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Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In dynamics of development of toxic heptatitis and cirrhosis the alterations in functionality of thyroid glands were accompanied by qualitative and quantitative changes of separate iodine-containing components in blood.
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PMID:[Form and content of iodine-containing components of blood in liver pathology]. 6 8

The authors studied the metabolism of fibrinogen labelled with iodine 125 in 57 cirrhotic patients and 25 controls. Their results show that if the 82 subjects are grouped according to biological period values (T) and plasma pool (N.I.) of each of them, 4 distinct populations emerge. In each of these 4 groups a physiopathological interpretation of fibrinogen metabolism may be proposed. In the context of consumption coagulopathies in cirrhosis, the examination is of real value and offers an objective criterion of therapeutic effectiveness.
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PMID:[Metabolism of fibrinogen in the cirrhotic patient. Dynamic study by isotope method]. 93 80

Indirect measurement of portal pressure and hepatic venography using the balloon catheter technique were investigated to assess the stage of chronic alcoholic liver disease, especially, to diagnose cirrhoses. 80 patients were studied and were categorised in 4 groups according to their liver histology: normal liver (N, n = 6), fibrosis (F, n = 27), incomplete cirrhosis (F/C, n = 11), complete cirrhosis (C, n = 36). Medians of wedged hepatic venous pressure gradient P (= WHVP-FHVP) and of a semiquantitative venographic score S showed increasingly higher values with more severe stages of the disease. Portal pressure (P) and venographic appearance (S) were correlated significantly (r = 0.778, p less than 0.0001). P was most useful to diagnose cirrhosis: Precirrhotic forms were associated with pressure gradients P less than or equal to 5 mm Hg in 97%. Incomplete cirrhoses were distributed in about 50% above and below P = 5 mm Hg, for complete cirrhoses P greater than or equal to 8 mm Hg was found in 97%. Pressure gradients P greater than or equal to 5 mm Hg indicated cirrhotic disease with a specificity of 97%. Sensitivity for complete cirrhoses was also high (97%), for incomplete cirrhoses however low (47%). Venography and measurement of portal pressure as diagnostic tools to predict cirrhoses of alcoholic origin were clearly more useful than biochemical tests (serum bilirubin, quick and cholinesterase). In comparison to laparoscopy the acceptance by patients is higher and the risk is lower if patients with known adverse reactions to contrast materials and risk of thyreotoxicosis induced by iodine are excluded.
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PMID:[Diagnosis of alcohol-induced liver cirrhosis by indirect portal vein pressure measurement and liver venography]. 160 9

Liver tumours frequently present at a late stage and only a minority of patients are likely to benefit from resection or transplantation. Inoperable tumours carry a grave prognosis. External beam irradiation of the liver is dose-limited by the radiosensitivity of hepatocytes, particularly in the presence of cirrhosis, but internal radiation using radio-isotope sources can achieve more selective irradiation of the chosen field. Sealed sources are dose-limited by their effects on surrounding tissues, whereas with unsealed sources the dose of radio-isotope administered is limited by bone marrow suppression. Iridium-192 wires are most frequently employed as a sealed intracavitary source. They may be inserted surgically, transhepatically or endoscopically. Doses of up to 60 Gy can be delivered to a malignant biliary stricture without damage to the surrounding parenchyma. The incidence of cholangitis is low if treatment is administered after insertion of an endoprosthesis. Unsealed radio-isotope sources may be injected directly into the tumour, administered embolically via the hepatic artery in the form of microspheres or lipid droplets, or given via parenteral infusion attached to tumour-specific antibodies. Of these vehicles, the lipid agent Lipiodol appears to be the most effective and can deliver a potentially lethal dose of radiation to small tumours. Host reaction to the injected antibody remains a major drawback to the use of monoclonal antibodies as targeting agents. Iodine-131 is a beta- and gamma-emitter, producing a local tumoricidal effect and allowing accurate dosimetry by means of external scintigraphy. Yttrium-90 is a pure beta-emitter with a greater maximum beta energy and cytotoxic range; however, it is retained in bony tissues, resulting in a dose-related risk of marrow suppression. Bone absorption cannot be measured by external imaging owing to the absence of gamma emission. This lack of accurate dosimetry, coupled with the toxic side-effects of yttrium treatment, make iodine-131 the current isotope of choice.
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PMID:Therapeutic aspects of radio-isotopes in hepatobiliary malignancy. 164 96

