Biomedical subjects

R T Prall

Publications and source records attributed to R T Prall.

4 recordsLinked to original sources

PubMed2001

Meckel's diverticulum causing intestinal obstruction.

Meckel's diverticulum is an uncommon cause of acute abdominal pain and small bowel obstruction in adults. We present a case of a 31-yr-old man with recurrent vomiting and abdominal pain in whom the diagnosis of Meckel's diverticulum was not suspected until CT of the abdomen revealed multiple fluid-filled, dilated loops of ileum with distal collapse after normal abdominal radiographs. We suggest that CT may be helpful when the diagnosis of Meckel's diverticulum is suspected.

Adult↗

PubMed2000

Current therapies and clinical controversies in the management of primary sclerosing cholangitis.

Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease of unknown etiology characterized by fibrosing inflammation of the intrahepatic and extrahepatic bile ducts, leading ultimately to cirrhosis and death caused by complications from liver failure if liver transplantation is not peformed. Despite a better understanding of the natural history of the disease, no significant breakthroughs have been made into its pathogenesis. Over the past decade and a half, many clinical trials of medical therapy have been conducted; however, none have demonstrated real efficacy. This reflects our lack of understanding into the basic mechanisms of disease pathogenesis in PSC. Progress has been made in the area of orthotopic liver transplantation for PSC, and to some extent in the diagnosis and management of complications, the most grave of which is the development of cholangiocarcinoma. This review highlights the progress that has been made, describes our current deficiencies, and discusses likely developments in the future. The authors also discuss management controversies and provide current practice guidelines where applicable.

Bile Duct Neoplasms↗

PubMed2000

Biliary tract physiology.

Cholangiocytes, the cells lining the bile ducts, are now recognized as important contributors to and modulators of bile formation. During the last few years, remarkable insights have been made into the mechanisms of fluid, electrolyte, and solute transport by biliary epithelia, as well as increasing knowledge of the complex endocrine, paracrine, and neurologic factors regulating bile formation. Advances in the past year include an increased understanding of the interaction between bile acids and cholangiocytes in the regulation of bile formation in normal and cholestatic states and greater insight into the pathogenic mechanisms of biliary diseases. References to recent comprehensive reviews of specific areas of biliary physiology are provided, and new experimental models are also described.

Journal Article↗

PubMed1999

Biliary tract physiology.

Largely because of the recent development of new experimental models, cholangiocytes--the cells lining the bile ducts--are now recognized as important contributors to and modulators of bile formation. Recent work elucidating the mechanisms and regulation of fluid, solute, and electrolyte transport indicates that the biliary epithelium influences bile formation through both autocrine and paracrine mechanisms. Novel roles for bile acids in cholangiocyte physiology have been proposed, and insight into the anatomic and functional differences of cholangiocytes along the biliary tree has been gained. Improved understanding of these concepts and the pathophysiologic response of the biliary tree to injury should provide new therapies for biliary diseases.

Journal Article↗