Acute acalculous cholecystitis

Eighteen patients developed acute acalculous cholecystitis at UCLA during a period of 18 years. Males were about 3 times more affected than females. The average age of patients was 54.8 years. Chronic vascular lesions with possible arteritis and thrombosis of the cystic artery were found in about one half of patients. Stress situations associated with major surgery or major trauma preceeded the development of the condition in one third of cases. Although the condition is rare, yet it is much more serious than acute cholecystitis associated with cholelithiases. Gangrene and perforation is much more frequent [40% of cases] and the postoperative mortality rate is much higher [28%]. More awareness of the condition, early recognition and emergency surgery are recommended to minimise the hazards of perforation

Structural and functional effects of total porta-caval shunt on normal canine liver

Total deprivation of the normal canine liver from portal blood by end to side porta-caval shunt produced significant degenerative and regenerative changes in the liver. The dominant ultrastructural changes were dilatation and diminution in the amount of the rough endoplasmic reticulum with loss of its ribosomes, disorganisation of mitochondria, diminution in glycogen granules, increase in the amount of fat vacuoles and appearance of secondary lysosomes in considerable number. The hepatocytes showed progressive atrophy, fatty degeneration and eventual necrosis. Proliferative changes in the form of nodulation, portal tract fibrosis and cirrhosis occurred later. There was significant loss in the weight of the liver together with considerable loss of body weight and poor health of the animals. Liver function tests were within normal range inspite of the remarkable pathological changes in the liver. The study shows the vital role played by portal venous blood in maintaining the size, structure, architecture and function of the liver and the potential hazards attending total portal blood diversion

Structural and functional effects of porta-caval shunt below the superior pancreatico-duodenal [SPD] vein on normal canine liver

The structure and function of the normal canine liver are still intact after its deprivation from both mesenteric and splenic venous blood by end to side porta-caval shunt below SPD vein. Consequently the hepatic damage caused by total porta-caval shunt is mainly due to deprivation of the liver from the pancreatico-duodenal hormones, contained in the SPD vein. The study indicates that porta-caval shunt constructed below SPD vein allows the pancreatic hormones to perfuse the liver and prevents the serious consequences of total porta-caval shunt. The clinical importance of such a shunt is obvious as it may turn to be the ideal shunt for the surgical treatment of portal hypertension in the future

Assessment of the humoral immune mechanism in simple nodular goitre [SNG] and in malignant thyroid

Determination of the serum immunoglobulins and complement was carried out on ten patients with SNG and nine patients with malignant thyroid as compared with ten control subjects. IgG was significantly high and the complement was significantly low in malignant thyroid as compared with SNG. On the other hand, IgE was significantly high in SNG. Therofore determination of serum IgG, IgE and complement is of definite value in early detection of malignancy in SNG

Humoral immunity in nodular hyperthyroidism

Ten patients with diffuse hyperthyroidism and eight patients with nodular hyperthyroidism were studied as regards function of the thyroid gland [T[3], T[4], TSH and RAIU] and humoral immunity [IgG, IgM, IgA, IgE and complement]. The study showed that in our patients with nodular hyperthyroidism, although IgG was of normal level, yet the low complement with relatively high lymphocytic infiltration of the gland could be taken as points in favour of considering nodular hyperthyroidism to be an autoimmune disease