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Biomedical subjects

J Funovics

Publications and source records attributed to J Funovics.

At least 73 records · Page 4Linked to original sources
PubMed1980

[Angiography in distal spleno-renal shunts (author's transl)].

The conception of Warren's Shunt--selective decompression of esophageal varices while maintaining prograde portal flow--was controlled by pre- and postoperative angiographic examinations on 12 patients: No change in portal perfusion was established angiographically in ten of the patients. Two patients developed aneurysmatic, arterio-portal fistulae as a result of postoperative portal decompression. In one of these cases, a thrombosis of the portal vein with hepatofugal perfusion of the left gastric vein was detected. The postoperative examinations indicated functioning shunts in 9 out of 12 patients. These results formed the basis for the discussion regarding the value of visceral angiography in the selection of the surgical technique and regarding its value in control of therapy. Surgical questions concerning the visceral vascular anatomy can be answered sufficiently. Furthermore, celiac and mesenteric angiography yield information on portal hemodynamics. Nevertheless, the additional application of invasive scintigraphy seems to be necessary for establishing quantitative radiological parameters of prognostic relevance.

Angiography↗
PubMed1980

[Urea production and cell-mediated immunity as indicators of preoperative catabolism (author's transl)].

In 38 preoperative patients the production of urea was estimated and cell-mediated immunity was measured. Ten patients were catabolic and had negative skin tests, all of them were inoperable. Fifteen patients were catabolic and had positive skin tests, five patients were inoperable. Twelve patients were not catabolic and had positive skin tests, two were inoperable. One female patient was not catabolic and had negative skin tests, but was operable. The catabolic state can be assessed by the urea production rate and one can give prognostic and trophotherapeutical indications in correlation with the degree of cellular immunity.

Energy Metabolism↗
PubMed1980

[Congenital cysts of the liver (author's transl)].

After reviewing the literature, case reports of 15 patients with congenital cysts of the liver are given. Surgery was done in these cases because of cholangitis, jaundice, suspected tumor. Cysts were removed totally, anastomized, punctured or supplied with a window, or lobectomy of the liver was done depending upon localisation, size, number and contents of the cysts.

Adult↗
PubMed1980

[Choice of anaesthesia technique in thoracic endoscopic sympathectomy (author's transl)].

Thoracic endoscopic sympathectomy (TES) is a short surgical procedure used for the treatment of palmar and axillary hyperhidrosis. It involves pneumothorax, the lateral and head up position, and necessitates minimal chest excursions during breathing, so that a special type of anaesthesia is required. In 13 patients two different methods were compared and blood gas analysis as well as circulatory parameters were studied. We therefore propose an anaesthetic method using controlled mechanical ventilation; relaxation; intravenous anaesthesia; at least 1 1 fluid replacement; and careful monitoring.

Adolescent↗
PubMed1979

[Diagnosis and therapy of hepatocellular cancer].

A patient with hepatocellular carcinoma of the right liver lobe is presented by case report. Although a right side hemihepatectomy was performed, a recidive was detected 3 months later. Since then he received adriamycin-therapy and 14 months after operation, he is almost completely free of pain. Diagnosis, and surgical as well as internal therapy, are presented.

Carcinoma, Hepatocellular↗
PubMed1979

[Plasmaperfusion through activated charcoal and amberlite XAD-7 in dogs with liver failure induced by yellow phosphorus (author's transl)].

Various sorbents were tested in-vitro for their ability to support hepatic excretory and detoxification functions, and their in-vivo perfusion with plasma was studied in an animal experiment. Amino acids, particularly phenylalanine and tyrosine, were strongest bound by activated charcoal, while Amberlite XAD-7 removed conjugated and unconjugated bilirubin and bile acids from plasma. Using a cell-separator plasma of dogs, in whom acute liver failure was induced by yellow phosphorus, was perfused through a combination of charcoal and Amberlite XAD-7 without major complications. Platelet counts remained nearly unchanged, platelet aggregation was inhibited reversibly, and circulating platelet aggregates occurred late only. It is concluded that using the method described, therapeutic trials in patients with fulminant hepatic failure can be performed.

