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Biomedical subjects

J Papp

Publications and source records attributed to J Papp.

At least 37 records · Page 2Linked to original sources
PubMed1988

[Combined antisecretory therapy in patients with duodenal ulcer].

The ulcer healing effect of the combination of pirenzepine and cimetidine was compared to the cimetidine monotherapy in 60 duodenal ulcer patients, in whom previous cimetidine monotherapy (at the dose of 1000 mg/day for 4 weeks) had not produced any healing effect. The study was conducted in a prospective, double blind, random fashion. In 30 patients the cimetidine monotherapy was continued at the dose of 1000 mg/day. The other 30 patients received the combination of pirenzepine (75 mg/day) and cimetidine (400 mg at bedtime). Endoscopy was carried out before and after 4 weeks therapy. In the cimetidine group the ulcers have been cured in 12 cases. The cure rate was higher with the combination therapy: control endoscopy showed healed ulcers in 24 patients in this group. The difference between the two groups is statistically significant (chi 2-Test: 10.0, p less than 0.001). These results indicated a higher effectiveness of the pirenzepine-cimetidine combination in duodenal ulcer patients who had not previously responded to cimetidine alone.

Adult↗
PubMed1988

[Pirenzepine and cimetidine in the treatment of duodenal ulcer].

The efficacy of pirenzepin--of anticholinergic effect--and the H2-receptor blocking cimetidine has been studied in duodenal ulcer with random, double blind fashion. Recurrence examinations were carried out 6 and 12 months following the treatment. 50 patients were given pirenzepin and 50 cimetidine. The average age of the patients was 44.5 and 43.8 years respectively. Of them 60 (24 + 36) were men and 40 (26 + 14) women. At the start, 6 weeks following the start 6 and 12 months after the finishing of the treatment gastroscopy was performed. In the course of the six-week-long treatment 38 (76%) of the pirenzepin taking patients and 36 (72%) of the cimetidine taking patients recovered. No significant difference was found between the efficacy of the both treatments. In the respect of the half and one year recurrence, no significant difference was observed between the two patient groups. Ten of the patients taking pirenzepin and 4 of those taking cimetidine complained of side effects. Dryness of mouth, visual disturbance in the former group and constipation in the latter one. On the basis of the examinations both secretion inhibitors were found equally suitable for the therapy of duodenal ulcer.

Adult↗
PubMed1987

[Endoscopic diagnosis and therapy of benign stenosis of Vater's papilla].

Out of 921 endoscopic papillotomies (EPT) 110 (12%) were performed in patients with benign stenosis of the papilla of Vater. Among these patients were 96 after cholecystectomy and 14 with gallbladder in situ. The diagnostic aspects of the stenosis of papilla and the complications of EPT were investigated on the basis of these patients. The dilation of the bile ducts is not a specific criteria for the diagnosis of papilla-stenosis. Dilatation could develop after cholecystectomy despite the normal sphincter pressure. The complication rate in patients with stenosis of papilla of Vater is increased (13.6%) in comparison with the patients with biliary stones (8.8%). This can be account for the increased number of haemorrhage and cholangitis.

Ampulla of Vater↗
PubMed1987

[Seasonal disposition of gastroduodenal ulcer--legend or reality?].

The seasonal activity of peptic gastroduodenal ulcers was studied on the basis of 17,106 gastroduodenoscopies which were done during a 10 years period. The activity of gastric and duodenal ulcer was increased only in autumn; their number in spring did not deviate from the average. The frequency of bleeding in duodenal ulcers was increased in autumn, whereas the gastric ulcer-bleeding was detected in more patients during winter. According to this examination the regular spring-autumn periodicity is not typical for the peptic ulcer.

Cross-Sectional Studies↗
PubMed1987

[Endoscopic papillotomy in patients with the gallbladder in situ].

Out of 731 endoscopic papillotomies (EPT), 175 (24%) were performed in patients with gallbladders in place. Gallstones were detected in 91 cases both in the gallbladder and in the bile ducts. The EPT resulted in a symptomless condition in 44 of these cases without surgery. In 47 patients the cholecystectomy became necessary later and since the cholostasis ceased the surgery could be done among better conditions. The EPT is recommended also in patients with gallbladder in situ because the surgery will be for some of these patients after the EPT unnecessary. However in that condition the risk of acute cholecystitis increases after EPT.

Aged↗
PubMed1987

Endoscopy in the diagnosis and treatment of benign stenosis of the papilla of Vater.

