[Carrier frequency of alpha thalassemia mutations among newborns in northern Iran]

Background and Objective: Alpha Thalassemia is one of the most prevalent hemaglobinophaties worldwide. Alpha thalasseima patients may represent wide spectrum of symptoms ranging from asymptomatic to severe life threatening anemia. This study was done to assess the carrier frequency of alpha globin gene mutations among newborns in north of Iran

Methods: In this descriptive study, 412 cord blood samples of neonate from Amir Mazandari hospitali were randomly selected during 2012. Genomic DNA was extracted using phenol-chloroform method. Multiplex Gap- PCR and PCR-RFLP methods were applied in order to detect three common gene deletions, one triplication and one point mutation

Results: Total allelic frequency of investigated mutations was 0.0825. The -alpha3.7 deletion with allelic frequency of 0.0485 was the most prevalent mutation among 412 neonates. Allelic frequencies of -alpha4.2, alphaalphaalphaanti3.7 triplication and alpha-5nt mutations were 0.0206, 0.0109 and 0.0024; respectively and -Med double gene deletion was not detected

Conclusion: Most mutated cases had single gene deletion that is asymptomatic while -Med double gene deletion was not detected among the neonates. Therefore, there is low probability of a child birth with Hb H disorder in the region

[Comparison of fluorescent spot test, decolorization test and quantitative enzyme assay in detection of G6PD enzyme deficiency]

Background and Objective: The national screening program for G6PD enzyme deficiency is not able to detect all affected neonates. This study was done to compare the fluorescent spot test [FST], decolorization test, and quantitative enzyme assay [QEA] for detecting G6PD enzyme deficiency in neonates

Methods: In this descriptive study, cord blood samples of 365 neonates were collected. Decolorization test, QEA and DNA test was done for each sample. All of the neonates were tested by FST as a part of national screening program on heel-prick blood sample collected on day 3-5 after birth. QEA was considered as the gold standard. According to QEA test results, neonates with <20% and 20-60% of mean normal enzyme activity were considered as total deficient and partial deficient, respectively

Results: Fluorescent spot test detected 13 male neonates with G6PD enzyme deficiency while decolorization test identified 18 male and 1 female neonates. Using QEA, 19 of male and 28 of female neonates with G6PD enzyme deficiency [26 cases with partial and 2 cases with total deficiency] were diagnosed. DNA analysis detected 34 female case as heterozygote and 14 male neonates as hemizygote for the disease

Conclusion: Fluorescent spot test do not have required sensitivity for screening of neonates with G6PD enzyme deficiency. QEA test is recommended to replace the fluorescent spot test in national screening program

[Detection of common mutations causing drug resistance to mycobacterium tuberculosis strains among patients with tuberculosis using line probe assay method]

Drug resistance to tuberculosis and especially multiple drug resistance tuberculosis [MDR-TB] variants are a serious problem in tuberculosis patients and make difficulties in controlling the disease. This study was coducted for detection of common mutations causing drug resistance of mycobacterium tuberculosis strains among tuberculosis patients using line probe assay method. In this descriptive study, fifty four sputum samples of tuberculosis patients were randomly selected in health centers of Mazandaran, northern Iran during 2012. After culturing of sputum samples on Lowenstein-Jensen medium, genomic DNA was extracted from colonies using CTAB method. Molecular analysis of mutations causing resistance to five different antibiotics including Isiniazide, Rifampin, Sterptomycine, Amicasin / Canamycine, Kinolon were performed using long probe assay [LPA] method. Out of 54 sputum samples, three [5.5%], three [5.5%], four [7.4%] were resistance to Kinolon, Amicasin / Canamycine and Sterptomycine, respectively. Mutation in KATG was seen in 2 samples resistant to Isiniazide. Mutation in rpoB 516 was seen in 3 samples resistant to Rifampin. Four samples [7.4%] were resistant to the two anti-tuberculosis antibiotics, while three samples were resistant to Sterptomycine and Kinolon and one sample was resistant to Rifampin and Canamycine. 7.4% of sputum samples were resistant to the two anti- tuberculosis antibiotics. Line probe assay is a rapid and suitable method for detecting tuberculosis drug resistance

