[Obstructive jaundice and prothrombin metabolism].
Explore the source record for details and available documents.
Hemostatics↗
SEARCH · PubMed Health
Results for “Jaundice, Obstructive”
Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
[Combined stratigraphy and pneumoperitoneum in the study of obstructive jaundice].
Explore the source record for details and available documents.
Abdomen↗
[Obstructive jaundice caused by intrapancreatic diverticulum of the second portion of the duodenum].
Explore the source record for details and available documents.
Diverticulum↗
[Intrahepatic obstructive jaundice in anti-syphilis therapy].
Explore the source record for details and available documents.
Humans↗
[A case of obstructive jaundice caused by incarceration of pancreatic stones in the ampulla of papilla Vater].
A very rare case of obstructive jaundice caused by the incarceration of pancreatic stones in the ampulla of papilla Vater is reported. A forty-eight-year-old man, who had been taking alcohol daily for 10 years, was admitted to our hospital because of recurrent attacks of upper abdominal pain. Biochemical analysis demonstrated typical pattern of chronic pancreatitis. US, CT and ERCP showed a markedly dilated pancreatic duct and pancreatic calcifications. Cholecystolithiasis, or dilatation of the choledochus was not noted. Conservative treatment was performed under the diagnosis of chronic calcifying pancreatitis for one month. Then, obstructive jaundice, severe epigastralgia, and high fever occurred. Obstructive jaundice with sudden onset and existence of pancreatic stones suggested incarceration of pancreatic stones in the bile duct, and cephalic pancreaticoduodenectomy was performed. The largest pancreatic stone was incarcerated into the ampulla of papilla Vater. Histopathological analysis of the pancreas showed severe chronic pancreatitis. No report of the similar case can be found in the literature. Incarceration of pancreatic stones into biliary system might be very rare, however, should not be forgotten in differential diagnoses of obstructive jaundice in chronic pancreatitis patients.
Ampulla of Vater↗
[Experimental study on acute ulceration in association with obstructive jaundice--with special reference to the effect of biliary drainage on gastric mucosal blood flow and energy kinetics].
The mechanism of acute ulceration in association with obstructive jaundice was studied experimentally by measurement of gastric mucosal blood flow and energy kinetics. The effect of biliary drainage was also evaluated. Three hundred thirty nine SD male rats weighing about 250 gr were grouped as follows; control group--Sham operation, obstructive jaundice group-2 weeks after ligation and dissection of the choledochus, and biliary drainage group-- A silicone tube was inserted and opened after 2 weeks of obstructive jaundice. All the animals were stressed by water immersion and ulcer index, gastric mucosal blood flow, gastric mucosal energy kinetics and liver function were assessed. The obstructive jaundice group showed significant higher ulcer index and lower gastric mucosal blood flow and energy kinetics than the control group. These factors of the biliary drainage group started to improve soon after biliary drainage and reached to the levels of the control group. In conclusion, reduction of defensive factors caused by jaundice was proved to play an important role in acute ulceration associating obstructive jaundice. Biliary drainage improves both gastric mucosal blood flow and gastric mucosal energy kinetics so that it is preventive against acute ulceration.
Acute Disease↗
[Acute gastric ulcerations in rats with obstructive jaundice--with special reference to gastric mucosal blood flow].
The mechanism of acute gastric ulcerations in rats with obstructive jaundice was investigated in terms of the changes in the gastric mucosal blood flow. Further, the effect of vagotomy with or without obstructive jaundice was examined. One hundred and eighty-eight Sprague-Dawley rats weighing about 250 g were prepared and divided into 4 groups as follows; sham operation (control group), ligation of the bile duct (jaundiced group), vagotomy with pyloroplasty (vagotomized group), ligation of the bile duct and vagotomy with pyloroplasty (jaundiced and vagotomized group). After two weeks, water immersion and restraint stress procedures were performed in these 4 groups. The gravity of the gastric ulcerations was calculated by ulcer index. The gastric mucosal blood flow was measured by hydrogen clearance technique. The following results were obtained. The control group showed increased ulcer index and decreased gastric mucosal blood flow after the stress procedures. The jaundiced group showed significantly higher ulcer index and early, significant decrease of gastric mucosal blood flow compared to the control group after the stress procedures. The vagotomized group showed significantly decreased ulcer index after stress procedures compared to the control group, however, the gastric mucosal blood flow were unchanged between both groups before and after the stress procedures. The jaundiced and vagotomized group showed significant decrease of ulcer index and improvement of decrease of gastric mucosal blood flow compared to the jaundiced group. These data suggested that the significant decrease of gastric mucosal blood flow during the stress procedures was one of exacerbating factors of the acute gastric ulcerations in rats with obstructive jaundice, and vagotomy might prevent them by maintaining the gastric mucosal blood flow in obstructive jaundice.
