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)

CEA is a beta1-glycoprotein (mol. w. approx. 200 000) which in embryonic life is usually found as a cell membrane associated antigen in the gastrointestinal (GI) tract and pancreas. Furthermore, it is secreted into body fluids. In healthy adults a very low serum concentration may be found. The clinical significance of CEA lies in its increased formation in primary and secondary adenocarcinomas of colon and rectum and pancreatic carcinoma, where values of 20 ng/ml and more are observed. However, other gastrointestinal (e.g. oesophagus, stomach, gall-bladder) and extragastrointestinal tumors (e.g. lung, breast, urogenital, prostatic, ovarial carcinomas) as well as non-malignant diseases mainly of the GI tract (e.g. hepatitis, cirrhosis, pancreatitis, colitis, diverticulitis) may provoke less frequent and lower increases in the CEA level. Healthy smokers also tend to show a slight increase in CEA concentration. A certain relationship exists between the CEA level and the size and extent of the tumor so that a decrease following operation may account for complete tumor removal, whereas a persistent or recurring increase in the CEA level is highly suspicious of metastases and/or recurrent tumor. Difficulties in proving and purifying CEA are mainly caused by multiple cross-reactions of CEA with other substances, e.g. blood group substances (A, B, Lea, Leb) and normal or other antigens (NGP, NCA, CEX, CCEA 2, NCA 2, CCA-III, FSA, BCGP). The radioimmunoassay is the most suitable method to determine CEA levels in body fluids. The 3 procedures used differ in the precipitation of the specific immune complex by ammonium sulphate (AS), Z-gel (ZG) or a second antibody (SA). Depending on the method, the upper normal limit in serum or plasma corresponds to approximately 2.5 (AS, ZG) or 12.5 (SA) nanogramme/milliliter. CEA determination in the urine is of interest in patients suffering from bladder carcinoma.
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PMID:[Carcinofetal antigens. II. Carcinoembryonic antigen (CEA). (author's transl)]. 108 Feb 18

Histiocytosis X describes a disease characterized by histiocytic infiltration of the reticuloendothelial system, skin, bones, and pituitary gland. The disseminated form frequently occurs in infants and children. Chemotherapy has significantly improved the prognosis in this disorder. Sixty-three per cent of survivors, however, have some residual disability related to fibrosis of tissues previously infiltrated by histiocytes. In instances of liver involvement, healing by fibrosis may result in cirrhosis with portal hypertension and bleeding esophageal varices. Clinical findings include hepatosplenomegaly, jaundice, ascites, hypoalbuminemia, prolonged prothrombin time, and Bromsulphalein retention. Histologic examination of the liver shows a characteristic dense "macronodular" periportal cirrhotic pattern. Three children with portal hypertension and bleeding varices due to healed histiocytosis X were sucessfully managed by portosystemic shunt procedures. Portacaval, mesocaval, and central splenorenal shunts were equally effective in relieving poral hypertension. These children had neither recurrence of bleeding nor evidence of encephalopathy. Two children remain well whereas in one patient a primary hepatoma developed fourteen years posthung and he died of pulmonary metastases. Portosystemic shunt procedures effectively relieve the threat of potentially fatal variceal hemorrhage and improve the opportunity for long-term survival in children with cirrhosis and portal hypertension due to healed histiocytosis X.
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PMID:Portal hypertension in infants and children with histiocytosis X. 108 50

The results of seven laboratory tests of liver function, including spleen/liver activity ratios obtained by densitometric analysis of scans, are analyzed in 50 patients with proven Laennec's cirrhosis. In this series, the liver scan not only disclosed the liver gross anatomy and structural abnormality and established the best possible site for biopsy examination, but also, the increased splenic activity served as a useful diagnostic indication of Laennec's cirrhosis. Of 50 proven cases of Laennec's cirrhosis, 41 (82%) had abnormal spleen/liver ratios. An abnormal spleen/liver ratio in combination with abnormal results from any one or two other tests was relatively effective in the detection of cirrhosis. The accuracy is improved if the other laboratory tests are chosen from among tests for serum albumin, serum bilirubin, and SGOT. (Liver abnormalities other than cirrhosis can also present an abnormal spleen/liver ratio.) This simple determination extends the value of the liver scan commonly requested in search of metastases, primary lesions, or inflammatory processes, or in preparation for needle biopsy examination.
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PMID:Technetium 99m sulfur colloid spleen/liver ratio and other liver tests in the diagnosis of cirrhosis. 115 58

