Management of Breast Cancer by Skin-Reducing Mastectomy and Immediate Breast Reconstruction by Prepectoral Implant Approach with Polypropylene Mesh for Patients with Large Breasts.

Objective: To assess the feasibility and outcomes of immediate breast reconstruction using a dermal sling and polypropylene mesh for fixation after skin-reducing mastectomy with prepectoral prosthesis placement in patients with large breasts who were diagnosed with cancer.

Methods: This retrospective study included demographic and clinical data from female patients with breast cancer and large breasts, who were candidates for skin-reducing mastectomy and immediate reconstruction. Data regarding operative technique, implant size, operative duration, and intraoperative complications were retrieved.

Bone demineralization in a cohort of Egyptian pediatric liver transplant recipients: Single center pilot study.

Liver transplantation (LT) is the definitive treatment of end-stage liver disease. The long-term survival following LT spurred more interest in improving the quality of life of patients. This was a cohort study that included 23 pediatric liver transplant recipients who underwent LT due to hereditary or metabolic liver diseases.

Combined liver-kidney transplantation for primary hyperoxaluria type I in children: Single Center Experience.

Primary hyperoxalurias are rare inborn errors of metabolism with deficiency of hepatic enzymes that lead to excessive urinary oxalate excretion and overproduction of oxalate which is deposited in various organs. Hyperoxaluria results in serious morbid-ity, end stage kidney disease (ESKD), and mortality if left untreated. Combined liver kidney transplantation (CLKT) is recognized as a management of ESKD for children with hyperoxaluria type 1 (PH1).

Pulmonary hypertension and cardiac hypertrophy in children recipients of orthotopic living related liver transplantation.

Surgical stress, liberation of cytokines associated with re-perfusion injury, and long standing use of immune suppressive medications in children recipients of orthotopic living related liver transplantation (OLRLT) pose cardiovascular risk. Reported cardiovascular adverse effects vary from left ventricular wall thickening, hypertrophic cardiomyopathy to resting ECG abnormalities, asymptomatic ST depression following increased heart rate and ventricular arrhythmias. Twenty-five consecutive children recipients of OLRLT were assessed by conventional 2-D, M-mode echocardiography and Doppler.

Technique for Minimizing Donor-site Morbidity after Pedicled TRAM-Flap Breast Reconstruction: Outcomes by a Single Surgeon's Experience.

Background: Breast reconstruction with pedicled transverse rectus abdominis myocutaneous (TRAM) flap can result in significant abdominal wall donor-site morbidity. We present our technique of transversely dividing the anterior fascia and rectus abdominis combined with reinforcement above the arcuate line for closure of the anterior abdominal wall defect to prevent contour deformities performed by a single senior surgeon and compare these results with those of our prior series.

Methods: We described our new technique of closure of the abdominal wall defect and retrospectively performed the comparison between the results of pedicled TRAM flaps using the new closure technique and those of 420 pedicled TRAM flaps from our 2003 publication in terms of abdominal bulging and hernia.

Evaluation of Lipofilling Safety in Elderly Patients with Breast Cancer.

Background: Lipofilling is widely used in breast reconstruction after mastectomy with reconstruction or breast conserving surgery in patients with breast cancer. The aim of this study is focused on complications associated with lipofilling in elderly breast cancer patients with breast defects after breast conserving surgery or reconstruction.

Methods: A total of 137 patients older than 60 years who underwent 153 lipofilling procedures were included.

Therapeutic superiority of combined propranolol with short steroids course over propranolol monotherapy in infantile hemangioma.

Unlabelled: Infantile hemangiomas are the most common benign childhood tumor that may have functional and/or cosmetic complications. We aimed to compare the clinical efficacy of propranolol alone and propranolol primed with systemic corticosteroids on the outcome of infantile hemangioma. A prospective randomized study included 40 infants aged less than 9 months with cutaneous hemangiomas.

Nipple sparing mastectomy: does breast morphological factor related to necrotic complications?

Background: Nipple sparing mastectomy (NSM) can be performed for prophylactic mastectomy and the treatment of selected breast cancer with oncologic safety. The risk of skin and nipple necrosis is a frequent complication of NSM procedure, and it is usually related to surgical technique. However, the role of the breast morphology should be also investigated.

Free nipple graft technique to correct nipple and areola malposition after breast procedures.

Secondary correction of nipple areola complex (NAC) malposition represents a major concern after breast reconstructive procedures. It is frequently requested by patients complaining about asymmetric areolas impairing the whole reconstructive procedure and asking for improved cosmetic outcomes. Several methods have been described to achieve a good symmetry between the 2 areolas, either natural or reconstructed.

Non-surgical treatment of early breast cancer: techniques on the way.

Trials are still on the way to evaluate different non-surgical techniques to treat early breast cancer with achieving maximum oncological control and aesthetic outcome. Also these techniques can help old patients to bypass surgical and radiation complications and facilitate the treatment of early breast cancer with minimum side effects.

Oncoplastic technique in breast conservative surgery for locally advanced breast cancer.

