In vitro differentiation of mouse embryonic stem cells into primitive blood vessels.

Mouse embryonic stem (ES) cells, derived from the inner cell mass of blastocyst stage embryos, undergo programmed differentiation in vitro to form a primitive vasculature. This programmed differentiation proceeds through similar processes of vasculogenesis and angiogenesis found during early vascular development in vivo. Partially differentiated ES cell clumps or embryoid bodies (EBs) first form blood islands that are subsequently transformed into a network of primitive blood vessels that contain lumens.

longitudinal analysis of levels of immunoglobulins against BK virus capsid proteins in kidney transplant recipients.

This study sought to evaluate serology and PCR as tools for measuring BK virus (BKV) replication. Levels of immunoglobulin G (IgG), IgM, and IgA against BKV capsids were measured at five time points for 535 serial samples from 107 patients by using a virus-like particle-based enzyme-linked immunosorbent assay. Viral DNA in urine and plasma samples was quantitated.

Biologic diversity of polyomavirus BK genomic sequences: Implications for molecular diagnostic laboratories.

Data on polyomavirus genomic diversity has greatly expanded in the past few years. The implications of viral DNA sequence variation on the performance of molecular diagnostic assays have not been systematically examined. 716 BK, 1626 JC, and 73 SV40 virus sequences available in GenBank were aligned using Clustal-X.

Length of hospital stay after percutaneous coronary interventions.

Introduction And Aim: Post-percutaneous coronary intervention (PCI) length of hospital stay (LOHS) is one of the key modifiers of hospital cost and quality assessment. Commencing 2000, the cardiovascular services at our institution engaged in a continuous quality improvement program to reduce post-PCI LOHS.

Methods: All PCI patients were screened for potential early discharge.

Banff schema for grading pancreas allograft rejection: working proposal by a multi-disciplinary international consensus panel.

Accurate diagnosis and grading of rejection and other pathological processes are of paramount importance to guide therapeutic interventions in patients with pancreas allograft dysfunction. A multi-disciplinary panel of pathologists, surgeons and nephrologists was convened for the purpose of developing a consensus document delineating the histopathological features for diagnosis and grading of rejection in pancreas transplant biopsies. Based on the available published data and the collective experience, criteria for the diagnosis of acute cell-mediated allograft rejection (ACMR) were established.

Correlation of histologic findings on preimplant biopsy with kidney graft survival.

Kidney biopsies are being used to evaluate marginal deceased donor organs, but, the literature on the utility of this practice remains conflicting. We re-examined this issue by performing a multivariate analysis of 597 kidney transplant recipients. The presence of moderate arteriosclerosis and/or moderate arteriolosclerosis (MA), defined as >or=25% luminal compromise, was a significant predictor of graft outcome in standard criteria donors (multivariate, P=0.

Alemtuzumab preconditioning with tacrolimus monotherapy-the impact of serial monitoring for donor-specific antibody.

Background: Antibody preconditioning with tacrolimus monotherapy has allowed many renal allograft recipients to be maintained on spaced weaning.

Methods: Of 279 renal allograft recipients transplanted between March 2003 and December 2004, 222 (80%) had spaced weaning (i.e.

Intra-operative parathyroid hormone monitoring using a laboratory based multichannel analyser.

Parathyroid hormone has a short half life in vivo. Intraoperative parathyroid hormone measurement can guide the surgeon by confirming successful removal of parathyroid adenomas. Point of care testing with a dedicated analyser and technician in theatre is expensive.

Posttransplant adenoviral enteropathy in patients with small bowel transplantation.

Transplant patients on immunosuppression represent a risk group for opportunistic infections, including adenoviral infections. The clinical and histopathologic findings of posttransplant adenoviral enteropathy in 3 adult intestinal transplant patients are described. The histopathologic pitfalls for the differential diagnosis between intestinal adenoviral enteropathy and acute rejection are discussed.

Acute renal allograft rejection: diagnostic significance of focal peritubular capillary C4d.

Background: Focal PTC C4d staining in acute renal allograft rejection has not been studied extensively.

Methods: Renal allograft biopsies performed after October 2003, representing the first episode of acute rejection (AR) in recipients with > or = 12 months follow-up postbiopsy, were assessed for extent of C4d and correlated with morphology, ELISA screen, donor-specific antibodies (DSA), response to treatment, and outcome.

Results: In 106 biopsies (16 C4d-diffuse; 24 C4d-focal; 66 C4d-negative), there were no differences among the three groups in terms of timing or grade of AR, creatinine level, tacrolimus level, and grade of interstitial fibrosis/tubular atrophy or graft loss.

Penicillium species as a rare isolate in tracheal granulation tissue: a case series.

Introduction: Granulation tissue formation is a major problem complicating the treatment of upper airway stenosis. We present two cases of recurrent tracheal granulation tissue colonisation by Penicillium species in patients undergoing laryngotracheal reconstructive surgery for post-intubation tracheal stenosis. We believe that although most Penicillium species do not cause invasive disease they can be a contributory factor to the occurrence of upper airway stenosis.

Measurements of global cell-mediated immunity in renal transplant recipients with BK virus reactivation.

The Cylex ImmuKnow Test (Cylex, Columbia, MD) measures immune cell function (ICF) and is based on the amount of adenosine triphosphate (ATP) released when T cells are stimulated by phytohemagglutinin. This preliminary study sought to determine if ICF measurements can be used to stratify kidney transplant recipients according to the risk for developing BK virus infection. ICF measurements were done in 15 samples from 8 patients with BK viremia, 38 samples from 25 patients with BK viruria, and 243 samples from 148 patients with no BK viruria or viremia.

