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At least 595 records · Page 33Linked to original sources
PubMed2001

External biliary drainage plus bile acid feeding is not equal to internal drainage in preserving the cellular immunity following prolonged obstructive jaundice.

This study investigates the importance of intestinal bile flow in cellular immunity. Sprague-Dawley rats undergoing bile duct ligation (BDL) and sham ceiliotomy (Sham) for 14 and 21 days were investigated. Experimental animals following BDL were further divided into an external drainage (ED) group, an ED group with rat chow mixed with 2:2:1 cholic acid, chenodeoxycholic acid, and deoxycholic acid (ED + BF), and an internal drainage (ID) group. Fourteen days later, they were killed and analyzed for spleen lymphocytic [3H] thymidine uptake (LHU) under mitogen stimulation with phytohemagglutinin, blood biochemistry, hemogram, and liver pathology. In the 14-day BDL experiment, LHU and serum albumin level were decreased in the BDL group (P < 0.05). After drainage, they were not significantly different among sham, ED, ED + BF, and ID groups. In the 21-day BDL experiment, the red cell volume was decreased (P < 0.05). After drainage, the ED, ED + BF, and ID groups still had a significantly lower LHU than the sham group (P < 0.05). However, the ID group had higher LHU than the ED and ED + BF groups (P < 0.05). The ED + BF group had a slightly higher LHU than the ED group but not statistically significant. Liver pathology returned to normal after drainage in the 14-day BDL model. In contrast, the 21-day BDL group had prominent periportal necrosis and developed periportal fibrosis after drainage. The present study reveals the duration of BDL determines the severity of hepatic damage. In the 14-day BDL groups, all kinds of drainage completely reverse the impaired liver function and cellular immunity. In the 21-day BDL group, 14-day drainage is inadequate for recovery because irreversible pathological changes are found. The reversal of cellular immunity in ID is better and faster, because it provides a better hepatic functional, nutritional, and hematological recovery besides the presence of primarily secreted bile acids.

Animals↗
PubMedDate not supplied

Differential diagnosis of periampullary carcinomas at MR imaging.

Periampullary carcinomas arise within 2 cm of the major duodenal papilla and comprise carcinomas of the ampulla, distal common bile duct, pancreas, and duodenum. Their clinical features and anatomic locations are similar, as are the therapeutic approaches; however, their long-term outcomes vary. Magnetic resonance (MR) images of 89 pathologically proved periampullary carcinomas (29 ampullary carcinomas, 27 distal common bile duct carcinomas, 21 pancreatic carcinomas, six duodenal carcinomas, and six unclassified carcinomas) were reviewed. Ampullary carcinoma manifests as a small mass, periductal thickening, or bulging of the duodenal papilla. Pancreatic carcinoma is characterized by a discrete parenchymal mass, which enhances poorly on dynamic gadolinium-enhanced images. Sometimes, two proximal and two distal pancreatic and biliary ducts appear as four separate ducts (the four-segment sign). Dilatation of side branches of the pancreatic ducts is frequently seen in pancreatic carcinoma but not in other periampullary carcinomas. Distal bile duct carcinoma manifests as luminal obliteration and wall thickening or as an intraductal polypoid mass. A dilated proximal bile duct, a nondilated distal bile duct, and a dilated or nondilated pancreatic duct may form the three-segment sign. MR cholangiopancreatography and sectional MR imaging are useful in determining the origins of periampullary carcinomas.

Ampulla of Vater↗
PubMed1991

Technical report: the use of the reformed sidewinder loop in the dilated ureter.

A case is presented of a patient requiring percutaneous stenting of a ureteroenteric stricture. A hairpin bend between the strictured ureter and the ileal conduit was easily negotiated by reforming a Sidewinder loop within the contralateral ureter and withdrawing it until the tip entered the conduit. This technique does not appear to have been described before.

Aged↗
PubMed2005

Idiopathic juxtafoveal retinal telangiectasis: new findings by ultrahigh-resolution optical coherence tomography.

