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Older candidates for kidney transplantation:Who to refer and what to expect?

World Journal of Transplantation 2016年第4期6卷 650-657页

作者： Beatrice P Concepcion Rachel C Forbes heidi M Schaefer Department of Medicine Division of Nephrology and Hypertension Vanderbilt University Medical Center Division of Kidney and Pancreas Transplantation Vanderbilt University Medical Center

The number of older end-stage renal disease patients being referred for kidney transplantation continues to increase. This rise is occurring alongside the continually increasing prevalence of older end-stage renal disease patients. Although older kidney transplant recipients have decreased patient and graft survival compared to younger patients, transplantation in this patient population is pursued due to the survival advantage that it confers over remaining on the deceased donor waiting list. The upper limit of age and the extent of comorbidity and frailty at which transplantation ceases to be advantageous is not known. Transplant physicians are therefore faced with the challenge of determining who among older patients are appropriate candidates for kidney transplantation. This is usually achieved by means of an organ systemsbased medical evaluation with particular focus given to cardiovascular health. More recently, global measures of health such as functional status and frailty are increasingly being recognized as potential tools in risk stratifying kidney transplant candidates. For those candidates who are deemed eligible, living donor transplantation should be pursued. This may mean accepting a kidney from an older living donor. In the absence of any living donor, the choice to accept lesser quality kidneys should be made while taking into account the organ shortage and expected waiting times on the deceased donor list. Appropriate counseling of patients should be a cornerstone in the evaluation process and includes a discussion regarding expected outcomes, expected waiting times in the setting of the new Kidney Allocation System, benefits of living donor transplantation and the acceptance of lesser quality kidneys.

关键词： Kidney transplant outcomes Frailty Elderly Expanded criteria donor Quality of life

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Tuberculosis in kidney transplant recipients:A case series

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World Journal of Transplantation 2017年第3期7卷 213-221页

作者： Manish Anand Ekta Nayyar Beatrice Concepcion Megha Salani heidi Schaefer Department of Medicine Division of NephrologyUniversity of Cincinnati Trihealth Infectious Disease Good Samaritan Hospital De-partment of Medicine Division of NephrologyVanderbilt University

Solid organ transplant recipients have an elevated risk of tuberculosis(TB) with high mortality. Data about TB in this population in the United States is sparse. We present four cases of active tuberculosis in kidney transplant recipients at our center. All patients had possible TB exposure prior to transplant and all were diagnosed with active TB within the first year of transplant. Disseminated TB was seen in half of the patients with extra-pulmonary TB being more common affecting lymph nodes, pericardium, and the kidney allograft. Delay in diagnosis from onset of symptoms ranged from fifteen days to two months. Two patients died from TB. TB is a largely preventable and curable disease. However, challenges remain in the diagnosis due to most recipients presenting with atypical symptoms. Physicians should maintain a high degree of suspicion for TB to promptly diagnose and treat posttransplant thereby minimizing complications. A review of the literature including the epidemiology, pathogenesis, clinical presentation, diagnosis and treatment options are discussed.

关键词： Mycobacterium tuberculosis Kidney transplant Disseminated disease Tuberculosis

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Cardiovascular surgery in Turner syndrome-early outcome and long-term follow-up

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World Journal of Cardiology 2020年第3期12卷 97-106页

作者： Margaret M Fuchs Christine Helena Attenhofer Jost Sameh M Said Donald J Hagler heidi M Connolly Joseph A Dearani Alexander C Egbe Department of Cardiovascular Medicine Mayo ClinicRochesterMN 55905United States Division of Pediatric Cardiothoracic Surgery Masonic Children’s HospitalUniversity of MinnesotaMinneapolisMN 55905United States Division of Pediatric Cardiology Mayo ClinicRochesterMN 55905United States Department of Cardiovascular Surgery Mayo ClinicRochesterMN 55905United States

