Biomedical subjects

T V Kalima

Publications and source records attributed to T V Kalima.

At least 37 records · Page 2Linked to original sources

PubMed1976

Modification of procine stress ulceration by methylprednisolone, vitaminA and methysergide treatment.

Using a swine shock ulcer model, three pharmacological agents, methylprednisolone, vitamin A and methysergide were evaluated, as they protect gastric mucosa against acute ulceration. Following haemorrhagic shock (3 h duration; mean arterial pressure 40 mm Hg) nine of the ten control animals (90%) developed gastric ulceration. Of the six test animals treated with intravenous methylprednisolone during the shock, only one (17%) developed gastric lesions (p less than 0.02; x2 = 5.76). Of the ten test animals pretreated with massive doses of parenteral vitamin A, only three (30%) developed lesions (p less than 0.05; x2 = 5.21). In contrast to this, treatment with methysergide, a serotonin antagonist, did not significantly effect the ulceration rate, since four of the six test animals (67%) had gastric lesions. The results suggest that methylprednisolone and vitamin A do protect the gastric mucosa from experiment stress ulceration, but their mechanism of action remain obscure and further investigation is needed to judge their value in clinical use.

Animals↗

PubMed1976

Selective loss of parietal cells in the gastric remnant following antral resection.

The mucosa of the gastric remnant of 41 subjects who had been operated upon 17-18 years earlier for peptic ulcer was studied histologically. The histological changes were classified as follows: 1) normal mucosa, 1; 2) simple gastritis, superficial or atrophic, 27; and 3) "selective loss of parietal cells", 13 subjects. The latter type was characterized by marked loss of parietal cells without corresponding loss of other epithelial elements and without an inflammatory reaction. These changes were thought to reflect a lack of a trophic action on parietal cells exerted by gastrointestinal hormones, as e.g. gastrins.

Aged↗

PubMed1976

Experimental regional enteritis in pigs.

Lymphatic obstruction is constantly present in regional enteritis, but its role in the pathogenesis is poorly understood. To clarify this the mesenterial lymphatics of the terminal ileum were obstructed in 21 pigs chosen for experiments because spontaneous ileitis is common in pigs. Long-lasting obstruction was produced by injecting formaline into regional lymph nodes. The growth of the pigs was retarded. Their ileum became reddish and oedematous with numerous intra-abdominal adhesions, and mucosal ulcerations. Eleven pigs developed fistulae; none had chylous ascites. Histologically the subserosa was infiltrated by round and giant cells giving an impression of granulomatous inflammation. Many lymphatics were thrombosed. The lymphoid tissue was hyperplastic. These changes became more prominent with extensive subserosal fibrosis after three weeks, when the oedema diminshed. Transmural inflammation with round cell aggregations was then the most typical feature. Purulent infection with crypt abcesses appeared near the fistulae. If the function of lymphatics is destroyed, transport of particles too big to enter blood vessels is inhibited. This produces chronic irritation and oedema with declining tissue nutrition and oxygenation, thus causing fibrosis. Moreover, the intestinal lumen is a source of infections, and the oedematous tissue is easily infected. This may lead to mucosal ulcerations and, progressively, to fistulae.

Animals↗

PubMed1976

Duodenogastric reflux of lysolecithin in the pathogenesis of experimental porcine stress ulceration.

The role of duodenogastric reflux of lysolecithin, a normal constituent of duodenal juice, in the pathogenesis of gastric stress ulcerations was investigated with a swine shock-ulcer model. Twenty-seven piglets, weighing 8 to 12 kilograms, were used. In an intact animal, the average concentration of intragastric lysolecithin before shock was 138 mug per milliliter (median, N = 6). At the end of the shock period, the average concentration of lysolecithin was 540 mug per milliliter and the over-all amount in the gastric juice was 14.3 mg. (median, N = 6). Following hemorrhagic shock (3 hours duration; mean arterial pressure, 40 mm. Hg), all six control animals with normal gastroduodenal continuity got gastric ulcerations. Interruption of duodenogastric reflux by duodenal exclusion and gastrojejunostomy completely abolished the development of these ulcerations in six test animals. When the interrupted duodenogastric reflux was replaced artificially by intragastric instillation of lysolecithin (500 mug per milliliter; 25 ml.), all six animals developed lesions. Intragastric lysolecithin without shock had no effect. The results provide further support to the concept that regurgitation of duodenal juice into the stomach is an essential factor in the pathogenesis of gastric stress ulceration. The results also suggest that, in this respect, one of the active components in duodenal juice is lysolecithin.

Animals↗

PubMed1975

Role of pyloric reflux in experimental stress ulceration during haemorrhagic shock.

The significance of pyloric reflux of bile and duodenal juice in experimental gastric stress ulceration was studied using a swine shock ulcer model. Following a haemorrhagic shock of 3 h duration, nine of the ten control piglets (90%) with normal bile flow have gastric mucosal lesions. None of the five piglets with permanent bile diversion (ligation of common bile duct; cholecystojejunostomy) has gastric lesions. Intragastric instillation of pure bile prior to the shock in piglets with permanent bile diversion induced gastric lesions in only one of the five test animals (20%). If duodenal juice was used instead, four of the six test animals (67%) have lesions. The results indicate that, in the pig, an uninterrupted flow of bile into the duodenum is a prerequisite for the development of gastric mucosal lesions following haemorrhagic shock. They also suggest that duodenal juice containing both bile and pancreatic juice has a stronger ulcerogenic influence on shocked porcine gastric mucosa than bile alone.

Animals↗

PubMed1975

Vascular pattern in ileal Crohn's disease.

Angio-, histo- and microangiographic studies were performed on five operative specimens of chronic regional enteritis affecting the ileum. In every patient the vascular pattern differed greatly from that seen in normal ileum and the changes were similar in each investigation. The number of long vasa recta and short vasa recta were increased, but the hypereaemic reaction was limited to the submucosa and mucosa. The long vasa recta arising from the marginal artery arcades were three to five times as close together in the affected regions as normally but their calibre was smaller than normal. The vessels were evenly spaced and ran without variation in their calibre up to the antimesenteric border of the gut. The thicker the mesentery, the wider the angle where the long vasa recta divided to form an anterior and a posterior branch. When the wrapping phenomen occurred this angle exceeded 90 degrees. The short vasa recta branching from the long vasa recta formed a very thin vascular network and thus the affected part of the gut could be easily distinguished from the normal ileum. The vascular changes were limited to the regions that were macroscopically abnormal. The arteries were well organized, but in the most severe cases where the architecture of the gut was destroyed the vascular pattern was also confused. The vascular pattern differed from that seen in malignant disease in two respects: there were no clear changes in the vascular calibres even in the most severe cases and no evidence of open arteriovenous shunts. The vascular changes were regarded as secondary to the fibrotic reaction in chronic regional enteritis and accurately reflected the severity of this reaction.

Adult↗

PubMed1975

Non-traumatic chylous effusion in the thorax and abdomen.

A female of 31 with chyloascites and bilateral chylothorax is presented. The thoracic duct was obstructed below the diaphragm. The lymph vessels in the left iliac and para-aortic areas were enlarged and there were lymphocysts. When the lymph loss was greatest the patient was in a state of grave malnutrition with marked hypoalbuminaemia and an absolute and relative lymphocytopenia in the blood. "Malignant" cells were demonstrated in the chylous fluid, but no malignancy could be found at laparotomy. It is possible that the cells were confused with immature lymphocytes. The lymphatic cysts were excised and the lymph vessels ligated. Decortication of the right lung was performed. The patient recovered. The follow up time has been over four years.

Adult↗

PubMed1974