Hepato Gastroenterol
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Hepato Gastroenterol · Mar 2000
Ultrastructural study of the remnant liver after extensive hepatectomy in dogs; especially morphological alterations of sinusoidal endothelial cells.
To investigate the role of sinusoidal endothelial cells in the mechanism of the remnant liver dysfunction after extensive hepatectomy, morphological alteration of sinusoidal endothelial cells and cytoprotective effects of prostaglandin I2 analog were studied by ultrastructural analysis. ⋯ Our data suggest that extensive hepatectomy changed the morphology of sinusoidal endothelial cells. Administration of prostaglandin I2 analog helped maintain structural integrity of sinusoidal endothelial cells, improved hepatic microcirculation and thus served to reduce remnant liver dysfunction.
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Although screening for rectal cancer remains a controversial topic, the case for screening has been strengthened by the demonstration that screening can reduce mortality from the disease. Three randomized controlled trials based on fecal occult blood testing have shown a significant reduction in overall colorectal cancer mortality in those offered testing. ⋯ Evidence from randomized controlled trials will not be available for another 8-10 years. Whatever screening method is chosen, factors such as the level of participation and the cost-effectiveness of protocols for adenoma follow-up will have major effects on the success of screening.
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Hepato Gastroenterol · Jan 2000
ReviewEtiology and pathophysiology of inflammatory bowel disease--environmental factors.
Environmental factors play an important role in the pathophysiology of inflammatory bowel disease. There is a strong and consistent association between smoking and Crohn's disease, and between nonsmoking and ulcerative colitis. Despite extensive research, the exact pathophysiological mechanisms for these associations remain unclear. ⋯ Other environmental factors such as hydrogen sulfide, tonsillectomy, diet, blood transfusions, and Listeria also require confirmation. There are, however, convincing data from genetic animal models and twin studies that environmental factors as the intestinal bacterial flora interact with susceptible hosts to cause inflammatory bowel disease. Inflammatory bowel diseases have multifactorial etiologies, which require a differentiated approach for treatment and prevention.
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Hepato Gastroenterol · Nov 1999
Comparative StudyHepatic function immediately after hepatectomy as a significant risk factor for early recurrence in hepatocellular carcinoma.
The aim of this study was to clarify the significant risk factors as they relate to early recurrence after hepatectomy in cirrhotic patients with hepatocellular carcinoma (HCC). ⋯ Hepatic functional damage immediately after hepatectomy is as significant risk factor for early intrahepatic recurrence in cirrhotic HCC. Careful perioperative management of hepatic function may therefore be important in preventing early recurrence and prolonging survival.
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Hepato Gastroenterol · Sep 1999
Case ReportsFulminant nonocclusive mesenteric ischemia developing just after esophagectomy.
Nonocclusive mesenteric ischemia (NOMI) is a poorly understood condition, marked by progressive ischemia of the intestine leading to infarction, sepsis and death. The mortality rate remains high. Three cases of NOMI occurred after esophagectomy at our facility. ⋯ Therefore, it should be distinguished from spontaneously developing NOMI. A huge water shift between the intravascular space and the extravascular space during and just after surgery is suspected to have played a major role in the development of post-operative NOMI. Diagnosis and treatment of NOMI after a major surgery are quite difficult.