bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hepatic Dystychoma: A Five Year Experience
Authors: Little J. M. , Richardson Arthur , Tait Noel 
Published: September 2007

In 5 years, 64 solid hepatic lesions have been referred for diagnosis and management which have been
found unexpectedly on organ imaging in well patients. We have called this lesion a “dystychoma”.Patients have undergone a two phase investigation programme which allows a diagnosis without
admission to hospital in about 50% of cases. About three quarters of patients (47/64) have had nonneoplastic
lesions, and about half (33/64) have had haemangiomas. About one patient in four (17/64) has
had a neoplasm, and the neoplasm has been malignant in about one in six (11/64) of all patients.We stress the need to pursue the diagnosis in these patients. There were no reliable clinical,
biochemical or imaging characteristics which individually distinguished benign from malignant lesions.
Age over 55 years, an enlarged liver or a palpable liver mass and a raised serum alkaline phosphatase
were all significantly more frequent with malignant tumours. The risk of malignancy rose with the
number of risk factors, and all patients with all three risk factors had malignant tumours.Only 11 of the 64 patients were judged to have benefited by significant increase in quality or quantity
of life as a result of what was frequently inappropriate organ imaging. There is no strong argument for
replacing history taking and physical examination by CT scanning, ultrasound examination or other
organ imaging.
Infections Following Orthotopic Liver Transplantation
Authors: Arnow Paul M. 
Published: September 2007

The epidemiology of infections associated with orthotopic liver transplantation is summarized herein, and approaches to prophylaxis are outlined. Infection is a major complication following orthotopic liver transplantation, and more than half of transplant recipients develop at least one infection. The risk of infection is highest in the first month after transplantation, and the most common pathogens are bacteria and cytomegalovirus (CMV). Bacterial infections usually occur in the first month, arise in the abdomen, and are caused by aerobes. The peak incidence of CMV infection is late in the first month and early in the second month after transplantationn. CMV syndromes include fever and neutropenia, hepatitis, pneumonitis, gut ulceration, and disseminated infection. Other significant problems are Candida intraabdominal infection, Herpes simplex mucocutaneous infection or hepatitis, adenovirus hepatitis, and Pneumocystis carinii pneumonia.Prophylaxis of infection in liver transplant recipients has not been well‐studied. Several different regimens of parenteral, oral absorbable, and/or oral non‐absorbable antibiotics active against bacteria and yeast have been used at various centers, but no randomized controlled trials have been conducted. Selective bowel decontamination appears to be a promising approach to the prevention of bacterial and Candida infections, while oral acyclovir may be a relatively convenient and effective agent for CMV prophylaxis.
Primary Bile Duct Stones and Bacterial Activity
Authors: Vitetta Luis , Sali Avni 
Published: September 2007

The results of this study suggest that infection with beta‐glucuronidase active bacteria is the initial event
in the nucleation of primary bile duct stones (PBDS).PBDS from five patients were morphologically fragile and “earthy” with alternating light and dark
brown pigment layers with no evidence of a distinct central nucleus that may have been reminiscent of a
different structure. Chemically, calcium bilirubinate and calcium palmitate were prominent throughout
their structure. All bile duct biles had a positive culture and were always associated with at least one
bacterial species which was beta‐glucuronidase active. Moreover, fragments of PBDS nuclear areas had
positive cultures that were comparable with those present in their individual bile duct bile. Microscopic
examination of bile showed abundant precipitation of calcium bilirubinate granules in all samples.Thus, bile duct bile infection with beta‐glucuronidase active bacteria (e.g. E. coli, C. perfringens)
appears to be a key factor in PBDS pathogenesis, having a precursor role, rather than being a
consequence. Bile stasis is likely to be a co‐factor which must have a supportive role in subsequent stone
growth.
Left‐Sided Hepatectomy With a Linear Stapling Device: An Experimental Study on Pigs
Authors: Zilling Thomas , Walther Bruno S. , Holmin Torsten 
Published: September 2007

