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)

During the 11-year period from 1977 through 1987, hepatic resections were carried out in 120 patients with hepatocellular carcinoma (HCC). Twenty-five had HCCs smaller than 5 cm in diameter. There were 97 male and 23 female patients, with an average age of 51.5 years. Among them, 45.8% had liver cirrhosis and 80.8% were positive for hepatitis B surface antigen. Fourteen with ruptured HCCs underwent hepatic resection to control the intra-abdominal hemorrhage. Operative mortality within one month after surgery was 4.1%. The postoperative course was complicated by pleural effusion in 5.8%, subphrenic abscess in 2.5%, postoperative bleeding in 1.6%, hepatic failure in 1.6%, and bile leakage in 0.8% of the patients. The overall five-year survival rate in this series was 25.9%, while survival for the last five years was better (42.3% vs 11.9% for patients treated between 1977 and 1982). The cumulative survival rate had no relation to tumor rupture or liver cirrhosis. The group of patients with smaller tumors (diameter, less than 5 cm) or without vascular invasion by tumor had better survival.
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PMID:Hepatic resection in 120 patients with hepatocellular carcinoma. 254 12

Liver resection for a neoplasm was performed in 100 patients between 1979 and 1987. There were 43 hepatocellular carcinomas (70% of them arising in patients with cirrhosis), 28 metastases from colorectal cancers, 20 benign tumors, and 9 miscellaneous tumors. Forty-nine patients had a major liver resection, 36 a segmentectomy, and 15 a nonanatomic liver resection. Great care was taken to avoid intraoperative and postoperative bleeding, including late ligation of the hepatic vein, the use of Kelly fracture and resorbable clips for hemostasis of transection planes in 74 patients, and temporary clamping of the portal pedicle in 22. Drainage of the abdomen was avoided in 21 patients to prevent ascitic leakage to decrease the postoperative hospital stay. Operative mortality was 1%. There were eight major complications, including one bile leak, one subphrenic abscess, and three subphrenic hematomas. The use of resorbable clips significantly reduced operative time and transfusion requirements. In patients with cirrhosis, temporary clamping of the hepatic pedicle significantly decreased blood loss. Avoiding drainage significantly decreased the postoperative hospital stay.
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PMID:Improved early results of elective hepatic resection for liver tumors. One hundred consecutive hepatectomies in cirrhotic and noncirrhotic patients. 254 13

A total of 109 patients with histologically proved hepatocellular carcinoma (HCC) have undergone hepatic resection during the 56-month period from October 1978 to May 1983. There were two sources of patients: those with symptomatic HCC (n = 47) and those with asymptomatic HCC (n = 62). A family tendency of HCC was noted in 11% of the patients studied. The percent of positive hepatitis B surface antigen (HBsAg) was 87%, and the serum alpha-fetoprotein was less than 20 ng/ml in 30% in the group with symptoms. The operative mortality rate was 3% and the hospital mortality rate was also 3%. The postoperative course was complicated with pleural effusion in 10%, bile leakage in 4%, subphrenic abscess in 4%, and upper gastrointestinal bleeding caused by gastritis in 1% of the patients. The actual survival rate for the 103 cases was 84% for 350 days and 28% for 1400 days. However, in the group with asymptomatic HCC with an average tumor size of 3.35 +/- 1.49 cm in diameter, the rate was 92% for 350 days and 44% for 1400 days. In the group with symptomatic HCC with an average tumor size of 10.6 +/- 5.1 cm in diameter, the rate was 76% for 350 days and 8% for 1400 days. The survival rate of the group with asymptomatic HCC was far better than that of the group with symptoms (p less than 0.05). In analysis of factors that might affect the patient's survival, only second or third operations (p less than 0.05), typical gross findings of tumor appearance (p less than 0.05), and an adequate margin were closely related (p less than 0.001). Neither the tumor size, the status of accompanying liver cirrhosis, the tumor location, nor the patient's sex and age affected the patient's survival (all p greater than 0.05).
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PMID:Surgical treatment of 109 patients with symptomatic and asymptomatic hepatocellular carcinoma. 300 72

From Aug 1984 to Aug 1990, under one-shot normothermic interruption of Porta Hepatis, hepatectomy was performed in 115 patients with primary liver cancer (PLC). The incidence of associated cirrhosis was 82.8% with liver function in Grade A in 59.4% of patients and in Grade B in 40.6% of patients according to Pugh's ranking criteria. Hemihepatic vascular occlusion was preferred. Due precautions were taken to prevent postoperative hepatic failure, including continuous low-pressure oxygen inhalation, the use of antioxidants and dexamethasone. Post-operative complications were: Hydrothorax (7.8%), subphrenic abscess (3.5%), bite leakage and gastrointestineal bleeding (0.9%). There was no operative mortality and hospital mortality.
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PMID:[Hepatectomy under liver normothermic ischemia in primary liver cancer patients associated with cirrhosis]. 869 80

Non Hodgkin's lymphoma revealed by hepatic manifestations is extremely rare. We describe here a 82-year old male patient who presented with a right subphrenic abscess and a solitary liver tumour that was shown to be a centrocytic lymphoma. Furthermore, asymptomatic cryptogenic liver cirrhosis was diagnosed. This previously unreported form of clinical presentation of a non Hodgkin's lymphoma as well as the association with liver cirrhosis are discussed in the context of the recent literature.
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PMID:Centrocytic lymphoma presenting as a subphrenic abscess and a solitary liver nodule. 922 67

