Etecp cytology and EUS-FNA cytology in the diagnosis of malignant distal biliary and pancreatic duct strictures

Endoscopic retrograde cholangio-pancreatography [ERCP] with ductal brushings and pancreatic juice cytology is widely used in suspected pancreatic cancer, despite its low sensitivity. In contrast the accuracy rates of endoscopic ultrasound [EUS]-fine needle aspiration [FNA] for diagnosis of pancreatic malignancy is high. Aim of the study: To compare diagnostic performance of ERCP cytology [ERCP-C] with EUS-FNA in suspected patients with malignant pancreatic duct stricture. Patients and A prospective study included 56 patients with pancreatic duct stricture was performed. ERCP-C and EUS-FNA were carried out for cytopathological diagnosis. The final diagnosis was pancreatic malignancy in 60.7% patients and benign pancreatic disease in 39.3% patients. The sensitivity, specificity, positive [PPV] and negative [NPV] predictive values and accuracy of EUS-FNA for malignant pancreatic ductal stricture were 87.9%, 100%, 100%, 84.6% and 92.7, respectively. The sensitivity, specificity, PPV, NP V, and accuracy of ERCP brush cytology alone [41.4%, 100%, 100%, 55.3%, 66%, respectively], and combined with pancreatic juice cytology [48.3%, 100%, 100%, 58.3%, and 70%, respectively] were inferior to EUS-FNA. Significant dfferences between post ERCP-C and post-EUS-FNA pancreatitis were detected [P<0.001]. EUS-FNA is more sensitive and safer for cytopathological diagnosis of pancreatic duct stricture than ERCP-C

clinicobiochemical approach to etiogenesis of immunocompromization in patients with chronic renal failure

Immunologic disturbance of T and B lymphocytes was reported in uremic patients. An approach to the etiology of such immunocompromization was made by determination of plasma adenosine deaminase [ADA], 5'-nucleotidase, IgG, zinc and vitamin B6 together with erythrocyte adenosine-5-phosphate deaminase [AMP], adenosine deaminase [ADA] and 5'-nucleotidase in 30 uremic patients before and after dialysis. The results were compared with their counterparts in 30 healthy controls which were age matched to patients. The results clarified that the immune disturbances in patients with uremia were multifactorial resulting from decreased ADA together with nutritional deficiency of zinc and vitamin B6. Therefore, supplement of these patients with deficient nutrients should be considered

Diagnostic value of ultrasonography in chronic renal failure

Seventy patients [140 kidneys] with chronic renal failure were studied. Sonographic examination of these kidneys revealed, 101 of them were small medically diseased, 27 were enlarged hydronephrotic kidneys, 4 showed pyohyrdronephrosis, another 4 were polycystic kidneys and two kidneys were pyonephritic. Two kidneys could not be visualized by plain X-ray, ultrasonography or by intravenous pyelography

Autoreactive lymphocytotoxic antibodies in sensitised ureamic patients

We have studied 60 end stage renal disease patients, their age ranged between 2040 years. The sera of these patients were screened for the presence of lymphocytotoxic antidodies against peripheral blood lymphocytes of a random cell panel. Lymohocytotoxic antibodies were demonstrated in 25 patients [40%]. Those patient, with positive lymphocytotoxic antibodies were divided into groups. Those who undergoing maintenance heamodialysis and have recieved several blood transfusion [Group A].Those who have diagnosed for the first time and have not recieved blood [Group B]. The serum of those patients which were reactive with 30-100% of the above cell panel were then tested against autologous peripheral blood lymphocytes for detection of autoreactive lymphocytotoxic antibodies [AlcAs]. Autoreactive antibodies were detected in 50% of patients of group A and 18.8% of group B