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1.
Nat Genet ; 24(1): 27-35, 2000 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-10615123

RESUMEN

DNA mismatch repair is important because of its role in maintaining genomic integrity and its association with hereditary non-polyposis colon cancer (HNPCC). To identify new human mismatch repair proteins, we probed nuclear extracts with the conserved carboxy-terminal MLH1 interaction domain. Here we describe the cloning and complete genomic sequence of MLH3, which encodes a new DNA mismatch repair protein that interacts with MLH1. MLH3 is more similar to mismatch repair proteins from yeast, plants, worms and bacteria than to any known mammalian protein, suggesting that its conserved sequence may confer unique functions in mice and humans. Cells in culture stably expressing a dominant-negative MLH3 protein exhibit microsatellite instability. Mlh3 is highly expressed in gastrointestinal epithelium and physically maps to the mouse complex trait locus colon cancer susceptibility I (Ccs1). Although we were unable to identify a mutation in the protein-coding region of Mlh3 in the susceptible mouse strain, colon tumours from congenic Ccs1 mice exhibit microsatellite instability. Functional redundancy among Mlh3, Pms1 and Pms2 may explain why neither Pms1 nor Pms2 mutant mice develop colon cancer, and why PMS1 and PMS2 mutations are only rarely found in HNPCC families.


Asunto(s)
Disparidad de Par Base , Proteínas Portadoras/genética , Reparación del ADN/genética , Repeticiones de Microsatélite/genética , Secuencia de Aminoácidos , Animales , Células Cultivadas , Clonación Molecular , Neoplasias Colorrectales Hereditarias sin Poliposis/genética , Humanos , Ratones , Ratones Endogámicos , Datos de Secuencia Molecular , Proteínas MutL , Polimorfismo Genético , ARN Mensajero/genética , Homología de Secuencia de Aminoácido , Especificidad de la Especie
3.
Sci Rep ; 11(1): 9822, 2021 05 10.
Artículo en Inglés | MEDLINE | ID: mdl-33972596

RESUMEN

Rift Valley fever phlebovirus (RVFV, Phenuiviridae) is an emerging arbovirus that can cause potentially fatal disease in many host species including ruminants and humans. Thus, tools to detect this pathogen within tissue samples from routine diagnostic investigations or for research purposes are of major interest. This study compares the immunohistological usefulness of several mono- and polyclonal antibodies against RVFV epitopes in tissue samples derived from natural hosts of epidemiologic importance (sheep), potentially virus transmitting insect species (Culex quinquefasciatus, Aedes aegypti) as well as scientific infection models (mouse, Drosophila melanogaster, C6/36 cell pellet). While the nucleoprotein was the epitope most prominently detected in mammal and mosquito tissue samples, fruit fly tissues showed expression of glycoproteins only. Antibodies against non-structural proteins exhibited single cell reactions in salivary glands of mosquitoes and the C6/36 cell pellet. However, as single antibodies exhibited a cross reactivity of varying degree in non-infected specimens, a careful interpretation of positive reactions and consideration of adequate controls remains of critical importance. The results suggest that primary antibodies directed against viral nucleoproteins and glycoproteins can facilitate RVFV detection in mammals and insects, respectively, and therefore will allow RVFV detection for diagnostic and research purposes.


Asunto(s)
Anticuerpos Antivirales/aislamiento & purificación , Inmunohistoquímica/métodos , Fiebre del Valle del Rift/diagnóstico , Virus de la Fiebre del Valle del Rift/aislamiento & purificación , Aedes/virología , Animales , Anticuerpos Antivirales/inmunología , Línea Celular , Chlorocebus aethiops , Reacciones Cruzadas , Culex/virología , Modelos Animales de Enfermedad , Drosophila melanogaster/virología , Epítopos/inmunología , Estudios de Factibilidad , Femenino , Humanos , Ratones , Mosquitos Vectores/virología , Proteínas de la Nucleocápside , Fiebre del Valle del Rift/transmisión , Fiebre del Valle del Rift/virología , Virus de la Fiebre del Valle del Rift/inmunología , Células Vero , Proteínas del Envoltorio Viral/inmunología
4.
Reprod Fertil Dev ; 21(3): 408-18, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19261218

