Dual plane penile augmentation with human acellular dermal matrix through penile lengthening incision / 中华医学美学美容杂志

Objective To illustrate the details and effects of a new technique of penile augmentation-a dual plane approach to enhance the penile girth with human acellular dermal matrix (ADM)through the incision on the dorsal penile root.Methods Firstly,a reversed V incision was made at the dorsal root of the penis and the superficial suspensory ligament of the penis was released.A Dartos fascia incision was then made and the plan between Dartos fascia and Buck's fascia was dorsally dissected toward the coronary sulcus.A Buck's fascia incision was made 1.5-2 cm from the coronary sulcus and the fascia was undermined distally.One or two sheets of ADM was dorsally placed by a dual plane method which combined partial sub-Buck's fascia plane and partial sub-Dartos fascia plane to enhance the penile circumference.Finally,the Dartos fascia incision was closed and followed by the closure of the wound with V-Y advancement.Results A total of 35 patients underwent dual plane penile augmentation No dorsal penile skin necrosis and exposure of ADM sheet happened in our group postoperatively.25 patients were followed from 6 to 24 months after operation.All patients were satisfied with their penile appearance and 21 married patients reported satisfied sexual activity.The increase of penile circumference was (2.65±0.41) cm at flaccid state and (1.85±0.35) cm at erectile state 6 months postoperatively.No pleat or absorb of the ADM sheet,losses of sensitivity of the penis occurred during the follow-up period.Conclusions By adjusting the plane of ADM placement,the dual plane penile augmentation ensures adequate soft-tissue coverage and sufficient blood supply of penile skin and offers increased benefits and fewer tradeoffs compared with a single plane.This technique could be an effective way to lengthen and enlarge the penis in one stage without major complication.

Poly-beta-hydroxybutyric acid scaffold for preadipocyte implantation in rats / 中国组织工程研究

BACKGROUND: The problem to be solved firstly in adipocyte implantatior after its in vitro adherent ulture f preadipocyte with scaffold using tissue-engineered technique is the biocompatibility of scaffold and dipocyte.OBJECTIVE: To investigate the feasibility of poly-β-hydroxybutyric acid (PHB) used for readipocyte implantation.DESIGN: Randomized controlled trial.SETTING: Medical College of Wuhan University.MATERIALS: This trial was carried out in Medical College, Wuhan University during October 2003 o June 2005. Twelve male SD rats(Experimental Animal Center, Medical College, Wuhan University), weighing rom 200 to 250 g, were involved.PHB scaffold was provided by Institute of Polymer Materials, Department f hemical Engineering, Tsinghua University.METHODS: The preadipocytes of rats were isolated, purified and ultured in vitro for use. PHB scaffold was made into 0.75 cm×0.75 cm ×0.2 cm lamellar cell biological caffold, then which were soaked by DMEM/F12 culture medium containing 150 g/L fetal bovine serum and laced in culture plate, one piece each well, 12 wells totally. 1.0 mL cultured cell suspension was added n each well to prepare cell scaffold complex. Eight rats were selected. The prepared complexes were implanted into right-side back tissue of a rat and fixed with 5-0 silk, serving as adipocyte scaffold roup; the biological scaffolds without adipocyte adherence were implanted into left-side back tissue of he same rat with the same method, serving as blank scaffold group. One lamellar biological scaffold was mplanted into each side. Eight weeks later, the appearance and structural change of grafts were observed, nd the grafts were weighted and their volumes were measured. Four lamellar biological scaffolds were mplanted into the other 4 rats separately and taken out after 3 weeks, then they were fixed by 100 g/L eutral formalin, sliced, and stained by haematoxylin and eosin (HE). Their histological changes were observed.MAIN OUTCOME MEASURES: ① Gross and histological observation of grafts in adipocyte scaffold roup and blank scaffold group. ② Comparison of volume and mass of grafts in two groups.RESULTS: Twelve ets were involved in the result analysis ,without deletion. ①Gross observation: In the adipocyte scaffold group, grafts presented flesh-color appearance and peplos in the peripheral region, and newly ormed minute blood vessels ingrowing into the scaffold. In the blank scaffold group, grafts presented rey ppearance, which was coated by peplos. ② HE staining: Three weeks later, a few scattered adipocytes were ound in the peripheral region of the grafts,there were very few vessels. Eight weeks later, lamellar ibrous peplos was found around the complex. Adipocytes ingrew from the peripheral region of scaffold into caffold, partial scaffold was nearly full of adipocytes and many vessels formed;In the blank scaffold roup, only peplos and vessels were found, scaffold was full of fibrous connective tissue and adipocytes ere not found. ③ Comparison of volume and mass: adipocyte scaffold group was superior to blank group in scaffold volume and mass [(257.5±70.2)vs.(144.6±62.6)mm3,(245.6±58.2) vs.(148.7±60.3)mg, both P＜0.01].CONCLUSION: Preadipocyte can adhere to PHB scaffold, proliferate and differentiate into mature dipocytes. It is feasible for PHB material to serve as a carrier for preadipocyte.

