STA Group Research Articles

Effector memory CD4+ T-cells and dendritic cells are noninvasive biomarkers of late cellular rejection after kidney transplantation

Introduction. Diagnosis of the kidney transplant cellular rejection in the long-term after transplantation remains a challenge. Usual surrogate markers are not enough sensitive and specific. Rejection is an immune reaction to donor alloantigens. The kidney transplant biopsy to diagnose a dysfunction is an invasive procedure with the incidence of complications about 12.6% and can lead to transplant loss. In this regard, the search of immunological biomarkers for early noninvasive and accurate diagnosis of kidney transplant rejection is an actual task.Material and methods. This is a report of the observational retrospective single-center, comparative case-control study in two groups involving 44 patients who underwent kidney transplantation. The first group (REJ) included the patients with the chronic graft dysfunction caused by a biopsy-confirmed late cellular rejection (22 patients). The second group (STA) included the recipients who had no dysfunction in the posttransplant period (22 patients). Flow cytometry of peripheral blood cells was performed to identify immunophenotyping markers of late cellular rejection after kidney transplantation (we determined subpopulations of T, B lymphocytes, and dendritic cells).Results. As a result of our work, we found significant differences in the absolute count of effector memory T cells making 0.147 (0.115–0.260) × 109 cell/L in REJ group, and 0.106 (0.067–0.136) × 109 cell/L in STA group (р = 0.0167). Relative and absolute counts of myeloid dendritic cells were also different between the groups: 0.65 (0.36–0.73) vs. 1.05 (0.67–1.4) % and 0.039 (0.028–0.056) vs. 0.063 (0.049–0.076) × 109 cell/L, respectively (р = 0.0009, р = 0.003). The numbers of plasmacytoid dendritic cells were also different between the study groups: 0.0038 (0.0021–0.0054) vs. 0.005 (0.0035–0.007) × 109 cell/L for an absolute count (р = 0.0414), and 0.055 (0.04–0.085) vs. 0.09 (0.05–0.12) % for a relative count (р = 0.0197).Conclusion. The obtained data showed that the blood level of dendritic cells, which are the main “professional” initiators of immune reaction, and the level of effector helper T memory cells, which constitute the main lymphocyte subpopulation posing a destructive impact on the kidney transplant, can be considered as diagnostic markers of kidney transplant cellular rejection in the long-term after surgery.

Dendritic Cells as a Non-Invasive Immunological Biomarker of the Late Cellular Rejection after Kidney Transplantation

The Aim of the Study was to determine the association between peripheral blood leukocytes subpopulations and late immunological kidney transplant dysfunction. Materials and Methods This is a report of retrospective single center case-control study involving 44 patients who underwent kidney transplantation. Inclusion criteria: adult kidney transplant recipients who received first kidney transplant with a follow-up 4 and more years after KT. Exclusion criteria were infectious and oncological complications in the postoperative period, high immunological risks at the time of surgery (HLA mismatching, PRA>15%). First group (REJ) include 22 patients with chronic graft dysfunction, caused by biopsy proven late cellular rejection. Second group (STA) contained of 22 recipients, who haven’t any dysfunction in posttransplant period. Flow cytometry of peripheral blood cells was performed for establishment of immunophenotyping markers of late cellular rejection after kidney transplantation. Results The level of dendritic cells (DC) subsets significantly differed in study groups. Myeloid DCs were significantly lower in participants (REJ) with late cellular rejection than in stable recipients (STA): 0,65% (0,36-0,73) vs 1,05% (0,67-1,4), respectively (p<0,01). Absolute counts of cells were 0,039 (0,028-0,056) x109/l vs 0,063 (0,049-0,076) x109/l respectively for REJ and STA groups (p=0,003). Plasmacytoid DCs were significantly lower in participants with late cellular rejection too: 0,055% (0,04-0,085) vs 0,09% (0,05-0,12), REJ vs STA respectively (p=0,02). Absolute counts of pDC were 0,0038 (0,0021-0,0054) x109/l vs 0,005 (0,0035-0,007) x109/l in REJ and STA groups (p=0,041) Diagnostic value of each marker was assessed by receiver operating characteristic analysis. Optimal cut-off of myeloid DC, which can accurately discriminate late cellular rejection, was assessed as 0.87%, with area under ROC curve (AUC) 0.784, sensitivity 86.36%, and specificity 63.64%. For plasmacytoid DC optimal cut-off was 0.085%, with AUC 0.7, sensitivity 77.72%, and specificity 59%. Odds ratio of DC subsets frequency mitigation at time of late kidney rejection was 11.08 (p<0.01) for myeloid DC, and 4.91 (p=0.017) for plasmacytoid DC respectively. Conclusion The results of the study showed that the level of circulating myeloid and plasmacytoid dendritic cells can be effective non-invasive immunological marker of late cellular rejection after kidney transplantation.

