The association of Helicobacter pylori infection with the development of gastroesophageal reflux disease (GERD).

A large number of studies were performed that support the association of Helicobacter pylori infection and the development of (GERD), although to prove that this association is a causation is still a matter of dispute. The objectives of this study was to prove this causal association in order to be able to plan a program for intervention. The work was conducted on 30 patients suffering from symptoms suggestive of gastro-esophogeal reflux disease diagnosed by upper endoscopic examination and 20 matched controls were chosen complaining from dyspeptic symptoms but with completely normal by upper endoscopic examination. The patients and controls were selected from Mataria Teaching Hospital and Ain Shams Specialized Hospital in Cairo and subjected to complete history taking, clinical examination, endoscopic examination and biopsy from the lower end of esophagus for examination of the presence of Helicobacter Pylon. No causal association between infection with Helicobacter pylon and the development of (GERD) could be demonstrated. It is highly recommended to further investigate this association in patients with grade IV esophagitis (Barrett's esophagus) only.

Renographic indices for evaluation of changes in graft function.

Radionuclide renal diagnostic studies play an important role in assessing renal allograft function, especially in the early post-transplant period. In the past two decades various quantitative parameters have been derived from the radionuclide renogram to evaluate changes in perfusion and/or function of the kidney allograft. In this review article we discuss the quantitative parameters that have been used to assess graft condition, with emphasis on the early postoperative period. These quantitative methods are divided into parameters used for assessing renal graft perfusion and parameters used for evaluating parenchymal function. The blood flow in renal transplants can be quantified (a) by measuring the rate of activity appearance in the kidney graft, (b) by calculating the ratio of the integral activity under the transplanted kidney and arterial curves and (c) by calculating the renal vascular transit time. In this article we review a number of parenchymal uptake and excretion indices, such as the accumulation index, the graft uptake capacity at 2 and 10 min, the excretion index and the elimination index. The literature on these parameters shows that they have some practical disadvantages. In addition, values suffer from significant overlap when various graft pathologies coexist. A retrospective study was designed in our institution to evaluate the clinical usefulness of some of the frequently used previously published methods in which the graft function is quantitatively assessed in the early post-transplant period. The quantitative parameters studied which were reasonably reproducible in our hands included: global perfusion index (GPI), cortical perfusion index (CPI), vascular transit time, and the parenchymal parameters uptake capacity at 2 min (UC2) and elimination index (K3/20). The patient population in this study consisted of 43 patients with 157 technetium-99m mercaptylacetyltriglycine renograms. The perfusion indices GPI and CPI did not allow differentiation of the acute tubular necrosis (ATN) group from the acute rejection (AR) group; however, they were of value in monitoring the improvement in the condition of the graft dysfunction in both the AR and ATN groups. As for the parenchymal parameters, both UC2 and K3/20 were able to differentiate stable graft function (SGF) versus AR and ATN groups but were unable to separate AR from ATN dysfunction. The ability of these parenchymal parameters to detect improvement in the graft function was poor and statistically non-significant. From the literature data and our own findings it is concluded that radionuclide scintigraphy of renal transplants has assumed an important role, especially if performed serially, in monitoring graft function in the post-transplant period. Many quantitative parameters have been derived from the radionuclide renogram to evaluate changes in perfusion and/or function of the kidney allograft. It appears that these quantitative numerical values are unable to differentiate unequivocally between grafts with ATN and AR cases. The real value of these parameters lies in the follow-up of the dysfunction processes, which helps the clinician to determine the appropriate therapeutic regimen.

Detection of Schistosoma mansoni antigen in the liver and antibodies in serum of patients with hepatic schistosomiasis.

Liver biopsies were taken from 28 patients with chronic hepatitic schistosomiasis for histopathological study and S. mansoni antigen detection by indirect immunofluorescence test. Circulating antibodies were estimated by indirect haemagglutination test. Thirteen cases (46.4%) revealed diffuse S. mansoni antigen in the liver blood sinusoids and in the formed granulomata. Circulating antibodies were detected in 21 cases, 11 of them showed antigen in the liver. Five cases only revealed definite granulomatous reactions around bilharzial ova, while the remaining 23 cases showed periportal fibrosis. So, for proper diagnosis of chronic hepatic schistosomiasis, it is recommended to examine the liver for S. mansoni antigen together with circulating antibodies detection.

Immune deficiency in Hodgkin and non-Hodgkin lymphoma.

Forty-three previously untreated Egyptian patients with Hodgkin's disease and thirty-five patients with non-Hodgkin lymphoma were studied with several readily available tests of immune function, number of peripheral blood lymphocytes, delayed hypersensitivity to two recall antigens, in vitro blastoid transformation by PHA, the capacity of E-rosette formation and surface marker criteria. The results were correlated to the histology, stage of disease and to the presence of general symptoms and signs.