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)

Over a 24-year period, 411 partial hepatic resections were performed: 142 right or left trisegmentectomies, 158 lobectomies, 25 segmentectomies, and 86 local excisions. The operations were performed for benign lesions in 182 patients, for primary hepatic malignancies in 106, and for hepatic metastases in 123, including 90 from colorectal cancers. The 30-day (operative) mortality rate was 3.2%, and there were an additional six late deaths (1.5%) due to hepatic failure caused by the resection. The highest operative mortality rate (6.3%) resulted from the trisegmentectomies, but this merely reflected the extent of the disease being treated. A mortality rate of 8.5% for patients with primary hepatic malignancy was associated not only with the extensiveness of lesions, but also with cirrhosis in the remaining liver fragment. There was no mortality for 123 patients with metastatic disease, 100 patients with cavernous hemangioma, 22 with liver cell adenoma, 17 with focal nodular hyperplasia, 16 with congenital cystic disease, and five with hydatid cysts. Trauma, pre-existing iatrogenic injury, and cirrhosis were the only conditions that had lethal portent in patients with benign disease. Furthermore, patients with benign disease who survived operation had minimal liability from recurrence of their original disease and none from the resection per se. By contrast, tumor recurrence dominated the actuarial survival rates for cancer patients, which at 1 and 5 years were 68.5% and 31.9%, respectively, after resection for primary hepatic malignancy, and 84.2% and 29.5%, respectively, for hepatic metastases. In this report, the expanding role of partial hepatectomy in the treatment of liver disease was emphasized, as well as the need for considering, in some cases, the alternative of total hepatectomy and liver replacement.
 ...
PMID:Personal experience with 411 hepatic resections. 317 30

In a consecutive autopsy series of 95 males, parenchymal hyperplastic nodules of clear cells occurred in 11.6% and liver cell dysplasia (LCD) in 7.4%. These two possible preneoplastic lesions never occurred together. Of the men, 50.5% had been alcoholics or had drunk more than an average of 80 g of alcohol daily, and 65.3% had been smokers, as established by interviewing a family member or a close friend of the deceased. Hyperplastic nodules of clear cells were found in association with liver cirrhosis (p less than 0.005), liver enlargement (p less than 0.025), and heavy alcohol consumption (p less than 0.05), and tended (n.s.) to be associated with smoking. The largest nodules of clear cells were found in nodular regenerative hyperplasia of the liver in a male who had used testosterone. In another case focal nodular hyperplasia coexisted. Hyperplastic nodules showed no association with the occurrence of cavernous hemangioma or benign bile duct tumors. Males with hyperplastic nodules of clear cells were significantly (p less than 0.01) younger (average 49.3 years) than those with LCD (average 61.1 years). Males with LCD were slightly (p less than 0.05) older, tended to have a small-sized liver, but were otherwise comparable with males without precursor lesions. The present results indicate that both hyperplastic nodules and liver cell dysplasia are common findings in male autopsy series comprising alcoholics and smokers. Hyperplastic nodules were associated with some of the predisposing factors of primary hepatocellular carcinoma.
 ...
PMID:Preneoplastic lesions of human liver. 357 Jan 37

Benign liver tumors are relatively uncommon and, even when large enough to be symptomatic, they usually remain undiagnosed prior to exploratory laparotomy. Hemangiomas constitute the majority of benign hepatic neoplasms and are 9 times as frequent in females as in males. Most are asymptomatic but abdominal swelling, a mass, or symptoms due to compression of adjacent organs may occur and abdominal hemorrhage is reported in 4.5% of patients. Hepatic hemangioma may produce a large arteriovenous communication serious enough to cause heart failure. Recently an increased frequency of liver tumors, mostly adenomas, has been noted in women taking oral contraceptives (OCs); the cause has been attributed to estrogens. The exact incidence is unknown but believed to be low. It is most common in women in their late 20s who have been on OCs for 7 years or more. The tumor occasionally completely regresses on withdrawal of the OCs. The tumor may be discovered incidentally at laparotomy or may manifest inself by pain, a palpable mass, or catastrophic hemoperitoneum. Hepatic adenoma is usually a solitary lesion and infrequently degenerates into malignancy. Differential diagnosis includes chronic gall bladder disease and peptic ulcer. Focal nodular hyperplasia (FNH) is apparently much less frequently related to OC use and is less likely to bleed seriously than adenoma. Hepatic chemistry is usually normal in adenoma and FNH, but slight increases in serum bilirubin, serum alkaline phosphatase, and serum transaminase may occur. Primary liver cancer (hepatocellular carcinoma or hepatoma) is mostly a disease of males and in the US and Western Europe seldom develops before age 40. Fibrolamellar carcinoma, which characteristically develops in adolescents and young adults, occurs with equal sex incidence. Doubt has been expressed about its relationship to OCs. In the US about 75% of primary hepatocellular carcinomas are associated with cirrhosis, and about 5% of cirrhosis cases develop primary liver cancer. Clinical manifestations of hepatoma have been divided into 5 groups: frank cancer (62.7%), acute abdominal cancer (8%), febrile cancer (8%), occult cancer (16%), and metastatic cancer (5%). Detection of large amounts of alpha fetoprotein has proven useful in diagnosis of hepatocellular carcinoma, but values may be negative in OC users. It has been estimated that 1/3 to 1/2 of all malignant tumors eventually metastasize to the liver.
 ...
PMID:Hepatic neoplasia: selected clinical aspects. 619 95

