Biochemical, Histological Changes, Protein Electrophoretic Pattern, and Field Application of CuPb-Ferrite/TiO2 Nanocomposites for Controlling Terrestrial Gastropod Eobania vermiculata (Müller).

Eobania vermiculata is a hazardous snail that can damage ornamental plants and cause significant harm to plant sections in Egyptian areas. Herein, the molluscicidal activity of CuPb-Ferrite/TiO2 and TiO2 nanoparticles (NPs) against E. vermiculata was evaluated using the poisonous bait method. LC50 values were determined using the leaf dipping and contact methods, with values of 631.23 and 1703.49 ppm for CuPb-Ferrite/TiO2 and 193.67 and 574.97 ppm for TiO2. Exposure to both NPs resulted in a significant increase in the biochemical parameters of alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP), as well as a decrease in total protein (TP) percentage of E. vermiculata. Histological examinations revealed that many digestive cells had ruptured, and their contents had been lost, while the foot's epithelial layer became ruptured. The average reduction was 66.36% for CuPb-Ferrite/TiO2 NPs compared to the recommended molluscicide, Neomyl, with a 70.23% reduction in the field application. Electrophoretic separation of total protein using sodium dodecyl sulfate-polyacrylamide gel electrophoresis after treatment with LC50 concentrations of TiO2 and CuPb-Ferrite/TiO2 demonstrated the potency of these synthetic compounds as molluscicidal agents. Therefore, we recommend the use of CuPb-Ferrite/TiO2 NPs as a novel land snail molluscicide because it is safe to use, and the baits are arranged to not affect irrigation water, with a high molluscicidal effect.

Molluscicidal and biochemical effects of green-synthesized F-doped ZnO nanoparticles against land snail Monacha cartusiana under laboratory and field conditions.

The glass clover snail, Monacha cartusiana (M. cartusiana) is one of the most seriously impacting economic animal pests spreading across Egypt which inflicts severe damages to the agriculture. A green route is developed by deploying an abundant Rosemary plant leaves aqueous extract to synthesize ZnO and F-doped ZnO (F-ZnO) nanoparticles (NPs) that display high molluscicidal activities against the M. cartusiana land snails via leaf dipping and contact techniques. The effect of lethal concentrations, that kills 50% of exposed snails (LC50) value of the treatments, is examined on the activity of alkaline phosphatase (ALP), aspartate aminotransferase (AST), alanine aminotransferase (ALT), enzymes, total protein (TP), total lipids (TL) and cholesterol level of snails, including the histopathological evaluation of the digestive gland and foot of M. Cartusiana. Their molluscicidal activity as poisonous baits under field conditions is also evaluated and compared to the recommended molluscicide, Neomyl. The results show that F- doping dramatically improves the snail control capability of ZnO NPs, and promotes a considerable increase in both ALT and AST enzymes with an enhancement of TL and Cholesterol levels, but a significant decrease in TP content and ALP activity in treated snails compared to the control group. The LC50 values are found to be 1381.55 and 2197.59 ppm using the leaf dipping for F-ZnO and ZnO, while 237.51 and 245.90 ppm can be achieved using the contact technique, respectively. The greenly synthesized F-ZnO and ZnO NPs induce severe histological alterations in the digestive gland and foot of M. cartusiana, including a complete destruction of the digestive tubules. The histological evaluation of the foot of M. cartusiana exposed to ZnO, shows a rupture of the epithelial layer of the foot sole, while F- ZnO NPs causes the folds of the foot becoming deeper and the rupture of epithelial layer. Our field experiments further demonstrate that F-ZnO achieves 60.08% reduction, while ZnO attains 56.39% diminution in snail population compared to the commercial, Neomyl (69.55%), exhibiting great potentials in controlling the harmful land snail populations.

Neurologic Outcomes in Aortic Arch Repair With Frozen Elephant Trunk Versus 2-Stage Hybrid Repair.

