Mechanical Animals was a worldwide tour by the band Marilyn Manson in support of their third LP record Mechanical Animals , released on September 15, 1998. The tour extended from late 1998 to early 1999 and was recorded in 1998 for the VHS -format God is in the TV which was released on November 2, 1999.
108-455: The Mechanical Animals European Festival Tour was supposed to be the first leg of the tour. This particular leg of the tour consisted of six dates to be played at various European festivals planned as the debut of follow-up material to Antichrist Superstar two months before the release of Mechanical Animals. This leg of the tour spanned from June 25, 1998, until July 12, 1999. Reportedly, drummer Ginger Fish became ill with mononucleosis . This led
216-426: A benign tumour the most common type of liver tumour, thought to be congenital. A genetic disorder causing multiple cysts to form in the liver tissue, usually in later life, and usually asymptomatic, is polycystic liver disease . Diseases that interfere with liver function will lead to derangement of these processes. However, the liver has a great capacity to regenerate and has a large reserve capacity. In most cases,
324-410: A dual blood supply from the hepatic portal vein and hepatic arteries. The hepatic portal vein delivers around 75% of the liver's blood supply and carries venous blood drained from the spleen, gastrointestinal tract, and its associated organs. The hepatic arteries supply arterial blood to the liver, accounting for the remaining quarter of its blood flow. Oxygen is provided from both sources; about half of
432-400: A form of autoimmune hemolytic anemia . The cold agglutinin detected is of anti-i specificity. The disease is diagnosed based on: The presence of an enlarged spleen , and swollen posterior cervical , axillary , and inguinal lymph nodes are the most useful to suspect a diagnosis of infectious mononucleosis. On the other hand, the absence of swollen cervical lymph nodes and fatigue are
540-408: A key role in this phenomenon. At birth, the liver comprises roughly 4% of body weight and weighs on average about 120 g (4 oz). Over the course of further development, it will increase to 1.4–1.6 kg (3.1–3.5 lb) but will only take up 2.5–3.5% of body weight. Hepatosomatic index (HSI) is the ratio of liver weight to body weight. In the growing fetus, a major source of blood to
648-678: A member of the Herpesviridae family of DNA viruses . It is one of the most commonly found viruses throughout the world. Contrary to common belief, the Epstein–Barr virus is not highly contagious. It can only be contracted through direct contact with an infected person's saliva , such as through kissing or sharing toothbrushes. About 95% of the population has been exposed to this virus by the age of 40, but only 15–20% of teenagers and about 40% of exposed adults actually develop infectious mononucleosis. About 5–7% of cases of infectious mononucleosis
756-515: A planned performance at the Landmark Theatre in Syracuse, New York , local activists began calling for a cancellation of the engagement. According to Associated Press , then-Syracuse Mayor Roy Bernardi attempted to block the venue's permit, citing a "moral obligation to the people of Syracuse", without specifying any reason for his objections. Onondaga County officials also attempted to extort
864-410: A population of the bipotential hepatoblasts. Hepatic stellate cells are derived from mesenchyme. After migration of hepatoblasts into the septum transversum mesenchyme, the hepatic architecture begins to be established, with liver sinusoids and bile canaliculi appearing. The liver bud separates into the lobes. The left umbilical vein becomes the ductus venosus and the right vitelline vein becomes
972-409: A role in the production of clotting factors, as well as red blood cell production. Some of the proteins synthesized by the liver include coagulation factors I (fibrinogen), II (prothrombin), V , VII , VIII , IX , X , XI , XII , XIII , as well as protein C , protein S and antithrombin . The liver is a major site of production for thrombopoietin , a glycoprotein hormone that regulates
1080-420: A superficial division of the liver into a left and right lobe. From below, the two additional lobes are located between the right and left lobes, one in front of the other. A line can be imagined running from the left of the vena cava and all the way forward to divide the liver and gallbladder into two halves. This line is called Cantlie's line . Other anatomical landmarks include the ligamentum venosum and
1188-670: A violent tumor in children. In adolescence and young adulthood, the disease presents with a characteristic triad: Another major symptom is feeling tired . Headaches are common, and abdominal pains with nausea or vomiting sometimes also occur. Symptoms most often disappear after about 2–4 weeks. However, fatigue and a general feeling of being unwell ( malaise ) may sometimes last for months. Fatigue lasts more than one month in an estimated 28% of cases. Mild fever, swollen neck glands and body aches may also persist beyond 4 weeks. Most people are able to resume their usual activities within 2–3 months. The most prominent sign of
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#17328721043191296-587: Is increased blood lymphocytes of which more than 10% are reactive. The monospot test is not recommended for general use due to poor accuracy. There is no vaccine for EBV; however, there is ongoing research . Infection can be prevented by not sharing personal items or saliva with an infected person. Mono generally improves without any specific treatment. Symptoms may be reduced by drinking enough fluids, getting sufficient rest, and taking pain medications such as paracetamol (acetaminophen) and ibuprofen . Mononucleosis most commonly affects those between
1404-401: Is a "satellite" of hepatitis B virus (it can only infect in the presence of hepatitis B), and co-infects nearly 20 million people with hepatitis B, globally. Hepatic encephalopathy is caused by an accumulation of toxins in the bloodstream that are normally removed by the liver. This condition can result in coma and can prove fatal. Budd–Chiari syndrome is a condition caused by blockage of
