Preoperative Assessment of Portal Hypertension

Wd, Warren; Fomon, John J.; Viamonte, Manuel; Zeppa, Robert

doi:10.1097/00000658-196706000-00015

Cited by 60 publications

(13 citation statements)

References 5 publications

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“…The formation of granulomas around schistosome eggs is mediated by CD4 ϩ T cells (28), and more recent studies have furnished numerous insights into the cytokine cascade that controls the development of these lesions (6,8,9,18). In the murine model of schistosomiasis, type 2-associated cytokines, including interleukin-4 (IL-4), IL-5, and IL-13, contribute to granuloma formation and the presence of eosinophils in these lesions (9).…”

mentioning

confidence: 99%

Association of Type 2 Cytokines with Hepatic Fibrosis in HumanSchistosoma mansoniInfection

Jesus

Magalhães

Miranda³

et al. 2004

Infect Immun

105

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The objective of this study was to evaluate the role of cytokines in hepatic fibrosis in the prehepatosplenic and early hepatosplenic stages of schistosomiasis mansoni. Hepatic fibrosis was classified by ultrasonography of 94 patients. Immunological evaluation was performed by the measurement of secreted cytokines (interleukin-5 [IL-5], IL-10, IL-13, gamma interferon, tumor necrosis factor alpha, and transforming growth factor ␤) in peripheral blood mononuclear cells (PBMC) stimulated by Schistosoma mansoni antigens. Significantly, higher levels of IL-5, IL-10, and IL-13 were found in supernatants of soluble egg antigen-stimulated PBMC from subjects with degree III hepatic fibrosis compared to patients with degree I or II fibrosis. Significant increases in IL-5 and IL-13 levels were also observed in some of the subjects who remained untreated for 1 year following initial assessment and developed more serious fibrosis during this period. The data suggest a role for type 2 cytokines in hepatic fibrosis in human schistosomiasis mansoni.

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mentioning

confidence: 99%

Association of Type 2 Cytokines with Hepatic Fibrosis in HumanSchistosoma mansoniInfection

Jesus

Magalhães

Miranda³

et al. 2004

Infect Immun

105

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“…The degree and pattern of collateral vessels were estimated. On the basis of radiographic appearance, the degree of interference with hepatic blood flow was estimated (Warren et al, 1967). The appearance and degree of the hepatic blush or hepatogram on late films were used to assess the amount of portal flow going to the liver in relation to that diverted through the collateral channels.…”

Section: Resultsmentioning

confidence: 99%

“…There is no single criterion which can be used in the selection of patients for non-operative or operative therapy or in determining the type of operation to be performed (Warren et al, 1967). Two major parameters were found useful, not only in selecting patients for the surgical procedure, but also in selecting the most suitable procedure for each individual patient: these were the clinicopathological stage and the haemodynamic pattern.…”

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confidence: 99%

Radiographic and haemodynamic patterns of portal hypertension in hepatosplenic schistosomiasis: selection of surgical procedure.

El-Gendi¹

1979

Gut

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SUMMARY Twenty-eight patients with hepatosplenic schistosomiasis and portal hypertension were studied. The transumbilical portal pressure, transsplenic portal pressure, and thoracic duct occluded pressure were measured simultaneously and thoracic duct lymph flow estimated. Changes in the splanchnic vasculature were studied radiologically by barium swallow, splenoportography, and umbilical portography. The transumbilical-transsplenic portal pressure gradient was found to be of particular value. The gradient was considered to be positive when the transumbilical portal pressure was higher than the transsplenic portal pressure, in such cases the primary generating factor of portal hypertension and/or ascites was most probably of hepatic origin. The gradient was considered to be negative when the transumbilical portal pressure was lower than the transsplenic portal pressure; in such cases the primary generating factor of portal hypertension and/or ascites was most probably of splenic or prehepatic origin. A correlation was found between the type of gradient and the radiographic pattern met with. For instance, in cases with positive gradient the hepatic blood flows, as estimated from the splenoportography, were mostly stage I or II, and showed no retrograde portal vein flow on umbilical portography. While, in cases with negative gradients, the hepatic blood flows were mostly stage III or IV, and showed retrograde portal vein flow on umbilical portography. The type of gradient, the clinicopathological stage, and the radiographic changes in the splanchnic vasculature were taken into account in selecting the surgical procedure to be used in each individual case.

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“…The formation of granulomas around schistosome eggs is mediated by CD4+ T cells (Warren et al 1967). In the murine model of schistosomiasis, type 2 associated cytokines, including interlukin (IL-4, IL-5, IL-13) contribute to granuloma formation and the presence of eosinophils in these lesions (Chiaromonte et al 2001).…”

mentioning

confidence: 99%