Acute Disease↗
Obstructive jaundice causes reduced expression of polymorphonuclear leucocyte adhesion molecules and a depressed response to bacterial wall products in vitro.
BACKGROUND: Obstructive jaundice is associated with an increased incidence of infection and endotoxaemia, which may result from impaired host immunity. Neutrophil adhesion to vascular endothelium is a key part of the inflammatory response. AIMS: To investigate neutrophil adhesion molecule expression and activation in obstructive jaundice. PATIENTS: Nine adult patients with obstructive jaundice and 11 control subjects. METHODS: The expression of the neutrophil adhesion receptors L-selectin, CD11a, CD11b, CD11c, and CD15 was determined using flow cytometry. CD11b expression in response to stimulation with fMLP and endotoxin was measured. RESULTS: The basal expression of L-selectin, CD11a, and CD15 was significantly decreased in jaundiced patients (p < 0.05) and the expression of CD11b in response to stimulation with fMLP and endotoxin was significantly impaired in the jaundiced group. Endotoxin stimulation without plasma did not reverse the impaired response showing that it is not caused by endotoxin inactivation by plasma proteins. CONCLUSIONS: Neutrophils from patients with obstructive jaundice show decreased adhesion receptor expression and an impaired response to stimulation with bacterial products. This cellular dysfunction may be responsible for the high incidence of septic complications in these patients.
Aged↗
Endoscopic retrograde cholangiopancreatography in evaluation of choledochal dilatation in patients with obstructive jaundice.
OBJECTIVE: To determine the causes of choledochal dilatation in patients with obstructive jaundice. METHODS: One hundred and sixty-four patients with obstructive jaundice were investigated by endoscopic retrograde cholangiopancreatography(ERCP), and patients with choledochal dilatation (group I, n=110) were compared with those without choledochal dilatation (group II, n=54). RESULTS: The causes of common bile duct dilatation were choledocholith, juxtapapillary duodenal diverticula and congenital dilatation of the common bile duct. The distal common bile duct and its surroundings were abnormal in 104 (94.55%) of the 110 patients and in 13 (24.08%) of the 54 patients (P<0.01). Juxtapapillary duodenal diverticulum accounted for 24.55% in group I, and only in 9.26% in group II (P<0.05). Post-cholecystectomy patients were 13.64% in group I, and only 5.56% in group II. CONCLUSIONS: The abnormalities of the distal common bile duct and its surroundings can usually be detected as underlying causes of common bile duct dilatation. ERCP is necessary before cholecystectomy, since it is considered the "gold standard" for the diagnosis of distal common bile duct abnormalities.
Adult↗
[Nutritional and immunological assessment in patients with malignant obstructive jaundice--the influence of preoperative biliary decompression and abdominal surgery].
A clinical study was undertaken to evaluate the nutritional and immunological status of patients with malignant obstructive jaundice with serum bilirubin level of 5mg/dl or greater (N = 22). Healthy volunteers (N = 9) and patients with cholecystolithiasis (N = 26) were assessed as non-icteric control, as well as patients with obstructive jaundice due to choledocholithiasis (N = 3) were used as icteric control. We also evaluated the time-course of five patients with malignant obstructive jaundice before and after PTCD and surgery. Nutritional status was assessed by prognostic nutritional index (PNI), blood chemistry and rapid turnover protein. Cellular and humoral immunity were assessed by peripheral lymphocyte count, lymphocyte stimulation test, antibody dependent cell-mediated cytotoxicity, and serum immunoglobulins. The following results were obtained. 1) Nutritional and immunological status of patients with malignant obstructive jaundice were severely depressed. 2) Nutritional and immunological status were not improved by preoperative biliary decompression such as PTCD. 3) The immunological indices recovered postoperatively. However, the nutritional indices did not recover by the time of discharge. Intensive nutritional support before and after surgery may be mandatory for patients with malignant obstructive jaundice.
