Surgical treatment of a presacral schwannoma: A case report.

Introduction And Importance: Schwannomas are rare benign tumors that develop from Schwann cells that represent 0.3 to 0.4 cases per 100,000 persons per year.

Atypical anti-NMDA receptor encephalitis associated with varicella zoster virus infection.

The triggering effect of herpes simplex virus infection on the development of anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is now well established. However, there are very few reports that has linked a varicella zoster virus (VZV) reactivation with anti-NMDAR encephalitis. In this report, we describe a case of a 57-year-old man presented with atypical clinical presentation of anti-NMDAR encephalitis with gait ataxia, complete ophtalmoplegia, and abolished reflexes followed by drowsiness and confusion.

Identifying Leukemia-associated Immunophenotypes in Acute Myeloid Leukemia Patients Using Multiparameter Flow Cytometry.

Objectives: We sought to identify leukemia-associated immunophenotypes (LAIPs) in 50 acute myeloid leukemia (AML) patients at diagnosis using an eight-color multiparameter flow cytometry (MFC) panel and to detect if they showed any alteration in relapsed/refractory cases.

Methods: We used the eight-color MFC panel with CD45/side scatter log gating strategy to analyze LAIPs in 50 AML patients presenting to Alexandria University Hospitals, Egypt at diagnosis and relapse and refractory cases. Twenty age and sex matched bone marrow samples from patients performing bone marrow aspirate for non-malignant hematological indications were included as controls.

The prognostic impact of loss of chromosome 7 material detected by fluorescence in situ hybridization (FISH) in myeloid malignancies.

Background: Monosomy 7 (-7) or deletion in its long arm [del(7q)] is among the most common chromosomal abnormalities in myeloid malignancies. There are prognostic variations between -7 and del(7q) in acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS).

Aim: To describe the clinical characteristics, response to treatment, and survival of patients with primary AML and MDS having -7 or del(7q) detected by fluorescence in situ hybridization (FISH).

Human leucocyte antigen alloimmunisation in repeatedly transfused thalassemic Egyptian children and its relation to febrile non-haemolytic transfusion reactions.

Objectives: To document the incidence of lymphocytotoxic antibodies (LCA) in chronically transfused children with β thalassemia major and the relationship between alloimmunisation and febrile non-haemolytic transfusion reactions. We also compared the effect of leucoreduced-packed red blood cells (RBCs) by bed-side filtration and washed RBCs in preventing FNHTRs and in inducing haemoglobin rise.

Background: Alloimmunisation to human leucocytic antigens is one of the common complications of transfusions, particularly in chronically transfused patients as those with thalassemia major, a common disease in Northern Egypt.

Wilson's disease: appreciable improvement of sub-cortical white matter abnormalities after copper chelating treatment: five years follow-up.

Severe sub-cortical white matter abnormalities are unusual features in Wilson's disease and are reported to be poorly or not responsive to copper chelating therapy or to be worsened by it. We report on a 12-year-old boy with Wilson's disease and extensive sub-cortical white matter involvement. After five years of copper chelating therapy, an appreciable improvement of these lesions was obtained.

Telomerase activity in Philadelphia positive chronic myeloid leukaemia.

Telomerase is a specialized type of reverse transcriptase that catalyzes the synthesis and extension of telomeric DNA. Activation of telomerase and stabilization of telomeres are considered necessary for immortalization of tumor cells. Chronic Myeloid Leukaemia (CML) is a good example to investigate the reactivation of telomerase as; after a variable period in chronic phase, CML undergoes further evolution.

A novel gene, FGA7, is fused to RUNX1/AML1 in a t(4;21)(q28;q22) in a patient with T-cell acute lymphoblastic leukemia.

AML1 is among the most frequent targets of chromosomal rearrangements in human leukemias. We report here the molecular analysis of a t(4;21)(q28;q22) that has disrupted AML1 in a patient with de novo T-cell acute lymphoblastic leukemia. By using 3'-RACE analysis, we show that this rearrangement results in the fusion of a novel gene immediately downstream of exon 5 or exon 6 of AML1, indicating that the AML1 breakpoint lies in intron 6 and that alternative fusion splice variants are generated.

A new translocation that rearranges the AML1 gene in a patient with T-cell acute lymphoblastic leukemia.

The AML1 gene (also known as RUNX1 or CBFA2), located in chromosome band 21q22, encodes a transcription factor which heterodimerizes with the CBFbeta protein forming a complex called human core binding factor (CBF). The CBF complex appears to regulate a number of genes important for hematopoiesis. AML1 is one of the most common targets of chromosomal rearrangements in human leukemias and has been involved in 14 chromosomal translocations to date.

AML1 gene over-expression in childhood acute lymphoblastic leukemia.

The present study was conducted on a series of 41 Egyptian children with newly diagnosed acute lymphoblastic leukemia (ALL) to investigate TEL and AML1 abnormalities. The TEL-AML1 fusion was observed in six patients both by RT-PCR and FISH analyses, with a frequency of 22.2% among the B-lineage group, whereas TEL deletion was seen by FISH analysis in seven patients (17.

