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T Holmin

Publications and source records attributed to T Holmin.

At least 37 records · Page 2Linked to original sources
PubMed1988

Splenic and gastro-duodenal vein occlusion--influence on the pancreatic gland and on the outcome of experimental pancreatitis.

The observation that splenic vein thrombosis results in pancreatic changes similar to haemorrhagic pancreatitis initiated the present investigation. The influence of splenic and/or gastroduodenal vein occlusion on the pancreatic gland was evaluated and compared to that obtained after induction of experimental pancreatitis (EP). The influence of splenic vein occlusion on EP was also investigated. An approximately 4-fold increase in serum amylase activity was obtained after simultaneous ligation of the splenic and gastroduodenal veins. This increase was comparable to that obtained after EP. On the other hand, amylase activity in ascites was considerably lower after vein occlusion than after EP. Splenic vein occlusion in rats with EP more moderately increased the amylase activity but did not influence mortality rate 24 h postoperatively. Venous thromboses were observed in all groups with occluded veins but not in rats with EP. Vein occlusion alone did not result in fat necroses. Although occlusion of the splenic and gastroduodenal veins results in macromorphologic and biochemical changes resembling those in EP, the microscopic findings of the two conditions differ. Thus, the results do not support the hypothesis that pancreatic vein thromboses are of etiologic significance for the development of acute haemorrhagic pancreatitis.

Amylases↗
PubMed1987

Microvascular polytetrafluoroethylene (Gore-Tex) grafts in the infrarenal rat aorta.

To evaluate the use of microvascular prosthetic grafts, the infrarenal aorta in 33 male Sprague-Dawley rats was replaced by an interposition graft of PTFE (polytetrafluoroethylene, Gore-Tex). Three groups of experimental animals were studied: Group A consisted of rats with 7-mm-long grafts, group B consisted of rats with 20-mm-long grafts, and group C consisted of rats with 20-mm-long grafts and ligatures of one patent after varying observation periods (6-92 days, median value 28 days, mean value 49 days). In group B all grafts but one (13/14) were patent (0-201 days, median value 198 days, mean value 118 days). In group C two grafts occluded immediately postoperatively, whereas the remaining six were patent (0-24 days, median and mean values 9 days). Twelve of 13 grafts observed for 3 months or more remained patent. There were no signs of infection. Angiography did not reveal any stenosis in the anastomoses of patent grafts. Light microscopy demonstrated a good adaptation between the grafts and the aorta in all animals. In the short grafts observed for 3 months and in the long grafts observed for 6 months, the luminal surfaces were completely covered by endothelial-like cells. In the occluded graft in group B, a stenosis was demonstrated in one of the anastomoses. This was not found in any other specimen. The results of this study document the possibility of using PTFE grafts of 1 mm diameter in experimental microvascular position.

Animals↗
PubMed1987

Hepatic sympathetic denervation potentiates glucagon-stimulated glycogenolysis and hyperinsulinaemia in the rat.

The influence of hepatic nerves on glucagon-stimulated hyperglycaemia and hyperinsulinaemia was studied in rats. Using microsurgical techniques, hepatic sympathectomy (resulting in approximately 80% reduction of liver noradrenaline content) or hepatic vagotomy was performed. Glucagon (10 micrograms/kg b.wt.) was injected i.v. one week after the operative procedure. Plasma levels of glucose and insulin rose more rapidly and to a higher level in rats subjected to hepatic sympathectomy than in sham-operated or non-operated control animals. In contrast, hepatic vagotomy did not influence the plasma glucose or insulin response to glucagon. In conclusion, our findings suggest a role for the hepatic sympathetic nerves in glucagon-stimulated glycogenolysis and insulin secretion in the rat.

Animals↗
PubMed1987

Hepatic reticuloendothelial function in rats with various portasystemic shunts and total liver arterialization.

