The hepatitis G virus (HGVlGBV-C) is recently discovered viralagent cloned from the serum of individuals with hepatitis. Like Hey, HOYappears to result commonly in chronic infection. The relationship of HOYinfection with liver disease and possible interaction between HGYandknown hepatitis viruses have also been estimated. However, so far no clearlink has been established between HOV and chronic liver disease.We aimed to study HGY infection in patients with chronic renalfailure under maintenance hemodialysis, intermittent peritonealdialysis.personal who deal with patients (doctors ,nurses worker ) innephrology unit Zagazig University hospital using different laboratorydiagnostic test.The present work included 40 patients on maintenance hemodialysis[29 males and 11 females with a mean age of(43.6±14.7) years and rangedfrom 20 to 72 years] and 20 patients on intermittent peritoneal dialysis [6males and 14 females with a mean age of(52.9±1O.7) years and rangedNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.The thirty patients were divided into three groups. Each group was subjected to a type of surgical treatment. All patients were subjected to full history taking and preoperative examinations including : Local nasal examinations. Endoscopic examination of thenose and nasopharynx. Evaluation of mucociliary functions by saccharin test. Rhinomanometric evaluation of nasal obstruction. CT sinus view. the results of the radiofrequency tissue ablation were satisfactory and had a very mild effect on the mucociliary function. Laser turbinectomy is an effective method for treatment of nasal obstruction but it has a very harmful effect on nasal mucociliary function. The effect of partial turbinectomy on mucociliary function of the nose was midway between that of the laser and the radiofrequency, however the incidence of postoperative heamorrhage was high and may reach up to 40% of the cases, and at some instances it might be life threatening.SUMMARYNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.The thirty patients were divided into three groups. Each group was subjected to a type of surgical treatment. All patients were subjected to full history taking and preoperative examinations including : Local nasal examinations. Endoscopic examination of thenose and nasopharynx. Evaluation of mucociliary functions by saccharin test. Rhinomanometric evaluation of nasal obstruction. CT sinus view. the results of the radiofrequency tissue ablation were satisfactory and had a very mild effect on the mucociliary function. Laser turbinectomy is an effective method for treatment of nasal obstruction but it has a very harmful effect on nasal mucociliary function. The effect of partial turbinectomy on mucociliary function of the nose was midway between that of the laser and the radiofrequency, however the incidence of postoperative heamorrhage was high and may reach up to 40% of the cases, and at some instances it might be life threatening.SUMMARYNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.The thirty patients were divided into three groups. Each group was subjected to a type of surgical treatment. All patients were subjected to full history taking and preoperative examinations including : Local nasal examinations. Endoscopic examination of thenose and nasopharynx. Evaluation of mucociliary functions by saccharin test. Rhinomanometric evaluation of nasal obstruction. CT sinus view. the results of the radiofrequency tissue ablation were satisfactory and had a very mild effect on the mucociliary function. Laser turbinectomy is an effective method for treatment of nasal obstruction but it has a very harmful effect on nasal mucociliary function. The effect of partial turbinectomy on mucociliary function of the nose was midway between that of the laser and the radiofrequency, however the incidence of postoperative heamorrhage was high and may reach up to 40% of the cases, and at some instances it might be life threatening.SUMMARYNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.The thirty patients were divided into three groups. Each group was subjected to a type of surgical treatment. All patients were subjected to full history taking and preoperative examinations including : Local nasal examinations. Endoscopic examination of thenose and nasopharynx. Evaluation of mucociliary functions by saccharin test. Rhinomanometric evaluation of nasal obstruction. CT sinus view. the results of the radiofrequency tissue ablation were satisfactory and had a very mild effect