1512-415: Is a dark reddish brown, wedge-shaped organ with two lobes of unequal size and shape. A human liver normally weighs approximately 1.5 kilograms (3.3 pounds) and has a width of about 15 centimetres (6 inches). There is considerable size variation between individuals, with the standard reference range for men being 970–1,860 grams (2.14–4.10 lb) and for women 600–1,770 g (1.32–3.90 lb). It
1620-407: Is both the heaviest internal organ and the largest gland in the human body. It is located in the right upper quadrant of the abdominal cavity , resting just below the diaphragm, to the right of the stomach, and overlying the gallbladder . The liver is connected to two large blood vessels : the hepatic artery and the portal vein . The hepatic artery carries oxygen-rich blood from the aorta via
1728-455: Is caused by human cytomegalovirus (CMV), another type of herpes virus . This virus is found in body fluids including saliva , urine , blood , tears , breast milk and genital secretions. A person becomes infected with this virus by direct contact with infected body fluids. Cytomegalovirus is most commonly transmitted through kissing and sexual intercourse. It can also be transferred from an infected mother to her unborn child. This virus
1836-502: Is common in the second and third weeks, although this may not be apparent on physical examination . Rarely the spleen may rupture. There may also be some enlargement of the liver . Jaundice occurs only occasionally. It generally gets better on its own in people who are otherwise healthy. When caused by EBV, infectious mononucleosis is classified as one of the Epstein–Barr virus–associated lymphoproliferative diseases . Occasionally
1944-445: Is generally self-limiting , so only symptomatic or supportive treatments are used. The need for rest and return to usual activities after the acute phase of the infection may reasonably be based on the person's general energy levels. Nevertheless, in an effort to decrease the risk of splenic rupture , experts advise avoidance of contact sports and other heavy physical activity, especially when involving increased abdominal pressure or
2052-450: Is known as the duodenal impression. The inferior surface of the left lobe of the liver presents behind and to the left of the gastric impression. This is moulded over the upper front surface of the stomach, and to the right of this is a rounded eminence, the tuber omentale , which fits into the concavity of the lesser curvature of the stomach and lies in front of the anterior layer of the lesser omentum . Microscopically, each liver lobe
2160-447: Is much the same, it is not always helpful–or possible–to distinguish between Epstein–Barr-virus mononucleosis and cytomegalovirus infection. However, in pregnant women, differentiation of mononucleosis from toxoplasmosis is important, since it is associated with significant consequences for the fetus . Acute HIV infection can mimic signs similar to those of infectious mononucleosis, and tests should be performed for pregnant women for
2268-558: Is not a valid technique for assessing spleen enlargement and should not be used in typical circumstances or to make routine decisions about fitness for playing sports. Serious complications are uncommon, occurring in less than 5% of cases: Once the acute symptoms of an initial infection disappear, they often do not return. But once infected, the person carries the virus for the rest of their life. The virus typically lives dormant in B lymphocytes. Independent infections of mononucleosis may be contracted multiple times, regardless of whether
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#17328721043192376-444: Is often "silent" because the signs and symptoms cannot be felt by the person infected. However, it can cause life-threatening illness in infants, people with HIV , transplant recipients, and those with weak immune systems . For those with weak immune systems, cytomegalovirus can cause more serious illnesses such as pneumonia and inflammations of the retina , esophagus , liver , large intestine , and brain . Approximately 90% of
2484-449: Is responsible for the breakdown and excretion of many waste products. It plays a key role in breaking down or modifying toxic substances (e.g., methylation ) and most medicinal products in a process called drug metabolism . This sometimes results in toxication , when the metabolite is more toxic than its precursor. Preferably, the toxins are conjugated to avail excretion in bile or urine. The liver converts ammonia into urea as part of
2592-405: Is seen to be made up of hepatic lobules . The lobules are roughly hexagonal, and consist of plates of hepatocytes , and sinusoids radiating from a central vein towards an imaginary perimeter of interlobular portal triads. The central vein joins to the hepatic vein to carry blood out from the liver. A distinctive component of a lobule is the portal triad , which can be found running along each of
2700-421: Is specific but not particularly sensitive (with a false-negative rate of as high as 25% in the first week, 5–10% in the second, and 5% in the third). About 90% of diagnosed people have heterophile antibodies by week 3, disappearing in under a year. The antibodies involved in the test do not interact with the Epstein–Barr virus or any of its antigens . The monospot test is not recommended for general use by
2808-405: Is the tube of endoderm that extends out from the foregut into the surrounding mesenchyme. The mesenchyme of septum transversum induces this endoderm to proliferate, to branch, and to form the glandular epithelium of the liver. A portion of the hepatic diverticulum (that region closest to the digestive tube) continues to function as the drainage duct of the liver, and a branch from this duct produces
2916-410: Is unclear. A review of the literature made an estimate of 33–49 days. In adolescents and young adults, symptoms are thought to appear around 4–6 weeks after initial infection. Onset is often gradual, though it can be abrupt. The main symptoms may be preceded by 1–2 weeks of fatigue, feeling unwell and body aches. About 90% of cases of infectious mononucleosis are caused by the Epstein–Barr virus ,
