30-d Survival Research Articles

Protective Effects of Recombinant Human Antithrombin III in Pig-to-Primate Renal Xenotransplantation

Older age, prior transplantation, pulmonary hypertension, and mechanical support are commonly seen in current potential cardiac transplant recipients. Transplants in 436 consecutive adult patients from 1994 to 1999 were reviewed. There were 251 using standard donors in 243 patients (age range 18-69 years). To emphasize recipient risk, 185 patients who received a nonstandard donor were excluded from analysis. The indications for transplant were ischemic heart disease (n = 123, 47%), dilated cardiomyopathy (n = 82, 32%), and others (n=56, 21%). One hundred and forty-nine (57%) recipients were listed as status I; 5 and 6% were supported with an intra-aortic balloon and an assist device, respectively. The 30-d survival and survival to discharge were 94.7 and 92.7%, respectively; 1-year survival was 89.1%. Causes of early death were graft failure (n = 6), infection (n = 4), stroke (n = 4), multiorgan failure (n = 3) and rejection (n = 2). Predictors were balloon pump use alone (OR= 11.4, p =0.002), pulmonary vascular resistance > 4 Wood units (OR = 5.7, p = 0.007), pretransplant creatinine > 2.0 mg/dL (OR = 6.9, p = 0.004) and female donor (OR = 8.3, p = 0.002). Recipient age and previous surgery did not affect short-term survival. Heart transplantation in the current era consistently offers excellent early and 1-year survival for well-selected recipients receiving standard donors. Early mortality tends to reflect graft failure while hospital mortality may be more indicative of recipient selection.

Androstenediol stimulates myelopoiesis and enhances resistance to infection in gamma-irradiated mice

The ionizing radiation-induced hemopoietic syndrome is characterized by defects in immune function and increased mortality due to infections and hemorrhage. Since the steroid 5-androstene-3β,17β-diol (5-androstenediol, AED) modulates cytokine expression and increases resistance to bacterial and viral infections in rodents, we tested its ability to promote survival after whole-body ionizing radiation in mice. In unirradiated female B6D2F1 mice, sc AED elevated numbers of circulating neutrophils and platelets and induced proliferation of neutrophil progenitors in bone marrow. In mice exposed to whole-body 60Co gamma-radiation (3 Gy), AED injected 1 h later ameliorated radiation-induced decreases in circulating neutrophils and platelets and marrow granulocyte-macrophage colony-forming cells, but had no effect on total numbers of circulating lymphocytes or erythrocytes. In mice irradiated (0, 1 or 3 Gy) and inoculated four days later with Klebsiella pneumoniae, AED injected 2 h after irradiation enhanced 30-d survival. Injecting AED 24 h before irradiation or 2 h after irradiation increased survival to approximately the same extent. In K. pneumoniae-inoculated mice (irradiated at 3–7 Gy) and uninoculated mice (irradiated at 8–12 Gy), AED (160 mg/kg) injected 24 h before irradiation significantly promoted survival with dose reduction factors (DRFs) of 1.18 and 1.26, respectively. 5-Androstene-3β-ol-17-one (dehydroepiandrosterone, DHEA) was markedly less efficacious than AED in augmenting survival, indicating specificity. These results demonstrate for the first time that a DHEA-related steroid stimulates myelopoiesis, and ameliorates neutropenia and thrombocytopenia and enhances resistance to infection after exposure of animals to ionizing radiation.

Changes in the inflammatory response of the lung during acute respiratory distress syndrome: prognostic indicators.

We studied paired bronchoalveolar lavage (BAL) in patients with sepsis-associated acute respiratory distress syndrome (ARDS). Patients were evaluated at one institution and underwent bronchoscopy with BAL within 48 h of the onset of ARDS. Patients were restudied with bronchoscopy and BAL after 4 d of treatment. Fifty-eight patients were initially studied, with 44 patients having follow-up bronchoscopy after 4 d. The overall 30-d survival for the ARDS group was 60%. In the initial lavage, there was no difference in the neutrophils between the survivors and nonsurvivors (survivors: 59 [0-98]%; Median [Range]; nonsurvivors: 55 [0-92]%). The follow-up lavage demonstrated a significant drop in the neutrophils for the survivors (36 [4-89]%, p < 0.002) which was not seen for the nonsurvivors (70 [26-95]%). Initial IL-8 concentrations in the BAL fluid were not significantly different between the two groups. In the follow-up lavage, there was a significant fall for the IL-8 concentrations for the survivors but not the nonsurvivors. We conclude that neutrophil influx in ARDS may rapidly resolve within a week of the onset of ARDS. The resolution of neutrophils was associated with a good prognosis.

Evaluation of a pneumonia practice guideline in an interventional trial.

