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)

The frequency and degree of intrahepatic periportal abnormal intensity (PAI) on magnetic resonance images in patients with or without various hepatobiliary and pancreatic diseases were analyzed. In 63 patients without hepatobiliary disease, except for a small metastatic liver tumor or cavernous hemangioma, no definite PAI was seen. Definite PAI was seen in all patients with obstructive jaundice, cholangitis, and cholangiocellular carcinoma. It was also clearly seen in all four cases of malignant lymphadenopathy in the hepatoduodenal ligament, in one of two cases of acute hepatitis, and in four of 47 cases of liver cirrhosis. However, in patients with bile duct dilatation or with gallstone or pancreatic disease without obstructive jaundice or cholangitis, no definite PAI was seen. Histologic studies of the liver performed in 23 patients with definite PAI showed edema, ductular proliferation, dilatation of lymph vessels, and inflammatory cell infiltration in portal tracts. It is concluded that definite intrahepatic PAI is a useful sign that indicates the presence of biliary or diffuse hepatic disease.
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PMID:Intrahepatic periportal abnormal intensity on MR images: an indication of various hepatobiliary diseases. 270 98

Gallbladder emptying after intramuscular injection of cerulein was investigated by 99mTc-EHIDA hepatobiliary scintigraphy in 23 patients with biliary disease, 55 patients with chronic liver disease, and 21 normal controls. The mean gallbladder ejection fraction in patients with gallstones and liver cirrhosis was significantly reduced compared with normal controls. (gallstones: 56.3 +/- 21.3%, LC with gallstones: 50.8 +/- 29.6%, LC without gallstones: 55.9 +/- 26.7%, vs. normal controls: 74.4 +/- 12.9%, p less than 0.01). The mechanism for sluggish gallbladder emptying in liver cirrhosis is unknown, however impaired emptying with bile stasis provides a potential pathophysiologic basis for the high frequency of pigment stones.
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PMID:[Evaluation of gallbladder emptying in patients with chronic liver disease by 99mTc-EHIDA hepatobiliary scintigraphy]. 275 59

During the last 6 years, 205 patients with primary hepatocellular carcinoma (HCC) were admitted to our surgical departments. Thirty-eight had HCC smaller than 3 cm in diameter. There were 34 men and 4 women with an average age of 56.5 years. All patients had underlying hepatic disease: liver cirrhosis in 35 patients and chronic active hepatitis with fibrosis in the remaining 3. Pre-operative complications included: oesophageal varices in ten, cholelithiasis in five, peptic ulcer in two, gastric cancer in one, and severe hypersplenism in one instance. A radical resection was performed in 32 cases and palliative resection in 6. Simultaneous operations were carried out for the above mentioned associated conditions: distal splenorenal shunt in six, Hassab's devascularization procedure in one, splenectomy in one, cholecystectomy in four, cholecystolithotomy in one, and partial gastrectomy in one. Four patients had postoperative complications: liver failure, rebleeding, right haemothorax, and upper gastrointestinal bleeding from acute mucosal lesion of the stomach. One patient with liver failure died in coma within 1 month. The operative and in-hospital mortality rates were 2.6 and 7.9 per cent, respectively. Survival rates during the first 4 years in 32 patients with radical hepatic resection were 89.9, 67.2, 58.8, and 58.8 per cent, respectively. We suggest that hepatic resection should be the first choice of treatment for minute HCC even in the presence of liver cirrhosis.
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PMID:Appraisal of hepatic resection in the treatment of minute hepatocellular carcinoma associated with liver cirrhosis. 282

A monoclonal antibody, gamma-120, was raised against a highly purified gamma-glutamyltransferase (gamma GT) from human primary hepatoma. The antibody preferentially bound to the small subunit of gamma GT from human hepatoma and kidney as evidenced by immunoblot analysis. Weak binding to the normal liver enzyme could be detected by solid-phase enzyme-linked immunosorbent assay (ELISA). With the use of this antibody, an ELISA was developed for the quantitation of immunoreactive gamma GT in human serum. Sera of 188 normal control subjects displayed a low level (9.4 micrograms/ml) of immunoreactive gamma GT. Highly elevated levels of immunoreactive gamma GT were detected in the sera of patients with primary hepatoma, metastatic liver cancer, pancreatic cancer, and certain types of lung cancer. Slightly elevated levels of immunoreactive gamma GT were seen in the sera of patients with liver cirrhosis. The levels of gamma GT were within a normal range in the sera of patients with gastrointestinal cancers and patients with nonmalignant diseases such as hepatitis and gallstones. The antibody has been shown to be useful for the diagnosis of some of the neoplastic diseases.
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PMID:A monoclonal antibody against gamma-glutamyltransferase from human primary hepatoma: its use in enzyme-linked immunosorbent assay of sera of cancer patients. 286 89

