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)

Of 483 patients with biopsy-verified cirrhosis who entered the controlled trial of prednisone treatment conducted by the Copenhagen Study Group for Liver Diseases, 99 had alcoholic hepatitis as defined by morphological criteria in the initial biopsy. The maximum period of observation varied from 5 to 12 years. The survival of prednisone-treated patients (median survival time 38 months) and placebo-treated patients (median survival time 34 months) with alcoholic hepatitis did not differ significantly. This was also true for each of the two subgroups comprising mild and severe cases respectively. The presence of morphologically defined alcoholic hepatitis was postively correlated with the daily consumption of alcohol but poorly correlated with the clinical syndrome usually attributed to alcoholic hepatitis.
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PMID:Alcoholic hepatitis superimposed on cirrhosis. Clinical significance and effect of long-term prednisone treatment. 77 15

Alcoholic hepatitis is the precursor of cirrhosis. Susceptibility is independent of amount and duration of ethanol intake or of diet. Centrilobular hyalin, the key morphologic abnormality, sensitizes lymphocytes to secrete factors which may account (in part) for necrosis, liver cell destruction, increased collagen synthesis and development of cirrhosis. Diagnosis may be facilitated by detection of alcoholic hyalin antigen (AHAg) and antibody (AHAb) in serum of patients with alcoholic hepatitis. Treatment requires abstinence. Steroids have not reduced mortality rates. Measures to improve immunologic reactivity may be helpful. Persons unable to abstain should be enrolled in a surveillance group.
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PMID:Alcoholic hepatitis. 77 53

A survey of 293 patients with alcoholic liver disease showed that women, particularly those aged under 45, had a significantly higher incidence of alcoholic hepatitis, with or without superimposed cirrhosis, than men. The long-term prognosis for both women who continued to drink and those who stopped drinking was worse than that for men. Autoantibodies were more common in women, which suggested that immune mechanisms may play a part in the pathogenesis and progression of alcoholic liver disease in women.
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PMID:Changing pattern of alcoholic liver disease in Great Britain: relation to sex and signs of autoimmunity. 87 31

Adult human liver biopsies were cultured from normal, alcoholic hepatitis, chronic active hepatitis, fibrosis plus alcoholic hepatitis (active cirrhosis), inactive cirrhosis, and drug hepatitis. The synthesis of collagen was estimated in cultures from 58 livers by measuring the conversion of [(14)C]proline to the [(14)C]hydroxyproline of collagen; that of glycosaminoglycans in cultures from 57 livers by the incorporation of [(3)H]acetate and (35)SO(4) into glycosaminoglycans (GAG). The synthesis of procollagen was increased only in cultures from alcoholic hepatitis, both in the pulse medium (P < 0.05) and in the chase medium (P < 0.02). The synthesis of insoluble collagen was increased in cultures from chronic (active) hepatitis (P < 0.01), fibrosis plus alcoholic hepatitis (active cirrhosis) (P < 0.001), and inactive cirrhosis (P < 0.05). Essentially all radioactive GAG was soluble in culture media. The predominant GAG were chondroitin-4 or -6-SO(4). The synthesis of GAG was increased only in cultures from fibrosis plus alcoholic hepatitis (active cirrhosis) both in the pulse medium (P < 0.01) and chase medium (P < 0.001). The data indicate that in the absence of immuno-competent cells or their secretory products, tissue cultures from livers showing biopsy evidence of active fibrosis in vivo may demonstrate increased synthesis of collagen and GAG in vitro. Increased (soluble) procollagen synthesis in cultures from alcoholic hepatitis was not associated with histologically demonstrable overt hepatic fibrosis in vivo, nor was it associated with increased GAG synthesis in vitro. No significant difference was demonstrable in collagen or GAG synthesis in paired cultures which contained either 300 mg/dl ethanol or 3.75 mg/dl methylprednisolone compared to their respective controls.
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PMID:The rate of synthesis of glycosaminoglycans and collagen by fibroblasts cultured from adult human liver biopsies. 87 75

Two patients with hepatorenal syndrome were treated by insertion of a peritoneovenous shunt. The renal deficit was corrected rapidly in both cases. A 62-year-old woman with a slow onset syndrome with urine output of 100 to 150 ml/day and urinary sodium excretion of 1 mEq/day responded with large volume urinary output and sodium excretion. She is alive with minimal ascites 18 months after shunt. A 53-year-old man with severe nutritional cirrhosis, alcoholic hepatitis, and eventual massive necrosis was treated for bleeding esophageal varices by portacaval shunt. Postoperative massive ascites progressed to acute hepatorenal syndrome. Insertion of a peritoneovenous shunt reversed the renal deficit. HE eventually exsanguinated due to a hemorrhagic diathesis caused by massive hepatic necrosis.
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PMID:Hepatorenal syndrome: reversal by peritoneovenous shunt. 88