Injury and mechanism of recombinant E. coli expressing STa on piglets colon.

Enterotoxigenic Escherichia coli (ETEC) is primary pathogenic bacteria of piglet diarrhea, over two thirds of piglets diarrhea caused by ETEC are resulted from STa-producing ETEC strains. This experiment was conducted to construct the recombinant E. coli expressing STa and study the injury and mechanism of recombinant E. coli expressing STa on 7 days old piglets colon. Twenty-four 7 days old piglets were allotted to four treatments: control group, STa group (2 × 109 CFU E. coli LMG194-STa), LMG194 group (2 × 109 CFU E. coli LMG194) and K88 group (2 × 109 CFU E. coli K88). The result showed that E. coli infection significantly increased diarrhea rates; changed DAO activity in plasma and colon; damaged colonic mucosal morphology including crypt depth, number of globet cells, density of lymphocytes and lamina propria cell density; substantially reduced antioxidant capacity by altering activities of GSH-Px, SOD, and TNOS and productions of MDA and H2O2; obviously decreased AQP3, AQP4 and KCNJ13 protein expression levels; substantially altered the gene expression levels of inflammatory cytokines. Conclusively, STa group had the biggest effect on these indices in four treatment groups. These results suggested that the recombinant strain expressed STa can induce piglets diarrhea and colonic morphological and funtional damage by altering expression of proteins connect to transportation function and genes associated with intestinal injury and inflammatory cytokines.

Effects of Strength Training and Anabolic Steroid in the Peripheral Nerve and Skeletal Muscle Morphology of Aged Rats

Thirty male 20-month-old Wistar rats were divided into groups: IC—initial control (n = 6), FC—final control (n = 6), AC—anabolic hormone control (n = 6), ST—strength trained (n = 6) and STA—strength trained with anabolic hormone (n = 6). All groups were submitted to adaptation, familiarization and maximum load carrying test (MLCT). Strength training (6–8×/session with loads of 50%–100% MLCT, 3×/week and pause of 120 s) was performed in ladder climbing (LC) for 15 weeks. The administration of testosterone propionate (TP) was performed 2×/week (10 mg/kg) in animals in the AC and STA groups. After the experimental period, animals were euthanized and the tibial nerve and plantaris muscle removed and prepared for electron transmission and histochemistry. To compare the groups we used one-way ANOVA (post hoc Bonferroni), student’s t-tests for pre vs. post (dependent and independent variables) comparisons and significance level set at p ≤ 0.05. The following significant results were found: (a) aging decreased the number of myelinated axon fibers; (b) use of isolated TP increased the diameter of myelinated fibers, along with increased thickness of myelin sheath; (c) ST increased area of myelinated and unmyelinated fibers, together with the myelin sheath. These changes made it possible to increase the area occupied by myelinated fibers keeping their quantity and also reduce the interstitial space; and (d) association of anabolic steroid and ST increased the area of unmyelinated axons and thickness of the myelin sheath. Compared to ST, both strategies have similar results. However, Schwann cells increased significantly only in this strategy.

Heart rate variability changes and emotion regulation abilities in short- and long-term abstinent alcoholic individuals

IntroductionDifficulties in identifying and regulating emotion are recognized as major factors of relapse in alcohol use disorders (AUD). This study aimed to evaluate the differences of emotion regulation processes in AUD patients with short-term (STA, less than one month) and long-term abstinence (LTA, at least six months) by recording the high frequency of Heart Rate Variability (HF-HRV) in response to emotional and neutral stimuli. MethodEmotional induction constituted the presentation of highly emotional and neutral pictures (IAPS data base) presenting human interactions. HF-HRV was recorded before (at rest), during (pictures) and after emotional induction (recovery). ResultsThe results showed higher phasic HF-HRV in the STA group in comparison to the LTA and C groups for negative, positive and neutral stimuli. In the LTA group, we observed a normalization of HRV, in response to emotional stimuli. However, for negative valence stimuli in the recovery period, LTA participants are no more different from STA group. A main positive correlation was observed for both patient groups between craving scores and increased HF-HRV during and after the emotion induction. ConclusionThe data support the hypothesis of emotion regulation impairment after STA but also show a partial improvement with prolonged abstinence. This impairment in patients may correspond to the maintenance of negative feedback that accentuates the difficulties in the emotional physiological process and limits the ability to engage in or maintain other processes. HF-HRV is a good indicator of emotion regulation processes related to the intensity of the craving even after long-term abstinence.

