Kub3 Deficiency Causes Aberrant Late Embryonic Lung Development in Mice by the FGF Signaling Pathway.

As a Ku70-binding protein of the KUB family, Kub3 has previously been reported to play a role in DNA double-strand break repair in human glioblastoma cells in glioblastoma patients. However, the physiological roles of Kub3 in normal mammalian cells remain unknown. In the present study, we generated Kub3 gene knockout mice and revealed that knockout (KO) mice died as embryos after E18.5 or as newborns immediately after birth. Compared with the lungs of wild-type (WT) mice, Kub3 KO lungs displayed abnormal lung morphogenesis and pulmonary atelectasis at E18.5. No difference in cell proliferation or cell apoptosis was detected between KO lungs and WT lungs. However, the differentiation of alveolar epithelial cells and the maturation of type II epithelial cells were impaired in KO lungs at E18.5. Further characterization displayed that Kub3 deficiency caused an abnormal FGF signaling pathway at E18.5. Taking all the data together, we revealed that Kub3 deletion leads to abnormal late lung development in mice, resulting from the aberrant differentiation of alveolar epithelial cells and the immaturation of type II epithelial cells due to the disturbed FGF signaling pathway. Therefore, this study has uncovered an essential role of Kub3 in the prenatal lung development of mice which advances our knowledge of regulatory factors in embryonic lung development and provides new concepts for exploring the mechanisms of disease related to perinatal lung development.

Should contrast CT urography replace non-contrast CT as an investigation for ureteric colic in the emergency department in those aged 65 and over?

PURPOSE: Elderly patients with upper tract urothelial cancer (UTUC) may present with colic and microscopic haematuria, mimicking urolithiasis. Patients presenting to emergency departments with acute ureteric colic are investigated with a CT KUB. CT urography (CTU) identifies UTUC better than a CT KUB. Thus, there is a possibility that a CT KUB may miss UTUC. METHODS: We studied patients aged 65 years or over presenting to the emergency department with ureteric colic and microscopic haematuria who had a CT KUB between January 2014 and October 2016. Patients who had both CT KUB and CTU were then compared to determine if CT KUB had missed a UTUC and if the diagnoses were concordant by the two tests. A radiologist independent from the reporting radiologists reviewed images as well as their reports. According to the Health Research Authority, England regulations, we did not obtain an ethical review on a voluntary basis for this retrospective study. RESULTS: Four hundred eighty-five patients [228 (47.01%) male and 257 (52.99%) female] had a CT KUB scan over the 34-month period. Their mean age was 74 (SD 6.97) [males 73 (SD 6.42), females 75 (SD 7.42)] years. One hundred eighty-seven scans were normal. Ureteric calculi (167), renal calculi (58) and renal cysts (28) were most frequent diagnoses. The diagnosis was uncertain in 33 patients (6.8%) [16 (48.49%) males and 17 (51.51%) females]. The mean age of this group of patients was 74 (SD 6.64) [males 73 (SD4.43), females 74 (SD7.64)] years. These patients had a CTU for clarity. CTU identified one UTUC not identified by CT KUB (0.2%), corroborated the diagnosis of a ureteric tumour in one patient and excluded UTUC in two others. CTU diagnosed two new bladder tumours and an endometrial tumour. Diagnoses were concordant between CT KUB and CTU in 17 of 33 patients (51.5%). CONCLUSIONS: CT KUB scans for patients 65 years and over presenting with ureteric colic is justified. Only a small proportion of patients will subsequently require the higher radiation dose CTU as the probability of missing UTUC is low.

Are We Using Abdominal Radiographs Appropriately in the Management of Pediatric Constipation?

