Role of multi detector computed tomography and virtual bronchoscopy in evaluation of pulmonary neoplasms

Objectives: The aim of this study was to evaluate the accuracy of Mlti detector CT with multiplanar reconstruction images, virtual bronchoscopy [VB] and volume rendering technique compared to the results of fiber-optic bronchoscopy [FOB] in defining bronchial pathologies in patients with pulmonary neoplasms

Methods: Fifty four patients with symptoms or chest X-ray abnormality raising the suspicion of pulmonary neoplasm in which FOB and CT chest were ordered for the initial investigation. Patients underwent both FOB and MDCT

Results: Fifty four patients were enrolled in the study [including 41 with an endobronchial lesion at FB] the sensitivity and specificity of VB to detect endobronchial lesions were 100% and 86.7% respectively [95% CI]. The positive and negative predictive values of VB were 95.3% and 100% respectively. The accuracy was 962%. Overall, the agreement between VB and FOB regarding the location on endobronchial lesions was perfect [weighted kappa: 0.9]. In 12 cases with obstruction of the main bronchi [5 in left main, 7 in right main bronchus], VB is able to bypass beyond the mass level in 4 cases [33.3% of cases]. The FOB was able to bypass beyond the mass lesion in only 2 cases [16.7% of cases], both of them were partially obstructing masses. FOB cannot by pass beyond the mass level in any case with totally obstructing mass. As regard to the extrabronchial structures evaluation, 34 of the 41 endobronchial lesions were associated with extrabronchial part of the endobronchial lesion [ratio about 63% of cases]. The FOB was not able to detect the extra-bronchial lesions in any case. In evaluating extrinsic compressions of the airway, FOB detected 11 lesions; VB+MPR [multi planar reconstruction] detected 10 lesions [5 of them caused by enlarged LNS, the remaining 5 were caused by extrabronchial soft tissue mass], VB could not see one of the external compressions with sensitivity, specificity 90.0% and 97.6% respectively. Curved planar reformation detected 13 lesions with sensitivity, specificity 90.9% and 95.3% respectively. Volume rendering detected 12 lesions with sensitivity, specificity 100.0% and 97.7% respectively. While FOB detected 4 mucosal lesions, VB cannot detect any of them with sensitivity and specificity 0%

Conclusion: VB is an extremely useful modality for evaluation of bronchial lesions, it is noninvasive, and the ability to examine 2D and 3D anatomic detail from multiple directions enables precise assessment of intraluminal, extent of the extraluminal diseases or airway patency distal to high-grade bronchial stenosis. We concluded that multi-slice CT in connection with VB became an essential complementary to FOB in selected patients with bronchial lesions

effect of pH on flavor formation and antioxidant activity of amino acid and sugars interaction products

Flavor is the crucial part of eating quality. In the preparation of natural identical flavor in different model systems like cysteine- ribose [cys-rib], cysteine-glucose [cys- glu] and cysteine-beef fat [cys-BF] affected at different pH [4.5, 7 and 10] a wide range of flavors was obtained. The proteins as glutamine, glutamic acid and the sugars as D- ribose and D-glucose,l,l-diphenyl-2-picrylhydrazyl [DPPH] and beta-Carotene and all the lab grade chemical as Linoleic acid, Polyoxyethylene sorbitan monopalmitate [Tween-80], Chloroform [99%], Anhydrous sodium sulfate, Dichloromethane [99.8%], 0.1 N HC1 and 0.1N NaOH, Gallic acid, Sodium carbonate, Folin-Ciocalteu reagent were used to conduct research. In sugar and amino acid model system, roasted and burnt meat flavor was obvious while in beef fat model system boiled meat flavor was dominated which was strongly supported by sensory evaluation. In rib-cys and glu-cys model systems total phenolic contents [TPC] were highest at pH 7 and pH 4.5, respectively along with browning, leading to strong antioxidant activity. In beef fat-cys model system it was found that as pH increases TPC, browning increases and antioxidant activity becomes maximum at basic pH. All the results indicated that, there is a positive relationship between the TPC, browning and antioxidant activity of all model systems