RESUMEN

Following insemination, ram spermatozoa are transported to the isthmus region of the oviduct where they bind to the oviductal epithelial cells (OEC), remaining viable for several hours. The aim of the present study was to begin to decipher which component(s) of the ewe oviduct actively participates in maintaining the viability of ram spermatozoa. A series of experiments was conducted to investigate whether: (1) soluble OEC apical plasma membrane proteins (sAPM) isolated from ewes prolong survival of ram spermatozoa over an extended (48 h) coincubation period at 39 degrees C; (2) a recombinant form of one of these oviductal proteins, namely heat shock 70 kDa protein 8 (HSPA8), prolongs survival of ram spermatozoa; and (3) pretreatment with HSPA8 antibody compromises the ability of sAPM to prolong the survival of ram spermatozoa. Both sAPM and recombinant HSPA8 had a beneficial effect on the viability of ram spermatozoa during coincubation, although both these effects were dose dependent. In contrast, pretreatment with HSPA8 antibody significantly negated the ability of sAPM to maintain the viability of ram spermatozoa. These findings suggest that HSPA8 is an active component of the ewe oviduct that participates in maintaining the viability of ram spermatozoa. This is a potentially valuable observation given that there is a great deal of room for improving existing diluents for storing fresh ram semen.


Asunto(s)
Trompas Uterinas/química , Proteínas HSP70 de Choque Térmico/fisiología , Ovinos , Espermatozoides/fisiología , Animales , Anticuerpos/farmacología , Membrana Celular/química , Supervivencia Celular/efectos de los fármacos , Femenino , Proteínas HSP70 de Choque Térmico/inmunología , Proteínas HSP70 de Choque Térmico/farmacología , Técnicas In Vitro , Masculino , Proteínas de la Membrana/farmacología , Proteínas Recombinantes/farmacología , Preservación de Semen/veterinaria , Factores de Tiempo
5.
Mol Vis ; 13: 1181-97, 2007 Jul 17.
Artículo en Inglés | MEDLINE | ID: mdl-17679943

RESUMEN

PURPOSE: Transforming growth factor beta (TGFbeta), a pro-fibrotic cytokine has been proposed a causative factor in the progression of lens pathologies including posterior capsule opacification (PCO), a condition that occurs after cataract surgery. This study employs oligonucleotide microarrays to provide a global profile of gene expression in FHL 124 cells, to identify changes in gene expression following treatment with TGFbeta1 and TGFbeta2, and to enable putative genes relating to TGFbeta regulation and PCO to be identified. METHODS: Routinely cultured FHL 124 cells maintained in serum free Eagle's Minimum Essential Medium (EMEM) were treated with either TGFbeta1 or TGFbeta2 at 10 ng/ml for 24 h then total RNA extraction was carried out. Total RNA (16 microg) was used to analyze gene expression by spotted oligonucleotide microarray hybridization. The spotted oligonucleotide microarrays employed contained 13,971 oligonucleotide probes, each designed to be specific for an individual gene. Array images were analyzed using GenePix Pro 3.0, followed by raw data import into GeneSpring 7.0 where a cross gene error model (CGEM) filter was applied. Data was subjected to LoWess normalization prior to comparison of the different treatment groups. Quantitative real-time polymerase chain reaction (QRT-PCR) was used to validate the oligonucleotide microarray data, using a select number of genes exhibiting differential expression. RESULTS: A total of 301 genes were up-regulated by more than 1.5 fold in FHL 124 cells by both TGFbeta1 and TGFbeta2. Many of these up-regulated genes had biological functions relevant to lens epithelial cells including roles in contraction, transdifferentiation and as extracellular matrix (ECM) components. A total of 164 genes were down-regulated by more that 1.5 fold in FHL 124 cells by both TGFbeta1 and TGFbeta2. Many of these down-regulated genes have biological functions including roles in apoptosis, signaling, and as anti-oxidants. Following treatment with TGFbeta1 and TGFbeta2, QRT-PCR successfully validated the differential changes in gene expression detected by oligonucleotide microarrays. CONCLUSIONS: TGFbeta1 and TGFbeta2 regulate the gene expression of genes that have important roles in human lens epithelial cell biology. Most importantly, TGFbeta induces the gene expression of a number of fibrotic markers which may have a role in promoting the development of PCO such as transdifferentiation markers, contractile factors, and ECM components.


