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

Carcinomatous involvement of the liver mimicking cirrhosis is a rare complication of metastatic carcinoma, most frequently seen with scirrhous carcinoma of the breast. The case of a 46-year-old woman with breast carcinoma presenting with ascites, jaundice, spider angiomata, and portal hypertension is reported. On hepatic scan the liver appeared to be almost the same size as the spleen, a finding frequently seen in cirrhosis. A chemotherapeutic program was introduced, but was of no benefit, and the patient died with uncontrolled esophageal bleeding. The prominent histologic feature on autopsy was intense stromal fibrosis and intravascular tumor infiltration with compression of vessels of the portal system.
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PMID:Metastatic carcinomatosis of the liver mimicking cirrhosis: case report and review of the literature. 111 19

The authors present an experimental series of prosthetic replacement of the common bile duct in the dog. The material used was silicone elastomere. In all the dogs studied, a new bile duct became formed around the prosthesis consisting of a fibrous tube covered with mucosa. The follow-up period in the first group of operated dogs was more than 2 1/2 years and in most dogs studied, there was neither biliary cirrhosis nor cholestasis. These encouraging results led the authors to suggest the operation in humans, particularly in carcinoma of the bile ducts.
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PMID:[Segmental replacement of the prinicipal extra-hepatic bile duct in the dog using a silicone elastomere prosthesis]. 115 Jul 60

A case of primary fibrosarcoma of the liver occurring in a 51-year-old man is added to 11 previously published cases. The neoplasm was moderately differentiated and occurred in a cirrhotic liver. Review of the literature revealed this to be the 3rd case of fibrosarcoma associated with cirrhosis. In 4 additional cases of cirrhosis-associated fibrosarcoma, a coexistent primary carcinoma was present in a different part of the same liver.
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PMID:Primary fibrosarcoma of the liver. Case report and review of the literature. 115 12

Ferritins are iron-containing proteins found in normal tissues; they increase in concentration in many tumors and the blood of tumor-bearing individuals. We utilized a double-antibody radioimmunoassay for measurement of serum ferritin and defined the upper limit of normal as 146 ng/ml for women (mean 34 ng/ml) and 193 ng/ml for men (mean 93 ng/ml). Serum ferritin levels exceeded these limits in preoperative sera of 41% of women with mammary carcinoma (mean 199 ng/ml) and in 67% of women with locally recurrent or metastatic mammary carcinoma (mean 671 ng/ml). Individuals with hepatic inflammatory states are known to have high serum ferritin, and ferritin was increased in 43% of patients with hepatitis or cirrhosis (mean 364 ng/ml) and in 13% of patients with ulcerative colitis or gastroduodenal ulcers (mean 106 ng/ml). Measurement of serum ferritin may be useful in evaluation of patients with breast cancer and in monitoring their response to therapy.
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PMID:Measurement of serum ferritin by radioimmunoassay: results in normal individuals and patients with breast cancer. 118 3

The significant increase in the number of people older than seventy forces the physician to be acquainted with both psychological and physical alterations induced by aging and to devote an ever increasing proportion of time for recognition and treatment os such alterations. In the medical sense, the biological and physiological age is more important than the chronological age. With increasing age there is--especially concerning the digestive tract and its accessory organs--a rise in the incidence of organic affections and a decline in the frequency of functional disorders. Besides it is wise to know, that the increasing age there is often a coexistence of multiple degenerative disorders and disease states, involving many body systems and organs. On the background of this recognition it is also important to know, that prognosis too varies with age because of the coexistence of individually prognosticated disease states and moreover to realize, that elderly patients do not tolerate invasive and prolonged surgical procedures. Structural or functional disturbances of the digestive organs by aging processes do not cause death per se, but can become one important factor; degenerative sclerotic vascular alterations bear relationship to the poorly contractile vasculature that brings up difficulties in the control of hemorrhagic gastroduodenal ulcers. Many gastrointestinal disorders in elderly patients occur with an equal frequency in younger patients, some are more common in the geriatric population; these include hiatal hernia, carcinoma of esophagus, stomach, pancreas, bile ducts and colon, intestinal obstruction (ileus) by neoplastic growth, gallstone ileus, external hernia and operative adhesions and especially diverticular diseases of the colon and its complications and ischemic colitis by mesenteric vascular occlusion. Cirrhosis of the liver is often diagnosed for the first time in the older age groups while acute viral hepatitis uses to run a cholestatic course and is therefore often misdiagnosed as mechanical obstruction. In general history is difficult to obtain, the response of the organism with temperature and white blood count to stress is often delayed and rigidity associated with an underlying inflammatory disease involving the peritoneum is often delayed and rigidity associated with an underlying inflammatory disease involving the peritoneum is often atypical. Because of this limited reaction to severe stress, early surgical intervention is imperative in the elderly patients.
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PMID:[Problems of the so-called geriatric gastrointestinal diseases]. 120 46

In order to evaluate the role of the Australia Antigen and of the many other factors commonly invoked in the etiology of chronic liver diseases a series of study have been performed by radioimmunoassay on: a group of blood donors who showed persistent antigenemia and two groups of patients with chronic hepatitis who were studied respectively at Brescia General Hospital and at the Departement of Internal Medicine of the University of Naples. The results were as it follows: 1) Liver damage, from mild to severe (from transient increase of GOT and GPT levels to cirrhosis) was present in 69 out of 145 blood donors with persistent antigenemia. 2) Antigenemia was more frequent in the neapolitan group of patients not only when considering the entire study population (39%) but also when the cirrhotic group was considered (40.7%). In the Brescia study group the figures were 11.7% and 8.6% respectively. 3) Comparable high incidence of antigenemia was present in both groups when only patients with chronic aggressive hepatitis and liver carcinoma were considered. 4) When only patients with chronic persistent hepatitis and chronic aggressive hepatitis were considered the incidence of antigenemia was remarkably different.
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PMID:[Geographical differences in the incidence of Australia antigen in chronic liver diseases]. 122 53

