Hepatic Splenosis Preoperatively Diagnosed as Hepatocellular Carcinoma in a Patient with Chronic Hepatitis B: A Case Report

We report on a case of hepatic splenosis. A 32-yr-old man underwent a splenectomy due to trauma at the age of 6. He had been diagnosed as being a chronic hepatitis B-virus carrier 16 yr prior to the surgery. The dynamic computer tomography (CT) performed due to elevated serum alpha-fetoprotein (128 ng/mL) demonstrated two hepatic nodules, which were located near the liver capsule. A nodule in Segment IVa had a slight enhancement during both the arterial and portal phases, and another nodule in Segment VI showed a slight enhancement only in the portal phases. Dynamic magnetic resonance imaging (MRI) of the mass in Segment VI showed enhanced development in the arterial phases and slight hyperintensivity to the liver parenchyma in the portal phases. These imaging findings suggested a hypervascular tumor in the liver, which could be either focal nodular hyperplasia, adenoma, or hepatocellular carcinoma (HCC). Even though these lesions were diagnosed as HCC, some of the findings were not compatible with typical HCC. On dynamic CT and MRI, all lesions showed a slight arterial enhancement and did not show early venous washout. All lesions were located near the liver capsule. These findings, along with a history of splenectomy, suggested a diagnosis of hepatic splenosis.

[Evaluation of alpha-fetoprotein and alkaline phosphatase levels in prediction of preterm labor]

Preterm labor is one of the complications of pregnancy affecting 7% of cases. To determine variations of AFP and ALP as a predictive index of preterm labor. A case-control study was performed on 210 patients in Kosar hospital, Qazvin. The case group composed of 70 pregnant women between 28-37 weeks who had their deliveries in labor ward and diagnosed as preterm labor. The first control group included 70 pregnant women between 28-37 wks who were followed until 37th week of pregnancy and the mentioned parameters were measured in their serum. The second control group consisted of 70 women who had term delivery and evaluated for the effect of labor on the level of predicting markers. The data derived from questionnaires were used as primary information. The analysis of data was performed based on parametric test [t-test] using SPSS 4 [confidence interval of 95%]. The mean of AFP in preterm labor group was 167.61 IU/ml followed by 77.5 and 70.5 IU/mL in first and second control groups, respectively. There was a significant difference [up to 2-205 times of mean value] between preterm labor group and the first control group [p<0.05]. The mean of ALP in preterm labor group was 320 IU/mL followed by 284.1 and 280.1 IU/mL in first and second control groups, respectively. Regarding ALP levels, no significant difference was found between two control groups. The serum level of AFP was increased in preterm labor whereas no variation in the level of ALP was observed

Gene cloning of murine alpha-fetoprotein gene and construction of its eukaryotic expression vector and expression in CHO cells / 华中科技大学学报（医学）（英德文版）

To clone the murine alpha-fetoprotein (AFP) gene, construct the eukaryotic expression vector of AFP and express in CHO cells, total RNA were extracted from Hepa 1-6 cells, and then the murine alpha-fetoprotein gene was amplified by RT-PCR and cloned into the eukaryotic expression vector pcDNA3.1. The recombinant of vector was identified by restriction enzyme analysis and sequencing. After transient transfection of CHO cells with the vector, Western blotting was used to detect the expression of AFP. It is concluded that the 1.8 kb murine alpha-fetoprotein gene was successfully cloned and its eukaryotic expression vector was successfully constructed.

Lack of correlation between alpha-fetoprotein and tumor size in hepatocellular carcinoma

OBJECTIVE: To determine whether there was a correlation between tumor size and alpha feto-protein [alpha-FP] levels in hepatocellular carcinoma. SETTING: Retrospective study in tertiary referral center with specialist Oncology services in Southern Pakistan. SUBJECTS: Consecutive patients with biopsy-proven hepatocellular carcinoma diagnosed between January 1994 and June 1998. MAIN OUTCOME MEASURES: Correlation between alpha-FP levels and maximum tumor diameter. The mean tumor size was 8.3 +/- 4.2 cm. The mean alpha-FP level was 17,027 ng/ml. Twenty four% patients had an alpha-FP level which was within the normal limits [< 10 ng/ml]. There was no correlation between tumor size and alpha-FP levels [r = -0.155; p = 0.129]. There was no correlation between the tumor size and alpha-FP levels

