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1.
J Anal Toxicol ; 43(1): 36-44, 2019 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-30060005

RESUMEN

Tris(chloropropyl)phosphate (TCPP) is an organophosphorus flame retardant (OPFR) and plasticizer increasingly used in consumer products and as a replacement for brominated flame retardants. Commercially available TCPP is a mixture of four structural isomers the most abundant of which is tris(1-chloro-2-propyl)phosphate (TCPP-1). Although there is a widespread use of TCPP and potential for human exposure, there is limited data on the safety or toxicity of TCPP. The National Toxicology Program is conducting long-term studies to examine the toxicity of the TCPP in rats after lifetime exposure, including perinatal oral exposure. Quantitative estimates of internal dose are essential to interpret toxicological findings in rodents. To aid in this, a method was fully validated to quantitate the most abundant isomer, TCPP-1, in female Harlan Sprague Dawley (HSD) rat and B6C3F1 mouse plasma with partial validation in male rat plasma, and male and female mouse plasma. The method used protein precipitation using trichloroacetic acid followed by the extraction with toluene, and analysis by gas chromatography with flame photometric detection. The performance of the method was evaluated over 5-70 ng TCPP-1/mL plasma. The method was linear (r ≥ 0.99), accurate (inter-day relative error: ≤ ± -7.2) and precise (inter-batch relative standard deviation: ≤27.5%). The validated method has lower limits of quantitation and detection of ~5 and 0.9 ng/mL, respectively, in female HSD rat plasma and can be used on samples as small as 50 µL demonstrating the applicability to plasma samples from toxicology studies.


Asunto(s)
Cromatografía de Gases/métodos , Retardadores de Llama/análisis , Organofosfatos/sangre , Fotometría/métodos , Plastificantes/análisis , Animales , Calibración , Cromatografía de Gases/normas , Femenino , Ionización de Llama , Límite de Detección , Masculino , Ratones , Fotometría/normas , Ratas Sprague-Dawley , Estándares de Referencia , Reproducibilidad de los Resultados
2.
Clin Oncol (R Coll Radiol) ; 30(10): 625-633, 2018 10.
Artículo en Inglés | MEDLINE | ID: mdl-30196845

RESUMEN

AIMS: Emerging evidence suggests that contact X-ray brachytherapy (CXB) may increase the clinical complete response rate and durability when administered after standard chemoradiotherapy in patients with rectal cancer. The addition of CXB in partial responders is therefore probably cost-effective. The affordability of widening access to CXB in the UK, however, has not been evaluated. MATERIALS AND METHODS: Decision analytical modelling with Monte Carlo simulation was used to evaluate long-term costs for the management of patients with rectal cancers who were given a CXB boost when a clinical complete response was not initially achieved following chemoradiotherapy in order to facilitate a watch and wait approach. A third-party payer (National Health Service) perspective was adopted, probabilistic sensitivity analysis was carried out and a scenario analysis was performed to investigate the effect of the number of referral centres and number of patients treated with CXB. RESULTS: We estimate that 818 (95% confidence interval 628-1021) patients per year are eligible for CXB as an adjunct to a watch and wait approach in England and Wales. As this management is less costly than surgical management for each individual patient, the more patients treated, the more affordable the technology. Even if as few as 125 patients are treated nationally in 15 centres, the cost of implementing this technology would be less than £4 million. If the average number of patients treated in each centre is 30, this technology would be cost saving within 5 years. CONCLUSIONS: The cost of CXB is not prohibitive according to the National Institute for Health and Care Excellence threshold for implementation of new technology and may even be cost saving within 5 years compared with standard surgical management, depending on the uptake of the technology and the number of referral centres.


Asunto(s)
Braquiterapia/economía , Braquiterapia/métodos , Costos de la Atención en Salud , Neoplasias del Recto/economía , Neoplasias del Recto/radioterapia , Quimioradioterapia , Ahorro de Costo , Análisis Costo-Beneficio , Inglaterra , Humanos , Neoplasias del Recto/terapia , Gales , Espera Vigilante , Rayos X
3.
Am J Transplant ; 18(4): 998-1006, 2018 04.
Artículo en Inglés | MEDLINE | ID: mdl-29178588

