Effect of primary polychemotherapy after sentinel lymph node biopsy on the necessity for lymphadenectomy in stage II breast cancer patients

e11589

Background: Sentinel lymph node (SLN) biopsy is the standard procedure for assessing axillary status in stage I-II breast cancer patients. Realizing this procedure before the administration of primary polichemotherapy would reduce the number of unnecesary lymphadenectomy in patients with negative sentinel lymph node. Methods: From January 2006 to May 2008, twenty-one patients with breast cancer on stage II-IIIA were included in the study. The median age was of 49 years (range 22–74y). The median palpable tumour size was of 3.5cm (range 1.8–6.0) and by ultrasonography 2.0cm (range 1.8–5.0cm.). Stage II:19 and Stage III:2 (cT:6.0cm.). Breast biopsy was performed in all cases with: IDC:20. G1:9 (42,8%), G:2:11(52%) and G3:1(4,76%). ER+:18 (85,7%), PR+:13 (61,9%), HER2 (+):6 (28,5) and triple negative:3 (14,2%).The scheme of treatment was: 4Epi: 90mg/M2 and Cyclophosphamide 600mg/M2 day 1/3w/4cycles, followed by paclitaxel (P) 100mg/M2 day 1/wekly/8. Trastuzumab was given during one year 4/2mg/Kg and started with (P). Tumorectomy and limphadenectomy was planned, followed by radiotherapy ± Hormonotherapy ± trastuzumab. Results: The 21 patients were evaluable for the analysis. The median sentinel lymph nodes resected was of 2 (range 2–6). The SLN biopsy was positive in 12 (57,1%) cases and negative in 9 (42,8%). Followed the primary chemotherapy, tumorectomy and axillary lymphadenectomy (AL) were performed in all 21 cases. The 12 positive SLN showed in the AL 9/12 (75%) pN0 and the 9 negative SLN showed in the AL 0/9 (0%) pN1. There were 4/20 (20%) completely pathological tumour response and 4/20 (20%) cases with only isolated malignant cells. The treatment was well tolerated with not a case of grade 3–4 toxicity. Conclusions: The primary chemotherapy given after the biopsy of sentinel lymph node was very effective showing in the lymphadenectomy a high percentage of pathologic negative lymph nodes (9/12) and an overall tumour response of 40% (8/20) with 4/20 (20%) completely pathological response and 4/20 (20%) cases with only isolated malignant cells.

No significant financial relationships to disclose.

Optimal characteristics of spermatozoa for semen technologies in pigs

Despite the great potential of sperm technologies such as sperm cryopreservation and sperm sex sorting for the improvement of different aspects of swine production, artificial insemination with fresh or stored semen is currently the only sperm technology used at a commercial scale in the pig industry. The lower reproductive performance associated with the use of these sperm technologies is the reason for such limited use. Since optimal characteristics are required for successful application of frozen-thawed and sex-sorted boar spermatozoa, the present paper summarises the value of the current available methods for their functional assessment as well as the effects of these technologies on boar sperm functionality. In addition, strategies developed to reduce sperm damage and improve the yields of both sperm technologies in swine production are also reviewed with particular attention to the contributions of the authors.

Tolerance, safety and efficacy of Hedera helix extract in inflammatory bronchial diseases under clinical practice conditions: a prospective, open, multicentre postmarketing study in 9657 patients

In this postmarketing study 9657 patients (5181 children) with bronchitis (acute or chronic bronchial inflammatory disease) were treated with a syrup containing dried ivy leaf extract. After 7 days of therapy, 95% of the patients showed improvement or healing of their symptoms. The safety of the therapy was very good with an overall incidence of adverse events of 2.1% (mainly gastrointestinal disorders with 1.5%). In those patients who got concomitant medication as well, it could be shown that the additional application of antibiotics had no benefit respective to efficacy but did increase the relative risk for the occurrence of side effects by 26%. In conclusion, it is to say that the dried ivy leaf extract is effective and well tolerated in patients with bronchitis. In view of the large population considered, future analyses should approach specific issues concerning therapy by age group, concomitant therapy and baseline conditions.

