{"title":"Noncirrhotic portal hypertension: recent concepts.","authors":"I R Wanless","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>NCPH is a result of obliteration of portal veins. Many inflammatory conditions may initiate the process by causing endothelial injury. As obliteration progresses, there is local stasis and low-grade portal hypertension. In many cases, superimposed PVT occurs before portal hypertension becomes clinically evident. Hypercoagulability is an important cofactor. Diagnosis requires the exclusion of cirrhosis. Focal atrophy and nodular hyperplasia on biopsy may be a clue to the presence of small vessel obliteration. The distribution of vascular disease should be documented with Doppler ultrasound of both portal and hepatic veins. Investigation of cause should include tests for myeloproliferative and other hypercoagulable disorders, systemic diseases associated with vascular injury (eg, autoimmune diseases and toxin exposure) and local portal tract inflammatory diseases (primary biliary cirrhosis and sarcoidosis). Advances in this field will likely be made with improved diagnosis of acute and recanalized PVT using MRI, the new Acuson Sequoia ultrasound technology, and intravascular ultrasonography. Advances in the cause of PVT await studies using new and improved tests for the diagnosis of hypercoagulable states.</p>","PeriodicalId":76373,"journal":{"name":"Progress in liver diseases","volume":"14 ","pages":"265-78"},"PeriodicalIF":0.0,"publicationDate":"1996-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20011733","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pathogenesis of brain edema in fulminant hepatic failure.","authors":"A T Blei","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76373,"journal":{"name":"Progress in liver diseases","volume":"13 ","pages":"311-30"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20168407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Gene therapy for human liver disease.","authors":"S E Raper, J M Wilson","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Investigators working in the area of gene therapy believe the potential for advances in all medical disciplines is enormous. It is humbling, however to appreciate how far we need to go, as the field is truly in its infancy. Gene transfer technologies currently under evaluation in clinical trials have major limitations. Vector systems used in the clinics by the year 2000 probably have yet to be discovered. An additional lesson learned is that efforts at gene therapy are hampered by a lack of knowledge of the basic biology of the target organ and pathogenesis of the underlying disease. Successful gene therapy programs will critically evaluate the field and through fundamental research move steadily forward toward the long-term goal of truly effective therapy for a wide spectrum of disease. In the near future, two liver diseases are the most likely to be treated with gene therapy. The evaluation of patients with familial hypercholesterolemia is ongoing, and once approved, more candidates will be enrolled for therapy. Progress also has been made in creating vectors for the treatment of ornithine transcarbamylase deficiency. It remains to be seen whether adenoviruses or retroviruses will be used first in attempts to control this disease. Although the inflammatory response noted with current recombinant viruses is a formidable problem, the efficiency of gene transfer into the liver with these vectors makes continued study worthwhile.</p>","PeriodicalId":76373,"journal":{"name":"Progress in liver diseases","volume":"13 ","pages":"201-30"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20168402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Urea cycle disorders: clinical paradigm of hyperammonemic encephalopathy.","authors":"S W Brusilow","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76373,"journal":{"name":"Progress in liver diseases","volume":"13 ","pages":"293-309"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20168406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Pharmacological treatment of portal hypertension.","authors":"D Patch, A K Burroughs","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":76373,"journal":{"name":"Progress in liver diseases","volume":"13 ","pages":"269-92"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20168405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Ethanol oxidizing enzymes: roles in alcohol metabolism and alcoholic liver disease.","authors":"D W Crabb","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The elucidation of nucleotide and amino acid sequences of the genes and enzymes involved in the metabolism of ethanol has led to the ability to genotype individuals simply and rapidly. Although the different isozymes were once thought to be a likely explanation for between individual differences in alcohol elimination rates, this has not been found to be the case. Other explanations that remain to be investigated include potential regulatory variants in the genes that alter the level of expression of the enzymes, and genetic influences on activity of the malateaspartate shuttle and rates of mitochondrial NADH reoxidation. However, the isozymes encoded by ADH2*2 and ALDH2*2 have been found to influence alcohol drinking behavior or alcoholism substantially. This supports the original premise that the metabolic disposition of ethanol affects individuals' responses to it. The results suggest that any additional variants might also contribute to the spectrum of individual drinking preferences. Among heavy drinkers, the influence of the isozymes on risk of alcoholic liver disease has not been found to be great, suggesting that many other factors, perhaps interacting with the enzyme polymorphisms, are involved in determining susceptibility.</p>","PeriodicalId":76373,"journal":{"name":"Progress in liver diseases","volume":"13 ","pages":"151-72"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20168400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Laparoscopic hepatobiliary surgery.","authors":"S M Strasberg, M P Callery, N J Soper","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>Laparoscopic hepatobiliary surgery has advanced rapidly in the past few years. Laparoscopic cholecystectomy has been the most significant advance and its value will become even greater as the incidence of biliary injuries is decreased. LCBDE and staging laparoscopy are very promising procedures. Other hepatobiliary laparoscopic operations such as liver resections and biliary-enteric anastomoses are still in developmental stages and will require a longer period of assessment.</p>","PeriodicalId":76373,"journal":{"name":"Progress in liver diseases","volume":"13 ","pages":"349-80"},"PeriodicalIF":0.0,"publicationDate":"1995-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"20168993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}