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Lowering cost will prompt the sustainable development of sugarcane‐based ethanol industry. In this work, we developed a low‐cost process for ethanol production from sugarcane by a genetically engineered Zymomonas mobilis. Fermentation media were first optimized, resulting in a 15.54% increase in ethanol fermentation efficiency as compared to control media. To further reduce the byproduct levan formation, a levansucrase‐encoding gene of Z. mobilis, sacB, was deleted through the type I‐F CRISPR‐Cas system, which resulted in a further elevation of both ethanol conversion ratio and productivity comparing with the starting strain ZMS912 (87.50% vs. 76.77%, 1.95 g/L/h vs. 1.71 g/L/h). Moreover, we conducted fed‐batch fermentation for ethanol production using sugarcane juice in 5 L bioreactors and employing the optimized media and engineered strain. The results showed that maximum ethanol titer of 81.59 g/L and productivity of 5.83 g/L/h were achieved. Finally, preliminary techno‐economic assessment demonstrated that our efforts to modify media and strain could reduce the processing cost of ethanol production from sugarcane juice, which provides the feasibility for economic ethanol production in the future. [ABSTRACT FROM AUTHOR]

Background: Conventional clinical detection methods such as CT, urine cytology, and ureteroscopy display low sensitivity and/or are invasive in the diagnosis of upper tract urinary carcinoma (UTUC), a factor precluding their use. Previous studies on urine biopsy have not shown satisfactory sensitivity and specificity in the application of both gene mutation or gene methylation panels. Therefore, these unfavorable factors call for an urgent need for a sensitive and non-invasive method for the diagnosis of UTUC. Methods: In this study, a total of 161 hematuria patients were enrolled with (n = 69) or without (n = 92) UTUC. High-throughput sequencing of 17 genes and methylation analysis for ONECUT2 CpG sites were combined as a liquid biopsy test panel. Further, a logistic regression prediction model that contained several significant features was used to evaluate the risk of UTUC in these patients. Results: In total, 86 UTUC− and 64 UTUC+ case samples were enrolled for the analysis. A logistic regression analysis of significant features including age, the mutation status of TERT promoter, and ONECUT2 methylation level resulted in an optimal model with a sensitivity of 94.0%, a specificity of 93.1%, the positive predictive value of 92.2% and a negative predictive value of 94.7%. Notably, the area under the curve (AUC) was 0.957 in the training dataset while internal validation produced an AUC of 0.962. It is worth noting that during follow-up, a patient diagnosed with ureteral inflammation at the time of diagnosis exhibiting both positive mutation and methylation test results was diagnosed with ureteral carcinoma 17 months after his enrollment. Conclusion: This work utilized the epigenetic biomarker ONECUT2 for the first time in the detection of UTUC and discovered its superior performance. To improve its sensitivity, we combined the biomarker with high-throughput sequencing of 17 genes test. It was found that the selected logistic regression model diagnosed with ureteral cancer can evaluate upper tract urinary carcinoma risk of patients with hematuria and outperform other existing panels in providing clinical recommendations for the diagnosis of UTUC. Moreover, its high negative predictive value is conducive to rule to exclude patients without UTUC. [ABSTRACT FROM AUTHOR]

Background: To examine the impact of the Mayo adhesive probability (MAP) score on the surgical complexity of exposing the tumor during laparoscopic partial nephrectomy (LPN). Patients and Methods: Our study included 318 patients who underwent LPN from January 2017 to December 2018 at our institution. Patients were divided into a lower MAP score group (≤2, n = 172) and a higher MAP score group (≥3, n = 146). Perioperative outcomes were compared between the groups. The operative time was predominantly occupied by the dissection time and the warm ischemia time (WIT). Results: A higher MAP score was associated with a longer operative time (131 vs 110 minutes, p < 0.001) and longer dissection time (71 vs 54 minutes, p < 0.001), respectively. The estimated blood loss (EBL) increased in patients with a higher MAP score (50 vs 20 mL, p < 0.001). No significant difference was found with respect to the WIT (21 vs 20 minutes, p = 0.370). In the multivariate linear regression model, male gender (β = 11.199, p = 0.001), body mass index (β = 1.197, p = 0.008), and MAP score (β = 9.958, p = 0.002) were significantly associated with the prolongation of dissection time. Conclusions: The MAP score was significantly associated with the prolongation of dissection time during LPN. In addition, the EBL increased in patients with a higher MAP score. Therefore, the MAP score can predict surgical complexity of exposing the tumor in patients undergoing LPN. [ABSTRACT FROM AUTHOR]

