bridging necrosis

架橋壊死

WordNet

1. the localized death of living cells (as from infection or the interruption of blood supply) (同)mortification, gangrene, sphacelus

PrepTutorEJDIC

1. 壊疽(えそ)

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• 1. 成人の非標的肝生検所見の解釈interpretation of nontargeted liver biopsy findings in adults [show details]
  …(spotty necrosis) to widespread (panlobular) involvement by necroinflammation. In some patients, bridging necrosis that typically links one vascular structure to another and confluent necrosis are present …
• 2. 慢性肝疾患に対する組織学的スコアリングシステムhistologic scoring systems for chronic liver disease [show details]
  …composite score that is based on histologic assessment of periportal and/or bridging necrosis, intralobular degeneration and focal necrosis, portal inflammation, and fibrosis . The score ranges from 0 to …
• 3. 薬物性肝障害drug induced liver injury [show details]
  …hepatocytes. Confluent necrosis, the death of larger groups of hepatocytes, can be zonal or nonzonal, depending on the offending agent. If extensive, confluent necrosis leads to bridging, submassive, or massive …
• 4. 自己免疫性肝炎：治療autoimmune hepatitis treatment [show details]
  …conjugated bilirubin level; Interface hepatitis on biopsy; Histologic features of bridging necrosis or multiacinar necrosis; Cirrhosis with any degree of inflammation on biopsy Children Our approach …
• 5. 肝疾患患者における手術リスクの評価assessing surgical risk in patients with liver disease [show details]
  …those with impaired hepatic synthetic or excretory function, portal hypertension, or bridging or multilobular necrosis on liver biopsy . The risk of surgery in patients with cirrhosis depends upon the severity …

English Journal

• Multimodality Treatment for Early-Stage Hepatocellular Carcinoma: A Bridging Therapy for Liver Transplantation.

• Ashoori N, Bamberg F, Paprottka P, Rentsch M, Kolligs FT, Siegert S, Peporte A, Al-Tubaikh JA, D'Anastasi M, Hoffmann RT, Reiser MF, Jakobs TF.SourceDepartment of Clinical Radiology, Ludwig Maximilians University (LMU) Munich, Campus Grosshadern, Munich, Germany.
• Digestion.Digestion.2012 Nov 28;86(4):338-348. [Epub ahead of print]
• Purpose: To evaluate the efficiency of a multimodality approach consisting of transcatheter arterial chemoembolization (TACE) and radiofrequency ablation (RFA) as bridging therapy for patients with hepatocellular carcinoma (HCC) awaiting orthotopic liver transplantation (OLT) and to evaluate the his
• PMID 23207185

• Heparin-induced thrombocytopenia associated with acute liver graft failure.

• Pannicke N, Pollok JM, Kluge S, Petzoldt M.SourceDepartment of Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
• BMJ case reports.BMJ Case Rep.2012 Nov 27;2012. pii: bcr2012007323. doi: 10.1136/bcr-2012-007323.
• An orthotopic liver transplantation (OLT) is of a proven benefit in an acute liver failure (ALF). Heparin-induced thrombocytopenia (HIT) is strongly associated with thromboembolic complications. We present the case of a 56-year-old patient who underwent an OLT owing to an ALF of unknown aetiology. H
• PMID 23188860

• Therapeutic potential of Moringa oleifera extracts against acetaminophen-induced hepatotoxicity in rats.

• Sharifudin SA, Fakurazi S, Hidayat MT, Hairuszah I, Aris Mohd Moklas M, Arulselvan P.SourceDepartment of Human Anatomy, Universiti Putra Malaysia , Selangor , Malaysia.
• Pharmaceutical biology.Pharm Biol.2012 Oct 8. [Epub ahead of print]
• Context: Moringa oleifera Lam. (Moringaceae) is a rich source of essential minerals and antioxidants; it has been used in human and animal nutrition. The leaves and flowers are being used by the population with great dietary importance. Objective: The present study was to investigate the therapeut
• PMID 23043505

Japanese Journal

• A fatal case of progressive steatohepatitis, possibly chemotherapy- associated steatohepatitis related to gemcitabine