OBJECTIVE: To identify the reasons why pediatric gastroenterologists obtain abdominal radiographs in the management of pediatric constipation. STUDY DESIGN: This was a prospective study surveying providers regarding their rationale, interpretation, resultant change, and confidence in their management before and after obtaining KUBs in patients seen for suspected constipation. Demographics and clinical findings were obtained from medical records. RESULTS: A total of 24 providers were surveyed after 72 patient encounters. Reasons for obtaining an abdominal radiograph included evaluation of stool burden (70%), need for a clean out (35%), fecal impaction (27%), cause of abdominal pain (24%), demonstration of stool burden to families (14%), assessment of response to therapy (13%), or encopresis (10%). The plan was changed in 47.6% of cases based on radiographic findings. In cases in which a plan was outlined before obtaining the radiograph (69%), the initial plan was implemented on average in 52.5%. In cases with no plans before obtaining the radiograph, previously unconsidered plans were implemented in 8.7%. Provider confidence in the management plan increased from 2.4 ± 2.7 to 4.1 ± 1.8 (P < .05) after the abdominal radiograph. CONCLUSION: Abdominal radiographs commonly are obtained by pediatric gastroenterologists in the evaluation and management of constipation. The majority used it to make a diagnosis, and nearly one-half changed their management based on the imaging findings. Overall, they reported an improved confidence in their management plan, despite evidence that radiographic findings poorly correlate with clinical severity. This study highlights the need for further provider education regarding the recommendations delineated in existing constipation guidelines.

High recurrence rate at 5-year followup in children after upper urinary tract stone surgery.

PURPOSE: Pediatric urolithiasis has been treated with shock wave lithotripsy, ureteroscopy and percutaneous nephrolithotomy with high success rates during short-term followup. We studied our success rate and modifiable risk factors in patients with at least 5 years of followup postoperatively. MATERIALS AND METHODS: Retrospective chart review was performed for patients younger than 18 years who underwent upper tract stone surgery between 1999 and 2007, were stone-free afterward and had at least 5 years of followup. Recurrence rate, and anatomical and metabolic abnormalities were assessed. RESULTS: Of 60 eligible children 30 (33 kidneys) had at least 5 years of followup. Average patient age at surgery was 10 years, 17 patients were female and 20 kidneys had anatomical abnormalities. Overall recurrence rate at 5 years was 55% (95% CI 38%-70%). Ureteral stones had a lower recurrence rate than renal stones (5 of 19 and 13 of 14, respectively, p <0.001). Patients with abnormal anatomy had a 65% (95% CI 43%-82%) chance of recurrence within 5 years vs 38% (95% CI 18%-65%) in those with normal anatomy (p = 0.17). Of the 18 recurrences 10 required a second operation, 7 demonstrated abnormal anatomy and 14 involved calcium based stones. A 24-hour urine test in 13 children revealed 10 with hypercalciuria and 11 with hypocitraturia, with 9 patients exhibiting both conditions. CONCLUSIONS: We found a high recurrence rate in children with stones requiring surgical intervention, particularly those with abnormal anatomy. This finding should be confirmed in a larger multicenter study of recurrence rates. In the meantime our results suggest a need for aggressive diagnosis and treatment of metabolic abnormalities.

Enhancement of Lactobacillus reuteri KUB-AC5 survival in broiler gastrointestinal tract by microencapsulation with alginate-chitosan semi-interpenetrating polymer networks.

AIMS: To evaluate an alginate-chitosan microcapsule for an intestinal probiotic delivery system for broilers. METHODS AND RESULTS: Lactobacillus reuteri KUB-AC5 was successfully microencapsulated with alginate and chitosan mixtures using an emulsion cross-linking method with high microencapsulation efficiency. Scanning electron microscopy revealed a large number of the bacteria entrapped in the semi-interpenetrating network. The microcapsule effectively protected the cells against strong acids. The in vitro study showed that the 8 log CFU g(-1) was released at the jejunum and ileum. For the in vivo study, the number of probiotics was detected by a polymerase chain reaction-based random amplified polymorphic DNA technique. From provision of 10 log CFU, cell numbers of 5-8 log CFU were observed in the intestine. CONCLUSIONS: The alginate-chitosan microcapsule can serve as a potential intestine-targeted probiotic delivery system. SIGNIFICANCE AND IMPACTS OF THE STUDY: To the best of our knowledge, this is the first comparison study of the in vitro and in vivo gastrointestinal profiles of microencapsulated probiotics used as feed additives for broilers. This study reveals the similarities and differences of the in vitro and in vivo probiotic profiles and provides convincing evidence of the potential use of the alginate-chitosan microcapsule as a probiotic delivery system.

Giant urinary bladder stone: A rare case report.