Asunto(s)
Células Epiteliales/metabolismo , Regulación de la Expresión Génica/efectos de los fármacos , Cristalino/citología , Cristalino/efectos de los fármacos , Análisis de Secuencia por Matrices de Oligonucleótidos , Factor de Crecimiento Transformador beta1/farmacología , Factor de Crecimiento Transformador beta2/farmacología , Regulación hacia Abajo/efectos de los fármacos , Células Epiteliales/efectos de los fármacos , Proteínas de la Matriz Extracelular/genética , Proteínas de la Matriz Extracelular/metabolismo , Perfilación de la Expresión Génica , Sustancias de Crecimiento/genética , Sustancias de Crecimiento/metabolismo , Humanos , Integrinas/genética , Integrinas/metabolismo , Cristalino/metabolismo , Cadenas Ligeras de Miosina/genética , Cadenas Ligeras de Miosina/metabolismo , Receptores de Superficie Celular/genética , Receptores de Superficie Celular/metabolismo , Reproducibilidad de los Resultados , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Transducción de Señal/efectos de los fármacos , Transducción de Señal/genética , Regulación hacia Arriba/efectos de los fármacos
6.
Clin Oncol (R Coll Radiol) ; 19(6): 470-80, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-17419040

RESUMEN

The expansion of our knowledge through the Human Genome Project has been accompanied by the development of new high-throughput techniques, which provide extensive capabilities for the analysis of a large number of genes or the whole genome. These assays can be carried out in various clinical samples at the DNA (genome), RNA (transcriptome) or protein (proteome) level. There is a belief that this genomic revolution, i.e. sequencing of the human genome and developments in high-throughput technology, heralds a future of personalised medicine. For clinical oncology, this progress should increase the possibility of predicting individual patient responses to radiotherapy. This review highlights some of the work involving sparsely ionising radiation and the new technologies.


Asunto(s)
Genómica , Neoplasias/genética , Neoplasias/radioterapia , Regulación Neoplásica de la Expresión Génica/genética , Regulación Neoplásica de la Expresión Génica/efectos de la radiación , Genotipo , Proyecto Genoma Humano , Humanos , Análisis de Secuencia por Matrices de Oligonucleótidos , Polimorfismo Genético/efectos de los fármacos , Polimorfismo Genético/efectos de la radiación , Tolerancia a Radiación/genética , Tolerancia a Radiación/efectos de la radiación , Transcripción Genética/genética , Transcripción Genética/efectos de la radiación
7.
Reprod Fertil Dev ; 17(7): 683-92, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16364221

RESUMEN

Previous experiments have shown that boar sperm survival in vitro is enhanced when co-incubated with a solubilised protein extract of porcine oviducal apical plasma membrane proteins. Here, we examine the hypothesis that the effects are mediated by direct oviduct-sperm contact and use in situ biotinylation of the oviducal epithelial surface to trace the surface-exposed biotinylated proteins through purification and solubilisation steps. We have also examined the effectiveness of mechanical scraping as a method of recovering oviducal epithelial proteins. We show that a subset of proteins originally exposed at the oviducal surface eventually bind to spermatozoa during incubation in vitro, but also show that a different protein subset is implicated if the sperm incubation is performed with proteins that had been biotinylated after (ex situ) extraction from the oviduct. Apical plasma membrane fractions biotinylated after purification contained many more biotinylated protein bands than preparations labelled before purification and multiple protein bands were eventually found to associate with spermatozoa. Although the evidence presented here supports the hypothesis that protein(s) anchored to the oviducal epithelium bind populations of spermatozoa directly and may have a role in the enhancement of sperm viability, it also shows that the choice of investigative technique exerts a major influence on experimental outcomes.