Locally advanced breast cancer (LABC) should be taken into decision making when planning breast conservative surgery, but this procedure should be done on the principle of oncologic safety in order to achieve negative surgical margin and maintain aesthetic result. This procedure should be offered as the choice of treatment in selected patients.

Immediate breast reconstruction: does the pathology affect the reconstruction?

Immediate breast reconstruction is related to many factors like type of mastectomy, desire of the patient but pathology is not included which should be encountered in decision making in immediate breast reconstruction.

Topical mitomycin C application is effective in management of localized caustic esophageal stricture: a double-blinded, randomized, placebo-controlled trial.

Background: Frequent sessions of endoscopic dilatation are usually required in the management of benign esophageal strictures, especially caustic induced ones. Topical mitomycin C (MMC) has been recently used in the management of resistant strictures. This study evaluated the efficacy of MMC application in prevention of stricture recurrence after endoscopic dilatation.

Lipofilling in breast cancer surgery.

Recently, lipofilling is being performed either as a part of oncoplastic technique or alone by itself for correction of defects and asymmetry after oncologic breast cancer surgery. Its efficacy, safety and technical procedures are varying among institutions and individual surgeon's experiences. We provide a literature review and view point focus on this novel technique which emphasize on the application on breast cancer reconstruction.

Liver transplantation in an African setting.

Liver disease in children in the developing world is a frequent occurrence, which is generally inadequately managed because of lack of resources. However, increasingly, there has been a demand for liver transplantation, where primary medical or surgical therapies have failed. The expertise and infrastructure required for a successful outcome are no different from those in more developed countries; if anything, the challenges are greater.

Intra-abdominal testis: histological alterations and significance of biopsy.

Purpose: Intra-abdominal testes represent only 5% of undescended testes. Review of the literature reveals that few data exist on the histological analysis of intra-abdominal testes. We studied histological alterations in intra-abdominal testes in relation to patient age at orchiopexy.

Biliary complications including single-donor mortality: experience of 207 adult-to-adult living donor liver transplantations with right liver grafts.

Background: After right lobe donation, biliary complication is the main cause of morbidity. Mortality after right lobe donation has been estimated to be less than 0.5%.

The safety of modern hydroxyethyl starch in living donor liver transplantation: a comparison with human albumin.

Background: Intravascular volume replacement therapy is an important issue in the perioperative management of liver transplantation. There is paucity of data on the safety of hydroxyethyl starch (HES) in patients undergoing liver transplantation. We evaluated the safety of a new HES 130/0.

Colonic replacement in cases of esophageal atresia.

Replacement of the esophagus in children is still a challenging problem; one of the major indications is failed esophageal atresia repair or long-gap ones. The colon is one of the best alternatives for replacement; long-term follow up has shown satisfactory results. In cases of complicated repair receiving frequent dilation and multiple operations, colon could be an alternative choice for these children to achieve normal swallowing.

Enhancement of dissolution amount and in vivo bioavailability of itraconazole by complexation with beta-cyclodextrin using supercritical carbon dioxide.

The main objective of this study was to improve the inclusion formation between itraconazole and beta-cyclodextrin and thus enhance dissolution amount and bioavailability characteristics of itraconazole. Inclusion complexes between itraconazole and beta-cyclodextrin were prepared using simple physical mixing, conventional coprecipitation method, and supercritical carbon dioxide (SC CO(2)). Effects of process variables (temperature, pressure) and drug:cyclodextrin ratio on inclusion yield and thermal behavior of the solid complexes prepared by SC CO(2) were studied and compared to those obtained by physical mixing and coprecipitation methods.

Congenital esophageal stenosis associated with esophageal atresia: new concepts.

Congenital esophageal stenosis (CES) is suspected by a fixed intrinsic narrowing of the esophagus that affects the normal swallowing mechanism. The diagnosis is only confirmed by histopathologic picture, which may show fibromuscular disease (FMD) or tracheobronchial remnants (TBR). The latter involves ciliated pseudo stratified columnar epithelium, seromucous glands or cartilage each alone or in combination.

Evolution of living donor liver transplantation in Egypt.

Objective: To date, cadaveric organ donation is illegal in Egypt. Therefore, Egypt recently introduced living donor liver transplantation (LDLT), aiming to save those who are suffering from end stage liver disease. Herein, we study the evolution of LDLT in Egypt.

Oxidative stress mediates drug-induced hepatotoxicity in rats: a possible role of DNA fragmentation.

Sodium diethyldithiocarbamate, diclofenac and ketoconazol are three important chemotherapeutic agents that are commonly associated with hepatotoxicity. This study was undertaken to provide a better understanding of the mechanism through which these drugs induce hepatotoxicity. Some of the possible mechanisms underlying such modulation were investigated.

Caustic esophageal strictures in children: 30 years' experience.

Many children in developing countries continue to sustain caustic esophageal injures. The first line of treatment is dilatation, unless contraindicated, where 60% to 80% success rate is expected. In cases of failure, esophageal replacement is the only hope for achieving normal swallowing.