Left subpancreatic transplexus exposure of the proximal abdominal aorta.

The authors report their experience based on the anatomical study of the celiac region and on the practice of abdominal multiorgan removal for transplantation. They particularly concentrate on the limits and the content of the celiac region of Luschka and particularly: -the position of the celiac axis in relation to the median arcuate ligament of the diaphragm, -the relations of the collateral branches of the abdominal aorta, -the place being taken by the celiac plexus and its situation in relation to the left renal v. From these elements, they describe an original transplexus surgical exposure of the origins of the celiac axis and of the superior mesenteric a. They show the importance of this approach in abdominal vascular surgery and during abdominal multiorgan removal in transplantation.

Histoenzymatic study of human renal tissue preservation: I--Proximal tubular glucose-6-phosphatase is correlated with transplant evolution.

Glucose-6-phosphatase was tested histochemically as a gluconeogenesis marker of ischemia-reperfusion injury of proximal tubular cells in human renal transplants. Histochemical enzyme activity, histology and transplantation conditions (preservation solution, cold and warm ischemia time, donor age), were compared to renal transplant evolution. Neither histology nor transplantation conditions were correlated with renal transplant evolution. Only glucose-6-phosphatase activity was significantly correlated with transplant evolution and could be used as a more sensitive marker than histology for the detection of ischemia-reperfusion injury of proximal tubules.

Platelet phosphatidylinositol kinase activity is not altered in Alzheimer disease.

We previously reported a specific decline in phosphatidylinositol (PI) kinase activity in the neocortex of patients with Alzheimer disease (AD) as compared to controls, whereas phosphatidylinositol phosphate (PIP) kinase activity appeared not to be affected (Jolles et al., 1992). In search of a possible systemic effect of AD, in the present study we investigated phosphoinositide kinase activity in platelets from patients with AD and from control subjects. The study was based on the notion that disease-specific abnormalities in the brain could be reflected in blood platelets. PI kinase activity was studied in platelet homogenates and in a salt-solubilized protein fraction of platelets, because of the difference in subcellular localization of the different types of PI kinases. In addition, NADH cytochrome-C reductase was measured in platelet homogenates as a marker for the endoplasmic reticulum, to detect a possible proliferation of the endoplasmic reticulum. AD patients and normal elderly controls showed no difference in PI kinase activity in either enzyme fraction. Furthermore, NADH cytochrome-C reductase activity and the protein/phospholipid ratio per 10(6) platelets were the same for AD patients and controls. This was taken as an indication that platelets in AD patients do not show proliferation of intracellular membranes.

Intestinal absorption of drugs: digitalis binding and transport by brush-border membrane vesicles from human duodenum.

The intestinal epithelial cell layer is the first major barrier to absorption encountered by xenobiotics. An understanding of the mechanism and sites of drug absorption and metabolism is thus a critical first step in developing orally active compounds. In this context human brush-border membrane vesicles obtained from multi-organ donor intestines have been purified. This model has been validated and used to investigate the duodenal absorption of drugs "in vitro", namely digitalis. It is well established that digitalis compounds present great variability in their respective "in vivo" bioavailability in human (60-90% for digoxin, 0% for ouabain). These particular characteristics prompted us to determine whether this membrane model constitutes a suitable tool in predicting the bioavailability or intestinal transport processes of these molecules. The uptake of [3H] digoxin and [3H] ouabain by membrane vesicles incubated in media of increasing osmolarities demonstrated that: i/two factors are involved in the uptake processes of digoxin: membrane binding and intravesicular transport (osmotic sensitive), ii/ for ouabain, no osmotic sensitivity was observed, indicating that no transport process occurred, but only membrane binding processes. These results are in complete agreement with the absolute bioavailability data reported for man "in vivo". This human brush-border model constitutes an interesting approach to the intestinal absorption phenomena which are known to be among the factors influencing the bioavailability of orally administered drugs.

[Anatomic basis of the harvest of abdominal organs for organ transplants]. / Bases anatomiques des prélèvements d'organes abdominaux en vue de transplantations d'organes.

The abdominal organs removals, with a view to transplants, are complex surgical operations which require a perfect knowledge of visceral vascular anatomy. The common point of these removals is the "birenal en bloc excision", whose we have codified the development. This removal has induced us to revise many points of surgical anatomy and particulary: the connections between the liver and the right kidney; the importance of the mesoduodenum; the relative orientations of the portal vein and inferior vena cava axis; the ureteral vascularisation; the topography and the number of renal arteries; the connections between renal arteries orifices and superior mesenteric arterial orifice. When we have to remove, besides the kidneys, the liver or the pancreas or even the small intestine, surgical problems are the same, but then, the dissections concern also the celiac axis and the superior mesenteric artery. These multiple removals raise also many questions to the anatomist, the most interesting concerning: the multiple hepatic arteries; the connections between celiac branches of the abdominal aorta. All these notions are envisaged not only by the light of the anatomical preparations but also by reference to the clinical experience of the authors.

Macroscopic study of the adult thymus.

The dissection of 48 cadaveric specimens has been compared with operative findings for a review of the shape, size and site of this gland in the adult. The structure of the thymic compartment and the relations of the thymus, particularly with the vessels of the superior mediastinum and the base of the neck, were studied. The relative positions of the inferior parathyroid glands and the thymus were identified, with respect to the influence of this topography on the surgery of these glands. The arterial suply to the thymus, which is still very abundant in the adult, presupposes a functional organ whose physiologic involution is slow.