Multidetector CT [MDCT] Findings of primary hepatic lymphoma

Objective: The aim of this study was to describe the triphasic multidetector CT [MDCT] finding of primary hepatic lymphoma [PHL]

Materials and Methods: This retrospective study included eighteen patients. Each patient presented with primary hepatobiliary lymphoma without associated lymphadenopathy or other visceral involvement. Triphasic CT scanning was performed on one of two systems [64 MD CT] in 12 patients and [6 MDCT] in 6 patients. All eighteen patients underwent ultrasound percutaneous trucut liver biopsy using 18-gauge biopsy needle. Pathology was confirmed on all cases

Results: Four of eighteen patients presented with a single focal lesion. Thirteen of eighteen patients presented with multiple well defined focal lesions. One patient presented with a diffuse hepatic involvement. On triphasic CT, three patients showed gradual progressive contrast enhancement. Lesions remained isodense to the liver on the arterial phase with mild enhancement in the portal phase and showed washout on the delayed phase in two patients. The remaining thirteen patients showed multiple hypodense non-enhancing lesions

Conclusions: PHL presents a wide spectrum of imaging findings on triphasic MDCT with no characteristic imaging pattern. MDCT can be used for detection of the lesion and biopsy is used for diagnosis. PHL should always be considered in the differential diagnosis of a liver focal lesion either single or multiple

Comparative investigation in detection of anti-ribosomal P protein antibodies in diagnosis of neuropsychiatric manifestations in systemic lupus erythematosus patients

The present study aims to compare the detection of anti-ribosomal P antibodies in SLE patients by western blotting and ELISA. Additionally, we examined the association between cerebral lupus and anti-ribosomal P antibodies using these techniques. Thirty-two of consecutive patients with SLE diagnosed according to the American College of Rheumatology [ACR] criteria for the diagnosis of SLE were included in this study. These patients were either outpatient attenders or inpatients of Rheumatology and Rehabilitation Department as well as the Internal Medicine Department of El-Minia University Hospital. Anti ribosomal P antibodies were investigated in patients serum by immuno blotting and Enzyme-Linked Immnuo Sorbant Assay [ELISA] techniques. Neuropsychiatric manifestation systemic lupus erythematosus [NPLSLE] were diagnosed in 81.7% of SLE cases. 16 cases [50%] had neuropsychiatric manifestation. Psychiatric manifestations were found in 6 cases [18.8%], whileneurological manifestations were found only in only 4 cases [12.5%]. On measuring anti ribosomal P antibodies in patients serum by using western blotting, they were detected in 7 cases [21.9%], while by using ELISA technique, they were detected in only 5 cases [15.6%]. Among 18 patients suffered from mood disorders, anti-ribosomal antibodies were detected in 7 cases [38.1%] by using immuno blotting, whereas by ELISA only 5 cases [24.8%] were identified. Among 10 cases, which were suffered from cognitive dysfuntions, anti ribosomal P antibodies were detected in only 2 cases [20%] by using ELISA and by immune blotting techniques. In each of anxiety disorders and psychosis, in only 1 case [50%], anti ribosomal P antibodies were detected by the use of both techniques. Among patients with headache complications, 4 from 16 cases [25%] serum samples were found positive for the presence of anti ribosomal P antibodies using western blotting, whereas ELISA detected just 2 positive samples [12.5%]. From 5 cases presented by seizures, 1 positive serum sample [20%] for anti-ribosomal P antibodies were detected using both techniques. In conclusion, immuno blotting is much more detectable technique in comparison with ELISA for detection of anti P ribosomal antibodies in the serum of patients with SLE

Effect of adrenaline and ATP on glycerinated skeletal muscle

Glycerinated psose muscles of rabbit were used to study the effect of adrenaline and ATP on the contractile machinery of skeletal muscle. The muscles were placed in pure glcerine for 22 days to rupture all the membranes and then a few fibres were stripped off. The tension was recorded with the help of a highly sensitive force transducer in the presence of adrenaline and ATP. The results obtained showed a 19% higher tension generated in the presence of adrenaline and this increase in tension was significant statistically. Since the muscles used were devoid of their membranes and electrical potentials, it was assumed that drug produced higher tension by acting directly on the contracticle proteins themselves

