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Y L Cao, W Li
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) which represented a new two-steps liver resection procedures has been considered a revolutionary innovation for liver surgery technique in recent 10 years, it was first discovered by Professor Lang in Germany in 2007.The first step of the classic surgical procedures for portal vein ligation and liver parenchyma, until the future liver remnant (FLR) increased to a sufficient remnant then resect the right three-leaf liver.With the development of ALPPS, the method of hepatic parenchyma separation and isolation materials have been modified, which improves the safety of operation...
April 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
E D Manea, I Stefan, C Olariu, O C Calina, R E Jipa, A Hristea
BACKGROUND: In our country, the national program for hepatitis C virus treatment with ombitasvir/paritaprevir/ritonavir and dasabuvir was approved for patients with stage four of liver fibrosis and stage three associated with specific comorbidities. Our aim was to analyze the characteristics associated with the presence of adverse events in patients receiving this antiviral regimen, with ribavirin in cirrhotic patients. METHODS: We prospectively studied a cohort of adults with hepatitis C virus infection with Child A cirrhosis, treated for 12 weeks with ombitasvir/paritaprevir/ritonavir/dasabuvir and ribavirin, which have been followed in an infectious diseases tertiary-care hospital...
January 2018: Acta Gastro-enterologica Belgica
Shun-Xin Zheng, Bang-De Xiang, Jia-Min Long, Cong Qu, Zhi-Jing Mo, Kun Li, Yuan Zhuang, Zhi-Lue Lv, Su-Fang Zhou
Objective: To evaluate the clinical value of senescence marker protein 30 (SMP30) and anti-SMP30 antibody in serum. Methods: We used enzyme-linked immunosorbent assay (ELISA) to analytically validate serum levels of SMP30 and anti-SMP30 antibody in 143 patients with hepatocellular carcinoma (HCC), compared with those levels in serum from 137 patients with chronic hepatitis (CH), 51 with liver cirrhosis (LC), and 165 healthy control individuals. Results: The positivity rate of SMP30 in the HCC group (8...
March 17, 2018: Laboratory Medicine
Noura S Abul-Husn, Xiping Cheng, Alexander H Li, Yurong Xin, Claudia Schurmann, Panayiotis Stevis, Yashu Liu, Julia Kozlitina, Stefan Stender, G Craig Wood, Ann N Stepanchick, Matthew D Still, Shane McCarthy, Colm O'Dushlaine, Jonathan S Packer, Suganthi Balasubramanian, Nehal Gosalia, David Esopi, Sun Y Kim, Semanti Mukherjee, Alexander E Lopez, Erin D Fuller, John Penn, Xin Chu, Jonathan Z Luo, Uyenlinh L Mirshahi, David J Carey, Christopher D Still, Michael D Feldman, Aeron Small, Scott M Damrauer, Daniel J Rader, Brian Zambrowicz, William Olson, Andrew J Murphy, Ingrid B Borecki, Alan R Shuldiner, Jeffrey G Reid, John D Overton, George D Yancopoulos, Helen H Hobbs, Jonathan C Cohen, Omri Gottesman, Tanya M Teslovich, Aris Baras, Tooraj Mirshahi, Jesper Gromada, Frederick E Dewey
BACKGROUND: Elucidation of the genetic factors underlying chronic liver disease may reveal new therapeutic targets. METHODS: We used exome sequence data and electronic health records from 46,544 participants in the DiscovEHR human genetics study to identify genetic variants associated with serum levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST). Variants that were replicated in three additional cohorts (12,527 persons) were evaluated for association with clinical diagnoses of chronic liver disease in DiscovEHR study participants and two independent cohorts (total of 37,173 persons) and with histopathological severity of liver disease in 2391 human liver samples...
March 22, 2018: New England Journal of Medicine
Daniel Ianni Filho, Ilka de Fatima Santana Ferreira Boin, Ademar Yamanaka
BACKGROUND: Fibrosis are common structural hepatic change in patients with chronic hepatitis. Liver biopsy is the gold standard for determining the extent of liver fibrosis. Considering the technical difficulties and cost, improvements in non-invasive screening tools are greatly needed. Bioimpedance have been shown to be safe to evaluate tissue fibrosis. OBJECTIVE: To assess the utility of using monofrequential bipolar bioimpedance for the detection of severity of liver fibrosis consistent with chronic viral hepatitis C infections...
January 2018: Arquivos de Gastroenterologia
Daniel Souza Lima, Abdon José Murad Júnior, Márcio Alencar Barreira, Guilherme Cardoso Fernandes, Gustavo Rego Coelho, José Huygens Parente Garcia
BACKGROUND: The Amazon region is one of the main endemic areas of hepatitis delta in the world and the only one related to the presence of genotype 3 of the delta virus. OBJECTIVE: To analyze the profile, mortality and survival of cirrhotic patients submitted to liver transplantation for chronic hepatitis delta virus and compare with those transplanted by hepatitis B virus monoinfection. METHODS: Retrospective, observational and descriptive study...
