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1Characterization of functional biliary pain and dyspeptic symptoms in patients with sphincter of Oddi dysfunction:Effect of papillotomy显示文摘AIM: To characterize functional biliary pain and other gastrointestinal (GI) symptoms in postcholecystectomy syndrome (PCS) patients with and without sphincter of Oddi dysfunction (SOD) proved by endoscopic sphincter of Oddi manometry (ESOM), and to assess the post- endoscopic sphincterotomy (EST) outcome. METHODS: We prospectively investigated 85 cholecystectomized patients referred for ERCP because of PCS and suspected SOD. On admission, all patients completed our questionnaire. Physical examination, laboratory tests, abdominal ultrasound, quantitative hepatobiliary scintigraphy (QHBS), and ERCP were performed in all patients. Based on clinical and ERCP findings 15 patients had unexpected bile duct stone disease and 15 patients had SOD biliary typeⅠ. ESOM demonstrated an elevated basal pressure in 25 patients with SOD biliary-type Ⅲ. In the remaining 30 cholecystectomized patients without SOD, the liver function tests, ERCP, QHBS and ESOM were all normal. As a control group, 30 ‘asymptomatic’ cholecystectomized volunteers (attended to our hospital for general cardiovascular screening) completed our questionnaire, which is consisted of 50 separate questions on GI symptoms and abdominal pain characteristics. Severity of the abdominal pain (frequency and intensity) was assessed with a visual analogue scale (VAS). In 40 of 80 patients having definite SOD (i.e. patients with SOD biliary typeⅠand those with elevated SO basal pressure on ESOM), an EST was performed just after ERCP. In these patients repeated questionnaires were filled at each follow-up visit (at 3 and 6 mo) and a second lookQHBS was performed 3 mo after the EST to assess the functional response to EST. RESULTS: The analysis of characteristics of the abdominal pain demonstrated that patients with common bile duct stone and definite SOD had a significantly higher score of symptomatic agreement with previously determined biliary-like pain features than patient groups of PCS without SOD and controls. In contrary, no significant differences were found when the pain severity scores were compared in different groups of PCS patients. In patients with definite SOD, EST induced a significant acceleration of the transpapillary bile flow; and based on the comparison of VASs obtained from the pre- and post-EST questionnaires, the severity scores of abdominal pain were significantly improved, however, only 15 of 35 (43%) patients became completely pain free. Post-EST severity of abdominal pain by VASs was significantly higher in patients with predominant dyspepsia at initial presentation as compared to those without dyspeptic symptoms. CONCLUSION: Persistent GI symptoms and general patient dissatisfaction is a rather common finding after EST in patients with SOD, and correlated with the presence of predominant dyspeptic symptoms at the initial presentation, but does not depend on the technical and functional success of EST.László Madácsy Roland Fejes Gábor Kurucsai Ildikó Joó András Székely Viktória Bertalan Attila Szepes János Lonovics 2006World Journal of Gastroenterology2006,12,42:33
