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Regional anesthesia for orthopedic procedures:What orthopedic surgeons need to know

World Journal of Orthopedics 2022年第1期13卷 11-35页

作者： ihab kamel Muhammad F Ahmed Anish Sethi Department of Anesthesiology Lewis Katz School of Medicine at Temple UniversityPhiladelphiaPA 19140United States

Regional anesthesia is an integral component of successful orthopedic *** anesthesia is commonly used for surgical anesthesia while peripheral nerve blocks are often used for postoperative *** evaluation for regional anesthesia should include neurological,pulmonary,cardiovascular,and hematological *** blocks include spinal,epidural,and combined spinal *** extremity peripheral nerve blocks include interscalene,supraclavicular,infraclavicular,and *** extremity peripheral nerve blocks include femoral nerve block,saphenous nerve block,sciatic nerve block,iPACK block,ankle block and lumbar plexus *** choice of regional anesthesia is a unanimous decision made by the surgeon,the anesthesiologist,and the patient based on a risk-benefit *** choice of the regional block depends on patient cooperation,patient positing,operative structures,operative manipulation,tourniquet use and the impact of postoperative motor blockade on initiation of physical *** anesthesia is safe but has an inherent risk of failure and a relatively low incidence of complications such as local anesthetic systemic toxicity(LAST),nerve injury,falls,hematoma,infection and allergic *** should be used for regional anesthesia procedures to improve the efficacy and minimize *** treatment guidelines and rescue medications(intralipid)should be readily available during the regional anesthesia administration.

关键词： Orthopedic surgery Regional anesthesia Spinal Epidural Combined spinal epidural Peripheral nerve blocks Neuraxial blocks Upper extremity Lower extremity Interscalene Supraclavicular Infraclavicular Axillary Femoral Fascia iliaca Popliteal Sciatic Saphenous Adductor canal Lumbar plexus Brachial plexus Ankle iPACK Complication Local anesthetic systemic toxicity Nerve injury Block failure Continuous nerve block catheters

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Current state of the art imaging approaches for colorectal liver metastasis

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Hepatobiliary Surgery and Nutrition 2020年第1期9卷 35-48页

作者： Bita Hazhirkarzar Pegah Khoshpouri Mohammadreza Shaghaghi Mounes Aliyari Ghasabeh Timothy M.Pawlik ihab R.kamel Russell H.Morgan Department of Radiology and Radiological Sciences Johns Hopkins University School of MedicineBaltimoreMDUSA Department of Surgery The Ohio State UniversityWexner Medical CenterColumbusOHUSA

One of the most common cancers worldwide, colorectal cancer (CRC) has been associated with significant morbidity and mortality and therefore represents an enormous burden to the health care system. Recent advances in CRC treatments have provided patients with primary and metastatic CRC a better long-term prognosis. The presence of synchronous or metachronous metastasis has been associated, however, with worse survival. The most common site of metastatic disease is the liver. A variety of treatment modalities aimed at targeting colorectal liver metastases (CRLM) has been demonstrated to improve the prognosis of these patients. Loco-regional approaches such as surgical resection and tumor ablation (operative and percutaneous) can provide patients with a chance at long-term disease control and even cure in select populations. Patient selection is important in defining the most suitable treatment option for CRLM in order to provide the best possible survival benefit while avoiding unnecessary interventions and adverse events. Medical imaging plays a crucial role in evaluating the characteristics of CRLMs and disease resectability. Size of tumors, proximity to adjacent anatomical structures, and volume of the unaffected liver are among the most important imaging parameters to determine the suitability of patients for surgical management or other appropriate treatment approaches. We herein provide a comprehensive overview of current-state-of-the-art imaging in the management of CRLM, including staging, treatment planning, response and survival assessment, and post-treatment surveillance. Computed tomography (CT) scan and magnetic resonance imaging (MRI) are two most commonly used techniques, which can be used solely or in combination with functional imaging modalities such as positron emission tomography (PET) and diffusion weighted imaging (DWI). Providing up-to-date evidence on advantages and disadvantages of imaging modalities and tumor assessment criteria, the current

关键词： Colorectal metastasis liver imaging tumor response

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Positioning patients for spine surgery: Avoiding uncommon position-related complications

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World Journal of Orthopedics 2014年第4期5卷 425-443页

作者： ihab kamel Rodger Barnette Temple University School of Medicine Philadelphia PA 19140 United States