Outcomes of open staged corrective surgery in the setting of adult spinal deformity

Background ContextAdult spinal deformity (ASD) represents a constellation of complex malalignments affecting the spinal column. Corrective surgical procedures aimed at improving ASD can be equally challenging, and commonly require multiple index procedures and potential revisions before definitive management. There is a paucity of data comparing the outcomes of same-day(simultaneous [SIM]) and 2-day (staged [STA]) procedures for long spinal fusions for ASD. Using a large patient cohort with surgeon- and patient-reported outcomes will be particularly useful in determining the utility and effect of staging long spinal fusions for ASD. PurposeThis study aimed to compare intraoperative, perioperative, and 2-year outcomes of STA and SIM procedures correcting ASD. Study DesignThis is a retrospective analysis of a prospective multicenter database. Patient SampleA total of 142 patients (71 STA, 71 SIM) were included. Outcome MeasuresPrimary outcome measures were intra- and perioperative (6 weeks) complication rates. Secondary outcome measures were 2-year thoracolumbar and spinopelvic radiographic parameters, 2-year health-related quality of life (HRQoL) changes (Oswestry Disability Index [ODI] and Short Form-36 [SF-36]), and 2-year complication rates. MethodsInclusion criteria included patients with ASD ≥18 years with 6-week and 2-year follow-up. Propensity score matching identified similar patients undergoing STA or SIM long spinal fusions based on surgical invasiveness, pelvic tilt, and sagittal vertical axis (SVA). Complications, HRQoL scores (Scoliosis Research Society-22 Patient Questionnaire [SRS-22r], SF-36, ODI), and patient characteristics were compared across and within treatment groups at follow-up with analysis of variance (ANOVA) and paired t tests at three surgical stages: intraoperatively, perioperatively (6 weeks), and postoperatively (>6 weeks). ResultsA total of 142 patients were included (71 STA, 71 SIM). Matching STA and SIM groups based on degree of deformity and surgical invasiveness created two groups similar in overall correction of the surgery. Patients undergoing STA underwent more anterior lumbar interbody fusion (ALIF) and lateral lumbar interbody fusion (LLIF) procedures, whereas patients undergoing SIM had longer fusions. Charlson comorbidity index and revision status were similar between groups (p>.05). Staging procedures had significantly more complications causing reoperation (STA: 47% vs. SIM: 8%, p=.021), and had a greater number of perioperative complications requiring a return to the operating room (OR) (STA: 9.9% vs. SIM: 1.4%, p=.029). There was no difference in intraoperative complications, mortality, or perioperative infection or wound complications (p>.05) between the two procedures. At 2-year follow-up, incidence of revision surgery was higher in STA (STA: 21.1% vs. SIM: 8.5%, p=.033). ConclusionStaged spinal fusions, which add ALIFs and LLIFs to the procedure, compared with similar-correction SIM procedures, result in similar intraoperative complication incidence, but significantly higher rates of peri- and postoperative complications leading to revision. Functional outcomes, radiographic parameters, and mortality were similar. This will aid surgeons in their determination of the optimal treatment for such complex procedures.

Radiological and functional 24-month outcomes of resurfacing versus stemmed anatomic total shoulder arthroplasty.

This study compared clinical and radiographic outcomes of patients undergoing resurfacing total shoulder arthroplasty (TSA) with those treated with a stemmed TSA. Patients with primary osteoarthritis who underwent humeral resurfacing (RES) or stemmed (STA) TSA were identified in our shoulder arthroplasty register for retrospective analysis. Standard radiographs and clinical/patient-rated assessments were made up to 24months post-surgery. Implant revisions were assessed. Patients were frequency-matched in a 1:1 (RES:STA) ratio based on gender and age, and compared with regard to operation time and shoulder function (Constant, SPADI and Quick DASH scores). Mixed models with statistical adjustments were applied. From 2006 to 2014, 44 RES and 137 STA operations were performed in 157 patients; one and two revisions were recorded in the RES and STA group, respectively. The final matched cohort included a total of 69 patients and 37 operations per treatment group. Resurfacing TSA was 17min shorter (95%CI: 5-28) compared to the stemmed procedure (p = 0.005). RES and STA patients showed significant functional improvement sixmonths post-implantation, yet all measured scores did not differ between the groups at 2years (p ≥ 0.131). The status of static centering of the humeral head, acromiohumeral distance, and a lack of signs of implant loosening were also similar between treatments. Similar 24-month post-operative radiological and functional outcome is achieved by RES and STA patients, even with a shorter RES surgery time. Larger cohorts and longer follow-up are required to better assess implant survival.

