Observation of thoracic duct morphology in portal hypertension by endoscopic ultrasound

Thoracic duct dilation has been demonstrated in portal hypertension and hepatic cirrhosis by lymphangiography and laparotomy and at autopsy. It is thought to be secondary to increased hepatic lymph flow and has been described in the absence of ascites or esophageal varices. The aim of the present study was to observe thoracic duct morphology by endoscopic ultrasound in various subsets of patients with portal hypertension and hepatic cirrhosis and also to validate existing radiologic/surgical data. METHODS: The thoracic duct of 33 patients with cirrhosis and portal hypertension was studied by endoscopic ultrasound. Patients were divided into four groups: 1, patients with ascites and esophageal varices; 2, esophageal varices without ascites; 3, without esophageal varices or ascites; 4, extrahepatic portal hypertension due to pancreatic malignancy. The thoracic duct diameter was also measured in 14 control subjects (group 5). RESULTS: When the thoracic duct diameter for the five groups was compared with analysis of variance, significance was p < 0.0001; by pairwise comparison, group 1 differed from the other four groups (p < 0.05). Thoracic duct dilation (5.61 mm) was seen in group 1 patients, whereas no dilation was present in groups 2 through 4. Additionally, thoracic duct diameter in 33 portal hypertensive and/or cirrhotic patients was significantly different from that in the 14 control subjects (p = 0. 003). CONCLUSION: The thoracic duct can be reliably identified by EUS in patients with hepatic cirrhosis and portal hypertension. Dilation of the duct is seen only in patients with hepatic cirrhosis, ascites, and esophageal varices. No thoracic duct dilation is present in extrahepatic portal hypertension. Contrary to existing radiologic/surgical data, thoracic duct dilation is not seen in all patients with hepatic cirrhosis and portal hypertension signifying advanced disease. A dilated thoracic duct by endoscopic ultrasound should be considered yet another sign of portal hypertension

Effect of method of secondary fermentation and type of base wine on physico-chemical and sensory qualities of sparkling plum wine

Plum base wines prepared with potassium metabisulphite or sodium benzoate were converted into sparkling wine, either by `Methode Champenoise' or tank method with artificially carbonated wine serving as a control. In both the secondary fermentation methods ethanol and low temperature acclimatized yeast; Saccharomyces cerevisiae UCD-595 with optimized sugar (1.5%) and di-ammonium hydrogen phosphate (0.2%) were used. Both methods of sparkling wine production and the type of base wine affected the physico-chemical and sensory characteristics of the sparkling wine produced. In the secondary fermented wines, most of the physico-chemical characteristics were altered compared to that of artificially carbonated wines except volatile acidity, methanol, propanol and ethanol. Furthermore, these wines contained lower proteins, minerals and amyl alcohol than the base wine. In general, the sparkling wines produced by either of the secondary fermentation method had lower sugar, more alcohol, higher macro elements but lower Fe and Cu contents than the artificially carbonated wines. An overview of the changes occurring in the sparkling wine in comparison to artificially carbonated wine revealed that most of the changes took place due to secondary fermentation. The bottle fermented wine recorded the highest pressure, low TSS and sugars. The secondary bottle fermented wine was the best in most of the sensory qualities but needed proper acid-sugar blend of the base wine before conducting secondary fermentation. Sparkling wine made from base wine with sodium benzoate was preferred to that prepared with potassium metabisulphite. The studies showed the potential of plum fruits for production of sparkling wine.<br>Os vinhos a base de ameixa preparado com metabisulfito de potássio ou benzoato de sódio foram convertidos em vinhos espumantes pelo método "Champenoise" ou método de tanque, usando vinho carbonatado artificialmente como controle. Em ambos métodos a fermentação secundária do ethanol a baixa temperatura aclimatizou a levedura Saccharomyces cerevisiae UCD-595 utilizando 1.5% de açúcar e 0.2% de fosfato di-amônio de hidrogênio. Não foi verificado nenhum tipo de alteração físico-química ou sensorial em nenhum dos métodos utilizados para a produção do vinho espumante Foram verificadas alterações físico-químicas na fermentação secundária do vinho espumante quando comparado com o vinho carbonatado artificialmente, exceto acidez volátil, metanol, propanol e ethanol. Além do mais, estes vinhos contiveram concentrações inferiores de proteínas, minerais e álcool amílico que o vinho de base. Em geral, os vinhos espumantes produzidos por qualquer método de fermentação secundária apresentaram açúcar residual baixo, concentrações elevadas de álcool, macroelementos elevados e concentrações baixas de Fe e Cu nos vinhos carbonatados artificialmente. Uma visão geral das mudanças que ocorrem no vinho espumante em comparação ao vinho carbonatado artificialmente demonstrou que a maioria das mudanças ocorreu devido a fermentação secundária. A garrafa do vinho fermentado registrou pressão elevada, TSS e açúcares residuais reduzidos. O Vinho espumante produzido utilizando benzoato de sódio foi preferido em relação ao preparado com metabissulfito de potássio. Esses estudos demostraram o potencial do uso de frutas como ameixa na produção de vinho espumante