Medical Terminology

Acute Hepatic Porphyria (AHP) refers to a family of rare genetic diseases characterized by potentially life-threatening attacks and, for some people, chronic (ongoing and sometimes lifelong) pain and other symptoms that interfere in their ability to live normal lives.

There are four types of AHP. Acute Intermittent Porphyria (AIP) makes up 80% of all cases. The remaining types are:

• Acute Intermittent Porphyria (AIP – makes up 80% of all cases)
• Variegate Porphyria (VP)
• Hereditary Coproporphyria (HCP)
• ALAD Deficiency Porphyria (ADP)

AHP is a hereditary disease, meaning that it can be passed from parents to children.  This can occur if either one or both parents carry the defective gene, depending on the AHP type. Men and women inherit the disease equally as often; however, women tend to suffer symptoms more often than men.

Acute intermittent porphyria (AIP) is a rare metabolic disorder that is characterized by partial deficiency of the enzyme hydroxymethylbilane synthase (also known as porphobilinogen deaminase). This enzyme deficiency can result in the accumulation of porphyrin precursors in the body.

Additional cancer treatment given after the primary treatment to lower the risk that the cancer will come back. Adjuvant therapy may include chemotherapy, radiation therapy, hormone therapy, targeted therapy, or biological therapy.

Aflatoxins are a family of toxins produced by certain fungi that are found on agricultural crops such as maize (corn), peanuts, cottonseed, and tree nuts. The main fungi that produce aflatoxins are Aspergillus flavus and Aspergillus parasiticus, which are abundant in warm and humid regions of the world.

Aminolevulinic acid, an endogenous non-proteinogenic amino acid, is the first compound in the porphyrin synthesis pathway, the pathway that leads to heme in mammals, as well as chlorophyll in plants. ALA is used in photodynamic detection and surgery of cancer.

ALAD Porphyria (ADP) is a very rare genetic metabolic disease characterized by almost complete deficiency of the enzyme delta-aminolevulinic acid (ALA) dehydratase. In ADP, the gene responsible is ALAD which produces the enzyme aminolevulinic acid dehydratase. Deficiency of this enzyme leads to the accumulation of the toxic porphyrin precursor ALA, which can potentially result in a variety of symptoms. Symptoms vary from one person to another, but usually come from the neurological and gastrointestinal systems. This disease is inherited as an autosomal recessive disorder. ADP is more severe than the other acute Porphyrias and can present in childhood. Only ~10 cases have been reported worldwide and all reported cases have been males, in contrast to the other acute Porphyrias where more women are symptomatic.

Alanine aminotransferase (ALT) is an enzyme mainly found in the liver. The ALT test measures the level of ALT in the blood. Consistently high levels of ALT can be a sign of liver swelling or injury.

Alkaline Phosphatase (ALP) is an enzyme found in in large amounts in your liver, bile ducts, and other parts of your body. The ALP test measures the level of ALP in your blood. High levels of ALP can be a sign of liver or bile duct damage.

Amino acids are organic compounds that contain amine (–NH2) and carboxyl (–COOH) functional groups, along with a side chain (R group) specific to each amino acid. The key elements of an amino acid are carbon (C), hydrogen (H), oxygen (O), and nitrogen (N), although other elements are found in the side chains of certain amino acids. About 500 naturally occurring amino acids are known (though only 20 appear in the genetic code) and can be classified in many ways. They can be classified according to the core structural functional groups’ locations as alpha- (α-), beta- (β-), gamma- (γ-) or delta- (δ-) amino acids; other categories relate to polarity, pH level, and side chain group type (aliphatic, acyclic, aromatic, containing hydroxyl or sulfur, etc.). In the form of proteins, amino acid residues form the second-largest component (water is the largest) of human muscles and other tissues. Beyond their role as residues in proteins, amino acids participate in a number of processes such as neurotransmitter transport and biosynthesis.

Ammonia is elevated in individuals with acute and chronic liver disease and is known to affect the brain in other disorders such as Reye syndrome and certain metabolic disorders. Ammonia is normally converted to urea in the liver and cleared out of the body through the urine. Ammonia is highly toxic to the brain.

Anabolic steroids are synthetic, or human-made, variations of the male sex hormone testosterone. The proper term for these compounds is anabolic-androgenic steroids. “Anabolic” refers to muscle building, and “androgenic” refers to increased male sex characteristics. Some common names for anabolic steroids are Gear, Juice, Roids, and Stackers.

Angiography or arteriography is a medical imaging technique used to visualize the inside, or lumen, of blood vessels and organs of the body, with particular interest in the arteries, veins, and the heart chambers.

Angioplasty is a procedure to restore blood flow through the artery. You have angioplasty in a hospital. The doctor threads a thin tube through a blood vessel in the arm or groin up to the involved site in the artery. The tube has a tiny balloon on the end.

An protein in the blood that is made by the body to fight germs such as viruses or bacteria. Antibodies can be a result of receiving a vaccine or coming into contact with a virus. They protect the body against future infections. An antibody is a protein in the blood that is made by the body to fight germs such as viruses or bacteria. Antibodies can be a result of receiving a vaccine or coming into contact with a virus. They protect the body against future infections.

Ascites is the build up of fluid in the abdomen that can occur with liver failure, cirrhosis and liver cancer.

Aspartate Transaminase (AST) is an enzyme found in large amounts in the liver and other parts of the body. The AST test measures the level of AST in the blood. High levels of AST can be a sign of liver damage.

Autoimmune is an immune response by the body against its own tissue, cells, or molecules. In people with autoimmune disease, their immune system may attack the same cells that it is supposed to protect.

Autoimmune hepatitis is a chronic (long-term) liver disease in which the immune system attacks the liver.

Azotemia is a medical condition characterized by abnormally high levels of nitrogen-containing compounds (such as urea, creatinine, various body waste compounds, and other nitrogen-rich compounds) in the blood. It is largely related to insufficient or dysfunctional filtering of blood by the kidneys. It can lead to uremia and acute kidney injury (kidney failure) if not controlled.

Bile is a liquid made in the liver that helps break down fats and other nutrients.

Bile ducts are tubes that drain the bile from the liver into the intestine.

Relating to bile or the bile duct.

Biliary atresia is a rare disease of the bile ducts that affects infants. In babies with biliary atresia, the bile ducts become blocked soon after birth.

Bilirubin (BR) is a yellow compound that occurs in the normal catabolic pathway that breaks down heme in vertebrates. This catabolism is a necessary process in the body’s clearance of waste products that arise from the destruction of aged or abnormal red blood cells. First the hemoglobin gets stripped of the heme molecule which thereafter passes through various processes of porphyrin catabolism, depending on the part of the body in which the breakdown occurs. For example, the molecules excreted in the urine differ from those in the feces. The production of biliverdin from heme is the first major step in the catabolic pathway, after which the enzyme biliverdin reductase performs the second step, producing bilirubin from biliverdin.

Bilirubin is excreted in bile and urine, and elevated levels may indicate certain diseases. It is responsible for the yellow color of bruises and the yellow discoloration in jaundice. Its subsequent breakdown products, such as stercobilin, cause the brown color of feces. A different breakdown product, urobilin, is the main component of the straw-yellow color in urine.

It has also been found in plants.

A biopsy is a medical test commonly performed by a surgeon, interventional radiologist, or an interventional cardiologist. The process involves extraction of sample cells or tissues for examination to determine the presence or extent of a disease.

Bland embolization is a way to treat cancer in the liver. It can be used for cancer that began in the liver or for cancers that spread to the liver. A tumor needs a supply of blood to grow. Liver tumors get most of their blood from a large blood vessel called the hepatic artery.

