Evaluation of the efficacy of immunocastration vaccine composed of gonadotrophin-releasing hormone conjugated with Salmonella typhimurium flagellin in rats

Immunocastration is an alternative method to replace surgical castration that is commonly performed in domestic and pet animals. In this study, a new immunocastration vaccine was developed, and its efficacy was evaluated in male rats. Six tandem copies of gonadotrophin-releasing hormone (GnRH) peptide were genetically fused to Salmonella typhimurium flagellin fljB (STF2) that is a ligand of toll-like receptor 5 (TLR5). The recombinant STF2-GnRH protein expressed in Escherichia coli was used as the immunocastration vaccine. Sixteen male rats were equally assigned to four groups. Excluding the control rats, three groups were immunized with 100, 200 and 400 μg of the STF2-GnRH vaccine, respectively. All of the immunized rats developed significantly higher titres of antibodies to GnRH than the control rats. The size and weight of both testes and epididymides from the immunized rats were significantly smaller than those of the control rats. Testicular tissues in the immunized rats demonstrated atrophy of seminiferous tubules and decreased numbers of both spermatogonia and spermatocytes. These data indicate that the newly developed STF2-GnRH vaccine has a potent immunogenicity to GnRH and efficiently suppresses the development of testes in rats.

A cranio-orbital-zygomatic approach to dumbbell-shaped trigeminal neurinomas using the petrous window

We applied a cranio-orbital-zygomatic approach that extends the temporal craniotomy more posteriorly and minimizes the frontal orbitotomy of an ordinary orbitozygomatic approach in order to provide wide access to the already eroded petrous apices along the long axis of trigeminal neurinomas. We treated seven dumbbell-shaped trigeminal neurinomas between 1991 and 1998 (mean follow-up, 38 months; range, 9 to 109 months). The configuration of the tumor mass was assessed on magnetic resonance imaging by measuring its long diameter in the middle and posterior fossae and the width of petrous erosion. Tumors were then classified into five types based on their distribution over the petrous ridge. Total removal was achieved in six patients, who showed no evidence of tumor recurrence during the follow-up period. The only major complication was one case of anesthesia dolorosa. The one patient with a subtotal removal developed a recurrence 12 months after surgery, in the posterior fossa. The cranioorbital-zygomatic approach could be an effective method for removing dumbbell-shaped trigeminal neurinomas, particularly in cases of wide petrous erosion from the tumor. If, however, the tumor has a larger posterior fossa component, this approach may not provide adequate exposure to achieve a total resection.

Benefit of downsizing hepatocellular carcinoma in a liver transplant population

BACKGROUND

Long-term results after downstaging hepatocellular carcinoma (HCC) prior to liver transplantation (LT) remain unknown.

AIMS

To investigate dropouts and post-transplant outcome among patients with downstaged HCC by transarterial chemo-lipiodolization (TACL).

METHODS

Between 2000 and 2007, 386 patients with HCC initially exceeding Milan criteria underwent TACL for tumour downstaging and were consecutively enrolled.

RESULTS

Overall, 160 (41.5%) patients achieved successful downstaging of HCC to within Milan criteria. During the follow-up, 82 eventually dropped off the waiting list for LT, with estimated dropout rates at 1, 2 and 5 years of 46.7%, 70.2%, and 87.2%, respectively. The overall post-transplant survival rates at 1, 2 and 5 years were 89.2%, 70.3% and 54.6% and the corresponding rates for recurrence-free survival were 74.7%, 71.8% and 66.3% respectively. Multivariate analysis indentified alpha-fetoprotein (AFP) levels > or = 100 ng/mL at LT (P = 0.003), maximum tumour size > or = 7 cm (P = 0.002) and the lack of complete necrosis by TACL (P = 0.048) as independent predictors of HCC recurrence after LT. Patients with none of these risk factors had an excellent post-transplant outcome, with an 87.5% probability of recurrence-free survival up to 6 years.

CONCLUSIONS

These long-term results may contribute to the database for optimizing management of LT candidates with downstaged HCC. Based on our data, patients with a maximum tumour size <7 cm who achieve complete necrosis together with AFP levels <100 ng/mL at LT may be the best candidates for LT following downstaging using TACL.

