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)

We have studied the effect of a protein meal on secretin (IRS) concentration in dogs and humans using a radioimmunoassay of improved sensitivity (8 pg/ml). After a meal, pancreatic bicarbonate secretion (PBS) increased markedly and proximal duodenal pH decreased from 6.2 to 4.3. Portal and peripheral IRS concentrations, however, remained unchanged in eight dogs and five patients with cirrhosis of the liver. Similarly, an alkaline solution of sodium oleate (pH 9.2) stimulated PBS but not IRS. Intraduodenal administration of various amounts of HCl in dogs demonstrated that acid-stimulated PBS was invariably accompanied by rises in peripheral venous IRS concentration. We conclude that the postprandial stimulation of PBS involves mechanisms more complex than acid-stimulated secretin release.
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PMID:Effects of a protein meal, intraduodenal HCl, and oleic acid on portal and peripheral venous secretin and on pancreatic bicarbonate secretion. 2 27

Portal systemic encephalopathy is a serious complication of cirrhosis. It can be prevented if the patient avoids the contributing factors--ingestion of alcohol, inappropriate diet, infection, stress, hepatotoxic agents--and if other complications are treated promptly.
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PMID:Preventing portal systemic encephalopathy in the patient with cirrhosis. 3 72

Portal branch ligation, a new surgical treatment for unresectable carcinoma of the liver, was performed in twenty patients. All the patients tolerated the procedure, and morbidity and mortality were minimal, even in patients in poor general condition. The responses to ligation differed considerably, but significant palliation was attained in some patients and one survived six years. The effect of portal branch ligation on the tumor appears to be closely related to the degree of tumor vascularity, tumor malignancy, and portal circulatory disturbances such as cirrhosis, portal hypertension, or portal thrombosis. We believe that the present procedure can be recommended for clinical application in some patients with unresectable carcinoma of the liver.
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PMID:Ligation of a branch of the portal vein for carcinoma of the liver. 17 Aug 37

56 consecutive patients with portal hypertension were studied with percutaneous transhepatic portography and the results were correlated to clinical findings and the number of upper gastrointestinal haemorrhages and the size of the individual bleeding. An abundance of collateral paths was noted in most patients. No regularity in development of these collaterals was found. It was not correlated to liver disease etiology, sex or liver function parameters. Portal pressure was not correlated to the size or amount of collaterals. In four patients with liver cirrhosis hepato-fugal flow in one segment of the liver was noted proving that portal flow through the liver is not uniform in this disease. The size of the haemorrhages was only correlated to presence of hepato-fugal flow in the main stem of the portal vein. It was not correlated to the estimated size of the oesophageal varices or to portal pressure. Percutaneous transhepatic portography seems to be of little help in selecting "high risk bleeders" in portal hypertension. Other factors may be of greater help in this task as indicated by the findings in this investigation that patients with alcohol cirrhosis had larger haemorrhages than those with cirrhosis of another etiology and that patients with none or few bleeding episodes had higher thrombocyte count than those with several haemorrhages.
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PMID:Correlation between percutaneous transhepatic portography and clinical findings in 56 patients with portal hypertension. 30 34

The effect of a portocaval shunt with and without portal arterialization of the liver on serum immunoglobulin concentrations and on the incidence of antibodies to 8 different serotypes of Escherichia coli was studied in 29 patients with cirrhosis of the liver. Compared with healthy controls, the serum concentrations of IgG, IgA and IgM were significantly elevated in cirrhotic patients. No difference in immunoglobulin concentrations could be observed between shunted and arterialized cirrhotics. The incidence of E. coli antibodies was significantly higher in patients with cirrhosis of the liver, showing a further increase in patients with portocaval shunt operations. Portal arterialization of the liver after portocaval shunting did prevent this additional increase, presumably by restoring the antigen clearing capacity of the cirrhotic liver, thus avoiding an additional stimulation of the antigen response after the portocaval shunt. The quantitative contribution of E. coli antibodies to the hyperimmunoglobulinemia of patients with cirrhosis of the liver seems to be of little significance. The results of this study underline the significance of the portal hepatic blood flow for the function of the reticulo-endothelial system of the liver.
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PMID:[Effect of portocaval shunt and arterialization of the liver on antibodies to Escherichia coli in patients with cirrhosis of the liver (author's transl)]. 36 Jun 47

Splanchnic and systemic hemodynamic observations in eight patients with cirrhosis and refractory ascites were compared to those of 25 patients with cirrhosis and responsive ascites. The refractory ascitic group was characterized by less portasystemic shunting from both the superior mesenteric and splenic vascular beds, a lower cardiac output, a higher systemic vascular resistance, a wider arterial-hepatic venous oxygen difference, and a tendency for a lower HBF and higher postsinusoidal resistance. Portal pressures assessed from hepatic vein catheterization were similar in the two groups. The absence of a well-developed portasystemic collateral bed in patients with refractory ascites could in part be caused by the tense ascites but could also be an important factor in the mechanism of refractory ascites.
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PMID:Splanchnic hemodynamic factors in cirrhosis with refractory ascites. 42 41

