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Query: UMLS:C0085584 (encephalopathy)
 18,178 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Analyses of the records of 120 patients who underwent portacaval shunting (PCS, 57%) or splenorenal shunting (SRS, 43%) from 1966-1973 disclosed that patients in each group undergoing elective shunts had the same preoperative physical condition and postoperative mortality rates (approximately 20%). Although the post-operative death rate from emergency shunts was 48%, patients having these procedures were poorer risks. Long-term incidences of encephalopathy were the same, irrespective of the type of shunt (PCS, 46%; SRS 36%, P greater than 0.5). Despite comparisons of data most unfavorable for PCS, 5-year survival rates were also the same after either type of shunt (all PCS, 29 +/- 7.5%, SRS, 42.0 +/- 7.4%, P = 0.23). The survival rate after elective PCS was also the same as after SRS during the entire 5-year period. However, the survival after all elective PCS and SRS was significantly greater than after emergency PCS (P range = 0.005-0.038); the poorer results of emergency shunting could be partly attributed to the poorer condition of patients selected. A numerical score based on serum bilirubin concentrations, ascites, and urgency of shunting reliably predicts postoperative mortality. Long-term encephalopathy is predicted by a history of encephalopathy and the urgency of shunting.
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PMID:Risks in therapeutic portacaval and splenorenal shunts. 96 96

We developed a rabbit model of fulminant hepatic failure by way of a two-staged total liver devascularisation procedure. For the first-stage procedure (portosystemic shunting), the clinical, biochemical and electro-encephalographic courses in 6 rabbits (group I) with an end-to-side portacaval shunt (ETS-PCS), 6 rabbits (group II) with a small-diameter side-to-side portacaval shunt (STS-PCS) and 6 rabbits (group III) with the same STS-PCS and 48 h of pretreatment with oxytetracycline were investigated and compared to 6 sham rabbits (group IV). The limited survival, the fall in clotting factors and the rapid development of hyperammonaemia with encephalopathy within 48 h in group I point to ETS-PCS-associated ischaemic liver necrosis. Group II showed improved survival, but was associated with portosystemic encephalopathy. Rabbits in group III survived portosystemic surgery without development of marked encephalopathy. In all animals of group III, the second-stage procedure (tightening of the loose ligature around the afferent hepatic vessels) could be performed, and a suitable model of fulminant hepatic failure was obtained.
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PMID:A surgical model of fulminant hepatic failure in the rabbit: different effects of end-to-side versus small-diameter side-to-side portacaval shunt. 365 55

The aim of this study was to investigate the possible role of N-methyl-D-aspartate (NMDA)-receptor overactivity in two different experimental rat models of encephalopathy: subacute encephalopathy caused by severe hyperammonemia in portacaval-shunted rats (AI-PCS rats) and acute hepatic encephalopathy caused by complete liver ischemia (LIS rats). The effect of the noncompetitive NMDA-receptor antagonist memantine (intraperitoneal [i.p.] 10-20 mg/kg bw or intravenous [i.v.] 5 mg/kg bw) was studied on the severity of encephalopathy by assessment of clinical grading and electroencephalogram (EEG) spectral analysis, on plasma ammonia concentrations, amino acid concentrations in cerebrospinal fluid (CSF), intracranial pressure (ICP), and brain water content. Both rat models developed encephalopathy within 3 to 6 hours, associated with increased CSF glutamate and aspartate concentrations and increased ICP and brain water content. Memantine administration in AI-PCS and LIS rats resulted in a significant improvement in clinical grading and less slowing of EEG activity (P < .05), and smaller increases in CSF glutamate (P < .05) concentrations. Moreover, ICP and brain water content were significantly lower in memantine-treated AI-PCS rats than in untreated AI-PCS rats (P < .05). Memantine had no significant effect on ICP and brain water content in LIS rats, and on ammonia concentrations in both models. These results indicate that NMDA-receptor activation might be involved in the pathogenesis of hyperammonemia-induced encephalopathy and of acute hepatic encephalopathy caused by LIS.
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PMID:Memantine, a noncompetitive NMDA receptor antagonist improves hyperammonemia-induced encephalopathy and acute hepatic encephalopathy in rats. 909 16