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L Okolicsanyi

Publications and source records attributed to L Okolicsanyi.

At least 37 records · Page 2Linked to original sources
PubMed1993

Clinical, ultrasonographic, and roentgenographic study in 134 asymptomatic gallstone carriers. Is oral ursodeoxycholic acid treatment worthwhile?

We investigated retrospectively the ultrasonographic and roentgenographic characteristics of the gallstones and the gallbladder in 134 symptom-free carriers and evaluated prospectively the outcome and side effects of 6 to 24 months' ursodeoxycholic acid (UDCA) therapy in 36 individuals with silent stones. Two-thirds of the 134 subjects had multiple stones, and 71-75% had stones less than 15 mm in diameter. Gallstone calcification was detected in 13%. A non-functioning gallbladder was observed in 19%, whereas gallbladder contraction was normal in 64 of 76 gallstone carriers. With regard to oral bile acid treatment, complete and partial dissolutions were achieved in 7 and 9 of 33 subjects, respectively (48.5%). Development of a non-functioning gallbladder occurred in 9%, and acquired gallstone calcification was seen in another 15%. We conclude that: i) the characteristics of the gallstones and the gallbladder are similar to those observed in symptomatic patients, and ii) UDCA therapy may be given in selected symptom-free carriers for no more than 6-12 months. Thereafter, it does not appear to be cost-effective.

Administration, Oral↗
PubMed1992

Hepatitis C virus in dialysis units: a multicenter study.

Three hundred and eighty-seven chronic hemodialysis patients were evaluated, in a multicenter study, to investigate the epidemiology of hepatitis C virus. In anti-HCV seropositive patients, serum ALT values and blood transfusions were retrospectively compared; blood donors were studied for serum transaminases. In seropositive patients without previous blood transfusions, analysis of dialysis schedule was done. Eventually, the intrafamilial transmission of hepatitis C virus was studied in 104 family members. The prevalence of HCV infection in hemodialysis patients was 15.7%. The incidence of acute hepatitis was frequent, while chronic hepatitis incidence was less than expected (17.5%). Intrafamilial diffusion was low (1.9%). Blood-transfusion-related infections seem to be negligible, while cross-contamination in dialysis units seems to be very important.

Alanine Transaminase↗
PubMed1992

Comparison between first- and second-generation test for anti-hepatitis C virus antibodies in hemodialysis patients.

The serum of 387 hemodialysis patients from 9 dialysis units was checked for anti-hepatitis C virus antibodies with a 1st-generation ELISA (Ortho) test: 61 patients were repeatedly positive. In order to avoid false-positive results, these sera were tested with a 1st-generation confirmatory RIBA test, 2nd-generation screening ELISA test and 2nd-generation confirmatory RIBA test. The 2nd-generation ELISA test confirmed data obtained with 1st-generation ELISA, however, the 1st-generation confirmatory RIBA test underestimated the number of anti-HCV-positive patients.

Diagnostic Errors↗
PubMed1992

Cytoprotection in the nineties: experience with ursodeoxycholic acid and silymarin in chronic liver disease.

The authors report their experience in the use of ursodeoxycholic acid and silymarin in patients with active cirrhosis of different aetiology. Both drugs seemed safe and ameliorated the biochemical indices of cytolysis; however, the former did not appear to be effective when hepatic dysfunction was associated to hepatitis C infection. The residual functional liver mass, as assessed by quantitative liver function tests, was not affected by either cytoprotective agent.

Chronic Disease↗
PubMed1992

Cytoprotection with ursodeoxycholic acid: effect in chronic non-cholestatic and chronic cholestatic liver disease.

Studies in vitro and in vivo show that hydrophobic bile acids tend to accumulate in the liver tissue in chronic liver disease, thus damaging hepatocyte membranes. Ursodeoxycholic acid (UDCA) is a hydrophilic bile acid which counteracts hepatotoxicity of more hydrophobic bile acids by partially replacing the pool of bile acids in the liver and/or by inhibiting the intestinal absorption of toxic bile acids. UDCA seems safe and effective in the early stages of primary biliary cirrhosis (PBC), primary sclerosing cholangitis (PSC) and possibly in other severe cholestatic syndromes of infancy. Moreover, there is increasing evidence that UDCA improves the common indices of liver function in chronic non-cholestatic hepatic disorders including active cirrhosis, though maintaining the residual functional liver mass. This article reviews the cytoprotective effect of UDCA in chronic cholestatic and non-cholestatic liver disease based on the results of major clinical trials on this topic.

