BACKGROUND/AIMS: Anti-thymocyte globulin (ATG) treatment for acute T-cell mediated rejection (TCMR) can increase the risk of cytomegalovirus (CMV) infection. We aimed to evaluate the effect of valacyclovir prophylaxis against CMV infection after ATG administration as anti-rejection therapy. METHODS: We retrospectively analyzed 55 kidney transplant recipients (KTRs) receiving ATG for steroid resistant TCMR. In all KTRs, we used intravenous ganciclovir during ATG injection. In 34 KTRs treated before July 2013, we performed preemptive therapy for CMV infection after ATG therapy. They were regarded as the historic control group (CONT). After July 2013, we used valacyclovir maintenance for 1 month after ATG therapy in 21 patients (VAL). The primary outcome was the incidence of CMV infection, and the secondary outcomes were subsequent acute rejection, and graft and patient outcome. RESULTS: Valacyclovir prophylaxis significantly reduced the incidence of CMV infection (VAL, 9.6% vs. CONT, 67.6%; p < 0.001), and CMV-free survival rate was higher in the VAL group compared to the CONT group (p = 0.009). In the VAL group, two cases of CMV infection were limited to CMV viremia, but CMV disease or syndrome (n = 3) was detected in the CONT group. There was no difference in graft failure (CONT, 70.5% vs. VAL, 47.6%; p = 0.152), incidence of subsequent rejection after ATG treatment (CONT, 41.1% vs. VAL, 33.3%; p = 0.776), and graft or patient survival between the two groups. There were no major adverse events associated with valacyclovir prophylaxis. CONCLUSIONS In conclusion, valacyclovir prophylaxis is effective in the prevention of CMV infection after ATG treatment for steroid resistant TCMR.

No abstract available.
Dupuytren Contracture ; Fibroma*

Image-guided radiation therapy (IGRT) is a process of incorporating imaging techniques such as computed tomography (CT), magnetic resonance imaging (MRI), Positron emission tomography (PET), and ultrasound (US) during radiation therapy (RT) to improve treatment accuracy. It allows real-time or near real-time visualization of anatomical information to ensure that the target is in its position as planned. In addition, changes in tumor volume and location due to organ motion during treatment can be also compensated. IGRT has been gaining popularity and acceptance rapidly in RT over the past 10 years, and many published data have been reported on prostate, bladder, head and neck, and gastrointestinal cancers. However, the role of IGRT in lymphoma management is not well defined as there are only very limited published data currently available. The scope of this paper is to review the current use of IGRT in the management of lymphoma. The technical and clinical aspects of IGRT, lymphoma imaging studies, the current role of IGRT in lymphoma management and future directions will be discussed.
Gastrointestinal Neoplasms ; Head ; Lymphoma* ; Magnetic Resonance Imaging ; Neck ; Positron-Emission Tomography ; Prostate ; Radiotherapy, Image-Guided* ; Tumor Burden ; Ultrasonography ; Urinary Bladder

BACKGROUND: Neuroprotective therapy is essential in the management of Parkinson's disease(PD). As symptomatic benefit of a treatment may clinically mask the disease progression, an evaluation of the effect of a neuroprotective therapy should be based on objective measurement of in vivo dopaminergic integrity: Nuclear imaging techniques such as SPECT or PET can visualize dopaminergic system using dopamine transporter ligands and show the promise for this purpose. The objective of this study is to examine the changes of dopamine transporter in the animal model of PD and those correlations with behavioral and biochemical changes. METHODS: We injected 6-hydroxydopamine into the substantia nigra in Sprague-Dawley rats to establish the unilateral PD model, and examined the rotation response after apomorphine injection as a behavioral aspect of the animal model. And we also measured the dopamine and DOPAC level in the striata and the dopamine transporter by [3H]-mazindol autoradiography. RESULTS: We observed that the rats showed turning behavior only after severe reduction of dopamine and DOPAC. There was a strong inverse correlation between rotation behavior and striatal dopamine, DOPAC and dopamine transporter density. There was a positive and strong linear-correlation between dopamine transporter density and dopamine or DOPAC levels. CONCLUSION: Measurement of dopamine transporter gives a good estimate of striatal dopamine level in an animal model of PD. In vivo measurement of dopamine transporter will give an objective information on the integrity of presynaptic nigrostriatal dopaminergic system.
3,4-Dihydroxyphenylacetic Acid ; Animals ; Apomorphine ; Autoradiography ; Disease Progression ; Dopamine Plasma Membrane Transport Proteins* ; Dopamine* ; Ligands ; Masks ; Models, Animal ; Oxidopamine* ; Parkinson Disease* ; Rats* ; Rats, Sprague-Dawley ; Substantia Nigra ; Tomography, Emission-Computed, Single-Photon