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)

The authors have refined a model of cirrhosis in the rat and used it to determine whether the administration of halothane anesthesia adversely affects preexisting liver disease. Male Wistar rats were placed on phenobarbital water and were assigned randomly to two groups. Group 1 rats were exposed by inhalation to carbon tetrachloride (CC14) at weekly intervals for 12 exposures while Group 2 rats received only air. All treatment including phenobarbital then was withdrawn for 4 weeks. Rats then were bled for SGOT and SGPT determinations and 24 h later were exposed to 1.8% halothane in oxygen for 3 h (HAL); the remaining rats from each group were exposed to 100% oxygen for 3 h (O2). Twenty-four hours later, rats were killed and blood was obtained for SGOT and SGPT by cardiac puncture. Light microscopic histologic examination was performed blind on liver sections for cirrhosis and scored for superimposed acute focal necrosis. The weekly sublethal CCl4 exposure resulted in histologically demonstrable cirrhosis in all surviving Group 1 animals. The mean (+/- SD) SGOT (128 +/- 32 IU/1) and SGPT (86 +/- 24 IU/1) values for the Group 1 rats were significantly greater (P less than 0.01) than those for Group 2 rats (98 +/- 18 IU/1 and 57 +/- 12 IU/1, respectively). Cirrhotic animals showed neither deterioration in liver function nor acute liver cell necrosis after Hal compared with O2. However, Group 2 rats showed a modest but significant increase in SGOT (P less than 0.05) after HAL, while this change was not noted after O2. Thus, 1.8% halothane anesthesia in oxygen did not result in superimposition of acute liver cell injury in already cirrhotic rats.
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PMID:Halothane anesthesia does not exacerbate hepatic dysfunction in cirrhotic rats. 396 63

The pharmacokinetics of thiopentone were compared in nine control patients and 10 patients with chronic alcoholism (without signs of cirrhosis or hepatitis) undergoing orthopaedic or abdominal surgery under general anaesthesia. The mean (+/- SD) alcohol intake was 92 +/- 14 litre of ethanol per year in the alcoholic patients and less than 10 litre yr-1 in the controls. Thiopentone plasma concentrations were measured by high pressure liquid chromatography after the administration of a single bolus dose (5-9 mg kg-1). The plasma clearance of thiopentone was significantly increased from 3.7 +/- 0.9 ml min-1 kg-1 in the controls to 5.4 +/- 2.2 ml min-1 kg-1 in the patients with chronic alcoholism. The volume of the central compartment and the total apparent volume of distribution were similar in both groups. The terminal elimination half-life was of 684 +/- 168 min in the alcoholics and did not differ significantly from the value found in the controls (750 +/- 212 min).
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PMID:Thiopentone pharmacokinetics in patients with chronic alcoholism. 649 49

Percutaneous transhepatic obliteration and surgical stapling transection of the oesophagus with the EEA gun were compared prospectively in the treatment of uncontrolled oesophageal variceal haemorrhage unresponsive to conservative measures. Twenty patients with cirrhosis, with a patient portal vein and who were considered suitable for general anaesthesia and surgery, were randomised to two treatment groups (10 patients each). Immediate arrest of haemorrhage was achieved in 17 patients (nine surgery, eight obliteration). In one other patient, stapling transection succeeded where attempted transhepatic obliteration failed, and in another patient obliteration succeeded where attempted transection had failed. One patient continued to bleed and died following attempts at both procedures. Two other patients also died in hospital, without rebleeding following surgery. Variceal rebleeding during the same hospital admission occurred in two patients in the obliteration group and in none after surgery. Oesophageal stapling transection compares very favourably with a non-surgical technique such as transhepatic obliteration of varices in the emergency treatment of uncontrolled variceal haemorrhage in patients with moderate liver failure.
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PMID:Randomised, controlled study of transhepatic obliteration of varices and oesophageal stapling transection in uncontrolled variceal haemorrhage. 660 67

The production of experimental cirrhosis in the rat, most commonly by multiple doses of carbon tetrachloride (CCl4), is a difficult process with a low yield of 'cirrhosis' of widely varied histology. This is due to an unpredictable variation in the response of the rat liver to CCl4. Using a method of monitoring the body weight change of the rat in response to intragastric CCl4 has produced a high yield (76%) of cirrhosis with 8-10 doses of CCl4. This improved control over liver damage has now made it possible to produce a 'standardized' type of decompensated micronodular cirrhosis. A simple non-invasive method of determining when this point has been reached, using a visual grading of ascites during light halothane/oxygen anaesthesia, is described.
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PMID:Standardized micronodular cirrhosis in the rat. 672 20

Umbilical hernia is a common finding in cirrhotic patients with ascites. Spontaneous disruption of the hernia and attendant discharge of ascitic fluid is an unusual and rarely reported complication in these patients and is associated with an overall mortality rate of nearly 30%. During the 5-year period 1977-1982, nine patients with hepatic cirrhosis and ascites were treated for spontaneous rupture of an umbilical hernia. Ascites was attributed to alcoholic cirrhosis in all cases and was present for an average of 21 months prior to rupture. In two cases, failed peritoneovenous shunts resulted in reaccumulation of massive ascites. Initial management included sterile occlusive dressings, fluid repletion, and intravenous antibiotic administration. Hernia repair was performed an average of 4.2 days after rupture. General anesthesia was used in eight cases and local anesthesia in one case. In one instance, the hernia became incarcerated and required urgent repair. Postoperative complications, including wound infection and colonic dilatation, occurred separately in two patients (22%). One patient died of hepatic failure 28 days after operation, for an overall mortality rate of 11%. Surviving patients have been followed for an average of 8 months, and most have done well. Spontaneous rupture of umbilical hernia in patients with ascites occurs uncommonly. Operative management is indicated uniformly and can be conducted safely when the patient's condition has stabilized. The prognosis is favorable for patients with good hepatic reserve.
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PMID:Management of spontaneous umbilical hernia disruption in the cirrhotic patient. 685 90

