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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Previous reports have emphasized the association of primary hepatocellular carcinoma in patients with idiopathic hemochromatosis with cirrhosis. In contrast, patients with idiopathic hemochromatosis without cirrhosis have no increased risk of hepatocellular carcinoma. Phlebotomy therapy, by preventing the accumulation of parenchymal iron and subsequent cirrhosis, is believed to prevent hepatocellular carcinoma in the precirrhotic stage of the disease. We report the case of a 67-yr-old man with a 32-yr history of idiopathic hemochromatosis complicated by cirrhosis, who had reversal of cirrhosis with phlebotomy therapy, yet developed hepatocellular carcinoma. There was no serologic or tissue evidence of hepatitis B infection.
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PMID:Primary hepatocellular carcinoma in idiopathic hemochromatosis after reversal of cirrhosis. 284 22

Two patients with primary haemochromatosis are reported in whom hepatocellular carcinoma supervened despite removal of excess iron after venesection therapy. These are the first patients described in whom hepatocellular carcinoma has complicated primary haemochromatosis in the absence of concomitant cirrhosis.
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PMID:Hepatocellular carcinoma in primary haemochromatosis in the absence of cirrhosis. 285 Feb 72

The liver is, under normal conditions, mitotically inactive and relatively resistant to chemical carcinogenesis. When rat or mouse hepatocytes are stimulated to divide, however, the liver becomes exquisitely sensitive to carcinogenesis. The heightened sensitivity of dividing liver cells to carcinogens is one of the most dramatic phenomena in the field of experimental chemical carcinogenesis and is reproducible with a wide variety of chemical agents and experimental conditions. This same phenomenon seems to apply to humans, as circumstances that produce a sustained hepatocellular proliferation in man are associated with an increased risk of hepatocellular carcinoma (HCC). These include inborn errors of metabolism (e.g., haemochromatosis, Wilson's disease, hereditary tyrosinaemia) as well as alcoholism. A recent editorial in this Journal suggested that any condition resulting in cirrhosis is also associated with an increased risk of HCC, and this may in turn be due to regenerative hyperplasia always present in cirrhotic liver (Johnson PJ, Williams R. J Hepatol 1987; 4: 140-147). In the case of HCC associated with hepatitis B virus (HBV) infection, the possibility must be entertained that chronic HBV infection serves to produce a sustained hepatonecrosis with concurrent (regenerative) hyperplasia. This proliferative state would in theory serve to increase the liver's susceptibility to environmental dietary carcinogens and may tend to increase the risk of HCC by this indirect mechanism. Until a molecular mechanisms is demonstrated whereby HBV produces a defined cellular lesion that endows hepatocytes with a malignant phenotype, it should not be assumed that HBV is a direct cause of HCC.
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PMID:Cell proliferation and the aetiology of hepatocellular carcinoma. 285 89

Rats fed a carbonyl iron-supplemented diet for 4-15 months were studied for iron content and morphologic changes in the liver, spleen, intestinal mucosa, pancreas and heart. All organs had an increased iron content measured by atomic absorption, with the highest concentrations in the liver and spleen. The periportal distribution of stored iron in the liver was similar to that in human hemochromatosis. In animals treated beyond 6 months Kupffer cells and sinusoidal lining cells also showed cytosiderosis. Electron microscopy provided information on ferritin and hemosiderin content and distribution within parenchymal and sinusoidal cells of the liver but no excessive fibrosis was found. Except for the spleen, the other organs showed less iron deposition. Iron-filled lysosomes (siderosomes) were found in macrophages in the intestinal lamina propria and pancreas, as well as in enterocytes, pancreatic acinar cells and heart muscle cells. Heavily iron-laden siderosomes had increased membrane instability which was demonstrated both morphologically and by measurements of latent lysosomal enzyme activities. Even though cirrhosis was not found, the distribution pattern of accumulated storage iron and lysosomal lability indicated that the carbonyl iron-fed rat is a suitable experimental model for human hemochromatosis.
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PMID:Ultrastructural observations in the carbonyl iron-fed rat, an animal model for hemochromatosis. 289 Feb 33

Melatonin is an indolamine synthesized from tryptophan in the pineal gland. It is regarded as "the epiphyseal hormone". Its antigonadotropic action has been demonstrated in animals, both in vitro and in vivo, together with its inhibitory effect on numerous endocrine functions and its anti-convulsive properties. Recently developed assay methods have made it possible to obtain clinical data, for the moment purely descriptive. Melatonin is present in several body fluids, such as urine, blood and cerebrospinal fluid. It is secreted in circadian cycles, with low concentrations during the day and high concentrations at night; sex has no influence on this pattern, but secretion is highest in the summer and winter and lowest in the spring and autumn. The part played by melatonin in the genesis of puberty is undetermined. Melatonin secretion appears to be mediated by the adrenergic system, since beta-blockers inhibit the nocturnal rise. However, contrary to what happens in animals, most beta-adrenergic stimulants do not increase melatonin concentrations. Abnormal concentrations or perturbations in the melatonin secretion rhythm have been demonstrated in such diseases as breast cancer, cirrhosis of the liver, Klinefelter's syndrome, Cushing's syndrome and haemochromatosis. Depressive syndromes are often associated with abnormal melatonin cycles. It has been suggested that melatonin could be used as a biological marker in cancer and psychiatric diseases, but its physiological function in man remains obscure.
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PMID:[Melatonin]. 293 8