Treatment of hallux valgus by double-V osteotomy

Thirty three feet in 29 patients with hallux valgus were treated by double-V wedge osteotomy of the head of the first metatarsal. They all had complete relief of pain and acceptable cosmetic appearance. There was occasional discomfort in one foot. The mean postoperative decrease of the intermetatarsal angle was 3, and of the hallux va1gus. angle 20. The surgical procedure described avoids or minimises the complication of Mitchell's operation and of its modifications

Treatment of persistent painful heel syndrome by corrective calcaneal osteotomy

One foot per subject was examined in a control material of 100 individuals, aged 21-65 years, mean 38.7 years, with non-symptomatic heels. Their calcaneus was radiographed in standard lateral and axial projections. The depths of both medial and plantar concavities of the normal calcaneus were measured, and their normal mean and standard deviation obtained. Based on these findings, and according to the radiological deformity of the os calcis, a calcaneal osteotomy was done for thirty one patients [34 heels], aged between 23 and 55 years, complaining of persistent painful heel. All patients were refractory to conservative treatment for at least 6 months prior to operation. They were followed up for an average of 26 months after operation. Complete symptomatic relief was obtained in 24 patients [27 feet]. Four patients had mild pain after long distance walking or running. Wound infection occurred in one case. Sloughing of the skin with exposure of the staples necessitating their removal occurred in another case. Painful neuroma happened in a third ease. It is concluded that calcaneal osteotomy has a beneficial biomechanical and biological effect in selected cases of persistent painful heel that are refractory to conservative treatment

Evaluation of the results of staged flexor tendon reconstruction

Twenty-one fingers in 19 patients were treated by a two-staged flexor tendon reconstruction. All injuries were in [no man's land] and both superficialis and profundus tendons were severed. The digits were evaluated 6 months or longer after stage-II surgery. The result were graded by comparing the preoperative passive motions of the metacarpophalangeal, proximal interphalangeal and distal interphalangeal joints after stage-I to the active motions of the same joints after stage-II. Overall end results were 19% excellent, 38.1% good, 23.9% fair and 19% poir. The result were affected by the patient age, severity of the injury, infection, adhesion and degree of flexion deformity prior to stage II. Complications included synovitis in 14.3%, infection in 9.5%, rupture of the tendon graft in 9.5% and adhesions after tendon grafting in 23.8%, This study revealed that staged tendon reconstruction is a useful method for restoration of digital function in flexor tendon injury with a badly scarred tendon bed

Prospective clinical and electrophysiological studies before and after anterior transposition of the ulnar nerve

Clinical and electrophysiological studies were performed for 41 patients [43 elbows] with tardy ulnar neuritis before and after subcutaneous anterior transposition of the ulnar nerve, with an average of 15 +/- 9.8 months follow up. Multiple mechanical causes for neuropathy were identified. Subjective improvement after the operation was obtained in more than 80% of the cases. The chance of recovery after the operation was greatly affected by preoperative symptoms period and the pathology which was present in the ulnar nerve and/or in the elbow, but seemed to be independent of the patient age

Computed tomography versus plain radiography in diagnosis of bone tumours

25 patients suspected to have bone tumours on clinical examination, were subjected to laboratory and radiological examination including plain X-ray and computed tomography [CT]. Pathological examination after biopsy was done to confirm the final diagnosis. 16 [64%] out of 25 cases were diagnosed by plain x-ray, 15 [60%] of them showed intramedullary extension, while CT was useful in establishing the primary diagnosis in 22 [88%] patients with intramedullary extension in all of them. CT is an effective method in the diagnosis of bone tumours providing excellent data about the exact anatomical locations and intra and extra-osseous extensions of bone tumours

Disorders of the first metatarsal sesamoids

143 cases with metatarsalgia presented with pain, tenderness and sometimes swelling under the head of the first metatarsal bone were examined clinically and radiologically, two cases of which were examined histopathologically and 75 asymptomatic feet were examined as a control. Their assessement revealed that : 16 cases [11.1%] with dysplasia, 32 cases [22.5%] with malformation, 54 cases [37.8%] with malposition, 13 cases [9%] with osteochondritis, 19 cases [13.3%] with sesamoidometatarsal arthritis, 6 cases [4.2%] with osteomyelitis, and 3 cases [2.1%] with fracture. The suggested radiological assessements were noted and discussed