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The number of congenital malformations in the world is increasing every year. One of the first places occupies by the congenital malformation of the urinary system. The incidence of kidney and ureter duplication is 1:125–150 of live+birth newborns, more often in girls, and in 20–40% of cases is bilateral. It can be complete (ureter duplex) and incomplete (ureter fissus). It has often asymptomatical course and is diagnosed accidentally or only after the manifestation of various complications. A clinical case of successful laparoscopic heminephrureterectomy in a girl with a congenital malformation of the urinary system is described, namely the right kidney complete duplication with ectopic ureteric orifice in the external genital organs and permanent urinary incontinence. The child recovered after minimally invasive radical surgery., Количество врожденных пороков развития в мире ежегодно увеличивается. Одно из первых мест занимают пороки развития мочевыделительной системы. Удвоение почек и мочеточников встречается с частотой 1 случай на 125–150 новорожденных, чаще у девочек, и у 20–40% случаев является двусторонним. Бывает полным (ureter duplex) и неполным (ureter fissus). Часто протекает бессимптомно и диагностируется случайно или только после появления различных осложнений. Описан клинический случай успешной лапароскопической геминефруретеректомии у девочки с врожденным пороком развития мочевыделительной системы: полным удвоением правой почки с эктопией устья мочеточника в наружные половые органы и постоянным недержанием мочи. После миниинвазивного радикального оперативного вмешательства ребенок выздоровел., Кількість природжених вад розвитку у світі щороку збільшується. Одне з перших місць посідають вади розвитку сечовидільної системи. Подвоєння нирок і сечоводів зустрічається з частотою 1 випадок на 125–150 новонароджених, частіше у дівчат, і у 20–40% випадків є двобічним. Буває повним (ureter duplex) і неповним (ureter fissus). Часто перебігає безсимптомно і діагностується випадково або лише після появи різноманітних ускладнень. Описано клінічний випадок успішної лапароскопічної гемінефруретеректомії в дівчинки з природженою вадою розвитку сечовидільної системи: повним подвоєнням правої нирки з ектопією устя сечоводу в зовнішні статеві органи та постійним нетриманням сечі. Після мініінвазивного радикального оперативного втручання дитина одужала.

A study was carried out at the supper segment of Qua Iboe River from November, 2018 to August, 2019 in four sampling stations to assess the impacts of coastal activities on water quality. Water samples were collected monthly and analyzed using standard procedures of Associations of Official Analytical Chemist and American Public Health Association. The stations comparisons and location of significant differences were carriedout using ANOVA and Least Significant Difference (LSD) test, while paired sample t-test were employed to compare the seasonal difference. The mean ranged values of water temperature were (25.03 – 25.330C), pH (5.8 –6.6 mg/l), DO(3.11 - 5.45 mg/l), TDS (18.63 – 32.53mg/l), EC (8.33-13.16􀀁s/cm), Turbidity (7.61 – 18.32 NTU), TSS (90.80 - 165.63 mg/L), NO3 -1(33.02 – 78.33mg/l), P04 3-(4.44 – 7.39mg/l), Cl-(43.60 – 63.21mg/l), COD(35.96 – 113.05mg/l), NH3(0.33 – 0.62 mg/l). Mean values of TSS, EC, TSS, NO3, PO4 3-, NH3 and turbidity were higher in wet season, while water temperature, pH, DO, Cl- and COD values obtained were higher in dry season. Spatial variations in parameters were ascribed to levels of anthropogenic activities and wastes discharged within the stations; the seasonal variations were emanated from influx of wastes, and dilution as result of surface run-offs during wet season. Based on the findings, the WQI values were poor for human consumption; especially from station 2 to4.These calls for urgent attention by Federal / State Ministry Health and Environment regards to its effects on human health and consistent water quality monitoring should be put into consideration. Keywords: Impact, Assessment, Coastal activities, Water Quality, Qua Iboe River Keywords: Impact, Assessment, Coastal activities, Water Quality, Qua Iboe River

