Successful transplantation of 50 single unit pediatric kidneys ages 11 to 48 months into adult recipients

There is currently an imbalance between the need for cadaveric kidneys for transplantation and the supply. The medical criteria for accepting cadaveric donors are changing and organs that were originally thought to be unacceptable have functioned well. Previous reports have discussed the problems with transplanting pediatric allografts less than 4 years old into adult recipients, and the results have not been encouraging. From 1986 to 1991 a total of 50 kidneys ages 11 to 48 months were transplanted as single units into adult recipients (Group A). Ninety-one adult donor cadaveric transplants were used as controls (Group B). The cadaveric transplants were 2nd or 3rd transplants in 7 of the Group A and 12 of the Group B patients. Renal preservation, storage times, and demographics were the same. Prednisone, cyclosporine, and either Minnesota ALG or OKT3 were used for immunosuppression in both groups. Imuran was added in immunologically high-risk patients. The 1-year actuarial patient and allograft survivals for Group A versus Group B were 89.5% versus 94.2% (p=0.49) and 71.3% versus 87.8% (p=0.01), respectively. There was no difference in allograft or patient survival in kidneys from donors 11-24 months of age or 25-48 months (p=0.56). Renal growth, as measured by sonography, occurred while on cyclosporine A. Excretory and hormonal function as measured by creatinine and hematocrit both improved. Seventy percent of the Group A patients and 76% of the Group B patients were free from rejection in the first 2 months post transplantation (p=0.45).(ABSTRACT TRUNCATED AT 250 WORDS)     

Solution X-ray scattering as a probe of hydration-dependent structuring of aqueous solutions

We report on new X-ray solution scattering experiments and molecular dynamics simulations conducted for increasing solute concentrations of N-acetyl-amino acid-amides and -methylamides in water, for the amino acids leucine, glutamine, and glycine. As the concentration increases, the main diffraction peak of pure water at Q = 2.0 Å^-1 shifts to smaller angle for the larger leucine and glutamine amino acids, and a new diffraction peak grows in at Q 0.8 Å^-1 for only the hydrophobic amino acid leucine. The unaltered value of the peak position at Q 0.8 Å^-1 over a large concentration range suggests that a stable and ordered leucine solute–solute distribution is sustained. Simulations of the distributions of leucines in water that reproduce the experimental observable show that mono-dispersed to small molecular aggregates of two to six hydrophobic amino acids are formed, as opposed to complete segregation of the hydrophobic solutes into one large cluster. The scattering results for the hydrophobic leucine amino acid are contrasted with experiments and simulations of the model hydrophilic side chain glutamine and the model backbone glycine. The self-assembly process of protein folding modeled with these experiments, in particular the condensation to a hydrophobic core, shares similar issues with the desolvation phenomena that are important in drug discovery.     

Sensory blockade after thoracic paravertebral injection of ropivacaine or bupivacaine

BACKGROUND AND OBJECTIVE: No clinical trials comparing the characteristics of sensory blockade caused by various local anaesthetics in thoracic paravertebral blockade have been published. The aim of this prospective study was a clinical assessment of sensory blockade after paravertebral injection of ropivacaine or bupivacaine in patients undergoing modified radical mastectomy. METHODS: Seventy ASA I-II patients were randomized to receive a single injection of ropivacaine 0.5% (n = 35) or bupivacaine 0.5% (n = 35) at the T4 level. General anaesthesia with propofol and fentanyl was provided during the procedure and patients were not intubated. The following parameters were analysed: duration and dynamics of the sensory blockade and the patient's and surgeon's assessment. RESULTS: Both ropivacaine and bupivacaine provided a similar level of analgesia. Ropivacaine was characterized by more rapid onset - after only 5 min 53% of patients in this group had the extent of sensory blockade wide enough to perform modified radical mastectomy in comparison to only 20% after bupivacaine (P 9 segments blocked) was noted more often in the ropivacaine group (88% vs. 65%, P < 0.05), lasted longer and appeared to be wider than sensory blockade produced by bupivacaine. Regression of sensory blockade was initially similar, but after 24 h sensory blockade in the ropivacaine group still had a potential to provide analgesia for modified radical mastectomy in 81% of patients in comparison to only 50% of such patients in the bupivacaine group (P < 0.05). Degree of postoperative pain, performance of the cardiovascular system, consumption of medications and complications were all similar between the study groups. CONCLUSIONS: Both agents provide satisfactory conditions for mastectomy, but ropivacaine seems to be superior to bupivacaine for thoracic paravertebral blockade during breast cancer surgery.     

Risk assessment of pollution with pesticides in food in the Eastern Romania area (1996-1997).

The extensive use of pesticides in agriculture can entail risks for environment and non-target organisms. Hence the need to assess the nature and degree of the risk and at the same time to take preventive measures aimed at minimizing possible damages. The aim of the present study was to investigate the pesticide residues in food and the human body (maternal, young) in the Eastern Romania area, between 1996 and 1997. The organochlorine pesticide residues were analyzed using gas-chromatographic method. DDT-total and HCH-total were determined in 'food' (milk, bread, diets, coffee) sampled in the Eastern Romania area; 'maternal body' (placenta, milk, urine) and 'young body' (serum, urine) from the Iassy district. These pollutants present in all analyzed products involve the necessity of the pollution reduction by a rational use of the pesticides and the continuation of the chemical pollutants determination in the environment elements for cancer prevention and the control of the exposure to environmental carcinogens and their effects.     

Small-angle scattering and the structure of ambient liquid water

Structural polyamorphism has been promoted as a means for understanding the anomalous thermodynamics and dynamics of water in the experimentally inaccessible supercooled region. In the metastable liquid region, theory has hypothesized the existence of a liquid-liquid critical point from which a dividing line separates two water species of high and low density. A recent small-angle X-ray scattering study has claimed that the two structural species postulated in the supercooled state are seen to exist in bulk water at ambient conditions. We analyze new small-angle X-ray scattering data on ambient liquid water taken at third generation synchrotron sources, and large 32,000 water molecule simulations using the TIP4P-Ew model of water, to show that the small-angle region measures standard number density fluctuations consistent with water’s isothermal compressibility temperature trends. Our study shows that there is no support or need for heterogeneities in water structure at room temperature to explain the small-angle scattering data, as it is consistent with a unimodal density of the tetrahedral liquid at ambient conditions.     

Quality of Life and Depression Among Mexican Americans on Hemodialysis: A Preliminary Report

Health-related quality of life (QOL) and depression burden of Mexican Americans with end-stage renal disease (ESRD) are not known. This observational cross-sectional study assessed QOL and depression and examined their inter-relatedness in Mexican Americans with type 2 diabetes and ESRD on maintenance hemodialysis (HD) treatment. Prevalent Mexican Americans on HD (N = 40) completed the Kidney Disease Quality of Life-Short Form (KDQOL-SF) and the Beck Depression Inventory II. The overall median scores for the mental component summary and the physical component summary scales in the KDQOL-SF were 40.9 and 34.0, respectively. The prevalence of severe depression was 40%. The most significant differences between depressed and non-depressed groups were symptom/problem list, cognitive function, and emotional well- being (P < 0.0001 for all). Mexican Americans with depression endure a more dismal QOL compared to non-depressed peers. Significant negative correlations between depression and several QOL scales underscore plausible interactions between the two conditions which warrants further evaluation.