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Clinicopathological features and surgical outcome of patients with fibrolamellar hepatocellular carcinoma(experience with 22 patients over a 15-year period)

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World Journal of Gastrointestinal Surgery 2017年第2期9卷 61-67页

作者： mohamed abdel wahab Ehab El Hanafy Ayman El Nakeeb Mahmoud abdelwahab Ali Gastroenterology Surgical Center Mansoura UniversityMansoura 35516Egypt

AIM To evaluate the clinicopathological features and the surgical outcomes of patients with fibrolamellar hepato-cellular carcinoma(FL-HCC)over a 15-year period. METHODS This is a retrospective study including 22 patients with a pathologic diagnosis of FL-HCC who underwent hepatectomy over a 15-year period. Tumor characteristics,survival and recurrence were evaluated. RESULTS There were 11 male and 11 female with a median age of 29 years(range from 21 to 58 years). Two(9%)patients had hepatitis C viral infection and only 2(9%)patients had alpha-fetoprotein level > 200 ng/m L. The median size of the tumors was 12 cm(range from 5-20 cm). Vascular invasion was detected in 5(23%)patients. Four(18%)patients had lymph node metastases. The median follow up period was 42 mo and the 5-year survival was 65%. Five(23%)patients had a recurrent disease,4 of them had a second surgery with 36 mo median time interval. Vascular invasion is the only significant negative prognostic factor CONCLUSION FL-HCC has a favorable prognosis than common HCC and should be suspected in young patients with non cirrhotic liver. Aggressive surgical resection should be done for all patients. Repeated hepatectomy should be considered for these patients as it has a relatively indolent course.

关键词： Fibrolamellar hepatocellular carcinoma Common hepatocellular carcinoma Recurrence after resection fibrolamellar hepatocellular carcinoma Pathology of fibrolamellar hepatocellular carcinoma Survivalefter resection fibrolamellar hepatocellular carcinoma

Outcomes of pancreaticoduodenectomy in elderly patients

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Hepatobiliary & Pancreatic Diseases International 2016年第4期15卷 419-427页

作者： Ayman El Nakeeb Ehab Atef Ehab El Hanafy Ali Salem Waleed Askar Helmy Ezzat Ahmed Shehta mohamed abdel wahab Gastroenterology Surgical Center Mansoura University

BACKGROUND： Although the mortality and morbidity of pancreaticoduodenectomy（PD） have improved significantly over the past years, the concerns for elderly patients undergoing PD are still present. Furthermore, the frequency of PD is increasing because of the increasing proportion of elderly patients and the increasing incidence of periampullary tumors. This study aimed to analyze the outcomes of PD in elderly ***： We studied all patients who had undergone PD in our center between January 1995 and February 2015. The patients were divided into three groups based on age： group I（patients aged 〈60 years）, group II（those aged 60 to 69 years） and group III（those aged ≥70 years）. The primary outcome was the rate of total postoperative complications. Secondary endpoint included total operative time, hospital mortality, length of postoperative hospital stay, delayed gastric emptying, re-exploration, and survival ***： A total of 828 patients who had undergone PD for resection of periampullary tumor were included in this study. There were 579（69.9%） patients in group I, 201（24.3%） in group II, and 48（5.8%） in group III. The overall incidence of complications was higher in elderly patients（25.9% in group I, 36.8% in group II, and 37.5% in group III; P=0.006）. There were more patients complicated with delayed gastric emptying in group II compared with the other two groups. There was no significant difference in the incidence of postoperative pancreatic fistula, biliary leakage, pancreatitis, pulmonary complications and hospital ***： PD can be performed safely in selected elderly patients. Advanced age alone should not be a contraindication for PD. The outcome of elderly patients who have undergone PD is similar to that of younger patients, and the increased rate of complications is due to the presence of associated comorbidities.

关键词： pancreaticoduodenectomy elderly pancreatic fistula delayed gastric emptying

Study of Aerosol Direct and Indirect Effects and Auto-conversion Processes over the West African Monsoon Region Using a Regional Climate Model

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Advances in Atmospheric Sciences 2018年第2期35卷 182-194页

作者： Zeinab SALAH Ahmed SHALABY Allison L. STEINER Ashraf S. ZAKEY Ritesh GAUTAM mohamed M. abdel wahab The Egyptian Meteorological Authority Cairo 11784 Egypt University of Michigan Department of Climate and Space Sciences and Engineering Ann Arbor M148109-2143 USA Centre of Studies in Resources Engineering and Interdisciplinary Program in Climate Studies Indian Institute of Technology Bombay Bombay 400076 India Cairo University Department of Astronomy Space Science and Meteorology Giza 12613 Egypt Environmental Defense Fund Washington DC 20009 USA

