RESUMO
The first lung transplantation in Hungary was performed on 12th of December, 2015. It was a joint effort of the National Institute of Oncology and the Semmelweis University. Hereby we summarise the results and experiences from the first three years. Until August, 2018, 55 lung transplantations were performed in Hungary. This was a retrospective analysis. All patients were listed according to the recommendation of the Lung Transplantation Committee. All implanted lungs have been procured from brain dead donors. Postoperative treatment and rehabilitation of the patients were continued at the Semmelweis University. Between 12. 12. 2015 and 31. 07. 2018, our team performed 76 organ retrievals: out of 45 Hungarian offers, 23 came from Eurotransplant countries and 8 outside of the Eurotransplant region. From these donations, 54 double and 1 single side transplantations were successfully performed. The surgical approach was single side thoracotomy (n = 1), bilateral thoracotomy (n = 1) and in the majority of the cases clamshell incision (n = 53). For the intraoperative veno-arterial extracorporeal membrane oxygenation support was used. The extracorporeal membrane oxygenation support had to be prolonged in 3 patients into the early postoperative period, two other recipients were bridged to transplant with extracorporeal membrane oxygenation. In the same time period, one combined lung-kidney transplantation was also performed. The distribution of recipients according to the underlying disease was: chronic obstructive pulmonary disease (n = 28); idiopathic pulmonary fibrosis (n = 8); cystic fibrosis (n = 12); primary pulmonary hypertension (n = 2); hystiocytosis-X (n = 1); bronchiectasis (n = 2); lymphangioleiomyomatosis (n = 1); and re-transplantation following bronchiolitis obliterans syndrome (n = 1), respectively. The mean age of recipients was 47.5 ± 15.18 years. The youngest recipient was 13 years old. We unfortunately lost 12 patients on our waiting list. The mean intensive care unit stay was 24.6 ± 18.18 days. Two patients were lost in the early postoperative phase. Tracheostomy was necessary in 13 cases due to the need of prolonged ventilation. 1-year survival of the recipients was 82.96% (until 31. 07. 2018). When looking at the first three years of the program, the case numbers elevated quickly throughout the years which is rather unique when compared to other centres in their starting period. Perioperative mortality and morbidity is comparable with high-volume lung transplantation centres. In the future we would like to increase the number of patients on the waiting list, thus increasing the total number of transplantations performed, and we are also planning to implement the use of the ex vivo lung perfusion system (EVLP) in our program. Orv Hetil. 2018; 159(46): 1859-1868.
Assuntos
Transplante de Pulmão/estatística & dados numéricos , Doadores de Tecidos/estatística & dados numéricos , Obtenção de Tecidos e Órgãos/estatística & dados numéricos , Feminino , Humanos , Hipertensão Pulmonar/cirurgia , Masculino , Doença Pulmonar Obstrutiva Crônica/cirurgia , Taxa de SobrevidaRESUMO
Efficient synthesis of novel 16-spiroisoxazolines in the androst-5-ene series was carried out by 1,3-dipolar cycloadditions of different aryl nitrile oxides to 3ß-acetoxy-16-methylene-androst-5-en-17-one. During the intermolecular ring closures, the attack of the O terminus of the nitrile oxide dipole from the α side on C-16 predominated for steric reasons permitting the reactions to occur in a regio- and stereoselective manner. The minor isomers in which the angular methyl group on C-13 and the O atom of the isoxazoline heteroring were in the ß, ß-cis orientation were obtained in a yield of only ~10 %. Moreover, the conversions were influenced to a certain extent by the substituents on the aromatic moiety of the 1,3-dipoles. The stereostructures of the related diastereomers were confirmed by 2D NMR methods. Deacetylation of the primarily formed main products resulted in the corresponding 3ß-OH analogs, which were further reduced to furnish 3ß, 17ß-diols. All of the synthetized compounds were subjected to in vitro pharmacological studies in order to investigate their antiproliferative effects on three malignant human adherent cell lines (HeLa, MCF7, and A431).
