumour of multicentric origin with increased frequency after organ transplantation. To date, only North American data from the Cincinnati Transplant Tumor Registry have given some information about this disease in organ transplant recipients, but its true prevalence still has to be determined. In order to analyze Kaposi's sarcoma after kidney, liver and heart transplantation, we performed a retrospective study using the oldest registry of organ transplant recipients in Europe. Among all 7923 organ transplant recipients recorded in the Groupe Collaboratif de Recherche en Transplantation de l'Ile de France (GCIF) registry from 1968 to 1990, we analyzed the prevalence and the clinical characteristics of Kaposi's sarcoma in 6229 kidney, 727 liver and 967 heart transplant recipients. In the subgroup of kidney transplant recipients, we assessed the role of cyclosporine on disease evolution. Overall prevalence of Kaposi's sarcoma after organ transplantation was 0.52%, but it was significantly higher among liver (1.24%) than among kidney (0.45%) and heart (0.41%) transplant recipients. Chronic hepatitis B surface antigen carriers were more frequent in liver than in kidney transplant recipients who developed Kaposi's sarcoma (66% vs 21%, p < 0.03). Following kidney transplantation, Kaposi's sarcoma was more severe in patients receiving cyclosporine (n = 16) when compared with those under conventional immunosuppression (n = 12). True prevalence of Kaposi's sarcoma among European transplant recipients is high (0.52%) and appeared significantly higher in liver compared with other organ transplant recipients. Cyclosporine seems to increase severity of the disease among kidney transplant recipient.

Opportunities to deter transplant tourism exist before referral for transplantation and during the workup and management of transplant candidates.

Science.gov (United States)

Gill, Jagbir; Diec, Olivier; Landsberg, David N; Rose, Caren; Johnston, Olwyn; Keown, Paul A; Gill, John S

2011-05-01

Transplant tourism is a global issue, and physicians in the developed world may be in a position to actively deter this practice. To examine such opportunities, we identified 93 residents of British Columbia, Canada who had a kidney graft through tourism and determined their previous interactions with our transplant programs. These patients were mainly ethnic minorities (90%) who traveled to their country of origin for transplantation. Many tourists were transplanted early in their disease course, with 27 having a preemptive transplant. Among the 65 tourists referred for transplant, 33 failed to complete the evaluation. All tourists who completed an evaluation were placed on a waiting list in British Columbia and, after waiting a median of 2 years, pursued tourism. Most of these patients (62%) had a potential living donor, but none had an approved donor, with 13 donors found medically unsuitable, 8 ABO incompatible, and 12 who did not complete their evaluation. Thus, strategies to deter tourism should start before the development of end-stage renal disease and should be part of pretransplant workup and wait-list management, focusing on patients not progressing through their evaluation, those with a declined living donor, and those facing longer wait times, as these groups appear to be at higher risks for transplant tourism. Further studies are needed to identify individuals at risk for transplant tourism and to define effective strategies to deter these individuals.

Transplant tourism: Outcomes of United States residents who undergo kidney transplantation overseas.

Science.gov (United States)

Canales, Muna T; Kasiske, Bertram L; Rosenberg, Mark E

2006-12-27

Although international commerce in kidney transplantation is a reality, little is known about U.S. residents who travel abroad for kidney transplantation. We retrospectively reviewed the clinical outcomes of patients who were evaluated at the University of Minnesota Medical Center or Hennepin County Medical Center, but then surreptitiously underwent kidney transplantation overseas. We identified 10 patients who underwent kidney transplantation outside the United States between September 16, 2002 and June 30, 2006 and then returned for care in our programs. Eight were transplanted in Pakistan (all Somali), one was transplanted in China (Chinese), and one was transplanted in Iran (Iranian). All but one had a living donor. Mean age was 36.8+/-12.5 years with median follow-up of 2.0 years (range 0.4-3.7). Three patients communicated their intent to travel abroad before transplantation. Induction immunosuppressive therapy (if any) was available in 3/10, and initial maintenance immunosuppression was known in 5/10. Complications were primarily infectious, with six potentially life-threatening infections in four patients. At last follow-up, mean serum creatinine was 1.13+/-0.34 mg/dL, acute rejection occurred in 2/10, 1/10 grafts failed due to acute rejection, and 9/10 patients were alive. Kidney function and graft survival were generally good after surreptitious overseas kidney transplantation. Major problems included incomplete perioperative information communicated to the posttransplant care facility and a high incidence of posttransplant infections. Longer follow-up and detailed cost analysis are needed to better understand the implications of the growing phenomenon of transplant tourism.

Evaluation of contributing factors of post transplant erythrocytosis in renal transplant patients

International Nuclear Information System (INIS)

Ahmed, S.; Ahmed, E.; Naqvi, R.; Qureshi, S.

2012-01-01

Objective: To evaluate the prevalence and contributing factors causing post transplant erythrocytosis in renal transplant patients. Methods: This retrospective study was conducted on live related renal transplant patients at SIUT. The records of all transplant recipients transplanted between April 2008 and December 2008 and who had at least 24 months follow up were studied. Patients in whom haematocrit exceeded 51% and those who received treatment for it were classified into post transplant erythrocytosis group. Results: Out of 200 renal transplant patients who had functioning graft at the time of analysis, 40 (20%) developed post transplant erythrocytosis (HCT >51%) after a mean interval of 9.5+- 2.5 months. Patients with erythrocytosis were mostly males (95% in PTE group vs 73.75% in non PTE group) ,had a shorter period on dialysis before undergoing renal transplantation (9.28 months in PTE group vs 14.56 months in non PTE group) and had relatively better graft function at the onset of erythrocytosis as judged by serum creatinine (S. Creatinine of 1.06+-0.29 mg/dl in PTE group vs 1.37 +- 0.51 mg/dl in non PTE group). No thrombotic complications were observed. All patients with erythrocytosis were treated with enalapril (ACE inhibitors) and 28 out of 40 required phlebotomy in addition to ACE inhibitors. The mean HCT at the time of last follow up in treated patients was 48.61+-1.85%. Conclusion: Post transplant erythrocytosis generally occurs in male patients with good graft function, thrombotic complications are of rare occurrence and response to ACE inhibitors is good. (author)

Syngeneic transplantation in aplastic anemia

DEFF Research Database (Denmark)

Gerull, Sabine; Stern, Martin; Apperley, Jane

2013-01-01

Aplastic anemia is usually treated with immunosuppression or allogeneic transplant, depending on patient and disease characteristics. Syngeneic transplant offers a rare treatment opportunity with minimal transplant-related mortality, and offers an insight into disease mechanisms. We present here...... a retrospective analysis of all syngeneic transplants for aplastic anemia reported to the European Group for Blood and Marrow Transplantation. Between 1976 and 2009, 88 patients received 113 transplants. Most transplants (n=85) were preceded by a conditioning regimen, 22 of these including anti-thymocyte globulin...

Comparison of Complications of Chorionic Villus Sampling and Amniocentesis

Directory of Open Access Journals (Sweden)

Nahid Shahbazian

2012-01-01

Full Text Available Background: A significant number of pregnancies are associated with the cytogenetic abnormalities of the fetus. Amniocentesis and chorionic villus sampling (CVS are procedures used for prenatal genetic diagnosis. In this study, we compare the safety and complications of mid-trimester amniocentesis and transabdominal CVS.Materials and Methods: This analytic cross-sectional study was performed in 308 patients from2.11.2007 to 26.10.2009. We had 155 cases of amniocentesis, which we performed in weeks 15-23 of pregnancy; and 153 cases of CVS, which we performed during weeks 10-14 of pregnancy.Results: There were 2 cases (1.2% of premature rupture of membrane (PROM in amniocentesis which occurred 1 and 10 days after the procedure and caused pregnancy loss before 20 weeks. We had 1 case (0.7% of abortion in CVS, which occurred 10 days after the procedure. Additionally, there was 1 case of amniotic fluid leakage (0.7% in which, after admission to the hospital and observation, leakage was stopped and the pregnancy continued normally.Conclusion: In this study, we had more complications with amniocentesis cases than CVS. CVS is a procedure performed in the earlier stages of pregnancy and its complications are less than amniocentesis. We suggest CVS to be the procedure of choice for genetic diagnosis.

Diagnostics of trophoblast disease and the control of therapeutic efficiency based on definition of chorionic gonadotrapin and trophoblastic beta1-glycoprotein

International Nuclear Information System (INIS)

Yugrinova, L.G.; Olefirenko, G.A.; Dotsenko, Yu.S.

1982-01-01

A comparative estimation of markers of trophoblast disease, chorionic gonadotropin (CG) and trophoblastic beta 1 -glycoprotein defined by different methods is given. It is found that diagnostics and control of therapeutic efficiency for patients having trophoblast disease based on CG definition are possible. In 86% of cases the clinical diagnosis was confirmed by the immunoradioautography, and in 33% - by the immunodiffusion method. The dependence of marker detection frequency on the therapeutic efficiency is found

CT scan-guided percutaneous osteosynthesis of a complex, multifocal fracture of the pelvic girdle in a 14-year-old adolescent

Energy Technology Data Exchange (ETDEWEB)

Gagne, Pierre-Thomas; Bertrand, Anne-Sophie; Caudal, Amandine; El Hayek, Tony; Amoretti, Nicolas [Centre Hospitalier Universitaire de Nice, Nice (France)

2014-08-15

We report on a 14-year-old girl with minimally displaced pelvic girdle and acetabular roof fracture following motor vehicle trauma, treated percutaneously under CT and C-arm fluoroscopic guidance by an interventional radiologist. After informed consent from the patient's parents, under surgical aseptic conditions and under general anesthesia, three screws were positioned adequately under dual guidance by a radiologist and without immediate or long-term complication. The patient was mobilized 48 h after the procedure and resumed normal activities after 1 month. Even though the technique has been described before on adults, to our knowledge this is the first time it has been described on a pediatric patient. (orig.)

What can happen after lung transplantation and the importance of the time since transplantation: radiological review of post-transplantation complications.

Science.gov (United States)

Daimiel Naranjo, I; Alonso Charterina, S

2016-01-01

Lung transplantation is the best treatment option in the final stages of diseases such as cystic fibrosis, pulmonary hypertension, chronic obstructive pulmonary disease, or idiopathic pulmonary fibrosis. Better surgical techniques and advances in immunosuppressor treatments have increased survival in lung transplant recipients, making longer follow-up necessary because complications can occur at any time after transplantation. For practical purposes, complications can be classified as early (those that normally occur within two months after transplantation), late (those that normally occur more than two months after transplantation), or time-independent (those that can occur at any time after transplantation). Many complications have nonspecific clinical and radiological manifestations, so the time factor is key to narrow the differential diagnosis. Imaging can guide interventional procedures and can detect complications early. This article aims to describe and illustrate the complications that can occur after lung transplantation from the clinical and radiological viewpoints so that they can be detected as early as possible. Copyright © 2016 SERAM. Publicado por Elsevier España, S.L.U. All rights reserved.

Bioethics of organ transplantation.

Science.gov (United States)

Caplan, Arthur

2014-03-01

As the ability to transplant organs and tissues has grown, the demand for these procedures has increased as well--to the point at which it far exceeds the available supply creating the core ethical challenge for transplantation--rationing. The gap between supply and demand, although large, is worse than it appears to be. There are two key steps to gaining access to a transplant. First, one must gain access to a transplant center. Then, those waiting need to be selected for a transplant. Many potential recipients do not get admitted to a program. They are deemed too old, not of the right nationality, not appropriate for transplant as a result of severe mental impairment, criminal history, drug abuse, or simply because they do not have access to a competent primary care physician who can refer them to a transplant program. There are also financial obstacles to access to transplant waiting lists in the United States and other nations. In many poor nations, those needing transplants simply die because there is no capacity or a very limited capacity to perform transplants. Although the demand for organs now exceeds the supply, resulting in rationing, the size of waiting lists would quickly expand were there to suddenly be an equally large expansion in the number of organs available for transplantation. Still, even with the reality of unavoidable rationing, saving more lives by increasing organ supply is a moral good. Current public policies for obtaining organs from cadavers are not adequate in that they do not produce the number of organs that public polls of persons in the United States indicate people are willing to donate.

Effectiveness of Multimedia for Transplant Preparation for Kidney Transplant Waiting List Patients.

Science.gov (United States)

Charoenthanakit, C; Junchotikul, P; Sittiudomsuk, R; Saiyud, A; Pratumphai, P

2016-04-01

A multimedia program could effectively advise patients about preparing for transplantation while on the waiting list for a kidney transplant. This study aimed to compare knowledge about transplant preparation for patients on a kidney transplant waiting list before and after participating in a multimedia program, and to evaluate patient satisfaction with the multimedia program. Research design was quasiexperimental with the use of 1 group. Subjects were 186 patients on the kidney transplant waiting list after HLA matching in Ramathibodi Hospital. The questionnaires were developed by the researchers. The statistical tools used were basic statistics, percentage, average, standard deviation, and the difference of score between before and after participation in the multimedia program (t test). The evaluation knowledge for transplant preparation for kidney transplant waiting list patients after participating in the multimedia program averaged 85.40%, and there was an increased improvement of score by an average 3.27 out of a possible full score of 20 (P multimedia program had good average, 4.58. Copyright © 2016 Elsevier Inc. All rights reserved.

Key issues in transplant tourism.

Science.gov (United States)

Akoh, Jacob A

2012-02-24

Access to organ transplantation depends on national circumstances, and is partly determined by the cost of health care, availability of transplant services, the level of technical capacity and the availability of organs. Commercial transplantation is estimated to account for 5%-10% (3500-7000) of kidney transplants performed annually throughout the world. This review is to determine the state and outcome of renal transplantation associated with transplant tourism (TT) and the key challenges with such transplantation. The stakeholders of commercial transplantation include: patients on the waiting lists in developed countries or not on any list in developing countries; dialysis funding bodies; middlemen, hosting transplant centres; organ-exporting countries; and organ vendors. TT and commercial kidney transplants are associated with a high incidence of surgical complications, acute rejection and invasive infection which cause major morbidity and mortality. There are ethical and medical concerns regarding the management of recipients of organs from vendors. The growing demand for transplantation, the perceived failure of altruistic donation in providing enough organs has led to calls for a legalised market in organ procurement or regulated trial in incentives for donation. Developing transplant services worldwide has many benefits - improving results of transplantation as they would be performed legally, increasing the donor pool and making TT unnecessary. Meanwhile there is a need to re-examine intrinsic attitudes to TT bearing in mind the cultural and economic realities of globalisation. Perhaps the World Health Organization in conjunction with The Transplantation Society would set up a working party of stakeholders to study this matter in greater detail and make recommendations.

Brief communication: sliding displacement of amnion and chorion following controlled laser wounding suggests a mechanism for short-term sealing of ruptured membranes.

Science.gov (United States)

Behzad, F; Dickinson, M R; Charlton, A; Aplin, J D

1994-10-01

The Erbium-YAG laser was used to produce narrow wounds of defined depth in term amniochorion. The charring effect of the laser meant that sites could be readily localized in histological sections. During brief post-wounding incubations, sliding displacement of the amnion relative to the chorion occurred through the plane of the spongy layer. This suggests a possible short-term mechanism whereby a spontaneous rupture could be sealed in vivo.

A Label-Free and Ultrasensitive Immunosensor for Detection of Human Chorionic Gonadotrophin Based on Graphene FETs.

Science.gov (United States)

Islam, Kamrul; Suhail, Ahmed; Pan, Genhua

2017-07-12

We report on a label-free immunosensor based on graphene field effect transistors (G-FETs) for the ultrasensitive detection of Human Chorionic Gonadotrophin (hCG), as an indicator of pregnancy and related disorders, such as actopic pregnancy, choriocarcinoma and orchic teratoma. Pyrene based bioactive ester was non-covalently anchored onto the graphene channel in order to retain the sp² lattice. The G-FET transfer characteristics showed repeatable and reliable responses in all surface modifying steps using a direct current (DC) readout system. The hCG concentration gradient showed a detection limit of ~1 pg·mL -1 . The proposed method facilitates the cost-effective and viable production of graphene point-of-care devices for clinical diagnosis.

Organ Procurement and Transplantation Network/Scientific Registry of Transplant Recipients 2014 Data Report: Intestine.

Science.gov (United States)

Cai, Junchao; Wu, Guosheng; Qing, Annie; Everly, Matthew; Cheng, Elaine; Terasaki, Paul

2014-01-01

As of September 19, 2014, 2441 cases of intestinal transplantation have been performed in 46 centers (2400 deceased, 41 living). Eight centers did more than 100 transplants. Annual case numbers peaked in 2007 (N = 198) and steadily decreased to 109 cases in 2013. Short gut syndrome (68%) and functional bowel problems (15%) are two major indications for intestinal transplantation. The 3 major types of transplants involving the intestine include: isolated intestine transplant (I); simultaneous intestine, liver, and pancreas transplant (I+L+P); and, combined intestine and liver (I+L) transplant. Graft survival has significantly improved in recent years, mainly due to improved first year graft survival. The 1-, 5-, and 10-year graft survivals were: 74%, 42%,and 26%, respectively (I); 70%, 50%, and 40%, respectively (I+L+P); and 61%, 46%, and 40%, respectively (I+L). The longest graft survivals for I, l+L+P, and l+L were 19 years, 16 years, and 23 years, respectively. Steroids, Thymoglobulin, and rituximab are 3 major induction agents used in recent years. Prograf, steroids, and Cellcept are 3 major maintenance agents. Induction recipients (68% of all patients) had a significantly lower acute rejection rate than nonrecipients before discharge (60% versus 75%, p compatible transplants. ABO identical transplant recipients had a significantly higher 5-year graft survival rate than ABO compatible recipients (39% versus 21%, p compatible (N = 188, 11%) than in the early decade (p compatible transplants were lower than those of ABO identical transplants. However, the difference did not reach statistical significance (46% versus 49%, p = 0.07). The effect of ABO compatibility on graft outcome was further confirmed by Cox Analysis. ABO incompatible transplants are still rarely performed (N = 4) in intestine. In conclusion, annual case numbers of intestinal transplants have been decreasing, regardless of improved graft survival. ABO compatible intestinal transplants previously

Florescimento e frutificação de lichieiras em função do anelamento de ramos Flowering and fruiting of lychee trees in response to girdling of branches

Directory of Open Access Journals (Sweden)

Eliseo García-Pérez

2006-04-01

Full Text Available Avaliou-se o efeito do anelamento de ramos sobre o florescimento e frutificação de lichieiras 'Bengal' com 17 anos de idade. Os tratamentos constaram de anelamento em ramos ou pernadas principais e ramos de 6; 4 e 2 cm de diâmetro, além do controle. O delineamento utilizado foi em blocos casualizados, com cinco repetições. As avaliações quanto à floração foram: percentagem de floração e comprimento de inflorescências por quadrante e árvore; quanto à frutificação, avaliaram-se: vingamento de frutos maduros por panícula, massa, diâmetros longitudinal e equatorial dos frutos, sólidos solúveis totais, época de colheita e rendimento. O anelamento nos ramos principais induziu maior florescimento, sem alterar as características das inflorescências; não houve diferenças no vingamento de frutos, mas o aumento na floração incrementou o rendimento por árvore, com significativa antecipação da colheita.The effects of girdling of branches on flowering and fruiting of 17 years old 'Bengal' lychee trees were evaluated. The treatments consisted of girdling of main branches, and branches with 6, 4 and 2 cm of diameter and the control. The experiment was conducted in a randomized block design, with 5 replicates. The evaluations in relation to flowering were: flowering per tree and per quadrant and length of flower panicles; in relation to fruiting were: fruit set per panicle, fruit weight, longitudinal and equatorial diameters, soluble solids, harvest time and production. The girdling in the main branches induced larger flowering, without influence on the flower panicles characteristics, there were no differences in the fruit set, but with an increasing in the flowering, it increased the production, with significant anticipation of the harvest.

[Liver transplantation].

Science.gov (United States)

Pompili, Maurizio; Mirante, Vincenzo Giorgio; Rapaccini, Gian Ludovico; Gasbarrini, Giovanni

2004-01-01

Liver transplantation represents the first choice treatment for patients with fulminant acute hepatitis and for patients with chronic liver disease and advanced functional failure. Patients in the waiting list for liver transplantation are classified according to the severity of their clinical conditions (evaluated using staging systems mostly based on hematochemical parameters related to liver function). This classification, together with the blood group and the body size compatibility, remains the main criterion for organ allocation. The main indications for liver transplantation are cirrhosis (mainly HCV-, HBV- and alcohol-related) and hepatocellular carcinoma emerging in cirrhosis in adult patients, biliary atresia and some inborn errors of metabolism in pediatric patients. In adults the overall 5-year survival ranges between 60 and 70%, in both American and European series. Even better results have been reported for pediatric patients: in fact, the 5-year survival rate for children ranges between 70 and 80% in the main published series. In this study we evaluated the main medical problems correlated with liver transplantation such as immunosuppressive treatment, acute and chronic rejection, infectious complications, the recurrence of the liver disease leading to transplantation, and cardiovascular and metabolic complications.

Bone metabolism dynamics in the early post-transplant period following kidney and liver transplantation.

Science.gov (United States)

Schreiber, Peter W; Bischoff-Ferrari, Heike A; Boggian, Katia; Bonani, Marco; van Delden, Christian; Enriquez, Natalia; Fehr, Thomas; Garzoni, Christian; Hirsch, Hans H; Hirzel, Cédric; Manuel, Oriol; Meylan, Pascal; Saleh, Lanja; Weisser, Maja; Mueller, Nicolas J

2018-01-01

Bone disease contributes to relevant morbidity after solid organ transplantation. Vitamin D has a crucial role for bone metabolism. Activation of vitamin D depends on the endocrine function of both, liver and kidney. Our study assessed key markers of bone metabolism at time of transplantation and 6 months after transplantation among 70 kidney and 70 liver recipients. In 70 kidney recipients 25-OH vitamin D levels did not differ significantly between peri-transplant (median 32.5nmol/l) and 6 months post-transplant (median 41.9nmol/l; P = 0.272). Six months post-transplant median 1, 25-(OH)2 vitamin D levels increased by >300% (from 9.1 to 36.5ng/l; Ptransplantation and of intact parathyroid hormone 6 months post-transplant. Among 70 liver recipients, 25-OH vitamin D, 1, 25-(OH)2 vitamin D and intact parathyroid hormone levels were not significantly altered between peri-transplant and 6 months post-transplant. Contrary to kidney recipients, median CTx increased by 60.0% (from 0.45 to 0.72 ng/ml; P = 0.002) and P1NP by 49.3% (from 84.0 to 125.4ng/ml; P = 0.001) in the longitudinal course. Assessed biomarkers didn't differ between liver recipients with and without fractures. To conclude, the assessed panel of biomarkers proved highly dynamic after liver as well as kidney transplantation in the early post-transplant period. After kidney transplantation a significant gain in 1, 25-(OH)2 vitamin D combined with a decline in iPTH, CTx and P1NP, whereas after liver transplantation an increase in CTx and P1NP were characteristic.

Pancreatic Islet Cell Transplantation

Science.gov (United States)

Warnock, Garth L.; Rajotte, Ray V.

1992-01-01

Transplantation of insulin-producing tissue offers a physiologic approach to restoration of glycemic control. Whereas transplantation of vascularized pancreatic grafts has recently achieved encouraging results, pancreatic islet cell transplantation holds the promise of low morbidity and reduced requirements for agressive immunosuppression for recipients. Islet cell transplantation was recently demonstrated to induce euglycemia with insulin independence. Imagesp1656-a PMID:21221366

Changing Patterns of Foreigner Transplants in Korea and Overseas Organ Transplants Among Koreans.

Science.gov (United States)

Ahn, Hyung Joon; Kim, Hwi Won; Han, Miyeun; Jeon, Hee Jung; Kwon, Oh Jung; Ahn, Curie

2018-02-01

This study aimed to estimate the numbers of foreign patients seeking organ transplantation (OT) in Korea and to examine the relationship between the trend of deceased donors in Korea and number of Korean patients seeking OT overseas since 2000. Data on foreigners who received a transplant in Korea were obtained from the Korean Network for Organ Sharing. Data on overseas transplants were obtained from 42 transplant centers surveyed through transplant coordinators. A total of 336 foreigners underwent OT (kidney transplantation [KT], 174; liver transplantation [LT], 162) in Korea between 2006 and 2016. The Mongolians were the most common foreigners who undergo KTs (32%), followed by the Chinese (18%), Americans (9%), and Emiratis (7%). Among foreigners undergoing LTs, the most common country of origin was Mongolia (39%), followed by United Arab Emirates (23%), China (13%), and the United States (6%). A total of 2206 Korean patients underwent overseas OT (KT, 977; LT, 1229) between 2000 and 2016. In 97% of overseas KT cases (n = 942) and 98% (n = 1205) of overseas LT cases, the transplantations were performed in China. The relationship between the number of deceased donors in Korea and the number of overseas transplants after 2006 indicates a highly negative correlation. (ρ = -0.988, P tourism.

Heart transplantation from older donors

Directory of Open Access Journals (Sweden)

V. N. Poptsov

2017-01-01

Full Text Available In the current situation of the shortage of suitable donor organs, heart transplantation from older donors is one of the ways to increase the performance of more heart transplants, particularly, in patients with urgent need of transplantation. While planning a heart transplantation from older donor one should consider increased risk of early cardiac allograft dysfunction, preexisting coronary artery disease, accelerated transplant vasculopathy which may adversely affect early and long-term survival of recipients. Subject to careful selection of donor–recipient pairs, effective prevention and treatment of early cardiac allograft dysfunction, pre-existing atherosclerosis and transplant vasculopathy the early and long-term survival of heart transplant recipients from older donors is comparable to heart transplantation from young donors.

The relationship between the variants in the 5′-untranslated regions of equine chorionic gonadotropin genes and serum equine chorionic gonadotropin levels

Directory of Open Access Journals (Sweden)

ShuQin Liu

2017-12-01

Full Text Available Objective An experiment was conducted to study the association between the single nucleotide polymorphisms (SNPs in 5′-untranslated regions (5′-UTR of equine chorionic gonadotropin (eCG genes and the serum eCG levels. Methods SNPs in 5′-UTR of eCG genes were screened across 10 horse breeds, including 7 Chinese indigenous breeds and 3 imported breeds using iPLEX chemistry, and the association between the serum eCG levels of 174 pregnant Da’an mares and their serum eCG levels (determined with ELISA was analyzed. Results Four SNPs were identified in the 5′-UTR of the eCGα gene, and one of them was unique in the indigenous breeds. There were 2 SNPs detected at the 5′ end of the eCGβ subunit gene, and one of them was only found in the Chinese breeds. The SNP g.39948246T>C at the 5′-UTR of eCGα was associated significantly with eCG levels of 75-day pregnant mare serum (pC mutation causes appearance of the specific binding site of hepatocyte nuclear factor 3 forkhead homolog 2 (HFH-2, which is a transcriptional repressor belonging to the forkhead protein family of transcription factors. Conclusion The SNP g.39948246T>C at the 5′-UTR of eCGα is associated with eCG levels of 75-day pregnant mare serum (p<0.05.

First trimester pregnancy-associated plasma protein A and human chorionic gonadotropin-beta in early and late pre-eclampsia

DEFF Research Database (Denmark)

Karahasanovic, Azra; Sørensen, Steen; Nilas, Lisbeth

2014-01-01

Abstract Background: The aim of this study was to compare pregnancy-associated plasma protein A (PAPP-A) and the β-subunit of human chorionic gonadotropin (hCGβ) measured in maternal plasma at the first trimester screening, in women who later developed early or late pre-eclampsia (PE) to women...... with normal pregnancies. Methods: In the study were included 161 cases with PE and 88 controls with uncomplicated pregnancies. Plasma PAPP-A and hCGβ were measured between gestational age (GA) 8+2 and 14+0, and cases with early and late onset PE were compared with controls. Results: Median of hCGβ (Mo...

The impact of repeated mismatches in kidney transplantations performed after nonrenal solid organ transplantation.

Science.gov (United States)

Côté, J M; Zhang, X; Dahhou, M; Sapir-Pichhadze, R; Foster, B; Cardinal, H

2018-01-01

The aim of this study was to determine whether kidney transplantations performed after previous nonrenal solid organ transplants are associated with worse graft survival when there are repeated HLA mismatches (RMM) with the previous donor(s). We performed a retrospective cohort study using data from the Scientific Registry of Transplant Recipients. Our cohort comprised 6624 kidney transplantations performed between January 1, 1990 and January 1, 2015. All patients had previously received 1 or more nonrenal solid organ transplants. RMM were observed in 35.3% of kidney transplantations and 3012 grafts were lost over a median follow-up of 5.4 years. In multivariate Cox regression analyses, we found no association between overall graft survival and either RMM in class 1 (hazard ratio [HR]: 0.97, 95% confidence interval [CI] 0.89-1.07) or class 2 (HR: 0.95, 95% CI 0.85-1.06). Results were similar for the associations between RMM, death-censored graft survival, and patient survival. Our results suggest that the presence of RMM with previous donor(s) does not have an important impact on allograft survival in kidney transplant recipients who have previously received a nonrenal solid organ transplant. © 2017 The American Society of Transplantation and the American Society of Transplant Surgeons.

Imaging in pancreatic transplants

International Nuclear Information System (INIS)

Heller, Matthew T; Bhargava, Puneet

2014-01-01

Pancreatic transplantation, performed alone or in conjunction with kidney transplantation, is an effective treatment for advanced type I diabetes mellitus and select patients with type II diabetes mellitus. Following advancements in surgical technique, postoperative management, and immunosuppression, pancreatic transplantation has significantly improved the length and quality of life for patients suffering from pancreatic dysfunction. While computed tomography (CT) and magnetic resonance imaging (MRI) have more limited utility, ultrasound is the preferred initial imaging modality to evaluate the transplanted pancreas; gray-scale assesses the parenchyma and fluid collections, while Doppler interrogation assesses vascular flow and viability. Ultrasound is also useful to guide percutaneous interventions for the transplanted pancreas. With knowledge of the surgical anatomy and common complications, the abdominal radiologist plays a central role in the perioperative and postoperative evaluation of the transplanted pancreas

The Classification, Natural History and Treatment of the Limb Girdle Muscular Dystrophies.

Science.gov (United States)

Murphy, Alexander Peter; Straub, Volker

2015-07-22

Over sixty years ago John Walton and Frederick Nattrass defined limb girdle muscular dystrophy (LGMD) as a separate entity from the X-linked dystrophinopathies such as Duchenne and Becker muscular dystrophies. LGMD is a highly heterogeneous group of very rare neuromuscular disorders whose common factor is their autosomal inheritance. Sixty years later, with the development of increasingly advanced molecular genetic investigations, a more precise classification and understanding of the pathogenesis is possible.To date, over 30 distinct subtypes of LGMD have been identified, most of them inherited in an autosomal recessive fashion. There are significant differences in the frequency of subtypes of LGMD between different ethnic populations, providing evidence of founder mutations. Clinically there is phenotypic heterogeneity between subtypes of LGMD with varying severity and age of onset of symptoms. The first natural history studies into subtypes of LGMD are in process, but large scale longitudinal data have been lacking due to the rare nature of these diseases. Following natural history data collection, the next challenge is to develop more effective, disease specific treatments. Current management is focussed on symptomatic and supportive treatments. Advances in the application of new omics technologies and the generation of large-scale biomedical data will help to better understand disease mechanisms in LGMD and should ultimately help to accelerate the development of novel and more effective therapeutic approaches.

Design of transplanting mechanism for system of rice intensification (SRI) transplanter in Kedah, Malaysia

Science.gov (United States)

Imran, M. S.; Manan, M. S. Abdul; Khalil, A. N. M.; MdNaim, M. K.; Ahmad, R. N.

2017-08-01

There is a demand to develop transplanter specifically for system of rice intensification (SRI) cultivation in Malaysia. This SRI transplanter is different from conventional transplanter as it is required special requirements for transplanting. The work focused on transplanting mechanism design which can be later attached to SRI transplanter. The mechanical design was established using linkage mechanism, having a wheel that act as timing wheel that will control the distance between transplanted seedlings. The linkage mechanism also control the opening of the flapper that allow the seedling together with its nursery soil to be dropped, and control the stopper to prevent next seedling from sliding down the tray. The use of simple mechanism will have low cost for fabrication. The design was analysed using motion analysis software. Results show the design is perfectly good and can be fabricated without any problem. The animation successfully shows the perfect movement of the mechanism and transplanting process.

Breast Reconstruction After Solid Organ Transplant.

Science.gov (United States)

Koonce, Stephanie L; Giles, Brian; McLaughlin, Sarah A; Perdikis, Galen; Waldorf, James; Lemaine, Valerie; TerKonda, Sarvam

2015-09-01

Solid organ transplant patients frequently develop posttransplant malignancies including breast cancer. They may desire breast reconstruction after mastectomy, which could potentially be complicated by their transplant status, immunosuppressive regimen, and previous operations. We review our experience with patients who have undergone solid organ transplant and subsequent breast reconstruction after mastectomy After institutional review board approval, we queried our prospective breast reconstruction and solid organ transplant databases for corresponding patients. Inclusion criteria comprised breast reconstruction after solid organ transplant. A chart review was conducted of identified patients. Seventeen patients were identified: 1 pulmonary transplant, 4 cardiac transplants, 2 liver transplants, 1 pancreas transplant, 2 combined kidney/pancreas transplants, and 7 kidney transplants. Indications for mastectomy included posttransplant malignancy and prophylaxis. Median time from transplant to completion of reconstruction was 186 months (range, 11-336 months). Median age at transplant was 34.5 years (range, 21-65 years) with the median age of the patients at reconstructive surgery 51.5 years (range, 34-71 years). Median body mass index was 25.3 (range, 21.3-46.5). No significant complications were noted after reconstructive surgery. All patients were on full immunosuppression at time of reconstruction. Breast reconstruction is a viable option for transplant patients after mastectomy and should not be refused based on their transplant status. Close coordination with the transplant team and careful preoperative planning is essential for optimal outcomes.

Choosing a Transplant Center

Science.gov (United States)

... however you can Daughter's dying wish became mother's motivation Be The Match Blog Stories Anna, transplant recipient ... for transplant costs. Location – You might have to travel to receive a transplant. Consider how far the ...

Appraisal of transplant-related stressors, coping strategies, and psychosocial adjustment following kidney transplantation.

Science.gov (United States)

Pisanti, Renato; Lombardo, Caterina; Luszczynska, Aleksandra; Poli, Luca; Bennardi, Linda; Giordanengo, Luca; Berloco, Pasquale Bartolomeo; Violani, Cristiano

2017-10-01

This study examined the relations between appraisal of transplant-related stressors, coping, and adjustment dimensions following kidney transplantation (KT). Two models were tested: (1) the main effects model proposing that stress appraisal and coping strategies are directly associated with adjustment dimensions; and (2) the moderating model of stress proposing that each coping strategy interacts with stress appraisal. Importantly, there is a lack of research examining the two models simultaneously among recipients of solid organ transplantation. A total of 174 KT recipients completed the questionnaires. Predictors of post-transplant adjustment included appraisal of transplant-related stressors and coping strategies (task-, emotion-, and avoidance-focused). Adjustment dimensions were psychological distress, worries about the transplant, feelings of guilt, fear of disclosure of transplant, adherence, and responsibility for the functioning of the new organ. The main and moderating effects were tested with regression analyses. Appraisal of transplant-related stressors and emotion-oriented coping were related to all adjustment dimensions, except of adherence and responsibility. Task-oriented coping was positively related to responsibility. Avoidance-oriented coping was negatively correlated with adherence. Only 1 out of 18 hypothesized interactive terms was significant, yielding a synergistic interaction between appraisal of transplant-related stressors and emotion-oriented coping on the sense of guilt. The findings have the potential to inform interventions promoting psychosocial adjustment among KT recipients. Copyright © 2016 John Wiley & Sons, Ltd.

Split-liver transplantation : An underused resource in liver transplantation

NARCIS (Netherlands)

Rogiers, Xavier; Sieders, Egbert

2008-01-01

Split-liver transplantation is an efficient tool to increase the number of liver grafts available for transplantation. More than 15 years after its introduction only the classical splitting technique has reached broad application. Consequently children are benefiting most from this possibility.

