1/517. Reactive lymphoid hyperplasia of liver coexisting with chronic thyroiditis: radiographical characteristics of the disorder.BACKGROUND: Reactive lymphoid hyperplasia of the liver is an extremely rare entity, with six cases reported so far. methods: We encountered a 47-year-old Japanese female with reactive lymphoid hyperplasia of the liver, which coexisted with chronic thyroiditis. The lesion was discovered incidentally as a hypo-echoic mass with a hyper-echoic rim at a routine ultrasonography examination. It increased from 12 to 17 mm diameter in 6 months. Radiological studies, such as contrast-enhanced computerized tomography (CT) and angiography demonstrated a hypervascular lesion. RESULTS: It was consequently diagnosed as a neoplasm with malignant potentiality and she underwent partial hepatectomy. The lesion was composed of small mature lymphocytes which formed prominent lymphoid follicles with germinal centres, scattered plasma cells and stromal fibrosis. Immunohistochemical study revealed polyclonal origins of the involved lymphocytes. dna analysis for the immunoglobulin heavy gene and the T cell receptor beta gene using Southern blot hybridization showed no monoclonality. The following features have characterized the images in past cases, as well as ours: hypo-echoic mass, occasionally with a rim, in ultrasonography and hypervascularity, shown by angiography and enhanced CT.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
2/517. Use of transdermal amitriptyline gel in a patient with chronic pain and depression.A man with severe inflammatory bowel disease suffered from chronic abdominal pain and depression. A transdermal amitriptyline gel preparation was compounded since he was unable to take drugs orally serum concentrations of amitriptyline and its active metabolite nortriptyline were measured over 24 hours. Symptoms of depression were monitored before starting transdermal therapy and at the end of 6 weeks. Pain symptoms and amitriptyline adverse drug events were monitored daily Steady-state serum concentrations of drug and metabolite were within the therapeutic range over 24 hours. The patient reported that his mood was improved but his abdominal pain remained unchanged. Transdermal amitriptyline gel was well tolerated and is an alternative delivery system in patients unable to take drugs orally.- - - - - - - - - - ranking = 0.16666666666667keywords = liver (Clic here for more details about this article) |
3/517. hepatitis c virus in peripheral blood mononuclear cells from a chronically infected patient receiving liver graft from infected donor.BACKGROUND: In hepatitis c virus (HCV)-positive patients receiving HCV-positive liver allografts either the donor or recipient strain overtakes the other strain. Whether these changes are reflected in peripheral blood mononuclear cell (PBMC)-associated virus is unknown. methods: We analyzed by single-strand conformation polymorphism and sequencing HCV rna from serum and PBMCs from a liver transplant recipient whose indigenous strain was replaced by the donor strain. RESULTS: Only the recipient strain was detectable in serum and PBMCs 3 and 5 days after transplantation; at day 7 and 8, a mixture of both was present in the PBMCs, but only recipient strain was detectable in serum. This coincided with the peak presence of donor dna in recipient PBMCs. From day 14 on, HCV sequences in serum and PBMCs were indistinguishable. CONCLUSIONS: Overtake phenomenon in the setting of liver transplantation from infected donors to infected recipients is manifested in PBMCs. Cells released from infected graft carry donor HCV strain.- - - - - - - - - - ranking = 1.1666666666667keywords = liver (Clic here for more details about this article) |
4/517. Combining IgG and interferon alpha-2b in chronic hepatitis c virus infection.Treatment of chronic active hepatitis c virus (HCV) liver disease remains unsatisfactory. Interferon alpha 2b (IFN) has shown favorable though often unsustained effects. Besides its antiviral properties, IFN is a recognized immune modulator. We present data showing the favorable evolution of a case treated with IFN and IgG. Besides the antibody repertoire, the influence of IgG on the immune network is increasingly considered. The complex interactions resulting from combining drugs with immunomodulatory properties, such as IFN and different IgG preparations, may sound confusing. However, it might provide an insight into the outcome of chronic HCV infection, in which, evidently, immune components are heavily implicated. Prolonged treatment, with high-dose intravenous immunoglobulin (IVIG) seemed to be effective, either independently or by potentiating IFN.- - - - - - - - - - ranking = 0.16666666666667keywords = liver (Clic here for more details about this article) |
5/517. Sibling cases of chronic recurrent hepatocerebral disease with hypercitrullinemia.Two sibling cases with chronic recurrent hepato-cerebral syndrome which correspond to the nutritional form of hepato-cerebral disease entitled by Shikata et al. and the data of plasma free aminoacids analyses of these cases were reported. The one case is 27 years old male and the other case is 36 years old female. Their parents were cousins. Both cases have had unbalanced diet, especially liked legumes unusually. Their main symptom was recurrent disturbance of conciousness and convulsive seizures. Slight abnormality of liver function test and hyperammonemia were demonstrated. Electroencephalogram showed the pattern of triphasic wave. Coeliac angiography did not revealed a portal-systemic shunt. Hepatic biopsy specimen revealed liver fibrosis with fatty change in the one case and mild fatty change in the other case. Analyses of plasma free aminoacids showed particurally high level of citrulline in both cases. From the results of plasma free aminoacids analyses, it is considered that pathogenesis of these patients is congenital hereditary urea cycle disorders.- - - - - - - - - - ranking = 0.33333333333333keywords = liver (Clic here for more details about this article) |
