Anatomical variations of donor portal vein in right lobe living donor liver transplantation: the safe use of variant portal veins

In right lobe (RL) living donor liver transplantation (LDLT), portal vein (PV) variations are of immense clinical significance. In this study, we describe in detail our PV reconstruction techniques in RL grafts with variant PV anatomy and evaluate the impact of accompanying biliary variations on the recipient outcomes. In a total of 386 RL LDLTs performed between July 2004 and July 2012, the clinical data on 52 (13%) transplants using RL grafts with variant PV anatomy were retrospectively analyzed. Portal vein anatomy was classified as type 2 in 20 patients, type 3 in 24 patients, and type 4 in eight patients. The PV reconstruction techniques utilized included back‐wall plasty (n = 21), back‐wall plasty with saphenous vein graft interposition (n = 6), saphenous vein graft interposition (n = 5), cryopreserved iliac vein Y‐graft interposition (n = 6), and quiltplasty (n = 3). There was no donor mortality. In a median follow‐up of 29 months, none of the recipients had vascular complications. Anomalous PV anatomy was associated with a high (54%) incidence of biliary variations; however, these variations did not result in increased biliary complication rate. Overall, the 1‐ and 3‐year patient survival rates of recipients were 91% and 81%, respectively. Vascular and biliary variations in RL grafts render LDLT technically more challenging. By employing appropriate reconstruction techniques, it is possible to successfully use RL grafts with PV variations without endangering recipient and donor safety.     

Serum adipokine levels in patients with sarcoidosis

Clinical Rheumatology - Sarcoidosis is a chronic inflammatory disease characterized by non-caseating granuloma which etiology is unknown yet. Adipokines are different proteins synthesized by...     

Effect of static magnetic field on experimental dermal wound strength

Context:

An animal model.

Aim:

We sought to evaluate the effect of static magnetic fields on cutaneous wound healing.

Materials and Methods:

Male Wistar rats were used. Wounds were created on the backs of all rats. Forty of these animals (M group) had NeFeB magnets placed in contact with the incisions, either parallel (Pa) and perpendicular (Pr) to the incision. The other 40 animals (sham [S] group) had nonmagnetized NeFeB bars placed in the same directions as the implanted animals. Half of the animals in each group were killed and assessed for healing on postoperative day 7 and the other half on postoperative day 14. The following assessments were done: gross healing, mechanical strength, and histopathology.

Statistical Analysis Used:

Intergroup differences were compared by using the Mann-Whitney U or t test. Values for P less than 0.05 were accepted as significant.

Results and Conclusions:

There were no differences between the magnetic and sham animals with respect to gross healing parameters. The mechanical strength was different between groups. On postoperative day 14, the MPr14 had significantly higher scores than the other groups. When static, high-power, magnetic fields are placed perpendicular to the wound, increased wound healing occurs in the skin of the experimental model.KEY WORDS: Static electromagnetic field, wound healing, breaking strength, skin     

Serial studies of T-lymphocyte subpopulations in HIV seropositive haemophiliacs

Serial determinations of the numbers of peripheral blood T-lymphocyte subpopulations (T-helper/inducer and T-suppressor/cytotoxic cells) were made using monoclonal antibodies in 12 patients with haemophilia who were HIV antibody positive. Eleven patients were clinically severe and one clinically moderate. Follow-up studies for 12-42 months in nine patients showed persisting abnormalities in five patients, abnormalities which developed in three patients who were initially normal, and a return to normal findings in one patient who was initially abnormal. The remaining three patients were followed up for 3-4 months; two showed persisting abnormalities and one a return to normal. Persistent generalized lymphadenopathy was found in one patient who showed raised levels of T-suppressor cells initially and low levels of T-helper cells in the follow-up, but low T-helper cells persisting for up to 12 months were not necessarily associated with disease.     

Type II autosomal dominant osteopetrosis

Two principal types of osteopetrosis have been distinguished. One is the dominantly inherited, relatively benign condition which is often detected radiologically in asymptomatic adults. A second type is the recessive, lethal, malignant form. Autosomal dominant osteopetrosis (ADO) has two distinct radiological subtypes known as types I and II. We report here a 23-year-old patient with ADO type II. Radiographic investigations of a skeletal survey showed generalised osteosclerosis with thickened cortex. Magnetic resonance imaging (MRI) scan disclosed osteosclerosis in superior and inferior portions of the vertebral bodies which produced a 'sandwich' appearance. The 'bone-within-bone' appearance was seen in the ileum of the patient. The vertebral bone density was found markedly elevated. The carbonic anhydrase II level was found to be normal. We discuss here the genetic etiology of this disorder.