The Experts below are selected from a list of 1437 Experts worldwide ranked by ideXlab platform
G P Van Bergehenegouwen - One of the best experts on this subject based on the ideXlab platform.
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apolipoprotein e4 genotype and gallbladder motility influence speed of gallStone clearance and risk of recurrence after extracorporeal shock wave lithotripsy
Hepatology, 1996Co-Authors: Piero Portincasa, K J Van Erpecum, P C Van De Meeberg, Geesje M Dallingathie, T W A De Bruin, G P Van BergehenegouwenAbstract:Abstract Extracorporeal shock-wave lithotripsy (ESWL) is an effective treatment in selected gallStone patients, but Stone recurrence is a major drawback. Factors potentially influencing gallStone clearance and recurrence were studied in 84 patients in whom Stone Dissolution was diagnosed after ESWL plus bile salt therapy for initial solitary (n = 55) or multiple (n = 29) radiolucent Stones. Apolipoprotein E (apoE) genotyping and gallbladder motility (sonography) were studied in a representative subgroup of patients (n = 50). The median follow-up after ESWL was 36 months (range, 4.5-67 months). GallStone clearance was achieved after 8.7 months (range, 0.2-30 months). Independent factors significantly enhancing gallStone clearance were the presence of E4 allele; small initial gallStone size and number; effectiveness of fragmentation; and good gallbladder emptying (P = .002). GallStone recurrence was seen in 30 patients after 18.6 months (range, 1.0-50 months). Cumulative gallStone recurrence rate (life-table analysis) was 15% within 1 year, increasing to 60% within 5.5 years. Although the probability of gallStone recurrence tended to be smaller in patients with initial solitary Stones than in those with multiple Stones during early follow-up, differences disappeared after long-term follow-up. Effective gallbladder emptying (residual volume
G. N. J. Tytgat - One of the best experts on this subject based on the ideXlab platform.
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Addition of dimethylsulphoxide to methyl-tert-butyl ether and ethyl propionate increases cholesterol dissolving capacity and cholesterol gall Stone Dissolution in vitro.
Gut, 1994Co-Authors: Jacques J. Bergman, Albert K. Groen, Kees Huibregtse, G. N. J. TytgatAbstract:There is a discrepancy between in vitro cholesterol dissolving efficacy of methyl-tert-butyl ether (MTBE) and ethyl propionate and cholesterol gall Stone Dissolution in vivo. This study investigated whether the presence of bile changes the cholesterol dissolving capacity of MTBE and ethyl propionate. The addition of dimethylsulphoxide to MTBE or ethyl propionate was also studied to discover if it improves the dissolving capacity for cholesterol gall Stones. The presence of bile caused a 25% decrease in cholesterol dissolving capacity of both MTBE and ethyl propionate (p
Piero Portincasa - One of the best experts on this subject based on the ideXlab platform.
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apolipoprotein e4 genotype and gallbladder motility influence speed of gallStone clearance and risk of recurrence after extracorporeal shock wave lithotripsy
Hepatology, 1996Co-Authors: Piero Portincasa, K J Van Erpecum, P C Van De Meeberg, Geesje M Dallingathie, T W A De Bruin, G P Van BergehenegouwenAbstract:Abstract Extracorporeal shock-wave lithotripsy (ESWL) is an effective treatment in selected gallStone patients, but Stone recurrence is a major drawback. Factors potentially influencing gallStone clearance and recurrence were studied in 84 patients in whom Stone Dissolution was diagnosed after ESWL plus bile salt therapy for initial solitary (n = 55) or multiple (n = 29) radiolucent Stones. Apolipoprotein E (apoE) genotyping and gallbladder motility (sonography) were studied in a representative subgroup of patients (n = 50). The median follow-up after ESWL was 36 months (range, 4.5-67 months). GallStone clearance was achieved after 8.7 months (range, 0.2-30 months). Independent factors significantly enhancing gallStone clearance were the presence of E4 allele; small initial gallStone size and number; effectiveness of fragmentation; and good gallbladder emptying (P = .002). GallStone recurrence was seen in 30 patients after 18.6 months (range, 1.0-50 months). Cumulative gallStone recurrence rate (life-table analysis) was 15% within 1 year, increasing to 60% within 5.5 years. Although the probability of gallStone recurrence tended to be smaller in patients with initial solitary Stones than in those with multiple Stones during early follow-up, differences disappeared after long-term follow-up. Effective gallbladder emptying (residual volume
Xing Peng Wang - One of the best experts on this subject based on the ideXlab platform.
