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Rheumatologic manifestations of hepatic diseases 被引量:3
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作者 Zhao-Chun Chi Su-Zhen Ma the Division of Gastroenterologr, Department of Medicine, People’s Hospital, Qingdao 266001, China the Department of Infectious Diseases, Qingdao University College of Medicine, Qingdao 266012, China 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2003年第1期32-37,共6页
A possible link is suggested between hepatic diseases and rheumatic disease. Polyarthralgia and polyarthritis may be seen during the prodromal period of acute viral hepatitis, especially in hepatitis B virus (HBV). Th... A possible link is suggested between hepatic diseases and rheumatic disease. Polyarthralgia and polyarthritis may be seen during the prodromal period of acute viral hepatitis, especially in hepatitis B virus (HBV). The symptoms of arthritis, mild, localized or generalized, mostly involve the small joints of hands. Joint symptoms frequently precede the onset of jaundice, no residual joint deformities. Circulating immune complexes are believed to play a causative role in the development of vasculitis and arthritis. Hemochromatosis is an antosomal recessive disorder of iron. About 43%-81% of patients with hemochromatosis have arthritis. The common extrahepatic manifestations of autoimmune hepatitis are arthralgia and skin rash. The reported prevalence of symptomatic inflammatory arthropathy in patients with primary biliary cirrhosis ranges from 4% to 50%. Skeletal involvement with Wilson's disease is common. Such patients may complain of pain and stiffness, mainly in the knee, wrist, or other large joints. Shwachman's syndrome is a disorder of pancreatic exocrine. Symmetric bone lesions have been reported in 10% to 15% of patients. They are involved predominantly at the femoral neck. Rheumatic symptoms are seen in one third of adult patients with cystic fibrosis and arthritis in 2.5% to 12% of patients. The arthritis caused by pancreatic panniculitis is usually symmetrical and involves the small joints of the hand, wrist, and feet, but may involve such larger joints as the elbow, ankle, and knee. 展开更多
关键词 hepatic diseases rheumatologic manifestation
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Therapeutic mechanism of Yīn-Chén-Hāo decoction in hepatic diseases 被引量:6
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作者 Jian-Yuan Li Hong-Yan Cao +6 位作者 Lin Sun Run-Fei Sun Chao Wu Yan-Qin Bian Shu Dong Ping Liu Ming-Yu Sun 《World Journal of Gastroenterology》 SCIE CAS 2017年第7期1125-1138,共15页
Yīn-Chén-Hāo decoction(YCHD) is a traditional Chinese medicine formula composed of capillaris(Artemisia capillaris), gardenia(Gardenia jasminoides), and rhubarb(Rheum rhabarbarum) that is used for the treatment... Yīn-Chén-Hāo decoction(YCHD) is a traditional Chinese medicine formula composed of capillaris(Artemisia capillaris), gardenia(Gardenia jasminoides), and rhubarb(Rheum rhabarbarum) that is used for the treatment of damp-heat jaundice. In modern clinics, YCHD is mostly used for hepatic diseases. This review summarizes the biological activities of YCHD and its medical applications. The main active compounds of YCHD are chlorogenic acid, rhein, geniposide, emodin, and scoparone. The pharmacological actions of YCHD include inhibition of hepatic steatosis, apoptosis, necrosis, anti-inflammation, and immune regulation. YCHD could be developed as a new therapeutic strategy for the treatment of hepatic diseases. 展开更多
关键词 Yīn-Chén-Hāo decoction hepatic disease Clinical application Effector mechanism Review
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Challenges and dilemmas in pediatric hepatic Wilson’s disease
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作者 Upasana Ghosh Moinak Sen Sarma Arghya Samanta 《World Journal of Hepatology》 2023年第10期1109-1126,共18页
Wilson disease is an autosomal recessive disorder affecting the ATP7B gene located on chromosome 13q.This leads to copper deposition in various organs,most importantly in the liver and brain.The genetic mutations are ... Wilson disease is an autosomal recessive disorder affecting the ATP7B gene located on chromosome 13q.This leads to copper deposition in various organs,most importantly in the liver and brain.The genetic mutations are vast,well reported in the West but poorly documented in developing countries.Hence the diagnosis is made with a constellation of clinico-laboratory parameters which have significant overlap with other liver diseases and often pose a significant dilemma for clinicians.Diagnostic scoring systems are not fool-proof.The availability and affordability of chelators in developing countries impact the drug compliance of patients.While D-penicillamine is a potent drug,its side effects lead to drug discontinuation.Trientine is cost-prohibitive in developing countries.There is no single test to assess the adequacy of chelation.Exchangeable urinary copper is an essential upcoming diagnostic and prognostic tool.In the presence of cirrhosis,hypersplenism clouds the assessment of myelosuppression of drugs.Similarly,it may be difficult to distinguish disease tubulopathy from druginduced glomerulonephritis.Neurological worsening due to chelators may appear similar to disease progression.Presentation as fulminant hepatic failure requires rapid workup.There is a limited window of opportunity to salvage these patients with the help of plasmapheresis and other liver-assisted devices.This review addresses the challenges and clinical dilemmas faced at beside in developing countries. 展开更多
