"Skinny needle" cholangiography--results of a pilot study of a voluntary prospective method for gathering risk data on new procedures.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to J A Balint.
Explore the source record for details and available documents.
Cancers of gastrointestinal tract are frequently unresectable at the time of diagnosis and the prognosis for these patients is discouraging. Chemotheapy is often administered in an attempt to prolong life or at least alleviate symptoms. Esophageal squamous cell carcinoma is notoriously refractory to chemotherapy. Gastric carcinoma has higher response rates to combination chemotherapy but over all survival is not greatly prolonged. Advanced pancreatic carcinoma occasionally responds transiently but again median survival is short. Less than 20% of advanced colorectal cancers respond to chemotherapy. Those few patients who do respond usually do live several months longer than nonresponders. The benefits of possible palliation versus the adverse side-effects of these drugs must be weighed on an individual basis. It is still too early to evaluate the efficacy of adjuvant chemotherapy but there may be room for cautious optimism.
The activity of the enzyme system involved in desaturation of palmitic and stearic acid has been examined in lungs of rats fed fat-free diets supplemented either with 4% safflower oil (controls) or 4% tripalmitin (essential fatty acid (EFA) deficient) both in vivo and in vitro in lung slices. Desaturation, as measured by appearance of 14C-labeled monounsaturated fatty acid in pulmonary total lipid and phospholipids, was significantly greater in vivo and in vitro in lung tissue from EFA-deficient rats. In vitro peincubation of lung slices for 1 to 4 hr with 1 mM oleic, linoleic, or linolenic acid reduced the extent of desaturation of [1-14C]-stearic acid significantly in both dietary groups, but the effect was greater in EFA-deficient tissues. The effect of linoleic acid was always greater than that of oleic acid. Preincubation with palmitic acid and 16,16-dimethyl PGE2 was without effect. Thus: 1) EFA deficiency has been shown to enhance desaturation of palmitic and stearic acid in lung; 2) in vitro addition of linoleic or linolenic acid inhibited desaturation significantly; and 3) oleic acid was inhibitory but to a lesser and more variable extent. Palmitic acid was not inhibitory.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A group of 29 patients with decompensated cirrhosis of the liver who retained a large amount of ascites under a hospital regimen during two months or longer was identified. The prognosis for this selected group of patients, while grave [during continuous hospitalization 11 out of 29 patients (= 38%) died], is not without hope: 18 patients (62%) improved and could be discharged from the hospital. Their further course was influenced by resumption of alcohol usage. Five of 11 (45.4%) who resumed drinking died due to hepatic causes within 10 months. Of the remaining six only one lost his ascites. Those who abstained (7 patients) remained alive for an average follow-up of 33 months and all lost their ascites. Alcohol resumption significantly decreased both survival (P less than 0.05) and ascites resorption (P less than 0.0015). Continued abstinence from alcohol may thus obviate the need for surgical measures to relieve ascites in these patients.
Explore the source record for details and available documents.
Male weanling rats were fed fat-free diets supplemented with 4% (w/w) safflower oil (control) or 4% tripalmitin (essential fatty acid (EFA) deficient) for 14 weeks. Whereas the amount of lecithin in lung lavage material remained unchanged, lung lavage lecithin from EFA-deficient rats contained significantly less palmitic acid (61.4 +/- 2.0% vs. 77.4 +/- 5.8%, P less than 0.01) than that from controls. Surface tension vs. area hysteresis loops were obtained for total lipid extracts (TLE) of lung lavage fluid, intra- and extra-cellular lipoprotein fractions (IBI and IBE) and lipid extracts of those lipoprotein fractions (LBI and LBE). A significant increase in minimal surface tension (gammamin) was found for all samples obtained from EFA-deficient rats as compared to controls. Refeeding of diets containing safflower oil for 7-14 days reversed these changes. Air pressure-volume curves on degassed, excised lungs indicated that greater pressure is required to maintain a given lung volume in EFA-deficient rats. These results support the hypothesis that the fatty acid composition of pulmonary surfactant lecithins is a major determinant of the surface activity of lung extracts.
Explore the source record for details and available documents.
In order to evaluate the role of surfactant lecithin composition in the development of the infantile respiratory distress syndrome (IRDS) we have examined lecithin fatty acid composition from gastric aspirates obtained at the time of delivery from 14 full term healthy infants, 9 control premature infants without respiratory distress, and 16 premature infants who developed IRDS. The latter had significantly reduced concentrations of palmitic acid (48.4 +/- 1.8% vs. 65.3 +/- 1.5% in fullterm and 59.5 +/- 0.8% in control premature infants, P less than 0.001). None of the infants in whom palmitic acid was more than 60% of total lecithin fatty acids developed IRDS, whereas 10 of 11 infants with values below 50% did develop this complication. Lecithin from gastric aspirate was shown to be similar in fatty acid composition to lecithins from tracheal washings and amniotic fluid. Palmitic acid concentrations in lecithins of serial tracheal washings paralleled the clinical course of eight infants with IRDS.
