Recombinant Factor VIIa for The Management of Uncontrollable Bleeding Following The Repair of Acute Type A Aortic Dissection

Background: Bleeding is a serious complication after surgical repair of acute type A aortic dissection. Recombinant factor VIIa (rFVIIa) could be used for the management of severe bleeding; however, it could lead to thromboembolic events. We aimed to report our experience in using rFVIIa in the management of severe bleeding following the surgical repair of acute type A aortic dissection. Methods:  We performed a retrospective study, including patients who had surgery for acute aortic dissection type A and received rFVIIa, in the period between January 2012 and January 2019. We reported the amount of bleeding 4 hours before and after the administration of rFVIIa, the number of blood products transfused before and after the use of rFVIIa, thrombosis of the central venous line, as well as the presence of disseminated intravascular coagulation. Results: There were ten patients (2 females and 8 males) out of 120 patients with acute type A aortic dissection, who required the use of rFVIIa for severe postoperative bleeding. The mean age was 67.7±10.5 years. The amount of drainage decreased from 889±585.6 ml during the 4 hours prior to the infusion, to 165±73.5 ml during the following 4 hours (p<0.001). The patients received 2752±1362.9 ml, and  618±483.3 ml packed RBCs before and after rFVIIa administration, respectively (p< 0.001). The patients received 1601±693.4 and 246±419.6 ml of fresh frozen plasma before and after the use of rFVIIa, respectively (p< 0.001). The prothrombin time decreased after the infusion of rFVIIa (42.7±32 and 17.1±8 seconds, p= 0.001). There were no clinical signs of thromboembolism after its use. Mortality occurred in five patients (50%). Conclusion: In the life-threatening situation of uncontrollable bleeding following surgical repair of type A acute aortic dissection, rFVIIa may have benefits to control bleeding. Furthers studies are recommended

Effect of salinity degree of injected water on oil recovery from carbonate reservoir

32-37Water injection is considered the most successful and widespread secondary recovery method. Low salinity water injections is a well-established and proved technique for water flooding application in sandstone rocks to enhance the recovery efficiency; where the water salinity is adapted to a certain degree to extract the highest amount of oil from a reservoir. Reserve-estimation statistics show the significance of oil reserves in carbonate reservoirs, hence this work deals with the carbonate rocks where water flooding may fail due to many reasons, and the most common one is fractures existence in the carbonate rocks. This work applied the water injection for six carbonate (limestone) core samples from Belayim Formation of Middle Miocene age that extracted from an Egyptian offshore oil field in the Gulf of Suez. This carbonate facies is hard, vuggy, fragmented, dolomitic, and highly saturated with oil and considered a good reservoir. Relative permeability test was carried out to investigate the reservoir response in terms of recovery efficiency hence residual oil saturation, when flooding the reservoir with waters having different salinity ratios. Results showed an increase in recovery efficiency for all the tested samples, on applying the low salinity water injection, where all the relative permeability curves displayed wettability modification/alteration toward water wetness properties

Tricuspid valve repair by DeVega technique versus ring annuloplasty in patients with functional severe tricuspid regurge

AbstractBackgroundRepairing the tricuspid valve in patients undergoing left heart valve surgery is still controversial. Severe Tricuspid regurge is repaired by most surgeons, while moderate regurge is frequently unaddressed. Another controversy is the technique of repair. DeVega technique is widely used; still, the longevity of this repair is still questioned. The risk of its early failure and subsequent recurrence of significant regurge requiring redo surgery has led many surgeons to adopt the use of annuloplasty rings. The aim of our study was to assess the short term results (1 year) of tricuspid repair with or without ring annuloplasty.Patients and methods80 patients who had tricuspid repair concomitantly with mitral valve surgery at Cairo University Hospitals over 5 years were studied by echocardiography at discharge and at 1 year after surgery.Results62 patients had repair using the DeVega annuloplasty (group A) while 18 had ring annuloplasty (group B). The mean age was 33 ± 6 years and 37 ± 8 years for group A and B respectively. The cardiopulmonary bypass (CPB) time was relatively longer in group B. There was only one mortality in group A. Echocardiography done for all patients of both groups at discharge and at 1 year postoperatively showed no significant difference between both groups.ConclusionTricuspid repair using ring annuloplasty has good results but with no significant benefits over DeVega annuloplasty at one year

Histopathology of Corneal Lenticules Obtained from Small Incision Lenticule Extraction (SMILE) versus Microkeratome Excision

