RP Group Research Articles

Evaluation of Dental Implants Placed in Preserved and Nonpreserved Postextraction Ridges: A 12-Month Postloading Study.

Forty-eight single dental implants were inserted 4 months after tooth extraction following ridge preservation (RP; n = 24) or spontaneous healing (EXT; n = 24). During surgery, 1 (7%) of 24 implants in the RP group and 14 (58%) of 24 in the EXT group required additional bone grafting, and the implant stability quotient value was similar in the two groups. The survival rate of the implants in both groups was 100% at the 1-year follow-up. The success rate was 95.83% in the RP group and 91.66% in the EXT group. No statistically significant differences in the marginal bone level were detected between the two groups. Similar outcomes of implants inserted in preserved or spontaneously healed ridges can be anticipated, but the use of an RP procedure reduces the need for further bone augmentation.

Is Remnant Preservation Truly Beneficial to Anterior Cruciate Ligament Reconstruction Healing? Clinical and Magnetic Resonance Imaging Evaluations of Remnant-Preserved Reconstruction

Background: Remnant-preserved anterior cruciate ligament (ACL) reconstruction was introduced to improve clinical outcomes and biological healing. However, the effects of remnant preservation and the influence of the delay from injury until reconstruction on the outcomes of this technique are still uncertain. Purpose/Hypothesis: The purposes of this study were to evaluate whether remnant preservation improved the clinical outcomes and graft incorporation of ACL reconstruction and to examine the influence of the delay between ACL injury and reconstruction on the usefulness of remnant preservation. We hypothesized that remnant preservation improves clinical results and accelerates graft incorporation and that its effect is dependent on the delay between ACL injury and reconstruction. Study Design: Cohort study; Level of evidence, 2. Methods: A total of 151 consecutive patients who underwent double-bundle ACL reconstruction using a semitendinosus graft were enrolled in this study: 74 knees underwent ACL reconstruction without a remnant (or the remnant was <25% of the intra-articular portion of the graft; NR group), while 77 knees underwent ACL reconstruction with remnant preservation (RP group). These were divided into 4 subgroups based on the time from injury to surgery: phase 1 was <3 weeks (n = 24), phase 2 was 3 to less than 8 weeks (n = 70), phase 3 was 8 to 20 weeks (n = 32), and phase 4 was >20 weeks (n = 25). Clinical measurements, including KT-1000 arthrometer side-to-side anterior tibial translation measurements, were assessed at 3, 6, 12, and 24 months after reconstruction. Magnetic resonance imaging evaluations of graft maturation and graft-tunnel integration of the anteromedial and posterolateral bundles were assessed at 3, 6, and 12 months after reconstruction. Results: There was no difference in side-to-side anterior tibial translation between the NR and RP groups. There was also no difference in graft maturation between the 2 groups. Furthermore, the time from ACL injury until reconstruction did not affect graft maturation, except in the case of very long delays before reconstruction (phase 4). Graft-tunnel integration was significantly increased in both groups in a time-dependent manner. However, there was no difference between the NR and RP groups. Conclusion: Remnant preservation did not improve knee stability at 2 years after ACL reconstruction. Furthermore, remnant preservation did not accelerate graft incorporation, especially during the acute and subacute injury phases.

Does an Open Recirculation Line Affect the Flow Rate and Pressure in a Neonatal Extracorporeal Life Support Circuit With a Centrifugal or Roller Pump?

The objective of this study is to evaluate the impact of an open or closed recirculation line on flow rate, circuit pressure, and hemodynamic energy transmission in simulated neonatal extracorporeal life support (ECLS) systems. The two neonatal ECLS circuits consisted of a Maquet HL20 roller pump (RP group) or a RotaFlow centrifugal pump (CP group), Quadrox-iD Pediatric oxygenator, and Biomedicus arterial and venous cannulae (8 Fr and 10 Fr) primed with lactated Ringer's solution and packed red blood cells (hematocrit 35%). Trials were conducted at flow rates ranging from 200 to 600 mL/min (200 mL/min increments) with a closed or open recirculation line at 36°C. Real-time pressure and flow data were recorded using a custom-based data acquisition system. In the RP group, the preoxygenator flow did not change when the recirculation line was open while the prearterial cannula flow decreased by 15.7-20.0% (P < 0.01). Circuit pressure, total circuit pressure drop, and hemodynamic energy delivered to patients also decreased (P < 0.01). In the CP group, the prearterial cannula flow did not change while preoxygenator flow increased by 13.6-18.8% (P < 0.01). Circuit pressure drop and hemodynamic energy transmission remained the same. The results showed that the shunt of an open recirculation line could decrease perfusion flow in patients in the ECLS circuit using a roller pump, but did not change perfusion flow in the circuit using a centrifugal pump. An additional flow sensor is needed to monitor perfusion flow in patients if any shunts exist in the ECLS circuit.

