Enzymatic and morphological evaluation of the hepatic cytoprotective effect of somatostatin and octreotide during extended experimental liver preservation.

Cytoprotective effects on the liver of somatostatin (ST) and octreotide (OT) have been previously described in normothermic ischemia-reperfusion models. The purpose of this study was an enzymatic and morphological assessment of hepatic cytoprotective effects during extended cold storage. Rat livers were washed in situ via the portal vein with University of Wisconsin solution (UW) UW+ST, or UW+OT. After 24 or 48 hours of cold ischemia time (CIT), livers were reperfused for 2 hours via the portal vein with oxygenated KHB at 37 degrees C using a nonrecirculating ex situ isolated perfusion system. Levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), and creatinine kinase (CK) were assessed in the perfusate during ex situ isolated reperfusion. After a 24-hour cold ischemia time (CIT) ALT, LDH, and CK levels were significantly lower (P < .05) in the UW+ST and the UW+OT livers than the UW livers. After 48-hour CIT, AST, ALT, LDH, and CK levels were significantly lower (P < .05) in the UW+ST and the UW+OT livers than the UW livers. Histopathological examination revealed mild differences after 24-hour CIT but an evidently less ischemically damage organ after 48-hour CIT. With the limitations of an in vitro model, ST and OT showed enzymatic and morphological effects during extended liver preservation.

Electrical impedance of the liver during experimental long-term liver preservation.

Measurements of electrical impedance were performed to assess ischemic damage in the rabbit liver during long-term preservation with University of Wisconsin (UW) or histidine-tryptophan-ketoglutarate (HTK) solution. The impedance was measured at a frequency of 200 Hz after in situ perfusion and after cold storage for 24 and 48 hours in UW or HTK solution (six livers per group). Z(200 Hz) was significantly higher (P < .01) after 48 compared with 24 hours of cold storage with both protection solutions without significant differences between the livers preserved with both solutions. Electrical impedance was observed to be a sensitive indicator of liver damage during long-term protection, showing similar preservation quality for both preservation solutions.

Cystic mature teratoma of the filum terminale in an adult. Case report and review of the literature.

Intradural spinal teratoma is a very rare entity, more prevalent in childhood, that may associate with dysraphic defects. The authors report a 46 years old man with a cauda equina syndrome and an L1-2 tumor. An L1-2 laminectomy was performed and a mass was resected at the base of the filum terminale, which was in contact with the conus medullaris. Histopathological diagnosis was of cystic mature teratoma. Spinal teratomas may be found anywhere along the spine, but are more frequent in the cauda equina. We discuss the origin of these tumors and review the literature concerning these lesions.

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Inflammatory C2-3 subluxation: a Grisel's syndrome variant.

The concurrence of non-traumatic atlanto-axial subluxation with inflammation of the adjacent neck tissues is known as Grisel's syndrome. We report a 5 year old boy with recurring episodes of head tilt and painful and restricted neck movements that developed after repeated bouts of sinusitis. Radiographs showed a subluxation of the C2-3 joint. Medical treatment, with cervical collar, physiotherapy, and non-steroid anti-inflammatory agents, led to complete cure of the disease. We suggest that Grisel's syndrome can occur in a location different from the classic atlanto-axial joint. To the best of our knowledge, this is the first report of a symptomatic case of Grisel's syndrome occurring at the C2-3 segment.

Atlanto-axial rotatory subluxation in children: early management.

Atlanto-axial rotatory subluxation (AARS) is an uncommon condition involving dislocation and abnormal fixation of the atlas on the axis. AARS is difficult to diagnose and if improperly treated it may lead to permanent neck deformity. We report a retrospective series of patients diagnosed with AARS seen during the last five years. The children presented with neck pain, head tilt, and reduction in neck mobility. In three of the cases the condition was secondary to cervical trauma and in the fourth it was associated with otitis (Grisel syndrome). The diagnosis was established by three-dimensional computerised tomography. In three cases, the atlanto-axial fixation was cured after cervical immobilisation and physiotherapy. A posterior cervical fusion was required in the remaining case. Early detection and intensive conservative treatment constitutes the mainstay of management of AARS. Surgery is reserved for cases with irreducible or recurrent subluxation.