Cytokines and growth factors in a biologic product obtained from patients' urine as immune-modulators to treat autoimmune and allergic diseases.

At "Instituto de Alergias y Autoinmunidad Dr. Maximiliano Ruiz Castañeda, A.C." in Mexico City, a non-traditional health care center focused on the treatment of autoimmune and allergic diseases using personalized medicine, an alternative treatment referred to as an "immune-modulator" has been developed. In this study, we will refer to this treatment substance as the "immune-modulator." In brief, a urine sample is collected from the patient and processed to obtain the peptide fraction, which is conditioned and then administered sublingually to the patient. Sample processing involves multiple steps aimed at the removal of toxic compounds and enrichment for cytokines, growth factors, and other immune peptides that may contribute to the function of the immune-modulator. This treatment has been administered for many years, and patients testify that it is useful and reliable. Despite the benefits of this treatment, the molecular mechanisms underlying its effects have not been thoroughly investigated. Therefore, this study aims to identify immunoregulatory peptides, such as cytokines and growth factors, in the immune-modulator. Urine and immune-modulator concentrations of cytokines and growth factors were assessed using a Luminex assay. Twenty-one cytokines and growth factors were identified in immune-modulator samples. MCP-1 was identified in 100% of the samples; MIP-1ß, IL-8, RANTES, INF-γ, and IP-10 were identified in approximately 65-70% of samples; IL5, IL-1B, and IL-17 in 50-60%; eotaxin, VEGF, IL-6, and FGF in about 40%; MIP-1α, IL-9, GM-CSF, G-CSF, IL-12, and IL-15 in about 20-30%; and IL-13 and PDGF-bb were identified in <6% of samples. Additionally, patients exhibited significant changes in IL-1ß, IFN-γ, and MCP-1 concentrations after treatment with the immune-modulator, whereas healthy individuals showed no significant change in response to the treatment. The immune-modulator is an alternative treatment based on the administration of cytokines and growth factors obtained from the urine of patients. In this study, its composition was characterized. The isolated products could be responsible for the effects of the immune-modulator. Further trials are required to evaluate the effective delivery of these molecules by the administration route described.

Role of HLA-DRB1*04 in the susceptibility and HLA-DRB1*08 in the protection for development of rheumatoid arthritis in a population of Southern Mexico: brief report.

Rheumatoid arthritis (RA) is an autoimmune inflammatory disease with an increased prevalence in Mexico. Although its etiology is unknown, its development can be influenced by environmental factors such as smoking and viral infections. But among the factors influencing susceptibility, it is the genetic factors that predominate, mainly the HLA-DRB1 genes, and specifically the alleles that have the shared epitope (SE). A transversal study was performed, in which 31 patients (28 women and 3 men) with RA, treated at the autoimmunity clinic of the High Specialty Hospital Ciudad Salud in Tapachula, Chiapas, southern México, were enrolled. Clinical, biochemical, and demographic data were analyzed; ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), RF (rheumatoid factor), and ACPA (anticitrullinated peptide antibody) were recorded. All patients had at least one positive RA biological marker. For HLA alleles frequencies comparison, we enrolled ethnically matched healthy controls in a ratio of 3:1 for 25 cases and 4:1 for 6 cases in order to guarantee the balance between groups regarding the mean of age and proportion of gender (males vs females). HLA-DRB1*04 was found to be significantly increased in patients compared with ethnically matched healthy controls (p 0.0007, OR: 2.8, 95% CI 1.5-5.1); contrarily, DRB1*08 showed a protective effect (p 0.005, OR 0.1). This paper confirmed the involvement of HLA genes on risk determination for RA in a population of Mexican Mestizos from Tapachula, Chiapas. Key Points • HLA-DRB1*04 confirms the increased risk of rheumatoid arthritis. • HLA-DRB1*08 showed a more definite protective effect in southern Mexicans mestizos, a population with more Amerindian ancestry.

Optical pyrometer system for collisionless shock experiments in high-power laser-produced plasmas.

