The importance of second look cystoscopy in children with PUV and its impact on future bladder, kidney functions and fertility

This study was designed to assess the importance of second look cystoscopy after primary ablation of posterior urethral valve in children. A prospective study was conducted at Kasr Al Ainy Pediatric Hospital (Aboulreesh), Urology Department, Cairo University on 50 male children, diagnosed to have posterior urethral valve between September 2016 and June 2017. Diagnosis of posterior urethral valve was made by voiding symptoms, ultrasonography and confirmed by voiding cystourethrogram. All children were treated by endoscopic ablation of posterior urethral valve using cold knife and were followed clinically for voiding symptoms and with ultrasonography and laboratory tests. All patients underwent 2nd look cystoscopy one month after primary valve ablation to see residual valves as a routine procedure irrespective of the improvement in symptoms, ultrasonography or laboratory results. Mean age at presentation was 8.3 ± 12.6 months. The presenting symptoms were acute urine retention in (44%); obstructive symptoms in (42%), recurrent febrile UTI in (10%) and two patients (4%) underwent primary valve ablation based on antenatal diagnosis. 92% showed hydronephrosis at presentation. Serum creatinine was elevated in 72% at presentation. Residual valves on 2nd look cystoscopy were found in 60%.&nbsp

The Importance of Second Look Cystoscopy in Children with PUV and Its Impact on Future Bladder, Kidney Functions and Fertility

This study was designed to assess the importance of second look cystoscopy after primary ablation of posterior urethral valve in children. A prospective study was conducted at Kasr Al Ainy Pediatric Hospital (Aboulreesh), Urology Department, Cairo University on 50 male children, diagnosed to have posterior urethral valve between September 2016 and June 2017. Diagnosis of posterior urethral valve was made by voiding symptoms, ultrasonography and confirmed by voiding cystourethrogram. All children were treated by endoscopic ablation of posterior urethral valve using cold knife and were followed clinically for voiding symptoms and with ultrasonography and laboratory tests. All patients underwent 2nd look cystoscopy one month after primary valve ablation to see residual valves as a routine procedure irrespective of the improvement in symptoms, ultrasonography or laboratory results. Mean age at presentation was 8.3 ± 12.6 months. The presenting symptoms were acute urine retention in (44%); obstructive symptoms in (42%), recurrent febrile UTI in (10%) and two patients (4%) underwent primary valve ablation based on antenatal diagnosis. 92% showed hydronephrosis at presentation. Serum creatinine was elevated in 72% at presentation. Residual valves on 2nd look cystoscopy were found in 60%.&nbsp

A combination of α-fetoprotein, midkine, thioredoxin and a metabolite for predicting hepatocellular carcinoma

Introduction and objectives: The heterogenous nature of hepatocellular carcinoma (HCC) motivated this attempt at developing and validating a model based on combined biomarkers for improving early HCC detection. Patients/materials and methods: This study examined 196 patients for an estimation study (104 patients with HCC, 52 with liver cirrhosis and 40 with liver fibrosis) and 122 patients for the validation study (80 patients with HCC, 42 with liver cirrhosis). All patients were positive for hepatitis C virus. Four markers were measured: Midkine and thioredoxin using ELISA, 1-methyladenosine and 1-methylguanosine using a gas chromatography–mass spectrometry (GC–MS). The results were compared with alpha-fetoprotein (AFP). The performance of the model was estimated in BCLC, CLIP and Okuda staging systems of HCC. Results: The model yielded high performance with an area under ROC (AUC) of 0.94 for predicting HCC in patients with liver cirrhosis, compared with AUC of 0.69 for AFP. This model had AUCs of 0.93, 0.94 and 0.94 in patients who had only one single nodule, absent macrovascular invasion and tumor size <2 cm, respectively, compared with AUCs of 0.71, 0.6 and 0.59 for AFP. The model produced AUCs of 0.91 for BCLC (0-A), 0.92 for CLIP (0–1) and 0.94 for Okuda (stage I) compared with AUCs of 0.56, 0.58 and 0.64 for AFP. No significant difference was found between AUC in the estimation and the validation groups. Conclusion: This model may enhance early-stage HCC detection and help to overcome insufficient sensitivity of AFP

Percutaneous nephrolithotomy in horseshoe Kidneys: is rigid nephroscopy sufficient tool for complete clearance? a case series study

Abstract Background this study represents a case series to evaluate how successful is the rigid percutaneous nephroscopy as a tool for clearance of all stones in various locations in horseshoe kidneys. Methods Between 2005 and 2009, we carried out PCNL (percutaneous nephrolithotomy) for calculi in horseshoe kidneys in 21 renal units (17 patients) in our department. The indications were large stone burden in 18 units and failed SWL(shock wave lithotripsy) in 3 renal units. All procedures were done under general anesthesia; using fluoroscopic guidance for localization and standard alkan dilatation followed by rigid nephroscopy and stone extraction with or without stone disintegration. We analyzed our results regarding the site and number of the required access, the intra and postoperative complications, the presence of any residual stones, as well as their location. Results The procedure was completed, using a single access tract in 20 renal units, with the site of puncture being the upper calyx in nine units and the posterior middle calyx in eleven units. Only in one renal unit, two access tracts (an upper and a lower calyceal) were required for completion and a supracostal puncture was required in another case. There was no significant intraoperative bleeding and no blood transfusion was required in any patient. A pelvic perforation occurred in one case, requiring longer PCN (percutaneous nephrostomy) drainage. One patient with infection stones suffered urosepsis postoperatively which was successfully managed. Three cases had residual stones, all located in the renal isthmus, all residuals were un approachable with the rigid instrument; resulting in a overall stone-free rate of 85.7% at discharge. Conclusion Percutaneous nephrolithotomy is generally safe and successful in the management of stones in horseshoe kidneys. However, location of the stones in these patients is crucial to decide the proper tool for optimal stone clearance result.</p

Investigation of the structural, electrical and magnetic properties of vanadium substituted Mn–Zn ferrites

Abstract This work revealed the role of altering vanadium (V) content in Mn–Zn ferrites. We used the traditional solid-state reaction method to prepare the $${\mathrm{Mn}}_{0.5}{\mathrm{Zn}}_{0.5}{\mathrm{V}}_{\mathrm{x}}{\mathrm{Fe}}_{2-\mathrm{x}}{\mathrm{O}}_{4}$$ Mn 0.5 Zn 0.5 V x Fe 2 - x O 4 (x = 0.0, 0.05, 0.10, 0.15, 0.20) ferrites. Powder X-ray diffraction was used to analyze the samples’ crystal structures, revealing the prepared sample’s spinal cubic crystal structure. With increasing Vanadium concentration, the lattice constant drops proportionately. We used Debye–Scherrer (D–S), Williamson–Hall (W–H) Plot, Halder–Wagner (H–W) Langford, and Size Strain Plot (SSP) methods to compare different structural properties. We also used the impedance analyzer to investigate the samples’ dielectric characteristics and AC conductivity at room temperature over a frequency range of 1 kHz–100 MHz. The magnetic properties, i.e., Saturation magnetization (Ms), Coercive field (Hc), and Remanent magnetization (Mr), were estimated from the ferromagnetic hysteresis behavior of the samples measured using a vibrating sample magnetometer (VSM). The saturation magnetization was observed to decrease with an increase in V content. The Mr and HC vary non-linearly with V contents. The prepared samples’ initial permeability was tested, and a reasonably constant complex permeability (µ') was recorded over a wide frequency range (~ 1000 Hz)