3024-413: Is uneven and concave. It is covered in peritoneum apart from where it attaches the gallbladder and the porta hepatis. The fossa of gallbladder lies to the right of the quadrate lobe, occupied by the gallbladder with its cystic duct close to the right end of porta hepatis. Several impressions on the surface of the liver accommodate the various adjacent structures and organs. Underneath the right lobe and to
3132-456: The CDC due to its poor accuracy. Serologic tests detect antibodies directed against the Epstein–Barr virus. Immunoglobulin G (IgG), when positive, mainly reflects a past infection, whereas immunoglobulin M (IgM) mainly reflects a current infection. EBV-targeting antibodies can also be classified according to which part of the virus they bind to: When negative, these tests are more accurate than
3240-477: The Valsalva maneuver (as in rowing or weight training ), for at least the first 3–4 weeks of illness or until enlargement of the spleen has resolved, as determined by a treating physician. Paracetamol (acetaminophen) and NSAIDs , such as ibuprofen , may be used to reduce fever and pain. Prednisone , a corticosteroid , while used to try to reduce throat pain or enlarged tonsils , remains controversial due to
3348-441: The ampulla of Vater . The liver plays a major role in carbohydrate, protein, amino acid, and lipid metabolism. The liver performs several roles in carbohydrate metabolism. The liver is responsible for the mainstay of protein metabolism , synthesis as well as degradation. All plasma proteins except Gamma-globulins are synthesised in the liver. It is also responsible for a large part of amino acid synthesis . The liver plays
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3456-425: The celiac trunk , whereas the portal vein carries blood rich in digested nutrients from the entire gastrointestinal tract and also from the spleen and pancreas . These blood vessels subdivide into small capillaries known as liver sinusoids , which then lead to hepatic lobules . Hepatic lobules are the functional units of the liver. Each lobule is made up of millions of hepatic cells (hepatocytes), which are
3564-442: The duodenum to help with digestion . The liver's highly specialized tissue , consisting mostly of hepatocytes , regulates a wide variety of high-volume biochemical reactions, including the synthesis and breakdown of small and complex organic molecules, many of which are necessary for normal vital functions. Estimates regarding the organ's total number of functions vary, but is generally cited as being around 500. For this reason,
3672-421: The fibrinogen beta chain protein. Organogenesis , the development of the organs, takes place from the third to the eighth week during embryogenesis . The origins of the liver lie in both the ventral portion of the foregut endoderm (endoderm being one of the three embryonic germ layers ) and the constituents of the adjacent septum transversum mesenchyme . In the human embryo , the hepatic diverticulum
3780-399: The hepatic veins (including thrombosis ) that drain the liver. It presents with the classical triad of abdominal pain, ascites and liver enlargement . Many diseases of the liver are accompanied by jaundice caused by increased levels of bilirubin in the system. The bilirubin results from the breakup of the hemoglobin of dead red blood cells; normally, the liver removes bilirubin from
3888-599: The heterophile antibody test . The Epstein–Barr virus was first identified in Burkitt's lymphoma cells by Michael Anthony Epstein and Yvonne Barr at the University of Bristol in 1964. The link with infectious mononucleosis was uncovered in 1967 by Werner and Gertrude Henle at the Children's Hospital of Philadelphia , after a laboratory technician handling the virus contracted the disease: comparison of serum samples collected from
3996-428: The ornithine cycle or the urea cycle, and the urea is excreted in the urine. Because the liver is an expandable organ, large quantities of blood can be stored in its blood vessels. Its normal blood volume, including both that in the hepatic veins and that in the hepatic sinuses, is about 450 milliliters, or almost 10 percent of the body's total blood volume. When high pressure in the right atrium causes backpressure in
4104-403: The right and left triangular ligaments . These peritoneal ligaments are not related to the anatomic ligaments in joints, and the right and left triangular ligaments have no known functional importance, though they serve as surface landmarks. The falciform ligament functions to attach the liver to the posterior portion of the anterior body wall. The visceral surface or inferior surface
4212-410: The round ligament of the liver , which further divide the left side of the liver in two sections. An important anatomical landmark, the porta hepatis , divides this left portion into four segments, which can be numbered starting at the caudate lobe as I in an anticlockwise manner. From this parietal view, seven segments can be seen, because the eighth segment is only visible in the visceral view. On
4320-511: The Falcon Islands. Some other outbreaks that occurred around this time would include some nurseries and boarding schools and also the U.S. Naval Base, Coronado, Calif, where hundreds were infected by this virus. The term "infectious mononucleosis" was coined in 1920 by Thomas Peck Sprunt and Frank Alexander Evans in a classic clinical description of the disease published in the Bulletin of
4428-482: The Johns Hopkins Hospital , entitled "Mononuclear leukocytosis in reaction to acute infection (infectious mononucleosis)". A lab test for infectious mononucleosis was developed in 1931 by Yale School of Public Health Professor John Rodman Paul and Walls Willard Bunnell based on their discovery of heterophile antibodies in the sera of persons with the disease. The Paul-Bunnell Test or PBT was later replaced by
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4536-454: The Landmark into halting the event by threatening to withhold $ 30,000 in county funds earmarked for the venue, prompting the venue's bookers to consider dropping the show altogether. Despite this, representatives for the Landmark started selling tickets on the day it was planned and the performance took place on the arranged date and venue. Various shows were recorded on the tour but there
