You are here:
Biology
Liver Biopsy - Hirokazu Takahashi, 404 Pages
- Liver biopsy is recommended as the gold standard method to determine diagnosis, fibrosis staging, prognosis and therapeutic indications in patients with chronic liver disease. However, liver biopsy is an invasive procedure with a risk of complications which can be serious. This book provides the management of the complications in liver biopsy. Additionally, this book provides also the references for the new technology of liver biopsy including the non-invasive elastography, imaging methods and blood panels which could be the alternatives to liver biopsy. The non-invasive methods, especially the elastography, which is the new procedure in hot topics, which were frequently reported in these years. In this book, the professionals of elastography show the mechanism, availability and how to use this technology in a clinical field of elastography. The comprehension of elastography could be a great help for better dealing and for understanding of liver biopsy.- Liver biopsy is still the most accurate tool to assess liver histopathology in chronic liver disease (CLD), especially in patients with chronic active hepatitis who need a treatment decision. Nowadays, there are many non-invasive methods are being used to assess liver fibrosis and might replace liver biopsy. One of the new methods is transient elastography (TE/Fibroscan) which has been widely used to predict liver fibrosis in chronic active hepatitis B and C. However, whether TE is ready to replace the liver biopsy is still controversial. In cases like chronic hepatitis B infection (CHB), autoimmune hepatitis (AIH), non-alcoholic steatohepatitis (NASH), drug induced liver injury (DILI), and cholestatic liver diseases, the role of liver biopsy is very important to make the whole information of liver histopathology (not only about liver fibrosis). On the other hand, to make a diagnosis of liver cirrhosis, we have some parameters that can be used, such as clinical stigmata of advanced chronic liver disease (jaundice, hyper pigmentation, spider nevi, palmar erythema, ascites, edema, and others), low level of platelet count, and low level of albumin, prolonged protombin time, and picture of liver cirrhosis based on ultrasound examination. In chronic active hepatitis B infection, the treatment decision is usually based on the increase level of alanine minotransferase (ALT), high HBV-DNA serum level, and the presence of HBeAg status. In patients with normal ALT level or less than 2x ULN, the liver biopsy is needed to decide whether the antiviral therapy should be started or not. In this group, not only liver fibrosis assessment is important, but also the degree of necroinflammation will influence the decision of antiviral therapy. From the point of view of liver fibrosis itself when using TE, it is not always accurate to differentiate between fibrosis 1 or 2, since this differentiation is also important to start antiviral therapy. Despite the etiology of liver injury, TE itself has problem with overweight and obese patients, and patients with narrowed intercostals space. TE also cannot be performed in ascitic patient because the interposed fluid blocks the shear wave. The increase of liver stiffness cut off is also can be influenced by metabolic syndrome, age, BMI, and the increase of ALT level. The liver biopsy still has the most important role in assessing liver histopathology but we might reduce the need of liver biopsy examination in some patients. At this moment, TE can be used as a predictor tool in assessing liver fibrosis in chronic active hepatitis with regard to clinical and laboratory parameters. A lot of study is still needed to validate the usefulness of TE in assessing liver fibrosis in chronic active hepatitis.
