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Biomedical subjects

E Ros

Publications and source records attributed to E Ros.

103 records · Page 6Linked to original sources
PubMed1979

Effects of chlorpromazine hydrochloride on bile salt synthesis, bile formation and biliary lipid secretion in the rhesus monkey: a model for chlorpromazine-induced cholestasis.

We studied the acute effects of intravenous infusions of chlorpromazine hydrochloride on bile salt synthesis, bile formation and biliary lipid secretion in the alert female Rhesus monkey prepared with a total biliary fistula and in a steady bile salt secretory state. In twelve studies (three animals), five doses of radiolabelled chlorpromazine hydrochloride (1-10 mg identical to 2.8-28 mumol/kg) were infused intravenously for 1 h in random order. Cholestasis was induced within minutes in all experiments. The radiolabel appeared rapidly in bile, with similar recoveries in bile and urine and a 90% total cumulative output in 4 days. Both bile flow, bile salt and other biliary lipid outputs were inhibited in a dose related and reversible manner. The apparent bile salt independent bile flow was consistently abolished, and a prompt return to basal values occurred when biliary concentration of the drug and metabolities fell below 1-2 mM. When chlorpromazine hydrochloride was infused at three doses (2.5, 5.0 and 10.0 mg identical to 7-28 mumol/kg) during constant intravenous infusion of 14C sodium taurocholate (300 mumol/h), bile flow, total bile salt output and 14C taurocholate output decreased within minutes. This was accompanied by a progressive rise in the serum 14C taurocholate concentration. After 90 min the taurocholate specific activity in bile increased significantly indicating that bile salt synthesis was inhibited. Secretion of retained bile salts and reversal of inhibition of bile salt synthesis occurred with time: the course of both events was correlated with the dose of the drug. Thus, in monkeys, chlorpromazine hydrochloride induces reversible, dose related cholestasis suppression of the bile salt dependent and independent flow, inhibition of bile salt synthesis and impairment of biliary lipid secretion. We suggest that these effects are due to both bile salt-chlorpromazine interactions and the effect of the latter on canalicular and other membranes.

Animals↗
PubMed1978

Incidence and clinical significance of sinusoidal dilatation in liver biopsies.

In a review of 906 consecutive liver biopsies, sinusoidal dilatation, unrelated to passive congestion of the liver, sinusoidal infiltration, or cirrhosis, was found in 26 cases (2.9%). In 21 of them the final diagnosis was a neoplastic or granulomatous disease (tuberculosis, brucellosis, Crohn's disease), but in only half of them was there evidence of neoplastic or granulomatous infiltration of the liver. In the remaining cases, sinusoidal dilatation was either the only histological abnormality or it was associated with nonspecific changes. Although the pathogenesis of sinusoidal ectasia is not known, our findings indicate a definite relationship to the presence of tumor or granulomatous disease in the liver or elsewhere in the body. It is concluded that the finding of sinusoidal dilatation as an isolated histological change in a liver biopsy specimen should prompt the search for a tumor or a disease associated with granulomas.

Adult↗
PubMed1977

Serum lipids, insulin, and glucagon after portacaval shunt in cirrhosis.

The cholesterol-lowering effect of portacaval anastomosis in homozygous familial hypercholesterolemia suggested a study of lipid metabolism in cirrhotic patients after portasystemic anastomoses. Fasting serum cholesterol, triglycerides, insulin, and glucagon levels were obtained in 20 patients with alcoholic cirrhosis and portacaval anastomosis, and in 21 nonshunted subjects with cirrhosis. After 100 g of glucose, given orally, insulin and glucagon levels were measured. In the shunted patients serum cholesterol was higher than in the nonshunted subjects, 240 +/- 15 mg per 100 ml (mean +/- 1 SEM) versus 180 +/- 13 mg per 100 ml, P less than 0.01. Triglycerides were normal in both groups. Fasting insulin was elevated to a greater extent in the shunted patients with cirrhosis (36 +/- 5 muU per ml) than in the nonshunted patients (22 +/- 4 muU per ml), P less than 0.05. Two hours after glucose, insulin levels were also elevated to a greater extent in the shunted subjects (304 +/- 50 muU per ml) than in the nonshunted subjects (167 +/- 29 muU per ml), P less than 0.03. Fasting glucagon (corrected for interference factor) was elevated to a greater extent in the shunted subjects (204 +/- 35 pg per ml) than in the nonshunted subjects (80 +/- 19 pg per ml), P less than 0.01. The explanation for serum cholesterol elevation after surgical shunting in cirrhotics is unknown. Two possible hypotheses--the differential action of insulin and glucagon on cholesterol metabolism and the effects of shunting on the cirrhotic liver--are discussed.

Alcoholism↗
PubMedDate not supplied

[Increased bile lithogenicity after simultaneous total parenteral nutrition and octrotide. A model of calcium palmitate Gallstones].

