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)

Concentrations of apoprotein A in whole serum, and cholesterol and phospholipids concentrations in the high-density lipoprotein fraction of serum were measured after the precipitation of low-density and very-low-density lipoproteins with sodium phosphotungstate-Mg2+ in 23 patients with liver cirrhosis, 19 patients with extrahepatic biliary obstruction, and 20 healthy control subjects. Patients with cirrhosis and cholestasis showed approximately one-half as much cholesterol and apoprotein A in the nonprecipitable high-density lipoprotein fraction as normal subjects did. High-density lipoprotein phospholipids concentrations in those patients were normal or slightly increased, however, which is about double what one would expect from the apoprotein A and cholesterol content.
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PMID:High-density lipoprotein cholesterol and phospholipids, and apoprotein A in serum of patients with liver disease. 706 98

A middle-aged woman with evidence of chronic cholestasis of several years and no previous abdominal surgery was initially thought to have primary biliary cirrhosis. Clinical evaluation disclosed a well-developed secondary biliary cirrhosis apparently caused by extrahepatic obstruction due to a 1 X 2 cm neoplasm of the periampullary duodenum. Electron microscopy and immunofluorescent studies showed the neoplasm to be a G-cell adenoma. Wide local excision has resolved the biliary obstruction. Bening or slow-growing duodenal tumors, if they involve the ampulla of Vater, may produce prolonged partial extrahepatic obstruction and secondary biliary cirrhosis.
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PMID:Gastrin-secreting tumor of the duodenum (G-cell apudoma) associated with secondary biliary cirrhosis. 707 77

The sera of 15 patients with liver disease and high serum concentrations of secretory component (SC) were analyzed by density gradient ultracentrifugation and radioimmunoassays for SC, IgA, and IgM to determine the molecular state of SC and IgA. Results in serum were compared to those obtained by simultaneous analysis of bile in five of the patients, and to those in serum and bile of a case of total IgA deficiency. Free SC was virtually not found in sera, although it was well represented in all bile, up to 88 and 97% of total bile SC in a case of complete biliary obstruction and in IgA deficiency, respectively. IgM-bound SC was found in all sera, amounting to 91% and 100% of total serum SC, respectively, in a case of acute hepatitis with a very high serum IgM concentration and in IgA deficiency. The proportions of SC bound to IgM and to polymeric IgA (p-IgA) in the sera correlated with their IgM/p-IgA molar ratio. This suggests that during liver disease, the hepatobiliary tissues could release free SC into the circulation, where it binds to p-IgA and IgM according to their respective concentrations and affinities for SC. The proportion of p-IgA in serum was not increased in four cases of biliary obstruction, in contrast to our cases of cirrhosis and acute hepatitis, indirectly supporting a minor transfer of p-IgA from blood to bile in humans, in contrast to rats and rabbits.
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PMID:Serum IgM-bound secretory component (sIgM) in liver diseases: comparative molecular state of the secretory component in serum and bile. 708 27

Thirty-six patients were referred to the Liver Unit between 1971 and 1980 after unsuspected liver disease had been found at laparotomy. The preoperative diagnosis had been extrahepatic biliary obstruction in 16 patients and intra-abdominal malignancy in 15. Misdiagnosis resulted from insufficient attention to the history and physical signs in 31 patients and omission or misinterpretation of liver function tests and of other hepatobiliary investigations in the remaining 5 patients. The morbidity and mortality of the 36 patients within 1 month of operation was 61 per cent and 31 per cent respectively. All patients with viral or alcoholic hepatitis died, and severe complications, which included bacterial peritonitis, wound dehiscence and hepatic failure, developed in 13 of 15 in whom ascites due to cirrhosis or the Budd-Chiari syndrome was present before operation.
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PMID:Adverse effects of exploratory laparotomy in patients with unsuspected liver disease. 710 30

