Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0019158 (hepatitis)
30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Efficiency of ceftriaxone (Rocephin Hoffman Laroche) was assessed in 16 children aged between 3 and 14 years and in 4 adults aged between 17 and 70 years with severe infections of the urinary and respiratory tracts caused by E. coli. S. pneumoniae, P. aeruginosa, P. mirabilis or enterococci. Pyelonephritis as a sole pathology was diagnosed in 10 patients whereas in further 8 patients it complicated other diseases (nephrotic syndrome, hepatitis, cholangitis, leukemia). Pneumonia complicated nephritis leukemia or lymphoma in 8 children. Peritonitis was diagnosed in 1 adult patient. Ceftriaxone was given in a single daily dose of 50 mg/kg to all children and 2.0 g to adult patients for 7-10 days. No adverse reactions were noted. Clinical improvement was achieved in all treated patients. Cultures became negative in 17 cases after the treatment. Significant bacteremia caused by P. aeruginosa persisted in 2 patients and by E. coli in 1 patient. No toxic effects on liver, renal, pancreatic and bone marrow functioning were seen. Ceftriaxone may be safely and efficiently used for the treatment of the urinary and respiratory infections.
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PMID:[Use of ceftriaxone in urinary and respiratory tract infections]. 223 13

The usefulness of hepatic artery infusion (HAI) with floxuridine is limited by the severe biliary and hepatic toxicity of floxuridine. This prompted the SAKK to evaluate the effectiveness, toxicity and feasibility of HAI with fluorouracil (FU) and mitomycin (MMC) administered by an external portable pump. Of 28 patients treated, partial responses were obtained in 14 (50%, 95% confidence interval: 30% to 70%) and stabilization in 11 (39%, 21% to 60%), for a median duration of 12.6+ months. Median survival was 19.5+ months. Grade I-II toxicity (WHO) consisted of nausea (46%), leucopenia (32%) thrombocytopenia (21%) and abdominal discomfort (25%). Two patients developed gastro-duodenal ulcers and two others grade III leucopenia. No life-threatening side effects, especially no sclerosing cholangitis or chemical hepatitis, were observed. In conclusion, HAI with FU and MMC is a valid alternative to floxuridine HAI in metastatic colorectal cancer confined to the liver.
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PMID:Effectiveness and low toxicity of hepatic artery infusion with fluorouracil and mitomycin for metastatic colorectal cancer confined to the liver. The Swiss Group for Clinical and Epidemiological Cancer Research (SAKK). 226 69

Cholestatic virus hepatitis (CVH) patients were examined for blood levels of free oxyproline, cholesterol and triglycerides to evaluate connective tissue in walls of the ducts and adjacent area. Significantly elevated levels of free oxyproline, cholesterol and triglycerides occurred in CVH. A 3--5--fold increase in oxyproline and cholesterol was typical for protracted and chronic CVH evolving due to sclerosing cholangitis. The rise of triglycerides proved moderate. In initial and apparent biliary hepatic cirrhosis triglyceride levels stood within normal range while those of oxyproline and cholesterol were on the increase. The changes in the indices indicative of the inflammation, sclerosis or proliferation of the connective tissue in the biliary ducts walls may suggest CVH complications, prognosticate outcomes, facilitate differential diagnosis with other hepatic lesions.
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PMID:[Diagnosis of cholestatic forms of viral hepatitis, its complications and outcomes]. 228 11

Intra-arterial hepatic chemotherapy (IAHC) with adriamycin (ADM) has not increased its therapeutic index. For our preclinical studies, we selected pirarubicin (THP), an ADM derivative with faster cellular uptake. In rabbits with VX2 tumor in the liver we compared plasmatic and cellular pharmacokinetics of ADM and THP after i.v. and IAH therapy. For ADM, there were no differences in plasma and heart concentrations, with only a slight increase in tumoral levels after IAH compared to i.v. administration; on the other hand, with IAH THP, there was important reduction in systemic exposure with a major increase in tumoral drug distribution. In the phase I study, involving nine patients with implanted catheters, the starting dose of THP was 30 mg/m2 with a 10 mg/m2 intrapatient escalation every 3 weeks in the absence of toxicity. Pharmacokinetics were compared for i.v. and IAH administration in seven patients. The limiting toxicity was neutropenia and the maximal tolerated dose (MTD) ranged from 50 to 110 mg/m2. Moderate nausea-vomiting (grade 1-2) and alopecia (grade 1) occurred at the MTD. No arterial occlusion, gastroduodenal ulcer, hepatitis, or sclerosing cholangitis were seen. In the phase II study, in colorectal cancer patients (CRC) with metastasis confined to the liver, patients were enrolled until June 1990. THP (40 min infusion every 3 weeks) was initiated at 60 mg/m2 with 10 mg/m2 increment until grade 2 hematotoxicity. The median MTD was 85 mg/m2 (range of 60-120 mg/m2), and the median number of cycles was 7 (range of 2-11) with cumulated doses from 180 to 1,030 mg/m2. Grade 2-4 neutropenia was reached in 15 patients. Other toxicities included two arterial occlusions, one episode of gastritis, but no hepatic toxicity and no heart failure. Antitumor effect (in 18 patients) included 1 CR, 5 PR, 3 MR, 6 NC, and 3 PD. The median survival was 18+ months and 1-year survival was 73% +/- 12%. Seven patients had extrahepatic progression at this time. In conclusion, besides 5-FU or Fudr, THP is active in IAHC (probably in relation with high local extraction) on CRC liver metastases usually unresponsive to ADM. It can be given in an outpatient setting with minimal toxicity.
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PMID:Intra-arterial hepatic chemotherapy with pirarubicin. Preclinical and clinical studies. 229 52

