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Recently we demonstrated that rat glioma cells when transfected with a vector encoding antisense IGF-I c-DNA lost tumorigenicity and induced a tumor specific immune response involving CD8+ lymphocytes. Here we showed, using immunostaining flow cytometry analysis, that the transfected cell lines, rat C-6 glioma and rat LF hepatoma, expressed an increase level of MHC-class I, and even the amount of MHC-I was found to be higher in the transfected hepatoma, than in the transfected glioma cells. This increased expression of MHC-I could contribute to the final immune recognition of tumour immunogenicity.

In a diabetic liver transplant recipient, immunosuppressed with FK 506, a severe digestive moniliasis required treatment with the antifungal imidazole derivative fluconazole. This was followed by a brisk rise in serum creatinine levels, which returned promptly to baseline when this combination was stopped. Serial measurements of FK 506 concentrations in plasma showed excessive areas under the 24 h time-concentration curve and trough levels during the concomitant intake of imidazole antifungals and FK 506. Eighteen months later, this patient presents with normal renal function. Antifungal imidazole derivatives inhibit the P 450 cytochrome enzyme system and may thus decrease the catabolism of FK 506. Meticulous monitoring of FK 506 trough levels and dosage adaptation are compulsory when concomitant treatment with such a drug is unavoidable. The same is true for cyclosporine in auto-immune diabetic patients receiving cyclosporine A.

Liver biopsies obtained from 10 liver transplant patients for whom a cytomegalovirus (CMV) hepatitis was suspected on the basis of clinical and biological abnormalities have been studied by an immunohistological method using the monoclonal antibody E-13 directed against an early viral antigen. Biopsies were performed between the 30th and the 77th day after transplantation. In 7 of the 10 cases, CMV hepatitis was diagnosed by histological examination because of the association of lobular cytolysis, inflammatory infiltrate with neutrophils and intranuclear inclusions. Ten cases were positive with the E-13 antibody including the 3 cases in which histological examination was not conclusive. In all cases, positive results gave a nuclear staining pattern in hepatocytes (63%) or endothelial cells (40%), independently of the presence of inclusions. Rapid diagnosis of CMV hepatitis is of significant importance since anti-viral drugs, such as DHPG (Ganciclovir), are now efficient. The immunohistochemical method with E-13 could permit easy and rapid detection of CMV in liver specimens.

The cause of upper gastrointestinal bleeding was studied in 85 cirrhotic patients by emergency endoscopy. In every patient, one or several lesions were observed and the site of bleeding was ascertained in 59. The two main causes were oesophago-gastric varices (46 p.cent) and acute mucosal lesions(42 p.cent). The source of bleeding appeared to be related to the degree of liver function impairment. In patients with no or moderate liver function impariment, bleeding usually originated from varices or from drug-associated mucosal erosions. Patients with severe impairment of liver function most often bled from spontaneous acute oeso-gastro-duodenal ulcerations. These ulcerations resembled what has been described in "stress" hemorrhage. Because of the relationship between liver function and the cause of hemorrhage, mortality was lower in variceal bleeders (29 p.cent) than in patients with spontaneous ulcerations (83 p.cent). In patients with severely impaired liver function, portacaval shunt was rarely indicated since hemorrhage was generally due to acute mucosal ulcerations.

Conflicting results have been reported on the influence of portacaval anastomosis on liver carcinogenesis. The purpose of this investigation was to study the effect of portal diversion on liver carcinogenesis induced in the rat by a potent chemical liver carcinogen, Aflatoxin B1 (AFB1). Liver tumors appeared earlier and were significantly bigger in rats with shunts than in sham-operated controls. Portal diversion also induced in rats fed AFB1 a splenic atrophy with nearly complete disappearance of Malpighian corpuscles suggesting a profound immunodepression. This might be responsible for the enhancement of liver cancer by portacaval anastomosis in the rats fed AFB1. Thus, the influence of portal diversion on liver cancers appears to be multifactorial.

For the diagnosis of jaundice, a comparison is established between a classical diagnostic attitude and a decisional attitude which consists in guiding and restricting the investigations according to the therapeutic possibilities. It appears from the comparative study of the two groups of patients that the decisional attitude is better, resulting in a treatment which occurs earlier, is less expensive and probably of a better quality.

The organization of the diurnal sleep pattern was studied in control rats and in rats with end-to-side portocaval shunt before operation and during five weeks after operation. In control rats, no modification of the states of sleep was observed during the experimentation. In shunted rats, the total duration of waking increased, the total duration of slow wave sleep and paradoxical sleep decreased. The number of phases of waking and slow wave sleep increased and the number of phases of paradoxical sleep decreased. The mean duration of the phases of slow wave sleep decreased. These results show that the electrophysiological expression of experimental hepatic encephalopathy is similar to the electroclinical expression of hepatic encephalopathy in man and the polygraphic study of sleep disturbances permits the description of the encephalopathies.

A retrospective study of selective angiography of the coeliac axis and superior mesenteric artery was conducted in 60 patients having a pancreatic disease. The purpose of this study was to precise the frequency, the specificity and the diagnostic value of each radiological sign in malignant and non malignant pancreatic affection. In patients with cancer of pancreas, the best radiological sign are the presence of an arterial obstruction, an irregular arterial stenosis, a venous obstruction or a parenchymal hypervascularization. In patients with benign affections, the most significant signs are á regular arterial stenosis alore or associated with an arterial involvement or the association of at least two of the three following signs: regular arterial stenosis, arterial involvement and venous compression. Using this signs, a correct diagnosis can be done, a posteriori, in 82% of the malignant pancreatic affections and in 76% of the benign pancreatic disease.

Embolization of the aeso-cardiotuberositary varices, by selective catheterization of the coronary vein of the stomach and the posterior gastrics, seems to be valuable palliative treatment in portal hypertension, owing to its relative innocuousness, inspite of a certain number of failures. It is carried out by transhepatic puncture of the portal system or catheterization of the umbilical vein.

The present clinicopathological study concerns 22 cases of hepatocellular carcinoma in non cirrhotic liver; they all underwent hepatectomy performed in the same surgical unit, and this group is clinically homogeneous. This cancer shows higher frequency in males (17/22), and in ages between 40 and 72. No etiologic relevance is shown. An abdominal mass is detected as first clinical symptom. Macroscopically: the tumor most often appears as a chief nodule 2-4 cm in diameter surrounded by smaller ones, always in close proximity. Histologically: the tumors are usually well or rather well differentiated hepatocarcinomas; 4 of them are fibrolamellar. Because of these macroscopical features and because of the absence of metastasis at the time of laparotomy even in case of recurrence, partial hepatectomy seems justified. A rich reticulin framework and its even distribution seem to be the best morphological signs indicating good prognosis. Long lasting survival, exceeding 11 years for one patient, concerns chiefly fibrolamellar tumors.

Electrocorticographic recordings were analyzed in two groups of Wistar rats with end-to-side portacaval shunt and sham portacaval shunt. The main electrical abnormalities observed in the shunted rats concerned slow wave sleep. Quantitative evaluation of these disturbances was made by measuring the duration of spindles normally present in this phase of sleep. Longer duration of the spindles appears to be a reliable index of electrocorticographic disorders after portacaval shunt in the rat.