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

The clinical data of 180 episodes of upper gastrointestinal bleeding in 168 patients with cirrhosis of the liver are examined. The source of bleeding had been determined by early endoscopy in all cases. In men under the age of 50 years, and without symptoms of liver failure, bleeding was due to ruptured gastro-oesophageal varices in 84% of cases. Severe liver failure was associated with acute lesions of gastric mucosa in many cases. No presumptive diagnosis of the source of haemorrhage could be based on the examination of other clinical data (presence of ascites, mode of presentation and pattern of bleeding, history of ulcer disease, alcoholism, and previous medication.
 ...
PMID:Upper gastrointestinal bleeding in cirrhosis: clinical and endoscopic correlations. 108 24

Sixty-eight patients with bleeding oesophageal varices due to cirrhosis of the liver who have had an emergency portasystemic shunt are reviewed. The reasons for the emergency shunt surgery and the results are described and discussed. The low postoperative mortality is attributed to careful case selection. Apart from clinical and serological factors, the importance of the bromsulphthalein excretion test is stressed. Emergency shunts are now undertaken by the author in patients whose serum bilirubin is less than 2-5/100 ml and bromsulphthalein retention less than 10 per cent in 30 minutes. This is in marked contrast to the author's previous series in which there was a 30 per cent mortality. The poor results in patients treated conservatively and the disparity between the author's results and those of other reported series are reviewed and discussed.
 ...
PMID:Emergency portasystemic shunt for bleeding varices. 108 1

Acute hemorrhage from esophageal varices is becoming more and more frequent, implying a poor prognosis for the patient and necessitating dramatic therapeutic procedures by the physician or the surgeon. Regular endoscopic controls of patients with liver cirrhosis and portal hypertension are necessary before the first bleeding occurs in spite of negative X-ray findings of the esophagus, since long-term therapeutic results may be inproved by such controls. Sclerosing the esophageal wall does not occlude the esophageal veins, which do remain open consequently; they are just "displaced" deeper into the mucosa. There are no risks or complications of this procedure especially when esophageal varices are just beginning to form and when the esophageal mucosa is still being intact. Therapeutic results are encouraging, and they are better as compared to the results of emergency shunt or elective shunt surgery. Until short time ago sclerosing the esophageal wall was sort of a preliminary preoperative therapeutic procedure. Today it is a well established therapy in its own right, although it is, as is shunt surgery, symptomatic therapy. It does seem to be superior however to all other forms of therapy aimed at preventing or treating esophageal bleeding, since primary mortality seems to be lower and longterm results seem to be better.
 ...
PMID:[Technique of submucous sclerosing in patients with bleeding esophageal varices -- therapeutic results (author's transl)]. 108 52

The growing scepticism about the use of portocaval anastomosis operations to prevent renewed bleeding of esophageal varices has led to the testing of new methods. This report describes subcutaneous transposition of the resected spleen in normal experimental animals with the Vena porta constricted with Ameroid rings and liver cirrhosis induced by DMNA. The report also covers 9 patients operated on from 1972 to 1973 with subcutaneous transposition of the spleen. A 77-year-old woman died postoperatively, one patient died after 2 years 4 months, and one had slight bleeding. All the other patients are alive 2-4 years after the operation, with no signs of renewed bleeding. The advantage of subcutaneous transposition of the spleen is that it eliminates hypersplenism.
 ...
PMID:[Subcutaneous transposition of the spleen: an experimental and clinical study (author's transl)]. 108 39

Fifty consecutive patients with cirrhosis of the liver were investigated, including 29 with gastrointestinal haemorrhage. Over two-thirds of these patients gave a history of heavy alcohol intake. The necessity for fibre-endoscopy is stressed in that barium studies alone showed oesophageal varices in only 40 percent of patients and erosive lesions were often present. Gastric varices, demonstrated by gastrophotography in 25 percent of patients with portal hypertension, were not readily detectable by standard barium meal or endoscopy. Radio-isotope scanning of the liver and spleen was invaluable in supporting not only the diagnosis of cirrhosis, but also the presence of portal hypertension, since the spleen was palpable in only 50 percent of such patients.
 ...
PMID:Hepatic cirrhosis, alcohol and haemorrhage. 108 91

