Search PubMed⌕ Search

Biomedical subjects

A Sali

Publications and source records attributed to A Sali.

At least 127 records · Page 7Linked to original sources
PubMed1989

Bacteria and gallstone nucleation.

This preliminary study reports for the first time that there might be a possible association between bacteria and the aetiology of some cholesterol calculi. The gall-bladder biles from 225 cholecystectomy patients underwent bacteriological and microscopic study. Cholesterol calculi from 13 patients (10.2%) were observed to be associated with gall-bladder bile profusely infected with at least one bacterial species that was shown to possess beta-glucuronidase activity, an enzyme that is thought to promote calcium bilirubinate precipitation in bile. Concomitantly, the associated gall-bladder bile was 'high' in calcium bilirubinate precipitation and the precipitate was also detected in the centre of the gallstones. Moreover, in approximately half of these patients (six of 13), the cholesterol gallstones' nuclear areas also contained calcium palmitate, which is also thought to be due to bacterial activity. The results also support the hypothesis that bacteria with active beta-glucuronidase (for example, Escherichia coli) can significantly influence the aetiology of brown pigment gallstones. In contrast, bacteria were observed to have no role in black pigment gallstone formation, as their associated gall-bladder biles were always observed to be sterile.

Adult↗
PubMed1989

Subcutaneous emphysema and pneumothorax following endoscopic sphincterotomy.

Endoscopic sphincterotomy is a commonly performed procedure for recurrent stones and retained stones in the common bile duct. This procedure, however, has significant morbidity and mortality. A complication, which appears to be unique, of endoscopic sphincterotomy leading to a right pneumothorax and subcutaneous emphysema is reported.

Cholangiopancreatography, Endoscopic Retrograde↗
PubMed1989

Effect on pregnancy on gallstone formation.

An ultrasound study was carried out to determine the incidence of gallstone formation during pregnancy. One hundred and thirty seven pregnant women attending antenatal clinics were studied; 70 women were primigravidas and 67 were 1 para or more. An ultrasound of the gallbladder was carried out at 20 weeks or less of gestation and a repeat of ultrasound examination was performed soon after delivery. Five women had gallstones diagnosed before pregnancy; 1 of these was a primigravida, the other 4 were para 1 or more. None of the women developed gallstones during pregnancy. This finding suggests that pregnancy is unlikely to be an important factor in gallstone formation.

Cholelithiasis↗
PubMed1988

Percutaneous extraction of retained common bile-duct stones via the T-tube track.

A total of 86 procedures were performed in 58 patients referred in the postoperative period, for percutaneous stone extraction through the T-tube track. In 43 patients, the stone or stones were extrahepatic, intrahepatic in nine, and both intrahepatic and extrahepatic in six patients. Of the 58 patients with residual bile-duct stone(s), 48 (83%) were treated successfully by percutaneous removal, seven (12%) had an endoscopic sphincterotomy following unsuccessful T-tube track extraction, one (2%) had a re-operation and two (3%) remain with residual stones. No major complications occurred in this series. In contrast to endoscopic sphincterotomy, percutaneous T-tube extraction of retained bile-duct stones is associated with no mortality and low morbidity and is advocated as the procedure of choice in the presence of a T-tube.

Adult↗
PubMed1988

Gallstones at autopsy and cholecystectomy: a comparative study.

An examination of 613 post-mortems gave a prevalence of biliary disease at autopsy of 36.5%, higher than reported previously in Australia. This consisted of an asymptomatic gallstone prevalence of 18.9%, with a further 5.7% of the autopsies having granular biliary sludge and 11.9% having had a previous cholecystectomy. Although the rate of occurrence of cholesterol gallstones was approximately half that of the pigment gallstones and pigment biliary sludge combined, no significant association between the sex of the postmortems and stone type was observed at autopsy (chi 2(1) = 0.1: P greater than 0.05). The ratio of biliary disease between females and males was approximately 2:1. Gallstones and biliary sludge from 310 cholecystectomy patients showed that cholesterol gallstones were approximately twice as common in men, and approximately six times as common in women than pigment gallstones. In this group of patients there was a significant association between the sex of the patient and the rate of occurrence of stone type. The rate of occurrence of cholesterol gallstones was significantly higher than pigment gallstones in both the males and females at cholecystectomy (chi 1(2) = 18.97; P less than 0.0001). A female to male ratio of approximately 2:1 was also observed. A statistically significant higher rate of pigmented biliary disease was observed at autopsy than at cholecystectomy. (chi 2 = 101.0; P less than 0.0001). Analyses on biliary sludge, a filterable, fine granular pigmented material in bile, suggest that it may be the direct precursor for a number of different gallstone types.

