Role of multi-detector computed tomography for biliary complications after liver transplantation

AIM: To investigate the diagnostic performance of multi-detector computed tomography(MDCT) in detecting biliary complications after orthotopic liver transplantation(OLT). METHODS: Eighty-three consecutive OLT recipients, who presented with clinical or biochemical signs of biliary complications, underwent MDCT examination. Two experienced radiologists assessed MDCT images in consensus to determine biliary complications. Final confirmation was based on percutaneous transhepatic cholangiography or endoscopic retrograde cholangiography in 58 patients, surgery in four patients, liver biopsy in 10, and clinical and sonography follow-up in 11 patients. RESULTS: Biliary complications were eventually confirmed in 62 of 83 patients(74.7%), including anastomotic biliary strictures in 32, nonanastomotic biliarystrictures in 21, biliary stones in nine(5 with biliary strictures), anastomotic bile leak in five, and biloma in six(all with nonanastomotic strictures, and 2 with biligenic hepatic abscess). Twenty-one patients had no detection of biliary complications. The sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MDCT for detecting biliary strictures were 90.6%, 86.7%, 89.2%, 92.3% and 83.9%, respectively. For detecting biliary stones, anastomotic bile leak and biloma, the sensitivity, specificity, accuracy, positive predictive value and negative predictive value of MDCT were all 100%.CONCLUSION: MDCT is a useful screening tool for detecting biliary complications after OLT.

Relationship between expression of hepatocyte grow factor and apoptosis of trophoblasts in hypertensive disorder complicating pregnancy

The aim of this study was to investigate the expression of hepatocyte growth factor(HGF)and Fas in placentas of uncomplicated pregnant women and those with hypertensive disorder complicating pregnancy(HDCP),and elucidate the possible relationship between HGF and apopto-sis of trophoblasts.Reverse transcription-polymerase chain reaction(RT-PCR)was undertaken to examine the concentra-tion of HGF mRNA and Fas mRNA obtained from 34 cases of HDCP and 30 cases of uncomplicated pregnancy.The expression of HGF mRNA in mild preeclampsia,severe preeclampsia and eclampsia cases was significantly lower than that in the uncomplicated cases(0.43P0.12,0.38P0.09,0.19P0.17 versus 0.67P0.19,P<0.05),while the expres-sion of Fas mRNAin mild preeclampsia,severe preeclampsia and eclampisa cases was significantly higher than that in the uncomplicated cases(1.58P0.26,2.96P0.14,5.98P1.17 versus 1.01P0.36,P<0.05).For HGF mRNA and Fas mRNA,there was no difference between gestational hyper-tension cases and control cases.Decreased HGF mRNA or increased Fas mRNA was found along with the progress of HDCP.Negative correlation was found between the expressions of HGF and Fas.These results indicate that HGF inhibits the apoptosis mediated by Fas,and the reduced expression of HGF in HDCP may be responsible for the apoptosis of trophoblasts.

Role of stair-climbing test in predicting postoperativecardiopulmonary complications in elderly patients with biliarydiseases

One hundred and twenty-six patients above 80 years old with biliary diseases undergoing operations in Shaoxing People’s Hospital from Jan.2002 to Jan.2007 were analyzed retrospectively.All patients performed a preoperative stair-climbing test,and the risks for cardio-pulmonary complications were evaluated with pair-matching and linear correlations analysis between stair-climbing height(h)and left ventricular ejective factor(EF),forced vital capacity(FVC)and forced expiratory volume in one second(FEV1).There was a significant difference in the incidence of cardiopulmonary complications among different stair-climbing heights.Stair-climbing heights were positively related with EF,FVC and FEV1.This suggests that the stair-climbing test is an effective and simple method for predicting cardiopulmonary complica-tions in elderly patients with biliary diseases.