关键词 Wilson’s disease CHILDREN hepatic Wilson disease D-PENICILLAMINE Trientine Exchangeable copper
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Effect of Chishao Chengqi Decoction (赤芍承气汤) on Endotoxin and TNF-α in Patients with Severe Hepatic Diseases 被引量:1
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作者 吴其恺 杨大国 +2 位作者 陶艳艳 聂广 邓欣 《Chinese Journal of Integrative Medicine》 SCIE CAS 2002年第4期270-274,共5页
Objective: To observe the effect of Chishao Chengqi decoction (CCD ) in treating severe hepatopathy and its influence on serum endotoxin(ET) and tu mor necrosis factor α (TNF-α), in order to explore the possible mec... Objective: To observe the effect of Chishao Chengqi decoction (CCD ) in treating severe hepatopathy and its influence on serum endotoxin(ET) and tu mor necrosis factor α (TNF-α), in order to explore the possible mechanism o f CCD in protecting liver cells and in preventing liver failure.Methods: Sixty patients suffering from hepatopathy were divided into the treated group and control group randomly, 30 in each group. They were treated with comprehensive treatment, including hepatocyte growth-promoting factors, thymosin, Transmetil and albumin. CCD was given to the treated group ad ditionally. The therapeutic effects were observed and the changes of some bioch emical criteria, including alanine transaminase (ALT), aspartate aminotransferas e (AST), total bilirubin (TB), albumin (ALB) as well as such parameters as proth rombin activity (PTA), serum levels of ET and TNF-α were all detected respec tively before treatment and after treatment.Results: In the treated group, 8 patients was clinically cured af ter treatment, 11 were markedly alleviated, 7 improved and 4 remained unchanged, while in the control group, the respective numbers were 5, 8, 8 and 9. The tota l effective rate of the treated group was significantly better than that of the control group by( P <0.05). ET and TNF-α levels in patients were signific antly higher than the normal range before treatment, and they were lowered after treatment. Comparison of the effect between the two groups showed significant d ifference ( P <0.05 ) , with that in the treated group better than that in t he control group.Conclusion: CCD decoction could reduce the production and releasi ng of ET and TNF-α in severe hepatopathy patients, which might be one of its therapeutic mechanisms. 展开更多
关键词 severe hepatic disease Chishao Chengqi decoction endotoxin tumor necrosis factor α
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Artificial intelligence-based ultrasound imaging technologies for hepatic diseases 被引量:1
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作者 Longfei Ma Rui Wang +6 位作者 Qiong He Lijie Huang Xingyue Wei Xu Lu Yanan Du Jianwen Luo Hongen Liao 《iLIVER》 2022年第4期252-264,共13页
Ultrasound(US)imaging is a non-invasive,real-time,economical,and convenient imaging modality that has been widely used in diagnosing and treating hepatic diseases.Artificial intelligence(AI)technology can predict or m... Ultrasound(US)imaging is a non-invasive,real-time,economical,and convenient imaging modality that has been widely used in diagnosing and treating hepatic diseases.Artificial intelligence(AI)technology can predict or make decisions based on the experience of clinical experts and knowledge obtained from training data.This technology can help clinicians improve the detection efficiency and evaluate hepatic diseases,promote clinical treatment of the liver,and predict the response of the liver after treatment.This review summarizes the current rapid development of US technology and related AI methods in the diagnosis and treatment of hepatic diseases.Covered topics include steatosis grading,fibrosis staging,detection of focal liver lesions,US image segmentation,multimodal image registration,and other applications.At present,the field of AI in US imaging is still in its early stages.With the future progress of AI technology,AI-based US imaging can further improve diagnosis,reduce medical costs,and optimize US-based clinical workflow.This technology has broad prospects for application to hepatic diseases. 展开更多
关键词 Artificial intelligence Ultrasound imaging hepatic diseases Diagnosis and treatment
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Gynura root induces hepatic veno-occlusive disease:A case report and review of the literature 被引量:27
