Production of polycolonal antibody against domain 2-4 of protective antigen of Bacillus anthracis in laboratory animals

زمینه و هدف: آنتراکس که مسبب آن باکتری باسیلوس آنتراسیس می‌باشد یک بیماری عفونی حاد است و اغلب در گیاه‌خواران و انسان اتفاق می‌افتد. فرم رویشی باسیلوس آنتراسیس یک اگزوتوکسین سه جزیی شامل آنتی ژن حفاظت کننده (Protective Antigen=PA)، فاکتور کشنده (Lethal Factor=LF) و فاکتور ادم (Edema Factor=EF) می‌باشد. آنتی ژن حفاظت کننده به عنوان یک ایمونوژن اولیه برای توسعه ایمنی حمایتی بر علیه آنتراکس بررسی شده است. این مطالعه با هدف تولید آنتی بادی علیه ناحیه 4-2 آنتی ژن حفاظت کننده این باکتری در حیوانات آزمایشگاهی طراحی و اجرا شده است. روش بررسی: در این مطالعه تجربی ناحیه 4-2 ژن PA از پلاسمید pXOI با جایگاه های آنزیمی BamHI و HindIII به روش PCR تکثیر و در وکتورها کلون و ساب کلون شد. وکتور (pET28a(+ در باکتری اشرشیاکلی سویه BL21(DE3) ترانسفورم گردید. بعد از القاء با IPTG، بیان پروتئین ژن PA مشاهده شد. پروتئین تخلیص شده در 4 نوبت به موش و خرگوش تزریق شد؛ سپس آنتی بادی تولید شده از سرم موش و خرگوش جداسازی و توسط آزمون الایزا تایید گردید. یافته ها: ناحیه 4-2 ژن PAکلون شده در وکتور بیانی pET28a(+) به وسیله ی توالی یابی، PCR، آنالیز آنزیمی، الکتروفورز در ژل پلی اکریل آمید و لکه گذاری وسترن مورد تأیید قرار گرفت. افزایش تیتر آنتی بادی در خون موش و خرگوش توسط آزمون الایزا تایید گردید. نتیجه گیری: با توجه به ایمونوژن بودن پروتئین PA، می‌توان از آن در طراحی واکسن و همچنین به عنوان ادجوانت قوی سیستم مخاطی استفاده نمود

Preoperative assessment of meningioma aggressiveness by Thallium-201 brain SPECT

Introduction: Meningioma is usually a benign brain tumor, but sometimes with aggressive course. The aim of this study was to assess the ability of 201Tl Brain SPECT to differentiate the pathologic grade of meningioma preoperatively. Methods: Thirty lesions in 28 patients were evaluated in this study. Early (20 minutes) and late (3 hours) brain SPECT images were performed and early uptake ratio (EUR), late uptake ratio (LUR) and retention index (RI) were calculated. All patients were operated and pathologic grade of tumors were defined according to World Health Organization grading system. Results: SPECT results were compared in different pathologic groups. Data analysis clarified no significant difference of EUR in benign and aggressive meningioma (P=0.2). However LUR and RI were significantly higher in aggressive tumors (P=0.001 and P=0.02, respectively). Conclusion: According to our data Tl-201 Brain SPECT with early and late imaging has 80 sensitivity and specificity to differentiate malignant from benign meningioma

Contemporary outcomes of patients undergoing robotic-assisted radical cystectomy: A comparative analysis between intracorporeal ileal conduit and neobladder urinary diversions

Objective: We aimed to compare perioperative and oncologic outcomes for patients undergoing robotic-assisted radical cystectomy (RARC) with intracorporeal ileal conduit (IC) and neobladder (NB) urinary diversion. Methods: Patients undergoing RARC with intracorporeal urinary diversion between January 2017 and January 2022 at the Icahn School of Medicine at Mount Sinai, New York, NY, USA were indexed. Baseline demographics, clinical characteristics, perioperative, and oncologic outcomes were analyzed. Survival was estimated with Kaplan-Meier plots. Results: Of 261 patients (206 [78.9%] male), 190 (72.8%) received IC while 71 (27.2%) received NB diversion. Median age was greater in the IC group (71 [interquartile range, IQR 65–78] years vs. 64 [IQR 59–67] years, p<0.001) and BMI was 26.6 (IQR 23.2–30.4) kg/m2. IC group was more likely to have prior abdominal or pelvic radiation (15.8% vs. 2.8%, p=0.014). American Association of Anesthesiologists scores were comparable between groups. The IC group had a higher proportion of patients with pathological tumor stage 2 (pT2) tumors (34 [17.9%] vs. 10 [14.1%], p=0.008) and pathological node stages pN2–N3 (28 [14.7%] vs. 3 [4.2%], p<0.001). The IC group had less median operative time (272 [IQR 246–306] min vs. 341 [IQR 303–378] min, p<0.001) and estimated blood loss (250 [150–500] mL vs. 325 [200–575] mL, p=0.002). Thirty- and 90-day complication rates were 44.4% and 50.2%, respectively, and comparable between groups. Clavien-Dindo grades 3–5 complications occurred in 27 (10.3%) and 34 (13.0%) patients within 30 and 90 days, respectively, with comparable rates between groups. Median follow-up was 324 (IQR 167–552) days, and comparable between groups. Kaplan-Meier estimate for overall survival at 24 months was 89% for the IC cohort and 93% for the NB cohort (hazard ratio 1.23, 95% confidence interval 1.05–2.42, p=0.02). Kaplan-Meier estimate for recurrence-free survival at 24 months was 74% for IC and 87% for NB (hazard ratio 1.81, 95% confidence interval 0.82–4.04, p=0.10). Conclusion: Patients undergoing intracorporeal IC urinary diversion had higher postoperative cancer stage, increased nodal involvement, similar complications outcomes, decreased overall survival, and similar recurrence-free survival compared to patients undergoing RARC with intracorporeal NB urinary diversion

