Non-invasive predictive score of fibrosis stages in chronic hepatitis C patients based on epithelial membrane antigen in the blood in combination with routine laboratory markers

Aim: The epithelial membrane antigen (EMA) could detect small deposits of liver malignant cells. However, no information exists regarding the use of EMA in patients with chronic hepatitis C (CHC). Therefore, we attempted to evaluate the diagnostic performance of EMA to distinguish patients with different liver fibrosis stages. Methods: Epithelial membrane antigen was identified in sera of 154 CHC patients using Western blot and enzyme linked immunosorbent assay (ELISA). Multivariate discriminant analysis (MDA) and receiver operating characteristic (ROC) curve analyses were used to create a predictive model including EMA in addition to a panel of routine blood markers. A combination algorithm was developed and validated prospectively in 170 CHC additional patients. Results: Epithelial membrane antigen at 130 kDa was identified, purified and quantified in sera of CHC patients using ELISA. Based on these encouraging results, we purified and developed a direct ELISA for the quantitation of EMA in sera of CHC. MDA selected a score for the prediction of significant liver fibrosis patients based on measurements of EMA, aspartate aminotransferase to platelet ratio index and albumin. Areas under the ROC curves (AUC) of the score for the three biomarkers were 0.82 for patients with liver fibrosis (F1–F4), 0.86 for significant liver fibrosis (F2–F4), 0.87 for advanced liver fibrosis (F3–F4) and 0.86 for liver cirrhosis (F4). The results of the validation study demonstrated that (74%) of patients could have avoided liver biopsy. Conclusion: This score was validated for the prediction of liver fibrosis stages and may minimize the need for liver biopsy.     

Comparative effects of gamma and microwave irradiation on anticarcinogenic effect of red chili in colon and liver of male albino rats

The comparative effect of raw red chili and red chili treated by gamma irradiation or microwave pasteurization with or without 5-fluorouracil on experimentally induced colon cancer in rats was investigated. Dimethylhydrazine was used to induce colon cancer which is histologically similar to and comparable with human neoplasm. Histopathological examination of dimethylhydrazine-treated rats demonstrated epithelial and goblet cell hyperplasia as well as preneoplastic changes of the rat colon expressed by loss of polarity of the nuclei and abnormal mitosis. The preneoplastic changes were developed to adenocarcinoma in 80% of cases. The liver showed different pathological pictures that included dysplastic changes, preneoplastic foci, and oval cell proliferation. We observed that red chili with or without 5-fluorouracil inhibited colon adenocarcinoma. The gamma red chili either alone or with 5-fluorouracil was the best groups. The gamma irradiated red chili alone decreased epithelial and goblet cell hyperplasia and preneoplastic changes in colon and dysplastic changes, oval cell proliferation, and Kupffer cell hyperplasia in the liver. The gamma irradiated red chili with 5-fluorouracil inhibited the preneoplastic changes in colon. It was concluded that the sanitization of red chili by gamma irradiation either alone or with 5-fluorouracil was more beneficial from the human health point of view than that by microwave.     

Role of combined use of potassium citrate and tamsulosin in the management of uric acid distal ureteral calculi

In this article, we investigated the effect of the combined use of tamsulosin and potassium citrate (Uralyt-U(?)) for the treatment of uric acid stones in the distal ureter. The study was designed as a prospective, double blind randomized controlled trial. A total of 191 adult patients with radiolucent distal ureteral calculi were recruited. We included patients with solitary stones ≥5 mm with mild or moderate hydronephrosis and a normal contralateral tract. The patients were randomized into four equal groups (the placebo, tamsulosin, Uralyt-U(?), and the combined treatment groups). The patients were treated for a maximum duration of 4 weeks or until stone expulsion. The stone size in all groups ranged from 5 to 11 mm (7.69 ± 1.7 mm). The total expulsion rate of the stones was significantly lower in the control group (26.1%) compared with that of any of the other three groups (68.8, 58.7, and 84.8% respectively) (P < 0.05). Meanwhile, the difference between the Uralyt-U(?) group and the combined treatment group was also statistically significant (P < 0.05). When we studied the patients with stones >8 mm as a separate subgroup to find the effect of the used drugs on the relatively large stones, we detected that the expulsion rate of these stones was significantly higher in the patients who received the combined treatment in comparison with any of the other three groups (P < 0.05). In conclusion, the use of urinary alkalization with tamsulosin can increase the frequency of spontaneous passage of distal ureteral uric acid stones especially those of 8-11 mm.     

Efficacy of unilateral combined (superficial and deep) cervical plexus block as a preemptive analgesia for unilateral neck dissection surgery

ObjectivesThe objectives of this study were designed to evaluate the intra- and postoperative analgesic efficacy of unilateral superficial and deep cervical plexus block for unilateral neck dissection surgery.Patients and methodsTwenty eight patients were randomly assigned into two groups to receive either saline (control group) or bupivacaine (study group), hemodynamic monitoring. Bispectral index (BIS) monitor and MAC of isoflurane were recorded. Postoperative visual analogue score were recorded, operative time and postoperative first time to take analgesic were recorded.ResultsCompared to the control group, patients received bupivacaine for unilateral superficial and deep cervical plexus block showed lower intraoperative isoflurane concentration and bispectral index, decreased postoperative visual analogue score, longer duration of analgesia, decreased plasma cortisol level. No patients developed adverse effects.ConclusionUnilateral combined superficial and deep cervical plexus block is an effective technique to reduce intraoperative anesthetics and reduce postoperative analgesic requirements in patients undergoing unilateral block neck dissection surgery without any adverse effects.     

