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Evaluation of GALAD Score in Diagnosis and Follow-up of Hepatocellular Carcinoma after Local Ablative Therapy

Journal of Clinical and Translational Hepatology 2023年第2期11卷 334-340页

作者： Rasha Eletreby Marwa Elsharkawy Alaa Awad taha Mohamed Hassany Amr Abdelazeem Mohamed El-Kassas ahmed Soliman Endemic Medicine Department Faculty of MedicineCairo UniversityCairoEgypt Clinical and Chemical Pathology Department Faculty of MedicineCairo UniversityCairoEgypt Hepatogastroenterology Department Theodore Bilharz Research InstituteGizaEgypt Hepatogastroenterology Department National Hepatology and Tropical Medicine Research InstituteCairoEgypt Endemic Medicine Department Faculty of MedicineHelwan UniversityCairoEgypt

Background and Aims:Strategies for detection of early hepatocellular carcinoma(HCC)are still *** GALAD score is a serum biomarker-based model designed to predict the probability of having *** aimed to assess the ability of GALAD score to diagnose early HCC and its validity to follow patients after local ablation ***:This multicenter prospective study included 108 patients in two groups,58 HCC patients(67 focal lesions)with local ablative therapy(study group),and a control group of 50 patients with liver *** GALAD scores of the study and control groups,and of the HCC patients before and after ablative therapy were ***:Most patients were men(74.1%in study group and 76%in controls)with hepatitis C virus infection(98.30%in the study group,and 94%in controls).GALAD scores were significantly higher in HCC patients than in those with benign cirrhosis(2.65 vs.−0.37,p=0.001).Ablative therapy was successful in 94.4%of focal lesions<2 cm,and in 86.10%of 2–5 cm *** GALAD score was also significantly lower at 1 month after ablation in patients with well-ablated tumors(2.19 vs.0.98,p=0.001).The best cutoff values of GALAD score for diagnosis of early HCC,and for prediction of well ablation of HCC were 0.74 and≤3.31(areas under the curve of 0.92 and 0.75,sensitivities of 84.48%and 76.19%,specificities of 89.13%and 83.33%,positive predictive values of 90.74%and 94.1%,and negative predictive values of 82%and 35.7%respectively).Conclusion:The GALAD score was effective for the diagnosis of early HCC and for followup after ablative therapy.

关键词： GALAD score HCC Ablative therapy Liver cirrhosis Egypt

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Surgical Results of Posterior Lumbar Interbody Fusion with Transpedicular Fixation in Management of Spondylolisthesis

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Open Journal of Modern Neurosurgery 2020年第1期10卷 146-156页

作者： ahmed taha Mohamed Youssef Neurosurgery Department Faculty of Medicine Al-Azhar University Damietta Egypt

Objective: To evaluate the surgical results of posterior lumber interbody fusion with transpedicular fixation with rod screw system in management of spondylolisthesis. Study Design: Retrospective study reviewed all patient treated by lumber interbody fusion with transpedicular fixation with rod screw system. Patients and Methods: They were 40 patients operated for lumber and lumbosacral spondylolisthesis from Feb 2014 to April 2017 in Al-Azhar university hospital. These patients followed postoperatively clinically for improved neural function and for fusion stability and hardware fixation by radiological investigation. Data about pain intensity (by Visual Analogue Scale) was collected pre- and postoperatively;and outcome was assessed by Oswetry disability index (ODI). Outcome was graded as excellent, good, fair, or poor. Pre- and Post-operative data were statistically compared. Results: The mean age was 45 years (range between 30 - 60 years) with female sex predominance (male:female = 1:3). They had lytic (n = 30) or degenerative (n = 10) spondylolisthesis;and all underwent PLIF (posterior lumbar interbody fusion). In lytic group, the level was L4/L5 in 19 patients and L5/S1 in 11 patients, while in degenerative group the level was L4/L5 in 4 patients, L5/S1 in 3 patients, L2/L3 in 2 and L3/L4 in one patient. The spondylolisthesis grade was grade I among 25 subjects, grade two among 11 subjects and retrolisthesis among 4 subjects. Sensory deficits reported in 22 subjects (19 had lytic and 3 had degenerative spondylolisthesis);while motor deficits reported among 10 subjects and reduced reflexes among 8 subjects. The outcome was excellent, good, and fair among 30, 7, and 3 subjects respectively. The return to previous levels of activity was reported among 32 patients. VAS was 3.5 ± 2.94 at the end of follow up, while ODI was 28% and 36.0% and 3 and 6 months respectively. Conclusion: PLIF associated with transpedicular rod screw fixation system for management of spondy

关键词： Spondylolisthesis Posterior Lumbar Interbody Fusion Transpedicular Fixation

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Surgical Outcome of Traumatic Intracranial Hematoma

