Paradoxically, inflammatory lipids and cytokines that promote VC

Paradoxically, inflammatory lipids and cytokines that promote VC have been shown to inhibit normal skeletal

mineralization.[35] Indeed, VC has been associated with loss of mineral from bone in patients with CKD and in post-menopausal women,[36, 37] and occurs simultaneously in some rodent models of arterial mineralization.[38] It is therefore possible to theorize that loss of bone-buffering selleck chemical capacity and increased flux of mineral through the bone-remodelling compartment and extracellular fluids may induce a state of mineral stress leading to increased CPP formation. This is consistent with our previous observation of a strong association between serum CPP fetuin-A levels and β-isomerized C-terminal telopeptides (a marker of bone turnover), independent of eGFR.[30] Although fetuin-A is widely regarded Protease Inhibitor Library as negative acute phase reactant,[39]

with hepatic synthesis being suppressed by pro-inflammatory cytokines,[40] we did not find a significant inverse relationship with serum CRP concentrations (r = −0.190, P = 0.084). This is consistent with previous reports in patients with pre-dialysis CKD,[41] but may reflect the fact that ‘total’ serum Fet-A concentrations are a heterogenous signal comprising free and complexed species that may be regulated differently. Moreover, while serum Fet-A RR (i.e. CPP), were strongly and positively correlated with CRP concentrations (r = 0.338, P = 0.002) supernatant Fet-A concentrations (i.e. free Fet-A) were strongly but inversely correlated with CRP (r = −0.409, P < 0.001) and weakly with albumin concentrations (r = 0.264, P = 0.032). find more Given the aforementioned putative vasculo-protective effects of free Fet-A, downregulation of hepatic production by inflammation is likely to potentiate the propensity for ectopic mineralization. Exceptionally high Fet-A RR were found in patients with CUA, implying a very severe perturbation of mineral regulation. Interestingly the fetuin-A knockout mouse develops lesions similar to those seen in CUA, suggesting that

if free Fet-A levels are depleted by the production of CPP we might see an acquired Fet-A deficiency.[8] Such a description was suggested by Brandenburg and colleagues when they described Fet-A concentrations reducing precipitately as CRP increased in a patient who developed CUA.[42] Consistent with some reports,[43, 44] but not others,[45] we observed significant reductions in serum total Fet-A concentrations during dialysis (mean 24% decrease). Somewhat unexpectedly, we also recorded reductions in CRP concentrations and serum Fet-A RR. Interestingly while the changes in serum CRP and total Fet-A were convincingly correlated (rho = 0.434, P = 0.008), there was no significant relationship between changes in CRP and Fet-A RR (rho = 0.050, P = 0.789). Given the size of CPP (50–200 nm), it seems unlikely that they would be removed by ultrafiltration; however, it is possible that particles may be retained by the membrane.

The results also showed that the proliferation of B6 spleen cells

The results also showed that the proliferation of B6 spleen cells with IL-2 pre-incubation was significantly weaker than that of the controls

without IL-2 pre-incubation (P = 0·0025, Fig. 2b). SOCS-3 can inhibit the Th1-type polarization which plays a critical role in the pathophysiology of aGVHD [21,22,35,36]; therefore, we explored whether high SOCS-3 mRNA expression induced by IL-2 pre-incubation can inhibit Th1-type polarization in B6 naive CD4+ lymphocytes. According to the regularity of expression of SOCS-3 mRNA, we pre-incubated B6 naive CD4+ lymphocytes and B6 spleen cells, respectively, with IL-2 for 4 h before stimulation of allogeneic antigen-BALB/c spleen cells inactivated by mitomycin for 48 h. We then collected the supernatants to detect the levels of IFN-γ and IL-4. The results showed that expression of IFN-γ and Selleck Quizartinib IL-4 of B6 naive CD4+ lymphocytes was different between pre-incubation of the two groups with or without IL-2. The IFN-γ level in group pre-incubation with IL-2 was lower than that in group pre-incubation without IL-2 (P = 0·000, Fig. 3a). The IL-4 level in group pre-incubation with IL-2 was higher than that in group pre-incubation without IL-2 (P = 0·000, Fig. 3a). The expression selleck screening library of IFN-γ and IL-4 of B6 spleen cells was similar to that of B6 naive CD4+ lymphocytes (P = 0·002, and 0·000, respectively, Fig. 3b) We assessed suppressive function in vivo in an aGVHD mice model.

