Analysis of Readmission Patients after Lumbar Microdiscectomy

No abstract available.

Waveform Changes of Compound Muscle Action Potentials Related to Voluntary Muscle Contraction and Alteration of Muscle Length

The influence of voluntary muscle contraction and alteration of muscle length on compound muscle action potential (CMAP) was studied in 20 healthy volunteers. The CMAPs were evoked by a supramaximal stimulation and recorded by a surface electrode array. Onset latencies were not significantly changed regardless of the muscle length and contraction. On shortening of the muscle there was a decrease in an area and duration of CMAP with no significant changes in an amplitude. During muscle contractions, there was an increase in amplitude and a decrease in area and duration. On a lengthening of the muscle with relaxation, the amplitude of CMAP decreased with an increased area and duration. During a voluntary contraction, there was a decrease in amplitude, area, and duration. The results are considered due to a peripheral factor such as an alteration of temporal or spatial summation rather than a central mechanism. We conclude that in nerve conduction studies, it is important to monitor the finger position and muscle relaxation to differentiate the waveform changes from the muscle length or contraction and those from the nerve lesions.

Effect of Transrectal Probe Insertion on the Opening of Internal Urethral Sphincter

OBJECTIVE: To evaluate the effect of a transrectal probe on the opening of internal urethral sphincter. METHOD: Twenty-five patients with a neurogenic bladder dysfunction were included in this study. For the transrectal ultrasonography (TRUS), a transrectal probe was inserted into the rectum before the bladder was filled. Internal urethral sphincter opening was investigated during the filling and voiding phases. The bladder was emptied and the probe was introduced intrarectally after the bladder filling for the investigation of internal urethral sphincter opening. Twelve subjects underwent an additional cystometry for the recording of maximal intravesical pressure with and without transrectal probe. RESULTS: There was no significant difference in the sensitivity of TRUS for the opening of internal urethral sphincter with insertion of the probe before or after the bladder filling. There was no significant change of the maximal intravesical pressure with or without the probe in the rectum. CONCLUSION: The results demonstrate that transrectal probe for TRUS does not cause a reflex effect on the opening of internal urethral sphincter.

Sensitivity of Transrectal Ultrasonography and Voiding Cystourethrography for Appearing of the Opening of Bladder Neck or External Sphincter

OBJECTIVE: To compare the sensitivity of transrectal ultrasonography (TRUS) and voiding cystourethrography (VCUG) in assessing the opening of bladder neck and external urethral sphincter during the filling phase and voiding phase. METHOD: TRUS and VCUG were performed for visualizing the opening of bladder neck and external sphincter in 36 patients with a neurogenic bladder dysfunction and the sensitivity of two techniques was compared. The finding was considered to be a true positive when the opening of internal or external sphincter was visualized on either one of TRUS or VCUG. RESULTS: The sensitivity of TRUS was significantly higher than VCUG in visualizing the opening of bladder neck during the filling phase. However, there was no significant difference in the sensitivity of two techniques for the opening of external sphincter during filling phase or the opening of internal and external sphincters during voiding phase. CONCLUSION: The results demonstrate that the TRUS provides a satisfactory information and can be an alternative method to the radiological VCUG in visualizing the opening of bladder neck or external sphincter.

Peroneal Nerve Entrapment Caused by an Atypical Popliteal Cyst in a Child: A case report

Baker's cyst is commonly associated with intraarticular pathology such as degenerative arthritis. Few cases of neural compression by a Baker's cyst in the popliteal fossa have been reported with intraarticular pathology. We report a case of peroneal nerve compression by an atypical Baker's cyst in a child without intraarticular pathology. A 10-year-old boy had 6-month history of the left foot drop without a known trauma. There was no swelling or pain in the knee. The electrodiagnostic study demonstrated a profound lesion of the deep peroneal nerve and a mild denervation of the superfical peroneal nerve. Magnetic resonance images displayed an atypical Baker's cyst originating from the popliteal fossa and extending to the posterolateral side of the fibular head. Clinical and electrophysiological findings improved after aspiration of the cyst.