bluuebunny/crossref_metadata_2025 huggingface dataset:
Chromosome pairing in haploid plants of radish derived from alien monosomic addition lines
Authors: Kaneko Y. , Bang S. W. , Torii‐Abe J. , Eduardo R. B. , Matsuzawa Y. , Jung C.
Published: October 2003

Six haploid plants of radish were obtained via alien monosomic addition lines (2n = 19). One plant was derived from anther culture of an Raphanus sativus‐Brassica oleracea addition line, one plant from the selected smaller seed of an R. sativus‐Sinapis arvensis addition line and four plants from an R. sativus‐B. rapa addition line. During metaphase I of pollen mother cells, two plants exhibited the chromosome pairing of (0‐3)II+ (3‐9)I, three showed (0‐1)III + (0‐3)II + (3‐9)I and the remaining plant (0‐2)II + (5‐9)I. Trivalents seemed to be formed by the pairing between two larger chromosomes and the smaller one with somewhat loose pairing. All haploid plants were inferior to the radish cv. ‘Shogoin’ (2n = 18) with respect to vegetative growth. Their flowers were smaller, with sterile pollen grains, but a few normal flowers with fertile pollen sporadically developed and then produced a few seeds. It is suggested that the radish genome (R, n = 9) might comprise three pairs of homoeologous chromosomes, with the remaining three chromosomes carrying the homologous region(s) that results in a trivalent formation.
Resistance of almond cultivars to Plum pox virus (sharka)
Authors: Rubio M. , Martínez‐Gómez P. , Dicenta F. , Weber W. E.
Published: October 2003

Sharka, a disease caused by Plum pox virus (PPV), mainly affects some Prunus species, including apricot, peach and plum, and to a lesser degree, sweet cherry and sour cherry. In almond, different PPV isolates have been transmitted experimentally to the ‘Aï’ cultivar. In this study, the resistance of 10 almond cultivars to a Dideron PPV isolate was evaluated in controlled conditions by grafting the cultivars on to inoculated GF305 peach rootstocks. The results demonstrated a high level of resistance to PPV in all the almond cultivars assayed. They did not show any symptoms and were ELISA and RT‐PCR negative, despite the strong symptoms observed in their GF305 rootstocks. The implications of these results for the dispersion of PPV, and the potential role of almond as a source of resistance to PPV in other Prunus species such as peach, are also discussed.
Bud pollination and hybrid seed production in detergent‐induced male sterile plants of Brassica juncea
Authors: Singh V. , Chauhan S. V. S. , Chevre A.M.
Published: October 2003

The efficacy of a synthetic detergent (Surf Excel) as a potential chemical hybridizing agent in Brassica juncea was studied. Foliar sprays with various concentrations of the detergent caused reductions in plant height, number of branches and leaves per plant, size of leaves, anther size, pollen per flower, ovules per flower, pollen fertility, fruits per plant, fruit size, seeds per fruit, total yield per plant and 100 seed weight as compared with those of untreated plants. The style in the floral buds of plants sprayed with different concentrations of Surf Excel elongated and so the receptive stigma protruded from the buds which facilitated cross‐pollination by honey bees. The plants sprayed once with 2% Surf Excel exhibited an elongated style with a raised receptive stigma and 100% pollen sterility without causing a significant reduction in total yield.
Inheritance of reduced plant height in the sunflower line Dw 89
Authors: Velasco L. , Pérez‐Vich B. , Muñoz‐Ruz J. , Fernández‐Martínez J. M. , Friedt W.
Published: October 2003

The objective of the present research was to study the inheritance of reduced plant height in the sunflower line Dw 89. Plants of the cytoplasmic male sterile version of this line, cmsDw 89 (mean plant height of 47.4 cm) were crossed with plants of the restorer line RHA 271 (mean of 120.9 cm). F1 plants averaged 120.4 cm, which indicated dominance of standard over reduced plant height. F2 plants followed a segregation pattern of 1 : 15 (reduced : normal height), suggesting that reduced plant height in Dw 89 is controlled by alleles at two loci, designated Dw1 and Dw2. Class assignment in the F2 was confirmed through the evaluation of the F3 generation. Backcrosses to Dw 89 segregated with 1 : 3 (reduced : normal height) ratios, which confirmed the digenic inheritance of the trait. The evaluation of plant height distributions in F3 families suggested possible genetic interaction between the Dw1 and Dw2 loci.
Fluorescence in situ hybridization polymorphism using two repetitive DNA clones in different cultivars of wheat
Authors: Schneider A. , Linc G. , Molnár‐Láng M. , Graner A.
Published: October 2003

Twenty‐two wheat cultivars and a wheat line were analysed with two‐colour fluorescence in situ hybridization (FISH) using the pSc119.2 and pAs1 repetitive DNA clones to detect if polymorphism could be observed in the hybridization patterns of different wheat cultivars. The FISH hybridization pattern of ‘Chinese Spring’ was compared with wheat cultivars of different origins. Differences were observed in the hybridization patterns of chromosomes 4A, 5A, 1B, 2B, 3B, 5B, 6B, 7B, 1D, 2D, 3D and 4D. Although a low level of polymorphism exists in the FISH pattern of different wheat cultivars, it is possible to identify 17 pairs of chromosomes according to their hybridization patterns with these two probes. This study will help to predict the expected variation in the FISH pattern when analysing wheat genetic stocks of different origin. It is presumed that variation in hybridization patterns are caused by chromosome structural rearrangements and by differences in the amount and location of repetitive sequences in the cultivars analysed.
Molecular marker analysis of kernel size and shape in bread wheat
Authors: Dholakia B. B. , Ammiraju J. S. S. , Singh H. , Lagu M. D. , Röder M. S. , Rao V. S. , Dhaliwal H. S. , Ranjekar P. K. , Gupta V. S. , Weber W. E.
Published: October 2003

