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Query: UMLS:C0028754 (obesity)
 124,988 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We studied a woman who underwent a jejunoileal bypass for the treatment of morbid obesity and in whom severe jaundice and hepatic failure developed six months later; these developments prompted restoration of the normal continuity of the small bowel. Four serial wedge biopsy specimens of the liver were taken during a three-year follow-up. The first biopsy was performed before the bypass surgery, the second six months after the operation, the third three months after restoration of normal continuity of the bowel, and the fourth three years later. The biopsy specimens clearly showed the morphologic changes of the liver in obesity, the effect of small intestinal bypass and its reversal on hepatic structure, and the natural evolution of liver disease in morbid obesity.
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PMID:Evolution of liver disease in morbid obesity after small-intestinal bypass and its restoration. A case report. 668 40

Problem areas in the necropsy diagnosis of alcoholic liver disease are reviewed, potential sources of confusion delineated, and diagnostic guidelines proposed. The entire spectrum of alcoholic liver disease, including alcoholic hepatitis, may be perfectly mimicked by severe obesity, diabetes, and perhexiline maleate toxicity. Focal fatty change in the liver introduces sampling errors in the assessment of steatosis. Nodular regenerative hyperplasia of the liver mimics a micronodular cirrhosis both clinically and macroscopically. Measurement of the liver iron concentration reliably differentiates between alcoholic liver disease with siderosis and idiopathic hemochromatosis. The evaluation of preexisting fibrosis or cirrhosis in cases of massive hepatic necrosis is aided by stains for elastic fibers. Alcohol abusers taking acetaminophen (paracetamol) in excessive, but not suicidal doses are at risk of developing fatal "late" acetaminophen hepatotoxicity. Fatal viral hepatitis may be overlooked in an alcoholic with preexisting liver disease.
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PMID:Problems in the necropsy diagnosis of alcoholic liver disease. 673 1

Ten patients with fatty liver, distinct from the well known diffuse alcoholic variety, comprise this report. All patients had an initial ultrasound examination followed by 99mTc-sulfur colloid liver and computed tomography (CT) body scans. Six patients had focal fatty infiltration producing a space-occupying mass within the liver. Four had ultrasound evidence of diffuse fat occurring in association with focal masses. These masses were all echo poor relative to the adjacent fat, and were subsequently found to represent nodules of normal uninvolved liver in two patients, and metastatic neoplasm and multiple liver cysts in single patients respectively. The clinical picture associated with fatty liver is variable and may include, in addition to alcohol abuse, obesity, malnutrition, exogenous glucocorticoids, diabetes mellitus, and other less well defined factors. Dramatic improvement in fatty liver occurred in two patients following appropriate therapy. The spectrum of changes produced by fatty infiltration of the liver on ultrasonic, radionuclide, and CT scans is extremely varied depending on the amount of fat deposition, its focal or generalized nature, and the presence of associated liver disease.
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PMID:Fatty infiltration of the liver--an imaging challenge. 716

A review of all literature on jejunoileal bypass for obesity disclosed 282 deaths, corresponding to a mortality rate of 4.2 percent. This rate has been fairly constant through the last 8 years. The causes of death and the postoperative duration are quantified. Pulmonary embolism, mostly early, and liver disease, sometimes late, dominate among the numerous causes of death. Details are too scarcely reported to allow guidance to better results.
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PMID:Fatal outcome after jejunoileal bypass for obesity. 730 19

Nonalcoholic steatohepatitis is a poorly understood and hitherto unnamed liver disease that histologically mimics alcoholic hepatitis and that also may progress to cirrhosis. Described here are findings in 20 patients with nonalcoholic steatohepatitis of unknown cause. The biopsy specimens were characterized by the presence of striking fatty changes with evidence of lobular hepatitis, focal necroses with mixed inflammatory infiltrates, and, in most instances, Mallory bodies; Evidence of fibrosis was found in most specimens, and cirrhosis was diagnosed in biopsy tissue from three patients. The disease was more common in women. Most patients were moderately obese, and many had obesity-associated diseases, such as diabetes mellitus and cholelithiasis. Presence of hepatomegaly and mild abnormalities of liver function were common clinical findings. Currently, we know of no effective therapy.
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PMID:Nonalcoholic steatohepatitis: Mayo Clinic experiences with a hitherto unnamed disease. 2901 67

Nonalcohol-induced fatty liver is widely believed to be a benign condition with little or no risk of disease progression. There have been occasional reports of progression to cirrhosis but none in the absence of preexisting fibrosis on the index biopsy specimen even when co-existing hepatitis was present (steatohepatitis). From our histological database (1978 to 1985), we identified 161 patients with fatty liver seen at our institution and traced the case notes of 156. One hundred five patients were initially excluded as having an alcohol-induced cause, and the remaining 51 either were seen in the clinic (37) or had died, in which cases copies of their death certificates were obtained (14). A further 7 patients were excluded after clinic attendance gave evidence of alcohol excess and another 4 after review of their initial biopsy showed the presence of fibrosis or steatohepatitis. The apparent cause of the steatosis in the 40 included patients with strictly nonalcohol-induced pure fatty liver was obesity in 12, diabetes in 4 (1 obese patient), and cachexia associated with extrahepatic malignancy in 6. Four of the remaining 19 had serological evidence of an autoimmune disorder, but none of these had any clinical or histological features of autoimmune liver disease. Nine patients had evidence of hyperlipidemia, 3 of whom were also obese. At a median follow-up of 11 years (7 to 16), 12 of 26 living patients had abnormal results of liver blood tests and had repeat liver biopsies performed. None had progressed to steatohepatitis or cirrhosis; 1 obese patient had developed mild fibrosis 9.8 years after her index biopsy.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:The natural history of nonalcoholic fatty liver: a follow-up study. 748 79

