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)

Total lactate dehydrogenase (LD; EC 1.1.1.27) and its five isoenzymes were determined in sera from (a) 98 cases of cirrhosis at various stages classified according to Child and Turcotte; (b) 37 cases of hepatocarcinoma (HC) at different stages of the Okuda classification; (c) 17 patients with secondary liver neoplasia (SLN), mainly from an abdominal primary site; and (d) 19 cases of abdominal neoplasia without liver metastasis, in an attempt to contribute to the differential diagnosis between these conditions. LD-4 was enhanced in SLN and LD-5 in HC, thus indicating the LD-4/LD-5 ratio as a potential index with which to differentiate between HC and SLN patients. At a cutoff value of 1.05, 91% of these patients were correctly classified (82% for SLN and 95% for HC). Consequently, this biochemical index appears to be an efficient and rapid indicator to distinguish HC from SLN. On the other hand, the LD isoenzymes are unable to discriminate between HC and cirrhosis or between abdominal neoplasia with and without liver metastases.
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PMID:Serum lactate dehydrogenase isoenzyme 4/5 ratio discriminates between hepatocarcinoma and secondary liver neoplasia. 165 Nov 82

16 patients (14 males, 2 females, mean age: 59.2 years) underwent sonographic-guided ethanol injections as treatment for 23 hepatocellular carcinomas (HCC) complicating cirrhosis. All lesions were pathologically proven by sonographic-guided cytology. Tumor sizes ranged from 9 to 66 mm. Sterile 96% alcohol was injected with a 17.7 cm-long 22 gauge spinal needle at one week intervals. At each session, 8-50 ml was injected depending on the diameter of the tumor. We regarded as a "success" the negativation of the cytologies one, two and three months after the end of the treatment associated with normalization of alpha-fetoprotein levels and typical echographic and tomodensitometric changes. No serious complication was associated with the procedure. In the "Child A" group1, 6 of 7 tumors have been successfully treated, the largest measuring 66 mm. The seventh lesion is currently being treated. In the "Child B" group1 3 of 6 lesions have been successfully treated. No success has been obtained in the "Child C" group. Volumes of alcohol greater than previously reported may be useful for lesions larger than 40 mm. Percutaneous alcohol injections can be considered as an alternative to surgery even for lesions larger than 50 mm. Among 4 patients presenting with 11 liver metastases of colic and gastric adenocarcinoma and 1 patient with a small bowel carcinoid tumor, one remission with a follow-up of 5 months was observed.
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PMID:[Percutaneous ethanol injection of malignant liver tumors under ultrasonographic guidance]. 165 40

During a period of 13 weeks, 45 patients with symptom-producing gall bladder stones (attacks of gall stone colic n = 39 (87%); acute cholecystitis n = 6 (13%)), corresponding to approximately 85% of the total number of gall bladder stone patients during the period were selected for laparoscopic cholecystectomy. Two patients had previously undergone upper abdominal operations and had adhesions and one patient suffered from cirrhosis of the liver with portal hypertension. It proved necessary to convert five of the laparoscopic cholecystectomies to open cholecystectomies (11%) on account of technical difficulties (severe acute changes due to cholecystitis (n = 3), indeterminable anatomical conditions (n = 1) and one case of liver metastases (n = 1)). The median duration of operation was 90 minutes with a range from 30 to 360 minutes. Peroperative cholangiography was not undertaken routinely. No cases of forgotten stones in the common bile duct occurred. No deaths occurred and, in all, three slight complications occurred (7%): two patients had haematoma in the abdominal wall and one patient minimal leakage of bile from the stump of the gall bladder on account of insufficient ligation of the cystic duct. This patient was treated with an endoscopically placed drain in the common bile duct for two weeks, after which she was well. No lesions of the common bile duct occurred. None of the complications required laparotomy. The median duration of hospitalization was 24 hours with a range from one to 14 days. All of the patients were at work or could manage their usual activities after 14 days. The median duration of sick leave was seven days.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Laparoscopic cholecystectomy. The first 45 operations]. 183 52

