Does general anesthesia affect sinusoidal liver cells as measured by beta-N-acetyl hexosaminidase serum activity level?

Background/aims: General anesthesia causes temporary hypoxia of liver tissue, resulting in several metabolic changes. The purpose of this study was to explore whether the function of hepatic sinusoidal cells, especially the Kupffer and endothelial cells, are damaged following general anesthesia.

Methodology: Liver sinusoidal cell (LSC) function was evaluated by means of measuring the serum level of activity of the lysosomal hydrolase beta-N-acetyl hexosaminidase before and 24 hours after general anesthesia in 20 patients who underwent orthopedic surgery.

Esophagogastric mucosal junction (EGMJ): its location as measured by endoscopy.

The "esophageal" length, i.e., incisors-esophagogastric mucosal junction distance, was measured endoscopically in 758 patients, retrospectively.

Superoxide dismutase activity in Helicobacter pylori-positive antral gastritis in children.

Reactive oxygen metabolites have been implicated in gastric mucosal injuries. Superoxide dismutase, a scavenger of superoxide radical, is a key enzyme in gastric mucosal protection against several damaging factors. This study was aimed at investigating the relationship of superoxide dismutase activity to Helicobacter pylori-induced antral gastritis in children.

Superoxide dismutase activity in duodenal ulcer patients.

Objective: To investigate whether duodenal ulcer (DU) is associated with increased free radical generation at the site of ulceration and to attempt, indirectly, to confirm the hypothesis by determining activity of free radical scavengers such as superoxide dismutase (SOD).

Study Design: Prospective study comparing SOD activity in biopsies taken from the ulcer edge, and antrum in DU patients before and after one month of treatment to SOD activity in biopsies from the duodenal bulb and antrum in a control population.

Setting: Institute of Gastroenterology of a university hospital.

Gastrointestinal patients in the emergency room.

Of 4,839 patients who visited the Emergency Room (ER) of a 650-bed general hospital (serving a regional population of 220,000) over a period of 28 consecutive days, 436 were suffering from gastrointestinal (GI) problems. The patients, together with their 140 ER doctors, were interviewed by 40 trained interviewers and information concerning demographic data, tests performed, diagnosis, treatment and hospitalization was collected and evaluated. Most of the GI patients (39.

[Groove pancreatitis and adenocarcinoma of the pancreatic head].

A mass within the head of the pancreas causing obstructive jaundice is frequently adenocarcinoma, or infrequently focal pancreatitis. Groove pancreatitis is an inflammation of the head of the pancreas which fills the anatomic space between the head of the pancreas on 1 side and the second part of the duodenum on the other. Obstruction from either cause may cause vomiting, abdominal pain, and loss of weight.

"Rendez-vous" procedure (RVP) for obstructive jaundice.

Seven patients with obstructive jaundice were palliatively treated with the "rendez-vous" procedure, which combines a percutaneous and an endoscopic approach to stent insertion into the biliary system. In six cases, pretreatment papillotomy was not needed. Endoscopy was also not really necessary for stenting in one patient.

Vaccination against hepatitis B in a general hospital in Israel: antibody level before vaccination and immunogenicity of vaccine.

We offered hepatitis B vaccine (Heptavax B) to 809 of the health care personnel of a 650-bed regional hospital; 290 accepted the offer. Anti-HBs measurement was done by enzyme immunoassay (AUSAB EIA, Abbott, UK) and expressed in mIU/ml. Seroconversion was determined at a level of 2.

Miliary Crohn's disease: early or different?

We describe what we take to be the eighth case of miliary Crohn's disease since 1967 with a view to the possibility that miliary Crohn's disease is a disease different from Crohn's disease, and not just an early stage. Miliary Crohn's disease might be a different disease because (a) miliary tubercles are seen so rarely on the serosal surface of the bowel, (b) the 100% chance of finding crowded, typical granulomas in the bowel wall, and (c) the anatomic distribution of the lesion.

Buerger's disease presenting as acute small bowel ischemia.

The case of a young man with an unusual presentation of thromboangiitis obliterans with ischemia of the small bowel, 2 years before peripheral vascular disease of the extremities was clinically expressed, is reported.

[Endoscopic retrograde cholangiopancreatography combined with laparoscopic cholecystectomy].

