摘要:

Report on Open Forum on Liver Transplantation and Organ Donation.Donor selection, procurement and preservation, for liver transplantation Russell Strong, The University of Queensland Brisbane, AustraliaUse of expanded donors: older and non‐heart beating donors John J. Fung, M.D., Ph.D. University of Pittsburgh, Pittsburgh, PA 15213Liver transplantation for fulminant hepatic failure K.C. Tan, Consultant Surgeon/Director The Liver Centre SingaporeXenotransplantation John J. Fung, M.D., Ph.D. University of Pittsburgh, Pittsburgh PA 15213Use of FK506 in living related Liver transplantation in children Koichi Tanaka, Yukihiro Inomata, Shinji Uemoto, Nobuhiro Ozaki, Yoshio Yamaoka Second Department of Surgery Faculty of Medicine Kyoto University Kyoto, JapanLiver Transplantation for hepatitis John J. Fung, M.D., Ph.D. University of Pittsburgh, Pittsburgh PA USACT liver volumetry and ultrasonography ‐ application in liver donation. Masatoshi Makuuchi, University of Tokyo JapanExperience of Liver Transplantation at Taiwan Chao‐long Chen, Chang Gung Memorial Hospital Kaohsiung, TaiwanLiver Transplantation ‐ Experience in Hong Kong C.M. Lo, Department of Surgery The University of Hong Kong Queen Mary Hospital, Hong KongExperience of Liver transplantation at Matsumoto and Tokyo Masatoshi Makuuchi, University of Tokyo JapanLiver transplantation in Brisbane and its relationship with Asia Russell Strong, The University of Queensland Brisbane, AustraliaLiving related liver transplantation in children: A review of 140 recipients Koichi Tanaka, Yukihiro Inomata, Shinji Uemoto, Nobuhiro Ozaki, Yoshio Yamaoka Second Department of Surgery Faculty of Medicine Kyoto University Kyot

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01358.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01359.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractThe aim of this study was to investigate liver histology in mice after immunization with the conserved self molecule dihydrolipoamide dehydrogenase, E3, a subunit of the mitochondrial 2‐OADC enzyme family identified as the M2 autoantigen in the liver disease, primary biliary cirrhosis. Mice were immunized by a novel procedure. The autoantigen E3 was introduced by pinocytosis into hypertonically treated syngeneic lymphoid cells to facilitate intracellular antigen processing and presentation and the generation of a cytolytic T cell response. Liver sections were examined and scored for evidence of an inflammatory response by two independent procedures: standard microscopy with visual scoring, and automated scanning with computerized scoring. There was a close correlation between read‐outs of liver histology by standard microscopy and automated scanning, using the index of mononuclear cellular infiltrations in hepatic portal tracts. Such infiltrates were prominent in the immunized mice, but, unexpectedly, the degree of infiltration was similar in mice injected with autoantigen (E3)‐loaded syngeneic cells, or syngeneic cells treated only with hypertonic medium. The equivalent changes in the liver with the experimental and control protocol is indicative of the reactivity of the liver to any provocative immune stimulus, and is cautionary for protocols designed for the induction of autoimmune liver disease in experimental an

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01337.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractClinicopathologic examination of 33 nodules from 23 cases of minimum‐sized hepatocellular carcinoma (HCC), less than 15 mm in diameter, was carried out by imaging and clinical follow up. On ultrasound (US), 16 hypoechoic nodules (48%) and 15 hyperechoic nodules (45%) on angiography 7 tumour stains (21%) and on computerized tomography (CT) 3 low density nodules (9%) were detected. Of 27 nodules on lipiodol CT (LpCT), 7 lipiodol‐deposited nodules (26%) were detected. Of 16 nodules on CO2US angiography (US‐angiography), 7 hypervascular (44%), 5 hypovascular (31%) and 4 isovascular nodules (25%) were detected. Of 13 nodules on CT during arterial portography (CTAP), 7 perfusion defect nodules (54%) were detected. The nodules were graded according to the Edmondson&Steiner Classification. Three nodules were resected; grossly, two were not distinct and one was poorly demarcated. Histologically, they were highly differentiated with irregularly‐thin trabecular‐patterned HCC where portal triads were detected. Cancer cells invaded the non‐cancerous liver cells by replacement, and the border between the cancerous and non‐cancerous regions was unclear; the latter region manifested chronic hepatitis or liver cirrhosis without hyperplasia. Minimum‐sized HCC is characteristically hypovascular in arterial and portal supply of blood, of multicentric origin and of a well‐differentiated pattern. Because the three resected nodules did not damage the liver acinus structure, they were considered to be an e

