Objectives:
Hypertensive living donors are potential candidates to expand the kidney donor pool. However, the impact of donor hypertension on graft survival and function remains to be clarified.
...Methods:
We analyzed 3907 kidney transplant recipients registered in a nationwide prospective cohort from 2014 to 2018. Patients were divided by donor types and the presence of donor hypertension. The primary and secondary outcome was the occurrence of death-censored graft failure and renal allograft function, respectively.
Results:
The prevalence of hypertension was 9.4% (258/2740) and 19.9% (232/1167) in living and deceased donors, respectively. During a median follow-up of 21.8 months, death-censored graft survival rate was significantly worse in recipients of hypertensive living donors than in those of normotensive living donors (
P
= 0.008). In multivariable analysis, recipients of hypertensive living donors had a significantly increased risk of graft loss (adjusted hazard ratio 2.91;
P
= 0.009). The risk of allograft loss was not different between recipients of hypertensive living and normotensive deceased donors. Propensity score-matched analyses had consistent worse graft survival rate in recipients of hypertensive living donors compared to those of normotensive living donors (
P
= 0.027), while it was not different between recipients of hypertensive living and normotensive deceased donors. Hypertension in living donors had a significant negative impact on one-year graft function (adjusted unstandardized
β
−3.64;
P
= 0.011).
Conclusions:
Hypertensive living donor recipients have significantly higher risks of renal allograft loss than normotensive living donor recipients, and showed similar outcomes compared to recipients of normotensive deceased donors.
Abstract
This experiment evaluated the effects of substituting corn with beet pulp (BP) on growth performance and ruminal fermentation characteristics and microbiomes in fattening steers. Twelve ...Korean cattle steers (body weight, 485 ± 19 kg; age, 18.0 ± 0.17 months) were divided into corn and BP groups. Both groups were fed the basal concentrate to meet 80% of the nutrient requirements. For the corn group, corn (dry matter) was supplemented for the remaining 20% of requirement by top dressing; the BP group was supplemented with 14.88% BP plus 1.92% fat to provide the iso-energy content as the corn group. Steers were fed oat grass (2 kg as-fed basis) daily. Body weight was measured, and rumen fluid was collected after 3 h of feeding using oral stomach tube methods: at the start of the experiment then at 4-week intervals. Feed intake, average daily gain, and gain-to-feed ratio were not (P > 0.05) affected by BP substitution; nor were acetate, propionate, butyrate, or total volatile fatty acid concentrations in the rumen fluid (P > 0.05). BP substitution increased (P < 0.05) the acetate to propionate ratio at 4, 8, and 12 weeks. Genomic DNA was extracted from pellets of rumen contents, and microbial populations were measured using real-time PCR at 8 and 12 weeks. BP substitution increased relative abundances of cellulolytic bacteria including Fibrobacter succinogenes (P = 0.01) and Ruminococcus albus (P = 0.04) at 12 weeks, whereas it did not affect amylolytic bacteria, including Succinimonas amylolytica, Ruminobacter amylophilus, and Streptococcus bovis. At 8 weeks, none of the microbial populations were altered by BP substitution. In conclusion, BP could provide a good energy source substitute for corn without affecting growth performance in the fattening period of beef cattle. Increased relative abundances of several cellulolytic bacteria supported the increased ruminal acetate to propionate ratio.
