Biomedical subjects
Publications and source records attributed to D Dejica.
Over the last years several case reports and articles have been published suggesting that a new form of chronic pancreatitis has been diagnosed and named autoimmune pancreatitis. The present overview scrutinizes the proposed evidence in the light of the current literature and aims to prove whether autoimmune pancreatitis is a special entity of chronic pancreatitis.
Circulating anti asialoglycoprotein receptor antibodies (anti-ASCPR) and soluble interleukin-2 receptor levels (sIL-2R) were blindly determined in sera of 23 patients with autoimmune hepatitis and compared to 18 healthy individuals. All patients underwent liver biopsy which was blindly staged and graded. 14 of 23 (61%) patients but none of normal controls showed anti-ASCPR positivity. Eleven of twelve (92%) patients with biopsy-proven grade 3 hepatitis were high-titered anti-ASCPR positive compared to three of eleven patients with grade I hepatitis. Mean levels of sIL-2R +/- standard deviation were 1.175 +/- 663 units/ml in the total number of patients with auto-immune hepatitis comparing to 372 +/- 69 units/ml in healthy controls (p < 0.001). Eleven of twelve patients with grade 3 hepatitis had significant higher sIL-2R levels (1,669 +/- 559) than patients with mild disease (635 +/- 113). Chi-square analysis demonstrated a significant correlation between positive anti-ASCPR titer and elevated sIL-2R values. A follow-up analysis of six patients showed a significant decrease of both anti-ASCPR titer and sIL-2R levels after three to nine months of immunosuppressive therapy. These findings suggest that elevated sIL-2R levels and anti-ASCPR titer are associated in patients with autoimmune hepatitis and- as a function of either T or B cell activation, respectively- could serve as reliable humoral marker for disease-specific activity.
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We carried out a preliminary study on the efficacy of endovaginal sonography (EVS) in the evaluation of rectal cancer. The study included 12 women with endoscopically documented rectal cancer, 10 of which were treated surgically. We found that EVS evidenced metastasized lymph nodes (7/9) and infiltration of the rectovaginal space more clearly; moreover, this technique can also be performed in cases of stenosing cancer. Endorectal sonography (ERS) evidenced infiltration of the rectal wall but was less accurate both in detecting metastasized lymph nodes (6/9) and for exploration of the rectovaginal space. We concluded that the two methods complement one another and improve ultrasonographic staging of rectal cancer.
The article deals with the valuation of endorectal and abdominal sonography in preoperative staging of rectal carcinoma. Data processing of 40 patients suffering from tumours of the rectum examined rectoscopically, by biopsy and via sonography showed that endorectal sonography can achieve preoperative staging (T) with a sensitivity of 89%, a specificity of 100%, a positive predictive value of 89% and a negative predictive value of 100%, the overall accuracy being 81%. Identification of pararectal adenopathies can be performed with a sensitivity of 16% and a specificity of 100%. Liver metastases were determined with a sensitivity and specificity of 100%. Hence, endorectal sonography is a valuable method for preoperative staging of carcinoma of the rectum.
By counterimmunoelectrophoresis in agarose gel the presence of alpha 2-PGA in the sera of 28 untreated patients with different localization of cancer was demonstrated. In 17 (60.7%) a precipitation line between the well with patient serum and that with monospecific anti-alpha 2-PGA serum, diluted 1 : 7 was obtained. At 1 : 7 dilution, with the sera from 28 healthy persons precipitation lines were not obtained. The determination of alpha 2-PAG can be made quickly and contributes to cancer diagnosis in men.
A method is described for increasing the sensitivity of conventional counterimmunoelectrophoresis (CIEP), i.e. double sequential counterimmunoelectrophoresis (DCIEP). Our method consists of a second electrophoretic migration made after the classical CIEP, where instead of HB antibody (from polytransfused patients), the anodic wells are filled with an antihuman-gammaglobulin antiserum. DCIEP is significantly more sensitive than CIEP (P less than 0.01), the number of positive sera in chronic lever diseases being 28.7% compared with 17.5%.
Double sequential counterimmunoelectrophoresis (DCIEP) (an improved method that we have developed) and Ausria II-125I (an indirect solid-phase radioimmunoassay) were compared for HBAg detection in chronic liver diseases. 26.8% of the patients were positive using DCIEP and 41.8% were positive with Ausria II125I. The conventional counterimmunoelectrophoresis (CIEP) is less sensitive than DCIEP, the level of positive results being 18.8% (P less than 0.001)9
Antibodies against rat myocardium were studied by means of histoimmunfluorescence (indirect technique) in 32 rheumatic fever patients. Antibodies were found in 54% of the cases without carditis or active rheumatic valvulitis and in 83% of those with carditis. The fluorescent patterns observed were : sarcolemmal, sarcoplasmic (intermyofibrillar) and smooth muscle of vessels. The sarcolemmal pattern was more frequently observed in rheumatic carditis while the intermyofibrillar one was more common in rheumatic fever without evidence of carditis as well as rheumatic valvulitis. The serum factors involved in the sarcolemmal fluorescence were inhibitied by the insoluble saline myocardium extract.
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