T-reg mediated suppression of the allograft response in the draining lymph node

We previously demonstrated that T-regs inhibit proliferation of graft-reactive T cells in the draining lymph node (DLN), suggesting that this site may be important for regulation. TCR transgenic mice (TS1) specific for viral hemagglutinin (HA) provided antigen-specific T cells for adoptive transfer into syngeneic Balb/c hosts bearing HA+ skin grafts. T-regs were obtained from (TS1xHA28)F1 mice known to have an expanded population of HA-specific T-regs. To determine whether the lymph node is an independent site of suppression, we developed a model in which donor antigen that migrates from the allograft to the DLN drives T-cell activation after graft removal. T-regs that did not encounter the allograft itself remained able to inhibit graft antigen-specific T-cell proliferation in the DLN. Alloantigen-induced regulation can occur in the absence of the graft. This finding identifies the DLN as a potentially critical site of regulation in the early posttransplant period.     

In vitro cultivation of Daels transplantable guinea-pig tumor

Summary To facilitate closer study of virus-like bodies present in dilated endoplasmic reticulum of Daels tumor cells, an attempt was made to cultivate the Daels tumorin vitro.The cultured cells maintained morphological characteristics essentially identical with those of cells from solid tumors. Groups of virus-like particles (VLP) were regularly observed in the endoplasmic reticulum of cells grownin vitro. Budding process of VLP might be considered as a sign for moderately enhanced virus production in comparison to tumor cells grownin vivo.The morphology and localization of VLP were very similar to those described byOpler (1967, 1968) in leukemia of guinea pigs. The regularly observed chromosomal changes can be considered as indirect indication of viral etiology. This and other morphological characteristics are suggestive of the possible involvement of an unidentified virus in the pathomechanism of Daels tumor development.     

A new ventilatory threshold equation for aerobically trained men and women

The purposes of the present study were to (i) modify previously published ventilatory threshold (VT) equations using the constant error (CE) values for aerobically trained individuals from a recent study; (ii) cross‐validate the modified equations to determine their accuracy for estimating VT in aerobically trained individuals; (iii) derive a new non‐exercise based equation for estimating VT in aerobically trained individuals if the modified equations are found to be inaccurate; and (iv) cross‐validate the new VT equation using the Predicted REsidual Sum of Squares (PRESS) statistic and an independent sample of aerobically trained individuals. Two hundred and eight (n = 208) aerobically trained men and women (mean ± SD: age = 38·8 ± 10·4 year) performed a maximal incremental test on a cycle ergometer to determine the observed VT. The predicted VT values from seven published equations were compared with the observed VT by examining the CE, standard error of estimate, validity coefficient (r), and total error (TE). Cross‐validation of the modified equations resulted in high %TE values. Therefore, a new VT equation was derived. Cross‐validation of this equation on an independent sample of 72 subjects resulted in a low %TE value. The new model is recommended over previous models for estimating VT in aerobically trained individuals.     

Efficacy of small-volume simethicone given at least 30 min before gastroscopy

AIM To evaluate the efficacy of 5 m L simethicone solution in decreasing gastric foam if given at least 30 min before gastroscopy.METHODS This was a randomized, placebo controlled, endoscopist blinded study performed at Changi General Hospital. Patients were at least 21 years old, had no prior sur-gical resection of the upper gastrointestinal tract, and scheduled for elective diagnostic gastroscopies. The primary outcome was the total mucosal visibility score(TMVS) which was evaluated using Mc Nally score. The sample size was calculated to be 24 per group(SD 2.4, 80% power, P 0.05, 2-sample t test). RESULTS Fifty-four patients were randomised to receive either simethicone [1 m L liquid simethicone(100 mg) in 5 m L of water] or placebo(5 m L of water) at least 30 min before their gastroscopy. Six accredited consultants conductedthe gastroscopy, and the interobserver agreement of scoring TMVS was good with a Kappa statistic of 0.73. The simethicone group had significantly better mean TMVS compared to placebo(5.78 ± SD 1.65 vs 8.89 ± SD 1.97, P 0.001). The improvement was statistically significant for the duodenum and the gastric antrum, angularis, body, and fundus. Percent 51.9 of patients in the simethicone group had a TMVS of 4(no bubbles at all) to 5(only 1 area with minimal bubbles), while in the placebo group 3.7% of patients had TMVS of 4 or 5. The number needed to treat was 2.1 to avoid a TMVS of 6 and more. The simethicone group also had a significantly shorter procedure time with less volume of additional flushes required during gastroscopy to clear away obscuring gastric foam.CONCLUSION With a premedication time of at least 30 min, 5 m L simethicone can significantly decrease gastric foam, decrease the volume of additional flushes, and shorten gastroscopy time.     

Efficacy and tolerability of vardenafil in Asian men with erectile dysfunction

Aim： To evaluate the efficacy and tolerability of vardenafil, a phosphodiesterase type-5 （PDE-5） inhibitor, in men of Asian ethnicity with erectile dysfunction （ED）. Methods： In this prospective, double-blind, multinational study, Asian men were randomized to receive vardenafil （10 mg） or placebo （4：1 ratio） for 12 weeks. The primary efficacy variables were the International Index of Erectile Function erectile function domain （IIEF-EF）, and Sexual Encounter Profile （SEP） questions related to penetration and intercourse completion. Significant mean improvements were required in all three measures to show positive benefits of vardenafil treatment. Secondary efficacy variables included the Global Assessment Question （GAQ） on erection improvement. Results： Least-squares mean baseline IIEF-EF domain scores （vardenafil 14.6, placebo 13.4） were consistent with moderate ED. After 12 weeks, vardenafil treatment was associated with significant increases from the baseline in IIEF-EF domain scores compared with the placebo （22.4 vs. 14.3; P 〈 0.001）. Vardenafil was associated with significant improvements from baseline in least squares （LS） mean success rates for SEP-2 （vardenafil 82.2 vs. placebo 43.6; P 〈 0.001） and SEP-3 （vardenafil 66.1 vs. placebo 24.0; P 〈 0.001）. Positive GAQ responses were reported by 81.8% of vardenafil recipients vs. 24.3% of placebo recipients. Adverse events were reported by 25.4% of the vardenafil group, the majority mild and transient. Conclusion： Vardenafil （10 mg） is a highly effective and well-tolerated treatment for moderate ED in Asian men. These results add to the increasing amount of data demonstrating the safety and efficacy of vardenafil for the treatment of ED in a range of patient populations.     

Estimating electromyographic and heart rate fatigue thresholds from a single treadmill test

Introduction: The purposes of this study were to (1) develop a fatigue threshold based on electromyography (EMG) and heart rate (HR) responses for treadmill running from a single incremental test; and (2) propose a new fatigue threshold called the RV_EMGFT and RV_HRFT. Methods: Eleven men performed incremental treadmill exercise to exhaustion on a single occasion. The RV_EMGFT and RV_HRFT were defined as the average of the highest velocity that resulted in a nonsignificant slope coefficient for the EMG amplitude versus time relationship and the lowest velocity that resulted in a significant positive slope coefficient. Results: There was a significant (P < 0.05) difference between the 2 thresholds [RV_EMGFT = 11.7 ± 0.6 km/h and RV_HRFT = 8.3 ± 0.8 km/h]. Conclusions: The fatigue threshold for EMG amplitude and heart rate can be determined from a single incremental treadmill test, but there are differences between cardiac and neuromuscular factors of fatigue. Muscle Nerve 46: 577–581, 2012