The economic value of wheat grain is determined by the kernel morphology which is an important parameter for manufacturing different food products requiring specific grain characteristics. Although kernel size and shape have emerged as important breeding objectives, not much information is available about the number or location of associated gene(s)/quantitative trait loci. In the present study, a recombinant inbred line population of 106 plants (F7) was phenotyped for four traits, namely kernel length, width, weight and factor form density (FFD) and genotyped with different polymerase chain reaction‐based markers. Transgressive segregants were observed for all the traits and genetic correlation studies showed positive correlations between the majority of the traits. The number of markers associated with each trait ranged from two to nine and the phenotypic contribution by an individual marker ranged from 3.3 to 16.6%. Many of the markers showed linkage to more than one trait. Strategies for improving the wheat grain quality traits and the utility of such markers in marker‐assisted selection (MAS) efforts are discussed.
Loperamide increases glucose ultilization in streptozotocin‐induced diabetic rats
Authors: Tzeng TF , Liu IM , Lai TY , Tsai CC , Chang WC , Cheng JT
Published: October 2003

1. Loperamide has an ability to lower the plasma glucose concentration in streptozotocin (STZ)‐induced diabetic rats. In the present study, we investigated the molecular mechanisms by which loperamide regulates plasma glucose concentrations in the absence of insulin.

2. Loperamide, at a dose sufficient (17.6 µg/kg) to activate µ‐opioid receptors, significantly decreased plasma glucose levels in STZ‐diabetic rats. The mRNA and protein levels of glucose transporter 4 (GLUT‐4) in soleus muscle, detected by northern and western blotting, respectively, were increased after repeated intravenous administration of loperamide (17.6 µg/kg) to STZ‐diabetic rats over 3 days. Moreover, similar treatment with loperamide (17.6 µg/kg) for 3 days reversed the elevated mRNA and protein levels of phosphoenolpyruvate carboxykinase (PEPCK) in the liver of STZ‐diabetic rats to near the levels seen in normal rats.

3. These results suggest that activation of µ‐opioid receptors by loperamide can increase glucose utilization in peripheral tissues and/or reverse the higher gene expression of PEPCK to inhibit hepatic gluconeogenesis, thereby lower plasma glucose in diabetic rats lacking insulin.
Spironolactone prevents cardiac collagen proliferation after myocardial infarction in rats
Authors: Mill José Geraldo , Milanez Maria da Conceição , Resende Micheline Monteiro de , Gomes Maria da Glória S , Leite Cláudia Mendes
Published: October 2003

1. Aldosterone has been considered a key hormone in the regulation of water, sodium and potassium metabolism, thus influencing blood pressure regulation. More recently, several studies have demonstrated that aldosterone is also produced in extra‐adrenal tissues (e.g. the heart), suggesting a paracrine effect for aldosterone, such as to increase collagen synthesis in the heart.

2. Because aldosterone production in the heart increases after myocardial infarction (MI), we investigated the effect of chronic administration of spironolactone, an aldosterone receptor antagonist, in rats after MI compared with the effects produced by losartan and hydralazine.

3. Myocardial infarction was produced in male Wistar rats by surgical ligature of the left coronary artery. Sham‐operated animals were used as controls.

4. Spironolactone (20 mg/kg per day), losartan (15 mg/kg per day) or hydralazine (20 µg/kg per day) were administered after MI and used for 1 month.

5. At the end of the treatment period, animals underwent haemodynamic recording (arterial and intraventricular pressures). The collagen content of the heart was evaluated by measuring the hydroxyproline (OH‐Pro) concentration in right (RV) and left ventricle (LV) muscle fragments.

6. Infarct size was unaffected by drug treatments. The increased LV end‐diastolic pressure observed in MI rats was prevented by losartan and remained unchanged following administration of spironolactone or hydralazine.

7. Losartan prevented RV and LV hypertrophy, as well as collagen proliferation in both ventricles, after MI. The postinfarction hypertrophy observed in RV and LV after MI remained unchanged in infarcted groups treated with spironolactone or hydralazine.

8. The OH‐Pro concentration was significantly reduced in LV muscle in the MI group treated with spironolactone (682 ± 40 vs 557 ± 21 µg/g for MI vs MI + spironolactone, respectively; P < 0.05), an effect not observed in the hydralazine‐treated group.

9. These data suggest that spironolactone prevents collagen proliferation in the surviving myocardium by mechanisms independent of the loading conditions of the heart chambers. Control of postinfarction hypertrophy and collagen accumulation produced by losartan seems to depend on the reduction in loading conditions of the heart chambers.
Hydrochlorothiazide abolishes the anti‐atherosclerotic effect of quinapril
Authors: Fonseca FAH , Ihara SSM , Izar MCO , Silva EP , Kasinski N , Lopes IEL , Pinto LESA , Paiva TB , Tufik S , De Paola AAV , Carvalho ACC
Published: October 2003

1. Antihypertensive treatment has been demonstrated to result in persistent reductions in morbidity and mortality due to stroke. However, the coronary risk attributable to hypertension has been only partially reversed. We hypothesized that diuretics could have unfavourable effects on atherosclerosis.

