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)

This study was performed to investigate modifications in the serum bilirubin forms, hepatobiliary enzymes, and some glycoproteic substances in patients during the course of extrahepatic cholestasis (stage A) and following its clinical resolution (stage B). The series consisted of 16 patients: 11 had main bile duct stones; two, benign stenosis of the main bile duct; and three, main bile duct cancer. Cholestasis resolved spontaneously in one case, under endoscopy in two, and following surgery in 13. Five patients with liver cirrhosis and a picture of intrahepatic cholestasis following anesthesia were also investigated. Serum bilirubin forms were measured using van den Bergh's method and the alkaline methanolysis-HPLC procedure; the mono- and di-conjugated forms were considered together in the overall evaluation of the results. The hepatobiliary enzymes (ALP, GGT, and AST) were increased at stage A and significantly decreased at stage B. Similar patterns were observed in total (TB), unconjugated (UB), and conjugated bilirubin (CB) and in the percentage of CB out of TB (% CB). In the majority of patients, % CB at stage B was lower than at stage A, whereas in subjects with a high initial UB value, a different % CB pattern was observed. The direct bilirubin percentage (% DB), on the other hand, had a different pattern, and the variations between stages A and B were not significant. The pathophysiological bilirubin pattern was similar in patients with intrahepatic cholestasis. At stage A, in a number of patients the levels of glycoproteic substances (CA 19-9, TPA and ferritin) were raised, but at stage B they tended to decrease towards the normal range.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Alterations in bilirubin metabolism during extra- and intrahepatic cholestasis. 160 Mar 31

We investigated by enzyme electrophoresis after prolonged neuraminidase treatment the activity of "intestinal variant" (alpha 2-globulin mobility) alkaline phosphatase (EC 3.1.3.1; ALP) in the plasma of 189 patients selected for disorders (diabetes mellitus, liver cirrhosis, and chronic renal failure) with a known high frequency of increased plasma intestinal (beta-globulin mobility) ALP activity. The overall frequency of the variant ALP was 23.8%, whereas in the samples showing intestinal ALP it was 45.0%. The variant ALP was not observed in the absence of intestinal ALP, nor in patients of blood group A. Its frequency did not differ significantly between the different patient groups. Quantification of the variant ALP by densitometry was unsatisfactory but the quantity could be estimated by subtracting the intestinal ALP activity measured by electrophoresis from the activity determined by immunoassay with monoclonal antibody that reacts with both the intestinal and the variant forms. This indicated median activity of 12 U/L for the variant, approximately equal to that of the concomitant intestinal ALP. From the effects of papain and bromelain treatments, we suggest that "intestinal variant" represents intestinal ALP with attached membrane-binding domain.
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PMID:Intestinal variant alkaline phosphatase in plasma in disease. 170 Jul 41

A sandwich ELISA system for detecting vascular basement membrane associated collagen (BAC) was developed. Serum levels of BAC were determined in patients with liver diseases (N = 53), various cancers (N = 65) and other diseases (399). Serum levels of procollagen type III (PIIIP) amino propeptide, type IV collagen.7s domain (7s domain) and other parameters (TP, ALB, GOT, GPT, CHE, gamma-GTP, ALP, LDH, CHE, TG, GLU) were also determined in those patients. In the whole patients, serum concentrations of BAC showed a weak correlation with GOT, GPT, ALB and CHE but not with gamma-GTP and ALP. There was no correlation between BAC and PIIIP or 7s domain. Although serum levels of BAC were elevated in both liver diseases and cancers, the increase in liver diseases was more marked. Markedly increased serum levels of BAC with low levels of CHE were found only in liver cirrhosis and liver cirrhosis plus hepatocellular carcinoma. Increased BAC may reflect capillarization of the liver sinusoid or remodeling of the vascular basement membrane which is observed in the progression of liver fibrosis. Serum BAC is thought to be a promising new marker, different from PIIIP or 7s domain for diagnosing fibrosis state in the organs, particularly in the liver.
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PMID:[Serum level of vascular basement membrane associated collagen by the sandwich ELISA with monoclonal antibodies and its clinical significance in various diseases]. 170 45

