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)

A perspective on serum alkaline phosphatase isoenzymes in liver disease is provided with a brief discussion of the location of the enzyme in liver and its presumed function. Mechanisms of entry of alkaline phosphatase into serum in liver disease are discussed. Characterization of high molecular weight alkaline phosphatase in obstructive jaundice is reviewed. The relationship between blood group O and the appearance of the intestinal enzyme in sera of such subjects with cirrhosis of liver is discussed. Properties of hepatoma alkaline phosphatase and the genesis of liver alkaline phosphatase in diseases not related to the liver are explored. Methods for detection of serum alkaline phosphatase isoenzymes in liver disease are discussed from the standpoint of the limitations of electrophoretic procedures, and the promise of procedures such as isoelectric focusing and high performance liquid chromatography that are currently non-routine.
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PMID:Serum alkaline phosphatase isoenzymes as markers of liver disease. 201 75

In 56 patients with various liver diseases and in 15 healthy controls fasting serum concentrations of caffeine (HPLC method) and total endogenous bile acids (enzymatic-spectrophotometric assay) were determined. Serum caffeine concentrations were significantly higher in patients with chronic hepatitis or liver cirrhosis than in controls but no differences was found between patients with obstructive jaundice and controls. Contrary to caffeine, fasting serum bile acids concentrations were higher in all patients groups than in controls. In all studied groups there was no correlation between caffeine and serum bile acids estimations. In patients with liver cirrhosis there was correlation between caffeine test and the Child's classification score. However, no correlation existed between the Child's classification and the serum bile acids concentration. Our data suggest that fasting serum caffeine concentration is more usefull indicator of liver injury than determination of total endogenous serum bile acids.
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PMID:[Comparison of the value of serum caffeine and bile acid concentrations as indicators of liver injury]. 207 20

Haemostatic parameters (PT,KCCT and platelet counts) were measures in conjunction with other biochemical tests in 80 consecutive jaundiced patients here in Zaria. The investigations were performed on admission and within 72 hours after parenteral vitamin K therapy. The prothrombin time and kaolin cephalin clotting time remained prolonged after the administration of vitamin K in cases of liver cirrhosis. Prothrombin times in obstructive jaundice returned to normal after the administration of vitamin K. The prothrombin time, therefore, differentiates between the jaundice of liver cirrhosis from obstructive jaundice.
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PMID:Use of haemostatic parameters as a diagnostic and prognostic index in persistent jaundice: a Zaria experience. 209 82

Tissue plasminogen activator (t-PA) in plasma obtained from patients with acute hepatitis, chronic hepatitis, liver cirrhosis, hepatocellular carcinoma, drug-induced intrahepatic cholestasis, obstructive jaundice, fulminant hepatitis or disseminated intravascular coagulation (DIC), was analysed chromatographically. Liver disease cases showed a new peak (peak C) on HPLC fractionation. The protein of peak C had a lower molecular weight than ovalbumin. Lysine- and zinc- chelating affinity chromatography revealed that the peak C consist with the light chain (L-chain) of t-PA. The L-chain was also found in patients with DIC, but disappeared after improvement of DIC. Therefore, it was suggested that appearance of the L-chain would be related to acceleration of secondary fibrinolysis in plasma. The L-chain was especially high in plasma obtained from patients with decompensated liver cirrhosis. These results indicated that high increase of the L-chain in cases of severe liver disease may be due to either impaired clearance of t-PA in the liver or secondary hyperfibrinolysis accompanied by DIC. We concluded that determination of the L-chain of t-PA may contribute to clarify the mechanism of hyperfibrinolysis in liver diseases.
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PMID:[Qualitative analysis of tissue plasminogen activator in plasma obtained from various liver diseases by gel filtration and affinity chromatography]. 210 95