2. New Zealand rabbits were fed a 0.5% cholesterol‐enriched diet for 12 weeks, followed by a 0.1% cholesterol diet for another 12 weeks. During the last 12 week period, 40 animals were randomly assigned to one of four groups: (i) group I was the control group; (ii) group II received hydrochlorothiazide (10 mg/day); (iii) group III received quinapril (30 mg/day); and (iv) group IV was treated with hydrochlorothiazide (10 mg/day) plus quinapril (30 mg/day).

3. The treatments did not affect either the lipid profile or serum electrolytes and oxidative stress. However, endothelium‐dependent vasorelaxation in isolated aortic rings was significantly improved with quinapril (group III) treatment (P < 0.001 vs other groups). In addition, therapy with quinapril promoted a significant reduction in atherosclerosis (intima area, intima/media ratio and perimeter of vessel with plaque; P < 0.05 vs other groups), as well as in cholesterol content of the aorta (P < 0.05 vs groups II and IV).

4. In conclusion, hydrochlorothiazide did not modify atherosclerosis and, when added to quinapril treatment, impaired the anti‐atherosclerotic effect seen with quinapril alone.
Different remodelling against left ventricular overload between diabetic and non‐diabetic haemodialysis patients
Authors: Nishimura Masato , Hashimoto Tetsuya , Kobayashi Hiroyuki , Fukukda Toyofumi , Okino Koji , Yamamoto Noriyuki , Nakamura Naoto , Yoshikawa Toshikazu , Takahashi Hakuo , Ono Toshihiko
Published: October 2003

1. Diabetes mellitus is significantly associated with the occurrence of congestive heart failure in end‐stage renal disease patients undergoing maintenance haemodialysis. In the present study, we asked whether the left ventricular remodelling against sustained pressure and/or volume overload to the left ventricle may be different between diabetic and non‐diabetic haemodialysis patients.

2. Left ventricular parameters, including left ventricular mass index (LVMI), interventricular septal wall thickness (IVST) and relative left ventricular wall thickness (rLVWT), were assessed in 486 patients receiving maintenance haemodialysis (145 diabetic and 341 non‐diabetic patients) using transthoracic echocardiography. Plasma concentrations of B‐type natriuretic peptide (BNP), measured with an immunoradiometric assay, were used as a humoral parameter indicating left ventricular wall stress.

3. In non‐diabetic patients, the plasma BNP concentration correlated with LVMI (r = 0.245; P = 0.0001), IVST (r = 0.250; P = 0.0001) and rLVWT (r = 0.149; P = 0.006). Furthermore, LVMI was correlated with mean blood pressure and pulse pressure and IVST and rLVWT were correlated with pulse pressure.

4. In contrast, none of the measured factors was correlated with LVMI and IVST in diabetic patients. Plasma BNP concentrations were positively correlated with end‐systolic and end‐diastolic left intraventricular dimensions and were inversely correlated with rLVWT and left ventricular fractional shortening in diabetic patients, but not in non‐diabetic patients.

5. In conclusion, a sustained increase in left ventricular wall stress is likely to elicit eccentric left ventricular remodelling in diabetic haemodialysis patients, whereas it causes concentric left ventricular remodelling in non‐diabetic haemodialysis patients. This difference in left ventricular remodelling against left ventricular overload may be associated with the high incidence of congestive heart failure in diabetic haemodialysis patients.
The effect of nitrous oxide diffusion on laryngeal mask airway cuff inflation in children
Authors: ALGREN JOHN , GURSOY FERAY , JOHNSON T. , SKJONSBY BARBARA
Published: October 2003

We studied the effect of nitrous oxide (N2O) diffusion on size 2 LMA cuff inflation in 52 children, 38±21 months of age. LMA cuffs were inflated with air (Group A) or 65% N2O, oxygen and halothane (Group B). Cuffs were inflated in a stepwise manner, achieving a cuff leak pressure of 17±4 cm H2O for all patients. Cuff volume and intracuff pressure increased in Group A (8.5±1.0 ml to 10.8±1.4 ml and 101±36 mmHg to 152±42 mmHg, respectively) and decreased in Group B (8.9±1.0 ml to 6.6±1.5 ml and 90±30 mmHg to 53±37 mmHg, respectively). Cuff leak pressure did not change significantly in either group. We conclude that cuff inflation with a mixture of N2O/oxygen prevents N2O diffusion into the cuff, avoiding cuff overinflation without compromising LMA function.
Attachment ability of the beetle Chrysolina fastuosa on various plant surfaces
Authors: Gorb E.V. , Gorb S.N.
Published: October 2003

