Objective: Complete cleft palate is still considered a complex problem. The proposed plan of management attempts to resolve the problem by adjusting the timing and steps of surgery. Methods: Forty-eight cases of unilateral and bilateral varieties were included in this study. Cases were operated by the author in King Khalid Civilian Hospital in Tabuk.Saudi Arabia and in University Malaya Medical Center, Malaysia, in the period from 1992 up to 2003. The study proposed to close the lip in the first week of life and palate by 7th to 10th month of age. Results: The results were satisfactory regarding closure, aesthetic appearance and speech improvement. Problems in the modified scheme are minor when compared with the classic scheme. Conclusion: Modifying the timing for treatment of complete cleft palate and lip allows early restoration of the normal anatomy of the mouth and face. This promotes normal growth of the facial skeleton and dentition, resulting in normal shape and good speech quality.

Objectives:To evaluate antifouling property of extracts from Red Sea soft corals against primary biofilm and biofouling.Methods:Seven species of soft corals Sarcophyton glaucum (a),Sinularia compressa,Sinularia cruciata (a),Heteroxenia fuscescens (a),Sarcophyton glaucum (b),Heteroxenia fuscescens (b) and Sinularia cruciata (b) were chosen to test their extracts as antibacterial and antifouling agents in Eastern Harbour of Alexandria,Mediterranean Sea.Bioactive compounds of soft corals were extracted by using methanol and concentrated under vacuum.The residues of extracts were mixed in formulation of inert paint which consisted of rosin,chlorinated robber and ferrous oxide against micro and macro fouling organisms.The formulated paints were then applied on PVC panels twice by brush,hanged in a steel frame and immersed in Eastern Harbour of Alexandria Mediterranean Sea followed by visual inspection and photographic recordings.Results:After 185 days of immersion in seawater,the antifouling results agreed with the antibactedal results where extracts of Sinularia compressa and Heteroxenia fuscescens (b) gave the best activity against marine fouling tubeworms and barnacles.The inhibition activity was correlated with the major functional groups (hydroxyl,amino,carbonyl,aliphatic (fatty acids),C=C of alkene or aromatic rings and C—Cl of aryl halites) of the extracts.Conclusions:The strong antifouling activity makes them promising candidates for new antifouling additives.After the screening and application of natural organic compounds from soft corals,marine organisms show activity against micro and macro fouling organisms.

PURPOSE: The purpose of the study was to assess the influence of build orientations and density of support structures on the trueness of the 3D printed removable partial denture (RPD) frameworks. MATERIALS AND METHODS: A maxillary Kennedy class III and mandibular class I casts were 3D scanned and used to design and produce two 3D virtual models of RPD frameworks. Using digital light processing (DLP) 3D printing, 47 RPD frameworks were fabricated at 3 different build orientations (100, 135 and 150-degree angles) and 2 support structure densities. All frameworks were scanned and 3D compared to the original virtual RPD models by metrology software to check 3D deviations quantitatively and qualitatively. The accuracy data were statistically analyzed using one-way ANOVA for build orientation comparison and independent sample t-test for structure density comparison at (α = .05). Points study analysis targeting RPD components and representative color maps were also studied. RESULTS: The build orientation of 135-degree angle of the maxillary frameworks showed the lowest deviation at the clasp arms of tooth 26 of the 135-degree angle group. The mandibular frameworks with 150-degree angle build orientation showed the least deviation at the rest on tooth 44 and the arm of the I-bar clasp of tooth 45. No significant difference was seen between different support structure densities. CONCLUSION Build orientation had an influence on the accuracy of the frameworks, especially at a 135-degree angle of maxillary design and 150-degree of mandibular design. The difference in the support’s density structure revealed no considerable effect on the accuracy.

