Midterm Outcome of Living-Related Kidney Transplantation From Aged Donors: A Single-Center Experience

BACKGROUND

Kidney transplantation (KT) is the most effective treatment of end-stage renal disease (ESRD). Using grafts from aged donors is increasing worldwide. Our aim was to better understand the safety and effectiveness of aged living donors.

METHODS

First, 482 cases with living-related kidney transplantation were analyzed retrospectively. The cases were divided into 2 groups by donor age ≥ 55 years (aged donor group, 136 cases) and <55 years (young donor group, 346 cases). Then donor and recipient characteristics were summarized. In addition, the renal function of graft was compared between young donor group and aged donor group. Finally, patient and graft survivals were examined with the use of Kaplan-Meier analysis and compared with the use of the log-rank test.

RESULTS

The mean donor estimated glomerular filtration rate (eGFR) was lower in the aged donor group compared with in the young donor group. After KT, the mean eGFR of the graft in the recipient was also lower in the aged donor group than in the young donor group. To confirm the effect of aged kidney grafts on renal function, we measured proteinuria. Compared with the young donor group, in the aged donor group incidence of proteinuria and 24-hour urinary protein were significantly higher. However, the incidence of delayed graft function was not significantly different between the 2 groups. We found that aged kidney grafts had no significant effect on long-term patient and graft survivals.

CONCLUSIONS

With the current lack of organs, aged kidney grafts are an acceptable alternative. Use of organs from aged donors safely expands the living donor pool.

Simultaneous changes in gray matter volume and white matter fractional anisotropy in Alzheimer's disease revealed by multimodal CCA and joint ICA

The prominent morphometric alterations of Alzheimer's disease (AD) occur both in gray matter and in white matter. Multimodal fusion can examine joint information by combining multiple neuroimaging datasets to identify the covariant morphometric alterations in AD in greater detail. In the current study, we conducted a multimodal canonical correlation analysis and joint independent component analysis to identify the covariance patterns of the gray and white matter by fusing structural magnetic resonance imaging and diffusion tensor imaging data of 39 AD patients (23 males and 16 females, mean age: 74.91±8.13years) and 41 normal controls (NCs) (20 males and 21 females, mean age: 73.97±6.34years) derived from the Alzheimer's Disease Neuroimaging Initiative database. The results revealed 25 joint independent components (ICs), of which three joint ICs exhibited strong links between the gray matter volume and the white matter fractional anisotropy (FA) and significant differences between the AD and NC group. The joint IC maps revealed that the simultaneous changes in the gray matter and FA values primarily involved the following areas: (1) the temporal lobe/hippocampus-cingulum, (2) the frontal/cingulate gyrus-corpus callosum, and (3) the temporal/occipital/parietal lobe-corpus callosum/corona radiata. Our findings suggest that gray matter atrophy is associated with reduced white matter fiber integrity in AD and possibly expand the understanding of the neuropathological mechanisms in AD.

Biosynthesis and actions of 5-oxoeicosatetraenoic acid (5-oxo-ETE) on feline granulocytes

The 5-lipoxygenase product 5-oxo-6,8,11,14-eicosatetraenoic acid (5-oxo-ETE) is the most powerful human eosinophil chemoattractant among lipid mediators and could play a major pathophysiological role in eosinophilic diseases such as asthma. Its actions are mediated by the OXE receptor, orthologs of which are found in many species from humans to fish, but not rodents. The unavailability of rodent models to examine the pathophysiological roles of 5-oxo-ETE and the OXE receptor has substantially hampered progress in this area. As an alternative, we have explored the possibility that the cat could serve as an appropriate animal model to investigate the role of 5-oxo-ETE. We found that feline peripheral blood leukocytes synthesize 5-oxo-ETE and that physiologically relevant levels of 5-oxo-ETE are present in bronchoalveolar lavage fluid from cats with experimentally induced asthma. 5-Oxo-ETE (EC50, 0.7nM) is a much more potent activator of actin polymerization in feline eosinophils than various other eicosanoids, including leukotriene (LT) B4 and prostaglandin D2. 5-Oxo-ETE and LTB4 induce feline leukocyte migration to similar extents at low concentrations (1nM), but at higher concentrations the response to 5-oxo-ETE is much greater. Although high concentrations of selective human OXE receptor antagonists blocked 5-oxo-ETE-induced actin polymerization in feline granulocytes, their potencies were about 200 times lower than for human granulocytes. We conclude that feline leukocytes synthesize and respond to 5-oxo-ETE, which could potentially play an important role in feline asthma, a common condition in this species. The cat could serve as a useful animal model to investigate the pathophysiological role of 5-oxo-ETE.

