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INTRODUCTION: Surgical decompression for lumbar spinal stenosis (LSS) has been associated with poorer outcomes in patients with pronounced low back pain (LBP) as compared to patients with predominant leg pain. This cross registry study assessed potential benefits of the interlaminar coflex® device as an add-on to bony decompression alone. METHODS: Patients with lumbar decompression plus coflex® (SWISSspine registry) were compared with decompressed controls (Spine Tango registry). Inclusion criteria were LSS and a preoperative back pain level of ≥5 points. 1:1 propensity score-based matching was performed. Outcome measures were back and leg pain relief, COMI score improvement, patient satisfaction, complication, and revision rates. RESULTS: 50 matched pairs without residual significant differences but age were created. At the 7-9 months follow-up interval the coflex® group had higher back (p=0.014) and leg pain relief (p<0.001) and COMI score improvement (p=0.029) than the decompression group. Patient satisfaction was 90% in both groups. No revision was documented in the coflex® and one in the decompression group (2.0%). DISCUSSION: In the short-term, lumbar decompression with coflex® compared with decompression alone in patients with LSS and pronounced LBP at baseline is a safe and effective treatment option that appears beneficial regarding clinical and functional outcomes. However, residual confounding of non-measured covariables may have partially influenced our findings. Also, despite careful inclusion and exclusion of cases the cross registry approach introduces a potential for selection bias that we could not totally control for and that makes additional studies necessary.
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Dolor de Espalda/cirugía , Descompresión Quirúrgica/efectos adversos , Descompresión Quirúrgica/estadística & datos numéricos , Vértebras Lumbares/cirugía , Estenosis Espinal/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Dolor de Espalda/epidemiología , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Persona de Mediana Edad , Satisfacción del Paciente , Complicaciones Posoperatorias , Estenosis Espinal/epidemiologíaRESUMEN
Vicilin peptidohydrolase, the protease that hydrolyzes the reserve proteins in the cotyledons of mung bean (Vigna radiata) seedlings, has been localized intracellularly by immunofluorescence microscopy using monospecific antibodies against the enzyme and rhodamine-coupled goat-anti-rabbit immunoglobulin G's. The enzyme can first be visualized after 3 days of seedling growth and is associated with small foci within the cytoplasm of the storage parenchyma cells farthest from the vascular bundles. On the 4th day of growth, the protease is also present in the numerous large protein bodies within these cells. Vicilin peptidohydrolase is known to be synthesized de novo starting on the 3rd day of growth. Our observations are therefore consistent with the interpretation that the enzyme is synthesized in the cytoplasm and subsequently transported to the protein bodies.
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Fabaceae/enzimología , Péptido Hidrolasas/análisis , Plantas Medicinales , Semillas/enzimología , Citoplasma/enzimología , Técnica del Anticuerpo Fluorescente , Péptido Hidrolasas/biosíntesis , Proteínas de Plantas , Factores de TiempoRESUMEN
State-of-the-art aerosol nanoparticle techniques all have one feature in common: for analysis they remove the nanoparticles from their original environment. Therefore, physical and chemical properties of the particles might be changed or cannot be measured correctly. To overcome these shortcomings, we apply synchrotron based small angle X-ray scattering (SAXS) as an in-situ measurement technique. Contrasting other aerosol studies using SAXS, we focus on particle concentrations which allow direct comparison to common aerosol nanoparticle analyzers. To this end, we analyze aerosol nanoparticles at ambient pressure and concentrations of slightly above ~106 cm-3. A differential mobility particle sizer (DMPS) is operated in parallel. We find that SAXS enables measurement of the primary particles and the aggregates, whereas the DMPS detects only aggregates. We conclude that in-situ nanoparticle characterization with ultra-low volume fractions of ~10-10 is feasible with SAXS. Our technique opens up a doorway to the in-situ analysis of aerosol nanoparticles under atmospheric conditions.
