bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcomes and predictive factors of pediatric kidney transplants: An analysis of the Thai Transplant Registry
Authors: Rianthavorn Pornpimol , Kerr Stephen J. , Lumpaopong Adisorn , Jiravuttipong Apichat , Pattaragarn Anirut , Tangnararatchakit Kanchana , Avihingsanon Yingyos , Thirakupt Prapaipim , Sumethkul Vasant 
Published: February 2013

AbstractAs universal coverage for pediatric kidney transplantation (KT) was introduced in Thailand in 2008, the number of recipients has been increasing. We evaluated predictive factors for graft failure to understand how to improve clinical outcomes in these children. Using data obtained from the National Transplant registry, we assessed the risk of graft failure using the Kaplan–Meier method and Cox proportional hazards regression. Altogether, 201 recipients aged <21 yr at the time of KT were studied. Living donors (LD) were significantly older than deceased donor (DD). Mean cold ischemia time of DD was 17 h. The mean donor glomerular filtration rate (GFR) was 84.0 mL/min/1.73 m2. Induction immunosuppressive therapy was administered more frequently in DD than in LDKT. Delayed graft function (DGF) occurred in 36 transplants. Over 719 person years of follow‐up, 42 graft failures occurred. Graft survival at one, three, and five yr post‐transplant were 95%, 88% and 76%, respectively. Two factors independently predicted graft failure in multivariate analysis. The hazard ratios for graft failure in patients with DGF and in patients with donor GFR of ≤30 mL/min/1.73 m2 were 2.5 and 9.7, respectively. Pediatric recipients should receive the first priority for allografts from young DD with a good GFR, and DGF should be meticulously prevented.
Alemtuzumab induction in pediatric kidney transplantation
Authors: Kaabak Michael M. , Babenko Nadezda N. , Samsonov Dmitry V. , Sandrikov Valery A. , Maschan Alexey A. , Zokoev Alan K. 
Published: February 2013

AbstractRecipient parenchymal lymphatic cells are crucial for direct and indirect pathways of allorecognition. We proposed that alemtuzumab, being infused several weeks pretransplant could eradicate peripheral lymphatic cells and promote donor‐specific tolerance. We present here a single center, retrospective review of 101 consecutive living‐donor kidney transplantations to pediatric patients aged from seven month to 18 yr, performed between September 2006 and April 2010. Immunosupression protocol included two 30 mg doses of alemtuzumab: first given 12–29 d prior to transplantation and second at the time of transplantation. Maintenance immunosupression was based on combination of low dose and wide range CNI and mycophenolate. Patients were followed for 3.8 ± 1.4 yr and protocol biopsies were taken one month, one, and three yr post transplant. The Kaplan–Meier graft and patient survival was 96% and 97% for one yr, 89% and 93% for three yr. Biopsy proven acute rejection developed in 26% patients at one yr and in 35% at two yr, no rejections occurred beyond two yr. We conclude that alemtuzumab pretreatment prior to living related donor kidney transplantation allows to reach satisfactory middle‐term results in pediatric patients with wide range and low CNI concentrations.
Kidney grafts from donors ≤5 yr of age: Single kidney transplantation for pediatric recipients or en bloc transplantation for adults?
Authors: Gallinat Anja , Sotiropoulos Georgios C. , Witzke Oliver , Treckmann Jürgen W. , Molmenti Ernesto P. , Paul Andreas , Vester Udo 
Published: February 2013

AbstractKidneys from donors ≤5 yr of age represent a controversial issue. The purpose of this study was to compare the transplant outcomes as single and single/en bloc grafts into pediatric and adult KT recipients, respectively. All recipients of kidneys from donors ≤5 yr old transplanted at our institution from 3/2003 to 12/2010 were evaluated, and corresponding data were analyzed. There were 11 pediatric and 14 adult recipients. Median donor age and body weight were 38 months and 14 kg, respectively. PNF, n = 2 and DGF, n = 1 were observed only among adult recipients. Five‐yr graft survival was 100% for children and 86% for adults. There were no significant differences in graft and patient survival, PNF, DGF, acute rejection, or postoperative complications among children/single (n = 10), adults/en bloc (n = 10), and adults/single (n = 4) KT. Major complications were documented in six adult recipients and one pediatric recipient after en bloc KT. Pediatric recipients showed significantly higher GFR during the first post‐transplant year. Kidneys from donors ≤5 yr of age have at least as good outcomes as when transplanted as single allografts into children. Although the study‐volume is small, it seems that children benefit from a pediatric‐oriented allocation policy.
Right diaphragmatic hernia after liver transplant in pediatrics: A case report and review of the literature
Authors: Lam Hwai‐Ding , Mejia Juan , Soltys Kyle A. , Sindhi Rakesh , Mazariegos George , Bond Geoffrey 
Published: February 2013

