OBJECTIVE: To evaluate the effect of ciclosporin A (CsA) on the organogenesis and function of embryonic metanephroi allografted into adult rats. METHODS: The whole metanephroi from the 15, 16 and 17 embryonic day-old (E15, E16, E17) embryos of Sprague-Dawley (SD) rat were allografted into the omenta of SD adult rats with their left kidneys resected, which were divided into 2 categories: 3 CsA-treated groups of 10 rats (E15CsASD, E16CsASD, and E17CsASD) and 3 non-CsA-treated groups of 10 rats (E15SD, E16SD, and E17SD). Thirty SD rats without kidney resection were divided into 6 equal groups and underwent allografting embryonic metanephroi in the same manner as mentioned above. The E15 metanephroi of Lewis rats were allografted into the omenta of Thirty adult Brown Norway (BN) rats with one kidney resected. Were divided into 6 equal groups, received allografting of embryonic metanephroi, and injected with CsA of normal saline in the manner as mentioned above (E15CsABN and E15BN). Two to 4 weeks after implantation, the metanephroi allografted in host rats were removed for histopathological examination or anastomosed for renal function measurement 4 weeks later. RESULTS: (1) Four weeks after implantation, the E17SD and E16SD metanephroi showed signs of acute rejection as hypercellular glomeruli and mononuclear cell infiltration in the interstitium. The E16CsASD and E17CsASD metanephroi formed mature nephrons and collecting ducts with few lymphocytic infiltrates. After CsA was discontinued, the E16CsASD and E17CsASD metanephroi were rejected fully within 21 days. (2) 4 weeks after implantation, the E15SD metanephroi were enlarged, became vascularized, and developed mature tubules and glomeruli; however, they were rejected by 100 days after implantation. The E15 Lewis metanephroi were fully rejected within two weeks in the BN adult rats. With CsA administrated, the E15 Lewis metanephroi developed normal mature nephrons and collecting ducts within the adult BN rats. If CsA was discontinued, the E15CsABN metanephroi were rejected. (3) The E15CsASD metanephroi had significantly lower values of wet weight (P = 0.006) and higher values of creatinine clearances (P = 0.007) than the E15SD metanephros transplants, but were identical to those of the E16CsASD metanephroi (P = 0.948, P = 0.840). (4) The metanephroi did not grow or differentiate in the rats without host kidney resection. CONCLUSIONS: (1) Cyclosporin A may suppress graft rejection, thus normalizing the growth and function of fetal metanephroi in the omenta of host rats. (2) A variety of factors affect the growth and development of allografted metanephroi, whereas rejection remains the major one.
Spirocerca lupi causes formation of nodules that may transform into sarcoma in the walls of aorta, esophagus and stomach of infected canids. In February 2013, post mortem examination of a red fox (Vulpes vulpes) hunted in Denmark revealed the presence of several nodules containing adult worms of Spirocerca sp. in the stomach and the omentum. The nodules largely consisted of fibrous tissue with infiltration of mononuclear cells, neutrophilic granulocytes and macrophages with hemosiderin deposition. Parasitological examination by three copromicroscopic methods, sedimentation, flotation with saturated sugar-salt solution, and sieving failed to detect eggs of Spirocerca sp. in feces collected from the colon. This is the first report of spirocercosis in Denmark, and may have been caused by a recent introduction by migrating paratenic or definitive host. Analysis of two overlapping partial sequences of the cox1 gene, from individual worms, revealed distinct genetic variation (7-9%) between the Danish worms and isolates of S. lupi from Europe, Asia and Africa. This was confirmed by phylogenetic analysis that clearly separated the Danish worms from other isolates of S. lupi. The distinct genetic differences of the current worms compared to other isolates of S. lupi may suggest the presence of a cryptic species within Spirocerca.