RESUMEN

Porcine islet xenografts have the potential to provide an inexhaustible source of islets for ß cell replacement. Proof-of-concept has been established in nonhuman primates. However, significant barriers to xenoislet transplantation remain, including the poorly understood instant blood-mediated inflammatory reaction and a thorough understanding of early xeno-specific immune responses. A paucity of data exist comparing xeno-specific immune responses with alloislet (AI) responses in primates. We recently developed a dual islet transplant model, which enables direct histologic comparison of early engraftment immunobiology. In this study, we investigate early immune responses to neonatal porcine islet (NPI) xenografts compared with rhesus islet allografts at 1 hour, 24 hours, and 7 days. Within the first 24 hours after intraportal infusion, we identified greater apoptosis (caspase 3 activity and TUNEL [terminal deoxynucleotidyl transferase dUTP nick end labeling])-positive cells) of NPIs compared with AIs. Macrophage infiltration was significantly greater at 24 hours compared with 1 hour in both NPI (wild-type) and AIs. At 7 days, IgM and macrophages were highly specific for NPIs (α1,3-galactosyltransferase knockout) compared with AIs. These findings demonstrate an augmented macrophage and antibody response toward xenografts compared with allografts. These data may inform future immune or genetic manipulations required to improve xenoislet engraftment.


Asunto(s)
Modelos Animales de Enfermedad , Rechazo de Injerto/inmunología , Supervivencia de Injerto/inmunología , Inflamación/inmunología , Trasplante de Islotes Pancreáticos/inmunología , Islotes Pancreáticos/inmunología , Macrófagos/inmunología , Animales , Animales Recién Nacidos , Apoptosis , Islotes Pancreáticos/patología , Macaca mulatta , Porcinos , Trasplante Heterólogo
4.
Clin Oncol (R Coll Radiol) ; 30(3): 166-177, 2018 03.
Artículo en Inglés | MEDLINE | ID: mdl-29248311

RESUMEN

AIMS: Following chemoradiotherapy in patients with rectal cancer, the addition of contact X-ray brachytherapy (CXB) in partial responders might increase the proportion of patients with a clinical complete response (cCR) and who are thus suitable for watch and wait management. However, the long-term cost-effectiveness of this approach has not been evaluated. MATERIALS AND METHODS: Decision analytical modelling and a Markov simulation were used to compare long-term costs, quality-adjusted life years (QALYs) and cost-effectiveness from a third-party payer (National Health Service) perspective for treatment strategies after chemoradiotherapy; watch and wait with CXB when a cCR was not initially achieved after external beam radiotherapy (EBRT) (WWCXB), watch and wait with EBRT alone (WWEBRT) and radical surgery for all patients. The effect of uncertainty in model parameters and patient demographics was investigated. RESULTS: WWCXB had a higher QALY payoff than both radical surgery and WWEBRT and was less costly in most scenarios and demographic cohorts. In all plausible scenarios, WWCXB was the most cost-effective, at a threshold of £20 000/QALY. This finding was insensitive to uncertainty associated with model parameters. CONCLUSIONS: WWCXB is likely to be cost-effective compared with both WWEBRT alone and radical surgery. These findings support the use of CXB boost as an adjunct to a watch and wait strategy.


Asunto(s)
Braquiterapia/economía , Neoplasias del Recto/economía , Neoplasias del Recto/radioterapia , Espera Vigilante/economía , Quimioradioterapia , Análisis Costo-Beneficio , Femenino , Humanos , Persona de Mediana Edad , Años de Vida Ajustados por Calidad de Vida , Neoplasias del Recto/tratamiento farmacológico
5.
J Med Primatol ; 47(1): 81-84, 2018 02.
Artículo en Inglés | MEDLINE | ID: mdl-28671309

RESUMEN

Recrudescence of latent and dormant viruses may lead to overwhelming viremia in immunosuppressed hosts. In immunocompromised hosts, Simian virus 40 (SV40) reactivation is known to cause nephritis and demyelinating central nervous system disease. Here, we report SV40 viremia leading to fatal interstitial pneumonia in an immunosuppressed host following renal allotransplantation.


Asunto(s)
Huésped Inmunocomprometido , Enfermedades Renales/fisiopatología , Macaca mulatta , Enfermedades de los Monos/fisiopatología , Neumonía/fisiopatología , Infecciones por Polyomavirus/veterinaria , Virus 40 de los Simios/fisiología , Infecciones Tumorales por Virus/veterinaria , Animales , Enfermedades Renales/virología , Trasplante de Riñón/veterinaria , Enfermedades de los Monos/virología , Neumonía/virología , Infecciones por Polyomavirus/complicaciones , Infecciones Tumorales por Virus/complicaciones
6.
Am J Transplant ; 15(5): 1241-52, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25702898

