Dopamine D2 receptor gene (DRD2) haplotypes in Caucasians.

The human dopamine D2 receptor gene (DRD2) is considered a candidate gene for neuro-psychiatric diseases. We typed three new DNA sequence variants in DRD2 intron 4, intron 6 and exon 8, in combination with the known TaqI A restriction fragment length polymorphism (RFLP) and exon 7 311Ser/Cys in 106 unrelated psychiatrically healthy Caucasians. Based on the genotypic data we delineated 10 distinct DRD2 haplotypes and their genetic relationship.

Recovery time and safe discharge of endoscopy patients after conscious sedation.

The aim of this study was to identify the best method for determining when to safely discharge the endoscopy patient; specifically, it was designed to determine whether the patient's risk factors, intraoperative occurrences, and/or medications used during endoscopy should be used to determine the minimum length of stay postconscious sedation or whether a general policy can be used, as is currently practiced at many institutions. Preoperative, intraoperative, and postoperative data were collected on a convenience sample of 405 adult ambulatory outpatients undergoing upper endoscopy and/or colonoscopy. Subjects were also interviewed by phone within 48 hours of discharge to assess postdischarge complications and their duration.

Kinetics of primary bile acids in patients after orthotopic liver transplantation.

Administration of cyclosporin A (CsA) may induce cholestasis, and this effect has been attributed to impaired hepatocellular uptake, transport, secretion and intestinal absorption of bile acids. Disturbances of the enterohepatic circulation may affect metabolism of bile acids. To test whether liver transplantation and treatment with CsA alters pool sizes or synthesis and turnover rates, we determined kinetics of primary bile acids in patients after orthotopic liver transplantation on CsA.

Aspergillus endocarditis, myocarditis and pericarditis complicating necrotizing fasciitis. Case report and subject review.

A patient with Aspergillus endocarditis, myocarditis and pericarditis is described. A 55-year-old man developed necrotizing fasciitis of the lower abdominal wall, pelvis and right thigh. Despite aggressive surgical débridement and antibiotic coverage, the patient died of multisystem organ failure.

[Liver transplantation and diagnostic radiology: socioeconomic aspects].

Purpose: For calculating cost-effectiveness in the context of diagnosis related groups (DRG) we analysed all radiological examinations for 56 consecutive liver transplantations during the primary stay in the surgical department (1052 chest x-rays, 296 ultrasonographies, 216 colour coded duplex sonographies, 72 cholangiographies, 35 CT, 23 angiographies, one MRI and one embolisation).

Methods: For calculation we used the reimbursement that the surgical wards received per patient day and the special fee for liver transplantation. We compared this with the refunds received by the department of radiology.

Improvement of hepatic microhemodynamics by N-acetylcysteine after warm ischemia.

In this study we investigated the influence of N-acetylcysteine (NAC) on the hepatic microcirculation after warm ischemia by intravital fluorescence microscopy. Clamping of the left liver lobe was performed in 20 male Wistar rats for 70 min. The treatment group (n = 10) received 400 mg NAC/kg body weight 20 min prior to clamping.

Impact of N-acetylcysteine on the hepatic microcirculation after orthotopic liver transplantation.

Recent observations showed an improvement of hepatic macro- and microhemodynamics as well as survival rates after warm ischemia of the liver following treatment with N-acetylcysteine (NAC). In this study we assessed the influence of NAC on the hepatic microcirculation after orthotopic liver transplantation (OLT) using intravital fluorescence microscopy. OLT with simultaneous arterialization was performed in 16 male Lewis rats following cold storage in University of Wisconsin solution for 24 hr.

A rapid and highly specific technique to detect hepatitis C RNA in frozen sections of liver.

Aims: To develop a polymerase chain reaction (PCR) based technique that would permit the rapid and highly specific detection of hepatitis C virus (HCV) RNA extracted from frozen liver tissue.

Methods: Samples of liver tissue from 18 patients undergoing orthotopic liver transplantation were studied. Nine patients were HCV positive.

Image reconstruction with acoustic measurement using distorted Born iteration method.

The distorted Born iterative method (DBIM) is applied to solve electromagnetics and ultrasonics inverse scattering problems. First, we use the DBIM to process the data, which are the scattered fields from two-dimensional cylinders with arbitrary cross section. From this simulation, we confirmed that the first-order Born approximation can be applied to larger objects as long as the phase change of a wave passing through the object due to its presence is smaller than a limit.

