Liver regeneration after partial hepatectomy: effects of glucose and branched-chain amino acid

The phenomenon of liver regeneration has been observed within several days after partial hepatectomy, though there is still much controversy as to its initiation, regulation, and the control factors behind it. Male Wistar rats weighing around 200 g were used as subjects in this study. Partial hepatectomy with resection of the median and left lateral lobes (67.31%) was performed. High glucose, low glucose, or high or low branched-chain amino acid (BCAA) solutions were given intravenously 2 days prior to the partial hepatectomy. The rats were sacrificed at 6, 24, 48, and 72 hours after the operation. Remnant liver weight, Deoxyribonucleic acid (DNA) content, DNA synthesis rate, and mitotic index were chosen as markers for comparing the effects of the glucose and branched-chain amino acid solutions on liver regeneration. The results were as follows: (1) following removal of two-thirds of a rat's liver, DNA synthesis increased abruptly, peaking at 24 hours, the mitotic index reached a maximum at 48 hours, and the remaining lobes had doubled in size by 48 hours and had attained around 90% of the normal liver weight at 72 hours; (2) judging by the results of the remnant liver weight, DNA content, and DNA synthesis rate, the low glucose infusion rates showed the worst regenerative condition; and (3) the only effect of BCAA on liver regeneration observed was that low BCAA infusion rates resulted in a lower DNA content in the remnant liver.

Effects of monomeric and polymeric diets on small intestine following massive resection

Since the introduction of long-term total parental nutrition, it has been possible to raise the survival rate in patients with massive intestinal resection. How to increase the remaining intestinal mucosa hyperplasia in these patients has become the focus of many studies. Early postoperative enteral feeding with exogenous intraluminal nutrition was considered to be one of the most essential factors. The best enteral food pattern, however, is still not conclusive. In this study, we used the animal model of rats with 60% small intestinal resection, giving them different kinds of enteral diets through gastrostomy tubes. The monomeric diet included amino acid, glucose, disaccharide, and triglyceride. The polymeric diet included the usual source of nutrition such as protein, polysaccharide, and fat. The rats were killed three weeks later. Histopathological changes of the remaining bowel and H3 thymidine incorporation to mucosal DNa were measured. We found: (1) hyperplasia of the remaining bowel in the 60% resected rats was definitely increased more than the rats of the sham operation; (2) from the protein content, the DNA content of mucosa cells, the villus height and crypt depth points of view, the polymeric diet fed rats had a better adaptation; (3) on the 21st postoperative day, the DNA synthetic rate was still very high in polymeric diet fed rats, but returned to preoperative levels in rats fed with a monomeric diet. Our conclusion of this study is that a polymeric diet can contribute to a better intestinal mucosa regeneration than a monomeric diet in the rats with massive intestinal resection.

Bone marrow involvement in non-Hodgkin's lymphoma

The frequency, pattern, extent and clinical features of bone marrow involvement in 94 cases of non-Hodgkin's lymphoma, classified according to the International Working Formulation, were reviewed. In 30% of cases there was bone marrow involvement by lymphoma at the time of diagnosis. Marrow involvement was most frequently found in the follicular small cleaved cell (57%), diffuse mixed small and large cell (56%), and lymphoblastic (56%) lymphomas. A paratrabecular pattern of marrow involvement tended to occur in low or intermediate grade lymphomas. High grade lymphomas tended to show an interstitial or diffuse pattern of marrow involvement. The results of marrow aspiration and biopsy were of equal value and complementary to each other. In 43% of cases with marrow lymphoma there was peripheral blood involvement at the time of diagnosis. Blood involvement was most frequently found in the lymphoblastic lymphoma (70%). In general, the degree of blood involvement was related to the extent of marrow involvement. Patients with marrow involvement often presented with "B" symptoms and hepatomegaly. Abnormalities in at least one of the blood counts were quite common (93%). A normal blood count made marrow involvement unlikely but not impossible. Other common laboratory findings included hyperimmunoglobulinemia (47%) and elevated serum levels of lactate dehydrogenase (56%). Patients with marrow involvement showed a significantly higher frequency of hepatomegaly and abnormal blood counts, as compared to those with negative marrows (p less than 0.05 and less than 0.001, respectively).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult non-Hodgkin's lymphoma in Taiwan area: a clinicopathologic study of 123 cases based on working formulation classification

