Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0015695 (fatty liver)
 13,941 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The earliest and most reproduceable lesion associated with chronic alcohol abuse is fatty liver. In some alcoholics this may be superseded by alcoholic hepatitis, which may represent the link between the early lesion and cirrhosis. Alcoholic cirrhosis usually begins as a regular, monolobular variety, but is eventually transformed into an irregular, multilobular type. All stages of alcoholic liver injury have now been produced in the baboon, despite high protein and vitamin supplemented diets. Alcohol may therefore now be regarded as a direct hepatotoxin. Epidemiological studies have indicated that alcoholic liver injury begins with an intake of more than 80 g ethanol a day, and that cirrhosis is generally not seen with an intake of less than 160 g per day. The development of cirrhosis correlates with the total duration and amount of alcohol ingested. Complications of alcoholic cirrhosis include iron overload and primary hepatic carcinoma.
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PMID:Relation of alcoholic liver injury to cirrhosis. 4 93

The large number of chemical agents administered for therapeutic or diagnostic purposes can produce various types of hepatic injury by several mechanism. Acute injury may be cytotoxic, cholestatic or mixed. Cytotoxic injury may consist of necrosis or steatosis. Cholestatic injury may be cholangiolitic (hepatocanalicular) or bland (canalicular). Chronic hepatic lesions caused by medicinal agents include chronic active hepatitis, steatosis, cirrhosis, fibrosis, hepatoportal sclerosis (non-cirrhotic portal hypertension), hepatic vein thrombosis, peliosis hepatis, adenoma, carcinoma, and angiosarcoma. There is a useful relationship between the type of hepatic injury and the chemical setting in which the drugs are employed. Some agents produce the liver damage because they are intrinsic (true, predictable) hepatotoxins. Other (non-predictable "hepatotoxins"), produce hepatic injury only in the rare and unusually susceptible individual (idiosyncratic injury). Hepatotoxic agents can be recognised by their dose-dependent and experimental reproducibility, properties which are not shared by agents which produce hepatic injury only in idiosyncratic hosts. Intrinsic hepatotoxins may be categorised as direct or indirect. Direct hepatotoxins injure the hepatocyte by direct physiochemical alteration and as a consequence produce metabolic defects. Indirect hepatotoxins selectively block metabolic pathways and, by producing a precise biochemical lesion, lead to structural changes. They may lead to hepatic steatosis or necrosis (cytotoxic indirect hepatotoxins) or block bile flow (cholestatic indirect hepatotoxins). Direct hepatotoxins are rarely encountered as drugs. Overdoses of some drugs and antineoplastic agents appear to be indirect cytotoxic hepatotoxins, and the C-17 alkylated anabolic and contraceptive steroids are indirect, cholestatic hepatotoxins. Idiosyncracy of the host is the mechanism for most types of drug-induced hepatic injury. It may reflect allergy to the drug or a metabolic aberration of the host permitting the production of hepatotoxic metabolites.
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PMID:Drug-induced liver disease. 35 64

Detection and exclusion of focal liver lesions is especially difficult in patients with diffuse liver disease. Magnetic resonance (MR) imaging may be particularly valuable in these patients. By judicious comparison of appropriate pulse sequences, normal and hypertrophic liver may be distinguished from atrophic, neoplastic, or otherwise abnormal hepatic parenchyma. Chemical shift (lipid-sensitive) techniques allow definitive identification of fatty liver, including focal fatty infiltration or focal sparing. T2-weighted and T2*-weighted images allow identification of iron overload, depicting malignancies as focal masses without iron. Analysis of signal intensity and internal morphology allows confident distinction between regenerative nodules and hepatocellular carcinoma in most instances, and allows diagnosis of early carcinoma within regenerative nodules. MR imaging provides capabilities for noninvasive characterization of liver tissue beyond those available with other noninvasive modalities.
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PMID:Focal manifestations of diffuse liver disease at MR imaging. 911 25