AbstractDiaphragmatic hernias (DH) are an unusual complication after pediatric liver transplantation; however, they have been reported with increased frequency in the past few years. DHs are responsible for nearly half of the small bowel obstructions requiring surgical intervention in this patient population. It has been suggested that the use of a left lobe liver graft, surgical trauma, malnourishment, elevated intra‐abdominal pressures, and mTor inhibitors may predispose to development of DH. The use of a segmental graft may increase the recognition of diaphragmatic hernia because the surgically damaged right hemi‐diaphragm often remains exposed to underlying viscera, instead of being covered by the right hepatic lobe. Treatment is surgical reduction, with up to 20% of the patients requiring resection of the herniated intestine. Herein we describe a case of DH after left segmental liver transplant in a two‐ yr‐old boy that presented one month post left lobe split liver transplant with abdominal pain, anorexia, and respiratory distress. Just like in the majority of the reported cases, an urgent laparotomy with primary repair was performed. No resection of the herniated segment of intestine was required. For pediatric patients with otherwise unexplained respiratory or gastrointestinal symptoms after a left lateral segment liver transplant, right‐sided diaphragmatic hernias should always be high in the differential diagnosis.
Risk factors for impaired quality of life and psychosocial adjustment after pediatric heart, kidney, and liver transplantation
Authors: Haavisto Anu , Korkman Marit , Sintonen Harri , Holmberg Christer , Jalanko Hannu , Lipsanen Jari , Qvist Erik 
Published: February 2013

AbstractFew studies compare HRQOL and PSA in children who have undergone different types of solid organ Tx. In this cross‐sectional study, HRQOL and PSA were assessed in 74 Tx patients (16 heart, 44 kidney, 14 liver) at a mean age of 11.5 (range 6.3–16.7), 7.2 yr post‐Tx (range 1.0–15.0). HRQOL was self‐assessed using standardized health utility questionnaires (15D–17D). The patients' PSA was evaluated using the Child Behavior Checklist for parents, Youth Self‐Report for patients aged 11–16 yr, and Teacher Report Form. Outcomes did not differ significantly between Tx groups. Preadolescents (8–11 yr) reported poorer HRQOL compared with same‐age peers (p = 0.020). In contrast, adolescents reported similar HRQOL and PSA compared to the general population. Proxy‐reports revealed more PSA problems compared with age expectations (p < 0.01), mainly in internalizing behavior (p < 0.01). Lower HRQOL was associated with shorter follow‐up time since Tx, congenital disease, and a psychiatric or neurological diagnosis. PSA problems were associated with family‐related variables, neurological diagnosis, shorter follow‐up time, and in teacher‐reports longer disease duration before Tx. Different pediatric Tx groups have similar outcome. Neurological comorbidity and shorter follow‐up time are important risk factors, but the impact of family‐related variables on PSA indicate the need of family interventions.
Low prostaglandin E2 and cyclooxygenase expression in nasal mucosa fibroblasts of aspirin‐intolerant asthmatics
Authors: Roca‐Ferrer Jordi , Pérez‐Gonzalez Maria , Garcia‐Garcia Francesc J. , Pereda Javier , Pujols Laura , Alobid Isam , Mullol Joaquim , Picado Cesar 
Published: February 2013