Analysis of hemodialysis patients’ thoughts about kidney transplantation and the national organ transplant system in terms of organ transplantation services management

Directory of Open Access Journals (Sweden)

Yasin Uzuntarla

2017-03-01

Results: It was determined that the hemodialysis patients responding to the survey were in the 20-95 age group with an average age of 58,64±15,64 years. 87,9% of the patients reported that they had been briefed about kidney transplants, 32,2% of those had been briefed said that the information had been delivered by the dialysis physician, 77,7% stated that they wanted a kidney transplant from a cadaver, 49,5% did not want a kidney transplant from a live donor and 35,5% indicated that the national organ transplant system operated adequately. Furthermore, it was noted that 50,9% of the responders were registered on the waiting lists of kidney transplant centers. Conclusions: It was concluded that it is necessary to provide sufficient information to hemodialysis patients about kidney transplants and the national organ transplant system to steer them to transplant centers. It is anticipated that the results of this study will assist officers of the Ministry of Health, politicians involved in health issues, decision makers and health professionals. [Arch Clin Exp Surg 2017; 6(1.000: 33-37

The lived experience of autologous stem cell-transplanted patients: Post-transplantation and before discharge.

Science.gov (United States)

Alnasser, Qasem; Abu Kharmah, Salahel Deen; Attia, Manal; Aljafari, Akram; Agyekum, Felicia; Ahmed, Falak Aftab

2018-04-01

To explore the lived experience of the patients post-haematopoietic stem cell transplantation and specifically after engraftment and before discharge. Patients post-stem cell transplantation experience significant changes in all life aspects. Previous studies carried out by other researchers focused mainly on the postdischarge experience, where patients reported their perceptions that have always been affected by the life post-transplantation and influenced by their surroundings. The lived experience of patients, specifically after engraftment and prior to discharge (the "transition" phase), has not been adequately explored in the literature. Doing so might provide greater insight into the cause of change post-haematopoietic stem cell transplantation. This study is a phenomenological description of the participants' perception about their lived experience post-haematopoietic stem cell transplantation. The study used Giorgi's method of analysis. Through purposive sampling, 15 post-haematopoietic stem cell transplantation patients were recruited. Data were collected by individual interviews. Data were then analysed based on Giorgi's method of analysis to reveal the meaning of a phenomenon as experienced through the identification of essential themes. The analysis process revealed 12 core themes covered by four categories that detailed patients lived experience post-haematopoietic stem cell transplantation. The four categories were general transplant experience, effects of transplantation, factors of stress alleviation and finally life post-transplantation. This study showed how the haematopoietic stem cell transplantation affected the patients' physical, psychological and spiritual well-being. Transplantation also impacted on the patients' way of thinking and perception of life. Attending to patients' needs during transplantation might help to alleviate the severity of the effects and therefore improve experience. Comprehensive information about transplantation needs

The pelvic fin and girdle of Panderichthys and the origin of tetrapod locomotion.

Science.gov (United States)

Boisvert, Catherine A

2005-12-22

One of the most marked transformations in the vertebrate transition to land was that of fins to limbs. This transformation involved not only the generation of morphological novelties (digits, sacrum) but also a shift in locomotory dominance from the pectoral to the pelvic appendage. Despite its importance, the transformation from pelvic fin to hindlimb is the least studied and least well-documented part of this transformation, which is bracketed by the osteolepiform Eusthenopteron and the early tetrapods Ichthyostega and Acanthostega, but is not directly illuminated by any intermediate form. Panderichthys is the closest tetrapod relative currently represented by complete fossils, but its pelvic fin skeleton has not been described. Here, I present the only known articulated pelvic fin endoskeleton and associated partial pelvis of Panderichthys. The pelvic girdle is even less tetrapod-like than that of the osteolepiform Eusthenopteron, but the pelvic fin endoskeleton shares derived characteristics with basal tetrapods despite being more primitive than the pectoral fin of Panderichthys. The evolution of tetrapod locomotion appears to have passed through a stage of body-flexion propulsion, in which the pelvic fins played a relatively minor anchoring part, before the emergence of hindlimb-powered propulsion in the interval between Panderichthys and Acanthostega.

Donor transplant programme

International Nuclear Information System (INIS)

Abu Bakar Sulaiman

1999-01-01

The transplantation of organs and tissues from one human to another human has become an essential and well established form of therapy for many types of organ and tissue failure. In Malaysia, kidney, cornea and bone marrow transplantation are well established. Recently, liver, bone and heart transplanation have been performed. Unfortunately, because of the lack of cadaveric organ donation, only a limited number of solid organ transplantation have been performed. The cadaveric organ donor rate in Malaysia is low at less than one per million population. The first tissue transplanted in Malaysia was the cornea which was performed in the early 1970s. At that time and even now the majority of corneas came from Sri Lanka. The first kidney transplant was performed in 1975 from a live related donor. The majority of the 629 kidney transplants done at Hospital Kuala Lumpur to date have been from live related donors. Only 35 were from cadaver donors. Similarly, the liver transplantation programme which started in 1995 are from live related donors. A more concerted effort has been made recently to increase the awareness of the public and the health professionals on organ and tissue donation. This national effort to promote organ and tissue donation seems to have gathered momentum in 1997 with the first heart transplant successfully performed at the National Heart Institute. The rate of cadaveric donors has also increased from a previous average of I to 2 per year to 6 per year in the last one year. These developments are most encouraging and may signal the coming of age of our transplantati on programme. The Ministry of Health in conjunction with various institutions, organizations and professional groups, have taken a number of proactive measures to facilitate the development of the cadaveric organ donation programme. Efforts to increase public awareness and to overcome the negative cultural attitude towards organ donation have been intensified. Equally important are efforts

Pulmonary rehabilitation in lung transplant candidates.

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Li, Melinda; Mathur, Sunita; Chowdhury, Noori A; Helm, Denise; Singer, Lianne G

2013-06-01

While awaiting lung transplantation, candidates may participate in pulmonary rehabilitation to improve their fitness for surgery. However, pulmonary rehabilitation outcomes have not been systematically evaluated in lung transplant candidates. This investigation was a retrospective cohort study of 345 pre-transplant pulmonary rehabilitation participants who received a lung transplant between January 2004 and June 2009 and had available pre-transplant exercise data. Data extracted included: 6-minute walk tests at standard intervals; exercise training details; health-related quality-of-life (HRQL) measures; and early post-transplant outcomes. Paired t-tests were used to examine changes in the 6MW distance (6MWD), exercise training volume and HRQL during the pre-transplant period. We evaluated the association between pre-transplant 6MWD and transplant hospitalization outcomes. The final 6MWD prior to transplantation was only 15 m less than the listing 6MWD (n = 200; p = 0.002). Exercise training volumes increased slightly from the start of the pulmonary rehabilitation program until transplant: treadmill, increase 0.69 ml/kg/min (n = 238; p volumes are well preserved among lung transplant candidates participating in pulmonary rehabilitation, even in the setting of severe, progressive lung disease. Participants with greater exercise capacity prior to transplantation have more favorable early post-transplant outcomes. Copyright © 2013 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

PHENOMENON OF DEMIKHOV. "Transplantation of vital organs In experiment" (1960. Transplantation immunity, artifi cial circulation in organ transplantation

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S. P. Glyantsev

2017-01-01

Full Text Available The article (the fourth of five presents the analysis of the 4th and 5th chapters from V.P.Demikhov's monograph "Transplantation of vital organs in experiment" (MedGIz Publisher, Moscow, 1960, where he described his studies of transplantation immunity in originally created models and his use of artificial blood-circulation systems in experimental organ transplantation. It has been shown that V.P.Demikhov changed his views on the tissue biological incompatibility in homoplastic transplants and turned from the Michurin-Pavlov's concepts (1946–1953 to natural-scientific views (1959. Meanwhile, his multiple attempts to study both the morphological and humoral immunological response to transplanted organs did not give conclusive results because of lacking the experience of such studies even in the country's leading scientists and due the imperfection of their techniques. Realizing that the retrieval of a beating heart from a human would have created further problems for its subsequent transplantation, V.P. Demikhov attempted to reanimate human hearts in corpses by means of extracorporeal devices to provide artificial circulation. Methodologically, those devices were based on S.S.Bryukhonenko's research and his "auto-injector" pump modified by V.P.Demikhov. However, by 1960, those studies had not come beyond the experiments.

Pre-transplantation glucose testing for predicting new-onset diabetes mellitus after renal transplantation.

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Ramesh Prasad, G V; Huang, M; Bandukwala, F; Nash, M M; Rapi, L; Montada-Atin, T; Meliton, G; Zaltzman, J S

2009-02-01

New-onset diabetes after renal transplantation (NODAT) adversely affects graft and patient survival. However, NODAT risk based on pre-transplant blood glucose (BG) levels has not been defined. Our goal was to identify the best pre-transplant testing method and cut-off values. We performed a case-control analysis of non-diabetic recipients who received a live donor allograft with at least 6 months post-transplant survival. Pre-transplant glucose abnormalities were excluded through 75 g oral glucose tolerance testing (OGTT) and random BG (RBG) measurement. NODAT was defined based on 2003 Canadian Diabetes Association criteria. Multivariate logistic and Cox regression analysis was performed to determine independent predictor variables for NODAT. Receiver-operating-characteristic (ROC) curves were constructed to determine threshold BG values for diabetes risk. 151 recipients met initial entry criteria. 12 had pre-transplant impaired fasting glucose and/or impaired glucose tolerance, among who 7 (58%) developed NODAT. In the remaining 139, 24 (17%) developed NODAT. NODAT risk exceeded 25% for those with pre-transplant RBG > 6.0 mmol/l and 50% if > 7.2 mmol/l. Pre-transplant RBG provided the highest AUC (0.69, p = 0.002) by ROC analysis. Increasing age (p = 0.025), acute rejection (p = 0.011), and RBG > 6.0 mmol/l (p = 0.001) were independent predictors of NODAT. Pre-transplant glucose testing is a specific marker for NODAT. Patients can be counseled of their incremental risk even within the normal BG range if the OGTT is normal.

Stem-cell-activated organ following ultrasound exposure: better transplant option for organ transplantation.

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Wang, Sen; Li, Yu; Ji, Ying-Chang; Lin, Chang-Min; Man, Cheng; Zheng, Xiao-Xuan

2010-01-01

Although doctors try their best to protect transplants during surgery, there remain great challenges for the higher survival rate and less rejection of transplants after organ transplantation. Growing evidence indicates that the stem cells could function after injury rather than aging, implying that suitable injury may activate the stem cells of damaged organs. Furthermore, it has been revealed that stem cells can be used to induce tolerance in transplantation and the ultrasound has great biological effects on organs. Basing on these facts, we hypothesize that the stem cells within the transplants can be activated by ultrasound with high-frequency and medium-intensity. Therefore, the stem-cell-activated organs (SCAO) can be derived, and the SCAO will be better transplant option for organ transplantation. We postulate the ultrasound can change the molecular activity and/or quantity of the stem cells, the membrane permeability, the cell-cell junctions, and their surrounding microenvironments. As a result, the stem cells are activated, and the SCAO will acquire more regenerative capacity and less rejection. In the paper, we also discuss the process, methods and models for verifying the theory, and the consequences. We believe the theory may provide a practical method for the clinical application of the ultrasound and stem cells in organ transplantation.

[Serum soluble HLA-G, soluble CD30 is correlated to the time after transplantation in renal transplant recipients].

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Jin, Zhankui; Xu, Cuixiang; Duan, Wanli; Yang, Jiangcun; Tian, Puxun

2017-07-01

Objective To investigate the expressions of serum soluble human leukocyte antigen G (sHLA-G) and soluble CD30 (sCD30) in renal transplant recipients at different time after transplantation, and explore the relationship between the expressions of serum sHLA-G, sCD30 and the time after renal transplantation. Methods Eleven kidney transplant recipients and 10 healthy donors were selected, in which the dynamic changes of serum sHLA-G and sCD30 were detected by ELISA before transplantation and 1 year after transplantation; 33 kidney transplant recipients with normal renal graft were selected and divided into three groups: 1-5 years, 5-10 years and 10 years post-transplantation. The expressions of serum sHLA-G and sCD30 in the recipients were tested over one year after transplantation. Results The level of serum sHLA-G before transplantation was not significantly different from that of the control group. There was no significant difference between pre-transplantation, 1 week and 1 month after transplantation. Serum sHLA-G level of renal transplant recipients at 3 months after transplantation was higher than that 1 month after transplantation. There was no significant change in serum sHLA-G level among 3, 6 and 12 months after transplantation. The level of serum sHLA-G in the group of transplant time >10 years was significantly higher than that in the group of transplant time ≤5 years. The serum sHLA-G level was significantly associated with the time after renal transplantation. The level of serum sCD30 before transplantation was higher than that in the control group and decreased in 1 week after transplantation. There were no significant differences in sCD30 level between 1, 3, 6, and 12 months after transplantation, and similarly, there were also no significant differences between the groups of transplant time ≤5 years, 5-10 years and 10 years after transplantation. The level of sCD30 was significantly associated with the time within 1 month after renal

Microsurgical techniques for experimental kidney transplantation and general guidelines to establish studies about transplantation immunology Técnicas microcirúrgicas para transplante renal experimental e condutas para estabelecer experimentos sobre imunologia do transplante

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Paulo Ney Aguiar Martins

2003-08-01

Full Text Available Experimental models of organ transplantation played a crucial role to establish the principles of transplantation immunology. The renal transplantation in rodents became the most used model to study the mechanisms of allograft rejection. To perform it, it is necessary to master the microsurgery techniques and the research group should cooperate with other specialists in the field. In this article we review the surgical techniques employed in rats, and we draw guidelines to establish studies about transplantation immunology.Os princípios da imunologia do transplante estabeleceram-se após o surgimento de modelos experimentais. Esses modelos foram fundamentais para descoberta de mecanismos de tolerância imunológica e as bases genéticas da reação de rejeição. Transplante renal em roedores utilizando técnicas de microcirurgia tornou-se o modelo ideal, e abriu um novo horizonte para condução de pesquisas sobre imunologia e fisiologia de transplantes. Neste artigo revisamos as técnicas de transplante renal, e esboçamos diretrizes para elaboração de estudos imunológicos em modelos de rejeição.

A Label-Free and Ultrasensitive Immunosensor for Detection of Human Chorionic Gonadotrophin Based on Graphene FETs

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Kamrul Islam

2017-07-01

Full Text Available We report on a label-free immunosensor based on graphene field effect transistors (G-FETs for the ultrasensitive detection of Human Chorionic Gonadotrophin (hCG, as an indicator of pregnancy and related disorders, such as actopic pregnancy, choriocarcinoma and orchic teratoma. Pyrene based bioactive ester was non-covalently anchored onto the graphene channel in order to retain the sp2 lattice. The G-FET transfer characteristics showed repeatable and reliable responses in all surface modifying steps using a direct current (DC readout system. The hCG concentration gradient showed a detection limit of ~1 pg·mL−1. The proposed method facilitates the cost-effective and viable production of graphene point-of-care devices for clinical diagnosis.

Pediatric Liver Transplantation: Our Experiences.

Science.gov (United States)

Basturk, Ahmet; Yılmaz, Aygen; Sayar, Ersin; Dinçhan, Ayhan; Aliosmanoğlu, İbrahim; Erbiş, Halil; Aydınlı, Bülent; Artan, Reha

2016-10-01

The aim of our study was to evaluate our liver transplant pediatric patients and to report our experience in the complications and the long-term follow-up results. Patients between the ages of 0 and 18 years, who had liver transplantation in the organ transplantation center of our university hospital between 1997 and 2016, were included in the study. The age, sex, indications for the liver transplantation, complications after the transplantation, and long-term follow-up findings were retrospectively evaluated. The obtained results were analyzed with statistical methods. In our organ transplantation center, 62 pediatric liver transplantations were carried out since 1997. The mean age of our patients was 7.3 years (6.5 months-17 years). The 4 most common reasons for liver transplantation were: Wilson's disease (n=10; 16.3%), biliary atresia (n=9; 14.5%), progressive familial intrahepatic cholestasis (n=8; 12.9%), and cryptogenic cirrhosis (n=7; 11.3%). The mortality rate after transplantation was 19.6% (12 of the total 62 patients). The observed acute and chronic rejection rates were 34% and 4.9%, respectively. Thrombosis (9.6%) was observed in the hepatic artery (4.8%) and portal vein (4.8%). Bile leakage and biliary stricture rates were 31% and 11%, respectively. 1-year and 5-year survival rates of our patients were 87% and 84%, respectively. The morbidity and mortality rates in our organ transplantation center, regarding pediatric liver transplantations, are consistent with the literature.

Determining the prevalence of patterns of pregnancy-induced pelvic girdle pain and low back pain in urban and rural populations: A cross-sectional study

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Arati Mahishale

2016-01-01

Full Text Available Background: Biomechanical changes during pregnancy impose postural deviations, leading to various musculoskeletal pain syndromes. Commonly noted pain syndromes are the pelvic girdle pain (PGP and low back pain (LBP, which were experienced by pregnant women globally. There is a prevalence of pregnancy-related PGP (PPGP and pregnancy-related LBP (PLBP in Western population. Data of the same in Indian pregnant population lack evidence. Objective: To find the rates of incidence and prevalence of different patterns of PPGP and PLBP in the urban and rural pregnant women. Materials and Methods: A total of 580 pregnant women were screened for inclusion criteria. Confirmation of diagnosis of PGP and LBP was done for 457 subjects using Modified Oswestry Disability Index (MODI questionnaire and the pelvic girdle questionnaire (PGQ. Once diagnosed, all participants were subjected to nine clinical tests to differentiate the site of pain and to classify them accordingly into three different groups, namely group A (LBP, group B [posterior pelvic pain (PPP], and group C [anterior pelvic pain (APP]. Results: The point prevalence of pain in group A (LBP was 31%, in group B (PPP was 65%, and in group C (APP was 15%. The prevalence of PGP and LBP was 75% in the urban pregnant population and 25% in the rural pregnant population. Conclusion: The prevalence rate of PPP (65% is higher than that of LBP (31% and APP (15%. Also PPP is reported to be highest in primiparous with gestational age of 38 weeks. The urban population showed 75% and rural population showed 25% of PGP and LBP.

Concurrent validity of kidney transplant questionnaire in US renal transplant recipients

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Chisholm-Burns MA

2011-10-01

Full Text Available Marie A Chisholm-Burns1,2, Steven R Erickson3, Christina A Spivey1, Rainer WG Gruessner2, Bruce Kaplan4 1Department of Pharmacy Practice and Science, University of Arizona College of Pharmacy, Tucson, AZ; 2Department of Surgery, University of Arizona College of Medicine, Tucson, AZ; 3Department of Clinical Sciences, University of Michigan College of Pharmacy, Ann Arbor, MI; 4Department of Medicine, The University of Arizona College of Medicine Tucson, AZ, USA Background: Valid instrumentation in the assessment of health-related quality of life (HQoL in renal transplant recipients is critical to identifying particular nuances and determinants of HQoL in this population. Therefore, the validity of disease-specific instruments to measure HQoL in renal transplant recipients, such as the Kidney Transplant Questionnaire (KTQ, needs further investigation. The objective of this study was to assess the concurrent validity of the KTQ in adult US renal transplant recipients using the well established SF-12 Health Survey version 2 (SF-12v2 as the comparison instrument. Methods: One hundred and fourteen renal transplant recipients met the following inclusion criteria for this study, ie, were at least 21 years of age, more than two years post-transplant, and receiving immunosuppressant therapy. Subjects were asked to complete a series of HQoL instruments, ie, the KTQ and the SF-12v2 (physical component summary [PCS-12] and mental component summary [MCS-12]. Descriptive statistics were calculated, and correlational analyses were conducted to examine the concurrent validity of the HQoL instruments. Results: Among 100 participants (87.7% response rate, the majority of participants were male (52%, had deceased donor transplants (63%, and received Medicare benefits (84%. PCS-12 was positively correlated with three of five KTQ subscales (P < 0.05, ie, KTQ-physical (r = 0.43, KTQ-fatigue (r = 0.42, and KTQ-uncertainty/fear (r = 0.2. MCS-12 was positively correlated

Immune System and Kidney Transplantation.

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Shrestha, Badri Man

2017-01-01

The immune system recognises a transplanted kidney as foreign body and mounts immune response through cellular and humoral mechanisms leading to acute or chronic rejection, which ultimately results in graft loss. Over the last five decades, there have been significant advances in the understanding of the immune responses to transplanted organs in both experimental and clinical transplant settings. Modulation of the immune response by using immunosuppressive agents has led to successful outcomes after kidney transplantation. The paper provides an overview of the general organisation and function of human immune system, immune response to kidney transplantation, and the current practice of immunosuppressive therapy in kidney transplantation in the United Kingdom.

Generation of an induced pluripotent stem cell line from chorionic villi of a Turner syndrome spontaneous abortion.

Science.gov (United States)

Parveen, Shagufta; Panicker, M M; Gupta, Pawan Kumar

2017-03-01

A major cause of spontaneous abortions is chromosomal abnormality of foetal cells. We report the generation of an induced pluripotent stem cell line from the fibroblasts isolated from chorionic villi of an early spontaneously aborted foetus with Turner syndrome. The Turner syndrome villus induced pluripotent stem cell line is transgene free, retains the original XO karyotype, expresses pluripotency markers and undergoes trilineage differentiation. This pluripotent stem cell model of Turner syndrome should serve as a tool to study the developmental abnormalities of foetus and placenta that lead to early embryo lethality and profound symptoms like infertility in 45 XO survivors. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

Clinical pancreatic islet transplantation.

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Shapiro, A M James; Pokrywczynska, Marta; Ricordi, Camillo

2017-05-01

Clinical pancreatic islet transplantation can be considered one of the safest and least invasive transplant procedures. Remarkable progress has occurred in both the technical aspects of islet cell processing and the outcomes of clinical islet transplantation. With >1,500 patients treated since 2000, this therapeutic strategy has moved from a curiosity to a realistic treatment option for selected patients with type 1 diabetes mellitus (that is, those with hypoglycaemia unawareness, severe hypoglycaemic episodes and glycaemic lability). This Review outlines the techniques required for human islet isolation, in vitro culture before the transplant and clinical islet transplantation, and discusses indications, optimization of recipient immunosuppression and management of adjunctive immunomodulatory and anti-inflammatory strategies. The potential risks, long-term outcomes and advances in treatment after the transplant are also discussed to further move this treatment towards becoming a more widely available option for patients with type 1 diabetes mellitus and eventually a potential cure.

Significance of radioimmunoassay of human chorionic gonadotropin and alpha fetoprotein in nonseminomatous germ cell tumors of the testis

Energy Technology Data Exchange (ETDEWEB)

Kausitz, J.; Hupka, S. (Institute for Postgradual Training of Physicians and Pharmaceutists, Bratislava (Czechoslovakia)); Cerny, V.; Bohunicky, L.; Korec, S. (Ustav Klinickej Onkologie, Bratislava (Czechoslovakia))

1980-01-01

Radioimmunoassays human chorionic gonadotropin (HCG) and alpha fetoprotein (AFP) made in 49 patients with nonseminomatous testicular tumors showed that these investigations make the diagnosis more precise, permit to follow up the dynamics of the course of the disease and the effectiveness of treatment and may help to reveal the presence of otherwise undetectable tumorous metastases. The significance of these assays is enhanced if the two tumorous proteins are investigated in parallel. The results proved positive in 43 (87.8%) and false negative in 6 (12.2%) of the patients. The absence of HCG and AFP production in some patients with active disorder has not as yet been elucidated.

Significance of radioimmunoassay of human chorionic gonadotropin and alpha fetoprotein in nonseminomatous germ cell tumors of the testis

International Nuclear Information System (INIS)

Kausitz, J.; Hupka, S.; Cerny, V.; Bohunicky, L.; Korec, S.

1980-01-01

Radioimmunoassays human chorionic gonadotropin (HCG) and alpha fetoprotein (AFP) made in 49 patients with nonseminomatous testicular tumors showed that these investigations make the diagnosis more precise, permit to follow up the dynamics of the course of the disease and the effectiveness of treatment and may help to reveal the presence of otherwise undetectable tumorous metastases. The significance of these assays is enhanced if the two tumorous proteins are investigated in parallel. The results proved positive in 43 (87.8%) and false negative in 6 (12.2%) of the patients. The absence of HCG and AFP production in some patients with active disorder has not as yet been elucidated. (author)

ABO-incompatible kidney transplantation

DEFF Research Database (Denmark)

Schousboe, Karoline; Titlestad, Kjell; Baudier, Francois

2010-01-01

INTRODUCTION: Kidney transplantation is the optimal treatment for many patients with end-stage renal disease (ESRD). Due to shortage of donor kidneys in Denmark, there is a need to expand the possibilities for donation. At the Odense University Hospital (OUH), we have introduced ABO......-incompatible kidney transplantation. We used antigenspecific immunoadsorptions to remove blood group antibodies and anti-CD20 antibody (rituximab) to inhibit the antibody production. The aim of introducing the ABO-incompatible kidney transplantation at the OUH was to increase the rate of living donor kidney...... transplantation without increasing rejection or mortality rates. MATERIAL AND METHODS: Retrospective evaluation. Eleven patients received ABO-incompatible kidney transplantation. The patients were followed for 3-26 months. RESULTS: One patient had an antibody-mediated rejection, one patient suffered T...

The association between pelvic girdle pain and sick leave during pregnancy; a retrospective study of a Norwegian population.

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Malmqvist, Stefan; Kjaermann, Inger; Andersen, Knut; Økland, Inger; Larsen, Jan Petter; Brønnick, Kolbjørn

2015-10-05

The incidence of pelvic girdle pain (PGP) in pregnancy is wide ranged depending on definition, the utilised diagnostic means, and the design of the studies. PGP during pregnancy has negative effects on activities of daily living and causes long sick leave, which makes it a major public health issue. Our objectives were to explore the frequency of sick leave in pregnancy due to PGP, assess the relationship between different types of pain-related activities of daily living, examine physical workload, type of work in relation to sick leave, and to explore factors that make women less likely to take sick leave for PGP. All women giving birth at the maternity ward of Stavanger University Hospital, Norway, were asked to participate and complete a questionnaire on demographic features, PGP, pain-related activities of daily living, sick leave in general and for PGP, frequency of exercising before and during pregnancy. Drawings of pelvic girdle and low back area were used for the localization of pain. PGP intensity was then rated retrospectively on a numerical rating scale. Non-parametric tests, multinomial logistic regression and sequential linear regression analysis were used in the statistical analysis. PGP is a frequent and major cause of sick leave during pregnancy among Norwegian women, which is also reflected in activities of daily living as measured with scores on all Oswestry disability index items. In the multivariate analysis of factors related to sick leave and PGP we found that work satisfaction, problems with lifting and sleeping, and pain intensity were risk factors for sick leave. In addition, women with longer education, higher work satisfaction and fewer problems with sitting, walking and standing, were less likely to take sick leave in pregnancy, despite the same pain intensity as women being on sick leave. A coping factor in pregnant women with PGP was discovered, most likely dependant on education, associated with work situation and/or work posture

Pre-transplant reversible pulmonary hypertension predicts higher risk for mortality after cardiac transplantation.

Science.gov (United States)

Butler, Javed; Stankewicz, Mark A; Wu, Jack; Chomsky, Don B; Howser, Renee L; Khadim, Ghazanfar; Davis, Stacy F; Pierson, Richard N; Wilson, John R

2005-02-01

Pre-transplant fixed pulmonary hypertension is associated with higher post-transplant mortality. In this study, we assessed the significance of pre-transplant reversible pulmonary hypertension in patients undergoing cardiac transplantation. Overall, we studied 182 patients with baseline normal pulmonary pressures or reversible pulmonary hypertension, defined as a decrease in pulmonary vascular resistance (PVR) to 50 mm Hg had a higher risk of death (odds ratio [OR] 5.96, 95% confidence interval [CI] 1.46 to 19.84 as compared with PAS 4.0 WU, but patients with TPG > or =16 had a higher risk of mortality (OR 4.93, 95% CI 1.84 to 13.17). PAS pressure was an independent predictor of mortality (OR 1.04, 95% CI 1.02 to 1.06). Recipient body mass index, history of sternotomy; and donor ischemic time were the other independent predictors of mortality. Pre-transplant pulmonary hypertension, even when reversible to a PVR of < or =2.5 WU, is associated with a higher mortality post-transplant.

Fecal microbiota transplant

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... page: //medlineplus.gov/ency/article/007703.htm Fecal microbiota transplant To use the sharing features on this page, please enable JavaScript. Fecal microbiota transplantation (FMT) helps to replace some of the " ...

Renal transplantation at the Johns Hopkins Comprehensive Transplant Center.

Science.gov (United States)

Montgomery, Robert A; Cooper, Matthew; Kraus, Edward; Rabb, Hamid; Samaniego, Milagros; Simpkins, Christopher E; Sonnenday, Christopher J; Ugarte, Richard M; Warren, Daniel S; Zachary, Andrea A

2003-01-01

A stagnant supply of transplantable organs in the face of a relentless burgeoning of transplant waiting lists has created a crisis. Necessity continues to be the mother of invention and as the crisis has deepened it has served as a crucible for the development of new ways to think about perennial problems. Our program has taken a 2-pronged approach to increasing the organ supply for our patients. First, through innovations like the laparoscopic donor nephrectomy, ABO-incompatible and positive-crossmatch transplantation protocols, unconventional paired kidney exchanges, and the use of altruistic donors we have more than doubled our utilization of live donor organs. At the same time, we have developed algorithms and interrogative techniques to enhance the intelligent use of kidneys from expanded criteria donors for patients who do not have an available live donor. The laparoscopic nephrectomy has proven to be a safe and effective way of removing a significant barrier to live donation. Our results from 100 ABOi, (+)XM, and PKE transplants are similar to national statistics for compatible live donor transplants, suggesting that existing paradigms of compatibility can be safely expanded. These encouraging early outcomes and the savings they transmit to the health care system have allowed us to obtain insurance coverage for the InKTP programs, setting the stage for further expansion of these opportunities to broaden the options for patients with end-stage renal disease.

[Kidney transplantation epidemiology in France].

Science.gov (United States)

Hiesse, Christian

2013-11-01

Kidney transplantation activity in France is among the most important worldwide: in 2011, 2976 transplants have been performed (47.5 per million population), and the number of patients living with a functional graft is estimated around 30,000, representing 44.7% of all patients (n = 67,270) treated for end-stage renal failure. However, the rate of preemptive kidney transplants remains very low, only 3.3% of incident patients starting renal replacement therapy. The analysis of demand showed a progressive increase in recent years, as demonstrated by the registration rate on the kidney transplantation waiting list, increasing by 5% yearly between 2006 and 2010, but with huge differences according to age categories and regional registration areas, reflecting discrepant appreciations in indications for kidney transplantation. The median waiting time between registration and transplantation increased progressively in recent years, reaching 22.3 months with considerable variations according to regional areas and transplantation teams. Kidney transplantation activity, while increasing continuously, is far to cover the rising demand, and inexorably patients accumulate on the waiting list (around 9000 patients were registered by January 2012). This situation is the consequence of insufficient organ procurement activity. The deceased organ procurement rate remained high: 1572 harvested donors in 2011 (24.1 per million population), but the proportion of older donors rose in recent years, to reach the rate of 26% of donors older than 65 years in 2011. The procurement activity of donors after cardiac arrest was reintroduced in 2006, but increased slowly: 65 transplants were performed in 2011 using kidney procured in non heart-beating donors. The living donor kidney transplantation activity has markedly increased recently: 302 living donor transplantations were performed in 2011, representing 10.1% of the kidney transplantations. Facing the predictable increase in the number of

Liver transplantation in the Nordic countries - An intention to treat and post-transplant analysis from The Nordic Liver Transplant Registry 1982-2013

DEFF Research Database (Denmark)

Fosby, Bjarte; Melum, Espen; Bjøro, Kristian

2015-01-01

AIM AND BACKGROUND: The Nordic Liver Transplant Registry (NLTR) accounts for all liver transplants performed in the Nordic countries since the start of the transplant program in 1982. Due to short waiting times, donor liver allocation has been made without considerations of the model of end-stage...

Effect of human chorionic gonadotropin on sexual maturation, sex steroids and thyroid hormone levels in Caspian lamprey (Caspiomyzon wagneri Kessler, 1870)

OpenAIRE

Abedi, M.; Mojazi Amiri, B.; Abdoli, A.; Javanshir, A.; Benam, S.; Namdarian, A.

2017-01-01

The objective of this study was to determine the effect of human chorionic gonadotropin (hCG) on sexual maturation, plasma sex steroids [17β-estradiol, (E2) and 17α-hydroxy progesterone (17α_OHP)] and thyroid hormones (triiodothyronine, T3 and thyroxin, T4) levels in upstream - migrating Caspian lamprey. During the experiment, 36 fish (24 females and 12 males) in spring 2013 and 36 fish (24 females and 12 males) in fall 2013 were collected from the Shirud River estuary in Mazandaran Province,...

Transplant tourism: a growing phenomenon.

Science.gov (United States)

Cohen, David J

2009-03-01

Medical tourism is increasing owing to high costs of care, lack of availability or long waits for procedures, and improvements in technology and standards of care in many countries. Transplant tourism is one example of medical tourism that has been attracting increasing attention because of concerns over poor treatment and outcomes of both donors and recipients. Most such cases involve vended kidneys obtained from vulnerable populations, and both donors and recipients receive inferior care by US standards. This commentary discusses a paper by Gill et al. that compared outcomes of 33 transplant tourists with those of patients transplanted at a US center. Fewer complications and better outcomes were seen in patients transplanted in the US center than among transplant tourists. Large transplant centers with long waiting times are increasingly likely to see patients return newly transplanted from overseas; such patients require urgent attention, with particular consideration to infectious complications.

A review of luteinising hormone and human chorionic gonadotropin when used in assisted reproductive technology

DEFF Research Database (Denmark)

Ezcurra, Diego; Humaidan, Peter

2014-01-01

to the purification process, thus hCG, mimicking LH action, is added to standardise the product. However, unlike LH, hCG plays a very minor role during the natural human menstrual cycle. It is secreted by the embryo and placenta, and its main role is to support implantation and pregnancy. More recently, recombinant......Gonadotropins extracted from the urine of post-menopausal women have traditionally been used to stimulate folliculogenesis in the treatment of infertility and in assisted reproductive technology (ART). Products, such as human menopausal gonadotropin (hMG), consist not only of a mixture...... of the hormones, follicle-stimulating hormone (FSH), luteinising hormone (LH) and human chorionic gonadotropin (hCG), but also other biologically active contaminants, such as growth factors, binding proteins and prions. The actual amount of molecular LH in hMG preparations varies considerably due...

Risk factors for Epstein-Barr virus-related post-transplant lymphoproliferative disease after allogeneic hematopoietic stem cell transplantation.

Science.gov (United States)

Uhlin, Michael; Wikell, Helena; Sundin, Mikael; Blennow, Ola; Maeurer, Markus; Ringden, Olle; Winiarski, Jacek; Ljungman, Per; Remberger, Mats; Mattsson, Jonas

2014-02-01

Allogeneic hematopoietic stem cell transplantation is a successful treatment for hematologic malignancies and a variety of genetic and metabolic disorders. In the period following stem cell transplantation, the immune-compromised milieu allows opportunistic pathogens to thrive. Epstein-Barr virus-associated post-transplant lymphoproliferative disease can be a life-threatening complication for transplanted patients because of suppressed T-cell-mediated immunity. We analyzed possible risk factors associated with post-transplant lymphoproliferative disease in a cohort of over 1,000 patients. The incidence of post-transplant lymphoproliferative disease was 4%. Significant risk factors identified by multivariate analysis were: human leukocyte antigen-mismatch (PEpstein-Barr virus mismatch recipient-/donor+ (Pdisease grade II to IV (P=0.006), pre-transplant splenectomy (P=0.008) and infusion of mesenchymal stromal cells (P=0.015). The risk of post-transplant lymphoproliferative disease has increased in more recent years, from less than 2% before 1998 to more than 6% after 2011. Additionally, we show that long-term survival of patients with post-transplant lymphoproliferative disease is poor despite initial successful treatment. The 3-year survival rate among the 40 patients with post-transplant lymphoproliferative disease was 20% as opposed to 62% among patients without post-transplant lymphoproliferative disease (Pdisease after transplantation in need of pre-emptive measures.

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.

What's hot, what's new in clinical organ transplantation: report from the American Transplant Congress 2015.

