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Query: UMLS:C0019158 (hepatitis)
30,205 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Emphasis is laid on the correlation existing between liver and biliary apparatus pathology. On the one hand, attention is called to the development of reactive hepatitis in 60-75 per cent of patients presenting complicated cholelithiasis, and in nearly 30 per cent of the forms free of complications. Removal of the biliary pathology leads to complete regeneration of liver parenchyma in 80 per cent of the patients, especially in operation undertaken in opportune time. On the other hand, pathological conditions of the liver aggravate the developmental course and worsen the prognosis of biliary system diseases when operative management of the letter is necessitated. On the basis of personal experience, the unduely elevated risk in combining surgical intervention for biliary pathology with liver cirrhosis (27 observations), cholangiohepatitis (89 observations), and obstructive jaundice conditioned by a benign underlying cause--usually concrement (164 observations), is underscored. In established cholelithiasis it is fully justified to advise early operation. Surgical intervention in liver cirrhosis should be done after adequate preparation only if absolutely necessary. Obstructive jaundice requires urgent operation, within 10 days, as long as the pathomorphological changes are still reversible.
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PMID:[Operations on the biliary system in liver damage]. 864 50

Immunochemical testing of salivary samples of 73 patients revealed a positive correlation between increased level of lactoferrin and the presence of chronic pancreatoduodenal diseases (gastroduodenitis, gastroduodenal ulcers, polyps of the antral portion of the stomach, cholecystitis, cholangitis, cholelithiasis, hepatitis, and pancreatitis, correlation coefficient 0.9). The test is proposed as a cheap and informative method for screening of the above diseases.
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PMID:[Study of salivary lactoferrin in prophylactic examinations]. 868 Jul 65

There have been many recent developments in the diagnosis and therapy of chronic liver diseases. These include identification of new hepatitis viruses, such as hepatitis C and E. Specific therapies such as interferon alfa are now approved for treatment of chronic viral hepatitis B and C, with improvement in liver tests in up to 50% of patients while on treatment. New therapies, such as ursodeoxycholic acid, are currently being studied for cholestatic liver diseases such as primary biliary cirrhosis and primary sclerosing cholangitis. Liver transplantation has become established as a proven treatment for end-stage liver disease, with 1-year survival rates above 80% and good long-term results. A variety of new surgical and nonsurgical treatments are available for treatment of gallstones, such as laparoscopic cholecystectomy, gallstone dissolution, and lithotripsy. The advent of endoscopy in the biliary tract with endoscopic retrograde cholangiopancreatography has made minimally invasive therapy possible for many biliary disorders. This article will focus on new therapies in hepatobiliary disease and recommend when to refer patients for further management.
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PMID:Update on therapy for hepatobiliary diseases. 882 89

Flutamide is a nonsteroidal antiandrogen commonly used in the treatment of prostate cancer. Hepatic toxicity associated with flutamide has been reported with an incidence from less than 1% to about 5%. Ursodeoxycholic acid (UDCA), a hydrophilic bile acid, has been widely used in the treatment of cholesterol gallstones and of several liver diseases, but few data are now available concerning its use in the management of drug-induced hepatitis. The case of a patient who presented severe hepatitis with jaundice following use of flutamide is reported. UDCA treatment was started on admission and, contemporaneously, flutamide was withdrawn. Clinical and biochemical improvement was progressively observed, and the patient was discharged six weeks after the admission. Since fatal flutamide-related hepatitis has been reported, monitoring of serum liver tests is advocated during flutamide administration, and the effectiveness of UDCA in the treatment of drug-induced hepatotoxicity requires further study.
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PMID:Flutamide-induced toxic hepatitis. Potential utility of ursodeoxycholic acid administration in toxic hepatitis. 894 75

