Cirrhosis, Hepatic Encephalopathy, and Ammonium Toxicity by Richard A. Hawkins, Anke M. Mans (auth.), Santiago Grisolía,

By Richard A. Hawkins, Anke M. Mans (auth.), Santiago Grisolía, Vicente Felipo, María-Dolores Miñana (eds.)

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2. Therefore at physiological pH values, - 99% of total ammonia exists as NHl . Cirrhosis, Hepatic Encephalopathy. and Ammonium ToxicilY Edited by S. , Plenum Press, New York, 1990· 23 markedly, increasing the burden on extrahepatic tissues, such as skeletal muscle, brain, and kidney, in maintaining ammonia homeostasis. The most commonly employed animal model of human liver disease is the rat in which an end-to-side portacaval shunt (PCS) has been surgically constructed. Brain glutamine synthetase activity is not increased in PCS rats and in some areas of the brain there may even be a decrease in activity.

J. Van Den Berg (1973). A model of compartmentation in the brain based on glucose and acetate metabolism. In: Metabolic Compartmentation in the Brain, edited by R. E. Cremer. Macmillan, London, pp. 137-166. L. Hertz (1979). Functional interaction between neurons and astrocytes. 1. Turnover and metabolism of putative amino acid transmitters. Progr. Neurobiol. 13: 277-323. P. Shank and G. LeM. Campbell. a -Ketoglutarate and malate uptake and metabolism by synaptosomes. Further evidence for an astrocyte-to-neuron metabolic shuttle.

Glutamate as a neurotransmitter. In: Glutamine and Glutamate in Mammals, Vol. II. Edited by E. Kvamme. ,-Soca Raton, FL, pp. 3-19. D. Haussinger and W. Gerok (1984). Hepatocyte heterogeneity in ammonia metabolism: impairment of glutamine synthesis in CC~ induced liver cell necrosis with no effect on urea synthesis. -Biol. Interact. 48:191194. G. Perez, B. Rietberg and E. Schiff (1978). Amino acid release by isolated perfused cirrhotic liver. Life Sci. 23:2533-2538. ~A. D. Cain and G. Dickinson (1972).

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