Blood plasma is a yellowish liquid component of blood that holds the blood cells of whole blood in suspension. It is the liquid part of the blood that carries cells and proteins throughout the body. It makes up about 55% of the body’s total blood volume. It is the intravascular fluid part of extracellular fluid (all body fluid outside cells). It is mostly water (up to 95% by volume), and contains important dissolved proteins (6–8%) (e.g., serum albumins, globulins, and fibrinogen), glucose, clotting factors, electrolytes (Na+, Ca2+, Mg2+, HCO3−, Cl−, etc.), hormones, carbon dioxide (plasma being the main medium for excretory product transportation), and oxygen. It plays a vital role in an intravascular osmotic effect that keeps electrolyte concentration balanced and protects the body from infection and other blood disorders.

What Is BRCA? The name “BRCA” is an abbreviation for “BReast CAncer gene.” BRCA1 and BRCA2 are two different genes that have been found to impact a person’s chances of developing breast cancer. Every human has both the BRCA1 and BRCA2 genes. Despite what their names might suggest, BRCA genes do not cause breast cancer.

Budd–Chiari syndrome is caused by blood clots that completely or partially block blood flow from the liver. The blockage may occur anywhere from the small and large veins that carry blood from the liver (hepatic veins) to the inferior vena cava.

 

A substance released into the bloodstream by both cancer cells and normal cells. Too much CA 19-9 in the blood can be a sign of pancreatic cancer or other types of cancer or conditions. The amount of CA 19-9 in the blood can be used to help keep track of how well cancer treatments are working or if cancer has come back. It is a type of tumor marker.

Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.

Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.

Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.

Cancer is the name given to a collection of related diseases. In all types of cancer, some of the body’s cells begin to divide without stopping and spread into surrounding tissues.

Cancer can start almost anywhere in the human body, which is made up of trillions of cells. Normally, human cells grow and divide to form new cells as the body needs them. When cells grow old or become damaged, they die, and new cells take their place.

When cancer develops, however, this orderly process breaks down. As cells become more and more abnormal, old or damaged cells survive when they should die, and new cells form when they are not needed. These extra cells can divide without stopping and may form growths called tumors.

Many cancers form solid tumors, which are masses of tissue. Cancers of the blood, such as leukemias, generally do not form solid tumors.

Cancerous tumors are malignant, which means they can spread into, or invade, nearby tissues. In addition, as these tumors grow, some cancer cells can break off and travel to distant places in the body through the blood or the lymph system and form new tumors far from the original tumor.

A substance that may be found in the blood of people who have colon cancer, other types of cancer or diseases, or who smoke tobacco. Carcinoembryonic antigen levels may help keep track of how well cancer treatments are working or if cancer has come back. It is a type of tumor marker. Also called CEA.

Cardiac arrhythmia refers to a group of conditions that cause the heart to beat irregular, too slowly, or too quickly. There are several categories of arrhythmia, including: bradycardia, or a slow heartbeat. tachycardia, or a fast heartbeat.

See “Budd-Chiari Syndrome…”

Chemoembolization is a palliative treatment for liver cancer. This can be a cancer originating in the liver or a cancer that has spread (metastasized) to the liver from other areas of the body. During chemoembolization, three chemotherapy drugs are injected into the artery that supplies blood to the tumor in the liver.

A cancer in the slender tubes that carry the digestive fluid bile through the liver. It’s a rare but aggressive form of cancer. Symptoms include yellow skin and eyes (jaundice), intensely itchy skin, and stool that’s white in color. Treatment may include surgery, chemotherapy, and radiation.

Cholestasis is a liver disease. It occurs when the flow of bile from your liver is reduced or blocked. Bile is fluid produced by your liver that aids in the digestion of food, especially fats. When bile flow is altered, it can lead to a buildup of bilirubin.

Cholesterol is a type of fat found in blood.

Ulcerative colitis is an inflammatory bowel disease (IBD) that causes inflammation and ulcers (sores) in your digestive tract. Ulcerative colitis affects the innermost lining of your large intestine (colon) and rectum. Symptoms usually develop over time, rather than suddenly.

Cirrhosis is extensive scarring of the liver — hard scar tissue replaces soft healthy tissue. Severe scarring of the liver can prevent the liver from functioning well.

A clinical trial is a medical research study conducted to find answers to health questions. Clinical trials often are conducted to evaluate new medications, combination of medications, or new ways to use current treatments. Also, clinical trials are conducted to evaluate new tests, equipment, and procedures for diagnosing and detecting health conditions and to find vaccines to prevent illnesses.

Collagen is the main structural protein in the extracellular matrix found in the body’s various connective tissues. As the main component of connective tissue, it is the most abundant protein in mammals, making up from 25% to 35% of the whole-body protein content. Collagen consists of amino acids bound together to form a triple helix of elongated fibril known as a collagen helix. It is mostly found in connective tissue such as cartilage, bones, tendons, ligaments, and skin.

The common hepatic duct is the part of the biliary tract formed by the convergence of the right hepatic duct (which drains bile from the right functional lobe of the liver) and the left hepatic duct (which drains bile from the left functional lobe of the liver). The common hepatic duct then joins the cystic duct coming from the gallbladder to form the common bile duct. The duct is usually 6–8 cm length.

In medicine, comorbidity is the presence of one or more additional conditions often co-occurring with a primary condition. Comorbidity describes the effect of all other conditions an individual patient might have other than the primary condition of interest, and can be physiological or psychological.

A CT scan is an imaging test that uses x-rays to get detailed pictures of the body.

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone (sternum). Pain caused by costochondritis might mimic that of a heart attack or other heart conditions.

Crohn’s disease is a type of inflammatory bowel disease (IBD). It causes inflammation of your digestive tract, which can lead to abdominal pain, severe diarrhea, fatigue, weight loss and malnutrition. Inflammation caused by Crohn’s disease can involve different areas of the digestive tract in different people.

Creatinine is a breakdown product of creatine phosphate in muscle, and is usually produced at a fairly constant rate by the body (depending on muscle mass).

A CT scan or computed tomography scan is a medical imaging technique that uses computer-processed combinations of multiple X-ray measurements taken from different angles to produce tomographic images of a body, allowing the user to see inside the body without cutting.

Decompensated alcohol related liver disease (ARLD) occurs when there is a deterioration in liver function in a patient with cirrhosis, which presents with jaundice, coagulopathy, ascites, and hepatic encephalopathy. The short term mortality rate from decompensated ARLD is high (10-20% at one month).

De novo lipogenesis (DNL) is a complex and highly regulated metabolic pathway. In normal conditions DNL converts excess carbohydrate into fatty acids that are then esterified to storage triacylglycerols (TGs). … Deregulations in the lipogenic pathway are associated with diverse pathological conditions.

Diabetes is a condition that occurs when the body cannot use glucose (a type of sugar) normally.

In medicine, dialysis is the process of removing excess water, solutes, and toxins from the blood in people whose kidneys can no longer perform these functions naturally. This is referred to as renal replacement therapy.

Dialysis is used in patients with rapidly developing loss of kidney function, called acute kidney injury (previously called acute renal failure), or slowly worsening kidney function, called Stage 5 chronic kidney disease, (previously called chronic kidney failure and end-stage renal disease and end-stage kidney disease).

Dialysis is used as a temporary measure in either acute kidney injury or in those awaiting kidney transplant and as a permanent measure in those for whom a transplant is not indicated or not possible.

Situated away from the center of the body or from the point of attachment.

Distal cholangiocarcinoma occurs in the portion of the bile duct nearest the small intestine.

A diuretic is any substance that promotes diuresis (increased urination and the physiologic process that produces such an increase involving extra urine production in the kidneys as part of the body’s homeostatic maintenance of fluid balance), the increased production of urine. This includes forced diuresis. There are several categories of diuretics. All diuretics increase the excretion of water from bodies, although each class does so in a distinct way. Alternatively, an antidiuretic, such as vasopressin (antidiuretic hormone), is an agent or drug which reduces the excretion of water in urine.

