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Biomedical subjects

I Rotkvić

Publications and source records attributed to I Rotkvić.

35 records · Page 2Linked to original sources
PubMed1991

The value of pancreatic pseudocyst amylase concentration in the detection of pseudocyst communication with the pancreatic duct.

The aims of the study were to compare the results of endoscopic retrograde cholangiopancreatography (ERCP) and percutaneous cystopancreatography (PCP) in the detection of the communication between the pancreatic pseudocyst and the pancreatic duct, and to assess the reliability of the increased amylase concentration in the pseudocyst content as an indicator of the existence of communication between the pancreatic pseudocyst and the pancreatic duct system. Forty-three patients were included in the study. Pseudocystic fluid content was obtained by percutaneous aspiration. Twenty-four patients had pseudocyst amylase concentrations above 64 Wolgemuth units (WU), and 19 patients had less than 64 WU. The communication between pseudocyst and the pancreatic duct was determined in 22 patients by ERCP and in 13 patients by PCP, all in the group with increased pseudocyst amylase concentration. Due to high sensitivity and specificity of pseudocyst amylase concentration for the existence of pseudocyst communication with the pancreatic duct, we conclude that guided percutaneous aspiration of the pancreatic pseudocyst with the determination of amylase concentration in the fluid can replace ERCP as a method of choice for the detection of pseudocyst communication with the pancreatic duct.

Adult↗
PubMed1990

Influence of the degree of liver failure on portal blood flow in patients with liver cirrhosis.

Portal vein haemodynamics as demonstrated by the pulsed Doppler system were studied in 37 patients with cirrhosis who had been classified in three groups (A, B, and C) in accordance with the degree of liver failure. Maximal inner diameter of the portal vein was significantly lower in patients who were considered to be in good condition (group A) than in patients with moderate and severe liver failure (group B and group C) (p less than 0.001). A significant difference was also found between group A and group B and between group A and group C with regard to the portal blood velocity and portal blood flow (p less than 0.001). In accordance with the presence and size of the oesophageal varices, in patients with large varices the portal blood velocity and portal blood flow were significantly lower than in patients without varices (p less than 0.001), whereas maximal inner portal vein diameter was significantly higher (p less than 0.001). This study demonstrated that in patients with cirrhosis circulatory alterations in the portal vascular bed may be, at least in part, an indicator of the stage of liver disease.

Adult↗
PubMed1990

[Spontaneous bacterial peritonitis in patients with decompensated liver cirrhosis and "tense" ascites].

In the study 52 patients with decompensated liver cirrhosis and "tense" ascites were included. According to the clinical picture, ascites cultures and the number of polymorphonuclears in cmm of the ascitic fluid, all patients were selected in one of the following groups: 1. group of patients with sterile ascites (28), 2. group of patients with spontaneous peritonitis (16), and 3. group of patients with bacterascites (8). The results have shown that the incidence of spontaneous peritonitis is much higher in the group of "tense" ascites patients than in the group of all patients with ascites, the ratio being 30.7% compared to 6% in all cirrhotic patients with ascites. Spontaneous bacterial peritonitis correlates with increased polymorphonuclears in the ascitic fluid (p less than 0.05), decreased pH values (p less than 0.0), and increased amounts of total proteins in the ascitic fluid (p less than 0.05). The lethality rate in the group of spontaneous peritonitis and sterile ascites was 43.7% and 7.1% respectively. Early diagnosis and, of course, adequate therapy are the main points in spontaneous bacterial peritonitis.

Adult↗
PubMed1989

[Evaluation of disorders of portal and total hepatic blood flow in patients with chronic diffuse liver diseases].

The total hepatic blood flow measured with radioactive colloidal gold and the portal blood flow with the echo-Doppler method were investigated in 19 healthy examinees and 63 patients with chronic diffuse liver diseases. In the group of healthy examinees, the average values of the total hepatic blood flow was 1254 +/- 231 ml/min and of the portal one 1104 +/- 227 ml/min. The lowest blood flow values were obtained in patients with decompensated cirrhosis, especially in the hepatic (704 +/- 186 ml/min) and the portal blood flow (562 +/- 198 ml/min). In all the groups of examinees, registered values of the total hepatic blood flow were significantly higher than the values of the portal blood flow. The relations of the values obtained by both methods, among groups, were similar. By both methods decreased values are not obtained in liver steatosis and chronic persistent hepatitis in relation to the normal values. In patients with more serious forms of chronic diffuse liver diseases (cirrhosis and chronic active hepatitis) significantly lower blood flow values than the normal ones were obtained. Both methods contribute to the investigation of liver circulation disturbances, liver function damages, and to the follow-up of the liver disease course. The possibility of an indirect evaluation of the arterial hepatic blood flow from the difference of hepatic and portal blood flows may mean a new approach to the investigation of pathophysiological liver occurrences.