on the mucociliary function. Laser turbinectomy is an effective method for treatment of nasal obstruction but it has a very harmful effect on nasal mucociliary function. The effect of partial turbinectomy on mucociliary function of the nose was midway between that of the laser and the radiofrequency, however the incidence of postoperative heamorrhage was high and may reach up to 40% of the cases, and at some instances it might be life threatening.SUMMARYNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.The thirty patients were divided into three groups. Each group was subjected to a type of surgical treatment. All patients were subjected to full history taking and preoperative examinations including : Local nasal examinations. Endoscopic examination of thenose and nasopharynx. Evaluation of mucociliary functions by saccharin test. Rhinomanometric evaluation of nasal obstruction. CT sinus view. the results of the radiofrequency tissue ablation were satisfactory and had a very mild effect on the mucociliary function. Laser turbinectomy is an effective method for treatment of nasal obstruction but it has a very harmful effect on nasal mucociliary function. The effect of partial turbinectomy on mucociliary function of the nose was midway between that of the laser and the radiofrequency, however the incidence of postoperative heamorrhage was high and may reach up to 40% of the cases, and at some instances it might be life threatening.SUMMARYNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.The thirty patients were divided into three groups. Each group was subjected to a type of surgical treatment. All patients were subjected to full history taking and preoperative examinations including : Local nasal examinations. Endoscopic examination of thenose and nasopharynx. Evaluation of mucociliary functions by saccharin test. Rhinomanometric evaluation of nasal obstruction. CT sinus view. the results of the radiofrequency tissue ablation were satisfactory and had a very mild effect on the mucociliary function. Laser turbinectomy is an effective method for treatment of nasal obstruction but it has a very harmful effect on nasal mucociliary function. The effect of partial turbinectomy on mucociliary function of the nose was midway between that of the laser and the radiofrequency, however the incidence of postoperative heamorrhage was high and may reach up to 40% of the cases, and at some instances it might be life threatening.SUMMARYNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.The thirty patients were divided into three groups. Each group was subjected to a type of surgical treatment. All patients were subjected to full history taking and preoperative examinations including : Local nasal examinations. Endoscopic examination of thenose and nasopharynx. Evaluation of mucociliary functions by saccharin test. Rhinomanometric evaluation of nasal obstruction. CT sinus view. the results of the radiofrequency tissue ablation were satisfactory and had a very mild effect on the mucociliary function. Laser turbinectomy is an effective method for treatment of nasal obstruction but it has a very harmful effect on nasal mucociliary function. The effect of partial turbinectomy on mucociliary function of the nose was midway between that of the laser and the radiofrequency, however the incidence of postoperative heamorrhage was high and may reach up to 40% of the cases, and at some instances it might be life threatening.SUMMARYNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.The thirty patients were divided into three groups. Each group was subjected to a type of surgical treatment. All patients were subjected to full history taking and preoperative examinations including : Local nasal examinations. Endoscopic examination of thenose and nasopharynx. Evaluation of mucociliary functions by saccharin test. Rhinomanometric evaluation of nasal obstruction. CT sinus view. the results of the radiofrequency tissue ablation were satisfactory and had a very mild effect on the mucociliary function. Laser turbinectomy is an effective method for treatment of nasal obstruction but it has a very harmful effect on nasal mucociliary function. The effect of partial turbinectomy on mucociliary function of the nose was midway between that of the laser and the radiofrequency, however the incidence of postoperative heamorrhage was high and may reach up to 40% of the cases, and at some instances it might be life threatening.SUMMARYNasal obstruction is one of the oldest and most