Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0038002 (splenomegaly)
 9,873 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The growth of syngeneic hepatoma H-2-73 in adult (CBA x C57BL/6j) F1 mice leads to the development of leukemoid response that is manifested by leukocytosis, splenomegaly and a considerable increase in the content of lymphoid cells in the spleen. Meanwhile the newborn recipients of the tumor do not develop leukemoid response but manifest physiological changes in the hemopoietic tissue normally occurring within the first weeks after birth. The sensitized cells of the spleen of the adult tumor-bearing mice enhance tumor growth in the newborn recipients and inhibit it in the adult mice. Spleen cells of normal adult donors do not affect tumor growth in the newborn recipients. The data obtained suggest that the opposite effect of the transferred sensitized spleen cells from the adult animals on tumor growth in the newborn and adult mice is related to the age-associated features of the immune system of recipient mice.
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PMID:[Characteristics of hematopoietic system reactions of newborn and adult mice to the growth of syngeneic hepatoma H-2-73]. 711 45

A multicenter longitudinal study was performed to assess the survival of hepatitis B surface antigen positive compensated cirrhosis, primarily in relation to hepatitis B virus replication and hepatitis delta virus infection, and to construct a prognostic index based on entry characteristics. This cohort study involved nine university medical centers in Europe. Three hundred and sixty-six Caucasian HBsAg positive patients with cirrhosis who had never had clinical manifestations of hepatic decompensation were enrolled and followed for a mean period of 72 months (6 to 202 months). Inclusion criteria were biopsy-proven cirrhosis, information on serum hepatitis B e antigen and antibody to hepatitis D virus at the time of diagnosis and absence of complications of cirrhosis. At entry 35% of the patients were HBeAg positive, 48% of the patients tested were HBV-DNA positive and 20% anti-HDV positive. Death occurred in 84 (23%) patients, mainly due to liver failure (45 cases) or hepatocellular carcinoma (23 cases). The cumulative probability of survival was 84% and 68% at 5 and 10 years, respectively. Cox's regression analysis identified six variables that independently correlated with survival: age, albumin, platelets, splenomegaly, bilirubin and HBeAg positivity at time of diagnosis. According to the contribution of each of these factors to the final model, a prognostic index was constructed that allows calculation of the estimated survival probability. No difference in survival of hepatitis D virus infected and uninfected patients was observed. Termination of hepatitis B virus replication and/or biochemical remission during follow up correlated with a highly significant better survival. These data show that in compensated cirrhosis B, hepatitis B virus replication, age and indirect indicators of poor hepatic reserve and established portal hypertension significantly worsen the clinical course of the disease, whereas hepatitis D virus infection does not influence the prognosis. The highly significant improvement in life expectancy following cessation of hepatitis B virus replication and biochemical remission favors antiviral therapy in those patients with a guarded prognosis, as estimated by a prognostic index.
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PMID:Survival and prognostic factors in 366 patients with compensated cirrhosis type B: a multicenter study. The Investigators of the European Concerted Action on Viral Hepatitis (EUROHEP). 781 13

Ultrasound is now widely used in the diagnosis of liver diseases. Applications of ultrasound in the diagnosis of liver cirrhosis are reviewed in this paper. Characteristic findings of liver cirrhosis in ultrasound are nodular liver surface, round edge, and hypoechoic nodules in liver parenchyma which represent regenerative nodules of cirrhotic liver. Detection of hypoechoic nodule more than 10 mm is important in the early diagnosis of hepatocellular carcinoma. Detection of splenomegaly, ascites, and portosystemic collaterals is possible by ultrasound. Evaluation of portosystemic collaterals is beneficial in the management of esophagogastric varices and portosystemic encephalopathy. Ultrasound is useful in the non-invasive diagnosis and long-term management of cirrhotic patients.
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PMID:[Ultrasonography in the diagnosis of liver cirrhosis]. 811 12