Rotating platform versus fixed bearing total knee arthroplasty at mid-term follow-up

BackgroundRotating platform posterior stabilized (RP) total knee arthroplasty (TKA) was initially developed in part to decrease polyethylene wear and to improve patellar tracking. There have been limited studies evaluating the longevity and causes of reoperation or revision for this implant. The following study compares mid-term survival rates and causes for reoperation between fixed bearing (FB) TKAs. MethodsWe identified 11,416 patients who underwent a primary posterior stabilized TKA between 2001 and 2013. This group was stratified to include patients with a RP (n=926) and FB (n=10,490) TKA design. Kaplan–Meier survival rates for each complication that led to reoperation were determined at five- and 10-years. Univariate hazard ratios were determined for the most common causes for reoperation and overall implant survival rates. A multivariate analysis was performed to account for the age, gender and preoperative diagnosis discrepancy between groups. ResultsThe reoperation data demonstrated statistically increased all-cause reoperation rate (p=<0.001) and reoperation rate for stiffness in the RP group (p=0.001). After adjusting for demographic variables we noted no statistically significant differences in reoperation rate and reoperation for stiffness. Additionally, a statistically significant decrease was noted in all-cause revision (p=0.024) and revision for aseptic loosening or osteolysis in the RP group (p=0.029). ConclusionAfter adjusting for patient demographic differences, we noted a statistically significant decrease in the overall revision and revision for aseptic loosening or osteolysis rates in the RP group.

Urine metabolomics study on the liver injury in rats induced by raw and processed Polygonum multiflorum integrated with pattern recognition and pathways analysis

Ethnopharmacological relevancePolygonum multiflorum L. is a famous traditional Chinese medicine that has always been perceived to be safe. Recently, the increasing case reports on hepatotoxicity induced by Raw P. multiflorum (RP) have attracted particular attention. However, the diagnosis and identification of RP-induced hepatotoxicity are still very difficult for its unknown mechanism and the lack of specific biomarkers. Aim of the studyTo further explore the toxicity and metabolic mechanisms involved in the hepatotoxicity induced by RP. Materials and methodsThe hepatotoxicity induced by RP and its processed products (PP) (dosed at 20g/kg for 4 weeks) on rats were investigated using conventional approaches including the biochemical analysis and histopathological observations. Further, a urinary metabolomic approach was developed to study the metabolic disturbances caused by RP and PP, followed by the pattern recognition approach and pathways analysis. ResultsRP showed obvious hepatotoxity whereas PP did not. 16 potential biomarkers (pyridoxamine, 4-pyridoxic acid, citrate et al.) differentially expressed in RP group were identified compared with the control and PP-treated groups. The pathways analysis showed that vitamin B6 metabolism, tryptophan metabolism and citrate cycle might be the major enriched pathways involved in the hepatotoxicity of the herb. Conclusion16 differentially expressed metabolites were identified to be involved in the RP-induced hepatotoxicity. Vitamin B6 metabolism might be mostly related to the hepatotoxicity induced by RP. This finding may provide a potential therapeutic target or option to treat hepatotoxicity induced by RP.

SU-F-T-354: Evaluation of New Features of Two Commercial Automated Treatment Planning Systems

Purpose: To evaluate the individual and combined performance of Auto-Planning and RapidPlan for IMRT plans applied to locally advanced cervical cancer. Methods: A cohort of 10 patients previously treated with IMRT technique were selected for this study. 10 plans (AP) were generated with Pinnacle version 9.10 based on on single template, and only one optimization cycle was allowed for each plan. 10 sets of patient specific DVH prediction were generated with RapidPlan (Eclipse 13.5). Objective parameters were extracted from the predicted DVHs and the were manually input into Pinnacle TPS to generate another 10 plans (RP). This time, minor amends were allowed to make all RP plans clinically acceptable. All the plans including the original manual plans (MP) and the effective working time of the semi-automated process were evaluated and compared. Results: Dose coverage was high and similar for all plans in this study. All semiautomated plans were clinically acceptable and achieved significant dose reduction for small bowel. The RP group showed superior bladder sparing over MP and AP groups. The dose to rectum did not differ significantly among three groups. The average effective working time of AP and RP groups were 10min and 15min respectively, while MP group took about 25min for each plan. Conclusion: The two automated planning systems showed their capabilities and efficiency in generating highly consistent and high quality plans as they achieved better OAR sparing while costing less effective working time.

