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Biomedical subjects

Z Tulassay

Publications and source records attributed to Z Tulassay.

At least 145 records · Page 8Linked to original sources

[Endoscopy of the bile ducts and pancreas in children].

ERCP was carried out in 8 children under 14 years age. The indications of examinations were in 7 cases obstructive jaundice caused in 3 patients by congenital anomalies of the biliary tract. In one case the ERCP was performed because of acute relapsing pancreatitis. The examinations were carried out under general anesthesia in 5 children and after sedative premedication in 3 cases. No complications of the procedures were recorded. ERCP is a useful method also in children for diagnosing bilio-pancreatic anomalies.

Acute Disease↗

[Gonadotropin-secreting liver cancer in ulcerative colitis].

The authors present the clinical and pathological data of a 28 year-old female patient, who died after several months of observation. The patient had a 15-year history of mild ulcerative colitis. On admission the diagnosis of primary sclerosing cholangitis was made, but subsequently paraneoplastic gonadotropin secretion became apparent. At autopsy a cholangio- and hepatocellular carcinoma was found and the extrahepatic bile ducts were infiltrated by the cholangiocarcinoma. Using the immunoperoxidase method, the hepatocellular part of the tumour was found to contain human choriogonadotropin.

Adenoma, Bile Duct↗

[Effect of somatostatin on metabolic changes following ERCP ].

An investigation was carried out on the ameliorating effect of cyclic somatostatin on the biochemical changes and impairment of glucose tolerance which follow endoscopic retrograde pancreatography. Serum amylase and plasma insulin and glucagon levels were significantly lower in a group of 20 patients receiving somatostatin prior to pancreatic radiography than in 35 control patients without such pretreatment. (Maximum increases in control and somatostatin-pretreated patients, respectively were: amylase: 4695 +/- 290; 1037 +/- 155 U/l p less than 0.001; insulin: 504 +/- 89; 179 +/- 43 pmol/l p less than 0.001; glucagon: 394 +/- 44; 62 +/- 13 pmol/l p less than 0.05.) Impairment of glucose tolerance was also considerably less in the patients given prophylactic somatostatin. These results indicate that postpancreatographic metabolic abnormalities can be ameliorated, or possibly even prevented altogether, by prior administration of somatostatin.

Amylases↗

[Postcholecystectomy syndrome: endoscopic and radiological aspects (author's transl)].

542 patients were subjected to ERCP at various periods after cholecystectomy. In this selected patient material there was a 56% incidence of morphological abnormalities in the biliary system, stenosis of the papilla and choledocholithiasis being the most frequent pathological findings. Laboratory examinations proved to be irrelevant with respect to the morphology of the bile ducts. A direct relationship between the clinical symptoms and the surgical procedure was established only in cases presenting with biliary duct stenosis (11% of all cases examined). In the majority of patients the postcholecystectomy complaints were due to incorrect surgical indication or inadequate surgical technique. Postcholecystectomy syndrome can be prevented by more accurate evaluation of the patient prior to and during surgery.

Adult↗

Changes in glucose tolerance after endoscopic retrograde cholangiopancreatography.

Changes in oral glucose-tolerance have been studied in patients subjected to endoscopic retrograde pancreatography. Glucose tolerance is impaired 72 hours after ductography, and significant changes can still be seen even after one month; glucose tolerance returns to normal six to 12 months after pancreatography. In an attempt to discover the mechanism underlying impaired tolerance serial measurements were made of plasma insulin and glucagon levels. The observation that the ratio I/G decreased in these patients indicates that enhanced glucagon release, probably due to mechanical and/or osmotic injury, may be responsible for the hyperglycaemia that is observed.

Amylases↗

[Differential diagnostic possibilities of the liver and bile duct cysts (author's transl)].

The authors examined the diagnostical possibilities of the liver and bile duct cysts with different origin. On the base of the literature and own experiences surveyed the specific signs and the diagnostic value of peritoneoscopy, liver biopsy, scintigraphy, angiography, gray-scale ultrasonography, ERCP and PTC in the hepato-biliary cysts. GSU is the most suitable method to demonstrate the cystous character, but the connection with the biliary tract can be verified by ERCP. Peritoneoscopy is the best procedure in the diagnosis of the polycystic liver; the congenital liver fibrosis can be recognized by biopsy, only. The hepato-biliary cysts can be separated preoperative with the parallel adoption of these methods, in the majority of cases.

Bile Duct Diseases↗

[The pathological endoscopic pancreatogram diagnostic value of radiomorphological changes (author's transl)].

The specificity of abnormal radiomorphological patterns in the endoscopic retrograde pancreatogram (ERCP) has been studied. Out of 3,000 ERCPs 381 contained pathological findings in the pancreatic duct, all of which was subsequently checked by histology. Comparison of the radiomorphologic data and the histologic abnormalities has revealed that ductal abnormalities are not specific to the underlying pancreatic disease. There are, however, changes in the radiomorphologic appearance which, owing to their greater incidence, may be regarded as characteristic to some pathologic process. Solitary stenosis or complete obstruction indicate the presence of tumour, nonsegmental extended dilatation points to papillary stenosis, filling of cavities reveals cysts, while diffuse abnormalities occur most frequently in chronic pancreatitis. Opacification of the bile ducts may yield complementary data, although their specificity is not absolute either. Nonsegmental stenosis of the intrapancreatic bile duct indicate chronic inflammation, while irregular narrowing supports the diagnosis of pancreatic tumours. Arc-shaped dislocation of the bile duct is frequently observed in response to cysts, stenosis confined to the ampullary segment and associated with dilated biliary system are characteristic findings in papillary stenosis. Thus the diagnostic value of the abnormal pancreatogram may be enhanced by simultaneous study of the biliary morphology

Cholangiopancreatography, Endoscopic Retrograde↗

New clinical aspects of pancreas divisum.

The clinical and pathogenetic features of pancreas divisum are surveyed on the basis of ERCP examination. This congenital anomaly of the pancreas can be distinguished from ductal obstruction on the basis of the radiographic configuration. In such patients the parenchyma of the pancreas can be properly evaluated only if the dorsal and ventral pancreatic ducts are visualized simultaneously. Pancreas divisum may be regarded as imposing an increased risk of supervening pancreatic diseases.

Adult↗

Diverticulum of the bile duct. Diagnosis by endoscopic retrograde cholangiopancreatography and ultrasonography.

Diverticulum of the bile duct is a rare disorder having the lowest incidence among the congenital dilatations of the biliary system. The abnormality was recognized preoperatively in two patients by endoscopic retrograde cholangiopancreatography (ERCP) and ultrasonography. Data from the 24 cases so far reported have been reviewed and the clinical features. diagnostic and therapeutic possibilities discussed.

Adult↗