It is hypothesised that endothelial cell reactive antibodies (ECRA) play a role in the progression of PAD through activation of endothelial cells and the release of inflammatory cytokines. We aimed ...to test this hypothesis by assessing levels of ECRA, E-selectin and IL-6 in patients with PAD of varying severity in a case controlled study.
Patients were assessed clinically and with ankle–brachial pressure indices. Patients with critical ischaemia (CI, n=30), stable claudicants (SC, n=30), and age-matched controls (AMC, n=20) were studied. Antibody, E-selectin and IL-6 levels were measured using ELISA.
ECRA levels were significantly raised in the CI group over AMC.
IL-6 levels were significantly elevated in both SC and CI over the control group and in CI over SC.
There were no significant differences in E-selectin levels between the AMC, SC and CI.
Our findings support the hypothesis that autoantibodies play a role in promoting PAD by elevating IL-6. The absence of an elevation in E-selectin in this study may be due to its short half-life, and casts doubt on its value as a marker of inflammation in atherosclerosis.
Whilst observations provide many examples of collimated outflows or jets from astrophysical bodies, there remain unresolved questions relating to their formation, propagation and stability. The ...ability to form scaled jets in the laboratory has provided many useful insights. Experiments (Lebedev et al.: 2002, ApJ564, 113) using conical arrays of fine metallic wires on the MAGPIE generator (1MA in 240 ns) have produced radiatively cooled collimated jets in vacuum using the redirection of convergent flows by a conical shock. Here we present results of a jet produced by this method propagating through a photo-ionized, quasi-stationary gas cloud. A working surface is observed at the head of the jet. The velocity of this working surface is lower than the velocity of a jet tip in vacuum.
Objective The current evidence for fibrin glue as a treatment for anal fistulae is mixed. This study reviews the experience of fibrin glue as a treatment for anal fistulae in a single tertiary ...referral centre and attempts to identify factors related to failure of therapy and the length of follow‐up required.
Method Patients with fistulae in ano that were treated with fibrin glue between February 2004 and August 2008 were analysed. All procedures were performed by two colorectal consultants based at the Queens Medical Centre, Nottingham. All patients were followed‐up to assess the outcome of this treatment.
Results Forty patients (21 male, 19 female) with a mean age of 46.5 years were studied. The mean duration of symptoms prior to presentation was 39 months (range 4–240 months). Presenting symptoms included perianal discharge (72.5%), perianal abscess (57.5%), pain (12.5%), PR bleeding (7.5%), itching (5%) and urgency (2.5%). Patients had a minimum of two follow‐up appointments and the median follow‐up period was 5.2 months (range 1–16 months). Following MRI and operative assessment, 28 (70%) of the 40 fistulae were considered complex (high trans‐sphincteric, extra‐sphincteric, pouch‐vaginal). Patients who had inflammatory bowel disease were classified as simple tracts but all failed to heal (three patients). Twenty of the complex fistulae failed to heal. Three patients who had repeat application of glue for their complex fistulae failed to heal on follow‐up. Of the remaining 12 patients who had simple fistulae in ano, five (41.7%) healed completely. There were no complications such as abscess, related to treatment. All patients who were asymptomatic at 3 months did not develop any further recurrence.
Conclusion Fibrin glue is a simple treatment strategy, preserves sphincter function with minimal adverse side effects. It should therefore be considered as possible first line treatment in simple fistulae but it is less likely to be successful in complex or those fistulae associated with inflammatory bowel disease. Repeat gluing is unlikely to be successful. Fistulae that have failed to heal by 3 months will need further treatment.
Displacement of herbivorous insects by the presence of predators on whole plants has rarely been studied. By semi-continuous observations of an externally feeding insect herbivore and a predator, we ...show how the mere presence of the predator, Geocoris lubra Kirkaldy (Hemiptera: Geocoridae), on a plant can have a strong influence on the movement and behaviors of Helicoverpa armigera (Hübner) (Lepidoptera: Noctuidae) larvae. The presence of predators, as opposed to mortality by predators, influenced the proportion of larvae feeding, resting and implementing avoidance activities. In addition, the proportion of time individual larvae allocated to feeding, resting and dropping off plants was affected when predators were present with and without contact between the two. Predators do more than just reduce numbers of herbivores; they influence feeding, displacement and subsequently the distribution of plant damage.
The approximate date of introduction to the British Isles of Lathraea clandestina L. is clarified and forma names provided for white and pink-flowered variants of the species. The use of forma names ...to recognise single-character variants is examined and found to be inherently contradictory to hierarchical classification. An extension of the Group system employed for cultivated plants to plants occurring in the wild is advocated.
