The incidence of hepatolithiasis is high throughout East Asia compared with the West, but the marked difference in the relative proportion of hepatolithiasis to all cholelithiasis cases exists even among countries of similar ethnic backgrounds. A retrospective study of cases was conducted in two areas in China with the aim of clarifying the presence of such regional difference in China itself. The relative proportion of hepatolithiasis was 21.2% in Shenyang, 9.2% in Beijing and 4.1% in Fukuoka, Japan. A significant difference in the location of stones was also found between Shenyang, Beijing and Fukuoka. Intra- and extrahepatic hepatolithiasis in all hepatolithiasis cases was 95% in Shenyang and 75% in Beijing. Involvement of both hepatic lobes was found in 73% in Shenyang and less than 60% in the other two, suggesting that hepatolithiasis of the old form or of an advanced stage still lingers in Shenyang. In conclusion, regional differences in the proportion and the type of hepatolithiasis exist in China itself, as well as in the Chinese population in Taiwan, Hong Kong and Singapore, as previously reported. The possible contribution of environmental factors to the occurrence of hepatolithiasis is again emphasized.

Adult↗

PubMedDate not supplied

The effects of dichloroacetate on liver damage and circulating fuels in rats exposed to carbon tetrachloride.

It has been known that carbon tetrachloride-induced liver damage in starved rats is ameliorated simply by restoration of feeding. An analogue of dichloroacetate has been reported to ameliorate carbon tetrachloride-induced liver damage, and dichloroacetate has been shown to have a variety of effects on fuel metabolism. We investigated simultaneously the effects of dichloroacetate on liver damage and on circulating fuels in rats exposed to carbon tetrachloride. The effects of carbon tetrachloride varied with the rat's condition. In starved rats, the liver damage was more severe, and serum ketone body concentration decreased. In non-starved rats, the liver damage was not as severe and the serum ketone body concentration increased. The administration of dichloroacetate ameliorated liver damage both in starved and in non-starved rats given carbon tetrachloride: the administration of dichloroacetate protected from the liver damage particularly in starved rats. There were associated changes in the concentrations of circulating fuels. When the pyruvate-lowering effect of dichloroacetate was diminished in carbon tetrachloride-injected, starved rats, the alanine aminotransferase-lowering effect of dichloroacetate was also diminished. We propose that dichloroacetate's effect on fuel metabolism may produce a hepato-protective effect.

Alanine Transaminase↗

PubMedDate not supplied

Ultrastructure of well-differentiated adenocarcinoma of the gallbladder.

The ultrastructure of four well-differentiated adenocarcinomas of the gallbladder was investigated by scanning and transmission electron microscopy and compared with the ultrastructure of nonneoplastic mucosa in the same specimens and of the mucosa of gallbladders with gallstones. The tumor cells seen by scanning electron microscopy had severe disorganization of the regular arrangement of columnar cells. They were bizarre in shape and size and were covered with less developed pleomorphic microvilli that were irregularly distributed. No such findings appeared in the control specimens. The tumor cells seen by transmission electron microscopy exhibited pleomorphic microvilli, well-developed cytoplasmic organelles, various mucus granules, abundant lysosomes, and nuclear changes. These findings suggest increased secretory and metabolic activity in the tumor cells. Gobletlike cells, Paneth-like cells, and endocrine cells were scattered in two of the carcinomas. These cells were also noted in the nonneoplastic mucosa of the carcinoma specimens but were rare in the mucosa when cholelithiasis was present.

Adenocarcinoma↗

PubMedDate not supplied

Etiologic significance of anatomic variations in the main intrahepatic bile ducts in hepatolithiasis.

Abnormal union of intrahepatic bile ducts has been suggested as a possible etiologic factor in the occurrence of intrahepatic stones. A series of 241 patients were examined by direct cholangiography, and anatomic variations in the intrahepatic bile ducts were classified into four types: Type A-1, normal union having a true right hepatic duct; Type A-2, absence of a right hepatic duct, with a trifurcation; Type B, posterior segmental duct draining into left hepatic duct; Type C, anterior segmental duct draining into left hepatic duct. The most dominant type was Type A-1, which occurred in 58.3 to 66.0 per cent of the cases, followed by Type A-2 with 12.5 to 19.8 per cent. Type B showed the lowest incidence, occurring in 4.5 to 10.4 per cent. No statistical difference existed in the distribution of the type of union of intrahepatic bile ducts on the one hand and the presence or absence of intrahepatic stones on the other. Thus, anatomic variations in the main intrahepatic bile ducts do not seem to be associated with hepatolithiasis, and their etiologic significance seems to be unlikely.

Adult↗