Fate of nitrogen species in nitrate reduction by nanoscale zero valent iron and characterization of the reaction kinetics

This study investigates the fate of nitrogen species during nitrate reduction by nanoscale zero valent iron (NZVI) as well as the related kinetics. The NZVI used for the experiments was prepared by chemical reduction without a stabilizing agent. The pseudo first order kinetic constant of nitrate reduction at 30 degrees C with an NZVI/nitrate ratio of 1.25:1, which were the reference conditions of this study, was 4.08 h(-1) (R(2)=0.955). A nitrogen mass balance was established by quantitative analysis of aqueous-phase and gas-phase nitrogen species. The results confirm that the nitrate was converted to ammonium ion, that ammonia stripping subsequently occurred under a strong alkaline condition, and that the total amount of aqueous nitrogen was consequently reduced. The nitrate reduction rate also increased with a lower pH and a higher temperature when microscale ZVI was used. However, in contrast to the reaction by microscale ZVI, the nitrate reduction rate by NZVI was higher for an unbuffered condition, possibly due to the abundance of surface atoms and the smaller size.

Efficacy of transarterial embolization as definitive treatment in lower gastrointestinal bleeding

Transarterial catheter embolization (TAE) is integral in the management of lower gastrointestinal bleeding (BLGIT). The efficacy of superselective embolization has reduced the need for emergent surgical resection as a treatment modality.

OBJECTIVE

To determine the outcomes of TAE in the management of BLGIT in terms of efficacy rates, recurrent bleeding rates and long term results without the need for surgical intervention.

METHOD

Patients who underwent TAE for BLGIT between September 2000 and May 2006 were analysed. Data were extracted from the records for analysis.

RESULTS

Sixty-eight patients with a mean age of 76 years and equal gender distribution were analysed. Sixty-nine per cent presented with haematochezia, 40% with malena. Sixty-three patients had a prior RBC scan performed, all of which were positive. Colonoscopy was attempted in 18 patients of which four managed to localize the bleeding site. Embolization was performed in these patients using mainly polyvinyl alcohol particles and/or microcoils. The morbidity rate was 21%, comprising mainly fever and nonspecific abdominal pain with only four ischaemic complications and one report of colonic infarction. Early recurrent bleeding occurred in six patients. Three were treated with repeat embolization and two required surgery. There were no mortalities. After a mean follow-up of 12 months, 12 (17.6%) patients developed further episodes of BLGIT, necessitating further intervention.

CONCLUSION

Transarterial catheter embolization is effective and safe in the acute management of BLGIT and reduces the need for further definitive surgery in a majority of patients.

Surgical techniques according to anatomic variations in living donor liver transplantation using the right lobe

OBJECTIVES

In living donor liver transplantation, the right lobe has many anatomic variations in the vascular tree, which could lead to surgical complications. We need to define surgical technique according to anatomy.

METHODS

From January 2000 to September 2007, 310 living donor liver transplantations using the right lobe were performed in patients with end-stage liver disease. The vascular trees were evaluated preoperatively with computed tomography and magnetic resonance angiography. We classified anatomic points for safe harvest in the hepatic artery, portal vein, and hepatic vein and described technical points based on anatomic variations.

RESULT

There were many anatomic variations in the hepatic vasculature. Hepatic artery variations were observed in 16.8% of cases. Double hepatic artery was observed in 14 cases (4.5%). Of these 14 cases, reconstruction as a single artery was performed in 6 and dual reconstruction was performed in 8 cases. Portal vein variation was observed in 45 cases (14.5%): Dual anastomosis to right and left portal vein was performed in type III (n = 20; 6.4%) and type IV (n = 3; 1.0%) variations. There were 70 cases of portal vein thrombosis. In 8 of the 70, a jump or interposition graft with iliac vein was utilized. Of the middle hepatic vein variant, segment V vein only was reconstructed in 188 (60.6%) cases. In 21 (6.8%) cases, segment VIII vein only was reconstructed, and in 43 (13.9%) cases, both segment V and segment VIII veins were reconstructed using the recipient's portal vein, a cryopreserved iliac vein, or a prosthetic graft. The most common variation of right inferior hepatic vein was type II (n = 141; 45.5%), which has 1 right inferior hepatic vein.

CONCLUSION

Living donor liver transplantation using the right lobe can be performed safely, but there is a potential operative risk because of various anatomic variations. To minimize operative complications, anatomic variations should be kept in mind to ensure a safe and successful operation.

Reconstruction of three right hepatic veins using cadaveric iliac vein in right lobe living donor liver transplantation: case report

In various right hepatic vein anatomies, reconstruction is a surgically challenging technique in right lobe living donor liver transplantation. The right inferior hepatic vein is the most common hepatic vein abnormality in right lobe living-donor liver transplantation. Three accessory right hepatic veins is a rare right hepatic vein variation. We experienced one case of three right hepatic vein reconstruction among 300 partial liver transplantations using the right lobe in our center over 10 years. The donor right lobe had one main right hepatic vein and three accessory hepatic veins at the lower border of the liver. Restoration of accessory hepatic veins to the inferior vena cava was performed after construction of one conduit from the three accessory hepatic veins using a cadaveric donor iliac vein.

