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Yeun Tarl Fresner Ng Jao
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November 1, 2016: International Journal of Cardiology
Fa-Yauh Lee, Sun-Sang Wang, Ming-Hung Tsai, Hui-Chun Huang, Han-Chieh Lin, Shou-Dong Lee
Nitric oxide (NO) participates in shock and poorer portal hypotensive effect to vasoconstrictors in portal hypertension with hemorrhage, the so-called splanchnic hyposensitivity. Relative adrenal insufficiency accompanies hemorrhagic shock and is found in liver disease, the 'hepatoadrenal syndrome', but the relevant interactions remain unsettled. Portal hypertensive rats were induced by partial portal vein ligation (PVL). Experiments were performed on the 14th day post PVL: (I) ACTH stimulation test for rats without or with hemorrhage; (II) Glypressin response (mean arterial pressure, MAP; portal pressure, PP) in rats (a) without hemorrhage or with hemorrhage, injected with (b) distilled water (DW), (c) dexamethasone 3 mg/kg; (III) To survey the dose-dependent effects of glucocorticoid without being confounded by endogenous adrenal hormone, glypressin response was surveyed in PVL rats with adrenalectomy: (a) without hemorrhage or with hemorrhage, injected with (b) DW; (c) dexamethasone 3 mg/kg; (d) dexamethasone 5 mg/kg...
2014: PloS One
Chien-Ting Chen, Chi-Jen Chu, Fa-Yauh Lee, Full-Young Chang, Sun-Sang Wang, Han-Chieh Lin, Ming-Chih Hou, Shwu-Ling Wu, Che-Chang Chan, Hui-Chun Huang, Shou-Dong Lee
BACKGROUND/AIMS: The portal hypotensive effect of vasopressin during hemorrhage is less effective than that during stable condition in cirrhotic patients or experimental portal hypertension (the so-called hyposensitivity phenomenon). Recent studies have demonstrated that constitutive nitric oxide activities and bradykinin in hemorrhage-transfused partially portal vein-ligated rats are responsible, at least partly, for the splanchnic hyposensitivity to glypressin (a long acting vasopressin analogue)...
September 2009: Hepato-gastroenterology
Hala Mégarbané, Stéphane Barete, Kiarash Khosrotehrani, Hassan Izzedine, Philippe Moguelet, Olivier Chosidow, Camille Frances, Selim Aractingi
INTRODUCTION: Triglycyl lysine vasopressin (terlipressin, Glypressin) is a potent vasoconstrictive drug which became popular because of its prolonged duration of action, ease of administration and lower incidence of side effects. Ischemic complications are rare but may be life threatening. OBSERVATIONS: Case 1, a 68-year-old man with alcoholic cirrhosis and hepatocellular carcinoma, was admitted due to acute functional renal failure. He was first treated for septic shock with intravenous catecholamines...
2009: Dermatology: International Journal for Clinical and Investigative Dermatology
Rey-Heng Hu, Po-Huang Lee
BACKGROUND/AIMS: Hemorrhage from esophageal varices is a major consequence of liver cirrhosis. Pharmacological treatment can be started immediately by an internist to arrest acute esophageal variceal hemorrhage (EVH). Terlipressin is easy to administer and effective in treating acute EVH, with or without adjuvant endoscopic sclerotherapy, and in reducing mortality in these patients. Due to these potentials, a phase IV bioequivalence study was conducted to compare a new brand of terlipressin (Haemopressin: contains 1 mg tri-glycyl-lysin-vasopressin acetate) with one that is currently available in the market (Glypressin)...
March 2008: Hepato-gastroenterology
Ji Eun Oh, Jung Soo Ha, Dae Hyeon Cho, Gil Jong Yu, Sang Goon Shim
Terlipressin is a synthetic analogue of vasopressin, which has been used in the treatment of acute variceal hemorrhage. In contrast to vasopressin, terlipressin can be administered as intermittent injections instead of continuous intravenous infusion. Thus, it has a less adverse reaction than vasopressin. We report a case of ischemic skin complication in a cirrhotic patient treated with terlipressin. A 71-year-old man with liver cirrhosis was admitted because of hematemesis and melena. He was commenced on terlipressin at a dose 1 mg every 6 hours for the treatment of varicieal bleeding...
