Objectives

Our aim was to evaluate the efficacy of MR Spectroscopy in characterization of white matter signal abnormalities diagnosed by MRI detect changes in different metabolites and peaks of inflammation.

Patients and methods

93 patients (49 females and 44 males) age ranging from 2 to 63 years with average (37 ± 2.34 years) presented with white matter hyperintense lesions on T2 and T2 FLAIR and/or contrast enhanced T1WI diagnosed on MRI are included our study.

Results

In Infectious group: Average Cho/NAA ratio: 0.79 ± 0.19, Cho/Cr ratio: 0.95 ± 0.17, NAA/Cr 1.89 ± 0.69, in inflammatory group Cho/NAA ratio: 0.65 ± 0.15, Cho/Cr ratio: 0.98 ± 0.29, Average NAA/Cr ratio 1.69 ± 0.19. In ischemic group: Average Cho/NAA ratio: 0.83 ± 0.09, Cho/Cr ratio: 0.81 ± 0.23, Average NAA/Cr 1.54 ± 0.39, in metabolic group: Average Cho/NAA ratio: 0.57 ± 0.13, Cho/Cr ratio: 0.76 ± 0.26; NAA/Cr ratio was 1.73 ± 0.44, in mitochondrial group, Average Cho/NAA ratio: 0.62 ± 0.19, Cho/Cr ratio: 0.54 ± 0.14, NAA/Cr ratio was 1.49 ± 0.59, in inherited dysmyelinating; Cho/NAA ratio: 0.51 ± 0.17, Cho/Cr ratio: 0.63 ± 0.13; Average NAA/Cr ratio was 1.87 ± 0.65. Glutamate and myoinositol peak raised in inflammatory, infectious, metabolic, inherited, and ischemic group mainly in the acute and subacute stage. Amino acids and succinate peak specifically are raised in brain abscesses.

Conclusion

MRS is a noninvasive additional MRI technique to define the nature of non-neoplastic brain lesions. Together with image analysis, it may be the key to etiologic diagnosis or, at least, definition of the group where the lesion is classified, by detecting changes in different metabolites and peaks of inflammation.

Objective

To detect the value of MSCTA in diagnosis and preplanning in endovascular management of adult thoracic and abdominal coarctation. The additional value of conventional angiography before or during the procedures is explained. The follow-up by either techniques is evaluated for early detection of re-coarctation and re-intervention.

Patients and methods

This retrospective study included 22 patients, 9 females and 13 males, age ranging from 17 to 49 years. The main clinical presentation was hypertension (n = 15). All patients were evaluated by MSCTA and conventional angiography with pressure gradient studies for preoperative evaluation and planning of treatment. Follow-up MSCTA was done at 6 months interval for 3 years.

Results

MSCTA detected suprarenal MAS (n = 3), infrarenal and juxtarenal MAS (n = 10), pre- and post-coarctation dilatation of the thoracic aorta and subclavian (n = 4), thoracic collateral pathways (n = 5). Mean narrowest diameter is 2.3 mm (1.2–4.5 mm). In conventional angiography peak systolic gradient decreased from 33 to 2 mmHg. Successful endovascular repair was done in n = 15, PTA was done alone in 6 and PTA and stenting were done in n = 9. Endovascular re-intervention was done in n = 3.

Conclusion

Aortic COA could be found in any segment of the aorta. Proper identification of the anatomical details and pressure gradient studies are important factors affecting the plan of management.

Objective

To detect the added value of magnetic resonance arthrography (MRA) over MRI in different triangular fibrocartilage complex (TFCC) and intrinsic wrist ligament lesions.

Patients and methods

MRI and MRA were achieved in 57 patients presented with wrist pain. Another symptompless Ten control individuals with negative MRI and MRA findings were included. Images were assessed for the presence of TFCC, scapholunate ligament (SCL) and lunotriquetral ligament (LTL) lesions. Imaging findings were compared with arthroscopic findings in all cases.

