We developed a sensitive chemiluminescent sandwich-type enzyme immunoassay (CL-EIA) of alpha-fetoprotein (AFP) using beta-D-galactosidase (beta-gal) as a label and 5-bromo-4-chloro-3-indolyl-beta-D-galactopyranoside as a substrate. The CL-EIA for AFP was performed using two monoclonal antibodies, one antibody is labelled with beta-gal, the other is coated onto the inside surface of a polystyrene tube. The detection limit for AFP was 0.5 ng/mL, equivalent to 10 pg/assay tube. The coefficient of variation for within and between assay imprecision were 2.0%-4.9% (n = 10) and 4.4%-9.8% (n = 5), respectively. AFP values in serum determined by this method correlated well with those obtained by radioimmunoassay (n = 26, r = 0.99). This sensitive AFP assay can be performed within 4 h and can be used as a routine assay in clinical diagnosis.

Carcinoma, Hepatocellular↗

PubMedDate not supplied

The development of Luminomaster, a fully automated chemiluminescent enzyme immunoassay system.

We have developed a fully automated discrete chemiluminescent heterogeneous enzyme immunoassay system called Luminomaster. The characteristics of this analyser are: 120 test/h throughput, 14 test menu, wide dynamic range, automated sample dilution, automatic retest, communication with a host central processing unit (CPU) and connection with sample transfer system.

Computers↗

PubMedDate not supplied

Neurilemmoma of the diaphragm mimicking a liver tumor: case report.

A 47-year-old male with a solid, previously cystic tumor in the subphrenic part of the liver consulted for surgery. Laparotomy showed a well-circumscribed tumor originating from the diaphragm, which made a significant depression in the liver. Complete removal of the tumor was achieved. Pathologic examination led to a diagnosis of neurilemmoma originating from the diaphragm.

Diagnosis, Differential↗

PubMedDate not supplied

Endoscopic diagnosis of common bile duct varices by percutaneous trans-hepatic choledochoscopy: differential diagnosis from bile duct carcinoma.

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Aged↗

PubMedDate not supplied

Safety limit of small partial liver allografts for orthotopic transplantation.

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Adult↗

PubMedDate not supplied

Palatal ruga anomaly induced by all-trans-retinoic acid in the Crj:SD rat: possible warning sign of teratogenicity.

We have reported that the critical period for cleft palate formation by all-trans-retinoic acid (RA) is on gestation day 14 in rats, and classified abnormal patterns of palatal rugae into minor variations and anomalous patterns. In this study, we examined the dose-response relationship for cleft palate and an anomalous pattern of palatal rugae formation and discussed the toxicologic significance of the palatal ruga anomaly as an indicator of teratogenicity. The ED(50) values for cleft palate and anomalous pattern were calculated to be 43.6 and 4.95 mg/kg, respectively. The results clearly show that anomalous rugal patterns occur in the fetuses from litters receiving RA at a lower dose than cleft palate induction; the anomalous ruga pattern is thus more sensitive than cleft palate induction. The anomalies of palatal rugae could be taken as a warning sign or an indicator of teratogenicity of a drug.

Abnormalities, Drug-Induced↗

PubMedDate not supplied

Severe bleeding tendency in a patient with Bernard-Soulier syndrome associated with a homozygous single base pair deletion in the gene coding for the human platelet glycoprotein Ibalpha.

PURPOSE: The genetic basis of Bernard-Soulier syndrome (BSS) was studied to clarify a relationship between severe clinical manifestations and gene abnormality. PATIENT AND METHODS: A patient with BSS had a severe bleeding tendency that was sometimes life threatening. Flow cytometric analysis of the patient's and normal control platelets was performed to study which glycoprotein (GP) was impaired in glycoprotein Ib/V/IX complex. The genes encoding GPIbalpha from the patient's and control genomic DNA were amplified and directly sequenced. RESULTS: Flow cytometric analysis revealed a defect of GPIbalpha on the surface of the patient's platelets. A homozygous single base pair deletion was identified in seven repeats of adenine at positions 1932 to 1938 in the GPIbalpha gene. This mutation, which has been previously reported, results in a frameshift and predicts a premature stop codon leading to a truncated peptide that cannot fix on the platelet membrane. CONCLUSION: This patient's severe clinical phenotype would be explained by this mutation in the GPIbalpha gene.

Adolescent↗

PubMedDate not supplied

Intra-operative hyaluronic acid clearance predicts postoperative graft function in living related liver transplantation.

Although intra-operative hyaluronic acid (HA) clearance has been reported to be a predictive parameter for early graft function after the implantation of a cadaveric hepatic graft, it has yet to be evaluated as a parameter in assessing graft function in living related liver transplantation. The aim of this study was to evaluate whether intra-operative HA clearance can be a predictive parameter of early graft function in living related liver transplant patients. Eight consecutive patients, who underwent a living related liver transplantation, were entered into the study. The HA clearance 180 min after reperfusion of the graft was evaluated. Significantly higher serum HA levels were found in the patients with fulminant hepatitis than in the patients with non-fulminant hepatitis before operation (P < 0.01), just before reperfusion (P < 0.01), and 180 min after reperfusion (P < 0.05). The HA clearance correlated with the peak total bilirubin within 5 postoperative days (P < 0.05) and the lactic acid one day after operation (P < 0.01). The intra-operative HA clearance serves as a sensitive parameter for assessing the postoperative graft function after the implantation of the new liver. Based on our findings, measuring the HA clearance was thus found to be clinically useful in the assessment of graft function in living related liver transplantation.

Adult↗

PubMedDate not supplied

Living-related auxiliary partial orthotopic liver transplantation for primary sclerosing chonangitis--subsequent removal of the native liver.

