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Beta 2-microglobulin concentration in plasma and production in liver cirrhosis.
Full text linkThe beta 2-microglobulin plasma level is often high in patients suffering from cirrhosis. Many authors believe this to be due to an increased production, provided that the creatinine level is in the normal range. In the present study, alterations in the plasma level and production of beta 2-microglobulin were investigated in patients with liver cirrhosis without overt renal failure. 62 patients, 48 men and 14 women, suffering from liver cirrhosis were examined. The glomerular filtration rate (GFR) and plasma beta 2-microglobulin were measured in all patients and in 16 controls. As beta 2-microglobulin is freely filtered by glomeruli and its extrarenal catabolism is negligible, the beta 2-microglobulin filtration rate was calculated as the product of the beta 2-microglobulin plasma level times the GFR. In steady state conditions, the beta 2-microglobulin filtration rate may be used as an indirect index of beta 2-microglobulin production. The beta 2-microglobulin plasma level was high in 26 patients; however, only 12 of them showed a definite rise in beta 2-microglobulin production, as shown by an increased beta 2-microglobulin filtration rate. The 14 patients with high beta 2-microglobulin plasma levels without high beta 2-microglobulin filtration rates obviously showed a decreased GFR; however, creatinine was not increased because of its small sensitivity as an index of renal function. A linear correlation was found between IgG and the beta 2-microglobulin filtration rate (r = 052; p less than 0.02), not between IgG and the beta 2-microglobulin plasma level. The other indices of liver damage were not related to the beta 2-microglobulin filtration rate of plasma level
Therapeutic options for cancer of the hypopharynx and cervical oesophagus.
No full textBetween 1980 and 1990, 291 patients with a cancer in the cervical area of the
oesophagus were admitted to our Department: in 187 the cancer was located mainly
in the cervical region, 76 in the hypopharynx and 28 had a tumour that had spread
to the cervical oesophageal region following laryngectomy. Most tumours of the
hypopharynx involved the cervical oesophagus when it was often difficult to
define the site of origin. 153 patients (53%) underwent surgical resection which
included a modified neck dissection followed by different kinds of
reconstruction. 96 patients underwent pharyngogastric anastomosis. Twenty
anastomotic leaks (23%) were recorded including both those clinically evident and
asymptomatic ones detected radiologically. Moreover, segmental proximal necrosis
was seen in ten patients. Hospital mortality rate after pharyngogastric
anastomosis was 14.7% (14/95). Colon interposition was used in 11 patients. Two
anastomotic leaks and two partial necroses were observed. Hospital mortality was
18% (2/11). Eighteen patients underwent laryngopharyngectomy and cervical
oesophagectomy with reconstruction performed by means of revascularized jejunal
loop. One anastomotic leak was observed and hospital mortality was nil in these
cases. Twenty-four patients underwent total oesophagectomy with larynx
preservation when the cancer was located at least 2 cm below the upper
oesophageal sphincter. Five anastomotic leaks and two partial necroses occurred
and hospital mortality was 8.3% (2/24) in these patients. The remaining five
patients operated on underwent miscellaneous surgical procedures with one
postoperative death. Overall survival for resections considered curative was
21%:37% for hypopharyngeal and 18% for cervical cancers respectively, while it
was nil at three years after palliative resection and total oesophagectomy with
larynx preservation.(ABSTRACT TRUNCATED AT 250 WORDS
LA LASER TERAPIA ENDOSCOPICA NEL TRATTAMENTO DEI CANCRI INOPERABILI DELL'ESOFAGO E DEL CARDIAS
No full textATTI DEL 1° CONGRESSO INTERNAZIONALE DI VIDEOENDOSCOPIA DIGESTIV
ENDOSCOPIC PALLIATION OF ESOPHAGEAL AND CARDIAL CANCERS
No full text1990 SURGICAL UPDATING ATTI: SECOND WORLD OF PROFESSIONAL UPDATING IN SURGERY AND IN SURGICAL AND ONCOLOGICAL DISCIPLINES OF THE UNIVERSITY OF MILA
LE PROTESI ENDOESOFAGEE NEL TRATTAMENTO DELLENEOPLASIE ESOFAGEE NON RESECABILI. CONFRONTO TRA TECNICA CHIRURGICA ED ENDOSCOPICA
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[The side effects associated with the interferon-alpha therapy of chronic viral hepatitis]
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