Foreign body reaction to polymethylsiloxane gel (Bioplastique) after vocal fold augmentation.

Statement Of Problem: The consequences of vocal fold paralysis include voice change, airway problems and difficulty swallowing. Medialisation procedures using injected material have been used for many decades, with varying outcomes, mainly secondary to lifespan, tissue reaction or migration. Newer materials have recently become clinically available which are easier to manage and supposedly less likely to elicit foreign body reaction.

Banff 07 classification of renal allograft pathology: updates and future directions.

The 9th Banff Conference on Allograft Pathology was held in La Coruna, Spain on June 23-29, 2007. A total of 235 pathologists, clinicians and scientists met to address unsolved issues in transplantation and adapt the Banff schema for renal allograft rejection in response to emerging data and technologies. The outcome of the consensus discussions on renal pathology is provided in this article.

Anti-BK virus activity of nucleoside analogs.

Polyomavirus BK is an important pathogen in transplant recipients with no effective therapy. This study demonstrates that alkoxyalkyl esters of (S)-9-(3-hydroxy-2-phosphonylmethoxypropyl)adenine and fatty acid derivatives of 9-[2-(phosphonomethyoxy)ethyl]adenine (P393 and P405) are potent and selective inhibitors of BK virus replication in vitro, with a 50% effective concentration in the micromolar-to-nanomolar range.

Clinical course of kidney transplant patients with acute rejection and BK virus replication following Campath therapy.

Background: Kidney transplant recipients with active BK virus (BKV) replication are generally treated with reduction in immunosuppression to allow a successful immune response against the virus.

Methods: We inadvertently administered Campath to two patients with BKV viruria, and one patient with BKV nephropathy, since allograft biopsies showed severe tubulitis or intimal arteritis, and results of PCR and in situ hybridization were not available at the time of therapeutic intervention.

Results: Increased viral replication was observed, but not uniformly in all cases, and follow-up biopsies showed nephropathy in one additional case.

Role of tonsillectomy in the search for a squamous cell carcinoma from an unknown primary in the head and neck.

Cervical metastases of an unknown primary lesion accounts for 5%-10% of head and neck cancers. Tonsillar carcinoma is the third most common, with an incidence in the region of 18%-47% of unknown primaries, and the likelihood of synchronous tonsillar tumour of about 5%-10%. Current practice for investigating an unknown primary includes computed tomography (CT) with or without magnetic resonance imaging (MRI), and then, if necessary, 18-fluoro-deoxy-glucose positron emission tomography (FDG-PET).

BK Virus replication in vitro: limited effect of drugs interfering with viral uptake and intracellular transport.

BK virus is an important pathogen in kidney transplant recipients. In vitro studies demonstrated slight antiviral activity for chloroquine and nystatin. A sialic acid derivative, BTB11968, was identified as a lead compound for further development.

The role of nasal feminization rhinoplasty in male-to-female gender reassignment.

Objective: To objectively assess the results of rhinoplasty in feminizing the facial profiles of male-to-female transsexual patients undergoing gender reassignment.

Methods: Twelve patients underwent nasal feminization as part of male-to-female gender reassignment. Global assessments of facial profile were performed, and nasofrontal, nasolabial, and supratip angles and the Goode ratio were objectively measured.

Peptide rescues GLUT4 recruitment, but not GLUT4 activation, in insulin resistance.

Insulin-stimulated GLUT4 recruitment to the plasma membrane is impaired in insulin resistance. We recently reported that a cell permeable phosphoinositide-binding peptide induces GLUT4 recruitment as potently as insulin, but does not activate GLUT4 to initiate glucose uptake. Here we investigated whether the peptide-induced GLUT4 recruitment is intact in insulin resistance.

Polyomavirus BK non-coding control region rearrangements in health and disease.

Background: BK virus is an increasingly recognized pathogen in transplanted patients. DNA sequencing of this virus shows considerable genomic variability.

Methods: To understand the clinical significance of rearrangements in the non-coding control region (NCCR) of BK virus (BKV), we report a meta-analysis of 507 sequences, including 40 sequences generated in our own laboratory, for associations between rearrangements and disease, tissue tropism, geographic origin, and viral genotype.

Primary hyperparathyroidism: do perioperative biochemical variables correlate with parathyroid adenoma weight or volume?

Objectives: To investigate the relationship between clinical variables and biochemical markers of calcium homeostasis and parathyroid adenoma size, in patients undergoing surgery for primary hyperparathyroidism. To determine the potential clinical utility of the findings in preoperative planning and prediction of postoperative hypocalcaemia.

Design: Retrospective data analysis.

Cold heparinized lactated Ringers with procaine (HeLP) preservation fluid in 266 living donor kidney transplantations.

Since the 1960s simple inexpensive cold lactated Ringers with additives has been used for short-term cold preservation of kidneys from living donors. We performed 266 living donor kidney transplantations from January 22, 2003 to October 30, 2006. Donor allografts were recovered laparoscopically and flushed with cold heparin, lactated Ringer's and procaine (HeLP) solution.

Cholesterol embolization in renal allografts: a clinicopathologic study of 12 cases.

Cholesterol embolization (CE) in renal allografts is a rare occurrence, the natural history and prognostic significance of which is poorly characterized. We studied the clinicopathologic features and outcome of the largest known series of CE in renal allografts and combined our cases with those in the literature. We identified renal allograft biopsies with CE from 1997 to September 2004 at University of Pittsburgh Medical Center (UPMC).