Management of complications of arteriovenous grafts in patients with chronic renal failure

Background: With increasing number of patients sustained on chronic Haemodialysis, access related surgery forms a significant proportion of vascular surgical practice today. A cursory review of patients with Arteriovenous graft access reveals a considerable variety in short and long term complications that could happen and in the management of those complications

Aim: The aim of this work is to assess the outcomes of different modalities of management of complications of Arteriovenous grafts in chronic renal failure patient on regular hemodialysis from arteriovenous graft

Patients and Methods: Thirty chronic renal failure patients with complicated Arterio-venous grafts performed before for regular hemodialysis were enrolled into this study. The patients were recruited from the Vascular Surgery outpatient clinic of El-Hussein University Hospital. Patients were followed up at intervals of: immediately after fistula creation, first day after creation, 1 month, 3 months, 6 months and 9 months after creation for detecting any complications. Follow up of all patients was based on clinical examination and also by duplex ultrasound and CT venography if needed

Results: Arteriovenous graft complications incidence were higher in male than females, those results were explained by male cases being associated with more co-morbidities and smoking. Venous outflow stenosis and venous hypertension were the most encountered complication, while surgical management in form of ligation and excision was the commonest management modality used. We also noticed a correlation between the duration from creation of AV synthetic graft and interval between primary and secondary intervention. The older the AV graft the longer was the interval between primary and secondary intervention. This can be correlated to years of education those group of patients had, as those patients tended to pay more attention to early manifestations and used better dialysis centers

Conclusion: Surgical management in form of graft ligation and excision or surgical revision seems to be the simplest yet most effective management modality facing the majority of the complications not neglecting the role of endovascular intervention in venous hypertension

Erectile dysfunction in patients with nonalcoholic fatty liver disease

Background and study aims: There is a lack of studies on erectile dysfunction [ED] in patients diagnosed with nonalcoholic fatty liver disease [NAFLD]. The present study aimed to estimate the prevalence of ED in patients with NAFLD and to determine the independent predictors of ED in these patients

Patients and methods: We conducted a prospective, hospital-based study of 192 consecutive male patients with NAFLD. All patients underwent clinical evaluation; abdominal ultrasonography; test for viral hepatitis markers; and estimation of liver chemistry panel, complete blood count, prothrombin time, serum lipids panel, serum testosterone, and fasting serum levels of glucose, insulin, and C-peptide

Results: The mean age of the study population was 42.4 +/- 7.7 years [79.1% >/= 40 years]. Of the 192 patients with NAFLD, 88 [45.8%] had ED, 28 [14.6%] had metabolic syndrome, 25 [13%] had type-2 diabetes mellitus [DM], and 131 [68.2%] had insulin resistance [IR]. The mean level of serum testosterone was 3.17 +/- 2.94 ng/mL, while the mean insulin resistance index was 2.9 +/- 1.7. Mild ED [38.6%] was the most frequent grade of ED. Age >/= 40 years [odds ratio [OR] 6.4; 95% confidence interval [CI] 1.7-24.1; p- 0.006], IR [OR 5.9; 95% CI 1.7-20.6; p- 0.005], and low serum testosterone [OR 5.1; 95% CI 1.5-17.1; p- 0.009] were the predictors of ED

Conclusions: ED is a common disorder in male patients with NAFLD; both IR and low serum testosterone contribute to its development. Treatment of IR may carry a dual benefit of improving erectile function and decreasing the grade of hepatic steatosis

[ news bar uses of the adolescents to some arabic T.V and news satellite channels and the gratification achievement from it]

Aims: Identify to what extent the Adolescents are interested to [the news bar], and is this news met the university students need?

