bluuebunny/crossref_metadata_2025 huggingface dataset:
Breast and ovarian cancer risk perception after prophylactic salpingo‐oophorectomy due to an inherited mutation in the BRCA1 or BRCA2 gene
Authors: Finch A , Metcalfe K , Lui J , Springate C , Demsky R , Armel S , Rosen B , Murphy J , Elit L , Sun P , Narod S
Published: February 2009

It is often recommended that women who carry a mutation in the BRCA1 or BRCA2 gene have their ovaries and fallopian tubes removed to reduce their risk of gynecologic cancer. The aim of this study was to evaluate women’s perception of their risk of breast and ovarian cancer before and after prophylactic salpingo‐oophorectomy. We surveyed 127 women who carry a BRCA1 or BRCA2 mutation and who underwent prophylactic salpingo‐oophorectomy at the University Health Network, Toronto. Subjects were asked to estimate their risks of breast and ovarian cancer before and after surgery. Their perceived risks of cancers were then compared with published risks, based on their mutation status. BRCA1 carriers estimated their risk of breast cancer risk to be, on average, 69% before surgery and 41% after surgery. They estimated their risk of ovarian cancer to be 55% before surgery and 11% after surgery. BRCA2 carriers estimated their risk of breast cancer to be 69% prior to surgery and 45% after surgery and their perceived risk of ovarian cancer to be 43% before surgery and 8% after surgery. Compared with published risk figures, the perceived risk of ovarian cancer before prophylactic salpingo‐oophorectomy was overestimated by 47% of BRCA1 mutation carriers and by 61% of BRCA2 mutation carriers. Most women who have undergone genetic counseling and subsequently choose prophylactic salpingo‐oophorectomy accurately perceive their risk of breast cancer. However, in this study, many women overestimated their risk of ovarian cancer, particularly women who carry a BRCA2 mutation.
Mutations in FAM20C also identified in non‐lethal osteosclerotic bone dysplasia
Authors: Simpson MA , Scheuerle A , Hurst J , Patton MA , Stewart H , Crosby AH
Published: February 2009

Raine syndrome is an osteosclerotic bone dysplasia, which has proved to be lethal within the first few weeks of life in all the reported cases to date. We recently identified a chromosomal rearrangement and telomeric microdeletion in a patient with Raine syndrome and subsequently identified mutations in the FAM20C gene, located within the deleted region, in six additional Raine syndrome cases. The phenotype of Raine syndrome in the cases examined was remarkably consistent with generalized osteosclerosis of all bones, periosteal bone formation, characteristic facial phenotype and lethal within the first few weeks of life. In the current study, we have identified two unrelated individuals who presented at birth with a sclerosing bone dysplasia with features very similar to those in Raine syndrome but who survived infancy and are now aged 8 and 11 years, respectively. Mutations in FAM20C, consistent with autosomal recessive inheritance, were identified in both cases. In the first case, a homozygous non‐synonymous mutation in exon 7 (1309G>A D437N) was identified, and in the second case, compound heterozygosity for non‐synonymous mutations in exon 2 (731T>A I244N) and in exon 3 (796G>A G266R) was revealed. Raine syndrome has been previously considered to be a neonatal lethal condition. However, the identification of mutations in these two patients confirms a broader phenotypic spectrum and that mutation of FAM20C does not always lead to the infantile lethality previously seen as a prerequisite for Raine syndrome diagnosis.
Preimplantation genetic diagnosis in an HIV‐serodiscordant couple carrier for sickle cell disease: lessons from a case report
Authors: Gonzalez‐Merino E , Zengbe V , Vannin AS , Place I , Bostan A , Emiliani S , Liesnard C , Goffard JC , Abramowicz M , Englert Y
Published: February 2009

Since 1999, the Erasme Hospital Fertility Clinic has carried a special programme for patients with HIV seropositivity. The philosophy of the programme is to give access to these patients in a secure environment to the same technological facilities available to any other patients. Many of these patients being native from sub‐Saharan countries, they are often sickle cell disease (SCD) carriers, a common autosomal recessive disorder in these regions, and a severe affection in homozygotes. We hereby report, for the first time, the birth of a healthy sickle haemoglobin (HbS) heterozygous baby after preimplantation genetic diagnosis (PGD) for SCD in an HIV‐serodiscordant couple of HbS mutation carriers with longstanding infertility. The prospective mother was 35 years old and HIV positive with an undetectable viral load under highly active antiretroviral therapy. One carrier embryo was transferred and resulted in the birth of a healthy HbS carrier baby girl. Despite stimulation difficulties, sometimes described in HIV patients, PGD represents an interesting additional technology, especially in populations where the coexistence of both diseases is frequent. PGD could even be preferred to prenatal diagnosis for couples of HbS carriers if the woman is HIV positive, as invasive prenatal samplings carry a risk of materno‐foetal viral transmission.
Role of mutational analysis in diagnosis of tuberous sclerosis complex
Authors: Vail EA , Rakowski SK , Numis AL , Thiele EA
Published: February 2009

We describe three cases in whom identification of a disease‐causing mutation in the TSC1 or TSC2 gene preceded the appearance or detection of symptoms sufficient for a clinical diagnosis of tuberous sclerosis complex (TSC). We suggest that genetic testing be given a more prominent role in the evaluation of individuals with a family history of TSC or symptoms suggestive of TSC and propose that diagnostic criteria be revised to include genetic testing.
Skoura – a genetic island for congenital insensitivity to pain and anhidrosis among Moroccan Jews, as determined by a novel mutation in the NTRK1 gene
Authors: Suriu C , Khayat M , Weiler M , Kfir N , Cohen C , Zinger A , Aslanidis C , Schmitz G , Falik‐Zaccai TC
Published: February 2009