This study investigated the effects of thermal treatment (70, 80, and 90 °C for 5, 10, and 20 min) on the titers of human norovirus (HuNoV) GII.4, a dominant genotype in fresh mussels using propidium ...monoazide (PMA) pretreatment and real-time reverse transcription quantitative-polymerase chain reaction (RT-qPCR) and the effects of thermal treatment on mussel quality (Hunter colors and sensory properties). Reductions of >1-log10 for HuNoV in PMA-treated mussels required 70 °C for 20 min, 80 °C for 10 min and 90 °C for 5 min. As assessed by PMA/RT-qPCR, the log10 reduction values of HuNoV in PMA-treated samples was significantly reduced (46% or 0.27 log10; P < 0.05) when heated to 90 °C for 20 min compared with non-PMA treated samples under identical conditions. Hunter color ‘L’-, and ‘a’- and ‘b’- values significantly (P < 0.05) decreased and increased, respectively with a stepwise increase of temperature (70–90 °C) and duration of heat treatment (5–20 min). The results of the untrained 7-point hedonic scale of sensory evaluation revealed that mussels heated to 90 °C for 10 min were the best quality sample among all thermally treated mussels. The results suggest that the PMA/RT-qPCR method could be very effective in distinguishing HuNoV viability following high heat treatment for an extended duration (eg, 90 °C for 20 min). Based on these results, the PMA/RT-qPCR method could be very effective in assessing HuNoV viability following high-heat treatment for an extended duration (eg, 90 °C for 20 min). Furthermore, our findings suggest that inactivation of HuNoV GII.4 in the bivalve molluscan shellfish may be accomplished by treatment at 70 °C for 20 min, 80 °C for 10 min, or 90 °C for 5 min. Among all thermal treatments, 90 °C for 10 min was considered the optimal cooking temperature and duration for mussels.
•>1-log10 reduction for HuNoV GII.4 in mussels required 20 min of 70 °C, 10 min of 80 °C, and 5 min of 90 °C.•PMA/RT-qPCR could be effective in assessing HuNoV viability following high-heat treatment.•Mussels heated to 90 °C for 10 min were the highest quality by sensory evaluation.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
495.
Korean guidelines for the management of gout Jennifer Jooha Lee; Ji Soo Lee; Min Kyung Chung ...
The Korean journal of internal medicine,
09/2023, Volume:
38, Issue:
5
Journal Article
Peer reviewed
Gout is the most common form of arthritis, with the prevalence increasing worldwide. The present treatment guidelines provide recommendations for the appropriate treatment of acute gout, management ...during the inter-critical period, and prevention of chronic complications. The guidelines were developed based on evidence-based medicine and draft recommendations finalized after expert consensus. These guidelines are designed to provide clinicians with clinical evidence to enable efficient treatment of gout.
OBJECTIVEWe investigated the feasibility of laparoscopic restaging surgery in patients with unexpected uterine cancer. METHODSThis retrospective study included eight patients who underwent ...laparoscopic restaging surgery for Iran University uterine cancer after a prior hysterectomy or myomectomy. RESULTSThe median age of the patients and their body mass index were 55 years (range, 44-78) and 23.8 kg/m2 (range, 20.75- 31.89), respectively. The median interval between the prior hysterectomy and the restaging surgery was 21 days (range, 10-35). The median operating time and time for the return of bowel activity were 325 minutes (range, 200-475) and 35 hours (range, 18-50), respectively. The median numbers of harvested pelvic and para-aortic lymph nodes were 17.5 (range, 14-29) and 20.5 (range, 7-36), respectively. In seven of the eight patients, uterine extraction was performed with vaginal or electronic morcellation. The final International Federation of Gynecology and Obstetrics stage was IA in all patients. Intraoperative and postoperative complications did not occur in any of the patients, except for the need for transfusion. Patient 4 had synchronous primary cancer (stage IA) of the endometrium and left ovary. Two of the eight patients with clear cell carcinoma received chemotherapy, and none received radiotherapy. All patients survived without disease recurrence. CONCLUSIONRestaging surgery might be necessary for highly selective patients with unexpected uterine malignancies. This would be an alternative surgical modality for complete staging and planning tailored adjuvant treatments. However, lymphadenectomy might not be performed in patients with early uterine cancer.
This phase II, open-label, multicenter study aimed to investigate the efficacy and safety of a rituximab intensification for the 1st cycle with every 21-day of rituximab, cyclophosphamide, ...doxorubicin, vincristine, and prednisolone (R-CHOP-21) among patients with previously untreated advanced-stage or bulky diffuse large B-cell lymphoma (DLBCL).
Ninety-two patients with stage III/IV or bulky DLBCL from 21 institutions were administered 8 cycles of R-CHOP-21 with an additional one dose of rituximab intensification on day 0 of the 1st cycle (RR-CHOP). The primary endpoint was a complete response (CR) rate after 3 cycles of chemotherapy.