Addressing the role of the extrusion pump-bearing pGRT1 plasmid in toluene biodegradation by Pseudomonas putida DOT-T1E under real case scenarios

The role of both the plasmid pGRT1 and the solvent extrusion pump ttgGHI during toluene biodegradation in Pseudomonas putida DOT-T1E cultures was investigated in a sterile suspended growth bioreactor operated as chemostat and inoculated independently with a wild type strain, a mutant lacking the pGRT1 plasmid (P. putida DOT-TIE-100), and a mutant with a modified pGRT1 plasmid lacking the genes encoding the ttgGHI solvent efflux pump (P. putida DOT-TIE-28). A similar process performance was recorded in all tested strains at 4 g tol m(-3) and dilution rates (D) of 0.1 h(-1). However, operation at 10 g tol m(-3) and D of 0.2 h(-1) revealed a much lower toluene EC (285 g m(-3) h(-1)) in P. putida DOT-T1E-100 cultures when compared to wild type and P. putida DOT-T1E-28 cultures (483-498 g m(-3) h(-1)), which suggests that other mechanisms rather than solvent extrusion by the ttgGHI efflux pump supported this superior process performance. Finally, the plasmid pGRT1 analysed exhibited a remarkable stability towards toluene harmful mediated effects, regardless the strain or toluene loading tested.

Role of phi cells and the endodermis under salt stress in Brassica oleracea

Phi cell layers were discovered in the 19th century in a small number of species, including members of the Brassicaceae family. A mechanical role was first suggested for this structure; however, this has never been demonstrated. The main objective of the present work was to analyse the ultrastructure of phi cells, their influence on ion movement from the cortex to the stele, and their contribution to salt stress tolerance in Brassica oleracea. Transmission electron microscopy and X-ray microanalysis studies were used to analyse the subcellular structure and distribution of ions in phi cells and the endodermis under salt stress. Ion movement was analysed using lanthanum as an apoplastic tracer. The ultrastructural results confirm that phi cells are specialized cells showing cell wall ingrowths in the inner tangential cell walls. X-ray microanalysis confirmed a build-up of sodium. Phi thickenings were lignified and lanthanum moved periplasmically at this level. To the best of our knowledge, this is the first study reporting the possible role of the phi cells as a barrier controlling the movement of ions from the cortex to the stele. Therefore, the phi cell layer and endodermis seem to be regulating ion transport in Brassica oleracea under salt stress.

Subtelomeric analysis of pediatric astrocytoma: subchromosomal instability is a distinctive feature of pleomorphic xanthoastrocytoma

Astrocytic neoplasms are genetically heterogeneous; however a low frequency of genomic changes has been found in juvenile pilocytic astrocytoma (PA) in molecular studies. Concerning pleomorphic xanthoastrocytomas (PXA), recent studies have given heterogeneous results for chromosomal alterations. We studied the subtelomeric regions of 19 primary astrocytoma tumors. Results were near normality for the PA group with relative scarcity of chromosomal imbalances, except for the duplication of 3pter in 4/15 and deletion of 21qter in 5/15 of them. In contrast, a specific profile was observed in the 4 PXA tumoral samples. This involved 3pter, 14qter and 19pter duplication and 4qter, 6qter, 9qter, 13cen, 17pter, 18qter and 21qter deletion. Our results indicate that the chromosomal and genetic aberrations in PXAs differed from those typically associated with the diffusely infiltrating astrocytic and oligodendroglial gliomas. These genetic differences would likely contribute to the more favorable behavior of PXAs and may be helpful for molecular differential diagnosis of pediatric cerebral tumors.

