Role of serum glypican-3 in the diagnosis and differentiation of small hepatocellular carcinoma from hepatitis-C virus cirrhosis

Background: Serum alpha-fetoprotein (AFP) has insufficient sensitivity and specificityfor detection of hepatocellular carcinoma (HCC). Recently, glypican-3 (GLP-3) was suggested as a new biomarker for the detection HCC.Objectives: To determine the role of serum GLP-3 levels in the early diagnosis and differentiation of small (3 cm or less in diameter) HCC from liver cirrhosis. Also, to correlate GLP-3 levels to clinico- laboratory data.Methods: The study included sixty patients; 30 of them with hepatitis C virus (HCV) cirrhosis, and 30 patients with proved HCC. In addition, 20 healthy subjects were included as a control group. Clinical and radiological features (abdominal ultrasonography and/or abdominal triphasic computed tomography) were recorded. Liver function tests, complete blood cell count, and serum AFP were measured. Serum GLP-3 values were determined by an ELISA technique.Results: Serum levels of GLP-3 were significantly elevated in patients with HCC compared with HCV cirrhosis group (p< 0.001). Also, these levels were significantly elevated in these two patients’ groups versus controls (p<0.001). Also, serum GLP-3 levels with cut-off value of P240 ug/L, had a higher sensitivity (100%) and same specificity (93.3%), than AFP with cut-off value of P200 ng/ ml, for detection of HCC. Moreover, GLP-3 levels showed a higher sensitivity than AFP (50% vs.41.7%), for detection of small HCC. The combined use of both markers (i.e. when either one of the two markers positive) improved the specificity to 88.9%. Regarding unicentric HCC, GLP-3 at cut-off value of 6580 ug/L had better specificity than AFP at cut-off value of 6765 ng/ml (57.1% vs. 42.9%). The combined use of both markers improved the sensitivity and specificity to 82.6% and 71.4%, respectively. Conclusion: Serum GLP-3 levels are higher in HCC versus HCV cirrhosis, which can differentiate HCC from liver cirrhosis. Also, serum GLP-3 is highly sensitive and specific for detecting HCC. Moreover, GLP-3 is more sensitive than AFP for the detection of small HCC. Furthermore, a combination of both serum markers yielded an improved specificity and both sensitivity and specificity for the diagnosis of small and unicentric HCC, respectively.Keywords: Serum tumor marker Alpha-fetoprotein Early hepatocellular carcinoma Diagnosis

Self-managed cells and their federation

Future e-Health systems will consist of low-power, on-body wireless sensors attached to mobile users that interact with a ubiquitous computing environment. This kind of system needs to be able to configure itself with little or no user input; more importantly, it is required to adapt autonomously to changes such as user movement, device failure, the addition or loss of services, and proximity to other such systems. This extended abstract describes the basic architecture of a Self-Managed Cell (SMC) to address these requirements, and discusses various forms of federation between/among SMCs. This structure is motivated by a typical e-Health scenario

Prevalence of methylenetetrahydrofolate reductase C677T and A1298C polymorphisms in Egyptian patients with type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) is a major public health problem around the world. The C677T and A1298C polymorphisms of the methylenetetrahydrofolate reductase (MTHFR) gene have been reported to be associated with T2DM and its complications. This study is a casecontrolstudy which was performed to clarify the association between polymorphisms in these two genes and T2DM among Egyptians. Study population (n=120) consists of 60 Egyptian diabetic patients and 60 healthy controls. The MTHFR C677T and A1298C polymorphisms were genotyped by polymerase chain reaction, followed by enzymatic digestion with HinfI and MboII enzymes, respectively. C677T and A1298C genetic polymorphisms conveyed an increase in T2DM risk (OR =3.5, 95% CI= 1.1–11.6, p= 0.032 and OR= 2.2, 95% CI =0.7–6.9, p= 0.004 respectively). Additionally, no significant associations between lipid/glucose metabolic indexes with MTHFR genotypes among diabetic patients were observed. Combined MTHFR gene polymorphisms revealed higher T2DM risk in homozygous and heterozygous forms compared to single gene polymorphism with pronounced risk in C677T/CT-A1298C/CC combined form (OR= 6.56, 95% CI= 0.76–56.2, p 0.041). In conclusion, our data suggest that MTHFR C677T and A1298C polymorphisms are risk factor for T2DM in Egyptian patients. Also, the two gene polymorphisms may act synergistically to increase the risk of diabetes. Furthermore, it should be noted that the size of the studied population was relatively small and therefore, largescale prospective studies are needed to confirm these findings

Denosumab-associated osteonecrosis of the jaw; A case series and literature review