Egyptian artichoke volatile compounds: protect against lead-induced hepatic and renal toxicity in male rats

Lead is a widely used chemical for the preparation of a number of industry and household-based products. The toxicity of lead compounds, like all other heavy metals, has been implicated in the etiology of different disorders in humans. The present study was designed to investigate the potential protective effect of Egyptian artichoke against the hepatorenal toxicity of lead in male albino rats. Twenty three compounds were identified as volatile compounds of artichoke with benzeneacetaldehyde and selinene as major constituents, 19.97% and 16.80% respectively. Four groups of rats were used, group 1 to serve as control, group 2 intraperitoneal injected with lead acetate [20 mg/kg B.W], group 3 lead injected rats given artichoke head extract with drinking water [10 g/1 liter] and group 4 lead injected rats given artichoke leaves extract. The experiment continued for 30 days. The plasma total protein, cholesterol, urea and creatinein were determined. The activities of each of Alanine aminotansferase [ALT] aspartate amino transferase [AST], gamma-glutamyltransferase [gamma-GT] were followed. The level of plasma oxidation products of malondialdehyde was estimated. The histopathological changes were examined. Artichoke [leaves or head] co-treatment to the lead - administered rats attenuated the increase of ALT, AST, gamma-GT activities. Also the change in cholesterol, urea, creatinine and protein levels was less marked. The values reported were near to normal. In addition, the morphological damage in the liver and kidney was reduced and the tissues appeared like those of controls. The present study suggests that, because the presence of volatile constituents with antioxidative properties, artichoke may be useful in combating damaging effect of lead toxicity

Comparative study between Magnesium and dexmedetomidine as adjuvant to lidocaine for intravenous regional anesthesia

We conducted this study to evaluate the effects of magnesium and dexmedetomidine when added to lidocaine for intravenous regional anesthesia [IVRA]. Forty-five patients undergoing elective hand surgery during IVRA were randomly assigned to three groups. IVRA was achieved with 10ml of saline plus 3mg/kg lidocaine 0.5% diluted with saline to a total of 40ml in group L, 10ml of 10% magnesium sulfate plus 3mg/kg lidocaine 0.5% diluted with saline to a total of 40m1 in group M and 0.5micro g/kg dexmedetornidine plus 3mg/kg lidocaine 0.5% diluted with saline to a total close of 40ml in group D. Injection pain, sensory and motor block onset and recovery time, tourniquet pain, and anesthesia quality were noted, Patients were instructed to receive 75mg of IM diclofenac when the visual analog scale [VAS] score was >4, and analgesic requirements were recorded. Sensory and motor block onset times were shorter and recovery times were prolonged in group M and D. VAS scores of tourniquet pain were lower in group M and D at 15, 20, 30, 40 and 50mm [p<0.001]. Anesthesia quality, as determined by the anesthesiologist and surgeon, was better in group M and D [p<0.05]. Time to the first postoperative analgesic request was 95 +/- 29, l55 +/- 38, 170 +/- 20min in groups L, M, D respectively. There was a statistically difference in VAS scores for tourniquet pain at 15. 20, 30, 40 and 50min after tourniquet inflation [p<0.001]: VAS scores were lower in group M and D. Postoperative VAS scores were significantly higher for the first postoperative 6 hours in group L compared with group M [p<0.05]. In group D, postoperative VAS scores were significantly lower for the first postoperative 12 hours compared with group M and L. Diclofenac consumption was significantly less in group M [50 +/- 35mg] and group D [40 +/- 10mg] compared with group L [130 +/- 55mg] and in group D compared with group M [p<0.05]. No adverse effects were seen through the 24 hours postoperative period in the three groups. We conclude that magnesium and dexmedetomidine as an adjuncts, to lidocaine improves the quality of anesthesia and analgesia in IVRA, more in dexmedetomidine group