Quantification of non-calcified and calcified coronary plaques using 64-slice MDCT in patients with acute coronary syndrome

To investigate the accuracy of 64-row MDCT to analyze and quantify coronary arterial plaques in patients presented with acute coronary syndrome [ACS]. Between April 2010 and December 2013, 50 patients presented with acute cardiac chest pain were categorized into 2 groups according to their diagnosis based on clinical evaluation, ECG findings and cardiac biomarkers; group A including patients with ACS and group B including patients with stable angina [SA]. Both groups underwent 64-row multidetector CT [MDCT] coronary arterial imaging. For each plaque, stenosis percentage was evaluated and the plaque was quantified using software [Sureplaque[registered]] based on the density [HU] and percentage of its individual components including lipid, soft tissue, and calcium density. Of the 50 patients; 24 and 26 were grouped into groups A and B respectively. The mean value of stenosis percent of the proximal and middle coronary segments of group A patients = 77.2% +/- 10.2% - 90.5% +/- 58.4% and 79.5% +/- 9.1% - 85.25% +/- 11% respectively, while in group B = 54.1% +/- 12.1% - 65.2% +/- 18.4% and 53.3% +/- 1.5% - 68.6% +/- 11.7% respectively [p=0.00-0.001]. Quantification showed a mean value of lipid content percentage of group A = 15.4% +/- 0.8% - 47.7% +/- 19.2%, while in group B = 7.2% +/- 5.5% - 10.3% +/- 8.2% [p=0.008-0.001]. The mean value of soft tissue content percentage in group A = 15.4% +/- 0.8% - 47.7% +/- 19.2%, while in group B = 7.2% +/- 5.5% - 10.3% +/- 8.2%. The calcification content percentage in group A = 18% +/- 8.7% - 35.1% +/- 16%, while in group B = 66.4% +/- 13.8% - 76.7% +/- 16.5%. 64-row MDCT angiographic quantification software provides a good basis for the future attempts of proper risk stratification of patients with coronary artery disease especially those liable for developing ACS

Interstitial cells of cajal in normal human alimentary tract: an immunohistochemical study

Objectiver lnterstitial cells of Cajal [ICC] are c-kit positive immunoreactive cells which are thought to play an important role in the control of gut motility. The work aimed at studying the morphology of ICC and precisely localize their regional and transmural pattern of distribution in normal human alimentary tract. The study included 102 normal human alimentary tract specimens obtained from male patients with a mean age 37.92 +/- 8.53. All sections were stained with hematoxylin and eosin and c-kit immunohistochemical staining. Immunohistochemically stained sections were submitted for a computer aided image analytical study to detect the area percent of immunoreactive cells. The data obtained was statistically analyzed. ICC could not be demonstrated in H and E stained sections. Immunohistochemically, two morphological subtypes of ICC were recognized, a spindle bipolar and stellate multipolar forms. ICC were detected in the myenteric plexus layer of the esophagus, corpus, pylorus, small intestine, colon and rectum. Intramuscular ICC could be demonstrated in the esophagus, fundus, corpus, pylorus, colon, rectum and anal canal. ICC at the deep muscular plexus were found only in the small intestine. In the pylorus, colon and rectum, ICC were also found at the submucosal border of the circular muscle layer. The wide distribution of ICC all over the human alimentary tract is compatible with their physiological role being important mediators of gut motility

Determination of the point of motion at the lumbosacral articulation in the sagittal plane

The point of motion at the lumbosacral articulation was determined in the sagittal plane in 22 normal young adults. The method used was the superimposition of the lateral radiographs in maximum flexion and extension. The film of the position was used as a reference position

Surgical treatment of lumbar disk prolapse

The results of 42 cases of lumbar disc prolapse treated surgically and followed up for 2-10 years were studied. The technique adopted for every case was total laminectomy with thorough decompression of the nerve roots on the affected segment which might necessitate deroofing of the lateral recess with or without partial or total facetectomy in some of the cases. there were 36 males and 6 females in this series. Of the patients were in the fourth and fifth decades of life with the youngest patients at the age of 17 and the oldest at the age of 56. Detailed history, clinical examination, plain X-ray and myelogram was the standard routine for every case. Early ambulation and excercises was the standard postoperative regime. The results were found satisfactory in 33 cases out of 42 [78.6%]. Of the 9 unsatisfactory results, 8 were fair and one was poor. The rating of the satisfactory results was based on the complete relief of all symptoms after the operation and throughout the period of follow up together with the return to the original job and normal life activity. the criteria for the success of the operation were analysed separately for the incidence and the pattern of recovery as well as the factors that might affect the results. Beyond all these factors it remains to be mentioned that surgical treatment of lumbar disc prolapsed is not and should not be the primary line of treatment. Conservative treatment should precede any thinking of the surgical choice. It the decision for surgery is logically and soundly determined, total laminectomy with adequate decompression of the nerve roots offended by the disc or otherwise is our recommendation to gain the most possible satisfactory results taking into consideration the other factors already outlined