In Japan, living-related auxiliary partial orthotopic liver transplantation (APOLT) is mainly indicated for small-for-size grafts. We present the case of a 24 year-old patient with primary sclerosing cholangitis (PSC) who underwent a living-related auxiliary partial orthotopic liver transplantation for a small-for-size graft, that was subsequently excised. During the transplantation procedure, the native liver was freed from the surrounding tissues, and was only connected to the body by the right hepatic artery and right hepatic vein. The auxiliary extended left lobe graft, corresponding to 22% of the estimated recipient liver volume, was orthotopically transplanted after extended left lobectomy of the recipient native liver. Post-transplant CT-volumetry showed rapid increase of the graft volume with atrophy of the native liver, and GSA scintigraphy showed dominant function of the graft. Although hyper-bilirubinemia was prolonged by the removal of the native liver on the 18th post-transplantation day, it gradually subsided after plasmapheresis was performed twice, and the patient was discharged on the 77th post-transplantation day. We conclude, based on this case, that subsequent removal of the native liver is necessary in APOLT for patients with potential hepatic malignancies. The optimal timing of the removal of the remnant native liver should be determined based on CT-volumetry, GSA scintigraphy, and the liver biopsy specimen of the graft.

Adult↗

PubMedDate not supplied

Doubly-armed short sutures are useful for microsurgical hepatic artery reconstruction in living-related liver transplantation.

Although microsurgical hepatic artery reconstruction has become the essential technique in pediatric and living-related liver transplantation, it remains a technical challenge. We describe here our microsurgical hepatic artery reconstruction technique in living-related liver transplantation using a doubly-armed short suture. From August 1998 to March 1999, 8 patients underwent living-related liver transplantation at the Kyushu University. For these 8 patients, microsurgical reconstruction with doubly-armed short sutures were undertaken. After preparing the operative field for microsurgery, operative microscopy with a continuous zoom magnification is introduced. Interrupted sutures using doubly-armed short sutures are performed in a biangular stay-sutured method with a double clip. None of the 8 patients developed hepatic artery thrombosis. We conclude that the use of doubly-armed sutures allows safe and reliable in microsurgical hepatic artery reconstruction in living related liver transplantation.

Adolescent↗

PubMedDate not supplied

Application of liver transplantation for familial amyloid polyneuropathy combined with Crohn's disease.

We describe the case of a 31-year-old Japanese man with familial amyloid polyneuropathy combined with Crohn's disease, who underwent living-related orthotopic liver transplantation. Although he had a 2-year history of alternating constipation/diarrhea, his bowel symptoms exacerbated severely during the period he was in our ward for pretransplant evaluation. Small bowel barium examination and gastroduodenal endoscopy showed typical features of Crohn's disease. He was diagnosed as having active Crohn's disease, and the scheduled living-related orthotopic liver transplantation was postponed. After controlling the active disease with conservative therapy for two months, he underwent living-related orthotopic liver transplantation using a graft of the left lobe from his father. Postoperative medication consisted of azathioprine, aminosalicylates, tacrolimus and steroids. His postoperative course was uneventful, and he was discharged from hospital on the 25th postoperative day. Pre- and postoperative transplant management of patients with Crohn's disease is also discussed, because it influences the clinical course of inflammatory bowel diseases.

Adult↗

PubMedDate not supplied

Biliary reconstruction in living donor liver transplantation with dye injection leakage test and without stent use.

Biliary complication remains a significant source of morbidity and mortality in living donor liver transplantation. From October 1996 to December 1999, 34 patients underwent 35 living donor liver transplantations at Kyushu University Hospital. In the initial twenty cases, anastomotic internal stents were placed. In the most recent fifteen cases, no internal stent was inserted and routine postreconstruction dye injection leakage tests were administered. In recipient biliary reconstruction, hepaticojejunostomy was performed using interrupted sutures without an anastomotic stent. After an intestinal clamp was applied at the anal side of the hepaticojejunostomy, leakage test was done using diluted indigocarmine solution injected into the jejunal loop lumen. Two (13%) of the fifteen recent patients suffered from biliary complications, whereas eight patients (40%) from the former twenty patients suffered from biliary complications. We conclude that the use of the stent was not useful, but the application of the dye injection leakage test was useful.

Adolescent↗

PubMedDate not supplied

Cytokinetic and cytotoxic responses of HeLa cells to the combination of hyperthermia and radiation.

Colony formation and cell cycle changes of HeLa cells were studied after the combination of hyperthermia and 60Co irradiation. Cells were heated by immersion in a water bath. The cell cycle progression was monitored using flow cytometry. The dose survival curve of asynchronous growing cells, with immediate postirradiation thermal treatment at 43 degrees C for 60 min, showed significant enhancement of radiosensitivity. When the sequence of heat and irradiation was varied, the greatest decrease in cell survival was obtained when irradiation was given immediately before or after thermal treatment. Flow cytometry analysis showed that irradiation of exponentially growing cells with 5 Gy induced a G2 block, and that heat treatment immediately after 5 Gy exposure caused a progression delay of the cells from G2 + M to G1 phase. Furthermore, the cellular DNA histogram at 48 hours after 5 Gy exposure, immediately before heating, had more cells in G2 + M phase as compared with cells exposed to 5 Gy alone or thermal treatment at 5 hours before or after 5 Gy exposure. These results suggest that hyperthermia immediately after irradiation inhibits some of the cells accumulated in G2 + M phase from traversing into G1 phase. This inhibition may be related to the synergistic cell-killing by hyperthermia and radiation.

Cell Cycle↗