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1.
Nature ; 530(7589): 190-3, 2016 Feb 11.
Artículo en Inglés | MEDLINE | ID: mdl-26829223

RESUMEN

Laser-plasma accelerators (LPAs) are capable of accelerating charged particles to very high energies in very compact structures. In theory, therefore, they offer advantages over conventional, large-scale particle accelerators. However, the energy gain in a single-stage LPA can be limited by laser diffraction, dephasing, electron-beam loading and laser-energy depletion. The problem of laser diffraction can be addressed by using laser-pulse guiding and preformed plasma waveguides to maintain the required laser intensity over distances of many Rayleigh lengths; dephasing can be mitigated by longitudinal tailoring of the plasma density; and beam loading can be controlled by proper shaping of the electron beam. To increase the beam energy further, it is necessary to tackle the problem of the depletion of laser energy, by sequencing the accelerator into stages, each powered by a separate laser pulse. Here, we present results from an experiment that demonstrates such staging. Two LPA stages were coupled over a short distance (as is needed to preserve the average acceleration gradient) by a plasma mirror. Stable electron beams from a first LPA were focused to a twenty-micrometre radius--by a discharge capillary-based active plasma lens--into a second LPA, such that the beams interacted with the wakefield excited by a separate laser. Staged acceleration by the wakefield of the second stage is detected via an energy gain of 100 megaelectronvolts for a subset of the electron beam. Changing the arrival time of the electron beam with respect to the second-stage laser pulse allowed us to reconstruct the temporal wakefield structure and to determine the plasma density. Our results indicate that the fundamental limitation to energy gain presented by laser depletion can be overcome by using staged acceleration, suggesting a way of reaching the electron energies required for collider applications.

2.
Phys Rev Lett ; 122(8): 084801, 2019 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-30932604

RESUMEN

Guiding of relativistically intense laser pulses with peak power of 0.85 PW over 15 diffraction lengths was demonstrated by increasing the focusing strength of a capillary discharge waveguide using laser inverse bremsstrahlung heating. This allowed for the production of electron beams with quasimonoenergetic peaks up to 7.8 GeV, double the energy that was previously demonstrated. Charge was 5 pC at 7.8 GeV and up to 62 pC in 6 GeV peaks, and typical beam divergence was 0.2 mrad.

3.
Phys Rev Lett ; 119(10): 104801, 2017 Sep 08.
Artículo en Inglés | MEDLINE | ID: mdl-28949165

RESUMEN

Single-shot, charge-dependent emittance measurements of electron beams generated by a laser plasma accelerator (LPA) reveal that shock-induced density down-ramp injection produces beams with normalized emittances a factor of 2 smaller than beams produced via ionization injection. Such a comparison is made possible by the tunable LPA setup, which allows electron beams with nearly identical central energy and peak spectral charge density to be produced using the two distinct injection mechanisms. Parametric measurements of this type are essential for the development of LPA-based applications which ultimately require high charge density and low emittance.

4.
Phys Rev Lett ; 114(14): 145003, 2015 Apr 10.
Artículo en Inglés | MEDLINE | ID: mdl-25910131

RESUMEN

An undulator is proposed based on the plasma wakefields excited by a laser pulse in a plasma channel. Generation of the undulator fields is achieved by inducing centroid oscillations of the laser pulse in the channel. The period of such an undulator is proportional to the Rayleigh length of the laser pulse and can be submillimeter, while preserving high undulator strength. The electron trajectories in the undulator are examined, expressions for the undulator strength are presented, and the spontaneous radiation is calculated. Multimode and multicolor laser pulses are considered for greater tunability of the undulator period and strength.

5.
Phys Rev Lett ; 115(18): 184802, 2015 Oct 30.
Artículo en Inglés | MEDLINE | ID: mdl-26565471

RESUMEN

Compact, tunable, radially symmetric focusing of electrons is critical to laser-plasma accelerator (LPA) applications. Experiments are presented demonstrating the use of a discharge-capillary active plasma lens to focus 100-MeV-level LPA beams. The lens can provide tunable field gradients in excess of 3000 T/m, enabling cm-scale focal lengths for GeV-level beam energies and allowing LPA-based electron beams and light sources to maintain their compact footprint. For a range of lens strengths, excellent agreement with simulation was obtained.

