WordNet

undergo a test; "She doesnt test well"
any standardized procedure for measuring sensitivity or memory or intelligence or aptitude or personality etc; "the test was standardized on a large sample of students" (同)mental test, mental testing, psychometric test
the act of undergoing testing; "he survived the great test of battle"; "candidates must compete in a trial of skill" (同)trial
the act of testing something; "in the experimental trials the amount of carbon was measured separately"; "he called each flip of the coin a new trial" (同)trial, run
a hard outer covering as of some amoebas and sea urchins
put to the test, as for its quality, or give experimental use to; "This approach has been tried with good results"; "Test this recipe" (同)prove, try, try out, examine, essay
achieve a certain score or rating on a test; "She tested high on the LSAT and was admitted to all the good law schools"
determine the presence or properties of (a substance)
show a certain characteristic when tested; "He tested positive for HIV"
the next to highest level of official classification for documents
information known only to a special group; "the secret of Cajun cooking" (同)arcanum
something that should remain hidden from others (especially information that is not to be passed on); "the combination to the safe was a secret"; "he tried to keep his drinking a secret"
not expressed; "secret (or private) thoughts" (同)private
communicated covertly; "their secret signal was a wink"; "secret messages"
indulging only covertly; "a secret alcoholic"
not open or public; kept private or not revealed; "a secret formula"; "secret ingredients"; "secret talks"
an examination of the characteristics of something; "there are laboratories for commercial testing"; "it involved testing thousands of children for smallpox"
the act of subjecting to experimental test in order to determine how well something works; "they agreed to end the testing of atomic weapons"
a gastrointestinal hormone that stimulates the secretion of pancreatic enzymes and the contraction and emptying of the gall bladder; its release is stimulated by the presence of fatty acids and amino acids in the small intestine
tested and proved useful or correct; "a tested method" (同)tried, well-tried
tested and proved to be reliable (同)time-tested, tried, tried and true

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(人の能力などの)『試験』,考査,テスト / (物事の)『試験』,検済,試錬,実験《+of+名》 / 化学分析;試薬 / =test match / …‘を'『試験する』,検査する / …‘を'化学分析する / (…の)試験を受ける,試験をする《+for+名》
『秘密の』,人目につかない / 《名詞の前にのみ用いて》(人・組織などが)秘かに活動する,(感情などが)表に出ない / 《補語にのみ用いて》《話》(人が)(…を)ないしょにする《+『about』+『名』》 / 『秘密』[の事],隠し事,ないしょの話 / 神秘,不思議 / 《単数形で》(…の)『秘けつ』,かぎ《+『of』+『名』(do『ing』)》,(…への)秘けつ《+『to』+『名』》

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2017/11/22 08:33:55」(JST)

wiki en

The secretin-cholecystokinin test (aka Secretin-CCK test, Secretin-Pancreozymin test^[1]) is a combination of the secretin test and the cholecystokinin test and is used to assess the function of both the pancreas and gall bladder.

Cholecystokinin, a hormone secreted by the APUD cells located in the proximal mucosa of the small intestine is administered intravenously, this stimulates the pancreatic secretion of the digestive enzymes amylase, trypsin, and lipase. These are measured by a catheter placed in the duodenum. Cholecystokinin also stimulates the flow of bile and causes the gall bladder to contract and thus determine if the gall bladder is emptying properly. It also affects the esophageal sphincter and the sphincter of Oddi by reducing contraction as well as increasing motility (movement) of the stomach and intestine. The CCK test may be administered in conjunction with an ultrasound test to visually monitor gall bladder contraction. While the test is usually administered in a supine position Dr. William Smedley of Wilkes Barre, Pennsylvania has detected previously missed gallbladder abnormalities by administering the test in an erect position.^[2]^[3]^[4]

The concentration and output of bicarbonate with the secretin-CCK test is similar to what has been observed with the standard secretin test . The secretin-induced rapid flow of water results in lower and often unreliable enzyme concentrations. CCK also induces gallbladder contraction and the release of bile, which may further dilute enzyme concentrations. As a result, the quantification of total enzyme output (units/min) must be determined through continuous collection of duodenal fluid with or without the use of perfusion markers. Measurement of more than one enzyme (i.e. amylase, lipase, and tryptase) and bicarbonate may improve sensitivity since some patients may possess deficiencies of one parameter and not the others .

