May plasma cholesterol level be considered a neoplastic marker in liver disease from cirrhosis to hepatocellular carcinoma?

BACKGROUND: Although the role of cholesterol in tumourigenesis is unclear, it is used by the tumoural cells for biosynthetic processes and for steroid synthesis. AIM: To accertain whether plasma cholesterol levels might be a reliable neoplastic marker of a developing hepatocellular carcinoma in patients with liver cirrhosis. PATIENTS: Plasma cholesterol has been studied in 287 liver cirrhosis patients without hepatocellular carcinoma and in 132 patients with hepatocellular carcinoma. RESULTS: Cholesterol (mean +/- SEM) was higher in hepatocellular carcinoma patients when compared with age-, sex- and Child-Pugh class matched cirrhotic controls. In Child-Pugh class A, B and C with uncomplicated liver cirrhosis these values were, respectively, 142.0 +/- 2.5, 117.3 +/- 2.5, 97.4 +/- 2.9 vs 172.5 +/- 4.7, 163.8 +/- 7.9, 153.5 +/- 8.0 +/- mg/dl in patients with hepatocellular carcinoma (p < 0.001). A significant increase of cholesterol (p < 0.001) has been reported in the patients with liver cirrhosis when complicated by hepatocellular carcinoma and it was not related to cholestasis. CONCLUSIONS: This observation seems to suggest that the enhanced cholesterol biosynthesis by tumoural cells leads to a rise in plasma cholesterol of patients with cancer, and, moreover, that, this increase may be used as a neoplastic marker indicating the development of a tumour in patients with liver cirrhosis.

Mesenteric vein thrombosis: a rare cause of abdominal pain in cirrhotic patients--two case reports.

Mesenteric vein thrombosis is a rare disorder which can develop rapidly with intestinal infarction or subacutely with abdominal pain due to intestinal ischemia. Despite the availability of modern diagnostic tools, which allow an early diagnosis in most cases, the mortality from this disease has not significantly diminished over the years. The problem is that the syndrome is rare and unusual and the clinical presentation is usually vague or confusing. Particularly in cirrhotic patients, this diagnosis requires the exclusion of several other complications of liver disease, like spontaneous bacterial peritonitis, tense ascites or portal thrombosis. Here, we report the occurrence of acute mesenteric vein thrombosis in two patients with liver cirrhosis. Severe subcontinuous abdominal pain out of proportion to the physical findings and abdominal distension were the major symptoms in both patients. Magnetic resonance imaging in one case and ultrasound scan with color Doppler followed by computed tomography in the other patient confirmed the diagnosis and enabled an appropriate early therapy to be undertaken.

Adult celiac disease and primary sclerosing cholangitis: two case reports.

The association of primary sclerosing cholangitis and celiac disease is uncommon. Herein, we report on 2 different cases which developed this association. Case 1 was a 59 year-old female who firstly complained of symptoms of cholestasis. The diagnosis of primary cholangitis was made on liver biopsy, and the endoscopic retrograde cholangiopancreatography (ERCP) showed narrowing and irregularity of the extra- and intrahepatic bile ducts. The results were positive for antiendomysial antibodies and the jejunal biopsy confirmed the coexistence of celiac disease, which was asymptomatic until that moment. The gluten-free diet ameliorated the index of cholestasis. Case 2 was an old man suffering from undiagnosed celiac disease for at least 5 years prior to admission at our Department. The diagnosis was based on the histological examination of a jejunal biopsy. The patient did not follow the gluten-free diet and was again admitted to our Department 6 years later with symptoms of cholestasis. The liver biopsy and ERCP confirmed the diagnosis of primary sclerosing cholangitis.

Changes in endogenous benzodiazepine-like compound levels during the course of fulminant hepatic failure: potential effects of decreased renal function.

The pathogenetic agents which cause encephalopathy due to fulminant hepatic failure are still under debate. Ammonia and benzodiazepine-like compounds are two of the most important agents considered, so far. Herein, we report the levels of benzodiazepine-like compounds in serum and in urine and of venous ammonia measured during the course of the disease (30 days). The patient rapidly developed stage IV encephalopathy with high levels of ammonia and with only a slight increase of benzodiazepine-like compounds. At that moment, the levels of these compounds were similar to those recorded in the blood when the patient regained full consciousness 28 days later. During the course of the disease, there was a 10-fold increase of benzodiazepine-like compounds in serum which was recorded in parallel with an impaired excretion due to oliguria. This observation seems to indicate that encephalopathy may develop in the absence of significantly increased levels of these compounds and that their episodic increase during fulminant hepatic failure may be an epiphenomenon linked with several factors such as impaired renal function.

