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)

The relationship between high-density lipoproteins (HDL) in plasma and hepatic structure and microsomal function has been investigated in 54 patients undergoing diagnostic liver biopsy. Plasma HDL cholesterol and major apoproteins were correlated with hepatic histology and microsomal enzyme activity assessed directly as liver cytochrome P-450 concentration and indirectly by plasma antipyrine clearance rate. HDL cholesterol, the concentrations of apoproteins A-I and A-II, the HDL cholesterol/total cholesterol ratio and cytochrome P-450 were low in subjects with moderate or severe hepatic fatty infiltration or cirrhosis when compared with the values for subjects with a normal live. HDL cholesterol and apoprotein A-I and the HDL cholesterol/total cholesterol ratio were directly proportional to the amount of non-fatty parenchyma in the livers. Subjects with a normal liver undergoing treatment with enzyme-inducing drugs, such as phenytoin, phenobarbital and primidone, had higher HDL cholesterol, apoproteins A-I and A-II, HDL cholesterol/total cholesterol ratio, cytochrome P-450 and antipyrine clearance rate than subjects not receiving such therapy. Treatment with inducers appeared to have compensated for the effect of liver disease in lowering plasma HLD. In the entire population, and also in subjects not taking inducing drugs, when considered separately, plasma HDL cholesterol, apoproteins A-I and A-II and the HDL cholesterol/total cholesterol ratio were significantly correlated with cytochrome P-450 concentration. In subjects on enzyme inducers, HDL cholesterol and apoprotein A-I levels and the HDL cholesterol/total cholesterol ratio were proportional to the magnitude of the induction. Serum triglycerides were inversely proportional to the measures of liver microsomal enzyme activity. The lipoprotein pattern, high HDL cholesterol and apoproteins A-I and A-II, and high HDL cholesterol/total cholesterol ratio that accompany microsomal induction are characterized by a reduced risk of atherosclerotic vascular disease and a prolonged expectation of life. The plasma changes presumably reflect the effect of enzyme inducers, such as phenytoin and phenobarbital on hepatic lipids and proteins.
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PMID:Plasma high-density lipoproteins and hepatic microsomal enzyme induction. Relation to histological changes in the liver. 717 98

Pulmonary arterial hypertension with severe pulmonary vascular disease is a rare association of portal hypertension in man, be it the result of cirrhosis of the liver or obstruction of the portal vein. We induced portal hypertension in 23 rats by partially ligating the portal vein or by totally occluding it in two stages. The rats were killed between one and 15 months after operation. A collateral circulation of varicose, anastomotic vessels was established, and in six animals well-marked oesophageal varices developed. Despite this evidence of sustained portal hypertension, hypertrophy did not develop in the right ventricle or in the media of the pulmonary trunk or muscular pulmonary arteries in any of the animals. This suggests that mechanical obstruction of the portal vein per se is not responsible for the development of pulmonary hypertension. Other factors, perhaps of a humoral nature, appear to be required to induce this rare association of portal hypertension but we have been unable to identify these. In particular, blood levels of oestrogen were not raised after ligation of the portal vein.
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PMID:Observations on the rare association between portal and pulmonary hypertension. 726 72

Anatomopathologic diagnosis were studied in a series of 500 clinical autopsies (440 adults and 9 children between 1 and 14 years old). Cancer was the most frequent cause of death (27.7%) followed by infectious processes (26.9%) divided between respiratory infections (14.3%), non-respiratory (8.8%) and tuberculosis (3.8%). Vascular disorders accounted for 25.2% and cirrhosis for 10.2%. The diagnosis of cancer were incorrect in 28.8%, of those, 16% were over-assessed and 12.8% under-assessed. Cancer was multiple in 2.7% of all cases, hepatic cancer was found in 17.6% of cirrhosis cases and in 11% of all cases, thromboembolism of different degree was seen.
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PMID:[Analysis of a series of 500 clinical post mortem studies. II. Basic diagnosis (author's transl)]. 732 38

The clinical and pathologic findings are reported in seven consecutive patients with progressive and fatal pulmonary hypertension which was not explained by predisposing cardiac or pulmonary diseases. Pulmonary arterial lesions consisted of atherosclerosis of the elastic pulmonary arteries, and medial hypertrophy and concentric laminar fibrosis of the muscular pulmonary arteries in seven patients, plexiform lesions in six patients and necrotizing vasculitis in one patient. Pulmonary emboli were not identified. Five patients had manifestations of autoimmune disease, including laboratory abnormalities (positive antinuclear antibody, positive latex agglutination for rheumatoid factor, hypergammaglobulinemia or antimitochondrial antibody) in four, necrotizing vasculitis in one, Raynaud's phenomenon in two and clinical evidence of multisystem collagen vascular disease in two. Five patients had liver disease which developed prior to or concomitant with the onset of pulmonary hypertension. At autopsy, one patient had prominent periportal fibrosis and four had macronodular (postnecrotic) cirrhosis (active in three and inactive in one). Four of these five patients with liver disease and pulmonary hypertension had evidence of autoimmune phenomena. The findings in the seven patients suggest an association between autoimmune disease, plexogenic pulmonary hypertension and liver disease of the chronic active hepatitis-postnecrotic cirrhosis type.
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PMID:Severe pulmonary hypertension associated with macronodular (postnecrotic) cirrhosis and autoimmune phenomena. 742 41