OBJECTIVE: To describe the successful laparoscopic management of a primary omental pregnancy. DESIGN: Case report. SETTING: Department of Obstetrics and Gynecology, Dr. Sami Ulus Obstetrics, Gynecology and Children's Hospital, Ankara, Turkey. PATIENT(S): A 22-year-old patient with an omental pregnancy. INTERVENTION(S): Laparoscopic partial omentectomy. MAIN OUTCOME MEASURE(S): Successful laparoscopic management of an omental pregnancy. RESULT(S): A 22-year-old woman presented to the emergency room with abdominal pain and vaginal spotting. She was undergoing clomiphene (CC) induction for infertility and had a positive urine pregnancy test at home. A right adnexal ectopic pregnancy was reported by ultrasonography. Due to increasing pain, laparoscopy was performed. The uterus and fallopian tubes appeared normal without any signs of pregnancy. A well-vascularized intact omental gestational sac was discovered in the right adnexal region in close proximity to the right ovary. By laparoscopy, the sac was resected with partial omentectomy. A primary omental pregnancy was confirmed by beta-hCG-positive trophoblast cells among omental fat cells. CONCLUSION(S): Omental pregnancy is rather difficult to identify due to localization. When in close proximity to the adnexal region, it may mimic a tubal ectopic pregnancy. Laparoscopy offers a minimally invasive method for diagnosis and therapy.
Seventy patients underwent coronary artery bypass grafting with the right gastroepiploic artery or the inferior epigastric artery between 1989 and 1992 at the Montreal Heart Institute. There were 68 men and 2 women with a mean age of 53 +/- 8 years, the right gastroepiploic artery in situ was anastomosed to the right coronary artery in 55 patients and the inferior epigastric artery (free graft) was used in 18 patients. Double internal thoracic artery grafts were used in all patients. Early patency rate of right gastroepiploic artery and inferior epigastric artery grafts was 91% (31/34 grafts) and 57% (8/14 grafts) respectively. One patient died after surgery (1.4%) from acute renal failure and one patient developed an acute myocardial infarction (1.4%) at surgery. Fifty-five patients (55/57, 96%) showed no evidence of angina at the last follow-up. In conclusion, patency rate and clinical results of coronary artery bypass grafting with the right gastroepiploic artery graft were excellent and patency rate of inferior epigastric artery graft was unsatisfactory. We suggest that epigastric artery grafts should be used with caution, only when no other alternative is available.
For the period from September 2010 to September 2014 there were operated 513 patients with endometrial cancer using laparoscopic installation the Karl Storz company. 304 patients (59.2%) underwent hysterectomy with appendages, 209 (40.8%)--hysterectomy with appendages and pelvic lymphadenectomy, including 11 patients (2.2%) with the addition of omentectomy in serous and serous-papillary forms of endometrial cancer. The average age of patients was 58.4 years (44-75 years). Body mass index over 25.0 was determined in 456 patients (88.9%), of whom 183 patients (35.6%) had an excess of body weight, in 159 (31.0%)--obesity of I degree, in 79 (15.5%)--obesity of II degree and in 35 patients (6.8%)--obesity of III degree. There were no reported complications during surgery. The postoperative period in the majority of patients was characterized by the minimal complications and absence of contraindications for adjuvant radiotherapy. During follow-up period there were registered 4 relapses: in 1 patient with serous--papillary form of endometrial cancer during the first year after surgery--in the form of dissemination of tumor in the abdomen and pelvis; in 3 patients--in the form of a cytological detection of glandular cancer cells in vaginal stump. As a result, regardless of age and comorbidities, laparoscopy allows performing to endometrial cancer patients the entire volume of planned radical surgery with minimum damage and with minimal risk of intra- and postoperative complications, favorable and accelerated rehabilitation period.
Soboliphyme baturini, a stomach-dwelling nematode of American martens (Martes Americana), reaches high levels of infection; however, its effects on the nutritional condition of the host are unknown. To understand the effects of this parasite on American martens, we collected S. baturini and measured abdominal fat deposits from 155 marten carcasses on Prince of Wales Island, southeastern Alaska, in the winter 2006-2007. We analyzed how the dried mass of abdominal fat varied as a function of S. baturini intensity. Parasite intensity and nutritional condition were not correlated; these results suggest that American martens were able to withstand even very high levels of S. baturini infection (up to 178 parasites per host).