Method: This is a descriptive study applied [Field Questionnaire Form]

Sample: 400 university students at the age of [17-18] from Egypt universities [Ain. Shams- Mansoura- Al Azhar-Minia]

Results: The results indicate that the percentage of strongly interested in pursuing the news bar of the total sample was 37.8%, distributed among the 31.3% of the total male sample, and 43% of the total female. The results also indicate that the news bar provides information and enough news in always, increased by 34.6%, of the total distributed sample rate 27.5% of the total sample, as opposed to 41.00% of the total females sample, The results indicate that the percentage of those who believe that the news bar contributes permanently to acquire of information was 45.3% divided by 40.8% of the total male sample, as opposed to 49.4% of as opposed to 59.00% of the total female sample

Some biological aspects and life table of the oat bird-cherry aphid, rhopalosiphum padi l. [homoptera: aphididae] as function of temperature

Some biological aspects and life table of the oat bird-cherry aphid, Rhopalosiphum padi L. feed on wheat [Sids 1] were studied at constant temperatures of 18°+/-2, 22°+/-2 and 26+/-2°C. At a given temperatures, the time needed for the development of nymphal instars decreased significantly with the increase in temperatures

The longest period was recorded at 18+/-2°C while the shortest one was found at 26+/-2°C

The calculated developmental threshold [tO] of the whole nymphal stage was estimated as 12.66°C. The thermal units needed for the development of the whole nymphal stage of the oat aphid were 67.95 day-degrees

Generation time [GT], reproductive potential [RO], population-doubling time [DT], intrinsic [rm] and finite rate [X] of increase of the pest were also computed and discussed. Based on the obtained data, temperatures of 22°+/-2 and 26+/-2°C were the most suitable temperatures for the development and multiplication of the oat aphid

Incremental value of 2-dimensional longitudinal radial and circumferential speckle tracking strain imaging to wall motion analysis for detection of coronary artery disease in patients undergoing dobutamine stress echocardiography

Background: DSE is considered one of the good options in clinical practice but due to some limitations new promising modalities like speckle tracking echocardiography [STE] was introduced. STE is a new imaging technique that allows evaluation of global and regional myocardial function independently from the angle of acquisition and from cardiac translational movements

Objectives: Determine optimal cutoff values for longitudinal, radial and circumferential strains at peak DSE for detection of significant stenosis on CA. Also investigate incremental value of combining strain measurements to wall motion analysis. Methods: The study population comprised 100 patients [age 50 +/- 9 years] underwent high dose DSE, STE followed by CA. DSE and STE results were compared and added to each other and finally compared to CA result

Results: GLS cutoff points [-16.75%] showed significantly higher accuracy when compared to GCS and GRS, with highest balanced sensitivity and specificity to predict CAD. GLS, GRS and GCS reduced the DSE false positivity by 83%, 72.2% and 66.6% respectively. STE also showed better Agreement with CA than DSE in detecting coronary territorial affection especially LAD [Kappa= 0.775]

Conclusions: STE is feasible during DSE, it helps increasing the diagnostic accuracy of DSE and decreasing its false positivity. Both global and segmental longitudinal strain can offer accurate, feasible and non invasive assessment of CAD

Adiponectin serum levels in adolescent boys with type 1 diabetes in relationships to pubertal grouth, development and glycemic control

Introduction: Adiponectin is a protein hormone secreted exclusive by adipocytes that regulate the metabolism of lipids and glucose. It has antidiabetic, antiatherogenic and anti-inflammatory properties

Objective: To asses adiponectin serum levels in adolescent boys with type development, body mass index [BMI], glycemic control and insulin dosage

Research design and methods: A case-control study was carried out on 45 adolescent boys with T1DM aged [12-18] years and 37 healthy control boys of similar age. Each of the cases and control groups were divided into four subgroups according to their Tanner stage .They were subjected to full history, reviewing medical records, auxology and pubertal stage assessment. Serum total adiponectin level was determined by ELISA technique in addition to giycatedhaemoglobin [HbAlc] and fasting blood glucose

Results: Mean adiponectin serum level [ +/- SD] was significantly higher in T1DM boys compared to healthy control group [12.93 +/- 5.24micro g/mlversus 8.91 +/- 3.21 micro g/ ml] [P<0.001] . Such higher serum levels of adiponectin were detected mainly at Tanner stage 2 [16.571 4.60 micro g/ mlvs 11.88 +/- 3.39 micro g/ ml] [P= 0.025] and Tanner stage 3 [12.77 +/- 3.71 micro g/ ml vs.6.59i 1.54 micro g ml] [P= 0.002]. Adiponectin level decreased significantly during pubertal development in control group and T1DM group. Adiponectin level was significantly higher in diabetic-poor controlled group than diabetic good-controlled group. Adiponectin was negatively correlated with pubertal stage, age, intermediate/ long acting insulin dose and positively correlated to HbAlc in diabetic group. In control group adiponectin levels were negatively correlated with pubertal stage and BMI

