bluuebunny/crossref_metadata_2025_split huggingface dataset:
Recombinant human α-interferon in patients with chronic non-A, non-B hepatitis: A multicenter randomized controlled trial from France
Authors: Marcellin Patrick , Boyer Nathalie , Giostra Emile , Degott Claude , Courouce Anne Marie , Degos FrançOise , Coppere Henri , Cales Paul , Couzigou Patrice , Benhamou Jean-Pierre 
Published: March 2007

We have conducted a multicenter randomized controlled trial comparing two doses of recombinant human α-interferon for efficacy in 60 patients with chronic non-A, non-B hepatitis. The source of infection appeared to be transfusion in 30 patients, intravenous drug abuse in 16 patients and was unknown in 14 patients. Patients were randomly assigned to no treatment or to treatment with either 1 or 3 MU of α-interferon given three times a week for 24 wk. Forty-five patients (75%) were positive for antibody to hepatitis C virus.
During the 24-wk treatment period, mean serum ALT levels decreased in both treatment groups, but the decrease was statistically significant only in the 3 MU group. However, at 24 wk, the proportion of patients with normal ALT levels was similar in the 3 MU group (39%) and the 1 MU group (45%), and both were significantly higher than in controls (0%). Repeat liver biopsy specimens showed a significant decrease in the severity of histological changes in the 3 MU group but not in the 1 MU group or in controls. Responses to α-interferon did not correlate with patients' age, gender, source of infection, pretreatment serum ALT, presence of anti-hepatitis C virus or cirrhosis. After treatment, the mean ALT levels rose in both treated groups. The proportion of patients with normal ALT levels at wk 48 was 28% in the 3 MU group and 20% in the 1 MU group.
In conclusion, a dose of 3 MU was superior to 1 MU of α-interferon given three times weekly for 24 wk in inducing improvements in serum ALT levels and liver histological examinations. Relapse in disease activity occurred in approximately half of the responders when interferon was stopped. The response to α-interferon did not correlate with the source of infection or with the presence or absence of anti-hepatitis C virus. (Hepatology 1991;13:393-397.)
Transcatheter oily chemoembolization in the management of advanced hepatocellular carcinoma in cirrhosis: Results of a western comparative study in 60 patients
Authors: Vetter Denis , Wenger Jean-Jacques , Bergier Jean-Michel , Doffoel Michel , Bockel René 
Published: March 2007

Transcatheter oily chemoembolization is widely used as palliative therapy for inoperable hepatocellalar carcinoma in high-incidence Asiatic areas. To assess its usefulness in the Western form of this cancer, 20 French patients were treated between 1987 and 1990 by intraarterial hepatic injection of a Lipiodoldoxorubicin emulsion followed by embolization with 0.5 to 1 mm gelatin sponge particles. The number of procedures ranged from one to five. All patients had advanced, symptomatic and inoperable hepatocellular carcinoma (Okuda's staging: I, n = 8; II, n = 14; III, n = 8); none was found under systematic screening. All had underlying cirrhosis (Child-Pugh's class: A, n = 15; B, n = 12; C, n = 3) that was alcoholic in origin in 27 case and posthepatitic B in origin in 3 cases. The results of the treatment were assessed by comparison with a group of 30 untreated patients admitted to the same unit between 1984 and 1987. Patients of both groups were closely matched for clinical presentation, global disease staging and precise anatomical extension. The overall 1- and 2-yr survival rate was 59% and 30%, respectively, for the treated patients vs. 0% at 1 yr for the untreated patients. The latter all died from local disease with end-stage liver failure and/or uncontrollable variceal bleeding. In the former, the three vatients with Child's class C cirrhosis died after the first procedure. During the follow-up (range = 3 to 26 mo), 11 additional patients died, 8 from metastatic generalization. In four of these cases, an adjuvant systemic chemotherapy with epirubicin was given and provided an effective response to functional symptoms in two cases (loss of pain caused by bone metastases). Fifteen autopsies were performed in the untreated group and all showed a cancerous thrombus of the main portal trunk, whereas this was found in only 1 of 10 autopsies in the treated group.
We conclude that transcatheter oily chemoembolization is an efficient palliative treatment in the Western form of hepatocellular carcinoma complieating cirrhosis; it acts as a locoregional therapy that prevents the cancerous invasion of the portal system. Further trials are needed to define the best therapy to prevent or to treat extrahepatic dissemination. (Hepatology 1991;13:427-433.)
Hepatic amino-nitrogen clearance to urea-nitrogen in control subjects and in patients with cirrhosis: A simplified method
Authors: Bianchi Giampaolo , Marchesini Giulio , Vilstrup Hendrik , Fabbri Andrea , De Mitri Maria Stella , Zoli Marco , Pisiél Emilo 
Published: March 2007

