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)

During the recent 10 years, 105 patients with hepatocellular carcinoma were admitted to our clinic. Seventy of them had an associated cirrhosis of the liver. The therapeutic results of these 70 patients were analyzed according to the mode of treatment. The mean survival periods after admission were as follows; No cancer treatment group (12 patients) 79 days, Chemotherapy group regardless of the mode of administration (25 patients) 97 days, Hepatic artery ligation with chemotherapy group (16 patients) 197 days. Hepatic resection was carried out in 17 patients; partial hepatectomy in 5, left lateral segmentectomy in 1, left lobectomy in 3, and right lobectomy in 8. The 50% survival period of all the hepatectomized patients was 8.5 months. Seven patients are living 5 months to 3 years after operation. Five patients died of recurrence of hepatoma between 4 months and 3 years and 2 months postoperatively. Five individuals died of causes related to the operation; two hepatic failure, two fatal infection, and one massive haemorrhage from acute duodenal ulcer. The results indicated that hepatic resection, from partial to extensive, might be possible even in patients with associated cirrhosis but more exact criteria are mandatory in selecting patients for major hepatic resection. Hepatic artery ligation with chemotherapy should be the first choice for those with nonresectable hepatoma. Continuous infusion of oncolytic agents into the hepatic artery may be considered for those in whom arterial ligation is contraindicated.
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PMID:Treatment of hepatocellular carcinoma with associated cirrhosis. 23 11

From 388 patients with upper G.I. bleeding investigated by endoscopy, radiology or emergent surgery, one third bled from duodenal ulcer, one third oesophageal varices, and from the remain the most frequent were gastric ulcer (14%) and gastric cancer (9%). From a sample of 53 patients with liver cirrhosis, 66% bled from varices and 34% from other lesions. The proportion of patients who bled from oesophageal varices is higher under 60 yrs. The mortality was higher after 60 yrs, except when there was associated chronic liver disease or renal or cardio-respiratory failure. In this group of patients, near half in our series, the mortality is the same under and above 60 years.
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PMID:Endoscopy in the upper G.I. bleedings. 31 42

The close interweaving of psychosocial and pathophysiological problems is emphasized with examples such as duodenal ulcer, the functional syndromes, psychogenic nanism, essential hypertension and even carcinoma. The increase in fatalities from coronary heart diseases, bronchial carcinoma, liver cirrhosis and road accidents confront us with the question of how far our industrial culture itself produces pathogenic factors. Medicine is therefore faced with the task of investigating the effects of human interreactions on health and disease. In so doing, medicine itself and the institutions it has created cannot be excluded. This is particularly true of internal medicine which, if it does not wish to withdraw from its traditional integrative duty, must cooperate still more closely with psychosomatic medicine.
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PMID:[Forty years of psychosomatic medicine. A historical retrospect (author's transl)]. 40 61

An analysis has been made of 235 deaths that occurred among 1905 patients with peptic ulcer who constituted a random sample of the occurrence of ulcer disease in an area of Denmark comprising half a million inhabitants. The disease itself, according to the death certificate, was considered the primary cause of death in 10% of the cases; half of these had been operated on immediately before death. The other patients died more frequently than expected from the following causes: chronic bronchitis, pulmonary emphysema, cancer of the lung, cirrhosis of the liver, and cancer of the pancreas. Although the comorbidity with chronic bronchitis and emphysema was especially pronounced in patients with gastric ulcer, the association with liver cirrhosis and cancer of the pancreas occurred only in patients with duodenal ulcer. In women the mortality rate attributable to cardiac and vascular diseases was lower than expected. No excess coincidence of suicide was found. Berkson's fallacy is considered to be of much less importance as a possible explanation of the comorbidity found in the present study than in the majority of publications concerned with this question.
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PMID:Causes of death in duodenal and gastric ulcer. 90 79

Upper gastrointestinal bleeding from isolated duodenal varices is a rare occurrence. We report the case of a patient with idiopathic duodenal varices in whom the diagnosis was established preoperatively by endoscopy. The patient did not have esophageal varices or portal hypertension, and he was treated by exicising the varix with a full thickness of duodenal wall. Bleeding has not recurred. Duodenal varices as well as duodenal ulcer and gastritis must be considered in evaluating a patient with cirrhosis and upper gastrointestinal bleeding.
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PMID:Duodenal varices. 125 52

The authors proposed a method for the determination of differences in the rate of evacuation of 3 types of test breakfast: boiled semolina, boiled semolina with proteins or fat. Evacuatory function of the gastroduodenal system was investigated in healthy persons and in patients using a gamma-camera. The results obtained have shown that in a majority of healthy persons carbohydrate breakfast was evacuated at the highest rate, breakfast with egg protein was evacuated slower, and breakfast with butter was evacuated even much slower. In duodenal ulcer the rate of evacuation of all 3 types of breakfasts was slowed down, and evacuation was undifferentiated (all 3 types were evacuated at the same slow rate). In patients with liver cirrhosis the evacuation of carbohydrate and protein breakfasts was slow, in calculous cholecystitis these types of breakfasts differed slightly as a result of the slow evacuation of carbohydrate breakfast. The evacuation of breakfast with butter was inhibited almost to the same degree. These results indicate the complex nature of gastric content evacuatory disorders in gastroenterologic patients, and it should be taken into account in differential diagnosis and therapy.
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PMID:[Gastric emptying rate in healthy subjects and patients (a radionuclide study)]. 203 80

