Search PubMed⌕ Search

Biomedical subjects

W J Hodgson

Publications and source records attributed to W J Hodgson.

At least 19 recordsLinked to original sources
PubMed1998

Fatty acid omega and (omega-1)-oxidation within intrasplenically transplanted fetal hepatocytes.

BACKGROUND: The expression and enzymatic activity of the cytochrome P450 LAomega within intrasplenically transplanted hepatocytes was investigated. METHODS: Fetal hepatocytes were harvested from spontaneously hypertensive rats and transplanted into recipient adult spontaneously hypertensive rat spleens. RESULTS: Microscopic examination revealed masses of hepatocytes in the red pulp. Immunochemical studies detected cytochrome P450 LAomega in transplanted hepatocytes by 6 and 10 weeks after transplantation. Cytochrome P450 LAomega mRNA accumulates at 6 weeks after transplantation. Cytochrome P450-arachidonic acid omega/omega-1 hydroxylase activity (formation of 20/19-hydroxyeicosatetraenoic acid) was detected at 10 weeks after transplantation. CONCLUSION: These results demonstrated that fetal hepatocytes grow in the spleen and function similarly to adult hepatocytes.

Animals↗
PubMed1998

Laparoscopic management of cystic disease of the liver.

BACKGROUND: Laparoscopic management of cystic disease of the liver, including severe polycystic disease, is evolving. METHODS: Wide unroofing, or "fenestration," as is required for a successful result in open cases, leads to complete resolution of the cysts. This can even occur in chronic cysts, with wide-enough unroofing, given time. RESULTS: In polycystic disease, adequate fenestration of superficial, cysts allows deeper cysts to prolapse and be similarly fenestrated, thus reducing pressure effects on the liver and restoring normal function. CONCLUSION: However, because of the distortion of anatomy by this disease, it is important that an experienced liver surgeon perform such a complex procedure, as operative complications could be severe.

Adult↗
PubMed1996

Laparoscopic cholecystostomy for acute acalculous cholecystitis.

Acute acalculous cholecystitis (AAC) can occur in up to 18% of severely injured patients. Diagnosis is made by positive ultrasound findings of gallbladder sludge, hydrox, and wall thickening. There may also be recent-onset jaundice, positive ultrasound induced Murphy's sign, and unexplained sepsis. Mortality can be as high as 50%. Laparoscopic confirmation was obtained in six ICU trauma patients when omentum was drawn up over a distended gallbladder. Laparoscopic cholecystectomy (LC) was done by first directly decompressing the gallbladder through the fundus. This trocar was replaced by a 16 French Foley catheter passed through an Endoloop into the gallbladder and secured by tightening the loop around a cuff of gallbladder. Sepsis resolved in all cases. Only one required subsequent laparoscopic cholecystectomy. LC has a low morbidity and may be life saving during the early stages of AAC. It is not indicated in gangrene or perforation of the gallbladder.

Acute Disease↗
PubMed1995

Ambulatory hemorrhoidectomy with CO2 laser.

PURPOSE: This study was undertaken to evaluate ambulatory hemorrhoidectomy using the CO2 laser. METHODS: Ninety consecutive patients (50 males, 40 females), 80 percent of whom had second or third degree hemorrhoids, had ambulatory hemorrhoidectomy performed with a CO2 laser in the left lateral Sims position under local anesthesia and intravenous sedation. Dissection was entirely performed with the CO2 laser using an open technique. RESULTS: One patient with polycythemia vera was admitted subsequently for secondary hemorrhage. All but three patients had healed within four weeks. No long-term sequelae were encountered. CONCLUSION: These results compare favorably with those obtained by others and show that ambulatory laser hemorrhoidectomy may simplify management in selected patients.

Adolescent↗
PubMed1994

Laparoscopic cholecystectomy. The early experience of surgical attendings compared with that of residents trained by apprenticeship.

During our first year of laparoscopic surgery, all cases were performed by attending surgeons; resident involvement was confined to camera work and occasionally to acting as first assistant. These residents were PGY3 or -4. During our second year, these same residents, who had learned the craft in the traditional apprenticeship method, on promotion to senior resident functioned as the primary surgeon in laparoscopic cholecystectomy cases, but under very close guidance by the credentialed attending. Ninety-two cases were attempted in the first year and 100 in the second. There were no differences in age, gender, or preoperative symptoms. More than half the patients had at least one co-morbidity in addition to their gallbladder disease. More women had laparoscopic cholecystectomy soon after pregnancy in the second year, but the percent of the patients with previous surgery declined from 21.4% to 5%. There was a threefold increase in the percent of cases performed in less than two hours and there was a significant reduction in hospital length of stay in the second year. Complication rates were similar in the first and second years. Training residents to do laparoscopic cholecystectomy can be done in a traditional residency program provided the attendings are adequately trained. However, the residents need a higher level of skill at this time than was necessary for open cholecystectomy and have to be further advanced in their training in order to perform this operation laparoscopically.

