Narrow Plate Research Articles

Flap valve of the heart foramen ovale revisited: macroscopic and histologic observations of human near-term fetuses

We assessed the flap valve of the foramen ovale (FO valve) by examining 30 hearts from human fetuses of gestational age 30–40 weeks. We dissected the hearts, examined their macroscopic morphology, and then prepared semiserial sagittal sections across the valve. Although the primary septum is expected to extend along the left atrial face, eight hearts had a superior rim of the fossa ovalis on the left atrial face that was too thick and high, so there was no smooth continuation with the valve. Moreover, three of these eight hearts each had a flap valve that was fused with a long and narrow plate arising from the caval orifice. Histological analysis indicated that 21 specimens each had a candidate primary septum that contained myocardium, although the left sinuatrial valve (LSAV) contained fibrous tissue, but little or no myocardium. In each of 17 hearts, a candidate primary septum was attached to the left atrial face of the fossa, and parts of the LSAV extended to and approached the right atrial face. However, seven of these 17 hearts each had a folded small primary septum. Another four of these 17 hearts each had an LSAV that extended widely to the fossa, and a candidate primary septum (which might be a remnant) attached to the left atrial side of the LSAV. These variations suggest that the LSAV makes a major contribution to the FO valve in some fetal hearts. Consequently, the fetal FO valve appears to have heterogeneous morphology and origin.

Osteological Re-Assessment and Taxonomic Revision of "Tanius laiyangensis" (Ornithischia: Hadrosauroidea) from the Upper Cretaceous of Shandong, China.

Tanius is the earliest named ornithischian genus from China. Since 1929, three species of this genus, namely T. sinensis (the type species), "T. chingkankouensis" and "T. laiyangensis", have been reported based on remains from the Wangshi Group of Shandong, China, and were previously recognized as hadrosaurines. Following the recent achievement of consensus on the phylogenetic placement of T. sinensis outside Hadrosauridae, the assignments of the "T. chingkankouensis" and "T. laiyangensis" material of hadrosaurid origin to the genus Tanius become problematic. Related taxonomic issues of "T. laiyangensis" therefore need re-appraisals. Here, we provide an overall taxonomic revision of "T. laiyangensis" from the Jingangkou Formation of northeast Shandong, by means of approaches of comparative anatomy, phylogeny and geometric morphometrics. Our osteological comparisons confirm the hadrosaurine affinity of "T. laiyangensis", given the presence of a suite of characters largely typical of Hadrosaurinae in the single specimen (i.e., a nearly complete sacrum and a partial right ilium), including a dorsoventrally narrow central plate of the ilium with the depth/length ratio <0.80. In the proposed phylogenetic framework, "T. laiyangensis" is inferred to be a member of Kritosaurini within Hadrosaurinae, as the sister taxon to Secernosaurus koerneri. The relative warp analysis on the lateral outline of the supraacetabular process also reveals a close resemblance of shape between the two species. Based on these different lines of evidence and considering no identification of any diagnostic characters from the specimen, we argue that the "T. laiyangensis" material comes from an indeterminate kritosaurin hadrosaurine in Asia. Anat Rec, 303:790-800, 2020. © 2019 Wiley Periodicals, Inc.

Outcome of Snodgrass (Tabularized Incised Plate) in Repair of Primary Distal Hypospadias with Narrow Urethral Plate

AbstractBackground: Options for urethroplasty in children with hypospadias can be classified as tubularizations of the urethral plate, skin flaps and grafts. Throughout the history of surgery for this condition flaps have been most commonly used, but in the past 10 years incision and tubularization of the urethral plate (tubularized incised-plate, TIP) has rapidly gained popularity for correcting distal, proximal and re-operative hypospadias. TIP potentially simplifies both decision-making and surgical technique, and has a low complication rate with better cosmetic results. However, careful attention to surgical details and awareness of contraindications to the procedure are needed to achieve optimal results.Aim of Study: Outcome of Snodgrass (Tabularized Incised Plate) in repair of primary distal hypospadias with narrow urethral plate.Patients and Methods: Twenty patients with primary distal and midpenile hypospadias were enrolled for repair with Snodgrass technique.Demographic data, hereditary relationship, urethral plate length and width, glans width, and intraoperative time were recorded and post-operative early and late complications were observed for parents and surgeon satisfaction.Results: Between the 20 patients, only three patients developed post-operative complication one was urethrocuta-neous fistula and two showed meatal stenosis with success rate 85%.Conclusion: Tubularized incised plate in repair of primary distal and midpenile hypospadias successfully fulfils all traditional hypospadias repair criteria. It offers a viable option in the management of primary hypospadias with a narrow urethral plate.

