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Traumatic pulmonary hernia is an uncommon occurrence resulting from chest trauma, typically covered by the skin. Chest trauma may arise from penetrating or blunt mechanisms, with blunt trauma being more frequently observed. When lung herniation transpires, various symptoms such as chest pain, dyspnea, subcutaneous emphysema, bone crepitation, and hemoptysis (in cases of lung parenchymal damage) may manifest. We present the case of a 66-year-old woman suffering from chest pain and dyspnea after blunt chest trauma due to a fall induced by delirium following alcohol abuse.
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Traumatismos Torácicos , Heridas no Penetrantes , Femenino , Humanos , Anciano , Traumatismos Torácicos/complicaciones , Traumatismos Torácicos/diagnóstico , Heridas no Penetrantes/complicaciones , Heridas no Penetrantes/diagnóstico , Pulmón , Hernia , Dolor en el Pecho , DisneaRESUMEN
BACKGROUND: Whether hepatitis E virus (HEV) infection can be transmitted by coagulation factor concentrates remains unclear. OBJECTIVES: The HEV seroprevalence in blood donors and recipients of coagulation factor concentrates was compared to obtain evidence of whether a transmission of HEV by coagulation factor concentrates could occur. METHODS: Archived samples from whole blood donors and patients who had received coagulation factor concentrates were investigated for the presence of anti-HEV IgG by ELISA. Western blotting was used to confirm the positive samples that showed reactivity in the ELISA. RESULTS: Of 357 blood donors, 68 (19%) presented IgG antibodies against HEV. Two of 92 patients who had received coagulation factor concentrates (2·2%) and 1 of the 69 patients who had received plasma-derived products (1·5%) tested positive for anti-HEV IgG. The seroprevalence of HEV in the patient group was significantly lower (P = 0·038) than that in the donor group. The two positive patients were a 72-year-old man treated with plasma-derived products and a 5-year-old girl treated with a recombinant coagulation factor concentrate. CONCLUSION: HEV seroprevalence was significantly higher in the blood donors than in the patients with a history of coagulation factor concentrate administration. In one of two patients with detectable anti-HEV IgG antibodies, the coagulation factor concentrate was not the probable source of infection. Our data suggest that HEV is efficiently inactivated during the manufacturing process of coagulation factor concentrates. Thus, testing for the presence of HEV RNA in plasma donated for the preparation of coagulation factor concentrates may not be necessary.
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Factores de Coagulación Sanguínea/administración & dosificación , Virus de la Hepatitis E , Hepatitis E/transmisión , Inactivación de Virus , Adulto , Anciano , Anticuerpos Antivirales/sangre , Femenino , Hepatitis E/sangre , Humanos , Inmunoglobulina G/sangre , Masculino , Persona de Mediana EdadRESUMEN
We study the dynamics of self-trapping in Bose-Einstein condensates (BECs) loaded in deep optical lattices with Gaussian initial conditions, when the dynamics is well described by the discrete nonlinear Schrödinger equation (DNLSE). In the literature an approximate dynamical phase diagram based on a variational approach was introduced to distinguish different dynamical regimes: diffusion, self-trapping, and moving breathers. However, we find that the actual DNLSE dynamics shows a completely different diagram than the variational prediction. We calculate numerically a detailed dynamical phase diagram accurately describing the different dynamical regimes. It exhibits a complex structure that can readily be tested in current experiments in BECs in optical lattices and in optical waveguide arrays. Moreover, we derive an explicit theoretical estimate for the transition to self-trapping in excellent agreement with our numerical findings, which may be a valuable guide as well for future studies on a quantum dynamical phase diagram based on the Bose-Hubbard Hamiltonian.
