The value of computed tomography-urography in predicting the postoperative outcome of antenatally diagnosed pelviureteric junction obstruction

Background The natural course of pelviureteric junction (PUJ) obstruction is  variable. Of those who require surgical intervention, there is no definite reliable  preoperative predictor of the likely postoperative outcome. We evaluated the value of preoperative computed tomography (CT)-urography in predicting the  postoperative outcome.Patients and methods Ten newborns with antenatally diagnosed PUJ obstruction  were evaluated after delivery with an abdominal ultrasound, and those with a renal pelvis measuring more than 3 cm in diameter were subjected to preoperative CT-urography. The kidney size, renal pelvis size, and renal parenchyma thickness were measured and documented. All underwent open surgical Anderson-Hynes dismembered pyeloplasty. The outcome was correlated to the preoperative renal parenchymal thickness as measured by means of preoperative CT-urography.Results Ten newborns (seven male and three female) with PUJ obstruction were  operated on. Their ages at surgery ranged from 8 days to 4 months (mean= 1.75 months). Eight had PUJ obstruction on the right side and two had PUJ obstruction on the left side. The mean renal pelvis size on the affected side was 4.9 cm (3.6–6.3 cm). The mean renal parenchymal thickness was 0.57cm (0.25–1.3 cm). Four patients had a renal parenchymal thickness less than 0.5 cm, and these patients showed poor results on followup isotope scan compared with those who had a renalparenchymal thickness of more than 0.5 cm [mean= 14.9% (12–19.6%)] compared with a mean of 44.2% (33–54%).Conclusion This is a preliminary report and the number of patients in our study is small to make definite conclusions, and further studies in this regard are important. We believe that renal parenchymal thickness as measured by means of preoperative CT-urography is an important predictor of the final outcome in patients with  antenatally diagnosed hydronephrosis. Those who had a renal parenchymal thickness of 0.5 cm or less showed poor results on followup isotope scan compared with those who had a renal parenchymal thickness of more than 0.5 cm.Keywords: outcome, pelviureteric junction obstruction, pyeloplast

EXPERIMENTAL EVIDENCES FOR THE PROMISING HERAPEUTIC ROLE OF VITIS VINIFERA SEED EXTRACT AGAINST NONALCOHOLIC STEATOHEPATITIS

Objective: The present study was planned to investigate the possible therapeutic effect of methanolic extract of Vitis vinifera seeds on high fat diet-induced nonalcoholic steatohepatitis (NASH) in forty adult female Wistar rats.Methods: The animals were divided into four groups, (G1)was served as healthy control group and the other three groups received high fat diet for 32 weeks for induction of NASH were assigned as follow: (G2) in which the animals bearing NASH were left untreated, (G3) in which the animals bearing NASH were treated with Vitis vinifera seed extract in a dose of 0.28g/kg b. wt (GSH) and (G4) in which the animals bearing NASH were treated with Vitis vinifera seed extract in a dose of 0.14g/kg b. wt (GSL).Results: The results revealed significant increase in serum ALT activity, plasma glucose, insulin levels, serum resist in, NF-κB, TNF-α, HGF levels, hepatic TNF-α and HGF gene expression levels. While, serum albumin, adiponectin levels and hepatic adiponectin gene expression level were decreased significantly in NASH group. Conversely, treatment of NASH groups with GSH or GSL resulted in significant decrease in serum ALT activity, plasma glucose, insulin levels, serum resist in, NF-κB, TNF-α, HGF levels, hepatic TNF-α and HGF gene expression levels. However, serum albumin, adiponectin levels and hepatic adiponectin gene expression level were increased significantly as a consequence of treatment with GSH or GSL.Conclusions: The efficacy of Vitis vinifera extract against NASH might be attributed to its strong hepatoprotective potential and powerful anti-inflammatory activity in addition to its potent role in ameliorating insulin resistance indices.Â

INVESTIGATION OF THE EFFECT OF TEMPERATURE AND TIME OF CASE HARDENING ON THE MECHANICAL PROPERTIES AND MICROSTRUCTURE OF LOW CARBON STEEL (AISI 1020)

