[Rapid perfusion technic for recovery of Schistosoma from the portal system of mammals, applicable in field work].
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In 20 mongrel dogs after a preliminary stenosis of the portal vein, formation of the spleno-renal or mesenteric-caval anastomosis has been performed. For revealing the vessels vital portography, injection of roentgenopaque masses and morphometry have been carried out. The spleno-renal anastomosis ensures a selective outflow of blood from the esophago-gastro-splenic zone. The collaterals, developing as a result of the porto-caval anastomoses with the anterior vena cava, and the collaterals, developing as a results of the porto-portal anastomoses, disappear. The mesenteric-caval anastomoses favourably affects the intestinal hemodynamics. The bypasses of the blood stream, developed between the portal vein and posterior vena cava reduce predominantly. The decompressive angioanastomoses result in local hypertension in the posterior vena cava system.
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The architectural arrangement of the elastic-fiber network in the wall of canine hepatic portal veins was observed with the scanning electron microscope (SEM). Selective NaOH sonication digestion and autoclaving were used to expose and isolate the networks of elastic fibers from six selected regions of the hepatic portal vessels from seven healthy dogs. Elastic stains of adjacent segments prepared for light microscopy demonstrated that the elastic fibers were concentrated in two areas within the intact portal wall. The innermost area corresponded to the internal elastic lamina (IEL) of the tunica intima, the internal muscular layer, and the connective tissue layer of the tunica media. The second area was in the tunica adventitia. SEM specimens revealed two sleeves of elastic fiber networks which corresponded to the above regions. Small scattered bundles of radially oriented elastic fibers spanned the gap between the two sleeves. Each tunica had a different architectural arrangement of elastic fibers. The IEL had circumferentially oriented fibers which branched and anastomosed to form a continuous network on the innermost surface. The architecture of the IEL was the most variable between the different regions. The network of the IEL was the most "open" in the caudal region (splenic vein) and became "denser" toward the liver. The large elastic fibers in the tunica media were oriented at approximately right angles to the primary fibers of the IEL. These longitudinally oriented fibers anastomosed with adjacent longitudinal fibers to form a continuous network. In the tunica adventitia, thick, longitudinally oriented fibers of the continuous network fused together to form incomplete layers of fibers. The architecture of the elastic-fiber network in the canine hepatic portal vein was compared to that previously described in the systemic canine saphenous vein.
The Authors discuss the instrumental diagnosis of portal hypertension, comparing echo-Doppler and splenoportography by celiac artery catheterization, performed on 42 patients with cirrhosis. From the data obtained, there may be observed a clear correlation between angiographic and echographic criteria, correlated to the degree of illness. In particular echo-Doppler whether it possible, in a non-invasive way, to control the evolution of progressive haemodynamic resistance, and hepatic and splenic parenchyma, leaving to splenoportography the role to depict anatomic characteristics of portal circulation for a correct surgical program.
UNLABELLED: OBJECTIVE. We used a method by which the portal shunt index via the superior mesenteric vein (SI-S) and that via the inferior mesenteric vein (SI-I) could be evaluated simultaneously. The clinical usefulness of the method was studied. METHODS: Scintigraphy was done 3 h after subjects took an enteric-coated capsule containing [123I]iodoamphetamine. At that time, the radionuclide was injected into the rectum. Counts for the lungs and the liver were used to calculate the two shunt indices. RESULTS: The mean SI-S and SI-I tended to be higher for disorders that were more severe, increasing in the order of chronic persistent hepatitis, chronic aggressive hepatitis, and cirrhosis. In cirrhotic patients, the SI-I was higher than the SI-S (p < 0.001). The SI-S and SI-I were both higher in cirrhotic patients with esophageal varices than in such patients without varices (p < 0.05 and < 0.001). The SI-S and SI-I were higher in cirrhotic patients with ascites than in such patients without ascites (p < 0.001 and < 0.01). Correlation between either of these indices and classical indicators of functional reserve was high. The correlation of SI-S with the Child-Turcotte classification and total bilirubin level was higher than the correlation of the SI-I and these indicators of functional reserve. CONCLUSIONS: This method permits assessment of the portal hemodynamics in a relatively noninvasive way, and is clinically meaningful.
Twenty-seven patients were evaluated by intra-arterial digital subtraction angiography: 20 for portal hypertension--6 also after a porto-systemic shunt--, 4 for evaluation of a hepatic mass and 3 for pancreatic or biliary tumours. Intra-arterial DSA has always shown vascular abnormalities. The advantage of intra-arterial DSA are reduction of the required amount of contrast medium and, consequent, reduction of the frequency of contrast medium reactions. Its disadvantages are limited field size of image intensifier and reduced spatial resolution as compared with conventional angiography. However diagnosis had never been affected by this limitation.
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