6.
J Appl Microbiol ; 118(5): 1199-209, 2015 May.
Artículo en Inglés | MEDLINE | ID: mdl-25630831

RESUMEN

AIMS: Isolation of Salmonella Typhi from blood culture is the standard diagnostic for confirming typhoid fever but it is unavailable in many developing countries. We previously described a Microwave Accelerated Metal Enhanced Fluorescence (MAMEF)-based assay to detect Salmonella in medium. Attempts to detect Salmonella in blood were unsuccessful, presumably due to the interference of erythrocytes. The objective of this study was to evaluate various blood treatment methods that could be used prior to PCR, real-time PCR or MAMEF to increase sensitivity of detection of Salmonella. METHODS AND RESULTS: We tested ammonium chloride and erythrocyte lysis buffer, water, Lymphocyte Separation Medium, BD Vacutainer(®) CPT(™) Tubes and dextran. Erythrocyte lysis buffer was the best isolation method as it is fast, inexpensive and works with either fresh or stored blood. The sensitivity of PCR- and real-time PCR detection of Salmonella in spiked blood was improved when whole blood was first lysed using erythrocyte lysis buffer prior to DNA extraction. Removal of erythrocytes and clotting factors also enabled reproducible lysis of Salmonella and fragmentation of DNA, which are necessary for MAMEF sensing. CONCLUSIONS: Use of the erythrocyte lysis procedure prior to DNA extraction has enabled improved sensitivity of Salmonella detection by PCR and real-time PCR and has allowed lysis and fragmentation of Salmonella using microwave radiation (for future detection by MAMEF). SIGNIFICANCE AND IMPACT OF THE STUDY: Adaptation of the blood lysis method represents a fundamental breakthrough that improves the sensitivity of DNA-based detection of Salmonella in blood.


Asunto(s)
Métodos Analíticos de la Preparación de la Muestra/métodos , Eritrocitos/química , Salmonella typhi/aislamiento & purificación , Fiebre Tifoidea/microbiología , Humanos , Reacción en Cadena en Tiempo Real de la Polimerasa , Salmonella typhi/genética , Sensibilidad y Especificidad , Fiebre Tifoidea/sangre
7.
Phys Rev Lett ; 112(12): 125001, 2014 Mar 28.
Artículo en Inglés | MEDLINE | ID: mdl-24724654

RESUMEN

A method is proposed to generate femtosecond, ultralow emittance (∼10-8 m rad), electron beams in a laser-plasma accelerator using two lasers of different colors. A long-wavelength pump pulse, with a large ponderomotive force and small peak electric field, excites a wake without fully ionizing a high-Z gas. A short-wavelength injection pulse, with a small ponderomotive force and large peak electric field, copropagating and delayed with respect to the pump laser, ionizes a fraction of the remaining bound electrons at a trapping wake phase, generating an electron beam that is accelerated in the wake.

8.
Phys Rev Lett ; 113(24): 245002, 2014 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-25541775

RESUMEN

Multi-GeV electron beams with energy up to 4.2 GeV, 6% rms energy spread, 6 pC charge, and 0.3 mrad rms divergence have been produced from a 9-cm-long capillary discharge waveguide with a plasma density of ≈7×10¹7 cm⁻³, powered by laser pulses with peak power up to 0.3 PW. Preformed plasma waveguides allow the use of lower laser power compared to unguided plasma structures to achieve the same electron beam energy. A detailed comparison between experiment and simulation indicates the sensitivity in this regime of the guiding and acceleration in the plasma structure to input intensity, density, and near-field laser mode profile.