Transition temperature enhancement of nano-structured superconductors: Shape dependence and effects of Cooper pair distribution

Enhancement of superconducting critical temperature Tc for nano-structured square and rectangular plates is investigated, using the Gor’kov equations and the finite element method. Tc increases with decreasing system size and shows sawtooth behavior as the function of system size. We find the enhancement of Tc becomes larger for narrower rectangular plate. We discuss mechanisms of these behaviors of Tc, investigating quasi-particle eigen-energies and spatial order parameter distributions.

Numerical–analytical model for transient dynamics of elastic-plastic plate under eccentric low-velocity impact

• A hybrid numerical-analytical model is presented for elastic-plastic plate impact. • The model has been verified by the experiment of sphere-plate impact. • The impact-induced waves have been detected by the experiments and the model. • The accuracy and efficiency are verified by three-dimensional finite element simulations . The aim of this study is to present an efficient model for the analysis of complicated nonlinear transient dynamics of an elastic-plastic plate subjected to a transversely eccentric low-velocity impact. A mixed numerical–analytical model is presented to predict the transient dynamic behaviours consisting of either plate impact responses or wave propagations induced by the impact in a plate with an arbitrary shape and support. This hybrid approach has been validated by comparison with results of laboratory tests performed on an elastic-perfectly plastic narrow plate eccentrically struck by an elastic sphere, and results of a three-dimensional finite element (FE) analysis for an elastic-perfectly plastic simply-supported rectangular plate eccentrically struck by an elastic sphere. The advantages of this hybrid approach are in the simplification of local contact force formulation, computational efficiency over the FE model, and convenient application to parametric study for eccentric impact behaviour. The hybrid approach can provide accurate predictions of the plate impact responses and plate wave propagations.

A new Epeorus (Caucasiron) (Ephemeroptera: Heptageniidae) species from Turkey based on molecular and morphological evidence.

Epeorus (Caucasiron) turcicus sp. nov. is described based on larvae from NE Turkey. The new species can be distinguished from other Caucasiron by a unique combination of several diagnostic characters: the presence of a rounded hypodermal medial femur spot, colouration of abdominal terga and sterna, narrow gill plate VII, fine hair-like setae on the surface of abdominal terga, and absence of postero-lateral projections on tergum X. In addition to morphological analysis, two single-locus analytical approaches are employed for delimiting the new species using COI sequences (Automatic Barcode Gap Discovery, ABGD; and General Mixed Yule Coalescent Model, GMYC). Both approaches unambiguously recognized E. (C.) turcicus sp. nov. as a distinct species. Our molecular dataset contains all Caucasiron species occurring in the Caucasus and the delimitation of individual species mostly follows the morphologically defined species. This study confirms the suitability of the GMYC approach for species delimitation within Caucasiron.

Periodic Solutions and Torsional Instability in a Nonlinear Nonlocal Plate Equation

A thin and narrow rectangular plate having the two short edges hinged and the two long edges free is considered. A nonlinear nonlocal evolution equation describing the deformation of the plate is introduced: well-posedness and existence of periodic solutions are proved. The natural phase space is a particular second order Sobolev space that can be orthogonally split into two subspaces containing, respectively, the longitudinal and the torsional movements of the plate. Sufficient conditions for the stability of periodic solutions and of solutions having only a longitudinal component are given. A stability analysis of the so-called prevailing mode is also performed. Some numerical experiments show that instabilities may occur. This plate can be seen as a simplified and qualitative model for the deck of a suspension bridge, which does not take into account the complex interactions between all the components of a real bridge.