After 12 days of culture, VX2 carcinoma cells were inoculated into the liver of 16 rabbits; 14 days later, 131I-labeled iodized oil ([131I]-Lp) suspended in lipiodol was injected into the hepatic artery. Selective accumulation of the contrast material in the tumor for an extended time was evident on X-rays and hepatic scintiphotographs. The antitumor effect was remarkable. [131I]-Lp agents warrant further examination for their clinical usefulness. Internal radiation therapy by transcatheter hepatic arterial injection of [131I]-Lp (group A) was evaluated in 9 patients with hepatocellular carcinoma (HCC, tumor stage III or IV) associated with liver cirrhosis (LC) and compared with combination therapy of Lp-TAE (group B) in 18 patients with HCC (tumor stage III or IV) associated with LC. In group A, serum AFP levels dropped rapidly in eight of the nine patients who had an elevated initial level of more than 500 ng/ml. The average reduction in tumor size was 50% in eight cases as determined by computed tomography. Histological examination of one resected liver specimen at 3 months after the third injection of [131I]-Lp revealed microscopic features highly suggestive of a radiation effect in the [131I]-Lp-containing area. The 1-year survival value for patients with HCC was estimated at 49.0% using the Kaplan-Meier method. The survival of patients treated with internal radiation therapy tended to be better than that of those treated with Lp-TAE (P = 0.119).
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PMID:Treatment of hepatocellular carcinoma by transcatheter hepatic arterial injection of radioactive iodized oil solution. 128 Oct 43

The clinical and pathological features of primary hepatocellular carcinoma (PHC) in 26 patients who had survived over 10 years after operation were analyzed. The results were as follows: 84.62% (22 patients) were detected by AFP screening, 80.77% (21 patients) were in clinical stage I, 76.96% (20 patients) were younger than 45 years of age. Serum AFP of all patients turned negative within 2 months after operation. The tumor diameters ranged from 1.2 cm to 15 cm, and solitary tumors accounted for 80.77% (21 patients). All tumors were encapsulated and infiltrated by lymphocytes. Cirrhosis was found only in 9 cases (34.62%). The positive rates of HBsAg and HBcAg were 80% and 15% respectively in hepatic tissues surrounding the carcinoma. These results suggest that good prognosis or long survival is related to early detection, younger age of the patient, solitary tumor, better encapsulation, mild injury of the surrounding liver tissues, and rapid negative turning of AFP after operation.
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PMID:[Clinical and pathological features of primary hepatocellular carcinoma in 26 patients survived over 10 years after operation]. 128 76

Alpha-fetoprotein (AFP) is a specific glycoprotein which is synthesised in the fetal liver and released into the blood stream together with the closely related protein, albumin. It has been proposed that AFP functions as a carrier of essential fatty acids to certain developing cells and as a possible immunosuppressor. In man its synthesis is under the strict and complicated control of transcription of a single gene on chromosome 4. The concentration of AFP in fetal serum is greatest at about 13 weeks gestation and then decreases up to birth. During pregnancy AFP passes into the amniotic fluid and also across the placenta, so that the concentration of AFP in maternal serum increases during pregnancy in a characteristic way. Greater than normal increases may indicate certain pathological states in the fetus. Serum concentrations of AFP in the newborn infant decrease rapidly to reach levels typical for adults (< 10 micrograms/L) usually by the end of the first year. Raised concentrations of serum AFP appear in a large proportion of patients with primary hepatoma and in a smaller percentage of patients with other malignant diseases (tumours of the testis, ovary, bronchi, gastrointestinal tract). In addition, increases in serum AFP are found in other illnesses accompanied by damage to hepatocytes in the liver (hepatitis, cirrhosis etc.). Certain differences in the structure of the oligosaccharide portion of the molecule have been shown between AFP synthesized by benign or by malignant cells and between AFP synthesised by hepatocytes or by cells of endodermal origin. These differences have been used as an aid in the diagnosis of liver diseases where serum AFP is elevated. Since AFP is not strictly specific for a certain type of carcinoma, its determination is primarily used in medicine for monitoring the effects of therapy and surgery on the course of malignant conditions which initially showed increased levels of serum AFP.
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PMID:[Synthesis, structure and function of alpha-fetoproteins and their importance in medicine]. 128 28

Using abdominal ultrasonographic data and laboratory tests, radiologists often find differential diagnoses of hepatic masses difficult. A computerized second opinion would be especially helpful for clinicians in diagnosing liver cancer because of the difficulty of such diagnoses. A back-propagation neural network was designed to diagnose five classifications of hepatic masses: hepatoma, metastatic carcinoma, abscess, cavernous hemangioma, and cirrhosis. The network input consisted of 35 numbers per patient case that represented ultrasonographic data and laboratory tests. The network architecture had 35 elements in the input layer, two hidden layers of 35 elements each, and 5 elements in the output layer. After being trained to a learning tolerance of 1%, the network classified hepatic masses correctly in 48 of 64 cases. An accuracy of 75% is higher than the 50% scored by the average radiology resident in training but lower than the 90% scored by the typical board-certified radiologist. When sufficiently sophisticated, a neural network may significantly improve the analysis of hepatic-mass radiographs.
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PMID:Using an artificial neural network to diagnose hepatic masses. 128 69


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