RESUMEN

Islet xenotransplantation is a potential treatment for diabetes without the limitations of tissue availability. Although successful experimentally, early islet loss remains substantial and attributed to an instant blood-mediated inflammatory reaction (IBMIR). This syndrome of islet destruction has been incompletely defined and characterization in pig-to-primate models has been hampered by logistical and statistical limitations of large animal studies. To further investigate IBMIR, we developed a novel in vivo dual islet transplant model to precisely characterize IBMIR as proof-of-concept that this model can serve to properly control experiments comparing modified xenoislet preparations. WT and α1,3-galactosyltransferase knockout (GTKO) neonatal porcine islets were studied in nonimmunosuppressed rhesus macaques. Inert polyethylene microspheres served as a control for the effects of portal embolization. Digital analysis of immunohistochemistry targeting IBMIR mediators was performed at 1 and 24 h after intraportal islet infusion. Early findings observed in transplanted islets include complement and antibody deposition, and infiltration by neutrophils, macrophages and platelets. Insulin, complement, antibody, neutrophils, macrophages and platelets were similar between GTKO and WT islets, with increasing macrophage infiltration at 24 h in both phenotypes. This model provides an objective and internally controlled study of distinct islet preparations and documents the temporal histology of IBMIR.


Asunto(s)
Inflamación/inmunología , Trasplante de Islotes Pancreáticos/métodos , Islotes Pancreáticos/citología , Animales , Animales Modificados Genéticamente , Glucemia/química , Plaquetas/inmunología , Activación de Complemento , Modelos Animales de Enfermedad , Galactosiltransferasas/genética , Inmunohistoquímica , Macaca mulatta , Macrófagos/inmunología , Neutrófilos/inmunología , Fenotipo , Porcinos , Factores de Tiempo , Trasplante Heterólogo
7.
Pediatr Transplant ; 18(2): E57-63, 2014 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-24438382

RESUMEN

The most common identifiable causes of acute liver failure in pediatric patients are infection, drug toxicity, metabolic disease, and autoimmune processes. In many cases, the etiology of acute liver failure cannot be determined. Acute leukemia is an extremely rare cause of acute liver failure, and liver transplantation has traditionally been contraindicated in this setting. We report a case of acute liver failure in a previously healthy 15-yr-old male from pre-B-cell acute lymphoblastic leukemia. He underwent liver transplantation before the diagnosis was established, and has subsequently received chemotherapy for pre-B-cell acute lymphoblastic leukemia. He is currently alive 31 months post-transplantation. The published literature describing acute lymphoblastic leukemia as a cause of acute liver failure is reviewed.


Asunto(s)
Leucemia de Células B/complicaciones , Leucemia de Células B/terapia , Fallo Hepático Agudo/complicaciones , Fallo Hepático Agudo/cirugía , Trasplante de Hígado , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicaciones , Leucemia-Linfoma Linfoblástico de Células Precursoras/terapia , Adolescente , Biopsia , Humanos , Inmunosupresores/uso terapéutico , Hígado/patología , Pruebas de Función Hepática , Masculino , Donantes de Tejidos , Resultado del Tratamiento
8.
Ment Health Fam Med ; 9(4): 275-87, 2012 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-24294302

RESUMEN

Introduction Maternal depressive symptoms increase the risk of poor maternal and child health outcomes, and are a primary barrier to health behaviour change. Social cognitive theory can guide our understanding of risk factors that may have an impact on maternal depressive symptoms. The aim of this paper was to understand the correlates of maternal depressive symptoms among low-income African American smokers completing a 16-week intervention trial to reduce young children's second-hand smoke exposure (SHSe). Methods This study presents a secondary analysis of depression symptoms among 227 maternal smokers completing the SHSe-reduction trial. The end-of-treatment Center of Epidemiologic Studies Depression Scale (CES-D) score was used to assess depressive symptoms (dichotomised as 0 = score of < 16 and 1 = score of ≥ 16). Multivariate logistic regression analysis was used to test the one-way hypothesis that odds of significant depressive symptoms would be associated with greater total number of household smokers, greater number of paediatric sick visits, greater daily exposure of child to cigarette smoke by their mother, greater life-event stress, and lower social support, marital status, employment status and level of educational attainment. Results Number of household smokers (OR = 1.57, P = 0.049), social support (OR = 0.88, P < 0.001) and life-event stress (OR = 1.04, P = 0.001) predicted significant maternal depressive symptoms; all other variables were not significant predictors in the model. Conclusion Number of household smokers is a novel risk factor for understanding significant maternal depressive symptoms in the context of a childhood SHSe-reduction trial. Improving our understanding of the household-level social milieu in the context of SHSe-reduction interventions will assist in reducing the risk of maternal depressive symptoms.