There are few available data to define the medically necessary duration of stay for patients hospitalized with pneumonia. Therefore, we investigated the safety and effectiveness of a practice guideline that provided information about switching patients from parenteral to oral antimicrobials and early hospital discharge. The study was a prospective controlled study with an alternate month design. The practice guideline was studied in 146 "low-risk" pneumonia patients hospitalized during a 22-month period. Medical care consistent with the practice guideline occurred in 64% and 76% of patients during control and intervention periods, respectively (p=0.15). There were no differences in patient outcomes in the control and intervention groups when measured 1 mo after hospital discharge, including hospital readmission rates, health-related quality of life, and patient satisfaction. Explicit and implicit review revealed that 98.6% (95% confidence interval [CI]: 95.1%, 99.8%) of low-risk patients would not have benefited from continued hospitalization after the fourth hospital day. The 30-d survival rate of the low-risk pneumonia patients was 99.3% (95% CI: 96.2%, 100%) and patient outcomes appeared to be favorable compared with previously published values. We conclude that duration of hospital stay was frequently consistent with the practice guideline in both study groups, and patient outcomes remained unchanged. The guideline will require additional testing before it can be recommended for use.

Effects of Surface Water Spray, Diet, and Phase Feeding on Swim Bladder Inflation, Survival, and Cost of Production of Intensively Reared Larval Walleyes

Abstract Three experiments were conducted to determine the effects of a surface water spray and diet on survival and swim bladder inflation of intensively reared larval walleyes. Survival and swim bladder inflation were determined at 30 d posthatch. In each experiment, 275-L cylindrical tanks were stocked with 20 fry/L. In experiment 1, a spray of water was applied to the surface of three tanks, and three additional tanks received no surface spray. BioKyowa FFK-B diet was fed to fish in all tanks. Survival of fish with the spray (11.8%) and without the spray (9.1%) was not significantly different, but the incidence of swim bladder inflation was higher with (98.4%) than without the spray (51.7%). In experiment 2, larval walleyes were fed one of three commercially available larval feeds—FFK-B, San Francisco Bay Brand EPAC, and Zeigler Larval AP200—and all tanks received a surface spray. Only the fish fed FFK-B had reasonable 30-d survival (33.1%) and swim bladder inflation rates (95.6%). In experiment 3, ph...

Technical Notes: Improved Survival of Walleye Fry during the First 30 Days of Intensive Rearing on Brine Shrimp and Zooplankton

Abstract Two techniques are described that increased the survival of walleye (Stizostedion vitreum) when fry were reared intensively on brine shrimp (Artemia sp.) and other zooplankton. Darkening the sides of rearing units and manipulating light intensity improved 30-d survival from approximately 7.5% in 1982–1983 to 37% in 1986 and 54% in 1987.

Effects of glutathione, as the dextran conjugate, on acetaminophen-induced hepatotoxicity.

Glutathione was covalently attached to dextran (T-40) by the CNBr activation method. In mice given a lethal dose of acetaminophen, the 30-d survival rate increased progressively with coadministration of the conjugate, whereas little improvement was found when free glutathione was given. The dextran conjugate of glutathione maintained the serum transaminase activities at lower levels after acetaminophen administration, giving effective protection against acetaminophen hepatotoxicity.

Purification and analysis of rat hematopoietic stem cells by flow cytometry.

The monoclonal antibody OX7 recognizes an epitope expressed on the Thy-1 glycoprotein, OX22 recognizes the high molecular weight form(s) on leukocyte common antigen, and W3/13 recognized determinants found on certain sialoglycoproteins. Recently, the rat colony-forming unit spleen (CFU-S) was characterized as being OX7 upper 20% positive (OX7u20%), OX22 negative (OX22-), and W3/13 weakly positive (W3/13+). In the present study these observations have been extended to include the hematopoietic stem cell (HSC). Rat marrow cells were incubated with allophycocyanine-OX7 Fab' (APC-OX7 Fab') and phycoerythrin B-OX22 Fab' (Phy B-OX22 Fab'). The cells were sorted with a FACS-II instrument by using a Krypton laser tuned to the 530 nm spectral line for phycobiliprotein excitation. It was found that marrow cells capable of protecting lethally irradiated Lewis rats (9.5 Gy total body radiation, 0.4 Gy/min Co60) had the phenotype OXu20%, OX22-. The percentage of cells in the marrow with this phenotype was found to be 0.34 +/- 0.01 (mean +/- S.E.). Three thousand of these cells were required to rescue 50% of lethally irradiated recipients (30-d survival), while the number of unsorted bone marrow cells required was 1.05 X 10(6). Thus, a 350-fold purification of the HSC was realized. Although CFU-S copurified with HSC, purification of only 105-fold was obtained. This might indicate that purified HSC have a reduced capacity to generate splenic hematopoietic colonies. The OX7u20%, OX22- -enriched HSC population could be further divided into W3/13 dim and W3/13+ subpopulations by three-parameter immunofluorescence analysis with the use of a new optical bench arrangement.