To study the role of different structures of a plant surface preventing insect attachment, a variety of plant surfaces were screened. Attachment ability of the beetle Chrysolina fastuosa Scop. (Coleoptera, Chrysomelidae) was measured on 99 surfaces among them smooth, hairy, felt‐like, waxy, and glandular ones of three plant organs (stems, leaves, fruits) of 83 plant species belonging to 45 families. Insects attached successfully to smooth, hairy, and felt‐like substrata. These surface types did not effect the further attachment of C. fastuosa, indicating the adhesive system remained intact after contacting these substrata. However, the beetles could not attach properly to surfaces covered with wax crystalloids or glandular hairs. In most experiments on pruinose plant substrata, no influence of the surfaces on the subsequent attachment ability of insects was observed. Only in one case (the stem of Acer negundo), was such an impairment recorded, but recovery of attachment ability was fast. Crystalloids of this plant species probably temporarily disable function of tenent setae of C. fastuosa. Four hypotheses, explaining anti‐adhesive properties of plant surfaces, covered with wax crystalloids are proposed. A plant surface with glandular trichomes disabled the attachment system of the beetle for a long time. Secretions of trichomes probably glue tenent setae together making further attachment impossible.
Glandular trichomes on perennial alfalfa affect host‐selection behavior of Empoasca fabae
Authors: Ranger Christopher M. , Hower Arthur A.
Published: October 2003

Selected behavior of Empoasca fabae (Harris) (Homoptera: Cicadellidae) was examined to elucidate resistance of commercially‐available glandular‐haired alfalfa to this key forage pest. The overall objective was to assess the effects of the glandular trichomes on the behavior of nymphs and adults. Studies of host‐plant acceptance by E. fabae nymphs found first and third instars to show a higher degree of change in settling location on the glandular‐haired FGplh13 alfalfa than on the nonglandular P5373 alfalfa. Nymphs also cleaned their tarsi more frequently when in contact with the glandular trichomes on FGplh13 alfalfa, and in addition a larger number of nymphs jumped/fell off the surface of FGplh13 alfalfa. The glandular trichomes on FGplh13 also impeded nymphal mobility more effectively than the nonglandular trichomes on P5373. No choice, time‐course analysis of adult host‐plant acceptance behavior found that adults settled less frequently on FGplh13 alfalfa with the glandular trichomes intact, than on either FGplh13 with the glandular trichomes removed, or P5373 alfalfa with the nonglandular trichomes intact or removed. Free choice, time‐course analysis of adult host‐preference behavior determined that at each observation, stems of the nonglandular P5373 alfalfa were preferred over FGplh13 alfalfa. Similarly, at each observation, stems of FGplh13 alfalfa with the glandular trichomes removed were preferred over FGplh13 with the glandular trichomes intact. These data provide additional evidence for the localization of a resistance factor in the glandular trichomes of FGplh13 alfalfa. An antixenotic resistance mechanism also appears to be present, which may function, in part, through a tactile avenue.
Variation in encapsulation sensitivity of Cotesia sesamiae biotypes to Busseola fusca
Authors: Mochiah Moses B. , Ngi‐Song Adele J. , Overholt William A. , Stouthamer Richard
Published: October 2003

Many braconid wasp species inject polydnaviruses to overcome their host's immune system. In the species Cotesia sesamiae, two biotypes exist that differ in their ability to develop in the host Busseola fusca. The biotype from coastal Kenya is infected with Wolbachia and is not able to develop in larvae of B. fusca, whereas the uninfected inland biotype of this wasp can develop in B. fusca. The genetic transmission of the developmental ability was studied through a series of genetic crosses and superparasitization experiments. The Wolbachia infection of the coastal type did not play a role in the encapsulation response of the host. Experiments show that the polydnaviruses of the wasps could not prevent the encapsulation of the coastal parasitoid eggs. Most likely, larval characteristics such as surface proteins played a more important role in the encapsulation response of the host even in the presence of a functional polydnavirus.
Role of visual stimuli in host and mate location of the Colorado potato beetle
Authors: Szentesi Á. , Weber D.C. , Jermy T.
Published: October 2003

Visual responses of adult male and female Colorado potato beetles CPB, Leptinotarsa decemlineata (Say) (Coleoptera, Chrysomelidae) to 10 × 20 cm coloured paper‐boards, beetle‐sized coloured beads or dead CPB, and to combinations of these in laboratory experiments in an arena of 52 cm diameter were investigated. In addition, visual discriminatory abilities of males exposed to female‐specific substances were also measured. The paths of the beetles were recorded on videotape by a computer‐aided motion detection system. Parameters of tracks were calculated and the tape‐recorded paths were further processed for behavioural analyses and for obtaining mean angular directions by circular statistics. Both sexes showed a strong preference for yellow‐black striped, yellow and light‐green boards and, to a lesser degree, were also attracted to yellow‐green, dark‐green, red and white boards, to beetle‐sized beads coloured either black or yellow‐black striped, and to some combinations of these. Males exposed to female substances immediately prior to entering the arena performed significantly more successful approaches to objects than did males of the control group. These results corroborate field observations on males' mate‐searching behaviour and increase our understanding of natural host‐ and mate‐finding processes.
Enhanced expression of enterocyte P-glycoprotein depresses cyclosporine bioavailability in a recipient of living donor liver transplantation
Authors: Masuda Satohiro , Goto Maki , Kiuchi Tetsuya , Uemoto Shinji , Kodawara Takaaki , Saito Hideyuki , Tanaka Koichi , Inui Ken-ichi
Published: October 2003

