Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0153418 (Pylorus)
 119 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We report a 69-year-old man with double cancers in the common bile duct. One cancer was located between the superior and middle parts of the bile duct, while the other cancer was in the inferior part of the bile duct. Pylorus-preserving pancreatoduodenectomy was performed. There was no communication between the two cancers in either the mucosal layer or the subepithelial layer. On pathological examination, the upper cancer was diagnosed as poorly differentiated adenocarcinoma, while the lower one was found to be moderately differentiated adenocarcinoma. We analyzed loss of heterozygosity (LOH), using microsatellite markers on five chromosomal arms, in both the upper and the lower cancers. Both cancers showed common regions of LOH at 5q, 6q, 9p, 17p, and 18q, whereas the upper cancer showed one additional region of LOH at 8p, thus suggesting progression, due to the acquisition of the additional LOH, in the upper cancer. No LOH was observed in the region between the two cancers. The presence of one additional LOH in the upper cancer suggests that the upper cancer was a metastasis of the lower one.
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PMID:Double cancers in the common bile duct: molecular genetic findings with an analysis of LOH. 1152 Nov 84

We encountered a rare variant of carcinoma of the ampulla of Vater in a 68-year-old man with postprandial abdominal pain and nausea. Ultrasonography and computed tomography showed a dilated common bile duct and main pancreatic duct. At duodenoscopy, the papilla of Vater was enlarged, and biopsy specimens taken from the papilla revealed signet-ring-cell carcinoma. Endoscopic ultrasonography showed a hypoechoic tumor without pancreatic invasion. Pylorus-preserving pancreatoduodenectomy was performed. Histologic examination of resected specimens indicated lymphatic and vascular invasion, but surgical margins were tumor-free. The patient is alive and disease-free 10 months after the operation.
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PMID:Signet-ring-cell carcinoma of the ampulla of Vater: a case report. 1199 97

Causes of unsatisfactory outcomes of pylorus preserving stomach resection are analyzed, method of prophylaxis and surgical correction is proposed. Pylorus preserving stomach resection was performed in 207 patients with chronic gastric ulcer. 2 groups of patients were compared: 166 patients who have undergone pylorus preserving stomach resection by Maky--Gorobashko (group 1); 41 patients operated according to an original method of suprapyloric stomach resection with preserving of distal Latarget nerves on serous-muscular flap formed from lesser curvature of the stomach (group 2). Of 122 examined patients of group 1 excellent and good long-term results according to Visick's criteria were achieved in 101 (82.79%), satisfactory--in 12 (9.84%), unsatisfactory--in 9 (7.37%). Bad stump evacuation due to a stable spasm of the denervated pylorus and hypokinesia of the stump were the main causes of unsatisfactory results. In group 2-39 of 41 patients were examined in long-term period. Excellent and good results were achieved in 38 patients, satisfactory--in 1. There were no unsatisfactory results.
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PMID:[Treatment of complications of pylorus preserving stomach resection]. 1200 82

Nerve fibres play an important role in the regulation of gastric emptying. The aims of this study were to clarify the distribution, projections and origin of neuronal type nitric oxide synthase (NOS)-, tyrosine hydroxylase (TH)-, vesicular acetylcholine transporter (VAchT)- and peptide-containing nerve fibres of the rat pyloric sphincter. Extrinsic and local denervations of the sphincter were performed in order to reveal the origin and projections of the various nerve fibre populations. Pylorus from control and denervated animals were processed for the immunocytochemical demonstration of cholecystokinin (CCK), enkephalin, gastrin-releasing peptide (GRP), somatostatin, calcitonin gene-related peptide (CGRP), neuropeptide Y (NPY), pituitary adenylate cyclase-activating peptide (PACAP), substance P (SP), vasoactive intestinal peptide (VIP), galanin, NOS, VAchT and TH. VAchT, TH, nNOS, and all of the peptides investigated were found in nerve fibres innervating the pyloric sphincter, and coexistence of several putative neurotransmitters were revealed. Extrinsic denervation caused a total loss of NPY/TH-, SP/CGRP- and SP/CGRP/VIP/NOS/PACAP-containing nerve fibres. Local denervation immediately proximal to the sphincter markedly reduced the numbers of VIP/NOS/galanin- and VIP/NOS/galanin/PACAP +/- NPY-containing fibres within the sphincter suggesting an origin of these fibres in myenteric ganglia in the antral region; denervation at the level of the oxyntic-pyloric border had no effect. Local denervation immediately distal to the sphincter caused a marked decrease in VAchT-, SP/enkephalin-, enkephalin-, somatostatin-, CCK- and GRP-containing fibres within the sphincter suggesting that these emanate from the duodenum. The latter procedure also reduced the number of SP/CGRP-containing fibres of extrinsic origin within the pyloric sphincter.
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PMID:Origins and projections of nerve fibres in rat pyloric sphincter. 1213 47

