Surgical specimens were obtained intraoperatively, treated with ultrasonication, and then analyzed with real-time polymerase

chain reaction. Methicillin-resistant Staphylococcus-specific polymerase chain reaction and 16S rRNA gene universal polymerase chain reaction were performed simultaneously to facilitate both specific and broad-range detection. Specimens obtained from the same GW-572016 chemical structure sites were also analyzed with microbiologic culture and histopathological evaluation.

Results: The specific polymerase chain reaction revealed methicillin-resistant Staphylococcus infection in specimens from six of the thirty operations analyzed in the present study, and the 16S rRNA gene universal polymerase chain reaction analysis was positive for specimens from AZD6094 Protein Tyrosine Kinase inhibitor thirteen operations. Conventional cultures revealed six methicillin-resistant Staphylococcus infections, two Staphylococcus aureus infections, one infection with another Staphylococcus species, and two Streptococcus infections. The sensitivity of the polymerase chain reaction method was 0.87 and the specificity was 0.8 when compared with the combined results of microbiologic culture and histopathological evaluation.

Conclusions: The ultrasonication method that we developed for accelerated DNA sample preparation as a replacement for conventional extraction made possible the potential intraoperative identification of periprosthetic infection during revision surgery. The simultaneous

detection of methicillin-resistant Staphylococcus and broad-range bacterial infections would be invaluable for the informed selection of antibiotics and also for the formulation of the subsequent treatment strategy (a one-stage

or two-stage revision) for the patient.”
“Purpose of review

Two main histopathological types of acute rejection are recognized in solid organ transplantation: T-cellmediated rejection (TCMR) and antibody-mediated rejection (AMR). In pancreas allografts the contrasting morphological features of these entities have only recently been described.

Recent findings

Acute TCMR is characterized by active septal infiltrates composed predominantly of T cells and KU57788 often involving veins (venulitis) and ducts (ductitis). Inflammation of the arterial endothelium (intimal arteritis or endarteritis) may be present. Focal or diffuse acinar inflammation (acinitis) is also typical of TCMR. Acute AMR in contrast, is characterized by predominantly macrophagic (+/- neutrophilic) inflammation, concentrated in, and around the interacinar microvasculature (interacinar inflammation, capillaritis) and typically shows focal or diffuse C4d staining of the interacinar capillaries. Architectural preservation is common in milder forms of AMR, whereas severe or untreated forms lead to extensive vascular injury and secondary parenchymal hemorrhagic necrosis. These morphological features strongly correlate with the presence of circulating donor-specific antibody (DSA) broken vertical bar.