Lipid peroxidation and anti-oxidative protection in patients with chronic type C hepatitis

The aim of the work was to study lipid peroxidation (LP) activity and antioxidation protection sufficiency in patients with HCV lesion of the liver. The subjects of the study were 238 such patients, divided into groups according to the degree of the pathological process severity. The results demonstrate a significant increase of malonic dialdehyde (MDA) serum concentration (up to 143.75%) and simultaneous decrease of catalase serum concentration in patients with minimal activity of HCV chronic hepatitis (CH). In patients with moderate and high activity of the pathological process MDA serum concentrations were 150 and 175%, respectively; catalase activity decreased down to 64.8 and 58.47%, respectively. Hepatocirrhosis in HCV patients (HCV-H) was characterized by a more pronounced LP product accumulation and decrease of serum catalase activity. MDA serum concentration in patients with mixed viral CH and hepatocirrhosis was lower than in patients with HCV-H.     

血清及肝组织胰岛素样生长因子1与慢性乙型肝炎及肝硬化肝细胞损伤的关系

目的探讨胰岛素样生长因子1(IGF-1)在慢性乙型肝炎和肝硬化患者肝细胞损伤中的作用及其意义。方法采用酶联免疫吸附(ELISA)法检测39例慢性乙型肝炎、37例乙型肝炎肝硬化及12例健康供血者血清IGF-1,其中26例肝组织标本行IGF-1的免疫组化染色,并采用多媒体彩色图文分析系统进行图像定量分析。结果慢性肝炎患者随着肝细胞损害程度的加重血清IGF-1逐渐降低,慢性肝炎轻、中、重度患者IGF-1分别为(173.18±49.50)μg/L(、101.36±35.73)μg/L、(87.63±20.19)μg/L(P<0.01);肝硬化组随着肝功能代偿能力的减退血清IGF-1明显下降,Child-Pugh A、B、C分别为(89.76±27.93)μg/L、(41.32±16.14)μg/L(、26.88±9.87)μg/L(P<0.01);炎症活动0级(G0)至G3IGF-1的光密度逐渐增加,但差异无统计学意义。结论血清IGF-1水平及肝组织IGF-1的表达强度在一定程度上反映肝细胞的炎症坏死程度及肝脏合成储备功能,可作为预测病情预后的可靠指标。     

Lipid peroxidation, collagen metabolism and cellular immunity indices of patients with chronic hepatitis and liver cirrhosis

An increase in the activity of lipid peroxidation was established in patients with chronic hepatitis and liver cirrhosis. They were noted in parallel with marked disorders of indices of cellular immunity and collagen metabolism. The relationship between lipid peroxidation and the main pathogenetic mechanisms of chronic hepatitis and liver cirrhosis (the immunological ones and fibrosis formation) was established.     

Cell immunity and hepatocyte apoptosis in chronic cholestatic hepatitis

The aim of the study was to evaluate activity and accumulation of natural T-killers (NK-cells, CD16+) and lymphocytes with apoptosis marker (CD95+) in peripheral blood and hepatic tissue of patients with chronic viral hepatitis, in connection with presence or absence of cholestasis. The subjects were 14 patients suffering from chronic hepatitis (CH) without cholestasis, and 16--with CH and cholestasis, aged 18 to 56 years. The study revealed significant elevation of the number of NK-cells in hepatic tissue of CH patients with cholestasis, not only vs. controls, but also vs. CH patients without cholestasis. Accumulation of natural T-killers in hepatic tissues was accompanied by reduction of their absolute number in peripheral blood and increase of the number of apoptotic bodies in the liver. There was a positive correlation between parameters of apoptosis of hepatocytes, on the one part, and the number of regenerating hepatocytes and serum indicators of cholestasis, on the other.     

Imaging diagnosis of cirrhosis and chronic hepatitis

Cirrhosis is an end stage of chronic diffuse liver disease, characterized by irreversible hepatic fibrosis. Cirrhosis slowly progresses from chronic hepatitis to early cirrhosis and finally to advanced cirrhosis with the increasing risk of complications, and causes regional morphologic changes of the liver during the course of the disease, according to disease severity. MR imaging is better able to provide comprehensive information about cirrhosis or chronic hepatitis and their complications than any other imaging modality currently available. In this article, we reviewed the spectrum of imaging findings of cirrhosis and chronic hepatitis, including regional changes of hepatic morphology, several signs of early and advanced cirrhosis, nodular liver surface, hepatic iron deposition, regenerative nodules, and varices and portosystemic collaterals.     

Lipid peroxidation as a possible mechanism of erythrocyte damage in patients with chronic kidney failure on hemodialysis]

Ten patients with chronic renal failure (CRF) treated by hemodialysis (HD) were examined. All the patients demonstrated remarkable anemia. The red blood cell count was (2.7 +/- 0.2) x 10(12)/I the concentration of hemoglobin 79.5 +/- 5.6 g/l, on the average, hematocrit 23.2 +/- 1.8%. The content of malonic dialdehyde in the patients' red blood cells was far greater than in controls, amounting to 132% (per 1 ml of hemolysate), 134% (per 1 mg of protein) (p < 0.05). Catalase and glutathione peroxidase activity in the patients' red blood cells did not differ from that in controls. Superoxide dismutase activity reduced by 43% as compared to that in donors (p < 0.001). The authors review possible mechanisms of lipid peroxidation (LPO) and a decrease of antioxidant defense in red blood cells of CRF patients on hemodialysis. It is concluded that activation of LPO processes and the decrease of antioxidant defense produce a noticeable destructive effect on the integrity of the red blood cell membrane. They also influence the development of hemolysis.     

