scholarly journals Enzyme pattern of biliary colic: A counterintuitive picture

2016 ◽  
Vol 8 (36) ◽  
pp. 1629 ◽  
Author(s):  
Elad Resnick ◽  
Shimon Shteingart ◽  
Bernardo Melamud ◽  
Tali Bdolah-Abram ◽  
Todd Zalut ◽  
...  
Keyword(s):  
Biliary Colic ◽  
Enzyme Pattern

Ontogenesis of Tissue Plasminogen Activator in the Human

1971 ◽  
Vol 25 (03) ◽  
pp. 469-480 ◽  
Author(s):  
B Åstedt ◽  
M Pandolfi
Keyword(s):  
Plasminogen Activator ◽  
Tissue Plasminogen Activator ◽  
Vena Cava ◽  
Vasa Vasorum ◽  
Moderate Activity ◽  
Foetal Development ◽  
Plasminogen Activator Activity ◽  
Stage Of Development ◽  
Tissue Plasminogen ◽  
Enzyme Pattern

SummaryThe ontogenesis of tissue plasminogen activator in various tissues was studied in 10 embryos and 58 foetuses with a histochemical method.The first appearance of activator activity was seen in a 4-weeks old embryo. At 8-9 weeks it was seen in the eye, meninges, heart, lungs, kidney and vena cava. In the foetal heart high activity was found in the coronary vessels, which can be regarded as the vasa vasorum of the heart. In the lungs a moderate activity increased at 24 weeks of age, when vascularisation increases more rapidly. Intense activity was seen in the highly vascularized corneoscleral junction of the eye later involved in the drainage of aqueous humor.In the kidney the activity could be related to the vessels, while no activity was seen in the glomeruli, the collecting system or the pelvis. In the vessels the activator activity was fairly high. No activity was seen in any stage of development of the liver.The plasminogen activator activity may be of importance for maintaining the foetomaternal circulation and micro-circulation in rapidly growing foetal organs. In the embryo the enzyme pattern is dominated by protein synthetizing enzymes. During foetal development the enzyme pattern changes owing to supervention of enzymes necessary for the function of the various organs. Plasminogen activator belongs to this latter group. The appearance of plasminogen activator activity may therefore be regarded mainly as a sign of functional maturity of the foetal organs.

Cholecystectomy for Biliary Hyperkinesia

2019 ◽  
Vol 85 (2) ◽  
pp. 219-222 ◽  
Author(s):  
Joshua Gazzetta ◽  
Betty Fan ◽  
Paul Bonner ◽  
John Galante
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Chart Review ◽  
Gallbladder Disease ◽  
Retrospective Chart Review ◽  
Biliary Colic ◽  
Study Cohort ◽  
Final Pathology ◽  
Pathology Reports ◽  
Histologic Changes

Patients with classic biliary colic symptoms and documented gallbladder ejection fractions on the higher end of the spectrum on hepatobiliary iminoacetic acid scans with cholecystokinin stimulation are presently understudied and the benefits of cholecystectomy are unclear. To determine whether patients with biliary-type pain and biliary hyperkinesia (defined as a gallbladder ejection fractions of 80% or greater) benefit from laparoscopic cholecystectomy, a retrospective chart review encompassing five community hospitals was performed. Patients 16 years and older with diagnosed biliary hyperkinesia who underwent laparoscopic cholecystectomy between January 1, 2010 and May 31, 2015 were included. Pathology reports were reviewed for histologic changes indicating cholecystitis. Resolution of biliary colic symptoms was reviewed one to three weeks after surgery in their postoperative follow-up documentation. Within our study cohort, we found 97 patients who underwent laparoscopic cholecystectomy for biliary hyperkinesia. Within this population, 84.5 per cent of patients undergoing laparoscopic cholecystectomy for biliary hyper-kinesia had positive findings for gallbladder disease on final pathology. Of the 77 patients with data available from their first postoperative visit, 70 (90.9%) reported improvement or resolution of symptoms. Our findings suggest that symptomatic biliary hyperkinesia may be treated successfully with surgery.