Science.gov (United States)

Sung, R S

2015-11-01

Innovative and exciting advances in the clinical sciences in organ transplantation were presented at the American Transplant Congress 2015. The full spectrum of transplantation was covered, with important developments in many topics. Key areas covered by presentations included living donor outcomes, optimal utilization and allocation of deceased donors, new immunosuppression regimens, antibody-mediated rejection and tolerance induction. This review highlights some of the most interesting and noteworthy clinical presentations from the meeting. © Copyright 2015 The American Society of Transplantation and the American Society of Transplant Surgeons.

Exchange donor transplantation: ethical option for living renal transplantation.

Science.gov (United States)

Gürkan, A; Kaçar, S; Varılsuha, C; Tilif, S; Turunç, V; Doǧan, M; Dheir, H; Sahin, S

2011-04-01

Taking in consideration the opinion of our team, which necessitates obligation of a relative relation between donors and recipients (genetic or matrimonial), we performed donor exchanges as an ethical alternative in living donor transplantations. We reviewed the outcomes of our exchange series. Between July 2003 and August 2010 we performed 110 exchange donor transplantations in four hospitals: one four-way, two three-way, and 100 two-way cases. Donors were mostly spouses (n = 71) or mothers (n = 15). The mean age of the donors was 48.8 (range = 23-69) and the recipients 41.4 years (range = 5-66). Two were transplanted preemptively and the others had a mean dialysis duration of 43 months (range = 1-120). Among 110 patients, three compatible pairs joined the group voluntarily; 71, due to ABO incompatibility and 36, due to crossmatch positivity. Induction therapy was used in 92 patients. HLA mismatches (MM) were: one MM in three; two MM in three; three MM in 18, four MM in 36; five MM in 34; and six MM in 18. Among 90 patients tested for panel-reactive antibodies PRA, five showed class I and 10, class II positivity. In 11 patients, B-cell positivity was detected by flow cytometry. Delayed graft function (n = 2), acute rejection (n = 11), BK virus infection (n = 1), and cytomegalovirus infection (n = 3) were seen postoperatively. Three (2.7%) patients died due to sepsis. Five patients returned to dialysis program due to interstitial fibrosis tubular atrophy (IFTA) (n = 2), renal vein thrombosis (n = 1), de novo glomerulopathy (n = 1), or primary nonfunction (n = 1). The 1- and 5-year patient and graft survival rates were 96% and 96%, 95% and 89%, respectively. We believe that exchange donor transplantation is as successful as direct transplants; it is a good, ethical alternative to unrelated living transplantations. Copyright © 2011 Elsevier Inc. All rights reserved.

Identifying Barriers to Preemptive Kidney Transplantation in a Living Donor Transplant Cohort

Directory of Open Access Journals (Sweden)

Ryan A. Helmick, MD

2018-04-01

Conclusions. Even among a patient population that is primarily white, educated, and has a spouse or first-degree relative donor, PreKTx rates remain concerningly low. Increased time between diagnosis or education and transplant are predictors of PreKTx. Greater emphasis on transplant education earlier in the stages of chronic kidney disease and community outreach from transplant centers may help to increase the rate of PreKTx.

Carcinoma of the tongue in a renal transplant recipient: A rare post-transplant malignancy

Directory of Open Access Journals (Sweden)

Jai Prakash

2015-01-01

Full Text Available Current immunosuppression improved long-term outcome of transplant patients, but it also increased the incidence of de novo malignancy. Organ transplant recipients have a threeto four-fold increased risk of developing carcinoma in comparison with the general population. Common malignancies encountered after transplantation include cancer of the skin, lips, post-transplant lymphoproliferative disease, ano-genital carcinoma and Kaposi sarcoma. Squamous cell carcinoma of the tongue is very rare. We report here a case of squamous cell carcinoma of the tongue in an adult male patient who developed it 11 years post-transplant. He underwent right hemiglossectomy and his graft function remained stable.

Association between pre-transplant dialysis modality and patient and graft survival after kidney transplantation

DEFF Research Database (Denmark)

Kramer, Anneke; Jager, Kitty J; Fogarty, Damian G

2012-01-01

Previous studies have found inconsistent associations between pre-transplant dialysis modality and subsequent post-transplant survival. We aimed to examine this relationship using the instrumental variable method and to compare the results with standard Cox regression.......Previous studies have found inconsistent associations between pre-transplant dialysis modality and subsequent post-transplant survival. We aimed to examine this relationship using the instrumental variable method and to compare the results with standard Cox regression....

Employment 12 months after kidney transplantation: An in-depth bio-psycho-social analysis of the Swiss Transplant Cohort.

Directory of Open Access Journals (Sweden)

Brigitta Danuser

Full Text Available Return to work with or after a chronic disease is a dynamic process influenced by a variety of interactions between personal, work, societal and medical resources or constraints. The aim of this study was to identify predictors for employment 12 months after transplantation in kidney patients, applying a bio-psycho-social model.All kidney patients followed in the Swiss Transplant Cohort between May 2008 and December 2012, aged 18 to 65 were assessed before, 6 and 12 months after transplantation.Of the 689 included patients, 56.2% worked 12 months post- transplantation compared to 58.9% pre-transplantation. Age, education, self-perceived health (6 months post- transplantation, pre- transplantation employment and receiving an organ from a living donor are significant predictors of employment post- transplantation. Moreover, while self-perceived health increased post- transplantation, depression score decreased only among those employed 12 months post- transplantation. Pre- transplantation employment status was the main predictor for post- transplantation employment (OR = 18.6 and was associated with sex, age, education, depression and duration of dialysis. An organ from a living donor (42.1% was more frequent in younger patients, with higher education, no diabetes and shorter waiting time to surgery.Transplantation did not increase employment in end-stage kidney disease patients but helped maintaining employment. Pre-transplantation employment has been confirmed to be the most important predictor of post-transplantation employment. Furthermore, socio-demographic and individual factors predicted directly and indirectly the post-transplantation employment status. With living donor, an additional predictor linked to social factors and the medical procedure has been identified.

Development of the National Transplant Program Has Significantly Decreased but Not Ended Transplant Tourism in Montenegro.

Science.gov (United States)

Ratkovic, M; Basic Jukic, N; Kastelan, Z; Radunovic, D; Kavaric, P; Brezak, J; Topalovic Grkovic, M; Hudolin, T; Prelevic, V

2018-06-01

Organ transplantation has prolonged and improved the lives of many patients around the world. However, a widespread shortage of donors remains the main factor that has led to organ trafficking and transplant tourism. To stop transplant tourism and to provide optimal treatment for its citizens with end-stage renal disease, Montenegro started performing renal transplantations in September 2012. Thirty-five transplantations have been performed since that time, 34 from living donors and only 1 from a deceased donor. This practice has significantly decreased but not ended transplant tourism in Montenegro. Copyright © 2018 Elsevier Inc. All rights reserved.

Thoracic organ transplantation: laboratory methods.

Science.gov (United States)

Patel, Jignesh K; Kobashigawa, Jon A

2013-01-01

Although great progress has been achieved in thoracic organ transplantation through the development of effective immunosuppression, there is still significant risk of rejection during the early post-transplant period, creating a need for routine monitoring for both acute antibody and cellular mediated rejection. The currently available multiplexed, microbead assays utilizing solubilized HLA antigens afford the capability of sensitive detection and identification of HLA and non-HLA specific antibodies. These assays are being used to assess the relative strength of donor specific antibodies; to permit performance of virtual crossmatches which can reduce the waiting time to transplantation; to monitor antibody levels during desensitization; and for heart transplants to monitor antibodies post-transplant. For cell mediated immune responses, the recent development of gene expression profiling has allowed noninvasive monitoring of heart transplant recipients yielding predictive values for acute cellular rejection. T cell immune monitoring in heart and lung transplant recipients has allowed individual tailoring of immunosuppression, particularly to minimize risk of infection. While the current antibody and cellular laboratory techniques have enhanced the ability to manage thoracic organ transplant recipients, future developments from improved understanding of microchimerism and graft tolerance may allow more refined allograft monitoring techniques.

Lung transplantation in children. Specific aspects.

Science.gov (United States)

Moreno Galdó, Antonio; Solé Montserrat, Juan; Roman Broto, Antonio

2013-12-01

Lung transplantation has become in recent years a therapeutic option for infantswith terminal lung disease with similar results to transplantation in adults.In Spain, since 1996 114 children lung transplants have been performed; this corresponds to3.9% of the total transplant number.The most common indication in children is cystic fibrosis, which represents between 70-80% of the transplants performed in adolescents. In infants common indications areinterstitial lung disease and pulmonary hypertension.In most children a sequential double lung transplant is performed, generally with the help ofextracorporeal circulation. Lung transplantation in children presents special challenges in monitoring and follow-up, especially in infants, given the difficulty in assessing lung function and performing transbronchial biopsies.There are some more specific complications in children like postransplant lymphoproliferative syndrome or a greater severity of respiratory virus infections .After lung transplantation children usually experiment a very important improvement in their quality of life. Eighty eight per cent of children have no limitations in their activity after 3 years of transplantation.According to the registry of the International Society for Heart & Lung Transplantation (ISHLT) survival at 5 years of transplantation is 54% and at 10 years is around 35%. Copyright © 2013 SEPAR. Published by Elsevier Espana. All rights reserved.

Probable high prevalence of limb-girdle muscular dystrophy type 2D in Taiwan.

Science.gov (United States)

Liang, Wen-Chen; Chou, Po-Ching; Hung, Chia-Cheng; Su, Yi-Ning; Kan, Tsu-Min; Chen, Wan-Zi; Hayashi, Yukiko K; Nishino, Ichizo; Jong, Yuh-Jyh

2016-03-15

Limb-girdle muscular dystrophy type 2D (LGMD2D), an autosomal-recessive inherited LGMD, is caused by the mutations in SGCA. SGCA encodes alpha-sarcoglycan (SG) that forms a heterotetramer with other SGs in the sarcolemma, and comprises part of the dystrophin-glycoprotein complex. The frequency of LGMD2D is variable among different ethnic backgrounds, and so far only a few patients have been reported in Asia. We identified five patients with a novel homozygous mutation of c.101G>T (p.Arg34Leu) in SGCA from a big aboriginal family ethnically consisting of two tribes in Taiwan. Patient 3 is the maternal uncle of patients 1 and 2. All their parents, heterozygous for c.101G>T, denied consanguineous marriages although they were from the same tribe. The heterozygous parents of patients 4 and 5 were from two different tribes, originally residing in different geographic regions in Taiwan. Haplotype analysis showed that all five patients shared the same mutation-associated haplotype, indicating the probability of a founder effect and consanguinity. The results suggest that the carrier rate of c.101G>T in SGCA may be high in Taiwan, especially in the aboriginal population regardless of the tribes. It is important to investigate the prevalence of LGMD2D in Taiwan for early diagnosis and treatment. Copyright © 2016. Published by Elsevier B.V.

Cell transplantation for Parkinson's disease

Institute of Scientific and Technical Information of China (English)

Jia Liu; Hongyun Huang

2006-01-01

OBJECTIVE: The motor symptoms of Parkinson's disease (PD) can be improved by cell transplantation,which has caught general attention from the field of the therapy for PD recently. In this paper, we summarize the cell-based therapy for PD.DATA SOURCES: A search for English literature related to the cellular transplantation of PD from January 1979to July 2006 was conducted in Medline with the key words of "Parkinson's disease, cell transplantation,embryonic stem cells, neural stem cells".STUDY SELECTTON: Data were checked in the first trial, and literatures about PD and cell transplantation were selected. Inclusive criteria: ① PD; ② Cell transplantation. Exclusive criteria: repetitive researches.DATA EXTRACTTON: A total of 100 papers related to cellular transplant and PD were collected and 41literatures were in accordance with the inclusive criteria.DATA SYNTHESIS: PD is a neural degeneration disease that threatens the health of the aged people, and most traditional therapeusis cannot delay its pathological proceeding. Cell transplantation is becoming popular as a new therapeutic tool, and the cells used to transplant mainly included dopamine-secreting cells, fetal ventral mesencephalic cells, embryonic stem cells and neural stem cells up to now. Animal experiment and clinical test demonstrate that cell transplantation can relieve the motor symptoms of Parkinson's disease obviously, but there are some problems need to be solved.CONCLUSTON: Cell transplantation has visible therapeutic efficacy on PD. Following the improvement of technique, and we have enough cause to credit that cell therapy may cure PD in the future.

Intellectual and Academic Outcomes After Pediatric Liver Transplantation: Relationship with Transplant-Related Factors.

Science.gov (United States)

Afshar, Soheil; Porter, Melanie; Barton, Belinda; Stormon, Michael

2018-05-09

As survival rates for pediatric liver transplantation continue to increase, research attention is turning towards long-term functional consequences, with particular interest in whether medical and transplant-related factors are implicated in neurocognitive outcomes. The relative importance of different factors is unclear, due to a lack of methodological uniformity, inclusion of differing primary diagnoses, variable transplant policies, and organ availability in different jurisdictions. This cross-sectional, single-site study sought to address various methodological limitations in the literature and the paucity of studies conducted outside of North America and Western Europe by examining the intellectual and academic outcomes of Australian pediatric liver transplant recipients (N = 40). Participants displayed significantly poorer intellectual and mathematical abilities compared to the normative population. Greater time on the transplant waitlist was a significant predictor of poorer verbal intelligence, working memory, mathematical abilities and reading, but only when considering the subgroup of children with biliary atresia. These findings support reducing the time children wait for a transplant as a priority. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Customizing Fair Use Transplants

Directory of Open Access Journals (Sweden)

Peter K. Yu

2018-02-01

Full Text Available In the past decade, policymakers and commentators across the world have called for the introduction of copyright reform based on the fair use model in the United States. Thus far, Israel, Liberia, Malaysia, the Philippines, Singapore, South Korea, Sri Lanka and Taiwan have adopted the fair use regime or its close variants. Other jurisdictions such as Australia, Hong Kong and Ireland have also advanced proposals to facilitate such adoption. This article examines the increasing efforts to transplant fair use into the copyright system based on the U.S. model. It begins by briefly recapturing the strengths and weaknesses of legal transplants. The article then scrutinizes the ongoing effort to transplant fair use from the United States. Specifically, it identifies eight modalities of transplantation. This article concludes with five lessons that can be drawn from studying the ongoing transplant efforts.

Leonardo da Vinci and Andreas Vesalius; the shoulder girdle and the spine, a comparison.

Science.gov (United States)

Ganseman, Y; Broos, P

2008-01-01

Leonardo Da Vinci and Andreas Vesalius were two important renaissance persons; Vesalius was a surgeon-anatomist who delivered innovative work on the study of the human body, Leonardo da Vinci was an artist who delivered strikingly accurate and beautiful drawings on the human body. Below we compare both masters with regard to their knowledge of the working of the muscles, their method and system of dissection and their system and presentation of the drawings. The investigation consisted of a comparison between both anatomists, in particular concerning their study on the shoulder girdle and spine, by reviewing their original work as well as already existing literature on this subject. The investigation led to the conclusion that the drawings mentioned meant a change in history, and were of high quality, centuries ahead of their time. Both were anatomists, both were revolutionary, only one changed history at the moment itself, while the other changed history centuries later. Leonardo has made beautiful drawings that are at a match with the drawings of today or are even better. Vesalius set the start for medicine as a science as it is until this day. Their lives differed as strongly as their impact. In the light of their time, the achievement they made was extraordinary.

Islet transplantation using donors after cardiac death: report of the Japan Islet Transplantation Registry.

Science.gov (United States)

Saito, Takuro; Gotoh, Mitsukazu; Satomi, Susumu; Uemoto, Shinji; Kenmochi, Takashi; Itoh, Toshinori; Kuroda, Yoshikazu; Yasunami, Youichi; Matsumoto, Shnichi; Teraoka, Satoshi

2010-10-15

This report summarizes outcomes of islet transplantation employing donors after cardiac death (DCD) between 2004 and 2007 as reported to the Japan Islet Transplantation Registry. Sixty-five islet isolations were performed for 34 transplantations in 18 patients with insulin-dependent diabetes mellitus, including two patients who had prior kidney transplantation. All but one donor (64/65) was DCD at the time of harvesting. Factors influencing criteria for islet release included duration of low blood pressure of the donor, cold ischemic time, and usage of Kyoto solution for preservation. Multivariate analysis selected usage of Kyoto solution as most important. Of the 18 recipients, 8, 4, and 6 recipients received 1, 2, and 3 islet infusions, respectively. Overall graft survival defined as C-peptide level more than or equal to 0.3 ng/mL was 76.5%, 47.1%, and 33.6% at 1, 2, and 3 years, respectively, whereas corresponding graft survival after multiple transplantations was 100%, 80.0%, and 57.1%, respectively. All recipients remained free of severe hypoglycemia while three achieved insulin independence for 14, 79, and 215 days. HbA1c levels and requirement of exogenous insulin were significantly improved in all patients. Islet transplantation employing DCD can ameliorate severe hypoglycemic episodes, significantly improve HbA1c levels, sustain significant levels of C-peptide, and achieve insulin independence after multiple transplantations. Thus, DCD can be an important resource for islet transplantation if used under strict releasing criteria and in multiple transplantations, particularly in countries where heart-beating donors are not readily available.

Validation of the Dutch version of the transplant effects questionnaire in liver transplant recipients

NARCIS (Netherlands)

Annema, Coby; Roodbol, Petrie F.; Stewart, Roy E.; Ranchor, Adelita V.

Little is known about the extent to which transplant recipients face emotional problems with the receipt of a transplanted organ. The Transplant Effects Questionnaire (TxEQ) enables the quantification of these problems. This study evaluates the psychometric properties of the Dutch translation of the

About the Operation: Heart Transplant

Science.gov (United States)

... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

Organ Transplantation: Frequently Asked Questions

Science.gov (United States)

... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

Radionuclide evaluation of renal transplants

International Nuclear Information System (INIS)

Yang Hong; Zhao Deshan

2000-01-01

Radionuclide renal imaging and plasma clearance methods can quickly quantitate renal blood flow and function in renal transplants. They can diagnose acute tubular necrosis and rejection, renal scar, surgical complications such as urine leaks, obstruction and renal artery stenosis after renal transplants. At the same time they can assess the therapy effect of renal transplant complications and can also predict renal transplant survival from early post-operative function studies

Allogeneic and Autologous Bone-Marrow Transplantation

OpenAIRE

Deeg, H. Joachim

1988-01-01

The author of this paper presents an overview of the current status of bone marrow transplantation, including indications, pre-transplant considerations, the transplant procedure, acute and delayed transplant-related problems, results currently attainable, and a short discussion of possible future developments.

B4GALNT2 (GALGT2) Gene Therapy Reduces Skeletal Muscle Pathology in the FKRP P448L Mouse Model of Limb Girdle Muscular Dystrophy 2I.

Science.gov (United States)

Thomas, Paul J; Xu, Rui; Martin, Paul T

2016-09-01

Overexpression of B4GALNT2 (previously GALGT2) inhibits the development of muscle pathology in mouse models of Duchenne muscular dystrophy, congenital muscular dystrophy 1A, and limb girdle muscular dystrophy 2D. In these models, muscle GALGT2 overexpression induces the glycosylation of α dystroglycan with the cytotoxic T cell glycan and increases the overexpression of dystrophin and laminin α2 surrogates known to inhibit disease. Here, we show that GALGT2 gene therapy significantly reduces muscle pathology in FKRP P448Lneo(-) mice, a model for limb girdle muscular dystrophy 2I. rAAVrh74.MCK.GALGT2-treated FKRP P448Lneo(-) muscles showed reduced levels of centrally nucleated myofibers, reduced variance, increased size of myofiber diameters, reduced myofiber immunoglobulin G uptake, and reduced muscle wasting at 3 and 6 months after treatment. GALGT2 overexpression in FKRP P448Lneo(-) muscles did not cause substantial glycosylation of α dystroglycan with the cytotoxic T cell glycan or increased expression of dystrophin and laminin α2 surrogates in mature skeletal myofibers, but it increased the number of embryonic myosin-positive regenerating myofibers. These data demonstrate that GALGT2 overexpression can reduce the extent of muscle pathology in FKRP mutant muscles, but that it may do so via a mechanism that differs from its ability to induce surrogate gene expression. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Socioeconomic aspects of heart transplantation.

Science.gov (United States)

Evans, R W

1995-03-01

Heart transplantation is an established treatment modality for end-stage cardiac disease. Unfortunately, relative to other health care priorities, heart transplantation has fallen into disrepute. Efforts to reform the health care system have focused on three fundamental issues--cost, quality, and access. On each count, heart transplantation is vulnerable to criticism. Managed care is an incremental approach to health care reform that imposes fiscal constraint on providers. This constraint is expressed in the form of capitation which, in turn, requires providers to assume risk and accept economic responsibility for clinical decisions. While the need for transplantation is considerable, there are both clinical and economic factors limiting the overall level of activity. In 1993, over 2200 heart transplants were performed in the United States on people who were dying of end-stage cardiac disease. The total demand for heart transplantation was estimated to be about 5900 persons, which was not met due to an insufficient supply of donor hearts. Absent donors, the fiscal consequences of heart transplantation are minimized. In 1993, actuaries estimated that the total charge per heart transplant was $209,100. By designating centers based on price and quality considerations, managed care plans have reduced this per procedure expense to less than $100,000. While the benefits of transplantation are noteworthy, there are still concerns. Sixty percent of patients report that they are able to work, but only 30% do so. Employers hope to improve upon this record by expanding the designated center approach. In conclusion, the future of heart transplantation is unclear. Opportunities for innovation are limited, although the management of heart failure is an area of increased interest.

Bone-marrow transplant - series (image)

Science.gov (United States)

Bone-marrow transplants are performed for: deficiencies in red blood cells (aplastic anemia) and white blood cells (leukemia or ... Bone-marrow transplants prolong the life of patients who might otherwise die. As with all major organ transplants, however, ...

Sporotrichosis in Renal Transplant Patients

Directory of Open Access Journals (Sweden)

Paulo Gewehr

2013-01-01

Full Text Available The current report describes two renal transplant recipients who presented with sporotrichosis. In addition, the authors review the general aspects of sporotrichosis in renal transplant recipients reported in the literature. Sporotrichosis is a rare fungal infection in transplant patients and has been reported primarily in renal transplant recipients not treated with antifungal prophylaxis. Extracutaneous forms of sporotrichosis without skin manifestations and no previous history of traumatic injuries have been described in such patients and are difficult to diagnose. Renal transplant recipients with sporotrichosis described in the present report were successfully treated with antifungal therapy including amphotericin B deoxycholate, lipid amphotericin B formulations, fluconazole and itraconazole.

Imaging in transplantation

International Nuclear Information System (INIS)

Bankier, A.A.

2008-01-01

This book covers all topics related to the imaging of organ transplantation. An introductory section addresses such issues as organ procurement, patient selection, immune responses, and ethical and economic considerations. The main part of the book then offers in-depth coverage of heart, renal, liver, lung, bone marrow and pancreatic and intestinal transplantation. Each of these topics is discussed firstly in a clinical chapter and then in a radiological chapter. The clinical chapters detail the epidemiology, clinical background, and surgical procedures, as well as any clinically relevant issues of which the radiologist should be aware. The radiological chapters describe and depict the imaging manifestations of specific organ transplantations, document the normal radiological appearance of transplanted organs and consider both early and late complications. This is a unique, superbly illustrated volume that will be of great assistance to all who work in this field. (orig.)

Multimodality postoperative imaging of liver transplantation

International Nuclear Information System (INIS)

Zamboni, Giulia A.; Pedrosa, Ivan; Kruskal, Jonathan B.; Raptopoulos, Vassilios

2008-01-01

Liver transplantation is the only effective and definitive treatment for patients with end-stage liver disease. The shortage of cadaveric livers has lead to the increasing use of split-liver transplantation and living-donor liver transplantation, but the expansion of the donor pool has increased the risk for postoperative vascular and biliary complications. Early recognition of the imaging appearances of the various postoperative complications of liver transplantation is crucial for both graft and patient survival. This review describes the imaging findings of normal and abnormal transplanted liver parenchyma and of vascular and biliary post-transplantation complications. (orig.)

How Should Social Media Be Used in Transplantation? A Survey of The American Society of Transplant Surgeons.

Science.gov (United States)

Henderson, Macey L; Adler, Joel T; Van Pilsum Rasmussen, Sarah E; Thomas, Alvin G; Herron, Patrick D; Waldram, Madeleine M; Ruck, Jessica M; Purnell, Tanjala S; DiBrito, Sandra R; Holscher, Courtenay M; Haugen, Christine E; Alimi, Yewande; Konel, Jonathan M; Eno, Ann K; Garonzik Wang, Jacqueline M; Gordon, Elisa J; Lentine, Krista L; Schaffer, Randolph L; Cameron, Andrew M; Segev, Dorry L

2018-04-21

Social media platforms are increasingly used in surgery and have shown promise as effective tools to promote deceased donation and expand living donor transplantation. There is growing need to understand how social media-driven communication is perceived by providers in the field of transplantation. We surveyed 299 members of the American Society of Transplant Surgeons (ASTS) about their use of, attitudes toward, and perceptions of social media and analyzed relationships between responses and participant characteristics. Respondents used social media to communicate with: family and friends (76%), surgeons (59%), transplant professionals (57%), transplant recipients (21%), living donors (16%), and waitlisted candidates (15%). Most respondents (83%) reported using social media for at least one purpose. While most (61%) supported sharing information with transplant recipients via social media, 42% believed it should not be used to facilitate living donor-recipient matching. Younger age (p=0.02) and fewer years of experience in the field of transplantation (p=0.03) were associated with stronger belief that social media can be influential in living organ donation. Respondents at transplant centers with higher reported use of social media had more favorable views about sharing information with transplant recipients (psocial media. Transplant center involvement and support for social media may influence clinician perceptions and practices. Increasing use of social media among transplant professionals may provide an opportunity to deliver high quality information to patients.

In Utero Hepatocellular Transplantation in Rats

Directory of Open Access Journals (Sweden)

Emma Muñoz-Sáez

2013-01-01

Full Text Available This work represents a step forward in the experimental design of an in utero hepatocellular transplantation model in rats. We focused on the enrichment optimization of isolated fetal hepatocytes suspension, arranging the surgery methodology of in utero transplantation, monitoring the biodistribution of the transplanted hepatocytes, and assessing the success of the transplants. Rat fetuses have been transplanted at the 17th embryonic day (ED17 with fetal hepatocytes isolated from rats at the end of pregnancy (ED21. We assessed possible differences between lymphocyte population, CD4 positive, CD8 positive, double-positive T-cells, and anti-inflammatory cytokines interleukins 4 and 10 (IL4 and IL10 as well. Cellular viability reached the rates of 90–95%. Transplanted groups had a limited success. Transplanted hepatocytes were not able to pass through the hematoplacental barrier. The hepatocytes injected were primarily located in the liver. There was an upward trend in the whole amount of T CD4 and T CD8 cells. There was an increased IL4 in the transplanted groups observed in the pregnant rats. The possibility to induce tolerance in fetuses with a hepatocyte transplant in utero could be a key point to avoid the immunosuppression treatments which must be undergone by transplanted patients.

Motion Transplantation Techniques: A Survey

NARCIS (Netherlands)

van Basten, Ben; Egges, Arjan

2012-01-01

During the past decade, researchers have developed several techniques for transplanting motions. These techniques transplant a partial auxiliary motion, possibly defined for a small set of degrees of freedom, on a base motion. Motion transplantation improves motion databases' expressiveness and

Psychological rejection of the transplanted organ and graft dysfunction in kidney transplant patients

Directory of Open Access Journals (Sweden)

Látos M

2016-06-01

Full Text Available Melinda Látos,1 György Lázár,1 Zoltán Horváth,1 Victoria Wittmann,1 Edit Szederkényi,1 Zoltán Hódi,1 Pál Szenohradszky,1 Márta Csabai2 1Department of Surgery, Faculty of Medicine, 2Psychology Institute, University of Szeged, Szeged, Hungary Abstract: Interdisciplinary studies suggest that the mental representations of the transplanted organ may have a significant effect on the healing process. The objective of this study was to examine the representations of the transplanted organ and their relationship with emotional and mood factors, illness perceptions, and the functioning of the transplanted organ. One hundred and sixty-four kidney transplant patients were assessed using the Spielberger Anxiety Inventory, the Beck’s Depression Scale, the Posttraumatic Growth Inventory, the Brief Illness Perception Questionnaire, and the Transplanted Organ Questionnaire. Medical parameters were collected from the routine clinical blood tests (serum creatinine and estimated glomerular filtration rate levels and biopsy results. Our most outstanding results suggest that kidney-transplanted patients’ illness representations are associated with health outcomes. The Transplanted Organ Questionnaire “psychological rejection” subscale was connected with higher serum creatinine and estimated glomerular filtration rate levels. Logistic regression analysis showed that psychological rejection subscale, Brief Illness Perception Questionnaire, and Posttraumatic Growth Questionnaire total scores were associated with graft rejection. These results may serve as a basis for the development of complex treatment interventions, which could help patients to cope with the bio-psycho-social challenges of integrating the new organ as part of their body and self. Keywords: anxiety, depression, illness representations, posttraumatic growth, psychological rejection, renal transplantation

DNA-methylation profiling of fetal tissues reveals marked epigenetic differences between chorionic and amniotic samples.

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Christel Eckmann-Scholz

Full Text Available Epigenetic mechanisms including DNA methylation are supposed to play a key role in fetal development. Here we have investigated fetal DNA-methylation levels of 27,578 CpG loci in 47 chorionic villi (CVS and 16 amniotic cell (AC samples. Methylation levels differed significantly between karyotypically normal AC and CVS for 2,014 genes. AC showed more extreme DNA-methylation levels of these genes than CVS and the differentially methylated genes are significantly enriched for processes characteristic for the different cell types sampled. Furthermore, we identified 404 genes differentially methylated in CVS with trisomy 21. These genes were significantly enriched for high CG dinucleotid (CpG content and developmental processes associated with Down syndrome. Our study points to major tissue-specific differences of fetal DNA-methylation and gives rise to the hypothesis that part of the Down syndrome phenotype is epigenetically programmed in the first trimester of pregnancy.

Soluble CD30 levels in recipients undergoing heart transplantation do not predict post-transplant outcome.

Science.gov (United States)

Ypsilantis, Efthymios; Key, Timothy; Bradley, J Andrew; Morgan, C Helen; Tsui, Stephen; Parameshwar, Jayan; Taylor, Craig J

2009-11-01

The pre-transplant serum level of soluble CD30 (sCD30), a proteolytic derivative of the lymphocyte surface receptor CD30, has been suggested as a biomarker for immunologic risk after organ transplantation. Pre-transplant serum sCD30 levels were determined in 200 consecutive adult heart transplant recipients undertaken at a single center. Transplant outcome (acute rejection in the first 12 months and patient survival up to 5 years post-transplant) was determined. Patients treated with a left ventricular assist device (LVAD) prior to transplantation (n = 28) had higher levels of sCD30 (median 64 U/ml, range 12 to 112 U/ml) than those (n = 172) with no LVAD (median 36 U/ml, range 1 to 158 U/ml, p sCD30 levels were "low" (lower quartile, 58 U/ml, n = 50). Neither acute rejection nor recipient survival differed according to sCD30 level, with values (mean +/- SEM) of 0.30 +/- 0.04, 0.23 +/- 0.03 and 0.30 +/- 0.05 acute rejection episodes per 100 days in the low, intermediate and high groups, respectively, with recipient survival rates at 1 year of 77.7%, 84.9% and 86% and at 5 years of 73.6%, 67.9% and 75.8%, respectively. Pre-transplant serum sCD30 level does not predict acute allograft rejection or recipient survival after heart transplantation, although sCD30 levels are increased by LVAD, possibly as a result of biomaterial-host immune interaction.

Risk factors of post renal transplant hyperparathyroidism

International Nuclear Information System (INIS)

Jahromi, Alireza Hamidian; Roozbeh, Jamshid; Raiss-Jalali, Ghanbar Ali; Dabaghmanesh, Alireza; Jalaeian, Hamed; Bahador, Ali; Nikeghbalian, Saman; Salehipour, Mehdi; Salahi, Heshmat; Malek-Hosseini, Ali

2009-01-01

It is well recognized that patients with end stage renal diseases (ESRD) have hyper-plastic parathyroid glands. In most patients, a decrease in parathyroid hormone (PTH) occurs by about 1 year after renal transplantation. However, some renal transplant recipients continue to have elevated level of PTH. We prospectively evaluated 121 patients undergoing renal transplantation between August 2000 and 2002. The duration of dialysis, calcium (Ca), phosphorus (P), albumin, creatinine and iPTH levels were recorded prior to transplantation and three months and one year after transplantation. These 121 patients were on dialysis for an average period of 17.4 months prior to transplantation. An increase in the serum Ca and a decrease in serum P and iPTH level was seen in the patients after transplantation (P< 0.001). Hyperparathyroidism was in 12 (9.9%) and 7 (5.7%) patients three months and one year after transplantation respectively. Elderly patients and patients with longer duration on dialysis had an increased risk of developing post transplant hyperparathyroidism and hypercalcemia in the first year post transplant (P< 0.05). In conclusion age and duration on dialysis before transplantation seems to be important risk factors for post transplant hyperparathyroidism. (author)

Gaming the Liver Transplant Market

OpenAIRE

Jason Snyder

2010-01-01

The liver transplant waiting list is designed to allocate livers to the sickest patients first. Before March 1, 2002, livers were allocated to patients based on objective clinical indicators and subjective factors. In particular, a center placing a prospective transplant recipient in the intensive care unit (ICU) leads to a higher position on the liver transplant waiting list. After March 1, 2002, a policy reform mandated that priority on the liver transplant waiting list no longer be influen...

[Laparoscopic cholecystectomy in transplant patients].

Science.gov (United States)

Coelho, Júlio Cezar Uili; Contieri, Fabiana L C; de Freitas, Alexandre Coutinho Teixeira; da Silva, Fernanda Cristina; Kozak, Vanessa Nascimento; da Silva Junior, Alzemir Santos

2010-02-01

This study reviews our experience with laparoscopic cholecystectomy in the treatment of cholelithiasis in transplant patients. Demographic data, medications used, and operative and postoperative data of all transplant recipients who were subjected to laparoscopic cholecystectomy for cholelithiasis at our hospital were obtained. A total of 15 transplant patients (13 renal transplantation and 2 bone marrow transplantation) underwent laparoscopic cholecystectomy. All patients were admitted to the hospital on the day of the operation. The immunosuppressive regimen was not modified during hospitalization. Clinical presentation of cholelithiasis was biliary colicky (n=12), acute cholecystitis (n=2), and jaundice (n=1). The operation was uneventful in all patients. Postoperative complications were nausea and vomiting in 2 patients, prolonged tracheal intubation in 1, wound infection in 1 and large superficial hematoma in 1 patient. Laparoscopic cholecystectomy is associated to a low morbidity and mortality and good postoperative outcome in transplant patients with uncomplicated cholecystitis.

Predicting Alloreactivity in Transplantation

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Kirsten Geneugelijk

2014-01-01

Full Text Available Human leukocyte Antigen (HLA mismatching leads to severe complications after solid-organ transplantation and hematopoietic stem-cell transplantation. The alloreactive responses underlying the posttransplantation complications include both direct recognition of allogeneic HLA by HLA-specific alloantibodies and T cells and indirect T-cell recognition. However, the immunogenicity of HLA mismatches is highly variable; some HLA mismatches lead to severe clinical B-cell- and T-cell-mediated alloreactivity, whereas others are well tolerated. Definition of the permissibility of HLA mismatches prior to transplantation allows selection of donor-recipient combinations that will have a reduced chance to develop deleterious host-versus-graft responses after solid-organ transplantation and graft-versus-host responses after hematopoietic stem-cell transplantation. Therefore, several methods have been developed to predict permissible HLA-mismatch combinations. In this review we aim to give a comprehensive overview about the current knowledge regarding HLA-directed alloreactivity and several developed in vitro and in silico tools that aim to predict direct and indirect alloreactivity.

Does hypertension remain after kidney transplantation?

