scholarly journals Role of Endoscopic Retrograde CholangioPancreatography (ERCP) and Intraductal Secretin Test (IDST) in the Diagnosis of Chronic Pancreatitis (CP)

2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Vitalis C. Osuji ◽  
Gail McNulty, RN, BSN, CCRC ◽  
Evan Fogel, MD, MSc, FRCP(C)
Keyword(s):  
Chronic Pancreatitis ◽  
Final Diagnosis ◽  
Secretin Test ◽  
Pure Pancreatic Juice ◽  
Bicarbonate Concentration ◽  
Endoscopic Retrograde ◽  
Collection Period ◽  
Collection Time

Background:   CP may be difficult to diagnose in the early stages when imaging may be normal. An IDST performed at ERCP may further evaluate for CP, with determination of pure pancreatic juice (PPJ) volume and bicarbonate concentration (BC). The optimal collection time for IDST is unknown. We report our experience with the IDST in 447 patients with suspected CP.            Experimental Design:   IDSTs performed from 2006-2018 were reviewed, with fluid collected at 5-min intervals for 20-60 minutes. Parameters evaluated were PPJ volume, Secretory Flow Rate (SFR), time of peak SFR, maximum BC and time to maximum BC.          Results:   Maximum BC was reached by 10-min in 59 patients (13.2%); 15-min: 207 patients (46.3%); 20 min: 340 patients (76.1%); 25-min: 384 patients (85.9%); 30-min: 421 patients (94.1%). Peak SFR was reached by 10-min in 92 patients (20.6%); 15-min: 177 patients (39.6%); 20-min: 240 patients (53.7%); 25-min: 284 patients (63.5%); 30-min: 323 patients (72.3%). Final diagnosis (normal vs. CP) for both SFR and BC was determined by 20-min (i.e. in CP pts, either the SFR or BC was low (SFR <3ml/min, BC <105mEq/L) and remained low throughout collection, or normal (>3ml/min and >105mEq/L) within the first 20-min. Further collection did not change the diagnosis.  Conclusion:   At IDST, a 20-minute collection period is necessary to categorize patients into normal or suspected CP groups. A study in control patients (no suspicion of CP) to validate these data is currently underway.  

scholarly journals The role of immunohistochemical evaluation in the diagnosis of malignant mesothelioma of the pleura

2013 ◽  
Vol 70 (11) ◽  
pp. 1010-1014 ◽  
Author(s):  
Milana Panjkovic ◽  
Aleksandra Lovrenski ◽  
Zivka Eri ◽  
Slavica Knezevic-Usaj ◽  
Dragana Tegeltija ◽  
...  
Keyword(s):  
Malignant Pleural Mesothelioma ◽  
Diagnostic Procedure ◽  
Histopathological Examination ◽  
Immunohistochemical Analysis ◽  
Final Diagnosis ◽  
Histopathological Diagnosis ◽  
Pleural Mesothelioma ◽  
Made In

Backround/Aim. The final diagnosis of malignant pleural mesothelioma is made exclusively by histopathological examination of biopsy materials that are routinely complemented by the use of immunohistochemical analysis. The aim of this paper was to determine the significance of immunohistochemical analysis and application of certain antibodies in the diagnosis of malignant pleural mesothelioma. Methods. This retrospective analysis included clinical data of 32 patients with the histopathological diagnosis of malignant pleural mesothelioma made in the period 2004-2009 at the Institute for Pulmonary Diseases in Sremska Kamenica. The material was processed and analyzed at the Center for Pathology. Results. CK5/6 was positive, in 63% of the cases calretinin, in 94% and HBME-1 in 80% of the cases. CK7 was positive in 78%, and EMA in 83% of the cases. All the cases (100%) were negative for TTF-1, CEA, CD20, desmin and MOC31. Conclusion. Immunohistochemistry has become an essential diagnostic procedure for the diagnosis and determination of the type of malignant pleural mesothelioma, and due to the lack of individual antibodies a combination of antibody with different sensitivity and specificity is in use today.