Successful transplantation in canines after long-term coronary sinus machine perfusion preservation of donor hearts

Machine perfusion is a promising strategy for donor heart preservation, but delivery of perfusate through the aorta may be limited by aortic valve incompetence. We hypothesized that retrograde machine perfusion preservation through the coronary sinus avoided this issue and allowed for recovery of donor hearts after long-term storage. Canine hearts were procured after arrest with 1 liter University of Wisconsin Machine Perfusion Solution (UWMPS) and preserved for 14 hours by static hypothermic storage (Static group, n = 5) or retrograde machine perfusion through the coronary sinus (RP group, n = 5). Myocardial oxygen consumption (MVo2) and lactate were monitored in perfused hearts. Hearts were implanted and reperfused for 6 hours. The pre-load recruitable stroke work was determined as a measure of myocardial function. Cardiac enzyme release was quantified. Cell death was evaluated by TUNEL (terminal deoxynucleotidyltransferase-mediated deoxy uridine triphosphate nick-end label). MVo2 decreased initially then stabilized. Lactate accumulation was low in RP hearts. All RP hearts separated from cardiopulmonary bypass. All Static hearts required a return to bypass (p < .05). Pre-load recruitable stroke work in RP hearts was increased (55 ± 7 mm Hg) compared with Static (20 ± 11 mm Hg, p < .05) and did not differ from baseline values. Creatine kinase release was greater in Static group hearts (102 ± 16 IU/liter/g) than in RP hearts (51 ± 8 IU/liter/g, p < .05). The fraction of TUNEL-positive cells was higher in the Static group, but this difference was not significant. Retrograde machine perfusion can preserve donor hearts for long intervals. Cardiac function after implantation suggested excellent myocardial protection. Retrograde machine perfusion appears promising for extending the donor ischemic interval and improving results of heart transplantation.

Immunogenicity and protective efficacy of Brucella abortus recombinant protein cocktail (rOmp19+rP39) against B. abortus 544 and B. melitensis 16M infection in murine model.

In this study, the immunogenicity and protective efficacy of recombinant proteins Omp19 (rO) and P39 (rP) from Brucella abortus were evaluated individually and compared with the cocktail protein (rO+rP) against B. abortus 544 and Brucella melitensis 16M infection in BALB/c mouse model. Intra-peritoneal (I.P.) immunization with rO+rP cocktail developed substantially higher antibody titers predominant with Th1 mediated isotypes (IgG2a/2b). Western blot analysis using anti-rO+rP antibodies showed specific reactivity with native Omp19 (19 kDa) and P39 (39 kDa) among whole cell proteins of B. abortus and B. melitensis. Splenocytes extracted from rO+rP immunized mice induced significantly (P<0.001) higher proliferative responses at 30 μg/ml with considerable expression of pro-inflammatory cytokines (IFN-γ, IL-2 and IL-12) than rO and rP. Macrophage cell (RAW 264.7) monolayer supplemented with anti-rO+rP polysera exhibited enhanced viability against challenge with B. abortus 544 (72.27%) and B. melitensis 16M (68.57%). On the other hand, individual anti-rO and anti-rP polysera resulted in relatively lesser protection against the pathogens (64.79%, 54.45% and 47.13%, 45.11%, respectively). Immunized group of mice when I.P. challenged with 5 × 10(4) CFU of B. abortus 544 and B. melitensis 16M were found significantly (P<0.001) protected in the rO+rP group (log units of protection, spleen: 2.38, 2.12; liver: 1.04, 0.81, respectively) than in rO (spleen: 1.43, 1.21; liver: 0.7, 0.47) and rP (spleen: 1.24, 1.17; liver: 0.65, 0.34). Findings from this study depicted that rO+rP cocktail is highly immunogenic with the Th1 predominant serum antibody titers and T-cell mediated immune protection, would be a valuable intervention in the development of a safer and improved Brucella vaccine.

