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Biomedical subjects

M J Slooff

Publications and source records attributed to M J Slooff.

210 records · Page 12Linked to original sources
PubMed1979

Venous hypertension of the hand caused by subcutaneous arteriovenous fistulae established for hemodialysis.

Side-to-side arteriovenous fistulae established in patients on chronic intermittent hemodialysis can cause venous hypertension. This gives rise to pain, pigmentation and trophic ulcers. Four patients with these complications are described. In three patients, with a fistula between the radial artery and the cephalic vein, the thumb and the second and third fingers were affected. In the fourth patient, with a fistula between the ulnar artery and the basilic vein, the fourth and fifth fingers were involved. This finding suggests segmental venous drainage of the hand. All patients were cured by ligation of the distal vein. An end-of-vein-to-side-of-artery fistula does not cause the complication described, and for this reason is to be preferred.

Arteriovenous Shunt, Surgical↗
PubMed1978

Machine perfusion versus cold storage for preservation of kidneys before transplantation.

Machine preservation was introduced into the Groningen Transplant Group in December 1972. Thirty five of the 90 kidneys transplanted in the following period of four years were preserved on a machine. The other kidneys were preserved by the so-called cold storage method. The advantages and disadvantages of both methods are outlined. Evidence is found in the literature and in this study that cold storage is sufficient for preservation-times up to 24 hours. When the preservation time exceeds this period, then machine preservation may be an advantage. Kidneys damaged by ischaemia were found to have a higher percentage of immediate function when preserved by the machine compared to those preserved by cold storage. There was no significant difference in one-year graft survival for the kidneys preserved by either method. Machine preservation helps to select between viable and non-viable kidneys from non-heartbeating donors. This is especially important in view of the lack of kidneys for transplantation. Therefore, in the opinion of the authors, it is necessary to continue with machine preservation in selected centres and to make the facilities of these centres available to every donor hospital in The Netherlands.

Animals↗
PubMedDate not supplied

Ultrasound and cholangiography for the diagnosis of biliary complications after orthotopic liver transplantation: a comparative study.

The ability of ultrasound to detect biliary obstruction, bile leakage and generalized ductal changes after orthotopic liver transplantation (OLT) was compared to cholangiography. Cholangiography was considered to be the gold standard. Adequate opacification of the biliary tree was achieved in 139 cholangiograms. Biliary obstruction, intermediate or large bile leakage, and generalized ductal changes were diagnosed with cholangiography in 15% (21/139), 14% (20/139), and 16% (22/139), respectively. Normal ultrasound findings could not exclude biliary stricture, generalized ductal changes, or bile leakage, and fluid collections were not correlated with bile leakage. Abnormal ultrasound findings were highly predictive of the cholangiographic diagnosis of biliary obstruction or generalized ductal changes (specificity of 98% and 100%, respectively). An irregular appearance of the bile ducts and increased periductal echogenicity proved to be characteristic features for generalized ductal changes.

Adolescent↗
PubMedDate not supplied

Orthotopic liver transplantation in Groningen, The Netherlands (1979-1983).

From March, 1979 to March, 1983, 26 orthotopic liver transplantations and 1 retransplantation were performed in our center. Sixteen patients are alive, 5 beyond 2 years and 1 longer than 4 years after transplantation. The actuarial 1- and 2-year survival is 60%. Factors contributing to this result are patient selection and biliary anastomosis. In cirrhotic patients, the degree of deterioration of liver function correlated with survival; in patients with hepatocellular carcinoma, extrahepatic spread of tumor was the most frequent limiting factor. Choledochocholedochostomy with a widening plasty had a low complication rate providing that the arterial blood supply was undisturbed. Until now, HLA-matching has not contributed to the result of liver transplantation, although the effect for long-term survival is still unknown. The high survival rate and excellent quality of life of long-term survivors justify liver transplantation as treatment for otherwise noncurable liver diseases.

Adolescent↗
PubMedDate not supplied

Subtypes of antimitochondrial antibodies in primary biliary cirrhosis before and after orthotopic liver transplantation.

Antimitochondrial antibodies are markers for primary biliary cirrhosis and probably reflect a specific defect in immunoregulation underlying this disease. Antimitochondrial antibodies and their primary biliary cirrhosis-specific subtypes were tested before and up to 6 years after orthotopic liver transplantation. Sera from 31 consecutive patients were tested, 15 patients had primary biliary cirrhosis and 16 non-primary biliary cirrhosis. Antimitochondrial antibodies were investigated under code by immunofluorescence, and primary biliary cirrhosis-specific subtypes were determined by radioimmunoassay (anti-p62, anti-p48) and complement fixation test (anti-M2, anti-M4, anti-M8). Before orthotopic liver transplantation, antimitochondrial antibodies were detected by immunofluorescence in 13 of 15 patients with primary biliary cirrhosis. Of these patients, 12 were positive for anti-p62 and 8 for anti-p48. Ten patients were positive for anti-M2, 4 patients for anti-M4 and 7 patients for anti-M8. Two primary biliary cirrhosis patients and all non-primary biliary cirrhosis patients were negative with all tests. One month after orthotopic liver transplantation, antimitochondrial antibodies titers declined or became negative by antimitochondrial antibodies immunofluorescence, 3 patients became negative by radioimmunoassay for anti-p62 and 1 for anti-p48. With complement fixation test, 4 patients became negative for anti-M2, 2 for anti-M4 and 4 for anti-M8. Antimitochondrial antibody titer reduction observed 1 month after orthotopic liver transplantation remained unchanged in most sera during the following years. A rise was observed in two patients after 4 and 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMedDate not supplied

Preoperative assessment of the portal vein and hepatic artery in children with end-stage liver disease: is selective angiography still necessary?