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Gholamreza Pourmand

2015-05-01

Full Text Available Hypertension is a common complication of kidney transplantation with the prevalence of 80%. Studies in adults have shown a high prevalence of hypertension (HTN in the first three months of transplantation while this rate is reduced to 50- 60% at the end of the first year. HTN remains as a major risk factor for cardiovascular diseases, lower graft survival rates and poor function of transplanted kidney in adults and children. In this retrospective study, medical records of 400 kidney transplantation patients of Sina Hospital were evaluated. Patients were followed monthly for the 1st year, every two months in the 2nd year and every three months after that. In this study 244 (61% patients were male. Mean ± SD age of recipients was 39.3 ± 13.8 years. In most patients (40.8% the cause of end-stage renal disease (ESRD was unknown followed by HTN (26.3%. A total of 166 (41.5% patients had been hypertensive before transplantation and 234 (58.5% had normal blood pressure. Among these 234 individuals, 94 (40.2% developed post-transplantation HTN. On the other hand, among 166 pre-transplant hypertensive patients, 86 patients (56.8% remained hypertensive after transplantation. Totally 180 (45% patients had post-transplantation HTN and 220 patients (55% didn't develop HTN. Based on the findings, the incidence of post-transplantation hypertension is high, and kidney transplantation does not lead to remission of hypertension. On the other hand, hypertension is one of the main causes of ESRD. Thus, early screening of hypertension can prevent kidney damage and reduce further problems in renal transplant recipients.

Influenza in solid organ transplant recipients.

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Martin, Spencer T; Torabi, Mina J; Gabardi, Steven

2012-02-01

To review available data describing the epidemiology, outcomes, prevention, and treatment of influenza virus in the solid organ transplant population and to evaluate the strengths and limitations of the current literature, with a focus on literature reviewing annual influenza strains and the recent pandemic novel influenza A/H1N1 strain. A systematic literature search (July 1980-June 2011) was performed via PubMed using the following key words: influenza, human; influenza; novel influenza A H1/N1; transplantation; solid organ transplantation; kidney transplant; renal transplant; lung transplant; heart transplant; and liver transplant. Papers were excluded if they were not written in English or were animal studies or in vitro studies. Data from fully published studies and recent reports from international conferences were included. The influenza virus presents a constant challenge to immunocompromised patients and their health care providers. The annual influenza strain introduces a highly infectious and pathogenic risk to solid organ transplant recipients. In 2009, the World Health Organization declared a pandemic as a result of a novel influenza A/H1N1 strain. The pandemic introduced an additional viral threat to solid organ transplant patients at increased risk for infectious complications. The mainstay for prevention of influenza infection in all at-risk populations is appropriate vaccination. Antiviral therapies against influenza for chemoprophylaxis and treatment of infection are available; however, dosing strategies in the solid organ transplant population are not well defined. The solid organ transplant population is at an increased risk of severe complications from influenza infection. Identifying risks, preventing illness, and appropriately treating active infection is essential in this patient population.

Attitude and Impact Factors Toward Organ Transplantation and Donation Among Transplantation Nurses in China.

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Xie, J-F; Wang, C-Y; He, G-P; Ming, Y-Z; Wan, Q-Q; Liu, J; Gong, L-N; Liu, L-F

Health workers' awareness and knowledge of transplantation medicine can improve people's sensitivity and reduce their degree of opposition to donations. The medical literature contains numerous examples of attitudes toward organ transplantation and donation aimed at university students or medical staff members, but rarely for transplantation nurses. The purposes of the study were to investigate the attitudes toward organ transplantation and donation among transplantation nurses and to explore the impact factors. The study was conducted in 37 transplantation surgery wards in 22 hospitals using cross-sectional approach. SPSS (International Business Machines Corporation, Armonk, New York, USA) 7.0 software was used to analysis descriptive and inferential statistics for data. Five hundred thirty-six effective questionnaires were received and the effective rate was 89.33%. Nurses' mean age was 28.40 years with a mean service length of 6.54 years. Among these nurses, 66.6% and 78.0% were willing to accept organ transplantation surgery for themselves and their relatives, respectively. Of these nurses, 33.4% would donate their organs after death; whereas 39.9% were uncertain. Only 38.2% were willing to register in the national organ donation system. Of these nurses, 28.2% were willing to sign the organ donation consent forms when their relatives became potential organ donors, and 45.7% were uncertain. Eight independent variables that affected nurses' attitudes toward donating their organs from most to least significant were: ratio of nurse to bed, title, employment form, age, length of service, position, monthly income, and the highest educational degree earned. Pearson correlation analysis showed a significant correlation among nurses' attitudes toward organ transplantation, organ donation, and online registration. The attitude toward donation and transplantation in the hospitals was not too optimistic, and an improvement in the training regarding transplantation and

Liver transplantation for nontransplant physicians

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Amany AbdelMaqsod Sholkamy

2014-01-01

Full Text Available Many of the nontransplant physicians who manage hepatic patients (internists and hepatologists keep asking about liver transplantation. The purpose of this article is to highlight important topics a nontransplant colleague may require in his practice. There are many topics in this respect; however, three most important topics need to be highlighted; those are; the time of referral to transplantation, the indications and contraindications and the metabolic issues regarding a transplanted patient. Still, there are no clear guidelines for the management of many of the metabolic issues regarding liver transplanted patients. And this why, collaborative efforts of transplant and nontransplant physicians are needed to conduct multicenter, long term randomized controlled trials and proper follow up programs.

Nanoparticle delivery of donor antigens for transplant tolerance in allogeneic islet transplantation.

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Bryant, Jane; Hlavaty, Kelan A; Zhang, Xiaomin; Yap, Woon-Teck; Zhang, Lei; Shea, Lonnie D; Luo, Xunrong

2014-10-01

Human islet cell transplantation is a promising treatment for type 1 diabetes; however, long-term donor-specific tolerance to islet allografts remains a clinically unmet goal. We have previously shown that recipient infusions of apoptotic donor splenocytes chemically treated with 1-ethyl-3-(3'-dimethylaminopropyl)-carbodiimide (donor ECDI-SP) can mediate long-term acceptance of full major histocompatibility complex (MHC)-mismatched murine islet allografts without the use of immunosuppression. In this report, we investigated the use of poly(lactide-co-glycolide) (PLG) particles in lieu of donor ECDI-SP as a synthetic, cell-free carrier for delivery of donor antigens for the induction of transplant tolerance in full MHC-mismatched murine allogeneic islet transplantation. Infusions of donor antigen-coupled PLG particles (PLG-dAg) mediated tolerance in ∼20% of recipient mice, and the distribution of cellular uptake of PLG-dAg within the spleen was similar to that of donor ECDI-SP. PLG-dAg mediated the contraction of indirectly activated T cells but did not modulate the direct pathway of allorecognition. Combination of PLG-dAg with a short course of low dose immunosuppressant rapamycin at the time of transplant significantly improved the tolerance efficacy to ∼60%. Furthermore, altering the timing of PLG-dAg administration to a schedule that is more feasible for clinical transplantation resulted in equal tolerance efficacy. Thus, the combination therapy of PLG-dAg infusions with peritransplant rapamycin represents a clinically attractive, biomaterials-based and cell-free method for inducing long-term donor-specific tolerance for allogeneic cell transplantation, such as for allogeneic islet transplantation. Copyright © 2014 Elsevier Ltd. All rights reserved.

Terapia nutricional no transplante hepático Nutritional therapy in liver transplantation

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Mônica Beatriz PAROLIN

2002-04-01

Full Text Available Racional - Deficiências nutricionais, por vezes graves, são comuns em pacientes com insuficiência hepática, candidatos a transplante de fígado. A terapia nutricional pode corrigir total ou parcialmente tais deficiências, melhorando as condições clínicas e o prognóstico desses indivíduos, frente ao grande desafio do transplante hepático. Objetivos - Breve revisão do papel do fígado no metabolismo dos diversos nutrientes. Descrição dos métodos de avaliação do estado nutricional, traçando-se as bases da terapia nutricional segundo condições hepáticas diversas, no pré e pós-transplante, em relação às necessidades calóricas e dos diversos nutrientes. Apresentação de intervenções nutricionais, no controle das complicações metabólicas resultantes do uso de drogas imunossupressoras. Conclusão - A terapia nutricional é valiosa aliada no tratamento clínico de pacientes candidatos ou já submetidos ao transplante hepático, contribuindo para um prognóstico favorável e para a melhora da qualidade de vida desses indivíduos.Background - Malnutrition, sometimes severe is common in patients with chronic hepatic diseases who are candidates for liver transplantation. Nutritional therapy can induce partial or total correction of such deficiencies, improving clinical conditions and prognosis of patients who face the great defiance of liver transplantation. Aims - Brief revision of hepatic role in the metabolism of several nutrients. Description of available methods of dietary therapy and its application both under different abnormal hepatic conditions and pre and post-transplant periods. The role of nutritional intervention in metabolic side effects due to immunosuppressive drugs. Conclusion - Nutritional therapy is a valuable adjuvant resource to the clinical treatment of candidates and submitted patients to hepatic transplantation providing better prognosis and improved life quality.

MR Imaging of renal transplants

International Nuclear Information System (INIS)

Gremo, L.; Avataneo, T.; Potenzoni, F.; Colla, L.; Segoloni, G.

1988-01-01

The authors report their experience in the study of renal transplant recipients by MR, in order to determine its clinical potentials. The main purpose of this work is to focus on MR patterns in relation to clinical findings of rejector or normally fuctioning kidney. Twenty-four patients were examined with a 0.5 T superconductive magnete, body coil, spin-echo pulse sequence (SE) and inversion-recovery (IR). MRI patterns could be seen in normally functioning kidneys and transplant rejections, while variable MRI findings were observed in transplants with acute tubular necrosis (ATN). In the normally functioning transplanted kidney there is a clear corticomedullary differentiation (CMD), and the extent of vascular penetration into the renal parenchyma is clearly seen. In transplant rejection, CMD is either diminished or absent, and there is no vascular penetration into the parenchyma; to differentiate acute from chronic rejections, the increase/decrease in renal size and the change in renal shape (spherical shape in acute transplant rejection) respectively must be observed. MRI proves thus to be useful in the study of renal transplants, even in case of questionable clinical findings, and in patients in whom renal biopsy is contraindicated

Spironolactone ameliorates transplant vasculopathy in renal chronic transplant dysfunction in rats

NARCIS (Netherlands)

Waanders, Femke; Rienstra, Heleen; Boer, Mark Walther; Zandvoort, Andre; Rozing, Jan; Navis, Gerjan; van Goor, Harry; Hillebrands, Jan-Luuk

Waanders F, Rienstra H, Walther Boer M, Zandvoort A, Rozing J, Navis G, van Goor H, Hillebrands JL. Spironolactone ameliorates transplant vasculopathy in renal chronic transplant dysfunction in rats. Am J Physiol Renal Physiol 296: F1072-F1079, 2009. First published February 25, 2009;

Outcomes of Technical Variant Liver Transplantation versus Whole Liver Transplantation for Pediatric Patients: A Meta-Analysis.

Science.gov (United States)

Ye, Hui; Zhao, Qiang; Wang, Yufang; Wang, Dongping; Zheng, Zhouying; Schroder, Paul Michael; Lu, Yao; Kong, Yuan; Liang, Wenhua; Shang, Yushu; Guo, Zhiyong; He, Xiaoshun

2015-01-01

To overcome the shortage of appropriate-sized whole liver grafts for children, technical variant liver transplantation has been practiced for decades. We perform a meta-analysis to compare the survival rates and incidence of surgical complications between pediatric whole liver transplantation and technical variant liver transplantation. To identify relevant studies up to January 2014, we searched PubMed/Medline, Embase, and Cochrane library databases. The primary outcomes measured were patient and graft survival rates, and the secondary outcomes were the incidence of surgical complications. The outcomes were pooled using a fixed-effects model or random-effects model. The one-year, three-year, five-year patient survival rates and one-year, three-year graft survival rates were significantly higher in whole liver transplantation than technical variant liver transplantation (OR = 1.62, 1.90, 1.65, 1.78, and 1.62, respectively, ptechnical variant liver transplantation. Continuing efforts should be made to minimize surgical complications to improve the outcomes of technical variant liver transplantation.

Protein Turnover and Cellular Stress in Mildly and Severely Affected Muscles from Patients with Limb Girdle Muscular Dystrophy Type 2I

DEFF Research Database (Denmark)

Hauerslev, Simon; Sveen, Marie-Louise; Vissing, John

2013-01-01

Patients with Limb girdle muscular dystrophy type 2I (LGMD2I) are characterized by progressive muscle weakness and wasting primarily in the proximal muscles, while distal muscles often are spared. Our aim was to investigate if wasting could be caused by impaired regeneration in the proximal...... by using the developmental markers embryonic myosin heavy chain (eMHC) and neural cell adhesion molecule (NCAM) and also assessing satellite cell activation status by myogenin positivity. Severe muscle histopathology was occasionally observed in the proximal muscles of patients with LGMD2I whereas distal...... highly increased in severely affected muscles compared to mildly affected muscles. Our results indicate that alterations in the protein turnover and myostatin levels could progressively impair the muscle mass maintenance and/or regeneration resulting in gradual muscular atrophy....

The Swiss Transplant Cohort Study's framework for assessing lifelong psychosocial factors in solid-organ transplants.

Science.gov (United States)

De Geest, Sabina; Burkhalter, Hanna; Berben, Lut; Bogert, Laura Jane; Denhaerynck, Kris; Glass, Tracy R; Goetzmann, Lutz; Kirsch, Monika; Kiss, Alexander; Koller, Michael T; Piot-Ziegler, Chantal; Schmidt-Trucksäss, Arno

2013-09-01

Understanding outcomes after transplant requires a biopsychosocial model that includes biomedical and psychosocial factors. The latter, to date, are assessed only in a limited way as part of transplant registries or cohort studies. The Swiss Transplant Cohort Study (STCS) is a nationwide open cohort study (starting May 2008) to systematically and prospectively assess psychosocial factors. This article describes the framework underpinning STCS's psychosocial assessment. The STCS framework was adapted from the multidimensional conceptual perspective of Dew et al to describe transplant psychosocial domains and specific outcomes by adding a time perspective, a system perspective, and interaction among domains. We propose a multidimensional, multilevel biopsychosocial framework representing mutually influencing domains from before to after transplant, and exemplify each domain by factors included in STCS and their measurement. The transplant patient, centrally positioned, is described by clinical and sociodemographic characteristics (eg, socioeconomic status, educational, professional, and relationship status). The following psychosocial domains further describe the patient: (1) physical/functional (eg, perceived health status, sleep quality, daytime sleepiness), (2) psychological (eg, depression, stress), (3) behavioral (eg, medication adherence, smoking, drug use, physical activity, sun protection), (4) social (eg, work capacity/return to work), and (5) global quality of life. Factors associated with health care system level (eg, trust in transplant team) are also included in the model. The STCS's psychosocial framework provides a basis for studying the interplay of biomedical, sociodemographic, psychosocial, behavioral, and health care system factors in view of transplant outcomes and therefore has the potential to guide biopsychosocial transplant research.

[History of kidney transplantation surgery].

Science.gov (United States)

Timsit, M O; Kleinclauss, F; Thuret, R

2016-11-01

To perform a state of the art about the history of kidney transplantation. An exhaustive systematic review of the scientific literature was performed in the Medline database (http://www.ncbi.nlm.nih.gov) and Embase (http://www.embase.com) using different associations of the following keywords (MESH): kidney transplantation, history, vascular anastomosis. From the first vascular ligations to the discovery of ciclosporin, the history of organ transplantation was made of surgical bets and medical discoveries, such as blood group, HLA-system, immunity, etc. The audacity of some surgeons led to the onset of renal transplantation as the treatment of choice for end stage renal disease. This article aims to describe the first surgical methods for vascular anastomosis and renal transplantation. Through a comprehensive search within the archives of the French National Library, the authors provide a precise description of the first renal transplantations performed, the technique that have been used and their authors. Copyright © 2016. Published by Elsevier Masson SAS.

Association Between GLCCI1 Promoter Polymorphism (Rs37972 and Post-Transplant Hypertension in Renal Transplant Recipients

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Aki Mafune Hamada

2017-12-01

Full Text Available Background/Aims: Post-transplant hypertension is highly prevalent in renal transplant recipients and is a risk factor for graft loss, cardiovascular disease and death. Glucocorticoid is used to prevent rejection, but simultaneously increases the risk of post-transplant hypertension. The glucocorticoid-induced transcript 1 (GLCCI1 promoter polymorphism (rs37972 has been reported to be associated with response to glucocorticoid therapy in asthma. We therefore examined the association between GLCCI1 promoter polymorphism and post-transplant hypertension in renal transplant recipients. Methods: We conducted a retrospective cohort study of renal transplantation at a single university hospital from October 2003 to January 2014. Fifty consecutive adult recipients were analyzed, with clinical data retrieved from a prospectively collected database. Genotyping was carried out using genomic DNA derived from recipient’s blood. GLCCI1 immunoreactivity in vascular endothelial cells was quantitatively analyzed by immunohistochemical staining of recipients’ native kidney biopsy-specimens. The primary outcome measure was post-transplant hypertension. Results: Post-transplant hypertension was observed in 14/17 (82% of recipients with CC, 18/20 (90% with CT, and 2/13 (15% with TT genotype. CC/CT genotype was significantly associated with post-transplant hypertension, even after adjustment for covariates (odds ratio, 10.6; 95% confidence intervals, 1.32 to 85.8; P = 0.026. In addition, we observed that GLCCI1 immunoreactivity in arteriolar endothelial cells was higher in kidney specimens obtained from recipients with a CC/CT genotype than a TT genotype (P = 0.021. Conclusion: GLCCI1 promoter polymorphism rs37972 may be associated with post-transplant hypertension.

Post-transplant outcomes in pediatric ventricular assist device patients: A PediMACS-Pediatric Heart Transplant Study linkage analysis.

Science.gov (United States)

Sutcliffe, David L; Pruitt, Elizabeth; Cantor, Ryan S; Godown, Justin; Lane, John; Turrentine, Mark W; Law, Sabrina P; Lantz, Jodie L; Kirklin, James K; Bernstein, Daniel; Blume, Elizabeth D

2017-12-13

Pediatric ventricular assist device (VAD) support as bridge to transplant has improved waitlist survival, but the effects of pre-implant status and VAD-related events on post-transplant outcomes have not been assessed. This study is a linkage analysis between the PediMACS and Pediatric Heart Transplant Study databases to determine the effects of VAD course on post-transplant outcomes. Database linkage between October 1, 2012 and December 31, 2015 identified 147 transplanted VAD patients, the primary study group. The comparison cohort was composed of 630 PHTS patients without pre-transplant VAD support. The primary outcome was post-transplant survival, with secondary outcomes of post-transplant length of stay, freedom from infection and freedom from rejection. At implant, the VAD cohort was INTERMACS Profile 1 in 33 (23%), Profile 2 in 89 (63%) and Profile 3 in 14 (10%) patients. The VAD cohort was older, larger, and less likely to have congenital heart disease (p < 0.0001). However, they had greater requirements for inotrope and ventilator support and increased liver and renal dysfunction (p < 0.0001), both of which normalized at transplant after device support. Importantly, there were no differences in 1-year post-transplant survival (96% vs 93%, p = 0.3), freedom from infection (81% vs 79%, p = 0.9) or freedom from rejection (71% vs 74%, p = 0.87) between cohorts. Pediatric VAD patients have post-transplant outcomes equal to that of medically supported patients, despite greater pre-implant illness severity. Post-transplant survival, hospital length of stay, infection and rejection were not affected by patient acuity at VAD implantation or VAD-related complications. Therefore, VAD as bridge to transplant mitigates severity of illness in children. Copyright © 2017 International Society for the Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Glucocorticoid Steroid and Alendronate Treatment Alleviates Dystrophic Phenotype with Enhanced Functional Glycosylation of α-Dystroglycan in Mouse Model of Limb-Girdle Muscular Dystrophy with FKRPP448L Mutation.

Science.gov (United States)

Wu, Bo; Shah, Sapana N; Lu, Peijuan; Richardson, Stephanie M; Bollinger, Lauren E; Blaeser, Anthony; Madden, Kyle L; Sun, Yubo; Luckie, Taylor M; Cox, Michael D; Sparks, Susan; Harper, Amy D; Lu, Qi Long

2016-06-01

Fukutin-related protein-muscular dystrophy is characterized by defects in glycosylation of α-dystroglycan with variable clinical phenotypes, most commonly as limb-girdle muscular dystrophy 2I. There is no effective therapy available. Glucocorticoid steroids have become the standard treatment for Duchenne and other muscular dystrophies with serious adverse effects, including excessive weight gain, immune suppression, and bone loss. Bisphosphonates have been used to treat Duchenne muscular dystrophy for prevention of osteoporosis. Herein, we evaluated prednisolone and alendronate for their therapeutic potential in the FKRPP448L-mutant mouse representing moderate limb-girdle muscular dystrophy 2I. Mice were treated with prednisolone, alendronate, and both in combination for up to 6 months. Prednisolone improved muscle pathology with significant reduction in muscle degeneration, but had no effect on serum creatine kinase levels and muscle strength. Alendronate treatment did not ameliorate muscle degeneration, but demonstrated a limited enhancement on muscle function test. Combined treatment of prednisolone and alendronate provided best improvement in muscle pathology with normalized fiber size distribution and significantly reduced serum creatine kinase levels, but had limited effect on muscle force generation. The use of alendronate significantly mitigated the bone loss. Prednisolone alone and in combination with alendronate enhance functionally glycosylated α-dystroglycan. These results, for the first time, demonstrate the efficacy and feasibility of this alliance treatment of the two drugs for fukutin-related protein-muscular dystrophy. Copyright © 2016 American Society for Investigative Pathology. Published by Elsevier Inc. All rights reserved.

Long-term effects of islet transplantation.

Science.gov (United States)

Holmes-Walker, D Jane; Kay, Thomas W H

2016-10-01

Islet transplantation has made great progress in recent years. This is a remarkable technical feat but raises the question of what the long-term benefits and risks are for type I diabetes recipients. Graft survival continues to improve, and recent multicenter studies show that islet transplantation is particularly effective to prevent hypoglycemic events even in those who do not become insulin-independent and to achieve excellent glycemic control. Concerns include histocompatability leucocyte antigen (HLA) sensitization and other risks including from immunosuppression that islet transplantation shares with other forms of allotransplantation. Reversal of hypoglycemia unawareness and protection from severe hypoglycemia events are two of the main benefits of islet transplantation and they persist for the duration of graft function. Islet transplantation compares favorably with other therapies for those with hypoglycemia unawareness, although new technologies have not been tested head-to-head with transplantation. HLA sensitization increases with time after transplantation especially if immunosuppression is ceased and is a risk for those who may require future transplantation as well as being associated with loss of graft function.

The Economics of Organ Transplantation.

Science.gov (United States)

Altınörs, Nur; Haberal, Mehmet

2018-03-01

To determine the cost effectiveness of transplantation, we analyzed the financial economics of the organ and tissue transplant process. We compared the cost of this process with traditional modalities for treating endstage liver and kidney disease. Medical, surgical, legal, social, ethical, and religious issues are important in organ transplant procedures. Government, health insurance companies, and uninsured individuals are affected by the financial economics of organ transplantation. The distribution of financial burden differs among countries and is dependent on the unique circumstances of each country.

Infrastructure, logistics and regulation of transplantation: UNOS.

Science.gov (United States)

Heimbach, Julie K

2013-12-01

Organ transplantation has evolved into the standard of care for patients with end-stage organ failure. Despite considering increasingly complex transplant recipients for organs recovered from donors with increasing comorbid conditions, 1-year patient survival following kidney transplantation is 97% in the United States, whereas liver transplant recipient 1-year survival is 90%. There were 16,485 kidney recipients in the United States in 2012, and 6256 patients who underwent liver transplantation. The intent of this review is to highlight the logistics required for transplantation as well as reviewing the current oversight of transplantation. Copyright © 2013 Elsevier Inc. All rights reserved.

Some biological properties of human chorionic follicle stimulating hormone

International Nuclear Information System (INIS)

Tojo, Shimpei; Ashitaka, Yoshihiko; Maruo, Takeshi; Nishimoto, Hiroyuki

1975-01-01

The biological properties of human chorionic FSH (hCFSH) for rat ovaries were investigated. Highly purified hCFSH had similar response to the ovarian augmentation test as bovine FSH and significantly enhanced 3 H-thymidine uptake by granulosa cells and theca cells in the ovary of hypophysectomized rat. In contrast, highly purified hCG little responded to the ovarian augmentation test and had no effect on 3 H-thymidine uptake by the ovary. These results indicate that hCFSH may promote the follicular growth of ovary resulting from granulosa cell proliferation and its enlargement. In addition, freshly harvested porcine granulosa cells were employed in an in vitro system to investigate specific binding of hCFSH to ovarian receptor. Radioiodinated hCFSH ( 125 I-hCFSH) and hCG ( 125 I-hCG) were respectively incubated with cell suspensions. Binding of these hormone preparations was proportional to the cell number and increased with the time of incubation through 120 minutes. The binding ability of 125 I-hCFSH to the cells was greater than that of 125 I-hCG. Increasing concentrations of unlabeled hCFSH in the incubation mixture progressively inhibited the uptake of 125 I-hCFSH by granulosa cells. Unlabeled hCG was not able to compete with 125 I-hCFSH binding. The similar phenomenon to inhibit the binding of 125 I-hCG to the cells was also recognized in the presence of unlabeled hCG. These findings suggest that granulosa cell has at least two different types of receptor sites: one for hCFSH and the other for hCG. (auth.)

Screening retinal transplants with Fourier-domain OCT

Science.gov (United States)

Rao, Bin

2009-02-01

Transplant technologies have been studied for the recovery of vision loss from retinitis pigmentosa (RP) and age-related macular degeneration (AMD). In several rodent retinal degeneration models and in patients, retinal progenitor cells transplanted as layers to the subretinal space have been shown to restore or preserve vision. The methods for evaluation of transplants are expensive considering the large amount of animals. Alternatively, time-domain Stratus OCT was previously shown to be able to image the morphological structure of transplants to some extent, but could not clearly identify laminated transplants. The efficacy of screening retinal transplants with Fourier-domain OCT was studied on 37 S334ter line 3 rats with retinal degeneration 6-67 days after transplant surgery. The transplants were morphologically categorized as no transplant, detachment, rosettes, small laminated area and larger laminated area with both Fourier-domain OCT and histology. The efficacy of Fourier-domain OCT in screening retinal transplants was evaluated by comparing the categorization results with OCT and histology. Additionally, 4 rats were randomly selected for multiple OCT examinations (1, 5, 9, 14 and 21days post surgery) in order to determine the earliest image time of OCT examination since the transplanted tissue may need some time to show its tendency of growing. Finally, we demonstrated the efficacy of Fourier-domain OCT in screening retinal transplants in early stages and determined the earliest imaging time for OCT. Fourier-domain OCT makes itself valuable in saving resource spent on animals with unsuccessful transplants.

Lung Transplantation for Lymphangioleiomyomatosis in Japan

Science.gov (United States)

Ando, Katsutoshi; Okada, Yoshinori; Akiba, Miki; Kondo, Takashi; Kawamura, Tomohiro; Okumura, Meinoshin; Chen, Fengshi; Date, Hiroshi; Shiraishi, Takeshi; Iwasaki, Akinori; Yamasaki, Naoya; Nagayasu, Takeshi; Chida, Masayuki; Inoue, Yoshikazu; Hirai, Toyohiro; Seyama, Kuniaki; Mishima, Michiaki

2016-01-01

Background Lung transplantation has been established as the definitive treatment option for patients with advanced lymphangioleiomyomatosis (LAM). However, the prognosis after registration and the circumstances of lung transplantation with sirolimus therapy have never been reported. Methods In this national survey, we analyzed data from 98 LAM patients registered for lung transplantation in the Japan Organ Transplantation Network. Results Transplantation was performed in 57 patients as of March 2014. Survival rate was 86.7% at 1 year, 82.5% at 3 years, 73.7% at 5 years, and 73.7% at 10 years. Of the 98 patients, 21 had an inactive status and received sirolimus more frequently than those with an active history (67% vs. 5%, p<0.001). Nine of twelve patients who remained inactive as of March 2014 initiated sirolimus before or while on a waiting list, and remained on sirolimus thereafter. Although the statistical analysis showed no statistically significant difference, the survival rate after registration tended to be better for lung transplant recipients than for those who awaited transplantation (p = 0.053). Conclusions Lung transplantation is a satisfactory therapeutic option for advanced LAM, but the circumstances for pre-transplantation LAM patients are likely to alter with the use of sirolimus. PMID:26771878

Pre-transplant soluble CD30 in combination with total DSA but not pre-transplant C1q-DSA predicts antibody-mediated graft loss in presensitized high-risk kidney transplant recipients.

Science.gov (United States)

Schaefer, S M; Süsal, C; Opelz, G; Döhler, B; Becker, L E; Klein, K; Sickmüller, S; Waldherr, R; Macher-Goeppinger, S; Schemmer, P; Beimler, J; Zeier, M; Morath, C

2016-02-01

Presensitized kidney transplant recipients are at high-risk for early antibody-mediated rejection. We studied the impact of pre- and post-transplant donor-specific human leukocyte antigen (HLA) antibodies (DSA) and T-cell-activation on the occurrence of antibody-mediated rejection episodes (AMR) and graft loss (AMR-GL) in a unique cohort of 80 desensitized high-risk kidney transplant recipients. Patients with pre-transplant DSA demonstrated more AMR episodes than patients without DSA, but did not show a significantly increased rate of AMR-GL. The rates of AMR and AMR-GL were not significantly increased in patients with complement split product (C1q)-binding pre-transplant DSA. Pre-transplant C1q-DSA became undetectable post-transplant in 11 of 13 (85%) patients; 2 (18%) of these 11 patients showed AMR but no AMR-GL. In contrast, the post-transplant presence of C1q-DSA was associated with significantly higher rates of AMR (86 vs 33 vs 0%; P transplant DSA without C1q-binding or the absence of DSA. Patients with both pre-transplant DSA and evidence of pre-transplant T-cell-activation as indicated by soluble CD30-positivity showed a significantly increased risk for AMR-GL [HR = 11.1, 95% confidence interval (CI) = 1.68-73.4; log-rank P = 0.013]. In these high-risk patients, AMR-GL was associated with total DSA in combination with T-cell-activation pre-transplant, and de novo or persistent C1q-binding DSA post-transplant. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Liver transplantation in the Nordic countries – An intention to treat and post-transplant analysis from The Nordic Liver Transplant Registry 1982–2013

Science.gov (United States)

Fosby, Bjarte; Melum, Espen; Bjøro, Kristian; Bennet, William; Rasmussen, Allan; Andersen, Ina Marie; Castedal, Maria; Olausson, Michael; Wibeck, Christina; Gotlieb, Mette; Gjertsen, Henrik; Toivonen, Leena; Foss, Stein; Makisalo, Heikki; Nordin, Arno; Sanengen, Truls; Bergquist, Annika; Larsson, Marie E.; Soderdahl, Gunnar; Nowak, Greg; Boberg, Kirsten Muri; Isoniemi, Helena; Keiding, Susanne; Foss, Aksel; Line, Pål-Dag; Friman, Styrbjörn; Schrumpf, Erik; Ericzon, Bo-Göran; Höckerstedt, Krister; Karlsen, Tom H.

2015-01-01

Abstract Aim and background. The Nordic Liver Transplant Registry (NLTR) accounts for all liver transplants performed in the Nordic countries since the start of the transplant program in 1982. Due to short waiting times, donor liver allocation has been made without considerations of the model of end-stage liver disease (MELD) score. We aimed to summarize key outcome measures and developments for the activity up to December 2013. Materials and methods. The registry is integrated with the operational waiting-list and liver allocation system of Scandiatransplant (www.scandiatransplant.org) and accounted at the end of 2013 for 6019 patients out of whom 5198 were transplanted. Data for recipient and donor characteristics and relevant end-points retransplantation and death are manually curated on an annual basis to allow for statistical analysis and the annual report. Results. Primary sclerosing cholangitis, acute hepatic failure, alcoholic liver disease, primary biliary cirrhosis and hepatocellular carcinoma are the five most frequent diagnoses (accounting for 15.3%, 10.8%, 10.6%, 9.3% and 9.0% of all transplants, respectively). Median waiting time for non-urgent liver transplantation during the last 10-year period was 39 days. Outcome has improved over time, and for patients transplanted during 2004–2013, overall one-, five- and 10-year survival rates were 91%, 80% and 71%, respectively. In an intention-to-treat analysis, corresponding numbers during the same time period were 87%, 75% and 66%, respectively. Conclusion. The liver transplant program in the Nordic countries provides comparable outcomes to programs with a MELD-based donor liver allocation system. Unique features comprise the diagnostic spectrum, waiting times and the availability of an integrated waiting list and transplant registry (NLTR). PMID:25959101

Pancreas transplantation: an overview

Directory of Open Access Journals (Sweden)

Andre Ibrahim David

2010-12-01

Full Text Available Pancreas transplantation is the only treatment able to reestablish normal glucose and glycated hemoglobin levels in insulin-dependent diabetic patients without the use of exogenous insulin. The evolution of pancreas transplantation in treatment of diabetes was determined by advances in the fields of surgical technique, organ preservation and immunosuppressants. The main complication leading to graft loss is technical failure followed by acute or chronic rejection. Technical failure means graft loss within the first three months following transplantation due to vascular thrombosis (50%, pancreatitis (20%, infection (18%, fistula (6.5% and bleeding (2.4%. Immunological complications still affect 30% of patients, and rejection is the cause of graft loss in 10% of cases. Chronic rejection is the most common late complication. Cardiovascular diseases are the most common causes of late mortality in pancreas transplantation, so it remains the most effective treatment for type 1 diabetes patients. There is a significant improvement in quality of life and in patient’s survival rates. The development of islet transplantation could eliminate or minimize surgical complications and immunosuppression.

Risk factors of post renal transplant anaemia among Sudanese patients, a study in three renal transplant centres

Directory of Open Access Journals (Sweden)

Elmusharaf Khalifa

2011-08-01

Full Text Available Abstract Background There is a relative lack of recent information about late post kidney transplantation anaemia (PTA, especially in the developing countries; data are scarce about the prevalence and risk factors of PTA. Sudan was a leading country in Africa and Arab world in kidney transplantation. The first kidney transplantation in Sudan was in 1973. Methods This is a cross-sectional hospital analytic study enrolling all kidney transplanted recipients following in the transplant referral clinics at Ahmed Gassim, Selma and Ibn Sina Hospitals, Khartoum/Sudan, in the period from 1/8/2010 to 1/9/2010, clinical and laboratory data were obtained from 114 patients, anaemia was defined as Hb levels of Results The study showed that 39.5% of the patients were anaemic. Univariate analysis showed that late PTA is significantly associated with not using Erythropoietin (EPO in the pre-transplant period (p = Conclusion The study concluded that late PTA is common and under recognized. Risk factors for late PTA include renal dysfunction, history of rejection, longer duration of transplantation and not using EPO in the pre-transplant period. Renal dysfunction and not using EPO in the pre-transplant period are major predictors of late PTA.

Transplant organizational structures: viewpoints from established centers.

Science.gov (United States)

Abouljoud, M; Klintmalm, G; Whitehouse, S

2012-10-01

This personal viewpoint report summarizes the responses of a survey targeting established transplant programs with a structured framework, such as center, institute, or department, and stability of leadership to assure valuable experiential observations. The 18-item survey was sent to 20 US institutions that met inclusion criteria. The response rate was 100%. Seventeen institutions had a distinct transplant governance structure. A majority of respondents perceived that their type of transplant structure was associated with enhanced recognition within their institution (85%), improved regulatory compliance (85%), transplant volume growth (75%), improved quality outcomes (75%) and increased funding for transplant-related research (75%). The prevailing themes in respondents' remarks were the perceived need for autonomy of the transplant entity, alignment among services and finances and alignment of authority with responsibility. Many respondents suggested that a dialogue be opened about effective transplant infrastructure that overcomes the boundaries of traditional academic department silos. © Copyright 2012 The American Society of Transplantation and the American Society of Transplant Surgeons.

Management of post-transplant lymphoproliferative disorder in adult solid organ transplant recipients - BCSH and BTS Guidelines.

Science.gov (United States)

Parker, Anne; Bowles, Kristin; Bradley, J Andrew; Emery, Vincent; Featherstone, Carrie; Gupte, Girish; Marcus, Robert; Parameshwar, Jayan; Ramsay, Alan; Newstead, Charles

2010-06-01

A joint working group established by the Haemato-oncology subgroup of the British Committee for Standards in Haematology (BCSH) and the British Transplantation Society (BTS) has reviewed the available literature and made recommendations for the diagnosis and management of post-transplant lymphoproliferative disorder in adult recipients of solid organ transplants. This review details the therapeutic options recommended including reduction in immunosuppression (RIS), transplant organ resection, radiotherapy and chemotherapy. Effective therapy should be instituted before progressive disease results in declining performance status and multi-organ dysfunction. The goal of treatment should be a durable complete remission with retention of transplanted organ function with minimal toxicity.

