Evaluation of the mesh-bridged posterior partial fundoplication-a new technique in treatment of gastroesophageal reflux disease

Disruption of the wrap and slipping are the most frequent causes of deficient reflux control after anti-reflux surgery. Isolauri et al. [1997], after an experimental study, suggested that if scarring could be induced between the fundal wrap and the esophagus, it could probably help to prevent slippage and disruption of the fundoplication wrap. This study was randomly conducted in the Gastrointestinal Surgery Unit, General Surgery Department, Tanta University Hospital on 60 patients suffering from GERD during the period from May 2003 to June 2005. They were randomly classified into two groups; group I comprised 30 patients for whom posterior partial fundoplication [modified Toupet technique] was performed and group II comprised 30 patients for whom mesh-bridged posterior partial fundoplication was performed. At 24 months postoperatively, 4 out of the 30 patients belonged to group I developed recurrence of GERD while none of the 30 patients belonging to group II developed recurrence. The difference in the recurrence rate between the two groups was found to be statistically significant. [P<0.0412]. The mesh-bridged posterior partial fundoplication proved to be effective in achieving the advantages and avoiding the disadvantages of both total and partial fundoplication in short term and mid-term follow-up; good reflux control and low incidence of mechanical complications. Moreover, did not significantly prolong the operation time and did not add to the patients' morbidity

value of electron microscopy in the diagnosis of Non-Hodgkin's Lymphoma

Fifteen patients presented with non-Hodgkin's lymphoma [NHL] were subjected to complete history taking and clinical examination, radiological studies and microscopic examination of lymph node biopsy. The most recent histopathological classification used is the Working Formulation. Recently, electron microscopy [EM] is used for better diagnosis and prognosis of malignant lymphoma. It was found that low grade lymphoma accounted for 13.33% by light microscopy [LM]. It shifted to the higher percentage [26.67] by EM. While, the high grade lymphoma accounted for 40% by light microscopy. It shifted to a lower percentage [20%] by EM. Although this type of investigation is expensive, it is very important in equivocal cases for the accurate diagnosis of NHL

Compartlve study of CA 15-3 and CEA in breast cancer patients

Serum CA 15-3 and CEA values were determined in 77 patients with breast oancer of different stages, 28 non-malignant breast disease and 36 hedlthy women. Increased -preoperative serum CA 15-3 values [> 30 U ml[-l] were observed in 30%, 75% and 91%, serum CEA values [> 3.5 ng ml[-1]] were observed in 17% 35% and 64% of patients with stage II, III and IV disease respectively. In 86% of patients with a single metastasis and 100% of patients with two or more metastases elevated values for both markers were noted. Only 10% of patients with non-malignant disease had elevated serum CA 15-3, 14% of them had elevated serun CEA and non of normal healthy women had elevated levels for both markers. In the postoperative samples, there was significant reduction in 90% of patients for serum CA 15-3 and CEA. In 66% of patients treated by radical radiotherapy there was a notable reduction in both markers one month later. In 58% of patients with metastatic breast carcinoma treated by combination chemotherapy FAC and CMF [in partial remission], there was a detectable reduction in both markers after eight courses. CEA showed parallel behaviour to CA 15-3., At the, time of recurence elevated serum CA 15-3 values were also observed in patients with normal preoperative values. Increased serum CA 15-3 values preceded the clinical detection of tumour recurrence by up to 11 months. In conclusion it is confirmed that serum CA 15-3 levels had reliable prognostic value in breast cancer, reflected the extent of tumour load, response to treatment and the presence of occult metastasis