Synthesis and antitumor activity of new sulfonamide derivatives of thiadiazolo[3,2-a]pyrimidines

New series of sulfonamide derivatives of [1,3,4]thiadiazolo[3,2-a]pyrimidine were synthesized and investigated as antitumor agents. Some of the newly prepared compounds were tested for their in vitro and in vivo antitumor activities. Preliminary biological studies revealed that compounds 4c, 4f, and 4j exhibited the highest affinity to DNA, while compounds 4h,i, 6a-c, 8 and 12-14 exhibited moderate activity. Also, compounds 4j, 4f and 4c showed the highest percentage increase in lifespan of mice inoculated with Ehrlich ascites cells over 5-flurouracil (positive control). The detailed synthesis, spectroscopic and biological data are reported.     

Assessment of the relationship between serum paraoxonase activity and epicardial adipose tissue in hemodialysis patients

Purpose

Paraoxonase-1 (PON-1) is a high-density lipoprotein-associated (HDL) enzyme, which has been shown to reduce susceptibility to low-density lipoprotein (LDL) peroxidation. Epicardial adipose tissue (EAT) is a marker of atherosclerosis. The aim of this study was to determine the relationship between PON-1 activity and EAT in hemodialysis (HD) patients.

Methods

This is a cross-sectional study conducted on 72 (43 males) HD patients with end-stage renal disease. Serum levels for lipid profiles, C-reactive protein, calcium, phosphate, and parathyroid hormone were measured. PON-1 activity was also measured and compared to the rate of enzymatic hydrolysis of paraoxon to p-nitrophenol. Echocardiography was used to measure EAT thickness (EATT). The correlation between PON-1 and EATT was assessed, while independent predictors of EATT in HD patients were similarly assessed using multivariate regression analysis.

Results

There was a significant low mean value of PON-1 activity in HD patients compared with the control group (82.1 ± 31.6 vs. 164.3 ± 61.5 U/l, p = 0.0001) and significant high mean value of EATT in HD patients, compared with controls (6.2 ± 1.7 vs. 3.9 ± 1.1 mm, p = 0.0001). In addition, there was a significant negative correlation between PON-1 activity and EATT (r = ?0.484, p = 0.0001) and a significant positive correlation between PON-1 activity and HDL-C (r = 0.417, p = 0.0003). PON-1, total cholesterol, triglycerides, LDL, HDL, age, and body mass index were found to be independent predictors of EATT.

Conclusion

Our study demonstrated that PON-1 activity was significantly lower in HD patients compared with healthy controls and that PON-1 activity was inversely correlated with EATT in this population.

     

Diffusion-weighted magnetic resonance imaging and micro-RNA in the diagnosis of hepatic fibrosis in chronic hepatitis C virus

BACKGROUND Diffusion-weighted magnetic resonance imaging has shown promise in the detection and quantification of hepatic fibrosis. In addition, the liver has numerous endogenous micro-RNAs(miRs) that play important roles in the regulation of biological processes such as cell proliferation and hepatic fibrosis.AIM To assess diffusion-weighted magnetic resonance imaging and miRs in diagnosing and staging hepatic fibrosis in patients with chronic hepatitis C.METHODS This prospective study included 208 patients and 82 age-and sex-matched controls who underwent diffusion-weighted magnetic resonance imaging of the abdomen, miR profiling, and liver biopsy. Pathological scoring was classified according to the METAVIR scoring system. The apparent diffusion coefficient (ADC) and miR were calculated and correlated with pathological scoring.RESULTS The ADC value decreased significantly with the progression of fibrosis, from controls(F0) to patients with early fibrosis(F1 and F2) to those with late fibrosis(F3 and F4)(median 1.92, 1.53, and 1.25 × 10~(-3) mm~2/s, respectively)(P = 0.001).The cut-off ADC value used to differentiate patients from controls was 1.83 × 10~(-3) mm~2/s with an area under the curve(AUC) of 0.992. Combining ADC and miR-200 b revealed the highest AUC(0.995) for differentiating patients from controls with an accuracy of 96.9%. The cut-off ADC used to differentiate early fibrosis from late fibrosis was 1.54 × 10~(-3) mm~2/s with an AUC of 0.866. The combination of ADC and miR-200 b revealed the best AUC(0.925) for differentiating early fibrosis from late fibrosis with an accuracy of 80.2%. The ADC correlated with miR-200 b(r =-0.61, P = 0.001), miR-21(r =-0.62, P = 0.001), and miR-29(r = 0.52,P = 0.001).CONCLUSION Combining ADC and miRs offers an alternative surrogate non-invasive diagnostic tool for diagnosing and staging hepatic fibrosis in patients with chronic hepatitis C.