Diagnóstico prenatal I: programa de diagnóstico prenatal de la Unidad de Genética Médica de la Universidad del Zulia, Maracaibo, Venezuela / Prenatal diagnostic I: prenatal diagnosis program at the medical Genetic Unit, University of Zulia, Maracaibo-Venezuela

La Unidad de Genetica Médica de la Universidad del Zulia (UGM-LUZ) cuenta con un Programa de Diagnóstico Prenatal (PDxPN) a través del cual se identificaron los Factores de Riesgo Genéticos (FRG) en las parejas que asisten a la consulta de Genética Prenatal, se aplican diferentes procedimientos de diagnóstico prenatal (DxPN) y se ofrece asesoramiento genético adecuado. El objetivo de este trabajo es mostrar los resultados preliminares obtenidos en el lapso comprendido entre enero 93 y diciembre 96 y estimular a grupos afines a desarrollar programas similares. La muestra analizada fue de 321 gestantes a quienes se les determinó los FRG, tomando en cuenta el motivo y/o los antecedentes de la historia clínica genética. Los FRG fueron: Edad materna avanzada (EMA), hijo previo con anormalidad cromosómica (HAC), antecedente de malformaciones congénitas (AMC), antecedente de defectos de cierre del tubo neural (ADTN), antecedente de cardiopatía congénita (ACC), alguno de los padres portador de anormalidad cromosómica (PAC), aborto habitual (AH), anormalidad ecográfica fetal (AEF), niveles anormales de alfafetoproteína sérica materna (AFPSM), otros: exposición a agentes potencialmente teratogénicos, antecedente de enfermedades mendelianas, enfermedades sistémicas maternas y ansiedad materna o en su pareja. De acuerdo a los FRG se diseño el plan de DxPN, el cual contempló: Ecografía fetal (EF), ecocardiografía fetal (EcF), amniocentésis (ACT), cordocentésis (CCT) y/o determinación de niveles de AFPSM. El 70 por ciento de las gestantes presentó sólo un FRG, el 58,4 por ciento consultó en el 2do. trimestre de la gestación y la EMA fue el FRG más frecuente (40,3 por ciento) seguido de HAC, AEF, AMC, ACC, AH, ADTN, PAC, y de otros . Los procedimientos de DxPN fueron específicos y permitieron valorar el estado de salud del producto y el diagnóstico y permitieron valorar el estado de salud del producto y el diagnóstico de los anormales. La identificación de los FRG permitió ofrecer un plan de DxPN que dió respuesta a las necesidades de las parejas y demostró la utilidad de la aplicación de un Programa de DxPN integral y multidisciplinario dirigido a toda gestante con el fin de identificar las de alto riesgo genético

Certain tumour markers in long standing chronic hepatitis B and C in Egyptian beta thalassemia

B-thalassemia major is the most Common haemolytic disease in Egypt and is transfusion dependent disease. Thalassemic patients have high prevalence of HCV and HBV. A study involving 135 polytransf used thalassemic Egyptian children was conducted from haematologic clinic Faculty of Medicine, Ain Shams Univesity and Ahmed Maher Teaching Hospital to determine the prevalence of HCV and HBV and the rule of blood transfusion in the spread of the virus and also to determine the levels of tumor markers AFPand CA 19.9 in the sera of the patients for early detection of HCC in polytransfused thalassemic patients with long standing chronic HCV and HBV. Also 25 healthy children considered as control group. Serum specimens were assayed for hepatitis markers [HBsAg, HBsAb, HBcAb [IgG, IgM] and HCV antibodies]. The result of this study showed that the prevalence of combined HCV and HBV was the highest one 79.2% then HBV only 10.4% then HCV antibodies 8.9% and lastly 1.5% had no any markers for HBV and HCV. Positive hepatitis cases were associated with increased duration of illness, and volume and number of transfusion when compared with negative cases. The high prevalence of HCV antibody [87.4%] among multitransfused children suggests that blood and blood products supplies should be regularly screened for HCV antibody. AFP and CA 19.9 measurements in cases showed that there is slight non significant increase in the level of both compared with control. Measuring of AFP and CA 19.9, liver sonography, isotope liver scan for selected cases showed no evidence of HCC in these patients

