Ablation of irreversibly rejected renal allograft by embolization with absolute ethanol: a new clinical application

Surgical allograft nephrectomy has been the conventional therapy for removing failed kidney allografts when clinical manifestations of graft intolerance appear. However, removal of a transplanted kidney is an extensive surgical procedure. On the other hand, transcatheter vascular embolization (TVE) has proven useful in ablating organs and could be applied to renal transplant ablation. The aim of this study was to present the results of TVE for the treatment of graft intolerance syndrome (GIS) in failed allograft kidneys. Transcatheter vascular embolization was performed in 14 allograft recipients (33 +/- 13 years of age; 10 men and four women) affected by GIS after irreversible kidney allograft failure. Graft intolerance syndrome was diagnosed by fever (93%), hematuria (50%), graft pain (36%), flu-like symptoms (29%), and increased graft size (29%). Absolute ethanol (0.1 mL/kg body weight) was injected in the allograft artery, and in seven patients a stainless steel coil was left in the renal artery following ethanol injection. All patients showed clinical disappearance of the GIS. No major complication occurred, although a postembolization syndrome of pain, fever, hematuria, numbness, and paresthesia of the affected area appeared in 11 of the 14 patients. After 2 to 56 months of follow-up no late complications occurred, with the exception of a graft abscess formation in one patient after 6 months of embolization. Subsequent transplantectomy was uneventful. In conclusion, TVE is a safe and effective method for kidney graft ablation, and it may become an alternative treatment for GIS following irreversible rejection.

Stimulation of IL-2-activated natural killer cells through the Kp43 surface antigen up-regulates TNF-alpha production involving the LFA-1 integrin

We have previously described that a mAb directed against a surface dimer (Kp43) expressed by NK cells was able to regulate cell proliferation, enhance the cytotoxicity of IL-2-activated NK cells, and activate phospholipase D. In this work we have analyzed the ability of the anti-Kp43 mAb to regulate the production of TNF-alpha. Our results show that the stimulation of IL-2-activated NK cells with soluble anti-Kp43 mAb or its F(ab')2 activated the secretion of the cytokine, inasmuch as this effect is associated with the induction of cellular aggregation. The intensity of the Kp43-mediated stimulation varied among different IL-2-activated NK cell samples. Even in those instances where the anti-Kp43 mAb alone could not detectably enhance TNF-alpha production, it displayed a synergistic effect combined to a soluble anti-CD16 mAb, which on its own did not efficiently activate cytokine production. The anti-Kp43 mAb also cooperated with a phorbol ester, although it did not modify the TNF-alpha production triggered by a Ca2+ ionophore. The anti-Kp43-mediated effect, which required the preactivation of cells with IL-2, was inhibited by cycloheximide and actinomycin D and was associated with an increase in the levels of TNF-alpha-specific mRNA. It is noteworthy that the Kp43-mediated production of TNF-alpha was partially inhibited by anti-CD18, anti-CD11a and anti-ICAM-1 mAb that blocked LFA-1-dependent cellular interactions, which impaired NK cell aggregation and, moreover, was dependent on the presence of extracellular Mg2+, thus suggesting that the leukocyte integrin is involved in the activation process triggered through Kp43.

Transient inhibition of foot-and-mouth disease virus infection of BHK-21 cells by antisense oligonucleotides directed against the second functional initiator AUG

The antiviral activity of antisense oligonucleotides corresponding to different regions of foot-and-mouth disease virus (FMDV) genome has been assessed in BHK-21 cells. The locations of the oligonucleotides used were: (i) two regions within the internal ribosome entry site (IRES), involved in the regulation of the translation initiation of the viral polyprotein; (ii) each of the two functional initiator AUGs; (iii) an internal sequence of P2A gene; and (iv) a region at the 3' end non-coding region. Cytoplasmic microinjection of oligodeoxyribonucleotides and oligoribonucleotides complementary to the second AUG resulted in a transient inhibition of viral VP1 expression in infected cells. Significant inhibitions, ranging from 35 to 52%, were obtained at 5 h post-infection using oligonucleotide concentrations of 125 microM and higher. The extent and duration of this inhibition seemed to be mediated by both a rapid transport to the nucleus and the short half-life of the oligonucleotide. This inhibition of FMDV protein synthesis was correlated with a reduction of virus yield of about 50%, as observed after the addition to the cell culture of an oligodeoxyribonucleotide phosphorothioate complementary to the second AUG.