Assuntos
Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Reação de Cicloadição , Isoxazóis/síntese química , Isoxazóis/farmacologia , Compostos de Espiro/química , Antineoplásicos/química , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Humanos , Isoxazóis/química , Modelos Moleculares , Conformação Molecular , Estereoisomerismo , Especificidade por SubstratoRESUMO
We conducted a comprehensive examination of liquid mycotoxin reference standards. A total of 30 different standards were tested, each containing 10 samples of three distinct substances: Aflatoxin B1, Deoxynivalenol, and Zearalenone. The standards were sourced from 10 different global market leading manufacturers. To facilitate comparison, all the standard sets were adjusted to the same concentration level. The standards were analyzed using the techniques LC-MS/MS, HPLC-DAD, and LC-HRMS to assess their quality attributes. Regarding the validation of the reference values, it was observed that 30% of the suppliers provided reference standards that were either below the lower acceptance limit or above the higher acceptance limit, confirmed by both the LC-MS/MS and HPLC-DAD methods. Furthermore, a total of 12 impurities were found in the DON standards, 10 in the AFB1 standards, and 8 in the ZON standards, distributed across all the suppliers. Therefore, this study suggests relevant adjustments to the ISO 17034 standard, proposing that the purity of a raw material should be uniformly based on q-NMR analysis, as most manufacturers state the purity of their certificates is determined using HPLC-UV or LC-MS/MS. Liquid standards with a shelf life of ≤1 year should not exceed an uncertainty of 3%. Standards that have a longer shelf life should not have more than 5% uncertainty. This study also emphasizes the importance of stability. The standards should undergo continuous long-term monitoring; otherwise, products may exhibit a target value of only 80%, as seen in one instance. It is also recommended to include proof of HPLC and LC-MS/MS analyses on the certificate of each released batch of a final product.
Assuntos
Aflatoxina B1 , Padrões de Referência , Espectrometria de Massas em Tandem , Tricotecenos , Zearalenona , Tricotecenos/análise , Zearalenona/análise , Aflatoxina B1/análise , Cromatografia Líquida de Alta Pressão , Contaminação de Alimentos/análise , Micotoxinas/análise , Cromatografia LíquidaRESUMO
Fumonisins are frequent food contaminants. The high exposure to fumonisins can cause harmful effects in humans and animals. Fumonisin B1 (FB1) is the most typical member of this group; however, the occurrence of several other derivatives has been reported. Acylated metabolites of FB1 have also been described as possible food contaminants, and the very limited data available suggest their significantly higher toxicity compared to FB1. Furthermore, the physicochemical and toxicokinetic properties (e.g., albumin binding) of acyl-FB1 derivatives may show large differences compared to the parent mycotoxin. Therefore, we tested the interactions of FB1, N-palmitoyl-FB1 (N-pal-FB1), 5-O-palmitoyl-FB1 (5-O-pal-FB1), and fumonisin B4 (FB4) with human serum albumin as well as the toxic effects of these mycotoxins on zebrafish embryos were examined. Based on our results, the most important observations and conclusions are the following: (1) FB1 and FB4 bind to albumin with low affinity, while palmitoyl-FB1 derivatives form highly stable complexes with the protein. (2) N-pal-FB1 and 5-O-pal-FB1 likely occupy more high-affinity binding sites on albumin. (3) Among the mycotoxins tested, N-pal-FB1 showed the most toxic effects on zebrafish, followed by 5-O-pal-FB1, FB4, and FB1. (4) Our study provides the first in vivo toxicity data regarding N-pal-FB1, 5-O-pal-FB1, and FB4.
Assuntos
Fumonisinas , Micotoxinas , Animais , Humanos , Fumonisinas/toxicidade , Fumonisinas/metabolismo , Micotoxinas/toxicidade , Peixe-Zebra/metabolismo , Albumina Sérica HumanaRESUMO
We have previously published six esterified O-acyl (EFB1) and three N-acyl fumonisin B1 derivatives extracted from rice cultures inoculated with Fusarium verticillioides, amongst these the identification of N-palmitoyl-FB1 has been clearly established in a spiking experiment. At that time, it was assumed that as in the case of O-acyl-FB1 derivatives, linoleic-, oleic- or palmitic acid esterify through the OH group on the 3C or 5C atom of the carbon chain of the fumonisins. In our most recent experiments, we have synthetically acylated the FB1 toxin and subsequently purified 3-O-palmitoyl- and 5-O-palmitoyl-FB1 toxins in addition to the N-palmitoyl-FB1 toxin. They were identified and characterised using 1H and 13C NMR as well as LC-HRMS. Our aim was the identification of the previously detected O-acyl-FB1 derivatives over the course of a spiking experiment, which were obtained through the solid-phase fermentation of Fusarium verticillioides. By spiking the three synthesized and identified components one-by-one into the fungal culture extract and analysing these cultures using LC-MS, it was clearly demonstrated that the F. verticillioides strain produced both the 5-O-palmitoyl-FB1 and N-palmitoyl-FB1 toxins, but did not produce 3-O-palmitoyl-FB1. Thus, it is highly probable that the components thought to be 3-O-acyl-(linoleoyl-, oleoyl-, palmitoyl-) FB1 derivatives in our previous communication are presumably 10-O-acyl-FB1 derivatives. Since these acylated FB1 derivatives can occur naturally in e.g. maize, the use of these synthesized components as reference materials is of great importance in order to obtain accurate qualitative and quantitative data on the occurrence of acylated fumonisins in different matrices including maize based feed samples. The production of these substances has also made it possible to test their toxicity in cell culture and small animal experiments.
