Difference in glenoid retroversion between two-dimensional axial computed tomography and three-dimensional reconstructed images

Background@#The glenoid version of the shoulder joint correlates with the stability of the glenohumeral joint and the clinical results of total shoulder arthroplasty. We sought to analyze and compare the glenoid version measured by traditional axial two-dimensional (2D) computed tomography (CT) and three-dimensional (3D) reconstructed images at different levels. @*Methods@#A total of 30 cases, including 15 male and 15 female patients, who underwent 3D shoulder CT imaging was randomly selected and matched by sex consecutively at one hospital. The angular difference between the scapular body axis and 2D CT slice axis was measured. The glenoid version was assessed at three levels (midpoint, upper one-third, and center of the lower circle of the glenoid) using Friedman’s method in the axial plane with 2D CT images and at the same level of three different transverse planes using a 3D reconstructed image. @*Results@#The mean difference between the scapular body axis on the 3D reconstructed image and the 2D CT slice axis was 38.4°. At the level of the midpoint of the glenoid, the measurements were 1.7° ± 4.9° on the 2D CT images and −1.8° ± 4.1° in the 3D reconstructed image. At the level of the center of the lower circle, the measurements were 2.7° ± 5.2° on the 2D CT images and −0.5° ± 4.8° in the 3D reconstructed image. A statistically significant difference was found between the 2D CT and 3D reconstructed images at all three levels. @*Conclusions@#The glenoid version is measured differently between axial 2D CT and 3D reconstructed images at three levels. Use of 3D reconstructed imaging can provide a more accurate glenoid version profile relative to 2D CT. The glenoid version is measured differently at different levels.

Ultrasound-Guided Regional Nerve Block in Below-Knee Amputation / 대한정형외과학회잡지

PURPOSE: This study compared the clinical results of an ultrasound (US)-guided regional nerve block with those of general anesthesia in below-knee amputation (BKA) surgery. In addition, the 1-year mortality rate of BKA patients was evaluated in relation to the preoperative comorbidity and postoperative hemoglobin level. MATERIALS AND METHODS: Among 47 patients who underwent BKA between January 2011 and August 2016, 18 patients in the US-guided regional nerve block group (group 1) and 29 patients in the general anesthesia group (group 2) were analyzed retrospectively and compared. For the clinical assessment, the 30-day mortality, 1-year mortality, postoperative hemoglobin level, and postoperative complications of both groups were investigated. The visual analogue scale (VAS) pain scores at postoperative 1, 6, and 12 hours for both groups were evaluated. The 1-year mortality of BKA patients was also evaluated in relation to the preoperative comorbidity and postoperative hemoglobin level (hemoglobin < 7 g/dl). RESULTS: Significant differences in the 30-day mortality were observed between the two groups (p=0.023). Group 1 showed a higher 30-day mortality but the 1-year mortality was similar in both groups (p=0.051). The postoperative hemoglobin level was similar in the two groups (p=0.085). The VAS pain scores for the postoperative 1-hour and 6-hour differed significantly between the two groups (p < 0.001). The VAS pain scores for postoperative 12-hour showed no significant difference (p=0.10). The 1-year mortality rate of both groups was not affected by hypertension, diabetes mellitus, arteriosclerosis obliterans, and postoperative hemoglobin less than 7 g/dl, but was affected by chronic kidney disease (CKD) (Pearson's chi-square=14.39, p < 0.05). CONCLUSION: Although US-guided regional nerve block showed comparable 1-year mortality and postoperative hemoglobin levels compared to general anesthesia in BKA, it showed better results in postoperative 1, 6 hour pain control than general anesthesia. The 1-year mortality of BKA was affected by CKD. Therefore, careful consideration is needed for patients with CKD before undergoing BKA regardless of the anesthetic methods.

