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1.
Min Eng ; 70(1): 42-48, 2018 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-29348700

RESUMEN

Float dust deposits in coal mine return airways pose a risk in the event of a methane ignition. Controlling airborne dust prior to deposition in the return would make current rock dusting practices more effective and reduce the risk of coal-dust-fueled explosions. The goal of this U.S. National Institute for Occupational Safety and Health study is to determine the potential of open-air water sprays to reduce concentrations of airborne float coal dust, smaller than 75 µm in diameter, in longwall face airstreams. This study evaluated unconfined water sprays in a featureless tunnel ventilated at a typical longwall face velocity of 3.6 m/s (700 fpm). Experiments were conducted for two nozzle orientations and two water pressures for hollow cone, full cone, flat fan, air atomizing and hydraulic atomizing spray nozzles. Gravimetric samples show that airborne float dust removal efficiencies averaged 19.6 percent for all sprays under all conditions. The results indicate that the preferred spray nozzle should be operated at high fluid pressures to produce smaller droplets and move more air. These findings agree with past respirable dust control research, providing guidance on spray selection and spray array design in ongoing efforts to control airborne float dust over the entire longwall ventilated opening.

2.
Min Eng ; 69(9): 61-66, 2017 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-28936001

RESUMEN

Float coal dust is produced by various mining methods, carried by ventilating air and deposited on the floor, roof and ribs of mine airways. If deposited, float dust is re-entrained during a methane explosion. Without sufficient inert rock dust quantities, this float coal dust can propagate an explosion throughout mining entries. Consequently, controlling float coal dust is of critical interest to mining operations. Rock dusting, which is the adding of inert material to airway surfaces, is the main control technique currently used by the coal mining industry to reduce the float coal dust explosion hazard. To assist the industry in reducing this hazard, the Pittsburgh Mining Research Division of the U.S. National Institute for Occupational Safety and Health initiated a project to investigate methods and technologies to reduce float coal dust in underground coal mines through prevention, capture and suppression prior to deposition. Field characterization studies were performed to determine quantitatively the sources, types and amounts of dust produced during various coal mining processes. The operations chosen for study were a continuous miner section, a longwall section and a coal-handling facility. For each of these operations, the primary dust sources were confirmed to be the continuous mining machine, longwall shearer and conveyor belt transfer points, respectively. Respirable and total airborne float dust samples were collected and analyzed for each operation, and the ratio of total airborne float coal dust to respirable dust was calculated. During the continuous mining process, the ratio of total airborne float coal dust to respirable dust ranged from 10.3 to 13.8. The ratios measured on the longwall face were between 18.5 and 21.5. The total airborne float coal dust to respirable dust ratio observed during belt transport ranged between 7.5 and 21.8.

3.
Biotribology (Oxf) ; 10: 42-50, 2017 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-28808674

RESUMEN

Artificial hip joints operate in aqueous biofluids that are highly reactive towards metallic surfaces. The reactivity at the metal interface is enhanced by mechanical interaction due to friction, which can change the near-surface structure of the metal and surface chemistry. There are now several reports in the literature about the in-situ generation of reaction films and tribo-metallurgical transformations on metal-on-metal hip joints. This paper summarizes current knowledge and provides a mechanistic interpretation of the surface chemical and metallurgical phenomena. Basic concepts of corrosion and wear are illustrated and used to interpret available literature on in-vitro and in-vivo studies of metal-on-metal hip joints. Based on this review, three forms of tribomaterial, characterized by different combinations of oxide films and organic layers, can be determined. It is shown that the generation of these tribofilms can be related to specific electrochemical and mechanical phenomena in the metal interface. It is suggested that the generation of this surface reaction layer constitutes a way to minimize (mechanical) wear of MoM hip implants.

