Pancreatic islet transplantation after upper abdominal exeriteration and liver replacement

Nine patients who became diabetic after upper-abdominal exenteration and liver transplantation were given pancreatic islet-cell grafts obtained from the liver donor (eight cases), a third-party donor (one), or both (four). Two patients were diabetic when they died of infections after 48 and 109 days, as was a third patient who died of tumour recurrence after 178 days. The other 6 are alive 101-186 days postoperatively, and five are insulin-free or on insulin only during night-time parenteral alimentation. C-peptide increased 1·7 to 3·3 fold in response to intravenous glucose in these five patients who have had glycosylated haemoglobin in the high normal range. However, the kinetics of the C-peptide responses to intravenous glucose in all eight patients tested revealed an absent first-phase release and a delayed peak response consistent with transplantation and/or engraftment of a suboptimal islet cell mass. The longest survivor, who requires neither parenteral alimentation nor insulin, is the first unequivocal example of successful clinical islet-cell transplantation. © 1990

Human islet isolation and allotransplantation in 22 consecutive cases

This report provides our initial experience in islet isolation and intrahepatic allotransplantation in 21 patients. In group 1, 10 patients underwent combined liver-islet allotransplantation following upper-abdominal exenteration for cancer. In group 2, 4 patients received a combined liver-islet allograft for cirrhosis and diabetes. One patient had plasma C-peptide >3 pM and was therefore excluded from analysis. In group 3, 7 patients received 8 combined cadaveric kidney-islet grafts (one retransplant) for end-stage renal disease secondary to type 1 diabetes mellitus. The islets were separated by a modification of the automated method for human islet isolation and the preparations were infused into the portal vein. Immunosuppression was with FK506 (group 1) plus steroids (groups 2 and 3). Six patients in group 1 did not require insulin treatment for 5 to > 16 months. In groups 2 and 3 none of the patients became insulin-independent, although decreased insulin requirement and stabilization of diabetes were observed. Our results indicate that rejection is still a major factor limiting the clinical application of islet transplantation in patients with type 1 diabetes mellitus, although other factors such as steroid treatment may contribute to deteriorate islet engraftment and/or function. © 1992 by Williams and Wilkins

The impact of 3D Printing Technology on the Supply Chain: Manufacturing and Legal Perspectives

This is the final version. Available on open access from Elsevier via the DOI in this recordAn earlier version of this paper entitled “Impact of 3D Printing Technology on Supply Chain in China” was presented at the 24th International Conference on Production Research (ICPR 2017), Poznan, Poland, 30 July–3 August 2017. It is available in ORE at: http://hdl.handle.net/10871/311773D Printing (3DP) technology has been receiving increased public attention. Many companies are seeking ways to develop new means of creating and disseminating 3DP content, in order to capture new business opportunities. However, to date the true business opportunities of 3DP have not been completely uncovered. This research explores the challenges posed in the development and deployment of 3DP and focuses on China, which is still the main manufacturing hub of the world. The main purpose of this research is to uncover the obstacles that resist mass-scale applications of 3DP. By means of empirical semi-structured interviews with 3DP companies in China, it is found that many companies can see the benefits of 3DP, but its potential has not been delivered as promised. One reason is due to the fact that 3DP has not been integrated well in the supply chain. The other reason concerns potential intellectual property issues that cannot effectively prevent counterfeiting. To tackle the above issues, several areas have been identified that could be improved further. In particular, the legal complications concerning 3D-printed content could be overcome by a licensing platform.The work is sponsored by the Arts and Humanities Research Council, and the Newton Fund, for the project “A Technological Licensing Framework for 3D printed content: A Focus on China”

Experimental Investigation of the Hybrid FRP-UHPC-Steel Double-Skin Tubular Columns under Lateral Impact Loading