9.
Food Chem Toxicol ; 47(4): 729-33, 2009 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-19166900

RESUMEN

Trivalent chromium (Cr(III)) has been proposed to be an essential element, which may increase sensitivity to insulin and thus participate in carbohydrate and lipid metabolism. Humans ingest Cr(III) both as a natural dietary constituent and in dietary supplements taken for weight loss and antidiabetic effects. Chromium picolinate (CP), a widely used supplement, contains Cr(III) chelated with three molecules of picolinic acid and was formulated in an attempt to improve the absorption of Cr(III). In order to examine the potential for CP to induce chronic toxicity and carcinogenicity, the NTP conducted studies of the monohydrate form (CPM) in groups of 50 male and female F344/N rats and B6C3F1 mice exposed in feed to concentrations of 0, 2000, 10,000 or 50,000 ppm for 2 years; exposure concentrations were selected following review of the data from NTP 3-month toxicity studies. Exposure to CPM did not induce biologically significant changes in survival, body weight, feed consumption, or non-neoplastic lesions in rats or mice. In male rats, a statistically significant increase in the incidence of preputial gland adenoma at 10,000 ppm was considered an equivocal finding. CPM was not carcinogenic to female rats or to male or female mice.


Asunto(s)
Neoplasias Experimentales/inducido químicamente , Ácidos Picolínicos/toxicidad , Pruebas de Toxicidad Crónica , Animales , Pruebas de Carcinogenicidad , Femenino , Masculino , Ratones , Ratas , Ratas Endogámicas F344
10.
J Clin Exp Neuropsychol ; 31(1): 73-89, 2009 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18608651

RESUMEN

This article considers the quantitative techniques currently in use in the evaluation of cognitive impairments associated with chemotherapy treatment for breast cancer. To illustrate differences among analytical approaches, all analyses were applied to baseline and posttreatment scores on neuropsychological tests obtained from Stages I and II breast cancer patients receiving either chemotherapy or hormonal therapy; a healthy control group with similar demographics to those of the treatment groups was also included. Conventional group analyses were compared with individual-based analyses (standardized regression-based and reliable change methods). Both univariate and multivariate techniques with and without covariates produced negligible effects. In contrast, results of the individual-based analyses identified a subset of participants in the chemotherapy group who experienced a severe decline in function on two or more tests. Differences between the control and treatment groups were greater than differences between the treatment groups alone. The standardized regression-based approach was more sensitive than the reliable change index in detecting chemotherapy and hormonal therapy subjects whose performance was different from baseline scores on two or more tests (roughly 80% vs. 50% of participants). From a clinical perspective, the degree of impairment determined on the basis of the individual-based methodologies could have a major impact on quality of life for those affected. On the whole, we argue that the standardized regression-based approach, allowing for the assessment of individual practice effects and evaluation of moderator variables, is the method of choice in this context.


Asunto(s)
Neoplasias de la Mama/fisiopatología , Neoplasias de la Mama/terapia , Quimioterapia/métodos , Hormonas/uso terapéutico , Procesos Mentales/fisiología , Modelos Estadísticos , Anciano , Estudios Transversales , Femenino , Humanos , Procesos Mentales/efectos de los fármacos , Persona de Mediana Edad , Pruebas Neuropsicológicas , Estudios Prospectivos , Reproducibilidad de los Resultados , Estudios Retrospectivos
11.
HPB (Oxford) ; 10(1): 25-9, 2008.
Artículo en Inglés | MEDLINE | ID: mdl-18695755

RESUMEN

The purpose of our study is to determine whether the current level of transplant fellow training is sufficient to meet the future demand for liver transplantation in the United States. Historical data from the Nationwide Inpatient Samples (NIS) for the years 1998 through 2003 were used to construct an estimate of the annual number of liver transplant procedures currently being performed in the United States, and the number projected for each year through 2020. Estimates for the current and future number of surgeons performing liver transplant procedures were also constructed using the same database. The NIS database was used because current national transplant registries do not include information on the number of surgeons performing liver transplant procedures. Using historical data derived from the NIS database, we project that the estimated number of liver transplant procedures per surgeon will remain relatively stable through 2020, with each surgeon performing an average of 12.9 procedures in 2020 compared to 12.9 currently. We conclude that the relationship between demand for liver transplantation in the United States and the supply of liver transplant surgeons will remain stable over the next 15 years.