2Effect of melatonin on the severity of L-arginine-induced experimental acute pancreatitis in rats显示文摘瞄准:决定 melatonin 预告的处理的效果并且在 L 精氨酸(L-Arg ) 的严厉上处理以后在老鼠的导致的试验性的胰腺炎。方法:男 Wistar 老鼠(25 ) 被划分成五个组。那些在 1h 的间隔在组 A 收到了 3.2g/kg 体重 L-Arg i.p 的二注射。在组麻省,老鼠与 50 mg/kg 体重 melatonin i.p 被对待在 L-Arg 管理以前的 30 min。在组 AM,在 L-Arg 被给以后,老鼠收到了 melatonin 1h 的一样的剂量。在组 M, melatonin 的单次量是以前描述了被管理。在组 C,对照动物收到了生理盐水注射 i.p 所有老鼠被给在第二 L-Arg 注射以后的 24 h。结果:引起严重引起坏死胰腺炎的 L-Arg 管理在浆液淀粉酶水平,胰腺的重量 / 身体重量比率(pw/bw ) ,胰腺的 IL-6 内容和 myeloperoxidase 由重要举起证实了活动,相对控制值。浆液淀粉酶水平的举起显著地在与仅仅与 L-Arg 注射的老鼠相比给 melatonin 追随者 L-Arg 的老鼠被减少。胰腺的抗氧化剂酶(Cu/Zn-superoxide 歧化酶(Cu/Zn-SOD ) 和过氧化氢酶(猫)) 的活动显著地被增加在胰腺炎以后的 24 h 感应。显著地在 L-Arg 之前给的 Melatonin 在独自与 L-Arg 对待的老鼠相对那减少了胰腺的猫活动。在肝, L-Arg 显著地每氧化水平,和谷胱甘肽过氧化物酶和 Cu/Zn-SOD 活动增加了类脂化合物,而 Mn 草皮活动作为与控制老鼠相比被减少。Melatonin 预告的处理阻止了这些变化。结论:Melatonin 是能在尖锐胰腺炎期间抵抗一些 L-Arg-induced 变化的一种抗氧化剂,并且可能因此在有尖锐引起坏死胰腺炎的病人的支持的治疗有用。Annamaria Szabolcs Russel J Reiter Tamas Letoha Peter Hegyi Gabor Papai Ilona Varga Katalin Jarmay Jozsef Kaszaki Reka Sari Zoltan Rakonczay Jr Janos Lonovics Tamas Takacs 2006World Journal of Gastroenterology2006,12,2:13
3Interplay between nitric oxide and VIP in CCK-8-induced phasic contractile activity in the rabbit sphincter of Oddi显示文摘AIM: The sphincter of Oddi (SO) plays an important role in delivery of bile into the duodenum. To establish whether vasoactive intestinal polypeptide (VIP) and nitric oxide (NO) were involved in phasic contractile activity of the rabbit SO stimulated by cholecystokinin-octapeptide (CCK-8).METHODS: Isolated SO muscle rings were cleaned of fat and mounted horizontally on two small L-shaped hooksone of which was connected to a force transducer for the measurement of isometric tension. The experiments were carried out in a thermostatically controlled (37±0.2℃)organ bath (5 mL) containing Krebs solution. The organ fluid was gassed with 95% O2 and 50 mL/L CO2 to keep the pH at 7.40±0.05. Contractile responses to CCK-8 (1μmol/L) were evaluated in the presence and absence of N^G-nitro-L-arginine (LNNA), an inhibitor of NO synthase (100μmol/L), and (p-chloro-D-Phe^6-Leu^17)-VIP (VIPa,30μmol/L), a VIP receptor antagonist.RESULTS: CCK-8 stimulated the phasic activity of the SO.NO synthase inhibition increased the frequency and amplitude of contractions with a slight increase in developed tension.Pre-incubation with VIPa also attenuated this CCK-8 effect.The combined application of LNNA and VIPa abolished the phasic activity of the muscle rings with a marked increase in tension in response to CCK-8.CONCLUSION: VIP and NO together contribute to an increase in phasic activity of SO.Attila Pálv(o|¨)lgyi Réka Sári József Németh Annamária Szabolcs István Nagy Péter Hegyi János Lonovics Zoltán Szilvássy 2005World Journal of Gastroenterology2005,11,21:11
4Clinical significance of granuloma in Crohn's disease显示文摘AIM: Granuloma is considered the hallmark of microscopic diagnosis in Crohn's disease (CD), but granulomas can be detected in only 21-60% of CD patients. The aim of this studywas to evaluate the frequency of granulomas by multiple endoscopic biopsies in patients with CD and to examine whether group of patients with or without granuloma exhibit a different clinical course.METHODS: Fifty-six patients with newly diagnosed Cdwere included in the study. Jejunoscopy, enteroclysis and ileo-colonoscopy were performed in all patients. At least two biopsy specimens from each examined gastrointestinal segment were examined microscopically searching granuloma. The clinical course was followed in all patients, and extraintestinal manifestations as well as details of any immunosuppressive therapy and surgical intervention were noted.RESULTS: Granuloma was found in 44.6% of the cases (25 patients). Patients with granuloma had higher activity parameters at the time of the biopsies. Extraintestinal manifestations were observed and surgical interventions were performed more often in the granuloma group. The need of immunosuppressive therapy was significantly more frequent in the patients with granuloma. Granuloma formation is more often seen in younger patients, and mainly in the severe, active penetrating disease. CONCLUSION: The significantly higher frequency of surgical interventions and immunosuppressive therapy suggests that granuloma formation is associated with a more severe disease course during the first years of CD.Tamás Molnár László Tiszlavicz Csaba Gyulai Ferenc Nagy János Lonovics 2005World Journal of Gastroenterology2005,11,20:5
