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)

N-acetyl-beta-D-glucosaminidase is a lysosomal glycosidase, which participates in the catabolism of the mucopolysaccharides and of the glycoproteins. For the determination of this enzyme the production of the substrate and a modified methodology are described. Measurements of the activity were performed by 4-nitrophenyl-alpha-D-galactopyranoside and 4-nitrophenyl-N-acetyl-beta-D-glucosaminide as substrates. Examinations of this enzyme were performed in patients with acute virus hepatitis, chronic hepatitis, liver cirrhosis and healthy test persons. In acute hepatitis and liver cirrhosis and significant increase of enzyme is provable, but not in protracted hepatitis.
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PMID:[Clinical value of N-acetyl-beta-D-glucosaminidase and alpha-galactosidase in liver diseases]. 626 8

Hospitalized patients with hepatic insufficiency often suffer from severe catabolic states and are in urgent need of nutritional support during their acute illness. Protein intolerence, however, remains a significant problem with respect to the provision of adequate nutrition, either enterally or parenterally. The following report is an anecdotal series of 63 consecutive patients in a large urban hospital treated prospectively with nutritional support using a prototype high branched-chain amino acid solution (FO80) given by technique of total parenteral nutrition by the subclavian or internal jugular route with hypertonic dextrose. Sixty-three patients, of which 42 had chronic liver disease (cirrhosis) with acute decompensation and 17 with acute hepatic injury as well as four with hepatorenal syndrome, are the subject of this report. All required intravenous nutritional support and were either intolerant to commercially available parenteral nutrition solutions or were in hepatic encephalopathy at the time they were initially seen. The cirrhotic patients had been hospitalized for a mean of 14.5 +/- 1.9 days before therapy, had a mean bilirubin of 13 mg/100 ml, and had been in coma for 4.8 +/- 0.7 days despite standard therapy. Patients with acute hepatitis had been in the hospital for 16.2 +/- 4.1 days before therapy, had a mean bilirubin of 25 mg/100 ml, and had been in coma 5.2 +/- 1.6 days before therapy. Routine tests of liver function, blood chemistries, amino acids, EEGs, and complex neurological testing including Reitan trailmaking tests were used in the evaluation of these patients. Up to 120 grams of synthetic amino acid solution with hypertonic dextrose was tolerated in these patients with improvement noted in encephalopathy of at least one grade in 87% of the patients with cirrhosis and 75% of the patients with hepatitis. Nitrogen balance was achieved when 75 to 80 grams of synthetic amino acids were administered. Survival was 45% in the cirrhotic group and 47% in the acute hepatitis group. Encephalopathy appeared to correlate with individual amino acids differentially in the various groups and with the ratio between the aromatic and the branched-chain amino acids. Ammonia did not correlate with either the degree of encephalopathy or improvement therefrom. In 24 Patients therapy for hepatic encephalopathy was limited to infusion of the branched-chain enriched amino acid solution only, with wake-up in 66% of this group. The results strongly suggest that in protein intolerant patients requiring nutritional support, infusion with branchedchain enriched amino acid solutions is well tolerated with either no worsening of or improvement in hepatic encephalopathy coincident with the achievement of nitrogen equilibrium and adequate nutritional support.
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PMID:Infusion of branched-chain enriched amino acid solution in patients with hepatic encephalopathy. 628 73

THe enzyme activity level of beta-hexosaminidase (beta-N-acetylglucosaminidase, EC 3.2.1.30; 2-acetamido-2-deoxy-beta-D-glucoside acetamidodeoxyglucohydrolase) in serum from patients with different forms of cirrhosis and cholestasis was found to be elevated. A comparison is also made with routine liver parameters. In the light of recent findings it seems probable that the increased level depends upon depressed clearance of this enzyme by the non-parenchymal cells in the liver.
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PMID:beta-Hexosaminidase in serum from patients with cirrhosis and cholestasis. 645 90