9.
Br J Dermatol ; 168(5): 1047-53, 2013 May.
Artículo en Inglés | MEDLINE | ID: mdl-23137036

RESUMEN

BACKGROUND: Organ transplant recipients have an increased risk of skin cancers. A specialist dermatology clinic for renal transplant recipients (RTRs) was established in 2005. OBJECTIVES: To analyse the type and incidence of skin cancers in prevalent patients in the West of Scotland after renal transplant, and to analyse the impact of the time since transplant and the immunosuppression regimen. METHODS: Skin cancer data for RTRs attending the transplant dermatology clinic over a 38-month period were collected and recorded in the West of Scotland electronic renal patient record. Skin cancer data were intrinsically linked to each individual's transplant and immunosuppression data. RESULTS: Overall, 610 patients attended. The median follow-up time from the date of first transplant was 10 years. Ninety-three patients (15.2%) had experienced a total of 368 skin cancers since transplant, and the prevalence increased with time since transplant. Basal cell carcinomas (BCCs) occurred in 74 patients (12.1%) and squamous cell carcinomas (SCCs) in 42 patients (6.9%). Three patients (0.5%) had experienced a melanoma. The SCC:BCC ratio was 0.7. Survival analysis showed significant reduction in the time to develop skin cancer in patients transplanted from 1995 onwards (P < 0.0001) and in patients who had been on triple immunosuppressant therapy at 1 year after transplant, compared with dual therapy (P < 0.0001). CONCLUSIONS: This is the first study of skin cancer in prevalent Scottish RTRs. The incidence of skin cancer is high and appears to have a direct relationship to the overall burden of immunosuppression. The SCC:BCC ratio, which is lower than reports from other centres, deserves further scrutiny.


Asunto(s)
Carcinoma Basocelular/etiología , Carcinoma de Células Escamosas/etiología , Trasplante de Riñón , Melanoma/etiología , Neoplasias Cutáneas/etiología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Terapia de Inmunosupresión , Inmunosupresores/administración & dosificación , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Prevalencia , Factores de Riesgo , Escocia/epidemiología , Adulto Joven
10.
Phys Rev Lett ; 109(6): 064802, 2012 Aug 10.
Artículo en Inglés | MEDLINE | ID: mdl-23006273

RESUMEN

X-ray spectroscopy is used to obtain single-shot information on electron beam emittance in a low-energy-spread 0.5 GeV-class laser-plasma accelerator. Measurements of betatron radiation from 2 to 20 keV used a CCD and single-photon counting techniques. By matching x-ray spectra to betatron radiation models, the electron bunch radius inside the plasma is estimated to be ~0.1 µm. Combining this with simultaneous electron spectra, normalized transverse emittance is estimated to be as low as 0.1 mm mrad, consistent with three-dimensional particle-in-cell simulations. Correlations of the bunch radius with electron beam parameters are presented.

11.
J Fluoresc ; 22(4): 1189-99, 2012 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-22534954

RESUMEN

In this study, we have investigated the fluorescence properties of SYBR Green I (SG) dye and its interaction with double-stranded DNA (dsDNA). SG/dsDNA complexes were studied using various spectroscopic techniques, including fluorescence resonance energy transfer and time-resolved fluorescence techniques. It is shown that SG quenching in the free state has an intrinsic intramolecular origin; thus, the observed >1,000-fold SG fluorescence enhancement in complex with DNA can be explained by a dampening of its intra-molecular motions. Analysis of the obtained SG/DNA binding isotherms in solutions of different ionic strength and of SG/DNA association in the presence of a DNA minor groove binder, Hoechst 33258, revealed multiple modes of interaction of SG inner groups with DNA. In addition to interaction within the DNA minor groove, both intercalation between base pairs and stabilization of the electrostatic SG/DNA complex contributed to increased SG affinity to double-stranded DNA. We show that both fluorescence and the excited state lifetime of SG dramatically increase in viscous solvents, demonstrating an approximate 200-fold enhancement in 100 % glycerol, compared to water, which also makes SG a prospective fluorescent viscosity probe. A proposed structural model of the SG/DNA complex is compared and discussed with results recently reported for the closely related PicoGreen chromophore.