Positioning patients for spine surgery is pivotal for optimal operating conditions and operative-site exposure. During spine surgery, patients are placed in positions that are not physiologic and may lead to complications. Perioperative peripheral nerve injury(PPNI) and postoperative visual loss(POVL) are rare complications related to patient positioning during spine surgery that result in significant patient disability and functional loss. PPNI is usually due to stretch or compression of the peripheral nerve. PPNI may present as a brachial plexus injury or as an isolated injury of single nerve, most commonly the ulnar nerve. Understanding the etiology, mechanism and pattern of injury with each type of nerve injury is important for the prevention of PPNI. Intraoperative neuromonitoring has been used to detect peripheral nerve conduction abnormalities indicating peripheral nerve stress under general anesthesia and to guide modification of the upper extremity position to prevent PPNI. POVL usually results in permanent visual loss. Most cases are associated with prolonged spine procedures in the prone position under general anesthesia. The most common causes of POVL after spine surgery are ischemic optic neuropathy and central retinal artery occlusion. Posterior ischemic opticneuropathy is the most common cause of POVL after spine surgery. It is important for spine surgeons to be aware of POVL and to participate in safe, collaborative perioperative care of spine patients. Proper education of perioperative staff, combined with clear communication and collaboration while positioning patients in the operating room is the best and safest approach. The prevention of uncommon complications of spine surgery depends primarily on identifying high-risk patients, proper positioning and optimal intraoperative management of physiological parameters. Modification of risk factors extrinsic to the patient may help reduce the incidence of PPNI and POVL.

关键词： Spine surgery Complication Position Nerve injury Visual loss

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Differences in characteristics of patients with and without known risk factors for hepatocellular carcinoma in the United States

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World Journal of Gastroenterology 2007年第5期13卷 781-784页

作者： Jon D Dorfman Richard Schulick Michael A Choti Jean-Francois H Geschwind ihab kamel Michael Torbenson Paul J Thuluvath Department of Surgery The Johns Hopkins University School of Medicine Baltimore MD 21205 United States Department of Radiology The Johns Hopkins University School of Medicine Baltimore MD 21205 United States Department of Pathology The Johns Hopkins University School of Medicine Baltimore MD 21205 United States Department of Medicine The Johns Hopkins University School of Medicine Baltimore MD 21205 United States

AIM： To examine the clinical characteristics of a subgroup of patients with hepatocellular carcinoma （HCC） and compare them to those with known risk factors. METHODS： We used the HCC database of 306 patients seen at our institution from January 1, 1995 to December 31, 2001. Of the 306 patients, 63 （20%, group 1） had no known risk factors （hepatitis C virus, hepatitis B virus, alcohol, hemochromatosis or cirrhosis from any cause） and 243 （group 2） had one or more risk factors. RESULTS： The median age was similar in both groups, but there were disproportionate numbers of younger （〈 30 years old）, older （〉 80 years） patients, women （33% vs 18%）, and Caucasians （81% vs 52%） in group 1 as compared to group 2. There were fewer Asians （2% vs 11%） and African Americans （13% vs 27%） in group 1. Abdominal pain （70% vs 37%） was more common while gastrointestinal bleeding （0% vs 11%） and ascites （4% vs17%） were less common in group i compared to group 2. Group 1 had larger tumor burden （median size 9.4 cm vs 5.7 cm） at the time of presentation, but there were no differences in the site （right, left or bilateral lesions）, or number of tumors between the two groups. CONCLUSION： HCC patients without identifiable risk factors have different characteristics and clinical presentation compared to those with known risk *** of cirrhosis and larger tumor burden may explain the differences in the presenting symptoms.

关键词： Hepatocellular carcinoma Patient charaocteristics Risk factors

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肝门部胆管癌的诊断、治疗选择与处理策略

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中国普通外科杂志 2014年第8期23卷 1011-1023页

作者： Kevin C.Soares ihab kamel David P.Cosgrove Joseph M.Herman Timothy M.Pawlik 冯铁成李新营美国霍普金斯大学医学院肿瘤外科美国霍普金斯大学医学院放射科美国霍普金斯大学医学院肿瘤科美国霍普金斯大学医学院肿瘤放疗科不详

肝门部胆管癌（HC）是一种少见的疾病,通常在60岁左右发病,预后较差;在美国,每年约有3 000例患者被诊断为该病,但仅有不到一半的人可以行手术治疗;有多种因素与HC的发病有关,最常见的有原发性硬化性胆管炎（PSC）,胆石症以及寄生虫肝病... 详细信息

