Comparison of the pancreozymin-secretin test and the Lundh test meal

The pancreozymin-secretin test and the Lundh test meal were performed on different days for comparison. Statistically significant differences in six parameters indicate that the pancreozymin-secretin test is more sensitive in detecting mild, acute or chronic pancreatic disease (P<.01). Results of the Lundh test meal were clearly abnormal in patients with severe chronic pancreatic disease.     

Standard procedure and the diagnostic criteria for the Ellsworth-Howard test using human PTH-(1-34)

The present study was undertaken to establish a standard method to perform the Ellsworth-Howard test using human PTH-1-34). For this purpose we made a survey of literature concerning the Ellsworth-Howard test and then examined the data of the Ellsworth-Howard tests performed on 178 hypoparathyroid patients using human PTH-(1-34). The main items of investigation were: (i) to determine the appropriate dose of PTH for administration to adults and children; and (ii) to define the criteria of practical usefulness for the differential diagnosis of the types of hypoparathyroidism. From the analysis of the data, the following findings and conclusions were obtained. The dose of human PTH-(1-34) appropriate for diagnostic use is 100 U per person for adults and 100 U per body surface area of one square meter (100 U/m2) for children. The criteria of positive response in the Ellsworth-Howard test are defined as follows. a) phosphaturic response: (U4 + U5) - (U2 + U3) = more than 35 mg/2 h b) cyclic AMP response: U4 - U3 = more than 1 mumol/h, and U4/U3 = more than 10 times. In the above formula, U2 - U5 represent the urine samples collected hourly in order. PTH is injected at the time between U3 and U4. For the application of the criteria in children, one should use the values corrected for body surface area of one square meter. It is necessary to confirm the following conditions before the application of the criteria: the presence of hypocalcemia and hyperphosphatemia; the lack of phosphate deficiency (basal urinary phosphate excretion more than 10 mg/2 h); the accuracy of timed urine collections (ratio of creatinine excretion during 2 hours before PTH to that after PTH administration in the range from 0.8 to 1.2); and the absence of marked diurnal variation in phosphate excretion (difference in phosphate excretion between the two basal hourly urine less than 17.5 mg/h). To ensure the above conditions, medications such as phosphate-binding antacids should be withheld for at least 1 week before the test, and the test should be performed according to the standard procedure described in this paper. The diagnosis of pseudohypoparathyroidism Type II should be done cautiously. It is necessary to take account of the high basal urinary cyclic AMP excretion and the elevated serum PTH level along with the results of the Ellsworth-Howard test (positive cyclic AMP response and negative phosphaturic response) for a definite diagnosis of this entity.     

Diagnostic criteria for vascular dementia.

The term vascular dementia implies the presence of a clinical syndrome (dementia) caused by, or at least assumed to be caused by, a specific disorder (cerebrovascular disease). In this review, the various sets of criteria used to define vascular dementia are outlined. The various sets of criteria are judged whether they contain criteria for both dementia and vascular disease as well as for the relationship between the two. We conclude that only the criteria of the State of California Alzheimer's Disease Diagnostic and Treatment Centers and of NINDS-AIREN provide sufficient operational criteria for dementia suitable for use in patients with vascular disease as well as for the diagnosis of cerebrovascular disease and for the establishment of a relationship between dementia and vascular disease. The latter criteria include also specific recommendations to the use of CT and MRI. However, the interpretation of the neuroimaging findings in the context of mixed vascular and degenerative dementia demands further study. Given the heterogeneous pathophysiology and pathology of vascular dementia and the modest reliability of the criteria, it seems plausible that the diagnosis of vascular dementia will become more reliable when specific diagnostic tests for the various degenerative diseases, from which vascular dementia has to be differentiated, become available.     

血清胃蛋白酶原检测诊断消化性溃疡的临床价值

目的探讨血清胃蛋白酶原（PG）检测诊断消化性溃疡（PU）的临床价值。方法采用时间分辨荧光免疫分析法检测98例PU患者和52例健康者的血清PGⅠ、PGⅡ和PGⅠ/PGⅡ,并进行比较。结果与健康者比较,PU患者血清PGⅠ、PGⅡ升高（P〈0.01）,PGⅠ/PGⅡ无明显变化（P〉0.05）。以受试者工作特征曲线分析PGⅠ、PGⅡ对DU的诊断价值,曲线下面积分别为0.79、0.72;PGⅠ205 ng/ml为其最佳诊断阈值,其灵敏度54.1%,特异度94.2%;PGⅡ17.5 ng/ml为其最佳诊断阈值,其灵敏度37.8%,特异度92.3%。结论血清PGⅠ、PGⅡ升高提示患PU的风险增加,PG检测在PU筛查及诊断中均有临床意义,PGⅠ可作为经济实用的PU筛查指标。