Purpose: To study the alterations on the lenticules extracted after femtosecond (Femto) small incision lenticule extraction (SMILE) versus the corneal free cap removed using a microkeratome. Methods: The visuMax (500 kHz; laser energy: 180 nJ) was used for small-incision lenticule extraction. Free caps from human cadaveric corneas were excised by microkeratome. The collected lenticules were examined with the light and transmission electron microscope (TEM) for histological analysis, DNA fragmentation was assessed by agarose gel electrophoresis, DNA damage was evaluated using comet assay, and corneal proteins secondary structure was assessed by Fourier transform infrared spectroscopy (FTIR). Results: Light microscopic examination showed the presence of more edematous stroma under Femto SMILE than under free cap with a percentage change of 101.6%. In the Femto SMILE group, TEM examination showed pyknotic keratocytes, disruption, and cavitation of the collagen arrays stromal area under Femto SMILE. The DNA fragmentation for the Femto SMILE group revealed one undefined band with a size of 1.1 Kbp. The comet assay analysis indicated the presence of 3% and 8.0% tailed cells for the free cap and Femto SMILE groups, respectively. The tail lengths were 1.33 ± 0.16 and 1.67 ± 0.13 μm (P < 0.01), the percentage of tail DNA was 1.41 ± 0.18% (P < 0.01) and 1.72 ± 0.15%, and the tail moments were 1.88 ± 0.12 AU and 2.87 ± 0.14 AU (P < 0.001) for the free cap and Femto SMILE groups, respectively. FTIR spectroscopy of the Femto smile group revealed disorders in the secondary and tertiary structure of the proteins. Conclusion: Femto SMILE technique induced more structural changes, DNA fragmentation, DNA damage, and corneal proteins secondary structure alteration than those induced by a microkeratome cutting. These changes may be attributed to the deep penetration of high energy levels to the corneal layer. These findings may highlight the potential impact of the Femto SMILE on the cornea and the necessity for managing the laser parameters used

Volume Estimation Of Curved Surfaces Using Structured Lighting And Their Similarity Measure

Tesis ini membentangkan hasil penyiasatan kaedah tak menyentuh yang dipanggil pencahayaan berstruktur untuk menentukan isipadu permukaan-permukaan licin. Kaedah ini menggunakan kamera yang merakam corak cahaya terubah bentuk yang diunjurkan ke atas suatu permukaan. Sistem tersebut disahkan dengan menggunakan objek-objek yang mempunyai permukaan licin. This thesis presents the investigation of a non-contact method called structured lighting to determine volumes of smooth surfaces. This method uses a camera that captures a deformed pattern of light projected upon a surface. The system was verified using objects having a smooth surface

The value of pericardial window in preventing pericardial effusion after cardiac surgery

Background: Pericardial window (PW) is a technique that allows the passage of fluid from the pericardial to the pleural cavity to reduce the postoperative pericardial effusion. The purpose of this study was to evaluate the effectiveness of the pericardial window in decreasing pericardial effusions after cardiac surgery. Methods: The study included 400 adult patients who underwent cardiac surgery from 2017 to 2020. Patients were randomly assigned into two groups; the pericardial window (PW) group included 200 patients who underwent posterior pericardiotomy, and the control group included 200 patients who did not undergo this procedure. Results: Preoperative data were comparable between both groups. More patients in the PW group had chest tube drainage more than 500 cc/ 24 hours (40 (20%) vs. 5 (2.5%), respectively; p=0.005). The drainage of 500 cc/24 hours or more in the mediastinal tube was lower in the PW group (10 (5%) vs. 40 (20%) patients in the PW and control groups, respectively; p<0.001). Early pericardial collection occurred in 6 patients in the PW group (3%) vs. 46 (23%) in the control group (p<0.001), and no patient had late effusion in the PW group vs. 26 (13%) in the control group (p< 0.001). Six patients in the PW group (3%) had postoperative atrial fibrillation and 12 patients (6%) in the control group (p= 0.23). Pulmonary complications were nonsignificantly higher in the PW group (Lung collapse: 40 (20%) vs. 26 (13%); p=0.08 and pleural effusion: 34 (17%) vs. 26 (13%); p= 0.3, in the PW vs. control groups, respectively). Conclusion: Posterior pericardiotomy is a simple technique that could reduce postoperative pericardial effusion, atrial fibrillation, and the pericardial tamponade. The technique did not increase the postoperative complications compared to the standard method

Stop Illegal Comments: A Multi-Task Deep Learning Approach

Deep learning methods are often difficult to apply in the legal domain due to the large amount of labeled data required by deep learning methods. A recent new trend in the deep learning community is the application of multi-task models that enable single deep neural networks to perform more than one task at the same time, for example classification and translation tasks. These powerful novel models are capable of transferring knowledge among different tasks or training sets and therefore could open up the legal domain for many deep learning applications. In this paper, we investigate the transfer learning capabilities of such a multi-task model on a classification task on the publicly available Kaggle toxic comment dataset for classifying illegal comments and we can report promising results.Comment: 10 pages, 4 figures, 1 tabl