First Report of Bacterial Canker of Tomato Caused by Clavibacter michiganensis subsp. michiganensis in Korea

In 2007, a new bacterial disease was observed in greenhouse-cultivated cherry tomatoes in Cheorwon and Iksan provinces, Korea. The disease caused severe wilt of tomatoes (Solanum lycopersicum cv. Koko). Infected young petioles were curled downward. Margins of the leaves rolled upward and whole leaves were distorted. Stem cankers had reddish or dark brown cavities. Vascular tissues in stems cut longitudinally were brown to deep brown, but no bird's eye lesions were observed. Eight bacterial strains recovered from the stems of wilted tomatoes produced yellow colonies on nutrient broth-yeast extract agar and pink colonies on triphenyl tetrazolium chloride. Pathogenicity of the strains (three plants per strain) on 18-day-old tomatoes (cv. Koko) was confirmed by clip inoculation of petioles of second leaves and spray inoculation with bacterial suspensions (1 × 10⁸ CFU/ml) in sterile distilled water. Wilt and canker symptoms were observed 2 weeks after inoculation. Symptoms produced by both inoculation methods were systemic and localized. Clip inoculation of tomatoes resulted in wilt, defoliation, and open stem cankers, whereas small, white spots (2 to 3 mm in diameter) and sometimes water-soaked, dark brown-to-black lesions on the leaf margins were observed with spray inoculation. Bacteria were reisolated from stems and leaves of the inoculated plants and their identities confirmed by direct PCR using specific primer set CMM5/CMM6 (1). No symptoms were observed on negative control plants inoculated with sterile water. All strains were gram-positive aerobic rods with no polar flagella. Strains were positive for esculin hydrolysis, gelatin liquefaction, H₂S production from peptone, utilization of citrate and succinate, and acid from d(+)mannose and negative for starch hydrolysis, casein hydrolysis, methyl red reaction, acid from inulin, mannitol, d(+)-melezitose and d(-)sobitol, and utilization of acetate, formate, lactate, propionate, and ribose. Identification as C. michiganensis subsp. michiganensis was confirmed using 16S rDNA universal primers fD1 and rP2 (4) and internal primers (3). The 1,439-bp PCR fragment of strain BC2643 was sequenced (GenBank Accession No. EU685335) and compared with reference C. michiganensis subspecies strains in GenBank: AM410696 (C. michiganensis subsp. michiganensis), AM410693 (C. michiganensis subsp. tessellarius), AM410697 (C. michiganensis subsp. nebraskensis), AM410694 (C. michiganensis subsp. sepedonicus), and AM410695 (C. michiganensis subsp. insidiosus). The sequence had a similarity index of 0.999 calculated by Juke-Cantor model (2) with the 16S rRNA sequence of C. michiganensis subsp. michiganensis (AM410696). The fragment size of eight strains amplified by PCR using CMM5/CMM6 (1) was identical to that of the C. michiganensis subsp. michiganensis reference strain KACC20122. On the basis of the physiological, genetic, and pathological characteristics, all strains were identified as C. michiganensis subsp. michiganenesis. To our knowledge, this is the first report of C. michiganensis subsp. michiganenesis causing bacterial canker on tomato in Korea. References: (1) J. A. Dreier et al. Phytopathology 85:464, 1995. (2) S. Kumar et al. Brief. Bioinform. 5:50, 2004. (3) S. W. Kwon et al. Int. J. Syst. Bacteriol. 47:1061, 1997. (4) W. G. Weinsburg et al. J. Bacteriol. 173, 697, 1991.

Infectious complications in living-donor liver transplant recipients: a 9-year single-center experience

BACKGROUND

Infectious complications following living-donor liver transplantation (LDLT) remain a major cause of morbidity and mortality. We analyzed the frequency and type of infectious complications according to the post-transplantation period, and their risk factors with regard to morbidity and mortality.

METHODS

We retrospectively analyzed 208 subjects who had undergone LDLT during a 9-year period.

