genetic metabolic and infiltrative diseases affecting the liver

... to the skin into the liver substance and extracted This is the quick part of the procedure The tip of the needle is now placed on sterile paper and some of the remaining saline flushed through the ... compartment of uncoupling of receptor and ligand (CURL) The receptor and ligand separate The receptor returns to sinusoidal plasma membrane and the ligand enters a lysosome and is degraded (e.g LDL, asialoglycoprotein, ... cells The hepatic lymphatics are found in the peri-portal connective tissue and are lined throughout by endothelium Tissue fluid seeps through the endothelium into the lymph vessels The branch of the...

Ngày tải lên: 10/08/2014, 15:20

... diameter and is not obliterated by pressure Venous stars are seen on the dorsum of the foot, legs, back and on the lower border of the ribs Palmar erythema (liver palms) The hands are warm and the ... especially the hypothenar and thenar eminences and pulps of the fingers (fig 6.12) Islets of erythema may be found at the bases of the fingers The soles of the feet may be similarly affected The mottling ... in the vascular territory of the superior vena cava and very rarely below a line joining the nipples Common sites are the necklace area, the face, forearms and dorsum of the hand (fig 6.10) They...

Ngày tải lên: 10/08/2014, 15:20

... bypass the block and return blood towards the liver These enter the portal vein in the porta hepatis beyond the block They include the veins at the hilum, venae comitantes of the portal vein and ... air in the dilated intestines The fullness is particularly conspicuous in the flanks The umbilicus is everted and the distance between the symphysis pubis and umbilicus seems diminished The increased ... 50% will die [78] The outlook depends on the association with recent gastrointestinal bleeding [10], the severity of the infection and the degree of renal and liver failure [47] The prevalence of...

Ngày tải lên: 10/08/2014, 15:20

... cations and anions The microvilli increase the surface area The organelles include the Golgi apparatus and lysosomes Vesicles carry proteins such as IgA from the sinusoid to the canaliculus, and ... results in portal hypertension and splenomegaly The intestinal contents are bulky and greasy; the more complete the cholestasis, the paler the stools The kidneys are swollen and bile stained Casts containing ... raised, yellow and soft and are usually noted around the eyes (g 13.12) They may also be seen in the palmar creases, below the breast and on the neck (g 13.13), chest or back The tuberous lesions,...

Ngày tải lên: 10/08/2014, 15:20

... Fig 17.3 The hepatitis B virion enters the hepatocyte and the core reaches the nucleus At first the virus replicates using its own viral DNA Then the viral DNA integrates with host DNA and the host ... acquired by passage from the mother to the neonate The infection is usually not via the umbilical vein, but from the mother at the time of birth and during close contact afterwards The chance of transmission ... contact The carrier rate of HBsAg varies worldwide from 0.1 to 0.2% in Britain, the USA and Scandinavia, to more than 3% in Greece and southern Italy and even up to 10–15% in Africa and the Far...

Ngày tải lên: 10/08/2014, 15:20

... patients with chronic viral liver disease J Hepatol 1999; 30: 1090 56 Naschitz JE, Slobodin G, Lewis RJ et al Heart diseases affecting the liver and liver diseases affecting the heart Am Heart J 2000; ... state of the liver The hydrogen generated replaces fatty acid as a fuel and is followed by triglyceride accumulation and fatty liver The redox state of the liver changes, protein synthesis is ... increased than the ALT (SGPT) which is confined to the liver In Liver biopsy This confirms liver disease and identifies alcohol abuse as the likely cause (table 22.7) The dangers of the liver damage...

Ngày tải lên: 10/08/2014, 15:20

... Cyprus, Greece and Spain, and the Middle and Far East The disease is rare in Britain, apart from some areas in Wales Clinical features These depend on the site, the stage and whether the cyst is ... 627 Liver flukes Cysts are consumed and larvae develop in the duodenum and eventually reach the bile ducts The flukes probably invade the liver through its peritoneal coat and are carried via the ... of the species Borrelia recurrentis It is encountered throughout the world except in New Zealand, Australia and some parts of the west Pacific The Borrelia multiply in the liver, invading liver...

Ngày tải lên: 10/08/2014, 15:20

... anomaly the gallbladder lies under the left lobe of the liver, to the left of the falciform ligament This may be caused by the gallbladder migrating to a position under the left lobe of the liver ... laterally over the gallbladder down to the duodenum, to the hepatic flexure of the colon and even to the right lobe of the liver, perhaps closing the foramen of Winslow In a milder form, a band of tissue ... Histologically (fig 33.3) the lobular architecture is unchanged and the liver cells are normal The cystic areas are related to the bile ducts and to biliary microhamartomas in the portal areas They are surrounded...

Ngày tải lên: 10/08/2014, 15:20

... usually used The left lobe of the donor liver is excised and the right lobe anastomosed to the portal vein, inferior vena cava and aorta of the recipient The donor liver hypertrophies and the recipient’s ... pooling in the lower part of the body and splanchnic congestion The cannulae are placed in the inferior vena cava (via the femoral vein) and the portal vein, and run to the subclavian vein The veno-venous ... which there is no acceptable, alternative therapy The patient and the family must understand the magnitude of the undertaking and be prepared to face the difficult early postoperative period and...

