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)

Portal hypertension (PH) which, for patients suffering from chronic liver disease, usually determines their subsequent fate, considerably exceeds the upper limit already in chronic hepatitis. With the aid of laparoscopic transhepatic manometry (LTM) in the branches of the portal and hepatic veins we measured portal vein pressures of 17.7 and hepatic vein pressures of 12.3 mm Hg in patients with chronic persistent hepatitis (CPH). In patients with chronic aggressive hepatitis (CAH) with still only moderate fibrosis, the pressure was 18.8 (in the portal vein) and 11.0 mm Hg (in the hepatic vein) while in CAH with marked remodeling, the average pressures were 19.9 and 11.8 mm Hg respectively. The early elevation of the PH, also in CPH, is an important indication for a thorough diagnostic work-up and "aggressive" therapy of the CH.
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PMID:Portal hypertension in chronic hepatitis--comparative manometric and clinico-chemical examinations. 738 30

Portal hypertension as the basis of threatening complications determines the subsequent fate of many patients with chronic inflammatory diseases of the liver. Normal values are exceeded considerably already in chronic hepatitis, but critical levels of pressure--with respect to the danger of bleeding from oesophageal varices--are only attained when cirrhotic remodelling is complete. With the aid of laparoscopic transhepatic manometry (LTM), we measured the levels of pressure in the branches of the portal vein and the hepatic vein in 23 patients suffering from chronic hepatitis (CH). In patients with chronic persistent hepatitis (CPH), the pressure in the portal vein was 17,7, in the hepatic vein 12,3 mm Hg (n = 4). In a group of 15 patients presenting with chronic aggressive hepatitis (CAH) with marked remodelling extending to cirrhosis, the average pressures were 19,9 and 11,8 mm Hg respectively; in four patients with CAH and, as yet, only slight fibrosis, the corresponding figures were 18,8 and 11,0 mm Hg respectively. In view of the recorded incidence of bleeding in 42 patients with complete hepatic cirrhosis, the early detection and intensive treatment of CH is of particular importance.
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PMID:[Portal hypertension in chronic hepatitis (author's transl)]. 738 37

Kinetics of lidocaine (L) and indocyanine green (ICG), substances with a high hepatic extraction ratio, was studied in 9 normal subjects (4 smokers and 5 nonsmokers) and in 6 patients with chronic type B hepatitis without portal hypertension. L metabolism was studied in each subject after intravenous and oral administration. The data were used to calculate L systemic and oral clearances, L systemic bioavailability, and apparent hepatic blood flow. In smokers, L systemic bioavailability was decreased secondary to a marked increase in oral clearance, reflecting induction of drug-metabolizing activity. In patients with chronic hepatitis, L systemic and oral clearances were higher than in the normal. These findings indicate that hepatic handling of drugs with a high hepatic extraction ratio, such as L, might be enhanced in patients with chronic type B hepatitis. L disposition approach was validated in 5 patients by comparing results with those using the ICG clearance and extraction method at the time of hepatic vein catheterization. The L systemic bioavailability after oral administration is a reflection of first-pass clearance by the liver and might be a useful kinetic method for evaluating overall ability of the liver to remove drugs with high hepatic extraction ratios.
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PMID:Effects of smoking and chronic hepatitis B on lidocaine and indocyanine green kinetics. 739 88

The incidence of hepatitis C virus (HCV) antibody positivity is unknown. The purpose of this study was to clarify the prevalence of HCV infection among surgical patients and to identify high risk surgical patients. HCV antibody tests were performed in 789 surgical patients between April 1991 and March 1992. Of these patients, 129 (16.3%) tested positive, which was much higher than the positivity of the ordinary Japanese. Hepatobiliary diseases and portal hypertension were associated with a higher positivity than other disease categories (94 of 206, 45.6% versus 35 of 583, 6%; p < 0.0001). Patients above 50 years of age had a higher positivity than their younger counterparts (118 of 578, 20.4% versus 11 of 211, 5.3%; p < 0.0001). The HCV positivity was as high as 54.1% (119 of 220) among surgical patients with known risk factors for hepatitis, in contrast to only 1.9% (10 of 569) among those without such risk factors. We conclude that surgical patients have a high incidence of HCV infection, for whom medical professionals should pay special attention to avoid disease transmission.
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PMID:Hepatitis C virus infection among Japanese general surgical patients. 757 65

Eighty percent of hemophiliacs exposed to plasma products are seropositive to hepatitis B and an even higher percentage are seropositive to hepatitis C. Post-transfusion hepatitis is followed by cirrhosis in up to 25% of the cases. In the wake of portal hypertension, the development of oesophageal varices entails the risk of life-threatening hemorrhage. We report on a patient with moderate hemophilia A (factor VIII:C 4-11%) who suffered from massive hematemesis, melaena and evolving shock after excessive alcohol ingestion. The diagnosis of Mallory-Weiss syndrome and the differential diagnosis of bleeding oesophageal varices as well as prognostic consequences are discussed.
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PMID:Mallory-Weiss syndrome in a patient with hemophilia A and chronic liver disease. 757 95

