A Novel Skew Estimation Approach Based on Same Height Grouping

Wassim Al-Khawand,Seifedine Kadry,Riccardo Bozzo,Khaled Smaili 보안공학연구지원센터(IJSIP) 2014 International Journal of Signal Processing, Image Vol.7 No.3

Daucus carota Pentane-Based Fractions Suppress Proliferation and Induce Apoptosis in Human Colon Adenocarcinoma HT-29 Cells by Inhibiting the MAPK and PI3K Pathways

Wassim N. Shebaby,K.B. Bodman-Smith,Anthony Mansour,Mohamad Mroueh,Robin I. Taleb,Mirvat El-Sibai,Costantine F. Daher 한국식품영양과학회 2015 Journal of medicinal food Vol.18 No.7

Daucus carota L. ssp. carota (Apiacea, wild carrot, Queen Anne’s lace) has been used in folk medicine throughout the world and recently was shown to possess anticancer and antioxidant activities. This study aims to determine the anticancer activity of the pentane fraction (F1) and the 1:1 pentane:diethyl ether fraction (F2) of the Daucus Carota oil extract (DCOE) against human colon adenocarcinoma cell lines (HT-29 and Caco-2). Treatment of cells with various concentrations of F1 or F2 fractions produced a dose-dependent inhibition of cell proliferation. Flow cytometric analysis indicated that both fractions induced sub-G1 phase accumulation and increased apoptotic cell death. Western blot revealed the activation of caspase-3, PARP cleavage, and a considerable increase in Bax and p53 levels, and a decrease in Bcl-2 level. Treatment of HT-29 cells with either fraction markedly decreased the levels of both phosphorylated Erk and Akt. Furthermore, the combined treatment of F1 or F2 with wortmannin showed no added inhibition of cell survival suggesting an effect of F1 or F2 through the phosphatidyl inositol 3-kinase (PI3K) pathway. This study proposes that DCOE fractions (F1 and F2) inhibit cell proliferation by inducing cell cycle arrest and apoptosis in HT-29 cells through the suppression of mitogen-activated protein kinase (MAPK)/Erk and PI3K/Akt pathways.

Research on Trust-Based Access Control in The Internet of Things

Pardis Pourghomi,Sadi Evren SEKER,Gheorghita Ghinea,Wassim Masri 보안공학연구지원센터 2016 International Journal of Security and Its Applicat Vol.10 No.12

The paper established TBRI(Trust-Based RBAC in IoT)model,calculation of trust value as the core in TBRI. It established groups, objects’ access threshold, objects’ influence and object evaluation, in order to realize accuracy calculation and prevent hackers obtain trust value through malicious repeated operation. Because the subjects in the Internet of things can be used as objects at the same time, TBRI use different trust value calculation formula to enhance the credibility of the trust value.

Late avulsion of a free flap in a patient with severe psychiatric illness: Establishing a successful salvage strategy

Schaffer, Clara,Hart, Andrew,Watfa, William,Raffoul, Wassim,Summa, Pietro Giovanni di Korean Society of Plastic and Reconstructive Surge 2019 Archives of Plastic Surgery Vol.46 No.6

Post-traumatic defects of the distal third of the leg often require skipping a few steps of the well-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patient has psychiatric illness affecting compliance with postoperative care. We describe a case of a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissue defect was covered with a free gracilis flap. On postoperative day 7, the patient ripped out the newly transplanted flap. The flap was too traumatized for salvage, so a contralateral free gracilis muscle flap was used. The patient showed good aesthetic and functional outcomes at a 1-year follow-up. When planning the postoperative management of patients with psychiatric illness, less complex and more robust procedures may be preferred over a long and complex surgical reconstruction requiring good compliance with postoperative care. The medical team should be aware of the risk of postoperative collapse, focus on the prevention of pain, and be wary of drug interactions. Whenever necessary, free tissue transfer should be performed despite potential compliance issues.