June 2008: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Felix W Leung
The use of reflectance spectrophotometry (RS) for mucosal hemodynamic measurement relies on the recognition of changes in indexes of mucosal hemoglobin concentration and oxygen saturation. Endoscopic application in clinical studies has confirmed important observations demonstrated in animal experiments. The vasoconstriction induced by propranolol, vasopressin, glypressin, or somatostatin in the portal hypertensive gastric mucosa and the reduction of gastroduodenal mucosal perfusion by nonsteroidal anti-inflammatory drugs (NSAIDs) or smoking, mesenteric venoconstriction associated with systemic hypoxia, and acid-induced duodenal hyperemia are important examples...
June 2008: Digestive Diseases and Sciences
Fergal Donnellan, Garret Cullen, John E Hegarty, P Aiden McCormick
AIM: To report three cases of extensive skin necrosis in cirrhotic patients treated with the vasoconstrictor agent terlipressin (Glypressin). METHODS: We identified three patients who developed skin necrosis and determined any factors, which put them at an increased risk of doing so. RESULTS: Two patients were obese and developed extensive abdominal wall skin necrosis. The third patient had lower limb chronic venous insufficiency and developed extensive necrosis of both lower limbs...
October 2007: British Journal of Clinical Pharmacology
Mads Hansen, Jesper Bjerg, Torben Gilsaa
The vasopressin analogue terlipressin (Glypressin) is generally considered an effective and safe treatment for acute oesophageal variceal haemorrhage. Safety is especially related to very few severe ischaemic side effects compared to those resulting from treatment with vasopressin. This case report describes reversible ischaemia in the colon and small intestine as seen by exploratory celiotomy in relation to treatment with terlipressin. The patient recovered fully without the need for intestinal resection.
May 7, 2007: Ugeskrift for Laeger
D Collins, L I Worthley
OBJECTIVE: To review the management of acute gastrointestinal bleeding in the critically ill patient in a two part presentation. DATA SOURCES: Articles and a review of studies reported from 1991 to 2001 and identified through a MEDLINE search of the English language literature on acute gastrointestinal bleeding. SUMMARY OF REVIEW: Oesophageal varices are a common source of upper gastrointestinal bleeding in patients who have portal hypertension...
June 2001: Critical Care and Resuscitation: Journal of the Australasian Academy of Critical Care Medicine
John Moschos, Grigoris I Leontiadis, Clive Kelly, James Henry, Savvas Kadis
BACKGROUND: Patients with systemic sclerosis may develop mild abnormalities of liver function tests. More serious hepatic involvement has been well documented but is rare. Idiopathic portal hypertension had been reported only in a few female patients with systemic sclerosis. CASE PRESENTATION: An 82-year-old man with known systemic sclerosis presented with melaena. Urgent gastroscopy revealed oesophageal varices, which re-started bleeding during the procedure and were treated ensocopically, with Sengstaken tube and glypressin...
2005: BMC Gastroenterology
Hui-Chun Huang, Yi-Chou Chen, Sun-Sang Wang, Che-Chang Chan, Fa-Yauh Lee, Full-Young Chang, Han-Chieh Lin, Ming-Chih Hou, Rei-Hwa Lu, Shwu-Ling Wu, Shou-Dong Lee
BACKGROUND: Nitric oxide (NO) has been proposed to participate in the vascular hyporesponsiveness to vasopressin and its long-acting analogue glypressin during hemorrhage in portal hypertensive states. This study surveyed the role of NO regarding splanchnic hyporeactivity to glypressin and NO synthases (NOS) expression in different vascular beds in bleeding portal-hypertensive rats. METHODS: Under general anesthesia with ketamine, partially portal vein-ligated male Sprague-Dawley rats without or with bleeding were used to investigate the hemodynamic effects of glypressin (0...
June 2004: Journal of the Chinese Medical Association: JCMA
D Lebrec
Vasoconstrictor agents such as terlipressin (Glypressin) have been shown to have beneficial effects in the treatment of hepatorenal syndrome (HRS), in terms of improving renal function and subsequent survival rates. Patients with HRS have also been shown to have improved survival after liver transplantation if they receive terlipressin treatment prior to transplantation. In addition, studies show that terlipressin may have beneficial effects in treating other indications, including paracentesis-induced circulatory dysfunction and endotoxic shock...
