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Biomedical subjects

P Devitt

Publications and source records attributed to P Devitt.

At least 37 records · Page 2Linked to original sources

Effects of somatostatin on hepatic haemodynamics in the cirrhotic rat.

Reports on the effects of somatostatin on hepatic haemodynamics in the cirrhotic patient have provided conflicting results. Therefore, we studied the effects of different modes and rates of somatostatin administration on hepatic haemodynamics in the cirrhotic rat. Portal pressure (PP), wedged hepatic venous pressure (WHVP), portal venous flow (PVF), liver blood flow (LBF) and systemic blood pressure were measured in rats with dimethylnitrosamine-induced cirrhosis. Somatostatin was administered as a rapid injection, a continuous infusion or as a bolus dose followed by a constant infusion. One group of rats with a previously constructed portacaval shunt received a bolus dose of somatostatin followed by a constant infusion. A rapid injection of somatostatin was attended by a rapid and significant fall in all the haemodynamic parameters measured (p less than 0.01). Continuous infusion of somatostatin [4 or 8 micrograms/kg body weight (BW) h] resulted in a gradual but significant reduction in PP, WHVP, PVF and LBF (p less than 0.05), but had no effect on systemic blood pressure. A bolus dose of somatostatin (2, 4 or 8 micrograms/kg BW over 2 min) resulted in a rapid decrease in PP, WHVP, PVF and LBF (p less than 0.01), the decreases being maintained by continuous infusion. In rats with a portacaval shunt a bolus dose of somatostatin (8 micrograms/kg BW) resulted in a rapid fall in WHVP and LBF, the decrease being maintained by a continuous infusion (8 micrograms/kg BW/h).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Effects of alcohol on hepatic haemodynamics in the rat.

The effects of varying rates of alcohol infusion (0.015-0.12 mg/g body weight/min) on hepatic haemodynamics were studied in male Wistar rats. An infusion of 0.015 mg/g body weight/min alcohol had no significant effect on portal pressure (PP) or wedged hepatic venous pressure (WHVP). However, increasing rates of infusion of alcohol (0.03-0.12 mg/g body weight/min) progressively increased PP and WHVP, the maximum increase in PP occurring following an infusion of 0.12 mg/g body weight/min (6.5 +/- 0.5 - 10.3 +/- 0.6 mm Hg). The effect of varying rates of alcohol infusion on portal venous flow and liver blood flow was biphasic. Thus following an infusion of 0.03 mg/g body weight/min alcohol, liver blood flow (40.6 +/- 4.9 - 54.3 +/- 5.8 ml/100 g/min) and portal venous flow (28.6 +/- 2.9 - 41.3 +/- 4.1 ml/min) were increased. However, following infusions of 0.06 and 0.12 mg/g body weight/min alcohol, liver blood flow and portal venous flow were decreased. The results suggest that previous conflicting reports on the effects of alcohol on hepatic haemodynamics may be related to the dose of alcohol administered.

Animals↗

A prospective randomised controlled clinical trial comparing somatostatin and vasopressin in controlling acute variceal haemorrhage.

Twenty two patients were entered into a randomised controlled clinical trial comparing the efficacy of somatostatin and vasopressin in controlling acute variceal haemorrhage. Somatostatin was significantly more successful in controlling acute variceal haemorrhage than vasopressin (p = 0.003). Furthermore, no complications were observed during treatment with somatostatin.

Adult↗

Effects of propranolol on hepatic haemodynamics in the cirrhotic and non-cirrhotic rat.

The effects of systemic and intraportal administration of propranolol on hepatic haemodynamics were studied in cirrhotic and non-cirrhotic rats. In the non-cirrhotic rat systemic infusion of 4 micrograms (kg body wt)-1 min-1 propranolol significantly decreased portal pressure, wedged hepatic venous pressure, portal venous flow and liver blood flow without affecting heart rate. Similar changes were observed in the cirrhotic rat following an infusion of 2 micrograms (kg body wt)-1 min-1 propranolol. Higher rates of propranolol infusion produced greater reductions in portal pressure, wedged hepatic venous pressure, portal venous flow and liver blood flow in cirrhotic and non-cirrhotic rats but these changes were accompanied by a bradycardia. The reduction in portal pressure effected by propranolol was accompanied by an increased splanchnic vascular resistance. Intraportal injection of propranolol resulted in a rapid but transient fall in portal pressure. The decrease in portal pressure was sustained if propranolol was infused intraportally. The results indicate that propranolol effects a reduction in portal pressure via a combination of increased splanchnic vascular resistance, increased hepatic arterial resistance and reduced cardiac output. The observation that propranolol can significantly reduce portal pressure without affecting heart rate may be clinically important in the long-term management of portal hypertension. Furthermore, the rapid reduction in portal pressure following intravenous administration suggests that propranolol may be of value in the acute control of variceal haemorrhage.