Asunto(s)
ADN/metabolismo , Fluorescencia , Compuestos Orgánicos/química , Compuestos Orgánicos/metabolismo , Benzotiazoles , ADN/química , Diaminas , Conformación de Ácido Nucleico , Quinolinas , Soluciones , Espectrometría de Fluorescencia , Electricidad Estática , Termodinámica , Viscosidad
12.
Am J Transplant ; 11(3): 463-9, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21342446

RESUMEN

Previous studies that described the long-term quality of life of living kidney donors were conducted in single centers, and lacked data on a healthy nondonor comparison group. We conducted a retrospective cohort study to compare the quality of life of 203 kidney donors with 104 healthy nondonor controls using validated scales (including the SF36, 15D and feeling thermometer) and author-developed questions. Participants were recruited from nine transplant centers in Canada, Scotland and Australia. Outcomes were assessed a median of 5.5 years after the time of transplantation (lower and upper quartiles of 3.8 and 8.4 years, respectively). 15D scores (scale of 0 to 1) were high and similar between donors and nondonors (mean 0.93 (standard deviation (SD) 0.09) and 0.94 (SD 0.06), p = 0.55), and were not different when results were adjusted for several prognostic characteristics (p = 0.55). On other scales and author-developed questions, groups performed similarly. Donors to recipients who had an adverse outcome (death, graft failure) had similar quality of life scores as those donors where the recipient did well. Our findings are reassuring for the practice of living transplantation. Those who donate a kidney in centers that use routine pretransplant donor evaluation have good long-term quality of life.


Asunto(s)
Trasplante de Riñón , Donadores Vivos , Calidad de Vida , Adulto , Estudios de Casos y Controles , Estudios de Cohortes , Femenino , Supervivencia de Injerto , Humanos , Masculino , Estudios Retrospectivos , Encuestas y Cuestionarios , Resultado del Tratamiento
13.
Clin Transplant ; 25(2): E199-204, 2011.
Artículo en Inglés | MEDLINE | ID: mdl-21303413

RESUMEN

Traditional risk factors do not adequately explain the increased prevalence of cardiovascular disease in renal patients. This study considered a "non-traditional" risk factor, serum phosphate and outcome in renal transplant recipients. Data from 377 patients who received a first deceased donor renal transplant between January 1, 1999, and December 31, 2008, were recorded; 10% (n=38) had diabetes, 16.7% (n=63) were smokers, and 18.8% (n=71) had a history of vascular disease. Three hundred and thirty-three patients were alive at the time of the analysis. Survivors were significantly younger, less likely to be smokers or diabetic, and had a higher estimated glomerular filtration rate at one yr post-transplantation. Serum phosphate was significantly lower in these patients (0.95 ± 0.23 vs. 1.04 ± 0.26, p = 0.031). Analysis of recipient survival, stratified by serum phosphate at one yr post-transplant, revealed that serum phosphate > 1.11 mMol/L was a significant predictor of all-cause mortality (p=0.006). Serum phosphate between 0.9 and 1.11 mMol/L afforded the best outcome. In multivariate analysis, serum phosphate remained a significant predictor of mortality (p=0.016). Serum phosphate at one yr after transplant seems to have a J-shaped relationship with mortality, and this effect is independent of traditional cardiovascular risk factors.


Asunto(s)
Trasplante de Riñón/mortalidad , Fosfatos/sangre , Cadáver , Femenino , Humanos , Masculino , Persona de Mediana Edad , Factores de Riesgo , Tasa de Supervivencia , Factores de Tiempo , Donantes de Tejidos , Resultado del Tratamiento
14.
Transpl Infect Dis ; 13(2): 109-16, 2011 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-21457419