Drug-induced cholestasis may be due to impairment of hepatocellular bile secretion (pure cholestasis or cholestatic hepatitis), obstruction of ductules (cholangiolitis) or interlobular ducts (cholangitis), or extrahepatic obstruction (sclerosing cholangitis). Mechanisms of hepatocellular cholestasis are multiple and include inhibition of various transport systems, cytoskeleton poisoning, disturbed intracellular calcium homeostasis and increased permeability with regurgitation of bile constituents into plasma. Pure hepatocellular cholestasis is mostly observed with sex steroid hormones and anabolic steroids. Ductular or ductal cholestasis (drug-induced cholangiopathy) may be acute and self-limited, or prolonged with ductopenia, occasionally leading to biliary cirrhosis. An immune mechanism has been proposed. Sclerosing cholangitis with strictures near the confluent of hepatic ducts is observed after intraarterial administration of floxuridine for chemotherapy of hepatic metastases. Some drugs may induce the formation of cholesterol gallstones, or precipitate in bile and form biliary sludge or stones in the gallbladder or common bile duct.
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PMID:Drug-induced cholestasis. 913 22

The most frequent hepatobiliary diseases in Vietnam are chronic hepatitis and cirrhosis, liver abscess, hepatobiliary ascaridiasis, angiocholitis, biliary lithiasis and primary liver cancer. The principal causes of chronic hepatitis and cirrhosis are HBV and HCV infections. Alcohol and chemicals (drugs, agricultural, industrial, war herbicides) also play an important role. Malaria causes hepatitis and fibrosis lesions, however no cirrhotic lesions were observed. There are two categories of liver abscess, amoebic and cholangitic, often caused by ascaridiasis. Treatment of amoebic abscesses is, at first, non-surgical for small abscesses, often combined with ultrasound guided abscess puncture. Cholangitis abscesses are more serious and often require surgical intervention. Among the gallstones, only 15% are of the gall-bladder, the majority are choledocho- and intrahepatic-lithiasis, composed largely of calcium bilirubinate and are frequently caused by Ascaris-related cholangitis and the nucleation of Ascaris eggs. Forty-seven per cent of acute cholecystitis are acalculous, showing a higher frequency than in Western countries. Primary liver cancer is one of the most frequent malignancies in Vietnam. More than 90% of liver cancers are hepatocellular carcinomas. The principal causes are HBV infection, followed by HCV infection, aflatoxin, alcohol and chemicals. Recent efforts aiming at earlier diagnosis, by selective screening in high-risk groups, have used clinical surveillance, abdominal sonography and AFP level determination. Promising results were obtained in prevention trials by reducing the high AFP level of cirrhotic patients using a vegetal drug, Gacavit, and by treatment with percutaneous ethanol injection therapy, as an alternative therapeutic measure for liver tumour resection.
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PMID:Some peculiarities of hepatobiliary diseases in Vietnam. 919 96

Extraintestinal manifestations and metabolic complications are very frequent in patients with idiopathic inflammations of the gut and are encountered in at least 35% of these patients. In Crohn's disease extraintestinal manifestations are more frequent than in ulcerative colitis, in particular when the large bowel is affected. Metabolic complications are the result of inflammatory changes of the small intestine or develop as a result of the reduced reabsorption surface of the gut. As to the relationship to the activity of the idiopathic inflammation of the gut, extraintestinal manifestations can be differentiated into those which depend on the activity of the basic disease and those which lack this dependence. From the aspect of a long-term prognosis extraintestinal manifestation independent on the activity of the inflammation of the gut are much more serious, because as a rule they have a long-term and usually progressive trend. The most serious extraintestinal complication is primary sclerotizing cholangitis which in the majority of patients leads to destruction of the biliary pathways and the development of biliary cirrhosis. Depending on the predominantly affected site of the biliary system, primary sclerotizing cholangitis is divided into three types. It is encountered much more frequently in ulcerative colitis than in Crohn's disease. Treatment of primary sclerotizing cholangitis is not very effective. At present it appears that the only drug with an effect on the course of the disease is long-term administration of urodesoxycholic acid. For patients with manifestations of hepatic insufficiency the only solution is transplantation of the liver. In all patients where the diagnosis of primary sclerotizing cholangitis was established, at the same time the possibility of inclusion in a transplantation programme should be considered. The relationship between sclerotizing cholangitis and pericholangitis has not been resolved conclusively. At present the majority of authors is inclined to believe that pericholangitis is part of changes associated with sclerotizing cholangitis. Other hepatobiliary complications of idiopathic inflammations of the gut such as cholelithiasis and parenchymatous liver damage, steatosis of the liver and chronic autoimmune hepatitis are not such a serious problem as sclerotizing cholangitis.
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PMID:[Hepatobiliary complications of idiopathic intestinal inflammations]. 922 Nov 79

