Tip Technique Research Articles

A novel triple dartous fixation in hypospadias repair

ObjectiveThis study investigates the impact of the use of dartos covering to augment the neourethra on functional and cosmetic results. To evaluate a novel technique demonstrating how to fix dartos flap to cover the neourethra as a barrier in hypospadias repair. Patients and methodsThis study comprised 204 male patients with different degree of hypospadias (DPH = 132, coronal hypospadias = 46, MPH = 26). Their ages ranged from 1 to 23 ys (mean age = 2 ys). Penile chordee was in (DPH = 45, coronal hypospadias = 33, MPH = 26). All patients had abnormal downward directed urinary stream. Hypospadias repair was performed by the classic TIP technique in addition to our novel modification of dartos covering. Patients were submitted to 5 years of follow-up including clinical examination of the functional and cosmetic parameters. ResultsSuccess rates were reported in 200 patients, 3 patients had complications with subcoronal urethrocutaneous fistula and one patient with complete repair disruption. ConclusionTriple dartos fixation is a simple technique for all hypospadiologists to minimize urethrocutaneous fistula as common complication of hypospadias repair with good functional and cosmetic results.

Interventional recanalization therapy in patients with non-cirrhotic, non-malignant portal vein thrombosis: comparison between transjugular versus transhepatic access

PurposeTo compare the safety and outcome of transjugular versus percutaneous technique in recanalization of non-cirrhotic, non-malignant portal vein thrombosis.MethodsWe present a retrospective bicentric analysis of 21 patients with non-cirrhotic, non-malignant PVT, who were treated between 2016 and 2021 by interventional recanalization via different access routes (percutaneous [PT] vs. transjugular in transhepatic portosystemic shunt [TIPS] technique). Complication rates with a focus on periprocedural bleeding and patency as well as outcome were compared.ResultsOf the 21 patients treated (median age 48 years, range of 19–78), seven (33%) patients had an underlying prothrombotic condition. While 14 (57%) patients were treated for acute PVT, seven (43%) patients had progressive thrombosis with known chronic PVT. Nine patients underwent initial recanalization via PT access and twelve via TIPS technique. There was no significant difference in complete technical success rate according to initial access route (55.5% in PT group vs. 83.3% in TIPS group, p = 0.331). However, creation of an actual TIPS was associated with higher technical success in restoring portal venous flow (86.6% vs. 33.3%, p = 0.030). 13 (61.9%) patients received thrombolysis. Nine (42.8%) patients experienced hemorrhagic complications. In a multivariate analysis, thrombolysis (p = 0.049) and PT access as the first procedure (p = 0.045) were significant risk factors for bleeding.ConclusionInvasive recanalization of the portal vein in patients with PVT and absence of cirrhosis and malignancy offers a good therapeutic option with high recanalization and patency rates. Bleeding complications result predominantly from a percutaneous access and high amounts of thrombolytics used; therefore, recanalization via TIPS technique should be favored.

Ball Tip Technique for S2AI Screw Placement in Sacropelvic Fixation: A Comparative Study with Conventional Freehand Technique.

ObjectiveTo evaluate the efficiency of the ball tip technique for S2AI screw placement and introduce this technique.MethodsSixty‐three patients who underwent pelvic fixation with S2AI screws were retrospectively reviewed. They were 29 males and 34 females with an average age of 59.6 ± 12.5 years. Among these patients, 35 patients (14 males and 21 females with an average age of 58.8 ± 11.3 years) received ball tip technique and 28 patients (15 males and 13 females with an average age of 63.7 ± 12.6 years) received conventional freehand technique. Ball tip technique was used in ball tip technique group. After a pedicle probe just penetrated the sacroiliac joint, a ball‐tipped probe consisting of a ball shaped metal tip with a flexible shaft was malleted to make a guide track within ilium. This ball‐tipped probe could bend automatically away from the cortex and forward through the cancellous bone when the tip met the cortical lamina of ilium, which can avoid penetration. After repeating the procedures, a guide hole was gradually formed. S2AI screw was inserted along the guide hole after tapping. In the conventional freehand group, S2AI screw was placed according to the conventional method. Postoperative computed tomography (CT) was used to assess the accuracy of screws. The time cost of screw insertion and screw‐related complications were recorded. Independent t‐test was used to compare the time cost between ball tip group and conventional freehand group. A chi‐square test was used to compare the accuracies of the ball tip group with the conventional group.ResultsThere were 35 patients (70 S2AI screws) in ball tip group and 28 patients (56 S2AI screws) in conventional freehand group. No screw‐related complication occurred in all patients. Time costs were 9.8 ± 4.5 mins in ball tip group and 20.2.0 + 8.6 mins in conventional freehand group, respectively (P < 0.05). Four screws penetrated iliac cortex in the ball tip group vs 10 screws in conventional freehand group (5.7% vs 17.9%) (P < 0.05).ConclusionsThe ball tip technique enhances the accuracy of screw placement and has less time cost compared with conventional freehand technique.