This paper presents a review of the literature on hepatic circulation and circulatory disorders of the liver in the dog and cat, and also includes a number of our own not previously published data. Circulatory disorders of the liver are frequently observed in dogs and cats. These disorders can be divided into congenital portosystemic shunts, disorders associated with outflow disturbances, and disorders associated with portal hypertension. Outflow disturbances result in passive congestion of the liver and in both species are mainly due to cardiac failure. Portal hypertension with resultant portosystemic collateral circulation and ascites mainly results from chronic liver disease, particularly cirrhosis. The main vascular disorder resulting in portal hypertension and ascites in the dog is primary hypoplasia of the portal vein.
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PMID:Circulatory disorders of the liver in dogs and cats. 757 Dec 84

Portal hypertensive gastropathy is a vascular disorder of the gastric mucosa distinguished by ectasia of the mucosal capillaries and submucosal veins without inflammation. During 1988 to 1993, 12 patients with biopsy-proven cirrhosis (10 alcoholic, 2 posthepatitic) were evaluated and treated prospectively by portacaval shunt for active bleeding from severe portal hypertensive gastropathy. Eleven patients had been hospitalized for bleeding three to nine times previously, and one was bleeding uncontrollably for the first time. Requirement for blood transfusions ranged from 11 to 39 units cumulatively, of which 8 to 30 units were required specifically to replace blood lost from portal hypertensive gastropathy. Admission findings were ascites in 9 patients, jaundice in 8, severe muscle wasting in 10, hyperdynamic state in 9. Child's risk class was C in 7, B in 4, A in 1. Ten of the 12 patients had previously received repetitive endoscopic sclerotherapy for esophageal varices, which has been reported to precipitate portal hypertensive gastropathy. Eight patients had failed propranolol therapy for bleeding. Portacaval shunt was performed emergently in 11 patients and electively in 1, and permanently stopped bleeding in all by reducing the mean portal vein-inferior vena cava pressure gradient from 251 to 16 mm saline. There were no operative deaths, and two unrelated late deaths after 13 and 24 months. During 1 to 6.75 years of follow-up, all shunts remained patent by ultrasonography, the gastric mucosa reverted to normal on serial endoscopy, and there was no gastrointestinal bleeding. Recurrent portal-systemic encephalopathy developed in only 8% of patients. Quality of life was generally good.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Treatment of bleeding from portal hypertensive gastropathy by portacaval shunt. 770 94

We had already made a report on outcome of schizophrenia (1986). The patients, 129 typical schizophrenia, were continuously observed over 30 years in the Kawagoe Dojinkai Hospital. Recently, we again evaluated their prognoses according to the same criteria as adopted in the first report, and divided them into the following five groups. [symbol: see text]: completely remitted group (21 persons, 16.3%), [symbol: see text]: almost remitted cases now holding jobs (23 persons, 17.8%), [symbol: see text]: Slightly remitted group showing good adjustment at home or hospital (41 persons, 31.8%), [symbol: see text]: maladjusted cases always showing an unfavorable condition (25 persons, 19.4%), x : incurable cases (19 persons, 14.7%). 1) In the last 8 years, there were 30 persons (23.3% of the whole patients) who showed prognostic changes (10 persons improved, 20 persons worsen). While the second group ([symbol: see text]) has seen fewer persons (12 persons down) than previous study, the third group ([symbol: see text]) has seen more persons (9 persons up). Each three groups, that is, the first two groups ([symbol: see text] + [symbol: see text], 44 persons, 34.1%), the third group ([symbol: see text], 41 persons, 31.8%), and the forth and fifth groups ([symbol: see text] + x, 44 persons, 34.1%) accounted for a third of the whole patients. It is after 32 years on the average (extending from 21 to 50 years) from the onset of illness that they showed prognostic changes. 2) Generally speaking, catatonic patients had favorable prognoses, hebephrenic patients unfavorable ones, and paranoid patients medium ones. But 4 improved persons in the forth and fifth groups were all hebephrenic type. 3) 17 among the 30 persons who showed prognostic changes were unstable type. They took a wave-like course. 4) 27 of all the 129 patients were dead. 25 were dead from disease mentioned below. Malignancy (8 persons), Cerebral vascular disease, Pneumonia and Diabetes (3 persons), Heart-failure (2 persons), Ileus, Myocardial infarction, Hepato-cirrhosis, Gastric ulcer, Tuberculosis and Natural death (1 person). 2 persons committed suicide. 5) Outcome of 45 patients who discontinued our medical therapy became clear as follows. [symbol: see text] + [symbol: see text]: 18 persons (40.0%), [symbol: see text]: 9 persons (20.0%), [symbol: see text] + x : 18 persons (40.0%). A smaller percentage of the patients belongs to the third group ([symbol: see text]) than that of our patients who were continuously followed by us.
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PMID:[Outcome of schizophrenia--extended observation (more than 30 years) of 129 typical schizophrenic cases [III]]. 773 53

