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| 1 | Trends and outcomes of pancreaticoduodenectomy for periampullary tumors: A 25-year single-center study of 1000 consecutive cases显示文摘AIM To evaluate the evolution, trends in surgical approaches a n d r e c o n s t r u c t i o n t e c h n i q u e s, a n d i m p o r t a n t lessons learned from performing 1000 consecutive pancreaticoduodenectomies(PDs) for periampullary tumors.METHODS This is a retrospective review of the data of all patients who underwent PD for periampullary tumor during the period from January 1993 to April 2017. The data were categorized into three periods, including early period(1993-2002), middle period(2003-2012), and late period(2013-2017).RESULTS The frequency showed PD was increasingly performed after the year 2000. With time, elderly, cirrhotic and obese patients, as well as patients with uncinate process carcinoma and borderline tumor were increasingly selected for PD. The median operative time and postoperative hospital stay decreased significantly over the periods. Hospital mortality declined significantly, from 6.6% to 3.1%. Postoperative complications significantly decreased, from 40% to 27.9%. There was significant decrease in postoperative pancreatic fistula in the second 10 years, from 15% to 12.7%. There was a significant improvement in median survival and overall survival among the periods.CONCLUSION Surgical results of PD significantly improved, with mortality rate nearly reaching 3%. Pancreatic reconstruction following PD is still debatable. The survival rate was also improved but the rate of recurrence is still high, at 36.9%. | ayman el nakeeb waleed askar ehab atef ehab el hanafy ahmad m sultan tarek salah ahmed shehta mohamed el sorogy emad hamdy mohamed el hemly ahmed a el-geidi tharwat kandil mohamed el shobari talaat abd allah amgad fouad mostafa abu zeid ahmed abu el eneen nabil gad el-hak gamal el ebidy omar fathy ahmed sultan mohamed abdel wahab | 2017 | World Journal of Gastroenterology2017，23，38： | 15 |
| 2 | Effect of alternative antibiotics in treatment of cefotaxime resistant spontaneous bacterial peritonitis显示文摘AIM:To evaluate effective alternative antibiotics in treatment of cefotaxime-resistant spontaneous bacterial peritonitis.METHODS:One hundred cirrhotic patients with spontaneous bacterial peritonitis [ascitic fluid polymorphonuclear cell count(PMNLs) ≥ 250 cells/mm 3 at admission] were empirically treated with cefotaxime sodium 2 g/12 h and volume expansion by intravenous human albumin.All patients were subjected to history taking,complete examination,laboratory tests(including a complete blood cell count,prothrombin time,biochemical tests of liver and kidney function,and fresh urine sediment),chest X-ray,a diagnostic abdominal paracentesis,and the sample subjected to total and differential cell count,chemical examination,aerobic and anaerobic cultures.Patients were divided after 2 d by a second ascitic PMNL count into group Ⅰ;patients sensitive to cefotaxime(n = 81),group Ⅱ(n = 19);cases resistant to cefotaxime(less than 25% decrease in ascitic PMNL count).Patients of group Ⅱ were randomly assigned into meropenem(n = 11) or levofloxacin(n = 8) subgroups.All patients performed an end of treatment ascitic PMNL count.Patients were considered improved when:PMNLs decreased to < 250 cells/mm 3,no growth in previously positive culture cases,and improved clinical manifestations with at least 5 d of antibiotic therapy.RESULTS:Age,sex,and Child classes showed no significant difference between group Ⅰ and group Ⅱ.Fever and abdominal pain were the most frequent manifestations and were reported in 82.7% and 80.2% of patients in group Ⅰ and in 94.7% and 84.2% of patients in group Ⅱ,respectively.Patients in group Ⅱ had a more severe ascitic inflammatory response than group Ⅰ and this was demonstrated by more ascitic lactate dehydrogenase(LDH) [median:540 IU/L(range:150-1200 IU/L) vs median:240 IU/L(range:180-500 IU/L),P = 0.000] and PMNL [median:15 000 cell/mm 3(range:957-23 822 cell/mm 3) vs 3400 cell/mm 3(range:695-26 400 cell/mm 3),P = 0.000] counts.Ascitic fluid culture was positive in 32% of cases.Cefotaxime failed in 19% of patients;of these patients,11(100%) responded to meropenem and 6(75%) responded to levofloxacin.Two patients with failed levofloxacin therapy were