Objective Although a wide range of sacral dysmorphisms has been documented with lumbosacral transitional vertebrae (LSTV) variations, quantitative characterization of the upper segment morphology and articular anatomy across the array of lumbosacral transitions are hardly found in the literature. This study presents LSTV anomalies as a series of sequential morphological changes (the LSTV spectrum) and quantitatively compares 6 LSTV subtypes with normative sacral dimensions including the anatomy at the upper sacral segments used for percutaneous sacroiliac screw insertion. Methods Seven linear dimensions were measured from LSTV subtypes and normal sacral variants from dried adult sacral specimens. The auricular, superior articular and facet surface areas were quantified. Obliquity and thickness of osseous corridors used for sacroiliac screw fixation were measured. Data were statistically compared within and between LSTV subtypes and the normal variants. Results LSTVs presented a wide range of morphometric differences in comparison to the normal bones. Grouping LSTV according to auricular surface positions (high, normal, and low) demonstrated significant between-group differences in the obliquity and thickness at the S1 and S2 segmental corridors. Conclusion Frequent occurrence of LSTV in the general population may require evaluation of anatomical parameters in these variations for safe sacroiliac instrumentation around this region.

To assess the upper body segment (US), lower body segment (LS) and US:LS ratio for children from birth to 18 y of age and to compare these data with other US:LS ratio norms from previously reported studies. A cross-sectional, observational study was conducted in children [birth to 18 y; n = 5454 children (3158 boys)] residing in Pune city, Western India, from December 2015 through June 2017, to evaluate the US, LS and the US:LS ratio. The mean US:LS ratio in boys at birth was 1.45; at one year of age it was 1.35 that decreased to 0.89 at 14 y. The nadir for the US:LS ratio in boys was reached at 14 y of age (0.89). In girls, the mean US:LS ratio at birth was 1.44, at one year of age it was 1.35 that decreased to 0.89 at 12 y. The nadir for the US:LS ratio in girls was reached at 12 y of age (0.89). From 12 to 18 y the US:LS ratio was fairly constant (for girls: 0.89, for boys: 0.9). On plotting the US and LS against the age in present study population, the US and LS curves crossed each other (US:LS = 1) at 7 to 8 y in boys and at 6 to 7 y in girls. The authors describe data for upper and lower body segments and their ratio in boys and girls from birth to 18 y in children from western Maharashtra. These data may help in the diagnosis of disproportionate short stature in children.

We have developed a method for entering Japanese hiragana characters using a 1-in. circular screen. The circumference of the smartwatch screen is divided every 90°. Hiragana is divided into 10 groups of 5 characters each, so the first half of the group is assigned to the left segment and the second half is assigned to the upper segment.

A 7-year-old male child has been crushed by a train causing the disconnect of the right calf, hospitalized 4 h after the injury, and the child was comatose with severe hemorrhagic shock. The right calf was disconnected 6 cm below the tibial plateau, and the stump was severely crushed (Fig. 25.1). The distal end combined with the middle and upper segment of about 10 cm bone and skin muscle composite tissue defected. The area below the ankle joint was relatively intact, and there was no skin covering above the ankle joint.

Abutment pressure distribution is the decisive factor affecting the stability of coal pillars, which has an important significance in realizing safe and efficient mining. In recent years, many working faces adopting double-roadway arrangement have appeared in the western mining areas in China, which makes coal pillar abutment pressure complex under repeated mining. In order to reveal the distribution pattern of coal pillar abutment pressure under repeated mining, the evolution of a stress field of surrounding rock was analyzed by a numerical method based on the actual situation of a double-roadway arranged mining roadway in Longde Coal Mine, and the distribution characteristics of coal pillar abutment pressure were revealed. The reasonable width of the section coal pillar was given further. The research results showed that (1) the surrounding rock stress is transferred to the working face coal body and section coal pillar between roadways under the influence of mining advance the working face, while the stress is transferred to the section coal pillar between roadways under the mining influence behind the working face. The presence of goaf in the upper segment makes the stress distribution of surrounding rock more complicated. (2) The distribution of coal pillar abutment pressure shows a staged change. The influence of mining advance the working face on the peak abutment pressure is notable, which highlights the significance of temporary reinforcement support in the advanced section of the working face. (3) After the mining of the upper working face is finished, the yield damage width of the coal pillar on the side of the goaf was about 4.0 m. During the second mining period, the yield damage width of the coal pillar was totally about 7.0 m. (4) Taking into account factors such as safe production and economic rationality, it was finally determined that the reasonable section coal pillar width is 12.5 m for this mine.