First Report of Leaf Spot of Maize Caused by Curvularia geniculata in India

HomePlant DiseaseVol. 105, No. 12First Report of Leaf Spot of Maize Caused by Curvularia geniculata in India PreviousNext DISEASE NOTE OPENOpen Access licenseFirst Report of Leaf Spot of Maize Caused by Curvularia geniculata in IndiaN. Manzar, A. S. Kashyap, P. K. Sharma, and A. K. SaxenaN. Manzarhttps://orcid.org/0000-0001-6622-1912Plant Pathology Lab, ICAR – National Bureau of Agriculturally Important Microorganisms, Maunath Bhanjan 275103, IndiaSearch for more papers by this author, A. S. Kashyap†Corresponding author: A. S. Kashyap; E-mail Address: abhijeet4497@gmail.comhttps://orcid.org/0000-0002-1360-9750Plant Pathology Lab, ICAR – National Bureau of Agriculturally Important Microorganisms, Maunath Bhanjan 275103, IndiaSearch for more papers by this author, P. K. SharmaPlant Pathology Lab, ICAR – National Bureau of Agriculturally Important Microorganisms, Maunath Bhanjan 275103, IndiaSearch for more papers by this author, and A. K. SaxenaPlant Pathology Lab, ICAR – National Bureau of Agriculturally Important Microorganisms, Maunath Bhanjan 275103, IndiaSearch for more papers by this author AffiliationsAuthors and Affiliations N. Manzar A. S. Kashyap † P. K. Sharma A. K. Saxena Plant Pathology Lab, ICAR – National Bureau of Agriculturally Important Microorganisms, Maunath Bhanjan 275103, India Published Online:12 Oct 2021https://doi.org/10.1094/PDIS-03-21-0637-PDNAboutSectionsView articlePDFSupplemental ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InRedditEmailWechat View articleIn India, 25.90 million metric tons of maize (Zea mays L.) was produced on 9.63 million hectares, with an average yield of 2.69 metric tons per hectare (Singh and Singh 2018). In March 2017, leaf spot was observed on maize cv. Kanchan during a survey of the Ballia district, with disease severity ranging from 1 to 20% (26.08°N, 83.71°E) in Uttar Pradesh, India. The upper mid canopy of symptomatic plants showed elliptical light brown spots (0.25 to 2.5 mm diameter) surrounded by chlorotic halo lesions with dark margins. Five plants showing leaf spots were collected and the symptomatic tissue was cut into pieces (4 mm2), surface sterilized with 1% sodium hypochlorite for 1 min, then rinsed three times with distilled water, plated on potato dextrose agar medium amended with streptomycin sulfate (125 ppm), and incubated at 26°C with a 12-h light period. After 5 days of incubation, five pure cultures were obtained using the hyphal tip technique and incubated at 28°C for 15 days. The upper surface of the colony was dark grayish black and the reverse colony was dark brown. Conidiophores on the apex were geniculate, unbranched, and septate. Conidia were spindle to elliptical in shape, light brown, with 3 to 4 septa with an enlarged central cell. Conidial size ranged from 10.0 to 14.1 μm wide and 19.3 to 26.2 μm long (n = 35). Based on morphology, the fungus was tentatively identified as Curvularia geniculata (Tracy & Earle) Boedijn (Hosokawa et al. 2003). Later, genomic DNA was extracted from the E29 isolate using the nucleopore GDNA Fungus Kit (Genetix Brand, India). ITS (White et al. 1990), LSU (Vilgalys and Hester 1990), D1 and D2 region of LSU (O’Donnell 1993), and glyceraldehyde-3-phosphate dehydrogenase (gpd) (Berbee et al. 1999) loci were amplified for molecular identification (Manamgoda et al. 2012). The amplicons were bidirectionally sequenced using the Sanger sequencing method. BLASTn analysis of different gene sequences of isolate E29 showed 99 to 100% similarity with sequences of C. geniculata. The gene sequences were submitted to GenBank, and accession numbers were assigned (ITS, MT524330; gpd, LC552684; LSU, MT516309; and D1 and D2 region of LSU, MT533847). The similarity index for ITS, gpd, LSU, and D1 and D2 region of LSU sequences of E29 showed high similarity with isolates of C. geniculata: 99.81% with MH856584 (CBS187.50), 99.52% with KM083609 (CBS187.50), 100% with MH868092 (CBS187.50), and 100% with MH868533 (CBS220.52), respectively. Pathogenicity of the isolate E29 was confirmed by inoculating 25-day-old maize cv. Kanchan (n = 10) with a spore suspension (106 spores/ml) prepared from 15-day-old cultures. Using a hand atomizer, the spore suspension was sprayed onto leaves until runoff and the noninoculated plants (n = 10) were sprayed with sterile distilled water. The plants were maintained in a glasshouse at 26 ± 2°C and humidity ≥90%. After 10 days, elliptical spots with chlorotic halo were observed on inoculated plants similar to those observed in the field, but no symptoms developed on noninoculated plants. C. geniculata was reisolated from symptomatic leaves, and its identity was confirmed by morphological observations. The pathogenicity tests were repeated twice. The disease appears not to be yield limiting; however, it has caused several stakeholder concerns, and anecdotal evidence suggests that maize hybrids may differ in susceptibility. To our knowledge, this is the first report of leaf spot of maize caused by C. geniculata in India, which extends the known agents of maize leaf spot.The author(s) declare no conflict of interest.