4.
J Occup Environ Hyg ; 13(4): 284-92, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-26618374

RESUMEN

Airborne coal dust mass measurements in underground bituminous coal mines can be challenged by the presence of airborne limestone dust, which is an incombustible dust applied to prevent the propagation of dust explosions. To accurately measure the coal portion of this mixed airborne dust, the National Institute for Occupational Safety and Health (NIOSH) developed a sampling and analysis protocol that used a stainless steel cassette adapted with an isokinetic inlet and the low temperature ashing (LTA) analytical method. The Mine Safety and Health Administration (MSHA) routinely utilizes this LTA method to quantify the incombustible content of bulk dust samples collected from the roof, floor, and ribs of mining entries. The use of the stainless steel cassette with isokinetic inlet allowed NIOSH to adopt the LTA method for the analysis of airborne dust samples. Mixtures of known coal and limestone dust masses were prepared in the laboratory, loaded into the stainless steel cassettes, and analyzed to assess the accuracy of this method. Coal dust mass measurements differed from predicted values by an average of 0.5%, 0.2%, and 0.1% for samples containing 20%, 91%, and 95% limestone dust, respectively. The ability of this method to accurately quantify the laboratory samples confirmed the validity of this method and allowed NIOSH to successfully measure the coal fraction of airborne dust samples collected in an underground coal mine.


Asunto(s)
Carbonato de Calcio/análisis , Minas de Carbón , Carbón Mineral/análisis , Polvo/análisis , Material Particulado/análisis , Contaminantes Ocupacionales del Aire/análisis , Monitoreo del Ambiente/instrumentación , National Institute for Occupational Safety and Health, U.S. , Estados Unidos
5.
Acta Biomater ; 21: 228-36, 2015 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-25797841

RESUMEN

The present study was initiated with the aim to assess the in vivo electrochemical corrosion behaviour of CoCrMo biomedical alloys in human synovial fluids in an attempt to identify possible patient or pathology specific effects. For this, electrochemical measurements (open circuit potential OCP, polarization resistance Rp, potentiodynamic polarization curves, electrochemical impedance spectroscopy EIS) were carried out on fluids extracted from patients with different articular pathologies and prosthesis revisions. Those electrochemical measurements could be carried out with outstanding precision and signal stability. The results show that the corrosion behaviour of CoCrMo alloy in synovial fluids not only depends on material reactivity but also on the specific reactions of synovial fluid components, most likely involving reactive oxygen species. In some patients the latter were found to determine the whole cathodic and anodic electrochemical response. Depending on patients, corrosion rates varied significantly between 50 and 750 mg dm(-2)year(-1).


Asunto(s)
Aleaciones/metabolismo , Corrosión , Técnicas Electroquímicas , Líquido Sinovial/química , Cromo/química , Cobalto/química , Humanos , Molibdeno/química
6.
Orthop Traumatol Surg Res ; 101(1): 123-6, 2015 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-25620029

RESUMEN

Complications related to the neck-stem junction of modular stems used for total hip arthroplasty (THA) are generating increasing concern. A 74-year-old male had increasing pain and a cutaneous reaction around the scar 1 year after THA with a modular neck-stem. Imaging revealed osteolysis of the calcar and a pseudo-tumour adjacent to the neck-stem junction. Serum cobalt levels were elevated. Revision surgery to exchange the stem and liner and to resect the pseudo-tumour was performed. Analysis of the stem by scanning electron microscopy and by energy dispersive X-ray and white light interferometry showed fretting corrosion at the neck-stem junction contrasting with minimal changes at the head-neck junction. Thus, despite dry assembly of the neck and stem on the back table at primary THA, full neck-stem contact was not achieved, and the resulting micromotion at the interface led to fretting corrosion. This case highlights the mechanism of fretting corrosion at the neck-stem interface responsible for adverse local tissue reactions. Clinical and radiological follow-up is mandatory in patients with dual-modular stems.