Impedance resonant frequency sensitivity based structural damage identification with sparse regularization: experimental studies

Electromechanical impedance (EMI) based structural health monitoring methods have been successfully applied to various engineering fields. However, the studies on damage quantification using EMI based techniques are still limited. In general, conventional EMI based methods evaluate the changes in the host structure by comparing the difference between impedance responses from undamaged and damaged structures, with statistical damage indicators, i.e. root mean square deviation (RMSD) and cross correlation. These damage indicators can detect the existence of damage in structures, but are not able to precisely locate and identify the severity of damages. This paper presents experimental validations on a novel structural damage identification approach based on the sensitivity of resonance frequency shifts in the impedance and sparse regularization technique. The coupled finite element model of the piezoelectric transducer and host structure is developed and calibrated for the damage quantification. A limited number of measured resonance frequency shifts are used to identify the damage in a number of segments in the host structure. Experimental verifications are conducted on narrow aluminum plates to demonstrate the accuracy and performance of the presented approach. The identification results demonstrate the effectiveness and performance of using the proposed approach for structural damage localization and quantification. To investigate the capacity of impedance based technique for SHM with the proposed approach, numerical studies are further conducted to discuss the sensitivity range of this method.

Comparative Functional Analysis of the Anatomy of the appendicular skeleton in two reptilian species

Aim of the work: the present study aimed to illustrate the osteological characters of the appendicular skeleton of two Egyptian lizard species, Acanthodactylus boskianus and Ptyodactylus guttatus and clarify the relationship between characteristics of the appendicular skeleton and mode of their locomotion of the two species. A. boskianus is diurnal insectivorous lizard forage in open area and it is a generalized ground-dwelling species and P. guttatus is a diurno-nocturnal omnivorous gecko which is a highly specialized climbing on vertical substrates. Material and methods: in the present study we used Alizarin red and Alcian blue as double skeletal staining to investigate the the bony and cartilaginous pattern of limbs and girdles of A. boskianus and P. guttatus. Results: in P. guttatus, the pectoral girdle was characterized by the presence of the interclavicles was dagger in shape and partially fused with clavicles, while it was cruciform and completely fused with the clavicles in A. boskianus. In P. guttatus, the epicoraoid was well developed, broad bony plates and fused with the interclavicles, while in A. boskianus it was narrow cartilaginous, plates and overlap in the mid-line. Moreover, in P. gutattus two fenestrae were appeared within coracoid and scapula with un-fenestrated cartilaginous sternum, while one fenestra appeared in both coracoid and sternum of A. boskianus. On other hand, the pelvic girdle of P. guttatus had complete fusions between the pubis, ischium and ilium, while in A. boskianus the pubis articulated poster-omedially with the ischium. In both P. gutattus and A. boskianus, the forelimbs posture was in horizontal plane, while the hind limbs were in vertical plane. In P. gutattus both the fore and hind limbs were relatively equal in length, while the fore limb in A. boskianus was greatly shorter than the hind limb. Conclusion: the P. gutattus is considered as a one of climbers species which have stout appendicular skeleton to support the climbing process on the vertical surface with relatively short limbs, while A. Boskianus is ground-dwellers and also good climbers and use their claws to walk and climbing on rocky areas and these abilities of locomotion depend on the flexibility of skeletal elements of its appendicular skeleton.

Comparative Functional Analysis of the Anatomy of the appendicular skeleton in two reptilian species

Aim of the work: the present study aimed to illustrate the osteological characters of the appendicular skeleton of two Egyptian lizard species, Acanthodactylus boskianus and Ptyodactylus guttatus and clarify the relationship between characteristics of the appendicular skeleton and mode of their locomotion of the two species. A. boskianus is diurnal insectivorous lizard forage in open area and it is a generalized ground-dwelling species and P. guttatus is a diurno-nocturnal omnivorous gecko which is a highly specialized climbing on vertical substrates. Material and methods: in the present study we used Alizarin red and Alcian blue as double skeletal staining to investigate the the bony and cartilaginous pattern of limbs and girdles of A. boskianus and P. guttatus. Results: in P. guttatus, the pectoral girdle was characterized by the presence of the interclavicles was dagger in shape and partially fused with clavicles, while it was cruciform and completely fused with the clavicles in A. boskianus. In P. guttatus, the epicoraoid was well developed, broad bony plates and fused with the interclavicles, while in A. boskianus it was narrow cartilaginous, plates and overlap in the mid-line. Moreover, in P. gutattus two fenestrae were appeared within coracoid and scapula with un-fenestrated cartilaginous sternum, while one fenestra appeared in both coracoid and sternum of A. boskianus. On other hand, the pelvic girdle of P. guttatus had complete fusions between the pubis, ischium and ilium, while in A. boskianus the pubis articulated poster-omedially with the ischium. In both P. gutattus and A. boskianus, the forelimbs posture was in horizontal plane, while the hind limbs were in vertical plane. In P. gutattus both the fore and hind limbs were relatively equal in length, while the fore limb in A. boskianus was greatly shorter than the hind limb. Conclusion: the P. gutattus is considered as a one of climbers species which have stout appendicular skeleton to support the climbing process on the vertical surface with relatively short limbs, while A. Boskianus is ground-dwellers and also good climbers and use their claws to walk and climbing on rocky areas and these abilities of locomotion depend on the flexibility of skeletal elements of its appendicular skeleton.