The present study was aimed to examine whether icariin, a traditional Chinese medicine, could improve therapeutic effects of adipose derived mesenchymal stem cells (ADSCs) for diabetes-associated erectile dysfunction (DMED). DMED were induced in rats by intraperitoneal injection of streptozotocin and confirmed by erectile function measurement. Then, rats of diabetic ED were randomly divided to receive the treatment of saline, ADSCs, icariin or ADSCs combined with icariin respectively. Compared with the treatment by ADSCs or icariin alone, intracavernosum injection of ADSCs combined with the following daily gastric gavage of icariin significantly augmented the value of ICP and ICP/MAP (p<0.01). Meanwhile, the survival of transplanted ADSCs was much improved due to the application of icariin. Similarly, immunofluorescent staining analysis demonstrated that the improved erectile tissue structure by combination of ADSCs and icariin was significantly associated with the increased expression of endothelial markers (vWF) (p<0.01) and smooth muscle markers (α-SMA) (p<0.01). Furthermore, the structure changes in corpus cavernosum were further confirmed by the Masson’s trichrome staining. To explore the possible mechanism underlying icariin-enhanced therapeutic efficacy of MSCs, we employed an in vitro testing system by introducing H2O2 to imitate oxidative stress condition considering the oxidative environment faced by engrafted ADSCs and anti-oxidative capacity of icariin. In vitro, we found that the addition of icariin considerably reduced the apoptosis of ADSCs, and attenuated the intracellular reactive oxygen species (ROS), the superoxidase dismutase (SOD) activity and the lactate dehydrogenase (LDH). Subsequently, we examined the expression of apoptosis-related proteins and explored the potential signaling pathway through which icariin promoted the survival of ADSCs against oxidative stress. It was demonstrated that icariin significantly inhibited the upregulation of apoptosis-related proteins under oxidative condition, including Bax and cleaved caspase-3, while promoted the expression of anti-apoptotic factor BCL2. These effects were accompanied with the activation of signal molecules, PI3K/Akt and STAT3. The further signal protein inhibition assays exhibited that the suppression of STAT3 abrogated the icariin-mediated anti-apoptotic effects observed above, while did not influence the expression of PI3K/Akt. However, PI3K inhibition could abrogate icariin–mediated STAT3 activation and achieved a similar effect as STAT3 inhibition. Our results suggested that icariin was an effective adjuvant for enhancing ADSC-based therapy of DMEM, which may be ascribed to their protection of ADSCs against oxidative stress via the regulation of PI3K/Akt-STAT3 signal pathway. [ABSTRACT FROM AUTHOR]

ABSTRACT In this letter, the design of planar six-way and eight-way power dividers by interconnecting power dividers with two and three output ports is studied. Using this approach, equal ripples of input reflection (S11) within a wide pass band are obtained. The interconnecting lines are used as additional matching sections. The isolation resistors are selected to obtain the optimal output port matching and isolation performances. A prototype of compact, low loss, and wideband eight-way power divider is designed, fabricated, and measured. The simulation and measurement results are in good agreement. © 2016 Wiley Periodicals, Inc. Microwave Opt Technol Lett 58:189-192, 2016 [ABSTRACT FROM AUTHOR]