Objective: : Hyperostosis in meningiomas can be present in 4.5% to 44% of cases. Radical resection should include aggressive removal of invaded bone. It is not clear however to what extent bone removal should be carried to achieve pathologically free margins, especially that in many cases, there is a T2 hyperintense signal that extends beyond the hyperostotic bone. In this study we try to investigate the perimeter of tumour cells outside the visible nidus of hyperostotic bone and to what extent they are present outside this nidus. This would serve as an initial step for setting guidelines on dealing with hyperostosis in meningioma surgery. Methods: : This is a prospective case series that included 14 patients with convexity meningiomas and hyperostosis during the period from March 2017 to August 2018 in two university hospitals. Patients demographics, clinical, imaging characteristics, intraoperative and postoperative data were collected and analysed. In all cases, all visible abnormal bone was excised bearing in mind to also include the hyperintense diploe in magnetic resonance imaging (MRI) T2 weighted images after careful preoperative assessment. To examine bony tumour invasion, five marked bone biopsies were taken from the craniotomy flap for histopathological examinations. These include one from the centre of hyperostotic nidus and the other four from the corners at a 2-cm distance from the margin of the nidus. Results: : Our study included five males (35.7%) and nine females (64.3%) with a mean age of 43.75 years (33-55). Tumor site was parietal in seven cases (50%), fronto-parietal in three cases (21.4%), parieto-occipital in two cases (14.2%), frontal region in one case and bicoronal (midline) in one case. Tumour pathology revealed a World Health Organization (WHO) grade I in seven cases (50%), atypical meningioma (WHO II) in five cases (35.7%) and anaplastic meningioma (WHO III) in two cases (14.2%). In all grade I and II meningiomas, bone biopsies harvested from the nidus revealed infiltration with tumour cells while all other bone biopsies from the four corners (2 cm from nidus) were free. In cases of anaplastic meningiomas, all five biopsies were positive for tumour cells. Conclusion : Removal of the gross epicentre of hyperostotic bone with the surrounding 2 cm is adequate to ensure radical excision and free bone margins in grade I and II meningiomas. Hyperintense signal change in MRI T2 weighted images, even beyond visible hypersototic areas, doesn’t necessarily represent tumour invasion.

Stem cells (SCs) are undifferentiated cells that are capable of self-renewal and differentiation and that therefore contribute to the renewal and repair of tissues. Their capacity for division, differentiation, and tissue regeneration is highly dependent on the surrounding environment. Several preclinical and clinical studies have utilized SCs in urological disorders. In this article, we review the current status of SC use in benign urological diseases (erectile dysfunction, Peyronie disease, infertility, and urinary incontinence), and we summarize the results of the preclinical and clinical trials that have been conducted.
Erectile Dysfunction/physiopathology/*therapy ; Female ; Humans ; Male ; Outcome Assessment (Health Care) ; Stem Cell Transplantation/*methods ; Urinary Incontinence/physiopathology/*therapy

Background: Endoscopic ultrasound (EUS) tissue acquisition requires rapid on-site evaluation to improve diagnostic yield with less needle passes;however, this is not readily available in all centers, also it increases the duration and the cost of the procedure. Macroscopic on-site evaluation (MOSE) is the direct assessment of the tissue sample provided by EUS-guided fine needle biopsy (EUS-FNB) macroscopically, to detect whether it is sufficient or not. Aim of this study was to define the role of MOSE in judging the adequacy of the tissue core specimens and to evaluate its diagnostic yield and accuracy. Methods: This prospective study was conducted at our institution with 215 participants of both genders presenting for evaluation of solid or mixed solid and cystic lesions by MOSE technique by EUS-fine needle aspiration (FNA) or FNB. Results: In obtaining conclusive sample MOSE score 1 sensitivity was 68.2%, specificity was 75%, positive predictive value (PPV) was 99.3, negative predictive value (NPV) was 4.3 and overall accuracy was 68.4, in MOSE score 2 sensitivity was 88%, specificity was 75%, PPV was 99.5, NPV was 10 and overall accuracy was 87, in MOSE 2 (FNB) sensitivity was 92%, Specificity was 67%, PPV was 99.4, NPV was 12, 5 and overall accuracy was 92.There was no statistically significant difference between the two groups with conclusive and inconclusive cytopathological results regarding size of the needle, number of needle passes, type of the needle and the specimen acquisition method. Conclusion Using MOSE for assessment of adequacy of the sample obtained by EUS-FNB showed higher diagnostic yield compared to conventional method using different needle sizes.

Background: Endoscopic ultrasound (EUS) tissue acquisition requires rapid on-site evaluation to improve diagnostic yield with less needle passes;however, this is not readily available in all centers, also it increases the duration and the cost of the procedure. Macroscopic on-site evaluation (MOSE) is the direct assessment of the tissue sample provided by EUS-guided fine needle biopsy (EUS-FNB) macroscopically, to detect whether it is sufficient or not. Aim of this study was to define the role of MOSE in judging the adequacy of the tissue core specimens and to evaluate its diagnostic yield and accuracy. Methods: This prospective study was conducted at our institution with 215 participants of both genders presenting for evaluation of solid or mixed solid and cystic lesions by MOSE technique by EUS-fine needle aspiration (FNA) or FNB. Results: In obtaining conclusive sample MOSE score 1 sensitivity was 68.2%, specificity was 75%, positive predictive value (PPV) was 99.3, negative predictive value (NPV) was 4.3 and overall accuracy was 68.4, in MOSE score 2 sensitivity was 88%, specificity was 75%, PPV was 99.5, NPV was 10 and overall accuracy was 87, in MOSE 2 (FNB) sensitivity was 92%, Specificity was 67%, PPV was 99.4, NPV was 12, 5 and overall accuracy was 92.There was no statistically significant difference between the two groups with conclusive and inconclusive cytopathological results regarding size of the needle, number of needle passes, type of the needle and the specimen acquisition method. Conclusion Using MOSE for assessment of adequacy of the sample obtained by EUS-FNB showed higher diagnostic yield compared to conventional method using different needle sizes.