Assuntos
Fumonisinas , Fusarium , Animais , Carbono , Fumonisinas/análise , Fusarium/química , Ácido Palmítico/química , Extratos VegetaisRESUMO
Stereoselective 1,4-Michael addition of azoimide to 17ß-acetoxy-5α-adrost-1-en-3-one was carried out to furnish a 1α-azido-3-ketone, which was reduced to give the 3ß- and 3α-hydroxy epimers in a ratio of 5 : 2. The Cu(I)-catalyzed 1,3-dipolar cycloaddition of the major isomer to terminal alkynes afforded 1α-triazolyl derivatives, which were deacetylated to the corresponding 3ß,17ß-diols or oxidized to the analogous 3-ketones. However, the ability of the minor 1α,3α-azidoalcohol to undergo similar cyclization was found to be affected significantly by the steric bulk of the substituents on the alkyne reaction partner. All triazolyl compounds were tested in vitro on three malignant gynecological cell lines (HeLa, MCF7 and A2780).
Assuntos
Androstanos/química , Proliferação de Células/efeitos dos fármacos , Androstanos/farmacologia , Linhagem Celular Tumoral , Humanos , Estrutura Molecular , Relação Estrutura-AtividadeRESUMO
A straightforward and reliable method for the regioselective synthesis of steroidal 1,4-disubstituted triazoles and 1,5-disubstituted tetrazoles via copper(I)-catalyzed cycloadditions is reported. Heterocycle moieties were efficiently introduced onto the starting azide compound 3ß-acetoxy-16ß-azidomethylandrost-5-en-17ß-ol through use of the "click" chemistry approach. The antiproliferative activities of the newly-synthesized triazoles were determined in vitro on three human gynecological cell lines (HeLa, MCF7 and A2780) using the microculture tetrazolium assay.
Assuntos
Androstenos/síntese química , Androstenos/farmacologia , Antineoplásicos/síntese química , Antineoplásicos/farmacologia , Triazóis/síntese química , Triazóis/farmacologia , Androstenos/química , Antineoplásicos/química , Linhagem Celular Tumoral , Proliferação de Células/efeitos dos fármacos , Células HeLa , Humanos , Triazóis/químicaRESUMO
A 65-day study was undertaken to test the effects of two doses (10 and 20 mg/kg) of dietary fumonisin Bs (FB) on the rabbit male reproduction system. Body and testicular weight was not affected by the intoxication, neither the fatty acid composition of the testicular total phospholipids; the testis histological analysis failed to reveal any toxic effect. The FBs increased the testicular concentration and activity of reduced glutathione and glutathione peroxidase and decreased initial phase lipid peroxidation (conjugated dienes and trienes) in a dose dependent manner. Sperm morphology and chromatin condensation were monitored on Feulgen-stained smears. No significant differences were observed between the treatment groups and between sampling time points. The live cell ratio in the sperm (as assessed with flow cytometry) was not different among groups at any of the five sampling timepoints and was also identical within groups. Similarly, the spermatozoa membrane lipid profile was also identical in all three groups after the total intoxication period. In summary, it was demonstrated that FBs in an unrealistic and unjustified high dose still do not exert any drastic harmful effect on the leporine, male reproduction system, meanwhile slightly augmenting testicular antioxidant response.
