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
Adjective phrase that have their head adjective on the right side of the phrase: The labels on the nodes in the trees are acronyms: A = adjective, Adv = adverb, AP = adjective phrase, N = noun/pronoun, P = preposition, PP = prepositional phrase. The constituency trees identify these phrases as adjective phrases by labeling the top node with AP, and the dependency trees accomplish the same thing by positioning the A node at the top of the tree. The following trees illustrate the structure of head-initial adjective phrases, i.e. adjective phrases that have their head on the left side of the