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Biomedical subjects

K Weinbren

Publications and source records attributed to K Weinbren.

At least 19 recordsLinked to original sources
PubMed1988

Cyclophosphamide-induced liver necrosis: a possible interaction with azathioprine.

Cyclophosphamide is a valuable drug for the treatment of vasculitis and hepatic toxicity resulting from its use has been reported rarely. We describe four patients in whom cyclophosphamide was associated with liver injury when its administration had been preceded by azathioprine. Microscopy of hepatic biopsy material in three of these cases showed liver cell necrosis. In two of the patients, cyclophosphamide had been given previously without earlier azathioprine and hepatic damage had not been noted. An apparent interaction of cyclophosphamide with azathioprine to cause liver cell necrosis has important implications for the treatment of patients with vasculitis and related disorders.

Adult↗
PubMed1987

Apparent extra-hepatic invasion by metastatic tumours in the liver.

Focal changes involving the liver capsule, subjacent tumour and contiguous structures are described on computed tomography (CT) in patients with metastatic tumours in the liver. These changes were correlated with the relevant resected liver tissue which had been perfused and sliced in planes comparable to the CT slices. The capsular changes represented 'umbilication', overlying necrotic and fibrosed tumour with contiguous structures, usually the diaphragm, perihepatic fat or omentum, fixed to the liver capsule by inflammatory or organising processes, but not invaded by tumour. Localised hypodense areas on CT in the region of the capsule do not represent extracapsular spread of tumour and therapy ought to be planned accordingly.

Abdominal Neoplasms↗
PubMed1987

Magnetic resonance imaging of the solitary hepatic mass: direct correlation with pathology and computed tomography.

Magnetic resonance images (MRI) of the liver were obtained using a combination of short time inversion recovery (STIR) and spin echo (SE) sequences. These were correlated with comparable tissue slices generated from resected specimens obtained at partial hepatectomy. All 10 cases appeared to have solitary masses on contrast enhanced computed tomography (CT). Histological examination revealed five primary tumours (two hepatocellular carcinomas, two haemangiomas and one cholangiocarcinoma) and five metastatic tumours. The STIR images demonstrated a high signal intensity in all areas of viable tumour involvement and reduced signal intensity in regions of confluent necrosis with superimposed haemorrhage or calcification. This sequence also demonstrated additional areas of high signal intensity adjacent to several lesions which were not visible on CT. Microscopy of these regions in the specimens demonstrated no tumour involvement or steatosis and their precise cause remains obscure. All the lesions demonstrated on the CT images were visible on MRI and no additional lesions were discovered on detailed microscopical examination of the specimens. Delineation of the extent of the cholangiocarcinoma was a problem with both techniques. MRI showed no major advantage over CT except for a higher contrast of the lesion compared with normal liver and also a better delineation of the tumour mass.

Adenoma, Bile Duct↗
PubMed1985

Structural aspects of the liver in patients with biliary disease and portal hypertension.

Structural changes were examined in liver tissue from 28 patients with chronic bile duct obstruction in whom portal hypertension was diagnosed. Extrahepatic portal occlusion was found in three patients and cirrhosis of the liver in two. In the remaining 23 patients diffuse hepatocyte hyperplasia and portal fibrosis were observed, but a normal spatial relation between portal tracts and hepatic venous radicles was, for the most part, retained. Liver tissue was also examined from a group of 76 patients with chronic bile duct obstruction in whom there was no indication of portal hypertension but some evidence of hepatocyte hyperplasia and fibrosis. Both these features were much less extensive than the changes seen in the group of patients ostensibly suffering from portal hypertension. The findings suggest that the combination of portal hypertension and chronic bile duct obstruction may not imply the unremitting, progressive, and irreversible changes that accompany cirrhosis because the normal vascular relations are retained. In the light of increasing experimental and clinical evidence of the resorption of collagen and the remodelling of hepatic plates it seems that the structural abnormalities in duct obstruction may substantially regress.

Adult↗
PubMed1984

Neurotensin secretion by fibrolamellar carcinoma of the liver.

Serum neurotensin concentrations were supranormal in 5 out of 20 patients with carcinoma of the liver. Liver specimens from 4 of these 5 patients demonstrated features typical of fibrolamellar carcinoma. Neurotensin may be suitable as a tumour marker for fibrolamellar carcinoma and may be useful for the detection of recurrences after treatment.

Carcinoma, Hepatocellular↗
PubMed1984

Pathological aspects of diffuse nodular hyperplasia of the liver.