Pylorus-preserving pancreatoduodenectomy (PPPD) was reintroduced in 1978. This pylorus-preserving modification was designed to minimize complications related to gastric resection, such as early satiety, marginal ulceration, and bile reflux gastritis, as well as diarrhea and dumping. Since 1978, PPPD has been performed preferentially for benign and malignant diseases of the periampullary region and pancreatic head. Some groups have argued against PPPD for cancer of the pancreatic head, because the pylorus-preserving procedure is likely to compromise the field of resection and does not allow lymph node dissection of the peripyloric and perigastric groups. However, comparative survival rates after PPPD have been the same as, or better than, those with classic pancreatoduodenectomy, showing the rationale for PPPD as a radical resection procedure for cancer of the pancreatic head. PPPD can be performed with low mortality. Delayed gastric emptying, which is the most common complication in the immediate postoperative period after PPPD, is always transient. Many investigators have shown that body weight and the majority of nutritional parameters are better than after PD. PPPD does not appear to cause any negative outcomes. We conclude that PPPD is the surgical procedure of choice for cancer of the head of the pancreas.
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PMID:The impact of pylorus-preserving pancreatoduodenectomy on surgical treatment for cancer of the pancreatic head. 1214 Jun 11

The anti-ulcerogenic potential of the leaf methanol extract of Ocimum suave (Lamiaceae) was investigated using four methods of gastric lesion induction in experimental Wistar rats (150-200 g): (1) HCl/ethanol-induced gastric lesions, (2) Absolute ethanol-induced gastric lesions, (3) Indomethacin-HCl/ethanol-induced gastric lesions, (4) Pylorus ligation-induced gastric lesions. Administration of the extract of O. suave to the rats by oral route (75-500 mg/kg) dose-dependently prevented the formation of acute gastric lesions induced using the four experimental techniques. The dose-dependent reduction of lesion formation was in all cases accompanied by significant increases in gastric mucus production. At the dose of 250 mg/kg there was complete inhibition of gastric lesions induced using the HCl/ethanol solution. Pre-treatment, by intraperitoneal route, with indomethacin significantly reduced the ability of the extract to inhibit the formation of HCl/ethanol-induced lesions. When the rats were subjected to pylorus ligation, the dose of 500 mg/kg completely inhibited lesion formation but did not have any effect on gastric acid secretion compared with the controls. The mucus secretion promoting effect of the extract was most significant when the gastric environment was highly acidic. These results suggest that a new anti-ulcer therapy regimen may be formulated which does not require the use of antacids and anti-secretory agents.
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PMID:Gastric cytoprotective anti-ulcer effects of the leaf methanol extract of Ocimum suave (Lamiaceae) in rats. 1224 79

A 49-year-old man was admitted to Hospital of Kyoto Prefectural University of Medicine complaining of epigastralgia and jaundice. There was a tumor (approximately 30 mm) in the pancreatic head on ultrasound, computed tomography and magnetic resonance imaging. Endoscopic retrograde cholangiopancreatography revealed a stenosis of the main pancreatic duct in the head of the pancreas. Pancreatoscopy with the peroral electronic pancreatoscope (PEPS) was performed to differentiate between pseudotumorous pancreatitis (PTP) and pancreatic carcinoma. The PEPS showed non-erosive erythematous mucosa around the stenosis and this unique finding was different from that of pancreatic carcinoma. Pylorus-preserving pancreatoduodenectomy was performed under the possible diagnosis of carcinoma. As a result, the diagnosis of PTP was confirmed histopathologically. At present, the diagnosis of PTP is difficult because of similar findings with carcinoma in various imaging procedures. However, we consider that detailed observation and accurate morphologic assessment of the main pancreatic duct with the PEPS has the possibility of differentiating PTP from pancreatic carcinoma.
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PMID:A case of pseudotumorous pancreatitis that presented unique pancreatoscopic findings with the peroral electronic pancreatoscope. 1251 34