We used female BALB/C recipients and male B6 donors. All recipients received 5 Gy TBI as conditioning regimen. In group A (n = 9), B6 spleen cells (3 × 107 cells) were injected intraperitoneally into recipients as control. We first explored whether aGVHD was inhibited in the recipients (group B, n = 9) which received Ureohydrolase 3 × 107 B6 spleen cells pre-incubated with IL-2 before intraperitoneal injection. We found that the mean survival time of group B (14·4 ± 1·5 days) was not statistically different from that of group A (12·2 ± 3·1 days) (P = 0·3090, Fig. 4a). The scores of aGVHD symptoms between the two groups were

also not different (P = 0·7851). These findings suggest that IL-2 pre-incubation can up-regulate the expression of SOCS-3, but it was a short-lived gene product induced by IL-2 in lymphocytes. If the spleen cells with short-lived SOCS-3 did not receive allogeneic antigen in time, aGVHD could also not be inhibited; therefore, we projected another group (group D, n = 9) in which recipients received 3 × 107 B6 spleen cells which were presented with host-allogeneic antigen-inactivated BALB/C spleen cells for 72 h after IL-2 pre-incubation for 4 h. The results showed that aGVHD was inhibited significantly in group D. The mean survival time of group D was 44·1 ± 23·8 days, which was longer than that of group A (P = 0·0042, Fig. 4b). The score of aGVHD in group D was lower than that in group A (P = 0·0046).

Vα2+, Vα12+ and Vα2Vα12-double positive cells were identified in

Vα2+, Vα12+ and Vα2Vα12-double positive cells were identified in gated CD4+CD25highCD127lowFOXP3+ Treg and in CD4+CD25−/lowCD127+FOXP3− Tconv, and used to calculate the frequencies of %dual TCR cells

as described elsewhere 21 (Fig. 1C). To determine surface expression levels of TSLPR on MDCs, PBMCs were stained with mAbs specific for CD11c, CD123, HLA-DR, TSLPR, and the lineage cocktail (Lin, mAbs specific for CD3 (T cells), CD14 (monocytes), CD16, CD56 (natural killer cells), and CD19, CD20 (B cells). Labeled PBMCs were first gated for HLA-DR+Lin−, and further analyzed for expression of CD11c and CD123 to identify CD11c+CD123− MDC. Finally, TSLPR-MFIs were determined on gated MDC; Fig. 1D. PBMCs were isolated from 10–50 mL of peripheral blood by density gradient centrifugation with Ficoll-Hypaque (Biochrom AG, Berlin,

Erlotinib Germany). click here Total Treg and Tconv were immunomagnetically separated as described previously 2, 37, 38. IL-7 levels in serum samples were measured using a highly sensitive enzyme-linked immunosorbent assay (Quantikine-HS, Human IL-7 Immunoassay; R&D, Abingdon, UK), according to the manufacturer’s instructions. Samples were assayed in duplicate. For quantitation of sIL-7Rα in serum samples an in-house two-step ELISA was established, according to the protocol described by Rose et al. 39. In short, a microtiter plate was coated with a mouse anti-human IL-7Rα mAb (clone 40131), and – after blocking with PBS/0.05% Tween 20 – incubated with 200 μL undiluted serum overnight at room temperature. A biotinylated goat anti-human

