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)

From 388 patients with upper G.I. bleeding investigated by endoscopy, radiology or emergent surgery, one third bled from duodenal ulcer, one third oesophageal varices, and from the remain the most frequent were gastric ulcer (14%) and gastric cancer (9%). From a sample of 53 patients with liver cirrhosis, 66% bled from varices and 34% from other lesions. The proportion of patients who bled from oesophageal varices is higher under 60 yrs. The mortality was higher after 60 yrs, except when there was associated chronic liver disease or renal or cardio-respiratory failure. In this group of patients, near half in our series, the mortality is the same under and above 60 years.
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PMID:Endoscopy in the upper G.I. bleedings. 31 42

A 61-year-old male was admitted because of hemoptysis. He had a 9 year history of liver cirrhosis associated with HB viral chronic hepatitis. Physical examination revealed no abnormalities. Laboratory investigations revealed positive HBs antigen with normal alpha-fetoprotein. Chest X-ray film showed large mediastinal lymph nodes and an endobronchial polypoid mass in the distal end of the right main bronchus. The right main PA was narrowed due to compression by the mediastinal mass. Bronchoscopic examination revealed a polypoid mass in the right main bronchus. The biopsy specimen was histologically diagnosed as undifferentiated large cell carcinoma. The patient developed respiratory failure, and died 3 weeks after admission. Autopsy revealed a small liver cancer of 1.3 cm diameter within the cirrhotic liver, associated with a small abdominal lymph node metastasis and large mediastinal lymph node swellings. Thromboembolism in the bilateral main pulmonary arteries was concluded to be the cause of death. The mediastinal mass which directly invaded into the right main bronchus had a close histological similarity with the liver cancer, showing undifferentiated carcinoma cells with bizarre nuclei and abundant cytoplasm. An immunohistological study revealed cells positive for alpha-fetoprotein in the mediastinal lymph nodes. The patient was diagnosed as having small liver cancer with mediastinal lymph node metastases. A survey of the literature revealed only a few cases of advanced hepatoma associated with prominent mediastinal metastases. This is the first reported case of small liver cancer presenting with large mediastinal lymph node metastases.
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PMID:[A case of small liver cancer presenting as a huge mediastinal mass]. 132 37

We studied the effects of infusion of a branched chain enriched amino acid mixture versus glucose on acute hepatic encephalopathy in patients with cirrhosis. Sixty-five patients were randomly treated with 1 g/kg per day of an amino acid mixture with 40% branched chain contents (32 patients), or isocaloric glucose (33 patients) for a maximum of 16 days. The regimens further included glucose infusion to a total of 26.5 kcal/kg per day and lactulose. The patients took part in the study for 5-6 days. In each group 17 patients woke up. In the amino acid group eleven died and four developed renal failure. In the glucose group ten died, three developed renal and two respiratory failure, and one remained encephalopathic. The coma score worsened in three of the patients who died in the amino acid group, but in all patients who died in the glucose group. The negative nitrogen balance on entry reversed in the amino acid group, but not in the glucose group. Thus, the branched chain enriched amino acid supplement did not change the prognosis for wake-up, but had other effects on the cerebral state and on nitrogen homeostasis.
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PMID:Branched chain enriched amino acid versus glucose treatment of hepatic encephalopathy. A double-blind study of 65 patients with cirrhosis. 219 6

The authors report the case history of the first patient in the world to have survived 18 and a half years with a heart transplant. This survival was marked by several episodes of rejection during the early years and various other incidents. The pathology encountered was primarily iatrogenic: diffuse osteoporosis sometimes limited the patient's activity. Two skin cancers and a lung cancer were diagnosed and treated. The patient died from progressive respiratory failure with pulmonary hypertension and signs of right ventricular failure. Pathological examination revealed a subnormal myocardium with a certain amount of overloading of the coronary arteries, confirmed the lung cancer and pulmonary hypertension and, most importantly, revealed the presence of nodular regenerative hepatic cirrhosis responsible for ascites during the last few months of life and a renal adenocarcinoma. These last two lesions are observed in immunosuppressed patients. The authors pay tribute to this patient who led an active and devoted life in the service of others.
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PMID:[Clinical history and anatomic findings following the longest survival after cardiac transplantation]. 265 66

