Fibroblast stimulating activity of extracts of hepatic granulomata of Schistosoma mansoni-infected rodents with marked or slight hepatic fibrosis

Eight weeks following infection with Schistosoma mansoni ICR strain mice showed much more marked hepatic fibrosis than did C57BL/6 mice or hamsters. None the less, extracts of the hepatic granulomata of these animals had similar fibroblast stimulating activity when assayed in vitro.

Exocrine pancreatic function in hepatosplenic schistosomiasis in the Sudan

Exocrine pancreatic function was studied in 36 patients with hepatosplenic schistosomiasis and 31 control subjects. The secretin test and the Lundh test meal were used to assess exocrine pancreas function. Patients with hepatosplenic schistosomiasis had a significantly lower bicarbonate concentration, less than 90 mmol/l in duodenal aspirate, than the control group (p less than 0.001). There were statistically insignificant differences in the volume of the duodenal aspirate after the secretin test and in the mean tryptic activity after the Lundh test meal between patients and controls. We conclude that exocrine pancreatic function is impaired with regard to bicarbonate secretion in hepatosplenic schistosomiasis.

The clinical significance of gastric acid secretion in bilharzial hepatic fibrosis

Gastric acid secretion was studied in 19 patients with bilharzial hepatic fibrosis and in 19 healthy controls. The patients had significantly lower volumes and acid output than the control group. After splenectomy and vasoligation, the patients' gastric secretion did not increase significantly. Gastric secretion was similar in 19 patients with bilharzial hepatic fibrosis who had never experienced any episode of bleeding and in 19 who bled.

Thyroid function and chronic hepatosplenic schistosomiasis: peripheral conversion of thyroxine to 3,5,3'-triiodothyronine and pituitary-thyroid relationship

The relationship between chronic hepatosplenic schistosomiaisis (CHES) and circulating thyroid hormones as well as the TSH response to TRH were investigated in 41 hospitalized CHES patients and compared to those in 11 patients with non-CHES cirrhosis with severe hepatic failure. CHES patients were subdivided into 3 groups depending on the severity of parenchymal dysfunction, based upon a composite clinical and laboratory index. Angiographic and hemodynamic studies of CHES patients revealed altered hepatic arteriograms, suggesting a decreased arterial blood flow associated with an increased venous blood flow from the portal system. A significantly reduced serum concentration of total T4 (but not free T4) was only found in the cirrhotic patients. Compared to CHES groups I and II, CHES group III patients and the non-CHES cirrhotics had significantly lower mean serum T3 levels of 80 +/- 12 and 52 +/- 8 ng/dl, respectively. The serum rT3 concentration was elevated (69 +/- 6.2 ng/dl) only in the cirrhotic patients. Both basal and peak TSH levels after TRH were within the normal range for all 4 groups of patients. The basal (40.7 +/- 8.3 ng/ml) and peak (85.5 +/- 13.7 ng/ml) serum PRL levels T4-binding globulin after TRH administration were only elevated in the cirrhotic group. Although the mean T4-binding globulin values were lower in CHES group III (17.5 +/- 3.2 micrograms/ml) and in the non-CHES cirrhotic group (18.3 +/- 2.1 micrograms/ml) compared to those in groups I (21.8 +/- 2.2 micrograms/ml) and II (20.4 +/- 2.3 micrograms/ml), the differences between groups were not statistically significant. It was concluded that hemodynamic changes without parenchymal failure have little, if any, effect on the hepatic T4 5'-monodeiodination to T3, and that the low T3 and high rT3 state does not modify the pituitary secretion of TSH, presumably by a local (at the thyrotroph level) normal conversion of T4 to T3, even at very low peripheral T3 concentrations.

[Hepatic blood flow in the surgical complications of opisthorchiasis]

The article presents the results obtained during the investigation of hepatic blood flow by the method of rheohepatography in 63 patients. Complicated opisthorchiasis is accompanied by disorders in hepatic hemodynamics. The data of rheohepatography and the parameters of the hepatic clearance allow fulfilling the immediate control of the efficiency of the surgical methods of correction as well as of the conservative treatment.

Clinical changes caused by the liver fluke Metorchis conjunctus in cats

Cats infected with metacercariae of the fluke Metorchis conjunctus were followed clinically through their infection. Cats given 200 metacercariae showed few symptoms. All the cats passed ova on the 17th day. Three hundred metacercariae caused diarrhea, icterus, discolored urine, green feces and eosinophilia after 18 to 21 days. Eosinophilia, leucine aminopeptidase and alanine aminotransferase were elevated and remain the best indicators for metorchiasis. The hematological and serological abnormalities resolved rapidly and were absent from cats with chronic infection. Acute lesions (less than 32 days) were confined to the biliary trees with extensive epithelial exfoliation, fibrosis, and pus from necrosis, tissue feeding by the worms and pressure atrophy. Chronic infections (32 to 150 days) caused hyperplasia of the bile epithelium, proliferation of connective tissues, and fibrosis of the perilobular areas. Intense eosinophilic infiltrates were replaced by mononuclear cells. Granuloma formation around an ovum was seen in one cat 719 days after infection. Adult worms established preferentially in the left lateral lobe and never in the caudal lobe. No gall bladder involvement was found even in heavy infections.