Asunto(s)
Membrana Celular/metabolismo , Trompas Uterinas/metabolismo , Proteínas de la Membrana/aislamiento & purificación , Proteínas de la Membrana/metabolismo , Espermatozoides/fisiología , Sus scrofa , Animales , Biotinilación/métodos , Biotinilación/veterinaria , Electroforesis/veterinaria , Epitelio/metabolismo , Estudios de Evaluación como Asunto , Trompas Uterinas/citología , Femenino , Masculino , Unión Proteica/fisiología , Espermatozoides/metabolismo
8.
Genes Nutr ; 10(3): 463, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25896409

RESUMEN

Iron homeostasis in the human body is maintained primarily through regulation of iron absorption in the duodenum. The liver peptide hepcidin plays a central role in this regulation. Additionally, expression and functional control of certain components of the cellular iron transport machinery can be influenced directly by the iron status of enterocytes. The significance of this modulation, relative to the effects of hepcidin, and the comparative effects of iron obtained directly from the diet and/or via the bloodstream are not clear. The studies described here were performed using Caco-2 cell monolayers as a model of intestinal epithelium, to compare the effects of iron supplied in physiologically relevant forms to either the apical or basolateral surfaces of the cells. Both sources of iron provoked increased cellular ferritin content, indicating iron uptake from both sides of the cells. Supply of basolateral transferrin-bound iron did not affect subsequent iron transport across the apical surface, but reduced iron transport across the basolateral membrane. In contrast, the apical iron supply led to subsequent reduction in iron transport across the apical cell membrane without altering iron export across the basolateral membrane. The apical and basolateral iron supplies also elicited distinct effects on the expression and subcellular distribution of iron transporters. These data suggest that, in addition to the effects of cellular iron status on the expression of iron transporter genes, different modes and direction of iron supply to enterocytes can elicit distinct functional effects on iron transport.

9.
Free Radic Biol Med ; 26(5-6): 646-55, 1999 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-10218653

RESUMEN

The effects of oxidative insult, applied with hydrogen peroxide, on gene transcript levels in a human lymphocyte cell line (Molt-17) were investigated using mRNA differential display. Several cDNA fragments corresponding to putatively up- or down-regulated transcripts were isolated. One of these was found to hybridize to two discrete transcripts on Northern blots of Molt-17 cell RNA. The more abundant transcript, that has previously been demonstrated to correspond to the mRNA for mitochondrial ATPase subunits 8 and 6, was unaffected by the hydrogen peroxide treatment. In contrast, levels of the rarer, larger transcript were consistently reduced in a rapid, sustained, and dose-dependent manner following hydrogen peroxide treatment. Prior supplementation of the cells with beta carotene provided some protection against the reduction in levels of this transcript following hydrogen peroxide treatment. In contrast, vitamins C and E had no effect at the concentrations tested. We have now cloned the cDNA corresponding to this stress-responsive transcript and demonstrated that it is an incompletely processed product of the mitochondrial genome encompassing ATPase subunits 8 and 6 plus the adjacent gene for cytochrome c oxidase subunit 3. This decrease in one specific mitochondrial transcript may represent a novel mechanism for differential expression of mitochondrially-encoded genes.


Asunto(s)
Glutatión/metabolismo , Peróxido de Hidrógeno/farmacología , Mitocondrias/metabolismo , Estrés Oxidativo , Transcripción Genética/efectos de los fármacos , Adenosina Trifosfatasas/genética , Línea Celular , Supervivencia Celular/efectos de los fármacos , ADN Complementario , ADN Mitocondrial/genética , Relación Dosis-Respuesta a Droga , Disulfuro de Glutatión/metabolismo , Humanos , Cinética , Linfocitos , Mitocondrias/efectos de los fármacos , Mitocondrias/genética , ARN Mensajero/genética , beta Caroteno/farmacología
10.
Free Radic Biol Med ; 28(9): 1438-46, 2000 May 01.
Artículo en Inglés | MEDLINE | ID: mdl-10924862

RESUMEN

Two related assays capable of determining cell extract repair activities for different oxidative lesions in DNA are described. Both assays measure the incorporation of radiolabeled nucleotides during repair of an oxidatively damaged template in a cell-free system. The assays differ in the type of oxidative damage present in the DNA. In one, singlet oxygen is used to generate predominantly 8-oxo-2'-deoxyguanosine lesions. In the other, hydroxyl radicals are used to generate a broad spectrum of damage including oxidized bases and strand breaks. Assay conditions were adjusted to ensure that radiolabel incorporation was directly proportional to cell extract repair activity. These assays represent sensitive tools for investigating the regulation of repair systems for oxidative DNA damage.


