AIM Endoscopic pancreatic sphincterotomy is less widely practiced than biliary sphincterotomy, in part because of the lack of firm data regarding its indications and safety. In addition, recent reports of ductal and ...
详细信息
AIM Endoscopic pancreatic sphincterotomy is less widely practiced than biliary sphincterotomy, in part because of the lack of firm data regarding its indications and safety. In addition, recent reports of ductal and parenchymal changes occurring after pancreatic stenting raise concerns about the standard practice of stent placement at the time of pancreatic sphincterotomy. We report our experience with pancreatic sphincterotomy and describe the use of a technique involving overnight nasopancreatic drainage rather than stenting.METHODS We reviewed the records of the 164 pancreatic sphincterotomies performed on 160 patients at our institution between January 1, 1991, and October 1, 1996, comparing procedures done with overnight nasopancreatic catheter placement with those done with stenting or no drainage. We also examined the longterm clinical outcome of patients after pancreatic sphincterotomy.RESULTS Of the 164 sphincterotomies, 98 were done with overnight nasopancreatic drainage, 50 with stent placement, and 16 with no drainage. Complications (all pancreatitis) were significantly more frequent in the group with no drainage (125%) as compared with those with drainage (07%); P<0003. Nasopancreatic drainage was as safe as stent placement, with no complications after 98 procedures. Pancreatic sphincterotomy was effective when used as primary therapy, with 64% of patients so treated experiencing complete and longlasting resolution of symptoms after the procedure.CONCLUSION Pancreatic sphincterotomy is safe and effective, although pancreatic drainage is required to reduce the incidence of pancreatitis. Overnight nasopancreatic drainage is the method of choice, as it carries as low a complication rate as stent placement, but without the need for a repeat procedure, and presumably without the risk of ductal and parenchymal damage.
Previously,it was found that several proteins of Haemonchus contortus were involved in the stimulation of the host immune ***,the information about the selection of superlative antigens with immunogenic efficacies on ...
Previously,it was found that several proteins of Haemonchus contortus were involved in the stimulation of the host immune ***,the information about the selection of superlative antigens with immunogenic efficacies on host DCs is *** the current study,the stimulatory effects of five recombinant proteins(elongation factor-1α,arginine kinase,ES-15,ES-24,and ADP-ribosylation factor 1) of *** on the maturation of goat monocyte-derived dendritic cells(md-DCs) were *** proteins were purified separately in *** expression and incubated with isolated goat peripheral blood mononuclear cells(PBMC).Immunofluorescence assay(IFA) results confirmed the binding of these molecules to the md-DC’s surface as compared to control *** the flow cytometry analysis,recombinant proteins induced md-DC stimulation via the up-regulation of the expression of the costimulatory molecule(CD80) and MHC-Ⅱ.Quantitative RT-PCR data showed a significant increase in the expression of specific genes of the WNT and toll-like receptor(TLR) signaling *** result of ELISA indicated the higher levels of cytokine(IL-10,IL-12,IFN-y,and TNF-α) secretion in the md-DC compared to the negative(pET-32 a His-Tag) and blank(PBS)control *** data gives valuable support in the selection of potential antigens for future studies on the immunomodulation of the host against the infection of ***.
暂无评论