Acquired immunologic tolerance: with particular reference to transplantation

The first unequivocally successful bone marrow cell transplantation in humans was recorded in 1968 by the University of Minnesota team of Robert A. Good (Gatti et al. Lancet 2: 1366–1369, 1968). This achievement was a direct extension of mouse models of acquired immunologic tolerance that were established 15 years earlier. In contrast, organ (i.e. kidney) transplantation was accomplished precociously in humans (in 1959) before demonstrating its feasibility in any experimental model and in the absence of a defensible immunologic rationale. Due to the striking differences between the outcomes with the two kinds of procedure, the mechanisms of organ engraftment were long thought to differ from the leukocyte chimerism-associated ones of bone marrow transplantation. This and other concepts of alloengraftment and acquired tolerance have changed over time. Current concepts and their clinical implications can be understood and discussed best from the perspective provided by the life and times of Bob Good

The Evolution of KTP Laser Vaporization of the Prostate

The search for a minimally invasive approach to the treatment of Lower Urinary Tract Symptoms (LUTS) suggestive of Benign Prostatic Hyperplasia (BPH) is probably as old as Transurethral Resection of the Prostate (TURP). In an effort to overcome the limitations and morbidities of TURP, and in light of evidence suggesting that medical treatment for BPH has a limited life-span, laser-based treatments have emerged during the last decade. Photoselective Vaporization of the Prostate (PVP) by the "GreenLight" KTP laser is considered one of the most promising options, one that is constantly evolving new technologies in prostate surgery. In this overview of KTP laser usage in BPH treatment, we will briefly discuss the evolution of this modality since it was first introduced and focus on the available evidence regarding safety, efficacy and cost parameters of its application

Biomonitoring of Exposure in Farmworker Studies

Although biomonitoring has been used in many occupational and environmental health and exposure studies, we are only beginning to understand the complexities and uncertainties involved with the biomonitoring process—from study design, to sample collection, to chemical analysis—and with interpreting the resulting data. We present an overview of concepts that should be considered when using biomonitoring or biomonitoring data, assess the current status of biomonitoring, and detail potential advancements in the field that may improve our ability to both collect and interpret biomonitoring data. We discuss issues such as the appropriateness of biomonitoring for a given study, the sampling time frame, temporal variability in biological measurements to nonpersistent chemicals, and the complex issues surrounding data interpretation. In addition, we provide recommendations to improve the utility of biomonitoring in farmworker studies

Impact of Prostate Volume on the Efficacy of High-Power Potassium-Titanyl-Phosphate Photoselective Vaporization of the Prostate: A Retrospective, Short-Term Follow-Up Study on Evaluating Feasibility and Safety

Purpose: We determined the impact of prostate volume on the efficacy of the high-power (80 W) potassium-titanyl-phosphate (KTP) photoselective laser vaporization of the prostate in men with lower urinary tract symptoms (LUTS). Materials and Methods: Patients were stratified into 3 groups according to prostate volume: `<40 g` (n = 49) and `40-59 g` (n = 49) and 60 g` (n = 22). Median follow-up was 9 months (range 6 to 21). Results: No differences in age and follow-up duration were observed in the three groups. At baseline, no significant differences were noted in the three groups in terms of the International Prostate Symptom Score (IPSS) (21.4, 19.4 and 19.1; p = 0.412) as well as the maximum flow rate (Qmax) (10.2, 9.2, and 8.6 mL/s; p = 0.291) and post-void residual (PVR) (66.2, 80.4, and 71.5 mL; p = 0.856). The mean operative times were 30.9, 46.9, and 58.6 minutes (p < 0.001) and total median energy deliveries for each group were 62.3, 97.6, and 135.9 kJ, respectively (p < 0.001). No severe intraoperative complication was observed. At the last follow-up, these parameters improved significantly regardless of prostate volume, and the IPSS (11.1, 9.4, and 12.3; p = 0.286) as well as Qmax (15.9, 15.9, and 14.2 mL/s; p = 0.690) and PVR (33.7, 28.4, and 14.2 mL; p = 0.395) were not significantly different among the groups. Conclusion: Although a larger prostate requires more time and energy delivery, photoselective laser vaporization of the prostate is safe and efficacious for patients with LUTS regardless of prostate volume.Spaliviero M, 2008, J ENDOUROL, V22, P2341, DOI 10.1089/end.2008.9708Rieken M, 2010, WORLD J UROL, V28, P53, DOI 10.1007/s00345-009-0504-zNaspro R, 2009, EUR UROL, V55, P1345, DOI 10.1016/j.eururo.2009.03.070Lee R, 2008, J UROLOGY, V180, P1551, DOI 10.1016/j.juro.2008.06.002Du CJ, 2008, J ENDOUROL, V22, P1031, DOI 10.1089/end.2007.0262Paick JS, 2007, J SEX MED, V4, P1701, DOI 10.1111/j.1743-6109.2007.00574.xMonoski MA, 2006, UROLOGY, V68, P312, DOI 10.1016/j.urology.2006.02.020Bouchier-Hayes DM, 2006, J ENDOUROL, V20, P580Te AE, 2006, BJU INT, V97, P1229, DOI 10.1111/j.1464-410X.2006.06197.xKrambeck AE, 2010, J ENDOUROL, V24, P433, DOI 10.1089/end.2009.0147Fu WJ, 2006, ASIAN J ANDROL, V8, P367, DOI 10.1111/j.1745-7262.2006.00134.xBarber NJ, 2006, UROLOGY, V67, P80, DOI 10.1016/j.urology.2005.07.028Bachmann A, 2005, EUR UROL, V48, P965, DOI 10.1016/j.eururo.2005.07.001Sandhu JS, 2005, J ENDOUROL, V19, P1196Sarica K, 2005, J ENDOUROL, V19, P1199Malek RS, 2005, J UROLOGY, V174, P1344, DOI 10.1097/01.ju.0000173913.41401.67Volkan T, 2005, EUR UROL, V48, P608, DOI 10.1016/j.eururo.2005.07.013Bachmann A, 2005, EUR UROL, V47, P798, DOI 10.1016/j.eururo.2005.02.003Kumar SM, 2005, J UROLOGY, V173, P511, DOI 10.1097/01.ju.0000150099.31289.d7Reich O, 2005, J UROLOGY, V173, P158, DOI 10.1097/01.ju.0000146631.14200.d4Sandhu JS, 2004, UROLOGY, V64, P1155Sulser T, 2004, J ENDOUROL, V18, P976Te AE, 2004, J UROLOGY, V172, P1404, DOI 10.1097/01.ju.0000139541.68542.f6Reich O, 2004, J UROLOGY, V171, P2502, DOI 10.1097/01.ju.0000128803.04158.76Hai MA, 2003, J ENDOUROL, V17, P93Shingleton WB, 1999, UROLOGY, V54, P1017Shingleton WB, 1998, SCAND J UROL NEPHROL, V32, P266Kuntzman RS, 1997, UROLOGY, V49, P703Kuntzman RS, 1996, UROLOGY, V48, P575