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01338.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractNational surveys of alcoholic liver disease (ALD) in Japan were performed in 1978 and 1985 by a previous Japanese study group for ALD (the Takeuchi group). In the present study, a subsequent nationwide survey of ALD in Japan was conducted from 1986 to 1991 and the results compared with the previous studies. In order to clarify the aetiological relationship between hepatitis C virus (HCV) infection and ALD, results were also analysed according to new diagnostic criteria for ALD proposed by the current ALD study group (the Takada group).According to the diagnostic criteria of the Takeuchi group, the incidence of ALD did not differ significantly from 1986 to 1991. However, the incidence of hepatocellular carcinoma (HCC) in alcoholic cirrhosis (AL‐LC) clearly increased during this period. The analysis, which included analysis of results from the previous studies, indicated that the incidence of ALD reached a plateau in 1980 and then stablized. However, HCC in AL‐LC continued to show a linear increase from 1976 to 1991.The new diagnostic criteria of the Takada group were used to analyse cases from 1990 and 1991. Approximately two out of every three cases of ALD were caused by alcohol alone, and the remainder were caused by a combination of alcohol and HCV. Cases caused only by HCV were very rare. The main aetiology in patients with alcoholic hepatitis and fibrosis was alcohol alone, and in the case of chronic hepatitis, in heavy drinkers, it was a combination of alcohol and HCV. In half the patients with AL‐LC the aetiology was alcohol alone, and in the other half it was a combination of both alcohol and HCV. In the majority of patients with HCC, the aetiology was a combination of alcohol and HCV, indicating that HCV infection may be important in the development of HCC in alcoh

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01339.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractA retrospective study was conducted of two groups of patients over (group 1,n= 57) and under (group 2,n= 655) the age of 70 years who underwent laparoscopic cholecystectomy (LC). The pre‐operative physical status and systemic complications, operation time, postoperative complications, postoperative hospital stay and other clinical features of the two groups were compared. The incidence of pre‐operative complications in group 1 was significantly higher than that in group 2 (P<0.05). Postoperatively no severe complication was found in any patient. Group 1 showed significantly prolonged operation time and postoperative hospital stay compared with group 2 (P<0.05). The difference between the groups in the intra‐operative treatment time and postoperative treatment is attributed to the greater prevalence of common bile duct stone in group 1 as there was little difference between the groups in the postoperative recovery after exclusion of these patients. No pulmonary complications, which are associated with LC, were observed; the postprocedure pain was slight and the period of bedrest was short. If complications associated with pneumoperitoneum can be prevented, this surgery is an excellent measure to improve the quality of life of even elderly patients with cholecystolith

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01340.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractHepatocyte related cell lines, namely human embryonic hepatocyte cell line (WRL68) and hepatoblastoma cell line (Hep G2), were tested for their ability to support hepatitis C virus (HCV) replicationin vitro.The replicative intermediate of the minus strand HCV RNA was newly transcribed from the inoculated virus, and was stable in WRL68 cells over a period of 62 days. HCV RNA detected in the culture medium at 62 days after infection suggested a long period of virus secretion from this cell line. In Hep G2, transcription of the minus strand HCV RNA was also detected until 39 days after infection, but transcription and secretion of viral progeny could not be demonstrated. Although HCV infection of WRL68 was not high, this cell line might prove to be a useful tool for studying HCV replicationin vitro.