Retrocaval ureter, which also called circumcaval ureter, is a rare abnormal development where the vena cava compresses the upper segment of ureter leading to different grades of hydronephrosis. We reported a case of a 50-year-old man has a retrocaval ureter with a stone in the loop behind the vena cava. Surgical correction with extraction of the stone was done successfully. On follow up, there was no hydronephrosis. In conclusion synchronized retrocaval ureter with a stone in the ureter is considered a surgical challenge to the urologist and it needs careful investigations to make the diagnosis.

Ciliwung River flows from Bogor district, Bogor city, Depok, to Jakarta. The river faces many problems, especially settlement occupation on its riparian zones. The problem has damaged its natural ecological structures and the agroforestry practices such as mixed gardens, forest gardens, and pekarangan (home garden) in riparian landscape. This research objective is to analyze the structure, function, and dynamics of riparian agroforestry landscape of Ciliwung River in Bogor City. The landscape ecological index analysis approach is used to quantify the structure, function, and dynamics of the landscape. The existing land use in Ciliwung riparian in Bogor City has been dominated by the constructed land, such as settlements and housing. Those land use can be found with an area of 33.78 ha (60.50%) in the upper segment and 34.65 ha (56.54%) in the under segment. Meanwhile, in the middle segment is still dominated by the agroforestry area, such as forest gardens, mixed garden, and pekarangan with an area of 17.59 ha (55.23%). The function of these structures is as the core habitat and movement media of material, energy, animal, and human. The spatial dynamics of the Ciliwung riparian landscape in Bogor City revealed that the more patches of settlements and housing on a landscape, the more patches of pekarangan on the landscape.Keywords: Agroforestry landscape, Ciliwung River, landscape ecology, riparian areas

The duplication of the urinary tract is a developmental anomaly of the urinary system, which is represented in 0.8% of the population. In most cases, the duplication is incomplete and clinically insignificant. However, in the case of complete duplication, there is possible both an association with such pathologies as ureterocele, vesicoureteral reflux (VUR), urinary incontinence, ureterohydronephrosis and relation to recurrent urinary tract infections. Depending on the identified pathology it is possible to perform surgical interventions. These are organ-displacing operations (heminephroureterectomy) and reconstructive surgery - ureterocystoplasty of the one ureter or both ureters “as a single unit”, as well as the formation of interureteral anastomoses. Currently, there is the possibility to perform both open and endoscopic surgeries. We present a case report of endoscopic minimal invasive reconstructive intervention, performed to patient with ureterohydronephrosis ectopied in the vagina of the urethra of the duplicated left kidney and complaints of urinary incontinence.

Bagheri, Hassan/0000-0002-6126-9543, WOS: 000498042800020, PubMed: 31660021, The upper segment of sacrum is an important for screw insertions of unstable lumbosacral spine. Measurements of the S1-S2 as sacral wings, pedicles, sacral foraminas and sacral canal were taken from 87 sacrums. the mean depths of S1 pedicle and sacral wing were estimated as 25.8 +/- 2.3 mm and 50.1 +/- 1.7 mm, respectively. Angles screw trajectory of sacral pedicle anteromedial and sacral wing were measured as 29.6 +/- 0.9 degrees and 29.7 +/- 2.1 degrees, respectively. To avoid injury to the vascular structures anteriorly and nerve roots medially, depth and angle of screw trajectory is important for the entrance off pedicular screw placement to the S1.

