Sequential quadruple immunosuppression including sirolimus in extended criteria and nonheartbeating donor kidney transplantation.

The aim was to evaluate feasibility and safety of calcineurin inhibitor-free immunosuppression in high-risk donor kidney transplantation with sequential sirolimus introduction. Kidney transplant patients (n=76) with a donor aged >60 years, donor with acute renal failure, or a nonheartbeating donor were included. Immunosuppression consisted of antithymocyte globulin or basiliximab, mycophenolate mofetil, prednisone, and sequential introduction of sirolimus.

Tomosynthesis and contrast-enhanced digital mammography: recent advances in digital mammography.

Digital mammography is more and more replacing conventional mammography. Initial concerns about an inferior image quality of digital mammography have been largely overcome and recent studies even show digital mammography to be superior in women with dense breasts, while at the same time reducing radiation exposure. Nevertheless, an important limitation of digital mammography remains: namely, the fact that summation may obscure lesions in dense breast tissue.

Weekly risedronate in kidney transplant patients with osteopenia.

Daily bisphosphonate is effective in preventing and treating corticosteroid-induced osteoporosis in renal transplant recipients, although it frequently has gastrointestinal side effects. The aim was to assess efficacy and side effect profile of weekly oral risedronate. Eighty-four renal transplant patients, receiving either cyclosporin A or tacrolimus and steroids were prospectively included.

Evaluation of 11-gauge and 9-gauge vacuum-assisted breast biopsy systems in a breast parenchymal model.

Rationale And Objectives: To compare three commercially available vacuum-assisted breast biopsy systems for tissue yield, length and fragmentation of specimens.

Materials And Methods: Specimens were acquired from radiolucent (bacon) and radioopaque (turkey breast) tissue using three different commercially available vacuum-assisted breast biopsy devices. Two systems (system 1 and 2) were equipped with 11 G needles, one system (system 3) with a 9 G needle.

How plants cope with foreign compounds. Translocation of xenobiotic glutathione conjugates in roots of barley (Hordeum vulgare).

Background And Aim: Numerous herbicides and xenobiotic organic pollutants are detoxified in plants to glutathione conjugates. Following this enzyme catalyzed reaction, xenobiotic GS-conjugates are thought to be compartmentalized in the vacuole of plant cells. In the present study, evidence is presented from experiments with roots of barley (Hordeum vulgare cv.

Influence of sirolimus on proteinuria in de novo kidney transplantation with expanded criteria donors: comparison of two CNI-free protocols.

Background: The contribution of mammalian target of rapamycin (mTOR) inhibitors to proteinuria is controversial. The aim was to analyse proteinuria in suboptimal kidney calcineurin inhibitor-(CNI) free de novo immunosuppression.

Methods: All patients from our centre with donors >60 years and CNI-free treatment were included (n = 108).

Tissue Doppler and strain imaging for evaluating tissue elasticity of breast lesions.

Rationale And Objectives: Sonoelastography depicts the intrinsic elastic properties of a tissue which are characterized by the strain applied to achieve tissue deformation and the velocity at which tissue deformation occurs. The present study served to investigate whether the specificity of B-mode ultrasound (US) can be improved by combining B-mode imaging with tissue Doppler imaging (TDI) and offline analysis of tissue strain imaging (TSI).

Materials And Methods: Fifty women, 25 with malignant and 25 with benign focal breast lesions, were examined by US with a linear transducer (9 MHz, Aplio, Toshiba, Otawara, Japan).

Digital mammography: what do we and what don't we know?

High-quality full-field digital mammography has been available now for several years and is increasingly used for both diagnostic and screening mammography. A number of different detector technologies exist, which all have their specific advantages and disadvantages. Diagnostic accuracy of digital mammography has been shown to be at least equivalent to film-screen mammography in a general screening population.

Contrast-to-noise ratios of different elements in digital mammography: evaluation of their potential as new contrast agents.

Purpose: To determine the contrast-to-noise ratios (CNRs) of different elements at different energies using various anode/filter combinations currently employed in digital mammography. The elements investigated included not only elements already used in conventional contrast agents such as gadolinium and iodine but also other elements to investigate their potential as mammographic contrast agents.

Materials And Methods: The CNRs of 20 mmol/L bismuth (Bi), gadolinium (Gd), ytterbium (Yb), dysprosium (Dy), and iodine (I) were determined at different slice thicknesses (0.

Pharmacokinetic and pharmacodynamic comparison of enteric-coated mycophenolate sodium and mycophenolate mofetil in maintenance renal transplant patients.

The aim of this single-center crossover substudy was to assess pharmacokinetics and pharmacodynamics [inosine 5'-monophosphate dehydrogenase (IMPDH) activity] of enteric-coated mycophenolate sodium (EC-MPS) and mycophenolate mofetil (MMF) at steady-state conditions. Stable maintenance renal transplant patients on 1 g MMF b.i.

Pregnancy on intensified hemodialysis: fetal surveillance and perinatal outcome.

Objectives: To evaluate the effect of intensive fetal surveillance via Doppler ultrasound and fetal non-stress test on the perinatal outcome of pregnant women undergoing an intensified hemofiltration scheme.

Methods: Five consecutive pregnancies of women undergoing intensified hemodialysis were analyzed due to the following parameters: maternal background, hemodialysis schedule during pregnancy, blood pressure, occurrence of fetal complications, occurrence of obstetric complications, gestational week at delivery, mode of delivery, and newborn outcome and follow-up.

Results: All pregnancies resulted in a live birth, mean gestational age was 32 weeks.