This study assesses the direct and indirect effects of natural and anthropogenic aerosols （e.g., black carbon and sulfate） over West and Central Africa during the West African monsoon （WAM） period （June-July-August）. We investigate the impacts of aerosols on the amount of cloudiness, the influences on the precipitation efficiency of clouds, and the associated radiative forcing （direct and indirect）. Our study includes the implementation of three new formulations of auto-conversion parameterization [namely, the Beheng （BH）, Tripoli and Cotton （TC） and Liu and Daum （R6） schemes] in RegCM4.4.1, besides the default model＇s auto-conversion scheme （Kessler）. Among the new schemes, BH reduces the precipitation wet bias by more than 50% over West Africa and achieves a bias reduction of around 25% over Central Africa. Results from detailed sensitivity experiments suggest a significant path forward in terms of addressing the long-standing issue of the characteristic wet bias in RegCM. In terms of aerosol-induced radiative forcing, the impact of the various schemes is found to vary considerably （ranging from -5 to -25 W m-2）.

关键词： aerosol, cloud West African monsoon auto-conversion RegCM

Problem of living liver donation in the absence of deceased liver transplantation program:Mansoura experience

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World Journal of Gastroenterology 2014年第37期20卷 13607-13614页

作者： mohamed abdel wahab Hosam Hamed Tarek Salah Waleed Elsarraf mohamed Elshobary Ahmed mohamed Sultan Ahmed Shehta Omar Fathy Helmy Ezzat Amr Yassen mohamed Elmorshedi mohamed Elsaadany Usama Shiha Gatrointestinal Surgery Liver Transplantation Unit Gastrointestinal Surgical Center Mansoura University Daqahlia 35516 Egypt Anesthesia Intensive Care Department Gastrointestinal Surgical Center Mansoura Faculty of Medicine Mansoura University Daqahlia 35516 Egypt Internal Medicine Department Mansoura Faculty of Medicine Mansoura University Daqahlia 35516 Egypt Radiology Department Gastrointestinal Surgical Center Mansoura University Daqahlia 35516 Egypt

We report our experience with potential donors for living donor liver transplantation(LDLT), which is the first report from an area where there is no legalized deceased donation program. This is a single center retrospective analysis of potential living donors(n = 1004) between May 2004 and December 2012. This report focuses on the analysis of causes, duration, cost, and various implications of donor exclusion(n = 792).Most of the transplant candidates(82.3%) had an experience with more than one excluded donor(median = 3). Some recipients travelled abroad for a deceased donor transplant(n = 12) and some died before finding a suitable donor(n = 14). The evaluation of an excluded donor is a time-consuming process(median = 3 d, range 1 d to 47 d). It is also a costly process with a median cost of approximately 70 USD(range 35 USD to 885 USD). From these results, living donor exclusion has negative implications on the patients and transplant program with ethical dilemmas and an economic impact. Many strategies are adopted by other centers to expand the donor pool; however, they are not all applicable in our locality. We conclude that an active legalized deceased donor transplantation program is necessary to overcome the shortage of available liver grafts in Egypt.

关键词： Living donor Liver transplantation Excluded donors Deceased donor Liver disease

Introduction of Fertigation in Sugarcane Production for Optimization of Water and Fertilizers Use

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Agricultural Sciences 2014年第11期5卷 945-957页

作者： Daffa Alla mohamed abdel wahab Agricultural Engineering Section Research and Development Department Kenana Sugar Company Rabak City Sudan

A fertigation experiment was conducted during 2009/2010 and 2010/2011 seasons under com-mercial field conditions in Kenana Sugar Scheme, Sudan (latitude 13.10’N and longitude 32.40’E) in heavy clay soils, with 65% clay, 24% silt, 11% sand and pH 7.5 - 8.5. The primary objective of this study was to compare different strategies for timing of injection, to develop management practices on the efficient use of water and fertilizers in production of sugarcane, maximize yield, and improve quality. In both seasons four treatments were studied in a randomized complete block design with three replications as: Injection of the dissolved urea (46% N) during entire irrigation time (100%), during the first half of the irrigation time, during the second half of the irrigation time, and Mechanical application of urea. The first three treatments were applied with the third irrigation cycle through the irrigation water so that nitrogen fertilizer in form of dissolved urea (46% N) was injected in irrigation water by means of pressure differential tank system which is based on the principle of a pressure differential being created by a valve and flow regulator forcing and injecting a varying amount of dissolved fertilizer into the irrigation water. In the fourth treatment the fertilizer spreader and rigid tine cultivator were used for urea application just before the third irrigation event. The reference evapotranspiration (ETo) and the amount of water required for irrigating sugarcane plants were calculated according to its phenological stages using Peman-Monteith approach. The results of this study support the general finding that the injection during the entire irrigation (100% of the irrigation) produced the best distribution uniformity of added urea. In this study, injection during the first half of the irrigation was not statistically different from injection during 100% of the irrigation.

