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https://www.readbyqxmd.com/read/29343892/first-two-bilateral-hand-transplantations-in-india-part-4-immediate-post-operative-care-immunosuppression-protocol-and-monitoring
#1
Subramania Iyer, Mohit Sharma, P Kishore, Jimmy Mathew, R Janarthanan, Raghuveer Reddy, Abhijeet Wakure, Sundeep Vijayaraghavan, S M Chetan Mali, Visakh Varma, Ashish Chaudhari, Swapnil Dhake, Akshay Omkumar, George Kurian, Rajesh Nair, Anil Mathew, Zachariah Paul, Malini Eapen, Lalitha Biswas
Introduction: Being able to counter immune-mediated rejection has for decades been the single largest obstacle for the progress of vascular composite allotransplantation (VCA). The human immune system performs the key role of differentiating the 'self ' from the 'non-self '. This, although is quintessential to eliminate or resist infections, also resists the acceptance of an allograft which it promptly recognises as 'non-self'. Materials and Methods: Pre-operative evaluation of the recipient evaluation included immunological assessment in the form of panel reactive antibodies (PRA), human leucocyte antigen (HLA) typing, donor-specific antibody detection assays (DSA) and complement-dependent cytotoxicity assays (CDC)...
May 2017: Indian Journal of Plastic Surgery: Official Publication of the Association of Plastic Surgeons of India
https://www.readbyqxmd.com/read/29343026/-applied-research-of-quadri-low-combined-with-automatic-tube-current-modulation-and-iterative-model-reconstruction-technology-in-head-and-neck-ct-angiography
#2
W Cai, C H Hu, X M Wang, S Hu, J Bao, J P Gong, G H Fan, W Zhang, D Shi, M H Qian
Objective: To investigate the feasibility of low tube voltage, low contrast medium concentration, injection rate and volume (quadri-low) combined with automatic tube current modulation (ATCM) and iterative model reconstruction (IMR) technology in head and neck CT angiography (CTA). Methods: A total of 70 patients whose body mass index (BMI)<25 kg/m(2) underwent head and neck CTA and digital subtraction angiography (DSA) from January to July 2017 were enrolled in this prospective study. According to random number table, patients were divided into two groups: group A (n=35) was scanned according to the protocol of 120 kV, 150 mAs, 50 ml and 5 ml/s iopromide (370 mg/ml) and filtered back projection (FBP) reconstruction; group B (n=35) was scanned with 80 kV, ATCM with mean tube current of 100 mAs, 30 ml and 3 ml/s iohexol (300 mg/ml) and IMR; the other parameters kept consistent between the two groups...
January 2, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29338437/elderly-population-have-a-decreased-aneurysmal-subarachnoid-hemorrhage-incidence-rate-than-middle-aged-population-a-descriptive-analysis-of-8-144-cases-in-mainland-china
#3
Yì Xiáng J Wáng, Lihong Zhang, Lin Zhao, Jian He, Xian-Jun Zeng, Heng Liu, Yun-Jun Yang, Shang-Wei Ding, Zhong-Fei Xu, Yong-Ming He, Lin Yang, Lan Sun, Ke-Jie Mu, Bai-Song Wang, Xiao-Hong Xu, Zhong-You Ji, Jian-Hua Liu, Jin-Zhou Fang, Rui Hou, Feng Fan, Guang-Ming Peng, Yue-Qi Zhu, Sheng-Hong Ju, Wai S Poon
PURPOSE: Rupture of an intracranial aneurysm is a life-threatening acute cerebrovascular event. The purpose of this study was to investigate whether aneurysmal subarachnoid haemorrhage (SAH) incidence rate is higher or lower in elderly population than in middle aged population. MATERIALS AND METHODS: Aneurysmal SAH cases were collected retrospectively from the archives of 21 hospitals in Mainland China. All the cases were collected from September 2016 and backward consecutively for a period of time up to 8 years...