Asunto(s)
Aductos de ADN/análisis , Daño del ADN , Reparación del ADN/fisiología , Estrés Oxidativo , Cromatografía Líquida de Alta Presión , Aductos de ADN/metabolismo , ADN Recombinante/análisis , Proteínas de Unión al ADN/genética , Compuestos Férricos/farmacología , Humanos , Radical Hidroxilo/metabolismo , Azul de Metileno/metabolismo , Ácido Nitrilotriacético/análogos & derivados , Ácido Nitrilotriacético/farmacología , Oxidación-Reducción , Oxígeno/metabolismo , Oxígeno Singlete , Células Tumorales Cultivadas/efectos de los fármacos , Células Tumorales Cultivadas/metabolismo , Xerodermia Pigmentosa/genética , Proteína de la Xerodermia Pigmentosa del Grupo A
11.
Virus Res ; 56(1): 69-76, 1998 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-9784066

RESUMEN

The medium (M) genome segment of hantaviruses (family Bunyaviridae) encodes the two virion glycoproteins. G1 and G2, as a precursor protein in the complementary sense RNA. We determined the nucleotide sequences of the M genome segments of three Chinese hantavirus isolates, a Hantaan-type (HTN) virus designated A9 and two Seoul-type (SEO) viruses designated L99 and HB55, and compared them to those of other HTN or SEO viruses isolated in Eastern Asia. The M segment of A9 is 3616 nucleotides in length and shows 99.5% identity at the nucleotide level and 99.1% identity at the amino acid level to that of the Chinese HTN isolate HV114. The M segments of L99 and HB55 are 3652 nucleotides in length, one nucleotide longer than the M segments of other sequenced SEO isolates such as SEO 80-39, SR-11, and Biken-1. The Chinese SEO isolates showed 95% nucleotide sequence identity and 99% amino acid sequence identity to SEO 80-39. We also sequenced a 736 nucleotides region of the M genome segment of another Chinese SEO isolate, R22, which revealed errors in the published data. Phylogenetic analysis of the available sequences indicated that both the Chinese HTN- and SEO-type viruses form lineages distinct from those of the isolates from other parts of Eastern Asia.


Asunto(s)
Orthohantavirus/genética , ARN Viral/química , Secuencia de Aminoácidos , Animales , Asia Sudoriental , Secuencia de Bases , China , Chlorocebus aethiops , Genoma Viral , Orthohantavirus/clasificación , Datos de Secuencia Molecular , Muridae , Filogenia , Reacción en Cadena de la Polimerasa , ARN Viral/genética , Ratas , Alineación de Secuencia , Células Vero
12.
J Endocrinol ; 138(1): 159-66, 1993 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-7852887

RESUMEN

The acute effects of different macronutrients on the secretion of glucagon-like peptide-1(7-36)amide (GLP-1(7-36)amide) and glucose-dependent insulinotropic polypeptide (GIP) were compared in healthy human subjects. Circulating levels of the two hormones were measured over a 24-h period during which subjects consumed a mixed diet. In the first study, eight subjects consumed three equicaloric (375 kcal) test meals of carbohydrate, fat and protein. Small increases in plasma GLP-1(7-36) amide were found after all meals. Levels reached a maximum 30 min after the carbohydrate and 150 min after the fat load. Ingestion of both carbohydrate and fat induced substantial rises in GIP secretion, but the protein meal had no effect. In a second study, eight subjects consumed 75 g glucose or the equivalent portion of complex carbohydrate as boiled brown rice or barley. Plasma GIP, insulin and glucose levels increased after all three meals, the largest increase being observed following glucose and the smallest following the barley meal. Plasma GLP-1(7-36)amide levels rose only following the glucose meal. In the 24-h study, plasma GLP-1(7-36)amide and GIP concentrations were increased following every meal and remained elevated throughout the day, only falling to fasting levels at night. The increases in circulating GLP-1(7-36)amide and GIP levels following carbohydrate or a mixed meal are consistent with their role as incretins. The more sustained rises observed in the daytime during the 24-h study are consistent with an anabolic role in lipid metabolism.