Abdomen↗
Effects of obstructive jaundice on neutrophil production and acquisition of chemotactic activity in the bone marrow.
BACKGROUND AND AIMS: Increased numbers and enhanced functions of peripheral neutrophils have been observed in obstructive jaundice. However, the effects of obstructive jaundice on the bone marrow, that is neutrophil production and acquisition of neutrophil chemotactic activity, have been poorly understood. In the present study, differentials of bone marrow cells and chemotactic activity of bone marrow neutrophils were evaluated in bile duct-obstructed rats. METHODS: Male Wistar rats underwent either bile duct obstruction for 10 days or bile duct obstruction for 4 days followed by 6 days' internal biliary drainage. Differentials of peripheral blood and bone marrow cells were sequentially determined. Chemotactic activity of peripheral and bone marrow neutrophils was evaluated with a modified Boyden method using interleukin-8 (recombinant rat Gro-beta) as a chemoattractant. RESULTS: Numbers of peripheral neutrophils significantly increased after bile duct obstruction. Significant increases in the myeloid/erythroid (M/E) ratio of bone marrow cells were observed after bile duct obstruction. The neutrophil proliferative pool (promyelocytes and myelocytes) increased initially, followed by an increased neutrophil storage pool (metamyelocytes, bands, and segmented neutrophils). The M/E ratio as well as the neutrophil proliferative and storage pools normalized after internal biliary drainage. Chemotactic activity was enhanced in both peripheral and bone marrow neutrophils after bile duct obstruction, and enhanced chemotaxis was alleviated with internal biliary drainage. CONCLUSION: The present results strongly suggest the principal role of the bone marrow in increasing the number of neutrophils and their chemotactic activity during obstructive jaundice.
Animals↗
[Changes of mitochondrial membrane potential (delta psi m) and calcium concentration in cultured glomerular mesangial cells of rats with obstructive jaundice].
OBJECTIVE: To explore the effect of mitochondrial membrane potential (delta psi m) and calcium concentration on the kidney injury of rats with obstructive jaundice and to probe into the underlying mechanism. METHODS: Sixty male Sprague-Dowley rats, weighing 200 g to 250 g were randomly divided into three groups: control group; sham operation group; experiment group. And the rats of experiment group were subdivided into two groups according to the time (15 d, 21 d) after the common bile duct ligation. The experiment groups were rendered jaundiced by doubly ligating the common bile duct. Glomeruli were isolated, the glomerular mesangial cells (GMCs) were cultured. The mitochondrial membrane potential (delta psi m) was measured by flow cytometry; the concentration of calcium was measured by confocal microscopes. RESULTS: The amount of mitochondrial membrane potential (delta psi m) was decreased (P < 0.05) in the rats with obstructive jaundice, compared with the control; the concentration of calcium was increased (P < 0.05) in the rats with obstructive jaundice, compared with the control. Conclusion The calcium incurrent that leads to changes in amount of mitochondrial membrane potential (delta psi m) has significant effect on the kidney injury of the rats with obstructive jaundice.
Animals↗
Short-term effects of external and internal biliary drainage on liver and cellular immunity in experimental obstructive jaundice.
BACKGROUND/PURPOSE: The effects of preoperative biliary drainage for obstructive jaundiced patients are controversial. Although experimental studies have proven the benefit of internal biliary drainage (ID) over external biliary drainage (ED), ID has several clinical problems, such as clogging or tube replacement. The aim of this study was to determine whether there were any differences in T-cell function, liver function, and histology, between rats in ID and ED groups in short-term experiments. METHODS: Following bile duct ligation (BDL) for 14 days, rats in the ED and ID groups had 7 days of ED and 7 days of ID, respectively. Normal rats were used as negative controls (control group). For positive controls, we used a group with BDL and no drainage (BDL group). Serum bilirubin, aspartate aminotransferase (AST), alanine aminotransferase (ALT), and alkaline phosphatase (ALP) were measured, splenic T-cell proliferation was assayed to check cellular immunity, and liver histology was examined. RESULTS: Recovery of bilirubin and ALT was similar in the ED and ID groups. Recovery of AST was worse in the ID group than in the ED group, but the difference was not statistically significant. Levels of ALP in the BDL and ID groups were significantly higher than those in the control and ED groups. Rats in the BDL group showed a significant decrease in T-cell function compared to the control group. The ED group showed better recovery of T-cell function than the ID group in the 7 days after relief of obstructive jaundice. The livers in the ID group demonstrated histologically moderate interface hepatitis with periportal inflammation and lymphocyte infiltration, which strongly suggested incomplete tube obstruction, but those in the ED group showed minimal change. CONCLUSIONS: ED is superior to ID concerning the recovery of cellular immunity and liver inflammation in the short-term after relief from biliary obstruction in this model. As the patency of the tube is well maintained in ED compared to ID, patency of the tube is essential to obtain good recovery of cellular immunity, irrespective of the drainage method.