Background: Endoscopic ultrasound (EUS) tissue acquisition requires rapid on-site evaluation to improve diagnostic yield with less needle passes;however, this is not readily available in all centers, also it increases the duration and the cost of the procedure. Macroscopic on-site evaluation (MOSE) is the direct assessment of the tissue sample provided by EUS-guided fine needle biopsy (EUS-FNB) macroscopically, to detect whether it is sufficient or not. Aim of this study was to define the role of MOSE in judging the adequacy of the tissue core specimens and to evaluate its diagnostic yield and accuracy. Methods: This prospective study was conducted at our institution with 215 participants of both genders presenting for evaluation of solid or mixed solid and cystic lesions by MOSE technique by EUS-fine needle aspiration (FNA) or FNB. Results: In obtaining conclusive sample MOSE score 1 sensitivity was 68.2%, specificity was 75%, positive predictive value (PPV) was 99.3, negative predictive value (NPV) was 4.3 and overall accuracy was 68.4, in MOSE score 2 sensitivity was 88%, specificity was 75%, PPV was 99.5, NPV was 10 and overall accuracy was 87, in MOSE 2 (FNB) sensitivity was 92%, Specificity was 67%, PPV was 99.4, NPV was 12, 5 and overall accuracy was 92.There was no statistically significant difference between the two groups with conclusive and inconclusive cytopathological results regarding size of the needle, number of needle passes, type of the needle and the specimen acquisition method. Conclusion Using MOSE for assessment of adequacy of the sample obtained by EUS-FNB showed higher diagnostic yield compared to conventional method using different needle sizes.

Uterine fibroids are benign tumors of the myometrium with a diverse range of manifestations. Fibroids can dramatically increase in size during pregnancy due to the increase in estrogen levels. After delivery, the fibroids usually shrink back to their pre-pregnancy size. Uterine myomas may have many complications, including abnormal uterine bleeding, infertility, pressure on nearby organs, degeneration, and malignant transformation. No previous reports have indicated that a fistula may develop between a uterine fibroid and the bowel loops, although previous studies have documented the occurrence of fistulas from the uterus to the bowel following myomectomy or uterine artery embolization performed to treat a myoma. In our case report, we document the rare complication of a fistula occurring between a degenerated myoma in the posterior wall and the ileum 1 week postoperatively in a patient who underwent a Caesarean section but did not have a history of uterine artery embolization.
Animals ; Cesarean Section* ; Estrogens ; Female ; Fistula* ; Humans ; Ileum ; Infertility ; Leiomyoma* ; Mice ; Myoma ; Myometrium ; Pregnancy ; Uterine Artery Embolization ; Uterine Hemorrhage ; Uterus

Spinal extradural arachnoid cyst (SEAC) is a rare cause of spinal cord compression. Bifocal location of thoracic and sacral SEACs is rarely reported in the literature. We report a case of thoracic spinal cord compression by SEAC associated with asymptomatic multiple sacral Tarlov cysts (TC). The surgical management and postoperative outcome of the patient are discussed. A 34-year-old woman was referred to the hospital for acute thoracic pain with a history of chronic long-standing back pain. She complained of walking difficulties. Neurological examination demonstrated incomplete spastic paraplegia with sensory level in T9. Magnetic resonance imaging revealed a large cystic formation from T7-11 and at the level of the sacrum. We performed laminectomies at the level of interest from T7-11. The cysts were dissected from the underlying dura after removal of the cerebrospinal fluid. We found nerve tissue in the cysts. We excised the cyst and preserved the nerve roots. Subsequently, a duraplasty was performed with autologous grafts from the lumbar fascia. The condition of the patient improved after surgery and he was recovering well at follow-up. Although the surgical treatment of TC is controversial, especially at the sacral lumbar level, decompression at the dorsal level in this case is indisputable.
Adult ; Arachnoid ; Back Muscles ; Back Pain ; Cerebrospinal Fluid ; Decompression ; Female ; Follow-Up Studies ; Humans ; Laminectomy ; Magnetic Resonance Imaging ; Nerve Tissue ; Neurologic Examination ; Paraplegia ; Sacrum ; Spinal Cord Compression* ; Spinal Cord* ; Tarlov Cysts* ; Transplants ; Walking