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  • 1
    ISSN: 1615-5947
    Keywords: Chylous ascites ; ascites ; abdominal aortic operations
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Three patients, two women, one man (mean age 74 years), who had abdominal aortic aneurysms (2) or aortobifemoral surgery (1), developed chylous ascites postoperatively. They were studied to determine their clinical course and develop a plan for management of this complication. In each patient, the ascites was not manifest until abdominal swelling developed two weeks after operation, and the problem was confirmed by the finding of milky fluid on paracentesis. A low serum albumin (mean 2.6 gm) was also characteristic. The ascites was not altered by parenteral nutrition or reduction of dietary fat and ingestion of medium chain triglycerides. In one patient (man, age 93) the ascites resolved spontaneously two months after abdominal aortic aneurysm surgery. Another (woman, age 70) was cured following operative ligation of a lymphatic fistula identified at operation five weeks after abdominal aortic aneurysm repair. In the third (woman, age 60), the ascites resolved immediately following placement of a peritoneal venous shunt six weeks after an aortobifemoral bypass. Chylous ascites is rare after aortic surgery and manifests itself about two weeks after operation, at times after discharge from hospital. It has an indolent course, but may resolve spontaneously up to two months after operation. Its course appears not to be foreshortened by diet, including omission of fat, but can be successfully treated surgically with a shunt or fistula ligation. If done early a protracted hospital course may be avoided.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1432-1912
    Keywords: β-Adrenergic ; Submandibular gland ; Mucin ; Drug interaction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We studied the effects of carbachol on isoprenaline-induced secretion of 3[H]glucosamine-labeled high molecular weight protein from in vitro fragments of rat submandibular gland. The concentration-response curve for isoprenaline was determined alone and in the presence of one of two concentrations of carbachol. Isobolic interaction indices were calculated from the resulting curves. The role of extracellular calcium on this interaction was assessed by examining the effect of increasing concentrations of [Ca2+]e on secretion induced by a fixed concentration of isoprenaline alone and in the presence of carbachol. Carbachol alone caused a small, but statistically significant, protein secretion. Carbachol markedly shifted the isoprenaline concentration-response curve to the left in a dose-dependent manner. In the absence of extracellular calcium, carbachol did not increase isoprenaline-induced secretion, but secretion increased as the [Ca2+]e was increased. The carbachol-induced increase in secretion reached a maximal level at approximately 2.0 mM [Ca2+]e. We conclude that carbachol's increase of isoprenaline-induced secretion of 3[H]glucosamine-labeled high molecular weight protein is not additive, but is true potentiation. This potentiation requires extracellular calcium, and may be maximal at physiological [Ca2+]e.
    Type of Medium: Electronic Resource
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