Inclusion of the donor spleen may be beneficial for small children who receive multivisceral transplantation (MVT) because asplenia is associated with increased risk of bacterial sepsis. Beginning in 2003, the spleen was transplanted together with multivisceral transplantation in 17 children under daclizumab induction (spleen group). The results were compared to 23 children who received multivisceral transplantation without the spleen (control group) with the same immunosuppression regimen. Median age of 17 patients who received a spleen was 0.80 years (range 0.54-1.66). Platelet counts at 30 and 60 days posttransplant were significantly lower in the spleen group (average values: day 30: 399,000 vs 636,000, P = .015; day 60: 413,000 vs 622,000, P = .0056). WBC counts at 30 and 60 days posttransplant were also decreased in the spleen group but the difference was not statistically significant. Median rejection-free survival was 205 days in the spleen group and 101 days in the control group (P = NS). Median length of hospital stay was 39 days in the spleen group and 61 days in the control group. With a median follow-up of 398 days (spleen group) and 1232 days (control group), 3 of 17 (17%) in the spleen group developed graft versus host disease (GVHD), whereas 1 of 23 (4.5%) in control group did (P = NS). In one patient in each group, GVHD was fatal. No patient developed posttransplant lymphoproliferative disorder (PTLD) in the spleen group, whereas 4 of 23 (17%) in the control group developed PTLD. One-year patient survival was 84% in the spleen group and 86% in the control group. Recipients of the spleen as part of a multivisceral graft had significantly lower platelet counts. Rejection-free survival may be prolonged, but the risk of GVHD may be increased.

Antibodies, Monoclonal↗

PubMedDate not supplied

Ovulation and pregnancy in the Chiari-Frommel syndrome. Report of 10 cases.

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Adult↗

PubMedDate not supplied

Effects of microsurgical removal of the rabbit uterotubal junction.

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Animals↗

PubMedDate not supplied

Enhanced biorecognition and internalization of HPMA copolymers containing multiple or multivalent carbohydrate side-chains by human hepatocarcinoma cells.

N-(2-hydroxypropyl)methacrylamide (HPMA) copolymers containing pendant saccharide moieties (galactosamine, lactose, and triantennary galactose) were synthesized. The relationship between the content of saccharide moieties and three-dimensional arrangement of galactose residues and their biorecognition and internalization by human hepatocarcinoma HepG2 cells was investigated. The results obtained clearly indicated preferential binding of the trivalent galactose and the lactose-containing copolymers to these cells. The higher the saccharide moieties content in HPMA copolymers, the higher the levels of binding. The biorecognition of the glycosylated HPMA copolymers by HepG2 cells was inhibited by free lactose. The data on the internalization and subcellular trafficking of HPMA copolymer conjugates obtained by confocal fluorescence microscopy correlated well with the flow cytometric analysis of their biorecognition by target cells. Structural features of the glycosides responsible for the specific recognition of the HPMA copolymers have been identified. The results underline the potential of glycosylated HPMA copolymers for delivery of pharmaceutical agents to hepatocarcinoma cells.

Biological Transport↗

PubMedDate not supplied

Digestion of starch and glycaemic response to mixed meals in pigs.

The digestion in the proximal intestine of mixed meals (5,160 kJ) containing either native (NS) or pregelatinized (PS) maize starches (approximately 200 g), and the postprandial glycaemic responses they induced were compared in pigs. For both meals, approximately 25% of the ingested starch was assimilated above the duodenal cannula (positioned 75 cm beyond the pylorus). Larger amounts of starch were collected for NS than for PS during the first 30 min. The glycaemic responses, however, indicated a higher rate of glucose absorption for PS during the first 30 min, which could be explained by the higher susceptibility of PS to hydrolysis, as we observed in vivo. Indeed, malto-oligosaccharides (G1-G3) represented almost 80% of the total alpha-glucans collected at 150 min in the duodenum after the PS meal. At that time, after the NS meal, only 30% of the alpha-glucans were malto-oligosaccharides. Thus, even after a mixed meal, the starch digestion rate can alter the observed postprandial glycaemic response.

Animals↗

PubMedDate not supplied

Persisting spongy myocardium. A case indicating the difficulty of antenatal diagnosis.

Persisting spongy myocardium (also known as noncompaction of the ventricular myocardium) is a rare and special form of cardiomyopathy. The few cases reported in the literature were detected postnatally and involved a high rate of cardiovascular complications. This anomaly of endomyocardial morphogenesis, which occurs during the embryonic phase at the stage of cardiac partitioning, is characterised by an excessive number of prominent trabeculae and by intertrabecular recesses within the myocardial wall. Antenatal detection is difficult in the absence of an associated malformation, which is the general situation. We report a case of antenatal cardiomyopathy which led to therapeutic abortion. The diagnosis of persisting spongy myocardium was made during fetopathologic examination.