5Autoimmune pancreatitis: Functional and morphological recovery after steroid therapy显示文摘自体免疫的胰腺炎,慢性胰炎的一种最近公认的类型,不在其它地方在它的日本,而是报告是稀罕的是相对不平常的。我们在匈牙利报导自体免疫的胰腺炎的第一个外科手术前地诊断的案例,它对类固醇处理作出回应很好并且提供了这改进的 X 光线照相术、功能的证据。与周期性的腹上部的疼痛和 5-kg 重量损失的 4 月的历史介绍的 62 岁的女性。口头的葡萄糖耐量测试(OGTT ) 显示糖尿病和烘便的弹性硬蛋白酶测试的结果是反常的。Ultrasonography (美国) 和 CT 扫描表明了广泛地扩大的胰,并且内视镜后退 cholangiopancreatography (ERCP ) 有在头和尾巴的长苛评的不规则的主要的胰腺的管。自体免疫的胰腺炎被诊断。病人每天在 32 mg 氢化尼松上被开始。在 4 wk 以后, OGTT 和排泄物的弹性硬蛋白酶测试结果使正常化。重复美国和 CT 扫描揭示了 diffuse 的显著改进胰腺,在重复 ERCP 上胀大,变窄的主要的胰腺的管被看见被改善。因为 AIP 能临床上类似于 pancreatobiliary 恶意,或长期或尖锐的胰腺炎,知道这疾病和它的诊断是重要的。然而在有慢性胰炎的对比,它的症状并且词法并且实验室改变被口头的类固醇治疗完全颠倒。László Czakó (E|')va Hegyk(o|¨)zi Attila Pálinkás János Lonovics 2006World Journal of Gastroenterology2006,12,11:3
6Diagnostic role of secretin-enhanced MRCP in patients with unsuccessful ERCP显示文摘AIM: To evaluate the value of MR cholangiopancreatography (MRCP) in patients in whom endoscopic retrograde cholangiopancreatography (ERCP) was unsuccessfully performed by experts in a tertiary center. METHODS: From January 2000 to June 2003, 22 patients fulfilled the inclusion criteria. The indications for ERCP were obstructive jaundice (n = 9), abnormal liver enzymes (n=8),suspected chronic pancreatitis (n = 2), recurrent acute pancreatitis (n = 2), or suspected pancreatic cancer (n=1). The reasons for the ERCP failure were the postsurgical anatomy (n = 7), duodenal stenosis (n = 3), duodenal diverticulum (n = 2), and technical failure (n = 10). MRCP images were evaluated before and 5 and 10 min after i.v. administration of 0.5 IU/kg secretin.RESULTS: The MRCP images were diagnosed in all 21patients. Five patients gave normal MR findings and required no further intervention. MRCP revealed abnormalities (primary sclerosing cholangitis, chronic pancreatitis, cholangitis, cholecystolithiasis or common bile duct dilation) in 10 patients, who were followed up clinically. Four patients subsequently underwent laparotomy (hepaticojejunostomy in consequence of common bile duct stenosis caused by unresectable pancreatic cancer; hepaticotomy+Kehr drainage because of insufficient biliary-enteric anastomosis; choledochojejunostomy, gastrojejunostomy and cysto-Wirsungo gastrostomy because of chronic pancreatitis, orcholedo chojejunostomy because of common bile duct stenosis caused by chronic pancreatitis). Three patients participated in therapeutic percutaneous transhepatic drainage. The indications were choledocholithiasis with choledochojejunostomy, insufficient biliary-enteric anastomosis, or cholangiocarcinoma. CONCLUSION: MRCP can assist the diagnosis and management of patients in whom ERCP is not possible.László Czakó Tamás Takács Zita Morvay László Csernay János Lonovics 2004World Journal of Gastroenterology2004,10,20:3
7Efficacy of 6-mercaptopurine treatment after azathioprine hypersensitivity in inflammatory bowel disease显示文摘AIM:To investigate the efficacy of 6-mercaptopurine (6-MP) in cases of azathioprine (AZA) hypersensitivity in patients with inflammatory bowel disease. METHODS: Twenty nine previously confirmed Crohn’s disease (CD) (n = 14) and ulcerative colitis (UC) (n = 15) patients with a known previous (AZA) hypersensitivity reaction were studied prospectively. The 6-MP doses were gradually increased from 0.5 up to 1.0-1.5 mg/kg per day. Clinical activity indicies (CDAI/CAI), laboratory variables and daily doses of oral 5-ASA, corticosteroids, and 6-MP were assessed before and in the