Survival rates were compared in 82 patients who underwent therapeutic portacaval shunt. All patients were followed for at least 5 years after shunt or until death. Survival rates were calculated by Life Table methods. Based on a combination of currently accepted histological and clinical criteria, there were 45 patients with Laennec's cirrhosis, 29 patients with postnecrotic cirrhosis, 11 of whom had histological evidence of chronic active hepatitis, and 8 patients with primary biliary cirrhosis. Survival rates were similar in all three groups, alcoholic cirrhosis, postnecrotic cirrhosis, and primary biliary cirrhosis. Hepatic reserve, as defined by Child's classification, provided the best criteria for predicting survival. The type of shunt, end-to-side, side-to-side, or splenorenal, did not influence survival. Histological evidence of chronic active hepatitis adversely affected survival in patients with postnecrotic cirrhosis. However, histological evidence of ongoing alcoholic hepatitis in patients with Laennec's cirrhosis did not influence survival adversely. The data indicate that once a patient with cirrhosis has bled from esophageal varices, the etiology of the cirrhosis is not a major factor in determining survival after a therapeutic portacaval shunt.
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PMID:Survival in patients with postnecrotic cirrhosis and Laennec's cirrhosis undergoing therapeutic portacaval shunt. 89 71

Alcoholic liver damage is only produced by constant alcohol intake. Close dose and time relationships are apparent. For many years, alcoholic fatty liver is the only noticeable alteration. It is completely reversible in 2-4 weeks when ethanol intake is stopped. After about 6 years of chronic abuse alcoholic hepatitis may develop. Once established it progresses within weeks or months to cirrhosis if ethanol intake is not discontinued. On the other hand, alcoholic hepatitis heals under complete abstenence from alcohol with unimportant fibrosis. After over-indulgence in alcohol over a period of 22 years, there is a 50% probability of cirrhosis. This shows clearly that the resistance of the liver to alcohol varies considerably in different individuals. Even in early stages of alcoholic cirrhosis the prognosis is reasonable. If these patients observe complete abstenence from ethanol, their life expectation is only slightly different from the average of the population. The extent of the consumption of alcohol is of decisive importance for the development of cirrhosis. New and very careful investigations reveal that the susceptibility to alcohol is different in both sexes. For men the danger level would thus appear to be around 60 g and for women around 20 g of pure alcohol a day. Beyond these critical levels the morbidity of cirrhosis multiplies almost in geometric progression with increasing amounts of ethanol.
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PMID:Alcohol consumption and diseases of the liver. 91 49

The liver histology of 503 consecutive victims of fatal (within 24 hours) traffic accidents submitted to medico-legal autopsy are used as a standard of reference. In 370 persons (74%) no pathological changes in the liver biopsies were observed. Fatty liver was found in 120 persons (24%), non-specific portal inflammation in 7 persons, alcoholic hepatitis in 6, and portal fibrosis in 5. No cases of cirrhosis, chronic aggressive hepatitis, changes compatible with chronic persistent hepatitis, viral hepatitis, or other internationally accepted morphological diagnoses were found. A significant positive correlation between the frequency of steatosis and age groups was demonstrable. Fatty liver was found in 1% of persons below 20 years, in 18% between 20--40 years, and in 39% of persons more than 60 years in this normal material. The persons with fatty liver had a higher body weight, but the overweight was not correlated to age. It is concluded that fatty infiltration in the liver is a normal observation in aged persons.
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PMID:Liver histology in a 'normal' population--examinations of 503 consecutive fatal traffic casualties. 91 53

Serial liver biopsies before and after Methotrexate therapy were performed in each of eight patients with severe, recalcitrant psoriasis treated for years with Methotrexate in a single, weekly, oral dose not exceeding 25 mg per dose. A total of 31 liver biopsies was studied. The study revealed liver damage commencing with small foci of piecemeal necrosis, followed by the destruction of the limiting plate and the occurrence of stellate periportal fibrosis. Eventually, partial and then whole fibrous septa developed between portal tracts and between portal tracts and central veins, with resultant distortions of the lobular architecture. In two patients with an admitted daily alcoholic intake, additional findings were seen, including alcoholic hepatitis, centrilobular fibrosis and development of partial and whole fibrous septa between the central vein area, and portal tracts adding to the number of septa running between the portal tracts and central veins which split up the lobules. The following conclusions seem probable: 1) Methotrexate therapy in psoriatics may cause development of fibrosis or cirrhosis; 2) the morphological changes during this development follow a consistent pattern; and 3) the pathogenesis of the development of fibrosis and cirrhosis is mixed in some cases, being dependent on both alcoholic and Methotrexate intake.
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PMID:Morphogenesis of fibrosis and cirrhosis in methotrexate-treated patients with psoriasis. 92 Aug 71

Serum zinc and copper levels were studied in relation to in vitro and in vivo drug metabolism in 25 alcoholics, in whom various diseases of the liver had been diagnosed by histology. Serum zinc was elevated in alcoholics with normal or fatty liver and was low in those with alcoholic hepatitis or cirrhosis. There was a significant positive correlation between serum zinc and cytochrome P-450 content of liver biopsies. The relationship between zinc and antipyrine half-life was significant and non-linear. Serum copper level was elevated in all the alcoholics and no significant relationship could be found between copper and drug metabolism in alcoholics. The findings suggest parallelism between changes in serum zinc and indices of drug metabolism in alcoholics.
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PMID:Serum zinc and serum copper and indices of drug metabolism in alcoholics. 92 28


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