Progression of disease in extra hepatic biliary atresia is associated with reduced total hepatic blood flow: descriptive results of a prospective pilot study

Hepatic fibrosis and cirrhosis develop progressively in extrahepatic biliary atresia despite timely surgical intervention. We aimed to study total hepatic blood flow [hepatic artery and portal vein flow] as a possible predictive factor of outcome of infants having biliary atresia who had underwent Kasai portoenterostomy. Twenty Infants having biliary atresia underwent colored and pulsed Doppler ultrasound studies. They were done before and 2-3 months after portoenterostomy. Hepatic artery, portal vein and single hepatic vein mean flow, mean diameter, mean velocity, hepatic arterial to portal venous flow ratio and total hepatic flow/kg were calculated and correlated to final outcome. The detected mean total hepatic flow and total hepatic flow/kg preoperatively was 685.5 +/- 296 ml/min and 147.1 +/- 51.4 ml/min/kg and post-operatively in those who became anicteric was 854.4 +/- 107 ml/min and 149.5 +/- 37.2 ml/min/kg, 539.2 +/- 337.7 ml/min and 112.1 +/- 78.6 ml/min/kg in those who developed chronic disease and in those who died was 157.6 +/- 79.6 and 30.9 +/- 16.1 ml/min/kg respectively. Unresolving cholestasis in infants having biliary atresia with poor outcome following portoenterostomy is associated with decreased post-operative total hepatic flow. Preoperative total hepatic flow did not correlate with postoperative total hepatic flow

Scintigraphic evaluation of disease activity in rheumatiod arthritis

This study was undertaken in a trial to assess the activity of RA in the Joints through using[99] Tc[m] HMPAO scintigraphy. Also, to investigate the repeatability of this technique and the correlation between the labeled white cell uptake, pain, inflammation and joint destruction. Twenty-nine RA patients were subjected to scanning on the first visit and 18 of them have been for a second visit. The score of pain and inflammation of the knee joint was rated using the visual analogue scale [VAS] of pain and inflammation by the patients. 99Tcm HMPAO labeled white cell uptake was estimated in each knee on both visits. The joint was measured on both imaging occasions. Joint destruction of the knee was measured by scoring the joint x-Ray using Larson's score. The data obtained were analyzed using the Pearson correlation analysis to estimate the correlation of the mean white cell uptake in the joints with other disease activity parameters are presented followed by the scatter plot of the mean white cell uptake in the joints against the significantly correlated variables. Pain correlated with objective measures of inflammation [labeled white cell uptake] and with the degree of joint destruction. There was no correlation with either x-ray scores or white cell uptake in the depressed patients