[Extreme hyperbilirubinemia].
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Biomedical subjects
Publications and source records attributed to R Olsson.
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In a series of 74 portacaval-shunted patients no statistically significant differences in long-term survival or in incidence of postoperative encephalopathy have been observed between electively and emergency operated patients, between patients with slight and moderate impairment of liver function (groups A and B according to Child) or between patients with alcoholic and non-alcoholic cirrhosis. Patients older than 60 years had a higher risk of postoperative encephalopathy and a border-line significantly lower survival rate six months after the operation. Among the patients with more than six months' survival, about 50% returned to work.
One group of 8 patients with primary biliary cirrhosis and one group of 7 patients with common duct stone both had generally high levels of blood coagulation factors and a wide range of other plasma proteins. In contrast, one group of 6 patients with chronic active hepatitis generally had low levels of the same coagulation factors and plasma proteins. Analyses of factor II-VII-X, plasminogen, ceruloplasmin, beta1C/1A-globulin, IgG and IgM are especially helpful in the differentiation between primary biliary cirrhosis and chronic active hepatitis. The data are interpreted as suggesting a generally increased synthesis of liver-produced proteins in cholestasis, although more specific factors may modify the degree of increase of the individual proteins.
Rats were given 36 per cent of calories as ethanol, gin, brandy, whisky or red wine together with hypocaloric (25 per cent of normal), hypocaloric--low-protein--highfat, or hypocaloric--low vitamin diets for several months and compared with rats given isocaloric amounts of glucose instead of alcohol. In spite of high mortality rate no severe liver lesions occurred, especially no cirrhosis. Congeners present in different alcoholic beverages therefore seem to lack important hepatotoxic effects at least in the rat.
Male rats were given 50 per cent of calories as ethanol, whisky, brandy, gin and red wine for 8-9 months together with moderate or low protein and vitamin supply. Histological studies at sacrifice failed to detect signs of hepatotoxicity, but biochemical studies indicated that at least red wine and whisky produced more undesirable effects on the liver than ethanol.
No pathological changes in the pancreas, kidneys or skeletal muscle were found in rats maintained for 8 to 9 months with a diet in which alcohol made up 50% of the total calories. An increase of the dietary fat content to 38% did not cause any fatty infiltration of the myocardium.
Seven patients with coexisting chronic active hepatitis and ulcerative colitis are reviewed. The activity of the two diseases varied independently. Proctocolectomy was necessitated in 6 patients and was followed by disappearance or decreased in titres of smooth muscle and antinuclear autoantibodies and immunoglobulins and, in one patient, by a rapid normalization of markedly elevated transaminases. Although the series are small, we feel that our data suggest that proctocolectomy for severe ulcerative colitis may have some beneficial effect on a coexisting chronic active hepatitis.
The constant failure to produce a liver cirrhosis that can be ascribed to alcohol in the rat promoted the present study in guinea-pigs. The animals were given 40 per cent of calories as ethanol during 8 months. However, no alcoholic hepatitis or cirrhosis developed. Triglycerides and cholesterol increased in the liver and in serum. The persistance of liver triglyceride increase in spite of a rather low fat content of the diet is in contrast to experiences in the rat. A slight depression of coagulation factors II, VII, X and XI was observed in the ethanol-fed animals.
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