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Intercostal Muscle Flap in Post Tuberculous Pneumonectomy: A New Technique

Surgical Science 2012年第5期3卷 249-252页

作者： Alaa Brik abdel-maged salem Osama Saber Department of Cardiothoracic surgery Zagazig University Hospital Zagazig Egypt

Objective: There are many risk factors for postoperative bronchopleural fistula (BPF), including extensive resection, diabetes, chronic infection, perioperative steroid therapy, preoperative chemotherapy, and radiotherapy, the risk of bronchopleural fistula increases with resection for inflammatory diseases, especially Mycobacterium tuberculosis (MTB). The aim of this study is to evaluate the efficacy and safety of using double pedicled intercostal muscle flaps with dual blood supply to buttress the bronchial stump after pneumonectomy for tuberculous lesions as a prophylactic new technique from post-pneumonectomy BPF. Methods: Between 2007 and 2011, 47 patients with pneumonectomy for post tuberculous lesions in the department of cardiothoracic surgery, Zagazig University Hospital were divided into two groups. Group A: 28 patients with single pedicled intercostal muscle flap used and applied on the bronchial stump after pneumonectomy. Group B: 19 patients with double pedicled intercostal muscle flaps used and applied on the bronchial stump. The mean age of the patients was 42.9 years (range 27 - 67 years) in Group A, 44.8 years (range 36 - 71 years) in Group B. Results: Bleeding in one patient in Group A (3.5%) and two patients in Group B (10.5%);empyema in two patients (7.1%) in Group A only one of them developed bronchopleural fistula;arrhythmias in one patients (3.5%) in Group A and one patient in Group B (5.2%);chylothorax in one patients (3.5%);Chronic chest pain in one patient in Group A (3.5%) and two patients in Group B (10.5%). The mean follow up period was 32.7 ± 12.9 months (range between 3 and 48 months). All patients remained symptom free with no evidence of late bronchopleural fistula in Group B. Conclusions: Double pedicled intercostal muscle flaps with dual blood supply buttressing the bronchial stump is new prophylactic technique from BPF after pneumonectomy for pulmonary tuberculous lesions in high risk patients.

关键词： Intercostal Muscles Pneumonectomy Tuberculosis

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Successful Use of Intercostal Muscle Flap in Cavitary Lung Lesions

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Open Journal of Thoracic Surgery 2013年第1期3卷 4-7页

作者： Alaa Brik abdel-maged salem Khaled Mostafa Departmeants of Cardiothoracic Surgery and Anesthesia Zagazig University Hospital Zagazig Egypt. Departments of Cardiothoracic Surgery and Anesthesia Zagazig University Hospital Zagazig Egypt.

Background: Lung cavities sometimes result from a number of pathological processes including suppurative necrosis, caseous necrosis, ischemic necrosis and cystic dilatation of lung structures. The aim of this study is to evaluate the use of intercostals muscle flap as a successful method to fill the lung cavity for reduction of symptoms and treatment of patients presented with symptomatic pulmonary cavity and to avoid the risk of pulmonary resection. Methods: This is a prospective study conducted between 2009 to 2012, in department of cardiothoracic surgery, Zagazig University Hospital. The study included 32 patients suffering from cavitary lung lesions divided into two groups, group (A): 14 patients treated by using intercostal muscle flap to fill the defect after Cavernostomy without lung resection;and group (B): 18 patients treated by traditional methods by lung resection. Patients with high risk of lung resection, suspicion of dense adhesion, symptomatic chronic lung abscess and patients with bad pulmonary function tests were included in group (A). Results: 20 patients were male and 12 were females in both groups, the large numbers of cases were lung abscess in group A (4 cases 28.5%) followed by Aspergilloma and TB cavity (3 cases 21.4%). Hemoptysis, persistent cough and expectoration were the main presentation of our patients. Poor pulmonary function was significant finding in group A (7 cases 50%). Complications reported in our study were bleeding, recurrent symptoms and one case mortality in group B after Pneuomenectomy. Conclusion: Using the intercostal muscle flap implanted inside the lung cavity after cavernostomy is a successful alternative curative method especially in cases with high risk of lung resection.