Explore the source record for details and available documents.
This study was undertaken to asses the role of luminal lecithin in the lymphatic transportation of fat as chylomicrons. Two doses of fat, the low and high dose, were fed to two different groups of rats, control and bile fistula. At low dose, infusing at 35 mumoles of total fatty acid per hr of a mixture of oleic acid and monoolein, molar ratio 2:1, solubilized in 55 mumoles of sodium taurocholate, there was no difference in the lymphatic output of absorbed fat during steady state (7th and 8th hour) absorption. Infusing at a high dose, 173 mumoles of total fatty acid per hr of a mixture of oleic acid and monoolein, molar ratio 2:1, solubilized in 55 mumoles of sodium taurocholate, the bile fistula rats had lower triglyceride and phospholipid output, with a higher proportion of oleic acid in lymph lecithin than did control rats. These alterations in bile fistula rats returned to normal by addding 10 mumoles per hr of biliary lecithin to the infusate. We conclude that intraluminal biliary lecithin plays a significant role in the translocation of high doses of absorbed fat into lymph and in the amount and type of lecithin synthesized.
Previous studies (Kyriakides, E.C., Beeler, D.A. and Balint, J.A. (1974) Clin. Res. 22, 717a, and Burnell, J.M. and Balint, J.A. (1975) Fed. Proc. 34, 426) have indicated that essential fatty-acid deficiency in rats resulted in significant reduction of palmitate content of lung tissue and lavage phosphatidylcholines. Experiments were, therefore, undertaken to confirm and further characterize these changes and to examine the reversal of these alterations when essential fatty acid deficient rats were fed fat-free diets supplemented with linoleate for 1-14 days. Analysis of the fatty acid composition of liver lipids was used to confirm the presence of essential fatty-acid deficiency in rats that were fed a fat-free diet supplemented with 4% by weight of tripalmitoylglycerol for 14 weeks. Phosphatidylcholines from lung tissue and lavage fluid of essential fatty-acid deficient rats contained significantly less palmitate and significantly more palmitoleate and oleate than those rats receiving linoleate. These changes in fatty acid composition were reflected in a significant reduction of disaturated phosphatidylcholines (predominantly dipalmitoyl) in lung tissue and lavage fluid from essential fatty-acid deficient rats, while the total phosphatidylcholine content remained unchanged. On feeding the diet containing linoleate to the deficient rats, a reversal of these changes began after one day and was nearly complete by 7-14 days.
Explore the source record for details and available documents.
Extensive infarction of the liver, initially thought to be halothane hepatitis, is described. The patient developed severe right upper quadrant abdominal pain and abnormal liver function tests after amputation of the leg. The correct diagnosis was made by percutaneous needle biopsy of the liver which demonstrated a large area of avascular necrosis. The patient recovered, indicating the remarkable ability of the liver to maintain function despite ischemic injury. The patient died later from an acute myocardial infarction, and at autopsy thrombosis of the hepatic artery and multiple hepatic infarcts were confirmed.
Two cases are presented of short bowel syndrome. Both had had the colon or part of the colon bypassed as part of prior surgical management in addition to having had extensive resection of the small bowel. Despite various medical regimens, both patients remained in negative fluid and electrolyte balance thus requiring intravenous fluid supplementation. In an effort to maintain positive fluid balance without intravenous therapy, colonic infusion of fluids was initiated. This modification of management proved effective in maintenance of adequate plasma volume and normal renal function. It is concluded that this type of therapy can be of great benefit in the management of patients with the short bowel syndrome.
A 23-year-old ex-bicycle racer with vague gastrointestinal symptoms had an acute weight loss of 13.6 kg (30 lb). During the period of maximal weight loss, he experienced muscle weakness, dysphagia, bradycardia, and T wave changes on the electrocardiogram. His skeletal muscle biopsy showed a severe vacuolar myopathy devastating the atrophic type II fibers. Without treatment, he recovered completely and has remained well. This may be an exaggerated or acute form of type II atrophy not previously reported, or it may represent an acute muscular degeneration.
Labeled lecithin (32P, 2-3H-glycerol, 1-14C-palmitate) was prepared for studying absorption of lecithin by rat intestine and its incorporation into microsomal and prechylomicron-chylomicron lecithin. Bile fistula rats were perfused intraduodenally with bile salts and lecithin plus a liquid diet. Intestinal samples were obtained after sacrifice and specific activities (DPM/mumol) of isotopes in lecithin were determined. Ratios of specific activities of isotopes were calculated and compared to respective ratios in the original perfusate lecithin. Radioactivity rapidly appeared in jejunal lecithin following perfusion. When specific activities of isotopes in prechylomicron-chylomicron lecithin were compared to those in microsomal lecithin, specific activities were always greater in prechylomicron-chylomicron lecithin. Analysis of ratios of specific activities of isotopes in jejunal lecithin showed that the ratios were nearly identical to those in perfusate phospholipid, indicating that the lysolecithin portion of luminal lecithin can be absorbed intact and can then be utilized for jejunal lecithin synthesis.