AIM: To evaluate the diagnostic value of different indirect methods like biochemical parameters, ultrasound (US) analysis, CT-scan and MRI/MRCP in comparison with endoscopic retrograde cholangiography (ERC), for diagn...AIM: To evaluate the diagnostic value of different indirect methods like biochemical parameters, ultrasound (US) analysis, CT-scan and MRI/MRCP in comparison with endoscopic retrograde cholangiography (ERC), for diagnosis of biliary complications after liver transplantation. METHODS: In 75 patients after liver transplantation, who received ERC due to suspected biliary complications, the result of the cholangiography was compared to the results of indirect imaging methods performed prior to ERC. The cholangiography showed no biliary stenosis (NoST) in 25 patients, AST in 27 and ITBL in 23 patients. RESULTS: Biliary congestion as a result of AST was detected with a sensitivity of 68.4% in US analysis (specificity 91%), of 71% in MRI (specificity 25%) and of 40% in CT (specificity 57.1%). In ITBL, biliary congestion was detected with a sensitivity of 58.8% in the US, 88.9%in MRI and of 83.3% in CT. However, as anastomotic or ischemic stenoses were the underlying cause of biliary congestion, the sensitivity of detection was very low. InMRI detected the dominant stenosis at a correct localization in 22% and CT in 10%, while US failed completely. The biochemical parameters, showed no significant difference in bilirubin (median 5.7; 4,1; 2.5 mg/dL), alkaline phosphatase (median 360; 339; 527 U/L) or gamma glutamyl transferase (median 277; 220; 239 U/L) levels between NoST, AST and ITBL.CONCLUSION: Our data confirm that indirect imaging methods to date cannot replace direct cholangiography for diagnosis of post transplant biliary stenoses. However MRI may have the potential to complement or precede imaging by cholangiography. Optimized MRCP-processing might further improve the diagnostic impact of this method.展开更多
AZM： To evaluate our experience in endoscopic retrograde cholangio-pancreatography （ERCP） in terms of fulfilling the ASGE guidelines in indications, positive findings, and complications in the post-magnetic resonan...AZM： To evaluate our experience in endoscopic retrograde cholangio-pancreatography （ERCP） in terms of fulfilling the ASGE guidelines in indications, positive findings, and complications in the post-magnetic resonance cholangiopancreatography （MRCP） era. METHODS： Between November 2001 and February 2003, consecutive ERCP cases were prospectively evaluated with regard to the indications, findings, cannulation techniques, devices used during the procedure, sedation given, duration of procedure, and complications. These data were entered in a database for subsequent processing and analysis. RESULTS： Of 336 cases, 21.4% were diagnostic and 78.6% therapeutic ERCR The indications for ERCP fulfilled the ASGE guidelines in 323 cases （96.1%）. Suspected bile duct stone was the most frequent indication （26.8%）, and this was followed by cholangitis （24.4%）, dilated common bile duct （14.9%）, and cholestatic jaundice （23.4%）. Cannulation success rate was 94%. Biliary sphincterotomy was performed in 175 （52.1%） patients. Repeated ERCP was performed on 31.5% of the patients. Overall, the complication rate was 9.8% with 0.3% being procedurerelated mortality. The complications were pancreatitis （5.4%）, bleeding （0.8%）, cholangitis （2.4%） and others （1.5%）. No significant difference was observed between the complication rate and the type of ERCP performed. CONCLUSION： Our study showed that post-ERCP complication rate was comparable with the other large prospective studies and there was no difference in the complication between the diagnostic and therapeutic ERCP.展开更多
AIM: To study the transcriptional regulation of human telomerase reverse transcriptase (hTERT) mRNA in normal human cholangiocytes (HBECs) after hepatitis B virus X (HBx) gene transfection and to elucidate the possibl...AIM: To study the transcriptional regulation of human telomerase reverse transcriptase (hTERT) mRNA in normal human cholangiocytes (HBECs) after hepatitis B virus X (HBx) gene transfection and to elucidate the possible mechanism of HBV infection underlying cholangiocarcinoma.METHODS: HBECs were cultured in vitroand co-transfected with a eukaryotic expression vector containing the HBx coding region and a doning vector containing coding sequences of enhanced green fluorescent protein (EGFP) using lipidmediated gene transfer. The transfection efficiency was determined by the expression of EGFP. The expressions of hTERT mRNA and HBx protein in HBECs were detected by RT-PCR and immunocytochemical stain, respectively.RESULTS: The transfection efficiencies were about 15% for both HBx gene expression plasmid and empty vector.No hTERT mRNA was expressed in HBECs when transfected with OPTI-NEN medium and empty vector, but a dramatic increase was observed for hTERT mRNA expression in HBECs when transfected with HBx expression vector. HBx proyein was only expressed in HBECs when transfected with HBx expression vector.CONCLUSION: HBx transfection can activate thet ranscriptional expression of hTERT mRNA. Cis-activation of hTERT mRNA by HBx gene is the primary mechanism underlying the proliferation, differentiation and tumorigenesis of biliary epithelia.展开更多