first, sixth and twelfth months of treatment. RESULTS: In 9 patients, 6-MP was withdrawn in the first 2 wk due to an early hypersensitivity reaction. Medication was ineffective within 6 mo in 6 CD patients, and myelotoxic reaction was observed in two. Data were evaluated at the end of the sixth month in 12 (8 UC, 4 CD) patients, and after the first year in 9 (6 UC, 3 CD) patients. CDAI decreased transiently at the end of the sixth month, but no significant changes were observed in the CDAI or the CAI values at the end of the year. Leukocyte counts (P = 0.01), CRP (P = 0.02), and serum iron (P = 0.05) values indicated decreased inflammatory reactions, especially in the UC patients at the end of the year, making the possibility to taper oral steroid doses. CONCLUSION: About one-third of the previously AZA- intolerant patients showed adverse effects on taking 6MP. In our series, 20 patients tolerated 6MP, but it was ineffective in 8 CD cases, and valuable mainly in ulcerative colitis patients.Ferenc Nagy Tamás Molnár Zoltán Szepes Klaudia Farkas Tibor Nyári János Lonovics 2008World Journal of Gastroenterology2008,14,27:2
8Regional differences in nitric oxide mediated relaxation of the rabbit sphincter of Oddi显示文摘Lonovics J Jakab I Jzilvassy J 1994Eur J Pharmacol1994,255,13:1
9显示文摘Takacs T Lonovics J Caroli-Bosc FX 1997Gastmenterol Clin Biol1997,21,10:1
10Re-Os isotopic sustematics and platinum group element fractionation during mantle melt extraction:a study of massif and xenolith peridotite suites显示文摘Pearson D G Irvine G J Lonov D A Boyd F R Dreibus G E 0,,:1
11Quality of life in the course of enzyme replacement therapy for chronic pancreatitis 显示文摘CZAKO L TAKACS T LONOVICS J 2002Orv Hetil2002,143,25:1
12Gallbladder hypomotility in diabetic polyneuropathy显示文摘Tamás T. Várkonyi M.D. Csaba Lengyel M.D. László Madácsy M.D. Borbála Vel?sy M.D. Ph.D. Péter Kempler M.D. Ph.D. D.Sc. Tamás Fazekas M.D. Ph.D. D.Sc. László Pávics M.D. Ph.D. László Csernay M.D. Ph.D. D.Sc. János Lonovics M.D. Ph.D 2001Clinical Autonomic Research2001,,6:1
13Insulin is necessary for the hypertrophic effect of cholecystokinin-octapeptide following acute necrotizing experimental pancreatitis显示文摘AIM: In previous experiments we have demonstrated that by administering low doses of cholecystokinin-octapeptide (CCK-8), the process of regeneration following L-arginine (Arg)-induced pancreatitis is accelerated. In rats that were also diabetic (induced by streptozotocin, STZ), pancreatic regeneration was not observed. The aim of this study was to deduce whether the administration of exogenous insulin could in fact restore the hypertrophic effect of CCK-8 in diabetic-pancreatitic rats.METHODS: Male Wistar rats were used for the experiments.Diabetes mellitus was induced by administering 60 mg/kg body mass of STZ intraperitoneally (i.p.), then, on d 8, pancreatitis was induced by 200 mg/100 g body mass Argi.p. twice at an interval of 1 h. The animals were injected subcutaneously twice daily (at 7 a.m. and 7 p.m.) with 1 μglkg of CCK-8 and/or 2 IU mixed insulin (300 g/L shortaction and 700 g/L intermediate-action insulin) for 14 d after pancreatitis induction. Following this the animals were killed and the serum amylase, glucose and insulin levels as well as the plasma glucagon levels, the pancreatic mass/body mass ratio (pm/bm), the pancreatic contents of DNA, protein, amylase, lipase and trypsinogen were measured. Pancreatic tissue samples were examined by light microscopy on paraffin-embedded sections.RESULTS: In the diabetic-pancreatitic rats treatment with insulin and CCK-8 significantly elevated pw/bm and the pancreatic contents of protein, amylase and lipase vs the rats receiving only CCK-8 treatment. CCK-8 administered in