ABSTRACT
155 cases of chronic pancreatitis in PUMC hospital from 1952 to 1990 were investigated. Because endoscopic retrograde cholangiopancreatography (ERCP) and exocrine pancreatic function tests have been used since 1974, the diagnostic rate of chronic pancreatitis during 1974-1990 is 6.6 fold as that during 1952-1974. The pancreatic duct in 97 cases among 105 cases with chronic pancreatitis examined by ERCP was compared with CT and ultrasonography in diagnosis of chronic pancreatitis. The accuracy of diagnosis for ERCP is 84.8%, and is significantly higher than that for CT (56.0%, P < 0.01) and ultrasonography (37.8%, P < 0.001). The detective rate of abnormal pancreatic duct for ERCP is 91.4%, and is also significantly higher than that for CT (80.0%) and ultrasonography (79.7%, P < 0.05). These data indicated that the clinical features of chronic pancreatitis in China is more related to biliary diseases, rather than alcoholism. BT-PABA test and ultrasonography are valuable screen examinations, and ERCP is credible important examination in diagnosis of chronic pancreatitis.
Subject(s)
Cholangiopancreatography, Endoscopic Retrograde , Pancreatitis/diagnostic imaging , Adolescent , Adult , Aged , Aged, 80 and over , Chronic Disease , Female , Humans , Male , Middle Aged , Sensitivity and Specificity , Tomography, X-Ray Computed , UltrasonographyABSTRACT
We used a catheter passing through the papilla duodeni under the view of endoscope, with persistent perfusion system and transducer, to measure the pressure and contraction frequency of sphincter of Oddi (SO) in 10 healthy persons and 20 patients. Meanwhile, we compared the effect of Buscopan, Nitrostat and Vitamin K3 on the pressure and contraction frequency (CF). SO basal pressure (BP) in healthy group was 5.21 +/- 1.61 kPa (mean +/- s), SO peak pressure (PP) 8.21 +/- 1.34 kPa and CF 6.14 waves/min. In the group of peripapillary fistula, SO pressure decreased significantly and CF slowed down greatly. In comparison with the healthy group, SO pressure and CF in the group of gallbladder stone, choledocholithiasis and pancreatic diseases did not show any change of statistic significance. Intravenous injection of Buscopan could decrease SO peak pressure and BP remarkably. Sublingual administration of Nitrostat and intramuscular injection of Vit K3 could reduce SO PP markedly, SO BP didn't change statistically. It was also showed that spheric and semi-spheric papillae had higher pressure than the flat ones (P less than 0.001).
Subject(s)
Cholelithiasis/physiopathology , Sphincter of Oddi/drug effects , Adult , Aged , Butylscopolammonium Bromide/pharmacology , Dipyrone/pharmacology , Drug Combinations , Female , Gallstones/physiopathology , Humans , Male , Manometry , Middle Aged , Nitroglycerin/pharmacology , Pancreatic Diseases/physiopathology , Parasympatholytics/pharmacology , Sphincter of Oddi/physiopathology , Vitamin K/pharmacologyABSTRACT
Basal and pentagastrin stimulated gastric acid secretions were measured in 20 patients with duodenal ulcer before and after one week of treatment with oral omeprazole 20 mg daily. Omeprazole markedly inhibited gastric acid secretion in all the patients. The mean basal intragastric pH rose from 1.6 to 6.3, and the BAO and MAO were reduced by 86.9% and 83.9% respectively on day 7 of the study. We also conducted a clinical trial in 63 duodenal and 12 gastric ulcer patients. Each patient received 20 mg omeprazole. 98% of the patients were free of pain within first week of the treatment. After 2, 4 and 6 weeks of treatment, the healing rates of duodenal ulcer were 81.3%, 96.8% and 100% respectively, and those of gastric ulcer were 50%, 91.7% and 100% respectively. The drug was well tolerated and no side effect was observed.
Subject(s)
Duodenal Ulcer/drug therapy , Gastric Acid/metabolism , Omeprazole/therapeutic use , Stomach Ulcer/drug therapy , Duodenal Ulcer/physiopathology , Gastric Acidity Determination , Humans , Omeprazole/administration & dosage , Stomach Ulcer/physiopathologyABSTRACT
CA 19-9 is a carbohydrate antigen isolated from human colon carcinoma cell line, and is reportedly a tumor marker for pancreatic carcinoma. In this study we determined serum CA 19-9 in 71 normal subjects, 103 patients with benign digestive diseases, 85 patients with periampullary cancers, and 160 patients with other digestive cancers. Serum CA 19-9 was elevated only in 2.3% of normals and benign digestive disease patients, whereas it was increased in 72.7%, 86.4%, and 89.5% of pancreatic, ampullary, and choledochal carcinoma patients, respectively. Of other digestive cancer patients, it was elevated in 23.8%. In addition, very high serum CA 19-9 (greater than 120 u/m) was more often observed in patients with pancreatic, ampullary, and biliary cancer patients than in GL cancer patients (54.1% vs 9.4%, p less than 0.001). In 18 normal subjects and 68 patients with benign and malignant diseases, it was found that CA 19-9 content in the pancreatic juice was significantly increased in pancreatic, ampullary, and choledochal cancer patients, whereas in chronic pancreatitis patients it was normal, indicating that it is a specific and valuable tumor marker in differential diagnosis of pancreatic cancer.
