Przeszczepienie wysp trzustkowych po transplantacji nerki — opis dwóch przypadków

Simultaneous pancreas and kidney transplantation is the best therapeutic option for patient with poorly controlled type 1 diabetes, end stage renal disease and with other secondary diabetic complications. However, when pancreas transplant is contraindicated or unavailable, pancreatic islet transplantation is alternative minimal-invasive procedure. It allows for improved and easier glucose control, prevent progression of secondary diabetic complications and improves quality of life. Here, we present two patients who receive an islet transplant some time after a kidney transplantation which led to improved glucose control, lower HbA1c, improved quality of life with stable and good kidney graft function.Jednoczasowe przeszczepienie nerki i trzustki jest najlepszą opcją terapeutyczną dla chorych z cukrzycą typu 1 o chwiejnym przebiegu, ze źle kontrolowaną glikemią prowadzącą do schyłkowej niewydolności nerek i innych wtórnych powikłań cukrzycy. Kiedy jednak przeszczep trzustki nie jest możliwy lub dostępny dla chorego, transplantacja wysp trzustkowych stanowi alternatywny, miniinwazyjny zabieg, który umożliwia lepszą i łatwiejszą kontrolę glikemii, zabezpiecza przed progresją wtórnych powikłań cukrzycy oraz poprawia jakość życia chorego. W artykule przedstawiono dwa przypadki chorych po transplantacji nerki, u których przeszczepiono wyspy trzustkowe, co doprowadziło do normalizacji poziomów glukozy w osoczu oraz wartości hemoglobiny glikowanej (HbA1c), przy zachowaniu stabilnej i dobrej funkcji nerki przeszczepionej i poprawie jakości życia pacjentów

Vascular architecture of the human uterine cervix, as assessed in light- and scanning electron microscopy

Objectives. The aim of this study was to visualize and describe the vasculature of the human uterine cervix.Materials and Methods. The material for this study was obtained from women (age between 20 to 45 years) during autopsy. The material was collected not later than 24 hours post-mortem. This study was performed using uteri from cadavers of menstruating nulliparas (33 uteri) and menstruating multiparas (27 uteri). Collected uteri were perfused via the afferent vessels with Mercox resin (for corrosion-casting and SEM assessment) or acrylic paint solution (light microscopy assessment). The research protocol was approved by the Jagiellonian University Ethics Committee (registry KBET/121/8/2007).Results. In all cases bilateral cervical branches (1-4), originating from the uterine artery, were found. Both in the vaginal and supravaginal parts of the cervix, four distinct vascular zones were found. In the pericanalar zone ran small veins, responsible for draining the mucosal capillaries. Both in the muscular layer, as well as in the pericanalar zone, arterioles and venules passed close to each other, often adjoining.Conclusions. This study does not confirm the existence of a single "cervicovaginal" artery, but shows that the vascular supply of the cervix comes from several vessels. It also introduces the idea of two systems, responsible for draining blood from the mucosal capillaries. Neither assessment in light microscopy nor in SEM has revealed any differences between multiparas and nulliparas, as to the vascular architecture of the cervix

Classification system of the tibiofibular syndesmosis blood supply and its clinical relevance

Due to the lack of anatomical studies concerning complexity of the tibiofibular syndesmosis blood supply, density of blood vessels with further organization of syndesmotic vascular variations is presented in clinically relevant classification system. The material for the study was obtained from cadaveric dissections. We dissected 50 human ankles observing different types of arterial blood supply. Our classification system is based on the vascular variations of the anterior aspect of tibiofibular syndesmosis and corresponds with vascular density. According to our study the mean vascular density of tibiofibular syndesmosis is relatively low (4.4%) and depends on the type of blood supply. The highest density was observed among ankles with complete vasculature and the lowest when lateral anterior malleolar artery was absent (5.8% vs. 3.5%, respectively). Awareness of various types of tibiofibular syndesmosis arterial blood supply is essential for orthopedic surgeons who operate in the ankle region and radiologists for the anatomic evaluation of this area. Knowledge about possible variations along with relatively low density of vessels may contribute to modification of treatment approach by the increase of the recommended time of syndesmotic screw stabilization in order to prevent healing complications