The lung in liver disease:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
1996
|
| Schriftenreihe: | Clinics in chest medicine
17,1 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | X, 173 S. Ill., graph. Darst. |
Internformat
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| 245 | 1 | 0 | |a The lung in liver disease |c Shih-Wen Chang ... guest ed. |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 1996 | |
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| 490 | 1 | |a Clinics in chest medicine |v 17,1 | |
| 650 | 7 | |a Leverziekten |2 gtt | |
| 650 | 7 | |a Longen |2 gtt | |
| 650 | 2 | |a Maladies du foie - Complication | |
| 650 | 2 | |a Maladies pulmonaires | |
| 650 | 4 | |a Gastroenterology |x Pulmonary Complications | |
| 650 | 4 | |a Liver |x Diseases | |
| 650 | 4 | |a Lung |x Liver Diseases | |
| 650 | 4 | |a Lungs |x Pathophysiology | |
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Datensatz im Suchindex
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| adam_text | I THE LUNG IN LIVER DISEASE
CONTENTS
Preface ix
Shih Wen Chang and Narumi Ohara
Structural and Pathologic Changes in the Lung Vasculature
in Chronic Liver Disease 1
Dean E. Schraufnagel and J. Michael Kay
The abnormal vascular pathways found in the hepatopulmonary syn¬
drome are portapulmonary, shunting passage around alveoli through
pleural and hilar blood vessels and intrapulmonary vascular dilatations.
Although there is evidence for each of these, dilatation of alveolar capillar¬
ies appears to be the most likely cause of arterial hypoxemia. Pulmonary
hypertension may occur in chronic liver diseases even without arterial
hypoxemia, but this is rare. The hypertensive pulmonary vascular disease
is pulmonary arteriopathy with plexiform lesions.
Pulmonary Hypertension in Chronic Liver Disease 17
M. Susan Mandell and Bertron M. Groves
Pulmonary hypertension develops in approximately 2% of patients with
portal hypertension. Diagnosis is often difficult and requires a high degree
of clinical suspicion. Treatment of patients with portal and pulmonary
hypertension is limited, and mean survival following diagnosis is approxi¬
mately 15 months. The effect of liver transplantation on the natural history
of disease is discussed.
Hepatopulmonary Syndrome: A Pulmonary Vascular Complication
of Liver Disease 35
Mario Castro and Michael J. Krowka
Hepatopulmonary syndrome is part of the spectrum of pulmonary vascu¬
lar disorders seen in advanced liver disease. The pathophysiology of these
entities likely is dependent on the degree of pulmonary vasoconstriction
or vasodilatation that occurs. Our understanding of hepatopulmonary
syndrome has helped further our knowledge of the interaction of the liver
and the lung. Advances in the management of this disorder, especially
VOLUME 17 • NUMBER 1 • MARCH 1996 V
liver transplantation, finally have allowed us to offer some hope to patients
with this disease.
Mechanisms of Gas Exchange Impairment in Patients With Liver
Cirrhosis 49
Alvar GN Agusti, Josep Roca, and Robert Rodriguez Roisin
The term hepatopulmonary syndrome refers to the abnormal pulmonary gas
exchange that often occurs in patients with cirrhosis in the apparent
absence of any intrinsic heart or lung disease. This article reviews the
pathophysiologic mechanisms underlying this syndrome. The effects of
hypoxia, hyperoxia, and exercise on the degree of ventilation perfusion
inequality and intrapulmonary shunt, and the diffusion of oxygen from
the alveoli to the capillary blood are considered. Potential pathogenic
pathways are outlined. Finally, the effects of external interventions on
pulmonary gas exchange are evaluated. These studies suggest that an
abnormal regulation of pulmonary vascular tone is the main cause of the
defective pulmonary gas exchange seen in patients with hepatopulmonary
syndrome.
Recent Pulmonary Observations in a^ Antitrypsin Deficiency, Primary
Biliary Cirrhosis, Chronic Hepatitis C, and Other Hepatic Problems 67
Michael J. Krowka
The pulmonary aspects of recent developments in severe aj antitrypsin
deficiency, primary biliary cirrhosis, chronic hepatitis C, noncirrhotic por¬
tal hypertension, and hepatic veno occlusive disease are reviewed in this
article. Management consideration concerning hepatic hydrothorax and
large volume paracenteses also are discussed, and pulmonary function
testing and arterial oxygenation studies in patients with advanced liver
disease are summarized.
Lung Liver Interactions in Sepsis and Multiple Organ Failure Syndrome 83
George M. Matuschak
This article examines interactions between the lungs and the liver during
microbial sepsis from four interrelated elements of host defense: (1) control
of systemic endotoxemia, bacteremia, and vasoactive by products of sepsis
via hepatic mononuclear phagocytic (Kupffer s) cell clearance; (2) biosyn¬
thesis and export of cytokine and eicosanoid inflammatory mediators into
hepatic venous blood; (3) metabolic inactivation and detoxification of
these mediators by Kupffer s cell—hepatocyte interactions at the hepatic
sinusoidal interface; and (4) cytokine driven synthesis of acute phase pro¬
teins, including a2 macroglobulin, C reactive protein, and lipopolysaccha
ride binding protein, that are capable of modifying sepsis related changes
in metabolism and inflammation.