INTRODUCTION: Giant urinary bladder stones are rare phenomenon which is associated with chronic urinary infections, intravesical foreign bodies, urethral strictures, bladder diverticula etc. CASE REPORT: A 52-year-old man presented with complaints of severe dysuria, urgency, frequency, suprapubic pain, and pollakuria for the last ten years. Physical examination revealed a palpable suprapubic mass with no obvious flank masses. Ultrasonography of the abdomen and pelvis revealed right-sided gross hydroureteronephrosis and thinning of renal parenchyma along with a hyperechoic structure with posterior acoustic shadowing was noted in the region of the urinary bladder, suggesting a vesical calculus. Plain CT of the kidneys, ureters, and bladder (KUB) confirmed right nephrolithiasis in lower poly calyx and a large vesical calculus (10.6 cm × 8.6 cm x8.8 cm, +1110 HU). Open cystolithotomy with a right-sided double-J "DJ" stent insertion was performed. Post-operative period went uneventful. DISCUSSION: Giant bladder stones are extremely rare, often resulting from neglected symptoms in otherwise normal individuals. They typically develop over several years and present with symptoms like severe dysuria, urgency, frequency, supra-pubic pain, and hematuria. Diagnosis is made by cystoscopy, ultrasonography and CT-KUB. Treatment includes intracorporeal cystolithotripsy using a laser, ultrasonic lithotripter, or pneumatic lithotripter, depending on availability. Endourologic procedures have been safer and more cost-effective for bladder stones, however, open removal is the treatment of choice for giant bladder stones. CONCLUSION: Open cystolithotomy can be performed to remove giant bladder stone with near 100 % stone removal rate.

Could radiological parameters help to predict the failure of ureteral access sheath placement.

To identify the radiological parameters which may help to predict the success of ureteral access sheath (UAS) placement during retrograde intrarenal surgery (RIRS).The study included 49 patients in whom failure ureteral access sheath placement in RIRS and 49 control group patients who were successfully placement between January 2023 and December 2023. The age, gender, body mass index (BMI), non-contrast computed tomography (NCCT), and kidney ureter bladder (KUB) radiographs were compared between the two groups. Measurements of the anteroposterior (ap) diameter of the pelvic inlet, anteroposterior diameter of the pelvic outlet, interspinous distance diameter were taken from non-contrast computed tomography (NCCT), while pelvic anteroposterior diameter and pelvic lateral diameter were measured from kidney ureter bladder (KUB) radiography. There were no significant differences between the groups in age, gender, body mass index, ap pelvic inlet diameter, ap pelvic outlet, and interspinous distance diameter. However, a statistically significant difference was found between the pelvic ap diameter and pelvic lateral diameter values measured on the KUB radiography. The values for pelvic ap diameter and pelvic lateral diameter measured in the KUB radiographs can be used to predict the likelihood of UAS passage during RIRC procedures. However, further studies with larger patient groups are needed to establish a cut-off value.

Predicting osteoporosis from kidney-ureter-bladder radiographs utilizing deep convolutional neural networks.

Osteoporosis is a common condition that can lead to fractures, mobility issues, and death. Although dual-energy X-ray absorptiometry (DXA) is the gold standard for osteoporosis, it is expensive and not widely available. In contrast, kidney-ureter-bladder (KUB) radiographs are inexpensive and frequently ordered in clinical practice. Thus, it is a potential screening tool for osteoporosis. In this study, we explored the possibility of predicting the bone mineral density (BMD) and classifying high-risk patient groups using KUB radiographs. We proposed DeepDXA-KUB, a deep learning model that predicts the BMD values of the left hip and lumbar vertebrae from an input KUB image. The datasets were obtained from Taiwanese medical centers between 2006 and 2019, using 8913 pairs of KUB radiographs and DXA examinations performed within 6 months. The images were randomly divided into training and validation sets in a 4:1 ratio. To evaluate the model's performance, we computed a confusion matrix and evaluated the sensitivity, specificity, accuracy, precision, positive predictive value, negative predictive value, F1 score, and area under the receiver operating curve (AUROC). Moderate correlations were observed between the predicted and DXA-measured BMD values, with a correlation coefficient of 0.858 for the lumbar vertebrae and 0.87 for the left hip. The model demonstrated an osteoporosis detection accuracy, sensitivity, and specificity of 84.7 %, 81.6 %, and 86.6 % for the lumbar vertebrae and 84.2 %, 91.2 %, and 81 % for the left hip, respectively. The AUROC was 0.939 for the lumbar vertebrae and 0.947 for the left hip, indicating a satisfactory performance in osteoporosis screening. The present study is the first to develop a deep learning model based on KUB radiographs to predict lumbar spine and femoral BMD. Our model demonstrated a promising correlation between the predicted and DXA-measured BMD in both the lumbar vertebrae and hip, showing great potential for the opportunistic screening of osteoporosis.