Asunto(s)
Ritmo Circadiano/fisiología , Ingestión de Alimentos/fisiología , Polipéptido Inhibidor Gástrico/sangre , Fenómenos Fisiológicos de la Nutrición/fisiología , Fragmentos de Péptidos/sangre , Adulto , Glucemia/análisis , Carbohidratos de la Dieta/metabolismo , Carbohidratos de la Dieta/farmacología , Grasas de la Dieta/metabolismo , Grasas de la Dieta/farmacología , Proteínas en la Dieta/metabolismo , Proteínas en la Dieta/farmacología , Glucagón , Péptido 1 Similar al Glucagón , Péptidos Similares al Glucagón , Glucosa/farmacología , Humanos , Insulina/sangre , Metabolismo de los Lípidos , Radioinmunoensayo , Factores de Tiempo
13.
Vopr Virusol ; 29(3): 301-9, 1984.
Artículo en Ruso | MEDLINE | ID: mdl-6380110

RESUMEN

A simple method of the so-called pinpoint hybridization for the detection of genome RNAs and individual fragments of genome of the Bunyamwera family viruses is described. The method established linking of 2 out of 3 fragments of genome RNA of different members of the family.


Asunto(s)
Bunyaviridae/genética , Genes Virales , Hibridación Genética , Recombinación Genética , Virus Bunyamwera/genética , Clonación Molecular , ADN/genética , ADN Viral/genética , Técnicas Genéticas , Genotipo , ARN Viral/genética , ARN Viral/aislamiento & purificación
14.
Genes Nutr ; 9(6): 432, 2014 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-25260660

RESUMEN

There is growing interest in the potential health benefits of diets that involve regular periods of fasting. While animal studies have provided compelling evidence that feeding patterns such as alternate-day fasting can increase longevity and reduce incidence of many chronic diseases, the evidence from human studies is much more limited and equivocal. Additionally, although several candidate processes have been proposed to contribute to the health benefits observed in animals, the precise molecular mechanisms responsible remain to be elucidated. The study described here examined the effects of an extended fast on gene transcript profiles in peripheral blood mononuclear cells from ten apparently healthy subjects, comparing transcript profiles after an overnight fast, sampled on four occasions at weekly intervals, with those observed on a single occasion after a further 24 h of fasting. Analysis of the overnight fasted data revealed marked inter-individual differences, some of which were associated with parameters such as gender and subject body mass. For example, a striking positive association between body mass index and the expression of genes regulated by type 1 interferon was observed. Relatively subtle changes were observed following the extended fast. Nonetheless, the pattern of changes was consistent with stimulation of fatty acid oxidation, alterations in cell cycling and apoptosis and decreased expression of key pro-inflammatory genes. Stimulation of fatty acid oxidation is an expected response, most likely in all tissues, to fasting. The other processes highlighted provide indications of potential mechanisms that could contribute to the putative beneficial effects of intermittent fasting in humans.

