Biomedical subjects
Publications and source records attributed to S Giler.
Halothane, but not methoxyflurane, was found to cause specific hepatocellular damage, the hepatotoxicity being prompt but transient. The hepatotoxicity was demonstrated by the elevation in the serum activity of xanthine oxidase, a highly sensitive marker for acute liver damage.
Halothan anesthesia was found to be hapatotoxic in the rat, as demonstrated by a significant elevation of serum xanthine oxidase (SXO) level. SXO appeared to be more sensitive marker of liver damage than serum glutamic oxalacetic transaminase. SXO was found to be elevated also following exposure to relative hypoxia.
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Three cases of carcinoma of the vermiform appendix are reported. The rarity of the disease has been emphasized as well as the resulting lack of clinical experience. Medical literature on the subject has been reviewed.
Peroral, intragastric staining method with toluidine blue was performed in 42 patients with suspected neoplastic lesions of the stomach. Fifteen out of 18 malignant lesions and one out of 13 benign lesions were stained. Normal mucosa, areas of gastritis and most of the benign lesions appeared unchanged. According to our results, the use of toluidine blue staining method prior to endoscopy might be of help in demonstrating minute malignant lesions of gastric mucosa and in the differential diagnosis between benign and malignant ulcers of the stomach.
The activity of serum xanthine oxidase, an enzyme mainly found in the liver, was determined in a random series of patients who underwent abdominal surgery of varying severity. Enzyme activity rose markedly on completion of operation in almost all patients undergoing biliary tract and gastric surgery, but not in those undergoing surgery of other abdominal organs, Serum glutamic oxaloacetic transaminase level rose to a smaller degree and in a smaller proportion of the patients. Elevation of the serum level of both enzymes following biliary and gastric surgery reflects hepatocellular damage caused by surgical trauma to the liver.
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Serum xanthine oxidase activity was measured by a radiochemical method in 137 consecutive patients with jaundice of varying etiology and in 40 non-jaundiced patients with liver or other disease. Serum xanthine oxidase was markedly increased, up to 50 times the upper normal limit (mean + 2 S.D.), in 32 out of 34 patients with infectious hepatitis. A slight elevation of serum xanthine oxidase, up to twice the upper normal limit, was found in 2 out of 49 patients with extrahepatic obstructive jaundice and in 4 out of 20 patients with chronic renal failure. In comparison to serum glutamic-oxaloacetic transaminase and lactate dehydrogenase serum xanthine oxidase appeared to be the more sensitive and specific indicator of acute hepatocellular damage.
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Vascular anastomoses are invariably performed manually and may be difficult technically particularly in smaller calibre vessels. This may be even more pronounced when an emergency situation exists and a surgeon relatively inexperienced in vascular surgery has to deal with the problem. A technique is described allowing for rapid anastomosis of vessels ranging upwards from a diameter of 2.5 mm using incomplete adjustable metal rings. The technique is simple and can be applied by surgeons with minimal vascular training. This could be extremely useful in the emergency situation, particularly when critical ischemia exists. Also, anastomoses of small calibre vessels such as in arterio-venous fistula may be more simply performed by the aid of the described rings.
During the last ten years, 15 major operations have been performed in our ward on 14 patients with leukemia. Nine had an uncomplicated postoperative course, two succumbed to overwhelming postoperative infections, another two died from cardiovascular complications and one from carcinomatous spread. There were no wound-related complications and no granulocyte or platelet transfusions were necessary. It is concluded that major surgery should not be avoided in patients solely because of the presence of a leukemic process.
Ferritins are a group of isometric proteins having an important function in iron storage and metabolism and are found in high concentration in the liver, spleen and bone marrow. Acidic isoferritins are found in human fetal liver, primary mammary, gastric and pancreatic carcinomas, and are termed carcinofetal ferritins. Elevated levels of serum ferritin were found in patients with various malignant diseases such as Hodgkin's disease, chronic myeloblastic, granulocytic and lymphatic leukemias and myeloblastosis, in patients with breast cancer, multiple myeloma, malignant lymphoma, carcinoma of the gastro intestinal tract and germinal cell tumors of the testis. Recently a subpopulation of circulating T lymphocytes bearing surface ferritin was found in patients with breast cancer and untreated Hodgkin's disease. No such lymphocytes were demonstrated in normals or in patients with benign breast disease. The appearance of such subpopulation in the circulation is an early manifestation of the neoplastic disease, and its identification may provide a tool of potential diagnostic and prognostic importance in the management of Hodgkin's disease and breast cancer.
The purpose of the present study was to document the increased leukocyte adhesiveness/aggregation (LAA) and tissue leukostasis that follow surgical trauma. We found that following major abdominal surgery, the percentage of aggregated leukocytes in the peripheral blood increased from 8.6 +/- 7 to 21.7 +/- 11.5 (p < 0.001), while the respective values for patients undergoing minor surgery were 3.7 +/- 2.4 and 19.7 +/- 7.6% (p < 0.001). The state of LAA was also determined in eight dogs after partial collectomy and four controls. A clear increment in the degree of tissue leukostasis (especially in the spleen, liver and lungs) was noted in the operated as compared to the control animals. In addition, a significant correlation was found between the state of LAA, determined in the venous (p = 0.0004) and arterial (p = 0.002) blood of these animals and the degree of tissue leukostasis. We conclude that a state of increased LAA in the peripheral blood is induced by surgical trauma and that this increased LAA correlates with tissue leukostasis.