Snodgrass procedure for distal penile and mid-shaft hypospadias repair in children

Introduction. Hypospadias is one of the most frequent penile malformations in newborn boys. Warren Snodgrass developed the «tubularized incised plate» (TIP) urethroplasty that is the most often procedure used in the surgical treatment of distal hypospadias for the last 20 years. Despite the great popularity of the technique, its no less famous Grafted TIP (GTIP) modification appeared. The technique is aimed at filling the defect in the urethral site with a foreskin free flap followed by tubularized urethroplasty.Purpose of the study. To compare the outcomes of TIP and GTIP procedures in our clinic which have been performed in the last 10 years.Materials and methods. One hundred-fourteen boys with hypospadias (aged 6 mo – 15 years) were operated on using the TIP technique and its modification GTIP during 2010 – 2020 (Sochi Center of Motherhood and Childhood Protection). The patients were: boys up to 1 year – 27 (23.7%), from 1 to 3 years – 57 (50%), 4 – 7 years – 19 (16.7%), from 8 to 14 years – 14 (12.3%). Primary repair was done in 112 cases (98.2%), the second procedure was done in 2 (1.8%) cases. There were 94 (82.5%) boys with distal hypospadias and 20 (17.5%) children with mid-shaft hypospadias. All patients were examined 3 and 12 months after surgery. We assessed the degree of skin scar process on the penile shaft, the location of the meatus and the quality of urination during the examination.Results. We observed 27 (23.7%) complications after urethroplasty out of 114 treated boys. There were 13 (11.4%) cases of urethral fistula, which were secondary repaired 6 months later. Meatal stenosis was observed in 2 (1.8%) cases, which required secondary meatoplasty. Repeat urethroplasty was done in 10 (8.7%) cases due to neourethral suture failure. There were also 2 (1.8%) cases of secondary penile curvature that required repeat surgery. The good cosmetical and functional results were achieved finally in all children.Conclusion. The analysis of our ten-year experience of using TIP-urethroplasty and its GTIP modification did not reveal significant differences in the overall incidence of postoperative complications. Yet, using the TIP procedure is associated with more fistulas. There were more cases of urethral suture failure in children whom the GTIP technique was performed. Our data suggest the need for a selective approach in the formation of indications for using TIP and GTIP procedures, along with research aimed at finding criteria for patient selection.

Meta Analysis Study of Complications Following Repair of Mid Penile Hypospadius using Different Surgical Techniques

Abstract Background Hypospadias is one of the most common congenital defects affecting the external male genitalia. The incidence is 1 in 250 male newborns, although its incidence seems to be increasing. Hypospadias is defined as an insufficient development of the urethral fold and the ventral foreskin, with or without penile curvature. The urethral opening is located more proximally anywhere between the tip of the penis and the perineum. Aim of the Work The aim of this study is to determine the best surgical technique with the least complications for repair of mid-penile hypospadias. Materials and Methods This systematic review and meta-analysis was performed in accordance to the recommendations of the Meta-analysis of Observational Studies in Epidemiology (MOOSE) statement. MOOSE is a reporting checklist for Authors, Editors, and Reviewers of Meta-analysis of interventional and observational studies. According to International committee of medical journal association (ICJME), reviewers must report their findings according to each of the items listed in those checklists. Results Fistula is less common after Preputial island flap technique. Fistula is more common with Modified koyanagi technique. Meatal stenosis is less common after Mathieu and Preputial island flap techniques. Meatal stenosis is more common after TIP technique. Wound Dehiscence is not common after lateral based flap and modified koyanagi and Onlay island flap techniques. Neourethral Stricture is not common after lateral based flap and Mathieu and Onlay island flap techniques. Conclusion The Mathieu and Preputial island flap techniques for mid-penile hypospadias reconstruction are associated with a significantly lower risk for postoperative urethral stricture and may be the preferred method for hypospadias. However, the clinical implications of the results can be discussed because the risk of stricture in all procedures was low. The implications for research are obvious because there had been no studies that provided firm guidelines on the best method for the operative intervention for hypospadias. Further trials are still needed to confirm our findings.

Extended TIP vs. Standard TIP for primary distal hypospadias repair: randomized study for comparing functional and cosmetic outcomes

