WAYS TO IMPROVE DIAGNOSIS OF PATIENTS WITH POSTCHOLECYSTECTOMY SYNDROME

2021 ◽  
pp. 31-35
Author(s):  
O. V. Gorbulitch ◽  
S. H. Yefimenko ◽  
S. A. Pavlychenko ◽  
O. A. Lazutkina ◽  
K. A. Aleksanian
Keyword(s):  
Morphological Changes ◽  
Gallstone Disease ◽  
Diagnostic Algorithm ◽  
Sphincter Of Oddi ◽  
Duodenal Papilla ◽  
Biliary Surgery ◽  
Postcholecystectomy Syndrome ◽  
Functional Changes ◽  
Post Surgery ◽  
Major Duodenal Papilla

Postcholecystectomy syndrome is a symptom complex that occurs or worsens after cholecystectomy and is a functional and / or organic disorder. It often complicates the post−surgery course of gallstone disease. The presence of symptoms of the disease indicates a deterioration in the quality of life of patients, but the diagnostic examination is not always possible to detect morphological or functional changes. Thus, at present the syndrome is an urgent problem of gastroenterology and biliary surgery. Diagnostic issues with a differentiated approach to the functional or organic nature of postcholecystectomy syndrome are important for the choice of further treatment tactics. In order to improve the diagnostic algorithm taking into account the changes in the area of the major duodenal papilla, a study was conducted in 137 patients. To determine the functional disorders of the sphincter of Oddi there was used the method of ultrasound investigation of hepatobiliary area and Vater's papilla with choleretic loading on Boyden as well as the Grigoriev's methods in the absence of organic obstruction of the terminal choledochus at previous stages of examination. Morphological changes in the major duodenal papilla area were evaluated using the technique of parietal ph−impedancemetry, which was performed on the background of benign mechanical jaundice in the patients after cholecystectomy during endoscopic retrograde cholangiopancreatography prior to endoscopic papillosphincterotomy. The obtained results help to perform a differentiated approach to the patients who underwent cholecystectomy, taking into account morphofunctional changes in the area of the major duodenal papilla and allow the implementation of the selected methods to the research algorithm of patients with postcholecystectomy syndrome. Key words: postcholecystectomy syndrome, functional and organic changes of major duodenal papilla, patency of the terminal choledochus, treatment tactics.

scholarly journals Contemporary Perspective of Comorbidity in Celiac Syndrome: Connection Between Morphological Changes in Duodenum Mucosa and Biliary Dysfunction

Doctor Ru ◽  
2020 ◽  
Vol 19 (7) ◽  
pp. 52-58
Author(s):  
L.S. Oreshko ◽  
◽  
Z.M. Tshovrebova ◽  
I.G. Bakulin ◽  
M.I. Safoev ◽  
...  
Keyword(s):  
Gall Bladder ◽  
Clinical Symptoms ◽  
Morphological Changes ◽  
Duodenal Papilla ◽  
Study Objective ◽  
Clinical Criteria ◽  
Major Duodenal Papilla ◽  
Study Results ◽  
Biliary Pathology ◽  
Bladder Abnormalities

Study Objective: to identify the key clinical and diagnostic markers of comorbidity presenting the risk of biliary pathology in celiac syndrome patients. Study Design: screening observation. Materials and Methods. The study included 133 patients with confirmed celiac syndrome and biliary dysfunction. Subjective clinical symptoms were analysed on the basis of reviews and questionnaires, while objective clinical symptoms were assessed following physical examination. When clinical symptoms were characterised, presence of subjective clinical criteria of functional disorders of gall bladder (GB) and Oddi’s sphincter were assessed. Study Results. Specific markers of biliary dysfunction in patients with celiac syndrome were identified. Following IV Rome criteria (2016), it was determined that subjective symptoms in some patients were signs of biliary indigestion syndrome: aches in right hypochondrium (45.1%), bitter taste in mouth (36.1%), nausea (36.1%). Subject had ultrasound signs on GB pathologies: bends in GB body (31.6%), GB neck (35.3%) and both (33.1%). Celiac syndrome patients had significant correlation between duodenitis severity and morphological characteristic of the major duodenal papilla. Major duodenal papilla inflammation is associated with lymphocytoplasmocytic (44.4%) and leucocytal infiltration (22.6%), dystrophic charges in glandular epithelium, gland hyperplasia (62.9%) (χ2(3) = 48.53; р < 0.001; С = 0.75), demonstrating impact on bile passage. A higher risk of biliary sludge in gall bladder in patients with celiac syndrome is due to GB abnormalities and signs of inflammation and atrophy in major duodenal papilla mucosa and its relation to major duodenal papilla. Conclusion. Our analysis demonstrated that comorbidity in patients with celiac syndrome is associated with biliary dysfunction syndrome. Biliary dysfunction markers are congenital abnormalities in GB structure, that are a result of GB deformation and dyscholia; marked chronic inflammation of major duodenal papilla and duodenum mucosa; stage 3 atrophic changes in duodenum mucosa, according M.N. Marsh. Keywords: celiac syndrome, biliary dysfunction, gall bladder abnormalities, comorbid pathology.

