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Biomedical subjects

D R Triger

Publications and source records attributed to D R Triger.

At least 73 records · Page 4Linked to original sources
PubMed1985

Phagocytic function in the isolated perfused rat liver. An experimental model.

An experimental model for measuring the phagocytic function of the isolated perfused rat liver is described. A progressive rise in phagocytosis was observed with increasing liver blood flow. This is due to an increase in total particle uptake by the liver with no alteration in the rate constant for phagocytosis except at the highest flow rate. Phagocytosis is substantially greater in the livers of 100-day-old rats than in 21-day-old rats, but the number of particles ingested per unit weight by the older rats is significantly less. Liver phagocytosis is shown to be both temperature- and oxygen-dependent, but independent of nutritional status and animal gender. This model may be useful for assessing the effects of drugs and toxins on hepatic phagocytosis.

Age Factors↗
PubMed1985

Gastric lesions in portal hypertension: inflammatory gastritis or congestive gastropathy?

This paper reports the incidence and natural history of macroscopic gastritis in a series of 127 consecutive patients with portal hypertension of various aetiologies. Gastritis was observed endoscopically in 65 patients (51%) and was of two main types. Twenty eight patients had severe or persistent gastritis which caused clinically significant bleeding on 80 occasions and accounted for 25% of the bleeds from all sources. The remainder had mild gastritis. The presence of gastritis seemed to be independent of the severity of liver disease or the degree of rise of wedged hepatic venous pressure and there was no difference in age, sex, or drugs prescribed in patients with or without gastritis. The mean follow up period and the mean number of sclerotherapy treatments was significantly greater (p less than 0.005) in patients with gastritis. Full thickness gastric biopsies in seven surgical patients and 11 autopsy specimens showed dilated and tortuous submucosal veins. Endoscopic biopsies in 14 patients showed vascular ectasia in the mucosal layer which was in excess of the degree of inflammatory infiltrate. Gastritis occurred in patients with portal hypertension of all common aetiologies and the clinical and pathological evidence supports the contention that it reflects a congested gastric mucosa and should be renamed congestive gastropathy. As injection sclerotherapy improves survival from variceal bleeding congestive gastropathy may become more common. The response to conventional ('anti-erosive') therapy is poor and measures aimed at reducing the gastric portal pressure may be the only effective means of treating this condition.

Adult↗
PubMed1985

An unusual case of Wilson's disease.

A man of 61 with a 26-year history of progressive cerebellar ataxia was admitted to hospital. He was found to have chronic liver disease and died 22 days after admission. A diagnosis of hepatolenticular degeneration (Wilson's disease) was supported by clinical investigations and confirmed at autopsy, when tissue copper studies were performed. Several unusual features were present, including a unilateral Kayser-Fleischer ring, a hepatocellular carcinoma, peripheral neuropathy, pontine demyelination and calcification of neurones in the medulla. The significance of these findings is discussed with a review of the relevant literature.

Brain↗
PubMed1985

Implications of a sclerotherapy program for the medical and surgical care of bleeding in portal hypertension.

The results of endoscopic sclerotherapy are promising and, at first sight, this technique offers a relatively simple and widely available method of achieving definitive control and preventing rebleeding from the esophageal varices. While it is an attractive option to operation, there is a small but significant group of patients, both at initial presentation and follow-up examination, in whom sclerotherapy is inappropriate. It remains to be determined whether shunt operation or a gastric vascularization procedure is superior. It must be remembered that surgical intervention may be required for a number of nonvariceal complications which may arise in patients with portal hypertension. Despite the apparent simplicity of endoscopic sclerotherapy, the management of these patients unquestionably requires a team of physicians, surgeons and nurses with back-up facilities from other personnel who are experienced in this problem, if mortality is to be kept to a minimum. The management of bleeding esophageal varices requires considerably more than a simple injection of sclerosant into a varix and a chronic sclerotherapy program imposes a large and inevitably increasing workload on a gastroenterologic unit.

Anesthesia↗
PubMed1984

Epidemiology of primary biliary cirrhosis.