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In yeast, HOP1 and RED1 are required during meiosis for proper chromosome segregation and the consequent formation of viable spores. Mutations in either HOP1 or RED1 create unique as well as overlapping phenotypes, indicating that the two proteins act alone as well as in concert with each other. To understand which meiotic processes specifically require Red1p-Hop1p hetero-oligomers, a novel genetic screen was used to identify a single-point mutation of RED1, red1-K348E, that separates Hop1p binding from Red1p homo-oligomerization. The Red1-K348E protein is stable, phosphorylated in a manner equivalent to Red1p, and undergoes efficient homo-oligomerization; however, its ability to interact with Hop1p both by two-hybrid and coimmunoprecipitation assays is greatly reduced. Overexpression of HOP1 specifically suppresses red1-K348E, supporting the idea that the only defect in the protein is a reduced affinity for Hop1p. red1-K348E mutants exhibit reduced levels of crossing over and spore viability and fail to undergo chromosome synapsis, thereby implicating a role for Red1p-Hop1p hetero-oligomers in these processes. Furthermore, red1-K348E suppresses the sae2/com1 defects in meiotic progression and sporulation, indicating a previously unknown role for HOP1 in the meiotic recombination checkpoint.
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Segregación Cromosómica/fisiología , Cromosomas Fúngicos/fisiología , Proteínas de Unión al ADN/metabolismo , Proteínas Fúngicas/metabolismo , Meiosis/fisiología , Proteínas de Saccharomyces cerevisiae , Saccharomyces cerevisiae/fisiología , Transducción de Señal/fisiología , Alelos , Aminoácidos , Proteínas Bacterianas/genética , Proteínas Bacterianas/metabolismo , Sitios de Unión , Segregación Cromosómica/genética , Intercambio Genético , Endonucleasas , Proteínas Fúngicas/genética , Eliminación de Gen , Expresión Génica , Mutagénesis , Oligopéptidos/genética , Oligopéptidos/metabolismo , Fenotipo , Recombinación Genética , Saccharomyces cerevisiae/genética , Saccharomyces cerevisiae/metabolismo , Serina Endopeptidasas/genética , Serina Endopeptidasas/metabolismo , Esporas Fúngicas/fisiologíaRESUMEN
The gene for mammalian type I DNA topoisomerase is constitutively expressed, but also regulated by a number of external stimuli. We compared the nucleotide sequences of the human and the mouse topoisomerase I gene promoters because promoter elements, essential for basic as well as regulated gene expression, should be conserved during evolution. We found that proximal upstream sequences are highly conserved and include potential binding sites for ubiquitous transcription factors, a regulatory CRE site as well as two novel promoter elements that have been shown to be important for the expression of the human gene. The more distal parts of the upstream sequences are less well conserved but include two regions that are almost identical in the human and the mouse gene. One of these regions contains a binding site for a basic-helix-loop-helix/leucine-zipper protein, and the other contains an AT-rich element with the potential for DNA bending.
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Secuencia Conservada , ADN-Topoisomerasas de Tipo I/genética , Regiones Promotoras Genéticas , Animales , Secuencia de Bases , Células Cultivadas , Células HeLa , Humanos , Ratones , Datos de Secuencia Molecular , Alineación de SecuenciaRESUMEN
Glycosyltransferases play an important role in the synthesis of glycoproteins. Here we report the isolation of a brain cDNA coding for 89% of the porcine UDP-N-acetylglucosamine:alpha-6-D-mannoside-beta-1,2-N-acetylglucosaminy ltransferase II (EC 2.4.1.143) (GnTII). The cDNA was used for screening a genomic liver DNA library and isolation of a recombinant lambda FIX II phage containing the complete porcine GnTII gene and upstream and downstream sequences. The beta-1,2-N-acetylglucosaminyltransferase II gene harbours a single exon with an open reading frame of 1338 bp coding for a 446 amino acid protein with a calculated molecular mass of 51.1 kDa. The promoter of the GnTII gene is lacking a TATA-box and shows variable transcription start sites. In the 3'-untranslated region a polymorphic polyadenosine stretch was detected. The porcine GnTII gene contains four polyadenylation sites. PCR analysis of a porcine-rodent hybrid cell panel revealed the chromosomal location of the GnTII gene on SSC 1q23-q27. The mapping data of the cell panel were confirmed by fluorescence in situ hybridization (FISH) on metaphase chromosomes.
