Paul D. Berk – 1 July 1993 – Health care costs are climbing throughout the western world. Aging populations and the costs of advanced technology are the principal forces behind much of this global increase. No country has yet succeeded in containing these growing costs other than by some form of rationing. A variety of experimental strategies, including managed competition, are being considered or tested, but none is clearly effective.

Joel Bass – 1 July 1993

Alan A. Seawright, Roger T. Snowden, I. Olusola Olubuyide, Joan Riley, David J. Judah, Gordon E. Neal – 1 July 1993 – A need exists for an appropriate animal model for the involvement of both hepatitis B virus infection and ingestion of aflatoxins in the etiology of liver cancer. Duck hepatitis B virus–infected ducks, on the basis of hepatoma development in the wild in China, appear to offer this possibility. The duck has been reexamined as a model system, and key metabolic processes have been assayed in comparison with the rat model for hepatocarcinogenesis.

K. S. Koch, R. G. Fletcher, M. P. Grond, H. L. Leffert – 1 July 1993

Robert Flisiak, Enrique Baraona, Jianjun Li, Charles S. Lieber – 1 July 1993 – Fat‐storing cells participate in the development of alcoholic liver disease. To study possible effects of ethanol on prostaglandin metabolism by fat‐storing cells, we isolated them from normal rat liver. Cultured fat‐storing cells produced substantial amounts (DNA, about 2 ng/μg every 24 hr) of prostaglandin E2 and prostaglandin I2 (measured as 6‐keto prostaglandin F1α) but no significant amounts of prostaglandin F2α.

Robert W. Jansen, Johan K. Kruijt, THEO J. C. van Berkel, Dirk K. F. Meije – 1 July 1993 – We covalently coupled 9‐β‐D‐arabinofuranosyladenine 5′‐monophosphate (ara‐AMP) to the carrier molecule lactosaminated human serum albumin using a water‐soluble carbodiimide with a two‐step conjugation method (pH 4.5 and pH 7.5) instead of the commonly used single‐step conjugation at pH 7.5. This resulted in a predominantly monomeric conjugate (lac27‐HSA–ara‐AMP9). The conjugate was stable in buffer (pH 7.4) and blood plasma.

Alan P. Venook – 1 July 1993 – Background: Liver transplantation for unresectable hepatocellular carcinoma yields disappointing results. Most cases recur within 2 years, often in the transplanted liver. Methods: A combination of neoadjuvant doxorubicin and orthotopic liver transplantation was used in 20 patients with unresectable hepatocellular carcinoma confined to the liver. Seventeen patients had tumors > 5 cm in greatest diameter, and 11 cases were stage IVA by the TNM classification.

Teresa Wright – 1 July 1993 – The clinical course of 10 liver transplant recipients who had hepatitis B virus (HBV) and five recipients with HBV and D (delta) infection before transplantation is described. Six patients who underwent eight transplants died. The estimated one and two year survival rates in patients with HBV only before transplantation were 74% and 67% respectively. The estimated one and two year survival in patients with HBV and HDV infection beforehand was 100%.

1 July 1993

Kenji Ikeda, Satoshi Saitoh, Isao Koida, Yasuji Arase, Akihito Tsubota, Kazuaki Chayama, Hiromitus Kumada, Masahiro Kawanishi – 1 July 1993 – To elucidate the appearance rates of hepatocellular carcinoma in cirrhosis and to assess the risk factors for hepatocellular carcinogenesis, we prospectively studied 795 consecutive patients with viral or alcoholic cirrhosis for 2 to 17 yr (median of 5.8 yr). During the observation period, hepatocellular carcinoma developed in 221 patients.