Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0023890 (cirrhosis)
 42,195 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Percutaneous transfemoral arterial balloon occlusion or gelatin sponge embolization of the splenic artery or both were carried out in three high-risk patients with hepatic cirrhosis to reduce splenic hyperfunction and improve severe thrombocytopenia. Although this maneuver raised peripheral platelet counts in each patient, in one patient left upper quadrant pain with splinting of the lower chest cage led to hypostatic lower lobe pneumonia, while in another septic splentitis with gas-forming organisms necessitated splecectomy. Transfemoral occlusion of the splenic artery, although an effective, noninvasive approach to control splenic hyperfunction, has at the same time potential dangers that should be viewed with extreme caution in therapeutic application.
 ...
PMID:Ischemic therapy in thrombocytopenia from hypersplenism. 98 62

We evaluated the applicability of limited hepatic resection in cases of hepatocellular carcinoma (HCC) in cirrhotic patients. According to the severity of impaired hepatocellular function, 37 patients underwent limited resection, and for 13, standard major hepatic resection was done. There were no significant differences in the mortality and survival rates between the two groups. This limited resection can be selectively used to treat cancer associated with cirrhosis and encapsulated tumors. For further evaluation of this limited procedure, an attempt was made to elucidate the manner in which the surgical margin is linked to a recurrence after curative resection for hepatocellular carcinoma in patients with cirrhosis. Forty patients were divided into two groups; those in whom the margin from the cut surface to HCC in the fresh specimen was less than 10 mm wide [TW(+)] and patients in whom the surgical margin was equal to or exceeded 10 mm [TW(-)]. There were 24 and 16 patients in the TW(+) and TW(-) groups, respectively. There was no statistically significant difference in the rate of recurrence between the two groups. In patients with a tumor less than 4 cm in diameter, the extent of TW is not linked to an early recurrence. However, when the tumor size exceeds 4 cm, 10 mm of TW is inadequate to achieve curability. When a wide resection is not feasible, then adjuvant therapy should be aggressive.
 ...
PMID:Surgical strategy for primary hepatocellular carcinoma associated with cirrhosis. 215 25

Ricinus communis agglutinin II-reactive glycoproteins from the ascites of patients with hepatocellular carcinoma were prepared using lectin affinity chromatography. Normal serum- and cirrhotic ascites-components were removed by columns with immobilized antibodies against them. Ricinus communis agglutinin II-reactive glycoproteins thus obtained were supposed to be hepatocellular carcinoma-associated and less than 0.1% of the protein in the starting material. Polyacrylamide gel electrophoresis of these glycoproteins revealed more than 10 major polypeptides with molecular weights ranging from 20K to 200K daltons. The rabbit antiserum raised against them reacted with at least three components of 45, 52 and 55K daltons. The serum level of this antibody-reactive glycoproteins was assessed by an enzyme-linked immunosorbent assay. It was elevated in 91% of cases of hepatocellular carcinoma, 70% of cases of other gastrointestinal carcinoma, 88% of cases of liver cirrhosis, 55% of cases of chronic hepatitis, and 25% of cases of acute hepatitis. The mean value of hepatocellular carcinoma was significantly greater than those of other groups. These results suggest that some of Ricinus communis agglutinin II-reactive glycoproteins in hepatocellular carcinoma patients may be cancer-associated glycoproteins and that their serum levels are increased in hepatocellular carcinoma patients.
 ...
PMID:Ricinus communis agglutinin II-reactive glycoproteins from the ascites of patients with hepatocellular carcinoma and their use in enzyme-linked immunosorbent assay. 303 39

We evaluated in retrospect the applicability of limited hepatic resection in cases of primary liver cancer in cirrhotic patients. According to the severity of impaired liver function, 37 patients underwent limited resection, and for 13, standard major hepatic resection was done. The mortality rate in case of limited resection was 10.8%, and the rate in case of massive excision was 15.4%. One, two- and five-year survival rates of limited operation were 79.9, 60.3, and 32.6%, respectively. After standard resection, the rates were 78.7, 67.5, and 22.5%, respectively. There were no significant differences in the mortality and survival rates between the two groups. These results indicate that, for the patient with a small liver cancer, and poor liver function, the limited procedure leads to a comparatively longer survival. This limited resection can be selectively used to treat cancer associated with cirrhosis and encapsulated tumors. For the preoperative evaluation, hepatic arteriograms aid in patient selection.
 ...
PMID:Limited hepatic resection effective for selected cirrhotic patients with primary liver cancer. 631 77