Resveratrol promotes myenteric neuroprotection in the ileum of rats after ischemia-reperfusion injury

AimsThe present study evaluated the effects of resveratrol in the myenteric plexus after intestinal ischemia-reperfusion (I/R) injury caused by occluding the superior mesenteric artery for 45min, followed by 7days of reperfusion. Main methodsForty-two male Wistar rats were divided into seven groups: control (C group), untreated sham surgery control (SC group), sham surgery control treated with resveratrol before surgery (STA group), sham surgery control treated with resveratrol before and after surgery (STAD group), ischemic control (IRC group), ischemic treated before I/R (IRTA group), and ischemic treated before and after I/R (IRTAD group). Resveratrol (10mg/kg) was administered for 4days and 2h prior to surgery and/or 7days later. Morphometric analyses were performed, and the density of the general neuronal population (HuC/D-immunoreactive [IR]), nitrergic subpopulation (neuronal nitric oxide synthase [nNOS]-IR), vasoactive intestinal peptide (VIP)ergic varicosities (VIP-IR), and glial cells (S100-IR) was determined. Key findingsInjury that was caused by I/R significantly reduced (p<0.01) the HuC/D-IR general neuronal population. Treatment with resveratrol before and after ischemia had a neuroprotective effect. Morphometric changes caused by I/R in nitrergic neurons and varicosities were also attenuated by resveratrol. Ischemia/reperfusion promoted the proliferation of enteric glial cells, and resveratrol treatment before and after I/R reversed this effect. SignificanceResveratrol had neuroprotective effects, showing promise for application in intestinal surgery and transplants.

Contingency management is effective in promoting abstinence and retention in treatment among crack cocaine users in Brazil: A randomized controlled trial.

Crack cocaine dependence has become a severe public health problem in Brazil, and current psychosocial approaches to this problem have shown little or no effectiveness. Although contingency management is among the most effective behavioral treatments for substance use disorders, it has never been applied in the treatment of crack cocaine-dependent individuals in Brazil. The aim of this study was to evaluate the efficacy of incorporating contingency management into standard outpatient treatment for crack cocaine dependence, as well as the impact that doing so has on treatment attendance, retention in treatment, maintenance of abstinence, and the frequency of substance use. We evaluated 65 treatment-seeking, crack cocaine-dependent individuals, randomized to receive 12 weeks of standard treatment plus contingency management (STCM; n = 33) or 12 weeks of standard treatment alone (STA; n = 32). Those in the STCM group received monetary incentives for being abstinent, earning up to US$235.50 if they remained abstinent throughout the entire treatment period. The STCM group participants attended a mean of 19.5 (SD = 14.9) treatment sessions, compared with 3.7 (SD = 5.9) for the STA group participants (p < .01). Those in the STCM group were 3.8, 4.6, and 68.9 times more likely to be retained in treatment at weeks 4, 8, and 12 than were those in the STA group. The likelihood of detecting 4, 8, and 12 weeks of continuous abstinence was 17.7, 9.9, and 18.6 times higher in the STCM group than in the STA group (p < .05). Compared to the STA group, the STCM group submitted a significantly higher proportion of negative samples for crack cocaine, delta-9-tetrahydrocannabinol, and alcohol (p < .001) when all expected samples were included in the denominator but not when only submitted samples were considered. The average monthly cost/participant for incentives was $29.00. Contingency management showed efficacy in a sample of Brazilian crack cocaine users. The intervention holds promise for broader application in international settings. (PsycINFO Database Record

Efficacy and safety of a NiTi CAR 27 compression ring for end-to-end anastomosis compared with conventional staplers: A real-world analysis in Chinese colorectal cancer patients