31P-MR spectroscopy was performed in 12 patients with focal and diffuse liver disease and in ten normal controls, using surface coils. Results so far show a significantly increased concentration of PME/beta-ATP and of PDE/beta-ATP in patients with liver metastases and in one patient with hepatic involvement by malignant lymphoma. The spectra of liver cirrhosis and fatty livers showed no characteristic changes.
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PMID:[In vivo 31-phosphorus magnetic resonance spectroscopy of liver diseases]. 216 78

A report is presented on patients admitted to hospital with chronic hepatitis or alcoholic cirrhosis of the liver and subjected to diagnostic laboratory tests, ultrasound scans and needle biopsies both non-surgical and during laparoscopy. The laboratory findings were compared with the results of ultrasound scans and biopsies. It was concluded that the diagnostic accuracy of ultrasound scans is sufficient, when backed by anamnestic clinical and laboratory data, to obviate the need for liver biopsy in cases of chronic hepatitis and alcoholic cirrhosis. Nor is biopsy required for differential diagnosis between the two conditions but should be reserved for the setting of diagnostic uncertainty about cancer-cirrhosis, or the presence of hepatoma, liver metastases, ascites or other oedematous forms. It is concluded that the undoubled diagnostic accuracy of biopsy does not compensate for the risk entailed especially for patients of this type.
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PMID:[Correlations between laboratory and ultrasonic diagnosis and needle biopsy in chronic hepatitis and alcoholic cirrhosis]. 217 68

Ascitic fluid concentrations of fibronectin, cholesterol and protein were determined in 95 patients: 38 with cirrhosis of the liver, 10 with miscellaneous nonmalignant diseases, 43 with peritoneal carcinomatosis and 4 with liver metastases or hepatocellular carcinoma. Fibronectin, cholesterol and protein at discrimination values of 7.5 mg/100 ml, 45 mg/100 ml and 3.0 g/100 ml, respectively, separated patients with peritoneal carcinomatosis from patients with cirrhosis with an efficiency of 94%, 90% and 85%, respectively. Thus, ascitic fluid determinations of fibronectin and cholesterol offer good discrimination of cirrhotic ascites from ascites related to peritoneal carcinomatosis, superior to the conventional protein determination. However, the failure of all parameters to distinguish ascites caused by miscellaneous nonmalignant diseases from malignancy-related ascites underscores the importance of highly specific methods to confirm a suspected diagnosis of malignancy-related ascites.
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PMID:Ascitic fluid concentrations of fibronectin and cholesterol: comparison of differential diagnostic value with the conventional protein determination. 238 56

HCC occurs infrequently in Western countries, with recent increases being reported in California and parts of Europe. Southeast Asia, Japan, and South Africa continue to have a high incidence of this tumor with HBV, cirrhosis, and the ingestion of aflatoxins being identified as probable risk factors. Although the majority of patients present with abdominal pain or mass indicative of extensive tumor, asymptomatic, small HCCs are being detected with increasing frequency. Early detection in high-risk individuals is best accomplished by screening with serum AFP determinations and liver ultrasonography. CT and arteriography are valuable preoperatively in defining anatomy and determining resectability. Five-year survival following resection for cure of HCC ranges from 20 to 40 per cent, with improved survival reported for small asymptomatic tumors. Resection of metastatic liver tumors from colorectal primaries results in 48 per cent 2-year and 24 per cent 5-year survivals, with an additional 5 per cent dying of recurrent cancer after 5 years. Although patients with simultaneous and metachronous metastases do equally well after resection, the presence of four or more individual deposits adversely affects survival. Hepatic artery ligation or embolization can produce a significant palliative reduction in total tumor mass in patients with unresectable liver metastases. Regional chemotherapy using implantable hepatic artery drug infusion pumps is promising, with reports of prolonged survival compared with historical controls. Regional hyperthermia, laser vaporization of tumor, and cryosurgical techniques may prove to have useful roles in the selective treatment of liver cancer in the future. Orthotopic liver transplantation has been successful primarily in those in whom the malignancy is found incidentally in the chronically diseased liver.
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PMID:Malignant tumors of the liver. 242 9

