Effect of panel reactive antibody on live related donor kidney transplantation: Indian experience

Serum samples from 95 recipients, transplanted with kidneys from live related donors, were tested for the presence of panel reactive antibodies (PRA) in pre- and post-transplant serum samples by the extended microdroplet lymphocytotoxicity test. The immunoglobulin class of antibodies was tested by treatment of serum with dithiothreitol. A significant correlation was found between the high PRA found in the 75 pretransplant sera tested and the subsequent rejection episodes. In addition, the level of pretransplant PRA activity was associated with graft survival in that patients with low PRA had significantly superior graft survival than those with high PRA. Furthermore, the present data show that patients with historical high PRA, but current low PRA, had graft survival similar to that in recipients who had moderate PRA in their current sera. High PRA patients had more often a positive crossmatch than patients with low PRA. The PRA level was also associated with prolonged waiting period. Immunoglobulin class of antibodies was related to graft acceptance in that the presence of IgM antibodies was not detrimental to transplantation. The results in the present study suggest that PRA of < 10% is negligible, while more attention should be paid to patients with PRA > 10%.     

Effects of intracervical injection of hyaluronidase in primigravidae during labour

A study was conducted on 75 primigravidae in labour of which 50 were injected with intracervical injection of hyaluronidase and 25 were taken as control. Labour could be accelerated and shortened by an average of 1.95 hours (p < .01) after intracervical injection of hyaluronidase. Its effect was insignificant on the latent phase of labour while it significantly shortened the active phase of labour by 2.09 hours (p < .001). Its effect on maximum rate of cervical dilatation (0.85 cm/hour) was also found to be statistically significant ie, p < .001. Hyaluronidase had no effect on uterine contractions, duration of 2nd and 3rd stages of labour and on involution of the uterus. There was no incidence of cervical tear in any of the cases.     

A two-phase model for controlled drug release from biphasic polymer hydrogels

A comprehensive two phase model is developed to describe the sustained release of a solute or drug from a biphasic hydrogel substrate. Such a material consists of a continuous hydrophilic phase (polymer backbone in water) and a dispersion of spherical microdomains made of the hydrophobic side chains of the polymer organised in a micelle like fashion. The solute or drug is assumed to be encapsulated within the dispersed microdomains, and to diffuse from the interior to the surface of the microdomain where it exchanges following a Langmuir isotherm. Mass transfer to the bulk phase occurs by desorption of the drug from the surface through a driving force that is proportional to the difference of surface and bulk concentration. Accordingly the drug is released to the surroundings by diffusion through the bulk. Depending on the values of the Langmuir constant and assuming well stirred behaviour in the interior of the microdomain, the present model results in either of the two asymptotic models developed in previous studies. The results of a parametric study show that the desired steady state flux of a specific drug to the surroundings may be obtained given appropriate values of structural properties of the material. This conclusion is further supported when using this model to simulate earlier experimental results. The polymer structural properties can be manipulated easily during the fabrication of dispersed-phase networks, as indicated by preliminary experiments.     

Identification of the Src family kinases, Lck and Fgr in platelets. Their tyrosine phosphorylation status and subcellular distribution compared with other Src family members

We have identified the Src family members, Lck and Fgr in resting human and rodent platelets and compared their subcellular distributions and tyrosine phosphorylation status to those of the other Src family kinases to gain insights into the signal transduction pathways active in maintaining platelets in the circulation. Like Fyn, Lyn, and Yes, most of Fgr and Lck was detergent-insoluble in human and rat platelets. In comparison, Src showed higher detergent solubility than the Src-related kinases. Most all human platelet Src was detergent-soluble, while that of rodent platelets was present in all detergent fractions. We also compared the tyrosine-phosphorylation status of Lck and Fgr to other Src family members in resting platelets using immunoprecipitation and immunoblotting. All of these Src family members except Fgr exhibited substantial phosphotyrosine antibody labeling. The partitioning of these kinases, with the exception of Src, with the detergent-insoluble fraction, their tyrosine-phosphorylation status, and co-localization with endocytotic vesicles lead us to hypothesize that the Src family kinases are involved in signaling events that drive cytoskeletal reorganization and active endocytosis of plasma proteins by circulating platelets.     

Production and characterization of multiple antigenic peptide antibodies to the adenosine A2b receptor

A polyclonal antibody to the human adenosine A2b receptor (A2bR) was produced by immunizing a chicken with a multiple antigenic peptide consisting of eight copies of a 16-amino acid peptide, corresponding to the presumed second extracellular loop of the A2bR, linked to a branched lysine core. Western blotting with affinity-purified antibody revealed the human A2bR to be a protein of approximately 50-55 kDa, found in a variety of tissues including thymus, colon, and small intestine. The antibody also recognized mouse and rat A2bRs and revealed heterogeneity in size, with a 35-kDa protein being detected in small intestine in addition to the larger 50-52-kDa species in thymus, colon, and placenta. The chicken anti-human A2bR peptide antibody recognized the receptor in both frozen and formalin-fixed tissue sections. In human colon, the A2bR was highly expressed in epithelial cells of the crypts. A2bR immunoreactivity was also apparent in syncytiotrophoblast cells of human placental villi and in the basal zone of murine chorioallantoic placenta. These cell type-specific patterns of expression are consistent with the hypothesized roles of the A2bR in mediating electrogenic Cl- secretion and the resulting secretory diarrhea caused by colonic crypt abscesses and in regulating morphogenesis of the placenta. Insight into the multiple physiological consequences of A2bR engagement will be forthcoming from an analysis of the cell type-specific expression of this receptor in additional tissues.     

