Hepatic artery pseudoaneurysm ligation after orthotopic liver transplantation-a report of 7 cases

Pseudoaneurysm (PA) is a rare but life-threatening complication of liver transplantation. The authors present their experience on 7 patients treated by ligation of a post-OLT PA. Hepatic artery ligation or embolization was performed from 10 to 70 days after liver transplantation. Of the seven patients, four survived, one developed a biliary stricture, treated by percutaneous ballon dilatation, two died of a complication not related to treatment, and one died of multiple organ failure. © 1992 by Williams & Wilkins

Radiographic features of liver allograft rejection

The radiographic features of 19 transplanted patients with failure of the liver allograft were evaluated. These features were: poor filling, stretching, attenuation of intrahepatic biliary ducts documented by T-tube cholangiogram, attenuation of branches of the hepatic artery seen on angiogram as well as a decrease of blood flow through the liver seen on angiogram and nuclear medicine dynamic scintigram. These findings were secondary to swelling of the transplanted liver and were not specific for rejection; they may also be present in hepatic infarction or infection

Loop-mediated isothermal amplification (LAMP) method for fast detection of Campylobacter spp in meat food products and environmental objects of a processing plant’s

There is constant necessity of developing the accurate and fast methods for detection of foodborne pathogens. Microorganisms of Campylobacter genus are one of the main causes of foodborne diseases worldwide. Fast identification of Campylobacter at all stages of the food life cycle is an efficient strategy to control foodborne campylobacteriosis. This article the authors evaluated a commercial loop-mediated isothermal amplification (LAMP) system with bioluminescence, called as the 3M™ Molecular Detection Analysis (MDA), which was used to find Campylobacter in food products with the help of a certain standard method, which is referred to as the reference method. The results of this study showed that the commercial LAMP based method is as efficient as the reference method, and features high specificity and minimum determinability (sensitivity). The LAMP based method has been shown to be a fast and reliable method for detection of Campylobacter spp. scarce presence (10 CFU/25 g) in meat, meat products, as well as carcass swabs and production facilities’ environment. The LAMP analysis required about 24–27 hours to achieve a result. However the LAMP based method will facilitate the detection of Campylobacter, as it provides much easier and faster detection of Cam  pylobacter spp., including Campylobacter jejuni/Campylobacter coli, than standard microbiological methods. The LAMP based method is an efficient tool to prevent the spreading of Campylobacter spp. contamination in food products.There is constant necessity of developing the accurate and fast methods for detection of foodborne pathogens. Microorganisms of Campylobacter genus are one of the main causes of foodborne diseases worldwide. Fast identification of Campylobacter at all stages of the food life cycle is an efficient strategy to control foodborne campylobacteriosis. This article the authors evaluated a commercial loop-mediated isothermal amplification (LAMP) system with bioluminescence, called as the 3M™ Molecular Detection Analysis (MDA), which was used to find Campylobacter in food products with the help of a certain standard method, which is referred to as the reference method. The results of this study showed that the commercial LAMP based method is as efficient as the reference method, and features high specificity and minimum determinability (sensitivity). The LAMP based method has been shown to be a fast and reliable method for detection of Campylobacter spp. scarce presence (10 CFU/25 g) in meat, meat products, as well as carcass swabs and production facilities’ environment. The LAMP analysis required about 24–27 hours to achieve a result. However the LAMP based method will facilitate the detection of Campylobacter, as it provides much easier and faster detection of Cam  pylobacter spp., including Campylobacter jejuni/Campylobacter coli, than standard microbiological methods. The LAMP based method is an efficient tool to prevent the spreading of Campylobacter spp. contamination in food products

Percutaneous transhepatic cholangiography and biliary drainage after liver transplantation: A five-year experience

Evaluation of the biliary tract by percutaneous transhepatic cholangiography (PTC) is often required in liver transplant patients with an abnormal postoperative course. Indications for PTC include failure of liver enzyme levels to return to normal postoperatively, an elevation of serum bilirubin or liver enzyme levels, suspected bile leak, biliary obstructive symptoms, cholangitis, and sepsis. Over a 5-year period 625 liver transplants in 477 patients were performed at the University Health Center of Pittsburgh. Fifty-three patients (56 transplants) underwent 70 PTCs. Complications diagnosed by PTC included biliary strictures, bile leaks, bilomas, liver abscesses, stones, and problems associated with internal biliary stents. Thirty-two percutaneous transhepatic biliary drainage procedures were performed. Ten transplantation patients underwent balloon dilatation of postoperative biliary strictures. Interventional radiologic techniques were important in treating other complications and avoiding additional surgery in many of these patients. © 1987 Springer-Verlag New York Inc

Yttrium-90 Radioembolization for Colorectal Cancer Liver Metastases: A Single Institution Experience

Purpose. We sought to evaluate our experience using yttrium-90 (90Y) resin microsphere hepatic radioembolization as salvage therapy for liver-dominant metastatic colorectal cancer (mCRC). Methods. A retrospective review of consecutive patients with unresectable mCRC who were treated with 90Y after failing first and second line systemic chemotherapy. Demographics, treatment dose, biochemical and radiographic response, toxicities, and survival were examined. Results. Fifty-one patients underwent 90Y treatments of which 69% were male. All patients had previously undergone extensive chemotherapy, 31% had undergone previous liver-directed therapy and 24% had a prior liver resection. Using RECIST criteria, either stable disease or a partial response was seen in 77% of patients. Overall median survival from the time of first 90Y treatment was 10.2 months (95% CI = 7.5–13.0). The absence of extrahepatic disease at the time of treatment with 90Y was associated with an improved survival, median survival of 17.0 months (95% CI = 6.4–27.6), compared to those with extrahepatic disease at the time of treatment with 90Y, 6.7 months (95% CI = 2.7–10.6 Conclusion: 90Y therapy is a safe locoregional therapy that provides an important therapeutic option to patients who have failed first and second line chemotherapy and have adequate liver function and performance status

