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.
Since more than a decade, human rights dialogue in the European Mediterranean Region has been marked by a number of tensions. Although a number of factors contribute to such disputes, the effect of human rights conditionality, which ties EU economic cooperation progression with partner countries human rights advancement, on the dialogue has not been studied. Understanding the aspects, impacts, and effects of conditionality on Euro-Med relations is crucial for furthering dialogue. Yet this variable has been almost entirely neglected in academic and policy research. The research concludes several direct and indirect impacts of conditionality on human rights dialogue using a mixed methodology approach. Direct effects are reflected in the wi
... Show MoreThe way artists deal with body in their artistic works has had so many forms and methods, whether as an object for their drawings or as a material to create live artistic performances that relate to the idea of correspondence and interaction between different artistic categories such as: drama, dance, and painting as it is the case of the artist Marina Abramovic who has always used her body as an artistic unit to generate meaning and to perform her lively shows.
To go deeper into her career, our work was divided into 3 sections:
The first section was devoted to follow the main artistic stages that her body had gone through, starting with paintings she performed using concepts based on acting, simulation and nudity and ending wi
The optimization calculations are made to find the optimum properties of combined quadrupole lens consist of electrostatic and magnetic lenses to produce achromatic lens. The modified bell-shaped model is used and the calculation is made by solving the equation of motion and finding the transfer matrices in convergence and divergence planes, these matrices are used to find the properties of lens as the magnification and aberrations coefficients. To find the optimum values of chromatic and spherical aberrations coefficients, the effect of both the excitation parameter of the lens (n) and the effective length of the lens into account as effective parameters in the optimization processing
This valve is intended for use in valves for steering movement, using the qualities of the Magneto-rheological (MR) fluid to regulate the fluid, direct contact without the utilization of moving parts like a spool, a connection between electric flux, and fluid power was made, The simulation was done to employ the" finite element method of magnetism (FEMM)" to arrive at the best design. This software is used for magnetic resonance valve finite element analysis. The valve's best performance was obtained by using a closed directional control valve in the normal state normally closed (NC) MR valve, with simulation results revealing the optimum magnetic flux density in the absence of a current and the shedding condition, as well as the optimum
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sequences. This paper presents a two-dimensional finite element method. In this method, the soil is divided into a number of triangle elements. A model soil (Gibson-type) with linearly increasing modulus of elasticity with depth is presented. The influences of modulus of elasticity, incremental loading, width of footing, and depth of footing are considered in this paper. The results are compared with authors' conclusions of previous studies.
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In this work, an experimental investigation has been done for heat transfer by natural-convection through a horizontal concentric annulus with porous media effects. The porous structure in gap spacing consists of a glass balls and replaced by plastic (PVC) balls with different sizes. The outer surface of outer tube is isothermally cooled while the outer surface of inner tube is heated with constant heat flux condition. The inner tube is heated with different supplied electrical power levels. Four different radius ratios of annulus are used. The effects of porous media material, particles size and annulus radius ratio on heat dissipation in terms of average Nusselt number have been analyzed. |
In this research is estimated the function of reliability dynamic of multi state systems and their compounds and for three types of systems (serial, parallel, 2-out-of-3) and about two states (Failure and repair) depending on calculating the structur function allow to describing the behavior of