Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0019204 (hepatocellular carcinoma)
 71,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Biliary cysts are connected with the biliary tract and primarily contain bile. Mostly this connection persists, which differentiates these cysts from all the others in this region. Therefore biliary cysts lead to a number of clinically serious complications such as calculi and abscess formation, cholangitis, cholestatic cirrhosis (possibly leading to portal hypertension or hepatoma), continuous enlargement of the cyst resulting in perforation into the abdominal cavity (and biliary peritonitis). The biliary cysts occur as a congenital-hereditary disease or develop because of an occlusion of hepatic artery branches. The congenital disease ist extremely rare. The secondary choleceles are caused by thrombo-embolic disorders (infarcts, periarteritis nodosa) or iatrogenically (ligations of vessels after traumatic liver rupture, embolization). Over the past years the secondary choleceles have gained in importance. Each case of cholecele should be diagnosed as early as possible. Though sonography and CT display cystic lesions excellently, differential diagnosis, however, remains difficult. The diagnosis is requested from the radiologist because therapeutic consequences are considerable.
 ...
PMID:[Increasing importance of biliary cysts (choleceles)]. 634 75

Chronic liver disease has become a significant complication of the therapy of hemophilia disorders. We describe two patients with hemophilia A and hepatitis B virus hepatitis who progressed to cirrhosis with bleeding esophageal varices. Each underwent distal splenorenal shunt under plasma concentrate therapy without difficulty. One patient died 19 months after operation and unsuspected hepatocellular carcinoma was found at autopsy. These cases illustrate the potential severity of liver disease in hemophilia and the ability to safely perform surgery for portal hypertension if required.
 ...
PMID:Cirrhosis, variceal bleeding, and distal splenorenal shunt in hemophilia A. 712 25

Liver scanning, using the radio-isotope indium-113m (113mIn), can now be routinely performed at the University Teaching Hospital, Lusaka, Zambia. The dose used is 1 - 4 mCi. Liver scans have been performed on 48 subjects, including 10 healthy individuals, 16 patients with histologically proven hepatocellular carcinoma, 11 with clinical and laboratory evidence of portal hypertension and 11 with miscellaneous illnesses. Seven representative scans are illustrated. The procedure is easy, and gives a fairly accurate functional estimate of Kupffer cell mass. In hepatoma, the scan may be either larger than or smaller than normal and reflects more accurately the residual function of the Kupffer cells. In cirrhosis of the liver with portal hypertension, residual Kupffer cell mass is small. Consequently, most of the 113mIn is taken up by the splenic reticuloendothelial system, resulting in a large spleen scan. This technique, although fraught with major limitations, is a useful additional diagnostic tool in the management of chronic liver disease.
 ...
PMID:Liver scanning using indium-113m at the University Teaching Hospital, Lusaka, Zambia. 730 48

Nine patients with hepatoma, 5 with massive ascites, 3 with rupture of esophageal varices and 1 with hematoemesis, successfully underwent TIPS without technical complications. Two of the patients died 3 and 5 months, respectively, after TIPS due to hepatic failure and/or tumor extension. Another patient in whom hepatoma ruptured 1 month after TIPS was experienced. It is concluded that TIPS is a useful and safety treatment for portal hypertension even in patients with hepatoma which was not existed through the puncture route. However TIPS should be performed in patients in whom hepatoma has been controlled by hepatic embolization and/or ethanol injection therapy.
 ...
PMID:[Transjugular intrahepatic portosystemic shunt for patients with hepatoma]. 773 76

The patient with advanced cirrhosis presents unique challenges to the critical care physician, in great measure because of the protean functions attributable to the liver and the multiplicity of derangements that may occur. Portal hypertension, once it develops, is the source of potentially devastating complications that include life-threatening hemorrhage, infection, renal failure, and coma. Parenchymal disease can result in coagulopathy as well as altered handling of both endogenous (hormones, metabolites) and exogenous (drugs) substances. Cirrhosis also can be complicated by the development of HCC, which may worsen portal hypertension, deplete parenchymal reserves, and result in catastrophic complications. The prospect of cure by liver transplantation in selected cases serves to underscore the importance of prompt and vigilant management of patients with decompensated cirrhosis in the critical care setting.
 ...
PMID:Complications of chronic liver disease. 778 40

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.
 ...
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