Adult↗
PubMed1989

[Potential risk of pharmacologically induced hypochlorhydria in the treatment of peptic ulcer disease].

The introduction of the very potent anti-secretory ulcer-healing drugs that effectively inhibit gastric acid secretion actualized the problem of pharmacologically induced hypochlorhydria. Potential dangers of hypochlorhydria relate mainly to the observation that various microorganisms normally destroyed by gastric acid survive and proliferate in the stomach and small intestine and thus increase the risk of the serious gastrointestinal infections. It has been also suggested that the proliferation of the intragastric bacteria may convert dietary nitrate into nitrite that may be nitrosated to carcinogenic N-nitroso compounds. Increased risks of nosocomial pneumonia or acute stress bleeding in ventilated intensive care unit patients become additional hazards during the treatment with antisecretory agents. Moreover, there is now evidence that after a course of treatment with antisecretory agents peptic ulcer recur more rapidly. Obviously, enthusiasm resulting of the great efficacy of antisecretory drugs in promoting ulcer healing must be hampered by previous considerations.

Anti-Ulcer Agents↗
PubMed1988

The influence of dopamine agonists and antagonists on indomethacin lesions in stomach and small intestine in rats.

Dopamine agents (saline in control groups) were coadministered with indomethacin by either single or repeated application. The ulcerogenic effect (erosions and/or ulcers) of repeated given indomethacin on gastric mucosa differed clearly from that on intestinal mucosa. The effect on intestinal mucosa was markedly greater than after a single dose. The effects of dopamine agents appeared to be more consistent. Domperidone and haloperidol, given as single or repeated doses, strongly aggravated both the gastric and intestinal lesions. Bromocriptine and amantadine had a protective effect. The adverse effects of both dopamine antagonists (increased after repeated administration) were strongly inhibited by the simultaneous administration of either bromocriptine or amantadine. The involvement of the dopamine system (central or peripheral) in the mechanisms that maintain gastric (probably related to cytoprotection also) and intestinal mucosa integrity is therefore suggested.

Animals↗
PubMed1988

The influence of dopamine receptor agonists and an antagonist on acute pancreatitis in rats.

The influence of the dopamine receptor-stimulating agent, bromocriptine, the dopamine-releasing drug, amantadine, and the dopamine antagonist, domperidone, on acute pancreatitis was studied in rats. Acute pancreatitis was induced by ligation of the bile duct at its point of entry into the duodenum. Each drug was applied intraperitoneally 1 h before induction of acute pancreatitis and all the surviving animals were killed 24 h thereafter. The control, saline-pretreated animals exhibited the mortality rate, macroscopical and histological changes, as well as increase of serum amylase levels that were consistent with acute pancreatitis. Domperidone induced a large increase in serum amylase which was significantly reduced by the simultaneous administration of bromocriptine. However, both bromocriptine and amantadine, when given separately did not prevent the increase of serum amylase levels to the control levels. Statistical analysis showed that the difference between the mortality rate in the control and treated groups did not reach the level of significance probably due to the rather limited number of animals used. On the other hand, application of bromocriptine as well as amantadine successfully reduced the onset of acute pancreatitis whereas domperidone, a rather specific peripheral dopamine receptor blocker, had the opposite effect. Both bromocriptine and amantadine significantly reduced the mortality rate from acute pancreatitis in domperidone-pretreated rats. Since the aggravating effect of domperidone was successfully reduced by simultaneous application of bromocriptine, we think that these effects are mediated by peripheral dopamine receptors. However, the mechanisms whereby dopamine receptor-stimulating and dopamine-releasing drugs produce their beneficial effects remain to be elucidated.

Acute Disease↗
PubMed1987

The influence of dopamine agonists and antagonists on gastric lesions in mice.

The dopamine agonist bromocriptine and L-dopa significantly inhibited whereas dopamine antagonist haloperidol aggravated the gastric lesions induced by pylorus ligation in mice as found earlier for rats. Furthermore, the successful use of a dopamine antagonist alone for the induction of gastric lesions also in mice was demonstrated, since the gastric lesions were induced by a single dose of haloperidol without any additional noxious treatment. Bromocriptine successfully inhibited both the gastric lesion-potentiating as well as the gastric lesion-inducing effect of haloperidol.