Hepatic reticuloendothelial function was measured in 6 experimental groups of rats with various portasystemic shunts or total liver arterialization by computer calculation of the hepatic uptake rate of intravenously injected 99mTc-sulphur colloid. Marked reduction of the hepatic reticuloendothelial system (RES) function was found both 1 and 3 weeks after the construction of a mesentericocaval or conventional end-to-side portacaval shunt. Hepatic RES function was also lowered both 1 and 3 weeks after a modified portacaval shunt, but the reduction was much less pronounced. Total liver arterialization produced a similar mild reduction of hepatic RES function after 1 week; however, there was no longer any significant reduction after 3 weeks. This study concludes that total liver arterialization ameliorates the negative effect that portasystemic shunting has on hepatic RES function.

Animals↗
PubMed1987

The effect of intraportal six-hydroxy-dopamine on hemorrhage after standardized liver trauma in rats.

Sympathetic denervation of the liver was accomplished by intraportal injection of 6-hydroxy-dopamine in rats. The animals were subjected to standardized liver trauma 1 week later. Blood loss and duration of bleeding from the cut raw surface were more than doubled in the denervated animals. Mean arterial blood pressure was significantly lower in the denervated animals, but stable during hemorrhage in both denervated and innervated animals. Platelet aggregation and the intrinsic coagulation system were not affected by the chemical denervation. Hepatic norepinephrine was almost eliminated by the denervation procedure. These findings suggest that the liver nerves at the porta hepatis should be preserved during hepatic resections.

Animals↗
PubMed1986

Pre-operative infusion cholangiography compared to routine operative cholangiography at elective cholecystectomy.

Routine operative cholangiography (group 1) was compared with pre-operative intravenous infusion cholangiography and selective operative cholangiography (group 2) in 200 patients subjected to elective cholecystectomy. All patients were examined with pre-operative intravenous infusion cholangiography. In group 1 patients, this examination was not made available to the surgeon and not used in any way except for a later analysis. Thirteen patients had to be excluded for different reasons. In group 1, normal operative cholangiograms were obtained in 82/94 cases. Choledocholithotomy was performed in 7/12 cases, choledochotomy in 2/12 and no exploration in 3/12 cases. In group 2, pathological or inconclusive infusion cholangiograms were demonstrated in 17/91 cases. Choledocholithotomy was performed in 11/17 cases. One of 17 patients was subjected to choledochotomy only. In 5/17 patients, no exploration was carried out because of normal operative cholangiography. No residual or retained stone/s have been revealed during a follow-up period of 1 year. The general clinical outcome in the two groups of patients was similar. Significantly shorter operative time was an important advantage of the strategy in group 2 patients.

Adolescent↗
PubMed1986

Systemic reactive amyloidosis caused by hepatocellular adenoma. A case report.

Systemic reactive amyloidosis caused by non-malignant tumors seems to be extremely rare. In the present paper a 39-year-old female with systemic reactive amyloidosis caused by a hepatocellular adenoma is described. The patient had a history of using contraceptive drugs. She had a pronounced nephrotic syndrome, a renal biopsy showing reactive (AA) amyloidosis, and a bone scintigraphy (99mTc methylene diphosphonate, TcMDP) showing an increased uptake in soft tissues. Removal of the adenoma was followed by a gradual resolution of the nephrotic syndrome and a normalization of the bone scintigraphy. The tumor was histologically a mixture of focal nodular hyperplasia and liver cell adenoma.

Adenoma↗
PubMed1986

Contractile effects of various vasoactive agents in small rat portal veins and hepatic arteries and the influence of sympathetic denervation on the noradrenaline response.

Contractile responses were studied in isolated tubal segments of branches of the rat portal vein (luminal diameter approximately 300 microns) and hepatic artery (luminal diameter approximately 200 microns). Portal veins were approximately three times more sensitive to noradrenaline (NA) than hepatic arteries. 5-hydroxytryptamine contracted hepatic arteries concentration-dependently, whereas it produced only weak and inconsistent contractions in portal veins. Vasopressin effectively contracted hepatic arteries, whereas it had no effect on portal veins. Both vessel types responded to prostaglandin F2 alpha with contractions, although the drug potency was relatively low (EC50 greater than 10(-5) mol l-1). Histamine and carbachol failed to induce (hepatic arteries) or caused only weak (portal veins) contractions. Microsurgical hepatic hilar denervation reduced the catecholamine content of the parenchyma to less than or equal to 25% of controls. In both portal veins and hepatic arteries, the denervation procedure increased the NA sensitivity by factors of 3.1 and 2.0, respectively. In non-denervated livers, cocaine produced a similar increase of the NA sensitivity, whereas the drug had no significant effect in vessels from denervated animals. Thus, there was a marked difference between rat portal veins and hepatic arteries in their responsiveness to several contractile agents. Furthermore, the results of the present study indicate that the adrenergic nerves in both vessel types can be adequately removed by the microsurgical denervation procedure used.