Adult↗
PubMed1994

The immunostimulant OK-432 enhances liver regeneration after 90% hepatectomy in rats.

The effect of reticuloendothelial system activation on liver regeneration after 90% hepatectomy was investigated. OK-432, a killed streptococcal preparation that increases reticuloendothelial system activity, was administered to rats before 90% partial hepatectomy. Pretreated rats showed marked improvement in long-term survival: 87% (18 of 23) survived beyond 42 hr, compared with only 44.2% (24 of 52) of controls (p < 0.05). Survival was determined by means of life-table analysis and regeneration response by means of bromodeoxyuridine labeling index of hepatic DNA. OK-432 pretreatment had significantly increased bromodeoxyuridine labeling index 18, 24, and 42 hr after partial hepatectomy (p < 0.05). The results indicate that reticuloendothelial system activation by OK-432 before 90% partial hepatectomy enhances liver regeneration and improves survival, but these factors may not be related. The improved survival may be because of less infection in macrophage-stimulated animals or more rapid clearance of hypotension-causing vasoactive compounds.

Adjuvants, Immunologic↗
PubMed1993

Laparoscopic cholecystectomy in a tertiary referral center.

Analysis of the first year's experience of 94 patients in a tertiary referral center showed that 21% had had previous surgery. Fifty-seven percent had medical problems: 17.8% hypertension, 16% cardiac problems, 8.9% diabetes mellitus, and 6.2% chronic renal insufficiency. Four patients had hypercarbia and were acidotic. The conversion rate to open cholecystectomy was 8.7%. Only one patient required reoperation for a bile leak. Fifty-five percent of our procedures took < or = 2 h, but 45% took > or = 3 h. Just over 50% of our patients stayed 48 h postoperatively. In this complex group of patients, it appears possible to achieve results similar to those previously published, but more time was required for surgery, and length of stay was increased.

Adult↗
PubMed1992

Hepatic resections for primary and metastatic tumors using the ultrasonic surgical dissector.

We have previously described the development of new hepatic surgical techniques using the ultrasonic surgical dissector. With 10 years' experience, we have found that major liver resections have been simplified and that the technique is repeatable in hands other than our own. Thirty-three patients had 37 tumors, averaging 5.65 cm in size, resected with an average blood loss of only 1,020 mL per case, which included 5 right trisegmentectomies, 12 lobectomies, 15 segmental resections, and 4 subsegmental resections. Twenty-two patients had metastatic colorectal cancer. Blood transfusion requirements averaged only 2.24 units in long-term survivors, which was significantly less than the 3.5 units received by patients who have since died (p = 0.092). There were no operative deaths. The median survival of these 22 patients was 56 months, and the 5-year actuarial survival rate was 35%. All of the early deaths occurred in patients with more than four tumors, and no patient with less than four tumors died before 42 months with recurrent disease. Six patients had bilateral tumors, and the fact that patients survived into the fourth and fifth post-resectional year indicates that resection was worthwhile. All these patients had Dukes' C primary tumors, but we found no statistical difference in survival between patients with Dukes' B and Dukes' C lesions. The results indicate that hepatic resection with the ultrasonic surgical dissector decreases blood loss, requires few transfusions, is safe to perform, and is associated with excellent long-term survival.

Adolescent↗
PubMed1992

An unusual recurrence to the neck after complete resection of hepatocellular carcinoma.

A case of hepatocellular carcinoma is presented. Work up at the time of resection revealed no evidence of metastasis. Two months later the patient developed an unresectable mass in his neck which invaded the second cervical vertebral body. This unusual metastasis is an indication that as one site of tumor is increasingly successfully cleared, we are likely to find more examples of tumor spread not seen previously.

Carcinoma, Hepatocellular↗
PubMed1988

Expression of heme oxygenase in hemopoiesis.