Objectives The aim of this study was to critically evaluate distal extension of the midline urethral plate incision, extended tubularized incised plate (e-TIP) technique, with the standard TIP and investigating predictors of functional and cosmetic success. Methods In a prospective study, consecutive patients with primary distal hypospadias presented for repair were randomized to undergo either extended TIP (e-TIP) or standard TIP (s-TIP) technique. Cosmetic outcome was evaluated postoperatively using Hypospadias-Objective-Penile-Evaluation (HOPE) score and measurement of ventral-glans-closure-length (VGCL) and meatal length (ML). Functional outcome was evaluated by maximal flow rate (Qmax), average flow rate (Qave), and postvoid residual urine (PVR). The effect of preoperative parameters on the outcome was assessed with regression analysis. Results In all 94 cases, out of 110 randomized, were available for analysis. Forty-six in e-TIP group and 48 cases in s-TIP group with comparable preoperative demographics. Median (inter-quartile range) of postoperative total HOPE-score was 57(45–60) vs. 55(44–60) for e-TIP and s-TIP (p < 0.001), respectively. The mean (SD) ratio of VGCL/ML was 87% (26) versus 46% (12) for e-TIP vs. s-TIP, respectively (p < 0.001). Both complications and functional outcomes were comparable. Urethral plate (UP) width and the use of e-TIP technique were significant predictors of successful cosmetic outcome in regression analysis (p = 0.019 and p = 0.001), respectively. Conclusion Extension of midline urethral plate can potentially create a vertical slit-like meatus located at the glans tip without compromising the functional outcome, thus providing better cosmetic outcome compared with the standard technique. The UP width was a significant predictor of superior cosmetic outcome.

Complications related to posterior hypospadias repair

Background: Proximal hypospadias repair carries high complications rates. single stage is the standard practice for management but sometimes it is not easy to perform single stage for posterior hypospadias and here appears the need for staged surgery in this study we assess the out coms and complications of the most commonly used techniques in Mosul pediatric surgery center at alkhansaa teaching hospital Objective: To assess the results of management of posterior hypospadias by Tubularized incised plate as single stage and staged repair and to knew the most important complications associated with these two procedures. Methods: this is prospective study for forty patients who were admitted to Mosul pediatric surgery center at alkhansaa teaching hospital from October 2011 till October 2013, their age ranged from 9 month to 15 years, five of them were operated before with complete failure, 31 patient operated by single stage Tubularized Incised Plate technique and the other 9 by two stage technique and they were followed for 6-18 months. Results: The total complications rate was (52%) as follow: (7) cases (17.5%) develop meatal stenosis, (4) patients (10%) develop retrusive meatus, No one develops stricture, (10) cases (25%) develop fistula and none of them develop diverticulum, the total complication rate for Single stage TIP technique was (48.3%) the total complication rate of complications for staged surgery was (66.6%). Conclusion: proximal hypospadias repair is very challenging with high complication rate which need a good experience to deal with it. Single stage or multistage procedure can be utilized to repair this type of hypospadias. Most of the published papers has low number of cases in comparison to the anterior type which represent 70_80% of all cases and for that reason may be the great difference in between different centers in the incidence of complications rate.

Comparison of rectal swab, glove tip, and participant-collected stool techniques for gut microbiome sampling

BackgroundStudies of the gut microbiome are becoming increasingly important. Such studies require stool collections that can be processed or frozen in a timely manner so as not to alter the microbial content. Due to the logistical difficulties of home-based stool collection, there has been a challenge in selecting the appropriate sample collection technique and comparing results from different microbiome studies. Thus, we compared stool collection and two alternative clinic-based fecal microbiome collection techniques, including a newer glove-based collection method.ResultsWe prospectively enrolled 22 adult men from our prostate cancer screening cohort SABOR (San Antonio Biomarkers of Risk for prostate cancer) in San Antonio, TX, from 8/2018 to 4/2019. A rectal swab and glove tip sample were collected from each participant during a one-time visit to our clinics. A single stool sample was collected at the participant’s home. DNA was isolated from the fecal material and 16 s rRNA sequencing of the V1-V2 and V3-V4 regions was performed. We found the gut microbiome to be similar in richness and evenness, noting no differences in alpha diversity among the collection methods. The stool collection method, which remains the gold-standard method for the gut microbiome, proved to have different community composition compared to swab and glove tip techniques (p< 0.001) as measured by Bray-Curtis and unifrac distances. There were no significant differences in between the swab and glove tip samples with regard to beta diversity (p> 0.05). Despite differences between home-based stool and office-based fecal collection methods, we noted that the distance metrics for the three methods cluster by participant indicating within-person similarities. Additionally, no taxa differed among the methods in a Linear Discriminant Analysis Effect Size (LEfSe) analysis comparing all-against-all sampling methods.ConclusionThe glove tip method provides similar gut microbiome results as rectal swab and stool microbiome collection techniques. The addition of a new office-based collection technique could help easy and practical implementation of gut microbiome research studies and clinical practice.

Phosphoproteomic Strategy for Profiling Osmotic Stress Signaling in Arabidopsis.