4644-615: The T.V. . The only full live recordings available are bootleg from their January 23, 1999 concert in Sydney , Australia during their headlining stint at the Big Day Out Music Festival. The video is of mediocre quality. A rare partial recording of the band's concert on November 16, 1998, in Detroit , Michigan , and unedited aftershow promotional interview also exist. Music critic Tim Finn of The Kansas City Star commented that, overall,
4752-504: The absorption of vitamin K from the diet. Some of the bile drains directly into the duodenum, and some is stored in the gallbladder. The liver produces insulin-like growth factor 1 , a polypeptide protein hormone that plays an important role in childhood growth and continues to have anabolic effects in adults. The liver is responsible for the breakdown of insulin and other hormones . The liver breaks down bilirubin via glucuronidation , facilitating its excretion into bile. The liver
4860-500: The ages of 15 and 24 years in the developed world . In the developing world , people are more often infected in early childhood when there are fewer symptoms. In those between 16 and 20 it is the cause of about 8% of sore throats. About 45 out of 100,000 people develop infectious mono each year in the United States. Nearly 95% of people have had an EBV infection by the time they are adults. The disease occurs equally at all times of
4968-449: The arms or trunk, which can be macular ( morbilliform ) or papular . Almost all people given amoxicillin or ampicillin eventually develop a generalized, itchy maculopapular rash, which however does not imply that the person will have adverse reactions to penicillins again in the future. Occasional cases of erythema nodosum and erythema multiforme have been reported. Seizures may also occasionally occur. Spleen enlargement
5076-587: The band to cancel the entire summer European leg and postpone the beginning of the tour to October 25, 1998. Beginning on October 25, 1998, and lasting until January 31, 1999, the "Mechanical Animals Tour" included two legs spanning a Fall to Winter World Tour in Europe, Japan, and North America and a 6 show headlining stint at the Big Day Out Music Festival in Australia. After declining a headlining slot at
5184-403: The basic metabolic cells. The lobules are held together by a fine, dense, irregular, fibroelastic connective tissue layer extending from the fibrous capsule covering the entire liver known as Glisson's capsule after British doctor Francis Glisson . This tissue extends into the structure of the liver by accompanying the blood vessels, ducts, and nerves at the hepatic hilum. The whole surface of
5292-455: The blood and constitute plasma proteins and hepatokines . Other liver-specific proteins are certain liver enzymes such as HAO1 and RDH16 , proteins involved in bile synthesis such as BAAT and SLC27A5 , and transporter proteins involved in the metabolism of drugs, such as ABCB11 and SLC2A2 . Examples of highly liver-specific proteins include apolipoprotein A II , coagulation factors F2 and F9 , complement factor related proteins , and
5400-520: The blood and excretes it through bile. Other disorders caused by excessive alcohol consumption are grouped under alcoholic liver diseases and these include alcoholic hepatitis , fatty liver , and cirrhosis . Factors contributing to the development of alcoholic liver diseases are not only the quantity and frequency of alcohol consumption, but can also include gender, genetics, and liver insult. Liver damage can also be caused by drugs , particularly paracetamol and drugs used to treat cancer. A rupture of
5508-646: The cancellation of the entire summer European leg and the postponement of the beginning of the tour to October 25, 1998, in Lawrence, Kansas. With this being the first leg of the tour, the stage show was minimal compared to later legs of the tour As with the band's preceding 1997 world tour, Dead to the World , the Mechanical Animals Tour met with heavy resistance from civic and religious leaders. The first of these protests occurred on October 19, 1998. A month before
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#17328721043195616-467: The centre of each segment are branches of the portal vein, hepatic artery, and bile duct. In the periphery of each segment is vascular outflow through the hepatic veins. The classification system uses the vascular supply in the liver to separate the functional units (numbered I to VIII) with unit 1, the caudate lobe, receiving its supply from both the right and the left branches of the portal vein. It contains one or more hepatic veins which drain directly into
5724-414: The common hepatic duct to form the common bile duct. The biliary system and connective tissue is supplied by the hepatic artery alone. Bile either drains directly into the duodenum via the common bile duct, or is temporarily stored in the gallbladder via the cystic duct. The common bile duct and the pancreatic duct enter the second part of the duodenum together at the hepatopancreatic ampulla, also known as
5832-406: The decomposition of red blood cells . The liver is also an accessory digestive organ that produces bile , an alkaline fluid containing cholesterol and bile acids , which emulsifies and aids the breakdown of dietary fat . The gallbladder , a small hollow pouch that sits just under the right lobe of liver, stores and concentrates the bile produced by the liver, which is later excreted to
5940-401: The diaphragmatic surface, apart from a triangular bare area where it connects to the diaphragm, the liver is covered by a thin, double-layered membrane, the peritoneum , that helps to reduce friction against other organs. This surface covers the convex shape of the two lobes where it accommodates the shape of the diaphragm. The peritoneum folds back on itself to form the falciform ligament and
