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1.
Nat Genet ; 24(1): 27-35, 2000 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-10615123

RESUMO

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


Assuntos
Pareamento Incorreto de Bases , Proteínas de Transporte/genética , Reparo do DNA/genética , Repetições de Microssatélites/genética , Sequência de Aminoácidos , Animais , Células Cultivadas , Clonagem Molecular , Neoplasias Colorretais Hereditárias sem Polipose/genética , Humanos , Camundongos , Camundongos Endogâmicos , Dados de Sequência Molecular , Proteínas MutL , Polimorfismo Genético , RNA Mensageiro/genética , Homologia de Sequência de Aminoácidos , Especificidade da Espécie
3.
Sci Rep ; 11(1): 9822, 2021 05 10.
Artigo em Inglês | MEDLINE | ID: mdl-33972596

RESUMO

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


Assuntos
Anticorpos Antivirais/isolamento & purificação , Imuno-Histoquímica/métodos , Febre do Vale de Rift/diagnóstico , Vírus da Febre do Vale do Rift/isolamento & purificação , Aedes/virologia , Animais , Anticorpos Antivirais/imunologia , Linhagem Celular , Chlorocebus aethiops , Reações Cruzadas , Culex/virologia , Modelos Animais de Doenças , Drosophila melanogaster/virologia , Epitopos/imunologia , Estudos de Viabilidade , Feminino , Humanos , Camundongos , Mosquitos Vetores/virologia , Proteínas do Nucleocapsídeo , Febre do Vale de Rift/transmissão , Febre do Vale de Rift/virologia , Vírus da Febre do Vale do Rift/imunologia , Células Vero , Proteínas do Envelope Viral/imunologia
4.
Reprod Fertil Dev ; 21(3): 408-18, 2009.
Artigo em Inglês | MEDLINE | ID: mdl-19261218

RESUMO

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


Assuntos
Tubas Uterinas/química , Proteínas de Choque Térmico HSP70/fisiologia , Ovinos , Espermatozoides/fisiologia , Animais , Anticorpos/farmacologia , Membrana Celular/química , Sobrevivência Celular/efeitos dos fármacos , Feminino , Proteínas de Choque Térmico HSP70/imunologia , Proteínas de Choque Térmico HSP70/farmacologia , Técnicas In Vitro , Masculino , Proteínas de Membrana/farmacologia , Proteínas Recombinantes/farmacologia , Preservação do Sêmen/veterinária , Fatores de Tempo
5.
Mol Vis ; 13: 1181-97, 2007 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-17679943

RESUMO

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


Assuntos
Células Epiteliais/metabolismo , Regulação da Expressão Gênica/efeitos dos fármacos , Cristalino/citologia , Cristalino/efeitos dos fármacos , Análise de Sequência com Séries de Oligonucleotídeos , Fator de Crescimento Transformador beta1/farmacologia , Fator de Crescimento Transformador beta2/farmacologia , Regulação para Baixo/efeitos dos fármacos , Células Epiteliais/efeitos dos fármacos , Proteínas da Matriz Extracelular/genética , Proteínas da Matriz Extracelular/metabolismo , Perfilação da Expressão Gênica , Substâncias de Crescimento/genética , Substâncias de Crescimento/metabolismo , Humanos , Integrinas/genética , Integrinas/metabolismo , Cristalino/metabolismo , Cadeias Leves de Miosina/genética , Cadeias Leves de Miosina/metabolismo , Receptores de Superfície Celular/genética , Receptores de Superfície Celular/metabolismo , Reprodutibilidade dos Testes , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Transdução de Sinais/efeitos dos fármacos , Transdução de Sinais/genética , Regulação para Cima/efeitos dos fármacos
6.
Clin Oncol (R Coll Radiol) ; 19(6): 470-80, 2007 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-17419040

RESUMO

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


Assuntos
Genômica , Neoplasias/genética , Neoplasias/radioterapia , Regulação Neoplásica da Expressão Gênica/genética , Regulação Neoplásica da Expressão Gênica/efeitos da radiação , Genótipo , Projeto Genoma Humano , Humanos , Análise de Sequência com Séries de Oligonucleotídeos , Polimorfismo Genético/efeitos dos fármacos , Polimorfismo Genético/efeitos da radiação , Tolerância a Radiação/genética , Tolerância a Radiação/efeitos da radiação , Transcrição Gênica/genética , Transcrição Gênica/efeitos da radiação
7.
Reprod Fertil Dev ; 17(7): 683-92, 2005.
Artigo em Inglês | MEDLINE | ID: mdl-16364221

RESUMO

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


Assuntos
Membrana Celular/metabolismo , Tubas Uterinas/metabolismo , Proteínas de Membrana/isolamento & purificação , Proteínas de Membrana/metabolismo , Espermatozoides/fisiologia , Sus scrofa , Animais , Biotinilação/métodos , Biotinilação/veterinária , Eletroforese/veterinária , Epitélio/metabolismo , Estudos de Avaliação como Assunto , Tubas Uterinas/citologia , Feminino , Masculino , Ligação Proteica/fisiologia , Espermatozoides/metabolismo
8.
Genes Nutr ; 10(3): 463, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25896409