Bacterial infections among home delivered neonates. Clinical picture and bacteriological profile

Thirteen cases of emergency left colon resection with primary anastomosis are presented. Production of an empty bowel and use of parenteral hyperalimentation, to delay intake until healing is evidenced by bowel function, are absolutely necessary, The "elective environment," assuring primary healing of the left colon anastomosis, consists of several factors: an empty decompressed bowel with adequate lumen, an antibiotic-depressed colon bacterial flora, assured blood supply, healthy bowel wall, and absence of anastomotic tension. The importance of not extraperitonealizing the anastomosis and the danger of long-term drains are emphasized.     

Metabolic derangements in nonmodulating hypertension

A positive association exists between insulin resistance, dyslipidemia, and hypertension, specifically salt-sensitive hypertension. A subgroup of salt-sensitive normal and high renin hypertensives called nonmodulators (NM) manifest an inability to modulate the adrenal and renal blood flow responses to a change in dietary sodium. Therefore, we tested the hypothesis that the NM subgroup would be insulin resistant and dyslipidemic when compared with normal and high renin hypertensives, in whom modulation is intact (M). Forty-six nondiabetic hypertensive individuals were evaluated and their modulation status defined by either renal or adrenal criteria. Fasting blood was drawn for measurement of several metabolic factors. Since the NM group had a greater body mass index (BMI) it was subdivided into a "lean" subgroup that matched the BMI of the M group. The fasting insulin levels in both the total NM and lean NM groups was significantly higher than in the M group (P = .013 and .04, respectively). There were no differences in age, blood pressure, or plasma/serum levels of glucose, triglycerides, total cholesterol, or potassium. NM had elevated fasting insulin levels compared to M, compatible with an insulin resistant state, but this insulin resistance are dissociable in the hypertensive population.     

The "Eve" procedure: the transfer of vascularized seventh rib, fascia, cartilage, and serratus muscle to reconstruct difficult defects

Very few microvascular units entertain the possibility of simultaneous vascularized transfer of bone, cartilage, muscle, and gliding fascia. In exceptionally complex conditions with loss of an essential joint, adjacent bone and functional muscle, reconstruction of all these structures at once may be necessary. At the same time, gliding tissue is often required to cover tendons. Reconstruction in one sitting prevents formation of dense scar tissue due to multiple interventions. Additionally, less bone resorption is seen if vascularized bone is used. Therefore, a more undisturbed tissue composition at the end is guaranteed. Moreover, rapid rehabilitation of moving function is possible with improvement in the final result. Finally, morbidity is lowered by using a single donor site, and costs are minimalized. We present four unique cases in which the seventh rib including the costochondral junction with overlying serratus muscle, branches of the thoracicus longus nerve, and adjacent fascia have been transferred as a microvascular unit to reconstruct two severely damaged hands and two other complex injuries. In analogy with the Bible story of the creation of "the woman," it is called the "Eve" procedure. The vascularized rib was used to reconstruct a first and fourth metacarpal bone, the ascending ramus of the mandible, and the clavicle. The rib cartilage was sculptured in four cases to reconstruct an articular surface. The serratus muscle served as coverage and filling for lost tissues. It also was used as a soft bed for facial nerve repair. In two cases muscle reinnervation was performed. The fascia provided gliding tissue surrounding reconstructed tendons or articular surfaces. In all cases a high degree of function was obtained with a good cosmesis. Rehabilitation was uneventful, and no reinterventions have been necessary. Donor-site morbidity was low. Therefore, this flap proved to be successful in complex injuries where bone, cartilage, muscle, and gliding tissue were needed simultaneously. Dynamic reconstruction was attempted in two cases and was successful in one.     

The relationship between stature, growth, and short-term changes in height and weight in normal prepubertal children

Electrical stimulation of the superior laryngeal nerve (SLN) can elicit reflex responses in the cricothyroid (CT) and thyroarytenoid (TA) muscles. We made bilateral recordings of the responses evoked in these muscles in piglets by the stimulation of either the right or the left superior laryngeal nerve (SLN). The stimulus intensity was gradually increased to study the "persistence" of the responses. We observed a direct, ipsilateral response in the CT muscle, and reflex, ipsilateral and crossed responses in both CT and TA muscles. The ipsilateral or contralateral responses obtained in TA muscles, following stimulation of the left SLN, were significantly delayed in comparison with those evoked by stimulation of the right SLN. This delay cannot be explained by the difference in length between the right and the left recurrent laryngeal nerves, but rather by an asymmetry in the sensory afferent pathway. The functional significance of this observation remains to be determined.     

Effect of soil bulk density on hydrolysis of surface-applied urea in unsaturated soils

In situ hydrolysis of broadcast urea occurs in unsaturated soils with different bulk densities. The effect of increasing soil bulk densities on the hydrolysis of urea was studied in open and in covered unsaturated soil columns incubated at 30°C. An increase in bulk density from 0.8 to 1.4 Mg/m³ markedly increased the hydrolysis of surface-applied urea in soils containing water > 6% up to near field capacity. Increased diffusion of urea to sorbed soil urease with an increase in bulk density may have enhanced formation of urease-urea complexes and therefore increased the hydrolysis. As urea diffused farther in more dense soils, the retarding effects of high urea concentration gradients on the hydrolysis probably decreased. In light-textured soils, increases in the bulk density had no apparent effect on the hydrolysis of surface-applied urea when evaporation occurred.