77 EFFECT OF SUGAR SUPPLEMENTATION ON THE CRYOPRESERVATION OF BOAR SPERMATOZOA

The optimization of cryopreservation extenders is an essential issue for the successful establishment of boar sperm cryobanks. The aim of the present study was to investigate the importance of sugar supplementation to the freezing extender and/or to the thawing diluents, and the interactions between these treatments on post-thaw survival of boar spermatozoa. Pooled sperm-rich fractions from 5 mature hybrid boars (5 ejaculates per boar) were divided into 7 aliquots, centrifuged at 2300g 3 min, and diluted to a final sperm concentration of approximately 1000 � 106 spermatozoa mL–1 with the freezing extender prior to freezing in 0.5-mL plastic straws; a standard freeze–thaw procedure with computer-controlled freezing equipment was utilized. All of the freezing extenders were based on Tris-citric acid buffer supplemented with 20% egg yolk and 0 mm (TC, no glucose), 0.05 mm, 2 mm, 4 mm, 10 mm, 50 mm, or 185 mm glucose (all media adjusted to 310 mOsm kg–1; pH 6.8). After thawing at 37�C/20 s, semen was immediately diluted 1:2 (v/v) with either TC (no glucose) or BTS (205 mm glucose, 20.39 mm NaCl, 5.4 mm KCl, 15 mm NaHCO3, and 3.35 mm EDTA). Post-thaw sperm motility (assessed with a computer-assisted semen analysis system) and plasma membrane and acrosome integrity (viability, assessed simultaneously by flow cytometry using triple fluorescent staining) were evaluated at 0, 30, and 150 min post-thaw and used to estimate the success of cryopreservation. Data were analyzed as a split plot design using a mixed model ANOVA including cryopreservation extender, thawing diluent, incubation time, and interactions as fixed effects and replicates as a random effect. The freezing extender did not have any significant effect on the percentage of motile or viable spermatozoa at either thawing or after 150 min (P > 0.05). There was a significant effect of incubation time (P < 0.0001) and thawing diluent (P < 0.0001) on motility and viability, with a significant interaction between them on motility (P = 0.018). Motility was similar (P > 0.05) at time 0 in both thawing diluents (mean � SEM: 49.4 � 3.7 v. 46.2 � 3.9% for BTS and TC, respectively), but decreased in Tris-diluted samples in a time-dependent manner (54.6 � 1.9 v. 42.5 � 2.6% at 30 min, and 40 � 3.4 v. 27.1 � 3.7% at 150 min). In contrast, viability was significantly higher (P < 0.05) in BTS-diluted samples at 0 (53.9 � 3.7 v. 49.7 � 3.8%), 30 (55 � 3.1 v. 47.7 � 3.31), and 150 min (51 � 4.2 v. 43.7 � 4.4%). These results indicate that, despite common beliefs, sugars are not necessary for cryopreservation but are beneficial for maintaining boar sperm metabolism for a longer time after thawing.

Phase I trial of gemcitabine (GEM) infused at fixed-dose rate (FDR) with high-dose docetaxel/melphalan/carboplatin (GEM-DMC) and autologous stem-cell transplant (ASCT)