Late avulsion of a free flap in a patient with severe psychiatric illness: Establishing a successful salvage strategy

Clara Schaffer,Andrew Hart,William Watfa,Wassim Raffoul,Pietro Giovanni di Summa 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.6

Post-traumatic defects of the distal third of the leg often require skipping a few steps of thewell-established reconstructive ladder, due to the limited local reliable reconstructive options. In rare cases, the reconstructive plan and flap choice may encounter challenges when the patienthas psychiatric illness affecting compliance with postoperative care. We describe a caseof a patient with severe intellectual disability and an open fracture of the distal lower limb. After fracture management and debridement of devitalized tissues, the resultant soft tissuedefect was covered with a free gracilis flap. On postoperative day 7, the patient ripped outthe newly transplanted flap. The flap was too traumatized for salvage, so a contralateral freegracilis muscle flap was used. The patient showed good aesthetic and functional outcomes ata 1-year follow-up. When planning the postoperative management of patients with psychiatricillness, less complex and more robust procedures may be preferred over a long and complexsurgical reconstruction requiring good compliance with postoperative care. The medicalteam should be aware of the risk of postoperative collapse, focus on the prevention of pain,and be wary of drug interactions. Whenever necessary, free tissue transfer should be performeddespite potential compliance issues.

Acute limb ischemia following perineal reconstruction in lithotomy position: take-home message for plastic surgeons

Sapino, Gianluca,Deglise, Sebastien,Raffoul, Wassim,di Summa, Pietro G. Korean Society of Plastic and Reconstructive Surge 2021 Archives of Plastic Surgery Vol.48 No.5

Despite the extensive use of lithotomy position in several plastic surgery procedures, most reports regarding the related incidence of complications are presented in the urologic, gynecologic, and anesthesiologic fields. We present the case of a 54-year-old male patient. polytrauma patient who underwent internal iliac artery embolization leading to extensive gluteal necrosis requiring: debridement, abdominoperineal resection and composite anterolateral thigh flap reconstruction with prolonged lithotomy position. The patient presented lower limb ischemia briefly after surgical theater. A computed tomography scan revealed the obstruction of the left superficial femoral artery requiring emergency revascularization. Arterial thrombosis is a potentially devastating complication and plastic surgeons should be aware of the possible dangers when performing surgeries in prolonged lithotomy position. Preoperative detection of patients at high risks for developing complications should be performed in order to implement preventive measures and avoid potentially life-threatening sequelae.

Abdominal-based adipocutaneous advancement flap for reconstructing inguinal defects with contraindications to standard reconstructive approaches: a simple and safe salvage reconstructive option

Schaffer, Clara,Haselbach, Daniel,Schiraldi, Luigi,Sorelius, Karl,Kalbermatten, Daniel F.,Raffoul, Wassim,di Summa, Pietro G. Korean Society of Plastic and Reconstructive Surge 2021 Archives of Plastic Surgery Vol.48 No.4

Background Groin wounds occurring after vascular surgical site infection, oncologic resection, or occasionally orthopedic surgery and trauma may represent a surgical challenge. Reconstruction of these defects by the usual workhorse flaps may be contraindicated following previous surgery and in patients with lower limb lymphedema or extreme morbidity. Methods This study included 15 consecutive patients presenting with inguinal wounds after vascular or general surgery that required debridement and soft tissue coverage. All cases had absolute or relative contraindications to conventional reconstructive techniques, including a compromised deep femoral artery network, limb lymphedema, scarring of potential flap harvesting sites, or poor overall condition. Abdominal adipocutaneous excess enabled the performance of adipocutaneous advancement flaps in an abdominoplasty-like fashion. Immediate and long-term outcomes were analyzed. Results Soft tissue coverage was effective in all cases. Two patients required re-intervention due to flap-related complications (venous congestion and partial flap necrosis). All patients fully recovered over a mean±standard deviation follow-up of 2.4±1.5 years. Conclusions Abdominal flaps can be an effective and simple alternative technique for inguinal coverage with reproducible outcomes. In our experience, the main indications are a compromised deep femoral artery network and poor thigh tissue quality. Relative contraindications, such as previous open abdominal surgery, should be considered.

