COMPARATIVE ASSESSMENT OF BILE DUCT DECOMPRESSION METHODS IN PATIENTS WITH OBSTRUCTIVE JAUNDICE OF NON-TUMOR GENESIS

Introduction: Obstructive jaundice is one of the most common diseases of the digestive system observed in 10-15% of the world’s population. The question of making a choice among methods of bile duct decompression is still under discussion, since both single-stage and two-stage methods of biliary decompression lead to progression of hepatic insufficiency after restoration of bile passage. The aim: To determine a tempo of biliary decompression after external and internal drainage of bile ducts, endoscopic transpapillary interventions in patients with obstructive jaundice of non-tumor genesis. Materials and methods: We analyzed the outcomes of surgical treatment of 180 patients with obstructive jaundice of the non-tumor genesis. The patients were divided into three groups: group I (n = 86), where endoscopic methods of biliary decompression were used; group II (n = 48), where biliodigestive anastomoses were formed; and group III (n = 46), where the external drainage of bile ducts was conducted. The average age was 62 ± 6.0 years. The average duration of obstructive jaundice was 20 ± 3.7 days. Results: The patients of the group I demonstrated a gradual decrease of bilirubin and alkaline phosphatase levels, which reached the normal readings on Day 7. The patients of the group II demonstrated normal levels of bilirubin and alkaline phosphatase on Day 14. The patients of the group III demonstrated rapid decrease of bilirubin and alkaline phosphatase levels, which reached the normal readings on Day 28. The transaminase level in each group of patients had reached the norm earlier. Conclusions: No significant disturbances of the functional state of the liver after endoscopic transpapillary interventions were observed. Formation of areflux biliodigestive anastomoses was accompanied by a moderate rate of biliary duct decompression. The external drainage of biliary ducts was characterized by a rapid rate of biliary decompression, leading to a post-compression syndrome.

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Stage surgical tactics in patients with obstructive jaundice complicated of the acute cholangitis and biliary sepsis

Modern medical technologies ◽

10.34287/mmt.2(41).2019.40 ◽

2019 ◽

Vol 41 part 3 (2) ◽

pp. 51-55

Author(s):

O. Ye. Kanikovskiy ◽

Ya. V. Karyi ◽

Yu. V. Babiichuk

Keyword(s):

Alkaline Phosphatase ◽

Obstructive Jaundice ◽

Acute Cholangitis ◽

Transaminase Level ◽

Biliary Decompression ◽

Group Iii ◽

Group I ◽

Biliary Sepsis ◽

Group Ii ◽

Surgical Tactics

Purpose of the study. Improve treatment results of the patients with obstructive jaundice complicated of the acute cholangitis and biliary sepsis.Materials and methods. We analyzed the outcomes of surgical treatment of 200 patients with obstructive jaundice of the non-tumor genesis. The acute cholangitis was observed in 35 patients, which was caused of the biliary sepsis in 10 cases. The patients were divided into three groups: group I (n = 95), where endoscopic methods of biliary decompression were used; group II (n = 48), where biliodigestive anastomoses were formed; and group III (n = 57), where the external drainage of bile ducts was conducted.Results. The patients of the group I demonstrated a gradual decrease of bilirubin and alkaline phosphatase levels, which reached the normal readings on Day 7. The patients of the group II demonstrated normal levels of bilirubin and alkaline phosphataseon Day 14. The patients of the group III demonstrated rapid decrease of bilirubin and alkaline phosphatase levels, which reached the normal readings on Day 28. The transaminase level in each group of patients had reached the norm earlier.Conclusions. Priority is given to stage surgical tactics in patients with obstructive jaundice complicated of the acute cholangitis and biliary sepsis. Single-stage correction is recommended for patients with hyperbilirubinemia of less than 200 mcmol/l and duration of jaundice for less than 14 days, in the presence of compensated or subcompensated co-occurring pathology as well as in the absence of acute cholangitis.Keywords:obstructive jaundice, acute cholangitis, biliary sepsis, biliary decompression.