Objective: The purpose of this study was to investigate the safety and efficacy of a modified CO2 laser technique for circumcision in adult males as compared with the conventional dorsal-slit method. Background data: Circumcision is one of the most commonly performed surgeries in the world. Although present techniques produce a good long-term result, there is a continuing need to improve the safety and efficacy of the circumcision procedure. Materials and methods: Data were analyzed from a prospective randomized controlled clinical study comparing two different operative techniques for adult circumcision: the modified CO2 laser circumcision technique, and the conventional dorsal-slit technique. A total of 300 patients >18 years of age were recruited in this study. Several perioperative data, including age, indications, operation time, intraoperative blood loss, complications, and postoperative pain were analyzed. Differences between the CO2 laser technique and the conventional technique were compared. Results: There was no statistically significant difference in age distribution and indications between the two groups. Compared with the conventional group, there were shorter operative time, less blood loss and lower postoperative complication rate in the laser group. The CO2 laser technique was associated with much less pain, as quantitated by a 10 point visual analogue scale (VAS) pain score at both 1 day and 7 days postoperatively. Conclusions: The modified CO2 laser technique that we introduced offers a simple, safe, faster, and effective alternative method to the conventional technique in adult male circumcision, with decreased blood loss, pain, and complications. [ABSTRACT FROM AUTHOR]

In this paper, the design of multiway power dividers by interconnecting power dividers with fewer output ports is studied by transforming them into multisection stepped-impedance transformers. By using this approach, it is easy to design multiway power dividers with required equal ripples of input reflection (S11) within a wide passband. The interconnecting lines can be used as additional matching sections to improve the input matching. General properties of this type of multiway power dividers can be easily obtained. Design of multiway power divider with required input reflection level can be readily performed by using the published data and tables of stepped-impedance transformer in the literature. Both even- and odd-mode analyses are performed to obtain the optimal isolation resistor values. A prototype of a wideband four-way power divider with a rhombic architecture is designed, fabricated, and measured. Simulation and measurement results are in good agreement and validate the proposed approach. [ABSTRACT FROM PUBLISHER]

Physical layer of cognitive-wave-radio receiver is investigated to identify interference signals, by spectrum sensing, in the presence of received QPSK data at 20 Mbps. The investigated cognitive-wave-radio receiver structure is based on existing wave radio physical layer (six-port receiver interferometer) adapted for the receiver data active cancellation. For active cancellation of the received digital data, four outputs of the standard wave radio receiver are used in conjunction with three 'single pole double throw' switches providing a single output of the 'zero state time interval' for spectrum sensing of the interference signal. Two interference signals were tested: a 7-dBm amplitude modulated interference and a wide band white noise with 0.01 mW/MHz. The microwave carrier of the QPSK signal is set at an amplitude of 16 dBm and a carrier frequency of 3.5 GHz. Once the interference signal spectrum is identified, the QPSK data are transmitted through the available channel. © 2010 Wiley Periodicals, Inc. Microwave Opt Technol Lett 53:195-200, 2011; View this article online at wileyonlinelibrary.com. DOI 10.1002/mop.25670 [ABSTRACT FROM AUTHOR]

A new SPDR design approach is proposed. The receiver contains an RF discriminator, power detectors, a signal level comparison circuit, a decoder, and data and carrier recovery circuits for BPSK and QPSK signals. The new receiver operates solely on analog circuits, and the proposed design is validated with circuit and system simulations of an RF discriminator and a Costas-type phase-locked loop, demonstration of a demodulator at 2.4 GHz, and MMIC fabrication of an RF discriminator at 15 GHz. The new design approach offers interesting possibilities to achieve SPDR-on-a-chip. © 2000 John Wiley & Sons, Inc. Microwave Opt Technol Lett 25: 356–360, 2000. [ABSTRACT FROM AUTHOR]

In this paper, a four-port digital millimetric receiver (FP/DMR) is studied in detail. The FP/DMR is achieved by eliminating one of the output ports and the reference port of an ordinary six-port junction in the digital millimetric receiver proposed earlier. This paper provides the principle of operation of FP/DMR, its real time or “on-line” calibration methods, and a comparison with a traditional quadrature I/Q receiver. The principle of operation of the FP/DMR can also be used at lower frequencies (e.g., in the L-band) whenever mass-market applications demand the lowest possible receiver costs. ©1999 John Wiley & Sons, Inc. Microwave Opt Technol Lett 22: 350–355, 1999 [ABSTRACT FROM AUTHOR]