Results

Out of fifty-seven patients, 38 males (66.6%) and 19 females (33.3%) (age range 19–61 years (mean = 34.3 years) were included in the study, The sensitivity, specificity and accuracy of MRI and MRA for TFCC peripheral tears were 79.16%, 100%, 85.29% and 91.66%, 100%, and 94.11% respectively, the sensitivity, specificity and accuracy of MRI and MRA for TFCC central tears were 60%, 100%, 80% and 90%, 100%, and 95% respectively. Sensitivity, specificity and accuracy of MRI and MRA for SCL partial tears were 63.15%, 100%, 75.86% and 94.73%, 100% and 96.55%, respectively. For LTL partial tears, the values were 20%, 100%, 73.33% and 80%, 100%, and 93.33% respectively.

n/a

X-ray diffraction, infrared (IR), and electrical properties for pure and Er (NO3)3-doped methyl-2-hydroxyethyl cellulose (MHEC) with concentrations of 0.5, 1, 2, 5, 7, and 10 wt % were studied. X-ray analysis indicates that the addition of Er (NO3)3, which is a crystalline material, to MHEC at concentrations 10 and 13 wt % leads to the formation of crystalline phases in the amorphous polymeric matrix. The appearance of the bending mode ν2 and the combination mode (ν1 + ν4) of Er (NO3)3 in the IR spectra of composite samples indicates the coordination of nitro group in the chains of MHEC. From the I–V characteristics, it was found that the charge transport mechanism in MHEC appears to be essentially space charge limited conduction, while the predominant mechanism in the composite samples is Poole–Frenkel. Values of both drift mobility (μ) and the charge carrier density (n) has been reported. The temperature dependence conductivity data has been analyzed in terms of the Arrhenius and Mott's variable range hopping models. Different Mott's parameters such as the density of states, N(EF), hopping distance (R), and average hopping energy (W) have been evaluated.

Planning a combined procedure requires ensuring an optimal fill of the reduced breast skin envelope, which in turn requires a system to quantify skin excess to ensure that the selected implant achieves that optimal fill. This has led us to develop a five-step approach that a surgical team can use to assess patients scheduled to undergo an augmentation mastopexy and arrive at an optimal surgical strategy.

Methods: This retrospective study included 50 consecutive cases where layered mastopexies combined with augmentation mammaplasties were performed. Step 1 entailed a preoperative examination and evaluation of the breasts. In step 2, the breast volume was assessed. The pocket plane was determined in step 3. The choice of which surgical technique to use was done in step 4, and in step 5, the horizontal skin excess was assessed.

Results: The average implant size was 300 cm (range: 170-350 cm). The overall revision rate was 4%: on average, revision surgeries were performed 24 months after the first surgery. The average implant size was 300 cm (range: 170-350 cm).

Conclusions: Early results of single-stage augmentation with mastopexy have shown that the design of this systematic five-step approach demonstrates a great potential for producing reliable results with minimal risk. Using this five-step approach will improve patient and surgeon satisfaction and help to replace the old concept of "fill and re-drape" with a new one of "plan, reduce, fill, and re-drape."

BACKGROUND: Rhinoplasty is one of the most commonly performed aesthetic surgical procedures in plastic surgery, the incidence of which has increased up to approximately 1 million cases in 2016 according to the recent International Society of Aesthetic Plastic Surgery survey. This study aimed at defining the importance of each sequential procedure within the same surgery, the extent to which a procedure can be performed, and those that can be omitted.

METHODS: In this descriptive study, 27 candidates (18 women; nine men; age range, 20-48 years) for primary rhinoplasty between September 2016 and September 2019 were included. All had long noses, their main concern was reduction of nasal tip projection and all were seeking cranial tip rotation to enhance their tip aesthetics. Those who required revision rhinoplasty or who had nasal deformities due to congenital defects, and those older than 60 or younger than 18 years of age, were excluded.

RESULTS: The average nasolabial angle in women preoperatively was 88.2 ± 6.6 and postoperatively 102.8 ± 5.6. In men, the average average nasolabial angle preoperatively was 79.6 ± 5.4 and postoperatively 92.3 ± 2.3. In both men and women, the value was <0.001, which indicates high significance. Tip rotation was achieved in all patients, with 81% achieving ideal rotation, and 19% exceeding the ideal range.

CONCLUSIONS: Rotating the tip in long noses is a complex procedure. It can be achieved by many described techniques, but not all are required. A general strategy should be followed during which variable techniques, with varying efficacy, can be utilized.