The most common etiogenic disease of portal hypertension that we experience is liver cirrhosis, which accounts for 84% of all cases. In patients with portal hypertension, congestion by portal blood due to cirrhosis causes a rise in portal pressure and development of collateral circulation between the portal system and the postcaval system is observed. Esophageal varices are associated with higher mortality than any other symptom of portal hypertension and are an important consideration in treatment. When emergency endoscopic examination and diagnosis show esophageal variceal bleeding, the varices must be constricted directly using a Sengstaken-Brakemor tube. If hemostasis is maintained, medical and surgical procedures can be performed after the recovery of body strength. Endoscopic Injection Sclerotherapy (EIS) has recently been widely carried out to prevent variceal bleeding and its application is increasing. However, treatment with EIS alone is not sufficient in terms of long-term efficacy, and surgical treatment is effective, especially in patients with gastric varices or splenomegaly. For Child A and B groups, both with good liver function, non-shunting operation, especially, the SUGIURA procedure, shows a marked effectiveness on varices. For group Child C, EIS is selected. The newly-developed Transjuglar Intrahepatic Portasystemic Shunt (TIPS), is being used, recently. For hepatic insufficiency, liver transplantation is expected to be one of the method for future treatment. Cirrhosis is also commonly accompanied by hepatoma, and this must be taken into consideration in treatment.
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PMID:[Etiology and management of esophageal varices]. 811 15

We studied 104 patients diagnosed with hepatocellular carcinoma on the basis of pathological findings, in order to establish differences between patients with and without liver cirrhosis in addition to carcinoma. Among the former we also tried to identify differences between patients with previously diagnosed cirrhosis and those in whom cirrhosis was diagnosed at the same time as carcinoma. No significant differences were observed between patients in whom cirrhosis was diagnosed before or at the same time as carcinoma in relation to age, sex, etiologic factors or Child-Pugh grade. Differences were found with regard to motives for suspecting a tumor, frequency of splenomegaly, and platelet and leukocyte counts. No significant differences were found between patients with and without cirrhosis except in some laboratory findings (leukocytes, platelets, erythrocyte sedimentation rate and gammaglutamyl transpeptidase higher in the latter group, and alpha-fetoprotein higher in the former). There were no significant differences between cases of hepatocellular carcinoma that appeared as the first manifestation of liver cirrhosis and those that were diagnosed in patients with known cirrhosis. The clinical and biological differences between patients with and without cirrhosis can be explained by the associated chronic hepatic disease.
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PMID:Clinical and morphological study of hepatocellular carcinoma associated with liver cirrhosis. 929 19

Virus-associated hemophagocytic syndrome (VAHS) is associated with a systemic viral infection and is mainly observed in immunosuppressed adult patients. This rare disease is characterized by symptoms which include a high fever, pancytopenia, and splenomegaly and sometimes results in a fatal outcome. However, thus far, little has been reported on VAHS in general surgical patients. We herein report this rare complication which occurred in a patient with hepatocellular carcinoma, as well as chronic hepatitis C, after a hepatic resection. A 66-year-old man with chronic hepatitis C and recurrent hepatocellular carcinoma underwent a repeat hepatic resection without any blood transfusions. In the early postoperative period, he recovered uneventfully. However, he suddenly began to suffer from a high fever (38.4 degrees C) and severe pancytopenia 8 days after surgery. Activated macrophages, which phagocytosed erythrocytes, were identified by a cytological study of the bone marrow. The patient was therefore treated with methylprednisolone pulse therapy 13 days after surgery. On the day following the initial administration of methylprednisolone, his clinical condition drastically improved. Fortunately, with methylprednisolone therapy, our patient recovered from acute, severe pancytopenia. In general surgery, it is often difficult for surgeons to use steroids due to their negative side effects. However, when symptoms such as fever, general fatigue and pancytopenia are observed, even in posthepatectomy patients with hepatocellular carcinoma and hepatitis, a bone marrow aspiration should be performed as soon as possible, and when VAHS is suspected, steroid pulse therapy should be the first treatment of choice. This rare but sometimes fatal complication should thus be taken into consideration in the postoperative management of hepatectomized patients with chronic hepatitis C.
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PMID:Virus-associated hemophagocytic syndrome after hepatic resection: a case report. 949 16

