Imaging findings of mucinous type of cholangiocellular carcinoma

OBJECTIVE

To demonstrate the imaging findings seen in two cases of mucinous type of cholangiocellular carcinoma of the liver.

MATERIALS AND METHODS

The CT and MR findings of two patients with pathologically proven mucinous type of cholangiocellular carcinoma were analyzed.

RESULTS

One of them showed calcification, both cases had no enhancing on the arterial dominant phase of dynamic CT, but showed enhancement in the periphery and internal septations on the equilibrium phase. The internal signal intensity was homogenous, and extremely hypo- and hyperintense on T1- and T2-weighted images, respectively.

CONCLUSION

Imaging findings were unique reflecting the characteristic pathological features that cancer cell nests are suspended in a large mucinous lake, and the specific diagnosis was considered to be possible by the integrated imaging diagnosis.

[Evaluation of hemodynamics of pelvic veins in pregnant women by the ultrasonic pulsed doppler flow velocity analysis]

By means of pulsed Doppler ultrasound, external iliac vein (EIV) velocimetries were carried out on non-pregnant, pregnant and postpartum women. 1. According to the results of a phantom simulation study, the difference between measured values and theoretical values increased when the angle of incidence was over 50 degrees. 2. The coefficient variation of the measured value for ten pregnant women was 4.4 to 9.8%. 3. EIV velocity was 21.4 +/- 7.7cm/sec for non-pregnant women, 20.8 +/- 9.5cm/sec in the 1st trimester, showing no significant difference between the two groups. In the 2nd trimester, it was 8.8 +/- 5.6cm/sec decreasing slightly (p < .001), and 6.1 +/- 3.3cm/sec in the 3rd trimester showing a further decrease (p < 0.01). At 24 hours postpartum, it was 12.7 +/- 4.3cm/sec, an increase over the 3rd trimester (p < 0.001), but it was lower than in non-pregnant women (p < 0.001). At 4 weeks postpartum, it was 19.3 +/- 5.3cm/sec, showing no significant difference from non-pregnant women. The results suggested the following. 1. EIV velocimetry by pulsed Doppler ultrasound is reliable for clinical studies. 2. EIV velocity decreased significantly in the 2nd and 3rd trimesters and recovered to the same level as non-pregnant women by 4 weeks postpartum.

Inhibition of 5-lipoxygenase promotes the regeneration of the liver after partial hepatectomy in normal and icteric rats

The role of leukotriene (LT) on liver regeneration after hepatectomy is still unknown. LTB4 stagnates in the liver with obstructive jaundice, because LTB4 is excreted in the bile; therefore, LTB4 may have an effect on liver regeneration after hepatectomy with obstructive jaundice. Release of obstructive jaundice and simultaneous 70% hepatectomy was performed in rats to study the effect of 5-lipoxygenase inhibitor (AA-861) on liver regeneration. Group 1 underwent hepatectomy with administration of 0.1 mL dimethyl sulfoxide (DMSO), group 2 underwent hepatectomy with administration of AA-861 (20 mg/kg/d) dissolved in 0.1 mL DMSO, group 3 underwent hepatectomy with administration of AA-861 (40 mg/kg/d) dissolved in 0.1 mL DMSO, group 4 underwent release of obstructive jaundice and hepatectomy with administration of 0.1 mL DMSO, and group 5 underwent relief of obstructive jaundice and hepatectomy with administration of AA-861 (20 mg/kg/d). DMSO or AA-861 was administered 24 hours before, during, and 24 hours after hepatectomy in each group. Whole blood LTB4 and serum alanine aminotransferase (ALT), total bilirubin, and bromodeoxyuridine labeling index (LI) were measured before and after hepatectomy. The LTB4 level increased during obstructive jaundice and after hepatectomy. LTB4 and serum ALT levels were significantly lower after hepatectomy in the rats that were administered AA-861, and a significantly higher LI was observed at 24 hours after hepatectomy in rats receiving AA-861. Inhibition of 5-lipoxygenase promotes liver regeneration and decreases hepatocyte injury after hepatectomy associated with obstructive jaundice.

