The function of the homotransplanted canine pancreas

Abstract

if a complete gap exists after excising the aneurysm, as in Case 4. If, however, a portion of the normal aortic wall remains, then a 'patch' of plastic material can be sutured to the lips of the defect, as in Case 5. SUMMARY I. Five cases of traumatic rupture of the aorta are described; 3 being acute and 2 chronic traumatic aneurysms. One of the latter was successfully excised.2 . The lesion should be suspected in all cases of deceleration injury.3. The aetiology, diagnosis, and management are briefly discussed.Addendum.-Since submitting this paper we have seen I further case of traumatic rupture of the aorta almost identical with Case 3. A 21-year-old man was thrown forward when the car in which he was travelling as a passenger veered off the road and struck a tree. Shortly afterwards he complained of pain in his chest and developed numbness in his legs which rapidly became paraplegic. There were no other external signs of injury. A chest radiograph demonstrated a mediastinal haematoma and the left radial pulse was diminished. On this evidence traumatic rupture of the aorta was diagnosed. I n view of the cord signs urgent thoracotomy was performed, but fatal catastrophic rupture of the periaortic haematoma occurred just after the chest was opened. Although this was temporarilycontrolled, irreversible ventricular fibrillation ensued.Vol. 53, No. 4, APRILWe would like to thank Mr. W. J. Fulford, for permission to include Cases I and 2, and our colleagues of the Birmingham Accident Hospital who allowed us to see and treat Case 3.

Glucose and Insulin Metabolism after Pancreatic Transplantation

“…Pancreatic grafts may temporarily restore to normal the glucose metabolism of animals rendered diabetic experimentally (De Jode and Howard, 1962;Reemstma et al, 1964;Bergan et al, 1965;Largrader, 1967;Mitchell and Davidson, 1967) and patients suffering from maturity onset or juvenile diabetes Lillehei et al, 1970). Although the side effects of immunosuppression make the procedure unjustifiable in most cases it is likely that with improved methods of suppressing graft rejection pancreatic grafting may well become a useful therapeutic tool in the treatment of diabetes, particularly if improved control of carbohydrate metabolism can be shown to influence the chronic retinal, neurological, and vascular side effects of the disease.…”

Organverpflanzung beim Menschen

“…Die zahlenmäßige Anlage geweblicher Einzeleigenschaften, verteilt auf verschiedene Lokalisationen mehrerer Chromosomen (Genloci), ist beispielsweise bei der Maus annähernd bekannt, sie kann beim Menschen dagegen bisher nur auf Grund gewisser Beobachtungen und Analogien geschätzt werden. Brent (10) spricht von 5 bis 20 Genloci und von Sicherlich spielt auch die größere Diskrepanz verschiedener, noch nicht definierter Einzelkomponenten der antigenen Gewebsmuster beim Antigenvergleich nicht verwandter Gewebe eine größere Rolle als bei nahen Verwandten. Wenn man außerdem mitberücksichtigt, daß Differenzen schwacher Antigene für die immunologischen Spätreaktionen entscheidend sein können (31), so ist es nicht überraschend, daß die klinischen Ergebnisse der Leithennierentransplantation über einen längeren Zeitraum (1-4 Jahre) schlechter werden, während bei Ubertragung von Verwandtennieren die Uberlebenskurve nach einem Jahr für den gleichen Zeitraum einen fast asymptotischen Verlauf erreichen kann (33,34).…”

“…Für die Transplantation des Pankreas liegen zahlreiche experimentelle Beobachtungen vor (8,11,19,20,24,32,42,43,71,72,87). Kelly berichtete über die ersten zwei kombinierten Pankreas-Nieren-Transplantationen, der inzwischen eine dritte folgte (persönliche Mitteilung).…”

The Pancreas [Abridged]

“…1967). In each case the pancreas was obtained from the same cadaveric donor with the duodenal loop attached to act as a conduit for exocrine secretion in the manner established experimentally by De Jode & Howard (1962). The pancreaticoduodenal allograft was placed in the left iliac fossa of the recipient, vascular anastomosis being made to the external iliac vessels.…”