Liver Abscess With a Markedly High Level of Carbohydrate Antigen 19-9

Background: Carbohydrate antigen (CA) 19-9 is considered as a tumor marker in biliary-pancreatic malignancy. Though a high level may indicate the presence of a malignant disorder, it may rise even in benign condition. Similarly, the value may be normal even in malignant condition.Methods: An observational comparative study was conducted in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from 01 June 2016 to 31 May 2017 to find out the sensitivity and specificity of CA 19-9 as a tumor marker in pancreatic malignancy in our perspective and to find out a cut-off value of CA 19-9 which might prove as a definitive indication of pancreatic malignancy.Results: The study shows when the cut off value of CA 19-9 is 37 U/ml. The sensitivity, specificity, positive and negative predictive values (PPV and NPV) were 77.8%, for all four characteristics respectively. But if the serum CA 19-9 threshold used to diagnose pancreatic cancer was raised to 100 and 120, sensitivity decreased to 72.2% and 66.7% and NPV decreased to 76.2% and 73.9% respectively. However, specificity increased to 88.9% and 94.4% and PPV increased to 86.7% and 92.3% respectively.Conclusions: Serum CA 19-9 level may be considered as an important determinant in the diagnosis of malignant pancreatic diseases and to assess the resectability of the lesions preoperatively, but other adjuncts are necessary in the overall management of pancreatic diseases.

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High level of preoperative carbohydrate antigen 19-9 is a poor survival predictor in gastric cancer

World Journal of Gastroenterology ◽

10.3748/wjg.v19.i32.5302 ◽

2013 ◽

Vol 19 (32) ◽

pp. 5302 ◽

Cited By ~ 18

Author(s):

A Ra Choi

Keyword(s):

Gastric Cancer ◽

Carbohydrate Antigen ◽

Poor Survival ◽

High Level ◽

Survival Predictor

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A Case Report of Carbohydrate Antigen 19-9 Producing Advanced Gastric Cancer

Cancer and Clinical Oncology ◽

10.5539/cco.v5n2p49 ◽

2016 ◽

Vol 5 (2) ◽

pp. 49

Author(s):

Konomi Mizuguchi ◽

Koichi Sato ◽

Hiroshi Maekawa ◽

Mutsumi Sakurada ◽

Hajime Orita ◽

...

Keyword(s):

Gastric Cancer ◽

Lymph Node ◽

Carbohydrate Antigen ◽

Cancer Case ◽

Gastric Cancer Case ◽

Poorly Differentiated Adenocarcinoma ◽

Epigastric Discomfort ◽

Aortic Lymph Node ◽

Poorly Differentiated ◽

High Level

The gastric cancer producing carbohydrate antigen 19-9 (CA 19-9) is a rare and unknown that characterize informations.74-year-old woman who was admitted with complaints of epigastric discomfort. An advanced cancer was found in her lower gastric region; biopsy of the tumor revealed poorly-differentiated adenocarcinoma. Her serum CA 19-9 was extremely elevated at 2322 U/ml and computed tomography demonstrated enlargement of the para-aortic lymph node; thus the tumor was considered unresectable. The patient received 8 cycles of chemotherapy with S-1/cisplatin, which shrank the para-aortic lymph node dramatically, hence she underwent D2 gastrectomy. Immunohistochemical staining of the resected cancer revealed that a third of the cancer cells were positive for CA 19-9. In addition, her serum CA 19-9 decreased rapidly after surgery and she remains alive without recurrence three years after surgery.We report one high level of CA 19-9 gastric cancer case with dramatically chemosensitive.

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Liver Abscess Caused by a Fish Bone

Hong Kong Journal of Emergency Medicine ◽

10.1177/102490790200900309 ◽

2002 ◽

Vol 9 (3) ◽

pp. 162-164 ◽

Cited By ~ 1

Author(s):

KL Fan

Keyword(s):

Emergency Department ◽

Gastrointestinal Tract ◽

Liver Abscess ◽

Fish Bone ◽

High Level

Fish bone ingestion is a common problem in the emergency department. Most cases have uneventful outcome. But occasionally it can cause serious complications if the gastrointestinal tract is perforated. A case of liver abscess caused by a fish bone is presented. It highlights the importance of maintaining a high level of clinical acumen in managing this apparently benign problem.