The functional hepatic nitrogen clearance during amino acid infusion is a measure of liver cell mass. The clinical feasibility of the test has so far been limited by methodological problems. A simplified procedure was used to measure the urea-nitrogen synthesis rate and functional hepatic nitrogen clearance in nine subjects with normal liver function and in nine patients with cirrhosis. The method was based on only four consecutive 2-hr urine collections and five blood samples. Total body water was calculated from a nomogram based on age and anthropometric data, whereas the gut urea hydrolysis was assigned one fixed fraction of synthesis (0.17 in control subjects and 0.26 in patients with cirrhosis). Finally, a solution of a single amino acid, alanine, was infused as substrate for urea synthesis. Urea-nitrogen synthesis rate increased linearly with increasing α-amino-nitrogen concentration, and the slope of the regression (functional hepatic nitrogen clearance) was reduced in cirrhosis from 37.5 ± 7.0 L/hr to 18.4 ± 6.7 L/hr; p <0.005. The hepatic nitrogen clearance was linearly related to the clinical status (Child-Pugh score), to routine liver function tests and to galactose elimination capacity (r = 0.869), a wellestablished, quantitative, liver function measure.
The simplified method makes the measurement of hepatic nitrogen clearance suitable for routine clinical use. The test might prove useful to study the alterations of nitrogen metabolism in cirrhosis, with special reference to hepatic encephalopathy. (Hepatology 1991;13:460-466.)
Trolox protects rat hepatocytes against oxyradical damage and the ischemic rat liver from reperfusion injury
Authors: Wu Tai-Wing , Hashimoto Noriaki , Au Jian-Xun , Wu Jun , Mickle Donald A. G. , Carey Doug 
Published: March 2007

Trolox, a hydrophilic analog of vitamin E, was reported to scavenge peroxyl radicals from artificial systems better than its parent compound. Here we examined the possible cytoprotective effect of Trolox in cultured hepatocytes and in the rat liver.
In cultured rat hepatocytes, 0.5 to 16 mmol/L Trolox (with optimum between 1 to 2 mmol/L) was observed to prolong the survival of cells exposed to oxyradicals generated with xanthine oxidase-hypoxanthine. The protection by 1 mmol/L Trolox surpassed that provided by either ascorbate, mannitol, superoxide dismutase and/or catalase-each at a level giving its maximal protection in the same system. In both a global and partial model of hepatic ischemia-reperfusion in rats, infusion of Trolox (7.5 to 10 μmol/kg body weight) just before reflow reduced by > 80% the liver necrosis sustained in untreated (no Trolox) control rats. Such organ salvage was apparently accompanied by ˜ 50% reduction in the amount of hepatic conjugated dienes, which were quantified by a highly specific radiochemical assay. Since conjugated dienes are presumed to be good “markers” of oxyradical damage, our data may have provided a semiquantitative link between free radical-induced necrosis and its chemical imprint in vivo. The data also indicated a relatively rapid and potent antioxidant-like action by Trolox on rat hepatocytes and on the postischemic reperfused rat liver. (Hepatology 1991;13:575-580.)
Incidence of parenchymal liver diseases in Denmark, 1981 to 1985: Analysis of hospitalization registry data
Authors: Almdal Thomas P. , Sørensen Thorkild I. A. 
Published: March 2007

