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)

To obtain information on the prevalence and clinical and laboratory correlates of osteopenia in patients with chronic liver disease, we measured bone densities and 30 selected laboratory variables in 133 subjects (70 men, 63 women) with liver disease. Thirty-two had alcoholic liver disease, 18 had primary biliary cirrhosis, 16 had primary sclerosing cholangitis, 48 had other forms of cirrhosis (cryptogenic, posthepatic) and 19 had chronic hepatitis or fibrosis without cirrhosis. Bone densities of the lumbar spine and three sites of the proximal femur (neck, Ward's triangle, greater trochanter) were estimated by dual-photon absorptiometry. Bone densities at all sites were significantly correlated to one another (r = 0.4 to 0.9; 95% confidence intervals = 0.24-0.54 to 0.81-0.90; p less than 0.0001 for all). Compared with an age- and gender-matched reference group, patients with liver disease had highly significant decreases in bone densities (greater than 2 standard deviations below control values; p less than 0.0008 at all sites). Decreases were particularly marked (24% to 42%) at Ward's triangle, the site of the femoral neck particularly prone to fracture. The prevalence of decreased bone densities ranged from 10% to 56%, depending on the site studied and the nature of the liver disease. Among 30 laboratory variables studied, there were significant (p less than 0.05) correlations with bone densities at more than one site for urinary creatinine (r = 0.21, 0.25), urinary calcium (r = -0.18, -0.23), serum total alkaline phosphatase (r = -0.18, -0.27) and the liver-1 isozyme of serum alkaline phosphatase (r = -0.19, -0.26).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Prevalence and prediction of osteopenia in chronic liver disease. 239 Oct 68

A group of ten patients suffering cirrhosis who were treated with 100 U/l of calcitonin was studied with the aim of knowing whether in patients with cirrhosis the calcitonin is able to provoke the usual characteristic biologic modifications on the basis of the knowledge of their hormonal high levels accompanied of oesteopenia. Regarding their baseline determinations, no statistically significant modifications have been observed in calcium, phosphorous, alkaline phosphatase or its thermostable and thermolabile fractions, magnesium, uric acid and creatinine plasma concentrations respectively. This absence of a biological response to calcitonin could be due either to a numeric or functional damage of the hormone receptors or a diminished biodisponibility, although there are facts suggesting a lesser hormone biopotenciality in these patients.
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PMID:[Results of the functional tests using calcitonin in patients with chronic diffuse hepatopathy]. 239 81

In patients with chronic pancreatitis, common bile duct obstruction is reported in 3.2-45.6% of patients; however, only 5-10% of all patients with chronic pancreatitis require operative decompression of the bile duct. The cause of the intrapancreatic stricture of the common bile duct may be either a fibrotic inflammatory restriction, or compression by a pseudocyst. Obstruction of the duodenum is much less common than common bile duct obstruction in chronic pancreatitis occurring in less than 1-2% of patients with chronic pancreatitis. Colonic obstruction secondary to pancreatitis is very infrequent. The intrapancreatic strictures of chronic pancreatitis are characteristically smooth and tapering on endoscopic retrograde cholangiopancreatography (ERCP), but in some patients, they may have a sharp cut-off and closely resemble the appearance of carcinoma of the pancreas invading the bile duct. The natural history of these intrapancreatic strictures is variable. They may progress and be associated with cholangitis, biliary cirrhosis, common duct stones, or may remain stable for years or regress. Prior pancreaticojejunostomy is not protective against the development of intrapancreatic biliary strictures which may follow in 5-30% of patients, with most authors reporting an incidence of less than 10%. Evaluation of alkaline phosphatase, bilirubin, the presence of jaundice, or the appearance of an intrapancreatic stricture on ERCP is not predictive of whether cholangitis or biliary cirrhosis may or may not develop. The incidence of cholangitis and biliary cirrhosis in patients with intrapancreatic stricture is 9.4% and 7.3%, respectively. Laennec's cirrhosis occurs in a similar number of patients. Operation is indicated in patients with intrapancreatic strictures of the common bile duct in association with chronic pancreatitis in patients developing cholangitis, biliary cirrhosis, common duct stones, progression of the stricture, persistent high elevations of alkaline phosphatase and/or bilirubin for over a month or inability to rule out cancer of the pancreas or periampullary region. The operation of choice is choledochoduodenostomy or Roux-en-Y choledochojejunostomy to bypass the obstructed intrapancreatic portion of the common bile duct. Persistent duodenal obstruction for over 3 or 4 weeks is an indication for gastrojejunostomy. Pain is not a feature of common bile duct obstruction in the absence of cholangitis. In the presence of pain associated with chronic pancreatitis, longitudinal pancreaticojejunostomy is the operation of choice combined with Roux-en-Y choledochojejunostomy. Some of the newer operations, e.g., the Beger and Frey procedures, may make the necessity of a separate operation for biliary decompression superfluous.
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PMID:Treatment of chronic pancreatitis complicated by obstruction of the common bile duct or duodenum. 240 39