关键词： Lung Resection Intercostal Muscle Flap Lung Cavities

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Surgical Outcome of Prosthetic Heart Valve Obstruction: Single Center Experience

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World Journal of Cardiovascular Surgery 2012年第4期2卷 81-85页

作者： Alaa Brik abdel-maged salem Nader Talat Amira Shoukry Department of Cardiology Zagazig University Hospital Zagazig Egypt Department of Cardiothoracic Surgery Zagazig University Hospital Zagazig Egypt Department of Internal Medicine Zagazig University Hospital Zagazig Egypt

Objective: Valve thrombosis defined as any thrombus not caused by infection attached to or near an operated valve that occludes part of the blood flow path and interferes with valve function. Treatment modalities are thrombolytic therapy, surgical thrombectomy and debridement, or re-replacement. The aim of this study is to review our experience in surgical thrombectomy and debridement for obstructed mechanical valve prosthesis, and the impact of the procedure on the outcome in comparison to re-replacement;Methods: The study was conducted retrospectively between 1995 to 2012 in Department of Cardiothoracic surgery, cardiology and internal medicine, Zagazig University Hospital. 92 patients with stuck valve were divided into two groups. Group (A): 54 patients with re replacement and Group (B): 38 patients treated by thrombectomy and debridement;Results: 92 patients with stuck valves the mean age was 38.4(±9.2), 68 male and 85 female in both groups. The large numbers of cases were mitral valve 35 (64.8%) patients in group A and 22 (57.9%) patients in group B, aortic malfunction in group A was 11 (20.4%)patients and 9 (23.7%) cases in group B, double valve malfunction was rare represent 8 (14.8%) and 7 (18.4%)cases in group A and group B respectively;Conclusion: We conclude that thrombectomy and debridement for malfunctioning mechanical valve is a safe, easy and rapid procedure to perform in some cases to avoid the risk of re replacement.

关键词： Malfunction Valve Mechanical Valve Thromboembolism

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Is Primary Repair of Tracheobronchial Rupture Curative?

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Open Journal of Thoracic Surgery 2013年第2期3卷 47-50页

作者： abdel-maged salem Alaa Brik Ali Refat Karem Elfagharany Abdalla Badr Department of Cardiothoracic Surgery Zagazig University Hospital Zagazig Egypt

Background: Tracheobronchial disruption as a result of blunt thoracic trauma is a rare entity and only clinically serious lesions come to our notice, which can be life-threatening and need prompt recognition and treatment. Objectives: To review the authors’ experience with tracheobronchial injuries to emphasize the need for prompt diagnosis and treatment to avoid lethal complications including severe hypoxic organ failure, sepsis, mediastinitis and bronchopleural fistula. Patients and methods: A retrospective study of total 32 patients with tracheobronchial injury from 2001 to 2011. This study limited to patients with thoracic tracheal or bronchial injury, excluding those with cervical injuries. The study includes collected information about mechanism of injury, presentation, time until diagnosis and treatment, anatomical site of injury, type of treatment, diagnostic methods, duration of follow up and outcome. Results: Twenty-four patients were male (75%) and eight were females (25%). Patient’s ages ranged from 7 - 53 years. Majority of cases was referred because of blunt trauma in 15 cases (46.8%), 6 (18.75) motor vehicle accident, 5 (15.6%) fall from a height and 4 (12.5%) with trauma by heavy object, while 8 cases (25%) were referred due to penetrating injury and 2 cases (6.25%) due to iatrogenic injury. In initially diagnosed group, the predominant clinical signs that give a suspicion of tracheobronchial disruption were increased subcutaneous surgical emphysema, shortness of breath, hemoptysis. After the admission to emergency unit, all of them were examined radiologically by chest X-ray film. Longitudinal tear of right upper lobe bronchus was found in 8 cases (32%), complete cut of right upper lobe bronchus in 4 cases (16%), tear of right intermediate bronchus in 4 cases (16%), 3 cases with clear cut left upper lobe (12%), longitudinal tear of distal lateral tracheal wall extend to right upper lobe in 2 cases (8%), 2 cases (8%) showed complex disruption of dist

关键词： Tracheobronchial Disruption Trauma

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Midterm Results of Leaflet Augmentation in Mitral Valve Repairin Rheumatic Valves Experience in One Center

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World Journal of Cardiovascular Surgery 2013年第2期3卷 90-96页

作者： Abd Allah Badr Alaa Brik abdel maged salem Ali Refat Khaled Mostafa Usama Badr Mamdouh Sharawy El-Rady Kamal Department of Anesthesia Azhar University Hospital Asuet Egypt Department of Anesthesia Zagazig University Hospital Zagazig Egypt Department of Cardiothoracic Surgery Zagazig University Hospital Zagazig Egypt

Patients with severe mitral regurgitation (MR) should undergo surgery when they present symptoms or if asymptomatic when there is objective evidence of left ventricular dysfunction. In this work, we analyze the midterm results of leaflet augmentation in mitral valve repair of rheumatic valves with gluteraldehyde preserved autologous pericardium. Patients and Methods: In our department 48 patients were exposed to mitral valve repair by leaflet augmentation either anterior or posterior beside other technique and all patients supported by flexible annuloplasty ring and followed for five years clinically and by echocardiography. Results: Age of the patients ranging from 12 to 47 years, mean age 25.9 ± 8.9 and there were 12 males (25%) and 36 females (75%) with male to female ratio of 1:3. All patients presented with shortness of breath (100%);with 14 patients were in NYHA class III (29.17%) and 34 patients were in NYHA class IV (70.83%). During follow-up period 5 patients needed reoperation by valve replacement, causes of reoperation were restrictive valve motion in one patient, left atrial thrombus in 1 patient and sever mitral regurgitation in 3 patients. Freedom from reoperation was 87.5%. At 5 years, (92.9%) were in New York Heart Association functional class I, three patients (7.1%) were in class II. Echocardiography at follow-up showed satisfactory mitral valve function. Conclusion: leaflet augmentation is a simple and reproducible method of valve repair for rheumatic MR with good midterm result.

