Carbon tetrachloride induced cirrhosis in rats: a useful tool for investigating the pathogenesis of ascites in chronic liver disease.
Explore the source record for details and available documents.
Animals↗
Biomedical subjects
V Arroyo
Publications and source records attributed to V Arroyo.
Gene expression of endothelin-1 and ET(A) and ET(B) receptors in human cirrhosis: relationship with hepatic hemodynamics.
Previous experimental studies have suggested that the paracrine endothelin system may participate in the regulation of hepatic hemodynamics in cirrhosis. The present study assesses the relationship between increased portal pressure and preproET-1, ET(A) receptor and ET(B) receptor gene expression in human cirrhosis. PreproET-1, ET(A) receptor and ET(B) receptor mRNA abundance was estimated by quantitative PCR in human hepatic tissue from subjects with normal liver and in cirrhotic patients in whom a hepatic hemodynamic study was performed. The expression of the three transcripts was significantly higher in liver samples of cirrhotic patients than in those obtained from subjects without any histological alteration. Moreover, while no significant correlation was found between preproET-1 mRNA abundance and portal pressure, there was a highly significant direct relationship between ET(A) and ET(B) receptor gene expression and portal pressure in cirrhotic patients. These results indicate that the liver paracrine endothelin system is overactivated in human cirrhosis and that a direct relationship exists between endothelin receptor mRNA abundance and the degree of portal hypertension in these patients.
Animals↗
[Paracentesis in the treatment of ascites in cirrhotic patients].
Explore the source record for details and available documents.
Ascites↗
ERCP in orthotopic liver transplanted patients.
BACKGROUND/AIMS: Biliary complications after orthotopic liver transplantation (OLT) are still common. The aim of the study was to assess the effectiveness of ERCP as a diagnostic and treatment tool in the management of biliary tract OLT complications. METHODOLOGY: The diagnostic and treatment effectiveness of ERCP in the management of biliary tract OLT complication from 1/1995 to 12/2001 was reviewed. RESULTS: 24/251 (9.6%) OLT patients presented biliary complications. These patients underwent a total of 31 ERCP (seven patients received two ERCP). The ERCP indication was cholestasis in 25 (80.6%). The success rate of these 31 ERCPs was 87%. In the 25 ERCPs indicated in patients with cholestasis, the procedure revealed strictures of the biliary anastomosis in 3, hepatic hilum strictures in 5, SOD in 4, lithiasis in 7 and sclerosing cholangitis in one. The final diagnosis of three patients with normal biliary tract was intrahepatic cholestasis. In three of the four patients with biliary leaks the ERCP's confirmed the diagnosis. The final treatment efficacy was 100% (7/7 patients), 50% (2/4 p.), 0% (0/3 p.), 75% (3/4 p.) and 100% (4/4 p.) for patients with biliary stones, strictures of the hilum, anastomotic strictures, biliary leaks and SOD, respectively. In the acute pancreatitis and in the PSC endoscopic treatment was not indicated. There were two mild cases of pancreatitis. CONCLUSIONS: Because of its availability, diagnostic accuracy, treatment efficacy and safety, ERCP should be used as the first-line procedure for treatment of biliary tract complications after OLT.
Biliary Tract Diseases↗
Pathophysiology and treatment of ascites in cirrhosis.
Ascites is the most frequent complication in patients with cirrhosis of the liver. In these patients, the onset of ascites indicates a profound impairment of hepatic and renal function and splanchnic and systemic hemodynamics and is therefore associated with a poor prognosis, the probability of survival at one and five years being of about 50 and 20 per cent, respectively. In patients with cirrhosis and ascites, parameters estimating splanchnic and systemic hemodynamics and renal function are better prognostic indicators than those currently used to evaluate liver function.
Ascites↗
Diuretic-resistant ascites in cirrhosis. Mechanism and treatment.
Refractory ascites (or diuretic-resistant ascites), i.e. ascites that cannot be mobilized by medical treatment (low sodium diet and high doses of furosemide and spironolactone) is an infrequent phenomenon in cirrhosis. It usually occurs in patients with functional renal failure as a consequence of alteration in both pharmacokinetics and pharmacodynamics of diuretics. Peritoneovenous shunting, a procedure which improves systemic hemodynamics and renal function and suppresses the plasma levels of renin, aldosterone, norepinephrine and antidiuretic hormone in cirrhotics with ascites, has been proposed as the treatment of choice in patients with refractory ascites. Unfortunately it is associated to a high rate of severe complications and does not prolong the survival of these patients. Moreover, in approximately one third of the patients the shunt becomes occluded within the first year after operation. Recent studies have shown that repeated large volume paracentesis (4-64 per day until disappearance of ascites) or total paracentesis (complete mobilization of ascites in only one paracentesis session) associated to i.v. albumin infusion are an effective and safe therapy of ascites. At present, there is only one controlled trial comparing therapeutic paracentesis versus peritoneo-venous shunt in the management of patients with refractory ascites. In this study, there were no significant difference between both therapeutic groups with respect to survival. However, the incidence of readmission to hospital for the treatment of ascites was higher in the paracentesis group. Therefore, both procedures are valid therapeutic alternatives for that type of patients. Future studies are necessary to investigate if there are subsets of cirrhotics with refractory ascites in which one of these two types of treatment is especially indicated.
Ascites↗
A method for the determination of the richness of trypsin observing the activity of the rolitetracycline citrate on a strain of Staphylococcus aureus.
Explore the source record for details and available documents.
Methods↗
[Portal hypertension, ascites and functional renal insufficiency in a patient with agnogenic myeloid metaplasia].
Explore the source record for details and available documents.
Aged↗
Spontaneous bacterial peritonitis.
In this article, authors reviewed etiology, diagnosis, prognosis and treatment of spontaneous bacterial peritonitis. The role of primary prophylaxis is discussed.
Ascitic Fluid↗
Hepatorenal syndrome.
The hepatorenal syndrome is a severe and common complication of patients with advanced cirrhosis and ascites. It is characterised not only by renal failure but also by marked alterations in systemic haemodynamics. Renal failure is due to a marked hypoperfusion of the kidney secondary to renal vasoconstriction. Although the pathogenesis of hepatorenal syndrome is not completely understood, it is thought to be the extreme manifestation of the underfilling of the arterial circulation secondary to an arterial vasodilation, located mainly in the splanchnic circulation. Recently, a revised definition and diagnostic criteria of hepatorenal syndrome have been proposed. The prognosis of patients with hepatorenal syndrome is very poor. Liver transplantation is the only effective treatment but it is not applicable in most cases due to short survival. New therapies developed during the last years, such as the use of systemic vasoconstrictors or transjugular intra-hepatic portosystemic shunts appear to be promising, but prospective investigations are needed to delineate their real usefulness.
Ascites↗