Recent studies have suggested a pathogenic role of human parvovirus B19 (B19) in the development of acute fulminant liver failure in children. The hypothesis was based on the detection of B19 DNA in 8 of 10 explanted livers of children requiring liver transplantation. In the present study, explanted livers from 43 adults selected at random undergoing orthotopic liver transplantation for various reasons were examined. Pre-transplant sera were available from 40 patients of whom 35 (88%) were anti-B19 IgG-seropositive. All but one serum were negative for anti-B19 IgM antibody. By polymerase chain reaction, B19 DNA was detected in the livers of 15/35 (43%) anti-B19 IgG-positive patients, in 2/3 livers of patients with unknown anti-B19 antibody status, and in the initial transplant of an anti-B19 IgG-positive patient who underwent liver retransplantation, and whose own liver was negative for B19 DNA. In a second study group, liver and bone marrow samples from 23 autopsied adults selected at random were tested. Serum specimens were available from 22 individuals, of whom 17 (77%) were anti-B19 IgG-seropositive. All sera were negative for anti-B19 IgM antibody. B19 DNA was detected in the livers of 4/17 (24%) anti-B19 IgG-positive individuals, three of whom had also B19 DNA in their bone marrow. This is the first report demonstrating that B19 DNA is frequently present in livers of anti-B19 seropositive adults suggesting persistence of B19 in the liver. Further studies are needed to address whether B19 is an innocent bystander in the liver or whether the presence of B19 in liver is of biological and clinical significance.

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L-carnitine represents a feasible metabolic adjunct for a safe and more successful preservation of ischemia-reperfusion-sensitive steatotic livers.

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Background and Aims: Up to now, various tumor markers have been proposed for the detection of the onset of malignant cell transformation or the better follow-up of cancer patients. The aim of the present study is to investigate the diagnostic value of systemic lipid peroxidation as an additional evaluative tool in the follow-up of surgical patients with colorectal cancer in combination to the clinically routine tumor markers carcinoembryonic antigen (CEA) and carcinoantigen 19-9 (CA 19-9). Patients and Methods: 36 patients with a colorectal carcinoma were included in this study. Blood samples were collected 1 day prior to the operation, 10 days and 1 year after the operation. Oxygen free radical mediated lipid peroxidation was determined by measurement of thiobarbituric acid-reactive substances in the same serum that were used for the determination of tumor markers. Results: Compared to control values, a highly significant increase of lipid peroxidation was found in the serum of all colorectal carcinoma patients up to the first 10 postoperative days. Differentiation of the patients, according to the T-stage, showed a marked and more obvious tendency towards higher serum lipid peroxides with increased tumor stage when compared to the conventional tumor markers. One year postoperatively the serum levels of lipid peroxidation returned to nearly normal values. Also the conventional tumor markers CEA and CA 19-9 showed a relative rise in the levels with the respective tumor stage, but differences were only statistically significant in the highest T-categories. Conclusion: After curative resection of the tumor, the level of systemic lipid peroxides decreases to normal values. We conclude from these results that the tumor is the primary cause of the increased systemic lipid peroxides.

In 1700, the French surgeon Alexandre de Littré described for the first time a new form of inguinal hernia. This hernia varied from the known forms of hernias in its clinical course and in the postmortem examination results performed by Littrè himself. The characteristic feature of this hernia was the fact that the entire circumference of the bowel wall was not part of the hernial sac, but only the antimesenteric part of the intestinal wall. The underlying pathomechanism was explained 100 years later by Meckel. In a scientific paper about hernias some years earlier, Richter described the intestinal wall hernia, and this initiated the confusing use of the clinical entity known as the Richter-Littré hernia in Germany. In this case report we describe the historic development of this entity.

The purpose of this article is to review the etiology, clinical presentation and treatment options of visceral artery aneurysms (VAA) on the basis of our experiences. Visceral artery aneurysms are uncommon lesions with a frequency of 0,1-0,2 % in autopsy statistics. In fact many visceral artery aneurysms still present first with a rupture (22 %) and despite emergency laparotomies the mortality rate is about 8,5 %. The course of disease often is disastrous due to rupture of the aneurysms or thromboembolic complications, emphasizing the importance to be aware of this differential diagnosis of abdominal pain. This article covers 9 patients with VAA. 3 patients each revealed an a. lienalis aneurysm and a. gastrica aneurysm, resp. In the other 3 patients an aneurysm of the a. gastroepiploica, the a. pancreatico-duodenalis and the a. mesenterica superior resp. was proven. In 8 of 9 patients a surgical therapy of the VAA took place. Only 2 patients (22 %) were interventionally treated. 1 patient deceased due to postoperative hemorrhage. Both the surgical and the radiological intervention therapy are available for treatment of the VAA. The decision on the choice of the therapeutic procedure should be made on an individual basis.

In this study, the importance of antioxidants during oxygenated liver preservation has been investigated. Livers were excised from rats after 60 min of cardiac arrest and stored for 24 h at 4 degrees C in University of Wisconsin solution (UW). Gaseous oxygen was applied to the livers during the storage period via the caval vein after superoxide dismutase (SOD, 600 U/mL), taurine (0.5 mg/mL), or no antioxidant was applied to the graft with the rinse solution. It was shown that oxygen persufflation significantly enhanced the viability of livers during cold preservation only in combination with SOD or taurine, which were both equally effective in reducing lipid peroxidation, enzyme release, and vascular resistance upon postischemic reperfusion. An increase in hepatic bile production was also observed.