Prosthechea cochleata
or clamshell orchid is recognized as a species of both conservation and commercial importance. It has long been prized by orchid breeders and growers for its unique flower and ...hardy disposition. The commercial market has failed to meet the demand for this species since it is still targeted for illegal collection in the wild. This study examines the effectiveness of the banana powder on two variants (var. diandra and var. triandra) with disparate home ranges and levels of genetic diversity using two commercially available agar-based media (PhytoTechnology P668 and P748). Undifferentiated protocorms of the two variants were monitored for shoot growth and differentiation across a period of 156 days. The growth media with 3% banana powder supplement (P748) was more effective in initiating shoot formation in both
P. cochleata
variants compared to control media (P668) (F = 27.15,
p
< 0.001, df = 81). The diandrous variant grown with banana showed the highest mean shoot count (28.67 shoots/flask) at the end of the monitoring period. Results suggest that banana supplement is an effective source of plant growth regulators and organic nutrients necessary to promote shoot formation and seedling development in this species. This research is important for the conservation of
P. cochleata
as it identifies an effective and cost-efficient method for in vitro propagation, which can aid in increasing the ex-situ and in situ populations of this threatened species. Additionally, the findings have implications for commercial orchid production, as it can potentially improve the cultivation and yield of this species for economic purposes.
To compare reduced colonic cleansing based on dietary fecal tagging (FT) with standard (non-FT) colonic cleansing with regard to patient acceptance, sensitivity, and specificity.
In 50 patients (FT ...group), FT was performed by means of diet, magnesium citrate, and a barium suspension. In another 50 patients (non-FT group), preparation was based on polyethylene glycol administration. All patients underwent conventional colonoscopy after computed tomographic (CT) colonography. Sensitivity and specificity for polyp detection were calculated by using conventional colonography as the reference standard. At CT colonography, fecal residue was evaluated. Patients were interviewed to determine discomfort, side effects, sleep quality, final opinion on examination comfort, and whether they would be reluctant to undergo the same examination again.
FT left more fecal residue but improved differentiation from polyps (FT specificity, 88% 30 of 34 patients; non-FT, 77% 23 of 30 patients). Sensitivities were comparable: FT, 88% (14 of 16 patients); non-FT, 85% (17 of 20 patients). FT significantly reduced discomfort, side effects, and sleep disturbance, and resulted in an improved final opinion of how comfortable the examination was (P <.05). Although FT improved patient willingness to repeat the examination, this improvement was not statistically significant (P >.05).
FT offers the patient a well-tolerated preparation and improves specificity, with improved differentiation of polyps from residual stool.
Various desensitization protocols were shown to enable successful living donor kidney transplantation across a positive complement‐dependent cytotoxicity crossmatch (CDCXM). Positive crossmatch ...transplantation, however, is less well established for deceased donor transplantation. We report a cohort of 68 deceased donor renal allograft recipients who, on the basis of broad sensitization (lymphocytotoxic panel reactivity ≥40%), were subjected to a protocol of peritransplant immunoadsorption (IA). Treatment consisted of a single session of immediate pretransplant IA (protein A) followed by posttransplant IA and antilymphocyte antibody therapy. Twenty‐one patients had a positive CDCXM, which could be rendered negative by pretransplant apheresis. Solid phase HLA antibody detection revealed preformed donor‐specific antibodies (DSA) in all 21 CDCXM‐positive and in 30 CDCXM‐negative recipients. At 5 years, overall graft survival, death‐censored graft survival and patient survival were 63%, 76% and 87%, respectively, without any differences between CDCXM‐positive, CDCXM‐negative/DSA‐positive and CDCXM‐negative/DSA‐negative recipients. Furthermore, groups did not differ regarding rates of antibody‐mediated rejection (24% vs. 30% vs. 24%, p = 0.84), cellular rejection (14% vs. 23% vs. 18%, p = 0.7) or allograft function (median 5‐year serum creatinine: 1.3 vs. 1.8 vs. 1.7 mg/dL, p = 0.62). Our results suggest that peritransplant IA is an effective strategy for rapid desensitization in deceased donor transplantation.
This study demonstrates successful transplantation of crossmatch‐positive deceased donor kidney allograft recipients using a protocol of peri‐transplant immunoadsorption for rapid alloantibody depletion immediately before transplant surgery.
