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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The combination of arterial hypoxemia and low pulmonary vascular resistance in patients with liver cirrhosis is unexplained. Pulmonary microcirculatory dilation, but not gross arterio-venous shunts, has been the usual postmortem finding in patients with liver cirrhosis. When 10 patients with alcoholic liver cirrhosis breathed 10% oxygen in nitrogen, they failed to increase their pulmonary vascular resistance. However, four patients with functional murmurs, three patients with hyperkinetic heart syndrome, six patients with normal pulmonary artery pressures and intracardiac left to right shunts, and five patients with renal failure and anemia all increased their pulmonary vascular resistances when they breathed 10% oxygen in nitrogen. These findings suggested that in liver cirrhosis the normal regulating mechanism (hypoxic vasoconstriction) of the pulmonary circulation may be impaired, resulting in failure of the lung to match perfusion with ventilation.
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PMID:Failure of hypoxic pulmonary vasoconstriction in patients with liver cirrhosis. 505 27

Liver function and histology, together with the haematological changes, were investigated in 12 patients with Felty's syndrome. Six of them were anaemic. The red cell mass was either normal or increased, and the anaemia was due to a considerable increase in the plasma volume. Two patients had increased haemolysis associated with red cell sequestration by the enlarged spleens.In eight patients liver function tests were abnormal, while in five the liver histology showed lymphocytic infiltration of the sinusoids and portal tracts together with portal tract fibrosis. One of these was later found to have a macronodular cirrhosis. In another there were apparent nodules without a true cirrhosis, and this appearance was also seen in two other patients with Felty's syndrome in whom histology was available. An increased blood flow through the spleen was found in the two patients examined.
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PMID:Liver in Felty's syndrome. 541 18

Studies were carried out on eight patients with primary biliary cirrhosis. Four patients were found to have a haemolytic anaemia; one had Coombs red cell antibodies. Two patients had evidence of splenic sequestration of red cells using the radio-chromium technique. There was a significant correlation between the red cell survival and the bromsulphthalein retention test and the red cell survival and the serum level of bilirubin. It was concluded that the anaemia of cirrhosis of the liver, including primary biliary cirrhosis, may be due to a number of mechanisms and a unifying hypothesis based on the degree of liver dysfunction is suggested.
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PMID:Red cell survival in biliary cirrhosis. 547 66

Iron absorption is under delicate control and the level of absorption is adjusted to comply with the body's need for iron. To measure the intestinal setting for iron absorption, and thereby indirectly assess body iron requirements, cobaltous chloride labelled with (57)Co or (60)Co was given by mouth and the percentage of the test dose excreted in the urine in 24 hours was measured in a gamma counter. Seventeen control subjects with normal iron stores excreted 18% (9-23%) of the dose. Increased excretion, 31% (23-42%), was found in 10 patients with iron deficiency anemia and in 15 patients with depleted iron stores in the absence of anemia. In contrast, 12 patients with anemia due to causes other than iron deficiency excreted amounts of radiocobalt within the normal control range. In patients with iron deficiency, replenishment of iron stores by either oral or parenteral iron caused the previously high results to return to normal.Excretion of the test dose was normal in portal cirrhosis with normal iron stores but it was markedly increased in patients with cirrhosis complicated by either iron deficiency or endogenous iron overload. It was also raised in primary hemochromatosis. Excretion of the dose was reduced in gluten-sensitive enteropathy. Gastrointestinal surgery and inflammatory disease of the lower small intestine had no effect on the results except that some patients with steatorrhea had diminished excretion.The cobalt excretion test provides the clinician with a tool for the assessment of iron absorption, the detection of a reduction in body iron stores below the level that is normal for the subject in question, the differentiation of iron deficiency anemia from anemia due to other causes, and the investigation of patients with iron-loading disorders.
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PMID:Cobalt excretion test for the assessment of body iron stores. 557 25

It is now possible to pinpoint the biochemical processes responsible for liver damage in alcoholics and to monitor detoxication from a biological point of view. Cirrhosis of the liver is a direct consequence of chronic alcoholism in 60-80 % of cases, and most alcoholics, after several years of drinking, cannot escape the ravages of alcohol, although it is not yet known why a small proportion are not affected biochemically. Psychological deterioration can be explained biochemically, due to the neurotoxic effects of acetaldehyde, formed by alcohol but 20-30 times more toxic, which acts on catecholamines and serotonin with, inter alia, depressant, habit-forming, hallucinogenic and convulsive properties. Hepatic symptoms depend on the stage the alcholic has reached - acute, subacute or the chronic and final stage of cirrhosis of the liver, and include disturbances of transaminases, gamma-GT, serum proteins, immunoglobulins, specific proteins, lipids (including very interestingly an increase in cholesterol-HDL which needs to be investigated further) and hematic changes with FDP and thrombocytes affected, and often anaemia.
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PMID:[Biological profile of liver damage in alcoholics (author's transl)]. 611 Mar 11

In view of the frequent erythrocyte abnormalities found in liver cirrhosis, erythrocyte deformability was studied in 62 patients. Deformability was determined by the initial filtration flow technique using a Hemorheometer. Results are given as a rigidity index (IR), which is characteristic of the average individual RBC. Deformability was significantly reduced in patients with cirrhosis. No correlation was found with the often increased MCV. A significant positive correlation was found between IR and the cell membrane free cholesterol/phospholipid ration, as the increase in cell rigidity is mainly due to a decrease in the cell membrane sphingomyelin content. The role of reduced RBC deformability in liver cirrhosis anemia still awaits elucidation.
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PMID:[Erythrocyte filtrability in liver cirrhosis]. 631 58