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Hydatid cyst of the liver which demaged the confluence of the hepatic ducts causing deep obstructive jaundice

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0308329c ◽

2003 ◽

Vol 131 (7-8) ◽

pp. 329-332

Author(s):

Radoje Colovic ◽

Nikica Grubor ◽

Miodrag Jovanovic

Keyword(s):

Alkaline Phosphatase ◽

Bile Duct ◽

Obstructive Jaundice ◽

Hydatid Cyst ◽

Bile Ducts ◽

Standard Procedure ◽

Biliary Reconstruction ◽

Liver Cysts ◽

Normal Limits

Complications of the hydatid cyst of the liver on bile ducts appear in 5-25% representing almost two third of all complications of the hydatid liver cysts. Fortunately a damage to the bile ducts causes only an infection of the cyst usually without major consequences. More serious complications such as cholangitis and deep obstructive jaundice are much rarer. The defect of the bile duct usually is a periferal one. Damage to the major ducts are rarer and those on the confluence of hepatic ducts itself are the rarity. In that case biliary reconstruction may be a serious chalenge. The authors present a 23 year-old man in whom a centrally localised hydatid cyst made a major damage of the confluence of all three hepatic ducts causing deep obstructive jaundice. After standard procedure for hydatid cyst an intracavital mucosa to mucosa hepaticoje-junostomy was carried out with excellent success. More then six years after surgery the patient stayed symptom-free with bilirubin and alkaline phosphatase within normal limits.

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Effects of Octreotide and Allopurinol on Liver Histology and Functions in Surgical Jaundice: An Experimental Study.

Albanian Journal of Trauma and Emergency Surgery ◽

10.32391/ajtes.v3i1.34 ◽

2019 ◽

Vol 3 (1) ◽

Author(s):

Özgür Ekinci ◽

Tunç Eren ◽

Aman Gapbarov ◽

Mert Gacemer ◽

Tulay Ozkinet ◽

...

Keyword(s):

Bile Duct ◽

Common Bile Duct ◽

Group Iv ◽

Liver Histology ◽

Direct Bilirubin ◽

Metabolic Effects ◽

Group Iii ◽

Group I ◽

Significant Difference ◽

Group Ii

Aim: Mechanical jaundice may lead to adverse metabolic effects in surgical patients. Our aim was to investigate the effects of octreotid and allopurinol on liver histology and functions in rats with experimantally created mechanical jaundice. Methods: The subjects were divided into five main groups. The rats in Group I (Control) received no interventions. In Group II, common bile duct ligation (CBDL) was performed. In Group III, the same ligation procedure was performed followed by the administration of octreotid. In Group IV, the rats received allopurinol following CBDL and in Group V (Sham), the common bile duct was dissected and left intact. After sacrification of each rat on the seventh postoperative day, blood samples were collected for serum hematocrit, direct bilirubin, alanine aminotransferase (ALT), aspartate aminotransferase (AST), amylase, and albumin measurements in addition to the histopathologic examinations of the collected tissue specimens from the liver, terminal ileum, and pancreas. According to statistical analysis, a value of p<0.05 was considered as significant. Results: The direct bilirubin, AST and ALT levels were detected to be significantly elevated in the groups II, III and IV, in which CBDL was performed (p<0.05). While significant reductions of serum direct bilirubin, AST and ALT levels were detected in the octreotide group, these parameters were significantly elevated in the allopurinol group (p<0.05 and p<0.05, respectively). There was no significant difference of hematocrit and albumine levels among the study groups (p>0.05). Additionally, in the allopurinol group four rats were found to have increased serum amylase levels and the histopathologic evaluations of their pancreatic samples revealed findings of pancreatitis. According to the histopathologic examinations, significant alterations were detected between the control and sham groups (groups I, V) and the CBDL groups (groups II, III, IV). However, these histopathological findings revealed no significant differences within the subgroup of subjects including CBDL alone (Group II), and CBDL along with the administration of either octreotide (Group III), or allopurinol (Group IV). Conclusion: The use of octreotide in mehanical jaundice may have protective metabolic effects. Further studies are considered necessary to be carried to support these findings.

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Evaluation of the phagocitary capacity of the mononuclear system in an experimental model of obstructive jaundice employing Tc- 99m Escherichia coli

Brazilian Archives of Biology and Technology ◽

10.1590/s1516-89132005000700005 ◽

2005 ◽

Vol 48 (spe2) ◽

pp. 37-43 ◽

Cited By ~ 1

Author(s):

Simone Odília Fernandes Diniz ◽

Alfredo José Afonso Barbosa ◽

Ivana Durval Araújo ◽

David Lee Nelson ◽

Leonardo Augusto da Silva Machado ◽

...

