Decision-related factors and attitudes toward donation in living related liver transplantation: ten-year experience.

INTRODUCTION: Living related liver transplantation (LRLT) has been performed since 1994 in Korea; more than 600 donors have contributed to our successful LRLT program for 10 years. Although the decision to donate is difficult and the donors need a formal psychosocial assessment, no system has been available to us for the assessment. This survey was performed as a presurveillance for the development of a psychosocial assessment protocol. METHODS: A survey questionnaire included 31 questions on general and medical characteristics, factors, and processes related to the decision for donation. Donors of partial livers at least 6 months ago during the period from December 1994 to August 2003 and whose address could be confirmed by telephone were enrolled in the study. RESULTS: A questionnaire was sent by mail to 441 contactable donors of whom 209 (47.4%) responded. Male-to-female ratio was 2:1 and mean age was 32.8 years (range: 16 to 60 years). The number of spousal donors was 120 (57.4%) and 164 (78.5%) donors were employed at the time of donation. Protestants, Buddhists, and Catholics were 29.2%, 19.1%, and 14.8%, respectively. Parents were the most common recipients (33.0%), followed by siblings (17.2%), extended family members (17.2%), and children (15.8%); one hundred eighty nine (90.4%) donors had decided by themselves, the major reason for donation in 192 (91.9%) donors was "to save the lives of family members and relatives." The first person who suggested donation was the donor (64.1%), followed by family members (23.9%) or the attending physicians (8.6%). Although 70.8% of donors answered that they were not hesitant to donate at the time of decision, 44.5% were uneasy at the possibility of being unable to sustain a normal life after donation, at their lack of knowledge on organ donation, and about the pain and fear of surgery. Family members and relatives (53.3%), medical personnel (46.7%), and previous donors (35.4%) were the preferable counselors compared to transplantation institutions and clergymen. The large majority (80.8%) of donors would encourage others to donate. CONCLUSIONS: Although the decision to donate was made by the donors themselves in most cases and they appeared firm and determined about their decision, a significant number of donors felt uneasy about possible complications of organ donation and effects on their lives after donation. A precise and formal psychosocial assessment protocol is needed to support and secure their decision before and after donation.

CBED and LACBED: characterization of antiphase boundaries.

Convergent-beam electron diffraction (CBED) and large-angle convergent-beam electron diffraction (LACBED) techniques are well adapted to the characterization of several types of crystal defects. In fact, dislocations, grain boundaries and stacking faults have already been successfully characterized with these methods. In the present paper, we describe the CBED and LACBED characterization of another type of crystal defect showing a special interest in materials science: antiphase boundaries (APBs). The first part of the paper is devoted to the determination of the effects of antiphase boundaries on CBED and LACBED patterns that could be expected from a theoretical point of view. It indicates that the superlattice excess lines present on these patterns are split into two lines with equal intensity when the incident beam is located on an APB. In the second part, we experimentally test these theoretical predictions on a specimen showing two different known types of antiphase boundaries. In a third part we indicate how these methods could be used to identify unknown APBs in a specimen. Finally, the advantages and disadvantages of both methods for the characterization of antiphase boundaries are discussed.

Central diabetes insipidus with Behçet's disease.

We encountered a case of Behçet's disease complicated with central diabetes insipidus. A hypothalamopituitary dysfunction is rare in Behçet's disease; only three cases of this association have been reported in the literature. Magnetic resonance imaging of the brain showed a dilatation of the left Sylvian vein and thickening of the pituitary stalk, which suggested intracranial vasculitic processes and lymphocytic infundibuloneurohypophysitis. The possible relationship of this disease combination is discussed as a form of autoimmune disease.

[Measurement of the common carotid arterial flow during parabolic flight in the anesthetized rat].

To measure the blood flow of a common carotid artery (CCA) during parabolic flight in the rat, we developed an animal double hold box (ADHB) made of styrene expanded form for the anesthetized rat to keep the animal at a proper posture in an aircaft. Twelve anesthetized rats weighing 291-342 g were surgically operated to mount a ultrasound flowmeter probe (1 mm size,1RS:Transonic Systems Inc.) around the right CCA and to insert a catheter into the right axillar artery for blood pressure measurement. These animals were held comfortably in ADHBs which were placed on the rack installed in the aircraft (MU-300). A total of 27 parabolic flights was performed and the blood flow was measured accurately in 9 rats. This special animal holding facility is useful for various types of animal experiments in an aircraft.

Purification and characterization of transmembrane forms of heparin-binding EGF-like growth factor.

