Giant left atrium is a rare condition, with a reported incidence of 0.3%, and following mainly rheumatic mitral valve disease. Although rheumatic heart disease represents the main cause of giant left atrium, other etiologies have been reported. Giant left atrium has significant hemodynamic effects and requires specific management. In this review, we present two cases, discuss the different definitions, etiologies, clinical presentation and management modalities.
Background: Osteoarthritis is a major joint disease between the elderly with the knee is the most common joint involved. Ultrasound is used for non-invasive assessment of knee joint status with evaluation of the meniscal position, joint space narrowing and presence of osteophytic lipping under load-bearing position for early detection of osteoarthritis. The aim of the study is to assess the role of high-resolution ultrasonography with dynamic assessment in evaluation of the medial compartment knee joint osteoarthritis.To investigate the correlation between the O.A grade determined by radiography and that by ultrasound evaluation and to investigate the diagnostic accuracy of O.A determined using US. Methods: This study was carried out at Radio diagnosis Department, Zagazig University Hospitals. The present study was carried on 35 patients of knee osteoarthritis. Diagnostic work up was done including plain radiography & MSUS. Results: Total of 38 of the 40 knees were correctly diagnosed by ultrasonography with sensitivity of 95 % and specificity of 80 %. The predictive value positive was 86.36 % and the predictive value negative was 92.3 % with 88.5% accuracy. Conclusions: Our results indicate that knee ultrasonography provides valuable information for the assessment of knee joint osteoarthritis. However, MSUS has an advantage of dynamic evaluation with qualitative and semi-quantitative assessment for early detection of knee O.A with good diagnostic accuracy.
P OWDERS of Samaria, Yttria doped ceria and co-doped with iron were synthesized by hydrothermal method. The iron content for all the investigated compositions is 0.5 wt. %. The powders were investigated by thermogravimetric analysis (TGA) X-ray diffraction (XRD), Infrared (IR), Transmission electron microscope (TEM) and Raman spectra. The effect of autoclaving time on the crystallinity was studied. The powders were impacted and sintered at different temperatures. The density and linear shrinkage were investigated for all sintered bodies. XRD revealed that the powders crystallize in fluorite centered cubic structure with the improvement in crystallinity. The presence of iron in the solid solution lowered the degree of crystallinity. TEM images for the co-doped powders displayed semi-rounded nano-sized particles with narrow size distribution. It is concluded that the optimum fluorite structure for solid solutions is obtained with 10 mol % Samaria doped ceria (10SDC)Fe and iron codoped 10 mol % Yttria doped ceria (10YDC) Fe samples.
Introduction Sinus of Valsalva aneurysms (SOVAs) occur when there is a congenital defect in the aortic media and incomplete fusion of distal bulbar septum (primitive bulbus cordis) and truncal ridges. These aneurysms usually rupture into the right side of the heart, with the right ventricle being the most common. Case Presentation A 32 year old male patient who presented to our facility with an attack of ulcerative colitis activity ,elevated inflammatory markers and thrombocytosis. During hospital stay, he developed sudden onset of retrosternal compressing chest pain. On examination he was afebrile with a blood pressure of 130/80 mm Hg and pulse rate 110 beats per minute. He had soft systolic and early diastolic murmurs with normal chest auscultation; there was no haemodynamic discrepancy between left and right sides or stigmata of endocarditis. His ECG showed sinus rhythm with no ST segment changes, and chest x ray was normal. Full blood count revealed thrombocytosis & normochromic normocytic anemia , cardiac enzymes were normal, blood cultures were sterile. A 2D transthoracic echocardiography (TTE) revealed dilated left ventricular dimensions , there is an aneurysm of the right sinus of Valsalva which is communicating with the right ventricle (RV)confirmed by color Doppler and negative contrast seen inside RV during bubble study. 3D TTE showed a small fistulous track between the right sinus and RV. The patient refused surgical or percutaneous closure. Conclusion Congenital RSVAs account for 0.1–3.5% of congenital heart defects.It has a higher incidence in Asian versus Western populations with male to female ratio 3:1. SOVAs arise from the right sinus of Valsalva in 80–85% of these cases and from the noncoronary sinus in 5–15%. They rarely arise from the left sinus, as the left coronary cusp embryologically is not derived from bulbar septum. This is distinct from acquired SOVAs, which can occur in any of the sinuses Traditionally, surgical closure has been the mainstay of treatment for RSOVAs, with an operative mortality rate of <5% and excellent long-term outcomes. Abstract P1468 Figure. RSOVA
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