RESUMEN

BACKGROUND: The aim was to report our experience of BK viremia surveillance after kidney transplant during a period of change from cyclosporine (CyA)-to lower-dose tacrolimus (Tac)-based primary immunosuppression regimens. METHODS: In a prospective single-center observational cohort study, 68 consecutive patients received renal transplant during the period when we used a CyA-based primary immunosuppression regimen and 66 after we changed to a lower-dose Tac-based regimen. Testing for BK viremia by quantitative polymerase chain reaction assay was performed at least monthly for a minimum of 1 year. RESULTS: Thirty-nine (29.1%) patients developed BK viremia and 2 (1.5%) developed BK nephropathy. The actuarial time to BK viremia was shorter in patients receiving CyA/mycophenolate mofetil (MMF)/prednisolone (Pred) compared with Tac/MMF/Pred (P=0.04) and primary immunosuppression with CyA/MMF/Pred was the only independent predictor of BK viremia (hazard ratio 1.95; P=0.047). Comparing patients who experienced BK viremia and those who did not, there was no difference in incidence of acute rejection (20.5% vs. 25.3%; P=0.56) or estimated glomerular filtration rate at 12 months (48.8 vs. 49.9 mL/min/1.73 m(2)), but the incidence of ureteric stenosis was higher (10.3% vs. 1.1%; P=0.01). CONCLUSIONS: Our data demonstrate a lower incidence of BK viremia in patients on lower-dose Tac compared with CyA-based primary immunosuppression in contrast to previous studies, and provide further support for the association between BK virus and ureteric complications.


Asunto(s)
Virus BK/aislamiento & purificación , Ciclosporina/uso terapéutico , Trasplante de Riñón/efectos adversos , Infecciones por Polyomavirus/prevención & control , Tacrolimus/uso terapéutico , Infecciones Tumorales por Virus/prevención & control , Ciclosporina/administración & dosificación , Humanos , Terapia de Inmunosupresión , Inmunosupresores/administración & dosificación , Inmunosupresores/uso terapéutico , Enfermedades Renales/sangre , Enfermedades Renales/prevención & control , Enfermedades Renales/virología , Ácido Micofenólico/administración & dosificación , Ácido Micofenólico/análogos & derivados , Ácido Micofenólico/uso terapéutico , Infecciones por Polyomavirus/sangre , Infecciones por Polyomavirus/complicaciones , Infecciones por Polyomavirus/virología , Prednisolona/administración & dosificación , Prednisolona/uso terapéutico , Tacrolimus/administración & dosificación , Factores de Tiempo , Infecciones Tumorales por Virus/sangre , Infecciones Tumorales por Virus/complicaciones , Infecciones Tumorales por Virus/virología , Viremia/sangre
15.
Phys Chem Chem Phys ; 13(9): 3831-8, 2011 Mar 07.
Artículo en Inglés | MEDLINE | ID: mdl-21225049

RESUMEN

Metal-Enhanced Fluorescence (MEF) effects from different density silver island films (SiFs) and the effects of far-field excitation irradiance on the observed enhancement of fluorescence were studied. It is shown that MEF non-linearly depends on silver nanoparticle (NP) size/density, reaching a maximum value for SiFs made at a deposition time (DT) of ∼5 minutes, i.e. just before SiFs become continuous. Numerical simulations of the silver-islands growing on glass revealed that the near-field magnitude depends non-linearly on size and interparticle distance exhibiting dramatic enhancement at ∼10 nm distance between the NPs. In addition, a remarkable effect of modulation in MEF efficiency by far-field excitation irradiance has been observed, which can be correlated well with numerical simulations that show an excitation power volume dependence. The near-field volume changes non-linearly with far-field power. This unique observation has profound implications in MEF, which has rapidly emerged as a powerful tool in the biosciences and ultimately allows for tunable fluorescence enhancement factors.


Asunto(s)
Metales/química , Nanopartículas del Metal/química , Plata/química , Espectrometría de Fluorescencia
16.
Biophys J ; 99(9): 3010-9, 2010 Nov 03.
Artículo en Inglés | MEDLINE | ID: mdl-21044599

RESUMEN

PicoGreen is a fluorescent probe that binds dsDNA and forms a highly luminescent complex when compared to the free dye in solution. This unique probe is widely used in DNA quantitation assays but has limited application in biophysical analysis of DNA and DNA-protein systems due to limited knowledge pertaining to its physical properties and characteristics of DNA binding. Here we have investigated PicoGreen binding to DNA to reveal the origin and mode of PicoGreen/DNA interactions, in particular the role of electrostatic and nonelectrostatic interactions in formation of the complex, as well as demonstrating minor groove binding specificity. Analysis of the fluorescence properties of free PicoGreen, the diffusion properties of PG/DNA complexes, and the excited-state lifetime changes upon DNA binding and change in solvent polarity, as well as the viscosity, reveal that quenching of PicoGreen in the free state results from its intramolecular dynamic fluctuations. On binding to DNA, intercalation and electrostatic interactions immobilize the dye molecule, resulting in a >1000-fold enhancement in its fluorescence. Based on the results of this study, a model of PicoGreen/DNA complex formation is proposed.


