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

The Authors present and discuss clinical and therapeutic aspects of several cases of chronic portal thrombosis, troncular and radicular, either isolated or variously associated. Splenoportography and selective arteriography do not always provide a clear-cut picture of the vascular situation, particularly in the presence of mural thrombi. Surgery may be needed as an emergency measure in cases of hemorrhage, but the best results are obtained if it can be done electively. Indications, however, must be evaluated very carefully in each individual case, especially for thrombosis not associated with cirrhosis of the liver, in which the tendency to a more favorable natural evolution may invite a more conservative approach. The choice of surgical procedures is dictated essentially by the site of obstruction in the portal system. After discussing the indications for various methods, the authors present some cases of thrombosis involving only the superior mesenteric vein, managed successfully by disobliteration and mesenterocaval anastomosis.
Chir Ital 1978 Dec
PMID:[Surgical aspects of thrombosis in the portal system (author's transl)]. 75 29

Various parameters of the insulin secretion in man may be appreciated and calculated by studying the insulin response to an intravenous pulse of glucose followed 120 minutes later by one of tolbutamide. The relative insensitivity of the B cell to glucose, probable marker of a constitutional pancreatic predisposition to diabetes may be assessed in a given individual whatever his age and body weight. The glucose intolerance per se is due to, or accompagnied by various B cell dysfunctions according to its etiology. This is illustrated by the results observed in chronic pancreatitis, liver cirrhosis, aged or obese subjects.
Nouv Presse Med 1976 Dec 25
PMID:[A method of studying insulin secretion in humans: the glucose stimulation test, followed by tolbutamide]. 79 23

An investigation into the possible role of endotoxins in the pathogenesis of renal failure in cirrhosis and obstructive jaundice showed the two to be closely related. None of the patients with cirrhosis who had endotoxaemia had other evidence of Gram-negative infection at the time of the study, and the endotoxaemia was therefore probably due to impaired hepatic clearance of toxins normally absorbed from the gastrointestinal tract. In contrast, bacteriological evidence of Gram-negative infection was found in most of the patients with obstructive jaundice and endotoxaemia.
Br Med J 1976 Dec 11
PMID:Endotoxaemia and renal failure in cirrhosis and obstructive jaundice. 79 99

Serum concentrations of 3,3',5'-triiodothyronine (reverse T3, rT3) were measured in adult patients with several systemic illnesses whose serum total and/or free T3 were low, serum total T4 was low or normal, and free T4 was either normal or elevated. The mean serum rT3 was 76, 46, and 77 ng per 100 ml in patients with hepatic cirrhosis, chronic renal failure, and acute febrile illnesses, respectively; the values in patients with hepatic cirrhosis and acute febrile illness were significantly higher than, and values in patients with renal failure did not differ significantly from, the mean serum rT3 (41 ng per 100 ml) in normal subjects. The mean serum rT3 in another group of patients from Calcutta, India, who had severe protein calorie malnutrition (PCM), was 53 ng per 100 ml; it was significantly higher than the corresponding value, 22 ng per 100 ml, in the same patients after feeding treatment. Mean serum rT3 in patients with systemic illnesses was not so high as that (151 ng per 100 ml) in the normal newborn, who also has low serum T3 and normal or high T4. High serum rT3 in patients with systemic illness could not be attributed to increased serum protein binding of rT3; whenever studied, the dialyzable fraction of rT3 was not decreased but actually increased. The mean serum-free rT3 was 450,207, and 366 pg per 100 per 100 ml in patients with hepatic cirrhosis, chronic renal failure, and acute febrile illnesses, respectively; each of these values was significantly higher than the corresponding value, 98 pg per 100 ml, in normal subjects. The mean serum free rT3, 516 pg per 100 ml, in newborn cord sera was similar to that in patients with hepatic cirrhosis but was higher than that observed in patients with chronic renal failure and acute febrile illnesses. High serum rT3 and low serum T3 in patients with PCM improved to normal or towards normal after feeding treatment. Since the peripheral metabolism of T4 is normally the predominant source of T3 as well as rT3 in man, our data, demonstrating reciprocal changes in serum rT3 and T3 and no consistent change in serum T4, suggest that body metabolism of T4 may be so altered in systemic illness that the conversion of T4 to rT3 may be increased while that to T3 is decreased. The mechanism or the biological significance of such a diversion of T4, from the normally occurring conversion to highly potent T3, to the generation of poorly calorigenic rT3 in systemic illness, is not clear at this time. The data in patients with PCM demonstrate, however, that such a change in the metabolism of T4 can be reversible.
J Clin Endocrinol Metab 1975 Dec
PMID:Reciprocal changes in serum concentrations of 3,3',5-triiodothyronine (T3) in systemic illnesses. 81 82

The surface features of single cells and of multicellular tissue units in cirrhotic rat livers have been studied by scanning electron microscopy (SEM). Cirrhosis of the liver was produced in rats by simultaneously treating them with carbon tetrachloride and sodium phenobarbital. Connective tissue septa consisted of a losse mesh-work of fibers in which fibroblasts were embedded. The arrangement and surface features of hepatocytes in cirrhotic nodules differed from those found in parenchyma of normal livers. Hepatocytes in cirrhotic nodules universally formed plates two cells thick. The portion of the hepatocyte surface covered by microvilli was greatly increased in cells from cirrhotic livers, and this was reflected in a corresponding reduction in the area occupied by the smooth-surfaced narrow intercellular space. Canaliculi between hepatocytes in cirrhotic livers were reduplicated and frequently branched. hepatocyte surfaces covered by microplicae and flattened microvilli, typical of connective tissue-facing surfaces in normal livers, were greatly increased in cirrhotic livers corresponding to the increase in connective tissue. Where hepatocytes directly contacted fibroblasts (and not fibers), their surfaces were entirely smooth. Sinusoidal endothelial cells in cirrhotic livers contained only isolated, relatively sparse pores, and they lacked both sieve plates (pore complexes) and large fenestrations.
Virchows Arch A Pathol Anat Histol 1976 Dec 07
PMID:Surface features of cirrhotic liver. 82 92

