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Biomedical subjects

G Gubernatis

Publications and source records attributed to G Gubernatis.

83 records · Page 5Linked to original sources
PubMed1985

Preserved incretin effect after complete surgical denervation of the pancreas in young pigs.

Plasma insulin responses to intragastric (i.g.) (1.5 g/kg b.wt.) and "isoglycemic" intravenous (i.v.) glucose were measured in ten unanesthetized young pigs to assess the contribution of gastrointestinal factors to the total insulin secretion as observed after i.g. glucose. The participation of nerves was estimated by comparing metabolic tests performed before and after total surgical pancreatic denervation. In the five animals which survived the procedure, 52.6% of the insulin response after i.g. glucose was calculated to be due to incretion factors, a value similar to the 54.8% found in the preoperative series (with intact pancreatic innervation). The response of IR-GIP to i.g. glucose was not significantly different between preoperative and postoperative tests, although a subtotal duodenectomy had to be performed in the course of the operation designed to completely denervate the pancreas. Intragastric and i.v. (also tested by bolus glucose injection) glucose tolerance was almost identical before and after the operation. It was concluded that nerves do not seem to play a major role in mediating the incretin effect in pigs. Hormonal factors, including GIP, appear to be more important.

Animals↗
PubMed1985

Glucostat capacity and metabolic zonation in rat liver after portocaval anastomosis.

The activities and zonal distribution of key enzymes of carbohydrate metabolism were studied in livers of rats after end-to-side portocaval anastomosis. Sham-operated control animals with the same periods of interruption of hepatic blood supply as the shunted animals were pair-fed. The following alterations were observed: Food uptake was reduced to about 20% at the first postoperational day; it was then increased continuously to about 70% at day 8. Body weight, after a small 10% postoperational decrease, remained unaltered, but liver weight was lowered to 55% at day 8 and then stayed constant. The total glycogen reserves of the liver (g X 100 g body weight-1) were reduced, after a transient fall to about 10% at day 1-4, to about 25%. The total activity of the glucogenic phosphoenolpyruvate carboxykinase (mumol . min-1 X 100 g body weight-1) was diminished, after a transient increase to 190% and 150% at day 1 and 2 respectively, to about 55% from day 8 onwards. The total activity of the glucogenic glucose-6-phosphatase was lowered without a transient rise to about 30%. The total activities of the glycolytic pyruvate kinase isoenzyme L and glucokinase were decreased continuously to about 40% at day 8; that of the citrate cycle enzyme succinate dehydrogenase was lowered parallel with liver weight to 55%. The transient decrease of the glycogen reserves and the intermediate increase of the phosphoenolpyruvate carboxykinase capacity were due to the operational stress, since they were observed also in the sham-operated control animals. All other alterations, the decrease of liver weight and of the capacities of both gluconeogenic and glycolytic key enzymes, were specific for the portocaval anastomosis. The normal periportal to perivenous gradient of phosphoenolpyruvate carboxykinase of about 3.5:1, as measured in microdissected tissue samples, remained the same with specific activities reduced to about 80% each in the two zones. The normal periportal to perivenous gradient of pyruvate kinase L of about 1:1.7 was equalized with levels lowered to 35% and 23%, respectively, in the two zones. The normal periportal to perivenous gradients of glucose-6-phosphatase and succinate dehydrogenase, demonstrated histochemically, were essentially maintained with perivenous bridging occurring transiently at day 4 and 8.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1983

[Effect of oxmetidine and ranitidine on reflux behavior in patients with esophagitis].

The behavior of reflux under oxmetidine and ranitidine has been examined by long-term-pH-metry in patients with endoscopic proved oesophagitis and pathological, gastro-oesophageal reflux (GER). Both H2-receptor antagonists lead to a significant decrease of the GER over the entire period of measurement of 18 hours. Statistical significant differences comparing both substances could not be found, so that as well oxmetidine as ranitidine seem to be appropriate for the therapy of reflux diseases.

