Pancreas transplantation: experience of single center.

BACKGROUND: Diabetes is the most common cause of renal failure. In patients with type I diabetes and renal failure,dialysis and insulin therapy can prevent a clinical context that causes rapid death, but they are insufficient to prevent longterm complications. Pancreas and islet cell transplantation inpatients with type I diabetes are the only curative treatment and have recently become more common. METHODS: Between December 2006 and August 2010 a total of 10 patients underwent pancreas transplantation. The patient's data were analysed retrospectively. RESULTS: 10 patients and their data were included in this study. Six patients were male and 4 patients were female. All patients are still alive, with functional grafts. CONCLUSIONS: Pancreas transplantation is the most effective treatment for patients with type I DM. This paper discusses the feasibility of this process and presents the experience of Ankara University in pancreas transplantation.

Single stapler technique in laparoscopic donor nephrectomy.

BACKGROUND: Laparoscopic donor nephrectomy (LDN) is usually performed with at least 2 separate vascular staplers for division of the renal artery and vein. However, we used a single stapler regardless of the number of renal arteries and veins. Furthermore, the graft was quickly retrieved by hand without using an extraction bag using our technique. Herein we have presented our experience with LDN of grafts with single or multiple renal arteries and/or veins using a single stapler and hand removal. METHODS: We reviewed demographic data, operative and warm ischemia times, postoperative complications, and graft function. RESULTS: Between December 2005 and September 2009, we performed 85 cases with 1 renal artery (group LDN-1), 8 cases with two renal arteries (group LDN-2), and 5 cases with 3 or more renal arteries (group LDN-3). The demographic data among the groups were similar. The mean operative time was significantly longer among groups LDN-2 (100.3 ± 9.5 minutes) and LDN-3 (120.6 ± 10.3 minutes) compared with LDN-1 (76.1 ± 9.3 minutes; P < .001). Similar results were observed with respect to warm ischemia times. There were no significant differences related to graft function and outcomes among these groups. CONCLUSION: The single stapler and hand removal technique was safe, technically feasible, and cost effective regardless of the number of renal arteries and veins. This technique removes the necessity of additional staplers and extraction bags, lowers the operative and warm ischemia times, and thus decreases the cost.

Activity-dependent patterning of retinogeniculate axons proceeds with a constant contribution from AMPA and NMDA receptors.

Neural activity is critical for the refinement of neural circuitry during development, although the mechanisms involved in stabilizing appropriate connectivity remain unclear. It has been proposed that the insertion of AMPA receptors at synapses with only NMDA receptors ("silent synapses") mediates this stabilization, leading to an increasing contribution from AMPA receptors as development proceeds. Here we show in a mammalian system known to undergo activity-dependent development [the segregation of retinal afferents into ON/OFF sublaminae in the ferret lateral geniculate nucleus (LGN)] that the refinement of the neural circuitry occurs in the presence of a constant functional contribution from AMPA and NMDA receptors. Although we detected a small number of silent synapses on LGN cells, their proportion did not decrease with age. The size and kinetics of NMDA-mediated spontaneous EPSCs (sEPSCs) were also stable over this period. Together with previous results reporting the stability of unitary AMPA-mediated EPSCs, the constancy of NMDA-mediated sEPSCs indicates an unchanging AMPA/NMDA contribution. Additionally, the CNQX-sensitivity did not increase for either sEPSCs or optic tract-evoked EPSCs. Likewise, the anatomical AMPA/NMDA ratio, as assayed by quantifying the colocalized expression of AMPA and NMDA receptor subunits, was fixed throughout ON/OFF sublamination. In particular, the colocalization of AMPA receptor subunits (GluR1 or GluR4) and NMDA receptor subunit NR1 opposite identified retinogeniculate terminals was stable during this period. These results add to the view of the population of retinogeniculate synapses as robustly stable or normalized during a period when retinogeniculate axons are undergoing dramatic activity-dependent refinement.