Ultrasound accuracy in evaluating renal calculi in Maysan province.

Renal calculi are a common clinical presentation. While ultrasound (US) is a widely used imaging modality for kidney stone diagnosis due to its accessibility and lower cost, its accuracy compared to computerized tomography (CT), the gold standard, remains understudied. This cross-sectional study evaluated the diagnostic accuracy of ultrasound for detecting and characterizing kidney stones compared to computed tomography (CT). Fifty-six patients with suspected kidney stones based on flank pain underwent abdominal ultrasound to assess stone presence, size, location, and the severity of any hydronephrosis (kidney swelling). These findings were then confirmed with a subsequent non-contrast CT scan. There was a fair agreement between US and CT (Kappa = 0.368) for detecting the stone location. The US could not detect 7 (12.5%) stones, being less sensitive in the middle and upper calyx compared to CT. There was a fair agreement between the US and CT (Kappa = 0.394) for detecting the severity of hydronephrosis. The US was less sensitive to moderate and severe hydronephrosis compared to CT. The abdominal ultrasound demonstrated excellent reliability for stone size measurement (intraclass correlation = 0.924), with CT measurements only slightly larger on average (mean difference 0.9 mm). Although abdominal ultrasound provides reliable stone size assessment, its capacity to accurately localize stones and assess hydronephrosis severity is limited.

Identification of kidney stones in KUB X-ray images using VGG16 empowered with explainable artificial intelligence.

A kidney stone is a solid formation that can lead to kidney failure, severe pain, and reduced quality of life from urinary system blockages. While medical experts can interpret kidney-ureter-bladder (KUB) X-ray images, specific images pose challenges for human detection, requiring significant analysis time. Consequently, developing a detection system becomes crucial for accurately classifying KUB X-ray images. This article applies a transfer learning (TL) model with a pre-trained VGG16 empowered with explainable artificial intelligence (XAI) to establish a system that takes KUB X-ray images and accurately categorizes them as kidney stones or normal cases. The findings demonstrate that the model achieves a testing accuracy of 97.41% in identifying kidney stones or normal KUB X-rays in the dataset used. VGG16 model delivers highly accurate predictions but lacks fairness and explainability in their decision-making process. This study incorporates the Layer-Wise Relevance Propagation (LRP) technique, an explainable artificial intelligence (XAI) technique, to enhance the transparency and effectiveness of the model to address this concern. The XAI technique, specifically LRP, increases the model's fairness and transparency, facilitating human comprehension of the predictions. Consequently, XAI can play an important role in assisting doctors with the accurate identification of kidney stones, thereby facilitating the execution of effective treatment strategies.

Dysfunctional elimination syndromes--how closely linked are constipation and encopresis with specific lower urinary tract conditions?