Morphologic Changes of Femoral Cam Lesion after Osteoplasty for Femoroacetabular Impingement / 대한정형외과학회잡지

PURPOSE: We evaluated the morphologic change of cam lesion of femoroacetabular impingement (FAI) using 3-dimensional computed tomography (3D-CT) at the minimum 2-year follow-up and estimated its relationship with clinical outcomes. MATERIALS AND METHODS: Between February 2007 and March 2014, all patients who underwent hip arthroscopic femoroplasty under the impression of FAI were retrospectively evaluated. We selected patients who received 3D-CT and were followed-up for more than 2 years. We estimated the quantitative volume of femoroplasty, alpha angle and femoral head-neck offset using 3D-CT. RESULTS: Thirty-two patients (37 cases) were selected in our study. The mean age was 31.2 years (16–69 years) and the mean follow-up duration was 47.3 months (26–119 months). The mean resection volume measured after femoroplasty using 3D-CT was 48.9 mm2 (13.2–106.4 mm2), and follow-up mean resection volume was 37.9 mm2 (7.83–90.37 mm2). A little bit of the mean volumatic overgrowth of the resection area between immediate postoperative and last follow-up was shown; however, there was no statistically significant difference in the mean values (p>0.05). The clinical outcomes showed a significant improvement during the perioperative and follow-up periods in all categories (p < 0.05). CONCLUSION: There was no significant regrowth of cam lesion after femoroplasty for FAI at maximum 9 years. Moreover, in most cases, clinical outcomes were improved. This suggests that we were able to achieve good clinical outcomes without harmful anatomical regrowth of cam deformity using arthroscopic femoroplasty.

Radiological and Clinical Effectiveness of a Novel Calcaneal Fracture Brace after Intra-articular Calcaneal Fracture Surgery

BACKGROUND: After calcaneal fracture surgery, a short leg splint and cast are typically applied. However, these restrict joint exercises, which is inconvenient for patients. In addition, there is a risk of complications, such as pressure ulcers or nerve paralysis with a short leg cast. In this study, we evaluated clinical and radiological outcomes of the use of a specially designed calcaneal brace after calcaneal fracture surgery. METHODS: From among patients who underwent open reduction and internal fixation for calcaneal fracture between July 9, 2013 and May 31, 2017, 102 patients who wore a calcaneal fracture brace (group A) and 82 patients who wore a postoperative short leg cast (group B) were randomly chosen for this study. Radiological changes and clinical factors were compared between the two groups. After swelling at the surgical site decreased, a special calcaneal brace was applied to patients in group A. They were allowed to perform early weight bearing and joint motion. Patients in group B were immobilized in a short leg cast and were told to avoid weight bearing for 6 weeks. In each group, the Böhler's angle and Gissane's angle were measured and compared using postoperative and final follow-up radiographs. Pain (measured using a visual analogue scale [VAS]) and ankle joint range of motion (dorsiflexion, plantar flexion, eversion, and inversion) were measured serially until the final follow-up visit. RESULTS: There were no significant differences in the Böhler's angle or Gissane's angle between the two groups as measured postoperatively and at the final follow-up (paired t-test). Differences in the VAS pain score and eversion were also statistically nonsignificant between the two groups. However, group A had a significantly higher range of dorsiflexion (p = 0.021), plantar flexion (p = 0.012), and inversion (p = 0.045) of the ankle than group B (independent t-test). CONCLUSIONS: Application of the calcaneal fracture brace after open reduction and internal fixation of a calcaneal fracture not only maintained the fracture reduction but allowed for greater joint motion than the short leg cast. Thus, the calcaneal fracture brace can be considered an effective postoperative management option that enables early resumption of daily activities and facilitates postoperative joint motion.

