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Biomedical subjects

H S Himal

Publications and source records attributed to H S Himal.

At least 37 records · Page 2Linked to original sources
PubMed1987

Endoscopy in patients undergoing gastroplasty for morbid obesity.

Fifty patients underwent gastroplasty for morbid obesity. The follow-up regimen included both nutritional and weight assessment and gastroscopy. Weight loss was satisfactory in patients with gastric stomas less than 9 mm in diameter. Stomal obstruction was endoscopically diagnosed in 5 patients. Endoscopic dilatation was successful in 4 patients. Gastroscopy should thus be a routine postoperative procedure in patients undergoing gastric partitioning for morbid obesity.

Female↗
PubMed1987

Endoscopic vs surgical gastrostomy for enteral nutrition.

A retrospective review of 78 patients who had undergone endoscopic gastrostomy and 22 patients who had undergone Stamm gastrostomy was carried out. The mean operative time for the Stamm gastrostomy group was 63 min, while that for the endoscopic gastrostomy group was 26 min. One operative complication--bleeding--requiring reoperation occurred in the Stamm gastrostomy group. The incidences of aspiration, pneumonia, wound infection, and mortality were significantly higher in the Stamm gastrostomy group. We conclude that percutaneous endoscopic gastrostomy is the preferred technique for long-term enteral nutrition.

Adolescent↗
PubMed1986

Therapeutic endoscopy.

The development of flexible endoscopic instruments has altered the surgical approach to many disease processes. Endoscopic treatment of gastrointestinal polyps, common bile duct stones and foreign bodies of the gastrointestinal tract has now become the preferred method of treatment. Endoscopic gastrostomy is replacing surgical gastrostomy for the patient who requires long term enteral nutrition. Sclerosis of esophageal varices has now become the preferred method of managing patients with portal hypertension and bleeding esophageal varices. As newer endoscopic instruments are developed, more and more operative procedures will be carried out by endoscopic methods.

Ampulla of Vater↗
PubMed1985

Endoscopic control of upper gastrointestinal bleeding.

One important objective in managing patients with upper gastrointestinal hemorrhage is to control the bleeding until the patient's condition is stable and definitive therapy can be carried out. Endoscopic techniques are now available to attain this goal. Endoscopic sclerosis has become an accepted treatment for bleeding esophageal varices, especially in patients with Child's class B or C cirrhosis. Control of nonvariceal bleeding by endoscopic techniques is now feasible and involves laser photocoagulation and electrocoagulation. Clinical experience with endoscopic laser photocoagulation has demonstrated that it can successfully arrest bleeding in gastric and duodenal ulcers. Endoscopic electrocoagulation has been successful in stopping bleeding from Mallory-Weiss tears, acute gastric erosions, and gastric, duodenal and stomal ulcers. Use of an endoscopic heater probe, now in the development stage, to control bleeding gastric and duodenal ulcers will be an important addition.

Adult↗
PubMed1984

Leukocyte lysosomal function in sepsis.

We investigated leukocyte lysosomal enzyme release, lysosome latency and myeloperoxidase activity in 117 patients admitted for elective operations and in 17 control patients. Fifteen patients had infectious complications develop in the postoperative period and in these patients, percentage lysosomal enzyme release and myeloperoxidase activity significantly decreased and remained low on the 7th postoperative day. In four of the 15 patients, these changes were present prior to the development of infectious complications. We conclude that abnormal leukocyte lysosomal enzyme release and myeloperoxidase activity may play a role in patients who have infectious complications develop after undergoing elective operations.

Humans↗
PubMed1983

Localized colonic perforation following renal transplantation.

Well-contained abdominal abscesses developed in two renal transplant patients ten years and six months, respectively, after transplantation. Investigations including gastrointestinal series and CT scan demonstrated cystic collections within the abdominal cavity. Laparotomy in each case revealed an infected cystic mass arising from the sigmoid colon. In both patients deroofing the abscess and, in one patient, defunctioning colostomy were performed. Both patients did well in the postoperative period.

Abscess↗
PubMed1983

Lysosomal enzymes and acute gastric erosions: a review.

Lysosomal enzymes, acid hydrolases with acid pH optimum, are involved in cell death. Recent evidence has also indicated a role for these enzymes in the pathogenesis of acute gastric erosions. Aspirin-acid, bile-acid and bacterial peritonitis cause lysosomal instability, the release of lysosomal enzymes and acute gastric erosions. Prostaglandins such as 16,16-dimethyl prostaglandin E2 will stabilize lysosomal membranes, decrease lysosomal enzyme release and prevent acute gastric erosions.

Animals↗
PubMed1983

The effect of methylprednisolone on bile-treated gastric mucosal lysosomes.