In this paper, a new approach to the real-time calibration of a six-port receiver (SPR) by averaging the received QPSK signals is proposed. At first, the S-parameters/Qi points of the six-port are calculated from the average of the outputs of the six-port power detectors, and then calibration parameters of the six-port receiver are computed. Simulations on SPW verified this proposed approach. Error analysis with nonideal QPSK standard signals used in the calibration procedure is also performed. This proposed method of calibration has a clear physical meaning, and gives accurate calibration coefficients, even for very poor-quality six-port junctions. ©1999 John Wiley & Sons, Inc. Microwave Opt Technol Lett 21: 346–351, 1999. [ABSTRACT FROM AUTHOR]

In this paper, a study of the simplification of real-time calibration of six-port receivers (SPRs) is given. A simple, real-time calibration procedure is proposed using the incoming QPSK signal as the calibration standard. Only two systems of four linear equations are necessary to be solved in the calculation of the calibration parameters. This calibration procedure is especially suitable for QPSK reception. Modulation errors will be cancelled if the received signal is selected for the calibration standards. SPW simulation results of 64 QAM signal reception validate the proposed calibration procedure. ©1999 John Wiley & Sons, Inc. Microwave Opt Technol Lett 20: 318–322, 1999. [ABSTRACT FROM AUTHOR]

In this paper two simple and effective methods are presented for solving electromagnetic problems of rectangular waveguides, loaded with lossy dielectrics. The procedures are demonstrated and the accuracy is shown for waveguides with three different types of dielectric filling. [ABSTRACT FROM AUTHOR]

Electromagnetic waves in magnetized (gyromagnetic) ferrite spheres are investigated by using coupled wave theory. Fields are expressed by means of superposition of modes in isotropic case. Some basic rules are obtained and some numerical results are calculated, which are in good agreement with experiments. [ABSTRACT FROM AUTHOR]

In this paper some simple and effective methods are presented for solving electromagnetic problems of dielectric-loaded rectangular waveguides. The procedures are demonstrated and the accuracy is shown for waveguides with three different types of dielectric filling. [ABSTRACT FROM AUTHOR]

Describes a structure of tightly coupled lines compatible with minolithic-microwave integrated circuit minature hybrid-microwave integraged-circuit (MMIC/MHMIC) technology. Theoretical assessment of tightly coupled lines with multisections; Conclusions of the study.

In this paper, the problem of local oscillator (LO) leakage to the input of a digital millimetric six-port receiver (SPR) is studied in detail. It is shown that this leakage can be considered as an additional in-band interference signal to the SPR that alters the output signals of the six-port discriminator as if the Qi points of the six-port junction are modified. Analysis and simulation results of this leakage are provided, and methods to overcome its effects for real-time operation are given. Improvements in the performance of a six-port junction in the presence of LO leakage are evaluated. © 1998 John Wiley & Sons, Inc. Microwave Opt Technol Lett 19: 27–34, 1998. [ABSTRACT FROM AUTHOR]

In this paper, the nonlinear cross-modulation noise/interference arising from channel filtering and leakage in a six-port digital millimetric receiver (DMR) is studied in detail. The in-band noise/interference arises from strong noise/interference outside the receiving bandwidth, and will deteriorate the bit-error rate (BER). Analysis and simulation results of this effect are provided, and results on methods of its suppression are also given. © 1998 John Wiley & Sons, Inc. Microwave Opt Technol Lett 17: 386–394, 1998. [ABSTRACT FROM AUTHOR]

In this paper an improved method is presented for waveguides loaded with lossy dielectric or magnetic materials. The accuracy of this method is shown for waveguides with three different types of filling. [ABSTRACT FROM AUTHOR]