Between 1979 and 1982 446 patients with clinically and bacteriologically established septicaemia were ascertained in a prospective study in a university hospital complex with 1200 beds. This corresponded to an incidence of 8,4 cases of septicaemia in 1000 admissions. In 47.1% of patients the infection had been acquired as out-patient, 52.9% were hospital-acquired. 53.1% of patients were more than 60 years of age, 71.3% had predisposing underlying diseases or risk factors. Main signs of infection were increased temperatures of more than 38.5 degrees C (77.8%), anaemia and leukocytosis. The fairly equal distribution of gram-positive (207) and gram-negative (200) organisms was remarkable. The most frequently isolated bacterial species were E. coli (25.3%), Staph. aureus (21.8%), streptococci (11.1%), Staph. epidermidis (8.4%), enterococci (8.2%), and Klebsiellae (6.5%). 29.1% of patients succumbed. Nosocomial disease, liver cirrhosis, underlying malignant diseases, infections with Staph. aureus, enterococci, pneumococci, Pseudomonas aeruginosa and polymicrobial aetiology had an unfavourable prognostic influence. Thus, frequency and mortality of septicaemic diseases remain of unchanged considerable relevance in medical and surgical units. At present, aetiology and treatment will again have to consider gram-negative organisms to an increased extent.
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PMID:[Septicemia. Etiology, epidemiology, clinical aspects and prognosis in 446 patients]. 636 Jun 17

Severe congestive cardiac failure developed in a few weeks in a 44 year old man who had undergone porto-caval anastamosis for post-hepatitis cirrhosis one year previously and then treated for anaemia by repeated blood transfusion and chronic daily oral iron therapy. Infiltrative, congestive and restrictive cardiomyopathy was diagnosed in the presence of global cardiomegaly, electrocardiographic changes (microvoltage, diffuse ST-T wave changes), echocardiographic appearances (dilatation of the left ventricle, with hypertrophic and hypokinetic walls), and hemodynamic signs of adiastole with equalisation of filling pressures at 15 mmHg and a cardiac index of 1,88 l/min/m2. Cardiac haemochromatosis was confirmed by the laboratory (serum iron: 35 mumol/l; siderophilin saturation: 100 p. 100; serum ferritin: 1854 ng/ml; induced siderouria: 51 mg/24 hours) and histological findings (endomyocardial biopsy showing pigment overload). The absence of a family history, of homozygote A3 antigen, of diabetes, of iron overload on hepatic biopsy one year previously, excluded the diagnosis of familial idiopathic haemochromatosis. A secondary form of the disease was diagnosed on a possible genetic predisposition (heterozygote A3 antigen) and on environmental factors (blood transfusions, iron therapy, cirrhosis, alcoholism and perhaps the porto-caval anastamosis. Cardiac haemochromatosis was cured in this case by iron chelating therapy comprising daily subcutaneous infusions of 2 g of desferrioxamine for 2 months. The cure was confirmed by regression of the signs of clinical cardiac failure and of cardiomegaly, the increase in QRS voltages and the near normalisation of the hemodynamic and laboratory findings.
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PMID:[Adiastole caused by a secondary cardiac hemochromatosis. Successful treatment with an iron chelating agent]. 641 3

The article reports on a patient with Cruveilhier-Baumgarten disease. The anamnesis of the 59-year-old housewife revealed previous anemia, splenomegaly and abnormal liver function 21 years ago. Three years ago, esophageal varices were found. A tortuously distended vein was seen in the falciform ligament at the time of laparoscopy, and this finding was confirmed by angiography and ultrasonography. Esophageal varices and hypersplenism were also noted. Despite these findings, liver biopsy specimens of both lobes showed only slight fibrosis with minimal lymphocyte infiltration in some portal areas, and no evidence of cirrhosis. Patency of the umbilical vein and portal hypertension without significant histologic change of the liver, are both in keeping with the features of this disease. Dilatation of the umbilical vein seemed to be congenital and did not contribute to active blood flow of portal hypertension in this patient. In Japan, development of "caput medusae" in portal hypertension is rather rare, whereas esophageal varices and splenomegaly are more frequent. Venous hum is also seldom found. 14 cases of Cruveilhier-Baumgarten disease and 28 cases of Cruveilhier-Baumgarten syndrome have been reported from Japan in the literature since 1911.
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PMID:Cruveilhier-Baumgarten disease in Japan--on the basis of our own case. 645 Jul 20

A study of 510 patients in Scotland and northeastern England with histological evidence of alcohol-induced liver disease showed no difference in the age of presentation between males and females. Single men and widowed females were particularly susceptible to alcoholic liver disease. The social class distribution was similar to the population in general. Women were more reluctant to volunteer a history of alcoholism than men, they had a higher incidence of previous psychiatric illness (usually due to alcohol abuse) and they developed liver disease at lower consumption thresholds of alcohol than men. Patients under 40 years of age were more likely to have alcoholic fatty liver and less likely to have active cirrhosis than those over 40. Most often, the presenting symptoms were non-specific and tended to be related to the gastrointestinal system, particularly in women. Five per cent of patients were asymptomatic and 14% came to hospital for conditions other than alcoholic liver disease. Important clues to asymptomatic alcoholic liver disease included hepatomegaly, clubbing of the fingers and abnormal liver function tests. Gastro-oesophageal varices accounted for 40% of instances of haemorrhage and the mortality from upper gastrointestinal bleeding was 17%. Anaemia was the most common haematological abnormality. Alcoholic hepatitis was observed more frequently in the Glasgow area then elsewhere.
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PMID:Alcoholic liver disease in Scotland and northeastern England: presenting features in 510 patients. 660 94


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