Symptomatic Non-parasitic benign hepatic cyst: Evaluation of Management by Deroofing in Ten Consecutive Cases

Background/Purpose: Solitary non-parasitic cysts of the liver are commonly asymptomatic and do not require treatment. Rarely, however, the cysts become symptomatic and are then best treated surgically. The optimal surgical treatment is debatable. The aim of this study was to evaluate the role of deroofing as a safe and effective approach in the management of simple non-parasitic hepatic cysts. Materials & Methods: From January 2002 to October 2008, 10 patients (8 females and 2 males) with histologically proven non-parasitic, benign, simple hepatic cysts underwent deroofing at Tanta University Hospital. Deroofing was achieved by open surgery in 3 cases and by laparoscopic surgery in 7 patients. The principle of both open and laparoscopic approaches was to remove as much as possible of the cyst wall, destroy the endothelial lining and pack the residual cavity with omentum. Results: All of our patients had a solitary cyst with a mean diameter of 12.5 cm (range; 9-18 cm) and all were symptomatic. The most common complaint was upper abdominal pain (n=7, 70%). Age ranged from 1 - 72 year with a median of 15 years. Three patients (30%) were treated with open deroofing while 7 patients (70%) underwent laparoscopic deroofing. One out of these 7 patients was converted to open surgery. Recurrence occurred in 2 patients but was asymptomatic and discovered on follow up because of the small diameter of recurrent cysts (3-4 cm). The follow up period ranged between 12 – 72 months (median 20 months). Conclusion: with proper selection of patients, laparoscopic deroofing of symptomatic, benign, solitary, non-parasitic hepatic cysts is safe, effective and offers all the advantages of minimally invasive surgery. Open deroofing should be reserved for cysts inaccessible by laparoscopy, when the diagnosis is in doubt and for difficulties encountered at laparoscopy.Index Word: hepatic cyst, laparoscopy

Effect of Filler Metal on the Performance of 2205 Duplex Stainless Steel Weldments

The escalated concern in duplex stainless steels by industries is due to their best mechanical and corrosion resistance properties. In this work, the mechanical properties welding duplex stainless steel 2205 has studied. Joints were made using the GTAW process with different fillers: duplex ER 2209 and austenitic filler ER 312. There is a similarity in the microstructure which is obtained between with the duplex ER 2209 filler to the duplex 2205 base material, but the joints produced with the austenitic fillers cause a increase of the ferrite(δ) to austenite(γ) phase ratio. In order to evaluate the influence of the fillers on the weld, the mechanical properties by impact , tensile test and the hardness test. The phase imbalance produced for the different fillers causes variation of the mechanical properties. Without getting any detrimental changes in the mechanical properties, by using different filler metals, has addressed in this work .while, ER 312 had the advantage in hardness , tensile, impact test and ferrite percent

Rheumatic tricuspid valve disease: Repair versus Replacement

Background: Tricuspid valve disease is most commonly functional, however, organic affection still accounts for one fourth of cases. Rheumatic fever which is endemic in Egypt is a main cause of organic affection. Current practice largely relies on tricuspid valve repair; however, it has been difficult to determine optimal procedure. Objectives: Herein, we study the outcome of replacement versus repair in such patients. Patients and methods: A prospective study was conducted on 300 consecutive patients with rheumatic heart disease showing severe tricuspid valve affection underwent tricuspid valve surgery, between 2014 and 2018. The patients were divided into two groups; TVR group (n=150) which included patients who underwent tricuspid valve replacement and TVr group (n=150) which included patients who underwent tricuspid valve repair. Diagnosis and follow up were done by echocardiography. Peri-operative variables, clinical outcome, morbidity, mortality, and follow up data were recorded. Results: Mean follow-up was 4±1.32 years. In-hospital mortality was 6 patients (4%) in TVR group and 3 patients (2%) in TVr group (P value ≥ 0.05). Postoperative low cardiac output syndrome and stroke were significantly higher in the repair group. Postoperative RV dysfunction, renal impairment, renal failure and chest re-exploration were significantly higher in the replacement group. Severe tricuspid regurgitation was reported in 19 patients (12.6%) of the repair group on follow up. Conclusion: Tricuspid valve repair is preferable to replacement to avoid the drawbacks of prosthesis. However, tricuspid valve replacement is feasible with comparable survival outcome and the progressive nature of the rheumatic disease may recommend replacement