Short- and long-term outcomes of laparoscopic surgery for colorectal cancer in the elderly: A prospective cohort study

BackgroundThe aim of this study was to evaluate the safety and validity of laparoscopic colorectal surgery for elderly patients. We compared the short and long-term postoperative outcomes of laparoscopic colorectal surgery in patients aged ≥75 years (elderly patients; EP) and <75 years (relatively younger patients; RP). MethodsClinicopathological data and short- and long-term outcomes after laparoscopic surgery for colorectal cancer were compared between the EP (n = 53) and RP groups (n = 155). ResultsIn the EP group, patients with American Society of Anesthesiologists score II (p = 0.047) and medical comorbidity rate (EP vs RP: 83.0% vs 56.8%, p < 0.001), especially for cardiovascular disease (64.2% vs 37.5%, p < 0.001) and diabetes mellitus (20.8% vs 9.7%, p = 0.044), were significantly higher than those in the RP group. Regarding the clinical characteristics, the ratio of right colectomy (50.9% vs 25.3%, p < 0.001) and pathological tumor grade T4 (18.9% vs 7.7%, p = 0.044) were significantly higher in the EP group. There was no significant difference in the variation of pathological stage between the two groups. In the postoperative course, there were no significant differences regarding short-term postoperative outcomes between the EP and RP groups, including that for timing of oral diet tolerance (3.9 days vs 3.5 days, p = 0.073), first flatus (2.3 days vs 2.0 days, p = 0.636), first bowel movement (3.3 days vs 3.7 days, p = 0.153), ambulation after surgery (1.7 days vs 1.5 days, p = 0.081), postoperative hospital stay (10.5 days vs 10.8 days, p = 0.469), and incidence of postoperative complications (20.8% vs 15.5%, p = 0.385), respectively. Regarding the long-term outcomes, there were no significant differences in recurrence-free survival (RFS) (5-year RFS, 74.0% vs 85.2%, p = 0.091) and overall survival (OS) (5-year OS, 81.8% vs 90.1%, p = 0.112) between the two groups. ConclusionLaparoscopic colorectal surgery in elderly patients was safe and well-tolerated in comparison with the relatively younger patients.

Contrast of retinal structure and function developing of premature rats versus full-term newborn rats

Background Premature birth is a high risk factor of abnormal development in the morphology and function of vision system.To observe the effect of premature birth on the structural and functional development of neonatal retina is of great importance. Objective This study aimed to compare the differences of retinal structure and function between premature rats and normal rats. Methods Twenty-eight gestational SD rats were randomized to bacterial lipopolysaccharide (LPS)-induced preterm (LP) group, mifepristone-induced preterm (RP) group, cesarean section-induced preterm (CP) group and normal control group, with 10-12 rats from each nest.LPS (20 μg/kg) or mifepristone (10 mg/kg) was injected on the 18 th day of gestation in the LP group and RP group, respectively, to establish premature birth rat models, and cesarean delivery was performed on the 19 th day of gestation in the CP group.Full-term newborn rats born in 22 days after gestation in the normal group.Systemic circulatory perfusion was carried out in the neonatal rats using normal saline solution and 4% triformal on postnetal 4, 7, 10 and 14 days and then the retinal sections of the left eyes were prepared for the hematoxylin and eosin staining to examin the retinal layers and cells counting.Electroretinogram (ERG) based on international standardization was recorded in the rats on postnetal 14, 21 and 28 days to evaluate the retinal function.All the results were compared between the premature rats and the normal rats.The use and care of the animals complied with the Regulations for the Administraion of Affair Concerning Experimental animals by State Science and Technology Commission. Results The number of neuroblast layers was more on postnetal 4-day and 7-day rats in the LP group, CP group and the RP group than those in the normal control group (LP: t=-7.07, -4.97, both at P 0.05). Compared with the normal group, the amplitudes of Rod-b wave, Max-a and b waves, oscillatory potentials (OPs), Cone-b wave and flicker ERG were not significantly changed on postnetal 14-day, 21-day and 28-day rats among the LP group, CP group and RP group (all at P>0.05). However, the latencies of Max-a and b waves were significantly extended on postnetal 14-day rats in the LP group (t =-3.94, -3.31, all at P<0.01), and the latencies of Rod-b wave, Max-b wave and Cone-b wave were prolonged in the CP group in comparison with the normal group (t=-2.42, -2.61, -2.16, all at P =0.02). Also, the latency of Max-b wave was extended in the RP group in comparison with the normal group (t=-3.67, P<0.01). In addition, the latencies of Max-a and b waves in 21-day rats and Max-b latency in 28-day rats in the LP group were significantly longer than those in the normal group (t =-3.18, -3.45, -3.61, all at P<0.01). Conclusions The developing lags of retinal structure and function propably are the anatomical basis of preterm children prone to retinal diseases. Key words: Premature/chemically and surgery induced; Gestational age; Animals, newborn; Development; Retina; Electroretinogram; Structure; Rats, Sprague Dawley