The role of the kidneys in hepatic carcinogenesis was studies in inbred A X C strain male rats ingesting 0.025% N-2-fluorenyldiacetamide. The experimental groups consisted of male rats with both kidney intact and male rats that had the left kidney removed. The incidence of hepatic carcinomas and the number of rats with large carcinomas, multiple carcinomas, poorly differentiated and undifferentiated carcinomas, and metastases was greater in rats with a left nephrectomy. The incidence of cirrhosis was the same in animals in both groups; however, cirrhosis was more severe in degree in the rats with the left kidney removed. Some animals in the latter group also developed carcinosarcomas of the salivary glands. The animals with one kidney apparently were not able to excrete the active metabolites of N-2-fluorenyldiacetamide as readily as the animals with both kidneys intact. The metabolites were then returned to the liver and salivary gland.
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PMID:Carcinoma and cirrhosis of the liver in A X C male rats with one kidney ingesting 0.025% N-2-fluorenyldiacetamide. 117 30

A total of 537 consecutive liver scintiscans were retrospectively reviewed and 80 of them revealed suspicious focal decreased activity in the region of the prota hepatis. Postmortem, surgical, or biopsy correlation was obtained in 40 of these cases: 14 were pathologically negative; 9, cirrhosis or fibrosis; 10, metastases; 3, dilated bile ducts; 1, viral hepatitis; 1, hepatic laceration; 1, falciform ligament cyst; and 1, ruptured gallbladder with abscessed head of the pancreas. Thus, only 42% represented significant disease. Sixty-eight percent of the defects were seen only on the anterior scintiscan. Appearance of the majority of defects was nonspecific. Subjective grading of defects according to size and comparative decrease in density was not beneficial. Elevations of serum alkaline phosphatase, total serum bilirubin, and serum glutamic-oxalacetic transaminase were nonspecific.
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PMID:Focal porta hepatis scintiscan defects: What is their significance? 118 57

Thirty right hepatic arteries discovered among 137 celiomesenteric angiographies show the high frequency (22%) of this variation. Radiologic anatomy of the right hepatic artery was discussed; with the exception of one atheromatous stenosis, the pathologic findings of the right hepatic artery and its terminal branches illustrate the development of a regional disease (12 cases or 40%). This assumed pathology is divided half in pancreatic causes (neoplasm, pancreatitis, pseudocysts) and half in hepatobiliary causes (metastatic cancer of the liver, cancer of the hilus, cirrhosis, hydatid cyst, alveolar echinococcosis or angioma). Five times the surgical technic was modified because of the right hepatic artery. Since these observations were made, we are studying the consequences of this hepatic artery over surgical technics and the approach to the various segments of this artery.
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PMID:A study of thirty right hepatic arteries. 125 99

A Nigerian series of 890 patients with primary liver cell carcinoma, seen during the recent three years, has been examined with a view to establishing the natural history of the tumour in untreated cases. There were 60 males and the mean age of all the patients was 50 years. Hepatitis B surface antigen was positive in 70 pc of tested patients and there were higher pathologic levels of aflatoxins in these patients when compared to normal controls. Liver cirrhosis was associated with 81 pc of patients. Alcohol and smoking were unlikely to be aetiologically important in these patients. The macroscopic type of tumour was mainly diffusely nodular and the commonest microscopic pattern was the characteristic trabecular pattern. Metastases were present in 52 pc of the patients and were mainly to the lungs. Due to late presentation and underlying cirrhosis, most patients were critically ill with high incidence of ascites, jaundice and hepatic precoma. The mean survival time of all patients was six months after onset of the initial symptoms to death and only three weeks after admission to death. The major causes of death were advanced cancer in 78 pc, hepatic failure in 48 pc and rupture of tumour, 39 pc. These observations clearly show that the prognosis of liver cancer is dismal in this environment, as elsewhere. Medical education on earlier presentation in hospital and early operative removal of the tumour should be emphasised. It is suggested that an attempt through immunisation should be employed to reduce the incidence of liver cancer in the population.
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PMID:The natural history of primary liver cell carcinoma: a study of 89 untreated adult Nigerians. 132 87