Childhood primary hepatocellular carcinoma is rare and accounts for less than 1% of all abdominal malignancies in children < or = 14 years of age. A review of the records of the Cancer Registry, Ibadan, Nigeria covering the period 1960-1995 was scrutinised and 19 cases of hepatocellular carcinoma (HCC) were registered, accounting for 0.49% of all abdominal malignancies over the period of review. The mean (SD) age at presentation was 10.4 (3.0) years and the duration of illness before presentation was short. All the children presented late with abdominal distension and hepatomegaly as the major clinical features. Weight loss was evident in 80% of cases, splenomegaly occurred in 50% and jaundice was present in a third of them. The prognosis was poor; all the cases died within 2 weeks of presentation in hospital. There was evidence to suggest an association between hepatitis B virus infection and HCC in all the liver tissue stained by Shikata-Orcein. This review shows that HCC, though uncommon, is important enough to be considered a possible cause of unexplained hepatomegaly in Nigerian children and that hepatitis B virus is an important aetiological factor. Though the number of cases under review is small, universal early vaccination against hepatitis B virus is necessary in Nigerian children in order to reduce the burden of chronic hepatitis B disease and hepatocellular carcinoma.
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PMID:Hepatocellular carcinoma in Nigerian children. 1147 Dec 62

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, especially in Asia. Gastrointestinal bleeding due to esophagogastric variceal hemorrhage is one of the leading causes of death in HCC patients. The aim of study was to determine whether clinical variables were predictive of the presence of large esophagogastric varices (EGV) before performing endoscopy. Three hundred and four HCC patients who received endoscopy were enrolled and studied retrospectively. Univariate and stepwise logistic regression analysis were used to evaluate associations between the presence of large EGV and patient characteristics. There were 248 patients with small or no EGV and 56 patients with large EGV. The optimal critical values determined by a receiver operating characteristic curve for platelet count and albumin level were 135,000/mm3 and 3.5 g/dl, respectively. Stepwise logistic regression analysis demonstrated that splenomegaly [odds ratio (OR): 9.72; confidence interval (CI): 3.75-25.17], portal vein thrombosis (OR: 2.73; CI: 1.50-4.97), low platelet count (<135,000/mm3) (OR: 3.78; CI: 2.07-6.90) and low albumin level (<3.5 g/dl) (OR: 3.44; CI: 1.73-6.82) were significant, independent predictors for large EGV. Large EGV also could be independently predicted by Child-Pugh classification, splenomegaly (OR: 4.93; CI: 1.87-13.01), or portal vein thrombosis (OR: 2.37; CI: 1.28-4.39) while excluding the non-cirrhotic patients. In conclusion, splenomegaly, low platelet count (<135,000/mm3), and low albumin level (<3.5 g/dl) are clinical predictors to stratify HCC patients at risk of developing large EGV. Besides factors related to liver cirrhosis, portal vein thrombosis is also an important predictor for HCC patients with large EGV.
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PMID:Clinical predictors of large esophagogastric varices in patients with hepatocellular carcinoma. 1199 99

Polystichum squarrosum fern fed (30% w/w) rats showed moderate mortality, decrease in body weight, less body fat and splenomegaly. On post-mortem examination, significant gross lesions were not seen in sacrificed animals. Histopathologically, Polystichum fed rats showed dilated Virchow Robin's space in brain, mild to moderate vascular changes likeoedema, engorgement of blood vessels and haemorrhages in most of the visceral organs, interstitial pneumonia in lungs, focal necrosis and generalised vacuolative degenerative changes in liver, more haemosiderin deposition and presence of higher number of megakaryocytes in spleen, shrunken glomeruli, more peri-glomerular space and more number of glomeruli per microscopic field in kidneys, focal hyperplasia of urinary bladder and moderate to marked depletion of germinal epithelium and spermatids in seminiferous tubules of testes. Pathologically, progressive changes were observed only in liver, urinary bladder and testes on 180 days post feeding (DPF). One fern fed rat sacrificed on 135 DPF showed hepatic tumour which was diagnosed as hepatocellular carcinoma. The results showed that P. squarrosum produced almost comparable pathological changes/preneoplastic lesions as reported in bracken fern fed animals. Long term exposure studies (i.e. 2 yrs) are desired.
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PMID:Pathological evaluation of Polystichum squarrosum (D. Don) fern in laboratory rats. 1201 78

Massive splenomegaly and ascites production with hypoproteinemia and hypocoagulability was observed in a 15-year-old boy after extended right hepatectomy for hepatocellular carcinoma (HCC). Angiography disclosed a kinking of the left hepatic vein immediately before the junction with the inferior vena cava. Ascites disappeared completely, and laboratory values normalized after placement of a 3-cm long balloon expandable stent. The current case shows that Budd-Chiari syndrome caused by hepatic outflow obstruction after major hepatic surgery can be managed effectively by percutaneous stent placement.
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PMID:Management of Budd-Chiari syndrome by hepatic vein stenting after extended right hepatectomy. 1240 58


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