RESULTS

The rate of infection was 1.69 per patient during the study period. The predominant infections were intra-abdominal infections (37.6%), primary bacteremia (17.4%), and pneumonia (14.5%). Within the first post-transplant month, 140 (39.9%) infections were detected, and catheter-related coagulase-negative staphylococci (44) were the most common infectious agents. During the 2-6-month post-transplant period, 109 infectious episodes occurred (31.1%), and Enterococcus sp. (n=16) related to biliary infection was the most frequent isolate. After the sixth month, 96 infectious episodes (29%) occurred, and biliary tract-related Escherichia coli (n=19) was the major causative organism. The overall mortality was 24.5% (51/208); 1-year survival rate was 88% (196/208). Post-transplant infection-related mortality was 52.9% (27/51). Biliary tract complications, such as biliary stenosis or leakage, significantly increased the mortality (P=0.01); however, reoperation (retransplantation or resurgery for biliary tract obstruction/leakage or to control bleeding) significantly reduced the mortality (P=0.01).

CONCLUSIONS

Our data showed that early catheter removal would mainly aid in reducing infectious complications in the 1-month post-transplantation period. Aggressive management, including reoperation, would lower the mortality in the LDLT recipients.

Atypical and anaplastic meningiomas: prognostic implications of clinicopathological features

OBJECTIVES

To evaluate patient outcome and investigate the prognostic factors of high-grade meningiomas by adopting the 2000 World Health Organization (WHO) classification system.

METHODS

Between 1986 and 2004, 74 patients were diagnosed with high-grade meningioma: 33 with atypical and 41 with anaplastic meningioma. The mean follow-up was 58.5 months. We reclassified all surgical specimens, according to the 2000 WHO classification system, using two expert neuropathologists.

RESULTS

Forty of 74 meningiomas were reclassified as atypical meningioma and 24 as anaplastic meningioma. Overall and recurrence-free survivals were significantly longer in patients with atypical than in those with anaplastic meningioma: 142.5 versus 39.8 months and 138.5 versus 32.2 months, respectively (p<0.001). In patients with atypical meningiomas, brain invasion and adjuvant radiotherapy were not associated with survival; however, in the brain invasion subgroup, adjuvant radiotherapy improved patients' survival. In patients with anaplastic meningioma, the prognostic factors were brain invasion, adjuvant radiotherapy, malignant progression, p53 overexpression and extent of resection. The p53 overexpression was the only factor associated with malignant progression (p = 0.009).

CONCLUSIONS

The 2000 WHO classification has identified the truly aggressive meningiomas better than did the previous criteria. A precise meningioma grading system may help to avoid over-treatment of patients with an atypical meningioma as, once the tumour has "declared itself" by recurrence and histological features, it becomes a tumour that is poorly amenable to current therapies.

Evaluation of tumour response after gamma knife radiosurgery for residual vestibular schwannomas based on MRI morphological features

OBJECTIVE

To evaluate tumour response after gamma knife (GK) radiosurgery for residual vestibular schwannoma (VS) based on MRI morphological features.

METHODS

Sixty-one patients with histopathologically confirmed VS underwent GK radiosurgery with marginal tumour doses of 9.0-14.0 Gy (mean, 12.5). Mean tumour volume at GK radiosurgery was 3.65 ml (range, 0.52-15.50). GK radiosurgery was performed 0.3-95.7 months (median, 5.8) after microsurgery. Tumour volumes and half-reduction time were calculated using serial MRI. The morphological features of VS were documented by pre-microsurgical MRI. Histopathological investigation included Antoni-type dominance, the proliferation marker Ki-67 and tumour vascularity.

RESULTS

Median duration of radiological follow-up was 53.7 months (range, 24.1-102.2) and the 8-year actuarial tumour control rate was 93.5%. No factor was associated with tumour control, although a cystic VS had borderline significance (p = 0.089). Mean tumour half-reduction time was 8.70 years (range, 0.57-79.89) and tumour half-reduction time in cystic VS proved to be significantly shorter than those in solid VS (p = 0.006). Thrombotic vessels (p = 0.015) and abnormal vessel proliferation (p = 0.003) were significantly more prominent in cystic VS than those in solid VS.

CONCLUSIONS

GK radiosurgery appeared to be an effective treatment modality for residual tumour control after microsurgery. Owing to having relatively abundant tumour vascularity, residual solid portions of cystic VS resulted in efficient shrinkage after GK radiosurgery. Therefore, GK radiosurgery was found to be a rewarding therapeutic approach to the residual solid portions of cystic VS.

The best candidates for transarterial chemotherapy in patients with hepatocellular carcinoma awaiting liver transplantation: a cohort-based characterization of dropout times

BACKGROUND

Although transarterial chemotherapy is used to retard tumour progression for hepatocellular carcinoma (HCC) patients awaiting orthotopic liver transplantation (OLT), information regarding the acceptable waiting time and appropriate patient selection for the therapy is lacking.

