Metabolic clearance rate of arginine vasopressin in patients with cirrhosis.

Metabolic clearance rate and half-time of arginine vasopressin were measured in 43 cirrhotic patients and 10 control subjects. Synthetic arginine vasopressin was infused intravenously at a rate of 500 pg/min/kg of body weight for 75 min. The metabolic clearance rate was significantly reduced, and the half-time of arginine vasopressin after stopping the infusion was significantly increased in patients with cirrhosis, particularly in those with ascites and in those with moderate or severe liver dysfunction.

Malignant lymphoma of jejunum with common variable hypogammaglobulinemia and diffuse nodular hyperplasia of the small intestine. A case study and literature review.

We report a patient with common variable hypogammaglobulinemia and diffuse nodular lymphoid hyperplasia of the small intestine complicated by a jejunal malignant lymphoma. Immunopathological and histological studies showed a polymorphous centroblastic lymphoma with intracytoplasmatic IgM immunoglobulin and lambda light chains. Some mucosal nodules separate from the tumor mass showed atypical lymphoid cell populations similar to lymphoma cells, suggesting a transition between hyperplastic nodules and lymphoma nodules.

[Serum aminoterminal procollagen type-III peptide in the diagnosis of chronic hepatopathies].

Background: The aims of the present study were to 1) compare the serum levels of the aminoterminal peptide of procollagen type III (PIIIP) in patients with different chronic liver diseases, 2) correlate their concentrations with histologic features in liver biopsy and 3) evaluate their use in the diagnosis of liver diseases and in recognition of fibrosis.

Methods: With these aims PIIIP was determined in 57 patients with different chronic liver diseases and in 50 healthy donors.

Results: PIIIP was significantly elevated in patients with chronic active hepatitis (18.

[Wilson's disease. A retrospective analysis of 12 cases].

We reviewed retrospectively 12 patients with Wilson's disease diagnosed during a 16-year period (1974-1989). The prevalence rate was 0.6 per 100,000 individuals.

Value of exercise stress test, radionuclide angiography and coronary angiography in predicting new coronary events in asymptomatic patients after a first episode of myocardial infarction.

One-hundred-and-fifty-five consecutive symptom-free patients underwent maximal treadmill exercise testing, rest and stress radionuclide angiography at least two months after an uncomplicated acute myocardial infarction; of these, 90 underwent coronary angiography. All patients were followed-up for a mean of 32 +/- 13 months regarding the prediction of hard (death and reinfarction) and soft (angina and coronary surgery) coronary events. The specificity, sensitivity, positive and negative predictive value of exercise stress test were 47%, 76% and 41% for any coronary events; none of the patients who incurred a hard coronary event showed ischemia during electrocardiographic exercise tests.

[Wilson's disease. A histological review of 7 patients and the value of histological copper positivity in relation to other hepatopathies].

Background: Wilson's disease is an infrequent entity. Biopsy is essential for establishing its presence and degree of hepatopathy but it lacks diagnostic specificity. It is necessary to know the significance of positivity or negativity of histochemically demonstrated copper when faced with the diagnosis of Wilson's disease and cholestatic diseases.

Effectiveness of histopathological diagnoses in dysfunction of hepatic transplantation. Review of 146 histopathological studies from 53 transplants.

In 47 patients who underwent 53 liver transplantations and immunosuppression with cyclosporine (cyclosporin A), methylprednisolone sodium succinate, and antithymocyte globulin, 146 histopathological studies were performed (138 biopsies, six hepatectomies, and two autopsies). The following microscopical diagnoses were made: 43 acute rejections (29.4%), six chronic rejections (4.

Effect of intrathoracic pressure on plasma arginine vasopressin levels.

Abdominal distention during pneumoperitoneum results in a marked increase in plasma arginine vasopressin levels, which has been ascribed to an increase in intrathoracic pressure. Because of this relationship, tense ascites could contribute to nonosmotic release of antidiuretic hormone, to the development of hyponatremia, and eventually to further ascites formation. The effect of pneumoperitoneum, thoracocentesis, and paracentesis on plasma arginine vasopressin levels was studied in three groups of patients, and the mechanism by which these maneuvers may induce these changes was investigated.

Rhabdomyolysis and cutaneous necrosis following intravenous vasopressin infusion.

A continuous IV infusion of vasopressin was administrated to a patient with cirrhosis of the liver and acute gastrointestinal bleeding from esophageal varices. In the first 24 hours, the patient developed rhabdomyolysis and cutaneous necrosis. Stopping vasopressin infusion resulted in relief of these lesions.

[Sixteen-year experience with gallbladder cancer. Review of 120 cases].