September 2004: Alimentary Pharmacology & Therapeutics
P Ginès, A Torre, C Terra, M Guevara
Hepatorenal syndrome (HRS) is a common complication of advanced cirrhosis characterized not only by renal failure but also by marked alterations in systemic haemodynamics and activity of endogenous vasoactive systems. Renal failure is due to a severe vasoconstriction of the renal circulation. The pathogenesis of HRS is not completely understood but it is probably the result of extreme underfilling of the arterial circulation secondary to arterial vasodilation located in the splanchnic circulation. As well as the renal circulation, all other extrasplanchnic vascular beds appear to be vasoconstricted...
September 2004: Alimentary Pharmacology & Therapeutics
S Møller, J H Henriksen
The hepatorenal syndrome (HRS) is a functional impairment of the kidneys in chronic liver disease caused by a circulatory failure. The prognosis is poor, particularly with type 1 HRS, but also type 2, and only liver transplantation is of lasting benefit. However, recent research into the pathophysiology of ascites and HRS has stimulated new enthusiasm in their prevention and treatment. Patients with HRS have hyperdynamic circulatory dysfunction with reduced arterial blood pressure and reduced central blood volume, owing to preferential splanchnic arterial vasodilatation...
September 2004: Alimentary Pharmacology & Therapeutics
F Nevens
Vasoactive drugs are safe and easy to administer, and universal treatment is the first-line approach for all patients with suspected variceal bleeding. There are strong arguments that the combination of vasoactive drugs, started as soon as possible, and endotherapy later on is the best therapeutic option, particularly in cases of ongoing bleeding at the time of endoscopy. The main action of vasoactive drugs is to reduce variceal pressure. This can be achieved by diminishing the variceal blood flow and/or by increasing resistance to variceal blood flow inside the varices...
September 2004: Alimentary Pharmacology & Therapeutics
E D Carvalho, M H Nita, L M Paiva, A A Silva
OBJECTIVE: To present an analysis of the occurrence of gastrointestinal bleeding in children and emphasize: i) diagnostic methods; ii) the organized use of different therapeutic approaches in upper gastrointestinal bleeding; iii) the review of concepts, classifications and techniques used in endoscopy, which are important to the practice of clinical pediatrics. METHODS: Literary review of chapters selected from textbooks, pertinent articles obtained through the Medline system and active search, as well as personal archives belonging to the authors...
July 2000: Jornal de Pediatria
H-C Huang, S-S Wang, Y-C Chen, F-Y Lee, F-Y Chang, H-C Lin, M-C Hou, C-C Chan, C-T Chen, S-L Wu, S-D Lee
BACKGROUND: Prostacyclin mediates, at least partly, the splanchnic vascular hyporesponsiveness to glypressin in bleeding portal hypertensive rats. This study investigated the relative contribution of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2) in the splanchnic hyposensitivity to glypressin in rats with portal hypertension induced by partial portal vein ligation (PVL). METHODS: Fourteen days after the operation, the rats were divided into without- and with-bleeding groups...
June 2003: European Journal of Clinical Investigation
Chantal Halimi, Philippe Bonnard, Brigitte Bernard, Philippe Mathurin, Ali Mofredj, Vincent di Martino, Renato Demontis, Edmond Henry-Biabaud, Patrick Fievet, Pierre Opolon, Thierry Poynard, Jean François Cadranel
OBJECTIVES: Hepatorenal syndrome (HRS) is a severe complication of cirrhosis, leading to death in more than 90% of cases in the absence of liver transplantation. Several treatments have been attempted as a bridge to liver transplantation. Among such treatments, terlipressin has been studied in several reports, two prospective pilot studies and a double-blind, short-term, controlled haemodynamic study. Promising results have been shown with this drug. The purpose of this multicentre retrospective study was to evaluate the effects of terlipressin on renal function and survival of patients with HRS...
February 2002: European Journal of Gastroenterology & Hepatology
P Vlavianos, D Westaby
Endoscopic therapy and in particular endoscopic variceal banding ligation, in experienced hands, is the treatment of choice for acute variceal bleeding which remains a major cause of death in patients with cirrhosis and portal hypertension. Pharmacological therapy with Glypressin or somatostatin can be useful to gain time when the endoscopic expertise is not available or to help to obtain a clearer endoscopic view. Transjugular intrahepatic porto-systemic stent shunt is currently used for endoscopic failures, producing similar results with the surgical portacaval shunts...
April 2001: European Journal of Gastroenterology & Hepatology
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