OBJECTIVES:This study aimed to evaluate the safety and efficacy of a new nickel-titanium shape memory alloy compression anastomosis ring, NiTi CAR 27, in constructing an anastomosis for colorectal cancer resection compared with conventional staples.METHODS:In total, 234 consecutive patients diagnosed with colorectal cancer receiving sigmoidectomy and anterior resection for end-to-end anastomosis from May 2010 to June 2012 were retrospectively analyzed. The postoperative clinical parameters, postoperative complications and 3-year overall survival in 77 patients using a NiTi CAR 27 compression ring (CAR group) and 157 patients with conventional circular staplers (STA group) were compared.RESULTS:There were no statistically significant differences between the patients in the two groups in terms of general demographics and tumor features. A clinically apparent anastomotic leak occurred in 2 patients (2.6%) in the CAR group and in 5 patients (3.2%) in the STA group (p=0.804). These eight patients received a temporary diverting ileostomy. One patient (1.3%) in the CAR group was diagnosed with anastomotic stricture through an electronic colonoscopy after 3 months postoperatively. The incidence of postoperative intestinal obstruction was comparable between the two groups (p=0.192). With a median follow-up duration of 39.6 months, the 3-year overall survival rate was 83.1% in the CAR group and 89.0% in the STA group (p=0.152).CONCLUSIONS:NiTi CAR 27 is safe and effective for colorectal end-to-end anastomosis. Its use is equivalent to that of the conventional circular staplers. This study suggests that NiTi CAR 27 may be a beneficial alternative in colorectal anastomosis in Chinese colorectal cancer patients.

Evaluation of Immune Profiles and MicroRNA Expression Profiles in Peripheral Blood Mononuclear Cells of Long-Term Stable Liver Transplant Recipients and Recipients With Acute Rejection Episodes

ObjectiveThis study aimed to document the difference of immunophenotypes in peripheral blood mononuclear cells (PBMCs) between long-term stable liver transplant recipients and recipients with acute rejection. We also sought to identify whether there is any correlation between microRNA (miRNA) expression profile and the differential immunoprofile in these 2 groups to establish a specific miRNA biomarker to identify potential liver transplant recipients. MethodsPBMCs were isolated from 53 stable liver transplant recipients (STA group) and 15 liver transplant recipients with repeated biopsy-proven rejection episodes admitted to our hospital. Immunoprofiles were analyzed by means of flow cytometry. Analysis of miRNA expression in the PBMCs was performed by means of real-time polymerase chain reaction. ResultsThe immune profiling analysis showed increased frequency of peripheral natural killer cells and regulatory T cells in stable liver transplant recipients compared with the acute rejection recipients and healthy volunteers (P < .05). There was no significant difference in the immune cell levels (CD19+ B cells, CD4+ T cells, and CD8+ T cells) in PBMCs among the transplant recipient groups and healthy control subjects. Three miRNAs, miR-18b, miR-340, and miR-106b, were up-regulated in the PBMCs of the STA recipients compared with recipients with acute rejection. ConclusionsThese results suggest that miR-18b, miR-340, and miR-106b, which regulate the expression of specific immunophenotypes, can be used as potential biomarkers to identify long-term stable liver transplant recipients from recipients with acute rejection.

The clinical value of serum sialic acid and lactadherin in the prognosis evaluation of atherosclerotic heart disease

Objective To discuss the effect and clinical value of serum sialic acid (SA)and lactadherin(MFG-E8)in the coronary atherosclerotic heart disease(CHD). Methods Selected 295 patients who visited to Wuhan University Renmin's Hospital cardiovascular medicine (from January to June, 2014), and then according to the results of coronary angiography divide the subjects into control group(n=78, the result of coronary angiography completely normal)and coronary heart disease group(n=217, the results of coronary angiography showed that one major coronary stenosis was more than 30%). Detected their serum level of lipid, SA, MFG-E8, hs-CRP index. At last, analyze the differences of SA and MFG-E8 between these groups, and the correlation with the severity of coronary stenosis (symbolize with Gensini score), use the binary logistic regression analysis to research the relationship among the serum level of SA, MFG-E8 and the risk of CHD. Results Compared with the control group, the patients with CHD have a higher level of serum SA and a lower level of MFG-E8 (U=4 402.5, 2 736.0 respectively, P<0.001); the AMI group has a higher level of serum SA than the StA and UA groups (U=1 329.0, 957.5 respectively, P<0.001); the AMI group has a lower level of serum MFG-E8 than the StA groups (U=1517.0, P<0.001). The spearman correlation analysis showed that the serum SA has a positively correlation with the level of TG, hs-CRP and Gensini score, and has a negatively correlated with the level of MFG-E8(r=0.214, 0.462, 0.378, -0.322 respectively, P<0.01); the MFG-E8 has a negatively correlated with the level of TG, hs-CRP and Gensini score (r=-0.18, -0.425, -0.564 respectively, P<0.01). Binary logistic regression analysis showed that there was a positive correlation between the serum SA and the risk of CHD (OD= 4.782, 5.319, 4.179 3.832, 3.648 respectively, P<0.001), and the was a negative correlation between the serum MFG-E8 and the risk of CHD (OD= 0.118, 0.112, 0.127, 0.135, 0.134 respectively, P<0.001). Conclusion With the serum SA rised and the MFG-E8 reduced, the risk of coronary heart disease was higher, combined detection these two indexes may be able to diagnose the CHD and assess the degree of stenosis and the risk of CHD.(Chin J Lab Med, 2015, 38: 746-750) Key words: Coronary disease; N-acetylneuraminic acid; Milk proteins; C-reactive protein; Risk factors