AbstractBackground and objectiveAnomalies in the regulation of cyclooxygenase (COX)‐1 and ‐2 have been described in nasal polyps of aspirin‐induced asthma (AIA). Whether these anomalies are specific to nasal polyps or affect all the nasal mucosa (NM) of upper airways is still unclear. The objective of this study was to compare the COX pathway in NM of AIA patients with the NM of control subjects.MethodsFibroblasts were isolated from NM of five AIA patients (AIA‐NM) and five control subjects (control‐NM). Cells were treated with 10 ng/mL interleukin (IL)‐1β for up to 72 h. Prostaglandin E2 (PGE2) production was measured by enzyme‐linked immunosorbent assay (ELISA), expression of COX‐1 protein by Western blot and COX‐2 protein by ELISA, Western blot and immunofluorescence techniques.ResultsIL‐1β increased PGE2 production and COX‐1 protein expression in control‐NM fibroblasts, but no changes were found in AIA‐NM. IL‐1β provoked a significant time‐dependent increase in COX‐2 protein expression in control‐NM fibroblasts but had a very mild effect on COX‐2 protein expression in AIA‐NM.ConclusionsOur data suggest that abnormalities in the COX pathway are not a phenomenon exclusive to nasal‐polyp mucosa as they are also present in all the NM of AIA patients. These anomalies may be involved in the pathogenesis of airway inflammation and non‐steroidal anti‐inflammatory drug intolerance in asthma patients with chronic rhinosinusitis and nasal polyposis.
Fibrin Sheath and its Relation to Subsequent Events after Tunneled Dialysis Catheter Exchange
Authors: Shanaah Almothana , Brier Michael , Dwyer Amy 
Published: February 2013

AbstractThe use of tunneled catheters (TDC) for chronic hemodialysis is frequent and often fails due to fibrin or thrombus and infection. We hypothesized that the presence of fibrin sheath in TDC increases the risk for subsequent catheter malfunction and infection. We did a retrospective review of TDC exchanges and de novo placements from January 2005 to September 2011. Demographic data, information about the catheter procedure, and radiological data were collected. Final outcome analysis included 168 procedure events. Three groups of catheter procedures were identified: catheter exchange without a fibrin sheath (CE), catheter exchange with a treated fibrin sheath (CEF), and de novo catheter placements (DCP). Fibrin sheath incidence was 47%. In the CEF group, there was no statistical difference in the incidence of subsequent infections or dysfunctions (7% and 60%, respectively), when compared with the CE group (9% and 43%, respectively), (p = 0.3). Mean time to subsequent dysfunction or infection was similar for CEF and CE (135 vs. 136 days, p‐value, 0.98). Fibrin sheaths are common and should be evaluated when performing TDC exchange. If the fibrin sheath is treated, there is no increased incidence in subsequent catheter dysfunction or infection compared with patients without a fibrin sheath.
The Ca2+‐binding protein PCaP2 located on the plasma membrane is involved in root hair development as a possible signal transducer
Authors: Kato Mariko , Aoyama Takashi , Maeshima Masayoshi 
Published: February 2013

SummaryPlasma membrane‐associated Ca2+‐binding protein–2 (PCaP2) of Arabidopsis thaliana is a novel‐type protein that binds to the Ca2+/calmodulin complex and phosphatidylinositol phosphates (PtdInsPs) as well as free Ca2+. Although the PCaP2 gene is predominantly expressed in root hair cells, it remains unknown how PCaP2 functions in root hair cells via binding to ligands. From biochemical analyses using purified PCaP2 and its variants, we found that the N–terminal basic domain with 23 amino acids (N23) is necessary and sufficient for binding to PtdInsPs and the Ca2+/calmodulin complex, and that the residual domain of PCaP2 binds to free Ca2+. In mutant analysis, a pcap2 knockdown line displayed longer root hairs than the wild‐type. To examine the function of each domain in root hair cells, we over‐expressed PCaP2 and its variants using the root hair cell‐specific EXPANSIN A7 promoter. Transgenic lines over‐expressing PCaP2, PCaP2G2A (second glycine substituted by alanine) and ∆23PCaP2 (lacking the N23 domain) exhibited abnormal branched and bulbous root hair cells, while over‐expression of the N23 domain suppressed root hair emergence and elongation. The N23 domain was necessary and sufficient for the plasma membrane localization of GFP‐tagged PCaP2. These results suggest that the N23 domain of PCaP2 negatively regulates root hair tip growth via processing Ca2+ and PtdInsP signals on the plasma membrane, while the residual domain is involved in the polarization of cell expansion.
Seroprevalence and incidence of hepatitis E virus infection in German blood donors
Authors: Juhl David , Baylis Sally A. , Blümel Johannes , Görg Siegfried , Hennig Holger 
Published: February 2013