Various investigators have reported that steroids have ulcerogenic properties both in the experimental and clinical situation, while others have reported that steroids will protect against acute ulcer formation. Lysosomal enzyme studies were carried out to investigate the role of steroids on gastric mucosal lysosomal membrane stability. Antral mucosa from normal male mongrel dogs were centrifuged, and the lysosomes isolated. The lysosomes were then incubated in different concentrations of methylprednisolone. Methylprednisolone at the lower doses caused increased free lysosomal enzyme release and decreased lysosome latency. However, at the higher dose, methylprednisolone did not alter lysosome latency. These results may explain the common finding that methylprednisolone at higher doses, causes gastric mucosal damage, while at lower doses it protects gastric mucosa against irritants.

Adrenal Cortex Hormones↗
PubMed1983

Prostaglandin cytoprotection and lysosomal stability in acute canine gastric erosions.

Prostaglandin cytoprotection may be related to lysosomal stability. In six mongrel dogs, bacterial peritonitis was created by the intraperitoneal instillation of Bacteroides fragilis, Pseudomonas aeruginosa, Streptococcus faecalis and Klebsiella pneumoniae in addition to canine gallbladder bile. In three dogs, gallbladder bile alone was instilled. Three of the six dogs with bacterial peritonitis also received 16,16-dimethyl prostaglandin E2 (PGE2) (0.2 micrograms/kg intramuscularly q6h) 24 hours before and for 3 days after the induction of peritonitis. In the dogs with bacterial peritonitis not receiving PGE2, gastroscopic examination demonstrated acute fundic erosions. None of the other dogs developed acute gastric erosions. In the dogs with bacterial peritonitis not receiving PGE2, fundic mucosal biopsy specimens demonstrated decreased lysosomal stability. In the dogs receiving PGE2, lysosomal stability was similar to that in the animals with bile peritonitis. These experiments demonstrate that PGE2 prevents the development of acute gastric erosions by stabilizing lysosomal membranes.

Animals↗
PubMed1982

Necrotizing pancreatitis in renal transplant patients.

Acute necrotizing pancreatitis developed in 5 of 405 patients who underwent renal transplantation. All five patients were taking immunosuppressive medication (azathioprine and steroids). Three patients also received rabbit antithymus serum. Alcohol ingestion or cholelithiasis did not play any causative role in the pancreatitis, which began between 7 days and 13 months after renal transplantation. The delay from the time of admission for pancreatitis to surgical exploration was a mean of 17 days. Operative findings included pancreatic necrosis, hemorrhage and abscess formation. All five patients died of the complications of necrotizing pancreatitis--persistent sepsis, respiratory and renal failure, upper gastrointestinal bleeding and disseminated intravascular coagulation. This review demonstrates that prolonged conservative therapy in renal transplant patients with necrotizing pancreatitis is associated with high mortality. The authors believe that earlier surgical intervention will lead to increased survival.

Acute Disease↗
PubMed1982

Increased mucosal lysosomal enzyme activity in sepsis-associated gastric lesions.

The role of lysosomal enzymes in the pathology of gastric mucosal damage has been demonstrated for stress-, aspirin-, and bile-induced acute gastric erosions. In a septic canine model we measured gastric mucosal beta-N acetylhexosaminidase activity during the evolution of septic-induced acute gastric erosions. In the first septic day bleeding acute gastric erosions developed in the fundus while in the antrum minimal petechiae appeared. During this period beta-N acetylhexosaminidase activity significantly increased in fundic mucosa that was grossly normal but significantly decreased in grossly normal antral mucosa. These experiments thus demonstrate that during the evolution of septic gastric mucosal damage the earliest abnormality is significant increase in mucosal lysosomal enzyme activity.

Animals↗
PubMed1981

Prognosis after surgical treatment for granulomatous enteritis and colitis.

To assess the rate of recurrence of Crohn's enterocolitis, 118 patients with Crohn's disease of the small intestine, the small and large intestine, or only the large intestine who had surgery were assessed. Of 53 patients with disease confined to the small intestine, 25 had recurrence, while 19 of 37 patients with disease of the small and large intestine had recurrence. Of 16 patients with Crohn's disease of the colon who had limited reaction, 11 had recurrence. None of the 28 patients with Crohn's disease of the colon or rectum, followed up for 5 years, had recurrence in the small intestine. This study demonstrates that (1) limited resection for Crohn's disease of the colon leads to a significant recurrence rate, and (2) in patients with Crohn's disease localized to the colon, follow-up for at least 5 years revealed no recurrence in the small intestine.

Adult↗
PubMed1981

Experimental and clinical studies of mesenteric infarction.

Results of our experimental studies have demonstrated that, during the evolution of mesenteric infarction, lysosomal membrane instability occurs with the release of beta-N acetylhexosaminidase into the portal and systemic circulation. Preliminary clinical results suggest an elevation of the Hex B fraction in mesenteric infarction. Measurements of total and various fractions of beta-N acetylhexosaminidase in the blood may prove to be an early indication of necrosis of the intestine.

Adult↗