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01341.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractTo predict interferon‐alpha (IFN‐α)‐induced thyroid dysfunction, anti‐thyroglobulin (anti‐TgAb) and anti‐thyroid peroxidase antibodies (anti‐TPOAb) were determined by radio‐immunoassay (RIA) before IFN‐α treatment in 30 patients with chronic hepatitis C in whom the conventional haemagglutination test had failed to detect anti‐thyroid auto‐antibodies. Seven patients developed thyroid dysfunction during IFN‐α treatment (transient thyrotoxicosis in four patients, transient hypothyroidism in two, and Graves’ disease in one). Anti‐TgAb and/or anti‐TPOAb were detectable before IFN‐α treatment in six of these seven patients, while these antibodies were detected before treatment in only four of 23 patients who did not develop any thyroid dysfunction. The prevalence of these antibodies was significantly higher (P= 0.002) in the former group of patients than in the latter. In four patients with detectable anti‐TgAb before treatment but no subsequent thyroid dysfunction, the antibody disappeared during IFN‐α treatment. Haemagglutination tests for anti‐thyroid microsomal antibodies have previously been reported to be a useful predictive marker of IFN‐α‐induced thyroid dysfunction. In conclusion, sensitive detection of anti‐thyroid auto‐antibodies using RIA may also be useful for the prediction of IFN‐α‐induced thyroid dysfun

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01342.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractMultiple hepatic granulomas in chronic hepatitis C patients treated with alpha interferon were recently observed. To assess the presence of hepatic granulomas in chronic hepatitis C, and to determine whether their presence is related to interferon therapy or primarily related to chronic hepatitis C viral (HCV) infection, 446 liver biopsy specimens from 239 Japanese patients with chronic hepatitis C were reviewed. Well‐formed non‐caseating epithelioid granulomas were found in five (1.1%) of 446 liver biopsy specimens from five (2.0%) of 239 patients. All five patients had been followed up for 1 to 3 years, having between one and six liver biopsy specimens taken at intervals of 6 months to 1 year. Four of these five patients received alpha interferon therapy during the follow‐up period. Hepatic granulomas were found in one of the pretherapy liver biopsy specimens in four patients and in one of the post‐therapy specimens in one patient. Extensive investigation of the aetiology of hepatic granulomas yielded no conclusive findings. The presence of hepatic granulomas could not be demonstrated in follow‐up liver biopsy specimens taken from the four patients who had undergone alpha interferon therapy. These findings suggest that hepatic granulomas may appear as an expression of non‐specific reaction in HCV‐related chronic hepatitis, and are not related to alpha inter

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01343.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

AbstractSixteen medical institutions in Japan collaborated in this study of the epidemiology of hepatitis C virus (HCV) genotypes. A total of 4176 patients with type C chronic liver disease, from the four main islands of Japan, were evaluated. Of those evaluated, 2794 had chronic hepatitis, 727 had liver cirrhosis and 655 had hepatocellular carcinoma. The HCV genotype of the patients was determined by an enzyme‐linked immunosorbent assay based on serological genotype 1‐ and 2‐specific recombinant peptides (SG‐1 and SG‐2, respectively) of the NS4 region. The prevalence of SG‐1 and SG‐2 HCV was similar in the four main islands of Japan. SG‐1 HCV predominated in each disease category (69–76%). The percentage of patients with SG‐1 HCV increased by 7%, while that of patients with SG‐2 HCV decreased by 7%, as liver disease progressed in severity from chronic hepatitis to carcinoma(P<0.001). Patients with either SG‐1 or SG‐2 had a similar mean age and history of blood transfusion. In conclusion, SG‐1 HCV was found to predominate in Japan, and the HCV genotype was found to be related to the s

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1995.tb01344.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY