Objective: to evaluate the benefit of coverage of
the urethral repair by dorsal dartos flap as a second
layer for preventing fistula and V like incision on
the tip of the glans for preventing meatal stenosis.
Patients and Methods:
Forty five children included in this study age
ranged ( 11 months – 7 years), they underwent
hypospadias repair between December 2008 to
March 2012, all cases with distal hypospadias,
same technique used for all patients, a combination
of techniques used for reconstruction starting
withtubularized incised plate urethroplasty with deepithelialized
or stripping of the skin from both
sides of U shaped incision surrounding the urethral
plate, adding a V like incision on the top (tip of
glans) of the midline urethral plate incision that
give wide meatus subsequently prevent meatal
stenosis and no need for dilatation after stent
removal, followed by harvesting well vascularized
dartos flap from de-epithelialized preputial skin
and transposing itventrally by buttonholing
maneuver and suturing the flap as a second layer
along the neourthral suture line, finally
approximation of glans , so achieving three layer
closure.
Results :All patients are followed for (6 months-
24 months) mean was 15 months, only two patients
(4.4%) complicated with small fistula at the
subcoronal region at the beginning of the study
operated after 6 months and the fistula closed
successfully. Twenty five cases (55.5%) with
Chordee were completely released with no
recurrence. No dilatation was needed after removal
of stent for neomeatus developed a good stream of
urine with no problems regarding stenosis.
Conclusions: In this study hypospadias repair
should achieve three layer closures by using a
dartosfalp as a second layer to cover neourethral
suture line combined with stripping the skin on the
edge of the U shaped incision to gain secure
closure of the neourethra, which will prevent
fistula formation. We recommend adding a
Vincision on the tip of the glans connected with
midline urethral plate incision to prevent meatal
stenosis.
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... Show MoreThe increasing demand for energy has encouraged the development of renewable resources and environmentally benign fuel such as biodiesel. In this study, ethyl fatty esters (EFEs), a major component of biodiesel fuel, were synthesized from soybean oil using sodium ethoxide as a catalyst. By-products were glycerol and difatty acyl urea (DFAU), which has biological characteristics, as antibiotics and antifungal medications. Both EFEs and DFAU have been characterized using Fourier transform infrared (FTIR) spectroscopy, and 1H nuclear magnetic resonance (NMR) technique. The optimum conditions were studied as a function of reaction time, reactant molar ratios, catalyst percentage and the effect of organic solvents. The conversion ratio of soybea
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Abstrct
The administrations of Presidents Clinton and Bush Jr. have seen the emergence of neoconservatives. The neoconservative were the establishment of the Project for the New American Century (PNAC) project in 1997 during the Clinton administration. The neoconservatives, through the New Century Project, were able to make important foreign policy decisions, notably the Iraq Liberation Law, which was passed by Congress on January 26, 1998 and signed by President Clinton and became a law legitimized. Clinton became authorized to take whatever measures he saw fit to contribute to regime change in Iraq. The Bush administration has also undergone major and significant shifts in US strategy on US foreign policy. During the Bush admin
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DC planar sputtering system is characterized by varying discharge potential of (250-2000 volt) and Argon gas pressures of (3.5×10-2 – 1.5) mbar. The breakdown voltage for silver electrode was studied with a uniform electric field at different discharge distances, as well as plasma parameters. The breakdown voltage is a product of the Argon gas pressure inside the chamber and gab distance between the electrodes, represent as Paschen curve. The Current-voltage characteristics curves indicate that the electrical discharge plasma is working in the abnormal glow region. Plasma parameters were found from the current-voltage characteristics of a single probe positioned at the inter-cathode space. Typical values of the electron temperature an
... Show MoreLower extremity exoskeletons can assist with performing particular functions such as gait assistance, and physical therapy support for subjects who have lost the ability to walk. This paper presents the analysis and evaluation of lightweight and adjustable two degrees of freedom, quasi-passive lower limb device to improve gait rehabilitation. The exoskeleton consists of a high torque DC motor mounted on a metal plate above the hip joint, and a link that transmits assistance torque from the motor to the thigh. The knee joint is passively actuated by spring installed parallel with the joint. The action of the passive component (spring) is combined with mechanical output of the motor to provide a good control on the designed exoskeleton whi
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