Introduction: Medication-related osteonecrosis of the jaw (MRONJ) is a severely debilitating condition of multifactorial pathogenesis. It primarily involves patients receiving intravenous bisphosphonates (BPs) and most recently the new antiresorptive drug, denosumab, for the treatment of skeletal-related malignancies. There is no curative treatment and no consensus exists regarding the clinical management of such patients. This review aims to share our current clinical experience at Sheffield Teaching Hospitals’ Trust and raise awareness of the increase in severity of ONJ in patients receiving denosumab. Patients and Methods: Four new cases with clinical diagnosis of MRONJ were presented to Sheffield Teaching Hospitals’ Trust. MRONJ was attributed to denosumab therapy, as all patients were treated solely with denosumab for skeletal-related malignancies. Results: All cases appear to have a more aggressive mode of ONJ compared to that seen with IV and/or oral BPs so far. The cause of MRONJ was observed in the presence of periodontal disease alone and following dental extractions. Progression of the disease occurred considerably faster with the development of widespread suppuration and tooth mobility within weeks. Imaging revealed rather extensive areas of bony destruction, sometimes with associated periosteal reaction in keeping with a chronic bony infection. Conclusion: It is imperative for all dental and medical teams involved in treating these patients to understand the side effects of RANKL inhibitors on bone metabolism and how it affects treatment. Helping patients to understand the chronicity and potential progression of the disease is essential to a satisfactory outcome

Synergetic effect of aged garlic extract and methotrexate on rheumatoid arthritis induced by collagen in male albino rats

33-38Aged garlic extract (AGE) exhibit anti-inflammatory effect in many diseases, and methotrexate (MTX) as rheumatoid arthritis (RA) treatment drug shows adverse hepatotoxicity effect. Therefore, in this study, we evaluated the antioxidant and anti-inflammatory effects of AGE treatment alone or with MTX in collagen-induced arthritis (CIA) rats to diminish the hepatotoxicity. The study used eight groups of rats as one control non treated group and seven treated groups with CIA, AGE (200 mg/kg/PO), MTX (1.5 mg/kg/2 days/subcutaneous), CIA-AGE, CIA-MTX, AGE-MTX and CIA-MTX-AGE. All treatments started from day 21 after the symptoms of arthritis appeared to day 50. The CIA-AGE and CIA-MTX-AGE groups showed significantly decreased serum liver function markers ASAT, ALAT and ALP enzymes activities. In line with the significantly increased antioxidants, total glutathione and SOD and CAT enzymes activities and decreased MDA levels as compared to CIA and CIA-MTX treated groups' values. In addition, the CIA-AGE and CIA-MTX-AGE groups recorded significant decrease in the measured cytokines (CRP and TNF) and interleukins (IL-17, IL-6, and IL-1) values as compared to the corresponding values in CIA and CIA-MTX groups. Results suggested the safety of AGE for achieving a better control in treatment of RA with the conventional drug MTX to diminish its hepatotoxicity

New heat treatment to prepare high quality polycrystalline and single crystal MgB2 in single process

We report here on a new heat treatment to prepare both dense polycrystalline and single crystal MgB2 high quality samples in one single process. Resistivity measurements for polycrystalline part of the sample gives a residual resistivity ratio RRR=16.6 and a very low normal state resistivity rho(40K)= 0.28 microOhmcm. Both SEM and SQUID study on polycrystals reveal the high quality, dense character and well coupling of grain boundaries. On the other hand, the high quality single crystals have a unique shape that resembles the hexagonal crystal structure. SQUID measurements reveals very weak flux pinning character implying our single crystals to be very clean. In this study, we conclude that heat treatment is playing a major rule on the characteristics of both polycrystalline and single crystal MgB2. Samples are thoroughly characterized by x-ray, resistivity, dc SQUID and SEM

Two-dimensional Vesicle dynamics under shear flow: effect of confinement

Dynamics of a single vesicle under shear flow between two parallel plates is studied using two-dimensional lattice-Boltzmann simulations. We first present how we adapted the lattice-Boltzmann method to simulate vesicle dynamics, using an approach known from the immersed boundary method. The fluid flow is computed on an Eulerian regular fixed mesh while the location of the vesicle membrane is tracked by a Lagrangian moving mesh. As benchmarking tests, the known vesicle equilibrium shapes in a fluid at rest are found and the dynamical behavior of a vesicle under simple shear flow is being reproduced. Further, we focus on investigating the effect of the confinement on the dynamics, a question that has received little attention so far. In particular, we study how the vesicle steady inclination angle in the tank-treading regime depends on the degree of confinement. The influence of the confinement on the effective viscosity of the composite fluid is also analyzed. At a given reduced volume (the swelling degree) of a vesicle we find that both the inclination angle, and the membrane tank-treading velocity decrease with increasing confinement. At sufficiently large degree of confinement the tank-treading velocity exhibits a non-monotonous dependence on the reduced volume and the effective viscosity shows a nonlinear behavior.Comment: 12 pages, 8 figure