A prospective safety-monitoring study of immunotherapy with biologically standardized extracts

We evaluated the safety of immunotherapy in 419 patients who attended our allergy department for treatment. They were suffering from rhinitis and asthma caused by sensitization to grass pollen or Dermatophagoides pteronyssinus. Immunotherapy was given by biologically standardized aluminum hydroxide adsorbed extracts according to a conventional schedule. Local reactions were recorded in 10.5% of the patients and systemic reactions in 4.8%. Only 0.37% of the doses administered were associated with systemic side-effects. We found that 84% of the patients who showed systemic reactions were asthmatic subjects (P < 0.01), and most of them were sensitized to D. pteronyssinus (71%). Side-effects occurred more frequently during the dose-increase period (P < 0.05). After 9482 doses had been administered, no anaphylactic shock or life-threatening reactions were registered. We believe the risk associated with immunotherapy to be drastically reduced when treatment is carefully monitored by skilled personnel. In such conditions, as shown by our study, immunotherapy is safe.

Design of primers for PCR amplification of highly variable genomes

A program to aid in the search of primers for specific polymerase chain reaction (PCR) amplification of highly variable genomes is presented. It involves the derivation of variability profiles to identify optimal regions for PCR amplification, taking into account stability of DNA-primer hybrids. An application of the program to foot-and-mouth disease virus diagnosis is presented.

Absence of mutagenicity of benzo[c]phenanthridine alkaloids in somatic cells of Drosophila melanogaster: comparison with 7,12-dimethylbenz[a]anthracene and chrysene

The wing somatic mutation and recombination test (SMART) of Drosophila melanogaster was used to study the mutagenic potential of three benzo[c]phenanthridines with antileukemic properties, fagaronine, nitidine and O-methylfagaronine, as compared with that of two structurally related aromatic polycyclic hydrocarbons: 7,12-dimethylbenz[a]anthracene and chrysene. Although toxic to larvae, the benzo[c]phenanthridines and chrysene gave negative or inconclusive results while 7,12-dimethylbenz[a]anthracene was found to be highly mutagenic and recombinogenic as previously reported. These results suggest that the alkoxy groups and the quaternary nitrogen of the benzo[c]-phenanthridines may reduce or eliminate their mutagenicity in spite of their similarity to methylated polycyclic aromatic hydrocarbons.

Heterotypic lymphoproliferative response in pigs vaccinated with foot-and-mouth disease virus. Involvement of isolated capsid proteins

The in vitro viral lymphoproliferative response of pigs vaccinated against foot-and-mouth disease virus (FMDV) has been characterized. Peripheral blood mononuclear cells from immunized animals up to 1 year post-immunization (p.i.) showed a time-dependent FMDV-specific response, as assayed by virus-specific cellular blastogenesis. The optimum viral concentration decreased with time (around 20 weeks p.i.), and the response was faster and weaker. Lymphoproliferation appeared to be mainly due to CD4+ T cells. The response was heterotypic, being induced by all FMDV serotypes tested (C, A and O) after only two vaccinations with FMDV of serotype C (C-S8). Each individual structural protein assessed (VP1, VP2 and VP3) induced proliferation, with VP3 and VP1 being more effective stimulators. In vitro serum neutralization activity and FMDV-specific IgG production were found to be active even at 1 year p.i.

Global transcription pattern of phi C31 after induction of a Streptomyces coelicolor lysogen at different growth stages

Using two complementary strategies for low-resolution S1 mapping, the global pattern of phi C31 transcription was studied after induction of thermoinducible phi C31 lysogens of Streptomyces coelicolor A3(2). A complex pattern of early transcripts was seen, with a peak of abundance at about 10 min post-induction. Nearly all of these transcripts were from DNA located to the right of the c (repressor) gene and to the left of the attP site: a region of about 14 kb. Early transcription was also observed immediately to the left of the c gene. The c gene itself was also induced, with an earlier expression peak (about 5 min post-induction). Primary late transcripts were generally relatively long, but degraded. They apparently corresponded to most of the 18 kb region to the left of the c gene. Some shorter and more persistent late transcripts corresponded to DNA close to or overlapping the cos site. Large late transcripts from a region close to the left-hand end of the phi C31 genome showed evidence of processing to more stable, smaller RNA species. A failure of older cultures (more than 12 h old) to be induced productively was correlated with a much longer period of early transcription, reduced late transcription, failure to synthesize a major virion protein, and failure to package phi C31 DNA. Moreover, heat treatment of the older lysogenic cultures did not result in the phi C31-dependent shut-down of host rRNA transcription previously observed for young cultures (Rodríguez et al., Journal of General Microbiology (1986) 132, 1695-1701; Clayton & Bibb, Molecular Microbiology (1990) 4, 2179-2185).