On Postoperative Day Balloon Angioplasty for Salvage of Newly-Placed, Flow-Limiting Native Arteriovenous Fistula

PURPOSE: To report result and usefulness of immediate postoperative balloon angioplasty of de novo arteriovenous fistula (AVF) with limited flow just after creation. MATERIALS AND METHODS: From January 1, 2012 to March 31, 2014, 1,270 patients received native AVF creations in a single vascular clinic. In twenty-four patients (1.9% of total AVF creation), immediate postoperative balloon angioplasty was performed because of limited flow on palpation (only pulsation or no thrill) just after AVF creation. Medical records were reviewed retrospectively; technical success (restoration of AVF flow)/clinical success (growing as functional AVF) rate, maturation time, primary patency rate and fistula survival outcome were analyzed during a mean 10.8 months of follow-up. RESULTS: Technical/clinical success rate was 95.8% (23/24 cases); AVF flow was restored after balloon angioplasty, and all the flow-restorated AVFs grew as functional AVFs with mean+/-standard deviation, 4.5+/-1.5 weeks of maturation time. In seven (30.4%) patients, a secondary balloon angioplasty was needed to enhance maturation. The overall primary patency after immediate postoperative balloon angioplasty was 69.6% at 1 and 6 months and 59.0% at 12 months. There was 1 complication (operation site hematoma). CONCLUSION: Immediate postoperative balloon angioplasty for salvage of newly-placed, flow-limiting native AVF is a useful, effective and safe procedure.

A Study of Serum HSP in Heart Transplanted Rats / 대한이식학회지

PURPOSE: This study was performed to investigate the availability of the serum HSP72 and HSP27 as serologic markers of cardiac allograft rejection through rat heterotopic heart transplatation model. METHODS: Inbred Lewis rats were randomly divided into three groups: the allograft heart transplant group, the isograft heart transplant group, and the sham-operated group. Six animals were studied in each group. In allograft heart tranplant group, the Brown Norway rats were used as donors and in isograft heart tranplant group, the Lewis rats were used as donors. The sera of the allograft heart transplanted rats, isograft heart transplanted rats, and sham- operated rats were collected at preoperative time, 3 days after operation and 6 days after operation, and analyzed for HSP72 and HSP27 by Western blots. Quantifications of band densities were carried out by laser densitometer and the results were expressed as % preoperative densities. RESULTS: The levels of serum HSP72 of 3 days and 6 days after heart transplantation significantly increased in the allograft heart transplant group than in the isograft heart transplant group, respectively (160.2+/-44.8% vs. 109.0+/-34.7%, 276.0+/-72.1% vs. 175.0+/-44.2%, P<0.05). The levels of seum HSP27 of 3 days and 6 days after heart transplantation significantly increased in the allograft heart transplant group than in the isograft heart transplant group, respectively (162.3+/-62.7% vs. 118.4+/-37.0%, 235.7+/-67.1% vs. 127.9+/-40.8%, P<0.05). CONCLUSION: It is concluded that serum HSP72 and HSP27 are useful markers to detect the cardiac allograft rejection.

Degeneration of the Cruciate Ligaments in Osteoarthritic Knee

PURPOSE: To assess the histological degeneration of the cruciate ligaments and it's correlation with gross appearance of the cruciate ligaments and functional status of the knee. MATERIALS AND METHODS: Macroscopic and microscopic evaluations of cruciate ligaments were made in 80 osteoarthritic knees undergoing cruciate-substituting total knee arthroplasty (TKA). Gross appearance was classified into "normal", "abnormal" and "tear". A scoring system was made to represent the degree of histological degeneration, and correlation with the gross appearance and functional status by knee society score (KSS) was statistically analysed. RESULT: Gross appearance of the anterior cruciate ligament (ACL) was "normal" in 24 cases, "abnormal" in 50 and "tear" in 6 with average histological score 3.7, 4.5 and 8.0 respectively. Gross appearance of the posterior cruciate ligament (PCL) was "normal" in 70, "abnormal" in 10 with average histological score 3.8 and 6.4 respectively. There was no "tear" of the PCL. Gross appearance of the ACL was correlated with histological score of ACL and PCL (p<0.05) and KSS (p<0.05). CONCLUSION: Gross appearance of the ACL was related to the degree of histological degeneration of the PCL as well as the ACL and functional loss of the knee. Therefore intraoperative gross appearance of the ACL can be one of the factors to decide if the PCL would be sacrificed or not during TKA.