[Phase II study of paclitaxel (BMS-181339) in patients with ovarian cancer by 3-hour intravenous infusion]

A phase II study of Paclitaxel in patients with ovarian cancer by 3-hour intravenous infusion was undertaken by a cooperative study group of 30 institutes. Of 66 cases enrolled, 57 cases were evaluable for efficacy, and 63 cases were evaluable for safety. In spite of the fact that all cases for efficacy evaluation were previously treated with chemotherapy including platinum-based drugs, 2 cases of complete response (CR) and 15 cases of partial response (PR) were observed, with a response rate of 29.8% (The 95% confidence interval of response rate was 18.4-43.4%). Paclitaxel also showed 28.2% (11/39) response rate in patients refractory to treatment by platinum-based drugs. Histologically, the response rates were 28.9% (11/38) in serous adenocarcinoma, 40.0% (2/5) in clear cell adenocarcinoma and 25.0% (1/4) in mucinous adenocarcinoma. As the major laboratory abnormalities, leukopenia, neutropenia and decrease in hemoglobin were observed with incidence rates of 98.4% (62/63), 95.2% (59/62) and 85.7% (54/63), respectively. However, these abnormalities were clinically manageable by either withdrawal of medication, administration of antibiotics, G-CSF or metachysis etc. In addition, thrombocytopenia, elevation in GOT and GPT were seen with moderate incidence. Peripheral neuropathy was a major adverse symptom with an incidence of 79.4% (50/63), followed by alopecia, myalgia, arthralgia and fever. However, the majority of these adverse reactions were less than grade 3. From these findings, we confirmed that 3-hour intravenous infusion of Paclitaxel was a clinically useful chemotherapeutic agent in patients with ovarian cancer.

[Familial ovarian cancer, uterine cancer]

Familial ovarian cancer is described as a familial aggregation of ovarian cancer. The disease is heterogeneous, with at least three genotypes prodisposing to distinctive hereditary syndrome, site-specific ovarian cancer, wherein familial cancer risk is restricted to ovarian carcinoma; breast/ovary carcinoma syndrome, that is ovarian carcinoma in association with carcinoma of the breast; and Lynch syndrome II, characterized by hereditary nonpolyposis colorectal cancer with proximal colonic cancer predominance, endometrial carcinoma, and ovarian carcinoma. When a familial aggregation of ovarian cancer is observed, unaffected women in the family should have periodic gynecologic examinations, including cytologic and ultrasonographic, radiologic studies and magnetic resonance imaging, in an effort to detect preinvasive ovarian cancer. Until more reliable diagnostic methods are developed, however, the physician should consider the advisability of prophylactic oophorectomy and oral contraceptives when counseling women who have several close relatives with ovarian cancer.

Pathological and immunohistochemical findings in a case of mucinous cholangiocarcinoma

A case of mucinous cholangiocarcinoma is reported. The patient was a 49 year old woman with the complaint of lumbago. Imaging examination disclosed a tumor 3.5 cm in diameter in the right hepatic lobe, which showed low density on computerized tomography scans and low signal intensity on T1-weighted magnetic resonance imaging (MRI) and high intensity on T2-weighted MRI. The hepatic tumor expanded rapidly and multiple pulmonary metastases and peritoneal dissemination developed. The patient died due to respiratory failure 5 months after the initial symptom. An autopsy, a massive tumor (9.5 cm in diameter) containing abundant mucus with several surrounding daughter nodules was found in the right hepatic lobe. Metastases were widespread. Histologically, the tumor was composed mainly of numerous lobulated mucus lakes in which adenocarcinoma cells floated. Admixed signet ring cells were also noted. These gross and histologic features differ from those in other mucin-producing hepatic tumors such as biliary papillomatosis and mucinous cystoadenocarcinoma. Immunohistochemically, the adenocarcinoma cells were strongly positive for carcinoembryonic antigen, Lewis Y, Tn, and T antigens and moderately positive for carbohydrate antigen 19-9, Lewis X, sialyl-Lewis X and sialyl-Tn antigen. Mature MUC1 mucin and core protein of MUC1 mucin were also expressed to varying degrees. The rapidly expanding, widespread metastases and poor prognosis found in the present case may be the clinicopathological features of mucinous cholangiocarcinoma.

