Dosing of growth hormone in growth hormone deficiency.

Growth hormone (GH) treatment of GH-deficient (GHD) children is to a certain extent standardized worldwide. Recombinant 22 kDa GH is injected once daily by the subcutaneous route, mostly in the evening. The amount of GH injected (calculated per kg body weight or body surface area, expressed in terms of IU or mg) in prepubertal children mimics the known production rate (approximately 0.

A better long-term outcome in cardiac transplant recipient with a history of previous open heart operations.

Objective: To investigate the effect of previous open heart operations (POHO) on the outcome of heart transplantation (HTX).

Methods: Between November 1984 and May 1996, HTX was performed on 151 patients at Hartford Hospital. Among them, 61 patients had previous open heart operations (POHO) (group A), and 90 did not (group B).

Ureteral leak after renal transplantation.

In the course of radionuclide dynamic studies in 187 consecutive patients who had renal transplants, leakage from a ureter was identified in five cases (an incidence of less than 3%). Demonstrated patterns fell into three classes: 1) perirenal collection (n = 2), 2) peribladder activity (n = 2), and 3) downward dissection (n = 1 case). The sensitivity and specificity of the radionuclide study for detecting ureteral escape of urine after renal transplantation is unknown.

Human eosinophils constitutively express a functional interleukin-4 receptor: interleukin-4 -induced priming of chemotactic responses and induction of PI-3 kinase activity.

Similar to interleukin-3 (IL-3), IL-5, and granulocyte macrophage colony-stimulating factor (GM-CSF), IL-4 can be secreted by several cell types involved in allergic inflammatory reactions, and therefore can affect eosinophil function similarly. In this study, we investigated the presence of an IL-4 receptor (IL-4R) on human eosinophils. When two different monoclonal antibodies (mAbs) against the IL-4R alpha-chain (IL-4Ralpha) were used, fluorescent-activated cell sorter analysis revealed the presence of an IL-4Ralpha on both eosinophils of normal donors and atopic dermatitis patients.

Eosinophil chemotactic activity in bronchoalveolar lavage from idiopathic pulmonary fibrosis is dependent on cytokine priming of eosinophils.

Increased numbers of eosinophils have been found in bronchoalveolar lavage (BAL) fluid obtained from patients with idiopathic pulmonary fibrosis (IPF). This suggests the presence of one or more cytokines in the lung tissue of patients with IPF, which are involved in the induction of migration of eosinophils towards the pulmonary compartment. To evaluate this hypothesis, we studied migratory responses of blood eosinophils towards BAL fluid.

GB virus C prevalence in blood donors and high risk groups for parenterally transmitted agents from Gauteng, South Africa.

The prevalence of GBV-C infection in voluntary blood donors and in groups at high risk for parenteral exposure to infectious agents was studied. The high risk groups included chronic renal failure patients on haemodialysis, renal transplant patients and haemophiliacs from Gauteng. The presence of GBV-C RNA in these populations was determined using reverse transcription polymerase chain reaction (RT-PCR) in the 5' non-coding region (NCR) of the virus.

Analysis of growth rate of pediatric kidneys transplanted into juveniles or adults.

Estimation of renal length was carried out during radionuclide function studies, in cases of pediatric kidneys transplanted into adolescents or adults. In all 24 cases of single kidney transplants, the kidneys eventually increased in size, but at varying rates. From 5 cases with repeat studies close in time, and shortly after transplantation, an apparent maximal growth rate was estimated.

Analysis of signal transduction pathways in human eosinophils activated by chemoattractants and the T-helper 2-derived cytokines interleukin-4 and interleukin-5.

Activation and recruitment of eosinophils in allergic inflammation is in part mediated by chemoattractants and T-helper 2 (Th2)-derived cytokines. However, little is known concerning the signal transduction mechanisms by which this activation occurs. We have investigated tyrosine kinase-mediated activation of phosphatidylinositol 3-kinase (PI3K) and compared this with the activation of the p21ras-ERK signaling pathway in human eosinophils.

Comparison of the roles of mitogen-activated protein kinase kinase and phosphatidylinositol 3-kinase signal transduction in neutrophil effector function.

Although it is known that many stimuli can activate mitogen-activated protein kinases (MAPKs) and phosphatidylinositol 3-kinases (PI3K) in human neutrophils, little is known concerning either the mechanisms or function of this activation. We have utilized a selective inhibitor of MAPK kinase (MEK), PD098059, and two inhibitors of PI3K, wortmannin and LY294002, to investigate the roles of these kinases in the regulation of neutrophil effector functions. Granulocyte/macrophage colony-stimulating factor, platelet-activating factor (PAF) and N-formylmethionyl-leucyl-phenylalanine are capable of activating both p44ERK1 and p42ERK2 MAPKs and phosphotyrosine-associated PI3K in human neutrophils.