In 19 patients with cirrhosis of the liver and portal hypertension, a catheter was inserted into the portal vein using a percutaneous transhepatic technique. The portal pressure was measured during general anaesthesia with and without halothane, and in the awake state. Addition of halothane to the N2O:O2 anaesthesia did not change portal venous pressure, in spite of a significant fall in arterial blood pressure. Portal venous pressure under general anaesthesia with complete muscle relaxation did not differ from the pressure in the resting, awake patient.
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PMID:Influence of general anaesthesia on portal pressure in liver cirrhosis and portal hypertension. 48 82

Percutaneous transhepatic catheterization of the portal venous system and pressure readings were performed in nineteen patients with cirrhosis of the liver and bleeding varices. Portal pressures were recorded in awake and mobile patients in supine, sitting and standing position, during sleep, ingestion of food, Valsalva manoeuvre and coughing. No significant differences were recorded in the different postures, during sleep or food intake. Four patients with hepatofugal portal blood flow had, however, lowest pressure in standing position. During Valsalva manoeuvre portal pressure was doubled, and it became fourfold during coughing. Elevations of this magnitude have not previously been reported. A relationship was found between portal pressure and size of varices.
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PMID:The influence of posture, Valsalva manoeuvre and coughing on portal hypertension in cirrhosis. 55 37

Renal handling of sodium was studied in five dogs where an end-to-side portacaval fistula was constructed prior to the induction of cirrhosis with DMN. Such a model permits the effects of cirrhosis to be studied separately from the consequences of portal hypertension. Three control animals without cirrhosis maintained normal liver and kidney function and remained in sodium balance for as long as 8 weeks following surgery. In the five cirrhotic dogs, urinary sodium retention preceded ascites formation and was independent of hyperaldosteronism, hypoalbuminemia, hepatic ischemia, or decreased renal perfusion. Portal venous pressure remained normal in all cirrhotic dogs, and the splanchnic area remained free of venous collaterals. Plasma volume expansion also preceded ascites formation, and this variable increased by 8.4% (p less than 0.05) following 6 days of sodium retention. These temporal relationships between sodium retention, expanded plasma volume, and ascites formation are similar to those observed in ordinary cirrhotic dogs previously studied in this laboratory. Total plasma volume increased by 13.2% (p less than 0.05) when measured during the ascitic phase of cirrhosis. However, when the splanchnic and nonsplanchnic ("effective") components of plasma volume were measured by an exclusion technique, the ratio of these components to total plasma volume was not different from that observed in normal dogs. Thus no preferential consignment of retained salt and water had occurred. We conclude that urinary sodium retention in cirrhotic dogs occurs independently of portal hypertension or augmented splanchnic vascular capacity and is associated with expansion of the effective plasma volume, even though ascites is present.
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PMID:Renal sodium retention and ascites formation in dogs with experimental cirrhosis but without portal hypertension or increased splanchnic vascular capacity. 62 53

Systemic endotoxaemia without evidence of gram-negative bacterial infection occurs in liver diseases in man. The endotoxaemia is probably due to impaired hepatic clearance of endotoxin absorbed from the gastrointestinal tract, but portal venous endotoxaemia has never been reported in man. By means of the limulus gelation test, portal venous blood from 21 patients without parenchymal liver disease and arterial blood from 21 patients without parenchymal liver disease and 31 patients with cirrhosis was examined for endotoxin. Portal venous endotoxaemia was found in 9 of 21 samples and systemic endotoxaemia was found in 2 of 21 samples from patients without liver disease. Systemic endotoxaemia in cirrhosis occurred with a frequency of 15/31. No relationship to gram-negative bacteraemia was found. Leucocytosis was only seen in endotoxin-positive patients with cirrhosis. In cirrhosis higher levels of E. coli O antibodies were found in endotoxin-positive than in endotoxin-negative patients, supporting the view that the limulus gelation test specifically detects endotoxin (i.e. E. coli O antigen). The study suggests that endotoxin is a normal constituent of portal venous blood in man. The normal human liver clears endotoxin from the portal venous blood. This effect is diminished in cirrhosis, most probably owing to decreased phagocytic function of the liver. The increased humoral immune response in cirrhosis may be related to spillover of endotoxin from the liver.
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PMID:Portal venous and systemic endotoxaemia in patients without liver disease and systemic endotoxaemia in patients with cirrhosis. 79 99


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