Comparison of Warm Blood Cardioplegia Delivery With or Without the Use of a Roller Pump

Various techniques for administration of blood cardioplegia are used worldwide. In this study, the effect of warm blood cardioplegia administration with or without the use of a roller pump on perioperative myocardial injury was studied in patients undergoing coronary artery bypass grafting using minimal extra-corporeal circuits (MECCs). Sixty-eight patients undergoing elective coronary bypass surgery with an MECC system were consecutively enrolled and randomized into a pumpless group (PL group: blood cardioplegia administration without roller pump) or roller pump group (RP group: blood cardioplegia administration with roller pump). No statistically significant differences were found between the PL group and RP group regarding release of cardiac biomarkers. Maximum postoperative biomarker values reached at T1 (after arrival intensive care unit) for heart-type fatty acid binding protein (2.7 [1.5; 6.0] ng/mL PL group vs. 3.2 [1.6; 6.3] ng/mL RP group, p = .63) and at T3 (first postoperative day) for troponin T high-sensitive (22.0 [14.5; 29.3] ng/L PL group vs. 21.1 [15.3; 31.6] ng/L RP group, p = .91), N-terminal pro-brain natriuretic peptide (2.1 [1.7; 2.9] ng/mL PL group vs. 2.6 [1.6; 3.6] ng/mL RP group, p = .48), and C-reactive protein (138 [106; 175] μg/mL PL group vs. 129 [105; 161] μg/mL RP group, p = .65). Besides this, blood cardioplegia flow, blood cardioplegia line pressure, and aortic root pressure during blood cardioplegia administration were similar between the two groups. Administration of warm blood cardioplegia with or without the use of a roller pump results in similar clinically acceptable myocardial protection.

Effects of protein sources for milk replacers on growth performance and serum biochemical indexes of suckling calves.

This study investigated the effects of protein sources for milk replacers on growth performance and serum biochemical indexes of suckling calves. Fifty Chinese Holstein bull calves with similar BW and age were randomly allocated to 5 groups (1 control and 4 treatments) of 10 calves in each group. Five types of milk replacers were designed to have the same level of energy and protein. The protein source for milk replacers of the control group was full milk protein (MP). The protein source of milk replacers of the 4 treatment groups was composed of MP and one vegetable protein (VP) (30 and 70% of total protein). The 4 types of VP were soybean protein concentrate (SP), hydrolyzed wheat protein (WP), peanut protein concentrate (PP), and rice protein isolate (RP). Results of the experiment showed: 1) there was no significant difference on average daily gain (ADG) and feed:gain ratio (F:G) among the MP, SP and RP groups (P > 0.05), whereas the ADG and F:G of the WP and PP groups were significantly lower compared with the MP group (P < 0.05); 2) there was not a significant difference in withers height, body length and heart girth among treatment groups compared with the MP group (P > 0.05). Thereby the 4 VP milk replacers had no adverse effects on body size of calves; 3) all groups showed no significant difference in the serum contents of urea nitrogen, total protein, albumin, globulin, β-hydroxybutyrate, growth hormone, insulin-like growth factor-1, and the ratio of albumin to globulin (A:G) (P > 0.05). In conclusion, SP or RP (accounts for 70% of the total protein) as calf milk replacers could substitute MP, whereas wheat gluten and PP had a significant adverse effect on growth performance in this experiment.

Plaque morphologies and the clinical prognosis of acute coronary syndrome caused by lesions with intact fibrous cap diagnosed by optical coherence tomography

BackgroundPathological studies have suggested that acute coronary syndrome (ACS) may be caused by culprit lesions with intact fibrous cap (IFC), including plaque erosions. This study sought to evaluate the morphological features and clinical outcomes of patients with ACS caused by lesions with IFC. MethodsA total of 318 patients with ACS who underwent optical coherence tomography (OCT) of a culprit lesion were investigated. The culprit lesions were categorized as follows: those with plaque rupture (PR group), those with an IFC (IFC group), and those with a massive thrombus precluding plaque visualization (MT group). Intravascular ultrasound (IVUS) was performed in 297 patients. Clinical follow-up data were collected regarding adverse cardiac events, including death, myocardial infarction, revascularization, and congestive heart failure requiring hospitalization. ResultsCulprit lesions were categorized into 141 RPs, 131 IFCs, and 46 MTs. IFC group exhibited a smaller remodeling index and less frequently attenuated plaques on IVUS. Three hundred and seven patients (96.5%) were followed for a median follow-up duration of 576days. Adverse cardiac events were observed in 93 patients (30.3%). Kaplan–Meier analysis demonstrated a significantly lower event rate in IFC group compared with the RP and MT groups. Cox proportional hazard analysis demonstrated that an IFC and multivessel disease were independent predictors of adverse events [hazard ratio 0.57, 95% confidence interval (CI) 0.33–0.98, p=0.043 and hazard ratio 1.72, 95% CI 1.09-2.73, p=0.021]. ConclusionsCulprit lesions with IFC showed smaller remodeling indices by IVUS, and were associated with better long-term prognosis compared with those with plaque rupture.