Sustainable Tourism and Culture: A Symbiotic Relationship

Cultural Tourism offers a strong motivation to preserve the elements of cultural heritage in tourist destinations. It helps to preserve cultural elements as important tourist attractions. Cultural tourism’s notion is unlimited to visiting monumental attractions only, but it has also become an interactive experience with the social fabric of the community through attending exhibitions, festivals and events, and the purchase of traditional local products. Thus, the human capital factor in tourism is linked to the quality of tourism products. With the growth of international tourism, the importance of sustainable tourism development has emerged to protect natural, cultural, and human resources, in addition to achieving economic development. As non-sustainable tourism development has led to the deterioration of tourism resources. This research paper examines if cultural tourism contributes to decrease tourism seasonality and achieve sustainable tourism development in cultural heritage sites. A case study of Aswan was selected. Aswan has unique and important elements of cultural heritage (Tangible and Intangible), but it still faces many problems like tourism seasonality, besides its tourism is still weak compared with other cities that have the same tourism potential. Based on a literature review and analytical study of global examples that achieved sustainability in cultural heritage sites, a field study of Aswan was conducted to evaluate the current status of cultural tourism, besides illustrating the challenges of achieving sustainability. The major result that has emerged from the study is paying attention to cultural tourism is the possible solution to the challenges that Aswan tourism faces. Finally, the paper concluded that investment in human capital creates opportunities for cultural tourism which in return resolves one of tourism’s major challenges: seasonality

Sustainable Tourism and Culture: A Symbiotic Relationship

Cultural Tourism offers a strong motivation to preserve the elements of cultural heritage in tourist destinations. It helps to preserve cultural elements as important tourist attractions. Cultural tourism’s notion is unlimited to visiting monumental attractions only, but it has also become an interactive experience with the social fabric of the community through attending exhibitions, festivals and events, and the purchase of traditional local products. Thus, the human capital factor in tourism is linked to the quality of tourism products. With the growth of international tourism, the importance of sustainable tourism development has emerged to protect natural, cultural, and human resources, in addition to achieving economic development. As non-sustainable tourism development has led to the deterioration of tourism resources. This research paper examines if cultural tourism contributes to decrease tourism seasonality and achieve sustainable tourism development in cultural heritage sites. A case study of Aswan was selected. Aswan has unique and important elements of cultural heritage (Tangible and Intangible), but it still faces many problems like tourism seasonality, besides its tourism is still weak compared with other cities that have the same tourism potential. Based on a literature review and analytical study of global examples that achieved sustainability in cultural heritage sites, a field study of Aswan was conducted to evaluate the current status of cultural tourism, besides illustrating the challenges of achieving sustainability. The major result that has emerged from the study is paying attention to cultural tourism is the possible solution to the challenges that Aswan tourism faces. Finally, the paper concluded that investment in human capital creates opportunities for cultural tourism which in return resolves one of tourism’s major challenges: seasonality

Aged garlic extract enhances paraoxonase 1 activity and suppress oxidative stress in CCl4

O presente estudo foi realizado para avaliar o potencial hepatoprotetor do extrato de alho envelhecido (AGE) contra hepatotoxicidade induzida por CCl4 em ratos machos adultos. CCl4 intoxicação (1ml/Kg no peso corporal, duas vezes por semana, ip durante 4 semanas) aumentou significativamente o Estresse oxidativo, tal como indicado pelo aumento da formação de MDA hepática, diminuição tanto de soro total e conteúdo de glutationa, e inibição da atividade de glutationa redutase hepática e paraoxonase soro 1 (POX1 ). Além disso, o tratamento com CCl4 produziu um aumento significativo nas atividades séricas de ALT, AST e nível de albumina com uma diminuição significativa no nível de proteína total. Ademais, o tratamento com CCl4 resultou num aumento significativo dos níveis de colesterol total, colesterol-LDL, triglicerídeos, bem como isoenzima creatina quinase e atividades da lactato desidrogenase, e uma diminuição significativa nos níveis de HDL-colesterol, se comparado com o grupo controle. O tratamento oral com AGE em doses de 100 e 200 mg / kg / dia em combinação com CCl4 demonstrou melhoras significativas na gravidade das alterações de CCl4 induzidas nos parâmetros acima mencionados, de uma maneira dose-dependente. Em conclusão, o presente estudo indicou que a idade aumenta a atividade de POX1 e atenua a disfunção no fígado e no coração induzidas por CCl4. Os efeitos protetores de idade contra a CCl4 toxicidade podem ser atribuídos aos seus antioxidantes e radicais livres, devido aos elevados teores de compostos organosulfurados.The current study was undertaken to evaluate the hepatoprotective potential of aged garlic extract (AGE) against hepatotoxicity induced by CCl4 in adult male rats. CCl4 intoxication (1ml/ kg b.w., twice a week, i.p. for 4 weeks) significantly increased oxidative stress as indicated by increased hepatic MDA formation, decreased both serum total and reduced glutathione contents, and inhibition of hepatic glutathione reductase and serum paraoxonase 1(POX1) activities. In addition, treatment with CCl4 produced a significant increase in the activities of serum ALT, AST and albumin level with a significant decrease in total protein level. Moreover, treatment with CCl4 resulted in significant increase in the levels of total cholesterol, LDL-cholesterol, triglycerides as well as creatine kinase isoenzyme and lactate dehydrogenase activities, and a significant decrease in HDL-cholesterol compared to control group. Oral treatment with AGE at doses of 100 and 200 mg/ kg/day in combination with CCl4 significantly ameliorated the severity of CCl4- induced changes in the above mentioned parameters in a dose- dependent manner. In conclusion, the present study indicated that AGE improves POX1 activity and attenuates liver and cardiac dysfunction induced by CCl4. The protective effects of AGE against CCl4 toxicity may be attributed to its antioxidant and free radical scavenging activities due to its higher contents of organosulphur compounds