Alkaline Phosphatase↗
Experimental obstructive jaundice disrupts intestinal mucosal barrier by altering occludin expression: beneficial effect of bombesin and neurotensin.
BACKGROUND: Little is known of the molecular events leading to increased intestinal permeability in obstructive jaundice. This study was undertaken to investigate the influence of experimental obstructive jaundice on the expression of the tight junction-associated protein occludin in the intestinal epithelium. STUDY DESIGN: Seventy male Wistar rats were randomly divided into five groups: I, controls; II, sham-operated; III, bile duct ligation (BDL); IV, BDL+Bombesin (BBS) (30 microg/kg/d); and V, BDL+Neurotensin (NT) (300 microg/kg/d). At the end of the experiment, on day 10, endotoxin was measured in portal and aortic blood. Tissue sections of the terminal ileum were examined histologically and immunohistochemically for evaluation of occludin expression in the intestinal epithelium. Lipid peroxidation and protein oxidation were determined on tissue homogenates from terminal ileum and microbiologic analysis was performed in cecal contents. RESULTS: Obstructive jaundice resulted in portal and aortic endotoxemia, which was significantly reduced after BBS or NT administration. In the BDL group, there was total loss of occludin expression in numerous enterocytes mainly at the upper third of the villi, while a gradient of positivity existed from crypt to tip. Occludin expression was restored to control state after treatment with BBS or NT. In addition, both peptides reduced intestinal lipid peroxidation, while BBS reduced protein oxidation as well. CONCLUSIONS: Experimental obstructive jaundice induces regional loss of occludin expression in the intestinal epithelium, which may be a key factor contributing to the disruption of the mucosal barrier. Gut regulatory peptides BBS and NT prevent this alteration, leading to lower portal and systemic endotoxemia.
Animals↗
The significance of serum mitochondrial aspartate aminotransferase activity in obstructive jaundice: experimental and clinical studies.
The serum level of mitochondrial aspartate aminotransferase was determined in experimental and clinical obstructive jaundice, using an immunoabsorbance method which allowed the differential determination of cytosolic and mitochondrial isozymes in the serum. In experimental obstructive jaundice using dogs, the serum mitochondrial aspartate aminotransferase value rapidly decreased to normal after biliary decompression following a period of biliary obstruction of within 3 weeks. On the other hand, when the period of jaundice was prolonged for 5 weeks, the activity of the enzyme after biliary drainage still continued to show high values, being 14.2 +/- 1.8 Karmen units at 4 weeks following biliary decompression. Determination of aspartate aminotransferase activity in tissue from such organs as the liver, heart, kidney, skeletal muscle and brain, as well as serum samples withdrawn from local veins, confirmed that high serum values of the enzyme in experimental obstructive jaundice were mostly attributable to hepatic impairment induced by biliary obstruction not by secondarily damaged tissues of other organs. Mitochondrial aspartate aminotransferase proved to be a more useful marker than other routine tests in icteric dogs. In 13 clinical patients with obstructive jaundice, decreasing rates of serum mitochondrial aspartate aminotransferase on the 7th and 14th postoperative days could be applied to evaluate the viability of the icteric liver. The decreasing rates were more advantageous than the preoperative activity itself in predicting the postoperative function of the liver. Thus, mitochondrial aspartate aminotransferase appears to serve as a useful marker for assessing the liver function in obstructive jaundice.
Adolescent↗
Expression of intercellular adhesion molecule-1 (ICAM-1) during hypoxia-reoxygenation by sinusoidal endothelial cells (SECs) in an obstructive jaundice model.