Assuntos
Exposição Dietética/efeitos adversos , Fumonisinas/toxicidade , Fusarium/metabolismo , Espermatozoides/efeitos dos fármacos , Testículo/efeitos dos fármacos , Ração Animal/microbiologia , Animais , Relação Dose-Resposta a Droga , Ácidos Graxos/metabolismo , Microbiologia de Alimentos , Fumonisinas/metabolismo , Peroxidação de Lipídeos/efeitos dos fármacos , Masculino , Estresse Oxidativo/efeitos dos fármacos , Fosfolipídeos/metabolismo , Coelhos , Espermatozoides/metabolismo , Espermatozoides/patologia , Testículo/metabolismo , Testículo/patologia , Fatores de TempoRESUMO
[This corrects the article DOI: 10.3389/fmicb.2020.01916.].
RESUMO
Fumonisin mycotoxins which are hazardous to humans and animals were produced in a Fusarium verticillioides-infected solid rice culture. To decrease the possibility of the formation of artifacts, the fumonisins were analysed by reversed-phase high-performance liquid chromatography/electrospray ionization time-of-flight (RP-HPLC/ESI-TOFMS) and ion trap mass spectrometry (RP-HPLC/ESI-ITMS) immediately after the extraction of the culture material, without any further sample clean-up. The fumonisin isomers were separated by using a flat gradient on a special, high-coverage C(18), narrow-bore HPLC column (YMC-Pack J'sphere ODS H80) suggested for the separation of structural isomers by the manufacturer. Exact mass measurements (TOFMS) of the protonated molecules and extraction of the ion chromatogram corresponding to the empirical formula (C(34)H(59)NO(15)) of FB(1) toxins led to the identification of 29 peaks and shoulders, including those of FB(1). The FB(1) toxin and 28 of its isomers were also detected by ITMS after separation with RP-HPLC. The characteristic m/z values of the product ions, including the backbones obtained by ITMS(2), undoubtedly indicated the structures of the FB(1) isomers for 28 peaks and shoulders. In the MS(2) spectra of the protonated molecules of the FB(1) isomers, with some exceptions, 15 characteristic product ions including the hydrocarbon backbone at m/z 299 were observed. The abundance ratio of the cation at m/z 299 ranged up to 5.8%. The relative quantities of the isomers found in the sample extract were expressed as percentages of the FB(1) content (0.001-0.579%). The total amount of the 28 FB(1) isomers was 2.803% of the quantity of FB(1) that is important from the aspect of food and feed safety.
Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Análise de Alimentos/métodos , Contaminação de Alimentos/análise , Fumonisinas/análise , Fumonisinas/química , Oryza/química , Espectrometria de Massas por Ionização por Electrospray/métodos , IsomerismoRESUMO
This paper demonstrates the development of an analytical method based on CE coupled to ESI-MS for the identification and quantification of fumonisin mycotoxins. Separation and detection parameters (pH of background electrolyte (BGE), organic modifier content, sheath liquid (SL) composition, MS mode and nebuliser pressure) were optimised. Ammonium formate/ammonia (pH = 9.5) with 10% ACN modifier was found the most suitable BGE. Positive mode MS was used for detection by scanning the m/z range of 400-1200. Separation was highly affected by the nebuliser pressure, a 25% improvement in peak resolution was achieved by applying the optimised parameters. The 'dilute and shoot' approach was applied to overcome disturbing effects caused by the matrix of fungi supernatant samples. The available sample volume affected the reproducibility of the measurements greatly: the scattering of peak intensities were between 4 and 11 RSD% instead of 27-195 RSD% for fumonisin B1 and fumonisin B2 when the available volume was ~200 µL instead of ~20 µL. Quantitative determinations were carried out in Fusarium verticillioides and Fusarium proliferatum culture supernatant (raw) and mycelium (cleaned up) samples. The optimised method enabled the detection of 11 fumonisins in Fusarium proliferatum inoculated rice samples; 2 of them were quantified based on external calibration and 4 other compounds with fumonisin-like formulas were detected.