Asunto(s)
Artroplastia de Reemplazo de Cadera/efectos adversos , Reacción a Cuerpo Extraño/etiología , Prótesis de Cadera/efectos adversos , Anciano , Reacción a Cuerpo Extraño/diagnóstico , Reacción a Cuerpo Extraño/cirugía , Humanos , Imagen por Resonancia Magnética , Masculino , Osteoartritis de la Cadera/cirugía , Diseño de Prótesis , Falla de Prótesis , Reoperación , Tomografía Computarizada por Rayos X
7.
Acta Biomater ; 8(2): 852-9, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22005332

RESUMEN

Knee and hip joint replacement implants involve a sliding contact between the femoral component and the tibial or acetabular component immersed in body fluids, thus making the metallic parts susceptible to tribocorrosion. Micro-motions occur at points of fixation leading to debris and ion release by fretting corrosion. ß-Titanium alloys are potential biomaterials for joint prostheses due to their biocompatibility and compatibility with the mechanical properties of bone. The biotribocorrosion behavior of Ti-29Nb-13Ta-4.6Zr was studied in Hank's balanced salt solution at open circuit potential and at an applied potential in the passive region. Reciprocating sliding tribocorrosion tests were carried out against technical grade ultra high molecular weight polyethylene, while fretting corrosion tests were carried out against alumina. The wear of the alloy is insignificant when sliding against polyethylene. However, depassivation does take place, but the tested alloy showed an ability to recover its passive state during sliding. The abrasivity of the alloy depends on the electrochemical conditions of the contact, while the wear of polyethylene proceeds through third body formation and material transfer. Under fretting corrosion conditions recovery of the passive state was also achieved. In a fretting contact wear of the alloy proceeds through plastic deformation of the bulk material and wear resistance depends on the electrochemical conditions.


Asunto(s)
Artroplastia de Reemplazo , Materiales Biocompatibles/farmacología , Técnicas Electroquímicas/métodos , Fricción/efectos de los fármacos , Niobio/farmacología , Tantalio/farmacología , Titanio/farmacología , Circonio/farmacología , Corrosión , Electricidad , Electrodos , Humanos , Microscopía Electrónica de Rastreo , Polietilenos/química , Difracción de Rayos X
8.
Am J Transplant ; 12(2): 492-5, 2012 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-22151900

RESUMEN

We report herein the patterns of type 1 diabetes recurrence in a simultaneous pancreas-kidney transplant (SPK) recipient, in the absence of rejection. A 38-year-old female underwent SPK for end-stage nephropathy secondary to type 1 diabetes. Fasting blood glucose, HbA1c, fructosamine, C-peptide and autoantibodies (GAD-65, IA-2) were monitored throughout follow-up. At 3.5 years post-SPK, HbA1c and fructosamine increased sharply, indicating loss of perfect metabolic control, despite C-peptide levels in the normal-high range. Exogenous insulin was restarted 4 months later. C-peptide levels abruptly fell and became undetectable at 5.5 years. Autoantibody levels, which were undetectable at the time of SPK, never converted to positivity. Pancreas retranspantation was performed at 6 years. The failed pancreas graft had a normal macroscopic appearance. On histology, there were no signs of cellular or humoral rejection in the kidney or pancreas. A selective peri-islet lymphocytic infiltrate was observed, together with near-total destruction of ß cells. At 2.5 years post retransplantation, pancreatic graft function is perfect. This observation indicates unequivocally that pancreas graft can be lost to recurrence of type 1 diabetes in the absence of rejection. GAD-65 and IA-2 autoantibodies are not reliable markers of autoimmunity recurrence.


Asunto(s)
Autoanticuerpos/inmunología , Diabetes Mellitus Tipo 1/complicaciones , Glutamato Descarboxilasa/inmunología , Fallo Renal Crónico/cirugía , Trasplante de Riñón/inmunología , Trasplante de Páncreas/inmunología , Adulto , Autoanticuerpos/sangre , Autoinmunidad , Diabetes Mellitus Tipo 1/inmunología , Diabetes Mellitus Tipo 1/cirugía , Nefropatías Diabéticas/complicaciones , Nefropatías Diabéticas/inmunología , Nefropatías Diabéticas/cirugía , Femenino , Estudios de Seguimiento , Glutamato Descarboxilasa/sangre , Humanos , Fallo Renal Crónico/etiología , Fallo Renal Crónico/inmunología , Recurrencia , Reoperación
9.
J Mater Sci Mater Med ; 22(3): 437-50, 2011 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-21221728

