Endoluminal ultrasound versus magnetic resonance imaging in assessment of rectal cancer after neoadjuvant therapy

BACKGROUND

Accurate rectal tumor staging guides the choice of treatment options. EUS and MRI are the main modalities for staging.

AIM OF THE WORK

To compare the performance of EUS and MRI for loco-regional staging of anorectal cancer after neo-adjuvant therapy.

METHODS

Seventy-three (37 male, 36 female) patients with rectal cancer after neo-adjuvant chemoradiotherapy were enrolled. Histopathological staging after surgery were used as reference for comparing the yield of loco-regional staging for EUS and MRI. EUS and MRI were done 1 month after completion of neo-adjuvant therapy.

RESULTS

Regarding post-surgical T staging, eight patients had early tumor (T2 = 16 and T1 = 9) and thirty six were locally advanced (T3 = 36), while N staging, forty patients with negative nodes and 33 were positive (N1 = 22 and N2 = 11). Comparing EUS to MRI, it showed a higher sensitivity (95.7% vs. 78.7%), specificity (84.6% vs. 68.0%) and accuracy (91.8% vs. 75.3%) for staging early and locally advanced tumor. Also, it had a higher sensitivity (78.8% vs. 69.7%), specificity (75.0% vs. 65.0%) and accuracy (76.7% vs. 67.1%) for detection of lymph nodes.

CONCLUSION

EUS appears to be more accurate than MRI in loco-regional staging of rectal carcinoma after neo-adjuvant therapy.

Primary thyroid chondrosarcoma: a case report of an extremely rare malignancy

Introduction

There are different types of malignant tumors that can affect the thyroid gland where differentiated thyroid carcinomas (papillary and follicular) are the most common representing nearly 90% of cases. Non-epithelial malignancies were also reported to affect the thyroid gland particularly lymphomas and sarcomas that were reported in literature to range from 0.01 to 1.5% of thyroid carcinoma. Herein, we present a case with primary thyroid chondrosarcoma, an extremely rare malignancy of the thyroid gland.

Case presentation

We present a 79-year-old female patient complaining of hard thyroid swelling that was proved to be primary thyroid chondrosarcoma after histopathological assessment.

Conclusion

Chondrosarcoma of the thyroid gland is extremely rare either in the primary or metastatic setting. Although the prognosis is bad, surgery is the main line of treatment after early prompt diagnosis.

An infarcted wandering spleen leading to a sigmoid volvulus presenting with acute large bowel obstruction: a case report

A wandering spleen is a very rare event characterised by the absence of the spleen in its anatomical position due to the hyperlaxity of its ligaments. We present a case of wandering spleen complicated by splenic vascular pedicle torsion, thrombosis and subsequent splenic infarction. Compression of the infarcted spleen on the rectosigmoid junction led to the development of a sigmoid volvulus, which presented as an acute large bowel obstruction. The patient underwent emergency laparotomy, splenectomy, sigmoid decompression and sigmoidopexy. After a follow-up period of two years, the volvulus had not recurred.

Papillary thyroid carcinoma in cervical lymph nodes with vanished thyroid gland after ablation of Graves' disease by radioactive iodine

Primary thyroid carcinoma after thyroid ablation by radioactive iodine is rare. We present a very rare condition of lateral apparent papillary thyroid carcinoma eight years after receiving radioactive iodine for thyrotoxicosis, which led to complete anatomical and functional involution of the thyroid gland.

Determination of barnidipine in human serum and dog plasma by HPLC with electrochemical detection

Barnidipine is a 1,4-dihydropyridine calcium antagonist. HPLC was conducted on a polybutadiene coated alumina column using an alkaline mobile phase and an electrochemical detector to determine the content of this drug in serum and plasma. A good linear relationship between barnidipine concentration and peak height was found in 5-500 ng/ml with a correlation coefficient of 0.998. The detection limit was 1 ng/ml. The within-day and day-to-day variations were examined for control human serum. Relative standard deviation of within-day assay for serum spiked with 10 ng/ml barnidipine.HCl was 6.9% and the recovery was 104%. A pharmacokinetic study was made in which the time course of barnidipine in dog plasma was followed.

Utility of certain pi-acceptors for the spectrophotometric determination of some penicillins

Two simple and sensitive spectrophotometric methods are described for the determination of six penicillin derivatives. The methods are based on the reaction of these drugs as n-electron donors with either 2,3-dichloro-5,6-dicyano-p-benzoquinone (DDQ) or 7,7,8,8-tetracyanoquinodimethane (TCNQ) as pi-acceptors, to give a highly coloured radical anion. The coloured products are quantified spectrophotometrically at 460 and 842 nm for DDQ and TCNQ, respectively. The optimization of the different experimental conditions is described. The interference from streptomycin sulphate and common degradation products was also studied. The proposed methods were applied successfully to the determination of the different penicillins investigated, either in pure or dosage forms, with good accuracy and precision. The results were compared with those given by the official United States Pharmacopeial XXI method.

Spectrophotometric methods for the determination of sulphathiourea

Three simple and sensitive spectrophotometric methods are described for the determination of sulphathiourea. The methods are based on the interaction of this thioamide with either iodine, tetracyanoethylene (TCNE) or copper nitrate to give the corresponding charge-transfer or metal-ion complexes, which can be measured at 363, 350 and 353 nm, respectively. In each case, a 1:1 complex was formed. Beer's law is obeyed for each procedure in a concentration range of 1-150 micrograms ml-1. The proposed procedures can be applied to the determination of sulphathiourea in its pharmaceutical formulations.

Spectrophotometric determination of some pharmaceutical amides through charge-transfer complexation reactions

A spectrophotometric method is described for the assay of fenpipramide hydrochloride, isopropamide iodide, trimethobenzamide hydrochloride, morphazinamide hydrochloride and tolazamide. The method is based on the formation of a charge-transfer complex between the drug as n-donor and iodine, a sigma-acceptor. The product exhibits absorption maxima at 295 and 365 nm; measurements are made at 365 nm for fenpipramide and at 295 nm for the other compounds. Beer's law is obeyed in a concentration range of 1-120 micrograms ml-1. The method is rapid, simple and sensitive and can be applied to the analysis of some commercial and laboratory prepared tablets without interference. A more detailed investigation of the complex was made with respect to its composition, association constant and free energy change.

Use of p-benzoquinone for the spectrophotometric determination of certain sulphonamides

A simple spectrophotometric method for the determination of 15 sulphonamides in bulk and in dosage forms is described. The method is based on the interaction of p-benzoquinone with sulphonamides in 0.1 M hydrochloric acid. The resulting chromophore is measured at 500 nm. The effects of different variables on colour development were established. Beer's law was obeyed in a concentration range of 10-50 micrograms ml-1. Results from the analysis of different sulphonamide tablets and ophthalmic solutions marketed locally were in good agreement with that of a reference method. Correlations between A1cm(1%) and certain physical parameters such as pKa values, characteristic volume Vx, and molecular connectivity indices 1X and 1Xv were determined by linear regression equations. A poor correlation was found between A1cm(1%) and bulkiness parameters but a highly significant negative correlation was obtained with apparent pKa values.