Keyword(s):

Escherichia Coli ◽

Renal Failure ◽

Alkaline Phosphatase ◽

Bile Duct ◽

Obstructive Jaundice ◽

Experimental Model ◽

Aspartate Aminotransferase ◽

Alanine Aminotransferase ◽

Bile Ducts ◽

Pulmonary Dysfunction

Infections and endotoxemia continue to be the principal causes of morbidity and mortality of patients with obstructions of the bile duct. The objective of the present work was the investigation of the phagocitary capacity of the mononuclear system in an experimental model of obstructive jaundice utilizing Tc-99m E.coli. The levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT) and alkaline phosphatase (ALP) were significantly higher in jaundiced rats than in the control animals (p < 0.001). The liver of the jaundiced animals presented a significant reduction in Tc-99m E.coli uptake when compared to the controls (p < 0.001). The data also showed that there was a significant increase in the uptake of Tc-99m E.coli by the lungs of jaundiced rats (p < 0.01). The histological analyses of the liver of jaundiced rats showed an intense and diffuse proliferation of the bile ducts and an intensified polyploidy of the hepatocytes (mean volume = 843 µm³), but no significant alterations were observed in the lungs of either group. This dates could contribute to a better understanding of the mechanisms involved in cases of bacteremia, renal failure and pulmonary dysfunction observed in clinical analyses of obstructive jaundice.

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Ultrastructural Lesions Produced by Alcohol and Sucrose in the Heart and Liver of C57BL Mice

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100068035 ◽

1970 ◽

Vol 28 ◽

pp. 208-209

Author(s):

K.K. SEKHRI ◽

C.S. ALEXANDER ◽

H.T. NAGASAWA

Keyword(s):

Osmium Tetroxide ◽

Male Mice ◽

Alcohol Group ◽

Group Iii ◽

Group I ◽

C57bl Mice ◽

Group Ii

C57BL male mice (Jackson Lab., Bar Harbor, Maine) weighing about 18 gms were randomly divided into three groups: group I was fed sweetened liquid alcohol diet (modified Schenkl) in which 36% of the calories were derived from alcohol; group II was maintained on a similar diet but alcohol was isocalorically substituted by sucrose; group III was fed regular mouse chow ad lib for five months. Liver and heart tissues were fixed in 2.5% cacodylate buffered glutaraldehyde, post-fixed in 2% osmium tetroxide and embedded in Epon-araldite.

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Heterogeneity and Immunochemical Properties of Anti-β2-glycoprotein I Autoantibodies

Thrombosis and Haemostasis ◽

10.1055/s-0037-1615218 ◽

1998 ◽

Vol 80 (09) ◽

pp. 393-398 ◽

Cited By ~ 33

Author(s):

V. Regnault ◽

E. Hachulla ◽

L. Darnige ◽

B. Roussel ◽

J. C. Bensa ◽

...

Keyword(s):