IL-7Rα mAb, streptavidin-HRP and TMB substrate were used for detection and visualization of sIL-7Rα with a detection limit of 0.5 ng/mL. Serial dilutions of recombinant human IL-7Rα-Fc chimera protein served as positive next control and were used for creation of a standard curve. All antibodies and reagents were purchased from R&D. Genomic DNA was extracted from 105–106 PBMC cells using a QIAamp DNA Blood Mini Kit (Qiagen, Düsseldorf, Germany) according to the manufactures’ protocol. Screening for the MS-associated rs6897932 SNP within the IL-7RA gene was performed by using a TaqMan® predesigned SNP genotyping assay (Applied Biosystems, Foster City, CA, USA). PCR reactions were performed and analyzed as described by the manufacturer utilizing an Applied Biosystems 7500 Real-Time PCR System. In vitro proliferation assays were performed as previously described 2, 37. In brief, 105 freshly isolated Tconv were incubated alone or in co-culture with 2.5×104 total Treg (Tconv/Treg ratio 4:1) and polyclonally activated by addition of soluble anti-CD3 (1 μg/mL) and anti-CD28 mAbs (1 μg/mL). After 4 days, cells were pulsed for 16 h with 1 μCi of 3[H]-thymidine per well. After harvesting T-cell proliferation was measured with a scintillation counter.

The crosstalk between the innate and adaptive

immune syst

The crosstalk between the innate and adaptive

immune systems is exemplified by responses involving marginal zone (MZ) B cells or invariant NKT (iNKT) cells. Indeed, these lymphocyte subsets mount very early, innate-like adaptive responses after recognizing microbial carbohydrate and glycolipid antigens via both germline-encoded and somatically recombined receptors [[3-5]]. B cells confer immune protection by producing antibody molecules, also known as immunoglobulins (Igs), which can recognize antigen through either low- or high-affinity binding modes. Bone marrow B-cell selleck chemicals precursors generate Ig recognition diversity by undergoing V(D)J gene recombination, an antigen-independent process that utilizes recombination activating gene (RAG) endonucleases to juxtapose noncontiguous variable (V), diversity (D) and joining (J) gene fragments into functional V(D)J genes encoding the antigen-binding V region of Ig molecules (reviewed in [[6]]). After further maturation events, multiple subsets of mature B cells co-expressing IgM and IgD emerge from GSI-IX research buy the

bone marrow and colonize different compartments of secondary lymphoid organs to initiate the antigen-dependent phase of B-cell development. In general, conventional follicular B cells, which are also called B-2 cells, predominantly participate in T-cell-dependent (TD) antibody responses to highly specific determinants usually associated with microbial proteins (reviewed in [[7]]). TD responses unfold in the germinal center of lymphoid follicles and generate high-affinity antibodies through a TD pathway that involves activation of B cells by follicular helper T (TFH) cells. This germinal center-associated

T-cell subset expresses the inducible T-cell costimulator (ICOS) receptor, the chemokine receptor CXCR5, the programmed cell death-1 (PD-1) inhibitory receptor and the transcription factor Bcl6 [[8-15]]. TFH cells provide help to B cells via CD40 ligand (CD40L) and cytokines such as IL-21, IL-4, and IL-10 [[16-19]]. However, recent findings indicate that follicular antibody responses further involve additional T-cell subsets, Mannose-binding protein-associated serine protease including follicular regulatory T (TFR) cells and iNKT cells [[4, 5, 20-22]]. Unlike follicular B cells, certain subsets of extrafollicular B cells such as B-1 cells, splenic MZ B cells (also referred to as IgM memory B cells in humans) and bone marrow perisinusoidal B cells predominantly give rise to rapid T-cell-independent (TI) antibody responses to highly conserved carbohydrate and glycolipid determinants associated with microbes [[3, 23-30]]. TI antibody responses usually unfold at the mucosal interface or in the splenic MZ and generate polyspecific and low-affinity antibodies through a TI pathway involving the interaction of B cells with DCs, macrophages, and granulocytes [[3, 30-34]].

