Cholesterol-crystal embolism presenting with delayed graft function and impaired long-term function in renal transplant recipients: two case reports

Introduction Impaired renal function and/or pre-existing atherosclerosis in the deceased donor increase the risk of delayed graft function and impaired long-term renal function in kidney transplant recipients. Case presentation We report delayed graft function occurring simultaneously in two kidney transplant recipients, aged 57-years-old and 39-years-old, who received renal allografts from the same deceased donor. The 62-year-old donor died of cardiac arrest during an asthmatic state. Renal-allograft biopsies performed in both kidney recipients because of delayed graft function revealed cholesterol-crystal embolism. An empiric statin therapy in addition to low-dose acetylsalicylic acid was initiated. After 10 and 6 hemodialysis sessions every 48 hours, respectively, both renal allografts started to function. Glomerular filtration rates at discharge were 26 ml/min/1.73 m2 and 23.9 ml/min/1.73 m2, and remained stable in follow-up examinations. Possible donor and surgical procedure-dependent causes for cholesterol-crystal embolism are discussed. Conclusion Cholesterol-crystal embolism should be considered as a cause for delayed graft function and long-term impaired renal allograft function, especially in the older donor population

Der Einfluss von UVA-Strahlung auf die Expression des vaskulären Permeabilitätsfaktors (VEGF-VPF) durch HaCat Keratinozyten

Immortalisierte HaCaT Keratinozyten sind im Gegensatz zu primären epidermalen Keratinozyten in der Lage, nach Exposition durch UV A Licht den hauptsächlichen Angiogenesefaktor der Haut, den vaskulären endothelialen Wachstumsfaktor VEGF/VPF, überzuexprimieren. Da VEGFNPF nicht nur angiogene Eigenschaften entfaltet, sondern auch den malignen Phänotyp von Tumorzellen verstärken kann, war es das Ziel der Arbeit, die molekularen Mechanismen der UV A-vermittelten VEGF/VPF Genexpression in HaCaT Zellen zu bestimmen, welche als präneoplastische Zelllinie in einem frühen Stadium der Transformierung dienten. Zusammenfassend konnten diese Untersuchungen eine AP-2 Transaktivierung als einen wesentlichen Mechanismus der UV A-induzierten VEGF/VPF Gentranskription in HaCaT Zellen identifizieren. Als funktionell wichtiges Reaktionselement wurde eine GC-reiche Region in unmittelbarer Nähe zum TranSkriptionsstart (bp -88/-70) ausgemacht. Ein kritischer Nukleotidaustausch innerhalb dieser Sequenz verhindert die UVA-induzierte VEGFNPF Gentranskription. Damit untermauern diese Befunde die zentrale Rolle von AP-2 Transkripiionsfaktor in der UVA-vermittelten Genexpression in immortalisierten HaCaT Keratinozyten. Der hemmende Einfluß potenter Singulett-Sauerstoff Quencher legt den Schluß nahe, dass die UVA-induzierte AP-2 Aktivierung an den VEGFNPF Promotor über die Generierung von Singulett-Sauerstoff vermittelt wird. Zusätzlich zeigen die vorgestellten Daten zum ersten Mal, dass den MKK1I2 und den nachgeschalteten p42/p44 MAP Kinasen in der UVA-vermittelten AP-2 Aktivierung eine besondere Bedeutung zukommt. Die gewonnenen Daten deuten auf einen potentiellen Mechanismus hin, durch den prämaligne Keratinozyten durch wiederholte UVA-induzierte VEGFNPF Expression möglicherweise einen malignen Phänotyp annehmen könnten

Attitudes of Palestinian Arab youth inside the green line toward experimentation with and regular use of psycho-active substances: Perceptions and influencing factors

employed self-report questionnaires to 548 Palestinian Arab adolescents to examine the attitudes toward the potential risks of experimenting and regularly using psychoactive substances, family cohesion, parental and friends\u27 attitudes toward the use of psych-active substances. It was hypothesized that the adolescents would attribute higher risk to the regular use when compared with experimentation. Furthermore, family cohesion, parents and friends’ attitudes toward psycho-active substances will significantly predict the attitudes toward the risk of using psycho-active substances among adolescents. After conducting regression analyses, it was found out that the adolescents attributed the higher risk to the regular use of psychoactive substances. The risk level attributed to experimenting and using psychoactive substances was associated with the risk level attributed to the different psychoactive substances; the adolescents attributed the higher risk to hard drugs, other illegal drugs and cannabis more than soft drugs like inhalants, medications, alcoholic beverages and cigarettes. Another finding was that the adolescents with cohesive and non-smoking families do not use inhalants, and/or medications in contrast with the teenagers with divided and smoking families. According to the teenagers, the stricter the parents, the higher the level of risk of experimenting with cigarettes, alcoholic beverages, inhalants and medications will be. In addition, the teenagers stated that the more negative the friends’ attitudes regarding psychoactive substances, the higher the level of risk of experimenting with alcoholic beverages, cannabis, medications and other illegal drugs will be. It can be concluded that the use of psycho-active substances is considered to have more risk than the regular use of the substances. In the Palestinian society, familial factors still have a high impact on the adolescents and affect their attitudes toward major issues, such as the experimentation of substance abuse