In order to determine the effects of intraoperative radiation therapy of the bile duct and surrounding tissues, seven adult dogs were subjected to laparotomy and intraoperative irradiation with 11 MeV electrons. Two animals were treated at each dose level of 2000, 3000, and 4500 rads. A single dog which received a laparotomy and sham irradiation served as a control. The irradiation field consisted of a 5 cm diameter circle encompassing the extrahepatic bile duct, portal vein, hepatic artery, and lateral duodenal wall. The animals were followed clinically for mor than 18 months after treatment, and autopsies were performed on dogs that died to assess radiation-induced complications or tissue damage. All dogs developed fibrosis and mural thickening of the common duct, which appeared by 6 weeks following irradiation and which was dose-related, being mild at low doses and more severe at high doses. Hepatic changes were seen as early as 6 weeks after irradiation, consisting of periportal inflammation and fibrosis. The hepatic changes appeared earliest at the highest doses. Frank biliary cirrhosis eventually developed at all dose levels. Duodenal fibrosis appeared in the irradiation portal, being most severe at the highest doses and in some animals resulting in duodenal obstruction. No changes were observed in irradiated portions of portal vein and hepatic artery at any dose level. It was concluded that intraoperative radiation therapy delivered to the region of the common duct leads to ductal fibrosis, partial biliary obstruction with secondary hepatic changes, and duodenal fibrosis if bowel wall is included in the field. Clinical use of intraoperative radiation therapy to the bile duct in humans may require routine use of biliary and duodenal bypass to prevent obstructive complications.
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PMID:Tolerance of bile duct to intraoperative irradiation. 711 2

Fibrosis of chronic pancreatitis can cause obstructive jaundice by compressing the intrapancreatic portion of the common bile duct. The frequency and clinical manifestations of common bile duct stricture from symptomatic chronic pancreatitis have been evaluated in 26 patients undergoing lateral pancreaticojejunostomy for intractable pain between 1974 and 1980. Four patients (15%) had a stricture with partial obstruction of the common duct in addition to pancreatic duct obstruction. Three of the four strictures were identified prior to operation by ERCP. The fourth developed biliary obstruction six months after pancreaticojejunostomy. Slight elevation of alkaline phosphatase was common and occurred in 12 of 22 patients with chronic pancreatitis without biliary obstruction. Alkaline phosphatase was elevated greater than four times normal in three of the four patients with a biliary stricture. Elevation of total and direct serum bilirubin occurred only in patients with stricture of the distal common duct. A waxing and waning picture of jaundice was seen in these four patients. When a fixed smooth stricture of the common duct is demonstrated in a patient with symptomatic chronic pancreatitis, drainage of the biliary tree should be combined with pancreatic duct drainage in order to prevent cholangitis, biliary cirrhosis, diagnostic confusion with pancreatic carcinoma, and persistence of pain.
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PMID:common duct obstruction in patients with intractable pain of chronic pancreatitis. 711 5

Cytotoxic effect of excessive copper in the liver of the dogs with longstanding obstructive jaundice were investigated. Common bile duct was ligated in adult mongrel dogs for a period of 21 to 93 days. Copper (0.5 mg/kg weight, every other day) was administered intravenously. Copper content and morphologic changes of the liver was compared with those of the common bile duct ligated dogs without copper administration and of the normal control. Liver copper content was quantitated by atomic absorption spectrophotometry and morphologic investigation was carried out ultrastructurally and histochemically (dimethylaminobenzylidine rhodanine stain for copper and orcein stain for copper associated protein). The copper content of the liver was 57 +/- 8.75 microgram/g wet weight (mean +/- S.E.) in the normal control, 80.84 +/- 15.76 in the common bile duct ligated dogs and 463.46 +/- 76.42 in the common bile duct ligated dogs with copper administration. There was a significant increase (p less than 0.01) of the liver copper content in the common bile duct ligated dogs with copper administration but not in the common bile duct ligated dogs without it. Histologically, the liver showed changes of longstanding cholestasis and of early biliary cirrhosis in the dogs over three months after ligation. Ultrastructurally, both groups showed dilatation of bile canaliculi with decreased and swollen microvilli protruding into their lumina, expanded pericanalicular ectoplasm with increased microfibrils and various forms of intracanalicular and intracytoplasmic bile assuming myelin-figure, crystalloid and dense-amorphous appearances. Also present were increased and dilated smooth-surfaced endoplasmic reticulum, mitochondria showing curled cristae with electron dense ground substance and decreased microvillous projections of hepatocyte cell membranes into Disse's space. Only significant morphologic difference between two groups was the presence of copper-protein complex demonstrated by rhodanine and orcein stains as intracytoplasmic coarse granules in the common bile duct ligated dogs with copper administration. These copper-protein complex granules correspond to partially membrane-bound dense bodies seen ultrastructurally, which probably represent autophagic vacuoles or lysosomal residual bodies. Above result suggests that excessive copper accumulated in the liver as lysosomal bodies in longstanding extrahepatic biliary obstruction with copper loading does not produce significant liver cell injury despite eight fold increase of the liver copper content.
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PMID:Copper and liver injury--experimental studies on the dogs with biliary obstruction and copper loading. 712 50