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Encéfalo/enzimología , Mapeo Cromosómico , N-Acetilglucosaminiltransferasas/biosíntesis , N-Acetilglucosaminiltransferasas/genética , Porcinos/genética , Animales , Secuencia de Bases , Clonación de Organismos , Cartilla de ADN , Exones , Datos de Secuencia Molecular , N-Acetilglucosaminiltransferasas/química , Sistemas de Lectura Abierta , Reacción en Cadena de la Polimerasa , Polimorfismo Genético , Proteínas Recombinantes/biosíntesis , Proteínas Recombinantes/química , Secuencias Reguladoras de Ácidos NucleicosRESUMEN
Chloroplast genomes encode rRNAs, tRNAs, and proteins involved in transcription, translation, and photosynthesis. The expression of 15 plastid genes representing each of these functions was quantitated during chloroplast development in barley (Hordeum vulgare). The transcription of all plastid genes increased during the initial phase of chloroplast development and then declined during chloroplast maturation. RNAs corresponding to rpoB- rpoC1-rpoC2, which encode subunits of a plastid RNA polymerase, and rps16, which encodes a ribosomal protein, reached maximal abundance early in chloroplast development prior to genes encoding subunits of the photosynthetic apparatus (rbcL, atpB, psaA, petB). Transcription of rpoB as well as 16S rRNA, trnfM-trnG, and trnK was high early in chloroplast development and declined 10-fold relative to rbcL transcription during chloroplast maturation. RNA hybridizing to psbA and psbD, genes encoding reaction center proteins of photosystem II, was differentially maintained in mature chloroplasts of illuminated barley. Differential accumulation of psbD mRNA relative to rbcL mRNA was due to light-stimulated transcription of psbD. In contrast, enhanced levels of psbA mRNA in mature chloroplasts were due primarily to selective stabilization of the psbA mRNA. These data document dynamic modulation of plastid gene transcription and mRNA stability during barley chloroplast development.
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NF-kappaB/Rel transcription factors are modulators of immune and inflammatory processes and are also involved in malignancy. Phosphorylation of the IkappaB inhibitors by the IkappaB kinase (IKK) complex leads to their proteasomal degradation, resulting in activated NF-kappaB. Here, we investigated the activation status of NF-kappaB and the IKK complex in acute myeloid leukemia (AML). Gelshift assays revealed an increased level of activated nuclear NF-kappaB in myeloid blasts. Both bone marrow and peripheral blood blasts from AML patients showed enhanced IKK activity relative to controls, whereas the IKK protein concentrations were comparable. In addition, an increased level of IkappaB-alpha was detected in AML blast cells, although this appeared to be insufficient to block nuclear translocation of NF-kappaB, also confirmed by immunofluorescence. In subtype M4 and M5 AML cells a more extensive NF-kappaB activation and higher IKK activity was found than in M1/M2 specimens. Isolated AML blasts cultured ex vivo responded to external stimulation (TNF, LPS) by further IKK activation, IkappaB degradation and NF-kappaB activation. Preincubation with the proteasome inhibitor PSI inhibited the NF-kappaB system in isolated AML blasts. This study established for the first time a dysregulation of IKK signaling in AML leading to increased NF-kappaB activity suggesting potential therapeutic avenues.
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Leucemia Mieloide/enzimología , FN-kappa B/metabolismo , Proteínas Serina-Treonina Quinasas/metabolismo , Enfermedad Aguda , Adulto , Anciano , Anciano de 80 o más Años , Western Blotting , Núcleo Celular/metabolismo , Electroforesis en Gel de Poliacrilamida , Ensayo de Cambio de Movilidad Electroforética , Femenino , Citometría de Flujo , Técnica del Anticuerpo Fluorescente , Humanos , Quinasa I-kappa B , Leucemia Mieloide/metabolismo , Leucemia Mieloide/patología , Lipopolisacáridos/farmacología , Masculino , Persona de Mediana Edad , Factor de Necrosis Tumoral alfa/farmacologíaRESUMEN
BACKGROUND: Obesity is associated with non-alcoholic fatty liver disease (NAFLD), and the patatin-like phospholipase 3 (PNPLA3) rs738409 (Ile148Met, C>G) gene polymorphism is one of the most important genetic determinants of NAFLD. Carriers have been reported to better respond to lifestyle modification. AIM: To investigate the effect of rs738409 on overweight/obese adolescents and adults with and without metabolic syndrome (MetS). METHODS: Two hundred and eighty-eight overweight/obese and 209 normal weight participants of the STYJOBS/EDECTA cohort (NCT00482924) were analysed for PNPLA3 genotypes. RESULTS: Compared to overweight/obese without MetS, in overweight/obese study participants with MetS, the presence of the G allele (148Met) was significantly higher (CC: 5.0% vs. 9.2%, Spearman's correlation, 0.12; P = 0.038). Persons with CG (heterozygote for the risk allele) and with GG (homozygote for the risk allele) genotypes showed significantly higher ALT levels than those with CC genotypes. Even young individuals aged below 20 years had significantly increased ALT levels if they were homozygote with the G allele. CONCLUSIONS: The PNPLA3 rs738409 polymorphism is associated already in youths with increased ALT, and is more frequent in obese with MetS of all ages. Hence, overweight/obese rs738409 carriers should be identified early in life and treated with a rigorous life style intervention.