Abstract A stepped short tube orifice (SSTO) consisting of two serial-connected short tube orifices with different diameters was recently proposed as an inexpensive expansion device in air conditioning/heat pump system. In this study, a split air conditioner/heat pump employing stepped short tube orifices was investigated experimentally to further evaluate the performance of the SSTO air conditioner/heat pump system. At first, the mass flow rate of refrigerant (R-22) through stepped short tube orifices and an original expansion device were studied in both cooling and heating flow directions to verify the throttling capacity difference of these two type of expansion devices. Then, the influence of geometric sizes of SSTOs, refrigerant charge amount and environment temperature on the performance of the SSTO air conditioner/heat pump were examined. Besides, the performance of the SSTO systems also compared with that of the original system with capillary tube under nominal and varying conditions. The results show that 18# SSTO system performed the best COP among all the five SSTO systems and one original system in nominal cooling and heating conditions, though the heating capacity of the 18# SSTO system was slightly inferior to that of the original system due to the insufficient throttling capacity of 18# SSTO in heating mode. [ABSTRACT FROM AUTHOR]

Purpose: To compare the treatment outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) versus laparoscopic RPLND (L-RPLND) for clinical stage I non-seminomatous germ cell testicular tumors (NSGCTs).Materials and Methods: We retrospectively reviewed the data of patients with stage I NSGCTs who underwent robotic or laparoscopic RPLND between 2008 and 2017. Perioperative data and oncologic outcomes were reviewed and compared between the two groups. Progression-free survival was analyzed using Kaplan-Meier survival curves and compared between two groups.Results: A total of 31 and 28 patients underwent R-RPLND and L-RPLND respectively. The preoperative characteristics of the patients were comparable in the two groups. Patients in R-RPLND group had significantly shorter median operative time (140 vs. 175 minutes, P < .001), a shorter median duration to surgical drain removal (2 vs. 4 days, P = .002) and a shorter median postoperative hospital stay (5 vs. 6 days, P = .001). There were no statistical differences in intra- and post-operative complication rate between the groups and the oncologic outcomes were similar in the two groups.Conclusion: In expert hands, R-RPLND and L-RPLND were comparable in oncological parameter and morbidity rate; R-RPLND showed superiority in operation duration, median days to surgical drain removal and postoperative hospital stay for stage I NSGCTs. Multicenter and randomized studies with good power of study and sufficient follow-up duration are required to validate our result. [ABSTRACT FROM AUTHOR]

A novel organic-inorganic eutectic phase change material (PCM) based on sodium acetate trihydrate (SAT) and polyethylene glycol (PEG) was developed to meet the needs of heat recovery and building heating. Three kinds of PEG with different molecular weights were selected to form organic-inorganic eutectic PCM with SAT. The thermal properties of three series of SAT-PEG eutectic PCM were compared based on DSC results, focusing on the impact of PEG addition on the phase change temperature and enthalpy of SAT, as well as the melting uniformity. The inhibitory effects of two nucleating agents on the supercooling of SAT-PEG eutectic PCM were systematically investigated. The effect of PEG on the crystallization behavior of SAT was studied using a metallographic microscope. To evaluate the thermal reliability of the SAT-PEG eutectic PCM, 600 cycles of melting-solidification experiments were conducted. Experimental results show that SAT can form eutectic PCMs with PEG200, PEG600, and PEG6000, respectively, with high enthalpy and excellent melting uniformity. The phase change temperature ranged from 55 °C to 60 °C and the enthalpy was as high as 250-280 kJ/kg. The results of the cooling curves show that 10 wt% tetrasodium pyrophosphate decahydrate (TPD) can reduce the supercooling degree to less than 1 °C. Significantly, all three series of SAT-PEG eutectic PCMs exhibit exceptional thermal reliability after 600 cycles of melting-solidification, with shifts in the phase change temperatures and enthalpies of less than 4%. XRD diffraction patterns showed that SAT, PEG, and TPD were physically mixed without a chemical reaction to form new substances. Microscopic images reveal that the addition of PEG preserves the original needle-shaped crystal morphology of SAT while reducing its crystal size. The rapid formation of small crystals can provide more nucleation points and expedite crystallization, thereby enhancing the heat release capabilities of the PCM.

