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Title: Studies related to portal hypertension
Author: Shah, Syed Hasnain Ali
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2002
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1: The role of nitric oxide as a mediator in the hyporesponsiveness of hepatic arteries in cirrhosis is investigated in vitro, noting the effect of inducible nitric oxide synthase (iNOS) inhibition on vascular contractility. Result: No difference between the contractile response of cirrhotic and non-cirrhotic blood vessels to phenylephrine was noted with or without iNOS inhibition. Conclusion: iNOS activity does not modulate α-adrenoceptor mediated contractility in hepatic cirrhosis. 2a: To assess the role of clinical palpation in diagnosing splenomegaly in hepatic cirrhosis and to determine the value of abdominal ultrasound in assessing spleen size. Ultrasonography is compared with radionuclide imaging in measuring spleen size. Spleen size has also been related to peripheral blood features of hypersplenism, severity of liver disease, size of GOV and with portal haemodynamic measurements. Results and conclusions: Clinical palpation is an insensitive tool in assessing spleen size. There is a good correlation between spleen weight and ultrasonically determined length of spleen. Ultrasonography and radionuclide imaging give comparable results in measuring spleen size. There is a good correlation of spleen size with portal vein blood flow volume but not with portal pressure gradient and azygos vein blood flow volume. 2b: Single photon emission computerized tomography (SPECT) of spleen has been used to assess severity of liver disease in hepatic cirrhosis. Results: Spleen uptake of radioisotope per unit volume (% injected dose of radioisotope/ml.) increases and the liver/spleen uptake ratio diminishes as the liver disease worsens. There is also a negative correlation between spleen uptake per unit volume and the size of spleen. Conclusion: SPECT of the spleen can be used to assess liver function in patients with liver disease.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (M.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available