P. Aiden McCormick, Graham L. Kaye, Lynda Greenslade, Fabrizio Cardin, Kenneth E. F. Hobbs, Neil McIntyre, Andrew K. Burroughs – 1 March 1992 – It is not clear which therapy should be used in patients with bleeding esophageal varices that are not controlled by emergency sclerotherapy. This is a high‐risk group with reported mortality rates of between 70% and 90%. We report our 7‐yr experience with staple transection of the esophagus in this patient group. Of 168 patients (280 bleeding episodes) treated with sclerotherapy, 22 had emergency staple transection for failure to control bleeding.

Patricia Sheiner, Wilfred de Majo, Gary A. Levy – 1 March 1992 – Background. When administered early after an overdose of acetaminophen, intravenous acetylcysteine prevents hepatic necrosis by replenishing reduced stores of glutathione. How acetylcysteine improves the survival of patients with established liver damage induced by acetaminophen, however, is unknown. This study was undertaken to determine whether the beneficial effect of acetylcysteine under such circumstances could be due to enhancement of oxygen delivery and consumption.

Satoru Todo, Thomas E. Starzl, Andreas Tzakis, Keith J. Benkov, Frantisek Kalousek, Takeyori Saheki, Kyuichi Tanikawa, Wayne A. Fenton – 1 March 1992 – Hyperammonemia, abnormalities in plasma amino acids and abnormalities of standard liver functions were corrected by orthotopic liver transplantation in a 14‐day‐old boy with carbamyl phosphate synthetase‐I deficiency and in a 35‐yr‐old man with argininosuccinic acid synthetase deficiency. The first patient had high plasma glutamine levels and no measureable citrulline, whereas citrulline values were markedly increased in Patient 2.

Margaret F. Bassendine, S. J. Yeaman – 1 March 1992

John Olynyk, Phillip Williams, Andrew Fudge, Steven Pulbrook, Rikki Kerr, Malcolm MacKinnon, Pauline Hall – 1 March 1992 – The potential application of fine‐needle aspiration liver biopsy in the documentation of hepatic iron overload has been assessed in iron‐loaded rats. Fineneedle aspiration and standard liver biopsy specimens were obtained from three groups of animals supplemented with oral and parenteral iron for 2 to 6 mo. The mean dry weights of standard and fine‐needle biopsy specimens were 7.41 ± 0.77 (± S.E.M.) and 0.57 ± 0.54 mg, respectively.

Jorge L. Poo, Alain Braillon, Antoine Hadengue, Christophe Gaudin, Didier Lebrec – 1 March 1992 – The hemodynamic responses to terbutaline – a selective β2‐adrenoceptor agonist – were studied in conscious normal rats and in conscious rats with secondary biliary cirrhosis. Compared with those of normal rats, dose‐response curves in cirrhotic rats indicated significantly decreased reactivity in arterial pressure and heart rate. Half‐maximal effective dose was not significantly different between the two groups.

Eugenio Grau, Vicente Felipo, María‐Dolores Miñana, Santiago Grisolía – 1 March 1992 – A protein‐free diet causes a paradoxical increase of blood ammonia levels that seems to be due to decreased liver content of acetylglutamate, the physiological activator of carbamylphosphate synthetase. The purpose of this study was to assess whether oral administration to rats of carbamylglutamate, a metabolically stable activator of carbamylphosphate synthetase, could decrease the blood ammonia levels increased by the protein‐free diet.

Ibrahim Yousef, Diane Mignault, Beatriz Tuchweber – 1 March 1992 – The effect of complete sulfation of conjugated cholic, chenodeoxycholic and deoxycholic acids on bile formation was investigated in rats. The sulfated bile acids were infused intravenously in stepwise increasing doses (1, 2, 3 and 4 μmol/min/100 gm body wt) in rats after 90 min of bile acid pool depletion. The effects of these bile acids on bile flow, bile salt, biliary phospholipid and cholesterol secretion rates were determined.

Hong‐Yuan Hsu, Mei‐Hwei Chang, Chin‐Yun Lee, Juei‐San Chen, Hey‐Chi Hsu, Ding‐Shinn Chen – 1 March 1992 – Spontaneous loss of HBsAg is infrequent in adult HBV carriers. Little is known about this serological change in children. In a prospective study of 420 hepatitis B virus–carrier children who were observed for 1 to 12 yr (mean = 4.3 yr), spontaneous loss of HBsAg occurred in 10 patients, with an average incidence of 0.6%/yr.

Santiago J. Muñoz – 1 March 1992 – The two main causes of gastrointestinal bleeding in cirrhosis are oesophageal varices and portal hypertensive gastropathy (PHG). Rebleeding from varices can be prevented by beta‐blockers, but it is not clear whether these drugs effectively reduce rebleeding from PHG. 54 cirrhotic patients with acute or chronic bleeding from severe PHG took part in a randomised, controlled trial to investigate the efficacy of propranolol in prevention of rebleeding from PHG.