PubMed Health⌕ Search

Biomedical subjects

S Furudera

Publications and source records attributed to S Furudera.

10 recordsLinked to original sources
PubMed1996

Prognostic factors for short-term survival in alcoholic hepatitis in Japan: analysis by logistic regression.

Prognostic factors for the outcome of patients with alcoholic hepatitis were identified by logistic regression analysis. To predict the outcome immediately after admission, clinical data from 97 patients with alcoholic hepatitis on admission were introduced to multivariate analysis. Independent prognostic factors for favorable outcome were hepaplastin time, peripheral white blood cell count, age (40 to 60 years), and serum creatinine level (below 1.4 mg/dl). Sensitivity, specificity, positive predictive value, negative predictive value, and predictive accuracy were 0.78, 0.89, 0.78, 0.89, and 0.86, respectively. The resultant equation for the death rate was applied to another set of patients with alcoholic hepatitis as a validation study. Predictive accuracy estimated 0.95 in validation. The prognostic index derived was simple, accurate, and useful in the prediction of the outcome in patients with alcoholic hepatitis. Furthermore, it provides the clinician with an indication of the necessity for the intensive care of patients in a critical condition.

Adult↗
PubMed1996

Two survival cases of alcoholic lactic acidosis complicated with diabetes mellitus and alcoholic liver disease.

We have experienced two patients with alcoholic lactic acidosis complicated with liver disease and diabetes mellitus who were successfully treated. They developed hypoglycemia, dehydration, lactic acidosis, and renal failure after drinking a large volume of alcohol without eating for 1 week before onset. Acidosis was thought to be directly related to excessive alcoholic intake, because it was no associated with severe liver failure and rhabdomyolysis. During monitoring of respiratory and circulatory functions, a rapid infusion of fluids adjusting to water and electrolyte imbalance was performed. A mixture of physiological saline and 5% glucose solution was thought to be effective in these cases. Patients recovered from renal failure and lactic acidosis without hemodialysis. Our experience will hopefully provide a key to successful treatment of fatal alcoholic lactic acidosis.

Acidosis, Lactic↗
PubMed1994

Role of serum interleukin-8 and intercellular adhesion molecule-1 in the severity of alcoholic hepatitis.

Among patients with alcoholic hepatitis, three groups were distinguished by histological findings and clinico-pathological features. The aim of this study was to clarify the role of soluble intercellular adhesion molecule-1 (sICAM-1) and interleukin-8 (IL-8) in the development of severe alcoholic hepatitis. The levels of sICAM-1 and IL-8 were well correlated with the severity of liver injuries. The concentrations of serum IL-8 were significantly correlated with the number of polymorphonuclear leukocytes infiltrating the liver. Serial determination of these two markers revealed that IL-8 may be complementary in assessing the severity and prognosis of alcoholic hepatitis.

Adult↗
PubMed1993

Chronic hepatitis C in alcoholic patients: studies with various HCV assay procedures.

Chronic hepatitis (CH) is one of the features of alcoholic liver disease (ALD). The role of hepatitis C virus (HCV) infection was investigated in 50 alcoholic patients with CH, employing various types of HCV antibody. All patients had a drinking history of more than 80 g/day of ethanol and the diagnosis of CH was made by liver histology within 2 weeks of abstinence. We assayed serum HCV using C100-3 antibody (Ortho EIA and RIA), the second generation (HCV-2nd) (DAINABOT EIA and PHA), and we also examined HCV-RNA by PCR. The positive rate of C100-3 antibody was 56% by EIA and 66% by RIA. The HCV-2nd was much higher; 80% and 82% by EIA and PHA, respectively. The HCV-RNA was positive in 82% of patients. The positive rate for either of the HCV markers was 92% (46/50). In patients positive for C100-3, serum aminotransferase levels were still elevated even after abstinence and most of them showed chronic active hepatitis by liver histology. Follow-up liver biopsies showed histological progression even after abstinence. On the other hand, in some patients positive only for HCV-2nd and/or HCV-RNA, serum aminotransferase levels were normalized and histological improvement was observed soon after abstinence. These results suggest that histological determined CH in alcoholics is attributed mainly to the infection of HCV, HCV plays an important role in the histological deterioration after abstinence, and that the presence of C100-3 antibody reflects the activity of liver disease caused by HCV.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1993

Roles of the splenic cytokines and arachidonic acid metabolites in severe hepatic injury after lipopolysaccharide injection in chronically alcohol-fed rats.

