Toxic hepatitis or drug-induced liver injury encompasses a spectrum of clinical disease ranging from mild biochemical abnormalities to acute liver failure.The advantages of a long half-life,wide spectrum,high tissue p...Toxic hepatitis or drug-induced liver injury encompasses a spectrum of clinical disease ranging from mild biochemical abnormalities to acute liver failure.The advantages of a long half-life,wide spectrum,high tissue penetration rate,and a good safety profile,make ceftriaxone,a third-generation cephalosporin,a frequent choice in the treatment of childhood infections.Previous studies have reported a few cases of high aspartate aminotransferase and alanine aminotransferase levels,along with three cases of hepatitis caused by ceftriaxone.Here,we report a case of drug-induced toxic hepatitis in a patient who was treated with ceftriaxone for acute tonsillitis.展开更多
AIM： To investigate the usefulness of direct hemoperfusion with a polymyxin B-immobilized fiber column （DHP-PMX therapy） for warm hepatic ischemia-reperfusion （I/R） injury after total hepatic vascular exclusion ...AIM： To investigate the usefulness of direct hemoperfusion with a polymyxin B-immobilized fiber column （DHP-PMX therapy） for warm hepatic ischemia-reperfusion （I/R） injury after total hepatic vascular exclusion （THVE） using a porcine model. METHODS： Eleven Mexican hairless pigs weighing 22-38 kg were subjected to THVE for 120 min and then observed for 360 min. The animals were divided into two groups randomly： the DHP-PMX group （n = 5） underwent DHP-PMX at a flow rate of 80 mL/min for 220 min （beginning 10 rain before reperfusion）, while the control group did not （n = 6）. The rate pressure product （RPP）： heart rate x end-systolic arterial blood pressure, hepatic tissue blood flow （HTBF）, portal vein blood flow （PVBF）, and serum aspartate aminotransferase （AST） levels were compared between the two groups. RESULTS： RPP and HTBF were significantly （P 〈 0.05） higher in the DHP-PMX group than in the control group 240 and 360 min after reperfusion. PVBF in the DHP-PMX group was maintained at about 70% of the flow before ischemia and differed significantly （P 〈 0.05） compared to the control group 360 min after reperfusion. The serum AST increased gradually after reperfusion in both groups, but the AST was significantly （P 〈 0.05） lower in the DHP-PMX group 360 min after reperfusion. CONCLUSION： DHP-PMX therapy reduced the hepatic warm I/R injury caused by THVE in a porcine model.展开更多
There is a general consensus in re-interpreting the so-called liver function tests in the light of novel discoveries. At the same time, recent evidence favours the use of different laboratory data to assess liver dama...There is a general consensus in re-interpreting the so-called liver function tests in the light of novel discoveries. At the same time, recent evidence favours the use of different laboratory data to assess liver damage, fibrosis or regenerative process, but this point is not always shared. Actually, balancing the need for diagnosis, prognostic evaluation and therapy response of liver disease with a good cost/benefit ratio is very difficult. New tests are probably not needed but the aim should be for better utilization of existing tests to contain the increasing cost of health care.展开更多
Objective:Hepatocellular carcinoma (HCC) is among the most common and rapidly increasing cancers in Pakistan.There is currently no standard management for advanced HCC.The aim of the study was to assess response rate ...Objective:Hepatocellular carcinoma (HCC) is among the most common and rapidly increasing cancers in Pakistan.There is currently no standard management for advanced HCC.The aim of the study was to assess response rate and toxicity of concomitant gemcitabine and external radiation therapy (ERT) in locally advanced HCC.Methods:Sixty patients were enrolled.Gemcitabine,70 mg/m2 was given weekly during ERT.ERT was delivered with 60Co beam up to 30.6 Gy,1.8 Gy/fraction.Tumor response was assessed by computed tomography (CT) at eight weeks.Complete and partial response (CR and PR),progressive and stable disease (PD and SD) were assessed.Hematological,gastrointestinal and hepatic toxicities were assessed weekly.Results:No CR was seen.PR,SD and PD were seen in 33%,40% and 27% of patients respectively.Grade 3/4 toxicity for total leukocyte count and platelets was observed in 7% and 27% patients.Grade 3/4 toxicity for liver failure,bilirubin,aspartate aminotransferase,alanine aminotransferase and alkaline phosphatase was seen in 35%,28%,38%,24% and 43% patients respectively.Conclusion:The study showed that concomitant gemcitabine and ERT is a feasible option with moderate toxicity in advanced HCC.展开更多