Knowledge of the pyelocaliceal system anatomy is essential for the safe and successful performance of endourologic procedures. The purpose of this study was to provide a better understanding of the full three-dimensional pyelocaliceal system anatomy. Morphometric parameters of the three-dimensional reconstructions of computed tomography intravenous urography scans (n = 25 scans) were analyzed. Both kidneys were divided into three equal-sized segments (US: upper segment, MS: mid segment, LS: lower segment). Infundibular length (IL), infundibular width (IW), the number of calyces, and the transverse orientation in hours of a clock of each calyx as well as the dimension of the pyelum were determined. The mean upper IL (n = 92) was longer than the middle (n = 154) and lower IL (n = 112) (30.6 ± 7.9 mm vs. 16.4 ± 7.7 mm vs. 16.0 ± 6.0 mm, respectively; P =

This research aims to propose the usage of riverbed sediment grains roundness/flatness as basic indicator of river valley management. It is based on the evaluation of anomalous morphometry condition of sediment grains and valley condition along the river as one indicator of the stability of the riverbank of the river valley. This stability express the physical condition of the river valleys. In this paper, we provide methodological explanation as well as a case study in Bogowonto River. Analysis of the morphometry of sediment grain on riverbed from upstream to downstream as well as the relationship between the distance of the upstream and morphometry of sediment grains along Bogowonto River were conducted. Finally, we evaluated the anomalous condition as indicator of different environmental condition of the riverbank. We conducted three stages survey processes: preparation, fieldwork, and post-fieldwork. The preparation phase includes site selection, depiction of the main river channel of Bogowonto River, and the determination of the sample location. The distance between each sampling site was 5 km along Bogowonto River. The results show that there is anomalous morphometry of sediment grains found in the study area. The reason is that the channel of the segment of the river flowing over rocky riverbed of breccia along the 7.5 km, with hard and sharps edge grained of rock particles. This is accompanied by landslide the occurrence in the upper segment of the river. This is why the value of roundness and flatness indexes are changed significantly become lower value than the previous segment. This condition can be implemented to be used as indicator to basic management of landslide along a certain segment which indicated by the changing in roundness and flatness index values of the sediment grains.

Objective: To explore the therapeutic outcome and significance of preoperative percutaneous nephrolithotomy (PCNL) via the central venous catheter in combination with two-step hard ureteroscopic lithotripsy for the treatment of ureteral stones in the middle-upper segment. Methods: The success rate and the occurrence of severe infection and perirenal hematoma were analyzed retrospectively in 37 patients who received preoperative PCNL via the central venous catheter in combination with two-step hard ureteroscopic lithotripsy for the treatment of ureteral stones in the middle-upper segment in our hospital between July 2012 and November 2014. Results: The operation duration was 12–38 min with a mean of 18.5 min. The procedure was performed successfully in all patients without the postoperative occurrence of perirenal hematoma in any patient. No severe infection occurred in any patient according to the Surviving Sepsis Campaign: International Guidelines for Management of Severe Sepsis (2012). Conclusion: Preoperative PCNL via the central venous catheter can significantly improve the success rate of ureteroscopic lithotripsy for the treatment of ureteral stones in the middle-upper segment, and reduce postoperative occurrences of severe infection and perirenal hematoma.

Background The diagnosis of paraduodenal hernia is still a challenge in clinical practice due to lacking of specific symptoms. Case presentation: An 83-yr-old male patient presented to our department due to severe abdominal pain for 8 h. Abdominal contrast enhanced computerized tomography (CT) scan indicated intussusception in the duodenum and the upper segment of jejunum, as well as internal hernia. He complaint of progression in the abdominal pain, and then laparoscope was carried out, which indicated left-sided paraduodenal hernia. Subsequently, the patient was transferred to celiotomy, during which slight ischemic changes were noticed in the intestinal canal. Meanwhile, a hernial orifice was noticed in the left orifice of the duodenum. Conclusions: In this case, we presented our experiences on the diagnosis of paraduodenal hernia and intussusception. Our study contributed to the understanding, early diagnosis and selection of surgical options for the surgeons.