Gallbladder stasis and gallstone formation are well-known complications of both fasting-associated total parenteral nutrition (TPN) and long-term treatment with octreotide. Additive noxious effects to hepatobiliary function may develop when both therapies are given together as treatment of enteric fistulae. The aim of this study was to assess the risk of gallstone formation during treatment with TPN and octreotide separately and in combination. We studied four groups of New Zealand rabbits (n = 32) during a 2-week intervention period: 14 chow-fed controls; 6 fasted and TPN-fed; 6 chow-fed and administered octreotide, and 6 fasted and treated with both TPN and octreotide. After treatment, the bile duct was cannulated and the gallbladder and liver tissue were obtained for histological analysis. Hepatic and gallbladder bile were retrieved for microscopic examination and measurement of biliary lipids, bilirubin, calcium, total protein, and cholesterol nucleation time. The chemical composition of gallstones was also analyzed. The results of the study suggest that simultaneous administration of these two therapies in rabbits has additive effects on gallbladder stasis and bile lithogenicity. The administration of both treatments can play an important role in the formation of calcium palmitate gallstones in these animals.

Animals↗
PubMedDate not supplied

[Chlamydia pneumoniae and cerebrovascular disease].

INTRODUCTION: Chlamydia pneumoniae has relationship with artherosclerosis of carotid artery by seroepidemiological studies and by demonstration of the bacteria in atheromata. We made a case-control study to know the seroprevalence of chronic infection of C. pneumoniae and the presence of the bacteria in arterial biopsies. PATIENTS AND METHODS: The cases group was constituted by 26 patients undergoing carotid surgery. In the control group there were 50 patients without atherosclerosis and who underwent removal of their varicose veins. There were matched for sex, age and smoking. We obtained serum samples to determinate IgG antibodies against MOMP by MIF and ELISA. In the cases group, we got the arterial biopsies from carotid artery, and from pudendal arteries in control group. We determined chlamydial DNA on the biopsies by heminested PCR (primers: HL-1, HM-1, HR-1). We measured fibrinogen in both groups. RESULTS: By MIF technique, the seroprevalence was (IgG > 1:32) 69.23% cases versus 24% controls (OR: 7.12, CI: 2.47-20.48). The ELISA showed 76.92% of seropositivity in cases versus 16% in controls (OR: 17.5, CI: 95%: 5.35-57.23). The DNA of C. pneumoniae was found in 18 cases and 6 controls, (p < 0.0001, chi 2). We did not find any relationship between fibrinogen levels and groups. CONCLUSION: We think that there is a relationship between chronic infection with C. pneumoniae and carotid atherosclerosis.

Adult↗
PubMedDate not supplied

Technique of implantation and removal of balloon catheters for the intra-aortic balloon counter pulsation.

During recent years, intra-aortic balloon counterpulsation has become the treatment of choice in patients suffering from left ventricular power failure following cardiac operations. In our clinic IABP became necessary in 55 patients out of 1873 patients operated with heart lung machine during the period under study. The patients were studied in two groups. In Group I the intra aortic balloon counter pulsation was started only after there was no response to pharmacological agents, which often included high doses of catecholamines and vasoconstrictors. The mortality in this group was 74%. The second group consisted of patients treated since 1975. In this group, the counter pulsation was started early before ventricular damage was irreversible. In this group the survival was 52%. In addition we have paid careful attention to the technique of implantation of the balloon catheter, thrombosis prophylaxis during the counter pulsation and removal of any possible thrombi in proximal and distal segments to the arteriotomy with the help of Fogarty catheters together with the closure of the arteriotomy with a vein patch. The technique described has resulted in almost no peripheral vascular complications.

Aorta↗
PubMedDate not supplied

Laparoscopic treatment of acute biliary pancreatitis.

UNLABELLED: Laparoscopic cholecystectomy (LC) has become the standard treatment of gallstones. Application of LC in certain complications of biliary stones such as acute biliary pancreatitis (ABP) is not well defined. 10-30% of patients with ABP present associated bile duct stones, and the realization of a preoperative ERCP has been routinely proposed. Nevertheless, this examination may be unnecessary in most patients. AIM: To investigate the applicability of laparoscopic surgery for treatment of ABP. MATERIALS AND METHODS: Between Jan-1992 and June-1995, 368 patients were prospectively evaluated for LC, 274 for indications other than ABP. (Group I, LC) and 91 as a consequence of ABP. (Group II, ABPxL). ERCP was indicated when ultrasonography showed a dilated bile duct (> 8 mm) or when the liver function test (LFT) presented high scores. Age, sex, operative time, incidence of bile duct stones, postoperative stay and morbimortality were evaluated. RESULTS: The two groups were well matched for age, sex and associated medical risk factors. There were no differences in the operative time, conversion rate or postoperative morbidity (10% vs 10%). ERCP was performed in 25 patients in Group II and bile duct stones were found in 12 cases. In all cases an intraoperative cholangiography was performed, and in 6 patients, bile duct stones were removed by laparoscopic means. Three patients were converted to open surgery on finding duct stones which could not be treated by laparoscopic means. Mean postoperative stay was significantly longer in Group II than in Group I. In two cases, pancreatic pseudocyst was attempted with a laparoscopic approach. CONCLUSIONS: Definitive treatment of ABP could be accomplished effectively by laparoscopy, with selective indication of ERCP.

Acute Disease↗