, 1997; Casjens et al , 2000) Although the B  burgdorferi chromo

, 1997; Casjens et al., 2000). Although the B. burgdorferi chromosome is rather small (approximately one megabase), the complexity and large sizes of many of the plasmids (some larger than 50 kb) greatly expand the DNA coding capacity of this spirochete. At the same time, however, it is currently poorly understood what role surface proteins encoded by genes on the various plasmids contribute to virulence and/or disease pathogenesis. The data accumulated thus far overwhelmingly support the hypothesis that plasmid-encoded proteins

are important in Lyme disease pathogenesis buy Buparlisib and could encode antigens that are important virulence factors and/or potential vaccinogens for Lyme disease. Given that the first vaccine developed for Lyme disease was generated against the fairly well conserved, plasmid-encoded OspA, it seems likely that PF-01367338 the identification of another outer surface protein that is well conserved throughout borrelial genospecies would be a viable candidate for a developing a new vaccine molecule. This review outlines the outer surface proteins that have been identified thus far in various borrelial species, although the main focus is on the type

strain B. burgdorferi strain B31. The outer surface proteins described below fall into two main categories, lipid-modified outer surface proteins that are anchored to the outer leaflet of the outer membrane through their lipid moieties (e.g. OspA, OspB, OspC, OspD, OspE, OspF, DbpA, DbpB, CspA, VlsE, BptA, and several others with no known function) and outer surface proteins that have one or more transmembrane domains that anchor them into the outer membrane (e.g. P13, P66, BesC, BamA, Lmp1, and BB0405). The sections following provide a detailed examination of what is currently known about outer surface lipoproteins and membrane-spanning OMPs of B. burgdorferi. The B. burgdorferi genome Diflunisal encodes several lipoproteins that are localized to the surface of B. burgdorferi (Fraser et al., 1997; Casjens

et al., 2000). The surface lipoproteins of B. burgdorferi are now well recognized as important virulence determinants. As mentioned previously, because of the extracellular nature of this pathogen, surface lipoproteins play an important role in virulence, host–pathogen interactions, and in maintaining the enzootic cycle of B. burgdorferi. Several borrelial surface lipoproteins have been identified that bind host proteins and promote the adherence to host cells. For instance, B. burgdorferi lipoproteins bind host glycosaminoglycans (GAGs), decorin, and fibronectin. Furthermore, lipoproteins have been implicated in evasion of the host immune response through antigenic variation and evasion of complement deposition.

59 Hence, SOCS proteins do not simply regulate

59 Hence, SOCS proteins do not simply regulate CD4+ T-cell commitment by inhibiting specific JAK/STAT responses, but rather, they adjust the balance between each lineage, suggesting that they might play an essential role in the regulation of CD4+ T-cell plasticity. It will be important to determine the relative expression of each SOCS in the context of human CD4+ T-cell polarization and ascertain whether these proteins might represent potential targets to medicate the growing allergy and autoimmune disease burden observed in recent decades. The authors

have no conflicts of interest to disclose. “
“The recognition by CD4+ T cells of peptides bound to class II MHC (MHCII) molecules expressed on the surface of antigen-presenting cells is a key step in RAD001 the initiation of an adaptive immune response. Presentation of peptides is the outcome of an intracellular selection process occurring in dedicated endosomal compartments involving, among others, an MHCII-like molecule named HLA-DM (DM). The impact of DM on the epitope selection machinery has been known for more than 15 years. However, the mechanism by which DM skews the presented

repertoire in favour of kinetically stable complexes has remained elusive. Here, a review of the most recent observations in the field is presented, ASK1 pointing to the possibility that DM decides the survival of a peptide–MHCII complex (pMHCII) on the basis of its conformational flexibility, which is a function of the ‘tightness’ of interaction between the peptide and the MHCII at a specific region of the binding site. Class II MHC (MHCII) molecules are transmembrane heterodimeric proteins expressed on the surface of antigen-presenting cells, and they initiate or propagate immune responses by presenting antigenic peptides to CD4+ T lymphocytes.[1]

