Hemobilia: Review of Recent Experience with a Worldwide Problem

Between 1981 and 1985, the reported incidence of hemobilia increased for two major reasons. First, a more sophisticated and better-trained medical community could entertain the diagnosis readily in certain settings and had broader access to diagnostic methods that precisely defined the source of bleeding into the biliary tract. Second, there was wider use of percutaneous techniques of diagnosis and treatment of biliary diseases. Once the diagnosis of hemobilia was made by endoscopic or arteriographic means, physicians and surgeons were quicker to institute proper therapeutic measures. For this reason, the mortality associated with hemobilia decreased compared with that reported earlier. The medical community must be aware that modern treatments are now the most common cause of this problem. Since invasive diagnostic methods are increasingly used by nonsurgeons, it is imperative that these patients are studied in the context of complete consultation with surgeons who can use definitive treatments when required.     

Localization of basic FGF-like immunoreactivity in the hypothalamo-hypophyseal neuroendocrine axis

We examined the localization of basic fibroblast growth factor (basic FGF) in the adult rat brain by immunohistochemical and Western blotting analysis using a specific antibody against a synthetic basic FGF fragment (N-terminal 12 residues). The antibody did not cross-react with acidic FGF. Basic FGF-like immunoreactivity was located exclusively in the neuronal elements and had very heterogenous distribution. Immunoreactive cell bodies were observed in the paraventricular, supraoptic and circular nuclei of the hypothalamus. Numerous immunoreactive neuronal processes originating from these basic FGF-positive cells extended lateroventrally and then caudally to the internal layer of the median eminence. In addition, the neurohypophysis contained a significant number of basic FGF-like immunoreactive fibers. Western-blotting analysis revealed that the hypothalamus and the hypophysis contained a main band of basic FGF immunoreactive with an apparent molecular weight of 17 kDa. These results show that the hypothalamo-hypophyseal neuroendocrine pathway contains basic FGF.     

Orthotopic allotransplantation of the canine liver; a simplified technic with hypothermia

A simplified technique of the liver transplantation under hypothermia has been studied in dog. An immersion hypothermia was used in both the donor and the recipient. The temperature of the graft at excision was lowered to 20 degrees C with supplemental use of topical cooling. The temperature of the recipient was lowered at 27 degrees C when the transplantation was attempted. Chlorpromazine and dopamine were employed beneficially in hypothermia. No perfusion or irrigation of the graft was performed. The use of heparin was avoided. Anastomoses were carried out in turn of the proximal vena cava, portal vein, distal vena cava and the hepatic artery with a stem shaped aorta. Reperfusion was established after the completion of anastomosis between the proximal vena cava and portal vein. The anhepatic phase of the recipient was uneventfully lasted without heparinization. All dogs, 5 out of 11 without early surgical troubles survived more than 5 days. Immunosuppressive therapy was not employed except one which died of pneumonia on the 19th postoperative day. Histologically, these dogs were free from ischemic injury and/or thrombotic lesion throughout transplantation procedure.     

Multiple pancreatic metastases from clear cell renal carcinoma: Diagnosis with chemical shift magnetic resonance imaging before surgery

We present a case in which multiple pancreatic tumours were diagnosed as metastatic clear cell renal carcinomas with chemical shift MRI (CSI) before surgery. Radiologists may be unable to recognize the loss of intensity on CSI macroscopically. We believe that it is useful to make subtraction images and calculate signal intensity on CSI, even if the lesions are multiple metastatic tumours.     

Low-molecular-weight copolymers composed of L-lactic acid and various DL-hydroxy acids as biodegradable carriers

Biodegradable copolymers of L -lactic acid (L -LA) and DL -α-hydroxy acids with relatively low molecular weights, for example L -LA/DL -lactic acid (DL -LA), L -LA/DL -α-hydroxybutyric acid (DL -HBA), L -LA/DL -α-hydroxyisovaleric acid (DL -HIVA), and L -LA/DL -α-hydroxyisocaproic acid (DL -HICA), were synthesized by quantitative direct copolycondensation without catalysts at 200°C. The in vitro degradation, which was evaluated by measuring the weight loss of these copolymers in M/15 phosphate buffer solution (pH 7,2) without enzymes at 37°C, is strongly dependent on the kind and molecular weight of these copolymers, resulting in the formation of different degradation patterns such as parabola type (L -LA/DL -HBA system), linear type (L -LA/DL -LA system), and S type (L -LA/DL -HIVA and L -LA/DL -HICA systems).