treated according to the in vitro culture and sensitivity(one case was treated with vancomycin and one case was treated with ampicillin/sulbactam).In group Ⅱ the meropenem subgroup had higher LDH(range:108-860 IU/L vs 120-491 IU/L,P = 0.042) and PMNL counts(range:957-23 822 cell/mm 3 vs 957-15 222 cell/mm 3,P = 0.000) at initiation of the alternative antibiotic therapy;there was no significant difference in the studied parameters between patients responsive to meropenem and patients responsive to levofloxacin at the end of therapy(mean ± SD:316.01 ± 104.03PMNLs/mm 3 vs 265.63 ± 69.61 PMNLs/mm 3,P = 0.307).The isolated organisms found in group Ⅱ were;enterococci,acinetobacter,expanded-spectrum β-lactamase producing Escherichia coli,β-lactamase producing Enterobacter and Staphylococcus aureus.CONCLUSION:Empirical treatment with cefotaxime is effective in 81% of cases;meropenem is effective in cefotaxime-resistant cases. | Ahmed Abouelkhair Badawy Tarik Ibrahim Zaher Samar Mahmoud Sharaf Mohamed Hassan Emara Noha Elsaid Shaheen Talaat Fathy Aly | 2013 | World Journal of Gastroenterology2013，19，8： | 13 |
| 3 | Ultrasound-guided transrectal extended prostate biopsy:a prospective study显示文摘Aim: To evaluate the diagnostic value of the 10 systematic transrectal ultrasound-guided (TRUS) prostate biopsy compared with the sextant biopsy technique for patients with suspected prostate cancer. Methods: One hundred and fifty-two patients with suspected prostate cancer were included in the study. Patients were entered in the study because they presented with high levels of prostate specific antigen (PSA) (over 4ng/mL) and/or had undergone an abnormal digital rectal examination (DRE). In addition to sextant prostate biopsy cores, four more biopsies were obtained from the lateral peripheral zone with additional cores from each suspicious area revealed by transrectal ultrasound. Sextant, lateral peripheral zone and suspicious area biopsy cores were submitted separately to the pathological department. Results: Cancer detection rates were 27.6%(42/152) and 19.7%(30/152) for the 10-core and sextant core biopsy protocols, respectively. Adding the lateral peripheral zone (PZ) to the sextant prostate biopsy showed a 28.6%(12/42) increase in the cancer detection rate in patients with positive prostate cancer (P<0.01).The cancer detection rate in patients who presented with elevated PSA was 29.3%(34/116). When serum PSA was 4-10ng/mL TRUS-guided biopsy detected cancer in 20.6%, while the detection rate was 32.4% and 47.0% when serum PSA was 10-20ng/mL and above 20ng/mL, respectively. Conclusion: The 10 systematic TRUS-guided prostate biopsy improves the detection rate of prostate cancer by 28.6% when compared with the sextant biopsy technique alone, without increase in the morbidity. We therefore recommend the 10-core biopsy protocol to be the preferred method for early detection of prostate cancer. | Mohammed Ahmed Al-Ghazo Ibrahim Fathi Ghalayini Ismail Ibrahim Matalka | 2005 | Asian Journal of Andrology2005，7，2： | 10 |
| 4 | Molecular detection of monocyte chemotactic protein-1 polymorphism in spontaneous bacterial peritonitis patients显示文摘AIM: To investigate the association of the functional monocyte chemotactic protein-1(MCP-1) promoter polymorphism(A-2518G) with spontaneous bacterial peritonitis(SBP).METHODS: Fifty patients with post-hepatitis C liver cirrhosis and ascites were categorized into two groups; group Ⅰ included 25 patients with SBP and group Ⅱ included 25 patients free from SBP. In addition, a group of 20 healthy volunteers were included. We assessed the MCP-1 gene polymorphism and gene expression as well as interleukin(IL)-10 levels in both blood and ascitic fluid. RESULTS: A significant MCP-1 gene polymorphism was detected in groups Ⅰ and Ⅱ(P = 0.001 and 0.02 respectively). Group Ⅰ was associated with a significantly higher frequency of AG genotype [control 8(40%) vs SBP 19(76.0%), P < 0.001], and group Ⅱ was associated with a significantly higher frequency of GG genotype when compared to healthy volunteers [control 1(5%) vs cirrhotic 16(64%), P < 0.001]. Accordingly, the frequency of G allele was significantly higher in both groups(Ⅰ and Ⅱ) [control 10(25%) vs SBP 27(54%), P < 0.001 and vs cirrhotic 37(74.0%), P < 0.001, respectively]. The total blood and ascetic fluid levels of IL-10 and