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)

A patient with cryptogenic cirrhosis was found to have corneal pigmentation rings indistinguishable from Kayser-Fleischer rings on slit-lamp examination. Although she had hepatic encephalopathy that included confusion, tremor, and slurred speech, diagnosis of Wilson's disease was ruled out because urinary cooper excretion and hepatic copper concentrations were below the range found in symptomatic Wilson's disease. The exact nature of these rings could not be determined, and they were considered as Kayser-Fleischer-like rings.
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PMID:Kayser-Fleischer-like ring in a cryptogenic cirrhosis. 71 54

Four hundred consecutive hip fractures were studied prospectively. Two hundred forty-seven patients were classified as unhealthy (poor cardiac status, pneumonia, cancer history, bowel obstruction history, malnutrition, dehydration, stroke history, renal failure history, cirrhosis). Twenty-two percent of this unhealthy group died, while only 6% of the remaining healthy group died. Death rates varied with admission activity level and mental status but not when patient health status was factored out. After factoring out health status, age was associated with higher death rates only in patients older than age 85. Confusion, a change of mental status in the hospital, occurred in 25% of patients. Confusion was associated with a medical complication in 94% of cases, was the presenting symptom of a medical complication in 79% of cases, and was associated with a 39% death rate. Major medical complications occurred in 9% of the healthy group (29% of them died) and 21% of the unhealthy group (64% of them died). Major medical complications in unhealthy, shut-in patients were associated with an 80% death rate. Vigorous urinary tract monitoring and early treatment of bacteriuria decreased death rate. Postfracture malnutrition was associated with higher complication rates. Hip surgery performed within 72 hours on patients with acute medical illnesses in addition to their fracture was associated with a higher death rate. Whether a patient walked postfracture seemed not to be correlated with the death rate. Patients who were not walking prefracture but treated by internal fixation had a 34% failure rate.
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PMID:Hip fracture mortality. A prospective, multifactorial study to predict and minimize death risk. 161 47

There are now many types of liver resection, depending on the amount of liver to be resected and the surgical technique selected. In the field of anatomical surgery the surgeon can choose between a major or a lesser hepatectomy and between preliminary ligation of the vessels or a primary parenchymatous resection. Sound knowledge of the anatomy is a prerequisite for anatomical surgery of this organ. Although confusion has existed as a result of differences in the nomenclature of the functional anatomy of the liver, we believe that the numerical segmental description of Couinaud is the most accurate and most easily understood. Operative ultrasonography has a fundamental role in liver surgery. It supplements information obtained by intensive preoperative investigations and enables the surgeon to make more precise and limited resections than were previously possible. It provides a greater range of options in the management of hepatocellular carcinoma. The surgeon confronted with a malignant tumour of the liver should base his decision for resection on the tumour characteristics: primary or secondary, extra- or intrahepatic spread, position, histological differentiation and presence or absence of cirrhosis. Anatomical resections should be performed providing good tumour clearance margins, while preserving as much functional parenchyma as possible. Supplementary therapies such as arterial ischaemia and chemotherapy should always be considered, but it must be borne in mind that at present hepatic resection offers the only hope of cure for malignant hepatic tumours.
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PMID:Surgical management of space-occupying lesions in the liver. 254 39

Although the liver is one of the four organs most often involved in generalized mastocytosis (GM), little is known about macroscopic and microscopic liver findings in this rare disease. This study included 182 patients with GM (confirmed in most by bone marrow histologic study), comprising 52 cases of our own and 130 reported in the literature. Hepatomegaly was found in 131 (72%) of the 182 patients, cirrhosis in seven (4%), and periportal fibrosis in 25 (14%). Mast cell (MC) infiltration of the liver was confirmed histologically in 77 (42%). Liver specimens were available for further histologic investigation in 11 of our own cases of GM. Nine of these contained MC aggregates. Mast cells were found predominantly in the portal tracts but numerous MC also were loosely scattered throughout the sinusoids. Diagnostic confusion of GM with reactive lesions of the liver is unlikely to occur since MC, according to our own observations and the available literature, are found only in very low numbers in normal liver tissue, where they occur mainly in the portal tracts. Reliable identification of MC does, however, require special stains, like Giemsa, toluidine blue, or naphthol AS-D chloroacetate esterase.
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PMID:Liver findings in generalized mastocytosis. A clinicopathologic study. 264 56