Purpose: To compare the treatment outcomes of robotic retroperitoneal lymph node dissection (R-RPLND) versus laparoscopic RPLND (L-RPLND) for clinical stage I non-seminomatous germ cell testicular tumors (NSGCTs)., Materials and Methods: We retrospectively reviewed the data of patients with stage I NSGCTs who underwent robotic or laparoscopic RPLND between 2008 and 2017. Perioperative data and oncologic outcomes were reviewed and compared between the two groups. Progression-free survival was analyzed using Kaplan-Meier survival curves and compared between two groups., Results: A total of 31 and 28 patients underwent R-RPLND and L-RPLND respectively. The preoperative characteristics of the patients were comparable in the two groups. Patients in R-RPLND group had significantly shorter median operative time (140 vs. 175 minutes, P < .001), a shorter median duration to surgical drain removal (2 vs. 4 days, P = .002) and a shorter median postoperative hospital stay (5 vs. 6 days, P = .001). There were no statistical differences in intra- and post-operative complication rate between the groups and the oncologic outcomes were similar in the two groups., Conclusion: In expert hands, R-RPLND and L-RPLND were comparable in oncological parameter and morbidity rate; R-RPLND showed superiority in operation duration, median days to surgical drain removal and postoperative hospital stay for stage I NSGCTs. Multicenter and randomized studies with good power of study and sufficient follow-up duration are required to validate our result.

BACKGROUND Mayo adhesive probability (MAP) score, an accurate and reliable predictor of adherent perinephric fat (APF), consists of posterior perinephric fat thickness and perinephric fat stranding. The present study aimed to identify the potential clinical characteristics associated with these 2 variables to further our understanding of APF. MATERIAL AND METHODS Clinical data of 346 patients subjected to minimally invasive nephrectomy was collected within our prospectively maintained database, between January 2015 and December 2016. Radiological data was assessed by 2 readers in an independent blinded - to each other and APF patient status - fashion. Ordinal logistic regression analyses were performed to evaluate risk factors of posterior perinephric fat thickness and perinephric fat stranding. RESULTS On multivariate analysis, posterior perinephric fat thickness was associated with older age (ß=1.05 [range, 1.03-1.07], P<0.01); male gender (ß=6.06 [3.18-11.54], P<0.01), and higher body mass index (BMI) (ß=1.31 [1.21-1.41], P<0.01). Perinephric fat stranding was associated with older age (ß=1.05 [1.02-1.07], P<0.01), male gender (ß=3.64 [2.09-6.34], P<0.01) and history of diabetes (ß=2.09 [1.24-3.52], P<0.01). MAP score was associated with older age (ß=1.05 [1.03-1.07], P<0.01), male gender (ß=5.07 [2.96-8.71], P<0.01), higher BMI (ß=1.14 [1.07-1.21], P<0.01), history of diabetes (ß=1.72 [1.06-2.78], P=0.03) and alcoholism (ß=1.88 [1.10-3.20], P=0.02). CONCLUSIONS The current study highlights that different risk factors influence the posterior perinephric fat thickness and perinephric fat stranding. Posterior perinephric fat thickness was correlated with age, gender, and BMI, while perinephric fat stranding was associated with age, gender, and history of diabetes.