January 17, 2018: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/29337230/cholesterol-modulates-the-liposome-membrane-fluidity-and-permeability-for-a-hydrophilic-molecule
#4
Samar Kaddah, Nathalie Khreich, Fouad Kaddah, Catherine Charcosset, Hélène Greige-Gerges
The effect of cholesterol (CHOL) content on the permeability and fluidity of dipalmitoylphosphatidylcholine (DPPC) liposome membrane was investigated. Liposomes encapsulating sulforhodamine B (SRB), a fluorescent dye, were prepared by reverse phase evaporation technique (REV) at various DPPC:CHOL molar ratios (from 100:0 to 100:100). The release kinetics of SRB was studied during 48 h in buffer (pH 7.4) containing NaCl at 37 °C. The DPPC:CHOL formulations were also characterized for their size, polydispersity index and morphology...
January 11, 2018: Food and Chemical Toxicology
https://www.readbyqxmd.com/read/29336366/potential-value-of-datura-stramonium-agglutinin-recognized-glycopatterns-in-urinary-protein-on-differential-diagnosis-of-diabetic-nephropathy-and-nondiabetic-renal-disease
#5
Xiao-Li Yang, Han-Jie Yu, Han-Yu Zhu, Ying Zheng, Qiu-Xia Han, Guang-Yan Cai, Xiang-Mei Chen
BACKGROUND: Diabetic nephropathy (DN) is the most common and serious microvascular complication of diabetes. To date, the gold standard for identifying DN and nondiabetic renal disease (NDRD) is a renal biopsy; however, there is currently no reliable diagnostic marker to identify DN and NDRD in a noninvasive manner. This study aimed to investigate the different glycopatterns in urine specimens of DN patients and NDRD patients for a differential diagnosis. METHODS: In total, 19 DN patients and 18 NDRD patients who underwent renal biopsies between March 2015 and March 2016 at the Chinese People's Liberation Army General Hospital were enrolled in this study...
January 20, 2018: Chinese Medical Journal
https://www.readbyqxmd.com/read/29335625/the-european-society-for-blood-and-marrow-transplantation-ebmt-consensus-guidelines-for-the-detection-and-treatment-of-donor-specific-anti-hla-antibodies-dsa-in-haploidentical-hematopoietic-cell-transplantation
#6
REVIEW
Stefan O Ciurea, Kai Cao, Marcelo Fernadez-Vina, Piyanuch Kongtim, Monzr Al Malki, Ephraim Fuchs, Leo Luznik, Xiao-Jun Huang, Fabio Ciceri, Franco Locatelli, Franco Aversa, Luca Castagna, Andrea Bacigalupo, Massimo Martelli, Didier Blaise, Rupert Handgretinger, Denis-Claude Roy, Paul O'Donnell, Asad Bashey, Hillard M Lazarus, Karen Ballen, Bipin N Savani, Mohamad Mohty, Arnon Nagler
Haploidentical donors are now increasingly considered for transplantation in the absence of HLA-matched donors or when an urgent transplant is needed. Donor-specific anti-HLA antibodies (DSA) have been recently recognized as an important barrier against successful engraftment of donor cells, which can affect transplant survival. DSA appear more prevalent in this type of transplant due to higher likelihood of alloimmunization of multiparous females against offspring's HLA antigens, and the degree of mismatch...
January 15, 2018: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/29335395/predictors-of-recanalization-after-endovascular-treatment-of-posterior-circulation-aneurysms
#7
Karol Wiśniewski, Bartłomiej Tomasik, Ernest J Bobeff, Ludomir Stefańczyk, Dariusz J Jaskólski
INTRODUCTION: Posterior circulation aneurysms account for approximately 30% of all intracranial aneurysms, and their rupture often causes aneurysmal subarachnoid hemorrhage (aSAH). Because surgical treatment of posterior circulation aneurysms is difficult, endovascular treatment is commonly indicated. However, simple coil embolization is associated with a high rate of recanalization. Our goal was to investigate morphometric aneurysmal features assessed on pre-embolization computed tomography angiography (CTA) as predictors of recanalization in patients with posterior circulation aneurysms...