Activated lymphocytes secrete soluble interleukin-2 receptor (sIL-2R); CD8-positive lymphocytes secrete soluble CD8 (sCD8). Liver dysfunction in cirrhosis and obstructive jaundice is known to result in depressed cellular immunity. To evaluate whether this is due to real inactivation of the immune system, we measured sIL-2R and sCD8 in the serum of 46 patients with liver cirrhosis, 25 patients with obstructive jaundice, 32 patients with alcoholic liver disease without evidence of cirrhosis, 23 healthy persons and 43 patients with unrelated disease. sIL-2R in patients with cirrhosis (mean +/- s.e.m. 1499 +/- 140 U/ml) and obstructive jaundice (1517 +/- 204) was significantly increased compared with healthy subjects (363 +/- 29) and patients with unrelated diseases (685 +/- 92); sCD8 was significantly increased in patients with cirrhosis (737 +/- 63) but not in patients with obstructive jaundice (419 +/- 32) compared with healthy subjects (322 +/- 23) and patients with unrelated diseases (375 +/- 22). No difference was found between patients with cirrhosis due to alcohol abuse (n = 15) and chronic hepatitis B (n = 6). The Child-Pugh score had no significant influence on the sIL-2R or sCD8 value. In obstructive jaundice, sIL-2R correlated with alkaline phosphatase as marker of cholestasis (r = 0.43). These data show that in spite of the apparent depressed cellular immune defense both in liver cirrhosis and obstructive jaundice there is a general activation of the immune system but the CD8+ cell compartment is only activated in liver cirrhosis. The great changes of sIL-2R and sCD8 in liver dysfunction are important for the interpretation of studies using these serum proteins as markers for immune activation.
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PMID:Soluble interleukin-2 receptor and soluble CD8 in liver cirrhosis and obstructive jaundice. 212 35

Between July 1973 and September 1988, 119 patients with hepatocellular carcinoma underwent hepatic resection at Keio University Hospital, Tokyo. Hepatic resection was performed not only for patients with liver cirrhosis and obstructive jaundice but also for patients with advanced disease. Eighty (67.2%) of the 119 patients had liver cirrhosis and four patients had obstructive jaundice. Two or more segments of the liver were resected in 56 (47.0%) patients, 29 of whom had liver cirrhosis. Eleven patients died within 30 days after surgery, an operative mortality rate of 9.2%. Seven additional patients could not be discharged from the hospital, resulting in a hospital death rate of 5.9%. Seventeen of these 18 patients had cirrhosis. Selection of patients with sufficient reserve function of the remaining liver portion, caused a great reduction of the incidence of postoperative death. The 5-year actuarial survival rate for the 101 patients who were discharged from the hospital was 39%, and 13 patients lived longer than 5 years, the longest survival period being 13 years 10 months. Hepatocellular carcinoma is amenable to hepatic resection if patients with sufficient reserve function of the liver are selected.
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PMID:Hepatic resection for hepatocellular carcinoma. 215 90

Death from hepatocellular carcinoma (HCC) is often heralded by the appearance of jaundice which is usually the result of extensive parenchymal damage from either progressive cirrhosis or diffuse tumour infiltration. In rare cases, patients with HCC may present with obstructive jaundice caused by migrated tumour fragments in the common bile ducts. We report three such patients. One patient underwent repeated palliative surgical and endoscopic procedures to clear the bile ducts of tumour fragments. He returned to a normal life but finally succumbed to the disease 17 months after diagnosis. Two patients underwent major hepatic resection after initial tube decompression of the obstructed bile ducts. One patient was found to have recurrence of the tumour 17 months after surgery and the other patient was well and disease-free 24 months after surgery. It is important to recognize and treat this group of patients with migrated tumour fragments in the common bile ducts, as good palliation and occasional cure are possible.
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PMID:Migrated tumour fragments in common bile ducts from hepatocellular carcinoma. 217 52