BackgroundHepatitis E virus (HEV) is transmissible by transfusion. More data are needed about seroprevalence, incidence, and viremia in blood donors for the assessment of risk of transfusion‐transmitted (TT)‐HEV infections.Study Design and MethodsSamples from 1019 whole blood donors were tested for anti‐HEV immunoglobulin (Ig)G by enzyme‐linked immunosorbent assay and Western blot. The incidence of HEV and presence of HEV RNA in donors who seroconverted were determined by testing archive samples and recipients of viremic donations were traced. Anti‐HEV IgM and alanine transaminase (ALT) testing were also performed to assess the value of such measures in the prevention of TT‐HEV infections.ResultsA total of 69 of 1019 donors tested positive for anti‐HEV IgG (6.8% seroprevalence), and seroconversion for anti‐HEV IgG occurred in seven of 69 donors within 2 years (incidence, 0.35%/year). Three of seven (42.8%) seroconverting donors provided an archive sample in which HEV RNA was detectable. One recipient of these donations was traceable; anti‐HEV IgG, IgM, and HEV RNA testing were negative 41 days after transfusion. Neither ALT levels nor anti‐HEV IgM detection correlated with the presence of HEV RNA.ConclusionsThe seroprevalence of HEV was 6.8%, and the annual incidence 0.35%. HEV RNA was detectable in several seroconverting donors, without evidence for HEV transmission in the only traceable recipient. Since neither ALT nor anti‐HEV IgM testing correlate with the presence of HEV RNA, HEV nucleic acid testing currently provides the only method for the prevention of TT‐HEV infection. However, before implementation, more data about clinical relevance of TT‐HEV infections and infectious dose of HEV are required.
Anti‐CD2 producing pig xenografts effect localized depletion of human T cells in a huSCID model
Authors: Brady Jamie L. , Sutherland Robyn M. , Hancock Manuela , Kitsoulis Susie , Lahoud Mireille H. , Phillips Peta M. , Hawthorne Wayne J. , d'Apice Anthony J. F. , Cowan Peter J. , Harrison Leonard C. , O'Connell Philip J. , Lew Andrew M. 
Published: February 2013

AbstractBackgroundWe investigated whether graft produced anti‐human CD2, mediated by adenovirus (Adv) transduction of pig neonatal islet cell clusters (pNICC), would protect xenografts in a humanized mouse model from immune attack and whether such immunosuppression would remain local.MethodsA mouse anti‐human CD2 Ab (CD2hb11) previously generated by us was genetically engineered to produce chimeric and humanized versions. The three forms of CD2hb11 were named dilimomab (mouse), diliximab (chimeric) and dilizumab (humanized). All 3 forms of CD2hb11 Ab were tested for their ability to bind CD3+ human T cells and to inhibit a human anti‐pig xenogeneic mixed lymphocyte reaction (MLR). They were administered systemically in a humanized mouse model in order to test their ability to deplete human CD3+ T cells and whether they induced a cytokine storm. An adenoviral vector expressing diliximab was generated for transduction of pNICC. Humanized mice were transplanted with either control‐transduced pNICC or diliximab‐transduced pNICC and human T cells within grafts and spleens were enumerated by flow cytometry.ResultsDilimomab and diliximab inhibited a human anti‐pig xenogeneic response but dilizumab did not. All 3 forms of CD2hb11 Ab bound human T cells in vitro though dilimomab and diliximab exhibited 300‐fold higher avidity than dilizumab. All 3 anti‐CD2 Abs could deplete human CD3+ T cells in vivo in a humanized mouse model without inducing upregulation of activation markers or significant release of cytokines. Humanized mice transplanted with diliximab‐transduced pNICC afforded depletion of CD3+ T cells at the graft site leaving the peripheral immune system intact.ConclusionsLocal production of a single Ab against T cells can reduce graft infiltration at the xenograft site and may reduce the need for conventional, systemic immunosuppression.
Model‐based prediction of portal dose images during patient treatment
Authors: Chytyk‐Praznik K. , VanUytven E. , vanBeek T. A. , Greer P. B. , McCurdy B. M. C. 
Published: February 2013