Protein phosphorylation is crucial for the regulation of enzyme activity and gene expression under osmotic condition. Mass spectrometry (MS)-based phosphoproteomics has transformed the way of studying plant signal transduction. However, requirement of lots of starting materials and prolonged MS measurement time to achieve the depth of coverage has been the limiting factor for the high throughput study of global phosphoproteomic changes in plants. To improve the sensitivity and throughput of plant phosphoproteomics, we have developed a stop and go extraction (stage) tip based phosphoproteomics approach coupled with Tandem Mass Tag (TMT) labeling for the rapid and comprehensive analysis of plant phosphorylation perturbation in response to osmotic stress. Leveraging the simplicity and high throughput of stage tip technique, the whole procedure takes approximately one hour using two tips to finish phosphopeptide enrichment, fractionation, and sample cleaning steps, suggesting an easy-to-use and high efficiency of the approach. This approach not only provides an in-depth plant phosphoproteomics analysis (> 11,000 phosphopeptide identification) but also demonstrates the superior separation efficiency (< 5% overlap) between adjacent fractions. Further, multiplexing has been achieved using TMT labeling to quantify the phosphoproteomic changes of wild-type and snrk2 decuple mutant plants. This approach has successfully been used to reveal the phosphorylation events of Raf-like kinases in response to osmotic stress, which sheds light on the understanding of early osmotic signaling in land plants.

The arrow tip technique for bilateral hanging ala: a 3-year review

Hanging ala is one of the alar-columellar discrepancies encountered in a rhinoplasty procedure among the Asian population. The principle of lifting both the ala effectively while keeping its symmetry remains a challenge. The arrow tip technique is designed to address the bilateral hanging ala which allows greater alar mobility and lifting effect, producing a desirable outcome of the overall nasal feature. This retrospective review is aimed to analyse the effectiveness of the proposed alar surgical technique and assesses the possible complications that require revision surgery. Fifteen Asian patients underwent the ‘arrow tip technique’ alar surgery in conjunction of a rhinoplasty procedure in a single-centre 3-year study for bilateral hanging ala. Pre- and post-operative clinical and photographic nasal analyses were performed for changes of alar vertical height on lateral and frontal views. On the frontal view, the mean percentage of alar shortening was 13.11%, 95%CI [11.46%, 14.76%]. On the lateral view, the mean percentage of alar shortening was 20.36%, 95%CI [19.01%, 21.71%]. The mean frontal-lateral alar shortening was − 7.25%, 95%CI [− 8.76%, − 5.74%]. Two patients required revision surgery for scars (13.3%) and another for nostril asymmetry (6%). This innovative technique is effective, safe and predictable in correcting the hanging ala. Understanding the relevance of performing an effective alar surgery through safe surgical landmarks, the use of full-thickness skin grafts and taking proper precautions can avoid the unnecessary fear of the complications of an external approach to an alar surgery such as scarring, bleeding, alar asymmetry and recurrence. Level of evidence: Level IV, therapeutic study.

Video Standards for Rhinoplasty Education: A Review and Recommended Guidelines.

Importance: Intraoperative videography is widely used to record rhinoplasty procedures, yet little is known about the optimal surgical vantage points at critical procedural steps. Objective: To assess commonly used camera angles in public and proprietary intraoperative rhinoplasty videos and discuss approaches to obtaining these viewing angles. Design: Public and propriety rhinoplasty videos were reviewed and categorized based on procedure type, specific area(s) of focus, and camera angles utilized at a series of critical operative steps. The most commonly used camera angles were recorded and assessed based on surgical field visualization and the authors' personal recording experiences. Results: Of the 114 videos that met inclusion criteria, 49 were full-length open rhinoplasty procedures, 20 full-length endonasal rhinoplasty procedures, 17 tip techniques, 8 opening techniques, 7 fashioning grafts, 7 osteotomies, and 6 cartilage harvests. With respective to footage acquisition, the upward camera angle was most frequently used for recording, and endoscopic view was least frequently used. Conclusions and Relevance: These findings demonstrate that there is extensive variability in camera angles between surgical films. Moreover, many of these camera angles are insufficient due to obstruction by surgical staff, inability to visualize deep structures, and difficulty capturing the three-dimensional nasal framework. A guide indicating the best viewing angles for different aspects of the procedure would be useful to optimize educational videos.

Blend scaffolds with polyaspartamide/polyester structure fabricated via TIPS and their RGDC functionalization to promote osteoblast adhesion and proliferation

Target of this work was to prepare a RGDC functionalized hybrid biomaterial via TIPS technique to achieve a more efficient control of osteoblast adhesion and diffusion on the three-dimensional (3D) scaffolds. Starting from a crystalline poly(l-lactic acid) (PLLA) and an amorphous α,β-poly(N-2-hydroxyethyl) (2-aminoethylcarbamate)-d,l-aspartamide-graft-polylactic acid (PHEA-EDA-g-PLA) copolymer, blend scaffolds were characterized by an appropriate porosity and pore interconnection. The PHEA-EDA-PLA interpenetration with PLLA improved hydrolytic susceptibility of hybrid scaffolds. The presence of free amino groups on scaffolds allowed to tether the cyclic RGD peptide (RGDC) via Michael addition using the maleimide chemistry. Cell culture test carried out on preosteoblastic cells MC3T3-E1 incubated with scaffolds, has evidenced cell adhesion and proliferation. Furthermore, the presence of distributed bone matrix on all scaffolds was evaluated after 70 days compared to PLLA only samples.