© 2020 American Society of Civil Engineers. The lateral impact behavior of hybrid fiber-reinforced polymer (FRP)-ultrahigh-performance concrete (UHPC)-steel double-skin tubular columns (DSTCs) was experimentally investigated in this study. Seven specimens, which had an outer diameter of 168 mm and a length of 2,000 mm, were tested under lateral impact loading. Different parameters, including the axial force level, impact energy, concrete type, void ratio, FRP tube thickness, and the presence/absence of the FRP tube, were investigated. The dynamic responses, including global/local damage modes, lateral deflection-time histories, impact force-time histories, strain-time histories, and acceleration-time histories, were investigated. The test results prove that the hybrid UHPC DSTCs exhibit very ductile behavior under lateral impact loading. The hybrid UHPC DSTCs have a higher lateral impact resistance capacity as compared to the hybrid DSTCs infilled with normal-strength concrete. The lateral impact resistance capacity of hybrid UHPC DSTCs with an applied axial force of 200 kN can be improved to some extent compared with those without any axial force. The impact energy, the void ratio, the FRP tube thickness, and the presence/absence of the FRP tube can significantly affect the lateral impact behavior of hybrid UHPC DSTCs. Furthermore, the lateral impact behaviors of hybrid DSTCs, concrete-filled double-skin steel tubes (CFDSTs), and concrete-filled steel tubes (CFSTs) were compared and discussed based on the experimental results in this study as well as in other literature studies

Islet cell allotransplantation in diabetic patients: Histologic findings in four adults simultaneously receiving kidney or liver transplants

Refined methods of islet cell purification have led to unprecedented success of islet cell allotransplantation via portal vein infusion in diabetic patients, resulting in marked reduction of exogenous insulin requirements and recently even insulin independence. The authors report the histologic findings of islet cell allografts in the liver of four patients who had undergone combined kidney-islet or liver-islet transplantation. Islet cell clusters were detected in subcapsular location at the edge of portal triads. The early post-transplant period was characterized by patchy mixed portal infiltrates. Only minimal inflammation but decreased islet cell granulation was observed in one patient 6 months after transplantation. As histologic detection of transplanted islet cells becomes available, additional parameters for evaluation of graft survival might be defined by morphologic assessment

Detection of intrahepatic human islets following combined liver-islet allotransplantation

This article describes the localization of intact insulin-containing intrahepatic islets after combined liver-islet allotransplantation. The patient was a 36-year-old woman who underwent upper abdominal exenteration for neuroendocrine carcinoma; 289,000 islets were transplanted via portal vein infusion immediately after complete revascularization of the liver. Immunosuppression was with low-dose FK-506. OKT3 and steroids were used to treat one rejection episode 2 weeks after transplantation, but the patient subsequently developed multiple infections and died 109 days after transplantation. At autopsy, the transplanted liver did not show any sign of rejection and well-preserved islets were present in portal triads sampled from the anterior inferior edge of the right lobe. Immunohistochemical labeling confirmed the presence of insulin-containing cells. This finding indicated that human islets can survive after intrahepatic allotransplantation, despite positive cross-match with no HLA antigen match, suggesting that upper abdominal exenteration and liver transplantation may constitute a protective factor for the survival of allogeneic human islets. © 1992 Raven Press, Ltd., New York

Outcome of human islet isolation and allotransplantation in 20 consecutive cases.

This report provides our initial experience on islet isolation and intrahepatic allotransplantation in 20 patients. In Group 1, 10 patients underwent combined liver-islet allotransplantation following upper-abdominal exenteration for cancer. One patient underwent pancreatic islet allograft after near total pancreatectomy for chronic pancreatitis. In Group 2, 3 Type I diabetic patients received a combined liver-islet allograft for cirrhosis and diabetes. In Group 3, 7 Type I diabetic patients received 8 combined cadaveric kidney-islet grafts (one retransplant) for end stage renal disease. The islets were separated by a modification of the automated method for human islet isolation and the preparations were infused into the portal vein. Immunosuppression was with FK-506 (Group 1) plus steroids (Groups 2 and 3). Six patients in Group 1 did not require insulin treatment for 5 to >16 mo. In Groups 2 and 3 none of the patients became insulin-independent, although ongoing C-peptide secretion, decreased insulin requirement and stabilization of diabetes were observed. Our results indicate that islet transplantation is most effective in pancreatectomy induced diabetes. However, rejection is still a major factor limiting the clinical application of islet transplantation in patients with Type I diabetes mellitus. Other factors such as steroid treatment may contribute to deteriorate islet engraftment and/or function