Of 921 endoscopic sphincterotomies (EST) performed by the authors, 110 (12%) were done for benign stenosis of papilla of Vater. Based on these data, they consider the possibilities of endoscopic diagnosis and treatment in the stenosis of papilla. One of the conditions for the diagnosis of papilla stenosis is the detectability of dilated biliary tract by endoscopic retrograde cholangiography. But this cannot be taken as a specific sign because, e.g., the biliary tract may become dilated in spite of normal sphincter tone after gall-bladder removal. At the same time, biliary tract dilation is a diagnostic criterion for papilla stenosis, and abnormal findings in biliary scintigraphy and the laboratory syndrome consistent with cholestasis cannot be avoided. EST is the method of first choice in the treatment of papilla stenosis in comparison to surgery. The complications of EST, however, occur in papilla stenosis more frequently than in choledocholithiasis (8.8%). Bleeding and cholangitis are responsible for the excess incidence.

Ampulla of Vater↗
PubMed1985

Pancreatic function after endoscopic and surgical occlusion of the pancreatic duct in patients with chronic pancreatitis.

Complex monitoring of pancreatic function was done after 18 endoscopic or surgical occlusions of the pancreatic duct in 15 patients with chronic pancreatitis. The indirect function tests (starch tolerance test, Lipiodol test and fat loading) as well as the direct tests (secretin-pancreozymin and Lundh tests) demonstrated only moderate pancreatic insufficiency. Overall values of the Lundh test performed before and after the treatment in 10 cases did not change significantly. The surgical procedure decreased pancreatic function somewhat more effectively, but the symptom-free "burned-out" state was only rarely achieved. Even glucose tolerance slightly diminished after treatment. The uneven results of obstruction therapy were attributed to the recovered exocrine function of the pancreas. Patients with severe pancreatic insufficiency or proximal resection of the pancreas seem to be better candidates for such treatments.

Chronic Disease↗
PubMed1985

[Endoscopic occlusion treatment in patients with chronic pancreatitis].

Between 1980 and 1983 an endoscopic occlusion of pancreatic duct was performed in 12 patients with chronic pancreatitis. In 4 patients it could be achieved a complete, in 8 patients only a partial occlusion. Four patients became free of pain whereas 5 patients have been operated on following an aggrevation of disease. After one year diabetes mellitus developed in 2 patients. We conclude that the endoscopic occlusion of the pancreatic duct may be recommended in some patients with defined diagnosis and special duct constellation.

Adult↗
PubMed1985

[Endoscopy of the bile ducts and pancreas in children].

ERCP was carried out in 8 children under 14 years age. The indications of examinations were in 7 cases obstructive jaundice caused in 3 patients by congenital anomalies of the biliary tract. In one case the ERCP was performed because of acute relapsing pancreatitis. The examinations were carried out under general anesthesia in 5 children and after sedative premedication in 3 cases. No complications of the procedures were recorded. ERCP is a useful method also in children for diagnosing bilio-pancreatic anomalies.

Acute Disease↗
PubMed1982

[Effect of somatostatin on metabolic changes following ERCP ].

An investigation was carried out on the ameliorating effect of cyclic somatostatin on the biochemical changes and impairment of glucose tolerance which follow endoscopic retrograde pancreatography. Serum amylase and plasma insulin and glucagon levels were significantly lower in a group of 20 patients receiving somatostatin prior to pancreatic radiography than in 35 control patients without such pretreatment. (Maximum increases in control and somatostatin-pretreated patients, respectively were: amylase: 4695 +/- 290; 1037 +/- 155 U/l p less than 0.001; insulin: 504 +/- 89; 179 +/- 43 pmol/l p less than 0.001; glucagon: 394 +/- 44; 62 +/- 13 pmol/l p less than 0.05.) Impairment of glucose tolerance was also considerably less in the patients given prophylactic somatostatin. These results indicate that postpancreatographic metabolic abnormalities can be ameliorated, or possibly even prevented altogether, by prior administration of somatostatin.

Amylases↗
PubMed1982

[A case of congenital cystic intrahepatic bile duct dilatation (Caroli syndrome) treated with hepato-lobectomy].

The authors report a successful hepatolobectomy of Caroli's disease (segmentally dilatated intrahepatic bile ducts). They also give a survey of congenital and acquired bile duct dilatations, with a view to differential diagnosis and medical treatment. When Caroli's disease is suspected, echography and ERCP can be a valuable diagnostic aid. The definitive cure i. e. the elimination of the anatomical basis of recidive cholangitis, can only be achieved by the resection of the liver containing the dilated intrahepatic bile ducts. Postoperative administration of antibiotics and anticholelithic drugs can help the liver to full recovery.

Bile Ducts, Intrahepatic↗