Polymerization behavior of hydrophilic-rich phase of dentin adhesive

The 2-fold objectives of this study were 1) to understand whether model hydrophobic- and hydrophilic-rich phase mimics of dentin adhesive polymerize similarly and 2) to determine which factor, the dimethacrylate component, bisphenol A glycerolate dimethacrylate (BisGMA) or photoinitiator concentration, has greater influence on the polymerization of the hydrophilic-rich phase mimic. Current dentin adhesives are sensitive to moisture, as evidenced by nanoleakage in the hybrid layer and phase separation into hydrophobic- and hydrophilic-rich phases. Phase separation leads to limited availability of the cross-linkable dimethacrylate monomer and hydrophobic photoinitiators within the hydrophilic-rich phase. Model hydrophobic-rich phase was prepared as a single-phase solution by adding maximum wt% deuterium oxide (D2O) to HEMA/BisGMA neat resins containing 45 wt% 2-hydroxyethyl methacrylate (HEMA). Mimics of the hydrophilic-rich phase were prepared similarly but using HEMA/BisGMA neat resins containing 95, 99, 99.5, and 100 wt% HEMA. The hydrophilic-rich mimics were prepared with standard or reduced photoinitiator content. The photoinitiator systems were camphorquinone (CQ)/ethyl 4-(dimethylamino)benzoate (EDMAB) with or without [3-(3, 4-dimethyl-9-oxo-9H-thioxanthen-2-yloxy)-2-hydroxypropyl]trimethylammonium chloride (QTX). The polymerization kinetics was monitored using a Fourier transform infrared spectrophotometer with a time-resolved collection mode. The hydrophobic-rich phase exhibited a significantly higher polymerization rate compared with the hydrophilic-rich phase. Postpolymerization resulting in the secondary rate maxima was observed for the hydrophilic-rich mimic. The hydrophilic-rich mimics with standard photoinitiator concentration but varying cross-linker (BisGMA) content showed postpolymerization and a substantial degree of conversion. In contrast, the corresponding formulations with reduced photoinitiator concentrations exhibited lower polymerization and inhibition/delay of postpolymerization within 2 h. Under conditions relevant to the wet, oral environment, photoinitiator content plays an important role in the polymerization of the hydrophilic-rich phase mimic. Since the hydrophilic-rich phase is primarily water and monomethacrylate monomer (e.g., HEMA as determined previously), substantial polymerization is important to limit the potential toxic response from HEMA leaching into the surrounding tissues.

Identification of potential targets for ovarian cancer treatment by systematic bioinformatics analysis

PURPOSE OF INVESTIGATION

To provide a systematic overview to understand the mechanism of ovarian cancer.

MATERIALS AND METHODS

Data of GSE14407 downloaded from Gene Expression Omnibus (GEO) database and differentially expressed genes (DEGs) were identified. Gene ontology and pathway enrichment analysis were performed by Database for Annotation, Visualization and Integrated Discovery (DAVID). Furthermore, the authors constructed the protein-protein interaction (PPI) network and co-expression networks by Cytoscape.

RESULTS

A total 1,442 genes were identified to be differentially expressed. Regulatory effects of DEGs mainly focused on cell cycle, transcription regulation, and cellular protein metabolic process. Significant pathways were determined to be p53 signaling pathway, amino sugar, and nucleotide sugar metabolism. The most significant transcription factor was aryl hydrocarbon receptor nuclear translocator (ARNT). Abnormal spindle-like microcephaly-associated protein (ASPM), Aurora kinase (AURKA), Cyclin-A2 (CCNA2), G2/mitotic-specific cyclin-B1, (CCNB1), and Cyclin-dependent kinase 1 (CDK1) were significant nodes in PPI network.

CONCLUSION

The significant genes and pathways show potential targets for the treatment of ovarian cancer.

