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Safety and efficacy of posterior sub-Tenon＇s carboplatin injection versus intravitreal melphalan therapy in the management of retinoblastoma with secondary vitreous seeds

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International Journal of Ophthalmology(English edition) 2018年第3期11卷 445-455页

作者： Azza mohamed Ahmed Said mohamed gamil al Hazem Omar Rashed Anwaar Mahmoud Rady Department of Ophthalmology Faculty of Medicine Ain Shams University Cairo 11566 Egypt Oncology and Radiation Medicine Department Faculty of Medicine Ain Shams University Cairo 11566 Egypt

AIM： To evaluate the safety and efficacy of posterior sub-Tenon＇s carboplatin injection compared to intravitreal melphalan injection in the management of retinoblastoma （RB） with secondary vitreous seeds. The outcome measures were vitreous seeds regression, need for other treatment modalities to achieve ocular salvage and treatment side effects. METHODS： A prospective interventional comparative nonrandomized study included RB eyes developed secondary vitreous seeds during the period of follow up. They subdivided into two groups： study group Ⅰ where posterior sub-Tenon＇s carboplatin （20 mg/2 mL） was injected and study group Ⅱ where intravitreal melphalan （20 μg/0.1 mL） was injected. The injections repeated every 2-4wk. RESULTS： Thirty-three eyes were included in the study. Seventeen eyes （16 patients） in study group Ⅰ and 16 eyes （16 patients） in study group Ⅱ. Ten eyes （30.3%） were completely salvaged following local chemotherapies, Ocular salvage was 23.5% following posterior sub-Tenon＇s carboplatin injection versus 37.5% following intravitreal melphalan raised to 47.1% and 75% with addition of external beam radiotherapy （EBR） with no statistically significant difference between the study groups （P=0.16）. A statistically significant correlation was found between ocular salvage rate and type of vitreous seeds either dust, spheres and clouds （r=0.42, P=-0.015） and eyes harbor new solid tumor growth （r=0.35, P=0.045）. The mean and median follow up periods following local chemotherapy injections were 2.0y in the study group Ⅰand 2.37y in the study group Ⅱ. Few complications were reported： periorbital edema in all eyes and ocular motility disturbances in 13 eyes （76.5%） following posterior sub-Tenon＇s carboplatin injection. Vitreous hemorrhage developed in 2 eyes （12.5%） and localized retinopathy in 5 eyes （31.25%） following intravitreal melphalan. ~ CONCLUSION： Local chemotherapy for treatment of RB with secondary vitreous seeds is safe and can salvage 30.3% of eyes

关键词： intravitreal melphalan posterior sub-Tenon'scarboplatin retinoblastoma secondary vitreous seeds

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A Comparative Analysis on Surgical Outcomes and Complications of Endoscopic and Open Vein Harvesting Techniques

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Open Journal of Thoracic Surgery 2024年第2期14卷 29-39页

作者： Mohammed Fawzy Eltaweel Ismail N. El-Sokkary Ahmed alherazi mohamed Wael Badawi Mohammed G. Abdellatif Bahaa A. Elkhonezy Ibrahim K. gamil Haytham mohamed Abd El Moaty Sarra Sadmi Mahmoud Khalil Department of Cardiothoracic Surgery Faculty of Medicine Menoufia University Shibin El Kom Egypt Department of Cardiovascular & Thoracic Surgery Faculty of Medicine Al-Azhar University Cairo Egypt Department of Cardiothoracic Surgery Faculty of Medicine Alexandria University Alexandria Egypt Faculty of Medicine University of Algiers Algiers Algeria Department of Cardiac Surgery Sabah Al-Ahmed Cardiac Center Al-Amiri Hospital Kuwait City Kuwait

