Allogeneic Whole Pancreas Transplantation in Insulin-Dependent Diabetes Mellitus

A clinical whole organ pancreas transplantation program for patients with insulin-dependent diabetes mellitus complicated by end-stage renal disease was initiated at Henry Ford Hospital in 1987. Five patients have received pancreatic allografts after a previous kidney transplant (phase 1), and six patients had simultaneous pancreas-kidney transplants (phase 2). Ten patients had functioning pancreatic grafts after surgery, and all of them had normal carbohydrate tolerance with appropriate plasma free insulin responses to an oral glucose tolerance test three months after transplantation. As long as 28 months postsurgery six patients remained free of insulin requirements; however, one patient rejected the pancreatic allograft, and three patients died because of cytomegalovirus pneumonia. Two of the latter patients had functioning pancreatic allografts at the time of their demise. These results compare favorably with those of the International Pancreas Transplant Registry which reflects the world experience. Pancreas transplantation is a unique experimental treatment with the potential of restoring euglycemia and improving the prognosis of insulin-dependent diabetic patients

Effect of Acute Posttransplant Renal Failure on the Survival of Perfused Cadaver Kidneys

Between 7973 and 7977 we encountered 22 cases of acute renal failure after transplantation in 70 patients who received perfused cadaver kidneys. Nearly two-thirds of 76 nonfunctioning grafts were lost due to subsequent superimposed rejection, often undetected and, hence, untreated. Thirty-one percent of the 76 recovered function. The recovery rate, we believe, can be improved by earlier diagnosis and treatment of rejection and by avoiding invasive diagnostic procedures in the early postoperative period. If the oliguric period extends beyond two weeks, a closed percutaneous renal biopsy is justified. The diagnosis of rejection and/or other abnormality as well as subsequent treatment are very important in these patients

The behaviour of repeat visitors to museums: Review and empirical findings

This study presents a theoretical and operational framework for analysing repeat visit to museums. Starting from the literature on repeat visit in tourism, the specificities of these cultural attractions are made explicit through a review of theoretical and applied works. Consistently with previous contributors, the paper suggests that the analysis of actual past behaviours has to be preferred to the one of attitudes. The application of proper econometric models is also remarked in order to put into account individual profiles. Information coming from three techniques is then used in an integrated way in order to provide a more comprehensive view of the phenomenon. Evidence from an ad hoc survey suggests the necessity to give a greater attention to perceived cultural value during the visit, promoting cultural events during the week and addressed to children, and taking care of those visitors that come from far places also through an integrated tourist supply. © 2013 Springer Science+Business Media Dordrecht

Soft tissue evaluation of an immediate esthetic zone single implant with a stereolithographic guide using 3D reconstruction and a CAD/CAM customized titanium anatomic abutment

Abstract The replacement of an unrestorable tooth with a single implant-supported prosthesis is a treatment with predictable and successful outcomes. The anterior maxilla region is a complicated site for such treatment, due to its esthetic, functional, and physiological sensitivity. The purpose of this study was to evaluate the changes in the soft tissue following an immediate implant procedure using guided surgery in combination with a computer-aided design and computer-aided manufacturing (CAD/CAM) customized titanium anatomic abutment in the esthetic zone. A total of 13 patients who had been treated with an immediate post-extraction implant placement and an immediate provisional restoration were included in the study. The changes in the soft tissue dimension, interdental papilla, and esthetic score were evaluated with a follow-up of at least one year. There was no significant change in the midfacial mucosal status when compared to the pre-treatment situation. The recession of the mesial papillary height was 0.32 mm and the distal papillary height was 0.10 mm. The mean horizontal change in the labial mucosa was 0.32 ± 0.83 mm. There was no significant difference between the mesial papilla index and the distal papilla index. The pink esthetic score value prior to treatment was 11.16, and at one-year follow-up, 10.25. Within the limitations of this study, the immediate post-extraction implant placement procedure with a stereolithographic guide and a provisionalization with a CAD/CAM customized titanium anatomic abutment may be a treatment option with predictable outcomes for the replacement of teeth in the esthetic zone