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Clinical Observations on Hepic Jibross

Clinical Observations on Hepic Jibross Abstract The pathogenesis,* biological effects,† and reversibility ‡ of hepatic fibrosis have been extensively studied in experimental animals. Difference in structure and physiology of the liver in humans and in lower vertebrates prevents direct application of these findings to man.12 Postmortem observations § and in vivo biopsies ∥ correlated with animal experiments provide a background for additional study. This paper records further clinical observations on the histogenesis, significance, and influence of therapy on hepatic fibrosis. The study is based on serial needle biopsies of the liver correlated with clinical and biochemical abnormalities. MATERIALS AND METHODS Clinical material included 237 patients with nutritional liver disease, 41 with extrahepatic biliary obstruction, 30 with viral hepatitis, and 75 with congestive heart failure. Liver-function tests used in these patients included determination of serum bilirubin,26 serum alkaline phosphatase,27 sulfobromophthalein excretion,28 serum cholesterol and esters,29 serum albumin and globulin,30 cephalin flocculation,31 References 1. References 1-6. 2. References 7 and 8. 3. References 9-11. 4. References 13-20. 5. References 21-25. 6. References 34 and 35. 7. References 37 and 38. 8. References 40 and 41. 9. References 43-46. 10. References 47-49. 11. References 54 and 55. 12. Leevy, C. M., and Zinke, M.: Unpublished data. 13. References 58-62. 14. Himmsworth, H. P.: Lectures on the Liver and Its Diseases , Comprising the Lowell Lectures Delivered at Boston, Mass., March 1947, Cambridge, Mass., Harvard University Press, 1947. 15. György, P.: Symposium on Nutritional Disorders: The Nutritional Aspects of Liver Injury , M. Clin. North America 33:1657, 1949. 16. Hartroft, W. S., and Ridout, J. H.: Pathogenesis of Cirrhosis Produced by Choline Deficiency: Escape of Lipid from Fatty Hepatic Cysts into Biliary and Vascular Systems , Am. J. Path. 27:951, 1951. 17. Hartroft, W. S.: The Trabecular Anatomy of Late Stages of Experimental Dietary Cirrhosis , Anat. Rec. 119:71, 1954.Crossref 18. Snell, A. N.; Greene, C. H., and Roundtree, L. G.: Further Studies in Experimental Obstructive Jaundice , Arch. Int. Med. 40:471, 1927.Crossref 19. Zimmerman, H. M., and Hillsman, J. A.: Chronic Passive Congestion of the Liver: An Experimental Study , Arch. Path. 9:1154, 1930. 20. Popper, H.: Liver Disease: Morphological Considerations , Am. J. Med. 16:97, 1954.Crossref 21. Harkness, R. D.: Collagen in Regenerating Liver of the Rat , J. Physiol. 117:257, 1952. 22. Morrione, T. G.: Regression of Scar Tissue, in Second Conference on Connective Tissue, edited by C. Ragan, New York, Josiah Macy, Jr., Foundation, 1952. 23. Gillman, J.; Gilbert, C.; Gillman, T., and Spence, I.: Complete Restitution of the Liver in Rats Following Necrosis and Fibrosis of Dietary Origin , Am. J. Digest. Dis. 19:201, 1952.Crossref 24. Sellers, E. A.; Lucas, C. C., and Best, C. H.: Lipotropic Factors in Experimental Cirrhosis , Brit. M. J. 1:1061, 1948.Crossref 25. Gershbein, L.; Elias, H., and Popper, H.: Comparison of the Liver of Man, Dog and Rat , Am. J. Med. 16:906, 1954.Crossref 26. Connor, C. L.: Fatty Infiltration of Liver and Development of Cirrhosis in Diabetes and Chronic Alcoholism , Am. J. Path. 14:347, 1938. 27. Moschcowitz, E.: Pathogenesis of Laennec's Cirrhosis with Special Reference to Angiogenesis , Arch. Path. 45:187, 1948. 