Animals↗
PubMed1985

Hepatic lipase activity increases after liver denervation in the rat.

We have investigated the effects of hilar denervation of rat liver upon the activity of hepatic lipase determined in tissue extracts. Denervated animals had an enzyme activity of 7.89 +/- 0.37 mU/mg protein, compared to 6.45 +/- 0.43 in sham-operated controls (mean +/- S.E.; P less than 0.05). We conclude that hepatic innervation may contribute to the regulation of hepatic lipase activity.

Animals↗
PubMed1985

Effects of portacaval shunt on the rat stomach.

In portacaval-shunted rats, basal but not pentagastrin-stimulated acid secretion was higher than in sham-operated controls. The basal serum gastrin concentration was unchanged and the postprandial serum gastrin concentration lowered following portacaval shunt. Thus, gastrin is not responsible for the elevated basal acid secretion. The present study provides evidence that there is no trophic effect on the oxyntic mucosa as a whole and that there is no change in parietal cell-associated gastrin receptors after portacaval shunting. Interestingly, however, endocrine cells in the oxyntic mucosa (the histamine-containing ECL cells) proliferated greatly and the pentagastrin- and cholecystokinin octapeptide-induced activation of the histamine-forming enzyme, histidine decarboxylase, in these cells was much greater than in control rats. Analysis of the dose-response curves for the enzyme-activating effect of pentagastrin and cholecystokinin-octapeptide indicated that the D50 values for these two stimulants were not altered by shunting but that the maximal enzyme activation was greatly elevated. The enhanced enzyme activation can be partly, but not fully, explained by the fact that the ECL cells were increased in number. The enhanced response following portacaval shunt probably reflects also an increased number of gastrin receptors per ECL cell. The effect of portacaval shunting on gastric ECL cells can perhaps be explained by impaired degradation in the liver of intestinal substance(s) exerting a highly specific trophic effect on the ECL cells or, alternatively, causing an enrichment of gastrin receptors on these cells, thereby making them more sensitive to the trophic effect of gastrin. The ECL cell hyperplasia is manifest about 4 weeks after the shunting. A modified procedure for portacaval shunting which left the gastroduodenal vein (otherwise ligated) drained to the liver produced the same trophic effect as conventional portacaval shunt, suggesting an intestinal rather than gastroduodenal origin of the agent(s) responsible for the trophic action.

Animals↗
PubMed1985

Efficient hepatic uptake of chylomicron remnant cholesterol in rats with a portacaval anastomosis.

Portacaval-shunted and sham-operated male rats, fed ad libitum and of similar weight, were studied 2-3 weeks after surgery. At this time serum cholesterol levels did not differ significantly between the two groups, whereas serum triacylglycerols and phospholipids were lower in the shunted group. These animals also showed an increased serum bile acid level and an increased serum estradiol to testosterone ratio. The metabolism of native chyle labeled with [3H]cholesterol and [14C]linoleic acid or of preformed chylomicron remnants with the same labeling was studied in the groups of rats. Ten minutes after intravenous injection of chylomicron remnants 10.6 +/- 0.5% (means +/- SEM, n = 8) of the injected [3H]cholesterol and 7.6 +/- 0.4% of the [14C]linoleic acid were found per 1 g liver in the portacaval-shunted rats; the corresponding figures in the sham-operated group (n = 8) were 6.4 +/- 0.4 and 4.9 +/- 0.3, respectively (p less than 0.001 for both 3H and 14C). Thus, despite a greater than 40% reduction of liver weight induced by the shunting procedure, the total liver uptake of chylomicron remnants was not significantly decreased. The uptake of chylomicron lipids per unit liver weight was normal in the atrophic livers of portacaval-shunted rats also when very large loads of chyle were administered.