Proteins, pathogens, and failure at the composite-tooth interface

In the United States, composites accounted for nearly 70% of the 173.2 million composite and amalgam restorations placed in 2006 (Kingman et al., 2012), and it is likely that the use of composite will continue to increase as dentists phase out dental amalgam. This trend is not, however, without consequences. The failure rate of composite restorations is double that of amalgam (Ferracane, 2013). Composite restorations accumulate more biofilm, experience more secondary decay, and require more frequent replacement. In vivo biodegradation of the adhesive bond at the composite-tooth interface is a major contributor to the cascade of events leading to restoration failure. Binding by proteins, particularly gp340, from the salivary pellicle leads to biofilm attachment, which accelerates degradation of the interfacial bond and demineralization of the tooth by recruiting the pioneer bacterium Streptococcus mutans to the surface. Bacterial production of lactic acid lowers the pH of the oral microenvironment, erodes hydroxyapatite in enamel and dentin, and promotes hydrolysis of the adhesive. Secreted esterases further hydrolyze the adhesive polymer, exposing the soft underlying collagenous dentinal matrix and allowing further infiltration by the pathogenic biofilm. Manifold approaches are being pursued to increase the longevity of composite dental restorations based on the major contributing factors responsible for degradation. The key material and biological components and the interactions involved in the destructive processes, including recent advances in understanding the structural and molecular basis of biofilm recruitment, are described in this review. Innovative strategies to mitigate these pathogenic effects and slow deterioration are discussed.

Two Potent OXE-R Antagonists: Assignment of Stereochemistry

5-Oxo-6,8,11,14-eicosatetraenoic acid (5-oxo-ETE) is formed by the oxidation of 5-hydroxy-6E,8Z,11Z,14Z-eicosatetraenoic acid (5-HETE), which is a major metabolite of enzymatic oxidation of arachidonic acid (AA). 5-Oxo-ETE is the most potent lipid chemoattractant for human eosinophils. Its actions are mediated by the selective OXE receptor, which is therefore an attractive target in eosinophilic diseases such as allergic rhinitis and asthma. Recently, we have reported two excellent OXE receptor antagonists that have IC50 values at low nanomolar concentrations. Each of these antagonists has a chiral center, and the isolation of the individual enantiomers by chiral high-performance liquid chromatography (HPLC) revealed that in each case one enantiomer is over 300 times more potent than the other. To unambiguously assign the stereochemistry of these enantiomers and to provide access to larger amounts of the active compounds for biological testing, we report here their total synthesis.

Quantitative determination of ketoconazole by UPLC-MS/MS in human plasma and its application to pharmacokinetic study

In this study, a simple, rapid and sensitive ultra-performance liquid chromatography tandem mass spectrometry (UPLC-MS/MS) method is described for determination of ketoconazole (KTZ) in human plasma samples using carbamazepine as the internal standard (IS). Sample preparation was accomplished through one-step liquid-liquid extraction by ethyl acetate, and chromatographic separation was performed on an Acquity BEH C18 column (2.1 mm×50 mm, 1.7 μm) with gradient profile at a flow of 0.45 mL/min. Mass spectrometric analysis was performed using a QTrap5500 mass spectrometer coupled with an electro-spray ionization (ESI) source in the positive ion mode. The MRM transition of m/z 531.2→489.3 was used to quantify for KTZ. The linearity of this method was found to be within the concentration range of 5-15 000 ng/mL for KTZ in human plasma. Only 1.5 min was needed for an analytical run. The method herein described was superior to previous methods and was successfully applied to the pharmacokinetic study of KTZ in healthy Chinese volunteers after oral administration.

Inhibition of 5-oxo-6,8,11,14-eicosatetraenoic acid-induced activation of neutrophils and eosinophils by novel indole OXE receptor antagonists

5-Oxo-6,8,11,14-eicosatetraenoic acid (5-oxo-ETE) is a 5-lipoxygenase product that is a potent granulocyte chemoattractant, which induces the infiltration of eosinophils into human skin when injected intradermally. It could therefore be an important proinflammatory mediator in eosinophilic diseases such as asthma and allergic rhinitis, and the OXE receptor, which mediates its actions, is therefore an attractive drug target. Using a structure-based approach in which substituents mimicking the essential polar (C1-C5) and hydrophobic (C15-C20) regions of 5-oxo-ETE were incorporated on an indole scaffold, we identified two potent selective OXE antagonists with IC50 values of about 30 nM. Neither compound displayed agonist activity and both inhibited 5-oxo-ETE-induced chemotaxis and actin polymerization and were relatively resistant to metabolism by rat liver homogenates. The active enantiomers of these racemic antagonists were even more potent, with IC50 values of <10 nM. These selective OXE antagonists could potentially be useful therapeutic agents in allergic diseases such as asthma.