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BACKGROUND AND OBJECTIVES: To assess the relevance of Parvovirus B19 (B19V) DNA at low to intermediate concentrations in blood donors for the recipients of their blood components. MATERIAL AND METHODS: We studied recipients of B19V DNA-positive blood components [red blood cell concentrates (RBCs), pooled platelet concentrates and fresh frozen plasma]. This included archived pretransfusion samples as well as follow-up samples investigated by ELISA or NAT and genome sequence analysis. RESULTS: In 132 out of 424 recipients, we could detect no anti-B19V IgG before transfusion. In 67 out of 132 sero-negative recipients, a follow-up sample was available. Sixty-five of these received blood components from donors with <10(4) IU B19V DNA/ml plasma and had no evidence of transfusion-transmitted (TT)-B19V infection. Homology in genome sequences in donor and recipient provided evidence for a TT-B19V infection in two recipients. Both patients received RBC containing 3.4 × 10(6) and 1.8 × 10(4) IU B19V DNA/ml plasma, respectively. The anti-B19V IgG titres in the donors were 2 and 76 IU/ml plasma, respectively. The antibodies in the second donor were directed against capsid proteins and are thus considered as potential neutralizing antibodies. CONCLUSIONS: TT-B19V infections through blood components with low (<10(4) IU/ml plasma) B19V DNA concentrations did not occur in our study. One of the TT-B19V infections occurred from RBC with intermediate B19V DNA concentration despite the presence of potential neutralizing antibodies in the donor, but its clinical significance was low.
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Donantes de Sangre , ADN Viral/sangre , Infecciones por Parvoviridae/sangre , Parvovirus B19 Humano/genética , Adulto , Secuencia de Bases , Transfusión de Componentes Sanguíneos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Datos de Secuencia Molecular , Infecciones por Parvoviridae/transmisión , Parvovirus B19 Humano/aislamiento & purificaciónRESUMEN
BACKGROUND AND OBJECTIVES: Parvovirus B19 (B19V) DNA seems to persist in the plasma of B19V-infected blood donors. The relevance of this for recipients of single-donor blood components is yet unclear. MATERIAL AND METHODS: We studied serial archive and follow-up samples from 75 B19V-infected blood donors to obtain more data about the duration and degree of viraemia and the presence of IgG and IgM anti-B19V. IgG antibodies were further characterized by Western blot analysis in 29 donors. RESULTS: In 411 B19V DNA-positive samples collected, we found high concentrations (>10(6) IU B19V DNA/ml plasma) in five. B19V DNA persisted for a mean of 21·5 months (range: 2·3-52·4; 95% confidence interval, 19·1-23·9 months) in all donors. Only 15 such samples had either no or low-titre IgG anti-B19V. IgG antibodies were predominantly directed against epitopes on the minor capsid protein VP1, thus probably of neutralizing type with high avidity. IgM anti-B19V was detectable in 9/13 samples with high DNA concentrations. CONCLUSIONS: The vast majority of single-donor blood components with detectable B19V DNA are probably not infectious for their recipients because DNA is at only low levels and the donors also have potentially neutralizing antibodies with high avidity. Anti-B19V IgM testing does not identify every donation with high B19V DNA concentrations, but, in addition to B19V NAT testing, donors with persistent IgG anti-B19V might be considered 'B19V-safe' for single-donor blood components.
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Donantes de Sangre , Inmunidad Humoral , Infecciones por Parvoviridae/sangre , Parvovirus B19 Humano/aislamiento & purificación , Adolescente , Adulto , Anticuerpos Antivirales/sangre , Western Blotting , Niño , Preescolar , ADN Viral/sangre , Femenino , Humanos , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , Masculino , Persona de Mediana Edad , Infecciones por Parvoviridae/transmisión , Infecciones por Parvoviridae/virología , Parvovirus B19 Humano/genética , Parvovirus B19 Humano/inmunología , Reacción en Cadena de la Polimerasa , Adulto JovenRESUMEN
Despite several experiments on chaotic quantum transport in two-dimensional systems such as semiconductor quantum dots, corresponding quantum simulations within a real-space model have been out of reach so far. Here we carry out quantum transport calculations in real space and real time for a two-dimensional stadium cavity that shows chaotic dynamics. By applying a large set of magnetic fields we obtain a complete picture of magnetoconductance that indicates fractal scaling. In the calculations of the fractality we use detrended fluctuation analysis-a widely used method in time-series analysis-and show its usefulness in the interpretation of the conductance curves. Comparison with a standard method to extract the fractal dimension leads to consistent results that in turn qualitatively agree with the previous experimental data.
