Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: EC:2.6.1.2 (alanine aminotransferase)
 26,722 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The authors performed a late evaluation of a distal splenorenal anastomosis minimum of five years following operation on 13 patients with schistosomiasis of the compensated liver-splenic type. The study of the anastomosis had been proven patent when the evaluation took place. Each patient underwent clinical, laboratorial, endoscopic and electroencephalographic assessment. The results demonstrated that no patient had shown any sign of recurrence of upper gastrointestinal hemorrhage. Among the endoscopic aspects, esophageal varices disappeared in 46.1% of the cases. There was reduction in the number, extent and volume of esophageal varices in 46.1%, 38.4% and 53.8% of the cases. Gastric varices disappeared in 91.6% of the cases. Only one patient (7.6%) had shown clinical and electroencephalographic signs of hepatic encephalopathy in the late final evaluation (non-significant). Only one patient (7.6%) had shown late postoperative ascites (non-significant). There were no significant alterations in serum levels of sodium, potassium, urea and creatinine in all the 13 patients. The values of indirect serum bilirubin increased in 92.3% of the patients. There was regression of splenomegaly in all 13 patients, as well as a significant improvement in their hematological values. There were no significant changes in the serum levels of aspartate aminotransferase and alanine aminotransferase or in the activity of the plasma prothrombin. The authors concluded that the distal splenorenal anastomosis became a protection factor against upper gastrointestinal hemorrhage and led to long-term improvement in the endoscopic aspects of esophagogastric varices, a significant improvement in the laboratorial aspects of hypersplenism and a marked reduction of splenomegaly with no significant changes in the hydroelectrolytic metabolism, renal function and hepatic function and had not compromised, long term, the quality of life of the majority of patients.
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PMID:Late clinical, biochemical, endoscopic and electroencephalographic evaluation of patients with schistosomal portal hypertension treated with distal splenorenal shunt. 970 17

Schistosomiasis mansoni is a widespread parasitic disease in the Brazilian territory that affects over 8 million individuals. Hepatosplenic schistosomiasis is a serious clinical presentation of this disease, associated with splenomegaly, liver fibrosis, and portal hypertension, and is responsible for approximately 7% of schistosomotic patients. The surgical treatment of portal hypertension in schistosomotic patients has distinct features when compared with cirrhotic patients, mostly because hepatic function is preserved in schistosomotic liver disease. Therefore, when attempting to reduce the portal pressure, the surgeon must be aware that the surgery might interfere with hepatic perfusion, and consequently with hepatic function. The aim of this study was to report the results achieved with splenectomy, division of the left gastric vein, devascularization of great gastric curvature, and postoperative endoscopic variceal sclerosis, as a surgical option to esophageal varices in hepatosplenic schistosomiasis. A total of 111 patients were studied, and the following is a list of inclusion criteria: age >16 years, history of gastrointestinal (GI) bleeding, presence of esophageal varices on preoperative endoscopy, hematocrit >22% and prothrombin enzymatic activity >50%, negative viral hepatitis on serologic tests (anti-HBV and anti-HCV), and definition, after liver biopsy, of exclusive schistosomotic liver disease. The following list includes exclusion criteria used: presence of liver disease other than schistosomotic, history of alcohol abuse, and preoperative thrombosis of the portal vein. The rebleeding rate was 14.4% during a mean 30-month follow-up period; portal vein thrombosis was 13.2%, and there was a global mortality of 5.4%. Gastric varices were present in 46.9% of the patients; for those patients, a gastrotomy and running suture of the varices achieved an eradication rate of the varices of 75.6%. The degree of periportal fibrosis was also analyzed. Periportal fibrosis staging revealed that patients with class II or III liver fibrosis had a significant increased risk of recurrent GI bleeding when compared with patients with class I liver fibrosis. Despite the elevation on alanine aminotransferase (ALT) and aspartate aminotransferase (AST), most other liver function tests showed no alteration or were corrected after surgery. We conclude that splenectomy, division of the left gastric vein, devascularization of great gastric curvature, and postoperative endoscopic variceal sclerosis showed good results globally and should be considered as therapeutic options in the treatment of hepatosplenic schistosomiasis.
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PMID:Surgical treatment of schistosomal portal hypertension. 1189 Mar 33