Forty patients with refractory Hodgkin's disease (24 patients) or non-Hodgkin's lymphoma (16 patients) who were considered for high-dose therapy but not for autologous bone marrow transplantation ...(ABMT) due to BM metastases, previous pelvic irradiation, a history of marrow involvement by tumor or hypocellular marrow in conventional harvest sites received high-dose therapy and autologous peripheral blood (PB) hematopoietic stem cell transplantation. Disappearance of circulating neutrophils and development of RBC and platelet transfusion-dependence was followed, in the evaluable patients, by reappearance of 0.5 × 109/L circulating granulocytes and sufficient platelets to obviate the need for platelet transfusions at a median of 25 days after transplantation. Twenty-three patients experienced a clinical complete remission (CR). The projected 2-year event-free survival was 20% for all 40 patients and 49% for the non-Hodgkin's lymphoma patients. The projected 18-month event-free survival for the Hodgkin's disease patients was 15%. PB stem cell transplantation provided an opportunity to administer high-dose salvage therapy to patients with refractory lymphoma who otherwise were not candidates for such therapy. For some of those patients, the high-dose therapy produced prolonged survival, free of tumor progression.
Eight different CD40 mAb shared with soluble trimeric CD40 ligand (sCD40LT) the capacity to rescue germinal center (GC) B cells from spontaneous apoptosis and to suppress antigen receptor-driven ...apoptosis in group I Burkitt's lymphoma cells. Three mAb (G28-5, M2 and M3) mimicked sCD40LT in its ability to promote strong homotypic adhesion in resting B cells, whereas others (EA5, BL-OGY/C4 and 5C3) failed to stimulate strong clustering. Binding studies revealed that only those mAb that promoted strong B cell clustering bound at, or near to, the CD40L binding site. While all eight mAb and sCD40LT were capable of synergizing with IL-4 or phorbol ester for promoting DNA synthesis in resting B cells, co-stimulus-independent activation of the cells into cycle through CD40 related directly to the extent of receptor cross-linking. Thus, mAb which bound outside the CD40L binding site synergized with sCD40LT for promoting DNA synthesis; maximal levels of stimulation were achieved by presenting any of the mAb on CD32 transfectants in the absence of sCD40LT or by cross-linking bound sCD40LT with a second antibody. Monomeric sCD40L, which was able to promote rescue of GC B cells from apoptosis, was unable to drive resting B cells into cycle. These studies demonstrate that CD40-dependent rescue of human B cells from apoptosis requires minimal cross-linking and is essentially epitope independent, whereas the requirements for promoting cell cycle progression and homotypic adhesion are more stringent. Possible mechanisms underlying these differences and their physiological significance are discussed.
Stromal Gene Signatures in Large-B-Cell Lymphomas Lenz, G; Wright, G; Dave, S.S ...
New England journal of medicine/The New England journal of medicine,
11/2008, Letnik:
359, Številka:
22
Journal Article
Recenzirano
Odprti dostop
In this study, microarrays of stromal-cell RNA showed one signature that correlated with extracellular-matrix deposition and monocytic infiltration and another that reflected tumor blood-vessel ...density. Immune cells, fibrosis, and angiogenesis in the microenvironment strongly influence the behavior of these lymphomas.
In this study, microarrays of stromal-cell RNA showed one signature that correlated with extracellular-matrix deposition and monocytic infiltration and another that reflected tumor blood-vessel density.
Although diffuse large-B-cell lymphoma is curable with anthracycline-based chemotherapy regimens such as a combination of cyclophosphamide, doxorubicin, vincristine, and prednisone (CHOP),
1
the addition of rituximab immunotherapy (R-CHOP) has improved overall survival among patients with diffuse large-B-cell lymphoma by 10 to 15%.
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Diffuse large-B-cell lymphoma is a molecularly heterogeneous disease,
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and it is unclear whether rituximab preferentially improves the outcome in certain subgroups of patients.
Gene-expression profiling has identified two biologically and clinically distinct molecular subtypes of diffuse large-B-cell lymphoma.
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,
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The germinal-center B-cell–like diffuse large-B-cell lymphoma subtype probably arises from normal germinal-center B cells, whereas the activated B-cell–like subtype may . . .
The Hill-Sachs lesion is a well-known entity that threatens recurrent instability, but the treatment options are multiple and the surgical indications remain undefined. The evidence for each ...operative technique is limited to retrospective reviews and small case series without controls. The decision of which technique to use resides with the surgeon. Older, osteopenic patients, especially those with underlying arthritis and large defects, should be managed with complete humeral resurfacing. Humeralplasty is best used in younger patients with good quality bone in an acute setting with small- to moderate-sized bone defects. Partial resurfacing and remplissage are best used with small to moderate lesions, and both require further study. Allograft humeral reconstruction is an established technique for patients with moderate to large defects, and is best applied to nonosteopenic bone. Surgeons must be able to recognize the presence of humeral bone loss via specialized radiographs or cross-sectional imaging and understand its implications. The techniques to manage humeral bone loss are evolving and further biomechanical and clinical studies are required to define the indications and treatment algorithms.
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