Animals↗

Effects of a selective beta 2-blocker (ICI 118,551) on hepatic haemodynamics in the cirrhotic and non-cirrhotic rat.

The effects of a selective beta 2-blocker (ICI 118,551) on hepatic haemodynamics were studied in cirrhotic and non-cirrhotic rats. Infusions of 10 and 20 microgram (kg body wt)-1 min-1 beta 2-blocker (in cirrhotic and non-cirrhotic rats) significantly reduced portal pressure, portal venous flow and liver blood flow without altering heart rate. Splanchnic vascular resistance was significantly increased following infusions of 10 and 20 micrograms (kg body wt)-1 min-1 beta 2-blocker. An intraportal injection of beta 2-blocker (10 micrograms body wt)-1 or hepatic artery ligation lowered portal pressure by approximately the same magnitude. Intraportal injection of beta 2-blocker after hepatic artery ligation did not further reduce portal pressure. The results indicate that a selective beta 2-blocker reduces portal pressure by a combination of increased splanchnic vascular resistance and hepatic arterial resistance. It is concluded that a selective beta 2-blocker may be of clinical value in the long-term managements of portal hypertension.

Adrenergic beta-Antagonists↗

The effects of vasopressin on hepatic haemodynamics in the cirrhotic and non-cirrhotic rat.

Liver blood flow (xenon-133 clearance method) and portal venous flow were measured in cirrhotic and non cirrhotic rats following the infusion of vasopressin at varying rates. At low rates of infusion, vasopressin had no significant effect on portal venous flow or liver blood flow in cirrhotic or non-cirrhotic rats. Infusion of vasopressin at a rate of 0.08 microU/g body wt/min in non-cirrhotic rats and 0.04 and 0.08 microU/g body wt/min in cirrhotic rats decreased portal venous flow and increased liver blood flow. At higher rates of infusion (0.2 microU/g body wt/min in non-cirrhotic rats and 0.16 microU/g body wt/min in cirrhotic rats) these effects were reversed. Furthermore, an infusion of 0.08 microU/g body wt/min vasopressin significantly reduced portal pressure in the cirrhotic rat. However, portal pressure was not significantly altered following an infusion of 0.16 microU/g body wt vasopressin. The implications of these findings in relation to the possible deleterious effects of high rates of vasopressin infusion in the management of portal hypertension and bleeding oesophageal varices is discussed.

Animals↗

The effect of vasopressin and hepatic artery ligation on the blood supply to normal and metastatic liver tissue.

The effect of low (0.08 microU g-1 body wt min-1) and high (0.16 microU g-1 body wt min-1) rates of vasopressin infusion on blood flow to normal liver tissue and to liver metastases derived from azoxymethane induced colorectal carcinomas was studied in 36 male Wistar rats. Portal venous flow was measured by electromagnetic flowmetry and blood flow to normal and metastatic liver tissue by the clearance of xenon-133 injected directly into the liver parenchyma or metastasis. The low rate of vasopressin infusion decreased portal venous flow but increased blood flow to normal and metastatic liver tissue while at the higher rate of infusion these effects were reversed. Hepatic artery ligation (HAL) immediately following a low rate of vasopressin infusion abolished the observed increase in blood flow to both normal liver tissue and metastases. HAL immediately following the higher rate of vasopressin infusion further reduced blood flow to metastases but did not further alter blood flow to normal liver tissue. HAL prior to the infusion of the vasoactive drug significantly reduced blood flow to metastatic liver tissue, increased portal venous flow and was without effect on blood flow to normal liver tissue. Following HAL, blood flow to metastatic liver tissue was not further altered by either the low or high rates of vasopressin infusion. However, blood flow to normal liver tissue after HAL was reduced by a low rate of infusion of vasopressin and increased by the higher rate of infusion. The results of this study indicate that blood flow to normal or metastatic liver tissue can be increased or decreased by differential rates of infusion of vasopressin. These observations may have important implications in the treatment of liver metastases in man where different rates of vasopressin infusion may potentiate the effects of hepatic artery ligation or cytotoxic therapy.

Animals↗

Release of antral gastrin in response to an intestinal meal in dogs.