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Open Journal of Modern Neurosurgery 2020年第1期10卷 51-62页

作者： Hedaya Hendam ahmed taha Department of Neurosurgery Damietta Faculty of Medicine Al-Azhar University Damietta Egypt

Objective: To evaluate the factors affecting the surgical outcome of traumatic intracranial hematoma. Patient and Methods: This study was retrospectively conducted on 60 patients with traumatic intracranial hematoma admitted to the Neurosurgery Department, Al-Azhar University Hospital and underwent surgical management. Results: The age range was 10 - 58 years, mean age was 31.50 years, male-to-female ratio was 3:1. The causative trauma was road traffic accident (45%), direct trauma to the head (30%) and fall from height (FFH) (25%) of all studied patients. Morbidity and/or mortality was reported in 38.3% and unfavorable outcome was significantly associated with longer delay time (time from injury to surgery), increased operative time, long duration of hospital stay and lower Glasgow coma scale at admission and discharge. Otherwise, the unfavorable outcome although increased with old age, there was no significant association. Conclusion: Head trauma is considered as a frequent cause of death and disability. Time consuming to reach the hospital, operative time, length of stay in hospital and Glasgow coma score of the patient on admission and discharge markedly determine the surgical outcome of traumatic intracranial hematoma.

关键词： Intracranial Hematoma Trauma Surgical Outcome Morbidity Mortality

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Surgical Outcome of Fusion in Recurrent Lumbar Disc Herniation

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Open Journal of Modern Neurosurgery 2020年第1期10卷 157-166页

作者： ahmed taha Mohamed Youssef Neurosurgery Department Faculty of Medicine Al-Azhar University Damietta Egypt

Background Data: Recurrent lumbar disc herniation means re-herniation of disc on the same site and at the same level where a previous discectomy had been performed: recurrent lumbar disc herniation occurs in 7% to 24% of patient underwent discectomy. Tow mean surgical options after reherniated lumbar disc are revision discectomy alone or revision discectomy with fusion discectomy alone in recurrent lumbar disc herniation may not be an efficient treatment without fusion. Objective: To evaluate the efficacy and safety of revision discectomy with fusion in management of recurrent lumbar disc. Study Design: Retrospective study reviewed all patient underwent revision discectomy with fusion, they were 40 patients operated for recurrent lumbar disc from September 2014 to April 2018 in Al-Azhar University Hospital Damietta. Pre- and post-operative data collection and analysis of the outcome were completed based on the “Japanese Orthopedic Association score” (JOAs), and radiographic follow-up. Patients and Methods: 40 patients (30 male and 10 female) underwent revision discectomy with fusion as surgical management for reherniated lumbar disc from September 2014 to April 2018. All patients presented with low back pain and radicular pain with mean duration of 18 months. The patients were investigated by standard plain X-ray CT SCAN and MRI of the lumbar spine. All patients had a discectomy and postero-lateral fusion in revision surgery. These patients followed post operatively clinically for improving pain and neural function, and radiologically for disc removal stability and fusion. Results: The age ranged from 30 to 60 years, mean age was 45 years, male to female ratio 3:1. Follow-up ranged from 18 - 30 months with a mean follow-up 24 months. 30 patients had an excellent outcome, 6 patients had a good outcome, 2 patients had a fair outcome, and 2 patients had a poor outcome. Conclusion: Recurrent lumbar disc herniation occurs in 7% to 24% of patient underwent discectomy. Rev

关键词： Reherniated Lumbar Disc Postero-Lateral Fusion Revision Discectomy

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Impact of referral pattern and timing of repair on surgical outcome after reconstruction of post-cholecystectomy bile duct injury:A multicenter study

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Hepatobiliary & Pancreatic Diseases International 2021年第1期20卷 53-60页

作者： Ayman El Nakeeb Ahmad Sultan Helmy Ezzat Mohamed Attia Mohamed Abd ElWahab taha Kayed Ayman Hassanen Ahmad AlMalki ahmed Alqarni Mohammed M Mohammed Gastrointestinal Surgical Center Mansoura UniversityMansouraEgypt Minia University Hospital MiniaEgypt Aseer Central Hospital Aseer regionSaudi Arabia