Competitive Market Analysis of Transplant Centers and Discrepancy of Wait-Listing of Recipients for Kidney Transplantation

OpenAIRE

Cho, P. S.; Saidi, R. F.; Cutie, C. J.; Ko, D. S. C.

2015-01-01

Background: There are over 250 kidney transplant programs in the USA. Objective: To determine if highly competitive regions, defined as regions with a higher number of transplant centers, will approve and wait-list more end-stage renal disease (ESRD) candidates for transplant despite consistent incidence and prevalence of ESRD nationwide. Methods: ESRD Network and OPTN data completed in 2011 were obtained from all transplant centers including listing data, market saturation, market share, org...

Stem Cell Transplantation from Bench to Bedside

Indian Academy of Sciences (India)

Table of contents. Stem Cell Transplantation from Bench to Bedside · Slide 2 · Slide 3 · Slide 4 · Principles of an allogeneic stem cell transplant · Principle of an allogeneic stem cell transplant · Principle of an autologous Stem Cell Transplant · Slide 8 · Conditioning · Slide 10 · Slide 11 · Stem Cell Transplantation · Slide 13.

A Study on the Directed Living Non-Related Donor Kidney Transplantation Submitted to the Hospital Transplant Ethics Committee at the National Kidney and Transplant Institute.

Science.gov (United States)

Suguitan, G; Arakama, M-H I; Danguilan, R

2017-03-01

In the latter part of 2009, the Department of Health of the Philippines prohibited kidney transplantation with non-related kidney donors. Hence, the National Kidney and Transplant Institute created a Hospital Transplant Ethics Committee. This study describes directed non-related kidney donation at the National Kidney and Transplant Institute. This retrospective study reviewed the profiles of recipients and directed living non-related kidney transplant donors submitted to the Hospital Transplant Ethics Committee. A total 74 recipients and donors were reviewed by the Hospital Transplant Ethics Committee in 2014. Donors initiated the talks about being a donor (75%) to repay the good deeds that were done by the recipient for them or their families; examples of which are: sometime in their lives they needed financial assistance for hospitalization for their relatives and it was the patient who paid the hospital bill; or because they pitied the recipient, whom they found to be a good person, thus they would want to give one of their kidneys. Seventy-four (100%) said that they were not expecting anything in return for this act but wanted to be of help to the recipient. Of these 74 cases, 70 cases (95%) were approved and the others were disapproved. With a Hospital Transplant Ethics Committee in place, directed kidney donation is a valuable tool as an additional source of kidney donor without violating any ethical issues. Copyright © 2016. Published by Elsevier Inc.

Face time: educating face transplant candidates.

Science.gov (United States)

Lamparello, Brooke M; Bueno, Ericka M; Diaz-Siso, Jesus Rodrigo; Sisk, Geoffroy C; Pomahac, Bohdan

2013-01-01

Face transplantation is the innovative application of microsurgery and immunology to restore appearance and function to those with severe facial disfigurements. Our group aims to establish a multidisciplinary education program that can facilitate informed consent and build a strong knowledge base in patients to enhance adherence to medication regimes, recovery, and quality of life. We analyzed handbooks from our institution's solid organ transplant programs to identify topics applicable to face transplant patients. The team identified unique features of face transplantation that warrant comprehensive patient education. We created a 181-page handbook to provide subjects interested in pursuing transplantation with a written source of information on the process and team members and to address concerns they may have. While the handbook covers a wide range of topics, it is easy to understand and visually appealing. Face transplantation has many unique aspects that must be relayed to the patients pursuing this novel therapy. Since candidates lack third-party support groups and programs, the transplant team must provide an extensive educational component to enhance this complex process. As face transplantation continues to develop, programs must create sound education programs that address patients' needs and concerns to facilitate optimal care.

Use of hematopoietic cell transplants to achieve tolerance in patients with solid organ transplants

OpenAIRE

Strober, Samuel

2016-01-01

The goals of tolerance in patients with solid organ transplants are to eliminate the lifelong need for immunosuppressive (IS) drugs and to prevent graft loss due to rejection or drug toxicity. Tolerance with complete withdrawal of IS drugs has been achieved in recipients of HLA-matched and mismatched living donor kidney transplants in 3 medical centers using hematopoietic cell transplants to establish mixed or complete chimerism.

The perception of sleep quality in kidney transplant patients during the first year of transplantation

Directory of Open Access Journals (Sweden)

Dnyelle Souza Silva

2012-12-01

Full Text Available OBJECTIVE: Poor sleep quality is one of the factors that adversely affects patient quality of life after kidney transplantation, and sleep disorders represent a significant cardiovascular risk factor. The objective of this study was to investigate the prevalence of changes in sleep quality and their outcomes in kidney transplant recipients and analyze the variables affecting sleep quality in the first years after renal transplantation. METHODS: Kidney transplant recipients were evaluated at two time points after a successful transplantation: between three and six months (Phase 1 and between 12 and 15 months (Phase 2. The following tools were used for assessment: the Pittsburgh Sleep Quality Index; the quality of life questionnaire Short-Form-36; the Hospital Anxiety and Depression scale; the Karnofsky scale; and assessments of social and demographic data. The prevalence of poor sleep was 36.7% in Phase 1 and 38.3% in Phase 2 of the study. RESULTS: There were no significant differences between patients with and without changes in sleep quality between the two phases. We found no changes in sleep patterns throughout the study. Both the physical and mental health scores worsened from Phase 1 to Phase 2. CONCLUSION: Sleep quality in kidney transplant recipients did not change during the first year after a successful renal transplantation.

Autogenous transplantation of maxillary and mandibular molars.

Science.gov (United States)

Reich, Peter P

2008-11-01

Autogenous tooth transplantation has been used as a predictable surgical approach to correct malocclusion and replace edentulous areas. This article focuses on the surgical approach and technique for molar transplantation. Thirty-two patients aged between 11 and 25 years underwent 44 autogenous molar transplantations. The procedure involved transplantation of impacted or newly erupted third molars into the extraction sockets of nonrestorable molars and surgical removal and replacement of horizontally impacted molars into their proper vertical alignment. Five basic procedural concepts were applied: 1) atraumatic extraction, avoiding disruption of the root sheath and root buds; 2) apical contouring of bone at the transplantation site and maxillary sinus lift via the Summers osteotome technique, when indicated, for maxillary molars; 3) preparation of a 4-wall bony socket; 4) avoidance of premature occlusal interferences; and 5) stabilization of the tooth with placement of a basket suture. All 32 patients successfully underwent the planned procedure. To date, 2 patients have had localized infection that resulted in loss of the transplant. The remaining 42 transplants remain asymptomatic and functioning, with a mean follow-up period of 19 months. No infection, ankylosis, loss of the transplant, or root resorption has been noted. In addition, endodontic therapy has not been necessary on any transplanted teeth. Autogenous tooth transplantation has been discussed and described in the literature previously, with a primary focus on cuspid and bicuspid transplantation. The molar transplant is infrequently discussed in today's literature, possibly because of the preponderance of titanium dental implants. Autogenous molar transplantation is a viable procedure with low morbidity and excellent functional and esthetic outcomes. This report shows the successful transplantation of 42 of 44 molars in 32 patients with a mean follow-up period of 19 months.

Four decades of kidney transplantation in Cuba.

Science.gov (United States)

Alfonzo, Jorge P

2013-01-01

This article describes the background, beginnings, development, evolution and outcomes of kidney transplantation in Cuba. Nephrology as a medical specialty in Cuba began in 1962 and was formalized in 1966. Conditions were created to implement renal replacement therapy (including transplants), bring nephrology care to the entire country and train human resources who would assume this responsibility, making Cuba one of the first countries with a comprehensive program for renal patient care. After three unsuccessful cadaveric-donor kidney transplantations in 1968-69, the ensuing history of kidney transplantation can be summarized in the following three stages. 1970-1975: In January 1970, cadaveric-donor kidney transplantation began at the Nephrology Institute. That year, 17 kidney transplantations were performed; four of these patients lived with functional kidneys for 15-25 years; 10-year graft survival was 23.5% (Kaplan-Meier survival curve); HLA typing began in 1974. By December 1975, 170 grafts had been done in three hospitals. 1976-1985: Seven transplantation centers performed 893 grafts during this period. HLA-DR typing was introduced in 1976 and the National Histocompatibility Laboratory Network was founded in 1978. The first related living-donor kidney transplantation was done in 1979. 1986-2011: The National Kidney Transplantation Coordinating Center and the National Kidney Transplantation Program were created in 1986; the first combined kidney-pancreas transplantation was performed the same year. In 1990, cyclosporine and the Cuban monoclonal antibody IOR-T3 were introduced for immunosuppression to prevent rejection, as were other Cuban products (hepatitis B vaccine and recombinant human erythropoietin) for transplant patients. By December 2011, the cumulative number of transplants was 4636 (384 from related living donors). With over 40 years of experience, kidney transplantation is now well established in Cuba; it is free and universally accessible, on the

Manipulating transplant morphology to advance post-transplant growth and yield in strawberry

NARCIS (Netherlands)

Reekie, J.Y.

2005-01-01

Two methods were developed to enhance transplant success and minimize water use of strawberry transplants harvested in Canadian nurseries for use in the annual strawberry production system in the Southern United States: mechanical leaf removal by mowing, and chemical control of growth and

International Transplant Nurses Society

Science.gov (United States)

... Expanded and updated to reflect today's thinking, this brand-new edition offers crucial, real-life direction on ... reduced rates in countries with emerging economies • Build awareness of World Organ Day, Transplant Games, and Transplant ...

Four-Way Kidney Exchange Transplant With Desensitization Increases Access to Living-Donor Kidney Transplant: First Report From India.

Science.gov (United States)

Kute, Vivek B; Patel, Himanshu V; Shah, Pankaj R; Modi, Pranjal R; Shah, Veena R; Kasat, Govind S; Patil, Mayur V; Patel, Jaydeep C; Kumar, Deepak P; Trivedi, Hargovind L

2017-09-26

This study reports our experience of the first 4-way kidney exchange transplant combined with desensitization in India, which allows increased access to living-donor kidney transplant for sensitized patients. Four-way kidney exchange transplant procedures were approved by the ethics committee of our institution and the Organ Transplantation Authorization Committee of state governments of India (as per the Transplantation of Human Organs Act of India). The protocols conformed to Declaration of Istanbul principles and the ethical guidelines of the 1975 Helsinki Declaration. Written informed consent was obtained from patients, donors, and their guardians. In April 2016, our transplant team completed simultaneous 4-way kidney exchange transplant procedures without any medical (rejection and infections) or surgical complications. Reasons for being included for kidney exchange transplant were ABO incom-patible (2 recipients) and sensitization (2 recipients). All 4 recipients had stable graft function with no proteinuria and donor-specific antibody at 11-month follow-up on standard triple immunosup-pression. Patient and graft survival rates were both 100%. To the best of our knowledge, this is the first single-center report of 4-way kidney exchange transplant combined with desensitization from India. This procedure has the potential to expand living-donor kidney transplant in disadvantaged groups (eg, sensitized patients). Recipients who are hard to match due to high panel reactive antibody and difficult to desensitize due to strong donor-specific antibodies can receive a transplant with a combination of kidney exchange and desensitization. Our study suggests that 4-way kidney exchange transplant can be performed in developing countries (India) similar to that shown in programs in developed countries with team work, kidney exchange registry, and counseling.

Lung transplantation: overall approach regarding its major aspects

Science.gov (United States)

de Camargo, Priscila Cilene León Bueno; Teixeira, Ricardo Henrique de Oliveira Braga; Carraro, Rafael Medeiros; Campos, Silvia Vidal; Afonso, José Eduardo; Costa, André Nathan; Fernandes, Lucas Matos; Abdalla, Luis Gustavo; Samano, Marcos Naoyuki; Pêgo-Fernandes, Paulo Manuel

2015-01-01

ABSTRACT Lung transplantation is a well-established treatment for patients with advanced lung disease. The evaluation of a candidate for transplantation is a complex task and involves a multidisciplinary team that follows the patient beyond the postoperative period. Currently, the mean time on the waiting list for lung transplantation in the state of São Paulo, Brazil, is approximately 18 months. For Brazil as a whole, data from the Brazilian Organ Transplant Association show that, in 2014, there were 67 lung transplants and 204 patients on the waiting list for lung transplantation. Lung transplantation is most often indicated in cases of COPD, cystic fibrosis, interstitial lung disease, non-cystic fibrosis bronchiectasis, and pulmonary hypertension. This comprehensive review aimed to address the major aspects of lung transplantation: indications, contraindications, evaluation of transplant candidates, evaluation of donor candidates, management of transplant recipients, and major complications. To that end, we based our research on the International Society for Heart and Lung Transplantation guidelines and on the protocols used by our Lung Transplant Group in the city of São Paulo, Brazil. PMID:26785965

The transplant team's support of kidney transplant recipients to take their prescribed medications: a collective responsibility.

Science.gov (United States)

Williams, Allison; Low, Jac Kee; Manias, Elizabeth; Crawford, Kimberley

2016-08-01

To obtain an understanding of how health professionals support the kidney transplant patient to take their medications as prescribed long term. Kidney transplantation requires stringent adherence to complex medication regimens to prevent graft rejection and to maintain general well-being. Medication nonadherence is common in kidney transplantation, emerging in the first few months post-transplantation, leading to poor patient outcomes. Exploratory qualitative design. Five focus groups were conducted with a total of seven renal nurse transplant coordinators, two renal transplant nurse unit managers, seven nephrologists, seven pharmacists, four social workers, and one consumer representative representing all five hospitals offering adult kidney transplantation in Victoria, Australia in 2014. The views of two general practitioners who were unable to attend the focus groups were incorporated into the data set. All data underwent thematic analysis. Analysis revealed that adherence was a collective responsibility involving the whole of the transplant team and the patient via education blitz in hospital, identifying and managing nonadherence, promotion of self-advocacy, and the partnership between the patient and health professional. Patients were directed how to take their complex medications to be self-empowered, yet the partnership between the patient and health professional limited the patient's voice. Although medication adherence was a collective responsibility, communication was often one-way chiefly as a result of staffing and time constraints, hindering effective partnerships necessary for medication adherence. Expert skills in communication and adherence counselling are necessary to identify barriers affecting medication adherence. Patients need to be systematically screened, prepared and supported long-term within an accommodating healthcare system for the reality of caring for their transplanted kidney. Kidney transplant recipients require systematic

The UNOS renal transplant registry.

Science.gov (United States)

Cecka, J M

2001-01-01

The shortage of cadaver kidneys relative to increasing demand for transplantation has lead to a remarkable rise in transplantation from living donors. Based upon data reported to UNOS, the number of living donor kidneys transplanted in 2000 (5,106) nearly equaled the number of cadaver kidneys from preferred donors aged 6-50. HLA-mismatched siblings, offspring, spouses and other genetically unrelated donors accounted for nearly 80% of increased living donor transplantation during 1994-2000. Despite the increased use of poorly HLA-matched living donor kidneys, the actuarial 10-year graft survival rates for transplants between 1988-2000 were clustered between 53-57% for HLA-mismatched living donor grafts, except for offspring-to-parent transplants (49%) when the recipients were generally older. The 10-year survival rate for 96,053 cadaver grafts was 38% during the same period. The 5-year graft survival rates for more recent (1996-2000) cadaver donor transplants were 66%, 62% and 56% for recipients of first, second and multiple grafts, respectively (p < 0.001). The comparable results among recipients of living donor kidneys were 67%, 66% and 59% (p = ns). The 5-year graft survival rates for HLA-matched first grafts were 7% higher than those for HLA-mismatched transplants when the kidney was from a living or cadaver donor. HLA-identical sibling transplants provided the best long-term graft survival (85% at 5 years and a 32 year half-life). Even with improved crossmatch tests and stronger immunosuppression, sensitization was associated with 8% lower graft survival at 5 years and with a higher rate of late graft loss among first cadaver kidney recipients. Sensitization also was associated with an increase in delayed graft function from 22% of unsensitized first transplant recipients to as much as 36% among multiply retransplanted patients. Recipient race was a key factor in long-term graft survival of both living and cadaver donor kidneys. The rate of late graft loss was

Lung transplantation for chronic obstructive pulmonary disease

Directory of Open Access Journals (Sweden)

Liou TG

2013-07-01

Full Text Available Theodore G Liou, Sanjeev M Raman, Barbara C CahillDivision of Respiratory, Critical Care and Occupational Pulmonary Medicine, Department of Medicine, School of Medicine, University of Utah, Salt Lake City, Utah, USAAbstract: Patients with end-stage chronic obstructive pulmonary disease (COPD comprise the largest single lung disease group undergoing transplantation. Selection of appropriate candidates requires consideration of specific clinical characteristics, prognosis in the absence of transplantation, and likely outcome of transplantation. Increased availability of alternatives to transplantation for end-stage patients and the many efforts to increase the supply of donor organs have complicated decision making for selecting transplant candidates. Many years of technical and clinical refinements in lung transplantation methods have improved survival and quality of life outcomes. Further advances will probably come from improved selection methods for the procedure. Because no prospective trial has been performed, and because of confounding and informative censoring bias inherent in the transplant selection process in studies of the existing experience, the survival effect of lung transplant in COPD patients remains undefined. There is a lack of conclusive data on the impact of lung transplantation on quality of life. For some patients with end-stage COPD, lung transplantation remains the only option for further treatment with a hope of improved survival and quality of life. A prospective trial of lung transplantation is needed to provide better guidance concerning survival benefit, resource utilization, and quality of life effects for patients with COPD.Keywords: outcomes, emphysema, COPD, alpha-1-antitrypsin deficiency, survival, single lung transplant, bilateral sequential single lung transplant, lung volume reduction, referral, guidelines, health related quality of life

Anatomical basics, variations, and degenerative changes of the shoulder joint and shoulder girdle

Energy Technology Data Exchange (ETDEWEB)

Prescher, Andreas E-mail: dkeyserlingk@post.klinikum.rwth-aachen.de

2000-08-01

-lesions may occur and at the glenoid rim, where the labrum is often not fixed to the bony margin, avulsions of the labrum may occur. This well-established anatomical condition must not be mistaken for a manifest Bankart-lesion. The glenohumeral ligaments, which are located in the ventral articular capsule, have a stabilizing function for the ventral part of the glenoid labrum. The glenohumeral ligaments lift the articular lip where it crosses the glenoid notch. This 'labrum-lift effect' supports the stabilizing features of the articular lip and the glenohumeral ligaments. The rotator cuff is composed of the tendons of the teres minor, infraspinatus, supraspinatus, and subscapularis muscles. This cuff has a poorly vascularized area, due to mechanical conditions, about 1.5 cm from the major tubercle, which causes degenerative changes and eventually may lead to ruptures. Results of the impingement-syndrome and the osteoarthrotic changes of the shoulder and acromioclavicular joint are also presented and discussed. Finally, the coracoclavicular joint, which probably represents no congenital entity but appears due to a changed, lowered position of the shoulder girdle, is discussed. The paper also presents instructive figures of anatomical preparations that can be used to make more precise radiological and differential diagnoses. All preparations were done by the author and are part of a series of more than 300 preparations of the shoulder joint and girdle.

Viral infections in transplant recipients.

Science.gov (United States)

Razonable, R R; Eid, A J

2009-12-01

Solid organ and hematopoietic stem cell transplant recipients are uniquely predisposed to develop clinical illness, often with increased severity, due to a variety of common and opportunistic viruses. Patients may acquire viral infections from the donor (donor-derived infections), from reactivation of endogenous latent virus, or from the community. Herpes viruses, most notably cytomegalovirus and Epstein Barr virus, are the most common among opportunistic viral pathogens that cause infection after solid organ and hematopoietic stem cell transplantation. The polyoma BK virus causes opportunistic clinical syndromes predominantly in kidney and allogeneic hematopoietic stem cell transplant recipients. The agents of viral hepatitis B and C present unique challenges particularly among liver transplant recipients. Respiratory viral illnesses due to influenza, respiratory syncytial virus, and parainfluenza virus may affect all types of transplant recipients, although severe clinical disease is observed more commonly among lung and allogeneic hematopoietic stem cell transplant recipients. Less common viral infections affecting transplant recipients include those caused by adenoviruses, parvovirus B19, and West Nile virus. Treatment for viruses with proven effective antiviral drug therapies should be complemented by reduction in the degree of immunosuppression. For others with no proven antiviral drugs for therapy, reduction in the degree of immunosuppression remains as the sole effective strategy for management. Prevention of viral infections is therefore of utmost importance, and this may be accomplished through vaccination, antiviral strategies, and aggressive infection control measures.

SPECIFIC FEATURES OF THE THEMATIC MATERIAL AND TEXTURE IN THE FANTASY FOR TWO PIANOS BRYUL LUI AMIHALACHIOAIE (AMIHALACHIOAIE’S GIRDLE BY VLAD BURLEA

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MAMALÂGA MARINA

2016-06-01

Full Text Available The article analyzes the fantasy „Bryul lui M. Amihalachioaie” (Amihalachioaie’s Girdle for two pianos composed by Vlad Burlea as the only example of this genre in his creative activity. This work is analyzed from the perspective of genre specificity, determined by the synthesis of the fantasy genre and the monumental miniature, revealing the interaction of variation and improvisation. The author comes to the conclusion that V. Burlea’s creation is characterized by a truthful realization of the language elements of national music, and namely that of the Moldovan dance. The article also considers the form and content of the present work, its intonation-thematic processes and the treatment of the two-piano ensemble that imitates the sound of the dulcimer.

Clinical outcome of combined conjunctival autograft transplantation and amniotic membrane transplantation in pterygium surgery

OpenAIRE

Tejsu Malla; Jing Jiang; Kai Hu

2018-01-01

AIM: To compare long-term outcome of primary and recurrent pterygium surgery with three different techniques: combined conjunctival autograft and overlay amniotic membrane transplantation (CAT with AMT), conjunctival autograft transplantation (CAT) alone and amniotic membrane transplantation (AMT) alone. METHODS: In this retrospective study, 142 eyes of 142 pterygium patients (104 primary, 38 recurrent) who underwent CAT (group A), AMT (group B) or CAT with AMT (group C) respectively follo...

Predictive value of plasma human chorionic gonadotropin measured 14 days after Day-2 single embryo transfer

DEFF Research Database (Denmark)

Løssl, Kristine; Oldenburg, Anna; Toftager, Mette

2017-01-01

Introduction: Prediction of pregnancy outcome after in vitro fertilization is important for patients and clinicians. Early plasma human chorionic gonadotropin (p-hCG) levels are the best known predictor of pregnancy outcome, but no studies have been restricted to single embryo transfer (SET) of Day......-2 embryos. The aim of the present study was to investigate the predictive value of p-hCG measured exactly 14 days after the most commonly used Day-2 SET on pregnancy, delivery, and perinatal outcome. Material and methods: A retrospective analysis of prospectively collected data on 466 women who had...... p-hCG measured exactly 14 days after Day-2 SET during a randomized trial including 1050 unselected women (aged 18–40 years) undergoing their first in vitro fertilization/ intracytoplasmic sperm injection treatment. Results: The p-hCG predicted clinical pregnancy [area under the curve (AUC) 0.953; 95...

Proteinuria in Egyptian renal transplant recipients

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Essam Khedr

2015-01-01

Full Text Available To evaluate the prevalence, risk factors, possible etiology, prognosis and management of proteinuria in renal transplant recipients, we studied 435 adult renal transplant recipient patients randomly selected from our center; 394 patients were reviewed retrospectively and 41 patients were followed-up prospectively for a period of one year. The patients were classified into three groups according to the results of urinalysis and spot urinary albumin creatinine ratio: Group A patients with normoalbuminuria; Group B patients with microalbuminuria; and Group C patients with macroalbuminuria. Persistent post-transplantation proteinuria was detected in 125 (28.8% patients. The etiology of post-transplantation proteinuria included chronic allograft dysfunction in 44 (35.2% patients, acute rejection in 40 (32% patients, transplant glomerulopathy in eight (6.4% patients, glomerular disease in 16 (12.8% patients and other etiology in 17 (13.6% patients. Proteinuric patients demonstrated significantly lower graft survival rates than did those without proteinuria (48.3% versus 51.7%, respectively; P = 0.017; Risk Ratio = 0.403; 95% confidence interval 0.188-0.862. We conclude that proteinuria is prevalent after kidney transplant in our population, and that it is most commonly associated with chronic allograft nephropathy, transplant glomerulopathy, glomerulonephritis and acute rejection. Post-transplant proteinuria is associated with decreased allograft survival.

[Danish experience with physical and occupational rehabilitation after heart transplantation. The heart transplantation group at Rigshospitalet].

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Aldershvile, J; Boesgaard, S; Kirchoff, G; Arendrup, H; Høyer, S

1993-01-11

Heart transplantations have been carried out for one year (1.9.1990-1.9.1991) in Denmark. Twenty-three out of 27 patients survived at the end of this period. Prior to transplantation, all of the patients were in NYHA groups III or IV. On discharge, all of the patients could manage a 45-60 minutes training programme followed by a stair test (two to six floors up). Prior to transplantation, 17 patients received financial aid in one form or another and one child received special schooling. On an average 165 days (1.9.1991) after transplantation, nine patients were in full or part-time employment, two were students, seven received financial aid and five were still in hospital. A correlation between the duration of financial aid before transplantation and return to work after transplantation was found. In addition, age was found to be of significance. It is concluded that physical status and return to work are satisfactory.

Growth in pediatric renal transplant recipients.

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Vasudevan, A; Phadke, K

2007-04-01

One of the fundamental challenges in managing pediatric renal transplant recipient is to ensure normal growth and development. The goal of renal transplant is not just to prolong life but to optimize quality of life. Short stature during childhood may be associated with academic underachievement and development of comorbidities such as attention deficit hyperactivity disorder, learning disability, and mood disorders. The most important factors affecting growth are use of corticosteroids, allograft function, and age and height deficit at the time of transplant. Aggressive conservative management of chronic renal failure and early use of growth hormone therapy will help in optimizing height at time of transplant. Early transplant, steroid minimization or withdrawal, and growth hormone therapy will help in achieving normal adult height in a majority of renal post transplant population. Steroid avoidance to achieve good growth still needs to be validated.

Antibody induction therapy for lung transplant recipients

DEFF Research Database (Denmark)

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

2013-01-01

Lung transplantation has become a valuable and well-accepted treatment option for most end-stage lung diseases. Lung transplant recipients are at risk of transplanted organ rejection, and life-long immunosuppression is necessary. Clear evidence is essential to identify an optimal, safe and effect...... and effective immunosuppressive treatment strategy for lung transplant recipients. Consensus has not yet been achieved concerning use of immunosuppressive antibodies against T-cells for induction following lung transplantation....

Inflammatory Response in Islet Transplantation

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Mazhar A. Kanak

2014-01-01

Full Text Available Islet cell transplantation is a promising beta cell replacement therapy for patients with brittle type 1 diabetes as well as refractory chronic pancreatitis. Despite the vast advancements made in this field, challenges still remain in achieving high frequency and long-term successful transplant outcomes. Here we review recent advances in understanding the role of inflammation in islet transplantation and development of strategies to prevent damage to islets from inflammation. The inflammatory response associated with islets has been recognized as the primary cause of early damage to islets and graft loss after transplantation. Details on cell signaling pathways in islets triggered by cytokines and harmful inflammatory events during pancreas procurement, pancreas preservation, islet isolation, and islet infusion are presented. Robust control of pre- and peritransplant islet inflammation could improve posttransplant islet survival and in turn enhance the benefits of islet cell transplantation for patients who are insulin dependent. We discuss several potent anti-inflammatory strategies that show promise for improving islet engraftment. Further understanding of molecular mechanisms involved in the inflammatory response will provide the basis for developing potent therapeutic strategies for enhancing the quality and success of islet transplantation.

Inflammatory Response in Islet Transplantation

Science.gov (United States)

Kanak, Mazhar A.; Kunnathodi, Faisal; Lawrence, Michael C.; Levy, Marlon F.

2014-01-01

Islet cell transplantation is a promising beta cell replacement therapy for patients with brittle type 1 diabetes as well as refractory chronic pancreatitis. Despite the vast advancements made in this field, challenges still remain in achieving high frequency and long-term successful transplant outcomes. Here we review recent advances in understanding the role of inflammation in islet transplantation and development of strategies to prevent damage to islets from inflammation. The inflammatory response associated with islets has been recognized as the primary cause of early damage to islets and graft loss after transplantation. Details on cell signaling pathways in islets triggered by cytokines and harmful inflammatory events during pancreas procurement, pancreas preservation, islet isolation, and islet infusion are presented. Robust control of pre- and peritransplant islet inflammation could improve posttransplant islet survival and in turn enhance the benefits of islet cell transplantation for patients who are insulin dependent. We discuss several potent anti-inflammatory strategies that show promise for improving islet engraftment. Further understanding of molecular mechanisms involved in the inflammatory response will provide the basis for developing potent therapeutic strategies for enhancing the quality and success of islet transplantation. PMID:24883060

Use of hematopoietic cell transplants to achieve tolerance in patients with solid organ transplants.

Science.gov (United States)

Strober, Samuel

2016-03-24

The goals of tolerance in patients with solid organ transplants are to eliminate the lifelong need for immunosuppressive (IS) drugs and to prevent graft loss due to rejection or drug toxicity. Tolerance with complete withdrawal of IS drugs has been achieved in recipients of HLA-matched and mismatched living donor kidney transplants in 3 medical centers using hematopoietic cell transplants to establish mixed or complete chimerism. © 2016 by The American Society of Hematology.

MELD score measured day 10 after orthotopic liver transplantation predicts death and re-transplantation within the first year

DEFF Research Database (Denmark)

Rostved, Andreas A; Lundgren, Jens D; Hillingsø, Jens

2016-01-01

-transplantation. MATERIAL AND METHODS: Retrospective cohort study on adults undergoing orthotopic deceased donor liver transplantation from 2004 to 2014. The MELD score was determined prior to transplantation and daily until 21 days after. The risk of mortality or re-transplantation within the first year was assessed...... day 1 the MELD score significantly diversified and was higher in the poor outcome group (MELD score quartile 4 versus quartile 1-3 at day 10: HR 5.1, 95% CI: 2.8-9.0). This association remained after adjustment for non-identical blood type, autoimmune liver disease and hepatocellular carcinoma...... (adjusted HR 5.3, 95% CI: 2.9-9.5 for MELD scores at day 10). The post-transplant MELD score was not associated with pre-transplant MELD score or the Eurotransplant donor risk index. CONCLUSION: Early determination of the MELD score as an indicator of early allograft dysfunction after liver transplantation...

Heart transplantation and arterial elasticity

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Colvin-Adams M

2013-12-01

Full Text Available Monica Colvin-Adams,1 Nonyelum Harcourt,1 Robert LeDuc,2 Ganesh Raveendran,1 Yassir Sonbol,3 Robert Wilson,1 Daniel Duprez11Cardiovascular Division, University of Minnesota, Minneapolis, MN, USA; 2Division of Biostatistics University of Minnesota, Minneapolis, MN, USA; 3Cardiovascular Division, St Luke's Hospital System, Sugar Land, TX, USAObjective: Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE and large (LAE artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population.Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients.Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P <0.01 and P < 0.0001, respectively. Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE.Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a

Post-transplantation Infections in Bolivia.

Science.gov (United States)

Arze, S; Arze, L; Abecia, C

2016-03-01

Over 26 years, we found 46 infectious episodes in 350 kidney transplant recipients. Fifteen were urinary tract infections, recurrent in 4 patients. There were 8 cytomegalovirus infections, three of them fatal when intravenous (IV) ganciclovir was not available. Seven patients had a reactivation of tuberculosis (TB) in the pleura, cervical spine, lumbar spine, knee, ankle, skin and peritoneum, respectively, and were all resolved satisfactorily with conventional anti-TB therapy. Three patients transplanted before routine prophylaxis with the use of acyclovir developed an extensive herpes zoster infection in the 1st 6 months after transplantation, which was resolved with the use of oral acyclovir, and 1 had a disseminated herpes simplex infection resolved with the use of IV acyclovir. Three patients transplanted before routine prophylaxis with trimethoprim sulfa developed Pneumocystis carinii pneumonia in the 1st 6 months after transplantation, which was fatal in one of them. In 2 patients, we found a Nocardia infection, confined to the lung, which was cured in one of the cases and systemic and fatal in the other. Two patients transplanted before routine prophylaxis with the use of nystatin developed esophageal candidiasis in the 1st 6 months after transplantation. One patient developed infective endocarditis in a stenotic bicuspid aortic valve and died 10 years later after another incident of infective endocarditis at the prosthetic aortic valve. Two patients developed an extensive condyloma at the penis, perianal region, and perineum owing to human papillomavirus, requiring extensive surgical resection and podophyllin applications. Another patient developed fatal post-transplantation lymphoproliferative disease due to Epstein-Barr virus infection 15 years after transplantation. One patient developed a severe and fatal mucocutaneous leishmaniasis with no response to conventional antimonial therapy. It is interesting to note that despite Chagas disease being endemic

De novo malignancy after pancreas transplantation in Japan.

Science.gov (United States)

Tomimaru, Y; Ito, T; Marubashi, S; Kawamoto, K; Tomokuni, A; Asaoka, T; Wada, H; Eguchi, H; Mori, M; Doki, Y; Nagano, H

2015-04-01

Long-term immunosuppression is associated with an increased risk of cancer. Especially, the immunosuppression in pancreas transplantation is more intensive than that in other organ transplantation because of its strong immunogenicity. Therefore, it suggests that the risk of post-transplant de novo malignancy might increase in pancreas transplantation. However, there have been few studies of de novo malignancy after pancreas transplantation. The aim of this study was to analyze the incidence of de novo malignancy after pancreas transplantation in Japan. Post-transplant patients with de novo malignancy were surveyed and characterized in Japan. Among 107 cases receiving pancreas transplantation in Japan between 2001 and 2010, de novo malignancy developed in 9 cases (8.4%): post-transplant lymphoproliferative disorders in 6 cases, colon cancer in 1 case, renal cancer in 1 case, and brain tumor in 1 case. We clarified the incidence of de novo malignancy after pancreas transplantation in Japan. Copyright © 2015 Elsevier Inc. All rights reserved.

Beta-Cell Replacement: Pancreas and Islet Cell Transplantation.

Science.gov (United States)

Niclauss, Nadja; Meier, Raphael; Bédat, Benoît; Berishvili, Ekaterine; Berney, Thierry

2016-01-01

Pancreas and islet transplantation are 2 types of beta-cell replacement therapies for type 1 diabetes mellitus. Since 1966, when pancreas transplantation was first performed, it has evolved to become a highly efficient procedure with high success rates, thanks to advances in surgical technique and immunosuppression. Pancreas transplantation is mostly performed as simultaneous pancreas-kidney transplantation in patients with end-stage nephropathy secondary to diabetes. In spite of its efficiency, pancreas transplantation is still a major surgical procedure burdened by high morbidity, which called for the development of less invasive and hazardous ways of replacing beta-cell function in the past. Islet transplantation was developed in the 1970s as a minimally invasive procedure with initially poor outcomes. However, since the report of the 'Edmonton protocol' in 2000, the functional results of islet transplantation have substantially and constantly improved and are about to match those of whole pancreas transplantation. Islet transplantation is primarily performed alone in nonuremic patients with severe hypoglycemia. Both pancreas transplantation and islet transplantation are able to abolish hypoglycemia and to prevent or slow down the development of secondary complications of diabetes. Pancreas transplantation and islet transplantation should be seen as two complementary, rather than competing, therapeutic approaches for beta-cell replacement that are able to optimize organ donor use and patient care. © 2016 S. Karger AG, Basel.