Hypertransaminasemia is a frequent side effect during chenodeoxycholic administration for gallstone dissolution. Evidence suggests that this effect is not mediated by lithocholic acid, the intestinal metabolite of chenodeoxycholic acid, but that toxicity is due to the chenodeoxycholic acid itself. In vitro cytotoxicity of bile salts is positively proportional to their detergent effect, which is, on the other hand, related to their hydrophobic-hydrophilic balance. We hypothesize that in vivo also liver injury can occur when the liver is perfused by an high proportion of strongly detergent bile salts. The more detergent bile salts are unconjugated or glycine conjugated, while the lesser are taurine conjugated and sulfated. Within each class the following order of decreasing detergent power can be indicated: lithocholic greater than deoxycholic greater than chenodeoxycholic greater than cholic greater than ursodeoxycholic acid. Besides chronic exogenous administration of chenodeoxycholic or deoxycholic acids, conditions in which the liver is perfused by an high mass of highly detergent bile salts are those characterized by an enhanced intestinal biodegradation of bile salts. These conditions, which are common features of some chronic inflammatory bowel diseases, are frequently associated with liver damage. On the other hand, a normally detergent bile salt pool can become hepatotoxic for liver cells which have already been injured. In this respect, as already reported for increased sulfation, the increased proportion of taurine conjugates and the reduced formation of deoxycholic acid in liver cirrhosis can be regarded as protective mechanisms. Liver toxicity induced by bile salts' detergent action can be prevented by favouring tauroconjugation or reducing the intestinal degradation of bile salts or by administering poorly detergent bile salts.
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PMID:Bile acid-induced liver toxicity: relation to the hydrophobic-hydrophilic balance of bile acids. 287 79

The purpose of this study was to determine the incidence of death as the initial manifestation of cholelithiasis. Records of patients who died or underwent cholecystectomy for gallstone-related disease at Duke University Medical Center between 1976 and 1985 were reviewed. Thirty patients died, six of whom (20%) had previous episodes of biliary pain and stone documentation. Twenty-four (80%) were asymptomatic (three with previous incidental diagnosis of cholelithiasis). Reason for admission included acute cholecystitis (nine), pancreatitis (eight), biliary pain (six), cholangitis (four), jaundice (one), and endocarditis (one). Three patients died of gallstone complications without surgical intervention; one patient had renal failure and two had septicemia. Other causes of death were: sepsis (seven patients), cardiac failure (six), pulmonary complications (four), renal failure (three), cerebrovascular accident (three), liver failure (two), pancreatitis (one), and gastrointestinal bleeding (one). During this period, 1731 cholecystectomies were performed without mortality. In this group, the patients were younger (50 +/- 8 years vs. 64 +/- 13 years, p less than 0.001), and had a lower incidence of cirrhosis (p less than 0.001) and diabetes (p less than 0.002). The sex ratio was inverted (p less than 0.001). This study demonstrates that death from gallstones is uncommon (three cases per year), as is death from their initial clinical manifestation (1.2%). The risk of death is two- and ninefold higher in patients with acute cholecystitis or acute pancreatitis. Age, cirrhosis, and diabetes are important determinants of outcome.
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PMID:Deaths from gallstones. Incidence and associated clinical factors. 291 58

