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Biomedical subjects

S Shiomi

Publications and source records attributed to S Shiomi.

At least 91 records · Page 5Linked to original sources
PubMed1994

[The managements of nutrition for hepatic cirrhosis].

Hepatic cirrhosis is the end stage in chronic liver diseases and this condition cause the patient's death because of hepatic failure. A prognosis of patients with hepatic cirrhosis depend on the liver function, especially the function of mass of residual hepatocytes and this function expressed by level of serum albumin, cholinesterase (Ch E) or ICGR-15. This function is improved a management of nutrition because hepatocytes are regenerate by intake of protein. In compensated hepatic cirrhosis, hepatocytes are regenerate by dietary intake of 100-120 g/day of protein and the function of mass of residual hepatocytes is increased. The prognosis of these patients with compensated hepatic cirrhosis are improved by this management of nutrition.

Dietary Proteins↗
PubMed1994

Measurement of portal systemic shunting by oral and per-rectal administration of [123I]iodoamphetamine, and clinical use of the results.

UNLABELLED: OBJECTIVE. We used a method by which the portal shunt index via the superior mesenteric vein (SI-S) and that via the inferior mesenteric vein (SI-I) could be evaluated simultaneously. The clinical usefulness of the method was studied. METHODS: Scintigraphy was done 3 h after subjects took an enteric-coated capsule containing [123I]iodoamphetamine. At that time, the radionuclide was injected into the rectum. Counts for the lungs and the liver were used to calculate the two shunt indices. RESULTS: The mean SI-S and SI-I tended to be higher for disorders that were more severe, increasing in the order of chronic persistent hepatitis, chronic aggressive hepatitis, and cirrhosis. In cirrhotic patients, the SI-I was higher than the SI-S (p < 0.001). The SI-S and SI-I were both higher in cirrhotic patients with esophageal varices than in such patients without varices (p < 0.05 and < 0.001). The SI-S and SI-I were higher in cirrhotic patients with ascites than in such patients without ascites (p < 0.001 and < 0.01). Correlation between either of these indices and classical indicators of functional reserve was high. The correlation of SI-S with the Child-Turcotte classification and total bilirubin level was higher than the correlation of the SI-I and these indicators of functional reserve. CONCLUSIONS: This method permits assessment of the portal hemodynamics in a relatively noninvasive way, and is clinically meaningful.

Administration, Oral↗
PubMed1993

Long-term therapeutic efficacy of interferon for patients with chronic hepatitis C.

Interferon is being used for therapy of chronic hepatitis C, but its long-term results have not been reported. We studied 65 patients with this disease who were monitored for at least 2 years after completion of the therapy. Almost all patients who had responded to therapy at 6 months after the end of therapy had normal levels of alanine aminotransferase (ALT) when evaluated later. The level of ALT became normal for the first time in some patients more than 6 months after therapy ended. The level of ALT in many of the patients without HCV RNA had become normal 6 months after the end of the therapy. One of three schedules was employed: three times weekly long-term; daily for two weeks and none for two weeks in a cycle; and daily for several weeks; 57%, 29%, and 17% of the patients on these schedules came to have normal ALT levels. Patients without HCV RNA at six months after completion of therapy tended to have higher responses in terms an increased level of 2',5'-oligoadenylate synthetase of mononuclear cells in vitro before therapy began. However, therapy three times per week was effective even for some patients judged not responsive to IFN by this test. The results showed that IFN therapy was effective for chronic hepatitis C when judged by long-term results.

Adult↗
PubMed1993

Absence of hepatic uptake of Tc-99m phytate in a man with chronic toluene hepatotoxicity.

The case reported here is of a 28-year-old man diagnosed as having toluene hepatotoxicity. He had a 5-year history of exposure to toluene and was admitted to hospital complaining of two episodes of loss of consciousness. The high total bilirubin and the low prothrombin time suggested serious liver dysfunction. Based on histologic examination of a liver biopsy specimen, the diagnosis of toxic liver dysfunction caused by toluene poisoning was made. Hepatic images were not present in Tc-99m phytate scintigrams, but they were present in hepatobiliary scintigrams done with the Tc-99m N-pyridoxyl-5-methyltryptophan. The diagnosis of hepatic reticuloendothelial failure was made.

Adult↗
PubMed1993

Finding of right hepatic vein focal defect in liver scan of a patient with veno-occlusive disease.