Pulmonary Complications of Liver Transplantation 99
Jeana D. O Brien and Neil A. Ettinger
With increasing numbers of patients undergoing liver transplantation for
end stage liver disease and continued improvements in survival rates,
attention to the respiratory status of these patients has achieved even
greater importance. This article discusses the preoperative pulmonary
assessment for conditions that may prohibit liver transplantation or affect
outcomes, in addition to discussing the possible intraoperative and early
infectious versus noninfectious postoperative complications. Also included
is a discussion of the most common pulmonary complications that may
be encountered late after liver transplantation.
Vi CONTENTS
The Hepatopulmonary Syndrome: Effect of Liver Transplantation 115
Paul A. Lange and James K. Stoller
The role of liver transplantation as a treatment for the hepatopulmonary
syndrome (HPS) has had an evolving and controversial history. Although
early experience was disappointing, more recent experience has docu¬
mented resolution of HPS associated hypoxemia after liver transplanta¬
tion. This article reviews the history of liver transplantation for patients
with the hepatopulmonary syndrome. In addition, we discuss the clinical
v features that have been considered to predict successful reversibility and
the time frame over which reversal occurs. Despite this evolution of
thought, many basic questions still remain.
Pulmonary Intravascular Macrophages: Role in Acute Lung Injury 125
Angeline E. Warner
Pulmonary intravascular macrophages are mature phagocytes within the
lumen of pulmonary capillaries of ruminants, pigs, cats, and horses. They
engulf circulating particles, bacteria, and endotoxin and have been sug¬
gested to contribute to acute injury through release of inflammatory medi¬
ators and recruitment of additional inflammatory cells into the pulmonary
microcirculation. Experimentally, they are induced in rats with chronic
cirrhosis, suggesting that development of a pulmonary phagocytic cell
population may be a factor in lung injury that occurs during severe chronic
hepatic disease.
Pulmonary Intravascular Phagocytosis in Liver Disease 137
Shih Wen Chang and Narumi Ohara
Pulmonary intravascular phagocytosis, the uptake of circulating particles
by lung cells, has been detected in rats with chronic biliary cirrhosis and
in humans with malignancy and liver diseases. Clinical and experimental
evidence supporting the association of pulmonary intravascular phagocy¬
tosis with liver cirrhosis is reviewed, and its relationship to pulmonary
intravascular macrophage is discussed. A hypothesis is asserted that the
induction of pulmonary intravascular macrophage in liver cirrhosis leads
to increased susceptibility to adult respiratory distress syndrome in these
patients.
Mediators, Cytokines, and Growth Factors in Liver Lung Interactions 151
Ralph J. Panos and Steven K. Baker
Multiple mediators have been implicated in the interactions between the
liver and the lungs in various disease states. The best characterized media¬
tor of liver lung interaction is arantitrypsin. Several cytokines and media¬
tors may be involved in the pathogenesis of the hepatopulmonary syn¬
drome and in the cytokine cascades that are activated in systemic
inflammatory states such as acute respiratory distress syndrome. Hepato
cyte growth factor or scatter factor is a recently described peptide with a
broad range of biologic effects that may mediate lung liver interactions.
Index 171
Subscription Information Inside back cover
CONTENTS Vii
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| series | Clinics in chest medicine |
| series2 | Clinics in chest medicine |
| spelling | The lung in liver disease Shih-Wen Chang ... guest ed. Philadelphia [u.a.] Saunders 1996 X, 173 S. Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Clinics in chest medicine 17,1 Leverziekten gtt Longen gtt Maladies du foie - Complication Maladies pulmonaires Gastroenterology Pulmonary Complications Liver Diseases Lung Liver Diseases Lungs Pathophysiology Leberkrankheit (DE-588)4034937-8 gnd rswk-swf Lungenkrankheit (DE-588)4036660-1 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Leberkrankheit (DE-588)4034937-8 s Lungenkrankheit (DE-588)4036660-1 s DE-604 Chang, Shih-Wen Sonstige oth Clinics in chest medicine 17,1 (DE-604)BV000001084 17,1 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=007158982&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | The lung in liver disease Clinics in chest medicine Leverziekten gtt Longen gtt Maladies du foie - Complication Maladies pulmonaires Gastroenterology Pulmonary Complications Liver Diseases Lung Liver Diseases Lungs Pathophysiology Leberkrankheit (DE-588)4034937-8 gnd Lungenkrankheit (DE-588)4036660-1 gnd |
| subject_GND | (DE-588)4034937-8 (DE-588)4036660-1 (DE-588)4143413-4 |
| title | The lung in liver disease |
| title_auth | The lung in liver disease |
| title_exact_search | The lung in liver disease |
| title_full | The lung in liver disease Shih-Wen Chang ... guest ed. |
| title_fullStr | The lung in liver disease Shih-Wen Chang ... guest ed. |
| title_full_unstemmed | The lung in liver disease Shih-Wen Chang ... guest ed. |
| title_short | The lung in liver disease |
| title_sort | the lung in liver disease |
| topic | Leverziekten gtt Longen gtt Maladies du foie - Complication Maladies pulmonaires Gastroenterology Pulmonary Complications Liver Diseases Lung Liver Diseases Lungs Pathophysiology Leberkrankheit (DE-588)4034937-8 gnd Lungenkrankheit (DE-588)4036660-1 gnd |
| topic_facet | Leverziekten Longen Maladies du foie - Complication Maladies pulmonaires Gastroenterology Pulmonary Complications Liver Diseases Lung Liver Diseases Lungs Pathophysiology Leberkrankheit Lungenkrankheit Aufsatzsammlung |
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