Alpha but not beta interferon is useful in chronic active hepatitis due to hepatitis C virus. A prospective, double-blind, randomized study.

Interferon-alpha has been widely used in chronic hepatitis C, but controlled studies with intramuscular interferon-beta are lacking. We therefore performed a prospective, double-blind, randomized study comparing intramuscular IFN-alpha and -beta in patients with chronic hepatitis C. Sixty patients were randomly assigned to receive 3 MU thrice weekly intramuscularly of either recombinant IFN-alpha or leukocyte IFN-alpha or fibroblast IFN-beta for six months. Nine of 20 patients (45.0%) in the recombinant IFN, 5/19 (26.3%) in the leukocyte IFN, and none in the IFN-beta group had a complete response during therapy (recombinant IFN vs IFN-beta: P < 0.01). Only in IFN-alpha-treated patients, was infection with a single HCV genotype (type 2a or 2b) associated with significantly better long-term outcome. IFN-alpha is useful in chronic hepatitis C while intramuscular IFN-beta interferon does not exert any beneficial effect. This is probably due to an insufficient bioavailability of IFN-beta when given intramuscularly.

Season of birth and handedness revisited.

In a sample of 15,390 students, no significant difference in the season of birth could be found between right- and left-handers, classified according to their responses to the Edinburgh Handedness Inventory. A separate analysis for each sex also yielded nonsignificant differences.

Career choice and handedness: a survey among university applicants.

By means of the Edinburgh Handedness Inventory the patterns of handedness were studied in 16,590 applicant students to several professional courses in a Brazilian university. The distributions of the laterality quotient (LQ) were different for male and female students, with more left-handers found among the males. The LQ's distributions were different for applicants to distinct courses or to blocks of related occupations. However, no differences were observed between left- and right-handers when each sex was studied separately. No statistically significant differences in handedness were found among the students of different courses that were accepted by the university.

The pineal recess of the opossum: a scanning and transmission electron microscope study.

Scanning and transmission electron microscope studies were performed in the pineal recess region of eighteen adult Didelphis albiventris opossums. With the scanning electron microscope, three concentric regions could be observed in the pineal recess: a central zone lined by cells free of cilia or microvilli, or by a meshwork of interdigitating cell processes; an intermediate zone lined by microvillous cells; and a peripheral zone, lined by ciliated cells. The transmission electron microscope revealed that the central zone is lined mainly by pinealocytes. The lining cells are frequently overlaid by a meshwork of pinealocytic and glial processes. A "subsurface labyrinth" (a meshwork of cellular processes underneath the lining cells) is constantly seen in the central zone. The intermediate zone is lined by elongated microvillous ependymal cells, and the peripheral zone by typical ependyma. The large liquor-contacting area in the pineal recess region, as well as the peculiar organization of its surface, suggest a complex interrelationship between the liquor and the pineal gland of the opossum.

The pineal recess of the opossum: a scanning and transmission electron microscope study.

Scanning and transmission electron microscope studies were performed in the pineal recess region of eighteen adult Didelphis albiventris opossums. With the scanning electron microscope, three concentric regions could be observed in the pineal recess: a central zone lined by cells free of cilia or microvilli, or by a meshwork of interdigitating cell processes; an intermediate zone lined by microvillous cells; and a peripheral zone, lined by ciliated cells. The transmission electron microscope revealed that the central zone is lined mainly by pinealocytes. The lining cells are frequently overlaid by a meshwork of pinealocytic and glial processes. A [quot ]subsurface labyrinth[quot ] (a meshwork of cellular processes underneath the lining cells) is constantly seen in the central zone. The intermediate zone is lined by elongated microvillous ependymal cells, and the peripheral zone by typical ependyma. The large liquor-contacting area in the pineal recess region, as well as the peculiar organization of its surface, suggest a complex interrelationship between the liquor and the pineal gland of the opossum.