12.
Eur J Clin Invest ; 38(8): 585-95, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18627419

RESUMEN

BACKGROUND: Visceral adiposity and obstructive sleep apnoea (OSA) may be independently associated with daytime sleepiness/low performance, insulin resistance, hypercytokinaemia, and/or hypertension. The objectives of this study are to simultaneously test these associations at baseline and after 3 months of continuous positive airway pressure (CPAP) therapy. MATERIALS AND METHODS: Sixteen obese men with OSA; 13 non-apnoeic, obese controls, and 15 non-obese controls were monitored in the sleep laboratory for four consecutive nights. Objective measures of daytime sleepiness and performance, serial 24 h plasma measures of interleukin-6 (IL-6), tumour necrosis factor-alpha (TNF-alpha), TNF receptor 1 (TNF-r1) and adiponectin, fasting blood glucose and insulin, visceral adiposity and blood pressure were obtained. Sleep apnoeics were re-assessed using the same protocol after 3 months of CPAP. RESULTS: At baseline, IL-6, TNF-r1, and insulin resistance were highest in OSA patients, intermediate in obese controls, and lowest in non-obese controls (P < 0.05). Visceral fat was significantly greater in sleep apnoeics than obese controls and predicted insulin resistance and IL-6 levels, whereas OSA predicted TNF-r1 levels (P < 0.05). CPAP decreased daytime sleepiness and blood pressure (P < 0.05), but did not affect fasting glucose or insulin or around the clock adiponectin, IL-6, TNF-alpha, or TNF-r1 levels. CONCLUSIONS: In obese sleep apnoeics, visceral fat is strongly associated with insulin resistance and inflammation. CPAP decreases sleepiness and moderates hypertension but does not affect visceral adiposity, insulin resistance, hypoadiponectinaemia or hypercytokinaemia, all of which are independent risk factors for cardiovascular disease and diabetes.


Asunto(s)
Adiposidad , Presión de las Vías Aéreas Positiva Contínua/métodos , Obesidad/fisiopatología , Síndromes de la Apnea del Sueño/fisiopatología , Síndromes de la Apnea del Sueño/terapia , Grasa Abdominal/diagnóstico por imagen , Adulto , Glucemia/análisis , Presión Sanguínea , Citocinas/sangre , Fatiga/fisiopatología , Humanos , Insulina/sangre , Interleucina-6/sangre , Masculino , Persona de Mediana Edad , Obesidad/complicaciones , Síndromes de la Apnea del Sueño/complicaciones , Factor de Necrosis Tumoral alfa/sangre , Ultrasonografía
13.
Am J Transplant ; 8(8): 1614-21, 2008 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-18557728

RESUMEN

Long-term survival of a pulmonary allograft is currently hampered by obliterative bronchiolitis (OB), a form of chronic rejection that is unique to lung transplantation. While tracheobronchial aspiration from gastroesophageal reflux disease (GERD) has clinically been associated with OB, no experimental model exists to investigate this problem. Using a WKY-to-F344 rat orthotopic left lung transplant model, the effects of chronic aspiration on pulmonary allograft were evaluated. Recipients received cyclosporine with or without 8 weekly aspirations of gastric fluid into the allograft. Six (66.7%) of 9 allografts with aspiration demonstrated bronchioles with surrounding monocytic infiltrates, fibrosis and loss of normal lumen anatomy, consistent with the development of OB. In contrast, none of the allografts without aspiration (n = 10) demonstrated these findings (p = 0.002). Of the grafts examined grossly, 83% of the allografts with chronic aspiration but only 20% without aspiration appeared consolidated (p = 0.013). Aspiration was associated with increased levels of IL-1 alpha, IL-1 beta, IL-6, IL-10, TNF-alpha and TGF-beta in BAL and of IL-1 alpha, IL-4 and GM-CSF in serum. This study provides experimental evidence linking chronic aspiration to the development of OB and suggests that strategies aimed at preventing aspiration-related injuries might improve outcomes in clinical lung transplantation.


Asunto(s)
Bronquiolitis Obliterante/etiología , Supervivencia de Injerto , Trasplante de Pulmón , Aspiración Respiratoria/complicaciones , Animales , Lavado Broncoalveolar , Modelos Animales de Enfermedad , Interleucinas/análisis , Masculino , Ratas , Ratas Endogámicas F344 , Ratas Endogámicas WKY , Factores de Crecimiento Transformadores/análisis , Factor de Necrosis Tumoral alfa/análisis
14.
Addict Behav ; 31(9): 1670-82, 2006 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-16448781

RESUMEN

We explored the influence of maternal smoking during late pregnancy on the likelihood of smoking among offspring in adolescence and adulthood, using birth cohort data collected in the United Kingdom as part of the 1958 National Child Development Study. Longitudinal analysis indicated that maternal smoking during late pregnancy was associated with an increased likelihood of being a non-smoker at 16-year, 23-year and 33-year follow-up. This association differed between male and female offspring, with women showing no significant association and men showing an increased likelihood of being a non-smoker. There did not appear to be any association between maternal smoking during late pregnancy and cigarette consumption among offspring who reported smoking for either sex. These results are inconsistent with some previous reports that maternal smoking during pregnancy increases the likelihood of smoking among female offspring, although the observation of a moderating effect of sex on smoking behaviour is consistent with several previous reports. We discuss possible mechanisms for this association, and suggest factors that may account for the observed sex differences in this association, and the discrepancy between our results and some previous reports.