Purpose:Dosimetric verification of radiation therapy is crucial when delivering complex treatments like intensity modulated radiation therapy (IMRT) or volumetric modulated arc therapy (VMAT. Pretreatment verification, characterized by methods applied without the patient present and before the treatment start date, is typically carried out at most centers.In vivo dosimetric verification, characterized by methods applied with the patient present, is not commonly carried out in the clinic. This work presents a novel, model‐based EPID dosimetry method that could be used for routine clinical in vivo patient treatment verification.Methods:The authors integrated a detailed fluence model with a patient scatter prediction model that uses a superposition of scatter energy fluence kernels, generated via Monte Carlo techniques, to determine patient scatter fluence delivered to the EPID. The total dose to the EPID was calculated using the sum of convolutions of the calculated energy fluence distribution entering the EPID with monoenergetic dose kernels, specific to the a‐Si EPID. Measured images with simple, square fields delivered to slab phantoms were validated against predicted images. Measured and predicted images acquired during the delivery of IMRT fields to slabs and an anthropomorphic phantom were compared using theχ‐comparison for 3% dose difference and 3 mm distance‐to‐agreement criteria.Results:Predicted and measured images of the square fields with slabs in the field agreed within 2.5%. Predicted portal dose images of clinical IMRT fields delivered to slabs and an anthropomorphic phantom agreed with measured images within 3% and 3 mm for an average of at least 97% of the infield pixels (defined as >10% maximum field dose) for each case, over all fields.Conclusions:This work presents the first validation of the integration of a comprehensive fluence model with a patient and EPID radiation transport model that accounts for patient transmission, including complex factors such as patient scatter and the energy response of the a‐Si detector. The portal dose image prediction model satisfies the 3% and 3 mm criteria for IMRT fields delivered to slab phantoms and could be used for patient treatment verification.
Characterization of the count rate performance of modern gamma cameras
Authors: Silosky M. , Johnson V. , Beasley C. , Cheenu Kappadath S. 
Published: February 2013

Purpose:Evaluation of count rate performance (CRP) is an integral component of gamma camera quality assurance and system deadtime (τ) may be utilized for image correction in quantitative studies. This work characterizes the CRP of three modern gamma cameras and estimates τ using two established methods (decay and dual source) under a variety of experimental conditions.Methods:For the decay method, uncollimated detectors were exposed to a Tc‐99m source of relatively high activity and count rates were sampled regularly over 48 h. Input count rate at each time point was based on the lowest observed count rate data point. The input count rate was plotted against the observed count rate and fit via least‐squares to the paralyzable detector model (PDM) to estimateτ (rates method). A novel expression for observed counts as a function of measurement time interval was derived, taking into account the PDM and the presence of background but making no assumption regarding input count rate. The observed counts were fit via least‐squares to this novel expression to estimate τ (counts method). Correlation and Bland‐Altman analyses were performed to assess agreement in estimates of τ between the rates and counts methods. The dependence of τ on energy window definition and incident energy spectrum were characterized. The dual source method was also used to estimate τ and its agreement with estimates from the decay method under identical conditions was also investigated. The dependences of τ on the total activity and the ratio of source activities were characterized.Results:The observed CRP curves for each gamma camera agreed with the PDM at low count rates but deviated substantially from it at high count rates. The estimates ofτ determined from the paralyzable portion of the CPR curve using the rates method and the counts method were found to be highly correlated (r = 0.999) but with a small (∼6%) difference. No statistically significant difference was observed between the estimates of τ using the decay or dual source methods under identical experimental conditions (p = 0.13). Estimates of τ increased as a power‐law function with decreasing ratio of counts in the photopeak to the total counts. Also, estimates of τ increased linearly as spectral effective energy decreased. No significant difference was observed between the dependences of τ on energy window definition or incident spectrum between the decay and dual source methods. Estimates of τ using the dual source method varied as a quadratic on the ratio of the single source to combined source activities and linearly with total activity.Conclusions:The CRP curves for three modern gamma camera models have been characterized, demonstrating unexpected behavior that necessitates the determination of bothτ and maximum count rate to fully characterize the CRP curve. τ was estimated under a variety of experimental conditions, based on which guidelines for the performance of CRP testing in a clinical setting have been proposed.