316 cases of proved hepatic cirrhosis (HC) which underwent Laparoscopy (L) were analysed. In 94 cases, hepatic biopsy by needle (HBN) was also practised under laparoscopic view, 96 cases were controlled until death, with a follow-up of almost 90 months. In 54 of these, there is a complete necropsy study. The performance in diagnosis of cirrhosis, L and HBN are compared separately. L gave the exact result of 96.6% and HBN 74.7%. HBN commonly practised with a Menghini needle (1.2 or 1.4 mm) as it is one that produces less complications, gives and insufficient sample, which determines that in 25.3% of the cases under biopsy, the HC diagnosis could not be proved, while L only fails in this aspect, in 3.38%. To this disadvantage of HBN, we must add another negative factor, the frequency which HBN can not be practised due to prothrombin under 50%, which nevertheless is not an obstacle for practising an L. In this series we have not reported any deaths with this two techniques. L has the additional advantage to contribute other useful data which can not be obtained with HBN alone. as revealing signs of portal hypertension, and hepatobiliary or peritoneal pathology which can coexist with HC. Due to this reasons, in the study of HC, we preferred as the first method of diagnosis, L, instead of HBN. When through this endoscopy we obtain the typical aspect, we omit adding HBN, which we only practised in doubtful cases of not very nodular livers (glabra cirrhosis) or when a probable post-hepatis, Wilson disease or hemochromatosis is being investigated. In the present conditions, we believe that the new methods of diagnosis "of non invasive images" can not substitute L or HBN in precising the diagnosis of HC.
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PMID:[Hepatic laparoscopy and biopsy in the diagnosis of hepatic cirrhosis]. 295 86

Gonadal function in idiopathic hemochromatosis (IHC) was evaluated by comparing clinical features and levels of sex hormones in 10 male patients with IHC (cirrhosis, 4; fibrosis, 6), 6 male patients with alcoholic cirrhosis (AC) and 10 healthy, age-matched controls. Impotence was present in 9 IHC and all AC patients and was associated with decreased plasma testosterone levels. However, gynecomastia, a feature in all patients with AC, was not present in IHC, and plasma sex hormone binding globulin was normal. Patients with IHC showed significantly lower basal estradiol levels (17.7 +/- 6.3 pg per ml) than did controls (28.5 +/- 8.5 pg per ml), and low LH levels (p less than 0.01), which were insufficiently stimulated by luteinizing hormone releasing hormone (n = 8) as well as a decrease in prolactin concentration (2.9 +/- 1.4 vs. 5.9 +/- 1.9 ng per ml in the controls) suggesting pituitary failure. Synthesizing capacity of sex hormones was determined by adrenocorticotropic hormone and human chorionic gonadotropin administration. Basal and stimulated levels of androstenedione and cortisol indicated normal function of the adrenals in IHC. However after adrenocorticotropic hormone, estrone levels increased to only 16.2 +/- 8.4 pg per ml (controls, 27.3 +/- 4.7 pg per ml; p less than 0.01). Increments of estrone (12.5 +/- 9.2 pg per ml) and estradiol (17.9 +/- 11.6 pg per ml) were also lower in IHC following human chorionic gonadotropin administration than in controls (26.0 +/- 7.2 and 37.5 +/- 11.4 pg per ml, respectively). In contrast, plasma human chorionic gonadotropin raised testosterone levels 3.3-fold in IHC and 2.2-fold in controls.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Androgen and estrogen response to adrenal and gonadal stimulation in idiopathic hemochromatosis: evidence for decreased estrogen formation. 298 1

Idiopathic hemochromatosis is a hereditary disease characterized by a progressive iron overload secondary to high intestinal iron absorption. After a latent period of many years, manifestations of liver cirrhosis, diabetes mellitus, cardiac failure, hypogonadism, skin hyperpigmentation and arthropathy can occur. Liver cirrhosis is the most common feature and it is complicated by hepatocellular carcinoma in 30% of cases. Tests of high sensibility are available for early diagnosis. Repeated phlebotomy can prevent clinical features in asymptomatic patients and can improve prognosis in symptomatic subjects. Current concepts in idiopathic hemochromatosis are reported in this review.
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PMID:[Idiopathic hemochromatosis]. 298 52

In evaluating nuclear magnetic tomography for the diagnosis of liver disease, one must differentiate between circumscribed and diffuse lesions. Nuclear magnetic tomography provides additional information for lesions which are echogenic on ultrasound and can differentiate between metastases, haemangiomas and hamartomas. In diffuse parenchymal disease measurement of relaxation time can differentiate between fatty liver, cirrhosis (alcoholic, primary biliary), haemochromatosis (cirrhotic transformation) and hepatoma. NMR spectroscopy is a method for the future.
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PMID:[Differential diagnosis of liver diseases in the nuclear spin tomogram]. 298 31

Patients with cirrhosis present a continuing diagnostic and therapeutic challenge. The status of their disease frequently changes, necessitating intensive serial evaluation. CT is an invaluable tool in the management of these patients because it can noninvasively provide vital information concerning liver size, contour, and occasionally hepatic parenchyma. More importantly, CT can demonstrate superficial and deep varices, assess the patency of the extrahepatic portal system, and detect other complications including ascites, hepatic steatosis, hemochromatosis, and hepatocellular carcinoma.
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PMID:Computed tomography in the evaluation of cirrhosis and portal hypertension. 298 57


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