Congenital insensitivity to pain with anhidrosis (CIPA) or hereditary sensory and autonomic neuropathy type IV is a rare, autosomal recessive neurologic disorder, characterized by absence of reaction to painful stimuli, mental retardation, self‐ mutilating behavior, anhidrosis, and recurrent episodes of hyperthermia. Mutations in the neurotrophic tyrosine kinase receptor 1, a receptor phosphorylated by nerve growth factor, have been documented in diverse ethnic groups. We identified the same novel nonsense mutation in two unrelated families of Moroccan Jewish descent, each with two affected siblings. This possible founder mutation may trace to the rural Jewish village in southern Morocco from where both these families originated. Genetic screening for the causative mutation among 300 unrelated Moroccan Jews did not reveal carriers for the causative mutation, thus excluding high risk for CIPA in this ethnic subpopulation.
Toriello–Carey syndrome in a patient with a de novo balanced translocation [46,XY,t(2;14)(q33;q22)] interrupting SATB2
Authors: Tegay DH , Chan KK , Leung L , Wang C , Burkett S , Stone G , Stanyon R , Toriello HV , Hatchwell E
Published: February 2009

Toriello–Carey syndrome (TCS; OMIM 217980) is a multiple congenital anomaly syndrome characterized by the common manifestations of corpus callosum agenesis, cardiac defects, cleft palate/Robin sequence, hypotonia, mental retardation, postnatal growth retardation and distinctive facial dysmorphology (including micrognathia, telecanthus, small nose and full cheeks). Both autosomal recessive and X‐linked inheritance have been proposed, but chromosomal abnormalities involving disparate loci have also been detected in a small number of cases. We report a patient with classical features of TCS and an apparently balanced de novo translocation between chromosomes 2 and 14 [46,XY,t(2;14)(q33;q22)]. Molecular characterization revealed direct interruption of the special AT‐rich sequence‐binding protein‐2 (SATB2) gene at the 2q33.1 translocation breakpoint, while the 14q22.3 breakpoint was not intragenic. SATB2 mutation or deletion has been associated with both isolated and syndromic facial clefting; however, an association with TCS has not been reported. SATB2 functions broadly as a transcription regulator, and its expression patterns suggest an important role in craniofacial and central nervous system development, making it a plausible candidate gene for TCS.
A prickly cause of progressive myoclonic epilepsy
Authors: Warby S
Published: February 2009

A homozygous mutation in human PRICKLE1 causes an autosomal‐recessive Progressive Myoclonus Epilepsy‐Ataxia Syndrome Bassuk et al. (2008) American Journal of Human Genetics 83: 1–10.
LRTOMT: a new tone in understanding the symphony of non‐syndromic deafness
Authors: Schulze JM
Published: February 2009

Mutations of LRTOMT, a fusion gene with alternative reading frames, cause nonsyndromic deafness in humans Ahmed et al. (2008) Nature Genetics 40: 1335–1340.
Immunosuppression without calcineurin inhibition: optimization of renal function in expanded criteria donor renal transplantation
Authors: Luke Patrick P.W. , Nguan Christopher Y. , Horovitz David , Gregor Laura , Warren Jeff , House Andrew A.
Published: February 2009

Abstract:  Introduction:  To assess the efficacy of calcineurin inhibitor (CNI)‐free immunosuppression vs. calcineurin‐based immunosuppression in patients receiving expanded criteria donor (ECD) kidneys.

Patient and methods:  Thirteen recipients of ECD kidneys were enrolled in this pilot study and treated with induction therapy and maintained on sirolimus, mycophenolate mofetil (MMF) and prednisone. A contemporaneous control group was randomly selected comprised of 13 recipients of ECD kidneys who had been maintained on CNI plus MMF and prednisone.

Results:  For the study group vs. the control group, two‐yr graft survival was 92.3% vs. 84.6% (p = NS), two‐yr patient survival was 100% vs. 92.3% (p = NS) and the acute rejection rates were 23% vs. 31% (p = NS), respectively. Renal function was significantly better in the study group compared with control up to the six‐month mark, after which, it remained numerically but not statistically significant. Complications were more common in the study group, but serious adverse events requiring discontinuation were rare.

Conclusion:  This pilot study demonstrates that CNI‐free regimens can be safely implemented in patients receiving ECD kidneys with excellent two‐yr patient and graft survival and good renal allograft function. Longer follow‐up in larger randomized controlled trials are necessary to establish these findings.
A randomized trial of basiliximab with three different patterns of cyclosporin A initiation in renal transplant from expanded criteria donors and at high risk of delayed graft function
Authors: Andrés Amado , Marcén Roberto , Valdés Francisco , Sánchez Plumed Jaime , Solà Ricard , Errasti Pedro , Lauzurica Ricardo , Pallardó Luis , Bustamante Jesús , Amenábar Juan José , Plaza Juan José , Gómez Ernesto , Grinyó Josep Maria , Rengel Manuel , Puig Josep Maria , Sanz Aurelio , Asensio Concepción , Andrés Inés ,   on behalf of the NI2A Study Group
Published: February 2009