BACKGROUND Cardiovascular disease is the leading cause of death in patients with Turner syndrome(TS),and cardiovascular surgery is frequently required for management of these *** is associated with medical comorbidities than can complicate the care of this patient *** To describe the cardiovascular surgical outcomes of patients with *** A retrospective case series was compiled of 51 consecutive TS patients who had at least one cardiovascular surgery at Mayo Clinic Rochester from *** baseline clinical data of these patients were reviewed including demographics,medical comorbidities,congenital heart disease history,and *** reports were analyzed in *** reports and surgical hospital courses were ***-term mortality was determined using medical records and the Social Security Death *** analysis was performed with the Kaplan Meier *** The cohort comprised 51 TS patients,average age at the time of surgery at Mayo Clinic was 28(8-41)years,and 23(45%)patients were under the age of *** the time of first Mayo Clinic surgery,18(35%)patients had previously undergone cardiac surgery at another *** most common procedures were repair of aortic coarctation in 14(28%)patients,aortic valve replacement in 6(12%)patients,and composite aortic root/ascending aorta replacement in 7(14%)patients,with 7 patients undergoing repair of more than one *** dissection required operative intervention in 5 *** initial Mayo Clinic surgery,subsequent operations were required in 6(13%)*** hospital length of stay was 6±2 *** were 4(8%)early surgical *** from death was 97%and 89%at 10 and 20 years,and the freedom from reoperation was 93%and 81%at 10 and 20 *** Cardiovascular surgery is associated with 8%early mortality given the medical complexity of TS *** who survive to dismissal have good *** cardiovas

关键词： Turner syndrome Cardiac surgery Congenital heart disease Aortic dissection Outcome Reoperation

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Role of soluble factors and three-dimensional culture in in vitro differentiation of intestinal macrophages

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World Journal of Gastroenterology 2007年第7期13卷 1032-1041页

作者： Tanja Spoettl Martin Hausmann Katrin Menzel heidi Piberger Hans Herfarth Juergen Schoelmerich Frauke Bataille Gerhard Rogler Department of Internal Medicine I and Institute of Pathology University of Regensburg Regensburg 93042 Germany

AIM: To examine the factor(s) involved in differentiation of intestinal macrophages (IMACs) using a recently established in vitro model. METHODS: To test whether soluble or membrane bound factors induce IMAC-differentiation, freshly elutriated monocytes (MO) were incubated with conditioned media or cell membranes of intestinal epithelial cells (IEC) or cultured with IEC in transwell systems. To determine the importance of an active migration of MO, three- dimensional aggregates from a 1:1-mixture of MO and IEC were examined by immunohistochemistry and flow cytometry. Apoptosis was examined by caspase-3 Western blots. Extracellular matrix production in differentiation models was compared by immunohistochemistry. RESULTS: IMAC differentiation was observed in a complex three-dimensional co-culture model (multicellular spheroid, MCS) with IEC after migration of MO into the spheroids. By co-culture of MO with conditioned media or membrane preparations of IEC no IMAC differentiation was induced. Co-culture of MO with IEC in transwell- cultures, with the two cell populations separated by a membrane also did not result in intestinal-like differentiation of MO. In contrast to IEC-spheroids with immigrating MO in mixed MCS of IEC and MO only a small subpopulation of MO was able to survive the seven day culture period. CONCLUSION: Intestinal-like differentiation of MO in vitro is only induced in the complex three-dimensional MCS model after immigration of MO indicating a roleof cell-matrix and/or cell-cell interactions during the differentiation of IMACs.

关键词： Intestinal macrophages Intestinal epithelialcells Multicellular spheroids Inflammatory boweldisease Tolerance differentiation

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Patterns of genomic and phenomic diversity in wine and table grapes

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Horticulture Research 2017年第1期4卷 181-191页

作者： ZoëMigicovsky Jason Sawler Kyle M Gardner Mallikarjuna K Aradhya Bernard H Prins heidi R Schwaninger Carlos D Bustamante Edward S Buckler Gan-Yuan Zhong Patrick J Brown Sean Myles Department of Plant Food and Environmental SciencesFaculty of AgricultureDalhousie UniversityTruroB2N 5E3NSCanada Anandia Labs VancouverV6T 1Z4BCCanada Agriculture and Agri-Food Canada Fredericton Research and Development CentreFrederictonE3B 4Z7NBCanada United States Department of Agriculture-Agricultural Research Service National Clonal Germplasm RepositoryUniversity of CaliforniaDavis95616CAUSA United States Department of Agriculture Agricultural Research ServiceGrape Genetics Research UnitNew York State Agricultural Experiment StationCornell UniversityGeneva14456NYUSA Department of Genetics Stanford UniversityStanfordCA 94305USA Department of Plant Breeding and Genetics Cornell UniversityIthaca14853NYUSA United States Department of Agriculture Agricultural Research ServicePlant Genetic Resources UnitNew York State Agricultural Experiment StationCornell UniversityGeneva14456NYUSA Department of Crop Science University of IllinoisUrbana61801ILUSA