A 38-year-old woman hospitalized for delivery after treatment for infertility with lymphocyte transfusions from her husband developed severe hepatopathy. On the basis of findings in a hepatic specimen obtained by biopsy, the authors diagnosed hepatic veno-occlusive disease. In scintigrams that used Tc-99m phytate, a long, narrow defect was found that extended from the outer part of the right lobe of the liver to the junction of the hepatic veins and the inferior vena cava. In SPECT of the liver performed with Tc-99m phytate, the defect corresponded to the region of the right hepatic vein.

Adult↗
PubMed1993

[Evaluation of clinical usefulness of 99mTc-GSA, a functional hepatic imaging agent--correlation with per-rectal portal scintigraphy].

Liver scintigraphy using 99mTc-GSA, which binds specifically to the asialoglycoprotein receptors on the surface of the hepatocytes, was performed in 41 patients with chronic liver disease (11 chronic hepatitis cases and 30 liver cirrhosis) to investigate the correlations between the images and the various liver function tests. Two liver functional indexes, HH15 for plasma clearance of 99mTc-GSA and LHL15 for liver accumulation of 99mTc-GSA, showed significant differences between the chronic hepatitis group and the decompensated liver cirrhosis group. These indexes also showed significant correlations with the liver function tests such as serum albumin level and prothrombin time. HH15 and LHL15 correlated with the per-rectal portal shunt index obtained in 10 patients by 99mTcO4- per-rectal portal scintigraphy. These results suggest that HH15 and LHL15 have value as new liver functional indexes.

Adult↗
PubMed1993

Results of surgery for portacaval shunt in a patient with situs inversus diagnosed and evaluated by per rectal portal scintigraphy.

A 70-yr-old man diagnosed with situs inversus was hospitalized because of hepatic encephalopathy. Per rectal portal scintigraphy showed portal hypertension and a region with high radionuclide activity in the right lateral region of the abdomen. In percutaneous transhepatic portograms, a giant portacaval shunt was seen in the region with high radionuclide activity. After the portacaval shunt was obstructed surgically, the hepatic encephalopathy disappeared. In per rectal portal scintigraphy done 2 wk after surgery, the pattern was normal and the region with high radionuclide activity had disappeared.

Aged↗
PubMed1992

Detection of hepatitis C virus antibody in the absence of viral RNA in patients with autoimmune hepatitis.

OBJECTIVE: To determine whether laboratory findings showing antibodies to hepatitis C virus (HCV) in patients with autoimmune hepatitis represent false-positive results and to identify possible explanations for true-positive results in these patients. DESIGN: Cross-sectional. SETTING: University-based hospital. PATIENTS: Fifty-two patients with non-A, non-B chronic hepatitis as a control group and 26 patients with classic chronic active autoimmune hepatitis. MEASUREMENTS: Comparison of the results of five kinds of assays of HCV antibodies and HCV RNA. MAIN RESULTS: Of 52 patients with non-A, non-B chronic hepatitis, HCV antibodies (anti-HCV) were detected in 42 patients (81%; 95% CI, 67% to 90%) by a first-generation enzyme-linked immunosorbent assay (ELISA-I), in 39 patients (75%) by Sp42 ELISA, in 37 patients (71%) by RIA-I, in 49 patients (94%) by ELISA-II, and in 48 patients (92%) by RIBA-II. We found HCV RNA in 47 patients (90%; CI, 79% to 97%). Of the 26 patients with autoimmune hepatitis, anti-HCV were detected in 23 patients (88%; CI, 70% to 98%) by ELISA-I, in 12 (46%) by both RIA-I and Sp42 ELISA, in 20 (77%) by ELISA-II, and in 9 (35%) by RIBA-II. However, HCV RNA was found in only five of these patients (19%; CI, 7% to 39%). None of our patients, including controls, had antibodies to superoxide dismutase. Of the 21 patients who had autoimmune hepatitis that was completely responsive to steroid therapy, 18 had anti-HCV by ELISA-I, but 13 of these patients had negative results by RIBA-II, and only two patients had HCV RNA. Of the five patients who did not respond to steroid treatment, all had anti-HCV by ELISA-I, four had negative results by RIBA-II, and three had HCV RNA. CONCLUSIONS: Testing for HCV antibodies in patients with autoimmune hepatitis frequently elicits positive results when the ELISA-I or ELISA-II tests are used. Most of these appear to represent false-positive results because HCV RNA is usually absent from the serum. Such false positivity may result from previous infection with HCV or from cross-reaction of an epitope of HCV. Other patients with apparent autoimmune hepatitis who fail to respond to corticosteroid therapy may actually have chronic hepatitis C (or other non-A, non-B hepatitis) infection.

