ABSTRACT
Endosonography is a distinct method in evaluating gastrointestinal [GI] structural lesions, particularly in the pancreatobiliary system. This procedure has made a fundamental change in the diagnosis of pancreatic mass lesions through fine needle aspiration [FNA]. This study aims to evaluate the results and efficacy of endosonographic fine needle aspiration [EUS-FNA] in patients presenting with solid pancreatic masses. This was a descriptive, prospective, case series study of patients who presented with solid pancreatic masses to Imam Khomeini Hospital, Tehran, Iran over a one year period [from November 2009-2010] In order to determine false negative cases, patients were followed for 6 to 12 months. A total of 53 patients underwent EUS-FNA with no complications. The results were diagnostic in 46 [87%] cases. The majority of patients were male [68%] and 81% had a mass in the pancreatic head. Cytopathology results revealed 36 [68%] adenocarcinomas, 7 [13%] other malignancies, 3 [6%] benign lesions and 7 [13%] nondiagnostic cases. The frequency of nondiagnostic results was significantly more in masses smaller than 3 cm [6 vs. 1, p < 0.002]. Patients with nondiagnostic results were younger than those with malignant cytopathologies [52 +/- 7.5 vs. 66 +/- 7.5 years, p < 0.001]. Sensitivity, specificity, PPV, NPV and accuracy of EUS-FNA in adenocarcinoma cases were 88%, 100%, 100%, 70% and 90%, respectively. EUS-FNA is an effective and safe procedure in the histopathologic diagnosis of pancreatic tumors
ABSTRACT
This preliminary study was designed to evaluate the effects of Heberon Alfa for the treatment of chronic hepatitis B infected subjects in Iran. A single center, open label, single treatment prospective study of Interferon Alfa [Heberon Alfa], 5 million units every other day for a period of 4 months, was performed between 1996 to 1998. A total number of 30 patients with histologically documented chronic hepatitis and positive serum HBsAg were included in the study. Serum ALT of all patients was greater than 1.5 times normal before start of therapy. Effect of therapy on aminotransferase activity and HBsAg, HBeAg seroconversion was monitored and all the patients underwent a second liver biopsy at the end of the study period. Mean age of patients was 35.5 +/- 12 [17 to 60 years old] and 73% of patients were mate. Most patients experienced adverse effects, but none warranted stopping the treatment. No serious or unexpected adverse event was reported during the study period. Thrombocytopenia was recorded in 2 patients. Liver biopsy showed a decrease in hepatic inflammation in 53.5% of patients, no change in 36.7% and increase in hepatic inflammation in 10% of patients after the treatment. Serum ALT returned to normal in 18 patients [60%], decreased in 7 patients [23.3%] and didn't change in 5 patients [16.7%]. There was a strong correlation between serum ALT normalization and histological improvement. HBsAg became negative in 5 patients [16.6%]. 10 patients had positive HBeAg prior to therapy, which became negative in 4 of them [40%] by the end of the study. The current study confirms the result of other clinical trials and indicates that Heberon Alfa is a safe and effective drug for the treatment of chronic hepatitis B infected subjects with histologically documented chronic hepatitis