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At least 19 recordsLinked to original sources
PubMed1991

[A case of pathological dilation of seminal vesicle with high level of serum CA-19-9].

A case of pathological dilation of seminal vesicle is presented. A 18-year-old male was admitted to our hospital with the complaints of gross hematuria and discomfort of the scrotum. IVP and abdominal CT scan revealed the left aplastic kidney, and ultrasound, vesiculography, and pelvic CT scan revealed markedly dilated bilateral seminal vesicles without filling defects. The level of serum CA19-9 was 390 u/ml, which was extremely high. After resection of dilated seminal vesicles, it returned to the normal range (37 u/ml). Sixty six cases of pathological dilation of seminal vesicle were collected from the Japanese literature. No cases showing a high level of serum CA19-9 have been reported in Japan.

Adolescent↗
PubMed1990

Pathological observations of intrahepatic peribiliary glands in 1,000 consecutive autopsy livers. III. Survey of necroinflammation and cystic dilatation.

Pathological changes and significance of intrahepatic peribiliary glands, hitherto poorly recognized intrahepatic elements, have been evaluated in our laboratory. In this report, we surveyed necroinflammatory and cystic changes of the peribiliary glands in 1,000 consecutive autopsy livers because these two changes coexisted frequently in the same liver. The necroinflammatory change was found in 228 livers (22.8%) and the cystic change in 202 livers (20.2%), and 103 cases showed both changes in the same liver. The necroinflammatory change was frequently found in intrahepatic cholangitis and extrahepatic biliary obstruction with bacterial infection, suggesting that biliary bacterial inflammation extends into these peribilary glands. This change was also frequent in systemic infection or septicemia without biliary bacterial infection, implying that the peribiliary glands were also damaged in such conditions without direct infection. The cystic change was frequent in livers with portal hypertension or obstruction, adult polycystic disease and necroinflammation of the glands, suggesting that the cystic change of the glands could occur as the result of the disturbance of intrahepatic circulation or as the result of inflammatory destruction of the glandular conduits. Some of peribiliary cysts may be of congenital origin. Dysfunction related to these pathological changes in the glands may diminish seromucous secretion and cause alterations in hepatic bile composition. The cystic change of the glands may retard bile flow by compressing bile duct lumina.

Bile Duct Diseases↗
PubMed1977

The influence of bladder fullness on upper urinary tract dimensions and renal excretory function.

Nearly full bladders (375 ml.) produced significantly greater dimensions of the renal calices, pelves and ureters on excretory urograms compared to nearly empty bladders. These dimensions were frequently to the point of being considered pathological dilatations. On planimetry the urographic areas of the pelviocaliceal systems decreased by 43 per cent on the right side and 38 per cent on the left side when the nearly full bladder was compared to the nearly empty bladder in 10 patients. Renal excretory function also was affected by nearly full bladders. Urea clearances after 1 hour were 24 per cent lower and creatinine clearances were 9 per cent lower when starting with a nearly full bladder as compared to starting with an empty bladder. The implications of these findings are of potential significance with respect to 1) interpretation of excretory urograms and 2) chronic urine holding in patients with recurrent urinary tract infections, impaired renal function and/or urolithiasis.

Adolescent↗
PubMed1991

Sonographic visualization of the ureter in pregnancy.

We describe a method of differentiating physiological from pathological dilatation of the renal collecting system in pregnant patients. In physiological hydronephrosis the dilated ureter extends down only to the level of the common iliac artery. In 2 patients with distal ureteral stones a dilated ureter was visualized past the vessels. To determine the frequency and reliability of visualizing the ureters in pregnant patients 105 consecutive asymptomatic pregnant patients were examined. Hydronephrosis was found in 83 kidneys in 59 of the patients. The dilated ureter was visualized in 64 of the renal units. The anatomy was well demonstrated by color flow Doppler scanning and in all of these cases the dilated ureter was seen to taper where it crossed the common iliac artery. These results suggest that the presence of a dilated ureter past the iliac artery is strong evidence for pathological distal ureteral obstruction in pregnancy.

Adult↗
PubMed1992

[Ureteral obstruction by the pregnant uterus].

