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Paleoclimate record in the Nubian Sandstone Aquifer, Sinai Peninsula, Egypt
- Abdou Abouelmagd, Mohamed Sultan, Neil C. Sturchio, Farouk Soliman, Mohamed Rashed, Mohamed Ahmed, Alan E. Kehew, Adam Milewski, Kyle Chouinard
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- Journal:
- Quaternary Research / Volume 81 / Issue 1 / January 2014
- Published online by Cambridge University Press:
- 20 January 2017, pp. 158-167
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Sixteen groundwater samples collected from production wells tapping Lower Cretaceous Nubian Sandstone and fractured basement aquifers in Sinai were analyzed for their stable isotopic compositions, dissolved noble gas concentrations (recharge temperatures), tritium activities, and 14C abundances. Results define two groups of samples: Group I has older ages, lower recharge temperatures, and depleted isotopic compositions (adjusted 14C model age: 24,000–31,000 yr BP; δ18O: − 9.59‰ to − 6.53‰; δ2H: − 72.9‰ to − 42.9‰; < 1 TU; and recharge T: 17.5–22.0°C) compared to Group II (adjusted 14C model age: 700–4700 yr BP; δ18O: − 5.89‰ to − 4.84‰; δ2H: − 34.5‰ to − 24.1‰; < 1 to 2.78 TU; and recharge T: 20.6–26.2°C). Group II samples have isotopic compositions similar to those of average modern rainfall, with larger d-excess values than Group I waters, and locally measurable tritium activity (up to 2.8 TU). These observations are consistent with (1) the Nubian Aquifer being largely recharged prior to and/or during the Last Glacial Maximum (represented by Group I), possibly through the intensification of paleowesterlies; and (2) continued sporadic recharge during the relatively dry and warmer interglacial period (represented by Group II) under conditions similar to those of the present.
Individualized approach to the surgical treatment of tetralogy of Fallot with pulmonary atresia*
- Ahmed Farouk, Kenneth Zahka, Ernest Siwik, Francine Erenberg, Yasser Al-Khatib, Alex Golden, Mohsen Karimi, Minhaz Uddin, Hani A. Hennein
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- Journal:
- Cardiology in the Young / Volume 19 / Issue 1 / February 2009
- Published online by Cambridge University Press:
- 16 December 2008, pp. 76-85
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Background
Tetralogy of Fallot with pulmonary atresia is a heterogeneous group of defects, characterised by diverse sources of flow of blood to the lungs, which often include multiple systemic-to-pulmonary collateral arteries. Controversy surrounds the optimal method to achieve a biventricular repair with the fewest operations while basing flow to the lungs on the native intrapericardial pulmonary arterial circulation whenever possible. We describe an individualized approach to this group of patients that optimizes these variables.
MethodsOver a consecutive 10-year period, we treated 66 patients presenting with tetralogy of Fallot and pulmonary atresia according to the source of the pulmonary arterial flow. Patients were grouped according to whether the flow of blood to the lungs was derived exclusively from the intrapericardial pulmonary arteries, as seen in 29 patients, exclusively from systemic-to-pulmonary collateral arteries, as in 5 patients, or from both the intrapericardial pulmonary and collateral arteries, as in the remaining 32 patients. We divided the latter group into 9 patients deemed simple, and 23 considered complex, according to whether the pulmonary arterial index was greater than or less than 90 millimetres squared per metre squared, and whether the number of collateral arteries was less than or greater than 2, respectively.
ResultsWe achieved complete biventricular repair in 58 patients (88%), with an overall mortality of 3%. Repair was accomplished in a single stage in all patients without systemic-to-pulmonary collateral arteries, but was staged, with unifocalization, in the patients lacking intrapericardial pulmonary arteries. Complete repair without unifocalization was achieved in all patients with the simple variant of the mixed morphology, and in 56% of patients with the complex variant. The average number of procedures per patient to achieve complete repair was 1, 2.2, 3.8, and 2.6 in patients with exclusively native intrapericardial, simple and mixed, complex and mixed and exclusively collateral pulmonary arterial flow, respectively.
ConclusionsAn individualized approach based on the morphology of the pulmonary arterial supply permits achievement of a high rate of complete intracardiac repairs, basing pulmonary arterial flow on the intrapericardial pulmonary arteries in the great majority of cases, and has a low rate of reoperation and mortality.