Non-alcoholic steatohepatitis induces non-fibrosis-related portal hypertension associated with splanchnic vasodilation and signs of a hyperdynamic circulation in vitro and in vivo in a rat model.

Introduction: Steatosis, without fibrosis, may lead to changes in liver blood flow, which are poorly understood, and to date have not been correlated to portal pressure and related haemodynamics.

Aims: To study the temporal relation between progressive steatosis, portal pressure, systemic haemodynamics, vascular responsiveness, mesenteric and portal blood flow in methionine-choline-deficient diet (MCDD)-fed rats.

Methods: Male Wistar rats fed the MCDD were examined at week (w) 0-1-2-3-4-5-6-7-8, respectively, including systemic haemodynamics and portal pressure.

The metabolic syndrome and the liver.

Together with the worldwide epidemic proportions of obesity the incidence of 'the metabolic syndrome' is rising across countries. The metabolic syndrome is described as a complex condition that is linked to (intra-abdominal) obesity and is characterized by insulin resistance, dyslipidaemia and hypertension. Several definitions for the metabolic syndrome have been suggested, all trying to identify individuals at high risk for both type 2 diabetes and cardiovascular disease.

Efficacy of the combination of long-acting release octreotide and tamoxifen in patients with advanced hepatocellular carcinoma: a randomised multicentre phase III study.

To assess the efficacy of the combination of long-acting release (LAR) octreotide and tamoxifen (TMX) for the treatment of advanced hepatocellular carcinoma (HCC). A total of 109 patients with advanced HCC were randomised to receive octreotide LAR combined with TMX (n=56) (experimental treatment group) or TMX alone (n=53; control group). The clinical, biological and tumoural parameters were recorded every 3 months until death.

Fine needle trucut biopsy in focal liver lesions: a reliable and safe method in identifying the malignant nature of liver lesions.

Background And Study Aims: The correct management of a focal liver lesion, suspected of being malignant, requires tissue for histopathological examination. To this purpose an ultrasonically guided fine needle trucut biopsy technique (FNTCB) can be used, to allow obtaining large tissue samples. The aim of the study is to see that FNTCB is a reliable method in identifying the malignant or benign character of a focal liver lesion.

Viral hepatitis and hepatocellular carcinoma.

Background: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors in the world. The incidence of HCC varies considerably with the geographic area because of differences in the major causative factors. Chronic hepatitis B and C, mostly in the cirrhotic stage, are responsible for the great majority of cases of HCC worldwide.

Bacillus Calmette-Guérin-induced granulomatous hepatitis in a patient with a superficial bladder carcinoma.

A 71-year-old male patient with a superficial transitional cell carcinoma of the urinary bladder developed high fever and jaundice, accompanied by progressively increasing serum aminotransferase activities, 2 weeks after the fourth local instillation with an attenuated live strain of Mycobacterium bovis [bacillus Calmette-Guérin (BCG)]. A liver biopsy showed non-caseating granulomatous hepatitis. Cultures for mycobacteria were negative.

Bilateral adrenal haemorrhage and acute adrenal insufficiency in a blunt abdominal trauma: a case-report and literature review.

Blunt abdominal trauma is frequently associated with adrenal haemorrhage, and is preferentially diagnosed by computed tomography scan. Lesions are mostly unilateral and asymptomatic and are therefore frequently overlooked. Bilateral haemorrhage, however, has a high mortality rate as a result of acute adrenal insufficiency.

Multifactorial aetiology of hepatic infarction: a case report with literature review.

The rarity of hepatic infarction has been explained by the protection from ischaemia provided by the double arterial and portal inflow. Hepatic infarction hence should require the association of multiple factors jeopardizing compensatory mechanisms. We report on a case of hepatic infarction related to combined hepatic arterial and portal venous thrombosis after a blunt abdominal trauma, a previously unreported cause of hepatic infarction.

Coagulation disorders in patients with cirrhosis and severe sepsis.

Background: In patients with cirrhosis, severe sepsis may stimulate the extrinsic coagulation pathway resulting in thrombin generation and fibrin formation.

Aims: To compare 23 patients with severe sepsis to 13 infected patients without severe sepsis and 18 patients without infection.

Methods: Zymogen forms of clotting factors involved in the extrinsic pathway (i.

The use of ursodeoxycholic acid in patients with primary biliary cirrhosis: sense or nonsense.

Ursodeoxycholic acid is the most widely evaluated drug for the treatment of primary biliary cirrhosis. The results of the first randomized controlled trials are very discordant in terms of survival benefit. This, however, can be explained by differences in methodology and insufficiently long period of treatment and follow-up.

Biopsy of focal liver lesions: guidelines, comparison of techniques and cost-analysis.

When a focal liver lesion is discovered, differentiation between a benign and malignant nature and further characterization are mandatory to guide further treatment. Histology remains the golden standard. Improving imaging techniques such as contrast enhanced Doppler ultrasonography, spiral CT and new MRI procedures are promising, but not 100% accurate.

Perforating oesophageal carcinoma presenting as necrotizing fasciitis of the neck.

A patient with a history of schizophrenia was admitted to our hospital in an already severe stage of necrotizing fasciitis of the neck, complicated with mediastinitis and gangrene. Later on, he also developed a vena cava superior syndrome and sepsis. In the few cases and small series described in the literature, necrotizing fasciitis of the neck is usually associated with surgery or trauma.

Ultrasonically guided fine needle puncture of focal liver lesions. Review and personal experience.

Despite recent advances in diagnostic imaging of the liver, the management of a patient with focal liver lesions often depends on obtaining tissue for histological diagnosis. Ultrasound guided fine needle biopsy is recommended as a safe and reliable method for cyto-histological confirmation of suspected hepatic malignancy. A fine needle is conventionally defined as having an outer diameter < or = 0.