Role of duodenal bile crystal analysis in idiopathic pancreatitis

BACKGROUND/AIM

The aim of this study was to find out the incidence and clinical use of duodenal bile crystal analysis in patients presenting with idiopathic pancreatitis.

MATERIALS AND METHODS

Sixty consecutive patients with acute pancreatitis were studied. They were divided into two subgroups (known and unknown causes). Sixty patients were used as controls and divided into 3 subgroups (n = 20 each). The patients of acute pancreatitis with severe or life threatening complications or those requiring surgical interventions were excluded. Bile samples from both groups were analyzed for presence or absence of crystals.

RESULTS

The maximum age incidence of acute pancreatitis was in the fifth decade (41-50 years). The M/F ratio was 3.6:1. Recurrent acute pancreatitis was observed in 26.6% cases (20% idiopathic vs. 6.6% known aetiology). Twenty-five percent of the control sub group (n = 20) cases of cholelithiasis without history of pancreatitis had positive microcrystals in their bile sample. In patients with idiopathic pancreatitis (n = 18), 7 cases (11.6%) had crystals in the bile. In those with known causes of pancreatitis (n = 42), 33 cases (55%) had positive crystals in the bile.

CONCLUSION

Thirty percent of our patients had idiopathic acute pancreatitis with a high rate of clinical recurrence (20%). Duodenal bile crystal analysis detected 7 cases of microlithiasis out of 18 cases in this group and suggested an aetiology. This procedure should be used more often.

Biodistribution of fluoresceinated dextran using novel nanoparticles evading reticuloendothelial system

The rapid clearance of circulating nanoparticles from the blood stream coupled with their high uptake by liver and spleen has thus far been overcome by reducing the particle size, and by making the particle surface hydrophilic with poloxamers and poloxamines. We have prepared hydrogel nanoparticles of polyvinylpyrrolidone of a size less than 100 nm diameter with precise size distribution. Since the inner cores of these particles are also hydrophilic, these particles are capable of encapsulating water-soluble compounds. Biodistribution of these particles shows practically negligible (<1%) uptake by the macrophages in liver and spleen, and approximately 5-10% of these particles remain in circulation even 8 h after i.v. injection. Increasing the surface hydrophobicity as well as particle size can increase the RES uptake of these particles. Because of longer residence in blood, the hydrogel nanoparticles have potential therapeutic applications particularly in cancer: the water-soluble cytotoxic agents encapsulated in these particles can be targeted to tumors while minimizing the likelihood of toxicity to reticuloendothelial system (RES).

pH- and Thermo-sensitive Hydrogel Nanoparticles

pH- and temperature-sensitive hydrogel nanoparticles of copolymers of vinylpyrrolidone (VP) and acrylic acid (AA) cross-linked with NN' methylene bis acrylamide (MBA) of sizes up to 50 nm diameter loaded with marker compound FITC-dextran (mol wt. 19.3 kD) were prepared in the aqueous core of reverse micellar droplets and were dispersed in aqueous buffer. These particles have high entrapment efficiency, and the lyophilized powder can be redissolved in buffer without any significant agglomeration. The release of FITC-dextran from these particles was found to be pH- and temperature-dependent. The release was slow in acid solution, but it increased considerably as the pH of the medium was increased. The release rate was also increased with the increase of temperature. Copyright 1998 Academic Press.

Novelty and complexity in human infants' exploratory behaviour

The effect of novel and complex stimulus cubes on the exploratory behaviour of human infants was analysed in two studies (ns = 30 and 20). Infants showed relatively greater preference for complex patterned cubes, and their exploratory behaviour habituated over 5 days.

Acute fatal DDS poisoning. (Report of 4 cases)

Acute dapsone poisoning is rare and such cases are either accidental or suicidal. Though accidental DDS poisoning are reported in children, the same is fairly uncommon in adults. Only 2 such cases are reported in India literature. We here report 4 cases of fatal sucidial DDS poisoning in adults resulting death in 3 cases. The reported acute symptoms include nausea, vomiting, hyperexcitability followed by depression, Carpopedal spasm or convulsions. The most marked signs are dyspnoea and cyanosis. The symptoms are due to methaemoglobinaemia, and or sulphaemoglobinaemia. Normally dapsone induces red cell haemolysis and even with small therapeutic doses of 25-100 mg per day, and in toxic doses reduces the oxygen carrying capacity of blood and damages the red cells making them more vulnerable for haemolysis. The peculiarity of the presentation in this series are manifestation of severe haemorrhagic episode in one case and progressive jaundice in another besides cyanosis. None of the cases had carpopedal spasm or convulsion. Out of four cases three died inspite of intensive care, intravenous vitamin C, exchange transfusion (2 cases) and other supportive measures. Intravenous methylene blue could not be used in these cases due to non-availability.