Background & Aims: Insulin resistance is the real determinant of both Nonalcoholic fatty liver disease (NAFLD) and diabetes, and can facilitate the accumulation of triglycerides in the liver. Overexpression of hepassocin (HPS) increased the accumulation of hepatic fat and NAFLD activity scores (NAS) in mice. The aim of this study was to investigate the relationship between hepassocin and steatosis of the liver in diabetic patients with or without NAFLD in humans. Methods: The study enrolled 60 patients plus 20 healthy controls that were divided into 4 groups: Group I: included 20 patients who were diagnosed as diabetes mellitus type 2, Group II: included 20 patients who were diagnosed as nonalcoholic fatty liver disease (NAFLD), Group III: included 20 patients who were diagnosed as diabetes type 2 and NAFLD, and Group IV (control group): included 20 healthy person or controls who were matched in age and sex with patients group. All patients and controls were subjected to full history taking, thorough clinical examination, laboratory investigations including measurement of serum hepassocin in peripheral blood by ELISA technique. Results: There was a significant overexpression of serum hepassocin in patients with type 2 diabetes and NAFLD patients (Group 3) more than diabetic patients (Group 1) and even more than non-alcoholic fatty liver disease (Group 2). Conclusion: This study provides evidence that increased HPS may facilitate increased hepatic lipid accumulation with NAFLD and type 2 diabetes.

All rights reserved. AbstractPhosphides poisoning is a commonly encountered poisoning in most developing countries and is emerging as a common self-poisoning agent. Over the past 20 years, biochemical markers of brain damage have been increasingly studied as potential tools for prognostic evaluation. S-100β protein is the β-subunit of a calcium binding protein present mainly in glial and Schwann cells. The current study was conducted to evaluate central nervous system affection and the prognostic value of S-100β protein for prediction of mortality after acute phosphides intoxication. Twenty nine patients admitted to Poison Control Unit (Emergency Hospital, Tanta University) suffering from acute phosphide poisoning in nine months period were included in this study. For all patients sociodemographic, clinical and toxicological data were explored. One milliliter venous blood was withdrawn for analysis of S-100β protein level. Primary outcome included mortality. Meanwhile, secondary outcomes included GCS, hypotension and length of hospital stay. There was statistical significant difference between survivor patients and non-survivor patients regarding blood pressure. Meanwhile, no statistical significant difference was noticed between survivors and non-survivors in either GCS, pulse or duration of hospital stay. Toxicological data of the participant patients revealed that (96.6%) of patients were in suicidal attempts by oral route. Zink phosphide was identified in (75.9%) of patients, while, aluminum phosphide was recognized in (24.1%) patients. Serum level of S-100β concentrations was significantly increased in phosphide intoxicated patients compared to the reference value for detection of injury to neural tissue (0.1 µg/L). There was significant negative statistical correlation between serum S-100β concentrations and GCS. Analysis of (ROC) curve of serum S-100β level as a predictor of mortality showed (AUC) = 0.956, P <0.0001* at a cut off value > 1.762 ug/l, serum S100β had a sensitivity of 100% and a specificity 95%. (PPV) was 95%, while (NPV) was 100%.

341 Background: The surgical outcome of patients with borderline resectable or locally advanced pancreatic ductal adenocarcinoma (BRPC/LAPC) treated with stereotactic body radiation therapy (SBRT) is unclear. Methods: A comparative study was performed to determine if surgical outcomes were different among patients receiving neoadjuvant SBRT vs chemoradiation therapy (CRT) vs chemotherapy only. Results: Between 2011 and 2014, 29 patients with BR/LA-PDAC underwent neoadjuvant chemotherapy and SBRT (6.6 Gy x 5 fractions) followed by pancreatectomy. Eighteen of 29 patients (62%) had LAPC. Their outcomes were compared with 82 patients who received neoadjuvant CRT and 26 patients who received neoadjuvant chemotherapy only (Table). When compared to neoadjuvant CRT and chemo only, the neoadjuvant SBRT group had a higher R0 resection rate (90% vs 84% vs 62%, p=0.02) and vascular resection rate (41% vs 13% vs 31%, p=0.005), respectively. Although the vascular resection and complication rates (Clavien grade 3 or above) were higher in the neoadjuvant SBRT group, no in-hospital mortality was encountered. In the SBRT group, the complete pathological response rate (21%) was higher than that of the other groups (4% and 0% respectively, p<0.001). Survival will be updated later as the current median postoperative follow-up is 6 months in the SBRT group. Conclusions: Neoadjuvant chemotherapy and SBRT is associated with improved surgical outcomes and pathologic complete response rates in selected patients with BRPC/LAPC. Longer follow-up is needed to determine its impact on survival. [Table: see text]

Background: This study discusses the effect of obesity on the number of lymph nodes harvested during systematic LND and the LND-related complications in ovarian cancer patients. Methods: This retrospective study enrolled women with ovarian cancer who were consecutively subjected to open surgical resection that included systematic LND (pelvic and para-aortic) in the Oncology Center in Mansoura University (OCMU) during the period between January 2012 and June 2017. Patients were categorized according to the recommendations of World Health Organization by their BMI as non-obese (BMI < 30.0 kg/m 2) and obese (BMI ≥ 30.0 kg/m 2). Results: Seventy-seven women with ovarian cancer were enrolled in the study according to our inclusion and exclusion criteria. 43 females (55.8%) were grouped as obese and 34 (44.2%) as non-obese. Lymph nodes retrieved in total and in different stations separately (pelvic and para-aortic) were all similar among patients in both groups. LND-related intraoperative complications were observed in 8 patients (18.6%) in the obese group and 3 patients in the non-obese group (8.8%) (P = 0.347). Hospital stay was the same in the two groups with a median of 4 days (IQR 3-5). Postoperative complications occurred in 13 patients (30.2%) in the obese group and only in one patient (3%) in the non-obese group (P = 0.004). Conclusion: Obese ovarian cancer patients may safely undergo comprehensive staging involving extensive lymph node dissection in open surgeries without significant increase in the rates of intraoperative complications.

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