The microscopical features in specimens of liver tissue from 14 patients considered to be suffering from Diffuse Nodular Hyperplasia (DNH) were compared with the changes found in livers from five other groups of patients. The diagnoses in these groups were macronodular cirrhosis, hepatic venous occlusion, congestive cardiac failure, compensatory hyperplasia after destruction of part of the liver and chronic biliary disease respectively. In all these groups the formation of thick hepatocyte plates, thought to represent cell proliferation, was a constant and striking feature. Such plate thickening in the periportal regions was associated with congestive cardiac failure and with hepatic venous occlusion. The diffuse involvement of almost all plates formed part of the changes in DNH, cirrhosis, compensatory hyperplasia and chronic biliary disease. Normal vascular relations were retained in the patients with compensatory hyperplasia and chronic biliary disease and lost in cirrhosis and, in some parts, in DNH. The nodules were small in DNH and larger in cirrhosis, where they were surrounded by fibrous tissue. DNH appeared to be recognizable in needle biopsy specimens.

Atrophy↗
PubMed1983

Pathological aspects of cholangiocarcinoma.

Tissue specimens resected from liver and bile-ducts were examined in an attempt to distinguish features of cholangiocarcinoma from those of other tumours and from reactions to duct obstruction and changes in the tumour-bearing liver. Macroscopical and microscopical features were compared and certain changes were found only in cases of cholangiocarcinoma. The type of tumour correlated moderately well with the level of bile duct involved and some microscopical findings were noted only in patients suffering from cholangiocarcinoma. Mucin was demonstrable in all 33 cholangiocarcinomas. Other striking features included heterogeneity of epithelial cells within the same acinus and a tendency to spread between hepatocyte plates, along duct walls and in relation to nerves. Reactive hyperplasia of ductal subepithelial mucous glands was found in association with duct obstruction with and without cholangiocarcinoma. Sclerosis, a common accompaniment of cholangiocarcinoma was noted in other tumours.

Adenocarcinoma↗
PubMed1982

6-thioguanine as a cause of toxic veno-occlusive disease of the liver.

Lesions of hepatic veno-occlusive disease were found in the needle biopsy specimen of one patient suffering from chronic granulocytic leukaemia and in the liver at necropsy of a second patient suffering from acute myeloid leukaemia. The treatment included administration of 6-thioguanine which was the only relevant compound used in the first patient and which was combined with cytosine arabinoside in the second patient.

Adult↗
PubMed1981

Periportal sinusoidal dilatation, inflammatory bowel disease, and the contraceptive pill.

Two women, aged 19 and 28 yr, who had been on the contraceptive pill for at least 18 mo, developed abnormal levels of circulating liver enzymes, minimal hepatomegaly, and elevated erythrocyte sedimentation rate. Liver biopsy in both women showed a sinusoidal dilatation sparing the perihepatic venous regions. The liver function abnormality resolved on stopping the pill. Both patients also had clinically mild inflammatory bowel disease. The possibility of both liver and bowel abnormalities being effects of contraceptive steroids is discussed.

Adult↗
PubMed1978

Intramuscular injections of iron compounds and oncogenesis in man.

To evaluate the evidence for iron compounds as local carcinogens in man, histological material and clinical reports have been reviewed in seven of the eight published cases of tumours developing at the site of intramuscular injections. The microscopical appearances suggested benign lesions in two cases and a variety of tumours in the other five. In only two cases (a rhabdomyosarcoma and a fibrosarcoma) was the interval between injections and tumour development longer than six years. Of the remaining three tumours, one was considered to be a rather slowly growing haemangiopericytoma (with an interval of two years), one appeared to be a subcutaneous lymphoma with no evidence of having arisen in the gluteal muscles, and one was a pleomorphic sarcoma with a possible five-year interval. Sarcomas induced experimentally by iron compounds differ in being less variable in type and in containing abundant iron-containing macrophages, which were negligible in these human tumours.Although the total number of patients who have received intramuscular injections of iron compounds is not known, the present findings, in contrast to experimental work, do not support the view that such treatment carries a strong risk of tumour development.

Adolescent↗
PubMed1977

Other views about the hepatotrophic concept.

In this paper two main questions are approached. The first relates to the aspects of the proliferative response which are influenced by alleged hepatotrophic substances and experiments will be recounted which were designed to test whether hepatocyte enlargement and division are separable. Both short-term and long-term data suggest the need to consider that these two reactions may be controlled by different factors. The second question is concerned with the indentification of hepatotrophic substances and the circumstances in which these are found to be effective. Experiments have been carried out which attempt to assess the extent to which normal liver cells are affected by specific hepatotrophic substances in vivo. The findings do not completely support the hypothesis that the integrity of the liver cell is dependent on a single identifiable hepatotrophic substance.

Animals↗
PubMed1975

The response of the rat liver to alterations in total portal blood flow.

In attempting to isolate the various components involved in the stimulus induced by partial hepatectomy, the effect of sudden increased portal flow to the whole liver has been studied. The technique involved the construction of a portacaval anastomosis and after a week, reconstitution of the original portal vein, allowing resumption of portal blood flow. The effects of increased portal flow in this experiment were to induce hypertrophy of hepatocytes and a minor degree of DNA synthesis.

Animals↗