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

In a group of 205 patients with alcoholic diseases of liver the diagnostic relevance of biochemical tests (GOT, GPT, AP, GGTP, BSP) was reconsidered with discriminatory process (separation of diagnosis). The group contained 16 patients with nutritional-caused and 41 cases with alcoholic-caused fatty-infiltration of liver. 148 patients showed a toxic chronic liver disease; 52 a chronic hepatitis and 96 cirrhosis of liver. Laparoscopy and morphology guaranteed the clinical diagnosis and therefore the accuracy of biochemistry in separation of diagnosis was given. The biochemical tests were not able to offer a separation of fatty-infiltration with reference to cause, changes of the process in toxic hepatitis and cirrhosis were announced. Intersection in several cases was noticed and biochemical tests were not able to substitute endoscopy and morphology for clinical and diagnostic use in all cases. In every regard the enzyme-tests,--above mentioned--, and determination of sulfobromthalein are aptly to development of diseases and deficiency of alcohol.
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PMID:[Relevance of biochemistry in diagnosis and development of alcoholic liver disease (author's transl)]. 0 20

With the development of simplified methods of bile acid analysis, a new era has drawned in the evaluation of hepatobiliary disease. 1. A total serum bile acid particularly in the postprandial periods is more sensitive than either BSP or ICG for the detection of minimal liver disease and will become a useful screening method. 2. The ratio of chenodeoxycholate to cholate in serum together with the total concentration can often distinguish hepatitis and cirrhosis from intrahepatic and extrahepatic cholestasis with normal liver cell parenchyma. However, in practice this is usually of less value than the total serum bile acid level. 3. Changes in serum bile acids throughout a 24 hour cycle reflect the enterohepatic circulation of bile acids and the capacity of the liver to transport them. These patterns are most useful in judging the severity of cholestasis and response to resin therapy. They also provide new insights into the pathophysiology of bile acid metabolism and excretion in different diseases of the liver.
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PMID:Diagnostic value of serum bile acids. 19 97

Increased incidence of renal insufficiency is observed in severe damage of liver parenchyma such as fulminant hepatitis, decompensated cirrhosis of the liver, septic cholangitis and the different forms of obstructive jaundice. Functional circulatory disturbances of the kidney, especially of the renal cortex, are of importance in the aetiology of this condition. Dopamine, at a dosage as low as 3 gamma/kg/min leads to an improvement in renal blood flow and also to an increase in hepatic blood flow. These observations are of therapeutic importance. Some important circulatory and functional parameters of both these organs, which influence each other under normal and pathological conditions, were studied in the presence of dopamine and the following results were obtained: 1. An investigation of the intrarenal haemodynamics with 133 Xenon in patients with severe cirrhosis of the liver and in patients with obstructive jaundice resulted in an increase of 91% in the mean renal blood flow. The blood flow in the renal cortex increased by 36.2% and in the renal medulla 18.5%, whereas the renal fat tissue showed no change. Compartment I, which was diminished as compared with the control value, also increased. The percentage contribution of the mean renal blood flow and the blood flow of the renal cortex towards the cardiac output was greater under the influence of dopamine; hence a greater part of the cardiac output flows into the kidney under dopamine. 2. The glomerular filtrate and the renal plasma flow increased under dopamine (13.5% and 43.1%, respectively). The increase was greater in compensated than in decompensated cirrhosis. In patients with obstructive jaundice there was a smaller increase in both these parameters than in patients with cirrhosis in the presence of dopamine. No connection was found between the increase in renal plasma flow with dopamine and the blood levels of bilirubin, cholinesterase, GOT and the Normotest. 3. The urinary output of sodium increased by 191.4% with dopamine. Patients with an initial renal plasma flow value of over 300 ml/min had a higher sodium output. These patients also eliminated more sodium under the influence of dopamine than those with an initial renal plasma flow value of under 300 ml/min. 4. Blood flow determinations in the portal vein and the hepatic artery in man, obtained during operation, showed an increase in portal flow of 28.5% and hepatic artery flow of 6.3% in response to dopamine. The percentage contribution of portal blood flow towards the cardiac output increase on dopamine administration. The functional hepatic blood flow, analyzed with 131-J-BSP, did not change. The wedged hepatic vein pressure, which is a good measure of portal pressure, increased on average by only 7% with dopamine at a dosage of 3 gamma/kg/min, but by 20.3% with twice the dosage. Dopamine did not cause a change in hepatic blood volume; hence, blood sequestration in the liver can be excluded in response to the dopamine-evoked increase in portal blood flow. 5...
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PMID:[Clinical and experimental investigations of the effect of dopamine on haemodynamics and function of kidney and liver (author's transl)]. 27 63

The concentration of bile acids in serum was measured by an enzymatic-fluorometric method under fasting conditions and 2 hours after a standardized meal in 26 patients with chronic liver disease (chronic hepatitis, liver cirrhosis, primary biliary cirrhosis) and compared with other tests of liver function. Postprandial bile acids and transaminases were false negative in only 12% and are thus the most sensitive tests after the BSP-retention test (3% false negative results). In comparison, fasting bile acids proved to be a relatively insensitive screening test for liver disease (38% false negative results). Postprandial bile acids were more closely correlated with BSP retention and BSP disappearance rate constant (Ki) than fasting bile acids. In view of these findings postprandial serum bile acid concentrations should be preferred to fasting bile acid concentrations in screening for liver disease and monitoring liver function.
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PMID:[Bile acid concentration in serum after a test meal in hepatobiliary diseases. A comparison with quantitative liver function tests]. 52 95