Production and characterization of monoclonal antibodies against human natriuretic peptide receptor-A or -B

Monoclonal antibodies (mAbs) against human natriuretic peptide receptor-A (NPR-A) or NPR-B were produced using NPR-expressing Chinese hamster ovary (CHO) cells and soluble chimeric NPRs consisting of the extracellular domain of each receptor fused to Fc region of human IgG. Three anti-NPR-A mAbs, designated as A144, A397 and A416, bound to human NPR-A but not to NPR-B, while an anti-NPR-B mAb B136 reacted with human NPR-B but not with NPR-A. Competition analysis with the anti-NPR-A mAbs revealed that two mAbs, A144 and A416, recognize an identical or the adjacent site of the receptor and that A397 is directed against another epitope. No anti-NPR-A mAb affected binding of atrial natriuretic peptide (ANP) to NPR-A, while the anti-NPR-B mAb B136 inhibited binding of C-type natriuretic peptide (CNP) to NPR-B. Inhibition of the ligand-binding by B136 is specific in that the mAb showed no effect on the binding of ANP to NPR-A. B136 also blocked CNP-mediated intracellular cGMP accumulation in NPR-B-expressing cells. These results suggest that the region recognized by B136 may be related to the ligand-binding region of NPR-B. NPR-A- and NPR-B-expressing cells were selectively detected by immunostaining using the mAbs. These findings demonstrate that the mAbs will be useful to elucidate the role of the natriuretic peptides and their receptors in normal and disease states in humans [correction of human].

Detection of human parvovirus B19 DNA by nested polymerase chain reaction

We describe the development of a nested polymerase chain reaction (PCR) technique used to detect human parvovirus B19 DNA. It was performed in a two-step reaction, first with a pair of outer primers, then with a pair of inner (ie, nested) primers. Primer sequences were selected in the VP1 gene, corresponding to the capsid protein, of human parvovirus B19. To establish the nested PCR assay, the plasmid pGEM-1 containing almost the entire coding sequence of a human parvovirus B19 isolate was used. The nested PCR could detect up to 1.8 x 10(-3) ag of B19 DNA, equivalent to 10(-4) genomes, by electrophoresis. No amplification product was detected by gel electrophoresis when the reaction mixture contained human placental DNA, cytomegalovirus DNA, and sterile distilled water as templates. We used this assay to evaluate four cases of maternal B19 infection that were diagnosed by determination of the presence of anti-B19 immunoglobulin-M in maternal serum. The advantages of our nested PCR for detecting B19 DNA are plating simplicity, safety, sensitivity, and specificity. Our results suggest that this method may have general applicability in the evaluation of nonimmune hydrops fetalis and in the documentation of the natural history of fetal infection with B19 when applied to specimens of amniotic fluid or fetal blood.

[Changes of tympanic temperature by stellate ganglion block]

The effects of stellate ganglion block (SGB) on the temperature of tympanic membrane were determined clinically. Thirty patients received SGB with 8 ml of 1 % mepivacaine. The tympanic temperature was measured using radiation non-contact tympanic membrane thermometer before and after administration of SGB for 30 min on the side where SGB was given. Before SGB the tympanic temperature was 37.29 +/- 0.08 degrees C, and there was no difference in the readings between the two sides. The tympanic temperature dropped significantly 5 min after SGB and reached its lowest value of 36.90 +/- 0.08 degrees C 15 min later. This drop persisted for more than 30 min after SGB. The fact that therapeutic effect of SGB is partly due to vasodilation and improvement in blood flow to the affected region was demonstrated, but these effects in internal carotid arterial system have not yet been studied in detail. Tympanic temperature has been proposed as a valid index of brain temperature in man. The mechanism of brain cooling has been suggested that countercurrent heat exchange takes place between carotid and jugular blood flow. Therefore the result of the study suggests that SGB could enhance an increase in the brain blood flow.

Prognostic significance of nucleolar organizer regions in hepatocellular carcinoma

It has been suggested that the number of argyrophilic nucleolar organizer regions (AgNORs) correlates with cellular activity and the aggressiveness of malignancy. The mean number of AgNORs per nucleus may, therefore, be a prognostic factor for hepatocellular carcinoma (HCC). The purpose of this study was to evaluate the prognostic significance of the number of AgNORs in HCC. The silver-staining technique was applied to surgically resected specimens to indicate AgNORs. Eighty-nine of the specimens were of HCC, 23 were of normal liver adjacent to HCC, and 32 were of cirrhotic liver adjacent to HCC. The number of AgNORs of HCC (mean +/- SD, 3.26 +/- 1.23) was significantly higher than those of normal liver (1.37 +/- 0.13) and cirrhotic liver (1.49 +/- 0.14). The number of AgNORs was significantly correlated with serum alpha-fetoprotein level, tumor size, portal vein invasion, and Edmondson-Steiner histological grade. In patients undergoing curative resection, the survival rate of those with a high number (> 3.04) of AgNORs was significantly worse than that of those with a low number (< or = 3.04) of AgNORs. Multivariate analysis showed that the number of AgNORs was a significant prognostic indicator in patients without portal vein invasion, and portal vein invasion was the only significant variable when all patients undergoing curative resection were assessed together. The results of this study suggest that the number of AgNORs is useful as an indicator of the grade of malignancy and as a predictor of the prognosis of patients with HCC who do not have portal vein involvement.

