Biomedical subjects

F Jakab

Publications and source records attributed to F Jakab.

76 records · Page 5Linked to original sources

PubMedDate not supplied

Biliary decompression in the treatment of acute pancreatitis.

The etiology and treatment of acute pancreatitis are discussed. The two main principles are conservative and surgical treatment. Biliary decompression was chosen as an elective method in the surgical treatment of acute pancreatitis, if signs of bile stasis and tension of the common bile duct could be seen. Peritoneal or peripancreatic dialysis were also applied. Five patients were treated in this way; according to literature and our experience it is a good, short and curative intervention for the treatment of acute pancreatitis.

Acute Disease↗

PubMedDate not supplied

Diagnosis and therapy of retroperitoneal abscesses.

The surgical importance of the retroperitoneal space is indisputable. Bordered by the transverse fascia, the abdominal and lumbar muscles and the spine, it is in connection with the mediastinum and the subperitoneal area, and may be the site of various processes causing diagnostic and therapeutic problems. Retroperitoneal processes may arise from organs which are completely or partly retroperitoneal (duodenum, kidneys, major vessels). Of these processes the retroperitoneal abscesses are dealt with in the present work.

Abscess↗

PubMedDate not supplied

Intraoperative estimation of liver blood flow in man.

The intraoperative measurement of the afferent circulation of the liver, namely the hepatic artery flow and portal venous flow was carried out upon 14 anaesthetized patients having carcinoma of the splanchnic area, mainly in the head of the pancreas, by means of transit time ultrasonic volume flowmeter. The hepatic artery flow, portal venous flow and total hepatic flow were 0.377 +/- 0.10; 0.614 +/- 0.21; 0.992 +/- 0.276 l/min, respectively. The ratio of hepatic arterial flow to portal venous flow was 0.66 +/- 0.259. There was a sharp, significant increase in hepatic arterial flow (29.8 +/- 6.1%, p < 0.01) after the temporary occlusion of portal vein, while the temporary occlusion of hepatic artery did not have any significant effect on portal venous circulation. The interaction between hepatic arterial flow and portal venous flow is a much disputed question, but according to the presented data here, it is unquestionable, that the decrease of portal venous flow immediately results a significant increase in hepatic artery circulation.

Adult↗

PubMedDate not supplied

The afferent circulation of the liver in patients with primary hepatocellular carcinoma.

BACKGROUND/AIMS: The data on the afferent circulation of the liver, in patients with primary hepatocellular carcinoma, are controversial or non-existent. MATERIALS AND METHODS: The authors measured hepatic arterial and portal venous flow intra-operatively by transit time ultrasonic volume flowmetry. RESULTS: In patients with primary hepatocellular carcinoma, the hepatic artery flow increased to 0.55 +/- 0.21 l, as compared with the control value of 0.37 +/- 102 l/min (p < 0.01). The portal venous flow decreased from 0.61 +/- 0.212 l/min to 0.47 +/- 0.203 l/min p < 0.01). Owing to the opposite changes in the afferent circulation, the total hepatic blood flow did not change significantly. The ratio of hepatic arterial flow to portal vein flow increased to 1.239 +/- 0.246 in patients with hepatocellular carcinoma, which is twice the basic control value (0.66 +/- 0.259 l/min). After resection, this ratio showed virtually no change. The surgical intervention, that is resection of the liver, did not significantly alter hepatic artery and portal venous flow, although total hepatic blood flow decreased significantly (p < 0.01). The pronounced increase in the ratio of hepatic arterial flow may be attributed to the decrease in portal venous flow caused by the primary hepatocellular carcinoma. The decrease in venous flow can most probably be explained by compression and infiltration of the intrahepatic branches of the portal vein. As we pointed out, the decrease in portal venous circulation leads to an increase in hepatic arterial flow. CONCLUSIONS: On the basis of our initial results, it seems probable that the ratio of the two circulations represents a diagnostic tool for the altered circulation in patients with hepatocellular carcinoma. The significance of this phenomena is not yet quite clear, but a review of the literature shows that similar observations have not been reported. In practical terms this phenomenon may be useful from the point of view of US and Doppler US diagnosis, e.g. in the case of a hypo-echoic or hyperechoir, mass in the liver, increased blood flow in the hepatic, artery, and decreased portal venous flow, a malignant liver tumor is virtually certain. The authors hypothesise that any pathology in the liver may lead to a primary decrease in PVF and a subsequent increase in HAF.

Adult↗