Chronic Pancreatitis in Late Childhood and Adolescence

1994 ◽  
Vol 33 (2) ◽  
pp. 88-94 ◽  
Author(s):  
Prasad Mathew ◽  
Robert Wyllie ◽  
Maureen Caulfield ◽  
Rita Steffen ◽  
Marsha Kay
Keyword(s):  
Chronic Pancreatitis ◽  
Pediatric Patients ◽  
Serum Amylase ◽  
Recurrent Abdominal Pain ◽  
Late Childhood ◽  
Childhood And Adolescence ◽  
Endoscopic Retrograde ◽  
Acute Exacerbations ◽  
Structural Abnormalities

Acute pancreatitis is unusual in pediatric patients, and chronic pancreatitis is even less common. Between 1983 and 1988, we diagnosed 24 patients in late childhood and adolescence with chronic pancreatitis. Our review revealed that chronic pancreatitis presents as recurrent abdominal pain in late childhood and adolescence. Individual laboratory and radiological investigations may be normal during acute exacerbations of pain, but the determination of serum amylase and lipase concentrations — combined with ultrasonography — will accurately identify most patients. We found that endoscopic retrograde cholangiopancreatography is a valuable tool in the diagnosis of structural abnormalities. Surgical intervention may reduce symptoms in patients with structural abnormalities. There is a tendency toward decreased frequency and severity of pain as the patients increase in age.

scholarly journals Role of Ultrasound as Compared with ERCP in Patient With Obstructive Jaundice

2015 ◽  
Vol 11 (3) ◽  
pp. 237-240 ◽  
Author(s):  
S Karki ◽  
KS Joshi ◽  
S Regmi ◽  
RB Gurung ◽  
B Malla
Keyword(s):  
Magnetic Resonance ◽  
Obstructive Jaundice ◽  
Imaging Modality ◽  
Final Diagnosis ◽  
Endoscopic Retrograde Cholangiography ◽  
University Hospital ◽  
Endoscopic Retrograde ◽  
Non Invasive ◽  
Imaging Tool

Background The diagnosis of obstructive jaundice relies on proper history taking, clinical examination, laboratory investigations and different non invasive imaging modalities like Ultrasonography (USG), Cholangio Computed Tomography (CCT), Magnetic resonance Imaging (MRI) with Magnetic Resonance Cholangio Pancreatography (MRCP) and invasive modalities like endoscopic retrograde cholangiography (ERCP) and percutaneous trans hepatic cholangiography (PTC). Objective To compare the role of ultrasound with endoscopic retrograde cholangiography and to determine the major causes of obstructive jaundice in our prospect. Methods This was a prospective, analytical study conducted on 88 patients presenting to Department of Radiodiagnosis and Imaging at Dhulikhel Hospital-Kathmandu University hospital from March 2011 to August 2012 with clinical diagnosis of obstructive jaundice. Sonographic evaluation was performed in Siemens acusion x-150 and x-300. The final diagnosis was made by endoscopic retrograde cholangiography and /or surgery and confirmed histopathologically. Results The most common benign causes of obstructive jaundice were choledocholithiasis (63%), CBD stricture (12.3%), cholangitis (8%) and pancreatitis (6.85%) whereas cholangio carcinoma (6.85%) and carcinoma head of pancreas (4%) comprised of the malignant causes . Ultrasonography had sensitivity of 100% and specificity of 89% in detecting choledocholithiasis. It was found to be 98.78% sensitive and 83.33% specific in cholangiocarcinoma. Similarly in pancreatitis, the sensitivity of ultrasonography was 97.59% and sensitivity was 66.67%. Conclusion Ultrasonography acts as a valuable diagnostic imaging modality in detecting the causes of obstructive jaundice. Due to its easy availability, non invasive nature and cost effectiveness, it can be considered as the first line imaging technique/ tool. ERCP is the invasive imaging tool and can be used for both diagnostic and therapeutic purpose. DOI: http://dx.doi.org/10.3126/kumj.v11i3.12512 Kathmandu Univ Med J 2013; 43(3):237-240

ID: 3525194 ROLE OF ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY AND INTRADUCTAL SECRETIN TEST IN THE DIAGNOSIS OF EXOCRINE PANCREATIC INSUFFICIENCY

2021 ◽  
Vol 93 (6) ◽  
pp. AB145
Author(s):  
Vitalis C. Osuji ◽  
Gail Mcnulty ◽  
Benjamin L. Bick ◽  
Glen A. Lehman ◽  
Stuart Sherman ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Pancreatic Insufficiency ◽  
Exocrine Pancreatic Insufficiency ◽  
Secretin Test ◽  
Endoscopic Retrograde

