ABSTRACT
Malnutrition and growth retardation remain a major complication in infants with extrahepatic biliary atresia associated cholestasis. The purpose of this study was to investigate whether oral supplementation with branched chain amino acids (BCAA) can correct malnutrition in a rat model of biliary atresia. Four groups of 15 rats, 30 d old, were used. Group A were shamoperated animals, given a normal laboratory diet (17.5% of caloric intake as proteins). Group B were cholestatic rats (biliary atresia) fed a diet enriched in BCAA (supplement of 8.5%, valine/leucine/isoleucine ratio 1:1:1). Group C were cholestatic mice fed a diet enriched in casein (supplement of 8.5%). Group D were cholestatic mice fed a normal diet. Thirty-two days after surgery, groups were compared for body weight, serum amino acid content, nitrogen balance, muscle mass, and carcass composition. The results showed that the weight of group B, C, and D animals was 85, 81, and 64% of group A (controls). Serum BCAA levels were markedly increased in group B animals. Nitrogen retention was similar in groups B and A, but reduced to 63 and 44% in groups C and D, respectively. Dry weights were similar in group A (39.1% of body weight) and B (37.7%), but reduced to 28.1 and 28.6% of body weight in groups C and D. Body proteins were higher in groups A (13.9%) and B (14.2%) than in group D (9.7%) rats. Mineral content of group B animals was 84% of those of group A, 50% in group C, and 23% in group D rats. It was concluded that an oral supplement of BCAA can correct growth, nitrogen retention, and body composition in experimental biliary atresia. Administration of BCAA supplements to cholestatic infants should be considered.
Subject(s)
Amino Acids, Branched-Chain/pharmacology , Biliary Atresia/diet therapy , Body Composition/drug effects , Food, Fortified , Muscle Development , Muscle, Skeletal/growth & development , Nitrogen/metabolism , Amino Acids/blood , Animals , Disease Models, Animal , Eating/physiology , Energy Intake/physiology , Male , Muscle Proteins/metabolism , Nitrogen/urine , Organ Size/physiology , Rats , Rats, Wistar , Weight Gain/physiologyABSTRACT
A method of quantitative liver tomoscintigraphy (SPECT) was compared for accuracy with planar scintigraphy (PS) in a group of patients with diffuse alcoholic liver disease. SPECT sensitivity was also compared with that of transmission computed tomography (CT), US, aminopyrine breath test (ABT) and liver chemistries (LC). One hundred and fourteen alcoholic patients with proven liver disease and 17 patients free of liver disease were included. Seven quantitative scintigraphic features and a score, including all criteria were considered. With a specificity of 95%, the sensitivity was 79% in steatosis and 97% in cirrhosis. SPECT showed a better sensitivity than PS (SPECT 89%, PS 66%), especially in patients with steatosis. In the same subsets of patients, SPECT sensitivity also compared favorably with that of transmission CT (SPECT 92%, CT 65%), ultrasonography (SPECT 88%, US 53%) and ABT (SPECT 90%, ABT 63%).
Subject(s)
Liver Diseases, Alcoholic/diagnostic imaging , Tomography, Emission-Computed, Single-Photon , Alanine Transaminase/blood , Aminopyrine , Aspartate Aminotransferases/blood , Bilirubin/blood , Breath Tests , Humans , Tomography, X-Ray Computed , Ultrasonography , gamma-Glutamyltransferase/bloodSubject(s)
Aging/physiology , Esophagus/physiology , Gastrointestinal Transit , Krypton Radioisotopes , Adolescent , Adult , Aged , Esophagus/diagnostic imaging , Female , Humans , Male , Middle Aged , Peristalsis , Radionuclide ImagingABSTRACT
This study investigated the suitability of propofol as a sole agent for continuous sedation in 100 unpremedicated patients during gastrointestinal endoscopy. The propofol was given very slowly (average 62.7 seconds) in order to prevent apnoea during induction, and the dose adjusted according to age (68% of patients were older than 50 years) and ASA grade (32% were ASA grade 3 or 4). There was no correlation under these circumstances between the observed haemodynamic variations and the age or ASA grade of the patients. The infusion rate during maintenance was also adjusted for age, and for the type of endoscopy. The mean rate was 4.3 mg/kg/hour. Recovery was rapid and of excellent quality; 77 patients were awake within 10 minutes and 99 reported total amnesia.
Subject(s)
Digestive System , Endoscopy , Hypnotics and Sedatives/administration & dosage , Phenols/administration & dosage , Adult , Age Factors , Aged , Aged, 80 and over , Blood Pressure/drug effects , Female , Humans , Infusions, Intravenous , Male , Middle Aged , Phenols/adverse effects , Phenols/pharmacology , PropofolSubject(s)
Antibodies, Viral/analysis , HIV/immunology , Personnel, Hospital , Adult , Democratic Republic of the Congo , Female , Humans , Male , Middle AgedABSTRACT
A patient with diffuse hepatic arteriovenous microfistulae suffered from secondary high-output right ventricular failure, pulmonary hypertension, and ascites, all of which could be managed by selective embolization of the hepatic artery. The vascular lesion of the liver seems to be essential, although hemorrhagic hereditary telangiectasia , perhaps aggravated by administration of oral contraceptives, may be considered contributory factors in this case.
Subject(s)
Arteriovenous Fistula/therapy , Embolization, Therapeutic , Heart Failure/etiology , Hepatic Artery , Hepatic Veins , Arteriovenous Fistula/complications , Arteriovenous Fistula/pathology , Ascites/etiology , Female , Humans , Hypertension, Portal/etiology , Hypertension, Pulmonary/etiology , Liver/pathology , Middle AgedSubject(s)
Food, Formulated/adverse effects , Liver Diseases/etiology , Parenteral Nutrition/adverse effects , Adult , Bile Duct Diseases/etiology , Energy Intake , Food, Formulated/poisoning , Humans , Infant, Newborn , Infant, Premature, Diseases/therapy , Liver/drug effects , Liver/enzymology , Liver/metabolism , Liver Function Tests , Nutritional RequirementsABSTRACT
A 50-year-old man with hypercalcemia related to Cope syndrome was referred for bone scintigraphy. There was a clear accumulation of the technetium-phosphate complex in the stomach. The condition was reversible with treatment of the underlying cause.