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OBJECTIVE AND BACKGROUND: To assess the performance characteristics of two fully automated human cytomegalovirus (HCMV) antibody tests. MATERIALS AND METHODS: Samples from negatively or not pre-screened blood donors were tested by the Biotest anti-HCMV recombinant IgG enzyme-linked immunosorbent assay (ELISA) in comparison to the Abbott Architect CMV IgG assay [chemiluminescent microparticle immunoassay (CMIA)]. For clarification, samples with discordant results between both assays were subjected to supplemental testing for anti-HCMV IgG, IgM and HCMV DNA in plasma. RESULTS: From 4938 samples tested, 362 delivered positive results in both assays (7.3%). 91 (1.8%) samples were discordant. Of 43 (two not further tested) samples positive only by ELISA, 41 were false positive, one true positive and one indeterminate. Of 45 (one not further tested) samples positive only by CMIA, 20 were false positive, 9 indeterminate and 16 true positive. Anti-HCMV IgM and HCMV DNA testing from the plasma were negative in indeterminate samples. Considering the results of supplemental testing, the CMIA achieved altogether better results concerning resolved sensitivity, resolved specificity as well as negative predictive value. Both assays had an inferior positive predictive value, with a better result for CMIA. CONCLUSION: Overall, the performance characteristics of the CMIA were better than those of the ELISA. Owing to the inferior positive predictive value, positive test results require confirmation if blood products from donors with remote HCMV infection should be administered.
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Anticuerpos Antivirales/sangre , Citomegalovirus , Inmunoglobulina G/sangre , Inmunoglobulina M/sangre , ADN Viral/sangre , Ensayo de Inmunoadsorción Enzimática/métodos , Ensayo de Inmunoadsorción Enzimática/normas , Femenino , Humanos , Masculino , Sensibilidad y EspecificidadRESUMEN
The ASTM 838-05 standard describes a bacteria challenge test procedure based on Brevundimonas diminuta (ATCC 19146) to verify a 0.2 µm rated sterilizing-grade filter. For process validation procedures a correct identification of the challenge organism is essential. The test strain ATCC 700892 repeatedly used for microbial challenge tests was incorrectly named Hydrogenophaga pseudoflava but is phylogenetically linked to the genus Curvibacter, as shown in Part I of this series. Based on these studies the misconception was consolidated that Hydrogenophaga pseudoflava, a widely isolated microorganism also found in biopharmaceutical production settings, is able to penetrate 0.2 µm rated filters. Here we show that the bacteria challenge test results of the strains Curvibacter sp. ATCC 700892 and Hydrogenophaga pseudoflava ATCC 33668 are different. In previous challenge tests analytical filter membranes were used; these do not represent the process scenarios within the sterilizing filtration in industrial processes. To represent process systems, the study data presented were determined with 10" filter cartridge elements. The strain Hydrogenophaga pseudoflava ATCC 33668 is completely retained by 0.2 µm and 0.1 µm rated filters. Depending on the different 0.2 µm filter material there are different retention rates of the strain Curvibacter sp. ATCC 700892; only the 0.1 µm rated filters showed consistent complete retention. However, up to date the genus Curvibacter seems to be of low relevance within biopharmaceutical production settings. LAY ABSTRACT: Bacteria challenge tests are used to determine the retention performance of sterilizing-grade filters. The model organism used for bacteria challenge tests and the verification of a 0.2 µm rated sterilizing-grade filter is Brevundimonas diminuta. In previous studies another proposed, model organism used for challenge tests was incorrectly labelled as Hydrogenophaga pseudoflava. Given the predefined retention characteristics, this mislabelled organism was recommended to be included in bacteria challenge studies. However, the herein presented testing demonstrated that the organism is actually phylogenetically affiliated to the genus Curvibacter and not to the strain Hydrogenophaga pseudoflava ATCC 33668. In this report, we demonstrate that the retention of the strain Hydrogenophaga pseudoflava ATCC 33668 with 0.1 µm and 0.2 µm rated filters is comparable to the retention of Brevundimonas diminuta ATCC 19146.