Auxiliary heterotopic partial liver transplantation in pigs with acute ischemic liver failure.

Background/aims: Fulminant hepatic failure (FHF) is usually fatal without liver transplantation. Auxiliary heterotopic partial liver transplantation (AHPLT) may offer advantages over orthotopic liver transplantation (OLT) or any other heterotopic procedure for the treatment of patients with fulminant liver failure. We studied AHPLT in a severe acute hepatic failure model in pigs.

Acute stress impairs lymphocyte function but spares pancreatic endocrine function.

In the same animal, following HS and recovery, pancreatic islet function remains intact while immunologic functions are impaired. Cellular responses to thermal stresses are complex and tissue specific.

Tyrosine phosphorylation-dependent activation of phosphatidylinositide 3-kinase occurs upstream of Ca2+-signalling induced by Fcgamma receptor cross-linking in human neutrophils.

The effect of wortmannin on IgG-receptor (FcgammaR)-mediated stimulation of human neutrophils was investigated. The Ca2+ influx induced by clustering of both Fcgamma receptors was inhibited by wortmannin, as was the release of Ca2+ from intracellular stores. Wortmannin also inhibited, with the same efficacy, the accumulation of Ins(1,4,5)P3 observed after FcgammaR stimulation, but did not affect the increase in Ins(1,4,5)P3 induced by the chemotactic peptide, formyl-methionine-leucine-phenylalanine.

Eosinophil priming by cytokines: from cellular signal to in vivo modulation.

Eosinophils play an important role in the effector phase of allergic inflammation. This review will focus on the conversion of the unprimed eosinophil phenotype in the peripheral blood of normal individuals to the primed phenotype found in the peripheral blood and tissues of allergic patients, a phenomenon called priming. Recent data on the signals initiated after cytokine receptor activation on eosinophils will be reviewed.

Organ transplantation at the Hartford Transplant Center.

Over 1,243 organ transplants have been performed at the Hartford Transplant Center over the past two decades. Survival in kidney, heart, liver, and pancreas patients is at or above the national average. Hartford was one of the first centers to use triple immunosuppression, which significantly improved survival in kidney transplantation.

Mechanisms involved in eosinophil migration. Platelet-activating factor-induced chemotaxis and interleukin-5-induced chemokinesis are mediated by different signals.

Eosinophils play an important role in the pathogenesis of allergic diseases such as allergic asthma. Eosinophil migration in vitro can be divided into directed migration, or chemotaxis, and random migration, or chemokinesis. Here, we studied intracellular signals involved in eosinophil migration in vitro induced by platelet-activating factor (PAF) and interleukin-5 (IL-5), applying a Boyden chamber assay.

A regional experience with emergency liver transplantation.

Liver transplantation for patients requiring life-support results in the lowest survival and highest costs. A ten year (1983-1993) regional experience with liver transplantation for critically ill patients was undertaken to ascertain the fate of several subgroups of patients. Of the 828 liver transplants performed at six transplant centers within the region over this period, 168 (20%) were done in patients who met today's criteria for a United Network of Organ Sharing (UNOS) status 1 (emergency) liver transplant candidate.

Albumin improves islet isolation: specific versus nonspecific effects.

1. BSA-containing solutions improve islet yields using standard collagenase digestion techniques. 2.

Management of cholelithiasis in heart and kidney transplant patients: with review of laparoscopic cholecystectomy.

The purpose of this study was to determine the incidence of cholelithiasis among heart and kidney transplant recipients. Since recommendations for cholecystectomy in transplant recipients varies widely, we discuss guidelines for surgery including laparoscopic techniques. We reviewed the records of 114 patients who underwent heart transplantation from 1984 to 1993 and 539 kidney transplant patients from 1972 to 1993.

How can we share the portal blood inflow in auxiliary partial heterotopic liver transplantation without portal hypertension?

Background: Auxiliary partial heterotopic liver transplantation (APHLT) may be an attractive treatment for fulminant hepatic failure in which recovery of the host liver is expected. We investigated the functional relationship between an auxiliary heterotopic partial liver graft and the host liver with or without portal hypertension in pigs.

Methods: Sixteen pigs underwent hepatic artery ligation and APHLT; in addition, various degrees of portal hypertension were created by banding the host portal vein.