Portal hypertension is treated by reducing portal pressure in order to prevent esophageal variceal bleeding or recurrent bleeding. Because portal hypertension depends on both elevated portal tributary blood flow and intrahepatic vascular resistance, the pharmacologic therapy of this syndrome consists in reducing portal blood flow or vascular resistance, or both. The pharmacologic prevention of first bleeding or recurrent bleeding has been performed with nonselective beta-adrenergic antagonists (propranolol or nadolol). Certain controlled studies have shown that this type of drug significantly reduces the risk of first bleeding by approximately 40% in patients with esophageal varices. A meta-analysis showed that death due to bleeding was also significantly lower in the beta-blocker group than in the placebo group. Moreover, beta-blockers are effective in patients in both good and poor condition and with all types of cirrhosis. The efficacy of beta-blockers on the risk of recurrent bleeding is less clear, but these substances significantly decrease the risk of rebleeding, by approximately 30%. Recurrent bleeding in patients treated with beta-blockers is associated with the occurrence of hepatocellular carcinoma or lack of compliance. In conclusion, it is clear that different substances have portal hypotensive effects and can be used to treat or prevent complications of portal hypertension. However, other drugs should be tested, and other clinical studies are needed to identify good responders.
 ...
PMID:Long-term management of variceal bleeding: the place of pharmacotherapy. 791 84

Bleeding esophageal and gastric varices caused by portal hypertension with (group I) or without (group II) liver damage should be treated primarily by sclerotherapy or shunt-operation if there is no indication for liver transplantation. In the case of rebleeding associated with thrombosis of portal-/mesenteric or splenic vein we performed in 17 patients a complete devascularisation of the proximal stomach, cardia and distal esophagus (Hassab's operation 1967) (N = 5--group I; N = 12--group II). In group I, the early postoperative (0-30 days p.o.) course was complicated by one necrosis of the gastric fundus. In group II, postoperative bleeding from gastric varices was noted in four patients, three of which were treated by proximal gastric resection; two of twelve patients died. No serious complications in the long-term follow-up (min. 171--max. 1217 days) occurred in group I. In group II, half of the patients died (1 bleeding episode, 1 liver coma, 1 hepatocellular carcinoma, 2 other causes). The operative risk and the long-term prognosis are essentially influenced by the basic disease and to a much lesser degree by the type of operation. The devascularisation of the esophago-gastric junction is per se a low risk intervention which is always practicable, even in high risk patients.
 ...
PMID:[Results of devascularization surgery of the gastroesophageal junction in recurrent hemorrhage of esophageal and fundus varices]. 802 94

Between 1979 and 1991, 156 patients with histologically proven liver cirrhosis, good liver function, and bleeding portal hypertension underwent operation with portal blood flow preserving procedures (selective shunts: 101; Sugiura-Futagawa: 55). Long-term results of the procedures and the quality of life of the 145 patients who survived the operation were studied. During the observation period (range 3 to 156 months), 28 patients died. The main causes of death were liver failure and hepatoma. Twenty-three patients were lost for follow-up. Twenty-six patients (18%) developed 1 or more encephalopathic episodes. Four patients (3%) experienced rebleeding. One hundred eight patients (74%) had a good quality of life, and 26 (18%) had a poor quality of life. Eleven (15%) of 73 patients with a history of alcoholism continued drinking. Five-year survival for the selective shunt group was 81% and for the devascularization group was 83%. In 81% of the patients, portal blood flow was maintained. It is concluded that both procedures are effective in the long-term. Most patients are able to rehabilitate from the use of alcohol, and most of them have a good quality of life. For patients with good liver function (whose main problem is bleeding), surgery is the best choice of treatment.
 ...
PMID:Survival and quality of life after portal blood flow preserving procedures in patients with portal hypertension and liver cirrhosis. 802 91

The most common causes of variceal bleeding are cirrhosis, schistosomiasis, and extrahepatic portal venous obstruction. The prognosis for an individual patient depends on the severity of the bleeding episode and the underlying liver function. Liver function is determined to a large extent by the underlying liver pathology. Patients with noncirrhotic portal hypertension or cirrhosis with good liver function have good short- and long-term prognoses. In patients with established cirrhosis, the presence of alcoholic hepatitis, hepatocellular carcinoma, or portal venous thrombosis may adversely affect prognosis. In addition to affecting prognosis, the underlying pathology may also influence choice of treatment. This point is particularly true for treatments such as shunt surgery, liver transplantation, or transjugular intrahepatic shunts.
 ...
PMID:Relation between liver pathology and prognosis in patients with portal hypertension. 804 20


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>