MCP-1 gene expression were significantly higher in group Ⅰ than in group Ⅱ. Group Ⅰ showed significant reductions in the levels of MCP-1 gene expression and IL-10 in the whole blood and ascetic fluid after therapy. CONCLUSION: MCP-1 GG genotype and G allele may predispose HCV infected patients to a more progressive disease course, while AG genotype may increase the susceptibility to SBP. Patients carrying these genotypes should be under supervision to prevent or restrict further complications. | Maysa Kamal Salama Dina Sabry Mohamed AS Al-Ghussein Rasha Ahmed Sayed AbdAllah Fatma Mohamed Taha Wael Fathy Miriam Safwat Wadie Mona Nabih Amr Abul-Fotouh Tarneem Darwish | 2014 | World Journal of Gastroenterology2014，20，33： | 7 |
| 5 | Magnetic resonance imaging of the spinal marrow:Basic understanding of the normal marrow pattern and its variant显示文摘For now, magnetic resonance(MR) is the best noninvasive imaging modality to evaluate vertebral bone marrow thanks to its inherent soft-tissue contrast andnon-ionizing nature. A daily challenging scenario for every radiologist interpreting MR of the vertebral column is discerning the diseased from normal marrow. This requires the radiologist to be acquainted with the used MR techniques to judge the spinal marrow as well as its normal MR variants. Conventional sequences used basically to image marrow include T1 W, fat-suppressed T2 W and short tau inversion recovery(STIR) imaging provides gross morphological data. Interestingly, using non-routine MR sequences; such as opposed phase, diffusion weighted, MR spectroscopy and contrastedenhanced imaging; may elucidate the nature of bone marrow heterogeneities; by inferring cellular and chemical composition; and adding new functional prospects. Recalling the normal composition of bone marrow elements and the physiologic processes of spinal marrow conversion and reconversion eases basic understanding of spinal marrow imaging. Additionally, orientation with some common variants seen during spinal marrow MR imaging as hemangiomas and bone islands is a must. Moreover, awareness of the age-associated bone marrow changes as well as changes accompanying different variations of the subject's health state is essential for radiologists to avoid overrating normal MR marrow patterns as pathologic states and metigate unnecessary further work-up. | Mohamed Ragab Nouh Ahmed Fathi Eid | 2015 | World Journal of Radiology2015，7，12： | 4 |
| 6 | Novel non-invasive biological predictive index for liver fibrosis in hepatitis C virus genotype 4 patients显示文摘AIM To investigate the diagnostic ability of a non-invasive biological marker to predict liver fibrosis in hepatitis C genotype 4 patients with high accuracy.METHODS A cohort of 332 patients infected with hepatitis C genotype 4 was included in this cross-sectional study. Fasting plasma glucose, insulin, C-peptide, and angiotensinconverting enzyme serum levels were measured. Insulin resistance was mathematically calculated using the homeostasis model of insulin resistance(HOMA-IR).RESULTS Fibrosis stages were distributed based on Metavir score as follows: F0 = 43, F1 = 136, F2 = 64, F3 = 45 and F4 = 44. Statistical analysis relied upon reclassification of fibrosis stages into mild fibrosis(F0-F) = 179, moderate fibrosis(F2) = 64, and advanced fibrosis(F3-F4) = 89. Univariate analysis indicated that age, log aspartate amino transaminase, log HOMA-IR and log platelet count were independent predictors of liver fibrosis stage(P < 0.0001). A stepwise multivariate discriminant functional analysis was used to drive a discriminative model for liver fibrosis. Our index used cut-off values of ≥ 0.86 and ≤-0.31 to diagnose advanced and mild fibrosis, respectively, with receiving operating characteristics of 0.91 and 0.88, respectively. The sensitivity, specificity, positive predictive value, negative predictive value and positive likelihood ratio were: 73%, 91%, 75%, 90% and 8.0 respectively for advanced fibrosis, and 67%, 88%, 84%, 70% and 4.9, respectively, for mild fibrosis.CONCLUSION Our predictive model is easily available and reproducible, and predicted liver fibrosis with acceptable accuracy. | Mahmoud Khattab Mohamed Amin Sakr Mohamed Abdel Fattah Youssef Mousa Elwy Soliman Ashraf Breedy Mona Fathi Salwa Gaber Ahmed Altaweil Ashraf Osman Ahmed Hassouna Ibrahim Motawea | 2016 | World Journal of Hepatology2016，8，32： | 2 |