Adult↗
PubMed1992

Course before and after treatment of a patient with Budd-Chiari syndrome monitored by iodine-123-iodoamphetamine scintigraphy per os and per rectum.

A 55-yr-old woman with Budd-Chiari syndrome was treated by percutaneous transluminal angioplasty with a balloon catheter. Before and after treatment, portal scintigraphy was performed by the administration of [123I]iodoamphetamine per os and per rectum. An enteric capsule was used for the oral administration. Before treatment, the portal shunt index via the superior mesenteric vein was 40.5%; two weeks after treatment, it was 50.2%; and five months after treatment, it was 41.2%. Before treatment, the portal shunt index via the inferior mesenteric vein was 86.0%; two weeks after treatment, it was 87.6%; and five months after treatment, it was 21.8%. The treatment improved the portal circulation through the inferior mesenteric vein only, with little effect on the portal circulation through the superior mesenteric vein.

Amphetamines↗
PubMed1991

Effects of vasopressin on gastric mucosal blood flow in portal hypertension.

In patients with portal hypertension, bleeding from the gastric mucosa is common, and is often treated with vasopressin (VP). VP reduces the portal pressure by contracting the arterioles of the abdominal organs. In normal rats, VP reduces the gastric mucosal blood flow (GMBF). However, it is not sure whether the reduction of the portal pressure by VP actually reduces the GMBF in patients with portal hypertension. Here, we studied the effects of VP on the GMBF of 24 patients with portal hypertension resulting from cirrhosis. The ICG15 test was done for 20 of the patients. We measured the GMBF of the antrum and body of the stomach using a laser Doppler flowmeter (Peliflux PF 2) connected with a gastrofiberscope without VP on one day and about 10 min after the start of administration of VP (0.4 U/min, i.v.) on another day. Unexpectedly, the GMBF was increased with VP in 14 of 22 patients at the antrum and in 19 of 24 patients at the body of the stomach. In the body of the stomach, there was correlation between the increase in the GMBF caused by VP and the results of the ICG15 test. A high ICG15 reflects high portal pressure, so this finding indicates that in high portal pressure, the GMBF is increased by VP, and in low portal pressure, the GMBF is decreased by VP.

Animals↗
PubMed1991

Therapeutic efficacy of interferon on HCV-RNA in chronic hepatitis C.

The efficacy of interferon therapy for chronic hepatitis C were evaluated by the changes of serum RNA of the hepatitis C virus (HCV) by the polymerase chain reaction. Before the treatment, HCV-RNA was detected in all of the 17 patients. 5 patients given IFN for 4 weeks, 12 cases given IFN by the 2 weeks/on 2 weeks off schedule (4 cases given 4 cycles and 8 given 6 cycles). Immediately after the treatment ended, the HCV-RNA was not detected in 12 (71%) cases. Five cases were persistently positive for HCV-RNA and showed continuously abnormal level of ALT. In 7 of 12 cases who became negative for HCV-RNA just after the treatment ended, HCV-RNA was detected again at first and 12th month after therapy. The ALT level were continuously abnormal in 4 of these 7 cases during and after the treatment, and became normal transiently in the other 3. In the 5 cases who became persistently negative (at least 1 year), ALT level decreased to normal or near-normal during follow up for more than one year. According to our results, we classified the therapeutic efficacy of IFN therapy for chronic hepatitis C. Type I response is complete response. In this type, HCV-RNA became negative persistently and ALT became normal or near-normal for at least 12 months after therapy. Type II is partial response. In this type, HCV-RNA became negative transiently and ALT level was transiently normal or poor. Type III is ineffective. In this type, HCV-RNA did not become negative and the effect for ALT was poor.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Hypereosinophilic syndrome appearing as a focal defect on liver scan.