December 30, 2017: Polski Przeglad Chirurgiczny
https://www.readbyqxmd.com/read/29325938/aortic-coarctation-complicated-with-intracranial-aneurysm-a-case-report-and-literature-review
#8
Hui Zhang, Lei Feng
BACKGROUND: Cases of aortic coarctation complicated with rupture and hemorrhage of intracranial aneurysms are not common in clinical practice. This paper reports a case of middle-aged female patient presented with acute severe headache. CASE DESCRIPTION: Head CT demonstrated her extensive subarachnoid hemorrhage. DSA demonstrated coarctation and occlusion of proximal thoracic aorta and occlusion of terminal aortic arch. Aortic-intracranial CTA confirmed that the patient had aortic coarctation complicated with anterior communicating artery aneurysm...
January 8, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29323631/endovascular-treatment-with-tirofiban-during-the-acute-stage-of-cervical-spinal-cord-infarction-due-to-vertebral-artery-dissection
#9
Yuanling Wu, Wenxian Li, Xiaomei Xie, Zhen Jing, Weibiao Lu, Li'an Huang
CONTEXT: Cervical spinal cord infarction is a rare and severe complication of vertebral artery dissection (VAD). We report a case of VAD in an acute stage followed by cervical spinal cord infarction that was treated using direct endovascular tirofiban infusion via digital subtraction angiography (DSA) monitoring. FINDINGS: A 48-year-old man presented with vertigo, neck pain, numbness and weakness in four limbs with subsequent cardiac and respiratory arrest. Neurological examination revealed hypoesthesia below the neck with grade one myodynamia on the right side of the limbs and zero on the left side...
January 11, 2018: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/29319602/an-interactional-profile-to-assist-the-differential-diagnosis-of-neurodegenerative-and-functional-memory-disorders
#10
Markus Reuber, Daniel J Blackburn, Chris Elsey, Sarah Wakefield, Kerry A Ardern, Kirsty Harkness, Annalena Venneri, Danielle Jones, Chloe Shaw, Paul Drew
OBJECTIVE: Specialist services for dementia are seeing an increasing number of patients. We investigated whether interactional and linguistic features in the communication behavior of patients with memory problems could help distinguish between those with problems secondary to neurological disorders (ND) and those with functional memory disorder (FMD). METHODS: In part 1 of this study, a diagnostic scoring aid (DSA) was developed encouraging linguists to provide quantitative ratings for 14 interactional features...
January 9, 2018: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29317301/antibody-mediated-rejection-due-to-de-novo-dsa-causing-venous-thrombosis-of-pancreas-allograft-a-case-report
#11
Kunal Yadav, Adrian Cotterell, Pamela Kimball, Laura Warmke, Melissa Contos, Gaurav Gupta, Anne King, Dhiren Kumar, Marlon Levy
This case describes a 34year old female who underwent an HLA identical living donor kidney transplant with a positive flow cytometric crossmatch (FCXM), but without any donor specific antibody (DSA). Tests to detect non-HLA antibody and autoantibody were negative. Allograft functioned well without rejection. She later received a pancreas allograft, again with a weakly positive FCXM, without DSA. After good initial graft function, she developed hyperglycemia six weeks posttransplant. Cross-sectional imaging demonstrated non-enhancing pancreas allograft with new vein thrombosis...
January 6, 2018: Transplant Immunology
https://www.readbyqxmd.com/read/29316203/offer-acceptance-practices-and-geographic-variability-in-allocation-meld-at-transplant
#12
Andrew Wey, Joshua Pyke, David P Schladt, Sommer E Gentry, Tim Weaver, Nicholas Salkowski, Bertram L Kasiske, Ajay K Israni, Jon J Snyder
Offer acceptance practices may cause geographic variability in allocation model for end-stage liver disease score (aMELD) at transplant and could magnify the effect of donor supply and demand on aMELD variability. To evaluate these issues, offer acceptance practices of liver transplant programs and donation service areas (DSAs) were estimated using offers of livers from donors recovered between January 1, 2016, and December 31, 2016. Offer acceptance practices were compared with liver yield, local placement of transplanted livers, donor supply and demand, and aMELD at transplant...