Animals↗
PubMed1978

[Whole gut irrigation for large bowel preparation (author's transl)].

In a controlled trial whole gut irrigation (w.g.i.) was compared with elemental diet for 4 days as large bowel preparation. Cleansing effect, caloric intake and preparation time were significantly better in the first group (w.g.i.). In addition w.g.i. was routinely used studying 42 patients in an open trial which showed also a reliable cleansing effect and good practicability. At present the experience refers to a total of 163 preparations by means of w.g.i. In a further study the efficacy of w.g.i. for removal of blood from the intestinal tract in patients with bleeding esophageal varices was investigated. In 8 out of 11 cases a complete removal of the blood masses was obtained, 3 of these patients showed an improvement of the preexisting coma-stage.

Aged↗
PubMed1978

[Transhepatic occlusion of bleeding oesophageal varices in cirrhosis of the liver (author's transl)].

The transhepatic method for occluding bleeding oesophageal varices described by Lunderquist and Vang has been carried out in eight patients. The technique, success rate and complications are discussed. In two patients attempt at thrombosis was unsuccessful. One patient suffered a fatal complication. Recurrent bleeding occurred from four days to four months. Bearing in mind the efficiency of the method, its risk, compared with other palliative measures, is acceptable.

Acute Disease↗
PubMed1978

[Therapy of hepatic encephalopathy. Modification of the plasma aminogram using amino acid infusions].

When amino acid solutions with high concentrations of branched chained amino acids and low concentrations of aromatic amino acids were administered to patients with cirrhosis of the liver 1. the serum levels of tyrosine and phenylalanine were significantly reduced, 2. the molar ratio of the branched chained amino acids to the aromatic amino acids substantially increased, and 3. as therapeutic response in all cases treated, a marked improvement of hepatic encephalopathy was achieved.

Aged↗
PubMed1978

[Long-term study of endocrine inhibition of exocrine pancreas secretion in the conscious dog].

A new model of a reversible long-term pancreatic fistula was used on an alert, unrestrained dog to test the effect of four substances of the GEP system on the exocrine pancreatic function. The results indicate that SST significantly inhibits not only the basal secretion but also the stimulated secretion of volume, bicarbonate, and trypsine. Calcitonine inhibits only the stimulated secretion whereas PGE1 inhibits only the secretin-stimulated output of trypsine. Glucagon inhibits secretin stimulation in all three parameters.

Animals↗
PubMed1976

[Mono- or biphasic release of gastrin. Results after isolated antrum perfusion in vitro].

In an in vivo preparation, isolated rat antra were perfused with different releasing agents in an oxygenated Krebs-Ringer-A solution. Upon perfusion with acetylcholine (+ 0,1 mM eserine), the mean gastrin levels in the effluent increased within 2 min to 4 times the basal level, while there was a smaller second release after 20 min. During perfusion with 50 mM glycine and 30 mM calcium chloride containing Krebs-Ringer-A solution gastrin levels in the effluent increased within 4 min to twice the basal level without a secondary release of gastrin. Perfusion with eserine alone or with Krebs-Ringer-A solution failed to release gastrin. The apparent biphasic release of gastrin with acetylcholine may suggest that antral gastrin may exist in two different populations, one of which is readily accessible, the other less so. Alternatively, the initial peak may consist only of stored gastrin and the second peak of newly synthesized gastrin, stimulated only by the physiologic stimulus of acetylcholine, and not by other releasers.

Acetylcholine↗
PubMed1976

[A new therapeutic principle in hepatic coma: parenteral supply of neutral amino acids].

The effect of two different amino acid solutions given i.v. was investigated in dogs with hepatic encephalopathy after portacaval shunt. The results suggest that (a) isocaloric protein-free nutrition has no impact on the characteristic plasma amino-gram, (b) the infusion of modified concentrations of 6 neutral amino acids may reduce mortality and morbidity in dogs with hepatic coma, and (c) manipulation and normalization of plasma amino acids may be efficacious in providing adequate nutrition while minimizing hepatic encephalopathy.