The sex-specific and age-specific incidence rates of the major parenchymal liver diseases in a North European population were estimated using a computerized registry of all admissions to somatic hospitals in Denmark.
The incidence was calculated by counting all incident cases of these diseases reported to the registry in the 5-yr period 1981 to 1985 and dividing the number of cases by the number of person-years at risk in this period.
The incidence rates (per million person-years) were for men and women, respectively: infectious hepatitis, 109 and 71; toxic hepatitis, 19 and 22; chronic hepatitis, 27 and 29; alcoholic cirrhosis, 190 and 85; nonalcoholic nonbiliary cirrhosis, 110 and 82; primary biliary cirrhosis, 4 and 14. The pattern of the age-specific incidence rates was similar in men and women in infectious hepatitis, alcoholic cirrhosis, nonalcoholic nonbiliary cirrhosis and primary biliary cirrhosis. Toxic and chronic hepatitis had a higher incidence in women than in men only in older age groups. The incidence of idiopathic hemochromatosis, Wilson's disease, secondary biliary cirrhosis, portal vein thrombosis and Budd-Chiari's syndrome were less than four in both sexes. (Hepatology 1991;13:650-655.)
Fucosyltransferases: Differential plasma and tissue alterations in hepatocellular carcinoma and cirrhosis
Authors: Hutchinson Winston L. , Du Ming-Qing , Johnson Philip J. , Williams Roger 
Published: March 2007

To determine whether abnormal metabolism of l-fucose in hepatocellular carcinoma is accompanied by alterations in the activities of fucosyltransferases, the latter were determined in plasma and liver tissue of patients with this disease and in cirrhotic and normal subjects. Activities of α-2/α-3 and α-6-l -fucosyltransferases were all significantly greater in plasma from patients with hepatocellular carcinoma than in plasma from cirrhotic patients or normal subjects (p < 0.025). The activity of each enzyme was dependent, to a similar extent, on Mn2+, Mg2+ and triton X-10, irrespective of the source, and all displayed pH optimums in the range of 7.5 to 8.0.
In contrast, activities of α-2/α-3 fucosyltransferases were significantly lower (p < 0.025) in homogenates prepared from tumorous liver tissue than in that prepared from nontumorous tissue from hepatocellular carcinoma and cirrhotic patients, whereas for the α-6 enzyme the situation was reversed (typically, tumor tissue levels were 5 pmol/hr/mg; in nontumor tissue they were 2 pmol/hr/mg). Activities of galactosyl and mannosyltransferase in tumor tissue were greater in all cases than in nontumor cirrhotic tissue. Plasma fucosyltransferases are specifically elevated in hepatocellular carcinoma but different mechanisms appear to underlie the changes seen for α-2/α-3 and α-6-l-fucosyltransferases. (Hepatology 1991;13:683-688.)
Randomized comparative study of hemaccel vs. albumin infusion after total paracentesis in cirrhotic patients with refractory ascites
Authors: Salerno Francesco , Badalamenti Salvatore , Lorenzano Elettra , Moser Pamela , Incerti Pierluigi 
Published: March 2007

Fifty-four cirrhotic patients with refractory ascites were treated with one-session large-volume paracentesis and randomly assigned to two groups. The first group was infused with human albumin, and the second group was infused with hemaccel at doses with comparable oncotic power. The two groups were compared for incidence of complications, recurrence of massive ascites after hospital dismissal and survival rate.
The incidence of complications traditionally related to paracentesis, the probability of requiring readmission to the hospital for ascites (p = 0.48) and the probability of survival after entry into the study (p = 0.85) were the same for the two groups. A multivariate analysis of 16 parameters, including treatment modality, identified absolute unresponsiveness to diuretics as the only independent predictor of mortality. These results indicate that hemaccel infusion may safely replace albumin infusion after total paracentesis for cirrhotic patients with refractory ascites. (Hepatology 1991;13:707-713.)
Biliary tract disease in rats with experimental small bowel bacterial overgrowth
Authors: Lichtman Steven N. , Keku John , Clark Richard L. , Schwab John H. , Sartor Ryan B. 
Published: March 2007