Beta globin gene haplotypes associated with hemoglobin D-Punjab in northern Iran

Background and Objective: Hemoglobin D-Punjab is one of the variant of hemoglobin caused by a mutation on position 121 of beta globin gene which is frequent in India, PakistanandIran. Heterozygote form of this variant is mainly asymptomatic while in combination with hemoglobin S, severe form of anemia occure. This study was carried out to determine the beta globin gene haplotypes associated with hemoglobin D-Punjab in Northern Iran. Methods: This descriptive study was carried out on families of 18 individuals whom were carriers of hemoglobin D-Punjab in Sari in Northern Iran. Genomic DNA was extracted from peripheral blood samples using Phenol-chloroform st and ard protocol. In order to identify different haplotypes associated with hemoglobin D-Punjab, PCR-RFLP method and family linkage analysis were used. Results: In 17 subjects hemoglobin D-Punjab was linked to [+ - - - - + +] haplotype and in one case association with [- + + - + + +] haplotype was observed. Conclusion: The hemoglobin D-Punjab alleles have mainly unicentric origin and [- + + - + + +] rare haplotype may have different genetic origin or is created as a result of gene recombination

[Cloning, sequencing and expression of HSP70 c-terminal domain in Mycobacterium avium subsp. paratuberculosis]

Heat shock proteins [HSPs] have been shown to act as an adjuvant when co-administered with different antigens, especially tumor antigens or antigens from infectious agents. C-terminal domain of Mycobacterium tuberculosis heat shock protein 70 [Hsp70], when fused to peptide antigens, provides a unique structure that is able to induce potent immune responses. In this study, aneukaryotic expression vector pEGFP-N1, containing C-terminal domain of Mycobacterium paratuberculosis HSP 70, Green Fluorescent Protein [GFP] gene in the plasmid construct, was designed for use as a reporter. With GFP system, expression of the target protein was evaluated in the cell culture. The nucleotide sequence of the cloned gene was revealed by sequencing. The protein expression of designed plasmid was also proved by reverse transcriptase polymerase chain reaction [RT-PCR]. Our eukaryotic expression vector [pEGFP-N1 -hsp70 c-terminal] was successfully constructed and HSP70 c-terminal domain protein was expressed effectively. The current experiment, as a basis for a new DNAvaccine design, can be used for the future studies on reverse vaccinology

[ effect of honey bee venom and all-trans retinoic acid on proliferation and differentiation of HL-60 cell line]

Differentiation therapy is one of the methods for treatment of cancer. In this method, some drugs such as All-trans Retinoic Acid, are used which can inhibit proliferation of cancerous cells and induce cell differentiation. Previus experiments showed some anti-proliferation materials, anti-inflammation materials or anti-oxidant materials could influence the effects of such drugs and decrease resulting side effects. In this research the effects of the Honey Bee Venom, on All-trans Retinoic Acid functions was measured. In this experimental project we used HL-60 cell line belonging to acute promyelocyte leukemia. The HL-60 cell line was obtained from Pasteur Institute of Iran, and were grown in RPMI 1640 medium [Roswell Park Memorial Institute] containing 10% FBS [Fetal Bovine Serum] and 1% streptomycin-penicilin. We used MTT [3-[4, 5-Dimethylthiazol-2-yl]-2, 5-Diphenyltetrazolium bromide] and NBT [Nitro-Blue tetrazolium chloride] tests for these purposes. All experiments were done three times and data were analyzed using SPSS. Both Honey Bee Venom and All-trans Retinoic Acid could inhibit proliferation of HL-60 cells, also All-trans Retinoic Acid could induce differentiation in this cells. The amount of differentiation was increased significantly [p<0.01] in the presence of Honey Bee Venom. On the base of our findings, it seemed that Honey Bee Venom could increase anti cancer effects of All-trans Retinoic Acid

Cloning and high level expression of bovine interferon gamma gene in eukaryotic cells [COS-7]