Thirteen pigs underwent resection of the left liver lobe. By random selection, the animals were resected
either with the aid of an RLG 90R linear stapling device or by the conventional finger‐fracture technique.
There was one postoperative death due to anaesthetic complications. The median operative time using
the stapler was 27 min (range 19–40 min) which was significantly shorter (p = 0.0065) than that required for resection by the finger‐fracture technique (42.5 min; range 37–55 min).The median blood loss, estimated by counting the number of gauze swabs used, was 425 ml and 275 ml
for the finger‐fracture resected and stapler resected groups, respectively (ranges 275–550 ml versus 175–
300 ml; p = 0.015).The animals were sacrificed and examined one week after the operative procedure. Except for a small
bile pseudo‐cyst in one pig operated upon with conventional resection, no sign of bleeding or biliary
leakage was revealed.This study demonstrates the feasibility of stapling the liver to facilitate resection.
Pancreaticogastrostomy After Pancreatoduodenectomy
Authors: Sauvanet A. , Belghiti J. , Panis Y. , Gayet B. , Camara E. , Urrejola G. , Fékété F. 
Published: September 2007

The aim of this study was to evaluate the place of pancreaticogastrostomy (PG) in reducing pancreatic
fistula after pancreatoduodenectomy. From January 1988 to June 1991, 32 consecutive patients (mean
age, 57 years) were operated on, 25 for malignant disease (78%). The pancreatic remnant was normal in
17 patients (53%) and sclerotic in the others. There was one operative death (3.1%) unrelated to PG.
Post‐operative complications occurred in five patients (16%). Only two complications were related to
PG: 1 patient had anastomotic intra‐gastric bleeding and was reoperated on, 1 patient with a normal
pancreatic remnant developed a pancreatic fistula (3.1%) treated conservatively.Reported series of PG, as well as our results, demonstrates that PG is associated with a dramatic
decrease of both pancreatic fistula and mortality rates. The risk of anastomotic haemorrhage can be
reduced by preventative ligation of submucosal gastric vessels.In conclusion, PG appears as a simple and reliable method of management of the pancreatic remnant
after pancreatoduodenectomy.
Massive Necrotizing Pancreatitis in an Immunosuppressed Renal Transplant Recipient (Successful Therapy)
Authors: Slaton Joel W. , Howard John M. , Selman Steven H. 
Published: September 2007

Severe pancreatitis may be associated with massive necrosis of the pancreas and/or retroperitoneal
adipose tissue. Toxicity results from the dead tissue and secondary infection. A 45 year old patient,
while fully immunosuppressed, developed this complication following cadaveric renal transplantation.
He survived continued immunosuppression, 16 operative debridements of the retroperitoneum, and
maintained a functioning renal transplant.In view of the previously reported high mortality rates from mild pancreatitis after transplantation,
the current experience warrants further evaluation of the open method of treatment.
The Effect of Biliary Decompression on Bacterial Translocation in Jaundiced Rats
Authors: Ding Jin Wen , Andersson Roland , Soltesz Vasile , Willén Roger , Loft Steffen , Poulsen Henrik E. , Pärsson Håkan , Olsson Kjell , Bengmark Stig 
Published: September 2007

Patients with obstructive jaundice are prone to septic complications after biliary tract operations.
Restoring bile flow to the intestine may help to decrease the complication rate. The present study is
aimed at evaluating the effect of biliary decompression on bacterial translocation in jaundiced rats.Sixty‐six male Sprague‐Dawley rats were randomly allocated to six groups subjected to common bile
duct ligation (CBDL) and transection (groups 2–6) or sham operation (group 1). In groups and 2 the
incidence of enteric bacterial translocation was determined 2 weeks after sham operation or CBDL. In
groups 3–6, biliary decompression was achieved by performing a choledochoduodenostomy after 2
weeks of biliary decompression. Bacterial translocation was then studied 1,2,3 and 5 weeks following
biliary decompression.The rate of bacterial translocation to mesenteric lymph nodes in obstructive jaundice was significantly
higher as compared with controls, and decreased with time to nil three weeks following biliary
decompression. The incidence of bacterial translocation was closely correlated (r = 0.844; p = 0.034) with serum alkaline phosphatase activity and seemed to fit with the morphological changes noted in the
small intestine. The decrease in bacterial translocation, however, lags behind the recovery of liver
function as measured by routine liver function tests and antipyrine clearance.Obstructive jaundice thus promotes bacterial translocation in the rat. Biliary decompression gradually
decreases the rate of bacterial translocation.
The Role of Hormonal and Dietary Factors in Pancreatic Carcinogenesis
Authors: Christopoulou A. , Blanc F. , Joyeux H. 
Published: September 2007