Abstract:  This study assays therapy with basiliximab and different patterns of cyclosporin A (CsA) initiation in renal transplant (RT) recipients from expanded criteria donors (ECD) and at high risk of delayed graft function (DGF). A multicentre six‐month open‐label randomized trial with three parallel groups treated with basiliximab plus steroids, mycophenolate mofetil and different patterns of CsA initiation: early within 24 h post‐RT at 3 mg/kg/d (Group 1; n = 38), and at 5 mg/kg/d (Group 2; n = 40), or delayed after 7–10 d at 5 mg/kg/d (Group 3; n = 36). There were no differences among groups in six months GFR (43.1 ± 12, 48.0 ± 14 and 47.2 ± 17 mL/min, respectively), DGF (Group 1: 31%, Group 2: 37%, Group 3: 42%), nor biopsy‐proven acute rejection, although clinically treated and biopsy‐proven acute rejection was significantly higher in Group 3 (25%) vs. Group 1 (5.3%, p < 0.05). At six months no differences were observed in death‐censored graft survival or patient survival. Induction therapy with basiliximab and three CsA‐ME initiation patterns in RT recipients from ECD and at high risk of DGF presented good renal function and graft survival at six months. Late onset group did not achieve improvement in DGF rate and showed a higher incidence of clinically treated and biopsy‐proven acute rejection.
Cerebral aspergillosis caused by Aspergillus ustus following orthotopic heart transplantation: case report and review of the literature
Authors: Florescu Diana F. , Iwen Peter C. , Hill Lisa A. , Dumitru Ioana , Quader Mohammed A. , Kalil Andre C. , Freifeld Alison G.
Published: February 2009

Abstract:  This report describes the first case of cerebral aspergillosis in a heart transplantation patient caused by Aspergillus ustus and reviews 15 previously reported cases of invasive aspergillosis in immunocompromised hosts caused by this mold. The utility of molecular analysis for the identification of unusual fungal pathogens is also described. The refractory nature of A. ustus to treatment is similar to other Aspergillus species and treatment options are reviewed.
Is veno‐venous bypass still needed during liver transplantation? A review of the literature
Authors: Hoffmann Katrin , Weigand Markus A. , Hillebrand Norbert , Büchler Markus W. , Schmidt Jan , Schemmer Peter
Published: February 2009

Abstract:  Orthotopic liver transplantation has been made feasible with intra‐operative femoral‐to‐jugular veno‐venous bypass (VVB) to redirect the blood from the lower extremities and the kidneys to the heart. This reduces hemodynamic instability and metabolic disturbances. However, complications such as thromboses with pulmonary thrombembolism or post‐reperfusion syndrome were observed in up to 30% of the cases. The latter, recent developments of cava‐sparing surgical techniques, shorter anhepatic times plus optimized anesthetic management have made the necessity for a routine use of VVB questionable.
Long‐term clinical outcomes of nocturnal hemodialysis patients compared with conventional hemodialysis patients post‐renal transplantation
Authors: Pauly Robert P. , Asad Reem A. , Hanley James A. , Pierratos Andreas , Zaltzman Jeffrey , Chery Anne , Chan Christopher T.
Published: February 2009

Abstract:  Nocturnal home hemodialysis (NHD) is a novel dialysis strategy associated with multiple advantages over conventional hemodialysis (CHD). Short‐ and long‐term clinical outcomes of NHD patients after kidney transplantation are unknown. We hypothesized that the incidence of delayed graft function (DGF), patient and graft survival, and post‐transplant estimated glomerular filtration rate (eGFR) is better among CHD‐transplanted individuals than among those having received NHD. Of 231 NHD patients, 36 underwent renal transplantation between 1994 and 2006 and were matched to 68 transplanted CHD patients with a maximum follow‐up of 11.7 yr. The incidence of DGF was not different between the two groups [NHD: 15/35 (42.9%) vs. CHD: 25/68 (36.8%) p = 0.43]. In modeling eGFR pre‐transplant weight, donor age and recipient race were most predictive. Dialysis modality prior to transplantation influenced neither the level of eGFR post‐transplantation (p = 0.34), nor the rate of eGFR decline. Patient survival was comparable between NHD and CHD groups (log‐rank p = 0.91). Based on this analysis, it appeared that the incidence of DGF was similar between NHD‐ and CHD‐transplanted patients and that pre‐transplant modality did not impact on the level or rate of deterioration of post‐transplant eGFR.
Impact of rituximab therapy for treatment of acute humoral rejection
Authors: Kaposztas Z. , Podder H. , Mauiyyedi S. , Illoh O. , Kerman R. , Reyes M. , Pollard V. , Kahan B.D.
Published: February 2009

Abstract:  Introduction:  Antibody mediated rejection (AMR) is associated with a greater incidence of allograft loss because traditional approaches ‐ pulse steroid or anti‐lymphocyte antibodies are usually ineffective. This retrospective analysis documented the benefit of rituximab administration in addition to plasmapheresis (PP).

Methods:  We retrospectively reviewed the data from 54 kidney transplant patients treated for AMR between 2001 and 2006, including 26 patients who received PP plus rituximab (Group A), versus 28 subjects who underwent PP without rituximab (Group B). Only patients whose serum IgG levels were below normal values received intravenous gamma globulin (IVIG). In addition to clinical and demographic variables we evaluated graft/patient survivals at two years post‐diagnosis, Banff classification of rejections, serum creatinine and calculated GFR values at baseline, rejection, resolution as well as three, six, 12 and 24 months thereafter.

Results:  The demographic features of the cohorts showed no significant differences. The two‐year graft survival for patients treated with rituximab plus PP was 90%, significantly better than 60% in the PP cohort (p = 0.005). Upon multivariate analysis administration of rituximab was the most significant factor (≥ 0.009); whereas, IVIG also produced a useful effect (p = 0.05). Neither the mean (≥ 0.42) nor the slope (p = 0.25) of GFR values showed a significant difference among salvaged kidneys over 24 months after completion of AMR treatment. The rates and types of infectious complications at three and six months did not show significant differences or impact on graft survival.