Pylorus-preserving distal gastrectomy (PPG) has frequently been performed on patients with early gastric cancer in Japan to prevent the postgastrectomy syndrome seen after conventional distal gastrectomy (CDG). The long-term postoperative quality of life (QOL) and gastric emptying function in patients after PPG has not been assessed in detail. To clarify the usefulness of PPG for treating early gastric cancer we investigated the relation between postgastrectomy syndrome and gastric emptying function 5 years after PPG and then compared the results with those 5 years after CDG. Altogether, 32 patients who underwent curative gastrectomy at our clinic for early gastric cancer (submucosal cancer without lymph node metastasis) were studied. Ten subjects who underwent PPG with D2 lymphadenectomy without preserving the hepatic and pyloric branches of the vagal nerve [group A: eight men, two women; age 33-70 years (mean 60.7 years)] were interviewed and asked about appetite, weight loss, epigastric fullness, reflux esophagitis, and early dumping syndrome. They were compared with patients after CDG [group B: 36-72 years (mean 63.6 years)]. Esophagogastric endoscopy, abdominal ultrasonography, and gastric emptying function were also studied. The gastric emptying time of a semisolid diet was measured with a radioisotope method using (99m)Tc-labeled rice gruel; the gastric emptying time of a liquid diet was measured with the acetaminophen method using orange juice. The control subjects (group C) consisted of 18 healthy volunteers (10 men, 8 women) without gastrointestinal symptoms aged 38 to 68 years (mean 60.8 years). The following results were obtained: PPG (group A) alleviated postoperative gastrointestinal symptoms such as appetite loss, reflux esophagitis, early dumping syndrome, lost body weight, endoscopic reflux esophagitis, endoscopic gastritis in the remnant stomach, and postogastrectomy cholecystolithiasis better than did CDG (group B). The only weak point with the PPG procedure was that it produced a feeling of epigastric fullness. The pattern of the gastric emptying curve for the semisolid diet was almost the same among groups A, B, and C, although delayed gastric emptying was clearly more frequent in group A than in group B or C ( p < 0.05). Gastric emptying with the liquid diet in group B was significantly faster than that in groups A and C ( p < 0.01). Gastric emptying in groups A and C was similar. These results showed that PPG improved the postoperative QOL, but the delayed emptying of semisolid diet after PPG led to a feeling of epigastric fullness after meals due to retention of contents in the residual stomach. Epigastric fullness after meals continued in many patients after PPG. Thus the only disadvantage of the PPG procedure is the sensation of epigastric fullness and gastric stasis due to delayed gastric emptying of a semisolid diet.
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PMID:Pathophysiological studies on the relationship between postgastrectomy syndrome and gastric emptying function at 5 years after pylorus-preserving distal gastrectomy for early gastric cancer. 1273 83

Immediate results of 151 pancreatoduodenal resections (PDR) were analyzed. This surgery was performed for tumors of gastropancreatoduodenal region in 88.1% patients, for chronic complicated pancreatitis--in 11.9%. Pylorus-saving PDR was performed in 82.8% patients, in combination with stomach resection--in 17.2%. Extended and regional pancreatectomy was performed in 20.3% patients with tumors of periampullar zone, extended lymphadenectomy--in 44.4%. Pancreatoenteroanastomosis was created in 82.8% patients, end-loop Wirsungenteroanastomosis by original author's method--in 52.3% of them, traditional Wirsungenteroanastomosis end-to-side--in 30.5%, complete external drainage of pancreas stump was performed in 13.9%, suturing of pancreas stump--in 2.6%, pancreatogastroanastomosis was created in 1 (0.7%) patient. There was no insufficiency of pancreatoduodenoanastomosis performed with original method, while in traditional Wirsungenteroanastomosis it was seen in 4.4% patients. End-loop anastomosis permitted to reduce number of complications after PDR 1.6--3 times. General lethality was 11.3%, in end-loop anastomosis--3.8% that significantly lower than after other methods of treatment of pancreas stump.
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PMID:[Immediate results of pancreatoduodenal resection with end-loop pancreatoenteroanastomosis]. 1279 57

A combination of duodenal telangiectasia with factor X deficiency presenting as recurrent malaena is rarely reported. Pylorus preserving pancreaticoduodenectomy done under cover of prothrombin complex resulted in complete recovery. Histopathology was consistent with angiomatosis. It is suggested that in managing a case of upper gastrointestinal bleeding, besides establishing the source of bleeding, it is important to detect underlying coagulopathy.
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PMID:Angiodysplasia of upper gastrointestinal tract with coagulopathy. 1470 Apr 96


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