17.
Clin Oncol (R Coll Radiol) ; 23(9): 613-24, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-21470834

RESUMEN

AIMS: A variety of dosimetric parameters have been shown to influence the incidence of late radiation toxicity. The effect of other treatment- and patient-related factors is less well established. The aim of this study was to elucidate the influence of such factors in the development of late symptoms after radical radiotherapy to the prostate. MATERIALS AND METHODS: Patient- and treatment-related factors that are thought to influence the development of late toxicity were analysed in 788 patients who had received radical radiotherapy to the prostate in the Medical Research Council RT01 trial. Late toxicity data were recorded using the Radiation Therapy Oncology Group, Late Effects of Normal Tissues/Subjective, Objective, Management, Analytic, Royal Marsden Hospital and the University of California, Los Angeles, Prostate Cancer Index. Acute toxicity was measured using the Radiation Therapy Oncology Group grading system. RESULTS: On multivariate analysis, acute bowel toxicity was statistically significantly associated with increased proctitis (hazard ratio=1.63, 95% confidence interval 1.18, 2.24; P=0.003) and increased stool frequency (hazard ratio=1.77, 95% confidence interval 1.27, 2.46; P=0.001). Hypertension was strongly associated with a decreased risk of poor urinary stream (hazard ratio=0.25, 95% confidence interval 0.09, 0.71; P=0.009). There was an increased risk of rectal bleeding with increased age (hazard ratio=1.04 per year of age, 95% confidence interval 1.01, 1.08; P=0.009). As expected, a higher prescribed dose increased the risk of several late toxicity end points. Although acute bladder toxicity was associated with the presence of bladder symptoms at 5 years, the effect disappeared for all symptoms except increased urinary frequency and haematuria when a change in bladder function from baseline was calculated. Patients with any pretreatment bladder symptoms were more likely to report increased urinary frequency (hazard ratio=2.09, 95% confidence interval 1.48, 2.95; P<0.0005), increased urinary incontinence (hazard ratio=4.22, 95% confidence interval 2.13, 8.35; P<0.0005) and decreased stream (hazard ratio=2.64, 95% confidence interval 1.62, 4.31; P<0.0005), after treatment and before the most recent follow-up assessment. CONCLUSIONS: In this study, increased acute gastrointestinal and bladder symptoms and prescribed dose were associated with increased late radiation toxicity. The presence of hypertension seemed to be protective for the development of late effects. Baseline symptoms should be taken into account when radiation toxicity is analysed.


Asunto(s)
Neoplasias de la Próstata/radioterapia , Traumatismos por Radiación/complicaciones , Traumatismos por Radiación/etiología , Relación Dosis-Respuesta en la Radiación , Enfermedades Gastrointestinales/etiología , Humanos , Masculino , Análisis Multivariante , Modelos de Riesgos Proporcionales , Neoplasias de la Próstata/tratamiento farmacológico , Radiometría , Dosificación Radioterapéutica , Radioterapia Conformacional/efectos adversos , Enfermedades de la Vejiga Urinaria/etiología
18.
Transplant Proc ; 43(9): 3521-8, 2011 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-22099833

RESUMEN

INTRODUCTION: Quadrimembral amputees, as patients who have lost both upper and lower extremities, may benefit greatly from hand transplantation. The objective of this study is to evaluate the indications and contraindications for transplantation in this subset of patients. METHODS: A retrospective review was conducted of five quadrimembral amputees evaluated by our program for transplantation. Information collected included age, sex, level of amputations, time since amputations, etiology, level of dependence, medical stability, psychosocial status, and the ability to tolerate immunosuppression. Indications and contraindications for transplantation were reviewed for each patient. RESULTS: All etiologies were based in extremity ischemia: three from septic shock, one from myocardial infarction, and one from drug overdose. All patients are completely dependent. Of the five patients, two needed further reconstructive surgery and two others had a history of resolved hepatic/renal insufficiency. After thorough evaluation, two patients were selected as potential transplant candidates. They demonstrated strong psychosocial support systems, a thorough understanding of hand transplantation, along with its risks and postoperative requirements. They had also completed a full regimen of rehabilitation along with prosthetic fitting and utilization. CONCLUSIONS: Clearance for transplantation is based on medical stability, absence of infection or systemic diseases, and strong psychosocial support systems. Contraindications for transplantation are drug dependence and noncompliant behavior. Relative contraindications include a history of hepatic/renal insufficiency which if not resolved may preclude the use of postoperative immunosuppression.


Asunto(s)
Amputación Quirúrgica/rehabilitación , Trasplante de Mano , Selección de Paciente , Adulto , Amputación Quirúrgica/psicología , Amputados , Miembros Artificiales , Actitud Frente a la Salud , Femenino , Humanos , Inmunosupresores/farmacología , Isquemia , Masculino , Persona de Mediana Edad , Procedimientos de Cirugía Plástica/métodos , Estudios Retrospectivos , Trasplante Homólogo , Listas de Espera
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