6048-409: The disease is often pharyngitis , which is frequently accompanied by enlarged tonsils with pus —an exudate similar to that seen in cases of strep throat . In about 50% of cases, small reddish-purple spots called petechiae can be seen on the roof of the mouth . Palatal enanthem can also occur, but is relatively uncommon. A small minority of people spontaneously present a rash , usually on
6156-609: The disease may persist and result in a chronic infection. This may develop into systemic EBV-positive T cell lymphoma . Infectious mononucleosis mainly affects younger adults. When older adults do catch the disease, they less often have characteristic signs and symptoms such as the sore throat and lymphadenopathy. Instead, they may primarily experience prolonged fever, fatigue, malaise and body pains. They are more likely to have liver enlargement and jaundice . People over 40 years of age are more likely to develop serious illness. The exact length of time between infection and symptoms
6264-425: The disease. It is primarily spread through saliva but can rarely be spread through semen or blood . Spread may occur by objects such as drinking glasses or toothbrushes or through a cough or sneeze. Those who are infected can spread the disease weeks before symptoms develop. Mono is primarily diagnosed based on the symptoms and can be confirmed with blood tests for specific antibodies . Another typical finding
6372-418: The edge of the liver lobule, where they merge to form bile ducts. Within the liver, these ducts are termed intrahepatic bile ducts, and once they exit the liver, they are considered extrahepatic. The intrahepatic ducts eventually drain into the right and left hepatic ducts, which exit the liver at the transverse fissure , and merge to form the common hepatic duct. The cystic duct from the gallbladder joins with
6480-493: The failing Lollapalooza summer music festival (along with numerous other bands) in early 1998 due to delays in Mechanical Animals ' release, the band launched the first of their own headlining tours in support of the album. The tour was originally intended to begin on June 25, 1998, with a series of 6 festival dates in Europe lasting until July 12, 1998. However, drummer Ginger Fish became ill with mononucleosis , leading to
6588-564: The family Herpesviridae such as the herpes simplex virus . Chronic (rather than acute) infection with hepatitis B virus or hepatitis C virus is the main cause of liver cancer . Globally, about 248 million individuals are chronically infected with hepatitis B (with 843,724 in the U.S.), and 142 million are chronically infected with hepatitis C (with 2.7 million in the U.S.). Globally there are about 114 million and 20 million cases of hepatitis A and hepatitis E respectively, but these generally resolve and do not become chronic. Hepatitis D virus
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#17328721043196696-448: The functional lobes are further divided into a total of eight subsegments based on a transverse plane through the bifurcation of the main portal vein. The caudate lobe is a separate structure that receives blood flow from both the right- and left-sided vascular branches. The Couinaud classification divides the liver into eight functionally independent liver segments. Each segment has its own vascular inflow, outflow and biliary drainage. In
6804-485: The functions of a mature hepatocyte, and eventually mature hepatocytes appear as highly polarized epithelial cells with abundant glycogen accumulation. In the adult liver, hepatocytes are not equivalent, with position along the portocentrovenular axis within a liver lobule dictating expression of metabolic genes involved in drug metabolism, carbohydrate metabolism , ammonia detoxification, and bile production and secretion. WNT/β-catenin has now been identified to be playing
6912-412: The gallbladder. Besides signals from the septum transversum mesenchyme, fibroblast growth factor from the developing heart also contributes to hepatic competence, along with retinoic acid emanating from the lateral plate mesoderm . The hepatic endodermal cells undergo a morphological transition from columnar to pseudostratified resulting in thickening into the early liver bud . Their expansion forms
7020-632: The heterophile antibody test in ruling out infectious mononucleosis. When positive, they feature similar specificity to the heterophile antibody test. Therefore, these tests are useful for diagnosing infectious mononucleosis in people with highly suggestive symptoms and a negative heterophile antibody test. About 10% of people who present a clinical picture of infectious mononucleosis do not have an acute Epstein–Barr-virus infection. A differential diagnosis of acute infectious mononucleosis needs to take into consideration acute cytomegalovirus infection and Toxoplasma gondii infections. Because their management
7128-536: The highest during the first six weeks following infection. Some studies indicate that a person can spread the infection for many months, possibly up to a year and a half. The virus replicates first within epithelial cells in the pharynx (which causes pharyngitis , or sore throat), and later primarily within B cells (which are invaded via their CD21 ). The host immune response involves cytotoxic (CD8-positive) T cells against infected B lymphocytes, resulting in enlarged, reactive lymphocytes ( Downey cells ). When
7236-407: The human population has been infected with cytomegalovirus by the time they reach adulthood, but most are unaware of the infection. Once a person becomes infected with cytomegalovirus, the virus stays in their body throughout the person's lifetime. During this latent phase, the virus can be detected only in monocytes . Toxoplasma gondii , a parasitic protozoon , is responsible for less than 1% of
7344-405: The imaginary plane, Cantlie's line, joining the gallbladder fossa to the inferior vena cava . The plane separates the liver into the true right and left lobes. The middle hepatic vein also demarcates the true right and left lobes. The right lobe is further divided into an anterior and posterior segment by the right hepatic vein. The left lobe is divided into the medial and lateral segments by