Biliary colic on abrupt withdrawal of octreotide

The Lancet ◽  
1991 ◽  
Vol 338 (8781) ◽  
pp. 1527 ◽  
Author(s):  
R.A. James ◽  
M. Rhodes ◽  
P. Rose ◽  
P. Kendall-Taylor
Keyword(s):  
Biliary Colic ◽  
Abrupt Withdrawal

Laparoscopic management of type VI choledochal cyst with common bile duct stone: report of a case and review of literature

2021 ◽  
Vol 14 (10) ◽  
pp. e244393
Author(s):  
G Revathi ◽  
Brijesh Kumar Singh ◽  
Yashwant Singh Rathore ◽  
Sunil Chumber
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Choledochal Cyst ◽  
Cystic Duct ◽  
Incidental Finding ◽  
Laparoscopic Approach ◽  
Biliary Colic ◽  
Type I ◽  
Laparoscopic Management ◽  
Cyst Excision

A young adult male presented with biliary colic and intermittent jaundice for 1 year. Abdomen findings were unremarkable. Routine investigations revealed a raised total bilirubin. On abdominal ultrasonography, common bile duct (CBD) dilatation with multiple stones was noted. On further imaging with magnetic resonance cholangiopancreatography, type I choledochal cyst (CDC) was suspected. A laparoscopic approach was planned. Intraoperatively, dilatation of cystic duct was noted which constitute type VI CDC. Partial malrotation of the gut and accessory right hepatic artery were also noted as incidental finding. Laparoscopic cholecystectomy with CBD exploration and removal of stones, biliary stent placement, cystic duct cyst excision and primary repair of CBD was done. Postoperatively, the patient improved symptomatically with a fall in bilirubin to normal range. We are describing the laparoscopic management of a rare case of type IV CDC which was diagnosed intraoperatively.

scholarly journals Superoxide dismutase, glutathione peroxidase and catalase in developing rat brain

1982 ◽  
Vol 204 (2) ◽  
pp. 535-540 ◽  
Author(s):  
I Mavelli ◽  
A Rigo ◽  
R Federico ◽  
M R Ciriolo ◽  
G Rotilio
Keyword(s):  
Superoxide Dismutase ◽  
Glutathione Peroxidase ◽  
Rat Brain ◽  
Rat Hepatocytes ◽  
Mitochondrial Fraction ◽  
Cytoplasmic Fraction ◽  
Mouse Ascites ◽  
Enzyme Pattern ◽  
Relative Deficiency ◽  
The Brain

The specific activities of Cu, Zn- and Mn-superoxide dismutases, of glutathione peroxidase and of catalase, the enzymes considered to be specifically involved in the defence of the cell against the partially reduced forms of oxygen, were determined as the function of postnatal age in the early (up to 60 days) period of rat brain development. The enzymes were assayed in the cytoplasmic fraction, in the crude mitochondrial fraction including peroxisomes, and in the mitochondria. The results show that the temporal changes of these enzymes cannot be correlated with each other, thus indicating that they do not concertedly parallel the increasing activity of aerobic brain metabolism during development. Specifically the cytoplasmic fraction shows a gradual increase of the Cu, Zn-superoxide dismutase activity with age, whereas the glutathione peroxidase activity is constant from birth. Furthermore the increase of the mitochondrial Mn-superoxide dismutase as a function of postnatal age is more remarkable than that of the cytoplasmic Cu, Zn-enzyme. Higher activities of catalase in adult animals are detectable only in the subcellular fraction containing peroxisomes, because of the modest catalase activity of the brain. These results indicate independent regulation of the expression of these enzyme activities in the process of brain differentiation and point to a relative deficiency of enzymic protection of the brain differentiation and point to a relative deficiency of enzymic protection of the brain against potentially toxic oxygen derivatives. This situation is similar to the pattern already described in the rat heart and in rat and mouse ascites-tumour cells, at variance with the much more efficient enzyme pattern present in rat hepatocytes.

