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  • amino acid imbalance  (1)
  • duodenal varices  (1)
  • hepatic encephalopathy  (1)
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  • 1
    ISSN: 1436-2813
    Keywords: upper gastrointestinal bleeding ; duodenal varices
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract The incidence of duodenal varices is exceedingly rare. A case of bleeding duodenal varices located in the third portion of the duodenum, secondary to idiopathic portal hypertension, which was successfully treated by surgery, is presented herein. Diagnosis was suspected at superior mesenteric angiography and was subsequently confirmed by endoscopy. A review of the literature reveals only 105 such cases in the world. While the duodenal bulb is the most common site of duodenal varices, the second portion of the duodenum appears to be the next most common site but duodenal varices in the other portions are extremely rare. From all of the possible causes of duodenal varices, liver cirrhosis remains the predominant etiological factor in 31 cases.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1573-7365
    Keywords: hepatic encephalopathy ; amino acid imbalance ; microdialysis
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Using microdialysis, we studied brain extracellular fluid (ECF) amino acid metabolism in rats with experimentally induced hyperammonemia and regional elevation of brain ECF ammonia levels. The total brain ECF amino acid level was increased by an elevation of the blood ammonia level. Hyperammonemia elevated brain ECF aromatic amino acids and reduced arterial blood branched chain amino acids. When rats with hyperammonemia were intravenously administered norleucine, the brain ECF norleucine level rose markedly, suggesting increased permeability of the blood-brain barrier. When rats with hyperammonemia were infused with a branched chain amino acid-rich preparation, the elevated brain ECF aromatic amino acids level was not suppressed. Following local intracerebral ammonia infusion, only glutamate levels showed a marked elevation. These results suggest that impairment of the blood-brain barrier related to hyperammonemia increases the inflow of low molecular weight substances including amino acids. Furthermore, the ammonia-induced increase of glutamate in the cerebral ECF suggests that high ammonia levels may increase the excitability of the brain. Thus, ammonia may serve as a key factor in the onset of hepatic encephalopathy.
    Type of Medium: Electronic Resource
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