Serum selenium concentrations in Egyptian chronic liver disease patients

Disturbance in the antioxidant system could play a role in pathogenesis of chronic liver disease. The most important defence mechanisms are associated with the activity of antioxidative enzymes, among which glutathione peroxidase [GSH-Px], belonging to so-called free radical scavengers, should be mentioned. Selenium, regarded as a bioelement, is present in GSH-Px. Involved in numerous redox reactions, it belongs to the factors protecting the organism from oxidative shock. To detect selenium concentrations in the serum of chronic liver disease patients whether compensated, decompensated or with hepatocellular carcinoma, and to correlate these levels with the progression of liver disease. This study was conducted on 20 patients with compensated liver disease [Group I], 20 patients with decompensated liver disease [Group II], and 10 patients with hepatocellular carcinoma [Group III], all compared with 20 healthy subjects serving as a control group. Participants were subjected to complete clinical and laboratory assessment, and abdominal ultrasonography. Estimation of serum selenium by Graphite Furnace Atomic Absorption Spectrometers was conducted on all samples. There was significant decrease in serum selenium level in hepatocellular carcinoma group compared to both decompensated and compensated groups [26.40 +/- 6.52ug/l, 42.35 +/- 6.12 ug/1 and 59.90 +/- 8.20 ug/1, respectively], when compared to control group [79.85 +/- 10.06 ug/1] [P < 0.01]. There was a significant positive correlation between serum selenium and albumin levels in the studied groups [P < 0.01]. A significant inverse correlation was found between serum selenium level and AST, total bilirubin and alkaline phosphatase in patients groups [P < 0.05]. No significant relationship was found between serum selenium level and age of patients. Serum selenium levels significantly decrease in relation to the progression of chronic liver disease. There is a potential need of selenium supplementation in these patients

Serum zinc concentration in Egyptian patients with chronic hepatitis C

The prevalence of HCV infection varies throughout the world, with the highest number of infections reported in Egypt. Zinc has been closely related to the pathogenesis of chronic hepatitis C. Zinc deficiency causes reduction in glutathione [GSH] which has been implicated in various cellular events. Zinc may play an important role as a negative regulator in HCV replication; zinc supplementation increases the therapeutic response of Interferon [IFN]. To detect serum zinc concentration in adult patients with chronic [compensated] hepatitis C prior to treatment with IFN, and correlate the levels with the degree of inflammation and stage of fibrosis. This study was conducted on 40 adult patients chronically infected with HCV as well as 10 healthy subjects serving as a control group. Participants were subjected to complete clinical and laboratory assessment, quantitative analysis of HCV RNA by PCR technique and abdominal ultrasonography, in addition to estimation of serum Zinc by Graphite Furnace Atomic Absorption Spectrometer. A significant negative correlation was found between the level of zinc and liver fibrosis. The mean value of zinc in patients was 39.5ug/dl, while in the control it was 75ug/dl [normal range: 70-80ug/dl]. There was a non significant negative correlation between serum zinc and serum AST, ALT, disease activity and level of viraemia. Our study suggested the possible important protective role of zinc in patients with chronic hepatitis C, as serum zinc levels showed negative significant correlation with the stage of liver fibrosis

Plasma and hepatic tissue endothelin-1 levels in cirrhotic patients with and without bleeding varices

Bleeding from varices is the most lethal event in cirrhotic patients. Bleeding esophageal varices contributed to 51.6% of causes of upper gastrointestinal hemorrhage among Egyptians. The potent vasoconstrictive peptide, endothelin [ET] has been suggested to contribute to the pathogenesis of portal hypertension. So, the present study was designed to determine levels of both circulating ET-1 and hepatic tissue ET-1 in cirrhotic patients with and without bleeding varices. Patients suffering from liver cirrhosis, portal hypertension and upper gastrointestinal bleeding due to esophageal and/or gastric varices were included in the study. Patients who had liver cirrhosis but had never bled before were studied as a comparative group. All patients were classifed according to modified Child's classification. Esophago-gastro-dudenoscopy was done to all patients. Liver biopsy was done whenever possible. Material was divided for both histopathological examinations [using hematoxin and eosin stain] and detection of hepatic tissue ET-1. ELIZA determined plasma and tissue ET-1. Seventy-five subjects were included in this study [fifty bleeders from varices and 15 non-bleeders]. Age of patients ranged between 28 and 67 years with a mean of 45.1 +/- 8.5 years. Fifty-two were males and thirteen were females. Ten healthy controls with a mean age of 41.6 +/- 13.8 years had also been studied. They were 8 males and 2 females. There was a statistically significant increase in the level of plasma ET-1 in bleeder group [12.90 +/- 5.51] when compared to the non-bleeder group [7.50 +/- 2.52] [p< 0.05]. In the same time, there was a statistically significant increase in the level of hepatic tissue ET-1 in bleeder group [77.6 +/-14.03] when compared to the non-bleeder group [52 +/-10.56] [p< 0.05]. Plasma endothelin-1 level showed significant correlation with parameters of hepatic function. In conclusion, results demonstrated that plasma and hepatic tissue ET-1 might play an important role in the genesis of bleeding varices seen in advanced liver cirrhosis and portal hypertension

utility of real-time ultrasonography vs alpha-fetoprotein estimation and computed tomography in the diagnosis of focal hepatocellular carcinoma associated with liver cirrhosis

A total of 146 cirrhotic patients were examined by ultrasonography. In 26 patients [17.8%], a space occupying lesion was detected, while the serum AFP level was higher than 200 ng/ml in only 10 of them [38.5%]. Abdominal CT scanning was successful in displaying the focal hepatic lesion in 22 out of the 26 patients [84.6%]. To verify the diagnosis of these lesion, CT-guided biopsy was performed in only 18 patients out of the 22 patients, 4 patients were excluded [liver bathed in ascites in 3 patients and prothrombin concentration below 40% in one patient

utility of real-time ultrasonography vs alpha-fetoprotein estimation and computed tomography in the diagnosis of focal hepatocellular carcinoma associated with liver cirrhosis

A total of 146 cirrhotic patients were examined by ultrasonography. In 26 patients [17.8%], a space occupying lesion was detected, while the serum AFP level was higher than 200 ng/ml in only 10 of them [38.5%]. Abdominal CT scanning was successful in displaying the focal hepatic lesion in 22 out of the 26 patients [84.6%]. To verify the diagnosis of these lesion, CT-guided biopsy was performed in only 18 patients out of the 22 patients, 4 patients were excluded [liver bathed in ascites in 3 patients and prothrombin concentration below 40% in one patient