Background:Bile duct injury(BDI)after cholecystectomy remains a significant surgical *** guideline exists to guide the timing of repair,while few studies compare early versus late repair *** study aimed to analyze the outcomes in patients undergoing immediate,intermediate,and delayed repair of ***:We retrospectively analyzed 412 patients with BDI from March 2015 to January *** patients were divided into three groups based on the time of BDI *** 1 underwent an immediate reconstruction(within the first 72 hours post-cholecystectomy,n=156);group 2 underwent an intermediate reconstruction(from 4 days to 6 weeks post-cholecystectomy,n=75),and group 3 underwent delayed reconstruction(after 6 weeks post-cholecystectomy,n=181).Results:Patients in group 2 had significantly more early complications including anastomotic leakage and intra-abdominal collection and late complications including anastomotic stricture and secondary liver cirrhosis compared with groups 1 and *** outcome was observed in 111(71.2%)patients in group 1,31(41.3%)patients in group 2,and 157(86.7%)patients in group 3(P=0.0001).Multivariate analysis identified that complete ligation of the bile duct,level E1 BDI and the use of external stent were independent factors of favorable outcome in group 1,the use of external stent was an independent factor of favorable outcome in group 2,and level E4 BDI was an independent factor of unfavorable outcome in group *** BDI and level E4 BDI were independent factors of unfavorable ***:Favorable outcomes were more frequently observed in the immediate and delayed reconstruction of post-cholecystectomy *** ligation of the bile duct,level E1 BDI and the use of external stent were independent factors of a favorable outcome.

关键词： Bile duct injury Hepaticojejunostomy Anastomotic stricture Biloma Biliary peritonitis

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Radiation Doses in Diagnostic Radiology and Method for Dose Reduction

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Open Journal of Radiology 2023年第1期13卷 34-41页

作者： taha M. taha Hoda A. ahmed Fathy A. Shaheen Radiation Protection Department Nuclear Research Center Egyptian Atomic Energy Authority Cairo Egypt Radiology Unit Medical Administration Nuclear Research Center Egyptian Atomic Energy Authority Cairo Egypt

Objective: The current research study aims to calculate entrance surface air kerma for skull, chest, cervical spine, lumbar spine, and pelvic X-ray examinations in interior posterior and posterior interior positions and generate a method for chest dose reduction to decrease radiation risk. Materials and Methods: The indirect dose measurement was used in the current research. The X-ray tube output was measured using RAD-CHECK Plus ionization chamber and the indirect entrance surface air kerma was calculated via applying physical acquisition parameters such as a focus on skin distance, tube current times exposure time (mAs), and applied tube voltage (kV), and applying a mathematical model. Results: The main findings were obtained from comparing the radiation doses with the reference levels of International organizations such as the American College of Radiology and the International Atomic Energy Authority. The mean entrance skin dose for the skull (AP), skull (PA), skull (LAT), cervical spine (PA), cervical spine (LAT), lumbar spine (AP), lumbar spine (LAT), pelvis (AP), and pelvis (LAT) of adult X-ray examinations was within the diagnostic reference dose level values obtained by ACR (2018) except for the ESD for chest (AP) which was 0.88 mGy. Conclusions: The results of the study concluded that by adjusting the applied tube voltage, kV, and tube current product time, mAs decreased the radiation dose to the chest X-ray by 58%.

关键词： Radiology Entrance Skin Dose Chest X-Ray Dose Minimization

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Validation of Calculated Thermal Parameters with Experimental Results in SOFCs

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Journal of Minerals and Materials Characterization and Engineering 2018年第2期6卷 193-202页

作者： Saeed Ghali Azza ahmed taha Mattar Steel Technology Department Central Metallurgical Research & Development Institute (CMRDI) Cairo Egypt

Eleven steel grades were designed to be used as metallic interconnects for Solid Oxide Fuel Cells (SOFC). Low carbon, high chromium steel with different additives of niobium, vanadium, aluminum, molybdenum, silicon, manganese and titanium were produced. Phase transformation temperatures;eutectoid temperature (Ac1) and temperature at which transformation of ferrite to austenite is completed during heating (Ac3) were measured by L75-76 dilatometer. The influence of the alloying elements on transformation temperatures was analyzed using MATLab. Considering the interaction between different alloying elements two equations for predicting Ac1 & Ac3 were obtained. The obtained Ac1 & Ac3 by these equations showed more compatibility than that obtained by traditional ones. In addition, the coefficients of thermal expansion of these steel grades were detected. The influences of chemical composition and temperature on the thermal expansion coefficient were analyzed;the obtained equations were verified to certain extent by using several kinds of steels. The predicted values were in good accordance with the experimental results which proof the validation of calculation model.

关键词： Transformation Temperature Thermal Expansion Coefficient SOFCs Steel Matlab

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Rod and Screw Fixation for Cranio-Cervical Instability

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Open Journal of Modern Neurosurgery 2020年第1期10卷 19-26页

作者： Hedaya Hendam ahmed taha Mohamed Youssef Department of Neurosurgery Al Azhar Faculty of Medicine Damietta Egypt