Cholecystosonography in approximately 40,000 patients over five years in two university hospitals revealed 30 (75%) of the 40 macroscopic primary carcinomas. In 3 cases the carcinoma was obscured by gallstones with shadowing, in 3 cases the origin of a tumour mass was misinterpreted, and in 4 cases the neoplastic growth mimicked gallbladder inflammatory changes or sludge. Malignancy was incorrectly diagnosed or suggested in 25 patients. The most frequent cause of a false positive report was acute or chronic inflammation, found at surgery in 16 gallbladders. Four carcinomas of the pancreatic head were believed to be gallbladder tumours. Cirrhosis with marked gallbladder wall thickening, gastric carcinomas with metastases, a common duct carcinoma, and two cases of sludge (with normal control studies) caused a false suggestion of gallbladder carcinoma. The most frequent ultrasonographic finding in gallbladder carcinomas was a mass filling the gallbladder (15 diagnosed cases), followed by wall thickening (9 cases), and polypoid or fungating tumour (6 cases). Real-time ultrasonography is a useful method for the preoperative diagnosis of gallbladder carcinoma, but considerable diagnostic problems in the differentiation from inflammatory diseases may be encountered.
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PMID:Ultrasonography in carcinoma of the gallbladder. 296 4

A sonographic prospective study of the prevalence of gallstones was performed in 140 patients with liver cirrhosis and in 140 controls. Gallstones were found more often in cirrhotic patients (29.2%) than in controls (13.6%) (p less than 0.01). Their prevalence increased with age. The ratio of women to men in cirrhotics was the same as in the general population, with a higher prevalence in women. The prevalence of gallstones increased in decompensated liver disease. There was a significantly higher prevalence of both hypersplenism and hemolysis in cirrhosis. No difference was found in gallstone prevalence in relation to cirrhosis etiology. This prospective study confirms, by means of sonography, the high prevalence of cholelithiasis in liver cirrhosis, and extends the previous data about the lithogenic risk factors in this disease.
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PMID:Prevalence of gallstones in liver cirrhosis: a sonographic survey. 304 36

Coagulation studies were performed in patients who underwent abdominal surgery. One hundred and twenty six patients with cholelithiasis, peptic ulcer and gastric cancer were examined. Although fibrinogen increased up to 560 mg/dl postoperatively, DIC did not occur among these patients, at all. For 30 patients who underwent hepatectomy, esophageal transection or pancreatoduodenectomy, HPT, PT, fibrinogen, platelet count, alpha 2-PI, AT-III, plasminogen and DIC score were investigated until 10 postoperative days. As for 13 patients without liver cirrhosis in this group, deterioration of HPT, PT and AT-III was noted on the second postoperative day, however these parameters improved on the fifth postoperative day and all patients recovered uneventfully. On the contrary, as to patients with liver cirrhosis, changes of coagulation parameters were drastic. Significant decrease of HPT, PT, AT-III, plasminogen and increase of FDP and DIC score were noted after operation and these values deteriorated with time in certain cases. Seven patients out of 17 died of DIC and multiple organ failure. More than half of these patients received Gabexate Mesilate (GM) injection in a dose of 1200 mg/day postoperatively for more than 5 days to prevent DIC. In patients who underwent hepatectomy due to hepatocellular carcinoma with liver cirrhosis, the increase of FDP and DIC score seemed to be inhibited by GM on the fifth postoperative day.
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PMID:[Coagulation studies in patients after abdominal surgery]. 308 4

Sandwich radioimmunometric assay (RIA) for a new tumor-associated carbohydrate antigen defined by a monoclonal antibody (MoAb), NCC-ST-439, was developed and the antigen levels were determined in sera of normal donors, and patients with various malignant and non-malignant disorders. In normal donors, 97.0% (226/233) of sera were antigen-negative (less than 12 units/ml) except for 7 serum samples from young females. In patients with malignant disorders, 34.2% (82/240) were antigen-positive, in particular 64.0% (16/25) of patients with pancreatic carcinoma, 66.7% (16/24) of patients with recurrent colorectal carcinoma and 54.5% (6/11) of patients with recurrent breast carcinoma. In patients with non-malignant disorders, 6.0% (7/116) were antigen-positive. The positive rate in benign hepatobiliary disorders, including gallstones, hepatitis and liver cirrhosis, was especially low at 4.3% (1/23). We concluded that determination of serum NCC-ST-439 antigen would be useful in serodiagnosis of carcinoma patients.
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PMID:Sandwich radioimmunometric assay with murine monoclonal antibody, NCC-ST-439, for serological diagnosis of human cancers. 313 14


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