Humoral alloreactivity is well established to predict adverse allograft outcomes. However, in some recipients, alloantibodies may also occur in the absence of graft dysfunction. We evaluated if and ...how often complement‐ and noncomplement‐fixing alloantibodies are detectable in stable recipients and whether, in this context, they affect long‐term outcomes. Sera obtained from 164 kidney transplant recipients at 2, 6 and 12 months were evaluated by FlowPRA screening and single‐antigen testing for detection of IgG‐ or C4d‐fixing HLA panel reactivity and donor‐specific antibodies (DSA). Applying stringent criteria, we selected 34 patients with an uneventful 1‐year course (no graft dysfunction or rejection) and excellent graft function at 12 months estimated glomerular filtration rate (eGFR) ≥60 mL/min and proteinuria ≤0.5 g/24 h. Nine (27%) and 5 (15%) of these recipients tested positive by IgG and C4dFlowPRA screening, respectively. In five cases, DSA were identified. Frequencies of positive test results and DSA binding intensities were not significantly lower than those documented for patients who did not fulfill the above criteria. In recipients with an excellent 1‐year course, FlowPRA reactivity was not associated with lower eGFR or increased protein excretion during 68‐month median follow‐up. Our results suggest cautious interpretation of antibody monitoring in patients with normal‐functioning grafts.
This study demonstrates that, in kidney transplant recipients with excellent 1‐year graft performance, the occurrence of complement‐ and noncomplement‐fixing anti‐HLA alloreactivity may not be associated with adverse long‐term graft function, suggesting cautious interpretation of post‐transplant antibody monitoring in the absence of graft dysfunction.
A family history of coronary artery disease (CAD), especially when the disease occurs at a young age, is a potent risk factor for CAD. DNA collection in families in which two or more siblings are ...affected at an early age allows identification of genetic factors for CAD by linkage analysis. We performed a genomewide scan in 1,168 individuals from 438 families, including 493 affected sibling pairs with documented onset of CAD before 51 years of age in men and before 56 years of age in women. We prospectively defined three phenotypic subsets of families: (1) acute coronary syndrome in two or more siblings; (2) absence of type 2 diabetes in all affected siblings; and (3) atherogenic dyslipidemia in any one sibling. Genotypes were analyzed for 395 microsatellite markers. Regions were defined as providing evidence for linkage if they provided parametric two-point LOD scores >1.5, together with nonparametric multipoint LOD scores >1.0. Regions on chromosomes 3q13 (multipoint LOD = 3.3; empirical
P value <.001) and 5q31 (multipoint LOD = 1.4; empirical
P value <.081) met these criteria in the entire data set, and regions on chromosomes 1q25, 3q13, 7p14, and 19p13 met these criteria in one or more of the subsets. Two regions, 3q13 and 1q25, met the criteria for genomewide significance. We have identified a region on chromosome 3q13 that is linked to early-onset CAD, as well as additional regions of interest that will require further analysis. These data provide initial areas of the human genome where further investigation may reveal susceptibility genes for early-onset CAD.
Capillary C4d deposition is a valuable marker of antibody‐mediated rejection (AMR). In this analysis, flow cytometric detection of alloantibody‐triggered C4d deposition to HLA antigen‐coated ...microparticles (C4dFlowPRA) was evaluated for its value as a marker for C4d deposition in renal allografts. For comparative analysis, 105 first renal biopsies performed for graft dysfunction and an equal number of concurrent sera were subjected to immunohistochemistry and C4d plus standard IgGFlowPRA, respectively. C4d deposition/fixation was detected in 17 biopsies and, applying C4dFlowPRA HLA class I and II screening, also in a small number of corresponding sera (N = 20). IgG reactivity detected by standard IgGFlowPRA was more frequent (49% of sera). Comparing C4dFlowPRA screening with capillary C4d staining, we found a high level of specificity (0.92 95% confidence interval: 0.86–0.98), which far exceeded that calculated for IgGFlowPRA (0.60 0.50–0.70). IgGFlowPRA screening, however, turned out to be superior in terms of sensitivity (0.94 0.83–1.05 vs. 0.76 0.56–0.97 calculated for C4d‐fixing panel reactivity). Remarkably, posttransplant single antigen testing for identification of complement‐fixing donor‐specific alloreactivities failed to improve the predictive value of FlowPRA‐based serology. In conclusion, our results suggest that detection of complement‐fixing HLA panel reactivity could provide a specific tool for monitoring of C4d‐positive AMR.