The pancreatic cancer continues to represent an important problem, as a cancer with extremely poor
prognosis.To date more than 16 chemicals have been shown to induce pancreatic tumors, in animal models. The
tumors developed in rats are essentially of acinar type and those in hamsters mostly of ductal type.
Many studies proved the direct or indirect role of hormonal and dietary factors in pancreatic cancer.
The development of alternative treatments according to biological and biochemical steps of carcinogenesis
is available as adjuvant treatment.We present herein an overview of current experimental and clinical results in order to understand the
evolution, histogenesis and biological behaviour of pancreatic cancer.
Structure and Innervation of the Extrahepatic Biliary System in the Australian Possum, Trichosurus Vulpecula
Authors: Padbury R. T. A. , Baker R. A. , Messenger J. P. , Toouli J. , Furness J. B. 
Published: September 2007

The morphology, microanatomy and innervation of the biliary tree of the Australian possum,
Trichosurus vulpecula, was examined. The gross morphology of the gallbladder, hepatic and cystic
ducts, and the course of the common bile duct, conforms to those of other species. The sphincter of
Oddi has an extraduodenal segment that extends 15mm from the duodenal wall; within this segment the
pancreatic and common bile ducts are ensheathed together by sphincter muscle. Their lumens unite to
form a common channel within the terminal intraduodenal segment.Nerve cell bodies of the gallbladder were found in an inter‐connecting network of ganglia that were
located in the serosa, muscularis and mucosa. Nerve fibres innervated the muscle, arterioles and the
mucosa. Few ganglia were found along the supra sphincteric portion of the common bile duct. Nerve
trunks followed the duct and a dense nerve fibre plexus was found in the mucosa. In the sphincter most
ganglia were located in two plexuses, the first between the layers of the external sphincter muscle, which
was continuous with the external muscle of the duodenum, and the second was associated with the
internal sphincter muscle. Nerve fibres were numerous in the sphincter muscle, and were also found in
the subepithelial and periglandular plexuses of both the pancreatic and common bile ducts.
The Effects on Liver Metastases of Circadian Patterned Continuous Hepatic Artery Infusion of FUDR
Authors: Kemeny M. Margaret , Alava Galo , Oliver Jorge M. 
Published: September 2007

Although continuous hepatic artery infusions (CHAI) of (FUDR) Floxuridine have been effective in
reducing the size of colorectal hepatic metastases the toxicity of the infusions have been high with almost
a quarter of the patients developing biliary sclerosis. Techniques to lower toxicity, yet continue the
beneficial antitumor effects, are being investigated. One suggested strategy is to change the flow pattern
of the continuous infusion from a constant rate to a day cycled pattern. In this infusion a continuous rate
is given over a 24 hour period with 60% of the infusion delivered between 3 PM and 9 PM and the least
amount of infusion delivered between 3 AM and 9 PM. Previous research has suggested that this day
cycle pattern will lower the toxicity of the infusion. This experiment is a test of “day cycled” continuous
hepatic artery infusions in rats bearing hepatic metastases from a colon adenocarcinoma. Previous
research from our laboratory has shown a lowered toxicity when the constant infusion was replaced with
the day cycled pattern.In the present study 10 rats with hepatic adenocarcinoma metastases were placed on constant CHAI
of FUDR at 10mg/kg/day for 14 days. There was an 80% mortality from chemotherapy toxicity and a
90% objective response rate. Nine other rats were treated with “day cycled” CHAI of FUDR at 15mg/kg/d. There was no mortality in this group and the objective response rate was 90% as in the previous
group. This study demonstrated that “day cycled” CHAI of FUDR was substantially less toxic and that
the antitumor effect was identical to the constant infusion.
Portal Hypertension Promotes Bacterial Translocation in Rats Mono‐ and Non Mono‐Associated with Escherichia Coli C25
Authors: Vauthey Jean-Nicolas , Duda Petra , Wheatley Anthony M. , Gertsch Philippe 
Published: September 2007