关键词： Irrigation Injection Fertigation Randomized Sugarcane Gated Pipe Hydro-Flume Evapotranspiration Phenological Stages

Tailored pancreatic reconstruction after pancreaticoduodenectomy: a single-center experience of 892 cases

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Hepatobiliary & Pancreatic Diseases International 2017年第5期16卷 528-536页

作者： Ayman El Nakeeb Ahmad M Sultan Ehab Atef Ali Salem Mostaffa Abu Zeid Ahmed Abu El Eneen Gamal El Ebidy mohamed abdel wahab Gastroenterology Surgical Center Mansoura UniversityMansoura 35516 Egypt

BACKGROUND: Pancreatic reconstruction following pancreaticoduodenectomy(PD) is still debatable even for pancreatic surgeons. Ideally, pancreatic reconstruction after PD should reduce the risk of postoperative pancreatic fistula(POPF) and its severity if developed with preservation of both exocrine and endocrine pancreatic functions. It must be tailored to control the morbidity linked to the type of *** study was to show the best type of pancreatic reconstruction according to the characters of pancreatic stump. METHODS: We studied all patients who underwent PD in our center from January 1993 to December 2015. Patients were categorized into three groups depending on the presence of risk factors of postoperative complications: low-risk group(absent risk factor), moderate-risk group(presence of one risk factor) and high-risk group(presence of two or more risk factors). RESULTS: A total of 892 patients underwent PD for resection of periampullary tumor. BMI >25 kg/m~2, cirrhotic liver, soft pancreas, pancreatic duct diameter <3 mm, and pancreatic duct location from posterior edge <3 mm are risk variables for development of postoperative complications. POPF developed in 128(14.3%) patients. Delayed gastric emptying occurred in 164(18.4%) patients, biliary leakage developed in 65(7.3%) and pancreatitis presented in 20(2.2%). POPF in low-, moderate-and high-risk groups were 26(8.3%), 65(15.7%) and 37(22.7%) patients, respectively. Postoperative morbidity and mortality were significantly lower with pancreaticogastrostomy(PG) in high-risk group, while pancreaticojejunostomy(PJ) decreases incidence of postoperative steatorrhea in all groups. CONCLUSIONS: Selection of proper pancreatic reconstruction according to the risk factors of patients may reduce POPF and postoperative complications and mortality. PG is superior to PJ as regards short-term outcomes in high-risk group but PJ provides better pancreatic function in all groups and therefore, PJ is superior in l

关键词： periampullary tumor pancreaticogastrostomy pancreaticojejunostomy pancreaticoduodenectomy postoperative pancreatic fistula

Classification of marine Ascomycota,Basidiomycota,Blastocladiomycota and Chytridiomycota

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Fungal Diversity 2015年第4期73卷 1-72页

作者： E.B.Gareth Jones Satinee Suetrong Jariya Sakayaroj Ali H.Bahkali mohamed a.abdel-wahab Teun Boekhout Ka-Lai Pang Department of Botany and Microbiology College of ScienceKing Saud UniversityP.O.Box:2455Riyadh 1145Saudi Arabia Fungal Biodiversity Laboratory BIOTECNational Science and Technology Development Agency(NSTDA)113 Thailand Science ParkThanon PhahonyothinTombon Khlong NuengAmphoe Khlong LuangPathum Thani 12120Thailand Department of Botany Faculty of ScienceSohag UniversitySohagEgypt CBS Fungal Biodiversity Centre(KNAW) Uppsalalaan 83584CT UtrechtThe Netherlands Institute of Marine Biology and Center of Excellence for the Oceans Taiwan Ocean University2 Pei-Ning RoadKeelung 20224TaiwanRepublic of China

This paper lists the accepted names and classification of marine fungi,updating the scheme presented in *** classification includes 1,112 species(in 472 genera):Ascomycota 805(in 352 genera),Basidiomycota 21 species(in 17 genera),Chytridiomycota and related phyla 26 species(in 13 genera),Zygomycota three(in two genera),Blastocladiomycota one species(one genus),asexual morphs of filamentous fungi 43(in 26 genera);and marine yeasts:Ascomycota 138 species(in 35 genera),Basidiomycota 75 species(in 26 genera).These fungi belong to 129 families and 65 *** Halosphaeriaceae remains the largest family of marine fungi with 141 species in 59 genera,while the most specious genera are Aspergillus(47 species),Penicillium(39 species)and the yeast genus Candida(64 species).The review includes details of recent higher order nomenclature changes,and accounts of new families,genera and species described over the past 5 years.