17500

Background: More active ASCT regimens are needed. We combined GEM, which inhibits DNA damage repair, with the potent DMC regimen (BBMT 11:297–306,2005). GEM infusions at FDR of 10 mg/m2/min, targeting steady-state concentrations (Css) <20 μM, which in vitro do not saturate its intracellular activation to GEM-triphosphate (GEM-TP), result in greater activity but more myelotoxicity than its usual short infusions. Methods: Pts with advanced, refractory tumors and normal organ function were eligible. Study endpoints: to define the maximum tolerated duration (MTD) of GEM at FDR with ASCT, dose-limiting toxicity (DLT) and regimen-related toxicity (RRT) of GEM-DMC, and pharmacokinetics (PK) of high-dose GEM and docetaxel. Daily GEM FDR infusions (d-5 to d-2) were extended in sequential cohorts (total length: 9 to 20 hr), followed on d-5 by docetaxel (350 mg/m2), on d-4 to d-2 by melphalan (50 mg/m2/d) and carboplatin (333 mg/m2/d), and ASCT on d0. Results: 52 pts accrued (breast ca [N=31], Ewing's [5], germ-cell [4], lymphoma [4], Hodgkin's [3], sarcoma [5]), median age 40 (6–66), 3 median prior chemo regimens and 3 organs involved. GEM MTD: 5 hr/d x 4 (total 20 hr, 12 g/m2). Neutrophils engrafted on d+8 (6–10) and platelets on d+11 (8–33). There were 3 non-RRT deaths (1 aspiration, 2 catheter-related sepsis). At the MTD (N=25), enteritis (20% G3) was DLT; all other RRT were = G3 and reversible (28% stomatitis, 8% ileus, 8% rash). The response rate was 97% (60% complete). At median follow-up of 18 (7–27) months, 58% EFS (median 22 mo) and 85% OS rates (median not reached). All pts had GEM Css <20 μM. The infusion length correlated linearly with the AUC of GEM (r2= 0.65, p<10-5) but not with its clearance (r2=0.03) or t1/2 (r2= 0.02). GEM AUC was associated with G3 RRT (p<10-3). The AUCs of GEM and GEM-TP (/106 mononuclear cells) correlated on d-5 (r2=0.5, p=0.01), but not on d-2 (r2= 0.05) due to late GEM-TP accumulation. Docetaxel had 3–4 fold higher AUC and peak levels and similar clearance compared to its standard-dose population PK. Conclusions: GEM-DMC, markedly extending GEM infusions at FDR, is tolerable and highly active, without saturating the activation of GEM to GEM-TP. High-dose GEM and docetaxel show adequate linear PK.

No significant financial relationships to disclose.

Recipient Conditioning with Mesenchymal Stem Cells and Interleukin-10 Prolonged Cardiac Allograft Survival (102.1)

Mesenchymal Stem Cells (MSC) and viral interleukin-10 (vIL-10) have immunosuppressive properties. In this study, we tested their ability to prevent cardiac allograft rejection. Bone marrow derived MSC from Lewis rat were expanded ex vivo and transduced with rvIL-10-retrovirus. Autologous MSC or vIL-10 transduced MSC were injected (~25 x 106; i.v.) into irradiated (4 Gy) rat (RT1.Al). Six weeks later heterotopic heart (RT1.An) transplantation (Tx) was performed. MSC therapy prolonged (P&lt;0.05) cardiac allograft survival (14±1 days; n= 4) compared to untreated controls (7±1 days; n=4). Also, vIL-10-MSC treatment prolonged (P&lt;0.01) graft survival (38±1 days; n=6) compared to empty vector treated group (15±1 days; n=4). In vIL-10-MSC preconditioned animals that received donor bone marrow after heart Tx, graft survival was 22±2 days (n=8). Intragraft expression of co-stimulatory molecule (CD80) and cytokines (IL-2, IFN-γ) as determined by RT-PCR was lower (P&lt;0.03) in vIL-10-MSC treated grafts compared to untreated control grafts. Ex vivo expanded MSC were CD34−, CD45+(5 %), CD29+(90%), CD80 (0%), CD 86 (8%), CD90+(93%), MHC Class I+(23–57%), and MHC Class II- as determined by FACS. Both vIL-10 and empty vector engineered MSC expressed CD29 (&gt;95%) but not other molecules. The vIL-10-MSC produced ~ 6 ng/ml of vIL-10 ex vivo. vIL-10-MSC addition in MLR cultures inhibited lymphoproliferative response (P&lt;0.05). TGF-β expression in stimulated (TNF-α or IL1-β) and unstimulated MSC was 46 – 65% of β-actin. IL-2, IL-4, IL-10, IFN-γ, and TNF-α expression was negligible in MSC (0–7% of β-actin). VEGF and HGF mRNA expression in MSC was 58% and 5% of β-actin, respectively. TgGFP+ MSC were demonstrable in various tissues for &gt;28 days. Both MSC and vIL-10 conditioning to promote allograft survival seems promising.

Characterization of A7r5 cell line transfected in a stable form by hSSAO/VAP-1 gene (A7r5 hSSAO/VAP-1 cell line)

A smooth muscle cell line (A7r5) was stably transfected with the human SSAO/VAP-1 (hSSAO/VAP-1) gene. The expressed protein was located solely in the membrane fraction of the cell. However it was also shown to be released into the cell-culture medium. Both the membrane-bound and released, soluble, forms had SSAO enzyme activity. Although MAO-A is present in wild-type A7r5 cells, it was undetectable in the transfected cells.

