Primary congenital anomalies of the coronary arteries and relation to atherosclerosis: an angiographic study in Lebanon

<p>Abstract</p> <p>Background</p> <p>Most coronary artery anomalies are congenital in origin. This study angiographically determined the prevalence of different forms of anomalous aortic origins of coronary anomalies and their anatomic variation in a selected adult Lebanese population. Correlation between these anomalies and stenotic coronary atherosclerotic disease was also investigated.</p> <p>Methods</p> <p>4650 coronary angiographies were analyzed for anomalous aortic origin. These anomalies were clustered in four main groups: anomalous left circumflex (LCX) coronary artery, anomalous right coronary artery, anomalous left main coronary artery and anomalous left anterior descending coronary artery.</p> <p>Results</p> <p>Thirty four patients had anomalous aortic origin of coronary arteries. Of these, anomalous LCX coronary artery was the most common (19 of 34 patients). The second most common anomaly was anomalous RCA origin (9 of 34 patients.) The incidence of coronary stenosis in non-anomalous vessels was 50%. However, a significantly smaller percentage (17.46%; 6 of 34 patients) of anomalous vessels exhibited significant stenosis, reminiscent of atherosclerotic disease. Of these six vessels, five were LCX coronary artery arising from right coronary sinus or from early branch of right coronary artery. The sixth was right coronary artery arising from left coronary sinus.</p> <p>Conclusion</p> <p>The incidence of congenital coronary anomalies in Lebanon is similar to other populations where the most common is the LCX coronary artery. Isolated congenital coronary anomalies do not increase the risk of developing coronary stenosis or atherosclerosis. Angiographic detection of these anomalies is clinically important for coronary angioplasty or cardiac surgery.</p

Membrane distillation as a second stage treatment of hydrothermal liquefaction wastewater after ultrafiltration

The aim of this study is the utilization of membrane distillation (MD) in the treatment of hydrothermal liquefaction wastewater (HTL-WW) to recover ammonium in the condensate. Experiments were carried out using MD under air–gap configuration with HTL-WW pretreated via Ultrafiltration. The results showed membrane stability in long-term operations, up to 36 days and through a wide range of feed temperatures, from 30 °C to 60 °C (Coolant temperature was kept at 20 °C). Feed temperatures, 50 °C and 60 °C provided the best condensate quality, defined by high ammonium concentrations, up to 12 g/L (for 60 °C feed temperature), and low impurity (low contamination by TOC) based on the highest NH4+:TOC ratio of 13 (for 50 °C feed temperature). Furthermore, since flux experienced an exponential growth with the increase of feed temperature, 60 °C was chosen as the optimal temperature to expand the study on membrane/condensate recovery, which was performed until 80%. From observational and several analytical methods, wetting was unavoidable above 60% recovery and the cause was credited to organic fouling, mainly via surfactants’ adsorption on the membrane surface. This decreased the membrane hydrophobicity, and eventually led to the progressive wetting of the membrane at 80% recovery

Impact de la varicocèle sur le volume testiculaire et les paramètres spermatiques

Introduction:&nbsp;la varicocèle est une pathologie masculine fréquente dont l’incidence est encore plus importante dans dans la population des hommes infertiles. Si ses mécanismes sont à ce jour incomplètement expliqués il semble acquis que la varicocèle peut être associée a une dysfonction testiculaire avec diminution du volume testiculaire et de la concentration en spermatozoïde de l’éjaculat. Méthodes:&nbsp;dans un premier temps nous exposons les résultats d’une étude rétrospective sur 5 ans (de Mars 2009 à Mars 2014), réalisée au service d’urologie A de l’hôpital Ibn Sina de Rabat et ayant comme objectif d’évaluer l’impact de la varicocèle palpable sur le volume testiculaire et les paramètres spermatiques. Tous les patients inclus dans notre étude avaient une varicocèle palpable. Dans un deuxième temps, et à travers une revue de la littérature nous discutons l’impact du traitement de la varicocèle sur la fertilité. Résultats:&nbsp;39 patients ont été inclus dans notre étude. L’âge moyen était de 29,71 ans et la varicocèle siégeait dans 89,74% des cas du coté gauche. Une atrophie testiculaire homolatérale à la varicocèle était retrouvée dans 7% des cas alors que des anomalies du spermogramme se voyaient dans 69,23% des cas. Conclusion:&nbsp;l’impact de la varicocèle sur l’altération des paramètres spermatiques a été clairement établi bien que sa physio pathogénie ne soit pas bien élucidée. Le traitement chirurgical de la varicocèle semble indiqué chez les hommes infertiles présentant une varicocèle clinique et une altération significative du sperme

Thrombose de la veine dorsale profonde de la verge revelant une maladie de Behcet