Aquablation for benign prostatic obstruction: Single center technique evolution and experience

Muhieddine Labban,Mazen Mansour,Nicolas Abdallah,Rola Jaafar,Wassim Wazzan,Muhammad Bulbul,Albert El-Hajj 대한비뇨의학회 2021 Investigative and Clinical Urology Vol.62 No.2

Purpose: Aquablation is a new technology that relies on real-time ultrasound guidance to ablate prostatic tissues using high velocity pressurized water. We hereby present our data and experience in this technique by exploring the perioperative surgical and functional outcomes. Materials and Methods: This is a prospectively filled study including consecutive patients who underwent aquablation at our Middle Eastern tertiary care center. Patient demographics, voiding parameters, and prostate disease specific variables were collected. We reported on the surgical and functional outcomes as well as the 3-month adverse events. We also explored the trend in hemoglobin drop and hemostasis method by dividing the consecutive cases into four temporal periods. Results: Fifty-nine patients underwent aquablation between March 2018 and March 2020. Mean time from transrectal ultrasound to Foley insertion was 48.5±2.5 minutes. Cautery was performed in 35 patients (59.3%) and a catheter-tensioning device was mounted in 50 patients (84.7%). On average, the hemoglobin dropped by −1.7±0.2 ng/dL (p<0.0001). The average length of catheterization and hospital stay were 2.1±0.3 days and 2.2±0.1 days, respectively. Only three patients (5.1%) were re-hospitalized. At three months, the average drop in serum prostate-specific antigen was −36.6±6.0% (p<0.0001) and functional outcomes considerably improved. We also recorded 14 adverse events in 13 patients (overall rate of 22.0%), with grade 1 and grade 2 complications comprising 71.4% of all adverse events. Conclusions: Our study results confirm the safety and efficacy of the aquablation procedure in the adoption phase.

The Unresolved Case of Sacral Chordoma: From Misdiagnosis to Challenging Surgery and Medical Therapy Resistance

Fabio Garofalo,Dimitrios Christoforidis,Pietro G. di Summa,Béatrice Gay,Stéphane Cherix,Wassim Raffoul,Nicolas Demartines,Maurice Matter 대한대장항문학회 2014 Annals of Coloproctolgy Vol.30 No.3

Purpose: A sacral chordoma is a rare, slow-growing, primary bone tumor, arising from embryonic notochordal remnants. Radical surgery is the only hope for cure. The aim of our present study is to analyse our experience with the challenging treatment of this rare tumor, to review current treatment modalities and to assess the outcome based on R status. Methods: Eight patients were treated in our institution between 2001 and 2011. All patients were discussed by a multidisciplinary tumor board, and an en bloc surgical resection by posterior perineal access only or by combined anterior/posterior accesses was planned based on tumor extension. Results: Seven patients underwent radical surgery, and one was treated by using local cryotherapy alone due to low performance status. Three misdiagnosed patients had primary surgery at another hospital with R1 margins. Reresection margins in our institution were R1 in two and R0 in one, and all three recurred. Four patients were primarily operated on at our institution and had en bloc surgery with R0 resection margins. One had local recurrence after 18 months. The overall morbidity rate was 86% (6/7 patients) and was mostly related to the perineal wound. Overall, 3 out of 7 resected patients were disease-free at a median follow-up of 2.9 years (range, 1.6–8.0 years). Conclusion: Our experience confirms the importance of early correct diagnosis and of an R0 resection for a sacral chordoma invading pelvic structures. It is a rare disease that requires a challenging multidisciplinary treatment, which should ideally be performed in a tertiary referral center.

Deep sternal wound infections: Evidence for prevention, treatment, and reconstructive surgery

Luigi Schiraldi,Gaby Jabbou,Paolo Centofanti,Salvatore Giordano,Etienne Abdelnour,Michel Gonzalez,Wassim Raffoul,Pietro Giovanni di Summa 대한성형외과학회 2019 Archives of Plastic Surgery Vol.46 No.4

Median sternotomy is the most popular approach in cardiac surgery. Post-sternotomy wound complications are rare, but the occurrence of a deep sternal wound infection (DSWI) is a catastrophic event associated with higher morbidity and mortality, longer hospital stays, and increased costs. A literature review was performed by searching PubMed from January 1996 to August 2017 according to the guidelines in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. The following keywords were used in various combinations: DSWI, post-sternotomy complication, and sternal reconstruction. Thirty-nine papers were included in our qualitative analysis, in which each aspect of the DSWI-related care process was analyzed and compared to the actual standard of care. Plastic surgeons are often involved too late in such clinical scenarios, when previous empirical treatments have failed and a definitive reconstruction is needed. The aim of this comprehensive review was to create an up-to-date operative flowchart to prevent and properly treat sternal wound infection complications after median sternotomy.