majid mahsa

Diagnostic imaging has a fundamental contribution to non - invasive diagnosis of the reasons for biliary obstruction and screening the patients at high risk. So, this study was aimed to compare the value of multidetector-row computed tomography (MDCT) in diagnosis of biliary obstruction reasons with the results obtained from invasive procedures. In this descriptive-analytical study, 50 patients were selected by stratified sampling from January 2010 to May 2011 with diagnosis of biliary obstruction based on per clinical and sonographic results and they were evaluated by MDCT. Their radiology report was compared with the results obtained from other invasive procedures including Percutaneous Transhepatic Cholangiography (PTC), Endoscopic Retrograde Cholangiopancreaticography (ERCP), and/or surgery. Findings indicated that sensitivity, specificity, and accuracy of MDCT was 100%, 88.4%, and 94%, respectively in diagnosis of malignant reasons for biliary obstruction, 75%, 100%, and 96% in diagnosis of benignant reasons for biliary obstruction, and 94.4%, 100%, and 98% in that of gallstones. No significant relationship was found between severity of bile duct dilatation and obstructive agent’s benignancy or malignancy (P<0.001). Based on this study findings, MDCT is found a rapid, non-invasive, and highly accurate method in diagnosis of biliary obstruction reasons, differentiation between benignant obstructive agents and malignant ones, and is useful for planning prior to surgery.

H. pylori infection is associated with gastritis and marked infiltration of the gastric mucosa by inflammatory cells secreting of several cytokines that contribute to maintain and expand the local inflammation. Different clinical expressions of the infection may reflect different patterns of cytokine expression. Interleukin (IL)-1β, tumor necrosis factor (TNF)-α, IL-17, IL-23, and IL-18 have been reported to be involved in H. pylori-induced gastric mucosal inflammation, but the details and relation to different patterns of inflammation remain unclear. Analysis of IL-18 RNA transcripts was performed by real-time PCR. Total RNA was extracted from gastric biopsies of 56 H. pylori-infected patients, 50 H. pylori-negative patients with gastritis, by biozol reagent according to the manufacturer's instructions. CDNA was synthesized from 1 mg of total RNA using First Strand cDNA Synthesis Kit (fermentas) and 3 μL cDNA was amplified by PCR using the 2x Rotor-Gene Probe PCR Master Mix (QIAGEN) and specific primers for each cytokine and β-actin. IL-18 mRNA expression was significantly increased in biopsies of H. pylori-infected patients compared to H. pylori-uninfected individuals. IL-18 may play an important role in the inflammatory response and promoting gastric Th1 responses to H. pylori colonization, and may ultimately influence the outcome of H. pylori-associated diseases that arise within the context of gastritis.