La thrombose de la veine dorsale profonde de la verge (TVDPV) est une urgence rare et mal connue en urologie. Elle nécessite une prise en charge précoce symptomatique et étiologique afin de préserver la fonction érectile et d’éviter les récidives. Nous rapportant à travers notre observation un cas de thrombose veineuse dorsale de la verge révélée par un priapisme spontané non résolutif, et confirmé par un écho-doppler pénien. Apres prise en charge du priapisme et de la TVDPV, l’enquête étiologique a révélé une maladie de Behçet dont le diagnostic a été retenu sur l’association d’un critère majeur qui est l’aphtose buccale, et de 3 critères  pathergique cutané positif à 24h. Un traitement étiologique a été instauré avec bonne évolution clinique, et conservation de la fonction érectile.Pan African Medical Journal 2016; 2

Schwannome benin primitif retrovesical : une tumeur très rare à propos d'un cas

Le schwannome est une tumeur le plus souvent bénigne, d'origine nerveuse se développant à partir des cellules de la gaine de Schwann. C'est une tumeur très rare tant par sa fréquence que par sa localisation rétrovésicale. L'examen anatomopathologique et immunohistochimique confirme le type histologique ainsi que le caractère bénin ou malin du schwannome. En raison des récidives, et du risque de transformation maligne, l'exérèse doit être complète. Nous rapportons le cas d'un patient âgé de 39 ans, admis pour une douleur pelvienne chronique à type de pesanteur, des signes irritatifs du bas appareil urinaire, et des troubles de transit. L'imagerie (échographie, TDM, IRM) a révélé la présence d'une masse pelvienne rétrovésicale, à paroi fine, latéralisée à gauche, mesurant 68x70x70 mm, exerçant un effet de masse sur la vessie et le sigmoïde. L'intervention chirurgicale menée par une laparotomie médiane a permis l'exérèse d'une masse retrovésicale bien encapsulée. L'examen anatomopathologique et immunohistochimique ont conclu à un schwannome bénin. La récidive et la transformation maligne bien que rare après chirurgie impose une surveillance post opératoire clinique et tomodensitométrique annuelle.Pan African Medical Journal 2016; 2

A Novel Technique For The Quantitative Determination Of Wettability Of A Severely Heterogeneous Tight Carbonate Reservoir

The objective of this study is to accurately measure the wettability contact angle of a cretaceous carbonate reservoir in a vertical well set-up known for as an unconventional tight carbonate oil reservoir. Also, to investigate the relative heterogeneity of these samples using digitally captured images; these images accurately capture natural pore-system in this carbonate rock samples and their wettability performance attributed towards building a vertical depth wettability/heterogeneity model. To capture, measure and model natural tight matrix static contact angle wettability in order to understand their new physics that will advance unconventional tight oil reservoir characterization. Entire vertical well depth reservoir core rock samples, in the form of rock fragments, are selected, then imaged, and then characterized for porosity, permeability, tortuosity/heterogeneity, and pore/grain-wettability contact angle in 2D format utilizing SEM-BSE imaging techniques. The generated big data images will be quantified using pre-defined logic for tortuosity/heterogeneity and wettability contact angle measurement. Each rock sample will process several images captured at X40 (mm), X400 (μm), and X4000 (nm) magnifications and will investigate wettability/heterogeneity relationships for unconventional tight pore system from the entire vertical depth. From measured data and computed logics, the major portions of captured rock investigated show water wet tendency. The wettability distribution in the vertical 250 feet shows strong to medium and even weak water-wet system variation (θ = 10° - θ = 90°). The dominant wettability is medium-water-wet (θ = 30° - θ = 60°), and it is found in the middle section of the vertical column. Medium-water-wet indicates a good candidate for secondary recovery water injection development programs. This study includes tortuosity/heterogeneity quantifications from imaging 2D technology which is valuable in understanding vertical/horizontal fluid movements. The authors feel that this study will narrow the gap in understanding contact angle wettability, heterogeneity characterizations from static conditions viewpoint and hence, the reservoir crude oil recovery vertical profile history from vertical rock samples

Place de la néphrolithotomie à ciel ouvert dans le traitement du calcul coralliforme: à propos d'une série de 53 patients