The One Year Outcome after KTP Laser Vaporization of the Prostate According to the Calculated Vaporized Volume

The aim of this study was to develop a new simple method for measuring the vaporized volume and to evaluate the outcome of high-power potassium-titanyl-phosphate (KTP) photoselective laser vaporization. A total of 65 patients, with a mean age of 67.7 yr (range 53 to 85), were included in the primary analysis. The vaporized volume was calculated as the pre-operative volume minus the immediate post-operative volume plus the volume of the defect. For all patients, the subjective and objective parameters improved significantly after surgery. Six and 12 months after surgery, the group with a smaller vaporized volume (<15 g) had a lower reduction of the mean International Prostate Symptom Score (P=0.006 and P=0.004) and quality of life index (P=0.006 and P=0.004) when compared to the group with a greater vaporized volume (≥15 g). There were no differences in the change of the maximum flow rate and post-void residual based on the vaporized volume. Our findings suggest that the subjective improvement, after a high-power KTP laser vaporization, may be dependent on the vaporized volume obtained after the procedure

New evidence on Allyn Young's style and influence as a teacher

This paper publishes the hitherto unpublished correspondence between Allyn Abbott Young's biographer Charles Blitch and 17 of Young's former students or associates. Together with related biographical and archival material, the paper shows the way in which this adds to our knowledge of Young's considerable influence as a teacher upon some of the twentieth century's greatest economists. The correspondents are as follows: James W Angell, Colin Clark, Arthur H Cole, Lauchlin Currie, Melvin G de Chazeau, Eleanor Lansing Dulles, Howard S Ellis, Frank W Fetter, Earl J Hamilton, Seymour S Harris, Richard S Howey, Nicholas Kaldor, Melvin M Knight, Bertil Ohlin, Geoffrey Shepherd, Overton H Taylor, and Gilbert Walker

Double-stranded RNA-activated protein kinase PKR of fishes and amphibians: Varying the number of double-stranded RNA binding domains and lineage-specific duplications

BackgroundDouble-stranded (ds) RNA, generated during viral infection, binds and activates the mammalian anti-viral protein kinase PKR, which phosphorylates the translation initiation factor eIF2alpha leading to the general inhibition of protein synthesis. Although PKR-like activity has been described in fish cells, the responsible enzymes eluded molecular characterization until the recent discovery of goldfish and zebrafish PKZ, which contain Z-DNA-binding domains instead of dsRNA-binding domains (dsRBDs). Fish and amphibian PKR genes have not been described so far.ResultsHere we report the cloning and identification of 13 PKR genes from 8 teleost fish and amphibian species, including zebrafish, demonstrating the coexistence of PKR and PKZ in this latter species. Analyses of their genomic organization revealed up to three tandemly arrayed PKR genes, which are arranged in head-to-tail orientation. At least five duplications occurred independently in fish and amphibian lineages. Phylogenetic analyses reveal that the kinase domains of fish PKR genes are more closely related to those of fish PKZ than to the PKR kinase domains of other vertebrate species. The duplication leading to fish PKR and PKZ genes occurred early during teleost fish evolution after the divergence of the tetrapod lineage. While two dsRBDs are found in mammalian and amphibian PKR, one, two or three dsRBDs are present in fish PKR. In zebrafish, both PKR and PKZ were strongly upregulated after immunostimulation with some tissue-specific expression differences. Using genetic and biochemical assays we demonstrate that both zebrafish PKR and PKZ can phosphorylate eIF2alpha in yeast.ConclusionConsidering the important role for PKR in host defense against viruses, the independent duplication and fixation of PKR genes in different lineages probably provided selective advantages by leading to the recognition of an extended spectrum of viral nucleic acid structures, including both dsRNA and Z-DNA/RNA, and perhaps by altering sensitivity to viral PKR inhibitors. Further implications of our findings for the evolution of the PKR family and for studying PKR/PKZ interactions with viral gene products and their roles in viral infections are discussed

Clinical practice: neonatal resuscitation. A Dutch consensus

The updated Dutch guidelines on Neonatal Resuscitation assimilate the latest evidence in neonatal resuscitation. Important changes with regard to the 2004 guidelines and controversial issues concerning neonatal resuscitation are reviewed, and recommendations for daily practice are provided and argued in the context of the ILCOR 2005 consensus