Successful Heart Transplantation After Desensitization in a Patient With Extremely High Panel-Reactive Antibody Levels and Pretransplant Donor-Specific Antibody: A Case Report.

Elevated panel-reactive antibody (PRA) levels serve as a significant risk factor for allograft survival and episodes of rejection after heart transplantation (HTX). Patients with high PRA levels tend to show expressions of donor-specific human leukocyte antigen antibodies (DSA), which can cause catastrophic hyperacute rejection after HTX. Therefore, such highly sensitized patients are required to undergo strategic perioperative desensitization therapy. We describe a successful HTX after desensitization in a patient with extremely high PRA levels and pretransplant DSA positivity.

Sulcus subarachnoid hemorrhage is a common stroke subtype in patients with implanted left ventricular assist devices.

BACKGROUND AND PURPOSE: Stroke is one of the major complications observed in patients with an implanted left ventricular assist device (LVAD). The purpose of this study was to clarify the types and characteristics of acute stroke in patients after LVAD implantation by using brain computed tomography (CT) findings. METHODS: Between 2005 and 2012, 110 consecutive patients who underwent LVAD implantation were reviewed. The most commonly used device was the pulsatile extracorporeal LVAD. Amongst them, 49 patients suffered from acute stroke at least once with a total of 115 stroke events. The clinical categories, lesion sites, laboratory data and CT findings of each acute stroke event were analyzed. RESULTS: Cerebral infarction (35 patients, 72 events), cerebral hemorrhage (25 patients, 31 events) and subarachnoid hemorrhage (SAH) (23 patients, 33 events) were identified. A mean of 2.3 stroke events occurred per person. Of the 72 infarction events, multiple infarctions were observed in 29 events. Of the cerebral hemorrhage events (n = 31), almost all were subcortical lesions (n = 27) and none were observed in the basal ganglia. Of the 23 patients with SAH events (n = 33), SAH localized within a single sulcus, sulcus SAH, was observed in 25 events. CONCLUSIONS: Computed tomography findings of acute stroke after implantation of an LVAD are characteristically multifocal cortical lesions, regardless of brain infarction and hemorrhage. Unexpectedly, sulcus SAH was a common stroke subtype in patients with implanted LVADs. Sulcus SAH should be carefully examined in patients after LVAD implantation, when they complain of non-specific neurological complaints.

Real-space imaging of alternate localization and extension of quasi-two-dimensional electronic States at graphite surfaces in magnetic fields.

We measured the local density of states (LDOS) of a quasi-two-dimensional (2D) electron system near point defects on a surface of highly oriented pyrolytic graphite with scanning tunneling microscopy and spectroscopy. Differential tunnel conductance images taken at very low temperatures and in high magnetic fields show a clear contrast between localized and extended spatial distributions of the LDOS at the valley and peak energies of the Landau level spectrum, respectively. The localized electronic state has a single circular distribution around the defects with a radius comparable to the magnetic length. The localized LDOS is in good agreement with a spatial distribution of a calculated wave function for a single electron in 2D in a Coulomb potential in magnetic fields.

Determinants of Staphylococcus aureus nasal carriage.

Nasal carriage of Staphylococcus aureus has been identified as a risk factor for community-acquired and nosocomial infections. We screened 230 donors of diverse ethnic and socioeconomic backgrounds and identified 62 (27%) whose nasal secretions were colonized by S. aureus. In 18 donors in whom the various regions of the nasal luminal surface were separately sampled, the predominant region of S. aureus colonization was the moist squamous epithelium on the septum adjacent to the nasal ostium. Nasal fluid from carriers was defective in killing endogenous S. aureus and nasal carrier isolates of S. aureus but not a laboratory S. aureus strain. Transmission electron microscopy revealed that S. aureus isolates incubated in nasal fluid from carriers for 2 h at 37 degrees C were less damaged than those incubated in noncarrier fluid and were coated with an electron-dense layer. Compared with that from healthy donors and patients with acute rhinitis, nasal fluid from carriers contained elevated concentrations of the neutrophil-derived defensins human neutrophil peptides 1 to 3 (47- and 4-fold increases, respectively), indicative of a neutrophil-mediated inflammatory host response to S. aureus colonization. The concentration of the inducible epithelial antimicrobial peptide human beta-defensin 2 was also highly elevated compared to that in healthy donors, in whom the level was below the detection limit, or patients with acute rhinitis (sixfold increase). Thus, nasal carriage of S. aureus takes hold in nasal fluid that is permissive for colonization and induces a local inflammatory response that fails to clear the colonizing bacteria.

Ground-state phase diagram of 2D electrons in a high Landau level: a density-matrix renormalization group study.

The ground-state phase diagram of 2D electrons in a high Landau level (index N = 2) is studied by the density-matrix renormalization group method. Pair correlation functions are systematically calculated for various filling factors from nu = 1/8 to 1/2. It is shown that the ground-state phase diagram consists of three different charge density wave states called stripe phase, bubble phase, and Wigner crystal. The boundary between the stripe and the bubble phases is determined to be nu(s-b)c approximately 0.38, and that for the bubble phase and Wigner crystal is nu(b-W)c approximately 0.24. Each transition is of first order.

Therapeutic effect of a pig-derived peptide antibiotic on porcine wound infections.

PURPOSE: We investigated the therapeutic potential of the pig-derived antimicrobial peptide protegrin-1 (PG-1) against porcine skin wounds infected with Pseudomonas aeruginosa. MATERIALS AND METHODS: Using a porcine skin wound model, PG-1 was added to the wound fluid either at the time of P. aeruginosa inoculation, four hours after inoculation or 24 hours after inoculation. Wound fluids were analyzed 20-24 hours later by use of colony-forming unit (CFU) assays, semiquantitative immunoblot analysis for PG-1, and radial diffusion assays (RDA) for residual in vitro activity. RESULTS: Results of the CFU assays indicated a 10,000-fold decrease in the number of bacteria when PG-1 was added at the time of inoculation, a 120-fold decrease when added 4 hours after inoculation and a 10-fold decrease when added 24 hours after inoculation. Results of immunoblot analysis and RDA indicated that PG-1 concentrations for each of the three conditions remained increased in wound fluid 20 to 24 hours after treatment, and correlated with increased residual in vitro antimicrobial activity. CONCLUSIONS: These results document that the endogenous antibiotic PG-1 significantly prevented the colonization of P. aeruginosa in wounds and reduced the in vivo bacterial concentration in established wound infections. Therapeutics used in the same animal species from which they were derived are a promising means for preventing and treating localized infections.

High-performance liquid chromatography of fullerence (C60) in plasma using ultraviolet and mass spectrometric detection.

Fullerence (C60) was determined by high-performance liquid chromatography using both ultraviolet and mass spectrometric detection. The detection limit for each method was 0.05 and 2.0 ng (signal-to-noise ratio (S/N = 2)) per injection, respectively. Rat plasma spiked with C60 (10 micrograms/ml) was extracted using solid phase extraction with a recovery of 62.1% and the coefficient of variation (c.v., n = 5) between intra-day assays was 4.0%. The calibration curve for peak area and plasma C60 concentration with ultraviolet detection showed good linearity (r = 0.996) over the range 0.5-60 micrograms/ml. This newly developed method was applied to rat plasma samples after intravenous administration of C60 solubilized with polyvinylpyrrolidone.