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Distal Humerus as Delayed Site of Metastasis from Small Cell Carcinoma of Gallbladder
Mutahir A. Tunio,Mushabbab AlAsiri,Asma Mohammed F. Ali,Eyad Fawzi AlSaeed,Muhammad Shuja,Hanadi Fatani
Case Reports in Gastrointestinal Medicine , 2013, DOI: 10.1155/2013/946835
Abstract: Background. Small cell carcinoma (SCC) of the gallbladder is a rare entity and is often seen in elderly women. SCC of gallbladder is typically a nonsecretory carcinoid tumor without overt clinical symptoms and is often discovered at advanced stages. SCC of gallbladder carries a dismal prognosis as compared to SCC of lung and adenocarcinoma of gallbladder. To date, only 73 case reports have been published in the world literature. Case Presentation. Herein, we report a case of a 73-year-old Saudi woman who presented with one week history of right upper quadrant abdominal pain and obstructive jaundice and was found to be a case of locally advanced, metastatic SCC of gallbladder cT4N1M1 (liver, para-aortic lymph nodes, and bone). The patient was treated with neoadjuvant etoposide and cisplatin (EP) chemotherapy three cycles after biliary stenting followed by radical cholecystectomy, lymphadenectomy, and adjuvant EP chemotherapy and then one year later developed distal humerus osseous metastasis. Conclusion. SCC of the gallbladder is very rare entity and is often seen at advanced stages. Osseous metastases of peripheral skeleton from SCC gallbladder are rarely reported. Surgery is curative option but only for early stage tumors. Incorporation of chemotherapy along with radical resection increases the survival. 1. Introduction Gallbladder carcinomas are the fifth most common gastrointestinal malignancies [1]. Most common histologic type is the adenocarcinoma (99%) which occurs mainly in elderly women with possible risk factors (cholelithiasis, choledochal cysts or chronic cholecystitis) [2]. The gallbladder small cell carcinoma (SCC) is an extremely rare histologic type comprising 0.2% of all gastrointestinal carcinoids [3]. Contrary to other sites carcinoids, the gallbladder SCCs are generally nonfunctional tumors without paraneoplastic symptoms secondary to secretion of biologically active peptides [4]. First SCC of gallbladder was reported in 1981 by Albores-Saavedra et al. and after that 73 cases have been published in the literature till date [5]. Further, similar to gallbladder adenocarcinoma, SCC has a strong association with cholelithiasis [6]. Gallbladder mucosa is devoid of neuroectodermal cells and SCC arises from metaplastic epithelium of the gallbladder wall secondary to cholelithiasis and chronic cholecystitis [7]. SCC is often diagnosed at advanced stages (locally advanced or metastatic) and carries a grave prognosis with survival rates worse than gallbladder adenocarcinomas [8]. Herein, we report a case of a 73-year-old Saudi woman with
MicroRNA Profiling of Salivary Adenoid Cystic Carcinoma: Association of miR-17-92 Upregulation with Poor Outcome
Yoshitsugu Mitani, Dianna B. Roberts, Hanadi Fatani, Randal S. Weber, Merrill S. Kies, Scott M. Lippman, Adel K. El-Naggar
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0066778
Abstract: Background Salivary adenoid cystic carcinoma (ACC) is a rare relentlessly progressive malignant tumor. The molecular events associated with ACC tumorigenesis are poorly understood. Variable microRNAs (miRNA) have been correlated with tumorigenesis of several solid tumors but not in ACC. To investigate the association of miRNAs with the development and/or progression of ACC, we performed a comparative analysis of primary ACC specimens and matched normal samples and a pooled salivary gland standard and correlated the results with clinicopathologic factors and validated selected miRNAs in a separate set of 30 tumors. Methods MiRNA array platform was used for the identification of target miRNAs and the data was subjected to informatics and statistical interrelations. The results were also collected with the MYB-NFIB fusion status and the clinicopathologic features. Results Differentially dysregulated miRNAs in ACC were characterized in comparison to normal expression. No significant differences in miRNA expression were found between the MYB-NFIB fusion positive and -negative ACCs. Of the highly dysregulated miRNA in ACC, overexpression of the miR-17 and miR-20a were significantly associated with poor outcome in the screening and validation sets. Conclusion Our study indicates that the upregulation of miR-17-92 may play a role in the biology of ACC and could be potentially targeted in future therapeutic studies.
Feasibility of Performing Sentinel Lymph Node Biopsy (SLNB) after Mastectomy: A Case Report  [PDF]
Hanadi Bu-Ali, Eleftherios P. Mamouna
Journal of Cancer Therapy (JCT) , 2010, DOI: 10.4236/jct.2010.12015
Abstract: Introduction: Previous mastectomy remains a contraindication to SLNB as normal drainage patterns of the breast can be disturbed. Patients diagnosed with DCIS on core biopsy and later found to have microinvasive or invasive carci-noma at the time of mastectomy are deprived of the opportunity for SLNB and need to undergo axillary dissection. We explored the option and feasibility of performing SLNB in a 39-year-old female who underwent a simple mastectomy without axillary sampling for extensive DCIS and later found to have microinvasive ductal carcinoma on permanent pathology. Results: Lymphatic mapping using subdermal injection of 99mTc-labeled sulfur colloid and blue dye led to the identification of five SLNs. Histopathologic examination showed no metastasis. Conclusion: SNLB is feasible in this setting. However, before its use is routinely adopted, its feasibility and accuracy has to be demonstrated in larger num-bers of patients in whom a negative SLNB is followed by a completion axillary dissection.