The purpose of the work was an assessment of TNF-alpha and Il-6 concentrations in 34 children with diagnosed chronic hepatitis. In all studied patients the values of TNF-alpha and Il-6 concentration were slightly increased. The correlations calculated between TNF-alpha and Il-6 concentrations calculated between TNF-alpha and Il-6 concentrations and laboratory parameters (laboratory indicators of hepatitis activity--AlAT; liver function indicators--prothrombin index, bilirubin concentration, bile acid concentration, alkaline phosphatase activity, anti-pyrin half-life) were non-significant in Spearman non-parametric test (p > 0.005) except for the correlation between albumin and TNF-alpha concentrations. No statistically significant differences of TNF-alpha and Il-6 concentrations were found between groups of patients with active and persistent hepatitis; groups with and without cirrhosis as well as between groups with and without portal hypertension. Normal or slightly increased TNF-alpha and Il-6 concentrations, observed in chronic hepatitis in children should be explained by compensated liver function in such patients.
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PMID:[Can TNF-alpha and IL-6 be helpful in assessment of chronic hepatitis in children?]. 771 32

A multicenter longitudinal study was performed to assess the survival of hepatitis B surface antigen positive compensated cirrhosis, primarily in relation to hepatitis B virus replication and hepatitis delta virus infection, and to construct a prognostic index based on entry characteristics. This cohort study involved nine university medical centers in Europe. Three hundred and sixty-six Caucasian HBsAg positive patients with cirrhosis who had never had clinical manifestations of hepatic decompensation were enrolled and followed for a mean period of 72 months (6 to 202 months). Inclusion criteria were biopsy-proven cirrhosis, information on serum hepatitis B e antigen and antibody to hepatitis D virus at the time of diagnosis and absence of complications of cirrhosis. At entry 35% of the patients were HBeAg positive, 48% of the patients tested were HBV-DNA positive and 20% anti-HDV positive. Death occurred in 84 (23%) patients, mainly due to liver failure (45 cases) or hepatocellular carcinoma (23 cases). The cumulative probability of survival was 84% and 68% at 5 and 10 years, respectively. Cox's regression analysis identified six variables that independently correlated with survival: age, albumin, platelets, splenomegaly, bilirubin and HBeAg positivity at time of diagnosis. According to the contribution of each of these factors to the final model, a prognostic index was constructed that allows calculation of the estimated survival probability. No difference in survival of hepatitis D virus infected and uninfected patients was observed. Termination of hepatitis B virus replication and/or biochemical remission during follow up correlated with a highly significant better survival. These data show that in compensated cirrhosis B, hepatitis B virus replication, age and indirect indicators of poor hepatic reserve and established portal hypertension significantly worsen the clinical course of the disease, whereas hepatitis D virus infection does not influence the prognosis. The highly significant improvement in life expectancy following cessation of hepatitis B virus replication and biochemical remission favors antiviral therapy in those patients with a guarded prognosis, as estimated by a prognostic index.
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PMID:Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter study. The Investigators of the European Concerted Action on Viral Hepatitis (EUROHEP). 781 13

A specific form of chronic hepatitis is described in 21 dogs. The disease appears to develop in the neonatal and juvenile period. Predominant clinical signs include weight loss, ascites, and jaundice. The liver is small, with a smooth surface or a limited number of hyperplastic nodules. A characteristic feature of the hepatitis is disruption of the hepatic architecture by complete fibrotic dissection of the lobular parenchyma into individual and small groups of hepatocytes with subsequent portal hypertension. This lesion may represent a specific pattern of hepatic reaction in the immature animal, and resembles human neonatal hepatitis.
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PMID:Lobular dissecting hepatitis in juvenile and young adult dogs. 806 58

The clinical features of liver cirrhosis are manifestation of altered hepatic hemodynamics and of reduced hepatic cell mass, represented by portal hypertension and sometimes hepatic failure. Histologically, cirrhosis is defined in general as a diffusely altered reconstruction of the lobular parenchyma with widespread connective tissue septa, which circumscribe regenerative nodules of the hepatocytes and contain anastomoses between efferent as well as afferent vascular systems linking central and portal canals. Thus, a large portion of portal blood flow bypasses the hepatocytes and reticuloendothelial cells, depleting them of their metabolic and detoxifying function. It is often impossible to make a morphologic classification of liver cirrhosis based on tiny biopsy specimens, and the histologic criteria are neither specific nor mutually exclusive. Furthermore, a frequent lack of correlation between the etiologic and morphologic types of cirrhosis has led the clinicians to classify the cirrhosis based on the main etiologic factor. According to the statistics (1991) of 40 representative medical institutes in Japan, covering approximately 8,600 liver cirrhosis cases, 16.9% of the cirrhosis is supposedly due to type B hepatitis virus infection, 54.9% to type C, 10.7% to alcoholic abuse and the remainder are of unknown etiology. It would be reasonable to apply the etiologic classification to liver biopsy specimens and morphologic classification to autopsy materials for thorough examination.
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PMID:[Definition and classification of liver cirrhosis]. 811 78

Idiopathic neonatal hepatitis is one of the more important causes of neonatal cholestasis. It is regarded one of the clinical presentations of 'idiopathic obstructive cholangiopathy', just like extrahepatic biliary atresia. Is it not possible to discriminate between intrahepatic and extrahepatic causes of neonatal cholestasis, or between idiopathic neonatal hepatitis and metabolic, infectious, or toxic causes, by using clinical or laboratory parameters. Liver histology is slightly more helpful: giant cell formation, focal liver necrosis, and lymphocytic and neutrophilic infiltration may be found in idiopathic neonatal hepatitis. In infectious hepatitis liver pathology mostly is only a lesser part of the symptomatology. Sporadic idiopathic neonatal hepatitis has a better prognosis than familial; about 75% of children with sporadic hepatitis experience complete recovery as compared to less than 25% of children with familial hepatitis. Therapy is confined to the prevention and treatment of complications such as itching, portal hypertension and variceal bleeding, and (fat) malabsorption.
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PMID:[Idiopathic neonatal hepatitis]. 812 25


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