Hepatic and respiratory failure, common complications following liver resection for hepatocellular carcinoma (HCC), especially when it is combined with liver cirrhosis, can be overcome by careful management of the circulatory and respiratory systems. Another common complication is intractable ascites which resists conventional therapy, such as, diuretics and protein replacement. Here we report a case in which intractable ascites was successfully treated with propranolol. The patient, a 48-year-old man who underwent liver resection for HCC combined with cirrhosis, started to suffer from ascites about 1 week after surgery. Upon administration of propranolol (1 mg/kg/day) with furosemide, his body weight decreased 500 g/day, returning to the preoperative value in 2 weeks in parallel with the normalization of the PRA. No side effects were observed during the medication period. Propranolol, a beta-adrenergic antagonist, is thought to suppress renin secretion from the juxtaglomerular apparatus in the kidney by blocking its beta-adrenergic receptor, thus suppressing the entire renin-angiotensin-aldosterone system. We concluded that propranolol is a promising drug for intractable ascites encountered with liver cirrhosis.
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PMID:[Effect of propranolol on intractable ascites following liver resection]. 287 20

Acute colectasia may occur in patients under mechanical ventilation. Causative factors include haemodynamic changes, potassium loss, underlying pathology (chronic respiratory failure, cirrhosis) and especially morphine-like compounds used for sedation. Analysis of the results obtained with various treatments suggests that surgery is not justified: caecal perforation is extremely rare in a previous healthy colon; any surgical procedure is hazardous in this type of patient, and colectasia frequently regresses under appropriate medical treatment, even though mechanical ventilation is pursued.
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PMID:[Acute colectasia in patients on artificial respiration. 10 cases]. 294 58

With the aim of temporarily assisting deterioration of liver function developing after surgery, extracorporeal blood purification therapy (EBPT) (plasma exchange and/or hemofiltration) was carried out in 26 postoperative patients. Initiation of EBPT was instituted according to the criteria of either a serum bilirubin greater than 15 mg/dl or Grade 2 or more coma. Plasma exchange was carried out 235 times in 23 patients and hemofiltration was performed 28 times for seven patients. In addition, hemodialysis and CAPD were linked in eight cases. Plasma exchange was found to control the progression of DIC and endotoxemia. Nine patients (35%) were weaned from EBPT. In the survivors the levels of blood ammonia and number of major complications were significantly lower compared to the nonsurvivors. Three patients treated only with hemofiltration were all lost. Among co-morbid factors present, incidences of renal failure, respiratory failure, and associated liver cirrhosis significantly increased poor clinical outcome on EBPT for postoperative liver failure.
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PMID:Temporary metabolic support by extracorporeal blood therapy for liver failure after surgery. 319 18