Background Owing to its unique advantages, 2-level artificial cervical disc replacement (ACDR) is gaining attention. Among artificial discs designed for use in ACDR, the Food and Drug Administration–approved Prestige-LP Cervical Disc is widely used. There are no standard implantation sequences for 2-level ACDR using the Prestige-LP disc, and complications resulting from inappropriate implantation sequences remain unknown. Case Description A 45-year-old woman underwent continuous 2-level ACDR using the Prestige-LP disc and experienced anterior migration of a previously inserted artificial disc after secondary disc implantation at an upper segment owing to an inappropriate implantation sequence during surgery. Intraoperative radiographs showed stable index levels and artificial discs. We tapped the migrated disc back into its correct position and recommended a postoperative functional exercise plan to the patient. We followed the patient for 8 years to verify the safety of our solution. We developed an implantation strategy for 2-level ACDR to avoid this complication in the future. Conclusions During 2-level ACDR, a top-down sequence should be used to implant prostheses. When anterior disc migration occurs, intraoperative radiographs should be obtained to ensure stability of the index levels. If there is no instability, the migrated tab can be tapped back into its correct position. In addition, limiting motion rather than allowing intermittent movement of the neck for at least 3 months is important to promote union between bone and prosthesis.

This paper investigates the existence and nature of constraints prevailing among Mexican microenterprises. It provides inter-temporal insights by relying on firm-level data spanning from 1994 to 2012. A performance index is defined based on firm levels of capital stock and monthly profits, and is used to estimate the empirical probability of a business’s success. The predicted values are used to classify every microenterprise into one of three categories: upper, middle, or lower segment. Overall, the study provides evidence of constrained productivity and capital misallocation. Specifically, middle-segment firms exhibit entrepreneurial features and their average marginal returns are 15 percent. Because this segment faces mainly external constraints, cost-effective interventions are plausible. Regarding the lower-segment firms, it is estimated that their average monthly marginal returns are 30 per cent, compared to 1 per cent for the upper segment. It is also shown that, over time, the share that middle-segment firms represent relative to all microenterprises increased from 16 to 22 percent. Lastly, the sources of variation in monthly profits among segments are explored using the Oaxaca-Blinder decomposition method.

The results of complex studies of the northeastern fumarole field of the Ebeko Volcano (Paramushir Island) are presented. The geochemical study of the thermal sources and potholes evidences the complex composition of the solutions: the high contents of certain chemical elements in the sources cannot be explained only by leaching from the host rocks. To identify the structural features that can lead to accumulation of elements in the thermal solutions, the geophysical study of the northeastern fumarole field of the volcano is carried out by frequency sounding, electric tomography, and temperature surveying along the profile. As a result, the structure of the subsurface space of the thermal field, the structure of the feeders, and the presence of a phase barrier for fluid separation are revealed. The complex of studies makes it possible to explain some features of the geochemical composition of the thermal sources and to describe the evolution of the fluids in the upper segment of the section.

Based on a companion publication that introduces the theoretical foundations, this paper describes the implemented architecture for formation control of the upper segment vehicles of the MORPH project. We highlight the necessary modifications and additional elements, mainly in terms of control and estimation, to allow for the implementation in real vehicles. We illustrate the performance of the system with results from sea trials in Lisbon and in the Azores, with a number of heterogeneous vehicles from multiple partners involved in the project.

The medial temporal lobe plays a central role in memory processing and is more than just the hippocampus.[1][1] The hippocampal formation, which forms the upper segment of the medial temporal lobe, is a heterogeneous structure consisting of the Ammon horn or Cornus Ammonis (Cornus Ammonis area 1 to

Surgery of the abdominal cavity may lead to postoperative defects to the ventricular segment of the abdominal wall. The reconstruction of these defects, especially in the area of the median line, represents an issue during the course of healing due to the role of the abdominal cavity in respiratory processes. Reconstructive surgical procedure was performed on an infected vast defect to the ventral segment of the abdominal wall in a 77-year-old woman by a modified “Mercedes closure pattern,” i.e., by combining three fasciocutaneous flaps: bipedicle flap of the upper segment of the abdominal wall and two sliding breast flaps. Application of a modified complex Mercedes closure pattern was successful and positively affected the redistribution of pressure forces at the places where the edges of the wound were in contact. The applied and described technique of closing the abdominal cavity decreased the possibility of infection to the prosthetic material, because direct contact between the sutures and the prosthetic no longer existed. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

IntroductionPJK is a well-described post-operative complication associated with long instrumented fusion constructs. The surgical creation of a stiff upper segment along with patient osteoporosis h...