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.

Ehoud Shmueli, Mark Walker, George Alberti, Christopher O. Record – 1 July 1993 – The site of impaired glucose uptake in cirrhosis is uncertain. We therefore performed hyperglycemic clamps (glucose 10 mmol/L) in 10 patients with compensated alcoholic cirrhosis and impaired glucose tolerance and in six control subjects. Muscle glucose uptake was estimated in patients and controls with the forearm technique. In the cirrhotic subjects splanchnic glucose uptake was measured with hepatic vein catheterization and primed continuous infusions of indocyanine green and [6−3H]glucose.

Ziv Ben‐Ari, Amar Paul Dhillon, Sheila Sherlock – 1 July 1993 – We describe four patients with features overlapping those of primary biliary cirrhosis and autoimmune chronic active hepatitis. Three were female and one was male; only one was symptomatic. Serum biochemical study showed increases in alkaline phosphatase and α‐glutamyltranspeptidase levels. Markers of hepatitis B and C viruses were absent. In all four patients, serum mitochondrial antibodies could not be detected on immunofluorescence study and serum M2 antibodies were absent.

Richard Callaghan, Paul V. Desmond, Phillip Paull, Maurice L. Mashfor – 1 July 1993 – The relative importance of alterations in hepatic enzyme activity, blood flow and drug binding to drug elimination in patients with liver disease remains controversial. In addition, liver disease appears to selectively impair drug oxidation pathways while leaving glucuronidation preserved.

Edward E. Cable, Julia W. Cable, Herbert L. Bonkovsky – 1 July 1993 – Heme‐ and tin‐chelated metalloporphyrins are known to decrease the activity of hepatic δ‐aminolevulinate synthase, the rate‐controlling enzyme of heme synthesis. We performed experiments in primary chick embryo liver cells with tin‐, zinc‐ and copperchelated porphyrins to assess their effects on activities of δ‐aminolevulinate synthase induced by prior treatment of cells with glutethimide and ferric nitrilotriacetate.

Khin Maung Win, Frederic Charlotte, Ariane Mallat, Daniel Cherqui, Nadine Martin, Philippe Mavier, Anne‐Marie Preaux, Daniel Dhumeau, Jean Rosenbaum – 1 July 1993 – We assessed the effect of transforming growth factor‐β1 on the proliferation of human Ito cells. Ito cells in their myofibroblastlike phenotype were grown from explants of human liver and were characterized with electron microscopy and positive immunostaining for desmin and smooth muscle α‐actin.

Jorge J. Gumucio, Irwin M. Arias – 1 July 1993 – The multidrug resistance (mdr1) gene product, P‐glycoprotein, is responsible for the ATP‐dependent extrusion of a variety of compounds, including chemotherapeutic drugs, from cells. The data presented here show that cells with increaed levels of the P‐glycoprotein release ATP to the medium in proportion to the concentration of the protein in their plasma membrane.