| 7 | Literature review of the outcome of and methods used to improve transperineal repair of rectocele显示文摘BACKGROUND Rectocele is commonly seen in parous women and sometimes associated with symptoms of obstructed defecation syndrome(ODS).AIM To assess the current literature in regard to the outcome of the classical transperineal repair(TPR)of rectocele and its technical modifications.METHODS An organized literature search for studies that assessed the outcome of TPR of rectocele was performed.PubMed/Medline and Google Scholar were queried in the period of January 1991 through December 2020.The main outcome measures were improvement in ODS symptoms,improvement in sexual functions and continence,changes in manometric parameters,and quality of life.RESULTS After screening of 306 studies,24 articles were found eligible for inclusion to the review.Nine studies(301 patients)assessed the classical TPR of rectocele.The median rate of postoperative improvement in ODS symptoms was 72.7%(range,45.8%-83.3%)and reduction in rectocele size ranged from 41.4%-95.0%.Modifications of the classical repair entailed omission of levatorplasty,addition of implant,concomitant lateral internal sphincterotomy,changing the direction of plication of rectovaginal septum,and site-specific repair.CONCLUSION The transperineal repair of rectocele is associated with satisfactory,yet variable,improvement in ODS symptoms with parallel increase in quality-of-life score.Several modifications of the classical TPR were described.These modifications include omission of levatorplasty,insertion of implants,performing lateral sphincterotomy,changing the direction of classical plication,and site-specific repair.The indications for these modifications are not yet fully clear and need further prospective studies to help tailor the technique to rectocele patients. | Mohammad Fathy Ahmed Hossam Elfallal Sameh Hany Emile | 2021 | World Journal of Gastrointestinal Surgery2021，13，9： | 2 |
| 8 | Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke显示文摘 | Khedr EM Ahmed MA Fathy N | 2005 | Neurology2005，65，3： | 1 |
| 9 | Surface tension (gamma (LV) ), surface energy ( gamma (SV) ) and crystal - melt interfacial energy ( gamma (SL) ) of metals 显示文摘 | FATHI A AHMED A | 2012 | Current Applied Physics2012，12，1： | 1 |
| 10 | Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke显示文摘 | Khedr EM Ahmed MA Fathy N | 2005 | Neurology2005，65，3： | 1 |
| 11 | Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke显示文摘 | Khedr EM Ahmed MA Fathy N etal | 2005 | Neurology2005，65，3： | 1 |
| 12 | Therapeutic trial of re- petitive transcranial magnetic stimulation after acute ischemic stroke 显示文摘 | Khedr EM Ahmed MA Fathy N | 2005 | Neurology2005，65，3： | 1 |
| 13 | Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke显示文摘 | Khedr EM Ahmed MA Fathy N | 2005 | Neurology2005，65，3： | 1 |
| 14 | The effect of Dega aeetahuloplasty and Salter innominate osteotomy on acetabular remodeling monitored by the acetabular index in walking DDH patients between 2 and 6 years of age: short- to middle-term follow-up显示文摘 | E1-Sayed M Ahmed T Fathy S | 2012 | J Child Orthop2012，6，6： | 1 |
| 15 | Outcome of Right Hepatectomy for Living Liver Donors: A Single Egyptian Center Experience显示文摘 | Tarek Salah Ahmad Sultan Omar Fathy Mohammed Elshobary Nabieh Elghawalby Ahmed Sultan Amr Yassen Walid Elsarraf Mohammed Elmorshedi Mohammed Elsaadany Usama Shiha M. Wahab | 2012 | Journal of Gastrointestinal Surgery2012，，6： | 1 |
| 16 | Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke 显示文摘 | Khedr EM Ahmed MA Fathy N | 2005 | Neurology2005，65，3： | 1 |
| 17 | Therapeutic trial of repetitive transcranial magnetic stimulation after acute iscbemic stroke显示文摘 | Khedr EM Ahmed MA Fathy N | | 0，，03： | 1 |
| 18 | T helper type 1/T helper type 17-related cytokines in chronic hepatitis C patients before and after interferon and ribavirin therapy显示文摘 | Fathy A Ahmed AS Metwally L | | 0，，： | 1 |
| 19 | Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke显示文摘 | Khedr EM Ahmed MA Fathy N | 2005 | Neurology2005，65，3： | 1 |
| 20 | Therapeutic trial of repetitive transcranial magnetic stimulation after acute ischemic stroke显示文摘 | Khedr EM Ahmed MA Fathy N | 2005 | Neurology2005，65，3： | 1 |
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