Abstract
• ~-ACID GLYCOPROTEIN IS INCREASED AND ASSOCIATED WITH RAPID NUCLEATION IN GALLBLADDER BILE WITH MULTIPLE CHOLESTEROL GALLSTONES BUT NOT WITH SOLITARY CHOLESTEROL OR PIGMENT GALLSTONES. Masato Abel, Naomi Tanaka, Shinji Tomita, Junichi Shoda, Takashi Yamaguchi*, ~ t s u z a k i , Toshiaki Osuga. Dept. of Gastroenterology, Institute of Chical Medicine, University of Tsukuba, and *Dept. of Gastroenterology, National Mito Hospital, Ibaraki, JAPAN. We have reported that the biliary a,-acid glycoprotein(AAG) promotes cholesterol(eho)-crystallization in vitro(Gastroenterology 106:231,1994) and that its level is elevated in gallbladder bile(GBE) with multiple(m) cho-gallstone (GS)(Hepatology 16:154A,1992). It is not known whether biliary AAG level is altered in GBB with other types of GS. AIM: To determine the precise role of biliary AAG in GS pathogenesis, AAG levels in GBB with different types of GS and their association with rapid NT were studied in comparison with control biles. METHODS: GBB was obtained during operation from 20 controls without GS and from 48 GS patients. GS were classified into 33 choI-GS(13 solitary(s), 20 m) and 15 pig-GS(10 s, 5 m) based on visual inspection and chemical analysis. AAG in GBB was measured by specific ELISA. RESULTS: As shown in the Table, CSI was higher and NT was shorter in GBB with cho-GS than in GBB with pig-GS or control biles. NT of m-cho-GS was shorter than that of s-cho-GS, but CSI was not different in both groups. Both AAG and AAG/total protein were significantly higher in GBB with m-cho-GS than in GBB with s-cho-GS, pig-GS or in control biles. Both AAG and AAG/total protein were significantly correlated with NT(r=-0.49; P 100 Ixg/ml, all of which were associated with very rapid NT, whereas only 1 of 13 m-choI-GS, none of 15 pig-GS, 1 of 20 controls showed AAG>100 pg/ml(p 100 p.g/ml for m-chol GS were 0.50, and 0.96, respectively. Table *p <january 1989), previous history of jaundice, asoites, encephalopathy and serum sodium. Only date of transplantation and serum sodium were kept in the final multivariate model. Our study shows that besides improvement of technical skill and peroperative management, only sodium influence 30 days mortality after liver transplantation.
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