Changes in heart rate variability to emotional information in short- and long-term alcohol abstinent patients

IntroductionSevere alcohol use disorders (AUD, DSM5 criteria, 2013) are associated with changes in the dynamics of emotional processes and emotional experience [1]. The aim of the study was to compare emotional information processing in patients with AUD in short-term abstinence (STA, less than 1 month) and in long-term abstinence (LTA, at least 6 months) with control participants (C). We studied the parasympathetic branch of the autonomic nervous system with the heart rate variability (HRV) and more particularly high frequencies (HF). This indicator is recognized as a reliable marker of physiological activation in reaction to emotional stimuli and as a good marker of vulnerability to AUD [2].MethodThe recording was performed for all participants during presentation of high emotional inducing stimuli presenting human interactions [3]. For each participant HRV was recorded before, during and after induction. Participants were asked to evaluate the intensity and the valence of emotional stimuli. In addition, a clinical and cognitive assessment was performed. We proposed in this study for abstinence in short- and in long-term to combine both behavioral and cognitive measures to this physiological indicator.ResultsWe observed:– significant differences in HF-HRV between LTA and STA groups, controls and STA groups but not between LTA and C groups;– significant correlations between craving scores [4] and HF-HRV results in LTA and STA groups.ProspectThe results support the relationship between the ability to process emotional information and the risk of relapse. HF-HRV results indicate specific deficits in regulation in STA group and also recoveries in LTA group. It suggests specific different therapeutic interventions in preventing the risk of relapse or maintenance of addiction.

Early supplementation of starter pellets with alfalfa improves the performance of pre- and postweaning Hu lambs.

This study aims to determine the effects of alfalfa supplementation on the pre- and postweaning performance, rumen development, and feed transition in starter diet-fed lambs. Six of 66 male Hu lambs were slaughtered at the age of 10 d to serve as a control. The other 60 lambs were randomly allocated to 2 dietary treatments: milk replacer and starter pellets without (STA) or with free-choice chopped alfalfa (S-ALF). The animals were offered 300 g/d of the concentrate mixture and had free access to alfalfa after weaning at the end of wk 4 (age 38 d). The alfalfa inclusion in the S-ALF group tended to increase the starter intake before weaning, significantly increased the concentrate intake soon after weaning ( < 0.05), and increased the BW ( < 0.01) and ADG ( < 0.10) in pre- and postweaning lambs. The S-ALF group had heavier carcasses ( < 0.05), rumens ( < 0.05), reticula ( < 0.05), omasums ( < 0.10), abomasums ( < 0.05), and visceral organs ( < 0.10) than the STA lambs after weaning. Alfalfa supplementation increased ( < 0.05) the rumen papillae length and the ratio of the duodenal villus height to the crypt depth; it also decreased ( < 0.05) the concentration and molar proportion of propionate in wk 1 and 5. The STA lambs had higher ( < 0.01) blood concentrations of globulin and blood urea nitrogen and lower β-hydroxybutyrate after weaning. The STA group also had a higher incidence of feed plaque. From the above results, we infer that the free-choice addition of chopped alfalfa to starter diets is beneficial to rumen development, relieves weaning stress, and improves the performance of lambs.