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Filtración , Ultrafiltración , Recuento de Colonia Microbiana , Comamonadaceae , Pruebas de Sensibilidad Microbiana , Filtros Microporos , EsterilizaciónRESUMEN
Microbial challenge testing is a common procedure to determine the retention efficiency, performance, and validity of a sterilizing-grade filter. The ASTM 838-05 standard describes a bacteria challenge test procedure based on Brevundimonas diminuta (ATCC 19146), routinely used to verify a 0.2 µm rated sterilizing-grade filter. Process validation procedures most often also utilize B. diminuta (ATCC 19146), but instead of the standard procedures and fluids, process, and product parameters are employed to determine whether these parameters influence the retentivity of the filter or changes to the challenge organism, which might result in the penetration of the filter. In certain instances, the native bioburden within the drug manufacturing process is used to perform such process validation challenge tests. Filter penetrations can happen and cause concern; therefore, it is essential to identify the organism species with accuracy to avoid unnecessary confusion. This paper and its follow-up will describe such imprecision and the resulting misconceptions. It will clarify past determinations and put perspective on the findings. LAY ABSTRACT: Sterilizing-grade filters are used to remove microorganisms from biopharmaceutical solutions. To determine the retention performance of such filters, bacteria challenge tests are utilized, often with a standard challenge organism (Brevundimonas diminuta), in instances with native bioburden. The accuracy of the microorganism identification is of importance to avoid flawed results and misinterpretation of the filter's performance.
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Esterilización , Ultrafiltración , Bacterias , Filtración , Pruebas de Sensibilidad Microbiana , Filtros MicroporosRESUMEN
BACKGROUND: The aim of this study was to evaluate the optimal preanalytical conditions prior to nucleic acid amplification technology (NAT) for human immunodeficiency virus-1 (HIV-1) or Hepatitis C virus (HCV) RNA in pools of 96 plasma specimens with regard to storage temperature, time and plasma separation in a blood donation environment. STUDY DESIGN AND METHODS: Changes in viral nucleic acid concentration of HIV-1 and HCV were observed for 5 days according to the Paul-Ehrlich-Institute's (PEI) guidelines that demand 95%-detection limit of at least 10 000 IU mL(-1) for HIV-1 RNA and 5000 IU mL(-1) for HCV RNA within a single donor blood specimen. Ninety-five per cent detection limits of HIV-1 RNA over 3 days after storage at either 5 or 21 °C were evaluated by using standardised HIV-1 RNA-positive plasma. RESULTS: HCV RNA in whole blood samples proved to be more stable than HIV-1 RNA. Whole blood storage at 21 °C was shown to decrease the detectability of HIV-1 RNA even after only 18 h. Plasma samples once used for NAT at time 18 h did not alter viral stability up to 48 h after donation. Ninety-five per cent detection limits of HIV-1 RNA were securely below 10 000 IU mL(-1) for 24 h after whole blood storage at 5 °C. CONCLUSIONS: These results may lead to a discussion around the most suitable preanalytical conditions in blood donation environments. Contrary to the current PEI guidelines that allow storage of whole blood specimens up to 18 h at 21 °C, these results suggest that immediate storage in a 5 °C container after blood donation is more suitable and would permit storage of whole blood up to 24 h prior to the separation of plasma from cells.
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Conservación de la Sangre/métodos , Seguridad de la Sangre , VIH-1/genética , Hepacivirus/genética , Estabilidad del ARN , ARN Viral/sangre , Donantes de Sangre , Conservación de la Sangre/economía , Conservación de la Sangre/instrumentación , Seguridad de la Sangre/economía , Seguridad de la Sangre/normas , Humanos , Técnicas de Amplificación de Ácido Nucleico/economía , Concentración Osmolar , Plasma/química , Guías de Práctica Clínica como Asunto , Sensibilidad y Especificidad , Temperatura , Factores de Tiempo , TransportesRESUMEN
BACKGROUND AND OBJECTIVES: As cytomegalovirus (CMV) DNA is frequently detectable in the plasma of recently infected sero-positive blood donors, information concerning primary CMV infection is important for the identification of possibly infectious donors. MATERIALS AND METHODS: Monitoring of 17 982 donors for CMV antibodies and DNA in plasma identified 14 subjects with ongoing primary CMV infection. Thirteen donors were interrogated for possible sources of infection and CMV-related symptoms, and monitored for CMV antigens, CMV DNA in plasma, leucocytes and urine, course of IgG and IgM antibodies as well as markers of systemic infection and parameters of organ function. RESULTS: CMV antigens and DNA were detectable in peripheral blood for up to 54 and 269 days respectively. Clearance of CMV DNA from blood correlated with clearance of IgM antibodies, development of IgG antibodies against the membrane glycoprotein gB and development of high avidity IgG antibodies. Eighty-five percent of subjects with primary CMV infection, but even 69% of matched controls reported possibly CMV-related symptoms. Sixty-two and 23%, respectively, had contact with possible sources of infection. One donor developed a febrile illness accompanied by increased levels of CMV DNA in peripheral blood 2 to 3 weeks after seroconversion. In other donors, neither markers of systemic infection nor parameters of organ function correlated with the course of CMV DNA and antigens. CONCLUSION: Potentially infectious donors can be identified by measuring CMV DNA, IgM antibodies or avidity of IgG antibodies. Alternatively, blood products donated during the first year after seroconversion should not be used for immunocompromised patients.
