BACKGROUND: Bolus steroids are usually administered prior to graft reperfusion in an attempt to provide protection against ischemia reperfusion injury (IRI). However, the anti-IRI properties of steroids have not been established. Living donor liver transplantation (LDLT) between identical twins provides a unique opportunity to study the natural production of cytokines during transplantation without the confounding influences of the alloimmune response or of immunosuppression in particular steroids. METHODS: A 38-year-old male with hepatitis C virus-related cirrhosis and multiple hepatocellular carcinomas received a hepatic right lobe graft from his identical twin. No immunosuppression was administered, not even intraoperative bolus steroids. IRI was assessed by serum transaminases as well as by proinflammatory interleukin (IL) IL-1beta, tumor necrosis factor (TNF)-alpha, IL-8 cytokines and for potent regenerative/anti-inflammatory (IL-6, IL-10) mediators. RESULTS: Despite no administration of steroids, low peak levels of serum transaminases were observed. Serum IL-6 and IL-10 dramatically and rapidly increased during liver transplantation, namely, 160 and 20 times higher than baseline, respectively. In contrast, IL-1beta and TNF-alpha remained low during and after transplantation and an increase in IL-8 was less obvious. CONCLUSION: Syngeneic LDLT without intraoperative bolus steroids is feasible, yielding no penalty in terms of IRI. A predominance of protective cytokines was observed in the absence of steroids. Thus, the concept that intraoperative administration of steroids is necessary to protect liver transplants from IRI must be revisited.

Adult↗

PubMedDate not supplied

Immunohistochemical detection of retinal cones in monkey retina: light and electron microscopic study.

PURPOSE: Retinal cones have wave-length-specific visual pigments. To identify subclasses of cones, opsin-specific antibodies were previously established for the immunohistochemical studies of frozen sections. In this study, we produced retinal cone antibodies and examined (1) the specificity of these antibodies with Western blot analysis, (2) the application of these antibodies to paraffin-embedded monkey retinal sections, and (3) the use of these antibodies in light and electron microscopic immunohistochemical analyses of the localization of retinal cones. METHODS: The N-terminal peptide of blue opsin, and the C-terminal peptide of green/red opsin were used as immunogens in New Zealand White rabbits. Immunohistochemical staining was performed using the ABC method and immunogold method. As antigen retrieval treatment, paraffin-embedded cynomolgus monkey retinas were subjected to enzyme and microwave treatment. RESULTS: Both anti-red/green and anti-blue cone opsin antibodies detected 40 kDa native cone opsins in crude retina extract. The red/green and blue cone opsin immunostaining after trypsin treatment revealed that a positive signal was observed in the cone outer segment. Immunogold labeling also showed that gold particles were concentrated on the cone outer segment. CONCLUSION: In the antigen retrieval method, trypsin treatment is the appropriate method to obtain optimal staining of paraffin sections of retina. Using this method, retinal cone in conserved old paraffin sections can be identified immunohistochemically.

Animals↗

PubMedDate not supplied

Surgical outcomes of trabeculotomy combined with sinusotomy for juvenile glaucoma.

PURPOSE: To evaluate the outcome of trabeculotomy combined with sinusotomy for juvenile glaucoma. METHODS: We studied 16 patients (25 eyes) (age range, 11-50 years) with juvenile glaucoma for a minimum follow-up period of 1 year. We performed combined trabeculotomy and sinusotomy surgery in 13 juvenile glaucoma patients (18 eyes), and trabeculotomy alone in 6 patients (7 eyes). RESULTS: The intraocular pressure (IOP) of the combined surgery group was 29.8 +/- 7.8 mm Hg before surgery and 15.6 +/- 3.0 mm Hg 1 year after surgery. The IOP of the trabeculotomy-alone group was 29.1 +/- 6.4 mm Hg before surgery and 15.4 +/- 2.4 mm Hg 1 year after surgery. A postoperative IOP spike that was higher than the preoperative IOP was recorded in 2 eyes of the combined surgery group and in 2 eyes of the trabeculotomy group. The combined surgery group consisted of 7 eyes with a previously failed glaucoma surgery, and 11 eyes having a first glaucoma surgery. The postoperative IOP in these 11 eyes was 15.5 +/- 2.8 mm Hg. CONCLUSION: Trabeculotomy is very effective in lowering the IOP in patients with juvenile glaucoma. Sinusotomy does not play an important role in tension control.

Adolescent↗

PubMedDate not supplied