BACKGROUND: We compared outcomes of single-stage hybrid aortic arch replacement (frozen elephant trunk) versus 2-stage hybrid repairs with primary open arch procedures followed by thoracic endovascular stenting. METHODS: This study reports a single-center retrospective review (2003 to 2016) of 118 patients undergoing hybrid repair of the aortic arch including 48 single-stage repairs versus 70 two-stage repairs. RESULTS: Single-stage repair was performed in 48 patients, including 31 (64.6%) men and 17 (35.4%) women with a mean age of 64 ± 11 years and a 2-stage procedure was performed in 70 patients, including 42 (60%) men and 28 (40%) women with a mean age of 65.67 ± 13.3 years (p = 0.46). More emergent single-stage procedures were performed in 23 of 48 (47.9%) patients versus 2-stage procedures in 8 of 70 (11.43%) patients (p < 0.001). Between the single- and 2-stage groups, there was no difference in stroke (6.25% [3 of 48] versus 14.28% [10 of 70]; p = 0.23), spinal cord ischemia (4.16% [2 of 48] versus 5.7% [4 of 70]; p = 1.0), or 30-day mortality rate: 8 of 48 (16.7%) patients versus a combined 30-day mortality rate of the 2-stage procedure of 14.8% (4 of 70 [5.7%] at the first stage and 5 of 55 [9.1%] at the second stage; p = 0.56), respectively. After exclusion of the 30-day mortality, midterm survival was 86% at 1 to 2 years for single-stage patients versus 80% at 1 year and 46% at 2 years for the 2-stage patients (p = 0.0019). CONCLUSIONS: Both single-stage and 2-stage hybrid arch replacements are effective approaches for treating complex aortic arch diseases. Early deaths and neurological outcomes in the single-stage group are comparable to those in the combined 2-stage group. Furthermore, in this series, patients who had a single-stage hybrid procedure had a higher survival rate at 2 years.

Is myocutaneous flap alone sufficient for reconstruction of chest wall osteoradionecrosis?

OBJECTIVES: This study was carried out to determine whether the myocutaneous flap, alone, is sufficient to reconstruct a chest wall defect after osteoradionecrosis and provide satisfactory stability to the chest wall. METHODS: This study involved five patients who were subjected to post-mastectomy radiotherapy as a treatment for breast cancer. Excision of the ulcer and all the necrotic ribs, with preservation of the parietal pleura and reconstruction with the latissimus dorsi flap, was done without the use of either an artificial prosthesis or autologous rib to reconstruct the chest wall defect. RESULTS: Clinical and radiological follow-up showed no complications regarding respiratory impairment or pleural complications. CONCLUSIONS: The use of myocutaneous flap in patients with chest wall defect following osteoradionecrosis is satisfactory to cover the chest wall defect and provide satisfactory stability to the chest wall.

Impact of obesity on outcome of patients undergoing off-pump coronary artery bypass grafting using aorta no-touch technique.

We prospectively examined 1359 adult patients undergoing isolated coronary revascularization with the Pi-circuit technique, consisting of beating heart, aorta no-touch, use of composite grafts, and off-pump arterial revascularization. Patients were divided into two groups based on body weight; Group A consisting of 295 (21.7%) obese patients [body mass index (BMI) > or =30 kg/m(2)] and Group B of 1064 (79.3%) non-obese patients (BMI <30 kg/m(2)). Advanced age and emergency surgery favored the non-obese group [63.0+/-10.4 vs. 65.3+/-9.6 years (P<0.0005) and 10.2% vs. 17.1% (P=0.004), with an increase in the number of octogenarians among them (1.7% Group A vs. 5.4% in Group B, P=0.11)]. The use of double internal mammary arteries (90.5% in Group A vs. 86.9% in Group B, P=0.109), the mean number of distal anastomoses (2.8+/-0.9 in Group A vs. 2.7+/-0.9 in Group B, P=0.5) and the number of sequential anastomoses performed (28.1% in Group A vs. 31% in Group B, P=0.3) were similar. No difference in morbidity rates was detected. All cause in-hospital mortality was comparable. Survival was similar in both groups also. Obesity is not a risk factor for morbidity and mortality in this group of patients.

Female risk using OPCAB, pi-circuit, and aorta no-touch coronary revascularization.

