Ohlsenwhitfield1768

l points. Severe blood vessels damage was observed only at 100 °C. The vascular perfusion was recorded 14% and 57% higher in 60 °C and 80 °C treated animals respectively when compared to control animals. However, at 100 °C due to highest vessel damage the perfusion was reduced to 53% compared to control. CONCLUSION Present study demonstrates that the device is able to generate precise and uniform burn wound in mice model. The device may be useful for burn related studies and validation of burn wound care products. BACKGROUND The direct-instillation nasal allergen challenge (NAC) and the environmental exposure chamber (EEC) are two methods of conducting controlled allergen provocations. The clinical and biological comparability of these methods has not been thoroughly investigated. OBJECTIVE To compare clinical and immunologic responses to cat allergen in NAC versus EEC. METHODS Twenty-four participants were randomized to receive either NAC followed by a two-day challenge in an EEC or a two-day challenge in EEC followed by NAC. Challenges were separated by 28-day washout periods. We measured total nasal symptom scores (TNSS), peak nasal inspiratory flow (PNIF), nasal (0-8hours) and serum cytokines, serum antibodies, peripheral blood antigen-specific T-lymphocytes, and gene expression in nasal scrapings. The primary outcome was the TNSS area under the curve for the first 3 hours after allergen exposure in NAC or after initiation of exposure in EEC. RESULTS Both challenges increased IL-5 and IL-13 in nasal fluids and serum and resulted in altered nasal cell expression of gene modules related to mucosal biology and transcriptional regulation. Changes in gene modules, more so than cytokine measurements, showed significant associations with TNSS and PNIF. Overall, EEC exposure generated larger responses and more early terminations compared to NAC. Although the two challenges did not correlate in symptom magnitude or temporality, striking correlations were observed in cytokine levels. CONCLUSION Although clinical outcomes of NAC and EEC were temporally different and non-equivalent in magnitude, immunologic responses were similar. Selection of a particular allergen challenge method should depend on considerations of study objectives and cost. BACKGROUND X-linked agammaglobulinemia (XLA) is the prototype of primary humoral immunodeficiencies. Long-term follow-up studies regarding disease-related complications and outcome are scarse. OBJECTIVE To describe the natural history of X-linked agammaglobulinemia. METHODS A nationwide multicenter study based on the IPINet registry was established in 2000 in Italy. Affected patients were enrolled by documenting centers and patients' laboratory, clinical and imaging data were recorded on an annual base. RESULTS Patients' data (N=168) derived from a cumulative follow-up of 1370 patient years with a mean follow-up of 8.35 years per patient. Mean age at diagnosis decreased upon the establishment of the IPINet registry (84 months before versus 23 months after). Respiratory, skin and gastrointestinal manifestations were the most frequent clinical symptoms at diagnosis and during long-term follow-up. Regular immunoglobulin replacement treatment reduced the incidence of invasive infections. Affected patients developed chronic lung disease over time (47% after 40 years of follow-up) in the presence of chronic sinusitis (84%). Malignancies were documented in a minority of cases (3.7%). Overall survival for affected patients was significantly reduced when compared to the healthy male Italian population, and further deteriorated in the presence of chronic lung disease. CONCLUSIONS This is the first detailed long-term follow-up study for XLA patients revealing that while immunoglobulin replacement treatment reduces the incidence of invasive infections, it does not appear to influence the development of chronic lung disease. Overall survival of affected patients is reduced. Further studies are warranted in order to improve patients' clinical management and increase awareness among physicians. The thymus is critical for central tolerance and diverse T-lymphocyte repertoire development, to provide lifelong defence against pathogens, whilst maintaining self-tolerance. Peak thymic output occurs in-utero, infancy and early childhood, diminishing throughout life. Infants with congenital heart disease requiring sternotomy, often undergo thymectomy to clear the surgical field. Longterm effects of early thymectomy are just being appreciated. Many patients remain asymptomatic, despite immunological findings mirroring those of immunosenescence. Few develop increased infection or lympho-reticular malignancy risk. When considering effects of infant thymectomy, patients with partial DiGeorge syndrome or hypomorphic RAG mutations may be instructive. These patients are lymphocytopenic, with increased early onset infection and autoimmunity risk, not seen in most infant thymectomy patients. Thymic structure of partial DiGeorge syndrome or hypomorphic RAG patients is abnormal, with disrupted architecture inclining to perturbation of central tolerance. Similar findings may be seen in patients with myasthenia gravis, although disrupted peripheral tolerance may play a greater role in autoimmunity development. In conclusion, infant thymectomy may increase future risk of infection or autoimmunity with premature immunosenescence, mediated through disruption of central and peripheral tolerance mechanisms, initiated by early cessation or diminution of thymic output. Ideally, some thymic tissue should be preserved at time of surgery. Follicular CD8 T cells are expanded in germinal centers of CVID patients with lymphadenopathy, show increased proliferation, an exhaustion-associated phenotype and IL-10 production