A high incidence of native portal vein thrombosis in veterans undergoing liver transplantation

The incidence of native portal vein thrombosis (PVT) in liver transplant recipients has been reported to range from 2.1 to 13.8%. We have identified an inordinately high incidence of PVT in a consecutive series of U.S. veterans receiving liver transplants. Between October 1989 and February 1994, 88 consecutive U.S. veterans received 99 orthotopic liver transplants under primary Tacrolimus (Prograf, formerly FK506) based immunosuppression. A number of clinical features were examined in an effort to identify risk factors for PVT and outcome was compared to patients without PVT. Native PVT was present in 23/88 (26%) patients. All of these patients were male U.S. veterans with a mean age of 47 years. When compared to the 65 patients without PVT, we found no significant difference with respect to underlying liver disease, age, Childs-Pugh score (mean = 12), UNOS status as defined prior to April 1995 (95% UNOS 3 or 4), previous abdominal surgery, or liver volume. Median blood loss for patients with PVT (21 units of packed red blood cells) was greater than for those without PVT (14 units, P = 0.04). Portal thrombectomy was performed in 11 patients, 11 patients required mesoportal jump grafts, and 1 patient had an interposition graft. Standard veno-venous bypass was used in 10 patients with single bypass utilized for the remainder. Actuarial patient survival for all patients at 1, 2, and 4 years was 88, 85, and 79%, respectively. There was no significant difference in patients with or without PVT. Patients with PVT had poorer graft survival than patients without PVT (86% vs 65%, 1 year; 81% vs 65%, 2 years; 81% vs 61%, 4 years; P = 0.03); however, this was not related to technical problems with the portal venous inflow. PVT occurred in 26% of U.S. veterans undergoing liver transplantation. These patients bad significantly higher operative blood loss and poorer graft survival. The high incidence of postnecrotic cirrhosis in a predominantly male group of patients with advanced disease, as is evident by the high mean Childs-Pugh score and UNOS status, perhaps accounts for our observations

Rim Pathway-Mediated Alterations in the Fungal Cell Wall Influence Immune Recognition and Inflammation

ACKNOWLEDGMENTS We acknowledge Jennifer Lodge, Woei Lam, and Rajendra Upadhya for developing and sharing the chitin and chitosan MTBH assay. We thank Todd Brennan of Duke University for providing MyD88-deficient mice. We acknowledge Neil Gow for providing access to the Dionex HPAEC-PAD instrumentation. We also acknowledge Connie Nichols for critical reading of the manuscript. These experiments were supported by an NIH grant to J.A.A. and F.L.W., Jr. (R01 AI074677). C.M.L.W. was supported by a fellowship provided through the Army Research Office of the Department of Defense (no. W911NF-11-1-0136 f) (F.L.W., Jr.). J.W., L.W., and C.M. were supported by the Wellcome Trust Strategic Award in Medical Mycology and Fungal Immunology (097377) and the MRC, Centre for Medical Mycology (MR/N006364/1). FUNDING INFORMATION MRC Centre for Medical MycologyMR/N006364/1 Carol A. Munro HHS | NIH | National Institute of Allergy and Infectious Diseases (NIAID) https://doi.org/10.13039/100000060R01 AI074677J. Andrew Alspaugh Wellcome https://doi.org/10.13039/100010269097377 Carol A. Munro DOD | United States Army | RDECOM | Army Research Office (ARO) https://doi.org/10.13039/100000183W911NF-11-1-0136 f Chrissy M. Leopold WagerPeer reviewedPublisher PD

Heme Oxygenase, Inflammation, and Fibrosis: The Good, the Bad, and the Ugly?

Upon injury, prolonged inflammation and oxidative stress may cause pathological wound healing and fibrosis, leading to formation of excessive scar tissue. Fibrogenesis can occur in most organs and tissues and may ultimately lead to organ dysfunction and failure. The underlying mechanisms of pathological wound healing still remain unclear, and are considered to be multifactorial, but so far, no efficient anti-fibrotic therapies exist. Extra- and intracellular levels of free heme may be increased in a variety of pathological conditions due to release from hemoproteins. Free heme possesses pro-inflammatory and oxidative properties, and may act as a danger signal. Effects of free heme may be counteracted by heme-binding proteins or by heme degradation. Heme is degraded by heme oxygenase (HO) that exists as two isoforms: inducible HO-1 and constitutively expressed HO-2. HO generates the effector molecules biliverdin/bilirubin, carbon monoxide, and free iron/ferritin. HO deficiency in mouse and man leads to exaggerated inflammation following mild insults, and accumulating epidemiological and preclinical studies support the widely recognized notion of the cytoprotective, anti-oxidative, and anti-inflammatory effects of the activity of the HO system and its effector molecules. In this review, we address the potential effects of targeted HO-1 induction or administration of HO-effector molecules as therapeutic targets in fibrotic conditions to counteract inflammatory and oxidative insults. This is exemplified by various clinically relevant conditions, such as hypertrophic scarring, chronic inflammatory liver disease, chronic pancreatitis, and chronic graft rejection in transplantation

State Plans for Containment of Pandemic Influenza

Current plans for control of pandemic influenza vary, and many do not include nonpharmaceutical interventions

Bacteremia in Lung Transplant Recipients in the Current Era

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/71409/1/j.1600-6143.2006.01565.x.pd

