Recovery of Allograft Function After Complete Withdrawal of Immunosuppression

We describe an interesting case of a patient who recovered function of a previously failed kidney allograft after immunosuppressive medications were discontinued for 4 months, requiring maintenance hemodialysis. He had a split-thickness skin graft to his abdomen because of previous surgical complications. His postoperative course was complicated by sepsis and refractory hypotension. The patient was diagnosed with adrenal insufficiency and was started on hydrocortisone. At the same time, hemodialysis was stopped for possible catheter-related infection. The patient recovered function of the previously failed allograft and has not required hemodialysis.

Atmospheric brown clouds: impacts on South Asian climate and hydrological cycle

South Asian emissions of fossil fuel SO(2) and black carbon increased approximately 6-fold since 1930, resulting in large atmospheric concentrations of black carbon and other aerosols. This period also witnessed strong negative trends of surface solar radiation, surface evaporation, and summer monsoon rainfall. These changes over India were accompanied by an increase in atmospheric stability and a decrease in sea surface temperature gradients in the Northern Indian Ocean. We conducted an ensemble of coupled ocean-atmosphere simulations from 1930 to 2000 to understand the role of atmospheric brown clouds in the observed trends. The simulations adopt the aerosol radiative forcing from the Indian Ocean experiment observations and also account for global increases in greenhouse gases and sulfate aerosols. The simulated decreases in surface solar radiation, changes in surface and atmospheric temperatures over land and sea, and decreases in monsoon rainfall are similar to the observed trends. We also show that greenhouse gases and sulfates, by themselves, do not account for the magnitude or even the sign in many instances, of the observed trends. Thus, our simulations suggest that absorbing aerosols in atmospheric brown clouds may have played a major role in the observed regional climate and hydrological cycle changes and have masked as much as 50% of the surface warming due to the global increase in greenhouse gases. The simulations also raise the possibility that, if current trends in emissions continue, the subcontinent may experience a doubling of the drought frequency in the coming decades.

Global air pollution crossroads over the Mediterranean

The Mediterranean Intensive Oxidant Study, performed in the summer of 2001, uncovered air pollution layers from the surface to an altitude of 15 kilometers. In the boundary layer, air pollution standards are exceeded throughout the region, caused by West and East European pollution from the north. Aerosol particles also reduce solar radiation penetration to the surface, which can suppress precipitation. In the middle troposphere, Asian and to a lesser extent North American pollution is transported from the west. Additional Asian pollution from the east, transported from the monsoon in the upper troposphere, crosses the Mediterranean tropopause, which pollutes the lower stratosphere at middle latitudes.

Aerosols, climate, and the hydrological cycle

Human activities are releasing tiny particles (aerosols) into the atmosphere. These human-made aerosols enhance scattering and absorption of solar radiation. They also produce brighter clouds that are less efficient at releasing precipitation. These in turn lead to large reductions in the amount of solar irradiance reaching Earth's surface, a corresponding increase in solar heating of the atmosphere, changes in the atmospheric temperature structure, suppression of rainfall, and less efficient removal of pollutants. These aerosol effects can lead to a weaker hydrological cycle, which connects directly to availability and quality of fresh water, a major environmental issue of the 21st century.

Renal transplantation

Renal Transplantation has progressed from an experiment in surgery, nephrology, and immunology to the preferred means of renal replacement therapy for patients with end-stage renal disease. Patient and graft survival rates are spectacular in the short run and improving steadily in the long. The current state of the art reflects deepened understanding of the alloimmune response and the T lymphocyte activation cascade in part driving the discovery of ever more potent immunosuppressive agents. Important issues remain such as chronic allograft dysfunction, the organ shortage, and tolerance induction. In this review, we will look at the history, the expanding treatment options based on better understanding of the immunobiology of alloantigen response, and the persistent challenges awaiting.

The Indian Ocean experiment: widespread air pollution from South and Southeast Asia

The Indian Ocean Experiment (INDOEX) was an international, multiplatform field campaign to measure long-range transport of air pollution from South and Southeast Asia toward the Indian Ocean during the dry monsoon season in January to March 1999. Surprisingly high pollution levels were observed over the entire northern Indian Ocean toward the Intertropical Convergence Zone at about 6 degrees S. We show that agricultural burning and especially biofuel use enhance carbon monoxide concentrations. Fossil fuel combustion and biomass burning cause a high aerosol loading. The growing pollution in this region gives rise to extensive air quality degradation with local, regional, and global implications, including a reduction of the oxidizing power of the atmosphere.

Reduction of tropical cloudiness by soot

Measurements and models show that enhanced aerosol concentrations can augment cloud albedo not only by increasing total droplet cross-sectional area, but also by reducing precipitation and thereby increasing cloud water content and cloud coverage. Aerosol pollution is expected to exert a net cooling influence on the global climate through these conventional mechanisms. Here, we demonstrate an opposite mechanism through which aerosols can reduce cloud cover and thus significantly offset aerosol-induced radiative cooling at the top of the atmosphere on a regional scale. In model simulations, the daytime clearing of trade cumulus is hastened and intensified by solar heating in dark haze (as found over much of the northern Indian Ocean during the northeast monsoon).

DNA sequencing using differential extension with nucleotide subsets (DENS)

Here we describe template directed enzymatic synthesis of unique primers, avoiding the chemical synthesis step in primer walking. We have termed this conceptually new technique DENS (differential extension with nucleotide subsets). DENS works by selectively extending a short primer, making it a long one at the intended site only. The procedure starts with a limited initial extension of the primer (at 20-30 degrees C) in the presence of only two out of the four possible dNTPs. The primer is extended by 6-9 bases or longer at the intended priming site, which is deliberately selected, (as is the two-dNTP set), to maximize the extension length. The subsequent termination reaction at 60-65 degrees C then accepts the extended primer at the intended site, but not at alternative sites, where the initial extension (if any) is generally much shorter. DENS allows the use of primers as long as 8mers (degenerate in two positions) which prime much more strongly than modular primers involving 5-7mers and which (unlike the latter) can be used with thermostable polymerases, thus allowing cycle-sequencing with dye-terminators compatible with Taq DNA polymerase, as well as making double-stranded DNA sequencing more robust.