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safety and efficacy of a novel plastic stent coated with Stone dissolving agents for the treatment of biliary Stones in a porcine model
Endoscopy, 2014Co-Authors: Xiao Bo Cai, Wei Xing Zhang, Qin Yang, Xing Peng Wang, Ru Ling Zhang, Xiao Dong Yuan, Yue Qin Qian, Xin Jian WanAbstract:Background and study aim: We previously reported on a plastic stent that was coated with ethylenediaminetetraacetic acid (EDTA) and sodium cholate, which dissolved common bile duct (CBD) Stones ex vivo. The aim of this study was to investigate the safety and efficacy of such stents on biliary Stones in a live porcine model. Methods: Stents without coating or with degradable membranes containing 0 % or 50 % EDTA and sodium cholate were inserted together with human CBD Stones into the porcine CBD. Serum laboratory variables, histological examinations of the bile duct, and the weight change in Stones were compared during and after stent placement for 6 months. Results: A total of 16 pigs were included (5 no coating, 5 0 % coating, 6 50 % coating). Biliary Stones showed decreased weight in all groups; however, Stones in the group with 50 % coated stents showed a greater reduction in weight compared with the no coating and the 0 % coating groups (269 ± 66 mg vs. 179 ± 51 mg [ P = 0.09]; 269 ± 66 mg vs. 156 ± 26 mg [ P = 0.01], respectively). Conclusions: The plastic stent coated with 50 % agent enhanced CBD Stone Dissolution in vivo and may be a promising tool for patients with difficult biliary Stones.
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the effect of a novel drug eluting plastic stent on biliary Stone Dissolution in an ex vivo bile perfusion model
Gastrointestinal Endoscopy, 2014Co-Authors: Xiao Bo Cai, Wei Xing Zhang, Xin Jian Wan, Qin Yang, Xing Peng WangAbstract:Background Temporary plastic stent insertion has been considered a safe and effective bridge therapy for difficult common bile duct (CBD) Stones. Infusing chemicals to directly dissolve Stones through the bile duct might also be effective. However, there are no studies on the efficacy of the combination of these 2 approaches. Objective To investigate the efficacy of a novel ethylenediaminetetraacetic acid (EDTA) and sodium cholate–eluting plastic stent on biliary Stones. Design Ex vivo model by using different doses of active ingredient. Setting and Interventions An ex vivo bile duct model perfused with porcine bile was created. Stents coated with degradable membranes containing various concentrations of EDTA and sodium cholate were placed in the model with CBD Stones. Main Outcome Measurements The change in the weight of stents and Stones was measured every week during perfusion until the coated membranes were completely biodegraded. Results The time that the stents required to be fully degraded and the efficiency of Stone Dissolution were positively correlated with the percentage of EDTA and sodium cholate in the stent membrane. However, the 50% EDTA and sodium cholate stents achieved the greatest percentage of Stone weight loss when the drugs were completely released. Limitations Ex vivo study. Conclusions The EDTA and sodium cholate–eluting plastic stent effectively dissolved CBD Stones and has prospect in the therapy for patients with difficult CBD Stones.
R H Dowling - One of the best experts on this subject based on the ideXlab platform.