The role of the N34S mutation in the trypsin inhibitor gene SPINK1 in patients with chronic pancreatitis from Romania

2009 ◽  
Vol 47 (06) ◽  
Author(s):  
B Diaconu ◽  
A Schneider ◽  
R Pfützer ◽  
T Mocan ◽  
M Scăfaru ◽  
...  
Keyword(s):  
Chronic Pancreatitis ◽  
Trypsin Inhibitor ◽  
N34s Mutation ◽  
Inhibitor Gene

A Molecular Approach to Immunoscintigraphy: A Study of the T-Antigen Conformation on the Surface of Tumors

1987 ◽  
Vol 26 (01) ◽  
pp. 1-6 ◽  
Author(s):  
S. Selvaraj ◽  
M. R. Suresh ◽  
G. McLean ◽  
D. Willans ◽  
C. Turner ◽  
...  
Keyword(s):  
Monoclonal Antibodies ◽  
Tumor Cell ◽  
T Antigen ◽  
Human Carcinomas ◽  
Animal Tumor ◽  
Synthetic Antigens

The role of glycoconjugates in tumor cell differentiation has been well documented. We have examined the expression of the two anomers of the Thomsen-Friedenreich antigen on the surface of human, canine and murine tumor cell membranes both in vitro and in vivo. This has been accomplished through the synthesis of the disaccharide terminal residues in both a and ß configuration. Both entities were used to generate murine monoclonal antibodies which recognized the carbohydrate determinants. The determination of fine specificities of these antibodies was effected by means of cellular uptake, immunohistopathology and immunoscintigraphy. Examination of pathological specimens of human and canine tumor tissue indicated that the expressed antigen was in the β configuration. More than 89% of all human carcinomas tested expressed the antigen in the above anomeric form. The combination of synthetic antigens and monoclonal antibodies raised specifically against them provide us with invaluable tools for the study of tumor marker expression in humans and their respective animal tumor models.

On The Mechanism Of Heparin-Induced Potentiation Of Platelet Aggregation

1981 ◽  
Author(s):  
M Yamamoto ◽  
K Watanabe ◽  
Y Ando ◽  
H Iri ◽  
N Fujiyama ◽  
...  
Keyword(s):  
Platelet Aggregation ◽  
Platelet Activation ◽  
Coagulation Factors ◽  
Marked Enhancement ◽  
Matrix Bound ◽  
Induced Aggregation ◽  
Aggregation Of Platelets ◽  
Plasma Heparin

It has been suggested that heparin caused potentiation of aggregation induced by ADP or epinephrine. The exact mechanism of heparin-induced platelet activation, however, remained unknown. In this paper, we have investigated the role of anti-thrombin III ( AT ) in heparin-induced platelet activation using purified AT and AT depleted plasma. When ADP or epinephrine was added to citrated PRP one minute after addition of heparin ( 1 u/ml, porcine intestinal mucosal heparin, Sigma Co. USA ), marked enhancement of platelet aggregation was observed, compared with the degree of aggregation in the absence of heparin. However, in platelet suspensions prepared in modified Tyrode’s solution, heparin exhibited no potentiating effect on platelet aggregation induced by epinephrine or ADP. Potentiation of epinephrine- or ADP-induced platelet aggregation by heparin was demonstrated when purified AT was added to platelet suspensions at a concentration of 20 μg/ml. AT depleted plasma, which was prepared by immunosorption using matrix-bound antibodies to AT, retained no AT, while determination of α1-antitrypsinα2- macroglobulin and fibrinogen in AT depleted plasma produced values which corresponded to those of the original plasma when dilution factor was taken into account. The activities of coagulation factors were also comparable to those of the original plasma. Heparin exhibited potentiating effect on ADP- or epinephrine-induced aggregation of platelets in original plasma, but no effect in AT depleted plasma. When purified AT was added back to AT depleted plasma at a concentration of 20 μg/ml, potentiation of platelet aggregation by heparin was clearly demonstrated.Our results suggest that effect of heparin on platelet aggregation is also mediated by anti-thrombin III.

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