The MHCII molecules feature a high level of polymorphism, predominantly restricted to the peptide-binding site. This groove-shaped domain is the main structural characteristic of the MHCII and defines its function. Each individual expresses a small number of different MHCII molecules. Hence, each of these must be able to bind a large number of different peptides to ensure an immune response against many possible pathogens.[2] The MHCII-restricted presentation of peptides to CD4+ T cells can be considered the outcome of an intracellular selection process. MHCII molecules are transported from the endoplasmic reticulum through the Golgi to the MHCII compartment (MIIC) as complexes with the chaperone protein invariant chain (Ii).[3, 4] Ii stabilizes the nascent MHCII and prevents the binding of other endoplasmic reticulum-resident polypeptides.

4A) We conclude that a strong passive saturating binding of IgE

4A). We conclude that a strong passive saturating binding of IgE to basophils occurs in IgE knock-in mice in vivo. The central experiment to demonstrate a function of increased IgE in allergy is the analysis of anaphylaxis. NVP-BEZ235 purchase The three genotypes (Fig. 3A) allowed a dissection of IgE versus IgG1 sensitizing capacity in an active anaphylaxis experiment. We used the same protocol for immunizing IgE knock-in mice as explained above (Fig. 3B), followed by an i.v. challenge with 30 μg TNP-OVA to induce systemic anaphylaxis (Fig. 4B). PBS-injected control mice did react with minimal body temperature drop of 0.5°C (Fig. 4B, panel2).

In sensitized IgEwt/ki and IgEki/ki mice, a comparable strong drop in body temperature of 6°C was observed, whereas WT mice reacted with moderate temperature drop of 4°C. It is important to note that the drop in body temperature in the IgE knock-in mice is more sustained compared with that in WT mice (Fig. 4B, panel 1). Surprisingly, only in the group of the

IgEki/ki mice, about 40%, died due to anaphylaxis (Fig. 4C panel 1). IgEki/ki find more lack IgG1 and express high levels of antigen-specific IgE, yet are more susceptible to anaphylactic shock compared with WT mice, which express high levels of antigen-specific IgG1, but little IgE. Therefore, we suggest that antigen-specific IgE is a more potent inducer of anaphylaxis compared with antigen-specific IgG1. Prostatic acid phosphatase Importantly, while the IgEki/ki and the IgEwt/ki mice had similar temperature curves, death occurred only in the IgEki/ki mice, arguing for the strongest anaphylactic reaction in the IgEki/ki mice. These results argue against a major role for the alternative pathway of systemic anaphylaxis, which is mediated largely through IgG1 and FcγRIII and basophil activation in our model [8, 9]. In the following experiment, we addressed two questions, namely, whether CD23, the low affinity receptor for IgE, on B cells in conjunction with the IgE knock-in affects the

outcome of systemic anaphylaxis, and if basophil depletion influences IgE-mediated active anaphylaxis. First, we backcrossed the IgE knock-in mice to CD23-deficient mice [23]. No significant effect of a loss of CD23 on anaphylaxis in the IgEwt/wt animals was observed (Fig. 4B panel 2, open squares) when compared with the CD23 competent IgEwt/wt mice (Fig. 4B panel 1, open triangles). Also, no CD23-deficient mice died due to anaphylaxis (Fig. 4C panel 2), similar to wild-type animals (Fig. 4C panel 1). The double-mutant CD23−/− IgE knock-in heterozygous and homozygous mice respond to the anaphylactic challenge with faster and more sustained temperature drop and death (Fig. 4B and C, panels 3 and 4). Again, homozygous CD23−/− IgEki/ki mice display the strongest increase in lethality.