On the mechanism of stimulation of ureagenesis by gluconeogenic substrates: role of pyruvate carboxylase

Gluconeogenic substrates, lactate or pyruvate, or ornithine produced 100% increase of urea synthesis from NH4Cl. The combined administration of ornithine and lactate (or pyruvate) produced more than additive effects, indicating that they acted at different steps in a potentiating manner. The uptake of ornithine was enhanced by gluconeogenic substrates. This finding may explain, at least in part, the stimulating effect of these substrates on ureagenesis from NH4Cl and ornithine. The gluconeogenic substrate-induced stimulation of ureagenesis from NH4Cl was still observed under conditions of reduced flux through pyruvate carboxylase, ruling out that their action was exclusively mediated by the anaplerotic effect of this enzyme. Pyruvate was a more potent stimulator of ureagenesis than lactate and its effect less sensitive to pyruvate carboxylase inhibition. These observations indicate that a correlation exists between stimulation of ureagenesis by gluconeogenic substrates and flux through pyruvate dehydrogenase. It is concluded that gluconeogenic substrates may stimulate ureagenesis from NH4Cl by 1) increasing intracellular ornithine availability and/or 2) enhancing flux through pyruvate dehydrogenase and consequently the tricarboxylic acid cycle activity.

Primer design for specific diagnosis by PCR of highly variable RNA viruses: typing of foot-and-mouth disease virus

A PCR assay for the specific detection and identification of viral sequences that correlate with established serotypes of foot-and-mouth disease virus (FMDV) has been developed. A new analysis based on homology profiles among reported sequences was used for primer design. RNA replicase (3D) gene regions that showed high homology among FMDVs, and low homology to other picornaviruses, were used for PCR amplification. Specific and highly sensitive detection was achieved for RNA of FMDV types C, A, and O, either purified or extracted from vesicular fluids of infected animals, under reaction conditions permissive for the detection of variants present in the virus population. Similarly, serotype-specific primers were designed to amplify the carboxy-terminal end of VP1 gene of FMDV types either C, A, or O. The results of PCR amplification of 15 different FMDV RNAs using type-specific primers are in agreement with the serological typing of the corresponding viruses and show that the primer-selection procedure developed for FMDV constitutes a reliable method of viral diagnosis.

Immunocytochemical study of the diffuse neuroendocrine system cells in equine lungs

This study was undertaken to investigate the presence of neuroendocrine cells (N.E.C.) by immunocytochemical means in equine lungs during three distinct evolutionary periods: fetal, neonatal and adult. The authors identified bombesin, somatostatin and calcitonin secretory cells. In the fetal lungs the N.E.C. were located in the interstitial tissue and exhibited greater immunoreactivity to bombesin than to the other two neuropeptides studied. A large number of calcitonin-producing cells and a smaller number of bombesin-positive cells were seen in the bronchial and bronchiolar epithelium of newborn Equidae. In the adult equine lungs far fewer N.E.C. were observed than in the earlier stages. Somatostatin-producing cells were not seen in neonatal or adult lung tissue.

[Chlamydia trachomatis detection by DNA-RNA hybridization]

BACKGROUND

A one-chain DNA probe, that complements ribosomal RNA of Chlamydia trachomatis was used as a detection method for this microorganism on clinical samples. We compare the method with the cell culture one.

METHODS

A total of 175 samples (cervix swabs) from women seen at the STD center of the Facultad de Medicina de Sevilla were examined by both diagnostic techniques. When the results were different, a third method (ELISA) was also used.

RESULTS

Using serial dilutions of a C. trachomatis cell culture as reference pattern, we determine the minimum number of inclusion forming units needed in order to be detected by the probe was 1000. Of all 175 samples, in 24 (14%) cell culture was positive for C. trachomatis, and 26 were positive using the DNA probe test. Sensitivity and specificity for this test were 93% and 95%, respectively.

CONCLUSIONS

We believe that the DNA probe test was similar to the cell culture test as screening test in Chlamydia trachomatis infections diagnosis, specially among high risk populations.

[Evaluation of 2 techniques for ventilation support during single-lung ventilation]

In a group of 22 patients undergoing thoracotomy we compared two techniques of ventilatory assistance to the nondependent lung during single lung ventilation. We simultaneously administered a 0.5% FiO2 to the dependent lung. We used a CPAP system with continuous O2 flow limited by an underwater valve at a pressure of +5 cmH2O. We performed 33 ventilatory assistances: in 15 cases to the nondependent lung (CPAP group) and in 18 patients to the lower lobe of the nondependent lung (lobar CPAP group). Evaluation of both techniques was performed by means of arterial blood gas measurement and the mean values were compared using the student's t test. During single lung ventilation the PaO2 in CPAP group increased from 85.86 +/- 22.28 mmHg to 155.52 +/- 59.54 mmHg (p less than 0.001) and in the lobar CPAP series it increased from 88.75 +/- 24.34 mmHg to 122.36 +/- 43.21 mmHg (p less than 0.01). In 11 out of the 22 patients we firstly applied the lobar CPAP and thereafter the CPAP to the whole lung in order to compare the efficacy of both techniques in the same patient. The PaO2 during single lung ventilation was 86.9 +/- 22.7 mmHg and it increased to 111.1 +/- 37.9 mmHg after lobar CPAP (p less than 0.01) ant to 163.3 +/- 64 mmHg after total lung CPAP ventilation (p less than 0.001). Our results confirm the usefulness of both techniques and they indicate that CPAP to the whole nondependent lung is the most effective.