文摘AIM: To evaluate the diagnostic value of different indirect methods like biochemical parameters, ultrasound (US) analysis, CT-scan and MRI/MRCP in comparison with endoscopic retrograde cholangiography (ERC), for diagnosis of biliary complications after liver transplantation. METHODS: In 75 patients after liver transplantation, who received ERC due to suspected biliary complications, the result of the cholangiography was compared to the results of indirect imaging methods performed prior to ERC. The cholangiography showed no biliary stenosis (NoST) in 25 patients, AST in 27 and ITBL in 23 patients. RESULTS: Biliary congestion as a result of AST was detected with a sensitivity of 68.4% in US analysis (specificity 91%), of 71% in MRI (specificity 25%) and of 40% in CT (specificity 57.1%). In ITBL, biliary congestion was detected with a sensitivity of 58.8% in the US, 88.9%in MRI and of 83.3% in CT. However, as anastomotic or ischemic stenoses were the underlying cause of biliary congestion, the sensitivity of detection was very low. InMRI detected the dominant stenosis at a correct localization in 22% and CT in 10%, while US failed completely. The biochemical parameters, showed no significant difference in bilirubin (median 5.7; 4,1; 2.5 mg/dL), alkaline phosphatase (median 360; 339; 527 U/L) or gamma glutamyl transferase (median 277; 220; 239 U/L) levels between NoST, AST and ITBL.CONCLUSION: Our data confirm that indirect imaging methods to date cannot replace direct cholangiography for diagnosis of post transplant biliary stenoses. However MRI may have the potential to complement or precede imaging by cholangiography. Optimized MRCP-processing might further improve the diagnostic impact of this method.
文摘AZM： To evaluate our experience in endoscopic retrograde cholangio-pancreatography （ERCP） in terms of fulfilling the ASGE guidelines in indications, positive findings, and complications in the post-magnetic resonance cholangiopancreatography （MRCP） era. METHODS： Between November 2001 and February 2003, consecutive ERCP cases were prospectively evaluated with regard to the indications, findings, cannulation techniques, devices used during the procedure, sedation given, duration of procedure, and complications. These data were entered in a database for subsequent processing and analysis. RESULTS： Of 336 cases, 21.4% were diagnostic and 78.6% therapeutic ERCR The indications for ERCP fulfilled the ASGE guidelines in 323 cases （96.1%）. Suspected bile duct stone was the most frequent indication （26.8%）, and this was followed by cholangitis （24.4%）, dilated common bile duct （14.9%）, and cholestatic jaundice （23.4%）. Cannulation success rate was 94%. Biliary sphincterotomy was performed in 175 （52.1%） patients. Repeated ERCP was performed on 31.5% of the patients. Overall, the complication rate was 9.8% with 0.3% being procedurerelated mortality. The complications were pancreatitis （5.4%）, bleeding （0.8%）, cholangitis （2.4%） and others （1.5%）. No significant difference was observed between the complication rate and the type of ERCP performed. CONCLUSION： Our study showed that post-ERCP complication rate was comparable with the other large prospective studies and there was no difference in the complication between the diagnostic and therapeutic ERCP.
基金Supported by the National High Technology Research and Development Program of China,863 Program,No.2002AA214061
文摘AIM: To study the transcriptional regulation of human telomerase reverse transcriptase (hTERT) mRNA in normal human cholangiocytes (HBECs) after hepatitis B virus X (HBx) gene transfection and to elucidate the possible mechanism of HBV infection underlying cholangiocarcinoma.METHODS: HBECs were cultured in vitroand co-transfected with a eukaryotic expression vector containing the HBx coding region and a doning vector containing coding sequences of enhanced green fluorescent protein (EGFP) using lipidmediated gene transfer. The transfection efficiency was determined by the expression of EGFP. The expressions of hTERT mRNA and HBx protein in HBECs were detected by RT-PCR and immunocytochemical stain, respectively.RESULTS: The transfection efficiencies were about 15% for both HBx gene expression plasmid and empty vector.No hTERT mRNA was expressed in HBECs when transfected with OPTI-NEN medium and empty vector, but a dramatic increase was observed for hTERT mRNA expression in HBECs when transfected with HBx expression vector. HBx proyein was only expressed in HBECs when transfected with HBx expression vector.CONCLUSION: HBx transfection can activate thet ranscriptional expression of hTERT mRNA. Cis-activation of hTERT mRNA by HBx gene is the primary mechanism underlying the proliferation, differentiation and tumorigenesis of biliary epithelia.