150 USING A LUTEINIZING HORMONE SURGE DETECTION TEST, PREDI&amp;apos;BOV&amp;reg;, TO OPTIMIZE THE TIME OF ARTIFICIAL INSEMINATION DURING A SUPEROVULATION PROTOCOL IN A HOLSTEIN HEIFERS HERD

Insemination of superovulated bovine donors in due time is of central importance for fertilization and embryo viability. A preliminary test focusing on LH surge detection during superovulation (unpublished datas) indicated that one quarter of the donors present LH surges 12 to 24 h before heat observation (which could correspond, in the case of AI after heat observation, to post ovulation AI). Therefore, it was hypothesised that the average number of embryos per flush could be improved by inseminating donors with early LH surge 12 h after the beginning of the LH peak whenever the heat occurs.In a donor herd station, a trial was performed with 54 Holstein heifers, equipped with Heatime® tags (system detecting the peak activity linked to the heat) collected twice or 3 times after the following superovulation protocol: D-6 to D-11 = reference heat; D0 = input of an implant of norgestomet (Crestar®); D2 8:00 = first FSH (Stimufol®) injection (FSH1); D4 8:00 = cloprostenol (Estrumate®) injection; D4 16:00 = implant removal; D5 8:00 = FSH7 and first LH surge detection test (Predi'Bov®); D5 16:00 = FSH8 and 2nd Predi'Bov® test. Two AI's at interval of 8 to 16h were done (AI's were performed either at 9:00, or between 17:00 and 19:00). For the standard protocol (= STA), thefirst AI occurred after heat observation or activity peak detection by Heatime (whatever the Predi'Bov® test results were). For the adjusted protocol (= ADJ), the first AI occurred from 11 to 16 h after the first positive Predi'Bov® test result or like STA protocol if both results were negative. Heifers followed alternately the 2 protocols, 27 beginning with the ADJ protocol, 27 others with the STA one. LH surge precocity was not repeatable among donors. In the case of an early LH surge detection (one positive Predi'Bov® test), the heat activity peak occurred from 2 to 8 h after the FSH8 for 44% of the flushes, from 8 to 24 h after FSH8 for 54% of the flushes and never for 2% of the flushes. When no early LH surge was observed, the heat activity peak occurred more than 8 h after FSH8 for 78% of the flushes. Interval of heat activity peak-FSH8, IA1-heat activity peak and IA1-early LH surge were highly variable but did not effect the mean number of viable embryos. However, we observed a significant effect (P = 0.04) of the precocity of the heat on the average number of total embryos: 13.8 ± 8.4 v. 11.1 ± 8.1 when the interval heat activity peak-FSH8 had been respectively &lt;8 h or ≥8 h, respecively. Among the 148 collections, 74 were done after the STA protocol, 74 after the ADJ protocol and 70 followed an early LH surge. The adjustment of the AI depending on the detection of an early LH surge (ADJ protocol) had a significant positive (P = 0.04) effect on the mean percentage of viable embryos per flush (52% ± 28 in STA group and 62% ± 31 in ADJ group). Nevertheless, regarding the mean number of viable embryos, this effect failed to reach significance (P = 0.23) (respectively 5.7 ± 5.1 in STA group and 6.7 ± 6.7 in ADJ group). A larger study on more animals is necessary to obtain a significant difference in the number of viable embryos.

Displaced Intra-Articular Calcaneal Fractures Treated in a Minimally Invasive Fashion

The optimal treatment for displaced intra-articular fractures of the calcaneus remains controversial. This study aims to assess the clinical outcomes of a minimally invasive longitudinal approach compared with the sinus tarsi approach in the surgical treatment of these fractures. Patients with a displaced intra-articular fracture of the calcaneus who were admitted to the trauma center of our hospital from September 2009 through April 2010 were randomly assigned to treatment using one of these two surgical techniques. All patients underwent the same standardized postoperative rehabilitation protocol. Functional outcome was assessed by using the American Orthopaedic Foot & Ankle Society scores. Linear regression analysis was performed to identify the potential influencing factors for functional outcomes. One hundred and sixty-seven patients who met the inclusion criteria were included in the study. Thirty-seven patients were lost to follow-up for various reasons, and the remaining 130 patients were followed for an average of twenty-seven months. Sixty-nine fractures in sixty-three patients were treated using a minimally invasive longitudinal approach (the MILA group), and seventy-two feet in sixty-seven patients were treated with a sinus tarsi approach (the STA group). The two groups were comparable in terms of age, sex, fracture type, and time from injury to operation. The operative time in the MILA group was significantly shorter than that in STA group (p < 0.05). Wound-healing complications were 2.9% in the MILA group and 12.5% in the STA group. The average time to the start of progressive weight-bearing exercise was 5.3 weeks in the MILA group and 5.6 weeks in the STA group (p > 0.05). The good and excellent results in the two groups were comparable for the Sanders type-II and III calcaneal fractures (p > 0.05), but the good to excellent rate in the STA group was significantly higher for the Sanders type-IV fractures (p < 0.05). Linear regression analysis showed that surgical technique, Sanders classification, and the time to the start of weight-bearing activity have a significant influence on functional outcomes. Outcomes are similar for the minimally invasive longitudinal and sinus tarsi surgical approaches in the treatment of Sanders type-II and III displaced intra-articular fractures of the calcaneus, with the benefit of a lower complication rate and shorter operative time for the minimally invasive technique. For Sanders type-IV fractures, however, the sinus tarsi approach appears to be the treatment of choice.