Evaluation of portal hypertension in cases of hepatosplenic schistosomiasis using ultrasound

Patients with hepatic schistosomiasis develop high degrees of portal hypertension. Various invasive techniques have been used to evaluate this degree of portal hypertension. In this work sonography was used as a safe, noninvasive technique to study the relationship between the degree of portal hypertension, as measured by percutaneous splenic manometry, and the diameters of the portal and splenic veins. A total of 25 patients were included in this study. A positive correlation was found between the degree of portal hypertension and the increase in the diameters of the portal and splenic veins.

Brain involvement in hepatosplenic Schistosomiasis mansoni

The brains of 46 patients with hepatosplenic schistosomiasis mansoni were studied. Eggs of Schistosoma mansoni were found in 12 brains (26 per cent). The parasite location, brain reaction, clinical features and the possible paths by which the eggs of S. mansoni reach the nervous system are discussed. Our data and those of the literature suggest that brain involvement is common in hepatosplenic schistosomiasis mansoni.

Effect of histamine and histamine antagonists on portal blood pressure in patients with hepatosplenic schistosomiasis

1 Histamine injection via the cannulated portal vein significantly raised the portal pressure in normal volunteers. This elevation was reversed by an H1-receptor blocker but not an H2-receptor blocker. When an H1-receptor blocker was injected first followed by histamine, no significant change in portal pressure was obtained. On the other hand, an H2-receptor blocker failed to antagonize the effect of histamine. 2 Histamine injection induced a non-significant increase in the portal pressure in patients with schistosomal portal hypertension, but when an H1-receptor blocker was injected a significant drop in the portal pressure was obtained. No similar effect was found after an H2-receptor blocker injection. 3 Angiographic study showed that histamine induced intrahepatic portal vasoconstriction in the normal controls. A similar change was obtained in the schistosomal group, particularly on the periportal neovascular formation. 4 In the light of the present study, it is suggested that histamine may contribute in part to the physiopathologic changes that lead to portal hypertension in hepatosplenic schistosomiasis. H1-receptor antagonists may have a role in the treatment of portal hypertension, particularly in bleeding varices.

Haemodynamic effects of splenectomy and vasoligation in bilharzial hepatic fibrosis

Patients with bilharzial hepatic fibrosis, when compared with control subjects, were found to be hypervolaemic as a result of increased plasma volume. The estimated hepatic blood flow in these patients was not significantly different from that of healthy individuals. Splenectomy and vasoligation was followed by a drop in portal pressure measured through an omental vein at operation. The estimated hepatic blood flow, however, was not altered by this surgical procedure. The blood volume, which was found to correlate with the size of the spleen, diminished and so did the plasma volume when measured after this operation.

Gastric secretion and basal gastrin concentration in bilharzial hepatic fibrosis

Gastric secretion and fasting plasma gastrin levels were investigated in 26 patients with bilharzial hepatic fibrosis and 26 controls. The groups did not differ in their basal secretion. When stimulated by intravenous infusion of histamine the maximal acid output in patients with bilharzial hepatic fibrosis was significantly less than in the control group. This was unlikely to be a result of neutralisation by reflux of alkaline duodenal contents as the volumes of reflux were not different from control subjects, but was compatible with a true reduction in gastric secretion as assessed by two-component hypothesis. Neither the lowered gastric acidity nor the liver damage in patients with bilharzial hepatic fibrosis correlated with circulating gastrin. The fasting levels of plasma gastrin in these patients were not different from controls. As in other liver diseases the cause of diminished gastric secretion remains unclear.

Thyroid function in hepatic schistosomiasis

Serum thyroxine (T4), serum tri-iodothyronine (T3-uptake) and the free thyroxine index in 17 men suffering from hepatosplenic schistosomiasis did not differ significantly from those of ten healthy male controls. There was no correlation between these values and serum protein levels or liver function tests.

Hepatosplenic schistosomiasis: a great neglected disease of the liver

Schistosomiasis mansoni and japonica, helminth infections involving the livers of 100 million people, are among the 'great neglected diseases of mankind' on the basis both of their prevalence and the relative lack of interest shown in them by clinicians and biomedical investigators. Schistosomiasis is not only an interesting disease in itself but has the added advantage of providing unique human and animal models of hepatic pathophysiology, immunopathogenesis, and collagen metabolism.