We evaluated levels of intestinal expression of absorptive-barrier P-glycoprotein (PGP) and cytochrome P-450 IIIA4 (CYP3A4) and immunosuppressant therapy in a patient who underwent living donor liver transplantation (LDLT) and received a second living donor liver transplant after chronic rejection of the first. PGP and CYP3A4 expression were measured using part of a Roux-en-Y limb. After the first LDLT, the concentration-dose ratio of orally administered tacrolimus was 159.8 ± 125.3 (average ± SD of 32 different days), similar to the average for 46 recipients of living donor liver transplants in our hospital (161.3 ± 88.1). However, the recipient required very large oral doses of cyclosporine (703.9 ± 385.4 mg/d, average ± SD of 13 different days) after the second LDLT. Although intestinal PGP level was increased markedly at the second LDLT, CYP3A4 level was decreased. In addition, levels of messenger RNA expression of several gene products related to the local inflammation, such as cyclooxygenase 2, interleukin-1β (IL-1β), IL-2, IL-6, IL-8, IL-10, and tumor necrosis factor-α, were increased. These results suggest that hepatic failure after LDLT, including chronic rejection and/or cholangitis, was accompanied by upregulation of intestinal PGP expression, which could depress the bioavailability of the immunosuppressant.
Renal function improves in liver transplant recipients when switched from a calcineurin inhibitor to sirolimus
Authors: Fairbanks Kyrsten D. , Eustace Joseph A. , Fine Derek , Thuluvath Paul J.
Published: October 2003

Sirolimus (Rapamune; Wyeth-Ayerst, Philadelphia, PA) is a newer immunosuppressive drug with no known acute or chronic nephrotoxic effects; however, limited data are available in liver transplant recipients. We prospectively evaluated changes in renal function in liver transplant recipients after conversion from a calcineurin inhibitor to sirolimus monotherapy. We measured serial serum creatinine levels in liver transplant recipients with chronic nephrotoxicity caused by calcineurin inhibitors before and after conversion to sirolimus therapy. Estimated glomerular filtration rate (eGFR) was calculated from the Modification of Diet in Renal Disease formula. Change in eGFR over time, incidence of acute hepatocellular rejection, and adverse events while being administered sirolimus monotherapy were recorded. Mean interval between liver transplantation and initiation of sirolimus therapy was 310 weeks (range, 9 to 780 weeks). Of 21 patients included in our study, 18 patients were converted to sirolimus monotherapy and 3 patients were switched to sirolimus and low-dose steroid therapy. Patients were followed up for a mean of 66.8 ± 38.9 (SD) weeks after conversion. Renal function improved in 71% of patients (15 of 21 patients). Median eGFR improved significantly from 34 mL/min/1.73 m2 at the time of conversion to 43 mL/min/1.73 m2 at the last follow-up (27% increase in eGFR; P = 001). Median monthly change in eGFR was from −0.25 mL/min/1.73 m2 pre-sirolimus therapy to +1.28 mL/min/1.73 m2 post-sirolimus therapy (P = .09). Adverse events were mostly mild and self-limited. Only 1 patient developed biopsy-proven acute cellular rejection, which was treated with sirolimus and mycophenolate mofetil. Two patients discontinued sirolimus therapy because of toxicity (oral ulceration, 1 patient; interstitial pneumonitis, 1 patient). Renal function improved significantly in the majority of liver transplant recipients with renal insufficiency caused by calcineurin inhibitors when converted to sirolimus therapy. Sirolimus monotherapy provided adequate immunosuppression with a low incidence of acute cellular rejection and minimal adverse events.
Executive summary from the Intraoperative Advisory Council on Donation After Cardiac Death of the United Network for Organ Sharing: Practice guidelines
Authors: Mandell Susan M. , Taylor Gloria J. , D’Alessandro Anthony , McGaw Lin J. , Cohen Edmond
Published: October 2003

The number of organs recovered from asystolic donors is less than anticipated and is explained partially by negative attitudes held by health care providers. To understand the reasons for these beliefs and find solutions, the United Network for Organ Sharing under contract with the Department of Health and Human Services convened the Intraoperative Advisory Council on Donation After Cardiac Death in September, 2001. The Council found that, unlike other medical specialties, operating room health care providers were uncertain of their roles and duties in the care of donors declared dead with cardiopulmonary criteria, known as donation after cardiac death. They were reluctant to care for terminally ill patients in whom death was an expected outcome. Council members deliberated these issues, seeking solutions to repatriate operating room health care providers with the national effort to provide reliable and compassionate care to organ donors and their families. The Council requested the construction of practice guidelines, believing that the structure provided by guidelines will improve health provider confidence in donation after cardiac death and thus improve the quality of care. Physician and nonphysician health care providers from the operating room met to create the Guidelines for the United Network for Organ Sharing, which they believe will improve the quality of care of asystolic organ donors.
Results of combined and sequential liver-kidney transplantation
Authors: Becker Thomas , Nyibata Miguel , Lueck Rainer , Bektas Hueseyin , Demirci Gülçin , Lehner Frank , Tusch Günter , Strassburg Christian , Schwarz Anke , Klempnauer Juergen , Nashan Bjoern
Published: October 2003

Experience with combined liver-kidney transplantation (L-KTx) has increased, but controversy regarding this procedure continues because the indications are not clearly defined yet. Between 1984 and 2000, 38 patients underwent simultaneous L-KTx and 9 patients underwent sequential transplantation, receiving either a liver before a kidney or a kidney before a liver. Main indications for a simultaneous procedure were polycystic liver-kidney disease with cirrhosis and coincidental renal failure. The main indications for sequential procedure were cirrhosis caused by viral infection for the liver and glomerulonephritis for the kidneys. Outcomes in these patients were evaluated retrospectively. Regarding simultaneous transplantation, 28 (73.7%) long-term survivors were followed up for 0.7 to 12.5 years. Currently, 24 (63.2%) patients are alive with good liver function. Fourteen patients died; 10 patients died in the early postoperative phase because of septic complications, and most of them were cirrhotic with a poor preoperative clinical status. Currently, 2 of the surviving patients (8%) have returned to dialysis, 4 (17%) have reduced renal function, and 18 (75%) have good renal function. Five liver and 2 kidney retransplantations were performed during the follow-up. In cases of sequential grafting, patients undergoing kidney transplantation in the presence of a previously transplanted stable liver did better than those who underwent liver transplantation after kidney transplantation. When liver transplantation was performed early and electively before substantial worsening, combined L-KTx is a safe procedure offering excellent long-term palliation.
Intrahepatic cholestasis after liver transplantation
Authors: Ben-Ari Ziv , Pappo Orit , Mor Eytan
Published: October 2003

