Anglotensin converting enzyme activity as a marker of hepatocellular carcinoma

Our study have pointed to the change of serum angiotensin-converting enzyme [SACE] values in patients with liver disease and cancer located at different sites. The aim of this study was to determine the change in SACE values in patients with hepatocellular carcinoma [HCC] and liver cirrhosis. The study comprised 20 patients with HCC and 20 patients with liver cirrhosis. The control group consisted of 10 healthy volunteers. Liver function tests, abdominal ultrasonography and liver biopsy for diagnosis and grading the cases of liver cirrhosis and HCC. Serum alpha-fetoprotein [AFP] was measured by radioimmunoassay and SACE was measured by colorimetric method. The mean SACE value was considerably significantly lower in patients with HCC when compared to those with liver cirrhosis and control groups. The mean value of SACE was significantly correlated with the degree of differentiation of the tumor. In patients with liver cirrhosis, SACE value was significantly increased when compared to HCC and control group. It was found that there was a negative correlation between AFP value and SACE value. The study has shown that SACE values are low in patients with advanced HCC and high in patients with liver cirrhosis. Using a cut-off point for ACE 3.8 U/L in patients with HCC yielding sensitivity and specificity 93.3% and 100% respectively. While using a cut-off point for AFP 200 ng/nil yielding sensitivity and specificity 56.7% and 100% respectively. It may be helpful in detecting HCC in patients with liver cirrhosis, where it can be difficult to differentiate between small HCC and regenerating nodules

Treatment of fracture of the oscalcis: comparative study of two methods

Fifty patients with 54 feet suffered from recent displaced intra-articular fractures of the os calcis. They were managed randomly by either one of two methods: 1] closed reduction and compression bandage with early mobilization, or 2] closed reduction using a pin and plaster [a modified Gissane's method]. The results of the second method were clinically better. The difference however was statistically insignificant. The results were found significantly affected by the age. The degree of displacement, the restoration of tuber joint angle and the period of follow-up showed an insignificant effect on the results. The period of incapacitation was shorter as compared with other previous studies. Closed reduction by Gissane's method helps much to restore the tuber-joint angle