Increase of proteinuria after conversion from calcineurin inhibitor to sirolimus-based treatment in kidney transplant patients with chronic allograft dysfunction.

Background: Conversion from calcineurin inhibitor to sirolimus, rapamycin has become an option in patients with chronic allograft dysfunction (CAD). However, in many cases an increase of proteinuria has been observed. The aim was to characterize the course of this so far unexplained proteinuria after conversion.

Evolution of proteinuria after conversion from calcineurin inhibitors (CNI) to sirolimus (SRL) in renal transplant patients: a multicenter study.

Conversion from calcineurin inhibitors (CNI) to sirolimus (SRL) has become an option in patients with chronic allograft nephropathy or other conditions. However, in some cases an increase of proteinuria has been reported after such therapeutic intervention. The aim of this study was to characterize the clinical course of this so far unexplained proteinuria after conversion.

Sirolimus monotherapy: feasible immunosuppression for long-term follow-up of kidney transplantation--a pilot experience.

Chronic allograft nephropathy (CAN), cardiovascular mortality, and posttransplant malignancy are complications of conventional immunosuppression after kidney transplantation. The aim was to study feasibility of sirolimus (SRL) maintenance monotherapy in a pilot experience. All patients with SRL monotherapy of at least 6 months follow-up were included.

Conversion from calcineurin inhibitors to sirolimus in chronic allograft dysfunction: changes in glomerular haemodynamics and proteinuria.

Background: The study was conducted in order to describe possible intraglomerular haemodynamic changes inducing proteinuria after 14 patients with chronic allograft dysfunction were converted from calcineurin inhibitors (CIs) to sirolimus without changing concomitant immunosuppression or antihypertensive treatment.

Methods: Creatinine, glomerular filtration rate (GFR), proteinuria, renal functional reserve (RFR) and effective renal plasma flow (ERPF) were determined before and 8 months after conversion. Intraglomerular pressure (P(G)), afferent arteriolar resistance (AAR) and efferent arteriolar resistance (EAR) were calculated using Gomez's formula.

A systematic approach to managing pregnant dialysis patients--the importance of an intensified haemodiafiltration protocol.

Background: Pregnancy is still uncommon in women on maintenance dialysis; and their outcomes is reported to have improved to 40% to 85% live births. Here, we report the successful multidisciplinary management of five consecutive pregnant dialysis patients.

Methods: In our centre, we treated each of five patients with a systematically intensified haemodiafiltration protocol, increased erythropoeitin dosages, a generous administration of water-soluble vitamins and trace elements, and a multidisciplinary clinical management approach with a very low threshold for hospitalization.

Breast lesion detection and classification: comparison of screen-film mammography and full-field digital mammography with soft-copy reading--observer performance study.

Purpose: To retrospectively compare screen-film and full-field digital mammography with soft-copy interpretation for reader performance in detection and classification of breast lesions in women in a screening program.

Materials And Methods: Regional ethics committee approved the study; signed patient consents were obtained. Two-view mammograms were obtained with digital and screen-film systems at previous screening studies.

Digital mammography using iodine-based contrast media: initial clinical experience with dynamic contrast medium enhancement.

Purpose: We sought to evaluate the potential of dynamic contrast enhancement after the intravenous administration of an iodine-based contrast medium in full-field digital mammography.

Material And Methods: A protocol for image acquisition was established for contrast-enhanced mammography and the mammography unit (Senographe 2000D, GE Healthcare, Buc, France) changed as required. The effect of the protocol parameters on imaging was investigated.

Monochromatic x-rays in digital mammography.

Rationale And Background: The emission spectrum of an x-ray tube is determined by the anode and filter materials as well as by the high voltage being used. For mammography, typical anode materials are molybdenum (Mo), rhodium (Rh), and tungsten (W); molybdenum, rhodium, and aluminum are favored for filters. Mammography is a soft tissue imaging modality demanding a high spatial resolution as well as a high detector sensitivity.

Predictors of success in conversion from calcineurin inhibitor to sirolimus in chronic allograft dysfunction.

Chronic allograft dysfunction (CAD) is a major cause of graft loss in long-term kidney transplant recipients. To identify predictors of successful conversion from calcineurin inhibitor (CNI) to sirolimus (SRL) we investigated 59 renal transplant patients with CAD without histological signs of acute rejection. They received 12-15 mg SRL once, then 4-5 mg/day, target trough level 8-12 ng/mL.

Sirolimus dosage during and after conversion from calcineurin inhibitor therapy to sirolimus in chronic kidney transplant patients.

Unlabelled: Sirolimus (SRL) is an alternative to calcineurin inhibitors (CNI) in kidney transplant patients with chronic allograft dysfunction.

Methods: 33 patients were converted to SRL receiving a single loading dose of 15 mg and initial maintenance dose of 5 mg/day. CNI was reduced by 50% on day 1 and tapered during 4-6 weeks after achieving SRL target (8-12 ng/ml).

Near monochromatic X-rays for digital slot-scan mammography: initial findings.

X-ray spectra are composed of a broad bremsspectrum and anode-characteristic emission lines. In mammography typically molybdenum (Mo), rhodium (Rh) or tungsten (W) anodes are used in combination with Mo, Rh or aluminium filters. Only the photons with energies between 17 and 22 keV of the resulting spectrum are suitable for the soft tissue imaging needed for mammography.

Evaluation of a wavelet-based computer-assisted detection system for identifying microcalcifications in digital full-field mammography.

Purpose: To evaluate a new wavelet-based computer-assisted detection (CAD) system for detecting and enhancing microcalcifications.

Material And Methods: A total of 280 mammograms acquired by full-field digital mammography (Senographe 2000D; G.E.