Asunto(s)
Efectos Tardíos de la Exposición Prenatal , Fumar/epidemiología , Adolescente , Métodos Epidemiológicos , Femenino , Humanos , Masculino , Madres/psicología , Embarazo , Factores Sexuales , Reino Unido/epidemiología
15.
Transplant Proc ; 37(8): 3564-6, 2005 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-16298662

RESUMEN

PURPOSE: We sought to evaluate the role of recipient body mass index (BMI) on postoperative complications in patients receiving pancreas transplants. METHODS: A single-institution retrospective study of 145 consecutive patients undergoing either simultaneous kidney pancreas (SPK) or pancreas after kidney (PAK) transplantation from January 1997 through December 2003. Variables analyzed included: age, sex, BMI, number of prior transplants, cytomegalovirus status of donor and recipient, postoperative insulin resistance, complications, and overall patient and graft survival. Differences in continuous variables and dichotomous variables were evaluated using two-tailed t test and Fisher exact test, respectively. Univariate and multivariate logistic regression analyses were employed to identify predictors of overall complications following surgery. RESULTS: Obesity was defined by a BMI > or = 30. Of the 145 patients, 33 (23%) had a BMI > or = 30 and 112 (77%) had a BMI < 30. There was no significant difference in age or sex between obese and nonobese patients (P = .98 and P = .56, respectively). The type of transplantation, SPK or PAK, did not affect the complication rate (P = .36). Overall complications (infection, dehiscence, evisceration, ventral hernia, allograft failure, gangrene, necrotizing fasciitis, postoperative bleeding, or death) were significantly higher in the obese group (81% vs 40%, P < .001). Obesity was specifically associated with increased frequency of dehiscence, ventral hernia, intra-abdominal infection, gangrene, necrotizing fasciitis, and repeat laparotomy. Obese patients also had a threefold higher rate of graft pancreatitis/enteric leak. Multivariate logistic regression analysis identified age > or = 50 and BMI > or = 30 as independent predictors of overall complications following surgery (odds ratio 4.0, P = .014 and OR 6.8, P < .001, respectively). There was no difference identified between groups with regards to allograft failure, posttransplant insulin resistance, and death. CONCLUSION: Obese patients are at increased risk of overall complications following pancreas transplantation. Specifically, obese patients experience higher frequency of dehiscence, ventral hernia, intra-abdominal infection, gangrene, and necrotizing fasciitis. This study demonstrates the need for careful postoperative monitoring in the obese patient.


Asunto(s)
Obesidad/complicaciones , Trasplante de Páncreas/efectos adversos , Complicaciones Posoperatorias/epidemiología , Adulto , Femenino , Gangrena/epidemiología , Gangrena/mortalidad , Humanos , Infecciones/epidemiología , Masculino , Persona de Mediana Edad , Trasplante de Páncreas/mortalidad , Complicaciones Posoperatorias/clasificación , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Análisis de Supervivencia
16.
Histol Histopathol ; 20(4): 1165-72, 2005 10.
Artículo en Inglés | MEDLINE | ID: mdl-16136499

RESUMEN

A number of antibodies that recognize human dendritic cells (DC) have been identified. The main aim of this study was to compare and contrast different antigen retrieval techniques using both enzymatic and non-enzymatic treatments in order to determine the expression and distribution of several DC markers on formalin-fixed, paraffin-embedded tissues. Normal human lung, oral epithelial hyperplasia lesions, oral squamous cell carcinoma, and prostate adenocarcinoma tissues were evaluated using a panel of DC specific antibodies. The results of immunohistochemical staining for CD83, CD1a, CD11c, and S-100 DC markers were compared following the different antigen retrieval approaches. The overall best results for the analysis of tumor-associated DC were obtained with the enzymatic methods. Protease XXIV digestion was determined to be essential for detection of S-100 and CD11c positive DC, whereas trypsin and pepsin were required for the recognition of CD1a and CD83 expressing tumor-associated DC. These results could be easily adapted for routine practice and should be useful for characterization of the DC system in cancer patients for both diagnostic and prognostic purposes. In addition, standardized procedures for evaluating different subpopulations of tumor-associated DC should bring new insights in understanding of DC-tumor cell interaction.


