Vasopressin/nitroglycerin infusion vs. esophageal tamponade in the treatment of acute variceal bleeding: A randomized controlled trial

Josep Teres, Ramon Planas, Julia Panes, Joan Manel Salmeron, Antoni Mas, Jaime Bosch, Covadonga Llorente, Josep Viver, Faust Feu, Joan Rodés – 1 June 1990 – Vasopressin infusion and esophageal tamponade are still widely used to arrest variceal bleeding, but no objective evidence exists on the superiority of either of the two procedures.

Evaluation of protocol before transplantation and after reperfusion biopsies from human orthotopic liver allografts: Considerations of preservation and early immunological injury

Saburo Kakizoe, Katsuhiko Yanaga, Thomas E. Starzl, A. Jake Demetris – 1 June 1990 – Light microscopic, immunohistochemical and ultrastructural analysis of protocol before transplantation and after reperfusion biopsy specimens from 87 randomly selected patients was performed to assess the contribution of preservation and immunological injury to early graft failure. Most biopsy specimens were essentially normal by light microscopy before transplantatio, and no particular feature could be relied on to predict function after transplantation.

Increased prooxidant action of hepatic cytosolic low‐molecular‐weight iron in experimental iron overload

Robert S. Britton, Marco Ferrali, Christopher J. Magiera, Richard O. Recknagel, Bruce R. Bacon – 1 June 1990 – In the iron‐loaded liver there may be an increase in the putative intracellular transit pool of iron, components of which could be catalytically active in stimulating lipid peroxidation. To study the levels of low‐molecular‐weight, catalytically active iron in the liver, cytosolic ultrafiltrates were tested in an assay containing rat liver microsomes and NADPH. Malondialdehyde production was used as an index of lipid peroxidation.

Hepatocellular carcinoma in primary biliary cirrhosis: An autopsy study

Yasuni Nakanuma, Tadashi Terada, Kenji Doishita, Atsushi Miwa – 1 June 1990 – A survey of Japanese autopsy cases of primary biliary cirrhosis disclosed that hepatocellular carcinoma is apparently becoming a better recognized complication of the advanced stage of primary biliary cirrhosis. Six autopsy cases (five women and one man) of primary biliary cirrhosis associated with hepatocellular carcinoma were obtained from several Japanese institutions and examined. All cases were in an established cirrhotic stage of primary biliary cirrhosis.

Inhibition of α‐ketoglutarate dehydrogenase activity by a distinct population of autoantibodies recognizing dihydrolipoamide succinyltransferase in primary biliary cirrhosis

David R. Fregeau, Thomas Prindiville, Ross L. Coppel, Marshall Kaplan, E. Rolland Dickson, M. Eric Gershwin – 1 June 1990 – Sera from patients with primary biliary cirrhosis contain autoantibodies that recognize mitochondrial proteins. Five of the target autoantigens have now been identified as enzymes of three related multienzyme complexes: the pyruvate dehydrogenase complex, the branched chain α‐ketoacid dehydrogenase complex and the α‐ketoglutarate dehydrogenase complex. Each complex consists of component enzymes designated E1, E2 and E3.

Transient induction of C‐jun during hepatic regeneration

Joseph A. Alcorn, Steven P. Feitelberg, David A. Brenner – 1 June 1990 – The cellular oncogene c‐jun is transiently expressed in cultured cells stimulated to proliferate but has not been identified in normal liver. Because partial hepatectomy results in coordinated cell proliferation in the remaining liver, we investigated c‐jun expression after partial hepatectomy in mice. Northern analysis of whole liver mRNA demonstrated a transient increased expression of c‐jun within half an hour of the operation.

Low‐dose corticosteroid therapy after multiple relapses of severe HBsAg‐negative chronic active hepatitis

Albert J. Czaja – 1 June 1990 – To evaluate the efficacy of low‐dose corticosteroid therapy after multiple relapses of severe HBsAg negative chronic active hepatitis, 22 patients who had relapsed on 3.4 ± 0.4 occasions (range = two to seven relapses) were treated with the lowest dose of medication necessary to ameliorate symptoms and maintain serum AST activity below five‐fold normal. Results were compared with those in 31 patients who had received conventional retreatments after 3.4 ± 0.3 relapses (range = two to eight relapses).

Acute phase responses after acute liver injury by parital hepatectomy in rats as indicators of cytokine release

Robert P. Cornell – 1 June 1990 – The purpose of this study was to support the hypothesis that cytokines such as interleukin‐1, tumor necrosis factor and interleukin‐6 are released by macrophages or monocytes within 1 to 2 hr of phagocytosis of circulating, gut‐derived backterial lipopolysaccharide translocated by acute liver injury. Time courses of fever, neutrophilia and low blood‐zinc levels generally attributed to cytokines were quantified after partial (37%) hepatectomy of rats under ether anesthesia.

Propranolol‐induced reduction in recurrent variceal hemorrhage in schistosomiasis

Harold O. Conn – 1 June 1990 – Fifty patients with non‐cirrhotic portal fibrosis who were admitted to hospital because of upper gastrointestinal bleeding were randomly assigned to treatment with either oral propranolol given in does that reduced the resting pulse rate by 25% (25 patients) or with a placebo (25 patients). One year after the start of the study 20 patients in the propranolol group and five patients in the placebo group were free from recurrent gastrointestinal bleeding (p < 0.0001).

Parenteral nutrition with branched‐chain amino acids in hepatic encephalopathy: Meta analysis

Rebecca Dersimonian – 1 June 1990 – The authors undertook a meta analysis of nine randomized clinical trials (RCTs) in which modified amino acid solutions that contained supplemental amounts of branched‐chain amino acida (BCAA) were compared with other forms of therapy of hepatic encephalopathy (HE). When five RCTs were pooled, analysis showed highly significant improvement in the degree of HE (p < 0.001). Various interpretations of the data gave similar reslts. The mortality data differed so widely in these RCTs that pooling of the data could not be meaningfully performed.

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