Hepatobiliary system

Technetium-99m teboroxime is a myocardial imaging agent and is excreted primarily by the hepatobiliary system. It is rapidly taken up by the myocardium and mosdy washes out within 30 minutes. Imaging protocols are performed immediately after injection. The product is a lyopbili ed mixture of boronic acid, dioxine, and other excipients, and the agent is formed with a beating step. 

Liver Gadolinium EOB DTPA Primovist MRI product, not approved for CT phase I, II clinical trials Uptake into hepatocytes Schmitz SA et al (1997) Detection of focal liver lesions CT of the hepatobiliary system with gadoxetic acid disodium, or Gd-EOB-DTPA. Radiology 2002 399-405... 

DSA 55-60 mg As 5 per kg ration for 8-12 weeks Elevated accumulations in tissues adverse effects on hepatobiliary system 20... 

While most lipophilic and large molecules are primarily excreted by the hepatobiliary system, the kidney is the major excretory organ for many small organic and inorganic molecules, drugs and hydrophilic metabolites, maintenance of fluid balance, and bone metabolism. These functions expose the kidney to a number of clinical, physiological, and pathological conditions that may compromise renal function. Some renal disorders that necessitate clinical intervention are listed in Table 2. 

Bexarotene is a member of a subclass of retinoids that selectively activate rehnoid X receptors (RXRs). These retinoid receptors have biologic activity distinct from that of rehnoic acid receptors (RARs). After oral administration bexarotene is rapidly absorbed. Bexarotene is thought to be eliminated primarily through the hepatobiliary system. It is approved for the treatment of cutaneous T-cell lymphoma in patients who are refractory to at least one prior systemic therapy. Adverse events possibly related to treatment are lipid abnormalities, hypothyroidism, rash, and blood dyscrasias. 

Bexarotene is available in oral and topical formulations. Peak plasma levels are achieved within 2 hours of oral administration, although higher levels are obtained when the drug is ingested with a fatty meal. It is thought to be metabolized primarily by the hepatobiliary system, with a terminal half-life of approximately 7 hours. 

Stiehl, A, W. Gerok, and G. Paumgartner Falk Symposium Staff, Bile Acids and the Hepatobiliary System-from Basic Science to Clinical Practice, Proceedings of the 68ih Gaik Symposium Held in Basel, Switzerland, Kluwer Academic Publishers, Norwell, MA, 1993. 

Schuhmann-Giampieri, G, Schmitt-Willich, H., Press, W.R., etal. (1992) PrecUnical evaluation of Gd-EOB-DTPA as a contrast agent in MR imaging of the hepatobiliary system. Radiology, 183, 59-64. 

The determination of urobilinogen based on the aldehyde reaction (which is non-specific for urobilinogen) was established by P. Ehrlich (1901). Excretion of urobilinogen in the urine is influenced by a number of factors. Since urobilinogenuria only occurs in relatively serious disorders of the hepatobiliary system, it is only of minor diagnostic relevance. A lack of urobilinogen in the urine in the presence of jaundice points to complete obstructive jaundice. Even after total cessation of bile production due to severe liver disease or destruction of the intestinal flora, urobilinogen may also be absent, (s. fig. 5.3) (s. tab. 5.8)... 

Various tumourous and pseudotumourous foci may form in the area of the liver and the hepatobiliary system. Differential diagnosis may therefore become challenging. A definitive diagnosis is, however, necessary to be able to initiate therapeutic measures and to establish a prognosis. 

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