Fourteen children (10 boys and 4 girls, aged 8 to 17 years) had 20 pheochromocytomas treated over a 36-year period from 1959 to 1995 inclusive. Nine patients had 11 tumors before 1980; 5 children had 9 tumors up to 1987. There were no new children with pheochromocytomas at our hospital from 1988 to 1995. Hypertension, sweating, headache, and visual blurring were the most common symptoms and signs (average 5 months). The most reliable biochemical investigations were the urinary catecholamines and norepinephrine. Before 1980, intravenous pyelography and angiography were most successful in localizing the tumor, but since then ultrasonography and computerized tomography have been the radiological investigations of choice. Early involvement of the anesthesiologist in the preoperative control of the hypertension is essential; blood pressure (BP) control was achieved with phenoxybenzamine. The main anesthetic drugs used were: sodium thiopental, fentanyl, methoxyflurane, isoflurane, nitrous oxide, and metocurine. Sixteen tumors were adrenal and 4 were extra-adrenal (1 intrathoracic and 1 extradural). All except 2 tumors were completely resected; they ranged in size from 1.3 to 14 cm. Ligation of the tumor's venous drainage was usually associated with a sudden, temporary fall in systemic BP. There were 2 children with malignant tumors. Four patients had five recurrences (second pheochromocytoma) within 6 years, and all were heralded by a return of their original symptoms and signs. One girl was left with no adrenal tissue. The only complication was in a boy with a large, partly-resected malignant right adrenal tumor who had a subphrenic abscess drained and was left with a temporary bile fistula, cirrhosis, and chronic pain. All children were normotensive when discharged from hospital and remain alive and well with a follow-up of 7 to 36 years. There were no deaths. Long-term follow-up is essential. Key word Pheochromocytoma
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PMID:Pediatric pheochromocytoma. A 36-year review. 935 33

The Kuzmak adjustable silicone gastric band (ASGB; 33 patients) and the vertical banded gastroplasty (VBG; 91 patients) are compared for weight loss, complication rates, and patient satisfaction. The complexity of the two operations is also compared, using operative time, blood loss, and length of hospitalization. When these three parameters were evaluated, the operations were remarkably similar, although a significant percentage of the ASGB patients left the hospital earlier than the VBG patients. The ASGB group of patients lost 52% of their excess weight (34 kg) and the VBG group 63% (40 kg), with the maximum follow-up being 15 months. Mechanical problems (leaks in the system) occurred in four ASGS patients. This slowed their weight loss and caused dissatisfaction with the procedure. Sixty-four percent of the patients underwent adjustment of the silicone band at least once during the 15 months. Complications included stomal stenosis in 9% of the ASGB patients vs 1.3% in the VBG patients. There was one staple-line leak, one subphrenic abscess (without a leak), and one retrogastric hematoma in the VBG patients. One death occurred in the ASGB group in a patient who was found at surgery to have unanticipated post-hepatitic cirrhosis. There were no deaths in the VBG group. The conclusion reached is that the ASGB compares favorably with the VBG as a bariatric surgical procedure.
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PMID:Adjustable Silicone Gastric Banding vs Vertical Banded Gastroplasty: a comparison of early results. 1075 18

The aim of the study is to elucidate premorbid grounds, diagnostic and clinical peculiarities, as well as medical and surgical management of non-parasitic spleen abscess. We study 6 cases, with median age 56.7 years, men/women ratio--2:1. Onset-diagnosis period was of median 20 days. In 5 cases (83.3%) spleen abscess developed in immune compromised patients (diabetes mellitus, liver cirrhosis, pancreatitis) and in one case (16.7%) subsequent to blunt abdominal trauma. Clinically, patients presented fever, weight loss and pain in the left upper quadrant of the abdomen. The imaging data (USG, CT, and Rx-thoracic) performed prior to surgery confirmed the diagnosis. USG revealed splenic injury in 80%, CT had a 100% sensibility and thoracic Rx revealed left-side pleuro-pulmonary reaction in 83% of cases. Bacteriological test was positive in 50% of cases. One death was recorded in first 24 hours after surgery. The rest of the cases had a favorable evolution, although, in 2 cases a left subphrenic abscess was noticed, one requiring drainage; in one case--colonic fistula, which closed spontaneously. Although, it's a rare pathology, an early diagnosis is as important, as impossible, and it's delay exhausts the organism and increases the postoperative morbidity rate, splenectomy remaining the safest method of treatment.
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PMID:[Splenic abscess--etiologic, clinical and diagnostic features]. 1768 60

The authors present a study on rates and management of complications of gastric carcinoma surgeries. During a five-year period, a total of 149 patients with gastric carcinomas were operated in the Ist Surgical Clinic (Charles University Faculty Hospital). Radical resections were performed in 121 subjects. In 7 subjects, upper pole resections were performed. 21 subjects underwent paliative therapy or surgical exploration. In the authors' study group, no serious perioperative complications were recorded. The following postoperative complications were observed: fistulas in esophagojejunal anastomosis (8x), duodenal stub fistula (lx), subphrenic abscess (2x), adhesive ileus (1x). In two subjects, esophagojejunal stricture was diagnosed during the late postoperative period. Incisional hernia was diagnosed in two subjects. Two subjects exited- the first one from respiratory failure with ARDS syndrome in esophagojejunal dehiscence, the second subject died of hepatorenal failure in liver cirrhosis. Complications cannot be excluded in any surgical procedure. Should they occur, their timely diagnosis and adequate treatment is required.
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PMID:[Gastric carcinoma--rates and management of surgical treatment complications]. 2051 13