Conclusion: Adiponectin serum levels in adolescent boys with type 1 diabetes were significantly higher than control mainly at early puberty. It decreased significantly during pubertal development and was' strongly positively related to glycemic control

possible role of chronic intestinal candidiasis in the genesis of intractable allergic diseases

A role of disturbed intestinal normal flora, such as Chronic Intestinal Candidiasis [C.I.C.] syndrome, in the genesis of intractable allergic diseases, through changing in the intestinal mucosal barrier was suggested. In this study, we have assessed the C.I.C. in the patients with intractable allergies to elucidate the potential involvement of this syndrome in the genesis of these diseases and to find out a relation between the serum level of candida IgG, IgM and IgA with the disease intractability [serum total IgE] through an intestinal functional impairment in these patients. The serum levels of candida IgG, IgM, IgA were assessed in 20 patients with C.I.C. and intractable allergic diseases as well as in 20 healthy volunteers and their levels were correlated to the laboratory parameter of disease intractability referring to an intestinal functional impairment in these patients. When compared with the control group, the patients showed a significantly higher concentration [< 0.0001] of only serum candida IgG. A statistically significant positive correlation was found between this higher concentration and disease intractability while a negative insignificant correlation was found between serum candida IgM and negative significant correlation between serum candida IgA and disease intractability in these patients. The results of intestinal biopsies showed variable lesions but there was absence of candida hyphae or intestinal invasion. The results of this study suggest that disturbed intestinal normal flora produced by C.I.C. may play important role in the genesis of intractable allergic diseases. Measurement of serum candida IgG reflects the disease intractability in these patients even without increasing frequency of acute intestinal candida infection [IgM] or invasion [IgA]. In addition, inhibition of C.I.C. either by drugs or diet adjustment may improve the clinical manifestations or decrease the progress of these diseases. However, further studies are needed to elucidate the exact role of C.I.C. in relation to other factors involved in the pathogenesis of intractable allergic diseases by affecting the intestinal mucosal barrier

Microbial contamination and determination of aflatoxin in nuts

The purpose of this study was to evaluate the microbiological contamination and aflatoxin content in unpacked and packed nuts after storage for different times under different temperatures. The results could be summarized as fallow: 1. At zero time, aerobic bacterial count in unpacked and packed nut were : [3.0x102 , 2.5x102 ] c.f.u /g , [5.0x103 , 2.0x102 ] , [6.0x103, 1.0x102 ] , [2.0x103 , 1.0x102] in almonds , walnut , Hazelnut and peanut respectively. 2. All of investigated samples were free from anaerobic bacteria, fecal coliform, and Bacillus cerus. 3. Staph aureus and coliform were detected in all of unpacked nuts and absent in all of packed nuts. 4. Moulds and yeast count in unpacked and packed nuts were [3.0x103], [1.0x102], [6.0x103, 7.0xlO]. [8.0xl04, 1.0xl02l and [9.0x103, l.0x102] c.f.u lg in almonds, walnut] Hazelnut and peanut respectively. 5. There were a gradual increase in aerobic bacteria, Staph.aureus, mould and yeast counts after scorage for 45 and 90 days at room temperature but there were gradual decrease after storage at low temperature. 6. All of packed nuts were free from aflatoxin [ B] and total aflatoxin, while it was detected in unpacked nuts ranged from [ 0.05 to 0.17 microg / kg ·1] for aflatoxin [ B 1] and from [ 0.5 to 1.6 microg/kg ] at the end of storage for total aflatoxin. The authors' mentioned that, packaged of nuts and storage under l0 temperatures are important factor for quality control of nuts