A temporally and spatially resolved optical pyrometer system has been fielded on Gekko XII experiments. The system is based on the self-emission measurements with a gated optical imager (GOI) and a streaked optical pyrometer (SOP). Both detectors measure the intensity of the self-emission from laser-produced plasmas at the wavelength of 450 nm with a bandpass filter with a width of ~10 nm in FWHM. The measurements were calibrated with different methods, and both results agreed with each other within 30% as previously reported [T. Morita et al., Astrophys. Space Sci. 336, 283 (2011)]. As a tool for measuring the properties of low-density plasmas, the system is applicable for the measurements of the electron temperature and density in collisionless shock experiments [Y. Kuramitsu et al., Phys. Rev. Lett. 106, 175002 (2011)].

Kelvin-Helmholtz turbulence associated with collisionless shocks in laser produced plasmas.

We report the experimental results of a turbulent electric field driven by Kelvin-Helmholtz instability associated with laser produced collisionless shock waves. By irradiating an aluminum double plane target with a high-power laser, counterstreaming plasma flows are generated. As the consequence of the two plasma interactions, two shock waves and the contact surface are excited. The shock electric field and transverse modulation of the contact surface are observed by proton radiography. Performing hydrodynamic simulations, we reproduce the time evolutions of the reverse shocks and the transverse modulation driven by Kelvin-Helmholtz instability.

Time evolution of collisionless shock in counterstreaming laser-produced plasmas.

We investigated the time evolution of a strong collisionless shock in counterstreaming plasmas produced using a high-power laser pulse. The counterstreaming plasmas were generated by irradiating a CH double-plane target with the laser. In self-emission streaked optical pyrometry data, steepening of the self-emission profile as the two-plasma interaction evolved indicated shock formation. The shock thickness was less than the mean free path of the counterstreaming ions. Two-dimensional snapshots of the self-emission and shadowgrams also showed very thin shock structures. The Mach numbers estimated from the flow velocity and the brightness temperatures are very high.

Low attenuation intratumoral matrix: CT and pathologic correlation.

Diffuse low attenuation lesions on CT scans are caused by various pathologic conditions, especially differences of the intratumoral matrix. Low attenuation on CT scans was more defined than fat density and less than muscle density, the so-called near water density. We present representative cases of low attenuation lesions in correlation with their pathologic features. Intratumoral matrix showing diffuse low attenuation on CT was classified into eight groups: fatty degeneration/fatty metamorphosis, intracellular high lipid content, large amounts of lipid-laden macrophages, mucin-producing tumor, myxoid degeneration/myxoid matriX, massive necrosis, true cystic growth of the neoplasm, and massive edema. Lesions with fatty degeneration or intracellular high lipid content could be shown as negative CT attenuation. Knowledge of the neoplasms or disease processes that tend to have such pathology will lead to correct interpretation of CT scans of various organs.

[Clinical manifestations and chest radiographic and CT findings of round pneumonia in adults].

Whereas round pneumonia in children is well known, there are few reports of this condition in adults. Chest radiographs, CT findings, clinical manifestations, and peripheral blood results in 14 cases of round pneumonia in 14 adults were evaluated. Round pneumonias ranged in size from 1 to 7 cm. Only round pneumonia was seen in 12 cases, whereas other consolidations besides round pneumonia were present in 2 cases. Eleven of 14 cases of round pneumonia were located in the lower lobes, and 8 of these 11 cases were in the superior segment of the lower lobe. Round pneumonia showed faint density in 9 cases and clear density in 5, while the margin was slightly ill-defined in 10 and well-defined in 4. No characteristic features of round pneumonia were shown on CT scan. CT showed other consolidations besides round pneumonia in 7 of 9 cases in which CT scan was carried out. Most large-sized (more than 2 cm) round pneumonias were associated with fever and elevated WBC and CRP, whereas most small (less than 2 cm) round pneumonias were associated with normal blood results and no fever. Round pneumonia in adults is not uncommon. Most round pneumonias present as slightly dense or ill-defined masses in the posterior subpleural region of the lower lobe. Round pneumonia is suggested by a history of cough, fever, elevated WBC and CRP, and a recent chest radiograph with normal findings.

[Balloon-occluded retrograde transvenous obliteration (B-RTO) for gastric varices: therapeutic results and problems].