Conclusion:  Addition of rituximab improved the outcomes of PP treatment of antibody mediated rejection episodes.
Associations of serum EBV DNA and gammopathy with post‐transplant lymphoproliferative disease
Authors: Rosselet Anne , Vu Dinh‐Hao , Meylan Pascal , Baur Chaubert Audrey S. , Schapira Marc , Pascual Manuel , Aubert Vincent , Tissot Jean‐Daniel , Duchosal Michel A.
Published: February 2009

Abstract:  Background:  Post‐transplant lymphoproliferative disease (PTLD) is a life‐threatening complication of immunosuppression following transplantation. Epstein–Barr virus (EBV) and gammopathy in serum are associated with PTLD, but these two parameters have not been evaluated in parallel for their association with PTLD.

Methods:  We evaluated the incidence of EBV load positivity, gammopathy, and protein expression in sera from all PTLD patients diagnosed at our hospital during the past seven yr. Results were compared with those of a control group including matched transplanted patients who did not develop PTLD.

Results:  Seven of 10 PTLD patients presented EBV+ PTLD, for which five patients had detectable serum EBV DNA levels compared with none of 38 controls (RR between two groups =121, p < 0.0001). Five out of 10 patients had gammopathy at PTLD diagnosis compared with 5/38 controls (RR between two groups = 6.6, p = 0.022). Additionally, protein serum analysis by high‐resolution two‐dimensional gel electrophoresis and image examination failed to evidence specific abnormality in patients with PTLD compared with controls.

Conclusions:  Our results confirm an association between EBV in sera and gammopathy with PTLD, and highlight the high specificity of the former analysis. Whether a combination of both analyses will improve the clinical detection of PTLD remains to be evaluated in a larger prospective cohort study.
Plasma adiponectin in heart transplant recipients
Authors: Ambrosi Pierre , Oddoze Christiane , Nicolay Alain , Penet‐Lorec Anne‐Marie , Riberi Alberto , Métras Dominique , Portugal Henri , Habib Gilbert
Published: February 2009

Abstract:  Background:  The association between plasma adiponectin and metabolic syndrome may be impaired in heart transplant recipients, since renal failure is frequent among these patients. Thus, we studied the relationship between metabolic syndrome and plasma adiponectin in transplanted heart recipients.

Methods:  Ninety‐five heart transplant recipients were prospectively included 8.3 ± 5.6 yr after transplantation in this cross‐sectional study. All patients had physical examination, echocardiography or routine biennial coronary angiography, and laboratory measurements.

Results:  Metabolic syndrome was found in 31% of these patients. Plasma adiponectin was significantly lower in patients with metabolic syndrome (12.5 ± 8.3 μg/mL) than in patients without (16.7 ± 9.4 μg/mL, p = 0.03). Adiponectin levels were usually in the normal or high range (< 4 μg/mL in only two patients). Low creatinine clearance was associated with higher plasma adiponectin (R=−0.26, p = 0.01). Plasma adiponectin was not significantly different between the 28 patients with angiographic evidence of graft vasculopathy (13.9 ± 9.5 μg/mL) and the 67 patients without (16.1 ± 9.1 μg/mL, p = 0.3).

Conclusions:  Contrasting with a high frequency of metabolic syndrome in these patients, adiponectin levels were usually in the normal or high range, probably as a consequence of renal failure. This suggests that adiponectin is not a major determinant for insulin resistance among these patients.
Boari flap vesicocalycostomy: a salvage drainage procedure for complete ureteric stricture and pyelocalyceal fistula
Authors: Gowda Basavaraj D.R. , Goldsmith Paul , Ahmad Niaz
Published: February 2009

Abstract:  To increase the working knowledge on how to drain a transplanted kidney via the use of a Boari flap as a salvage procedure. A female with a transplant kidney had complete obstruction at the ureteropelvic junction and multiple strictures of the ureter causing deterioration of the graft function. Surgery was the only way to successfully drain the obstructed kidney, but conventional methods were not possible due to dense fibrosis around the kidney. A Boari flap to the lower pole calyx of the transplant kidney was therefore employed. A Boari flap vesicocalycostomy is a potential method available to the transplant surgeon to successfully restore graft function in a case where the transplant or native ureter is unsalvageable.
Focal segmental glomerular sclerosis in renal transplant recipients: predicting early disease recurrence may prolong allograft function
Authors: Sener Alp , Bella Anthony J. , Nguan Chris , Luke Patrick P.W. , House Andrew A.
Published: February 2009

Abstract:  Recurrence of focal segmental glomerular sclerosis (FSGS) in the allograft following renal transplantation can be graft threatening. To assess risk factors associated with FSGS recurrence, we analyzed 22 patients with FSGS who underwent transplantation between 1996 and 2004. Five patients (Group I, 23%) developed FSGS post‐transplantation. Of these patients, 60% had undergone bilateral nephrectomy (BN) for progressive disease compared with none of the patients that were free of recurrence (Group II) (p = 0.0006). Other factors linked with recurrent FSGS were time to first dialysis (Group I: 3.1 ± 1.1 yr vs. Group II: 11.9 ± 1.9 yr; p = 0.03), pre‐transplant proteinuria (Group I: 7.0 ± 1.8 g/d vs. Group II: 2.5 ± 0.7 g/d; p = 0.02), young age at transplantation (p = 0.09) and female sex (Group I: 80% vs. Group II: 24%; p = 0.021). Eighty percent of Group I patients received a living related transplant vs. 24% in Group II (p = 0.021). All grafts continue to function at last follow‐up with comparable serum creatinines. Overall, post‐transplant FSGS recurrence may be associated with BN, severity of pre‐transplant FSGS, female gender, and living donation. These patients should be monitored closely for early recurrence and may benefit from early plasmapheresis to restore and facilitate long‐term graft function.
Role of dietary intervention and nutritional follow‐up in heart transplant recipients
Authors: Guida Bruna , Perrino Nunzia Ruggiero , Laccetti Roberta , Trio Rossella , Nastasi Annamaria , Pesola Domenica , Maiello Ciro , Marra Claudio , De Santo Luca Salvatore , Cotrufo Maurizio
Published: February 2009