Cyphostemma digitatum （Vitaceae） is a perennial, climbing, succulent undershrub with compound fleshy leaves and tendrils. The plant is used mainly as a food flavoring, but it is also a main constituent of traditiona...Cyphostemma digitatum （Vitaceae） is a perennial, climbing, succulent undershrub with compound fleshy leaves and tendrils. The plant is used mainly as a food flavoring, but it is also a main constituent of traditional Yemeni soup （Marak）. Besides that, it has been described to be used as a medicinal plant. The aim of this work was to study the hepatoprotective effect of the aqueous extract of C. digitatum against CCl4-induced liver injury in Guinea pigs. Animals were divided into four groups. Group I, served as normal control. Group II received 2 mL CCl4/kg b.w. diluted with olive oil, at 1：1 ratio on day 11. Group III （test group） was pre-treated orally with 100 mg/kg b.w. aqueous leaves extract of C. digitatum for 10 days followed by subcutaneous injection of CC14 （2 mL/kg b.w.）, once on day 11. Group IV were orally given Liv-52 （100 mg/kg b.w.） once daily for 10 days followed by subcutaneous injection of CC14. Our results show that, the activity of serum hepatic enzymes （alanine aminotranferase （ALT）, aspartate aminotranferase （AST）, and alkaline phosphatase （ALP）） were significantly elevated in Guinea pigs treated with CCl4, while both the C. digitatum extract and Liv-52 reduced significantly these enzymes activity. Also, the levels of glucose, urea, cholesterol and triglycerides were decreased when compared with intoxicated control. Histopathological examination of intoxicated animals showed fatty changes, inflammation and necrosis indicating liver damage, while the animals received C. digitatum or Liv-52 showed less pathological effects or normal liver when compared to animals treated with CC14 alone. Biochemical and histological results confirm the hepatoprotective effect of aqueous extract of C. digitatum.展开更多
文摘Toxic hepatitis or drug-induced liver injury encompasses a spectrum of clinical disease ranging from mild biochemical abnormalities to acute liver failure.The advantages of a long half-life,wide spectrum,high tissue penetration rate,and a good safety profile,make ceftriaxone,a third-generation cephalosporin,a frequent choice in the treatment of childhood infections.Previous studies have reported a few cases of high aspartate aminotransferase and alanine aminotransferase levels,along with three cases of hepatitis caused by ceftriaxone.Here,we report a case of drug-induced toxic hepatitis in a patient who was treated with ceftriaxone for acute tonsillitis.
文摘AIM： To investigate the usefulness of direct hemoperfusion with a polymyxin B-immobilized fiber column （DHP-PMX therapy） for warm hepatic ischemia-reperfusion （I/R） injury after total hepatic vascular exclusion （THVE） using a porcine model. METHODS： Eleven Mexican hairless pigs weighing 22-38 kg were subjected to THVE for 120 min and then observed for 360 min. The animals were divided into two groups randomly： the DHP-PMX group （n = 5） underwent DHP-PMX at a flow rate of 80 mL/min for 220 min （beginning 10 rain before reperfusion）, while the control group did not （n = 6）. The rate pressure product （RPP）： heart rate x end-systolic arterial blood pressure, hepatic tissue blood flow （HTBF）, portal vein blood flow （PVBF）, and serum aspartate aminotransferase （AST） levels were compared between the two groups. RESULTS： RPP and HTBF were significantly （P 〈 0.05） higher in the DHP-PMX group than in the control group 240 and 360 min after reperfusion. PVBF in the DHP-PMX group was maintained at about 70% of the flow before ischemia and differed significantly （P 〈 0.05） compared to the control group 360 min after reperfusion. The serum AST increased gradually after reperfusion in both groups, but the AST was significantly （P 〈 0.05） lower in the DHP-PMX group 360 min after reperfusion. CONCLUSION： DHP-PMX therapy reduced the hepatic warm I/R injury caused by THVE in a porcine model.
