Intestinal transplantation in composite visceral grafts or alone

Under FK 506-based immunosuppression, the entire cadaver small bowel except for a few proximal and distal centimeters was translated to 17 randomly matched patients, of whom two had antigraft cytotoxic antibodies (positive cross-match). Eight patients received the intestine only, eight had intestine in continuity with the liver, and one received a full multivisceral graft that included the liver, stomach, and pancreas. One liver-intestine recipient died after an intestinal anastomotic leak, sepsis, and graft- versus-host disease. The other 16 patients are alive after 1 to 23 months, in one case after chronic rejection, graft removal, and retransplantation. Twelve of the patients have been liberated from total parenteral nutrition, including all whose transplantation was 2 months or longer ago. The grafts have supported good nutrition, and in children, have allowed growth and weight gain. Management of these patients has been difficult and often complicated, but the end result has been satisfactory in most cases, justifying further clinical trials. The convalescence of the eight patients receiving intestine only has been faster and more trouble free than after liver-intestine or multivisceral transplantation, with no greater difficulty in the control of rejection

Erlotinib as salvage treatment after failure to first-line Gefitinib in non-small cell lung cancer

Purpose Chemotherapy is the mainstay treatment for advanced non-small cell lung cancer (NSCLC). Gefitinib, an epidermal growth factor receptor-tyrosine kinase inhibitor (EGFR-TKI), has been recently shown to be effective as a first-line treatment in Asian patients with advanced NSCLC, especially for those with favourable clinical features such as female, non-smoker and adenocarcinoma. However, resistance to gefitinib ensues invariably and there is little evidence as for the effectiveness of subsequent salvage treatment. The purpose of this study is to evaluate the efficacy of erlotinib, another EGFR-TKI, after failed first-line use of gefitinib. Method Retrospective review of NSCLC patients with favourable clinical features who received gefitinib as firstline treatment and subsequent salvage treatment with erlotinib. Results A total of 21 patients with NSCLC were included in the study. Among them, 18 (85.7%) patients had disease control with gefitinib and 12 (57.1%) patients with salvage erlotinib. There was an association between the disease control with gefitinib and erlotinib (p = 0.031). The disease control rate of erlotinib was independent of the chemotherapy use between the two EGFR-TKIs. Conclusion For NSCLC patients with favourable clinical features, erlotinib was effective in those who had prior disease control with first-line gefitinib. © Springer-Verlag 2009.published_or_final_versionSpringer Open Choice, 01 Dec 201

Modulation of the Disturbed Motor Network in Dystonia by Multisession Suppression of Premotor Cortex

Daily sessions of therapeutic transcranial brain stimulation are thought to prolong or amplify the effect of a single intervention. Here we show in patients with focal hand dystonia that additional, new effects build up progressively over time, making it difficult to predict the effect of long term interventions from shorter treatment sessions. In a sham-controlled study, real or sham continuous theta burst stimulation (cTBS) was given once daily for five consecutive days to dorsolateral premotor cortex (PMd). Five days of real, but not sham, premotor cTBS improved intracortical inhibition in primary motor cortex (M1) to a similar extent on day 1 and day 5. However 5 days of cTBS were required to restore the abnormal PMd-M1 interactions observed on day 1. Similarly, excessive M1 plasticity seen at baseline was also significantly reduced by five days of real premotor cTBS. There was only a marginal benefit on writing. The results show that additional, new effects, at sites distant from the point of stimulation, build up progressively over time, making it difficult to predict the effect of long term interventions from shorter treatment sessions. The results indicate that it may take many days of therapeutic intervention to rebalance activity in a complex network