PURPOSE: It is recognized that there is a strong association between bladder and bowel dysfunction. We determined the association of constipation and/or encopresis with specific lower urinary tract conditions. MATERIALS AND METHODS: We reviewed our database of children with lower urinary tract dysfunction and divided cases into 3 categories of bowel dysfunction (constipation, encopresis and constipation plus encopresis) and 4 lower urinary tract conditions (dysfunctional voiding, idiopathic detrusor overactivity disorder, detrusor underutilization disorder and primary bladder neck dysfunction). Associations between bowel dysfunction types and each lower urinary tract condition were determined. RESULTS: Of 163 males and 205 females with a mean age of 8.5 years constipation was the most common bowel dysfunction (27%). Although encopresis is generally thought to reflect underlying constipation, only half of children with encopresis in this series had constipation. Dysfunctional voiding was associated with the highest incidence of bowel dysfunction. All but 1 patient with encopresis had associated urgency and detrusor overactivity, and the encopresis resolved in 75% of patients after initiation of anticholinergic therapy. Constipation was significantly more common in girls (27%) than in boys (11%, p <0.01), while encopresis was more common in boys (9%) than in girls (3%, p = 0.02), likely reflecting the higher incidence of dysfunctional voiding in girls and idiopathic detrusor overactivity disorder in boys. CONCLUSIONS: Active bowel dysfunction was seen in half of the children with a lower urinary tract condition. Constipation was more common in patients with dysfunctional voiding, while encopresis was significantly increased in those with idiopathic detrusor overactivity disorder and in those with dysfunctional voiding, severe urgency and detrusor overactivity. Anticholinergics, despite their constipating effect, given for treatment of detrusor overactivity resolved encopresis in most children with this bowel dysfunction.

Radiation exposure in urology: a genitourinary catalogue for diagnostic imaging.

PURPOSE: Computerized tomography use increased exponentially in the last 3 decades, and it is commonly used to evaluate many urological conditions. Ionizing radiation exposure from medical imaging is linked to the risk of malignancy. We measured the organ and calculated effective doses of different studies to determine whether the dose-length product method is an accurate estimation of radiation exposure. MATERIALS AND METHODS: An anthropomorphic male phantom validated for human organ dosimetry measurements was used to determine radiation doses. High sensitivity metal oxide semiconductor field effect transistor dosimeters were placed at 20 organ locations to measure specific organ doses. For each study the phantom was scanned 3 times using our institutional protocols. Organ doses were measured and effective doses were calculated on dosimetry. Effective doses measured by a metal oxide semiconductor field effect transistor dosimeter were compared to calculated effective doses derived from the dose-length product. RESULTS: The mean±SD effective dose on dosimetry for stone protocol, chest and abdominopelvic computerized tomography, computerized tomography urogram and renal cell carcinoma protocol computerized tomography was 3.04±0.34, 4.34±0.27, 5.19±0.64, 9.73±0.71 and 11.42±0.24 mSv, respectively. The calculated effective dose for these studies Was 3.33, 2.92, 5.84, 9.64 and 10.06 mSv, respectively (p=0.8478). CONCLUSIONS: The effective dose varies considerable for different urological computerized tomography studies. Renal stone protocol computerized tomography shows the lowest dose, and computerized tomography urogram and the renal cell carcinoma protocol accumulate the highest effective doses. The calculated effective dose derived from the dose-length product is a reasonable estimate of patient radiation exposure.

Renal Imaging in Stone Disease: Which Modality to Choose?

Numerous imaging modalities are available to the provider when diagnosing or surveilling kidney stones. The decision to order one over the other can be nuanced and especially confusing to non-urologic practitioners. This manuscript reviews the main modalities used to image stones in the modern era - renal bladder ultrasound, Kidney Ureter Bladder plain film radiography (KUB), magnetic resonance imaging (MRI), and non-contrast computerized tomography (NCCT). While NCCT has become the most popular and familiar modality for most practitioners, particularly in the acute setting, ultrasound is a cost-effective technology that is adept at monitoring interval stone development in patients and evaluating for the presence of hydronephrosis. KUB and MRI also occupy unique niches in the management of urolithiasis. In the correct clinical setting, each of these modalities has a role in the acute workup and management of suspected nephrolithiasis.

Ubiquitylome analysis reveals the involvement of ubiquitination in the cold responses of banana seedling leaves.

