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  • 1
    Digitale Medien
    Digitale Medien
    Effects of exercise-induced sympathoadrenergic activation on portal blood flow (1995)
    Springer
    Digestive diseases and sciences 40 (1995), S. 48-51 
    Details
    ISSN: 1573-2568
    Schlagwort(e): portal circulation ; echo Doppler ; plasma noradrenaline concentration ; isotonic exercise
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We examined the relationship between portal venous blood flow and sympathoadrenergic activation after muscle exercise. For this purpose, we used echo Doppler and measured plasma noradrenaline concentration before and after mild (7 metabolic units,N=8) and maximal exercise (14 metabolic units,N=8) in 16 patients without significant disease. Portal venous flow did not change after mild exercise. In contrast, a significant reduction in portal venous flow was observed after maximal exercise (P〈0.01). This was due to reductions in both cross-sectional area of the portal vein (P〈0.01) and portal venous velocity (P〈0.01). Overall, there were significant inverse relationships between the change in plasma noradrenaline concentration and that in cross-sectional area of the portal vein [r=−0.44,P〈0.01 (absolute change);r=−0.47,P〈0.01 (relative change)], that in portal venous velocity (r=−0.63,P〈0.01;r=−0.61,P〈0.01), and that in portal venous flow (r=−0.54,P〈0.01;r=− 0.59,P〈0.01). These results suggest that the reduction in portal venous flow after exercise is related to the degree of sympathoadrenergic activation. This reduction may be due mainly to splanchnic vasoconstriction.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02063940
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  • 2
    Digitale Medien
    Digitale Medien
    Reduced portosystemic hemodynamic responsiveness after orthostasis in patients with cirrhosis (1993)
    Springer
    Digestive diseases and sciences 38 (1993), S. 1251-1258 
    Details
    ISSN: 1573-2568
    Schlagwort(e): portal blood flow ; orthostasis ; liver cirrhosis ; noradrenaline ; Doppler flowmetry
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We studied portosystemic hemodynamic responsiveness after 1 min orthostasis in nine patients with cirrhosis and nine age-matched normal subjects. Orthostasis increased diastolic arterial pressure, which is a close indicator of arterial tone, in normal subjects (+17%,P〈0.01). In contrast, no significant change in diastolic arterial pressure was observed in patients with cirrhosis (−3%, NS). The increase in heart rate was less in patients with cirrhosis than in normal subjects (+15% vs +28%,P〈0.05). Orthostasis also decreased portal blood flow, which was assessed by an echo-Doppler flowmetry, in normal subjects (−27%,P〈0.01), but in patients with cirrhosis it was not modified (−3%, NS). Plasma noradrenaline concentration showed similar increase in both groups (normal vs cirrhosis; +61% vs +55%, NS). Although the change in plasma noradrenaline concentration was related with that in diastolic arterial pressure (r=0.71,P〈0.05) and inversely with that in portal blood flow (r=−0.69,P〈0.05) in normal subjects, no such significant correlation was found in patients with cirrhosis. We conclude that (1) a reduced hemodynamic responsiveness to sympathetic stimulation exists on both systemic and portohepatic vascular beds and (2) such a blunted baroreflex function is probably located at the receptor or effector level in patients with cirrhosis.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF01296074
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  • 3
    Digitale Medien
    Digitale Medien
    Wedged hepatic venous pressure reflects portal venous pressure during vasoactive drug administration in nonalcoholic cirrhosis (1994)
    Springer
    Digestive diseases and sciences 39 (1994), S. 2439-2444 
    Details
    ISSN: 1573-2568
    Schlagwort(e): intraclass correlation coefficient ; portal venous pressure ; wedged hepatic venous pressure ; portal hypertension ; vasoactive agents
