摘要:

ABSTRACTIn order to study the acute effects of pharmacological agents on the vascular resistance of portal‐systemic collaterals, a model of total portal vein occlusion with 100% portal‐systemic shunts was developed in the conscious rat. The haemodynamic effects of several vaso‐active substances were evaluated in this model and compared with those obtained after saline administration. Prazosin (0.5 mg), an α1‐adrenergic antagonist, significantly reduced mean arterial pressure by 29%, portal pressure from 13.8 ± 1.0 (mean ± s.e.m.) to 10.1 ± 0.4 mmHg and portal tributary blood flow (radioactive microspheres) from 13.6 ± 2.1 to 11.7 ± 1.2 mL/min. It also decreased portal‐systemic vascular resistance from 95 ± 16 to 73 ± 9 dyn s/cm5x 103. Propranolol (4 mg), a β‐adrenergic antagonist, significantly reduced mean arterial pressure by 12% and portal pressure from 15.5 ± 1.2 to 13.3 ± 0.9 mmHg while reducing portal tributary blood flow from 14.6 ± 1.5 to 11.0 ± 1.7 mL/min and increasing portal systemic collateral vascular resistance from 88 ± 7 to 103 ± 8 dyn s/cm5x 103. Ketanserin (0.25 mg/kg), a 5‐hydroxytryptamine receptor antagonist, reduced portal pressure from 15.8 ± 1.0 to 13.3 ± 0.7 mmHg at a dose that did not alter mean arterial pressure or portal tributary blood flow. It achieved this by reducing portal‐systemic collateral vascular resistance from 90 ± 14 to 74 ± 13 dyn s/cm5x 103. Saline had no significant effect on systemic and splanchnic haemodynamics. This study shows that ketanserin decreases vascular resistance of portal‐systemic collaterals while propranolol increases it. Thus, it is suggested that collateral vascular resistance is access

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01018.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTA community health survey of 923 residents aged 30 years or more was performed in Putai Township of Taiwan. To elucidate the relationships between hepatitis C virus (HCV) and surrogate tests for non‐A, non‐B hepatitis in hyperendemic areas of hepatitis B virus (HBV) serum levels of alanine aminotransferase (ALT), triglycerides, cholesterol, hepatitis B surface antigen (HBsAg) and antibody to HCV (anti‐HCV) were examined. Glucose tolerance tests and the history of diabetes treatment were used to define the diabetes status. Fatty liver was diagnosed by sonography. The prevalence of anti‐HCV was 2.6% (95% confidence interval, 1.6–3.6%). Elevated ALT and fatty liver were significantly associated with anti‐HCV in univariate analysis. Anti‐HCV was not an associated factor for fatty liver after adjusting for serum triglycerides and cholesterol, sex, body mass index and diabetes status through multiple logistic regression. However elevated ALT was still associated with anti‐HCV after adjusting for serum triglycerides, sex, body mass index, HBsAg and age through multiple linear regression. The anti‐HCV prevalence was similar between HBsAg‐positive and negative subjects. Aggregation of HCV infection was found among spouses. It was concluded that elevated ALT and intimate contact with HCV carriers might be associated factors for HCV infection, and that HBV infection and fatty liver were not related to HCV

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01019.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTFirst generation serologic tests (ELISA‐1) for hepatitis C virus infection measure antibodies directed against a short non‐structural segment of the virus (anti‐c100‐3). A major disadvantage of this test is that it lacks sensitivity in the identification of hepatitis C virus among patients at risk of infection. Thus, only 70–90% of chronic non‐A, non‐B cases are ELISA‐1 positive. The present study set out to determine whether antibodies directed against the core region would be a more sensitive indicator of hepatitis C virus infection in patients with chronic non‐A, non‐B hepatitis. Sera were studied from 97 patients with raised serum alanine aminotransferase levels for more than 6 months in whom other causes of abnormal alanine aminotransferase were excluded. Using ELISA‐1, 85 sera (87%) were anti‐c100‐3 positive. Sera were then tested for presence of antibody directed against Po, a core peptide of a Japanese strain of hepatitis C virus, using an ELISA method. Eighty‐eight sera (91%) were anti‐Po positive. Among the 12 anti‐c100‐3 negative patients, six were anti‐Po positive. A second generation ELISA for anti‐HCV (ELISA‐2) incorporates a different antibody to the core region (c22‐3) in addition to an expanded non‐structural region, c200, which consists of c100‐3 plus c33c. With these tests, all sera but one were positive, including 11 of 12 ELISA‐1 negative and eight of nine anti‐Po negative sera. It is concluded that most patients considered to have chronic non‐A, non‐B hepatitis on exclusion and risk factor criteria have one or more markers of hepatitis C virus infection. Individual antibody tests against core or non‐structural regions appear to have similar sensitivities (85–90%), but the results supplement each other. Thus, the sensitivity of a commercially available second generation ELISA test (which combines one core and two non‐structural antibodies) approached 100% in this study and

