Establishment of an in vitro plantlet regeneration protocol for unique varieties of brinjal (Solanum melongena L.) var. Mattu Gulla and Perampalli Gulla.

Brinjal (Solanum melongena L.) var. Mattu Gulla (MG) and var. Perampalli Gulla (PG) are unique varieties with distinct flavour cultivated in Udupi, Karnataka State, and are exposed to several biotic and abiotic stresses. An efficient and reproducible in vitro regeneration method is required to expedite the manipulation of these brinjal varieties to cope up with stress by tissue culture and gene transfer methods. The present study, reports a rapid and efficient in vitro regeneration protocol for these two varieties. The in vitro growth response was studied on Murashige and Skoog (MS) medium supplemented with 2, 4-D, BAP and IAA, and the plantlets were regenerated efficiently from callus cultures of leaf, cotyledon and hypocotyl explants. Among the three explants, the hypocotyl explants were found to have better callus induction and multiple shoot regeneration. High frequency of shoot initiation was achieved from hypocotyl derived calluses in MS media with 2.0 mg/L BAP and 0.5 mg/L IAA in MG and PG. Efficient and rapid shoot proliferation, and elongation were noted in MS medium with 1.0 mg/L BAP and 0.3 mg/L GA3. The in vitro regenerated shoots produced healthy roots when they were cultured on MS medium supplemented with 0.5 mg/L IBA. A significant difference was observed in percentage of callus induction, number of shoots per callus, shoot elongation and number of hardened plantlets of MG and PG. MG showed maximum response in all stages of culture than PG. Hardening of plantlets in tissue culture was achieved in three weeks. The hardened plantlets were grown in pots for further acclimatization in green house and finally transplanted to experimental garden where they developed into flowering plants and produced mature fruits with viable seeds.

Pancreas transplantation from donors after circulatory death from the United Kingdom.

This study reports the comparative short-term results of pancreas transplantation from donors after circulatory death (DCD) (Maastricht III & IV), and pancreases from brainstem deceased donors (DBD). Between January 2006 and December 2010, 1009 pancreas transplants were performed in the United Kingdom, with 134 grafts from DCD and 875 from DBD. DCD grafts had no premortem pharmacological interventions performed. One-year pancreas and patient survival was similar between DCD and DBD, with pancreas graft survival significantly better in the DCD cohort if performed as an SPK. Early graft loss due to thrombosis (8% vs. 4%) was mainly responsible for early graft loss in the DCD cohort. These results from donors with broader acceptance criteria in age, body mass index, premortem interventions, etc. suggest that DCD pancreas grafts may have a larger application potential than previously recognized.

Pancreas allograft thrombosis following intravenous immunoglobulin administration to treat parvovirus B19 infection.

Pancreas graft thrombosis is one of the commonest non-immunological causes for early graft loss after transplantation. This case report describes a patient who developed graft thrombosis after intravenous immunoglobulin administration to treat acute parvovirus B19 infection. The potential role of hypercoagulability in graft thrombosis and the implications for immunoglobulin therapy in transplant patients with hypercoagulable states is discussed.

Alemtuzumab induction and steroid-free maintenance immunosuppression in pancreas transplantation.

Alemtuzumab is a humanized anti-CD52 antibody that depletes lymphocytes and has been increasingly used as induction agent in transplantation. The impact of alemtuzumab induction immunosuppression in pancreas transplantation was evaluated, with particular reference to steroid avoidance in maintenance. A total of 100 patients who received 102 pancreas transplants (83 simultaneous kidney-pancreas [SPK], 15 pancreas after kidney transplantation [PAK] and 4 pancreas transplant alone [PTA]) were included. All patients received two doses of 30-mg alemtuzumab i.v. with tacrolimus (trough level 8-12 ng/mL) and mycophenolate mofetil (MMF,1g/day) with no maintenance steroids. This analysis included 62 male and 38 female recipients, with mean (+/-SD) age of 42 (+/-7.6) years. Median follow-up was 17 months (range 8-41 months). One-year patient, pancreas and kidney graft survival (actuarial) was 97%, 89% and 94%, respectively. Overall incidence of rejection was 25%. Side effects of alemtuzumab administration included thrombocytopenia (14%), pulmonary edema (2%) and rash (1%). Twenty-five percent required reoperations (12% for bleeding). Infectious complications included Cytomegalovirus (CMV,6.8%) BK viruria (3.8%), fungal infections (4%), primary varicella (1%) and posttransplant lymphoproliferative disorders (PTLD,1%). Eighty-three percent did not require any steroids posttransplant. These results indicate that alemtuzumab is safe and enables pancreas transplantation to be carried out without maintenance steroids in 83% of cases and acceptable rejection rate.