Floral Reversion in <i>Arabidopsis suecica</i> Is Correlated with the Onset of Flowering and Meristem Transitioning

<div><p>Angiosperm flowers are usually determinate structures that may produce seeds. In some species, flowers can revert from committed flower development back to an earlier developmental phase in a process called floral reversion. The allopolyploid <i>Arabidopsis suecica</i> displays photoperiod-dependent floral reversion in a subset of its flowers, yet little is known about the environmental conditions enhancing this phenotype, or the morphological processes leading to reversion. We have used light and electron microscopy to further describe this phenomenon. Additionally, we have further studied the phenology of flowering and floral reversion in <i>A</i>. <i>suecica</i>. In this study we confirm and expand upon our previous findings that floral reversion in the allopolyploid <i>A</i>. <i>suecica</i> is photoperiod-dependent, and show that its frequency is correlated with the timing for the onset of flowering. Our results also suggest that floral reversion in <i>A</i>. <i>suecica</i> displays natural variation in its penetrance between geographic populations of <i>A</i>. <i>suecica</i>.</p></div

Floral reversion in <i>A</i>. <i>suecica</i> originates from the replum.

<p>A: The top valve of a reverting carpel was removed and the tissue imaged using environmental SEM. Multiple new floral stems (light green) originate out of the replum (dark green), which is connected to the gynophore (bottom right). The original stigma of the reverting flower is colored yellow for orientation. B: The same reverting carpel as in A. In this view the new inflorescence was unfolded and placed above its remaining carpel valve. Gynophore and replum are fused (dark green), and several new inflorescence stems branch off of the replum (light green). Stigma is colored in yellow as above. Colors are false colors. Size bar in B is the same as for A = 25 mm.</p

Floral reversion frequency increases in short days.

<p>Individuals from each population were grown in incubators (20°C; and day lengths set at 8h light/16h dark; 12h light/12h dark; 16h light/8h dark; 24h light) until senescence. Reverting flowers were counted along the inflorescence axis from the first (oldest) to the 80th flower position and the proportion of total reverting flowers was calculated for each condition. Here, data from all eleven populations were analyzed together. The plot on the left includes data from all plants from the study, the plot on the right excludes plants that exhibited no case of floral reversion. Statistically significant differences in reversion rates between treatments were determined using ANOVA and Tukey posthoc testing. Treatments not connected by a letter are statistically significantly different from each other (p< 0.05). Boxplots show data range, including median (bold line), the 25^th, 75^th, and 5^th or 95^th percentile of data distribution (lower and upper end of box, and lower and upper whiskers, respectively), plus outliers (circles). N = 148 (reverting), 190 (never reverting).</p

Flowering time is significantly increased in shorter days.

<p>Plants of eleven populations were grown in growth chambers at the indicated day lengths. The first day of flowering was defined as the day when the first flower opened or the inflorescence was 1 cm tall, whichever occurred first. ANOVA, followed by Tukey post hoc testing was performed for the combined data set of all populations of <i>A</i>. <i>suecica</i> (N = 270; data for all individual populations can be found in <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127897#pone.0127897.s003" target="_blank">S3 Fig</a>). Treatments not connected by the same letter are statistically significantly different. (For general boxplot description see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127897#pone.0127897.g004" target="_blank">Fig 4</a>.)</p

Floral reversion is positively correlated with flowering time.

<p>Flowering time and reversion data were plotted for each individual plant that showed any reversion, and the Pearson correlation coefficient was calculated (p< 0.0001, R² = 0.169, N = 148).</p

Floral reversion is more likely to occur earlier in development when days are short.

<p>To determine if reversion was equally likely for each position along the inflorescence from the oldest to the 50^th flower, “weighted reversion frequencies” (see <a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0127897#sec002" target="_blank">Methods</a> for details) were calculated for each day length condition and plotted. Statistical significance between the positions of the peaks was calculated using ANOVA and Tukey post hoc testing. Statistically significant differences in peak positions for reversions were found only for the two extreme values of 8h and 24h of light.</p