Patterns of systolic stress distribution on mitral valve anterior leaflet chordal apparatus. A structural mechanical theoretical analysis.

Increasing diffusion and complexity of mitral valve repair procedures may prompt an interest in the evaluation of the patterns of stress distribution on the chords, which are, from the structural mechanical point of view, the weakest element of valve apparatus. This theoretical analysis concentrates in particular on the mitral valve anterior leaflet. As is known, the vast majority of the chordae are attached to the anterior leaflet within the coaptation area; during systole they are then necessarily parallel, aligned along the same plane as that of the leaflets' coaptation surface, to which they are attached; moreover the thickness of the chordae increases significantly from the marginal chordae to the more central ones.

[Partial resection of the tracheal wall and introverting tracheoplasty].

A tracheal tumor involving roughly the half circumference of the tracheal wall and 3.5 cm length, was resected preserving the part of the tracheal cylinder not invaded by the tumor; reconstruction was carried out by an introverting tracheoplasty. This reconstruction technique, already successfully carried out in main bronchus resections, allowed iuxtapositioning of the tracheal rims very firmly without tension, the maneuvers for laryngeal or carenal release being not necessary.

[Longitudinal bronchotomy on the pars membranacea for endoscopic foreign body extraction].

Purpose of this paper is to report a case of foreign body obstructing the middle lobe bronchial origin, surgically removed through a longitudinal bronchotomy on the pars membranacea, reached by passing posteriorly to the lung. Anatomical considerations suggest that longitudinal bronchotomy on the pars membranacea of the main bronchial axis (stem bronchi, intermedius br (right), and lower lobar bronchus) gives direct visualization from inside also of foreign bodies sited into the lobar bronchi (sup, middle and lingula), allowing an easy bronchotomy repair, without lumen distortion or stenosis. Since the pulmonary artery is not in contact with this pars membranacea, broncho-arterial fistula in case of suture line dehiscence is quite improbable.

Internal mammary blood supply for ileo-colon interposition in esophagogastroplasty: a case report.

We report on a clinical case where microsurgical techniques successfully supported traditional surgery in a wide reconstruction between the oropharynx and small bowel. Several years ago, the patient sustained a severe corrosive injury of the upper digestive tract with subsequent esophageal stricture and stiffening; at that time, an emergency gastrectomy was performed. In this case, the restoration of the defect could not rely on the classic colonic interposition.

[A device for synthesis of the costal plane after posterolateral thoracotomy using transosseous incisions to prevent compression of intercostal nerves].

The purpose of this paper is to illustrate the use of a device to quickly perform little holes in the costal lateral arch for synthesis of the standard posterolateral thoracotomy. The working principle of the instrument is similar to that of a hollow punch device. Preliminary laboratory experience allowed to identify the best diameter of the costal holes (2 mm), without fracture.

[Invaginated bronchoplasty: wedge resection and sleeve reconstruction].

The purpose of this report is to illustrate a bronchoplastic technique in upper right lobectomy which is equivalent to sleeve resection but allows to preserve the unaffected portion of the bronchial wall. The technique consists in the resection of the infiltrated bronchial wall, sparing the unaffected part The distal bronchial stump is then invaginated into the stem bronchus in such a way that the anastomosis line is located at the highest possible level, ideally where it would be carried out if standard sleeve resection would be performed. The anastomosis is accomplished by U-Shaped, 3-0 vicryl sutures.

Expandable prosthesis for sutureless anastomosis in thoracic aorta prosthetic substitution.

Objective: Most complications of descending aorta prosthetic substitution seem mainly to be related directly (ischemia to distal organs, i.e. liver, kidney, spinal cord) or indirectly (extracorporeal circulation or shunts and systemic heparinization complications) to the duration of blood flow interruption.

Aortic wall structural strengthening by intraluminal net prosthesis to arrest aneurysm progression and to prevent dissection and rupture.

The major limitation implicit in the endovascular procedures for aortic prosthetic substitution is that they cannot be used in those tracts of the aorta where important collateral branches originate (aortic arch, thoraco-abdominal tract, upper abdominal), that would be occluded by the prosthesis. In order to overcome this limitation we hypothesized the endovascular positioning of a prosthesis in the form of a wide mesh network that would be gradually and spontaneously covered by new intima and included in the aortic wall. The fabric framework linked to the aortic wall would then condition its significant, regular and uniform mechanical strengthening that fractionates and partially absorbs the centrifuge pulsatile stress of the bloodstream.

[Postoperative infections. A prospective analysis of 1396 cases].

Postoperative infections are the most frequent complications in surgery and are the commonest cause of the lengthening of hospital stay. The purpose of this study is to prospectively evaluate the incidence and predisposing factors of postoperative infections in 1396 surgical patients admitted to our Institute from 1984 to 1988. Patients undergoing minor surgical procedures (wound less than 2 cm) were excluded from the study.