combination with insulin also elevated the number of acinar cells with mitotic activities, whereas CCK-8 alone had no effect on laboratory parameters or the mitotic activities in diabetic-pancreatitic rats.CONCLUSION: Despite the hypertrophic effect of CCK-8 being absent following acute pancreatitis in diabetic-rats,the simultaneous administration of exogenous insulin restored this effect. Our results clearly demonstrate that insulin is necessary for the hypertrophic effect of low-doses of CCK-8 following acute pancreatitis.Péter Hegyi Zoltán RakonczayJr Réka Sári László Czakó Norbert Farkas Csaba Góg József Németh János Lonovics Tamás Takács 2004World Journal of Gastroenterology2004,10,15:1
14Regional differences in nitric oxide-mediated relaxation of the rabbit sphincter of Oddi显示文摘Lonovics J Jakab I Szilvassy J 1994Eur J Pharmacal1994,255,13:1
15NF-κB activation is detrimental in arginine-induced acute pancreatitis显示文摘Zoltán Rakonczay Katalin Jármay József Kaszaki Yvette Mándi Ern? Duda Péter Hegyi Imre Boros János Lonovics Tamás Takács 2003Free Radical Biology and Medicine2003,,6:1
16Stimulated gastrointestinal hormone release and gallbladder contraction during continuous jejunal feeding in patients with pancreatic pseudocyst is inhibited by octreotide显示文摘Tamás Takács Ferenc Hajnal József Németh János Lonovics ákos Pap 2000International Journal of Pancreatology2000,,3:1
17Stimulated gastrointestinal hormone release and gallbladder contraction during continuous jejunal feeding in patients with pancreatic pseudocyst is inhibited by octreotide显示文摘Tamás Takács Ferenc Hajnal József Németh János Lonovics ákos Pap 2000International Journal of Pancreatology2000,,3:1
18A Pilot Study of Fecal Serine-Protease Activity: A Pathophysiologic Factor in Diarrhea-Predominant Irritable Bowel Syndrome显示文摘Richárd Róka András Rosztóczy Mathilde Leveque Ferenc Izbéki Ferenc Nagy Tamás Molnár János Lonovics Rafael Garcia–Villar Jean Fioramonti Tibor Wittmann Lionel Bueno 2007Clinical Gastroenterology and Hepatology2007,,5:1
19Effect of herpesvirus infection on pancreatic duct cell secretion显示文摘AIM: To examine the effect of acute infection caused by herpesvirus (pseudorabies virus, PRV) on pancreatic ductal secretion.METHODS: The virulent Ba-DupGreen (BDG) and nonvirulent Ka-RREpOlacgfp (KEG) genetically modified strains of PRV were used in this study and both of them contain the gene for green fluorescent protein (GFP). Small intra/interlobular ducts were infected with BDG virus (107 PFU/mL for 6 h) or with KEG virus (1010 PFU/mL for 6 h), while non-infected ducts were incubated only with the culture media. The ducts were then cultured for a further 18 h.The rate of HCO3- secretion [base efflux -J(B-)] was determined from the buffering capacity of the cells and the initial rate of intracellular acidification (1) after sudden blockage of basolateral base loaders with dihydro-4,4,-diisothiocyanatostilbene-2,2,-disulfonic acid (500 μmol/L)and amiloride (200 μmol/L), and (2) after alkali loading the ducts by exposure to NH4Cl. All the experiments were performed in HCO3--buffered Ringer solution at 37 ℃ (n = 5ducts for each experimental condition). Viral structural proteins were visualized by immunohistochemistry. Virallyencoded GFP and immunofluorescence signals were recorded by a confocal laser scanning microscope.RESULTS: The BDG virus infected the majority of accessible cells of the duct as judged by the appearance of GFP and viral antigens in the ductal cells. KEG virus caused a similarly high efficiency of infection. After blockage of basolateral base loaders, BDG infection significantly elevated -J(B-) 24 h after the infection, compared to the non-infected group. However, KEG infection did not modify -J(B-). After