Management of Fibrous Dysplasia of Proximal Femur by Internal Fixation Without Grafting: A Retrospective Study of 19 Patients.

Introduction:This paper assesses whether treating patients with fibrous dysplasia of proximal femur by internal fixation with correction of the deformity, if present, without grafting is enough or not.Methods:This study is a retrospective study using patient's medical records, including analysis of 19 patients with fibrous dysplasia of proximal femur treated by internal fixation only and followed up between 2000 and 2017 for at least 2 years. Epidemiologic data, clinical manifestations, radiologic and histologic investigations, surgery, functional outcomes, and complications in these patients were analyzed.Results:The study included 12 male patients and 7 female patients, with a mean age of 20.74 years. Of these, two patients presented with pathologic fractures, two presented with shepherd's crook deformity, and the remaining presented with hip pain and limping. Implants used for internal fixation were intramedullary nail in four patients, dynamic hip screw in eight patients, cannulated screws in four patients, broad dynamic compression plate in two patients, and narrow dynamic compression plate in one patient. The mean follow-up period was 53.58 months. Four patients had postoperative complications. The mean Musculoskeletal Tumor Society score was 27.63 points.Discussion:The optimal management option for fibrous dysplasia of proximal femur is debatable. We suggest that internal fixation without grafting has a good local control and satisfactory functional long-term outcome.

A study of clinical profile of hypospadias cases at a medical college hospital of South Gujarat, India

Background: Hypospadias is a common congenital anomaly in which the anterior urethra is incompletely developed and does not extend to the tip of the glans penis. The present study was aimed to study clinical profile of hypospadias cases at a medical college hospital of southern Gujarat.Methods: This prospective study was conducted at a tertiary care hospital of South Gujarat, India including 32 patients of hypospadias. Data collected for each patient included age, sex, demography, and major symptoms, duration of symptoms and relevant past and treatment history.Results: Out of 32, 9 (28%) patients are between 4 years to 6 years of age and mean age of presentation of patients of hypospadias is 7.55 years. Twenty seven (84%) patients of Hypospadias were associated with prepucial hood, 17 (53%) patients of Hypospadias were associated with meatal stenosis, 6 (19%) patients of hypospadiasis were associated with severe chordee and 2 (6%) patients associated with narrow urethral plates.Conclusions: T Most cases of hypospadias were presented at age 9 years and below. Most common type of hypospadias was coronal and distal penile followed by penoscrotal type. Hypospadias was associated with prepucial hood (84%), meatal stenosis (53%), Chordee (19%) and narrow urethral plates (6%) out of total cases. Hypospadias was associated with undescended testis, bilateral retractile testis, cervical rib, mental retardation and microcephaly with mental retardation, squint and bifid tongue.

Phylogeny, morphology and toxicity of benthic dinoflagellates of the genus Fukuyoa (Goniodomataceae, Dinophyceae) from a subtropical reef ecosystem in the South China Sea

