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Biomedical subjects

I M Murray-Lyon

Publications and source records attributed to I M Murray-Lyon.

At least 19 recordsLinked to original sources
PubMed1992

Dideoxyinosine for chronic hepatitis B infection.

Six patients positive for both human immunodeficiency virus (HIV) and hepatitis B were studied to assess the effect of dideoxyinosine (DDI) on hepatitis B virus (HBV) replication. Two patients died during the follow-up period and four had at least 8 weeks of therapy. One patient demonstrated HBV DNA suppression and became transiently negative. In the remaining five patients, there was no appreciable change in HBV DNA levels during DDI therapy. DDI was well tolerated in all patients, the only significant side effect being diarrhoea. It is concluded that DDI has no notable antiviral effect in patients with chronic HBV infection when coinfected with HIV.

Adult↗
PubMed1992

Prevalence of antibodies to hepatitis C in dialysis patients and transplant recipients with possible routes of transmission.

The prevalence of hepatitis C infection and possible predisposing factors was assessed in a renal unit. Of 343 patients at our renal dialysis centre, 37 (10.8%) were anti-HCV positive by a 1st-generation assay (ELISA, Ortho/Chiron) and confirmed positive in 35 (10.2%) with a 2nd-generation test (UBI, New York). Anti-HCV positivity was significantly associated with: duration of renal replacement therapy (P < 0.0001); quantity of blood transfused (P < 0.002); duration of hospital haemodialysis (P = 0.0001); duration with a functional renal transplant (P = 0.039); and aspartate aminotransferase (P < 0.0001). Logistic regression determined the following variables to be independent risk factors: duration of renal replacement therapy with a relative risk of 34.3 for 5-9 years and 87.4 when the duration was in excess of 10 years; renal transplant for less than 1 year (relative risk of 5.0); transfusion in excess of 50 units of blood (relative risk of 11.6). Clinical assessment of anti-HCV-positive patients revealed peripheral signs of chronic liver disease in 40%, hepatomegaly in 34%, and splenomegaly in 9%. This prevalence of hepatitis C infection is similar to other European and North American centres, but contrasts with low prevalence rates reported from dialysis populations in the UK. It adds further support for routine screening of blood and possibly organ donors and implementation of further infection control measures in dialysis centres.

Adult↗
PubMed1979

Dacron bypass grafting in the relief of obstructive jaundice.

A new technique using a 'Dacron' tube bypass graft for relief of obstructive jaundice due to malignant disease is described. This method is applicable when a conventional bypass operation is technically impossible. Good palliation was achieved in all seven patients who survived the immediate postoperative period.

Carcinoma↗
PubMed1979

Liver disease among homosexual males.

5% of 2612 homosexual males attending genitourinary clinics were found to be hepatitis-B surface-antigen (HBsAg) positive. Liver biopsy was done in 25 who had abnormal liver-function tests but no symptoms or signs of liver disease, and 14 (56%) of these proved to have chronic active hepatitis or active cirrhosis. Neither the liver-function tests nor the viral markers in serum reflected the severity of the liver disease. 38% of a group of 118 HBsAg positive patients were HBeAg positive, and sexual contacts of these individuals may be at serious risk of infection.

Carrier State↗
PubMed1979

The influence of ammonia and octanoic acid on liver regeneration in the rat.

1. We have investigated the effect of intermittent doses of ammonia and octanoic acid on liver regeneration in the rat after partial hepatectomy. Regeneration was assessed by uptake of tritiated thymidine into liver deoxyribonucleic acid. 2. We have found a reduction in hepatic regenerative response in animals treated with ammonium acetate as a source of ammonia. 3. No inhibiting effect of octanoic acid on liver regeneration was found, at the dose used. 4. The implications of the results for management of fulminant hepatic failure are discussed.

Ammonia↗
PubMed1979

Cholangiocarcinoma.

Cholangiocarcinoma may arise in the small bile ducts within the liver or in the large ducts in the hilum or the extrahepatic biliary tree. Curative surgical excision is being increasingly attempted for tumours at all sites and the best results are achieved with cancer at the lower end of the common bile duct. Palliative bypass surgery to drain the biliary tree gives good symptomatic relief and may provide prolonged survival because these tumours are often slow growing. Radiotherapy deserves more extensive trials since about 50 per cent of patients derive benefit. The results of treatment with cytotoxic drugs are so far disappointing.

Adenoma, Bile Duct↗
PubMed1978

Induction of remission in hepatocellular carcinoma with doxorubicin.

Doxorubicin (60 mg/m2 at 3-weekly intervals to a maximum total of 550 mg/m2) induced clinical remission in 14 (32%) of 44 patients with hepatocellular carcinoma. In 3 of those who responded, hepatic arteriography showed clearing of the previously extensive tumour circulation, and in a 4th there was disappearance of the tumour on serial ultrasound examinations. A fall in serum-alpha-fetoprotein level after the initial injection of doxorubicin predicted a favourable clinical response, whereas the level continued to rise in patients who did not respond.

Adult↗
PubMed1978

Vitamin B12 binding protein as a tumour marker for hepatocellular carcinoma.

Grossly raised levels of tumour related vitamin B12 binding protein, reflected by rises in serum vitamin B12 and unsaturated vitamin B12 binding capacity (UBBC), were found in three of 44 patients with hepatocellular carcinoma. All three were HBsAg negative and had normal serum alpha fetoprotein levels. The patients did not have underlying cirrhosis and the tumours contained characteristic intracellular inclusions. In the first patient the UBBC level fell during a partial remission induced by adriamycin therapy and in the second patient UBBC levels rose with progression of her disease. In the third patient serum B12 binding protein levels fell after tumour resection. Assay and subsequent monitoring of serum vitamin B12 and UBCC may prove valuable in the assessment and follow-up of some patients with hepatocellular carcinoma whose alpha fetoprotein levels are normal.

Adolescent↗
PubMed1978

Oesophageal function in cirrhotic patients undergoing injection sclerotherapy for oesophageal varices.

Oesophageal function has been studied in three groups of cirrhotic patients: those without varices, those with varices and those with varices treated by injection sclerotherapy. Using the Honeywell Model 31 oesophageal motility probe and the Ingold combined stomach pH electrode, measurements were made of the lower oesophageal sphincter (LES) pressure and length, swallowing responses, reflux and clearance of acid. The presence of varices was associated with an increase in LES length and reduced lower oesophageal contraction pressure during swallowing and some failure of sphincter relaxation during swallowing. Sclerotherapy was associated with a reduction in the maximum LES pressure both at rest and during swallowing, and an impairment of acid clearance, but postural reflux of acid was not observed in any patient.

Deglutition↗
PubMed1977

Liver damage from long-term methyltestosterone.

Of 60 patients (42 female transsexuals and 18 impotent males) receiving long-term therapy with methyltestosterone 50 mg three times a day, 19 had abnormal liver-function tests and 33 out of 52 had abnormal liver scans, particularly those who had been treated for more than a year. Liver biopsy specimens showed accumulation of hepatocytes in the liver cords and within the walls of centrilobular veins, and early peliosis hepatis. One patient had a hepatic adenoma. Of the androgens, only 17alpha-alkylated steroids seem to be implicated in the development of cholestatic jaundice, peliosis hepatis, and liver tumours.

Adenoma↗