common human complaints. Hypertrophy of the inferior turbinate is a common cause of chronic nasal obstruction. Mucociliary function is an important defense mechanism that protect the respiratory system against bacteria and other foreign particles. Nasal Mucociliary function is impaired in the majority of surgical reduction of inferior turbinate. In the present study we used both subjective symptoms and objective tests to assess the efficacy of radiofrequency energy, CO2 laser and partial turbinectomy in treatment of nasal obstruction attributed to inferior turbinate hypertrophy.The study was subjected to thirty patients from the patients of the out patients clinic that complaining from chronic nasal obstruction attributed to inferior turbinate hypertrophy.There is growing interest in QT dispersion as a marker for arrhythmia potential being a marker of inhomogenicity of ventricular repolarization. The QT dispersion is increased in myocardial ischemia and infarction, and levels are higher in patients with ventricular arrhythmias. This study was performed to assess QT dispersion in patients with acute myocardial infarction treated with thrombolytic therapy with successful reperfusion versus those who treated with thrombolytic therapy with failed reperfusion and those who treated with conventional therapy and to correlate between QT dispersion and the complicating serious ventricular arrhythmias following acute myocardial infarction. And it is also performed to assess the influence of age, sex, obesity, smoking, diabetes mellitus, hypertension and site of infarction on QT dispersion. The study included 100 patients with recent acute myocardial infarction and they are classified to 3 groups:Group 1: 30 patients who received streptokinase with successful reperfusion.Group 2: 30 patients who received streptokinase with failed reperfusion.Group 3: 40 patients who did not receive streptokinase (control group).Every patient was subjected to full history taking and thorough clinical examination. Analysis of serum electrolytes (Na, K and ca) was done and cases showing abnormal results were excluded. Serum CPK was checked on admission, after 6 hours, after 12 hours and after 24 hours after onset of thrombolytic therapy. ECG was done for every patient on admission, two hours post thrombolytic therapy and predischarge in groups I and 2. In group 3, ECG was done on admission and predischarge.The study concluded that:1- There is a statistically significant reduction in QT dispersion in patients who received thrombolytic therapy with successful reperfusion versus those who received thrombolytic therapy with failed reperfusion and those who did not receive thrombolytic therapy.2- There is a reduction in the incidence of ventricular arrhythmias in patients with successful reperfusion therapy associated with the reduction in the QT dispersion. So, reduction of QT dispersion may be a mechanism of benefit of thrombolytic therapy.Conclusions• SCPL gives oncological results comparable to that of TL for management of T1 and T2 glottic and supraglottic carcinomas with invasion of the AC that failed radiation therapy as a 1st line of treatment as well as T3 carcinomas.• The functional results, guided by the HNQOL questionnaire, of SCPL is superior to that of TL-TEP especialy for the emotion domain.• It is recommended to use SCPL as a suitable alternative to TL-TEP for the treatment of the previousely mentioned lesions provided that the contraindications are rigorously respected.الملخص العربيمقارنة النتائج الوظيفية والورمية لاستئصال الحنجرة فوق الحلقاني واستئصال الحنجرة الكاملالمقدمة :-تعتبر النتائج الورمية لإستئصال الحنجرة الرأسي وإستئصال الحنجرة فوق المزماري غير مقبولة في علاج سرطان الحنجرة المزماري وفوق المزماري في المرحلة الأولى و الثانية والذي يمتد ليشمل المقرن الأمامي وفشل معهم العلاج الإشعاعى وكذلك في المرحلة الثالثة.لذلك كان يعد استئصال الحنجرة الكامل هو الجراحة الفضلى لمثل هذه الحالات ، إلا أن المريض يفقد بعدها وظائف الحنجرة مع وجود شق حنجري دائم .وبالرغم من استخدام طرق تأهيل الصوت والتي مكَّنت المرضى من القدرة على الكلام بعد استئصال الحنجرة الكامل ، إلا أن وجود الشق الحنجري أثَّر على جودة وكيفية حياتهم .يعد استئصال الحنجرة فوق الحلقاني هو البديل الأمثل لإستئصال الحنجرة الكامل في الحالات السابقة وذلك لأنها تعطي نتائج ورمية مماثلة مع الاحتفاظ بوظائف الحنجرة وعدم وجود شق حنجري دائم ومنها نوعان :-• النوع الأول : يستخدم في سرطان الحنجرة فوق المزماري وفيه يتم الاحتفاظ بالغضروف الحلقاني وواحد على الأقل من الغضروفين الطرجهاريين ويتم تثبيت الغضروف الحلقاني بالعظمة اللامية .