Small bowel bacterial overgrowth, which develops in surgically created jejunal self-filling blind loops, is associated with hepatic injury in susceptible rat strains. The histological findings are portal tract inflammation and bile duct proliferation and destruction. In this study, evidence of injury to the extrahepatic and intrahepatic bile ducts in susceptible and resistant inbred rats with self-filling blind loops was determined by bile flow rates, histological appearance of cross-sections of bile ducts and cholangiography. Lewis and Wistar rats with self-filling blind loops had thickening of the cross-sectional area of the extrahepatic bile ducts compared with controls and nonsusceptible Buffalo rats (p < 0.001). Daily metronidazole therapy significantly reduced thickening of bile ducts in Lewis and Wistar rats with self-filling blind loops. Bile flow was increased in Lewis and Wistar rats with blind loops compared with controls (p < 0.05).
Cholangiograms of Lewis and Wistar rats with self-filling blind loops demonstrated extrahepatic ductal dilatation and ectasia with irregular, beaded, rapidly tapering and tortuous intrahepatic ducts. Blinded cholangiographical scores of susceptible rat strains with self-filling blind loops were higher (score = 5.9 ± 2.3) than those of controls (1.2 ± 0.4), rats with blind loops treated with metronidazole (0.8 ± 1.3) and nonsusceptible Buffalo rats with blind loops (0.6 ± 0.9) (p < 0.01). Biliary histological and cholangiographical abnormalities found in this rat model resemble features of primary sclerosing cholangitis. This animal model will be useful in exploring mechanisms of the association of hepatobiliary inflammation with intestinal injury and investigating potential therapeutic agents. (Hepatology 1990;13:766-772.)
Treatment of hepatocellular carcinoma
Authors: Gumucio Jorge J. , Di Bisceglie Adrian M. 
Published: March 2007

Fifty-one patients with unresectable hepatocellular carcinoma were treated by embolization of the hepatic artery with Gelfoam powder, contrast material and three chemotherapeutic agents (doxorubicin, mitomycin, cisplatin). Twelve patients (24%) had a partial response with a decrease in the tumor diameter by at least 50%, 13 patients (26%) had only minor responses, 12 (24%) had stabilization of disease and the remainder had progressive disease. Tumor liquefaction was noted on computed tomographic scanning in 70% of patients, and 23 of 34 patients with elevations in serum alphafetoprotein values had a greater than 50% reduction following treatment. The median patient survival time from treatment was 207 days. Most patients experienced transient pain, fever, nausea and elevations in serum aminotransferase activities as a result of therapy. Ascites developed in 14 patients. There were two treatment-related deaths: one from tumor hemorrhage and one from liver failure. Chemoembolization therefore appears to have significant activity in patients with hepatocellular carcinoma and is relatively well tolerated.
This study reports the results of resection in 72 cirrhotic patients with hepatocellular carcinoma from Europe. One and 3 year survival rates were 68% and 51% respectively. Survival was significantly higher in Child's class A than in class B or C patients. Patients with a thickly encapsulated tumor lived longer than those with an infiltrating tumor and also had a significantly lower recurrence rate. There was no relationship between the size of the tumor or the presence of symptoms and survival. These data suggest that good results can be achieved by resection of hepatocellular carcinoma in European cirrhotic patients. A thickly encapsulated tumor and good liver function are the main determinants of low cancer recurrence and high survival.
Relationship between insulin sensitivity, insulin secretion and glucose tolerance in cirrhosis
Authors: Kruszynska Yolanta T. , Home Philip D. , McIntyre Neil 
Published: March 2007

