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排序方式: 共有492条查询结果,搜索用时 31 毫秒
1.
Outcomes at 3 years of a prospective pilot study of Campath-1H and sirolimus immunosuppression for renal transplantation 总被引:2,自引:0,他引:2
Rolf N. Barth Christina A. Janus Christine A. Lillesand Nancy A. Radke John D. Pirsch Bryan N. Becker Luis A. Fernandez L. Thomas Chin Yolanda T. Becker Jon S. Odorico Anthony M. D''Alessandro Hans W. Sollinger Stuart J. Knechtle 《Transplant international》2006,19(11):885-892
Campath-1H (alemtuzumab) induction was used for renal transplantation in combination with sirolimus as immunosuppression. We previously reported a high (28%) rate of early rejection with this regimen, and now report 3-year outcomes. Twenty-nine patients were recipients of either deceased donor or non-HLA (Human Leukocyte Antigen) identical living donor primary renal allografts. Clinical parameters including infection, malignancy, kidney function, and kidney histology were followed prospectively for 3 years. Three-year cumulative graft and patient survival were 96% and 100%, respectively. Twenty patients were maintained on steroid-free immunosuppressive regimens, and 15 patients were maintained on monotherapy for immunosuppression (12 on sirolimus). No serious infectious complications were observed and two patients developed basal cell skin cancer. The 3-year results of our initial pilot study demonstrate good graft (96%) and patient (100%) outcomes. Campath-1H induction has yielded a high proportion of patients maintained on immunosuppressive monotherapy (57%) without serious infectious- and no malignancy-related complications. The reported regimen yielded novel insights into both Campath-1H and sirolimus therapy in renal transplantation. Because of the higher incidence of early rejection, we recommend a modified strategy of immunosuppression including a brief course of a calcineurin inhibitor. 相似文献
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S. J. Pelletier M. K. Guidinger R. M. Merion M. J. Englesbe R. A. Wolfe J. C. Magee H. W. Sollinger 《American journal of transplantation》2006,6(7):1646-1652
The optimal use of kidneys from small pediatric deceased donors remains undetermined. Using data from the Scientific Registry of Transplant Recipients, 2886 small (< 21 kg) pediatric donors between 1993 and 2002 were identified. Donor factors predictive of kidney recovery and transplantation (1343 en bloc; 1600 single) were identified by logistic regression. Multivariable Cox regression was used to assess the risk of graft loss. The rate of kidney recovery from small pediatric donors was significantly higher with increasing age, weight and height. The odds of transplant of recovered small donor kidneys were significantly higher with increasing age, weight, height and en bloc recovery (adjusted odds ratio = 65.8 vs. single; p < 0.0001), and significantly lower with increasing creatinine. Compared to en bloc, solitary transplants had a 78% higher risk of graft loss (p < 0.0001). En bloc transplants had a similar graft survival to ideal donors (p = 0.45) while solitary transplants had an increased risk of graft loss (p < 0.0001). En bloc recovery of kidneys from small pediatric donors may result in the highest probability of transplantation. Although limited by the retrospective nature of the study, kidneys transplanted en bloc had a similar graft survival to ideal donors but may not maximize the number of successfully transplanted recipients. 相似文献
5.
There is growing evidence for the existence of an idiotypic network in the mammalian response to alloantigens, in particular to MHC antigens. The direct evidence for induction of Ab-2 to particular donor HLA-specificities by DST is strong; in addition, there is recent evidence for Ab-2 to Ab-1 specific for constant regions of HLA-ABC antigens in the sera of multiply-transfused patients. On the other hand, evidence for induction of anti-TCR antibodies by DST is based primarily on functional specificity rather than biochemical evidence; the evidence available suggests that MLC BF induced by DST may be directed against V beta family or public idiotypes on recipient T cells, since the amount of inhibition obtained is weak and no evidence of "clonotypic" antibodies has been found in studies of T cell lines or lymphoblasts. Better molecular probes, including human monoclonal antibodies, T cell clones, and purified TCR are needed to screen for specific anti-idiotypes in transfused patients. 相似文献
6.
Calcium ionophore-induced acrosome reaction correlates with fertilization rates in vitro in patients with teratozoospermic semen 总被引:5,自引:3,他引:5
The aim of this study was to determine the relationship between calcium
ionophore A23187-induced acrosome reaction (AR) and sperm fertilizing
ability. Semen samples remaining after preparation for standard IVF were
studied in 109 patients who had sperm concentrations > or =20 x
10(6)/ml. Ionophore-induced AR was performed on motile spermatozoa selected
by centrifugation on a Percoll gradient. Semen analysis was performed using
standard methods. Patients with higher (>50%, n = 76) fertilization
rates had significantly higher ionophore-induced AR than patients with
lower (<50%, n = 33) fertilization rates (49 +/- 14 versus 38 +/- 21%, P
< 0.05). When the data from all patients were analysed by logistic
regression, only the percentage sperm motility in insemination medium and
ionophore-induced AR were significantly related to fertilization rates.
