Search PubMed⌕ Search

Biomedical subjects

H Bismuth

Publications and source records attributed to H Bismuth.

At least 433 records · Page 24Linked to original sources
PubMed1979

[Experimental hepatic encephalopathy. The effect of portocaval shunt on the evolution of the anterior hypothalamic neurosecretion in the rat (author's transl)].

The evolution of the anterior hypothalamic neurosecretion is studied in control, sham-operated and portocaval shunt rats. In sham-operated related to control rats, no modification of the anterior hypothalamic neurosecretion is observed. In portocaval shunt rats, the hypothalamic neurosecretion increases. This increase is mainly observed into the median eminence in all the portocaval shunt rats. The hypothesis according to which the modification of neurosecretory acitivity of the hypothalamic structures may be related to a discrepancy between the central monoamines is discussed.

Animals↗
PubMed1978

[The economical use of methods employed in the diagnosis of jaundice: decisional attitude as opposed to diagnostic attitude (author's transl)].

For the diagnosis of jaundice, a comparison is established between a classical diagnostic attitude and a decisional attitude which consists in guiding and restricting the investigations according to the therapeutic possibilities. It appears from the comparative study of the two groups of patients that the decisional attitude is better, resulting in a treatment which occurs earlier, is less expensive and probably of a better quality.

Aged↗
PubMed1978

Long term results of Roux-en-Y hepaticojejunostomy.

One hundred and twenty-three patients with benign diseases involving the bile ducts, curable by biliary bypass, underwent a Roux-en-Y hepaticojejunostomy, and the long term results of this operation were evaluated to ascertain if hepaticojejunostomy is a safe and durable procedure. There were no operative deaths. A peptic ulcer developed postoperatively in two patients. Only one instance of anastomotic stenosis was observed at follow-up study, averaging 5.5 years. Six of the 11 patients with postoperative biliary symptoms had intrahepatic lithiasis, a possible indication that the symptoms were due to temporary obstruction of the anastomosis by residual stones. A refined operative technique has improved the results which over-all are highly satisfactory.

Adult↗
PubMed1977

Upper gastrointestinal haemorrhage in hepatic cirrhosis: causes and relation to hepatic failure and stress.

Emergency fibroscopy revealed bleeding lesions in 84 cirrhotic patients. In patients with moderate or no hepatic failure, the commonest actively bleeding sources were oesophagogastric varices and acute mucosal ulcers associated with the ingestion of anti-inflammatory drugs. In patients with severe hepatic failure, acute mucosal ulcers unrelated to drugs predominated and there was evidence that these were stress-induced erosions.

Acute Disease↗
PubMed1977

Temporary liver transplantation in acute liver failure.

The ability of a heterotopic graft to prolong life in animals dying in hepatic coma due to liver necrosis has never been definitely established. Acute hepatic failure was produced in 15 dogs by an hour of total interruption of the hepatic blood supply. Nine dogs received an intrathoracic hepatic homograft concurrently. Nontransplanted dogs died within 21 hours in hepatic coma, while transplanted dogs survived significantly longer (P less than .001). In all transplanted dogs, biological signs of hepatic failure were corrected in 24 hours. In four animals, the graft was removed on the fifth postoperative day. Two of those survived for 10 and 15 days respectively with normal hepatic function. These results demonstrate that a temporary heterotopic liver transplant is able to support life during the acute, normally lethal phase in dogs with massive liver necrosis.

Acute Disease↗
PubMed1977

Improving cholecystectomy.

Bacteriologic study of bile in 100 patients undergoing cholecystectomy for various manifestations of choletithiasis yielded 36 per cent positive cultures, with greater frequency in older individuals and those with acute cholecystitis and common duct stone; these results are comparable to those in previous studies and reaffirm the septicity of the bile. Incidence of wound infection, averanging 10 per cent in published series of cholecystectomies, was 0.5 per cent in 200 patients in whom a water-impermeable wound drape was sewn to the peritoneum to prevent contamination by potentially infected bile. This result, in patients with an infectious risk comparable to that in other series, establishes the value of meticulous wound isolation in preventing wound infection.