Reoperative Urethroplasty after Failed Hypospadias Repair

AbstractBackground: Reported reoperation rates after primary hypospadias repair can exceed 50%. Failed hypospadias occurs when the primary surgery does not achieve the cosmetic and functional goals of a straight penis with glanular meatus that enables normal urinary and sexual function. Treatment of patients with failed hypospadias repair can be a challenging task in the majority of cases and the selection of the most appropriate technique for this repair is the corner stone for success in these cases.Aim of Study: Is to evaluate the results and success rate of some common techniques for redo urethroplasty in cases with failed hypospadias repair.Patients and Methods: The study included forty two patients with recurrent hypospadias and their ages ranged from 2-15 years. The final position of the external urethral meatus after release of chordee, was subcoronal (13 cases), distal penile (13 cases), mid-penile (13 cases) and penoscrotal (3 cases). TIP technique was applied in 12 cases, Mathieu technique in 10 cases, transverse dorsal preputial onlay flap in 10 cases and two-stage repair with buccal mucosa graft in 10 cases. The operative technique was selected according to the status of the urethral plate and the nearby penile skin.Results: Our overall results showed that 24 patients (57.14%) had successful repair while failed repair was reported in 8 patients (19.04%). Minor complications were also reported in 10 cases (23.80%) which included urethrocutaneous fistula, meatal stenosis and urethral diverticulum. The success rates of TIP, Mathieu, transverse dorsal preputial onlay flap and the two-stage repair were 58.33%, 50%, 50% and 70% respec-tively.Conclusion: TIP urethroplasty is an effective technique for redo hypospadias repair if the patient has a non-scarred and wide urethral plate. Similar results can also be achieved by Mathieu's repair or transverse onlay flap in patients with narrow and non-scarred urethral plate. However, patient with scarred unhealthy urethral plate should have a two stage repair with buccal mucosa graft.

THE RELATION OF HYPOSPADIAS TYPES, AGES, AND SURGICAL TECHNIQUES FOR URETHROCUTANEOUS FISTULA COMPLICATION IN CHILD HYPOSPADIAS CASES

Objective: To find correlation between hypospadias type, age, and surgical technique for urethrocutaneous fistula in child hypospadias cases. Material &amp; Method: This research was an observational analytic research with cross sectional approach. It was conducted at Bina Sehat Jember Hospital, Paru Jember Hospital, and Bhayangkara Bondowoso Hospital. The research samples were hypospadias patients who had done hypospadias repair with susceptible age from 0 months until 16 years. Result: In this study, was found correlation between type of hypospadias with urethrocutaneous fistula (p=0.03 and r=0.43). And the other hand, this research did not find relationship between age at hypospadias surgery with urethrocutaneous fistula complication (p=0.34 and r=0.3). The results of this study indicate that the incidence of urethrocutanoeus fistula complications in the surgery using TIP technique was greater than Onlay Island Flap technique, but in this study, there was no association between hypospadias surgery technique used with complications of uretrocutanoeus fistula (p=0.3 and r=0.22). Conclusion: In this study, there was a significant relationship between hypospadias type with urethrocutaneous fistula complication with statistically moderate strength and positive correlation direction. This study did not show any significant relationship between age and hypospadias surgery technique with complications of urethrocutanoeous fistula.

First Report of Red Crown Rot of Soybeans Caused by Calonectria ilicicola (Anamorph: Cylindrocladium parasiticum) in Illinois