A comparison of the musculoskeletal assessments of the shoulder girdles of professional rugby players and professional soccer players

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Horsley Ian G

2012-09-01

Full Text Available Abstract Objective To identify posture types that exist in professional rugby players, and compare them with a population of non-overhead athletes in order to identify possible relationships towards the potential for shoulder injuries. Design Observational design Setting: Sports Medicine Clinic Participants: Convenience sample Methodology: Static assessment of posture was carried out in standing, active and passive range of glenohumeral motion, and isometric strength was carried out in accordance with previously recorded protocols. Interventions Nil Outcome Measures: Observational classification of posture, active and passive range of glenohumeral joint range of motion, isometric strength of selected muscle groups, selected muscle flexibility and Hawkins and Neer impingement tests. Results There was a significant difference on range of motion between the two groups (0.025–0.000, isometric middle (0.024–0.005, and lower trapezius (0.01–0.001. Conclusion: There were significant differences between strength and flexibility of muscles around the shoulder girdle between professional rugby players and a control group of professional non-overhead athletes.

Liver transplantation:Yesterday,today and tomorrow

Institute of Scientific and Technical Information of China (English)

Osman Abbasoglu

2008-01-01

With the advances in technical skills,management of postoperative complications and improvements in immunosuppressive drugs,liver transplantation is the standard treatment for many patients with chronic liver disease.Today,shortage of donor organs seems to be the major limiting factor for the application of liver transplantation.This review focuses on five issues that are challenging to clinical practice of liver transplantation and relevant to gastroenterologists.These include living donor liver transplantation,recurrent viral hepatitis,non-heart-beating donors,hepatocellular carcinoma,and ABO incompatible livertransplantation.Living donor and non-heart beating donor transplantations were initiated as a solution to increase the donor organ pool and it is expected that there will be an increase in the number of these donors.Recurrent hepatitis C and hepatocellular carcinoma following liver transplantation are among major problems and ongoing research in these diseases may lead to better outcomes in these recipients.

Pediatric renal transplant practices in India.

Science.gov (United States)

Sethi, Sidharth Kumar; Sinha, Rajiv; Rohatgi, Smriti; Kher, Vijay; Iyengar, Arpana; Bagga, Arvind

2017-05-01

Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India. A designed questionnaire formulated by a group of pediatric nephrologists with the aim of understanding the current practice of pediatric renal transplantation was circulated to all adult and pediatric nephrologists of the country. Of 26 adult nephrologists who responded, 16 (61.5%) were involved in pediatric transplantation, and 10 of 15 (66.6%) pediatric nephrologists were involved in pediatric transplantation. Most of the centers doing transplants were private/trust institution with only three government institutions undertaking it. Induction therapy was varied among pediatric and adult nephrologists. There were only a few centers (n=5) in the country routinely doing >5 transplants per year. Preemptive transplants and protocol biopsies were a rarity. The results demonstrate lower incidence of undertaking pediatric transplants in children below 6 years, paucity of active cadaveric programs and lack of availability of trained pediatric nephrologists and staff. In contrast to these dissimilarities, the immunosuppressant use seems to be quite similar to Western registry data with majority favoring induction agent and triple immunosuppressant (steroid, mycophenolate mofetil and tacrolimus) for maintenance. The survey also identifies major concerns in availability of this service to all regions of India as well as to all economic segments. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

[Personalized medicine in transplantation therapy].

Science.gov (United States)

Nakatani, Kaname

2013-05-01

Personalized medicine based on pharmacogenomics is being developed at the clinical stage. Various evidence is accumulating in transplantation therapy. Tacrolimus, a calcineurin inhibitor, is usually used for immunosuppressive therapy after transplantation. Tacrolimus is mainly metabolized by cytochrome P450 isozymes, CYP3A4 and CYP3A5, expressed in the intestine as well as in the liver. Recent studies of pharmacogenomics have reported that several single nucleotide polymorphisms (SNPs) of CYP3A5 are correlated with gene expression and enzyme activity. Phenotypes of CYP3A5 are typed as expressors (*1/*1 and *1/*3) or non-expressors (*3/*3) . In living-donor liver transplantation, CYP3A5 phenotypes could predict the blood concentration of tacrolimus. In particular, preoperative assessment of CYP3A5 genotypes in both recipients (intestine) and donors (graft liver) is required for predicting tacrolimus pharmacokinetics. In kidney transplantation, blood tacrolimus concentrations were significantly different between expressors and non-expressors. Genotyping and phenotyping of recipients were useful to predict blood tacrolimus levels in early phase of post-transplantation. Furthermore, phenotypes of CYP3A5 could predict the initial dose of tacrolimus. Combination therapy was performed after bone marrow transplantation to prevent complications. Genotyping and phenotyping of metabolic enzymes for combination dugs would be useful for predicting drug actions. In conclusion, phenotyping based on pharmacogenomics supports personalized medicine in transplantation therapy. In future, multiplex testing should be developed to support personalized medicine in various fields.

Predicting adherence to health care recommendations using health promotion behaviours in kidney transplant recipients within 1-5 years post-transplant.

Science.gov (United States)

Lin, Su-Yueh; Fetzer, Susan J; Lee, Po-Chang; Chen, Ching-Huey

2011-12-01

This study examined health promotion behaviours of kidney transplant recipients, 1-5 years after transplant and identified the risk factors predicting non-adherence to post-transplant recommendations. Non-adherence to health care recommendations and health promotion behaviours is one of the top three reasons for graft loss following kidney transplantation. A cross-sectional study. Kidney transplant recipients (n=101) in southern Taiwan completed a self reported survey, the Kidney Transplant Health Promotion Behavior and Healthcare Provider Support survey. Kidney transplant patients had better adherence with medication and least adherence with regular exercise health promotion behaviours. Age, post kidney transplant time, health care provider support and financial satisfaction accounted for 37·2% of the explained variance in monitoring and management for rejection and infection. Marital status, post kidney transplant time and gender accounted for 16·2% of the explained variance in infection prevention. Age was the sole predictor of exercise (odds ratio=1·08, p=0·025). Health promotion behaviours declined with time and perceived healthcare provider support decreased at the third (p=0·04) post kidney transplant year. In this study, young, single, males were identified as requiring specific strategies to improve post kidney transplant health promotion behaviours. The need for health promotion must be continually reinforce by healthcare providers throughout the lifespan of a kidney transplant recipient. Understanding the changes of health behaviours of post kidney transplant recipients and their risk factors, healthcare providers can be more aware of the needs of patients in maintaining health promotion behaviours. © 2011 Blackwell Publishing Ltd.

Pancreas transplants

International Nuclear Information System (INIS)

Chandra, J.; Phillips, R.R.; Boardman, P.; Gleeson, F.V.; Anderson, E.M.

2009-01-01

Cadaveric, whole pancreas transplantation has proved an effective therapy in the treatment of long-standing type 1 diabetes mellitus and is capable of achieving an insulin-independent eugyclaemic state. As a result, this procedure is being increasingly performed. However, the surgical procedure is complex and unfamiliar to many radiologists. Imaging with computed tomography (CT) and magnetic resonance imaging (MRI) gives excellent results and can be used confidently to diagnose vascular, enteric, and immune-mediated complications. We present a review of the normal post-transplantation appearance and the features of early and late complications.

Pancreas transplants

Energy Technology Data Exchange (ETDEWEB)

Chandra, J.; Phillips, R.R.; Boardman, P.; Gleeson, F.V. [Department of Radiology, Churchill Hospital, Headington, Oxford (United Kingdom); Anderson, E.M. [Department of Radiology, Churchill Hospital, Headington, Oxford (United Kingdom)], E-mail: ewan.anderson@orh.nhs.uk

2009-07-15

Cadaveric, whole pancreas transplantation has proved an effective therapy in the treatment of long-standing type 1 diabetes mellitus and is capable of achieving an insulin-independent eugyclaemic state. As a result, this procedure is being increasingly performed. However, the surgical procedure is complex and unfamiliar to many radiologists. Imaging with computed tomography (CT) and magnetic resonance imaging (MRI) gives excellent results and can be used confidently to diagnose vascular, enteric, and immune-mediated complications. We present a review of the normal post-transplantation appearance and the features of early and late complications.

Neurologic Complications of Transplantation.

Science.gov (United States)

Dhar, Rajat

2018-02-01

Neurologic disturbances including encephalopathy, seizures, and focal deficits complicate the course 10-30% of patients undergoing organ or stem cell transplantation. While much or this morbidity is multifactorial and often associated with extra-cerebral dysfunction (e.g., graft dysfunction, metabolic derangements), immunosuppressive drugs also contribute significantly. This can either be through direct toxicity (e.g., posterior reversible encephalopathy syndrome from calcineurin inhibitors such as tacrolimus in the acute postoperative period) or by facilitating opportunistic infections in the months after transplantation. Other neurologic syndromes such as akinetic mutism and osmotic demyelination may also occur. While much of this neurologic dysfunction may be reversible if related to metabolic factors or drug toxicity (and the etiology is recognized and reversed), cases of multifocal cerebral infarction, hemorrhage, or infection may have poor outcomes. As transplant patients survive longer, delayed infections (such as progressive multifocal leukoencephalopathy) and post-transplant malignancies are increasingly reported.

Employment outcomes following successful renal transplantation.

Science.gov (United States)

Eng, Mary; Zhang, Jie; Cambon, Alexander; Marvin, Michael R; Gleason, John

2012-01-01

Data on employment outcomes after successful renal transplantation are few. We conducted this study to identify favorable factors for employment after transplantation. Adult patients rate was obtained where 56% of respondents were employed after transplantation. Race, marital status, previous transplant, and complicated post-operative course did not influence employment. Favorable factors include male gender (p=0.04), younger age (employment (pemployment was 4.9±6.3 months (median three months). Common reasons for unemployment were disability (59%) and retirement (27%). Finally, 7% correctly responded that Medicare benefits end 36 months following transplantation. Potentially modifiable factors to improve employment are earlier referral and better education regarding Medicare eligibility. © 2011 John Wiley & Sons A/S.

Extravascular complications following abdominal organ transplantation

International Nuclear Information System (INIS)

Low, G.; Jaremko, J.L.; Lomas, D.J.

2015-01-01

A variety of transplants have been performed in the abdomen including liver, kidney, pancreas and islet, bowel, and multivisceral transplants. Imaging plays an important role in graft surveillance particularly to exclude post-transplant complications. When complications occur, therapeutic image-guided interventions are invaluable as these may be graft-saving and even life-saving. Vascular complications following transplantation have been extensively reported in recent reviews. The focus of this review is to discuss post-transplant complications that are primarily extravascular in location. This includes biliary, urological, intestinal, malignancy, infections, and miscellaneous complications. Familiarity with the imaging appearances of these complications is helpful for radiologists as accurate diagnosis and expedient treatment has an impact on graft and patient survival

Current issues in allogeneic islet transplantation.

Science.gov (United States)

Chang, Charles A; Lawrence, Michael C; Naziruddin, Bashoo

2017-10-01

Transplantation of allogenic pancreatic islets is a minimally invasive treatment option to control severe hypoglycemia and dependence on exogenous insulin among type 1 diabetes (T1D) patients. This overview summarizes the current issues and progress in islet transplantation outcomes and research. Several clinical trials from North America and other countries have documented the safety and efficacy of clinical islet transplantation for T1D patients with impaired hypoglycemia awareness. A recently completed phase 3 clinical trial allows centres in the United States to apply for a Food and Drug Administration Biologics License for the procedure. Introduction of anti-inflammatory drugs along with T-cell depleting induction therapy has significantly improved long-term function of transplanted islets. Research into islet biomarkers, immunosuppression, extrahepatic transplant sites and potential alternative beta cell sources is driving further progress. Allogeneic islet transplantation has vastly improved over the past two decades. Success in restoration of glycemic control and hypoglycemic awareness after islet transplantation has been further highlighted by clinical trials. However, lack of effective strategies to maintain long-term islet function and insufficient sources of donor tissue still impose limitations to the widespread use of islet transplantation. In the United States, wide adoption of this technology still awaits regulatory approval and, importantly, a financial mechanism to support the use of this technology.

Transplantation tolerance after total lymphoid irradiation

Energy Technology Data Exchange (ETDEWEB)

Strober, S.; Slavin, S.; Fuks, Z.; Kaplan, H.S.; Gottlieb, M.; Bieber, C.; Hoppe, R.T.; Grumet, F.C.

1979-03-01

We have presented an animal model of tissue transplantation tolerance using the unusual effects of TLI on the immune system. The application of TLI to bone marrow and whole-organ transplantation in humans merits further study, since TLI offers several advantages over presently used therapeutic modalities. Current regimens used to prepare patients for marrow transplantation are lethal in the absence of allogeneic marrow engraftment, and marrow donors are restricted to HLA-matched siblings due to the danger of GHVD. On the other hand, TLI is a nonlethal procedure that has been used successfully in animals to transplant allogeneic marrow from unmatched donors without the development of GHVD. Thus, TLI might allow for marrow transplantation in all patients with a single sibling, whereas conventional procedures are feasible in only one of four such cases (probability of finding a single HLA-matched sibling). In addition, the induction of transplantation tolerance with TLI would obviate the requirement for the use of maintenance immunosuppressive drugs after whole-organ transplantation. Systemic infections associated with the use of these drugs currently account for the majority of deaths in heart transplant patients. Serious infectious complications associated with TLI are rare; thus this therapeutic regimen may offer considerable improvement in the long-term survival of organ graft recipients as compared to that presently obtained with immunosuppressive drugs.

Transplantation in autoimmune liver diseases

Institute of Scientific and Technical Information of China (English)

Marcus Mottershead; James Neuberger

2008-01-01

Liver transplantation remains an effective treatment for those with end-stage disease and with intractable liver-related symptoms.The shortage of organs for transplantation has resulted in the need for rationing.A variety of approaches to selection and allocation have been developed and vary from country to country.The shortage of donors has meant that new approaches have to be adopted to make maximal use of the available organs;these include splitting grafts,use of extended criteria livers,livers from nonheart-beating donors and from living donors.Post transplantation, most patients will need life-long immunosuppression,although a small proportion can have immunosuppression successfully withdrawn.Newer immunosuppressive drugs and different strategies may allow a more targeted approach with a reduction in sideeffects and so improve the patient and graft survival.For autoimmune diseases, transplantation is associated with significant improvement in the quality and length of life.Disease may recur after transplantation and may affect patient and graft survival.

Nutritional Therapy in Liver Transplantation

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Ahmed Hammad

2017-10-01

Full Text Available Protein-energy malnourishment is commonly encountered in patients with end-stage liver disease who undergo liver transplantation. Malnutrition may further increase morbidity, mortality and costs in the post-transplantation setting. The importance of carefully assessing the nutritional status during the work-up of patients who are candidates for liver replacement is widely recognized. The metabolic abnormalities induced by liver failure render the conventional assessment of nutritional status to be challenging. Preoperative loss of skeletal muscle mass, namely, sarcopenia, has a significant detrimental impact on post-transplant outcomes. It is essential to provide sufficient nutritional support during all phases of liver transplantation. Oral nutrition is preferred, but tube enteral nutrition may be required to provide the needed energy intake. Herein, the latest currently employed perioperative nutritional interventions in liver transplant recipients are thoroughly illustrated including synbiotics, micronutrients, branched-chain amino acid supplementation, immunonutrition formulas, fluid and electrolyte balance, the offering of nocturnal meals, dietary counselling, exercise and rehabilitation.

Hematopoietic stem cell transplantation in Europe 2014: more than 40 000 transplants annually.

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Passweg, J R; Baldomero, H; Bader, P; Bonini, C; Cesaro, S; Dreger, P; Duarte, R F; Dufour, C; Kuball, J; Farge-Bancel, D; Gennery, A; Kröger, N; Lanza, F; Nagler, A; Sureda, A; Mohty, M

2016-06-01

A record number of 40 829 hematopoietic stem cell transplantation (HSCT) in 36 469 patients (15 765 allogeneic (43%), 20 704 autologous (57%)) were reported by 656 centers in 47 countries to the 2014 survey. Trends include: continued growth in transplant activity, more so in Eastern European countries than in the west; a continued increase in the use of haploidentical family donors (by 25%) and slower growth for unrelated donor HSCT. The use of cord blood as a stem cell source has decreased again in 2014. Main indications for HSCT were leukemias: 11 853 (33%; 96% allogeneic); lymphoid neoplasias; 20 802 (57%; 11% allogeneic); solid tumors; 1458 (4%; 3% allogeneic) and non-malignant disorders; 2203 (6%; 88% allogeneic). Changes in transplant activity include more allogeneic HSCT for AML in CR1, myeloproliferative neoplasm (MPN) and aplastic anemia and decreasing use in CLL; and more autologous HSCT for plasma cell disorders and in particular for amyloidosis. In addition, data on numbers of teams doing alternative donor transplants, allogeneic after autologous HSCT, autologous cord blood transplants are presented.

Intravenous versus oral iron supplementation for correction of post-transplant anaemia in renal transplant patients

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Mudge David W

2009-06-01

Full Text Available Abstract Background Post-transplant anaemia remains a common problem after kidney transplantation, with an incidence ranging from nearly 80% at day 0 to about 25% at 1 year. It has been associated with poor graft outcome, and recently has also been shown to be associated with increased mortality. Our transplant unit routinely administers oral iron supplements to renal transplant recipients but this is frequently accompanied by side effects, mainly gastrointestinal intolerance. Intravenous iron is frequently administered to dialysis patients and we sought to investigate this mode of administration in transplant recipients after noticing less anaemia in several patients who had received intravenous iron just prior to being called in for transplantation. Methods This study is a single-centre, prospective, open-label, randomised, controlled trial of oral versus intravenous iron supplements in renal transplant recipients and aims to recruit approximately 100 patients over a 12-month period. Patients will be randomised to receive a single dose of 500 mg iron polymaltose (intravenous iron group or 2 ferrous sulphate slow-release tablets daily (oral iron group. The primary outcome is time to normalisation of haemoglobin post-transplant. Prospective power calculations have indicated that a minimum of 48 patients in each group would have to be followed up for 3 months in order to have a 90% probability of detecting a halving of the time to correction of haemoglobin levels to ≥110 g/l in iron-treated patients, assuming an α of 0.05. All eligible adult patients undergoing renal transplantation at the Princess Alexandra Hospital will be offered participation in the trial. Exclusion criteria will include iron overload (transferrin saturation >50% or ferritin >800 μg/l, or previous intolerance of either oral or intravenous iron supplements. Discussion If the trial shows a reduction in the time to correction of anaemia with intravenous iron or less side

T cell depleted haploidentical transplantation: positive selection

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Franco Aversa

2011-06-01

Full Text Available Interest in mismatched transplantation arises from the fact that a suitable one-haplotype mismatched donor is immediately available for virtually all patients, particularly for those who urgently need an allogenic transplant. Work on one haplotype-mismatched transplants has been proceeding for over 20 years all over the world and novel transplant techniques have been developed. Some centres have focused on the conditioning regimens and post transplant immune suppression; others have concentrated on manipulating the graft which may be a megadose of extensively T celldepleted or unmanipulated progenitor cells. Excellent engraftment rates are associated with a very low incidence of acute and chronic GVHD and regimen-related mortality even in patients who are over 50 years old. Overall, event-free survival and transplant-related mortality compare favourably with reports on transplants from sources of stem cells other than the matched sibling.

Ethnic Disparities in Liver Transplantation

OpenAIRE

Kemmer, Nyingi

2011-01-01

End-stage liver disease is a major cause of morbidity and mortality among ethnic minorities. In the United States, ethnic minorities comprise approximately 30% of all adult liver transplantations performed annually. Several studies have suggested that ethnic populations differ with respect to access and outcomes in the pre- and post-transplantation setting. This paper will review the existing literature on ethnic variations in the adult liver transplantation population.

Challenges in renal transplantation in Yemen.

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El-Nono, Ibrahiem H; Telha, Khaled A; Al-Alimy, Gamil M; Ghilan, Abdulilah M; Abu Asba, Nagieb W; Al-Zkri, Abdo M; Al-Adimi, Abdulilah M; Al-Ba'adani, Tawfiq H

2015-02-16

Background Renal replacement therapy was first introduced in Yemen in 1978 in the form of hemodialysis. Twenty years later, the first renal transplantation was performed. Kidney transplantations were started in socially and financially challenging circumstances in Yemen in 1998. A structured program was established and has been functioning regularly since 2005. A pediatric transplantation program was started in 2011. Material and Methods This was a prospective study of 181 transplants performed at the Urology and Nephrology Center between May 1998 and 2012. All transplants were from living related donors. The immunosuppressive protocol consisted initially of double therapy with steroid and mycophenolate mofetil (MMF). Subsequently, triple therapy with addition of a calcineurin inhibitor was introduced. Primary graft function was achieved in 176 (97.2%) recipients. Results Cold ischemia time was 48-68 min. Episodes of acute rejection in 12 patients were treated with high-dose steroids. Anti-thymocyte globulin (ATG) was used in cases of vascular or steroid-resistant rejection in 2 patients. The post-transplant complications, either surgical or medical, were comparable to those recorded in the literature. Conclusions Renal transplantation is a good achievement in our country. The patients and graft survival rates are comparable to other reports.

Pre-transplant and post-transplant soluble CD30 for prediction and diagnosis of acute kidney allograft rejection.

Science.gov (United States)

Nafar, Mohsen; Farrokhi, Farhat; Vaezi, Mohammad; Entezari, Amir-Ebrahim; Pour-Reza-Gholi, Fatemeh; Firoozan, Ahmad; Eniollahi, Behzad

2009-01-01

Serum levels of soluble CD30 (sCD30) have been considered as a predictor of acute kidney allograft rejection. We have evaluated the pre-transplant and post-transplant levels of sCD30 with the aim of determining its value in predicting and diagnosing kidney rejection. We measured sCD30 serum levels before kidney transplantation, 5 days post-operatively, and at creatinine elevation episodes. The predictive value of sCD30 for diagnosing acute rejection (AR) within the first 6 post-operative months was assessed in 203 kidney recipients from living donors. Pre-transplant and post-operative levels of serum sCD30 were 58.10 +/- 52.55 and 51.55 +/- 49.65 U/ml, respectively (P = 0.12). Twenty-three patients experienced biopsy-proven acute rejection, and 28 had acute allograft dysfunction due to non-immunologic diseases. The pre-transplant sCD30 level was not different between patients with and without AR. However, post-transplant sCD30 was higher in the AR group. The median serum level of post-transplant sCD30 was 52 U/ml in the AR group and 26.3 U/ml in a control group (P sCD30 on day 5 were higher in patients with AR (P = 0.003). Based on post-transplant sCD30 levels, we were able to differentiate between kidney recipients who experienced an AR within 6 months post-surgery and those without an AR (cutoff value 41 U/ml; sensitivity 70%; specificity 71.7%). The level of sCD30 during periods of elevated serum creatinine was not independently associated with the diagnosis of AR. Post-transplant sCD30 levels and their relative changes are higher in patients experiencing AR. We propose further studies on the post-transplant trend of this marker for the prediction of AR.

A Case of Alloimmune Thrombocytopenia, Hemorrhagic Anemia-Induced Fetal Hydrops, Maternal Mirror Syndrome, and Human Chorionic Gonadotropin–Induced Thyrotoxicosis

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Venu Jain

2013-05-01

Full Text Available Fetal/neonatal alloimmune thrombocytopenia (FNAIT can be a cause of severe fetal thrombocytopenia, with the common presentation being intracranial hemorrhage in the fetus, usually in the third trimester. A very unusual case of fetal anemia progressed to hydrops. This was further complicated by maternal Mirror syndrome and human chorionic gonadotropin–induced thyrotoxicosis. Without knowledge of etiology, and possibly due to associated cardiac dysfunction, fetal transfusion resulted in fetal demise. Subsequent testing revealed FNAIT as the cause of severe hemorrhagic anemia. In cases with fetal anemia without presence of red blood cell antibodies, FNAIT must be ruled out as a cause prior to performing fetal transfusion. Fetal heart may adapt differently to acute hemorrhagic anemia compared with a more subacute hemolytic anemia.

Laparoscopic cholecystectomy in a cardiac transplant recipient.

Science.gov (United States)

Pandya, Seema R; Paranjape, Saloni

2014-04-01

An increasing number of cardiac transplants are being carried out around the world. With increasing longevity, these patients present a unique challenge to non-transplant anesthesiologists for a variety of transplant related or incidental surgeries. The general considerations related to a cardiac transplant recipient are the physiological and pharmacological problems of allograft denervation, the side-effects of immunosuppression, the risk of infection and the potential for rejection. A thorough understanding of the physiology of a denervated heart, need for direct vasoactive agents and post-transplant morbidities is essential in anesthetic management of such a patient. Here, we describe a case of a heart transplant recipient who presented for a cholecystectomy at our center.

First trimester serum placental growth factor and hyperglycosylated human chorionic gonadotropin are associated with pre-eclampsia: a case control study.

Science.gov (United States)

Keikkala, Elina; Koskinen, Sini; Vuorela, Piia; Laivuori, Hannele; Romppanen, Jarkko; Heinonen, Seppo; Stenman, Ulf-Håkan

2016-11-25

To study whether maternal serum hyperglycosylated human chorionic gonadotropin (hCG-h) improves first trimester prediction of pre-eclampsia when combined with placental growth factor (PlGF), pregnancy-associated plasma protein-A (PAPP-A) and maternal risk factors. Gestational-age-adjusted concentrations of hCG, hCG-h, PlGF and PAPP-A were analysed in serum samples by time-resolved immunofluorometric assays at 8-13 weeks of gestation. The case-control study included 98 women who developed pre-eclampsia, 25 who developed gestational hypertension, 41 normotensive women with small-for-gestational-age (SGA) infants and 177 controls. Of 98 women with pre-eclampsia, 24 women developed preterm pre-eclampsia (diagnosis factors.

Pediatric liver transplantation in 31 consecutive children

Institute of Scientific and Technical Information of China (English)

SHEN Zhong-yang; WANG Zi-fa; ZHU Zhi-jun; ZANG Yun-jin; ZHENG Hong; DENG Yong-lin; PAN Cheng; CHEN Xin-guo

2008-01-01

Background Although liver transplantation has become a standard therapy for end-stage liver diseases, the experience of pediatric liver transplantation is limited in China. In this article we report our experience in pediatric liver transplantation, and summarize its characters in their indications, surgical techniques, and postoperative managements. Methods Thirty-one children (≤18 years old) underwent liver transplantation in our centers. The mean age at transplantation was 12.4 years old (ranged from 5 months to 18 years) with 7 children being less than 4 years of age at transplantation. The most common diagnosis of patients who underwent liver transplantation were biliary atresia, Wilson's disease, primary biliary cirrhosis, glycogen storage disease, hepatoblastoma, urea cycle defects, fulminant hepatic failure, etc. The surgical procedures included 12 standard (without venovenous bypass), 6 pigyback, 6 reduced-size, 3 split, 3 living donor liver transplantation, and 1 Domino liver transplantation. The triple-drug (FK506, steroid, and mycophenolate mofetil) immunosuppressive regimen was used in most of patients. Patients were followed up for a mean of 21.8 months. Results Five of the 31 patients died during perioperative time; mortality rate was 16.1%. The reasons of death were infections, primary non-function, heart failure, and hypovolemic shock. Postoperative complications in 10 patients included biliary leakage, acute rejection, abdominal infection, hepatitis B virus (HBV) or hepatitis C virus (HCV) infection, and pulmonary infection. Overall patient cumulative survival rate at 1-, 3-, and 5-year was 78.1%, 62.6%, 62.6%, respectively.Conclusions The most common indications of pediatric liver transplantation were congenital end-stage liver diseases. According to patients' age and body weight, standard, piggyback, reduced-size, split, or living donor liver transplantation should be performed. Pediatric liver transplantation especially requires higher

Renal transplant scintigraphy (Part 1)

International Nuclear Information System (INIS)

Chew, Ghee

2005-01-01

Renal transplantation is the most effective mode of renal replacement therapy for correction of renal failure. Renal donors can either be: a. a deceased person - the kidneys being removed when brain death or absence of cerebral cortical function / perfusion is confirmed - the cadaveric kidney is packed in ice and nutrient solution and transplanted within 24 hours of removal ('cold ischemia') ob. a living donor - the donor may or may not be related to the recipient. Due to the limited length of the renal vessels and ureter of the donor kidney, it is implanted close to the bladder of the recipient. The donor vessels are anastomosed to the iliac artery and vein of the recipient. Transplant variants: a. 2 kidneys maybe transplanted because: - an old donor with less kidney reserve from atrophy due to age or disease (e.g. hypertension) - an infant donor when both kidneys are removed en bloc, b. Donor kidneys with more than 1 artery, vein or ureter. c. Donor horse shoe kidney d. Combined renal and pancreas transplant for type I diabetics -a short segment of duodenum transplanted with the pancreas maybe implanted into the bladder. Copyright (2005) The Australian and New Zealand Society of Nuclear Medicine

Sociological and ethical issues in transplant commercialism.

Science.gov (United States)

Epstein, Miran

2009-04-01

'Global transplant commercialism' (practices and policies involving international trade in organs from living vendors, e.g., 'transplant tourism') is currently subjected to unprecedented criticism. In parallel, the debate around 'local transplant commercialism' (practices and policies that confine trade in organs from living vendors to national markets or economic unions) is heating up. In an attempt to assess the potential outcomes of these trends, this article reviews and discusses some sociological and ethical issues, ending with a proposal for a reinvigorated anticommercialist strategy. The current international campaign against global transplant commercialism is conducted by an ad hoc alliance between strange bedfellows, proponents of local transplant commercialism on the one hand and opponents of any transplant commercialism on the other. Disparities in the rigor of the respective ethical discourses, the expanding list of precedents of legitimized commerce in the human body, and the political economy of transplantation, all suggest that the former have the upper hand. Recent achievements in the struggle against international organ trafficking may not herald the abolition of transplant commercialism but rather presage its reconfiguration in deglobalized forms. In light of such a prospect, those who wish to prevent the pervasive commodification of the human body from entering the gates of transplant medicine should consider devising a new, perhaps more radical, strategy.

[Lung transplantation: supply and demand in France].

Science.gov (United States)

Stern, M; Souilamas, R; Tixier, D; Mal, H

2008-10-01

For a decade lung transplantation has suffered from a lack of donor organs which aroused a national debate and led to planned action in collaboration with The French National Agency for Transplantation. Analysis of the stages of the process from potential donor to lung transplantation identified lung procurement as the main priority. An increase in the number of potential lung donors and revision of the acceptance criteria led to a doubling of the annual rate of lung transplantation in less than two years. In the near future we may solve the problem of donor family refusals and establish scientifically based criteria for lung acceptance to increase the rate of lung transplantation. Transplantation from non heart-beating donors and the reconditioning of ex vivo non acceptable lungs might supply additional organs to fulfill demand in the long term. The rate of lung transplantation activity in France doubled as the result of a dramatic increase of donor lung proposals. The current improvement in the results of lung transplantation might create new demands and generate future difficulties in the supply of donor lungs. New approaches, such as transplantation from non heart-beating donors and reconditioning ex vivo non acceptable lungs, should be examined in the near future.

Diabetic Foot Complications Despite Successful Pancreas Transplantation.

Science.gov (United States)

Seo, Dong-Kyo; Lee, Ho Seong; Park, Jungu; Ryu, Chang Hyun; Han, Duck Jong; Seo, Sang Gyo

2017-06-01

It is known that successful pancreas transplantation enables patients with diabetes to maintain a normal glucose level without insulin and reduces diabetes-related complications. However, we have little information about the foot-specific morbidity in patients who have undergone successful pancreas transplantation. The purpose of this study was to investigate the prevalence and predisposing factors for foot complications after successful pancreas transplantation. This retrospective study included 218 patients (91 males, 127 females) who had undergone pancreas transplantation for diabetes. The mean age was 40.7 (range, 15-76) years. Diabetes type, transplantation type, body mass index, and diabetes duration before transplantation were confirmed. After pancreas transplantation, the occurrence and duration of foot and ankle complications were assessed. Twenty-two patients (10.1%) had diabetic foot complications. Fifteen patients (6.9%) had diabetic foot ulcer and 7 patients (3.2%) had Charcot arthropathy. Three patients had both diabetic foot ulcer and Charcot arthropathy. Three insufficiency fractures (1.4%) were included. Mean time of complications after transplantation was 18.5 (range, 2-77) months. Creatinine level 1 year after surgery was higher in the complication group rather than the noncomplication group ( P = .02). Complications of the foot and ankle still occurred following pancreas transplantation in patients with diabetes. Level III, comparative study.

An examination of photoacclimatory responses of Zostera marina transplants along a depth gradient for transplant-site selection in a disturbed estuary

Science.gov (United States)

Li, Wen-Tao; Kim, Seung Hyeon; Kim, Jae Woo; Kim, Jong-Hyeob; Lee, Kun-Seop

2013-02-01

Growth and photosynthetic responses of Zostera marina transplants along a depth gradient were examined to determine appropriate transplanting areas for seagrass restoration. Seagrass Z. marina was once widely distributed in the Taehwa River estuary in southeastern Korea, but has disappeared since the 1960s due to port construction and large scale pollutant inputs from upstream industrial areas. Recently, water quality has been considerably improved as a result of effective sewage treatment, and the local government is attempting to restore Z. marina to the estuary. For seagrass restoration in this estuary, a pilot transplantation trial of Z. marina at three water depths (shallow: 0.5 m; intermediate: 1.5 m; deep: 2.5 m relative to MLLW) was conducted in November 2008. The transplant shoot density increased gradually at the intermediate and deep sites, whereas the transplants at the shallow site disappeared after 3 months. To find the optimal transplantation locations in this estuary, the growth and photosynthetic responses of the transplants along a depth gradient were examined for approximately 4 months following transplantation in March 2009. In the 2009 experimental transplantation trial, shoot density of transplants at the shallow site was significantly higher than those at the intermediate and deep sites during the first 3 months following transplantation, but rapidly decreased approximately 4 months after transplantation. The chlorophyll content, photosynthetic efficiency (α), and maximum quantum yield (Fv/Fm) of the transplants were significantly higher at the deep site than at the shallow site. Shoot size, biomass and leaf productivity were also significantly higher at the deep site than at the shallow site. Although underwater irradiance was significantly lower at the deep site than at the shallow site, transplants at the deep site were morphologically and physiologically acclimated to the low light. Transplants at the shallow site exhibited high

Bone marrow transplantation immunology

International Nuclear Information System (INIS)

Trentin, J.J.; Kiessling, R.; Wigzell, H.; Gallagher, M.T.; Datta, S.K.; Kulkarni, S.S.

1977-01-01

Tests were made to determine whether genetic resistance (GR) to bone marrow transplantation represents a natural lymphoma-leukemia defense mechanism, as follows: (C57 x AKR) F 1 hybrid mice show GR to C57 parental bone marrow cells, but not to AKR parental bone marrow cells (C3H x AKR) F 1 hybrids show no GR to bone marrow transplantation from either parental strain. However, transplantation of AKR lymphoma cells into lethally irradiated ''resistant'' (C57 x AKR) F 1 and ''nonresistant'' (C3H x AKR) F 1 hybrids produced lymphomatous spleen colonies in ''nonresistant'' hybrids but not in ''resistant'' hybrids. Thus ''resistant'' (C57 x AKR) F 1 hybrids can recognize and reject AKR lymphoma cells, but not normal AKR bone marrow cells. A normal biologic role of leukemia-lymphoma surveillance was postulated for genetic resistance to marrow transplantation, directed at antigens which, like TL, are expressed on normal hemopoietic cells of some strains, but only on leukemic cells of other strains

Clinical aspects of bone marrow transplantation

International Nuclear Information System (INIS)

Shmitts, N.; Gassmann, V.; Leffler, G.

1986-01-01

Experience of bone marrow transplantation into patients with myeloproliferative syndromes, myelodysplasias and highly malignant lymphomas is presented. Side early and late effects of transplantation are described. The frequency and severity of complications of bone marrow transplantation depend sufficiently on the disease as well as on patient's age and general condition

Medicine non-adherence in kidney transplantation.

