A comparison of sclerotherapy with staple transection of the esophagus for the emergency control of bleeding from esophageal varices.

We compared two procedures for the emergency treatment of bleeding esophageal varices in patients who did not respond to blood transfusion and vasoactive drugs. We randomly assigned 101 patients with cirrhosis of the liver and bleeding esophageal varices to undergo either emergency sclerotherapy (n = 50) or staple transection of the esophagus (n = 51). Four patients assigned to sclerotherapy and 12 assigned to staple transection did not actually undergo those procedures, but all analyses were made on an intention-to-treat basis.

New hope in irresectable hepatoma?

Primary hepatocellular carcinoma (HCC) is mostly irresectable and the survival time is short. Treatment can be palliative but hardly improves survival. Some promising future aspects that should be considered include continuous intra-hepatic chemotherapy (fraught with difficulties but nevertheless worth pursuing), direct percutaneous injection of alcohol into the tumor tissue under ultrasound guidance, as well as cryotherapy of "occult" tumors.

New haemocompatible polymers assessed by thrombelastography.

Mimicry of the nonthrombogenic surface of the erythrocyte has been advocated as the starting point for the development of nonthrombogenic biomaterials. Phosphorylcholine forms 88% of the outer surface of the erythrocyte, and so materials containing it should be nonthrombogenic. We have evaluated the thrombogenicity of such materials and compared them with Dacron and PTFE.

A new algorithm for deriving pulsatile blood flow waveforms tested using stimulated dynamic angiographic data.

In vascular pathology the assessment of disease severity and monitoring of treatment requires quantitative and reproducible measurements of arterial blood flow. We have developed a new technique for processing sequences of dynamic digital X-ray angiographic images. We have tested it using computer simulated angiographic data which includes the effect of pulsatile blood flow and X-ray quantum noise.

Material thrombelastography: an assessment of phosphorylcholine compounds as models for biomaterials.

The use of phosphorylcholine (PC) containing compounds as possible biomaterials has been evaluated by material thrombelastography (MTEG). The detailed analysis of the MTEG technique is discussed. A remarkable reduction of thrombogenicity by compounds containing the PC group is demonstrated.

Increased expression of major histocompatibility antigens in the liver as a result of cholestasis.

Increased expression of major histocompatibility complex (MHC) antigens may occur following liver transplantation. The mechanism by which this occurs is unclear. Postoperative complications may result in cholestasis.

Functional testing of hepatocytes following their recovery from cryopreservation.

Various tests of function have been suggested for assessing hepatocytes recovered from cryopreservation. In this study we have investigated hepatocyte attachment during tissue culture and cellular density in order to assess function and compared them with two classical dye exposure tests. The ability of hepatocytes to exclude trypan blue dye (TB) and metabolize fluorescein diacetate (FDA) was demonstrated.

Lipid peroxidation in hepatocyte cell cultures: modulation by free radical scavengers and iron.

Rat hepatocytes were isolated and then maintained in serum-free cell culture medium for 24 h. The amount of malondialdehyde (MDA) accumulated in the medium was assayed and used as a measure of lipid peroxidation. The activity of lactate dehydrogenase (LDH) and urea were measured in the medium and used as indicators of hepatocellular viability and function.

Effects of diethyldithiocarbamate and structural analogs in mice with systemic candidal infections.

Three different substituted dithiocarbamates: sodium diethyldithiocarbamate (DDTC), sodium dimethyldithiocarbamate (DmDTC), and sodium N-methyl-D-glucamine dithiocarbamate (NMG-DTC) were evaluated for their ability to combat the growth and development of three human pathogenic strains of Candida albicans, in vitro and in vivo, in mice. DDTC and DmDTC produced marked growth inhibition on agar plates, in vitro, of three different strains of Candida albicans, while NMG-DTC displayed little inhibitory effect. Low, nontoxic doses of each compound administered to immunosuppressed mice exhibited impressive therapeutic effects in treating candidiasis.

Conditioning and breeding facilities for the cynomolgus monkey (Macaca fascicularis) in the Philippines: a progress report on the SICONBREC project.

Large-scale breeding of Macaca fascicularis in the country of origin is a way in which the demands of the research community can be met whilst the feral population of monkeys is safeguarded. The establishment of the SICONBREC project and the success of its breeding programme to date is clear evidence of the future trend in the supply of non-human primates for biomedical research.

Biological differences among MCF-7 human breast cancer cell lines from different laboratories.

MCF-7 human breast cancer cells are used widely for studies of tumor biology and hormone mechanism of action. Conflicting results have often been obtained in studies reported from different laboratories. In this report several biological properties were studied in four MCF-7 cell lines obtained from different laboratories.

Free radicals in hypothermic rat heart preservation--prevention of damage by mannitol and desferrioxamine.

The free radical mediated oxidation of proteins in stored hypothermic rat hearts has been investigated by the estimation of fluorescence (Ex 360, Em 440-460 nm) believed to result from the oxidation of tryptophan residues. Damage occurring during ischaemia results in the release of oxidised proteins. This damage is significantly attenuated by mannitol and desferrioxamine although the mechanism of action of the two compounds may be different.

Transplantation. The liver.

Liver transplantation has been described as one of the most difficult of surgical operations. But in a few major centres throughout the world good results follow this procedure and patients otherwise condemned to an early and miserable death can enjoy a happy life once more.

Prostacyclin in the circulation of patients with vascular disorders undergoing surgery.

The object of this study was to investigate clinical conditions in which increased production of prostacyclin (PGI2) has been reported. 6-Oxo-prostaglandin F1 alpha (6-oxo-PGF1 alpha) is the stable hydrolysis product of PGI2 and was measured in plasma from patients undergoing hepatic or cardiac surgery and in unoperated patients with vascular and hepatic disease, using gas chromatography/mass spectrometry. Blood obtained simultaneously from portal and peripheral veins, during emergency surgery for bleeding oesophageal varices in six patients with cirrhosis of the liver, contained very high concentrations of 6-oxo-PGF1 alpha (range 99-11,485 pg/ml of plasma).

Getting a job: the interview.

The interview is a vital part of the process of selecting the best candidate for a hospital post from many suitable ones. Most doctors should be able to develop an interview technique that does justice to all their qualities.

In situ freezing of the pancreas and portal vein in the pig.

The pathophysiological results of a study of simultaneously freezing the pancreas and portal vein in the pig are presented. There was little reduction in portal venous flow despite the vein being frozen, and there were no cases of occlusion, rupture, or dilatation of the vein. Major histological changes in the vein wall were noted however.

Expression of beta-2-microglobulin on hepatocytes after liver transplantation.

The distribution of beta 2-microglobulin was studied by an immunoperoxidase method in paraffin sections from sixteen serial graft liver biopsy samples taken after liver transplantation from four patients who had received transplants for advanced primary biliary cirrhosis. Mild to moderate acute rejection was diagnosed in three of the patients. Expression of beta 2-microglobulin on hepatocyte membranes was greater during rejection, and tended to fall after the rejection episode.