AIM

To examine dropout times and determine the best candidates for pre-transplant transarterial therapy in a cohort study.

METHODS

In total, 180 consecutive HCC candidates receiving pre-transplant chemo-lipiodolization were included in the study.

RESULTS

Overall, 70 (38.9%) patients dropped off the waiting list during the median follow-up of 19 months. According to the Child-Pugh (C-P) classification, the estimated dropout rates at 1 and 2 years were 17.2% and 44.8% for the C-P A group and 33.4% and 81.3% for the C-P B/C group, respectively. C-P B/C patients experienced more frequent dropouts than C-P A patients (P < 0.001). Risk factor analysis identified C-P classification to be the strongest predictor of dropout (P < 0.001). On multivariate analysis, alpha-fetoprotein (AFP) >100 ng/mL, tumour size >3 cm and multiple nodules remained independently predictive of dropout for C-P A group (all P < 0.05). Candidates with none of these factors were found to be at the lowest risk of dropout, with only a 22.5% dropout rate up to 41 months.

CONCLUSIONS

This study suggests that Child-Pugh A patients with one nodule <3 cm and AFP < 100 ng/mL may be the best candidates for pre-transplant chemo-lipiodolization, with the lowest dropout rate. However, comparative studies with other therapeutic options are needed to assess the definitive role of transarterial therapy in this setting.

Microsatellite instability and MLH1 hypermethylation - incidence and significance in colorectal polyps in young patients

OBJECTIVE

Microsatellite instability (MSI) is observed in most hereditary nonpolyposis colorectal cancer-related colorectal cancers (CRC). The original Bethesda criteria recommends MSI testing in patients <or=40 years diagnosed with adenomas. We aimed to determine the incidence of MSI and the presence of hypermethylation of the promoter site of the MLH1 gene in these polyps.

METHOD

Patients aged <or=40 years diagnosed with colonic polyps removed endoscopically from 1998 to 2003 were identified and their charts reviewed. DNA extractions were performed and tested for MSI at the Bethesda Consensus recommended loci. Samples were characterized by immunohistochemical staining of the four mismatch repair (MMR) proteins. MLH1 hypermethylation was assessed using a real-time methylation-specific polymerase chain reaction (PCR). The appropriate statistical analyses were applied.

RESULTS

23 patients with 38 polyps were analysed. Eight patients had a positive family history colorectal polyp, 11 a family history of CRC. No significant correlation between a family history of colorectal polyps or cancer and polyp location was found. About 53% of the polyps were tubulo-adenomas and 27% tubulovillous adenomas. Immunohistochemistry (IHC) staining revealed appropriate expression of the MMR proteins in all samples. None of the polyps exhibited MSI. MLH1 'A' hypermethylation was present in 16% of the polyps. No hypermethylation was observed at region 'C'. A positive family history of colorectal polyps and cancer were associated with a higher incidence of MLH1 'A' hypermethylation. There was no determinable correlation between the clinico-pathological features of the polyp with MLH1 hypermethylation.

CONCLUSION

MLH1 HM was found in approximately 16% of polyps found in young patients and represents one of the epigenetic changes that may result in the subsequent progression to carcinoma along an accelerated sequence. The yield of MSI testing in these patients is low and is not recommended.

Adult living donor liver transplantation using the right lobe

BACKGROUND

This article reviewed our experience with right lobe donor hepatectomy in living donor liver transplantations (LDLT), particularly in the context of preserving donor safety.

MATERIALS AND METHODS

From January 2000 to August 2005, we performed 206 adult LDLT operations using the right lobe. The donor characteristics, operative findings, postoperative results including the peak values of liver enzymes (aspartate transferase [AST], alanine transferase [ALT], and bilirubin) and regeneration volumes, as evaluated by computed tomography volumetry, were reviewed at 1 week, as well as 3 and 6 months after surgery. The effects of three risk factors on donor safety were analyzed: age (<55 years, > or =55 years): fatty change in the donor liver (<10%, > or =10%); and remnant volume (<35%, > or =35%).