Species of Fukuyoa, recently revised from the globular Gambierdiscus, are toxic benthic dinoflagellates associated with ciguatera. In this study, a total of ten strains of Fukuyoa collected from Hong Kong waters were characterized using morphological and phylogenetic analyses. Results from both analyses showed that one of the strains is a putative new species, namely Fukuyoa sp. HK Type 1 (plate formula Po, 3′, 7″, 6c, 7s, 5‴, 1p and 2′‴ with a distinctive small and narrow cell shape, narrow Po plate, high Po pore density, large and broad Plate 1′ but small and round Po pore size, small and narrow Plate 2′, long and narrow Plates 2′‴ and 1p), and the others were F. ruetzleri. This is the first report of these two species of Fukuyoa in the South China Sea and Asia-Pacific region. Phylogenies on 18S, 28S D1/D3 and D8/D10 ribosomal DNA sequences strongly support that Fukuyoa sp. HK Type 1 is currently the most divergent species in the genus Fukuyoa. The diagrammatic plots on the p-distance matrices of 18S, 28S D1/D3 and D8/D10 and ITS regions resolved that the species of Fukuyoa were separated into three main groups, i.e., Fukuyoa sp. HK Type 1, F. paulensis and a group consisting of F. ruetzleri, F. yasumotoi and F. cf. yasumotoi, while Fukuyoa sp. HK Type 1 was always the most distant from the other two groups. Additionally, the pairwise p-distance values calculated based on the ITS region have always been the highest for pairs between Fukuyoa sp. HK Type 1 and other Fukuyoa species, ranging from 0.142 to 0.150. Our molecular results suggested that Fukuyoa sp. HK Type 1 is a putative new species. Both morphological and molecular data of more strains from different localities should be, however, collected to address its intraspecific variability and further evaluate its taxonomic status. A bioassay analysis demonstrated that algal lysates extracted from F. ruetzleri and Fukuyoa sp. HK Type 1 were lethal to brine shrimp larvae, indicating that both species were toxic. Bulk cultures were tested for Pacific ciguatoxins (P-CTXs) and maitotoxins (MTXs) by liquid chromatography-tandem mass spectrometry (LC–MS/MS). All isolates of Fukuyoa produced neither P-CTXs nor MTX-1, but isolates of F. ruetzleri produced a compound putatively assigned as MTX-3. This study has updated the current biodiversity and distribution of the toxic benthic dinoflagellates Fukuyoa, and thus contributes to the understanding of their emerging threats to the sub-tropical reef systems locally and regionally.

Interfacial debonding propagation in orthotropic layered plates with a compliant internal layer

The failure of layered plates with internal compliant layers is associated with interfacial debonding mechanisms, whose geometrically irregular propagation is governed by a three-dimensional stress state. This paper faces this challenge by developing a multi-layered, high-order plate theory and a triangular finite element that incorporate cohesive interfaces. The formulation tracks the evolution of two-dimensional debonding areas at the layered plate's interfaces. The model is used to study debonding mechanisms in a narrow plate with initial delaminations. Attention is given to the unstable response along equilibrium paths, the evolving irregular debonding front contours, and their impact on the structural resilience.

Comparative study between tubularized incised plate urethroplasty with and without dorsal inlay graft

Objectives The aim of this study was to compare the results of two single-stage hypospadias repairs, namely, tubularized incised plate (TIP) repair with and without dorsal inlay preputial skin graft urethroplasty as regards meatal stenosis, urethral stricture, and cosmetic outcome. Background The most commonly performed operation to repair distal hypospadias is the TIP repair. The key step is midline incision of the urethral plate, which widens a narrow plate and converts a flat groove into a deep plate groove, ensuring a vertical, slit neomeatus and a normal-caliber neourethra. At times in cases of distal hypospadias, the urethral plate is very narrow and needs to be augmented or substituted for further tubularization. We report our experience with primary single-stage dorsal inlay urethroplasty using inner preputial skin grafts. Patients and methods This study included 30 patients less than 10 years old who presented with primary distal types of hypospadias with narrow urethral plate at the Department of Plastic Surgery, Menoufia University Hospital and were divided into two groups: group A included 14 patients operated by TIP without dorsal inlay graft and group B included 16 patients operated by TIP with dorsal inlay graft. Patients who had undergone circumcision, previous hypospadias repair, or who had a deeply grooved urethral plate were excluded. Results A total of 16 children underwent primary dorsal inlay preputial graft urethroplasty, of whom one (6.2%) child had partial wound dehiscence, two (12.5%) of the children had meatal stenosis, and one (6.2%) of these children developed urethral stricture; 14 children underwent TIP urethroplasty, of whom two (14.3%) children had wound dehiscence, four (28.6%) of the children had meatal stenosis, and four (28.6%) of these children developed urethral stricture. Conclusion Primary dorsal inlay inner preputial graft urethroplasty successfully fulfills all traditional hypospadias repair criteria. It offers a viable, safe, rapid, and easy option in the management of proximal hypospadias with a narrow urethral plate.

