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)

13N-ammonia, applied rectally, after absorption and transportation visualises the liver. After release of 13N-aminoacids and 13N-urea by the liver, 13N-activity can be measured over other organs. In patients with porta-systemic shunts, 13N-ammonia will appear in the systemic circulation as well. In 16 controls and 26 patients with cirrhosis, activities were measured for 20 minutes over liver, spleen, heart, lungs and forearm. In all subjects, the liver was visualised within a minute, in some patients with cirrhosis faintly, however. Release by the liver of 13N-ammonia metabolites started within a few minutes. Liver/heart activity ratios proved to be more discriminating between the control- and the cirrhosis group than liver/lung and liver/spleen ratios. In the control group, the 20 minutes' liver/heart ratio was most suitable for determining the normal range. The lower normal level was found to be 2.25. Fourteen of the 26 patients with cirrhosis had a normal, 12 an abnormally low 20 minutes' liver/heart ratio.
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PMID:Rectal administration of 13N-ammonia in cirrhosis of the liver. 98 59

The 20 minutes' liver/heart activity ratio after rectal administration of 13N-ammonia was abnormally low (less than 2.25) in 12 of 26 patients with cirrhosis of the liver. An abnormal conventional rectal arterial ammonia test (porta-systemic shunts), an abnormally low urea index (prevailing hepatofugal portal venous flow direction), marked portal hypertension (hepatic sinusoidal pressure greater than or equal to 8 mm Hg), ascites and extreme enlargement of the spleen occurred significantly more often in the patients with an abnormally low 13N-liver/heart ratio than in those with a ratio greater than or equal to 2.25. There was no correlation between the 13N-liver/heart ratio and absence or presence of oesophageal varices. The non-invasive rectal 13N-ammonia test appears to be an easy to perform, informative test in cirrhosis of the liver.
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PMID:Rectal 13N-ammonia test (13N-liver/heart ratio), hepatic sinusoidal pressure and prevailing portal flow direction in cirrhosis of the liver. 98 60

In two cases of hepatic coma following advanced liver cirrhosis exchange transfusions were applied with plasmapheresis. In both cases the general condition of patients improved and consciousness returned. After exchange transfusions with plasmapheresis the serum levels of bilirubin, urea and ammonia decreased. Using appropriately selected fluids for erythrocyte suspension it is possible to affect selectively protein depletion and depletion of plasma blood clotting factors.
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PMID:Exchange transfusion with plasmapheresis in the management of hepatic coma. 98 46

Thanks to diuretics, adequate diet, and other measures, the treatment of cirrhotic ascites in recent years has brought better results. Nonetheless, a certain number of patients do not respond to the above mentioned treatment. Such patients are afflicted with so called Refractory Ascites on which diuretics have no effect. In recent years the concentrated continuous reinjection methods has been accepted. During a nine month period, we have treated and analyzed thirty patients with severe Hepatic Ascitogenic Cirrhosis. The results have shown: 8 patients with satisfactory improvement with one reinjection, in 2 patients Ascites did not reoccur; 6 patients died; 6 patients failed to return for a control reexamination; in 2 patients, ascites persisted even after repeated reinjections. The patients were given diuretics the third week following the reinjection, and were put on a low salt diet. Ascites reoccurred, and to a greater degree during the second third, and fourth month. A reduced sodium level was corrected by the reinjection and by the administration of NaCl during the reinjection. K and Cl levels did not change significantly. Urea levels, which were elevated in many cases were normalized. Ammoniums and Phenols also tended to normalize following reinjection. Bilirubin values were highly variable especially in two patients. One of whom had a severely damaged liver (direct bilirubin), the other of whom had bleeding varicoses of the esophagus (indirect bilirubin). Both of these patients died. In such cases reinjection should not be performed until the bilirubin values fall below 5 mgr %. Of the six patients who died, four died of unforeseen esophageal hemorrhaging. A larger number of patients grew more tolerant of diuretics. Preparation for a Portocaval Shunt with the reinjection method is of a special advantage because of an overall improvement in condition, making surgery possible. Complications resulting from reinjection were insignificant and transitory. As a whole, our results (sixteen patients in satisfactory condition), showed that Continuous Venous Reinjection of peritoneal fluid, even though a palliative method, represents a significant step forward in the treatment of Ascites in the severely ill.
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PMID:[Treatment of cirrhotic ascites by means of venous concentrated reinjected of the peritoneal fluid]. 99 28