Gonadal Tumors Developed from Consecutively Transplanted Spleens Bearing Gonad Implants

This study was conducted by consecutively transplanting spleens, which had gonads implanted previously. A total of 84 cases for infantile testicles and 106 cases for ovarian follicles were performed. In the case of ovarian implants, the results were determined by the total number of follicle implants. A modified spleen transplantation technique called double implantation of ovarian follicles was applied to increase the amount of the implants. In this technique, an extra spleen is implanted into the potential donor so that the ovarian follicles can be implanted to two different spleens, doubling the amount of implants. Through consecutive spleen transplantation, we observed the results beyond a typical rat's life span. In many of these cases, we found more aggressive forms of malignant tumor, seminoma and dysgerminoma. We present the results and discuss possible pathogenic mechanisms of tumor formation.

The Effect of Percutaneous Transluminal Angioplasty on Hemodialysis Shunt Insufficiency / 대한신장학회잡지

PURPOSE: The purpose of this study was to evaluate the effect of percutaneous transluminal angioplasty(PTA) and to determine patency rates and the factors affecting the long-term patency rates in the management of insufficient arteriovenous fistulae. METHODS: Sixty-one cases of insufficient dialysis shunts in 53 patients underwent venography of the fistula. These patients' indications of venographys were reviewed. Forty-six cases of insufficient dialysis shunts in 38 patients were treated by PTA. These patients' clinical characteristics and patency rates were evaluated. According to the patient's age, history of diabetes mellitus, duration of renal failure, type and age of the arteriovenous fistula, the site of AVF and length of the stenosis, and to the degree of residual stenosis, patency rates were compared within each subgroup using the Kaplan-Meier log- rank test. To estimate reasons for the incidence of vascular access failure, Cox regression model was used. Venographic findings of failed PTAs and PTA related complications were evaluated RESULTS: The success rate was 80.7%. In cases in which initial success was obtained, postintervention primary patency rate at 6, 12 and 24 months were 68%, 38% and 5% respectively. With repeatitive PTAs, postintervention assisted primary patency rate at 6, 12 and 24 months were 69%, 40% and 10% respectively. The effect of the above mentioned factors(age, DM, duration of CRF etc.) on long-term patency was not statistically significant(p > 0.05). Among 11 cases of failed PTA, there were 6 cases of total obstruction due to massive thrombosis and 5 cases of extensive vascular stenosis(>5 cm of length, >4 sites of stenosis and >75% of stenosis in all cases). There were no PTA related complications. CONCLUSION: PTA is considered to be an effective and safe treatment modality for shunt stenosis. No factors affected long-term patency rates in our study.

Ulnobasilic Arteriovenous Fistula for Hemodialysis / 대한신장학회잡지

BACKGROUND: Although native radiocephalic arteriovenous fistula provides the best possible vascular access for hemodialysis, available veins for this fistula are limited. Ulnobasilic arteriovenous fistula (UBF) is alternative method for native fistula of forearm. But this method is not commonly used because detection of the vein is difficult and cannulation for hemodialysis id uncomfortable. This study was performed to evaluate clinical usefulness of UBF. METHODS: From June 1999 to April 2000 and from September 2001 to February 2002, 256 arteriovenous fistulae were made in 239 patients with chronic renal failure and among them, 26 UBF were made by one surgeon. At April 2002, a total of 26 UBF were reviewed. RESULTS: The results were as follows : There were 17 men and 9 women, aged 31 to 72 years. There were 7 diabetic patients. 22 patients of them had previous history of arteriovenous fistula operation. There were six failures : one delayed occlusion; one venous hypertension due to proximal stenosis during hemodialysis; four inadequate maturation. The 20 patients showed good patency. CONCLUSION: This study shows that UBF can be useful method in patients with failed radiocephalic arteriovenous fistula or poor cephalic vein and preserve upper arm vein for future operation.

A Case of Obstructive Jaundice Caused by Extrinsic Compresson of Biliary Cystadenoma of the Common Hepatic Duct / 대한소화기내시경학회지

Biliary cystadenoma is a rare tumor that arises in the liver or, less frequently, in the extrahepatic ducts. Jaundice in patients with biliary cyst adenoma is not uncomon, but it is very rare that the jaundice is caused by tumor compression of the bile duct. A 43-year-old woman who had a huge biliary cystadenoma occupying the left liver developed deep jaundice. Endoscopic retrograde cholangiopancreatograpy demontrated that this tumor compressed the common hepatic ducts extrinsically which caused the deep jaundice.