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Lipasa/genética , Proteínas de la Membrana/genética , Síndrome Metabólico/complicaciones , Enfermedad del Hígado Graso no Alcohólico/genética , Obesidad/genética , Adolescente , Adulto , Anciano , Alelos , Estudios de Casos y Controles , Niño , Femenino , Genotipo , Heterocigoto , Humanos , Estilo de Vida , Masculino , Síndrome Metabólico/genética , Persona de Mediana Edad , Obesidad/complicaciones , Polimorfismo Genético , Estudios Prospectivos , Adulto JovenRESUMEN
Yeast plasma membranes have been isolated from homogenized yeast cells, identified as pure plasma membrane vesicles which were used as antigens. By crossed immunoelectrophoresis with anti-membrane immunoglobulins, 17 discrete antigens have been detected in Triton X-100 extracts from plasma membranes. Three different immunoabsorption experiments were performed with : a) isolated membranes exposing the cytoplasmic surfaces (PS) and the external surfaces (ES), b) yeast protoplasts exposing only antigenic determinants on the ES, c) lysed protoplasts which had been saturated on the ES with antibodies prior to lysis. These absorption experiments demonstrated that seven of the antigens are expressed on the ES while eight immunogens expose antigenic determinants on the PS. Four of the principal immunoprecipitates are not affected by absorption with surface antigens whereas two of the antigens indicate transmembrane characteristics. Of these 17 immunoprecipitates four were shown by zymograms to possess enzymatic activities: ATPase (EC 3.6.1.3) and NADH-dehydrogenase (EC 1.8.99.3) (three separate components). Three of these enzymes are expressed on the PS, and one NADH-dehydrogenase exposes determinants on the ES of the protoplasts. The presence of antigens on the PS of the plasma membrane could also be demonstrated on micrographs by the indirect ferritin-antibody labeling technique followed by freeze-etching and shadowing of the membranes.
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Antígenos Fúngicos/análisis , Antígenos de Superficie/análisis , Saccharomyces cerevisiae/inmunología , Adenosina Trifosfatasas/metabolismo , Fraccionamiento Celular , Membrana Celular/inmunología , Contrainmunoelectroforesis , Epítopos , NADH NADPH Oxidorreductasas/metabolismo , Saccharomyces cerevisiae/enzimología , Saccharomyces cerevisiae/ultraestructuraRESUMEN
The large protein bodies of the storage parenchyma cells of mung bean (Vigna radiata) cotyledons contain vesicles measuring 0.2 to 2.0 mum in diameter. The vesicles contain ribosomes, ribosomes, membranous elements which may be derived from the endoplasmic reticulum and occasionally Golgi bodies and mitochondria. The vesicles can be seen by transmission electron microscopy in thin sections of plastic embedded specimens and in replicas of freeze-fractured preparations. Serial sections show that the vesicles are completely separated from the protein body membrane and are not invaginations of that membrane. Vesicles with cytoplasmic structures are seen most frequently in 2 to 4 day old seedlings. The vesicles may be formed when undulations of the protein body membrane are so deep as to permit the pinching-off of a portion of the cytoplasm, resulting in its subsequent isolation from the cytoplasm within the protein body. The digestion of the storage protein in the protein body is accompanied by the disappearance of the ribosomes and the membranous elements in the vesicles. We interpret this disappearance of the cytoplasmic structures in the vesicles as being due to their digestion by the protein body hydrolases (ribonuclease, proteinase and lipolytic enzymes). The uptake of cytoplasmic structures by the protein bodies continues after the reverse proteins have been digested. Cytochemical staining shows that the protein bodies and especially the vesicles are rich in acid phosphatase, a known marker of lytic activity in cells. The evidence presented here indicates that the protein bodies are the intracellular sites at which the digestion of cytoplasmic structure occurs. Protein bodies should therefore be considered not only as compartments for the hydrolysis of the stored protein, but also as autophagic organelles involved in the degradation of cytoplasmic macromolecules. The term protein bodies is well established, but the term protein storage vacuoles may describe these organelles more precisely.