Abstract:  Background:  Obesity, dyslipidemia, hypertension, and diabetes mellitus are common features after heart transplantation and they lead to coronary artery disease and graft loss.

Aim:  To determine the effects of a dietary intervention on nutritional status and metabolic outcome of two groups enrolled during or after the first year from the transplant.

Methods:  Forty two subjects (mean age 51.36±12.4 yr) were studied; 20 were enrolled during the first year by the transplant, 22 were enrolled after the first year from the transplant (7.9±3.86 and 56.86±38.6 months after surgery, respectively). According to diet compliance both groups were divided into two subgroups and they were prospectively followed for 4 years. Anthropometric measurements, biochemical nutritional markers, and dietary records were collected at baseline (T0) and after a 12‐month follow‐up period (T12) and a 48‐month follow‐up period (T48). Body composition was performed at T0 and T12.

Results:  Diet compliance was associated with a decrease in total cholesterol, triglycerides and glucose plasma level and with a weight loss mainly due to a decrease in fat mass.

Conclusion:  Our study shows the efficacy of dietary intervention to obtain an early and late weight and metabolic control after heart transplant.
The association between MMF and risk of progressive renal dysfunction and death in adult liver transplant recipients with HCV
Authors: Lake John , Patel Dharmesh , David Kristin , Richwine Jason , Morris Jonathan
Published: February 2009

Abstract  The impact of a three‐drug regimen including mycophenolate mofetil (MMF) vs. a two‐drug (no MMF) regimen on progressive renal dysfunction (PRD) in liver transplant recipients with hepatitis C virus (HCV) infection has not been well described. Adults with HCV who received a primary liver transplant between January 1, 2000 and December. 31, 2005 and were discharged from the hospital on a three‐drug regimen [CNI+MMF+steroids (S)] (n = 4 946) were compared with those discharged on two‐drug regimen (CNI+S) (n = 3 884). Time to PRD (defined by a post‐transplant 25% decline in estimated GFR, based on the four‐variable MDRD equation) and recipient death were evaluated using Kaplan–Meier analysis. Cox proportional hazards regression was used to estimate the risk for post‐transplant PRD and death after controlling for baseline characteristics and extended steroid use. The two groups were similar in baseline characteristics. The percentage of recipients on three‐ vs. two‐drug regimen without PRD was higher, 36.8% vs. 31.9%, (p < 0.001), at three yrs post‐transplant; three‐drug therapy was associated with a 6% lower adjusted risk of PRD. The death rate and adjusted risk for death was lower for recipients on a three‐ vs. two‐drug regimen. Liver transplant recipients with HCV on a MMF‐containing regimen are at a lower risk for PRD and death compared with recipients on a regimen not including MMF.
Administration of donor‐derived transplant acceptance‐inducing cells to the recipients of renal transplants from deceased donors is technically feasible
Authors: Hutchinson James A. , Gövert Felix , Riquelme Paloma , Bräsen Jan Hinrich , Brem‐Exner Beate G. , Matthäi Martina , Schulze Maren , Renders Lutz , Kunzendorf Ulrich , Geissler Edward K. , Fändrich Fred
Published: February 2009

Abstract:  Patient KW, a 36‐yr‐old male renal transplant recipient, received transplant acceptance‐inducing cells (TAICs) as an adjunct immunosuppressive therapy. In the weeks post‐transplantation, the patient’s conventional immunosuppressive treatment was gradually minimized, such that, from the 21st wk post‐transplantation onwards, the patient was stably maintained on tacrolimus monotherapy. Treatment with TAICs was without complication, both at the time of administration and in the four‐yr follow‐up period. It is concluded that the production and administration of TAICs to recipients of kidney transplants from deceased donors is technically feasible.
Parameters for successful pig islet isolation as determined using 68 specific‐pathogen‐free miniature pigs
Authors: Kim Hyoung‐Il , Lee Song‐Yi , Jin Sang Man , Kim Kang Seok , Yu Jae Eun , Yeom Su‐Cheong , Yoon Tai Wook , Kim Jae Hyeon , Ha Jongwon , Park Chung‐Gyu , Kim Sang‐Joon
Published: February 2009

Abstract: Background:  Islet cell transplantation is a novel therapeutic modality for the cure of diabetes. Pig islet cells are an attractive substitute for human islet cells; however, they are known to be particularly difficult to isolate because of a weak islet capsule and a tendency to be fragmented during enzymatic digestion. Therefore, parameters favoring successful pig islet isolation were investigated using specific‐pathogen‐free (SPF) miniature pigs.

