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
British Institute of Organ Studies British Institute of Organ Studies The British Institute of Organ Studies, more commonly known by its acronym BIOS, is a British organisation and registered charity which aims to promote study and appreciation of all aspects of the pipe organ. Further, it acts as a lobbying body to raise awareness of organ issues with appropriate statutory bodies. Membership is open to all. The aims of BIOS are BIOS publishes a quarterly Reporter newsletter and magazine and a yearly Journal which contains articles on organ history. BIOS is also responsible for the National Pipe Organ Register (NPOR), which aims to catalogue all