Inhomogeneous Low Frequency Spin Dynamics in La_{1.65}Eu_{0.2}Sr_{0.15}CuO_4

We report Cu and La nuclear magnetic resonance (NMR) measurements in the title compound that reveal an inhomogeneous glassy behavior of the spin dynamics. A low temperature peak in the La spin lattice relaxation rate and the ``wipeout'' of Cu intensity both arise from these slow electronic spin fluctuations that reveal a distribution of activation energies. Inhomogeneous slowing of spin fluctuations appears to be a general feature of doped lanthanum cuprate.Comment: 4 pages, 2 figures. Very slight modifications to figure

In vitro characterization of a biodegradable chitosan/bioactive glass coating for Mg alloys

Magnesium and its alloys have already been proposed for biomedical applications in 1878. However, up to date no extended, successful medical Mg product is commercially available. The drawbacks of permanent implants, like stress-shielding or possible release of metal ions through wear, can be avoided with the use of biodegradable metals. Temporary implants as such could make a second surgical process to remove the implant unnecessary, not only decreasing the healthcare costs and associated risks of a surgery, but also reducing the trauma to the patient. Mg is an abundant cation in the human body and in part physiologically beneficial as the surrounding tissue can absorb and consume the ions. The main problems related to the usage of Mg and its alloys is its high chemical reactivity, a related low corrosion resistance, especially in chloride-containing environments and the accompanying fast hydrogen gas production. [1] In order to overcome these problems in this study a coating of a natural polymer/bioactive glass composite is applied using electrophoretic deposition. Additionally, functional properties like drug delivery characteristics and antibacterial capacity are added to these coatings. As natural, cationic polymer chitosan is taken which is the supporting material in the exoskeleton of crustaceans and insects (crab, butterfly) and in cell walls of fungi. It combines biodegradability and biocompatibility with the ability to promote cell adhesion. [1] To avoid dissolution of the Mg alloy substrate during the deposition, a pretreatment is used. The immersion in DMEM for 24 h is increasing the corrosion resistance to a level that the acidic, aqueous electrolyte during deposition is not corroding the Mg substrate. [2] A comparative study was performed on replacing part of the bioactive glass as ceramic part with silica particles in order to maintain a topography during dissolution of the glass. A constant solid content of 1 g/l was chosen, with 0.5 g/l chitosan in 1 vol% acetic acid, 20 vol% water and 79 vol% ethanol following previous studies. [3] For the cathodic deposition process 0.5 cm electrode distance with stainless steel as the counter electrode was used. The deposition was performed under constant current (50 V) and constant voltage (35 mA) with varying processing times. [1] Heise S, Virtanen S, Boccaccini AR. 2016. Tackling Mg alloy corrosion by natural polymer coatings—A review. J Biomed Mater Res Part A 2016:104A:2628–2641 [2] Wagener V, Virtanen S. 2016 Protective layer formation on magnesium in cell culture medium. Mater. Sci. Eng. C 63, 341–351 [3] Cordero-Arias, L. et al. 2013 Electrophoretic deposition of nanostructured-TiO2/Chitosan composite coatings on stainless steel. R. Soc. Chem. 3, 11247-11254 Acknowledgements: This study is supported by the German Science Foundation (DFG)

DEVELOPMENT OF A BIODEGRADABLE NATURAL POLYMER/CERAMIC COATING FOR MG ALLOYS USING ELECTROPHORETIC DEPOSITION

Magnesium and its alloys have already been proposed for biomedical applications in 1878. However, up to date no extended, successful medical Mg product is commercially available. The drawbacks of permanent implants, like stress-shielding or possible release of metal ions through wear, can be avoided with the use of biodegradable metals. Temporary implants as such could make a second surgical process to remove the implant unnecessary, not only decreasing the healthcare costs and associated risks of a surgery, but also reducing the trauma to the patient. Mg is an abundant cation in the human body and in part physiologically beneficial as the surrounding tissue can absorb and consume the ions. The main problems related to the usage of Mg and its alloys is its high chemical reactivity, a related low corrosion resistance, especially in chloride-containing environments and the accompanying fast hydrogen gas production. [1] In order to overcome these problems in this study a coating of a natural polymer/bioactive glass composite is applied using electrophoretic deposition. Additionally, functional properties like drug delivery characteristics and antibacterial capacity are added to these coatings. As natural, cationic polymer chitosan is taken which is the supporting material in the exoskeleton of crustaceans and insects (crab, butterfly) and in cell walls of fungi. It combines biodegradability and biocompatibility with the ability to promote cell adhesion. [1] To avoid dissolution of the Mg alloy substrate during the deposition, a pretreatment is used. The immersion in DMEM for 24 h is increasing the corrosion resistance to a level that the acidic, aqueous electrolyte during deposition is not corroding the Mg substrate. [2] A comparative study was performed on replacing part of the bioactive glass as ceramic part with silica particles in order to maintain a topography during dissolution of the glass. A constant solid content of 1 g/l was chosen, with 0.5 g/l chitosan in 1 vol% acetic acid, 20 vol% water and 79 vol% ethanol following previous studies. [3] For the cathodic deposition process 0.5 cm electrode distance with stainless steel as the counter electrode was used. The deposition was performed under constant current (50 V) and constant voltage (35 mA) with varying processing times. [1] Heise S, Virtanen S, Boccaccini AR. 2016. Tackling Mg alloy corrosion by natural polymer coatings—A review. J Biomed Mater Res Part A 2016:104A:2628–2641 [2] Wagener V, Virtanen S. 2016 Protective layer formation on magnesium in cell culture medium. Mater. Sci. Eng. C 63, 341–351 [3] Cordero-Arias, L. et al. 2013 Electrophoretic deposition of nanostructured-TiO2/Chitosan composite coatings on stainless steel. R. Soc. Chem. 3, 11247-11254 Acknowledgements: This study is supported by the German Science Foundation (DFG)