Significance of the Pathologic Findings in Implantation Biopsies for Kidney Allografts Survival.

BACKGROUND: There is no consistent association between individual histological lesions and composite scores in donor kidney biopsy and transplant outcomes. OBJECTIVE: To evaluate which acute or chronic individual histological lesions and composite scores in donor kidney were associated with graft survival in the recipient. METHODS: We investigated the association of individual histological lesions and 8 composite scoring systems in implantation biopsies of cadaveric (n=101) and living (n=29) kidneys with 5-year death-censored graft survival. RESULTS: We found a high frequency of chronic lesions in donor kidneys, mostly associated with arteriosclerosis, and less dependent from donor age. Acute, chronic, and total Banff scores for post-transplant biopsies, chronic and total Banff scores for pre-implant biopsies, donor damage score and chronic damage score predicted death-censored graft loss. However, only chronic and total Banff-scores had significant effects in multivariate model. Chronic pre-implant and total post-transplant Banff scores demonstrated the highest area under the curve (AUC) of 0.722 and 0.717, respectively. Among individual lesions, glomerulosclerosis ≥20%, interstitial inflammation >0, arteriosclerosis =3, arteriolar hyalinosis >0, and interstitial fibrosis >0, assessed with Banff-grading criteria, were associated with lower allograft survival. We created the Donor Kidney Damage Index (DKDI), by summing regression coefficients for these lesions, which yielded the AUC of 0.747. When combined with retransplantation, cold ischemia time and acute rejection, DKDI, chronic pre-implant and total post-transplant Banff scores further improved their predictive accuracy, yielding AUCs of 0.842, 0.807, and 0.802, respectively. CONCLUSION: DKDI, chronic pre-implant and total post-transplant Banff scores alone and combined with clinical variables may facilitate decision making in post-transplant period.

[The feasibility of using Quick Dementia Rating System in clinical practice: results of a multi-center prospective validation study]. / Vozmozhnost' ispol'zovaniia shkaly bystroi otsenki dementsii v klinicheskoi praktike: rezul'taty mnogotsentrovogo prospektivnogo issledovaniia.

AIM: To determine the sensitivity and specificity of the Quick Dementia Rating System (QDRS), a 10-item questionnaire for the assessment of cognitive, behavioral, and functional impairments, in the Russian population. MATERIAL AND METHODS: The authors examined 2357 patients,1479 female (63%) and 878 male (37%), with subjective cognitive impairment (SCI), mild cognitive impairment (MCI) or dementia. Their average age was 73,1±9,7. All patients were assessed using QDRS and MMSE on baseline visits and reassessed after 1, 3, and 6 months. RESULTS: The sensitivity and specificity of QDRS were 79,2% and 81,2%, respectively, at cut-interval of more than 7 points. There was a strong inverse correlation between QDRS and MMSE indicators (r=-0,740). QDRS was the most sensitive for the detection of severe dementia (sensitivity of 78,2% and specificity of 85,2%), while for mild and moderate dementia the sensitivity was high (79,4% and 81,6%) and specificity was low (56,6% and 61,9%, respectively). The sensitivity and specificity of separate subtests were variable. CONCLUSION: The QDRS sensitivity and specificity allow recommending it for clinical practice. The questionnaire is the most sensitive to detect more severe cognitive impairment.

Rupture and recoil of bent-core liquid crystal filaments.

The recoil process of free-standing liquid crystal filaments is investigated experimentally and theoretically. We focus on two aspects, the contraction speed of the filament and a spontaneously formed undulation instability. At the moment of rupture, the filaments buckle similarly to the classical Euler buckling of elastic rods. The tip velocity decays with decreasing filament length. The wavelength of buckling affinely decreases with the retracting filament tip. The energy gain related to the decrease of the total length and surface area of the filaments is mainly dissipated by layer rearrangements during thickening of the fibre. A flow back into the meniscus is relevant only in the final stage of the recoil process. We introduce a model for the quantitative description of the filament retraction speed. The dynamics of this recoil behaviour may find relevance as a model for biology-related filaments.

[URINE UNDER CHRONIC DYSFUNCTION OF RENAL ALLO-TRANSPLANT].

The study was organized to provide additional characteristic of chronic dysfunction of renal allo-transplant using such biomarkers of serum and urine as enzymes (alanine aminotransferase), aspartate aminotransferase, gamma- glutamiltransferase, alkaline phosphatase, N-acetyl-ß-D-glucosaminidase, interleukins (IL-2, IL-8, IL-10), beta-2- microglobulin. The chronic dysfunction of renal allo-transplant is characterized by increasing of concentration of IL-10 and beta-2-microglobulin in serum and increasing of concentration of beta-2-microglobulin, IL-2, IL-8 in urine and increasing of activity of N-acetyl-ß-D-glucosaminidase, alkaline phosphatase, aspartate aminotransferase, gamma-glutamiltransferase as compared with patients with satisfactory function of renal allo-transplant. The multivariant logistic regression analysis established that only activity of N-acetyl-ß-D-glucosaminidase in urine was reliably independently related to chronic dysfunction of renal allo-transplant. It is assumed that increasing of concentration of beta-2-microglobulin in serum testifies glomerular dysfunction and in urine--tubular dysfunction of renal allo-transplant. The enzymeuria indicates continuing damage of epithelium of proximal tubules of nephron. The classification of patients with satisfactory function and chronic dysfunction of renal allo-transplant established that the highest indicators of square under ROC-curves had concentration of beta-2-microglobulin in serum (0.858 ± 0.061) and urine (0.733 ± 0.079) and activity of N-acetyl-ß-D-glucosaminidase in urine (0.701 ± 0.061). To specify diagnosis of chronic dysfunction of renal allo-transplant the most useful (ratio of likelihood of positive result 10 and 11 correspondingly) are tests of beta-2- microglobulin in serum (more than 8.55 mkg/ml) and N-acetyl-ß-D-glucosaminidase/creatinine in urine (more than 34 nmol/(sl)/ mmol/l). These discoveries require further validation and confirmation by implementation of morphological analysis of bioptat of renal allo-transplant.