To elucidate the clinicopathologic features of non-Hodgkin's lymphoma (NHL) in Taiwan, 123 adult patients with proven NHL were studied. They were classified according to the international working formulation as: low grade (LG), 12.2%; intermediate grade (IG), 42.3%; and high grade (HG) lymphoma, 45.5%. The most common subtypes were diffuse large cell (26.8%) and large cell immunoblastic (26.8%) lymphomas. Follicular lymphoma accounted for only 8.9% (11 cases). Complete remission rates for LG, IG and HG lymphomas were 53%, 35% and 34%, respectively. LG lymphoma had a significantly better survival than that of IG and HG lymphomas. The IG lymphoma encompassed a heterogeneous group of patients with varying prognoses but the overall survival curve was indistinguishable from that of HG lymphoma. Clinically, 66% of HG, 77% of IG and 86% of LG lymphoma presented with advanced disease. LG lymphoma had high frequencies of hepatosplenomegaly (30-50%) and bone marrow involvement (53%), whereas skin, bone and central nervous system involvement occurred exclusively in IG and HG lymphomas. Mild anemia was common and occurred in 40-50% of the patients. Hyperimmunoglobulinemia was found in 50-60% of all 3 grades of lymphoma, monoclonal gammopathy in 3 cases of IG lymphoma, and hypercalcemia in 4 cases of IG and HG lymphomas. Elevated serum lactate dehydrogenase occurred mainly in IG and HG lymphomas and was an important prognostic factor. In conclusion, the characteristic features of NHL in Taiwan include: (1) a high proportion of HG lymphoma and low proportions of LG and follicular lymphomas; (2) a heterogeneous patient composition of IG lymphoma with an unfavorable overall prognosis.(ABSTRACT TRUNCATED AT 250 WORDS)

Extrarenal Wilms' tumor--a case report

Extrarenal Wilms' tumor is extremely rare. To our knowledge, only 22 cases had been reported up to 1984. We treated a 5-year-old girl with an extrarenal Wilms' tumor arising in the right inguinal region. Total excision was performed. Abdominal sonogram, computed tomography (CT) scan, and intravenous pyelogram (IVP) showed normal kidneys, no other mass, and no evidence of metastasis. Postoperative chemotherapy was administered. The patient has been disease-free since first diagnosis 19 months ago.

Effect of partial portal vein ligation on hepatic regeneration

To evaluate the effect of portal hypertension and diminished portal venous blood flow to the liver on hepatic regeneration, male rats were subjected to partial portal vein ligation and subsequently to a two-thirds partial hepatectomy. The levels of ornithine decarboxylase activity at 6 h after partial hepatectomy were greater (p less than 0.001) in the rats with prior partial portal vein ligation than in those without portal hypertension. The rats with prior partial portal vein ligation also had greater (p less than 0.005) levels of thymidine kinase activity at 48 h after partial hepatectomy than did those without portal hypertension. Hepatic sex hormone receptor activity was not affected by prior partial portal vein ligation either before or after partial hepatectomy. The reductions in both estrogen and androgen receptor activity observed in the hepatic cytosol after partial hepatectomy were similar to those observed in control animals. These data indicate that animals with portal hypertension having a diminished hepatic portal blood flow have a normal capacity to regenerate hepatic mass following a hepatic resection.

Heterotopic heart transplantation in the rat receiving FK-506 alone or with cyclosporine

In rats, FK significantly prolonged heterotopic heart graft survival over a wide dose range when given for 2 weeks starting on the day of the operation. Brief courses of FK for one to four days preoperatively, and especially beginning four days postoperatively, allowed long subsequent survival of heart grafts in otherwise untreated recipients. The seeming acceptance of the grafts with postoperative FK treatment was largely but not exclusively donor specific when tested eight days after the last FK dose by second grafts from the same donor v third-party donor grafts. FK in minimally therapeutic doses was synergistic with suboptimal doses of CyA.