Grapes are one of the most economically and culturally important crops worldwide,and they have been bred for both winemaking and fresh *** we evaluate patterns of diversity across 33 phenotypes collected over a 17-year period from 580 table and wine grape accessions that belong to one of the world’s largest grape gene banks,the grape germplasm collection of the United States Department of *** find that phenological events throughout the growing season are correlated,and quantify the marked difference in size between table and wine *** pairing publicly available historical phenotype data with genome-wide polymorphism data,we identify large effect loci controlling traits that have been targeted during domestication and breeding,including hermaphroditism,lighter skin pigmentation and muscat *** for larger berries in table grapes was traditionally concentrated in geographic regions where Islam predominates and alcohol was prohibited,whereas wine grapes retained the ancestral smaller size that is more desirable for winemaking in predominantly Christian *** uncover a novel locus with a suggestive association with berry size that harbors a signature of positive selection for larger *** results suggest that religious rules concerning alcohol consumption have had a marked impact on patterns of phenomic and genomic diversity in grapes.

关键词： harbor religious crops

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Recycled fibres and fibrous sludge as reinforcement materials in injection moulded polypropylene(PP)and poly(lactic acid)(PLA)composites

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Journal of Bioresources and Bioproducts 2017年第3期2卷 116-122页

作者： Elina Pääkkönen Lisa Wikström heidi Peltola Kyösti valta Elias Retulainen Department of Fibres and Biobased Materials VTT Technical Research Centre of Finland LtdKoivurannantie 1PO Box 1603JyväskyläFI-40101Finland Department of Fibres and Biobased Materials VTT Technical Research Centre of Finland LtdSinitaival 6PO Box 1300Tampere FI-33101Finland

Wood flour or sawdust is often used as filler in conventional wood plastic composite(WPC)***,there has been an increasing interest to the use of wood pulp fibres in reinforced plastic applications,because they can provide enhanced strength properties and better biodegradability characteristics for the *** research compares the effect of recycled fibres or side streams of paper as reinforcement in poly(lactic acid)(PLA)or polypropylene(PP)*** from liquid packaging board and non-deinked old newspapers,and fibrous sludge from recycling processes are compared with virgin softwood kraft pulp *** were produced by melt processing to a fibre content of 30%(or 10%fibrous sludge),and the mechanical properties were *** fibres provided comparable,or even higher,plastic reinforcement than virgin softwood *** PP composites,the differences in mechanical properties between different fibre types were relatively *** sludge decreased the mechanical performance of composites but can be considered as cheap filler in cases when mechanical properties are not *** possibility to use low-cost materials like recovered paper or deinking sludge in wood plastic composites is an interesting option for future sustainable applications.

关键词： Wood fibres Liquid packaging board Fibrous sludge Recycled fibres Biocomposite Mechanical properties

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Neutralizing antibodies in hepatitis C virus infection

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World Journal of Gastroenterology 2007年第36期13卷 4824-4830页

作者： Mirjam B Zeisel Samira Fafi-Kremer Isabel Fofana heidi Barth Franoise Stoll-Keller Michel Doffo■l Thomas F Baumert Inserm U748Strasbourg France Université Louis Pasteur Strasbourg France Liver Diseases Branch National Institute of Diabetes and Digestive and Kidney Diseases National Institutesof Health Bethesda MD United States Universitaires de Strasbourg Strasbourg France Service d'Hépatogastro-entérologie Hpitaux Universitaires de Strasbourg