肝门部胆管癌（HC）是一种少见的疾病,通常在60岁左右发病,预后较差;在美国,每年约有3 000例患者被诊断为该病,但仅有不到一半的人可以行手术治疗;有多种因素与HC的发病有关,最常见的有原发性硬化性胆管炎（PSC）,胆石症以及寄生虫肝病。患者通常表现为腹痛、瘙痒、体质量减轻和黄疸。CT、MRI及超声可以用来发现胆道病损;逆行性胰胆管造影术（ERCP）及经皮肝胆管造影术（PTC）在评估肿块位置、长度的同时还可以行治疗性的胆汁引流。MRCP在辨别肿瘤延伸范围时同PTC及ERCP有相同的准确性,并且并发症较前两者少。HC的治疗方式主要为手术切除、放射治疗、化疗及光动力学治疗。残余肝脏胆汁引流有助于降低胆红素水平,进而促进残肝的生长;标准的治疗包括切缘为阴性切除（R0）,范围为肝外胆管切除、肝切除及周围的淋巴结清扫术;局部的切除术是不适当的;淋巴结侵犯的程度、肿瘤的级别以及切缘的性质是重要的预后指标;如果无法行肿瘤切除,那么在经反复选择后的患者中实施肝移植术也是种可行的方式;尽管数据有限,化疗对于不可切除的患者来说仍有一定的作用;经手术切除的HC患者5年生存率约为10%～40%,然而即使为R0切除,复发率也高达50%～70%。由于这种疾病的复杂性,多种学科的综合治疗是较为理想的治疗方式。

关键词：胆管肿瘤诊断胆管肿瘤治疗 Klatskin肿瘤

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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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胰腺偶发囊肿的管理--美国放射学院(ACR)偶发病变委员会白皮书

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放射学实践 2018年第2期33卷 123-133页

作者： Alec J.Megibow Mark E.Baker Desiree E.Morgan ihab R.kamel Dushyant V.Sahani Elliot Newman William R.Brugge Lincoln L.Berland Pari V.Pandharipande 赵心明曾蒙苏薛华丹刘再毅石喻不详中国医学科学院肿瘤医院影像诊断科北京复旦大学附属中山医院放射科上海北京协和医院放射科北京广东省人民医院放射科广州中国医科大学附属盛京医院放射科沈阳

美国放射学院(American College of Radiology,ACR)偶发病变委员会(Incidental Findings Committee,IFC)发布了CT或MR偶发胰腺囊肿的管理建议。该建议是对美国放射学院杂志(JACR)2010年发布的肾上腺、肾脏、肝脏以及胰腺偶发病变管理白... 详细信息

美国放射学院(American College of Radiology,ACR)偶发病变委员会(Incidental Findings Committee,IFC)发布了CT或MR偶发胰腺囊肿的管理建议。该建议是对美国放射学院杂志(JACR)2010年发布的肾上腺、肾脏、肝脏以及胰腺偶发病变管理白皮书中胰腺部分的更新。该管理方案由多位腹部影像医师、1位胃肠道学医师以及1位胰腺外科医师所组成的胰腺亚组委员会制定。该方案参考已发表的文献和专家意见,经反复协商,最终达成共识。该方案的分支成功地根据患者的临床特点及影像特征将胰腺囊肿进行分类,评估终点为良性和/或进展缓慢病变的诊断(足以结束随访)或具体的管理建议。该方案适用于大多数但非全部的病理及临床情况。该方案旨在通过提供胰腺偶发囊肿的管理指导,来提高患者的管理质量。

关键词：胰腺囊肿导管内乳头状黏液瘤偶发病变

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Levant Drought Occurrence, Lebanon Case

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Atmospheric and Climate Sciences 2024年第1期14卷 118-127页

作者： ihab Jomaa Mariam Choker Nisrine El Haj Marie Therese Abi Saab Matteo Funaro Simone Mereu Department of Irrigation and AgroMeteorology (DIAM) of the Lebanese Agriculture Research Institute (LARI) Tal Amara Lebanon Climate and Water Unit Lebanese Agricultural Research Institute Fanar Lebanon CMCC—Centro Euro-Mediterraneo sui Cambiamenti Climatici IAFES Division Sassari Italy