Effect of Partial Portal Arterialization on Graft Survival in Experimental Liver Transplantation / 대한이식학회지

PURPOSE: In liver transplantation, low portal perfusion pressure may result in underperfusion of grafts and be the cause of primary nonfunction. Partial arterialization of portal vein could preserve graft perfusion. Up till now, there have been several clinical cases of temporary or permanent portal arterialization in liver transplantation. METHODS: In this study, we designed rat model for evaluating the effect of portal arterialization to improve survival of the under-perfused graft. Partial heterotopic non-regenerative liver transplantation was used with portal inflow only from inferior vena cava, which is known as portal under-perfusing liver transplantation model. Partial portal arterialization was performed by fenestration of the common wall between the IVC and the aorta through venotomy which was made for portacaval anastomosis. RESULTS: Immediate after arterialization, satisfactory macroscopic and duplex ultrasonographic liver perfusion were seen and the arterialized-graft survival was significantly improved to 95% (19/20) vs. 35% (7/20) of nonarterialized grafts. At 2-week after transplantation, the arterialized liver graft was atrophied showed normal gross appearance. The histopathologic examination with light microscope revealed no significant pathologic abnormality. CONCLUSION: Partial portal arteria;ization improved graft-survival of the under-perfusing liver grafts significantly and not affects the histologic hepatic structure adversely.

Brain Magnetic Resonance Imaging Findings in Children with Cerebral Palsy: Compared between Preterm and Term Groups

PURPOSE: We used MRI to retrospectively analyze the brain of patients suffering from cerebral palsy. Our aim is to determine MRI's role in the assessment of brain damage, the relationship of gestational age. METHODS: A total of 66 patients (29 preterm group and 37 term group), who visited Kang-Dong Sacred Heart Hospital from January, 1994 to July, 1998, were enrolled in this study. RESULTS: Among the 29 in the preterm group, 13 patients showed MR images of hypoxic ischemic injury in which periventricular leukomalacia (PVL) and multifocal ischemic necrosis in 12 (41.3%) and 1 (3.4%) respectively. Neuronal migration disorders were 6 (20.8%), other congenital malformations 5 (17%) and normal MR images 5 (17%) in this preterm group. Among the 37 in the term group, 22 patients showed MR images of hypoxic ischemic injury in which selective neuronal necrosis were 11 (29.7%), PVL 4 (10.8%), focal and multifocal ischemic necrosis 4 (10.8%) and status marmoratus 3 (8.1%). Neuronal migration disorders were 4 (10.8%), other congenital malformations 5 (13.5%) and normal MR images 6 (16.2%) in the term group. CONCLUSION: MRI provided useful information in a majority of children with cerebral palsy. Hypoxic ischemic injury was significantly different in preterm and term groups. PVL was frequent in the preterm group and selective neuronal necrosis was statistically common in the term group.

Testicular Transplantation in the Rat Model: The Comparison of Testosterone, Gonadotropin, and Histological Change in Allogenic and Isogenic Transplantation Group, and Implantation Group / 대한비뇨기과학회지

PURPOSE: The fate of avascular implants was compared with that of testicular transplants using vascular anastomosis in castrated inbred rats. MATERIALS AND METHODS: Mature inbred male rats were bilaterally castrated and received one testicle as a transplant to the scrotum. The blood supply of the grafts was reestablished by performing an end-to-side anastomosis between an aorto-caval segment of the donor bearing the testicular vessels and the abdominal aorta plus vena cava of the recipient. The average ischemia was 90 min. Lutenizing hormone(LH), follicle-stimulating hormone(FSH) and testosterone were determined by radioimmunoassay in serum samples. RESULTS: In 12 transplant recipients(6 isografts and 6 allografts), a good blood perfusion of the graft was achieved. Out of these, 6 isogenic transplants maintained normal testosterone,LH and FSH during follow up. Implant recipients,however, all displayed a strking early rise of the serum gonadotropins and concomitant castrsted levels of serum testosterone. CONCLUSIONS: Vascular transplantation rather than simple implantation is the method of choice for further research. And in allogenic testicular transplantation, there remains a problem of rejection after the operation, as in any other organ transplantation.