Which Surgical Attitude to Choose in the Context of Non-Resectability of Ovarian Carcinomatosis: Beyond Gross Residual Disease Considerations

In ovarian cancer, the increased rate of radical surgery comprising upper abdominal procedures has participated to improve overall survival (OS) in advanced stages by increasing the rate of complete cytoreductions. However, in the context of non-resectability, it is unclear whether radical surgery should be considered when it would lead to microscopic but visible disease (≤1 cm). We aimed to compare the survival outcomes among patients with incomplete cytoreduction according to the extent of surgery. Overall, 148 patients presenting with advanced stage ovarian carcinomas were included in this retrospective study, regardless of treatment schedule. These patients were stratified according to the extent of surgery (standard or radical). Complete cytoreduction at the time of debulking surgery could not be carried out in all cases. Among our study population (n = 148), 96 patients underwent standard procedures (SPs) and 52 underwent radical surgeries (RP). Patients in the SP group had a lower Peritoneal Index Cancer (PCI) at baseline (12.6 vs. 14.9; p = 0.049). After PCI normalization, we observed similar OS in the SP and RP groups (39.7 vs. 43.1 months; p = 0.737), while patients in the SP group had a higher rate of residual disease >10 mm (p < 10(-3)). Patients in the RP group had an increased rate of relapse (p = 0.005) but no difference in disease-free survival compared with the SP group (22.2 for SP vs. 16.3 months; p = 0.333). Residual disease status did not impact survival outcomes. In the context of non-resectable, advanced stage ovarian cancer, standard surgery seems as beneficial as radical surgery regarding survival outcomes and should be considered to reduce surgery-associated morbidity.

Short- and long-term outcomes of kidney transplants with kidneys lavaged by retrograde perfusion technique

ObjectiveTo evaluate the clinical safety and efficacy of the retrograde perfusion technique in kidney transplantation. MethodsBetween January 2001 and June 2011, 24 cases of kidney transplantation with kidneys perfused using the retrograde perfusion technique due to renal artery variations or injury were selected as the observation group (retrograde perfussion group, RP group). Twenty-two cases of kidney transplantation via conventional perfusion were chosen as the control group (antegrade perfussion group, AP group). There were no statistically significant differences in donor data between the two groups. Cold ischemia time, warm ischemia time, renal perfusion time, amount of perfusion fluid, acute renal tubular necrosis, wound infection, urinary fistula, graft kidney function, and the 1-year, 3-year, and 5-year survival rates for the grafted kidney in both groups were observed and recorded. ResultsThe kidney perfusion time was shorter in the RP group than that in the AP group (3.14 ± 1.00 vs. 5.02 ± 1.15 min, P = 0.030). There were 10 cases of acute renal tubule necrosis in the RP group and 5 in the AP group. The length of hospital stay was 40 ± 14 d in the RP group and 25 ± 12 d in the AP group. The follow-up time was 3.5–8.5 years (mean 6.25 years). The 1-, 3-, and 5-year survival rates for the grafted kidney were 95.8%, 75.5%, and 65.5% in the RP group and 97.1%, 82.5%, and 68.4% in the AP group, respectively (P>0.05). ConclusionsThis study indicates that retrograde perfusion is safe and practicable for cadaveric kidney harvesting and can be regarded as a better alternative or remedial measure for a poorly perfused kidney due to vascular deformity or injury.