scholarly journals Diagnosis of Tumors of the Major Duodenal Papilla

2020 ◽  
Vol 16 (30) ◽  
pp. 74-80
Author(s):  
M.V. Orlova ◽  
◽  
V.A. Kim ◽  
Ye.V. Bystrovskaya
Keyword(s):  
Diagnostic Algorithm ◽  
Pathological Process ◽  
Duodenal Wall ◽  
Pancreatic Ducts ◽  
Duodenal Papilla ◽  
Major Duodenal Papilla ◽  
Exact Size ◽  
Methods Of Treatment ◽  
Minimally Invasive Methods ◽  
Future Management

With the development of endoscopic minimally invasive methods of treatment, endoscopic ultrasonography (EUS) is becoming increasingly relevant in the diagnostic algorithm for examining patients with neoplasms of the major duodenal papilla. Assessment of the exact size of the neoplasm, involvement in the pathological process of the duodenal wall, common bile and main pancreatic ducts, pancreatic parenchyma plays an important role in determining the future management of patients. The introduction of additional techniques such as contrast enhancement (CH-EUS), fine needle puncture (EUS-FNA) contribute to improving the possibility of morphological verification of tumors

scholarly journals ОСОБЛИВОСТІ ПРОМЕНЕВОЇ ДІАГНОСТИКИ УРАЖЕННЯ ЛЕГЕНЬ ПРИ МУКОВІСЦИДОЗІ

2019 ◽  
pp. 13-20
Author(s):  
Artem Malysh ◽  
Fedir Prytkov ◽  
Nataliia Morozova ◽  
Mykhailo Tkachenko
Keyword(s):  
Cystic Fibrosis ◽  
Ct Scan ◽  
Computer Tomography ◽  
Viral Infections ◽  
Maxillary Antrum ◽  
Morphological Changes ◽  
Diagnostic Algorithm ◽  
Functional Changes ◽  
Computer Tomography Scan ◽  
High Level

Our method was used to clarify the possibilities of diagnostic in case of cystic fibrosis and the installation of a computer tomography place in a diagnostic algorithm. Consequently we have analyzed the results of cases of 5 patients at the age from 19 to 25 years with the diagnosis of cystic fibrosis confirmed by sweat samples and genetic investigations. From September 2017 to 2018, the patients were placed in the infection epidemic department No. 2 of Oleksandrivskiy Clinical Hospital die to complications of the main disease. The patients were in the group of middle and high level of severity, respiratory failure II, III stages. These patients were dynamically examined by digital radiography of the chest cavity organs “Radrex” by Toshiba. All of the patients were united by an young age, asthenic and low nutrition body structure, short stature and prolonged anamnesis from early childhood, anamnesis of respiratory diseases, acute respiratory viral infections, bronchitis, sinusitis of the maxillary antrum. It was proved that the results obtained by radiography are typical for CF, but not specific, as well as they could be found in other diffuse lung diseases. After multispiral Computer tomography scan, we have found the main symptoms of cystic fibrosis, such as: total systemic damage of bronchopulmonary structures, two-sides character of pulmonary bronchiectasis . The presence of pronounced dilation of the bronchi of all orders, at least 200% of the original size, with a consolidation and thickening of their walls: a symptom of "ring" and the symptom of "paired strips" and filling of abruptly dilated bronchi of all calibers with a viscous secretion and as a result of this the mucous plugs are formed. Conclusion. The results of the X-ray examination are typical for CF and not specific, as well as for other diffuse pulmonary diseases. Computer tomography can be used for diagnostics of thin structurally functional particles characteristic for cystic fibrosis. It has also been established that the expression of morphological changes of cystic fibrosis are increased with the age of the patients. CT scan is the most useful for the detection morphological and functional changes for cystic fibrosis. Moreover, the CT scan is able to improve the early diagnoses for lungs pathology among the adolescent and the adults, and decrease the period of expectation of the result of the treatment.