Swelling equilibrium of dentin adhesive polymers formed on the water-adhesive phase boundary: experiments and micromechanical model

During their application to the wet, oral environment, dentin adhesives can experience phase separation and composition change, which can compromise the quality of the hybrid layer formed at the dentin-adhesive interface. The chemical composition of polymer phases formed in the hybrid layer can be represented using a ternary water-adhesive phase diagram. In this paper, these polymer phases are characterized using a suite of mechanical tests and swelling experiments. The experimental results were evaluated using a granular micromechanics-based model incorporating poro-mechanical effects and polymer-solvent thermodynamics. The variation in the model parameters and model-predicted polymer properties was studied as a function of composition along the phase boundary. The resulting structure-property correlations provide insight into interactions occurring at the molecular level in the saturated polymer system. These correlations can be used for modeling the mechanical behavior of the hybrid layer, and are expected to aid in the design and improvement of water-compatible dentin adhesive polymers.

Anti-inflammatory effect of purified dietary anthocyanin in adults with hypercholesterolemia: a randomized controlled trial

BACKGROUND AND AIM

Atherosclerosis is a chronic inflammatory disease and previous studies have demonstrated that anthocyanin inhibits atherosclerosis. In the present study, we explored the effects of anthocyanins on inflammatory cytokines in hypercholesterolemic adults and cell lines.

METHODS AND RESULTS

A total of 150 subjects with hypercholesterolemia consumed a purified anthocyanin mixture (320 mg/d) or a placebo twice a day for 24 weeks in a randomized, double-blind trial. Anthocyanin consumption significantly decreased the levels of serum high sensitivity C-reactive protein (hsCRP) (-21.6% vs. -2.5%, P = 0.001), soluble vascular cell adhesion molecule-1 (sVCAM-1) (-12.3% vs. 0.4%, P = 0.005) and plasma IL-1β (-12.8% vs. -1.3%, P = 0.019) compared to the placebo. We also found a significant difference in the LDL-cholesterol (-10.4% vs. 0.3%, P = 0.030) and HDL-cholesterol level changes (14.0% vs. -0.9%, P = 0.036) between the two groups. In cell culture assays in vitro, purified anthocyanin mixture, delphinidin-3-Ο-β-glucoside (Dp-3g) and cyanidin-3-Ο-β-glucoside (Cy-3g) inhibited IL-6 and IL-1β-induced CRP production (P < 0.05) in HepG2 cell line and LPS-induced VCAM-1 secretion (P < 0.05) in porcine iliac artery endothelial cell line respectively in a dose-dependent manner. In addition, the reduction of inflammatory cytokines associated with anthocyanin mixture was stronger when compared with the effects of Dp-3g and Cy-3g separately (P < 0.05).

CONCLUSIONS

Anthocyanin mixture reduced the inflammatory response in hypercholesterolemic subjects. In addition, different anthocyanin compounds were found to have additive or synergistic effects in mediating anti-inflammatory responses in vitro cell culture assays.

The results of surgery for colorectal hepatic metastases following expansion of the indications in 2005

AIM

Safety and survival were investigated in patients treated according to expanded surgical indications for colorectal hepatic metastases.

METHOD

A retrospective analysis of all consecutive patients who underwent resection of colorectal hepatic metastases at Zhongshan Hospital from 2000 to 2010 was conducted. The patients were divided into two groups based on a change in the surgical indications introduced in 2005. Patients in Group I underwent hepatic surgery between 2000 and 2004 and those in Group II between 2005 and 2010. The clinicopathological data and survival rates of both groups were analysed.

RESULTS

There were 530 patients who underwent hepatic surgery between 2000 and 2010. After the expansion of surgical indications, the rate of surgical resection rose from 25.1 to 35.1% (P < 0.05). There was no significant difference in perioperative mortality (2.2% vs 0.9%) or morbidity (20.9% vs 29.8%). Recurrence occurred in 27.5% and 36.7% in Groups I and II, respectively, and 5-year overall survival was 43% and 49%, respectively (not significant).

CONCLUSION

Expanding the indications for surgical resection of hepatic metastases increased the resection rate but had no significant effect on survival.

First measurements of spin-dependent double-differential cross sections and the Gerasimov-Drell-Hearn Integrand from 3He(γ,n)pp at incident photon energies of 12.8 and 14.7 MeV

The first measurement of the three-body photodisintegration of longitudinally polarized (3)He with a circularly polarized γ-ray beam was carried out at the High Intensity γ-ray Source facility located at Triangle Universities Nuclear Laboratory. The spin-dependent double-differential cross sections and the contributions from the three-body photodisintegration to the (3)He Gerasimov-Drell-Hearn integrand are presented and compared with state-of-the-art three-body calculations at the incident photon energies of 12.8 and 14.7 MeV. The data reveal the importance of including the Coulomb interaction between protons in three-body calculations.