Fluid Phase ◽

Anticardiolipin Antibodies ◽

Dual Reactivity ◽

Group Iii ◽

Important Group ◽

Epitope Specificity ◽

Glycoprotein I ◽

Group I ◽

Group Ii ◽

Sufficient Concentration

SummaryMost anticardiolipin antibodies (ACA) associated with antiphospholipid syndrome (APS) are directed against epitopes expressed on β2-glycoprotein I (β2GPI). Despite a good correlation between standard ACA assays and those using purified human β2GPI as the sole antigen, some sera from APS patients only react in the latter. This is indicative of heterogeneity in anti-β2GPI antibodies. To characterize their reactivity profiles, human and bovine β2GPI were immobilized on γ-irradiated plates (β2GPI-ELISA), plain polystyrene precoated with increasing cardiolipin concentrations (CL/β2GPI-ELISA), and affinity columns. Fluid-phase inhibition experiments were also carried out with both proteins. Of 56 selected sera, restricted recognition of bovine or human β2GPI occurred respectively in 10/29 IgA-positive and 9/22 IgM-positive samples, and most of the latter (8/9) were missed by the standard ACA assay, as expected from a previous study. Based on species specificity and ACA results, IgG-positive samples (53/56) were categorized into three groups: antibodies reactive to bovine β2GPI only (group I) or to bovine and human β2GPI, group II being ACA-negative, and group III being ACA-positive. The most important group, group III (n = 33) was characterized by (i) binding when β2GPI was immobilized on γ-irradiated polystyrene or cardiolipin at sufficient concentration (regardless of β2GPI density, as assessed using 125I-β2GPI); (ii) and low avidity binding to fluid-phase β2GPI (Kd in the range 10–5 M). In contrast, all six group II samples showed (i) ability to bind human and bovine β2GPI immobilized on non-irradiated plates; (ii) concentration-dependent blockade of binding by cardiolipin, suggesting epitope location in the vicinity of the phospholipid binding site on native β2GPI; (iii) and relative avidities approximately 100-fold higher than in group III. Group I patients were heterogeneous with respect to CL/β2GPI-ELISA and ACA results (6/14 scored negative), possibly reflecting antibody differences in terms of avidity and epitope specificity. Affinity fractionation of 23 sera showed the existence, in individual patients, of various combinations of antibody subsets solely reactive to human or bovine β2GPI, together with cross-species reactive subsets present in all samples with dual reactivity namely groups III and II, although the latter antibodies were poorly purified on either column. Therefore, the mode of presentation of β2GPI greatly influences its recognition by anti-β2GPI antibodies with marked inter-individual heterogeneity, in relation to ACA quantitation and, possibly, disease presentation and pathogenesis.

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Oxygen Fraction Adjustment According to Body Surface Area during Extracorporeal Circulation

The Heart Surgery Forum ◽

10.1532/hsf.1325 ◽

2015 ◽

Vol 18 (3) ◽

pp. 098

Author(s):

Cem Arıtürk ◽

Serpil Ustalar Özgen ◽

Behiç Danışan ◽

Hasan Karabulut ◽

Fevzi Toraman

Keyword(s):

Body Temperature ◽

Surface Area ◽

Body Surface Area ◽

Body Surface ◽

Extracorporeal Circulation ◽

Group Iii ◽

Oxygen Fraction ◽

Arterial Blood ◽

Group I ◽

Group Ii

Background: The inspiratory oxygen fraction (FiO2) is usually set between 60% and 100% during conventional extracorporeal circulation (ECC). However, this strategy causes partial oxygen pressure (PaO2) to reach hyperoxemic levels (>180 mmHg). During anesthetic management of cardiothoracic surgery it is important to keep PaO2 levels between 80-180 mmHg. The aim of this study was to assess whether adjusting FiO2 levels in accordance with body temperature and body surface area (BSA) during ECC is an effective method for maintaining normoxemic PaO2 during cardiac surgery.Methods: After approval from the Ethics Committee of the University of Acıbadem, informed consent was given from 60 patients. FiO2 adjustment strategies applied to the patients in the groups were as follows: FiO2 levels were set as 0.21 × BSA during hypothermia and 0.21 × BSA + 10 during rewarming in Group I; 0.18 × BSA during hypothermia and 0.18 × BSA + 15 during rewarming in Group II; and 0.18 × BSA during hypothermia and variable with body temperature during rewarming in Group III. Arterial blood gas values and hemodynamic parameters were recorded before ECC (T1); at the 10th minute of cross clamp (T2); when the esophageal temperature (OT) reached 34°C (T3); when OT reached 36°C (T4); and just before the cessation of ECC (T5).Results: Mean PaO2 was significantly higher in Group I than in Group II at T2 and T3 (P = .0001 and P = .0001, respectively); in Group I than in Group III at T1 (P = .02); and in Group II than in Group III at T2, T3, and T4 (P = .0001 for all). Conclusion: Adjustment of FiO2 according to BSA rather than keeping it at a constant level is more appropriate for keeping PaO2 between safe level limits. However, since oxygen consumption of cells vary with body temperature, it would be appropriate to set FiO2 levels in concordance with the body temperature in the rewarming period.