3 patients with hepatic cirrhosis and ascites underwent increased diuresis on six occasions, closely related to episodes of gastrointestinal bleeding. In each instance the increased urine volume was preceded by a sharp increase in blood urea nitrogen, presumably due to absorption of nitrogenous compounds from the gastrointestinal tract, suggesting a mechanism of osmotic diuresis. In each case there was a signigicant increase in serum sodium and osmolality, related to the greater-water-than-sodium diuresis induced by urea, which was promptly reversed by the administration of water or isotonic solution. Clinically this syndrome may be defined as the association of hypernatremia and hyperosmolality due to osmotic diuresis from urea appearing in a cirrhotic patient with ascites and gastrointestinal bleeding.
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PMID:Hypernatremia following gastrointestinal bleeding in cirrhosis with ascites. 107 10

In a control group (n = 50) and in 52 patients with cirrhosis, urea was administered orally and ratios for hepatic venous/arterial increment were determined up to 120 minutes after loading. A complete, hepatofugal diversion of the portal blood flow would result in ratios less than or equal to 1. The best discrimination between controls and cirrhotics was obtained with the 0-15 minute ratio ("urea index") which has a normal lower limit of 1.25. In cirrhosis an urea index less than or equal to 1.2 is correlated with an abnormal ammonia test and with the presence of marked portal hypertension (hepatic sinusoidal pressure greater than or equal to 8 mmHg, N: 0-3 mmHg). Ascites occurs more often in patients with cirrhosis and a low index. Regardless of the urea index value, ascites in cirrhosis is associated with an hepatic sinusoidal pressure greater than or equal to 8 mmHg. The urea index procedure may easily be conducted together with the measurement of hepatic sinusoidal pressure.
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PMID:The "urea index" as a marker of portal flow direction in cirrhosis of the liver. 127 21

The prevalence of anti-HCV antibodies in Chinese patients with HBsAg-negative chronic liver diseases was studied retrospectively. Anti-HCV was detected by two different ELISAs. In 97 patients with HBsAg-negative chronic liver disease, 26 (27%) were anti-HCV positive. Of 157 control subjects, only 1 (0.6%) was anti-HCV positive (P less than 0.001). Anti-HCV was detected in 18 of 27 (67%) patients with post-transfusion non-A, non-B (PTNANB) chronic hepatitis or cirrhosis, 5 of 25 (20%) patients with cryptogenic chronic hepatitis or cirrhosis, 2 of 33 (6%) patients with alcoholic liver disease, 1 of 5 (20%) patients with autoimmune chronic active hepatitis (AICAH), none of 4 patients with primary biliary cirrhosis (PBC), and none of 3 patients with fatty liver. The prevalence in this group of patients was lower when compared to reports from other countries. The addition of a urea washing step reduced false-positivity in alcoholic and AICAH groups. The ELISA that employs three recombinant HCV antigens confirmed all positive results by another ELISA with the exception of one weakly positive result in the AICAH group and one in the alcoholic group. One patient in the PTNANB group was detected in addition by the second generation assay. In conclusion, ELISA with a urea wash proved to be useful in reducing false-positivity, and the second generation assay proved to be a sensitive and specific test for anti-HCV antibody.
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PMID:Prevalence of antibody to hepatitis C virus in HBsAg-negative chronic liver disease in Hong Kong using different assays. 132 Dec 25