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01020.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTA mathematical model was used to calculate the efficacy of screening to detect hepatocellular carcinoma at a resectable stage in hepatitis B virus carriers. Data relating to tumour incidence, efficacy of screening tests and tumour growth times were obtained from a literature review. Various tests were costed according to charges currently prevailing at the authors’ institution. The cost per early tumour detected is inversely proportional to tumour incidence. It is relatively low for populations with high incidences of hepatocellular carcinoma for example, male carriers over the age of 30. Both the costs and the proportions of early tumour detected increase with increasing frequency of screening. However, the use of ultrasonography at 10 monthly intervals or both ultrasonography and α‐fetoprotein estimation at yearly intervals will detect 90% of tumours early at a cost of S$20 000 (US$11 800) per early tumour detected. The results would be significantly altered if tumour growth times were markedly different from those reported in the litera

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01021.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTThe accuracy of ultrasonographic diagnosis of hypoechoic focal fatty change in the ‘bright liver’ was evaluated in 40 lesions found in 35 patients followed up for a mean period of 37.8 months. Patients with ultrasound and laboratory findings suggesting liver cirrhosis were excluded from the study.All patients underwent a blind liver biopsy in order to verify the diagnosis of diffuse disease suggested by the finding of ‘bright liver'. No guided biopsy was performed on the focal lesions in order to establish the accuracy of ultrasound alone in recognizing focal fatty change.Clinical, haematologic and echographic follow‐up confirmed the diagnosis in all cases. All histological specimens revealed liver steatosis, indicating a 100% sensitivity of ultrasonography in identifying non‐cirrhotic fatty liver with an accompanying focal change.Increased echogenicity and hypoechoic focal changes are reliable indicators of fatty infiltration, making ultrasonography an acceptable, non‐invasive method for the diagnosis of live

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01022.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTThree patients with submassive hepatic necrosis developed acute liver failure during the severe reactivation of chronic hepatitis B. The activity of hepatitis B virus (HBV) DNA polymerase increased in all three patients immediately before the onset of hepatic failure. Liver biopsy specimens obtained before and after the episode of submassive hepatic necrosis showed progression to advanced liver cirrhosis.The nucleotide sequences of the precore and core regions of HBV‐DNA were investigated in two of the three patients and in another two patients with piecemeal and bridging necrosis. The nucleotide and amino acid sequences of the HBV‐DNA core region changed after reactivation in the the two patients with submassive hepatic necrosis, while the sequences in the other two patients with piecemeal necrosis remained unchanged before and after reactivation. These results suggest that the antigenicity of the HBV‐DNA core region may have been changed before and after severe reactivation. Due to mutation at the core region, a different type of epitope would be expressed on the hepatocytes after submassive hepatic necrosis, which would not be a target for the cytotoxic T cell. This was evident by the continuation of the normal serum GPT for 5 and 9 years, respect

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01023.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTTo determine the role of platelet‐activating factor (PAF) in endotoxin‐induced portal hypertension, we performed continuous recording of both blood pressure (BP) and portal venous pressure (PVP) in rats following the administration of intravenous PAF (25 ng/kg), intraportal PAF (25 ng/kg), intraportal endotoxin (2 mg/kg), and intraportal endotoxin (2 mg/kg) for 1 min subsequent to pretreatment with a specific PAF‐antagonist (CV‐6209, 1 mg/kg, i.v.). Basal resting values of both BP (102.3 ± 9.3 mmHg) and PVP (7.7 ± 1.2 mmHg) fell rapidly after intravenous infusion of PAF (BP: 36.7 ± 5.8 mmHg; PVP: 5.7 ± 0.8 mmHg) and followed by gradual return. Intraportal PAF infusion elicited a rapid but less severe depression of BP (57.2 ± 9.4 mmHg) as compared with intravenous PAF infusion, whereas PVP was increased transiently around 4 min after treatment (11.0 ± 5.3 mmHg). A similar degree of PVP elevation (10.7 ± 2.0 mmHg) was observed between 8 and 20 min after intraportal administration of endotoxin. Depression of BP was initiated 12 min after endotoxin administration but was not severe (76.6 ± 12.8 mmHg). CV‐6209 significantly alleviated the endotoxin‐induced elevation of PVP and completely inhibited the hypotension. These observations suggest that: (i) PAF‐induced elevation of PVP is a direct response of the liver to PAF; and (ii) endogenous PAF plays an important role in the endotoxin‐indu

