Study of the enhancing effect of sodium chloride injection on radiofrequency ablation of hepatocellular carcinoma

One of the potential strategies to increase the efficacy of RFA is to modulate the biologic environment of the treated tissues. Several investigators have studied increasing RFA heating by combining intra-tumoral injections of different concentrations of sodium chloride with RFA. The aim of this study is to assess the enhancing effect of normal saline [NS] on radiofrequency ablation [RFA] of hepatocellular carcinoma [HCC] using a cool-tip needle. This study included 40 patients with HCC [proved by histopathology or combined spiral CT and elevated alpha-fetoprotein]. They were randomly divided into two groups [20 patients in each group]. The first group was treated with RFA preceded by intra-tumoral normal saline injection [RFA + S]; the second group was treated with RFA only [RFA]. The procedure was successful in all patients [100%] of the RFA + S group and in 11 [55%] of the RFA group [as proved by spiral CT or pathology]. This difference between the two procedures was statistically highly significant [P = <0.01]. No major complications occurred in either group. Combined RFA and normal saline is more effective than RFA alone. Considering the reduced cost and wide availability of isotonic saline together with the easy performance of the intra-tumoral injection, the dramatic improvement in therapeutic effect of RFA to 100% could be a breakthrough in future strategies to modernize the RFA technique

new echocardiography method to assess the progress of the left ventricular outflow tract obstruction in children

Discrete subaortic stenosis is considered an acquired cardiac defect of postnatal development; usually appear after the first year of life and causes LVOT of rapid hemodynamic progression. The relationship between ridgeseptal angle and progress of LVOTO has not been evaluated yet. Our objective was to evaluate the ridgeseptal angle as an important risk factor for progress of LVOT obstruction. 19 patients enrolled in this study, 12 in group one [RSA was right angle], 5 patients with acute angle in group two and 2 patients were in group three [oubtuse angle], follow-up echocardiography study every 6 months for 2 years to evaluate the progression of LVOT obstruction for each group. A total of 19 patients enrolled in this study [mean ages 5.5 +/- 1.7 mmHg] were diagnosed as isolated DSS, group [1] with right angle [RSA] showed that gradient increased 4 +/- 2.2 mmHg after 2 years, 2 +/- 2 mmHg, 2 +/- 1.2 mmHg in the other two groups [2and3] respectively. The results demonstrated that the maximum progressions in LVOTO were found in right angle group 4mmHg after two years with no statistical significance. Our results demonstrated that the maximum increase in LVOTO were found in the right angel [RSA] patients group where the hydraulic dynamic force was a maximum value. We recommended to measure the RSA echocardiography in every patient with DSS to assess how fast the progress of LVOTO

Percutanous ablative therapy for HCC: a comparison of three modalities

This study was performed on 78 patients having liver cirrhosis with 91 focal hepatic lesions detected by ultrasound and proved histopathologically to be HCC [biopsy and/or fine needle aspiration cytology; FNAC]. They were 70 males and 8 females their ages ranged between 37 and 75 years old. Patients were classified into three groups, Group A was formed of 32 patients with 37 focal lesions where they received RFA. Group B encountered 25 patients with 26 focal lesions and they received PAI Group C included 21 patients with 28 focal lesions were treated by PEI. Complete ablation was assessed by re-biopsy and/or FNAC, triphasic CT and AFP serum level. As regards the outcome of therapy in group A, complete ablation was achieved in 14/18 [78%] for lesions

Significance of renal staging in lupus nephritis in relation to clinical manifestations, kidney function and serum autoantibodies profile

To assess the significance of renal staging in lupus nephritis in relation to clinical manifestation, kidney function and serum auto antibodies profile in patients with systemic lupus erythematosus [SLE] Thirty-eight patients with SLE nephritis subjected to renal biopsy were included in this study. The biopsies were classified according to WHO classification for renal staging. The activities of the disease were recorded using BILAG scoring for activity. Immunological profile include anti-dsDNA,ANA,C3,C4,Immunoglobulin G,M,A, were assessed and the kidney function includes serum creatinine,urea, 24 hours urinary protein as well as total serum protein and serum albumin were measured. There was significance increase in creatinine, 24-hour urinary protein excretion and anti-ds DNA in lupus nephritis patients than those with extra-renal lupus [controls]. In comparative study between different histological classes we found a significant elevation of serum creatinine in stage V glomerulonephritis [GN]. Significant increased urinary protein per 24 hours excretion in stage III and IV GN. Significant increase anti-dsDNA in stage IV GN Significant increase the incidence of renal insufficiency with stage V GN [p<0.05]. Significant positive correlation between the histological stages of lupus nephritis and renal insufficiency and serum creatinine level with insignificant positive correlation with activity score, anti-dsDNA, C3,C4, immunoglobulin level IgG,M,and A. Renal biopsy and histological staging has no significant relation to other parameters of clinical activity of systemic lupus erythematousus. Close monitoring of urine for protinurea, serum creatinine levels and anti-ds DNA especially in histological stages IV and V GN of renal biopsy may play a role in prediction of renal insufficiency in lupus nephritis

Assessment of myocardial perfusion in rheumatoid arthritis: evaluation with radioisotope imaging

RA patients have a decreased life expectancy and ischemic heart disease [IHD] is accused to be the leading contributor to mortality in this disease. IHD is a clinically silent disease and difficult to predict with neither symptoms nor ECG changes. This study aimed to detect myocardial perfusion defects [PDs] by using single photon emission computerized tomography [SPECT] in adult RA patients, with special regards to age, type of medication, disease duration and activity. The study included 31 RA patients diagnosed according to the ACR criteria. Patients neither had cardiac complaints nor ECG changes. All patients were subjected to: thorough medical history and cardiac examination, rheumatological assessment for: function status and disease activity. Lipid profile, CRP and RF were determined. All patients were assessed with SPECT for the presence of PDs; ischemia, scar and/or combinations of such. RA patients were 9 males [29%] and 22 females [71%]. Their age ranged between 34-63 years with a mean of 49.32 +/- 7.71. The disease duration ranged between 1-22 years with a mean of 9.51 +/- 6.6. Based on SPECT evaluation; 14 patients [45.2%] had PDs: 9 patients [29%] had ischemia and 5 patients [16.1%] hah ischemia and scar. The incidence of cardiac involvement in RA patients when compared with non-ischemic RA patients was found to be highly statistically significant [p

Effect of hepatitis-C viral infection on platelets

This study was conducted on 35 patients with established chronic liver diseases due to hepatitis C. Their ages ranged from 20 to 60 years. A full clinical assessment, ultrasound, complete blond picture including platelet number and functions, liver function tests [SGOT, SGPT, serum albumin, serum bilirubin and prothrombin time and concentration] were applied for every patient. Hepatitis markers for B and C and PCR for HCV and, lastly, liver biopsy were also detected. They were classified into three groups [according to their platelet number]: Group I [12 patients] with platelet count 151-350,000/mm3, group II [13 patients] with platelet count 80-140,000/mm3, and group III [10 patients] with platelet count 25-79,000/mm3. The three groups were statistically compared regarding platelet number, platelet aggregation, liver function tests, histopathological study and correlation between platelet number and aggregation. The results revealed a direct correlation between liver span and platelet number and platelet aggregation. Inverse correlations were noticed between spleen size and portal vein diameter and platelet count and aggregation. Direct correlations were present between platelet number, aggregation and liver function tests [prothrombin time, SGPT, S. Bilirubin, OT/PT ratio and albumin], but there was no correlation with SGOT