Most children may continue to have SDNS despite receiving cycloph

Most children may continue to have SDNS despite receiving cyclophosphamide. Additional alternative drugs may be needed. In the present study, the effects on SDNS of sequential treatment after cyclophosphamide usage were established. Methods:  Forty-six children with SDNS were enrolled in this retrospective uncontrolled study. In addition to prednisolone, patients were treated with cyclophosphamide as a first-line alternative drug. Children who still had SDNS despite cyclophosphamide therapy received chlorambucil, ABT-888 in vivo levamisole or another course of cyclophosphamide. The treatment responses were recorded and the mean duration of follow up was 96 months.

Results:  Seventeen patients (37%) experienced no relapse after cyclophosphamide therapy. Twenty-five patients (54%) had varied responses. Only four patients showed no effect. Children who

still had SDNS despite cyclophosphamide therapy received second or more alternative drugs. Cyclophosphamide with or without chlorambucil resolved steroid-dependency in 33 of 46 (72%) children who either had complete remission or developed steroid-sensitive, rather than steroid-dependent, nephrotic syndrome. Conclusion:  With the exception of four patients who were lost to follow up and four who were refractory and needed other treatment, most children with SDNS could spare the steroid (complete remission or steroid sensitive nephrotic syndrome) after using one or more of these modulating agents. “
“In the Australian state of Victoria, the Renal Health Clinical Network (RHCN) of the Department of Health Victoria established a Renal Peptide 17 supplier Key Performance Indicator (KPI) Working Group in 2011. The group developed four KPIs related to chronic kidney disease (CKD) and

dialysis. A transplant working group of the Fossariinae RHCN developed two additional KPIs. The aim was to develop clinical indicators to measure the performance of renal services in Victoria in order to drive service improvement. A data collection and bench-marking program was established, with data provided monthly to the Department using a purpose designed website portal. The KPI Working Group is responsible for analysing data each quarter and ensuring indicators remain accurate and relevant. Each indicator has clear definitions and targets and the KPIs assess (1) patient education, (2) timely creation of vascular access for haemodialysis, (3) the proportion of patients dialysing at home, (4) the incidence of dialysis-related peritonitis, (5) the incidence of pre-emptive renal transplantation, and (6) timely listing of patients for deceased donor transplantation. Most KPIs have demonstrated improved performance over time with limited gains notably in two: the proportion of patients dialysing at home (KPI 3) and timely listing of patients for transplantation (KPI 6). KPI implementation has now been established in Victoria for 2 years, providing recent performance data without additional funding.

8 nm The incident laser-light was scattered by added dispersing

8 nm. The incident laser-light was scattered by added dispersing particles (titandioxide parcticles, TiO2) in the perfusion fluid and resulted in a scattered-light. The TiO2 particles were used as tracer particles for the LDA measurements and followed the flow slip-free,

as previously described.[26] The scattered-light with the laser Doppler-signal was received in a photomultiplier and forwarded to a data processor. With the help of a 3-D Traversier-Table (x-y-z table equipped with a stepping motor) the model could be moved for the LDA-measurements. Velocity components axial (x-axis) and perpendicular (z-axis) to the recipient vessel were recorded at four defined cross-sections proximal, in and distal to the anastomosis. Ferroptosis inhibitor The specimen analyzed contained 20 arteries for analyses for each technique

find more and flow data were gained by the mean ± standard deviation of 7 circles of perfusion of the models. Velocity and pressure distributions were measured with the help of the LDA-system (BBC Goerz. Spectraphysics; Munich, Germany) and pressure transducers were positioned proximal and distal to the model (type P 11/0.5 bar; Hottinger Baldwin measurement technics; Darmstadt, Germany). The outgoing data from Doppler-signal-processor was forwarded to a data processor, using the graphically orientated DIAdem™ software (Version 8.0; National Instruments Corporation; Austin, TX). We used the data visualization and analysis software Tecplot (Version 10.0-0-7; Tecplot Inc.; Bellevue, WA 98015) for further evaluations. Data were analyzed with the ‘‘Statistical Package for the Social Sciences” (SPSS for Windows,