Interferon gamma [IFN-gamma] is one of the key cytokines in defining T helper 1 lymphocyte immune responses. In this study, the bovine IFN-gamma gene was cloned from spleen tissue RNA using the reverse transcription-polymerase chain reaction [RT-PCR]. IFN-gamma cDNA was sub-cloned and expressed in mammalian expression plasmid [pcDNA3.1[+]] under the control of the human cytomegalovirus [CMV] promoter. The predicted amino acid [aa] sequence of bovine IFN-gamma compared with corresponding known sequence from bovine [Bos taurus] was 100% identity and with ovine, caprine, camel, lama, equine, canine, feline, human, mice and chicken cytokine was 95, 95, 86, 83, 77, 75, 75, 61, 44 and 35%, respectively. Invitro expression of recombinant bovine IFN-gamma [rBoIFN-gamma] and secretion to culture medium was confirmed by ELISA test. Maximum expression of rBoIFN-gamma occurred at 96 and 144 h after transfection in COS-7 cells. These results showed that pcDNA3.1 expression vector and COS-7 cells transfected by diethylaminoethyl [DEAE]-dextran allowed the high level expression of bovine IFN-gamma gene and the release of protein in supernatant of cell culture

Unilateral blindness as the only finding in a patient with high flow carotid-cavernous fistula

The authors reported a patient with unilateral blindness of the left eye after trauma. Apart from paralysis of the 4th cranial nerve and mild optic nerve edema, there was no structural problem during the ophthalmologic examination. Brain CT scan, CT angiography and MRI demonstrated aneurysm in the left pericavernous region. The patient underwent angiography for coiling of the aneurysm, which detected large carotid cavernous fistula [CCF] mainly draining into the petrous sinus. Therapeutic embolization was performed with balloon and the CCF vanished completely. The most important points of this case are the blindness without exophthalmia as the only presentation of CCF which has not been reported as the only symptom and failure of CT-angiography and MRI evaluation for the diagnosis of CCF

Tailoring of interventional procedures for HCC patients-review article

One of the most frequent primary malignant tumors in the world is hepatocellular carcinoma [HCC]. Currently, the optimal treatment methods for HCC are hepatic resection and liver transplantation. Unfortunately, surgical therapies are suitable for 20% of patients and those who are not eligible for surgery should undergo interventional therapies. In the past decade, a variety of interventional procedures have been employed for local control of hepatocellular carcinoma [HCC] including transcatheter arterial chemoembolization [TACE] and many tumor ablation techniques, such as percutaneous ethanol injection [PEI], radio-frequency ablation [RFA], percutaneous microwave coagulation therapy [PMC], laser-induced interstitial thermotherapy [LITT], cryoablation, and acetic acid injection. By development of new technologies in imaging and drug delivery, it is likely that in the future patients with HCC will be treated by combination therapies to improve patient survival. Computed tomography [CT] and magnetic resonance imaging [MRI] have a crucial role in diagnosis and also follow-up of HCC patients treated by interventional procedures, by which the treatment efficacy, recurrence of disease and certain complications are evaluated. In this review article, we discuss the imaging modalities and also tailoring of interventional procedures for HCC patients

Evaluation of incidental findings in brain CT scans of mild head trauma patients [GCS: thirteen to fifteen]

To determine the prevalence of incidental findings on brain CT scan in mild head trauma patients. From November 2005 to April 2006, we evaluated 732 CT Scans of cases with mild head trauma [Glasgow Coma Scale Score of thirteen, fourteen, and fifteen], whom referred to our university affiliated hospital. In this study, we evaluated incidental findings on brain CT of our patients, as well as size of the cistern magna. Five hundred [68.3%] of our patients were male and 232 [31.7%] were female. The mean age of our cases were 27.4 +/- 19.2 [one month to 89 years old].Incidental findings were found on 22 cases [3.1%].Among these, there were five tumors [0.7%], eight arachnoids cysts [1.1%], and five bones lesions [0.7%]. Large cisterna magna [>10 cm3] was seen in four cases. Incidental findings in males were seen in ten cases [45%] and in females were seen in 12 cases [55%] [P=0.019]. The mean age of cases with incidental findings were 37.2 +/- 20.6 years and in cases without incidental findings were 27.1 +/- 19.1 years [P=0.011]. In this study we found that arachnoid cyst was the most common incidental finding, and brain tumor and bone lesions were next common ones

Carotid doppler ultrasonography in preoperative assessment of coronary artery bypass graft surgery in an Iranian population: association between atherosclerosis risk factors and carotid stenosis