Bile Acids and Salts↗
PubMed1990

Effect of age on single- and multiple-dose pharmacokinetics of erythromycin.

The effect of age on the pharmacokinetics of erythromycin was investigated by comparing its kinetic behaviour in eight young healthy adults and eight healthy elderly subjects after single and repeated oral doses of erythromycin stearate 1 g b.d. for 7 doses. The peak serum concentration and area under the serum concentration-time curve (AUC) were significantly greater in the elderly subjects than in the young controls after single and multiple doses. Accordingly, the apparent oral clearance was lower in the elderly subjects (0.31 vs 0.64 and 0.22 vs 0.69 l.h-1.kg-1 after the first and seventh administration, respectively). The mean elimination half-life was significantly longer in the elderly group only after multiple dosing (4.8 vs 2.3 h). No age-related difference was observed in the time to peak serum concentration and apparent volume of distribution. The multiple-dose regimen resulted in an almost two-fold accumulation of erythromycin in the older individuals and no accumulation in the young adults. Mean drug accumulation in elderly subjects at steady state was 43% greater than was predicted from the AUC after the first dose, suggesting a time-dependent reduction in both systemic and presystemic clearance. The results indicate that the metabolic elimination processes for erythromycin are impaired in normal elderly subjects and suggest that caution is required on administering a high dose of it to aged people.

Adult↗
PubMed1990

Laparoscopy and liver biopsy: further evidence that the two procedures improve the diagnosis of liver cirrhosis. A retrospective study of 1,003 consecutive examinations.

We examined retrospectively 1,003 patients with chronic liver disease who underwent laparoscopy and liver biopsy. The diagnosis of cirrhosis was made in 411 patients and excluded in 570; in the remaining 22 patients, the laparoscopic/histologic diagnosis was inconclusive. When the two techniques were considered separately, a final diagnosis of cirrhosis was possible in 78.4% by laparoscopy and in 78.8% by biopsy of the total of 411 cases, whereas, doing both procedures improved the diagnostic yield to 97.7% by decreasing the percentage of false negatives for each technique. Laparoscopy can also provide important additional information by detecting intrabdominal signs of portal hypertension and so improve the macroscopic diagnosis of cirrhosis. In particular, splenomegaly seen at laparoscopy seems to be an important feature for the diagnosis and evaluation of chronic liver disease.

Adolescent↗
PubMed1989

Pharmacokinetics of miocamycin in patients with liver cirrhosis.

The pharmacokinetics of miocamycin, a new macrolide antibiotic, was studied in 6 healthy controls and 6 patients with compensated liver cirrhosis. The results indicate that in chronic liver disease the kinetics of the drug is altered. Therefore, a dosage adjustment of miocamycin is recommended when dealing with these patients.

Administration, Oral↗
PubMed1988

Smooth liver surface may conceal cirrhosis. Evidence for the late development of nodular surface of the cirrhotic liver.

A 22-year-old male student with HBs Ag + acute hepatic necrosis was admitted to our clinic for further examination. Since his liver function worsened, laparoscopy with direct vision hepatic biopsy was performed. Macroscopically, the surface of the liver did not show the characteristic nodular appearance, in contrast to histological alterations suggestive of liver cirrhosis. Eight months later, a second laparoscopic/bioptic examination was performed. The liver surface appeared nodular, while the histological picture was unchanged vis-a-vis the first examination. The discrepancy between the macroscopic findings observed at the first laparoscopy and those seen eight months later, would suggest that cirrhosis initially develops "inside" the liver and can only be detected histologically; the characteristic nodularity of the liver surface "emerges" subsequently.

Adult↗
PubMed1988

[Echography with portable equipment. Its possibilities and limits in the hepatobiliary area].

Ultrasound examination of the liver by simple low-cost equipment (LCUS) is currently performed. In order to evaluate the accuracy of this imaging technique in the detection of liver diseases, 150 outpatients were examined with a LCUS unit. The same patients were then re-examined with more sophisticated equipment (SEUS) in a department of radiology. The images thus obtained were compared to the previous ones: LCUS appears to be a valuable screening method, even though several US features--i.e. hyperechogenicity of the liver, focal hypoechoic lesions, and microlithiasis--are better demonstrated by more sophisticated units.

