Home
Science
I.T.
Arts
Laws

Optimization Of Diagnostics And The Medical Correction Of Biliary Tract Dysfunction  


Abstract Category: Other Categories
Course / Degree: PhD
Institution / University: Dnipropetrovsk State Medical Academy, Institute of Gastroenterology, Ukraine
Published in: 2005


Dissertation Abstract / Summary:

This thesis contributes knowledge to the diagnosis and treatment of biliary tract dysfunction. The research broadens what is known about the physiological background of biliary tract motility and pathogenetic mechanisms of biliary dysfunction development.

The most frequently-occurring type of biliary tract dysfunction is the hypokinetic-hypotonic type defined as gallbladder hypokinetics combined with the Sphincter of Oddi hyper-tonus (51.7%). Patients with this condition have hypofunction of autonomic regulation with its components reactivity decreasing. The autonomic imbalance in biliary tract dysfunction with spasm of the Sphincter of Oddi is characterized by significant sympathetic hyperactivity. In 78.6% of patients, the biliary tract dysfunction is combined with other gastroenterological diseases, most frequently with chronic pancreatitis (50.9%). Some patients with biliary dysfunction are obese (9.7%) or overweight (35.5%). Among patients with biliary dysfunction combined with other gastroenterological diseases, 21.1% are obese and 31.6% are overweight. Concomitant diseases aggravate autonomic dysfunction, expressed as an increase of subjective perceptions of autonomic dysfunction symptoms and objective decline of autonomic regulation components reactivity. A correlation with r= -0,436 is determined between the increasing degrees of subjective perception of autonomic dysfunction symptoms and decreases of autonomic regulation components reactivity.

Criteria have been established which allow researchers to evaluate biliary tract motility and level of its autonomic maintenance based on the results of dynamic ultrasonography of gallbladder . Gallbladder contraction is associated with increased vagal activity (r= 0,998) if initial gallbladder volume is between 41.7 and 60.1 ml and its contraction coefficient for the first 20 minutes is between 79.2% and 80.2%. The functional state of autonomic regulation is characterized by initial parasympathetic dominance. Autonomic maintenance of biliary tract motility is sufficient and physiologically adequate. Gallbladder contraction is correlated with vagal activity declining (r= -0.324) if initial gallbladder volume is between 41.7 and 60.1 ml and its contraction coefficient for the first 20 minutes is between 46.0% and 51.8%. The level of autonomic maintenance of biliary tract motility is depressed. There is high risk of development of biliary tract dysfunction if the gallbladder contraction coefficient is lower than 51.8%. These results may be helpful for screening examinations, a primary prevention tool. These investigations justify the expediency of performing dynamic ultrasonography for the selection of medication and therapy.

The single dose of Choliver (extract of artichoke 25mg; extract of bile 25mg; turmeric powder 50mg) causes strong prolonged cholekinetic effect in patients with hypokinetic-hypotonic and hypokinetic-normotonic types of biliary tract dysfunction. The gallbladder contraction curves induced by Choliver and stimulant (50.0 ml per oral dose of 25% magnesium sulphate solution) were identical in 80.0% and 83.3% patients respectively. This proves the similarity of the effect of Choliver to physiological effect. The research also proved that Choliver improves biliary motility due to increasing gallbladder contractility. The dynamics of the functional state of autonomic regulation show that parasympathetic reactivity significantly improves. The highest efficiency Choliver has in patients with hypokinetic-hypotonic and hypokinetic-normotonic types of biliary tract dysfunction.

Ursochol (ursodeoxycholic acid) predominately eliminates spasm of the biliary tract sphincters. The dynamics of the functional state of autonomic regulation shows a significant improvement of initial vaginal activity while parasympathetic reactivity improves insignificantly. Ursochol usage shows more important positive effects in patients with the hypokinetic-hypertonic type of biliary tract dysfunction.

An argument is made for the efficiency of treatment by Choliver and Ursochol, valuable in the regeneration of coordinated interrelations of biliary tract structures and improvement of the functional state of autonomic regulations components. These findings justify using these drugs in most patients for combinative correction of both biliary dysfunction and disorders of functional state of autonomic regulations components.


Dissertation Keywords/Search Tags:
biliary tract, motility, functional disorders, autonomic regulation, diagnostic, treatment

This Dissertation Abstract may be cited as follows:
Lytvyak E. Optimization of diagnostics and the medical correction of biliary tract dysfunction [dissertation]. Dnipropetrovsk: Dnipropetrovsk State Medical Academy, Institute of Gastroenterology of National Academy of Medical Sciences of Ukraine; 2005.


Submission Details: Dissertation Abstract submitted by Ellina Lytvyak from Canada on 24-Jul-2012 19:21.
Abstract has been viewed 2129 times (since 7 Mar 2010).

Ellina Lytvyak Contact Details: Email: lytvyak@ualberta.ca



Disclaimer
Great care has been taken to ensure that this information is correct, however ThesisAbstracts.com cannot accept responsibility for the contents of this Dissertation abstract titled "Optimization Of Diagnostics And The Medical Correction Of Biliary Tract Dysfunction". This abstract has been submitted by Ellina Lytvyak on 24-Jul-2012 19:21. You may report a problem using the contact form.
© Copyright 2003 - 2019 of ThesisAbstracts.com and respective owners.


Copyright © Thesis Abstract | Dissertation Abstracts Thesis Library 2003-2019.
by scope.com.mt @ website design