Among the 92 DLBCL patients assessed herein, the response rate after 3 cycles of chemotherapy was 88.0% (38.0% CR+50.0% partial response PR). After the completion of 8 cycles of chemotherapy, the overall response rate was observed for 68.4% (58.7% CR+9.8% PR). The 3-year progression-free survival rate was 64.0%, and the 3-year overall survival rate was 70.4%. Febrile neutropenia was one of the most frequent grade 3 adverse events (40.0%) and 5 treatment-related deaths occurred. Compared with the clinical outcomes of patients who received R-CHOP chemotherapy as a historical control, the interim CR rate was higher in male patients with RR-CHOP (20.5% vs. 48.8%, p=0.016).
Rituximab intensification on days 0 to the 1st cycle of the standard 8 cycles R-CHOP-21 for advanced DLBCL yielded favorable response rates after the 3 cycles of chemotherapy and acceptable toxicities, especially for male patients. ClinicalTrials.gov ID: NCT01054781.
In this study, polymerase chain reaction (PCR)-based microsatellite instability (MSI) testing was comprehensively analyzed and compared with immunohistochemistry (IHC) for mismatch repair (MMR) ...protein expression in patients with gastric cancer (GC).
In 5,676 GC cases, PCR-based MSI testing using five microsatellites (BAT-26, BAT-25, D5S346, D2S123, and D17S250) and IHC for MLH1 were performed. Re-evaluation of MSI testing/MLH1 IHC and additional IHC for MSH2, MSH6, and PMS2 were performed in discordant/indeterminate cases.
Of the 5,676 cases, microsatellite stable (MSS)/MSI-low and intact MLH1 were observed in 5,082 cases (89.5%), whereas MSI-high (MSI-H) and loss of MLH1 expression were observed in 502 cases (8.8%). We re-evaluated the remaining 92 cases (1.6%) with a discordant/indeterminate status. Re-evaluation showed 1) 37 concordant cases (0.7%) (18 and 19 cases of MSI-H/MMR-deficient (dMMR) and MSS/MMR-proficient (pMMR), respectively), 2) 6 discordant cases (0.1%) (3 cases each of MSI-H/pMMR and MSS/dMMR), 3) 14 MSI indeterminate cases (0.2%) (1 case of dMMR and 13 cases of pMMR), and 4) 35 IHC indeterminate cases (0.6%) (22 and 13 cases of MSI-H and MSS, respectively). Finally, MSI-H or dMMR was observed in 549 cases (9.7%), of which 47 (0.8%) were additionally confirmed as MSI-H or dMMR by re-evaluation. Sensitivity was 99.3% for MSI testing and 95.4% for MMR IHC.
Considering the low incidence of MSI-H or dMMR, discordant/indeterminate results were occasionally identified in GCs, in which case complementary testing is required. These findings could help improve the accuracy of MSI/MMR testing in daily practice.
Introduction: Liver tumor resection requires precise localization of tumors and blood vessels. Despite advancements in 3-dimensional (3D) visualization for laparoscopic surgeries, challenges persist. ...We developed and evaluated an augmented reality (AR) system that overlays preoperative 3D models onto laparoscopic images, offering crucial support for 3D visualization during laparoscopic liver surgeries. Methods: Anatomic liver structures from preoperative computed tomography scans were segmented using open-source software including 3D Slicer and Maya 2022 for 3D model editing. A registration system was created with 3D visualization software utilizing a stereo registration input system to overlay the virtual liver onto laparoscopic images during surgical procedures. A controller was customized using a modified keyboard to facilitate manual alignment of the virtual liver with the laparoscopic image. The AR system was evaluated by 3 experienced surgeons who performed manual registration for a total of 27 images from 7 clinical cases. The evaluation criteria included registration time; measured in minutes, and accuracy; measured using the Dice similarity coefficient. Results: The overall mean registration time was 2.4±1.7 minutes (range: 0.3 to 9.5 min), and the overall mean registration accuracy was 93.8%±4.9% (range: 80.9% to 99.7%). Conclusion: Our validated AR system has the potential to effectively enable the prediction of internal hepatic anatomic structures during 3D laparoscopic liver resection, and may enhance 3D visualization for select laparoscopic liver surgeries.
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