The Effects of Elliptical Versus Slit Arteriotomy on Patency in End-to-Side Microvascular Anastomosis

The fashion of vascular anastomosis, end-to-end or end-to-side (E-to-S), are depended upon surgeon's preference or surgical situations. In E-to-S anastomosis two different methods of arteriotomy are applicable but it has been suggested the type, either elliptical or slit arteriotomy, play a different role in the flow hemodynamics. We thought that the difference is more considerable in microvascular surgery. This study examines the effects of elliptical versus slit arteriotomy on morphologic vessel patency. Twenty male Sprague-Dawley rats were divided into two groups of ten rats each. Both carotid arteries were selected as a experimental model. During the procedures the rat brain was tolerable to ischemia and all animals were survived after operations. The morphologic analysis of anastomosis site was through resin-casting method with scanning electromicroscopic examination. The results showed notable difference between two groups in three-dimensional morphology at two-month of operation. This difference may affect the flow hemodynamics and long-term vessel patency. In microvascular anastomosis, the mortpologic difference of the elliptical arteriotomy is worse than slit arteriotomy which compromises the vessel circumference.

An Experimental Study on the Immune Responses to Regenerating Allografts in the Rat / 대한이식학회지

Partial liver transplantation from a living donor or by splitting the liver was developed to expand the donor pool. Sometimes the small-for-size liver is transplanted into larger recipient and it regenerates shortly to ideal volume for the recipient. The relationship between regeneration and rejection-intensity has not defined clearly yet. In this study the 30% partial liver of DA (Dark-Agauti) rats were transplanted heterotopically to Lewis rats by microsurgical technique. End-to-side cavocaval and end-to-end portoportal (or portomesenteric) anastomoses were performed but the artery and the bile duct were not reconstructed. In regenerating group (R), total portal blood of the recipient was diverted to the graft. In non-regenerating group (N), the superior mesenteric vein below the confluence of the splenic vein was anstomosed to the portal vein of the recipient. Both groups were treated with tacrolimus (FK-506 2 mg/kg/d) and compared with non-treated groups. Transplantations were successful with minimal operative mortality. The animals could survive for the studying period in both groups. When compared on day 3, day 5, and day 7, histologic examination revealed no significant differences of cellular infiltration between two groups. In tacrolimus-treated groups, the cellular infiltration was markedly decreased and there were no significant differences in cellular infiltration between regenerating group treated with tarcrolimus (R-F) and non-regenerating group treated with tarcrolimus (N-F). These findings suggest that immune responses to the allograft are not significantly influenced by the hepatic regeneration process in small-for-size graft. Further immunologic and molecular biologic investigation may be needed.

Simple Auxiliary Liver Transplantation without Bile Duct Reconstruction in the Rat / 대한이식학회지

There has been numerous experimental liver transplantation models in the rodent : orthotopic versus hetrerotopic; whole liver versus partial liver; microvascular suture versus cuff method in technical aspects. Several simplified modifications were introduced for experimental liver transplantation for improving animal-survival rate. Liver transplantation without arterial reconstruction, the cuff tchnique or stent method were the examples of simplifing modification. In practice, complications related to biliary reconstruction are frequent causes of intraabdominal infection in our rat liver transplantation. Here we propose using simple liver transplantation model of partial heterotopic liver transplantation without artery and bile duct reconstruction in the studies which need only observation of immediate graft survival or very short-term follow-up. Here we examined the serial histologic changes of auxiliary liver grafts without biliary reconstruction during short period after transplantation. Until 7 days of transplantation, bile duct proliferation was confined in the portal area of grafts and did not distort the lobular structure. Early graft-survival and rapid immunologic response might be evaluated by this easy transplantation model.