Animals↗
PubMed1985

Double-blind evaluation of intravenous indomethacin and oxycone-papaverine in the treatment of acute biliary pain.

In a prospective double-blind study, 51 patients with acute biliary pain were treated with intravenously administered indomethacin 50 mg (Confortid) or oxycone-papaverine 5+50 mg. The intensity of pain was evaluated before and 20 min after each injection according to an analog visual scale. Both drugs gave comparable and significant pain relief. A second injection was required by 7 of the 23 patients initially given indomethacin and by 12 of the 28 after oxycone-papaverine. The second injection, which was given with a cross-over procedure, contributed to additional pain relief. Side effects were transient in both groups, with a tendency to be milder in the indomethacin group. From the etiologic viewpoint, use of a prostaglandin synthesis inhibitor is appropriate, and the results indicate that indomethacin can be recommended as the drug of choice in patients with acute biliary pain.

Adolescent↗
PubMed1985

Preoperative herniography in clinically manifest groin hernias.

Herniography was performed in 88 patients (7 females, 81 males) clinically judged to have a groin hernia. The preoperative herniography demonstrated the exact type of hernia in 62 out of 94 hernias operated on (66%), and the hernias found at operation were predicted by the herniography in 69 out of 94 hernias operated on (73%). A contralateral asymptomatic hernia was revealed by herniography in 17 out of 88 patients. The majority (11) of these hernias were small and lateral. One patient with an asymptomatic femoral hernia underwent hernioplasty. The remaining 16 patients have not been operated on and have remained symptom-free. According to our experience, preoperative herniography does not appreciably alter the operative management of patients with clinically manifest groin hernias. Although the examination reveals a significant number of additional asymptomatic hernias, this diagnostic knowledge is probably of minimal clinical significance, especially when considering the discomforts and cost of the examination.

Adult↗
PubMed1984

Contrast tomography of the gallbladder wall and ultrasonography in the diagnosis of acute cholecystitis.

Rapid and reliable diagnostic methods are necessary for regular early surgical intervention in patients with acute cholecystitis. Eighty-three patients with clinical suspicion of acute cholecystitis were investigated with ultrasonography (US) and contrast tomography of the gallbladder wall (CTGW). The diagnosis in each case included in the study was verified either at operation or follow-up cholecystography. The sensitivity and specificity of US were 69 and 100 per cent, respectively. With CTGW the corresponding figures were 73 and 100 per cent. The combined use of these methods resulted in a sensitivity of 89 per cent and a specificity of 100 per cent.

Acute Disease↗
PubMed1984

A microsurgical method for denervation of the liver in the rat.

The role of the nerves in the hepato-duodenal ligament should be of special surgical interest, since these nerves are often injured in hepatic and biliary tract surgery. We have developed a microsurgical procedure for liver denervation. All visible nerves were resected after staining. Norepinephrine values in central liver tissue of denervated rats were only 18% of the corresponding values in innervated liver tissue, indicating an appreciable degree of sympathetic denervation. No detectable immunoreactivity of gastrin, cholecystokinin, vasoactive intestinal polypeptide, substance P, somatostatin or enkephalin were found within resected hepatic nerves. The described denervation procedure is simple and reproducible. It can be used to obtain additional information about the nervous regulation of various liver functions.

Animals↗
PubMed1984

Hepatic rupture secondary to pre-eclampsia--report of a case treated conservatively.

Hepatic rupture during pregnancy is related to toxaemia and is most often fatal. Epigastric pain and signs of intra-abdominal bleeding are the most common presenting symptoms. In previous reports liver surgery has been considered the method of choice in all patients. However, we have successfully treated a patient with bilateral hepatic rupture and intra-thoracic bleeding with termination of the pregnancy but otherwise conservative measures. The importance of early diagnosis, by ultrasonography and/or explorative laparotomy, and early termination of the pregnancy is stressed. Also, it is suggested that liver surgery should be individually tailored and that it is preferably avoided in some patients.

Adult↗