Asunto(s)
Antígenos CD1/biosíntesis , Antígenos CD/biosíntesis , Antígeno CD11c/metabolismo , Células Dendríticas/metabolismo , Inmunoglobulinas/biosíntesis , Glicoproteínas de Membrana/biosíntesis , Neoplasias/metabolismo , Lesiones Precancerosas/metabolismo , Proteínas S100/biosíntesis , Biomarcadores , Células Dendríticas/inmunología , Humanos , Hiperplasia , Inmunohistoquímica , Pulmón/inmunología , Pulmón/metabolismo , Mucosa Bucal/inmunología , Mucosa Bucal/metabolismo , Mucosa Bucal/patología , Neoplasias/inmunología , Lesiones Precancerosas/inmunología , Bazo/inmunología , Bazo/metabolismo , Bazo/patología , Antígeno CD83
17.
Environ Mol Mutagen ; 40(4): 236-42, 2002.
Artículo en Inglés | MEDLINE | ID: mdl-12489113

RESUMEN

Arsenic, a human carcinogen, is genotoxic, although its mechanism(s) of action for tumorigenesis is not well understood. Among the toxicity-related properties of this chemical are its clastogenic and aneugenic activities, as well as its capacity for inducing stress-response in the form of elevated heat shock protein (HSP) expression. In the present study, we evaluated the effects of Hsp70 expression on arsenite (As)-induced structural and numerical chromosome anomalies in human cells. Human MCF-7 Tet-off cells stably transfected with a pTRE/Hsp70-1 transgene construct were used to regulate Hsp70 levels prior to in vitro As exposures. Separate cultures of relatively high vs. low Hsp70-expressing cells were established. A cytokinesis block micronucleus assay with kinetochore immunostaining was used to detect micronuclei (MN) derived from chromosome breakage (K-MN) or loss (K+MN). These studies demonstrated significant increases in micronucleus frequencies in response to As following either a long exposure (5 or 10 microM for 46 hr), or short exposure (10 or 40 microM for 8 hr) protocol. Overall, the long protocol was more efficient in producing K+MN and cells with multiple MN. Overexpressing Hsp70 resulted in significant reductions in the percent of cells positive for MN for both the long and short As exposure protocols. Both K+ and K- types of As-induced MN were lower in cells with elevated Hsp70 as compared to cells without overexpression of Hsp70. We conclude that the dose and duration of As exposure influence the type as well as amount of chromosomal alteration produced and that inducible Hsp70 protects against both the clastogenic and aneugenic effects of this chemical.


Asunto(s)
Arsenitos , Carcinógenos , Proteínas HSP70 de Choque Térmico/metabolismo , División Celular/efectos de los fármacos , Cromosomas/efectos de los fármacos , Daño del ADN , Relación Dosis-Respuesta a Droga , Humanos , Cinetocoros/efectos de los fármacos , Pruebas de Micronúcleos , Compuestos de Sodio , Factores de Tiempo , Transfección , Células Tumorales Cultivadas , Regulación hacia Arriba
18.
J Clin Endocrinol Metab ; 87(8): 3941-6, 2002 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12161537

RESUMEN

Both external and internal exposure to radiation have been linked to the development of papillary thyroid cancer. Rearrangement of the gene for RET tyrosine kinase and subsequent expression of this protein has also been found to occur in many papillary thyroid cancers, and with increased frequency in radiation-related cancers following the Chernobyl accident. However, little has been reported on the frequency of RET rearrangements in cancers after exposure to external radiation. We here report on RET protein immunoreactivity in paraffin-embedded thyroid samples from 30 patients with papillary thyroid cancer who received radiation treatment during childhood for benign conditions at Michael Reese Hospital in Chicago, and in 34 patients identified from the tumor registry as having papillary thyroid cancer with no history of therapeutic radiation. The subjects were characterized by sex, age at surgery, and the following attributes of tumor pathology: size, number of lobes involved, number of foci, lymph node metastases, and soft tissue invasion. Representative tissue samples were reacted with an antibody against the RET tyrosine kinase domain whose expression has been shown to correlate highly with RET/PTC rearrangements. A greater percentage of cancers positive for RET immunoreactivity was found in the radiation-exposed group (86.7% vs. 52.9%, P = 0.006). Although the mean age at surgery of the exposed group was lower than the control group, there was no correlation of positive RET immunoreactivity with the age at surgery. No characteristics of the tumors were associated with positive RET immunoreactivity. In summary, the greater incidence of RET-immunopositives in the irradiated group indicates that the expression of RET immunoreactivity is strongly associated with radiation exposure, but the prognostic significance of this is not yet clear.