BACKGROUND: Selective angiography involves increased risk for children and may cause vascular complications. The aim of this study was to determine whether selective angiography is still necessary for viewing the portal vein and hepatic artery. METHODS: Doppler ultrasound, abdominal aortography, and selective angiography were performed and interpreted independently in 62 children (median age = 1 year 3 months), with end-stage liver disease, who were candidates for orthotopic liver transplantation. RESULTS: Selective angiography agreed with the Doppler ultrasound findings of patency, flow direction, and diameter of the extrahepatic portal vein in 84%, 73%, and 79% of the children, respectively. Important additional information was obtained from selective angiography in only five of the 62 children (8%). Selective angiography showed an anomaly of the hepatic artery in 21 of the 62 children (33%). In 18 out of these 21 children (85%), an anomaly of the hepatic artery was already visible on the abdominal aortogram. CONCLUSION: Selective angiography did not play any significant role in the detection of an anomaly of the hepatic artery and should only be done if the Doppler ultrasound findings of the portal vein are inconclusive or if abdominal aortography cannot provide reliable information about the hepatic artery. For the evaluation of the portal vein and hepatic artery, we recommend Doppler ultrasound and abdominal aortography, a less invasive angiographic procedure.

Female↗
PubMedDate not supplied

The applicability of rat and human liver slices to the study of mechanisms of hepatic drug uptake.

In the present study we investigated the applicability of the liver slice model to study mechanisms of drug uptake. Four model compounds were investigated that enter hepatocytes via entirely different membrane transport mechanisms. Rhodamine B (RB), which enters hepatocytes by passive diffusion, was homogeneously distributed throughout the rat liver slice (250 microm thickness) within 5 min, indicating that the penetration rate into the slice and the diffusion rate into the cells are rapid. In contrast, lucigenin (LU), which is taken up by hepatocytes through adsorptive endocytosis, was detected in the inner cell layers after 15 min. Digoxin uptake into the slice showed a temperature-dependent component and was stereoselectively inhibited by quinine, which is compatible with the involvement of a carrier-mediated uptake mechanism. The neo-glycoalbumin Lactose(27)-Human Serum Albumin (Lact(27)-HSA) and the negatively charged Succinylated-Human Serum Albumin (Suc-HSA) entered the slices and were taken up temperature-dependently into hepatocytes and endothelial cells, respectively. The liver slice preparation is a valuable tool to investigate the mechanisms of cellular uptake of drugs. Moreover, the precision-cut liver slices offer the unique possibility to study both hepatocyte and endothelial cell function in human and rat liver.

Aconitic Acid↗
PubMedDate not supplied

Serum obtained from rats after partial hepatectomy enhances growth of cultured colon carcinoma cells.

Tumour-bearing rats were randomized to a 70% partial hepatectomy or a sham operation. At days 1, 3 or 14, portal and systemic serum was obtained and colon carcinoma cells were cultured in the presence of 5, 10, 20 or 50% serum. Proliferation and epidermal growth factor receptor (EGFr) expression was measured in tumour cells. Proliferation was 25-40% higher in tumour cells cultured with portal serum after hepatectomy than after sham operation when using serum obtained at day 3, but not days 1 and 14 after operation. In cultures with serum obtained at day 14 after operation CC 531 cells showed a 30% higher proliferation rate with systemic hepatectomy serum than CC 531 cells with sham systemic serum. These effects were not mediated by a change in EGFr mRNA and protein levels as the used colon carcinoma cells did not reveal EGFr activity by any of the three detection methods used.

Adenocarcinoma↗
PubMedDate not supplied

Percutaneous drainage of emphysematous cholecystitis associated with pneumoperitoneum.

Emphysematous cholecystitis, a relatively rare variant of acute cholecystitis, is associated with high morbidity and mortality rates. In the presence of a concomitant pneumoperitoneum, these rates may be considered even higher, approaching those of perforation of the gallbladder. The first choice of treatment in cases presenting with pneumoperitoneum is emergency laparotomy. We performed a staged procedure as a second best alternative. In a 65 year-old female patient, initial percutaneous cholecystostomy with a strict intravenous antibiotics regimen, and subsequent cholecystectomy 6 months, later was carried out with successful outcome. A review of the literature revealed 13 other cases of this combination. Treatment modalities and outcome of these patients are discussed.

Acute Disease↗