[Different gain-setting affects measurement of extrahepatic bile duct by real-time ultrasound].
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Biomedical subjects
Publications and source records attributed to Y H Ho.
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Using a high-resolution real-time scanner, a technique has been established in our laboratory for visualizing the entire extrahepatic bile duct with multiple longitudinal oblique approaches and, if necessary, several transverse scans through the pancreatic head. To determine the normal size of the extrahepatic bile duct and to evaluate the effect of aging on the duct diameter, 256 healthy subjects and patients without hepatobiliary disease were examined using this technique from January to August, 1982. The entire extrahepatic duct was detected in 203. The inner diameter of the widest point of the duct varied from 1 mm to 10 mm, and was found to be age-dependent (r = 0.60, P less than 0.001). It is concluded that, based on the visualization of the entire extrahepatic duct echographically, the normal inner diameter of common bile duct can be up to 10 mm, and there is a mild change of duct size with age.
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Technetium-99m di-isopropylphenylcarbamoylmethylimidodiacetic acid cholescintigraphy, together with measurements of radioactivity in duodenal juice, was used to evaluate 23 infants with prolonged obstructive jaundice. Four patients proved to have biliary atresia. The remainder had neonatal hepatitis. There was distinct differentiation of biliary atresia from neonatal hepatitis when the time-activity curves were analyzed. In neonatal hepatitis the radioactivity in duodenal juice is obviously higher, peaking above 1500 cpm/100 microliter per mCi dose. In biliary atresia the pattern is flattened, with maximal activity below 500 cpm/100 microliter per mCi dose.
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Serum copper levels (SCL) and serum zinc levels (SZL) were evaluated in 128 patients with nasopharyngeal carcinoma (NPC) of varying stages before, during, and after radiotherapy, and then compared with normal age-matched subjects. Among these patients, there were 119 undifferentiated squamous cell carcinoma, 5 differentiated squamous cell carcinoma, and 4 moderately differentiated squamous cell carcinoma, respectively. Before radiotherapy, SCLs were significantly higher in NPC patients than in normal subjects, but the difference of SZLs was not significant. The ratio of Cu/Zn also showed a significant difference between normal subjects and NPC patients preradiotherapy. Moreover, except stage II, patients with more advanced stages of the disease had more elevated Cu/Zn ratios. During and after the period of radiotherapy, the SCL decreased as compared with the level of preradiotherapy. The Cu/Zn ratio also decreased after radiotherapy but not significant. However, Cu/Zn ratio of expired patients at least 2 yr after radiotherapy did not show the significant decrease in contrast to the alive ones.
Total pelvic exenteration is often the only curative option for recurrent or locally advanced pelvic cancers, but it carries a high risk of mortality and morbidity. A dedicated multispecialty team operative approach may provide the expertise to perform this uncommon procedure with favorable outcomes. Data were analyzed from a prospectively collected computerized database. There were 14 patients (2 men; mean age, 54.6 +/- 3.6 years) with mainly cervical cancers, of which 71.4% were recurrent. Anesthetic time was 5 +/- 0.9 hours, intraoperative blood loss was 2.1 +/- 0.5 liters, and postoperative hospitalization was 22 +/- 9.9 days. An ileal conduit was performed in all patients, but intestinal continuity was restorable with colonic J-pouch in 71.4% of the patients. There was no mortality at 30 days or during hospitalization. Complication rates were 35.7%, accounting for reoperations in 28.6%. Recurrences were detected in 50% patients at a mean follow-up of 53.1 +/- 9.2 months. The mean time for cancer recurrence was 13.3 +/- 3.3 months. Fifty percent of those patients had otherwise survived to date. We conclude that a dedicated multispecialty team may perform total pelvic exenteration with minimum mortality and acceptable morbidity.
Epstein-Barr virus (EBV) has consistently been shown to be associated with undifferentiated nasopharyngeal carcinoma, and an EBV-associated nuclear antigen (EBNA) has been detected in the cells of nasopharyngeal carcinoma. A study on the applicability of EBNA detection in fine needle aspiration (FNA) smears from cervical lymph nodes in the diagnosis of metastatic nasopharyngeal carcinoma was performed. All 11 cases (100%) with metastatic nasopharyngeal carcinoma showed EBNA-positive tumor cells, characterized by bright, granulated nuclear fluorescence. Three (50%) of six cases with other metastatic head and neck carcinomas also showed EBNA-positive tumor cells. These findings suggest that the presence of EBNA-positive tumor cells in FNA smears from cervical lymph nodes is not specific for metastatic nasopharyngeal carcinoma. On the other hand, a negative result in the presence of tumor cells may help to exclude it. A larger study is required to verify these preliminary findings.