Patients with diabetes mellitus are at a higher risk to undergo surgical intervention compared with the non-diabetic population, and additionally, they have an increased perioperative morbidity and mortality. Insulin deficiency and insulin resistance are aggravated by surgery and anaesthesia. The consequences of hyperglycemia are glycosuria, volume depletion from osmotic diuresis, impairment of wound healing and leucocyte function and exacerbation of ischemic brain damage. Depending on the extent of hypoinsulinemia, lipolysis and ketogenesis are enhanced which may result in metabolic acidosis with subsequent electrolyte disturbances. Protein catabolism is increased because of increased breakdown and decreased synthesis. Insulin administration reverts or overcomes most of these disturbances. The preoperative assessment includes the diagnoses of the long-term complications to judge the intraoperative risks. Long-acting insulins, such as ultralente of animal origin should be stopped preoperatively and substituted by protamine and lente insulins. In type-2-diabetic patients, long-acting sulfonylurea drugs such as chlorpropamide should be stopped and substituted by short-acting agents. Metformin must always be stopped. Type-2-diabetic patients with marked hyperglycemia under oral treatment should be switched to insulin before operation. The insulin requirements in diabetic patients during surgery vary from 0.25-0.40 U per gram glucose in normal weight patients, 0.4-0.8 U per gram glucose in case of obesity, liver disease, steroid therapy or sepsis, to 0.8-1.2 U per gram glucose in patients undergoing cardiopulmonary bypass surgery. Therefore, the appropriate dose has to be determined individually. The regimen nowadays preferred by most authors is based on variable rate insulin infusion.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Perioperative management of the diabetic patient. 758 26

AIMS. 1) To evaluate the nutritional status of a group of alcohol abusers, relatively to their liver function and morphology, and 2) to compare these data with those of a previous study carried out by out team ten years ago. According to their body weight, 135 alcohol abusers were divided into three groups: normal-weight, over-weight and under-weight. The severity of their hepatopathy was defined as: 1. slight hepatopathy; 2. alcohol-induced hepatitis; 3. alcohol-induced hepatitis plus cirrhosis; 4 child A cirrhosis; 5. child B cirrhosis. RESULTS. 1. The overweight group was homogeneously distributed among the several degrees of compensated hepatopathy. 2. There was a marked reactivity to skin tests (Multitest) in patients with alcohol hepatitis without cirrhosis, independently of nutritional disorders. 3. Only decompensated cirrhosis may cause caloric-protein malnutrition; consequently, nutritional disorders due to alcohol abuse appear late and they are unlikely to play a leading role in the pathogenesis of liver disease due to alcohol abuse. Obesity, on the other hand, may facilitate the onset of liver steatosis.
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PMID:[Nutritional status of patients with alcoholic liver diseases: comparison of the situation in the seventies and at present]. 764 38

To evaluate the relation between the working conditions and the workers' health, particularly the prevalences of obesity, liver disorder and hyperlipidemia, we analyzed physiological examination data and the questionnaire survey about life behaviors and working conditions during the terms of car manufacturing work and car sales work among 61 male subjects. In the physiological examination data, compared with the term of car manufacturing work, the values of body weight, body mass index (BMI), GOT, GPT, gamma-GTP, TG and T-CHO elevated and the prevalences of obesity and liver disorder increased during the term of car sales work. During the term of car sales work, the prevalences of alcohol drinkers and cigarette smokers increased and the changes of food intake behaviors were noted. It was estimated that the changes of food intake behaviors associated with the differences of working conditions contributed increasing number of obesity and liver disorder that was based on fatty liver caused by hyperlipidemia. These results of this study suggested that working conditions associated with the prevalences of obesity, liver disorder and hyperlipidemia were important to conduct the effective health education in the present occupational health administration.
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PMID:[The study of the relation between the working conditions and the prevalences of obesity, liver disorder and hyperlipidemia: evaluation of physiological examination data during the terms of car manufacturing work and car sales work]. 778 Aug 61

In spite of the improvement on chemotherapy results in treating testicular cancer and the introduction of adjuvant chemotherapy to node negative (as well as node positive) breast cancer patients, there is still present a wide spectrum of early and late toxic manifestations. The combination of cisplatin, vinblastine and bleomycin given to testicular cancer might result in cariovascular, neurological, gastrointestinal and renal problems. Late effects of cyclophosphamide, methotrexate and 5-fluorouracil given to breast cancer patients might cause obesity, amenorrhea and infertility. We report a persistent asymptomatic indirect hyperbilirubinemia which was observed in two cancer patients (breast; testis) 3 and 14 months following the cessation of chemotherapy. Metastatic liver disease and involvement of other sites, as well as other causes of hyperbilirubinemia, were excluded. The exact cause of the indirect hyperbilirubinemia remained obscure.
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PMID:Chemotherapy-related persistent indirect hyperbilirubinemia. 788 4


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