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)

Cancerembryonic antigen (CEA) and beta2-microglobulin (beta2m) have been measured in cancer patients and patients with benign diseases. Of 168 patients with intestinal cancer, almost 90% had increasing concentrations of either CEA or beta2m or both. In 29 patients at different stages of pancreatic cancer there was a high incidence of increased values in the more severe cases. In 60 patients with histologically classified colorectal cancer the TNomegaMomega group of 19 patients had 47% and 42% of elevated beta2m and CEA respectively. A significant correlation of beta2m or CEA to extension of disease was noted. In benign intestinal disease like cirrhosis and pancreatitis both beta2m and CEA is commonly elevated. Of 26 breast cancer patients, seven had elevated CEA and five had elevated beta2m values before treatment. In the patients with extraganglionary metastasis almost 90% had high beta2m or CEA or both. Of 40 patients with uterine cancer, 26 were found to have increased values of beta2m or CEA or both. Finally, 140 colorectal cancer patients, 62 patients with breast cancer and 10 patients with uterine cancer have been followed longitudinally.
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PMID:[beta2-Microglobulin in cancer patients (author's transl)]. 8 77

The authors report 3 cases and report the diagnostic usefulness of two signs of minor cholestasis described by one of them in 1966. A relative increase, in the absence of obvious virus hepatitis or cirrhosis, of the serum bilirubin, cholesterol, lipids and alkaline phosphatase, together with B.S.P. excretion. suggest minor cholestasis. The sign of "metacritical aggravation" when there is some suspicion of minor cholestasis, the supervision of the course of the disease, or a retrospective inquiry, permit, in the presence of minor symptoms, such as, pain, fever, jaundice, or pruritus, one to make the diagnosis of minor cholestasis. The latter is due either to the presence of small gall stones in the common bile duct, or to inflammation of the ampulla of Vater, or sphincter of Oddi, a Vaterian ampulloma, pancreatitis, or following damage to the common bile duct. In practice, liver biopsy confirms the diagnosis, and intravenous cholangiography, by the perfusion method, is usually able to demonstrate obstruction of the common bile duct.
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PMID:[Relative increase and metacritic aggravation in the diagnosis of anicteric cholestasis]. 16 83

The enzyme gamma-glutamyl transpeptidase is widely distributed throughout the body, notably kidney, seminal vesicles, pancreas, liver, spleen and brain. Being one of the enzymes of the gamma-glutamyl cycle, it is involved in aminoacid transport, catalysing a transpeptidation reaction between gamma-glutamyl peptides and most common amino acids. Methods of assay of the enzyme are based on its ability also to act on synthetic amides of glutamic acid; kinetic methods monitoring the release of p-nitroaniline from the substrate L-gamma-glutamyl p-nitroanilide are the most satisfactory. In diseases of the liver, the highest levels occur in association with cirrhosis, alcoholism, hepatic secondaries and cholestasis. As the enzyme is present in the endoplasmic reticulum of the hepatocyte, its activity is increased in situations leading to microsomal enzyme induction. Raised levels can also occur in pancreatitis, diabetes, myocardial infarction, congestive cardiac failure, chronic renal failure, cerebrovascular accidents, cerebral tumours and chronic obstructive pulmonary disease. Although the lack of specificity must be recognised, the estimation can be useful in the elucidation of some clearly defined problems arising during investigation of patients with suspected hepatic disease, especially where performed as part of a biochemical profile.
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PMID:Role of gamma-glutamyl transpeptidase activity in the diagnosis of hepatobiliary disease. 24 76

Elevated circulating CEA levels occur in patients with benign gastrointestinal and hepatic disorders. These are usually less than 10 ng/ml. Of clinical importance is the influence of liver disease on the interpretation of CEA. At least 50% of patients with severe benign hepatic disease have elevated CEA levels, most often active alcoholic cirrhosis, and also chronic active and viral hepatitis, and cryptogenic and biliary cirrhosis. Patients with benign extrahepatic biliary obstruction may have increased plasma CEA, the highest in patients with co-existent cholangitis and especially liver abscess. The liver appears to be essential for the metabolism and/or excretion of CEA. Hence, liver work-up is needed to assess any patient with an elevated CEA. A damaged liver may further augment elevated CEA levels due to cancer. The increased circulating CEA observed in some patients with active ulcerative colitis tends to correlate with severity and extent of disease and usually returns to normal with remission. CEA levels also may be mildly elevated in patients with pancreatitis and in adults with colonic polyps. Smoking may contribute to the increased CEA levels seen in patients with alcoholic liver disease and pancreatitis. Therefore, in interpreting mildy elevated circulating CEA levels in patients with GI tract diseases, one must consider benign as well as malignant etiologies.
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PMID:Carcinoembryonic antigen (CEA) levels in benign gastrointestinal disease states. 36 Dec

Men drafted into the Army, hospitalized during 1944 to 1945 for service-connected trauma to the extremities, and consequently separated for disability were followed for mortality from January 1946 to April 1977. Three groups were established consisting of those whose injury resulted in (a) limb amputation, (b) disfiguration without loss of body part, (c) loss of part of hand or part of foot. Group (a) had a mortality, standardized for age and calendar time, 1.4 times that of Group (b), matched on age and length of service at admission, and 1.3 times that of Group (c), similar on age and length of service to Group (a). The excess mortality of limb amputees was statistically significant (P less than .05) for ischemic heart disease, other diseases of the cardiovascular system, suicide by poisoning, alcholic cirrhosis, and cute pancreatitis. Possibly (P less than .1) there was also an increased risk of diabetes and cancer of the buccal cavity and pharynx.
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PMID:Report to the Veterans' Administration Department of Medicine and Surgery on service-connected traumatic limb amputations and subsequent mortality from cardiovascular disease and other causes of death. 39 10