Effects of electrical stimulation of cervical sympathetic trunks on microcirculation in the facial nerve

This study evaluates the circulatory effects of electrical stimulation of the cervical sympathetic trunks on blood flow in the common carotid artery and facial nerve tissue in dogs. Marked increases in arterial pressure and heart rate were observed due to electrical stimulation of the cervical sympathetic trunks, while blood flow volume in the common carotid artery and in the facial nerve tissue decreased markedly. It was assumed that microcirculation of the facial nerve is definitely impaired by electrical stimulation of the cervical sympathetic trunks, and the tonicity of the sympathetic nervous system appears to be a major factor in changes in the microcirculation of the facial nerve. It is well known that impaired circulation in the nutrient vessels of the facial nerve has an important effect on the pathogenesis of facial palsy. The hypertonicity of the sympathetic nervous system is closely involved in the onset of facial palsy.

Ellagic acid/phospholipid-induced coagulation and dextran sulfate-induced fibrinolytic activities in beta 2-glycoprotein I-depleted plasma

Beta 2-glycoprotein I (beta 2-GPI) binds negatively charged substances and inhibits intrinsic blood coagulation in the presence of ellagic acid-phospholipid suspension. Beta 2-GPI is thought to be an important protein in the reaction between negatively charged phospholipids and anti-phospholipid antibodies which appear in patients with lupus anticoagulant/antiphospholipid antibody syndrome. We prepared a monoclonal antibody against beta 2-GPI purified from human plasma and obtained beta 2-GPI-depleted plasma using a monoclonal antibody-coupled column. Either partial thromboplastin time or the activation of prekallikrein induced by diluted ellagic acid-phospholipid suspension in beta 2-GPI-depleted plasma was not different from that in control plasma. Beta 2-GPI inhibited the intrinsic blood coagulation only when added to control or beta 2-GPI-depleted plasma in excess (more than physiological concentrations). The intrinsic fibrinolysis in beta 2-GPI-depleted plasma induced by dextran sulfate was not impaired and, again, beta 2-GPI inhibited the intrinsic fibrinolysis only when added to control or beta 2-GPI-depleted plasma in excess. These results indicate that both in vitro Actin-induced intrinsic coagulation and dextran sulfate-induced fibrinolytic activities are significantly inhibited by more than physiological concentrations of beta 2-GPI.

Postoperative adjuvant hepatic arterial infusion of Lipiodol containing anticancer drugs in patients with hepatocellular carcinoma

Vascular invasion and intrahepatic metastasis by hepatocellular carcinoma are important factors predisposing to tumor recurrence. Recurrences of this malignancy occur frequently in residual liver, and its prevention is one of the most important factors in obtaining better surgical survival. Fifty patients who underwent hepatectomy for invasive hepatocellular carcinoma with vascular invasion and/or intrahepatic metastases were studied to evaluate the effect of adjuvant bolus hepatic arterial infusion of iodized poppyseed oil (Lipiodol) containing anticancer drugs in preventing recurrence and in prolonging survival. Patients were assigned to two treatment groups. Twenty-three of the fifty patients received adjuvant bolus infusion of Lipiodol containing doxorubicin and mitomycin C, whereas 27 patients received no therapy. The disease-free survival rate for the patients who received adjuvant therapy was significantly better (p < 0.05) than that for those who did not when measured at 172, 516, 688 and 860 days after hepatectomy, and the disease-free survival curve for patients with adjuvant therapy was significantly (p = 0.0237) better than that without adjuvant therapy. The cumulative survival rates and curves were not significantly different between the two groups. While adjuvant hepatic arterial infusion of Lipiodol containing anticancer drugs was effective in improving disease-free survival, the effect was not satisfactory. Further trials of adjuvant chemotherapy are required to improve the surgical survival of hepatocellular carcinoma patients.

