The effect of prestorage irradiation on posttransfusion red cell survival

Transfusion-associated graft-versus-host disease (TA-GVHD) may occur whenever immunologically competent allogeneic lymphocytes are transfused to an immunocompromised recipient. Irradiation of blood components eliminates the risk of TA-GVHD but may damage the cellular elements in the transfused component, particularly if the cells are stored for prolonged periods in the irradiated state. To study the effect of irradiation on long-term storage of red cells, AS-1 red cells from eight normal subjects were prepared on two occasions. On one occasion, the units were stored as standard AS-1 red cells for 42 days at 4 degrees C; on the other, they were exposed to 3000 cGy radiation within 4 hours of collection and then were stored as AS-1 red cells for 42 days at 4 degrees C. The donations were at least 12 weeks apart. Irradiated units demonstrated significant elevations in poststorage plasma hemoglobin (Hb) (623 +/- 206 vs. 429 +/- 194 g/dL [6230 +/- 2060 vs. 4290 +/- 1940 g/L], p less than 0.02) and plasma potassium (78 +/- 4 vs. 43 +/- 9 mEq/L [78 +/- 4 vs. 43 +/- 9 mmol/L], p less than 0.01) and significant decreases in red cell ATP (1.9 +/- 0.2 vs. 2.1 +/- 0.3 microM/g Hb, p less than 0.04) and 24-hour posttransfusion red cell recovery (68.5 vs. 78.4%, p less than 0.02), as compared to nonirradiated units. It can be concluded that irradiation with 3000 cGy damages red cells and that long-term storage in the irradiated state may enhance this damage. Red cells should not be stored for 42 days after irradiation with 3000 cGy.     

Langzeitergebnisse nach transanaler Rektumwandresektion mittels Stapler bei der obstruktiven Defäkationsstörung

Background and Purpose

Rectocele and distal rectal intussusception are potential organic causes of obstructive defecation syndrome and can be corrected surgically once conservative treatment measures have been exhausted. Stapled transanal rectal resection (STARR procedure) was introduced as a new treatment approach. This study presents the first long-term results of this procedure.

Patients and Methods

A STARR procedure was performed in 19 patients (17 female, 2 male, age 53±12 years) between January 2003 and February 2007. The surgical indication was a severe, conservatively treated stool evacuation disorder secondary to symptomatic rectocele and/or distal intussusception.

Results

The mean follow-up period for all patients was 60±17 months (35–82 months). The defecation score (0–20 points) decreased from a preoperative 13.4±3.4 to 3.7±2.7 after 3 months and increased slightly to 4.8±3.6 by the time of the final follow-up examination. In 16 patients (84.2%), the obstructive defecation syndrome was significantly improved. These positive results were maintained also in the long term. Slight worsening of continence in terms of urge incontinence was reported by 6 patients (31.6%). The patients most affected were those with normal continence preoperatively. Procedure-related anal reoperations were required in 3 patients (15.8%)

Conclusion

Even in the long term, transanal rectal wall resection seems to be an effective therapy for obstructive defecation syndrome. However, it is associated with a substantial number of reoperations and of patients with persistent urge incontinence.     

Fractionation of Spatial Memory in GRM2/3 (mGlu2/mGlu3) Double Knockout Mice Reveals a Role for Group II Metabotropic Glutamate Receptors at the Interface Between Arousal and Cognition

Group II metabotropic glutamate receptors (mGluR2 and mGluR3, encoded by GRM2 and GRM3) are implicated in hippocampal function and cognition, and in the pathophysiology and treatment of schizophrenia and other psychiatric disorders. However, pharmacological and behavioral studies with group II mGluR agonists and antagonists have produced complex results. Here, we studied hippocampus-dependent memory in GRM2/3 double knockout (GRM2/3^−/−) mice in an iterative sequence of experiments. We found that they were impaired on appetitively motivated spatial reference and working memory tasks, and on a spatial novelty preference task that relies on animals'' exploratory drive, but were unimpaired on aversively motivated spatial memory paradigms. GRM2/3^−/− mice also performed normally on an appetitively motivated, non-spatial, visual discrimination task. These results likely reflect an interaction between GRM2/3 genotype and the arousal-inducing properties of the experimental paradigm. The deficit seen on appetitive and exploratory spatial memory tasks may be absent in aversive tasks because the latter induce higher levels of arousal, which rescue spatial learning. Consistent with an altered arousal–cognition relationship in GRM2/3^−/− mice, injection stress worsened appetitively motivated, spatial working memory in wild-types, but enhanced performance in GRM2/3^−/− mice. GRM2/3^−/− mice were also hypoactive in response to amphetamine. This fractionation of hippocampus-dependent memory depending on the appetitive-aversive context is to our knowledge unique, and suggests a role for group II mGluRs at the interface of arousal and cognition. These arousal-dependent effects may explain apparently conflicting data from previous studies, and have translational relevance for the involvement of these receptors in schizophrenia and other disorders.     

Adjuvant radiotherapy after radical prostatectomy shows no ability to improve rates of overall and cancer‐specific survival in a matched case‐control study

OBJECTIVE

To assess the effect of adjuvant radiotherapy (aRT) on the rate of cancer‐specific and overall survival after radical prostatectomy (RP) in a group of patients with a long‐term follow‐up, as there is controversy about the benefit of aRT after RP for prostate cancer when endpoints beyond biochemical and local recurrence are considered.

