Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Percutaneous transphepatic cholangiography patterns of intrahepatic bile ducts in 134 patients were analysed. The majority of case material consisted of gallstone disease and complications of its surgery (44 cases) and secondary or primary neoplasms of the liver (40 cases). A satisfactory filling of the peripheral bile ducts was obtained after drainage of bile and with an injection of somewhat increased quantities of contrast medium into the biliary system. PTC was found to be highly effective in detecting space occupying lesions of neoplastic origin i.e. sensitivity-90 percent, specificity-95 percent, predictive value of a positive result-88 percent. PTC patterns of liver cirrhosis with concommitant extraheptic obstruction, chronic cholangitis, congenital ectasia of the bile ducts, liver abscesses are described. Although PTC is aimed primarily at the detection of nature and level of the extraheptic biliary obstruction there is no essential reason for neglecting its possibilities in recognizing intrahepatic disease.
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PMID:[Cholangiographic appearance of the intraphepatic bile ducts (author's transl)]. 14 73

Several forms of intrahepatic developmental anomalies were found on histological examination in 40 children, among them several siblings and polyovular twins. These anomalies affect in principle all structural elements of the liver. In several cases--some of them complicated by cholangitis-there was cholangiofibrosis and cholangiodysplastic pseudo-cirrhosis. In addition, in six children there developed hepatocellular carcinoma between the ages of six months and twelve years. In the course of the development of hepatic carcinoma obligatory nodular for occur. They are made up of light, glycogen-loaded epithelial cells, which later are transformed into small atypical, basophilic cells. These dark cells have a high mitosis rate, have already escaped from the physiological regulation of proliferation. Presumably the various embryonic disorders of liver structure and carcinoma of the liver are based on the action of the same causative factor, which may be of chemical-toxic origin and transferred across the placenta.
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PMID:[Developmental anomalies of the liver and carcinoma of the liver in infants and children (author's transl)]. 19 31

A 51-year-old man underwent extended right lobectomy for hepatoma of the right lobe with obstructive jaundice due to migration of the tumor mass in the common and bilateral hepatic ducts. Severe jaundice amounting to 32.6 mg% and suppurative cholangitis were relieved by drainage through the cannulation into the hepatic ducts of the bilateral lobes. Although hepatoma was combined with liver cirrhosis, the patient could tolerate extended right lobectomy. The patient is doing relatively well without jaundice 2 years after operation, but a recurrent tumor appeared on the celiac angiogram taken 1 year and 6 months following operation. This is the fourth report on hepatic resection of such cases, and difficult problems involved with that procedure are presented and discussed.
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PMID:Hepatoma with obstructive jaundice due to the migration of a tumor mass in the biliary tract: report of a successful resection. 21 57

This study is based on an analysis of 1839 consecutive necropsies. Liver diseases are common in Singapore. Of particular importance are cholelithiasis, cirrhosis and primary carcinoma of the liver. Gallstones are mainly of the pigment variety and a significant proportion are present in the bile ducts. The multiracial composition of the population is reflected in a difference in the pattern of liver diseases among the different ethnic groups. Indians are found to have more alcoholic hepatitis and cirrhosis which are often of the micronodular type, while the Chinese have significantly more macronodular cirrhosis and hepatocellular carcinoma. Clonorchiasis and schistosomiasis are confined to the immigrant Chinese. The pattern of liver diseases is changing. Cholangitis and cholangitic abscesses as a result of cholelithiasis are becoming more common while amoebic abscesses and hepatic ascariasis are definitely on the decline. This is attributable to improved sanitary conditions.
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PMID:The pattern of liver diseases in Singapore. An autopsy study. 22 47