Liver abnormalities in the course of Adult Onset Still's Disease (AOSD), both in form of hepatomegaly and elevation of hepatic enzymes, have been reported in up to three-quarts of the affected patients. These abnormalities may reflect disease activity or may be induced by drugs. Only in a few of this patients a liver biopsy was performed. However liver histology has shown, generally, non specific abnormalities or even normal pictures. We have recently observed a 47-year-old woman with a febrile illness started five months before, who after pertinent investigation was diagnosed as AOSD (according to criteria of Yamaguchi et al.). Apart from laboratory findings characteristic of an inflammatory disease, in absence of drug therapies the biochemical data showed raised levels of aspartate aminotransferase, alanine aminotransferase, alkaline phosphatase and aminoglutamil transferase. Serological tests for either viral hepatitis viruses (HAV, HBV, HCV) or other viruses were negative. Ultrasonographic examination of gallbladder and bile ducts did not find gallstones or other abnormalities. A liver biopsy was performed, which histopathologic examination showed moderate fatty methamorphosis with focal areas of hepatocellular swelling with minimal necrosis, mild Kuppfer cell hyperplasia, portal and sinusoidal infiltrates of mononuclear cells. This picture consisted with the diagnosis of an acute unspecific reactive hepatitis.
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PMID:[Acute hepatitis in a patient with adult onset Still disease]. 937 53

The Authors report a case of prostatic carcinoma in a 84 year old male, treated with cyproterone acetate (CPA), complicated by a fatal fulminant hepatitis. He was admitted with a mixed jaundice followed by a derange of all liver function tests. Serological markers for hepatitis were negative. Ultrasonography and CT revealed no hepatic abnormality but gallstones and dilatation of principal bile duct with a terminal stricture. By the endoscopic retrograde cholangiography and sphincterotomy we put an external drain tube. He died 9 days after admission. Fatal hepatis due to CPA is a very rare complication but all patients on anti-androgenic drugs should have liver function closely monitored. CPA must be discontinued immediately at the first derange of liver function tests.
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PMID:[Acute hepatic necrosis in a patient treated with cyproterone acetate]. 962 65

Although primary sclerosing cholangitis (PSC) is not a common disease, it is important in the differential diagnosis of hepatobiliary tract diseases in clinical practice. A diagnosis of PSC should be made only after the exclusion of similar diseases with well known etiologies or pathogeneses. In this review, the pathology of classical PSC and its variants or related diseases is highlighted. PSC is histologically characterized by progressive periductal fibrosis with luminal stenosis or obliteration, along with the formation of a fibrous core, as well as dilatation (cholangiectasis). Its etiology is unknown. Bacterial ascending cholangitis is superimposed on its long clinical course. Such a heterogeneous distribution of biliary lesions with biliary obliteration and cholangiectasis is responsible for the radiological demonstration of biliary abnormalities, particularly the beaded appearance. Sampling variability is common in needle or wedge biopsied specimens. As a result of biliary damage, the liver shows progressive cholestatic change followed by biliary fibrosis and cirrhosis, and this hepatic progression is divisible into four stages. There are several variants of PSC or related diseases, such as localized biliary sclerosis and stenosis, sclerosing cholangitis associated with inflammatory pseudotumor, and PSC-autoimmune hepatitis overlapping syndrome. Cholelithiasis, including secondary hepatolithiasis and, to a lesser degree, biliary carcinoma and dysplasia, are also known to develop at the perihilar bile ducts as a late complication of PSC.
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PMID:Definition and pathology of primary sclerosing cholangitis. 1066 78


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