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作者 Ning Dai Ying-Cong Yu +4 位作者 Tian-Hua Ren Jia-Guo Wu Yuan Jiang Lai-Gen Shen Jing Zhang 《World Journal of Gastroenterology》 SCIE CAS CSCD 2007年第10期1628-1631,共4页
Gynura root has been used extensively in Chinese folk medicine and plays a role in promoting microcirculation and relieving pain.However,its hepatic toxicity should not be neglected.Recently,we admitted a 62-year old ... Gynura root has been used extensively in Chinese folk medicine and plays a role in promoting microcirculation and relieving pain.However,its hepatic toxicity should not be neglected.Recently,we admitted a 62-year old female who developed hepatic veno-occlusive disease(HVOD)after ingestion of Gynura root.Only a few articles on HVOD induced by Gynura root have been reported in the literature.It is suspected that pyrrolizidine alkaloids in Gynura root might be responsible for HVOD.In this paper,we report a case of HVOD and review the literature. 展开更多
关键词 hepatic veno-occlusive disease Gynura root
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A case report of hepatic veno-occlusive disease after ingesting dainties 被引量:3
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作者 Yong-Song Guan 《World Journal of Gastroenterology》 SCIE CAS CSCD 2006年第41期6734-6735,共2页
Hepatic veno-occlusive disease (HVOD) is rarely encountered and easily misjudged as Budd-Chiari syndrome. It is often related to stem cell transplantation in recent years. We report a case of HVOD that is related to i... Hepatic veno-occlusive disease (HVOD) is rarely encountered and easily misjudged as Budd-Chiari syndrome. It is often related to stem cell transplantation in recent years. We report a case of HVOD that is related to ingestion of some palatable local dishes. The diagnosis was confirmed by liver biopsy pathology with specific observation of inflammatory changes and fibrosis of venules intima, dilated sinusoids and central veins. Chronic diarrhea is unique for this case as a result of ingesting harmful stuffs. This case demonstrated that supervision and instruction of food recipe and traditional medicine are crucial, and prompt diagnosis, supportive care and specific treatment are essential to decreasing the morbidity and mortality of HVOD. 展开更多
关键词 hepatic veno-occlusive disease DIAGNOSIS MANAGEMENT BIOPSY
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Hepatic veno-occlusive disease induced by Gymura segetum: report of two cases 被引量:3
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作者 Hui-Fen Dai, Yuan Gao, Ming Yang, Chao-Hui Yu, Zhu-Ying Gu and Wei-Xing Chen Zhejiang University School of Medicine, Hangzhou 310031, China Department of Emergency Medicine and Department of Gastroenterology , First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2006年第3期406-408,共3页
BACKGROUND: Hepatic veno-occlusive disease (VOD) or sinusoidal obstruction syndrome is associated with a high mortality because of its severity. Gymura segetum, a Chinese herbal medicine, is always used to cure injury... BACKGROUND: Hepatic veno-occlusive disease (VOD) or sinusoidal obstruction syndrome is associated with a high mortality because of its severity. Gymura segetum, a Chinese herbal medicine, is always used to cure injury and bleeding in rural areas in China. This study was undertaken to better understand VOD and its relations to the effect of Gymura segetum. METHODS: Between 2000 and 2002,two patients were admitted to our department because of VOD. Before admission, both of them had been injured and taken oral decoction of patent drug Gymura segetum. We analyzed the clinical manifestations, diagnosis and therapy of the two patients. RESULTS: Pyrrolizidine in Panax notginseng was proved to induce VOD. The diagnosis of VOD depended on hepatic biopsy. CONCLUSION: Gymura segetum can induce VOD. More attention should be paid to its unsuscepted side effects. 展开更多
关键词 hepatic veno-occlusive disease ASCITES drugs Chinese herbal liver transplantation
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One patient of hepatic veno-occlusive disease with an increased cancer antigen-125 expression caused by misuse of Sedum aizoon
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作者 Siliang Wu 《TMR Clinical Research》 2018年第1期15-19,共5页
Nowadays hepatic veno-occlusive disease is mainly caused by Sedum aizoon in China,and its prognosis dependents on the dosage and courses of the Sedum aizoon treatment but lacks other objective indicators.There are a l... Nowadays hepatic veno-occlusive disease is mainly caused by Sedum aizoon in China,and its prognosis dependents on the dosage and courses of the Sedum aizoon treatment but lacks other objective indicators.There are a lot relationships between CA125 level and liver cirrhosis,this case had a obvious increased CA125 level in the serum,hydrothorax and ascites,following by the liver cirrhosis in a short time,and then died of upper gastrointestinal bleeding.By now we guess that CA125 level could forecast the liver cirrhosis following by hepatic veno-occlusive,which will become the prognosis of the hepatic veno-occlusive. 展开更多