January 9, 2018: Liver Transplantation
https://www.readbyqxmd.com/read/29312863/human-leukocyte-antigen-typing-and-crossmatch-a-comprehensive-review
#13
REVIEW
Mohammed Mahdi Althaf, Mohsen El Kossi, Jon Kim Jin, Ajay Sharma, Ahmed Mostafa Halawa
Renal transplantation remains the best option for patients suffering from end stage renal disease (ESRD). Given the worldwide shortage of organs and growing population of patients with ESRD, those waitlisted for a transplant is ever expanding. Contemporary crossmatch methods and human leukocyte antigen (HLA) typing play a pivotal role in improving organ allocation and afford better matches to recipients. Understanding crossmatch as well as HLA typing for renal transplantation and applying it in clinical practice is the key step to achieve a successful outcome...
December 24, 2017: World Journal of Transplantation
https://www.readbyqxmd.com/read/29309977/usefulness-and-stability-of-intraoperative-digital-subtraction-angiography-using-the-trans-radial-route-in-arteriovenous-malformation-surgery
#14
Won Ki Yoon, Hoon Kim, Young Woo Kim, Seong Rim Kim, Ik Seong Park
OBJECTIVE: Digital subtraction angiography (DSA) is the gold standard to confirm complete removal of an AVM nidus. However, the trans-femoral approach requires specialized instrumentation and is cumbersome and difficult to perform with the patient in the prone or decubitus position. The authors report the use of intraoperative DSA (iDSA) with the trans-radial approach and examine its usefulness and safety. MATERIAL AND METHODS: We retrospectively reviewed clinical features, radiologic images, surgical findings, and iDSA findings of AVM patients who underwent nidus removal surgery...
January 5, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29309735/diagnostic-accuracy-of-simulated-low-dose-perfusion-ct-to-detect-cerebral-perfusion-impairment-after-aneurysmal-subarachnoid-hemorrhage-a-retrospective-analysis
#15
Saif Afat, Carolin Brockmann, Omid Nikoubashman, Marguerite Müller, Kolja M Thierfelder, Marc A Brockmann, Konstantin Nikolaou, Martin Wiesmann, Jong Hyo Kim, Ahmed E Othman
Purpose To evaluate diagnostic accuracy of low-dose volume perfusion (VP) computed tomography (CT) compared with original VP CT regarding the detection of cerebral perfusion impairment after aneurysmal subarachnoid hemorrhage. Materials and Methods In this retrospective study, 85 patients (mean age, 59.6 years; 62 women) with aneurysmal subarachnoid hemorrhage and who were suspected of having cerebral vasospasm at unenhanced CT and VP CT (tube voltage, 80 kVp; tube current-time product, 180 mAs) were included, 37 of whom underwent digital subtraction angiography (DSA) within 6 hours...
January 8, 2018: Radiology
https://www.readbyqxmd.com/read/29306766/clinical-management-of-traumatic-superior-orbital-fissure-and-orbital-apex-syndromes
#16
Hai Jin, Shun Gong, Kaiwei Han, Junyu Wang, Liquan Lv, Yan Dong, Danfeng Zhang, Lijun Hou
OBJECTIVES: Both traumatic orbital apex syndrome (OAS) and traumatic superior orbital fissure syndrome (SFOS) are rare conditions after craniofacial injury. Few types of researches investigate the difference in clinical characteristics and outcome between them. We describe clinical features and cranial nerves functional recovery of traumatic OAS or SOFS and to discuss surgical decompression of these patients. PATIENTS AND METHODS: A retrospective study was performed of 15 patients diagnosed with traumatic OAS and 39 patients with traumatic SOFS from July 2010 to July 2017 in our hospital...
