Acute liver failure

PURPOSE: This article reviews the literature on radiographic imaging techniques and image interpretation for dental implant treatment. MATERIALS AND METHODS: MEDLINE was used to identify published peer-reviewed literature for this report. RESULTS: Radiographic images are indispensable in the evaluation of osseous structures when planning treatment for dental implants. Potential bone sites for implant placement can be assessed clinically by means of palpation or probing through the mucosa; however, diagnostic imaging provides the best means for indirectly measuring bone dimensions. After healing of the implant site, the application of radiology is useful to verify the amount of bone adjacent to the implant and that the transmucosal abutments fit the implant. Upon completion of the implant prosthesis, radiology may be used to monitor initial and long-term success of implant treatment. CONCLUSION: Recommendations for the application of radiology over the course of treatment are made for various implant cases ranging from the overdenture to the single-tooth implant.     

Acute renal failure following bone marrow transplantation

The medial preoptic nucleus (MPN) is an essential site for the regulation of male sexual behavior. Previous studies using c-fos as a marker for neural activation have shown that copulation increased c-fos expression in the MPN. Neural activation was also present in brain regions that are connected with the MPN and are involved in male sexual behavior, including the posteromedial bed nucleus of the stria terminalis (BNSTpm), posterodorsal preoptic nucleus (PD), posterodorsal medial amygdala (MEApd), and parvocellular subparafascicular thalamic nucleus (SPFp). The present study investigated whether the copulation-induced, activated neurons in these brain regions are involved in the bidirectional connections with the MPN. Therefore, mating-induced Fos expression was combined with application of anterograde (biotinylated dextran amine) or retrograde (cholera toxin B subunit) tracers in the MPN. The results demonstrated that neurons in the BNSTpm, PD, MEApd, and SPFp that project to the MPN were activated following copulation. However, in males that displayed sexual behavior but did not achieve ejaculation, few double-labeled neurons were evident, although both retrogradely labeled neurons and Fos-immunoreactive cells were present. In addition, retrograde neurons that expressed Fos were located in discrete subdivisions within the brain regions studied, where Fos is induced after ejaculation. Likewise, anterogradely labeled fibers originating from the MPN were not distributed homogeneously but were particularly dense in these discrete subdivisions. These results demonstrate that copulation-induced Fos-positive neurons in specific subdivisions of the BNSTpm, PD, MEApd, and SPFp have bidirectional connections with the MPN. Taken together with previous findings, this supports the existence of a discrete subcircuit within a larger neural network underlying male sexual behavior.     

Acute renal failure following copper sulphate intoxication

Eleven out of a series of twenty-nine patients (37-9%) with acute copper sulphate poisoning developed acute renal failure. Intravascular haemolysis appeared to be the chief factor responsible for renal lesions in these patients. Histological lesions observed in the kidney varied from those of mild shock to well established acute tubular necrosis. In one case, granulomatous lesions were seen in response to tubulorrhexis. Renal failure was the chief indication for dialysis in ten patients, whereas one patient was dialysed primarily for removal of copper. Notwithstanding the adequate control of uraemia by dialysis, only six of the eleven patients recovered. Septicaemia was responsible for death in three, hepatic failure in one and methaemoglobinaemia in another. It is postulated that release of copper from haemolysed red cells during acute haemolytic episodes may initiate, or contribute to, the development of renal damage.     

Acute renal failure in orthotopic liver transplantation

Aqueous humor was taken from 32 patients with senile and presenile cataract at the operation by means of anterior chamber puncture. Uric acid was marked by indirect method with uricase. The mean content of uric acid in aqueous humor of patients with cataract was 187.13 mumol/l and in the control group 309.34 mumol/l. The difference between the groups is statistically significant. The results suggest that uric acid as strong endogenous antioxidant may play an important role in pathogenesis of cataract.     

Acute liver failure due to temporary hepatic ischemia in the pig

The model of temporary complete liver ischemia was investigated in 60 pigs in order to produce a disease which resembles liver failure in man. The interval of time leading to death in every animal differed in a wide range. A number of biochemical alterations was of no value as for the prognosis of the animal under investigation. The ammonium in the peripheral blood is elevated during shunting of portal blood around the liver only. Microscopic examinations demonstrated that the damage produced is limited to the hepatic tissue. The lesions were less when ischemia was produced after a longer interval after the operation. The role of processes of regeneration and reparation of liver tissue is discussed.     

Acute liver failure caused by isoniazid in a child receiving carbamazepine

Pregnancy, delivery and puerperium in primigravida after surgical correction of vesical exstrophy and reconstruction of vagina with chronic renal insufficiency was presented. Both pregnancy and delivery were successful. Vesical exstrophy the rare congenital malformation in aspect of obstetrical-gynaecological treatment were discussed. Conduction of pregnancy with chronic renal disease was briefly reviewed.     

