摘要:

Liver transplantation continues to be refined in terms of indications, technique, immunosuppression, and the diagnosis of allograft rejection. Alcoholic cirrhosis, chronic hepatitis B, and hepatocellular carcinoma remain controversial indications for liver transplantation; recent papers provide opinions and shed some light on these indications. Descriptions of liver biopsy abnormalities after liver transplantation, including findings attributed to rejection and to preservation injury, were well described this past year. Finally, literature regarding the new immunosuppressive agent, FK506, is just begining to appear; controlled trials of its efficacy in liver transplantation should be published in the near future.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Investigation of patients with severe liver disease, particularly candidates for liver transplantation, now includes quantitative studies of drug metabolism and clearance in attempts to improve prediction of short-and medium-term prognosis. Radiologic investigation of the liver has become more sophisticated and more commonly used. As a result focal hepatic disease has become an ever increasing clinical problem for radiologists and practitioners alike. Drug hepatotoxicity continues to be encountered and explored. To some degree there has been an effort to seek common ground between the “metabolists” and the “immunoallergists‘’ regarding mechanisms of drug-induced liver injury. More has been learned of some familiar hepatotoxins and other drugs have been recognized as potential hepatotoxins. The occurrence of liver injury with parenteral nutrition regimens continues to pose management difficulties, without there being obvious explanations.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

A considerable wealth of new information was gained on the metabolism and hepatotoxicity of ethanol during 1991. Much progress has been made on the elucidation of pathways of ethanol metabolism, including gastric alcohol dehydrogenase and associated alcohol-drug interactions, as well as genetic determinants of hepatic alcohol metabolism and associated changes of relevance to alcoholic liver injury. Significant, though less impressive, advances have been made in the field of prevention and treatment.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The liver is involved in systemic infections and also (due to the fact that it lies at the distal end of the portal circulation) many others that involve the gastrointestinal tract. Systemic bacterial infections are often accompanied by hepatocellular dysfunction; the pathogenesis of this event is poorly understood. Opportunistic infections are increasingly encountered in advanced human immunodeficiency virus disease. Granulomatous involvement of the liver occurs in a wide range of infections (and also malignancies). Pyogenic liver abscess still carries a significant mortality rate, although there is overall evidence that management is improving. In a tropical context, invasive hepatic amebiasis remains the most common cause of a space-occupying hepatic lesion or lesions. Schistosomal liver disease, complicated by portal hypertension, is a major gastroenterologic problem in Africa, the Middle East, and southern America, and biliary parasitic infections (with resultant adenocarcinoma) cause severe morbidity and mortality in southeastern Asia.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

In this review, we concentrate on those inherited metabolic disorders that manifest in hepatic disease as a predominant component of a generalized metabolic disturbance, often for the first time in adult or early adult life. They include hereditary hemochromatosis, Wilson's disease, α1-antitrypsin deficiency, and certain disorders of lipid storage such as Gaucher's and Niemann-Pick diseases.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The past year was not a vintage year for advances in knowledge of malignant hepatic tumors. Nevertheless, important information, especially concerning the pathogenesis of hepatocellular carcinoma, did emerge and indicates new direction for research into hepatocarcinogenesis. Most exciting was the demonstration of a specific mutation of the putative tumor-suppressor gene,p53, in hepatocellular carcinomas from patients living in geographic regions where aflatoxin B1 is a risk factor, and of the carcinogenic potential of the hepatitis B virus X gene protein. An accurate assessment of the closeness of the association between hepatitis C virus infection and hepatocellular carcinoma in different populations awaits the determination of what proportion of the positive serum results for antibody to hepatitis C are false-positive. The interaction, if any, between hepatitis B and C viruses in the pathogenesis of hepatocellular carcinoma, and the mechanism whereby hepatitis C virus might induce malignant transformation of hepatocytes, remain uncertain. The cost effectiveness of surveillance programs designed to detect presymptomatic, resectable hepatocellular carcinomas is still being debated. Reports in the literature during the past year have not helped in resolving this issue because they contained data that supported both sides of the argument. No convincing evidence has yet emerged that either intravenous infusion of newer cytotoxic drugs, alone or in various combinations, or infusion of these drugs into the hepatic artery, with or without lipiodol targeting, or transcatheter hepatic artery embolization or chemoembolization, or hormonal manipulation have a positive effect on survival of patients with hepatocellular carcinoma.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The standard hepatic biochemical tests are modified during pregnancy by normal physiologic changes. Primary sclerosing cholangitis appears to be far more common than previously suspected and exists in an asymptomatic form. This asymptomatic form may be progressive with a considerable mortality and morbidity including the development of cholangiocarcinoma. Because no effective parasiticide agent is available hepatic hydatid disease is still a surgical condition requiring surgical extirpation of the entire cyst. Rarer infections that may involve the liver include tuberculosis, leptospirosis, cytomegalic viral infection, andSalmonella typhi.In patients with fulminant hepatic failure manifesting fever and evidence of sepsis unresponsive to antibiotics, fungal infections have to be excluded. Liver disorders associated with thyroid dysfunction can occur for both hypo-and hyperthyroidism. The role of prostaglandins in hepatic disease is still being evaluated particularly relating to the hepatorenal syndrome as well as fulminant hepatic failure. Nonalcoholic steatohepatitis is encountered with increasing frequency and its differentiation from alcoholic hepatitis is now becoming more clearly demarcated. Certainly, the presence of a normal prothrombin time, a normal albumin, and an aspartate aminotransferase:alanine aminotransferase ratio of less than two favors the nonalcoholic form. The role of nutrition in liver disease has been largely neglected and it is now apparent that malnutrition is a major risk factor for surgery in general and specifically for liver transplantation.

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1992

数据来源: OVID