and may thus potentially contribute to germinal center dysregulation in some CVID patients. OBJECTIVE Ex vivo lung perfusion creates a proinflammatory environment leading to deterioration in graft quality that may contribute to post-transplant graft dysfunction. Triptolide has been shown to have a therapeutic potential in various disease states because of its anti-inflammatory properties. On this basis, we investigated the impact of triptolide on graft preservation during ex vivo lung perfusion and associated post-transplant outcomes in a rat transplant model. METHODS We performed rat normothermic ex vivo lung perfusion with acellular Steen solution containing 100 nM triptolide for 4 hours and compared the data with untreated lungs. Orthotopic single lung transplantation after ex vivo lung perfusion was performed. RESULTS Physiologic and functional parameters of lung grafts on ex vivo lung perfusion with triptolide were better than those without treatment. Graft glucose consumption was significantly attenuated on ex vivo lung perfusion with triptolide via inhibition of hypoxia signaling resulting in improved mitochondrial function and reduced oxidative stress. Also, intragraft inflammation was markedly lower in triptolide-treated lungs because of inhibition of nuclear factor-κB signaling. Furthermore, post-transplant graft function and inflammatory events were significantly improved in the triptolide group compared with the untreated group. CONCLUSIONS Treatment of lung grafts with triptolide during ex vivo lung perfusion may serve to enhance graft preservation and improve graft protection resulting in better post-transplant outcomes. OBJECTIVE Whether mitral valve repair is superior to replacement in the population with rheumatic heart disease has been debated. This study aims to compare outcomes of repair with replacement by the propensity score method. METHODS This observational, prospective study enrolled patients with rheumatic heart disease who underwent mitral valve repair and replacement from January 2011 to April 2019. The propensity score method was used to select 2 groups with similar baseline characteristics. Baseline, clinical, and follow-up data were collected. Clinical outcomes included death from any cause, reoperation, and valve-related complications. RESULTS The overall population before matching (N = 1644) included 612 patients who underwent repair and 1032 patients who underwent replacement. The propensity score analysis generated matches for 1058 patients (529 pairs). The median follow-up time was 4.12 years. Early mortality and death from any cause during follow-up were significantly lower in the repair group compared with the replacement group (hazard ratio, 0.19; 95% confidence interval [CI], 0.05-0.64; P = .003; hazard ratio, 0.38; 95% CI, 0.19-0.74; P = .003, respectively). Patients in the repair group had a lower risk of valve-related complications compared with patients in the replacement group (subhazard ratio, 0.44; 95% CI, 0.21-0.90; P = .025). In terms of reoperation, no significant difference was observed between the repair and replacement groups (subhazard ratio, 2.54; 95% CI, 0.89-7.22; P = .081). CONCLUSIONS The results suggest that rheumatic mitral valve repair in select patients is superior to mitral valve replacement with regard to lower mortality and fewer valve-related complications; meanwhile, it has a comparable risk of reoperation compared with replacement. BACKGROUND Moderate hypothermic circulatory arrest (MHCA) with antegrade cerebral perfusion (ACP) is safe and efficient in total arch replacement (TAR) and frozen elephant trunk (FET) for acute type A aortic dissection (ATAAD). Complications related to hypothermia and ischemia are inevitable, however. The aortic balloon occlusion (ABO) technique is performed to elevate the lowest nasopharyngeal temperature to 28°C and shorten the circulatory arrest time. In this study, we aimed to evaluate the efficacy of this new technique. METHODS We reviewed the clinical data of patients with ATAAD who underwent TAR and FET, including 79 who underwent ABO and 109 who underwent MHCA/ACP. RESULTS Circulatory arrest time was significantly lower in the ABO group compared with the MHCA/ACP group (mean, 4.8 ± 1.2 minutes vs 18.4 ± 3.1 minutes; P 24 hours (odds ratio [OR], 0.455; 95% confidence interval [CI], 0.234-0.887; P = .021), hepatic dysfunction (OR, 0.218; 95% CI, 0.084-0.561; P = .002), and grade II-III AKI (OR, 0.432; 95% CI, 0.204-0.915; P = .028). CONCLUSIONS The ABO technique significantly shortens the circulatory arrest time in TAR and FET. Available clinical data suggest that it has a certain protective effect on the liver and kidney. Future large-sample studies are warranted to thoroughly evaluate this new technique. The present detailed study aimed to establish for the first time the ovarian and uterine hemodynamic change in dairy cows after the end of the puerperal period to investigate a possible association between Doppler indices and volume of blood flow. Twenty cows weighing 500-600 kg (mean 400 ± 50 kg) and 4-5 years of age (mean 3.2 ± 0.5 years) categorized into two main groups (true anestrum, with corpus luteum, n = 10) and (normal cyclic, n = 10), The period of examination started from day 39 till day 70 after calving with day after day routinely examination by b-mode and Doppler performed on both ovaries with ovarian arteries (OA) and uterus with uterine arteries (MUA) in the ipsilateral (ipsi) and contralateral (contra) side to ovulation, in addition to a thickness in horns and body was measured. Estradiol and progesterone were also measured. Results showed that both Doppler indices in the OA and MUA ipsi and contra had a positive (P ≤ 0.001) correlation with contra Doppler indices, but revealed a negative (P ≤ 0.