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H Solomon

Publications and source records attributed to H Solomon.

111 records · Page 7Linked to original sources

Hepatic alpha-smooth muscle actin expression in hepatitis C patients before and after interferon therapy.

BACKGROUND/AIMS: The mechanism of hepatic fibrogenesis with chronic viral hepatitis is not well understood. Persistent activation of hepatic stellate cells is felt to play a role in the development of fibrogenesis and progression to cirrhosis. METHODOLOGY: We determined the expression of hepatic alpha-smooth muscle actin, a marker of hepatic stellate cell activation, in 29 patients with chronic hepatitis C and varying degrees of liver injury and fibrosis. In addition to a baseline evaluation, we assessed the effect of interferon therapy on alpha-smooth muscle actin expression in 11 patients, including 6 with a sustained response to therapy. Specimens were evaluated by light microscopy for grade of inflammation and stage of fibrosis. Expression of alpha-smooth muscle actin was assessed semiquantitatively by immunohistochemical staining. RESULTS: At baseline, all patients had alpha-smooth muscle actin expressed within the liver without an obvious correlation with the severity of liver injury. However, among sustained responders, a reduction in hepatic necroinflammatory activity was associated with a trend towards a decrease in alpha-smooth muscle actin expression. This however did not reach statistical significance. CONCLUSIONS: Hepatic alpha-smooth muscle actin expression, as a marker of hepatic stellate cell activation appears reversible and tends to correlate with necroinflammatory activity.

Actins↗

[Resection of the kidney in nephrolithiasis].

The results of 155 partial nephrectomies performed in 149 patients during the years 1962-1981 are discussed. Indications, surgical technique, complications and results are presented. The results show that partial nephrectomy has an acceptably low risk and late results show lower recurrence of stone formation as compared with pyelolithotomy or nephrolithotomy. The rate of true ipsilateral recurrences was 18.69 per cent in 123 followed kidneys.

Adolescent↗

Early detection and treatment of a leaking gastrojejunostomy following gastric bypass.

A leaking anastomosis between the proximal stomach and the jejunum is a serious postoperative complication of the gastric bypass operation. Associated intra-abdominal sepsis carries a high mortality rate. Early diagnosis, particularly at the time of operation, and remedial treatment reduce mortality. We have devised a method for the detection of leaks, using nasogastric infusion of methylene blue with an i.p. sump suction catheter. In our initial group of 150 patients, where this method was not used, 5 patients had an anastomotic leak and 2 died of fulminant sepsis. The presence of a leak in these cases was diagnosed on clinical grounds and confirmed in all five by Gastrografin swallow between the 3rd and 5th postoperative day. In a later group of 250 patients, methylene blue was routinely used intra-operatively and twice daily thereafter to verify the integrity of the anastomosis. Of this group, seven patients developed leaks, five of which were diagnosed intra-operatively while the other two were diagnosed on the 1st postoperative day. There was no mortality in this group. The use of methylene blue provides early detection of a leaking anastomosis and thus may significantly reduce the morbidity and mortality of the gastric bypass operation.

Adolescent↗