Serum CA 19-9 was determined in 83 control subjects, 99 patients with pancreatic cancer, 104 with chronic pancreatitis and 137 with extra-pancreatic diseases mainly of gastrointestinal origin in order to evaluate whether hepatic factors can influence circulating CA 19-9 in pancreatic cancer. Sensitivity, specificity and accuracy of this test in determining pancreatic malignancy were: 74%, 83% and 57%. We divided patients into two groups: group A (159 cases) and group B (181 cases) with and without anatomical liver damage (presence of primary or metastatic cancer, cirrhosis, hepatitis, steatofibrosis, cholangitis). Group A presented higher CA 19-9 values as compared to group B. Significant correlations were found in group B but not in group A between CA 19-9 and ALT, ALP and total bilirubin. Multiple regression analysis (CA 19-9 dependent and ALT, ALP and total bilirubin predictor variables) was significant only in group B. The standardized partial regression coefficients found to be significant were those of ALP and total bilirubin. We can conclude that CA 19-9 is an index of pancreatic cancer with satisfactory sensitivity and specificity. The presence of anatomical liver damage seems to increase the value of this index, probably releasing CA 19-9 into the bloodstream. Extra-hepatic cholestasis may also be an important factor in elevating CA 19-9 probably by reducing the hepatic catabolism of this glycoprotein.
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PMID:How does liver dysfunction influence serum CA 19-9 in pancreatic cancer? 213 20

Radiation tolerance of the partially irradiated liver was studied in eight patients with primary hepatoma treated by a multimodal approach. Seven patients were treated by transarterial embolization therapy (TAE) with Lipiodol-MMC, and two patients were treated by operation, combined with radiotherapy. Six patients had liver cirrhosis and the other one had renal dysfunction. Respiration-gated irradiation was employed to reduce a treatment volume for seven patients. Radiation portals were carefully tailored using the embolized Lipiodol or a metal clip inserted into the tumor as references. Two or three portals were used for each patient. The treatment volume ranged from 64 to 1400 cm3. The target dose ranged from 50.4 Gy to 81.0 Gy, from 73.5 to 108.6 in TDF. Liver function tests (GOT, GPT, LDH, ALP, ChE and total Bilirubin) were examined for 30 weeks after initiation of irradiation. Three patients showed abnormal value in more than 5 tests. Of these three patients, the hepatic hilum was included in the treatment volume in two, and the tumor progressed during the observation period in two. Leukopenia and thrombopenia were observed, but these values were not below 2000 and 40000/mm3, respectively, although the thrombocyte count before irradiation was below 100000/mm3 in 7 patients. AFP titers decreased after the treatment in six out of seven patients with abnormally elevated pretreatment titer. The survival period after staring irradiation was 6.5 to 25 months. "The volume dose" did not correlate well with the degree of the liver function aggravation.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Radiation tolerance of partially irradiated liver in a multidisciplinary treatment for hepatoma]. 216 20

Clinical usefulness of mean transit time (MTT) through the liver was evaluated by deconvolution analysis using 99mTc-EHIDA hepatobiliary scintigraphy in 82 patients with various hepatobiliary diseases and 18 normal controls. Initial transfer factor was also obtained according to the method of Rutland. Results obtained were as follows. 1) Effect of the age on MTT was not observed in normal controls. 2) MTT in left lobe of normal controls was significantly prolonged compared with that of right lobe (P less than 0.01). This kind of difference was not observed in patients with liver cirrhosis. 3) MTT in patients with obstructive jaundice, chronic liver diseases, liver cirrhosis at decompensative state and primary biliary cirrhosis was significantly prolonged compared with that in normal controls (P less than 0.01). 4) MTT in patients with liver cirrhosis at compensative state showed normal values, although blood clearance rate in those patients was significantly decreased (P less than 0.05). 5) Positive correlation was observed between MTT and values of T-Bil, ALP, LAP, and gamma-GTP. Negative correlation was observed between MTT and value of cholinesterase. 6) Initial transfer factor correlated with blood clearance rate. (r = 0.76, P less than 0.01). 7) Initial transfer factor in left lobe of normal controls was significantly decreased compared with that of right lobe (P less than 0.01). This kind of difference was not observed in patients with liver cirrhosis. 8) Initial transfer factor in patients with liver cirrhosis in both compensative and decompensative states and PBC was significantly decreased compared with that in normal controls. Estimation of MTT and initial transfer factor could be a useful parameters to assess transfer function of the liver.
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PMID:[Hepatic mean transit time of 99mTc-EHIDA estimated by deconvolution analysis]. 232 33