Methods:  Sixty‐eight SPF miniature pigs were used for islet isolation. Birth weight, body weight, age, sex, pregnancy history, and the fasting blood glucose levels of each pig were determined. Each pig’s general condition was assessed with regard to feeding status and physical activity. Pancreas procurement was performed by one surgical team. Anesthesia duration, operation duration, procedure quality, and perfusate type were recorded. After pancreatectomy, a biopsy was performed for islet density analysis. Decapsulation, cannulation duration, degree of distension, and cold ischemic time were assessed. During islet isolation, pancreas weight, digestion time, and digested tissue proportion were recorded. Isolation results were evaluated by total islet equivalents (IEQ), islet equivalents per gram of pancreas (IEQ/g), isolation index, islet recovery rate, purity, and visual grade. To identify the predictors of higher islet isolation yield, we performed binary logistic regression analysis with significant (P < 0.05) variables from the univariate analysis.

Results:  The pigs were categorized into high (n = 34) and low yield (n = 34) groups according to the median IEQ/g or total IEQ values. Body weight and age were significantly different between the two groups. Being male or a positive history of pregnancy in females was factors favoring successful islet isolation. General condition assessments failed to estimate islet isolation results. Long anesthesia duration, which might have caused ischemic injury to the pancreas, negatively affected islet isolation results. Decapsulation, cannulation duration, and subsequent pancreas distension were significantly important in successful islet isolation. Inter‐lot variability of Liberase was not observed because of screening processes performed before purchase. Isolation index and islet recovery rate correlated well with islet yields.

Conclusions:  Multivariate analysis using total IEQ and IEQ/g as outcome variables indicated that age older than 2, being male and moderate distension by Liberase injection are major determinants influencing successful islet isolation.
No in vivo infection of triple immunosuppressed non‐human primates after inoculation with high titers of porcine endogenous retroviruses*
Authors: Specke Volker , Plesker Roland , Wood James , Coulibaly Cheick , Suling Kristen , Patience Clive , Kurth Reinhard , Schuurman Henk‐Jan , Denner Joachim
Published: February 2009

Abstract: Background:  Porcine endogenous retroviruses (PERVs) released from pig tissue can infect selected human cells in vitro and therefore represent a safety risk for xenotransplantation using pig cells, tissues, or organs. Although PERVs infect cells of numerous species in vitro, attempts to establish reliable animal models failed until now. Absence of PERV transmission has been shown in first experimental and clinical xenotransplantations; however, these trials suffered from the absence of long‐term exposure (transplant survival) and profound immunosuppression.

Methods:  We conducted infectivity studies in rhesus monkeys, pig‐tailed monkeys, and baboons under chronic immunosuppression with cyclosporine A, methylprednisolone, and the rapamycin derivative. These species were selected because they are close to the human species and PERVs can be transmitted in vitro to cells of these species. In addition, the animals received twice, a C1 esterase inhibitor to block complement activation before inoculation of PERV. In order to overcome the complications of microchimerism, animals were inoculated with high titers of cell‐free PERV. In addition, to enable transmission via cell–cell contact, some animals also received virus‐producing cells. For inoculation the primate cell‐adapted strain PERV/5° was used which is characterized by a high infectious titer. Produced on human cells, this virus does not express alpha 1,3 Gal epitopes, does not contain porcine antigens on the viral surface and is therefore less immunogenic in non‐human primates compared with pig cell‐derived virus. Finally, we present evidence that PERV/5° productively infects cells from baboons and rhesus monkeys.

Results:  In a follow‐up period of 11 months, no antibody production against PERV and no integration of proviral DNA in blood cells was observed. Furthermore, no PERV sequences were detected in the DNA of different organs taken after necropsy.

Conclusion:  These results indicate that in a primate model, in the presence of chronic immunosuppression, neither the inoculation of cell‐free nor cell‐associated PERV using a virus already adapted to primate cells results in an infection; this is despite the fact that peripheral blood mononuclear cells of the same animals are infectible in vitro.
Synergistic effects of α‐1,2‐fucosyltransferase, DAF, and CD59 in suppression of xenogenic immunological responses
Authors: Li Sheng‐Zhi , Qu Yan‐Chun , Liu Bing‐Qian , Wang Guang‐You , Zhang Yue , Ma Zhi‐Fang , Ma Teng‐Xiang , Qiu Mengsheng , Han Rui‐Fa
Published: February 2009

Abstract: Background:  Previous studies showed that α‐1,2‐fucosyltransferase (HT), decay accelerating factor (DAF), and CD59 have an inhibitory effect on the immunological rejection of xenogenic transplantation.

Methods:  To investigate their possible synergistic effects in suppression of heterogeneic transplantation, we produced transgenic mouse lines expressing human HT, DAF, and/or CD59 by the standard pronuclear injection approach. PCR and Southern blot were used to identify the transgenic founder lines. Flow cytometry confirmed the high‐level expression of HT, DAF, or CD59 in the transgenic mice.

Results:  The deposition of IgM, C3c, or C9 in the cardiac vascular endothelial cells of the HT, HT/CD59, and/or DAF multiple positive transgenic mice was markedly decreased. The survival time and function of the hearts of the co‐transgenic mice were significantly longer and higher than that of the single HT‐positive transgenic mice (P < 0.05).