Acute liver failure induced by alcohol and paracetamol in an HCV-infected haemophiliac

Paracetamol (acetaminophen) is frequently used by haemophiliacs in the management of acute or chronic pain, primarily due to its lack of adverse effects when taken at therapeutic doses. We describe acute hepatic and renal toxicity of paracetamol in a 36-year-old patient with haemophilia B, chronic hepatitis C and chronic alcohol abuse. Moderate doses of paracetamol (6 g/d for 4 d), taken with therapeutic intent, resulted in life-threatening organ dysfunction which gradually recovered with full supportive care.     

Acute heart failure

OBJECTIVE: The purpose of this study was to determine whether arthrosis begins at an unusually early age in professional dancers; if there is an association between hypermobility and osteoarthrosis in dancers; and if osteoarthrosis is a contributing factor to retirement from a professional career in this population. DESIGN: Dance and injury history; physical examinations of back, lower extremities, and ligamentous laxity; and radiographs of lower extremity joints were performed in retired dancers. The dancers' radiographs were compared to those of age-matched nondancers. The radiologist was blinded to the origin of the radiographs. PARTICIPANTS: Fourteen retired dancers aged 27 to 46 years who had performed professionally for a minimum of 10 years were included in the study. Thirty-six age-matched nondancers with injuries or pain in various lower extremity joints were used as controls. MAIN OUTCOME MEASURES: This study measured radiographic findings of osteoarthrosis, including sclerosis, joint space narrowing, osteophytes, and subchondral cysts; hypermobility (after Klemp) as manifested by > 3 of 5 tests being positive; and the dancers' reasons for retirement. RESULTS: Changes of arthrosis were found in 34 of 56 joints in 14 dancers and in 3 of 36 joints in 36 nondancers. Hip calcifications were found in 10 hips in 7 dancers and in 1 nondancer's hip. None of the participants in this study was hypermobile or had retired because of arthrosis. CONCLUSIONS: The prevalence of arthrosis in knees, ankles, and first metatarsophalangeal joints in young dancers was increased when compared to that of nondancers in the same age group. Arthrosis does not necessarily cause retirement from a performance career.     

Acute wound failure

The causes and treatment of acute failure of the abdominal incision are reviewed, along with a summary of studies on fascial healing. Emphasis is placed on taking large bites of tissue during closure to prevent dehiscence. Patient-related risk factors are viewed as less important in the causation of wound failure.     

Induction of peripheral-type benzodiazepine receptors in mouse brain following thioacetamide-induced acute liver failure

To investigate the possible role of peripheral-type benzodiazepine receptors (PBR) in hepatic encephalopathy, we examined expression of PBR in mouse brain following thioacetamide (TAA)-induced acute liver failure. Treatment of mice with TAA resulted in an increase in the number of binding sites of the PBR ligand [3H] Ro5-4864 to brain homogenates, with no significant change in affinity of the ligand. The order of potency of different ligands to compete against [3H] Ro5-4864 binding in the brain of TAA-treated mice was Ro5-4864 > PK11195 > diazepam > protoporphyrin IX, findings similar to those in the control. Northern blot analysis revealed an increase in PBR/isoquinoline binding protein (PBR/IBP) mRNA in mouse brain following TAA treatment, in a time- and dose-dependent manner. These results indicate that the increased number of PBR in the brains of TAA-treated mice relates to the induction of PBR/IBP expression and suggest that the induction of PBR in brain may contribute to pathogenesis of hepatic encephalopathy.     

Acute liver injury following infection with a cytopathic strain of duck hepatitis B virus

It is well established that systemic inflammation induces a counter-regulatory anti-inflammatory response particularly resulting in deactivation of monocytes/macrophages. However, recently we demonstrated a systemic anti-inflammatory response without preceding signs of systemic inflammation in patients with brain injury/surgery and release of cytokines into the cerebrospinal fluid (CSF). In order to analyze the mechanisms and pathways of systemic immunodepression resulting from sterile cerebral inflammation we established an animal model using continuous intra-cerebroventricular (i.c.v.) or intra-hypothalamic (i.h.) infusion of rat recombinant (rr) tumor necrosis factor (TNF)-alpha and interleukin (IL)-1beta for 48 h. Controls received intra-venous (i.v.) cytokine administration. Interestingly, i.c.v. and i.h. infusion of IL-1beta but not TNF-alpha produced distinct signs of central nervous system (CNS) inflammation. Correspondingly, i.c.v. infusion of IL-1beta particularly diminished the TNF-alpha but increased the IL-10 concentration in whole blood cultures after endotoxin stimulation. All parameters normalized within 48 h after termination of the infusion. Blocking the hypothalamic-pituitary-adrenal (HPA) axis by hypophysectomy (HPX) led to complete recovery of the diminished TNF-alpha concentration and temporarily inhibited the IL-10 increase. Blocking the sympathetic nervous system (SNS) transmission by application of the beta2-adrenoreceptor antagonist propranolol not only inhibited the increase but further downregulated the endotoxin induced IL-10 concentration in the media of whole blood cell cultures, whereas the TNF-alpha decrease was only partially prevented. Interestingly, HPX and propranolol also diminished the cell invasion into the CSF. In summary, activation of both the HPA axis and the SNS plays an important role in systemic anti-inflammatory response resulting from cytokines in brain and cerebral inflammation.