Cholestasis is a common sequela of liver transplantation. Although the majority of cases remain subclinical, severe cholestasis may be associated with irreversible liver damage, requiring retransplantation. Therefore, it is essential that clinicians be able to identify and treat the syndromes associated with cholestasis. In this review, we consider causes of intrahepatic cholestasis. These may be categorized by time of occurrence, namely, within 6 months of liver transplantation (early) and thereafter (late), although there may be an overlap in their causes. The causes of intrahepatic cholestasis include ischemia/reperfusion injury, bacterial infection, acute cellular rejection, cytomegalovirus infection, small-for-size graft, drugs for hepatotoxicity, intrahepatic biliary strictures, chronic rejection, hepatic artery thrombosis, ABO blood group incompatibility, and recurrent disease. The mechanisms of cholestasis in each category and the clinical presentation, diagnosis, treatment, and outcome are discussed in detail.
Early and late complications in the recipient of an adult living donor liver
Authors: Broelsch Christoph E. , Frilling Andrea , Testa Giuliano , Cicinnati Vito , Nadalin Silvio , Paul Andreas , Malago Massimo
Published: October 2003

Key points

1. Adult-to-adult living donor liver transplantation has been established as a means of overcoming the cadaveric organ shortage.

2. The anatomic situation of right-liver grafts and additional factors, i.e., underlying liver disease of the recipient, are responsible for different results in pediatric and adult recipients.

3. In transplant recipients, small-for-size grafts, vascular problems, and biliary tract complications contribute to surgical morbidity.

4. Management of biliary leakages needs additional attention to achieve better overall survival rates.
Donor and recipient outcomes after adult living donor liver transplantation
Authors: Humar Abhinav
Published: October 2003

Key points

1. When looking at outcomes after adult living donor (LD) liver transplantation, both donor and recipient outcomes must be examined.

2. The estimated risk for mortality after right-lobe donation is 0.5%. The risk for complications is approximately 10% to 20%.

3. Current national data show slightly inferior patient and graft survival rates with LD versus deceased donor transplantation. The difference may be caused by a greater incidence of surgical complications after LD liver transplantation.

4. The main surgical complication in the donor and recipient remains biliary leak.
Regulation and oversight of adult living donor liver transplantation
Authors: Miller Charles M.
Published: October 2003

Key points

1. Ethical principles and informed consent standards should be implemented for all living donors.

2. Institutions that perform living donor transplantation should provide an independent donor advocate to ensure that informed consent standards and ethical principles are applied to the practice of all live organ donor transplantation.

3. A database of health outcomes for all live donors should be established and funded through and under the auspices of the US Department of Health and Human Services.

4. Serious consideration should be given to the establishment of a separate resource center for living donors and their families.

5. The present preference in Organ Procurement and Transplantation Network allocation policy, given to previous living organ donors who subsequently need a kidney, should be extended so that any living organ donor would be given preference as a candidate for any organ transplant, should one become needed.

6. A process should be established to verify qualifications of a center to perform living donor liver or lung transplantation.
Selection of donors for living donor liver transplantation
Authors: Trotter James F.
Published: October 2003

Key points

1. The donor evaluation is performed in three staged phases to disqualify inappropriate candidates as early as possible in the process.

2. Approximately half the potential transplant recipients are unable to identify a suitable donor for evaluation.

3. Approximately half the individuals evaluated for living donation are found suitable.

4. The donor pool in many parts of the country is significantly limited by the high prevalence of obesity.
Evaluation of the donor liver for living donor liver transplantation
Authors: Brandhagen David , Fidler Jeff , Rosen Charles
Published: October 2003

Key points

1. Accurate assessment of the donor liver is an important component of the living donor liver evaluation and is critical to ensure a successful outcome for both donor and recipient.

2. Liver biochemistry tests, viral hepatitis serological tests, tests to exclude chronic liver disease, and volumetric computed tomographic or magnetic resonance (MR) imaging of the liver are performed routinely as part of the donor evaluation.

3. Liver biopsy should be a standard component of the donor evaluation in all donors, with the possible exception of those with a body mass index less than 25 who have normal liver test and abdominal imaging study results and no risk factors for chronic liver disease or hepatic steatosis.

4. The maximum acceptable percentage of steatosis in the donor liver is unknown, but most centers use an upper limit of 10% to 30%.

5. A graft-recipient body weight ratio of at least 0.8% provides the recipient with adequate hepatic mass in most situations.

6. Anatomic variants in donor biliary and hepatic vascular anatomy are common.

7. Evaluation of donor vascular anatomy varies among centers and includes MR or computed tomographic angiography and hepatic angiography.