A Gram-stain-negative, non-spore-forming, non-motile and aerobic coccobacilli-shaped strain, designated BRTC-1T, was isolated from the gut of Omphisa fuscidentalis Hampson, which is a larva of a moth and was collected from Xishuangbanna Dai Autonomous Prefecture in China. The isolate was found to grow at NaCl concentrations of 0-5 % (w/v) (optimum: 0 %), 10-45 °C (optimum: 30-35 °C) and pH 5.0-9.0 (optimum: pH 6.0) on tryptic soy agar. Analysis of the 16S rRNA gene sequence indicated that the isolate belonged to the genus Acinetobacter and was most closely related to Acinetobacter rudis LMG 26107T, Acinetobacter guillouiae LMG 988T and Acinetobacter bereziniae LMG 1003T with 96.4, 96.3 and 96.3 % sequence similarity, respectively. The comparative sequence analyses of the rpoB and gyrB genes showed that BRTC-1T is distant from the species of the genus Acinetobacter with validly published names (≤84.0 and ≤82.0 % similarity, respectively). The average nucleotide identity and digital DNA-DNA hybridization values (≤77.0 and ≤22.8 %, respectively) between the whole-genome sequence of BRTC-1T and those of the known taxa were far below the thresholds used to discriminate bacterial species. The major fatty acids were determined to be C16 : 0, C18 : 1ω9c and C16 : 1ω7c/iso-C15 : 0 2-OH. The respiratory quinone was Q-9. The polar lipids were found to be diphosphatidyglycerol, phosphatidylglycerol, phosphatidylethanolamine, five phospholipids and one phosphatidylcholine. Based on its phenotypic and chemotaxonomic characteristics from this study, the isolate is concluded to represent a novel species of the genus Acinetobacter, for which the name Acinetobacter larvae sp. nov. is proposed. The type strain is BRTC-1T (=ACCC 19936T=JCM 31367T).

Objective: This study aimed to retrospectively evaluate the safety and efficacy of transurethral photoselective Greenlight(™) laser vaporization in adult patients with orthotopic ureterocele., Materials and Methods: Thirty adult patients diagnosed with orthotopic urecterocele were recruited at our center. Transurethral photoselective Greenlight laser vaporization was used as the exclusive technique for endoscopic management during the study period. Information, including age, gender, mode of presentation, ureterocele size, vesicoureteral reflux, hydronephrosis status, and incidence of reoperation, were collected for evaluation., Results: Our series included 12 men and 18 women. The mean patient age at presentation was 30.5 years (range, 18-62 years). The mean size of ureterocele was 18 mm (range, 10-41 mm). All patients successfully underwent transurethral photoselective Greenlight laser to vaporize the ureterocele. The operation ranged from 13 min to 38 min (mean 19.6 min). The average blood loss was <10 mL. No patient had intraoperative complications. The average postoperative hospital stay was 18.3 h. All patients were voided after postoperative catheter removal. None of the patients demonstrated any residual ureterocele and/or hydronephrosis when evaluated with ultrasonography after 3 months. Only one patient with a duplex collecting system presented asymptomatic low-grade reflux at 3 months, which was spontaneously resolved after 6 months of follow-up. All patients were free of any symptoms. No reoperative procedures were required at a mean follow-up of 14.2 months (range, 8-16)., Conclusions: Transurethral photoselective Greenlight laser vaporization is safe, effective, and efficient for the management of orthotopic urecteroceles in adults. Therefore, this technique should be considered as the initial treatment in most patients.

Objective: The purpose of this study was to investigate the safety and efficacy of a modified CO2 laser technique for circumcision in adult males as compared with the conventional dorsal-slit method., Background Data: Circumcision is one of the most commonly performed surgeries in the world. Although present techniques produce a good long-term result, there is a continuing need to improve the safety and efficacy of the circumcision procedure., Materials and Methods: Data were analyzed from a prospective randomized controlled clinical study comparing two different operative techniques for adult circumcision: the modified CO2 laser circumcision technique, and the conventional dorsal-slit technique. A total of 300 patients >18 years of age were recruited in this study. Several perioperative data, including age, indications, operation time, intraoperative blood loss, complications, and postoperative pain were analyzed. Differences between the CO2 laser technique and the conventional technique were compared., Results: There was no statistically significant difference in age distribution and indications between the two groups. Compared with the conventional group, there were shorter operative time, less blood loss and lower postoperative complication rate in the laser group. The CO2 laser technique was associated with much less pain, as quantitated by a 10 point visual analogue scale (VAS) pain score at both 1 day and 7 days postoperatively., Conclusions: The modified CO2 laser technique that we introduced offers a simple, safe, faster, and effective alternative method to the conventional technique in adult male circumcision, with decreased blood loss, pain, and complications.