Hepatic Function and Fibrosis Assessment Via 2D-Shear Wave Elastography and Related Biochemical Markers Pre- and Post-Gastric Bypass Surgery.

BACKGROUND: Nonalcoholic fatty liver disease (NAFLD) exhibits a worldwide distribution and encompasses a wider range of hepatic abnormalities that can culminate in serious clinical outcomes. The growing incidence of NAFLD necessitates more efficient management strategies particularly in clinically severe obese patients. Weight reduction is the cornerstone of NAFLD treatment; therefore, bariatric surgery could be a therapeutic approach in selected obese patients afflicted with NAFLD and other cardiometabolic comorbidities. OBJECTIVE: The present study focused on the potential role of bariatric surgery on hepatic function and NAFLD-related histopathological features measured through a noninvasive method. METHOD: Ninety patients entered to this study and underwent initial preoperative assessments including demographic profile, anthropometric measurements, standard laboratory tests, and hepatic biopsy. Liver stiffness was also evaluated via two-dimensional shear wave elastography (2D-SWE). All assessments were repeated over the subsequent 6 months following surgery except for liver biopsy. RESULTS: Postoperative hepatic elasticity was lessened after 6 months (p = 0/002).The levels of alanine aminotransferase, gamma-glutamyl transferase, total protein, lipid indices, glucose, and platelet count were also improved following surgery (p < 0/001). Further progression of fibrosis was observed in 25% of patients after surgery. CONCLUSION: Bariatric surgery was associated with a favorable impact on anthropometric and hepatic elasticity indices as well as metabolic parameters. The ideal target population for bariatric surgery should be thoroughly addressed, and the underlying risk factors for fibrosis progression need to be controlled before surgery. However, expanded research designed as comprehensive randomized controlled trials are recommended to confirm these findings.

Immunohistochemical assessment of MGMT expression and p53 mutation in glioblastoma multiforme.

AIMS AND BACKGROUND: The prognosis of glioblastoma multiforme (GBM) remains poor despite advances in surgery and adjuvant therapies. TP53 and O6-methylguanine-DNA methyltransferase (MGM) are tumor suppressor genes that are implicated in GBM resistance to radiation and chemotherapy. In order to assess the expression of the protein products of these two genes, 50 GBM samples were analyzed in this study. METHODS: Demographic and clinical data along with postsurgery tumor samples from 50 GBM patients were collected from the pathology archive. MGMT and p53 protein expression was evaluated by immunohistochemistry. RESULTS: 52% of cases had mutated p53, predominantly expressed in the nuclei of tumor cells. MGMT immunohistochemistry was negative in 35 (70%) patients and positive in 15 (30%) others. Immunohistochemistry-negative specimens for MGMT expression showed a significantly higher expression of mutant p53 (P = 0.03). CONCLUSION: MGMT expression was significantly lower in cells bearing p53 mutation. This indicates that there is a tendency for p53 activity to decline with MGMT inactivation. However, this study could not deduce which protein was the regulator of the other.