• Ren Xiangshan,Harada Kenichi,Yoshikawa Seiichi,Igarashi Saya,Urabe Takeshi,Yamada Shinya,Katayanagi Kazuyoshi,Kurumaya Hiroshi,Nakanuma Yasuni
• Clinical Journal of Gastroenterology 3(4), 191-194, 2010-08
• … Ballooning degeneration and necrosis of hepatocytes accompanying neutrophil infiltration, Mallory bodies, and a few bile plugs were found in zone 3. … Marked perivenular and pericellular/perisinusoidal fibrosis and extensive bridging fibrosis were also found. …
• NAID 120002907452

• A fatal case of progressive steatohepatitis, possibly chemotherapy-associated steatohepatitis related to gemcitabine

• Ren Xiangshan,Harada Kenichi,Yoshikawa Seiichi,Igarashi Saya,Urabe Takeshi,Yamada Shinya,Katayanagi Kazuyoshi,Kurumaya Hiroshi,Nakanuma Yasuni
• Clinical Journal of Gastroenterology 3(4), 191-194, 2010-08
• … Ballooning degeneration and necrosis of hepatocytes accompanying neutrophil infiltration, Mallory bodies, and a few bile plugs were found in zone 3. … Marked perivenular and pericellular/perisinusoidal fibrosis and extensive bridging fibrosis were also found. …
• NAID 120002224337

Related Links

• bridging necrosis

Definition: Bridging necrosis is the term given to confluent necrosis linking terminal venules to portal tracts. The term "Bridging necrosis" has been used for necrosis linking any of the vascular structures, but it is now more often restricted to the ...

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★リンクテーブル★

リンク元

「慢性肝炎」

「慢性肝炎」

　　[★]

英

chronic hepatitis

ラ

hepatitis chronica

同

慢性ウイルス性肝炎 chronic viral hepatitis

関

肝炎、肝炎ウイルス。新犬山分類

まとめ

• 6か月以上肝炎が持続している病態で、主にウイルス性とくにC型肝炎ウイルスによるものが大半を占める。多くは無症状であり検査値異常で気づかれる。検査上、ALT優位にトランスアミナーゼが上昇、ガンマグロブリン上昇、ICH停滞率上昇、血小板は肝臓の線維化を反映して低下している。蛋白合成能の指標となるアルブミンやコリンエステラーゼは正常である。病理所見としては肝小葉を中心とした持続性炎症である。肝門脈域の限界板破壊像(piecemeal necrosis)がみられ、慢性肝炎の進行度の指標となる。肝門部の壊死が拡大してお互い重なり合う壊死像(bridging necrosis)は、肝硬変の進展リスクを反映する。腹腔鏡では、肝臓表面に肝臓の再生を示す斑紋と門脈域辺縁の肝細胞が壊死後の血液貯留を反映する赤色紋理を認める。診断はウイルスの検出と肝生検による組織診団によってなされ、治療は原因疾患に応じた治療を行う。

概念

• 6か月以上肝炎が持続している病態

疫学

• B型が約20%、C型が約75%、非B非C型慢性肝炎や自己免疫性肝炎(AIH)はそれぞれ数%。(IMD)

病因

ウイルス性

• B型肝炎ウイルス：キャリアの10-20%が慢性肝炎に移行。B型肝硬変から肝細胞癌は2.5-3%/年
• C型肝炎ウイルス：罹患者の60-70%が慢性肝炎に移行。C型肝硬変から肝細胞癌は5-7%/年

病理

• 肝臓表面の赤色紋理：腹腔鏡上の所見。点状、小斑状、網状の赤色調局面。piece meal necrosisなどにより門脈域辺縁の肝細胞が壊死した後血液の貯留を示す。肝炎の活動性の所見。

症状

• 多くは無症状
• B型慢性肝炎：急性増悪期に黄疸や食欲低下、全身倦怠感を認めることがある
• C型慢性肝炎：黄疸は極めて稀

検査

• AST,ALTの上昇、AST<ALT
• ZTT, TTTの高値
• アルブミンの低下、血小板の低下