Extrato envelhecido de alho incrementa a atividade de paraoxonase 1 e suprime o estresse oxidativo em ratos intoxicados com CCl4 -

The current study was undertaken to evaluate the hepatoprotective potential of aged garlicextract (AGE) against hepatotoxicity induced by CCl4 in adult male rats. CCl4 intoxication (1ml/kg b.w., twice a week, i.p. for 4 weeks) significantly increased oxidative stress as indicated byincreased hepatic MDA formation, decreased both serum total and reduced glutathione contents,and inhibition of hepatic glutathione reductase and serum paraoxonase 1(POX1) activities. Inaddition, treatment with CCl4 produced a significant increase in the activities of serum ALT, ASTand albumin level with a significant decrease in total protein level. Moreover, treatment with CCl4resulted in significant increase in the levels of total cholesterol, LDL-cholesterol, triglycerides as wellas creatine kinase isoenzyme and lactate dehydrogenase activities, and a significant decrease inHDL-cholesterol compared to control group. Oral treatment with AGE at doses of 100 and 200 mg/kg/day in combination with CCl4 significantly ameliorated the severity of CCl4- induced changes inthe above mentioned parameters in a dose- dependent manner. In conclusion, the present studyindicated that AGE improves POX1 activity and attenuates liver and cardiac dysfunction inducedby CCl4. The protective effects of AGE against CCl4 toxicity may be attributed to its antioxidant andfree radical scavenging activities due to its higher contents of organosulphur compounds.O presente estudo foi realizado para avaliar o potencial hepatoprotetor do extrato de alhoenvelhecido (AGE) contra hepatotoxicidade induzida por CCl4 em ratos machos adultos. CCl4intoxicação (1ml/Kg no peso corporal, duas vezes por semana, ip durante 4 semanas) aumentousignificativamente o Estresse oxidativo, tal como indicado pelo aumento da formação de MDAhepática, diminuição tanto de soro total e conteúdo de glutationa, e inibição da atividade deglutationa redutase hepática e paraoxonase soro 1 (POX1 ). Além disso, o tratamento com CCl4produziu um aumento significativo nas atividades séricas de ALT, AST e nível de albumina comuma diminuição significativa no nível de proteína total. Ademais, o tratamento com CCl4 resultounum aumento significativo dos níveis de colesterol total, colesterol-LDL, triglicerídeos, bem comoisoenzima creatina quinase e atividades da lactato desidrogenase, e uma diminuição significativanos níveis de HDL-colesterol, se comparado com o grupo controle. O tratamento oral com AGE emdoses de 100 e 200 mg / kg / dia em combinação com CCl4 demonstrou melhoras significativas nagravidade das alterações de CCl4 induzidas nos parâmetros acima mencionados, de uma maneiradose-dependente. Em conclusão, o presente estudo indicou que a idade aumenta a atividadede POX1 e atenua a disfunção no fígado e no coração induzidas por CCl4. Os efeitos protetoresde idade contra a CCl4 toxicidade podem ser atribuídos aos seus antioxidantes e radicais livres,devido aos elevados teores de compostos organosulfurados