28. Moschcowitz, E.: Morphology and Pathogenesis of Biliary Cirrhosis , A. M. A. Arch. Path. 54:259, 1952. 29. Moschcowitz, E.: The Morphology and Pathogenesis of Cardiac Fibrosis of the Liver , Ann. Int. Med. 36:933, 1952.Crossref 30. Popper, H.; Szanto, P. R., and Elias, H.: Transition of Fatty Liver into Cirrhosis , Gastroenterology 28:183, 1955. 31. Popper, H., and Elias, H.: Histogenesis of Hepatic Cirrhosis Studied by the 3-Dimensional Approach , Am. J. Path. 31:405, 1955. 32. Moon, V. A.: Histogenesis of Atropic Cirrhosis , Arch. Path. 13:691, 1932. 33. Karsner, H. T.: Morphology and Pathogenesis of Hepatic Cirrhosis , Am. J. Clin. Path. 13:569, 1943. 34. Leevy, C. M.; Zinke, M. R.; White, T. J., and Gnassi, A. M.: Clinical Observations on the Fatty Liver , A. M. A. Arch. Int. Med. 92:527, 1953.Crossref 35. Leevy, C. M.; Dvorschak, C. K., and Gnassi, A. M.: The Liver in Extrahepatic Biliary Obstruction , Am. J. M. Sc. 227:272, 1954.Crossref 36. Sherlock, S.: The Liver in Heart Failure: Relations of Anatomical Functional and Circulatory Changes , Brit. Heart J. 13:273, 1951.Crossref 37. White, T. J.; Leevy, C. M.; Brusca, A. M., and Gnassi, A. M.: The Liver in Congestive Heart Failure , Am. Heart J. 49:250, 1955.Crossref 38. Leevy, C. M.; Fialkowski, L., and Gnassi, A. M.: Clinical Variants of Viral Hepatitis , J. M. Soc. New Jersey 52:237, 1955. 39. Malloy, H. T., and Evelyn, K. A.: Determination of Bilirubin with Photoelectric Colorimeter , J. Biol. Chem. 119:481, 1937. 40. Bodansky, A.: Phosphatase Studies: Determination of Serum Phosphatase; Factors Influencing Accuracy of Determination , J. Biol. Chem. 101:93, 1933. 41. MacDonald, D.: Practical and Clinical Test for Liver Reserve , Surg., Gynec. & Obst. 69:70, 1939. 42. Bloor, V. R., and Knudson, A.: The Separate Determination of Cholesterol and Cholesterol Esters in Small Amounts of Blood , J. Biol. Chem. 27:107, 1916. 43. Campbell, W. R., and Hanna, M. I.: Albumin, Globulins and Fibrinogen of Serum and Plasma , J. Biol. Chem. 119:15, 1937. 44. Hanger, F. M.: Flocculation of Cephalin Cholesterol Emulsion by Pathological Sera , Tr. A. Am. Physicians 53:148, 1938. 45. MacLagan, N. F.: Thymol Turbidity Test: New Indicator of Liver Dysfunction , Brit. J. Exper. Path. 25:234, 1944. 46. Quick, A. J.: The Hemorrhagic Diseases and the Physiology of Hemostasis , Springfield, Ill., Charles C Thomas, Publisher, 1942. 47. Kinsell, L. W.; Michaels, G. D.; Weiss, R. A., and Barton, H. C., Jr.: Studies in Hepatic Glycogen Storage: I. Adrenalin-Induced Hyper- glycemia as an Index of Liver Function , Am. J. M. Sc. 217:554, 1949. 48. Leevy, C. M.; O'Connell, W., and White, T. J.: Carbohydrate Disturbances in Liver Disease , J. M. Soc. New Jersey 50:44, 1953. 49. White, T. J.; Leevy, C. M.; Kemp, N. F.; Gnassi, A. M., and Price, H. P.: Needle Biopsy of the Liver: A Critical Evaluation , J. M. Soc. New Jersey 46:549, 1949. 50. Gomori, G.: A Rapid One-Step Trichrome Stain , Am. J. Clin. Path. 20:661, 1950. 51. Lillie, R. D.: Histopathologic Technic , Philadelphia, The Blakiston Company, 1948. 52. Leevy, C. M.; Zinke, M. R.; White, T. J., and Gnassi, A. M.: Prognosis in Nutritional Cirrhosis, to be published. 53. Rappaport, A. M.; Borowy, Z. J.; Lougheed, W. M., and Lotto, W. N.: Subdivision of Hexagonal Liver Lobule into a Structural and Functional Unit , Anat. Rec. 119:11, 1954. 54. Elias, H.: A Re-Examination of Structure of Mammalian Liver: Hepatic Lobule and Its Relation to Vascular and Biliary Systems , Anat. Rec. 85:379, 1949. 