Abstract 827: Analysis of p63 protein expression in rat ventral prostate submitted to intrauterine undernutrition associated to hormonal exposure in adult life

Abstract Basal cells expressing p63 contain multipotent stem cells that can efficiently differentiate during postnatal prostate morphogenesis, adult prostate epithelial homeostasis and carcinogenesis. Our project aim is to investigate p63 expression by focusing on the rates of basal epithelial cell proliferation/differentiation in the ventral prostate after intrauterine undernutrition (IUN) associated with or without hormonal exposure in adult life. Briefly, 20 Sprague Dawley dams were distributed equally into two groups during gestation: control diet (NP; fed a normal diet containing 17% protein) and restricted protein diet (RP, fed a diet containing 6% protein). After birth, all animals were maintained on the control diet. Experiment 1: To analyze p63 expression during prostate development, NP and RP animals were euthanized at postnatal day (PND) 3, 10, 21 and 35. The ventral prostate (VP) was dissected, weighed and processed for IHC (Ki67, p63 and AR) and Western blot (WB) analysis (PCNA, p63 and AR). Experiment 2: To analyze p63 expression in adults after hormonal exposure, 14 week-old NP and RP animals were subjected to 17-beta estradiol+testosterone administration (subcutaneous implant) for 16 weeks. The animals were killed at 35 weeks old and the VP was excised, weighed and processed for IHC and WB analysis. RP treated animals showed lower body weight compared to NP control treated animals. Reductions of testosterone plasma levels as well as the absolute and relative values of VP weights from the RP animals compared to the NP animals were observed. Normal glandular architecture was observed in both groups at PND 3, 10, 21 and 35. There was a reduction of AR expression in VP from RP animals at all ages analyzed. However, the proliferation rate and p63+ cells were higher in the RP group indicating that the low androgenic stimulation induced by IUN promoted a delay in VP development. As a consequence, the proliferation/differentiation cell dynamic was impaired, leading to an increase in basal cell number and damaging their differentiation into secretory luminal cells. We observed in hormone exposed adults that prostatitis aggressiveness and prostatic intraepithelial neoplasia (PIN) incidence were higher in the RP compared to NP animals. These results were followed by a decrease in apoptosis index and increases in proliferation rate and p63+ cells. It is clear that IUN alters adult prostate response to androgen/estrogen exposure and interferes in adult prostate susceptibility to diseases. In conclusion, IUN-induced fetal programming impairs ventral prostate growth, maturation and homeostasis highlighting the importance of adequate nutritional status during embryonic/fetal development. Note: This abstract was not presented at the meeting. Citation Format: Jaqueline C. Rinaldi, Caroline N. Barquilha, Sergio AA Santos, Ana C. Camargo, Ketlin T. Colombelli, Sergio L. Felisbin, Luis A. Justulin. Analysis of p63 protein expression in rat ventral prostate submitted to intrauterine undernutrition associated to hormonal exposure in adult life. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 827. doi:10.1158/1538-7445.AM2015-827

Which prosthetic system restores hip biomechanics more effectively? Comparison among three systems

Background: The aim of this paper was to compare ability to restore hip biomechanics among short-stem prosthesis (SSP; MiniHip® Corin, UK), cementless total hip arthroplasty (CTHA; Corail® De Puy, USA) and resurfacing prosthesis (RP; Durom® Zimmer, USA). Methods: One hundred and twenty-four patients with a mean age of 52 yr (26–65 yr) operated on for osteoarthritis were retrospectively studied. There were three groups: SSP n=36, CTHA n=46, and RP n=42. Center of rotation, lateralization, and leg-length discrepancy were evaluated on radiographs and compared to the contralateral healthy (or Tönnis 0 or 1) hips. Results: The center of rotation was equally accurate for the three implants evaluated, but the SSP controlled leg-length discrepancy better than the other two implants; 1.2 mm (−4.7-7 mm) compared with 2.3 mm (−6-7.4 mm) for the CTHA and -2.1 mm (−15-8) for the RP (P=0.001). The mean offset discrepancy in the CTHA group was only 0.6 mm (−7-7) compared with 4.5 mm (−4-7) in SSP and −3.9 (−15-8) in the RP group (P=0.003). The offset was more accurately controlled with the CTHA than the rest of the implants (1.7 mm instead of 3.5 [SSP] and -3.9 [RP] [P=0.0038]). Leg-length accuracy within ±5 mm was obtained in 94% of the hips for SSP, 87% for CTHA, and 67% for RP (P=0.003). Conclusions: Restoration of the center of rotation was equally precise with the three analyzed systems. Considering the contralateral healthy hip, SSP restored more favorably limb length, and offset was more accurately restored with CTHA.