In anatomy and physiology, a duct is a circumscribed channel leading from an exocrine gland or organ.

A dysplastic nodule is a nodular region of hepatocytes at least 1 mm in diameter with dysplasia but without definite histologic criteria for malignancy. These nodules are usually found in cirrhotic livers. Dysplastic nodules can be low grade or high grade (^,7).

An echocardiogram (echo) is a graphic outline of the heart’s movement. During an echo test, ultrasound (high-frequency sound waves) from a hand-held wand placed on your chest provides pictures of the heart’s valves and chambers and helps the sonographer evaluate the pumping action of the heart.

Edema is the build up of fluid in the legs that can occur due to liver failure, cirrhosis, and liver cancer.

Encephalopathy means any disorder or disease of the brain, especially chronic degenerative conditions. In modern usage, encephalopathy does not refer to a single disease, but rather to a syndrome of overall brain dysfunction; this syndrome has many possible organic and inorganic causes.

Endometriosis is an often painful disorder in which tissue similar to the tissue that normally lines the inside of your uterus — the endometrium — grows outside your uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis.

An endoscopy (looking inside) is a procedure used in medicine to look inside the body. The endoscopy procedure uses an endoscope to examine the interior of a hollow organ or cavity of the body. Unlike many other medical imaging techniques, endoscopes are inserted directly into the organ.

There are many types of endoscopes. Depending on the site in the body and type of procedure an endoscopy may be performed either by a doctor or a surgeon. A patient may be fully conscious or anesthetised during the procedure. Most often the term endoscopy is used to refer to an examination of the upper part of the gastrointestinal tract, known as an esophagogastroduodenoscopy.

For non-medical use, similar instruments are called borescopes.

 

Chronic liver failure, also called end-stage liver disease, progresses over months, years, or decades. Most often, chronic liver failure is the result of cirrhosis, a condition in which scar tissue replaces healthy liver tissue until the liver cannot function adequately. Patients with abnormal liver function who develop ascites, variceal hemorrhage, hepatic encephalopathy, or renal impairment are considered to have end-stage liver disease (ESLD).

Enzymes are protein cells that help important chemical reactions to occur in the body.

The cause, set of causes, or manner of causation of a disease or condition.

Extrahepatic bile duct cancer is a rare disease in which malignant (cancer) cells form in the part of bile duct that is outside the liver.

See nonalcoholic fatty liver disease.

Ferritin is a blood protein that contains iron. A ferritin test helps your doctor understand how much iron your body stores. If a ferritin test reveals that your blood ferritin level is lower than normal, it indicates your body’s iron stores are low and you have iron deficiency. As a result, you could be anemic.

Fibromyalgia is a disorder characterized by widespread musculoskeletal pain accompanied by fatigue, sleep, memory and mood issues. Researchers believe that fibromyalgia amplifies painful sensations by affecting the way your brain and spinal cord process painful and nonpainful signals.

FibroScan is a specialized ultrasound machine for your liver. It measures fibrosis (scarring) and steatosis (fatty change) in your liver. Fatty change is when fat builds up in your liver cells.

FibroScan will help your healthcare provider learn more about your liver disease. It can be used alone or with other tests (such as blood tests, imaging scans, or biopsies) that also measure scarring or fatty change in your liver.

Fibrosis is the initial scarring of the liver.

In vertebrates, the gallbladder is a small hollow organ where bile is stored and concentrated before it is released into the small intestine. In humans, the pear-shaped gallbladder lies beneath the liver, although the structure and position of the gallbladder can vary significantly among animal species. It receives and stores bile, produced by the liver, via the common hepatic duct, and releases it via the common bile duct into the duodenum, where the bile helps in the digestion of fats.

The gallbladder can be affected by gallstones, formed by material that cannot be dissolved – usually cholesterol or bilirubin, a product of haemoglobin breakdown. These may cause significant pain, particularly in the upper-right corner of the abdomen, and are often treated with removal of the gallbladder called a cholecystectomy. (Cholecyst means gallbladder.) Cholecystitis, inflammation of the gallbladder, has a wide range of causes, including result from the impaction of gallstones, infection, and autoimmune disease.

A gastroenterologist is a doctor who specializes in the study of digestive organs including the liver.

Genetic refers to something that is related, caused by or affected by genes.

A hepatitis C genotype is the genetic makeup of a cell, an organism, or an individual. In the study of liver diseases, the term genotype is used often to describe different strains of hepatitis C virus.

Gestational diabetes is diabetes diagnosed for the first time during pregnancy (gestation). Like other types of diabetes, gestational diabetes affects how your cells use sugar (glucose). Gestational diabetes causes high blood sugar that can affect your pregnancy and your baby’s health.

Glucose is a simple sugar with the molecular formula C6H12O6. Glucose is the most abundant monosaccharide, a subcategory of carbohydrates. Glucose is mainly made by plants and most algae during photosynthesis from water and carbon dioxide, using energy from sunlight, where it is used to make cellulose in cell walls, which is the most abundant carbohydrate. In energy metabolism, glucose is the most important source of energy in all organisms. Glucose for metabolism is stored as a polymer, in plants mainly as starch and amylopectin, and in animals as glycogen. Glucose circulates in the blood of animals as blood sugar. The naturally occurring form of glucose is d-glucose, while l-glucose is produced synthetically in comparatively small amounts and is of lesser importance. Glucose is a monosaccharide containing six carbon atoms and an aldehyde group, and is therefore an aldohexose. The glucose molecule can exist in an open-chain (acyclic) as well as ring (cyclic) form. Glucose is naturally occurring and is found in fruits and other parts of plants in its free state. In animals, glucose is released from the breakdown of glycogen in a process known as glycogenolysis.

Glycogen is a multibranched polysaccharide of glucose that serves as a form of energy storage in animals, fungi, and bacteria. The polysaccharide structure represents the main storage form of glucose in the body.

Glycogen functions as one of two forms of energy reserves, glycogen being for short-term and the other form being triglyceride stores in adipose tissue (i.e., body fat) for long-term storage. In humans, glycogen is made and stored primarily in the cells of the liver and skeletal muscle. In the liver, glycogen can make up 5–6% of the organ’s fresh weight, and the liver of an adult weighing 1.5 kg can store roughly 100–120 grams of glycogen. In skeletal muscle, glycogen is found in a low concentration (1–2% of the muscle mass) and the skeletal muscle of an adult weighing 70 kg stores roughly 400 grams of glycogen. The amount of glycogen stored in the body—particularly within the muscles and liver—mostly depends on physical training, basal metabolic rate, and eating habits. Small amounts of glycogen are also found in other tissues and cells, including the kidneys, red blood cells, white blood cells, and glial cells in the brain. The uterus also stores glycogen during pregnancy to nourish the embryo.

Approximately 4 grams of glucose are present in the blood of humans at all times; in fasting individuals, blood glucose is maintained constant at this level at the expense of glycogen stores in the liver and skeletal muscle. Glycogen stores in skeletal muscle serve as a form of energy storage for the muscle itself; however, the breakdown of muscle glycogen impedes muscle glucose uptake from the blood, thereby increasing the amount of blood glucose available for use in other tissues. Liver glycogen stores serve as a store of glucose for use throughout the body, particularly the central nervous system. The human brain consumes approximately 60% of blood glucose in fasted, sedentary individuals.