Animals↗
PubMed1986

Dopamine antagonists induce gastric lesions in rats.

Gastric lesions were provoked in all rats that had received intraperitoneally a single dose of the dopamine antagonists haloperidol, metoclopramide or domperidone 24 h before. Dose-dependence was demonstrated for haloperidol. This drug induced gastric lesions as early as 90 min after its application. The ulcerogenic effect of haloperidol was completely prevented or markedly reduced by simultaneous applications of dopamine agonists bromocriptine or L-dopa. We conclude that the model of gastric lesions induced by dopamine antagonists could be successfully applied in further investigations of the role of dopamine in the pathogenesis of ulcer disease.

Animals↗
PubMed1983

Eosinophilia caused by iodinated radiographic contrast media.

Statistically significant eosinophilia was noted in the peripheral blood of a group of 108 patients 48 h after the administration of iodinated radiographic contrast medium (RCM). The duration of eosinophilia was approximately 6 days. Eosinophilia had no accompanying clinical symptoms except for two cases where urticaria appeared. The incidence of eosinophilia was irrespective of dosage or type of RCM. Possible mechanisms responsible for eosinophilia have been considered. Since eosinophilias of other aetiologies are common, it is of practical importance to distinguish these from RCM-induced eosinophilias.

Contrast Media↗
PubMedDate not supplied

Assessment of value of pancreatic pseudocyst amylase concentration in the treatment of pancreatic pseudocysts by percutaneous evacuation.

The aim of our study was to determine the value of the percutaneous pancreatic pseudocyst evacuation. We assessed the relation between the amylase concentration of the pseudocyst contents and the final outcome of the disease treated by the percutaneous evacuation. Forty-three patients with a history of acute pancreatitis and pancreatic pseudocysts larger than 5 cm in diameter that persisted beyond 6 weeks were divided into four groups relative to the amylase concentration in the pseudocystic contents and the number of evacuations. The results show a good correlation between low amylase concentration in the liquid pseudocystic contents (less than or equal to 64 WU) and the healing rate after the percutaneous evacuation (p less than 0.001). The percutaneous evacuation of the pseudocysts failed in patients with increased amylase concentrations in the pseudocyst fluid regardless of the number of evacuations. We conclude that surgical treatment is indicated in patients who have amylase-rich pseudocyst contents.

Adult↗
PubMedDate not supplied

[New findings in the etiopathogenesis of ulcers and reevaluation of therapy].

The etiopathogenesis of ulcer disease is comprehensive and many experimental and clinical data failed to prove the primary cause of the disease. Although much has been learned concerning the pathophysiological mechanism which appear important in the development of ulcer disease, our present knowledge of the etiology of this disease is incomplete. Depression of the gastric acid secretion still remains the main treatment approach, although the cytoprotective drugs are interesting therapeutic challenge. Etiology of the peptic ulcer disease is not solved yet, but the defense mechanisms of the gastric mucosa are much more clear what will lead to better understanding of the defense mechanisms in the gastric cancer. Omeprazole is an interesting new drug healing peptic ulcer in almost 100% of the patients. A philosophic question may be asked: "Do we need to know the etiology of the disease in order to be able to treat it properly?" Omeprazole heals the ulcer and, in fact, we do not know its etiology. In the cost-benefit ratio, the most widely used drugs are still H2-receptor antagonists and sucralfate, and omeprazole is reserved for the patients with resistant ulcer disease, Zollinger-Ellison syndrome and severe reflux esophagitis.

Humans↗
PubMedDate not supplied

[Cigarette smoking and ulcerative colitis--is there a causal relationship?].

The relation between cigarette smoking and ulcerative colitis was assessed in a case-control study of 235 cases of ulcerative colitis and 311 age- and sex-matched control subjects admitted to the hospital for conditions unrelated to smoking. Smoking habits and daily number of cigarettes smoked were analysed. We found significantly less number of smokers and more ex-smokers in the ulcerative colitis group. The intensity of smoking was equal in both groups. It was noted that pancolitis occurred more frequently in the ex-smokers group. The intensity of smoking did not influence the extension and clinical course of ulcerative colitis. For ulcerative colitis, the relative risk for nonsmokers was 7.4. The study revealed a positive correlation between nonsmoking and ulcerative colitis, higher incidence of pancolitis among ex-smokers and higher relative risk of ulcerative colitis for never-smokers. Various possible causes of influence of smoking on ulcerative colitis are discussed.

Adolescent↗