RESULTS

The liver enzymes and regeneration volumes showed no significant difference according to age, only ALT was significant increased associated with the severity of fatty change (P < .05). There were significant differences in postoperative AST, ALT, and regeneration volume between the group with <35% and the group with > or =35% remnant liver volume (P < .05). Upon further analysis with combinations of two out of three risk factors, the group according to remnant volume and fatty change was meaningful. Follow-up data on donor ALT showed a return normal levels and after postoperative 3 months there was regeneration of the remnant liver to more than 70% of the whole liver preoperatively. There was no donor mortality, but postoperative complications were observed in 39 patients (39/206, 18.9%). Biliary complications were encountered in 24 patients: one bile duct injury, 22 bile leakages, and one bile duct stricture. Other complications consisted of pleural effusion (n = 8), delayed gastric emptying (n = 6), atelectasis (n = 1), and hepatic encephalopathy (n = 1).

CONCLUSION

In cases of careful donor selection, a right lobectomy can be performed safely with minimal risks when the remnant liver volume exceeds 35% of the total liver volume and shows less than 10% fatty changes.

Effect of middle hepatic vein reconstruction in living donor liver transplantation using right lobe

BACKGROUND

This study reviewed the impact of middle hepatic vein (MHV) reconstruction on right lobe graft with regard to functional recovery and graft regeneration at 1 week after transplantation.

MATERIALS AND METHODS

From January 1999 to September 2005. 211 adult living donor liver transplantations were performed using the right lobe. The reconstruction of hepatic venous tributaries from segment 5 or segment 8 or both was performed in every cases of sufficient size. The patency of graft vessels was evaluated with computed tomography (CT) angiography on postoperative day 7. We analyzed liver enzymes (aspartate transferase [AST], alanine transferase [ALT] and bilirubin) at 1 week postoperatively and evaluated regeneration activity by CT volumetry at 1 week postoperatively.

RESULTS

Among 211 cases, 182 (86.3%) were reconstructed with interpositional MHV grafts. Among them, 51 cases (51.9%) were patent at 1 week postoperatively. The levels of AST and ALT in patent cases of all patients and small-for-size grafts were lower than among the occlusion cases, albeit not significantly. The mean graft regeneration at 1 week postoperatively among patent cases was 1.75 +/- 0.39 versus 1.64 +/- 0.24 in the occluded cases (P = .111), but among small-for-size grafts, there was a significant difference in graft regeneration between patent versus occluded cases (2.05 +/- 0.50 vs 1.66 +/- 0.17, P = .037).

CONCLUSION

Functional recovery and graft regeneration in small-for-size grafts showed a beneficial effect in patent cases, compared with occluded cases. Our selection criteria for MHV reconstruction must include cases of small-for-size grafts not all cases.

Detection of Donor-Specific Anti-HLA Class I and II Antibodies Using Antibody Monitoring System

The antibody monitoring system (AMS, GTI Inc) is a solid enzyme-linked immunosorbent assay (ELISA) crossmatch test for the detection of immunoglobulin G (IgG) antibody to donor-specific solubilized HLA class I and class II antigens. The objective of this study was to compare the results of the AMS assay with donor-specific anti-HLA IgG antibodies (DS-HLA Abs), as determined by ELISA panel reactive antibody (PRA) and the flow cytometric crossmatch test (FCXM). A total of 107 sera were screened for the presence of HLA Abs by ELISA PRA (LAT-M, One-Lambda Inc), the DS-HLA Abs were determined in 34 serum samples (31.8%) by an ELISA panel (LAT class I and class II, One-Lambda Inc) and FCXM. The FCXM and AMS assays were performed with matched lymphocytes from 56 donors. There was a significant degree of concordance (89.7%) between the two tests (P < .001). The sensitivity, specificity, positive predictive value, and negative predictive value of AMS assay to detect DS-HLA Abs was 88.2%, 94.5%, 88.2%, and 94.5%, respectively. The AMS is a simple, objective test, which has several advantages over the cell-based crossmatch test, such as elimination of non-HLA antibody reactivity, elimination of non-donor-specific antibody reactivity, no need for viable cells, and preparation of the donor's HLA antigens in advance. In summary, this study suggested that AMS may be useful as a supportive crossmatch test or as a monitoring test after transplantation to detect class I or class II DS-HLA Abs.