The time change of laboratory variables in cirrhosis was studied by analysis of data from 488 patients with cirrhosis included in a controlled clinical trial of long-term prednisone vs. placebo. In the placebo group, a marked regression towards normal was seen within 3 months of entry into the trial (increase in serum albumin, acetylcholinesterase, cholesterol, hemoglobin and decrease in erythrocyte sedimentation rate). The subsequent course did not show a clear pattern, except for a slight increase in serum bilirubin and decrease in albumin. When studied in relation to the time of death in patients dying from a "hepatic" cause, marked increase in bilirubin and decrease in prothrombin index, albumin and cholesterol were seen in the year prior to death with little change before that time. In the prednisone group, a more marked decrease in bilirubin, SGOT, alkaline phosphatase, gamma-globulin, sulfobromophthalein retention, erythrocyte sedimentation rate and increase in leukocytes, prothrombin index and cholesterol were seen during the first 3 months. In relation to time of death from a "hepatic" cause, similar changes were seen as in the placebo group except that alkaline phosphatase increased and cholesterol did not decrease. A beneficial effect of prednisone on survival, as expressed by a previously developed therapeutic index, was associated with decrease in SGOT, alkaline phosphatase and gamma-globulin within the first 3 months. An increase in SGOT during prednisone seemed to be associated with harmful effects of therapy.
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PMID:Changes of laboratory variables with time in cirrhosis: prognostic and therapeutic significance. 241 49

Elevated values of pancreatic-type amylase activity in serum were found in 59% of patients with liver cirrhosis not complicated with renal failure, in 67% of patients with chronic renal failure not complicated with hepatopathy and in 95% of patients with chronic renal failure complicated with hepatopathy. In all the three groups, a significant positive correlation was found between the pancreatic-type amylase and intestinal isoenzyme of serum alkaline phosphatase which is an asialoglycoprotein. However, in pancreatitis a prevalence of an increase in pancreatic-type amylase with respect to intestinal alkaline phosphatase was found. A multivariate analysis showed that in chronic renal failure not complicated with hepatopathy, and in chronic renal failure complicated with chronic liver disease, the changes in calcium homeostasis and also the liver disorder, respectively, contribute significantly to the above-normal values for pancreatic-type amylase.
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PMID:Role of secondary hyperparathyroidism and liver function in hyperamylasemia in chronic renal failure. 241 93

Over the period of the past 9 years (1980-1988), 320 patients (mean age 60.9 +/- 13.2 years) suffering from various liver diseases have been examined. There were three main groups of patients: (1)--24 patients with primary liver cancer (PLC), 19 of them with hepato- and 5 with cholangiocellular carcinoma, (2)--153 patients with metastatic liver tumors (MLT), and (3)--143 patients with inflammatory liver diseases (ILD). The results of examination of alpha-fetoprotein (AFP), carcinoembryonic antigen (CEA), alkaline phosphatase (ALP) and gamma-glutamyl transpeptidase (GMT) in these patients have been analyzed with the aim to evaluate their contribution to the differential diagnostics of tumorous and inflammatory liver processes. For the diagnostics of malignant hepatoma AFP appeared to the most specific test. The significance of other tests for diagnostics of malignant hepatic diseases is obviously limited. These tests are recommended to be considered (in the case of their increase) in close connection with the clinical image and additional examinations. The importance of correlation between cirrhosis and malignant hepatoma is also to be noticed. In spite of all this, we believe that in the case of positivity of the above tests the patients have to be carefully examined and followed up, and that the clinical course and the dynamic of the mentioned tests has to be thoroughly observed. Because of the specificity of values of the AFP-test with malignant hepatoma, we find it useful to perform this test in all patients with chronic liver diseases.
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PMID:Alpha-fetoprotein, carcinoembryonic antigen and various biochemical tests in patients with tumorous and inflammatory liver diseases. 246 43