119 OXIDATIVE STRESS DURING THE CRYOPRESERVATION OF BOAR SPERMATOZOA

The cryopreservation procedure causes dramatic changes in boar sperm survival but it is yet unclear where and how the process affects spermatozoa. Cryopreservation damage appears partly associated with oxidative stress and reactive oxygen species (ROS) generation. The present study evaluates the effect that various steps of a conventional cycle of cryopreservation have on the intracellular production of ROS by boar spermatozoa (spz). Sperm-rich fractions collected from 2 mature boars (3 ejaculates per boar), cooled to 17�C, and kept for 16 h were cryopreserved following a standard freeze–thaw process with 0.5-mL plastic straws. The production of ROS was recorded in 5 steps of the cryopreservation process. These steps were as follows: step (1) after collection, when the fresh semen was extended (1:1, v/v) in Beltsville Thawing Solution (BTS, 205 mM glucose, 20.39 mM NaCl, 5.4 mM KCl, 15.01 mM NaHCO3, and 3.35 mM EDTA); step (2) after cooling and storage for 16 h at 17�C; step (3) after centrifugation (2400g for 3 min) and re-extension of the pellet with lactose-egg yolk extender; step (4) at 5�C, after the addition of lactose-egg yolk-glycerol-Equex Stem Paste to 1 � 109 spz mL; and step (5) immediately after thawing at 37�C for 20 s. For the ROS measurement, all samples were re-extended in BTS (3 � 106 spz mL-1) and incubated without (basal ROS level) or with ROS inducers (1 mM tert-butyl hydroperoxide) for 120 min at 37�C and 5% CO2. Cells were simultaneously stained with 22,72-dichlorodihydrofluorescein diacetate (1 �M) to estimate the production of ROS, and propidium iodide (12 �M) to exclude dead sperm from the analysis. Samples were evaluated at 30 min and 120 min by flow cytometry (Coulter Epics XL; Coulter Corporation, Miami, FL, USA); further analyses of the parameters were done by FCSExpress software (DeNovo Software, Thornhill, Ontario, Canada). ROS production was expressed as the mean of the green intensity fluorescence units of the viable sperm population. Data from 3 replicates were analyzed as a split plot design using a mixed model ANOVA including cryopreservation step, boar, and incubation time as fixed effects and replicate as random effect. Results indicated that the basal ROS formation remained relatively low and constant (P = 0.95) through the cryopreservation process, without differences between boars (P = 0.559), although with a significant increase after 120 min of incubation (P &lt; 0.001). However, the exposure to tert-butyl hydroperoxide significantly increased the intracellular ROS formation in all of the steps (P &lt; 0.001), showing significant differences between them, and being especially raised at steps 3 and 4. In conclusion, the present study confirms that the basal intracellular ROS production during cryopreservation of boar sperm is low. Nevertheless, the susceptibility of those spermatozoa to external stresses vary through the cryopreservation process, especially after centrifugation and later extension at 17�C and after the slow cooling at 5�C. This work was supported by CICYT (AGF2005-00706), Madrid, Spain