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Citoplasma/metabolismo , Organoides/metabolismo , Proteínas de Plantas/metabolismo , Plantas/metabolismo , Vacuolas/metabolismo , Fabaceae/embriología , Fabaceae/metabolismo , Plantas/ultraestructura , Plantas MedicinalesRESUMEN
We have isolated recombinant lambda-phage clones that contain sequences complementary to the 3' half of the cDNA encoding human topoisomerase I (hTOP1). These lambda clones belong to three distinct classes: class-I clones contain sequences from the active gene located on human chromosome 20. Class-II and class-III clones contain sequences corresponding to the cDNA encoding hTOP1 from nucleotide (nt) 2208 to 3434 and from nt 1639 to 3434, respectively. These sequences exhibit the characteristic features of retroposons or retrosequences. They are most likely derived from truncated mRNA transcripts of the active gene. We propose to designate the truncated hTOP1 sequence located on chromosome 1 as the pseudogene 1 (psi 1-hTOP1) and the sequence on chromosome 22 as the pseudogene 2 (psi 2-hTOP1). Pseudogene psi 1-hTOP1 has two unique properties: it is flanked by upstream sequences which display promoter activity in transient expression assays, and it contains an open reading frame which could code for the 211 C-terminal amino acids of hTOP1. Pseudogene psi 2-hTOP1 is located within an AluI repetitive element and is flanked on one side by a (CA)21 stretch.
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ADN-Topoisomerasas de Tipo I/genética , Seudogenes , Secuencia de Bases , Cromosomas Humanos Par 1 , Clonación Molecular , Codón , ADN-Topoisomerasas de Tipo I/metabolismo , Humanos , Datos de Secuencia Molecular , Mutación , Regiones Promotoras Genéticas , Secuencias Repetitivas de Ácidos Nucleicos , Mapeo RestrictivoRESUMEN
Chick embryos with an undeveloped blood-brain barrier were used to examine the down-regulation of GABAA receptors in vivo. The GABAA receptor agonist isoguvacine (5 mumol) was applied to the vascularized chorioallantoic membrane of 8 day embryos. This treatment was repeated on embryonic days 11, 14, and 17, and the embryos were sacrificed on day 18 (stage 42). Isoguvacine administration reduced the clonazepam-displaceable binding of [3H]flunitrazepam to washed cerebellar membranes by 34.0 +/- 3.0% compared to vehicle-treated controls. Binding reductions of lower magnitude were found in membranes from the cerebrum and optic lobes. Administration of isoguvacine had no significant effect on the wet weights of whole embryos or cerebella, the yield of cerebellar membranes, or the binding of [3H]N-methylscopolamine. The reduction of [3H]flunitrazepam binding to cerebellar membranes was dose-dependent, allowing a half saturation value of 8 microM isoguvacine to be estimated. Scatchard analysis showed that the Bmax for [3H]flunitrazepam binding was reduced by 28.3 +/- 6.7% compared to controls, without a change in the Kd. Embryonic exposure to isoguvacine also caused a reduction of 43.6 +/- 6.0% in the binding of the GABAA receptor channel ligand [35S]t-butylbicyclophosphorothionate to washed cerebellar membranes. Taken together, these results indicate that isoguvacine induces a down-regulation of the receptor subunits in vivo. However, measurements of cerebellar GABAA receptor mRNAs for the alpha 1, beta 2L, beta 2S, beta 4, gamma 1, gamma 2L, and gamma 2S subunits by reverse transcriptase-polymerase chain reaction (RT-PCR) revealed no significant alterations by isoguvacine administration. The data suggest that translational or post-translational mechanisms, rather than those modulating the synthesis or stability of subunit mRNAs, take precedence in establishing GABAA receptor down-regulation.