Le but de notre étude est de discuter la place de la chirurgie ouverte dans le traitement de la lithiase rénale, et notamment le coralliforme complexe, devant l'avènement de nouvelles techniques moins invasives. Nous rapportons une série de 53 calculs coralliformes colligés au sein de notre formation durant une période de 7 ans, de janvier 2011 au janvier 2018, traités par néphrolithotomie ouverte par lombotomie. La moyenne d'hospitalisation postopératoire était de 10 jours. Les suites postopératoires immédiates et précoces étaient simples chez 36 patients, 6 patients ont nécessités une transfusion sanguin, 2 ont représenté un sepsis sévère en postopératoire, 5 cas une infection de la paroi et 4 cas une fistule urinaire jugulée secondairement par un drainage endoscopique. Les calculs résiduels sont retrouvés dans 9 cas (16,9%). Ces calculs sont traités essentiellement par la lithotripsie extra corporelle. Les suites tardives étaient marquées par une atrophie rénale chez 2 patients, une récidive lithiasique chez 9 patients. Une amélioration de la clairance de créatinine chez 9 patients, et une légère aggravation chez 5 patients. La chirurgie à ciel ouvert de la lithiase rénale a de nombreuses complications, elle n'est pas recommandée en première ligne, mais il est important de reconnaître les patients chez lesquels une néphrolithotomie par voie ouverte pourrait représenter un choix valide de traitement

Kuwaiti Carbonate Reservoir Oil Recovery Prediction Through Static Wettability Contact Angle Using Machine Learning Modeling

The objective of this study is to predict EOR efficiencies through static wettability contact angle measurement by Machine Learning (ML) modeling. Unlike conventional methods of measuring static wettability contact angle, the unconventional digital static wettability contact angle is captured and measured, then (ML) modeled in order to forecast the recovery based on wettability distribution phenomenon. Due to success in big data collection from reservoir imaging samples, this study applies data science lifecycle logic and utilizes Machine Learning (ML) models that can predict the recovery through wettability contact angles and thus identify the treatment of oil recovery for a candidate reservoir. Using developed morphological driven pixel-data and transformed numerical wettability contact angle data are acquired from Scanning Electron Microscope Backscattered Electron (SEM-BSE) for 27 fresh core samples from top to bottom of the reservoir. These samples are properly sequenced and then images are selected. Big data from imaging technology have been processed in a manner to train, and test the model accuracy. Applied Data Science Lifecycle technique, such as data mining, is utilized. Data Exploration Analysis (DEA) is implemented to understand and review data distribution as well as relationships among input features. Different supervised ML models to predict recovery are utilized and an optimal model is identified with an acceptable accuracy. The selected prediction model is applied to model the optimal recovery practice. Extreme Gradient Boosting (XGBoost) algorithm is utilized and found as a best-fit model for this Kuwaiti reservoir case practice. Moreover, decision tree and Artificial Neural Network (ANN) models could provide acceptable accuracy. Other supervised learning models were attempted and were not promising to provide feasible accuracy for this carbonate reservoir. The novel of this unique solution of the data-driven ML model is to predict recovery based on static wettability contact angles (?°). The static wettability contact angles (?°) and pore morphological features introduce an insights method to support reservoir engineers in making value-added decisions on production mechanisms and hydrocarbon recovery for their reservoirs. Hence, it improves the field development strategy

Practical Imaging Applications Of Wettability Contact Angles On Kuwaiti Tight Carbonate Reservoir With Different Rock Types

This study focuses on a tight carbonate reservoir which is located in Northern Kuwait and is classified as an unconventional reservoir. A practical imaging technique of wettability contact angle (θ°) presents big data as well as relative-permeability (Krw and Kro) measurements. Also, modeling, through rock image technology, the vast well-documented grain/pore boundary morphology available inside fresh rock fragments have achieved good results. Conventional laboratory relative-permeability experiments are expensive and time-consuming. This study introduces a novel method to measure/calculate relative permeability through fast, less expensive, non-destructive, and environmentally friendly techniques of imaging technology. One tight carbonate reservoir is selected, imaged, processed, analyzed, and then modeled using several pore diameter morphological models. The images are captured using a backscattered electron microscopy BSE-SEM technology analyses. In this study, two-dimensional images are used to characterize the morphology of selected samples grains and pores, using a two-step technique. In the first step, the image is captured using a backscattered electron detector (BSE), digital electron microscopy imaging, and pore-counting processing technology. All of the sample grain/pore features captured in the image are reported in micrometer units. In the second step, the pore area of such features is scanned using image analysis software that can accurately measure several morphological parameters of pore and grain spaces. A robust technique of visual estimate is used, which has the advantage of speeding the image analysis process. The visual analysis software tool counts different pores and counts grains and also measures their shapes and sizes which are crucial for relative permeability calculations. Several pore morphological models have been considered for optimum accuracy comparisons, including pore/grain relationships (area/perimeter), pore contact angle (θ), and pore count. Relative permeability is calculated based on the area of the pore/grain features measured from two-dimensional images. The study objectives are to accurately measure the wettability contact angle of huge pore geometries using 2D image technology to understand the nature of the pore network in the candidate reservoir. To study the relative permeability of internal influences of pore and grain morphology needed for enhanced oil recovery/improved oil recovery (EOR/IOR) future programs. And, finally, to measure relative permeability faster and more accurately