55. Hill, K. R.; Rhodes, K.; Stafford, J. L., and Aub, R.: Serous Hepatosis: A Pathogenesis of Hepatic Fibrosis in Jamaican Children , Brit. M. J. 1:117, 1953. 56. Maximow, A. A., and Bloom, W.: A Text Book of Histology , Philadelphia, W. B. Saunders Company, 1952. 57. Ragan, C.: The Physiology of Connective Tissue , Ann. Rev. Physiol. 14:51, 1952. 58. Downey, H.: The Development of Histocytes and Macrophages from Lymphocytes , J. Lab. & Clin. Med. 45:499, 1955. 59. Carrel, A., and Ebeling, A. H.: The Fundamental Properties of the Fibroblasts and the Macrophage: I. The Fibroblast , J. Exper. Med. 44:261, 1926. 60. Porter, K. R.: Repair Processes in Connective Tissues, in Transactions of the Second Conference on Connective Tissue, May 24-25, 1951, edited by C. Ragan, New York, Josiah Macy, Jr., Foundation, 1952. 61. Gersh, I., and Catchpole, H. R.: The Organization of Ground Substance and Basement Membrane and Its Significance in Tissue Injury, Disease and Growth , Am. J. Anat. 85:457, 1949.Crossref 62. Klemperer, P.: The Concept of Collagen Diseases , Am. J. Path. 26:505, 1950. 63. Leibowitz, S., and Brody, H.: Cirrhosis of the Liver Following Infectious Mononucleosis , Am. J. Med. 8:675, 1950.Crossref 64. McCullough, N. B., and Eisele, C. W.: Brucella Hepatitis Leading to Cirrhosis of the Liver , A. M. A. Arch. Int. Med. 88:793, 1951.Crossref 65. Shay, H.; Berk, J. E.; Sones, M.; Aegerter, E. E.; Weston, J. H., and Adams, A. B.: The Liver in Sarcoidosis , Gastroenterology 19:441, 1951. 66. Colsky, J.; Greenspan, E. M., and Warren, T. N.: Hepatic Fibrosis in Children with Acute Leukemia After Therapy with Folic Acid Antagonists , A. M. A. Arch. Path. 59:198, 1955. 67. Post, J., and Rose, J. V.: Clinical Functional and Histologic Studies in Laennec's Cirrhosis of the Liver , Am. J. Med. 8:300, 1950.Crossref 68. Kinsell, L. W.; Weiss, H. A.; Michaels, G. D.; Shaver, J. S., and Barton, H. C.: The Correlation of Hepatic Structure and Function , Am. J. Med. 6:292, 1949.Crossref 69. Leevy, C. M.; Cunniff, C. L.; Walton, D., and Healey, M.: Organization and Function of a Clinic for the Chronic Alcoholic Patient with Liver Disease: I. Effect of Rehabilitation on Hepatic Abnormalities , Quart. J. Stud. Alcohol 15:537, 1954. 70. Warren, S., and Wahi, P. N.: Quantitation Estimation of the Fibrous Tissue in the Pathological Liver , Arch. Path. 44:563, 1947. 71. Patek, A. J., Jr.; Post, J.; Ratnoff, O. D.; Mankin, H., and Hillman, R. W.: Dietary Treatment of Cirrhosis of the Liver: Results in 124 Patients Observed During a 10-Year Period , J. A. M. A. 138:543, 1948.Crossref 72. Morrison, L. M.: New Methods of Therapy in Cirrhosis of the Liver , J. A. M. A. 13:4673, 1947. 73. Eisenmenger, W. J.: Role of Sodium in Formation and Control of Ascites in Patients with Cirrhosis , Ann. Int. Med. 37:261, 1952.Crossref 74. Reynolds, T. B.; Freedman, T., and Winsor, W.: Results of the Treatment of Bleeding Esophageal Varices with Balloon Tamponage , Am. J. M. Sc. 224:500, 1952.Crossref 75. Butt, H. R.; Amatuzio, D. S.; Bollman, J. L.; Gabuzda, G. J.; Giges, B.; Sborov, V. M., and Seligson, D.: Panel Discussion: The Clinical and Biochemical Features of Hepatic Insufficiency , Gastroenterology 25:471, 1953. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png A.M.A. Archives of Internal Medicine American Medical Association

Clinical Observations on Hepic Jibross

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References (74)

Publisher
American Medical Association
Copyright
Copyright © 1955 American Medical Association. All Rights Reserved.
