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)

Sixteen long-term (more than 5 years) survivors after hepatic resection performed for hepatocellular carcinoma (HCC) from 1970 to 1988, were reviewed. The mean age of the patients was 51 years. There were 11 males and 5 females. HBs antigen was positive in 9 patients. Liver cirrhosis was associated with 11 patients but its severity was designated as Child's A in all patients except one. The mean tumour diameter was 2.8 cm and was relatively small. At the first operation, limited procedures (i.e. partial hepatectomy and subsegmentectomy) were employed in 87.5% of patients. A large percentage of tumours were located in S5 and S6 segments. A recurrence of HCC occurred in 9 patients after the first resection. A second resection was carried out in 7 patients, in 2 of which a third resection was done. Transcatheter arterial embolization (TAE) was performed on 4 patients. These results show that, in addition to detection of small tumours and early resection, repeated operation or TAE for treatment of recurrent HCC was important in achieving long-term survival after HCC resection.
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PMID:Long-term survivors after hepatectomy for hepatocellular carcinoma. 196 95

Previous studies have demonstrated that plasma tissue plasminogen activator (t-PA) level was elevated in patients with liver disease. In this study, t-PA antigen levels were investigated in patients with acute hepatitis (AH; N = 12), chronic hepatitis (CH; N = 8), compensated liver cirrhosis (CLC; N = 40), decompensated liver cirrhosis (DLC; N = 23) and hepatocellular carcinoma (HCC; N = 35). The increased t-PA levels (higher than 14 ng/ml) were found in 33% (4/12) of AH on the early hospital days, 25% (2/8) of CH, 45% (18/40) of CLC and 91% (21/23) of DLC, and 60% (21/35) of Hcc cases. In patient with LC, the correlations between t-PA levels and serum total bilirubin (T.Bill) and hepatic synthetic functions were investigated. The results were that the t-PA levels correlated positively with T. Bil and negatively with liver synthetic functions such as albumin, protein C and choline-esterase, indicating that t-PA increased almost in proportion to the deterioration of hepatic function. Serial determination of t-PA in patients with HCC treated by transcatheter arterial embolization (TAE) revealed that TAE failed to normalize the t-PA levels. In one case of HCC complicated with disseminated intravascular coagulation (DIC), t-PA showed a marked increase at acute phase of DIC and subsequent decrease after the successful treatment for DIC by gabexate mesilate (FOY) infusion. These results suggest that increased t-PA in liver disease is due mainly to deterioration of hepatic function, and that secondary fibrinolytic state, such as DIC, is also a contributing factor.
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PMID:[Evaluation of plasma tissue plasminogen activator (I-PA) levels in patients with liver diseases]. 210 6

Thrombin-antithrombin III complex (TAT) and Plasmin-alpha 2 plasmin inhibitor complex (PIC) were examined in fifty two cases of various chronic liver diseases. TAT was significantly elevated in cases of hepatocellular carcinoma (HCC), but PIC did not show significant changes in any chronic liver diseases. Elevations of TAT and PIC were seen in cases of HCC accompanied by tumor enlargement and extensive tumor thrombosis. In cases of HCC undergoing transcatheter arterial embolization (TAE), TAT and PIC increased on the next day after TAE, and tended to recover with time, returning to almost normal at fourth week. Prolongation of prothrombin time, elevation of FDP and positive FM test were noted more often in liver cirrhosis with disseminated intravascular coagulation (DIC) than in severe liver dysfunction without DIC. Of five cases confirmed as DIC, only three cases were diagnosed as DIC by DIC score. On the other hand, TAT and PIC were significantly elevated in DIC cases. Especially, TAT exceeded 30 ng/ml in all DIC cases. TAT was regarded to be useful for the diagnosis of DIC in severe liver dysfunction.
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PMID:[Clinical significance of thrombin-antithrombin III complex and plasmin-alpha 2 plasmin inhibitor complex in chronic liver diseases]. 214 51