Assuntos
Fumonisinas/análise , Fusarium/química , Micélio/química , Venenos/análise , Eletroforese Capilar , Espectrometria de Massas , Estrutura MolecularRESUMO
Aflatoxins, produced mainly by filamentous fungi Aspergillus flavus and Aspergillus parasiticus, are one of the most carcinogenic compounds that have adverse health effects on both humans and animals consuming contaminated food and feed, respectively. Aflatoxin B1 (AFB1) and aflatoxin B2 (AFB2) as well as aflatoxin G1(AFG1) and aflatoxin G2 (AFG2) occur in the contaminated foods and feed. In the case of dairy ruminants, after the consumption of feed contaminated with aflatoxins, aflatoxin metabolites [aflatoxin M1 (AFM1) and aflatoxin M2 (AFM2)] may appear in milk. Because of the health risk and the official maximum limits of aflatoxins, there is a need for application of fast and accurate testing methods. At present, there are several analytical methods applied in practice for determination of aflatoxins. The aim of this review is to provide a guide that summarizes worldwide aflatoxin regulations and analytical methods for determination of aflatoxins in different food and feed matrices, that helps in the decision to choose the most appropriate method that meets the practical requirements of fast and sensitive control of their contamination. Analytical options are outlined from the simplest and fastest methods with the smallest instrument requirements, through separation methods, to the latest hyphenated techniques.
RESUMO
Weaned piglets (n = 3 × 6) were fed 0, 15 and 30 mg/kg diet fumonisin (FB1, FB2 and FB3, i.e., FBs, a sphinganine analogue mycotoxin), from the age of 35 days for 21 days, to assess mycotoxin induced, dose-dependent changes in the red cells' membrane. Ouabain sensitive Na+/K+ ATPase activity was determined from lysed red cell membranes, membrane fatty acid (FA) profile was analysed, as well as antioxidant and lipid peroxidation endpoints. Final body weight was higher in the 30 mg/kg group (vs. control), even besides identical cumulative feed intake. After 3 weeks, there was a difference between control and the 30 mg/kg group in red cell membrane sodium pump activity; this change was dose-dependent (sig.: 0.036; R2 = 0.58). Membrane FA profile was strongly saturated with non-systematic inter-group differences; pooled data provided negative correlation with sodium pump activity (all individual membrane n6 FAs). Intracellular antioxidants (reduced glutathione and glutathione peroxidase) and lipid peroxidation indicators (conj. dienes, trienes and malondialdehyde) were non-responsive. We suppose a ceramide synthesis inhibitor (FB1) effect exerted onto the cell membrane, proven to be toxin dose-dependent and increasing sodium pump activity, with only indirect FA compositional correlations and lack of lipid peroxidation.
Assuntos
Membrana Eritrocítica/efeitos dos fármacos , Fumonisinas/toxicidade , Estresse Oxidativo/efeitos dos fármacos , ATPase Trocadora de Sódio-Potássio/metabolismo , Administração Oral , Animais , Antioxidantes/metabolismo , Relação Dose-Resposta a Droga , Membrana Eritrocítica/metabolismo , Ácidos Graxos/metabolismo , Fumonisinas/administração & dosagem , Peroxidação de Lipídeos/efeitos dos fármacos , Esfingosina N-Aciltransferase/antagonistas & inibidores , Esfingosina N-Aciltransferase/metabolismo , Sus scrofa , Regulação para CimaRESUMO
The mortality of severe ARDS is almost 60%. Ventilation-associated lung-injury can be avoided by low-pressure, low-volume ventilation. Potential use of ECMO in case of refractory hypoxemia beside modern ventilatory therapy can be considered. Increasing numbers of respiratory ECMO runs are seen worldwide, though the efficacy remains controversial. The authors present the first successful venovenous-ECMO treatment in severe ARDS in our Institute. We report the case of a 67-year-old male who was admitted with community-acquired pneumonia caused by Legionella. Despite empirical and later targeted antibiotic therapy, severe ARDS with sepsis evolved. Neither ventilation nor prone position resulted in permanent improvement in oxygenation. The patient was referred to our Institute for extracorporeal life support (ECLS) therapy. On admission, blood gas showed severe hypoxemia with mild hypercapnia (PaO2/FiO2: 60, pCO2: 53 mmHg at PEEP: 14 mmHg, PIP: 45 mmHg). X-ray showed bilateral patchy infiltrates while cardiac impairment (EF: 45%) and dilated right ventricle were seen on echocardiography. Elevated pulmonary artery pressure (mPAP: 41 mmHg) was measured. After implantation of femoral-jugular VV ECMO, oxygen saturation was appropriate with lung protective ventilation (FiO2: 0.5, TV: 3-4 ml/kg). Improving lung function enabled us to stop ECMO after 8 days and further 5 days later the patient was weaned off ventilation. After 21 days of intensive care we discharged him to the referral hospital. By reporting this case we emphasise the potential role of respiratory ECMO. Consideration should be given to increase the contingent of this modality in the Hungarian intensive care in accordance with international practice. Orv Hetil. 2019; 160(6): 235-240.
