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 origin of biliary epithelial cells (BEC) lining hyperplastic bile ductules in the liver in biliary disease is uncertain. Depending on the underlying condition, the hyperplastic BEC may arise by multiplication of existing BEC, transdifferentiation of liver cells to BEC or by both mechanisms. Using histological, autoradiographic and immunohistochemical techniques, the development of these ductules was assessed in rats following total biliary obstruction (TBO) for periods of up to 50 days. Histologically, a biliary cirrhosis developed after 21 days. Apoptosis was observed in both liver cells and BEC at all stages following TBO, and focal involution of hyperplastic ductules by this mode of cell deletion was noted at 50 days. The 3H-thymidine labelling index was approximately 25 times greater (p less than 0.0005) than control values in both liver cells and BEC at all stages following TBO, reaching peak values at 48 h of 6.07 +/- 0.82% for liver cells and 15.99 +/- 1.47% for BEC. In sections stained by the immunoperoxidase technique and using a prekeratin antiserum to identify BEC, an increase in the number of canals of Hering was observed at days 7 and 21. An intermediate-type cell possessing the morphological appearance of a liver cell and expressing prekeratin antigens was seen in an occasional canal of Hering. On the basis of the high cell replication rate of liver cells and BEC and the very occasional intermediate-type cell, it was concluded that hyperplastic BEC are derived essentially from existing BEC by cell division. The contribution to the BEC pool from an intermediate cell type within the canals of Hering was small.
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PMID:Origin and involution of hyperplastic bile ductules following total biliary obstruction. 235 54

A case of hepatoma presenting as extrahepatic biliary obstruction due to hemobilia is reported. The patient, a 49-year-old woman, developed jaundice of the obstructive type after a history of B-viral hepatitis. On laparotomy, the liver revealed macronodular cirrhosis without any noticeable mass. A 4-cm sized friable tissue and blood clots were identified within the distended left hepatic duct. Pathologic examination of this tissue confirmed the diagnosis of hepatocellular carcinoma extended in the hepatic duct.
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PMID:Hepatoma presenting as extrahepatic biliary obstruction due to hemobilia. 256 May 94

In 18 horses there was no effect of age or sex on plasma activities of gamma-glutamyl transferase (gamma-GT), 5'-nucleotidase (5'-NT) and leucine aminopeptidase (LAP). All the enzymes were equally stable after storage for one month at -20 degrees C and there was no significant difference between their activities in serum and plasma in clinically normal horses. The pattern of release of gamma-GT, 5'-NT and LAP into plasma was studied in 114 horses which had a variety of orthopaedic, gastrointestinal, cardiovascular and hepatic (necrosis, lipidosis, neoplasia and cirrhosis) conditions. A definitive diagnosis of hepatic disease was established by histological examination of the liver. gamma-GT and 5'-NT were leaked into plasma in hepatic disease and gamma-GT was the more sensitive indicator of liver damage. There was some evidence that gamma-GT and 5'-NT plasma activities may increase in hepatic necrosis as well as in biliary obstruction. LAP was insensitive and not hepatic specific in the horse.
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PMID:Observations on gamma-glutamyl transferase, 5'-nucleotidase and leucine aminopeptidase activities in the plasma of the horse. 256 9

Endoscopic therapy was attempted in 24 patients with spontaneous or postoperative persistent biliary fistulas. Endoscopic retrograde cholangiography demonstrated the site of the fistula in 22 cases. Sphincterotomy or biliary stent placement resulted in rapid resolution of the fistula in 16 of 24 patients. Failures were attributed to exclusion of the injured intrahepatic bile duct in two cases, insufficient dilation of a bile duct stricture in one, the large size of the bile duct defect in two, and associated lesions in three (cirrhosis, arterial trauma, subhepatic abscess). Endoscopic management of biliary fistulae requires: (1) visualization of the location of the fistula by retrograde cholangiography especially in case of an intrahepatic lesion, (2) prior percutaneous drainage of associated subhepatic or subphrenic abscesses, and (3) appropriate relief of distal biliary obstruction in order to reduce the intraductal biliary pressure. The outcome is uncertain when endoprostheses are used to bridge large bile duct defects.
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PMID:Endoscopic treatment of biliary tract fistulas. 259 91

One hundred thirty-one consecutive infants with biliary atresia were operated on during the 15-year period between 1973 and 1988. Six patients did not have biliary reconstruction because of advanced cirrhosis or transplant preference. The other 125 infants had excision of all nonpatent extrahepatic bile ducts; biliary drainage was provided by a gallbladder-common bile duct conduit in 14 patients and by a Roux-en-Y portoenterostomy in 111 infants (including the seven patients with correctable biliary atresia). The bilioenteric conduit was temporarily exteriorized and, for the past 2 years, a conduit intussusception valve was incorporated. Immediate postsurgical bile drainage was achieved in 103 infants (82%). Reoperation during the first 6 postoperative weeks restored bile flow in 14 of 18 infants who had shut down. Seventy-two patients (57%) had sustained (more than 1 year) relief of biliary obstruction. Postoperative morbidity was substantial. The six children not having corrective surgery died within 19 months. Three patients were lost to follow-up. Sixty-eight patients having Kasai's operation died, 55 from complications of liver disease, 1 from a coexisting malformation, and 12 after liver transplantation. Fifty-seven patients are alive, 13 by virtue of liver replacement, 9 with mild-to-moderate hepatic sequelae, and 35 (28%) with normal to near-normal liver function. Although none is considered "cured," the 35 children are anicteric, have normal growth and development, and participate in full school activities (including contact sports). Average follow-up is 85.8 months (range 1 to 15 years).
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PMID:The surgery of biliary atresia. 267 83

