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Biomedical subjects

J Terblanche

Publications and source records attributed to J Terblanche.

At least 163 records · Page 9Linked to original sources
PubMed1981

Acute hepatic ischaemia in the pig- the changes in plasma hormones, amino acids and brain biochemistry.

Acute hepatic ischaemia was induced in pigs by means of a portacaval shunt with hepatic artery ligation after 24 hours. Despite significant elevation in blood ammonia, fatty acids, aspartate aminotransferase, cerebrospinal fluid glutamine and ammonia, and brain tissue glutamine, ammonia and tryptophan, the experimental animals remained awake and alert and indistinguishable from sham-operated controls. The molar ratio of branched-chain to aromatic amino acids fell sharply in the arterial blood, but showed a terminal attempt at compensation in muscle venous samples. Portal and muscle venous insulin levels were elevated, and glucagon values rose in all circulation segments in the experimental group. The failure to induce coma in these pigs, despite the presence of many of the classical biochemical features, suggests that the syndrome of encephalopathy comprises several stages, and that the pig may be an important model in which to define these.

Acute Disease↗
PubMed1980

Insulin, glucagon and liver regeneration.

Partially hepatectomized rats receiving intragastric amino acids synthesize less DNA than similar rats receiving intragastric water alone. In the present study insulin and glucagon levels were measured in rats receiving amino acids or water alone. In both groups of rats insulin levels were depressed and glucagon levels elevated. These findings suggest that insulin and glucagon do not play a major role in the regulation of liver regeneration after partial hepatectomy in the rat.

Amino Acids↗
PubMed1980

Takayasu's syndrome--evidence for a liver lesion.

Liver function tests were carried out in 40 patients with Takayasu's syndrome. The alkaline phosphatase level was elevated in 73% of patients, the SGOT level in 59%, and the lactic dehydrogenase level in 84,6%. In contrast, creatinine phosphokinase levels were elevated in only 23.5% and bilirubin levels were normal in all patients. Histological abnormalities were present in 3 out of 5 patients in whom a biopsy had been performed. These abnormalities may shed light on the aetiology of this syndrome.

Adolescent↗
PubMed1980

The management of patients with portal hypertension and oesophageal varices.

The management of patients with portal hypertension and oesophageal varices remains controversial. Patients with suspected variceal bleeding are resuscitated, and emergency endoscopy is mandatory to determine the source of bleeding. Both intravenous pitressin and the Sengstaken tube are useful in stopping haemorrhage temporarily, but bleeding frequently recurs. In such patients additional treatment is necessary. Currently acceptable alternatives are percutaneous transhepatic obliteration of varices, oesophageal transection with the stapling gun, or peroesophageal injection sclerotherapy. Data are presented to support the use of the latter technique, which is proposed as the treatment of patients whohave bled previously include conventional medical therapy with treatment of each recurrent haemorrhage as it occurs, the use of newer forms of shunts such as the Warren shunt, and repeated sclerotherapy. Whem sclerotherapy is used, a case is made for peroesophageal injection sclerotherapy using a modified, rigid Negus oesophagoscope under general anaesthesia.

Emergencies↗
PubMed1980

The investigation of small vessel anatomy by scanning electron microscopy of resin casts. A description of the technique and examples of its use in the study of the microvasculature of the peritoneum and bile duct wall.

Scanning electron microscopy of microvascular resin casts has revolutionised the study of small blood vessel anatomy in various animals. The present report is the first in which the technique has been used to study capillary networks in man and baboon. The microvasculature of human visceral peritoneum has been described for the first time and the small vessels within the bile duct wall of the baboon have been demonstrated using stereo pairs. The technique is a valuable tool that deserves wider application in both human and animal anatomical research.

Animals↗
PubMed1980

Cholecystojejunocholecystostomy: a new method of biliary drainage in auxiliary liver allotransplantation.

A subhepatic, whole auxiliary liver allotransplant technique, previously developed in the pig, was assessed for technical feasibility in 26 human cadaver transplants. All technical aspects of the subhepatic technique were feasible, with the exception of donor to recipient gallbladder-to-gallbladder anastomosis, which could only be performed in 50% of subjects due to excessive separation of the two gallbladders. To oversome the problem, an original technique was developed--namely, the use of an isolated, vascularized, isoperistaltic loop of jejunum to act as a conduit between donor and recipient gallbladders (cholecystojejunocholecystostomy). Cholecystojejunocholecystostomy was subsequently developed and studied in a series of live porcine auxiliary allografts. The local, reginal, and general effects seen in 14 allografted pigs with cholecystojejunocholecystostomy were compared with those seen in a parallel and identical series of 14 allografts with cholecystocholecystostomy. The subhepatic transplantation technique is described in detail for the first time. Liver biopsies, blood samples, and clinical data were obtained at weekly intervals and at 28 days all survivors were killed. Cholecystojejunocholecystostomy proved to be a successful method of biliary drainage in the pig. Thirteen of the 14 interposed jejunal loops were viable and essentially normal at autopsy, leaks and naked eye stasis were infrequent, and the histological incidence of intrahepatic cholangitis and cholestasis minimal. The local, regional, and general effects were comparable in every way with those obtained with cholecystocholecystostomy.