Objective: The great saphenous vein (GSV) is commonly used as a conduit for grafting during CABG surgery, and open GSV harvesting (OVH), commonly used with long incision to expose the vein. However, endoscopic vein harvesting (EVH) is an alternative approach, utilizing specialized instruments and small incisions to harvest the vein. Methods: A retrospective analysis was conducted on a cohort of patients who underwent Coronary artery bypass graft (CABG) requiring great saphenous vein (GSV) harvesting which was done by EVH or OVH procedures. Demographic variables, including age and gender, were assessed for both groups. Intraoperative variables such as the number of grafts, cardiopulmonary bypass time, X clamp time, and type of procedure were analyzed. Postoperative variables, including infection and bleeding rates, were also evaluated. Results: The study included 30 patients each undergoing Coronary artery bypass graft (CABG) with need of great saphenous vein harvesting which was done by EVH and OVH. Demographic variables were well-matched between the two groups in terms of age, while a significant difference in gender distribution was observed. Obesity and smoking were more prevalent in the OVH group, and EVH was associated with a higher mean number of grafts compared to OVH. Conversion to an open technique occurred in a portion of the EVH cases, and infection rates did not significantly differ between the EVH and OVH groups. However, the incidence of postoperative bleeding was significantly higher in the EVH group. Conclusion: This study provides valuable insights into the demographic, intraoperative, and postoperative variables associated with EVH and OVH techniques. EVH demonstrated advantages in terms of reduced infection rates compared to OVH. However, the higher incidence of postoperative bleeding associated with EVH raises concerns about potential risks.

关键词： Endoscopic Vein Harvesting (EVH) Open Vein Harvesting (OVH) Coronary Artery Bypass Grafting (CABG) Great Saphenous Vein (GSV) Surgical Outcomes

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Assessment of seminal plasma laminin in fertile and infertile men

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Asian Journal of Andrology 2007年第1期9卷 63-67页

作者： mohamed R. El-Dakhly gamil A. Tawadrous Taymour Mostafa mohamed M. F. Roaia Abdel R. M. El-Nashar Shedeed A. Shedeed Ihab I. Kamel Amal A. Aziz Yasser El-Mohtaseb Andrology Department Faculty of Medicine Cairo University Cairo 12311 Egypt Medical Biochemistry Department Faculty of Medicine Cairo University Cairo 12311 Egypt Clinical Pathology Department Faculty of Medicine Cairo University Cairo 12311 Egypt

Aim： To assess laminin levels in the seminal plasma of infertile and fertile men, and to analyze the correlation of laminin levels with sperm count, age, sperm motility and semen volume. Methods： One hundred and twenty-five recruited men were equally divided into five groups according to their sperm concentration and clinical examination： fertile normozoospermia, oligoasthenozoospermia, non-obstructive azoospermia （NOA）, obstructive azoospermia （OA） and congenital bilateral absent vas deferens （CBAVD）. The patients＇ medical history was investigated and patients underwent clinical examination, conventional semen analysis and estimation of seminal plasma laminin by radioimmunoassay. Results： Seminal plasma laminin levels of successive groups were： 2.82 ± 0.62, 2.49 ± 0.44, 1.77 ± 0.56, 1.72 ± 0.76, 1.35 ± 0.63 U/mL, respectively. The fertile normozoospermic group showed the highest concentration compared to all infertile groups with significant differences compared to azoospermic groups （P 〈 0.05）. Testicular contribution was estimated to be approximately one-third of the seminal laminin. Seminal plasma laminin demonstrated significant correlation with sperm concentration （r = 0.460, P 〈 0.001） and nonsignificant correlation with age （r = 0.021, P = 0.940）, sperm motility percentage （r = 0.142, P = 0.615） and semen volume （r = 0.035, P = 0.087）. Conelusion： Seminal plasma laminin is derived mostly from prostatic and testicular portions and minimally from the seminal vesicle and vas deferens. Estimating seminal laminin alone is not conclusive in diagnosing different cases of male infertility.

关键词： male infertility semen seminal plasma testis basement membrane laminin azoospermia congenital bilateral absent vas deferens

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