6/517. The development of a pancreatic abscess, suppurative pylethrombosis, and multiple hepatic abscesses after a pancreatojejunostomy for chronic pancreatitis: report of a case.We present herein an autopsy case of 63-year-old Japanese man who died as a result of pancreatic abscess, suppurative pylethrombosis, and multiple liver abscesses that had developed 10 years after a pancreato- and cystojejunostomy with side-to-side anastomosis for chronic pancreatitis. Even after this operation, the patient had continued to consume excessive amounts of alcohol. He had first experienced back pain with leukocytosis 9 years after the operation, which relapsed the following year. Despite percutaneous transhepatic gallbladder drainage, his icterus had deteriorated into hepatic insufficiency. Computed tomographic scans of the abdomen had disclosed multiple liver abscesses. At autopsy, a pancreatic abscess and suppurative pylethrombosis as well as multiple liver abscesses were found. There have been few reported cases of such lethal complications developing after a pancreato- and cystojejunostomy for chronic pancreatitis. As the consumption of alcohol would have exacerbated the chronic pancreatitis, such patients should be strongly advised to abstain from drinking alcohol.- - - - - - - - - - ranking = 0.5keywords = liver (Clic here for more details about this article) |
7/517. Improvement of pulmonary hypertension after liver transplantation.Pulmonary hypertension at the end stage of chronic liver disease is not an uncommon situation. This association termed portopulmonary hypertension raises the question of the feasibility of performing orthotopic liver transplantation (OLT). In the case reported herein, there was a favorable outcome after OLT, even though the mean pulmonary artery pressure (MPAP) before transplantation was increased to 45 mm Hg. Before OLT, the cardiac index (CI) was considerably elevated (7.69 L/min/m2), giving evidence of a marked hyperdynamic circulatory state. The CI decreased significantly after OLT (3.38 L/min/m2), and this produced a significant decrease in the MPAP. Our observation suggests that portopulmonary hypertension due to a marked increase in the CI can be managed successfully by OLT.- - - - - - - - - - ranking = 1keywords = liver (Clic here for more details about this article) |
8/517. A case of adult chronic copper self-intoxication resulting in cirrhosis.copper "supplements" taken in a dose of 30-60 mg/day during 3 years caused severe liver cirrhosis necessitating orthotopic liver transplantation.- - - - - - - - - - ranking = 0.33333333333333keywords = liver (Clic here for more details about this article) |
9/517. Percutaneous endoscopic gastrostomy for continuous feeding in children with chronic cholestasis.BACKGROUND: malnutrition associated with chronic cholestasis in children often requires continuous enteral feeding through a nasogastric tube, which may be poorly tolerated. METHOD: Percutaneous endoscopic gastrostomy was performed in five children (age range, 20 months to 13 years) with severe cholestasis (alagille syndrome in four; biliary atresia in one) and severe malnutrition (mean weight, -2.6 standard deviations; mean height, -2.7 standard deviations) who were awaiting liver transplantation. The pull-through technique was used in patients under general anesthesia, and the button was set within 2 months. RESULTS: Minor wound infection required antibiotic therapy in one patient. In the four children with alagille syndrome, enteral feeding by means of percutaneous endoscopic gastrostomy was used until liver transplantation for a mean period of 14 months with a mean weight gain of 350 g/mo and a mean height gain of 0.53 cm/mo. Seventeen months to 3 years, 3 months after liver transplantation, all four children were alive and in good clinical condition with normal readings in liver function tests. The technique had to be discontinued in the child with biliary atresia because of secondary occurrence of ascites, gastric intolerance, and refractory wound infection. CONCLUSION: Percutaneous endoscopic gastrostomy may be a valuable alternative to nasogastric tube for nutritional support in children with cholestasis and mild portal hypertension.- - - - - - - - - - ranking = 0.66666666666667keywords = liver (Clic here for more details about this article) |
10/517. The location of chronic pregnancy hypertension on the vasoconstriction-volume spectrum: working hypothesis.OBJECTIVE: The purpose of this study was to examine whether volume loading is a factor in chronic pregnancy hypertension. STUDY DESIGN: Five patients with chronic hypertension performed home self-monitoring daily with a noninvasive pressure transducer from a fingertip. Determinants of mean arterial pressure were computed from the pressure data and a concurrent electrocardiogram. For this study blood pressure and rapid ejection time, which is an empiric indicator of arterial compliance, were evaluated during antihypertensive therapy. Data were transmitted by facsimile to the hospital. RESULTS: One patient with hypertension who was admitted to the study at 10 weeks' gestation became normotensive with a diuretic (furosemide) alone. Medication was discontinued at 23 weeks' gestation. This patient remained normotensive until delivery at 41 weeks' gestation. blood pressure was controlled with furosemide combined with nifedipine and labetolol in the other 4 cases. Three patients were studied with concurrent blood pressure and rapid ejection time measurements made before and after antihypertensive medication. All 3 showed decreases in these measurements with medication. CONCLUSION: Both volume excess and vasoconstriction should be considered in the pathogenesis of chronic pregnancy hypertension.- - - - - - - - - - ranking = 0.16666666666667keywords = liver (Clic here for more details about this article) |
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