ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Traditional anatomic pathology studies and molecular investigations both contributed to the breadth of current information in the field of liver pathology this year. Techniques such as reverse transcription polymerase chain reaction can identify recurrence of hepatitis C virus infection in the liver as early as 5 days after transplantation. Chronic rejection after transplantation may be characterized not only by ductopenia but also by loss of portal tract hepatic artery branches. There are many diseases of small bile ducts in adults, and idiopathic adulthood ductopenia has been identified in extended family members. Adverse reactions to drugs may precipitate their removal from the pharmacopoeia, such as the many cases reported of severe bridging and submassive necrosis due to troglitazone (a thiazolidinedione antidiabetic agent). Several publications highlighted the association of hepatitis C virus infection with lymphoproliferative diseases and, newly, with cholangiocarcinoma.

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Recently, several lines of investigation focused on basic mechanisms governing cellular and molecular aspects of liver biology have intersected at the study of the hepatic stem cell. Despite years of study, the very question of the existence of the hepatic stem cell has yet to be unequivocally established. A second field of investigation into the cellular and molecular aspects of liver biology is aimed at liver-directed gene therapy in which several new vehicles have been devised to mediate gene transfer. Gene therapy is no longer thought of in the limited framework of a means to correct inherited disorders; it is now expanding into new therapeutic applications. A third major area of investigation includes studies of mechanisms that regulate membrane protein traffic necessary to maintain the integrity of differentiated liver cell function. In this review, some of the most recent advances and applications in these three areas are highlighted, and, where appropriate, points of interaction and potential therapeutic importance are emphasized.

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Research has substantiated the role of several mechanisms responsible for alcohol-induced hepatotoxicity. These mechanisms include: oxidative stress and lipid peroxidation; immunogenic processes initiated by formation of protein adducts of acetaldehyde, other aldehydes and 1-hydroxyethyl radicals; and activation of Kupffer cells by endotoxin and subsequent cascade of events that involved cytokines, chemokines, and adhesion molecules. Increasing evidence implicates enhanced intestinal permeability caused by alcohol ingestion as the culprit that leads to endotoxemia. While oxidative stress is important, the principal source of reactive oxygen species that causes alcohol-induced liver injury is hotly debated. Potential sources may include cytochrome P450IIE1, activated Kupffer cells, and mitochondrial electron transfer chain. Apoptosis is likely an important pathway that culminates in hepatocyte cell death. Abstinence, corticosteroids, and enteral nutrition remain the cornerstones in the treatment of alcoholic hepatitis. The efficacies of medications such as S-adenosylmethionine and pentoxifylline will need further confirmation by additional randomized trials before they can be recommended as standard therapies for alcoholic hepatitis.

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The discovery of novel metabolic pathways and the genetic basis for diseases of the liver continues to yield new insights into the pathogenesis of inherited metabolic diseases of the liver, whereas the application of new technologies to their treatment continues to advance therapeutic options. This review of selected articles covers a wide range of subjects, from the identification of novel proteins and transport pathways to disease diagnosis and treatment of acute liver failure. Four selected topics, Wilson disease, hemochromatosis and iron overload disorders, &agr;-1 antitrypsin disease, and exciting new therapeutic options for lysosomal storage diseases are the focus of this review.

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

This year’s review is divided into several sections: the first describes drug withdrawals and new general reviews of drug-induced liver disease (DILD), including a review of a classification of drug injury. We review agents newly described as causing DILD, and new reports of DILD from established agents appearing in the year 2000. New aspects regarding the treatment of acetaminophen toxicity are included, and in the final section we deal with prevention of DILD as well as issues surrounding the use of potentially hepatotoxic medications in patients with underlying chronic disease.

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

New insights into the regulation of hepatobiliary transport proteins have provided the basis for a better understanding of the pathogenesis of cholestatic liver diseases. Mutations of transporter genes can cause hereditary cholestatic syndromes, the study of which has shed much light on the basic mechanisms of bile secretion and cholestasis. Important new studies have been published about the pathogenesis, clinical features, and treatment of primary biliary cirrhosis, primary sclerosing cholangitis, cholestasis of pregnancy, total parenteral nutrition–induced cholestasis, and drug-induced cholestasis.

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

The major hepatobiliary infections (excluding the viral hepatitides) include amebic and pyogenic liver abscess and cholangitis. Little new information has been published in the area of cholangitis during the last several years. In contrast, the clinical presentation and management of liver abscess have evolved considerably, not only in the last several years but also during a more extended period spanning the last two decades. In the United States, amebic liver abscess occurs largely in individuals from endemic areas or in those traveling to endemic areas. Recent data suggest that patients with human immunodeficiency virus (HIV) infection are at an increased incidence of amebic liver abscess. New serologic tests and molecular techniques are being added to the diagnostic armamentarium for amebic liver abscess. In most cases, amebic liver abscess is associated with an excellent prognosis (up to 100% survival) if properly managed. Pyogenic liver abscess, although commonly occurring in patients with known biliary tract disease, is often cryptogenic in origin (ie, no clear causal factor can be identified) or often is caused by underlying medical disorders. An emerging population of patients with pyogenic liver abscess includes those with complications of aggressive interventions (hepatic chemoembolization, cryoablation, liver transplantation). Pyogenic liver abscess was predominantly managed by surgical methods up until the early 1980s, but almost entirely has changed to being managed by interventional techniques; in 2000, this trend has continued. In contrast to amebic liver abscess, pyogenic liver abscess is associated with greater morbidity and mortality, ostensibly caused by the severity of the underlying disease in many patients. However, it should be emphasized that the prognosis of patients with pyogenic liver abscess, who do not have underlying comorbid conditions, is excellent.

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID

摘要:

Viral hepatitis constitutes the most common entity seen in hepatology practice. Hepatitis A vaccination is recommended for patients with chronic hepatitis. Both lamivudine and interferon are established therapies against chronic hepatitis B, with other treatments not equally effective. Adefovir dipivoxil is a promising new treatment for lamivudine-resistant hepatitis B mutants. Lamivudine and hepatitis B immunoglobulin are effective in preventing recurrence of hepatitis B after transplantation. The combination of interferon and ribavirin has been shown to be effective for treatment of hepatitis C. Studies support the antiviral, antifibrotic, and antineoplastic effect of interferon therapy. Recurrence of hepatitis C after transplantation has been associated with more rapid progression to cirrhosis. Other major advances in the field of viral hepatitis during the past year are highlighted.

ISSN:0267-1379    

出版商:OVID    

年代:2001

数据来源: OVID