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Cartilage tympanoplasty in the treatment of adhesive otitis media with and without Eustachian tube balloon dilatation

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Journal of Otology 2022年第4期17卷 226-231页

作者： Ahmed abdel rahman abdel aziz Ahmed Mahmoud Youssef mostafa Mohamed mostafa mostafa talaat Khaled Mohamed Abdelzaher Ahmed Adel Sadeq Department of Otorhinolaryngology Faculty of MedicineEl MiniaEgypt Radiology Department Faculty of MedicineEl MiniaEgypt

Purpose:To compare cartilage tympanoplasty(CT)combined with eustachian tube balloon dilatation(ETBD)and cartilage tympanoplasty alone as a surgical treatment modality for adhesive otitis media(AdOM)in terms of graft healing,audiological outcomes,and impact on life style,using Chronic Otitis Media Outcome Test 15(COMOT-15).Methods:50 patients with AdOM were randomly classified into 2 groups:25 patients for cartilage tympanoplasty only(CT group)and 25 patients for cartilage tympanoplasty combined with eustachian tube balloon dilatation(CT t ETBD group).Clinical outcomes in both groups were compared at 3 and 6 months of follow up.Results:There was no significant difference in graft healing between the two groups.Postoperative COMOT-15 scores significantly decreased in both groups with a significant difference between the groups with regard to the decrease in COMOT-15 scores at 3 and 6 months of follow-up(P<0.05).Hearing improvement was achieved,as the mean preoperative ABG was 26.5±5.4 and 27.1±4.6 dB,and the mean postoperative ABG at 6 months was 19.4±4.4 and 14.6±3.9 dB in the CT and the CT t ETBD groups,respectively.The difference in the magnitude of ABG reduction in the two groups was significant at 3 and 6 months of postoperative follow-up(P<0.05)in favour of the CT t ETBD group.Conclusion:ETBD can increase the success rate of cartilage tympanoplasty in patients with AdOM by enhancing the audiological outcome and quality of life.

关键词： balloon healing otitis

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Assessment of heme oxygenase-1 （HO-1） activity in the cavernous tissues of sildenafil citrate-treated rats

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Asian Journal of Andrology 2007年第3期9卷 377-381页

作者： M. talaat Abdel Aziz M. Farid Al-Asmar Taymour mostafa Hazem Atta Laila Rashed Dina Sabry Shedeed Ashour Ahmed T. Abdel Aziz Molecular Biology Unit Medical Biochemistry Department Faculty of Medicine Cairo University Cairo 11553 Egypt Medical Biochemistry Department Faculty of Medicine Ain Shams University Cairo Egypt Andrology Department Faculty of Medicine Cairo University Cairo 11553 Egypt

Aim： To assess heine oxygenase-1 （HO-1） activity in the cavemous tissue of sildenafil citrate-treated rats. Methods： One hundred and ninety-two Sprague-Dawley male rats, divided into four equal groups, were investigated. Group 1, the control group, received regular animal chow; group 2 received sildenafil citrate by intragastric tube; group 3 received sildenafil and HO inhibitor （zinc protoporphyrin, ZnPP）; and group 4 received sildenafil and nitric oxide synthase （NOS） inhibitor L-nitroarginine methyl ester （L-NAME）. Twelve rats from each group were killed after 0.5 h, 1 h, 2 h and 3 h of drug administration. Then HO-1 activity, cGMP levels and NOS enzymatic activity in the cavernous tissues were estimated. Results： In cavemous tissue, HO-1 activity, NOS enzymatic activity and cGMP concentration increased significantly in sildenafil-treated rats compared to other groups throughout the experiment. Rats receiving either HO or NOS inhibitors showed a significant decrease in these parameters. HO- 1 cavemous tissue activity and NOS enzymatic activity demonstrated a positive significant correlation with cGMP levels （r = 0.646, r = 0.612 respectively; P 〈 0.001）. Conclusion： The actions of PDE5 inhibitor sildenafil citrate in the cavernous tissue are partly mediated through the interdependent relationship between both HO-1 and NOS activities.

关键词： erectile dysfunction heme oxygenase sildenafil citrate nitric oxide synthase carbon monoxide

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Trends and outcomes of pancreaticoduodenectomy for periampullary tumors: A 25-year single-center study of 1000 consecutive cases

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World Journal of Gastroenterology 2017年第38期23卷 7025-7036页

作者： ayman el nakeeb waleed askar ehab atef ehab el hanafy ahmad m sultan tarek salah ahmed shehta mohamed el sorogy emad hamdy mohamed el hemly ahmed a el-geidi tharwat kandil mohamed el shobari talaat abd allah amgad fouad mostafa abu zeid ahmed abu el eneen nabil gad el-hak gamal el ebidy omar fathy ahmed sultan mohamed abdel wahab gastroenterology surgical center mansoura university

AIM To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(PDs) for periampullary tumors.METHODS This is a retrospective review of the data of all patients who underwent PD for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period(1993-2002), middle period(2003-2012), and late period(2013-2017).RESULTS The frequency showed PD was increasingly performed after the year 2000. With time, elderly, cirrhotic and obese patients, as well as patients with uncinate process carcinoma and borderline tumor were increasingly selected for PD. The median operative time and postoperative hospital stay decreased significantly over the periods. Hospital mortality declined significantly, from 6.6% to 3.1%. Postoperative complications significantly decreased, from 40% to 27.9%. There was significant decrease in postoperative pancreatic fistula in the second 10 years, from 15% to 12.7%. There was a significant improvement in median survival and overall survival among the periods.CONCLUSION Surgical results of PD significantly improved, with mortality rate nearly reaching 3%. Pancreatic reconstruction following PD is still debatable. The survival rate was also improved but the rate of recurrence is still high, at 36.9%.

关键词： Pancreaticoduodenectomy Pancreaticogastrostomy Pancreaticojejunostomy 手术后的胰腺的管 Periampullary 肿瘤

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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 cirrhosis.METHODS:We studied retrospectively all patients who underwent PD in our centre between January 2002and December 2011.Group A comprised patients with cirrhotic livers,and Group B comprised patients with non-cirrhotic livers.The cirrhotic patients had ChildPugh classes A and B(patient’s score less than 8).Preoperative demographic data,intra-operative data and postoperative details were collected.The primary outcome measure was hospital mortality rate.Secondary outcomes analysed included duration of the operation,postoperative hospital stay,postoperative morbidity and survival rate.RESULTS:Only 67/442 patients(15.2%)had cirrhotic livers.Intraoperative 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 patients.Postoperative stay was significantly longer in group A(P=0.03).The median survival was 19 mo in group A and 24 mo in group B.Portal 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 PHT.CONCLUSION: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 cirrhosis.PD 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

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