RESUMEN
BACKGROUND/AIMS: Peritoneoscopy allows the clinician to assess the activity of the surface of the liver and helps him to make a prognosis in cases of liver disease by judging the structural changes of the surface. In chromoperitoneoscopy using an intravenous injection of indocyanine green (ICG), hepatic parenchyme is stained after intravenous injection of ICG while interstitial connective tissue, fatty deposition and hepatoma are not. So diagnostic accuracy is, therefore believed to be elevated in chromoperitoneoscopy than conventional peritoneoscopy or blind liver biopsy. This study was performed to assess the clinical usefulness of chromoperitoneoscopy in various chronic liver diseases. METHODS: Intravenous ICG was administered at 2 mg/Kg mixed with 20 cc of saline in 30 cases with several kinds of hepatic disorders during conventional peritoneoscopic examinatians. Liver surface was examined 5 minutes after ICG injection.
Asunto(s)
Biopsia , Carcinoma Hepatocelular , Tejido Conectivo , Verde de Indocianina , Inyecciones Intravenosas , Laparoscopía , Hepatopatías , Hígado , PronósticoRESUMEN
Lactate is the most commonly used buffer in CAPD. The buffering effect of lactate is accomplished by its complete metabolism in liver and kidney. In patients with hepatic disease the rate of metabolism may be lower with a consequent increase in plasma lactate levels. Plasma lactate levels, however, have not been measured in CAPD patients. This study was performed to evaluate the plasma lactate levels and acid-base status in CAPD patients with liver cirrhosis. The concentrations of arterial L-lactate, pH, bicarbonate and venous total CO2 were measured in 6 CAPD patients with LC, 36 CAPD patients without liver disease and 17 LC patients. All CAPD patients used commercially available dialysate containing 40mmol/L lactate(D,L-racemic solution). Arterial lactate levels were 4.19mmol/L in CAPD patients with LC, 1.43mmol/L in CAPD patients and 1.94mmol/L in LC patients(p<0.05). Arterial pH were not different among subgroups. Arterial bicarbonate concentrations were 20.5meq/L in CAPD patients with LC, 24.2meq/L in CAPD patients and 24.4meq/L in LC patients. Venous total CO2 levels were 21.4, 24.7 and 23.4meq/L, respectively. Anion gap were 13.1, 9.4 and 8.1, respectively. From our results and possible toxicity of elevated lactate levels, lactate-containing PD solutions should be used carefully to treat CAPD patients with LC.
Asunto(s)
Humanos , Equilibrio Ácido-Base , Concentración de Iones de Hidrógeno , Riñón , Ácido Láctico , Cirrosis Hepática , Hepatopatías , Hígado , Metabolismo , Diálisis Peritoneal Ambulatoria Continua , PlasmaRESUMEN
BACKGROUND: Mitral and pulmonary venous(PV) flow velocity variables are being used for the indirect evaluation of left ventricular(LV) diastolic function. However, these flow velocities are influenced by age, loading conditions and other factors. This study was designed to evaluate usefulness of left atrial size and function in addition to the relation of mitral and PV flow velocity variables in the estimation of LV filling pressures. METHODS: Mitral and PV flow velocity variables. left artial size and function were assessed just before a cardiac catherization in 31 patients. According to the LV filling pressures, patients were divided into two subgroups and echocardiographic variables were compared. RESULTS: 1) LV end-diastolic pressure was related to the duration of reverse flow in the PV at atrial contraction(r=0.58) and difference in mitral and PV flow velocity duration at atrial contraction(r=0.54), and the similar findings were observed in other left ventricular filling pressures. 2) Left atrial size and volumes were greater in the subgroup of abnormal LV filling pressures(P < 0.05), but left atrial ejection fraction was not different between subgroups. CONCLUSION: In addition to variables of the mitral and PV flow velocities, left atrial size and volume may provide an additive value in the estimation of left ventricular filling pressures.