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Infecciones por Citomegalovirus/sangre , Citomegalovirus/inmunología , Reacción a la Transfusión , Adolescente , Adulto , Antígenos Virales/inmunología , Donantes de Sangre , Infecciones por Citomegalovirus/diagnóstico , Infecciones por Citomegalovirus/inmunología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Adulto JovenRESUMEN
Among the family of herpes viruses, only cytomegalovirus (CMV) and, to a lesser extent, human herpes virus 8 (HHV-8) are of relevance in transfusion medicine. Due to neutropism, herpes simplex viruses (HSV) types 1 and 2 are considered to be of minor relevance. However, several reports gave evidence that a HSV DNAemia might occur and HSV could therefore be transmissible by blood products. The aim of our study was to collect data about prevalence of HSV antibodies among blood donors and to clarify whether HSV DNAemia is possible. HSV antibody states of 653 blood donors were investigated. Blood specimens of 46 patients with primary and recurrent HSV infection were tested for HSV-1 and HSV-2 DNA using TaqMan polymerase chain reaction. In 505 of the 653 blood donors HSV antibodies were detectable, most of which were HSV-1 antibodies. HSV DNA was detected in plasma, but not in peripheral blood mononuclear cells (PBMCs) of seven rather seriously ill patients with primary herpes genitalis. No HSV viraemia was detectable in otherwise healthy patients with recurrent herpes labialis. Thus, HSV DNAemia is possible, but seems to be limited to primary infections and could not be detected in the recurrent infection. Therefore, blood donors with primary herpes infection should be deferred from donation. Blood donors with recurrent HSV infection are probably not at risk of transmitting HSV, but further studies are necessary to prove this hypothesis. Detection of HSV DNA in PBMCs as described formerly could not be confirmed by this study.
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Donantes de Sangre , Transfusión Sanguínea/normas , ADN Viral/sangre , Selección de Donante/normas , Herpes Simple/virología , Herpesvirus Humano 1/aislamiento & purificación , Herpesvirus Humano 2/aislamiento & purificación , Plasma/virología , Viremia/virología , Adolescente , Adulto , Anciano , Anticuerpos Antivirales/sangre , Femenino , Alemania/epidemiología , Herpes Genital/sangre , Herpes Genital/epidemiología , Herpes Genital/virología , Herpes Labial/sangre , Herpes Labial/epidemiología , Herpes Labial/virología , Herpes Simple/sangre , Herpes Simple/epidemiología , Herpes Simple/prevención & control , Herpes Simple/transmisión , Herpesvirus Humano 1/genética , Herpesvirus Humano 1/inmunología , Herpesvirus Humano 2/genética , Herpesvirus Humano 2/inmunología , Humanos , Leucocitos/virología , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Prevalencia , Recurrencia , Sensibilidad y Especificidad , Estudios Seroepidemiológicos , Reacción a la Transfusión , Viremia/epidemiología , Adulto JovenRESUMEN
In mesoscopic systems, conductance fluctuations are a sensitive probe of electron dynamics and chaotic phenomena. We show that the conductance of a purely classical chaotic system, with either fully chaotic or mixed phase space, generically exhibits fractal conductance fluctuations unrelated to quantum interference. This might explain the unexpected dependence of the fractal dimension of the conductance curves on the (quantum) phase breaking length observed in experiments on semiconductor quantum dots.