关键词： Mitral Repair Valve Surgery

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Allocation and sizing of reactive power compensators considering PV power and load demand uncertainty using beetle-antenna grey wolf optimization

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Clean Energy 2023年第2期7卷 350-362页

作者： Rasha Elazab M.Ser-Alkhatm maged A.Abu Adma K.M.abdel-Latif Department of Electrical Power and Machines Engineering Faculty of EngineeringHelwan UniversityCairoEgypt

Distributed photovoltaic(PV)systems play an important role in supplying many recent *** absence of reactive power support for these small-scale PV plants increases total microgrid losses and voltage-instability *** power compensations(RPCs)should be integrated to enhance both microgrid losses and voltage *** planning is a non-linear,complicated *** this paper,a combined RPC allocation and sizing algorithm is *** RPC-integrating buses are selected using a new adaptive approach of loss sensitivity *** the sizing process,the uncertainties in PV power and load demand are modelled using proper probability density *** simulation techniques for handling uncertainties are compared to define the accurate and fast accurate method as follows:Monte Carlo simulation(MCS),scenario tree construction and reduction method,and point estimation method(PEM).The load flow equations are solved using the forward-backward sweep *** are optimally sized using the beetle-antenna-based strategy with grey wolf optimization(BGWO)to overcome the local minima problem that appeared in the other pre-proposed *** have been compared using particle swarm optimization and conventional *** proposed model is verified using the IEEE 33 radial bus *** expected power loss has been reduced by 22% and 31% using compensation of 26% and 44%,*** results obtained prove that the BGWO optimal power flow and PEM to handle the uncertainty can significantly reduce the computation time with sufficient *** the study conditions,PEM reduces the computation time to 4 minutes compared with 4 hours for MCS,with only a 3% error compared with MCS as an uncertainty benchmark method.

关键词： distributed PV plants reactive power compensator sizing PV uncertainty beetle-antenna grey wolf optimization

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Techno-economic analysis to develop the first wind farm in the Egyptian western desert at Elkharga Oasis

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Clean Energy 2022年第1期6卷 211-225页

作者： Mohamed A.abdelrahman Radwan H.abdel-Hamid maged Ahmed Abo Adma Mohamed Daowd Electrical Power and Machines Department Faculty of EngineeringHelwan UniversityCairoEgypt

During the past few years,Egypt has increased the share of electricity generation from renewable energy sources to achieve the renewable-energy *** Egyptian Ministry of Electricity and Renewable Energy has set an ambitious target to increase the share of renewable energy among the total energy mix to be 20%by 2022 and 42%by *** target will be achieved using several approved policies such as feed-in tariffs,build-own-operate and independent power producers under a merchant *** paper presents a full analysis of wind-potential characteristics at Elkharga Oasis in Egypt based on an actual wind-measurement campaign taken by a met mast at two height levels of 10 and 25 m,*** measurements show an average annual wind speed of 5.72 m/s at 10-m height and 6.53 m/s at>25-m *** estimated wind speed,however,is 8.38 m/s at 120 m,which is technically convenient to generate electricity from wind *** this paper,the wind potential in the area is assessed using the statistical method of the Weibull probability density *** different methods to estimate the Weibull distribution parameters are presented and the relevant accuracy is verified based on the root mean square error.A techno-economic assessment and selection of the optimal wind-turbine size with ideal micro-sitings are performed using the software package *** cases of study for three typical wind-turbine models with various rotor diameters,power capacity,layout configuration and annual yield are assessed at the *** selection of the most convenient wind turbine is determined based on the IEC 61400 standard criteria and the turbine that produces the lowest levelized cost of electricity.