Conclusion:  The mice co‐expressing HT/DAF or HT/CD59 could resist the hyperacute rejection better than those expressing HT alone. It is feasible to use HT and C‐reactive proteins co‐transgenic tissues to resist hyperacute rejection and xenograft rejection.
Insecticidal bacterium isolated from an ant lion larva from Munakata, Japan
Authors: Egami I. , Iiyama K. , Zhang P. , Chieda Y. , Ino N. , Hasegawa K. , Lee J. M. , Kusakabe T. , Yasunaga‐Aoki C. , Shimizu S.
Published: February 2009

Twenty bacteria were isolated from four ant lion larvae. The isolates were classified into three groups by biological characteristics. Since Group I, Group II and Group III were isolated from individual larvae Kuo1, Kuo3, 4 and Kuo2, respectively, with exception of one isolate Kuo2‐1, each ant lion tested had its own dominant bacterial flora. Groups I and II were closer to Serratia liquefaciens and Enterobacter cloacae, respectively, whereas Group III could not be identified by the test used. The phylogenetic analysis of GroEL amino acid sequences revealed that Group I, II and III were related to those of Serratia spp., E. cloacae and Salmonella spp. –Escherichia/Shigella spp., respectively. Among these groups, Group I was highly virulent against Bombyx mori and Periplaneta americana, and caused 100% mortality within 24 h. The other two groups (Group II and III) were avirulent to these insect species. The culture filtrate of Group I caused killing activity to B. mori larvae and the insecticidal substance was purified from culture filtrate of Group I bacterium. Since the insecticidal activity highly correlated with proteolytic activity in the chromatographies, Group I bacterium may secret insecticidal proteinase in vitro.
Benthic indicators and index approaches in the three main estuaries along the French Atlantic coast (Seine, Loire and Gironde)
Authors: Dauvin Jean‐Claude , Bachelet Guy , Barillé Anne‐Laure , Blanchet Hugues , De Montaudouin Xavier , Lavesque Nicolas , Ruellet Thierry
Published: February 2009

The three main estuaries in the French Atlantic coast – the Seine, Loire and Gironde, all with high tidal regimes – are interfaces between the continental and the coastal ecosystems. The Seine and Gironde are highly contaminated, whereas the Loire remains in a more natural state. Both the Seine and Gironde have suffered from harbour construction, and as a result, their biological units are extremely compartmentalized. Benthic species and communities have adapted to tolerate temporal physical and chemical changes (e.g. salinity, substrata, depth, and levels of fine particles and oxygen) and human activities (e.g. dredging, shipping traffic, and habitat reduction). Although numerous bio‐indicators and indices are used to define the ecological quality status (EcoQS) of coastal waters, very few of them were developed specifically for environments with a mosaic of conditions and salinity levels, including freshwater. The main problem appears to be that all the indices for determining anthropogenic stress examine the abundances of stress‐tolerant species, which may also be able to tolerate natural stressors such as those occurring in estuaries. This paper takes a look at the development status of the benthic indicators and index approaches used in the three main estuaries along the French Atlantic coast. In addition, it examines the adaptation of the different benthic indicators to the taxonomic sufficiency principle, and the adaptation of the Benthic Opportunistic Polychaetes Amphipods index (BOPA) and the Benthic Opportunistic Annelida Amphipod index (BO2A) for use in the freshwater zones of transitional waters (i.e. up to the upper limit of the tidal range). Several perspectives are discussed in light of the diverse disturbances and the heterogeneity of such stressed zones, such as the use of multimetric and scoring approaches.
Environmental features of deep‐sea habitats linked to the genetic population structure of a crustacean species in the Mediterranean Sea
Authors: Maggio Teresa , Lo Brutto Sabrina , Cannas Rita , Deiana Anna Maria , Arculeo Marco
Published: February 2009

The deep‐sea habitat, from 200 to 2000 m depth, has long been thought as an ecosystem where biotic and abiotic factors vary very little and consequently species are not disturbed by processes and phenomena which could promote fast evolutionary mechanisms. Unfortunately, biological information relating to deep water is limited, especially regarding the population genetics of species inhabiting the Mediterranean Sea, and general patterns cannot be inferred. In this study we report data on the population genetic structure of Aristeus antennatus, a deep‐sea decapod crustacean species which has been widely studied due to its important economic value. We surveyed and examined the variation in a 369‐bp fragment of the mtDNA control region from individuals caught by Spanish and Italian trawlers in eight localities. High levels of mitochondrial control region haplotypic diversity (ranging from 0.884 to 0.989) were observed. AMOVA showed a high level of genetic variation, more within than between populations, and a low but significant ΦST value was recovered. Minimum spanning network did not separate any haplotype group and haplotype distribution does not mirror the geographic origin of the samples. The absence of population substructuring was also observed with a principal coordinates analysis, which uses an individual‐by‐individual comparison. These results revealed extensive gene flow among populations. Information on demographic history based on mismatch analysis revealed an unstable population, showing an alternate pattern of growth and decline. Our results indicated that in the western and central Mediterranean basins A. antennatus is a large panmictic population with a fluctuating abundance. The absence of deep‐sea barriers and adult migration may prevent the structuring of the species into genetically differentiated populations.
Comparison of the clinical practice satisfaction of nursing students in Korea and the USA
Authors: Lee Chung Yul , White Barbara , Hong Yoon Mi
Published: February 2009

The objective of this research was to compare the clinical practice satisfaction of nursing students in South Korea and the United States. A self‐report questionnaire on ‘Satisfaction of clinical nursing practice of undergraduate students’ was used to survey 131 nursing students of the Yonsei University in South Korea and 109 nursing students of the Colorado Christian University in the USA. Findings indicate that American nursing students had significantly higher clinical practice satisfaction levels than the Korean students. Two factors were identified to explain the differences. One is the different motivation for choosing a nursing major and the second is the different clinical practice environment. Although different countries utilize clinical practice differently, it is beneficial to understand the factors that influence students’ satisfaction levels by comparing countries’ nursing education system.
Streptococcus bovis endocarditis, a silent sign for colonic tumour
Authors: Gupta A. , Madani R. , Mukhtar H.
Published: February 2009

Aim  An association between colonic carcinoma and Streptococcus bovis endocarditis/bacteraemia was first suggested in 1951. This knowledge has great clinical implications, yet we found scant awareness amongst general surgical trainees. The aim of this article was to review the evidence available in the literature and explore the pathophysiology behind this association.