Esophagitis, Peptic↗
PubMed1978

[Pre and postoperative EEG monitoring as illustrated in various routine anesthesia methods].

EEG monitoring was performed on 600 patients during anesthesia or postoperatively. Typical courses were evaluated. Examples of EEG dependence on the kind of anesthesia, the age of the patient, and individual sensitivity to the dosage of the anesthetic agent are given. These results may indicate that EEG monitoring is valuable in the clinical routine and in adjusting the dosage of anesthetics to the individual cerebral situation.

Adult↗
PubMedDate not supplied

Score-aided decision making in patients with severe liver damage after hepatic transplantation.

This article describes how a system of scoring risk factors contributes to deciding whether a patient showing signs of liver failure soon after hepatic transplantation should be treated expectedly or should undergo immediate retransplantation. Of 78 adult patients receiving a first liver graft, 25 had evidence of severe damage of the graft and were further investigated. Nine had failure due to irreversible initial nonfunction, and 2 of the 9 died before a second graft was available. Seven were retransplanted with 3 long-term survivors. The other 16 patients showed reversible severe damage and survived without retransplantation. Since retransplantation for irreversible initial nonfunction is successful only in the first postoperative days, there is an urgent need to identify the degree of the observed damage. We devised a scoring system which identified and weighted factors that were predictable in determining irreversibility. Measurements of highest relevance are transaminases, bile volume, the slope of the enzyme GLDH, and the amount of fresh blood and fresh-frozen plasma required for support on the day of operation and the following day. Logistic regressional analysis produced a numerical score which was applied to a decision tree and produced probabilities and utilities to indicate whether reoperation is advisable. We use this scoring system and believe it assists our decisions in the early posttransplant period.

Abstracting and Indexing↗
PubMedDate not supplied

Auxiliary partial orthotopic liver transplantation (APOLT) for fulminant hepatic failure: first successful case report.

Fulminant hepatic failure is a life-threatening event with a high mortality rate up to 80%. Orthotopic liver transplantation has markedly decreased this mortality rate and is therefore a well established procedure for hepatic failure. However, this treatment neglects the fact that patients surviving hepatic failure without liver transplantation experienced a complete morphologic and functional recovery of their own liver. Temporary support of liver function in such cases could therefore be desirable and adequate therapy. Auxiliary liver transplantation could fulfill this demand. However, the standard technique of auxiliary grafting, transplanting a graft in a heterotopic position, is burdened by problems such as elevated venous back-pressure, insufficient respectively competing portal blood supply for both livers with an unpredictable long-term outcome. In order to cope with these problems, we performed an auxiliary transplantation in an orthotopic position. To accomplish this procedure we had to reduce the size of both the recipient and the donor livers. We, thus, performed an auxiliary partial orthotopic liver transplant (APOLT). The first patient was a 33 year old female who was transplanted on November 25, 1989. She developed a HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome and fell into a deep coma. At the time of transplantation histologic examination of her own liver revealed 80% confluent necrosis. We resected segments 2 and 3 of the recipient liver and transplanted the whole left lobe of the donor liver into this position.(ABSTRACT TRUNCATED AT 250 WORDS)

Abortion, Induced↗
PubMedDate not supplied

Liver transplantation in pigs: a model for studying reperfusion injury.

A model of orthotopic liver transplantation in pigs was developed to investigate reperfusion injury of the liver. To have direct access to the liver for organ monitoring a relaparotomy was performed 6 h after revascularization. The details of modification in anesthesia and surgical technique are given. Salient features of the technique include (1) the use of an extremely short cuff of the donor suprahepatic caval vein, (2) the use of a central venous catheter fixed in a hepatic vein, and (3) the use of an aortic graft for standardized arterial reconstruction. Twenty-nine transplantations were performed. The total anesthetic time was 13.28 +/- 1.45 h and the operative time was 10.06 +/- 0.77 h. The animals withstood this long procedure remarkably well.

Anesthetics↗