8. Evaluation of biliary anatomy is performed most commonly using intraoperative cholangiography. Some centers use MR cholangiography or endoscopic retrograde cholangiopancreatography in selected situations.
The impact of the model for end-stage liver disease on recipient selection for adult living liver donation
Authors: Freeman Richard B.
Published: October 2003

Key points

1. The Model for End-Stage Liver Disease (MELD) system can be used to assess recipient pre-transplant risks and help select appropriate candidates for the adult to adult living donation liver transplant procedure.

2. Selection of candidates for the adult to adult living donation liver transplant procedure requires assessment of candidate risk of death without a transplant, risk of death with a transplant, and donor risk of death.

3. Understanding of the risks involved allows for development of clinical decision models to inform the risk benefit analyses.

4. MELD provides a useful, objective, and universal tool for clinicians around the world to estimate risks for clinical decision making in all forms of liver transplantation.
Role of adult living donor liver transplantation in patients with hepatitis C
Authors: Everson Gregory T. , Trotter James
Published: October 2003

Key points

1. Living donor liver transplantation (LDLT) is an option for patients with end-stage liver disease or hepatoma caused by chronic hepatitis C.

2. Reports from some, but not all, transplant centers indicate that hepatitis C may recur earlier, recurrence may be more severe, and graft loss caused by recurrent hepatitis C may be more frequent in LDLT compared with cadaveric transplantation.

3. Several unique characteristics of LDLT (versus cadaveric transplantation) may favor severe recurrence of hepatitis C. These include an increase in genetic similarity between donor and recipient, higher degree of HLA matching, greater systemic bioavailability of immunosuppressive agent, and hepatic regeneration.

4. Hepatic regeneration may promote the acceleration and severity of recurrent hepatitis C by enhancement of hepatitis C viral uptake by hepatocytes through stimulation of the low-density lipoprotein receptor and increase in activity of the internal ribosomal entry site.
Psychosocial assessment of adult living liver donors
Authors: Shrestha Roshan
Published: October 2003

Key points

1. Adult-to-adult living donor liver transplantation is used increasingly to treat patients with end-stage liver disease.

2. Donor selection limits the use of living donor liver transplantation. Psychosocial assessment is a critical component of the donor evaluation.

3. There are no strict guidelines for the psychosocial assessment of potential living liver donors before and after donation.

4. The attitude toward living liver donation remains high.

5. Both short-and long-term psychosocial assessment of living liver donors is necessary after donation.
Surgical techniques used in adult living donor liver transplantation
Authors: Belghiti Jacques , Kianmanesh Reza
Published: October 2003

Key points

1. The main goal of hepatectomy for adult living donor liver transplantation (ALDLT) is to provide a graft with sufficient volume and adequate vascular inflow and outflow.

2. Although the risk is increased in the donor, right grafts, which provide maximum liver volume, are used by a majority of transplant teams.

3. Although right grafts are easily positioned in the donor, facilitating the right hepatic vein anastomosis, the venous drainage is not always complete because the anterior sector is drained through the middle hepatic vein.

4. The harvesting of the middle hepatic vein, which allows the optimal venous drainage for the recipient, is debated with the fear of adverse effects for the donor.

5. The back-table procedure is essential for vascular reconstruction of the hepatic veins and for portal and arterial reconstruction in case of dual vessels.

6. There is a tendency to perform duct-to-duct biliary anastomosis.

7. The use of left grafts, which are an anatomical entity with single inflow and outflow orfices, is limited by the small volume of the grafts.

8. In order to overcome the small-for-size syndrome, some promising technical procedures (partial porto-systemic shunt and splenic artery ligation) are under evaluation.
Role of adult living liver donation in patients with hepatocellular cancer
Authors: Roberts John Paul
Published: October 2003

Key points

1. Transplantation represents the best therapy for hepatocellular carcinoma (HCC) as compared with resection.

2. On an intention-to-treat basis, living donor transplantation (LDLT) represents a better alternative to cadaveric transplantation (CLT).

3. Current criteria for transplantation for patients with HCC using cadaveric organs may be appropriate for living donor transplantation.
Financial impact of adult living donation
Authors: Russo Mark W. , Brown Robert S.
Published: October 2003

Key points

1. Cost analyses of living-donor liver transplantation (LDLT) and deceased-donor liver transplantation should capture costs incurred during the pretransplantation time period because benefits of LDLT likely result from reducing complications and cost pretransplantation.

2. Cost analyses should capture the costs associated with donor evaluation in LDLT since these costs are specific to LDLT and not associated with deceased-donor liver transplantation.

3. Indirect costs, such as time lost from work for donor and recipient, are difficult to estimate and frequently are not incorporated in cost-effectiveness analyses. However, they are important, particularly from a societal perspective.
Hepatic regeneration in living donor liver transplantation
Authors: Olthoff Kim M.
Published: October 2003

Key points

1. Active hepatocyte replication occurs after cadaveric transplantation to replace cells lost to ischemic and immunologic damage. Significantly more regeneration is also required after adult-to-adult living donor transplantation because of the small size of the graft.

2. The molecular mechanisms initiating regeneration are well described in animal models, which include priming with cytokines, activation of transcription factors, and expression of immediate early genes, which then cause the hepatocyte to progress through the cell cycle.

3. Certain factors have been shown to affect liver regeneration and recovery. These include ischemic injury, graft size, immunosuppression, steatosis, and donor age. Other factors that have been implicated are venous flow and gender.