Thirty panendoscopic examinations were carried out on 24 patients with oesophageal varices and hepatic cirrhosis who presented with gastrointestinal hemorrhage. A mucosal lesion, focal or diffuse, was found in the upper gastrointestinal tract in all but three instances. The findings confirmed previous reports that hemorrhage in patients with oesophageal varices frequently occurs from a source other than variceal. This study has also demonstrated that where hemorrhage occurs from oesophageal varices, erosions of the oesophageal mucosa may play a major role in its pathogenesis.
 ...
PMID:Bleeding mucosal lesions in the upper gastrointestinal tracts of patients with oesophageal varices and hepatic cirrhosis. 108 54

This is a critical retrospective study of a homogeneous group of 24 patients with hepatic cirrhosis and portal hypertension who underwent emergency surgery for bleeding oesophageal varices. The adopted procedure was the porta-azygos disconnection, according to Torres-Degni, with or without splenectomy. The criterion derived from the need to stop bleeding, from contraindications to a portal-systemic shunt, or from other situations which are illustrated. The difficulty of selecting in these cases the appropriate surgery and the high operative death rate (46%) is commented. In survivors, the long-term outcome depends on the progress of the underlying liver disease.
 ...
PMID:[Present position of non-shunt surgery for bleeding oesophageal varices (author's transl)]. 108 67

A 39-year-old male with bleeding esophageal varices due to portal hypertension was observed. The patient had taken an arsenical preparation during a period of 12 yr because of psoriasis and subsequently developed keratotic changes of the palms and soles of his feet and an epithelioma of the scrotum. Physical examination was unremarkable except for splenomegaly and skin lesions. Liver function tests were normal; a needle biopsy of the liver (right lobe) showed nonspecific changes. Combined hepatic and umbilicoportal catheterization revealed, on splenography and portography, huge esophageal varices and patent portal vein; dilation, distortion, and cut-off of many intrahepatic portal branches were found. A marked gradient existed between the free portal venous pressure (25 mm Hg) and the wedged hepatic venous pressure (9.5 mm Hg). Hepatic blood flow, portal PO2, cardiac output, cardiac index, and blOOD volume were within normal range. Arteriographies did not reveal arteriovenous shunts in the splanchnic or splenic vessels. A splenorenal shunt were performed and a wedged biopsy of the liver (left lobe) revealed nonspecific changes. Three years later the patient had not experienced any episode of hemorrhage or hepatic encephalopathy but developed an epithelioma of the tongue. No known cause could be incriminated in the pathogenesis of the portal hypertension. However, there was unequivocal chronic arsenic intoxication. Toxic hepatitis, cirrhosis, noncirrhotic portal hypertension, and hemangiosarcoma of the liver have been reported with the intake of arsenicals. Thus, it is suggested that in this patient, presinusoidal portal hypertension was secondary to chronic arsenical intake associated with marked intrahepatic vascular changes seen on portography.
 ...
PMID:Noncirrhotic presinusoidal portal hypertension associated with chronic arsenical intoxication. 112 3

The determination of plasma viscosity in 37 patients with liver disease allowed their subdivision into three groups. Firstly, decreased viscosity (hypoviscosity) was found in patients with cirrhosis, marked portal hypertension and esophageal varices. Secondly, normal viscosity (normoviscosity) was found in patients with inactive cirrhosis without portal hypertension, and thirdly, increased viscosity (hyperviscosity) was found in patients with active cirrhosis and chronic progressive hepatitis. The concentrations of total serum protein, of fibrinogen and of IgG were found to influence plasma viscosity. A detailed differentiation revealed that increased plasma viscosity is caused by increased levels of IgG while decreased viscosity correlates with low fibrinogen levels. Furthermore a close correlation exists between plasma viscosity and the enzymatic activity of SGOT, SGPT and GLDH. In 5 patients with chronic progressive hepatitis treated with corticosteroids the plasma viscosity normalized in parallel with improvement of the hepato-cellular damage. These findings will be discussed in detail. Hyperviscosity might possibly serve as an additional parameter to characterize chronic progressive hepatitis and to indicate steroid treatment.
 ...
PMID:[Changes of blood-flow properties in patients with chronic liver disease (author's transl)]. 113 47

A new selective shunt operation, namely left gastric vena caval shunt, has been applied to 100 patients with esophageal varices, including 77 with cirrhosis of the liver and 19 with so-called idiopathic portal hypertension. Early death occurred in 3.0 percent and postoperative rebleeding from esophageal varices in 10.4 percent. The 5 year survival rate was 78.0 percent and the rehabilitation status of the surviving patients has been satisfactory, without any signs of hepatoencephalopathy. The shunt was proved to be patent in about 90 percent of the patients.
 ...
PMID:Results of left gastric vena caval shunt for esophageal varices: Analysis of one hundred clinical cases. 118 6


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>