The 13C-urea breath test (13C-UBT) is a non-invasive method for detecting Helicobacter pylori. This study was performed to determine the cutoff value and evaluate the sensitivity and specificity of 13C-UBT in Taiwan. 13C-Urea (100 mg of 99% 13C-labeled urea) was dissolved in 50 ml sterile water for the test. The test meal for delaying gastric emptying was 100 ml fresh milk. Patients fasted for at least 6h. A baseline breath sample was collected 5 min after they had the test meal. Two other samples were collected at 15 and 30 min after the patients ingested the 13C-urea. The test was evaluated in 352 patients after routine upper gastrointestinal endoscopy, and the urease test, culture, and histopathology were taken as the gold standards for detecting H. pylori. According to the receiver operating characteristic (ROC) curves, we chose values of 2.8 and 4.2 excess delta 13CO2 per mil as the cut-off values for 15 and 30 min, respectively, post 13C-urea. The sensitivity and specificity of 13C-UBT were 99% and 93% at 15 min, and 98% and 93% at 30 min post 13C-urea, respectively. The 13C-UBT breath test is an efficient non-invasive method of high sensitivity and high specificity for detecting H. pylori infection. We suggest that the use of fresh milk as the test meal and the detection of excess delta 13CO2 15 min after the ingestion of 13C-urea are suitable for the clinical use of 13C-UBT. This test is simple and rapid.
Biliary cystadenocarcinoma and its benign counterpart, biliary cystadenoma, are rare hepatic cystic tumors arising from the hepatobiliary epithelium. We report the case of a 68-year-old Taiwanese woman who presented initially with acute cholangitis. A series of imaging studies including abdominal ultrasound, computerized tomography, endoscopic retrograde cholangiopancreatography, and percutaneous transhepatic cholangiography showed bilateral intrahepatic duct (IHD) and common bile duct (CBD) stones with IHD and CBD dilatation, and an ill-defined tumor within the atrophied left hepatic lobe. The patient underwent surgical resection of the tumor and choledocholithotomy. The pathologic diagnosis was biliary cystadenocarcinoma. We review this rare disease entity and discuss its unusual radiologic features mimicking intrahepatic cholangiocarcinoma.
Alloy phases in the as-aged (T6) ZK60 magnesium alloy were investigated. More attentions were paid to types and morphologies of main alloy phases in the as-aged ZK60 magnesium alloy. The experimental results indicated that there was an abundant flower-shaped segregation in the solution-treated ZK60 magnesium alloy. A small quantity of undissolved compounds, MgZn2, was also found. They distributed irregularly in the form of similar parallelogram, with a dimension of 200nm~500nm and not sensitive to heat-treatment. Mg2Zn3 was found to be a main secondary compound in the as-aged ZK60 alloy, which precipitated during aging. Another precipitation phase, MgZn, in the as-aged ZK60 magnesium alloy was also found in the form of long and thin rods with a dimension of 500nm.
With the deepening of living space, the living behavior gradually become the basis of living space, Based on the steppe nomads living behavioral interviews, Analysis of the steppe nomads living behavior, Provide design basis for the study of the grassland dwelling pattern.
From July 1998 to December 2000, the distribution of pulmonary blood flow was evaluated in 34 consecutive surviving patients who had been randomly assigned to one of 4 different modes of total cavopulmonary connection. All patients underwent radionuclide lung perfusion imaging with 99m Tc-macroaggregated albumin to determine the distribution of blood from the superior and inferior venae cavae and the total pulmonary flow to each lung. The most physiological distribution of blood between the right and left lungs was obtained when the inferior vena cava anastomosis was widened and slightly offset towards the right pulmonary artery in patients without persistent left superior vena cava. This type of anastomosis should also reduce the incidence of arteriovenous malformations in the lung caused by exclusion of hepatic venous return.
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