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排序方式: 共有439条查询结果,搜索用时 31 毫秒
1.
AIM/BACKGROUND: Primary biliary cirrhosis (PBC) is a chronic cholestatic liver disease of unknown aetiology. Up to 10% of patients with typical features of PBC will have additional features of autoimmune hepatitis (AIH). A subset, however, have no such features but go on to develop a 'sequential' AIH overlap syndrome. Objectives: Describe our experience with eight patients who developed AIH after the diagnosis of PBC was made. METHODS: We reviewed the charts of all PBC patients over a 9-year period (from 1996 to 2005). Only PBC patients with no features of AIH were included. RESULTS: There were 1476 patients with PBC. Of these, eight patients developed features of AIH overlap syndrome based on biochemical and histological parameters. Treatment included prednisone and azathioprine for 24 or more months. The majority of patients remained on ursodeoxycholic acid (UDCA) throughout treatment. Response to therapy was defined by improvement in enzymes, and was rapid for all patients. One patient was able to discontinue treatment with prednisone and azathioprine, while seven have continued on therapy to date. CONCLUSIONS: A 'sequential' overlap syndrome of AIH with PBC can occur. Treatment with prednisone and azathioprine may lead to a rapid improvement in aminotransferase levels. 相似文献
2.
Keith D. Lindor 《Hepatology research》2007,37(S3):S474-S477
Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown etiology that is frequently associated with inflammatory bowel disease. It is characterized by diffuse inflammation and fibrosis of the biliary tree, and it usually leads to biliary cirrhosis and portal hypertension. PSC is most commonly diagnosed with endoscopic retrograde cholangiopancreatography, although magnetic resonance cholangiography (MRC) is rapidly emerging as a first choicediagnostic test. MRC has the advantage of being non-invasive, does not require radiation, and is cost-effective in that it does not carry the risk of pancreatitis associated with retrograde studies. 2 Percutaneous cholangiography is seldom performed anymore. 相似文献
3.
Use of herbal supplements for chronic liver disease. 总被引:3,自引:0,他引:3
Cynthia Levy Leonard D Seeff Keith D Lindor 《Clinical gastroenterology and hepatology》2004,2(11):947-956
BACKGROUND & AIMS: Complementary and alternative medicine (CAM) is becoming popular among patients with liver disease. Although there is a growing body of evidence regarding potential mechanisms of action of these and other herbs, caution must be used to interpret the results of the few clinical trials available. Our goal was to discuss the biologic rationale for the use of specific herbs (silymarin, glycyrrhizin, sho-saiko-to, Phyllanthus amarus , Picrorrhiza kurroa , Compound 861, CH-100, and LIV.52) in the treatment of chronic liver diseases, as well as the evidence for their efficacy and adverse effects according to clinical trials. METHODS: Because of the relative paucity of clinical studies using herbs, every trial published in English was reviewed. RESULTS: Although many trials suggest that these herbs can decrease serum transaminase levels, the effects on hepatic histopathology and long-term survival are either poorly studied or conflicting. LIV.52 has been withdrawn from the market because of deleterious effects in patients with liver disease. CONCLUSIONS: Based on current evidence, we cannot recommend the use of herbal supplements for the routine treatment of any chronic liver disease and further well-designed clinical trials are necessary. 相似文献
4.
A retrospective review was made of results of conventional liver function tests in adult patients who received fat-free total parenteral nutrition (TPN) for two weeks or longer and who did not have other obvious causes for liver function abnormalities. A "meaningful" increase (greater than or equal 50% increase above baseline pre-TPN value) in SGOT levels was noted in 68% of patients, in alkaline phosphatase levels in 54%, and in serum bilirubin levels in 21% of patients. The median peak values for SGOT, alkaline phosphatase, and bilirubin were 3-, 1.9-, and 0.25-fold above the upper limit of normal, respectively. The median time interval of peak increase for each of the three tests was between 9 and 12 days after TPN was started. Liver biopsy specimens from four patients, taken when liver function values were abnormal, showed pronounced steatosis in three patients and mild periportal cholestasis in the fourth patient. The cause(s) of the elevated liver values is unknown, but possibilities include cellular damage, such as steatosis, and an "overshoot" of enzymes when starved patients are refed. 相似文献
5.