From 1986 to 1988, 35 patients with a hepatoma judged either inoperable or unresectable because of coexistent cirrhosis were treated with hepatic arterial embolization of mitomycin C microcapsules. Five of these 35 patients (14.5%) could not be treated because of inability to selectively cannulate the hepatic artery and were therefore excluded from the evaluation (feasibility rate, 86%). There were 24 men and six women with a median age of 57 years (range, 47 to 79) who could be classified as Okuda I (14 pts) or Okuda II (16 pts) and Child Class A:18 and Child Class B:12 in the remaining patients. A median dose of 0.5 mg mitomycin C/kg was administered to each subject and the treatment was repeated at 5 to 6 week intervals. Seventy courses were administered to these 30 patients (median, two courses/patient; range, 1 to 4). Minor complications were frequent (63%) but always either resolved spontaneously or after appropriate medical treatment. Neither severe renal nor hepatic toxicity was observed. No specific treatment related mortality was observed. When alpha-fetoprotein levels and tumor volume were assessed to evaluate the response to treatment using established criteria for identifying a response, an objective response was found in 43% of the cases treated. The actuarial median survival was 7 months and the 1-year actuarial survival was 36% (51% for those rated as Child Class A and 0% for those identified as Child Class B, P = 0.04 and 78% rated as Okuda Types I and 0% Okuda type II, P = 0.0001). The excellent quality of life and the increased survival rate experienced after mitomycin C microcapsule embolization suggest that this treatment modality can be used successfully in patients seen in the West who have unresectable hepatoma.
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PMID:Hepatic arterial embolization with microencapsulated mitomycin C for unresectable hepatocellular carcinoma in cirrhosis. 216 35

The spontaneous rupture of hepatocellular carcinoma (HCC) constitutes usually critical and life threatening condition because of hypovolemic shock due to massive hemorrhage, underlying liver cirrhosis and extensive tumor growth. Recently, transcatheter arterial embolization (TAE) has been used for controlling arterial bleeding of spontaneous rupture of HCC. We report a long surviving case (1 year 9 months) with stage IV ruptured HCC treated by emergency TAE.
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PMID:[A long surviving case (1 year 9 months) with stage IV ruptured HCC treated by emergency embolization]. 216 76

The ketone body ratio (acetoacetate/3-hydroxybutyrate:KBR) and levels of pyruvate and lactate in arterial blood of patients with hepatocellular carcinoma (HCC) were examined. KBRs and levels of pyruvate and lactate in patients with HCC were similar to those in patients without liver diseases (1.57 +/- 0.88, 0.84 +/- 0.32, 11.4 +/- 4.5 vs 1.80 +/- 0.9, 0.89 +/- 0.48, 10.8 +/- 6.2). However, pyruvate to lactate ratios were significantly lower in HCC patients (7.45 +/- 1.57 vs 8.62 +/- 2.15, p less than 0.05). Among the HCC patients the levels of pyruvate and lactate were significantly higher in patients with liver cirrhosis (LC) than those in patients without LC. The sequential changes of KBRs and levels of pyruvate and lactate were examined before and after transcatheter arterial embolization (TAE). Although KBRs were transiently decreased immediately after TAE, they were at higher levels from the 3rd to 21st day in comparison with those before TAE. The levels of pyruvate and lactate showed no significant changes immediately after TAE. However, they followed a course similar to that of KBRs after TAE. Lower KBRs and higher levels of pyruvate and lactate tended to be observed in HCC patients with LC after TAE than in those without LC. This suggests a decrease of intrahepatic blood flow probably due to histological reconstruction. These results suggest that the presence of LC is one of the most important factors influencing the functional reserve of liver in HCC patients. In HCC patients without LC, the recovery from the overload of TAE may operate at mitochondrial levels at least the 3rd day after TAE.
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PMID:[Changes in ketone body ratio and levels of pyruvate and lactate in arterial blood of patients with hepatocellular carcinoma after transcatheter arterial embolization]. 216 47