关键词 hepatic veno-occlusive disease Sedum aizoon Cancer antigen-125
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Rising incidence,progression and changing patterns of liver disease in Wales 1999-2019
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作者 Thomas Peter Ignatius Pembroke Gareth John +7 位作者 Berry Puyk Keith Howkins Ruth Clarke Fidan Yousuf Marek Czajkowski Andrew Godkin Jane Salmon Andrew Yeoman 《World Journal of Hepatology》 2023年第1期89-106,共18页
BACKGROUND Liver disease incidence and hence demand on hepatology services is increasing.AIM To describe trends in incidence and natural history of liver diseases in Wales to inform effective provision of hepatology s... BACKGROUND Liver disease incidence and hence demand on hepatology services is increasing.AIM To describe trends in incidence and natural history of liver diseases in Wales to inform effective provision of hepatology services.METHODS The registry is populated by International Classification of Diseases-10(ICD-10)code diagnoses for residents derived from mortality data and inpatient/day case activity between 1999-2019.Pseudo-anonymised linkage of:(1)Causative diagnoses;(2)Cirrhosis;(3)Portal hypertension;(4)Decompensation;and(5)Liver cancer diagnoses enabled tracking liver disease progression.RESULTS The population of Wales in 2019 was 3.1 million.Between 1999 and 201973054 individuals were diagnosed with a hepatic disorder,including 18633 diagnosed with cirrhosis,10965 with liver decompensation and 2316 with hepatocellular carcinoma(HCC).Over 21 years the incidence of liver diseases increased 3.6 fold,predominantly driven by a 10 fold increase in non-alcoholic fatty liver disease(NAFLD);the leading cause of liver disease from 2014.The incidence of cirrhosis,decompensation,HCC,and allcause mortality tripled.Liver-related mortality doubled.Alcohol-related liver disease(ArLD),autoimmune liver disease and congestive hepatopathy were associated with the highest rates of decompensation and all-cause mortality.CONCLUSION A 10 fold increase in NAFLD incidence is driving a 3.6 fold increase in liver disease in Wales over 21 years.Liver-related morbidity and mortality rose more slowly reflecting the lower progression rate in NAFLD.Incidence of ArLD remained stable but was associated with the highest rates of liver-related and all-cause mortality. 展开更多
关键词 EPIDEMIOLOGY CIRRHOSIS Liver failure Non-alcoholic fatty liver disease hepatitis Hepatocellular carcinoma
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Hepatitis B virus infection in patients with Wilson disease:A large retrospective study
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作者 Hua-Ying Zhou Xu Yang +5 位作者 Kai-Zhong Luo Yong-Fang Jiang Wen-Long Wang Jun Liang Ming-Ming Li Hong-Yu Luo 《World Journal of Gastroenterology》 SCIE CAS 2023年第32期4900-4911,共12页
BACKGROUND Wilson disease(WD)is the most common genetic metabolic liver disease.Some studies have shown that comorbidities may have important effects on WD.Data on hepatitis B virus(HBV)infection in patients with WD a... BACKGROUND Wilson disease(WD)is the most common genetic metabolic liver disease.Some studies have shown that comorbidities may have important effects on WD.Data on hepatitis B virus(HBV)infection in patients with WD are limited.AIM To investigate the prevalence and clinical impact of HBV infection in patients with WD.METHODS The clinical data of patients with WD were analyzed retrospectively,and the data of patients with concurrent WD and HBV infection were compared with those of patients with isolated WD.RESULTS Among a total of 915 WD patients recruited,the total prevalence of current and previous HBV infection was 2.1%[95%confidence interval(CI):1.2%-3.0%]and 9.2%(95%CI:7.3%-11.1%),respectively.The main finding of this study was the identification of 19 patients with concurrent WD and chronic hepatitis B(CHB)infection.The diagnosis of WD was missed in all but two patients with CHB infection.The mean delay in the diagnosis of WD in patients with concurrent WD and CHB infection was 32.5 mo,which was significantly longer than that in patients with isolated WD(10.5 mo).The rates of severe liver disease and mortality in patients with concurrent WD and CHB infection were significantly higher than those in patients with isolated WD(63.1%vs 19.3%,P=0.000 and 36.8%vs 4.1%,P<0.001,respectively).Binary logistic regression analysis revealed a significantly higher risk of severe liver disease at the diagnosis of WD in patients with current HBV infection[odds ratio(OR)=7.748;95%CI:2.890-20.774;P=0.000)]or previous HBV infection(OR=5.525;95%CI:3.159-8.739;P=0.000)than in patients with isolated WD.CONCLUSION The total prevalence of current HBV infection in patients with WD was 2.1%.The diagnosis of WD in CHB patients is usually missed.HBV infection is an independent risk factor for severe liver disease in WD patients.The diagnosis of WD should be ruled out in some patients with CHB infection. 展开更多