A differential diagnosis of liver tumors was attempted on the basis of the pattern of blood flow within and around tumors on color Doppler flow images. The study comprised 35 patients with liver mass lesions: 20 patients had hepatocellular carcinoma, six had hemangiomas, four had metastatic liver cancers, one had cholangiocellular carcinoma, one had focal fatty liver, and three had liver cysts. A basket pattern (a fine blood-flow network surrounding the tumor nodule) was observed in 15 (75%) of the 20 hepatocellular carcinomas. An image of vessels within the tumor (blood flow that runs into and branches within the tumor) was observed in 13 (65%) of the 20 hepatocellular carcinomas. These two findings were observed only in hepatocellular carcinomas; even when the tumor was smaller than 2 cm in diameter, these findings were observed frequently. In the patients with multiple hepatic metastases, a "detour" pattern (a dilated portal vein meandering around the tumor nodules) was observed. In three of the six hemangiomas, a "spot" pattern (color-stained dots or patches in the central region of the tumor) was seen. Our experience suggests that hepatocellular carcinomas have a characteristic appearance on color Doppler flow images.
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PMID:Color Doppler flow imaging of liver tumors. 215 12

We assessed the prevalence of previously unrecognized hemochromatosis among patients in whom diabetes mellitus was diagnosed after the age of 30 yr, and we evaluated the positive predictive value of biochemical screening tests for hemochromatosis in diabetic subjects. Thirty-eight of 572 patients screened (6.6%) had a serum ferritin level greater than 324 micrograms/L; 16 patients had normal levels on repeat testing. Four patients' serum ferritin levels fell to less than 400 micrograms/L. Seven of 18 patients with a persistently elevated serum ferritin level did not undergo a liver biopsy because of a recognized cause of hyperferritenemia (carcinoma, alcoholism, or systemic lupus erythematosus). The diagnosis of hemochromatosis seemed certain in 1 of 3 patients who were not biopsied for technical reasons. Of 8 patients biopsied, 2 had hemochromatosis, 4 had fatty liver, 1 had hemosiderosis, and 1 had a chronic inflammatory cell infiltrate with no iron deposition. Of 4 patients with a raised transferrin saturation level, 2 had raised serum ferritin levels and hemochromatosis, 1 had raised serum ferritin and hemosiderosis on liver biopsy, and 1 had a normal transferrin saturation level on repeat testing. Two of 3 cases of hemochromatosis had other clinical markers of the condition. Therefore, routine screening of diabetic patients for hemochromatosis is not necessary, because patients with hemochromatosis will often have other clinical features of the disease. When screening diabetic patients for hemochromatosis, it should be remembered that a persistently raised serum ferritin level has a low positive predictive value (16.6%) and that a normal transferrin saturation level does not exclude the diagnosis.
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PMID:Usefulness of biochemical screening of diabetic patients for hemochromatosis. 235 Oct 33

In this study, the author intended to examine the validity of the inhaled hydrogen gas clearance method (i-H2) for determination of the hepatic blood flow (HBF), and also to show some applicabilities of the method in experimental animals and patients with liver diseases. Simultaneous determinations of HBF by i-H2 and electromagnetic flowmetry in rabbits revealed an excellent correlation between the values obtained by the two methods. Moreover, HBF in rabbits measured by i-H2 varied in parallel with that by thermocouple flowmetry or laser Doppler velocimetry after administration of norepinephrine, propranolol or glucagon. In carbon tetrachloride-treated rats, HBF measured by i-H2 correlated better with the severity of damage in the sinusoidal structure than the severity of hepatic cell injury or the serum levels of transaminases. HBF as determined by i-H2 was significantly decreased in acute hepatitis (AH), chronic inactive hepatitis (CIH), chronic active hepatitis (CAH), liver cirrhosis (LC) and fatty liver. Reduced HBF in AH returned to normal during recovery of the disease. The ratio of HBF in tumor/normal tissue was greater than 1.0 for hepatocellular carcinoma in contrast to the ratio of less than 1.0 for metastatic liver carcinoma. Propranolol caused a decrease in HBF by 31%, and vasopressin by 39% in patients with CIH or LC. In contrast, glucagon induced its increase by 65%, 35% and 17%, respectively, in patients with CIH, AH and LC.
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PMID:[Measurement of hepatic blood flow by the hydrogen gas clearance method. Experimental and clinical observations]. 236 96