Development of computational models for the purpose of conducting individual livestock and premises traceback investigations utilizing National Animal Identification System-compliant data

Many of the efforts surrounding the development of the National Animal Identification System have encompassed the identification of livestock production and handling premises as well as individuals or herds of animals, whereas little effort has been directed toward the ultimate goal of animal traceback within 48 h. A mock data set representative of the Colorado cattle population was created for modeling of cattle traceability. Using this data set, algorithms were developed to complete rapid and accurate traceback and traceforward of animals or premises or both. On July 19, 2005, the Colorado Department of Public Health and Environment, in conjunction with the Colorado Department of Agriculture, conducted a test exercise pertaining to homeland security. The exercise team randomly identified animal number 926,583 (of the 2 million total animals) as a potentially infected animal of interest and requested a traceback of this animal. Traceback was accomplished in 215 s, and 540 primary coresident animals were identified. However, due to animal movements, the number of coresidents (animals exposed, directly or indirectly, to the animal of interest) expanded with coresidency level (level 1 = direct contact; level 2 = direct contact with an animal that had direct contact with the animal of interest; level 3 = direct contact with an animal that had contact with an animal that had direct contact with the animal of interest, etc.) to more than 1.2 million coresidents at level 4, and more than 90% of all animals identified as a coresident at some level. In addition to the coresidency results, the premises containing the coresidents were identified and sorted by the number of coresidents. Because of animal movement, all 19,391 premises included in the data set had coresidents at some level. This exercise demonstrated the capability of the developed algorithms to complete rapid traceback and the complexity of the resulting animal traceback output.

AtBAG6, a novel calmodulin-binding protein, induces programmed cell death in yeast and plants

Calmodulin (CaM) influences many cellular processes by interacting with various proteins. Here, we isolated AtBAG6, an Arabidopsis CaM-binding protein that contains a central BCL-2-associated athanogene (BAG) domain. In yeast and plants, overexpression of AtBAG6 induced cell death phenotypes consistent with programmed cell death (PCD). Recombinant AtBAG6 had higher affinity for CaM in the absence of free Ca2 + than in its presence. An IQ motif (IQXXXRGXXXR, where X denotes any amino-acid) was required for Ca2 +-independent CaM complex formation and single amino-acid changes within this motif abrogated both AtBAG6-activated CaM-binding and cell death in yeast and plants. A 134-amino-acid stretch, encompassing both the IQ motif and BAG domain, was sufficient to induce cell death. Agents generating oxygen radicals, which are known to be involved in plant PCD, specifically induced the AtBAG6 transcript. Collectively, these results suggest that AtBAG6 is a stress-upregulated CaM-binding protein involved in plant PCD.

Microstrain fields for cortical bone in uniaxial tension: Optical analysis method

This study employed an optical strain measurement method, called microdisplacements by machine vision photogrammetry (DISMAP), to measure both the global and local strain fields in microtensile specimens of cortical bone subjected to controlled uniaxial tension. The variation of local maximum principal strains was measured within the gauge region of samples as a function of applied tensile stress during testing. High gradients of local strain appeared around microstructural features in stressed bone even while the global strain for the entire gauge region showed a strong linear correlation with increasing tensile stress (r2 = 0.98, p < 0.0001). The highest local strain around micro-structural features in bone was 11.5-79.5 times higher than the global strain.

Microcystic meningiomas: radiological characteristics of 16 cases

BACKGROUND

As a rare subtype of meningioma, only a few reports deal with radiological characteristics of microcystic meningiomas and the problem remains controversial. The authors have analyzed the radiological findings of a series of microcystic meningiomas with a special focus on magnetic resonance images (MRI) and conventional angiography.

METHOD

Sixteen patients of histologically proven microcystic meningiomas were included. Analysis of preoperative MRI including signal intensity characteristics, enhancement patterns and peritumoural edema were performed and correlated with angiographic and histological findings. Peritumoural edema was graded using edema index (EI) which was defined as the ratio of VE/VT.

FINDINGS

The tumours were uniformly visualized as a high-signal mass lesion in T2-weighted images and as a low-signal mass lesion in T1-weighted images regardless of tumour vascularity shown by angiography. T2-weighted images revealed that peritumoural brain edema was severe in 11, moderate in 1, mild in 2 and negligible in 2 patients and this was closely related to the co-existence of irregular tumour marginal enhancement. However, other features failed to distinguish these lesions from other subtypes of meningioma.

CONCLUSIONS

The cases presented demonstrate that characteristic MRI findings suggestive of microcystic meningiomas are; (1) low signal intensity mass in T1- and high signal intensity mass in T2-weighted images; (2) high incidence of peritumoural edema.