In 11 of 82 patients undergoing laparoscopic cholecystectomy, preoperative endoscopic retrograde cholangiopancreatography (ERCP) was performed. Indications were biliary pancreatitis in 5 and suspected common bile duct (CBD) stones in the other 6 (based on US or liver function tests, or both). The biliary tree was normal in 9 and laparoscopic cholecystectomy was performed.

[Percutaneous endoscopic gastrostomy].

Although percutaneous endoscopic gastrostomy (PEG) for feeding purposes has been in use for the past 10-12 years, many practitioners are unaware of this option. We describe 10 patients who underwent PEG with only 1 major, but nonfatal, complication. We stress that PEG is indicated for those who cannot swallow, and is safe, easy to perform, and a relatively cheap procedure.

Helicobacter pylori Before and After Gastric Reduction for Morbid Obesity.

Nine patients with morbid obesity were evaluated for the presence of Helicobacter pylon (Hp) before gastric reduction, and all were negative. Fifteen patients, Including those nine, were evaluated for the presence of Hp in antral and 'channel' region biopsies by culture and urease test after gastric reduction. Hp-negative patients totaled 73.

Appreciation of pain in the elderly.

Pain was evaluated in 333 duodenal ulcer patients, and 86 myocardial infarction patients by the verbal rating scale method. We compared older patients (greater than 65 years of age) to younger controls and found a highly significant association between old age with mild pain and young age with moderate or severe pain in both diseases. We investigated two totally different diseases and got similar results.

Serum B-N-acetyl hexosaminidase levels in rats with experimental acute pancreatitis, small-bowel ischemia, and small-bowel obstruction.

B-N-acetyl hexosaminidase (B-NAH), a lysosomal hydrolase, was measured in the blood of rats with induced acute pancreatitis, massive small-bowel ischemia, and small-bowel closed-loop obstruction. B-NAH was not significantly elevated within 24 h after induction of the above conditions. This suggests that B-NAH is not an acute phase reactant in a severe acute abdominal catastrophe, such as those mentioned above.

B-N-acetyl hexosaminidase (B-NAH) serum levels after endotoxin administration into the portal vein in the rat.

Endotoxin was injected directly into the portal vein in rats with and without common bile duct (CBD) ligation. B-N-acetyl hexosaminidase (B-NAH) activity levels in the serum were found to be significantly elevated 24 h later in both groups. Serum bile acid levels were found to be significantly higher in the endotoxin-injected groups of rats compared to controls.

Hepatotoxicity induced by the Oriental hornet (Vespa orientalis) venom sac extract.

Experiments were performed to investigate the nature of the in vitro and human liver damage exposed to hornets' acute or repeated stings. The hornet investigated is the one ubiquitous in Israel - Vespa orientalis. Experiments were performed in living cats and rats, after single or multiple exposures to venom-sac extracts (VSE) and in various doses.

Serum-beta-N-acetyl hexosaminidase (beta-NAH) in the elderly.

Serum levels of beta-N-Acetyl Hexosaminidase (beta-NAH) provide information on the normal non-phagocytic function of Kupffer cells in the liver. Beta-NAH can thus be used as an indicator for non-parenchymal non-phagocytic liver cell function, whereas most of the more routine liver function tests measure hepatocytic status or function. Serum beta-NAH activity levels found in 49 patients and 10 healthy individuals above the age of 65 did not differ significantly from those found in younger controls.

Aeromonas in adult diarrhea: an enteropathogen or an innocent bystander?

This is a study from a district hospital in Israel serving a population of 250,000. During 1986-1987, 1,005 stool specimens were cultured from 932 adult inpatients with acute diarrhea. Seventeen yielded Aeromonas species.

[Hepatotoxicity of oriental hornet venom].

Reports of hepatic damage following multiple stings by hornets led to this study of the effects of venom sac extract (VSE) from the oriental hornet. We used in-vivo models (serum of cats following a single exposure, and of rats following repeated exposures), in-situ models (perfusion of intact livers) and in-vitro models (monolayers of fetal rat liver tissue culture). Enzyme activities were measured in serum, in perfusates, and in media of cultures, as well as in liver fractions obtained by ultracentrifugation.