Alcohol-induced chronic pancreatitis involving the head of pancreas may have profound effects on the hepatobiliary system. The natural history, complications, and management of the syndrome are presented, using selected cases to emphasize important features. Chronic pancreatitis can cause mechanical obstruction to both the distal common bile duct and the proximal pancreatic duct. In the common bile duct this will result in proximal dilatation above the stenosis with bile stasis. Possible sequelae are ascending cholangitis, cholecystitis, biliary calculi formation, and secondary biliary cirrhosis. The mechanical effects of stricture of the proximal pancreatic duct may exacerbate pancreatic dysfunction. The clinicopathological spectrum of chronic pancreatitis with biliary obstruction encompasses three clinical types--"transient," "recurrent", and "persistent." The widespread effects of the syndrome are evident from the involvement of pancreas, proximal pancreatic duct, papilla of Vater, liver, peripheral biliary tree, common bile duct, gallbladder, and reticuloendothelial system. Essential to management is surgery which should be considered when there is objective evidence of obstruction to the common bile duct. Choledochoduodenostomy is the preferred type of operation. If dilatation is mild and jaundice transient, conservative therapy with careful observation is advocated.
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PMID:Chronic pancreatitis and the hepatobiliary system. 713 42

Failure of early diagnosis of biliary atresia results in the development of cirrhosis and death. Commonly used hepatobiliary agents are not ideal for follow-up studies because of their unfavorable physical properties or short half-life. The excellent physical properties of Ru-97 should overcome these limitations. Therefore, Ru-97 PIPIDA (N,alpha-(p-isopropyl acetanilide) iminoacetic acid) is being investigated as a potential hepatobiliary agent that would allow an improved diagnosis of the disease. Ruthenium-97 PIPIDA and Tc-99m PIPIDA showed similar blood clearance rates in dogs. Ru-97 PIPIDA scintigrams in dogs showed early uptake in liver and gallbladder and slow excretion through the gastrointestinal tract. Biodistribution studies were performed in normal rats and rats with biliary obstruction. The findings suggest that Ru-97 PIPIDA should be useful for delayed studies (1-3 days) of the biliary tract.
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PMID:Ruthenium-97 hepatobiliary agents for delayed studies of the biliary tract. I. ru-97 PIPIDA: concise communication. 720 82

Serum activity of glutathione reductase (GR), glucose phosphate isomerase (GPI), aspartate aminotransferase (AST), alanine aminotransferase (ALT) phosphate alkaline (PAL), and gamma-glutamyl transferase (GGT) was studied in 142 patients, in all serum bilirubin was more than 2 mg/dl. Distribution was as follows; 68 cirrhosis of the liver; 27 acute hepatitis; 31 benign extra-hepatic biliary obstruction; and 16 neoplastic obstruction of the biliary tract without liver metastasis. Fifty-three healthy volunteer blood donors were used as the control group. Mean values for GR activity in our patients were significantly higher than those for the control group, although less so in benign obstruction (p less than 0.01) than in those with acute hepatitis (p less than 0.001), cirrhosis (p less than 0.01) and neoplasic biliary obstruction (p less than 0.001). The GPI values were higher than the control groups in patients with acute hepatitis (p less than 0.001) and obstructive neoplastic jaundice (p less than 0.02). In cases with cirrhosis, 87% presented slightly higher values of GR, while GPI was within normal levels in 93 % of all cases. In patients with acute hepatitis, 92% showed a definite increase in GPI and GR values. In 71% of those with benign biliary obstruction levels for both enzymes were normal, as they were in only 6% of those with obstructive neoplastic jaundice. These findings are statistically significant in all cases and of diagnostic value in establishing a differential enzymatic diagnosis in patients presenting with clinical and biological patterns of cholestasis.
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PMID:[Determination of serum activity of glucose phosphate isomerase and glutathione reductase in intra and extra hepatic cholestasis.(author's transl)]. 732 37


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