A new venous conduit utilizing the recipient portal vein branches for segment V in adult partial liver transplantation

Right anterior-medial lobe congestion due to temporary clamping of segment V and/or VIII is common in the operative theater during adult donor right lobe liver transplantation, the most common procedure in our institute. We have used an autogenous saphenous vein conduit to recipient portal vein tributaries in 15 cases, as a "Y-to-I venoplasty" since January 2004. The recipient portal vein is transected 5 mm proximal to its bifurcation and extended to both sides with partial hepatic dissection. The "Y-to-I venoplasty" is made by suture closure of the portal vein transversely to form a tube. The average length is 7.5 cm with a 1.3 cm width. One end of "Y-to-I venoplasty" conduit is anastomosed to the donor segment V branch on the back table. And the other end is anastomosed directly to the IVC via a new window or the middle hepatic vein stump in recipient. The phase distension of the conduit with respiration is noted in the operative field. A 6/15 (40%) patency rate, was observed by CT angiography at the second postoperative week. All-patient conduits showed good flow on serial examinations at the 60th postoperative day. This new venous graft, made of recipient portal vein is a good conduit for segment V decongestion in adult right lobe partial liver transplantation.

Neuropeptide Y immunoreactivity and corticotropin-releasing hormone mRNA level are increased in the hypothalamus of mouse bearing a human oral squamous cell carcinoma

We examined gene expression of corticotropin-releasing hormone and neuropeptide Y level in the hypothalamic paraventricular nucleus of mouse bearing a human oral squamous cell carcinoma. A cell line derived from a human oral squamous cell carcinoma was inoculated into the lower dorsal area of nude mice. Body weight, tumor size and daily food intake were recorded every morning. Mice were sacrificed for corticotropin-releasing hormone mRNA in situ hybridization and neuropeptide Y immunohistochemistry, when the tumor ratio reached to 11-13% of real body weight. The results were compared with the age-matching non-tumor controls injected with saline instead of carcinoma cell. Body weight gain was significantly reduced in tumor bearing mice, however, no compensatory hyperphagia was found, i.e. daily food intake of the tumor mice did not differ from the non-tumor mice. Both neuropeptide Y immunoreactivity and corticotropin-releasing hormone mRNA level were significantly increased in the hypothalamic paraventricular nucleus of tumor mice. These results suggest that a human oral squamous cell carcinoma may induce anorexia, at least partly, via increasing the hypothalamic expression of corticotropin-releasing hormone in the tumor subjects. Additionally, neuropeptide Y-induced feeding appears to be inhibited in this tumor anorexia model, and this may correlate with increased expression of corticotropin-releasing hormone.

Delayed bleeding after gamma knife surgery for meningioma

We report the occurrence of haemorrhage in a meningioma after gamma knife surgery.A 52-year-old woman had undergone gamma knife radiosurgery for a growing meningioma in the left tentorial hiatus three years earlier (A radiation dose of 15 Gy was administered to the margin, with a maximum dose of 30 Gy, Fig. 1a). The size of the mass decreased steadily, and central lucency was seen in the follow-up magnetic resonance images, a usual finding seen after gamma knife surgery (MRI, Fig. 1b). However, a MRI taken at the 30-month follow-up showed the tumour to be swollen, and peritumoural oedema had increased (Fig. 1c). Three years later, apoplectic symptoms occurred, and computed tomography revealed a peritumoural haemorrhage, with oedema (Fig. 1d). An emergency craniotomy was carried out, and the biopsy showed a transitional type of meningioma, with vasculopathy and necrosis. After operation she had a right hemiparesis and a visual defect.

The significance of gemistocytes in astrocytoma

BACKGROUND

A retrospective clinical analysis of astrocytomas which contained a significant proportion of gemistocytes was carried out in order to evaluate their effect on prognosis, and other factors influencing prognosis.

METHOD

From 253 consecutive cases of astrocytic tumours in adults, 25 were selected who had more than 20% gemistocytes in every high-power field examined. 9 of these had anaplasia, the remainder did not. They were divided into two groups according to the proportion of gemistocytes; group A, contained more than 60% gemistocytes, and group B, had between 20 and 60% gemistocytes. TUNEL and immunohistochemical staining for PCNA, p53, Ki-67, bcl-2 were performed in the 20 available cases.

FINDINGS

The median follow-up period was 46 months. There were 14 recurrences, with a median time to recurrence of 15 months. Thirteen repeat operations were performed in nine cases, and two cases showed recurring malignant transformation. The overall median survival time following diagnosis was 73 months and the 5-year survival rate was 52%. There were no significant differences in median survival between groups A and B with different proportions of gemistocytes. On the other hand the median survival of the gemistocytic astrocytomas with anaplasia was 25 months, compared with 158 months for those without anaplasia (p=0.0005). The significant impact of anaplasia on survival persisted in both groups. There were no significant differences in immunohistochemical staining between the two groups, with the exception of staining for Ki-67 (means of the two groups: group A 1.40; group B 2.50).

CONCLUSIONS

It is suggested that the proportion of gemistocytes does not itself affect prognosis.