There has been an increasing trend in free tissue transplantat ion procedures on children in recent years, with strict blood flow monitoring need ed postoperatively. In this study, we performed blood flow monitoring by means of a met hod for measuring blood glucose level, and compared this to a method utilizing th e INVOS 5100C, and a method utilizing laser Doppler blood flow imaging device. In flap s in which venous thrombosis occur, various alterations in metabolism occur as well as an alteration in glucose metabolism. By using a combination of monitoring method s, it is possible to lower the number of postoperative complications of venous thrombosis in children to nearly zero.

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Currently, the composite tissue allotransplantation (CTA) is used clinically. However, side effects due to the immunosuppressant agents not for critical grafting become a major issue. Immunological tolerance introduced by the bone marrow transplantation (BMT) is an innovative therapy enabling long survival of a graft without immunosuppressant agents. We developed a new CTA model in order to apply the immunological tolerance introduction to the CTA. We prepared a rat lower limb transplantation model, a toe transplantation model, a forearm transplantation model, and mouse thigh chimera CTA model using supermicrosurgical technique. Additionally, we prepared a swine mandible CTA model in order to apply the technology to humans showing it is useful and with a wide clinical application. The CTA models developed by us do not include bones containing a lot of marrow (i.e., femur, humerus). They are superior CTA models that can evaluate the effect of immune tolerance by BMT.

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Women who undergo hysterectomy due to uterine malignancy, benign disease or postpartum hemorrhage and those with congenital uterine infertility due to a uterine or vaginal defect (Rokitansky syndrome) cannot have a child in Japan because surrogate conception is not permitted. This may be a serious impediment to their marriage, relationship and quality of life. To restore fertility, uterine implantation has been proposed as assisted reproductive technology (ART), as a successor to surrogate conception without the associated ethical problems, and fundamental studies are ongoing. The attitudes toward surrogacy and uterine implantation were investigated by analysis of comments of maternity nurse students, who are likely to play a leading role in maternal management. The results showed that many students answered "I cannot say yes or no" to the question "Would you want to have a child by a surrogate mother or uterine implantation?". Only 1 (7.7%) and 5 (38.5%) of 13 student nurses answered positively to wanting a child by a surrogate mother and by uterine implantation, respectively. In this article, we evaluate the responses of the Japanese maternal nurse students and discuss the current status and restrictions on surrogacy in Japan.

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