Microbiological profile and aflatoxin content in dried fruits "Yamish Ramadan"

This study was conducted to evaluate the microbiological profile and aflatoxins content in unpacked and packed dried fruits after storage under different conditions. Samples were stored for 45 days, 90 days at room temperature and refrigeration. Microbiological examination and aflatoxins content were periodically determined in addition of zero time. The results could be summarized as follow: 1. At zero time, aerobic bacterial count in unpacked and packed dried fruits were [3.0xl03, l.0x102], [l.0xl03, 2.5x102], [l.0x105, 4.0x102] and [3.0x104, 3.5 x102 ] c.f.u / gm in dried dates , dried figs , dried grapes and dried apricots respectively. Mould and yeast count were [5.0 x104, l.0x102], [6.0xl04, 1.5 x102], [7.0x104, 1.0x102] and [6.0x105, 2x102] c.f.u / gm in the investigated samples respectively. All the samples were free from anaerobic bacteria, fecal coliform and Bacillus cereus. Coliform and Staph aureus were detected in the unpacked dried fruits and absent in packed dried fruits. Aflatoxin B1 [AF/ B1] and total aflatoxins were not detected in all the investigated packed samples. 2. There were a gradual increase in aerobic bacteria, mould and yeast counts after storage for 45, 90days at room temperature, and then there were a gradual decrease especially after the end of storage at cooling temperature. 3. Aflatoxin B1 and total aflatoxins were detected only in unpacked dried figs, apricots and date after storage for 90 days at room temperature. The authors recommended that during storage fruits must be protected from rodents and insects. The drying process must be rapid enough to preclude significant growth of spoilage forms before theaw is reduced to a safe level and storage in the refrigerator at cooling temperature

Isolation, expansion, and characterization of mesenchymal stem cells from adult rat bone marrow

Mesenchymal stem cells [MSCs] have been studied and applied extensively because of their ability to self-renew and differentiate into various cell types. To isolate, increase the expansion rate and define rat bone marrow MSCs by immunohistochemical and electron microscopic studies. Twenty adult male albino rats were used and divided equally into two groups. The bone marrow was harvested and flushed out from the long bones of each group. In group 1, the cells were cultured using complete medium containing Dulbecco's modified Eagle's medium, 1% antibiotics, and 10% fetal bovine serum. In group 2, the cells were cultured in complete medium supplemented with 8% fetal bovine serum and 2% autologous rat serum. When the primary culture became nearly confluent, the adherent cells were subcultured. After 12 days from the primary culture, aliquots of the cells were prepared for Giemsa stain, transmission electron microscopy, and immunohistochemical staining for CD44, CD105, and CD34. The adherent cells in both groups were heterogeneous in appearance, and most of them were spindle or star-shaped with vesicular nuclei. Some cells were binucleated. The MSCs in group 2 reached confluency more rapidly than those in group 1. After passaging of group 2, the adherent cells became more homogeneously fibroblast-like in appearance. Immunostaining of MSCs revealed a positive reaction for CD44 and CD1 05 and a negative reaction for CD34. Ultrastructural examination revealed that the native MSCs appeared with many pseudopodia, the nucleus was eccentric, and the inner zone of the cytoplasm was rich in free ribosomes, many mitochondria, few rough endoplasmic reticulum, with obvious Golgi complex, and some lysosomes. Some MSCs showed no pseudopodia with central nucleus. Others appeared with two euchromatic elliptical nuclei and a nucleolus in one of them. MSCs can be easily purified, cultured, and expanded more rapidly using autologous rat serum

Immunological study of expression of CD1 in preimplantation and midgestation mouse embryo cells and placental trophoblasts and the role of decidual natural killer T cells at the feto-maternal interface