• النوع الثاني : يستخدم في سرطان الحنجرة المزماري وفيه يتم الاحتفاظ بالإضافة لما سبق في النوع الأول بالجزء العلوي من لسان المزمار ويتم تثبيت الغضروف الحلقاني بالجزء المتبقي من لسان المزمار ثم بالعظمة اللامية .الهـدف من البحــث :-مقارنة النتائج الوظيفية والورمية لاستئصال الحنجرة فوق الحلقاني واستئصال الحنجرة الكامل في الحالات الآتية :-1. سرطان الحنجرة المزماري وفوق المزماري في المرحلة الأولى والثانية والذي يشمل المقرن الأمامي وفشل معهم العلاج الإشعاعى .2. سرطان الحنجرة المزماري وفوق المزماري في المرحلة الثالثة .المرضى وطرق البحث :-لقد ضم البحث 45 مريضاً خضعوا جميعاً للآتي :-• أخذ التاريخ المرضي .• الفحص الكامل .• الفحص بمنظار الحنجرة لتحديد مكان وامتداد الورم وأخذ عينة للتحليل .• عمل الأشعة المقطعية على الحنجرة لتحديد مكان وامتداد الورم بدقة أكثر.تم تقسيم المرضى إلى مجموعتين :-o المجموعة الأولى :-ضمت 21مريضاً أجريت لهم عملية استئصال الحنجرة فوق الحلقاني وكان منهم 9 مرضى في المرحلة الثانية مع امتداد الورم للمقرن الأمامي وجميعهم فشل معهم العلاج الإشعاعي . أما الإثنى عشر الباقون فكانوا في المرحلة الثالثة .لقد تم اختيار المرضى بحيث لا يكون هناك أي موانع من استخدام استئصال الحنجرة فوق الحلقاني وهي :-• ثبات الغضروف الطرجهاري .• امتداد الورم تحت المزمار لأكثر من 10 مم من الأمام أو 5 مم من الخلف .• امتداد الورم للغضروف الحلقاني .• امتداد الورم لكلى الغضروفين الطرجهاريين .• امتداد الورم للمقرن الخلفى.• الامتداد الكبير للحيز أمام لسان المزمار .• وظائف التنفس الغير جيدة .o المجموعة الثانية :-ضمت 24 مريضاً أجريت لهم عملية استئصال الحنجرة الكامل وكان منهم تسعة مرضى في المرحلة الثانية مع امتداد الورم للمقرن الأمامي وجميعهم فشل معهم العلاج الإشعاعي أما الخمسة عشر الباقون فكانوا في المرحلة الثالثة . لقد تم اختيار المرضى بحيث يكون لديهم أي من موانع استخدام استئصال الحنجرة فوق الحلقاني. تم تأهيل الصوت لتسعة عشر مريضاً من هذه المجموعة بوضع جهاز تعويضي في فتحة بين المريء والقصبة الهوائية .قورنت المجموعتان من حيث النتائج الورمية بحساب معدل السيطرة الموضعي و النتائج الوظيفية باستخدام استبيان جودة الحياة للرأس والرقبة وخاصة بالنسبة للأكل والكلام والانفعال.نتائج البحث :-أظهرت الدراسة أن معدل السيطرة الموضعي هو 90.5% لاستئصال الحنجرة فوق الحلقاني و91.6 % لاستئصال الحنجرة الكامل ، ولم تظهر الإحصاءات فرقاً ذا دلالة إحصائية بين المعدلين . أما بالنسبة للنتائج الوظيفية فلم تظهر الإحصائيات فرقاً بالنسبة للأكل والكلام بينما أظهرت فرقاً ذا دلالة إحصائية لصالح استئصال الحنجرة فوق الحلقاني بالنسبة للحالة الإنفعالية .الاستنتاج :-استئصال الحنجرة فوق الحلقاني هو بديل مناسب لاستئصال الحنجرة الكامل في حالات سرطان الحنجرة المزماري وفوق المزماري في المرحلة الأولى والثانية والذي يمتد ليشمل المقرن الأمامي و فشل معهم العلاج الإشعاعي وكذلك في المرحلة الثالثة وذلك لأنه يعطي نتائج ورمية مماثلة تعزى للآتي :-• الإستئصال الكامل للغضروف الدرقي .• إستئصال الحيز جانب المزمار على الناحيتين .• الانتقاء الجيد للحالات .كما أن استئصال الحنجرة فوق الحلقاني يحفظ وظائف الحنجرة مع عدم وجود شق حنجري دائم الشيء الذي كان يؤثر بشكل كبير على جودة حياة المرضى وخاصة الجانب الانفعالي منها .مقارنة النتائج الوظيفية والورمية لإستئصال الحنجرة فوقالحلقاني واستئصال الحنجرة الكاملتهدف الرسالة إلى مقارنة النتائج الوظيفية والورمية لإستئصال الحنجرة فوق الحلقاني واستئصال الحنجرة الكامل في حالات سرطان الحنجرة المزماري وفوق المزماري في المرحلة الأولى والثانية والذي يشمل المقرن الأمامي وفشل معهم العلاج الإشعاعى وكذلك في المرحلة الثالثة.لقد ضم البحث 45 مريضاً أختيروا بعد أخذ التاريخ المرضي و الفحص الكامل مع إستخدام المناظير و كذلك عمل الأشعة المقطعية على الرقبة .تم تقسيم المرضى إلى مجموعتين :-المجموعة الأولى :ضمت 21مريضاً أجريت لهم عملية استئصال الحنجرة فوق الحلقاني0 لقد تم اختيار المرضى بحيث لا يكون هناك أي موانع من استخدام العملية0المجموعة الثانية :ضمت 24 مريضاً لديهم أى من موانع استخدام استئصال الحنجرة فوق الحلقاني و قد أجريت لهم عملية استئصال الحنجرة الكامل. لقد تم تأهيل الصوت لتسعة عشر مريضاً من هذه المجموعة بوضع جهاز تعويضي في فتحة بين المريء والقصبة الهوائية .قورنت المجموعتان من حيث النتائج الورمية بحساب معدل السيطرة الموضعي و النتائج الوظيفية باستخدام استبيان جودة الحياة للرأس والرقبة وخاصة بالنسبة للأكل والكلام والحالة الإنفعاليةأظهرت الدراسة أن معدل السيطرة الموضعي هو 90.5% لاستئصال الحنجرة فوق الحلقاني و91.6 % لاستئصال الحنجرة الكامل ، ولم تظهر الإحصاءات فرقاً ذو دلالة إحصائية بين المعدلين .أما بالنسبة للنتائج الوظيفية فلم تظهر الإحصائيات فرقاً بالنسبة للأكل والكلام بينما أظهرت فرقاً ذو دلالة إحصائية لصالح استئصال الحنجرة فوق الحلقاني بالنسبة للحالة الإنفعالية.نخلص من ذلك إلي أن إستئصال الحنجرة فوق الحلقاني هو بديل مناسب لإستئصال الحنجرة الكامل في الحالات التي أجريت عليها الدراسة لأنه يعطي نتائج ورمية مماثلة , كما يحفظ وظائف الحنجرة مع عدم وجود شق حنجري دائم الشيء الذي كان يؤثر بشكل كبير على جودة حياة المرضى وخاصة الجانب الانفعالي منها .