PATIENTS AND METHODS

Within a study cohort of 752 patients treated with RP, 118 (15.7%) received aRT; these patients were matched with controls who did not receive aRT after RP. Exact matches were made for pT stage, RP Gleason sum, surgical margin status, age (±10 years), year of surgery (±10 years) and delivery of hormonal therapy. Kaplan‐Meier and life‐table analyses were used to assess overall and cancer‐specific survival

RESULTS

The median (range) follow‐up was 11.4 (0.1–41) years. The 10‐ and 20‐year overall survival after RP in those with no aRT were, respectively, 81.1% and 44.8%, vs 75.5% and 40.0% in the aRT group (P = 0.1). The corresponding probabilities for cause‐specific survival were, respectively, 97.3% and 89.0% vs 86.3% and 69.3% (P < 0.001). There was no statistically significant difference in the overall and cause‐specific survival between the groups after matching (hazard ratio 0.9, log rank P = 0.6; and 2.1, log rank P = 0.1, respectively).

CONCLUSIONS

Our analysis showed that, in a matched case‐control study, aRT has no effect on overall and cancer‐specific survival. Further randomized long‐term studies are necessary to confirm these results.     

Cellular prion protein regulates the motor behaviour performance and anxiety-induced responses in genetically modified mice

The cellular prion protein (PrP(C)) is a sialoglycoprotein involved in neuroplasticity processes and synaptic transmission. This study investigated behavioural responses (balance in the rota-rod test at 24 rpm, motility in the open-field test, anxiety in the elevated plus-maze test) in Zurich developed wild-type adult mice (WT, controls of normal PrP(C) expression), in knockout (KO) mice (Prnp(0/0), with no PrP(C) expression), and in PrP(C) overexpressing Tg-20 mice. After 8 min in the rota-rod test, Tg-20 animals presented significantly fewer falls (1.08+/-1.56 falls) than both WT (7.27+/-4.36) and KO (7.6+/-6.15) mice (p<0.01). In the open field test, Tg-20 animals showed significantly increased motility [rearing=23.4+/-7.85, crossing=97.30+/-32.11) when compared with KO mice (rearing=5.45+/-3.69 and crossing=59.73+/-15.43) or WT mice (rearing=6.5+/-20.23 and crossing=45.18+/-20.33) (p<0.01). In the elevated plus-maze test, Tg-20 mice showed less anxiety (head projections=7.3+/-1.62) when compared with WT animals (3.38+/-0.67) (p<0.05). Moreover, KO mice spent more time in the centre of the plus maze (37.80+/-5.57 s) than did WT mice (22.57+/-3.82) (p<0.05). PrP(C) overexpressing mice evoked increased motility, less anxiety, and increased equilibrium when compared with WT control animals in the behavioural protocols used. KO animals also tended to evoke fewer anxiety-related responses in the elevated plus-maze test. These findings indicate that the levels of PrP(C) in adult life are associated with possible changes in motility, anxiety, and equilibrium.     

Changes in lipid composition in hippocampus early and late after status epilepticus induced by kainic acid in wistar rats

Oxidative damage to biological membranes has been reported as a cause of alterations in many different diseases. We had previously reported lipid peroxidation in the kainic acid model of temporal epilepsy. In this study we evaluated earlier and later modifications in the lipid composition after status epileticus induced by kainic acid. Lipid composition was determined by thin-layer chromatography, in the cortex and hippocampus 12–14 h, 7–8, 75–80, or 140–150 days after the end of status epileticus. In the hippocampus there was a significant change in the lipid protein ratio after status epileticus and this was accompanied by an alteration in lipid composition in all tested times. These results suggested that lipid peroxidation induced by kainic acid could be accompanied by chronic changes in the lipid composition that could be related to the development of seizures.     

Adult children and their parents' expectations of future elder care needs

OBJECTIVE: Lifestyle changes and medical advances warrant an investigation into perceptions of elder care needs held by today's adult children (AC) and their parents. METHOD: Surveys were distributed to 200 AC. Eighty AC and 102 of their parents responded. RESULTS: Paired sample t tests revealed that AC (M = 10.61, SD = 4.5) and parents (M = 10.4, SD = 4.60) did not differ in their own expectations of future care needs. However, ACs' expectations of their parents' needs (M = 15.82, SD = 5.77) were significantly higher than both self-expectations. In addition, among six caregiving tasks minimal but significant differences were found in expected receipt of assistance. DISCUSSION: Consistent with Weinstein's (1980) theory of unrealistic optimism, results demonstrated the tendency for AC and parents to underestimate their own future care needs. Such underestimation may in turn, lead to inadequate planning for future care needs.     

Basics of German teleradiology

The methods and techniques of teleradiology are used in numerous clinical specialties. Several teleradiology projects have been state-aided in Germany over the last 10 years. Using the teleradiology standard proposed by the German Radiology Society, some of these systems are also interoperable. Several techniques are available for realizing teleradiology connections, including Web servers, virtual private networks (VPNs), and e-mail-based solutions. For the establishment of a new teleradiology connection, the needed applications must be analysed in order to find an adequate and cost-effective solution. Legal, financial, and data security aspects must also be taken into account. Legal regulations for the use of teleradiology-guided examinations in Germany demand a high technical and organisational standard for the set-up and the quality control of teleradiology installations.