Heparin-binding epidermal growth factor-like growth factor (HB-EGF), whose cDNA has a predicted 208-codon open reading frame, is synthesized as a membrane-spanning precursor that is processed to release mature mitogenic proteins of approximately 73-87 amino acids in length. Previous work has focused on the structural and biological properties of secreted HB-EGF. In this study, human recombinant transmembrane HB-EGF, produced by expression of HB-EGF1-208 cDNA in a baculovirus system, has been isolated, purified, and characterized structurally and biologically. Two isoforms of transmembrane HB-EGF (HB-EGFTM) were purified from membrane fractions of infected insect cells by a combination of heparin affinity chromatography and reversed-phase high performance liquid chromatography. The isoform designated as HB-EGFTM-1, a 21.5-kDa protein, yielded no N-terminal sequence, suggesting that it is N-terminally blocked. However, HB-EGFTM-II, a 24-kDa protein, was N-terminally sequenced and found to be initiated at Asp63 in the 208-amino acid residue primary translation product. This N terminus is the same as that determined for a 18-kDa isoform of secreted HB-EGF purified from the conditioned medium of insect cells expressing HB-EGF1-149 cDNA and is also identical to the N terminus of the longest form of secreted HB-EGF initially purified from human macrophage-like U-937 cell conditioned medium. HB-EGFTM-II cross-reacted on a Western blot with an antibody directed against the 16 C-terminal amino acids of the cytoplasmic tail of HB-EGF, indicating that it contains a putative transmembrane domain. HB-EGFTM-II was bioactive and stimulated the proliferation of BALB/c 3T3 cells and smooth muscle cells and the motility of smooth muscle cells, albeit with approximately 10-25% of the specific activity of secreted HB-EGF isoforms. We concluded that transmembrane HB-EGF is bioactive when isolated, consistent with the possibility of its functioning as a juxtacrine growth factor when still tethered to the cell.

Parathyroid hormone induces sequential c-fos expression in bone cells in vivo: in situ localization of its receptor and c-fos messenger ribonucleic acids.

Localization of PTH/PTH-related peptide (PTH/PTHrP) receptor mRNA and PTH induction of c-fos expression were examined in bones of 4-week-old rats by in situ hybridization. Receptor transcripts were most highly expressed by growth plate chondrocytes from lower proliferating to upper hypertrophic cell layers. PTH/PTHrP receptor mRNA also was expressed in osteoblasts as well as in some bone marrow stromal cells. Subcutaneous administration of human PTH-(1-84) (225 micrograms/kg) induced rapid, transient, and sequential expression of the protooncogene c-fos mRNA in cells in bone. Osteoblasts and chondrocytes expressing PTH/PTHrP receptor transcripts as well as some stromal cells expressed c-fos mRNA first (15-60 min), followed by transient expression in the majority of stromal cells and in osteoclasts (1-2 h). Delayed and transient induction of c-fos in cells with few or no detectable receptor transcripts suggests that PTH acts indirectly on stromal cells and osteoclasts by either stimulating osteoblasts to secrete a substance(s) that acts locally and/or inducing changes in cell-cell contacts between osteoblasts and adjacent cells.

[A multi-institutional study on the efficacy and toxicity of imipenem/cilastatin sodium in severe infections complicating hematological diseases and cancers in children. Study Group of Infectious Diseases in Pediatric Hematology/Oncology in Hokkaido].

A multi-institutional study was conducted between September 1990 and April 1992 to evaluate the efficacy and toxicity of imipenem/cilastatin sodium (IPM/CS) in severe infections in cases of granulocytopenia in children with hematological diseases and cancers. A total of 60 episodes of infection were treated with the drug, and an overall efficacy rate of 80% (48/60) was obtained. The efficacy rate in patients who were positive for Endospecy test was 90.0%. A group of patients who had previously received other antibiotics showed an efficacy rate of 79.2%, while the patients who had not received previous antibiotic treatment showed an efficacy rate of 80.6%. The difference between the 2 groups was statistically insignificant, however. Granulocyte counts appeared to have influence on the efficacy of the drug, but the influence was not strong. Three patients had nausea, vomiting and/or diarrhea, and 2 other patients showed abnormal liver function test parameters though they recovered soon after the cessation of the drug treatment. From these results, we have concluded that IPM/CS is an effective antibiotic for treatment of severe infections with hematological diseases and cancers in children.

[Structural anomalies of dog hemoglobin after ionizing irradiation]. / Strukturnye anomalii gemoglobina sobak pri vosdeistvii ioniziruiushchikh izluchenii.

Heterogeneity of dog hemoglobin is established with application of chromatographic analysis. Ionizing radiation (4 Grey) induces no changes in the ratio of hemoglobin components. The comparative dactylographical analysis of the hemoglobin components in norm and in different periods after irradiation revealed differences in responses to tryptophan in peptide T-25. The changes found are connected with disturbances in the structure of the DNA molecule as well as with modification of the protein molecule under conditions of radiation injury.