Complete reversal of FK 506 induced diabetes in a liver transplant recipient by change of immunosuppression to cyclosporine A.

We report the case of a 41-year old patient who underwent orthotopic liver transplantation because of decompensated liver cirrhosis due to chronic HCV-infection. Severe acute allograft rejection was insufficiently controlled by cyclosporine A, steroids and a 6-day regimen of OKT 3 monoclonal antibody therapy. As a consequence immunosuppressive therapy was switched to FK 506 in a dose of 3 mg bid.

Prolonged allograft survival by the inhibition of costimulatory CD2 signals but not by modulation of CD48 (CD2 ligand) in the rat.

The CD2 receptor is an important costimulatory molecule in T cell activation. Its ligand CD48 in rodents is supposed to be a homologue of human CD58, because of its similarities in structure and distribution. We evaluated the immunosuppressive activity of CD2/CD48-directed therapy in vitro and in vivo for the efficacy in prolonging rat heart allograft survival in a high responder transplant model.

Two-year data from the European multicentre tacrolimus (FK506) liver study.

To provide a more definitive assessment of the efficacy and safety of tacrolimus therapy in comparison with cyclosporin, the extended follow-up of the European multicentre study is reported. Two-year Kaplan-Meier estimates indicated significant reductions in acute (tacrolimus 45.4%, cyclosporin 55.

First clinical realization of continuous monitoring of liver microcirculation after transplantation by thermodiffusion.

To date, no method is available for the continuous long-term monitoring of liver microcirculation in patients. Experimentally, thermodiffusion has been validated in the quantification of hepatic perfusion. In an attempt to investigate the practicability of thermodiffusion technology in patients after liver transplantation thermodiffusion probes were inserted into the graft in seven patients during liver transplantation.

Validation of endothelin (ET) immunoreactivity in human bile by HPLC. Comparison of biliary ET concentration in liver transplant recipients with values obtained during cholecystectomy.

High endothelin (ET) concentrations were recently detected in human bile after orthotopic liver transplantation (OLT). In the present study we compared biliary ET/big-ET levels measured by radioimmunoassay (RIA) in liver graft recipients (n = 37) with levels measured in non-transplant patients during cholecystectomy (n = 38) to clarify the influence of transplantation on the levels of biliary ET peptides. HPLC elution profiles of biliary ET were analyzed for characterization of ET peptide composition and validation of RIA analysis in bile extracts.

Oxygenation of dog liver transplants as an early indicator of graft failure.

This study examines the potential value of liver oxygenation as a predictor of early graft function. pO2 measurements were performed on 10 pairs of beagle (donor) and foxhound (recipient) dogs during pentobarbital anesthesis. Two different explantation techniques were used: complete preparation and dissection before perfusion and explantation (group A) or rapid perfusion and explantation with detailed preparation of the liver and dissection of vessels ex situ after explantation (group B).

Allograft survival following immunization with membrane-bound or soluble peptide MHC class I donor antigens: factors relevant for the induction of rejection by indirect recognition.

T cells recognize foreign antigens in the form of peptide fragments resulting from antigen processing by antigen-presenting cells. In contrast to this indirect recognition, MHC molecules of foreign cells can be directly recognized by T cells. Direct recognition has for a long time been considered the only mechanism responsible for transplant rejection.

Remission of severe alcoholic polyneuropathy after liver transplantation.

Alcoholic polyneuropathy presents with variable severity. Only few very severely disabled patients showed good clinical and electrophysiological improvement after cessation of alcohol abuse. We report a 55 year old patient with polyneuropathy who underwent orthotopic liver transplantation for decompensated alcoholic cirrhosis.

Involvement of the CD95 (APO-1/Fas) receptor and ligand in liver damage.

Apoptosis occurs in the normal liver and in various forms of liver disease. The CD95 (APO-1/Fas) (CD95) receptor mediates apoptosis, and liver cells in animal models are acutely sensitive to apoptosis initiated by this receptor. We have used primary human hepatocytes as a model system to investigate CD95-mediated apoptotic liver damage.

[Resections of recurrence in the liver of primary and secondary liver cancers].

1) Only one third of primary hepatic carcinomas and in particular hepatocellular carcinomas are amenable to liver resection. Approximately half of these patients develop tumor recurrences within the first two years accounting for the poor prognosis of this condition. The liver is the site of first failure in about 80 percent of patients.