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  • 1
    ISSN: 1436-2813
    Keywords: intraperitoneal sepsis ; hepatic resection ; bile leakage ; blood transfusion ; gut-origin sepsis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract In this study, the risk factors related to intraperitoneal septic complications occurring after hepatectomy (IPSCH) as well as the effect of various perioperative variables on the outcome of IPSCH between 1985 and 1990 were analyzed. Twenty-one of 211 patients (10.0%) developed IPSCH. The findings in the patients with IPSCH were compared with those in 190 patients without IPSCH. The significant variables associated with the development of IPSCH included a high incidence of accompanying chronic renal failure (14.3% vs 2.1%), a larger blood loss during surgery (2,130 vs 1,340 ml) as well as a greater amount of intraoperative blood replacement (1,130 vs 570 ml), and a greater weight of the resected liver (367 vs 233g). IPSCH occurred in 10 of 12 patients who had postoperative bile leakage. Eighteen patients (85.7%) with IPSCH were discharged from the hospital after non-operative management; however, the hospital death rate (14.3% vs 1.1%) was significantly higher in patients with IPSCH. This review suggests that the incidence of IPSCH has not decreased recently. Thus, to prevent IPSCH, at least following bile leakage, it is necessary to perform a careful division of the liver parenchyma followed by a bile leakage test, and when this complication occurs unexpectedly in patients who have a good functional reserve of the remnant liver, IPSCH can be effectively drained percutaneously under ultrasound guidance.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-2568
    Keywords: hepatitis C virus ; transforming growth factor-ga ; transforming growth factor-β1 ; insulin-like growth factor-II
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The molecular role of hepatitis C virus (HCV) in liver disease has yet to be clarified. In this study, we analyzed the relationship of HCV replication with mRNA expression of growth factors and mutation of tumor suppressor gene, ie, transforming growth factor-β1 (TGF-β1), which promotes cirrhotic changes; TGF-α, insulin-like growth factor-II (IGF-II), which are both related to hepatocyte transformation; and tumor suppressor genep53, which is associated with HCC progression. A semiquantitative RNA polymerase chain reaction (RNA-PCR) was used to analyze genetic expression in 31 cirrhotic liver specimens from patients with HCV. In order to detect HCV replication, the minus-strand RNA of HCV, which serves as a template for the synthesis of genomic plus-strand RNA, was examined. The expression of the growth factors was semiquantified by RNA-PCR, and the mutation ofp53 was detected using PCR-single-strand conformation polymorphism. According to the semiquantitative analysis, HCV replication was not associated with the expression of TGF-β1 but was significantly so with the overexpression of TGF-α (r=0.74) and IGF-II (r=0.65) in the HCV-positive cirrhotic livers. No mutation ofp53 was recognized in any of the samples. Our investigation thus suggested that the replication of HCV might mediate the coexpression of TGF-α and IGF-II and act as a possible initiating factor for hepatocarcinogenesis.
    Type of Medium: Electronic Resource
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