Glycogen is the analogue of starch, a glucose polymer that functions as energy storage in plants. It has a structure similar to amylopectin (a component of starch), but is more extensively branched and compact than starch. Both are white powders in their dry state. Glycogen is found in the form of granules in the cytosol/cytoplasm in many cell types, and plays an important role in the glucose cycle. Glycogen forms an energy reserve that can be quickly mobilized to meet a sudden need for glucose, but one that is less compact than the energy reserves of triglycerides (lipids). As such it is also found as storage reserve in many parasitic protozoa.

Guillain-Barre syndrome is a rare disorder in which your body’s immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms.

A record of information about a person’s health. A personal health history may include information about allergies, illnesses, surgeries, immunizations, and results of physical exams and tests. It may also include information about medicines taken and health habits, such as diet and exercise. A family health history includes health information about a person’s close family members (parents, grandparents, children, brothers, and sisters). This includes their current and past illnesses. A family health history may show a pattern of certain diseases in a family. Also called medical history.

Heme or haem is a substance precursive to hemoglobin, which is necessary to bind oxygen in the bloodstream. Haem is biosynthesized in both the bone marrow and the liver.

Hemochromatosis is a genetic condition in which the body stores too much iron and the iron builds up in the liver.

Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of purifying the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure. Hemodialysis is one of three renal replacement therapies (the other two being kidney transplant and peritoneal dialysis). An alternative method for extracorporeal separation of blood components such as plasma or cells is apheresis.

Hemoglobin (American English) or haemoglobin, abbreviated Hb or Hgb, is the iron-containing oxygen-transport metalloprotein in the red blood cells (erythrocytes) of almost all vertebrates (the exception being the fish family Channichthyidae) as well as the tissues of some invertebrates. Hemoglobin in blood carries oxygen from the lungs or gills to the rest of the body (i.e. the tissues). There it releases the oxygen to permit aerobic respiration to provide energy to power the functions of the organism in the process called metabolism. A healthy individual has 12 to 20 grams of hemoglobin in every 100 ml of blood.

Heparin is an anticoagulant (blood thinner) that prevents the formation of blood clots. Heparin is used to treat and prevent blood clots caused by certain medical conditions or medical procedures. It is also used before surgery to reduce the risk of blood clots.

Hepatectomy is the surgical resection (removal of all or part) of the liver. While the term is often employed for the removal of the liver from a liver transplant donor, this article will focus on partial resections of hepatic tissue and hepatoportoenterostomy.

The hepatic artery proper (also proper hepatic artery) is the artery that supplies the liver and gallbladder. It raises from the common hepatic artery, a branch of the celiac artery.

The hepatic veins are the veins that drain de-oxygenated blood from the liver into the inferior vena cava. There are usually three upper hepatic veins draining from the left, middle, and right parts of the liver. These are larger than the group of lower hepatic veins that can number from six to twenty.

HE is a condition that occurs in people with advanced cirrhosis or severe liver damage. The damaged liver cannot remove the toxins (ammonia) that a healthy liver normally would. These toxins then travel through your body until they reach your brain. They can then affect the brain and cause HE.

Hepatic hydrothorax refers to the presence of a pleural effusion (usually >500 mL) in a patient with cirrhosis who does not have other reasons to have a pleural effusion (eg, cardiac, pulmonary, or pleural disease). Hepatic hydrothorax occurs in approximately 5 to 15 percent of patients with cirrhosis.

The portal vein or hepatic portal vein (HPV) is a blood vessel that carries blood from the gastrointestinal tract, gallbladder, pancreas and spleen to the liver. This blood contains nutrients and toxins extracted from digested contents. Approximately 75% of total liver blood flow is through the portal vein, with the remainder coming from the hepatic artery proper. The blood leaves the liver to the heart in the hepatic veins.

The portal vein is not a true vein, because it conducts blood to capillary beds in the liver and not directly to the heart. It is a major component of the hepatic portal system, one of only two portal venous systems in the body – with the hypophyseal portal system being the other.

The portal vein is usually formed by the confluence of the superior mesenteric, splenic veins, inferior mesenteric, left, right gastric veins and the pancreatic vein.

Conditions involving the portal vein cause considerable illness and death. An important example of such a condition is elevated blood pressure in the portal vein. This condition, called portal hypertension, is a major complication of cirrhosis.

Hepatic veno-occlusive disease is a clinical syndrome characterized by hepatomegaly, ascites, weight gain and jaundice, due to sinusoidal congestion which can be caused by alkaloid ingestion, but the most frequent cause is haematopoietic stem cell transplantation (STC) and is also seen after solid organ transplantation. The incidence of veno occlusive disease (VOD) after STC ranges from 0 to 70%, but is decreasing. Survival is good when VOD is a mild form, but when it is severe and associated with an increase of hepatic venous pressure gradient > 20 mmHg, and mortality is about 90%. Prevention remains the best therapeutic strategy, by using non-myeloablative conditioning regimens before STC. Prophylactic administration of ursodeoxycholic acid, being an antioxidant and antiapoptotic agent, can have some benefit in reducing overall mortality. Defibrotide, which has pro-fibrinolytic and antithrombotic properties, is the most effective therapy; decompression of the sinusoids by a transjugular intrahepatic portosystemic shunt (TIPS) can be tried, especially to treat VOD after liver transplantation and when multiorgan failure (MOF) is not present. Liver transplantation can be the last option, but can not be considered a standard rescue therapy, because usually the concomitant presence of multiorgan failure contraindicates this procedure.

Hepatitis means “inflammation of the liver”.

Hepatitis A is a liver disease caused by the hepatitis B and hepatitis C, it does not become chronic (long-term). The hepatitis A virus (HAV). HAV causes the liver to swell and prevents it from working well. HAV is passed from person to person through fecal matter. Most often it is transmitted because of poor hand washing after using the bathroom or changing a diaper, or before preparing and eating food. Unlike hepatitis B and hepatitis C, it does not become chronic (long-term).

Hepatitis B is a liver disease caused by the hepatitis B virus (HBV). HBV causes the liver to swell and prevents it from working well. HBV is passed from person to person through bodily fluids such as blood, semen, or vaginal secretions. Most often it is transmitted through sexual contact or from an infected mother to her infant during birth.

Hepatitis C is a liver disease caused by the hepatitis C virus (HCV). HCV causes the liver to swell and prevents it from working well. HCV is passed from person to person by blood. It is most often transmitted when a person’s blood comes into direct contact with infected blood.

See liver cancer.

A hepatocyte is a cell of the main parenchymal tissue of the liver. Hepatocytes make up 80% of the liver’s mass. These cells are involved in:

• Protein synthesis
• Protein storage
• Transformation of carbohydrates
• Synthesis of cholesterol, bile salts and phospholipids
• Detoxification, modification, and excretion of exogenous and endogenous substances
• Initiation of formation and secretion of bile

A hepatologist is a doctor who specializes in the study of the liver.

A cancer of the cells of the liver.

Hepatorenal syndrome (often abbreviated HRS) is a life-threatening medical condition that consists of rapid deterioration in kidney function in individuals with cirrhosis or fulminant liver failure. HRS is usually fatal unless a liver transplant is performed, although various treatments, such as dialysis, can prevent advancement of the condition.

HRS can affect individuals with cirrhosis, severe alcoholic hepatitis, or liver failure, and usually occurs when liver function deteriorates rapidly because of a sudden insult such as an infection, bleeding in the gastrointestinal tract, or overuse of diuretic medications. HRS is a relatively common complication of cirrhosis, occurring in 18% of people within one year of their diagnosis, and in 39% within five years of their diagnosis. Deteriorating liver function is believed to cause changes in the circulation that supplies the intestines, altering blood flow and blood vessel tone in the kidneys. The kidney failure of HRS is a consequence of these changes in blood flow, rather than direct damage to the kidney. The diagnosis of hepatorenal syndrome is based on laboratory tests of individuals susceptible to the condition. Two forms of hepatorenal syndrome have been defined: Type 1 HRS entails a rapidly progressive decline in kidney function, while type 2 HRS is associated with ascites (fluid accumulation in the abdomen) that does not improve with standard diuretic medications.

