The Hepatic Coma Syndromes and Lactulose

abnormalities action activity acute administration agents amino acids ammonia concentration ammonium amount animals appears arterial associates bacteria biochemical blood ammonia blood ammonia levels body brain cause changes chronic cirrhosis cirrhotic patients Clin clinical colon Conn controlled cycle decrease deficiency degradation determined developed disease disorders dogs dose effect elevated encephalopathy enzyme excretion Figure fluid given glucose glutamic grade hepatic coma hepatic encephalopathy hepatic failure improvement increased induced ingestion intestinal lactose lactulose less liver liver disease lower mean measured mental metabolism method monia neomycin nitrogen normal observed occurred oral pattern period plasma portal portal-systemic encephalopathy present production protein rats reduced reported response Reye's syndrome severe showed shown shunt significant similar stool stool pH studies subjects substances suggested synthesis syrup Table therapy tion toxicity tract treated treatment urea