Dilatation of the upper urinary tract occurs in more than 80% of pregnant women during the last half of pregnancy. It is caused by compression of the ureter between the growing uterus and linea terminalis. A few patients develop pathological dilatation, flank pain and impaired renal function, a so-called symptomatic hydronephrosis. We have treated ten patients by means of internal drainage by using double pigtail catheters. Nine patients were completely relieved of their symptoms, and one reported marked reduction of pain. Five women complained of irritation of the bladder. In three of the women the intravesical portion of the catheter was shortened with success. Eight women kept the stent up to the time of birth. Two were removed two and eight weeks before delivery because of infection. There were no serious complications. Use of double pigtail catheters is a safe and simple way of treating symptomatic hydronephrosis of pregnancy.

Adult↗
PubMed1991

Ejaculatory duct obstruction in subfertile males: analysis of 87 patients.

OBJECTIVE: To study the causes, presentation, and treatment of ejaculatory duct obstruction in subfertile males. DESIGN: Collaborative retrospective study of clinical experience collected by two urologists over a 15-year period. SETTING: National Health Service and Private Care Hospitals. PATIENTS, PARTICIPANTS: Subfertile males with azoospermia (n = 67), very severe oligozoospermia (n = 17), oligozoospermia (n = 1), or normal sperm concentration (n = 2) in small volume ejaculates with acid pH and little or no fructose. INTERVENTIONS: Exploration of scrotum with vasogram and testicular biopsy, plus reconstruction if possible. MAIN OUTCOME MEASURES: Follow-up seminal analysis and occurrence of pregnancy in female partners. RESULTS: The causes were: müllerian duct cyst (n = 17); wolffian duct malformation (n = 19); previous surgical trauma (e.g., imperforate anus) (n = 15); previous genital infection (n = 19); tuberculosis (n = 8); megavesicles (pathological dilatation of vesicles and ampullae of unknown cause) (n = 8); and carcinoma of prostate (n = 1). After incision of Mullerian duct cysts, five pregnancies were produced. Five pregnancies occurred in the other groups using a variety of surgical techniques. CONCLUSIONS: Routine vasography has shown that ejaculatory duct obstruction is not as rare as previously thought. The diagnosis should not be missed because the condition is simple to correct surgically in certain cases.

Constriction, Pathologic↗
PubMed1978

Angiographic, operative, and histologic findings after embolization of craniofacial angiomas.

After pre- or intraoperative angiography and Gelfoam embolization in patients with deforming vascular malformations in the craniofacial region, the angiographic findings and the results of embolization were controlled by operation and histology. In arteriovenous hemangiomas the disfigurations of the craniofacial region originate from the shunt vessels themselves, in capillary hemangiomas exclusively from neoplastic, pathologically dilated and convoluted veins which could be demonstrated only by percutaneous punctures. Lymphatic hemangiomas also could be radiologically shown only after direct punctures and without any feeding or draining vessels. During operation vast necrosis of the fatty tissue in the region of embolization and massive phlebolithiasis in the draining veins were found. Histologically, arterial obliterations could be shown in the former shunt area. The reconstructive operations could be done in bloodless surgical regions and always showed good cosmetic results, which were regarded as constant because of the embolization of the shunt area.

Adolescent↗
PubMed1978

[Comparative studies of various suture techniques in transthoracic esophagogastric anastomoses in dogs (author's transl)].

In 27 dogs esophagogastric anastomoses were performed in a single-layered end-on, a three-layered end-on and a double-layered inverting technique. The anastomoses were reinvestigated on the 2., 4., 7., 15. and 30. postoperative day. Suture line leakages were not observed. The inverted suture resulted in considerable anastomotic stenosis, ulceration of the mucosa, disordered and initially incomplete revascularisation, and widespread granulomatous inflammatory reaction. In contrast, the end-on technique led to almost no stenosis, ordered revascularisation, and narrow and delicate scar tissue formation while maintaining a normally layered structure. The single-layered methode was superior to the three-layered one. The best results were obtained by the extramucous technique.

Animals↗
PubMed1991

Percutaneous transhepatic manometry of sphincter of Oddi.

