Onlay urethroplasty with unilatreral parameatal penopreputial flap: Mansoura modification of Koyanagi technique in the management of hypospadias without chordee

Background/purpose: One-stage urethroplasty with bilateral parameatal foreskin flap was first described by Tomohiko Koyanagi for cases of severe hypospadias. He also introduced the onlay urethroplasty with unilateral parameatal foreskin flap for distal hypospadias. Emir and colleagues in 2000 devised a modification of the bilateral Koyanagi repair of severe hypospadias. We in turn modified the (unilateral) Koyanagi technique for the repair of hypospadias without chordee. The aim of this study is to analyze the results of the Mansoura modification of the (unilateral) Koyanagi technique as a one-stage repair of hypospadias without chordee.Patients and methods: During the period from March 2013 to March 2015, 30 patients underwent treatment of hypospadias without chordee using the modified onlay urethroplasty with unilatreral parameatal penopreputial flap (modified unilateral Koyanagi technique).Results: The patients’ age at the time of surgery ranged from 6 to 30 months. Sixteen cases had distal penile meatus, 10 had mid-penile meatus; and four had proximal penile meatus. The follow-up ranged from 3 months to 1 year. Primary success occurred in 28 (93%) cases with accepted cosmetic appearance. Complications occurred in two (7%) cases, in the form of urethrocutaneous fistula. There was no incidence of meatal stenosis nor recession, urethral stricture or flap necrosis.Conclusion: The Mansoura modification of the onlay urethroplasty with unilatreral parameatal penopreputial flap (unilateral Koyanagi) is applicable for all forms of hypospadias without chordee showing acceptable results.Keywords: hypospadias, modified Koyanagi, one-stage urethroplasty, onlay urethroplasty with parameatal penopreputial flap, original Koyanag

Monitoring of uncultured Dunaliella sp. in an Egyptian solar saltern field based on RuBisCO-encoding gene cbbL

Culture-independent molecular approach was used to explore and evaluate the diversity of Dunaliella species living at the salt field Malahat El-Max Alexandria, Egypt. Bulk genomic DNA was extracted directly from the collected salt water samples. Specific PCR primers and methodology were designed to amplify the gene cbbL, which encodes the large subunit of the enzyme ribulose-1,5-bisphosphate carboxylase/oxygenase (RuBisCO, EC 4.1.1.39) of only Dunaliella species, from the extracted microbial metagenome. The 700 bp-PCR amplicons were cloned and cbbL clone library was constructed and analyzed by sequencing. Rarefaction curve was saturated at sequence analyses of 23 clones, obtaining 19 phylotypes of Dunaliella cbbL, representing the total composition of Dunaliella in the collected sample. All recorded phylotypes had the known deduced amino acid cbbL motive sequence and catalytic sites. Fingerprint sequence, characterizing Dunaliella cbbL, was recorded. The cbbL phylotypes were grouped into two distinct phylogenetic clusters. The cluster 1, consisting of 18 current  cbbL phylotypes was rooted with a cluster containing cbbLs of Dunaliella salina, Dunaliella bioculata, Dunaliella primolecta and Dunaliella tertiolecta. The single phylotype, uncultured Dunaliella ElMax.3, forming cluster 2, showed a unique phylogenetic lineage in the evolution of Dunaliella cbbL. This study introduced the first functional gene markers for exploring Dunaliella species in salt waters without culture.Keywords: Uncultured Dunaliella, RuBisCO cbbL, solar saltern water, diversity.African Journal of Biotechnology Vol. 12(34), pp. 5361-536

The role of PI3K and NADPH oxidases in vasculogenesis/angiogenesis of mouse embryonic stem cells

The impact of reactive oxygen species (ROS) and Phosphoinositide 3 kinase (PI3K) in vascular differentiating of embryonic stem (ES) cells is largely unknown. Here we show that silencing PI3K catalytic subunit p110α and NOX1 using short hairpin RNA (shRNA) or inhibition of Rac1 significantly abolished the superoxide (O2-) production stimulated by vascular endothelial growth factor (VEGF) in mouse ES cells and in ES cell-derived Flk-1+ vascular progenitor cells. Moreover, silencing p110α or inhibition the Rac1 arrested vascular development at initial stages of vasculogenesis in embryoid bodies even under VEGF treatment. In sorted Flk-1 positive ES cells tube-like structure formation on matrigel and cell migration in the scratch migration assay were totally impaired in absence of p110α, whereas silencing NOX1 in ES cells caused a significant reduction in the PECAM-1 positive area, branching points, cell migration and tube length upon VEGF treatment. However, vascular differentiation markers were still produced in shRNA VEGF treated NOX1 knock down ES cells. The efficiency of silencing the p110α catalytic subunit of PI3K and NOX1 to inhibit angiogenesis/vasculogenesis were investigated for their capacity to inhibit tumor-induced angiogenesis in confrontation cultures consisting of embryoid bodies and multicellular DU-145 prostate tumor spheroids. Interestingly, we found that silencing p110α can strongly inhibited the vascularization of multicellular tumor spheroids in confrontation cultures. These findings provide direct evidence that the activity of p110α in endothelial cells is essential in vasculogenesis/angiogenesis and suggest that p110α and their downstream signalling cascade may represent promising therapeutic targets for the treatment of numerous human diseases that involve aberrant neovascularization