This study demonstrates a high level of concordance between in vitro C4d fixation to FlowPRA beads and the finding of capillary C4d deposition in renal allografts, suggesting that, as an adjunct to conventional FlowPRA, C4dFlowPRA could provide a specific tool for monitoring of C4d positive antibody‐mediated rejection. See also editorial by Schaub and Scornik in this issue on page 5.
There is a bevy of recent art, poetic and otherwise, that chronicles the losing of Protestant faith by former conservative Christian children of the turn of the millennium. (3) Hansen stresses the ...inherent value of the practice of spirituality, down to that typical Evangelical church-going uniform of khakis and collared shirt. According to Hansen, “You” have a list of people you pray for each day (“bless Andrew, bless Lynne” (2), “You... suffer” through “Bad Sermons” (5), “you rise early” to pray alone, but are nonetheless distracted by “your fickle affections / your weakened will” (9, 13). Hansen moves beyond the Protestant context, drawing in subjects like Mother Theresa and the Eastern Orthodox practice of the Jesus Prayer.
The purpose was to evaluate supine/left decubitus as an alternative to supine/prone scanning in computed tomographic colonography (CT colonography). Fifty patients were randomised to supine/prone, ...another 50 to supine/left decubitus scanning. Patients were scanned using a single-slice CT scanner. The colon was divided into eight segments. Comparisons of distension, breathing artefacts, residus and polyp detection were made between the two groups as well as between the different positions. Adequate distension was found in approximately 85, 97 and 95% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased the percentage of adequate distension to 98.5% for prone-supine and 97.7% for left decubitus-supine scanning ( P<0.0005 compared to supine, P=0.001 compared to left decubitus and P=0.046 compared to prone scanning). Absence of residual material was found in approximately 62.7, 69.7 and 64% of segments in the supine, prone and left decubitus positions, respectively. Combined scanning increased this percentage to approximately 99% for both groups. No significant differences towards distension or residual material were found between combined supine-prone or supine-left decubitus scanning. In the supine-prone group, combined scanning additionally revealed four lesions and improved conspicuity in two cases of stalked polyps. In the supine-left decubitus group, combined scanning additionally revealed two lesions and improved conspicuity in one stalked polyp. There were significantly fewer breathing artefacts with left decubitus scanning than prone scanning ( P=0.005). A strong positive correlation was found between breathing artefacts and the age of patients in both patient groups. Colonic distension and preparation is improved by using supine and prone or supine and left decubitus scanning in combination, with a subsequent improved polyp detection. There were no significant differences between the two scanning protocols. Prone scanning, however, is hampered by breathing artefacts, especially in the elderly. Therefore, supine-left decubitus scanning is considered a valuable alternative to supine-prone scanning for the elderly.
De novo lymphangiogenesis influences the course of different human diseases as diverse as chronic renal transplant rejection and tumor metastasis. The cellular mechanisms of lymphangiogenesis in ...human diseases are currently unknown, and could involve division of local preexisting endothelial cells or incorporation of circulating progenitors. We analyzed renal tissues of individuals with gender-mismatched transplants who had transplant rejection and high rates of overall lymphatic endothelial proliferation as well as massive chronic inflammation. Donor-derived cells were detected by in situ hybridization of the Y chromosome. We compared these tissues with biopsies of essentially normal skin and intestine, and two rare carcinomas with low rates of lymphatic endothelial proliferation that were derived from individuals with gender-mismatched bone marrow transplants. Here, we provide evidence for the participation of recipient-derived lymphatic progenitor cells in renal transplants. In contrast, lymphatic vessels of normal tissues and those around post-transplant carcinomas did not incorporate donor-derived progenitors. This indicates a stepwise mechanism of inflammation-associated de novo lymphangiogenesis, implying that potential lymphatic progenitor cells derive from the circulation, transmigrate through the connective tissue stroma, presumably in the form of macrophages, and finally incorporate into the growing lymphatic vessel.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
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