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 concept of the "inappropriate" has a well-defined and easily comprehended meaning when applied to tumour secretion of antidiuretic hormone (A.D.H., vasopressin). When applied to high A.D.H. in other situations such as nephrotic syndrome, congestive cardiac failure, or cirrhosis, the use of the term "inappropriate secretion" simply reflects the fact that an easily measured controlling factor (plasma tonicity) is being overridden by a less easily measured one (effective extracellular volume). Similarly, sodium excretion in hypertension is said to be inappropriately low for the raised renal perfusion pressure: in this case inappropriateness results from the antinatriuretic effect of a minor degree of sodium depletion produced by pressure natriuresis. A similar objection can be made to the application of the term to the relations between renin or angiotensin-II concentrations and blood-pressure in some forms of hypertension. Since inappropriateness merely reflects the position and predilections of the observer, the widespread use of the term should be abandoned.
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PMID:On the inappropriate in hypertension research. 7 8

The enzyme gamma-glutamyl transpeptidase is widely distributed throughout the body, notably kidney, seminal vesicles, pancreas, liver, spleen and brain. Being one of the enzymes of the gamma-glutamyl cycle, it is involved in aminoacid transport, catalysing a transpeptidation reaction between gamma-glutamyl peptides and most common amino acids. Methods of assay of the enzyme are based on its ability also to act on synthetic amides of glutamic acid; kinetic methods monitoring the release of p-nitroaniline from the substrate L-gamma-glutamyl p-nitroanilide are the most satisfactory. In diseases of the liver, the highest levels occur in association with cirrhosis, alcoholism, hepatic secondaries and cholestasis. As the enzyme is present in the endoplasmic reticulum of the hepatocyte, its activity is increased in situations leading to microsomal enzyme induction. Raised levels can also occur in pancreatitis, diabetes, myocardial infarction, congestive cardiac failure, chronic renal failure, cerebrovascular accidents, cerebral tumours and chronic obstructive pulmonary disease. Although the lack of specificity must be recognised, the estimation can be useful in the elucidation of some clearly defined problems arising during investigation of patients with suspected hepatic disease, especially where performed as part of a biochemical profile.
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PMID:Role of gamma-glutamyl transpeptidase activity in the diagnosis of hepatobiliary disease. 24 76

This study was undertaken in order to assess the K+ sparing ability of amiloride. Thirty patients with liver cirrhosis and ascites or congestive heart failure were divided into three groups and treated with amiloride (Group A), hydrochlorothiazide (Group B) and amiloride plus hydrochlorothiazide (Group C) for 15 days. In all groups there was an increased diuresis while only in group A and C there was a statistically significant rise of K+ serum levels and a slight increment of K+ urinary loss. Total body K+ evaluated by 42K increased in group A and C while decreased in group B. Our results seem to confirm that amiloride has a mild diuretic action with a powerful K+ sparing capacity; amiloride is also able to counterbalance and reverse hydrochlorthiazide induced K+ urinary loss.
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PMID:Potassium sparing effect of amiloride in patients receiving diuretics: a quantitative study. 31 89

Nineteen patients with severe oedema due to either cirrhosis of the liver or to congestive cardiac failure, who had failed to respond to previous diuretic therapy, were treated with either increasing doses of frusemide (Group A), or with frusemide in a fixed dose of 80 mg daily and increasing doses of spironolactone (Group B). In Group A there was an inverse correlation between the baseline 24-hr urinary sodium: potassium (Na : K) ratio and the 24-hr urinary potassium excretion during diuresis, and a direct correlation between the urinary Na : K ratio before and after diuresis. Thus, in patients of this group during diuresis, there was a significantly higher urinary potassium excretion in those with a baseline urinary Na : K ratio of less than 1, as compared with those with a ratio of greater than 1. In Group B a satisfactory diuresis was achieved without marked urinary potassium loss in those patients with a baseline urinary Na : K ratio of less than 1, whereas no diuresis was obtained in the two patients with a baseline urinary Na : K ratio of greater than 1. These results suggest that the measurement of the baseline urinary Na : K ratio is of help in determining the potential value of spironolactone in patients with resistant oedema.
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PMID:The urinary sodium: potassium ratio and response to diuretics in resistant oedema. 32 34

Xipamide (4-chloro-5-sulphamyl-salicylic acid 2', 6'-dimethylanilide) is a diuretic and antihypertensive agent. A clinical trial of the drug was performed in 11 patients, 8 with nephrotic syndrome, 1 with oedema and ascites due to hepatic cirrhosis, and 2 with congestive cardiac failure due to idiopathic cardiomyopathy. The drug proved to be potent, safe and efficacious. Side-effects were similar to those encountered with other thiazide-derived diuretics, but were not of a severe nature. Wider clinical usage of xipamide would appear to be warranted.
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PMID:Xipamide in the management of renal, hepatic and cardiac oedema. 36 81