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gall Stone recurrence and its prevention the british belgian gall Stone study group s post Dissolution trial
Gut, 1993Co-Authors: K A Hood, Dermot Gleeson, D C Ruppin, R H DowlingAbstract:The British/Belgian Gall Stone Study Group (BBGSG) post-Dissolution trial was a prospective, multicentre, randomised, double blind trial of: (i) low dose ursodeoxycholic acid, (ii) placebo, and (iii) a high fibre, low refined carbohydrate diet in the prevention of gall Stone recurrence in patients with complete gall Stone Dissolution. Further aims included establishing the timing and frequency of recurrence and its association with biliary symptoms, a comparison of the sensitivity of ultrasonography v oral cholecystectography in detecting recurrent Stones, and a search for risk factors predicting recurrence. Ninety three patients entered the study, and 82 were followed up for up to five years (mean (SEM) 28 (1.5) months) with six monthly ultrasonography and yearly oral cholecystectography. There were 21 recurrences (26 by oral cholecystectography or ultrasonography, or both), only two of which were symptomatic, which were detected between 12 and 42 months after trial entry. This corresponded to an actuarial recurrence rate of 33.9 (7.0%) by lifetable analysis at 42 months and subsequently. There were four recurrences in the ursodeoxycholic acid, six in the placebo, and 11 in the diet groups, corresponding to 21.9 (9.9)%, 27.4 (10.1)%, and 45.8 (12.4)% respectively at 42 months by lifetable analysis (NS). Variables including age, obesity, menopausal state, pregnancy, and oestrogen containing drugs were not shown to affect recurrence rate. Men had more frequent recurrence than women (NS). Patients who had had multiple Stones experienced more recurrences than did those with single Stones (NS). Recurrence did not occur in patients who took non-steroidal anti-inflammatory drugs (NSAIDs) (p nine months had a recurrence rate of only 12.7 (6.0)% at 42 months compared with 55.4 (12.5)% in those Stone free < nine months (p < 0.01). There was imbalance between the ursodeoxycholic acid and placebo groups for this factor, and after applying a statistical correction, the adjusted recurrence rate in the ursodeoxycholic acid group was 15% compared with 30% in both placebo and diet groups (NS). These data suggest that after medical Dissolution, the risk of gall Stone recurrence is not reduced by a high fibre, low refined carbohydrate diet: it may be lowered, but not abolished, by low dose ursodeoxycholic acid.
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combination therapy with oral ursodeoxycholic and chenodeoxycholic acids pretreatment computed tomography of the gall bladder improves gall Stone Dissolution efficacy
Gut, 1992Co-Authors: Julian R F Walters, K A Hood, Dermot Gleeson, Joseph P M Ellul, A Keightley, G M Murphy, R H DowlingAbstract:In a five year study, 55 patients with radiolucent gall Stones were treated with the combination of 7.5 mg chenodeoxycholic acid (CDCA) and 5.0 mg ursodeoxycholic acid (UDCA)/kg/day--that is, half the monotherapeutic doses. Side effects were few but four patients could not tolerate the prescribed bile acids because of diarrhoea or nausea. Analysis of fasting duodenal bile confirmed that CDCA+UDCA converted supersaturated into unsaturated bile but the saturation indices did not predict the Dissolution response. By actuarial analysis, the confirmed (by ultrasound x2) complete gall Stone Dissolution rates in all 55 patients were mean (SEM) 29 (7)% at 12 and 44 (8)% at 24 months. The advent of routine computed tomography before treatment enabled comparison of Dissolution efficacy in those screened by computed tomography (n = 24), whose maximum gall Stone attenuation was less than 100 Hounsfield units, with that in those not screened (n = 29). Although Stone size and number were comparable, patients screened by computed tomography had significantly better Dissolution rates (p less than 0.025) than those not screened in this way. At 12 months, partial or complete gall Stone Dissolution rates were 93 (7)% in the screened and 55 (11)% in the non-screened patients. At 18 months, complete Dissolution rates were 64 (12%) and 20 (9)% respectively. Computed tomography before treatment is cost effective in selecting those patients likely to achieve gall Stone Dissolution on treatment with UDCA+CDCA.