The basis for the high incidence of infectious complications in portal hypertension (PHT)
remains unclear. The hypothesis that PHT induces bacterial translocation (BT) was tested in
a rat model with or without mono‐association with streptomycin resistant Escherichia coli C25
and with or without hypovolemic shock. PHT was achieved by partial portal vein ligation and
three weeks later hypovolemic shock (HS) was induced. Blood, liver, spleen and mesenteric
lymph nodes cultures were performed twenty‐four hours later.PHT promoted BT to mesenteric lymph nodes in indigenous flora (4/6 [67%]) and mono‐associated
animals (7/9 [78%]) compared to sham laparotomy and sham shock (SL + SS)
animals (0/6 [0%] and 2/9 [22%] respectively) (p = 0.03). The combination of PHT and HS
resulted in increased mortality in mono‐associated (7/15 [47%]) and non mono‐associated
animals (8/15 [53%]). No significant translocation was noted in liver and spleen and bacteremia
was found only in the PHT + HS mono‐associated animals (4/8 [50%]).PHT induces BT to mesenteric lymph nodes and this may account for the high incidence of
septic complications associated witti PHT. In this model, the addition of HS to PHT leads to an
increased mortality but without uniform translocation of the gut flora beyond mesenteric lymph
nodes.
The Influence of Portal Deviation on the Effect of Repeat Dearterializations of a Transplantable Adenocarcinoma to the Rat Liver
Authors: Wang L. Q. , Persson B. G. , Bengmark S. 
Published: September 2007

As liver tumours receive some of their blood supply from the portal vein, we wanted to illustrate
the influence of portal blood flow in combination with dearterialization in the treatment of liver
tumours. Forty male, inbred Wistar/Furth rats with an adenocarcinoma transplanted to the liver
were treated with various inflow occlusions repeated daily for 5 days. Deviation of the portal
blood flow alone with an end‐side porto‐caval shunt did not alter the tumour growth (p = 0.089).
Thirty min of repeat dearterializations was potentiated by portal deviation so that tumour
growth was delayed (p = 0.004). However, repeat dearterializations for 60 min in portal deviated
rats induced irreversible liver damage and all rats died in a few days. Repeated dearterializations
for 60 minutes alone retarded the tumour growth as efficiently (p = 0.007). Simultaneous
occlusion of the hepatic artery and the portal vein for 30 minutes with a side‐side porto‐caval
shunted (total devascularization) did not affect tumour growth (p = 0.154). Liver aminotransferases
(ASAT and ALAT) were substantially increased following dearterialization for 30 min in
rats with either an end‐side or a side‐side porto‐caval shunt. Dearterialization for 60 min in rats
with end‐side porto‐caval shunts gave a further release of ASAT and ALAT.In conclusion, portal deviation did not augment the therapeutic benefit of repeat dearterializations
for the treatment of this experimental liver tumour. Repeat dearterializations alone
seemed to be a feasible and efficient therapy for liver tumours.
The Effect of Propofol on the Canine Sphincter of Oddi
Authors: Baron T. H. , Dalton C. B. , Cotton P. B. , May G. R. , Milton L. G. , Chari R. S. , Meyers W. C. 
Published: September 2007

To assess the effect of propofol on the canine sphincter of Oddi (SO), sphincter of Oddi manometry (SOM)
was performed in fasting dogs which had undergone cholecystectomy and placement of modified Thomas
duodenal cannulae. Using two water‐perfused, single‐lumen manometric catheters, SO and duodenal
pressures were measured simultaneously. Baseline SO activity was recorded for at least one complete
interdigestive cycle followed by bolus injections of propofol (Diprivan ®) (N = 31) from 0.1 to 4.0 mg/kg
during Phase I of the Migrating Motor Complex (MMC).When propofol was administered in bolus doses ≤ 0.5 mg/kg, no change in SO or duodenal motor
function was seen. In doses ≥ 0.5 mg/kg, SO basal pressure, amplitude, and frequency of contractions
increased significantly. Increases in duodenal activity paralleled SO activity. Our results suggest that
propofol in low doses may be useful for sedation during Sphincter of Oddi manometry in humans. Further
studies of the effects of propofol on the human sphincter of Oddi are warranted.
Clinical and Enzymatic Investigation of Induction of Oxygen Free Radicals by Ischemia and Reperfusion in Human Hepatocellular Carcinoma and Adjacent Liver
Authors: Yamanoi Akira , Nagasue Naofumi , Kohno Hitoshi , Kimoto Takeo , Nakamura Terushisa 
Published: September 2007