Ngày tải lên: 10/08/2014, 15:20

... have shared their expertise and their time to create this seventh edition The Chair and Co-Chair of the USAHA Committee on Foreign and Emerging Diseases, Corrie Brown, DVM, PhD, and Alfonso Torres, ... have involvement in these activities 22 FOREIGN ANIMAL DISEASES They include: the U.S Fish and Wildlife Service, the U.S Geological Service, the U.S National Park Service and the Bureau of Indian ... Operations, and Planning (Fig 1) Duties and responsibilities of the sections are outlined below and also in Fig The Command Section is led by one Incident Commander and this Command Section controls...

Ngày tải lên: 22/02/2014, 05:20

... produced in the epithelial cells Both prostate epithelial cells and stromal cells express androgen receptors and depend on androgens for growth Testosterone, the major circulating androgen, is ... is converted by the enzyme 5αreductase to dihydrotestosterone in the gland The periurethral portion of the gland increases in size during puberty and after the age of 55 due to the growth of nonmalignant ... prostate is located in the pelvis and is surrounded by the rectum, the bladder, the periprostatic and dorsal vein complexes that are responsible for erectile function, and the urinary sphincter...

Ngày tải lên: 07/07/2014, 02:20

... which the tempo of the illness is altered and symptoms controlled until the patient dies of other causes These can be equivalent therapeutically from a patient standpoint if the patient has not ... death, the states model allows a distinction between cure the elimination of all cancer cells, the primary therapeutic objective when treating most cancers and cancer control, in which the tempo ... follows that the more advanced the disease, the greater the need for treatment For those without a cancer diagnosis, the decision to undergo testing to detect a cancer is based on the probability...

Ngày tải lên: 07/07/2014, 02:20

... biopsy Each core of the biopsy is examined for the presence of cancer, and the amount of cancer is quantified based on the length of the tumor within the core and the percentage of the core involved ... warrant further testing Free and complexed PSA measurements are used when levels are between and 10 ng/mL to decide whether a biopsy is needed The level of free PSA is lower in men with cancer The ratios ... screening is the detection and treatment of cancers with such a low malignant potential that they would not have shortened survival or produced symptoms during the patient's lifetime The side effects...

Ngày tải lên: 07/07/2014, 02:20

... identified solely on the basis of an abnormal PSA (T1c), those that are palpable but clinically confined to the gland (T2), and those that have extended outside the gland (T3 and T4) (Table 91-1) ... respect to the extent of the disease within the gland, the presence or absence of capsular invasion, involvement of seminal vesicles, and extension of disease to lymph nodes Because of the inadequacy ... of DRE for staging, the staging system was modified to include the results of imaging studies Unfortunately, no single test has proven to indicate accurately the stage or the presence of organ-confined...

Ngày tải lên: 07/07/2014, 02:20

... to 47% and impotence rates range from 25 to 89% Part of the variability relates to how the complication is defined and whether the patient or physician is reporting the event The time of the assessment ... more advanced the disease, the lower the probability of local control and the higher the probability of systemic relapse More important is that within the categories of T1, T2, and T3 disease ... therapy, and brachytherapy (seed implantation) These are being refined continually to incorporate other clinical parameters and biologic determinants Surgical technique, radiation therapy delivery,...

Ngày tải lên: 07/07/2014, 02:20

... radiation therapy (IMRT) to maximize the dose to the prostate and to minimize the exposure of the surrounding normal structures The addition of IMRT has permitted further shaping of the dose, ... improve as the ability to determine whether the tumor is localized to the gland improves based on different biopsy algorithms and with imaging The result is better case selection and better surgical ... further shaping of the dose, allowing the delivery of still higher doses to the prostate and a further reduction in normal tissue exposure These advances have enabled the safe administration of doses...

Ngày tải lên: 07/07/2014, 02:20

... surgery and/ or radiation therapy By definition, patients have no evidence of disease on scan For these patients the central issue is whether the rise in PSA results from persistent disease in the ... undergone radiation therapy The decision to recommend radiation therapy after prostatectomy is often made on the basis of the pathologic findings at surgery, as imaging studies such as CT and bone scan ... waiting, or deferred therapy, is a policy of monitoring the illness at fixed intervals with DREs, PSA measurements, and repeat biopsies of the prostate as indicated, but with no therapeutic intervention(s)...

Ngày tải lên: 07/07/2014, 02:20

... 5, and years, respectively If the time to recurrence was 10 months), the proportion with metastatic disease at the same time intervals was 23, 32, and ... 69, and 79% if the doubling time was short (

Ngày tải lên: 07/07/2014, 02:20

... Outcomes of Androgen Depletion The antiprostate cancer effects of the various androgen depletion strategies are similar, and the clinical course is predictable: an initial response, then a period ... against the flare Intermittent Hormone Therapy Another way to reduce the side effects of androgen depletion is to administer hormones on an intermittent basis This was proposed as a way to prevent the ... pathway In this way, the surviving cells that are allowed to proliferate in the presence of androgen will retain sensitivity to subsequent androgen depletion Applied in the clinic, androgen depletion...

Ngày tải lên: 07/07/2014, 02:20