A 67-year-old Japanese woman with liver cirrhosis was affected by an unusual acute progressive encephalopathy, presenting mental confusion and slurred speech as its initial symptoms. She died in profound coma, following the entire course of 17 days. Autopsy disclosed bilateral symmetrical, widespread, edematous and necrotic lesions, their centers being located in the basal ganglia, diencephalon and midbrain, and their peripheries expanding into the cerebral white matter, cerebellum, pons and medulla. Diapedesis of erythrocytes and serum plasma was conspicuous, in contrast to paucity of capillary proliferation. Although the lesions were somewhat similar to those of Wernicke's and Leigh's encephalopathies, they were considered to be representative of a more acute metabolic disorder distinct from the latter conditions.
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PMID:Acute necrotizing encephalopathy with widespread edematous lesions of symmetrical distribution. 273 85

In a study of 228 consecutive medico-legal autopsies, malignant disease was discovered in 19 cases. The malignant diseases are discussed as to their primary sites and histologic types, age groups in which they occurred, conditions with which they may have been associated, symptoms and signs which in some cases may have warned of malignant disease, and supposed reasons why the malignant diseases were not recognized while the deceased were still alive. It was found that undetected malignant diseases occur mainly in the elderly, that chronic renal disease with scarred kidneys and cirrhosis of the liver may be predisposing conditions in cancer development, and that malignant disease in the aged may be undetected because of confusion with general weakness or because of small size and obviously slow growth of the tumor with lack of symptoms.
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PMID:[Malignant diseases as secondary findings in forensic autopsies]. 291 26

Extensive intrahepatic portal-hepatic venous anastomosis is very rare. This report describes a 47-year-old man with cirrhosis who presented with mental confusion and flapping tremor, and in whom percutaneous transhepatic portography and superior mesenteric angiography demonstrated shunting between the portal vein branches and the right hepatic vein. Measurements of pressure, ammonia, and immunoreactive insulin in blood of the portal and right hepatic veins clearly indicated that a large amount of portal vein blood was being shunted into the right hepatic vein. These findings suggest that hepatic encephalopathy in this patient is accounted for at least in part by an intrahepatic portal-hepatic venous shunting.
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PMID:Hepatic encephalopathy associated with extensive portal-hepatic venous shunts: a case report. 403 31

Wedge biopsies from the inferior border of the normal liver were studied in 72 cases. They were divided into three groups according to the extent and degree of capsular and subcapsular fibrous tissue. The changes were not sufficiently severe or extensive to cause confusion with nodular cirrhosis or to make wedge biopsy unreliable as a diagnostic tool.
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PMID:Variation in subcapsular liver structure and its significance in the interpretation of wedge biopsies. 560 86

Problem areas in the necropsy diagnosis of alcoholic liver disease are reviewed, potential sources of confusion delineated, and diagnostic guidelines proposed. The entire spectrum of alcoholic liver disease, including alcoholic hepatitis, may be perfectly mimicked by severe obesity, diabetes, and perhexiline maleate toxicity. Focal fatty change in the liver introduces sampling errors in the assessment of steatosis. Nodular regenerative hyperplasia of the liver mimics a micronodular cirrhosis both clinically and macroscopically. Measurement of the liver iron concentration reliably differentiates between alcoholic liver disease with siderosis and idiopathic hemochromatosis. The evaluation of preexisting fibrosis or cirrhosis in cases of massive hepatic necrosis is aided by stains for elastic fibers. Alcohol abusers taking acetaminophen (paracetamol) in excessive, but not suicidal doses are at risk of developing fatal "late" acetaminophen hepatotoxicity. Fatal viral hepatitis may be overlooked in an alcoholic with preexisting liver disease.
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PMID:Problems in the necropsy diagnosis of alcoholic liver disease. 673 1

1063 hepatic cirrhoses, 138 epicirrhotic carcinomas, and 138 carcinomas without cirrhosis from the autopsy material of the Dresden region obtained from 1970 to 1979 were examined for the occurrence of HBsAg by means of reclassification and after-staining of the documented section material with orcein staining according to Shikata. The portion of the post-B-hepatic cirrhoses of the liver was 95 (8.9 per cent of the total material). In epicirrhotic carcinomas a HBsAg-containing cirrhotic portion was identified in 14 cases (10.1 per cent), whereas hepatic tissue of carcinomas without cirrhosis never showed HBsAg. A relation between the activity degree of the hepatic cirrhosis and the quantity and distribution of HBsAg could not be established. The found out numbers (about equally frequent occurrence of HBsAg in hepatic cirrhosis and epicirrhotic carcinomas, no identification in the hepatic tissue of carcinomas without cirrhosis) reveal that the thesis of a hepatocarcinogenic effect of the hepatitis B virus cannot be supported by the histologic identification of HBsAg in our investigational material. The possibility of confusion of ground-glass hepatocytes with liver oncocytes in the HE-stained section material of the autopsy material is pointed out.
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PMID:[Morphologic studies on the occurrence of HBs antigen in liver cirrhoses, epicirrhotic and pure cancers in a large autopsy sample]. 684 31


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