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Features of the cervix uteri in women of reproductive age with endometrial polyps and micropolyps

HEALTH OF WOMAN ◽

10.15574/hw.2016.113.108 ◽

2016 ◽

pp. 108-111

Author(s):

T.F. Tatarchuk ◽

◽

D.G. German ◽

Keyword(s):

Reproductive Age ◽

Cervix Uteri ◽

Control Group ◽

Women Of Reproductive Age ◽

Endometrial Polyps ◽

Group Iii ◽

Aggressive Form ◽

Group I ◽

Group Ii ◽

Control Group Group

The article presents the comparative analysis of the state of the cervix in women with endometrial polyps and micropolyps. Patients and methods. The study involved 130 patients aged 18-35 years: 70 patients with endometrial polyps (group I), 30 patients with micropolyps (group II) and 30 patients of the control group (group III). Results. According to the anamnesis of women in the I group were significantly more frequent diseases of the cervix, which corrected physical surgery methods, in particular cryodestruction. In group II, the representatives of these indicators were similar to healthy. Normal colposcopic picture met significantly less frequently in patients and I, and II group. The differences in the incidence of HPV high oncogenic risk in all groups were not statistically significant. Conclusion. Destructive methods used in the detection of any changes in the cervix are often overly aggressive, form scars and contributing to inflamaciones process. In the chain of events leading to the formation of PE, cervical pathology and its correction can take the basic place. Key words: endometrial polyp, micropolyps, chronic endometritis, uterine cervix, colposcopy.

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THE USE OF BOLUSES REDUCES THE NEGATIVE EFFECT OF SUBCLINICAL KETOSIS ON THE REPRODUCTIVE FUNCTION OF HIGHLY PRODUCTIVE COWS

Molochnoe i miasnoe skotovodstvo ◽

10.33943/mms.2020.25.18.008 ◽

2020 ◽

Author(s):

Г.В. ШИРЯЕВ ◽

Ю.Г. ТУРЛОВА ◽

Г.С. НИКИТИН

Keyword(s):

Reproductive Function ◽

Sexual Cycle ◽

Feed Additive ◽

Hydroxybutyric Acid ◽

Subclinical Ketosis ◽

Group Iii ◽

Group I ◽

Negative Effect ◽

Group Ii ◽

Reproductive Indices

Изучено влияние кормовой добавки в форме индивидуальных болюсов Метраболь на возможность снижения негативного влияния субклинического кетоза (СКК) и результативность искусственного осеменения высокопродуктивных молочных коров в посттранзитный период. Животные были подобраны по принципу условных аналогов и разделены на 3 группы в зависимости от концентрации β-оксимасляной кислоты в их крови. В I группе (n=18) у коров не было СКК, концентрация кислоты составляла <1,0 ммоль/л, во II группе (n=21) у животных зарегистрирован СКК, концентрация кислоты — 1,0…1,4 ммоль/л. С целью поиска решения по снижению негативного влияния СКК на репродуктивные показатели была сформирована III группа коров, переболевших СКК (n=24) с концентрацией β-оксимасляной кислоты в крови 1,0…1,4 ммоль/л, но с использованием болюсов, применяемых для ускоренного восстановления репродуктивной функции коров после отела. Важной составляющей опыта явилось то, что к моменту гормональной синхронизации у коров всех 3 групп фиксировалось отсутствие СКК (снижение β-оксимасляной кислоты до уровня <1,0 ммоль/л). Для синхронизации полового цикла выбрана схема Пресинх-овсинх. Установлено, что гормональная синхронизация животных, перенесших СКК, в сравнении со здоровыми, не позволяет снизить негативное влияние данного нарушения обмена веществ. Во II группе у животных зафиксированы самые низкие репродуктивные показатели (количество использованных доз; индекс осеменения, сервис-период; время от первого до успешного осеменения; результат первичного осеменения; количество животных, осемененных 3 и более раз). В III группе применение болюсов позволило, в сравнении с животными II группы, не только избежать отрицательного воздействия СКК, но и превзойти по изучаемым параметрам животных из I группы. The effect of the feed additive in the form of individual boluses Metrabol on the possibility of reducing the negative effect of subclinical ketosis (CCK) and the effectiveness of artificial insemination of highly productive dairy cows in the post-transit period was studied. The animals were selected according to the principle of conditional analogs and divided into 3 groups depending on the concentration of β-hydroxybutyric acid in their blood. In group I (n=18), the cows did not have SSC, the acid concentration was <1.0 mmol/L, in group II (n=21), SSC was registered in animals — 1.0...1.4 mmol / L. In order to find a solution to reduce the negative effect of CCB on reproductive indices, a group III of cows was formed who had CCB (n = 24) with a concentration of β-hydroxybutyric acid in their blood of 1.0...1.4 mmol/L, but using boluses, used to accelerate the restoration of the reproductive function of cows after calving. An important component of the experiment was that by the time of hormonal synchronization, cows of all 3 groups had no SSC (decrease in β-hydroxybutyric acid to a level of <1.0 mmol/L). To synchronize the sexual cycle, the Pressinh-ovsinh scheme was chosen. It was found that hormonal synchronization of animals that underwent SSC, in comparison with healthy ones, does not allow reducing the negative effect of this metabolic disorder. In group II, animals had the lowest reproductive indices (number of doses used; insemination index, service period; time from first to successful insemination; result of primary insemination; number of animals inseminated 3 or more times). In group III, the use of boluses made it possible, in comparison with animals of group II, not only to avoid the negative effect of SSC, but also to surpass the animals from group I in terms of the studied parameters.