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CA 19-9 levels in patients with acute pancreatitis due to gallstone and metabolic/toxic reasons

Revista da Associação Médica Brasileira ◽

10.1590/1806-9282.65.7.965 ◽

2019 ◽

Vol 65 (7) ◽

pp. 965-970 ◽

Cited By ~ 2

Author(s):

Omer Burcak Binicier ◽

Zehra Betul Pakoz

Keyword(s):

Acute Pancreatitis ◽

Laboratory Tests ◽

Early Stage ◽

Carbohydrate Antigen ◽

Clinical Event ◽

Standard Laboratory ◽

Laboratory Findings ◽

Group 2 ◽

High Level ◽

Group 1

SUMMARY OBJECTIVE Acute pancreatitis (AP) is an important clinical event with an increased frequency due to increased life expectancy, obesity, and alcohol use. There are some data about the elevation of carbohydrate antigen (CA) 19-9 levels in benign and malignant pancreaticobiliary events in the literature, but in AP they are limited. The aim of this study was to evaluate the CA 19-9 level in patients with AP and determine its relationship according to the cause. METHODS Between 2010-2018, 173 patients evaluated with CA 19-9 levels as well as by standard laboratory tests were included in the study. CA 1 9-9 levels and laboratory findings were compared in patients with pancreatitis due to gallstone (group 1) and metabolic/toxic reasons such as hyperlipidemia, alcohol, or drug use (group 2). RESULTS There were 114 (66%) patients in the group 1 and 59 (34%) patients in the group 2. The majority of patients with high CA 19-9 level were in group 1 (92.1% vs 6.8%). CA 19-9 level, as well as amylase, lipase, AST, ALT and bilirubin levels were found to be statistically higher in patients with AP due to gallstone compared to patients with metabolic/toxic AP. CONCLUSIONS Patients with AP due to gallstone, were found to have a high level of CA 19-9 at admission. Early stage CA 19-9 levels may contribute to standard laboratory tests in the etiology of the disease in patients diagnosed with AP.

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Persistent High Level of Urinary Tumor Marker Carbohydrate Antigen 19-9 in Prenatally Diagnosed Dysplastic Kidney

Case Reports in Urology ◽

10.1155/2014/259870 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Reza Khorramirouz ◽

Maryam Ebadi ◽

Fatemeh Rahimi Sherbaf ◽

Abdol-Mohammad Kajbafzadeh

Keyword(s):

Tumor Marker ◽

Congenital Abnormality ◽

Carbohydrate Antigen ◽

Epithelial Lining ◽

Gastrointestinal Malignancies ◽

Dysplastic Kidney ◽

Urinary Levels ◽

Cyst Aspiration ◽

High Level

Tumor marker carbohydrate antigen 19-9 (CA 19-9) level has gained clinical significance in gastrointestinal malignancies and in various solid and cystic diseases. Dysplastic kidney is a congenital abnormality resulting from atresia of the ureteral bud during the embryogenesis which can be unilateral or bilateral. We report unilateral dysplastic kidney with extremely large cyst diagnosed by routine ultrasonography in the 32nd week of gestational age with high levels of CA 19-9 in cystic and amniotic fluid, as well as persistent high urinary levels of this tumor marker during the 1-year follow-up. Persistent high urinary CA 19-9 level even after cyst aspiration may be attributable to remained function of dysplastic kidney due to remained epithelial lining.

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Sporadic, Trauma-Induced Pancreatic Desmoid Tumor: Case Report of a Rare Disease and Literature Review

10.21203/rs.3.rs-214030/v1 ◽

2021 ◽

Author(s):

zhongfei zhu ◽

Bin Song ◽

Gang Jin

Keyword(s):