Assuntos
Oxigenação por Membrana Extracorpórea/métodos , Doença dos Legionários/terapia , Pneumonia/terapia , Síndrome do Desconforto Respiratório/terapia , Idoso , Humanos , Doença dos Legionários/diagnóstico , Masculino , Pneumonia/microbiologia , Síndrome do Desconforto Respiratório/microbiologia , Resultado do TratamentoRESUMO
BACKGROUND: After its initial difficulties were overcome, lung transplantation became an accepted and effective treatment for end-stage lung disease. Patients can take part in almost all kinds of sports after lung transplantation, including high-altitude mountaineering, which is an extreme sport even for healthy individuals. Several articles have been published about high-altitude tolerance of transplanted patients. However, this was the first high-altitude expedition that included only lung transplant patients. METHODS: The Vienna lung transplantation team organized an expedition in 2017 to conquer the peak of Mount Kilimanjaro, which consisted of 10 lung transplanted patients and 24 accompanying medical personnel. The participants were tested before and several times during the hike to evaluate their general and cardiopulmonary status, the severity of altitude sickness, and radio-morphologic changes. The results of the lung transplanted patients were compared to the results of their healthy companions. RESULTS: The group started at 2360 meters and reached the 5895-meter-high summit of Mount Kilimanjaro after 6 days on June 18, 2017. Eight transplant patients and 24 escorting medical personnel reached the peak. This means that the success rate was 94%, which is significantly higher than the reported 85% for this route. The 2 transplant patients who did not make the summit turned back on the first and second day because they lacked the necessary fitness for the trip. We did not see a significant difference in the results regarding cardiopulmonary status or the severity of altitude sickness, although we observed mildly higher blood pressure and altitude sickness score results in the lung transplant group. CONCLUSION: Based on our experiences, we can state that a stable patient after lung transplantation who attains the necessary physical fitness can achieve similar or even better physical results than an average healthy individual.
Assuntos
Transplante de Pulmão , Montanhismo , Transplantados , Adulto , Altitude , Feminino , Humanos , Pulmão/fisiopatologia , Masculino , Pessoa de Meia-Idade , TanzâniaRESUMO
In this article we summarize the results of the first 3 years after launching the Hungarian Lung Transplantation Program. PATIENTS AND METHODS: The first lung transplant in Hungary was carried out on December 12, 2015, with the collaboration of the National Institute of Oncology and the Semmelweis University. Up to December 31, 2018, a total of 62 lung transplants were performed. Data were analyzed retrospectively. Patients were listed for lung transplant after the indication was established by the National Lung Transplantation Committee. Donor lungs were procured from brain-dead donors only. RESULTS: Within this period our team was involved in 87 lung procurements, 61 of which resulted in bilateral lung transplant and 1 in single-sided transplant. The operative approach was unilateral thoracotomy (n = 1), bilateral thoracotomy (n = 1), or clamshell incision (n = 60) with venoarterial extracorporeal membrane oxygenation support. The underlying disease of the recipients was obstructive lung disease (n = 30), lung fibrosis (n = 11), cystic fibrosis (n = 18), primary pulmonary hypertension (n = 2), histiocytosis-X syndrome (n = 1), bronchiectasis (n = 2), lymphangioleiomyomatosis (n = 1), and retransplant because of bronchiolitis obliterans syndrome (n = 1). The youngest patient was 13 years of age, while the oldest was 65 years. Three patients died in the early postoperative phase. One-year survival was 80%. DISCUSSION: The number of cases rises steadily in the Hungarian Lung Transplantation Program, which is exceptional compared with the start of other centrums. The incidence of complications and mortality is comparable with those of other experienced centers around the world. Our future goal is to broaden our waiting list, thus increasing the number of lung transplants carried out.
