[Duplex ultrasonography of the portal circulation before and after sclerotherapy of esophageal varices]. / A portalis keringés duplex ultrahangvizsgálata oesophagus varix sclerotherapia elött és után.

Authors examined 40 patients suffered from portal hypertension before and after sclerotherapy of esophageal varices with duplex ultrasonography. The patients were divided into four groups: the first and recurrently bleeding patients and those who were treated with propranolol. The average velocity of the main portal vein before the treatment was significantly lower in the patient group, than in the normal control group. There were no significant changes observed after treatment. The portal blood flow increased in the first bleeding patients who did not take propranolol. The diameter of the main portal vein increased in the recurrently bleeding patients. The conclusion is, that the duplex ultrasonography of the portal circulation is a valuable noninvasive method. One has to take into consideration the limits of this technique and further data are needed for the diagnostic and prognostic accuracy.

Effect of laser irradiation and prostaglandin F2 alpha on the production of gastric mucus in human patients.

An increase in gastric mucus production was observed after PGF2 alpha administration and low dose argon-laser irradiation in human patients. The effect of PGF2 alpha on functioning of the gastric mucosa is opposite to that of the PGE group. The observed increase in mucus production is a new aspect of the bio-stimulatory effect of laser irradiation.

Morphological changes induced by heterologous antibodies in the rat liver.

The dynamics of organ fixation of heterologous antibodies were studied with the immunofluorescent technique. This allowed to conclude to the presence of liver-specific antibodies in the immune serum on the basis of the tissue fixation of antibodies. A perivascular round cell infiltration is characteristic of the liver damage induced by antibodies. Dilatation of the rough endoplasmic cisterns and a condensation of the matrix was revealed by electron microscopic pictures. It is concluded on the basis of the regressive phenomena and of the mesenchymal reactions that some importance can be attached to humoral immunity in immunopathological processes.

Effect of anti-rat-liver rabbit immune serum on the local circulatory reactions of the rat liver.

The effect of anti-rat-liver rabbit immune serum was studied on liver blood flow and on the reaction to vasoactive substances of the hepatic blood vessels. Male rats weighing 250 to 300 g were anaesthetized with pentobarbital. The femoral artery, the femoral vein and the portal vein were cannulated. Blood pressure was continuously registered in the femoral artery. A thin thermoelement was placed into the liver and in one of experimental groups into the kidney as well, in order to measure the local blood flow. On a single intravenous administration of immune serum, systemic blood pressure, and the local blood flow of the liver and kidney decreased significantly. The decrease was more marked in the kidney than in the liver. The circulatory response so obtained was general and it was not localized to the liver. Arterial blood pressure was unchanged after intravenous pretreatment with 0.5 ml/100 g of immune serum daily for 3 days, but the portal blood pressure decreased. The hepatic local vasoconstriction induced by vasopressin administered into the portal vein was less important than in the control group. The hepatic local circulatory response to noradrenaline and isoproterenol administered into the portal vein was similar in normal and immune serum treated animals. Although immune serum pretreatment caused histological changes in the hepatic blood vessels and reduced portal pressure, it did not affect the adrenergic regulation of hepatic local blood flow, but decreased the sensitivity to vasopressin.

Relationship between lysosomal damage, fatty infiltration and hepatocellular necrosis in the course of acute liver injury induced by carbon tetrachloride in the rat.

In the course of liver injury induced by CCl4 in rats the change of the endoplasmic reticulum takes 5 hours and that of the lysosomal membrane, 18 hours to develop. The latter change precedes hepatocellular necrosis. Elevation of plasma free fatty acids and fatty infiltration of the liver can be observed at 3 hours after CCl4 administration. The maximum of fatty infiltration, hepatocellular necrosis and the highest degree of lysosomal damage develop at the same time. Since CCl4 is eliminated in a few hours, it must initiate a cellular process which then leads to lysosomal membrane damage and hepatocellular necrosis.

Haemodynamic changes associated with CCl4-induced acute liver injury.

Minor doses of CCl4 have been found to produce acute haemodynamic changes which promote elimination of the poison from the body. Major doses absorbed into the blood are followed by a transitory fall of perfusion pressure resulting in a deficient oxygenation of the tissues. The released mechanisms of adjustment result in general haemodynamic changes directed at the maintenance of blood flow in the vital organs, primarily in the brain. Accumulation of CCl4 is associated with prolonged haemodynamic alterations: the cardiac output and tissue flow decreases while peripheral resistance increases. The reduction in blood flow was most marked in the liver. The transitory and prolonged haemodynamic changes result in an impairment of hepatocellular nutrition and oxygenation, thus precipitating the injury caused by the CCl4 accumulated in the liver cells.