The aim of this study was to assess the frequency of significant carotid artery stenosis and its association with the cardiovascular risk factors in a group of Iranian candidates for CABG. Three hundred and one patients with critical coronary artery disease, who were candidates for coronary artery bypass graft [CABG] were evaluated by internal carotid Doppler study. The relations between age, gender, hypertension, diabetes mellitus, smoking, lipid profile, left main coronary stenosis greater than 50% by diameter and coronary artery disease with carotid stenosis were assessed. Significant carotid stenosis greater than 70% was detected in 13 patients [4.3%]. According to the meaningful relationship between significant carotid stenosis and low HDL serum level [lower than 45 in women and lower than 35 in men, p=0.028], hypertension [p=0.021], history of smoking [p=0.026] and left main coronary artery stenosis greater than 50% [p=0.035], they were identified as risk factors valuable enough to guide for selective screening. Among all cardiovascular risk factors. It seems that serum HDL, smoking, left main coronary stenosis and hypertension could be associated with significant carotid artery stenosis in CABG candidates

[Fracture resistance of two different designs in fiber-reinforced composite restorations in mandibular anterior bridges: an in-vitro study]

The purpose of this study was to assess the fracture resistance of two different designs of tooth preparation and fiber placement in fiber-reinforced composite restorations replacing a missing mandibular lateral incisor. Forty newly extracted human mandibular intact teeth [20 centrals and 20 canines] were selected for fabrication of twenty FRC inlay bridges. A box preparation design with straight fibers, and a slot design preparation with curved fibers were implemented. After preparation, the teeth were mounted in self-cured acrylic resin with 6.5 mm distance from each other. PDL was simulated with polyether material. After taking impressions with polyether material, the impressions were poured with dental stone. The two groups of bridges were fabricated and bounded to teeth with panavia F[2]. The cyclic load of 1.2 x 10[6] x 20N x 1.66HZ was applied with 130° angle. The samples were stored in 37°C water for seven days and then thermo cycled [2000 cyles, 5-55°C]. The fracture strength was tested by a universal testing machine [Instron 1195] at a speed of 1 mm/min. The mode of fracture was observed under stereomicroscope. The data was analyzed by using independent sample T-test. The mean fracture resistance for the box design and direct fiber group was 1411.07 N and in the slot and curved fibers group was 377.33 N. The group difference was statistically significant [P=0.012]. It could be concluded that in fiber-reinforced composite restorations, box design with straight fiber has more fracture resistance than slot design with curved fiber

[Reliability of six methods of measuring convergence angle in posterior teeth for single PFM crown]

There are several methods of measuring Convergence Angle in posterior single PFM crown. The aim of the present study was to compare the reliability of these methods. This experimental study was conducted with twenty selected stone dies, numbered 1 to 20. The convergence angles were measured and recorded by five last year dental students using manual and computer assisted methods. The manual methods used were: 1. Photocopy machine, 2. Digital camera, 3. Analogue camera [photography], 4. Overhead projector; the computer assisted methods were: 5. Scanner machine and 6. Microscope. Data were analyzed using One Way Random Effect, and SPSS version 11 statistical software. Coefficient of reliability for methods 1 to 6 was 0.9981, 0.9988, 0.9986, 0.9991, 0.9957, and 0.9994 respectively. No significant difference was detected among these methods and all were found to be reliable. There were no significant differences among the methods evaluated. Moreover, all methods were found to be significantly reliable and can be used for measuring convergence angles

Association between clinical symptoms and CT findings in chronic rhinosinusitis

This study was conducted to find out the association between the clinical symptoms of chronic rhinosinusitis [CRS] and CT findings. 50 patients with CRS were studied. Their clinical symptoms were recorded according to the sinonasal outcome questionnaire [SNOT-20] and their CT findings were graded by the Lund-Mackay grading system. The Pearson correlation coefficient was assessed between these two scores. Also we used multiple regression models for adjusted association among variables. The mean +/- SD of SNOT-20 and the Lund-Mackay score were 45 +/- 8.7 [range: 29- 67] and 18.5 +/- 5 [range: 8-24], respectively. The mean +/- SD SNOT-20 score was higher for postnasal drip [PND] and facial pain; the lowest mean scores were for dizziness and ear pain. Pearson's correlation coefficient of SNOT-20 and the Lund-Mackay grading system was 0.74 [p=0.0001]. In simple regression analysis considering the Lund-Mackay score as dependent variable and SNOT symptom domains [nasal, oropharyngeal, sleep, facial, and systemic] as independent variables, the best associated clinical symptom domain was the nasal symptom domain [model r2=0.76; p<0.0001]. In the multivariate linear regression model, considering the five symptom domains as independent variables, the model r2 was 0.8 [p<0.0001] and the only significant variable in the model was the nasal symptom domain [p<0.0001]. Patients with higher symptom scores are more likely to have CT imaging evidence of rhinosinusitis