[Circulatory effects of stellate ganglion block and high thoracic epidural block]

A comparative study of the circulatory effects of stellate ganglion block (SGB) and high thoracic epidural block (TEB) was conducted in 11 patients. Although blood pressure and heart rate showed no significant changes even after SGB, they both decreased significantly following TEB. The blood flow in the common carotid artery (CCA) increased markedly at 5 minutes after performing SGB, and at 20 minutes it reached its peak value of 163.5 +/- 7.8%, and the increase remained significant up to 75 minutes. On the other hand, it increased significantly from 5 minutes after performing TEB and reached its peak of 122.2 +/- 7.6% at 15 minutes, and this increase remained significant up to 60 minutes. In comparing these two nerve blocks, the blood flow in the CCA showed a more marked increase following SGB than after TEB from 5 to 60 minutes after performing. The blood flow rate in the CCA increased markedly from 5 minutes after performing SGB, reached its peak of 139.1 +/- 11.3% at 20 minutes, and this increase remained significant up to 60 minutes thereafter. After performing TEB no significant changes were observed. In comparing SGB and TEB, from 5 to 60 minutes after performing, the rate became markedly faster after SGB than after TEB. The vascular diameter of the CCA from 5 minutes after performing SGB showed a slight but significant enlargement, and at 20 minutes it reached its maximum of 111.7 +/- 3.0%, and this significant enlargement persisted up to 60 minutes. From 10 minutes after performing TEB, it showed a slight but significant enlargement.(ABSTRACT TRUNCATED AT 250 WORDS)

[Circulatory effects of stellate ganglion block in idiopathic facial palsy]

The circulatory effects of stellate ganglion block (SGB) on the blood flow through the common carotid artery were determined in 35 patients in acute phase of idiopathic facial palsy (Bell's palsy). SGB was performed by para-tracheal approach with 8 ml of 1% mepivacaine. The blood flow was measured with an ultrasonic blood flowmeter before and 30 minutes after SGB at both sides of the common carotid artery in 20 cases. Measurement was performed continuously for 90 minutes on the palsy side in the other 15 patients. Before SGB, there were no significant differences between the blood flow of the palsy side and the intact side. Thirty minutes after SGB, the blood flow markedly increased to 169.4 +/- 6.2% on the performed side with no change on the non-performed side in 20 cases. In the other 15 patients, the blood flow increased significantly 5 minutes after SGB and reached its peak of 179.7 +/- 11.1% at 20 minutes later. This increase continued for 75 minutes after SGB. It is well known that impaired microcirculation in the facial nerve has an important role in the pathophysiology of Bell's palsy. In view of the fact that the nutrient arteries for the facial nerve are the peripheral branches of the external carotid artery, we believe that SGB which causes significant increase in the blood flow through the common carotid artery is an effective treatment in Bell's palsy.

Prognostic factors of hepatocellular carcinoma in patients undergoing hepatic resection

BACKGROUND/AIMS

Prognostic analysis on hepatocellular carcinoma (HCC) in patients undergoing hepatectomy is necessary to determine the clinical value of hepatectomy on prognosis.

METHODS

Survival and disease-free survival were analyzed in 104 HCC patients undergoing hepatectomy using clinicopathologic factors by univariate and multivariate analyses. The value of the International Union Against Cancer (UICC) TNM classification on prognosis was assessed in the patients.

RESULTS

In multivariate analysis, portal vein invasion was the most influential factor. The difference between stage 1 and 2 or stage 3 and 4A using UICC's TNM classification was not significant with respect to survival or disease-free survival. The UICC's classification was modified as follows; stage 1, solitary tumor without vascular invasion; stage 2, solitary or multiple tumor(s) involving adjacent to vessel branch; stage 3, tumor(s) involving major vessel branch or with regional lymph nodal metastasis; and stage 4, tumor(s) with distant metastasis. The differences between each stage in the modified classification were significant with respect to disease-free survival.

CONCLUSIONS

The UICC's TNM classification was not of prognostic significance. Further studies on survival in patients with HCC are necessary to evaluate the value of the UICC's TNM classification; some modification may be necessary.

Methods in pathology. p53 expression in formalin-fixed, paraffin-embedded archival specimens of intrahepatic cholangiocarcinoma: retrieval of p53 antigenicity by microwave oven heating of tissue sections