Portosystemic shunt fraction estimation using transcolonic iodine-123-iodoamphetamine (IMP) has been previously validated relative to portal vein macroaggregated albumin injections using an experimental model of cirrhosis. Transcolonic technetium-99m-pertechnetate (TcO4-) has been proposed as an alternative tracer to IMP to study portal circulation in cirrhotic patients. We compared shunt fraction estimates from paired transcolonic IMP and TcO4- studies performed on a group of dogs before and after common bile duct ligation surgery. Pertechnetate over-estimated shunt fraction in 6/7 postoperative studies relative to IMP. A good correlation between the two methods was demonstrated, however, the slope of the regression line was substantially less than 1.0 with TcO4- values reaching 100% at IMP shunt values of approximately 60%. This apparent inability to accurately assess high shunt flows may limit the quantitative aspects of TcO4- studies on patients with severe portosystemic shunting.
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PMID:Comparison of shunt fraction estimation using transcolonic iodine-123-iodoamphetamine and technetium-99m-pertechnetate in a group of dogs with experimentally-induced chronic biliary cirrhosis. 184 11

We recommend that the CT technique of choice for routine screening of the liver, especially when there is potential for neoplasia, is dynamic CT using a single monophasic bolus of not less than 150 mL of a 60% iodinated contrast agent and a dynamic incremental package yielding at least 7 sections/minute. Routine use of noncontrast CT prior to dynamic CT is not indicated unless there is suspicion of a hypervascular tumor. We prefer to examine these particular patients with delayed CT 4 to 6 hours after receiving at least 60 g of iodine, as lesion to liver contrast is superior to noncontrast CT. Other indications for delayed CT include indeterminate lesions on dynamic CT or CTAP and perfusion defects on CTAP. In patients who are possible candidates for hepatic tumor resection, more invasive techniques such as CTAP are indicated as they yield the highest sensitivity to focal hepatic lesions, especially small lesions. A combination of CTAP and MR, however, demonstrates a superior lesion detection rate than either modality alone. CT-Lipiodol is a useful technique for detecting and palliating hepatocellular carcinomas, especially in patients with concomitant cirrhosis.
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PMID:Techniques for computed tomography of the liver. 194 41

Grading of goitre size according to WHO or the palpatory estimation of thyroid volume does not allow a quantitative estimation of thyroid size or an objective follow-up during treatment with e.g. radioiodine. The present and other studies have demonstrated that the ultrasonic evaluation of thyroid volume is both accurate and precise. In addition, it is non-invasive, rapid, inexpensive and without discomfort to the patient. Using this technique it was demonstrated that thyroid volume increases with increasing age and body weight in both sexes, with weight having the most pronounced influence. The relationship between thyroid volume, body weight and age in non-goitrous healthy subjects can be described using a formula that allows the calculation of normal thyroid size for a population: Thyroid volume (ml) = 1.97 + 0.21 x bodyweight (kg) + 0.06 x age (years). Cigarette smoking is associated with an approximately 10-fold increase in goitre frequency probably due to a combination of an increased sympathetic stimulation of the thyroid and an iodine deficiency state caused by inhalation of thiocyanate. Although no seasonal alteration in serum TSH level could be demonstrated thyroid volume is 23% higher in the winter than in the summer. Cyclic alterations of thyroid volume possibly related to TSH alterations have been found with a 50% difference between minimum values in the first half and maximum values in the second half of the menstrual cycle. Nonthyroidal illnesses are associated with marked alterations in thyroid volume. Thus, chronic renal disease and acute hepatic disease demonstrate significant increases in thyroid volume although the precise mechanisms have not been clarified. Chronic hepatic disease per se and chronic nonrenal nonhepatic disease does not seem to influence thyroid volume. Chronic alcoholism, however, with or without liver cirrhosis is associated with a marked decrease in thyroid volume and an increase in the amount of fibrosis probably related to a direct toxic effect of alcohol on the thyroid. All these factors should be kept in mind when goitre frequency, goitrogenic action of drugs and goitre treatment effects are evaluated.
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PMID:Thyroid size determined by ultrasound. Influence of physiological factors and non-thyroidal disease. 219 37