Increased incidence of renal insufficiency is observed in severe damage of liver parenchyma such as fulminant hepatitis, decompensated cirrhosis of the liver, septic cholangitis and the different forms of obstructive jaundice. Functional circulatory disturbances of the kidney, especially of the renal cortex, are of importance in the aetiology of this condition. Dopamine, at a dosage as low as 3 gamma/kg/min leads to an improvement in renal blood flow and also to an increase in hepatic blood flow. These observations are of therapeutic importance. Some important circulatory and functional parameters of both these organs, which influence each other under normal and pathological conditions, were studied in the presence of dopamine and the following results were obtained: 1. An investigation of the intrarenal haemodynamics with 133 Xenon in patients with severe cirrhosis of the liver and in patients with obstructive jaundice resulted in an increase of 91% in the mean renal blood flow. The blood flow in the renal cortex increased by 36.2% and in the renal medulla 18.5%, whereas the renal fat tissue showed no change. Compartment I, which was diminished as compared with the control value, also increased. The percentage contribution of the mean renal blood flow and the blood flow of the renal cortex towards the cardiac output was greater under the influence of dopamine; hence a greater part of the cardiac output flows into the kidney under dopamine. 2. The glomerular filtrate and the renal plasma flow increased under dopamine (13.5% and 43.1%, respectively). The increase was greater in compensated than in decompensated cirrhosis. In patients with obstructive jaundice there was a smaller increase in both these parameters than in patients with cirrhosis in the presence of dopamine. No connection was found between the increase in renal plasma flow with dopamine and the blood levels of bilirubin, cholinesterase, GOT and the Normotest. 3. The urinary output of sodium increased by 191.4% with dopamine. Patients with an initial renal plasma flow value of over 300 ml/min had a higher sodium output. These patients also eliminated more sodium under the influence of dopamine than those with an initial renal plasma flow value of under 300 ml/min. 4. Blood flow determinations in the portal vein and the hepatic artery in man, obtained during operation, showed an increase in portal flow of 28.5% and hepatic artery flow of 6.3% in response to dopamine. The percentage contribution of portal blood flow towards the cardiac output increase on dopamine administration. The functional hepatic blood flow, analyzed with 131-J-BSP, did not change. The wedged hepatic vein pressure, which is a good measure of portal pressure, increased on average by only 7% with dopamine at a dosage of 3 gamma/kg/min, but by 20.3% with twice the dosage. Dopamine did not cause a change in hepatic blood volume; hence, blood sequestration in the liver can be excluded in response to the dopamine-evoked increase in portal blood flow. 5...
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PMID:[Clinical and experimental investigations of the effect of dopamine on haemodynamics and function of kidney and liver (author's transl)]. 27 63

Three cases of septicemic shock after liver biopsy are reported. Escherichia coli was cultured in 2 patients and in 1 E. coli was cultured with Streptococcus viridans. All 3 patients were afebrile and had normal WBC counts before the procedure. Two had cholangitis and the 3rd had primary hepatoma and cirrhosis of the liver. Septicemic shock should be recognized as a rare complication of liver biopsy in patients with biliary obstruction.
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PMID:Septicemia as a complication of percutaneous liver biopsy. 32 Dec 91

Of 103 patients with the syndrome of primary biliary cirrhosis (chronic, nonsuppurative destructive cholangitis) who entered a double-blind, randomized, controlled treatment trial with either D-penicillamine or placebo, 21 (20%) were asymptomatic with respect to their liver disease. Study of these 21 patients revealed that (1) 43% of patients with asymptomatic primary biliary cirrhosis had advanced histologic lesions (fibrosis or cirrhosis); (2) asymptomatic patients with advanced histologic lesions likely have had their disease for 10 years or more; (3) stage of primary biliary cirrhosis may remain unchanged for years; and (4) most asymptomatic patients receiving D-penicillamine, when compared with patients given placebo, had improved liver function tests at 1-year follow-up. However, the incidence of major toxicity with D-penicillamine for primary biliary cirrhosis in a maintenance dose of 1 g approximates 20%. Furthermore, one of our patients who was asymptomatic but who had advanced histologic changes died recently from D-penicillamine-associated bone marrow suppression. It remains to be determined whether the benefit-to-risk ratio of D-penicillamine in primary biliary cirrhosis justifies its use.
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PMID:Asymptomatic primary biliary cirrhosis. Presentation, histology, and results with D-penicillamine. 35 32