scholarly journals OPPORTUNITIES OF CONTACT LITHOLYSIS IN THE TREATMENT OF GALLSTONE DISEASE

2014 ◽  
Vol 13 (1) ◽  
pp. 110-115
Author(s):  
Ye. V. Razmakhnin ◽  
S. L. Lobanov ◽  
O. G. Konovalova
Keyword(s):  
High Efficiency ◽  
Gallstone Disease ◽  
Common Bile Duct Stones ◽  
Duodenal Papilla ◽  
Major Duodenal Papilla ◽  
High K ◽  
Low Toxicity ◽  
And Control

For the treatment of calculouscholecystitis in patients with high-risk surgery in the treatment of choledocholithiasis in an effort to preserve the sphincter apparatus major duodenal papilla are encouraged to use the contact litholysis gallstones saxifragant mixture of octanoic acid – glycerol in a ratio of 1 : 1.The possibility of dissolution of stones in experiments in vitro (n = 51) and in vivo (n = 35), confirmed the low toxicity and high efficiency of the proposed technique. In vitro experiments, for more convenient evaluation was introduced conditional coefficient (K) that reflects the time lithodialysis in minutes per 1 mg of the stone weight. In experiments in vitro: K' = 5.76 (n = 51). It is noted that in the group of stones with low mineralization using saxifragant mixture K' = 4.50 (n = 15), with an average K' = 5.76 (n = 17), high K' = 6.88 (n = 19).In an in vivo experiment used 35 sexually mature rabbits after modeling cholelithiasischolecystitis was made through the introduction of a mixture of saxifragant rate of 0.2 ml/kg body weight once a day. Lowmineralized stones disappeared in all cases (after the double administration) medium mineralizedwhen administered for 3 days or more, the highly mineralized 4 – day of treatment. After treatment, histologically and biochemically, were found pronounced toxic effects of the drug.The clinic is possible to impose mikroholetsistostomy under ultrasound gui dance, irrigation lumen of the gall bladder, treatment of acute inflammation, followed by solvent solubility and control of stones with ultrasound studies, or using fistuloholangiografiyu. When choledocholithiasis, especially when residual common bile duct stones in an effort to preserve the sphincter apparatus ma jor duodenal papilla, possibly through the introduction of a mixture of saxifragant hepaticocholedochus established percutaneously transhepatic under ultrasound guidance, either through drainage nazobi liarny established endoscopically through major duodenal papilla. The advantages of this method compared to peers is less toxic solvent, speed lysing effect, the efficiency of the process calculi with different composition (cholesterol and pigment). Compared with the traditional methods of trea tment of gallstone disease differs minimally invasive and thus significantly reduces the risk of intra -and postoperative complications, both local and general, and significantly shorten the treatment of patients and their stay in hospital.

Morphological Changes in the Rat Granulosa Cell Surface During Differentiation Induced by Estradiol and Gonadotropins

1977 ◽  
Vol 35 ◽  
pp. 484-485
Author(s):  
P. Bagavandoss ◽  
JoAnne S. Richards ◽  
A. Rees Midgley
Keyword(s):  
Cell Surface ◽  
Granulosa Cell ◽  
Morphological Changes ◽  
Follicular Development ◽  
Female Rats ◽  
Functional Changes ◽  
Group 4 ◽  
Group 3 ◽  
Group 5 ◽  
Group 2

During follicular development in the mammalian ovary, several functional changes occur in the granulosa cells in response to steroid hormones and gonadotropins (1,2). In particular, marked changes in the content of membrane-associated receptors for the gonadotropins have been observed (1).We report here scanning electron microscope observations of morphological changes that occur on the granulosa cell surface in response to the administration of estradiol, human follicle stimulating hormone (hFSH), and human chorionic gonadotropin (hCG).Immature female rats that were hypophysectcmized on day 24 of age were treated in the following manner. Group 1: control groups were injected once a day with 0.1 ml phosphate buffered saline (PBS) for 3 days; group 2: estradiol (1.5 mg/0.2 ml propylene glycol) once a day for 3 days; group 3: estradiol for 3 days followed by 2 days of hFSH (1 μg/0.1 ml) twice daily, group 4: same as in group 3; group 5: same as in group 3 with a final injection of hCG (5 IU/0.1 ml) on the fifth day.