The ammonia hypothesis is the most likely explanation for the pathogenesis of hepatic encephalopathy in cirrhosis patients. Reduction of hyperammonemia is therefore the most consistent therapy. From this point of view, the antibiotics have a central significance for the reduction of ammonia formation in the intestinal tract. Equally important is the correction of the hypopotassemia, which may lead to a renally induced hyperammonemia. At the same time, disorders which favor the cerebral toxicity of ammonia, especially anemia and hypoxias, must be compensated. These various measures have improved the prognosis for hepatic encephalopathy of the cirrhosis patient, but were without effect on the course of the coma in severe toxic hepatitis. During the last toxic hepatitis. During the last 10 years, many treatment methods have been reported whose efficacy, however, could not be proved.
MMW Munch Med Wochenschr 1976 Dec 24
PMID:[Present-day therapy of hepatic encephalopathy (author's transl)]. 82 98

Nafcillin, a semisynthetic penicillin effective against penicillinase-producing staphylococci, is eliminated largely in man via the liver. This study assessed the effect of cirrhosis and extrahepatic biliary obstruction in man on the pharmacokinetics of nafcillin. The plasma clearance of nafcillin controls was 583 +/- 144.2 ml per min (mean +/- SD) and fell strikingly to 291 +/- 147.6 and 163 +/- 56.3 ml per min in patients with cirrhosis and extrahepatic obstruction, respectively (P less than 0.001). In the latter two groups nafcillin excreted in urine increased from about 30 to 50% of administered dose (P less than 0.02), suggesting that renal disease superimposed on hepatic disease would further decrease over-all nafcillin clearance. The depression of nafcillin clearance with hepatobiliary disease did not correlate with any conventional liver laboratory test. The initial volume of distribution of nafcillin (V1) was unaltered but at steady state (Vd()) there was a significant reduction in the distribution volume in the patients with liver disease. Accordingly, the impairment in drug elimination, as assessed by its clearance from plasma, was underestimated by the prolongation of the nafcillin elimination half-life (t1/2(beta)) which was 1.02 +/- 0.20 hr in controls, and 1.23 +/- 0.31 (P greater than 0.05) and 1.73 +/- 0.44 hr (P less than 0.03), respectively, in patients with cirrhosis and extrahepatic obstruction.
Gastroenterology 1977 Dec
PMID:Disposition of nafcillin in patients with cirrhosis and extrahepatic biliary obstruction. 91 79

Clinicians should not minimize or overlook the importance of percussion of the liver and the spleen and of auscultation over the liver as routine parts of abdominal examination. Splenic percussion can be used to detect splenomegaly even before the spleen becomes palpable. The span of liver dullness on percussion can be compared with established normal standards to detect hepatomegaly or alterations caused by cirrhosis. A systolic bruit, a friction rub, or a venous hum detected by auscultation over the liver is an important sign of liver disease.
Postgrad Med 1977 Dec
PMID:Abdominal examination: role of percussion and auscultation. 92 43

Supine plasma aldosterone and plasma renin activity were determined in patients with cirrhosis of the liver and ascites (n = 10). Most of the patients initially showed an increase in plasma aldosterone and plasma renin activity. However, values within the normal range were observed (plasma aldosterone, n = 3; plasma renin activity, n = 4). In the ascitic fluid renin activity could not be detected, whereas aldosterone concentrations correlated significantly with the respective plasma levels (r = 0.8, p less than 0.01). During therapy with spironolactone alone (n =2) or in combination with furosemide (n = 4), diuresis and natriuresis showed no correlation with changes in plasma aldosterone and/or plasma renin activity. Our results suggest that other factors than renin and aldosterone secretion may be important in the formation of ascites in patients with cirrhosis of the liver. In addition, the inverse correlation between mean arterial blood pressure and plasma renin activity (r = -0.65, p less than 0.05) found in our patients supports the assumption that the increase in renin secretion is probably induced by changes in (renal) hemodynamics.
Schweiz Med Wochenschr 1977 Dec 03
PMID:[Aldosterone and renin in liver cirrhosis with ascites]. 92 37

Lower esophageal sphincter (LES) function in cirrhosis was evaluated using an infused manometric system. LES pressure (LESP) in 10 subjects with cirrhosis (22 +/- 1 mm Hg) (mean +/- SE) was not significantly (P greater than 0.05) different from that of 10 control subjects (21 +/- 1 mm Hg) but was significantly (P less than 0.01) greater than the LESP recorded in 5 subjects with cirrhosis and ascites (16 +/- 2 mm Hg). There was no significant difference in LES response to intravenous pentagastrin, intravenous edrophonium, or straight-leg raising in the three groups. After loss of ascitic fluid, LESP significantly (P less than 0.01) increased (deltaP : 9 +/- 3 mm Hg) and gastric pressure (GP) significantly (P less than 0.01) decreased (deltaP: 8 +/- 2 mm Hg). The changes in LESP and GP revealed a significant (R = 0.83, P less than 0.001) linear correlation. These data indicate (1) cirrhosis is associated with normal LES function, and (2) the mechanism of lowered LESP with ascites may be the inability of the LES to maintain a sustained response to chronic increases in GP.
Am J Dig Dis 1977 Dec
PMID:Lower esophageal sphincter function in cirrhosis. 93 Sep 10


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