[Primary liver cancer. Its epidemiological, clinical and biochemical characteristics]. / Cáncer hepático primario. Características epidemiológicas, clínicas y bioquímicas.

Epidemiological, clinical, biochemical and topographic features of primary hepatic cancer (PHC) were reviewed retrospective and prospectively in this study. This review consisted of 76 patients from 1971 to 1990. Forty nine males and 27 females. The mean age was 66.1 +/- 11.7 years. Hepatocellular carcinoma (HC) was the most frequent histological type (84.1%), followed by cholangiocarcinoma (87.7%). Mixed carcinoma and hepatoblastoma were 4.3 and 2.9% respectively. The prevalence af PHC among 1485 autopsies was 0.74%. The most frequent sites af metastasis were the lungs (66%) and portal vein (50%). Hepatocellular carcinoma was associated to cirrhosis in 80% of the cases. A syndrome including asthenia, weight loss, hepatomegaly and cholestasis was identified in most of the patients, and alkaline phosphatase was the most frequently disturbed laboratory test. 60% of tumors were bilateral and none of the solitary tumors had less than 5 cms in diameter. 20% of HC showed normal serum levels of AFP (< 20 ng/ml). 40% had at least one of the markers of B virus hepatitis in serum.

Total therapeutic paracentesis (TTP) with and without intravenous albumin in the treatment of cirrhotic tense ascites: a randomized controlled trial.

We studied 35 cirrhotic patients with tense ascites assigned at random into two groups: Group I consisted of 17 patients treated by total therapeutic paracentesis (TTP) (6-15 l) plus i.v. albumin (5 g/l of fluid) and Group II consisted of 18 patients treated by TTP (5.5-15.5 l) without albumin. On 19 patients we performed a sequential assessment of cardiac output (CO), plasma renin activity (PRA) and plasma aldosterone (PA). Both groups were similar in age, sex, and etiology of cirrhosis. CO, PRA and PA values were expressed as mean changes occurring in relation to their respective baseline values. CO changes after TTP (l/min): Group I: 2.5 after 6 h and 2.2 after 12 h; Group II: 2.2 after 6 h and -0.4 after 12 h, (p < 0.05 comparing values after 12 h between the two groups). PRA changes after TTP (ng/dl/h): Group I: -7.4 after 1 h, -7.8 after 6 h and -3.2 after 24 h; Group II: -2.4 after 1 h, -0.8 after 6 h and 3.9 after 24 h (p < 0.05 comparing values between both groups after 6 and 24 h). PA changes after TTP (ng/dl): Group I: -50.5 after 1 h, -36.7 after 6 h and -34.6 after 24 h; Group II: -18.2 after 1 h, -2.2 after 6 h and 20 after 24 h, (p < 0.05 comparing values between both groups after 1 and 6 h). Complications were minimal in both groups.(ABSTRACT TRUNCATED AT 250 WORDS)

[Pathogenesis of portal systemic encephalopathy]. / Conceptos actuales sobre la fisiopatogenia de la encefalopatía hepática.

Hepatic encephalopathy is a neuropsyquiatric syndrome associated to multifactorial metabolic disruptions. Several physiopathogenic theories have been proposed. In this review authors explain and analyze most of theses theories which include ammonia, mercaptans, false neurotransmitters, gamma aminobutiric acid, endogenous benzodiazepins, and zinc deficiency as well as some of the new biochemical concepts of neurotransmission.