A nonoperative examination of the function of the sphincter of Oddi, involving percutaneous transhepatic manometry via the percutaneous transhepatic biliary drainage tract, was developed and clinically applied in 23 patients with biliary disease. Long-term recording of sphincter of Oddi motility, which was impossible using conventional intraoperative or endoscopic manometry, was made possible by means of this method and revealed various changes of sphincter of Oddi motility. The mean recording time was 131.33 +/- 9.77 min. The frequency of contractions of the sphincter of Oddi in basal fasting conditions varied from 0 to 13/min and high-frequency contractions (frequency 9.49 +/- 0.35/min, duration 5.77 +/- 0.54 min) were observed in 12 patients on a total of 19 occasions. In five patients, high-frequency contractions were observed twice during one session of continuous recording and the interval between burst contractions was 85.4 +/- 13.3 min. Long-term continuous recording is advantageous for the evaluation of the function of the sphincter of Oddi and short-term manometry may not be representative of overall sphincter of Oddi motility.

Adult↗
PubMed1992

Extracorporeal shock-wave lithotripsy of pancreatic calculi.

Extracorporeal shock-wave lithotripsy (ESWL) has been used to disintegrate pancreatic stones located in the main pancreatic duct for 123 patients with severe chronic pancreatitis. Endoscopic management following ESWL is aimed at restoring the pancreatic flow to the duodenum. Stone disintegration was achieved in 122 patients, whereas a decrease in the main pancreatic duct diameter resulted in 111, and complete clearance of the main pancreatic duct was obtained in 72. Pain relief, complete (40/88) or partial (35/88), correlated significantly with the results of the endoscopic drainage of the main pancreatic duct (e.g., decrease in main pancreatic duct diameter). Relapsing pain was most often related to recurrent pancreatic duct obstruction. Of 76 patients whose body weight had decreased before ESWL, 54 gained weight. Improvement of the exocrine function, evaluated by the [14C]triolein breath test before and 11 months, on the average, after ESWL, was observed in 12 patients among 22 for whom this test was performed before and after treatment. Improvement of the endocrine function after relief of obstruction of the main pancreatic duct was less frequently recorded (4/41). ESWL of pancreatic stones is a new, safe, and highly effective method of facilitating the endoscopic procedures for relief of pancreatic duct obstruction in severe chronic pancreatitis.

Adolescent↗
PubMed1976

The pathology of esophageal intramural pseudodiverticulosis.

The gross and microscopic findings of an atuopsied case of esophageal intramural pseudodiverticulosis are presented. The source of the pseudodiverticula is shown to be pathologically dilated pre-existing excretory ducts of the submucosal glands, with which the pseudodiverticula often remained in continuity. Unlike what has been previously reported but poorly documented, the submucosal glands themselves did not contribute to the structure of the pseudodiverticula, the number of duct-gland units was not increased, and the thickening of the wall of the esophagus was the result of submucosal fibrosis, not hypertrophy of the muscularis propria. The etiology of this entity remains unidentified.

Autopsy↗
PubMed1991

Ectatic blood vessels in port-wine stains lack innervation: possible role in pathogenesis.

The innervation pattern of port-wine stains was investigated using indirect immunohistochemistry with antibodies to protein gene product 9.5 (PGP 9.5), neuron-specific enolase (NSE), calcitonin gene-related peptide (CGRP), and neurofilament (NF). The pathologically dilated vessels in the middle and deep dermis were found to have defective innervation with only single or no nerve fibers in their vicinity, while other structures in the skin showed a normal density of fibers. NSE- and PGP-like immunoreactive (-LI) nerve fibers were observed innervating vessels with a normal morphology and other structures in the skin, such as sweat glands and hair follicles, as free nerve endings and in nerve bundles. The nerve bundles were often seen to pass the ectatic vessels without giving off any branches. CGRP-LI nerve fibers were detected running toward epidermis, whereas no fibers were found around the ectatic vessels. NF-LI fibers were seen innervating normal vessels in dermis, while in relation to the dilated vessels, no or only occasional fibers were observed. The lack of innervation may be of importance for the development of the disease as a result of decreased tonus of the vessels and/or a loss of neuronal trophic factors.

Adult↗
PubMed2026

Inflammatory cytokines mediate thoracic aortic aneurysm formation via plasma metabolites: A two-step Mendelian randomization and single cell sequencing-based investigation.