Using chromatography on diethylaminoethyl (DEAE) cellulose, we measured biliary alkaline phosphatase (BALP; EC 3.1.3.1) activities in sera from 182 patients, most with hepatobiliary disorders but some with non-hepatobiliary diseases. Relative BALP activities were extremely low in otherwise healthy carriers of hepatitis B virus (mean: 5.4 U/L) and in patients with non-hepatobiliary diseases (mean: 5.3 U/L). Although BALP activities were detectable in some cases of liver cirrhosis and chronic hepatitis, these values were generally low (respective means: 12.6 and 12.0 U/L). High BALP activities were detected in patients with primary hepatocellular carcinoma, secondary metastatic liver tumors, and obstructive jaundice: mean values were 27.2, 37.2, and 73.6 U/L, respectively. There was no correlation between BALP activity and bilirubin concentration in patients with obstructive jaundice, nor between BALP activities in obstructive jaundice caused by stones and in those caused by extrahepatic tumor. Some patients with primary hepatocellular carcinoma had high BALP but low alpha-fetoprotein (AFP) values, some others the reverse. Based on AFP alone, the sensitivity for detecting hepatocellular carcinoma was 79%; adding BALP in parallel improved the sensitivity to 97%. We found minicolumn chromatography on DEAE-cellulose useful for determining BALP activity in hepatobiliary diseases.
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PMID:Biliary alkaline phosphatase measured by mini-column chromatography on DEAE-cellulose: application to detection of hepatobiliary diseases. 247 88

Neopterin is a pyrazino-pyrimidine compound which is biosynthesized by macrophages. Increased concentrations of neopterin have been reported in conditions causing stimulation of cellular immunity, such as viral and other infections, graft versus host disease, autoimmune diseases and different malignancies. Recently, increased urinary neopterin levels have been found in patients with acute viral hepatitis and NANB chronic hepatitis. In the present study, neopterin serum levels were measured in 23 cirrhotic patients (6 HBV related, 7 alcoholic and 10 cryptogenetic cirrhosis) and in 24 normal subjects. Mean values of serum neopterin were statistically increased in cirrhotics (3.92 +/- 3.28 ng/mL versus 1.24 +/- 0.51 ng/mL in controls, p less than 0.01). Serum neopterin values were not statistically different either in cirrhotics assessed in three different classes according to Child's classification or in cirrhotics with or without serological findings of active disease. In fact, in cirrhotic patients, serum neopterin levels did not correlate with serum aspartate and alanine aminotransferases, alkaline phosphatase, gamma-glutamyltransferase and gammaglobulins values. These data show that increased levels of serum neopterin occur in cirrhotic patients, but there is no relation between serum neopterin values and the histological activity or the clinical severity of the disease. The results are consistent with the hypothesis that activated macrophages are involved in all forms and in all stages of liver cirrhosis.
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PMID:[Blood levels of neopterin in patients with liver cirrhosis]. 248 6

The efficacy of silymarin treatment in preventing biochemical and histological alterations in CCL4-induced liver cirrhosis in rats was studied. Four groups of rats were treated with: (1) CCL4; (2) mineral oil; (3) CCL4 + silymarin; and (4) silymarin. All animals were sacrificed 72 h after the end of treatments. The activities of alkaline phosphatase (alk. phosp.), gamma-glutamyl transpeptidase (GGTP), glutamic pyruvic transaminase (GPT) and glucose-6-phosphatase (G6Pase), and bilirubin content were determined in serum. Na+, K+-ATPase and Ca++-ATPase activities were measured in isolated plasma membranes. Lipoperoxidation, triglycerides (TG), and glycogen contents were also measured in liver homogenates. Liver cirrhosis was evidenced by significant increases in liver collagen, lipoperoxidation, serum activities of alk. phosp., GGTP, GPT, G6Pase, bilirubin content, and liver TG. Activities of ATPases determined in plasma membranes were significantly reduced, as was liver glycogen content. Silymarin cotreatment (50 mg/kg b.wt) completely prevented all the changes observed in CCL4-cirrhotic rats, except for liver collagen content which was reduced only 30% as compared to CCL4-cirrhotic rats. Silymarin protection can be attributed to the agent's antioxidant and membrane-stabilizing actions.
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PMID:Prevention of CCL4-induced liver cirrhosis by silymarin. 254 40

Primary liver tumour, i.e. hepatocellular carcinoma (HCC) is one of the world's most common malignancies. The age-standardized incidence rate varies widely from 6/100,000 (Austria) to 100 and more per 100,000 in Mozambique and Taiwan. In these high-risk areas, infection with hepatitis B virus is considered the main risk factor. In low-incidence areas as in Western Europe, main risk factors are older age, male sex and liver cirrhosis. The prognosis depends mainly on the size of the tumour. Alpha-fetoprotein is an ideal tumour marker for prospective screening in high-incidence areas. There is not much information, however, on the value of this marker for screening in low-incidence areas. There is some information that HCC-associated alkaline phosphatase could be a good tumour marker in non-viral liver tumours. Furthermore, des-gamma-carboxyprothrombin and vitamin B 12-binding protein could be specific markers for tumours in non-cirrhotic livers. But large clinical studies have not yet confirmed the value of these markers. Hormonal and haematological markers and some isoenzymes are tumour markers characterized by high sensitivity but low specificity. There are no specific tumour markers for metastatic liver disease.
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PMID:[Tumor markers in internal medicine hepatology]. 254 32


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