[Myxoma in the left heart auricle].
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Biomedical subjects
Publications and source records attributed to J Siman.
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Seventy-five patients after jejunoileal bypass for morbid obesity were investigated. The body weight, fat and nitrogen balances were followed. In the second year after operation the stabilization of body weight was observed. The fecal fat excretion was average one third of the ingested amount of fat and the fecal nitrogen loss was twice or three-times higher than normal value. In the first year after operation in many patients the positive nitrogen balance was stated on the ward, caused first of all by decrease of the nitrogen excretion in the urine. Authors conclude that the decrease of body weight is caused on the hand by decrease of oral intake and resorption of nutrients in the shortened small intestine and on the other hand by inadequate physical load after operation.
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By means of direct method hepatic blood supply was examined after ligation of hepatic artery and portal vein. 15 per cent of the total blood supply to the liver were arterial. This amount can rise to 30 per cent under extreme conditions, caused by an increase of arteriovenous pressure difference as well as by a decrease of the arterial flow resistance in the liver.
Blood supply to the liver was determined by help of the direct method after 70 per cent hepatic resection and after ligation of the left branch of portal vein in dogs. The total blood supply remains unchanged after both surgical procedures, while the circulation in the remaining lobes, resp. in those patent for portal blood stream, considerably increases. After the resection portal hypertension develops. This elevated portal pressure was not observed after ligation of the left portal branch.
Values of intrahepatic arterial pressure gradients are presented on a table, based on own hepatic circulatory measurements and own anatomic studies. The importance of the peribiliar net for hemodynamics is stressed, which has regulative properties steering the pressures under which arterial blood gets into the sinusoid capillaries.
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