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Biomedical subjects

D Lebrec

Publications and source records attributed to D Lebrec.

At least 289 records · Page 16Linked to original sources
PubMed1982

Effect of propranolol on hepatic blood flow in normal and portal hypertensive rats.

1. The effects of propranolol on heart rate, arterial pressure, portal venous pressure and fractional hepatic blood flow were studied in rats with hepatic artery ligature or with portal vein stenosis, and in sham-operated rats. The effect of propranolol on cardiac output was also studied in normal rats. 2. In rats with hepatic artery ligature or with portal vein stenosis, and in sham-operated rats, propranolol decreased heart rate and portal venous pressure significantly and did not alter arterial pressure. Propranolol decreased fractional hepatic blood flow significantly in rats with hepatic artery ligature, but did not change hepatic blood flow in rats with portal vein stenosis or in sham-operated rats. 3. We conclude therefore that: (a) propranolol decreases portal venous pressure in rats; (b) this decrease in portal venous pressure results in a reduction in portal blood flow which is related, in part, to a reduction in cardiac output; (c) propranolol does not alter hepatic blood flow in normal rats or in rats with portal hypertension.

Animals↗
PubMed1982

Changes in splanchnic blood flow in portal hypertensive rats.

This study was undertaken to assess splanchnic blood flow in rats with portal hypertension induced by portal vein stenosis. Splanchnic blood flow, estimated by the microsphere method, was significantly higher in portal hypertensive rats than in sham-operated rats: 26.5 +/- 3.9 (mean +/- SD) and 17.5 +/- 3.3 ml/min, respectively (P less than 0.001). Hepatic blood flow, estimated by the clearance method, was significantly lower in portal hypertensive rats than in sham-operated rats: 12.7 +/- 1.1 and 17.3 +/- 2.8 ml/min, respectively (P less than 0.001). It is concluded that splanchnic blood flow is increased in rats with portal hypertension and that hepatic blood flow is different from splanchnic blood flow in these portal hypertensive rats. It is hypothesized that splanchnic blood flow may also be increased in patients with portal hypertension.

Animals↗
PubMed1982

The inconvenience of investigations used in hepatology: patients' and hepatologists' opinions.

The purpose of this study was to estimate and compare the inconvenience of six investigations used in hepatology, as experienced by 113 inpatients and imagined by 80 hepatologists. For patients, the investigations, in order of increased inconvenience rate were: (1) venous puncture, (2) BSP clearance, (3) transvenous liver biopsy, (4) percutaneous liver biopsy, (5) laparoscopy and (6) oesogastroscopy. Hepatologists gave a higher inconvenience rate for all investigations than patients and the ranking of the crude inconvenience rate of each investigation was different for hepatologists and patients. For 84% of patients, oesogastroscopy was over 10 times more inconvenient than a venous puncture, whereas only 15% of hepatologists considered oesogastroscopy over 10 times more inconvenient (p less than 0.001). Multidimensional analysis indicated that hepatologists underestimated the role of pain in the rejection of re-investigation for transvenous liver biopsy, percutaneous liver biopsy and oesogastroscopy. These results suggest that hepatologists must improve the psychological and pharmacological premedication of these investigations according to the reaction of their patients, especially before oesogastroscopy.

Biopsy, Needle↗
PubMed1982

Transvenous liver biopsy: an experience based on 1000 hepatic tissue samplings with this procedure.

Transvenous liver biopsy was attempted 1033 times in 932 patients in whom percutaneous liver biopsy was contraindicated. A hepatic tissue specimen was obtained in 1000 out of these 1033 attempts. The specimen was unfragmented and/or large enough to allow correct evaluation of liver architecture in 518 of the 807 successful biopsies (64.2%) in patients with liver fibrosis or cirrhosis and in 191 of the 193 successful biopsies (98.9%) in patients with nonfibrotic lesion of the liver. Transvenous liver biopsy was followed by no or minor complication in all our patients except for one who suffered fatal intraperitoneal bleeding due to perforation of the liver capsule. It is concluded that transvenous liver biopsy is a workable, efficient, safe procedure for obtaining hepatic tissue specimens and that this method is essential in a department of hepatology.

Biopsy↗
PubMed1981

Propranolol for prevention of recurrent gastrointestinal bleeding in patients with cirrhosis: a controlled study.

It has been suggested that because propranolol decreases portal venous pressure, it may prevent gastrointestinal bleeding associated with portal hypertension. We randomly assigned 74 patients with cirrhosis, who were admitted because of gastrointestinal bleeding, to either oral propranolol given in doses that reduced the heart rate by 25 per cent (38 patients) or to a placebo (36 patients). The proportion of patients free of recurrent gastrointestinal bleeding one year after inclusion in this study was 96 per cent in the propranolol group and 50 per cent in the placebo group (P less than 0.0001). We conclude that continuous administration of propranolol by mouth is effective in preventing recurrent gastrointestinal bleeding in patients with cirrhosis.

Administration, Oral↗
PubMed1981

Measurement of hepatic blood flow in the rat using fractional clearance of indocyanine green and colloidal radiogold.

Two new methods are described to measure hepatic blood flow in the anaesthetized rat. These methods are based on the fractional clearance and extraction of indocyanine green, which is removed by hepatocytes, and of colloidal radiogold, which is removed by Kupffer cells. Hepatic blood flow was found to be 2.11 +/- 0.35 ml . min-1 . g liver-1 (mean +/- SD) and 2.01 +/- 0.31 ml . min-1 . g liver-1, respectively, with these two substances (P greater than 0.80).

Animals↗
PubMed1981

Portal vein thrombosis and fatal pulmonary thromboembolism associated with oral contraceptive treatment.

We report a 33-year-old woman who took oral contraceptives for 8 years, and who developed gastrointestinal bleeding from esophageal varices. Celiac and mesenteric angiography demonstrated a portal vein thrombosis. Because of several episodes of dyspnea, a pulmonary angiogram was also performed, and showed partial or complete obstruction of both inferior pulmonary arteries with "pruning" of lower lobes. Despite immediate anticoagulant therapy, the patient died suddenly some days later. We believe that oral contraceptive treatment could have induced thromboembolic disease both in portal and pulmonary circulations in this patient.

Adult↗