Coma with Increased Amino Acids of Brain and Cerebrospinal Fluid in Dogs with Eck's Fistula

The eck fistula in animals and humans

“…This acceptance was maintained in spite of the demonstration that canine livers after venous transposition actuall1s showed centrilobular atrophy,24 and major deglycogenation,27. 8 and thus were not in fact normal. The con census favoring the Aow hypothesis was an uneasy one, and in 1961 Bollman, one of Mann's younger associates, wrote, "In the 83 years since it was first reported the Eck fistula has been reasonably successful in hiding its secrets as well as giving rise to many additional ques- 28 Reproduced by permission.)…”

“…The earlylfiO and subsequent [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19] reports from ,Johannesburg have confirmed the value of portacaval shunt in FH hut have provided minimal incentive for expanded trials. Of LJ homozygous patients with unstipulated membrane receptor status, one died 2 days postoperatively of a myocardial infarction.…”

The ECK fistula in animals and humans

“…Such observations were still being made in more complicated and perhaps less convincing experiments more than 60 years later. 8,9 Three quarters of a century passed before it was realized that the atrophy caused by Eck's fistula occurred with astonishing rapidity, being 90% complete within 3-4 days. 10,11 In addition, the use of electron microscopy in recent years has made it possible to develop a clear picture of the organelle changes caused by portacaval shunt in the hepatocytes of previously normal rats, [12][13][14][15] dogs, 10,11, ,16,17 subhuman primates, 17,18 and humans.…”

Pathogenesis of Hepatic Coma

“…Bollman, Flock and associates (34, 35) had shown that in the hepatectomized or Eck's fistula dog the overwhelm ingly predominant amino acid in brain and spinal fl uid is glutamine. With the further development of chromatographic and ion-exchange column methods for separation of amino acids there has been a resurgence of interest in studying the abnormalities to be found in hepatic failure.…”