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Compuestos Bicíclicos Heterocíclicos con Puentes , Cerebelo/metabolismo , Agonistas del GABA/farmacología , Ácidos Isonicotínicos/farmacología , Receptores de GABA/biosíntesis , Alantoides , Animales , Compuestos Bicíclicos con Puentes/metabolismo , Membrana Celular/metabolismo , Cerebelo/efectos de los fármacos , Cerebelo/embriología , Embrión de Pollo , Corion , Convulsivantes/metabolismo , Regulación hacia Abajo , Flunitrazepam/metabolismo , Cinética , Sustancias Macromoleculares , Reacción en Cadena de la Polimerasa , ARN Mensajero/análisis , ARN Mensajero/biosíntesis , Ensayo de Unión Radioligante , Receptores de GABA/metabolismoRESUMEN
We have used quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) to analyze the expression of GABAA receptor subunit genes in cultured neurons from the chick embryo cerebral cortex. During maturation of the neurons between day 2 and day 8 in culture, levels of the alpha 1 subunit transcript (per ng total RNA) increased 3.8 +/- 0.3 fold, while those for the beta 2S and beta 4S subunits increased 2.4 +/- 0.4 and 1.8 +/- 0.2 fold, respectively. The accumulation of the beta 4 S subunit mRNA was more rapid than those encoding either the alpha 1 or beta 2S polypeptides. After 4 days in culture the beta 4S subunit transcript level reached 105 +/- 7.7% of that found after 8 days, while the corresponding amounts for the alpha 1 and beta 2S subunit mRNAs were 50 +/- 7.1% and 44 +/- 10.7%, respectively. On the other hand, no significant differences were observed in the level of either the gamma 1 or the gamma 2S subunit mRNA during development in vitro. Likewise, the ratios of the large/small splice variants (beta 2 = 0.16 +/- 0.02; beta 4 = 0.57 +/- 0.02; gamma 2 = 0.30 +/- 0.06) did not show detectable changes during this period. To study the down-regulation of the mRNAs, a single dose of 100 microM GABA was added to the culture medium. After 7 days of exposure to GABA, the levels of transcripts for the alpha 1, beta 2, beta 4, gamma 1, and gamma 2 subunits and their splice variants (where present) were all reduced by 47-65% compared to untreated controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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Corteza Cerebral/metabolismo , Expresión Génica , Neuronas/metabolismo , Receptores de GABA-A/biosíntesis , Ácido gamma-Aminobutírico/farmacología , Actinas/biosíntesis , Empalme Alternativo , Animales , Secuencia de Bases , Southern Blotting , Células Cultivadas , Senescencia Celular , Embrión de Pollo , Cartilla de ADN , Regulación hacia Abajo/efectos de los fármacos , Expresión Génica/efectos de los fármacos , Sustancias Macromoleculares , Datos de Secuencia Molecular , Reacción en Cadena de la Polimerasa , ARN Mensajero/biosíntesis , Transcripción Genética , Regulación hacia ArribaRESUMEN
Over a two-year period, 275 duplex Doppler ultrasound (US) examinations were performed on 75 renal allograft recipients. Retrospective visual analysis of the Doppler tracings was compared to concurrent clinical findings and to biopsy results. One hundred eight of the 176 Doppler examinations (61%) that showed acute rejection clinically or histologically were interpreted as rejection, while 80 of 99 examinations (81%) in clinically normal patients were interpreted as normal. Two hundred thirty-four examinations had resistive index (RI) calculations. Seventy-two of 141 examinations (51%) with RI less than 0.70 had clinical or biopsy evidence of rejection. Studies compared with only concurrent biopsies revealed that 35 of 39 US examinations interpreted as rejection were confirmed histologically, but only one of 32 examinations that appeared normal sonographically was histologically normal. The low sensitivity of Doppler US, whether by waveform analysis or RI calculation, makes it a poor screening test for acute rejection. The findings support the conclusion that Doppler sonography cannot replace biopsy in the evaluation of renal transplant dysfunction, particularly when the waveform analysis is normal and the RI less than 0.70.