Expression of major histocompatibility complex molecules in the preimplantation embryo is important for control of development and immune recognition of the embryo by the mother. Four types of major histocompatibility complex class I molecules that have been identified are as follows: class Ia, class Ib, class Ic, and class Id. Expression of class Ic and class Id antigens in preimplantation embryos has not yet been fully evaluated. Cluster of differentiation 1 [CD1] molecule is a member of class Id antigen. Localization and regulation of CD1 expression remain unclear. The aim of this study was to detect expression of the CD1 molecule in a preimplantation mouse embryo at two-cell, four-cell, eight-cell, and blastocyst stages and in the embryo cells and placental trophoblasts at 10 days of gestation. Detection of invariant natural killer T [iNKT] cells in the decidua at the site of attachment of the placenta was also investigated. Mice of the C57BL/6 genetic background were used. Forty-eight female and 16 male mice of 10-12 weeks of age were divided into two groups. Group 1 included 24 female and eight male mice. Eight breeding colonies were constructed in which each cage contained one male and three female mice. The pregnant female mice were killed at 36, 48, 60, and 80 h of appearance of the vaginal plug to collect two-cell, four-cell, eight-cell, and blastocyst stages of embryos, respectively. The embryos were then processed for immunohistochemistry. Group 2 animals included 24 female and eight male mice. Eight breeding colonies were constructed in which each cage contained one male and three female mice. The pregnant female mice were killed at 10 days of gestation when embryo cells, placental cells, and decidual cells were isolated and processed for culturing and immunohistochemistry. This study showed no expression of CD1 molecules in any of the preimplantation mouse embryo stages till the blastocyst stage, but were detected on the cell surface and inside the cytoplasm of embryo cells and placental trophoblasts at 10 days of gestation. A high proportion of iNKT cells was also detected in the decidua at the site of attachment of the placenta. The CD1 molecule is not actively involved in the regulation of early development of embryo till the blastocyst stage, and the true biological role of CD1 in preimplantation development remains to be determined. However, it may play a role in the placenta and in embryo development during midgestation by preventing lysis of fetal and placental cells through an interaction with decidual iNKT cells at the feto-maternal interface

Cytomegalovirus frequency in neonates with biliary atresia

Biliary atresia [BA] is the most severe hepatic disorder in newborns and its etiopathogenesis remains unknown. Viral involvement has been proposed, including the human cytomegalovirus [HCMV]. The aims of the study were to use the polymerase chain reaction [PCR] to screen the liver tissue of neonates with biliary atresia or cholestasis due to non atretic causes for HCMV-DNA and to correlate the results with serological antibodies to CMV and plasma PCR for CMV-DNA. This study was carried on sixty patients suffered from cholestasis, thirty patients suffered from BA [BA group] and thirty patients suffered from cholstasis without BA [Non Atretic cholestasis group]. Patients with BA were divided according to the result of the tissue PCR for CMV-DNA in the liver biopsies into two groups, group I, BA patients with positive tissue PCR and group II, BA patients with negative tissue PCR. All groups were subjected to complete history take, clinical biopsy, CMV [IgG and IgM] antibodies [ELIZA], Plasma-PCR for CMVDNA by Cobas Amplicator Analyzer and tissue PCR for CMV-DNA. Results showed that liver tissues PCR for CMV in BA patients was positive in 43.3%, however its incidence was very low in patients with non Atretic cholestaesis [3.3%], we found also that CMV IgG was positive in [73.3%], CMV IgM was positive in [16.7%], plasma PCR-CMV was positive in [13.3%] in BA group. On other hand IgG was positive in 33.3%, IgM was positive in 10%, plasma PCR was positive in 3.3% in non atretic group with significant differnces p< 0.05. So these results indicate an elevated frequency of CMV in neonates with BA which was more prevalent in females. No significant correlation between groups I and II of BA group as regard clinical picture, laboratory results and pathological changes p>0.05. The accuracy of plasma PCR was 45.9%, CMV IgM was 47.9%and CMV IgG was 46.1% when consider tissue PCR as golden test. In Conclusions, there was high frequency of CMV in neonates with BA which was more prevalent in females. The accuracy of serological testing for CMV using ELISA techniques and plasma CMV-DNA PCR are not reliable and indicate that virological assessment by tissue PCR should be carried out to prove the role of the CMV infection in etiology BA cases

Evaluation of daily diet for mental handicapped children and adolescents in egypt