Intraoperative ultrasonography was performed in 50 patients with various liver tumors; 35 hepatocellular carcinoma (hepatoma), 2 cholangiocellular carcinoma, 5 secondary liver cancer, 5 cavernous hemangioma, and 3 hyperplastic nodule in the cirrhotic liver. Various kinds of liver surgery were carried out on these patients; subsegmental resection of the liver in 19, segmentectomy in 12, hepatic lobectomy in 10, tumor extirpation in 4, and palliative surgery in 5 instances. Thirty-three of 35 hepatoma patients had associated cirrhosis of the liver. Sixty per cent of hepatomas smaller than 5 cm in diameter were invisible at surgery. Three hyperplastic nodules in the cirrhotic liver and three cavernous hemangiomas were also invisible because of the lesions being embedded in the liver parenchym . The sonographic examination proved to be a useful method not only for knowing the exact localization of invisible tumors but also for preventing vascular injury at subsegmental or segmental resection of the liver.
 ...
PMID:Intraoperative ultrasonography in the surgical treatment of hepatic tumors. 633 Oct 33

Our experience at the Ramathibodi Hospital with 20 infants and children who had Aeromonas septicemia is reviewed. Their ages were from 1 day to 14 years. Eighteen patients had underlying diseases: leukemia, 5; aplastic anemia, 4; cirrhosis, 2; thalassemia/hemoglobinopathy, 3; renal failure, 1; ileal perforation, 1; marasmus, 1; and cavernous hemangioma with thrombocytopenia, 1. Blood cultures yielded Aeromonas hydrophila in all patients, and four patients had polymicrobial bacteremia. Fifteen episodes of septicemia were community-acquired and five were hospital-acquired. The clinical manifestations of these patients were similar to septicemia due to other Gram-negative enteric bacilli. Two patients each had ecthyma gangrenosum, necrotizing fasciitis and meningitis. Antibiotic treatment included penicillins, cephalosporins, aminoglycosides and sulfamethoxazole-trimethoprim. The overall case fatality rate was 50%; eight of the nine patients with acute leukemia or aplastic anemia died. With the exception of one child the blood cultures were sterile in all patients before death. Aeromonas septicemia is an uncommon but severe infection which occurs predominantly in compromised hosts.
 ...
PMID:Aeromonas septicemia in infants and children. 672 2

The purpose of this discussion is to document the finding of contractile fibroblasts and to examine their possible origin in a further pathological process: focal nodular hyperplasia (FNH) of the liver. A 31-year old female patient underwent laparotomy for a hypochondrial mass. The patient had been taking OCs for 1 year. The mass was located in the right lobe of the liver and excision of the tumor was performed. Some distance from it a subcapsular hemangioma was discovered and resected. After 16 months of follow-up the patient is well. The tumor mass (10 cm diameter) grey in color, was very well demarcated, although not encapsulated. A central scar was present. Radiating septa divided the periphery of the mass into multiple, variable sized modules, simulating a pattern of focal cirrhosis. No areas of hemmorhage or infraction were observed. The hemangioma specimens showed multiple cyst-like cavities filled with blood. The bosselated and lobulated appearance was because of areas of fibrosis, which was most marked centrally. Vascular changes similar to those described by Mays et al. and bile ductular proliferation analogous to that described by others were seen. Single small bile ductules were frequently observed within parenchymal nodules, without any relation to the intranodular scars. Cells with elongated, cross banded nuclei were in close vicinity of the newly formed ductules. Inflammatory and fibroblast-like cells were seen in the fibrous connective tissue septa. The 2nd lesion showed the typical features of a cavernous hemangioma. Typical fibroblasts were identified by their elongated or star-like shape, the slender fusiform shape and relatively smooth outline of the nucleus, the well developed RER and Golgi apparatus, the scattered mitochondria, and the absence or scanty presence of cytofilaments. A large number of elongated cells exhibited the characteristic morphology of modified contractile fibroblasts (MF). They showed a variable amount of intracytoplasmic microfilaments, arranged in longitudinal bundles, usually parallel to the long axis of the cell predominantly located beneath the plasma membrane. Intracellular connections between modified fibroblasts were frequently observed; they were mostly of the macula-adherens type. The finding of contractile fibroblasts raises questions concerning the origin and the significance of such cells in FNH. Since MFs are similar to both fibroblasts and smooth muscle cells, it seemed reasonable to conclude that both cells, under appropriate conditions, may become MF. Fat storing cells of Ito may also be a progenitor of contractile fibroblasts.
 ...
PMID:Myofibroblasts in focal nodular hyperplasia of the liver. 688 82