One study reviewed the relative diagnostic value of enzyme and bicarbonate concentrations compared with enzyme output in 363 secretin-CCK tests . The investigators also evaluated the requirement for perfusion markers to accurately quantify volume, and the validity of a shortened sampling time (first 20 minutes). Only 60 percent of volume was recovered with the duodenal aspiration tube, suggesting that marker perfusion to correct for distal loss of secretion is important to accurately quantify volume.

Using a trypsin output <50 U/kg/h as the reference standard, measurement of enzyme concentration alone misclassified approximately 10 percent of patients. Use of a shortened collection time misclassified approximately 4 percent of patients. The authors concluded that this was an unacceptably high rate of misclassification and that the standard prolonged collection of fluid using a perfusion marker must be performed to accurately measure exocrine function.

References

^ Steer, et al. Medical Progress: Chronic Pancreatitis. N Engl J Med 1995; 332:1482-1490 June 1, 1995 DOI: 10.1056/NEJM199506013322206
^ Burton Pet al.The use of cholecystokinin to test gall bladder function in man. Gut. 1960 Sep;1:193-204. PMID 13689291
^ Walkowiak J, Cichy WK, Herzig KH. Comparison of fecal elastase-1 determination with the secretin-cholecystokinin test in patients with cystic fibrosis.Scand J Gastroenterol. 1999 Feb;34(2):202-7. PMID 10192202
^ Heij HA.et.al.Evaluation of the secretin-cholecystokinin test for chronic pancreatitis by discriminant analysis. Scand J Gastroenterol. 1986 Jan;21(1):35-40. PMID 3952450

UpToDate Contents

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1. 膵外分泌機能検査 pancreatic exocrine function tests
2. オッディ括約筋機能不全の臨床症状よび診断 clinical manifestations and diagnosis of sphincter of oddi dysfunction
3. 吸収不良の臨床的特徴および診断 clinical features and diagnosis of malabsorption
4. セクレチン secretin
5. MR胆道膵管造影（MRCP） magnetic resonance cholangiopancreatography

English Journal

Influence of chronic ethanol consumption on extra-pancreatic secretory function in rat.

Urita Y1, Watanabe T, Imai T, Miura Y, Honda Y, Washizawa N, Sanaka M, Shimada N, Nakajima H, Sugimoto M.
North American journal of medical sciences.N Am J Med Sci.2009 Oct;1(5):239-43. doi: 10.4297/najms.2009.5239.
BACKGROUND: The usefulness of the typical direct methods involving duodenal intubation, such as the secretin and secretin-cholecystokinin tests, in the diagnosis of exocrine pancreatic dysfunction is widely accepted. However, these diagnostic tests tend to be avoided because of their technical compl
PMID 22666702

Fecal chymotrypsin and elastase-1 determination on one single stool collected at random: diagnostic value for exocrine pancreatic status.

Molinari I1, Souare K, Lamireau T, Fayon M, Lemieux C, Cassaigne A, Montaudon D.
Clinical biochemistry.Clin Biochem.2004 Sep;37(9):758-63.
OBJECTIVE: The secretin-cholecystokinin test is the "gold standard" to evaluate exocrine pancreatic function. But this direct duodenal intubation test is invasive, particularly in children, time-consuming, and expensive. For several years, indirect noninvasive tests of pancreatic insufficiency have
PMID 15329313

Faecal elastase-1 test is superior to faecal lipase test in the assessment of exocrine pancreatic function in cystic fibrosis.

Walkowiak J1, Lisowska A, Przyslawski J, Grzymislawski M, Krawczynski M, Herzig KH.
Acta paediatrica (Oslo, Norway : 1992).Acta Paediatr.2004 Aug;93(8):1042-5.
BACKGROUND AND AIMS: Direct tests are characterized by the highest sensitivity and specificity. However, their practical use, especially in children, is limited. Among the indirect tests, the highest sensitivity and specificity was documented for faecal elastase-1 test, yet the value of faecal lipas
PMID 15456193

Japanese Journal

A comparative evaluation of endoscopic retrograde cholangiopancreatography and the secretin-cholecystokinin test in the diagnosis of chronic pancreatitis : A multicentre study in 124 patients