Alpha feto-protein and albumin in ascitic fluid in hepatocellular carcinoma patients

The aim of this work was to study the value of estimating AFP in ascitic fluid of HCC patients with ascites. This work was a case control study on 32 patients, including 22 cases with ascites and HCC and 10 cases [control group] with ascites due to liver cirrhosis without HCC. The level of AFP was estimated in serum and in ascitic fluid by radioimmunoassay [RIA]. The serum ascites albumin gradient [SAAG] was assessed by measuring albumin in all samples using bromocresol green dye binding. Guided aspiration liver biopsy and ascitic fluid cytology were done, stained with H and E. It was found that AFP level in serum was elevated in 72.7% of HCC patients and in ascitic fluid, it was elevated in 63.6% of HCC patients. Also, there was a highly significant, direct positive correlation between elevation of AFP in serum and in ascitic fluid [r = 0.778]. No elevation of AFP in serum and in ascitic fluid was detected in the control group. Ascitic fluid cytology showed malignant cells in one case only. SAAG was significantly lower in the HCC group [0.83 g/dl] than the control group [2.43 g/dl]

Alpha-fetoprotein production by rhabdomyosarcoma of the urinary bladder.

Alpha-fetoprotein has emerged as a useful diagnostic tool for hepatic tumour and tumours of germ cell origin. However, isolated case reports of association of this tumour marker with tumours of the lung and non-germ cell tumours of the ovary are reported. We present a case of a Rhabdomyosarcoma, a generally non-secretory tumour that showed raised levels of AFP in serum and reacted positively for the same in a PAP technique for AFP. Cross striations were visible in many cells on II & E stained sections.

Effect of low-dose triphasic and biphasic oral contraceptive preparation of alpha-fetoprotein[AFP] and pregnancy B1 glycoprotein [SP1]

50 women in productive age was included in this study with aim of comparative study on alpha-fetoprotein and pregnancy specific B[1]-glycoprotein level in two group of women receiving two types of oral contraceptive pills, [Nordette and Trivolar] after six month of pill intake. The serum is withdraw from women after overnight fasting and allowed to clot at 37°C, the retracted clot is removed and centrifugation at room temperature, the serum was stored in deep freez at-4°C until use. Enzyme-linked immuno-sorbent Assay [ELISA] used for determination of AFP and SP[1] Enzgnast AFP Hoechest [1982] and Enzognast SP[1] Hoechest [1982] and both are measured photometrically at wave length [492 nm]. The serum AFP after six month of pill intake in Nordette group was 4.92 +/- 1.08 Iu/ml] these level was significantly increased. [P < 0.001] as compared to control group, [3.02 +/- 1.06 Iu/ml]. But in Trivolar group, the serum AFP was [3.11 +/- 1.35 Iu/m], statistically significant decrease if it is compared to Nordette group [P < 0.001] and insignificant if it is compared to control group. The serum level of SP[1] in study group [Nordett and Triovlar] was 0.62 +/- 2.8 and 0.56 +/- 0.26 ug/l respectively this figures was insignificant if it is compared to control group

Large Mononuclear Cells in Seminoma: An Immunohistochemical Analysis of 21 Cases

Twenty-one cases of seminoma (including testicular seminoma, ovarian dysgerminoma and extragonadal germinoma) were reviewed for the cell types responsible for the production of alpha-fetoprotein (AFP) and human chorionic gonadotropin (HCG). Histologically the cases included seventeen classical seminomas and 4 anaplastic seminomas. The latter had some mononuclear and multinuclear giant cells. All 4 patients with anaplastic seminoma had elevated levels of serum AFP, and each of these cases contained AFP producing tumor cells identified by immunoperoxidase staining. All seminomas of patients with elevated serum levels of HCG were of the classical type but HCG producing tumor cells could not be identified by immunoperoxidase staining. Immunoreactivity to anti-AFP was found in some large mononuclear cells and anaplastic cells. To explain these results, we propose that the large mononuclear cell is a multipotential cell capable of differentiating into a germ cell, yolk sac and embryo, and that the anaplastic seminoma cells might represent a stage on the continuum of cellular differentiation from the large mononuclear cells to germ cells. The multinuclear giant cell does not appear to be essential for the production of either AFP or HCG in seminoma.