Elevated circulating CEA levels occur in patients with benign gastrointestinal and hepatic disorders. These are usually less than 10 ng/ml. Of clinical importance is the influence of liver disease on the interpretation of CEA. At least 50% of patients with severe benign hepatic disease have elevated CEA levels, most often active alcoholic cirrhosis, and also chronic active and viral hepatitis, and cryptogenic and biliary cirrhosis. Patients with benign extrahepatic biliary obstruction may have increased plasma CEA, the highest in patients with co-existent cholangitis and especially liver abscess. The liver appears to be essential for the metabolism and/or excretion of CEA. Hence, liver work-up is needed to assess any patient with an elevated CEA. A damaged liver may further augment elevated CEA levels due to cancer. The increased circulating CEA observed in some patients with active ulcerative colitis tends to correlate with severity and extent of disease and usually returns to normal with remission. CEA levels also may be mildly elevated in patients with pancreatitis and in adults with colonic polyps. Smoking may contribute to the increased CEA levels seen in patients with alcoholic liver disease and pancreatitis. Therefore, in interpreting mildy elevated circulating CEA levels in patients with GI tract diseases, one must consider benign as well as malignant etiologies.
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PMID:Carcinoembryonic antigen (CEA) levels in benign gastrointestinal disease states. 36 Dec

Endoscopic retrograde intrahepatic cholangiograms were evaluated in 107 patients and correlated with intrahepatic diagnoses determined by liver biopsy. Included were normal livers (six), cirrhosis (38) portal fibrosis (14), cholangitis (22), metastases (11), and miscellaneous diagnoses (16). Results suggest that differentiation of the normal from the abnormal intrahepatic biliary system using the endoscopic retrograde intrahepatic cholangiogram is possible, and that certain patterns of abnormality prevail within given disease categories. The cholangiogram in cirrhosis is marked by ductular stenosis, diminished arborization, tortuosity, and approximation of the intrahepatic ducts. Sclerosing cholangitis demonstrates focal stenoses with concomitant ectasias and frequent similar involvement of the extrahepatic system. Chronic cholangitis and portal fibrosis are frequently associated with extrahepatic obstructing lesions and increased intrahepatic ductal caliber, but demonstrate no distinguishing intrahepatic characteristics. Intrahepatic metastases, polycystic liver disease, and primary hepatic neoplasm produce mass effects consisting of ductal displacement, narrowing, and obstruction. The potential of endoscopic retrograde intrahepatic cholangiography in evaluating the intraheptic biliary tree is significant; specifically in separating normal from abnormal, in distinguishing between intrahepatic processes, and as an adjunct to liver biopsy in determining the extent and location of intrahepatic abnormalities.
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PMID:Endoscopic retrograde intrahepatic cholangiogram: radiographic findings in intrahepatic disease. 40 87

Computed tomography (CT) and radionuclide examinations of the liver and pancreas in 50 patients were compared retrospectively to evaluate their value as diagnostic tests. CT was superior to 75Se-selenomethionine in evaluating pancreatic disease. Both 99mTc-sulfur colloid scans and CT scans were sensitive detectors of liver masses; however, there were more false positive 99mTc-sulfur colloid scans (16% compared to 4%). CT was superior in detecting biliary obstruction and ascites, in assessing diseases that involved the liver extrinsically, and in evaluating the status of adjacent organs. 99mTc-sulfur colloid scans were more sensitive in detection of diffuse non-neoplastic liver diseases (cirrhosis, hepatitis, and cholangitis). Simultaneous interpretation of CT and radionuclide scans was often more helpful than independent interpretation, and the two techniques are therefore complementary.
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PMID:Retrospective comparison of radionuclide scans and computed tomography of the liver and pancreas. 40 38


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