Ex Vivo Repair and Renal Autotransplantation for Complex Renal Artery Aneurysms in a Solitary Kidney

Renal artery aneurysm (RAA) is a rare clinical entity with an incidence of 0.015-1%. Indications for interventional or surgical repair of RAAs are expanding aneurysms, diameter >2.5 cm, intractable renovascular hypertension, dissecting RAA, hematuria, and renal infarction after distal embolization. Interventional insertion of a stent graft as well as aortorenal bypass implantation are both low-risk procedures in simple aneurysms of the proximal renal artery. However, complex distal renal aneurysms involving several renal artery branches require not only an excellent result of vascular reconstruction, but also a surgical technique offering maximal protection for the kidney during the ischemic period. Here, we present a case of a solitary kidney with two consecutive RAAs of segmental renal artery branches (type 2 RAA). A surgical strategy including renal explantation, ex vivo renal preservation, ex vivo reconstruction of the renal artery, and renal heterotopic autotransplantation was successfully applied. The technique of ex vivo repair is a safe and effective surgical procedure in this clinical setting.     

Successfully overcoming the inhibitory impact of the "forget" instruction: A voxel-based morphometric study of directed forgetting

In directed-forgetting studies, test items are followed by an instruction either to "remember" or to "forget" (F). Many to-be-forgotten (TBF) stimuli are not retrieved at the recognition phase. However, some subjects are able to correctly recollect a high number of TBF stimuli. We examined whether this ability is reflected in the structure of brain regions involved in memory and the control of retrieval processes. In subjects with high recognition rates for TBF stimuli, voxel-based morphometry revealed increased gray matter (GM) volume in the left ventrolateral prefrontal cortex (VLPFC) and the right hippocampus (H). GM volume in these regions correlated positively with the TBF recognition rate. No significant differences were detected in subjects who forgot many TBF stimuli. Our findings indicate that the right H and left VLPFC are of particular relevance in releasing TBF items from inhibition caused by the F instruction.     

Examining the combinatorial model of motor neuron survival by expression profiling of trophic factors and their receptors in the embryonic Gallus gallus

During embryogenesis, limb‐innervating lateral motor column (LMC) spinal motor neurons (MN) are generated in excess and subsequently nearly half of them die. Many motor neuron survival factors (MnSFs) have been shown to suppress this default programmed cell death (PCD) program through their receptors (MnSFRs), raising the possibility that they are involved in matching specific MNs with their target muscles. Published observations suggest a combinatorial model of MnSF/Rs function, which assumes that during the PCD phase, MNs are expressing combinations of MnSFRs, whereas the limb muscles innervated by these MNs express cognate combinations of MnSFs. We tested this model by expression profiling of MnSFs and their receptors in the avian lumbosacral spinal cord and limb muscles during the peak PCD period. Our findings highlight the complexity of MnSF/Rs function in the control of LMC motor neuron survival. Developmental Dynamics 239:965–979, 2010. © 2010 Wiley‐Liss, Inc.