ABSTRACT
Kidney transplantation is the best treatment option for kidney failure. Major medical progress has been made in the field of renal transplantation over the last 40 years. The surgical procedure has been standardized and the complication rate is low. Overall, the outcome of renal transplantation is excellent and has improved over time. Vascular complications after renal transplantation are the most frequent type of complication following urological complications. Renal artery spasm [RAS] following manipulation of renal artery is a common problem during live donor nephrectomy [LDN]. The aim of this study was to determine whether or not it is necessary to wait for reverse of RAS and resumption of urinary flow before nephrectomy. In this clinical trial 16 cases of LDN who developed RAS during surgery received intra-arterial injection of 40 mg papaverine. In 8 cases surgery continued towards nephrectomy and in other 8 cases we waited for reverse of RAS. All analyses were performed using SPSS-11. In both groups urinary flow started a few minutes [Mean, 12 min] after declamping of transplanted kidney and normal renal consistency and color were achieved. There was no significant difference between urinary volume during 12 h after transplantation in two groups. The results showed that it might not be necessary to wait for reverse of RAS before LDN. Both patient [less anesthesia complications] and hospital [less expenses] will benefit from this time saving
ABSTRACT
In periodontal diseases, pathogen discrimination by the immune system is an essential factor for triggering host responses. The Toll-like receptor family is responsible for recognition of evolutionarily conserved microbial structures like bacterial lipopolysaccharide [LPS] and activates signaling pathways that eventually lead to immune responses. The aim of the present study was to use real-time PCR to compare TLR-2 and TLR-4 gene expression levels in diseased sites and healthy sites of gingival tissue from periodontitis patients. Gingival biopsies were harvested from healthy sites [BOP- and PD /= 5mm] of 20 patients with moderate to severe chronic periodontitis. RNA was extracted from all gingival biopsies. Real-time PCR was performed to evaluate relative quantities of TLR-2 and TLR-4 mRNA. Statistical analyses were done using the Paired Wilcoxon test [2 related sample tests]. The relative expression levels of both TLR-2 and TLR-4 were significantly higher at diseased sites [2.41 +/- 2.06 and 1.25 +/- 1.16] than at healthy sites [0.91 +/- 1.04 and 0.41+0.60] [P<0.01]. Periodontal disease can significantly increase TLR-2 and TLR-4 gene expression in gingival tissues
Subject(s)
Humans , Toll-Like Receptor 2 , Toll-Like Receptor 4 , Real-Time Polymerase Chain Reaction , Gene Expression , GingivaABSTRACT
Several cytokines, including IL-6 have been implicated in the pathogenesis of periodontal disease. It is established that monocytes from periodontitis subjects show an increased production of IL-6 as compared to healthy subjects. However, little is known about the effect of periodontal treatment on IL-6 production by monocytes in subsets of periodontitis patients. The aim of the present study was to evaluate the effect of surgical periodontal treatment on IL-6 production of peripheral blood monocytes [PBM] in aggressive periodontitis patients [AP] and chronic periodontitis patients [CP] before and after stimulation by E.coli LPS. Fifteen AP patients, 15 CP patients and 15 periodontally healthy subjects [PH] took part in the study. PBM IL-6 production was measured, using ELISA, before and after stimulation of cultured PBM cells by 0.1 jig/mi LPS of Emit. Following full-mouth non-surgical and surgical periodontal treatment of the AP and CP groups, the same measurements were repeated for these two groups. LPS-stimulated lL-6 production was significantly greater than non- stimulated IL-6 for all 3 groups. Before periodontal treatment, LPS-stimulated TL-6 production of the AP group was significantly greater than the other 2 groups. Periodontal treatment did not result in a significant decrease in unstimulated or LPS-stimulated IL-6 production by PBM cells in AP and CP patients. No correlation was detected between TL6 levels and baseline clinical parameters or changes in clinical parameters. PBM cells in AP patients might be hyper-responsive in terms of IL-6 production. This hyper-responsiveness does not seem to return to that of healthy subjects even after a successful periodontal treatment. Moreover, the regulation of host inflammatory mechanisms upon LPS challenge might be different between AP and CP patients