Hepatic insulin extraction is difficult to measure in humans; as a result, the interrelationship between defective insulin secretion and insulin insensitivity in the pathogenesis of glucose intolerance in cirrhosis remains unclear. To reassess this we used recombinant human C-peptide to measure C-peptide clearance in cirrhotic patients and controls and thus derive C-peptide and insulin secretion rates after a 75-gm oral glucose load and during a 10 mmol/L hyperglycemic clamp. Cirrhotic patients were confirmed as insulin-insensitive during a euglycemic clamp (glucose requirement: 4.1 ± 0.1 mg/kg/min vs. 8.1 ± 0.5 mg/kg/min; p < 0.001), which also demonstrated a low insulin metabolic clearance rate (p < 0.001). Although intolerant after oral glucose, the cirrhotic patients had glucose requirements identical to those of controls during the hyperglycemic clamp (cirrhotic patients: 6.1 ± 1.0 mg/kg/min; controls: 6.3 ± 0.7 mg/kg/min), suggesting normal intravenous glucose tolerance.
C-peptide MCR was identical in cirrhotic patients (2.93 ± 0.16 ml/min/kg) and controls (2.96 ± 0.24 ml/min/kg). Insulin secretion was higher in cirrhotic patients, both fasting (2.13 ± 0.26 U/hr vs. 1.09 ± 0.10 U/hr; p < 0.001) and from min 30 to 90 of the hyperglycemic clamp (5.22 ± 0.70 U/hr vs. 2.85 ± 0.22 U/hr; p < 0.001). However, with oral glucose the rise in serum C-peptide concentration was relatively delayed, and the insulin secretion index (secretion/area under 3-hr glucose curve) was not elevated. Hepatic insulin extraction was reduced both in fasting and during the hyperglycemic clamp (p < 0.001).
Thus hypersecretion and decreased insulin clearance contribute to the four- to sixfold increased insulin levels in cirrhotic patients (fasting and after oral or intravenous glucose). In response to intravenous glucose, this hyperinsulinemia compensates for peripheral-tissue insulin insensitivity, accounting for normal rates of glucose disposal. In response to oral glucose, compensation is only partial, glucose intolerance being most marked in those cirrhotic patients with a lower insulin secretory response (r = −0.76, p < 0.02). (HEPATOLOGY 1991;14:103-111.)
Asymptomatic bacterascites: Is it spontaneous bacterial peritonitis?
Authors: Pelletier Gilles , Lesur Gilles , Ink Olivier , Hagege Hervé , Attali Pierre , Buffet Catherine , Etienne Jean-Pierre 
Published: March 2007

Asymptomatic bacterascites is defined as the presence of bacteria in ascitic fluid without clinical features of peritonitis or increased ascitic fluid polymorphonuclear cells. Asymptomatic bacterascites is a controversial entity, and little information is available regarding its spontaneous evolution. Clinical features, bacteriological data and outcome in 22 cirrhotic patients with asymptomatic bacterascites are reported and are compared with those of a group of 36 cirrhotic patients with spontaneous bacterial peritonitis. Eleven patients had gram-negative bacteria and 11 had one gram-positive bacteria. Only in three patients (13.6%) did peritonitis develop. Twelve patients received no antibiotic therapy, and in none did peritonitis develop. At 1 month, 27% of patients with asymptomatic bacterascites had died. Patients with asymptomatic bacterascites had less-severe liver disease; they more frequently had gram-positive bacteria in ascitic fluid and had a lower 1-mo mortality rate than did patients with spontaneous bacterial peritonitis.
We conclude that asymptomatic bacterascites is usually the transient residence of bacteria in ascitic fluid. Peritonitis rarely develops in patients with asymptomatic bacterascites and, in most of them, antibiotic therapy is not required. (HEPATOLOGY 1991;14:112-115.)
Impaired binding properties of thyroxine-binding globulin in hepatocellular carcinoma and chronic liver disease
Authors: Hutchinson Winston L. , White Yvette S. , Fagan Elizabeth A. , Johnson Philip J. , Williams Roger 
Published: March 2007

To determine the factors underlying the apparent reduction in binding ability of thyroxine-binding globulin in hepatocellular carcinoma, hormonebinding characteristics were further examined in patients with this disease and in control subjects. No differences in affinity constants with respect to triiodothyronine or serum thyroxine-binding globulin from hepatocellular carcinoma, cirrhotic and normal subjects were found. The affinity for thyroxine was significantly reduced in hepatocellular carcinoma (0.41 ± 0.13 × 1010 mol−1) and cirrhotic (0.65 ± 0.1 × 1010 mol−1) patients compared with normal subjects (0.94 ± 0.7 × 1010 mol−1).
Investigations carried out on liver tissue obtained from patients with hepatocellular carcinoma and chronic liver disease showed that thyroxine-binding globulin within tumor tissue was elevated and bound less exogenous tracer hormone compared with that obtained from nontumor tissue. Tumor-derived thyroxine-binding globulin with altered binding properties is, at least partly, responsible for the abnormal behavior of the serum protein in patients with hepatocellular carcinoma. (HEPATOLOGY 1991;14:116-120.)