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Serum Endocrine Profile in Relation to Estrus Synchronization in Surti Does

THE INDIAN JOURNAL OF VETERINARY SCIENCES AND BIOTECHNOLOGY ◽

10.21887/ijvsbt.v13i03.10609 ◽

2018 ◽

Vol 13 (03) ◽

Author(s):

M. M. Chaudhary ◽

C. T. Khasatiya ◽

S. B. Patel ◽

S. S. Chaudhary ◽

V. B. Atara ◽

...

Keyword(s):

Jugular Vein ◽

Estrus Synchronization ◽

Progesterone Concentration ◽

Serum Progesterone ◽

Blood Samples ◽

Group Iii ◽

Group I ◽

Endocrine Profile ◽

Group Ii ◽

And Control

The serum progesterone and estradiol profiles during synchronization of estrus by buck effect and PGF2α treatments were monitored in Surti does. Total eighteen non-pregnant does selected were evenly divided into 3 groups, 6 does in each group. The does of Group I were teased with a sexuallyactive- apronized buck; and those of Group II were treated with PGF2α, i.e., Inj. Lutalyse® @ 7.5 mg/doe IM twice 11 days apart, while the Group III served as untreated control. Blood samples were collected from all the animals on day 0 (before 1st PGF2α injection), 3rd day (during treatment), 11th day (before 2nd PGF2α injection), 14th day (after treatment) and 40th day (post-service) by jugular vein puncture. The serum separated was stored at -20°C till further analysis. In all the three groups, 83.33% does, conceived at first service in the sampling cycle. The overall mean serum progesterone concentration of Group I does (5.82±0.72 ng/ml) was significantly higher (p less than 0.01) as compared to Group II (2.93±0.38 ng/ml) and III (2.88±0.30 ng/ml). Similarly, the overall mean serum progesterone concentration of Surti does on day 0 (2.65±0.46 ng/ml), 3rd (2.56±0.80 ng/ml), 11th (4.45±0.84 ng/ml) and 14th (3.40±0.63 ng/ml) did not differ significantly, but the overall mean level at day 40 (6.31±0.45 ng/ml) was significantly (p less than 0.01) higher, because most of animals became pregnant at that time. The overall mean serum oestradiol-17β levels of Group I (24.40±2.98 pg/ ml) was significantly higher (p less than 0.01) than in Group II (15.77±1.77 pg/ml) and III (12.21±1.45 pg/ ml). On the other hand, the overall mean serum oestradiol-17β levels of Surti does on day 0 (12.89±1.21 pg/ml), 3rd (15.84±1.74 pg/ml), 11th (14.81±1.96 pg/ml), 14th (22.15±2.97 pg/ml) and 40th (21.64±5.16 pg/ml) did not differ significantly (p>0.05) and the slightly higher overall mean level found at 40th day might be the influence of the non-pregnant does at first service in the cumulative animals. The hormonal profile reflected the initiation of cyclicity and establishment of pregnancy in treated and control animals.

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