| Nguồn | : Internet |
| Tác giả | : Hirokazu Takahashi, |
| Kiểu tập tin | |
| Độ lớn tập tin | : 41MB |
| Đăng bởi | : Thanh Ngoc |
| Cập nhật | : 28.10.2011 |
| Số lượt xem | : 372 |
| Số lượt tải | : 2 |
Bạn phải đăng nhập mới có thể download
Các tin liên quan mới nhất:
- Virology Principles and Applications by John Carter | V. Saunders, 383 Pages 12.05.2012
- Clinical Nutrition in Practice by Nikolaos Katsilambros, 232 Pages 18.12.2011
- Efficient Decision Support Systems: Challenges From Current to Future, 542 Pages 22.10.2011
- DNA Repair: On the Pathways to Fixing DNA Damage and Errors, 380 Pages 22.10.2011
- Genetic Transformation - María Alvarez, 328 Pages 21.10.2011
- Artificial Insemination in Farm Animals – Milad Manafi, 300 Pages 22.08.2011
- Plant Sciences: Macmillan Science Library - Richard Robinson, 768 Pages 09.05.2011
- Primate Neuroethology 1st Edition - Michael Platt, 688 Pages 09.05.2011
- Kingdoms and Domains, 4th Edition - Lynn Margulis, 659 Pages 01.05.2011
- Life: The Science of Biology, 7th Edition - William K. Purves, 1121 Pages 01.05.2011
Các tin trước đó:
- Efficient Decision Support Systems: Challenges From Current to Future, 542 Pages 22.10.2011
- DNA Repair: On the Pathways to Fixing DNA Damage and Errors, 380 Pages 22.10.2011
- Genetic Transformation - María Alvarez, 328 Pages 21.10.2011
- Artificial Insemination in Farm Animals – Milad Manafi, 300 Pages 22.08.2011
- Plant Sciences: Macmillan Science Library - Richard Robinson, 768 Pages 09.05.2011
- Primate Neuroethology 1st Edition - Michael Platt, 688 Pages 09.05.2011
- Kingdoms and Domains, 4th Edition - Lynn Margulis, 659 Pages 01.05.2011
- Life: The Science of Biology, 7th Edition - William K. Purves, 1121 Pages 01.05.2011
- The Cambridge Dictionary of Human Biology and Evolution, 668 Pages 27.04.2011
- Animal Welfare: Competing Conceptions and Their Ethical Implications 27.04.2011
Thành Viên
Bùi Nhã Quyên748
NGUYEN Tuan Anh680
nguyen tran thuy trang666
momo momox654
Vinh Bui649
vuabongda85646
Pham Thi Hoang Anh625
trần anh thụ624
dmt618
Nguyễn Hồng Ánh617
SANG TRUONG399
Hoàng Văn Hải383
Vũ Mạnh Dũng342
Pham Dinh Lam335
HAI VAN328
nam tang322
william hoang322
Nguyễn Nhiên317
Lam Trinh313
nguyen uyen311
thanhagg098303
Bui Duc Chung289
Garu286
Long Khong262
Tran Thuy Bang Chau238
Đinh Hiệp Dũng228
David Phan223
Nguyen Xuan Dung212
Thanh Nhu203
Traihai4196
Phan Anh Tu175
Nguyễn Văn Nam174
Kyou167
Trần Thanh Tùng155
Chuoichat150
Huỳnh Thị Kim Mai150
minh vong149
Phan Phương Thảo139
Dang Bac137
Dai Co Viet135
Hứa Văn Thành135
Nguyen Van An130
anhlt08104129
Long Nguyen127
Hung Nguyen126
Le Phuong Thao126
vu thang116
funny_hippo115
nguyen thanh khai112
minhquan108
ngaymoi105
Den Ngoc Son103
Lê Hữu Ngọc90
Trần Châu Tâm87
Nguyễn Canh Thân75
Tuan Tran73
Nguyễn Thị Ngọc Hạnh57
Campos Hector54
truong lam45
lê hoàng việt45
Quoc Thai45
QUANG VAN LE45
lien36
BIEN XUAN DUNG35
Ta Tri Nhan35
phan duc be33
Pham Thanh Tan25
Ngo Duc Mau25
Thanh An23
panyucheng22
thien15
Huỳnh Uyên Vũ15
Nguyen Van Minh14
Tra Thi My Phuong14
võ phạm trưuờng an12
Hà San12
inguyentri11
Nguyễn Thị Kim Vân11
Nguyen Mai Tu Oanh7
thuygiang6
Hướng5
Nguyen Thi Thuy2
Lê Đình Thuận1
tran long1
Nghĩa Hưng1
ta thi lan1
lehoang1
Trần Thị Lan1
Thiên Kim1
Võ Văn Thiện1
trang1
Minh Duc1
Trần Hồng Phúc1
lekinhquoc1
nguyễn chí công1
NGUYỄN VĂN LỤC1
Lưu Thị Phương Liên1
dao dinh tuan1
long do1
le van tan1
Hỗ trợ trực tuyến
Mr Hạnh
ĐT: 0944.625.325
Lịch Vạn Niên
Phần mềm hỗ trợ
Hiện có 13532 khách và 137 thành viên Trực tuyến
