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
The Great Australian Adjective The Great Australian Adjective The Great Australian Adjective is a humorous poem by English writer and poet W. T. Goodge. It was first published in "The Bulletin" magazine on 11 December 1897, the Christmas issue of that publication, and later in the poet's only collection "Hits! Skits! and Jingles!". The poem was originally published with the title "-----!", a subtitle of "The Great Australian Adjective" and was signed as by "The Colonel", a regular pseudonym of Goodge's. The poem is written with a number of words "blanked out", allowing the reader to substitute whatever they choose. For example: <poem> The