Hepatic resection for trauma, tumour and biliary obstruction.

Hepatic resection was performed in 37 patients. Fifteen emergency procedures were undertaken for blunt trauma and 16 patients had elective resection for hepatic tumour. A further 6 resections were performed for benign biliary tract obstruction.

Activated charcoal haemoperfusion via an extracorporeal circuit in the unrestrained and unanaesthetized rat.

Repeated haemoperfusion over activated charcoal was performed in unanaesthetized and unrestrained rats, using a specially designed system. This allowed the effects of haemoperfusion on body weight, organ weight and various biochemical and haematological parameters to be studied, without the possible influence of repeated stress and exposure to anaesthetic agents. The procedure was well tolerated, even after 4 consecutive haemoperfusions.

Renal function and other factors in obstructive jaundice.

Renal function and other factors that possibly affect the outcome of operation were measured in 24 patients with obstructive jaundice and in 15 non-jaundiced controls. The preoperative features that were associated with a poor postoperative recovery from obstructive jaundice were a raised serum fibrinogen/fibrin degradation product concentration, infection, hypoalbuminaemia and a low glomerular filtration rate. Preoperative serum fibrinogen/fibrin degradation product concentrations were raised in 4 of the 6 jaundiced patients who died after surgery but in none of the controls, in whom there was no mortality.

Serum enzymes in colorectal cancer.

A study of the value of serum enzymes in 184 patients with colorectal cancer has been performed. The enzymes studied were gamma glutamyltransferase (gammaGT), alkaline phosphatase (AP), lactate dehydrogenase (LDH), 5'-nucleotidase (5'-NT), glutathione reductase (GR), alanine and aspartate transaminases. In patients without liver metastases, elevated enzyme levels were found in 11-55% preoperatively.

The role of grey scale ultrasonography in the investigation of jaundice.

Sixty-seven patients were prospectively studied using grey scale ultrasound (GSU) to assess its possible role as part of a jaundice investigation programme. All scans were performed by one radiologist, without clinical information. When intrahepatic ductal dilatation was found an attempt was made to establish the level and cause of obstruction.

Rupture strength of skin wounds in jaundiced rats.

The rupture strength of 7-day-old wounds in normal rats, in rats in which there had been a previous skin incision, and in sham bile-duct-ligated and bile-duct-ligated jaundiced groups of rats was studied. It was found that wounds in jaundiced rats were significantly weaker than the wounds in the normal group of rats. Skin wounds in normal animals were significantly stronger than wounds in animals with sham bile-duct ligation.

A simple technique of measuring liver blood flow--intrasplenic injection of 133Xenon.

Intrasplenic injection of 133Xe was studied as an inert gas clearance technique for measuring liver blood flow in 13 dogs. This was done by comparing technique with intraportal injection of 133Xe (n = 41), and with electromagnetic flowmeter measurements of total liver blood flow. Very good correlation was obtained against the two latter techniques, the correlation coefficients being 0.

A critical comparison of the value of pregnancy-associated alpha2-glycoprotein and carcinoembryonic antigen assays in patients with colorectal cancer.

Absolute serum concentrations of pregnancy-associated alpha2-glycoprotein (alpha2-PAG) and carcinoembryonic antigen (CEA) were compared in 54 patients before and after surgery for colorectal cancer. Preoperatively, elevated levels of alpha2-PAG were found in 32 (59%) and of CEA in 35 (65%). Postoperatively, elevated alpha2-PAG levels were found in 10 of 18 patients (56%) without clinical evidence of recurrence whereas elevated CEA levels were present in three (16%).

Changes in the nuclei of astrocytes following portacaval shunting and portacaval transposition in the rat.

Structural abnormalities are found in the astrocytes of the dentate nuclei of animals after portacaval shunting (PCS). These changes are also found in man in association with portal-systemic encephalopathy. To investigate the relationship between portal-systemic shunting and hepatocellular dysfunction in the pathogenesis of these changes, PCS and protacaval transposition (PCT) were performed in rats.

The prognostic and therapeutic implications of the positive radionuclide bone scan in clinically early breast cancer.

Seventy-five women with clinical stage I or stage II carcinoma of the breast have had radionuclide bone scans at the time of presentation and at 6-monthly intervals during a mean follow-up period of 39 months. Patients with evidence of metastases on bone scan, either at the time of presentation or during follow-up, had significantly higher mortality and morbidity rates than those with persistently negative scans. Whatever the clinical stage, breast cancer patients with a positive bone scan have a very poor short term prognosis and local therapy to the breast is inadequate.

Duodenitis.

Many questions regarding duodenitis remain unanswered. However, the evidence suggests that duodenitis is a clinical entity which can give rise to dyspepsia and, on rare occasions, gastrointestinal haemorrhage. Conventional and double contrast radiology has only a small part to play in the diagnosis of duodenitis but is important in helping to exclude other lesions such as duodenal ulcer.

The value of pregnancy-associated alpha2-glycoprotein in patients with colorectal cancer.

Serum pregnancy-associated alpha2-glycoprotein (alpha2PAG) levels have been measured in 67 patients with colorectal cancer. Postoperative changes in alpha2PAG concentrations were observed in patients undergoing apparently curative surgery and compared with results in patients with residual local or metastatic tumour. Significant increase in alpha2PAG levels were found only in those patients with residual or disseminated tumour.

An isotope clearance method for measurement of liver blood flow during portasystemic shunt in man.

The clearance from the surface of the liver of krypton 85 following its injection into the portal vein was measured in 10 patients. Six control patients (i.e.

Prolyl hydroxylase and collagen biosynthesis in rat liver following varying degrees of partial hepatectomy.

Prolyl hydroxylase activity and collagen biosynthesis have been measured at intervals following 2 extents of hepatic resection in rats. Prolyl hydroxylase activity is validated as a measure of collagen biosynthesis. The levels rise to a peak at 72 h and thereafter decline.

Three-centre study on urinary hydroxyproline excretion in cancer of the breast.

A study instigated by the British Breast Group and involving 3 centres (Edinburgh, Glasgow and Liverpool) was carried out to compare 3 methods for the estimation of urinary hydroxyproline. No significant difference between the first and the second 24 h urine collection was found for each measure of urinary hydroxyproline, within laboratories and within patient groups. Reliable hydroxyproline studies can, therefore, be performed on one 24 h urine collection.