RESUMEN

The corrosion behaviour and the wear ranking of biomedical high carbon (HC) and low carbon (LC) CoCrMo alloys sliding against an alumina ball in four different simulated body fluids [NaCl and phosphate buffered solutions (PBS) with and without albumin] has been analyzed by tribocorrosion and electrochemical techniques. The effects of alloy and of albumin on corrosion depend on the base electrolyte: differences between LC and HC alloy were only observed in NaCl solutions but not in PBS. Albumin increased significantly corrosion of both alloys in PBS solutions while its effect in NaCl was smaller. The wear ranking of the HC and LC alloys also depends on the environment. In the present study, HC CoCrMo alloy had lower wear resistance in NaCl and PBS + albumin than the LC alloy, while no differences between both alloys were found in the other solutions. This was attributed to surface chemical effects affecting third body behaviour.


Asunto(s)
Materiales Biocompatibles/química , Vitalio/química , Albúminas/química , Aleaciones , Líquidos Corporales , Carbono/química , Corrosión , Electroquímica/métodos , Electrólitos , Ensayo de Materiales , Fosfatos/química , Sales (Química)/química , Cloruro de Sodio/química
10.
J Med Primatol ; 38(6): 444-7, 2009 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-19793176

RESUMEN

BACKGROUND: A 3.3-year-old-male cynomolgus macaque (Macaca fascicularis) showed a focally extensive soft, dark, discoid dermal mass, 0.5 cm in diameter, on the dorsal surface of the right hind foot, over the fourth and fifth metatarsal bones. METHODS AND RESULTS Microscopic examination revealed a cutaneous melanoma with local lymphatic invasion, characterized by neoplastic melanocytes within the subcapsular sinus of popliteal and inguinal lymph nodes. The diagnosis was confirmed by immunohistochemistry and transmission electron microscopy. CONCLUSIONS: To our knowledge, this is the first documented case of melanoma in a cynomolgus monkey.


Asunto(s)
Macaca fascicularis , Melanoma/patología , Neoplasias Cutáneas/patología , Piel/patología , Animales , Metástasis Linfática , Masculino
11.
Am J Transplant ; 8(3): 701-6, 2008 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-18294167

RESUMEN

There is a crucial need for noninvasive assessment tools after cell transplantation. This study investigates whether a magnetic resonance imaging (MRI) strategy could be clinically applied to islet transplantation. The purest fractions of seven human islet preparations were labeled with superparamagnetic iron oxide particles (SPIO, 280 microg/mL) and transplanted into four patients with type 1 diabetes. MRI studies (T2*) were performed prior to and at various time points after transplantation. Viability and in vitro and in vivo functions of labeled islets were similar to those of control islets. All patients could stop insulin after transplantation. The first patient had diffuse hypointense images on her baseline liver MRI, typical for spontaneous high iron content, and transplant-related modifications could not be observed. The other three patients had normal intensity on pretransplant images, and iron-loaded islets could be identified after transplantation as hypointense spots within the liver. In one of them, i.v. iron therapy prevented subsequent visualization of the spots because of diffuse hypointense liver background. Altogether, this study demonstrates the feasibility and safety of MRI-based islet graft monitoring in clinical practice. Iron overload (spontaneous or induced) represents the major obstacle to the technique.


Asunto(s)
Medios de Contraste , Rechazo de Injerto/diagnóstico , Trasplante de Islotes Pancreáticos , Islotes Pancreáticos , Imagen por Resonancia Magnética/métodos , Nanopartículas del Metal , Adulto , Femenino , Compuestos Férricos/química , Humanos , Masculino , Nanopartículas del Metal/química , Persona de Mediana Edad , Coloración y Etiquetado
12.
J Colloid Interface Sci ; 318(2): 264-70, 2008 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-18054951

RESUMEN

Functionalization of colloidal particles based on the use of polyelectrolytes and heterocoagulation was combined with electrophoretic deposition (EPD), with the aim of depositing titania-polystyrene (TiO(2)-PS) composite particles on Ti6Al4V substrates. The composite particles were obtained by heterocoagulation of TiO(2) nanoparticles on the surface of monosized polystyrene beads of 4.6 microm in diameter. Two alternative methods were developed for the preparation of the TiO(2)-PS suspensions in organic fluids for cathodic electrodeposition. The first method was carried out in alkaline aqueous medium with the use of polyelectrolytes and intermediate control measurements of zeta potential, conductivity, and pH; the second one was carried out directly in the organic solvent used for EPD, typically isopropanol. Examples of deposits obtained by EPD in both suspensions and a comparative analysis between the two methods are presented.