Method  The literature was reviewed, between 1950 and 2008, using Pubmed, Embase and Ovid database searches. We utilized different combinations of the keywords: Streptococcus bovis, endocarditis, septicaemia and colon cancer/carcinoma. Quality assessment was determined using the Oxford Centre for Evidence‐based Medicine Levels of Evidence (May 2001). Studies were selected based on their relevance to the aims to be addressed.

Results  We included nine case reports and found 24 studies demonstrating an association between S. bovis bacteraemia/endocarditis and colon cancer; the reported incidence in studies was variable (6–67%). The majority of studies (20) were retrospective analysis of data; only four studies were prospective. A total of 12 of 24 studies also reported an association with extra‐colonic malignancy (1–22%) and 12 with liver disease (3–57%). Eight studies relevant to the pathophysiology of this association were identified.

Conclusion  Streptococcus bovis endocarditis and/or bacteraemia is an early clue to the likely presence of colorectal cancer. Whilst further studies are required to determine the precise pathophysiology, clinicians should be aware of this association. It is advisable to investigate rigorously for colon cancer in all patients presenting with S. bovis endocarditis/bacteraemia; such patients may also present with liver disease or, occasionally, extra‐colonic malignancy.
The evolution of the protonephridial terminal organ across Rotifera with particular emphasis on Dicranophorus forcipatus, Encentrum mucronatum and Erignatha clastopis (Rotifera: Dicranophoridae)
Authors: Riemann Ole , Ahlrichs Wilko H.
Published: February 2009

Riemann, O. and Ahlrichs, W.H. 2009. The evolution of the protonephridial terminal organ across Rotifera with particular emphasis on Dicranophorus forcipatus, Encentrum mucronatum and Erignatha clastopis (Rotifera: Dicranophoridae). —Acta Zoologica (Stockholm) 91: 199–211

We report on the ultrastructure of the protonephridial terminal organ in three species of dicranophorid rotifers (Dicranophorus forcipatus, Encentrum mucronatum and Erignatha clastopis). Differences between the three species relate to shape and size, the morphology of the filter region and the number of microvilli and cilia inside the terminal organ. A comparison across Rotifera indicates that the terminal organs in D. forcipatus display a number of plesiomorphic characters, but are modified in E. mucronatum and Er. clastopis. This is in accordance with the results of phylogenetic analyses suggesting a basal position of D. forcipatus compared with the more derived species E. mucronatum and Er. clastopis. Moreover, we survey available data on the terminal organ in Rotifera and discuss its evolutionary transformations. The protonephridial terminal organ in the common ancestor of Rotifera consisted of a cytoplasmic cylinder with cilia united into a vibratile flame and a single circle of circumciliary microvilli. Depending on the topology on which characters are optimized, the site of ultrafiltration was formed by longitudinal cytoplasmic columns spanned by a fine filter diaphragm or by pores in the wall of the terminal organ. In several taxa of Rotifera, the terminal organ – probably independently – lost its circumciliary microvilli.
Ultrastructure and functional features of midgut of an adult water mite Teutonia cometes (Koch, 1837) (Hydrachnidia: Teutoniidae)
Authors: Shatrov Andrew B.
Published: February 2009

Shatrov, A. B. 2010. Ultrastructure and functional features of midgut of an adult water mite Teutonia cometes (Koch 1837) (Hydrachnidia: Teutoniidae). —Acta Zoologica (Stockholm) 91: 222–232

The midgut of the adult water mite Teutonia cometes (Koch 1837) (Hydrachnidia: Teutoniidae) was investigated by means of transmission electron microscopy and on semi‐thin sections. The midgut is represented by a blind sac composed of the narrow ventriculus, two proventricular lateral diverticula and three pairs of postventricular caeca. A single‐layered epithelium consists of one type of endodermal digestive cells of quite different shape and size, which may form protrusions into the midgut lumen. The large nuclei are frequently lobed and contain one to three nucleoli. The apical cell membrane forms short scarce microvilli, between their bases the pinocytotic vesicles of unspecific macropinocytosis as well as the narrow pinocytotic canals are formed and immersed into the cell. The intracellular digestion of the food ingested into the midgut after extraintestinal digestion is predominant. The pinocytotic vesicles fuse with small clear vesicles of proposed Golgi origin to form secondary lysosomes. The digestive cells also contain small amounts of rough endoplasmic reticulum, variously structured heterolysosomes, residual materials in the form of both the small electron‐dense bodies and the large variously granulated substances, reserve nutritive materials such as lipid and glycogen, as well as clear vacuoles. Residual materials are obviously extruded from the cells into the gut lumen.
Environmental Change, Human Resources and Organizational Turnaround
Authors: Boyne George A. , Meier Kenneth J.
Published: February 2009

abstract

Research on turnaround has largely focused on the impact of retrenchment and repositioning, and has paid less attention to the impact of changes in the task environment and human resources on recovery from decline. Moreover, all of the empirical research on turnaround has been conducted on private organizations. We develop a new model that is derived from theories of environmental and human resource effects on organizational performance. We apply this model to failing school districts in Texas, and find that turnaround is influenced by changes in the munificence and complexity of task environments, and the appointment of a new chief executive and front‐line staff.