The dietary protein assimilation by cirrhotic undernourished patients (lower lean body mass and plasma TBPA and RBP levels) was investigated in five-adult male subjects suffering from histologically diagnosed liver cirrhosis, in its clinically mild stage (Child-Turcotte-Pugh grade A). During the 9 day-dietary study the patients received orally a sequence of complete-regional diets containing different protein-energy compositions identified as (g prot/Cal/kg/day): D0 = 0.42/20.9; D1 = 0.91/37.5; D2 = 0.99/47.9 and D3 = 1.60/40.5. The respective N-balance values (g/day) found were (mean +/- SD): low protein calorie (D0) = -4.24 +/- 2.46; normal protein calorie (D1) = 0.66 +/- 1.99; normal protein-high calorie (D2) = 1.14 +/- 2.54; high protein normal calorie (D3) = 5.12 +/- 2.48. The correspondent urea-N output (g/kg/day) were D0 = 0.22 +/- 0.100; D1 = 0.238 +/- 0.099; D = 0.20 +/- 0.063 and D3 = 0.310 +/- 0.121. The present data thus suggest that protein rather than energy intake would be the limited factor for increasing the N-retention in (mild) cirrhotic patients whom tolerate well dietary protein at either normal or elevated levels.
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PMID:[Metabolic response of cirrhotic patients (Child A) to the increase of protein and/or caloric intake. Nitrogen balance study]. 134 Jul 47

A block in the transsulfuration pathway has previously been suggested in cirrhosis on the basis of increased fasting methionine concentrations, decreased methionine elimination and low levels of methionine end products. To date, methionine elimination has never been studied under controlled steady-state conditions, and the relation of the severity of liver disease to impaired methionine metabolism has not been clarified. We measured methionine plasma clearance in 6 control subjects and in 12 patients with cirrhosis during steady-state conditions obtained by a primed, continuous methionine infusion. In the presence of high-normal fasting methionine concentrations (range = 14 to 69 mumol.L-1 in controls and 26 to 151 mumol.L-1 in cirrhotic patients), methionine plasma clearance was reduced in cirrhotic patients (2.25 +/- S.D. 0.43 ml.sec-1 vs. 2.86 +/- S.D. 0.43 ml.sec-1 in controls; p less than 0.05), whereas methionine half-life was increased (282 +/- 90 min vs. 187 +/- 25 min in controls; p less than 0.05). Fasting methionine significantly correlated with methionine clearance. The infused methionine was not degraded to urea to any significant extent in cirrhotic patients, whereas a threefold increase in urinary urea nitrogen excretion rate was observed in controls. Similarly, taurine concentrations significantly increased both in plasma and in the urine in controls but not in cirrhotic patients. In cirrhotic patients methionine plasma clearance significantly correlated with galactose elimination capacity (r = 0.818) and with the Child-Pugh score (rs = -0.795). The study supports a major role of impaired liver cell function in the reduced metabolism of methionine and decreased formation of methionine end products that occur in cirrhosis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Defective methionine metabolism in cirrhosis: relation to severity of liver disease. 137 58

The clinical significance and prognosis of culture-negative neutrocytic ascites in cirrhotic patients is a controversial topic. In the present study, the clinical and humoral presentation and the short- and long-term prognosis were analyzed in 36 patients with cirrhosis and culture-positive spontaneous bacterial peritonitis and in 28 patients with cirrhosis and ascitic fluid polymorphonuclear count greater than 250/mm3, a negative ascitic fluid culture, and without previous antibiotic therapy. On admission there were no significant differences between groups related to age, sex, alcoholism, fever, abdominal pain, serum albumin, serum urea, serum creatinine, Child-Pugh score, polymorphonuclear count, and total protein concentration in ascitic fluid. A greater frequency of positive blood culture was found in patients with spontaneous bacterial peritonitis (15/21 vs 2/18) (P < 0.001). Mortality during the first episode was 36% in patients with spontaneous bacterial peritonitis and 46% in patients with culture-negative neutrocytic ascites (NS). Mortality during follow-up was high and survival probability at 12 months was 32% in spontaneous bacterial peritonitis and 31% in culture-negative neutrocytic ascites. The probability of recurrence at 12 months was 33% in spontaneous bacterial peritonitis and 34% in culture-negative neutrocytic ascites. Our results show that spontaneous bacterial peritonitis and culture-negative neutrocytic ascites are variants of the same disease with a high mortality and poor prognosis.
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PMID:Analysis of clinical course and prognosis of culture-positive spontaneous bacterial peritonitis and neutrocytic ascites. Evidence of the same disease. 139 94


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