Effects of copper, nickel and zinc on three species of oregon freshwater snails

AbstractThree snail species collected from western Oregon were exposed to metals—Juga plicifera and Lithoglyphus virens, which inhabit cool coastal streams, and Physa gyrina, which is found in Willamette Valley ponds. J. plicifera were exposed in flow‐through laboratory tests to copper and nickel, L. virens were exposed to copper, and P. gyrina were exposed to nickel and zinc. J. plicifera had a 96‐h LC50 (50% of the test group died) of 0.015 mg/L for copper and a no observed effect level (NOEL, mortality not significantly different from that in control groups) of 0.006 mg/L (30‐d survival). J. plicifera had a 96‐h LC50 for nickel of 0.237 mg/L and a NOEL of 0.124 mg/L. L. virens had a 96‐h LC50 for copper of 0.008 mg/L and a NOEL of less than 0.008 mg/L. P. gyrina had a 96‐h LC50 for nickel of 0.239 mg/L, a 96‐h LC50 for zinc of 1.274 mg/L and a NOEL for zinc of 0.570 mg/L.

Effects of salinity on respiration and nitrogen excretion in two species of echinoderms

The 30-d survival limit of Eupentacta quinquesemita and Strongylocentrotus droebachiensis is 12–13‰ S. The activity coefficient (1 000/righting time in seconds) of stepwise acclimated sea urchins declined from 16.3 at 30‰ S to 3.5 at 15‰ S. Oxygen consumption rates (QO2) of both species held at 30‰ S and 13°C were highest in June and lowest in December. During the summer, when environmental salinity is most variable in southeastern Alaska, the QO2 of both species held at 30, 20 and 15‰ S varied directly with salinity. Perivisceral fluid PO2 varied directly with acclimation salinity in sea urchins, but not in sea cucumbers. Perivisceral fluid oxygen content of acclimated sea urchins was significantly lower at 15 and 20‰ S than at 30‰ S due to reduced PO2 and extracellular fluid volume at the lower salinities. The QO2 of both species varied directly with ambient salinity during a 30-10-30‰. semidiurnal pattern of fluctuating salinity. No change occurred in the average QO2 of either species over a 15-30-15‰. semidiurnal pattern of fluctuating salinity. Sea urchin perivisceral fluid PO2 declined as ambient salinity fluctuated away from the acclimation salinity in both cycles and increased as ambient salinity returned to the acclimation salinity. Total nitrogen excretion of stepwise acclimated sea cucumbers declined significantly from 30 to 15‰ S, but there was no salinity effect on total nitrogen excretion in sea urchins. Ammonia excretion varied directly with salinity in stepwise acclimated sea cucumbers (67–96% of total nitrogen excreted), but there was no salinity effect on ammonia excretion (89–95% of total nitrogen excreted) of sea urchins. Urea excretion did not vary with salinity in sea cucumbers (2–4% of total nitrogen excreted) or sea urchins (2–9% of total nitrogen excreted). Primary amines varied inversely with salinity in sea cucumbers (2–30% of total nitrogen excreted), but did not vary with salinity in sea urchins (2–4% of total nitrogen excreted). The oxygen: nitrogen ratio of both species indicated that carbohydrate and/or lipid form the primary catabolic substrate. The O:N ratio did not vary as a function of salinity. Both species are more tolerant to reduced salinity than previously reported, however, rates of oxygen consumption and/or nitrogen excretion are modified by salinity as well as season.

Effects of Waste Oil on the Survival and Reproduction of the American Flagfish, Jordanella floridae

Short-term lethality tests, tests on the 30-d survival of 1-d-old larvae, and a life cycle test showed that used crankcase oil adversely affected the survival and reproduction of the American flagfish, Jordanella floridae. Four-day LC50's for juveniles in static and flow-through tests were 36 200 μL/L and 9500 μL/L, respectively, for the water-soluble fraction (wsf) of a 10% oil–water mixture and 485 μL/L and 82.7 μL/L, respectively, for oil–water emulsions. The general descriptive characteristics of the test oil and the hydrocarbon composition and concentration of 13 metals were determined for the oil and its water-soluble fraction. The life cycle test began with embryos and continued through 45 d of spawning. Egg production was impaired by exposure to 3380 μL wsf/L. Tissue residue analyses indicated the uptake of lead, cadmium, and zinc at higher exposure levels. The 30-d LC50 for larvae exposed as embryos was &gt; 8100 μL wsf/L and for larvae unexposed as embryos was 755 μL wsf/L. The maximum acceptable toxicant concentration for the water-soluble fraction of used crankcase oil was estimated to fall between 325 and 930 μL/L. Based on the compounds identified in the water-soluble fraction, previous toxicity data, and tissue residue analyses, we speculate that zinc, lead, and cadmium probably contribute significantly to the toxicity of the waste oil tested.Key words: waste oil, used crankcase oil, American flagfish, lethality, reproduction, embryo–larvae, zinc, lead, cadmium