Because the majority of patients with carcinoma of the pancreas are already in a state of malnutrition on admission, various complications can easily occur after surgery and adjuvant therapy such as radiation and chemotherapy. Therefore, the importance of nutritional management in the treatment of pancreatic carcinoma was examined in our department and the following results were obtained: 1) Preoperative nutritional assessment The nutritional state was evaluated using the Prognostic Nutritional Index for Surgery: PNI-S = -0.147 X (ratio of weight loss) + 0.046 X (weight for height) + 0.010 X (% triceps skin fold thickness) + 0.051 X (hepaplastin test), which was calculated from our results. In patients with the PNI-S of over 8, total pancreatectomy was performed safely, and when the PNI-S was more than 6, pancreaticoduodenectomy was done successfully. When the PNI-S was more than 5, it was possible to perform distal pancreatectomy or bypass operation. Depending on the nutritional assessment before surgery, the appropriate operative method could be selected, and the operative results could be improved by preoperative nutritional support. 2) Postoperative nutritional management Administration of a high-calorie by both parenteral and enteral nutrition during the early postoperative period produces good operative results, accompanied by a reduction of postoperative complications, such as fatty liver and so on. This approach also reduces the adverse effects of adjuvant therapy, such as radiation and chemotherapy, with an improvement of prognosis. Thus, it was revealed that nutritional assessment and management was very important for improving the therapeutic results in cases of carcinoma of the pancreas.
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PMID:[Importance of nutritional management for the treatment of carcinoma of the pancreas]. 313 85

A study of FAM (5-FU, ADM, MMC) hepatic infusion chemotherapy via the left subclavian artery was performed in 40 patients with liver metastasis from colorectal carcinoma. The response rate was 61.1% (1 CR and 21 PR among 36 evaluable cases), and the 50% survival period was 11.6 months. CT imaging in the 22 responders was discussed. The CT scan images showed no remarkable changes except for tumor size in 10 cases (45.5%), a decrease of marginal density in 4 cases (18.2%), an increase of calcification in 2 cases (9.1%), dimpling sign in 3 cases (13.6%) and fatty liver degeneration and abscess formation in the hepatic duct in 1 case (4.5%). These findings on CT scan were important for evaluating the effects and side effects in patients receiving hepatic infusion chemotherapy, and provided useful information for follow-up.
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PMID:[The effect and CT imaging of FAM hepatic infusion chemotherapy in patients with liver metastasis from colorectal carcinoma]. 363 74

Three patterns of hepatocyte injury in man, direct, immunological, and cholestatic, are described. The characteristics of the direct pattern are predominantly mitochondrial damage, central (zone 3) necrosis, and, usually, fatty change. It can be subdivided into the alcohol type (also seen with obesity, in diabetes, as a reaction to perhexiline, in Wilson's disease, and in Indian childhood cirrhosis) and the Reye's syndrome type (also seen with tetracycline toxicity, fatty liver of pregnancy, and cytotoxic drugs). Reactive drug metabolites, metal poisoning, and anoxia are also associated with the direct pattern of hepatocyte injury. The immunological pattern is characterised by damage to cell membranes with piecemeal necrosis of periportal (zone 1) hepatocytes and mononuclear-cell infiltration. Examples include chronic active hepatitis, primary biliary cirrhosis, and drug reactions such as those to halothane. In the cholestatic pattern there is disturbance of the bile-secretory mechanism with retention of bile within the hepatocytes. Cholestatic liver injury may be intrahepatic, as in sex-hormone cholestasis, or extrahepatic, as in choledocholithiasis or carcinoma of the bile ducts. Identification of the type of hepatocyte injury is valuable in diagnosis, in assessing prognosis, and in selecting treatment.
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PMID:Patterns of hepatocyte injury in man. 612 Dec 33

Serum beta 2-microglobulin was determined in 53 patients with chronic liver diseases. No elevation was shown in fatty liver due to obesity or alcoholism. Serum beta 2-microglobulin was abnormal only in 4% of the patients with chronic hepatitis. Determination of serum beta 2-microglobulin seems not useful for the differential diagnosis between chronic hepatitis and fatty liver due to obesity or alcoholism. Serum beta 2-microglobulin was elevated in 29% of the patients with alcoholic liver cirrhosis, in 41% of those with non-alcoholic liver cirrhosis, and in 75% of those with primary liver carcinoma. The average serum beta 2-microglobulin concentration was significantly higher in non-alcoholic liver cirrhosis than in alcoholic liver cirrhosis. There was a significant correlation between serum beta 2-microglobulin and gamma-globulin concentrations in liver cirrhosis.
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PMID:Serum beta 2-microglobulin in chronic liver diseases. 617 12


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