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01024.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTThe three‐dimensional ultrastructure of nuclei and cell organelles including rough‐surfaced endoplasmic reticulum (RER), mitochondria, and cytoskeleton were studied in normal rat hepatocytes by the quick‐freezing and deep‐etching method. Peroxisomes and mitochondria were observed as spherical structures with granular matrices. Peroxisomes were identified by their size and matrices, which were more condensed than those of mitochondria. Ribosomes were identified as granular structures and were attached to the surface of endoplasmic reticulum. Cytoskeletal filaments were identified by their differences in diameter on the replica membranes, as well as in conventional ultrathin sections. Microfilaments were mainly localized around the bile canaliculi and adjacent to sinusoids. Intermediate filaments were observed around the bile canalicular microfilaments. Only a few filaments were observed near the lateral plasma membranes. Cross‐bridges measuring 5–7 nm in diameter were localized between the lamellae of RER and the surface of mitochondria. The quick‐freezing and deep‐etching method could be used to clarify the three‐dimensional association between the cytoskeleton and membrane‐bound organe

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01025.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTNinety‐one (11.4%) subjects with hypercholesterolaemia (serum cholesterol level more than 250 mg/dL) of 792 Chinese patients with hepatocellular carcinoma (HCC) were studied in Taiwan. All 91 patients had large tumours greater than 7 cm in diameter and a tumour volume greater than 50%; 56 (61%) of these patients manifested tumour involvement in both lobes of the liver. The HCC patients with hypercholesterolaemia had significantly higher mean serum levels of albumin, triglyceride and α‐fetoprotein (AFP) compared with age‐sex‐tumour volume matched HCC patients without hypercholesterolaemia. The associated incidence of hypoglycaemia in hypercholesterolaemic HCC patients was significantly higher than in HCC patients without hypercholesterolaemia (15/90vs4/90;P= 0.01). There was no significant difference in the survival analysis between HCC patients with and without hypercholesterolaemia. Eight and 11 of hypercholesterolaemic HCC patients had their tumours surgically resected and received transcatheter hepatic arterial chemoembolization (TAE), respectively. Serum cholesterol levels fell to the normal range after treatment and rose to abnormal levels again when tumours recurred after surgery or progressively enlarged after TAE. The change in pattern of serum cholesterol was parallel to the change in serum AFP. Serum cholesterol levels may serve as another marker in identifying tumour recurrence and the presence of a viable tumour mass in hypercholesterolaemic HCC patients who have received surgical resectio

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01026.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY

摘要:

ABSTRACTThe hydroxyl radical is the most potent free radical derived from oxygen, and has been implicated in damage caused to the gastroduodenal mucosa. The ability of human gastric juice to generate hydroxyl radicals has been investigated in 54 adults with endoscopically normal gastroduodenal mucosa and in 39 patients with chronic duodenal ulcer. Hydroxyl radical production was measured by the formation of formaldehyde from dimethylsulfoxide. Unlike other body fluids, this reaction could proceed without the extraneous addition of catalysts such as hydrogen peroxide (H2O2), ascorbate and iron. Measurement of H2O2, iron and ascorbate showed that these catalysts are already present in the gastric juice. There was no significant difference in the concentration of these components in gastric juice between normal subjects and patients with duodenal ulcer, except that H2O2levels were slightly higher in duodenal ulcer patients. Although generation of free radicals has been investigated in other body fluids, this is the first reported case regarding the production of these active species in normal human gastric juice. Since hydroxyl production is not significantly enhanced in duodenal ulcer, we suggest that attention may be turned to mucosal antioxidant defences in this disease.

ISSN:0815-9319    

DOI:10.1111/j.1440-1746.1992.tb01027.x

出版商:Blackwell Publishing Ltd    

年代:1992

数据来源: WILEY