Clinical and experimental pancreatic islet transplantation to striated muscle: establishment of a vascular system similar to that in native islets.

Objective: Curing type 1 diabetes by transplanting pancreatic islets into the liver is associated with poor long-term outcome and graft failure at least partly due to inadequate graft revascularization. The aim of the current study was to evaluate striated muscle as a potential angiogenic site for islet transplantation.

Research Design And Methods: The current study presents a new experimental model that is found to be applicable to clinical islet transplantation.

Performance of a novel repositioning head frame for gamma knife perfexion and image-guided linac-based intracranial stereotactic radiotherapy.

Purpose: To evaluate the geometric positioning and immobilization performance of a vacuum bite-block repositioning head frame (RHF) system for Perfexion (PFX-SRT) and linac-based intracranial image-guided stereotactic radiotherapy (SRT).

Methods And Materials: Patients with intracranial tumors received linac-based image-guided SRT using the RHF for setup and immobilization. Three hundred thirty-three fractions of radiation were delivered in 12 patients.

Forkhead box F1 regulates tumor-promoting properties of cancer-associated fibroblasts in lung cancer.

Cancer-associated fibroblasts (CAF) attract increasing attention as potential cancer drug targets due to their ability to stimulate, for example, tumor growth, invasion, angiogenesis, and metastasis. However, the molecular mechanisms causing the tumor-promoting properties of CAFs remain poorly understood. Forkhead box F1 (FoxF1) is a mesenchymal target of hedgehog signaling, known to regulate mesenchymal-epithelial interactions during lung development.

Long-term cost-minimization analysis comparing laparoscopic with open (Lichtenstein) inguinal hernia repair.

Background: Laparoscopic surgery has emerged as a new treatment modality for inguinal hernia repair. The aim of the present study was to analyse its long-term costs in relation to those of open repair.

Methods: A randomized multicentre study comparing totally extraperitoneal laparoscopic repair (TEP) with open repair by the Lichtenstein procedure was performed on men with a primary inguinal hernia.

Nuclear Janus-activated kinase 2/nuclear factor 1-C2 suppresses tumorigenesis and epithelial-to-mesenchymal transition by repressing Forkhead box F1.

Progression to metastasis is the proximal cause of most cancer-related mortality. Yet much remains to be understood about what determines the spread of tumor cells. This paper describes a novel pathway in breast cancer that regulates epithelial-to-mesenchymal transition (EMT), motility, and invasiveness.

Elderly people with multi-morbidity and acute coronary syndrome: doctors' views on decision-making.

Background: In most Western countries the growing gap between available resources and greater potential for medical treatment has brought evidence-based guidelines into focus. However, problems exist in areas where the evidence base is weak, e.g.

Angiostatic factors normally restrict islet endothelial cell proliferation and migration: implications for islet transplantation.

New blood vessel formation in transplanted islets occurs within 7-14 days post-transplantation through both the expansion of donor islet endothelium and ingrowth of blood vessels from the implantation organ. However, several studies indicate that although the islets attract recipient blood vessels, the formed intra-islet vascular network is insufficient, which affects islet post-transplant function. This study aimed to develop an in vitro model to investigate the migration and proliferation properties of isolated liver and islet endothelium.

Effect of high perioperative oxygen fraction on surgical site infection and pulmonary complications after abdominal surgery: the PROXI randomized clinical trial.

Context: Use of 80% oxygen during surgery has been suggested to reduce the risk of surgical wound infections, but this effect has not been consistently identified. The effect of 80% oxygen on pulmonary complications has not been well defined.

Objective: To assess whether use of 80% oxygen reduces the frequency of surgical site infection without increasing the frequency of pulmonary complications in patients undergoing abdominal surgery.

Oxygenation of islets and its role in transplantation.

Purpose Of Review: To summarize recent studies on the oxygenation of pancreatic islets and its role in islet transplantation.

Recent Findings: Pancreatic islet cells are highly sensitive to hypoxic conditions. Hypoxia contributes to poor islet yield at isolation, as well as inflammatory events and cellular death during culture and early posttransplantation.

Individual responsibility for what? - a conceptual framework for exploring the suitability of private financing in a publicly funded health-care system.

Policymakers in publicly funded health-care systems are frequently required to make intricate decisions on which health-care services to include or exclude from the basic health-care package. Although it seems likely that the concept of individual responsibility is an essential feature of such decisions, it is rarely explicitly articulated or evaluated in health policy. This paper presents a tentative conceptual framework for exploring when health-care services contain characteristics that facilitate individual responsibility through private financing.

Vascular niche of pancreatic islets.

Pancreatic islets are highly vascularized micro-organs. Approximately 10% of an islet consists of blood vessels. The induction and maintenance of the islet vascular system depend on VEGF secreted from β-cells.

Endothelial cell signalling supports pancreatic beta cell function in the rat.