Vaccination with recombinant protein (r22C03), a putative attachment factor of Neoparamoeba perurans, against AGD in Atlantic salmon (Salmo salar) and implications of a co-infection with Yersinia ruckeri

Amoebic gill disease (AGD) affects salmonids during the marine grow-out phase in the Tasmanian industry and in other major salmonid producing countries. During the period post-transfer to seawater, the bacterial condition yersiniosis can also cause high levels of mortality in Atlantic salmon grown in Tasmania, in addition to the hatchery outbreaks. The recombinant protein r22C03, a mannose-binding protein-like (MBP-like) similar to attachment factors of other amoebae, was tested as a vaccine candidate against AGD in a large scale challenge trial. Fish were immunised with r22C03 combined with FCA via intraperitoneal (i.p.) injection, and given a booster five weeks later by either i.p. injection (RP group) or by a dip-immersion (mRP). Fish were then challenged twice with Neoparamoeba perurans: the initial challenge 16 weeks after primary immunisation was terminated due to presence of ulcerative lesions in the skin of salmon; the second challenge was carried out after five weeks of treatment with oxytetracycline. These skin lesions might have been associated with a concurrent infection with Yersinia ruckeri, which was detected by real-time qPCR in serum of a large proportion of moribund and survivor fish after the AGD challenge. Before and during the N. perurans infection, levels of antibodies against r22C03 were measured by ELISA in serum, skin mucus and supernatant from skin and gill explants. For the second challenge, the average size of AGD lesions was recorded from histology sections and survival curves were obtained. Before AGD challenge, r22C03 induced antibody responses in serum and explants with both vaccination strategies. At the end of the challenge, levels of antibodies were lower than before challenge irrespective of treatment. Both vaccinated groups presented increased serum antibody responses, while only mRP presented antibody responses in skin mucus, and no significant antibody responses were measured in the explants. Antibodies did not confer protection to N. perurans infection, as no difference was observed in the survival curves of the vaccinated and control groups, and there was no effect on the gill lesion size. The concurrent yersiniosis infection probably represented more closely infection patterns observed in commercial settings. However, it could have interfered with the survival results and with the ability of the fish to respond to the amoebae infection.

Comparing the efficacy and safety between robotic-assisted versus open pyeloplasty in children: a systemic review and meta-analysis.

This manuscript is mainly to systemically review the published reports that compared the efficacy and safety of robotic-assisted (RP) versus open pyeloplasty (OP) in children with ureteropelvic junction obstruction (UPJO). We did a systemic search in the PubMed(®) for all randomized controlled trials or comparative studies that compared the surgical results of robotic versus open pyeloplasty in children with UPJO. Two of the authors (Hsu and Chang) independently did the literature search, quality assessment, and data extraction. The obtained data were analyzed with Cochrane Collaboration Review Manager (RevMan(®), version 5.3). The end points of the analysis and review included age, operative time, hospital stay, costs, complications, and success rate. In total, seven comparative trials and three studies using national database met the criteria that comprised 20,691 (RP:OP = 1956:18,735) patients in the meta-analysis. Most studies reported median value of patient age, operative time, and hospital stay. Only a small proportion of studies could be included for meta-analysis. The enrolled trials revealed that RP was more frequently performed in older children, required longer operative time, and shorter hospital stay. The postoperative success rate was comparable (RR = 0.99, 95 CI 0.94-1.04). Comparing with OP, there was a significant higher complication rate (RR = 1.29, 95 CI 1.10-1.51) and higher costs in the RP group. Robotic-assisted pyeloplasty may be a promising alternative minimal invasive surgery for UPJO in children if the higher complication rates and higher costs in the RP can be overcome in the near future.

Effects of joint position on the distraction distance during grade III glenohumeral joint distraction in healthy individuals.

[Purpose] The study investigated the effects of joint position on the distraction distance during Grade III glenohumeral joint distraction in healthy individuals. [Subjects and Methods] Twenty adults in their forties without shoulder disease were randomly divided into neutral position group (NPG; n = 7), resting position group (RPG; n = 7), and end range position group (ERPG; n = 6). After Kaltenborn Grade III distraction for 40s, the distance between glenoid fossa and humeral head was measured by ultrasound. [Results] The average distances between the humeral head and glenoid fossa before distraction were 2.86 ± 0.81, 3.21 ± 0.47, and 3.55 ± 0.59 mm for the NP, RP, and ERP groups. The distances after applying distraction were 3.12 ± 0.51, 3.86 ± 0.55, and 4.35 ± 0.32 mm. Between-group comparison after applying distraction revealed no significant differences between the NP and RP groups, while there was a statistically significant difference between the NP and RP groups, as well as between the NP and ERP groups. [Conclusion] Joint space was largest in ERP individuals when performing manual distraction.