ISSN
0888-2479
DOI
10.1001/archinte.1955.00250150081009
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Abstract

Abstract The pathogenesis,* biological effects,† and reversibility ‡ of hepatic fibrosis have been extensively studied in experimental animals. Difference in structure and physiology of the liver in humans and in lower vertebrates prevents direct application of these findings to man.12 Postmortem observations § and in vivo biopsies ∥ correlated with animal experiments provide a background for additional study. This paper records further clinical observations on the histogenesis, significance, and influence of therapy on hepatic fibrosis. The study is based on serial needle biopsies of the liver correlated with clinical and biochemical abnormalities. MATERIALS AND METHODS Clinical material included 237 patients with nutritional liver disease, 41 with extrahepatic biliary obstruction, 30 with viral hepatitis, and 75 with congestive heart failure. Liver-function tests used in these patients included determination of serum bilirubin,26 serum alkaline phosphatase,27 sulfobromophthalein excretion,28 serum cholesterol and esters,29 serum albumin and globulin,30 cephalin flocculation,31 References 1. References 1-6. 2. References 7 and 8. 3. References 9-11. 4. References 13-20. 5. References 21-25. 6. References 34 and 35. 7. References 37 and 38. 8. References 40 and 41. 9. References 43-46. 10. References 47-49. 11. References 54 and 55. 12. Leevy, C. M., and Zinke, M.: Unpublished data. 13. References 58-62. 14. Himmsworth, H. P.: Lectures on the Liver and Its Diseases , Comprising the Lowell Lectures Delivered at Boston, Mass., March 1947, Cambridge, Mass., Harvard University Press, 1947. 15. György, P.: Symposium on Nutritional Disorders: The Nutritional Aspects of Liver Injury , M. Clin. North America 33:1657, 1949. 16. Hartroft, W. S., and Ridout, J. H.: Pathogenesis of Cirrhosis Produced by Choline Deficiency: Escape of Lipid from Fatty Hepatic Cysts into Biliary and Vascular Systems , Am. J. Path. 27:951, 1951. 17. Hartroft, W. S.: The Trabecular Anatomy of Late Stages of Experimental Dietary Cirrhosis , Anat. Rec. 119:71, 1954.Crossref 18. Snell, A. N.; Greene, C. H., and Roundtree, L. G.: Further Studies in Experimental Obstructive Jaundice , Arch. Int. Med. 40:471, 1927.Crossref 19. Zimmerman, H. M., and Hillsman, J. A.: Chronic Passive Congestion of the Liver: An Experimental Study , Arch. Path. 9:1154, 1930. 20. Popper, H.: Liver Disease: Morphological Considerations , Am. J. Med. 16:97, 1954.Crossref 21. Harkness, R. D.: Collagen in Regenerating Liver of the Rat , J. Physiol. 117:257, 1952. 22. Morrione, T. G.: Regression of Scar Tissue, in Second Conference on Connective Tissue, edited by C. Ragan, New York, Josiah Macy, Jr., Foundation, 1952. 23. Gillman, J.; Gilbert, C.; Gillman, T., and Spence, I.: Complete Restitution of the Liver in Rats Following Necrosis and Fibrosis of Dietary Origin , Am. J. Digest. Dis. 19:201, 1952.Crossref 24. Sellers, E. A.; Lucas, C. C., and Best, C. H.: Lipotropic Factors in Experimental Cirrhosis , Brit. M. J. 1:1061, 1948.Crossref 25. Gershbein, L.; Elias, H., and Popper, H.: Comparison of the Liver of Man, Dog and Rat , Am. J. Med. 16:906, 1954.Crossref 26. Connor, C. L.: Fatty Infiltration of Liver and Development of Cirrhosis in Diabetes and Chronic Alcoholism , Am. J. Path. 14:347, 1938. 27. Moschcowitz, E.: Pathogenesis of Laennec's Cirrhosis with Special Reference to Angiogenesis , Arch. Path. 45:187, 1948. 