We examined the early changes after lipopolysaccharide (LPS) injection in chronically alcohol-fed rats with or without splenectomy. Administration of 2 mg/kg body weight LPS caused severe hepatic injury. The plasma aspartate aminotransferase (ASAT) activity was significantly higher in sham-operated rats 8 hr after LPS injection than in splenectomized rats. The plasma tumor necrosis factor (TNF) activity was also significantly higher 1 hr after LPS injection in sham-operated rats than in splenectomized rats. The plasma thromboxane (TX) B2/6-keto-prostaglandin (PG) F1 alpha ratio increased in sham-operated rats after LPS injection. Therefore, the balance of arachidonic acid metabolites was in a hypercoagulated state in sham-operated rats after the LPS injection. Neutrophil infiltration into liver tissue increased in sham-operated rats after the LPS injection. The cytokines and arachidonic acid metabolites released from the spleen after LPS injection in alcohol-fed rats may play important roles in severe hepatic injury.

Animals↗
PubMed1993

Clinical and pathological features, and the mechanism of development in severe alcoholic hepatitis, especially in comparison with acute type fulminant hepatitis.

Among the patients with alcoholic hepatitis, the patients with severe alcoholic hepatitis (SAH) were distinguished by clinical course, laboratory data and histological findings. The aim of this study was to clarify the clinicopathological features, pathological condition and pathogenesis of SAH. Twenty-four SAH patients were compared with 55 patients with acute type fulminant hepatitis (FH) and the other types of alcoholic liver disease. SAH showed a very poor prognosis with a survival rate of 25% and was complicated by multiple organ failure earlier than FH. IgA class lipid A antibody, endotoxin (Et) and tumor necrosis factor-alpha (TNF-alpha) levels in the blood well reflected the pathological condition and severity of SAH. The white blood cell count in the peripheral blood was thought to be the simplest indicator for the prediction of the prognosis of SAH. In conclusion, SAH involves hyper-endotoxemia due to dysfunction of the reticuloendothelial system in the liver, and cytokines including TNF-alpha and neutrophils play an important role in the severity of liver injury.

Adult↗
PubMed1993

Fatal acute hepatitis B virus infection while receiving immunosuppressants after renal transplantation.

A 47-year-old man with acute hepatitis B virus (HBV) infection who had been receiving immunosuppressants after renal transplantation developed progressive liver failure. During the clinical course (approximately 7 months), anti-HBc IgM antibody and HBV-DNA polymerase levels remained high, but the serum alanine aminotransferase (ALT) level was consistently less than 150 K.U. Histopathologic examination of the liver showed submassive hepatic necrosis without significant inflammation accompanied by marked fibrosis. Most hepatocytes showed strong nuclear expression of HBc antigen by immunohistochemical staining and electron microscopy revealed numerous intranuclear core-like particles. Hepatitis B virus infection in immunosuppressed individuals occasionally insidiously progresses, resulting in liver failure. The clinical course of such patients thus merits close scrutiny.

Acute Disease↗
PubMed1992

[Infection of C type hepatitis virus in patients with alcoholism. Studied by serum HCV antibody of C100-3 and 2nd generation].

To investigate the infectious situation and causes of hepatitis C virus (HCV) in patients with alcoholism, C100-3 antibody (C100-3) and HCV antibody of the 2nd generation (HCV-2nd) were examined on admission, and the factors that affected the infection of HCV were studied in 226 alcoholics. The positive rate of anti-HCV was as high as 16.4% by C100-3 and much higher by HCV-2nd as 33.2%. The incidence of cases with the history for blood transfusion, drug addict and/or tattoos in alcoholics was as high as 39.4% (89/226). To clarify the influence of the background such as blood transfusion, drug addict and/or tattoos on HCV infection, the positive rate of anti-HCV was compared between those with the background and without the background. In alcoholics without the backgrounds, the positive rate of C100-3 and HCV-2nd were significantly (p less than 0.001) higher than patients without the backgrounds, namely 27.0% vs 9.5%, 56.2% vs 18.2%, respectively. In alcoholics without the backgrounds, the positive rate of anti-HCV became higher in proportion as the age of the patients grows older from 20 to 60 years. These results suggest that a high incidence of HCV infection in alcoholics may resulted from increased the backgrounds that can provide chances of HCV infection and that in those without the backgrounds, alcohol and aging may lead the tolerance to HCV infection.

Adult↗