Urethral stripping for delicate excision of dorsal accessory urethra

Duplication of the urethra is a rare anomaly. The accessory urethra may be dorsal or ventral, relative to the orthotopic urethra. Dorsal urethral duplication describes a normally located meatus and another accessory epispadiac meatus. Excision of the dorsal accessory urethra is usually curative, on the condition that the ventral  orthotopic urethra is normal. However, most reports recommend surgery only when there are significant functional or cosmetic problems, for fear of possible damage to the neurovascular bundle, or the continence mechanism during surgical excision. In this  report, we describe a modification for excising the dorsal accessory channel by stripping with minimal disturbance to the glans. With continuous refinement of the  surgical technique together with more reports confirming its safety, we believe that total excision of the dorsal accessory urethra can be offered to more patients as being the standard level of care.Keywords: accessory urethra, epispadias, urethral duplicatio

Biliary duodenostomy: a safe and easier biliary drainage procedure after choledochal cyst excision

Background/purpose: The treatment of choice for choledochal cyst (CC) is complete excision followed by biliary–enteric anastomosis. Roux-en-Y biliary jejunostomy has been favored by most surgeons for decades, with satisfying results. The use of biliary duodenostomy (BD) is another simple alternative for biliary drainage after CC excision. Our intermediate-term outcomes of both biliary drainage procedures after CC excision are presented.Methods: We carried out a retrospective analysis of the outcome of CC management in children operated at the Pediatric Surgery Department of Ain-Shams University over 5 years, from January 2010.Results: A total of 23 cases (16 females) were included in this study. The mean age at operation was 4.02 ± 2.52 years. Twenty-one cases had type I and two cases had type III CC. Complete excision of the CC was performed in 22 cases, and partial excision with mucosectomy was performed in one case. Biliary–enteric anastomosis was performed with the duodenum in 18 patients (group I, BD) and with the jejunum in five cases (group II, Roux-en-Y biliary jejunostomy). The mean follow-up period was 53± 4.48 months. A patient from group II suffered from ascending cholangitis 6 months postoperatively.Conclusion: BD is a simple technique for biliary drainage after CC excision with no major complications at intermediate-term follow-up.Keywords: biliary obstruction, choledochal cyst, hepaticoduodenostomy, jaundic

On the energy-momentum tensor in non-commutative gauge theories

We study the properties of the energy-momentum tensor in non-commutative gauge theories by coupling them to a weak external gravitational field. In particular, we show that the stress tensor of such a theory coincides exactly with that derived from a theory where a Seiberg-Witten map has been implemented (namely, the procedure is commutative). Various other interesting features are also discussed.Comment: 3 page

Repair of low anorectal anomalies in female patients: risk factors for wound dehiscence

Background/purpose: Wound dehiscence after rectoperineal/vestibular fistulae repair may have adverse effects on the continence mechanism with delayed functional sequels. We report the incidence of wound complications following the sagittal anorectoplasty in a group of female patients, in addition to studying the effect of some possible risk factors.Patients and methods: This is a prospective cohort study conducted on female patients with rectoperineal or rectovestibular fistula operated during the period from January 2011 to December 2015. Patients were divided into three groups: group A (no dehiscence); group B (minor dehiscence); and group C (major dehiscence). Patients were compared regarding their age at the time of repair, the type of anorectal anomaly, the degree of dilation of the colon, and the prevalence of covering colostomy.Results: The study included 63 female patients. Group A included 34 patients (those with no dehiscence, 52.4%), group B included 17 patients (minor wound dehiscence, 26.98%), and group C included 13 patients (major wound dehiscence, 20.6%). There was no statistically significant difference between the three groups regarding the studied risk factors.Conclusion: With regard to the wound complications following the repair of rectoperineal/vestibular fistulae in the female patients, none of the studied risk factors appear to have a significant effect on the outcome.Keywords: anterior sagittal anorectoplasty, colostomy, posterior sagittal anorectoplasty, rectoperineal fistula, rectovestibular fistula, wound dehiscenc

Identification of Candidate Genes and Genomic Regions Associated with Adult Plant Resistance to Stripe Rust in Spring Wheat

Wheat stripe rust (caused by Puccinia striiformis f. sp. tritici) is a major disease that damages wheat plants and affects wheat yield all over the world. In recent years, stripe rust became a major problem that affects wheat yield in Egypt. New races appeared and caused breakdowns in the resistant genotypes. To improve resistance in the Egyptian genotypes, new sources of resistance are urgently needed. In the recent research, a set of 95 wheat genotypes collected from 19 countries, including Egypt, were evaluated for their resistance against the Egyptian race(s) of stripe rust under field conditions in the two growing seasons 2018/2019 and 2019/2020. A high genetic variation was found among the tested genotypes. Single marker analysis was conducted using a subset of 71 genotypes and 424 diversity array technology (DArT) markers, well distributed across the genome. Out of the tested markers, 13 stable markers were identified that were significantly associated with resistance in both years (p-value ≤ 0.05). By using the sequence of the DArT markers, the chromosomal position of the significant DArT markers was detected, and nearby gene models were identified. Two markers on chromosomes 5A and 5B were found to be located within gene models functionally annotated with disease resistance in plants. These two markers could be used in markerassisted selection for stripe rust resistance under Egyptian conditions. Two German genotypes were carrying the targeted allele of all the significant DArT markers associated with stripe rust resistance and could be used to improve resistance under Egyptian conditions

Sacrococcygeal teratoma excision: a vertical rather than transverse wound closure

Background: The chevron incision has been the standard approach for sacrococcygeal teratoma (SCT) excision. Here, we are reporting our experience of shifting to the vertical posterior sagittal approach.Patients and methods: During the period 2011 through 2016, we operated on 17 (16 female and one male) cases of SCT. Their age at presentation ranged from day 1 to 26 months (mean=4.8 months, median=2 months). The chevron incision was used in five, whereas the vertical posterior sagittal approach was used in 12 patients.Results: In this series, we had one case of perioperative mortality, in addition to another case of perineal wound disruption (in the group of vertical wound closure), which was managed conservatively (to heal by secondary intention) with a very satisfactory hidden scar at 6-month follow-up. Overall, we did not find the vertical approach to add any extra limitations to the surgical exposure or dissection; meanwhile, it provided a well-recognized cosmetic advantage.Conclusion: The vertical posterior sagittal approach for excision of SCT is both feasible and advantageous in terms of the cosmetic outcome. It provides a well-hidden scar in the natal cleft and preserves normal contouring of the buttocks.Keywords: buttock, cosmesis, posterior sagittal, reconstruction, sacrococcygeal teratom