Asunto(s)
Nanopartículas/química , Poliestirenos/química , Titanio/química , Coloides , Electrodos , Electrólitos/química , Electroforesis , Tamaño de la Partícula , Propiedades de Superficie , Suspensiones/química
13.
Proc Inst Mech Eng H ; 221(3): 291-303, 2007 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-17539584

RESUMEN

The degradation of Co-Cr-Mo ASTM F75-92 hip implants after a harvesting period of 81 months in sheep was investigated. Hip prostheses and tissue samples were obtained from a medical study involving total hip arthroplasty of the cemented type in 12 sheep. Upon euthanasia, the explants were retrieved for analyses of the surfaces and evidence of degradation, while tissue samples from the interface regions were harvested for chemical analysis and evidence of Co, Cr, and Mo contents. Clear evidence of wear and corrosion was detected. Results also indicated that the modes of metal transport through the poly(methyl methacrylate) bone cement play an important role as the surface degradation mechanisms of the metal. The results are being discussed in terms of electrochemical and triboelectrochemical behaviour of the Co-Cr-Mo alloy.


Asunto(s)
Cuerpos Extraños/etiología , Cuerpos Extraños/patología , Articulación de la Cadera/patología , Prótesis de Cadera/efectos adversos , Vitalio/efectos adversos , Animales , Corrosión , Análisis de Falla de Equipo , Femenino , Articulación de la Cadera/cirugía , Ensayo de Materiales , Falla de Prótesis , Ovinos
14.
Environ Sci Technol ; 41(3): 710-6, 2007 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-17333567

RESUMEN

Elemental carbon (EC) is currently used as a surrogate for diesel particulate matter (DPM) in underground mines since it can be accurately measured at low concentrations and diesels are the only source of submicrometer EC in underground mines. A disadvantage of using EC as a surrogate for DPM is that the fraction of EC in DPM is a function of various engine parameters and fuel formulations, etc. In order to evaluate how EC predicts DPM in the underground mining atmosphere, measurements of total carbon (TC; representing over 80% of the DPM) and EC were taken away from potential interferences in four underground metal/non-metal mines during actual production. In a controlled atmosphere, DPM mass, TC, and EC measurements were also collected while several different types of vehicles simulated production with and without different types of control technologies. When diesel particulate filters (DPFs) were not used, both studies showed that EC could be used to predict DPM mass or TC. The variability of the data started to increase at TC concentrations below 230 microg/m3 and was high (> +/- 20%) at TC concentrations below 160 microg/m3, probably due to the problem with sampling organic carbon (OC) at these concentrations. It was also discovered that when certain DPFs were used, the relationship between DPM and EC changed at lower DPM concentrations.


Asunto(s)
Contaminantes Atmosféricos/análisis , Carbono/análisis , Monitoreo del Ambiente/métodos , Minería , Emisiones de Vehículos/análisis , Monitoreo del Ambiente/normas , Gasolina/análisis , Humanos , Medición de Riesgo
15.
Am J Transplant ; 6(7): 1704-11, 2006 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-16827874

RESUMEN

Recent updates of the Edmonton trial have shown that insulin independence is progressively lost in approximately 90% of islet transplant recipients over the first 5 years. Early prediction of islet graft injury could prompt the implementation of strategies attempting to salvage the transplanted islets. We hypothesize that islet damage is associated with the release and detection of insulin mRNA in the circulating blood. Whole blood samples were prospectively taken from 19 patients with type 1 diabetes receiving 31 islet transplants, immediately prior to transplantation and at regular time-points thereafter. After RNA extraction, levels of insulin mRNA were determined by quantitative reverse tran-scriptase-polymerase chain reaction. All patients exhibited a primary peak of insulin mRNA immediately after transplantation, without correlation of duration and amplitude with graft size or outcome. Twenty-five subsequent peaks were observed during the follow-up of 17 transplantations. Fourteen secondary peaks (56%) were closely followed by events related to islet graft function. Duration and amplitude of peaks were higher when they heralded occurrence of an adverse event. Peaks of insulin mRNA can be detected and are often associated with alterations of islet graft function. These data suggest that insulin mRNA detection in the peripheral blood is a promising method for the prediction of islet graft damage.