Arterial ketone body ratio (AKBR) were examined in 114 cases of hepato-biliary tract diseases. AKBR of the normal control was 1.47 +/- 0.38, while it remained less than 0.7 in liver cirrhosis, hepatocellular carcinoma (HCC), alcoholic liver diseases and malignant biliary tract obstruction. AKBR correlated well with serum albumin and cholinesterase. Thirty five cases of HCC were treated with transcatheter arterial embolization (TAE), 20 cases with gelatin sponge and 15 cases without gelatin sponge. In cases with gelatin sponge AKBR decreased significantly immediately after TAE and recovered gradually during 24 hours. Without gelatin sponge AKBR decreased slightly and remained unchanged until 24 hours later. Concerning the prognosis after TAE, AKBR recovered well in cases with good prognosis, while in poor prognosis AKBR progressively decreased to below 0.3. In experimental TAE with gelatin sponge using rabbit VX2-induced liver tumor, AKBR decreased significantly. In fatal rabbit group after TAE, AKBR decreased progressively. Plasma endotoxin was also measured in TAE with experimental rabbit, AKBR and endotoxin showed reverse correlation. From these results it was suggested that the measurement of AKBR is very useful for the evaluation of efficacy and prognosis of TAE in primary liver cancer.
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PMID:[Changes in arterial ketone body ratio after transcatheter arterial embolization for hepatocellular carcinoma-clinical and experimental studies]. 217 Jul 13

Hepatocellular carcinoma (HCC) with or without cirrhosis in autopsy cases were compared clinically and pathologically. Seventy-five patients with HCC were autopsy cases: 51 had cirrhosis and 24 did not. The patients had been admitted between 1976 and 1986 and were studied in regard to age, sex, clinical onset, past history of hepatic disease, concomitant illness, etiologic factors (HB virus, blood transfusion and alcoholic history), cause of death, extrahepatic metastasis, time span between onset and death, size of the liver and spleen, mode of metastasis, tumor size, degree of anaplasia and also cancer cell histology, metastasis in patients who had received a transhepatic arterial embolization (TAE). Differences were found between the cirrhotic and non-cirrhotic groups with respect to past history of hepatic disease, history of alcoholic abuse and cause of death. Notably in non-cirrhotic HCC, death was due to infection in many cases. Additionally extrahepatic metastasis was compared with respect to tumor type and degree of anaplasia. The incidence of metastasis was over 5 cm in solitary nodule cases. Patients with hematogenous metastasis alone were found in many cases to have multiple nodule type tumors in both the cirrhotic and non-cirrhotic groups. The rate of extrahepatic metastasis was high in patients with anaplasia III and IV in both groups, but the incidence of hematogenous metastasis was particularly high in anaplasia I and II in HCC with cirrhosis. Cancer cell histology was not correlated with extrahepatic metastasis. All the patients treated with TAE were shown to have metastasis in the autopsy. However, the patterns of metastasis in these patients were similar to those in patients who did not receive TAE.
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PMID:[A clinicopathological study of extrahepatic metastasis in autopsy cases of hepatocellular carcinoma with or without cirrhosis]. 217 97

The author describes one case of spontaneous intraperitoneal hemorrhage secondary to the rupture of a liver-cell carcinoma complicating hepatic cirrhosis. The emergent surgical treatment consists in a subsegmentectomy. The discussion puts forwards three possibilities for treatment: surgical resection, arterial embolization and cryoapplication.
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PMID:[Emergency diagnosis: hemoperitoneum caused by spontaneous rupture of hepatocarcinoma in a patient with liver cirrhosis]. 217 58

During the last 20 years, we encountered 14 arterioportal fistulas in 12 patients. Gastrointestinal hemorrhage or mesenteric artery insufficiency were the most frequent conditions found after the diagnosis. Arterioportal arterial fistulas were congenital in two cases and acquired in 10; seven of these 10 were iatrogenic. One patient had three successive and different sites of arterioportal fistula. The fistula originated from a branch of the celiac axis in nine cases, the superior mesenteric artery in three, and the inferior mesenteric artery in two. One patient died of massive anal bleeding before any treatment was possible. Eight fistulas were treated surgically and five by arterial embolization. After treatment there was no early mortality, while hemorrhagic and ischemic complications regressed in all cases. Three hemorrhagic recurrences were observed in patients with preexisting cirrhosis (two cases) or by recurrence of a congenital arteriovenous fistula (one case). Closure of symptomatic arterioportal fistula is justified. The choice of the most appropriate method for each patient should be discussed between the surgeon and interventional radiologist on a case by case basis.
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PMID:Arterioportal fistulas: twelve cases. 226 20


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