Diagnostic accuracy of Multi-Slice Computed Tomographic [MSCT] angiography in the detection of cerebral aneurysms

Multislice computed tomographic [MSCT] angiography is a rapid and minimally invasive method for the detection of intracranial aneurysms. The purpose of this study was to compare MSCT angiography with digital subtraction angiography [DSA] in the diagnosis of cerebral aneurysms. In this cross sectional study we evaluated 111 consecutive patients [42[37.8%] male and 69[62.2%] female], who were dmitted under clinical symptoms and signs, suggestive of harboring an intracranial aneurysm by using a four detector MSCT angiography. Then we compared results of MSCT angiography with DSA results as a gold standard method. DSA was performed by bilateral selective common carotid artery injections and either unilateral or bilateral vertebral artery injections, as necessary. MSCT angiography images were interpreted by one radiologist and DSA was performed by another radiologist who was blinded to the interpretation of the MSCT angiograms. The mean +/- SD age of the patients was 49.1 +/- 13.6 years [range: 12-84 years]. We performed MSCT in 111 and DSA in 85 patients. the sensitivity, specificity, positive predictive value [PPV], negative predictive value [NPV], positive and negative likelihood ratio [LR] of MSCT angiography, when compared with DSA as the gold standard, were 100%, 90%, 87.5%, 100%, 10 and 0, respectively. MSCT angiography seems to be an accurate and non-invasive imaging modality in the diagnosis of intracranial aneurysms

Fluoroscopic versus conventional computed tomography-guided biopsy

To determine the success rate of computed tomographic [CT] fluoroscopic CT [FCT] and conventional CT [CCT] for needle navigation in biopsies from mediastinum, bone, abdomen, liver and pelvis. Data from 122 consecutive percutaneous interventional biopsies performed with use of FCT guidance [mean age of 50.5; range: 1-79 years] and 84 consecutive biopsies with CCT guidance [mean age: 50.7; range, 12-83 years] were gathered from the interventional radiologist and general practitioner. The success rate of procedure was increased in the FCT group as compared with that of CCT group in some organs such as bone, abdomen, liver and pelvis. A statistically significant difference was noted when we compared FCT group with CCT in liver biopsies [P=0.019]. The mean procedure time was lower in FCT group. The overall mean [ +/- SD] FCT time was 200 +/- 90 [range: 20-400] sec; in CCT group, it was 420 +/- 260 [range: 605-800] second. FCT facilitates CT-guided biopsy procedures and reduces the procedure time by allowing visualization of the needle tip from skin entrance to the target point

[Incidental sinus abnormalities in 256 patients referred for brain MRI]

Imaging abnormalities in the paranasal sinuses are regularly noted as incidental findings on MRI, however, little is known about their prevalence in the Iranian population. The purpose of this study was to classify these findings in the paranasal sinuses as seen on MRI and to investigate the prevalence, according to site and type of paranasal abnormality. In this cross-sectional study, the T2-weighted axial MRI of 256 patients with diseases unrelated to their paranasal sinuses were reviewed between May 2002 and June 2003. The findings were categorized according to the anatomic location and the imaging characteristics of the abnormality. The abnormalities recorded included total sinus opacification, mucoperiosteal thickening >/= 5mm, air fluid levels and retention cysts or polyps. Unilateral or bilateral involvement and septal deviation were also noted. A sinus was considered normal if it was fully aerated and no soft-tissue density was apparent within the cavity. Among our cases, 111 [43.5%] were male and 145 [56.5%] were female. Of these patients, abnormalities in one or more of the sinus groups were found in 110 subjects [42.9%], 55.5% of which were male and 44.5% were female [P=0.001]. Maxillary sinus abnormalities were observed in 66.4% of the patients, while ethmoid sinus abnormalities were found in 63.6%. Of the ethmoid abnormalities, 21% were found in the anterior section, 9% in the middle ethmoid, and 8% in the posterior ethmoid. The most common abnormality found was mucosal thickening. Among our cases, 23.4% had septal deviation, which was significantly higher among those with sinusitis [29% versus 19.1%; P<0.01]. Of those patients with sinus involvement, 16% were involved in the sphenoid sinus and 5% in the frontal sinus. The results obtained from the patients with sinus abnormality revealed that 85% suffered from cough, nasal obstruction, runny nose, facial pain and post nasal discharge and 24% had been diagnosed with chronic sinusitis by physician. Our results showed that there was a high rate of incidental abnormalities in the paranasal sinuses that are unrelated to the patient's presenting problems