release 20, SPSS Inc., Chicago, IL). For differences of flow pattern in the silicone rubber models values were evaluated using the t-test in comparison between both groups containing both techniques as they were normally distributed. Differences were considered statistically significant for a two-sided p-value of less than 0.05. The main vessel’s diameter in the conventional technique and Opened End-to-Side technique model were 2.2 mm and 2.1 mm. The diameters of the branching vessel in both models were 1.6 mm. The flow rate proximal to the bifurcation was adjusted to 48 ml/min. Distal to the bifurcation the flow rate was divided into 36 ml/min in the main vessel and 12 ml/min in the branching vessel, resulting Molecular motor in a flow rate ratio of 3:1. Seven physiologic flow curve cycles were recorded and averaged at four defined cross-sections in both models. As an example the velocity distributions during the maximal systolic (90°) and diastolic phase (270°) for each model in all of the four measurement planes are presented in Figure 4. The Womersley parameter was smaller for this experimental setup in both models (Table 1). The maximal and minimal axial and perpendicular velocities during the systolic and diastolic phase in the all vessel components of each technique can be found in comparisons in Table 2 and illustrated in Figure 4.

All of patients except for one regained protective sensation from

All of patients except for one regained protective sensation from 3 to 12 months postoperatively. Our experience CH5424802 showed

that the sural flap and saphenous flap could be good options for the coverage of the defects at malleolus, dorsal hindfoot and midfoot. Plantar foot, forefoot and large size defects could be reconstructed with free anterolateral thigh perforator flap. For the infected wounds with dead spce, the free latissimus dorsi musculocutaneous flap remained to be the optimal choice. © 2013 Wiley Periodicals, Inc. Microsurgery 33:600–604, 2013. “
“The aim of this study was to investigate intestinal ischemia-reperfusion and its local and systemic hemorheological relations in the rat. Ten anaesthetized female CD outbred rats were equally divided into 2 experimental groups. (1) Ischemia-reperfusion (I/R): the superior mesenterial artery was clipped for 30 minutes. After removing the clip, 60 minutes of the reperfusion was observed before extermination. Blood samples were taken from the caudal caval vein and from the portal vein before

ischemia, 1 minute before and after clip removal, and at the 15th, 30th, and 60th minutes of the reperfusion. (2) Sham operation: median laparotomy and blood sampling were done according to the timing as in I/R group. Hematological parameters, red blood cell aggregation, and deformability were determined. Leukocyte Vadimezan count and mean volume of erythrocytes increased slightly but continuously in portal venous samples during the reperfusion period. Red blood cell aggregation values were higher in portal blood by the end of ischemia, and then became elevated further comparing to the caval venous blood. Both in caval and portal venous samples of I/R group red blood cell deformability significantly worsened during the experimental

period compared to its base and Sham group. In portal blood red blood cell deformability was impaired more than in caval vein samples. Histology showed denuded villi, dilated capillaries, and the inflammatory cells were increased after a 30 minutes ischemia. In conclusion, intestinal ischemia-reperfusion causes changes Urease in erythrocyte deformability and aggregation, showing local versus systemic differences in venous blood during the first hour of reperfusion. © 2009 Wiley-Liss, Inc. Microsurgery, 2010. “
“Closing large skin defects of the upper back is a challenging problem. We have developed an efficient design for a latissimus dorsi musculocutaneous flap for reconstruction in this region. The longitudinal axis of the skin island was designed to be perpendicular to the line of least skin tension at the recipient site so that primary closure of the flap donor site changed the shape of the recipient site to one that was easier to close. We used this method for four patients with skin cancers or soft-tissue sarcomas of the upper back in 2011 and 2012.