A 61-year-old male was admitted because of hemoptysis. He had a 9 year history of liver cirrhosis associated with HB viral chronic hepatitis. Physical examination revealed no abnormalities. Laboratory investigations revealed positive HBs antigen with normal alpha-fetoprotein. Chest X-ray film showed large mediastinal lymph nodes and an endobronchial polypoid mass in the distal end of the right main bronchus. The right main PA was narrowed due to compression by the mediastinal mass. Bronchoscopic examination revealed a polypoid mass in the right main bronchus. The biopsy specimen was histologically diagnosed as undifferentiated large cell carcinoma. The patient developed respiratory failure, and died 3 weeks after admission. Autopsy revealed a small liver cancer of 1.3 cm diameter within the cirrhotic liver, associated with a small abdominal lymph node metastasis and large mediastinal lymph node swellings. Thromboembolism in the bilateral main pulmonary arteries was concluded to be the cause of death. The mediastinal mass which directly invaded into the right main bronchus had a close histological similarity with the liver cancer, showing undifferentiated carcinoma cells with bizarre nuclei and abundant cytoplasm. An immunohistological study revealed cells positive for alpha-fetoprotein in the mediastinal lymph nodes. The patient was diagnosed as having small liver cancer with mediastinal lymph node metastases. A survey of the literature revealed only a few cases of advanced hepatoma associated with prominent mediastinal metastases. This is the first reported case of small liver cancer presenting with large mediastinal lymph node metastases.
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PMID:[A case of small liver cancer presenting as a huge mediastinal mass]. 132 37

A retrospective analysis of 194 patients who underwent hepatic resection for primary or metastatic malignant disease from January 1962 to December 1988 was undertaken to determine variables that might aid the selection of patients for hepatic resection. Hepatic metastases were the indication for resection in 126 patients. The 5-year survival rate was 17 per cent. For patients with resected metastases from colorectal cancer (n = 104), the survival rate at 5 years was 18 per cent. The 5-year survival rate was 27 per cent when the resection margin was > 5 mm compared with 9 per cent when the margin was < or = 5 mm (P < 0.01). No patient with extrahepatic invasion, lymphatic spread, involvement of the resection margin or gross residual disease survived to 5 years, compared with a 23 per cent 5-year survival rate for patients undergoing curative resection (P < 0.02). The survival rate of patients with poorly differentiated primary tumours was nil at 3 years compared with a 20 per cent 5-year survival rate for patients with well or moderately differentiated tumours (P not significant). The site and Dukes' classification of the primary tumour, the sex and preoperative carcinoembryonic antigen level of the patient, and the number and size of hepatic metastases did not affect the prognosis. The 5-year survival rate for patients with hepatocellular carcinoma (n = 42) was 25 per cent. An improved survival rate was found for patients whose alpha-fetoprotein level was normal (37 per cent at 5 years) compared with those having a raised level (nil at 3 years) (P < 0.01). Involvement of the resection margin, extrahepatic spread and spread to regional lymph nodes were associated with an 8 per cent 5-year survival rate versus 44 per cent for curative resection (P < 0.005). The presence of cirrhosis, the presence of symptoms, and the multiplicity and size of the tumour did not affect the prognosis. The 5-year survival rate of 11 patients with hepatic sarcoma was 25 per cent. No patient with peripheral cholangiocarcinoma survived to 1 year in contrast to patients with hilar cholangiocarcinoma, all four of whom survived for more than 14 months.
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PMID:Survival after hepatic resection for malignant tumours. 133 Jan 97

A study of 66 primary hepatic tumours was carried out on cattle. These consisted almost entirely of adult females. Fifty hepatocellular tumours (10 adenomas and 40 carcinomas), 10 cholangiocellular tumours (three adenomas and seven carcinomas), two cavernous haemangiomas, two haemangioendothelial sarcomas, one fibroma and one Schwannoma were diagnosed. The 50 hepatocellular tumours were classified into adenomas (20 per cent) and carcinomas (80 per cent), both prevalent in the solitary macronodular form. The hepatocellular carcinomas were divided into six groups based on their distinctive histological arrangement and the morphology of the neoplastic cells: trabecular (55 per cent), pseudoglandular (10 per cent), solid (12 per cent), scirrhous (12 per cent), pleomorphic (7 per cent) and fibrolamellar (2 per cent). Twenty-seven of 50 hepatocellular tumours (54 per cent) were associated with features of blood-filled lakes resembling telangiectasis within the neoplastic tissue. Metastasis was uncommon (10 per cent of hepatocellular carcinomas) and grading according to Edmondson's system (1958) showed a low level of anaplasia in most carcinomas (55 per cent). An association with cirrhosis was never found.
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PMID:Primary hepatic tumours in cattle. A classification of 66 cases. 133 Dec 8


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