7452-561: The infection is acute (recent onset, instead of chronic ), heterophile antibodies are produced. Cytomegalovirus , adenovirus and Toxoplasma gondii ( toxoplasmosis ) infections can cause symptoms similar to infectious mononucleosis, but a heterophile antibody test will test negative and differentiate those infections from infectious mononucleosis. Mononucleosis is sometimes accompanied by secondary cold agglutinin disease , an autoimmune disease in which abnormal circulating antibodies directed against red blood cells can lead to
7560-424: The infectious mononucleosis cases. Viral hepatitis , adenovirus , rubella , and herpes simplex viruses have also been reported as rare causes of infectious mononucleosis. Epstein–Barr virus infection is spread via saliva , and has an incubation period of four to seven weeks. The length of time that an individual remains contagious is unclear, but the chances of passing the illness to someone else may be
7668-437: The inferior vena cava, allowing placental blood to bypass the liver. In the fetus, the liver does not perform the normal digestive processes and filtration of the infant liver because nutrients are received directly from the mother via the placenta . The fetal liver releases some blood stem cells that migrate to the fetal thymus , creating the T cells (or T lymphocytes). After birth, the formation of blood stem cells shifts to
7776-463: The inferior vena cava. The remainder of the units (II to VIII) are numbered in a clockwise fashion: About 20,000 protein coding genes are expressed in human cells and 60% of these genes are expressed in a normal, adult liver. Over 400 genes are more specifically expressed in the liver, with some 150 genes highly specific for liver tissue. A large fraction of the corresponding liver-specific proteins are mainly expressed in hepatocytes and secreted into
7884-402: The lack of evidence that it is effective and the potential for side effects. Intravenous corticosteroids , usually hydrocortisone or dexamethasone , are not recommended for routine use but may be useful if there is a risk of airway obstruction, a very low platelet count , or hemolytic anemia . Antiviral agents act by inhibiting viral DNA replication. There is little evidence to support
7992-423: The left hepatic vein. The hilum of the liver is described in terms of three plates that contain the bile ducts and blood vessels. The contents of the whole plate system are surrounded by a sheath. The three plates are the hilar plate , the cystic plate and the umbilical plate and the plate system is the site of the many anatomical variations to be found in the liver. In the widely used Couinaud system,
8100-445: The liver and drain into the inferior vena cava. The biliary tract is derived from the branches of the bile ducts. The biliary tract, also known as the biliary tree, is the path by which bile is secreted by the liver then transported to the first part of the small intestine, the duodenum . The bile produced in the liver is collected in bile canaliculi , small grooves between the faces of adjacent hepatocytes. The canaliculi radiate to
8208-492: The liver are carried out by the liver cells or hepatocytes. The liver is thought to be responsible for up to 500 separate functions, usually in combination with other systems and organs. Currently, no artificial organ or device is capable of reproducing all the functions of the liver. Some functions can be carried out by liver dialysis , an experimental treatment for liver failure . The liver also accounts for about 20% of resting total body oxygen consumption. The liver receives
8316-417: The liver can be caused by a liver shot used in combat sports. Primary biliary cholangitis is an autoimmune disease of the liver. It is marked by slow progressive destruction of the small bile ducts of the liver, with the intralobular ducts ( Canals of Hering ) affected early in the disease. When these ducts are damaged, bile and other toxins build up in the liver ( cholestasis ) and over time damages
8424-435: The liver has sometimes been described as the body's chemical factory . It is not known how to compensate for the absence of liver function in the long term, although liver dialysis techniques can be used in the short term. Artificial livers have not been developed to promote long-term replacement in the absence of the liver. As of 2018 , liver transplantation is the only option for complete liver failure . The liver
8532-490: The liver in response to injury or inflammation. The most common chronic liver disease is nonalcoholic fatty liver disease , which affects an estimated one-third of the world population. Hepatitis is a common condition of inflammation of the liver. The most usual cause of this is viral , and the most common of these infections are hepatitis A , B , C , D , and E . Some of these infections are sexually transmitted . Inflammation can also be caused by other viruses in
8640-404: The liver is the umbilical vein, which supplies nutrients to the growing fetus. The umbilical vein enters the abdomen at the umbilicus and passes upward along the free margin of the falciform ligament of the liver to the inferior surface of the liver. There, it joins with the left branch of the portal vein. The ductus venosus carries blood from the left portal vein to the left hepatic vein and then to
8748-419: The liver only produces symptoms after extensive damage. Hepatomegaly refers to an enlarged liver and can be due to many causes. It can be palpated in a liver span measurement. Consuming caffeine regularly may help safeguard individuals from liver cirrhosis . Additionally, it has been shown to slow the advancement of liver disease in those already affected, lower the risk of liver fibrosis, and provide
8856-584: The liver tissue in combination with ongoing immune related damage. This can lead to scarring ( fibrosis ) and cirrhosis . Cirrhosis increases the resistance to blood flow in the liver, and can result in portal hypertension . Congested anastomoses between the portal venous system and the systemic circulation, can be a subsequent condition. There are also many pediatric liver diseases, including biliary atresia , alpha-1 antitrypsin deficiency , alagille syndrome , progressive familial intrahepatic cholestasis , Langerhans cell histiocytosis and hepatic hemangioma