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Rechazo de Injerto , Trasplante de Riñón/inmunología , Ultrasonografía/métodos , Adulto , Estudios de Evaluación como Asunto , Femenino , Humanos , Masculino , Persona de Mediana EdadRESUMEN
Ultrasound and oral cholecystography (OCG) are both used to evaluate candidates for biliary lithotripsy. Some investigators have suggested abandoning the OCG, believing that sufficient screening information can be obtained from ultrasound. This study compares ultrasound and OCG in assessing the size and number of gallstones, both in vitro and in vivo. In the in vitro model, 35 gallstones, divided into 20 groups, were separately suspended in dilute contrast media in a phantom, and examined by ultrasound and simulated OCG by each of three gastrointestinal radiologists. In the in vivo study, the ultrasound and OCG examinations from 53 patients were independently reviewed by three radiologists. The number and size of the stones were recorded in both studies. In the in vitro study, the stone size was measured within 2 mm of the actual size by OCG in 23/35 stones (66%) and by ultrasound in 4/35 stones (11%). The correct number of stones was determined by OCG in 19/20 groups (95%), and by ultrasound in 14/20 (70%). In the in vivo study, all readers saw the same number of stones in 40/50 (80%) patients by OCG and 33/49 (67%) patients by ultrasound. Statistical analyses revealed correlation coefficients for OCG greater than those for ultrasound in each comparison. The size of the largest stone was within 2 mm by all readers in 26/51 (51%) of patients by OCG and 20/47 (43%) patients by ultrasound. Oral cholecystography is more reliable than ultrasound for the determination of size and number of stones in patients being screened for biliary lithotripsy.
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Colecistografía , Colelitiasis/diagnóstico , Vesícula Biliar/diagnóstico por imagen , Litotricia , Radiografía Intervencional , Adulto , Anciano , Colelitiasis/epidemiología , Colelitiasis/terapia , Estudios de Evaluación como Asunto , Femenino , Humanos , Técnicas In Vitro , Litotricia/instrumentación , Litotricia/métodos , Masculino , Persona de Mediana Edad , Modelos Estructurales , Estudios Retrospectivos , UltrasonografíaRESUMEN
Both ultrasonography (US) and oral cholecystography (OCG) are being used to evaluate patients after extracorporeal shock wave lithotripsy (ESWL) for gallstones. Criteria for retreatment after the initial ESWL are usually related to the size of the residual fragments. This study examines the efficacy of ultrasound and OCG for determining both the size and number of stone fragments in the gallbladder in an in vitro model and in patients. Ultrasonography and OCG examinations using an in vitro ESWL phantom with ten groups of stones, and on 39 patients, were reviewed independently by three radiologists to determine both the size and number of stone fragments. For the in vitro study, the three readers estimated the correct number of fragments, or the next closest range, in 87% of observations by OCG and in 43% by US. The size of the largest fragment was measured within 1 mm of its actual size in 87% of observations by OCG and 20% by US. Correlation coefficients for the mean measurements of the three readers versus the actual fragment size and number were greater for OCG than for US. For the in vivo study, the three readers agreed in 47% of the OCG versus 32% of US examinations with respect to the number of fragments, and in 65% of OCG compared to 40% of US studies with respect to size of the largest fragment. Multiple statistical analyses demonstrate that these differences are statistically significant. A discrepancy among the readers concerning whether a patient was eligible for retreatment occurred in 15% of OCG as compared to 45% of US studies. Both the in vivo and in vitro studies indicate that there is more interobserver reproducibility for OCG than for US, and that OCG is more reliable in making the decision concerning patient eligibility for retreatment following lithotripsy.