Science.gov (United States)

Williams, Allison Fiona; Manias, Elizabeth; Gaskin, Cadeyrn J; Crawford, Kimberley

2014-06-01

The increasing prevalence of chronic kidney disease, the relative shortage of kidney donors and the economic- and health-related costs of kidney transplant rejection make the prevention of adverse outcomes following transplantation a healthcare imperative. Although strict adherence to immunosuppressant medicine regimens is key to preventing kidney rejection, evidence suggests that adherence is sub-optimal. Strategies need to be developed to help recipients of kidney transplants adhere to their prescribed medicines. This review has found that a number of factors contribute to poor adherence, for example, attitudes towards medicine taking and forgetfulness. Few investigations have been conducted, however, on strategies to enhance medicine adherence in kidney transplant recipients. Strategies that may improve adherence include pharmacist-led interventions (incorporating counselling, medicine reviews and nephrologist liaison) and nurse-led interventions (involving collaboratively working with recipients to understand their routines and offering solutions to improve adherence). Strategies that have shown to have limited effectiveness include supplying medicines free of charge and providing feedback on a participant's medicine adherence without any educational or behavioural interventions. Transplantation is the preferred treatment option for people with end-stage kidney disease. Medicine non-adherence in kidney transplantation increases the risk of rejection, kidney loss and costly treatments. Interventions are needed to help the transplant recipient take all their medicines as prescribed to improve general well-being, medicine safety and reduce healthcare costs. © 2014 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Small Bowel Transplantation: Current Clinical Status

Directory of Open Access Journals (Sweden)

David Sigalet

1991-01-01

Full Text Available With recent refinements in immunosuppression techniques, the first successful reports of small bowel transplantation in humans have now been made, increasing interest in bowel transplantation among clinicians and patients alike. This article reviews recent developments in understanding of the functional capabilities and requirements for effective immune suppression in bowel transplantation. Both experimental and clinical experience with transplantation are discussed, as are the areas which appear to offer the most promise for future developments. Finally guidelines for consideration of patient selection for this procedure are reviewed.

Social participation after successful kidney transplantation.

Science.gov (United States)

van der Mei, Sijrike F; van Sonderen, Eric L P; van Son, Willem J; de Jong, Paul E; Groothoff, Johan W; van den Heuvel, Wim J A

2007-03-30

To explore and describe the degree of social participation after kidney transplantation and to examine associated factors. A cross-sectional study on 239 adult patients 1-7.3 years after kidney transplantation was performed via in-home interviews on participation in obligatory activities (i.e., employment, education, household tasks) and leisure activities (volunteer work, assisting others, recreation, sports, clubs/associations, socializing, going out). Kidney transplantation patients had a lower educational level, spent less time on obligatory activities, had part-time jobs more often, and participated less in sports compared to a control group from the general population. No difference was found in socializing, church attendance, volunteer work and going out. Multivariate regression analysis showed a negative association of age and a positive association of educational status and time since transplantation with obligatory participation. Multivariate logistic regression showed positive associations of education and time since transplantation with volunteer work; age was negatively and education positively associated with sports and going out, whereas living arrangement was also associated with going out. Although kidney transplantation patients participate less in employment and sports, they do participate in household tasks, volunteer work, going out, socializing and other leisure activities. Participation is associated with factors as age, educational status and time since transplantation.

The effect of squash training on shoulder girdle mobility and frequency of injury among player

Directory of Open Access Journals (Sweden)

Mikołaj Gajewski

2017-05-01

Full Text Available Introduction: Squash is a relatively new field in the Polish sports market. Its specification is based primarily on dynamic movements, often taking place at the end of its scope. This condition is an increased risk of injury as well as numerous compensations throughout the body. Aim: The aim of the study was to examine the impact of squash training on shoulder mobility of active athletes and to identify factors likely to increase trauma among players. Does squash game cause hypermobility in all dimension? Do long-term breaks in squash training increase the frequency of injuries? Does pre-training warm up affect trauma? Material and method: The study consists 110 active players: 19 women (17% and 91 men (83% age between 17 and 50 years. The research tool was an author’s questionnaire consisting of metrics and closed questions, which examined the problem and testing the mobility of the shoulder girdle using  an inclinometer and functional tests. Descriptive statistics were made. The greatest limitation of the range of motion in the shoulder joint is observed in the sagittal plane - flexion. No injury was associated with a prolonged break from training. Conclusion: Squash players did not have hypomobility in the shoulder joint and even had a limited range of motion. Long-term breaks in squash training do not increase the level of trauma.

Pulmonary Infection In Renal Transplant Recipients

Directory of Open Access Journals (Sweden)

Rassulineiad M

2003-11-01

Full Text Available Renal transplantation is ideal treatment of chronic renal failure. Pulmonary infection is a common and serious post transplant infection requiring hospitalization and is associated with high mortality. Increased susceptibility to infection is due to a decrease in the patients' immunological response caused by immunosuppression through drug administration, and by other influences."nMaterials and Methods: This study was case series and prospective, from July 2001 to July 2002 in Imam Khomeini hospital of Tehran."nResults: 164 renal transplant recipients were studied, 14 patients (8.5% had pulmonary infection, 11 of them (78.6% were female and 3 (21.4% were male. The mean age of them was 42.6 years. The patients were followed up for 9 to 12 months. All patients were on triple immunosuppressive regimens. The interval between transplantation and the appearance of pneumonia was 2 months to 10 years. The time of beginning infection in 3 cases (21.4% was between 1 to 6 months post transplantation, 11 cases (78.6% were occurred beyond 6 months after transplantation. In 7 cases (50%, pulmonary infection was occurred during first year after transplantation. None of the 14 patients developed pulmonary infection in first month after transplantation. BAL were used in 6 cases (42.8% of pulmonary infection, and organism were detected in 5 of them (83.3%. The most common clinical feature was fever. Six cases were due to mycobacterium tuberculosis (42.9%, this organism was the most common ethiology of pneumonia. In this study tuberculosis was seen in 3.6% of renal transplant recipients. One patient had pulmonary mucormycosis. All patients with pulmonary TB were cured, and other cases with unknown case, were cured with empirical treatment."nConclusion: Our finding indicate the invasive diagnostic procedures are required in order to earlier and reliable diagnosis and then better outcome of transplantation."n"n"n"n"n"n"n 

Appraisal of the coordinator-based transplant organizational model.

Science.gov (United States)

Filipponi, F; De Simone, P; Mosca, F

2005-01-01

In 1999, the Italian Parliament passed a law aimed at setting the standards of practice and quality in organ, tissue and cell donation, and transplantation. For the first time in the history of Italian transplantation, a coordinator-based model reproducing some of the basic principles of the Spanish system was officially enacted by the Parliament, bringing to an end years of lacking regulation. What differentiates those coordinator-based systems adopted in Southern Europe from Northern European national and multinational transplant organizations is the functional integration of donor and transplant care activities enacted by national governments. The Italian model of transplant health care consists of four levels of transplant coordination: local, regional, interregional, and national. The latter is represented by Centro Nazionale Trapianti (CNT; the Italian National Center for Transplantation). CNT objectives consist of ensuring equitable access to donation and transplant care for all citizens according to the principles of the Italian National Health System. In achieving these goals, CNT acts in cooperation with three interregional transplant agencies: the Nord Italia Transplant program, the Associazione InterRegionale Trapianti, and the Organizzazione Centro Sud Trapianti. Whereas local and interregional coordinators are at the front line of all donation and transplant activities, regional and national coordinators function to monitor, direct, and plan donation and transplant health care activities. Based on the increase in donation and transplant activities recently achieved in those countries that have adopted a governmental coordinator-based transplant care model, we believe that such a system is appropriate to serve patients' interests according to the principles of subsidiary and equity. However, it should further be improved by expansion of the governance model throughout Europe, through implementation of current standards of care, and by adopting the

An economic assessment of contemporary kidney transplant practice.

Science.gov (United States)

Axelrod, David A; Schnitzler, Mark A; Xiao, Huiling; Irish, William; Tuttle-Newhall, Elizabeth; Chang, Su-Hsin; Kasiske, Bertram L; Alhamad, Tarek; Lentine, Krista L

2018-05-01

Kidney transplantation is the optimal therapy for end-stage renal disease, prolonging survival and reducing spending. Prior economic analyses of kidney transplantation, using Markov models, have generally assumed compatible, low-risk donors. The economic implications of transplantation with high Kidney Donor Profile Index (KDPI) deceased donors, ABO incompatible living donors, and HLA incompatible living donors have not been assessed. The costs of transplantation and dialysis were compared with the use of discrete event simulation over a 10-year period, with data from the United States Renal Data System, University HealthSystem Consortium, and literature review. Graft failure rates and expenditures were adjusted for donor characteristics. All transplantation options were associated with improved survival compared with dialysis (transplantation: 5.20-6.34 quality-adjusted life-years [QALYs] vs dialysis: 4.03 QALYs). Living donor and low-KDPI deceased donor transplantations were cost-saving compared with dialysis, while transplantations using high-KDPI deceased donor, ABO-incompatible or HLA-incompatible living donors were cost-effective (<$100 000 per QALY). Predicted costs per QALY range from $39 939 for HLA-compatible living donor transplantation to $80 486 for HLA-incompatible donors compared with $72 476 for dialysis. In conclusion, kidney transplantation is cost-effective across all donor types despite higher costs for marginal organs and innovative living donor practices. © 2018 The American Society of Transplantation and the American Society of Transplant Surgeons.

HLA in bone marrow transplantation

International Nuclear Information System (INIS)

Tsuji, Kimiyoshi

1989-01-01

It has been well understood that human major histocompatibility antigen system, HLA is the most important role in the allo transplantation. Therefore, the structure of HLA genes was presented by the recent information (1987). Moreover, their functions in vitro and in vivo also were described. Finally, bone marrow transplantation and HLA network system in Japan against HLA mismatched case was proposed. It is eagerly expected that functional and clinical bone marrow transplantation in Japan could be succeeded. (author)

Transplantation of Hearts Donated after Circulatory Death

Directory of Open Access Journals (Sweden)

Christopher W. White

2018-02-01

Full Text Available Cardiac transplantation has become limited by a critical shortage of suitable organs from brain-dead donors. Reports describing the successful clinical transplantation of hearts donated after circulatory death (DCD have recently emerged. Hearts from DCD donors suffer significant ischemic injury prior to organ procurement; therefore, the traditional approach to the transplantation of hearts from brain-dead donors is not applicable to the DCD context. Advances in our understanding of ischemic post-conditioning have facilitated the development of DCD heart resuscitation strategies that can be used to minimize ischemia-reperfusion injury at the time of organ procurement. The availability of a clinically approved ex situ heart perfusion device now allows DCD heart preservation in a normothermic beating state and minimizes exposure to incremental cold ischemia. This technology also facilitates assessments of organ viability to be undertaken prior to transplantation, thereby minimizing the risk of primary graft dysfunction. The application of a tailored approach to DCD heart transplantation that focuses on organ resuscitation at the time of procurement, ex situ preservation, and pre-transplant assessments of organ viability has facilitated the successful clinical application of DCD heart transplantation. The transplantation of hearts from DCD donors is now a clinical reality. Investigating ways to optimize the resuscitation, preservation, evaluation, and long-term outcomes is vital to ensure a broader application of DCD heart transplantation in the future.

The ethics of uterus transplantation.

Science.gov (United States)

Catsanos, Ruby; Rogers, Wendy; Lotz, Mianna

2013-02-01

Human uterus transplantation (UTx) is currently under investigation as a treatment for uterine infertility. Without a uterus transplant, the options available to women with uterine infertility are adoption or surrogacy; only the latter has the potential for a genetically related child. UTx will offer recipients the chance of having their own pregnancy. This procedure occurs at the intersection of two ethically contentious areas: assisted reproductive technologies (ART) and organ transplantation. In relation to organ transplantation, UTx lies with composite tissue transplants such as face and limb grafts, and shares some of the ethical concerns raised by these non-life saving procedures. In relation to ART, UTx represents one more avenue by which a woman may seek to meet her reproductive goals, and as with other ART procedures, raises questions about the limits of reproductive autonomy. This paper explores the ethical issues raised by UTx with a focus on the potential gap between women's desires and aspirations about pregnancy and the likely functional outcomes of successful UTx. © 2011 Blackwell Publishing Ltd.

Post-transplant survival in idiopathic pulmonary fibrosis patients concurrently listed for single and double lung transplantation.

Science.gov (United States)

Chauhan, Dhaval; Karanam, Ashwin B; Merlo, Aurelie; Tom Bozzay, P A; Zucker, Mark J; Seethamraju, Harish; Shariati, Nazly; Russo, Mark J

2016-05-01

Lung transplantation is a widely accepted treatment for patients with end-stage lung disease related to idiopathic pulmonary fibrosis (IPF). However, there are conflicting data on whether double lung transplant (DLT) or single lung transplant (SLT) is the superior therapy in these patients. The purpose of this study was to determine whether actuarial post-transplant graft survival among IPF patients concurrently listed for DLT and SLT is greater for recipients undergoing the former or the latter. The United Network for Organ Sharing provided de-identified patient-level data. Analysis included lung transplant candidates with IPF listed between January 1, 2001 and December 31, 2009 (n = 3,411). The study population included 1,001 (29.3%) lung transplant recipients concurrently listed for DLT and SLT, all ≥18 years of age. The primary outcome measure was actuarial post-transplant graft survival, expressed in years. Among the study population, 433 (43.26%) recipients underwent SLT and 568 (56.74%) recipients underwent DLT. The analysis included 2,722.5 years at risk, with median graft survival of 5.31 years. On univariate (p = 0.317) and multivariate (p = 0.415) regression analyses, there was no difference in graft survival between DLT and SLT. Among IPF recipients concurrently listed for DLT and SLT, there is no statistical difference in actuarial graft survival between recipients undergoing DLT vs SLT. This analysis suggests that increased use of SLT for IPF patients may increase the availability of organs to other candidates, and thus increase the net benefit of these organs, without measurably compromising outcomes. Copyright © 2016 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

Technology and outcomes assessment in lung transplantation.

Science.gov (United States)

Yusen, Roger D

2009-01-15

Lung transplantation offers the hope of prolonged survival and significant improvement in quality of life to patients that have advanced lung diseases. However, the medical literature lacks strong positive evidence and shows conflicting information regarding survival and quality of life outcomes related to lung transplantation. Decisions about the use of lung transplantation require an assessment of trade-offs: do the potential health and quality of life benefits outweigh the potential risks and harms? No amount of theoretical reasoning can resolve this question; empiric data are needed. Rational analyses of these trade-offs require valid measurements of the benefits and harms to the patients in all relevant domains that affect survival and quality of life. Lung transplant systems and registries mainly focus outcomes assessment on patient survival on the waiting list and after transplantation. Improved analytic approaches allow comparisons of the survival effects of lung transplantation versus continued waiting. Lung transplant entities do not routinely collect quality of life data. However, the medical community and the public want to know how lung transplantation affects quality of life. Given the huge stakes for the patients, the providers, and the healthcare systems, key stakeholders need to further support quality of life assessment in patients with advanced lung disease that enter into the lung transplant systems. Studies of lung transplantation and its related technologies should assess patients with tools that integrate both survival and quality of life information. Higher quality information obtained will lead to improved knowledge and more informed decision making.

Predictors of hyperparathyroidism in renal transplant recipients

International Nuclear Information System (INIS)

Houssaini, T.S.; Arrayahani, M.; Rhou, H.; Amar, Y.; Benamar, L.; Ouzeddoun, N.; Bayahia, R.

2008-01-01

The changes in parathyroid hormone secretion after successful renal transplantation remain to be clearly elucidated. Our study was aimed at identifying the predictors of hyperparathyroidism in renal transplant recipients. A retrospective single center study involving 37 renal transplant recipients, with a follow-up of at least one year, was performed. All transplants were performed using kidneys from living related donors. The average age of study patients was 30+-10 years, with a male-female ratio of 1.31. The mean duration on hemodialysis (HD) prior to transplantation was 25+-18 months. All the grafts but one were functional after a mean follow-up of 41+-21 months. We noted a rapid reduction of the mean parathyroid hormone (iPTH) level from 383+-265 pg/ml before transplantation to 125+-67 pg/ml at one year and 108+-66 pg/ml at two years after transplantation (p=0.01). Bivariate analysis revealed that the level of iPTH obtained during follow-up correlated with the duration on HD (p=0.03), the serum creatinine at 24-months (p=0.013), and to the level of iPTH in the first year post transplantation (P=<0.001). Other clinical or laboratory parameters were not predictive of hyperparathyroidism after kidney transplantation. Liner regression showed that only the serum creatinine at 24-months independently correlated with the level of iPTH at last follow-up (p=0.02). Our study suggests that short duration on HD and a functional graft are the main predictors of correction of hyperparathyroidism after renal transplantation. (author)

Native kidney reincarnation following a failed transplant

International Nuclear Information System (INIS)

Mansberg, R.; Roberts, J.M.

2002-01-01

Full text: A 51-year-old woman with end stage renal failure secondary to Haemolytic Uraemic syndrome underwent a cadaveric renal transplant. A routine post transplant DTPA scan was performed which demonstrated satisfactory renal transplant perfusion and function. Incidental note was made of tracer uptake in the pelvis in the mid-line, which was suspected to be a uterine fibroid. This was confirmed on ultrasonography and at surgery. One week post transplantation the patient became acutely unwell and at laparotomy a perforated diverticular abscess was drained. Intraoperatively the transplant kidney was examined and the surgeon thought there was a area of infarction. This was confirmed on biopsy. As the patient's creatinine was rising a repeat DTPA study was performed. Perfusion and function of the transplant kidney was virtually absent while Doppler studies showed no flow. The patient however continued to produce urine and the creatinine was stable. Subsequently a mercaptoacetyltriglycine (MAG) 3 study was performed which again confirmed absent perfusion and function by the the transplanted kidney as well as the previous noted uterine fibroid. The native kidneys however demonstrated good perfusion and function. The patient's renal function remained stable and she did not require dialysis. A necrotic infarcted transplant kidney was removed uneventfully. This case illustrates the importance of imaging the native kidneys as well as the transplant kidney when there are puzzling clinical features. The presumed cause of the recovery of native renal function was the immunosuppression given for the transplant. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

Thyrotropin-luteinizing hormone/chorionic gonadotropin receptor extracellular domain chimeras as probes for thyrotropin receptor function

International Nuclear Information System (INIS)

Nagayama, Yuji; Wadsworth, H.L.; Chazenbalk, G.D.; Russo, D.; Seto, Pui; Rapoport, B.

1991-01-01

To define the sites in the extracellular domain of the human thyrotropin (TSH) receptor that are involved in TSH binding and signal transduction the authors constructed chimeric thyrotropin-luteinizing hormone/chorionic gonadotropin (TSH-LH/CG) receptors. The extracellular domain of the human TSH receptor was divided into five regions that were replaced, either singly or in various combinations, with homologous regions of the rat LH/CG receptor. The chimeric receptors were stably expressed in Chinese hamster ovary cells. The data obtained suggest that the carboxyl region of the extracellular domain (amino acid residues 261-418) and particularly the middle region (residues 171-260) play a role in signal transduction. The possibility is also raised of an interaction between the amino and carboxyl regions of the extracellular domain in the process of signal transduction. In summary, these studies suggest that the middle region and carboxyl half of the extracellular domain of the TSH receptor are involved in signal transduction and that the TSH-binding region is likely to span the entire extracellular domain, with multiple discontinuous contact sites

Faecal microbiota transplantation

DEFF Research Database (Denmark)

Jørgensen, Simon M D; Hansen, Mette Mejlby; Erikstrup, Christian

2017-01-01

BACKGROUND: Faecal microbiota transplantation (FMT) is currently being established as a second-line treatment for recurrent Clostridium difficile infection. FMT is further being considered for other infectious and inflammatory conditions. Safe and reproducible methods for donor screening, laborat......BACKGROUND: Faecal microbiota transplantation (FMT) is currently being established as a second-line treatment for recurrent Clostridium difficile infection. FMT is further being considered for other infectious and inflammatory conditions. Safe and reproducible methods for donor screening...

[Melanoma in organ transplant patients].

Science.gov (United States)

Lévêque, L; Dalac, S; Dompmartin, A; Louvet, S; Euvrard, S; Catteau, B; Hazan, M; Schollhamer, M; Aubin, F; Dreno, B; Daguin, P; Chevrant-Breton, J; Frances, C; Bismuth, M J; Tanter, Y; Lambert, D

2000-02-01

The incidence of cutaneous melanoma has rapidly increased in the white population over the last decades. It has been estimated that the incidence doubles world-wide every 10 years. Different risk factors have been identified, including immunosuppression. The aim of our study-was to determine the relative risk of developing melanoma in the organ transplant population and the clinical and histological features of their melanomas. This retrospective study was conducted with the collaboration of 9 University Hospital Centers: Besançon, Brest, Caen, Dijon, Lille, Lyon, Nantes, Paris (Pitié-Salpétrière) and Rennes. A questionnaire was sent to the different departments of dermatology of these hospitals to obtain information on patients who had presented a melanoma after a transplantation between 1971 and 1997. During this period, there were 12,477 organ transplant recipients in the transplantation units of these 9 hospitals. Average follow-up for these patients was about 5 years and the average duration of immunosuppressive therapy was about 4.5 years. Among 12,477 organ transplant recipients, we found 17 cases of melanoma but no data could be obtain on one case: 14 occurred in renal transplant recipients and 3 in cardiac transplant recipients. Clinical and histological data were only available in 16 patients. The average time between transplantation and diagnosis of melanoma was 63 months, but it was 5 times shorter for 2 patients who had a past history of melanoma before transplantation. Two patients had a mucosal melanoma; for the cutaneous melanomas, 2 appeared on Dubreuilh melanosis, 2 were in situ melanomas, 7 were superficial spreading melanomas and 3 were nodular melanomas. The histological review of 11 cutaneous melanomas revealed a precursor nevus in 6 cases and a weak or no stroma reaction in 7/7 cases. Complete excision of the melanoma was performed in all patients except one with anorectal melanoma. Four patients died of visceral metastasis within a mean

Post-transplantation Development of Food Allergies.

Science.gov (United States)

Newman, Erik N; Firszt, Rafael

2018-01-29

The development of food allergies is increasingly being recognized as a post-solid organ transplant complication. In this article, we review the spectrum of post-transplant food allergy development and the proposed mechanisms for de novo food allergies and the clinical significance they pose. The development of new food allergies is disproportionately associated with pediatric liver transplants, where it occurs in up to 38% of select populations. The mechanism of food allergy development is not completely understood; however, it is likely promoted by unbalanced immune suppression. De novo food allergy development is a common complication of solid organ transplants with the highest risk occurring in pediatric liver transplant recipients. There are likely multiple mechanisms for food allergy development including passive transfer of membrane-bound IgE and lymphocytes from donor to recipient, as well as loss of food tolerance and active development of new food allergies. The optimal management of food allergies following organ transplants has not been well researched but may include changing the immune suppression regimen if the food allergy does not resolve without intervention.

Overview of marrow transplantation

International Nuclear Information System (INIS)

Thomas, E.D.

1985-01-01

Bone marrow transplantation is now an accepted form of therapy for many hematologic disorders including aplastic anemia, genetically determined diseases and malignant diseases, particularly leukemia, and for rescue of patients given intensive chemoradiotherapy for malignant disease. The donor may be a healthy identical twin, a family member or even an unrelated person. Selection is made on the basis of human leukocyte antigen tissue typing. Intensive chemoradiotherapy is used to suppress patients' immune systems to facilitate engraftment and destroy diseased marrow. Transfusion of platelets, erythrocytes and granulocytes (or all of these), antibiotic coverage and protection from infection are necessary during the pancytopenic period. Survival rates vary considerably depending on a patient's disease, clinical state and age. Patients with aplastic anemia transplanted early in the course of their disease have a survival rate of approximately 80%. Patients with acute lymphoblastic leukemia are usually transplanted in a second or subsequent remission and have a survival rate of 25% to 40%. Patients with acute nonlymphoblastic leukemia in remission have survivals ranging from 45% to 70%. More than 200 patients in the chronic phase of chronic granulocytic leukemia have been transplanted with survival ranging from 50% to 70%. Complications of marrow transplantation include marrow graft rejection, graft-versus-host disease, immunologic insufficiency and the possibility of recurrence of the leukemia. 14 references

Depression and Liver Transplant Survival.

Science.gov (United States)

Meller, William; Welle, Nicole; Sutley, Kristen; Thurber, Steven

Patients who underwent liver transplantation and experienced clinical depression have heretofore evinced lower survival rates when compared to nondepressed counterparts. To investigate the hypothesis that transplant patients who seek and obtain medical treatment for depression would circumvent the prior reduced survival findings. A total of 765 patients with liver transplants were scrutinized for complications following transplantation. Further, 104 patients experienced posttransplant depression as manifested by diagnosis and treatment by medical personnel. Survival analyses were conducted comparing hazard and survival curves for these selected individuals and the remainder of transplant patients. Contrary to prior data and consistent with the aforementioned hypothesis, median survival durations, survival curves, and hazard functions (controlling for age and prolonged posttransplant survival for the depressed patients were better. The improved survival for the depressed patients may simply be related to an amelioration of depressed symptoms via antidepressant medications. However, this interpretation would only be congruent with reduced hazard, not elevated survival, beyond the norm (median) for other transplant participants. Assuming the reliability and generalization of our findings, perhaps a reasonable and compelling interpretation is that combined with the effectiveness of antidepressant medications, the seeking and receiving treatment for depression is a type of proxy measure of a more global pattern of adherence to recommended posttransplant medical regimens. Copyright © 2017 The Academy of Psychosomatic Medicine. Published by Elsevier Inc. All rights reserved.

Bone Marrow Transplantation: MedlinePlus Health Topic

Science.gov (United States)

... marrow transplant - discharge (Medical Encyclopedia) Also in Spanish Topic Image MedlinePlus Email Updates Get Bone Marrow Transplantation ... transplant - slideshow Graft-versus-host disease Related Health Topics Bone Marrow Diseases Stem Cells National Institutes of ...

[Association of human chorionic gonadotropin level in embryo culture media with early embryo development].

Science.gov (United States)

Wang, Haiying; Zhang, Renli; Han, Dong; Liu, Caixia; Cai, Jiajie; Bi, Yanling; Wen, Anmin; Quan, Song

2014-06-01

To investigate the association of human chorionic gonadotropin (HCG) level on day 3 of embryo culture with embryo development. Spent culture media were collected from individually cultured embryos on day 3 of in vitro fertilization and embryo transfer (IVF-ET) cycles. HCG concentration in the culture media was measured using an ELISA kit and its association with embryo development was assessed. In the 163 samples of embryo culture media from 60 patients, HCG was positive in 153 sample (93.8%) with a mean level of 0.85 ± 0.43 mIU/ml. The concentration of hCG in the culture media increased gradually as the number of blastomeres increased (F=2.273, P=0.03), and decreased as the morphological grade of the embryo was lowered (F=3.900, P=0.02). ELISA is capable of detecting HCG levels in spent culture media of embryos on day 3 of in vitro culture. The concentration of HCG in spent culture media is positively correlated with the status of early embryo development and implantation rate and thus serves as a useful marker for embryo selection in IVF-ET procedure.

Liver Transplantation: Evolving Patient Selection Criteria

Directory of Open Access Journals (Sweden)

Andy S Yu

2001-01-01

Full Text Available The widespread recognition of the success of liver transplantation as a treatment for most types of acute and chronic liver failure has led to increased referrals for transplantation in the setting of a relatively fixed supply of cadaver donor organs. These events have led to a marked lengthening of the waiting time for liver transplantation, resulting in increased deaths of those on the waiting list and sicker patients undergoing transplantation. Nearly 5000 liver transplantations were performed in the United States in 2000, while the waiting list grew to over 17,000 patients. The mounting disparity between the number of liver transplant candidates and the limited supply of donor organs has led to reassessment of the selection and listing criteria for liver transplantation, as well as revision of organ allocation and distribution policies for cadaver livers. The development of minimal listing criteria for patients with chronic liver disease based on a specific definition for decompensation of cirrhosis has facilitated the more uniform listing of patients at individual centres across the United States. The United Network for Organ Sharing, under pressure from transplant professionals, patient advocacy groups and the federal government, has continuously revised allocation and distribution policies based on the ethical principles of justice for the individual patient versus optimal utility of the limited organ supply available annually. Beginning in 2002, it is likely that the Model for End-stage Liver Disease (MELD score will be implemented to determine disease severity and direct donor organs to the sickest patients rather than to those with the longest waiting times.

Types of Cancer Associated with Transplant Recipients

Science.gov (United States)

... After the transplant Preventing rejection Post-transplant medications Types of immunosuppressants Switching immunosuppressants Side effects Other medications Generic and brand name drugs Post-transplant tests Infections and immunity Lifestyle changes Health concerns Back to work or ...

A Metabolomic Approach (1H HRMAS NMR Spectroscopy) Supported by Histology to Study Early Post-transplantation Responses in Islet-transplanted Livers

OpenAIRE

Vivot, Kevin; Benahmed, Malika A.; Seyfritz, Elodie; Bietiger, William; Elbayed, Karim; Ruhland, Elisa; Langlois, Allan; Maillard, Elisa; Pinget, Michel; Jeandidier, Nathalie; Gies, Jean-Pierre; Namer, Izzie-Jacques; Sigrist, S?verine; Reix, Nathalie

2016-01-01

Intrahepatic transplantation of islets requires a lot of islets because more than 50% of the graft is lost during the 24 hours following transplantation. We analyzed, in a rat model, early post-transplantation inflammation using systemic inflammatory markers, or directly in islet-transplanted livers by immunohistochemistry. 1H HRMAS NMR was employed to investigate metabolic responses associated with the transplantation. Inflammatory markers (Interleukin-6, ?2-macroglobulin) are not suitable t...

Young transplant surgeons and NIH funding.

Science.gov (United States)

Englesbe, M J; Sung, R S; Segev, D L

2011-02-01

Transplant surgeons have historically been instrumental in advancing the science of transplantation. However, research in the current environment inevitably requires external funding, and the classic career development pathway for a junior investigator is the NIH K award. We matched transplant surgeons who completed fellowships between 1998 and 2004 with the NIH funding database, and also queried them regarding research effort and attitudes. Of 373 surgeons who completed a fellowship, only 6 (1.8%) received a K award; of these, 3 subsequently obtained R-level funding. An additional 5 individuals received an R-level grant within their first 5 years as faculty without a K award, 3 of whom had received a prior ASTS-sponsored award. Survey respondents reported extensive research experience during their training (78.8% spent median 24 months), a high proportion of graduate research degrees (36%), and a strong desire for more research time (78%). However, they reported clinical burdens and lack of mentorship as their primary perceived barriers to successful research careers. The very low rate of NIH funding for young transplant surgeons, combined with survey results that indicate their desire to participate in research, suggest institutional barriers to access that may warrant attention by the ASTS and the transplant surgery community. ©2010 The Authors Journal compilation©2010 The American Society of Transplantation and the American Society of Transplant Surgeons.

Optical Coherence Tomography in Kidney Transplantation

Science.gov (United States)

Andrews, Peter M.; Wierwille, Jeremiah; Chen, Yu

End-stage renal disease (ESRD) is associated with both high mortality rates and an enormous economic burden [1]. The preferred treatment option for ESRD that can extend patients' lives and improve their quality of life is kidney transplantation. However, organ shortages continue to pose a major problem in kidney transplantation. Most kidneys for transplantation come from heart-beating cadavers. Although non-heart-beating cadavers represent a potentially large pool of donor kidneys, these kidneys are not often used due to the unknown extent of damage to the renal tubules (i.e., acute tubular necrosis or "ATN") induced by ischemia (i.e., lack of blood flow). Also, ischemic insult suffered by kidneys awaiting transplantation frequently causes ATN that leads to varying degrees of delayed graft function (DGF) after transplantation. Finally, ATN represents a significant risk for eventual graft and patient survival [2, 3] and can be difficult to discern from rejection. In present clinical practice, there is no reliable real-time test to determine the viability of donor kidneys and whether or not donor kidneys might exhibit ATN. Therefore, there is a critical need for an objective and reliable real-time test to predict ATN to use these organs safely and utilize the donor pool optimally. In this review, we provided preliminary data indicating that OCT can be used to predict the post-transplant function of kidneys used in transplantation.

An elderly-onset limb girdle muscular dystrophy type 1B (LGMD1B) with pseudo-hypertrophy of paraspinal muscles.

Science.gov (United States)

Furuta, Mitsuru; Sumi-Akamaru, Hisae; Takahashi, Masanori P; Hayashi, Yukiko K; Nishino, Ichizo; Mochizuki, Hideki

2016-09-01

Mutations in LMNA, encoding A-type lamins, lead to diverse disorders, collectively called "laminopathies," which affect the striated muscle, cardiac muscle, adipose tissue, skin, peripheral nerve, and premature aging. We describe a patient with limb-girdle muscular dystrophy type 1B (LGMD1B) carrying a heterozygous p.Arg377His mutation in LMNA, in whom skeletal muscle symptom onset was at the age of 65 years. Her weakness started at the erector spinae muscles, which showed marked pseudo-hypertrophy even at the age of 72 years. Her first episode of syncope was at 44 years; however, aberrant cardiac conduction was not revealed until 60 years. The p.Arg377His mutation has been previously reported in several familial LMNA-associated myopathies, most of which showed muscle weakness before the 6th decade. This is the first report of pseudo-hypertrophy of paravertebral muscles in LMNA-associated myopathies. The pseudo-hypertrophy of paravertebral muscles and the elderly-onset of muscle weakness make this case unique and reportable. Copyright © 2016 Elsevier B.V. All rights reserved.

[Transplantation-associated infections].

Science.gov (United States)

Würzner, R

2004-01-01

Transplantation-associated infections are caused by an infected transplanted organ or the endogenic or exogenic environment of the recipient in a state of induced immunodeficiency. The best therapy would be to reconstitute the immunodeficiency, but this is usually impossible as it endangers the transplanted organ. Thus, a specific, standardised anti-infectious therapy is needed even in the absence of clearly identified micro-organisms [bacteria (in two thirds gram-positive rods), parasites (in central Europe predominantly Toxoplasma), fungi (especially Candida spp. or Aspergillus spp.) or viruses (such as Parvovirus B19 and Cytomegalovirus)]. Origins of infection (e.g., hygiene), types of infection (e.g., reactivation), typical localisations, diagnostic tools (e.g., blood cultures, antigenic tests, PCR, CT, advantages and disadvantages of antibody assays) and possible therapies are briefly discussed. The take home messages are to avoid economy measures in microbial diagnostics and to use CMV-seronegative donors whenever possible.

Infection in the bone marrow transplant recipient and role of the microbiology laboratory in clinical transplantation.

OpenAIRE

LaRocco, M T; Burgert, S J

1997-01-01

Over the past quarter century, tremendous technological advances have been made in bone marrow and solid organ transplantation. Despite these advances, an enduring problem for the transplant recipient is infection. As immunosuppressive regimens have become more systematic, it is apparent that different pathogens affect the transplant recipient at different time points in the posttransplantation course, since they are influenced by multiple intrinsic and extrinsic factors. An understanding of ...

SINGLE-CENTER EXPERIENCE OF ABO-INCOMPATIBLE LIVER TRANSPLANTATION

Directory of Open Access Journals (Sweden)

S. V. Gautier

2011-01-01

Full Text Available Since 2008 up to 2010 eight ABO-incompatible liver transplantations have been performed in our center: one of them was urgent liver transplantation to adult patient from deceased donor, other seven were transplantations of left lateral segment to children from living relative donors. Own experience, as well as world one, proves, that barrier of ABO-incompatibility can be overcome more successfully in liver transplantation, particularly in pediatric population, that in other solid organs transplantation. Good results can be achieved even with less ag- gressive immunosuppressive therapy. Recipient conditioning before operation can significantly improve results of ABO-incompatible liver transplantation, but as own experience has shown, often there’s no need to hold some special preparation of children, because their anti-ABO antibodies are very low or absent before transplantation and do not increase after it. Thereby ABO-incompatible liver transplantation is reasonable in urgent cases and in pediatric population because of the limited pull of living relative donors for children. 

Osteonecrosis or spontaneous fractures following renal transplantation

International Nuclear Information System (INIS)

Andresen, J.; Nielsen, H.E.; Aarhus Univ.

1981-01-01

31 renal transplant recipients with posttransplant development of osteonecrosis or spontaneous fractures were evaluated with regard to age, duration of dialysis before transplantation. Determination of metacarpal bone mass at the time of transplantation and registration of bone resorption and soft tissue calcification at the time of transplantation and at the time of onset of osteonecrosis and spontaneous fractures were made. Apart from the increased mean age in patients with spontaneous fractures no difference was seen between the groups. Osteonecrosis and spontaneous fractures occurred in areas of trabecular bone. It seems most likely that after renal transplantation the patients show bone complications of different localization. (orig.) [de

Cross-border quest: the reality and legality of transplant tourism.