Adolescent↗
PubMed1987

Validity of laparoscopy after abdominal surgery.

The authors carried out a retrospective study to investigate the effect of previous abdominal surgery on the validity of laparoscopy. Laparoscopy was done in 2,000 patients with liver disease, between 1976 and 1985. Of these, 250 (12.5%) had undergone abdominal operations, and all presented with intraperitoneal adhesions. The whole surface of the liver was visible in 45.3%, but only in part in 46.2% of patients with upper abdominal operations (cholecystectomy, gastric surgery). Lower abdominal surgery (appendectomy, gynaecological operations) was associated with complete visibility of the liver in 97.5% of the cases. Laparotomy was followed by the highest incidence of non-visibility of the liver (28.5%). In the other 1,750 patients without abdominal operations, adhesions were detected only in 83 (4.1%) and the liver was entirely observable in 83.1% of these. In conclusion, previous abdominal surgery does not represent an absolute contraindication to laparoscopy, since risks are not as great as one might suppose. Although the view of the liver is sometimes impaired, laparoscopy retains its role in the assessment and therapy of liver disease, and avoids complications related to blind biopsy of the liver.

Abdomen↗
PubMed1986

The effect of drugs on bile flow and composition. An overview.

Many drugs are eliminated via the hepatobiliary route, after biotransformation in the liver. Some of them may affect bile flow and/or the hepatic secretion of biliary lipids such as bile acids, cholesterol and phospholipids. Bile acids are the most potent agents which increase bile flow, especially unconjugated bile acids. Other drugs which increase bile flow include phenobarbitone (phenobarbital), theophylline, glucagon and insulin. In contrast, ethacrynic acid, amiloride, ouabain, oestrogens and chlorpromazine are among those agents which decrease bile flow. Biliary bile acid secretion is altered by a variety of drugs, including cheno- and ursodeoxycholic acids (CDCA and UCDA), the bile acid sequestrants cholestyramine and colestipol, and ethinyloestradiol. The composition of bile can also be altered by drug therapy. Thus, clofibrate increases biliary cholesterol secretion, and reduces bile acid concentrations, without altering biliary phospholipid concentrations. However, other clofibrate derivatives may produce changes of a different pattern, suggesting that the risk of developing gallstones may differ for each derivative. Nicotinic acid and d-thyroxine also increase biliary cholesterol saturation, while CDCA and UDCA reduce biliary cholesterol concentration. The potential consequences of drug-induced changes in bile flow and composition extend to the liver, the gallbladder and the intestine. If adverse effects are to be avoided, further study in this often overlooked area is required.

Animals↗
PubMed1985

Pharmacokinetics of Josamycin in patients with liver cirrhosis and Gilbert's syndrome after repeated doses.

The pharmacokinetics of Josamycin was studied in 31 subjects (10 normals, 9 Gilbert's syndrome and 12 compensated liver cirrhosis) after the administration of Josamycin (1 g orally) and in 13 subjects (4 normals, 4 Gilbert's syndrome and 5 compensated liver cirrhosis) after 3-day Josamycin treatment (1 g orally every 12 hours). Josamycin pharmacokinetics was impaired in liver cirrhosis and, to a lesser extent, in Gilbert's syndrome. Moreover, in the three groups of individuals studied the drug accumulated after multiple dosing. These results suggest that a dosage adjustment of Josamycin is recommended when dealing with these patients.

Adult↗
PubMed1984

Oral and intravenous pharmacokinetics of ranitidine in patients with liver cirrhosis.

The kinetics of p. o. (150 mg) and i.v. (50 mg) ranitidine was studied in nine healthy controls and in nine patients with compensated liver cirrhosis. Plasma concentrations and urinary recovery of unchanged drug were determined by high performance liquid chromatography. The pharmacokinetic data observed in the cirrhotic patients did not differ from those of controls after p.o. or i.v. administration. Moreover, oral bioavailability was similar in controls and cirrhotics. In conclusion, the pharmacokinetics of ranitidine is not altered in patients with compensated liver cirrhosis.

Administration, Oral↗