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Investigation of ammonia metabolism in liver disease has developed in a large field, from which some significant basic and practical principles already have emerged. Methods of blood ammonia measurements have to be appraised very critically. In uncomplicated cirrhosis, the ammonia tolerance test with simultaneous measurements of arterial and venous ammonia provides a distinction between hepatic and extrahepatic ammonia metabolism; blood ammonia at different venous levels varies in relation to circulatory conditions.
Electroencephalographic changes have been related to different blood ammonia patterns obtained by ammonia loading in cirrhosis. Ammonium salts can induce coma or neurologic symptoms in cirrhotics under special predisposing
Stahl J. Genesal and Practical Significance of Ammonia in Liver Disease. Lilly Lecture.. Ann Intern Med. ;56:681. doi: 10.7326/0003-4819-56-4-681_1
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Published: Ann Intern Med. 1962;56(4):681.
Gastroenterology/Hepatology, Liver Disease.
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Print ISSN: 0003-4819 | Online ISSN: 1539-3704
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