During the period from 1971 to 1988 there were 212 fatalities out of 24,822 obductions because of gastrointestinal bleeding. Bleeding from oesophagus varices was most often found, followed by bleeding from duodenal ulcer (16%), gastric ulcer (14%) and haemorrhagic gastritis (11%). The sex-ratio was 2:1 in favour of men. In most cases alcohol related problems were found (with organic diseases such as fat liver, liver cirrhosis, pancreatitis as well as social deprivation, sometimes with acute alcoholization.
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PMID:[Hemorrhage from the upper gastrointestinal tract as a cause of sudden death]. 205 28

The effects of hepatic disease on the pharmacokinetics of the histamine H2-receptor antagonist famotidine were studied in seven healthy volunteers and 20 patients with chronic liver disease. The acute effects of famotidine on hepatic hemodynamics were studied in six healthy volunteers and eight patients with chronic liver disease, and its long-term effects on peptic ulcer, portal blood flow, and hepatic function were studied in 34 patients with chronic liver disease and peptic ulcer. Famotidine clearance was reduced only in patients with decompensated cirrhosis, probably because of concomitant renal impairment. Infusion of 20 mg of famotidine did not reduce hepatic or portal blood flow in healthy subjects, nor did it reduce the gradient between wedged hepatic vein pressure and free hepatic vein pressure or hepatic and portal blood flow in patients with chronic liver disease. An oral dose of 20 mg of famotidine twice daily for two months healed the peptic ulcers in 33 of 34 patients (97%) with chronic liver disease without altering portal blood flow and hepatic function. Even in patients with decompensated cirrhosis, famotidine did not change hepatic function. Thus, famotidine had no effect on hepatic hemodynamics or function in healthy subjects and patients with chronic liver disease. The drug was shown to be well tolerated and effective in the treatment of gastric and duodenal ulcer associated with chronic liver disease.
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PMID:Effects of hepatic disease on the pharmacokinetics of famotidine and effects of famotidine on hepatic hemodynamics and peptic ulcer. 221 Jun 13

Clinical studies show that patients with liver cirrhosis associated with portal hypertension have a high incidence of duodenal ulcer and duodenitis. However, little information is available concerning pathophysiological process of such duodenal diseases in liver cirrhosis. Hemodynamics of the duodenal mucosa was studied in cirrhotics with esophageal varices (68 cases) and in noncirrhotics with non-ulcer dyspepsia (37 cases) as well. In each group, hemoglobin concentration in the peripheral venous blood was measured, and mucosal hemodynamics was examined in 4 regions of the duodenum by endoscopic reflectance spectrophotometer. No significant intergroup difference was noted in the mean age or sex ratio. Hemoglobin concentration in the peripheral venous blood was significantly lower (p less than 0.01) in the cirrhotics. There were no significant intergroup differences in duodenal mucosal blood volume. However, the cirrhotics showed significantly lower oxygen saturation of hemoglobin in all regions of the duodenum (p less than 0.01). These results show that the cirrhotics with esophageal varices had relative increase in blood volume and decrease in oxygen saturation of hemoglobin in the duodenal mucosa. Such microcirculatory disturbances seem to predispose liver cirrhosis patients to duodenal injury.
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PMID:Duodenal mucosal hemodynamics in patients with liver cirrhosis. 226 Apr 99

The prevalence of symptomatic duodenal ulcer (DU) assessed primarily in alcoholic males with cirrhosis is estimated to be approximately fivefold increased compared to the normal population. Little information is available, however, as to the prevalence of DU in nonbleeding, nonalcoholic subjects with cirrhosis. In order to estimate the prevalence of DU in males with various types of cirrhosis and its relation to the degree of portal hypertension, 216 male cirrhotic patients (165 with parenchymal liver disease and 51 with cholestatic liver disease) being evaluated for liver transplantation at the University of Pittsburgh between January 1985 and June 1987 underwent pan-upper gastrointestinal endoscopy. The prevalence of DU in each group was 7.8%. However, among the various subgroups it was as follows: chronic active hepatitis due to HBV: 9.4%, alcoholic: 12.2%, cryptogenic: 3.5%, autoimmune chronic active hepatitis: 6.6%, primary sclerosing cholangitis (PSC): 9.5%. The reference data for this study consist of data reported in the literature obtained in 355 healthy asymptomatic male volunteers. The prevalence of DU in this group is significantly less than in the study group (2.2% vs 7.8%; P less than 0.005). While the estimated risk for a DU is increased 3.71-fold (95% CI: 8.74, 1.57; P less than 0.005) in cirrhotic males in general as compared to normal males, only the subgroups with CAH due to HBV, alcoholism, and PSC were found to have an increased estimated risk of DU (all at least P less than 0.01). No association between the prevalence of DU and degree of portal hypertension could be demonstrated in either group.
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PMID:Prevalence of duodenal ulcer in cirrhotic males referred for liver transplantation. Does the etiology of cirrhosis make a difference? 230 78


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