Low temperature is a crucial environmental factor limiting the productivity and distribution of banana. Ubiquitination (Kub) is one of the main posttranslational modifications (PTMs) involved in plant responses to abiotic stresses. However, little information is available on the effects of Kub on banana under cold stress. In this study, we used label-free quantification (LFQ) to identify changes in the protein expression and Kub levels in banana seedling leaves after chilling treatment. In total, 4156 proteins, 1089 ubiquitinated proteins and 2636 Kub sites were quantified. Western blot assays showed that Kub was abundant in leaves after low-temperature treatment. Our results show that the proteome and ubiquitylome were negatively correlated, indicating that Kub could be involved in the degradation of proteins in banana after chilling treatment. Based on bioinformatics analysis, low-temperature stress-related signals and metabolic pathways such as cold acclimation, glutathione metabolism, calcium signaling, and photosynthesis signaling were identified. In addition, we found that transcription factors and chromatin remodeling factors related to low-temperature stress were ubiquitinated. Overall, our work presents the first systematic analysis of the Kub proteome in banana under cold stress and provides support for future studies on the regulatory mechanisms of Kub during the cold stress response in plants. SIGNIFICANCE: Banana is a typical tropical fruit tree with poor low-temperature tolerance,however, the role of PTMs such as Kub in the cold response of banana remains unclear. This study highlights the fact that the effects of low-temperature on proteome and ubiquitylome in the banana seedling leaves, we discussed the correlation between transcriptome and proteome, ubiquitylome and proteome, and we analyzed the expression and the changes of ubiquitination levels of low-temperature related proteins and pathway after chilling treatment, and we found that transcription factors and chromatin remodeling factors related to low-temperature stress were ubiquitinated. This study provides new insights into the ubiquitination pathway of banana under cold stress.

Acute Colonic Pseudo-Obstruction in a Patient With COVID-19 Pneumonia: A Case Report.

Coronavirus disease (COVID-19) is primarily a respiratory illness caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus. However, the disease is also known to cause a range of extrapulmonary manifestations, including gastrointestinal (GI) symptoms such as nausea, vomiting, and diarrhea. The exact mechanisms by which the virus causes extrapulmonary manifestations are not fully understood, but it is theorized that the virus can enter cells in other organs including the GI tract, through the angiotensin-converting enzyme 2 (ACE2) receptor. This can result in inflammation and damage to the affected organs. In rare cases, COVID-19 can also cause acute colonic pseudo-obstruction (ACPO), a condition characterized by symptoms of bowel obstruction but without a physical obstruction present. Acute colonic pseudo-obstruction is a serious and potentially life-threatening complication of COVID-19 that requires prompt recognition and treatment to prevent further complications such as bowel ischemia and perforation. We hereby present a case report of a patient with COVID-19 pneumonia developing ACPO and discuss the suggested pathophysiology, diagnostic approach, and treatment options.

Can radiological scores predict difficulties in removal of encrusted ureteral stents?

In the present study, we aimed to report our single-center experience in encrusted ureteral stent management and to compare the utility of two different scoring systems in patient management. This is a retrospective study of patients who underwent various surgical procedures to remove encrusted ureteral stent. Encrusted stent grading was performed using KUB and FECal grading sytems. FECal grading system scored from Grade 1 to Grade 5 according to stone size, location, and degree of stent incrustation and the KUB score is the sum of the stone burden scores of three different parts of an encrusted stent within the kidney, ureter, and bladder determined using a scale from 1 to 5 according to the maximal diameter of encrustation. We compared these two classifications for the prediction of perioperative outcomes. Fifty patients were included in the study (52% female, mean age 48 years). The mean time from ureteral stent insertion until diagnosis of encrustation was 11.4 ± 13.6 months. High-grade incrustations (FECal Grade 3, 4, and 5) accounted for 62% of cases. The mean KUB score was 9.8 ± 2.7. The average number of procedures required to remove the stent was 1.71 ± 1.38. Multimodal surgery was required to remove 42% of the stents. Both, a total KUB score ≥ 9 and high-grade FECal classification were found to be significant predictors of longer operative time (> 100 min), need for multiple surgeries, and need for invasive surgery. While high-grade FECal classification showed a significant association with need for multimodal surgery (OR 6.92, p = 0.008), a total KUB score ≥ 9 showed no association (OR 2.91, p = 0.086). These two scores seem to be good indicators in predicting difficulties for surgical management of encrusted ureteral stent with a clear advantage of the FECal score in terms of prediction of multimodal surgery.

The feasibility of ultrasound-guided mini-percutaneous nephrolithotomy for ESWL-resistant lower calyx renal stones of up to two centimeters: a single center experience.