OBJECTIVE: To investigate the capabilities of ultrahigh-resolution optical coherence tomography (UHR OCT); to compare with the commercially available OCT standard-resolution system, StratusOCT, for imaging of idiopathic juxtafoveal retinal telangiectasis (IJT); and to demonstrate that UHR OCT provides additional information on disease morphology, pathogenesis, and management. DESIGN: Retrospective, observational, interventional case series. PARTICIPANTS: Nineteen eyes of 10 patients diagnosed with IJT in at least one eye. METHOD: All patients were imaged with UHR OCT and StratusOCT at the same visit. A subset of patients was also imaged before and after treatment of IJT. MAIN OUTCOME MEASURES: Ultrahigh- and standard-resolution cross-sectional tomograms of IJT pathology. RESULTS: Using both standard- and ultrahigh-resolution OCT, we identified the following features of IJT: (1) a lack of correlation between retinal thickening on OCT and leakage on fluorescein angiography, (2) loss and disruption of the photoreceptor layer, (3) cystlike structures in the foveola and within internal retinal layers such as the inner nuclear or ganglion cell layers, (4) a unique internal limiting membrane draping across the foveola related to an underlying loss of tissue, (5) intraretinal neovascularization near the fovea, and (6) central intraretinal deposits and plaques. In 63% of cases, the presence of abnormal vessels and a discontinuity of the photoreceptor layer correlated with visual acuity. CONCLUSIONS: Ultrahigh-resolution OCT improves visualization of the retinal pathology associated with IJT and allows identification of new features associated with it. Some of these features, such as discontinuity of the photoreceptor layer, are revealed only by UHR OCT.

Adult↗
PubMed1988

Pathology of hepatolithiasis associated with biliary malformation in Japan.

A national survey of the morphologic features of hepatolithiasis in Japan disclosed that 13 (4.8%) of the 273 cases examined were associated with obvious biliary malformations: Caroli's disease with congenital hepatic fibrosis (one case), adult polycystic disease of the liver and kidneys (one case), choledochal cyst (nine cases), and anomalous pancreaticobiliary ductal union (four cases). The latter two malformations overlapped in two cases. Intrahepatic calculi in all of these cases were of brown pigment stones, suggesting that focal bile stasis as well as bacterial infection might have played an important role in their formation and growth. It seems likely that such phenomena occur in the congenitally dilated segments of the intrahepatic biliary tree. These data imply that biliary malformation is one of the lithogenic factors in hepatolithiasis in Japan.

Adult↗
PubMed1994

Dilatation of bronchial stenoses due to sarcoidosis using a flexible fiberoptic bronchoscope.

Stenosis of the trachea and bronchi can complicate many diseases and lead to significant pulmonary complaints. Unfortunately, steroids rarely yield satisfactory results in reversing symptoms. We describe six patients with symptomatic airway stenosis from sarcoidosis, all of whom were refractory to steroid therapy. By using a Fogarty embolectomy catheter inserted through the inner channel of a flexible bronchoscope, we were able to dilate the stenotic areas under direct vision. Patients had significant subjective improvement following dilatation and no significant complications occurred. We believe this technique represents an improvement on previously described methods because it can easily access the upper lobes and more distal segments and can be performed at the bedside.

Adult↗
PubMed1998

[Rigid ureteroscopy. Apropos of 88 cases].

Rigid ureteroscopy has become a common tool for the diagnosis and management of several diseases of the upper urinary tract. Between April 1990 and April 1996, 92 ureteroscopy procedures were performed in 88 patients in the B Urology Department of Avicennes hospital for diagnostic or therapeutic purposes. The commonest therapeutic procedure was stone manipulation (72 cases). The overall success rate was 90.8% (Distal ureter: 89.6%, mid ureter: 80%, lumbar ureter: 100%) and the complication rate was 4%. Therapeutic ureteroscopy was also used to dry ureterovaginal fistula (4 cases) and ureteral fistula with retroperitoneal urinoma (2 cases), and to remove a double J stent which had migrated into the pelvic ureter (3 cases). Diagnostic ureteroscopy was performed for 7 ureteral strictures including 3 extrinsic compressions and 4 ureteral strictures all treated with dilatations after biopsy. One false passage was observed among diagnostic ureteroscopy procedures. Rigid ureteroscopy is a minimally invasive and reliable technique for the management of ureteric calculi and for the diagnosis and treatment of other ureteric lesions.