Mixed-typed cryoproteins, consisting of IgG and IgM, were demonstrated in the sera of four sisters. While the IgG component was polyclonal in every instance, in two of them the IgM component was found to be monoclonal with type chi light chains. Clinical diagnoses included the purpura-weakness-arthralgias syndrome, posthepatitis cirrhosis, congestive heart failure and mitral stenosis. The cryocrit differed in the four sisters, ranging from 3 to 16%; in addition, rheumatoid factor activity was consistently associated with both washed cryoprecipitates and their isolated IgM components. Endomembraneous deposits of IgG and IgM were revealed by immunofluorescent studies of the renal biopsy specimen from one patient. A genetic abnormality, possibly of the autosomal recessive type, is suggested in this instance of familial cryoglobulinemia.
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PMID:Cryoimmunoglobulinemia in four sisters. 41 43

The association of high amplitude echoes returned from the liver and advanced cirrhosis is well recognized. We have become increasingly aware of a bright liver echo pattern in relatively mild cases of cirrhosis and in other chronic liver diseases. The pattern is very characteristic but non-specific in pathological terms. We have undertaken a small pilot study based on the observation of this characteristic ultrasound appearance to assess its clinical significance. Recognition of this pattern has always corresponded with liver disease of one of five types: cirrhosis, fatty infiltration, portal tract fibrosis, severe hepatitis or longstanding congestive cardiac failure. Although the use of ultrasound appears to be sensitive in the detection of generalized liver disease, it is relatively non-specific.
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PMID:Ultrasound in the detection of chronic liver disease (the "bright liver"). 43 96

Arteriosclerotic and nonarteriosclerotic rats were treated with carbon tetrachloride (CCL4) to induce cirrhosis of the liver. Massive myocardial infarction was then induced in intact and CCL4-treated animals. During acute necrosis (Days 1 thru 3), animals were killed at 4, 8, 12 and 24 h on Days 1 and 2, and during myocardial repair on Days 4, 5 and 8. During the induction of cirrhosis, animals developed polydypsia, polyuria, and hyperglycemia; during myocardial infarction, the arteriosclerotic + cirrhotic animals developed severe and persistent congestive heart failure, i.e., hydrothorax. Adrenal and thymus gland weights and corticosterone levels indicated that cirrhosis per se increased pituitary--adrenal activity, particularly in arteriosclerotic animals. Enzyme levels of SGOT and SGPT demonstrated severe hepatic damage due to cirrhosis and acute myocardial infarction. Blood triglycerides and cholesterol responded abnormally in cirrhotic animals during acute myocardial ischemia due to their entrapment within hepatic cells. The cirrhotic animals manifested poor myocardial repair with persistent foci of necrosis, calcification, and a high incidence of large, occlusive, atrial thrombi. It is suggested that cirrhosis interferes with lipid metabolism and adrenal steroid conjugation leading to abnormal levels of mineralocorticoids which favor congestive heart failure, poor myocardial repair, and atrial thrombosis.
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PMID:Effect of CCL4-induced cirrhosis on the pathophysiologic course of acute myocardial infarction in nonarteriosclerotic vs arteriosclerotic male rats. 46 16

Study on a diurnal rhythm of plasma aldosterone (PA) and plasma renin activity (PRA) was performed in 8 patients with congestive heart failure. All patients had been digitalized and received diuretics under mild sodium restriction. An obvious diurnal rhythm of PA similar to the normal subjects, with the lowest value in the evening and the highest value in the morning, was observed in 7 of 8 cases, while a diurnal rhythm of PRA was obscure except in one case. The PA generally did not run parallel with PRA. Although the reason of the absence of PRA diurnal rhythm in congestive heart failure was not clear, it was considered that reninangiotensin system did not play a significant role for the development of PA diurnal rhythm in congestive heart failure. The determined PA values were entirely within normal range except in 2 cases, although they were administered the potent diuretics chronically. A high PA value was observed only in early morning in one case, while all determined PA values were extremely high in another case with severe congestive heart failure involved in cardiac liver cirrhosis. The PRA values were relatively low in 2 cases, normal in 5 and high in one.
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PMID:The diurnal rhythm of plasma aldosterone and plasma renin activity in patients with congestive heart failure. 56 23

Ascitic fluids from patients with cancer, cirrhosis, and congestive heart failure and from a patient with noninfectious tuberculosis contain measurable levels of tissue polypeptide antigen (TPA). Only the cancer patients had levels higher than 2.0 microgram TPA per ml. The average TPA levels of 29 cancer patients was 6.4 microgram/ml compared to 0.9 microgram/ml for the controls. Seventeen of 22 cancer ascitic fluids and 7 of 9 fluids from patients with liver disease were immunosuppressive as measured by the inhibition of [3H]thymidine incorporation into phytohemagglutinin-stimulated lymphocytes. Fluids from a patient with congestive heart failure and a patient with noninfectious tuberculosis were not suppressive. We were unable to obtain a significant correlation coefficient between immunosuppression and TPA levels in these fluids. In addition, TPA levels remained constant over a period of 18 months of testing, whereas the in vitro immunosuppressive activity was lost in 9 to 10 months. Sephadex G-200 fractionation of the ascitic fluid resulted in the TPA and immunosuppressive activity eluting in the first large molecular weight peak from the column. Although the 2 activities eluted together in this fractionation, the data suggest that TPA is not responsible for the immunosuppression.
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PMID:Immunosuppressive activity and tissue polypeptide antigen content of human ascitic fluids. 68 26


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