A multi-national survey of the clinical and epidemiological aspects of primary biliary cirrhosis (PBC) has been conducted in 10 countries in Western Europe, surveying a population of over 24 million. The prevalence on 31 December, 1981 was 23/million, but this showed a marked variation from centre to centre for reasons which are not clear. The annual incidence of PBC has remained constant at about 4/million over the past 4 years, while the point prevalence has continued to rise, suggesting that the true prevalence may be rather higher than present figures suggest. The female: male sex ratio is 10:1, but in stages I & II this ratio is 6.5:1 compared with 11.4:1 in stages III & IV. Possible reasons for this are discussed.

Europe↗
PubMed1984

Hepatitis B immunization: experience in a provincial centre.

A programme for identifying medical and para-medical personnel in a large provincial city at risk for hepatitis B with a view to immunization is described. 177 individuals were offered vaccine, but this was accepted by only 56%. The reasons for the low acceptance rate are discussed.

England↗
PubMed1983

Kupffer-cell depletion in chronic liver disease: implications for hepatic carcinogenesis.

It is suggested that the increased incidence of hepatocellular carcinoma complicating cirrhosis may be related to the lobular and nodular depletion of liver macrophages. The occurrence of other hepatic tumours can also be related to the anatomical distribution of these macrophages within the liver. These observations are consistent with the hypothesis that the liver macrophage (Kupffer cell) may play an important role in tumour surveillance.

Carcinoma, Hepatocellular↗
PubMed1983

Computed tomography: qualitative and quantitative recognition of liver disease in haemophilia.

Thirty haemophiliac patients have been investigated by computed tomography (CT). Quantitative studies using dual energy scans with and without contrast enhancement, together with autocorrelation function analysis of the characteristics of the liver and spleen, revealed significant changes in the liver. The CT findings corresponded to the presence of liver disease, including chronic active hepatitis and cirrhosis, in 13 patients confirmed by percutaneous liver biopsy.

Hemophilia A↗
PubMed1982

What does the antimitochondrial antibody mean?

In a prospective survey positive antimitochondrial antibodies have been detected in 69/4200 (1.64%) of all sera submitted to a routine immunology laboratory. Of the 69, only nine patients had uniquivocal primary biliary cirrhosis, six others had chronic active hepatitis, 10 had abnormal liver function tests without evidence of primary biliary cirrhosis, while the remaining 44 had no clinical or biochemical evidence of liver disease. Outside the context of liver disease antimitochondrial antibodies were observed with similar frequency in patients with autoimmune disorders as in other conditions. It was not possible to distinguish primary biliary cirrhosis from patients without liver disease by antibody titre or by immunoglobulin subclass. The positive antimitochondrial antibody patients without liver disease were uniformly distributed throughout the city of Sheffield, in contrast with the marked clustering of cases of primary biliary cirrhosis. We conclude that, in the absence of clinical liver disease, the antimitochondrial antibody test alone (as detected by routine immunofluorescent techniques) does not appear to be a specific screening test for primary biliary cirrhosis. While we cannot exclude the possibility that the autoantibody indicates a predisposition to develop primary biliary cirrhosis, further prospective studies are needed to determine which patients will progress in this manner. The possibility that environmental factors may be implicated cannot be discounted.

Adolescent↗
PubMed1982

Lysozyme in chronic liver disease: a biochemical and histological study.

Serum lysozyme activities and semiquantitative analysis of tissue lysozyme distribution were studied in patients with primary biliary cirrhosis (PBC), chronic hepatitis (CH), miscellaneous liver diseases, and normal subjects. Serum lysozyme was significantly raised in PBC and CH. Portal venous blood has similar lysozyme activities to peripheral venous blood in a group of various liver diseases. Lysozyme-containing intralobular cells were decreased in all liver diseases studied but portal tract lysozyme was increased only in PBC and CH. Thus the increase in serum lysozyme in PBC and CH appears to originate from the portal inflammatory infiltrate, seen in these diseases.

Chronic Disease↗