Biliary mucinous cystadenocarcinoma is an extremely rare tumour. Less than 50 cases have been reported. It is usually a multilocular cystic tumour covered with mucous producing epithelium, with papillary excrescences containing mucinous mass arising from bile ducts. The size of the tumour varies from 3.5 to 25 cm in diameter. It is more frequent in women. The majority of patients belong to the middle age population. We present a 63-year-old man who had been suffering from an epigastric and right subcostal pain of unknown aetiology for over 35 years. During the last 10 years he suffered from multiple attacks of cholangitis with high temperature, rigor, chills, pain and obstructive jaundice. Five years ago he had the attack of pancreatitis with retroperitoneal fatty necrosis for which he was operated on in another institution and cholecystectomy and pancreatic necrectomy were carried out. The attacks of cholangitis continued they were more serious and more frequent until June 1987, when the "cyst" in the left lobe of the liver, dilated bile ducts and "polyps" in the common bile duct were diagnosed by ultrasonography. During the operation advanced biliary cirrhosis, portal hypertension, splenomegaly, very dilated common bile duct full of jelly and the "cyst" in the liver filled with jelly, were found. The removal of the jelly and choledochojejunostomy resulted in temporary relief. Two months later he was reoperated for recurrent obstructive jaundice during which left lobectomy, partial excision of the cyst and cystojejunostomy between the rest of the cyst and another Roux-en-Y jejunal limb, were carried out.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Biliary mucinous cystadenocarcinoma of the liver]. 221 37

The disappearance rate of indocyanine green (K.ICG) and the maximum removal rate (Rmax) usually correlate with each other. However, in some cases it was shown there was a dissociation between them. We investigated the relationship between the two rates in 146 subjects. K.ICG and Rmax correlated strongly with a correlation coefficient of 0.749 (p less than 0.001). Sixty-six cases were included in the limits of 95% confidence, and the other 80 cases outside the limits were defined as dissociated cases. Among them a lower Rmax rate as compared to the K.ICG rate was found in many cases of obstructive jaundice. Particularly a lower K.ICG rate compared to the Rmax rate was found in many cases of liver cirrhosis accompanied by esophageal varices and idiopathic portal hypertension. On the other hands, we performed multiple regression analysis on 12 other liver function tests. K.ICG was strongly related to platelet count, circulatory blood volume, and albumin, all factors relating to portal hypertension. Rmax largely depended on LCAT, A/G ratio, and cholinesterase, which are Therefore, the dissociation between K.ICG and Rmax was caused by differences in the characteristic of each disease.
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PMID:[Evaluation of correlation between the disappearance rate of indocyanine green and the maximum removal rate]. 223 72

Clinical usefulness of mean transit time (MTT) through the liver was evaluated by deconvolution analysis using 99mTc-EHIDA hepatobiliary scintigraphy in 82 patients with various hepatobiliary diseases and 18 normal controls. Initial transfer factor was also obtained according to the method of Rutland. Results obtained were as follows. 1) Effect of the age on MTT was not observed in normal controls. 2) MTT in left lobe of normal controls was significantly prolonged compared with that of right lobe (P less than 0.01). This kind of difference was not observed in patients with liver cirrhosis. 3) MTT in patients with obstructive jaundice, chronic liver diseases, liver cirrhosis at decompensative state and primary biliary cirrhosis was significantly prolonged compared with that in normal controls (P less than 0.01). 4) MTT in patients with liver cirrhosis at compensative state showed normal values, although blood clearance rate in those patients was significantly decreased (P less than 0.05). 5) Positive correlation was observed between MTT and values of T-Bil, ALP, LAP, and gamma-GTP. Negative correlation was observed between MTT and value of cholinesterase. 6) Initial transfer factor correlated with blood clearance rate. (r = 0.76, P less than 0.01). 7) Initial transfer factor in left lobe of normal controls was significantly decreased compared with that of right lobe (P less than 0.01). This kind of difference was not observed in patients with liver cirrhosis. 8) Initial transfer factor in patients with liver cirrhosis in both compensative and decompensative states and PBC was significantly decreased compared with that in normal controls. Estimation of MTT and initial transfer factor could be a useful parameters to assess transfer function of the liver.
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PMID:[Hepatic mean transit time of 99mTc-EHIDA estimated by deconvolution analysis]. 232 33


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