The risk of death in hepatorenal syndrome is very high; the mortality of individuals with type 1 HRS is over 50% over the short term, as determined by historical case series. The only long-term treatment option for the condition is liver transplantation. While awaiting transplantation, people with HRS often receive other treatments that improve the abnormalities in blood vessel tone, including supportive care with medications, or the insertion of a transjugular intrahepatic portosystemic shunt (TIPS), which is a small shunt placed to reduce blood pressure in the portal vein. Some patients may require hemodialysis to support kidney function, or a newer technique called liver dialysis which uses a dialysis circuit with albumin-bound membranes to bind and remove toxins normally cleared by the liver, providing a means of extracorporeal liver support until transplantation can be performed.

Hereditary coproporphyria (HCP) is a rare inherited form of liver (hepatic) porphyria, characterized by neurological symptoms in the form of episodes (acute attacks) of stomach pain, nausea, vomiting, weakness, numbness, and pain in the hands and feet (neuropathy).

The HFE gene provides instructions for producing a protein that is located on the surface of cells, primarily liver and intestinal cells. The HFE protein is also found on some immune system cells. The HFE protein interacts with other proteins on the cell surface to detect the amount of iron in the body.

Cholesterol is a waxy substance found in your blood. Your body needs cholesterol to build healthy cells, but high levels of cholesterol can increase your risk of heart disease.

With high cholesterol, you can develop fatty deposits in your blood vessels. Eventually, these deposits grow, making it difficult for enough blood to flow through your arteries. Sometimes, those deposits can break suddenly and form a clot that causes a heart attack or stroke.

High cholesterol can be inherited, but it’s often the result of unhealthy lifestyle choices, which make it preventable and treatable. A healthy diet, regular exercise and sometimes medication can help reduce high cholesterol.

 

Triglycerides are a type of fat found in your blood. Your body uses them for energy.

You need some triglycerides for good health. But high triglycerides might raise your risk of heart disease and may be a sign of metabolic syndrome.

Metabolic syndrome is the combination of high blood pressure, high blood sugar, too much fat around the waist, low HDL (“good”) cholesterol, and high triglycerides. Metabolic syndrome increases your risk for heart disease, diabetes, and stroke.

A blood test that measures your cholesterol also measures your triglycerides. For a general idea about your triglycerides level, compare your test results to the following:

• Normal is less than 150.
• Borderline-high is 150 to 199.
• High is 200 to 499.
• Very high is 500 or higher.

Hyperlipidemia means your blood has too many lipids (or fats), such as cholesterol and triglycerides. One type of hyperlipidemia, hypercholesterolemia, means you have too much non-HDL cholesterol and LDL (bad) cholesterol in your blood. This condition increases fatty deposits in arteries and the risk of blockages.

High blood pressure (hypertension) is a common condition in which the long-term force of the blood against your artery walls is high enough that it may eventually cause health problems, such as heart disease.

Immunotherapy is a type of cancer treatment that helps your immune system fight cancer. The immune system helps your body fight infections and other diseases. It is made up of white blood cells and organs and tissues of the lymph system. Immunotherapy is a type of biological therapy.

The inferior vena cava (or IVC) is a large vein that carries the deoxygenated blood from the lower and middle body into the right atrium of the heart. It is formed by the joining of the right and the left common iliac veins, usually at the level of the fifth lumbar vertebra.

The inferior vena cava is the lower (“inferior”) of the two venae cavae, the two large veins that carry deoxygenated blood from the body to the right atrium of the heart: the inferior vena cava carries blood from the lower half of the body whilst the superior vena cava carries blood from the upper half of the body. Together, the venae cavae (in addition to the coronary sinus, which carries blood from the muscle of the heart itself) form the venous counterparts of the aorta.

It is a large retroperitoneal vein that lies posterior to the abdominal cavity and runs along the right side of the vertebral column. It enters the right auricle at the lower right, back side of the heart. The name derives from Latin: vena, “vein”, cavus, “hollow”.

Interferon is a protein used by the body to fight infection. It is prescribed as an injected medication for people with hepatitis B or hepatitis C.

The international normalized ratio (INR) is a calculation based on results of a PT and is used to monitor individuals who are being treated with the blood-thinning medication (anticoagulant) warfarin (Coumadin®). The PT and INR are used to monitor the effectiveness of the anticoagulant warfarin.

In interventional radiology (also called IR), doctors use medical imaging to guide minimally invasive surgical procedures that diagnose, treat, and cure many kinds of conditions. Imaging modalities used include fluoroscopy, MRI, CT, and ultrasound.  At UVA Health System, these radiologists work in the department of vascular and interventional radiology.

Intrahepatic cholangiocarcinoma occurs in the parts of the bile ducts within the liver and is sometimes classified as a type of liver cancer.

Intrauterine fetal demise (IUFD) is fetal death that occurs after 20 weeks gestation but before birth. If the gestational age is unknown at the time of death, a fetus that weighs ≥350 g is considered an IUFD. In 2005, IUFD occurred at a rate of 6.22 per 1000 pregnancies, which amounted to 25,894 deaths.

Irritable bowel syndrome (IBS) is a common disorder that affects the large intestine. Signs and symptoms include cramping, abdominal pain, bloating, gas, and diarrhea or constipation, or both. IBS is a chronic condition that you’ll need to manage long term.

Jaundice is the yellowing of the skin and white part of the eyes.

The kidneys are two reddish-brown bean-shaped organs found in vertebrates. They are located on the left and right in the retroperitoneal space, and in adult humans are about 12 centimeters (4-1⁄2 inches) in length. They receive blood from the paired renal arteries; blood exits into the paired renal veins. Each kidney is attached to a ureter, a tube that carries excreted urine to the bladder.

A medical procedure that involves testing a sample of blood, urine, or other substance from the body. Laboratory tests can help determine a diagnosis, plan treatment, check to see if treatment is working, or monitor the disease over time.

This drug is used by mouth or rectally to treat or prevent complications of liver disease (hepatic encephalopathy). It does not cure the problem, but may help to improve mental status. Lactulose is a colonic acidifier that works by decreasing the amount of ammonia in the blood. It is a man-made sugar solution.

The liver is the second largest organ in your body. It processes what you eat and drink into energy and nutrients your body can use. The liver also removes harmful substances from your blood.

A liver biopsy is a medical procedure used to remove a small piece of liver tissue that is studied in the lab to determine the liver’s condition.

Liver cancer is the growth and spread of unhealthy cells in the liver.

Liver cysts are abnormal sacs filled with fluid in the liver.

Liver failure is the inability of the liver to function and perform its jobs.

Liver function tests help check the liver’s health and detect liver damage. These blood tests measure the levels of certain proteins and enzymes in the blood.

A liver transplant is the process of replacing a sick liver with a donated, healthy liver.

A living-related liver transplantation is the transplantation of a portion of a healthy person’s liver to a person with advanced liver damage.

In anatomy, a lobe is a clear anatomical division or extension of an organ (as seen for example in the brain, lung, liver, or kidney) that can be determined without the use of a microscope at the gross anatomy level. This is in contrast to the much smaller lobule, which is a clear division only visible under the microscope.

Interlobar ducts connect lobes and interlobular ducts connect lobules.

A MRI scan uses magnetic waves to obtain images of the liver or other organs.

Meconium is a thick, green, tar-like substance that lines your baby’s intestines during pregnancy. Typically this substance is not released in your baby’s bowel movements until after birth. However, sometimes a baby will have a bowel movement prior to birth, excreting the meconium into the amniotic fluid.