Asunto(s)
Insulina/genética , Trasplante de Islotes Pancreáticos , Leucocitos/metabolismo , Adulto , Femenino , Supervivencia de Injerto , Humanos , Islotes Pancreáticos/patología , Islotes Pancreáticos/fisiología , Masculino , Persona de Mediana Edad , ARN Mensajero/genética
16.
Transplant Proc ; 37(6): 2846-7, 2005.
Artículo en Inglés | MEDLINE | ID: mdl-16182829

RESUMEN

UNLABELLED: Simultaneous pancreas-kidney (SPK) transplantation has become the therapy of choice for type 1 diabetic patients with end-stage renal disease. The current analysis examined the impact of HLA matching on graft outcome following SPK transplantation. The study population was obtained from patients enrolled in the Euro-SPK 001 study. PATIENTS AND METHODS: The effect of HLA matching on graft function and survival was assessed in 180 SPK recipients in whom complete donor-recipient HLA data were available. A group of 45 patients with 0 to 3 HLA mismatches (MM) was compared to 135 patients with 4 to 6 MM. RESULTS: There were no differences in 3-year kidney, pancreas, or patient survival rates between the 0 to 3 and 4 to 6 MM groups. Biological parameters of kidney and pancreas graft function were similar in both groups. Significantly more patients with 0 to 3 MM (66%) were rejection free at 3 years than those with 4 to 6 MM (41%; P = .003). The relative risk of acute rejection was 2.6 times higher among patients with 4 to 6 MM than among those with 0 to 3 MM. In conclusion, there was no evidence that HLA matching was associated with improved kidney or pancreas survival. However, a higher rate of acute rejection was observed with poor HLA matches, which may impact long-term survival.


Asunto(s)
Prueba de Histocompatibilidad , Trasplante de Riñón/inmunología , Trasplante de Páncreas/inmunología , Estudios de Seguimiento , Supervivencia de Injerto , Humanos , Trasplante de Riñón/mortalidad , Trasplante de Páncreas/mortalidad , Análisis de Supervivencia
17.
Transplant Proc ; 37(2): 1326-7, 2005 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15848711

RESUMEN

AIM: Islet transplantation is gaining recognition as a therapeutic option for selected diabetic patients. The immunosuppressive regimen based on sirolimus/low-dose tacrolimus is considered a major breakthrough that allowed considerable improvement in graft survival. A high incidence of side effects associated with such a regimen has been reported in the literature, but this immunosuppressive protocol is generally considered safe or even protective to the kidney. Herein, we analyze the impact of the sirolimus/low-dose tacrolimus-based protocol on kidney function. PATIENTS AND METHODS: Five islet-after-kidney and 5 islet-transplant-alone patients were enrolled and followed up. Renal function was assessed by the periodic measurement of serum creatinine and by the presence of albuminuria. Metabolic control markers and graft function were followed, as well as immunosuppressive whole blood trough levels. RESULTS: Kidney function significantly decreased in 6 of 10 patients. Neither metabolic markers nor immunosuppressive drugs levels were significantly associated with the decreased kidney function. CONCLUSION: Although a specific etiology was not identified, subsets of patients presented a higher risk for decrease of kidney function. The presence of low creatinine clearance, albuminuria, and long-established kidney graft were associated with poorer outcomes.