Abortion, Therapeutic↗

PubMedDate not supplied

Contribution of tridimensional sonography and magnetic resonance imaging to prenatal diagnosis of Apert syndrome at mid-trimester.

A diagnosis of Apert syndrome, suspected at 24 weeks' gestation after conventional sonography showing turribrachycephaly and syndactyly of hands and feet, was confirmed at 26 weeks' gestation by tridimensional sonography and magnetic resonance imaging. This is only the second prenatal diagnosis reported at mid-trimester, excluding cases published from affected mothers or in connection with a context of recurrence. Additional findings have been collected from tridimensional sonography (mid-facial hypoplasia, downslanting palpebral fissures) and from magnetic resonance imaging (verticalization of the clivus and flattened angle of the cranial base).

Acrocephalosyndactylia↗

PubMedDate not supplied

Seeing visual hallucinations with functional magnetic resonance imaging.

We have used blood oxygenation level dependent imaging with functional magnetic resonance imaging (fMRI) to investigate the visual cortex response to photic stimulation during and in the absence of continuous visual hallucinations. A patient with cortical Lewy body dementia who experienced persistent and vivid complex hallucinations underwent fMRI on and off treatment with risperidone. When he was not hallucinating, photic stimulation produced a normal bilateral activation in striate cortex. During hallucinations, very limited activation in striate cortex could be induced. We interpret this result as indicating that at least part of the activity in the brain responsible for the experience of visual hallucinations is located in the primary visual cortex.

Hallucinations↗

PubMedDate not supplied

Prenatal diagnosis of tetraploidy.

A pregnancy was terminated at 24 weeks of amenorrhea when tetraploidy (92 XXXX) was diagnosed in fetal blood subsequent to ultrasonographic detection of a polymalformation syndrome. The severity of the neurological deficit in tetraploid infants and their death before 2 years of age require that prenatal diagnosis by cordocentesis be performed for analysis of fetal blood in cases of equivocal and nonspecific polymalformation syndrome and justify that medically-induced termination of pregnancy is suggested in the event of intrauterine tetraploidy diagnosis.

Abnormalities, Multiple↗

PubMedDate not supplied

Russell-Silver syndrome: an explanation for discordant growth in monozygotic twins.

Severe intrauterine growth retardation and suggestive dysmorphic and malformation syndrome in 1 twin with a normal karyotype during a monozygotic, monochorionic pregnancy led to the diagnosis of discordant Russell-Silver syndrome (RSS). Placental anomalies (velamentous cord insertion, single umbilical artery, placental hypotrophy) for the small-for-date twins and a twin-twin transfusion syndrome confirmed at 21 weeks of amenorrhea suggest that early hemodynamic disorders may reveal or trigger RSS which has been considered to be of genetic origin. The prognosis for RSS is favorable, except for diminished adult size (less than -2 standard deviations).

Adult↗

PubMedDate not supplied

Peribulbar and retrobulbar combined anesthesia for vitreoretinal surgery using ropivacaine.

PURPOSE: To evaluate the efficacy and clinical effects of local retrobulbar anesthesia using ropivacaine in vitreoretinal surgery. METHODS: Prospective study. A total of 919 vitreoretinal operations were followed. The operations were divided into three groups, depending on the degree of anesthesia needed. Group A: Vitrectomies with episcleral procedures (208 vitrectomies for detached retina or perforating trauma). Group B: Episcleral procedures only (410 operations for detached retina without vitrectomy). Group C: Vitrectomies without episcleral surgery (301 operations for macular pucker or hole, proliferative diabetic retinopathy, or silicone oil removal). Anesthesia was administered using a 23-gauge Atkinson-type retrobulbar needle, after topical anesthesia. Six mL of the solution containing 7.5 mg ropivacaine/mL were injected into the peribulbar space, and the other 4 mL deeper, into the retrobulbar space. The degree of infiltration of the palpebral region, the motor block in the extrinsic ocular muscles, and pain felt were checked and rated. RESULTS: Swelling of lids was seen in 885 patients (96%); in 21 (2%) swelling was partial. In 13 patients (1%) there were no signs of infiltration. The motor block was total in 801 (87%) eyes, while 118 (12%) had reduced ocular movements. The degree of anesthesia was as follows, considering the three groups together: no pain = 855 (93%) patients; moderate pain = 44 (4%) patients; very strong pain = 20 (2%) patients. No adverse events or side effects were observed. CONCLUSIONS: Ropivacaine used for retrobulbar-peribulbar combined anesthesia in vitreoretinal surgery showed excellent clinical efficacy as regards analgesia and muscle akinesia.

Adult↗