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D S Zimmon

Publications and source records attributed to D S Zimmon.

At least 73 records · Page 4Linked to original sources
PubMed1969

Albumin to ascites: demonstration of a direct pathway bypassing the systemic circulation.

The transport of plasma albumin and newly made albumin into ascitic fluid was studied in eight patients with cirrhosis and ascites. The thoracic duct was cannulated in two patients and lymph collected over a period of 2 hr. Simultaneously albumin-(131)I and carbonate-(14)C were injected intravenously. The albumin-(131)I measured the transfer of plasma albumin into ascites and into thoracic duct lymph. The carbonate-(14)C, by labeling newly formed albumin, permitted the estimation of the transfer of newly formed albumin into plasma, ascites, and lymph. If the newly synthesized albumin entering ascites and thoracic duct lymph is delivered initially into the plasma, then the ratios of the albumin-(14)C and -(131)I in ascites and lymph compared with the content of albumin-(14)C and -(131)I in plasma would be identical. However, if some newly formed albumin is delivered directly into ascites or lymph, the ratio for albumin-(14)C would be higher than that for albumin-(131)I in lymph or ascites. The ratios of both labeled albumins found in ascites or lymph are expressed as per cent of the total plasma pool. In the eight patients studied 4.2-11.7% of the albumin-(14)C in plasma was found in ascites in 2 hr whereas only 0.4-2.2% of plasma albumin-(131)I entered in this same period. In the two patients studied during thoracic duct lymph drainage 6.1 and 13.5% of newly made albumin-(14)C appeared in lymph in 2 hr whereas only 2.8 and 3.8% of plasma albumin-(131)I was found in the lymph. In cirrhosis with ascites some newly formed albumin entered ascites and thoracic duct lymph by a direct pathway from the liver bypassing the systemic circulation.

Albumins↗
PubMedDate not supplied

Endoscopic management of biliary tract stones and stenosis.

The role of endoscopy in managing biliary tract stones and stenosis is surveyed. Rapid advances in endoscopic videoimaging with small diameter maneuverable or large instrument channel endoscopes allows diagnosis and therapy under visual or radiographic control at almost any site in the biliary tree. Techniques for cytology, biopsy, sphincterotomy, mechanical or laser lithotripsy, dilatation with balloon or bougie, large (15 F) or small stent insertion, "polypectomy" or excision with laser or electrosurgery, and brachytherapy provide a therapeutic armamentarium that must be considered as painless, low risk, and cost-effective alternatives to surgical or percutaneous therapy.

Cholelithiasis↗
PubMedDate not supplied

The endoscopic intrahepatic cholangiogram. Clinicopathologic correlation with postmortem cholangiograms.

Endoscopic retrograde cholangiography (ERC) allows visualization of the entire biliary tree. The cholangiographic appearance of the intrahepatic bile ducts has received relatively little attention. This postmortem study was performed to define cholangiographic alterations produced by disease and to aid in the recognition of pathologic intrahepatic cholangiographic patterns produced by ERC. Intrahepatic cholangiographic patterns in the normal biliary tree, hepatic cirrhosis, hepatic infiltrative processes, and hepatic mass lesions are presented.

Adenocarcinoma↗
PubMedDate not supplied

The hepatic vasculature and its response to hepatic injury: a working hypothesis.

The hepatic circulation is unique in that high volumes of low pressure blood flow are supplied through a dual venous and arterial circulation. This vascular supply is modulated both by the gastrointestinal vascular bed and an intrahepatic microcirculation. This complex vascular system is influenced by pathologic processes within the liver. Alterations in the hepatic circulation reflect hepatic metabolic adaptation and injury. It seems reasonable to assume that in some circumstances hepatic circulatory alterations are inappropriate, exaggerated or inadequate and contribute to the initiation or perpetuation of hepatic injury. This paper attempts to focus on evidence derived from studies of the normal and abnormal hepatic circulation that provide insights into hepatic circulatory responses and their role in the initiation and perpetuation of hepatic injury. A possible relationship of these vascular changes to pathologic processes within the liver is proposed. Ultimately, precise measurement and understanding of hepatic vasculature changes may allow appropriate intervention to offset injury or stimulate maximum effective repair.

Blood Pressure↗