Search

The prevention of perinatal complications of congenital gastrointestinal (GI) diseases such as cystic fibrosis may require prenatal treatment. New Zealand White rabbits were evaluated as a potential animal model to study gastrointestinal anatomy and transit in the fetus. The lengths of the GI tract of fetuses at 21/31 and 28/31 days gestation were established, and gastric volume was measured. Gastric volume at 28 days gestation averaged 2.6 mL, adequate to permit instillation of a solution into the fetal stomach. A study was then carried out to establish gastric emptying and delivery of the solution into the small bowel. Using ultrasound guidance, the stomachs of 26 fetuses from 7 litters were punctured and 0.5 mL of dilute barium was injected. A cesarean section was performed 4 h later and the progression of barium though the GI tract was measured. In 18/26 (69.2%) of the fetuses barium was successfully delivered to the lumen of the stomach. In these 18 fetuses, barium progressed to the duodenum in 15 (58%), the jejunum in 13 (50%), and the ileum in 8 (31%). The stomach of the 3.5- to 4-week-old fetus is large enough to allow transuterine delivery of a solution of dilute barium. Gastric and intestinal motility in the 25-day-old rabbit fetus is coordinated and results in delivery of barium to the small bowel in 50% of animals successfully injected. The results suggest that the rabbit is an acceptable model for the study of gastrointestinal delivery of therapeutic drugs or genes to the fetus.

Correction of hepatic failure or metabolic disease by hepatocellular transplantation may require replacement of up to 10% of enzyme function with normal or genetically corrected cells. Although single injections of hepatocytes have not been able to consistently achieve this level of functional replacement in experimental models, multiple injections should theoretically be able to approach this goal. Delivery of multiple doses of hepatocytes to the spleen in experimental animals is complicated by the need to perform multiple laparotomies. By relocating the spleen to a subcutaneous position, the authors have designed an animal model to facilitate multiple splenic injections without the need for repeated celiotomies. Because it is in the prefascial plane, multiple hepatocyte injections can be delivered to the spleen percutaneously using only minimal sedation. Bleeding secondary to needle puncture is contained by a pseudocapsule which develops around the spleen. No statistical difference in the degree of hepatocyte migration to the liver has been demonstrated in animals transplanted via the subcutaneous spleen compared with animals transplanted by laparotomy (0.51% vs. 0.56%, p = .785).

Background Chronic granulomatous disease (CGD) of childhood is a rare congenital abnormality of the phagocyte NADPH oxidase system. Affected neutrophils and macrophages have an ineffective respiratory burst and cannot destroy certain phagocytized bacteria and fungi. CGD patients usually present with recurrent pyogenic and fungal infections. Catalase-positive bacteria are frequently involved, since they metabolize the hydrogen peroxide they produce, making it unavailable for augmentation of microbicidal activity in CGD neutrophils. Afflicted patients also have a tendency to form granulomas, which can lead to obstruction of the gastrointestinal and genitourinary tracts. Methods Charts of 10 patients with CGD were reviewed for age at diagnosis, surgical procedures, complications of these procedures, and medical treatment. Results Eight of the 10 children were male. The average age at first presentation was 18 months (range 2 days to 9.8 years). Each child developed a mean of 9.9 infections and an average of 1.4 infections per year. All required surgical procedures, with an average of 2.9 procedures each. Five children had operative procedures for infections that preceded the diagnosis of CGD. The procedures performed most frequently were incision and drainage of soft-tissue abscesses (7) or perirectal abscess (3), thoracentesis (3), and bronchoscopy (3). Three children had poor wound healing following surgery. Two developed partial gastric outlet obstruction which resolved with antibiotic therapy. One developed granulomatous cystitis with obstruction which responded to antibiotics. Conclusions Since patients with undiagnosed CGD may present with surgical problems, surgeons need to be familiar with this condition. The diagnosis should be suspected in children who have recurrent or unusual infections or unexplained problems with wound healing.

Research in hepatocellular gene therapy requires a consistently reproducible cell marker to detect transplanted hepatocytes. We have used a Y-specific genomic DNA probe to accomplish this goal. This technique enables the identification of transplanted male cells in recipient female tissues. Donor hepatocytes from male mice were transplanted into female mice via splenic injection. Recipient mouse livers were harvested 1, 24, and 48 hr after transplant. Transplanted (male) hepatocytes were detected in liver biopsy sections using in situ hybridization with the Y chromosome probe.

Nikyo is the second teaching of Aikido ( ni-two, kyo-teaching, in Japanese). It is a joint-lock technique that results in extreme pain. It allows one to control an opponent by destroying his will to continue fighting. Nikyo is accomplished by flexing and adducting an opponent's wrist producing an instantaneous sharp pain that causes him to fall to his knees involuntarily to alleviate the pressure. The exact etiology of the pain elicited by this technique has been obscure to many practitioners. The usual explanations have been nerve compression, joint capsular stretch, tendon/muscle strain, or partial ligamentous disruption. Studies of a cadaver's wrist have shown that Nikyo forcibly compresses the pisiform bone against the ulna, two bones that do not normally articulate. The intense pain thereby produced results from stimulation of the periosteal nerves in these bony surfaces.

BACKGROUND: Chronic granulomatous disease (CGD) of childhood is a rare congenital ahnormality of the phagocyte NADPH oxidase system. Affected neutrophils and macrophages have an ineffective respiratory burst and cannot destroy certain phagocytized bacteria and fungi. CGD patients usually present with recurrent pyogenic and fungal infections. Catalase-positive bacteria are frequently involved, since they metabolize the hydrogen peroxide they produce, making it unavailable for augmentation of microbicidal activity in CGD neutrophils. AI&ted patients also have a tendency to form granulomas, which can lead to obstruction of the gastrointestinal and genitourinary tracts. METHODS: Charts of 10 patients with CGD were reviewed for age at diagnosis, surgical procedures, complications of these procedures, and medical treatment. RESULTS: Eight of the 10 children were male. The average age at first presentation was 18 months (range 2 days to 9.8 years). Each child developed a mean of 9.9 infections and an average of 1.4 infections per year. All required surgical procedures, with an average of 2.9 procedures each. Five children had operative procedures for infections that preceded the diagnosis of CGD. The procedures performed most frequently were incision and drainage of soft-tissue abscesses (7) or perirectal abscess (3), thoracentesis (3), and bronchoscopy (3). Three children had poor wound healing following surgery. Two developed partial gastric outlet obstruction which resolved with antibiotic therapy. One developed granulomatous cystitis with obstruction which responded to antibiotics. CONCLUSIONS: Since patients with undiagnosed CGD may present with surgical problems, surgeons need to be familiar with this condition. The diagnosis should be suspected in children who have recurrent or unusual infections or unexplained problems with wound healing.