Similar results were also obtained when the data from a subgroup of
patients with poor (<15% normal) sperm morphology were analysed.
However, when patients with normal sperm morphology > or =15% were
analysed separately, only sperm count and the percentage of spermatozoa
with progressive motility in semen were significantly related to
fertilization rates. In conclusion, ionophore- induced AR was significantly
related to fertilization rates in vitro mainly in patients with
teratozoospermic semen. Tests for ionophore- induced AR may provide
additional information about sperm fertilizing ability but may not indicate
specific defects of the physiological AR.
相似文献
7.
Detection of reactive oxygen species (ROS) and apoptosis in human fragmented embryos 总被引:8,自引:2,他引:8
Yang HW; Hwang KJ; Kwon HC; Kim HS; Choi KW; Oh KS 《Human reproduction (Oxford, England)》1998,13(4):998-1002
In human in-vitro fertilization (IVF)-embryo transfer, the in-vitro culture
environment differs from in-vivo conditions in that the oxygen
concentration is higher, and in such conditions the mouse embryos show a
higher concentration of reactive oxygen species (ROS) in simple culture
media. ROS are believed to cause damage to cell membranes and DNA
fragmentation in somatic cells. This study was conducted to ascertain the
level of H2O2 concentration within embryos and the morphological features
of cell damage induced by H2O2. A total of 62 human oocytes and embryos (31
fragmented, 15 non-fragmented embryos, 16 unfertilized oocytes) was
obtained from the IVF-embryo transfer programme. The relative intensity of
H2O2 concentrations within embryos was measured using
2',7'-dichlorodihydrofluorescein diacetate by Quanti cell 500 fluorescence
imaging and DNA fragmentation was observed with transmission electron
microscopy and an in-situ apoptosis detection kit. The H2O2 concentrations
were significantly higher in fragmented embryos (72.21 +/- 9.62, mean +/-
SEM) compared to non-fragmented embryos (31.30 +/- 3.50, P < 0.05) and
unfertilized oocytes (30.75 +/- 2.67, P < 0.05). Apoptosis was observed
only in fragmented embryos, and was absent in non-fragmented embryos.
Electron microscopic findings confirmed apoptotic bodies and cytoplasmic
condensation in the fragmented blastomeres. We conclude that there is a
direct relationship between increased H2O2 concentration and apoptosis, and
that further studies should be undertaken to confirm these findings.
相似文献
8.
Stein TP; Oram-Smith JC; Leskiw MJ; Wallace HW; Long LC; Leonard JM 《The American journal of physiology》1976,230(5):1321-1325
9.
Interchromosomal duplications of the adrenoleukodystrophy locus: a phenomenon of pericentromeric plasticity 总被引:13,自引:5,他引:13
Eichler EE; Budarf ML; Rocchi M; Deaven LL; Doggett NA; Baldini A; Nelson DL; Mohrenweiser HW 《Human molecular genetics》1997,6(7):991-1002
A 9.7 kb segment encompassing exons 7-10 of the adrenoleukodystrophy (ALD)
locus of the X chromosome has duplicated to specific locations near the
pericentromeric regions of human chromosomes 2p11,10p11, 16p11 and 22q11.
Comparative sequence analysis reveals 92-96% nucleotide identity,
indicating that the autosomal ALD paralogs arose relatively recently during
the course of higher primate evolution (5-10 million years ago). Analysis
of sequences flanking the duplication region identifies the presence of an
unusual GCTTTTTGC repeat which may be a sequence-specific integration site
for the process of pericentromeric- directed transposition. The breakpoint
sequence and phylogenetic analysis predict a two-step transposition model,
in which a duplication from Xq28 to pericentromeric 2p11 occurred once,
followed by a rapid distribution of a larger duplicon cassette among the
pericentromeric regions. In addition to facilitating more effective
mutation detection among ALD patients, these findings provide further
insight into the molecular basis underlying a pericentromeric-directed
mechanism for non- homologous interchromosomal exchange.
相似文献
10.
Clarke GN; Bourne H; Hill P; Johnston WI; Speirs A; McBain JC; Baker HW 《Human reproduction (Oxford, England)》1997,12(4):722-726
Donor insemination (DI) using cryopreserved semen commenced at The Royal
Women's Hospital in 1976. Over the next 15 years we performed 5953
treatment cycles to achieve 816 pregnancies (13.7% per cycle) and 706 live
births. In-vitro fertilization (IVF) using donor spermatozoa commenced in
1986. Over the next 5 years we performed 303 treatment cycles for 185
couples. Including subsequent transfer of cryopreserved embryos, a total of
33% of couples achieved a successful pregnancy by IVF. Statistical analysis
indicated that, for DI pregnancies, the most important semen variable was
the percentage post-thaw motility, whilst for normal fertilization in IVF
it was the pre-freeze motility. These results may be explained by the
compensatory effects of post-thaw processing of spermatozoa for IVF, but
not for DI in our clinic.
相似文献