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We report on a 67-year-old female patient who was admitted to our intensive care unit with acute renal failure and severe hypoxemia. Transiently, the patient had to be treated with kidney replacement therapies and artificial ventilation. The actual illness started with general weakness, recurrent bloody diarrhea and intermittent dermatitis of the lower legs. Skin symptoms were initially observed 2 years before the actual clinical findings. The bloody diarrhea was attributed to an inflammatory stenosis of the sigma. The life-threatening clinical aggravation was due to diffuse alveolar hemorrhage and alveolitis. In the search for the cause of the systemic disease, both a monoclonal y-globulinemia, causing a cryoglobulinemia type II and an acute cytomegalovirus infection were diagnosed. Additionally, the course of the disease was complicated by a secondary antibody deficiency as well as an endocarditis of the aortic valve caused by Enterococcus faecium. A cryoglobulinemic vasculitis type II was histologically found in biopsy specimen of the kidney. Thus, the present case reports on a coincidence of a monoclonal gammopathy causing a cryoglobulinemia type II with extensive organ involvement and a florid CMV infection. We hypothesize that the CMV infection has triggered the cryoglobulinemia and its particular severe organ involvement.
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Crioglobulinemia/diagnóstico , Infecciones por Citomegalovirus/complicaciones , Vasculitis/diagnóstico , Anciano , Crioglobulinemia/etiología , Crioglobulinemia/terapia , Infecciones por Citomegalovirus/microbiología , Infecciones por Citomegalovirus/terapia , Endocarditis/microbiología , Endocarditis/patología , Femenino , Glomerulonefritis/microbiología , Glomerulonefritis/patología , Humanos , Vasculitis/etiología , Vasculitis/microbiología , Vasculitis/terapia , gammaglobulinas/deficienciaRESUMEN
Hepatitis delta virus (HDV) RNA editing controls the formation of hepatitis-delta-antigen-S and -L and therefore indirectly regulates HDV replication. Editing is thought to be catalysed by the adenosine deaminase acting on RNA1 (ADAR1) of which two different forms exist, interferon (IFN)-alpha-inducible ADAR1-L and constitutively expressed ADAR1-S. ADAR1-L is hypothesized to be a part of the innate cellular immune system, responsible for deaminating adenosines in viral dsRNAs. We examined the influence of both forms on HDV RNA editing in IFN-alpha-stimulated and unstimulated hepatoma cells. For gene silencing, an antisense oligodeoxyribonucleotide against a common sequence of both forms of ADAR1 and another one specific for ADAR1-L alone were used. IFN-alpha treatment of host cells led to approximately twofold increase of RNA editing compared with unstimulated controls. If ADAR1-L expression was inhibited, this substantial increase in editing could no longer be observed. In unstimulated cells, ADAR1-L suppression had only minor effects on editing. Inhibition of both forms of ADAR1 simultaneously led to a substantial decrease of edited RNA independently of IFN-alpha-stimulation. In conclusion, the two forms of ADAR1 are responsible almost alone for HDV editing. In unstimulated cells, ADAR1-S is the main editing activity. The increase of edited RNA under IFN-alpha-stimulation is because of induction of ADAR1-L, showing for the first time that this IFN-inducible protein is involved in the base modification of replicating HDV RNA. Thus, induction of ADAR1-L may at least partially cause the antiviral effect of IFN-alpha in natural immune response to HDV as well as in case of therapeutic administration of IFN.
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Adenosina Desaminasa/fisiología , Virus de la Hepatitis Delta/fisiología , Interferón-alfa/inmunología , Edición de ARN/fisiología , ARN Viral/metabolismo , Carcinoma Hepatocelular , Línea Celular Tumoral , Electroforesis en Gel de Poliacrilamida , Silenciador del Gen , Virus de la Hepatitis Delta/genética , Virus de la Hepatitis Delta/inmunología , Humanos , Immunoblotting , Oligorribonucleótidos Antisentido/farmacología , ARN Mensajero/análisis , Proteínas de Unión al ARN , Reacción en Cadena de la Polimerasa de Transcriptasa InversaRESUMEN
BACKGROUND: In the setting of severe perigenicular trauma or complicated endoprosthetic knee surgery, primary knee fusion may be the last resort for salvage of the limp. In this case, the patella looses its destination as an anterior knee stabilizer and can become a substantial donor of bone substance, especially if osseous defects are involved. PATIENTS AND METHODS: 12 formalin fixated cadavers were studied in terms of vascular anatomy, pedicle reliability, arc of rotation and their relation to sex, age, and height. Moreover, the operation was performed on a suitable patient. RESULTS: The quadriceps with the vastus medialis and the patella can be raised from the tibial tuberosity up to the entrance of the osteoarticular branch of the superficial femoral artery into the vastus medialis muscle ca 16 cm (15-19 cm) from the inferior patellar pole. This distance correlated well to the overall height of the cadavers (P=0.009). The vascular prerequisites were always present. In the clinical case, there was a favorable outcome with knee fusion after 4 months, despite of the lateral condylar defect. DISCUSSION: The composite vastus medialis-patellar complex osseomuscular flap can be safely used as a source of vascularized femoral condyle substitute in the setting of primary knee fusion.
