Virtual colonoscopy as a new diagnostic tool in cancer colon

Virtual reality imaging is a new technology that combines helical computed tomography and magnetic resonance [MR] data and advanced three-dimensional graphics software to generate endoluminal perspective images of hollow organs. Computed tomography colonography [Virtual colonoscopy] is an imaging procedure in which a series of helical CT scans of the patient's colon are rendered by computer into slices that can be visualized as serially combined images to provide a three-dimentional tour of the colon. So, this technique has been evaluated, mostly conducted in diagnostic [rather than screening] setting in higher-risk patients. In this work, we try to evaluate the sensitivity and accuracy of virtual colonoscopy as a new modality for colorectal evaluation in patients subjected to traditional colonoscopy and double-contrast barium enema study who are diagnosed as having cancer colon and to correlate the findings of virtual colonoscopy with those of conventional colonoscopy and barium study. This work was conducted on twenty [20] patients, selected among 91 patients of different colonic illness admitted in Mansoura and Banha Gastroenterology Centers. They were thirteen [13] males and seven [7] females with age ranging form 49-75 years; mean age [59.5 +/- 8.6] years. All patients were subjected to complete medical history, thorough clinical examination, routine laboratory tests and special laboratory investigations as carcino-embryonic antigen [CEA] and occult blood in stool. Abdominal ultrasonography, barium double-contrast enema, traditional colonoscopy and virtual colonoscopy were done for all patients. Colonoscopic biopsies were obtained as routine in every case in addition to biopsy from any suspected areas or detected masses. Histopathological examination was done also for every sample. From this study, we concluded that CT colonography [Virtual Colonoscopy] is feasible for the detection of colorectal cancer with high success in sizes more than 10mm and further technical advances will improve the performance of CT colonoscopy and will allow patients available imaging modality for full structural examination of the colon

Functional and structural cardiac abnormalities in cirrhotic patients with and without ascites

This study was done to clarify the nature of cardiac involvement in liver cirrhosis, the study comprised 40 patients with liver cirrhosis and 10 healthy control subjects. These patients were categorized under 3 groups: Patients with liver cirrhosis and tense ascites: This group comprised 20 patients [7 females [35%] and 13 males [65%] with age range from 40 to 70 years [mean = 55 +/- 8] [Group 1]. Patients with liver cirrhosis with no evidence of actual ascites at clinical and abdominal ultrasound examination but with history of clinically previous episodes of ascites. This group comprised 20 patients [5 females [25%] and 15 males [75%] with age range from 46 to 70 years [mean 55 +/- 5] [Group 2]. 10 healthy subjects [3 females [30%] and 7 males [70%]] with age range from 45 to 70 years [mean= 56 +/- 7], served as normal control for comparison [Group 3]. All patients were subjected to full history taking, full clinical examination, laboratory investigation [assessment of liver function, hepatitis marker, indirect haemaglutination [IHA] for bilharziasis, arterial blood gases], abdominal ultrasound, X ray chest and heart, electrocardiography, doppler echocardiography. The results showed that patients with liver cirrhosis with and without ascites showed increased prevalence of Q-Tc interval prolongation that correlate positively with the severity of liver cirrhosis and Child Pugh Score and was attributed to autonomic dysfunction, adrenergic hypertone, electrolyte imbalance and female gender. The study showed also irrespective of the ascites and the cause, patients with advanced liver cirrhosis had left ventricular diastolic dysfunction and wall thickness increase while the left ventricular systolic function still normal and impairment of left ventricular diastolic function correlates positively with the severity of liver disease and Child Pugh Score. The possible mechanisms responsible for the cardiac changes in liver cirrhosis include left ventricular overload induced by hyperdynamic circulation, impairment of B adrenergic receptors and its signal transudation pathway, abnormalities of circulating humoral factors and changes of cardiac plasma membrane physical properties