Asunto(s)
Carcinoma Papilar/química , Proteínas de Drosophila , Neoplasias Inducidas por Radiación/química , Proteínas Proto-Oncogénicas/genética , Proteínas Tirosina Quinasas Receptoras/genética , Neoplasias de la Tiroides/química , Adulto , Carcinoma Papilar/epidemiología , Carcinoma Papilar/etiología , Preescolar , Femenino , Humanos , Inmunohistoquímica , Incidencia , Lactante , Masculino , Persona de Mediana Edad , Neoplasias Inducidas por Radiación/epidemiología , Prevalencia , Pronóstico , Proteínas Proto-Oncogénicas/metabolismo , Proteínas Proto-Oncogénicas c-ret , Liberación de Radiactividad Peligrosa , Proteínas Tirosina Quinasas Receptoras/metabolismo , Enfermedades de la Tiroides/radioterapia , Neoplasias de la Tiroides/epidemiología , Neoplasias de la Tiroides/etiología
19.
J Toxicol Environ Health A ; 64(6): 473-84, 2001 Nov 23.
Artículo en Inglés | MEDLINE | ID: mdl-11732698

RESUMEN

The groundwater in Bayingnormen (Ba Men), located in Central West Inner Mongolia, China, is naturally contaminated with arsenic at concentrations ranging from 50 microg/L to 1.8 mg/L. Various adverse health effects in this region, including cancer, have been linked to arsenic exposure via drinking water. A pilot study was undertaken to evaluate frequencies of micronuclei (MN), as measures of chromosomal alterations, in multiple exfoliated epithelial cell types from residents of Ba Men chronically exposed to arsenic via drinking water. Buccal mucosal cells, airway epithelial cells in sputum, and bladder urothelial cells were collected from 19 residents exposed to high levels of arsenic in drinking water (527.5 +/- 24 microg/l), and from 13 control residents exposed to relatively low levels of arsenic in drinking water (4.4 +/- microg/L). Analytical results from these individuals revealed that MN frequencies in the high-exposure group were significantly elevated to 3.4-fold over control levels for buccal and sputum cells, and to 2.7-fold over control for bladder cells (increases in MN frequency significant at p < .001 for buccal cells; p < .01 for sputum cells; p < .05 for bladder cells). When smokers were excluded from high-exposure and control groups the effects of arsenic were observed to be greater, although only in buccal and sputum cells; approximately 6-fold increases in MN frequency occurred in these tissues. The results indicate that residents of Ba Men chronically exposed to high levels of arsenic in drinking water reveal evidence of genotoxicity in multiple epithelial cell types; higher levels of induced MN were observed in buccal and sputum cells than in bladder cells.


Asunto(s)
Arsénico/efectos adversos , Exposición a Riesgos Ambientales/efectos adversos , Células Epiteliales/patología , Micronúcleos con Defecto Cromosómico/patología , Contaminantes Químicos del Agua/efectos adversos , Adulto , Arsénico/análisis , China , Femenino , Humanos , Masculino , Pruebas de Micronúcleos , Mucosa Bucal/citología , Vejiga Urinaria/citología , Contaminantes Químicos del Agua/análisis , Abastecimiento de Agua
20.
Cell ; 107(5): 605-16, 2001 Nov 30.
Artículo en Inglés | MEDLINE | ID: mdl-11733060

RESUMEN

Use-dependent synapse remodeling is thought to provide a cellular mechanism for encoding durable memories, yet whether activity triggers an actual structural change has remained controversial. We use photoconductive stimulation to demonstrate activity-dependent morphological synaptic plasticity by video imaging of GFP-actin at individual synapses. A single tetanus transiently moves presynaptic actin toward and postsynaptic actin away from the synaptic junction. Repetitive spaced tetani induce glutamate receptor-dependent stable restructuring of synapses. Presynaptic actin redistributes and forms new puncta that label for an active synapse marker FM5-95 within 2 hr. Postsynaptic actin sprouts projections toward the new presynaptic actin puncta, resembling the axon-dendrite interaction during synaptogenesis. Our results indicate that activity-dependent presynaptic structural plasticity facilitates the formation of new active presynaptic terminals.


Asunto(s)
Actinas/metabolismo , Calcio/metabolismo , AMP Cíclico/análogos & derivados , Estimulación Eléctrica , Plasticidad Neuronal/fisiología , Neuronas/metabolismo , Sinapsis/metabolismo , Valina/análogos & derivados , 6-Ciano 7-nitroquinoxalina 2,3-diona/farmacología , Compuestos de Anilina/metabolismo , Animales , Células Cultivadas , AMP Cíclico/metabolismo , AMP Cíclico/farmacología , Inhibidores Enzimáticos/farmacología , Antagonistas de Aminoácidos Excitadores/farmacología , Colorantes Fluorescentes/metabolismo , Genes Reporteros , Proteínas Fluorescentes Verdes , Hipocampo/citología , Luz , Proteínas Luminiscentes/genética , Proteínas Luminiscentes/metabolismo , Microscopía por Video , Neuronas/efectos de los fármacos , Ratas , Receptores de N-Metil-D-Aspartato/metabolismo , Proteínas Recombinantes de Fusión/metabolismo , Transducción de Señal , Silicio/química , Tionucleótidos/farmacología , Valina/farmacología , Xantenos/metabolismo
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