alkali loading the ducts, -J(B-) was significantly elevated in the BDG group compared to the control group 24 h after the infection. As we found with the inhibitor stop method, no change was observed in the group KEG compared to the non-infected group.CONCLUSION: Incubation with the BDG or KEG strains of PRV results in an effective infection of ductal epithelial cells. The BDG strain of PRV, which is able to initiate a lytic viral cycle, stimulates HcO3- secretion in guinea pig pancreatic duct by about four- to fivefold, 24 h after the infection. However, the KEG strain of PRV, which can infect,but fails to replicate, has no effect on HCO3- secretion.We suggest that this response of pancreatic ducts to virulent PRV infection may represent a defense mechanism against invasive pathogens to avoid pancreatic injury.Péter Hegyi Balázs rdg Zoltán Rakonczai Jr Tamás Takács János Lonovics Annamária Szabolcs Réka Sári András Tóth Julius G Papp András Varró Mária K Kovács Mike A Gray Barry E Argent Zsolt Boldogki 2005World Journal of Gastroenterology2005,11,38:0
20Ethanol inhibits the motility of rabbit sphincter of Oddi in vitro显示文摘AIM: The role of the sphincter of Oddi (SO) in ethanol (ETOH)-induced pancreatitis is controversial. Our aim was to characterise the effect of ETOH on basal and stimulated SO motility.METHODS: SOs removed from white rabbits were placed in an organ bath (Krebs solution, pH7.4, 37℃). The effects of 2 mL/L, 4 mL/L, 6 mL/L and 8 mL/L of ETOH on the contractile responses of the sphincter were determined.1 SOs were stimulated with either 0.1μol/L carbachol, 1μol/L erythromycin or 0.1μol/L cholecystokinin (CCK).RESULTS: ETOH at a dose of 4 mL/L significantly decreased the baseline contractile amplitude from 11.98±0.05 mN to 11.19±0.07 mN. However, no significant changes in the contractile frequency were observed. ETOH (0.6%) significantly decreased both the baseline amplitude and the frequency compared to the control group (10.50±0.01 mN,12.13±0.10 mN and 3.53±0.13 c/min, 5.5±0.13 cycles(c)/min,respectively). Moreover, 0.8% of ETOH resulted in complete relaxation of the SO. Carbachol (0.1μol/L)or erythromycin (1μol/L) stimulated the baseline amplitudes (by 82% and 75%, respectively) and the contractile frequencies (by 150% and 106%, respectively). In the carbachol or en/thromydn-stimulated groups 2-6 mL/L of ETOH significantly inhibited both the amplitude and the frequency. Interestingly,a 4-5 min administration of 6 mL/L ETOH suddenly and completely relaxed the SO. CCK (0.1μol/L) stimulated the baseline amplitude from 12.37±0.05 mN to 27.40±1.82 mN within 1.60±0.24 min. After this peak, the amplitudede creased to 17.17±0.22 mN and remained constant during the experiment. The frequency peaked at 12.8±0.2 c/min,after which the constant frequency was 9.43±0.24 c/min throughout the rest of the experiment. ETOH at a dose of 4 mL/L significantly decreased the amplitude from 16.13±0.23 mN to 14.93±0.19 mN. However, no significant changes in the contractile frequency were observed. ETOH at a dose of 6 mL/L inhibited both the amplitudes and the frequencies in the CCK-stimulated group, while 8 mL/L of ETOH completely relaxed the SO.CONCLUSION: ETOH strongly inhibits the basal, carbachol,erythromycin, and CCK-stimulated rabbit SO motility.Therefore, it is possible that during alcohol-intake the relaxed SO opens the way for pancreatic fluid to flow out into the duodenum in rabbits. This relaxation of the SO may protect the pancreas against alcohol-induced damage.Réka Sári Attila Pálv lgyi Zoltán Rakonczay Jr Tamás Takács János Lonovics László Czakó Péter Hegyi Zoltán Szilvássy 2004World Journal of Gastroenterology2004,10,23:0
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