Assuntos
Transplante de Pulmão/métodos , Transplante de Pulmão/estatística & dados numéricos , Transplante de Pulmão/tendências , Adolescente , Adulto , Idoso , Feminino , Humanos , Hungria , Pneumopatias/cirurgia , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto JovemRESUMO
INTRODUCTION: Lung transplantation is the only successful treatment option for patients experiencing end-stage lung disease. Results have improved significantly in the last decade; however, the number one limiting factor is still the shortage of donor lungs. Due to the discrepancy between available donor lungs and patients awaiting lung transplantation, many centers have reintroduced donation after cardiac death (DCD). According to their results, DCD and donation after brain death (DBD) are comparable in terms of survival and graft function. Currently in Hungary, donation is only allowed from DBD donors; however, due to the Eurotransplant agreement, non-heart-beating donation (NHBD) organs can be transplanted into Hungarian patients, and in some cases Hungarian transplant teams can also take part in NHBDs within the Eurotransplant region. The Hungarian experience. A Hungarian patient received a lung from a 15-year-old uncontrolled DCD in Vienna. The donor was reanimated for 54 minutes and after lung procurement the lungs were put on ex vivo lung perfusion and later successfully implanted into the Hungarian recipient. The recovery was very successful and the patient is still alive. The Hungarian Lung Transplantation Team was involved in a controlled Maastricht III donation in 2017. A 49-year-old female donor was reported from Ghent, Belgium. A multiorgan donation was carried out with 15 minutes of warm ischemic time in the case of the lungs. CONCLUSION: DCD is an effective, safe, and available method to increase the donor pool. In the case of controlled donations, the necessary protocols have already been prepared. Although DBD is working very successfully in Hungary, infrastructural developments, education of professionals, and social preparations are all needed to implement a DCD protocol in Hungary.
Assuntos
Morte , Transplante de Pulmão/métodos , Doadores de Tecidos/provisão & distribuição , Obtenção de Tecidos e Órgãos/métodos , Adolescente , Feminino , Humanos , Hungria , Masculino , Pessoa de Meia-IdadeRESUMO
A rapid liquid chromatography-atmospheric pressure photoionization mass spectrometry (LC-APPI-MS) method was developed for the determination of ergosterol in wheat grains. The effects of the dopants acetone, toluene and anisole on the ionization efficiency were studied. To identify the predominant ions, APPI-MS-MS studies were performed. Different LC and MS parameters were optimized to obtain maximum sensitivity. The effects of the mobile phase composition and of the flow rate were investigated. Additionally, the effects of the nebulizer gas pressure, the drying gas flow, the vaporizer temperature, the fragmentor voltage and the capillary voltage on the ionization efficiency were evaluated. The calibration curve exhibited good linearity and reproducibility. The detection limit (S/N=3) was 0.15 ng on column, which allows the determination of ergosterol in wheat at a concentration as low as 0.12 microg/g. Twenty wheat varieties artificially infected with Fusarium graminearum were investigated by this method.
Assuntos
Cromatografia Líquida de Alta Pressão/métodos , Ergosterol/análise , Fusarium/patogenicidade , Espectrometria de Massas/métodos , Doenças das Plantas/microbiologia , Triticum/química , Triticum/microbiologia , Pressão Atmosférica , Reprodutibilidade dos Testes , Sensibilidade e EspecificidadeRESUMO
Fusarium strains were isolated from rotten banana fruit imported into Hungary from some African and some Neotropical countries. The strains were identified using morphological features, 2-benzoxazolinone tolerance, translation elongation factor (EF-1α) sequences and inter simple sequence repeat (ISSR) analysis. All strains from Africa proved to be F. verticillioides whereas the strains from the Neotropics are Fusarium musae. According to the PCR proof and the fumonisin toxin measurement F. musae strains cannot produce any fumonisins (FB1-4).
Assuntos
Fusarium/fisiologia , Musa/microbiologia , Sequência de Bases , Benzoxazóis/farmacologia , Frutas/microbiologia , Fumonisinas/metabolismo , Proteínas Fúngicas/genética , Fusarium/efeitos dos fármacos , Fusarium/genética , Hungria , Repetições de Microssatélites/genética , Dados de Sequência Molecular , Micotoxinas/metabolismo , Filogenia , Análise de Sequência de DNARESUMO
The reactions of ethyl pyruvate with acetic anhydride and pyridine were studied by electrospray ionization mass spectrometry (ESI-MS). Ethyl 2-acetoxy-2-pyridiniumpropionate (1) (m/z 238) resulting from the reaction of the acetylpyridinium cation with ethyl pyruvate, and the adduct of ethyl 2-acetoxyacrylate with a pyridinium cation (2), bound together by non-covalent interactions (m/z 238), were identified by ESI-MS for the first time. Structures 1 and 2 cannot be distinguished, probably because one may be converted into the other and vice versa.