Diffuse Extension of the Southern Mariana Margin

AbstractExtension within the southern Mariana margin occurs both normal to and parallel to the trench. Trench‐normal extension takes place along focused and broad backarc spreading axes forming crust that is passively accreted to the rigid Philippine Sea plate flank to the northwest. To the southeast, trench‐parallel extension has split apart the Eocene‐Miocene forearc terrain accreting new crust diffusely over a 150–200 km wide zone forming a pervasive volcano‐tectonic fabric oriented at high angles to the trench and the backarc spreading center. Earthquake seismicity indicates active extension over this forearc region and basement samples date young although waning volcanic activity. Such diffuse formation of new oceanic crust and lithosphere is unusual; in most oceanic settings extension rapidly focuses to narrow plate boundary zones—a defining feature of plate tectonics. Diffuse crustal accretion has been inferred to occur during subduction zone infancy, however. We hypothesize that in a near‐trench extensional setting, the continual addition of water from the subducting slab creates a weak overriding hydrous lithosphere that deforms broadly. This process counteracts mantle dehydration and strengthening proposed to occur at mid‐ocean ridges that may help to focus deformation and melt delivery to narrow plate boundary zones. The observations from the southern Mariana margin suggest that where lithosphere is weakened by high water content narrow seafloor spreading centers cannot form. These conditions likely prevail during subduction zone infancy, explaining the diffuse contemporaneous volcanism inferred in this setting.

Pore structure, wettability and tracer migration in four leading shale formations in the Middle Yangtze Platform, China

Deposited in different sedimentary settings, four leading shale formations (Late Ordovician Wufeng, Early Silurian Longmaxi, Late Permian Dalong, and Early Jurassic Dongyuemiao Shales) are currently the most promising zones for shale gas development in the Middle Yangtze Platform of South China. Based on complementary tests [low pressure gas physisorption, mercury injection capillary pressure (MICP), contact angle measurement, fluid imbibition into initially dry shale, and tracer diffusion into initially fluid-saturated shale followed by tracer mapping with laser ablation-inductively coupled plasma-mass spectrometry (LA-ICP-MS)], this work investigates their pore structure (both geometry and connectivity) and wettability characteristics, as well as the coupled effects of these characteristics on fluid flow and tracer migration.Pores <50 nm account for the majority of the pore volume in these organic shales. The shapes of hysteresis loop from gas physisorption show that the pores are mostly inkbottle-shaped in Wufeng, Longmaxi and Dongyuemiao Shales, while they are mostly narrow plate- or slit-like shaped pores in Dalong Shale. These four organic shales are strongly oil-wetting and moderately water-wetting. According to the imbibition behaviors toward aqueous (deionized water) and oleic (n-decane) phases, hydrophobic pores are better connected than hydrophilic pore networks, which is consistent with the measured contact angles. Diffusion of nano-sized nonsorbing (perrhenate [ReO4−]) and sorbing (cesium [Cs+]) tracers into brine-saturated shales indicates a high spatial variability and limited pore connectivity in these organic shales. The effective diffusion coefficient values are on the order of 10−13 m2/s with an associated geometric tortuosity ranging from 11.1 to 41.4. Due to the limited edge-connected pore spaces and low diffusion coefficients, the migration of hydrocarbons will be very slow from the shale matrix to hydraulically created fractures, with the initially high production of hydrocarbons from connected pore spaces near the sample edge (e.g., fracture face).

