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G H Hoversten

Publications and source records attributed to G H Hoversten.

4 recordsLinked to original sources
PubMed1986

Radionuclide evaluation of bile leakage and the use of subhepatic drains after cholecystectomy.

Our study addresses the question of efficacy of drainage after cholecystectomy by evaluation of the leakage of radiolabeled bile. Based on our data, drains placed at the time of surgery do not appear to reliably remove bile or to decrease morbidity. Our study reveals that bile leakage after cholecystectomy is frequent, cannot be accurately predicted at operation, is not related to the experience of the operating surgeons, and does not necessarily correlate with morbidity. The shorter postoperative hospital stay in the group of patients with subhepatic bile leakage compared with the group without evidence of leakage after cholecystectomy is not statistically significant. However, this trend does suggest that there is no increase in morbidity associated with bile leakage per se. A large, clinically significant bile leak can easily be treated by modern interventional radiologic techniques if drainage is indicated. A larger, double-blind study is necessary to further evaluate the issues surrounding bile leakage and drainage after cholecystectomy.

Adult↗
PubMed1978

Replacement of pancreatic beta cells as treatment for diabetes mellitus: a review.

At the present time, two major factors limit further clinical application of islet cell transplantation in treatment of the insulin-deficient diabetic patient. First, the yield of islet tissue obtainable from a single donor pancreas is insufficient for adequate reconstitution of normal beta cell mass. The purification procedures required to eliminate acinar contamination and allow safe portal vein infusion cause large islet cell losses. Other procedures designed to minimize islet loss result in crude preparations containing substantial acinar tissue. In dogs and rats, crude preparations have been inoculated with safety into the spleen and function well in this location, but such a procedure might not be feasible in the human. Preliminary trials of these techniques in the monkey have not been successful. Second, dispersed and isolated islets inoculated into any site are exceptionally vulnerable to rejection and cease to function within a few days. Successful human islet allografting must await development of improved techniques of histocompatibility matching and/or immunosuppression. An additional question, unanswered in experiments to date, relates to the probable requirement for accuracy in replacement of alpha cells and beta cells for cure of the insulin-deficient juvenile diabetic patient. In rats, transplantation of large volumes of islet cells has resulted in hyperglucagonemia, hyperinsulinemia, and polyphagia, although the rats remain normoglycemic and have normal glucose tolerance tests. Bewick has elicited hyperinsulinemia in dogs by denervation and shunting the pancreatic venous drainage from portal to systemic. The metabolic effects of this abnormal state have not been adequately studied. These unresolved issues mandate that pancreatic transplantation remain an experimental procedure in humans. Whole or segmental pancreatic implants are technically feasible and are capable of function for extended periods of time. Islet implantation is reserved for carefully controlled experiments and in patients immunosuppressed for other organ transplants.

Aging↗