The thyreostatic therapy of a hyperthyroidism in coincident chronic hepatopathy is problematic. On the one hand, this therapy may be an additional load, particularly by the development of a cholestasis for the ill liver. On the other hand, due to the hyperthyroidism disturbance of the liver function and liver diseases up to cholestatic hepatitis may develop. At the instance of two patients with liver cirrhosis, whose simultaneous hyperthyroidism was treated thyreostatically, the therapeutic problems are represented. On the basis of the treatment of a not small number of patients with this constellation of findings we recommend the use of Thiamazol as therapy of choice in the at present, usual lower initial dosage. If functional disturbances of the liver and other side effects appear under this therapy, the radio-iodine therapy offers itself as alternative.
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PMID:[Thyrostatic therapy in patients with liver cirrhosis]. 241 55

Hepatocellular pseudotumor (HCP) occurs in cirrhotic liver and can resemble hepatocellular carcinoma. Liver ultrasonography shows a space-occupying lesion. The aim of this study was to describe the clinical, radiological and histologic features of HCP based on seven patients (3 women, 4 men), mean age 48 years (24 to 62), with histologically proven cirrhosis (alcoholic, 4 cases; autoimmune, 1 case; postnecrotic, 1 case, idiopathic, 1 case). Serum alphafetoprotein was below 16 ng/ml in 5 patients and remained over 120 ng/ml in the remaining 2. Desgammacarboxyprothrombin, performed in 3 cases, was below the upper limit of normal range. Real time ultrasonography of the liver showed a homogeneous parenchyma in 1 case and median size (20-48 mm) space-occupying nodular lesions in 6 cases. Sonography patterns of hepatocellular pseudotumor were as follows: anechoic lesions in 5 cases and mixed pattern (sonodense and hypoechogenic) in 1 case. Angiographic findings exhibited different patterns: hypervascular or hypovascular nodules, multinodular uptake after lipiodol bolus injection. Computed tomography showed iso- or hypodense space-occupying lesions. Lipiodol injection, performed in 3 cases, showed nodular lipiodol uptake. Fine needle biopsy always showed normal hepatocytes. At laparotomy, performed in 3 cases, an hyperplastic nodule was found in 1 case only. All patients were alive at 12 to 36 months. These findings are consistent with the fact that hepatocellular pseudotumor is a true entity. Differential diagnosis is difficult. Iodine oil nodular fixation on CT scan may be non specific for hepatocellular pseudotumor. Histologic data is mandatory before beginning a non surgical therapeutic regimen for suspected hepatocellular carcinoma.
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PMID:[Pseudotumor nodules of the liver in cirrhotic patients. Study of 7 cases]. 306 32

I examined whether the rate of ascites formation in cirrhosis is increased by volume expansion and whether this rate is related to the intensity of renal sodium retention, and I examined the mechanisms by which ascites is mobilized during diuresis. The plasma-ascites filtration rate (PFR) of intravenously injected iodine 125-labeled albumin (the rate of ascites formation by the liver) after volume expansion with normal saline solution in seven patients was similar to that observed in 14 patients who had not received infusions (0.010 +/- 0.003 vs. 0.013 +/- 0.006 L/hr/m2) and was unrelated to natriuresis both before and after intravenous administration of 80 mg furosemide the previous day (r = 0.04 and -0.36). Diuresis of seven patients who had not received infusions reduced PFR (from 0.679 +/- 0.267 to 0.411 +/- 0.198 L/day, P less than 0.05) and total ascites formation rate (from 3.029 +/- 1.620 to 1.465 +/- 1.053 L/day, P less than 0.02) but not plasma volume (from 3.464 +/- 0.646 to 3.391 +/- 0.775 L). Increases occurred in ascites albumin concentration (from 7 +/- 4 to 9 +/- 4 gm/L, P less than 0.05) and in the ascites/serum albumin ratio (from 0.26 +/- 0.12 to 0.35 +/- 0.13, P less than 0.05) but not in the serum-ascites albumin gradient (portal pressure). Fractional changes in ascites volume and albumin concentration were unrelated (r = 0.20). The calculated rate of ascites reabsorption decreased in five patients during diuresis, indicating that ascites was mobilized by decreased formation. Ascites reabsorption increased in two patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ascites kinetics in cirrhosis: effects of rapid volume expansion and diuretic administration. 333 70


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