Palmar Nerve Sheath Myxoma: A Case Report
Amany Fathaddin,Rehab Fatani
Oman Medical Journal , 2012,
Abstract: Nerve sheath myxoma is a rare benign tumor of the peripheral nerves. It typically presents as a painless, firm, and slow growing nodule with a predilection for extremities mostly fingers and knees. Microscopically, it has characteristic multilobules of spindle cells in an abundant myxoid stroma. The cells are strongly positive for S-100 protein. However, this rare tumor is usually misdiagnosed as other more common benign neuronal tumors. This report describes a rare case of nerve sheath myxoma involving the palmar surface of a 23-year-old female. Clinically, it was diagnosed as a fibroma. It was excised and the final diagnosis was made after histopathological and comprehensive immunohistochemical examination of the specimen. The clinicopathological features of this rare tumor and its important differential diagnoses are discussed along with a brief review of the literature.
Investigating Factors Associated with Vaccine Hesitancy in Makkah, KSA  [PDF]
Rana Albarakati, Lujain Almatrafi, Gaidaa Fatta, Batool Fatani, Yosra Alhindi
World Journal of Vaccines (WJV) , 2019, DOI: 10.4236/wjv.2019.92003
Abstract: Introduction: Vaccination provides health and economic benefits to the individual and to society. In Saudi Arabia, public support for immunisation programmes is generally high and well received. However, the benefits of vaccines are often not fully known or appreciated. When public discussion on vaccine safety, quality or efficacy occurs, very often misinformation creeps into the debate through the internet and other media sources, significantly weakening immunisation programmes. Vaccine hesitancy is a concept frequently used in the discourse around vaccine acceptance. This study reflects on the factors associated with vaccine hesitancy, through a study focusing on knowledge, attitudes and beliefs among parents of young children. Methods: A cross-sectional study was carried out in seven primary schools in Makkah city, Saud Arabia. Data were collected in 2017 through a computer based-survey administered to 100 parents with children aged between 2 months and 17 years of age. Questionnaire responses were analysed using Minitab. Results: Many parents (with a total of 292 children) agreed on the importance of vaccinations, to protect their children’s health and to prevent the spread of diseases in the community. Most parents (68.7%, P < 0.05) reported their child had received all recommended vaccines. Approximately one third (31.3%, P < 0.05) of parents indicated their hesitation in having their child vaccinated. The lack of vaccines in primary care centres, fear of adverse events and vaccine safety were the reasons most frequently mentioned by these vaccine-hesitant parents. In addition, some parents believed vaccines had become a business and that profits were more important than their children’s safety. Other parents complained about the increasingly “crowded” vaccination schedules. A minority of parents believe that vaccines did not prevent the spread of disease in the community (P < 0.05). Discussion and Conclusions: Vaccine hesitancy is a common problem in Makkah, Saudi Arabia. Further research will be needed to better understand when, how and why these beliefs are formed.
Effect of filler particles on surface roughness of experimental composite series
Marghalani, Hanadi Yousif;
Journal of Applied Oral Science , 2010, DOI: 10.1590/S1678-77572010000100011
Abstract: objective: the purpose of this study was to evaluate the effect of different filler sizes and shapes on the surface roughness of experimental resin-composite series. material and methods: thirty-three disc-shaped specimens of the series (spherical-rzd 102, 105, 106, 107, 114 and irregular-rzd 103, 108, 109, 110, 111, 112) were prepared in a split teflon mold and irradiated with an halogen light-curing unit (450 mw/cm2 for 40 s) at both top and bottom surfaces. the specimens were stored for 3 months in distilled water. the surface roughness values in form of surface finish-vertical parameter (ra), maximum roughness depth (rmax) and horizontal roughness parameter (sm) were recorded using a contact profilometer. the data were analyzed by one-way anova and the means were compared by scheffé post-hoc test (a=0.05). results: the lowest surface roughness (ra) was observed in s-100 (0.079±0.013), while the roughest surface was noted in i-450/700/1000 (0.125±0.011) and i-450/1000 (0.124±0.004). the spherical-shape series showed the smoothest surface finish compared to the irregular-shape ones with higher significant difference (p>0.05). the vertical surface roughness parameter (ra) values increased as the filler size increased yielding a linear relation (r2=0.82). on the contrary, the horizontal parameter (sm) was not significantly affected by the filler size (r2=0.24) as well as the filler shape. conclusions: filler particle's size and shape have a great effect on the surface roughness parameters of these composite series.