CT in hepatic cirrhosis and chronic hepatitis.

Cirrhosis is a diffuse liver disease with premalignant potential in which hepatocellular carcinoma (HCC) frequently develops. The hemodynamics of contrast material are the key to diagnosis of focal liver lesions with computed tomography (CT). Lesions with arterial-dominant vascularity, such as HCC, show brisk enhancement during the arterial phase, whereas lesions with portal blood supply can appear as hyperenhancing lesions in the portal phase. The advent of helical CT has significantly improved the CT examination of the liver because the arterial phase can be displayed independently of the portal phase. The addition of arterial phase imaging to conventional portal phase imaging seems to improve tumor detection and characterization. Although HCC is the single most frequent tumor seen in chronic liver disease, other lesions such as peripheral cholangiocarcinoma and hemangioma should be considered in the differential diagnosis. Optimization of helical CT techniques may allow better detection and characterization of these lesions. In addition to tumor detection, CT plays an important role in preoperative staging of HCC as well as in preoperative assessment of patient candidates to hepatic transplantation. The use of CT angiography with maximum intensity projection techniques may allow for better preoperative work-up and vascular mapping in HCC patients. This article shows the spectrum of helical CT findings in chronic liver disease and specifically in the imaging of HCC and other focal lesions.     

MR imaging in chronic hepatitis and cirrhosis.

The role of magnetic resonance imaging (MRI) in the evaluation of diffuse parenchymal abnormalities of the liver has been expanded by recent technical advances of MR systems as well as the evolution of intravenous contrast media. Currently, MR is undoubtedly the most useful imaging modality for detecting the presence of chronic liver disease. Tailored sequences allow acurate depiction of specific disorders, including steatohepatitis and iron-overload states. Morphologic changes and signal intensity effects not only facilitate the diagnosis of chronic liver disease with MRI but they also help to distinguish between different etiologies, and they assist in staging the histologic severity of certain chronic conditions. Moreover, the faster MRI scanning techniques presently available permit the dynamic assessment of contrast enhancement, which permits improved characterization of focal hepatic lesions, including regenerative nodules, dysplastic nodules, and hepatocellular carcinoma (HCC). Although overlap in MRI findings still may exist among different types of chronic liver disease and among focal liver lesions, familiarity with certain specific imaging features may be diagnostic in the proper clinical setting. Finally, comprehensive MRI examination, including MR angiography and MR cholangiography, is the most sensitive and cost-effective technique for detecting extrahepatic disease, diagnosing vascular disorders, and evaluating the patient before or after liver transplantation. This article focuses on the current role of MR imaging in patients with chronic liver disease. The subjects covered include the detection and characterization of chronic hepatitis and cirrhosis, specific findings seen in steatohepatitis and certain metabolic diseases, the evaluation of extrahepatic vascular complications of cirrhosis, and patient assessment before and after liver transplantation. The characterization of hepatic masses is also included briefly. This subject is covered in greater depth elsewhere in this issue.     

Doppler in hepatic cirrhosis and chronic hepatitis.

Doppler ultrasound and color Doppler are being used routinely in the study of vascular structures of the abdomen, and more particularly the liver. Reports published in the literature to date have shown that all patients with hepatic cirrhosis and chronic hepatitis should be studied in the first stage of their illness and in follow-up by using Doppler techniques. With new ultrasound software and the latest generation of contrast agents, we can obtain a better and more complete vascular study of the liver, which previously could be achieved only with triple-phase CT. Therefore, hepatic cirrhosis and chronic hepatitis, as well as their vascular complications, can be followed up more closely. The vascular complications include flow alterations in the hepatic artery and veins, portal hypertension, portal vein thrombosis, portosystemic shunts, and vascularization associated with liver tumors.     

Lipid peroxidation and the antioxidant activity of the sputum in chronic obstructive bronchitis]

A method for measuring lipid peroxidation (LPO) products and antioxidant activity of the sputum in patients with chronic obstructive bronchitis is suggested. Both measurements are based on the reaction of LPO products with thiobarbituric acid.     

慢性乙肝和乙肝后肝硬化肝脏形态的变化

目的 探讨慢性乙肝和乙肝后肝硬化肝脏MRI形态的变化.方法 对慢性乙肝患者32例、乙肝后肝硬化患者17例及无肝脏疾病的患者(对照组)18例行MR轴位T1W、T2W及动态增强扫描,观察肝脏形态.结果 肝脏表面不规则、肝脏边缘变钝、胆囊窝扩大、肝脏右后切迹征及再生结节能提示肝硬化(P＜0.05),以其中任一种阳性诊断肝硬化,敏感度为99.85％,以其中任两种同时阳性诊断肝硬化,特异度为98.80％～99.96％;上述指标与炎症活动度无关(P＞0.05);肝脏边缘变钝提示早期肝硬化(P＜0.05),其余各指标在对照组和慢性乙肝不同分期、分级间差异无统计学意义(P均＞0.05).结论 MRI显示的肝脏形态变化能提示乙肝后肝硬化,与肝炎症活动度无关.     

Monoclonal immunoglobulinopathy in chronic active hepatitis and liver cirrhosis

The clinico-laboratory and morphological studies were performed to examine and characterize 15 patients with chronic active hepatitis and liver cirrhosis mainly of viral etiology, going in association with monoclonal immunoglobulinopathy. The diagnostic difficulties determined by the syndrome of monoclonal immunoglobulinopathy are demonstrated. The results of a long follow-up (up to 17 years) of the indicated patients' group are provided. A possible role is discussed of hepatitis B virus as a source of long antigenic stimulation in the origin of monoclonal immunoglobulinopathy in chronic diffuse diseases of the liver.