Thirty-three patients with liver metastases of colorectal cancer were treated by intra-arterial 5-FU chemotherapy. The median survival time of all patients was 14 months. A partial remission could be observed in nine patients, and a further 15 patients had stable disease. Patients were treated on an outpatient basis and the toxicity of treatment was mild. We observed no case of sclerosing cholangitis or chemical hepatitis. Intra-arterial 5-FU chemotherapy provided treatment results similar to those reported for FUdR but with less hepatobiliary toxicity.
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PMID:Hepatic arterial infusion (HAI) chemotherapy for liver metastases of colorectal cancer using 5-FU. 232 13

Extensive liver resection for hilar bile duct carcinoma with jaundice has high morbidity and mortality rates because of postoperative liver failure. To minimize postoperative liver dysfunction, a portal venous branch was embolized before surgery to induce atrophy of the lobe to be resected and hypertrophy of the contralateral lobe in 14 patients with hilar bile duct carcinoma. Bile was drained before surgery in 11 patients with jaundice. Portal embolization did not produce major side effects, and moderate increases of serum transaminase activity or bilirubin returned to baseline values within 1 week. Hepatectomy with bile duct resection and lymphadenectomy was performed 6 to 41 days after embolization, at which time the embolized lobe was atrophied in 12 of the patients. Extended right or left lobectomy or left trisegmentectomy (10, 3, and 1 cases, respectively) with biliointestinal reconstruction was performed. One patient with jaundice and suppurative cholangitis died 30 days after hepatectomy. Another patient died 3 months after surgery of aggravated hepatitis. After surgery, no bile leakage occurred and hyperbilirubinemia was usually moderate and reversible.
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PMID:Preoperative portal embolization to increase safety of major hepatectomy for hilar bile duct carcinoma: a preliminary report. 233 92

Fifty-nine colorectal cancer patients with metastatic liver cancer who underwent intra-arterial infusion chemotherapy (IAIC) at the National Cancer Center Hospital from May 1986 to February 1989 were reviewed. Excisions of metastatic liver cancer were performed in 36 patients and 23 had nonresectable metastatic liver cancer. Catheter troubles, including severe infection (8), extravasations (3), obstruction (1) and other problems (1) occurred in 13 (22.0%) patients, and 6 patients (10.2%) were unable to receive IAIC. Three patients did not undergo IAIC because of hepatitis or other reasons. Serious complications following IAIC, including sclerosing cholangitis (6), extravasations (6) and obstructions (3) were observed in 15 patients (30.0%). Results of IAIC were discussed in 21 patients undergoing hepatic resection and 17 patients with nonresectable metastatic liver cancer. 5-Fluorouracil (5-FU) (700 mg/m2) and mitomycin C (MMC) (7 mg/m2) were infused through implantable pumps every week or every two weeks. Total infused doses of 5-FU ranged from 500 to 15,000 mg (mean: 8,300 +/- 3,400 mg) and those of MMC were from 26 to 144 mg (mean: 58.8 +/- 32.7 mg) in 21 patients undergoing hepatic resections, whereas 1,500-26,250 mg (mean: 11,000 +/- 7,800 mg) of 5-FU and 0-130 mg of MMC (mean: 57.3 +/- 33.3) were infused in 17 patients with nonresectable liver cancer. Seven patients (33.3%) had recurrent liver cancer during 7-31 months (mean: 16.2 +/- 6.0 m) follow-up after hepatic resections, whilst only 3 of 13 patients (23.1%) with solitary liver metastasis had recurrent liver cancer. Three of these recurrent liver cancer patients (37.5%) underwent hepatic re-excision. Seven of 17 nonresectable patients (41.2%) were responders. Three patients completely responded (CR) and 4 responded partially (PR). Another study is needed to clarify the effect of IAIC in survival. IAIC should be undertaken as a treatment not only for patients with nonresectable metastatic liver cancer, but also for those with resectable metastatic liver cancer in order to prevent hepatic recurrence.
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PMID:[Results of intra-arterial infusion chemotherapy of colorectal cancer in patients with metastatic liver cancer]. 250 27