Comparative study of ultrasonographic findings with the operative findings of biliary surgery

2020 ◽  
Vol 22 (1) ◽  
pp. 25-29
Author(s):  
Zubayer Ahmad ◽  
Mohammad Ali ◽  
Kazi lsrat Jahan ◽  
ABM Khurshid Alam ◽  
G M Morshed
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Imaging Modality ◽  
False Positive Rate ◽  
Gallstone Disease ◽  
False Negative ◽  
False Negative Rate ◽  
Biliary Disease ◽  
Biliary Surgery ◽  
Operative Findings

Background: Biliary disease is one of the most common surgical problems encountered all over the world. Ultrasound is widely accepted for the diagnosis of biliary system disease. However, it is a highly operator dependent imaging modality and its diagnostic success is also influenced by the situation, such as non-fasting, obesity, intestinal gas. Objective: To compare the ultrasonographic findings with the peroperative findings in biliary surgery. Methods: This prospective study was conducted in General Hospital, comilla between the periods of July 2006 to June 2008 among 300 patients with biliary diseases for which operative treatment is planned. Comparison between sonographic findings with operative findings was performed. Results: Right hypochondriac pain and jaundice were two significant symptoms (93% and 15%). Right hypochondriac tenderness, jaundice and palpable gallbladder were most valuable physical findings (respectively, 40%, 15% and 5%). Out of 252 ultrasonically positive gallbladder, stone were confirmed in 249 cases preoperatively. Sensitivity of USG in diagnosis of gallstone disease was 100%. There was, however, 25% false positive rate detection. Specificity was, however, 75% in this case. USG could demonstrate stone in common bile duct in only 12 out of 30 cases. Sensitivity of the test in diagnosing common bile duct stone was 40%, false negative rate 60%. In the series, ultrasonography sensitivity was 100% in diagnosing stone in cystic duct. USG could detect with relatively good but less sensitivity the presence of chronic cholecystitis (92.3%) and worm inside gallbladder (50%). Conclusion: Ultrasonography is the most important investigation in the diagnosis of biliary disease and a useful test for patients undergoing operative management for planning and anticipating technical difficulties. Journal of Surgical Sciences (2018) Vol. 22 (1): 25-29

scholarly journals Effect of captopril on post-infarction remodelling visualized by light sheet microscopy and echocardiography

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Urmas Roostalu ◽  
Louise Thisted ◽  
Jacob Lercke Skytte ◽  
Casper Gravesen Salinas ◽  
Philip Juhl Pedersen ◽  
...  
Keyword(s):  
Morphological Changes ◽  
Light Sheet ◽  
Automated Image Analysis ◽  
Border Zone ◽  
Vascular Density ◽  
Mouse Heart ◽  
Imaging Method ◽  
Light Sheet Microscopy ◽  
Post Surgery ◽  
Captopril Treatment

AbstractAngiotensin converting enzyme inhibitors, among them captopril, improve survival following myocardial infarction (MI). The mechanisms of captopril action remain inadequately understood due to its diverse effects on multiple signalling pathways at different time periods following MI. Here we aimed to establish the role of captopril in late-stage post-MI remodelling. Left anterior descending artery (LAD) ligation or sham surgery was carried out in male C57BL/6J mice. Seven days post-surgery LAD ligated mice were allocated to daily vehicle or captopril treatment continued over four weeks. To provide comprehensive characterization of the changes in mouse heart following MI a 3D light sheet imaging method was established together with automated image analysis workflow. The combination of echocardiography and light sheet imaging enabled to assess cardiac function and the underlying morphological changes. We show that delayed captopril treatment does not affect infarct size but prevents left ventricle dilation and hypertrophy, resulting in improved ejection fraction. Quantification of lectin perfused blood vessels showed improved vascular density in the infarct border zone in captopril treated mice in comparison to vehicle dosed control mice. These results validate the applicability of combined echocardiographic and light sheet assessment of drug mode of action in preclinical cardiovascular research.

scholarly journals Detailed Morphological Changes of Foveoschisis in Patient with X-Linked Retinoschisis Detected by SD-OCT and Adaptive Optics Fundus Camera

