摘要:

Viral hepatitis accounts for substantial morbidity and mortality worldwide, To date, the molecular sequences of six hepatotropic viruses have been described and designated hepatitis A, B, C, D, E, and G. Various methods have been employed to decrease the occurrence of these diseases, and advances in vaccination strategies have aided in prevention of viral hepatitis. There are currently two FDA-approved vaccines licensed for use in the United States, aimed at eradication of hepatitis A and hepatitis B viral infection. A considerable amount of research has been devoted to the development of these vaccines, and progress has been made toward the development of vaccines aimed at the other hepatotropic viruses. In this article, the development and current status of the vaccines directed against the hepatitis viruses are reviewed.

ISSN:0257-2753    

DOI:10.1159/000171585

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Primary sclerosing cholangitis is an increasingly recognized cause of chronic cholestatic liver disease. The etiology is unknown, although a number of immunologic and nonimmunologic factors have been considered. The most important diagnostic findings are diffuse irregularity and narrowing of extrahepatic and intrahepatic bile ducts. The prognosis varies, and a number of relatively unique complications may develop. No adequate treatment exists, although a number of potential treatments have been evaluated. Liver transplantation still remains the most appropriate treatment for end-stage disease. These various topics related to primary sclerosing cholangitis are reviewed.

ISSN:0257-2753    

DOI:10.1159/000171586

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Fibrosis is a common end stage for most chronic liver diseases. It results from an imbalance between collagen production and degradation. One promising approach for prevention and treatment is the stimulation of coUagenolytic processes. In nonhuman primates it was found that polyenylphosphatidylcholine (PPC), extracted from soybeans, protects against alcohol-induced fibrosis and cirrhosis and prevents the associated hepatic phosphatidylcholine (PC) depletion by increasing 18:2-containing PC species; it also attenuates the transformation of lipocytes into collagen-producing transitional cells. Furthermore, it increases collagen breakdown, as shown in cultured lipocytes enriched with pure dilinoleoyl PC (18:2– 18:2 PC), the main PC species present in the extract, which may be the active ingredient. Since PC appears to promote the breakdown of collagen, there is reasonable hope that this treatment may affect not only the progression of the disease, but may also reverse preexisting fibrosis, as demonstrated for CGU-induced cirrhosis in the rat. Therefore, PPC may be useful for the management of fibrosis of alcoholic and nonalcoholic etiologies as well. S-Adenosylmethionine opposes CCU-induced fibrosis and can affect some of the consequences of the ethanol-induced oxidative stress in experimental animals and in man. Anti-inflammatory medications (corticosteroids, colchicine) are also being used and agents that interfere with collagen synthesis, such as inhibitors of prolyl-4-hydroxylase and antioxidants, are being teste

ISSN:0257-2753    

DOI:10.1159/000171587

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Enterohemorrhagic Escherichia coli (EHEC) have emerged over the last decade as important enteric pathogens because of their potential to induce both hemorrhagic colitis and fatal hemolytic uremic syndrome (HUS). HUS following EHEC colitis has become the leading cause of pediatric renal failure requiring kidney transplant in North America. The ability for EHEC to induce disease is dependent upon their ability to adhere to the intestinal mucosa in an intimate fashion, and to produce potent cytotoxins. These virulence factors (toxin production and enteroadherence) have been implicated in the pathogenesis of EHEC-induced disease. In this review we will discuss the symptomatology, epidemiology, laboratory diagnosis, pathogenesis, complications, treatment, and prevention of EHEC disease. We will review HUS with emphasis on treatment and prevention. Finally we will review animal models for EHEC infection in order to discuss their role in developing new strategies for the treatment and prevention of EHEC-associated diseases.

ISSN:0257-2753    

DOI:10.1159/000171588

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Recurrent peptic ulcer disease has traditionally posed problems for practicing physicians. While many treatment options have been promoted in the past, recent understanding of the role of Helicobacter pylori has completely altered our approach to this clinical problem. Since most ulcers are related to H. pylori infection or to ingestion of aspirin or non-steroidal anti-inflammatory drugs, improved understanding of these factors and the development of rational treatment approaches should limit recurrent peptic ulceration in the future. This should help improve our patients’ quality of life and should have a positive economic impact on the long-term treatment of peptic ulcer by reducing the requirement for continuous medical treatment. The issue of recurrent peptic ulceration and some approaches to management are discussed in this articl

ISSN:0257-2753    

DOI:10.1159/000171589

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Endoscopic esophageal dilation, laser therapy, and plastic and metal stent placement provide effective palliation of dysphagia in most patients with esophageal cancer. Because the techniques and indication are still being refined, the choice of endoscopic palliation should be based on patient-specific factors such as location and character of the tumor and more importantly on the availability of physician expertise.

ISSN:0257-2753    

DOI:10.1159/000171590

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

A 66-year-old man presented with severe chronic dysphagia and weight loss. A barium esophagogram revealed a proximal esophageal stricture and multiple pseudodiverticula. After death from aspiration pneumonia, a postmortem examination revealed extensive esophageal pseudodiverticulosis. Clinical presentation, pathogenesis, diagnosis, and management of this unusual disorder are reviewed.

ISSN:0257-2753    

DOI:10.1159/000171591

出版商:S. Karger AG    

年代:1997

数据来源: Karger

摘要:

Several experimental and clinical studies have shown that citrates are useful in dissolving calcifications and proteic plug in pancreatic ducts both of alcoholic etiology and in patients with chronic pancreatitis. Until now, using citrates to dissolve stones in clinical studies was performed orally with satisfactory medium-term results, including control of abdominal pain and eradication of shadows on X-rays. Laboratory studies have shown that these concretions dissolve quickly when such compounds are applied directly. This paper reports 2 women aged 27 and 40 with histories of chronic abdominal pain, and who, by abdominal X-ray and endoscopic retrograde cholangiopancreatography (ERCP), were shown to have multiple calcifications in the main and accessory pancreatic ducts. In both patients, endoscopic sphincterotomy of the bile and pancreatic segments of the sphincter of Oddi and introduction of a nasopancreatic catheter and intraductal infusion of citrates were performed. Radiological controls showed fragmentation and disappearance of calcifications. Clinically, there was complete absence of abdominal pain in the first week following the procedure. This is the first human study of intraductal administration of citrates to dissolve pancreatic lithiasis with highly favorable results.

ISSN:0257-2753    

DOI:10.1159/000171592

出版商:S. Karger AG    

年代:1997

数据来源: Karger

ISSN:0257-2753    

DOI:10.1159/000171593

出版商:S. Karger AG    

年代:1997

数据来源: Karger