Clopidogrel-associated acute migratory arthritis following kidney-pancreas transplantation.

Clopidogrel is a potent inhibitor of platelet aggregation and has been used as an alternative, or as an adjunct to aspirin in reducing the risk of thrombosis. A 34-year-old uremic type 1 male diabetic patient who underwent simultaneous kidney-pancreas transplantation was given clopidogrel as he was allergic to aspirin. He developed polyarthralgia one week later, followed in a few days by symmetrical migratory polyarthritis, which resolved completely on withdrawing the drug. The implications to clinical management in a transplant setting are discussed.

Risk factors for discharge against medical advice in patients with UGI bleeding or abdominal pain: a study of 170 discharges against medical advice among 11,996 emergency department visits.

AIM: The aim of this study was to identify rate of and risk factors for patients leaving against medical advice (AMA) from the emergency department (ED) with abdominal pain or upper gastrointestinal (GI) bleeding. METHODS: The National Hospital Ambulatory Medical Care Survey is a limited access dataset that includes ED visit data. All patients who left AMA between years 2007-2009 who had the diagnosis of upper GI bleeding or abdominal pain were studied. The following demographic factors were analyzed as potential risk factors for discharge AMA: patient age, sex, race/ethnicity, geographic location, annual income, type of insurance, urban versus rural status, prior ED visits, ED waiting time, and diagnosis of psychiatric illness. RESULTS: From 2007-2009, a total of 104,566 ED visits were analyzed, of which 1135 (1.1%) were ED visits of patients leaving AMA. Among those leaving AMA, 170 patients (1.4%) leaving AMA presented with upper GI bleeding or abdominal pain. Of nine analyzed parameters, only two parameters statistically significantly affected the rate of leaving AMA. First, patients aged 19-44 years were significantly more likely to leave AMA (P=0.001, odds ratio (OR)=1.67; 95%-CI: 1.21-2.32) whereas patient aged >65 years were less likely to leave AMA with upper GI bleeding or abdominal pain (P=0.01; OR=0.49; 95%-CI: 0.27-0.87). Second, patients with 1-5 prior ED visits were significantly more likely to leave AMA than other patients (P=0.009; OR=1.85; 95% CI: 1.15-2.97). Patients with psychiatric illness tended to have a greater risk of leaving AMA, with borderline statistical significance (P=0.04) Gender, race/ethnicity, geographic region, type of insurance, urban status, and waiting-time >60 minutes did not significantly affect AMA discharge rates. CONCLUSION: This study identifies risk factors for leaving AMA, including young age (19-44 years old), 1-5 prior ED visits within the prior 2 years, and psychiatric illness. Physicians may use these data to help design targeted strategies, based on the identified risk factors, to reduce AMA discharges.

Effect of factory effluents on physiological and biochemical contents of Gossypium hirsutum l.

The effect of sago and sugar factory effluents was studied on Gossypium hirsutum L. var. MCU 5 and MCU 11. Plants were irrigated with 0, 25, 50, 75 and 100% of effluents of both factories. At lower concentration (25%) of sugar factory effluents had stimulatory effect on all biochemical contents observed. Moreover, all concentration of sago factory effluents were found to have inhibitory effect on all biochemical contents except proline content which increased with increasing concentration of both the effluents. Plants growing on adjacent to sago and sugar factories or they irrigated with such type of polluted water, may accumulate the heavy metals found in both the effluents, at higher levels in plant products and if consumed may have similar effect on living organisms.

Simultaneous pancreas--kidney transplantation: to anticoagulate or not? Is that a question?

Pancreas graft loss due to venous thrombosis is the leading non-immunological cause for graft failure following kidney-pancreas transplantation. Thromboelastography (TEG)-directed anticoagulation protocol has shown that approximately one-third of the patients undergoing pancreas transplantation require therapeutic anticoagulation to prevent the occurrence of graft thrombosis. This article presents the argument for individualised anticoagulation in these patients based on their TEG tracings and suggests the use of TEG in patients undergoing pancreas transplantation.