Prostate-specific antigen screening and prostate cancer treatment in renal transplantation candidates: A survey of U.S. transplantation centers.

INTRODUCTION: Renal transplantation candidates are a highly screened population. There are currently no guidelines or consensus on prostate cancer (CaP) screening in these patients. In light of the recent United States Preventive Services Task Force recommendations against prostate-specific antigen (PSA) screening, we conducted a survey of transplantation surgeons to gain a better understanding of practice patterns among U.S. centers. MATERIALS AND METHODS: A 14-question multiple-choice online survey was e-mailed to 195 U.S. renal transplantation centers. The questionnaire assessed CaP screening and treatment practices. The survey also evaluated characteristics of the respondent\u27s institution. Descriptive statistics were used for each of the responses, and associations were made with program characterization using logistic or linear regression models. RESULTS: A total of 90 surgeons responded, representing 65 of 195 programs (33% response rate). Overall, 89% of respondents reported routinely screening for CaP in renal transplantation candidates and 71% had set guidelines for PSA screening. The most common age to start PSA screening was 50 years (51%) and 79% of respondents reported no age limit to stop PSA screening. Definitive treatment of CaP was required before proceeding to transplantation in 45% of respondents. Active surveillance was a viable option in 67% of responders. Most respondents (73%) replied that the waiting time for eligibility after treatment depended on the CaP stage and risk. CONCLUSIONS: Although most programs have guidelines on PSA screening in renal transplantation candidates, there is still variation nationwide in screening and treatment practices. AS is a viable treatment option in most of the programs. Our results suggest a benefit of a consensus panel to recommend guidelines in this population

Comparative effectiveness of treatment strategies for bladder cancer with clinical evidence of regional lymph node involvement

Purpose: Patients with bladder cancer with clinical lymph node involvement (cN+) are at high risk for distant metastases, but are potentially curable. Such patients are excluded from neoadjuvant chemotherapy trials and pooled with patients with distant metastases in first-line chemotherapy trials not suited to define the role of combined-modality therapy. To address this evidence void, we performed a comparative effectiveness analysis. Methods: Weincluded cTanyN1-3M0 bladder cancer patients from the National Cancer Data Base (2003-2012) treated with chemotherapy and/or cystectomy. We used multistate survival analysis, allowing for delayed entry, to assess overall survival (OS) according to various treatment strategies. Effectiveness was estimated with multivariable adjustment for tumor-, patient-, and facility-level characteristics. Results: Among 1,739 patients (cN1, 48%; cN2, 45%; cN3, 7%), 1,104 underwent cystectomy and 635 were treated with chemotherapy alone. Of the cystectomy patients, 363 received preoperative and 328 received adjuvant chemotherapy. The crude 5-year OS for chemotherapy alone, cystectomy alone, preoperative chemotherapy followed by cystectomy, and cystectomy followed by adjuvant chemotherapy was 14% (95% CI, 11% to 17%), 19% (95% CI, 15% to 24%), 31% (95% CI, 25% to 38%), and 26% (95% CI, 21% to 34%), respectively. Compared with cystectomy alone, preoperative chemotherapy was associated with a significant improvement in OS (hazard ratio, 0.80; 95% CI, 0.66 to 0.97). Adjuvant chemotherapy was also associated with a significant improvement in survival compared with cystectomy alone. The survival of patients treated with chemotherapy alone was worse than those treated with cystectomy alone. Conclusion: A subset of patients with cN+ bladder cancer achieves long-term survival. Combined-modality therapy, with chemotherapy and cystectomy, is associated with the best outcomes. © 2016 by American Society of Clinical Oncology