HomePlant DiseaseVol. 103, No. 7First Report of Red Crown Rot of Soybeans Caused by Calonectria ilicicola (Anamorph: Cylindrocladium parasiticum) in Illinois PreviousNext DISEASE NOTESFirst Report of Red Crown Rot of Soybeans Caused by Calonectria ilicicola (Anamorph: Cylindrocladium parasiticum) in IllinoisN. Kleczewski, D. Plewa, C. Kangas, E. Phillippi, and V. KleczewskiN. Kleczewski†Corresponding author: N. Kleczewski; E-mail Address: nathank@illinois.eduhttp://orcid.org/0000-0001-5671-6727University of Illinois, Department of Crop Sciences, Urbana, IL 61801Search for more papers by this author, D. PlewaUniversity of Illinois, Department of Crop Sciences, Urbana, IL 61801Search for more papers by this author, C. KangasUniversity of Illinois, Department of Crop Sciences, Urbana, IL 61801Search for more papers by this author, E. PhillippiUniversity of Illinois, Department of Crop Sciences, Urbana, IL 61801Search for more papers by this author, and V. KleczewskiGrowmark Inc., Bloomington, IL 61701Search for more papers by this authorAffiliationsAuthors and Affiliations N. Kleczewski1 † D. Plewa1 C. Kangas1 E. Phillippi1 V. Kleczewski2 1University of Illinois, Department of Crop Sciences, Urbana, IL 61801 2Growmark Inc., Bloomington, IL 61701 Published Online:7 May 2019https://doi.org/10.1094/PDIS-01-19-0105-PDNAboutSectionsSupplemental ToolsAdd to favoritesDownload CitationsTrack Citations ShareShare onFacebookTwitterLinked InRedditEmailWechat In September 2018 soybean (Glycine max) disease was observed in a commercial field located near Pittsfield, Illinois. Signs and symptoms resembled those of red crown rot, caused by Calonectria ilicicola (Hartman et al. 2015). Red to brown lesions were observed at the stem base, and red, raised perithecia were observed on the lesion surface. The root systems of affected plants were black and severely rotted, often with only taproots remaining after removal from the soil. The inner pith of the lower stem was light gray in appearance. Foliar symptoms included interveinal chlorosis and defoliation. Disease incidence was estimated at 75%, and yield loss was estimated at approximately 25%. Affected plants were harvested, placed in a cooler on ice, and transported to the University of Illinois. Stems were surface sterilized in 10% bleach (30 s), 75% ethanol (30 s), followed by two rinses in sterile distilled water bleach, and allowed to air dry under a biosecurity cabinet. Isolations were made from sections of symptomatic stems on Petri plates containing half-strength potato dextrose agar placed under a light bank equipped with cool fluorescent lights set on a 12-h light/dark cycle at 20°C. Fungi were isolated from 100% of sections plated, and individual isolates were collected via hyphal tip technique. Isolated colonies initially produced white, aerial mycelia that later turned burnt red to brown with age. Conidia were hyaline, cylindrical with zero to three septae, and measured 28.5 to 87.1 × 3.9 to 7.6 μm. Perithecia were reddish orange, oval to globose, 202.6 to 424.7 μm tall, and 100.3 to 353.8 μm in width. Asci were hyaline and clavate and measured 111.0 to 206.1 × 10.5 to 28.6 μm, and each contained eight falcate ascospores with one to two septa. Morphological characteristics identified this organism as C. ilicicola (anamorph: Cylindrocladium parasiticum [Hartman et al. 2015]). A 600-bp fragment of the β-tubulin gene was amplified using the T1 (O’Donnell and Cigelnik 1997) and Bt2b (Glass and Donaldson 1995) primers. Thermocycler conditions were as follows: initial denaturation for 10 min at 96°C followed by 30 cycles of 96°C for 15 s, 55°C for 35 s, and 75°C for 35 s, with a final elongation step of 75°C for 2 min (Crous et al. 1999). Polymerase chain reaction products were purified and sequenced at the Roy J. Carver Biotechnology Center at the University of Illinois at Urbana-Champaign. A sequence of the representative isolate 3A was submitted to GenBank (MK370992). Comparisons with GenBank showed 99% similarity with multiple sequences of C. ilicicola (top match JX0693831.1, bit score 1,107, E = 0.0, 607/610 bp). Pathogenicity was confirmed by inoculating 3-week-old seedlings of soybean cultivar Pioneer 93Y25 grown in in 15-cm-diameter pots containing autoclaved greenhouse potting media. Six plants were present in each pot, and three pots were used per treatment. Inoculation was conducted by drenching with a 105 conidia/ml suspension acquired from 14-day-old, single-spore fungal isolates. Three unamended pots were used as controls. Plants were watered daily and maintained in a greenhouse set to 23°C and a 14-h/10-h light/dark cycle. After 14 days, inoculated plants showed similar basal stem symptoms and after 30 days developed interveinal chlorosis on leaves. C. ilicicola was reisolated from diseased plants and confirmed through microscopy. This pathogen may pose a threat to >440,000,000 ha of soybean in Illinois, not including surrounding states. Our understanding of impact and management under Midwest production practices is currently unknown.The author(s) declare no conflict of interest.

Role of ERCC1 expression in colorectal adenoma-carcinoma sequence and relation to other mismatch repair proteins expression, clinicopathological features and prognosis in mucinous and non-mucinous colorectal carcinoma.

There are several DNA repair pathways that protect cellular DNA from injury, such as nucleotide excision repair (NER) and mismatch repair (MMR). The protein product of the excision repair cross-complementation group 1 (ERCC1) gene plays a pivotal role in NER. The exact relationship between MMR proteins and ERCC1 is not well known in colorectal carcinoma (CRC). To investigate expression of ERCC1 and MMR proteins in colorectal mucinous carcinoma (MA) and non-mucinous carcinoma (NMA) using tissue microarray technique. We studied tumor tissue specimens from 150 patients with colorectal mucinous (MA) and non-mucinous adenocarcinoma (NMA). Tissue microarrays were constructed using modified mechanical pencil tips technique and immunohistochemistry for ERCC1, MLH1, MSH2, MSH6, and PMS2. NMA showed a significantly more frequent aberrant cytoplasmic expression than MA while MA showed a more frequent intact nuclear expression than NMA. There were no significant differences between the NMA and MA groups in the expression of MMR proteins. In NMA cases, ERCC1 expression was significantly related to MMR status while was not significantly related in MA cases. ERCC1 expression was not significantly related to overall and disease-free survival in both NMA and MA groups. this study is the first to investigate the relation between MMR status and ERCC1 expression in colorectal MA and NMA. ERCC1 expression was significantly related to MMR status only in NMA cases. Hence, the current study emphasizes that further research about the relation between various DNA repair pathways is needed.

Comparative evaluation of three obturation systems in primary molars - A randomized clinical trial.