To evaluate the role of a circulating inhibitor of extrathyroidal conversion of T4 to T3 (IEC) in the causation of low T3 states in patients with various nonthyroidal illnesses (NTI), we measured the in vitro T3 production in the presence of ether extract of plasma. Blood samples were obtained from 22 normal subjects and 140 patients with various NTI; liver cirrhosis (LC) 37, diabetes mellitus (DM) 48, respiratory failure (RF) 15, chronic renal failure (CRF) 10 and others 30. The assay procedure of in vitro T3 production was as follows. Rat liver homogenate was incubated with 2.5 microM T4 in the presence of evaporated ether extract of plasma and the amount of T3 produced was quantified by RIA. In each assay, control plasma extracts taken from the two normal subjects were used. The results were expressed as a percentage of the control value (%T3 production), and estimated as positive IEC when %T3 production was under 72.7%, that was 2SD below the mean value of normal controls. Patients were divided into three groups; Group I (T3 greater than or equal to 80 ng/dl), Group II (80 greater than T3 greater than or equal to 50) and Group III (50 greater than T3). The %T3 productions were 88.5 +/- 22.0 in Group I, 84.9 +/- 31.5 in Group II and 78.9 +/- 34.0 in Group III respectively. The %T3 productions of each group were significantly lower than that of normal control, 101.9 +/- 14.6. IEC was positive 23.4% in Group I, 41.9% in Group II and 43.8% in Group III. There were eight nonsurvivors, and they all belonged to Group III, in which both serum T3 and T4 were subnormal. In nonsurvivors, serum concentrations of T3 (20 +/- 11 ng/dl) and TSH (1.2 +/- 1.1 microU/ml) were significantly lower than that of survivors in Group III (T3; 38 +/- 10 ng/dl p less than 0.005, TSH; 2.8 +/- 1.4 microU/ml p less than 0.05). The %T3 productions were 83.8 +/- 32.1 in survivors and 64.8 +/- 37.9 in nonsurvivors, and the incidences of positive IEC were 37.5% in survivors and 62.5% in nonsurvivors. From the standpoint of the underlying illnesses, serum concentrations of T3 (mean +/- SD ng/dl) were 49 +/- 21 in LC, 64 +/- 11 in DM, 40 +/- 22 in RF and 63 +/- 15 in CRF, and %T3 productions were 60.6 +/- 26.5 in LC, 82.5 +/- 25.8 in DM, 109.6 +/- 32.1 in RF and 97.6 +/- 24.3 in CRF.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:[An inhibitor of extrathyroidal conversion of thyroxine to 3,5,3'-triiodothyronine (IEC) in plasma of patients with various nonthyroidal illnesses]. 339 31

Using multivariate probit analysis, the data of 565 patients who underwent major abdominal surgery were retrospectively analyzed, and the etiologic role of blood transfusion in organ system failure (OSF), which includes respiratory failure, gastrointestinal stress bleeding, renal failure, nonobstructive, nonhepatitic jaundice, and coagulopathy, was studied. Apart from the amount of blood transfusion, the following factors were included in the analysis as possible contributors to OSF: age, preoperative hematocrit, organ failure risk (diffuse peritonitis, obstructive cholangitis, liver cirrhosis, terminal cancer, and hemorrhagic shock), operative time, blood loss, and postoperative highest hematocrit. The results showed that, except for preoperative hematocrit, all the factors are statistically significant contributors, blood transfusion being the most significant. There was no statistically significant interaction between blood transfusion and organ failure risk. It is concluded that blood transfusion is an important, independent factor contributing to OSF, and its contribution cannot be attributed to the underlying conditions that require blood transfusion.
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PMID:Role of blood transfusion in organ system failure following major abdominal surgery. 348 12

One hundred twenty-five infants underwent surgical intervention for necrotizing enterocolitis between 1972 and 1984. Sixty-three infants, who survived more than 30 days postoperatively, were evaluated for long-term complications. There were 28 girls and 35 boys (mean birth weight 1,725 +/- 890 g; gestational age 32 +/- 4 weeks). Associated problems included hyaline membrane disease (43), cardiac anomalies (25), and trisomy 21(2). Thirty-six survivors required long-term ventilatory support. Fifty-nine infants underwent bowel resection and enterostomy, 3 decompressing enterostomies without resection, and 1, exploratory laparotomy only. Enterostomies were closed at four months. Twenty four had short bowel syndrome. Fifteen infants subsequently died for a late mortality rate of 23%. Mortality was related to sepsis (3), respiratory failure (5), cardiac anomalies (3), cardio-respiratory arrest (2), and TPN related liver failure (2), and was common with gestational age less than 31 weeks and birth weight less than 1,000 g. Medical problems included cholestasis (17), TPN induced cirrhosis (3), meningitis (3), seizures (8), and nutritional rickets (6). Significant developmental and intellectual delays were observed.
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PMID:Long-term follow-up after surgical management of necrotizing enterocolitis: sixty-three cases. 372 6


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