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)

In two simultaneously-taken needle biopsies of the liver from 70 consecutive patients, a number of changes were evaluated semiquantitatively and compared in n x m tables. The lesions examined were steatosis, Mallory's hyalin, alcoholic hepatitis, cirrhosis and cholestasis; furthermore the size, amount of inflammatory cells, connective tissue and bile-duct proliferation of the portal tracts and finally focal necroses and acidophilic bodies in the lobules were recorded. Cirrhosis, cholestasis and steatosis showed a high correlation, while the agreement between the two interdependent biopsies, especially concerning acidophilic bodies and bile-duct proliferation, was low. Possible reasons for the variation in the agreement of the lesions are discussed.
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PMID:The variation of pathological changes in the liver evaluated by double biopsies. 42 6

The elimination of propranolol by perfused livers of rats made cirrhotic by chronic carbon tetrachloride inhalation during phenobarbital treatment has been compared with control animals receiving only phenobarbital. Cirrhosis reduced propranolol clearance at a constant flow of 20 ml/min from 1.43 +/- 0.08 to 1.12 +/- 0.08 ml/min/g liver (P less than 0.025). In addition, an increase in intrahepatic shunting of 15-micron microspheres from 0.41 +/- 0.01 to 9.4 +/- 4.1% was found in cirrhotic livers (P less than 0.05). Finally, in cirrhotic livers, reducing blood flow did not produce the normal rise in hepatic extraction ratio, which actually fell from 0.873 +/- 0.021 at 20 ml/min to 0.836 +/- 0.025 at 15 ml/min and 0.823 +/- 0.026 at 10 ml/min. At each flow the observed extraction was significantly lower than that predicted to result from a reduced enzyme activity alone, consistent with the development of functionally significant intrahepatic shunts. An operational model is proposed that explains impaired drug metabolism in cirrhosis on the basis of the development of intrahepatic shunts which perfuse nonfunctioning tissue, while the remaining blood flow is exposed to a reduced mass of hepatocytes with an apparently normal amount of drug metabolizing enzyme (the intact hepatocyte theory).
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PMID:Intact hepatocyte theory of impaired drug metabolism in experimental cirrhosis in the rat. 43 33

Sampling variability of liver biopsy was determined in three consecutive biopsy specimens obtained from each of 118 patients immediately prior to autopsy. No sampling variability was found for fatty liver, alcoholic hepatitis, nonspecific hepatitis, fulminant hepatitis, leukemic infiltrate, and venous congestion. Cirrhosis was diagnosed in 80% of cases at the first biopsy but in all cases after three biopsies. Chronic aggressive and chronic persistent hepatitis were diagnosed correctly in two of three cases each at the first biopsy, and in all cases after three biopsies. Metastatic carcinoma was detected in 46% of cases at the first biopsy and in 69% after three biopsies. Granulomas were missed once on the first biopsy, but found on a subsequent biopsy. The amounts of fat and fibrosis in the biopsy specimens often were not representative of the amounts present at autopsy.
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PMID:Sampling variability on percutaneous liver biopsy. 44 70

Cirrhosis is complicated by numerous abnormalities of carbohydrate metabolism although these are seldom of clinical importance. Carbohydrate intolerance is extremely common and is accompanied by hyperinsulinaemia, hyperglucagonaemia and elevated levels of gluconeogenic precursors. The hyperinsulinaemia results from impaired hepatic degradation of insulin while recent evidence suggests that pancreatic hypersecretion is responsible for the elevated levels of glucagon in cirrhosis. The role of hepatocellular damage and portal-systemic shunting in the pathogenesis of these abnormalities is controversial but the derangements in carbohydrate metabolism probably reflect hepatocellular damage rather than portal-systemic shunting.
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PMID:The glucoregulatory hormones in cirrhosis of the liver. 47 36

The spectrum and incidence of liver disease is described among a large series of patients with inflammatory bowel disease. The incidence of significant liver disease identified by the presence of serial biochemical abnormalities of liver function was 8.2 per cent. Transient peri-operative changes in liver function tests are common and usually relate to underlying intra-abdominal sepsis. Percholangitis, sometimes termed portal triaditis, is one of the commoner lesions, and is usually associated with extensive colitis and improves with resection of the underlying bowel disease. Cirrhosis of the liver is an important but uncommon complication and is usually associated with extensive long-standing disease. Stenosing cholangitis and biliary tract carcinoma are both important though rare associations. They are both associated with extensive disease of long-standing, but resection of the underlying inflammatory bowel disease does not necessarily protect the individual from these complications. Although stenosing cholangitis is a diffuse lesion of the biliary tree it is important to exclude strictures of the extra-hepatic biliary tree which may be amenable to surgical correction. Hepatic dysfunction is rarely the sole indication for advising surgery for the underlying bowel disease but the identification of the nature of the hepati- dysfunction provides a rational basis for such a decision and opportunities for the surgical correction of the hepatic lesion itself.
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PMID:The spectrum of hepatic dysfunction in inflammatory bowel disease. 48 86

