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Results for “Jaundice, Obstructive”

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PubMed1997

Immune dysfunction in patients with obstructive jaundice, mediators and implications for treatments.

Patients with obstructive jaundice have an increased perioperative complication rate. Sepsis, bleeding, wound problems, renal and liver malfunction are all seen in these patients. Assessment of immune function has been an active research area in these patients. This review will examine various aspects of immune functions in obstructive jaundice, discuss the recent research results and controversies and then go on to discuss the relevant mediators of immune function and some possible implications for treatment.

Animals↗

PubMed1989

Congenital foramen of Bochdalek's hernia in an infant with obstructive jaundice.

A case of infantile obstructive jaundice caused by a right-sided foramen of Bochdalek's diaphragmatic hernia is reported. This association has not previously been reported in an infant. At operation, extrahepatic biliary obstruction was relieved by reduction of the contents of the hernia. This unusual presentation of a right-sided congenital diaphragmatic hernia underscores the usual diagnostic delay seen with such lesions.

Cholestasis, Extrahepatic↗

PubMed1994

Dynamic aspects of glutathione metabolism in obstructive jaundice.

The dynamic aspects of glutathione metabolism during obstructive jaundice were analyzed in rats. Plasma bilirubin levels increased after ligation of the bile duct, with a concomitant increase in hepatorenal glutathione levels. When the bile duct was recanalized, plasma bilirubin levels rapidly decreased, with a concomitant decrease in hepatorenal glutathione levels. The half-life of hepatic glutathione turnover increased markedly after bile duct obstruction, returning to normal after recanalization of the bile duct. Intravenous administration of a loading dose of bilirubin inhibited the biliary secretion of glutathione in a dose-dependent manner. On the other hand, renal glutathione efflux increased markedly after bile duct obstruction. These observations suggest that glutathione status is significantly affected in obstructive jaundice, predominantly due to the inhibition of hepatic secretion by increased bilirubin.

Animals↗

PubMed1990

Diagnosis of atretic prolonged obstructive jaundice; technetium 99m hepatolite excretion study.

Since 1982 we have developed a diagnostic method for differentiation between atretic prolonged obstructive jaundice (biliary atresia) and nonatretic prolonged obstructive jaundice in a neonate. The first report was presented at the Fukuoka Meeting in 1983. Analysis of duodenal juice (excretion test of intravenous injected hepatolite into the duodenum) has proved to be extremely reliable to differentiate biliary atresia from nonatretic prolonged obstructive jaundice. The major diagnostic features of the study are (1) biliary tract to bowel transit of radiotracer, and (2) observation on color of duodenal juice. Diagnostic accuracy was 98.4%. It is time-saving, requiring only 6 hours, noninvasive, and simple.

Bile Acids and Salts↗

PubMed1997

[Alpha-glucosidase and alanine-amino-peptidase in the early diagnosis of renal failure in obstructive jaundice].

Renal failure is a serious complication of obstructive jaundice. Early diagnosis and prevention of spontaneous evolution of the disease can improve prognosis, otherwise very poor in many cases. The Authors, on the basis of experimental researches from literature, expose their clinical experience about the validity of the determination of Alpha-Glucosidase and Alanine-Amino-Peptidase for early diagnosis and differentiation between organic or functional forms of renal failure. They conclude that determination of urinary levels of AGS and AAP is a valid aid for the evaluation of renal function in patients with obstructive jaundice.

Adult↗

PubMed1999

Preoperative assessment of body fluid disturbances in patients with obstructive jaundice.

Postoperative renal dysfunction in obstructive jaundice (OJ) patients has been associated with hypovolemia and depletion of the extracellular water compartment (ECW). The aim of the study was to evaluate the preoperative status of body compartments in OJ patients measured by two methods. In a prospective study 39 OJ patients (11 benign and 28 malignant obstructions) were investigated, with 15 healthy subjects used as a control group (CG). Bioelectrical impedance analysis (BIA) determinations and values derived from anthropometric measurements were used to assess body compartment status. The coefficient of variation of BIA was below 4% in both OJ and CG subjects. No differences were found in intracellular water. However total body water (TBW) and ECW were reduced in OJ patients (50.5 +/- 4.6 vs. 56 +/- 8% body weight, p = 0.05; and 21 +/- 4.5 vs. 23.8 +/- 2.5% body weight, p < 0.05, respectively). There were no differences between benign and malignant obstructions. Seventy four percent of OJ patients had an ECW volume below the mean +/- 2 SD in the CG subjects. Anthropometric and BIA determinations correlated closely for TBW measurements in both CG (r = 0.92, p < 0.001) and OJ patients (r = 0.91, p < 0.001). Bland-Altman analysis also showed that for TBW the BIA was in agreement with anthropometry. In the present study, BIA offered a good correlation with anthropometric determinations and was a reliable method for body fluid disturbances assessment in jaundiced patients.