The Model for End-Stage Liver Disease, or MELD, is a scoring system for assessing the severity of chronic liver disease.

Metabolic syndrome is the name for a group of risk factors that raises your risk for heart disease and other health problems, such as diabetes and stroke.

The term “metabolic” refers to the biochemical processes involved in the body’s normal functioning. Risk factors are traits, conditions, or habits that increase your chance of developing a disease.

In this article, “heart disease” refers to ischemic heart disease, a condition in which a waxy substance called plaque builds up inside the arteries that supply blood to the heart.

Plaque hardens and narrows the arteries, reducing blood flow to your heart muscle. This can lead to chest pain, a heart attack, heart damage, or even death.

Metabolism is the set of life-sustaining chemical reactions in organisms. The three main purposes of metabolism are: the conversion of food to energy to run cellular processes; the conversion of food/fuel to building blocks for proteins, lipids, nucleic acids, and some carbohydrates; and the elimination of metabolic wastes. These enzyme-catalyzed reactions allow organisms to grow and reproduce, maintain their structures, and respond to their environments. (The word metabolism can also refer to the sum of all chemical reactions that occur in living organisms, including digestion and the transport of substances into and between different cells, in which case the above described set of reactions within the cells is called intermediary metabolism or intermediate metabolism).

Having to do with metastasis, which is the spread of cancer from the primary site (place where it started) to other places in the body.

Liver cancer, also referred to as hepatic cancer, develops in the tissues of the liver, one of the largest organs of the human body. The liver has a variety of functions, including detoxification, breaking down fats, synthesizing proteins and aiding in digestion.

By traveling through lymph or blood vessels, cancerous cells sometimes travel throughout the body, invading new tissues or organs in a process called metastasis. Metastatic liver cancer is an advanced stage of the disease that started in the liver but has spread to other parts of the body.

Picture a bustling city on a weekday morning, the sidewalks flooded with people rushing to get to work or to appointments. Now imagine this at a microscopic level and you have an idea of what the microbiome looks like inside our bodies, consisting of trillions of microorganisms (also called microbiota or microbes) of thousands of different species. [1] These include not only bacteria but fungi, parasites, and viruses. In a healthy person, these “bugs” coexist peacefully, with the largest numbers found in the small and large intestines but also throughout the body. The microbiome is even labeled a supporting organ because it plays so many key roles in promoting the smooth daily operations of the human body.

Each person has an entirely unique network of microbiota that is originally determined by one’s DNA. A person is first exposed to microorganisms as an infant, during delivery in the birth canal and through the mother’s breast milk. [1] Exactly which microorganisms the infant is exposed to depends solely on the species found in the mother. Later on, environmental exposures and diet can change one’s microbiome to be either beneficial to health or place one at greater risk for disease.

The microbiome consists of microbes that are both helpful and potentially harmful. Most are symbiotic (where both the human body and microbiota benefit) and some, in smaller numbers, are pathogenic (promoting disease). In a healthy body, pathogenic and symbiotic microbiota coexist without problems. But if there is a disturbance in that balance—brought on by infectious illnesses, certain diets, or the prolonged use of antibiotics or other bacteria-destroying medications – dysbiosis occurs, stopping these normal interactions. As a result, the body may become more susceptible to disease.

Magnetic resonance imaging is a medical imaging technique used in radiology to form pictures of the anatomy and the physiological processes of the body. MRI scanners use strong magnetic fields, magnetic field gradients, and radio waves to generate images of the organs in the body.

Treatment given as a first step to shrink a tumor before the main treatment, which is usually surgery, is given. Examples of neoadjuvant therapy include chemotherapy, radiation therapy, and hormone therapy.

Nephrotoxicity is toxicity in the kidneys. It is a poisonous effect of some substances, both toxic chemicals and medications, on renal function. There are various forms, and some drugs may affect renal function in more than one way. Nephrotoxins are substances displaying nephrotoxicity.

Nephrotoxicity should not be confused with the fact that some medications have a predominantly renal excretion and need their dose adjusted for the decreased renal function (e.g., heparin).

The nephrotoxic effect of most drugs is more profound in patients already suffering from kidney failure.

Nonalcoholic fatty liver disease (NAFLD) is the build up of extra fat in liver cells that is not caused by alcohol.

Nonalcoholic steatohepatitis (NASH) is a severe form of nonalcoholic fatty liver disease that causes the liver to swell and become damaged.

Nonsteroidal anti-inflammatory drugs (NSAIDs) are a drug class that reduce pain, decrease fever, prevent blood clots and, in higher doses, decrease inflammation. Side effects depend on the specific drug, but largely include an increased risk of gastrointestinal ulcers and bleeds, heart attack and kidney disease.

An oncologist is a doctor who treats cancer and provides medical care for a person diagnosed with cancer. The field of oncology has three major areas: medical, surgical, and radiation. A medical oncologist treats cancer using chemotherapy or other medications, such as targeted therapy or immunotherapy.

Palliative care is specialized medical care for people living with a serious illness. This type of care is focused on providing relief from the symptoms and stress of the illness. The goal is to improve quality of life for both the patient and the family.

Palliative care is provided by a specially-trained team of doctors, nurses and other specialists who work together with a patient’s other doctors to provide an extra layer of support. Palliative care is based on the needs of the patient, not on the patient’s prognosis. It is appropriate at any age and at any stage in a serious illness, and it can be provided along with curative treatment.

Paracentesis is a form of body fluid sampling procedure, generally referring to peritoneocentesis (also called laparocentesis or abdominal paracentesis) in which the peritoneal cavity is punctured by a needle to sample peritoneal fluid.

The procedure is used to remove fluid from the peritoneal cavity, particularly if this cannot be achieved with medication. The most common indication is ascites that has developed in people with cirrhosis.

Pathogenesis is the process by which a disease or disorder develops. It can include factors which contribute not only to the onset of the disease or disorder, but also to its progression and maintenance. The word comes from Greek πάθος pathos ‘suffering, disease’ and γένεσις genesis ‘creation’.

A pathologist is a medical healthcare provider who examines bodies and body tissues. He or she is also responsible for performing lab tests. A pathologist helps other healthcare providers reach diagnoses and is an important member of the treatment team.

Perihilar cholangiocarcinoma, which is a rare primary malignancy, originates from the epithelial cells of the bile duct. Usually invading the periductal tissues and the lymph nodes, perihilar cholangiocarcinoma is commonly diagnosed in the advanced stage of the disease and has a dismal prognosis.

A positron emission tomography (PET) scan is an imaging test that helps reveal how your tissues and organs are functioning. A PET scan uses a radioactive drug (tracer) to show this activity. This scan can sometimes detect disease before it shows up on other imaging tests.

Porphobilinogen is an organic compound that occurs in living organisms as an intermediate in the biosynthesis of porphyrins, which include critical substances like hemoglobin and chlorophyll. The name is often abbreviated PBG.

 

Polycystic liver disease (PLD) is an inherited disorder estimated to affect around 1 in 100,000 people. It is characterized by the progressive growth of cysts of various sizes scattered throughout the liver. People affected by this condition tend to have more and larger cysts as they age and usually start to have symptoms around age 50, although symptoms can begin to occur earlier. However, many affected individuals do not have symptoms. Enlargement of the liver (hepatomegaly) can cause abdominal pain and discomfort, shortness of breath (dyspnea), early satiety and gastro-esophageal reflux. Rare complications are hepatic cyst hemorrhage, infection or rupture. Surgical and medical treatment is available to manage the symptoms, but the only definitive treatment for this condition is liver transplant. Most cases are inherited in an autosomal dominant pattern, but some cases seem to occur with no apparent cause (sporadically). Sometimes, cysts are found in the liver in association with the presence of autosomal dominant polycystic kidney disease (ADPKD). In fact, most people who have ADPKD have liver cysts.