关键词 Wilson disease Hepatitis B virus Chronic hepatitis B Kayser-Fleischer ring CERULOPLASMIN Concurrent Wilson disease and hepatitis B virus infection
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PKHD1L1 blocks the malignant behavior of lung adenocarcinoma cells and restricts tumor growth by regulating CBX7
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作者 KEWEI CHENG LEI SHI +2 位作者 CAIWEN SHI SHUANSHUAN XIE CHANGHUI WANG 《BIOCELL》 SCIE 2024年第8期1209-1221,共13页
Objective:To explore the role of polycystic kidney and hepatic disease 1-like 1(PKHD1L1)in lung adenocarcinoma(LUAD).Methods:Bioinformatics tools were utilized to examine the clinical profile of PKHD1L1 and chromobox ... Objective:To explore the role of polycystic kidney and hepatic disease 1-like 1(PKHD1L1)in lung adenocarcinoma(LUAD).Methods:Bioinformatics tools were utilized to examine the clinical profile of PKHD1L1 and chromobox protein homolog 7(CBX7)in LUAD.The Cell Counting Kit-8,colony formation,terminal deoxynucleotidyl transferase dUTP nick end labeling,Transwell,and wound-healing assays were carried out to assess the proliferative,apoptotic,invasive,and migrative capacities of the cells.Furthermore,the interrelation between PKHD1L1 and CBX7 was validated using a co-immunoprecipitation assay.A LUAD mice model was constructed by subcutaneous injection of A549 cells.Finally,immunohistochemical staining was performed to evaluate CBX7 and Ki67 expression.Results:PKHD1L1 was downregulated in LUAD and predicted dismal outcomes in patients with LUAD.PKHD1L1 upregulation repressed the proliferative,invasive,and migrative capabilities of A549 cells and exacerbated the apoptotic rate.Additionally,PKHD1L1 may bind to CBX7 and positively modulate CBX7 expression.CBX7 deletion partly abrogated the effects of PKHD1L1 upregulation on the cellular biological activities in A549 cells.Furthermore,the PKHD1L1/CBX7 axis regulates the Hippo signaling pathway in A549 cells.PKHD1L1 restricted tumor growth in LUAD xenograft mice;this was partly abolished by CBX7 knockdown.Conclusion:PKHD1L1 can hinder LUAD progression by regulating CBX7-mediated Hippo signaling. 展开更多
关键词 Lung adenocarcinoma Polycystic kidney and hepatic disease 1-like 1 CBX7 Hippo signaling
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Psychotropic drugs and liver disease:A critical review of pharmacokinetics and liver toxicity 被引量:3
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作者 Diogo Telles-Correia António Barbosa +3 位作者 Helena Cortez-Pinto Carlos Campos Nuno B F Rocha Sérgio Machado 《World Journal of Gastrointestinal Pharmacology and Therapeutics》 CAS 2017年第1期26-38,共13页
The liver is the organ by which the majority of sub-stances are metabolized, including psychotropic drugs. There are several pharmacokinetic changes in end-stage liver disease that can interfere with the metabolizatio... The liver is the organ by which the majority of sub-stances are metabolized, including psychotropic drugs. There are several pharmacokinetic changes in end-stage liver disease that can interfere with the metabolization of psychotropic drugs. This fact is particularly true in drugs with extensive first--pass metabolism, highly protein bound drugs and drugs depending on phase I hepatic metabolic reactions. Psychopharmacological agents are also associated with a risk of hepatotoxicity. The evidence is insufficient for definite conclusions regarding the prevalence and severity of psychiatric drug-induced liver injury. High-risk psychotropics are not advised when there is pre-existing liver disease, and after starting a psychotropic agent in a patient with hepatic impairment, frequent liver function/lesion monitoring is advised. The authors carefully review the pharmacokinetic disturbances induced by end-stage liver disease and the potential of psychopharmacological agents for liver toxicity. 展开更多
关键词 LIVER TOXICITY Psychotropic drugs PHARMACOKINETICS hepatic disease
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Indole alkaloids of Alstonia scholaris(L.)R.Br.alleviated nonalcoholic fatty liver disease in mice fed with high-fat diet 被引量:2
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作者 Shui-Fen Sun Hui-Jie Zhong +7 位作者 Yun-Li Zhao Xiu-Ying Ma Jin-Bo Luo Ling Zhu Yu-Ting Zhang Wen-Xue Wang Xiao-Dong Luo Jia-Wei Geng 《Natural Products and Bioprospecting》 2022年第1期168-178,共11页
