Principles of Fetal Surgery

Fetal therapy (in utero therapy) is a type of special therapy which aims to prevent or correct congenital anomalies in fetus, and prevents their severe consequences on later fetal development. It includes the use of in utero human fetal stem cell transplantation, fetal gene therapy and gene-editing technology as a new treatment for fetal genetic disorders. It started with open fetal surgery and then significantly advancing with innovations, toward minimally invasive fetal procedures, which are undoubtedly the future of fetal surgery, with the goal of providing the best possible fetal outcome, while minimizing the morbidity and mortality to the mother. The goal of fetal treatments is to decrease both fetal and maternal risks and prevent premature rupture of membranes. Fetal ultrasound and MRI are crucial for successful fetal interventions. Moreover, multidisciplinary fetal teams, including fetal surgeon, ultrasonographer, perinatologist, and anesthesiologist, are essential for optimum care to both mother and fetus. Finally, any new modality of fetal therapy must be thoroughly evaluated in animal models before clinical practice. In this chapter, we discuss the basic principles of fetal surgery, milestones of fetal surgery, specific fetal anomalies that are amenable for fetal surgery, successful fetal surgery criteria and future of fetal surgery

Inguinal Hernia in Infancy and Children

Congenital inguinal hernia is a very important subject for both general and pediatric surgeons, and many issues related to the inguinal hernia in infants and children are still confusing. Herein, the subject of congenital inguinal hernia, including the relevant embryology, related anatomy, the symptoms and signs essential for diagnosis, and the needed examination tests and investigations, is presented in a systematic manner. Also, the updated treatment options were discussed including both open and laparoscopic approaches with spotlight on the very recent single incision laparoscopic inguinal hernia repair in children. Finally, at the end of the chapter, there are many valuable references for more details

Coupled dynamics of flow, microstructure, and conductivity in sheared suspensions

We propose a model for the evolution of the conductivity tensor for a flowing suspension of electrically conductive particles. We use discrete particle numerical simulations together with a continuum physical framework to construct an evolution law for the suspension microsutructure during flow. This model is then coupled with a relationship between the microstructure and the electrical conductivity tensor. The parameters of the joint model are fit experimentally using rheo- electrical conductivity measurements of carbon black suspensions under flow over a range of shear rates. The model is applied to the case of steady shearing as well as time-varying conductivity of unsteady flow experiments. We find that the model prediction agrees closely with the measured experimental data in all cases.Comment: 5 pages, 4 figure

Impact of in-vitro gastro-pancreatic digestion on polyphenols and cinnamaldehyde bioaccessibility and antioxidant activity in stirred cinnamon-fortified yogurt

In this study, cinnamon powder was supplemented into yogurt as a functional ingredient. The total phenolic compounds, individual phytochemicals and radical scavenging activity of the yogurts were measured and compared with a cinnamon water extract treated in the same way as the fortified yogurt. Cinnamon-fortified yogurt displayed higher total phenolic content (P < 0.05) and higher radical scavenging activity (P < 0.05) compared to plain yogurt. Phenolic acids, flavonols and cinnamaldehyde were identified in the cinnamon-fortified yogurt. Results showed that only the 34.7% of the total phenolic compounds present in the cinnamon water extract were found in the cinnamon-fortified yogurt, the remaining being bound to milk proteins. A low recovery was also found for the individual phytochemicals. However, in-vitro digestion of the cinnamon-fortified yogurt resulted in the release of phenolic compounds from milk proteins so that at the end of the digestion the amount of phenolic compounds recovered in the cinnamon-fortified yogurt was higher than that found in the digested cinnamon water extract (P < 0.05). These results clearly showed that yogurt matrix enhance the gastro-intestinal stability and the bioaccessibility of cinnamon polyphenols. Cinnamon-fortified yogurt can be considered an important source of dietary bioaccessible polyphenols

Magnetic Field Treatment to Control Scale Growth and Oxygen Scavenger Performance in Mono Ethylene Glycol Regeneration Process

Magnetic fields application is gaining increased importance in all areas of industry, this includes physical and chemical applications. Even though these have excellent prospects, it is not understood whether magnetic fields treatment can work efficiently at MEG regeneration systems in oil and natural gas industries. Magnetic fields applications, the focus of this study, proposes non-chemical techniques to control scale (CaCO3) formation growth and oxygen contamination after conventional approaches have been exhausted

Five years’ experience of laparoscopic-assisted dismembered pyeloplasty versus open dismembered pyeloplasty

Purpose Pyeloplasty for ureteropelvic junction obstruction (UPJO) in children has traditionally been performed using an open technique. However, the large lumbar incision in open pyeloplasty necessitates several weeks before a return to normal activity and requires significant tissue retraction to expose the field; hence, the damage is often more than that anticipated. We present our long-term experience with laparoscopic-assisted pyeloplasty in the treatment of UPJO, to evaluate the feasibility, safety, and long-term outcome of this technique in children.Patients and methods In total, 40 children with UPJO requiring operative repair were included in the study. Twenty patients with UPJO were randomly selected to undergo open dismembered pyeloplasty (group A) and the remaining 20 patients to undergo laparoscopic-assisted dismembered pyeloplasty (group B) at the PediatricSurgery Department between January 2013 and December 2017. All patients were followed-up for 5 years postoperatively. The outcome was measured by the ultrasonography and diuretic renography with resolution of obstructive symptoms.Results The mean laparoscopic procedure time was 25 min. There was a slight relationship between age and operative time. No major perioperative complicationsoccurred in any cases. Renal pelvic anterior–posterior diameter at postoperative ultrasonography significantly decreased (P<0.05). Postoperative split renal function on diuretic renography significantly improved. Overall, successful resolution of UPJO was observed in all patients.Conclusion Laparoscopic-assisted pyeloplasty appears to be a safe, feasible, and effective alternative to open pyeloplasty in children. There are shorter operative times in the laparoscopic-assisted pyeloplasty and shorter overall hospitalization. It avoids large lumbar incision and gives excellent functional and cosmetic results. Keywords: laparoscopy-assisted pyeloplasty, minimally invasive surgery, ureteropelvic junction obstruction