Arterioportal shunting is observed angiographically in a wide variety of pathologic conditions. The route of flow has classically been considered to be via the hepatic sinusoids (transsinusoidal). This route occurs in cases of cirrhosis or the Budd-Chiari syndrome, and results in retrograde hepatofugal flow in portal branches. More recently, a transvasal route has been recognized angiographically, in which portal flow often remains hepatopetal. The transvasal route occurs in cases of hepatocellular carcinoma, metastases, shock, hepatic arterial obstruction, and many other conditions. Histologic confirmation of this route has been sought for many years, with other partial success. Nevertheless, angiographic evidence, as presented here, is sufficiently compelling to justify description of this pathway and its significance. Arterioportal flow may also occur via a post-traumatic fistula (disruption of adjacent portions of hepatic artery and portal vein), and via benign tumor vessels in hemangioma or hemangioendothelioma.
 ...
PMID:Arterioportal communications: observations and hypotheses concerning transsinusoidal and transvasal types. 706 71

Family history of hepatocellular carcinoma (HCC) has been identified as a risk factor of HCC. The pathogenesis is still uncertain. In order to evaluate the risk factors and to detect the small HCC. 721 asymptomatic family members (419 males and 302 females with a mean age of 40.21 years) of the index cases of HCC received a series of examinations including: serum GOT, GPT, alpha-fetoprotein (AFP). HBsAg, Anti-HCV, and abdominal ultrasonography (US). Of the 18 patients with liver tumor detected by US. 6 were proved to be HCC, 8 were hemangioma, and the nature of the rest was undetermined. The US found 22 with cirrhosis, 24 with chronic liver disease, 133 with fatty liver, and 14 with a liver cyst. The incidence of HCC in our study was 0.96% in males (4 of 419 cases), and 0.66% in females (2 of 302 cases) which was much higher than that in the general population of Taiwan (0.025% in males and 0.01% in females). The positive rate of HBsAg in the participants, including all the newly detected HCC patients, was 46.5% (335 cases) which was also higher than the prevalence in Taiwan (15-20%). Male, sibling and liver cirrhosis seemed to have higher risk. These results suggest that family members of patients with HCC have a high risk of developing HCC. The hepatitis B virus may be the most important link. Early diagnosis is possible by screening the family members by means of AFP and abdominal US.
 ...
PMID:Risk factors of hepatocellular carcinoma with familial tendency. 776 61

Hepatic hemangioma is the most common benign tumor of the liver, but there are a few reports on chronological changes in size of hepatic hemangioma. To elucidate natural history of hepatic hemangioma, we evaluated consecutive ultrasonograms of 27 hemangiomas in 23 patients. Underlying liver disease in these 23 patients included seven cases with chronic hepatitis, five cases with liver cirrhosis and three cases with fatty liver. The remaining eight cases showed no evidence of liver disease. Follow-up period ranged 12 to 114 months (average 44). During the follow-up, six (22.2%) hemangiomas changed in size on US, which included three lesions with increase in size, one lesion with decrease in size and two lesions with spontaneous regression. Of 12 patients with chronic liver disease, only one patient showed significant change in the hemangioma size, which regressed spontaneously. These results showed that there was no case showing increase in size of hemangioma in patients with chronic liver disease. Thus, if clinically diagnosed hemangioma which tends to increase in size is detected on US or other imaging modalities in patients with chronic liver disease, aimed aspiration biopsy should be preferably performed considering the possibility of hepatocellular carcinoma.
 ...
PMID:[Follow-up study of hepatic hemangiomas]. 786 25

Liver cirrhosis (LC) in habitual drinkers is divided into three categories: (1) alcoholic LC, (2) LC due to hepatitis C virus and alcohol, and (3) LC due to hepatitis C virus. In Japan, the frequency of LC related to hepatitis B virus in habitual drinkers is comparatively low. Although making a distinct differentiation is very difficult, it is possible to point out some characteristics which ars due to either alcohol or hepatitis C virus: (1) multiple spider angioma, acne rosacea, and palmar erythema are more frequently found in categories 1 and 2 than in 3, (2) levels of AST/ALT, gamma-GTP, TG, ALP, lactate, and UA are higher in category 1 than in 3, (3) enlargement of both lobes is observed in category 1, and (4) abnormality due to alcohol improves relatively soon after abstinence of alcohol.
 ...
PMID:[Differentiation alcoholic liver cirrhosis from viral liver cirrhosis]. 790 45


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