Hepatic encephalopathy An imbalance between aromatic amino acids (phenylalanine, tryptophan and tyrosine) and branched-chain amino acids (leucine, isoleucine and valine) has been described; this would lead to the generation of false neurotransmitters (such octopamine and 2-hydroxyphenethylamine). Dysregulation of the serotonin system, too, has been reported. Depletion of zinc and accumulation of manganese may play a role. Inflammation elsewhere in the body may precipitate encephalopathy through the action of cytokines and bacterial lipopolysaccharide on astrocytes. The diagnosis of hepatic encephalopathy can only be made in the presence of confirmed liver disease (types A and C) or a portosystemic shunt (type B), as its
Collateral adjective and Wagnalls" dictionaries, but as they are currently out of print, the term has become rare. A synonym sometimes seen in linguistics is "suppletive (denominal) adjective," though this is a liberal and arguably incorrect use of the word 'suppletive'. Collateral adjective A collateral adjective is an adjective that is identified with a particular noun in meaning, but that is not derived from that noun. For example, the word "bovine" is considered the adjectival equivalent of the noun "cow", but it is derived from a different word, which happens to be the Latin word for "cow". Similarly, "lunar" serves as an