Design Indicators of Criteria of Different Activities in Public Places During Covid-19 Pandemic

Health pandemics are one of the greatest threats to human life. The more spacious and interdependent the city becomes, the faster the spread of epidemics is unless the State takes public health measures. Green places and public places contribute to improving the health of the population during the pandemics. Therefore, Poland has banned cars in parks to help people to get out and walk of their homes during the quarantine. However, as spatial spacing measures continue, cities may allocate more public places to, people only to practice their various activities. This paper aims to observe ideas introduced about how to change our relationship with public places, through a review some proposals by multiple parties concerned with the issue of urbanization under the Corona pandemic. Such proposals focus on identifying design guides for activities in public places within; the city, Such as providing the places with sanitary facilities that help with the ongoing sterilization process, as well as technical facilities that help monitor the status quo to alert and act accordingly. In addition to the various urban solutions that we will review in the context of the study in terms of achieving the principle of social convergence and spatial divergence. The study follows the theoretical and analytical approach in monitoring the changes that occurred on urban places as a result of Corona virus, analyzing models for the study that clarified the changes of activities in urban places, and reaching a set of indicators for designing urban places during the pandemic

Two-stage repair of low anorectal malformations in girls: is it truly a setback?

Background/purpose Anorectal malformations (ARMs) affect 1 in 4000–5000 births. Low ARMs are nowadays treated in the first stage rather than at second or third stages. However, reports suggest problems with continence in these children because of wound dehiscence and infection; thus, protective colostomy may still be recommended. Colostomies do have complications, but the question is whether these disadvantages outweigh the protective effect on wound healing after anal reconstruction. The aim of this study was to define whether two-stage repair of low ARMs in girls is truly a setback or whether it is beneficial.Patients and methods During the period of June 2008–June 2012, 30 female patients suffering from low ARMs were admitted to Mansoura University Children Hospital. Their ages at the time of surgery ranged from 3 to 11 months (mean age 6.2) and they were divided into two equal groups. The fistula location was defined either anocutaneous or anovestibular according to the Pena classification. The choice of management was totally randomized; thus, patients of group A underwent a two-stage posterior sagittal anorectoplasty and group B patients underwent a one-stage posterior sagittal anorectoplasty operation. Data recorded included age, fistula location, associated anomalies, operation performed, operative time, length of hospital stay, approximate cost, and postoperative complications.Results A comparison of data showed that treatment of patients of group A involved more time and money and they had a longer duration of hospital stay than did patients of group B. Seven patients (47%) in group A and nine patients (60%) in group B showed postoperative complications. Wound infection occurred in three patients (20%) of group A and in eight patients (53%) of group B. More importantly, two (13%) wound disruptions occurred among the three cases with wound infection in group A, whereas six (40%) disruptions occurred among the eight patients (53%) with wound infections in group B. The incidence of redo operation in group B was found to be significantly higher than in group A. Mucosal prolapse occurred in only one patient (7%) of group B. Complications related to colostomy occurred in group A only; five patients (33%) suffered skin excoriation around the stoma and one patient (7%) showed a prolapsed distal stoma loop. Constipation was noted during follow-up in five patients (33%) of group A and in six patients (40%) of group B.Conclusion Two-stage repair of low ARM in girls is truly beneficial, as we could perform a successful operation and achieve continence in the child regardless of the complications of colostomy, which are temporary and tolerable.Keywords: anorectal malformations, colostomy, posterior sagittal anorectoplasty, two-stage repair of low anorectal malformatio

Inverse Axiomatic Design: An Approach to Design Manufacturing Paradigms

A robust manufacturing paradigm, as a part of manufacturing support system, pushes the manufacturing system towards worldwide manufacturing. That is achieved through the ability of waste removal and market responsiveness of a manufacturing system. Thus, several excellent manufacturing practices should be applied for that purpose. The selection and implementation of manufacturing practices isn’t an easy task because of the cost and time consumed. Wrong practices lead to the failure of a manufacturing system. Therefore, this paper introduces a structured approach to design the manufacturing paradigm based on Axiomatic Design and Binary Ordering algorithm to minimize the running cost of manufacturing systems. The proposed approach is applied to a case from steel industry