Adult↗
PubMed1987

Limy 'milky' bile: without apparent gall-bladder obstruction by a gallstone.

Limy bile, characterized by excessive precipitation of calcium carbonate, is an uncommon complication of gallstone disease, and is a condition that seems to follow gall-bladder obstruction. Limy bile was observed at cholecystectomy in a 57 year old woman who presented with biliary colic. At operation a mass of precipitated cohesive crystals, that had coalesced into a whitish paste of calcium carbonate, was observed obstructing the outlet of the gall-bladder. This case report is unique in that calcium carbonate precipitation appears to have preceded gall-bladder obstruction.

Bile↗
PubMed1987

Prediction of the secondary structures of stefins and cystatins, the low-molecular mass protein inhibitors of cysteine proteinases.

A procedure for classifying proteins of known sequence into structurally similar groups was developed on the basis of the Argos parametric approach. It is shown that stefins and cystatins constitute two structurally well resolved, but homologous groups of proteins. Furthermore, it is very probable that segments of secondary structures within each family are conserved, although significant differences between stefins and cystatins are indicated at the level of secondary structure. Next, secondary structures of all sequenced stefins and cystatins were predicted and used in the construction of secondary structures of the "typical stefin" and the "typical cystatin". Results were interpreted in the light of evolution and inhibition mechanism: Alignment of the "typical stefin" versus the "typical cystatin" secondary structure segments suggests that the divergence of stefin and cystatin families did not occur by a gene fusion event, but only by a mechanism of substitution, insertion and/or deletion. The central region of low-molecular mass cystatins, which is assumed to interact with cysteine proteinases, is predicted to be in a beta-sheet conformation. This resembles the beta-sheet in the active site of "standard mechanism" serine proteinases inhibitors.

Amino Acid Sequence↗
PubMed1985

Oestrogen receptors in focal nodular hyperplasia of the liver.

Two patients with focal nodular hyperplasia of the liver and positive results of tests of oestrogen receptor status are described. Both patients were women, both had used oral contraceptive agents and in both the lesion was symptomatic and was surgically resected. The biological and potential therapeutic implications of positive results of tests of oestrogen receptor status in focal nodular hyperplasia is discussed.

Adult↗
PubMed1985

Intrahepatic gallbladder and obstructive jaundice.

A case of intrahepatic gallbladder--a rare anomaly of the biliary tree which predisposes towards the formation of calculi--is reported. The special difficulties which may be encountered in the management of the complications of cholelithiasis in these circumstances are described.

Aged↗
PubMed1983

Diagnostic accuracy of flexible endoscopic biopsy in carcinoma of the oesophagus and cardia.

The endoscopic diagnoses of 51 patients with carcinoma of the oesophagus and cardia were studied. Tissue for histology and cytology was obtained through either the flexible (28) or rigid (23) endoscope and the results compared. Squamous cell carcinoma was diagnosed accurately (100%) by either method. Adenocarcinoma was poorly diagnosed by flexible endoscopy (five out of 13 with one false positive) while rigid endoscopy remained accurate (six out of six). Misdiagnosis with the flexible endoscope has been shown to occur in the presence of inflammation of the mucosa or tumour infiltration of the submucosa of the lower oesophagus. This has been attributed to the inadequacy of the specimen size for accurate diagnosis in these circumstances.

Aged↗