CT criteria of asymmetric fascial thickening and gas are valuable in assessing suspected necrotizing fasciitis. CT also can provide information on coexistent deep collections.

A low discrepancy rate was found between interpretations made by radiology residents and those made by staff neuroradiologists of posttraumatic cranial CT scans. There were no adverse clinical outcomes.

We've established a nonhuman primate islet allotransplant model to address questions such as whether transplanting islets into the gut's arterial system would more safely and as effectively support long-term islet allograft survival compared with the traditional portal vein approach. We reasoned that islets make up <2% of pancreatic cell mass but consume an estimated 20% of arterial blood flow, suggesting an advantage for the arterial site. Access to the arterial system is also easier and safer than the portal system. Pancreatectomized rhesus macaques were transplanted with allogeneic islets infused into either the portal vein (n ‫؍‬ 6) or the celiac artery (n ‫؍‬ 4). To prevent rejection, primates were given daclizumab, tacrolimus, and rapamycin. In five of six portal vein experiments, animals achieved normoglycemia without exogenous insulin. In contrast, none of the animals given intra-arterial islets showed even transient insulin independence (P ‫؍‬ 0.048). Two of the latter animals received a second islet transplant, this time to the portal system, and both achieved insulin independence. Thus, intraportal islet transplantation under conventional immunosuppression is feasible in primates and can result in long-term insulin independence when adequate immunosuppression is maintained. Arterial islet injection, however, does not appear to be a viable islet transplantation technique. Diabetes 51:2135-2140, 2002 T ype 1 diabetes results from the immune-mediated destruction of the insulin-producing pancreatic ␤-cells, located in cell clusters called the islets of Langerhans (1,2). The field of islet transplantation recently emerged as a promising way to restore patients with type 1 diabetes to insulin independence (3-5). Before islet transplantation can be developed as a clinically viable treatment for type 1 diabetes, however, important issues need be addressed. These include formulating guidelines to predict an appropriate islet dose, identifying reliable markers of islet quality, generating a renewable islet source, determining the best islet infusion site, promoting islet viability and growth, and improving ways to monitor and prevent rejection. We reasoned that many of these questions could best be addressed using a preclinical nonhuman primate model. Nonhuman primates are highly relevant because of their phylogenetic relationship to humans (6) and because many of the newer immunomodulatory agents (antibodies and receptor fusion proteins) are specific for human epitopes, many of which cross-react with the corresponding primate epitopes. (5,7,8).We sought to establish a nonhuman primate model to closely mimic a recently reported steroid-sparing regimen (5,9). Currently, isolated islets are transplanted in the clinical setting via a catheter percutaneously placed into the recipient's portal vein to the liver (5). We asked whether transplanting islets to an arterial bed (e.g., the celiac tree) versus the portal vein would more safely and as effectively support long-term islet allograft survival. We reasoned that b...

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