Hepatitis C virus (HCv) is a major cause of hepatitis world-wide. The majority of infected individuals develop chronic hepatitis which can then progress to liver cirrhosis and hepatocellular carcinoma. Spontaneous viral clearance occurs in about 20%-30% of acutely infected individuals and results in resolution of infection without sequaelae. Both viral and host factors appear to play an important role for resolution of acute infection. A large body of evidence suggests that a strong, multispecific and long-lasting cellular immune response appears to be important for control of viral infection in acute hepatitis C. Due too the lack of convenient neutralization assays, the impact of neutralizing responses for control of viral infection had been less defined. In recent years, the development of robust tissue culture model systems for HCv entry and infection has finally allowed study of antibody-mediated neutralization and to gain further insights into viral targets of host neutralizing responses. In addition, detailed analysis of antibody-mediated neutralization in individual patients as well as cohorts with well defined viral isolates has enabled the study of neutralizing responses in the course of HCv infection and characterization of the impact of neutralizing antibodiesfor control of viral infection. This review will summarize recent progress in the understanding of the molecular mechanisms of antibody-mediated neutralization and its impact for HCv pathogenesis.

关键词： Hepatitis C virus virus-host cell interaction viral entry Neutralizing antibodies

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The growth of Staphylococcus aureus and Escherichia coli in low-direct current electric fields

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International Journal of Oral Science 2014年第1期6卷 7-14页

作者： Dunya Zituni heidi Schtt-Gerowitt Marion Kopp Martin Krnke Klaus Addicks Christian Hoffmann Martin Hellmich Franz Faber Wilhelm Niedermeier Department of Prosthetic Dentistry School of Dental and Oral Medicine Cologne University Institute for Medical Microbiology Immunology and HygieneCologne University Institute for Anatomy I Cologne University Institute for Medical Statistics Informatics and Epidemiology Cologne University Department of Pre-Clinical Dentistry School of Dental and Oral Medicine Cologne University

Electrical potentials up to 800 mv can be observed between different metallic dental restorations. These potentials produce fields in the mouth that may interfere with microbial communities. The present study focuses on the impact of different electric field strengths （EFS） on the growth of Staphylococcus aureus （ATCC 25923） and Escherichia coil （ATCC 25922） in vitro. Cultures of S. aureus and E. coil in fluid and gel medium were exposed to different EFS. Effects were determined by calculation of viable counts and measurement of inhibition zones. In gel medium, anodic inhibition zones for S. aureuswere larger than those for E. coliat all field strength levels. In fluid medium, the maximum decrease in the viable count of S. aureus cells was at 10 v.m-1. Field-treated S. aureus cells presented ruptured cell walls and disintegrated cytoplasm. Conclusively, S. aureus is more sensitive to increasing electric field strength than E. coll.

关键词： direct current Escherichia coli electrogaNanism gold electrode Staphylococcus aureus

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The LEGUE high latitude bright survey design for the LAMOST pilot survey

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Research in Astronomy and Astrophysics 2012年第7期12卷 792-804页

作者： Yue-Yang Zhang Jeffrey L. Carlin Fan Yang Chao Liu Li-Cai Deng heidi Jo Newberg Hao-Tong Zhang Sebastien Lepine Yan Xu Shuang Gao Norbert Chfi' stlieb Zhan-Wen Han Jin-Liang Hou Hsu-Tai Lee Xiao-Wei Liu Kai-Ke Pan Hong-Chi Wang Key Lab for Optical Astronomy National Astronomical Observatories Chinese Academy ofSciences Beijing 100012 China Graduate University of Chinese Academy of Sciences Beijing 100049 China Department of Astrophysics Division of Physical Sciences American Museum of NaturalHistory Central Park West at 79th Street New York NY 10024 USA Department of Physics Applied Physics and Astronomy Rensselaer Polytechnic Institute 1108th Street Troy NY 12180 USA carlij@rpi.edu University of Heidelberg Landesstemwarte K6nigstuhl 12 D-69117 Heidelberg Germany Yunnan Astronomical Observatory Chinese Academy of Sciences Kunming 65()011 China Shanghai Astronomical Observatory Chinese Academy of Sciences Shangthai 200030 China Institute of Astronomy and Astrophysics Academia Sinica EO. Box 23-141 Taipei 106 China Department of Astronomy & Kavli Institute of Astronomy and Astrophysics Peking UniversityBeijing 100871 China Apache Point Observatory PO Box 59 Sunspot NM 88349 USA Purple Mountain Observatory Chinese Academy of Sciences Nanjing 210008 China