An ultrasonic analytical method has been developed which is capable of remote, in vivo differentiation between various types of soft tissue on the basis of differences in their gross histological structure. The method is analogous to that employed in X-ray crystallography and is referred to as ultrasonic diffraction analysis. A clinical trial of this method in the investigation of liver disease in 70 patients is reported, in which a total of 416 ultrasonic diffraction patterns associated with various liver conditions have been analysed and related to independent follow-up information. The existance of a malignant condition of the liver has been identified in 95% of the cases involving focal metastatic deposits and in all of the 11 cases studied where the livers had diffuse malignant involvement. Cirrhosis and secondary involvement of the liver due to Hodgkin's disease have also been shown to exhibit specific tissue signatures which enable them to be differentiated from other hepatic disorders.
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PMID:Ultrasonic diffraction analysis in the investigation of liver disease. 52 96

Testing for soluble fibrin complexes was performed using a sensitive and reliable haemagglutination assay, with red cells sensitized by fibrin monomers. The principle is based on the fact that the monomers linked to red cells and induce their agglutination. This test, used in clinical trials, has revealed the presence of soluble complexes in every confirmed case of acute DIC, but also in Chronic DIC where diagnosis is difficult to establish (negative ethanol gelation test, normal or sub-normal levels of fibrin breakdown products). In Cirrhosis of the liver, the test gives positive results in a non negligible number of cases. Several hypotheses are made to explain why in certain confirmed cases of DIC, low fibrin breakdown products levels are found.
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PMID:[The detection of soluble fibrin complexes by a haemagglutination test. Clinical applications (author's transl)]. 60 Jul 51

Congenital membranous obstruction of the inferior vena cava is a rare phenomenon resulting from failure of anastomosis between the right subcardinal vein and the liver. A case is reported in which the presenting symtpom was bleeding from esophageal varices. Cirrhosis was present and other signs of vena caval obstruction were minimal. The diagnosis was made only after an ineffective mesenterico-caval shunt had been performed. Venacavography or pressure measurements in the inferior vena cava are mandatory before attempting a porta-systemic shunt operation.
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PMID:Congenital membranous obstruction of the inferior vena cava. 64 Aug 19

Alcoholic patients frequently have evidence of nutritional deficiency the consequences of which may be seen in all systems of the body. Alcoholism is theoretically a completely preventable disorder which requires more attention by the general public, practising physicians and research workers. Rehabilitation of the established alcoholic will sometimes be limited by failure to modify behaviour or because of nutritionally induced brain damage but we are beginning to understand some of the mechanisms by which malnutrition evolves (Figure 2). Better methods must be developed to limit alcohol-induced tissue injury in patients whose drinking cannot be controlled. The final mechanisms of liver injury remain to be established. Cirrhosis may be induced in animals ingesting a good diet but this does not ensure adequate delivery and utilization of nutrients at the subcellular level. Cirrhosis takes a long time to evolve and the natural history, including longitudinal nutritional profiles in man, has not been established. Therefore, although normal liver morphology is sometimes seen in alcoholics with gross stigmata of malnutrition suggesting that factors other than malnutrition are important, it may be that critical nutrients have not been deficient for long enough in these individuals or severe depletion has been intermittent. Whether or not malnutrition is of decisive importance in the toxicity of alcoholic liver injury in man, adequate replacement is essential for protection and repair of liver cells. Established daily minimal requirements are not adequate for patients with active liver disease. Hepatocyte injury reduces the capacity of this major storage site and causes release of vitamins (co-enzymes) into the circulation in the form of holoenzymes. Liver damage reduces the conversion of nutrients into their metabolically useful forms required for catabolic processes and to meet increased needs for DNA/RNA synthesis necessary for repair of damaged cells and to replace necrotic cells. The choice and route of therapy must take account of the patient's metabolic needs and their absorptive defects. The effects of alcohol and maternal undernutrition on the fetus/neonate may cause intra-uterine death or varying degrees of brain damage, thus limiting the potential of the next generation.
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PMID:Alcohol and nutrition. 68 85

Immunosuppressive treatment with prednisolone and/or azathioprine has been assessed in three chronic liver diseases with immunological features, namely chronic active hepatitis, cryptogenic cirrhosis and primary biliary cirrhosis. In chronic active hepatitis, controlled prospective clinical trials have shown clinical, biochemical and hepatic histological improvement when prednisolone with or without azathioprine is employed. Azathioprine alone has no advantage over placebo tablets. Cirrhosis is probably not prevented. Selection of patients for treatment, the response and therapeutic regimes are discussed. Patients with hepatitis B surface antigen positive chronic active hepatitis have a worse therapeutic response than those patients with chronic active hepatitis who are HBsAg negative. In primary biliary cirrhosis, corticosteroid treatment is contra-indicated on account of bone thinning. Azathioprine has been used in controlled clinical trials and is of only marginal benefit.
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PMID:Immunosuppressive therapy in chronic liver disease. 71 60


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