The case reported here is of a 34-year-old man diagnosed as having hypereosinophilic syndrome. Blood tests showed a large increase in the number of eosinophils and a slight increase in aspartate aminotransferase and alkaline phosphatase. In scintigraphy of the liver with Tc-99m-phytate and with Ga-67-citrate, a focal defect was found in the outer part of the right lobe of the liver. Abdominal computed tomography showed a low density lesion in the same area. Histological inspection of the biopsy specimen showed heavy periportal infiltration with eosinophils. The results suggested that the focal defect seen in liver scintigraphy arose from a circulatory disturbance arising from infiltration by eosinophils.

Adult↗
PubMed1991

Measurement of hepatic blood flow by use of per-rectal portal scintigraphy with 133Xe.

A relatively noninvasive method is needed to evaluate the hepatic blood flow of patients with liver disease. We used per-rectal portal scintigraphy with 133Xe, and analysed the time-activity curves of the liver and portal vein. To do this, wash-out curves of the liver were plotted, and the hepatic blood flow and the ratio of the blood flow to the right lobe of the liver to that to the left lobe (R/L ratio) were calculated. The mean hepatic blood flow was 137 +/- 23 ml/100 g/min for four patients with fatty liver, 139 +/- 16 ml/100 g/min for seven patients with chronic persistent hepatitis, 120 +/- 15 ml/100 g/min for ten patients with chronic aggressive hepatitis, and 75 +/- 21 ml/100 g/min for 14 patients with cirrhosis. All seven patients with hepatic blood flow that was less than 100 ml/100 g/min and an R/L ratio less than 1.0 had cirrhosis. Only two of the 22 patients with hepatic blood flow that was greater than 100 ml/100 g/min and an R/L ratio greater than 1.0 had cirrhosis. Per-rectal portal scintigraphy can be used to measure the hepatic blood flow, but it was not useful for the diagnosis of fatty liver.

Administration, Rectal↗
PubMed1990

Effects of putrescine on D-galactosamine-induced acute liver failure in rats.

We studied the effect of putrescine on acute liver failure caused in rats by two injections of 1 gm/kg D-galactosamine. The hepatic polyamine level rose only slightly in the D-galactosamine-injected rats treated with glucagon and insulin, and [3H]thymidine incorporation into DNA increased little; these hormones did not improve the survival rate. When D-galactosamine-injected rats were given putrescine, the putrescine concentration in the liver increased and the survival rate of the rats was significantly higher than that of control rats given only D-galactosamine. Putrescine administration tended to lower the serum level of alanine aminotransferase in rats injected with D-galactosamine, so the polyamine might have a protective effect on hepatocytes. Putrescine significantly increased [3H]thymidine incorporation in the liver; thus it accelerated liver regeneration. Difluoromethylornithine decreased the level of putrescine in the liver, decreasing both [3H]thymidine uptake and the survival rate. In the rats treated with D-galactosamine, in which liver damage was so severe that treatment with glucagon and insulin was ineffective, the intraperitoneal administration of putrescine increased the survival rate in acute liver failure. This probably resulted mainly from activation of liver regeneration and possibly from a protective effect of putrescine on the liver.

Alanine Transaminase↗
PubMed1990

Changes in interferon receptors on peripheral blood mononuclear cells from patients with chronic hepatitis B being treated with interferon.

We studied the binding of 125I-labeled human interferon-alpha to peripheral blood mononuclear cells and the activity of 2',5'-oligoadenylate synthetase in peripheral blood mononuclear cells obtained from 21 patients with chronic hepatitis B who were treated with human interferon-alpha or interferon-beta. Fourteen patients were given interferon daily for 4 wk. Interferon receptors per cell decreased to about 50% of baseline but increased to baseline by 2 wk after therapy ended. The activity of 2',5'-oligoadenylate synthetase rose about fivefold during therapy, decreasing to baseline by 1 wk after the end of therapy. The seven other patients were given interferon daily for 2 wk, no interferon for 2 wk and then interferon daily for 2 wk more. During both periods of therapy on this schedule, interferon receptors decreased to about 50% but returned to baseline 1 wk after the interferon was stopped. The activity of 2',5'-oligoadenylate synthetase increased about fivefold during both the first and second periods of therapy and decreased to baseline 1 wk after interferon was stopped. Close negative correlation existed between the number of interferon receptors and the 2',5'-oligoadenylate synthetase activity. The results of interferon therapy could not be predicted by either the numbers of interferon receptors before therapy or by the decrease in this number during therapy.

2',5'-Oligoadenylate Synthetase↗