129 IMPROVEMENT OF BOAR SPERM CRYOSURVIVAL BY THE OPTIMIZATION OF CRYOPRESERVATION CONDITIONS

One of the most important limiting factors for the efficient commercial application of frozen–thawed semen on pig artificial insemination programs is the significant and consistent inter-boar variability in sperm cryosurvival. The objective of the present study was to evaluate the effectiveness of different cryopreservation conditions (CCs) for freezing and thawing boar spermatozoa, and to determine their suitability for individual boars, with particular reference to those that showed an intrinsic poor sperm cryosurvival. Using a split-ejaculate technique, single ejaculates from 53 boars were suspended in lactose-egg yolk extender containing 2 or 3% final glycerol concentration, packaged in 0.5-mL straws, cooled at rates of 10, 40, or 60�C min-1 using a programmable cell freezer, and stored in liquid nitrogen; the frozen samples were warmed at ≈1200�C min-1 (37�C water bath for 20 s) or ≈1800�C min-1 (70�C for 8 s). The cryopreservation condition including 2% glycerol, 40�C min-1 of cooling, and ≈1200�C min-1 of warming was considered as the control. Frozen–thawed sperm were evaluated at 30 and 150 min post-thawing for sperm motility (CASA system), plasma membrane integrity (SYBR-14 and propidium iodide), and acrosome membrane integrity (FITC-peanut agglutinin and propidium iodide). Data were analyzed using 2 different ANOVA mixed models. Whereas cooling rate had no influence (P ≥ 0.05), glycerol concentration and warming rate, both independently, affected (P ≤ 0.05) all post-thawing sperm assessments. No interaction (P ≥ 0.05) among effects was detected for any of the sperm parameters assessed. Evaluating the combined effect of glycerol concentration and warming rate, the highest post-thaw sperm quality was achieved from the semen samples frozen with 3% of glycerol and thawed at ≈1800�C min-1. Significant differences (P ≤ 0.05) among ejaculates (boars) to support the different CCs were shown in all post-thaw sperm assessments. Three different (P ≤ 0.05) ejaculate (boar) populations, defined by PATN analysis (PATN software package, CSIRO, Canberra, Australia), were identified according to post-thaw sperm assessments in semen samples frozen and thawed using control CC (populations so-called 'good', 'moderate', and 'bad' sperm freezers). Different (P ≤ 0.05) susceptibility in the tolerance of spermatozoa to support the different CCs was found among the ejaculate populations. Whereas spermatozoa from ejaculates considered as 'good' freezers are relatively unaffected (P ≥ 0.05), those from 'moderate' and, mainly, 'bad' freezers are very sensitive (P ≤ 0.05) to the modifications in the CCs. In conclusion, slight modifications in the CCs — glycerol concentration and warming rate for thawing — can improve the sperm cryosurvival of some ejaculates (boars), the improvement being particularly larger in those ejaculates (boars) classified as ' bad' sperm freezers. This work was supported by CICYT (AGF2005-00760), Madrid, Spain.

130 EFFECTIVENESS OF BUTYLATED HYDROXYTOLUENE AS EGG YOLK SUBSTITUTE FOR CRYOPRESERVATION OF BOAR SPERMATOZOA

Butylated hydroxytoluene (BHT) has proven to be efficient as a supplement for cryopreservation boar spermatozoa (Roca et al. 2004 J. Androl. 25, 397–405). Moreover, it has been successfully used as an egg yolk substitute to cryopreserve goat spermatozoa (Khalifa and El-Saidy 2006 Anim. Reprod. Sci. 93, 303–315). The objective of this study was to evaluate the effectiveness of BHT as an egg yolk substitute for freezing boar spermatozoa. Nine sperm-rich ejaculate fractions were collected from 3 boars (3 ejaculates per boar) using the gloved-hand method. After centrifugation (2400g for 3 min), the sperm pellet of each ejaculate was split into 5 aliquots. The aliquots were diluted (to a final concentration of 1 � 109 sperm/mL) in a Tris-citric-glucose extender with 3% glycerol and supplemented with 20% egg yolk (positive control, PC aliquot) or BHT at the final concentrations of 0 (negative control, NC aliquot), 0.2, 0.4, and 0.8 mM. Diluted semen samples were dispensed into 0.5-mL straws, and frozen in a programmable cell freezer at 20�C min. Thawing was carried out in a water bath at 70�C for 8 s. Post-thaw sperm survival was assessed according to total sperm motility (TSM, %) using a CASA system (SCA�; Microptic, Barcelona, Spain), and plasma membrane integrity (PMI, %) and acrosome membrane integrity (AMI, %) using a flow cytometric procedure (SYBR-14/propidioum iodide/FITC-phycoerythrin), at 30 and 150 min post-thawing in diluted Beltsville thawing solution with spermatozoa held in a waterbath at 37�C (3 straws per ejaculate). Data were analyzed using a ANOVA mixed model including the main effects of aliquot, boar, post-thaw assessment time, and their interactions, with ejaculate and straw as random effects. All main effects had significant influence (P ≤ 0.01) in all post-thaw sperm assessments. However, no interactions (P ≥ 0.05) among main effects were shown. Data were combined for the 2 post-thaw assessment times. The best (P ≤ 0.05) post-thaw sperm quality (mean � SEM) was achieved in PC aliquots (47.11 � 3.10, 58.98 � 2.78, and 51.35 � 3.42 for TSM, PMI, and AMI, respectively). In NC aliquots, the percentage of TSM, PMI, and AMI were always below 1% (P ≤ 0.05). BHT has a beneficial (P ≤ 0.05) effect on post-thaw sperm assessments, and no differences (P ≥ 0.05) among concentrations were shown. The mean post-thaw sperm quality in the BHT aliquots was 8.50 � 0.80, 20.29 � 0.53, and 16.03 � 0.55 for TSM, PMI, and AMI, respectively. On the basis of these data, we can conclude that BHT has a protective effect for boar spermatozoa during the cryopreservation process. However, BHT alone is insufficient to replace the protective effect of egg yolk. This work was supported by CICYT (AGF2005-00706), Madrid, Spain.