RESUMO

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

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

RESUMO

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


Assuntos
Glutationa/metabolismo , Peróxido de Hidrogênio/farmacologia , Mitocôndrias/metabolismo , Estresse Oxidativo , Transcrição Gênica/efeitos dos fármacos , Adenosina Trifosfatases/genética , Linhagem Celular , Sobrevivência Celular/efeitos dos fármacos , DNA Complementar , DNA Mitocondrial/genética , Relação Dose-Resposta a Droga , Dissulfeto de Glutationa/metabolismo , Humanos , Cinética , Linfócitos , Mitocôndrias/efeitos dos fármacos , Mitocôndrias/genética , RNA Mensageiro/genética , beta Caroteno/farmacologia
10.
Free Radic Biol Med ; 28(9): 1438-46, 2000 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-10924862

RESUMO

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


Assuntos
Adutos de DNA/análise , Dano ao DNA , Reparo do DNA/fisiologia , Estresse Oxidativo , Cromatografia Líquida de Alta Pressão , Adutos de DNA/metabolismo , DNA Recombinante/análise , Proteínas de Ligação a DNA/genética , Compostos Férricos/farmacologia , Humanos , Radical Hidroxila/metabolismo , Azul de Metileno/metabolismo , Ácido Nitrilotriacético/análogos & derivados , Ácido Nitrilotriacético/farmacologia , Oxirredução , Oxigênio/metabolismo , Oxigênio Singlete , Células Tumorais Cultivadas/efeitos dos fármacos , Células Tumorais Cultivadas/metabolismo , Xeroderma Pigmentoso/genética , Proteína de Xeroderma Pigmentoso Grupo A
11.
Virus Res ; 56(1): 69-76, 1998 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-9784066

RESUMO

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


Assuntos
Orthohantavírus/genética , RNA Viral/química , Sequência de Aminoácidos , Animais , Sudeste Asiático , Sequência de Bases , China , Chlorocebus aethiops , Genoma Viral , Orthohantavírus/classificação , Dados de Sequência Molecular , Muridae , Filogenia , Reação em Cadeia da Polimerase , RNA Viral/genética , Ratos , Alinhamento de Sequência , Células Vero
12.
J Endocrinol ; 138(1): 159-66, 1993 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-7852887

RESUMO

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


Assuntos
Ritmo Circadiano/fisiologia , Ingestão de Alimentos/fisiologia , Polipeptídeo Inibidor Gástrico/sangue , Fenômenos Fisiológicos da Nutrição/fisiologia , Fragmentos de Peptídeos/sangue , Adulto , Glicemia/análise , Carboidratos da Dieta/metabolismo , Carboidratos da Dieta/farmacologia , Gorduras na Dieta/metabolismo , Gorduras na Dieta/farmacologia , Proteínas Alimentares/metabolismo , Proteínas Alimentares/farmacologia , Glucagon , Peptídeo 1 Semelhante ao Glucagon , Peptídeos Semelhantes ao Glucagon , Glucose/farmacologia , Humanos , Insulina/sangue , Metabolismo dos Lipídeos , Radioimunoensaio , Fatores de Tempo
13.
Vopr Virusol ; 29(3): 301-9, 1984.
Artigo em Russo | MEDLINE | ID: mdl-6380110

RESUMO

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


Assuntos
Bunyaviridae/genética , Genes Virais , Hibridização Genética , Recombinação Genética , Vírus Bunyamwera/genética , Clonagem Molecular , DNA/genética , DNA Viral/genética , Técnicas Genéticas , Genótipo , RNA Viral/genética , RNA Viral/isolamento & purificação
14.
Genes Nutr ; 9(6): 432, 2014 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-25260660

RESUMO

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

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

RESUMO

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


Assuntos
Neoplasias da Próstata/radioterapia , Lesões por Radiação/complicações , Lesões por Radiação/etiologia , Relação Dose-Resposta à Radiação , Gastroenteropatias/etiologia , Humanos , Masculino , Análise Multivariada , Modelos de Riscos Proporcionais , Neoplasias da Próstata/tratamento farmacológico , Radiometria , Dosagem Radioterapêutica , Radioterapia Conformacional/efeitos adversos , Doenças da Bexiga Urinária/etiologia
18.
Transplant Proc ; 43(9): 3521-8, 2011 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-22099833

RESUMO

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


Assuntos
Amputação Cirúrgica/reabilitação , Transplante de Mão , Seleção de Pacientes , Adulto , Amputação Cirúrgica/psicologia , Amputados , Membros Artificiais , Atitude Frente a Saúde , Feminino , Humanos , Imunossupressores/farmacologia , Isquemia , Masculino , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/métodos , Estudos Retrospectivos , Transplante Homólogo , Listas de Espera
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