2015 ◽  
Vol 2015 ◽  
pp. 1-8
Author(s):  
Keiichiro Akeo ◽  
Shuhei Kameya ◽  
Kiyoko Gocho ◽  
Daiki Kubota ◽  
Kunihiko Yamaki ◽  
...  
Keyword(s):  
Adaptive Optics ◽  
Morphological Changes ◽  
Fundus Photography ◽  
Foveal Thickness ◽  
Functional Changes ◽  
Fundus Camera ◽  
Fundus Photographs ◽  
Topical Dorzolamide ◽  
Retinal Folds ◽  
Sd Oct

Purpose. To report the morphological and functional changes associated with a regression of foveoschisis in a patient with X-linked retinoschisis (XLRS).Methods. A 42-year-old man with XLRS underwent genetic analysis and detailed ophthalmic examinations. Functional assessments included best-corrected visual acuity (BCVA), full-field electroretinograms (ERGs), and multifocal ERGs (mfERGs). Morphological assessments included fundus photography, spectral-domain optical coherence tomography (SD-OCT), and adaptive optics (AO) fundus imaging. After the baseline clinical data were obtained, topical dorzolamide was applied to the patient. The patient was followed for 24 months.Results. A reportedRS1gene mutation was found (P203L) in the patient. At the baseline, his decimal BCVA was 0.15 in the right and 0.3 in the left eye. Fundus photographs showed bilateral spoke wheel-appearing maculopathy. SD-OCT confirmed the foveoschisis in the left eye. The AO images of the left eye showed spoke wheel retinal folds, and the folds were thinner than those in fundus photographs. During the follow-up period, the foveal thickness in the SD-OCT images and the number of retinal folds in the AO images were reduced.Conclusions. We have presented the detailed morphological changes of foveoschisis in a patient with XLRS detected by SD-OCT and AO fundus camera. However, the findings do not indicate whether the changes were influenced by topical dorzolamide or the natural history.

scholarly journals Abstract No. 228 EE: Duodenal stenting over the major duodenal papilla using a transhepatic approach

2010 ◽  
Vol 21 (2) ◽  
pp. S87-S88
Author(s):  
L.N. Boucher ◽  
C. Dey ◽  
R. Gadahadh ◽  
T. Cabrera ◽  
N. Khattar ◽  
...  
Keyword(s):  
Duodenal Papilla ◽  
Major Duodenal Papilla

scholarly journals MODERN CONCEPTION AS TO THE FUNCTIONAL MORPHOLOGY OF THE OLFACTORY SYSTEM AND ITS CHANGES UNDER THE INFLUENCE OF SOME EXOGENOUS POLLUTANTS

2019 ◽  
Vol 23 (3-4) ◽  
pp. 37-40
Author(s):  
A.D. Shkodina ◽  
R.M. Hrinko ◽  
I.I. Starchenko
Keyword(s):  
Environmental Factors ◽  
Olfactory Epithelium ◽  
Functional Organization ◽  
Morphological Changes ◽  
Human Life ◽  
Experimental Studies ◽  
Experimental Models ◽  
Functional Changes ◽  
Olfactory Analyzer ◽  
Long Time

The interaction between a body and an environment provides the main aspects of human life. The study of the functional structure of the olfactory analyzer plays an important role both in clinical and in experimental studies, but the question of its features in humans needs detailed research. The paper presents the modern data of the structural and functional organization of the olfactory analyzer. Particular attention is paid to the structural organization of olfactory bulbs as most complicated and least studied component of the olfactory analyzer. The morphological and functional changes of the olfactory analyzer are developing in some diseases and in action of adverse environmental factors are described while the accentuation is placed on the differences of the mechanism in the pathogenesis of damage to the olfactory analyzer, depending on the nature of the influence of pathogenic factors. In this way as the result of short-term intense effects of the pollutant, irreversible atrophic changes are primarily affected to the olfactory epithelium, thus, to some extent, preventing the spread of the toxin to other analyzer structures. Conversely, a long-term exposure to low doses usually retains the functional activity of the olfactory epithelium, while harmful substances penetrate the central unit of the olfactory analyzer. In such cases, the olfactory dysfunction can be diagnosed after a long time after the start of the cohort with certain pollutants. Currently, studies of the influence of exogenous toxins on various parts of the olfactory analyzer on animal experimental models are quite active. At the same time, the issue of functional and morphological changes in various structural components of the human olfactory analyzer under the influence of negative environmental factors remains poorly understood and requires further morphological and biochemical studies, in order to be able to further develop effective therapeutic and prophylactic means.

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