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Traumatismos de la Rodilla/cirugía , Recuperación del Miembro/métodos , Rótula/cirugía , Colgajos Quirúrgicos , Arterias/anatomía & histología , Artrodesis/métodos , Estatura , Femenino , Fracturas del Fémur/cirugía , Fracturas Abiertas/cirugía , Humanos , Traumatismos de la Rodilla/diagnóstico por imagen , Articulación de la Rodilla/irrigación sanguínea , Masculino , Persona de Mediana Edad , Músculo Esquelético/trasplante , Radiografía , Colgajos Quirúrgicos/irrigación sanguíneaRESUMEN
BACKGROUND AND OBJECTIVES: Inflammatory cytokines in platelet concentrates (PC) may cause side-effects such as febrile non-haemolytic transfusion reactions. The maximum white blood cell (WBC) content tolerable to avoid the accumulation of cytokines, and whether these cytokines originate from degranulating leucocytes or de novo synthesis during storage, had not been investigated prior to this study. MATERIAL AND METHODS: We investigated the secretion of interleukin (IL)-1beta, IL-2, IL-6, IL-8, tumour necrosis factor-alpha (TNF-alpha) and interferon-gamma (IFN-gamma) and quantified the appropriate expression of corresponding mRNA in PC with regard to different levels of WBC contamination and storage times. In addition we tested the viability of WBCs during PC storage (by staining with 7-aminoactinomycin D) and their ability to perform de novo cytokine synthesis (by using superantigen stimulation). RESULTS: We detected a statistically significant increase of IL-1beta, IL-6, IL-8 and TNF-alpha in PC with > or = 108 WBCs. Quantitative reverse transcription-polymerase chain reaction (RT-PCR) showed increasing mRNA expression of the respective cytokines depending on the number of WBC present. On day 5 of storage, WBC viability was > 80% and the leucocytes were still able to produce cytokines de novo. CONCLUSIONS: These data show clear evidence for de novo synthesis of cytokines in PC. The cytokine pattern supports the hypothesis that activated monocytes are responsible for this cytokine synthesis. PC with a WBC contamination of > or = 108 contain inflammatory mediators in clinically relevant concentrations.
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Plaquetas/inmunología , Quimiocinas/biosíntesis , Citocinas/biosíntesis , Transfusión de Plaquetas/efectos adversos , Técnicas de Cultivo de Célula , Quimiocinas/efectos adversos , Quimiocinas/inmunología , Citocinas/efectos adversos , Citocinas/inmunología , Cartilla de ADN , Perfilación de la Expresión Génica , Humanos , ARN Mensajero/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Manejo de EspecímenesRESUMEN
BACKGROUND: The objective of this work was to develop a novel and highly sensitive RT-PCR method that is suitable for HCV RNA screening of blood donations according to the criteria released by the Paul Ehrlich Institute, the federal licensing agency of Germany, for routine HCV NAT. STUDY DESIGN AND METHODS: RNA was prepared from plasma pools of up to 20 single blood donations using an automated nucleic acid isolation system (NucliSens Extractor, Organon Teknika). For reverse transcription, amplification, and simultaneous detection of PCR products, a novel approach based on the TaqMan technology was developed. Glyceraldehyde-3-phosphate dehydrogenase messenger RNA, which is detectable in human plasma, was coamplified in each reaction as an internal positive control. RESULTS: The HCV genotypes and subtypes 1a, 1b, 2a, 2b, 2c, 2i, 3a, 4, and 5a were detected in parallel with comparable amplification efficiency. The 95-percent detection limit related to the WHO HCV RNA standard preparation was calculated to be 389 IU per mL of plasma of the single blood donation. Total CVs (%) were <4. The screening of up to 180 blood donations took 5 hours; as a rule, the blood components could be released on the day of donation. CONCLUSION: The TaqMan HCV RT-PCR is an almost completely automated, highly sensitive, specific, and rapid method that is reliable for HCV RNA screening of blood donations. It allows a closed-tube HCV RNA detection without risk of contamination by PCR products.