The effect of a topical anesthetic on the sensitivity of calf dehorning wounds

The objective was to determine the effect of a topical local anesthetic on the sensitivity of dehorning wounds in calves. Thirty 2-mo-old Holstein-Friesian calves were randomly allocated to sham dehorning control (CON), scoop dehorning without treatment with topical anesthetic (SnoTA), or scoop dehorning with an application of a topical anesthetic (STA). Sensitivity was measured by providing mechanical stimulation to the dehorned wound and peri-wound area using von Frey monofilaments calibrated at 10 and 300g. Calf responses were categorized as absent, minor, moderate, or severe. Sensitivity measurements were performed before treatment and at various time points up to 24h posttreatment. Sham dehorned calves displayed unchanging absent or minor responses to stimulation. Regardless of whether topical anesthetic was applied, scoop dehorned calves were more likely to display minor, moderate, or severe responses than sham dehorned control calves, and responses tended to be most extreme at 4h postdehorning. Calves in the STA group tended to be less likely to display minor, moderate, or severe responses than calves in the SnoTA group at most time points (exception at 4h postdehorning). Responses were significantly more likely to be less severe in STA calves than in SnoTA calves at 40min and 1.5h following dehorning. Thus, the use of the topical anesthetic for calves reduced the short-term sensitivity of scoop dehorning wounds.

Soluble Human Leukocyte Antigen-G in Pediatric Renal Transplantation

Soluble Human Leukocyte Antigen-G in Pediatric Renal Transplantation

Timing of events in STEMI patients treated with immediate PCI or standard medical therapy: Implications on optimisation of timing of treatment from the CARESS-in-AMI trial

Objectives Early angioplasty after thrombolysis is now recommended for ST-elevation myocardial infarction, but the current guidelines propose a wide time-window ranging between 3 and 24 h after lytic administration. To identify the optimal timing for PCI after thrombolysis, we analyzed frequency and time course of the adverse events in patients randomized in the multicenter CARESS-in-AMI trial. Methods 598 high-risk patients with STEMI recruited in the CARESS-in-AMI study, were divided into the Immediate PCI group (IMM, n = 298), Rescue PCI group (RES, n = 107) and Standard Treatment Arm without rescue PCI (STA, n = 193). Results RES patients had worse pre-procedural TIMI flow and post-procedural blush grade. At 30 days, there were 23 deaths: 11 (10.3%) in RES, 9 (3%) in IMM and 3 (1.6%) in STA ( p < 0.001). There were 22 episodes of refractory ischemia or re-infarction: 17 (8.8%) in the STA group, 4 (1.6%) in IMM and 1 (0.9%) in RES ( p < 0.001). In the RES group 10/11 (90.9%) deaths occurred before day 5. In the STA group, all deaths and the majority of ischemic events occurred after day 3. A reduction of risk of death was observed if PCI after thrombolysis was performed within 3.35 h from initial hospitalization. Conclusions The mortality benefit of immediate referral to PCI after pharmacological treatment for STEMI derives from a reduction in the time to reperfusion of patients with failed thrombolysis in need of rescue PCI. In patients with evidence of successful reperfusion, “elective” PCI within 3 days may be sufficient to reduce the recurrent ischemic events.

Interindividual size heteromorphism of NOR and chromosomal location of 5S rRNA genes in Iheringichthys labrosus

Twenty-five specimens of Iheringichthys labrosus from the Capivara Reservoir were analysed cytogenetically. AgNORs were detected in a pair of ST chromosomes, in the telomeric region of the long arm. Some individuals showed size heteromorphism of this region between homologous chromosomes. Treatment with CMA3 displayed GC-rich regions corresponding to the AgNOR pair, plus other fluorescent staining. In situ hybridization by fluorescence (FISH) with the 18S rDNA probe showed only one pair of stained chromosomes, confirming the heteromorphism observed with AgNO3 and CMA3 in some individuals. The 5S rDNA probe revealed telomeric staining on the long arm of a pair of chromosomes of the ST-A group, probably different from the NOR pair.