4. Active regeneration in the living donor setting may affect other processes, including viral replication, the alloimmune response, drug metabolism, and recurrent hepatocellular carcinoma. More investigation is needed in these areas. Adult-to-adult living donor transplantation provides a unique opportunity to study human liver regeneration and return of normal liver function after resection.
Future of adult living donor liver transplantation
Authors: Ghobrial Mark R. , Busuttil Ronald W.
Published: October 2003

Key points

1. Future application of adult living donor liver transplantation (ALDLT) will be determined by accurate assessment of hazards imposed on the donor and documentation of potential benefits for the recipient.

2. Definition of the risks imposed on living donors can be elucidated only by the adoption of a standardized uniform method for adverse-event reporting that defines the severity of complications and assessment of living donor health-related quality of life after donation.

3. Recipient survival outcomes after ALDLT should be risk adjusted to allow valid comparison to outcomes achieved by whole-organ transplantation.

4. Short-and long-term transplant recipient complications must be compared with those of whole-organ recipients by using standardized approaches.

5. The use of living donor grafts in patients with hepatitis C virus (HCV) infection and hepatocellular carcinoma (HCC) must be investigated because advantages of early transplantation in HCV-infected transplant recipients may be offset by risks for graft loss caused by rapid recurrence, whereas early transplantation of patients for HCC may not provide additional survival benefits because shorter waiting times may negate evaluation of tumor biological characteristics, as is possible by longer waiting times for cadaveric transplant recipients.
Early and late complications in the right-lobe adult living donor
Authors: Pomfret Elizabeth A.
Published: October 2003

Key points

1. Reported complication rates for right-lobe liver donors vary widely, but are estimated to be approximately 35%, with a surgical mortality rate of approximately 0.3%.

2. Biliary complications, including leak, biloma, or stricture, are the most commonly reported morbidity in right-lobe living donors.

3. Other significant donor morbidity includes portal vein thrombosis, pulmonary embolus, bowel obstruction, bleeding requiring reoperation or transfusion, and incisional hernia.

4. These data underscore the reality that living donation is associated with a small, but real, possibility of death and potentially significant morbidity, emphasizing the need for a comprehensive database to precisely define true living donor morbidity and mortality.
Molecular dissociation and vibrational excitation in the surface scattering of (N2)n and (O2)n clusters
Authors: Nguyen Tao-Nhân V. , Koch Denise M. , Peslherbe Gilles H. , Vach Holger
Published: October 2003

Theoretical studies have predicted that the extreme conditions produced within a cluster during cluster-surface scattering could catalyze multicenter reactions with large activation barriers. However, recent experimental results did not reveal vibrational excitation or molecular dissociation in the scattering of molecular van der Waals clusters on a graphite surface. Building on our previous investigations of translational and rotational excitation, we carried out a detailed study of the mechanisms of energy transfer to the vibrational degrees of freedom of the products of (N2)n and (O2)n cluster-surface scattering by means of molecular dynamics simulations. Our results indicate that the monomer product vibrational energy distributions are best fit by a sum of two Boltzmann distributions, which suggests that two distinct thermal-like processes of vibrational excitation may be occurring during cluster scattering. The cold component of the distribution was shown to involve monomers originating from the cluster interior while the hot component of the distribution is made up of monomers essentially lying at the outskirts of the cluster at surface impact. Under current experimental conditions, cluster products are found to be only slightly vibrationally excited. Only a small fraction of the incident cluster kinetic energy is transferred to the monomer product vibrational modes, such that molecular dissociation is not possible under typical experimental conditions, and a much larger incident kinetic energy is required to obtain a significant probability of surface-induced monomer dissociation. Furthermore, our results indicate that increasing cluster size does not catalyze, but rather hinders monomer vibrational excitation, and enhances vibrational relaxation. Our findings suggest the existence of an optimal cluster size for experimental studies of cluster-catalyzed reactions.
A molecular dynamics simulation study of elastic properties of HMX
Authors: Sewell Thomas D. , Menikoff Ralph , Bedrov Dmitry , Smith Grant D.
Published: October 2003

Atomistic simulations were used to calculate the isothermal elastic properties for β-, α-, and δ-octahydro-1,3,5,7-tetranitro-1,3,5,7-tetrazocine (HMX). The room-temperature isotherm for each polymorph was computed in the pressure interval 0⩽p⩽10.6 GPa and was used to extract the initial isothermal bulk modulus Ko and its pressure derivative using equations of state employed previously in experimental studies of the β-HMX isotherm. The complete elastic tensor for each polymorph was calculated at room temperature and atmospheric pressure. For the case of β-HMX, the calculated elastic tensor is compared to one based on a fit to sound speed data yielding reasonably good agreement. The bulk modulus of β-HMX obtained from equation-of-state fits to the room-temperature isotherm agrees well with that determined from the complete elastic tensor and from volume fluctuations at atmospheric pressure. However, the value of Ko obtained from the isotherm is sensitive to choice of equation of state fitting form and to the weighting scheme employed in the fit. Based upon simulation results and reanalysis of experimental data, the commonly accepted value of the initial isothermal bulk modulus for β-HMX should be revised from a value of ∼12.4–13.5 GPa to ∼15–16 GPa. The present report provides the first accurate determination of the elastic tensors and isotropic moduli for α- and δ-HMX. Predicted values of the shear moduli for α- and δ-HMX are more than a factor of 2 smaller than for β-HMX.