28. Moschcowitz, E.: Morphology and Pathogenesis of Biliary Cirrhosis , A. M. A. Arch. Path. 54:259, 1952. 29. Moschcowitz, E.: The Morphology and Pathogenesis of Cardiac Fibrosis of the Liver , Ann. Int. Med. 36:933, 1952.Crossref 30. Popper, H.; Szanto, P. R., and Elias, H.: Transition of Fatty Liver into Cirrhosis , Gastroenterology 28:183, 1955. 31. Popper, H., and Elias, H.: Histogenesis of Hepatic Cirrhosis Studied by the 3-Dimensional Approach , Am. J. Path. 31:405, 1955. 32. Moon, V. A.: Histogenesis of Atropic Cirrhosis , Arch. Path. 13:691, 1932. 33. Karsner, H. T.: Morphology and Pathogenesis of Hepatic Cirrhosis , Am. J. Clin. Path. 13:569, 1943. 34. Leevy, C. M.; Zinke, M. R.; White, T. J., and Gnassi, A. M.: Clinical Observations on the Fatty Liver , A. M. A. Arch. Int. Med. 92:527, 1953.Crossref 35. Leevy, C. M.; Dvorschak, C. K., and Gnassi, A. M.: The Liver in Extrahepatic Biliary Obstruction , Am. J. M. Sc. 227:272, 1954.Crossref 36. Sherlock, S.: The Liver in Heart Failure: Relations of Anatomical Functional and Circulatory Changes , Brit. Heart J. 13:273, 1951.Crossref 37. White, T. J.; Leevy, C. M.; Brusca, A. M., and Gnassi, A. M.: The Liver in Congestive Heart Failure , Am. Heart J. 49:250, 1955.Crossref 38. Leevy, C. M.; Fialkowski, L., and Gnassi, A. M.: Clinical Variants of Viral Hepatitis , J. M. Soc. New Jersey 52:237, 1955. 39. Malloy, H. T., and Evelyn, K. A.: Determination of Bilirubin with Photoelectric Colorimeter , J. Biol. Chem. 119:481, 1937. 40. Bodansky, A.: Phosphatase Studies: Determination of Serum Phosphatase; Factors Influencing Accuracy of Determination , J. Biol. Chem. 101:93, 1933. 41. MacDonald, D.: Practical and Clinical Test for Liver Reserve , Surg., Gynec. & Obst. 69:70, 1939. 42. Bloor, V. R., and Knudson, A.: The Separate Determination of Cholesterol and Cholesterol Esters in Small Amounts of Blood , J. Biol. Chem. 27:107, 1916. 43. Campbell, W. R., and Hanna, M. I.: Albumin, Globulins and Fibrinogen of Serum and Plasma , J. Biol. Chem. 119:15, 1937. 44. Hanger, F. M.: Flocculation of Cephalin Cholesterol Emulsion by Pathological Sera , Tr. A. Am. Physicians 53:148, 1938. 45. MacLagan, N. F.: Thymol Turbidity Test: New Indicator of Liver Dysfunction , Brit. J. Exper. Path. 25:234, 1944. 46. Quick, A. J.: The Hemorrhagic Diseases and the Physiology of Hemostasis , Springfield, Ill., Charles C Thomas, Publisher, 1942. 47. Kinsell, L. W.; Michaels, G. D.; Weiss, R. A., and Barton, H. C., Jr.: Studies in Hepatic Glycogen Storage: I. Adrenalin-Induced Hyper- glycemia as an Index of Liver Function , Am. J. M. Sc. 217:554, 1949. 48. Leevy, C. M.; O'Connell, W., and White, T. J.: Carbohydrate Disturbances in Liver Disease , J. M. Soc. New Jersey 50:44, 1953. 49. White, T. J.; Leevy, C. M.; Kemp, N. F.; Gnassi, A. M., and Price, H. P.: Needle Biopsy of the Liver: A Critical Evaluation , J. M. Soc. New Jersey 46:549, 1949. 50. Gomori, G.: A Rapid One-Step Trichrome Stain , Am. J. Clin. Path. 20:661, 1950. 51. Lillie, R. D.: Histopathologic Technic , Philadelphia, The Blakiston Company, 1948. 52. Leevy, C. M.; Zinke, M. R.; White, T. J., and Gnassi, A. M.: Prognosis in Nutritional Cirrhosis, to be published. 53. Rappaport, A. M.; Borowy, Z. J.; Lougheed, W. M., and Lotto, W. N.: Subdivision of Hexagonal Liver Lobule into a Structural and Functional Unit , Anat. Rec. 119:11, 1954. 