The hepatopulmonary syndrome results from erythrocytes bypassing the lung without oxygenation. In addition to ventilation-perfusion mismatching, the hypoxemia may result from portapulmonary shunting, passage around alveoli through pleural and hilar blood vessels, and intrapulmonary vascular dilatations. Dilated vascular channels between arteries and veins on the pleural surface are seen more often than dilated intrapulmonary capillaries in chronic liver disease. These anastomoses appear grossly as vascular "spider nevi" on the pleura. Portal vein-to-pulmonary vein anastomoses could produce arterial hypoxemia because the deoxygenated portal venous blood can mix with oxygenated pulmonary venous blood. There is an association of esophageal varices with the hepatopulmonary syndrome and anastomoses between the portal veins and pulmonary veins have been found in both animals and humans. As portal pressures increase, the mediastinal veins enlarge, enhancing the chance that they may penetrate the pleura and drain into pulmonary veins. Direct splenic injections in patients, however, suggest that this shunt pathway is uncommon and small. Pulmonary artery injection studies have demonstrated dilated intrapulmonary vascular segments in humans and animals. Dilation of capillaries may allow a more rapid flow through the lung and the greater distance between the erythrocyte and alveolar wall may make it more difficult to oxygenate rapidly passing erythrocytes. Pulmonary capillary dilation can explain the abnormalities of the perfusion lung scan and contrast echocardiogram that portapulmonary shunting cannot. Pulmonary hypertension may occur in chronic liver disease even without arterial hypoxemia, but it is rare. The prevalence of hypertensive pulmonary vascular disease in patients with cirrhosis of the liver is less than 1%, although a higher percentage (2%) has been found when patients with portal hypertension were studied by cardiac catheterization. The hypertensive pulmonary vascular disease (pulmonary arteriopathy with plexiform lesions) that occurs in patients with liver disease appears identical to that encountered in patients with congenital cardiac shunts and unexplained (primary) pulmonary hypertension.
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PMID:Structural and pathologic changes in the lung vasculature in chronic liver disease. 866 83

Twenty-eight patients (aged: 44-76 years) with liver cirrhosis secondary to chronic hepatitis were included in this study. None of the patients had a history of gastric surgery, diabetes, hypothyroidism, or neurological or collagen vascular disease. The patients were divided into groups based on the presence or absence of the following conditions: (1) ascites, (2) splenomegaly, (3) esophageal varices. Radionuclide labelled solid meals were used to evaluate gastric emptying (GE). GE was represented by the gastric retention ratio of the solid meal at 90 min (RR90), and calculated by the following formula: RR90 = residual radioactivity within the region of interest (ROI) covered the whole stomach at 90 min divided by the initial radioactivity within the ROI at 0 min. The RR90 values of the patients were compared with the RR90 values of 25 normal control volunteers. If the RR90 was more than two standard deviations (SD) above the mean of the control group (> 0.687), GE was defined as abnormal. The results showed 71% (20/ 28) of the cirrhotic patients had abnormal GE. Patients with ascites, splenomegaly, or esophageal varices had higher RR90 values than patients without ascites, splenomegaly or esophageal varices. The differences in RR90 among patients with and without ascites, and patients with and without splenomegaly, were not significant (P values > 0.05). However, there were significant differences among the 2 patient groups separated according to the presence or absence of esophageal varices (P values < 0.05). In addition, poor correlations (R square values < 0.01) were found for RR90 and serum values of bilirubin and albumin.
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PMID:Abnormal gastric emptying in patients with liver cirrhosis. 867 34

Our objective was to analyze the survival of diabetic patients on renal replacement therapy and to compare their survival on extracorporeal and on peritoneal dialysis. All data regarding diabetic patients admitted to dialysis between 1 January 1983 and 31 December 1993 were collected by means of individual patient questionnaires sent to all of the 44 regional Renal Units (100% answers) of Lombardy, Italy. Cox proportional hazards model, stepwise procedure, was applied in order to select the covariates significantly associated with survival. Age (at baseline), sex, type of diabetes, initial modality of treatment (hemodialysis or peritoneal dialysis), and initial clinical risk factors (malignancies, serious heart disease, vascular disease, cirrhosis of the liver, cachexia) were considered. Descriptive analysis of survival was performed using the Kaplan-Meier technique. The survival of all diabetic patients (895) was 86.5% at one year, 52% at three years, and 34% at five years. The main causes of the 488 deaths of diabetic patients were cardiovascular diseases (56%), cachexia (18%), and infections (11%). The relative death risk of patients on peritoneal dialysis versus those on hemodialysis, after taking into account the main comorbid conditions, did not significantly differ from 1, as estimated by the Cox proportional hazards regression model. Five-year survival of diabetic patients was 34%, and no differences were found between peritoneal dialysis and hemodialysis as far as mortality is concerned.
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PMID:Survival of diabetic patients on peritoneal dialysis or hemodialysis. 872 8


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