Objective: To evaluate serum anti-C1q antibodies as a biomarker of systemic lupus erythematosus (SLE) flare and as a proposed noninvasive alternative to renal biopsy which is still the “gold standard” to determine renal activity in SLE.Methods: Serum anti-C1q antibodies were measured in our patients (all were females), they were followed at the nephrology and pediatric nephrology units at the Faculties of Medicine of Cairo University and Misr University for science and technology (MUST). Our study included 120 patients in the pediatric and adolescent age group and they were categorized into three groups with (mean ± SD of 16.7 ± 3, 16.1 ± 2, 15.9 ± 3) respectively: Group 1 including 40 patients with SLE and active lupus nephritis; Group 2 including 40 patients with SLE and without active lupus nephritis, but with some extra renal activity mainly arthritis; and Group 3 including 40 healthy subjects.Results: Anti-C1q antibodies were found to be significantly higher in patients with active lupus nephritis than those without active nephritis than control individuals with a median (range) of [27.5 (14 – 83), 9 (2.5 – 30), 7 (2 – 13)] respectively. In those with active lupus nephritis, anti-C1q was found to correlate significantly with other parameters assessing lupus nephritis activity like C3 (r = -0.33, p < 0.04), C4 (r = -0.32, p < 0.044), daily urinary protein excretion (r = 0.32, p < 0.036), renal SLEDAI (r = 0.64, p < 0.001), and activity index (r = 0.71, p < 0.001).Conclusions: Anti-C1q antibodies can be used as a considerable marker for LN activity in that age group with 97.5% sensitivity and 65% specificity with the cutoff level 12 U/l. These levels are clearly higher than those for traditional markers of disease activity such as C3/C4 consumption and anti-dsDNA.

Background:
Hepatocellular carcinoma (HCC) ranks as 5th most common cancer. Chronic infection by hepatitis viruses especially HBV and HCV lead to complicated microenvironment which may lead to hepatocarcinogenesis. Lnc RNAs and serum Amyloid A (SAA) have been suggested to have role in tumorogenesis and progression. In this work we investigated the role of lnc RNA AF085935 and SAA as a diagnostic biomarkers in sera of HBV, HCV, HCC patients.
Subjects and Methods: RT-PCR technique was used to assess Lnc RNA AF085935 quantitative expression and ELISA technique was used to detect expression level of SAA at sera of 149 adult Egyptian subjects. They were divided as 35 HCC patients on top of HCV and 24 HCC patients on top of HBV, 35 patients with HBV and 35 patients with HCV and 20 healthy donors.
Results: The level of LncRNA-AF085935 and SAA were high significantly upregulated in HCC patients, HCV patients and HBV patients compared with that in normal controls (p value = <0.001). In addition, higher expressions of Lnc RNA-AF085935 and SAA were observed in HCC patients than in HCV and HBV patients. SAA showed a relatively high accuracy for HCC screening (area under the curve (AUC) = 0.927, 95 % confidence interval (CI) = 0.858-0.997) to be differentiated from normal control. LncRNA-AF085935 showed a relatively higher accuracy for HCC screening ( AUC= 0.931, 95 % CI  = 0.862-1.00) than SAA (AUC = 0.74, 95 % CI = 0.587-0.894) from HBV patients.
Conclusion: Lnc RNA-AF085935 and SAA were observed with an aberrant serum level in sera of HCC, HCV and HBV patients. Lnc RNA-AF085935 and/or SAA can be used as potential biomarkers in HCC tumorogenesis.

BACKGROUND: Hair transplantation is the only method available to regrow new hairs; hence, enhancing the results of this procedure using state-of-the-art methods has become mandatory in clinical practice. Recent studies have suggested that significant improvements in hair density and stimulation of hair growth occur when follicular units are pretreated with platelet plasma growth factors before implantation. This study aimed to investigate and compare the outcomes of this procedure using platelet-rich plasma (PRP)-preserved hair grafts and saline-preserved hair grafts.

METHODS: This is a randomized controlled study. The study included 27 men and 3 women aged 22-51 years. Clinical examination (general and local) and preoperative marking were performed in these patients. The surgical technique involved graft extraction, PRP preparation, and hair implantation. Postsurgical patient satisfaction and clinical improvement were evaluated.

RESULTS: There were significant differences between the groups in hair uptake and hair thickness after 1 year follow-up, with value <0.05. Using PRP therapy with follicular unit extraction increases the success of follicular unit extraction hair transplantation. All participants in the PRP group had >75% hair regrowth after 6 months. They had more rapid improvements in hair density and skin recovery than those in the non-PRP group.

CONCLUSION: Preserving hair grafts in PRP before implantation increases the hair density, the graft uptake, and the hair thickness compared with pretreatment preservation of hair grafts in saline.