Asunto(s)
Diabetes Mellitus Tipo 1/cirugía , Trasplante de Islotes Pancreáticos/inmunología , Sirolimus/uso terapéutico , Tacrolimus/uso terapéutico , Creatinina/metabolismo , Diabetes Mellitus Tipo 1/tratamiento farmacológico , Quimioterapia Combinada , Estudios de Seguimiento , Humanos , Hipoglucemiantes/uso terapéutico , Inmunosupresores/uso terapéutico , Insulina/uso terapéutico , Trasplante de Islotes Pancreáticos/métodos , Trasplante de Islotes Pancreáticos/fisiología , Pruebas de Función Renal , Resultado del Tratamiento
18.
J Dairy Sci ; 87(3): 602-8, 2004 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-15202644

RESUMEN

Gene therapy has great potential to enable synthesis of protein molecules in targeted cells of an animal. One application may be the production of antibacterial enzymes by the mammary gland as a means of preventing or treating mastitis. We have previously demonstrated that goat mammary cells are capable of producing lysostaphin, an antistaphylococcal enzyme, after being transduced in vivo with a recombinant adenoviral vector containing a modified lysostaphin gene (Ad-lys). The current study examined duration of expression, and antibody response to lysostaphin and the adenoviral vector. Following intramammary infusion into nonlactating goats (n = 4), recovery of transducible adenoviral vector in mammary secretions persisted for 11 d. Transducible vector was not detected in serum, saliva, urine, or feces. Peak lysostaphin concentrations (< 20 microg/mL) in mammary secretions of infused udders were detected approximately 1 wk postinfusion, and generally returned to undetectable levels after an additional 1 to 2 wk. The poor persistency of expression was likely due to the very potent immune response to both the adenovirus and the expressed lysostaphin. Serum IgG antibodies recognizing the adenoviral vector developed within 7 d of the infusion, and titers rose dramatically to greater than 1:1 x 10(5). Similar titers of serum IgG antibodies to lysostaphin developed in 3 goats, with more moderate titers in the fourth goat. The antibody response to lysostaphin was delayed by approximately 4 d in comparison to the response to the adenovirus. Serum IgG antibody profiles were reflected in mammary secretions. No IgA antibodies to adenovirus or lysostaphin were detected in sera or mammary secretion. We demonstrate that while the lysostaphin gene can be introduced to the mammary gland using an adenoviral-mediated gene transfer technique, the strong immune response that it provokes makes the approach unsuitable for combating mastitis.


Asunto(s)
Adenoviridae/genética , Endopeptidasas/genética , Expresión Génica , Vectores Genéticos , Cabras , Glándulas Mamarias Animales/enzimología , Adenoviridae/inmunología , Animales , Anticuerpos Antivirales/sangre , ADN Recombinante/genética , Endopeptidasas/análisis , Endopeptidasas/inmunología , Femenino , Inmunoglobulina G/sangre , Glándulas Mamarias Animales/metabolismo , Transfección
19.
Transplant Proc ; 36(4): 1123-4, 2004 May.
Artículo en Inglés | MEDLINE | ID: mdl-15194391

RESUMEN

OBJECTIVE: The objective of this article is to report a single-center experience with islet autotransplantation after extensive pancreatic resection for benign tumors of the pancreas. MATERIALS AND METHODS: Seven patients underwent extensive left pancreatectomy for benign lesions located at the neck of the pancreas. Once an unequivocal diagnosis of a benign nature was ascertained, the rest of the specimen was processed and the unpurified pancreatic digest was infused into the portal vein. The results were compared with those of 8 autotransplantations performed for chronic pancreatitis over the same period. RESULTS: Tumors were 4 cystadenomas, 2 insulinomas and 1 neuroendocrine tumor. Mean islet yields were 275,000 islet equivalents (IEQ) versus 129,000 in chronic pancreatitis (P =.04) or 6700 IEQ/g of tissue versus 1900 (P =.002), resulting in transplantation of 4200 IEQ/kg body weight vs 2150 in chronic pancreatitis (P =.03), respectively at 4-month to 7.5-year follow-up, all patients are alive and 6 of 7 are off insulin. All patients off insulin after at least 1 year currently have a normal IVGTT, with K values ranging between -1.19 and -2.36 (normal < -1.00). All patients, including 1 on insulin, display positive basal and glucagon-stimulated C-peptide levels. CONCLUSIONS: Compared with chronic pancreatitis tissue resected for benign tumors is more likely to achieve good islet yields, and thus insulin independence after autotransplantation. Islet autotransplantation should be considered when extensive pancreatectomy is required for resection of a benign tumor, and only if the benign nature of the lesion is demonstrated unequivocally.


