Objective: To investigate the usefulness of intravoxel incoherent motion (IVIM) in determining the severity of hepatic fibrosis, steatosis, and inflammation in patients with chronic liver disease.

Methods: Forty-nine patients who had liver MRI with IVIM sequence and liver biopsy within three months of MRI were enrolled. A reviewer, blinded to histology, placed regions of interest of 1–2 cm2 in the right liver lobe. In addition, the first twenty patients were assessed with a second reviewer. Perfusion fraction (f), pseudodiffusion coefficient (D_fast), true diffusion coefficient (D_slow), and apparent diffusion coefficient (ADC) were calculated from normalized signal intensities that were fitted into a biexponential model. Errors in the model were minimized with global stochastic optimization using Simulated Annealing. ANOVA with post hoc Tukey–Kramer test and multivariate generalized linear model analysis were performed, using histological findings as the gold standard.

Results: The most common etiologies for liver disease were hepatitis C and alcohol, accounting together for 76% (37/ 49) of patients. Low-grade fibrosis (F0, F1), hepatic steatosis, and inflammation were seen in 24% (12/49), 31% (15/49), and 29% (14/49) of patients, respectively. The interobserver correlation was poor for D_fast and D_slow (0.105, 0.173) and moderate for f and ADC (0.461, 0.418). ANOVA showed a strong inverse association between D_fast and liver fibrosis grade (p = 0.001). A weak inverse association was seen between ADC and hepatic steatosis (p = 0.059). Multivariate general linear model revealed that the only significant association between IVIM parameters and pathological features was between D_fast and fibrosis. On ROC curve analysis, D_fast< 23.4 9 10-3 mm2 /s had a sensitivity of 82.8% and a specificity of 64.3% in predicting high-grade fibrosis.

Conclusion: D_fast has the strongest association with hepatic fibrosis but has weak interobserver correlation. IVIM parameters were not significantly associated with hepatic inflammation or steatosis.

Key words: MRI—Hepatic fibrosis—Hepatic steatosis—Hepatitis—IVIM

m s abdel raheem  m s hasnein   s  m a omar  m g abdelraheem  s r helal  egyp  j  anaesthesia    january  3 th   2004

m s hasanein  golnar m fathy  moh m abdel latif  j e s m p vol 21 no 2  october  2003      95   101

Objectives

Deep hypothermic circulatory arrest (DHCA) is often required for patients undergoing repair of descending thoracic aortic aneurysm (DTAA) or thoracoabdominal aortic aneurysm via left thoracotomy when proximal crossclamping is not feasible or when aneurysmal disease extends into the transverse aortic arch. Historical literature suggests higher complications rates due to the technical complexity of this approach; we examined outcomes with this approach at our center.

Methods

Between January 2008 and May 2018, 84 patients with DTAA or Crawford extent I thoracoabdominal aortic aneurysm underwent open repair. DHCA was employed in 46 of 84 (55%) patients, of which 33 (72%) required repair of distal arch and DTAA, and 13 (28%) required repair of the distal arch and extent I thoracoabdominal aortic aneurysm. Patients who underwent DHCA had more chronic dissections than those in the non …

Objective

Valve‐sparing root replacement is commonly used for management of aortic root aneurysms in elective setting, but its technical complexity hinders its broader adoption for acute type‐A aortic dissection (ATAAD). The Florida sleeve (FS) procedure is a simplified form of valve sparing aortic root reconstruction that does not require coronary reimplantation. Here, we present our outcomes of the FS repair in patients with dilated roots in the setting of an ATAAD.

Methods

We retrospectively reviewed 24 consecutive patients (2002–2018) treated with FS procedure for ATAAD. Demographic, operative, and postoperative outcomes were queried from our institutional database. Long term follow‐up was obtained from clinic visits for local patients, and with telephone and telehealth measures otherwise.

Results

Mean age was 49 ± 14 years with 19 (79%) males. Marfan syndrome was present in 4 (16.7 …

Eimeria  sp.  is  one  of  the  most  important  parasites  that  cause  very  high  economic  loss  in 
poultry farms in Egypt. It causes a disease called coccidiosis.  This study aimed to detect the 
prevalence of  Eimeria  species in chicken and detection of its pathological effect  within the 
intestinal  mucosa.  The  present  study  investigate  the  prevalence  of  Eimeria  sp.  in  chicken 
through  fecal  examination  and  the  diagnosis  was  based  on  direct  fecal  sample  examination 
(unstained  wet  mount  technique)  and  concentration  techniques,  followed  by  sporulation  of 
unsporulated  oocyst  for  identification  of  Eimeria  spp.  and  finally  studying  the  pathological 
effect of this parasite in the intestinal mucosa of infected chicken. The total prevalence rate of
Eimeria spp. was (66%). The incidence rate in Broiler chickens was (70%) and in Balady was 
(58%).  The highest percent of infection was at the age of (15-30) day  (54.3% in Broiler and 
72.4% for Balady), and the disease was more prevalent in winter than in summer. The species 
that  were  detected  are  E.acovullina  (the  highest  prevalence  rate)  followed  by  E.tenella, 
E.necatrix  followed  by  E.mitis  (lowest  prevelance  rate).  These  results  indicate  that  the 
coccidiosis  is  a  serious  parasitic  disease  that  effect  on  the  poultry  production  in  Egypt  and 
control measures should be put in consideration to overcome this disease. 
Keyswords: Eimeria - prevalence- coccidiosis- oocyst