In a 69 year-old female patient who had been a pet bird enthusiast, cryptococcosis of the central nervous system was surprisingly established as cause of death at postmortem. Clinically, a diagnosis of cirrhosis of the liver associated with atypical coma hepaticum had been suspected. Apart from damage due to alcohol abuse, no other underlying disease could be found. The fecal matter of a budgerigar (Melopsittacus undulatus) has been suggested as the probable source of infection. Using Guizotia abyssinica creatinine agar, Cryptococcus neoformans could be isolated from dry fecal matter collected from the bird cage. In a pet shop in the neighbourhood of the patient's home, fecal matter from various pet bird species was collected. Using the same method, examination also revealed the presence of Cr. neoformans. Contrastingly, masses of pigeon manure found in the garret of the patient's house did not contain Cr. neoformans. The epidemiological significance of the fecal matter of pet birds as a habitat for Cr. neoformans is discussed.
 ...
PMID:[Fatal cryptococcosis in a bird fancier. A clinical case report on pathology, diagnosis and epidemiology of cryptococcosis]. 636 34

Caring for the problem drinker in the perioperative period is a challenging task. If alcohol abuse is suspected, a careful assessment is indicated before surgery is performed. Both the CAGE and SMAST questionnaires are good screening tools for alcoholism. Preoperative evaluation of alcohol-dependent patients should include a complete blood count, blood urea nitrogen, serum electrolyte levels, creatinine and glucose levels, liver function tests, coagulation studies, an electrocardiogram and a chest radiograph. Smoking cessation and aggressive postoperative respiratory care are especially important for alcoholic patients who have chronic obstructive pulmonary disease. Elective surgery should not be considered in patients with acute hepatitis or cirrhosis, since the operative mortality rate is quite high in these patients. Alcohol withdrawal is managed primarily with benzodiazepines, although clonidine and beta blockers may also be beneficial.
 ...
PMID:Perioperative management of the alcohol-dependent patient. 748 20

The clinicopathologic relevance of the hepatic expression of Lewis Y (Le(y)), a carbohydrate antigen, and its plasma levels was studied in benign and malignant liver diseases. Tissue and plasma antigens, respectively, were determined with an avidin-biotin-peroxidase complex method and a radioimmunoassay using monoclonal antibody AH6. Normal liver cells and bile ductules did not express Le(y). In the inflammatory tissues, the liver cells and proliferated bile ductules expressed Le(y). The strongest expression by the liver cells was observed in chronic active hepatitis with severe activity and that by the ductules in liver cirrhosis. Only 1 of 16 hepatocellular carcinomas expressed Le(y). The plasma levels of Le(y) increased significantly but nonspecifically in chronic persistent hepatitis, chronic active hepatitis, liver cirrhosis, and hepatocellular carcinomas. It was concluded that (1) Le(y) is an inflammation-associated but not a cancer-associated antigen; (2) the more the tissue damage advances, the more the antigen is expressed; and (3) hepatic and plasma Le(y) are, however, nonspecific markers of necroinflammatory liver diseases.
 ...
PMID:Hepatic neoexpression and increased plasma levels of Lewis Y, a carbohydrate antigen, in chronic inflammatory liver diseases. 804 85

A cancer-associated, high-molecular-weight glycoprotein antigen (6B3.Ag) recognized by monoclonal antibody 6B3 was purified from culture medium of human large cell lung carcinoma cell line (HLC-2) and characterized biochemically and immunochemically. The 6B3.Ag was purified more than 1,200-fold with a yield of 30% by salting out, precipitation by acidification at pH 4.5, and chromatographies on Sepharose 4B and concanavalin A-Sepharose. The molecular weight of 6B3.Ag is approximately 1,000,000 and the molecule is a homodecamer of 94,000 subunits. The 6B3.Ag is a glycoprotein containing 22.9% sugars, consisting of both N- and O-glycoside chains. The N-terminal 19 amino acids were determined and only 4 out of 19 amino acid residues were different from those of an antigen, L3, secreted by lung carcinoma cell line Calu-1. The serum level of 6B3.Ag was determined in normal adults as well as patients with various diseases by enzyme-linked immunosorbent assay. The mean serum level of 6B3.Ag was 3.1 micrograms/ml, ranging from 1.6 to 6.2 micrograms/ml in 131 healthy adults. When the cut-off value was set at 6.2 micrograms/ml, the incidence of positive values in the sera was elevated not only in malignant diseases such as hepatoma (73%) and leukemia (62%), but also in benign diseases such as chronic hepatitis (42%) and liver cirrhosis (63%). While the incidence of positive values was elevated in advanced liver diseases, namely, chronic hepatitis, liver cirrhosis and hepatoma, the cancer specificity of 6B3.Ag did not appear to be high.
 ...
PMID:Detailed characterization of a high-molecular-weight glycoprotein secreted by lung cancer cells. 840 67