Prevention and treatment of postoperative complications of the penile elongation / 华中科技大学学报（医学）（英德文版）

To explore the causes of the postoperative complications of the penile elongation and the measures to prevent them in order to raise the success rate of the penile elongation. 1,000 patients who had received the penile elongation were reviewed and analyzed for the causes of postoperative complications, and the measures of prevention and treatment were discussed. Our results showed that, of the 1,000 cases, 64 had the postoperative complications, including 20 cases of edema of prepuce, 15 cases of flap necrosis, 12 hematoma, 9 infections, and 8 cases of fat and clumsy penis. It is concluded that correct operative manipulation, strict aseptic measures and necessary postoperative care and management could avoid or reduce the postoperative complications. When complications happened, a satisfactory result can be achieved with timely and correct treatment in the majority of the patients.

Prevention and treatment of postoperative complications of the penile elongation / 华中科技大学学报（医学）（英德文版）

To explore the causes of the postoperative complications of the penile elongation and the measures to prevent them in order to raise the success rate of the penile elongation. 1,000 patients who had received the penile elongation were reviewed and analyzed for the causes of postoperative complications, and the measures of prevention and treatment were discussed. Our results showed that, of the 1,000 cases, 64 had the postoperative complications, including 20 cases of edema of prepuce, 15 cases of flap necrosis, 12 hematoma, 9 infections, and 8 cases of fat and clumsy penis. It is concluded that correct operative manipulation, strict aseptic measures and necessary postoperative care and management could avoid or reduce the postoperative complications. When complications happened, a satisfactory result can be achieved with timely and correct treatment in the majority of the patients.

Treatment of baldness with hair-bearing scalp minigrafting / 中华医学美学美容杂志

Objective To improve survival rate of hair follicle after hair-bearing scalp minigrafting and to investigate the role of microsurgery in this procedure. Methods From 1990 to 2003, 156 cases suffered from male pattern baldness (MPB) and cicatrical baldness (CB) received hair-bearing scalp minigrafting. Moreover microsurgical technique was applied to this procedure. Among of them, the largest alopecia zone was about 12.5 cm ?15 cm. Results Survival rate of transplanted hair follicles was 95% (MPB) and 89% (CB) respectively. Baldness never occured in the former alopecia zone. Survival rate of transplanted hair follicles in CB was significantly higher than that of the former reports. There were 2 cases with abnormal figure of hair margin and 4 cases with unsatisfactory hair direction in hair grafted zone. Hematoma occurred in 2 patients who had no negative effects on hair follicle after hematoma were cleaned. The other cases all obtained satisfactory postoperative appearance. Conclusions Hair-bearing scalp minigrafting, combined with microsurgery technique, can improve survival rate of hair follicle after hair transplantation. Preoperative design, choice of indication and anesthesia, etc. are very important, too.

Changes of androgen and estrogen receptors in male pattern baldness after hair autografting / 中华医学美学美容杂志

Objective To explore the role of androgen receptor (AR) and estrogen receptor (ER) on male pattern baldness (MPB). Methods The contents of AR and ER in donor and recipient sites of scalps after hair autografting were determinated in 13 cases of MPB. Fluorescent steroid hormone conjugate technique was employed in this study. Results There was no statistical difference in the contents of AR and ER between donor site and grafted scalps in recipient site. Conclusion After the donor tissues are transplanted to the recipient site (the former baldness site), there is no change in contents of AR and ER. The abnormal change of the content of AR and ER in scalp plays an important role in MPB development.