Rainfall data is probably one of the longest-recorded climatic parameters in Lebanon. On the central coast of Lebanon, the Beirut weather station started collecting rainfall data in 1876. However, the recorded data is not available at one data provider source. Published data is found in historical documents but it reaches the early 1970s and then appears a data gap till 1990. Still the data is available, but it might be found to be saved privately. This study investigated the SPI variability on annual time scale between the years 1876 and 2021. The SPI was computed using R-Stat software to compare every year between 1876 and 2021. The majority (about 70% of the years) of the years are near normal in the precipitation rate. The Standardized Precipitation Index (SPI) demonstrated a normal distribution of years. Dry and wet years constitute about 15% of the total 146 years (1876-2021). Extremely dry years might appear in two consecutive years between 50 to 60 years count. After 1991, there were no wet years it was only near normal and few dry years. The last 30 years showed a trend of increasing drought years without any occurrence of wet years. This study demonstrated the importance of keeping records of at least rainfall data and it must be recorded on a daily basis or intensity on time. It is highly important on a managerial basis and for water security reasons to understand the drought event occurrence and investigate the changes in rainfall rates. Climate change scenarios always forecast a decrease in rainfall rates which will not appear without such studies.

关键词： Climate Change Standardized Precipitation Index (SPI) Beirut Rainfall Gag-es

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NIBU: a new approach to representing and analysing interior utility networks within 3D geo-information systems

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International Journal of Digital Earth 2012年第1期5卷 22-42页

作者： ihab Hamzi Hijazi Manfred Ehlers Sisi Zlatanova Institute for Geoinformatics and Remote SensingIGF University of OsnabrueckOsnabrueckGermany OTB Research Institute for HousingUrban and Mobility StudiesDelft University of TechnologyDelftThe Netherlands

Facility management departments’responsibilities include monitoring and maintenance of building infrastructure,such as water,gas or *** often these tasks are completed using paper maps,which make integrated analysis of networks *** to consider interior network structure and provide semantic and connectivity information supporting the required analysis operations are thus *** paper presents an approach relying on Building Information Model(BIM)as a data source for obtaining information about interior *** semantic and connectivity information of BIM is mapped onto a new model called Network for Interior Building Utilities(NIBU).NIBU is based on the semantic categorisation of utilities,and the spatial functions that have to be *** scenarios(‘maintenance operation’,‘emergency response’and‘inspection operation’)are developed to test the proposed *** model and its functions are implemented in spatial *** model is populated directly from a BIM server applying an Industrial Foundation Class(IFC)parser developed *** analysis functions are implemented to support spatial operations:trace upstream,trace downstream,find ancestors,find source and find *** investigation proves that BIM provides both the required semantics and attributes,and connectivity information that can facilitate analysis of interior utility *** provides a simple yet flexible way to manage interior network information,which can be integrated into Digital Earth.

关键词： building information model(BIM) building service system graph spatial DBMS utility network industrial foundation class(IFC)

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NIBU:An Integrated Framework for Representing the Relation Among Building Structure and Interior Utilities in Micro-Scale Environment

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Geo-Spatial Information Science 2011年第2期14卷 98-108页

作者： ihab HIJAZI Sisi ZLATANOVA Manfred EHLERS Institute for Geoinformatics and Remote Sensing (IGF) University of Osnabrueck OTB Research Institute for HousingUrban and Mobility Studies Delft University of Technology

This paper describes a framework for modeling interdependencies between different network systems and building *** provides an approach for the integrated analysis of interior building utilities by describing a framework to model and simulate infrastructure interdependencies and their complex *** is a graph-based spatial model that can support use cases such as providing the location and specifications of interior utilities to a technician who wants to perform a maintenance *** location could be needed for maintenance or replacement,or to investigate the result of damage to the building structure on another utility network,or to estimate the effect of different maintenance operations in different locations along utilities service *** model accounts for two important aspects:first,the relationship between interior utilities and building elements or spaces and second,the building hierarchy structure to which the utilities network is related.A proper hierarchy of the building is developed which supports the generation of human-oriented descriptions of interior utilities,where a method for partitions of large building element and spaces as well as a method to reference a network element to another building are *** connection of the different utilities network systems and buildings are generated using joints,which are based on a containment *** example is presented which shows the effectiveness of this approach for supporting maintenance operations,as well as the independences between the maintenance operation location and the other network *** paper presents the data model and explains the links with current 3D building model standards.

关键词： Building Information Model (BIM) building service system utility network graph city models

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