The total of 1326 [906 males and 420 females] mentally retarded children and adolescents aged between 6-20 years at urban area from governmental and non-governmental handicap schools and establishments were included in this study. Six governorates were chosen from different geographical areas of Egypt. Food history was taken using 24 h recall method for 50% of the sample. Hemoglobin concentration was determined for all. The results indicated that most of individuals [81%] were attending to low social level; the total caloric intake was insufBcient for 78% of the sample .The mean intakes of protein were less than the requirements for 14.4 %. The shortage in dietary vit A was for 69.8% and vit E for 85.6%. Over 90% of the sample consumed less than the Recommended Dietary Intakes RDIs from calcium, iron, zinc, and iodine. Although, the mean copper and vit C intake was satisfactory as a whole, yet there was insufficient copper intake for 55.8% and vit C for 24.1%. There was a high incidence of anemia [64%]. The mean of Hemoglobin concentration [cone.] for anemic subjects was 11.07+/- 1.07 g/dl and for non anemic was 13.76 +/- 1.06 g/dl. Sex difference had a significant role in the Hb cone. The recommendation should be: 1- improving the socioeconomic status for the poor families. 2- Increase the budget of feeding program for mental handicapped schools and establishments and it must re-planning the daily diet to contain more Protein, carbohydrates, calcium, zinc, iodine , vit A and vit E according to RDIs. The suggested dietary sources are legumes, cereals, milk and dairy products, dry date, and intake the iodized salt?

Effect of diet restriction on the survival of myenteric neurons in jejunum of aging male albino rat. histological and immunohistochemical study

Dysfunctions of the gastrointestinal system are more common complaints of the elderly. Enteric neurons are known to be vulnerable to age related cell death. So, the aim of this study was to study the effect of diet restriction on the histological changes in the myenteric neurons of jejunum of aged male albino rat. Thirty male albino rats of 6 months were used. Group I was the control group. Subgroup Ia included 5 rats of 6 months and subgroups Ib and Ic included 5 animals each and were continued to live up to the age of 12 and 18 months, respectively. Group II included 10 rats which were early fed the restricted diet [25 gm diet/rat! day] and subdivided into two subgroups five animals each. Subgroup ha were fed the restricted diet starting from 6 to 12 months. Subgroup IIb were fed the restricted diet starting from 6 to 18 months. Group III included 5 rats that were lately fed the restricted diet from 12 to 18 months. At time of sacrifice all the animals were anaesthetized, the jejunum was dissected out and specimens were processed for histological examination. Immunohistochemical expression of the pan-neuronal marker PGP 9.5 and neuronal nitric oxide synthase [nNOS] was investigated. As age advances in subgroup lb and Ic there was increased neuronal loss and obvious gaps in the myenteric ganglia with significant decrease in the number of PGP positive neurons. Animals of subgroup ha and llb showed that most of the myenteric neurons maintained their usual structural arrangement and expression of PGP. In group III rats showed neuronal loss and significant decrease in the PGP positive neurons. There was non significant decrease in the number of nNOS positive neurons in all groups. The results of the current study revealed that age related change involved mainly the cholinergic neurons and starting diet restriction early at 6 months age might slow or delay the age related damage of the rat myenteric neurons

Fate of large renal tumors[t2 and t3] after palliative surgery

Since January 2000 till 2004 we performed nephrectomy on 33 patients having large renal tumors [more than 8cm] at Damanhour Oncology Center. We excluded patients who had lung metastasis or adherence to nearby organs. Thirty of the tumors were found to be malignant and only 3 were benign. The tumor was slightly more common in females [17 patients] than in males [16 patients]; also it was affecting the right kidney in 48.5% and the left kidney in 51.5% of the patients. Out of 30 patients having malignant tumors 7 patients died and 23 patients survived till June 2005. The mean follow-up period was 31.95 month +/- 4.97. The microscopic picture of the renal tumors of the surviving patients was clear cell type [23 patients 76.6%]. Meanwhile four of the patients who had died also had clear cell type renal cell carcinoma, and the other three had collecting duct carcinoma. We found that lymph node involvement was significantly positive in the patients who had died. Neither the capsular infiltration nor the tumor size was significantly different between the patients who had survived and the patients who had died. Lymph node involvement was significantly positive in the patients who died [86%]. Neither the capsular infiltration nor the tumor size was significantly different bet%veen the surviving patients and the patients who had died. Among large renal tumors benign tumors could be found [9%]