关键词： wind energy wind-resource assessment Weibull distribution windPRO levelized cost of electricity

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Sex Predictive Value of Frontal Sinus Index Compared to Maxillary Sinus Index:Lateral Cephalometric Study

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Journal of Forensic Science and Medicine 2023年第2期9卷 162-166页

作者： Fatma Mohamed Hassan maged Nabil Hussein Noran Ayman abdel Motagally Walaa Samir Department of Forensic Medicine and Clinical Toxicology Faculty of MedicineCairo UniversityCairoEgypt Department of Forensic Evidence Abu Dhabi Police GHQAbu DhabiUnited Arab of Emirates Department of Orthodontics Misr University for Science and TechnologyGizaEgypt Department of Oral and Maxillofacial Radiology Faculty of DentistryBeni-Suef UniversityBeni-SuefEgypt

Sex estimation is a crucial step to outline the biological profile of unknown human *** frontal and maxillary sinuses have unique anatomical features and can be utilized efficiently in individual *** studies investigated the frontal and maxillary sinus indexes separately for sex ***,comparing the predictive value of the frontal sinus index(FSI)to the maxillary sinus index(MSI)has not been investigated *** study aimed to evaluate the sex predicting value of FSI compared to MSI assessed on digital lateral *** retrospective cross-sectional study included 88 digital lateral cephalometric images of known sex(44 males and 44 females)and age(20-50 years).Two radiologists measured the maximum anteroposterior sinus width and height of the frontal sinus and maxillary ***,the sinus index was calculated for each *** obtained frontal and maxillary sinuses parameters were tabulated,along with the patient’s sex and age,and subjected to statistical *** results revealed significant differences between males and females regarding frontal sinus width,FSI,and *** discriminant function analysis obtained in this study accurately predicted sex with an overall accuracy of 71.6%(81.8%of males and 61.4%of females)using FSI,and 60.2%(63.6%in females and 56.8%in males)using *** and maxillary sinus indexes can be useful tools for sex *** function equations were developed for both the frontal and maxillary sinus indexes with higher accuracy rates for FSI compared to MSI.

关键词： Cephalometry discriminant analysis paranasal sinuses sex prediction sinus index

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Detecting Accuracy of Three Dimensional Power Doppler (3DPD) Vascular Indices for Prenatal Diagnosis of Morbidly Adherent Placenta in Patients with Placenta Previa

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Open Journal of Obstetrics and Gynecology 2020年第1期10卷 49-64页

作者： Ahmed Sherif abdel-Hamid maged Mahmoud Elshourbagy Mohamed Sayed Aly Shahira Zakaria Mohamed Ali Ghaly Department of Obstetrics and Gynecology Faculty of Medicine Ain-Shams University Cairo Egypt Department of Obstetrics and Gynecology in Shoubra General Hospital Cairo Egypt

Objective:?The study’s objective was to assess the accuracy of using prenatal 3-dimensional power Doppler analysis of vascular placental indices to accurately diagnose morbidly adherent placenta objectively. Background:?Traditionally, 2D ultrasound was used for the diagnosis of a suspected morbidly adherent placenta (MAP) previa. More objective techniques like 3D power Doppler haven’t been well studied. Study Design:?A prospective cohort study?is?designed for women with gestational age between 28 and?32 weeks with suspected placenta previa. Patients were examined by 2D ultrasound which was used in management decisions.?3D Power Doppler’s VI, FI and VFI were measured during the same examination after manual tracing of placenta;data were blinded to obstetricians. Histopathology was performed to confirm MAP. Results: Our results showed that the 3D power Doppler VI ≥ 16 predicted the diagnosis of MAP with 100% sensitivity, 100% specificity which is better than those of 2D ultrasound. While VI > 33.1 measured by 3D Doppler predicted severe MAP with a sensitivity of 73.9% and specificity of 86.4%, which was superior to 2D ultrasound. Conclusion:?In patients with placenta previa, the 3D Doppler’s vascular index accurately predicts MAP. Furthermore, vascular and vascular flow indices of 3D Doppler were more predictive of severe cases of MAP compared to 2D ultrasound.

关键词： 3D Color Doppler 2D Ultrasound Placental Vascular Indices Morbidly Adherent Placenta Placenta Previa

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Investigation of a Modified Cobalt-Free Alloy for Nuclear Application

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Journal of Materials Science and Chemical Engineering 2015年第9期3卷 52-56页

作者： Mamdouh Mahmoud Eissa maged Mahmoud Kassab Samir Uoshaa El-Kameesy Ahamed abdel-Latif Mohamed Department of Steel and Ferroalloys CMRDI Helwan Egypt Department of Physics Faculty of Engineering Fayoum University Fayoum Egypt Department of Physics Faculty of Science Ain Shams University Cairo Egypt

Cobalt-free alloy of constituent’s “0.045%C-12.73%Ni-6.53%Cr-3.2%Mo-0.02%Ti-0.01%V” has been prepared by electro slag remelting technique. Mass attenuation coefficient, half value layer and effective atomic number have been determined for the prepared sample at photon energies 235 - 2700 keV. The results are compared with the corresponding theoretical calculations based on XCOM program and a fair agreement is obtained.

关键词： Cobalt Free Gamma Shielding Effective Atomic Number Mass Attenuation Coefficient

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