Computed tomography findings in patients with mild head trauma

To determine the frequency of computed tomography [CT] findings in patients with mild head trauma. In this cross-sectional study conducted between September 2005 and April 2006, 708 patients with mild head trauma as defined by a Glasgow Coma Score [GCS] of 13-15, were underwent standard clinical examination and cranial CT. The mean +/- SD age of our patients was 26.8 +/- 19.03 years [range: 1 month to 89 years]. 489 [68.9%] patients were male and 219 [30.8%] were female. GSC was 13 in 1%, 14 in 4.6% and 15 in 94.4% of patients. The most common mechanism of trauma was car accident and falling down, each of which happened for 132 patients [18.6%].The most common findings on CT were subgaleal hematomas in 213[30%] and intracranial lesions were seen in 41 patients[5.8%] ;among them 37 were male. Among intracranial lesions, the most common finding was epidural hematoma in 18 patients followed by hemorrhagic contusion in 13 patients. Intracranial lesions were observed in 28.6% of patients with GCS of 13; in 15.2% with GCS of 14 and in 5.1% with GCS of 15 [P=0.002]. Many of patients with GCS equal to 15 after head trauma have considerable intracranial lesions and minor focal neurologic signs revealed by careful physical examination could be a good marker of these lesions

[Effects of rapeseed meal and iodine supplement on broiler chicks]

To study the effects of rapeseed meal and iodine supplementation on performance, organs weight and some biochemical parameters of broiler chicks. Completely randomized design with 3 dietary treatments. One hundred and twenty one-day-old Arian broiler chicks [mixed male and female]. Chickens were categorized into 3 groups: soybean meal, rapeseed meal, and rapeseed meal plus iodine [2mg/kg]. feed intake, body weight gain and feed conversion ratio were determined at the end of starter, grower, finisher and whole priod states Moreover, the values of relative weight of liver, gallbladder, heart, spleen, gizzard, abdominal fat pad and carcass accompaning with serum concentrations of triiodothyronine, thyroxine, gamma glutamyltransferase and alanin aminotransferase were determined at 49 day of age. Significant differences among treatments determined by Duncan's multiple range tests. While rapeseed meal [RSM] reduced, body weight gain and feed conversion ratio, iodine supplement did not affect body weight gain and feed conversion ratio during starter, grower and whole period states. In contrast to iodine treatment the highest weight of gallbladder and its ratio to whole body weight were seen with RSM. The weight of abdominal fat pad and its ratio to whole body weight were reduced in RSM and RSM puls iodine supplementation. Iodine Supplementation had effect on the concentration of thyroxine, triiodothyronine gamm glutamyltransferase and alanin aminotransferase in RSM group. The complete replacement of rapeseed meal with soybean reduced performance and concentration of triiodothyronine hormone, and increased some organs weight, idoine supplementation had no effect on erfrmanc

Radiofrequency ablation of liver tumors: the first preliminary reported in Iran

Radiofrequency ablation [RFA] is emerging as a new therapeutic technique for unresectable hepatic malignancies. We report our experience with the use of this method for the first time in Iran. Eighteen patients with primary or metastatic hepatic malignancies, which were considered not suitable for surgical resection, were included in our study. RFA was performed via the percutaneous ultrasound'guided method, under general anesthesia, by an interventional radiologist. Patients were followed prospectively with contrast-enhanced CT or ultrasonography, and tumor marker serum levels 1, 3 and 6 months after RFA. RFA was used to treat 26 tumors [diameters of 12-70 mm]. These tumors included hepatocellular carcinoma in three cases and metastatic carcinoma in 23 cases. Three patients had complications: two bilomas and one abscess in the right lobe. At follow-ups, tumor recurred at the site of RFA in four tumors, all of which were over 4 cm in diameter. RFA is a procedure with the potential to be safe and effective for treating unresectable liver tumors