Aims/hypothesis: The proximity of endothelial cells and beta cells in islets by necessity means that they are exposed to each other's products. Whereas islet endothelial cells require signals from beta cells to function properly, endothelin-1, thrombospondin-1 and laminins, among others, have been identified as endothelial-derived molecules, although their full effects on beta cells have not been explored. We tested the hypothesis that islet endothelial-derived products affect beta cell function.

Perfluorohexyloctane improves long-term storage of rat pancreata for subsequent islet isolation.

Pancreas oxygenation by means of the hyperoxygen carrier perfluorodecalin (PFD) has been established to prevent ischemically induced damage from cold-stored pancreata. However, large-scale studies did not confirm the promising results that had been observed in smaller donor populations. This study assessed whether islet isolation from pancreata stored for prolonged periods can be improved by utilizing the new oxygen carrier perfluorohexyloctane (F6H8) characterized by lower gravity and higher lipophilicity than PFD.

Analysis of gene polymorphisms associated with K ion circulation in the inner ear of patients susceptible and resistant to noise-induced hearing loss.

Noise-induced hearing loss (NIHL) is one of the leading occupational health risks in industrialized countries. It results from an interaction between environmental and genetic factors, however the nature of the genetic factors contributing to NIHL has not yet been clarified. Here, we investigated whether genetic variations in 10 genes putatively involved in the potassium recycling pathway in the inner ear may influence susceptibility to noise.

Beneficial role of pancreatic microenvironment for angiogenesis in transplanted pancreatic islets.

Pancreatic islets implanted heterotopically (i.e., into the kidney, spleen, or liver) become poorly revascularized following transplantation.

Primary care patients' attitudes to priority setting in Sweden.

Objective: To analyse attitudes to priority setting among patients in Swedish primary healthcare.

Design: A questionnaire was given to patients comprising statements on attitudes towards prioritizing, on the role of politicians and healthcare staff in prioritizing, and on patient satisfaction with the outcome of their contact with primary healthcare (PHC).

Settings: Four healthcare centres in Sweden, chosen through purposive sampling.

Iodinated contrast media decrease renomedullary blood flow. A possible cause of contrast media-induced nephropathy.

The renal medulla has been implicated as a key target for contrast media-induced nephropathy (CIN). Although the effects of contrast media (CM) on whole kidney blood flow are well characterized, the effect of CM on renal medullary blood flow has been controversial. It has been reported that an extremely high dose of a high osmolar CM (iothalamate; 2900 mg I/kg bw) injected rapidly increased the renal outer medullary blood flow (OMBF).

Low revascularization of human islets when experimentally transplanted into the liver.

Previously, we have found that human islets experimentally transplanted beneath the kidney capsule have lower vascular density than native islets. This study aimed to investigate whether human islets experimentally transplanted into the liver are also poorly revascularized in the same manner as islets at the renal subcapsular site. Human islets were transplanted to nude mice.

Candidate gene association study for noise-induced hearing loss in two independent noise-exposed populations.

Millions of people are daily exposed to high levels of noise. Consequently, noise-induced hearing loss (NIHL) is one of the most important occupational health hazards worldwide. In this study, we performed an association study for NIHL based on a candidate gene approach.

Attitudes towards priority-setting and rationing in healthcare -- an exploratory survey of Swedish medical students.

Background: Healthcare priority-setting is inextricably linked to the challenge of providing publicly funded healthcare within a limited budget, which may result in difficult and potentially controversial rationing decisions. Despite priority-setting's increasing prominence in policy and academic discussion, it is still unclear what the level of understanding and acceptance of priority-setting is at different levels of health care.

Aims: The aim of this study is threefold.

Prolactin treatment improves engraftment and function of transplanted pancreatic islets.

Transplantation of pancreatic islets is clinically used to treat type 1 diabetes but requires multiple donors. Previous experimental studies demonstrated that transplanted islets have a low blood vessel density, which leads to a hypoxic microenvironment. The present study tested the hypothesis that experimental prolactin pretreatment, a substance that seems to stimulate angiogenesis in endogenous islets, would increase graft blood vessel density, thereby improving transplantation outcome.

Could benefits of epidural analgesia following oesophagectomy be measured by perceived perioperative patient workload?

Background: A controversy exists whether beneficial analgesic effects of epidural analgesia over intravenous analgesia influence the rate of post-operative complications and the length of hospital stay. There is some evidence that favours epidural analgesia following major surgery in high-risk patients. However, there is a controversy as to whether epidural analgesia reduces the intensive care resources following major surgery.

Perioperative oxygen fraction - effect on surgical site infection and pulmonary complications after abdominal surgery: a randomized clinical trial. Rationale and design of the PROXI-Trial.

Background: A high perioperative inspiratory oxygen fraction may reduce the risk of surgical site infections, as bacterial eradication by neutrophils depends on wound oxygen tension. Two trials have shown that a high perioperative inspiratory oxygen fraction (FiO(2) = 0.80) significantly reduced risk of surgical site infections after elective colorectal surgery, but a third trial was stopped early because the frequency of surgical site infections was more than doubled in the group receiving FiO(2) = 0.