BACKGROUND/PURPOSE: The aim of the present study was to investigate the expression of intercellular adhesion molecule-1 (ICAM-1) by sinusoidal endothelial cells (SECs) during hypoxia-reoxygenation in an obstructive jaundice model. METHODS: Male Wistar rats aged 6 to 8 weeks were assigned to an obstructive jaundice group (group OJ; n = 8) and a sham-operated control group (group S; n = 8). Using flow cytometry, we determined the percentage of ICAM-1-positive cells and the mean fluorescence intensity (MFI) of ICAM-1 per cell in each group during hypoxia-reoxygenation. RESULTS: The percentage of ICAM-1-positive cells in group OJ did not change significantly under successive incubation conditions. However, the MFI in group OJ differed significantly between normoxia and 24-h renormoxia. The present study investigated the function of isolated SECs from rats with obstructive jaundice and hypoxia-reoxygenation. The percentage of ICAM-1-positive cells and the MFI of ICAM-1-positive cells showed quite similar changes caused by hypoxia-reoxygenation stress in group S and Group OJ. The ICAM-1 expression increased with hypoxia-reoxygenation in both normal and OJ SECs, and the amount of ICAM-1, on the whole, increased. Obstructive jaundice increased the percentage of ICAM-1-positive cells from the normal state. CONCLUSIONS: The amount of ICAM-1 increased with hypoxia-reoxygenation in obstructive jaundice than normal state.
Animals↗
Obstructive jaundice, an unusual initial manifestation of intraabdominal non-Hodgkin's lymphoma in children: complications of percutaneous transhepatic cholangial drainage.
Obstructive jaundice is an unusual initial manifestation of non-Hodgkin's lymphoma in children. Two pediatric patients with primary intraabdominal non-Hodgkin's lymphoma causing obstructive jaundice are presented. Although percutaneous transhepatic cholangial drainage (PTCD) is frequently used to treat obstructive jaundice, there was no definite rule for management of PTCD during chemotherapy, which may rapidly resolve the obstruction. Biliary peritonitis occurred in both patients soon after removal of the PTCD tube after chemotherapy. It was speculated that secure formation of the fistula for PTCD was impaired because of chemotherapy for a considerably long period. The PTCD tube that was already placed for obstructive jaundice in a non-Hodgkin's lymphoma patient should be maintained during chemotherapy with great care for displacement of the tube. PTCD can result in complications, and is probably unnecessary when lymphoma has been diagnosed before PTCD.
Abdominal Neoplasms↗
Phenylalanine breath test as a method to evaluate hepatic dysfunction in obstructive jaundice.
BACKGROUND: The purpose of this study was to investigate whether the hepatic dysfunction associated with obstructive jaundice can be measured from changes in expiratory 13CO2 levels after intravenous administration of l-[1-(13)C]phenylalanine, using a rat model of obstructive jaundice. MATERIALS AND METHODS: Under pentobarbital anesthesia, bile duct ligation (BDL) was performed (n=12). In the control group, simple laparotomy was performed (n=12). On postoperative day 7, 20 mg/kg l-[1-(13)C]phenylalanine was administered via the femoral vein. Phenylalanine breath test (PBT) was performed for 30 min. We compared single point of 13CO2 level (SPT: T: min) and sum of 13CO2 output (ST) values between BDL and control rats. We examined the correlation of SPT or ST with phenylalanine hydroxylase activity (PHA) and blood chemical parameters. RESULTS: Both SPT and ST values decreased in BDL compared to control 3 min after the start of PBT (SP10; 103+/-12 (per thousand) versus 84+/-16 (per thousand) P=0.025). PHA/g liver in BDL was significantly decreased compared to control (40.81+/-4.80 (U) versus 28.93+/-9.60 (U) P=0.008). PHA/g liver was correlated with SPT with correlation coefficient of more than 0.715, 10 min after the start of PBT, and the maximum correlation was at SP20 (r=0.801). Blood chemical parameters were correlated with S15 (total bilirubin, r=-0.717; alkaline phosphatase, r=-0.841; gamma-glutamyl transpeptidase, r=-0.759; alanine aminotransferase, r=-0.776; albumin, r=0.819). CONCLUSIONS: In the breath test with intravenously l-[1-(13)C]phenylalanine, hepatic dysfunction associated with obstructive jaundice could be measured in a short period.
Animals↗