Liver damage was produced in male Wistar rats aged 15 weeks by daily oral administration of 40 mg/kg thioacetamide over a period of 24 weeks. All of the animals were weighed once a week. Furthermore, the duration of hexobarbital anaesthesia and the activities of the enzymes ASAT, ALAT, GIDH, LDH, LAP and alkaline phosphatase in the serum were determined in 6 experimental and 4 control animals after 3 d and 1, 2 and 4 weeks, and then at intervals of 4 weeks. For the purpose of comparison the same investigations were performed (under identical experimental conditions) both in rats fed normally and rats starved for 24 h to which a single dose of thioacetamide was applied. The histological study of the livers revealed destruction of the lobule architecture and profuse bile-duct proliferations after 12 weeks. Cirrhosis was observed after 16 weeks. The activities of ASAT, ALAT, GIDH and LDH increased for a short time and then returned closely to normal. During the whole experimental period, the LAP and alkaline phosphatase activities remained in the pathological range, as well as the duration of hexobarbital anaesthesia. Enzyme diagnosis is not suitable for assessing the degree of severity of a liver damage produced by thioacetamide.
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PMID:[Enzyme activities in the blood serum from rats with chronic liver damage. part 3: Effect of thioacetamide]. 686 88

The production of experimental cirrhosis in the rat, most commonly by multiple doses of carbon tetrachloride (CCl4), is a difficult process with a low yield of "cirrhosis" of widely varied histology. This is due to an unpredictable variation in the response of the rat liver to CCl4, and the lack of a reliable method of monitoring the rapidly changing liver damage with each dose. A simple non-invasive method is described in which the daily body weight change of the rat in response to weekly intragastric doses of CCl4 has been shown empirically to sufficiently reflect the state of the liver as to enable each dose of CCl4 to be calibrated by the weight change of the previous dose. The death rate is markedly reduced and a critical level of liver damage can be maintained. This improved control over liver damage has made it possible to produce a high yield (72%) of a standardized decompensated micronodular cirrhosis with 8-10 doses of CCl4. Under these weight-calibrated conditions this point is determined non-invasively by using a visual grading of a critical level of ascites estimated during light halothane/oxygen anaesthesia to relax the abdominal musculature.
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PMID:Controlled induction of cirrhosis in the rat. 688 79

Acute variceal hemorrhage in patients with alcoholic cirrhosis and poor liver function is associated with a high mortality. A nonoperative treatment, endoscopic sclerotherapy, was employed in 22 patients with cirrhosis and poor liver function who had 24 episodes of acute variceal hemorrhage over a 20 month period. Portal hypertension was secondary to alcoholic cirrhosis in 21 patients and cystic fibrosis in 1 patient. Of the 24 patient admissions, 21 were of patients in Child's class C and 3 were class B. Endoscopic sclerotherapy was performed under endotracheal general anesthesia using a modified Negus rigid esophagoscope. The sclerosant (5 percent sodium morrhuate) was injected into all visible varices near the gastroesophageal junction using a MacBeth needle. Definitive control of variceal hemorrhage for the entire hospitalization was achieved in 19 of 24 admissions (79 percent). The in-hospital mortality for acute variceal bleeding was 29 percent; 81 percent of the patients were discharged after control of hemorrhage. There were two major and five minor complications related to sclerotherapy. Based on this preliminary experience it is concluded that injection sclerotherapy controls bleeding and reduces mortality associated with acute variceal hemorrhage in patients with poor liver function.
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PMID:Endoscopic sclerotherapy in acute variceal hemorrhage. 697 2

Eight patients had major hemorrhage from esophageal varices; in seven, one or two embolizations of the coronary and short gastric veins resulted in cessation of hemorrhage. This procedure can be used in patients with massive ascites, severe coagulopathy, or profound liver failure, as the access route through the dilated umbilical vein can be reached via a supraumbilical incision done with the patient under local anesthesia. All patients died; two deaths were attributable to complications of the procedure, the other six to the severity of the cirrhosis. Sclerotherapy may be combined with coronary vein embolization, but the risk of esophageal perforation may be greater than with sclerotherapy alone.
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PMID:Emergency transumbilical embolization of bleeding esophageal varices. 697

Although studied for most of this century there is still no reliable model of severe decompensated micronodular cirrhosis that can be predictably produced in reasonable quantity. The current most successful model, inhalation of carbon tetrachloride vapor in the phenobarbitone-induced rat, has a low yield of severe cirrhosis and a high death rate because there is no way to determine both the variation in response to carbon tetrachloride and the maintenance of a constant critical level of liver damage. A new approach to this old problem is described in which both variation and level of critical damage are monitored by the daily weight change of the rat in response to intragastric carbon tetrachloride given during light halothane/oxygen anesthesia; the response each time being used to calibrate the subsequent dose of carbon tetrachloride to fit the individual rat. The method is effective in producing cirrhosis with ascites in about 75% of rats after 8-10 doses of carbon tetrachloride.
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PMID:High yield micronodular cirrhosis in the rat. 712 27


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