Immunohistochemical demonstration of p53 is thought to reflect mutations of the p53 gene. Although p53 expression or mutation has been investigated in a variety of carcinomas, it has not been examined in intrahepatic cholangiocarcinoma (CC). We investigated expression of p53 in formalin-fixed, paraffin-embedded archival specimens of 40 CCs (22 autopsy cases and 18 surgical cases) by immunohistochemistry using four antibodies (PAb1801, DO-7, BP53-12, CM1). We also attempted to enhance p53 expression by pretreatments of tissue sections by pepsin digestion as well as by microwave oven heating. Formalin-fixed, paraffin-embedded archival surgical specimens of 15 colon carcinomas were used as controls. In surgical cases, p53 expression was abolished by pepsin predigestion, although it was greatly enhanced by pretreatment of microwave oven heating in all immunostainings (PAb1801, DO-7, BP53-12, CM1). In surgical cases immunostained with microwave oven heating, DO-7, BP53-12, and CM1 showed frequent p53 expression (22% in CC; 60-67% in colon carcinoma), whereas PAb1801 showed low p53 expression (0% in CC; 13% in colon carcinoma). In contrast to the surgical cases, all 22 CCs of autopsy cases showed no p53 expression by any antibodies as well as by any pretreatments. These results shows that a pretreatment of tissue sections by microwave oven heating is a very good method for demonstrating p53 protein in formalin-fixed, paraffin-embedded archival materials and that DO-7, BP53-12, and CM1 are useful antibodies for detection of p53 in formalin-fixed, paraffin-embedded archival materials. No expression of p53 in autopsy cases of CC suggests that p53 antigenicity is lost during autopsy procedure.(ABSTRACT TRUNCATED AT 250 WORDS)

Increased graft survival by utilization of 15-deoxyspergualin in a canine pancreatic allotransplantation model

The purpose of this study was to evaluate the effectiveness of 15-deoxyspergualin (DSG) administration against acute rejection of canine pancreatic allografts. Subsequent to partial pancreatic allotransplantation and total extirpation of the pancreas, 20 adult mongrel dogs were divided into four groups and treated with saline (group 1, controls, n = 5), DSG at 1.0 mg/kg/day (group 2, n = 5), DSG at 3.0 mg/kg/day (group 3, n = 5), or DSG at 5.0 mg/kg/day (group 4, n = 5) on postoperative days 4-7. The graft survival, defined by a fasting serum glucose level < 150 mg/dl, was significantly prolonged from 6.2 +/- 1.2 days in group 1 to 12.4 +/- 2.7 days in group 3 (p < 0.05) and to 16.8 +/- 3.2 days in group 4 (p < 0.05). Graft survival was not significantly prolonged in group 2, however. Two normoglycemic dogs in group 4 died due to gastrointestinal toxicity, one of the most serious side effects of DSG. The observation that the serum insulin levels increased in dogs treated with DSG was compatible with dose-dependent graft survival and suggested that DSG had no toxic effects on pancreatic endocrine function. In group 1 significantly increased thromboxane B2 (TXB2) levels and TXB2/6-keto-prostaglandin F1 alpha (PGF1 alpha) ratios were observed on postoperative days 3-5 which was thought to reflect acute rejection. Following administration of DSG, both TXB2 levels and TXB2/PGF1 alpha ratios were decreased on the 5th postoperative day in groups 2-4.(ABSTRACT TRUNCATED AT 250 WORDS)

The immunosuppressive effect of 5-lipoxygenase inhibitor on liver allotransplantation in rats

This study was performed to examine the immunosuppressive effect of a 5-lipoxygenase inhibitor, AA-861, on liver transplantation in rodents, and also to examine the production of eicosanoids during rejection of liver allograft in these animals. Rats were divided into three groups: group I (syngenic orthotopic liver transplantation from LEW to LEW), group II (allogenic OLT from ACI to LEW with dimethyl sulfoxide), and group III (allogenic OLT from ACI to LEW with AA-861 [20 mg/kg/day] s.c. dissolved in DMSO). Histological examinations were performed, survival time was monitored, and eicosanoid levels at 3, 5, and 7 days after transplantation were measured. Mean survival time in group III was significantly longer than that in group II (36.0 +/- 6.8 vs. 11.1 +/- 0.7 days, mean +/- SEM; P < 0.01). Histologically, the degree of rejection in group III was moderate compared with that in group II. On day 3, the LTB4 level in group II was significantly higher than that in group I (3361 +/- 985 vs. 407 +/- 70 pg/ml, P < 0.05), and the PGE2 level in group III was significantly higher than that in group 1 (50.3 +/- 4.8 vs. 23.5 +/- 4.7 pg/ml, P < 0.01) and in group II (32.9 +/- 4.2 pg/ml, P < 0.05). These findings suggest that AA-861 reduced liver allograft rejection by suppressing the elevation of 5-lipoxygenase products and increasing PGE2 production in the early stage of rejection.