Twenty-one of 30 patients with essential mixed cryoglobulinemia (EMC) had evidence of liver involvement. The liver disease was characterized by the absence of clinical symptoms, hepatosplenomegaly, mild elevation of enzymes, abnormal BSP retention and low albumin levels. Histology, available in 12 patients, showed either chronic persistent or chronic active hepatitis or liver cirrhosis; 44% of the patients had HBsAg or HBsAb in sera and/or cryoglobulins, confirming the high frequency of exposure to hepatitis B virus (HBV) infection in EMC. However, liver lesions were similar in all patients, regardless of HBV exposure. Since other factors usually associated with chronic liver diseases were absent or apparently irrelevant, it is temptative to speculate that a 'cryoglobulinemic hepatitis' may exist as a distinct syndrome. The characteristic complement profile of the patients with EMC (low CH50 and C4, normal C3PA), not related to albumin levels, can help to differentiate this disease from chronic liver disease without cryoglobulins.
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PMID:Liver involvement in essential mixed cryoglobulinemia. 54 44

Methods to quantitatively assess all the hemodynamic alterations which occur in cirrhosis of the liver unfortunately are not as yet available. Within this context, transhepatic catheterization of portal vein branches represents a real progress. A better understanding of the pathophysiology of the BSP plasma disappearance curve has revealed that the second exponential component (k2) is particularly useful for the early diagnosis of cholestasis.
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PMID:[Hepatic hemodynamics and function (author's transl)]. 63 11

Two canine models of cirrhosis induced by administration of dimethyl-nitrosamine (DMNA) alone or in combination with hepatic vein ligation, were studied. The criteria used for development of cirrhosis were not only the appearance of portal hypertension, ascites, biochemical disorders or retention of BSP but also the formation of histological lesions such as sclerotic transformation of the liver lobules together with nodular regeneration. According to these criteria, the experimental protocol consisting in hepatic vein ligation and prolonged administration of DMNA was successful in inducing in animals liver cirrhosis similar to human conditions.
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PMID:Comparative study of two models for experimental cirrhosis in the dog. 65 65

In order to improve the clinical usefulness of the plasma disappearance curve of sulfobromophthalein (BSP), its components were analyzed in 26 control subjects, in 28 patients with cirrhosis, and in 13 cases of miscellaneous liver abnormalities. The uncorrected initial disappearance rate (ki) was found to discriminate best between the control and the patient groups. The second exponential component (k2) was linearly correlated with the transport maximum (Tm) on a double logarithmic plot, but appeared to be independent of the estimated hepatic plasma flow (EHPF). An interpretation of this relationship was possible, when based on a model having saturation kinetics for biliary excretion. The first exponential component (ki) appeared primarily determined by hepatic perfusion. These relationships may contribute to a better understanding and more rational use of dye excretion tests as measures of hepatic function. The data also add to our knowledge about the nature of the excretory defect in cirrhosis.
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PMID:A new look at the plasma disappearance of sulfobromophthalein (BSP): correlation with the BSP transport maximum and the hepatic plasma flow in man. 99 41

Factor VII levels have been measured in 100 patients with liver disease following parenteral vitamin K1 therapy. There was good agreement between specific factor VII measurements and the one-stage prothrombin time apart from six patients with compensated cirrhosis in whom the prothrombin time was prolonged despite the presence of normal factor VII levels. A mean activity of 58% was found in patients with cirrhosis. Cirrhotic patients with features of hepatic decompensation had a significantly lower mean level of activity (40%) than the "contrast" patients with surgical obstruction of the major bile ducts (93%). Patients with chronic active liver disease had moderate depression of factor VII levels and those with non-cirrhotic liver damage had mean activities similar to the contrast group. Factor VII levels could not be correlated with BSP retention but there was a correlation with serum albumin concentration. It is concluded that the prothrombin time using Quick test with a standardized thromboplastin showing good sensitivity to factor VII, eg, the Manchester reagent (BCT), provides a reliable index of coagulability in chronic liver disease, and specific factor VII assays are not indicated.
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PMID:Factor VII as a marker of hepatocellular synthetic function in liver disease. 100 40

Liver biopsy and liver function tests were performed in 17 obese patients before and 14 months after intestinal shunt operation for obesity. In another 20 patients liver biopsy was performed postoperative only, in 12 patients preoperatively only. Steatosis was present in 85 per cent. of the patients before the operation. After the operation steatosis decreased in half the patients and increased in the other half. In patients with biopsy twice postoperatively there was a significant trend of decreasing steatosis up to 56 months after the operation. No patient developed cirrhosis during the time of observation. Within the first postoperative year there was a substantial and significant increase in serum alanine-aminotransferase and a minor increase in alkaline phosphatases and BSP. There was no correlation between the rate of weight loss and the change in steatosis or liver function.
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PMID:Liver morphology and liver function before and after intestinal shunt operation for obesity. 115 33


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