Heme oxygenase has been purified to electrophoretic homogeneity from detergent solubilized adult human liver microsomes. Treatment of microsomes with Triton X-100, sodium cholate and subsequent batchwise DEAE-cellulose, 2', 5' ADP-sepharose 4B, Sepharose CLB and hydroxylapatite column resulted in 17% yield of the purified heme oxygenase. The reconsituted system of heme oxygenase, composed of heme oxygenase, NADPH cytochrome c (P450) reductase and biliverdin reductase was equiactive with 1 mM NADPH and 4 nM NADH and showed complete dependence on added heme for catalytic activity. The Km values for NADPH and NADH were .046 and .526 mM, respectively. While NADPH concentration was held constant, the Km value for heme was 1.01 microM with a specific activity of 583 unit/mg protein. The activity of the reconstituted heme oxygenase system was not affected by preincubation with heavy metals despite their inhibitory effect of NADPH cytochrome c (P450) reductase and biliverdin reductase. However, the metalloporphyrins of these heavy metals were found to be strong inhibitors of the reconsituted system with Ki values of 0.015, 0.6, 2.3 and 5 microM for Sn-, Co-, Zn- and Mg- protoporphyrins, respectively. Similarly, the sulfhydryl inactivating reagents, HgCl2, iodoacetamide and p-chloromercurylbenzoate, inhibited the reconstituted heme oxygenase activity. Rabbits were immunized with purified human liver heme oxygenase and the resulting antibody preparation was used to examine the species specificity of the enzyme. Microsomal protein with a molecular weight of 32,000 from rat and human liver as well as HepG2 cells were identified on dot and Western blots by their reaction with the anti-heme oxygenase similar to the purified enzyme protein. Anti-heme oxygenase precipitated quantitatively, the entire heme oxygenase of rat liver microsomes obtained from animals maintained on standard diet. The human bone marrow microsomal heme oxygenase activity was also quantitatively precipitated by this antibody. Antibody inhibition of rat and human heme xoygenase demonstrated a degree of conservation of both enzyme proteins between the species. As judged by Western blotting, the anti-heme oxygenase recognized only a single protein in spleen, liver, kidney, brain, heart, bone marrow, integtine and corneal epithelium. The human heme oxygenase cDNA was isolated by screening a cDNA library in the Okayama-Berg vector with a rat liver cDNA and was subjected to nucleotide sequence analysis. The deducted human heme oxygenase is also composed of 288 amino acids with a molecular mass of 32,800 Da.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1988

Minimally invasive devascularization for variceal bleeding that could not be controlled with sclerotherapy.

The appropriate therapy for continued bleeding despite sclerotherapy remains controversial. This study evaluates a devascularization procedure performed without the risks of major surgery and general anesthesia. Fifty consecutive patients, each with an endoscopically proven variceal hemorrhage that was uncontrollable with sclerotherapy, were treated with minimally invasive devascularization. The procedure was performed in three stages. First, the portal pressure was sharply reduced by angiographic embolization of the midsplenic artery. Then the esophagogastric variceal network was thrombosed by means of a catheter introduced during laparotomy, which created a portoazygos disconnection. Finally, the left gastric and left gastroepiploic arteries were embolized, which completed devascularization of the proximal stomach. According to the Child classification, 16 patients were in class B and 34 were in class C. All Child's class B patients (16/16) and 71% (24/34) of Child's class C patients survived hospitalization. One-year survival was 94% (15/16) for Child's class B and 62% (21/34) for Child's class C patients. Rebleeding occurred in 63% (25/40) of the discharged patients but caused the death of only seven. In conclusion, the 20% initial hospital mortality for these difficult patients was significantly better than that reported for emergency surgery, and the rate of rebleeding was comparable to that seen with other nonshunting therapies.

Arteries↗
PubMed1986

Treatment of colorectal hepatic metastases by intrahepatic chemotherapy alone or as an adjuvant to complete or partial removal of metastatic disease.

Because of the wide variation in reported benefits from the use of intrahepatic chemotherapy for colorectal hepatic metastases, the authors performed their own phase II studies comparing the use of intrahepatic chemotherapy alone and intrahepatic chemotherapy as an adjuvant to complete or partial removal of metastatic colorectal cancer to the liver. Techniques for partial removal included unilateral and bilateral wedge resection, peripheral presinusoidal embolization of the liver, and portal vein branch ligation. Patients were staged using the per cent hepatic replacement method of Pettavel and Taylor, and patients with bilateral metastases were included in the study. Twenty-seven patients, mean age 60.3 years, were examined. There were 19 males, mean age 60.4 years, and eight females, mean age 60 years. The patients were divided into four groups. Group A had an implantable pump only; Group B had an implantable pump and resection; Group C had an implantable pump and arterial embolization and portal vein branch ligation; and Group D had an implantable pump, partial resection, arterial embolization, and portal vein branch ligation. Kaplan-Meyer survival curves were calculated for all of these groups. A separate analysis was carried out for each of the stages, and a comparison was made. The study indicated that the overall median survival time was 18 months and that the more radical the treatment in addition to chemotherapy, the better the results. Such results were not totally dependent on the staging of the tumor volume but were dependent on the degree of extirpation of the tumor. In Group C, consisting primarily of Stage IIa, IIIa, and IV patients (i.e., unresectable patients), a doubling of expected median survival to 12 months could be achieved, compared to those in Group A, which achieved a median survival of only 6 months.

Adult↗