C3d-binding Donor-specific HLA Antibody Is Associated With a High Risk of Antibody-mediated Rejection and Graft Loss in Stable Kidney Transplant Recipients: A Single-center Cohort Study.

BACKGROUND: One risk factor for antibody-mediated rejection (ABMR) and poor outcome after kidney transplantation is donor-specific anti‒human leukocyte antigen (anti-HLA) antibodies (DSAs). In this study we sought to determine whether the presence of DSAs that bind complement component C3d could better predict ABMR and graft loss in stable kidney transplant recipients (KTRs). METHODS: We included 220 stable KTRs in this study and screened them for DSAs from July 2013 to July 2016. RESULTS: Of the 220 KTRs, DSAs were detected in 24 (10.9%). The incidence of ABMR was 3.6% (8 of 220) overall, and C3d-DSA‒positive KTRs had a significantly higher incidence than SA-DSA‒positive KTRs (63.3% vs 38.9%, P = .03). Most C3d-binding DSAs were anti-HLA class II antibodies (11 of 13, 84.6%). Class II C3d-binding DSA was also significantly associated with graft failure on multivariate analysis, as were ABMR, chronic ABMR, and high serum creatinine. Class II C3d-binding DSA was also significantly associated with lower graft survival after ABMR. CONCLUSION: C3d-binding DSA, especially class II, was significantly associated with the risk of ABMR and graft loss in stable KTRs. We suggest that monitoring of stable KTRs for C3d-binding DSA, followed by biopsy, could aid in early recognition of ABMR and prevention of graft loss.

Dental restorative composites fabricated from a novel organic matrix without an additional diluent.

Commercial organic matrixes of dental composites generally include diluents such as triethylene glycol dimethacrylate (TEGDMA) to reduce viscosity. However, the diluent exhibits adverse effects such as curing shrinkage and diminished mechanical properties of the dental composites. To overcome these adverse effects, organic monomers that can be used as an organic matrix may be developed. In this study, various novel organic monomers were developed by substituting alkoxy for hydroxyl groups in 2,2-bis[4-(2-hydroxy-3-methacryloyloxy propoxy)phenyl]propane (bis-GMA). Viscosities of the alkoxy-substituted monomers were decreased by increasing substituent size. The viscosity of 2,2-bis[4-(2-ethoxy-3-methacryloyloxy propoxy)phenyl]propane (bis-E-GMA) was higher than the control organic matrix (70 wt % bis-GMA and 30 wt % TEGDMA). However, those of 2,2-bis[4-(2-propoxy-3-methacryloyloxy propoxy)phenyl]propane (bis-Pr-GMA), 2,2-bis[4-(2-butoxy-3-methacryloyloxy propoxy)phenyl]propane (bis-B-GMA), and 2,2-bis[4-(2-pentoxy-3-methacryloyloxy propoxy)phenyl]propane (bis-P-GMA) were lower than the control organic matrix. To this end, these monomers could be used as organic matrixes of dental composites without an additional diluent. Among these monomers, bis-B-GMA exhibited the lowest curing shrinkage. In comparison to the control organic matrix, the curing shrinkage of the bis-B-GMA dental composite was approximately 40%. Additionally, dental composites prepared from bis-B-GMA exhibited excellent mechanical properties.

Nutritional status in acute stroke: undernutrition versus overnutrition in different stroke subtypes.

OBJECTIVES: Nutritional status in the acute stage of stroke has not been properly evaluated in different stroke subtypes. The objective of this study was to investigate the nutritional status of different subtypes of stroke patients. SUBJECTS AND METHODS: We studied 88 female patients with first-ever strokes. Strokes were divided into cerebral infarction (CI, n=67) and intracerebral hemorrhage (ICH, n=21). We measured the nutritional status of the patients in the acute stage of stroke with the use of 8 parameters including 3 biochemical and 5 anthropometric ones. These variables were assessed in stroke patients and 120 age-matched controls, and were compared with each other. RESULTS: In the acute stage of stroke, undernourishment was significantly (P=0.000) more prevalent in the ICH group (62%) than in the CI group (25%) or controls (13%). On the other hand obesity was present in 10%, 24% and 17% in patients with ICH, those with CI, and controls, respectively, which was not significantly different (P=0.461). Only abdominal skinfold thickness was significantly greater in patients with CI than in those with ICH or controls. Conclusions - Our results illustrate that undernourishment is prevalent in acute stroke patients, significantly more so in patients with ICH than in those with CI. Stroke patients, especially those with ICH, should receive special nutritional intervention starting immediately after admission.

Pulse-amplitude-equalized output from a rational harmonic mode-locked fiber laser.

We report, for the first time to our knowledge, the demonstration of amplitude equalization of high-repetition-rate pulses generated from a rational harmonic mode-locked Er-doped fiber laser. The output pulses are injected into another fiber laser with a nonlinear optical loop mirror. This scheme provides pulse-amplitude equalization up to the ninth rational harmonic mode-locked pulse train.

Generation of multiorder Stokes and anti-Stokes lines in a Brillouin erbium-fiber laser with a Sagnac loop mirror.

We have demonstrated a novel multiwavelength lasing scheme in which a Brillouin erbium-fiber laser with a Sagnac loop mirror and a metal-coated planar mirror were used. The Sagnac loop permitted the simultaneous presence of a stimulated Brillouin scattering (SBS) pump and Stokes lines within the loop and thus generated high-order Stokes and anti-Stokes waves through a four-wave mixing (FWM) process. A total of 34 lines of Stokes and anti-Stokes waves with 0.08-nm line spacing was generated through the SBS and FWM processes with 1.5-mW SBS pump power at 1561 nm and 80-mW erbium-doped-fiber pump power.

Analysis of polarization properties of a mode-locked fiber laser gyroscope.

We investigated the polarization characteristics of a mode-locked fiber laser gyroscope (MLPLG) formed with a Nd-doped fiber as an optical gain medium and a Sagnac loop mirror. The output pulse patterns and the polarization states were found to be determined by fiber birefringence in the different sections of the MLPLG. We describe the conditions for the MLPLG to operate with automatic reciprocity leading to the possibility of phase-error-free operation.