Management of symptomatic urachal cysts in Children

Aim: We report the results of the surgical treatment of symptomatic urachal cysts. Materials and Methods: The medical records of patients who underwent urachal cyst excision between 2012 and 2017 were reviewed retrospectively at our hospital. The age, sex, presenting complaint, method of diagnosis, average cyst diameter, surgical procedure, and postoperative complications of each patient were recorded.Results: Twenty‑seven patients who had urachal cyst were included in this study; 5 out of 27 patients were treated conservatively and the rest of patients were treated surgically, made up of 16 males (72%) and 6 females (28%). The average age of the patients was 7 years (range: 1–17). The most common reason for referral was abdominal pain in 12 patients (54%), discharge in 6 patients (28%), fever in 2 patients (9%), and an abdominal mass in 2 patients (9%). An ultrasound scan was performed in all patients as an initial imaging study. The average cyst diameter was 1.5 cm (range: 1–6 cm). Laparotomy was performed in 16 patients, with 6 patients  undergoing laparoscopic excision. Postoperative wound infection developed in two patients. Conclusions: Patients with urachal cysts may be managed conservatively initially. However, patients who do not show any clinical and radiological signs of regression, or those who have large cysts, should undergo surgical excision through laparotomy or a laparoscopic approach.Keywords: Children, surgical treatment, urachal cys

Effect of high hydrostatic pressure in physicochemical properties and in vitro digestibility of cornstarch by nuclear magnetic resonance relaxometry

Starch is the major polysaccharide consumed by human being. It is not classified as a dietary fiber as it is digestible by the enzymes present in the saliva and small intestines. However, it is possible to modify starch with thermal and nonthermal techniques. High hydrostatic pressure (HHP) is a cold pasteurization technique that has increased application in food industry with minimum effect on nutritional quality of the food products. It is hypothesized that the use of HHP could be a modification strategy for starch. In this study, effects of different HHP parameters (400 and 500 MPa) at different temperatures (20, 30, and 40°C) for 5, 15, and 30 min on in vitro digestibility and physicochemical properties of cornstarch were studied by Nuclear magnetic resonance (NMR) relaxometry. Results showed that HHP treatment increased slowly digestible starch (SDS) and rapid digestible starch (RDS) significantly with pressure and temperature (p <.05). In addition, it was shown that HHP treatment decreased the solubility and swelling power of the cornstarch and it is proposed that 30 min HHP treatment at 500 MPa and 40°C is the onset for cornstarch gelatinization according to NMR relaxometry results. Practical Applications: High hydrostatic pressure (HHP) is a nonthermal processing technology that is commonly used in the food industry for extending the shelf life of food products by destroying vegetative cells, enzymes, microorganisms effectively, and it can modify the starch so the aim of this study was to investigate the effects of different HHP parameters on in vitro digestibility and physicochemical properties of cornstarch by nuclear magnetic resonance relaxometry. © 2019 Wiley Periodicals, Inc

A case of isolated female epispadias and our approach to treatment

Cases of isolated female epispadias (IFE) without exstrophy of the bladder are quite rare. The clinical symptoms of IFE are abnormal external genitalia with primary urinary incontinence. Our patient was a 7-year-old girl with total urinary incontinence. Physical examination revealed a patulous urethra, bifid labia minora, and a bifid clitoris. The vagina and hymen appeared to be normal. Uroflowmetry demonstrated an overflow-type pathological voiding pattern with low voiding pressure. A voiding cystourethrogram showed no indications of reflux. To treat our IFE patient, we performed a single stage genital approach reconstruction of the urethra, clitoris, and labia minora. Follow up with the patient ensured that she was continent and that her external genitals took on an acceptable appearance