Pancreatic Adenocarcinoma ◽

Desmoid Tumor ◽

Immunohistochemical Analysis ◽

Carbohydrate Antigen ◽

Magnetic Resonance Imaging Scan ◽

Presumptive Diagnosis ◽

Abdominal Magnetic Resonance Imaging ◽

Recommended Treatment ◽

Resected Tumor ◽

High Level

Abstract Background:Desmoid tumor (DT) is a rare neoplasm. It is a benign tumor, but it has the potential to become invasive. The number of reported intra-abdominal DT cases does not exceed 100. The etiology is usually associated with a surgery, with the tumor occurring especially at the surgical margins. Cases induced by trauma have not been reported before. Case presentation:Here we report of a case of a 15-year-old boy who fell and was hit in his abdomen by his bicycle’s handle. He was referred to our unit due to the yellowing of the skin and sclera. We assumed it to be pancreatic adenocarcinoma because he had obstructive jaundice, a high level of the carbohydrate antigen 19-9 and the diagnosis of abdominal magnetic resonance imaging scan, which demonstrated pancreatic cancer.Elective surgery was performed based on a presumptive diagnosis of pancreatic adenocarcinoma. Immunohistochemical analysis on the resected tumor concluded a diagnosis of pancreatic DT. After 48 months of follow up, the patient still shows no sign of recurrence. Conclusion:Based on the reviewed literature, curative resection is the recommended treatment for pancreatic DT, and the rate of recurrence for sporadic pancreatic DT is low.

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Klebsiella pneumoniae-related invasive liver abscess syndrome complicated by purulent meningitis: a review of the literature and description of three cases

BMC Infectious Diseases ◽

10.1186/s12879-020-05702-3 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Ruixue Sun ◽

Hui Zhang ◽

Yingchun Xu ◽

Huadong Zhu ◽

Xuezhong Yu ◽

...

Keyword(s):

Glycemic Control ◽

Klebsiella Pneumoniae ◽

Liver Abscess ◽

Clinical Manifestations ◽

Case Presentation ◽

Purulent Meningitis ◽

Strict Glycemic Control ◽

Uncontrolled Diabetes ◽

High Level ◽

Short Time

Abstract Background Klebsiella pneumoniae (K. pneumoniae) invasive liver abscess syndrome (ILAS) with purulent meningitis was rarely identified the mainland of China. Last winter, we received 3 cases of K. pneumoniae meningitis and all of them died in a short time. We report these cases in order to find the reason of high mortality and discuss effective effort to improve these patients’ prognosis. Case presentation Three patients with uncontrolled diabetes developed live abscess and purulent meningitis. Upon admission, the clinical manifestations, laboratory result of blood and cerebrospinal fluid (CSF) and imaging examinations were compatible with K. pneumoniae ILAS which had metastasis infection of meningitis. Even with timely adequate antibiotic therapy and strict glycemic control, all of the patients’ condition deteriorated rapidly and died in a short time. Conclusion The reason of patients’ poor prognosis might be the absence of liver abscess drainage, high level of CSF protein which indicates severe inflammation and unknown special but stronger virulence factors of K. pneumoniae the patients’ living place Zhangjiakou. Strict glycemic control, early drainage of liver abscess and appropriate antibiotic application are recommended for treating this condition, further progress on the pathogenesis and treatment of K. pneumoniae meningitis may help patients gain a better prognosis.

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Transcription factor/DNA interactions visualized by electron spectroscopic imaging

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s0424820100122654 ◽

1992 ◽

Vol 50 (1) ◽

pp. 450-451

Author(s):

David P. Bazett-Jones ◽

Mark L. Brown

Keyword(s):

Transcription Factor ◽

Dna Sequences ◽

Transcription Initiation ◽

Molecular Mechanisms ◽

Phosphorus Content ◽

Spectroscopic Imaging ◽

Electron Spectroscopic Imaging ◽

Dna Backbone ◽

Two Parameters ◽

High Level

A multisubunit RNA polymerase enzyme is ultimately responsible for transcription initiation and elongation of RNA, but recognition of the proper start site by the enzyme is regulated by general, temporal and gene-specific trans-factors interacting at promoter and enhancer DNA sequences. To understand the molecular mechanisms which precisely regulate the transcription initiation event, it is crucial to elucidate the structure of the transcription factor/DNA complexes involved. Electron spectroscopic imaging (ESI) provides the opportunity to visualize individual DNA molecules. Enhancement of DNA contrast with ESI is accomplished by imaging with electrons that have interacted with inner shell electrons of phosphorus in the DNA backbone. Phosphorus detection at this intermediately high level of resolution (≈lnm) permits selective imaging of the DNA, to determine whether the protein factors compact, bend or wrap the DNA. Simultaneously, mass analysis and phosphorus content can be measured quantitatively, using adjacent DNA or tobacco mosaic virus (TMV) as mass and phosphorus standards. These two parameters provide stoichiometric information relating the ratios of protein:DNA content.

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