This study was designed to determine whether gastrin is released by the antrum in response to an intestinal meal in dogs. Two groups of anesthetized dogs were prepared with innervated antral pouches. The antrum and duodenum were separated by complete division at the pylorus to prevent duodenoantral reflux. The duodenum and proximal jejunum were perfused with 10% liver extract at 200 ml/hr. In one group of six dogs a significant elevation of antral vein gastrin levels was observed after 45 minutes. Gastrin levels in portal and peripheral blood were not significantly elevated. In another group of eight dogs, in which antral veins were not cannulated, a significant rise in peripheral gastrin concentration was noted after 60 minutes. We conclude that gastrin is released by the antrum during the intestinal phase of gastric acid secretion; significantly increased levels of gastrin are detected in both antral and peripheral venous blood. Duodenoantral reflux, as a possible cause of this release, is ruled out by complete surgical separation between duodenum and antrum.

Animals↗

Pancreatic polypeptide. A review.

Pancreatic polypeptide (PP), 36-amino acid peptide, may function as an important feedback inhibitor of pancreatic secretion after a meal. It arises from both islet and acinar cells of the pancreas. Release of PP by a meal, primarily protein, occurs in a biphasic manner. The first rapid release occurs as a result of vagal stimulation; the second, more prolonged rise (the so-called intestinal phase) occurs in response to hormonal stimulation, predominantly cholecystokinin. Plasma PP levels increase with age; PP levels are elevated above those of age-controlled normal subjects in diabetic patients and in some patients with pancreatic amine precursor uptake decarboxylase tumors. The value of plasma PP as a possible marker for pancreatic tumors is as yet unsettled but may be a valuable tool.

Animals↗

Does luminal gastrin stimulate gastric acid secretion?

The effects of pentagastrin on acid secretion, short circuit current, electrical conductance and potential difference were determined in isolated bullfrog fundic mucosa. Biologically active luminal pentagastrin had no effect on gastric mucosa, even at a concentration 100 times higher than that necessary for stimulation of the mucosa from the serosal side. It is concluded that luminal gastrin does not appear to have a physiologic role in gastric secretory processes.

Animals↗

Release of pancreatic polypeptide in humans by infusion of cholecystokinin.

Plasma levels of pancreatic polypeptide were measured after a test meal and after infusion of graded doses of 99% pure cholecystokinin in 6 healthy volunteers. Initial attempts at sterilization of 99% pure cholecystokinin resulted in complete inactivation. Successful sterilization was accomplished by filtration by using specially treated silver-coated filters. Biologic activity of sterilized material was confirmed with cholecystokinin bioassay, and plasma levels of sterilized cholecystokinin achieved by exogenous infusions were measured with a specific cholecystokinin radioimmunoassay. Significant increases in plasma levels of pancreatic polypeptide were found with a test meal and with infusions of 0.25 and 0.5 micrograms/kg-hr of 99% pure cholecystokinin. Integrated values of pancreatic polypeptide released by the low-dose and the high-dose infusions of 99% pure cholecystokinin were 59% and 50% of that obtained by food, respectively. Integrated levels of cholecystokinin after 45 min of infusion of 0.25 micrograms/kg-hr were equal to those after a standard meal. Cholecystokinin, therefore, is an effective humoral releaser of pancreatic polypeptide in humans and may play an important role in the intestinal phase of release of pancreatic polypeptide.

Adult↗

Short term metronidazole therapy contrasted with povidone-iodine spray in the prevention of wound infection after appendicectomy.

In a prospective, randomized trial metronidazole was found to be significantly better than povidone-iodine in reducing the incidence of wound infection after appendicectomy (P less than 0.005). The metronidazole was given as a established 7-day course. Over 65 per cent of the wound infections presented after the patients had been discharged from hospital.

Aerosols↗

Emergency geriatric surgical admissions.

The emergency surgical work load created by patients aged 80 and over in a district hospital was assessed and the results of treatment examined. Over one year 248 patients aged 80 or over were admitted as emergencies, and the overall mortality rate was 21.8%. When terminal disease was excluded mortality rate was 12.5%. These elderly patients had an average length of stay in the acute surgical ward of 14.7 days compared with a mean of 8.4 days for all patients, and all but seven patients were discharged to their original place of referral.Elderly patients do exacerbate the bed shortage in acute surgical wards because they tend to stay longer than younger patients, but these elderly surgical patients imposed only a small load on the inpatient geriatric services, as 78% were discharged straight to their own homes and a further 17% went home after a period on the surgical convalescent wards.

Aged↗

Granular cell myoblastoma of the biliary tree.

A granular cell myoblastoma of the common bile duct is described which caused episodes of jaundice in a young woman. Histological examination demonstrated a close association of the tumour with nerve fibres, tending to support the theory of origin from Schwann cells. The lesion is benign and after excision carries an excellent prognosis.

Adolescent↗