ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Our understanding of viral hepatitis becomes greater with time. The ubiquitous hepatitis A virus could soon become obsolete with advances in the development of new vaccines. Hepatitis B is well characterized by its serologic markers and the potential role of the polymerase chain reaction. Its presentation and prognosis can be influenced by the development of cirrhosis, concurrent immunocompromised states, and age. The transmission, diagnosis, and long-term prognosis of chronic hepatitis C is becoming less cryptic and more defined with the help of more sensitive and specific testing methods and continued patient follow-up. Close associations to hepatitis C are being established with many other disease states. Hepatitis D and its relationship to hepatitis B are defined. Finally, an overview of the developing characterization of hepatitis E is also presented.

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Chronic hepatitis is classified etiologically. The autoimmune type predominantly affects genetically predisposed females. It is classified according to the pattern of circulating autoantibodies. Long-term corticosteroid therapy is usually successful. Associations between antibodies to liver-kidney microsomes and the hepatitis C virus can cause diagnostic difficulties. Antiviral treatment of chronic hepatitis B and C is aimed at controlling symptoms and abnormal biochemistry and particularly the progression to cirrhosis and liver cancer. Interferon-α is usually employed but there is no consensus concerning the best regimen. Patients who have developed cirrhosis rarely respond. Hepatitis C is particularly liable to relapse after apparently successful treatment. Serum hepatitis C viral RNA should be used to predict response and monitor progress. Alternative therapies such as thymosin for hepatitis B virus and ribavirin for hepatitis C virus are being evaluated. Some nucleoside analogues such as FIAU (fluoro-iodo-arabino-furanosyl-uracil) have had disastrous results in clinical trials.

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Immunohistochemistry provided new perspectives on diagnostic problems in liver pathology in 1993, including the use of a monoclonal antibody, hepatocyte paraffin 1, to stain normal and malignant hepatocytes. Several experimental models investigated programmed cell death (apoptosis). After decades of use, the nomenclature of chronic hepatitis (chronic persistent, chronic lobular, and chronic active hepatitis) will undergo revision. An association between primary sclerosing cholangitis and Hodgkin's disease is reported and HIV-1 is identified byin situhybridization in Kupffer cells and hepatocytes. Pathologic studies in liver transplantation have highlighted the cytopathic injury seen in the fibrosing cholestatic hepatitis associated with recurrent hepatitis B infection.

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Immunologic mechanisms have been proposed in the pathogenesis of the putative autoimmune hepatobiliary diseases: primary biliary cirrhosis, autoimmune hepatitis, and primary sclerosing cholangitis. Advances in our understanding of the human immune response have led to an appreciation of the complexity of interactions that initiate, perpetuate, and regulate autoimmunity. This appreciation has catalyzed the rapid pace of investigation into the immunogenetics of disease susceptibility, identification of B-cell and T-cell antigenic epitopes involved in autoantibody production, functional analyses of T cells from both peripheral blood and the inflamed livers of patients, and the immunologic mechanisms of hepatocellular necrosis and bile duct injury. Although specific immunologic mechanisms of hepatobiliary injury remain poorly defined, continued studies are likely to provide the insights necessary to devise new diagnostic and therapeutic approaches.

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

Viral infections, malignant transformation, and xenobiotics may elicit immune responses capable of mediating tissue injury. Accumulating evidence indicates that immune responses against viral antigens expressed by infected hepatocytes may mediate hepatocellular necrosis during hepatitis B or C viral infections. Recent studies have clarified the role of T cells, cytokines, and both major histocompatibility complex and adhesion molecules during hepatitis B and C infections. Additional studies have assessed the impact of hepatitis B virus mutants on the immune response and the ability of the hepatitis B virus to alter the phenotype of infected hepatocytes. Emerging data also indicate that hepatitis C infection may play a role in autoimmune reactions. New observations have further defined a relationship between the development of hepatocellular carcinoma and the immune response. In addition, continuing investigations have emphasized the importance of the immune response in the pathogenesis of alcoholic hepatitis. Further understanding of these immune mechanisms may lead to innovative therapeutic strategies.

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

An ever-enlarging portion of hepatology research falls under the rubric of molecular biology. Thus, an attempt to summarize all molecular biology studies of liver disease in the past year is less than satisfying. One topic of particular significance relevant to molecular biology during the past year is the study of cytokines. Examples of these studies include: 1) the use of transgenic mouse models and other methodologies to study the effects of growth factors, especially transforming growth factor-α in liver regeneration and oncogenesis, 2) progress in studying the interactions between nonparenchymal cells and growth factors in liver processes, and 3) elucidation of the roles transforming growth factor-β and platelet-derived growth factor play in hepatic fibrogenesis.

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

In the past few years, there have been dramatic advances in the field of radiology—in technology, in contrast agents, and in therapeutic procedures. The new computed tomography and magnetic resonance technology will permit new imaging protocols to be used, thus revolutionizing how the radiologist images the liver. Likewise, advances in both computed tomography and magnetic resonance contrast agents will aid in lesion localization and increase diagnostic confidence. In patients with known or suspected hepatocellular carcinoma, techniques such as ultrasound-guided percutaneous biopsy of portal vein thrombi and percutaneous ethanol ablation therapy are changing how physicians deal with this group of patients. Transjugular intrahepatic portosystemic shunt, a new therapeutic nonoperative procedure for management of variceal bleeding, is effective in lowering portal pressure and in controlling variceal bleeding both in patients unresponsive to sclerotherapy and in patients with chronic variceal bleeding before liver transplantation.

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID

摘要:

The pathogenesis of ascites formation, hepatic encephalopathy, and the hepatorenal syndrome are still uncertain. Recent studies have furthered our understanding of these processes. This paper reviews current understanding of these processes and discusses current developments that may have therapeutic implications in these areas. Recent studies regarding spontaneous bacterial peritonitis and the malnutrition of cirrhosis are also reviewed.

ISSN:0267-1379    

出版商:OVID    

年代:1994

数据来源: OVID