Adipose Tissue↗

PubMed1990

[Pilot study of a stent made of a shape memorizing alloy used for obstructive jaundice].

To learn about endoprosthetic stents used for obstructive jaundice, we examined the pathohistologic effects of stents on bile ducts using 35 adult mongrel dogs. Small histological changes of the epithelium were observed under a microscope for materials having a shape-memorizing alloy with gold plating. Our stent contain NiTi, which restored the memorized shape and size at 40-42 degrees C. The initial outer diameter of stent was 3 mm. After memory restoration, the diameter expanded 5 mm in diameter. An alloy was 0.3-0.5 mm phi in diameter. In this paper, we introduced our insertion devices and display those of cases where stents were used for endoprosthesis in obstructive jaundice.

Animals↗

PubMed1998

Polyethylene glycol-modified bilirubin oxidase improves hepatic energy charge and urinary prostaglandin levels in rats with obstructive jaundice.

BACKGROUNDS/AIMS: No study has so far been conducted to clarify whether the presence of hyperbilirubinemia is detrimental to liver and renal functions. In the present study, the effects of polyethylene glycol-modified bilirubin oxidase (PEG-BOX) therapy on liver and renal function tests, hepatic energy charge and urinary prostaglandin levels were evaluated in a rat model of obstructive jaundice. METHODS: Sprague-Dawley rats were used in the experimental model of obstructive jaundice. PEG-BOX or an equivalent amount of PEG alone was intravenously injected into the animals and sampling of blood and urine, and liver harvesting were done sequentially after bile duct ligation. RESULTS: Conventional liver function tests showed no difference between PEG-BOX and control groups. However, bilirubin concentrations in the peripheral blood and liver tissue specimens markedly decreased, and the hepatic energy charge significantly increased in the PEG-BOX group as compared to controls. The blood concentration of bile acid was lower, but its urinary excretion was higher in the PEG-BOX group than in the control group. In vitro incubation of PEG-BOX with serum from rats with obstructive jaundice decreased the concentration of bilirubin but not that of bile acid. The urinary levels of prostaglandin E2 and the thromboxane B2/6-keto-prostaglandin Fla ratio were significantly lower in the PEG-BOX group than in the control group. CONCLUSIONS: The systemic reduction of bilirubin concentration may contribute to normalization of the urinary levels of prostaglandins and thromboxane B2, to decrease in serum bile acid levels, and to improvement of the hepatic energy charge in obstructive jaundice. These findings suggest that preoperative improvement of jaundice may be beneficial to patients with obstructive jaundice.

Animals↗

PubMed1997

The effects of ursodeoxycholic acid in patients with severe obstructive jaundice after drainage procedure.

BACKGROUND: The aim of this study is to evaluate the therapeutic effect of ursodeoxycholic acid (UDCA) for patients with severe obstructive jaundice after drainage procedure. METHODS: From September 1993 to December 1994, patients admitted with severe obstructive jaundice (serum bilirubin > 15 mg/dl) and successful drainage were enrolled into our study. They were randomly divided into two groups to receive UDCA 600 mg per day (UDCA group) or a placebo (placebo group) until operation or discharge. Bile drainage amount, clinical symptoms and signs and adverse effects of drugs were recorded daily. Biochemical tests, including albumin, total bilirubin, cholesterol, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase and prothrombin time, were checked first, on the third and seventh days, and then two weeks after drainage. RESULTS: Thirty-eight patients (M/F = 36/ 2, mean age 66.6 +/- 6.4 years) completed the study, 18 in the UDCA group and 20 in the placebo group. There were no differences in age, sex, causes of obstructive jaundice or methods of drainage procedure between the UDCA and placebo groups. Improvement in biochemical test results were noted in both groups. However, bile drainage amount and changes in liver biochemical test, especially the decrement of serum bilirubin, were not significantly different between both groups. CONCLUSIONS: UDCA seemed not to benefit patients with severe obstructive jaundice after successful drainage.

Aged↗

PubMed1958