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)

For the evaluation of certain differences in the diminution of export proteins of the liver we examined some exactly defined groups of liver diseases with the aim of further differentiation of the pathogenetic mechanisms. We measured the activity of glutamate-oxalacetate transaminase, glutamate-pyruvate transaminase, glutamate dehydrogenase, lactate dehydrogenase, alkaline phosphatase, cholinesterase and lecithin-cholesterol acyltransferase, the Quick value, the coagulation factors I, II, V, VII, VIII, IX and X. Clotting factors were determined by a Schnitger-Gross Coagulometer. Prothrombin, antithrombin III, plasminogen, factor VIII associated antigen and activated factor XIII were measured by immunoelectrophoresis according to Laurell. Lipoprotein electrophoresis in agarose gel was performed to evaluate changes in lecithin-cholesterol acyltransferase activity. Except of the rising diminution of export proteins in the course of liver disease from acute hepatitis to cirrhosis we found also specific changes of the patterns of the plasma specific enzymes. These proteins were diminished dependent on their half life time and the inflammatory activity--measured as the height of the transaminases. Lecithin cholesterol acyltransferase and factor VIII did not participate in the general diminution of the most export proteins; some details were found to explain this differing behaviour. Results are critically discussed with regard to new aspects in the biochemistry of the damaged liver cell.
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PMID:[Correlations between the diminished secretion of export proteins from the liver and the plasmatic activity of liver cell enzymes (author's transl)]. 42 91

A prothrombin complex concentrate was used in attempts to control life-threatening hemorrhage in 4 patients with chronic liver disease. The population manifested profuse bleeding from varices and/or hemorrhagic gastritis; 3 had Laennec's cirrhosis and 1 had postnecrotic cirrhosis from childhood hepatitis. In all patients the complex was given in amounts needed to raise the prothrombin (factor II) level to approximately 100% of normal. In all 4 cases the prothrombin time and prothrombin complex factors approached normal within 1-2 hr after beginning the infusion. In all patients bleeding ceased with correction of the clotting status. One patient rebled several hours after completing the infusion. In several patients, increases in factors V and VIII were noted following infusion of the concentrate. A further unexpected finding was a spontaneous increase in factors II and IX at 3 days postinfusion. Prothrombin complex concentrate appears to be useful in controlling the hemorrhage of chronic liver disease when used alone or in combination with other modalities to correct specific hemostatic defects; however, patients may be expected to rebleed when the effect of the concentrate wears off. Its use, therefore, should probably be restricted to those patients who are to undergo corrective surgery of the bleeding point once hemostasis is achieved.
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PMID:Prothrombin complex concentrate: use in controlling the hemorrhagic diathesis of chronic liver disease. 108 Mar 55

A controlled clinical trial comparing 2-Mercapto-Priopionyl-Glycine (2-MPG) plus B12 vitamin with B12 vitamin alone in chronic liver disease has been conducted in seven hospitals in Italy. Patients were divided into two groups on the basis of liver histology; group I included 26 patients showing histological evidence for chronic persistent hepatitis (C.P.H.) (according to De Groote et al.) whereas group II consisted of 54 patients with chronic aggressive hepatitis (C.A.H.) or compensated liver cirrhosis. Patients of each group were randomly allocated to 2-MPG plus B12 vitamin, or to placebo plus B12 vitamin, in a double-blind way. The drug (or placebo) was diluted in 500 ml of 10% Levulose, and administered intravenously; 1000 gamma of B12 vitamin were added to each bottle. Patients in the 2-MPG group received 2.5 gms of the drug daily; the treatment lasted for 30 days. The following parameters were checked in all patients on admission, and repeated at the end of treatment: Serum bilirubin, serum Cholesterol, A.P., BSP retention, Prothrombin time, S-GOT, S-GPT, Gamma-GT, Total serum Protein, serum electrophoresis, Immunoglobulins. Patients given 2-MPG showed significant decreases of serum transaminases, and improvement of BSP retention.
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PMID:[Controlled clinical trial of 2-mercapto-propionyl-glycine in chronic hepatopathies]. 125 87

The relation between coagulation indexes and survival rate was studied and analyzed in 46 patients with advanced liver cirrhosis (grade B and C Child-Pugh Classification), during a follow-up of 1 year. Twenty-four patients (52%) died of liver failure or fatal haemorrhage within 12 months of follow-up. Prothrombin activity, fibrinogen, fibrin(ogen) degradation products, prekallikrein and factor VII, serum bilirubin, and the degree of liver insufficiency, scored by Child-Pugh classification, proved to be significantly correlated with survival by univariate analysis. A multivariate survival analysis (Cox regression model) disclosed two variables, prekallikrein and factor VII, that predicted survival. The rate ratios of death increased to 2.8 and 7.6 with values of prekallikrein < 26% and factor VII < 39%, respectively. This study shows that some simple laboratory tests exploring the clotting system may identify patients with poor prognosis in severe liver failure.
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PMID:1-year survey of patients with advanced liver cirrhosis. Prognostic value of clinical and laboratory indexes identified by the Cox regression model. 143 38

