Biochemical parameters which may be useful in improving organ viability after storage.

Biochemical methods that accurately detect ischemic damage in livers stored by flush cooling would be useful in the efficient development of new storage solutions. This study compares UW and Collins' solutions to evaluate those biochemical parameters which may be useful in assessing the reversibility of ischemic damage and the efficiency of organ storage solutions. Livers stored in UW solution showed higher levels of adenine nucleotides at all storage times studied. This increase in adenine nucleotides averaged 29% and was statistically significant. There was also a significant increase in the NAD levels in organs stored in UW solutions; however, the ATP levels were not significantly different after storage in either solution. Storage of livers in UW solution also decreased the amount of DNA damage which occurs with storage as compared to storage in Collins' solution, becoming statistically significant after 48 hr of storage. This suggests that these biochemical parameters may be useful in designing improved storage solutions since they reflect the extent of ischemic damage to the organ and can be determined on a small section of liver taken by biopsy.

Oncofetal antigen-I: distribution in human tumors.

Oncofetal antigen-I (OFA-I) is a human tumor-associated fetal antigen that cross-reacts with fetal brain. The biological distribution of this antigen was studied in a variety of histologic types of human tumors and normal tissues. A total of 170 human tumors and 89 normal tissues obtained from biopsied and autopsied specimens were tested by immune adherence absorption assay. The antigen was most prevalent in malignant melanomas (82%); next in order of incidence were lung carcinomas (71%), sarcomas (61%), brain tumors (58%), and breast carcinomas (53%). However, OFA-I was found in only 15% of gastrointestinal tumors. The four hepatoma specimens tested were negative for OFA-I. OFA-I was also present in metastases and normal-appearing tissues of patients with OFA-I positive tumors but was not found in normal tissues from noncancer patients. These studies demonstrated that OFA-1 is widely distributed among human tumors. It appears to be more prevalent in tumors of ectodermal and mesodermal origin.

Altered lymphatic drainage following lymphadenectomy.

Radionucleotide scanning with colloidal 198Au and 99Tc sulfur colloid was used to evaluate preoperative and postoperative lymphatic drainage in 10 patients with primary malignant melanoma of the trunk. After an intradermal injection of radionucleotide aroung the primary melanoma site, tomographic scanning was performed to identify the regional lymph nodes to which the radionucleotide drained. Approximately one year following lymphadenectomy, each patient was rescanned to see if the lymphatic drainage had changed. Of the 10 patients tested, 8 had postoperative drainage patterns that differed from the preoperative scans. Three patients had no drainage to the lymphadenectomy site, which two patients retained some drainage to the lymphadenectomy sites but also showed drainage to a new site. One patient retained drainage to only one of two preoperative sites, and 2 patients had no identifiable lymphatic drainage postoperatively. Thus, interruption of lymphatic channels is temporary, and new routes that may differ from preoperative ones generally develop within one to two years.

Role of ultrasonography in the primary diagnosis of cholelithiasis: an analysis of fifty cases.

The use of ultrasonography to diagnose cholelithiasis has recently been recommended to supplement standard reinforced oral cholecystography or as an alternative to reinforced oral studies when a single dose fails to visualize the gallbladder. As yet the use of ultrasonography in the primary diagnosis of cholelithiasis is not generally accepted. To assess the specificity and sensitivity of this mode of diagnosis, fifty patients were reviewed retrospectively. The findings of ultrasonography are compared with standard oral cholecystography and with the pathologic findings. The results of this analysis suggest that diagnosis of cholelithiasis by ultrasonography has a high level of accuracy. Use of this mode of evaluating the gallbladder is suggested as a primary diagnostic test for jaundiced or pregnant patients.