Relationship between insulin resistance, liver fibrosis and steatosis in non-diabetic non-obese chronic hepatitis C patients

Relationship between HCV and DM was documented in several studies. HCV through pro-inflammatory cytokines causes insulin resistance. Steatosis in HCV is a well known pathological feature. Interest in the last decade was turned into the possible link between insulin resistance and Steatosis and their effect on fibrosis progression was to study relationships between fibrosis, inflammation, Steatosis and insulin resistance in HCV patients. This study was conducted on 80 patients with HCV and 20 healthy controls. Participants were subjected to clinical examination, laboratory investigations [liver and kidney function tests, hepatitis markers, fasting glucose, insulin, and serum lipids], HOMA score estimation, BMI calculation and abdominal ultrasonography. Patients underwent liver biopsy and qualitative PCR for HCV RNA. showed higher HOMA score and fasting insulin levels in HCV patients than controls. A strong positive correlation was found between insulin resistance, fasting insulin levels and liver fibrosis in HCV patients. No correlation was found between insulin resistance and neither BMI nor age of patients. Prevalence of Steatosis in HCV patients biopsies was 93.75%. Significant correlation was found between fibrosis and Steatosis, and between insulin resistance and Steatosis. detection and treatment of insulin resistance in chronic hepatitis C patients are recommended to improve outcome of patients and decrease rate of progression of fibrosis

Endoprosthetic replacement for aggressive benign and malignant bone tumors around the knee joint

The concept of limb-sparing surgery, or limb salvage, has gradually evolved over the past 25 years. Prior to this the basic principles of surgical oncology for the extremities consisted solely of determining the correct level at which to perform an amputation. Extremity amputation with wide or radical surgical margins was the primary treatment for bone and soft tissue malignancies involving the extremities until the 1970s. Advances in adjuvant treatments modalities, including chemotherapy and radiotherapy have improved survival and increased the role of limb salvage surgery. In addition, it has been shown that local control with limb salvage does not adversely affect the progression of the systemic disease. The use of endoprosthetic replacement as a method of reconstruction after major skeletal defects created after wide resection of tumor around the knee joint is a major progress that provides an immediate mobile joint after surgery. Twenty patients were included in this work. According to the staging system of Enneking et al., they were classified into 6 patients with an aggressive benign giant cell tumor [30%] and 14 patients with primary malignant bone tumors [70%]. These tumors were all located around the knee, 8 at proximal tibia [40%] and 12 at the distal femur [60%]. The six benign lesions were recurrent giant cell tumor after a pervious operative curettage and autogenous bone grafting or packing with bone cement in 4 of them [20%] and 2 [10%] were aggressive giant cell tumor grade 3 from the start. The 14 patients with primary malignant bony lesions, 3 of them were grade 1B and 11 were grade 11B. Wide resection was achieved followed by reconstruction by modular replacement endoprosthetic system. The follow up time was between 30 - 60 months with a mean of 46.3 months. The functional results of the procedure were rated as good to excellent with a mean of 83.3%. The end results of the procedure are justifiable for tumor surgery provides mobile knee joint with a stable limb and excellent functional end result. Complications occurred in 5 patients [25%] 4 of them necessitate reoperation. The use of endoprosthetic replacement as a method of reconstruction after major skeletal defects created after wide resection of tumor around the knee joint is a major progress that provided an immediate mobile joint after surgery. It has also obviated the need for prolonged immobilization in cast as with cases of biological reconstruction. This concept is important in such patients with short life expectancy but it is not free of complications and may need multiple surgeries

Diagnostic value of antisoluble liver antigen/ liver pancreas antigen [SLA/LP] and other autoantibodies in the diagnosis of patients with autoimmune liver disease