Lower pole renal stones present a significant challenge in urologic practice due to difficulty in accessing the calyx and eliminating fragments. Management options for these stones include watchful waiting for asymptomatic stones, extracorporeal shock wave lithotripsy (ESWL), ureterorenoscopy (URS), and percutaneous nephrolithotomy (PCNL). Mini-PCNL is a newer modification of conventional PCNL. The study aimed to assess the feasibility of mini-PCNL in treating lower pole renal stones equal to or less than 20mm that were not responsive to ESWL therapy. We included 42 patients (24 male and 18 female) with a mean age of 40±2.3 who underwent mini-PCNL at a single urology center between June 2020 and July 2022 and assessed operative and postoperative outcomes. The mean total operative time was 47±3.11 minutes, ranging from 40 to 60 minutes. The stone-free rate was 90%, and the overall complication rate was 26%, which included minor bleeding (5%), hematuria (7%), pain (12%), and fever (2%). The mean hospital stay was 80±3.34 hours (3-4 days). Our findings suggest that mini-PCNL is an effective treatment option for lower pole renal stones that are not responsive to ESWL therapy. The immediate stone-free rate was high, with minimum non-serious complications.

KUB-UNet: Segmentation of Organs of Urinary System from a KUB X-ray Image.

PURPOSE: The alarming increase in diseases of urinary system is a cause of concern for the populace and health experts. The traditional techniques used for the diagnosis of these diseases are inconvenient for patients, require high cost, and additional waiting time for generating the reports. The objective of this research is to utilize the proven potential of Artificial Intelligence for organ segmentation. Correct identification and segmentation of the region of interest in a medical image are important to enhance the accuracy of disease diagnosis. Also, it improves the reliability of the system by ensuring the extraction of features only from the region of interest. METHOD: A lot of research works are proposed in the literature for the segmentation of organs using MRI, CT scans, and ultrasound images. But, the segmentation of kidneys, ureters, and bladder from KUB X-ray images is found under explored. Also, there is a lack of validated datasets comprising KUB X-ray images. These challenges motivated the authors to tie up with the team of radiologists and gather the anonymous and validated dataset that can be used to automate the diagnosis of diseases of the urinary system. Further, they proposed a KUB-UNet model for semantic segmentation of the urinary system. RESULTS: The proposed KUB-UNet model reported the highest accuracy of 99.18% for segmentation of organs of urinary system. CONCLUSION: The comparative analysis of its performance with state-of-the-art models and validation of results by radiology experts prove its reliability, robustness, and supremacy. This segmentation phase may prove useful in extracting the features only from the region of interest and improve the accuracy diagnosis.

Comparative genomics-based probiotic relevance of Limosilactobacillus fermentum KUB-D18.

Limosilactobacillus fermentum KUB-D18 is a heterofermentative lactic acid bacterium that its potential probiotic relevance originally isolated from the chicken intestine. This study sequenced a whole-genome of L. fermentum KUB-D18 and annotated its genes and functions in relation to probiotic properties. As a result, the genome sequence of L. fermentum KUB-D18 approximately contained 2.02 Mbps with GC content of51.7%. After annotating the genome by integrated protein and pathway databases, 2,158 protein-encoding genes were majorly annotated for metabolisms of amino acids, carbohydrates and cofactors as well as vitamins which showed a versatile metabolic capability to gastrointestinal microhabitats. According to the comparative genome analysis of L. fermentum KUB-D18 and the other related strains, L. fermentum KUB-D18 showed common characteristics e.g., folate biosynthesis and bile salt hydrolase enzymes-related cholesterol lowering effect as well as a unique gene cluster involved in metabolism of l-ascorbic acid of L. fermentum KUB-D18. Taken together, L. fermentum KUB-D18 genome provides the genetic basis towards cellular capability for further elucidating the functional mechanisms of its probiotic properties. This study serves for designing desirable targets for the development of probiotic foods and feeds.

Complete duplication of the penis - A case report.

Penile duplication is a very rare urological entity. It may be associated with other congenital conditions such as urogenital, GI tract and musculoskeletal anomalies. Properly classifying the condition may dictate the final treatment options. Our current case is the complete true duplication in which we performed side-to-side urethra-urethral anastomosis. We spared the posterior urethra as it may end up with postoperative urinary incontinence.