Allogeneic transplantation of the radial side of the hand in the rhesus monkey: I. Technical aspects.

Since allogeneic transplantation of extremities can only be considered if uneventful long-term survival and functional recovery can be achieved, a series of 12 transplantations of the radial side of the hand were performed in rhesus monkeys so that these factors could be assessed. The transplant incorporated the first ray of the hand in conjunction with the radial forearm flap. Graft survival times varied from 21 to 179 days. Ten of 12 transplants showed rejection. In 2 of the 10, rejection could be reversed. Immunosuppressive therapy consisted of cyclosporin A, prednisone, monoclonal antibodies, and preoperative third-party blood transfusions. Monitoring of the microcirculation of the allograft could not provide a predictive value for transplant rejection. The first clinical signs of sensory and motor function recovery were detected after an average of 42 and 44 days, respectively. Indefinite uneventful allograft survival could not be established. Major complications such as sepsis, shock, and lymphoma development leading to death were encountered. The model, however, is technically feasible, and the results for functional recovery under immunosuppression are promising.

A protective thermoplast splint for the forearm and hand in nonhuman primates.

A custom-made thermoplastic splint was developed for the protection of the upper extremity after experimental surgery. It was used in 39 cases for a duration of 12-79 days. Complications were minimal and transient. The cast was easy to make, in one piece and inexpensive. Frequent removal for wound inspection was simple. This splint provides a good immobilization and protection of the arm and hand in the nonhuman primate.

Replantation of the radial side of the hand in the rhesus monkey: anatomical and functional aspects. A preliminary study to composite tissue allografting.

Before human hand transplantation can even be considered, an appropriate research model must be studied in a non-human primate. The first ray of the hand, augmented with a radial forearm flap, was chosen as a functional composite tissue graft. Four technically successful replantation of the radial unit have been carried out. One monkey died on the first post-operative day due to cardiac arrythmia. Normal wound healing occurred in the other three animals. In three monkeys, functional sensory and motor recovery was almost complete. The monkeys were able to pick up small particles of food with the index finger and thumb. It is suggested that this model could be used for allogeneic composite tissue transplantation in a non-human primate.

Test characteristics of carbohydrate-deficient transferrin and gamma-glutamyltransferase in alcohol-using perimenopausal women.

BACKGROUND: The application of biochemical markers to detect heavy alcohol use in women has shown disappointing results until now. We evaluated carbohydrate-deficient transferrin (CDT) by the CDTect method and gamma-glutamyltransferase (GGT) in a large cohort of alcohol-using perimenopausal women studied primarily for osteoporosis. METHODS: CDT and GGT were measured in 431 women aged 46 to 54 years, who were selected from a large cohort (n = 8503) of pre-, peri-, and postmenopausal women. Their alcohol intake was known from questionnaires and face-to-face interviews. Three groups were constructed for statistical analysis: those drinking on average less than 7 alcoholic drinks per week (n = 103), those drinking 7 to 34 per week (n = 280), and those drinking at least 35 per week (n = 48). RESULTS: The mean values of CDT and GGT of the three groups increased with an increasing alcohol intake, but there was a poor correlation between CDT and GGT in the complete study group (r = 0.3). The specificities of CDT and GGT were comparable, 83% and 78%, respectively. The sensitivities for CDT and GGT were 30% and 50%, respectively. A logistic regression model could assign, overall, 77% of the women correctly in relation to their alcohol intake: 43% of the women drinking at least 35 drinks per week and 92% of the women drinking less than 7 drinks per week. CONCLUSIONS: The test characteristics of both GGT and CDT are not good enough to be used as biochemical markers for detecting heavy alcohol use in women. The use of a logistic regression model offers an advantage, because both numeric values of CDT and GGT are taken into account instead of arbitrary cutoff values.

Depression and the lower risk for breast cancer development in middle-aged women: a prospective study.

BACKGROUND: Depression has been hypothesized to be potentially linked to an increased risk of breast cancer. Few studies have addressed this question using population-based cohorts and prospective designs, adjusting for known biomedical risk factors. This has been done in the present investigation. METHOD: Participants were 5191 women from a cohort of women born between 1941 and 1947 and living in the city of Eindhoven, The Netherlands. All women completed questionnaires regarding the presence of depressive symptoms (Edinburgh Depression Scale) and background (demographic, medical and lifestyle) variables. The questionnaire data were linked with the records of the Eindhoven Cancer Registry. These records provided data on breast cancer diagnoses, which took place up to 5 years after the questionnaire screening. RESULTS: Fifty-eight women (1.1%) were found to have developed breast cancer at least 2 years after the questionnaire screening. After controlling for 15 potential risk factors, of which family history of breast cancer, hypothyroidism and unilateral oophorectomy were significant predictors of breast cancer development, women with depressive symptoms had a lower risk of subsequent breast cancer (OR=0.29, 95% CI=0.09-0.92, P=0.04). CONCLUSIONS: Depressive complaints may be associated with a protective factor involved in the development of breast cancer. Some of the possible candidates for this factor are discussed.