scholarly journals Anomalous choledocho-pancretic ductal junction in a choledochal cyst: A case report

2004 ◽  
Vol 132 (5-6) ◽  
pp. 179-181
Author(s):  
Miodrag Jovanovic ◽  
Dragoljub Bilanovic ◽  
Radoje Colovic ◽  
Nikica Grubor ◽  
Milenko Ugljesic
Keyword(s):  
Bile Duct ◽  
Choledochal Cyst ◽  
Bile Ducts ◽  
Postoperative Recovery ◽  
Biliary Colic ◽  
Duodenal Wall ◽  
Choledochal Cysts ◽  
Bile Duct Wall ◽  
Intrahepatic Bile Ducts ◽  
Inflammatory Changes

Choledochal cysts are rare congenital anomalies, mostly detected in adults. Pathogenesis of these cysts seems to be in anomalous junction between pancreatic and common bile duct, above the papillary sphincterand outside of the duodenal wall. The absence of the sphincter above the junction is followed by reflux of the pancreatic juice into the bile duct leading to dilatation and fibrous changes of bile duct wall. A 38-year-old female is presented in whom a choledochal cyst was found 11 years earlier, during the operation performed for obstructive jaundice, when cystojejunostomy with Roux-en Y jejunal limb was carried out. In February 1990, she was admitted to our Institution for jaundice and biliary colic. The patient was reoperated. Operative cholangiography showed an anomalous pancreatobiliary junction, choledochal cyst, dilated cystic duct and moderate dilatation of intrahepatic bile ducts. Cholecystectomy, desanastomosis with partial excision of choledochal cyst, and retrocolic choledochojejunostomy with the same Roux-en-Y jejunal limb were performed. Total excision of choledochal cyst was too risky due to chronic inflammatory changes in the hepatoduodenal ligament. Postoperative recovery was uneventful and the patient remained symptom-free so far.

scholarly journals Laparoscopic cholecystectomy during COVID-19 pandemic- Retrospective analysis of tertiary care centre

2021 ◽  
Vol 2 (2) ◽  
pp. 82-86
Author(s):  
Uttam Laudari ◽  
Rosi Pradhan ◽  
Dibesh Shrestha ◽  
Bibek Timilsina ◽  
Suhail Sapkota ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Retrospective Analysis ◽  
Infection Prevention ◽  
Open Cholecystectomy ◽  
Gallbladder Disease ◽  
Tertiary Care ◽  
Infection Prevention And Control ◽  
Biliary Colic ◽  
Tertiary Care Centre ◽  
Duration Of Hospitalization

INTRODUCTION: Laparoscopic cholecystectomy is the most commonly performed general surgical procedure. During the COVID-19 pandemic, general recommendation worldwide is to postpone elective surgeries as far as possible to decrease the resource utilization and also aerosol-related transmission among hospital staff and patients. We conducted this study to see the burden of gallbladder disease, their management and outcomes of all patients who presented to our centre during first wave of COVID-19 pandemic. METHODS: We conducted a retrospective analysis of all patients who underwent laparoscopic cholecystectomy at the Hospital for Advanced Medicine and Surgery (HAMS) after the commencement of strict lockdown in the first wave of the COVID-19 pandemic. Ethical approval for the study was taken from Nepal Health Research Council. All the surgeries were performed as per HAMS interim policy for infection prevention and control during the COVID-19 pandemic. Data were extracted from the discharge sheet and outcomes in terms of duration of hospitalization, morbidity, mortality, and COVID -19 infection among patient and operating team staff after surgery were assessed. RESULTS: Out of 110 cases operated for gallbladder disease, 90 patients were included in the study with complete data. The most common presentations were dyspepsia (28) and biliary colic (22). Patients were managed with laparoscopic cholecystectomy (79), percutaneous cholecystostomy (4), laparoscopic subtotal cholecystectomy (5), open cholecystectomy (1). The median duration of hospitalization 22 hours. There was no COVID-19 transmission among staff and patients. CONCLUSIONS: Laparoscopic cholecystectomies are feasible during COVID-19 pandemic and safely performed following infection prevention guidelines. It can be still be performed in day case basis to decrease the bed occupancy and avoiding crowd in hospitals.  