Alstonia scholaris(L.)R.Br(Apocynaceae)is a well-documented medicinal plant for treating respiratory diseases,liver diseases and diabetes traditionally.The current study aimed to investigate the effects of TA on non-a... Alstonia scholaris(L.)R.Br(Apocynaceae)is a well-documented medicinal plant for treating respiratory diseases,liver diseases and diabetes traditionally.The current study aimed to investigate the effects of TA on non-alcoholic fatty liver disease(NAFLD).A NAFLD model was established using mice fed a high-fat diet(HFD)and administered with TA(7.5,15 and 30 mg/kg)orally for 6 weeks.The biochemical parameters,expressions of lipid metabolism-related genes or proteins were analyzed.Furthermore,histopathological examinations were evaluated with Hematoxylin-Eosin and MASSON staining.TA treatment significantly decreased the bodyweight of HFD mice.The concentrations of low-density lipoprotein(LDL),triglyceride(TG),aspartate aminotransferase(AST)and alanine aminotransferase(ALT)were also decreased significantly in TA-treated mice group,accompanied by an increase in high-density lipoprotein(HDL).Furthermore,TA alleviated hepatic steatosis injury and lipid droplet accumulation of liver tissues.The liver mRNA levels involved in hepatic lipid synthesis such as sterol regulatory element-binding protein 1C(SREBP-1C),regulators of liver X receptorα(LXRα),peroxisome proliferator activated receptor(PPAR)γ,acetyl-CoA carboxylase(ACC1)and stearyl coenzyme A dehydrogenase-1(SCD1),were markedly decreased,while the expressions involved in the regulation of fatty acid oxidation,PPARα,carnitine palmitoyl transterase 1(CPT1A),and acyl coenzyme A oxidase 1(ACOX1)were increased in TA-treated mice.TA might attenuate NAFLD by regulating hepatic lipogenesis and fatty acid oxidation. 展开更多
关键词 hepatic disease hepatic lipogenesis Fatty acid oxidation
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Liver cirrhosis in hepatic vena cava syndrome(or membranous obstruction of inferior vena cava) 被引量:8
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作者 Santosh Man Shrestha 《World Journal of Hepatology》 CAS 2015年第6期874-884,共11页
Hepatic vena cava syndrome(HVCS) also known as membranous obstruction of inferior vena cava reported mainly from Asia and Africa is an important cause of hepatic venous outflow obstruction(HVOO) that is complicated by... Hepatic vena cava syndrome(HVCS) also known as membranous obstruction of inferior vena cava reported mainly from Asia and Africa is an important cause of hepatic venous outflow obstruction(HVOO) that is complicated by high incidence of liver cirrhosis(LC) and moderate to high incidence of hepatocellular carcinoma(HCC). In the past the disease was considered congenital and was included under Budd-Chiari syndrome(BCS). HVCS is a chronic disease common in developing countries, the onset of which is related to poor hygienic living condition. The initial lesion in the disease is a bacterial infection induced localized thrombophlebitis in hepatic portion of inferior vena cava at the site where hepatic veins open which on resolution transforms into stenosis, membrane or thick obstruction,and is followed by development of cavo-caval collateral anastomosis. The disease is characterized by long asymptomatic period and recurrent acute exacerbations(AE) precipitated by clinical or subclinical bacterial infection. AE is managed with prolonged oral antibiotic. Development of LC and HCC in HVCS is related to the severity and frequency of AEs and not to the duration of the disease or the type or severity of the caval obstruction. HVOO that develops during severe acute stage or AE is a pre-cirrhotic condition. Primary BCS on the other hand is a rare disease related to prothrombotic disorders reported mainly among Caucasians that clinically manifest as acute, subacute disease or as fulminant hepatic failure; and is managed with life-long anticoagulation, portosystemic shunt/endovascular angioplasty and stent or liver transplantation. As epidemiology, etiology and natural history of HVCS are different from classical BCS, it is here, recognized as a separate disease entity, a third primary cause of HVOO after sinusoidal obstruction syndrome and BCS. Understanding of the natural history has made early diagnosis of HVCS possible. This paper describes epidemiology, natural history and diagnosis of HVCS and discusses the pathogenesis of LC in the disease and mentions distinctive clinical features of HVCS related LC. 展开更多
关键词 hepatic venous outflow obstruction Budd-Chiari syndrome hepatic inferior vena cava disease Bacterial infection Hepatocellular carcinoma
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Clinical significance of connective tissue growth factor in hepatitis B virus-induced hepatic fibrosis 被引量:13
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作者 Rong-Li Piao David R Brigstock +2 位作者 Jie Zhu Man-Li Zhang Run-Ping Gao 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第18期2280-2286,共7页
