Although nusinersen has been demonstrated to improve motor function in patients with spinal muscular atrophy (SMA), no studies have investigated its effect on fine manual dexterity. The present study aimed to investigate the ability of nusinersen to improve fine manual dexterity in patients with SMA type 2. A total of five patients with SMA type 2 were included. The Hammersmith Functional Motor Scale (expanded version) (HFMSE) and Purdue Pegboard (PP) tests were used to evaluate gross motor function and fine manual dexterity, respectively, until 18 months after nusinersen administration. HFMSE scores improved by 3–10 points (+13–53%) in all patients following nusinersen administration. PP scores also improved in all patients, from 4 to 9 points (+80–225%) in the preferred hand and from 3 to 7 points (+60–500%) in the non-preferred hand. These results suggest that nusinersen treatment improved both gross motor function and fine manual dexterity in children with SMA type 2. Addition of the PP test may aid in evaluating the fine manual dexterity essential for activities of daily living in these patients.

To describe a modified retroperitoneoscopic renal pedicle lymphatic disconnection (MRRPLD) and to compare the efficacy and safety of MRRPLD with traditional retroperitoneoscopic renal pedicle lymphatic disconnection (RRPLD). From September 2008 to July 2012, RRPLD and MRRPLD were performed respectively on 18 and 14 patients at our center. Comparison was conducted including operative time, intraoperative blood loss, postoperative time of bed rest, hospital stay, postoperative urine chyle test, and complications. All operations were completed without conversion to open surgery. The mean operative time, intraoperative blood loss, postoperative time of bed rest, and hospital stay from MRRPLD group were all decreased compared with data from RRPLD group. There was significant difference in operative time, postoperative time of bed rest, and hospital stay (P<0.05). Complications occurred only in one patient receiving RRPLD. Chyluria disappeared in all patients after the operation. No recurrence was observed during the follow-up. MRRPLD has a good effect and safety for chyluria. It is a simpler, more minimally invasive, and more economic surgical therapy compared with traditional RRPLD.

Rectus sheath hematoma (RSH) in patients who have undergone video-assisted thoracoscopic surgery (VATS) has not been reported to date. This report describes a case of RSH in a patient with right abdominal muscle atrophy due to an intercostal nerve injury following VATS. A 61-year-old male patient complained of a bulge in the right upper abdominal quadrant after undergoing VATS. Computed tomography (CT) revealed atrophied right abdominal muscles, including the rectus abdominis, and the electrodiagnostic findings were compatible with right 8th and 9th intercostal neuropathy. The patient visited the emergency room 444 days after undergoing VATS, complaining of a left abdominal mass and pain. He had a severe cough 2 weeks prior due to underlying asthma. CT revealed an RSH in the left abdomen that shrank after 4 weeks of observation. In cases of abdominal muscle weakness due to intercostal neuropathy following VATS, the precipitating factors for RSH must be managed thoroughly.