A prospective series of 26 patients with portal hypertension and recent bleeding from esophageal varices was investigated with percutaneous transhepatic selective portography (PTP). PTP was performed immediately prior to and, in 23 patients, just after the initial endoscopic injection sclerotherapy (ST) session to study the acute effects of ST on the mediastinal portal-systemic collaterals. Late follow-up PTP was performed after a median of 8 months in 21 of 26 patients considered endoscopically to be free from esophageal varices after a median of 6 ST sessions. Five patients rebled from esophageal or gastric varices during the follow-up period of 15 months, but there were no fatalities due to variceal hemorrhage. In all patients, the initial PTP showed portal-systemic mediastinal collaterals. Immediately after ST, it was not possible to opacify esophageal varices at all (10 patients) or only partially (7 patients). Five patients died prior to late follow-up PTP. Endoscopic judgment of complete eradication of esophageal varices after repeated ST was in agreement with the late PTP results in 18 of 21 patients. In one patient, PTP showed residual esophageal varices subsequently confirmed by endoscopy. The results were uncertain in two patients for technical reasons. This study supports the opinion that submucosal esophageal varicose veins, as visualized by PTP, can be efficiently eradicated by serial ST, leaving the other mediastinal collaterals unaffected.

Endoscopy↗

PubMedDate not supplied

Malabsorption of hydrochlorothiazide following intestinal shunt surgery.

Hydrochlorothiazide 775mg was administered orally to 5 patients who had undergone intestinal shunt operations for obesity 1.5 to 6 years previously. Postoperative weight loss averaged 53.4kg. The concentrations of hydrochlorothiazide in plasma and urine were determined with gas/liquid chromatography. The mean area under the plasma concentration time curve during 9h in 4 of the patients was 889ng/ml.h. Mean total urinary recovery of hydrochlorothiazide amounted to 23.0mg in the 5 patients, which corresponds to approximately half that seen in healthy volunteers. The gastrointestinal hydrochlorothiazide appears to be substantially reduced after intestinal shunt surgery.

Adult↗

PubMedDate not supplied

Phosphoinositide metabolism and shape control in sheep red blood cells.

Metabolic depletion of sheep red blood cells leads to decreased intracellular concentrations of ATP and reduced glutathione as well as degradation of phosphoinositides. In sheep red blood cells, depletion of ATP induced two types of shape transformation: one early phase involving formation of protrusions on the cell surface similar to those observed upon depletion of human red blood cells; and one late phase, in which the sheep red blood cells develop long, rod-shaped projections. During the initial stages of shape changes, degradation of the phosphoinositides parallels the discocyte-echinocyte transformation, thus giving further support to a shape-controlling mechanism based on the bilayer-couple hypothesis. However, formation of the long projections does not coincide with turnover of the phosphoinositides but rather with the level of reduced glutathione. This indicates that development of these rod-like extensions on the cell surface is induced by oxidative processes that may well involve cross-linking of membrane skeleton proteins.

Adenosine Triphosphate↗