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract Hepatic venous catheterization is widely used to assess portal pressure. However, it remains unclear whether wedged hepatic venous pressure is a close indicator of portal venous pressure during vasoactive drug administration in nonalcoholic cirrhosis. To address this issue, we analyzed the data from our previous published studies. Forty patients with nonalcoholic cirrhosis (HBV infection in five, HCV infection in 28, and cryptogenic in seven) were available in this analysis. A vasoconstrictor (N=14), vasodilator (N=10), or combination (N=16) was administered. The agreement of the changes between portal and wedged hepatic venous pressures during pharmacological manipulation was assessed by an intraclass correlation coefficient. The intraclass correlation coefficient in each subgroup was more than 0.60 (0.62 in vasoconstrictor group, 0.87 in vasodilator group, and 0.73 in combination group). When the analysis was performed according to the cause of liver disease, the values were 0.67 in HBV infection, 0.73 in HCV infection, and 0.74 in cryptogenic cirrhosis. These results suggest that wedged hepatic venous pressure reflects portal venous pressure during vasoactive drug administration in patients with nonalcoholic cirrhosis.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02087663
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  • 4
    Digitale Medien
    Digitale Medien
    Gastric mucus generation in cirrhotic patients with portal hypertension (1996)
    Springer
    Digestive diseases and sciences 41 (1996), S. 1727-1732 
    Details
    ISSN: 1573-2568
    Schlagwort(e): gastric mucus generation ; hexosamine ; liver cirrhosis ; portal hypertension ; tetraprenylacetone
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract We have evaluated gastric mucus generation (study 1) and the effects of tetraprenylacetone on gastric mucus generation (study 2) in cirrhotic patients with portal hypertension. Study 1: Included were 50 noncirrhotics (group A), 25 cirrhotics without portal hypertension (group B), and 25 cirrhotics with portal hypertension (group C). The antrum, corpus, and fundus mucus generation was assessed by hexosamine concentration using biopsy specimens. In groups A and B, the antrum hexosamine concentration was significantly higher compared with the corpus (P〈0.01,P〈0.01) and the fundus (P〈0.01,P〈0.01). In contrast, the hexosamine concentration at each location was similar in group C. Furthermore, the antrum hexosamine concentration of group C was significantly lower compared with that of group A (P〈0.05). In study 2, a double-blind design, 300 mg of tetraprenylacetone was administered for four weeks in 10 cirrhotics with portal hypertension and placebo in 10. The regional hexosamine concentrations were measured before and after drug administration. Placebo administration did not change hexosamine concentration at each location. In contrast, tetraprenylacetone increased the antrum and corpus hexosamine concentration (P〈0.01,P〈0.05), although the fundus concentration did not change. These data suggest that cirrhotics with portal hypertension have reduced gastric antral mucus generation and tetraprenylacetone normalizes this.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02088737
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  • 5
    Digitale Medien
    Digitale Medien
    Evaluation of patient outcome following sclerotherapy for esophageal varices (1996)
    Springer
    Journal of gastroenterology 31 (1996), S. 387-393 
    Details
    ISSN: 1435-5922
    Schlagwort(e): endoscopic injection sclerotherapy ; esophageal varices ; liver cirrhosis ; hepatic failure
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Notizen: Abstract After excluding terminally all patients, we evaluated a total of 718 patients treated with endoscopic injection sclerotherapy. They involved 350 episodes of acute hemorrhage and 368 prophylactic procedures in patients with risky varices. The 1-year cumulative survival rate was significantly lower in the acute hemorrhage group than in the prophylactic group (P〈0.05). The difference in survival between the two groups was primarily due to the number of deaths in the first 2 months after sclerotherapy (20.1% vs 0.8%,P〈0.0005). Improvements in the sclerotherapy technique significantly reduced the number of deaths from bleeding (9.3% vs 3.4%,P〈0.05), but not those from liver failure following variceal hemorrhag. Prophylactic EIS is advantageous in the treatment of esophageal varices, i.e. it may prevent deaths fromliver failure attributed to variceal hemorrhages. The present study shows that preliminary prevention of variceal hemorrhage provides favorable hemostatic efficacy in patients with risky varices.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF02355029
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