The pharmacokinetics of femoxetine (a 5-HT uptake inhibitor with antidepressive effect) was studied in 12 patients with liver cirrhosis and in 6 healthy controls after a single oral dose of femoxetine HC1. The average blood concentration of femoxetine, as assessed by the values of AUC (area under the plasma concentration/time curve), was significantly higher in the patients with liver cirrhosis than in the healthy controls in spite of dose reduction in the patients. The elimination half-life of femoxetine was within the normal limits in most of the patients. The oral clearance of femoxetine was considerably lower in patients, (0.65-4.02 1/hr/kg) than in the controls (8.13- greater than 50 1/hr/kg). It was not directly related to the metabolic function of the liver, measured as the galactose elimination capacity being 0.015-0.024 mmol/min./kg and 0.033-0.041 mmol/min./kg, respectively. When treating patients with reduced liver function, it is recommended to reduce the doses and to monitor closely the plasma levels.
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PMID:Femoxetine clearance in patients with liver cirrhosis. 652 8

Continuous vasopressin infusion has been shown to control bleeding from oesophageal varices in patients with cirrhosis of the liver. The mortality, however, has not been changed. To investigate whether reduction of portal blood flow over a period of hours deteriorates the liver function, we measured the splanchnic blood flow and galactose and oxygen consumption in five cirrhotic patients during liver vein catheterization. Vasopressin was given as a continuous infusion of 0.2 units per min for three h. The splanchnic blood flow was reduced to 70% of control values and remained so throughout the infusion. After three h no impairment of the liver function was found. The wedged hepatic pressure (portal pressure) rose slightly, probably due to the increase of the central venous pressure reflecting impaired cardiac function. The reported beneficial effect of vasopressin on varix bleeding probably depends on the reduced portal flow per se.
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PMID:The effect of continuous vasopressin infusion on splanchnic blood flow, liver function, and portal and central venous pressures in patients with cirrhosis. 661 Feb

Twenty-two patients with cirrhosis and acute encephalopathy who were refractory to medical therapy were entered into a randomized, double-blind prospective trial. This trial consisted of either neomycin or a modified amino acid solution rich in branched chains and low in aromatic amino acids and methionine (F080) in the presence of isocaloric amounts of dextrose. The groups were indistinguishable from each other by clinical or laboratory criteria; they were primarily patients who had undergone operation and they would tolerate only 30 gm of oral protein or intravenous standard amino acids. The group receiving F080 had a faster and more complete improvement in encephalopathy. This improvement correlated with the plasma molar ratio and occurred with a lower mortality rate. In addition, the patients also tolerated twice the amino acid load without encephalopathy and were in positive nitrogen balance. Modified metabolic support is effective in the setting of acute liver failure in chronic cirrhosis, particularly in patients who have undergone operation.
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PMID:Cirrhosis, encephalopathy, and improved results with metabolic support. 662 61

Cimetidine has been shown to reduce liver blood flow, as measured by indocyanine green clearance, in normal subjects. Concern over the potential deleterious effects of such reduction in cirrhosis led to the measurement of blood flow in 14 cirrhotics receiving oral or intravenous cimetidine. Liver blood flow was measured by the clearance of galactose at steady state during infusion of 40 mg per min. In six patients receiving 300 mg cimetidine by mouth each 6 hr for 4 days, basal flow (1,019 +/- 186 ml per min) was not significantly altered by cimetidine (1,087 +/- 156 ml per min). Intravenous infusion of cimetidine (300 mg) did not significantly alter flow in five patients between the basal (1,096 +/- 334 ml per min) and treatment periods (1,051 +/- 383 ml per min). Hepatic extraction of galactose in three patients (82 +/- 19%) was not significantly altered by cimetidine infusion (81 +/- 13%). The failure to reduce liver blood flow with cimetidine in this population may be due to their diminished proportion of portal venous flow, or alternatively suggests that histamine is not an important modulator of flow via H2 receptors. At a clinical level, the use of cimetidine in this population can continue without fear of further reduction in liver blood flow.
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PMID:Cimetidine does not reduce liver blood flow in cirrhosis. 662 21

