Insulin-like growth factor-1 (IGF-1) can promote enterocyte proliferation which may be beneficial to postoperative conditions after massive small bowel resection (SBR) including the ileocecal valve (ICV). Wistar rats were subjected to SBR including or preserving ICV and continuously received IGF-1 or saline alone. Nutritional status, enterocyte proliferation, liver damage and hepatic IGF-1 mRNA levels were analyzed. Body weights, serum levels of total protein and transferrin, and enterocyte proliferation were significantly lower after SBR including ICV than preserving it. IGF-1 mRNA levels in the liver were decreased after SBR, especially after SBR including ICV. However, IGF-1 therapy significantly attenuated those decreased levels after SBR including ICV. Furthermore, IGF-1 significantly decreased serum liver transaminase levels which were increased after SBR including ICV. Continuous administration of IGF-1 may be available as a supplemented therapy for short bowel syndrome without ICV.

Animals↗

PubMedDate not supplied

High calorie infusion-induced hepatic impairments in infants.

Hepatic impairments have been reported sporadically in infants receiving long-term high calorie infusion. Some characteristic hepatic impairments induced with high calorie infusion at the Juntendo University Hospital, Tokyo, are studied in 18 surgical infants, with discussion of the possible etiology of this complication in the context of high calorie infusion. The hepatic dysfunctions were classified into 3 types by sequential liver function determinations: Type I with a transient and slightly elevated serum transaminase without elevation of alkaline phosphatase; Type II, an elevation of alkaline phosphatase and total and direct bilirubin without elevation of serum transaminase; Type III, a marked and prolonged elevation of aklaline phosphatase, total and direct bilirubin, and serum transaminase. The etiology of these hepatic impairments during high calorie infusion is unknown.

Alanine Transaminase↗

PubMedDate not supplied

An enteral elemental diet for infants and children with surgical disorders.

Sixty-nine infants and children with surgical disorders were fed an enteral elemental diet consisting of synthetic L-amino acids, dextroglucose, soybean oil, electrolytes and vitamins. Satisfactory clinical results were achieved in 55 patients, whose average positive nitrogen balance was approximately 578 mg/day in neonates, 1,518 mg/day in infants and 2,452 mg/day in children; average weight gain was approximately 16 g/day in neonates, 23 g/day in infants, and 21 g/day in children during total enteral nutrition with the diet. Elevation of serum transaminase values was noted in 5 patients receiving total enteral nutrition with the diet. Liver toxicity may have been caused by the composition of amino acids of the diet, solely free amino acids as protein component. However, the diet provided a valuable therapeutic alternative to total parenteral nutrition in selected infants and children requiring surgery.

Child↗

PubMedDate not supplied

Administration of prostaglandin E1 reduces post-operative hepatocellular damage and restores hepatic integrity in patients undergoing hepatectomy.

BACKGROUND/AIMS: The direct protective effects of prostaglandin E1 against hepatic dysfunction are unclear in recent studies. The aim of the present study was to investigate whether post-operative administration of prostaglandin E1 reduces serum concentrations of alpha-glutathione S-transferase, a new indicator of hepatocellular injury, in patients undergoing hepatectomy. METHODOLOGY: The subjects were 15 patients with hepatocellular carcinoma or hilar cholangiocarcinoma undergoing hepatectomy. Prostaglandin E1 was administered to 10 patients (PGE1 group) and was not administered to 5 patients (control group). Prostaglandin E1 was administered for 24 hours from noon on post-operative day 1 to noon on post-operative day 2. Serum concentrations of alpha-glutathione S-transferase, reduced glutathione, cyclic adenosine monophosphate, and total bilirubin, and the concentration of reduced glutathione in bile were measured post-operatively. RESULTS: The serum concentration of alpha-glutathione S-transferase was significantly lower and the serum bilirubin concentration was lower in the PGE1 group than in the control group. The serum concentrations of reduced glutathione and cyclic adenosine monophosphate were significantly higher in the PGE1 group than in the control group. Reduced glutathione in bile was higher in the PGE1 group than in the control group. CONCLUSIONS: The present results show that administration of prostaglandin E1 reduces hepatocellular injury and restores hepatic integrity, post-operatively, in patients undergoing hepatectomy.

Adult↗

PubMedDate not supplied

Predicting survival and post-operative complications with Tc-GSA liver scintigraphy in hepatocellular carcinoma.

BACKGROUND/AIMS: Technetium-99m galactosyl human serum albumin is a novel liver scintigraphic agent. The aim of the present study was to examine whether liver scintigraphy with this agent could predict changes in hepatic function affecting survival in patients with inoperable hepatocellular carcinoma and liver cirrhosis. We also investigated whether the risk of major complications after hepatectomy for hepatocellular carcinoma could be assessed. METHODOLOGY: Liver scintigraphy was performed in 42 patients with inoperable hepatocellular carcinoma and cirrhosis and 40 patients undergoing hepatectomy. The ratio of liver to heart plus liver radioactivity 15 min after injection (LHL15) was calculated. RESULTS: The 1-year survival rates were higher in patients with higher LHL15: 100%, LHL15 > or = 0.91; 77.8%, 0.81 < or = LHL15 < or = 0.90; and 28.6%, LHL15 < or = 0.80. On multifactorial analysis, LHL15 significantly predicted the 1-year mortality rate in the 42 patients (p<0.001). Pre-operative LHL15 was significantly lower in 9 patients with major post-operative complications (0.88+/-0.02) than in 31 patients with uneventful courses or minor post-operative complications (0.93+/-0.01, p<0.001). CONCLUSIONS: Our results suggest that technetium-99m galactosyl human serum albumin liver scintigraphy is effective for predicting short-term survival in patients with inoperable HCC and cirrhosis and for assessing the risk of major complications after hepatectomy.

Aged↗