Modified Koyanagi Technique in Management of Proximal Hypospadias

Background/Purpose: One stage urethroplasty with parameatal foreskin flap (OUPF) applicable to all types of hypospadias was first described by Tomohiko Koyanagi, however high complication rates were reported.The aim of this study is to analyze the results of a modification of the Koyanagi technique as a one-stage repair of proximal hypospadias. Patients and Methods: During the period of from March 2008 to March 2009, 30 patients underwent treatment of proximal hypospadias using the modified Koyanagi technique. Patient age at the time of surgery ranged from 6 to 24 months. In all cases, the urethral opening was at or just proximal to the penoscrotal junction. Follow up ranged from 3 months to 1 year. Results: Primary success occurred in 27 cases (90%) with accepted cosmetic appearance. Complications occurred in 3 cases (10%). Urethrocutaneous fistula occurred in 2 cases (6.7%). Meatal recession occurred in 1 case (3.3%). There was no incidence of meatal stenosis, urethral stricture, residual chordee or complete flap necrosis. Conclusion: The modified technique permits one-stage repair of proximal hypospadias with low complication rates. Keywords: Hypospadias, Koyanagi, One stage urethroplasty

Optimal planning of RDGs in electrical distribution networks using hybrid SAPSO algorithm

The impact of the renewable distributed generations (RDGs), such as photovoltaic (PV) and wind turbine (WT) systems can be positive or negative on the system, based on the location and size of the DG. So, the correct location and size of DG in the distribution network remain an obstacle to achieving their full possible benefits. Therefore, the future distribution networks with the high penetration of DG power must be planned and operated to improve their efficiency. Thus, this paper presents a new methodology for integrated of renewable energy-based DG units with electrical distribution network. Since the main objective of the proposed methodology is to reduce the power losses and improve the voltage profile of the radial distribution system (RDS). In this regard, the optimization problem was formulated using loss sensitivity factor (LSF), simulated annealing (SA), particle swarm optimization (PSO) and a combination of loss sensitivity index (LSI) with SA & PSO (LSISA, LSIPSO) respectively. This paper contributes a new methodology SAPSO, which prevents the defects of SA & PSO. Optimal placement and sizing of renewable energy-based DG tested on 33-bus system. The results demonstrate the reliability and robustness of the proposed SAPSO algorithm to find the near-optimal position and size of the DG units to mitigate the power losses and improve the radial distribution system's voltage profile

The value of intra-abdominal pressure monitoring through transvesical route in the choice and outcome of management of congenital abdominal wall defects

Introduction Gastroschisis and omphalocele are most common congenital abdominal wall defects (AWDs). Surgical management aims to reduce the evisceration safely, close the defect with a cosmetically acceptable outcome under guidance of intraoperative monitoring of intra-abdominal pressure (IAP). Intravesical pressure monitoring technique recommended by (WSACS) is the most reliable technique for IAP measurement in neonates.Aim The aim of this study is to assess the value of IAP monitoring via vesical pressure measurement in the choice and outcome of management of congenital AWDs.Patients and methods This is a prospective study of 25 cases that suffered congenital anterior AWDs (gastroschisis and omphalocele) admitted to Mansoura University Children Hospital during the period from October 2013 to October 2015. They were all operated upon guided by IVP monitoring during and after repair. Results In our study, 14 (56%) cases presented with gastroschisis and 11 (44%) presented with exomphalos with a median age of 24 h. Males (56%) were slightly more than females (44%). Congenital anomalies were reported in 16 cases (64%). Primary fascial closure was successful in 15 (60%) cases, whereas Silo repair was done in six (24%) cases and skin closure in only four (16%) cases. During the attempts of closure the mean abdominal perfusion pressure was 40.24 ± 5.59, the mean peak inspiratory pressure was 24 ±6.11 and the mean IAP was 22.60± 6.89. Two cases developed intra-abdominal hypertension after abdominal closure (8%) and only one of them needed decompressive laparotomy (4%). Postoperative complications were reported in 15 (60%) cases and mortality occurred in eight (32%) cases.Conclusion Increased IAP secondary to forceful closure of the abdominal defect is associated with the occurrence of complications. IVP monitoring is feasible during closure of AWDs and a threshold of 20cm H2O is  appropriate to decide between primary and staged approach. Keywords: congenital abdominal wall defect, intravesical pressure, intra-abdominal hypertensio