Virtual colonoscopy as a new diagnostic tool in cancer colon

Virtual reality imaging is a new technology that combines helical computed tomography and magnetic resonance [MR] data and advanced three-dimensional graphics software to generate endoluminal perspective images of hollow organs. Computed tomography colonography [Virtual colonoscopy] is an imaging procedure in which a series of helical CT scans of the patient's colon are rendered by computer into slices that can be visualized as serially combined images to provide a three-dimentional tour of the colon. So, this technique has been evaluated, mostly conducted in diagnostic [rather than screening] setting in higher-risk patients. In this work, we try to evaluate the sensitivity and accuracy of virtual colonoscopy as a new modality for colorectal evaluation in patients subjected to traditional colonoscopy and double-contrast barium enema study who are diagnosed as having cancer colon and to correlate the findings of virtual colonoscopy with those of conventional colonoscopy and barium study. This work was conducted on twenty [20] patients, selected among 91 patients of different colonic illness admitted in Mansoura and Banha Gastroenterology Centers. They were thirteen [13] males and seven [7] females with age ranging form 49-75 years; mean age [59.5 +/- 8.6] years. All patients were subjected to complete medical history, thorough clinical examination, routine laboratory tests and special laboratory investigations as carcino-embryonic antigen [CEA] and occult blood in stool. Abdominal ultrasonography, barium double-contrast enema, traditional colonoscopy and virtual colonoscopy were done for all patients. Colonoscopic biopsies were obtained as routine in every case in addition to biopsy from any suspected areas or detected masses. Histopathological examination was done also for every sample. From this study, we concluded that CT colonography [Virtual Colonoscopy] is feasible for the detection of colorectal cancer with high success in sizes more than 10mm and further technical advances will improve the performance of CT colonoscopy and will allow patients available imaging modality for full structural examination of the colon

Plasma alpha glutathione S - transferase in chronic hepatitis C infection in Egypt

Chronic hepatitis C [CHC] infection is a progressive disease whose activity must be regularly assessed. alpha -Glutathione S-transferase [alpha -GST] has been suggested as a better marker of hepatocellular damage than aminotransferases in toxic and autoimmune hepatitis. The present study assessed alpha -GST as a biochemical marker of hepatocellular damage in 50 Egyptian patients with CHC [seropositive for anti-hepatitis C virus [HCV] and HCV-RNA]. They were evaluated for conventional liver biochemistry, plasma alpha -GST, serum HCV-RNA levels and liver biopsy. Plasma alpha -GST was significantly higher in CHC patients than the reference values [p < 0.01] Sixteen patients [32%] had normal values for alanine aminotransferase [ALT], plasma alpha -GST was elevated in 11 of them [3 with minimal hepatitis; 6 mild and 2 moderate hepatitis]. Elevated plasma alpha -GST levels may indicate a hepatocellular damage even when ALT level is normal in CHC infection. Plasma alpha -GST was significantly higher in cirrhotic than non-cirrhotic patients [p < 0.01] suggesting that alpha -GST measurement is probably a sensitive test detecting liver damage occurring in association with cirrhosis. Plasma alpha -GST was significantly correlated with ALT [r = 0.67, p < 0,01] and aspartate aminotransferase [AST] [r = 0.62, p < 0.01] suggesting that alpha -GST may be a potential indicator of chronic hepatocellular damage due to HCV. Furthermore, plasma alpha -GST was significantly correlated with histologic grading score of hepatitis activity [r = 0.94, p < 0.01] and staging score of architectural alterations [r = 0.65, p < 0.01] indicating that plasma alpha -GST may be a sensitive and non invasive marker for detecting hepatitis activity and hepatocellular damage in CHC patients. There was a non-significant correlation between alpha -GST and serum HCV-RNA level indicating that plasma alpha -GST could not reflect the degree of viremia in these patients. The present data showed that alpha-GST has the highest sensitivity, specificity and accuracy [84%, 90% and 90%, respectively] for the diagnosis of parenchymal disintegrity and hepatocellular damage associated with chronic HCV infection followed by ALT [68%, 85% and 80%, respectively] then AST [62%, 75% and 68%, respectively]. This may indicate that alpha -GST gives better results than ALT and AST and may be preferred to them for monitoring hepatocellular damage associated with HCV infection. In conclusion, plasma alpha-GST determination appeared to be a sensitive, specific and non-invasive biochemical marker for detecting hepatocellular damage and may have a role in the follow up of CHC patients