Animals↗
PubMed1980

Stimulation of hepatic regeneration after partial hepatectomy by infusion of a cytosol extract from regenerating dog liver.

A cytosol liver extract was prepared from adult dog livers and from liver remnants that had been regenerating for one, two and three days after 72 per cent partial hepatectomy. Given intraportally, the most active of these cytosols did not stimulate proliferation in the livers of normal dogs. However, infused during a six hour period into the portal vein of test group dogs, the cytosol from 48 and, especially, 72 hour regenerating livers augmented the regeneration response ordinarily produced by 44 per cent partial depatectomy. The effect was delayed. It became identifiable 48 hours after infusion and rached a peak at 72 hours. Neither augmentation nor significant inhibition of the normal regeneration response was produced by cytosol from normal liver and 24 hour regenerating liver or by six hour infusion of insulin. The amplification effect of active cytosol was equivocal when the infusions were given intraperitoneally and was not demonstrable at all by the intravenous route. In these investigations, it is confirmed that there are growth control factors in regenerating liver but the nature or physiologic significance of the factor or factors has not been clarified.

Animals↗
PubMed1980

Thymidine kinase: an inexpensive index of liver regeneration in a large animal model.

Most studies of liver regeneration have been restricted to small animals because of the cost of assessment of DNA synthesis by the standard method of thymidine incorporation in vivo. This paper presents the use of thymidine kinase as an inexpensive measure of regeneration in large animals. The use of the large model is advantageous because of the availability of serial blood and tissue samples from the same animal. Initially, the responses in thymidine kinase and thymidine incorporation over a period of 96 hr were shown to correspond well in rats subjected to 68% and 34% hepatectomy. Any delays could be attributed to different times of operation. A reproducible technique for 50% partial hepatectomy in the pig was developed, and the animals were studied by daily open liver biopsy for 7 days. The responses in thymidine kinase activity and mitotic indices showed tha peak regeneration occurred at 3-4 days. Levels of aspartate amino transferase were elevated sevenfold after partial hepatectomy but returned to normal within 96 hr. The levels of alkaline phosphatase and bilirubin were unaltered, confirming that the biliary drainage had not been compromised. This study offers the pig as another suitable model for the study of liver regeneration and thymidine kinase activity as a suitable index.

Animals↗
PubMed1979

Liver tumours and the contraceptive pill: Controversies in aetiology, diagnosis and management.

Six female patients seen at Groote Schuur Hospital between 1973 and 1977, with the types of liver lesion that have been linked aetiologically with the contraceptive pill, are described. Four had focal nodular hyperplasia (1 with spontaneous rupture), and 1 patient had a hepatocellular carcinoma. The sixth patient had spontaneous rupture of the liver but no tumour was demonstrated. Based on this experience and a review of the literature, controversies in aetiology, diagnosis and managment are presented. A defined management policy is proposed for the benign lesions, a less aggressive approach being advocated for focal nodular hyperplasia than for hepatic adenoma.

Adenoma↗
PubMed1979

Acid secretion in the bile duct-ligated pig.

Bile duct ligation is associated with severe gastric ulceration in the pig, but the pathogenesis is unknown. Gastric acid secretion was therefore studied before and after bile duct ligation in pigs with Heidenhain pouches. Basal pouch secretion and the response to submaximal pentagastrin stimulation incresed significantly 6--14 days after ligation of the common bile duct (P < 0,05). Bile duct ligation was not followed by gastric ulceration in the pigs in this study which had had, in effect, a 50--70% gastric resection in the course of fashioning the Heidenhain pouch. These observations suggest that oesophagogastric junction ulceration in pigs is associated with gastric acid hypersecretion.

Animals↗
PubMed1979

Growth-stimulating factor in regenerating canine liver.

Extracts from dog livers which had been regenerating for 24, 48, and 72 h after hepatectomy were infused for 6 h into the left portal vein of animals which had fresh portacaval shunts (Eck fistula) and which were killed 2 and 3 days later. The brief exposure to the 48-h and especially the 72-h regenerating liver extracts induced a delayed proliferative response predominantly in the left liver lobes, with a slight spillover effect to the right liver lobes but none to the kidney. The response reached its peak 3 days later. In the left but not the right liver lobes, both the 48-h and the 72-h regenerating liver extract reversed the atrophy ordinarily caused by Eck fistula in 3 days and partly prevented the ultrastructural hepatocyte deterioration characteristic of Eck fistula. The active liver extracts apparently contained a growth-control factor or factors which is (are) not insulin or glucagon.

Animals↗