The Na+/H+ exchange inhibitor cariporide is washed out of the myocardium by crystalloid cardioplegia

BACKGROUND

Inhibition of the Na (+)/H (+) exchanger (NHE) is cardioprotective, but dosage and timing of NHE-inhibitors are critical for their efficacy. We studied the effect of a new dosing regime of the NHE-inhibitor cariporide on myocardial function and damage after cardioplegic arrest (CPA) and determined its myocardial and serum concentrations.

METHODS

3 pigs received a bolus of 180 mg cariporide intravenously (i. v.) and were sacrificed shortly thereafter to allow measurement of the myocardial concentrations of cariporide. Subsequently, 10 pigs were randomized to receive either i. v. cariporide (bolus followed by an infusion of 40 mg/h) or placebo. Cardiopulmonary bypass was initiated, and the heart was arrested for 60 minutes by infusion of St. Thomas Hospital solution. Left ventricular (LV) function was studied using microsonometry. Myocardial damage was assessed by troponin T. Serum concentrations of cariporide were measured throughout the study, and myocardial concentrations were measured before the end of CPA and 180 minutes thereafter.

RESULTS

Cariporide was present in all myocardial specimens (median: 1.4 ng/mg) studied previously. In the main study, LV function or myocardial damage did not differ significantly between the groups at any time point. Stable serum cariporide concentrations were achieved (3.4 +/- 0.5 microg/ml). Cariporide was detectable in only one of the myocardial biopsies obtained before the end of CPA, but 180 minutes thereafter, the myocardial cariporide concentration was 2.5 +/- 0.3 ng/mg.

CONCLUSION

We observed no effect of i. v. cariporide on LV function or myocardial damage after cardioplegic arrest. Our data suggest that cariporide is washed out of the myocardium by repeated application of crystalloid cardioplegia. Thus, the mode of delivery also appears to be critical for cardioprotection with NHE-inhibitors.

Effect of heat and pressure processing on DNA fragmentation and implications for the detection of meat using a real-time polymerase chain reaction

The design of real-time polymerase chain reaction (PCR) assays for the detection of meat in processed products has focused on using small amplicons, often to the detriment of specificity. However, the relationship between amplification rates and the amplicon size for processed meat products has yet to be determined. To investigate this relationship, real-time PCR assays were designed to give a series of amplicons of increasing size. These assays were then used to assess amplification rates, in relation to amplicon size, in processed meat matrices. Although the most sensitive assays were those that used the smallest amplicons, amplification was still observed using amplicons of 351 base pairs for highly processed samples. It was found, therefore, that although in general, amplicons should be as small as possible, larger amplicons give efficient amplification and that small amplicons should not be chosen if they compromise assay specificity.