Background Data: Atlanto-occipital dislocation is a rare and fatal condition. Pain, limitation of movements, and weakness, were the main complaints of patients with upper cervical lesions. Internal fixation and fusion was indicated in all patients of Atlanto occipital dislocation with deficits. CT scan is the imaging modality of choice for evaluation. Objective: To evaluate the efficacy and safety of rod and screw fixation in cranio-cervical instability. Study Design: Retrospective study reviewed all patient treated by rod and screw fixation, they were 12 patient operated for atlanto-occipital instability from April 2013 to April 2016 in Alazher University Hospital Damietta. Pre and postoperative data collection and analysis of the outcome were completed based on the Frankel classification and grading. Patients and Methods: We operated 12 patients, 10 with traumatic and 2 with pathologically diagnosed Atlanto occipital instability. From April 2013 to April 2016. All patients presented with neck pain, limitation of neck movement, and neurological deficits. The patients were investigated by standard plain X ray to the cervical spine, CT scan and MRI of the cervical spine pre-operatively, and they operated thorough posterior Cranio-cervical fixation. These patients followed post-operatively clinically for improving neural functions and radiologically for alignment, stability, fusion and efficacy of hard ware fixation. Results: The mean age of the studied cases was 42.1 years, trauma was the cause of instability in 10 patients, and 2 patients one with rheumatoid arthritis and one with neoplastic lesion. The mean follows up period is 14.7 months. We used screw rod system in posterior craniocervical fixation with iliac bone graft without operative or post-operative complications. All our patients were improved neurologically post-operatively and no hardware failure during the follow up period. Conclusion: Craniocervical instability was rare condition, with miss diagnosis

关键词： Spine Atlanto-Axial Atlanto-Occipital Cranio-Cervical Internal Fixation

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Recent Techniques in Management of Lumbosacral Region Tumours: A Prospective Comparative Study

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Open Journal of Modern Neurosurgery 2018年第2期8卷 239-249页

作者： Mostafa Abd Elsamea Mohamed Shaaban ahmed taha Department of Neurosurgery Al-Azhar University Hospital Damietta Egypt

Background: The lumbosacral plexus consists of the ventral rami from the L2 to S3 nerve roots, with some additions from the L1 and S4 nerve roots as well. The standard treatment for spinal cord compression is urgent surgically decompressive laminectomy over the affected level with resection as much as possible of the exposed tumor to relieve the cord compression. We aim to correlate the impact of preoperative clinical picture, duration of symptoms, and the pathological nature of the lumbo-sacral spine tumors on the outcome of comparative study different modalities of management. Patients and Methods: During the period between 2015 and 2017, thirty cases were studied and surgically managed in Al-Azhar University Hospital, Damietta. Cases were selected for surgery if they were diagnosed as having a symptomatizing lumbosacral lesion. Results: Thirty patients were included in the current study;the commonest lesion in this study was ependymoma eight patients (27%), astrocytoma six patients (20%), and meningioma five patients (17%). Nerve sheath tumor comprised five cases (17%) with the hemangioblastomas three cases (10%), epidermoid one case (3%), and ependymoma of the filum terminale two cases (6%). The mean age of the included patients was 38.96 ± 15.42. The mean duration of lesions was 13.66 ± 10.93. They were 15 male patients (50%), and 15 female patients (50%), with male: female ratio 1:1. The mean duration of symptoms ranged for 1:60 months. The most common presenting manifestations were sensory followed by motor and sphinctric disturbance. Complications occurred in 8 patients (23%), and the most common was postoperative CSF leak. 19 out of 30 cases were surgically totally resected (63%), while 11 cases (37%) were grossly totally resected. Conclusions: Ependymoma and meningioma have more favorable outcome compared to other spinal tumors. Accurate and rapid diagnosis prior to surgery also associated with good outcome.

关键词： Lambosacral Lesion Astrocytoma Ependymoma

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Management of Post-Craniotomy Persistent CSF Subgaleal Collection in Skull Base Procedures: Local Experience

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Open Journal of Modern Neurosurgery 2020年第1期10卷 114-121页

作者： Hosam Shata Mahmoud Saad ahmed Nageeb taha Neurosurgery Department Mansoura University Mansoura Egypt

Background: Post-craniotomy CSF collection is a problem that may cause severe complications as meningitis, wound disruption, prolonged hospitalization, and additional surgeries. Objective: To evaluate our cases with resistant post-operative subgaleal CSF collection, trying to identify causes and optimal management. Methods: Retrospective review of elective skull base cases during the period of January 2104 to January 2019 identification of cases with post-operative CSF subgaleal collection, which either managed conservatively or needed a second surgery. Results: 219 patients, 30 of them suffered subgaleal CSF collection, 22 patients improved with non-operative measures, eight patients needed second surgery with pericranial graft augmentation, and obliteration of subgaleal space resulted in resolution of CSF leak with no morbidities. Conclusion: Meticulous tensionless dural closure, obliteration of subgaleal space, tethering of dural grafts to bone edges are useful techniques in preventing post-operative CSF leak.

关键词： Subgaleal CSF Post-Operative Dural Repair Craniotomy

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