文摘There is a general consensus in re-interpreting the so-called liver function tests in the light of novel discoveries. At the same time, recent evidence favours the use of different laboratory data to assess liver damage, fibrosis or regenerative process, but this point is not always shared. Actually, balancing the need for diagnosis, prognostic evaluation and therapy response of liver disease with a good cost/benefit ratio is very difficult. New tests are probably not needed but the aim should be for better utilization of existing tests to contain the increasing cost of health care.
文摘Objective:Hepatocellular carcinoma (HCC) is among the most common and rapidly increasing cancers in Pakistan.There is currently no standard management for advanced HCC.The aim of the study was to assess response rate and toxicity of concomitant gemcitabine and external radiation therapy (ERT) in locally advanced HCC.Methods:Sixty patients were enrolled.Gemcitabine,70 mg/m2 was given weekly during ERT.ERT was delivered with 60Co beam up to 30.6 Gy,1.8 Gy/fraction.Tumor response was assessed by computed tomography (CT) at eight weeks.Complete and partial response (CR and PR),progressive and stable disease (PD and SD) were assessed.Hematological,gastrointestinal and hepatic toxicities were assessed weekly.Results:No CR was seen.PR,SD and PD were seen in 33%,40% and 27% of patients respectively.Grade 3/4 toxicity for total leukocyte count and platelets was observed in 7% and 27% patients.Grade 3/4 toxicity for liver failure,bilirubin,aspartate aminotransferase,alanine aminotransferase and alkaline phosphatase was seen in 35%,28%,38%,24% and 43% patients respectively.Conclusion:The study showed that concomitant gemcitabine and ERT is a feasible option with moderate toxicity in advanced HCC.
文摘Cyphostemma digitatum （Vitaceae） is a perennial, climbing, succulent undershrub with compound fleshy leaves and tendrils. The plant is used mainly as a food flavoring, but it is also a main constituent of traditional Yemeni soup （Marak）. Besides that, it has been described to be used as a medicinal plant. The aim of this work was to study the hepatoprotective effect of the aqueous extract of C. digitatum against CCl4-induced liver injury in Guinea pigs. Animals were divided into four groups. Group I, served as normal control. Group II received 2 mL CCl4/kg b.w. diluted with olive oil, at 1：1 ratio on day 11. Group III （test group） was pre-treated orally with 100 mg/kg b.w. aqueous leaves extract of C. digitatum for 10 days followed by subcutaneous injection of CC14 （2 mL/kg b.w.）, once on day 11. Group IV were orally given Liv-52 （100 mg/kg b.w.） once daily for 10 days followed by subcutaneous injection of CC14. Our results show that, the activity of serum hepatic enzymes （alanine aminotranferase （ALT）, aspartate aminotranferase （AST）, and alkaline phosphatase （ALP）） were significantly elevated in Guinea pigs treated with CCl4, while both the C. digitatum extract and Liv-52 reduced significantly these enzymes activity. Also, the levels of glucose, urea, cholesterol and triglycerides were decreased when compared with intoxicated control. Histopathological examination of intoxicated animals showed fatty changes, inflammation and necrosis indicating liver damage, while the animals received C. digitatum or Liv-52 showed less pathological effects or normal liver when compared to animals treated with CC14 alone. Biochemical and histological results confirm the hepatoprotective effect of aqueous extract of C. digitatum.