December 30, 2017: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29302189/the-effect-of-demographic-features-on-aortic-arch-anatomy-and-its-role-in-the-etiology-of-cerebrovascular-disease
#17
Yılmaz İnanç, Yusuf İnanç, Halil Ay
Purpose: The aim of this study was to retrospectively evaluate the distribution of aortic arches, the relationship with demographic characteristics, and the results of carotid and vertebral artery stenting procedures in patients diagnosed with cerebrovascular disease through the intra-arterial digital subtraction angiography (DSA) technique. Methods: A retrospective examination was performed on 288 patients diagnosed with cerebrovascular disease, who underwent DSA in the Department of Neurology of Gaziantep University Medical Faculty and Kahramanmaraş¸ Sütçü Imam University Medical Faculty...
2018: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/29300231/long-term-nonhuman-primate-renal-allograft-survival-without-ongoing-immunosuppression-in-recipients-of-delayed-donor-bone-marrow-transplantation
#18
Kiyohiko Hotta, Tetsu Oura, Abbas Dehnadi, Svjetlan Boskovic, Masatoshi Matsunami, Ivy Rosales, Rex N Smith, Robert B Colvin, A Benedict Cosimi, Tatsuo Kawai
BACKGROUND: We have previously reported successful induction of renal allograft tolerance in nonhuman primates (NHP) following an initial posttransplant period of conventional immunosuppression (delayed tolerance) using a nonmyeloablative conditioning regimen consisting of anti-CD154 and anti-CD8 mAbs plus equine ATG (Atgam) and donor bone marrow transplantation (DBMT). Since these reagents are not currently clinically available, the protocol was revised to be applicable to human recipients of deceased donor allografts...
January 4, 2018: Transplantation
https://www.readbyqxmd.com/read/29300203/evolving-criteria-for-the-diagnosis-of-antibody-mediated-rejection-in-renal-allografts
#19
Mark Haas
PURPOSE OF REVIEW: To review changes in the Banff schema for antibody-mediated renal allograft rejection over the past decade, including key revisions agreed upon during and immediately subsequent to the 2017 Banff Conference on Allograft Pathology. RECENT FINDINGS: The original Banff schema for diagnosis of acute and chronic active antibody-mediated rejection (ABMR) in renal allografts was formulated at the 2001 and 2007 Banff Conferences, and required histologic (primarily microvascular inflammation and transplant glomerulopathy), immunohistologic (C4d in peritubular capillaries), and serologic [circulating donor-specific antibodies (DSA)] evidence for a definitive diagnosis of ABMR...
January 2, 2018: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29298238/desensitization-and-prevention-of-antibody-mediated-rejection-in-vascularized-composite-allotransplantation-by-syngeneic-hematopoietic-stem-cell-transplantation
#20
Howard D Wang, Samuel A J Fidder, Devin T Miller, Georg J Furtmüller, Ali Reza Ahmadi, Felix Nägele, Joseph Lopez, Amy Quan, Joshua Budihardjo, Denver M Lough, Burcu Akpinarli, Joanna Etra, Dalibor Vasilic, Giorgio Raimondi, W P Andrew Lee, Robert A Montgomery, Zhaoli Sun, Gerald Brandacher
BACKGROUND: Candidates for vascularized composite allotransplantation (VCA) are frequently sensitized, putting them at risk for antibody-mediated rejection (AMR). Current desensitization strategies are imperfect and require a living-donor setting. Here we investigated the impact of sensitization on and the efficacy of a desensitization protocol utilizing syngeneic hematopoietic stem cell transplantation (HSCT) to prevent AMR in VCA. METHODS: Skin transplants from Dark Agouti (DA) to Lewis rats were performed for sensitization...
January 2, 2018: Transplantation
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