Haemostatic parameters (PT,KCCT and platelet counts) were measures in conjunction with other biochemical tests in 80 consecutive jaundiced patients here in Zaria. The investigations were performed on admission and within 72 hours after parenteral vitamin K therapy. The prothrombin time and kaolin cephalin clotting time remained prolonged after the administration of vitamin K in cases of liver cirrhosis. Prothrombin times in obstructive jaundice returned to normal after the administration of vitamin K. The prothrombin time, therefore, differentiates between the jaundice of liver cirrhosis from obstructive jaundice.
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PMID:Use of haemostatic parameters as a diagnostic and prognostic index in persistent jaundice: a Zaria experience. 209 82

A multivariate Cox regression analysis with time-dependent variables has been performed on the data of 415 patients with cirrhosis included in a controlled clinical trial of 10-15 mg prednisone daily versus placebo. The analysis showed that a poor prognosis was associated with a low prothrombin index, marked ascites, GI bleeding, high age, high daily alcohol consumption, high bilirubin and alkaline phosphatase and low albumin values, little liver connective tissue inflammation, and poor nutritional status. Prothrombin index and ascites showed significant interaction with the treatment in such a manner that high prothrombin index and absence of ascites were associated with a beneficial effect of prednisone, whereas low prothrombin index and presence of ascites were associated with a harmful effect of prednisone treatment. The final model was validated in independent patients by comparing their actual survival with that predicted from the model, using a split-sample testing technique. The prognostic factors were combined with an index that can be used to update prognosis whenever changes occur in the clinical status of a patient during the course of the disease. The probability of surviving the next 3 or 6 months can be estimated from the prognostic index at any time during the course. The index may be of value for the correct timing of special therapeutic procedures such as liver transplantation.
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PMID:Updating prognosis and therapeutic effect evaluation in cirrhosis with Cox's multiple regression model for time-dependent variables. 352 Jul 95

A conservative approach toward elective cholecystectomy in the patient with cirrhosis has been suggested because of the strong likelihood of excessive bleeding, sepsis, and multiple organ failure. We reviewed this problem in two medical centers, studying 27 patients with cirrhosis who had undergone nonemergency biliary tract surgery. Most patients had adequate liver function preoperatively. Most operations were cholecystectomies without duct exploration. Among factors analyzed were liver function tests, coagulation tests, and Child's classification. Prothrombin time was less than 2.5 s above control in 18 patients, more than 2.5 s above control in four patients, and not recorded in five patients. All survived the operation with benign postoperative courses. Only one patient had excessive bleeding; this patient had an elevated prothrombin time preoperatively. We conclude that elective cholecystectomy can be performed safely in patients with cirrhosis who have relatively normal liver function.
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PMID:Cholecystectomy in patients with mild cirrhosis. A more favorable situation. 405 37

Prothrombin, both by a one- and a two-stage method, and progressive antithrombin were determined on the same plasma samples from 47 patients with cirrhosis and 27 patients with acute hepatitis. In the first group prothrombin estimated by the two-stage method was significantly higher than by the one-stage method. The values were often within the normal range and were not correlated with the indices of protein synthesis. Since progressive antithrombin was also depressed, the unduly high levels measured by the two-stage method are probably related to the influence exerted by antithrombin on the two-stage method. The opposite pattern was observed in patients with acute hepatitis, ie, the one-stage assay gave higher values than the two-stage assay. The one-stage method correlated better with the indices of protein synthesis. It is suggested that a one-stage assay should be used in patients with liver failure to evaluate the haemostatic balance before liver biopsy or surgery.
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PMID:Estimation of prothrombin in liver disease. 543 Apr 18

Laser nephelometry is a technique which allows the evaluation of the concentration of several serum proteins and clotting factors. By means of this technique it is also possible to study the kinetics of the reaction between antigen and antibody. We studied the kinetics of the reaction between prothrombin and an antiprothrombin antiserum using several prothrombins namely: Prothrombin Padua, prothrombin Molise, which are two congenital dysprothrombinemias, cirrhotic, coumarin or normal prothrombins. Different behaviors in the kinetics of the reactions were shown even when the concentration of prothrombins was about the same in all plasma tested. These differences were analyzed by means of a computer (Apple II 48 RAM) programmed to solve four unknown equations (Rodbard's equation). From the data so obtained one can see that when voltages at the beginning and at the end of the reaction are in all cases about the same, a clear difference in the time required to reach half the maximum value of the voltage can still be demonstrated. This parameter, which is expressed in minutes, is longer in coumarin and prothrombin Molise than in controls. On the contrary it is shorter in prothrombin Padua and has about the same value of controls in the cirrhotic patient. Moreover the time at which the maximum rate is obtained is longer in coumarin and prothrombin Molise than in controls and shorter in liver cirrhosis and prothrombin Padua. In conclusion data obtained show that coumarin prothrombin behaves in a different way from cirrhotic prothrombin and also that there is a different behaviour between the two congenital dysprothrombinemias.
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PMID:Prothrombin evaluation as obtained by kinetics studies of antigen-antibody reaction in a laser nephelometer. 649 58

Prothrombin was assayed in 24 patients with liver cirrhosis both as activity and as antigen. Prothrombin was found to be decreased by all methods and a good correlation was found among the three methods used. The serum prothrombin assay by means of the electroimmunoassay showed levels comparable to those observed in plasma, as expected. In the bidimensional electrophoresis system, plasma prothrombin appeared decreased but showed a normal mobility. Serum prothrombin in the same system showed the presence of three normal albeit reduced peaks or precipitates.
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PMID:An immunological study of prothrombin in liver cirrhosis. 699 72


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