Acute renal failure following bone marrow transplantation

The medial preoptic nucleus (MPN) is an essential site for the regulation of male sexual behavior. Previous studies using c-fos as a marker for neural activation have shown that copulation increased c-fos expression in the MPN. Neural activation was also present in brain regions that are connected with the MPN and are involved in male sexual behavior, including the posteromedial bed nucleus of the stria terminalis (BNSTpm), posterodorsal preoptic nucleus (PD), posterodorsal medial amygdala (MEApd), and parvocellular subparafascicular thalamic nucleus (SPFp). The present study investigated whether the copulation-induced, activated neurons in these brain regions are involved in the bidirectional connections with the MPN. Therefore, mating-induced Fos expression was combined with application of anterograde (biotinylated dextran amine) or retrograde (cholera toxin B subunit) tracers in the MPN. The results demonstrated that neurons in the BNSTpm, PD, MEApd, and SPFp that project to the MPN were activated following copulation. However, in males that displayed sexual behavior but did not achieve ejaculation, few double-labeled neurons were evident, although both retrogradely labeled neurons and Fos-immunoreactive cells were present. In addition, retrograde neurons that expressed Fos were located in discrete subdivisions within the brain regions studied, where Fos is induced after ejaculation. Likewise, anterogradely labeled fibers originating from the MPN were not distributed homogeneously but were particularly dense in these discrete subdivisions. These results demonstrate that copulation-induced Fos-positive neurons in specific subdivisions of the BNSTpm, PD, MEApd, and SPFp have bidirectional connections with the MPN. Taken together with previous findings, this supports the existence of a discrete subcircuit within a larger neural network underlying male sexual behavior.     

Partial orthotopic liver transplantation

From October 1990 to May 1992, nine of 38 patients with liver transplants (24%) had partial orthotopic liver transplantation on account of lack of size-matching donor livers. The preliminary results have presented very few problems; there was no per- or postoperative mortality and no surgical complications. Four patients had episodes of acute rejection which responded to anti-rejection therapy, and two patients were treated for CMV infection. All patients are discharged with normal liver function 4-9 weeks after transplantation (median 5 weeks). The method seems to be safe and can be used in centers with limited activity, where there is a problem of having the correct liver at the correct time.     

Partial orthotopic liver transplantation in rats

A partial orthotopic liver transplantation technique (70% POLT) for use in rats and comparable with the corresponding recipient operation in the 'splitting transplantation' in man was developed. Body weight, liver function, histological and electron-microscopic findings were studied in comparison with whole rat liver transplantation with rearterialization, 30% POLT and corresponding liver resections. After 70 and 30% POLT typical signs of hepatic regeneration were found, but no pathological alterations in the electron-microscopic picture. This POLT model might be helpful for the investigation of unresolved questions in 'splitting transplantation'.     

Disease recurrence after orthotopic liver transplantation

With the advent of cyclosporine immunosuppression in the late 1970s, liver transplantation became a widespread modality for the treatment of end-stage liver disease. Several metabolic disorders that produce liver injury, such as Wilson's disease and alpha-1-antitrypsin deficiency, are cured by liver transplantation. However, many other diseases for which transplantation is undertaken may recur in the allograft. As follow-up increases and newer diagnostic modalities become available, those diseases that recur, and their natural histories, are becoming better understood. This new information may lead to a reevaluation of the suitability of some conditions for transplantation. This article briefly reviews disease recurrence in orthotopic liver transplants.     

Laparoscopic evaluation of liver disease in chronic renal failure prior to renal transplantation

It is not rare that controversial indications about the presence or the expression level of multidrug-resistant (MDR) proteins come out from different laboratories upon examination of identical tumor specimens. Distinct aspects, including the use of weakly discriminating monoclonal antibodies (MAbs) and/or unsuitable techniques and procedures, contribute in generating differences in the MDR phenotype evaluation of cancer cells. In this regard we describe here an innovative immunohistochemical approach for the determination of P-glycoprotein expression in cells and tissues. The method is based on the ability of phage-displayed peptides to mimic antibody epitopes. For this purpose we utilized the phage clone #55, which was affinity-purified from a phage-displayed random-peptide library using the MAb MM4.17 (specific for MDR1-P-glycoprotein) as previously described. This clone has been chosen since it clearly and undoubtedly reacts with its cognate MAb, as was determined by ELISA and dot blot tests. Inhibition of the MAb MM4.17 binding to MDR1-P-glycoprotein-expressing cells could be performed by adding a calibrated concentration of phage clone #55 particles, which mimic MDR1-P-glycoprotein antigen. This methodology can eliminate misleading interpretations concerning the presence and expression level of MDR1-P-glycoprotein and might well contribute in routine clinical determinations of MDR in tumor specimens, thus contributing to our understanding of the basis of the mechanisms of tumor cell resistance to drugs.     

