By Hans Popper (auth.), Professor Dr. Gorig Brunner, Professor Dr. Friedrich Werner Schmidt (eds.)
The regenerative means of the liver mobilephone is nearly limitless. accordingly after acute liver harm, be it viral, poisonous, hypoxic, or surgical in foundation, restitutio advert integrum is the standard final result. In types of liver ailment, even if, this isn't the case: in fulmi nant hepatic failure, liver regeneration usually isn't really quickly sufficient to maintain the organism alive; in end-stage cirrhosis, regeneration is dis turbed via a hypertrophic structure of fibrotic tissue. For those severe types of liver sickness and for severe events ahead of and after liver surgical procedure, synthetic liver aid is required. This booklet comprises the newest leads to this sector of analysis pre sented through scientists from allover the area at a global symposium held in Celle, Germany, June 2-4, 1980. interesting new equipment like non-stop membrane plasma sepa ration and liver mobilephone transplantation into the spleen were de veloped. The older equipment of hemoperfusion and dialysis were better. Enzymological equipment and liver transplantation have made stable development. we are hoping that this quantity can assist the clinician in his decision-making and stimulate inventive new re look for the advantage of our liver patients.
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The primary requirement in enzymatic detoxification is that the final product of biotransformation should be considerably less toxic than the precursors, in order to provide the organism with immediate relief from the effects of intoxication. A further, and equally important prerequisite is that the final metabolite be easily excretable from the organism, usually via renal and biliary mechanisms. These two definitions explain the fundamental characteristics of the detoxification processes. The broad acceptor-substrate specificity is necessary to deal with the vast range of endogenous and exogenous toxins to which the organism may be exposed, even in a changing environment.
1980), we found free phenols also significantly increased in serum, together with mercaptans, ammonia and free fatty acids (Brunner et al. 1979). Tables 2 and 3 show the results of inhibition experiments with phenols extracted from patients in fulminant hepatic failure upon enzymes in liver and brain homogenates from the rat. Free phenols extracted from serum of patients in fulminant hepatic failure were added to liver and brain homogenates in the same concentrations found in the sera of patients in fulminant hepatic failure.
The citric acid cycle is slowed down. 5. The urea cycle is probably impaired. To summarize, by loss of specific functions, the enzyme pattern in the liver becomes indistinct and resembles the pattern of fetal or neoplastic cells. If the slowly developing, final alterations of enzyme activities in the liver could be related to earlier findings in serum, it would then be possible to distinguish between benign hepatitis, the necrotizing type and the most severe course, in which coma ensues. We compared the enzyme pattern in serum in average viral hepatitis and in a small group of 10 patients, who had necrotizing hepatitis but did not lapse into liver failure, with the enzyme pattern of 10 patients who had been admitted into our unit with liver coma diagnosed as fulminant hepatic failure, who therefore underwent charcoal hemoperfusion.