Biaxial nematic order induced by smectic fluctuations.

We report on a series of measurements on the microscopic structure and the magneto-optical properties of a calamitic liquid crystalline compound in its nematic phase. Structural studies show the existence of short-range, tilted smectic order consistent with pretransitional effects above an underlying smectic phase. Concomitantly, magneto-optical results exhibit the existence of an optic axis not collinear with the uniaxial director. This apparent biaxial nature is discussed within the context of coupling between the tensor nematic and the smectic order parameters.

Elasticity of lyotropic chromonic liquid crystals probed by director reorientation in a magnetic field.

Using a magnetic Frederiks transition technique, we measure the temperature and concentration dependences of splay K1, twist K2, and bend K3 elastic constants for the lyotropic chromonic liquid crystal sunset yellow formed through noncovalent reversible aggregation of organic molecules in water. K1 and K3 are comparable to each other and are an order of magnitude higher than K2. At higher concentrations and lower temperatures, K1 and the ratios K1/K3 and K1/K2 increase, which is attributed to elongation of self-assembled lyotropic chromonic liquid crystal aggregates, a feature not found in conventional thermotropic and lyotropic liquid crystals formed by covalently bound units of a fixed length.

Magneto-optical technique for detecting the biaxial nematic phase.

The existence of the elusive biaxial phase has been the subject of much discussion since it was predicted by Freiser in 1970. More recently, there have been numerous attempts to find a thermotropic liquid crystal that exhibits a biaxial phase and with this, conflicting reports about whether such a phase has been positively identified in bent-core liquid crystals. One reason for the discrepancy is that there is currently no way to rule out surface effects or anchoring transitions, both of which may give a false positive identification of a uniaxial-biaxial nematic transition. We have developed a technique that uses a magnetic field to align the uniaxial director, thus widening its application to any bent-core nematic material.

Magnetic-field induced isotropic to nematic liquid crystal phase transition.

We report on measurements of magnetic-field induced nematic order in the bent-core liquid crystal 4-chlororesorcinol bis[4-(4-n-dodecyloxybenzoyloxy) benzoate]. Using the 31 T solenoid at the National High Magnetic Field Laboratory, we have observed, at temperatures less than 1 degrees above the clearing point, a first-order transition to the nematic phase. The critical magnetic field at which this occurs increases with temperature. We discuss these results within the context of both Maier-Saupe and Landau-de Gennes mean-field models for the nematic-isotropic transition. The implications of possible tetrahedratic order are also discussed. To our knowledge, this is the first observation of such a magnetic-field induced transition in a thermotropic liquid crystal; the reasons for which this behavior is now attainable are discussed.

[Multiple primary malignant neoplasms of the large intestine]. / Pervichno-mnozhestvennye zlokachestvennye novoobrazovaniia tolstoi kishki.

Of the 3182 patients with malignant tumors of the large intestine, in 140 (4.4%), the primary multiple malignant neoplasms were revealed: in 59 (42.1%) of them--the synchronous, in 81 (57.9%)--the metachronous ones. Surgical treatment was performed in 137 (97.9%) patients, including the radical treatment--115 (83.9%). The postoperative lethality was 7.3%. 75.3% of the patients are alive for five years, 21.3%--for ten years.

[Continuous long-term treatment with diuretics of hypertension and the status of the renin-angiotensin-aldosterone system]. / O dlitel'nom nepreryvnom lechenii diuretikami bol'nykh gipertonicheskoi bolezn'iu i sostoianie renin-angiotenzin-al'dosteronovoi sistemy.

One hundred fifty eight patients with essential hypertension (both in- and out-patients) at stages IIA and IIB were treated with diuretics: furosemide (120 mg/day) during three days followed by hydrochlorothiazide in the doses that allow maintaining the renal sodium and water transport of the changed level. Criteria developed for prognosis of the efficiency of diuretic therapy according to the degree of reduction of the mean BP and plasma renin activity after 3-day furosemide intake; indications were worked out for a simultaneous prescription of the potassium-sparing drug amiloride. A good hypotensive effect was noted (reduction of the mean BP by 10 mm Hg) during the first month of treatment in 60 and 70% of in-patients, and in 22 and 40% out-patients with IIB and IIA stages of the disease, respectively. During 6 months of prolonged treatment with diuretics (1-2 years) the sensitivity of the patients to the therapy was increased that permitted the dose of hydrochlorothiazide to be reduced to 25 mg a day or every other day. Patients with good hypotensive effect of therapy were noted to have less pronounced degree of activation of the renin-angiotensin-aldosterone system, than that in patients with ineffective treatment.

[Detection and prophylactic treatment of arterial hypertension at an industrial enterprise]. / Vyiavlenie i profilakticheskoe lechenie arterial'noi gipertenzii na promyshlennom predpriiatii.

Examination was conducted of 390 men (84.2%) aged from 20 to 38 and of 1116 men of 40 to 54 years of age. Arterial hypertension was found in 39% of the examined. One year later the incidence of arterial hypertension in the older age group decreased to 25.4%. Repeated examination revealed increased arterial pressure in 66.7% of persons of the 40- to 54-year-old group. Regular treatment of arterial hypertension conducted a the medical center of the enterprise for 1 year raised the effectiveness of treatment form 2.7 to 62.2%.