Infant survival after orthotopic liver transplantation

Of all head and neck neoplasms, 3% are malignant salivary neoplasms. Only 20% of them affect submandibular glands. These tumours vary histologically, which results from the complex embryogenesis of the glands. Malignant submandibular gland tumours are twice as frequent as parotid gland tumours. Simultaneous occurrence of quite different malignant tumours in the same salivary gland is extremely rare. The age range of patients affected with salivary gland neoplasms is wide. However, the occurrence of these neoplasms in children is exceptionally rare. The authors describe a case of a 13-year-old girl with acinose adenoid carcinoma and cystiscarcinoma coexisting in one submandibular salivary gland.     

Percutaneous femoro-porto-jugular venovenous shunt in orthotopic liver transplantation

Veno-venous bypass (VVB) by the percutaneous introduction of cannulas in the right internal jugular vein during liver transplantation may reduce the complications derived from the classical method of axillary vein dissection. The results and complications observed over a two and a half year period in 126 consecutive patients submitted to liver transplantation in whom preparation for femoral-portal-jugular veno-venous bypass was carried out are reported. Twelve complications (9.5%) were observed in the 126 patients. All the complications were due to jugular cannulation and were divided as follows: in 7 patients (5.5%) some of the guide introductions were unsuccessful following multiple punctures; in 2 patients (1.6%) the right carotid artery was punctured; 2 hemothorax (1.6%) were observed and one pneumothorax (0.8%). Forty patients required veno-venous bypass. The blood flows obtained during VVB were suffice in all the cases with a mean +/- standard deviation of 2.21 +/- 0.44 l/min-1. The technique of femoral-portal-jugular veno-venous bypass is a good alternative to the classical method of the axillary approach. It has advantages such as in the speed of installation of VVB and the utility of the large jugular vein during the remainder of the surgery for rapid fluid transfusions. Although the number of complications is low, they may be important thereby hindering intra management and post operative of the patients.     

Acute liver failure

PURPOSE: This article reviews the literature on radiographic imaging techniques and image interpretation for dental implant treatment. MATERIALS AND METHODS: MEDLINE was used to identify published peer-reviewed literature for this report. RESULTS: Radiographic images are indispensable in the evaluation of osseous structures when planning treatment for dental implants. Potential bone sites for implant placement can be assessed clinically by means of palpation or probing through the mucosa; however, diagnostic imaging provides the best means for indirectly measuring bone dimensions. After healing of the implant site, the application of radiology is useful to verify the amount of bone adjacent to the implant and that the transmucosal abutments fit the implant. Upon completion of the implant prosthesis, radiology may be used to monitor initial and long-term success of implant treatment. CONCLUSION: Recommendations for the application of radiology over the course of treatment are made for various implant cases ranging from the overdenture to the single-tooth implant.     

The donor stage of orthotopic liver transplantation

First clinical experience of the harvesting (donor) stage of orthotopic transplantation of the liver in Russia is represented. During 5-year period in National Research Center of Surgery RAMS 16 orthotopic transplantations of the liver were carried out. Surgical modes of harvesting of the donor liver are detailed ("standard" and "fast"), the regimes and methods of preservation of the liver were determined. The influence of various parameters on function of the graft in postoperative period was established. Adequate selection of donors, correct and proper choice of donor-recipient pair, limited time of preservation allow to decrease the number of graft function failure and to eliminate primarily nonfunctioning grafts.     

Surgical techniques of orthotopic rat liver transplantation

OBJECTIVES: To analyze the frequency of behavioral/emotional problems and somatic complaints of children aged four to ten as rated by their parents. METHOD: The analysis is based on the PAK-KID study on behavioural and emotional problems and psychosocial competencies of children and adolescents in Germany. In a nationally representative sample of N = 1030 children aged four to ten years the parents rated their child using the Child Behavior Checklist. RESULTS: The prevalence rates of the symptoms are presented. Additionally global prevalence rates based on three different models were calculated and compared. They range from 13.1% to 28.3%. The issues of defining cutoffs necessary for the calculation of prevalence rates are discussed.