An N-terminal extension to the hepatitis B virus core protein forms a poorly ordered trimeric spike in assembled virus-like particles.

Virus-like particles composed of the core antigen of hepatitis B virus (HBcAg) have been shown to be an effective platform for the display of foreign epitopes in vaccine development. Heterologous sequences have been successfully inserted at both amino and carboxy termini as well as internally at the major immunodominant epitope. We used cryogenic electron microscopy (CryoEM) and three-dimensional image reconstruction to investigate the structure of VLPs assembled from an N-terminal extended HBcAg that contained a polyhistidine tag.

Successful rescue of severe hypernatraemia (196 mmol/L) by treatment with hypotonic fluid.

Hypernatraemia over 160 mmol/L is considered to be severe. This case reports a patient who developed extreme hypernatraemia with a serum sodium concentration of 196 mmol/L. The patient was known to have chronic renal impairment and was admitted with acute deterioration of renal function secondary to dehydration.

A retrospective study of the prognostic impact of cytokine secretion in mixed lymphocyte culture on long-term graft function following allogeneic renal transplantation.

We have previously shown that in vitro measurement of cytokine production prior to renal transplantation can provide predictive information on the risk of acute rejection. Our earlier studies demonstrated that patients who secreted high levels of interferon-gamma (IFN-gamma) in OKT3-stimulated or mixed lymphocyte culture had a significantly increased risk of acute rejection compared with patients who secreted lower levels. In this study, we performed a retrospective analysis of the same cohort of patients in order to determine the prognostic value of cytokine profiles and other variables on long-term graft function.

Terminal right heart failure due to complex congenital cardiac disease successfully managed by home peritoneal drainage.

A man, aged 32, who had undergone surgical correction of complex congenital cardiac disease, had chronic severe right heart failure. Increasing reliance on diuretics led to deteriorating renal function, and he was rejected as a candidate for cardiac transplantation. By inserting a Tenckhoff catheter, and training him to drain his ascites at home, we achieved a dramatic improvement in both his cardiac and renal function.