scholarly journals Pathology of the Liver and Gallbladder in Patients with Inflammatory Bowel Diseases

2021 ◽  
Vol 17 (4) ◽  
pp. 28-33
Author(s):  
M.M. Kudishina ◽  
◽  
I.V. Kozlova ◽  
A.L. Pakhomova ◽  
A.P. Bykova
Keyword(s):  
Inflammatory Bowel Diseases ◽  
Structural Changes ◽  
Liver Steatosis ◽  
Steroid Resistance ◽  
Biliary Colic ◽  
Alcoholic Fatty Liver ◽  
Bowel Diseases ◽  
Inflammatory Bowel ◽  
Functional Features ◽  
Pathology Of The Liver

Pathology of the liver and gallbladder is one of the extra-intestinal manifestations of inflammatory bowel diseases (IBD). Targeted examination indicates clinical, laboratory, and structural changes in the liver and gallbladder in 30% of patients with IBD. However, information about the state of the hepatobiliary zone in comparison with the IBD phenotype, the features of the course, and the nature of therapy are few, and their results are contradictory. The aim − to study the frequency of occurrence, to analyze the structural and functional features of the liver and gallbladder in relation to the phenotype, clinical and endoscopic activity of the process, the nature of the course, and the effectiveness of IBD therapy. Material and methods. A simple, open, single-stage, non-randomized study involved 157 patients with ulcerative colitis (UC) and 37 patients with Crohn's disease (CD) who were treated in the Gastroenterology Department of the City Clinical Hospital No. 5 in Saratov in the period of 2016−2019. Complex clinical, biochemical, and instrumental studies were performed (ultrasound examination of the abdominal organs, fibrogastroduodenoscopy and colonoscopy, general morphological examination of colonobioptates). Results. Non-alcoholic fatty liver disease (NAFLD) was verified in 10.8% of patients with UC (3.8% had non-alcoholic steаthohepatitis (NASH), 7% − liver steatosis) and in 27% of patients with CD (NASH – 5.4% of cases, liver steatosis – 21.6%). Dysfunctional disorders and structural changes of the gallbladder were detected in 14.3% of patients with UC and 20.8% with CD. Of these, cholelithiasis was found in 9.5% of patients with UC and 10.8% with CD. When analyzing the association of risk factors for hepatobiliary pathology with a variant of IBD, NAFLD was associated with the type of IBD course (recurrent course for CD), localization of the process (in UC – with left-sided colitis, in CD – with terminal ileitis), an operational history on the intestine in CD, the duration of CD for more than five years, overweight in UC, and the effects of basic therapy (steroid resistance). The pathology of the gallbladder is associated with the duration of IBD for more than three years, the continuous course of UC, and surgical interventions on the intestine in CD. When analyzing laboratory and structural markers of steatosis, it was noted that high values of the steatosis index prevailed in UC (according to J.H. Lee). Abdominal ultrasound revealed mild (41% in UC, 40% in CD) and moderate (47.1% in UC, 50% in CD) liver steatosis more often. When analyzing the clinical features of the hepatobiliary system, it was found that liver pathology was detected by instrumental and laboratory criteria, and gallbladder pathology was characterized clinically by symptoms of biliary dyspepsia in the absence of biliary colic attacks. Conclusion. The features of liver and gallbladder pathology identified during the study can be used to optimize the management of patients with IBD

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