Adolescent↗
PubMed2006

Awake tracheobronchial dilation without the use of rigid bronchoscopy.

Benign tracheal strictures have been treated by repeated dilations using rigid bronchoscopy and general anesthesia. An alternative approach using conscious sedation, fluoroscopy, flexible bronchoscopy, and Savary-Gilliard esophageal dilators (Cook Endoscopy, Inc, Winston-Salem, NC) is reported. All patients undergoing dilation while awake had lesions due to inflammatory disease or lesions that were not amenable to resection. This method may be less traumatic than rigid bronchoscopy and can be accomplished on an outpatient basis without the use of general anesthesia.

Adult↗
PubMed1983

[Megaureters in adults].

Megaureters are common in children but are rarely found in adults, probably due to the scarcity of clinical symptoms. Reconstruction surgery in adults has been performed only exceptionally up to a few years ago. We encountered 7 adults with 7 megaureters in the recent 6 years. The underlying pathologic entities responsible for the megaureters were non-peristaltic lower segment, ectopic ureter and ureterovesical junction stenosis. Six adults with 6 megaureters were treated by complete surgical reconstruction and reimplantation of the ureter. The outcome of all the reported cases was excellent.

Adult↗
PubMed1980

Clinicopathologic consideration of protein-losing enteropathy due to lymphangiectasia of the intestine.

The pathogenesis of intestinal lymphangiectasia and mechanism of enteric loss of serum protein has been discussed from the pathologic and roentgenologic viewpoints of the two patients with this disease. Enteric loss of serum protein was attributed to exudation of lymph from ruptured lymphatic vessels, resulting from non-specific multiple ulcers of the small intestine in one patient and malrotation of the gut in another.

Adult↗
PubMed1986

Transient gallbladder distention in sick premature infants: the value of ultrasonography and radionuclide scintigraphy.

Transient gallbladder distention in sick premature infants has been reported with increasing frequency over the last few years. It is important to be aware of this entity of gallbladder disease which resolves spontaneously and to be able to differentiate it from other problems that require surgical correction. We believe that ultrasonography is most helpful in confirming the diagnosis, excluding stone formation, and documenting any changes in size or appearance. However, there are no reliable ultrasonic criteria for distinguishing inflamed or pathologically distended gallbladders from noninflamed or temporarily enlarged gallbladders. Radioisotope imaging, though useful in demonstrating malfunction of the hepatobiliary system, should be interpreted with caution. In the final analysis, the dilemma as to whether gallbladder distention is a transient or persistent malfunction can be settled best by thoughtful clinical judgement.

Dilatation, Pathologic↗
PubMed2006

[Ileal and right colonic strictures due to prolonged non steroidal anti-inflammatory drug intake].

Ileal and right colonic strictures due to long term NSAID intake are well known but rare. We report the case of a patient with rheumatoid arthritis presenting with one ileal, as well as a right and transverse colonic stricture. The latter two were treated by dilatation under colonoscopy, but due to an associated recurrence, and the necessity of treating the ileal stricture which was inaccessible, a transverse ileocolonic shunt was proposed under local anesthesia. Ileal and colonic strictures due to long term NSAID intake should first be treated, if possible, by discontinuing the drug, then by pneumatic dilatations and finally, if necessary, by surgery usually resection. The advantage of a gastrointestinal shunt is that it can be performed under local anesthesia in patients who are often in poor condition.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMedDate not supplied

Treatment of intrahepatic biliary stricture associated with hepatolithiasis.

Biliary stricture is a difficult complication in the management of hepatolithiasis. Resection of the hepatic segment containing biliary stricture(s) is ideal. Dilatation and stenting therapy with PTCSL in selective cases is a good adjuvant, sometimes alternative, therapy. We recommend a combination of multimodal treatment with a systemic approach to improve results. For recurrent or residual cases, PTCSL becomes the mainstay of treatment.

