Medium term results of lung transplantation for end stage pulmonary sarcoidosis

BACKGROUND—Lung transplantation is an acceptedtherapeutic option for patients with end stage pulmonary sarcoidosis.However, the medium term outcome of transplantation in this patientgroup is unknown.
METHODS—This study was performed to evaluate ourexperience with lung transplantation for end stage pulmonarysarcoidosis. Between July 1988 and July 1997 12 patients (nine men)underwent lung transplantation for sarcoidosis at our institution. Tenunderwent single lung transplantation and two double lung transplantation.
RESULTS—Survival at three and five years was 70%and 56%, respectively. Three patients developed obliterativebronchiolitis at six, 18, and 45 months. One died at the time ofretransplantation. Sarcoid granulomas have recurred in the donor organin three patients. In one the development of granulomas has beenassociated with clinical deterioration, necessitatingretransplantation. Mean (SD) forced expiratory volumes in one second atthree and five years were 1.37 (0.67) l and 1.34 (0.13) l, respectively.
CONCLUSIONS—Lung transplantation is a viableoption for patients with end stage pulmonary sarcoidosis. The mediumterm results are comparable with patients undergoing lungtransplantation for other indications. Despite histological recurrenceof sarcoidosis, the risk of clinically important recurrence is low.

     

Molecular cloning and characterization of an invertebrate homologue of a neuropeptide Y receptor

Neuropeptide Y is an abundant and physiologically important peptide in vertebrates having effects on food intake, sexual behaviour, blood pressure and circadian rhythms. Neuropeptide Y homologues have been found in invertebrates, where they are very likely to play similar, important roles. Although five neuropeptide Y-receptor subtypes have been identified in mammals, none has been reported from invertebrates. Here we describe the cloning of a neuropeptide Y-receptor from the brain of the snail Lymnaea stagnalis. The identity of the receptor was deduced by expressing the neuropeptide Y-receptor-encoding cDNA in Chinese Hamster Ovary cells, which were subsequently challenged with size-fractionated Lymnaea brain extracts. An active peptide, selected on the basis of its ability to induce changes in cAMP levels, was purified to homogeneity, analysed by mass spectrometry and amino acid sequence determination, and turned out to be a Lymnaea homologue of neuropeptide Y.     

Inactivation and clearance of an anti-CEA carboxypeptidase G2 conjugate in blood after localisation in a xenograft model.

Studies with a conjugate of carboxypeptidase G2 (CPG2) and the F(ab'')2 fragment of monoclonal anti-CEA antibody, A5B7, have shown specific localisation in a human colon tumour xenograft, LS174T, growing in nude mice. The conjugate reaches a peak concentration in the tumour within 24 h but enzyme activity in blood remains above a critical value for therapeutic purposes for several days. Here we describe a new monoclonal antibody, SB43, raised against CPG2 which is capable of reducing enzyme activity in blood. In vitro studies demonstrated specific binding of SB43 to CPG2 causing inactivation. Moreover, in the nude mouse model SB43 was also capable of inactivating the enzyme in the circulation within minutes of administration. Radiolabelled native SB43 persisted in blood for several days and appreciable non-specific uptake into the xenograft was also observed. Uptake of SB43 by the tumour, with possible inactivation of CPG2 at this site, could be limited by first coupling the antibody to galactose. This ensured recognition and excretion of SB43 and SB43-enzyme complexes via the liver and their rapid removal from the circulation. Galactosylation had no effect on the ability of SB43 to inactivate the enzyme.     

Current thinking in the treatment of the minimal pit and fissure lesion

Cavity preparation techniques changed little for the first fifty years of this century: now, three factors--changing thinking on cavity preparation, successful preventive techniques and the introduction of composites with improved wear characteristics, have combined to bring a new philosophy to the treatment of the minimal occlusal carious lesion.     

An updated survey on the utilization of hand over mouth (HOM) and restraint in postdoctoral pediatric dental education

A survey of directors of advanced educational programs in pediatric dentistry, identical to one conducted in 1979, was undertaken to examine the utilization of and indications for various physical restraint techniques. Updated results indicated that there is still a high acceptance of the hand-over-mouth (HOM) technique. Only 11.1% of programs never use the technique. However, the acceptance of airway restriction is significantly lower than in 1979. Program directors currently report increased situations in which other physical restraint techniques, such as the Papoose Board, are recommended. Despite the continued acceptance of physical restraint techniques, a significant number of directors report that they are less certain that these techniques do not induce psychological problems. Although the current survey data indicates that there may be a discrepancy between professional standards as espoused by program directors, and material standards, that discrepancy is greatest for those program directors with tenures in excess of 10 years. These directors were much more likely to believe that HOM was indicated in situations other than for the control of hysterical and tantrum-like behavior and were much less likely to tell the child why HOM was being used. Additionally, such directors were as likely to use airway restriction as were 1979 respondents, although directors with tenures of less than 10 years were significantly less likely to use airway restriction.