Adult↗
PubMed1977

Modifications of 3'-methyl-4-dimethylaminoazobenzene carcinogenesis of rat liver and carcinogen metabolism by portacaval anastomosis.

The effect of portacaval shunt on hepatocarcinogenesis was studied in rats fed 3'-methyl-4-dimethylaminoazobenzene. Portacaval anastomosis resulted in a decrease of hepatocarcinogenesis as reflected by a delay in the early peak of alpha-fetoproteins, an absence of late appearance of alpha-fetoproteins, and a significantly lower incidence of tumors than in nonshunted rats. Reduction of hepatocarcinogenesis in shunted rats was associated with a decrease of the binding of 3'-methy-4-dimethylamioazobenzene metabolites to liver proteins. This effect seemed to be related to modifications of carcinogen-metabolic pathways. While the detoxifying azoreductase activity was not affected by portal diversion, the activating pathway leading to the binding of 4-dimethylaminoazobenzene metabolites to DNA, a major step for cell carcinogenesis that is mediated by microsomal enzymes, was decreased in shunted rats to about 50 percent of control values. The decrease of liver weight that occurred in shunted rats without loss of body weight produced a very significant reduction of the total capacity of liver to activate 4-dimethylaminoazobenzene while the total capacity of detoxification remained unchanged. This could be a direct consequence of portacaval anastomosis, as has been shown for other microsomal enzymes.

Animals↗
PubMed1976

Transient bile duct obstruction. Response of serum bilirubin and alkaline phosphatase levels in the rat.

The immediate evolution of changes in serum bilirubin and alkaline phosphatase levels during and after brief temporary occlusion (12 hours or less) of the main bile duct was studied in the rat. Transient obstruction of the main bile duct of more than one hour was characterized by a simultaneous increase in serum levels of both bilirubin and alkaline phosphatase. The time required for return to normal values was less for bilirubin than the duration of a brief obstruction and was more prolonged for alkaline phosphatase than the duration of obstruction. In obstruction of four or more hours, it was rare to find an isolated elevation of serum bilirubin; this occurred when the control value for alkaline phosphatase levels was low and their relative increase was obscured. Thus, an isolated increase in the serum bilirubin level is infrequently compatible with obstruction of the bile duct, even when transient and of brief duration. Conversely, isolated elevation of serum alkaline phosphatase levels in an acute abdominal syndrome may indicate relieved biliary obstruction.

Alkaline Phosphatase↗
PubMed1976

Portal diversion for portal hypertension in early childhood.

Twenty-three children under 6 years of age with portal hypertention were treated by portal diversion. Fourteen had cavernomatous transformation of the portal vein and 9 had an intrahepatic block due to cirrhosis (8) or congenital hepatic fibrosis (1). Portal-systemic shunts were central splenorenal in 20 patients, side-to-side portacaval in 2 and mesocaval in one. In 20 of the 21 peripheral shunts, the veins used for the anastomosis were less than 10 mm in diameter. There was no operative mortality. Thrombosis of the shunt occurred in 3 children (13%) and was responsible for recurrent bleeding in one who was treated later with success by a mesocaval shunt. The two other children with a thrombosed shunt are waiting, at the present time, for a mesocaval anastomosis. The volume of blood flowing through the shunt was small initially and the fall in pressure gradient was slight: therefore intraoperative angiography appeared to be a better way to assess the patency of shunts done at an early age than pressure or flow measurements. The figures recently reported by Clatworthy, with a mortality rate of 12% directly or indirectly related to repeated hemorrhage, are for us a forceful argument for early adequate management of portal hypertension in children. Until now, portal-systemic shunts have been complicated by a high frequency of thrombosis and have given discouraging results. Our results suggest that it is possible to perform portal diversion successfully on diminutive veins (down to 4 mm). From this experience early portal diversion appears to represent the treatment of choice for portal hypertension in childhood.

Child, Preschool↗