We reviewed retrospectively 120 patients with histologically diagnosed gallbladder carcinoma and collected during 16-years (1974-1989). Age and sex, annual distribution, predisposing factors, histological findings, clinical manifestations, complementary diagnostic methods, therapeutic measures and follow-up of patients were analyzed. Our results suggest the following conclusions: a) the annual incidence of gallbladder carcinoma remains unchanged; b) there is a close association with gallstones; c) the late diagnosis is due to unspecificity of clinical manifestations and low diagnostic effectivity of complementary methods; d) computed tomography and laparoscopy are the more effective complementary diagnostic methods in advanced gallbladder carcinoma; e) early gallbladder carcinoma is only diagnosed casually in cholecystectomy pieces; f) only the early carcinoma (grade I or II) is curable.

Antidiuretic hormone and renal function after water loading in patients with cirrhosis of the liver.

Renal function and plasma antidiuretic hormone (ADH) levels were studied basally and after oral water load in four groups of subjects: 15 healthy controls (group I), 15 cirrhotics without ascites (group II), 15 cirrhotics with ascites (group III), and 10 decompensated cirrhotics with hyponatremia (group IV). Renal function and ADH levels were normal in group II. In groups III and IV water diuresis and fractional proximal sodium excretion were significantly decreased, whereas fractional distal sodium resorption and fractional excretion of potassium did not differ from those of controls.

Cerebral blood flow and volume in symptom-free migraineurs: a SPECT study.

Both CBF and CBV were evaluated by gamma-camera SPECT in 14 patients with classic migraine, all studied while symptom-free. Nuclear data were correlated with CT and MRI. A decreased regional CBF was observed in 13 of the 14 patients.

[Diagnostic role of BAL in pulmonary alveolar microlithiasis].

From 1982-90, 3721 fiber bronchoscopies were performed for the diagnostics of diffused alveolar-septal pathologies; BAL was performed in 400 cases. Alveolar pulmonary microlithiasis was diagnosed in 6 patients, and two of them were related. The staging and the evolution of the pathology were evaluated as follows: chest x-ray in various projections, calcemia, lung function tests, fiber bronchoscopy with analysis of BAL and quantitative evaluation of macrophagic and lympho-monocytic elements and in percentage of calcosferitics.

Budd-Chiari syndrome associated with nodular regenerative hyperplasia of the liver.

The Budd-Chiari syndrome due to membranous obstruction of the hepatic blood outflow tract is a rare condition in western countries, and its association with nodular regenerative hyperplasia of the liver has never been described. We present the case of a 34-year-old woman with membranous obstruction of hepatic veins and nodular regenerative hyperplasia of the liver. Although webs have been difficult to demonstrate by sonography, we were able to image a structure in the hepatic vein near the junction with the inferior vena cava, suggesting a membranous nature.

Spontaneous bacterial peritonitis due to Yersinia enterocolitica in secondary alcoholic hemochromatosis.

Yersinia enterocolitica is a rare cause of systemic infections, including spontaneous bacterial peritonitis. Most reported cases have been in patients with iron overload or host defenses compromised by chronic illnesses. We report the case of an alcoholic patient with hemochromatosis who developed spontaneous bacterial peritonitis due to Yersinia enterocolitica.

Plasma arginine vasopressin concentration during laparoscopy.

Plasma arginine vasopressin concentration (pAVP) was determined in 47 patients during the insufflation stage of laparoscopy. Laparoscopy was performed under local anesthesia in 39 patients, and under general anesthesia in 8. Pneumoperitoneum was induced with 3-4 1 nitrous oxide to a maximum intra-abdominal pressure of 10 mm Hg.

[Sternal osteomyelitis associated with a severe attack of ulcerative colitis with multiple extra-intestinal manifestations].

A case of ulcerative colitis in which multiple extraintestinal manifestations: erythema nodosum, pyoderma gangrenosum, vesicle pustule lesions, aseptic osteomyelitis and possible local myositis appeared in the course of an acute decompensation is presented. The pathogenesis of these lesions are discussed and the not previously reported association between ulcerative colitis and aseptic osteomyelitis is presented.

[Role of the ultrasonic examination in the diagnosis of pelvic pathology].

The diagnostic accuracy of sonography in pelvic pathology is assessed in the case in which the operator is aware of the clinical report. Results attribute in absolute terms more effectiveness to sonography than to the clinical examination but it must, in any case, be considered as an extension of the gynaecological examination and not a replacement of the anamnestic history and physical examination.

Dynamic renal scanning using 99mTc-MAG-3 in man.

99mTc-labelled mercapto-acetyltriglycine (MAG-3) has recently been proposed as an ortho-iodohippurate (OIH) substitute for dynamic renal imaging. Experience with MAG-3 is, however, still limited and its biokinetics are not completely known. Moreover, most of the published studies have used HPLC purified MAG-3 which is inpractical for routine clinical work.