The increasing importance of physiological and functional surgical procedures in the surgical therapy of benign abdominal disease is implied. Positive results were achieved at the 2nd Department of Surgery of the University of Vienna following parietal cell vagotomy in hypersecretory gastroduodenal ulcer, latero-lateral pancreatico-jejunostomy according to Puestov-Mercadier in chronic relapsing pancreatitis, distal splenorenal shunt according to Warren in portal hypertension and following peritoneo-venous shunt according to Warren in portal hypertension and following peritoneo-venous shunt according to Le Veen in ascites and cirrhosis of the liver.
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PMID:[Modern functional and physiological techniques in abdominal surgery (author's transl)]. 42 27

Ascites occurring in patients with a history of alcoholism is usually due to cirrhosis but clinically significant ascites also occurs in association with pancreatic disease. We reviewed 265 cases of pancreatitis over a five-year period. There were 129 blacks and 136 Caucasians. Ages ranged from 19-86 years with a mean of 46.2 years. Eight of these cases (3%) were found to have pancreatic ascites. The initial serum and urinary amylase had no prognostic value regarding the subsequent development of pancreatic ascites. The mean ascitic fluid amylase was 14,426 Somogyi units (range 1,279-67,774). The mean ascitic fluid protein was 4.6 gm./100ml. (range 1.4-7.2). High enzyme and protein concentration in the ascitic fluid are characteristic of pancreatic ascites. Out of eight cases, two were associated with a pseudocyst, three with hemorrhagic pancreatitis and three with acute edematous pancreatitis. Four of these eight (50%) died. Pancreatic ascites is a distinct clinical entity which should be differentiated from cirrhotic, tuberculous or malignant ascites.
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PMID:Pancreatic Ascites. 43 2

The chronic pancreatitis population of Wadsworth VA Hospital over the past five years was screened for two-fold or greater alkaline phosphatase elevation at any time during their course, as a marker for either distal common bile duct stenosis or other hepatobiliary disease. Forty-seven of 207 patients screened met this criterion and are reviewed in detail. Of the 16 patients with persistent alkaline phosphatase elevation (group B), 15 had proven common bile duct stenosis, demonstrating a clear pathophysiologic role of partial bile duct obstruction in their liver disease. Three had developed secondary biliary cirrhosis, marking this entity the commonest cause of secondary biliary cirrhosis at our hospital. Of the remaining 31 patients with transient alkaline phosphatase elevation (group A), only 4 had proven duct abnormalities which may resolve during recovery. Alcoholic liver disease was demonstrated with normal extrahepatic ducts in the remainder in group A adequately studies. Persistent greater than two-fold alkaline phosphatase elevation in pancreatitis thus represents a reliable marker of distal common bile duct stenosis, whose sequelae may include cholangitis and secondary biliary cirrhosis and which requires operative intervention in these cases. When a persistent alkaline phosphatase elevation greater than two-fold is encountered in a chronic pancreatitis patient, adequate cholangiography and liver histology are both necessary to confirm and grade this frequent and treatable complication.
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PMID:Common bile duct stenosis from chronic pancreatitis: a clinical and pathologic spectrum. 51 65

Abnormally large duodenal aspirates have been reported in a large percentage of patients with cirrhosis of the liver. The source of this fluid has been variously ascribed to the liver and/or pancreas. The present study was undertaken to clarify its source. Eleven patients with cirrhosis of the liver and one with cholestatic hepatitis underwent an intraductal secretin test during endoscopic cannulation of the pancreatic duct. Six patients with cirrhosis had pancreatic hypersecretion ranging from 7.8 to 26.0 ml/min, while three patients demonstrated low secretory flow rates. Bile flow was negligible or nonexistent in ten patients, while in two others, larger but unmeasurable amounts of bile secretion were present. This study conclusively demonstrates that pancreatic hypersecretion may occur in patients with cirrhosis during secretin stimulation. Impaired metabolism of secretin or the associated pancreatic hypersecretion of early pancreatitis may be responsible for this finding.
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PMID:Pancreatic hypersecretion in liver disease. 61 31

Endoscopic retrograde cholangiopancreatography (ERCP) is essential in the diagnosis of pancreatic disease, jaundice and in post-cholecystectomy syndromes, as well as in cases where cholecystography and i.v. cholangiography fail to explain disturbances that strongly suggest bile duct involvement. Its confirmation of clinically established pancreatic disease is much more positive than that given by scintiscanning and multiple superselective arteriography. Unlike the latter, it also permits the differential diagnosis of chronic pancreatitis, cancer of the pancreas, pseudocysts, etc. and distinguishes medical and surgical pancreatitis (stenosis, proteinaceous calculi, and obstructing pseudocysts). Differential diagnosis of progressive jaundice on clinical grounds or with the aid of ordinary means of examination is sometimes unsatisfactory. ERCP clearly distinguishes medical and surgical forms, so that exploratory laparotomy is not needed in subjects with liver-cell forms. It also shows the nature, site and extent of extrahepatic obstruction, and points to the organic cause in 79% of cases of postcholecystectomy syndrome. Right hypochondrial pain or intermittent jaundice and negative cholecystography and i.v. cholangiography is a further indication, since ERCP will reveal disease of the pancreas or bile ducts (cholelithiasis, choledocholithiasis, sclerosing cholangitis, etc). It is also useful in the diagnosis of cirrhosis, abscess, echinococcus cyst and primary or secondary cancer in cases where needle biopsy and-or arteriography are either contra-indicated or inconclusive.
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PMID:[Diagnostic value of retrograde cholangiopancreatography by transendoscopic route]. 66 74


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