ERK and AKT signaling cooperate to translationally regulate survivin expression for metastatic progression of colorectal cancer

The MEK/ERK and PI3K/AKT pathways are often concurrently activated by separate genetic alterations in colorectal cancer (CRC), which is associated with CRC progression and poor survival. However, how activating both pathways is required for CRC metastatic progression remains unclear. Our recent study showed that both ERK and AKT signaling are required to activate eIF4E-initiated cap-dependent translation via convergent regulation of the translational repressor 4E-BP1 for maintaining CRC transformation. Here, we identified that the activation of cap-dependent translation by cooperative ERK and AKT signaling is critical for promotion of CRC motility and metastasis. In CRC cells with coexistent mutational activation of ERK and AKT pathways, inhibition of either MEK or AKT alone showed limited activity in inhibiting cell migration and invasion, but combined inhibition resulted in profound effects. Genetic blockade of the translation initiation complex by eIF4E knockdown or expression of a dominant active 4E-BP1 mutant effectively inhibited migration, invasion and metastasis of CRC cells, whereas overexpression of eIF4E or knockdown of 4E-BP1 had the opposite effect and markedly reduced their dependence on ERK and AKT signaling for cell motility. Mechanistically, we found that these effects were largely dependent on the increase in mTORC1-mediated survivin translation by ERK and AKT signaling. Despite the modest effect of survivin knockdown on tumor growth, reduction of the translationally-regulated survivin profoundly inhibited motility and metastasis of CRC. These findings reveal a critical mechanism underlying the translational regulation of CRC metastatic progression, and suggest that targeting cap-dependent translation may provide a promising treatment strategy for advanced CRC.

Toxoplasma gondii infection in Bactrian camel (Camelus bactrianus) in China

Camel is important to the economy of many countries. We report Toxoplasma gondii infection in Bactrian camels (Camelus bactrianus), first for this host. Antibodies to T. gondii were found in sera of 7 of 234 C. bactrianus from Qinghai Province, northwestern China. Sera were tested by a commercial indirect hemagglutination test at a cut-off of 1:64. Age or the gender of the camel did not significantly affect the seroprevalence. Results are of public health and economic importance because camel milk and meat are used for human consumption in many countries, including China.

Friedel-like oscillations from interstitial iron in superconducting Fe(1+y)Te0.62Se0.38

Using polarized and unpolarized neutron scattering, we show that interstitial Fe in superconducting Fe(1+y)Te(1-x)Se(x) induces a magnetic Friedel-like oscillation that diffracts at Q⊥=(1/2 0) and involves >50 neighboring Fe sites. The interstitial >2μ(B) moment is surrounded by compensating ferromagnetic four-spin clusters that may seed double stripe ordering in Fe(1+y)Te. A semimetallic five-band model with (1/2 1/2) Fermi surface nesting and fourfold symmetric superexchange between interstitial Fe and two in-plane nearest neighbors largely accounts for the observed diffraction.

Ternary phase diagram of model dentin adhesive exposed to over-wet environments

When adhesives and/or composites are bonded to the tooth, water in the environment can interfere with proper interface formation. Formation of water blisters and phase separation at the adhesive/dentin interface have appeared as new types of bond defects. To better understand this problem, we determined the near-equilibrium partition of the hydrophobic/hydrophilic components when exposed to over-wet environments. Model methacrylate-based adhesives were mixed with different amounts of water to yield well-separated aqueous and resin phases. It was found that less than 0.1% BisGMA but nearly one-third of the HEMA diffused into the aqueous phase, leaving the remaining resin phase relatively hydrophobic. A partial phase diagram was created for the ternary BisGMA/HEMA/water system. All the experimental phase partitioning data were plotted, and the points lay on a binodal curve that separated the single-phase region from the two-phase region. We obtained the 3 tie lines by connecting the 2 points of each conjugate pair of the phase partitioning data from the 3 sets of tripartite mixtures. Information about solubility, water miscibility, distribution ratio, and phase partitioning behavior could be obtained quantitatively. This type of phase diagram will provide a more thorough understanding of current adhesive performance and elucidate directions for further improvement.