Different effect of percutaneous plate insertion via anteromedial vs anterolateral approach on intracompartmental pressure of the leg: A cadaveric study

BackgroundCurrently Minimally Invasive Plate Osteosynthesis (MIPO) technique for tibial shaft fracture management has gained wide attention. However, an increased intracompartmental pressure after the plate insertion may result in postoperative acute compartment syndrome. We reported the difference of immediate effect of percutaneous plate insertion using 2 approaches of MIPO technique on anterior compartment pressure of the legs. Materials and methodsEight soft cadaveric legs (one female and three males) without previous history of skeletal trauma or surgery were infused with normal saline to create the sustained intracompartmental pressure of 20mm Hg in all four compartments. The Synthes® 4.5mm 11-hole Narrow Locking Compression Plate was inserted via anteromedial and anterolateral approach. Anterior compartment pressure was measured by portable digital monitoring device through side-port needle (Stryker® Intracompartmental Monitoring Device) before and after plate insertion for each approach. ResultsBy using anteromedial approach, a mean of anterior compartment pressure was increased by 0.375mm Hg after plate insertion (5 of 8 legs had no change in pressure and the remaining 3 resulted in 1mm Hg pressure elevation). For anterolateral plate insertion, all of the 8 legs had an elevation of anterior compartment pressure with a mean of 3.5mmHg (ranged from 2 to 6mm Hg). ConclusionsWhen both approaches were compared to each other, the anterolateral plate insertion resulted in higher intracompartmental pressure elevation of the anterior compartment than the anteromedial approach. Surgeon should be more aware of acute compartment syndrome when considering the anterolateral approach in treating close tibial fracture. However, in patients with suspected acute compartment syndrome, close observation and continuous monitoring of the intracompartmental pressure is still imperative for all healthcare provider.

Tubularized proximally-incised plate in distal/midshaft hypospadias repair.

The aim of this study was to verify the validity, feasibility, and the functional results, by uroflowmetry, of Tubularized proximallyincised plate technique in selected case of distal/midshaft hypospadias. Out of 120 patients scheduled to undergo TIP (or Snodgrass) procedure, 23 were selected between January 2013 and January 2016 (19.1%). This case series comprised 16 patients with distal and 7 with midshaft hypospadias. Mean age at surgery was 2.9 years. The inclusion criteria were a deep and wide glandular groove and a proximal narrow urethral plate. The procedure was carried out as described by Snodgrass but the incision of the urethral plate, including the mucosal and submucosal tissue, was made only proximally, between the original meatus and the glandular groove in no case extending to the entire length of the plate. Postoperatively a foley catheter was left in place from 4 to 7 days. Uroflowmetry was performed when the patients age ranged from 2.5 to 5.7 years (mean age 3.11 years and mean follow-up 1.8 years, body surface 2). No patient presented fistulas nor perioperative complications. At uroflowmetry, eighteen patients presented values above the 25th percentile and 5 showed a borderline flow. All patients in this group remained stable without urinary symptoms. In selected cases, the tubularized proximally-incised plate yields satisfactory cosmetic and functional results for the treatment of midshaft proximal hypospadias. A long-term follow-up study is needed for further evaluation. Patient selection is crucial for the success of this technique.

Grafted tubularised incised plate urethroplasty: an excellent option in primary hypospadias with poor urethral plate

Background: Hypospadias represents the most frequent penile anomaly. The most challenging part of hypospadias surgery is urethral reconstruction. We here-in assess the cosmetic and functional outcome with primary single stage dorsal inlay urethroplasty using preputial skin grafts in tubularised incised-plate. We extended this indication to be the standard technique for primary hypospadias repair with poor urethral plate, flat glans and minimal ventral curvature.Methods: Children with a narrow urethral plate, shallow glans and minimal ventral curvature formed the study group. Children having severe chordee needing transection of the urethral plate,having undergone circumcision and failed hypospadias repair was excluded. This prospective study included the surgical experience of 87 cases of primary hypospadias operated upon between 2010 and 2016.Results: A straight penis was achieved in 97.7% of the patients with a 3.4% incidence of urethrocutaneous fistula. Acceptable cosmetic results were achieved in 96.5% of cases. Slit like appearance of neo urethral meatus was achieved in 96.5%, position was on the tip in 81 patients and in 6 it was mid glans. Glans dehiscence was seen in 3 patients. Meatal stenosis in 1, stricture, diverticulum and penile torsion was not seen in this series. Single and straight urinary stream was seen in 91.95%, splaying of urine in 3 patients and a thin stream in 4 patients.Conclusions: Primary dorsal inlay inner preputial graft urethroplasty successfully fulfils all traditional hypospadias repair criteria. It offers a viable option in the management of primary hypospadias with a narrow urethral plate.