Intestinal transplantation in composite visceral grafts or alone

Under FK 506-based immunosuppression, the entire cadaver small bowel except for a few proximal and distal centimeters was translated to 17 randomly matched patients, of whom two had antigraft cytotoxic antibodies (positive cross-match). Eight patients received the intestine only, eight had intestine in continuity with the liver, and one received a full multivisceral graft that included the liver, stomach, and pancreas. One liver-intestine recipient died after an intestinal anastomotic leak, sepsis, and graft- versus-host disease. The other 16 patients are alive after 1 to 23 months, in one case after chronic rejection, graft removal, and retransplantation. Twelve of the patients have been liberated from total parenteral nutrition, including all whose transplantation was 2 months or longer ago. The grafts have supported good nutrition, and in children, have allowed growth and weight gain. Management of these patients has been difficult and often complicated, but the end result has been satisfactory in most cases, justifying further clinical trials. The convalescence of the eight patients receiving intestine only has been faster and more trouble free than after liver-intestine or multivisceral transplantation, with no greater difficulty in the control of rejection

Analysis of Germline Gene Copy Number Variants of Patients with Sporadic Pancreatic Adenocarcinoma Reveals Specific Variations

Objectives: The rapid fatality of pancreatic cancer is, in large part, the result of diagnosis at an advanced stage in the majority of patients. Identification of individuals at risk of developing pancreatic adenocarcinoma would be useful to improve the prognosis of this disease. There is presently no biological or genetic indicator allowing the detection of patients at risk. Our main goal was to identify copy number variants (CNVs) common to all patients with sporadic pancreatic cancer. Methods: We analyzed gene CNVs in leukocyte DNA from 31 patients with sporadic pancreatic adenocarcinoma and from 93 matched controls. Genotyping was performed with the use of the GeneChip Human Mapping 500K Array Set (Affymetrix). Results: We identified 431 single nucleotide polymorphism (SNP) probes with abnormal hy-bridization signal present in the DNA of all 31 patients. Of these SNP probes, 284 corresponded to 3 or more copies and 147 corresponded to 1 or 0 copies. Several cancer-associated genes were amplified in all patients. Conversely, several genes supposed to oppose cancer development were present as single copy. Conclusions: These data suggest that a set of 431 CNVs could be associated with the disease. This set could be useful for early diagnosis

Plasma Bmil mRNA as a potential prognostic biomarker for distant metastasis in colorectal cancer patients

published_or_final_versio

Distribution of cyanotoxins in aquatic environments in the Niger Delta

The presence and types of cyanotoxins in some aquatic environments in the Niger Delta were investigated. Water samples surveyed in the study were surface water of Sombreiro, Nun and New Calabar Rivers. Others were groundwater from Abonnema and Kiama and pond water from Ogboro. Sampling locations of Sombreiro and the New Calabar rivers and the groundwater at Abonnema are all in the Rivers State while other locations were in Bayelsa State all in Nigeria. Cyanotoxins wereextracted using the rotary evaporator procedure. The toxins were intraperitoneally administered to mice. Pathological studies revealed that the extracts contained hepatotoxic peptides (microcystin andnodularin), cytotoxic alkaloids (cylindrospermopsin) and neurotoxic alkaloids (anatoxin-a, anatoxin-a(s) and saxitoxin). Cyanobacterial examination of the water samples revealed that Anabena was the mostpredominant cyanobacterium. Anabena and Microcystis were more predominant in the river and pond water while Anabena and Cylindrospermopsis were more predominant in the ground water. The nutrient load of water bodies influenced biomass (weight) of cyanobacteria. High nutrient load (BOD, COD, nitrates, sulphate, etc) produced high cyanobacterial biomass while low nutrient load producedcorrespondingly low cyanobacterial biomass. Nutrient load of river water were significantly higher than groundwater samples. The pond water produced intermediate values of most physicochemical parameters. The percentage hydrocarbon utilizing fungal counts (6.6 - 10.0%), total coliform (240 MPN/100 ml) and fecal coliform (92 to 160 MPN/100 ml) counts were greater than ground water samples (0%, 7.9 to 24 MPN/100 ml and 0.18 to 0.93 MPN/100 ml) respectively. These results suggested that though the conventional bacterial indicators were high, the presence of cyanobacteria and cyanotoxinsin these aquatic systems may also contribute to rendering these drinking water sources unfit for domestic consumption