Sulfobromophthalein dye test and galactose tolerance test were performed, using both substances simultaneous i.v. injection, in 48 subjects with chronic persistent hepatitis, chronic active hepatitis and liver cirrhosis (with and without ascites). As control group 10 normal subjects were tested. Sulfobromophthalein excretion constant ( K1BSF ) drawn from the first part of the retention curve, and the galactose excretion constant (K Gal) were considered. The following conclusions were obtained: a) K1 BSF and K Gal are well-correlated; b) K1 BSF appears more sensitive for a whole evaluation of liver involvement, in absence of evident jaundice (total serum bilirubin less than 6 mg/100 ml); c) K Gal is less reliable in presence of ascites because of the artificial increase in galactose plasmatic clearance provoked by the substance passage to the effusion fluid; d) the statistical analysis using discrimining function methods makes possible a better distinction among the various kinds of liver diseases; e) the same type of statistical analysis shows a difference between cirrhotics with ascites responding to medical therapy in comparison to treatment- resistent ascites. This fact may account for a different level of hepatic functional activity.
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PMID:[Clinico-statistical evaluation of the simultaneous clearance of sulfobromophthalein and galactose in chronic liver diseases]. 667 75

Low-dose galactose clearance is a new method for measuring functional (nutrient) liver blood flow. In 22 healthy beagle dogs, the mean (+/- SD) blood galactose clearance rate of 311 +/- 93 mL/min was not significantly different from the mean measurement obtained using electromagnetic flow probes (322 +/- 37 mL/min). This shows that galactose clearance can be used to measure liver blood flow in healthy dogs. The 22 dogs were divided into two groups of 11. The first group underwent portacaval shunting and weekly galactose clearance rates were measured until death an average of 6 weeks later. The anticipated fall in liver blood flow was successfully detected by the second week after shunting. This suggests that long-term (week-to-week) changes in liver blood flow can be detected by this method. In the second group, ligation of the common bile duct was used to induce secondary biliary cirrhosis. Galactose clearance was measured weekly for 6 weeks and showed a significant decrease by 6 weeks. At 7 weeks, laparotomy was performed in order to take flow-probe measurements; the galactose clearance rate was also measured. Whereas the two methods were similar at the time of the original operation, 7 weeks after ligation there was a significant difference (p = 0.02) with the rate of liver blood flow as measured by galactose clearance being much lower than the flow rate measured by the electromagnetic flow probes. These findings suggest that in cirrhotic dogs, galactose clearance measures functional or effective (nutrient) liver blood flow whereas the electromagnetic flow probe measures anatomic flow. The effective flow gives a more accurate reflection of perfusion of the hepatocyte by blood.
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PMID:Measurement of liver blood flow by galactose clearance. 672 69

The systemic availability of oral glyceryl trinitrate may be a measure of the fraction of portal blood bypassing the hepatocytes through portal-systemic shunts. In order to test this hypothesis without the need for blood sampling, measurements of drug concentrations in plasma were replaced by assessments of pharmacologic effects by using digital plethysmography. Dose-response curves resulting from graded intravenous infusions of glyceryl trinitrate (8 and 25 microgram/min) were used as standard of comparison for the pharmacologic response resulting from an oral dose of 800 microgram. In 9 normal volunteers, systemic availability of oral glyceryl trinitrate was 2 +/- 4% SD. In 7 patients with end-to-side portacaval shunts it was 94 +/- 18%, in 3 patients with distal splenorenal shunts 57 +/- 11%, and in 10 patients with cirrhosis of the liver it varied between 15% and 85%. Systemic availability of glyceryl trinitrate was negatively correlated with the initial plasma disappearance rate of sulfobromophthalein (r = -0.72, p less than 0.01). No significant correlation was found with the galactose elimination capacity (r = -0.12, n = 17). The lack of systemic availability of glyceryl trinitrate in healthy volunteers together with an availability close to 100% after end-to-side shunts is compatible with a very high hepatic extraction of the test compound by the normal liver, and with the idea that the systemic availability of of oral glyceryl trinitrate comes close to representing portal-systemic shunting. The procedure is rapid, essentially noninvasive, and well tolerated by patients.
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PMID:Noninvasive assessment of portal-systemic shunting: evaluation of a method to investigate systemic availability of oral glyceryl trinitrate by digital plethysmography. 680 Aug 68


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