Post-irradiation vickers microhardness development of novel resin composites
Marghalani, Hanadi Yousif;
Materials Research , 2010, DOI: 10.1590/S1516-14392010000100017
Abstract: the aim of this study was to evaluate the effect of post-irradiation dry aging at different periods of time on vickers microhardness of some dental composites based on various resin matrices. sixty four disc-shaped specimens of the resin composites were prepared in a split teflon mold (8 × 2 mm) and irradiated by optilux 501 light cure (500 mw.cm-2 for 40 seconds) on their top side. the specimens were aged-dry in dark at 23 and 37 °c for the following storage periods; immediate, 1/2 an hour, 1, 6, 12, 24, 48 and 168 hours. the microhardness values were recorded using a vickers hardness tester at 300 g load for 15 seconds. results showed that filtek? p90 and definite expressed the highest hardness value followed by tetric evoceram and then premise enamel. at each aging period, all materials demonstrated significant differences between hardness values of top and base surfaces as well as both temperatures examined (p < 0.05). in conclusion, surface hardness developed gradually in most of the materials reaching optimum after 168 hours post-irradiation aging. dental composites based on silorane and ormocer resin matrices achieved higher vickers microhardness than those based on dimethacrylates resin.
Effect of Pulsed Laser on the Structure and Morphology of Alumina-Zirconia Coatings  [PDF]
Hala Omar, Ahmed Ibrahim, Hanadi Salem, Sherif Sedky
Journal of Surface Engineered Materials and Advanced Technology (JSEMAT) , 2013, DOI: 10.4236/jsemat.2013.33033

The effect of excimer laser annealing on the structure and morphology of ceramic coatings were investigated. Alumina-40% zirconia (AZ-40) coatings were sprayed with a water-stabilized plasma spray gun. The coated surface was treated by excimer laser having a wavelength of 248 nm and pulse duration of 24 ns. The surface structure of the treated coating was examined by field emission scanning electron microscope (FESEM) and X-ray diffraction (XRD). A detailed parametric study was performed to investigate the effects of different parameters such as laser energy density (fluence), pulse repetition rate (PRR), and the number of shots on the mechanical properties, surface morphology, and microstructure of the coatings. The results of this study indicated that laser energy and pulse repetition rate have significant effects on surface morphology, porosity, and microstructure of the coating.

Validity of Ultrasound in Patients with Acute Pelvic Pain Related to Suspected Ovarian Torsion  [PDF]
Leena Mawaldi, Charu Gupta, Hanadi Bakhsh, Maissa Saadeh, Mostafa A. Abolfotouh
Surgical Science (SS) , 2011, DOI: 10.4236/ss.2011.26069
Abstract: Objective: Ultrasound has been proven to be useful in detecting underlying ovarian pathology. However, its role in the prediction of ovarian torsion has been controversial. The aim of the study was to assess the validity of ultrasound in the prediction of ovarian torsion in patients with acute pelvic pain related to clinically suspected ovarian torsion. Methods: A retrospective observational study was conducted at the Ob/Gyn department using a 10-year chart review of all female patients older than 11 years of age with highly suspected ovarian torsion who underwent clinical assessment and ultrasound prior to surgery (n = 62). The sensitivity and specificity of ultrasound were determined by cross-tabulation of the ultrasound and surgical findings. Results: Of the suspected cases, 54 (87.1%) were confirmed to be cases of ovarian torsion by surgery. The majority of the cases were suggestive of ovarian torsion, which was indicated by clinical examination (77.4%), ultrasound (77.4%), or pathological examination (79%). Almost one-half of the cases (46.8%) showed a pain score >6; two-thirds (62.9%) presented with vomiting and/or nausea; and more than one-third (38.7%) presented with leukocytosis. The estimated sensitivity and specificity of ultrasound were 0.74 and 0.0, respectively. The positive predictive value was 0.83. Ultrasound was significantly associated with both clinical examination (p = 0.039) and pain score (p = 0.008). Conclusion: The diagnosis of ovarian torsion cannot be exclusively based on ultrasound. Both clinical and sonographical evaluation of acute pelvic pain should be considered for the diagnosis. A definitive diagnosis remains challenging.
The Development of Entrepreneurial Companies through Business Incubator Programs
Hanadi M. Al-Mubaraki,Michael Busler
International Journal of Emerging Sciences , 2011,
Abstract: This paper explores, investigates and identifies the business incubators (BI) that are used worldwide for the development of entrepreneurial companies. Business incubation is a public and/or private, entrepreneurial, economic and social development process designed to nurture business ideas and start-up companies, and through a comprehensive business support programme, help them establish and accelerate their growth and success. Researchers and practitioners alike are claiming positive potential of BI diversify economies, commercialise technologies, create jobs and build wealth. The purpose of the study is, therefore to identify and develop the best practice of business incubation process based on successful implementation of case studies. Methodology/approach: The research methodologies adopted in this research study are desk-research and case study of 10 incubator organisations in the developing countries. Findings: The findings of this study indicate the business incubators as an effective and innovative tool in supporting the start up businesses. Practical implications: The empirical results highlight some implications for successfully developing and implementing best practice of business incubation program. Originality/value: This study makes a contribution to knowledge about the process of business incubation.
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