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PubMed2003

Effects of protein deficiency on liver trace elements and antioxidant activity in carbon tetrachloride-induced liver cirrhosis.

In liver cirrhosis, liver tissue becomes progressively substituted by fibrosis, ultimately leading to architectural distortion, liver circulatory changes, and liver failure. Some data support the hypothesis that protein undernutrition may play a role in the development and progression of nonalcoholic liver cirrhosis and that this progression is at least partially mediated by changes in glutathione peroxidase (GPX), superoxide dismutase (SOD), and other antioxidative systems, leading to an increase in lipid peroxidation. We analyzed the effects of protein deficiency on liver Cu, Fe, Zn, Mn, and Se in carbon tetrachloride (CCl4)-induced liver cirrhosis, the relation of protein undernutrition and these trace elements with the activity of some hepatic antioxidative enzymatic mechanisms, and the relation of all of them with morphological and biochemical changes in 40 male adult Sprague-Dawley rats divided in four groups. Liver cirrhosis was induced by intraperitoneal injection of CCl4 to 10 rats fed a 2% protein diet and another 10 fed a 18% protein control diet; two further groups included rats without cirrhosis fed the 2% protein and the 18% protein diets. The study period lasted 6 wk. GPX, SOD, and lipid peroxidation products as well as Zn, Cu, Mn, Se, and Fe were determined in liver samples. We found that liver GPX and Se were reduced in the cirrhotic animals, especially in the low-protein-fed ones, protein deficiency, but not cirrhosis, exerting the main effects. A close correlation was found between liver GPX and serum albumin and weight loss and an inverse one among GPX and hepatocyte ballooning, liver fibrosis, and fat, histomorphometrically determined. These results suggest a pathogenetic role of decreased GPX in the progression of liver disease, which may become enhanced by concomitant protein undernutrition. In addition to iron, the levels of which were increased in the malnourished rats, no differences were found regarding the other trace elements, SOD activity, and lipid peroxidation products.

Animals↗
PubMed1985

Blood analysis for liver cirrhosis.

Liver fibrosis is one of the most important factors of disturbed liver function, but could not be measured by simple blood tests until recently. Among several parameters used for this purpose, the aminoterminal procollagen type III peptide (PIIIP) appears to be the most widely accepted. Studies conducted in several clinical groups have shown that PIIIP effectively distinguishes between non-fibrotic and fibrotic liver disease. A reliable commercial kit is available and a wide application possible to evaluate the clinical meaning of serum PIIIP for the long-term outcome of chronic liver disease. With this novel blood test we can now assess liver fibrosis as we can measure the hepato-biliary function.

Blood Chemical Analysis↗
PubMed1986

Persistence of circulating complexes between HBsAg and immunoglobulin M in sera of hepatitis B surface antigen positive patients suffering from liver cirrhosis or primary liver cancer.

Complexes between hepatitis B surface antigen (HBsAg) and immunoglobulin M (IgM) have been detected in acute type B hepatitis. Sequential serum testing for the presence of these complexes has been shown to be the best method for predicting disease chronicity. The presence of HBsAg/IgM complexes was investigated using an enzyme-linked immunosorbent assay with selected sera from Senegal. The three population groups studied were composed of 405 Senegalese soldiers as well as 84 liver cirrhosis and 169 primary liver cancer patients. Only one of the 122 HBsAg negative sera tested was found to be positive for HBsAg/IgM complexes. Complexes were detected 13.9% of the HBsAg positive soldiers, in 40% of the HBsAg positive liver cirrhosis patients, and in 50% of the HBsAg positive primary liver cancer patients. HBsAg/IgM complexes were also detected in 53.6% of the hepatitis B e antigen (HBe) positive soldiers, compared to 75 and 76% for the HBeAg positive liver cirrhosis and primary liver cancer patients, respectively. In anti-HBe positive sera, an increased proportion of HBsAg/IgM complexes was observed during the sequence chronic hepatitis (5%)-cirrhosis (29%)-primary liver cancer (42%). On the other hand, it has been reported that in the sequence of events leading from chronic hepatitis to primary liver cancer, there is an increase in anti-HBeAg prevalence and in alpha-fetoprotein levels. In this study, only alpha-fetoprotein levels were found to increase. Values higher than 15 IU/ml were observed in 4.3, 27.3, and 86.4% of the HBsAg positive individuals from the three groups. No significant variation was observed in the anti-HBe prevalence between the population group (64-75%).

Antigen-Antibody Complex↗
PubMed1985

[Chronic hepatitis, liver cirrhosis, primary liver cancer and virus HB infection. Epidemiologic study in a sahelian hospital milieu. Apropos of 185 cases].

From December 1982 to June 1985, 185 patients with signs of chronic liver disease are investigated in National Hospital (Niamey, Republic of Niger). A first group ("Hepatopathy") of 131 patients (75 males, 56 females) is made of 3 chronic liver diseases: 35 chronic hepatitis (CH), 58 hepatic cirrhosis (HC), 38 hepatocellular carcinoma (HCC). A second group ("Controls") of 54 patients (29 males, 25 females) is made of miscellaneous diseases other than CH, HC, HCC. In the first group ("Hepatopathy") serum hepatitis B virus (HBV) surface antigen (HBsAg-radioimmunoassay) is present in 64.9% (85/131). In the second group ("Controls") serum HBsAg is present in 3.7% (2/54) (Chi-2 test P less than 10(-9)). Serum HBsAg prevalence is more than 50% in each group of CH, HC and HCC. A maximum value is observed in males with HCC (75.7%). These results demonstrate the importance of evolutive HBV infection in the course of CH, HC and HCC in the sahelian region.