Eruption cyst treated with a laser powered hydrokinetic system

Eruption cysts are benign cysts that appear on the mucosa of a tooth shortly before its eruption. The majority disappear on their own. If they hurt, bleed or are infected they may require surgical treatment to expose the tooth and drain the content. Here we present a clinical case of a six-year-old child with an eruption cyst on the permanent maxillary central left incisor, which was handled using treatment with an Er,Cr-YSGG laser. It did not require suture, there was no haemorrhage, swelling, infection or postoperative pain. The treatment of eruption cysts with this technique facilitates obtaining the cooperation of pediatric patients and makes behavior management by the pediatric dentist easier.

Particle size distributions and concentrations of airborne endotoxin using novel collection methods in homes during the winter and summer seasons

A comparison study of novel collection methods for airborne bacteria and endotoxin was performed in an environmentally controlled chamber and in pilot-field studies. Airborne particulate matter was collected in swirling liquid impingers, air-monitoring filter cassettes, and with a micro-orifice uniform deposit impactor (MOUDI) to evaluate aerodynamic particle size distributions. Environmentally controlled chamber studies showed that impingers and MOUDI recovered significantly more airborne bacteria than filter cassettes, whereas collection methods for airborne endotoxin were not significantly different. In addition, total airborne bacteria and endotoxin concentrations were measured indoors and outdoors at three homes in Boulder, CO during winter and summer seasons. Indoor concentrations collected with the three different samplers were significantly different for airborne endotoxin, but not for airborne bacteria. Total airborne bacteria indoors and outdoors significantly varied with seasons. Outdoor airborne endotoxin significantly varied with season; no seasonal variation was seen for indoor airborne endotoxin. Indoor and outdoor levels were not significantly different for both airborne bacteria and endotoxin. The largest proportion of endotoxin was associated with airborne particulate matter <1 microm.

PRACTICAL IMPLICATIONS

This study compared sampling methods for airborne endotoxin, a potent and nonspecific immune system stimulant which can induce negative health responses. The data from this study showed that swirling liquid impingers and the micro-orifice uniform deposit impactor (MOUDI) recovered significantly more airborne endotoxin than the more widely adapted method of collecting airborne endotoxin on membrane filters, when collection methods were applied in realistic settings (homes). The MOUDI measured the particle size distribution of airborne endotoxin, which can be useful for determining endotoxin respiratory toxicity and its health effects.

Donors older than 70 years in liver transplantation

INTRODUCTION

Expansion of donor criteria has become necessary with the increasing number of liver transplantation candidates, as aged donors who have been considered to yield marginal organs.

METHODS

Our database of 477 liver transplants (OLT) included 55 cases performed from donors at least 70 years old vs 422 with younger donors. We analyzed pretransplantation donor and recipient characteristics as well as evolution of the recipients.

RESULTS

The old donor group showed significantly lower ALT (23 +/- 17 vs 48.9 +/- 67; P = .0001) and LDH (444 +/- 285 vs 570 +/- 329; P = .01). There was a trend toward fewer hypotensive events in the aged donor group (27.2% vs 40.5%; P = .07). No steatosis (>10%) was accepted in the old donor group. Cold ischemia time was statistically shorter for the aged donors (297 +/- 90 minutes vs 346 +/- 139 minutes; P = .03). With these selected donors, the results were not different for primary nonfunction, arterial and biliary complications, hospitalization, acute reoperation or acute retransplantation, and hospital mortality when donors > or =70 years old were compared to younger donors. Functional cholestasis, neither related to rejection nor to biliary complications, was seen more frequently in old donor recipients (40% vs 22%; P = .03). No differences in 1, and 3 year survivals were observed between recipients of donors over 70 years old and these of younger organs: 93.8% and 90.6% vs 90.7% and 82.8%, respectively.

CONCLUSION

When using selected donors > or =70 years old the outcomes were comparable to those obtained with younger donors. Strict selection is necessary to achieve good long-term survival.