Polycythemia vera (pol-e-sy-THEE-me-uh VEER-uh) is a type of blood cancer. It causes your bone marrow to make too many red blood cells. These excess cells thicken your blood, slowing its flow, which may cause serious problems, such as blood clots.

Porphyria refers to a group of diseases that affect fewer than 200,000 people.  Acute Hepatic Porphyria (AHP) refers to a family of rare genetic diseases characterized by potentially life-threatening attacks and, for some people, chronic (ongoing and sometimes lifelong) pain and other symptoms that interfere in their ability to live normal lives.

There are four types of AHP:

• Acute Intermittent Porphyria (AIP – makes up 80% of all cases)
• Variegate Porphyria (VP)
• Hereditary Coproporphyria (HCP)
• ALAD Deficiency Porphyria (ADP)

AHP is a hereditary disease, meaning that it can be passed from parents to children.  This can occur if either one or both parents carry the defective gene, depending on the AHP type. Men and women inherit the disease equally as often; however, women tend to suffer symptoms more often than men.

Porphyria cutanea tarda (PCT) is a type of porphyria or blood disorder that affects the skin. PCT is one of the most common types of porphyria. It’s sometimes referred to colloquially as vampire disease. That’s because people with this condition often experience symptoms following exposure to sunlight.

Porphyrins are a group of heterocyclic macrocycle organic compounds, composed of four modified pyrrole subunits interconnected at their α carbon atoms via methine bridges (=CH−). The parent of porphyrin is porphine, a rare chemical compound of exclusively theoretical interest. Substituted porphines are called porphyrins. With a total of 26 π-electrons, of which 18 π-electrons form a planar, continuous cycle, the porphyrin ring structure is often described as aromatic. One result of the large conjugated system is that porphyrins typically absorb strongly in the visible region of the electromagnetic spectrum, i.e. they are deeply colored. The name “porphyrin” derives from the Greek word (porphyra), meaning purple.

Metal complexes derived from porphyrins occur naturally. One of the best-known families of porphyrin complexes is heme, the pigment in red blood cells, a cofactor of the protein hemoglobin.

Portal hypertension is hypertension (high blood pressure) in the hepatic portal system – made up of the portal vein and its branches, that drain from most of the intestine to the liver. Portal hypertension is defined as a hepatic venous pressure gradient. Cirrhosis (a form of chronic liver failure) is the most common cause of portal hypertension; other, less frequent causes are therefore grouped as non-cirrhotic portal hypertension. When it becomes severe enough to cause symptoms or complications, treatment may be given to decrease portal hypertension itself or to manage its complications.

The hepatic portal vein is a vessel that moves blood from the spleen and gastrointestinal tract to the liver. It is approximately three to four inches in length and is usually formed by the merging of the superior mesenteric and splenic veins behind the upper edge of the head of the pancreas.

Preeclampsia is a pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had been normal.

Primary Biliary Cholangitis (PBC) is a long-term liver disease that slowly destroys bile ducts in the liver.

Primary liver cancer is a disease in which malignant (cancer) cells form in the tissues of the liver.

Primary sclerosing cholangitis (PSC) is a long-term liver disease that slowly damages the bile ducts in the liver.

Proteins are large molecules that make sure the body’s organs function properly.

Situated nearer to the center of the body or the point of attachment.

Radiation therapy is a type of cancer treatment that uses beams of intense energy to kill cancer cells. Radiation therapy most often uses X-rays, but protons or other types of energy also can be used. The term “radiation therapy” most often refers to external beam radiation therapy.

Radioembolization is a cancer treatment in which radioactive particles are delivered to a tumor through the bloodstream. The particles lodge in the tumor and emit radiation that kills cancer cells. Radioembolization is most often used on cancers in the liver.

Radiofrequency ablation (RFA), also called radiofrequency neurotomy is a procedure that involves heating a part of a pain-transmitting nerve with a radiofrequency needle to create a heat lesion. This resulting lesion prevents the nerve from sending pain signals to the brain. RFA treatment typically provides longer-lasting pain relief compared to other therapeutic injections.

Red blood cells (RBCs), also referred to as red cells, red blood corpuscles (in humans or other animals not having nucleus in red blood cells), haematids, erythroid cells or erythrocytes (from Greek erythros for “red” and kytos for “hollow vessel”, with -cyte translated as “cell” in modern usage), are the most common type of blood cell and the vertebrate’s principal means of delivering oxygen (O2) to the body tissues—via blood flow through the circulatory system. RBCs take up oxygen in the lungs, or in fish the gills, and release it into tissues while squeezing through the body’s capillaries.

Cut out (tissue or part of an organ).

Ribavirin is an oral medication that is prescribed together with interferon for some people with hepatitis C.

This medication is used to treat diarrhea caused by the common bacteria known as E. coli (“traveler’s diarrhea”). Rifaximin should not be used if you have a fever or bloody diarrhea. It works by stopping the growth of bacteria. This antibiotic treats only bacterial infections. It will not work for viral infections (such as common cold, flu). Using any antibiotic when it is not needed can cause it to not work for future infections. Rifaximin is also used to treat irritable bowel syndrome with diarrhea. It is also used to prevent a brain problem caused by liver disease (hepatic encephalopathy). It may help you think more clearly.

In epidemiology, a risk factor or determinant is a variable associated with an increased risk of disease or infection. Determinant is often used as a synonym, due to a lack of harmonization across disciplines, in its more widely accepted scientific meaning.

See “Budd-Chiari Syndrome…”

Sarcopenia is a progressive and generalized skeletal muscle disorder involving the accelerated loss of muscle mass and function that is associated with increased adverse outcomes including falls, functional decline, frailty, and mortality.

A liver metastasis is a cancerous tumor that has spread to the liver from a cancer that started in another place in the body. It’s also called secondary liver cancer. Primary liver cancer originates in the liver and most commonly affects individuals who have risk factors such as hepatitis or cirrhosis.

Segmental resection is a surgical procedure to remove part of an organ or gland, as a sub-type of a resection, which might involve removing the whole body part. It may also be used to remove a tumor and normal tissue around it.

Septa, the plural of septum, in anatomy, a wall of tissue dividing a cavity (e.g., in the nose).

Splenomegaly is an enlargement of the spleen. The spleen usually lies in the left upper quadrant (LUQ) of the human abdomen. Splenomegaly is one of the four cardinal signs of hypersplenism which include: some reduction in number of circulating blood cells affecting granulocytes, erythrocytes or platelets in any combination; a compensatory proliferative response in the bone marrow; and the potential for correction of these abnormalities by splenectomy. Splenomegaly is usually associated with increased workload (such as in hemolytic anemias), which suggests that it is a response to hyperfunction. It is therefore not surprising that splenomegaly is associated with any disease process that involves abnormal red blood cells being destroyed in the spleen. Other common causes include congestion due to portal hypertension and infiltration by leukemias and lymphomas. Thus, the finding of an enlarged spleen, along with caput medusae, is an important sign of portal hypertension.

Spontaneous bacterial peritonitis (SBP) is the development of a bacterial infection in the peritoneum, despite the absence of an obvious source for the infection. It is specifically an infection of the ascitic fluid – an increased volume of peritoneal fluid. Ascites is most commonly a complication of cirrhosis of the liver. It can also occur in patients with nephrotic syndrome. SBP has a high mortality rate.

Performing exams and tests to learn the extent of the cancer within the body, especially whether the disease has spread from where it first formed to other parts of the body. It is important to know the stage of the disease in order to plan the best treatment.

In medicine, a stent is a metal or plastic tube inserted into the lumen of an anatomic vessel or duct to keep the passageway open, and stenting is the placement of a stent.