Thoracic aortic aneurysm (TAA) is a life-threatening condition characterized by pathological dilation of the aorta. While inflammatory responses have been implicated in TAA pathogenesis, the causal relationships remain elusive. This study aimed to elucidate potential causal associations between inflammatory cytokines, plasma metabolites, and TAA risk using Mendelian randomization (MR) analysis. We conducted bidirectional two-sample MR analysis utilizing genome-wide association study data from 91 inflammatory cytokines (n = 14,824), 1400 plasma metabolites (n = 8299), and TAA (n = 385,857). The inverse-variance weighted method served as the primary analytical approach, with comprehensive sensitivity analyses performed to assess pleiotropy and heterogeneity. Two-step MR analysis was employed to explore potential mediating roles of plasma metabolites. Single-cell sequencing analysis was utilized to detect cell type enrichment and elucidate cellular functions of identified cytokines. Additionally, we conducted an analysis to identify druggable proteins as potential therapeutic targets for TAA. MR analysis revealed that genetically-determined increases in C-X-C motif chemokine 10 (CXCL10) (odds ratios [OR] = 1.149, 95% confidence interval [CI]: 1.009-1.309, P = .037) and fibroblast growth factor 5 (OR = 1.101, 95% CI: 1.013-1.196, P = .024) were associated with elevated TAA risk. Conversely, C-C motif chemokine 20 (CCL20) (OR = 0.870, 95% CI: 0.759-0.996, P = .043) and CD40L receptor (CD40) (OR = 0.906, 95% CI: 0.827-0.992, P = .033) demonstrated inverse associations with TAA risk. Two-step MR analysis identified potential mediating metabolites: the phosphate to linoleoyl-arachidonoyl-glycerol ratio for CXCL10, thyroxine and X-24585 for FGF-5, and the creatine to carnitine ratio for CCL20. Single-cell sequencing analysis revealed enrichment of these cytokines in specific cell types and pathways relevant to TAA pathogenesis. Drug-gene interaction analysis identified CXCL10, CCL20, and CD40 as potential targets for treatment of TAA. This study provides robust genetic evidence supporting causal relationships between specific inflammatory cytokines and TAA risk, with plasma metabolites potentially mediating these effects. CXCL10 and FGF-5 were identified as potential risk factors, while CCL20 and CD40 may confer protective effects. These findings offer novel insights into TAA pathogenesis and suggest potential targets for intervention. Further research is warranted to elucidate the underlying mechanisms and validate these results across diverse populations.

Aortic Aneurysm, Thoracic↗
PubMed1979

Echocardiographic findings in ventricular septal rupture and anterior wall aneurysm complicating myocardial infarction.

Echocardiographic findings in a patient with ventricular septal rupture and anterolateral wall aneurysm complicating myocardial infarction are presented. The findings were confirmed by cardiac catheterization and surgery. Using M-mode ultrasonocardiography one was able to demonstrate and localize the aneurysm as well as the ventricular septal defect which presented as an oblique interventricular communication appearing only during systole. Thus echocardiography supplemented the invasive examinations in exactly revealing the site of ventricular septal rupture. Other echocardiographic features of ventricular septal rupture were right ventricular dilatation, pathological septal motion and abnormal tricuspid valve motion as recently reported by other authors.

Cardiac Catheterization↗
PubMed1991

Hospitalisation of prostatic cancer patients undergoing orchiectomy.

We report our experience with 100 orchiectomies for advanced prostatic cancer in hospitalised patients. Approximately 60% of the patients required hospitalisation for additional treatment and investigation of complications due to their disease at the time of orchiectomy. In 51 cases the orchiectomy was combined with transurethral resection of the prostate (TURP); 37 patients had pathological levels of serum creatinine and 17 had pathological dilatation of the upper urinary tract, 6 of whom required a nephrostomy catheter. Because of anaemia on admission, 21 patients received a peri-operative blood transfusion. Two patients had significant post-operative bleeding, 2 developed a wound infection and 1 had a deep thrombophlebitis. The patients' mean age was 76.4 years and the period of hospitalisation ranged from 3 to 150 days with peaks at 3 and 8 days. The most important reason for prolonged hospitalisation was social problems. It was concluded that many patients who were hospitalised as a direct consequence of their prostatic carcinoma would have been in hospital for a similar period regardless of the method of hormonal manipulation used. Because so many patients have other reasons for hospitalisation, or require additional surgical procedures such as TURP, the true average cost of orchiectomy for advanced prostatic cancer is difficult to determine.

Aged↗