8964-467: The liver volume is occupied by parenchymal hepatocytes. Nonparenchymal cells constitute 40% of the total number of liver cells but only 6.5% of its volume. The liver sinusoids are lined with two types of cell, sinusoidal endothelial cells , and phagocytic Kupffer cells . Hepatic stellate cells are nonparenchymal cells found in the perisinusoidal space , between a sinusoid and a hepatocyte. Additionally, intrahepatic lymphocytes are often present in
9072-444: The liver's oxygen demand is met by the hepatic portal vein, and half is met by the hepatic arteries. The hepatic artery also has both alpha- and beta-adrenergic receptors; therefore, flow through the artery is controlled, in part, by the splanchnic nerves of the autonomic nervous system. Blood flows through the liver sinusoids and empties into the central vein of each lobule. The central veins coalesce into hepatic veins, which leave
9180-530: The liver, except for the bare area , is covered in a serous coat derived from the peritoneum , and this firmly adheres to the inner Glisson's capsule. Terminology related to the liver often starts in hepat- from ἡπατο-, from the Greek word for liver. The liver is grossly divided into two parts when viewed from above – a right and a left lobe – and four parts when viewed from below (left, right, caudate , and quadrate lobes ). The falciform ligament makes
9288-421: The liver, the liver expands, and 0.5 to 1 liter of extra blood is occasionally stored in the hepatic veins and sinuses. This occurs especially in cardiac failure with peripheral congestion. Thus, in effect, the liver is a large, expandable, venous organ capable of acting as a valuable blood reservoir in times of excess blood volume and capable of supplying extra blood in times of diminished blood volume. Because
9396-429: The lobule's corners. The portal triad consists of the hepatic artery, the portal vein, and the common bile duct. The triad may be seen on a liver ultrasound, as a Mickey Mouse sign with the portal vein as the head, and the hepatic artery, and the common bile duct as the ears. Histology , the study of microscopic anatomy, shows two major types of liver cell: parenchymal cells and nonparenchymal cells. About 70–85% of
9504-552: The lymph formed in the body under resting conditions arises in the liver. The liver is a vital organ and supports almost every other organ in the body. Because of its strategic location and multidimensional functions, the liver is prone to many diseases. The bare area of the liver is a site that is vulnerable to the passing of infection from the abdominal cavity to the thoracic cavity . Liver diseases may be diagnosed by liver function tests –blood tests that can identify various markers. For example, acute-phase reactants are produced by
9612-448: The most useful to dismiss the idea of infectious mononucleosis as the correct diagnosis. The insensitivity of the physical examination in detecting an enlarged spleen means it should not be used as evidence against infectious mononucleosis. A physical examination may also show petechiae in the palate . The heterophile antibody test, or monospot test, works by agglutination of red blood cells from guinea pigs, sheep and horses. This test
9720-442: The neck, and fatigue . Most people recover in two to four weeks; however, feeling tired may last for months. The liver or spleen may also become swollen, and in less than one percent of cases splenic rupture may occur. While usually caused by the Epstein–Barr virus, also known as human herpesvirus 4, which is a member of the herpesvirus family , a few other viruses and the protozoon Toxoplasma gondii may also cause
9828-432: The organism, and the synthesis of proteins and various other biochemicals necessary for digestion and growth. In humans , it is located in the right upper quadrant of the abdomen , below the diaphragm and mostly shielded by the lower right rib cage . Its other metabolic roles include carbohydrate metabolism , the production of hormones , conversion and storage of nutrients such as glucose and glycogen , and
9936-481: The person is already carrying the virus dormant. Periodically, the virus can reactivate, during which time the person is again infectious, but usually without any symptoms of illness. Usually, a person with IM has few, if any, further symptoms or problems from the latent B lymphocyte infection. However, in susceptible hosts under the appropriate environmental stressors, the virus can reactivate and cause vague physical symptoms (or may be subclinical), and during this phase,
10044-429: The pores in the hepatic sinusoids are very permeable and allow ready passage of both fluid and proteins into the perisinusoidal space , the lymph draining from the liver usually has a protein concentration of about 6 g/dl, which is only slightly less than the protein concentration of plasma. Also, the high permeability of the liver sinusoid epithelium allows large quantities of lymph to form. Therefore, about half of all
10152-753: The portal vein. The expanding liver bud is colonized by hematopoietic cells . The bipotential hepatoblasts begin differentiating into biliary epithelial cells and hepatocytes. The biliary epithelial cells differentiate from hepatoblasts around portal veins, first producing a monolayer, and then a bilayer of cuboidal cells. In ductal plate, focal dilations emerge at points in the bilayer, become surrounded by portal mesenchyme, and undergo tubulogenesis into intrahepatic bile ducts. Hepatoblasts not adjacent to portal veins instead differentiate into hepatocytes and arrange into cords lined by sinusoidal epithelial cells and bile canaliculi. Once hepatoblasts are specified into hepatocytes and undergo further expansion, they begin acquiring
10260-400: The production of platelets by the bone marrow. The liver plays several roles in lipid metabolism: it performs cholesterol synthesis, lipogenesis , and the production of triglycerides , and a bulk of the body's lipoproteins are synthesized in the liver. The liver plays a key role in digestion, as it produces and excretes bile (a yellowish liquid) required for emulsifying fats and help