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Donantes de Sangre , Hepacivirus/genética , Tamizaje Masivo , ARN Viral/análisis , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa/normas , Humanos , Sensibilidad y Especificidad , Factores de TiempoRESUMEN
PURPOSE: Beside the established maturation of hepatitis B virus (HBV) transcripts at a polyadenylation signal downstream of the HBV x protein open reading frame, maturation at an internal polyadenylation signal has been observed in the chronically infected liver. In the present study, it was the aim to identify the respective circulating full-length and truncated transcripts in plasma/serum of carriers. EXPERIMENTAL DESIGN: Nucleic acids extracted from sera were analyzed using established PCR and reverse transcription-PCR procedures targeted to HBV x protein gene regions. Amplification products were cloned and sequenced. RESULTS: Base substitution patterns were determined, which indicated infection stages advanced to different degrees regardless of the transcript type analyzed. HBV full-length RNA (fRNA) showed a high correlation with hepatitis B e antigen and viral DNA, indicative for a replicative infection. In contrast, truncated RNA (trRNA) appeared to be independent of hepatitis B e antigen and showed only a weak association with circulating viral DNA. No correlation was observed between the levels of trRNA and the apparent liver damage as reflected by alanine transaminase levels. An age-dependent representation of fRNA and trRNA was observed: fRNA decreased progressively to low levels, whereas trRNA remained at comparably high values. trRNA and RNA not polyadenylated at either of the two polyadenylation signals were detected even in the absence of any other conventional HBV seromarker, including viral DNA. This was shown for patients with cryptogenic cirrhosis and hepatitis C virus carriers. CONCLUSIONS: The identification of HBV RNA in human serum has a diagnostic potential for apparent and for inapparent infection stages.
Asunto(s)
Virus de la Hepatitis B/genética , Hepatitis B Crónica/virología , ARN Viral/sangre , Adolescente , Adulto , Factores de Edad , Alanina Transaminasa/sangre , Niño , Cartilla de ADN , ADN Complementario/química , ADN Complementario/genética , ADN Viral/sangre , ADN Viral/química , Variación Genética , Antígenos de Superficie de la Hepatitis B/sangre , Antígenos de Superficie de la Hepatitis B/genética , Antígenos e de la Hepatitis B/sangre , Antígenos e de la Hepatitis B/genética , Hepatitis B Crónica/sangre , Humanos , Persona de Mediana Edad , Oligodesoxirribonucleótidos/genética , Poli A/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Análisis de Secuencia de ADN , Transactivadores/sangre , Transactivadores/genética , Transcripción Genética , Proteínas Reguladoras y Accesorias Virales , Replicación Viral/genéticaRESUMEN
Aqueous solutions of atrazine [2-chloro-4-(isopropylamino)-6-(ethylamino)-s-triazine] (CIET) decompose upon illumination with a low-pressure Hg-arc lamp (254 nm). However, no decomposition takes place with lambda > 300 nm. On the other hand, addition of polyoxometalates (POM), PW12O40(3-) or SiW12O40(4-), into a solution of atrazine photodecomposes the substrate within a few minutes (cutoff fiter 320 nm). Ultrasound (US) treatment also decomposes aqueous solutions of atrazine within a few minutes. Both methods, sonolysis and photolysis with POM, give common intermediates, namely, 2-hydroxy-4-(isopropylamino)-6-amino-s-triazine (OIET), 2-chloro-4-(isopropylamino)-6-amino-s-triazine (CIAT), 2-chloro-4-amino-6-(ethylamino)-s-triazine (CAET), 2-hydroxy-4,6-diamino-s-triazine (OAAT), and 2-hydroxy-4-hydroxy-6-amino-s-triazine (OOAT) among others. The final products for both methods, US and photolysis with POM, were cyanuric acid (OOOT), NO3-, Cl-, CO2, and H2O. OOOT showed no signs of decomposition by sonication and/or photolysis with POM. It also resisted degradation upon photolysis with plain UV light (254 nm). However, it has been reported to decompose upon photolysis with lambda > 200 nm. Combination of US and photolysis with POM produces only a cumulative effect.