PubMed · 4780500
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E I Gal'perin. 1973. [Obstructive jaundice].. https://pubmed.ncbi.nlm.nih.gov/4780500/
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Rapid and safe gallbladder clearance from residual, post-MTBE stone debris is believed to be absolutely necessary to reduce stone recurrence after contact litholysis. Because the clearing effect of prokinetic agents is considered an uncertain postdissolution trial, we investigated by in vitro experiments whether and to what extent debris from various cholesterol and "mixed stones" could be removed by direct (topical) chemolysis. Debris from radiolucent cholesterol stones could be dissolved very easily, using the aqueous solvent S-01, composed of EDTA-2Na (1-2%), lauryl sulfobetaine-12 (0.1 M), and 0.1 M sodium carbonate/boric acid buffer, pH 9,5. Its dissolution capacity (DC) was 8.06 +/- 2.3 mg debris/ml and its dissolution efficacy (DE) was 16.2 +/- 4.6 mg debris/ml/hr. Debris from mixed, slightly to moderately calcified stones needed another treatment with S-05, composed of sodium citrate (0.25 M), lauryl sulfobetaine-12 (0.01 M), and citric acid. The initial pH was 5.2. The DC of S-05 ranged from 1.61 +/- 1.1 (debris enriched with Ca-phosphate) to 3.94 +/- 1.3 mg/ml (debris enriched with Ca-carbonate). Stones which did not respond immediately to MTBE because of a thin rim of inorganic or/and organic Ca salts could be made ready for MTBE litholysis by pretreatment with S-01 or S-05 or with a combination of both solvents. Debris containing large portions of biliary mucus could be dissolved most effectively by successive application of S-01 and S-06 (2 M urea).
The delineation of T helper cell subsets into T helper type 1 (Th1) and T helper type 2 (Th2) populations based on the production of specific cytokines has been useful in understanding the regulation and progression of immune-based pathologies. In order to test the relevance of this concept to human solid organ transplantation, in situ and system Th1 and Th2 cytokine profiles were characterized in liver allograft recipients. Bile and serum samples obtained posttransplant were analyzed for the cytokines IL-2, IFN-gamma, IL-4, and IL-10. Significant elevations of IL-4 and IL-10 were measured at the site of graft rejection. In contrast, IL-2, IFN-gamma, and IL-4 were markedly elevated in the circulation during rejection. Analyses of sequential bile samples revealed that Th1 and Th2 cytokines showed similar kinetics of production in response to alloantigen. Taken together, these results indicate that acute rejection of human allografts can proceed [correction of procede] in the presence of minimal levels of the Th1 cytokines IL-2 and IFN-gamma and high levels of IL-4 and IL-10.