Science.gov (United States)

Ambagtsheer, Frederike; Zaitch, Damián; van Swaaningen, René; Duijst, Wilma; Zuidema, Willij; Weimar, Willem

2012-01-01

Background. Transplant tourism is a phenomenon where patients travel abroad to purchase organs for transplants. This paper presents the results of a fieldwork study by describing the experiences of Dutch transplant professionals confronted by patients who allegedly purchased kidney transplants abroad. Second, it addresses the legal definition and prohibition of transplant tourism under national and international law. The final part addresses the legal implications of transplant tourism for patients and physicians. Methods. The study involved seventeen interviews among transplant physicians, transplant coordinators and policy-experts and a review of national and international legislation that prohibit transplant tourism. Results. All Dutch transplant centers are confronted with patients who undergo transplants abroad. The estimated total number is four per year. Transplant tourism is not explicitly defined under national and international law. While the purchase of organs is almost universally prohibited, transplant tourism is hardly punishable because national laws generally do not apply to crimes committed abroad. Moreover, the purchase of organs (abroad) is almost impossible to prove. Conclusions. Transplant tourism is a legally complex phenomenon that warrants closer research and dialogue. The legal rights and obligations of patients and physicians confronted with transplant tourism should be clarified.

Uterine transplantation: Review in human research.

Science.gov (United States)

Favre-Inhofer, A; Rafii, A; Carbonnel, M; Revaux, A; Ayoubi, J M

2018-06-01

Uterine transplantation is the solution to treat absolute uterine fertility. In this review, we present the historical, medical, technical, psychological and ethical perspectives in human uterine transplantation research. We reviewed the PubMed database following PRISMA guidelines and added data presented by several research teams during the first international congress on uterine transplantation. Copyright © 2018. Published by Elsevier Masson SAS.

[Hepatic cell transplantation: a new therapy in liver diseases].

Science.gov (United States)

Pareja, Eugenia; Cortés, Miriam; Martínez, Amparo; Vila, Juan José; López, Rafael; Montalvá, Eva; Calzado, Angeles; Mir, José

2010-07-01

Liver transplantation has been remarkably effective in the treatment in patients with end-stage liver disease. However, disparity between solid-organ supply and increased demand is the greatest limitation, resulting in longer waiting times and increase in mortality of transplant recipients. This situation creates the need to seek alternatives to orthotopic liver transplantation.Hepatocyte transplantation or liver cell transplantation has been proposed as the best method to support patients. The procedure consists of transplanting individual cells to a recipient organ in sufficient quantity to survive and restore the function. The capacity of hepatic regeneration is the biological basis of hepatocyte transplantation. This therapeutic option is an experimental procedure in some patients with inborn errors of metabolism, fulminant hepatic failure and acute and chronic liver failure, as a bridge to orthotopic liver transplantation. In the Hospital La Fe of Valencia, we performed the first hepatocyte transplantation in Spain creating a new research work on transplant program. Copyright 2009 AEC. Published by Elsevier Espana. All rights reserved.

TRANSPLANTATION

African Journals Online (AJOL)

stage ... renal artery thrombosis, renal vein thrombosis, ureteric leak or stenosis ... alternative organ source for patients with end-stage renal disease. Kidney ... status.27,28 Post-transplant acute tubular necrosis is caused by ischaemic injury to the ...

Blood pressure control in hypertensive pediatric renal transplants: role of repeated ABPM following transplantation.

Science.gov (United States)

Krmar, Rafael T; Berg, Ulla B

2008-10-01

Hypertension in pediatric renal transplants is a widespread condition associated with high mortality risk in early adult life. Ambulatory blood pressure monitoring (ABPM) was found to be superior to office blood pressure (BP) in identifying true hypertensive and responders to treatment. The aim of this study was to investigate the role of repeated ABPM, performed at yearly intervals following transplantation, in the assessment and decision-making processes of post-transplant hypertension. Thirty-seven recipients (23 males; aged 10.5 +/- 4.3 years) who were followed for 4.3 +/- 2.2 years (range 2-9) after transplantation were eligible for analysis. The mean follow-up time between the baseline (1 year post-transplantation) and the most recent ABPM examination was 3.3 +/- 2.2 years (range 1-8). Throughout the follow-up period, antihypertensive therapy was either started or intensified in 27 recipients. These interventions were decided based on ABPM results obtained on 40 of 44 occasions. At last follow-up, 24 of 29 treated hypertensive recipients displayed controlled BP. This figure was significantly higher compared to our historical hypertensive control recipients in whom ABPM was applied for the first time in treatment at 6 +/- 3.3 years (range 2-15) after transplantation, while therapeutic decisions were driven by office BP measurements (95 % confidence interval (95% CI) for the difference between proportions (80.6-32 %) 36-60 %, P = 0.001). Our study shows that, in a population with high risk for hypertension, repeated ABPM may significantly help to improve BP control.

Diagnosis of post-transplant lymphoproliferative disorder in solid organ transplant recipients - BCSH and BTS Guidelines.

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Parker, Anne; Bowles, Kristin; Bradley, J Andrew; Emery, Vincent; Featherstone, Carrie; Gupte, Girish; Marcus, Robert; Parameshwar, Jayan; Ramsay, Alan; Newstead, Charles

2010-06-01

A joint working group established by the Haemato-oncology subgroup of the British Committee for Standards in Haematology (BCSH) and the British Transplantation Society (BTS) has reviewed the available literature and made recommendations for the diagnosis and management of post-transplant lymphoproliferative disorder (PTLD) in adult recipients of solid organ transplants. This review details the risk factors predisposing to development, initial features and diagnosis. It is important that the risk of developing PTLD is considered when using post transplant immunosuppression and that the appropriate investigations are carried out when there are suspicions of the diagnosis. These must include tissue for histology and computed tomography scan to assess the extent of disease. These recommendations have been made primarily for adult patients, there have been some comments made with regard to paediatric practice.

Pancreas transplantation

International Nuclear Information System (INIS)

Snider, J.F.; Hunter, D.W.; Castaneda-Zuniga, W.R.; Letourneau, J.G.

1989-01-01

Pancreas transplantation can be complicated by vascular thrombosis, stenosis, or anastomotic leak, complications that predispose to transplant pancreatectomy. The relative roles of noninvasive radiologic studies in such vascular complications have been correlated with angiographic or pathologic data. The results of 54 scintigraphic studies, 25 CT studies, 16 sonograms, and 23 color Doppler examinations have been correlated with those of 40 angiograms and 28 pathologic studies in a population of 185 recipients. CT (sensitivity, 100%; specificity, 75%; accuracy, 92%) and US (sensitivity, 88%; specificity, 80%; accuracy, 85%) were most helpful in noninvasive screening for vascular complications, while angiography remains nearly definite in the radiographic diagnosis of these problems

Stem Cell Transplants (For Teens)

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... Safe Videos for Educators Search English Español Stem Cell Transplants KidsHealth / For Teens / Stem Cell Transplants What's ... Take to Recover? Coping Print What Are Stem Cells? As you probably remember from biology class, every ...

TRANSPLANTATION AND POTENTIAL IMMORTALITY OF MAMMALIAN TISSUES.

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Loeb, L

1926-06-20

1. Serial transplantation of tumors made it possible in 1901 and following years to draw the conclusion that various mammalian tissues have potential immortality. Serial transplantations of normal tissues did not succeed at first, because the homoioreaction on the part of the lymphocytes and connective tissue of the host injures the transplant. 2. In continuation of these experiments we found that cartilage of the rat can be transplanted serially to other rats at least for a period of 3 years. At the end of that time great parts of the transplanted cartilage and perichondrium are alive. 3. Not only the cartilage of young rats can be homoiotransplanted, but also the cartilage of very old rats which are nearing the end of life. By using such animals we have been able to obtain cartilage and perichondrium approaching an age of 6 years which is almost double the average age of a rat. 4. We found that cartilage can be homoiotransplanted more readily than other tissues for the following reasons: (a) While in principle the homoioreaction towards cartilage is the same as against other tissues, cartilage elicits this reaction with less intensity; (b) cartilage is better able to resist the invasion of lymphocytes and connective tissue than the majority of other tissues; (c) a gradual adaptation between transplant and host seems to take place in the case of cartilage transplantation, as a result of which the lymphocytic reaction on the part of the host tissue decreases progressively the longer the cartilage is kept in the strange host. 5. At time of examination we not only found living transplanted cartilage tissue, but also perichondrial tissue, which in response to a stimulus apparently originating in the necrotic central cartilage, had been proliferating and replacing it. These results suggest that it may perhaps be possible under favorable conditions to keep cartilage alive indefinitely through serial transplantations. 6. At the same time these experiments permit the

Decreased cerebral blood flow in renal transplant recipients

International Nuclear Information System (INIS)

Kamano, Chisako; Komaba, Yuichi; Sakayori, Osamu; Iino, Yasuhiko; Katayama, Yasuo

2002-01-01

We performed single-photon emission computed tomography (SPECT) to investigate the influence of renal transplantation on cerebral blood flow (CBF). Fifteen renal transplant recipients and twelve normal subjects underwent cerebral SPECT with N-isopropyl-p-[ 123 I] iodoamphetamine ( 123 I-IMP). All transplant recipients received prednisolone and cyclosporine (CyA). Regional CBF (rCBF) was measured by defining regions of interest in the cerebral cortex, deep white matter, striatum, thalamus, and cerebellum. In transplant recipients, correlations to the mean overall cortical CBF were assessed using the interval from transplantation to measurement of SPECT, as well as the serum creatinine concentration. Moreover, to investigate the influence of CyA on CBF, the correlation between mean overall cortical CBF and CyA trough concentrations was assessed. In all regions, CBF in renal transplant recipients was significantly lower than in normal subjects. No significant correlation was seen between serum creatinine, interval from transplantation, or CyA trough concentrations and mean overall cortical CBF. Renal transplant recipients demonstrated a decrease in CBF, that can have an associated secondary pathology. Therefore, renal transplant recipients may benefit from post-operative MRI or CT. (author)

De novo malignancy is associated with renal transplant tourism.

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Tsai, Meng-Kun; Yang, Ching-Yao; Lee, Chih-Yuan; Yeh, Chi-Chuan; Hu, Rey-Heng; Lee, Po-Huang

2011-04-01

Despite the objections to transplant tourism raised by the transplant community, many patients continue travel to other countries to receive commercial transplants. To evaluate some long-term complications, we reviewed medical records of 215 Taiwanese patients (touring group) who received commercial cadaveric renal transplants in China and compared them with those of 321 transplant recipients receiving domestic cadaveric renal transplants (domestic group) over the same 20-year period. Ten years after transplant, the graft and patient survival rates of the touring group were 55 and 81.5%, respectively, compared with 60 and 89.3%, respectively, of the domestic group. The difference between the two groups was not statistically significant. The 10-year cumulative cancer incidence of the touring group (21.5%) was significantly higher than that of the domestic group (6.8%). Univariate and multivariate stepwise regression analyses (excluding time on immunosuppression, an uncontrollable factor) indicated that transplant tourism was associated with significantly higher cancer incidence. Older age at transplantation was associated with a significantly increased cancer risk; however, the risk of de novo malignancy significantly decreased with longer graft survival. Thus, renal transplant tourism may be associated with a higher risk of post-transplant malignancy, especially in patients of older age at transplantation. © 2011 International Society of Nephrology

Renal transplantation: Sonography and Doppler assessment of transplanted kidneys in adult Sudanese patients

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Moawia Gameraddin

2017-06-01

Full Text Available Background Every year, thirty-five thousand patients receive renal transplants worldwide. Kidney transplant provides better quality of life and reduced morbidity. Doppler and sonography were the best imaging modalities for evaluation. Aims To assess the sonographic findings of renal allograft and to determine the correlation between Doppler resistive index and size of allograft and echogenicity. Methods This was a cross-sectional study conducted in Khartoum State from January to August 2016. A total of 86 patients with known transplanted kidneys were scanned with ultrasound using 3MHz and 5MHz transducers. The age was categorized into four groups and so the Doppler indices. Descriptive statistics used to analyse quantitative and qualitative variables (percent and means ± SD. Spearman's rho test was used to find the correlation between RI of renal vessels and allograft size. The Qui-square test was used to find an association between RI and echogenicity of the graft. Results Renal transplantation was common at the age of 20 to 50 years. The mean Doppler index of the renal artery was 0.68±0.11 in renal allografts. Renal transplantation was common in professionals and homemakers (30.2 per cent and 20.93 per cent respectively. Hypertension and diabetes were the most common causes (44.1 per cent and 18.6 per cent. A significant correlation was found between RI and allograft size (p-value=0.012. There was no statistical association between RI and echogenicity of allograft (pvalue=0.106. Conclusion The Doppler resistive index is significantly correlated with allograft size and had no association with echogenicity. Patients with enlarged allograft had raised resistive indices. The study recommended that Duplex ultrasound should be used in the initial assessment and follow-up of renal transplant.

Stem Cell Transplants (For Parents)

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... of Transplants Transplantation Recovery Coping Print en español Trasplantes de células madre Stem cells are cells in ... finding a match is called tissue typing (or HLA [human leukocyte antigen] typing). HLA is a protein ...

Waiting narratives of lung transplant candidates.

Science.gov (United States)

Yelle, Maria T; Stevens, Patricia E; Lanuza, Dorothy M

2013-01-01

Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman's concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients' stories and hear what is most meaningful in their lives.

Waiting Narratives of Lung Transplant Candidates

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Maria T. Yelle

2013-01-01

Full Text Available Before 2005, time accrued on the lung transplant waiting list counted towards who was next in line for a donor lung. Then in 2005 the lung allocation scoring system was implemented, which meant the higher the illness severity scores, the higher the priority on the transplant list. Little is known of the lung transplant candidates who were listed before 2005 and were caught in the transition when the lung allocation scoring system was implemented. A narrative analysis was conducted to explore the illness narratives of seven lung transplant candidates between 2006 and 2007. Arthur Kleinman’s concept of illness narratives was used as a conceptual framework for this study to give voice to the illness narratives of lung transplant candidates. Results of this study illustrate that lung transplant candidates expressed a need to tell their personal story of waiting and to be heard. Recommendation from this study calls for healthcare providers to create the time to enable illness narratives of the suffering of waiting to be told. Narrative skills of listening to stories of emotional suffering would enhance how healthcare providers could attend to patients’ stories and hear what is most meaningful in their lives.

Beta-human chorionic gonadotropin concentrations in cervicovaginal secretions in preterm delivery

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Talip Gül

2010-05-01

Full Text Available Objectives: To investigate beta-human corionic gonadotropin (β-hCG levels in cervicovaginal secretions as an early marker for preterm delivery.Methods: The study included 55 patients at 25-36 of gestational weeks with preterm delivery risk factors including a history of preterm labor in a previous pregnancy or history of second trimester abortion. Beta-human chorionic gonadotropin (β-hCG levels of cervicovaginal secretions were measured in all patients by the radioimmunoassay method using a commercial kit.Results: Preterm delivery was observed in 25 patients and 30 patients gave term delivery. No significant differences were found between preterm and term delivery groups in age, gravidity and parity (P>0.05. APGAR scores and anthropometric measurements of newborns were significantly lower in preterm delivery group (P<0.001. Preterm delivery group had significantly higher cervicovaginal β-hCG levels compared with normal controls (94.7±37.7 vs. 35.5±14.8 mIU/ml, respectively, P<0.001. When 75 mIU/ml value of β-hCG level was taken as cut-off value; the sensitivity of the test was found as 76%, specifity 91.6%, positive predictive value 95.0% and negative predictive value as 79.9%.Conclusion: Concentrations of β-hCG in cervicovaginal secretions may be a useful early biochemical marker to detect preterm. Based on β-hCG levels in cervicovaginal secretions a closer follow-up may decrease some complications of preterm delivery. J Clin Exp Invest 2010; 1(1: 16-20

Perception of Hair Transplant for Androgenetic Alopecia.

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Bater, Kristin L; Ishii, Masaru; Joseph, Andrew; Su, Peiyi; Nellis, Jason; Ishii, Lisa E

2016-12-01

Hair transplant is among the most common cosmetic services sought by men, with more than 11 000 procedures performed in 2014. Despite its growing popularity, the effect of hair transplant on societal perceptions of youth, attractiveness, or facets of workplace and social success is unknown. To determine whether hair transplant improves observer ratings of age, attractiveness, successfulness, and approachability in men treated for androgenetic alopecia and to quantify the effect of hair transplant on each of these domains. A randomized controlled experiment was conducted from November 10 to December 6, 2015, using web-based surveys featuring photographs of men before and after hair transplant. One hundred twenty-two participants recruited through various social media platforms successfully completed the survey. Observers were shown 2 side-by-side images of each man and asked to compare the image on the left with the one on the right. Of 13 pairs of images displayed, 7 men had undergone a hair transplant procedure and 6 had served as controls. Observers evaluated each photograph using various metrics, including age, attractiveness, successfulness, and approachability. A multivariate analysis of variance was performed to understand the effect of hair transplant on observer perceptions. Planned posthypothesis testing was used to identify which variables changed significantly as a result of the transplant. Observer ratings of age (in number of years younger) and attractiveness, successfulness, and approachability (on a scale of 0 to 100; scores higher than 50 indicate a positive change). Of the 122 participants in the survey, 58 were men (47.5%); mean (range) age was 27.1 (18-52) years. The initial multivariate analysis of variance revealed a statistically significant multivariate effect for transplant (Wilks λ = 0.9646; P hair transplant on observers' perceptions of age (mean [SD] number of years younger, 3.6 [2.9] years; P hair transplant. Participants also

[Early human transplants: 60th anniversary of the first successful kidney transplants].

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Gentili, Marc E

2015-11-01

First kidney transplant attempts begin with the 20th century: improving vascular sutures, understanding the phenomena of rejection or tolerance, then progress in HLA groups enable early success in the second half of the century. Definition of brain death, use of corticosteroids, radiotherapy and prime immunosuppressors promote the development of transplants. Discover of cyclosporine in the 1980s, and legislative developments augur a new era. Many advances are arising: use of stem cells from the donor, enhancement of Maastricht 3 donor or living donation. Finally organ transplantation remains an immense human adventure, but also scientific and ethic. Copyright © 2015 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Imaging in haematopoietic stem cell transplantation

International Nuclear Information System (INIS)

Evans, A.; Steward, C.G.; Lyburn, I.D.; Grier, D.J.

2003-01-01

Haematopoietic stem cell transplantation (SCT) is used to treat a wide range of malignant and non-malignant haematological conditions, solid malignancies, and metabolic and autoimmune diseases. Although imaging has a limited role before SCT, it is important after transplantation when it may support the clinical diagnosis of a variety of complications. It may also be used to monitor the effect of therapy and to detect recurrence of the underlying disease if the transplant is unsuccessful. We present a pictorial review of the imaging of patients who have undergone SCT, based upon 15 years experience in a large unit performing both adult and paediatric transplants

Imaging in haematopoietic stem cell transplantation

Energy Technology Data Exchange (ETDEWEB)

Evans, A.; Steward, C.G.; Lyburn, I.D.; Grier, D.J

2003-03-01

Haematopoietic stem cell transplantation (SCT) is used to treat a wide range of malignant and non-malignant haematological conditions, solid malignancies, and metabolic and autoimmune diseases. Although imaging has a limited role before SCT, it is important after transplantation when it may support the clinical diagnosis of a variety of complications. It may also be used to monitor the effect of therapy and to detect recurrence of the underlying disease if the transplant is unsuccessful. We present a pictorial review of the imaging of patients who have undergone SCT, based upon 15 years experience in a large unit performing both adult and paediatric transplants.

Bone marrow transplantation

International Nuclear Information System (INIS)

Storb, R.; Santos, G.W.

1979-01-01

Bone marrow transplantation has been increasingly used to treat patients with severe combined immunodeficiency diseases, severe aplastic anemia, and malignant hematologic diseases, especially leukemia. At the Workshop a number of problems were discussed, e.g., conditioning regimens aimed at overcoming the problem of marrow graft rejection and reducing the incidence of recurrent leukemia, prevention of graft-versus-host disease (GVHD), possible mechanisms involved in stable graft-host tolerance, graft-versus-leukemia effect in mice, and finally, the possible use of autologous marrow transplantation

Hematopoietic Stem Cell Transplantation in India-2017 Annual Update.

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Naithani, Rahul

2018-01-01

There has been a steady rise in number of transplant centers in India over last few years. This year many papers related to bone marrow transplants were presented in annual conference of Indian society of Hematology and Transfusion Medicine. All oral and poster presentations which were published were reviewed. There were many publications on autologous transplant, allogeneic transplant and lab aspects of transplant. Centers shared their data on autologous transplants in newly set-up units with resource constraints with good outcomes. Encouraging data from across India is likely to boost more centers to set up transplant centers.

Renal transplantation in high cardiovascular risk patients.

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Bittar, Julio; Arenas, Paula; Chiurchiu, Carlos; de la Fuente, Jorge; de Arteaga, Javier; Douthat, Walter; Massari, Pablo U

2009-10-01

Current transplant success allows recipients with previous contraindications to transplant to have access to this procedure with more frequency and safety. The concept of high-risk patient has changed since the first stages of transplantation. In the first studies, the high-risk concept was based on probability of early graft failure or on a patient's clinical condition to cope with high perioperatory morbimortality. Later on, this concept implied immunological factors that were crucial to ensure transplant success because hypersensitized or polytransfused patients experienced a higher risk of acute rejection and subsequent graft loss. Afterward, the presence of various comorbidities would redefine the high-risk concept for renal transplant mainly considering recipient's clinical aspects. Currently, the change in epidemiological characteristics of patients starting dialysis causes that we now deal with a greater increase of elderly patients, diabetic patients, and patients with history of cardiovascular disease. Today, high-risk patients are those with clinical features that predict an increase in the risk of perioperative morbimortality or death with functioning graft. In this review, we will attempted to analyze currents results of renal transplant outcomes in terms of patients and graft survival in elderly patients, diabetic patients, and patients with previous cardiovascular disease from the most recent experiences in the literature and from experiences in our center. In any of the groups previously analyzed, survival offered by renal transplant is significantly higher compared to dialysis. Besides, these patients are the recipient group that benefit the most with the transplant because their mortality while remaining on dialysis is extremely high. Hence, renal transplantation should be offered more frequently to older patients, diabetic patients, and patients with pretransplant cardiac and peripheral vascular disease. A positive attitude toward renal

Other women's wombs: uterus transplants and gestational surrogacy

Science.gov (United States)

Robertson, John A.

2016-01-01

The birth of a child after uterus transplant from a living donor in Sweden in October, 2013 has spurred reproductive and transplant physicians in Europe and North America to investigate whether uterus transplants, from living or cadaveric donors, will be a safe and effective therapy for women with uterine insufficiency. While progress with uterus transplant depends on medical factors, there are also important ethical and legal concerns. Uterus transplant is essential for women without access to surrogacy. It may also be sought by infertile women who dislike surrogacy. This article examines medical, ethical, legal, and policy issues that arise with womb transplant, including the role of surrogacy policies that make them necessary. The conclusion is that there is a clear ethical path for either surrogacy or uterus transplant to be used by women with uterine insufficiency. PMID:27774233

Other women's wombs: uterus transplants and gestational surrogacy.

Science.gov (United States)

Robertson, John A

2016-04-01

The birth of a child after uterus transplant from a living donor in Sweden in October, 2013 has spurred reproductive and transplant physicians in Europe and North America to investigate whether uterus transplants, from living or cadaveric donors, will be a safe and effective therapy for women with uterine insufficiency. While progress with uterus transplant depends on medical factors, there are also important ethical and legal concerns. Uterus transplant is essential for women without access to surrogacy. It may also be sought by infertile women who dislike surrogacy. This article examines medical, ethical, legal, and policy issues that arise with womb transplant, including the role of surrogacy policies that make them necessary. The conclusion is that there is a clear ethical path for either surrogacy or uterus transplant to be used by women with uterine insufficiency.

Laparoscopic robot-assisted pancreas transplantation: first world experience.

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Boggi, Ugo; Signori, Stefano; Vistoli, Fabio; D'Imporzano, Simone; Amorese, Gabriella; Consani, Giovanni; Guarracino, Fabio; Marchetti, Piero; Focosi, Daniele; Mosca, Franco

2012-01-27

Surgical complications are a major disincentive to pancreas transplantation, despite the undisputed benefits of restored insulin independence. The da Vinci surgical system, a computer-assisted electromechanical device, provides the unique opportunity to test whether laparoscopy can reduce the morbidity of pancreas transplantation. Pancreas transplantation was performed by robot-assisted laparoscopy in three patients. The first patient received a pancreas after kidney transplant, the second a simultaneous pancreas kidney transplantation, and the third a pancreas transplant alone. Operations were carried out through an 11-mm optic port, two 8-mm operative ports, and a 7-cm midline incision. The latter was used to introduce the grafts, enable vascular cross-clamping, and create exocrine drainage into the jejunum. The two solitary pancreas transplants required an operating time of 3 and 5 hr, respectively; the simultaneous pancreas kidney transplantation took 8 hr. Mean warm ischemia time of the pancreas graft was 34 min. All pancreatic transplants functioned immediately, and all recipients became insulin independent. The kidney graft, revascularized after 35 min of warm ischemia, also functioned immediately. No patient had complications during or after surgery. At the longer follow-up of 10, 8, and 6 months, respectively, all recipients are alive with normal graft function. We have shown the feasibility of laparoscopic robot-assisted solitary pancreas and simultaneous pancreas and kidney transplantation. If the safety and feasibility of this procedure can be confirmed by larger series, laparoscopic robot-assisted pancreas transplantation could become a new option for diabetic patients needing beta-cell replacement.

The use of complementary and alternative medicine (CAM) for pregnancy related low back and/ or pelvic girdle pain: An online survey.

Science.gov (United States)

Hughes, Ciara M; Liddle, S D; Sinclair, Marlene; McCullough, Julie E M

2018-05-01

Low back and pelvic girdle pain (LBPGP) is a common complaint among pregnant women, which increases throughout pregnancy and women use various complementary and alternative medicine (CAM) therapies to manage their pain. Using an online survey, CAM treatments used by pregnant women in the UK and their perceptions of these therapies to relieve LBPGP were investigated. 191 women completed the survey and 70% experienced LBPGP lasting more than one week. Over half of women who sought treatment from a GP or physiotherapist were dissatisfied. 25% of participants used CAM during pregnancy, the most popular being aromatherapy (21%), acupuncture (21%), and reflexology (15%). 81% of women used CAM to manage their LBPGP and 85% found it useful for pregnancy symptoms. Women experience high levels of pain during pregnancy with limited treatment options. Research into effective CAM treatments for LBPGP is required to allow women to make informed decisions regarding treatment options. Copyright © 2018 Elsevier Ltd. All rights reserved.

Transplanting oligodendrocyte progenitors into the adult CNS

International Nuclear Information System (INIS)

Franklin, R.J.M.; Blakemore, W.F.; Cambridge Univ.

1997-01-01

This review covers a number of aspects of the behaviour of oligodendrocyte progenitors following transplantation into the adult CNS. First, an account is given of the ability of transplanted oligodendrocyte progenitors, grown in tissue culture in the presence of PDGF and bFGF, to extensively remyelinate focal areas of persistent demyelination. Secondly, we describe how transplanted clonal cell lines of oligodendrocyte progenitors will differentiate in to astrocytes as will oligodendrocytes following transplantation into pathological environments in which both oligodendrocytes and astrocytes are absent, thereby manifesting the bipotentially demonstrable in vitro but not during development. Finally, a series of studies examining the migratory behaviour of transplanted oligodendrocyte progenitors (modelled using the oligodendrocyte progenitor cell line CG4) are described. (author)

The significance of renoscintigraphy for renal transplantation

International Nuclear Information System (INIS)

Oei Hong Yoe.

1981-01-01

The aim of the study reported here was to evaluate the contribution of renoscintigraphy performed frequently and systematically, for differentiation between the various complications occurring after renal transplantation. Relevant complications of renal transplantation are described, with special attention to the diagnostic methods available at present, and the methods used for radionuclide investigations in renal transplantation are reviewed. The abnormalities seen on the sequential images in ten cases complicated by urine leakage or urinary tract obstruction are described. These are illustrated by the scintigrams and the corresponding radiograms. The results in eight patients whose transplant did not show Hippuran uptake are also described. Transplant failure in five of these eight patients was clearly demonstrated by perfusion scintigraphy. (Auth.)

Mycobacterium tuberculosis Infection following Kidney Transplantation

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Karima Boubaker

2013-01-01

Full Text Available Introduction and Aims. Post-transplant tuberculosis (TB is a problem in successful long-term outcome of renal transplantation recipients. Our objective was to describe the pattern and risk factors of TB infection and the prognosis in our transplant recipients. Patients and Methods. This study was a retrospective review of the records of 491 renal transplant recipients in our hospital during the period from January 1986 to December 2009. The demographic data, transplant characteristics, clinical manifestations, diagnostic criteria, treatment protocol, and long-term outcome of this cohort of patients were analyzed. Results. 16 patients (3,2% developed post-transplant TB with a mean age of 32,5 ± 12,7 (range: 13–60 years and a mean post-transplant period of 36,6months (range: 12,3 months–15,9 years. The forms of the diseases were pulmonary in 10/16 (62,6%, disseminated in 3/16 (18,7%, and extrapulmonary in 3/16 (18,7%. Graft dysfunction was observed in 7 cases (43,7% with tissue-proof acute rejection in 3 cases and loss of the graft in 4 cases. Hepatotoxicity developed in 3 patients (18,7% during treatment. Recurrences were observed in 4 cases after early stop of treatment. Two patients (12.5% died. Conclusion. Extra pulmonary and disseminated tuberculosis were observed in third of our patients. More than 9months of treatment may be necessary to prevent recurrence.

Treatment of pregnancy-related pelvic girdle and/or low back pain after delivery design of a randomized clinical trial within a comprehensive prognostic cohort study [ISRCTN08477490

Directory of Open Access Journals (Sweden)

Klabbers Aldegonda BA

2004-12-01

Full Text Available Abstract Background Pregnancy-related pelvic girdle and/or low back pain is a controversial syndrome because insight in etiology and prognosis is lacking. The controversy relates to factors eliciting pain and some prognostic factors such as the interpretation of pain at the symphysis. Recent research about treatment strategies also reflects those various opinions, in fact suggesting there is professional uncertainty about the optimal approach. Currently, physiotherapists often prescribe a pain-contingent treatment regime of relative rest and avoiding several day-to-day activities. Additionally, treatment more often includes an exercise program to guide rectification of the muscle imbalance and alignment of the pelvic girdle. Effectiveness of those interventions is not proven and the majority of the studies are methodologically flawed. Investigators draw particular attention to biomedical factors but there is growing evidence that important prognostic issues such as biopsychosocial factors appear to be even more important as point of action in a treatment program. Methods/design This pragmatic randomized controlled trial is designed to evaluate the effectiveness of a tailor-made treatment program with respect to biopsychosocial factors in primary care. The effect of the experimental intervention and usual care are evaluated as they are applied in primary health care. The trial is embedded in a cohort study that is designed as a longitudinal, prospective study, which studies prevalence, etiology, severity and prognosis during pregnancy until one year after delivery. The present paper focuses on choices regarding recruitment procedures, in-/exclusion criteria and the development of a well-timed intervention. Discussion This section briefly discusses the actions taken to minimize bias in the design, the proper time-window for the experimental intervention and the contrast between the experimental intervention and usual care.

Local expansion in circulatory death kidney transplant activity improves wait-listed outcomes and addresses inequities of access to transplantation

OpenAIRE

Mirshekar-Syahkal, Bahar; Summers, Dominic; Bradbury, Lisa L; Aly, Mohamed; Bardsley, Victoria; Berry, Miriam; Norris, Joseph M; Torpey, Nick; Clatworthy, Menna Ruth; Bradley, J Andrew; Pettigrew, Gavin John

2016-01-01

In the UK, circulatory death (DCD) kidney transplant activity has increased rapidly, but marked regional variation persists. We report how increased DCD kidney transplant activity influenced wait-listed outcomes for a single centre. Between 2002/03 and 2011/12, 430 (54%) DCD and 361 (46%) DBD kidney-only transplants were performed in the Cambridge Transplant Centre, with a higher proportion of DCD donors fulfilling expanded criteria status (41% DCD vs 32% DBD; $\\small \\textit{P}$=0.01). Compa...

Organ transplantation and replacement

Energy Technology Data Exchange (ETDEWEB)

Cerilli, G.J.

1988-01-01

This book contains 49 chapters. Some of the titles are: Molecular, Genetic, and Clinical Aspects of the HLA System; The Normal Immune Response; Significance of the ABO Antigen System; The Role of Dialysis in the Management of End-Stage Renal Disease; Access for Dialysis; Patient Selection for Renal Transplantation; The Living Donor in Kidney Transplantation; and Kidney Preservation by Cold Storage.

Restoration of vision after transplantation of photoreceptors.

Science.gov (United States)

Pearson, R A; Barber, A C; Rizzi, M; Hippert, C; Xue, T; West, E L; Duran, Y; Smith, A J; Chuang, J Z; Azam, S A; Luhmann, U F O; Benucci, A; Sung, C H; Bainbridge, J W; Carandini, M; Yau, K-W; Sowden, J C; Ali, R R

2012-05-03

Cell transplantation is a potential strategy for treating blindness caused by the loss of photoreceptors. Although transplanted rod-precursor cells are able to migrate into the adult retina and differentiate to acquire the specialized morphological features of mature photoreceptor cells, the fundamental question remains whether transplantation of photoreceptor cells can actually improve vision. Here we provide evidence of functional rod-mediated vision after photoreceptor transplantation in adult Gnat1−/− mice, which lack rod function and are a model of congenital stationary night blindness. We show that transplanted rod precursors form classic triad synaptic connections with second-order bipolar and horizontal cells in the recipient retina. The newly integrated photoreceptor cells are light-responsive with dim-flash kinetics similar to adult wild-type photoreceptors. By using intrinsic imaging under scotopic conditions we demonstrate that visual signals generated by transplanted rods are projected to higher visual areas, including V1. Moreover, these cells are capable of driving optokinetic head tracking and visually guided behaviour in the Gnat1−/− mouse under scotopic conditions. Together, these results demonstrate the feasibility of photoreceptor transplantation as a therapeutic strategy for restoring vision after retinal degeneration.

Transplantation with positive complement-dependent microcytotoxicity crossmatch in contemporary kidney transplantation: Practice patterns and associated outcomes

Directory of Open Access Journals (Sweden)

Ralph J Graff

2012-01-01

Full Text Available We analyzed clinical factors and graft survival associated with complement-dependent microcytotoxicity (CDC crossmatch (XM positive (+ kidney transplants in 1995 to 2009 United Network of Sharing (UNOS registry data. CDCXM negative (- transplants were selected from centers and years in which at least one CDCXM+ transplant was performed at a given center in a given year. CDCXM+ and CDCXM- results were compared with bivariate and multivariate survival analysis. Our observations are as follows: (1 The risk of graft loss with CDCXM+ vs. CDCXM- results was markedly lower than the risk observed historically, e.g., living donor (LD-CDCXM+ absolute all-cause graft survival reductions were 0.7% at 24 hours (P=0.007, 2.9% at one year (P <0.0001, 3.7% at five years (P<0.0001; deceased donor (DD-CDCXM+ absolute graft survival reductions were 0.7% at 24 hours (P=0.02, 3.5% at one year (P <0.0001, 2.7% at five years (P=0.0009. On covariate adjustment, the only significant association of CDCXM+ vs. CDCXM- results was with one-year graft loss risk: LD aHR 1.44 (95% CI 1.05-1.96, DD aHR 1.33 (CI 1.10-1.61. (2 CDCXM+ transplantation was more commonly performed among groups disadvantaged with respect to transplant access, including sensitized, previously transplanted women and black recipients. (3 In CDCXM+ recipients, there was a high percentage of flow cytometry (FC XM- and autoXM+ results. After removing these groups, outcomes with CDCXM+ results were relatively good. (4 CDCXM+/FCXM+ vs. CDCXM-/FCXM- graft loss risk was observed only in LD recipients transplanted at centers performing fewer than 10 such transplants during the study period: 11.0% reduction (P<0.0001 and aHR of 2.86 (CI 1.18-6.94 at one year; 14.7% reduction (P<0.0001 and aHR of 1.77 (CI 0.88-3.58 at five years. Although using CDCXM+ as a contraindication to transplantation has been associated with virtual elimination of hyperacute rejection, the negative effect of a CDCXM+ in contemporary