Fifty-nine colorectal cancer patients with metastatic liver cancer who underwent intra-arterial infusion chemotherapy (IAIC) at the National Cancer Center Hospital from May 1986 to February 1989 were reviewed. Excisions of metastatic liver cancer were performed in 36 patients and 23 had nonresectable metastatic liver cancer. Catheter troubles, including severe infections (8), extravasations (3), obstruction (1) and other (1) occurred in 13 (22.0%) patients, and 6 patients (10.2%) were unable to receive IAIC. Three patients did not undergo IAIC because of hepatitis or other reasons. Serious complications following IAIC, including sclerosing cholangitis (SC) (6), extravasations (6) and obstructions (3) were observed in 15 patients (30.0%). 5-Flourouracil (5-FU) (700 mg/m2) and mitomycin C (MMC) (7 mg/m2) were infused through implantable pumps weekly or every two weeks. Total infused doses of 5-FU ranged from 7,000 to 26,250 mg (mean: 11,800 + 7,700 mg) and those of MMC from 24 to 84 mg (mean: 45.3 + 25.8 mg) in 6 patients (12%) with SC, 4 resectable and 2 non-resectable cases. All six patients with SC had cholangiographic abnormalities of the biliary tract by endoscopic retrograde cholangiography (ERCP) or percutaneous transhepatic cholangiography (PTC), but serial CT examination of the liver did not show any progression of the tumor at the hilum in these patients. Segmental stricture at the common hepatic duct and bifurcation appeared specific to IA-5-FU induced SC. Obstructive jaundice occurred in 3 patients. Four patients had epigastralgia and 3 exhibited elevated alkaline phosphatase level prior to the cholangiographic examination. The elevated level of alkaline phosphatase was reversible in one patient without obstructive jaundice. Although the relation of the sclerosing process to IA-5-FU dose is not yet clear as well as IA-FUDR, it should be important to make an early detection of SC by ERCP and also to discontinue IAIC as soon as possible. In our opinion, SC may relate to the arterial delivery of 5-FU. In order to prevent SC, devascularization of the right hepatic artery via surgical procedures may well be effective, because retrograde flow from the right hepatic artery was confirmed by several clinical and anatomical studies.
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PMID:[Complications of intra-arterial infusion chemotherapy in patients with colorectal cancer with liver metastasis, with special reference to IA-5-FU induced sclerosing cholangitis]. 250 36

An investigation of specific course of the disease in 911 patients operated upon for acute cholecystitis with bilirubinemia has shown that mechanical jaundice resulting from choledocholithiasis takes place in a third of the patients. Obstruction of the bile duct was confirmed in 27.1% of the patients during cholangiography. Prevalence of a number of factors was noted indicating of a toxic lesion of the liver (destructive forms of acute cholecystitis in 81.0% of the patients, higher level of bilirubinemia in long terms of the disease, the presence of coexistent pancreatitis in 30.5%, cholangitis--in 39.3%). An investigation of 207 bioptates of the liver in acute cholecystitis has revealed fatty degeneration of hepatocytes in 56.5%, pericholangitis--in 43.0%, cholestasis--in 21.3% of the cases. The cause of jaundice in acute cholecystitis mainly is an alteration of the hepatic cells due to pyo-resorptive intoxication manifested as cholestasis and hepatitis.
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PMID:[Pathogenesis of jaundice in acute cholecystitis]. 259 23

Between 1980 and 1985, 40 patients were treated surgically for hydatid disease of the liver. In 4 cases (10%) jaundice was the first and most conspicuous sign of this disease. The patients originated from Spain, Morocco, Turkey and Lebanon. In 2 of these cases the initial diagnosis was hepatitis; one patient was operated on for suspected acute cholecystitis. All 4 patients had an eosinophilia and positive hydatid serology. Hydatid material was found in the biliary tract in two cases, while bile-stained hydatid fluid proved that there was a communication between cystic cavity and biliary tract in the other two patients. Obstruction of the common bile duct by hydatid elements causes jaundice and probably also cholangitis. Calcifications in the cyst are no guarantee against future complications. Surgery is the treatment of choice. When patients from an endemic area present with jaundice, hydatid disease of the liver should be suspected, particularly if eosinophilia also exists.
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PMID:Jaundice caused by hydatid disease of the liver. 263 84


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