Serum concentration of thiobarbituric acid (TBA) reactants in the hepatic vein were measured before
and after transient dearterialization of the liver in five human subjects bearing unresectable
hepatocellular carcinoma (HCC). During 1 hour of the occlusion of the hepatic artery, change inTBA
reactants level was slight. However, the mean value of TBA reactants in 1 hour after the reflow
increased to 1.50 ± 0.11 nmol/ml (mean ± S.E.) and was significantly higher (p < 0.05) than those
before hepatic dearterialization (1.28 ± 0.11 nmol/ml) and just before the release of occlusion (1.32 ±
0.09 nmol/ml).Further, two endogeneous scavenger enzymes, superoxide dismutase (SOD) and catalase (CAT),
and one of the major sources of oxygen free radicals, xanthine oxidase (XOD) were measured in
human untreated HCC and the corresponding adjacent liver tissue. The results demonstrated an
increase in SOD in 81.8% (9/11) of HCC, and a decrease in CAT in 72.7% (8/11) of HCC when
compared with the corresponding adjacent liver tissue. The mean value of SOD in HCC was
significantly higher (66.8 ± 6.5 vs 52.8 ± 3.8 U/mg protein; p < 0.05), and that of CAT was
significantly lower (22.6 ± 2.4 vs 36.0 ± 6.1 U/mg protein; p < 0.05) than those in liver tissue. All of
nine HCC samples had a significantly lower activity of XOD (6.4 ± 1.9 vs 20.3 ± 3.4 pmol/minute/mg
protein; p < 0.01) than the corresponding liver tissue. There was no obvious relation between the
content of SOD and CAT in HCC, or in liver tissue.These data may suggest that oxygen free radicals can be generated in human HCC by ischemia
and reperfusion of the tumor‐ bearing liver. It is also indicated that the antioxidant system of HCC is
not always impaired, and that HCC might develop several lines of defence systems against the
oxidative attack. A possible strategy of the treatment for liver tumor with oxygen derived free radicals
induced by ischemia and reperfusion is hypothized here.
Biochemical Prediction of Acute Cholangitis and Symptomatic Bile Duct Stones by Gallstone Hepatitis
Authors: Isogai M. , Hachisuka K. , Yamaguchi A. , Hori A. 
Published: September 2007

We have adopted the clinical concept of gallstone hepatitis indicated by marked serum
transaminase elevation due to an acute inflammatory liver cell necrosis in the early stages of
gallstone impaction in the bile duct as clinical and biochemical criteria for identifying high‐risk
patients for acute cholangitis or bile duct stones causing symptoms (symptomatic bile duct
stones, SBDS).One hundred and fifty‐eight (80.2%) of 197 patients with acute gallstone disease and
concomitant elevation of serum transaminase (gallstone hepatitis) underwent emergency
treatment, either surgery (138 patients) or percutaneous transhepatic biliary drainage
(PTBD)/endoscopic sphincterotomy (ES) (20 patients). One hundred and forty‐two (89.9%) and
67 (42.4%) were confirmed to have SBDS and acute cholangitis, respectively, in the early stage of
the disease. The majority of the patients who had no bile duct stones identified at surgery had
either biliary pancreatitis or multiple small stones in the gallbladder. They were assumed to have
migrating stones or false negative operative cholangiograms.In conclusion, gallstone hepatitis indicates that SBDS and acute cholangitis are probable, and
facilitates rapid selection of patients for urgent biliary tract exploration in patients with acute
gallstone disease.
Pancreatic Enzyme Supplementation in Acute Pancreatitis
Authors: Patankar R. V. , Chand R. , Johnson C. D. 
Published: September 2007

This study evaluates the effect of oral pancreatic enzyme supplements on pain, analgesic requirement
and the incidence of complications in patients with acute pancreatitis. This double blind, prospectively
randomised placebo controlled study included 23 patients. Pain was monitored using a visual analogue
scale; the analgesic requirement was assessed with a numerical score.No significant differences were noted between the median (range) pain scores of patients who
received placebo: 22 (17.1–58) and those who received enzymes: 23 (11.3–63). Hospital stay was 7
(5–10) days in patients on placebo and 8 (6–24) days in the enzyme group (p = 0.069). Analgesic
requirements were: placebo 20 (6–60) and enzymes: 16 (0–63) (p = 0.56). This study has shown no
beneficial effect of oral pancreatic enzyme supplements in the initial management of patients with
acute pancreatitis.