BACKGROUND: In this study, we evaluated female sex as a risk factor in the off-pump coronary artery bypass (OPCAB), aorta no-touch technique. MATERIALS AND METHODS: From February 2001 to November 2005, 1359 patients in our institution underwent isolated coronary revascularization with the pi-circuit technique, which consists of (1) beating heart surgery, (2) OPCAB, (3) no touching of the aorta, (4) use of composite grafts, and (5) arterial revascularization. There were 1159 men (group A) and 200 women (group B). Both groups were compared with respect to preoperative risk factors, intraoperative parameters, and postoperative morbidity and mortality. Follow-up lasted from 4 to 60 months. Data were analyzed with the chi(2) test, the Fisher exact test, the Kaplan-Meier method, and the Cox model of regression analysis. RESULTS: Female patients were older (P < .0005) and had higher prevalences of obesity (P < .0005), arterial hypertension (P < .0005), and diabetes (P < .0005). Emergency operations were also more frequent in this group (P < .027). There was no difference between the groups in the preoperative use of an intra-aortic balloon pump (IABP). The 2 groups were not significantly different with respect to 30-day mortality (1.1% versus 4%) or 7-day mortality (0.3% versus 0%). The 2 groups had comparable rates of IABP use postoperatively. Cognitive disturbances and strokes were rarely encountered (0.6% in men and 0.2% in women). In the early postoperative phase, women had more pulmonary complications (P < .014), and survival seemed to favor the male group during the follow-up period (P < .001). Further analysis with the Cox regression model with exclusion of confounding preoperative morbidity factors (more prevalent in group B) showed that the 2 groups had similar survival rates. As a group, women were 1.06 times more likely to die from a cardiac cause than men (P < .897). CONCLUSIONS: The use of the pi-circuit, aorta no-touch technique is equally effective and safe for both sexes. Women are more prone to pulmonary complications in the early postoperative phase. The apparent difference in survival favoring men can be attributed to the higher prevalence of preoperative risk factors in women. In general, we consider the off-pump, aorta no-touch technique an effective method for lowering morbidity and mortality in the relatively high-risk female patient group.

Aorta no-touch off-pump coronary artery revascularization in octogenarians: 5 years' experience.

BACKGROUND: Approximately 18% of octogenarians have ischemic heart disease. Increasingly, they are being referred for coronary artery revascularization by surgical and/or percutaneous procedures. These strategies have been questioned, however, because of reports of poor outcomes in the elderly. In this study, we aimed to determine the impact of age on morbidity and mortality in patients undergoing off-pump coronary artery bypass (OPCAB) with the pi-circuit procedure during 5 years of follow-up. MATERIALS AND METHODS: From February 2001 to November 2005, 1359 patients underwent isolated coronary revascularization with the pi-circuit technique, which consists of (1) beating heart surgery, (2) OPCAB, (3) no touching of the aorta, (4) use of composite grafts, and (5) arterial revascularization. Sixty-two patients were > or = 80 years of age (group A), and 1297 were <80 years old (group B). Both groups were compared with respect to preoperative risk factors, intraoperative parameters, and postoperative morbidity and mortality. Follow-up lasted from 4 to 60 months. Data were analyzed with the chi(2) test, the Fisher exact test, the Kaplan-Meier method, and the Cox model of regression analysis. RESULTS: Females predominated among the octogenarians (P < .0005). Octogenarians more frequently underwent emergent operations (P < .031) and had worse ejection fractions (P < .026). Obesity was also less prevalent among these patients (P < .007). There were no differences between the groups in the preoperative and postoperative use of an intraaortic balloon pump. Octogenarians had lower cholesterol levels (P < .0005) and had fewer distal anastomoses (2.24 + or - 0.0.76 versus 2.77 + or - 0.92, P < .0005). The 2 groups were not significantly different with respect to 30-day mortality (3.2% versus 1.5%) and 7-day mortality (1.6% versus 0.2%). Differences were noted in the incidences of pulmonary complications (12.9% versus 5.6%, P < .027), atrial fibrillation (41.9% versus 19%, P < .0005), and cognitive disturbances (6.5% versus 0.3%, P < .0005). During follow-up, survival seemed to favor the younger group (P < .001). Nevertheless, further analysis of the data with the Cox regression model to exclude confounding risk factors, revealed the survival rates of the 2 groups to be similar. CONCLUSIONS: Use of the pi-circuit technique is very effective for octogenarians. Although these older patients have a higher incidence of early postoperative morbidity, overall survival is not affected.