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Colecistografía , Colelitiasis/diagnóstico , Vesícula Biliar/diagnóstico por imagen , Litotricia , Radiografía Intervencional , Adulto , Anciano , Anciano de 80 o más Años , Colelitiasis/epidemiología , Colelitiasis/terapia , Estudios de Evaluación como Asunto , Femenino , Estudios de Seguimiento , Humanos , Técnicas In Vitro , Litotricia/instrumentación , Litotricia/métodos , Masculino , Persona de Mediana Edad , Modelos Estructurales , Estudios Retrospectivos , UltrasonografíaRESUMEN
Inability to demonstrate the renal corticomedullary junction (CMJ) on magnetic resonance (MR) images has been reported in connection with several medical renal diseases. T1-weighted spin echo pulse sequences have been advocated to demonstrate a signal intensity difference between cortex and medulla. This study was undertaken to determine which of several T1-weighted spin echo (SE) and gradient echo (GE) sequences are better for delineation of the CMJ. The MR studies were performed at 0.5 Tesla on 27 normal volunteers. Multi-slice axial images of both kidneys were obtained in all subjects at each of the following five pulse sequences: SE 250/20, SE 500/30, SE 900/30, and GE 300/15 with 80 degrees and 64 degrees flip angles. Contrast/noise ratios were calculated for the signal intensity differences between cortex and medulla; the average standardized contrast/noise ratios ranked as follows: GE 300/15/80 degrees = 3.01 +/- 0.74, GE 300/15/64 degrees = 2.72 +/- 0.74, SE 250/20 = 2.02 +/- 0.33, SE 500/30 = 1.96 +/- 0.51, and SE 900/30 = 1.71 +/- 0.39. In addition, the five sequences for each patient were randomized and the images were independently ranked for delineation of CMJ by three MR radiologists. The cumulative subjective ranking for all observers from best to worst is as follows: SE 500/30, GE 300/15/80 degrees, GE 300/15/64 degrees, SE 900/30, SE 250/20. Although better contrast/noise ratios are achieved with the GE sequences and the more T1-weighted SE sequences, as a practical matter this does not seem to be the only significant factor when compared with the visual image evaluation by independent observers.(ABSTRACT TRUNCATED AT 250 WORDS)
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Corteza Renal/anatomía & histología , Médula Renal/anatomía & histología , Imagen por Resonancia Magnética , Adulto , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Masculino , Persona de Mediana EdadRESUMEN
We report 6 patients with myelodysplasia who, on routine cytogenetic studies, demonstrated trisomy 15. Four of these also had sex chromosome loss. A review of the literature revealed 6 other cases of trisomy 15 with sex chromosome loss and 22 cases of trisomy 15 as the sole chromosomal abnormality. All cases had hematologic malignancy or myelodysplasia. Trisomy 15 is uncommon but tends to be associated with myelodysplasia in older subjects, and with sex chromosome loss in about one third of cases.
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Aberraciones Cromosómicas , Cromosomas Humanos Par 15 , Neoplasias Hematológicas/genética , Síndromes Mielodisplásicos/genética , Cromosomas Sexuales , Trisomía , Anciano , Anciano de 80 o más Años , Femenino , Humanos , Cariotipificación , MasculinoRESUMEN
Clathrin-coated vesicles are thought to be a vehicle for the sequestration of GABAA receptors. For coated vesicles from bovine cerebrum, we examined the binding properties of [3H]muscimol. a GABAA-specific agonist. [3H]flunitrazepam a benzodiazepine agonist, and [35S]t-butylbiocyclophosphorthionate (TBPS), a ligand for GABAA receptor channels. Under standard conditions, the binding level of [3H]muscimol, [3H]flunitrazepam, and [35S]TBPS to coated vesicles represented 12.3 +/- 1.8%, 7.9 +/- 1%, and 10.2 +/- 1.8%, respectively, of that in crude synaptic membranes. Coated vesicles showed a single [3H]flunitrazepam binding site with a KD value (12 nM) which was 9-fold that for synaptic membranes. The allosteric coupling between binding sites was measured by the addition of GABA to [3H]flunitrazepam and [35S]TBPS binding assays. For [3H]flunitrazepam binding to synaptic membranes, GABA gave an EC50 = 2.0 microM and at saturation (100 microM) an enhancement of 122%. This stimulation was completely blocked by the GABA antagonist SR95531. In contrast, neither GABA nor SR95531 had a significant effect on [3H]flunitrazepam binding to CCVs, indicating that the allosteric interaction between GABA and benzodiazepine binding sites is abolished. Likewise, GABA displaced nearly all of the [35S]TBPS binding to synaptic membranes but had no effect on binding to coated vesicles, indicating that coupling between the GABA binding sites and chloride channel is also impaired. Thus GABAA receptors appear to be uncoupled during normal intracellular trafficking via coated vesicles. The presence of major GABAA receptor subunits on these particles was verified by quantitative immunoblotting. Relative to the levels in synaptic membranes, CCVs contained 110 +/- 14% and 29.5 +/- 3.8%, respectively, of the immunoreactivity for GABAA receptor beta 2 and alpha 1 subunits. Thus, in comparison to GABAA receptors on synaptic membranes, those on CCVs have a reduced alpha 1/beta 2-subunit ratio. It may be suggested that a selective decline in the content of alpha 1 subunits in coated vesicles could in part account for GABAA receptor uncoupling.