The pineal recess of the opossum: a scanning and transmission electron microcospe study

Scanning and transmission electron microscope studies were performed in the pineal recess region of eighteen adult Didelphis albiventris opossums. With the scanning electron microscope, three concentric regions could be observed in the pineal recess: a central zone lined by cells free of cilia or microvilli, or by a meshwork of interdigitating cell processes; an intermediate zone lined by microvillous cells; and a peripheral zone, lined by ciliated cells. The transmission electron microscope revealed that the central zone is lined mainly by pinealocytes. The lining cells are frequently overlaid by a meshwork of pinealocytic and gliak oricesses. A <> (a meshwork of cellular processes underneath the lining cells) is contantly seen in the central zone. The intermediate zone is lined by elongated microvillous ependymal cells, and the peripheral zone by typical ependyma. The large liquor-contacting area in the pineal recess region, as well as the peculiar organization of its surface, suggest a complex interrelationship between the liquor and the pineal gland of the opossum (AU)

The pineal recess of the opossum: a scanning and transmission electron microcospe study

Scanning and transmission electron microscope studies were performed in the pineal recess region of eighteen adult Didelphis albiventris opossums. With the scanning electron microscope, three concentric regions could be observed in the pineal recess: a central zone lined by cells free of cilia or microvilli, or by a meshwork of interdigitating cell processes; an intermediate zone lined by microvillous cells; and a peripheral zone, lined by ciliated cells. The transmission electron microscope revealed that the central zone is lined mainly by pinealocytes. The lining cells are frequently overlaid by a meshwork of pinealocytic and gliak oricesses. A <> (a meshwork of cellular processes underneath the lining cells) is contantly seen in the central zone. The intermediate zone is lined by elongated microvillous ependymal cells, and the peripheral zone by typical ependyma. The large liquor-contacting area in the pineal recess region, as well as the peculiar organization of its surface, suggest a complex interrelationship between the liquor and the pineal gland of the opossum

Afferent connections of the ventral lateral geniculate nucleus in the rat: an HRP study.

The afferent connections of the ventral lateral geniculate nucleus (VLGN) of the albino rat were studied using the HRP-retrograde transport method. Neurons projecting to the VLGN were found in 4 visual systems areas: layer V of the ipsilateral visual cortex (areas 17 and 18), the stratum griseum superficiale of the ipsilateral superior colliculus, the ipsilateral olivary, anterior and posterior pretectal nuclei and in the contralateral medial divisions of the VLGN. Labeled neurons were also found bilaterally in the nucleus raphe dorsalis and nucleus locus coeruleus.

Noradrenaline content of the hypothalamus and brain-stem of rats inoculated with Trypanosoma cruzi.

O conteudo de noradrenalina do hipotalamo e do tronco encefalico de ratos controle e inoculados con a cepa Y (300.000 tripomastigotas, i.p.) de Trypanosoma cruzi foi medido pela tecnica fluorimetrica de Anton e Sayre. Os animais foram sacrificados 20 e 32 dias depois da inoculacao. Para avaliacao do grau de desnervacao simpatica do coracao dos animais infectados, a auricula direita foi observada com microscopio de fluorescencia apos tratamento histoquimico pela tecnica do acido glioxilico.O conteudo de noradrenalina do hipolatamo e do tronco encefalico dos animais infectados nao diferiu do medido nos animais controle Contudo, um quase completo desaparecimento das fibras adrenergicas foi observado no coracao dos animais chagasicos, sugerindo que o mecanismo envolvido na lesao discrimina neuronios adrenergicos centrais e perifericos

Somatic sensory cortical regions of the agouti, Dasyprocta aguti.

The localization and organization of primary (SmI) and secondary (SmI) somatic sensory cortical regions in agoutis, have been studied with micro- and macroelectrode-evoked potential techniques. For SmI, the mean surface area determined using microelectrodes was 13% smaller than that obtained using macroelectrodes. The location and organization of SmI are similar to those of other rodents: the largest representations were those of the vibrissae, the perioral regions and the first digit of the hand. As in some other animals, SmII is related to both sides of the body. It shows excellent somatopic differentiation and was located lateral and posterior to SmI, in relation to which it is arranged as a reduced mirror image. The area of SmII represents 31% of that of SmI in agoutis. The large size of the forepaw representation in SmI is reflected in SmII, that of the face representation is not; this agrees with similar findings from several other species. SmI was completely mapped using light touch stimuli, and contains many projections from vibrissae and hairs along with some proprioceptive projections. SmI overlaps with visual projections. SmII receives less light touch, vibrissae and hair projections than SmI, and it receives numerous deep mechanical and auditory projections. In SmII latencies were 10.96 msec for somesthetic and 13.39 msec for auditory stimuli; in SmI latencies were 13.25 msec for somesthetic and 39.80 msec for visual stimuli. One sulcus separates the SmI projections of the forelimb from those of the hindlimb, and another is often found marking the posterolateral boundary of SmII.