Steroids are medications prescribed to treat diseases caused by overactivity of the immune system such as autoimmune liver disease.

Surfactants are compounds that lower the surface tension between two liquids, between a gas and a liquid, or between a liquid and a solid. Surfactants may act as detergents, wetting agents, emulsifiers, foaming agents, or dispersants. The word “surfactant” is a blend of surface-active agent, coined c. 1950.

Sustained virologic response (SVR) is a person’s successful response to antiviral medications when a virus is not present in the blood six months after treatment is completed.

Thoracentesis is a procedure to remove fluid or air from around the lungs. A needle is put through the chest wall into the pleural space. The pleural space is the thin gap between the pleura of the lung and of the inner chest wall. The pleura is a double layer of membranes that surrounds the lungs.

Transient elastography (FibroScan) is a non-invasive method proposed for the assessment of hepatic fibrosis in patients with chronic liver disease by measuring liver stiffness. It can be easily performed at the bedside or in the outpatients clinic with immediate results and good reproducibility.

Transjugular intrahepatic portosystemic shunt (TIPS or TIPSS) is an artificial channel within the liver that establishes communication between the inflow portal vein and the outflow hepatic vein. It is used to treat portal hypertension (which is often due to liver cirrhosis) which frequently leads to intestinal bleeding, life-threatening esophageal bleeding (esophageal varices) and the buildup of fluid within the abdomen (ascites).

An interventional radiologist creates the shunt using an image-guided endovascular (via the blood vessels) approach, with the jugular vein as the usual entry site.

The procedure was first described by Josef Rösch in 1969 at Oregon Health and Science University. It was first used in a human patient by Dr. Ronald Colapinto, of the University of Toronto, in 1982, but did not become reproducibly successful until the development of endovascular stents in 1985. In 1988 the first successful TIPS was realized by M. Rössle, G.M. Richter, G. Nöldge and J. Palmaz at the University of Freiburg. The procedure has since become widely accepted as the preferred method for treating portal hypertension that is refractory to medical therapy, replacing the surgical portocaval shunt in that role.

Click here for more information about TIPS.

Triglycerides are a type of fat found in blood

Abdominal Obesity
A clinical form of obesity which is more common in men. Those with waists > 40 inches have a 3-fold > risk of high cholesterol, were 4-fold more likely to be in poor physical condition, and had a 7-fold increased risk of diabetes.

Central Obesity
Obesity defined as increased waist-to-hip and waist-to-thigh ratios, waist circumference and sagittal abdominal diameter, which is accompanied by an increased risk of cardiovascular disease.

Truncal Obesity
A body habitus where fat stored is patterned in the trunk rather than on the arms, legs, or elsewhere on the body.

A tumor is an abnormal growth of cells that form a lump.

Type 2 diabetes is an impairment in the way the body regulates and uses sugar (glucose) as a fuel. This long-term (chronic) condition results in too much sugar circulating in the bloodstream. Eventually, high blood sugar levels can lead to disorders of the circulatory, nervous and immune systems.

In type 2 diabetes, there are primarily two interrelated problems at work. Your pancreas does not produce enough insulin — a hormone that regulates the movement of sugar into your cells — and cells respond poorly to insulin and take in less sugar.

Type 2 diabetes used to be known as adult-onset diabetes, but both type 1 and type 2 diabetes can begin during childhood and adulthood. Type 2 is more common in older adults, but the increase in the number of children with obesity has led to more cases of type 2 diabetes in younger people.

There’s no cure for type 2 diabetes, but losing weight, eating well and exercising can help you manage the disease. If diet and exercise aren’t enough to manage your blood sugar, you may also need diabetes medications or insulin therapy.

Tyrosinemia is a genetic disorder characterized by disruptions in the multistep process that breaks down the amino acid tyrosine, a building block of most proteins. If untreated, tyrosine and its byproducts build up in tissues and organs, which can lead to serious health problems.

An ultrasound is an imaging technique that uses waves to see inside views of the body.

The urinary system, also known as the renal system or urinary tract, consists of the kidneys, ureters, bladder, and the urethra. The purpose of the urinary system is to eliminate waste from the body, regulate blood volume and blood pressure, control levels of electrolytes and metabolites, and regulate blood pH. The urinary tract is the body’s drainage system for the eventual removal of urine. The kidneys have an extensive blood supply via the renal arteries which leave the kidneys via the renal vein. Each kidney consists of functional units called nephrons. Following filtration of blood and further processing, wastes (in the form of urine) exit the kidney via the ureters, tubes made of smooth muscle fibers that propel urine towards the urinary bladder, where it is stored and subsequently expelled from the body by urination (voiding). The female and male urinary system are very similar, differing only in the length of the urethra.

A vaccine is a medication that stimulates the production of antibodies to protect against a specific disease.

Gastric varices are dilated submucosal veins in the lining of the stomach, which can be a life-threatening cause of bleeding in the upper gastrointestinal tract. They are most commonly found in patients with portal hypertension, or elevated pressure in the portal vein system, which may be a complication of cirrhosis. Gastric varices may also be found in patients with thrombosis of the splenic vein, into which the short gastric veins which drain the fundus of the stomach flow. The latter may be a complication of acute pancreatitis, pancreatic cancer, or other abdominal tumors, as well as hepatitis C. Gastric varices and associated bleeding are a potential complication of schistosomiasis resulting from portal hypertension.

Patients with bleeding gastric varices can present with bloody vomiting (hematemesis), dark, tarry stools (melena), or rectal bleeding. The bleeding may be brisk, and patients may soon develop shock. Treatment of gastric varices can include injection of the varices with cyanoacrylate glue, or a radiological procedure to decrease the pressure in the portal vein, termed transjugular intrahepatic portosystemic shunt or TIPS. Treatment with intravenous octreotide is also useful to shunt blood flow away from the stomach’s circulation. More aggressive treatment including splenectomy (or surgical removal of the spleen) or liver transplantation may be required in some cases.

Variegate Porphyria is a rare genetic metabolic disorder characterized by deficient function of the enzyme protoporphyrinogen oxidase (PPO or PPOX). This deficiency is caused by heterozygous mutations in the PPOX gene and leads to the accumulation of certain chemicals called porphyrins and toxic porphyrin precursors in the body, which, in turn, can potentially result in a variety of symptoms. Specific symptoms can vary greatly from one person to another. Some affected individuals present with skin symptoms, some with neurological symptoms and some with both. Blistering and fragility of sun-exposed skin are the most common skin (cutaneous) symptoms. Common neurological symptoms include abdominal pain, nausea, vomiting, constipation, extremity pain and weakness, anxiety, restlessness and convulsions. Many different PPOX mutations have been identified in different families with Variegate Porphyria. The genetic mutation in a family is inherited as an autosomal dominant trait, but many individuals who inherit a PPOX mutation do not develop any symptoms (asymptomatic).

Viral hepatitis is liver inflammation due to a viral infection. It may present in acute form as a recent infection with relatively rapid onset, or in chronic form.

The most common causes of viral hepatitis are the five unrelated hepatotropic viruses hepatitis A, B, C, D, and E. Other viruses can also cause liver inflammation, including cytomegalovirus, Epstein-Barr virus, and yellow fever. There also have been scores of recorded cases of viral hepatitis caused by herpes simplex virus.

A viral load is the amount of a virus, such as hepatitis B or hepatitis C virus, in the blood.

Xanthelasma (also known as xanthelasma palpebra) is a well-circumscribed flat or slightly elevated yellowish growth that typically occurs on or around the eyelids. It is made up of cholesterol deposits that accumulate underneath the skin and is usually an obvious clinical diagnosis.

Wilson disease is a genetic condition in which the body stores too much copper and the copper builds up in the liver.