The objective of this study is to evaluate and compare the radiographic efficacy of the quality of obturation and to assess the number of voids and the obturation time in primary teeth using Pastinject™, disposable needle, and capillary tips. A total of 34 teeth with 103 canals were randomly divided into three groups using chit method, based on used application: Group 1: Pastinject™ (Micro-Mega, Besancon, France); Group 2: Disposable needle (23G short needle BD Discardit™, Becton Dickinson India Pvt. Ltd.), and Group 3: Capillary tips (Meta Biomed© Co. Ltd., China). All the groups were named based on obturation systems used. To compare the quality of obturation, the Chi-square test was used; to assess the number of voids, Kruskal-Wallis ANOVA test was used; and to evaluate the obturation time, post hoc Scheffe one-way ANOVA test was used. All P values having <0.05 were considered as statistical significant (P < 0.05). Kappa statistics were performed to check interexaminer reliability. Descriptive statistics were used for evaluation using SPSS (version. 21). Capillary tips resulted in better optimal filled canals and less obturation time, compared to disposable needle and Pastinject (P < 0.001). There was no significant difference evident among three groups in relation to voids (P = 0.111). Capillary tip technique proved to be the most effective, yielding a higher number of optimally filled canals and minimal voids, combined with easier placement of the material into the canals when compared to Pastinject and disposable needle obturation.

First Report of Fruit Rot of Bell Pepper Caused by Fusarium incarnatum in Pakistan

Evidence of fruit rot disease was observed in 12 bell pepper (Capsicum annuum L.) fields located in the Chakwal district (32°56′00″N, 72°51′30″E) of Pakistan during the period June 2016 to 2017. Disease incidence was estimated to be between 15 and 24%. Yield loss in affected fields was estimated as 11%. Symptoms of disease were seen as water-soaked, discolored necrotic lesions predominantly around the calyx. There were also symptoms of internal rot as seeds and the inner fruit surface were covered with white to light gray fungal growth. In the case of severe disease symptoms, fungal growth was also observed externally at the calyx end. The disease progressed as a soft decay with leakage. Diseased fruits were cut into 5-mm² pieces, surface disinfested with 1% NaOCl for 2 min, rinsed thrice with sterile distilled water, and incubated on potato dextrose agar (PDA) at 25 ± 2°C for 3 to 4 days under continuous fluorescent light. Eighteen isolates of similar morphology were purified using the hyphal tip technique. Colonies were fast growing, fluffy, white with pale cream to beige coloration on the reverse side of the Petri dish. Microconidia were hyaline, single celled to one septate, and 3.5 to 5.0 × 2.7 to 4.0 μm (mean = 4.0 × 3.8 μm). Mesoconidia were fusoid, usually three septate, and 9.8 to 17.5 × 3.0 to 4.5 μm (mean = 13.4 × 4.0 μm). Macroconidia were three to five septate, cylindrical, slightly curved, tapered at the apex, and 26.2 to 37.4 × 3.5 to 4.8 μm (mean = 32.5 × 4.2 μm). Based on morphological characteristics, the fungus was tentatively identified as Fusarium incarnatum (Leslie and Summerell 2006). DNA from two representative isolates, FICW7 and FICW16, was amplified with translation elongation factor (EF1-α) and β-tubulin genes using primers EF1/EF2 (O’Donnell et al. 1998) and Bt1a/Bt1b (Glass and Donaldson 1995), respectively. The obtained sequences for EF1-α (accession nos. MF977815 and MG770586) and β-tubulin (MF977818 and MG770587) were deposited in GenBank. The MegaBLAST and Fusarium ID database analysis revealed 99 to 100% homology to the Fusarium incarnatum-equiseti species complex, GenBank accession no. JF270273 (EF1-α), and AB587036 (β-tubulin) respectively. Pathogenicity tests of six isolates were conducted on three healthy bell pepper fruits per isolate, wound inoculated with a 20-μl drop of 10⁶ spores/ml. Three control fruits per isolate were inoculated with 20-μl droplets of sterile distilled water. Inoculated and control fruits were incubated in moist chambers at 25°C. After 3 to 5 days, white fluffy mycelial growth surrounded by water-soaked necrotic lesions appeared identical to the symptomatic fruits observed in the field/tunnel. No symptoms were observed on control fruits. The fungi isolated from the diseased fruits were morphologically similar to the original isolates on PDA. The pathogen was previously reported to cause the internal fruit rot disease of bell pepper in Trinidad (Ramdial et al. 2016). This is the first report of F. incarnatum (Desm.) Sacc. causing fruit rot on bell pepper in Pakistan. New strategies need to be developed for effective management of disease.

Preparation of surfaces of composite samples for tip based micro-analyses using ion beam milling

Ion beam milling, as a method of surface design for tip analytical techniques, was explored. A sample of clay, embedded in a resin, was treated by the ion beam and allowed AFM (a typical tip technique) to be successfully applied. The method is suitable for advanced tip analyses based on AFM, like TERS or SNOM, and for samples that are not possible to prepare by standard mechanical methods. The approach can be useful for characterisation of the surfaces of many different types of materials in versatile applications such as catalysis, corrosion science or advanced material characterisation.