Structural basis of transposon end recognition explains central features of Tn7 transposition systems

Tn7 is a bacterial transposon with relatives containing element-encoded CRISPR-Cas systems mediating RNA-guided transposon insertion. Here, we present the 2.7 Å cryoelectron microscopy structure of prototypic Tn7 transposase TnsB interacting with the transposon end DNA. When TnsB interacts across repeating binding sites, it adopts a beads-on-a-string architecture, where the DNA-binding and catalytic domains are arranged in a tiled and intertwined fashion. The DNA-binding domains form few base-specific contacts leading to a binding preference that requires multiple weakly conserved sites at the appropriate spacing to achieve DNA sequence specificity. TnsB binding imparts differences in the global structure of the protein-bound DNA ends dictated by the spacing or overlap of binding sites explaining functional differences in the left and right ends of the element. We propose a model of the strand-transfer complex in which the terminal TnsB molecule is rearranged so that its catalytic domain is in a position conducive to transposition

How are falls and fear of falling associated with objectively measured physical activity in a cohort of community-dwelling older men?

BACKGROUND: Falls affect approximately one third of community-dwelling older adults each year and have serious health and social consequences. Fear of falling (FOF) (lack of confidence in maintaining balance during normal activities) affects many older adults, irrespective of whether they have actually experienced falls. Both falls and fear of falls may result in restrictions of physical activity, which in turn have health consequences. To date the relation between (i) falls and (ii) fear of falling with physical activity have not been investigated using objectively measured activity data which permits examination of different intensities of activity and sedentary behaviour. METHODS: Cross-sectional study of 1680 men aged 71-92 years recruited from primary care practices who were part of an on-going population-based cohort. Men reported falls history in previous 12 months, FOF, health status and demographic characteristics. Men wore a GT3x accelerometer over the hip for 7 days. RESULTS: Among the 12% of men who had recurrent falls, daily activity levels were lower than among non-fallers; 942 (95% CI 503, 1381) fewer steps/day, 12(95% CI 2, 22) minutes less in light activity, 10(95% CI 5, 15) minutes less in moderate to vigorous PA [MVPA] and 22(95% CI 9, 35) minutes more in sedentary behaviour. 16% (n = 254) of men reported FOF, of whom 52% (n = 133) had fallen in the past year. Physical activity deficits were even greater in the men who reported that they were fearful of falling than in men who had fallen. Men who were fearful of falling took 1766(95% CI 1391, 2142) fewer steps/day than men who were not fearful, and spent 27(95% CI 18, 36) minutes less in light PA, 18(95% CI 13, 22) minutes less in MVPA, and 45(95% CI 34, 56) minutes more in sedentary behaviour. The significant differences in activity levels between (i) fallers and non-fallers and (ii) men who were fearful of falling or not fearful, were mediated by similar variables; lower exercise self-efficacy, fewer excursions from home and more mobility difficulties. CONCLUSIONS: Falls and in particular fear of falling are important barriers to older people gaining health benefits of walking and MVPA. Future studies should assess the longitudinal associations between falls and physical activity

Urgent revascularization of liver allografts after early hepatic artery thrombosis

Between April 1993 and May 1995, 17 adult orthotopic liver transplant recipients were found to have early hepatic artery thrombosis (HAT) after a median of 7 postoperative days (mean, 11). The HAT was diagnosed in all cases by duplex ultrasound. Thrombectomy was performed with urgent revascularization (UR), using an interposition arterial graft procured from the cadaveric liver donor, and arterial patency was verified with intraoperative angiography. In seven cases, intra-arterial urokinase was administered after the thrombectomy. Fifteen (88%) of the livers remained arterialized throughout the follow-up period (median, 15 months); the remaining two patients developed recurrent HAT after 6 and 8 months. Although there was a high rate of subsequent complications, 11 (65%) of the patients are alive without retransplantation, with a mean follow-up of 17 months. Despite having a patent hepatic artery, the remaining six patients (35%) died from infectious complications that usually were present before the UR. Thus, UR effectively restored arterial inflow in 88% of the patients with early HAT. The ultimate outcome was determined mainly by the presence of intra- abdominal complications at the time of UR. In conclusion, UR, rather than retransplantation, should be considered the prime treatment option for patients who develop early posttransplant HAT

Age-Related Attenuation of Dominant Hand Superiority

The decline of motor performance of the human hand-arm system with age is well-documented. While dominant hand performance is superior to that of the non-dominant hand in young individuals, little is known of possible age-related changes in hand dominance. We investigated age-related alterations of hand dominance in 20 to 90 year old subjects. All subjects were unambiguously right-handed according to the Edinburgh Handedness Inventory. In Experiment 1, motor performance for aiming, postural tremor, precision of arm-hand movement, speed of arm-hand movement, and wrist-finger speed tasks were tested. In Experiment 2, accelerometer-sensors were used to obtain objective records of hand use in everyday activities