We describe the footprint and input catalog for bright nights in the LAMOST Pilot Survey, which began in October 2011. Targets are selected from two stripes in the north and south Galactic Cap regions, centered at δ = 29°, with 10° width in declination, covering right ascensions of 135° to 290° and -30° to 30° re- spectively. We selected spectroscopic targets from a combination of the SDSS and 2MASS point source catalogs. The catalog of stars defining the field centers （as re- quired by the Shack-Hartmann wavefront sensor at the center of the LAMOST field） consists of all v 〈 8m stars from the Hipparcos catalog. We employ a statistical selection algorithm that assigns priorities to targets based on their positions in mul- tidimensional color/magnitude space. This scheme overemphasizes rare objects and de-emphasizes more populated regions of magnitude and color phase space, while en- suring a smooth, well-understood selection function. A demonstration of plate design is presented based on the Shack-Hartmann star catalog and an input catalog that was generated by our target selection routines.

关键词： surveys: LAMOST -- techniques: spectroscopic -- Galaxy: stellar con-tent

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Occult hepatitis B virus infection among Egyptian blood donors

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World Journal of Hepatology 2013年第2期5卷 64-73页

作者： Zeinab N Said Manal H El Sayed Iman I Salama Enas K Aboel-Magd Magda H Mahmoud Maged El Setouhy Faten Mouftah Manal B Azzab heidi Goubran Amal Bassili Gamal E Esmat Microbiology and Immunology Department Faculty of Medicine(for Girls)AlAzhar University11511 CairoEgypt Pediatric Department Hematology/Oncology DivisionFaculty of MedicineAin Shams University11511 CairoEgypt Community Medicine Department National Research Center12411 GizaEgypt Ain-Shams Maternity and Women's University Hospital 11511 CairoEgypt Community Enviromental and Occupational Medicine DepartmentFaculty of MedicineAin Shams University11511 CairoEgypt National Blood Transfusion Center 11511 CairoEgypt TB Surveillance officer STB/WHO/EMRO.Focal pointTropical Disease Research11511 CairoEgypt Tropical Medicine Department Faculty of Medicine-Cairo University11511 CairoEgypt

AIM:To identify blood donors with occult hepatitis B virus(HBv) infection(OBI) to promote safe blood ***:Descriptive cross sectional study was conducted on 3167 blood donors negative for hepatitis B surface antigen(HBsAg),hepatitis C antibody(HCv Ab) and human immunodeficiency virus *** were subjected to the detection of alanine aminotransferase(ALT) and aspartate transaminase(AST) and screening for anti-HBv core antibodies(total) by two different techniques;[Monoliza antibodies to hepatitis B core(Anti-HBc) Plus-Bio-Rad] and(ARC-HBc total-ABBOT).Positive samples were subjected to quantitative detection of antibodies to hepatitis B surface(anti-HBs)(ETI-AB-AUK-3,Dia Sorin-Italy).Serum anti-HBs titers > 10 IU/L was considered *** HBv DNA by real time polymerase chain reaction(PCR)(QIAGEN-Germany) with 3.8 IU/mL detection limit was estimated for blood units with negative serum anti-HBs and also for 32 whose anti-HBs serum titers were > 1000 IU/***,265 recipients were included,34 of whom were followed up for 3-6 *** were investigated for ALT and AST,HBv serological markers:HBsAg(ETI-MAK-4,Dia Sorin-Italy),anti-HBc,quantitative detection of anti-HBs and ***:525/3167(16.6%) of blood units were positive for total anti-HBc,64% of those were antiHBs *** by ARCHITECT anti-HBc assay were carried out for 498/525 anti-HBc positive samples,where 451(90.6%) confirmed *** for anti-HBc was considered confirmed only if two positive results were obtained for each sample,giving an overall prevalence of 451/3167(14.2%) for total *** DNA was quantified by real time PCR in 52/303(17.2%) of anti-HBc positive blood donors(viral load range:5 to 3.5 x 105 IU/mL) with a median of 200 IU/mL(mean:1.8 x 104 ± 5.1 x 104 IU/mL).AntiHBc was the only marker in 68.6% of *** and multivariate logistic analysis for identifying risk factors associated with anti-HBc and HBv-DNA positivity a

关键词： Hepatitis B virus Total anti-HBc Occult hepatitis B virus infection Hepatitis B surface antigen Hepatitis B virus-DNA

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