We evaluated the utility of magnetic resonance angiography (MRA) for the detection of esophago-gastric varices and assessment of their therapeutic response to endoscopic injection sclerotherapy (EIS). MRA was performed in a total of 12 patients with esophago (E)-gastric (G) varices (V) (9 EV and 3 GV patients) both before and two-weeks after EIS. 25-35 horizontal images were obtained during single breath holding and data were reconstructed by using the two dimension time of flight method. MRA detected varicose lesions in all GV patients and in 7 of 8 EV patients of the grades F2 or higher. Varicose lesion in grade F1 EV patients were initially undetectable before EIS but became evident on MRA after EIS. The portal collaterals were equally well displayed by MRA and the superior mesenteric arteriography at its portogram phase. MRA and endoscopy were concordant for the disappearance or persistence of varicose lesions after EIS. We conclude that MRA is useful for the detection of esophago-gastric varices and other portal collaterals. MRA provides a non-invasive and workable technique in evaluation of patients with esophago-gastric varices undergoing EIS.
Correlation between 5-FU (20mg/kg) administrated via the peripheral vein and tissue concentration of its metabolite was studied in hepatic metastasis model prepared for rats. The measurement of tissue samples collected 30 min. after the 5-FU administration suggested a possible negative correlation between the F-dUMP concentration and the blood flow in the normal hepatic tissue of the control group and the tumor tissue in the metastasis group. In administering 5-FU, a time-dependent anticancer drug, to the tumor rich in the tissue blood flow, washing-off effect of the drug by blood outflow cannot be neglected. Some device of prolonging the exposure time of anti-cancer agent to the tumor tissue will be necessary.
Lactitol, a non-absorbable synthetic disaccharide, was administered at a dose of 36g/day for 3-4 weeks to 8 patients with liver cirrhosis and hepatic encephalopathy in order to investigate its effects on fecal bacterial flora and clinical symptoms of hepatic encephalopathy. Lactitol significantly increased occupation ratio (ratio to total bacterial number) of anaerobic Bifidobacterium (before administration 7.1%→after 4 weeks 46.0% (p<0.05)) as well as bacterial count of Lactobacillus. On the other hand, bacterial counts of Bacteroides and Clostridium, which are considered to be NH3-producing bacteria, and that of total aerobic bacteria were not markedly changed, but their occupation ratio were decreased after the administration. Further, tendencies toward decreased fecal pH, increased frequency of defecation and soft stools were observed. As for clinical efficacy, a decrease in blood ammonia concentration, improvement in mental state and flapping tremor were also observed.
We studied protective effects of dibutyryl cyclic AMP (DBcAMP 15mg/kg i.p.) and OK-432 (5 KE/body), and the role of the spleen on D-galactosamine (D-Gal 500mg/kg i.p.) and lipopolysaccharide (endotoxin : Et 0.5mg/kg i.p.) induced acute liver failure. The survival rates were 10% in the control group (D-Gal + Et), 53% in the group I A (DBcAMP was administered at 1 hour before D-Gal administration), 79% in the group I B (Splenectomy was performed at 24 hours before D-Gal administration on the group I A), 87% in the group II A (OK-432 was administered at 24 hours before D-Gal administration), and 64% in the group II B (Splenectomy was performed at 24 hours before D-Gal administration on the group II A). GOT activities and TNF activities were significantly improved in the treatment groups, and in the group I B and group II A, they were more improved than in the group I A and group II B. In conclusion, spleen had the positive effect for OK-432 treatment, and also had the negative effect for DBcAMP treatment on acute liver failure induced by D-Gal and Et.
Ultrasonic and laboratory studies were performed in 816 white-collar workers over 35 years old who received health examination. Prevalence of fatty liver diagnosed by ultrasonography was 17.9% in all subjects and was maximum (24.4%) in males 45-49 years of age. Obesity index and body mass index were higher in fatty liver than in normal controls. Serum levels of glutamate pyruvate transaminase (GPT), cholinesterase, glutamate oxaloacetate transaminase (GOT), gamma-glutamyl transpeptidase (γ-GTP), triglyceride, total cholesterol, uric acid, HbA1C and glucose were significantly higher, and a serum level of HDL-cholesterol was significantly lower in males with fatty liver than in controls with obesity. Prevalence of abnormal laboratory findings in fatty liver was also shown, and prevalence of fatty liver was prominently high in males with severe obesity or with mild elevation of GPT. A major cause of fatty liver was considered as obesity. In conclusion, fatty liver was a common cause of liver dysfunction and was closely related to risk factors for atherosclerosis especially in white-collar workers.