[Suggested model for the diagnosis and treatment of chronic pancreatic diseases].
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Biomedical subjects
Publications and source records attributed to T Popiela.
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Intraoperative fibercholangioscopy allows direct inspection of the entire biliary tree up to the secondary distributaries. In 100 patients with suspected biliary tract pathology on account of endoscopic retrograde cholangiography the following findings were obtained: choledocholithiasis (solitary or multiple) in 66, biliary mud in 4, stricutres in 15, common bile duct carcinoma in 8, choledochal cyst in 1 and extrinsic lesions in 6. Peroral direct transpapillary cholangioscopy is still in an experimental stage but its results are promising.
Secretion patterns of gastric lipase and pepsin were studied in duodenal ulcer patients before and after vagotomy and in healthy subjects following continuous administration of pentagastrin in graded doses. The lipase output increased in response to pentagastrin stimulation in similar fashion as that of pepsin. The output of the two enzymes were correlated with each other and with hydrogen ion output. Evaluation of dose-response relationships showed that in duodenal ulcer patients the secretion of gastric lipase and pepsin is more sensitive to pentagastrin stimulation than that of hydrogen ions.
Electrophoretic separation of gastric juice and the homogenate of stomach body mucosa on polyacrylamide gel followed by staining for esterolytic activity resulted in a characteristic zymogram composed of five activity bands located in the cathodal part of the electropherogram. This pattern was lacking in zymograms obtained for the homogenates of antral and duodenal mucosa. Lipolytic activity was confined to the same area of the gel where the five band pattern of esterolytic activity was localized. It was concluded that gastric juice and homogenate of stomach body mucosa contain one esterolytic enzyme of wide specificity, known as gastric lipase.
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168 persons occupationally exposed to vinyl chloride and 236 persons exposed to mercury in plants electo two-stage medical and laboratory examinations. Workers exposed to vinyl chloride in average concentrations of 133 mg/m3 were found to show megalohepatia and abnormal enzymatic tests results (transaminic, A1AT, AP). The frequency of disturbances in workers exposed to vinyl chloride, average concentration 17.9 mg/m3, was considerably lesser. The second stage of studies involved those exposed to vinyl chloride for more than 10 years, with megalohepatia and at least 1 abnormal enzymatic test. No angiosarcoma was found. An analysis of the diagnostic value of biological tests used, indicated a great usability of liver scintigraphy and vascular system examinations for early diagnosis of vinyl chloride intoxications. In the plant where workers were exposed to mercury the Hg concentrations were found to range from 0.05 to 0.07 mg/m3. No significant differences between these workers and the control group were found, in respect to medical and laboratory examinations. The second stage of studies involved 118 persons exposed to mercury in concentrations above 20 mg/m3 of air, no matter how long the exposure lasted. The second stage of studies consisted of extensive biochemical studies, examinations of the liver using isotopic scintigraphy, psychological, psychiatric examinations and encephalographic determinations. Psychological, psychiatric and encephalographic examinations were said to be of great importance in early diagnosis of chronic mercury intoxications.
The response of peripheral blood mononuclear cells to PHA and PPD in migration inhibition test has been studied in patients with Duke's B-D colorectal carcinoma. It was found the response of patients cells to both stimulants was increased. This enhanced lymphokine release and/or production was closely connected with the tumor load. The implications of these findings to the regulatory mechanisms of the immune response in cancer patients are briefly discussed.
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The reactivity of peripheral blood lymphocytes from patients with advanced malignancy was assessed by mitogen-induced stimulation of protein synthesis as measured by 3H-leucine incorporation. It was confirmed that the lymphocyte response of patients was depressed. Furthermore, the lymphocytes of 15 out of 27 cancer patients, selected because of their low responses, inhibited the reactivity of normal lymphocytes in co-cultures. The lymphocytes from one patient with Hodgkin's disease were also inhibitory. In contrast, lymphocytes from healthy subjects, patients with chronic lymphocytic leukaemia, lymphosarcoma or multiple myeloma caused no suppression. Experiments with purified cell populations from patients with carcinoma indicated that purified T cells responded to mitogens while unseparated lymphocytes failed to respond and that the inhibitory activity was due to adherent cells, presumably monocytes. There was no evidence for B-cell-mediated suppression. However, in two cases inhibition was caused by isolated T cells of the patients and not by adherent cells. These experiments suggested that one mechanism for the depression of cell-mediated immunity seen in patients with advanced cancer may be the nonspecific suppresssion of certain T-cell functions by circulating monocytes.
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Concentrations of free and total hydrogen ions, total protein and pepsin were measured in gastric juice fractions collected during basal secretion and upon stimulation by graded doses of pentagastrin administered intravenously. Undissociated hydrogen ion and non-pepsin protein concentrations were calculated as derived quantities. The studies were carried out in nine patients with duodenal ulcer both before and after truncal vagotomy. It was found that after vagotomy the undissociated hydrogen ion concentration was significantly lower and non-pepsin protein higher than before the operation. No correlation was found between the two quantities both before and after vagotomy. It was concluded that in duodenal ulcer patients either not all non-pepsin protein takes part in buffering of hydrogen ions secreted by parietal cells, or that non-protein buffers play a more important role.
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