Results of complete penile disassembly for epispadias repair in 42 patients

PURPOSE: We evaluated the Mitchell complete penile disassembly technique for epispadias repair. MATERIALS AND METHODS: A total of 42 males 1 month to 22 years old presented for repair of epispadias between 1998 and 2002. Cases were divided into 2 groups. Group 1 included 29 cases of complete epispadias as a component of bladder exstrophy, 8 with previous continent urinary diversion. Group 2 included 13 cases of epispadias alone (10 primary and 3 secondary). Of the 29 patients in group 1, 21 underwent complete penile disassembly as part of 1-stage primary closure of bladder exstrophy. RESULTS: Mean followup was 37.5 months (range 6 to 52). Ischemic changes at the glans penis were observed in 5 cases during our initial experience. Ventral orthotopic meatus was observed in all 42 patients, conical glans in 40 (95.2%), straight shaft in 34 (81%) and urethral fistula in 1 (2.4%). There were no cases of dehiscence, meatal stenosis or urethral stricture. Erectile function was preserved in all patients. CONCLUSIONS: Complete penile disassembly is a safe procedure that can provide normalization of the urethra and penis together with satisfactory cosmetic and functional outcome.     

Intracerebroventricular administration of ouabain as a model of mania in rats

Background: Human bipolar illness is characterized by mood state- and diagnosis-associated abnormalities of cellular cation distribution and transport. These include reduced sodium pump activity and expression and increased intracellular sodium. If these alterations are related to the pathophysiology of the disease, rather than secondary or ancillary abnormalities, then one would expect that modeling of these changes in vivo would produce lithium-preventable behavioral abnormalities.
Methods: Ouabain, a potent inhibitor of the sodium pump, was administered intracerebroventricularly to male rats previously fed lithium-containing food or plain rat chow. Locomotion was then quantified in an open field.
Results: Ouabain increased locomotion 300% over baseline. Lithium pretreatment prevented the ouabain-induced hyperlocomotion response.
Conclusion: Inhibition of central nervous system sodium pump with ouabain produces a plausible animal model of mania. This model may be useful for preclinical screening of potential mood stabilizers.     

Segmental tracheal replacement in mongrel dogs

OBJECTIVE: To evaluate the use of alcohol- and detergent-preserved tracheal allografts in dogs. MATERIAL AND METHODS: Experimental segmental tracheal replacement was performed in 18 adult mongrel dogs. Three different techniques were tried in three groups of dogs. In the first group, a four-ring cervical tracheal segment was dissected out and implanted in the trachea of another dog. In the second group, the procedure was performed using a tracheal allograft that had been preserved in 70% ethyl alcohol for 20 days. In the third group, tracheal grafts were previously impregnated in 10% povidone iodine for 72 h before being implanted. Allografts were harvested 60 days after transplantation and assessed both histologically and in terms of the percentage patency. Dogs that died within 60 days were also included in the analysis. RESULTS: The best results were found in the group in which the tracheal allograft had been preserved in ethyl alcohol and this was explained by the reduced antigenicity of the graft in this group. CONCLUSIONS: The use of alcohol-preserved allografts is a practical method of tracheal transplantation, and the alcohol-preservation technique markedly reduces the immunogenicity of the grafts.     

Non-recurrent laryngeal nerve in thyroid surgery

A case of non-recurrent laryngeal nerve is reported. The non-recurrent laryngeal nerve was found on the right side and was not associated with any vascular abnormalities. The anatomy and surgical implication of this rare condition is discussed     

Adenocarcinoma of the uterine cervix

Adenocarcinoma of the cervix represented 12.7% of all cervical carcinomas seen at the University of Washington. The mean age of 66 patients with adenocarinoma of the cervix was not significantly different from the mean age of those with squamous cell carcinoma and was 43.6 (range 15–83). Seventy-six percent of the patients were assigned to Stage I disease. Stage II disease was diagnosed in 15% and Stages III–IV represented 9%. The pathologic diagnosis included adenocarcinoma in 50 patients, adenosquamous carcinoma in 9, clear cell carcinoma in 5, and adenoid cystic carcinoma in 2. The survival rate was directly related to the stage of disease and to the presence or absence of lymph node metastasis. The recurrence rate was significantly higher in adenocarcinoma of the cervix with node metastasis when compared with a similar group of patients with squamous cell carcinoma.     

Neonatal tumours in Malaysia: a call for heightened awareness

Purpose  

Neonatal neoplasms are rare tumours notorious for their atypical presentation and unpredictable behaviour. Their optimal treatment remains uncertain, a dilemma compounded by the deleterious effects of adjuvant chemo- or radiotherapy during this vulnerable period of growth. This paper examined the relatively high incidence of these tumours and its impact on paediatric surgery in Malaysia.     

Oncological outcome and patient satisfaction with skin-sparing mastectomy and immediate breast reconstruction: a prospective observational study

Background  

The management of early breast cancer (BC) with skin-sparing mastectomy (SSM) and immediate breast reconstruction (IBR) is not based on level-1 evidence. In this study, the oncological outcome, post-operative morbidity and patients' satisfaction with SSM and IBR using the latissimus dorsi (LD) myocutaneous flap and/or breast prosthesis is evaluated.