Kouichi Akamatsu

Inhibitory activity of the serum from patients with fulminant hepatitis against liver regeneration

SummaryThe effect of sera from 8 patients with fulminant hepatitis, including 2 survival cases, on DNA and protein synthesis in primary cultured rat hepatocytes was studied. The serum from patients at an early stage or within 10 days after onset tended to intensify DNA synthesis in isolated hepatocytes, whereas the serum from patients with a history of over 50 days distinctly inhibited synthesis. When the serum was fractionated by gel filtration or free-flow electrophoresis, only the albumin fraction inhibited DNA synthesis in cultured hepatocytes. The suppressive effect of the albumin fraction was demonstrated even in patients suffering for only a short period of time. The inhibitory activity against DNA and protein synthesis in cultured hepatocytes was demonstrated in a substance extracted with a chloroform and methanol mixture from the albumin fraction of patients with fulminant hepatitis. The extract from the patients’ sera also inhibited acceleration of DNA synthesis by epidermal growth factor (EGF) in the same cells.

Short communication: Fulminant hepatitis induced by cimetidine

Despite the widespread use of cimetidine, there have been only few reports of cimetidine‐induced severe liver damage. This is an account of a 44 year old woman who developed, after a year of daily administration of cimetidine, fulminant hepatitis which was confirmed by unintentional rechallenge.

Effect of dobutamine on serum bile acid levels in patients with cirrhosis

Abstract To investigate whether improving hepatic blood flow is effective as a treatment for cirrhosis we measured cardiac output and hepatic blood flow in eight patients with cirrhosis and hepatocellular carcinoma (5 women and 3 men, aged 51 to 64 years) who were given dobutamine intravenously through a peripheral vein. The relationship between changes in hepatic blood flow and changes in total bile acid concentration in the peripheral blood were assessed. Hepatic blood flow was measured by using the xenon 133 gas clearance method with a catheter positioned in the portal vein. Dobutamine infusion increased cardiac output and hepatic blood flow to 133.9% and 111.4% of preinfusion values, respectively, and decreased total serum bile acid concentration 120 minutes after the start of infusion to 59.0% of the pretreatment value. The bile acids, in descending order of the highest percent decrease, were ursodeoxycholic, cholic, deoxycholic, chenodeoxycholic, and lithocholic; however, there were no significant differences between the free, glycine-conjugated, and taurine-conjugated forms. The percent decrease in total serum bile acids was significantly correlated with the percent increase in hepatic blood flow. These findings suggest that increasing blood flow could be an effective way to decrease total serum bile acid levels and thus possibly promote liver function in patients with cirrhosis