Cerebral blood flow and metabolism in patients with chronic liver disease undergoing orthotopic liver transplantation

Barbara J. Philips, Ian R. Armstrong, Anthony Pollock, Alistair Lee – 30 December 2003 – Changes in cerebral hemodynamics and metabolism associated with anesthesia and liver transplantation may present particular hazards for patients with cirrhosis. Fifteen patients undergoing liver transplantation were studied, 7 of whom had encephalopathy. Cerebral blood flow (CBF) was measured at the start of surgery, during veno‐venous bypass and post reperfusion, using a method based on the Kety‐Schmidt method.

Hepatitis B virus with antigenically altered hepatitis B surface antigen is selected by high‐dose hepatitis B immune globulin after liver transplantation

Ulrike Protzer‐Knolle, Uta Naumann, Ralph Bartenschlager, Thomas Berg, Uwe Hopf, Karl‐Hermann Meyer zum Büschenfelde, Peter Neuhaus, Guido Gerken – 30 December 2003 – “Escape” variants of hepatitis B virus (HBV) can cause infection despite previous immunization. These viruses show alterations of the immunogenic major hydrophilic loop of the HBV small surface protein (s‐protein).

A two‐year prospective study of the effect of ursodeoxycholic acid on urinary bile acid excretion and liver morphology in cystic fibrosis–associated liver disease

Anders Lindblad, Hans Glaumann, Birgitta Strandvik – 30 December 2003 – The efficacy of 2 years of treatment with ursodeoxycholic acid (UDCA) in cystic fibrosis (CF)‐associated liver disease was evaluated by liver biopsies and liver function tests in 10 patients aged 8 to 28 years. The metabolism of UDCA was investigated by analysis of urinary bile acids with fast atom bombardment mass spectrometry (FABMS) and gas‐liquid chromatography–mass spectrometry. Eight patients responded with normalization of liver function tests (LFT) and all with decreased serum levels of immunoglobulin G (IgG).

Carrier‐mediated entry of 4‐methylumbelliferyl sulfate: Characterization by the multiple‐indicator dilution technique in perfused rat liver

Masato Chiba, Andreas J. Schwab, Carl A. Goresky, K. Sandy Pang – 30 December 2003 – The hepatocellular entry of 4‐methylumbelliferyl sulfate (4MUS) a highly ionized and highly bound anion capable of futile cycling, was examined in the single‐pass albumin‐free perfused rat liver preparation. Desulfation of 4MUS to 4‐methylumbelliferone (4MU) was verified in vitro to be a low‐affinity, high‐capacity process (Km= 731 μmol/L;Vmax= 414 nmol min−1g−1 liver).

Nitric oxide suppression reversibly attenuates mitochondrial dysfunction and cholestasis in endotoxemic rat liver

Masaya Shiomi, Yoshiyuki Wakabayashi, Tsuyoshi Sano, Yuichi Shinoda, Yuji Nimura, Yuzuru Ishimura, Makoto Suematsu – 30 December 2003 – This study aimed to examine whether nitric oxide (NO) plays a causal role in endotoxin‐induced dysfunction of biliary transport. Rats were treated with intraperitoneal injection of endotoxin (O111B4, 4 mg/kg). At 2 hours, the liver was excised and perfused ex vivowith taurocholate (TC)‐containing Krebs‐Ringer solution under monitoring bile output and NO2in the perfusate and tissue cyclic guanosine monophosphate (cGMP) levels as indices of NO production.

Enhanced cyclooxygenase‐1 expression within the superior mesenteric artery of portal hypertensive rats: Role in the hyperdynamic circulation

Ming‐Chih Hou, Paul A. Cahill, Shuangmin Zhang, Yi‐Ning Wang, Richard J. Hendrickson, Eileen M. Redmond, James V. Sitzmann – 30 December 2003 – Portal hypertension (PHT) is characterized by splanchnic hyperemia due to enhanced production of vasodilator substances. Enhanced vasodilation and increased splanchnic blood flow contribute to the elevated portal pressure characteristic of PHT. The aim of this study was to determine whether cyclooxygenase (Cox) expression is altered in PHT vessels and whether chronic inhibition of this enzyme impacts on splanchnic blood flow in PHT.

Variceal pressure is a factor predicting the risk of a first variceal bleeding: A prospective cohort study in cirrhotic patients

Frederik Nevens, Rami Bustami, Ilse Scheys, Emmanuel Lesaffre, Johan Fevery – 30 December 2003 – Predictive criteria for a first variceal hemorrhage lack substantial accuracy. Cross‐sectional studies suggest a close relationship between variceal pressure (VP) and the occurrence of variceal bleeding. In the present prospective cohort study, the significance of VP measurement for prediction of a first variceal bleed was assessed. Eighty‐seven patients with cirrhosis and large esophageal varices who had never developed variceal bleeding were followed for 12 months.

Therapy of hepatitis C: Patients with cirrhosis

S W Schalm, G Fattovich, J T Brouwer – 30 December 2003 – The management of both compensated and decompensated cirrhosis caused by hepatitis C must be viewed in the context of the natural history of the disease. The prognosis of compensated cirrhosis caused by hepatitis C is relatively good. In a recent retrospective study, after 5 years of follow‐up evaluation, 18% of patients had developed hepatic decompensation and 7% hepatocellular carcinoma. Overall 5‐year survival rate was 91%.

Side effects of α interferon in chronic hepatitis C

G Dusheiko – 30 December 2003 – Alpha interferons have been used widely to treat chronic hepatitis C virus infection. These include recombinant interferons, purified natural leukocyte, and lymphoblastoid interferons. Alpha interferon is administered by subcutaneous or intramuscular injection either daily or three times weekly for a period of 6 to as long as 24 months. A wide array of adverse effects of α interferon have been described. Several side effects such as fever, headache fatigue, arthralgias, and myalgias are common, especially with the initial injections.

The prevalence of surface antigen variants of hepatitis B virus in Papua New Guinea, South Africa, and Sardinia

W F Carman, F J Van Deursen, L T Mimms, D Hardie, R Coppola, R Decker, R Sanders – 30 December 2003 – Three assays, one based on monoclonal antibodies and the others on polyclonal antibodies, were employed to detect hepatitis B surface antigen (HBsAg)‐reactive samples in both vaccinated and unvaccinated populations in areas of the world where hepatitis B virus (HBV) is endemic.

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