Adult↗
PubMed2006

[Ascending aortic aneurysm following aortic valve replacement due to aortitis syndrome; report of a case].

A 60-year-old woman had previously undergone aortic valve replacement for aortic regurgitation. As the aortic wall was elastic hard, inflammatory change was suspected; therefore, we undertook a partial biopsy of the ascending aortic wall and the intraoperative pathological specimens were compatible with aortitis syndrome. As there was no active inflammatory change, she was diagnosed as inactive aortitis syndrome and steroid therapy was not applied. Seven years later, a follow-up computed tomography (CT) showed an ascending aortic aneurysm of 65 mm in diameter. Aortic root replacement was planned based on a clinical diagnosis of an aneurysm of the ascending aorta. The patient was discharged without complication 21 days after surgery. It is possible that an inactive stage of aortitis may lead to late dilatation of the ascending aorta; therefore, careful postoperative follow-up is necessary in such cases.

Aorta↗
PubMed1994

MR findings in seven patients with organic mercury poisoning (Minamata disease).

PURPOSE: To study the long-term MR findings in seven patients with Minamata disease. METHODS: All patients examined were affected after eating daily considerable amounts of the methylmercury-contaminated seafoods from 1955 through 1958 and showed typical neurologic findings. T1- and T2-weighted images were obtained in axial, coronal, and sagittal sections. RESULTS: The visual cortex, the cerebellar vermis and hemispheres, and the postcentral cortex were significantly atrophic. The visual cortex was slightly hypointense on T1-weighted images and hyperintense on T2-weighted images, probably representing the pathologic changes of status spongiosus. CONCLUSION: MR demonstrated the lesions, located in the calcarine area, cerebellum, and postcentral gyri, which are probably related to three of the characteristic manifestations of this disease: the constriction of the visual fields, ataxia, and sensory disturbance, respectively.

Atrophy↗
PubMed1994

Efficacy of dilatations for anastomotic colorectal stenoses: prognostic factors.

The authors report their experience of 30 patients with colorectal anastomotic stenosis treated by 62 dilatation sessions in order to evaluate which anastomotic characteristics could influence the success of dilatation therapy. Patients were subdivided into group A (dilatation successful) and group B (dilatation unsuccessful). Overall, dilatation was successful in 73.3% of cases, with only one important complication. The prognostic factors considered were anastomotic dehiscence, adjuvant radiotherapy, presence of colostomy at dilatation, site, morphology and length of the stenosis, presence of neoplastic recurrence, type of anastomosis and type of dilatation. Radiotherapy, local neoplastic recurrence and large anastomotic dehiscence were the more important independent prognostic factors. If present together, they were associated with an almost 100% probability of failure and, vice versa, if they were absent this probability was 5%.

Adult↗
PubMedDate not supplied

Balloon dilatation of alimentary tract strictures.

From a series of balloon dilatations of alimentary tract strictures 11 patients with different types of gastric and oesophagogastric anastomotic stenoses are reported. The dilatation of gastric outflow tract obstructions was highly effective in the treatment of retention. In 7 out of 8 cases with gastric outflow stenosis surgery could be entirely avoided and replaced by balloon dilatation. The importance of eliminating retention in the healing of gastric ulcer is discussed. Fistulation in oesophagogastric anastomoses due to stenosis of the outflow portion was successfully treated. The importance of achieving a free outflow tract in order to prevent insufficiency of the anastomosis and formation of a fistula is stressed.

Adult↗
PubMedDate not supplied

Computed tomographic findings in cerebral arterial ectasia.

The computed tomographic findings in 15 patients with angiographically documented cerebral arterial ectasia are reported. In addition to demonstrating the majority of pathologic arterial segments, computed tomography also documents the presence and extent of associated intracranial abnormalities. In this study these included cerebral atrophy (10 patients), infarction (three patients), and subarachnoid hemorrhage (one patient).

Adult↗