Asunto(s)
ADN/química , Colorantes Fluorescentes/química , Sitios de Unión , Fenómenos Biofísicos , Bisbenzimidazol/química , Sustancias Intercalantes , Sustancias Macromoleculares/química , Modelos Moleculares , Simulación de Dinámica Molecular , Compuestos Orgánicos/química , Espectrometría de Fluorescencia , Electricidad Estática
17.
Anal Biochem ; 396(1): 8-12, 2010 Jan 01.
Artículo en Inglés | MEDLINE | ID: mdl-19748479

RESUMEN

PicoGreen (PG) is a fluorescent probe for both double-stranded DNA (dsDNA) detection and quantification based on its ability to form a luminescent complex with dsDNA as compared with the free dye in solution. To expand the sensitivity of PG detection, we have studied the spectral properties of PG, both free and in complex with DNA in solution, when the fluorophore is in proximity to silver nanoparticles. We show that for a broad range of PG concentrations (20 pM-3.5 microM), it does not form dimers/oligomers and it exists in a monomeric state. On binding to DNA in the absence of silver, PG fluorescence increases approximately 1100-fold. Deposition of PG/DNA complex onto silver island films (SiFs) increases fluorescence approximately 7-fold due to the metal-enhanced fluorescence (MEF) effect, yielding fluorescence enhancement of 7700-fold as compared with the free dye on glass. In contrast to PG in complex with DNA, the free dye on SiFs demonstrates a decrease in brightness approximately 5-fold. Therefore, the total enhancement of PG on binding to DNA on silver reaches a value of approximately 38,000 as compared with free PG on SiFs. Consequently, the metal-enhanced detection of PG fluorescence is likely to find important utility for amplified dsDNA quantification.


Asunto(s)
ADN/análisis , Plata/química , Emparejamiento Base , Vidrio/química , Compuestos Orgánicos/química , Concentración Osmolar , Fotoblanqueo , Soluciones , Espectrometría de Fluorescencia , Factores de Tiempo
18.
Nature ; 431(7008): 538-41, 2004 Sep 30.
Artículo en Inglés | MEDLINE | ID: mdl-15457252

RESUMEN

Laser-driven accelerators, in which particles are accelerated by the electric field of a plasma wave (the wakefield) driven by an intense laser, have demonstrated accelerating electric fields of hundreds of GV m(-1) (refs 1-3). These fields are thousands of times greater than those achievable in conventional radio-frequency accelerators, spurring interest in laser accelerators as compact next-generation sources of energetic electrons and radiation. To date, however, acceleration distances have been severely limited by the lack of a controllable method for extending the propagation distance of the focused laser pulse. The ensuing short acceleration distance results in low-energy beams with 100 per cent electron energy spread, which limits potential applications. Here we demonstrate a laser accelerator that produces electron beams with an energy spread of a few per cent, low emittance and increased energy (more than 10(9) electrons above 80 MeV). Our technique involves the use of a preformed plasma density channel to guide a relativistically intense laser, resulting in a longer propagation distance. The results open the way for compact and tunable high-brightness sources of electrons and radiation.

