Electromyographic activity of the anterolateral abdominal wall muscles during the vesical filling and evacuation

The role of the anterolateral abdominal wall muscles [AAWMs] during the vesical filling and evacuation has not been sufficiently addressed in the literature. We have investigated the hypothesis that the AAWMs exhibit the increased electromyographic [EMG] activity on the vesical distension and contraction which presumably assists vesical evacuation. The effects of the vesical balloon distension on the vesical pressure [VP], vesical neck [VNP] pressures and the AAWMs' EMG activity were studied in 28 healthy volunteers aged 40.7 +/- 9.7 years [18 men, 10 women]. These effects were tested after the individual anesthetization of the bladder and AAWMs and after saline infiltration. The VP and the VNP showed a gradual increase upon the incremental vesical balloon distension which started at a distending volume of 120-140 ml. At a mean volume of 364.6 +/- 23.8 ml, the VP increased to a mean of 36.6 +/- 3.2 cmH2O, the VNP decreased to 18.4 +/- 2.4 cmH2O, and the AAWMs EMG registered a significant increase. This effect disappeared in the individual bladder and in the AAWMs' anesthetization. However, it did not disappear in the saline administration. The AAWMs appear to contract simultaneously with vesical contraction. This action presumably increases the IAP and it assists vesical contraction. The AAWMs contraction on vesical contraction seems to be mediated through a reflex which is called the 'vesico-abdominal wall reflex'. Further studies are required to investigate the role of this reflex in vesical disorders

study of the aesthetic patterns of the umbilicus among Egyptians with a new technique for umbilical reconstruction de novo

The umbilicus is an anatomical and aesthetic landmark in the middle of the abdomen. Modern plastic surgery of the abdominal wall is usually concerned with preservation of this landmark to achieve the best esthetic results. Preserving the umbilicus could be reached either by transposition or creation of a new umbilicus in cases with large hernias where the umbilicus is sacrificed to ensure proper hernia repair. In this work an anatomical study of the position, shape and dimensions of the umbilicus in normal Egyptian male and female volunteers of young age was done and different methods to locate the position of the umbilicus were evaluated. Four forms of umbilical shapes are prevalent among Egyptians, the rounded hooded, vertical, and transverse. Measuring umbilical position from the two anterior superior iliac spines was found to be most accurate. Moreover, the ASIS are easily located even in obese patients so, they should be used as reference points while relocating the umbilicus. A new technique for creation of new umbilicus is here described which proved simple, easy, reliable and with low rate of complications