This study aimed to evaluate the role of auto antibody profile in the diagnosis of patients with suspected autoimmune liver disease and their ability to define the putative type 3 autoimmune hepatitis [AIH]. Forty adult patients with abnormal liver function, elevated serum IgG and negative hepatitis markers were chosen from those attending the Hepatology Clinic and Internal Medicine Clinic of Alexandria Main University Hospital and Armed Forces Hospital. According to the results of liver biopsy, 36 patients were diagnosed as AIH, one patient as primary biliary cirrhosis [PBC] and the other 3 patients were still undiagnosed. Also, 10 patients with documented diagnosis of non-immune hepatitis B virus in addition to 10 age and sex matched healthy controls were enrolled in this study. Autoantibody profile of ANA, ASMA, AMA, LKM and p-ANCA was measured by indirect immunofluorescent technique [IF] and anti SLA/LP, LKM-1, LC-1 and AMA-M2 autoantibodies were detected by western blot assay. The sensitivity of ANA, ASMA, AMA, LKM, p-ANCA, SLA/LP and LC-1 were 48.6%, 51.4%, 2.7%, 8.1, 56.8%, 18.9% and 10.8% respectively with high specificity [100% for all auto-antibodies except that for ANA 95.7% and ASMA 87%]. However, the overall sensitivity of the complete profile was increased to 100% and specificity was 91.3% from this study we conclude that a complete profile of autoantibodies can be used as a useful tool for the diagnosis of patients with suspected autoimmune liver disease. Anti SLA/LP is an additional specific and diagnostic marker for the diagnosis of AIH type 1 and it remains to be seen whether the seropositivity of SLA/LP may characterize the patients who are more likely to relapse after corticosteroid therapy

Influences of intermittent anaerobic exercise program on physical fitness and plasma lactate, oxidant and anti-oxidant status in smokers and non-smokers judo players

There is evidence of smoking's negative impact and physical activity's positive impact on long-term health. However, evidences regarding the association between smoking and exercise activity and the independent effects of these factors on antioxidant defense are lacking. The aim of this study is to investigate the association between smoking and the intermittent anaerobic exercise on the physical fitness, oxidant and antioxidant status in Judo player. Twenty male Judo player student from Department of Physical Education Al Azhar University were enrolled in the study. They were of 2 groups, Non-smokers [NS] and smokers [SM]. Both groups were subjected to regular Judo training program [2 hours/day, 3 sessions/week for 12 weeks]. Also, both groups were subjected to an effort test [running of submaximal intensity until exhaustion] and record of the maximum oxygen capacity [VO[2] max] using an ergometric bicycle. Heart rate [HR], mean arterial blood pressure [MBP] were recorded and blood samples were taken pre and post-effort test for determination of malondialdehyde [MDA],total antioxidant capacity [TAC], uric acid [Ua] and lactate [La] in the plasma. Also the time to exhaustion was recorded during the effort test. These measures were performed pre and post the training program. At rest the pre-program data of SM showed significantly higher H.R., and plasma MDA,and significantly lower TAC with tendency to increase in MBP and La levels, and decrease in VO2max, and Ua levels compared to NS. Before program and in response to acute exercise SM showed significantly higher H.R, MDA and La levels with significantly lower TAC, Ua and time to exhaustion compared to NS. On the other hand, after the program and in response to acute exercise, SM showed more pronounced significantly higher HR. MBP, MDA and La with significantly lower VO[2] max, time to exhaustion and TAC with insignificant changes in the Ua compared to the NS that showed significant increase in the Ua levels with insignificant changes in the MDA, TAC and the La levels in response to acute exercise. In response to the training program, SM showed significantly higher HR, MBP, MDA and La levels, with significantly lower VO[2] max, time to exhaustion, and TAC, and insignificant changes in the Ua levels compared to NS. We conclude that cigarette smoking has a significant detrimental effects on cardiovascular fitness, physical endurance, TAC and lipid peroxidation that all worsened by the intermittent anaerobic exercise. On the contrary, this type of training is beneficial in nonsmokers. Also we demonstrated that smoking prevent the beneficial effects of exercise, so smoking should be avoided in Judo players. Smokers should be given strong encouragement to stop smoking and to improve physical fitness