Egg incubator control system with short message service (sms) fault analysis alert

The egg incubator system with temperature sensor can measure the state of the incubator and automatically change to the suitable condition for the egg. The health of the egg is very important for the development of embryo. The status condition in the incubator system will appear on the liquid crystal display (LCD) screen. To make sure all part of egg was heated by lamp, direct current (DC) motor was used to rotate iron rod at the bottom side and automatically change the position of egg. The entire element is controlled using programmable integrated circuit (PIC) – a type of microcontroller that can process a data from sensor and will execute the control element to change the condition of the incubator system. The heater is interfaced with the controller through the optocoupler. The optocoupler isolates the microcontroller from the alternating current (AC) power, thereby preventing any possible flow back of the AC into the control circuit. The software intelligent agent was embedded into 8051 family of micro controllers, emulating the attention commands of mobile cell phone using window HyperTerminal and microcontroller and thus translate  attention commands to assembly language, having machine cycle of 1.085s,R=10K,C=10ìF, t=2.17ìs,transistor collector current, Ic=800mA and emitter forward current gain, hfe gives 200.The SMS mobile cell phone using AT89C51 microcontroller in the prototype self diagnostic systems, will not only control the temperature of an incubator but also detect and analyze faults in the system. The programme used in this work is user friendly since the incubator system can move to other places. Keywords: Microcontroller, Optocoupler, Programmable Integrated Circuit (PIC) and Window HyperTermina

A comparison of weather variables linked to infectious disease patterns using laboratory addresses and patient residence addresses

Background: To understand the impact of weather on infectious diseases, information on weather parameters at patient locations is needed, but this is not always accessible due to confidentiality or data availability. Weather parameters at nearby locations are often used as a proxy, but the accuracy of this practice is not known. Methods: Daily Campylobacter and Cryptosporidium cases across England and Wales were linked to local temperature and rainfall at the residence postcodes of the patients and at the corresponding postcodes of the laboratory where the patient’s specimen was tested. The paired values of daily rainfall and temperature for the laboratory versus residence postcodes were interpolated from weather station data, and the results were analysed for agreement using linear regression. We also assessed potential dependency of the findings on the relative geographic distance between the patient’s residence and the laboratory. Results: There was significant and strong agreement between the daily values of rainfall and temperature at diagnostic laboratories with the values at the patient residence postcodes for samples containing the pathogens Campylobacter or Cryptosporidium. For rainfall, the R-squared was 0.96 for the former and 0.97 for the latter, and for maximum daily temperature, the R-squared was 0.99 for both. The overall mean distance between the patient residence and the laboratory was 11.9 km; however, the distribution of these distances exhibited a heavy tail, with some rare situations where the distance between the patient residence and the laboratory was larger than 500 km. These large distances impact the distributions of the weather variable discrepancies (i.e. the differences between weather parameters estimated at patient residence postcodes and those at laboratory postcodes), with discrepancies up to ±10 °C for the minimum and maximum temperature and 20 mm for rainfall. Nevertheless, the distributions of discrepancies (estimated separately for minimum and maximum temperature and rainfall), based on the cases where the distance between the patient residence and the laboratory was within 20 km, still exhibited tails somewhat longer than the corresponding exponential fits suggesting modest small scale variations in temperature and rainfall. Conclusion: The findings confirm that, for the purposes of studying the relationships between meteorological variables and infectious diseases using data based on laboratory postcodes, the weather results are sufficiently similar to justify the use of laboratory postcode as a surrogate for domestic postcode. Exclusion of the small percentage of cases where there is a large distance between the residence and the laboratory could increase the precision of estimates, but there are generally strong associations between daily weather parameters at residence and laboratory