The main objective of this paper is experimental study of pack carburizing of carbon steels (AISI 1020) by using two parameters (holding time and carburizing temperature). This study was conducted by using electrical furnace. This process is carried out at temperatures of 950°C for durations time 90 minutes. From the experiment, the surface hardness and thickness of carbon layer was different according to the parameters used. The quenching medium that uses in this experiment is water, oil, sea water and air. For carburizing temperature at 950°C, the highest of surface hardness value for air is 128 HV that carburized for 90 minutes, the highest of surface hardness value for water is 224 HV that carburized for 90 minutes. For carburizing temperature of 950°C, the highest of surface hardness value for sea water is 166.9 HV that carburized for 90 minutes and for carburizing temperature at 950°C which is the highest of surface hardness value for oil is 126 HV. The thickness of carbon layer was between 40μm to 120μm. The result indicates the carburizing process accelerates the diffusion of carbon atoms into the surface, thus increasing the thickness of carburized layer as well as the surface hardness

Middle Meningeal Artery Arising from the Basilar Artery

Various anomalies for the origin of the middle meningeal artery (MMA) have been described in the literature. However, origin of the MMA from the basilar trunk is an extremely rare variant. We report on a 54-year-old female who presented with frequent headaches; magnetic resonance imaging showed a right parietal meningioma. The abnormal origin of the middle meningeal artery from the basilar artery was diagnosed by angiography performed for preoperative embolization of the tumor. We report on the case with a review of the embryologic basis, possible explanations for this aberrant origin, and its clinical implications

Adjustment to target debt maturity and equity mispricing: evidence from Asia Pacific

This paper examines firms’ target adjustment behavior for debt maturity structure for selected countries from the Asia Pacific region. The literature documents that managers’ structure debt issues in line with a target maturity structure which is limited by transactions costs, information asymmetry, agency problems, liquidity needs as well as institutional factors. Our paper contends that firms adjust to target levels at differing rates based on whether the current maturity structure is above or below target levels as well as equity mispricing. We estimate the target debt maturity based on the lead level and measure speed of adjustment to target levels by regressing the difference between the simulated and actual values. Our findings indicate that firms which are below target debt maturity tend to adjust at more rapid rates during periods of overvaluation. Firms which are above target debt maturity tend to adjust at more rapid rates during periods of undervaluation. Our findings indicate asymmetric adjustment rates indicating that debt maturity structure serves as an important tool for signaling. The implications provide a better understanding on the impact of debt maturity on information asymmetry leading to differences in adjustment to target debt maturity structures

Predicting Distribution of Aedes Aegypti and Culex Pipiens Complex, Potential Vectors of Rift Valley Fever Virus in Relation to Disease Epidemics in East Africa.

The East African region has experienced several Rift Valley fever (RVF) outbreaks since the 1930s. The objective of this study was to identify distributions of potential disease vectors in relation to disease epidemics. Understanding disease vector potential distributions is a major concern for disease transmission dynamics. DIVERSE ECOLOGICAL NICHE MODELLING TECHNIQUES HAVE BEEN DEVELOPED FOR THIS PURPOSE: we present a maximum entropy (Maxent) approach for estimating distributions of potential RVF vectors in un-sampled areas in East Africa. We modelled the distribution of two species of mosquitoes (Aedes aegypti and Culex pipiens complex) responsible for potential maintenance and amplification of the virus, respectively. Predicted distributions of environmentally suitable areas in East Africa were based on the presence-only occurrence data derived from our entomological study in Ngorongoro District in northern Tanzania. Our model predicted potential suitable areas with high success rates of 90.9% for A. aegypti and 91.6% for C. pipiens complex. Model performance was statistically significantly better than random for both species. Most suitable sites for the two vectors were predicted in central and northwestern Tanzania with previous disease epidemics. Other important risk areas include western Lake Victoria, northern parts of Lake Malawi, and the Rift Valley region of Kenya. Findings from this study show distributions of vectors had biological and epidemiological significance in relation to disease outbreak hotspots, and hence provide guidance for the selection of sampling areas for RVF vectors during inter-epidemic periods