Amino Acids↗
PubMed1975

Secretin-induced bile secretion, bile acid output and blood supply to the liver in the dog.

Bile secretion and blood flow in the portal vein and the hepatic artery were determined in cholecystectomized anesthetized dogs before and during continuous infusion of varying doses of secretin. Secretin increases bile volume without alteration of bile acid output. Hepatic arterial flow was not altered by any dose. However, high doses of secretin increased portal venous blood flow significantly. It is concluded that secretin action on liver blood flow mirrors mainly superior mesenteric arterial vasodilation and seems to be a rather pharmacologic than a physiologic response. Bile secretion is not influenced by changes of hepatic blood flow in the physiologic range.

Animals↗
PubMed1975

[New evaluation of effect of total colectomy and intestinal sterilization following portacaval shunt].

The effect of total colectomy and "intestinal sterilisation" following chronic portocaval shunt was investigated in 96 Sprague-Dawley rats: while both therapeutic procedures are of no significant impact on serum ammonia concentrations there is a significant reduction of brain octopamine, a known false neuro-chemical transmitter, and a clear response on aromatic amino acid levels in brain and plasma. The interference with central and peripheral neurotransmitters is suggested as an alternative mechanism in experimental encephalopathy.

Ammonia↗
PubMed1975

Effect of portacaval shunt and arterialization of the liver on bile acid metabolism.

The effect on bile acid clearance of portacaval end-to-side shunt, with and without arterialization of the hepatic portal venous bed, was studied in dogs. Portacaval shunt reduced liver blood flow by 75%, and peripheral serum bile acid concentration rose from 3 to 239 muM. Arterialization maintained total liver blood flow within physiological range and serum bile acid concentration was only 19 muM. Since hepatic bile acid extraction was similar in both groups, bile acid clearance was determined largely by total liver blood flow. The results of this study indicate that hepatic clearance of substances originating from portal blood is impaired in portacaval shunt and can be restored by increasing the arterial blood supply to the liver.

Ammonia↗
PubMed1975

[Mechanism for the liberation of duodenal gastrin in the dog].

The mechanisms of duodenal gastrin release were studied in 13 mongrel dogs after selective mucosal antrectomy: Vagal stimulation with insulin and local perfusion with acetylcholine at pH 7 resulted in a significant increase of the serum gastrin level taken from the pancreatico-duodenal vein. No significant amounts were detected after vagal stimulation with 2-deoxy-d-glucose, local perfusion with acetylcholin at pH 1, 5 nor after duodenal distension with 20, 40 and 120 cm water.

Acetylcholine↗
PubMed1975

[Cerebral manifestations in the hepatic coma syndrome (author's transl)].

The pathogenesis of hepatic encephalopathy has been investigated in a two-stage devascularization model in the rat with portavacal shunt and hepatic artery ligation. There is a significant increase in brain octopamine and phenylethanolamine and a decrease in brain norepinephrine (NE) 6 to 9 hours after hepatic artery ligation. The depletion of NE seems the sequel of diminished synthesis in the presence of an unaltered turnover rate, due to a blockade of tyrosine hydroxylase either by accumulation of false neurochemical transmitters or by phenylalanine. It is most marked in the cortex and midbrain. The high-energy phosphate compounds, ATP, phosphocreatine and glucose-6-phosphate are not diminished in hepatic coma, nor is glucose, indicating that other mechanism are involved in the pathogenesis of metabolic state by the increased ammonia level. "intestinal sterilization" and total colectomy have no significant effect on the ammonia level, but cause a decrease in the level or aromatic precursor amino acids in the plasma and brain, with normalization of the level of cerebral transmitters. These results permit the formulation of a unified concept of the hepatic coma syndrome and its clinical manifestations such as flapping tremor, the hyperdynamic cardiovascular state and the hepatorenal syndrome. Moreover, they form the basis for the introduction of a new therapeutic principle in the management of hepatic encephalopathy by L-dopa or modified amino acid solutions, which act by altering the central and peripheral neurotransmitters.

Animals↗