Thirty nine patients undergoing surgery for chronic pancreatitis were investigated for evidence of hepatobiliary disease. In addition to pre-operative assessment by liver function tests, ultrasound, ERCP (in 33) and percutaneous transhepatic cholangiography (in five), all had peroperative liver biopsy. Common bile duct stenosis was diagnosed in 16 (62%) of the 26 patients with successful cholangiography. Features of extrahepatic biliary obstruction were found on biopsy in 11 patients, three of whom showed features of secondary sclerosing cholangitis. No patients had secondary biliary cirrhosis. Three had parenchymal liver disease (cirrhosis, resolving hepatitis and alcoholic hepatitis respectively) and two others had features suggestive of previous alcohol-induced injury. Five (83%) of the patients with clinical jaundice had biopsy features of extrahepatic biliary obstruction, as did eight (67%) with alkaline phosphatase above twice normal and seven (44%) with radiological common bile duct stenosis. Neither alkaline phosphatase rise, nor common bile duct stenosis alone or in combination, were a reliable indication of the need for biliary enteric bypass surgery. Pre-operative liver biopsy may be a valuable adjunct in the assessment of such patients.
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PMID:Hepatobiliary complications in chronic pancreatitis. 271 85

The case of a 27-year-old man who became symptomatic for a choledochal cyst at the age of 6 months is presented. Treatment of this patient mirrored the major surgical procedures recommended in the literature over the patient's lifetime. The surgical procedure that seems to be curative is excision of the cyst with Roux-Y hepaticojejunostomy. This procedure eliminates the major complications of this disease, which are biliary obstruction, ascending cholangitis, biliary cirrhosis, malignant degeneration, and, occasionally--as in this patient--erosive ulceration with bleeding.
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PMID:Surgical procedures for choledochal cysts. 278 95

In a 33 years old woman an orthotopic liver transplantation was performed because of an endstage posthepatic liver cirrhosis. Postoperatively the unconjugated bilirubin levels remained elevated although liver enzyme values were within normal range. Because hemolysis, rejection, infection or biliary obstruction could be excluded we suspected a Gilbert's Syndrome and were able to confirm this diagnosis by low caloric intake and nicotinic acid test. This case report therefore describes the first time the transplantation of a clinically harmless metabolic disorder but inborn error of metabolism by liver grafting into the recipient.
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PMID:[Manifestation of Gilbert syndrome (Meulengracht disease) following orthotopic liver transplantation: a rare cause of postoperative hyperbilirubinemia]. 285 Apr 4

Increased levels of octopamine in adrenergic nerve terminals and plasma have been implicated in the circulatory and renal disturbances of chronic hepatic failure. Little is known about its renal actions in normal animals. In the present study, DL-octopamine was administered both i.v. and into one renal artery of anaesthetized dogs in doses ranging between 25-200 micrograms/min (1.6-20 micrograms/kg/min). Octopamine was hypertensive in doses of 100 micrograms/min and more and this change was associated with a significant decrement in GFR and renal perfusion. This amine also exerted a direct tubular effect since decreased excretion of sodium and water occurred in the absence of blood pressure or renal perfusional changes when given i.v. When given into one renal artery octopamine produced only an ipsilateral antidiuresis and antinatriuresis, in the absence of any change to GFR or renal perfusion. Lithium clearances suggest that octopamine acts beyond the proximal tubule in altering the tubular reabsorption of salt and water. Because octopamine was found to increase blood pressure in the presence of a hypertensive infusion of noradrenaline, it is likely that this amine exerts a primary pharmacological effect rather than liberating noradrenaline from nerve terminals. Saline expansion (7% body weight), acute biliary obstruction, chronic cirrhosis with ascites, and chronic thoracic caval constriction with the production of ascites all abolish the effect of octopamine when administered at 100 micrograms/min. Though octopamine may directly influence renal perfusion, its possible role in liver disease remains uncertain.
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PMID:Effects of octopamine on renal function in anaesthetized dogs. 314 28

1. Young and adult rats subjected to complete bile duct ligation from 4 to 40 days revealed different liver histopathologies at the end of the experimental period. 2. In young rats, ductal and ductular proliferation resulted in septal fibrosis which, originating from the portal spaces, tended to delimit areas of nodular parenchymal transformation (secondary biliary cirrhosis). In adult rats, proliferating ductal and ductular structures diffusely invaded the hepatic parenchyma, dissociating the liver cell plates in a pattern similar to that of a malignant neoplastic growth. 3. The different result of the lesions in young and old rats suggests that an age-related factor may be involved in the pathogenesis of lesions resulting from biliary obstruction.
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PMID:Differences in hepatic pathology resulting from bile duct obstruction in young and old rats. 317 83


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