19.
Nephron Clin Pract ; 111(1): c7-11, 2009.
Artículo en Inglés | MEDLINE | ID: mdl-19033691

RESUMEN

INTRODUCTION: The incidence of multiple myeloma (MM) has increased in Scotland over the last 20 years. Approximately 25% of cases present directly to renal services. Serum electrophoresis is commonly included in the diagnostic screening tests performed in patients with chronic kidney disease (CKD). We examined the utility of serum electrophoresis in the population presenting to renal outpatient services in Glasgow. METHODS: All new patient attendances at general nephrology clinics in the Glasgow renal units between 1/08/2004 and 31/07/2006, along with clinical data, were retrieved from the electronic patient records. Patients with acute kidney injury were excluded. All serum and urine electrophoresis requests and results for the same period were identified from Biochemistry and Immunology Laboratory Services. RESULTS: A total of 2,544 new patients attended a renal clinic for the first time in the inception period, of whom 1,608 (63.2%) had serum electrophoresis tested. One patient with MM was identified, but the diagnosis was clinically apparent before the serum electrophoresis result was requested. A further 40 subjects had abnormal serum electrophoresis with mean paraprotein of 8.3 g/l (SD 6.1); none of these patients have subsequently developed MM, and the renal abnormalities are felt to be unrelated. This prevalence of monoclonal gammopathy of uncertain significance in 2.5% of the cohort is consistent with the expected prevalence in the general population. CONCLUSION: Our data demonstrate that serum electrophoresis in patients with CKD is not a useful screening test to identify MM.


Asunto(s)
Electroforesis de las Proteínas Sanguíneas , Enfermedades Renales/etiología , Tamizaje Masivo , Mieloma Múltiple/diagnóstico , Proteínas de Mieloma/análisis , Anciano , Anciano de 80 o más Años , Proteína de Bence Jones/orina , Calcio/sangre , Enfermedad Crónica , Humanos , Enfermedades Renales/sangre , Persona de Mediana Edad , Mieloma Múltiple/sangre , Mieloma Múltiple/complicaciones , Mieloma Múltiple/epidemiología , Mieloma Múltiple/orina , Servicio Ambulatorio en Hospital/estadística & datos numéricos , Paraproteinemias/sangre , Estudios Retrospectivos , Escocia/epidemiología
20.
Clin Radiol ; 64(11): 1081-7, 2009 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-19822241

RESUMEN

AIM: To evaluate the potential application of microbubble agents in the immediate post-transplant period, by studying contrast uptake and washout, and to correlate these values with clinical indices, and thus, assess the potential prognostic value of this technique. MATERIALS AND METHODS: The study group comprised 20 consecutive renal transplant patients within 7 days of transplantation. Sonovue was administered as an intravenous bolus with continuous imaging of the transplant kidney at low mechanical index (MI) for 1 min post-injection. These data were analysed off-line by two observers, and time intensity curves (TIC) for the upper, mid, and lower poles constructed. Within each pole, a region of interest (5 mm square) was placed over the cortex, medullary pyramid, and interlobar artery, resulting in a total of nine TIC for each patient. TIC parameters included the arrival time (AT), time to peak (TTP), peak intensity (Max), gradient of the slope (M), and the area under curve (AUC). RESULTS: For both observers there was good agreement for all values measured from the cortex and medulla, but poor interobserver correlation for the vascular values. In addition, there was only agreement for these values in the upper and mid-pole of the transplant with poor agreement for the lower pole values. The mid-pole of the transplant kidney was chosen as the point of measurement for subsequent studies. Mid-pole values were correlated with clinical data and outcome over the 3-month post-transplant period. Renal microbubble perfusion correlated with the transplant estimated glomerular filtration rate (eGFR) at 3 months post-transplantation (p=0.016). DISCUSSION: In conclusion, this is the first study to confirm reproducibility of the Sonovue TIC data in transplant patients and to quantify regional variation and perfusion. The statistically significant estimates of transplant perfusion may be of future benefit to transplant recipients and potentially utilized as a prognostic tool. However, a more in depth study will be required to support or refute these early study findings.


Asunto(s)
Medios de Contraste/farmacocinética , Trasplante de Riñón/diagnóstico por imagen , Riñón/diagnóstico por imagen , Microburbujas , Hexafluoruro de Azufre/farmacocinética , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Fosfolípidos , Proyectos Piloto , Periodo Posoperatorio , Pronóstico , Estudios Prospectivos , Reproducibilidad de los Resultados , Factores de Tiempo , Resultado del Tratamiento , Ultrasonografía
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