1.Cirrhotic Cardiomyopathy.
Moon Young KIM ; Soon Koo BAIK
The Korean Journal of Hepatology 2007;13(1):20-26
Most patients with liver cirrhosis have hyperdynamic circulatory alterations with increased cardiac output, and decreased systemic vascular resistance and arterial pressure. But, in spite of the increased resting cardiac output, ventricular contractile response to stressful stimuli is attenuated in cirrhotic patients which is termed as cirrhotic cardiomyopathy. The prevalence of cirrhotic cardiomyopathy remains unknown at present. Clinical features include structural, histological, electrophysiological, systolic and diastolic dysfunction. Multiple factors are considered as responsible, including impaired beta-adrenergic receptor signal transduction, abnormal membrane biophysical characteristics, and increased activity of cardiodepressant systems mediated by cGMP. Generally, cirrhotic cardiomyopathy with overt severe heart failure is rare. However, major stresses on the cardiovascular system such as liver transplantation, infections and insertion of transjugular intrahepatic portosystemic shunts (TIPS) can unmask the presence of cirrhotic cardiomyopathy and thereby convert latent to overt heart failure. Cirrhotic cardiomyopathy may also contribute to the pathogenesis of hepatorenal syndrome and circulatory failure in liver cirrhosis. Because of the marked paucity of treatment studies, current recommendations for management are empirical, nonspecific measures. Further studies for pathogenesis and new therapeutic strategies in this area are required.
Cardiomyopathies/*diagnosis/*etiology/therapy
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Humans
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Liver Cirrhosis/*complications
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Prognosis
2.Expert consensus on clinical diagnosis and treatment of portal hypertension with hepatocellular carcinoma (2022).
Chinese Journal of Surgery 2022;60(4):310-320
At present, there is no uniform standard for diagnosis and treatment of portal hypertension complicated with hepatocellular carcinoma internationally. Although in recent years, with the significant advances of surgical technique and the positive progress of targeted and immunotherapy in the field of hepatocellular carcinoma, the survival of hepatocellular carcinoma patients has improved, but the risk of surgery in patients with portal hypertension complicated with hepatocellular carcinoma remains high, and surgical treatment is still controversial. Therefore, based on the existing evidence, the Chinese Society of Spleen and Portal Hypertension Surgery, Chinese Society of Surgery, Chinese Medical Association has organized relevant experts to develop the consensus on clinical diagnosis and treatment of portal hypertension with hepatocellular carcinoma (2022) after full discussion. This consensus aims to provide the latest guidance for the standardized diagnosis and treatment of portal hypertension with hepatocellular carcinoma in China. Given that most portal hypertension originates from cirrhosis, this consensus only addresses the diagnosis and treatment of cirrhosis-related portal hypertension with hepatocellular carcinoma.
Carcinoma, Hepatocellular/therapy*
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Consensus
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Humans
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Hypertension, Portal/therapy*
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Liver Cirrhosis/complications*
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Liver Neoplasms/therapy*
4.The diagnosis and treatment of abnormal uterine bleeding in nonpregnant patients with hepatic cirrhosis.
Jun LIU ; Ling WANG ; Min LIU ; Yu-qing BAI
Chinese Journal of Hepatology 2011;19(1):52-54
To investigate the clinical characteristics of abnormal uterine bleeding (AUB) in nonpregnant hepatic cirrhosis patients and to assess the treatment and curative effects of AUB. A retrospective analysis was conducted on 72 nonpregant AUB patients treated in Ditan Hospital from October 2008 to October 2009. Data were assessed with SPSS 10.0 and the constituent ratio was examined by chi-square tests. 58 out of the 72 nonpregnant AUB patients were climacteric patients (80.56%). Approximately 42.5% and 68.8% (x2=7.189, P = 0.027) of the AUB patients were diagnosed with compensated and decompensated liver cirrhosis, respectively, which presents a statistical significance. Among the 18 cases of AUB with hypermenorrhea, 12 were with compensated cirrhosis and 6 with decompensated cirrhosis, which makes a statistical significance with a chi-square result of 7.189, P = 0.027. 41 out of the 52 cases with diagnostic curettage (75.00%) were observed with pathological changes in endomembrane. During the three months to one year follow-up,10 of 67 patients showed effective expectant treatment and 16 cases with hysterectomia complained no postoperative complications. A high frequency of AUB was observed in nonpregnant cirrhosis patients. The main bleeding pattern of the nonpregnant AUB patients with cirrhosis is hypermenorrhea.
Female
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Humans
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Liver Cirrhosis
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complications
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diagnosis
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therapy
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Middle Aged
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Retrospective Studies
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Uterine Hemorrhage
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complications
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diagnosis
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therapy
7.Portal flow steal after liver transplantation.
Bohyun KIM ; Kyoung Won KIM ; Gi Won SONG ; Sung Gyu LEE
Clinical and Molecular Hepatology 2015;21(3):314-317
Portal flow steal occasionally persists even after the liver transplantation, which may reduce the portal flow and thus threaten the patients' outcome. Therefore, pre- and peri-operative detection of portal steal phenomenon requiring radiological or surgical interruption is essential for the liver transplantation candidates as well as for the recipients.
Adult
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Hepatitis B, Chronic/complications
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Humans
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Liver Cirrhosis/etiology/*therapy
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*Liver Transplantation
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Male
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Mesenteric Veins/*ultrasonography
8.Obesity and liver fibrosis.
Chinese Journal of Hepatology 2004;12(7):432-432
Fatty Liver
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etiology
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pathology
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Humans
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Liver Cirrhosis
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etiology
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pathology
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Obesity
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complications
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pathology
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therapy
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Risk Factors
10.A Case of Percutaneous Endoscopic Gastrostomy in a Patient with Liver Cirrhosis Accompanied by Both Esophageal and Gastric Varices.
Dong Hoon PARK ; Jae Woo KIM ; Kyu Hong KIM ; Hye Jung KIM ; Myeong Gwan JEE ; Yong Soon PARK ; Soon Koo BAIK ; Hyun Soo KIM ; Sang Ok KWON
The Korean Journal of Gastroenterology 2006;48(1):51-54
Malnutrition in patients with liver disease is common. Consequently, percutaneous endoscopic gastrostomy may be needed for the correction of malnutrition. Percutaneous endoscopic gastrostomy is rarely performed in patients with liver cirrhosis because of the presence of varices and coagulation abnormalities. However, if careful insertion technique along with thorough clinical assessment is undertaken, percutaneous endoscopic gastrostomy may be successfully performed in patients with liver cirrhosis. Here, we report successful application of percutaneous endoscopic gastrostomy in a patient with liver cirrhosis accompanied by both gastric and esophageal varices.
Aged
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*Endoscopy
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*Enteral Nutrition
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Esophageal and Gastric Varices/*complications
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Gastrostomy/*methods
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Humans
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Liver Cirrhosis/complications/*therapy
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Male