Some recent proposals in management of alcoholic liver disease are discussed focusing on early diagnosis and treatment of alcohol abuse itself, alcoholic hepatitis early mortality, clinical meaning of nutritional therapy, serological approach and treatment of hepatic fibrosis, and problems in liver transplantation for end stage alcoholic liver cirrhosis. CAGE or similar systematized brief questionnaires, and desialylated transferrin/total transferrin ratio as serological marker, seems to be interesting contributions to "hidden" alcohol abuse diagnosis and abstinence control while psycho-social support and voluntary incorporation to self-aid groups are the best weapons to reach persistent abstinence. Corticosteroids seems to improve survival in a selected group of patients with severe alcoholic hepatitis, specially in those presenting encephalopathy but free of GI bleeding, decompensated diabetes, active infections, pancreatitis, and other contraindications or adverse effects of these drugs. Relationship between direct toxicity and nutritional deficiencies in pathogenesis of alcoholic liver injury are not clear enough, but malnutrition is generally present in patients requiring hospitalization, and related to clinical severity; oral, enteral or parenteral nutritional supplementation in this order of preference according to patients condition, associated or not with steroid anabolics, are useful in cases with moderate to severe alcoholic hepatitis or decompensated cirrhosis to eliminate the catabolic state, reaching a better nitrogen balance and liver function tests, without special adverse effects. A special role on liver regeneration is discussed. Antioxidants and supernutrients are special "modern" aspects of nutritional therapy in alcoholic liver disease generally related to the MEOS activation in chronic alcoholism, the excessive production of free radicals, and the depletion of glutathione, membrane phospholipids (specially phosphatidycholine), and vitamin A, E, and C. Natural supplements as soybean polyunsaturated lecithin, with high concentration of phosphatidycholine, or oral supplementation with natural metabolic products depleted from the liver of chronic heavy drinkers, such SAMe, have an interesting rationale based on experimental and clinical findings besides availability and costs. Carotenoids and tocopherols supplementation seems to be an useful tool, but are limited in the case of vitamin A because its special toxicity in chronic alcoholism. Serological markers of metabolism of liver connective tissue are clearly involved in fibrogenesis process and other inflammatory connected events; standardization of laboratory methods surely will result in new possibilities of non-invasive valuation of liver injury, evolution and therapeutic response; special histological damage such as sinusoidal "cappilarization" (type i.v. collagen and laminin), endothelial sinusoidal cell function (seric hyaluronate), or collagenase activity (TIMP-1 or tissue inhibitor of metalloproteinases-1) seems to be valuable by these new technologies.(ABSTRACT TRUNCATED AT 400 WORDS)
 ...
PMID:[New suggestions for the management of alcoholic liver diseases]. 852 63

Cancer risk in patients with cirrhosis could be modified by factors such as changes in hormonal levels, impaired metabolism of carcinogens, or alteration of immunological status. We investigated the risk of liver and various forms of cancer in patients with cirrhosis in a follow-up study. We identified 11,605 1-year survivors of cirrhosis from the files of the Danish National Registry of Patients (NRP) from 1977 to 1989. Occurrence of cancer through 1993 was determined by linkage to the Danish Cancer Registry. For comparison, the expected number of cancer cases was estimated from national age-, sex-, and site-specific incidence rates. Overall, 1,447 cancers were diagnosed among the study subjects, as compared with 708.1 expected, to yield a standardized incidence ratio (SIR) of 2.0 (95% CI: 1.9 to 2.2). In all diagnostic subgroups of cirrhosis, the risk of primary liver cancer, mainly hepatocellular carcinoma, was markedly elevated, with 245 observed cases and an overall 36-fold elevated risk (59.9-fold elevated for hepatocellular carcinoma and 10-fold for cholangiocarcinoma). Substantial and persistent excesses during follow-up were seen for all types of cancer associated with tobacco and alcohol habits (cancer of the lung, larynx, buccal cavity, pharynx, pancreas, urinary bladder, and kidney), while moderate excesses were seen for cancers of the colon and breast. The latter, however, were not complemented by any decrease in the risk of prostate cancer (SIR: 1.0; 95% CI: 0.7 to 1. 3). A slightly increased risk was seen for testis cancer, but disappeared after 10 years. We found evidence of an increased risk for liver and several extrahepatic cancers in patients with cirrhosis. Although part of this increase is likely attributable to alcohol and tobacco consumption, our study opens up the possibility that cirrhosis plays a role in the carcinogenesis of types of cancer other than liver cancer.
 ...
PMID:Risk of liver and other types of cancer in patients with cirrhosis: a nationwide cohort study in Denmark. 975 26


1 2 3 4 5 Next >>