10368-412: The red bone marrow . After 2–5 days, the umbilical vein and ductus venosus are obliterated; the former becomes the round ligament of liver and the latter becomes the ligamentum venosum. In the disorders of cirrhosis and portal hypertension , the umbilical vein can open up again. Unlike eutherian mammals, in marsupials the liver remains haematopoietic well after birth. The various functions of
10476-415: The right of the fossa , between the bare area and the caudate lobe, and immediately above the renal impression. The greater part of the suprarenal impression is devoid of peritoneum and it lodges the right suprarenal gland. Medial to the renal impression is a third and slightly marked impression, lying between it and the neck of the gall bladder. This is caused by the descending portion of the duodenum, and
10584-410: The right of the gallbladder fossa are two impressions, one behind the other and separated by a ridge. The one in front is a shallow colic impression, formed by the hepatic flexure and the one behind is a deeper renal impression accommodating part of the right kidney and part of the suprarenal gland . The suprarenal impression is a small, triangular, depressed area on the liver. It is located close to
10692-465: The same reason as toxoplasmosis. People with infectious mononucleosis are sometimes misdiagnosed with a streptococcal pharyngitis (because of the symptoms of fever, pharyngitis and adenopathy ) and are given antibiotics such as ampicillin or amoxicillin as treatment. Other conditions from which to distinguish infectious mononucleosis include leukemia , tonsillitis , diphtheria , common cold and influenza (flu). Infectious mononucleosis
10800-499: The show was "far less a spectacle than the Antichrist Superstar tour." Mononucleosis Infectious mononucleosis ( IM , mono ), also known as glandular fever , is an infection usually caused by the Epstein–Barr virus (EBV). Most people are infected by the virus as children, when the disease produces few or no symptoms. In young adults, the disease often results in fever , sore throat, enlarged lymph nodes in
10908-416: The sinusoidal lumen. The central area or hepatic hilum , includes the opening known as the porta hepatis which carries the common bile duct and common hepatic artery , and the opening for the portal vein. The duct, vein, and artery divide into left and right branches, and the areas of the liver supplied by these branches constitute the functional left and right lobes. The functional lobes are separated by
11016-499: The technician before and after the onset revealed development of antibodies to the virus. Yale School of Public Health epidemiologist Alfred E. Evans confirmed through testing that mononucleosis was transmitted mainly through kissing, leading to it being referred to colloquially as "the kissing disease". Liver The liver is a major metabolic organ exclusively found in vertebrate animals , which performs many essential biological functions such as detoxification of
11124-635: The term Drüsenfieber ("glandular fever"). The word mononucleosis has several senses , but today it usually is used in the sense of infectious mononucleosis, which is caused by EBV. Around the 1920’s , infectious mononucleosis was not known and there were not many things to test whether people were infected or not. Before this there weren’t many cases disclosed besides a few and one of these would take place in 1896. This outbreak infected an Ohio community which ended leaving them devastated. Epidemics seemed to keep reappearing here and there including an outbreak that happened in which 87 people were infected in
11232-453: The throat, such as with streptococcus ( strep throat ). However, ampicillin and amoxicillin are not recommended during acute Epstein–Barr virus infection as a diffuse rash may develop. Splenomegaly is a common symptom of infectious mononucleosis and health care providers may consider using abdominal ultrasonography to get insight into the enlargement of a person's spleen. However, because spleen size varies greatly, ultrasonography
11340-638: The use of antivirals such as aciclovir and valacyclovir although they may reduce initial viral shedding. Antivirals are expensive, risk causing resistance to antiviral agents, and (in 1% to 10% of cases) can cause unpleasant side effects . Although antivirals are not recommended for people with simple infectious mononucleosis, they may be useful (in conjunction with steroids) in the management of severe EBV manifestations, such as EBV meningitis, peripheral neuritis, hepatitis, or hematologic complications. Although antibiotics exert no antiviral action they may be indicated to treat bacterial secondary infections of
11448-547: The virus can spread to others. The characteristic symptomatology of infectious mononucleosis does not appear to have been reported until the late nineteenth century. In 1885, the renowned Russian pediatrician Nil Filatov reported an infectious process he called "idiopathic adenitis" exhibiting symptoms that correspond to infectious mononucleosis, and in 1889 a German balneologist and pediatrician, Emil Pfeiffer , independently reported similar cases (some of lesser severity) that tended to cluster in families, for which he coined
11556-550: The year. Mononucleosis was first described in the 1920s and is colloquially known as "the kissing disease". The signs and symptoms of infectious mononucleosis vary with age. Before puberty, the disease typically only produces flu -like symptoms, if any at all. When found, symptoms tend to be similar to those of common throat infections (mild pharyngitis , with or without tonsillitis ). Denis Burkitt reckoned that 18 per 100,000 children every year are infected with Burkitts’s lymphoma(Epstein-Barr virus). This usually causes
11664-479: Was no specific information about which dates. A 40-minute short film was released on VHS entitled God Is in the T.V. following the tour, however it only contained short live clips from various shows. Widely heralded as the band's best tour, their 2012 comeback sparked interest in the release of an uninterrupted live DVD of this tour. It is not known if the full recordings exist of the performances shown in God Is in
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