Asunto(s)
Diabetes Mellitus/etiología , Trasplante de Islotes Pancreáticos/métodos , Pancreatectomía/efectos adversos , Neoplasias Pancreáticas/cirugía , Anciano , Anciano de 80 o más Años , Péptido C/sangre , Enfermedad Crónica , Diabetes Mellitus/prevención & control , Femenino , Humanos , Tiempo de Internación , Masculino , Persona de Mediana Edad , Pancreatitis/cirugía , Trasplante Autólogo , Resultado del Tratamiento
20.
Am J Med ; 106(5): 499-505, 1999 May.
Artículo en Inglés | MEDLINE | ID: mdl-10335720

RESUMEN

PURPOSE: To assess whether implementation of guidelines increases the prescription of drugs, particularly beta blockers, recommended for secondary prevention after acute myocardial infarction. SUBJECTS AND METHODS: Prescription patterns among 355 patients discharged from a public teaching hospital after recovery from myocardial infarction were prospectively monitored in a before-after trial. The implementation strategies included educational interventions (large group meetings), placement of guidelines in patients' records, and bimonthly general reminders sent to physicians. RESULTS: Beta blockers were prescribed in 93 (38%) of 243 survivors of acute myocardial infarction before guideline implementation (12-month control period), as compared with 71 (63%) of 112 patients (P <0.001) after their implementation (6-month period). During the entire study period, the prescription of beta blockers at a neighboring public teaching hospital, used as a comparison, was unchanged. After adjusting for potential confounders, implementation of the guidelines remained significantly associated with prescription of beta blockers at discharge [odds ratio (OR) = 10; 95% confidence interval (CI), 3.2 to 33; P <0.001]. Other independent predictors of prescription of beta blockers were previous coronary artery bypass grafting (OR = 8.7; 95% CI, 2.5 to 31; P = 0.001), hypertension (OR = 2.5; 95% CI, 1.4 to 4.5; P = 0.003), age per 10-year increase (OR = 0.82; 95% CI, 0.67 to 0.99; P = 0.04), secular trend in prescription patterns expressed in months (OR = 0.9; 95% CI, 0.8 to 1.0; P = 0.02), a left ventricular ejection fraction < or = 40% (OR = 0.2; 95% CI, 0.1 to 0.4; P <0.001), the presence of atrioventricular block (OR = 0.1; 95% CI, 0.02 to 0.7; P = 0.02), and concomitant prescription of digoxin (OR = 0.2; 95% CI, 0.05 to 0.8; P = 0.02) or calcium antagonists (OR = 0.06; 95% CI, 0.01 to 0.3; P = 0.001). CONCLUSION: When appropriately developed and implemented by local experts, literature-based guidelines may be effective in modifying use of recommended drugs for secondary prevention of coronary artery disease, such as prescription of beta blockers.


Asunto(s)
Antagonistas Adrenérgicos beta/uso terapéutico , Prescripciones de Medicamentos/estadística & datos numéricos , Infarto del Miocardio/tratamiento farmacológico , Infarto del Miocardio/prevención & control , Anciano , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Bloqueadores de los Canales de Calcio/uso terapéutico , Cardiotónicos/uso terapéutico , Puente de Arteria Coronaria , Digoxina/uso terapéutico , Femenino , Bloqueo Cardíaco/complicaciones , Humanos , Hipertensión/complicaciones , Masculino , Infarto del Miocardio/complicaciones , Infarto del Miocardio/cirugía , Oportunidad Relativa , Guías de Práctica Clínica como Asunto , Índice de Severidad de la Enfermedad , Volumen Sistólico , Suiza , Disfunción Ventricular Izquierda/etiología
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