Objective To investigate the effect of ventral urethroplasty for postoperative anastomotic stricture in patients with hypospadias. Methods From August 2000 to December 2005, 20 patients with anastomotic stricture after hypospadias repair were treated with ventral urethroplasty. The age ranged from 2 to 27 years with an average of 6.4 years. All patients showed dysuria after operation. Main clinical manifestation included dysuria and acraturesis. Interruption of urinary stream occurred in 17 cases; of them, 3 cases had urinary stasis and 4cases had frequent micturition, urgent micturition and pain in urination. Urethrography and cystourethrography showed 0.5-1.0 cm stricture with proximal dilat ion of urethra in 16 cases and obvious diverticularization in 9 cases. Urine routine examination showed that white blood cell was ++ to ++++ in 16 cases and pus cell was ± to++ in 13 cases.Results Twenty cases were followed up 2 months to 4 years (mean 2.3 years). All the cases achieved good results in urination with normosthenuria and normal force of urinary stream. No recurrent stricture, urethrocutaneous fistula, or penile curvature occurred. The cosmesis was satisfactory, and the results of urine routine examination was normal. Conclusion Ventral urethroplasty for postoperative anastomotic stricture inpatients with hypospadias is a simple and effective procedure.
OBJECTIVE To repair the huge incisional hernia of abdominal wall, a new surgical method was introduced. METHODS Eight cases of huge ventral incisional hernia, developed in 3 months to 12 months after operation, were treated in this new method with the defects ranged from 8 cm x 4 cm to 12 cm x 6 cm. RESULTS They were followed up for 6 months to 18 months after operation. The clinical results showed that all of the 8 cases recovered satisfactorily without recurrence. CONCLUSION The new method was recommendable for its advantages of easier manipulation, shortened time, no tissue reaction and less tissue trauma from operation.
OBJECTIVE To understand the influence of selective ventral rhizotomy on the function of lower extremity and to investigate its effect in the treatment of spastic cerebral palsy. METHODS Ten domestic dogs were used in this study. Under anesthesia, the lumbar spinal canal was reached through posterior approach. The ventral rami consisted of left L5, L6 and L7 spinal nerves was separated. The electromyographic changes of each branch of the rami was examined by electrical stimulation. 60 percents of the L6 ventral nerve root which was the major innervation of the gastrocnemius muscle in dogs, and 30 percents of the other two rami were culted off. The muscle tone, the coordinated movement and balanced capacity of the dogs were observed. After one month, the electrophysiological changes of the biceps femoris, semitendinous, gastrocnemius and anterior tibial muscles were examined and compared with that of the identical muscles of the contralateral limbs. RESULTS Selective ventral rhizotomy was well correspondent to the innervated muscles. After operation, the coordinated movement and balanced capacity were good, but the muscle tone of the corresponding muscle was lowered. This technique was applied on 3 patients with satisfactory short-term results. CONCLUSION For the treatment of spastic cerebral palsy, it is worth trying the selective ventral rhizotomy.
Objective To investigate and summarize preliminarily the clinical experiences of laparoscopic incisional hernia repair with intraperitoneal patch placement for the patients over 70 years old. Methods From July 2005 to July 2008, laparoscopic incisional hernia repair with intraperitoneal onlay meshes were applied in 8 patients, and whose clinical data were studied retrospectively. Results The procedures were performed successfully in all patients except one converted to open because of severe adhesion. The mean operative time was 105 min (ranged from 50 min to 180 min). One postoperative hypercapnia was resolved through mechanic ventilation for 24 h. One seroma and 1 prolonged postoperative pain over 1 month occurred, which were cured with conservative therapy. Mean postoperative hospital stay was 9.5 d (ranged from 7 d to 14 d). There was no recurrence or local discomfort during 12-36 months (average 26.5 months) follow-up.Conclusions Laparoscopic incisional hernia repair with intraperitoneal onlay mesh for the patients over 70 years old is safe and feasible, which has some advantages such as less trauma and rapid recovery. The perioperative management and operative technique are very important for the success of operation.
Objective To study the advances in clinical application of hernioplasty by high molecular material. Methods The literature in the recent years on the advances of hernioplasty by high molecular material was reviewed. Results At present time many operative techniques of hernioplasty by high molecular material have been developed. The representative techniques were ①Rives-Stoppa′s mesh inlay hernioplasty; ②Lichtenstein′s tesion-free herniorrhaphy; ③mesh plug hernioplasty; ④Gilbert′s sutureless hernioplasty; ⑤laparoscopic inguinal hernioplasty. The reparing high molecular material was divided into absorbable and unabsorbable material, the former included polyglycolic-acid and polyglaction, the later consists of polypropylene polyester and expanded polytetrafluoroethylene.Conclusion The clinical application of henioplasty by high molecular material is increasing. According to the hernia type and patient condition, excellent outcome will be achieved by the application of proper repairing method and repair material.
ObjectiveWe report a special case to explain seizure semiology and epileptogenic network of seizure arising from ventral motor cortex, and to explore Focal cortical dycplasia (FCD) features on MR of epileptic patients with DEPDC5 mutation.MethodsA drug-resistant focal epilepsy patient with DEPDC5 mutation was underwent a detailed presurgical evaluation. The epileptogenic area(EA) was localized with SEEG and removed later by surgery. Related literatures were thoroughly reviewed.ResultsSubtle FCD of ventral branch of inferior precentral sulcus(IPv) on MR(1.5T) was noticed. With SEEG recording, seizure onset zone was detected on IPv with the probable lesion, early spreading to anterior insula, central operculum and ventral precentral gyrus. According to the architectures of ventral motor trend, seizure semiology with evolution from contralateral dystonia to ipsilateral chorea movement could be better comprehended. Seizure was controlled after totally resection on the sites of IPv, anterior insula, and central operculum. Pathological change was FCD type I. Other literatures reported that DEPDC5 mutation related FCD may be located in motor system, and seizure onset could also be in anterior insula cortex besides motor cortex in other SEEG cases.ConclusionsEarly contralateral dystonia and chorea movement could be definite figures of seizure arising from inferior precentral sulcus; DEPDC5 mutation maybe a clue to find subtle FCD in motor cortex.
Temporal interference (TI) as a new neuromodulation technique can be applied to non-invasive deep brain stimulation. In order to verify its effectiveness in the regulation of motor behavior in animals, this paper uses the TI method to focus the envelope electric field to the ventral posterior lateral nucleus (VPL) of the thalamus in the deep brain of mouse to regulate left- and right-turning motor behavior. The focusability of TI in the mouse VPL was analyzed by finite element method, and the focus area and volume were obtained by numerical calculation. A stimulator was used to generate TI current to stimulate the mouse VPL to verify the effectiveness of the TI stimulation method, and the accuracy of the focus location was further determined by c-Fos immunofluorescence experiments. The results showed that the electric field generated by TI stimulation was able to focus on the VPL nuclei when the stimulation current reached 800 μA; the mouse were able to make corresponding left and right turns according to the stimulation position; and the c-Fos positive cell markers in the VPL nuclei increased significantly after stimulation. This study confirms the feasibility of TI in regulating animal motor behavior and provides a non-invasive stimulation method for brain tissue for animal robots.