An Experimental Study on the Immune Responses to Regenerating Allografts in the Rat / 대한이식학회지

Partial liver transplantation from a living donor or by splitting the liver was developed to expand the donor pool. Sometimes the small-for-size liver is transplanted into larger recipient and it regenerates shortly to ideal volume for the recipient. The relationship between regeneration and rejection-intensity has not defined clearly yet. In this study the 30% partial liver of DA (Dark-Agauti) rats were transplanted heterotopically to Lewis rats by microsurgical technique. End-to-side cavocaval and end-to-end portoportal (or portomesenteric) anastomoses were performed but the artery and the bile duct were not reconstructed. In regenerating group (R), total portal blood of the recipient was diverted to the graft. In non-regenerating group (N), the superior mesenteric vein below the confluence of the splenic vein was anstomosed to the portal vein of the recipient. Both groups were treated with tacrolimus (FK-506 2 mg/kg/d) and compared with non-treated groups. Transplantations were successful with minimal operative mortality. The animals could survive for the studying period in both groups. When compared on day 3, day 5, and day 7, histologic examination revealed no significant differences of cellular infiltration between two groups. In tacrolimus-treated groups, the cellular infiltration was markedly decreased and there were no significant differences in cellular infiltration between regenerating group treated with tarcrolimus (R-F) and non-regenerating group treated with tarcrolimus (N-F). These findings suggest that immune responses to the allograft are not significantly influenced by the hepatic regeneration process in small-for-size graft. Further immunologic and molecular biologic investigation may be needed.

Simple Auxiliary Liver Transplantation without Bile Duct Reconstruction in the Rat / 대한이식학회지

There has been numerous experimental liver transplantation models in the rodent : orthotopic versus hetrerotopic; whole liver versus partial liver; microvascular suture versus cuff method in technical aspects. Several simplified modifications were introduced for experimental liver transplantation for improving animal-survival rate. Liver transplantation without arterial reconstruction, the cuff tchnique or stent method were the examples of simplifing modification. In practice, complications related to biliary reconstruction are frequent causes of intraabdominal infection in our rat liver transplantation. Here we propose using simple liver transplantation model of partial heterotopic liver transplantation without artery and bile duct reconstruction in the studies which need only observation of immediate graft survival or very short-term follow-up. Here we examined the serial histologic changes of auxiliary liver grafts without biliary reconstruction during short period after transplantation. Until 7 days of transplantation, bile duct proliferation was confined in the portal area of grafts and did not distort the lobular structure. Early graft-survival and rapid immunologic response might be evaluated by this easy transplantation model.

The Effect of Aminoguanidine and Insulin on the Development of Insulitis and the Expression of Inducible Nitric Oxide Synthase in Multiple Low Dose Streptozotocin-induced Diabetic Mice

In this study the effect of insulin and aminoguanidine on the expression of iNOS and the development of insulitis in the multiple low dose streptozotocin (SZ) induced diabetic (LDSD) mice was evaluated. Eighty mice (Charles-River CD-1 mice) were divided into four groups. Group I received SZ for five days. Group II received SZ for five days and was followed by insulin treatment. Group III received SZ for five days and was followed by aminoguanidine treatment. Group IV was normal control group. The blood glucose level and body weight were measured weekly. On the 35th day, pancreat ic sections were observed to evaluate the frequency and the severity of insulitis in addition to the immunohistochemical expression of iNOS in the pancreatic islets. Blood glucose levels of group IV were significantly lower than other experimental groups on the 21st, 28th, and 35th day. The difference in blood glucose levels was not statistically significant. Incidence of the insulitis was lower in group II than in groups I and III. The severity of insulitis correlated with the increase in blood glucose level only in group II. The expression of iNOS was more pronounced in group I than in groups II and III. Aminoguanidine did not inhibit development of the insulitis but decreased expression of iNOS in the pancreatic islets. Therefore it is speculated that iNOS production is one of the factors and other pathogenetic mechanisms might be involved in the development of insulitis.