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Current Issue

July - September, 2002

Vol. 1 Issue 3

On the cover: Official Journal of the Mexican Association of Hepatology

CONCISE REVIEW

  • Drug treatment for portal hypertension Maria Mela, Andrea Mancuso, Professor Andrew Burroughs Page 102-120

    Pharmacological treatment of portal hypertension has played an increasing clinical role in the past 20 years. In the setting of acute variceal bleeding, drug therapy should be considered the initial treatment of choice and can be administered as soon as possible; even during the transfer of the patient to hospital. Several recent trials have reported similar efficacy to emergency sclerotherapy, therefore drug treatment should no longer be considered as a "stop gap" therapy until definitive endoscopic therapy is performed but continued for several days. Antibiotic prophylaxis is an integral part of therapy as it reduces mortality and should be instituted from admission. Non selective b-blockers are the treatment of first choice for secondary and primary prevention. If they are contraindicated or non tolerated banding ligation can be used. There is less evidence for the benefit of ligation for primary prophylaxis. The use of haemodynamic targets for reduction in hepatic venous pressure gradient response need further study, and surrogate markers of pressure response need evaluation.

  • From lipid secretion to cholesterol crystallization in bile. Relevance in cholesterol gallstone disease Piero Portincasa, Antonio Moschetta, Giuseppe Palasciano Page 121-128

    Failure of cholesterol homeostasis in the body can lead to cholesterol gallstone disease, the most common and costly gastrointestinal disease. The primum movens in cholesterol gallstone formation is the hypersecretion of hepatic cholesterol; this condition leads to bile chronically surpersaturated with cholesterol which is prone to rapid precipitation as cholesterol crystals in the gallbladder. Essential topics reviewed here deal with pathways of biliary lipid secretion, cholesterol solubilization and crystallization in bile, according to recent advances. Main in vivo events in cholesterol gallstone disease are also described.

  • Hepatitis C and liver transplantation Rosalba Moreno, Marina Berenguer Page 129-135

    Hepatitis C virus-related end-stage liver disease, alone or in combination with alcohol, has become the leading indication for liver transplantation in most transplant programs accounting for approximately half of transplants performed in European centers. The aim of this review is to analyze the factors involved in the results in different groups of patients with HCV underwent to liver transplantation. The groups involved those pretransplantation, post-transplant HCV infection, preventive early post-transplantation and with of recurrent hepatitis C.

  • Hepatic adenomatosis in an Hispanic patient. A case report and review of the literature Aldo Montaño-Loza, Aurelio Ríos-Vaca, José María Remes-Troche, Judith Meza-Junco, Sagrario del Pilar Trinidad-Hernández Page 136-139

    Objective: Liver adenomatosis (LA) is a rare disease originally defined by Flejou et al. in 1985 from a series of 13 cases. Only 57 cases have been reported in the literature, and all have been documented among Caucasian population. The aim of this study is to review and reappraise the characteristics of this rare liver disease, and to discuss the diagnosis and therapeutic options. Background: LA is defined as the presence of >10 adenomas in an otherwise normal liver parenchyma. Neither female predominance nor a relation with estrogen/progesterone intake has been noted. Natural progression is poorly understood. Methods: We describe the clinical presentation, evolution, radiologic studies, histologic characteristics and therapeutic options in a 3rd generation Mexican woman with LA. We also include an updated review of the literature. Results: The natural history and pathogenesis of LA are unclear. The risk of spontaneous hemorrhage or malignant transformation are a major concern. There is controversy regarding the optimal treatment for this disease; treatment options range from conservative medical therapy to surgical resection and even liver transplantation. Conclusion: LA is a rare disease, more common in women, and its outcome and evolution vary. Most often, conservative surgery is indicated. Liver transplantation is indicated only in highly symptomatic and aggressive forms of the disease.

ORIGINAL ARTICLES

  • The effect of rewarming media composition on the ammonia detoxification ability of cold preserved rat hepatocytes Sebastián Dante Calligaris, Edgardo Elvio Guibert, Joaquín Valentín Rodríguez Page 140-146

    We examined how different media composition of rewarming solutions affected ammonium detoxification function, urea synthesis and the viability of hepatocytes after 72 hs of cold storage in UW solution. Freshly isolated rat hepatocytes were incubated at 37 ºC in a cell culture medium (MEM-E) with 3 mM glycine, 5 mM fructose and 2.5 mM adenosine (group 1) and in Krebs-Heinseleit buffer with 3 mM glycine, 5 mM fructose, 2 mM ornithine, 10 mM lactate and adenosine, that was used in two different concentrations: 2.5 mM (group 2) and 10 mM (group 3). We found that freshly isolated cells produced ammonium in group 1 and 2 but the cells were able to diminish ammonium extracellular concentration in group 3. Urea synthesis and ammonium extracellular concentration in group 1 was higher than in group 2. As a result of this observations, we used the Krebs-Heinseleit solution with addition of 10 mM adenosine to determinate the effect of hypothermic preservation on ammonium detoxification and urea synthesis ability of cells. In conclusion the addition of 2.5 mM adenosine into the rewarming Original Article The effect of rewarming media composition on the ammonia detoxification ability of cold preserved rat hepatocytes Sebastián Dante Calligaris,1 Edgardo Elvio Guibert,2 Joaquín Valentín Rodríguez1 medium interfered with the detection of ammonium detoxification of hepatic cells.

IMAGES IN HEPATOLOGY

SPECIAL NOTICE

The Official Journal of the Mexican Association of Hepatology, the Latin-American Association for the Study of the Liver and the Canadian Association for the Study of the Liver

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