Neopterin is a pyrazino-pyrimidine compound which is biosynthesized by macrophages. Increased concentrations of neopterin have been reported in conditions causing a stimulation of cellular immunity, such as viral and other infections, graft versus host disease, autoimmune disease and different malignancies. Recently, urinary neopterin levels have been found increased in patients with acute viral hepatitis and NANB chronic hepatitis. In the present study, neopterin serum levels have been measured in 23 cirrhotic patients (6 HBV related, and 17 cryptogenetic cirrhosis, 7 of them occurring in alcoholic subjects) and in 24 normal subjects. Mean values of serum neopterin were significantly 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 found to be significantly different in cirrhotics assessed in three different clinical classes according to Child's classification and in cirrhotics with and without serological findings of active disease. In fact, in cirrhotic patients, serum neopterin levels did not correlate with the values of serum AST, ALT, ALP, GGT and gamma-globulin. These data show that increased levels of serum neopterin occur in cirrhotic patients, but there is no relation between serum neopterin values and the activity or the clinical severity of the disease. The results are consistent with the hypothesis that activated macrophages are involved in all stages of liver cirrhosis irrespective of its aetiology.
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PMID:Serum neopterin levels in liver cirrhosis. 263 48

Sex, age and 21 routine liver function assays were analyzed by stepwise selection and the best-of-all-possible-combinations method to identify a small group of assays valuable in establishing which liver cirrhosis (LC) patients have a high risk of hepatocellular carcinoma (HCC), when alpha-fetoprotein (AFP) is not elevated. Data was obtained from 115 HCC and 122 LC patients on admission. Tumor size correlated with AFP (0.73), alkaline phosphatase (ALP, 0.47), leucine aminopeptidase (LAP, 0.42), lactic dehydrogenase (LDH, 0.42), and the glutamic oxaloacetic transaminase (GOT)/glutamic pyruvic transaminase (GPT) ratio (GOT/GPT, 0.41). The mean of the correct diagnosis rates (CDR) of HCC and LC utilizing AFP as the sole parameter (89%) was markedly higher than those of the other parameters. The best-of-all-possible-combinations method presented a more powerful combination than stepwise selection. The best combination of 7 parameters (LAP, GOT/GPT, choline esterase, one-hour erythrocyte sedimentation rate, age, albumin/globulin ratio, and total bilirubin) presented a mean CDR of 80%, HCC CDR of 77%, and false positive rate of 18%. LC patients statistically diagnosed as having HCC by these 7 parameters are proposed as high risk patients. Fourteen (78%) of 18 HCC patients who were AFP-negative were statistically diagnosed. This analysis can be applied to LC patients to distinguish those that should be followed closely by imaging diagnostic techniques.
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PMID:Diagnosis of hepatocellular carcinoma in patients with liver cirrhosis using liver function assays. 620 37

This article reports the clinical characteristics of 38 cases of patients with hepatitis B (HB) which developed into primary hepatocyte carcinoma (PHC), during a period of observation for 2-28 years (average 11.4 years). These patients were admitted repeatedly for 2 to 12 times (average 3.4 times). The clinical characteristics of the development of the symptoms in these patients were as follows: 1. Liver function fluctuated again and again. Ninety percent of these patients with HB developed liver cirrhosis (LC). Subsequently they developed into PHC. 2. HBV markers were positive over a long period of observation. During the phases of LC and PHC the rates of positive anti-HBe were 23.5% and 54.5%, respectively (P < 0.05). Comparing with anti-HBe, the rate of positive HBeAg was lower. 3. During the phase of HB, 21.0% of these patients had elevated alpha FP (mean titer 80.0 ng/ml). During the phase of PHC, 65.8% of the patients had abnormal alpha FP (mean titer 635.9 ng/ml) (P < 0.01). Sustained high level of gamma-GT and the ratio of gamma-GT/ALT higher than 1.5 were dangerous signals (P < 0.05). The level of ALP in these patients with HB was below 170 u/L. But 50% of them had high level of ALP when they developed into PHC. During the phase of LC these patients were detected regularly with ultrasonic waves.
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PMID:[The study on clinical characteristics of the development of primary hepatocyte carcinoma induced by hepatitis B]. 751 49

Liver cirrhosis (LC) in habitual drinkers is divided into three categories: (1) alcoholic LC, (2) LC due to hepatitis C virus and alcohol, and (3) LC due to hepatitis C virus. In Japan, the frequency of LC related to hepatitis B virus in habitual drinkers is comparatively low. Although making a distinct differentiation is very difficult, it is possible to point out some characteristics which ars due to either alcohol or hepatitis C virus: (1) multiple spider angioma, acne rosacea, and palmar erythema are more frequently found in categories 1 and 2 than in 3, (2) levels of AST/ALT, gamma-GTP, TG, ALP, lactate, and UA are higher in category 1 than in 3, (3) enlargement of both lobes is observed in category 1, and (4) abnormality due to alcohol improves relatively soon after abstinence of alcohol.
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PMID:[Differentiation alcoholic liver cirrhosis from viral liver cirrhosis]. 790 45


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