AIM:To determine the utility of connective tissue growth factor(CCN2/CTGF) for assessing hepatic fibrosis in hepatitis B virus(HBV)-induced chronic liver diseases(CLD-B).METHODS:Enzyme-linked immunosorbent assay was u... AIM:To determine the utility of connective tissue growth factor(CCN2/CTGF) for assessing hepatic fibrosis in hepatitis B virus(HBV)-induced chronic liver diseases(CLD-B).METHODS:Enzyme-linked immunosorbent assay was used to measure CCN2 in sera from 107 patients with chronic hepatitis B(CHB) and 39 patients with HBVinduced active liver cirrhosis and 30 healthy individuals.Liver samples from 31 patients with CHB,8 patients with HBV-induced liver cirrhosis and 8 HBV carriers with normal liver histology were examined for transforming growth factor β-1(TGF-β1) or CCN2 mRNA levels by in situ hybridization,and computer image analysis was performed to measure integrated optimal density(IOD) of CCN2 mRNA-positive cells in liver tissues.Histological inflammation grading and fibrosis staging were evaluated by H and E staining and Van Gieson's method.RESULTS:Serum CCN2 concentrations were,respectively,4.0-or 4.9-fold higher in patients with CHB or active liver cirrhosis as compared to healthy individuals(P < 0.01).There was good consistency between the levels of CCN2 in sera and CCN2 mRNA expression in liver tissues(r = 0.87,P < 0.01).The levels of CCN2 in sera were increased with the enhancement of histological fibrosis staging in patients with CLD-B(r = 0.85,P < 0.01).Serum CCN2 was a reliable marker for the assessment of liver fibrosis,with areas under the receiver operating characteristic(ROC) curves(AUC) of 0.94 or 0.85 for,respectively,distinguishing normal liver controls from patients with F1 stage liver fibrosis or discriminating between mild and significant fibrosis.CONCLUSION:Detection of serum CCN2 in patients with CLD-B may have clinical significance for assessment of severity of hepatic fibrosis. 展开更多
关键词 Connective tissue growth factor Liver fibrosis Chronic hepatitis B Chronic liver disease Chronic hepatitis C
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Non-invasive determination of hepatic steatosis by acoustic structure quantification from ultrasound echo amplitude 被引量:15
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作者 Hidekatsu Kuroda Keisuke Kakisaka +7 位作者 Naohisa Kamiyama Takayoshi Oikawa Mio Onodera Kei Sawara Kanta Oikawa Ryujin Endo Yasuhiro Takikawa Kazuyuki Suzuki 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第29期3889-3895,共7页
AIM:To use leptin-deficient(ob/ob) mice with demonstrated differences in steatosis levels to test a new diagnostic method using the acoustical structure quantification(ASQ) mode and the associated analytical parameter... AIM:To use leptin-deficient(ob/ob) mice with demonstrated differences in steatosis levels to test a new diagnostic method using the acoustical structure quantification(ASQ) mode and the associated analytical parameter,"focal disturbance ratio"(FD-ratio).METHODS:Nine ob/ob mice,at 5,8,and 12 wk of age(n = 3 in each age group),were used as models for hepatic steatosis.Echo signals obtained from ultrasonography in the mice were analyzed by ASQ,which uses a statistical analysis of echo amplitude to estimate inhomogeneity in the diagnostic region.FD-ratio,as calculated from this analysis,was the focus of the present study.FD-ratio and fat droplet areas and sizes were compared between age groups.RESULTS:No fibrosis or inflammation was observed in any of the groups.The fat droplet area significantly(P < 0.01) increased with age from 1.25% ± 0.28% at 5 wk to 31.07% ± 0.48% at 8 wk to 51.69% ± 3.19% at 12 wk.The median fat droplet size also significantly(P < 0.01) increased with age,from 1.33(0.55-10.52) m at 5 wk,2.82(0.61-44.13) m at 8 wk and 6.34(0.66-81.83) m at 12 wk.The mean FD-ratio was 0.42 ± 0.11 at 5 wk,0.11 ± 0.05 at 8 wk,and 0.03 ± 0.02 at 12 wk.The FD-ratio was significantly lower at 12 wk than at 5 wk and 8 wk(P < 0.01).A significant negative correlation was observed between the FD-ratio and either the fat droplet area(r =-0.7211,P = 0.0017) or fat droplet size(r =-0.9811,P = 0.0052).CONCLUSION:This tool for statistical analysis of signals from ultrasonography using the FD-ratio can be used to accurately quantify fat in vivo in an animal model of hepatic steatosis,and may serve as a quantitative biomarker of hepatic steatosis. 展开更多
关键词 Non-alcoholic fatty liver disease Quantitation of hepatic steatosis Animal model Focal disturbance ratio Acoustic structure quantification Ultrasonography
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Hepatitis B virus pre-S2 start codon mutations in Indonesian liver disease patients 被引量:3
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作者 Andi Utama Marlinang Diarta Siburian +11 位作者 Ismail Fanany Mariana Destila Bayu Intan Rama Dhenni Tri Shinta Kurniasih Syafruddin AR Lelosutan Wenny Astuti Achwan Nasrul Zubir Arnelis Benyamin Lukito Irawan Yusuf Laurentius Adrianus Lesmana Ali Sulaiman 《World Journal of Gastroenterology》 SCIE CAS CSCD 2012年第38期5418-5426,共9页