January 2018: Arquivos de Gastroenterologia
A Teriaky, M Mosli, N Chandok, B Al-Judaibi, P Marotta, K Qumosani
PURPOSE: To evaluate the prevalence of fat-soluble vitamin (A, D, and E) and zinc deficiency in patients with cirrhosis being assessed for liver transplantation and the correlations between vitamin deficiencies, nutritional markers, and severity of liver disease. METHODS: This is a single centre retrospective study. Serum vitamin A, D, E, and zinc levels were collected in adult patients being assessed for liver transplantation between January and July 2012. Patient and liver disease demographics, nutritional markers, Child-Pugh score, and MELD-Na score were collected...
April 2017: Acta Gastro-enterologica Belgica
S S Sidhu, S Agarwal, O Goyal, H Kishore, S Sidhu
A 60 year old male, known case of Hepatitis C related cirrhosis was diagnosed with exophytic Hepatocellular carcinoma (size 2.1 x 2.2 cm), Barcelona Clinic Liver Cancer Stage A, on routine surveillance. He refused liver Transplant and underwent laparoscopic segmental resection. Thereafter patient was started on Tablet Sorafenib 400mg twice daily to prevent recurrence of Hepatocellular carcinoma. On 18st post-operative day, patient presented with Hepatic encephalopathy. Routine investigations and MRI Brain were normal; Venous ammonia was high...
October 2017: Acta Gastro-enterologica Belgica
U Vespasiani-Gentilucci, F Vorini, S Carotti, A De Vincentis, G Galati, P Gallo, N Scopinaro, A Picardi
BACKGROUND: Even if the jejunoileal bypass has been definitely abandoned due to the high rate of hepatic complications, cases of liver injury after the new bariatric procedures are still reported. We aimed to review the available literature concerning liver damage associated with the older and newer types of bariatric surgeries. METHODS: An extensive literature search of MEDLINE was performed using different combinations of the following terms: "bariatric surgery OR biliopancreatic diversion OR jejunoileal bypass OR roux-en-y gastric bypass OR vertical banded gastroplasty OR laparoscopic adjustable gastric banding" AND "hepatic/liver damage OR hepatic/liver impairment OR hepatic/liver failure"...
October 2017: Acta Gastro-enterologica Belgica
Jon G Persichino, Argun D Can, Tam T Van, Michele N Matthews, Scott G Filler
Invasive pulmonary mucormycosis and aspergillosis are rare, life-threatening fungal infections. Most documented cases have been reported in non-cirrhotic patients with diabetes mellitus, neutropenia, or treatment with corticosteroids. The prevalence of each infection is low among patients with hepatic cirrhosis. We report the first likely case of combined invasive pulmonary mucormycosis and aspergillosis in a male with decompensated hepatic cirrhosis. This report also highlights the first non-diabetic case of invasive pulmonary mucormycosis with decompensated hepatic cirrhosis...
September 2018: Medical Mycology Case Reports
Kazushige Nirei, Tatsuo Kanda, Hitomi Nakamura, Shunichi Matsuoka, Tadatoshi Takayama, Masahiko Sugitani, Mitsuhiko Moriyama
Objective: Hepatitis C virus (HCV) infection has long been treated with interferon therapy (IFN). Currently, more than 90% of IFN-treated patients show a sustained virological response (SVR) when also treated with ribavirin and/or a protease inhibitor. Histological inflammation and fibrosis improve in IFN-treated patients, which indicates HCV clearance. IFN also reduces the incidence of hepatocellular carcinoma (HCC). However, a small proportion of patients with SVR develop HCC. To investigate the causes of hepatic carcinogenesis after SVR, we compared the liver histological findings before IFN to those after the development of HCC...
2018: International Journal of Medical Sciences
Ping Luo, Chunzi Liang, Xianwei Zhang, Xuefang Liu, Yingchao Wang, Mengmeng Wu, Xiaobo Feng, Jiangcheng Tu
Hepatocellular carcinoma (HCC) is the third major cause of cancer related death. Abundant researches show that lncRNAs play critical roles in the initiation and progression of HCC and may serve as diagnostic markers for HCC. In the present study, 6 lncRNAs were chosen as candidate genes on the basis of previous literature to evaluate their diagnostic value on HCC by qRT-PCR. Experiment was first carried out in 22 pairs of tissues from HCC and then those differently expressed in tissues were further tested in plasma from 20 HCC patients and 20 control cases...
March 20, 2018: Bioscience Reports
Jelena Krstic, Markus Galhuber, Tim J Schulz, Michael Schupp, Andreas Prokesch
Lifestyle-related disorders, such as the metabolic syndrome, have become a primary risk factor for the development of liver pathologies that can progress from hepatic steatosis, hepatic insulin resistance, steatohepatitis, fibrosis and cirrhosis, to the most severe condition of hepatocellular carcinoma (HCC). While the prevalence of liver pathologies is steadily increasing in modern societies, there are currently no approved drugs other than chemotherapeutic intervention in late stage HCC. Hence, there is a pressing need to identify and investigate causative molecular pathways that can yield new therapeutic avenues...