The actual interest of immunoscintigraphy for the detection of liver tumours was investigated by both visual examination and quantitative analysis in 41 patients with hepatoma (HCC, 21 cases, 13 AFP-secreting), other primary or secondary liver cancer (9 cases), testicular cancer (2 cases) and cancer free cirrhosis (9 cases). All patients were injected with 123I-anti-alphafetoprotein (AFP) monoclonal antibodies (MAbs) and scans were performed after 28 +/- 2 h. In the hepatoma-bearing patients, 11 positive anti AFP scans were found; 9 of them had an enhanced serum; besides, 3 non HCC tumours were also detected. With respect to hepatoma diagnosis, sensitivity was 52.5% and specificity 66.5%. For all hepatomas, it was striking that the positivity rate was 2/10 and 9/11, respectively, when HCC was and was not associated with cirrhosis. Among 6 patients with a positive anti AFP scan who were also injected with control anti hCG 123I-MAb, 5 positive anti hCG scans were surprisingly found, with specificity indices ranging between 1.00 and 1.75. The quantitative study also highlighted the importance for hepatoma detection of specific and non specific factors such as serum AFP, tumoural vascularization, non tumoural liver uptake and intrahepatic distribution of HCC. Anti AFP immunoscintigraphy appears as a poorly sensitive and moderately specific method for hepatoma diagnosis. In contrast, non tumoural liver uptake level could be more useful for discriminating HCC from liver metastases and perhaps to detect the early extension of HCC.
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PMID:Is anti-alphafetoprotein immunoscintigraphy a promising approach for the diagnosis of hepatoma? Implications of a quantitative study in 41 patients. 246 95

The aim of this study was to test the diagnostic value of ascitic fluid cholesterol and triglycerides concentrations and of serum-ascites albumin concentration gradient in the differentiation between cirrhotic and malignant ascites. These biological parameters were determined, on the one hand in 34 cirrhotic patients, 6 of them having an hepatocellular carcinoma and 6 others having a spontaneous bacterial peritonitis and, on the other hand, in 16 patients with malignant ascites, 13 of them having an abdominal extra-hepatic or pelvic cancer, and 3 others having an extra-abdominal cancer with multiple liver metastases. Ascitic carcinoembryonic antigen assay and ascitic fluid cytology were also done in the 50 patients. In differentiating the cirrhotic patients from those with malignancy, ascitic fluid cholesterol concentration (discriminating value less than 1.1 mmol/l) ascitic fluid triglycerides concentration (discriminating value 0.5 mmol/l) and serum-ascites albumin concentration gradient (discriminating value greater than 11 g/l) allowed a diagnostic efficiency of 0.92, 0.80 and 0.77, respectively. Ascitic fluid cytology showed presence of malignant cells in 3/6 patients with hepatocellular carcinoma associated with cirrhosis, in 9/16 patients having a malignant ascites, and was negative in other patients. Ascitic carcinoembryonic antigen assay was abnormal only in 3/16 patients with malignant ascites. These results suggest that measurement of ascitic fluid cholesterol concentration must be included in the initial evaluation of patients with ascites of unknown origin.
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PMID:[Concentration of lipids in ascitic fluid and the concentration gradient of albumin in blood and ascites: diagnostic significance]. 261 52

To assess the utility of changes in the volume of the caudate lobe in the sonographic diagnosis of liver cirrhosis, the authors studied 58 patients with histologically proved cirrhosis, 18 patients with fatty liver, 28 patients with liver metastases, seven patients with lymphomatous liver involvement, and 75 healthy individuals. The longitudinal (CL), transverse (CT), and anteroposterior (CAP) diameters of the caudate lobe and the transverse diameter of the right lobe (RL) were measured, and one-, two-, and three-dimensional caudate lobe indexes and ratios were calculated. The analysis of the diagnostic performance of these criteria, compared by means of receiver-operating characteristic curves, revealed that the ratio of the three-dimensional caudate index (CI3) to the right lobe diameter (CI3/RL = [CL X CT X CAP]/RL) was superior to all other calculated criteria. At a specificity of 95%, the sensitivity of CI3/RL was 94.7%, compared with 73.3% for CT/RL. No significant differences were found between the control group and patients with fatty liver, metastases, or lymphomatous involvement. The study suggests that CI3/RL is the most reliable quantitative criterion for the US diagnosis of liver cirrhosis.
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PMID:Diagnosis of liver cirrhosis with US: receiver-operating characteristic analysis of multidimensional caudate lobe indexes. 264 15


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