PURPOSE: To evaluate the usefulness of balloon-occluded retrograde transvenous obliteration (B-RTO) in the treatment of gastric varices. MATERIALS AND METHODS: Twenty-one patients with ruptured or high-risk gastric varices underwent B-RTO. A 5-7F balloon catheter was advanced into the gastrorenal shunt and/or gastrophrenic shunt from the femoral vein. Five percent ethanolamine oleate iopamidol (EOI) was injected via the balloon catheter or a microcatheter that was advanced through the balloon catheter. EOI was withdrawn via the catheter after stagnation for 30-60 minutes. Contrast enhanced CT findings, endoscopic findings, and liver and renal function tests were evaluated before and after B-RTO. RESULTS: Nineteen patients (90%) were successfully treated with B-RTO. In 17 of them, CT within two weeks after B-RTO showed complete thrombosis of the gastric varices, and the varices had disappeared or markedly regressed on endoscopy after 1-3 months. In the other two patients, in whom CT showed partial thrombosis of the varices, the varices regressed minimally. Liver and renal function tests did not show significant changes in 17 of 19 patients (89%). Transient worsening of liver function was seen in one patient in whom a small amount of EOI moved into the splenic vein during balloon occlusion. Acute renal failure occurred in the other patient with the use of 50 ml of EOI. CONCLUSION: B-RTO is an effective therapy for gastric varices. However, careful attention should be paid to the amount of EOI and hemodynamic change caused by shunt occlusion.

[In vivo evaluation of the new antithrombogenic reservoir-catheter coated with polymer blend copolymer].

We evaluated the antithrombogenicity of 4F-catheters coated with the new antithrombogenic material fluorine-acryl- styrene-urethane-silicone (FASUS) graft-block copolymer by dissecting microscopic and scanning electron microscopic observations. These catheters were temporarily used for the infusa-A-port, which was prepared for the treatment of four patients with bladder cancer. Two heparin-coated catheters were also evaluated. All FASUS-coated catheters contained thrombi consisting of red thrombi and/or fibrin thrombi. Massive red thrombus was seen at the site of curvature of the catheters, 1 cm distal to the tip of the catheter. However, the portion 20 cm distal to the tip of the catheter had no red thrombus, but contained minimal fibrin thrombus or plasma protein. The heparin-coated catheters showed the same findings as the FASUS catheters. The FASUS-coated catheters were not superior in antithrombogenicity to the heparin-coated catheters. It was concluded that the FASUS-coated catheters used in this study seemed to have problems in regard to their preshaped curvature and the material used in catheter. These aspects need to be improved.

[Effective dose evaluation of angiography staff].

The effective doses received by staff members involved in angiographic examinations were determined using data compiled on radiation doses obtained from monitoring personnel and phantom measurements. Thermoluminescence personnel monitors were used to evaluate the personal doses received by the staff during radiological procedures. Organ or tissue doses were determined by using phantom measurements in which a RANDO-woman phantom was used to simulate geometric conditions during actual angiographic examinations. The annual effective dosage received by radiologists was estimated to be 8 to 9 mSv per year when they wore a lead-rubber protector. When this protector was disregarded, their annual effective doses frequently went beyond the annual limit of 50 mSv. The surface dose to the female abdomen per ten months was estimated as 1.7 mSv. Thus, care should be taken by women staff members.

Atelectasis as a complication of tracheobronchial stent therapy.

Although insertion of expandable metallic stents in cases of tracheobronchial stenosis is effective as palliation for respiratory distress, the potential risk of creating obstructive atelectasis and aggravating symptoms of patients should be noted. The authors' experience in two cases is presented, and prevention of this potential complication is discussed.

[Fracture of percutaneously inserted IVC filters--two cases of Günther's filter].

During the period from 1988 to 1990, percutaneous insertion of Günther vena caval filters were performed in ten patients in our institution. In two of them, fracture and partial migration of anchoring limbs were observed. Günthter's filter is an attractive device for interventional radiologist because of its technical ease of percutaneous placement and relative stability within the vein. However, our experience suggests that this device is not entirely safe and reliable. The patients should be carefully followed up with a possibility of distal migration in mind. Further structural improvement seems necessary.