Adult↗
PubMed1989

Relationship between cirrhosis, liver cancer, and hepatic metastases. An autopsy study.

Consecutive autopsies (5241) performed in the Trieste area and consecutive autopsies (6511) performed in the Tokyo-Chiba area were analyzed to study the frequency of liver metastases in cirrhotics. The Italian material included 500 cases and the Japanese material included 529 cases of liver cirrhosis. Both of these groups were matched for sex and age with a control group. The results were similar in both areas and confirmed the widely held but disputed opinion that metastases in cirrhotic liver are rare. These results seem to be clinically important since they agree with the fact that most neoplasms in cirrhotic liver are primary. From a biologic and epidemiologic point of view, these results call for reconsideration of the complex relationship existing between cancer and liver cirrhosis, in relation to major causative factors such as alcohol and hepatitis B virus (HBV) infection.

Age Factors↗
PubMed2006

Off-pump coronary artery bypass grafting in a patient with Child class C liver cirrhosis awaiting liver transplantation.

We report the case of a Child class C cirrhotic patient who was diagnosed with coronary artery disease in the course of his pretransplantation evaluation. He underwent off-pump coronary artery bypass grafting (OPCAB), which was complicated with acute renal failure. The morbidity and mortality associated with cardiac operation in patients with cirrhosis is discussed, and the potential advantage of OPCAB in this patient population is emphasized.

Coronary Artery Bypass, Off-Pump↗
PubMed1992

Delayed increases in liver cirrhosis mortality and frequency of alcoholic liver cirrhosis following an increment and redistribution of alcohol consumption in Finland: evidence from mortality statistics and autopsy survey covering 8533 cases in 1968-1988.

Changes in the legal restrictions for alcohol consumption in 1969 liberated purchasing and marketing of low-alcohol beer. Subsequently, within the space of 5 years, the per capita consumption of absolute alcohol increased from 4.2 to 6.5 liters. To evaluate the possible effects of this change upon liver cirrhosis mortality as well as prevalence of liver cirrhosis in autopsy series, we surveyed mortality statistics and data from 8,533 medicolegal autopsies in 1968 through 1988. Liver cirrhosis mortality statistics revealed a highly significant (p less than 0.001) increase from 6.4 to 13.7 per 100,000 during the period, and similarly, the prevalence of liver cirrhosis in the autopsy series showed a highly significant (p less than 0.001) increase from 3.0% to 6.1%. More specifically, this increase was attributable to a highly significantly (Chi-square 15.4, p less than 0.001) increased proportion of alcoholic liver cirrhosis occurring at a younger age and almost exclusively in males. The stepwise mode of increase as well as the changes in sex and age distribution of cirrhosis since 1969 could be interpreted as an effect of distribution of consumption to a new generation of consumers. The forensic autopsy series seemed to reflect changes in per capita consumption with a shorter time lag than with mortality statistics. Additionally, only 7% of the 448 cirrhotics singled out from this material exhibited liver cirrhosis as a cause of death and were thus also included in the official mortality statistics, suggesting the greater accuracy of our forensic autopsy series.

Adult↗
PubMed1984

Flow cytometry of nuclear DNA content in liver cirrhosis and liver tumours in rats exposed to acetylaminofluorene.

Male Wistar rats were fed a diet containing 0.025% of the hepatocarcinogen acetylaminofluorene (AAF). One group on animals was exposed to the carcinogen for 16 weeks, following which phenobarbitone 0.5% was added to the drinking water. Liver tumours appeared about 8 months later. Animals from this group showed no marked regenerative changes (cirrhosis or oval cell proliferation) when studied during the initial AAF-treatment. The liver tumours were well differentiated hepatocellular carcinomas and some adenomas. When analyzed by flow cytometry (FCM) these tumours were shown to contain diploid stemlines. After a change in the housing conditions leading to a higher food intake and hence a higher dose of AAF, most of the animals in a subsequent experiment developed hepatic cirrhosis and oval cell proliferation during the initial 10 weeks of AAF-feeding. Eleven cirrhotic nodules from these animals were analyzed by FCM and showed a diploid nuclear DNA-content. Cell samples from liver tissue heavily infiltrated with oval cells also showed diploid nuclear DNA contents.

2-Acetylaminofluorene↗
PubMed1997

[Rehabilitation of patients with alcoholic liver cirrhosis after orthotopic liver transplantation: a 7-year follow-up].

Alcoholic liver cirrhosis is the main indication for orthotopic liver transplantation. Since 1988, 52 patients with alcoholic liver cirrhosis have been transplanted at the Department of Surgery of the University of Heidelberg. The survival rates are as follows: 73% of the patients survived for 1 year, 68% for 2 and 3 years, 64% for 4 years, and 57% survived for 5 years. After transplantation, recidivism occurred in 6 patients. Remarkable in this case was the fact that all 6 patients had a relatively short period of abstention prior to surgery (2 to 5 months). In 12 patients, a small carcinoma was found in the cirrhotic liver. This had neither been seen previously by ultrasound nor by computer tomography. In summary, orthotopic liver transplantation is an excellent mode of treatment in end-stage alcoholic liver cirrhosis. However, the patients have to be carefully selected in order to avoid recidivism following transplantation.

Adult↗