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.
The icon and the symbol represent the constituents of the communication process, through their intellectual and philosophical concepts that have been addressed by the current research that it has touched upon their importance in conveying the design idea for the recipient and showing the specificity of each one of them in the communication process. The research problem has been limited by the following question: what are the communication roles that the symbol and the icon present for the user in designing the industrial product?
The research objective is to reveal the theoretical visualization that describes the icon and the symbol in the industrial product and its importance in the communication process through stating the of simil
In cooling water systems, cooling towers play a critical role in removing heat from the water. Cooling water systems are commonly used in industry to dispose the waste heat. An upward spray cooling water systems was especially designed and investigated in this work. The effect of two nanofluids (Al2O3/ water, black carbon /water) on velocity and temperature distributions along reverse spray cooling tower at various concentrations (0.02, 0.08, 0.1, 0.15, and 0.2 wt.%) were investigated, beside the effect of the inlet water temperature (35 ,40, and 45 ͦ C) and water to air flow ratio (L/G) of 0.5, 0.75, and 1. The best thermal performance was found when the working solution contained 0.1 wt.% for each of Al2
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(1)
Foundations supporting reciprocating engines, radar towers, turbines, large electric motors, and generators, etc. are subject to vibrations caused by unbalanced machine forces as well as the static weight of the machine. If these vibrations are excessive, they may damage the machine or cause it not to function properly. In the case of block foundation, if changes in size and mass of the foundation do not lead to a satisfactory design, a pile foundation may be used. In this study, the dynamic response of piles and pile Groups in dry sand is investigated experimentally. The analysis involves the displacement response under harmonic excitation. In addition, a numerical modeling by using finite element method with a three-dimensional formula
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(4)
Background Psoriasis is one of the most prevalent chronic inflammatory skin conditions; its prevalence ranges from 1 to 3%. Tumor necrosis factor-alpha (TNF-α), a cytokine that enhances inflammation, is overexpressed in synovium and skin plaques in psoriasis. TNF-α plays a critical role in the pathogenesis of psoriasis. IL-10 is the most crucial cytokine for reducing excessive immune responses and decreasing pro-inflammatory reactions in all autoimmune disorders. Objective To evaluate the effect of Apremilast on ILـ10, TNFـα, and BMI in obese psoriatic patients. Methods Thirty patients included in this investigative study to measure the concentrations of TNFـα, ILـ10 and BMI, before and after receiving Apremilast. TNFـα and
... Show MoreApparent molar volume, V?, and viscosity B-coefficient of nicotinc acid in water and in aqueous NaCl solutions have been determined from density and viscosity measurements at (293.15, 298.15, 303.15 and 308.15) K. The experimental density data were evaluated by Masson equation, and the derived, apparent molar volume at infinite dilution, Vo?, and the slope Sv, were interpreted in term of solute-solvent and solute- solute interactions. Transfer apparent molar volumes at infinite dilution of nicotinic acid from water to NaCl solutions at various temperatures have been calculated.The viscosity data have been analyzed using Jones-Dole equation, and the derived parameters, Jones-Dolecoefficient, B,and Falkenhagen coefficient,A, have been also in
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In this study, a genetic algorithm (GA) is used to detect damage in curved beam model, stiffness as well as mass matrices of the curved beam elements is formulated using Hamilton's principle. Each node of the curved beam element possesses seven degrees of freedom including the warping degree of freedom. The curved beam element had been derived based on the Kang and Yoo’s thin-walled curved beam theory. The identification of damage is formulated as an optimization problem, binary and continuous genetic algorithms
(BGA, CGA) are used to detect and locate the damage using two objective functions (change in natural frequencies, Modal Assurance Criterion MAC). The results show the objective function based on change in natural frequency i
(18)
(18)
(2)
Education in it s different levels becomes development in any country. There fore, nations pay great attention to educational systems, because they perceive that preparing human resources is essential to the development of these nations.
The present study deals with the a academic frames which formulate education in each educational system such as educational philosophy , educational aims , educational strategies by which the academic frames are carried out, which is limited to curriculum, teacher preparations, school activities, in addition to guidance and counseling.
This study reaches some conclusion which are derived from the description of the academic and practical frames some suggestion are made for the mechanism which facil