Distribution and function of the lethal of scute gene product during early neurogenesis in Drosophila

Genes of the achaete-scute complex (ASC) participate in the formation of the central nervous system in the Drosophila embryo. Previous genetic analyses have indicated that lethal of scute (l'sc) is the most important gene of the complex in that process. We have obtained antibodies against the l'sc protein to study the expression of the gene during early neurogenesis. The protein is found in groups of embryonic neuroectodermal cells, analogous to the proneural clusters that precede the appearance of precursors of peripheral sensory organs in imaginal epithelia. The groups appear in different regions of the neuroectoderm, accompanying the three successive waves of neuroblast segregation. Most neuroblasts delaminate from these clusters and express position-specific levels of l'sc protein. No significant differences have been found between the distribution of l'sc RNA and protein. Phenotypic analysis of a l'sc deficiency has shown that the gene is required for neuroblast commitment, although this requirement is less widespread than the domain of l'sc expression, suggesting a high degree of redundancy in the function of genes that participate in the process of neuroblast segregation. The ASC genes have been postulated to play a role in the control of NB identity, revealed by the generation of a defined lineage of identifiable neurons. However, our study in l'sc mutants of the expression of fushi tarazu, engrailed, and even-skipped, used as markers of neuronal identity, has not provided evidence to support this hypothesis.

Role of central dopaminergic pathways in the neural control of growth hormone secretion in normal men: studies with metoclopramide

The aim of this study was to gain further insight into the role that central dopaminergic pathways play in GH neuroregulation in man. Our experimental hypothesis was based on the possibility that most of the controversies on DA role could be due to the fact that the hypothalamic somatotroph rhythm (HSR) was not taken into account when interpreting the GH responses after pharmacological manipulations on dopaminergic pathways. In 10 normal subjects we monitored the effect of central dopaminergic blockade, achieved with metoclopramide (MCP; 10 mg, i.v. bolus), on the pattern of spontaneous GH secretion and the GH responses to a GHRH challenge (GRF1-29, 1 microgram/kg, i.v. bolus) administered together with MCP or 60 min after this drug was given. The study of HSR was made according to our previous postulate. Our results indicate that MCP administration, either prior to or together with the GHRH bolus, significantly increased GHRH-induced GH release during a refractory HSR phase; but not when the GHRH challenge took place during a spontaneous secretory phase. The strong relationship between pre-GHRH plasma GH values and GHRH-elicited GH peaks was lost when MCP was given. These data indicate that MCP was able to disrupt the intrinsic HSR by inhibiting the hypothalamic release of somatostatin (SS). While a main conclusion would be that central DA is a secretagogue for SS secretion, our results also suggest that this role could be dependent on its effects on the adrenergic inputs to SS neurons.

[Penile self-injection of a papaverine-phentolamine combination, as treatment of impotence, in patients treated with radical cystoprostatectomy]

Four patients with impotence secondary to radical cystoprostatectomy due to infiltrant vesical urothelial carcinoma, received treatment with a mixture of papaverine-phentolanin, at dosages of 18-0, 34 mg respectively. Good results were obtained in every occasion, all four cases achieving rigid erection for over an hour which allowed penetration. Currently, patients continue peneal self-injection treatment with these drugs, with no complications or therapy failure being reported.

[The value of high dose steroid therapy in obstructive uropathy caused by a tumor]

The case of an 82-years old female patient with acute renal failure secondary to tumoral obstructive uropathy by neoplasic invasion of the trigone is described. The condition was treated with urinary deviation through percutaneous nephrostomy of the left kidney which achieved an improvement in the renal function. Later, the percutaneous nephrostomy was unintentionally moved not being possible to place a new one in none of the kidneys. The patient remained anuric for 24 hours, and therapy was then instaured with high doses of intravenous steroids (6 Metyl-Prednisolone 1.5 g I.V. in 24 hours), diuresis was recovered and renal function became normalized within a few days. The mechanism of action and therapeutic usefulness of high dosage steroids in tumoral obstructive pathology is discussed.