March 20, 2018: International Journal of Molecular Sciences
Mariana Verdelho Machado, Anna Mae Diehl
Nonalcoholic fatty liver disease (NAFLD) encompasses a spectrum of obesity-associated liver diseases and it has become the major cause of cirrhosis in the Western world. The high prevalence of NAFLD-associated advanced liver disease reflects both the high prevalence of obesity-related fatty liver (hepatic steatosis) and the lack of specific treatments to prevent hepatic steatosis from progressing to more serious forms of liver damage, including nonalcoholic steatohepatitis (NASH), cirrhosis, and primary liver cancer...
March 20, 2018: Critical Reviews in Biochemistry and Molecular Biology
Alexandre de Araujo, Augusto Mantovani, Carlos Thadeu Schmidt Cerski, Antonio Barros Lopes, Luiza Cristina Bortoncello, Marcelo Basso Gazzana, Hugo Cheinquer
A 41-year-old woman diagnosed with idiopathic pulmonary hypertension presented symptoms despite the use of vasodilators, requiring treatment with bosentan. Previously, the patient had no signs of autoimmunity and had normal liver function. After three years of bosentan use, aminotransferase levels increased, without improvement after bosentan suspension, leading to complementary investigation. The diagnosis of autoimmune hepatitis was confirmed by biopsy, already in the stage of cirrhosis. In conclusion, in case of aminotransferase levels that remain persistently elevated, despite the reduction in doses and/or suspension of bosentan, autoimmune hepatitis must be investigated and treated urgently due to possibly rapid progression to cirrhosis...
March 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
Alina M Suciu, Dana A Crisan, Bogdan D Procopet, Corina I Radu, Carmen Socaciu, Marcel V Tantau, Horia O Stefanescu, Mircea Grigorescu
BACKGROUND AND AIMS: Current management of alcoholic liver disease (ALD), especially for alcoholic hepatitis (AH) is still driven by liver biopsy. Therefore, the identification of novel and accurate noninvasive biomarkers for the diagnosis and assessment of severity is important. Metabolomics, because it unravels changes closest to the phenotype, may represent the key for novel biomarkers. The aim of this study was to identify and characterize potential metabolomic biomarkers for diagnosis, staging and severity assessment of ALD...
March 2018: Journal of Gastrointestinal and Liver Diseases: JGLD
A C Jemilohun, O G Adewoye
Autoimmune hepatitis (AIH) is a rare cause of chronic liver disease (CLD). It presents with varied clinical features from acute hepatitis to CLDs like chronic viral hepatitis and alcoholic liver disease, making it difficult to diagnose in the absence of a high index of suspicion and adequate laboratory support. Autoantibody-mediated hepatocyte injury is the major feature of AIH. We present a 44 year old woman with recurrent jaundice, ascites, splenomegaly, coagulopathy, negative chronic viral hepatitis screening, elevated IgG and positive anti-smooth muscle antibody...
December 2017: Annals of Ibadan Postgraduate Medicine
Henry H Nguyen, Abdel Aziz Shaheen, Natalia Baeza, Ellina Lytvyak, Stefan J Urbanski, Andrew L Mason, Gary L Norman, Marvin J Fritzler, Mark G Swain
BACKGROUND AND AIMS: Up to 20% of Primary Biliary Cholangitis (PBC) patients are estimated to have features that overlap with Autoimmune Hepatitis (AIH). Patients with PBC-AIH overlap syndrome (PBC-AIH OS) have been reported to exhibit suboptimal responses to ursodeoxycholic acid therapy, and are more likely to progress to cirrhosis. Anti-double stranded DNA (anti-dsDNA) and anti-p53 have been previously suggested to be potential autoantibodies for identifying patients with PBC-AIH OS...
2018: PloS One
Brian C Baumann, Jenny Wei, John P Plastaras, John N Lukens, Nevena Damjanov, Maarouf Hoteit, Christine Hsu, Matthew Levine, Jeffrey Mondschein, Gregory Nadolski, Kim Olthoff, Kim A Reiss, Mark Rosen, Evan Siegelman, James M Metz, Edgar Ben-Josef
OBJECTIVES: Stereotactic body radiotherapy (SBRT) is potentially curative treatment for small hepatocellular carcinomas (HCC), but data are limited on its efficacy and toxicity. We hypothesized that SBRT can achieve excellent local control (LC) with acceptable toxicity treating HCC lesions, even in advanced cirrhosis. MATERIALS AND METHODS: Thirty-seven nonmetastatic HCC patients received SBRT to 43 lesions between October 2012 and April 2016. Median dose was 50 Gy/5 fractions...
March 16, 2018: American Journal of Clinical Oncology
Matthew Klinge, Tami Coppler, Jane M Liebschutz, Mohannad Dugum, Ajay Wassan, Andrea DiMartini, Shari Rogal
Purpose of review: The treatment of pain in patients with cirrhosis is complicated by unpredictable hepatic drug metabolism and a higher risk of adverse drug reactions. We aimed to conduct a scoping review regarding pain management in cirrhosis. Recent findings: Despite the high prevalence of pain in patients with cirrhosis, there is little literature to guide the management of pain in this population. Complex pain syndromes and disease-specific pain etiologies exist are common in patients with cirrhosis...
March 2018: Current Hepatology Reports
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