关键词： Fungal classification Marine fungi Molecular phylogeny New taxa Praelongicaulis gen nov Tirisporellales Torpedosporales ordo nov

Impact of cirrhosis on surgical outcome after pancreaticoduodenectomy

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World Journal of Gastroenterology 2013年第41期19卷 7129-7137页

作者： Ayman El Nakeeb Ahmad M Sultan Tarek Salah mohamed El Hemaly Emad Hamdy Ali Salem Ahmed Moneer Rami Said Ahmed AbuEleneen Mostafa Abu Zeid Talaat Abdallah mohamed abdel wahab Gastroenterology surgical center Mansoura UniversityMansoura 35516Egypt

AIM:To elucidate surgical outcomes of pancreaticoduodenectomy(PD)in patients with liver ***:We studied retrospectively all patients who underwent PD in our centre between January 2002and December *** A comprised patients with cirrhotic livers,and Group B comprised patients with non-cirrhotic *** cirrhotic patients had ChildPugh classes A and B(patient’s score less than 8).Preoperative demographic data,intra-operative data and postoperative details were *** primary outcome measure was hospital mortality *** outcomes analysed included duration of the operation,postoperative hospital stay,postoperative morbidity and survival ***:Only 67/442 patients(15.2%)had cirrhotic *** blood loss and blood transfusion were significantly higher in group A(P=0.0001).The mean surgical time in group A was significantly longer than that in group B(P=0.0001).Wound complications(P=0.02),internal haemorrhage(P=0.05),pancreatic fistula(P=0.02)and hospital mortality(P=0.0001)were significantly higher in the cirrhotic *** stay was significantly longer in group A(P=0.03).The median survival was 19 mo in group A and 24 mo in group *** hypertension(PHT)was present in 16/67 cases of cirrhosis(23.9%).The intraoperative blood loss and blood transfusion were significantly higher in patients with PHT(P=0.001).Postoperative morbidity(0.07)and hospital mortality(P=0.007)were higher in cirrhotic patients with ***:Patients with periampullary tumours and well-compensated chronic liver disease should be routinely considered for PD at high volume centres with available expertise to manage liver *** is associated with an increased risk of postoperative morbidity in patients with liver cirrhosis;therefore,it is only recommended in patients with Child A cirrhosis without portal hypertension.

关键词： Periampullary tumour Liver cirrhosis Portal hypertension Pancreaticoduodenectomy

Interrelationship between Toll-like receptors and infection after orthotopic liver transplantation

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World Journal of Transplantation 2020年第6期10卷 162-172页

作者： Mahmoud El-Bendary Mustafa Naemattalah Ahmed Yassen Naser Mousa Dina Elhammady Ahmed M Sultan mohamed abdel-wahab Department of Tropical Medicine and Hepatology Faculty of MedicineMansoura UniversityMansoura 35111Egypt Department of Medical Biochemistry Faculty of MedicineMansoura UniversityMansoura 35111Egypt Gastroenterology Surgical Centre Faculty of MedicineMansoura UniversityMansoura 35111Egypt

Early microbial recognition by the innate immune system is accomplished by Toll-like receptors(TLRs),with resultant initiation of a pro-inflammatory response against infecting *** spite of presence of an abundance of Toll-like receptors on the surface of the liver,gut bacteria does not elicit an inflammatory reaction in healthy individuals due to tolerance to these TLRs,suggesting that the inflammatory responses seen in the liver are the result of breakdown of this *** orthotopic liver transplantation is often life saving in many instances,death following this procedure is most commonly due to infection that occurs in up to 80%of transplant recipients,most commonly due to microbial causes in up to 70%of cases and viral infections in 20%,while fungal infections affect only 8%of *** probability of acquiring infection following hepatic transplantation is heightened due to affection of the innate immune defense mechanisms of the host following this *** nucleotide polymorphisms of TLRs have been associated with increased likelihood of either development of post-transplant infection or eradication of infecting ***,conflicting reports from other studies reveal that prevalence of this single nucleotide polymorphism is not increased in infected patients.

关键词： Toll like receptors Infection Liver transplantation Cirrhosis Immunity Orthotopic