Brittany C. Thomas Stephen N. Thibodeau Noralane M. Lindor 《Current colorectal cancer reports》2005,1(2):103-109
Referrals to genetics services are becoming increasingly common for patients who are diagnosed with early-onset colorectal
cancer (CRC) or patients who have a family history of CRC. Microsatellite instability (MSI) testing and immunohistochemical
analysis (IHC) of the patient’s tumor tissue, which assess indirectly the cellular status of DNA mismatch repair, have proven
important tools for geneticists and genetic counselors to determine whether or not these individuals may be at risk for an
inherited cancer syndrome, Lynch syndrome (a subset of hereditary nonpolyposis colorectal cancer). The application of tumor
MSI/ IHC also extends to the group of providers involved in the diagnosis and management of CRC, demonstrating the growing
clinical applicability of MSI/IHC testing. This review discusses the clinical utility of MSI/IHC analysis, including its benefits
and limitations, and addresses some of the current debates surrounding testing. 相似文献
6.
7.
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9.
Jie Shang Jeanette C. Reece Daniel D. Buchanan Graham G. Giles Jane C. Figueiredo Graham Casey Steven Gallinger Stephen N. Thibodeau Noralane M. Lindor Polly A. Newcomb John D. Potter John A. Baron John L. Hopper Mark A. Jenkins Aung Ko Win 《International journal of colorectal disease》2016,31(8):1451-1457
Purpose
Gallbladder diseases and cholecystectomy may play a role in the development of colorectal cancer (CRC). Our aim was to investigate the association between cholecystectomy and CRC risk overall and by sex, family history, anatomical location, and tumor mismatch repair (MMR) status.Methods
This study comprised 5847 incident CRC cases recruited from population cancer registries in Australia, Canada, and the USA into the Colon Cancer Family Registry between 1997 and 2012 and 4970 controls with no personal history of CRC who were either randomly selected from the general population or were spouses of the cases. The association between cholecystectomy and CRC was estimated using logistic regression, after adjusting for confounding factors.Results
Overall, there was no evidence for an association between cholecystectomy and CRC (odds ratio [OR] = 0.88, 95 % confidence interval 0.73, 1.08). In the stratified analyses, there was no evidence for a difference in the association between women and men (P = 0.54), between individuals with and without family history of CRC in first-degree relative (P = 0.64), between tumor anatomical locations (P = 0.45), or between MMR-proficient and MMR-deficient cases (P = 0.54).Conclusion
Cholecystectomy is not a substantial risk factor for CRC, regardless of sex, family history, anatomical location, or tumor MMR status.10.
Lenora W. M. Loo Maarit Tiirikainen Iona Cheng Annette Lum‐Jones Ann Seifried James M. Church Robert Gryfe Daniel J. Weisenberger Noralane M. Lindor Steven Gallinger Robert W. Haile David J. Duggan Stephen N. Thibodeau Graham Casey Loïc Le Marchand 《Genes, chromosomes & cancer》2013,52(5):450-466
Microsatellite stable (MSS), CpG island methylator phenotype (CIMP)‐negative colorectal tumors, the most prevalent molecular subtype of colorectal cancer, are associated with extensive copy number alteration (CNA) events and aneuploidy. We report on the identification of characteristic recurrent CNA (with frequency >25%) events and associated gene expression profiles for a total of 40 paired tumor and adjacent normal colon tissues using genome‐wide microarrays. We observed recurrent CNAs, namely gains at 1q, 7p, 7q, 8p12‐11, 8q, 12p13, 13q, 20p, 20q, Xp, and Xq and losses at 1p36, 1p31, 1p21, 4p15‐12, 4q12‐35, 5q21‐22, 6q26, 8p, 14q, 15q11‐12, 17p, 18p, 18q, 21q21‐22, and 22q. Within these genomic regions we identified 356 genes with significant differential expression (P < 0.0001 and ±1.5‐fold change) in the tumor compared to adjacent normal tissue. Gene ontology and pathway analyses indicated that many of these genes were involved in functional mechanisms that regulate cell cycle, cell death, and metabolism. An amplicon present in >70% of the tumor samples at 20q11‐20q13 contained several cancer‐related genes (AHCY, POFUT1, RPN2, TH1L, and PRPF6) that were upregulated and demonstrated a significant linear correlation (P < 0.05) for gene dosage and gene expression. Copy number loss at 8p, a CNA associated with adenocarcinoma and poor prognosis, was observed in >50% of the tumor samples and demonstrated a significant linear correlation for gene dosage and gene expression for two potential tumor suppressor genes, MTUS1 (8p22) and PPP2CB (8p12). The results from our integration analysis illustrate the complex relationship between genomic alterations and gene expression in colon cancer. © 2013 Wiley Periodicals, Inc. 相似文献