54. Elias, H.: A Re-Examination of Structure of Mammalian Liver: Hepatic Lobule and Its Relation to Vascular and Biliary Systems , Anat. Rec. 85:379, 1949. 55. Hill, K. R.; Rhodes, K.; Stafford, J. L., and Aub, R.: Serous Hepatosis: A Pathogenesis of Hepatic Fibrosis in Jamaican Children , Brit. M. J. 1:117, 1953. 56. Maximow, A. A., and Bloom, W.: A Text Book of Histology , Philadelphia, W. B. Saunders Company, 1952. 57. Ragan, C.: The Physiology of Connective Tissue , Ann. Rev. Physiol. 14:51, 1952. 58. Downey, H.: The Development of Histocytes and Macrophages from Lymphocytes , J. Lab. & Clin. Med. 45:499, 1955. 59. Carrel, A., and Ebeling, A. H.: The Fundamental Properties of the Fibroblasts and the Macrophage: I. The Fibroblast , J. Exper. Med. 44:261, 1926. 60. Porter, K. R.: Repair Processes in Connective Tissues, in Transactions of the Second Conference on Connective Tissue, May 24-25, 1951, edited by C. Ragan, New York, Josiah Macy, Jr., Foundation, 1952. 61. Gersh, I., and Catchpole, H. R.: The Organization of Ground Substance and Basement Membrane and Its Significance in Tissue Injury, Disease and Growth , Am. J. Anat. 85:457, 1949.Crossref 62. Klemperer, P.: The Concept of Collagen Diseases , Am. J. Path. 26:505, 1950. 63. Leibowitz, S., and Brody, H.: Cirrhosis of the Liver Following Infectious Mononucleosis , Am. J. Med. 8:675, 1950.Crossref 64. McCullough, N. B., and Eisele, C. W.: Brucella Hepatitis Leading to Cirrhosis of the Liver , A. M. A. Arch. Int. Med. 88:793, 1951.Crossref 65. Shay, H.; Berk, J. E.; Sones, M.; Aegerter, E. E.; Weston, J. H., and Adams, A. B.: The Liver in Sarcoidosis , Gastroenterology 19:441, 1951. 66. Colsky, J.; Greenspan, E. M., and Warren, T. N.: Hepatic Fibrosis in Children with Acute Leukemia After Therapy with Folic Acid Antagonists , A. M. A. Arch. Path. 59:198, 1955. 67. Post, J., and Rose, J. V.: Clinical Functional and Histologic Studies in Laennec's Cirrhosis of the Liver , Am. J. Med. 8:300, 1950.Crossref 68. Kinsell, L. W.; Weiss, H. A.; Michaels, G. D.; Shaver, J. S., and Barton, H. C.: The Correlation of Hepatic Structure and Function , Am. J. Med. 6:292, 1949.Crossref 69. Leevy, C. M.; Cunniff, C. L.; Walton, D., and Healey, M.: Organization and Function of a Clinic for the Chronic Alcoholic Patient with Liver Disease: I. Effect of Rehabilitation on Hepatic Abnormalities , Quart. J. Stud. Alcohol 15:537, 1954. 70. Warren, S., and Wahi, P. N.: Quantitation Estimation of the Fibrous Tissue in the Pathological Liver , Arch. Path. 44:563, 1947. 71. Patek, A. J., Jr.; Post, J.; Ratnoff, O. D.; Mankin, H., and Hillman, R. W.: Dietary Treatment of Cirrhosis of the Liver: Results in 124 Patients Observed During a 10-Year Period , J. A. M. A. 138:543, 1948.Crossref 72. Morrison, L. M.: New Methods of Therapy in Cirrhosis of the Liver , J. A. M. A. 13:4673, 1947. 73. Eisenmenger, W. J.: Role of Sodium in Formation and Control of Ascites in Patients with Cirrhosis , Ann. Int. Med. 37:261, 1952.Crossref 74. Reynolds, T. B.; Freedman, T., and Winsor, W.: Results of the Treatment of Bleeding Esophageal Varices with Balloon Tamponage , Am. J. M. Sc. 224:500, 1952.Crossref 75. Butt, H. R.; Amatuzio, D. S.; Bollman, J. L.; Gabuzda, G. J.; Giges, B.; Sborov, V. M., and Seligson, D.: Panel Discussion: The Clinical and Biochemical Features of Hepatic Insufficiency , Gastroenterology 25:471, 1953.

Journal

A.M.A. Archives of Internal Medicine – American Medical Association

Published: Oct 1, 1955

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