Methotrexate hepatotoxicity and the premature reporting of Mark Twain's death: Both greatly exaggerated

Marshall M. Kaplan – 1 October 1990 – Ten histological criteria were evaluated semiquantitatively in the liver biopsies of 60 patients with rheumatoid arthritis (RA) before initiation of methotrexate (MTX) and were compared with 40 biopsies taken during MTX treatment (mean cumulative dose 1,322 mg). Mesenchymal changes (Kupffer cell proliferation, portal tract infiltration) and parenchymal alterations (nuclear variability, ballooning, fatty infiltration) were very common without statistically significant difference between the 2 groups.

Transport of chenodeoxycholic acid and its 3‐α‐ and 7‐α‐sulfates by isolated perfused rat liver

Ulrich Gärtner, Tobias Goeser, Adolf Stiehl, Richard Raedsch, Allan W. Wolkoff – 1 October 1990 – In patients with cholestasis, levels of sulfated bile acids rise. Sulfate esters of chenodeoxycholic acid are the most abundant of these bile acid sulfates. These compounds are taken up by the liver and excreted into bile, although their plasma clearance and biliary excretion are reduced compared with that of unsulfated bile acids. It is not clear whether this is due to differences in intrinsic hepatic uptake or biliary excretion.

Changes of serum hepatitis B virus DNA and aminotransferase levels during the course of chronic hepatitis B virus infection in children

Ping‐Ing Lee, Mei‐Hwei Chang, Chin‐Yun Lee, Hong‐Yuan Hsu, Juei‐San Chen, Pei‐Jer Chen, Ding‐Shinn Chen – 1 October 1990 – During a follow‐up period of 3.2 ± 1.6 (1 to 8.6) yr, 1,087 serum specimens from 230 HBsAg carrier children were tested for hepatitis B virus markers.

Prognostic factors of hepatocellular carcinoma in the west: A multivariate analysis in 206 patients

Xavier Calvet, Jordi Bruix, Pere Ginés, Concepció Bru, Manel Sole, Ramón Vilana, Joan Rodés – 1 October 1990 – To investigate the prognostic factors in Western patients with hepatocellular carcinoma, 206 patients with confirmed diagnoses of hepatocellular carcinoma were studied in terms of survival. All patients were diagnosed between 1983 and 1987.

Relative frequencies of portosystemic pathways and renal shunt formation through the “posterior” gastric vein: Portographic study in 460 patients

Kunio Kimura, Masao Ohto, Shoichi Matsutani, Junji Furuse, Kazuhiko Hoshin, Kunio Okuda – 1 October 1990 – Percutaneous transhepatic portography was carried out in 460 patients with portal hypertension to study various collateral routes. Besides the left gastric vein, which was the most frequent collateral route and feeder of esophageal varices, a distinct vein located between the left gastric vein and the short gastric vein constituted a major collateral route in 191 patients (42%).

Prospective study of early detection of hepatocellular carcinoma in patients with cirrhosis

Hiroko Oka, Narito Kurioka, Kosyun Kim, Toru Kanno, Tetsuo Kuroki, Yasuhiro Mizoguchi, Kenzo Kobayashi – 1 October 1990 – We prospectively monitored 140 cirrhotic patients for the development of hepatocellular carcinoma for 6 yr, using periodical screening by high‐resolution convex‐array ultrasonography and α‐fetoprotein. Twenty‐eight patients were positive for HBs antigen, 26 patients had received blood transfusions and were negative for HBs antigen and 26 patients had a history of heavy drinking. We detected hepatocellular carcinoma in 40 patients during this period.

Endoscopic ligation of esophageal varices: An endoscopist's opinion

Francis J. Tedesco – 1 October 1990 – One hundred consecutive patients with bleeding esophageal varices were treated with a new endoscopic ligating device that effects strangulation of varices using small elastic “O” rings. Treatments were continued after initial hospitalization to achieve variceal eradication. Follow‐up ranged from 6 to 26 (mean: 15) months. Bleeding was controlled until discharge from hospital or death in 18 of 21 patients who were actively bleeding at index endoscopy. Overall, 26 patients died during the study, 12 during the index hospitalization.

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