AIM: To identify the prevalence of pre-S2 start codon mutations and to assess their association with liver disease progression. METHODS: The mutations were identified by direct sequencing from 73 asymptomatic carriers... AIM: To identify the prevalence of pre-S2 start codon mutations and to assess their association with liver disease progression. METHODS: The mutations were identified by direct sequencing from 73 asymptomatic carriers, 66 chronic hepatitis (CH), 66 liver cirrhosis (LC) and 63 hepatocellular carcinoma (HCC) patients. Statistical significances were determined using Fisher's exact test, χ 2 test, and t -test analyses whenever appropriate. Pre-S mutation as a risk factor for advanced liver disease was estimated by unconditional logistic regression model adjusted with age, sex, and hepatitis B e antigen (HBeAg). P < 0.05 was considered significant. RESULTS: Mutation of the hepatitis B virus (HBV) pre-S2 start codon was found in 59 samples from 268 subjects (22.0%), with higher prevalence in patients with cirrhosis 27/66 (40.9%) followed by HCC 18/63 (28.6%), chronic hepatitis 12/66 (18.2%) and asymptomatic carriers 2/73 (2.7%) (P < 0.001). Logistic regression analysis showed that pre-S2 start codon mutation was an independent factor for progressive liver disease. Other mutations, at T130, Q132, and A138, were also associated with LC and HCC, although this was not statistically significant when adjusted for age, sex, and HBeAg. The prevalence of pre-S2 start codon mutation was higher in HBV/B than in HBV/C (23.0% vs 19.1%), whilst the prevalence of T130, Q132, and A138 mutation was higher in HBV/C than in HBV/B. The prevalence of pre-S2 start codon mutation was higher in LC (38.9%) and HCC (40.0%) than CH (5.6%) in HBeAg(+) group, but it was similar between CH, LC and HCC in HBeAg(-) group. CONCLUSION: Pre-S2 start codon mutation was higher in Indonesian patients compared to other Asian countries, and its prevalence was associated with advanced liver disease, particularly in HBeAg(+) patients. 展开更多
关键词 Hepatitis B virus Pre-S2 start codon Liver disease Hepatitis B e antigen seroconversion Indonesia
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Pathogenesis and treatment of hepatitis C virus-related liver diseases
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作者 Kyuichi Tanikawa 《Hepatobiliary & Pancreatic Diseases International》 SCIE CAS 2004年第1期17-20,共4页
BACKGROUND: Few comprehensive reviews on the pa- thogenesis of hepatitis C virus (HCV)-related liver diseases have been presented to the present. This article was to re- view the pathogenesis and treatment of HCV-rela... BACKGROUND: Few comprehensive reviews on the pa- thogenesis of hepatitis C virus (HCV)-related liver diseases have been presented to the present. This article was to re- view the pathogenesis and treatment of HCV-related liver diseases. DATA SOURCES: Data presented here are mostly taken from Japanese studies. RESULTS: HCV infection is characterized by persistent in- flammation of the liver and frequent development of hepa- tocellular carcinoma (HCC) in most cases. These charac- teristic evidences could be explained by immunological al- terations and oxidative stress in the hepatocyte caused by HCV infection. Interferon (IFN) treatment is carried out, at present, not only for the elimination of infected HCV for the treatment of chronic liver diseases, but also for both the prevention of HCC and the treatment of advanced HCC with chemotherapy. The treatment for oxidative stress is al- so important for non-responders to IFN. CONCLUSION: It is important to understand the pathoge- nesis of HCV-related liver diseases for a successful treat- ment. 展开更多
关键词 hepatitis C virus hepatitis C virus-related liver diseases interferon therapy
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Biliary cystadenocarcinoma diagnosed with real-time contrast-enhanced ultrasonography:Report of a case with diagnostic features 被引量:2
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作者 Ren, Xiao-Long Yan, Rui-Ling +7 位作者 Yu, Xiao-Hui Zheng, Ying Liu, Jun-E Hou, Xiao-Bin Zuo, Si-Yang Fu, Xiao-Yan Chang, Hong Lu, Jian-Hong 《World Journal of Gastroenterology》 SCIE CAS CSCD 2010年第1期131-135,共5页
Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver,which is often misdiagnosed due to a poor recognition of it.We report a case of a 60-year-old man with biliary cystadenocarcinoma with his ... Biliary cystadenocarcinoma is a very rare malignant cystic tumor of the liver,which is often misdiagnosed due to a poor recognition of it.We report a case of a 60-year-old man with biliary cystadenocarcinoma with his real time contrast enhanced ultrasound(CEUS)characteristics compared to those of computed tomography(CT)and magnetic resonance imaging(MRI),which were correlated with the surgical and pathologic findings.Cystic wall enhancement,internal septations and intra-cystic solid portions in the arterial phase were observed on CEUS after contrast agent injection.The enhancement was washed out progressively and depicted as hypo-enhancement in the portal and late phases.CT revealed a large irregular cystic lesion in the left liver lobe with no clear septations and solid components.MRI showed an irregular cystic occupying lesion with septations. 展开更多
关键词 Biliary cystadenocarcinoma Cystic neoplasm hepatic disease Contrast medium ULTRASONOGRAPHY
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