Anatomical Results (anatomical + result)

Distribution by Scientific Domains


Selected Abstracts


Induction of a neoarthrosis by precisely controlled motion in an experimental mid-femoral defect

JOURNAL OF ORTHOPAEDIC RESEARCH, Issue 3 2002
Dennis M. Cullinane
Bone regeneration during fracture healing has been demonstrated repeatedly, yet the regeneration of articular cartilage and joints has not yet been achieved. It has been recognized however that the mechanical environment during fracture healing can be correlated to the contributions of either the endochondral or intramembranous processes of bone formation, and to resultant tissue architecture. Using this information, the goal of this study was to test the hypothesis that induced motion can directly regulate osteogenic and chondrogenic tissue formation in a rat mid-femoral bone defect and thereby influence the anatomical result. Sixteen male Sprague Dawley rats (400 ± 20 g) underwent production of a mid-diaphyseal, non-critical sized 3.0 mm segmental femoral defect with rigid external fixation using a custom designed four pin fixator. One group of eight animals represented the controls and underwent surgery and constant rigid fixation. In the treatment group the custom external fixator was used to introduce daily interfragmentary bending strain in the eight treatment animals (12°s angular excursion), with a hypothetical symmetrical bending load centered within the gap. The eight animals in the treatment group received motion at 1.0 Hz, for 10 min a day, with a 3 days on, one day off loading protocol for the first two weeks, and 2 days on, one day off for the remaining three weeks. Data collection included histological and immunohistological identification of tissue types, and mean collagen fiber angles and angular conformity between individual fibers in superficial, intermediate, and deep zones within the cartilage. These parameters were compared between the treatment group, rat knee articular cartilage, and the control group as a structural outcome assessment. After 35 days the control animals demonstrated varying degrees of osseous union of the defect with some animals showing partial union. In every individual within the mechanical treatment group the defect completely failed to unite. Bony arcades developed in the experimental group, capping the termini of the bone segments on both sides of the defect in four out of six animals completing the study. These new structures were typically covered with cartilage, as identified by specific histological staining for Type II collagen and proteoglycans. The distribution of collagen within analogous superficial, intermediate, and deep zones of the newly formed cartilage tissue demonstrated preferred fiber angles consistent with those seen in articular cartilage. Although not resulting in complete joint development, these neoarthroses show that the induced motion selectively controlled the formation of cartilage and bone during fracture repair, and that it can be specifically directed. They further demonstrate that the spatial organization of molecular components within the newly formed tissue, at both microanatomical and gross levels, are influenced by their local mechanical environment, confirming previous theoretical models. © 2002 Orthopaedic Research Society. Published by Elsevier Science Ltd. All rights reserved. [source]


Twenty years of experience with Krzeski's cystovaginoplasty for vaginal agenesis in Mayer-Rokitansky-Küster,Hauser syndrome: anatomical, histological, cytological and functional results

BJU INTERNATIONAL, Issue 11 2008
Andrzej Borkowski
OBJECTIVE To evaluate the long-term anatomical results using the original method of vaginal reconstruction with a pedicled bladder flap (Krzeski's cystovaginoplasty, CVP) in women with Mayer-Rokitansky-Küster,Hauser syndrome (MRKHS) and the evaluation of radiological, histological, cytohormonal and functional results of CVP. PATIENTS AND METHODS Between 1981 and 2000, 38 patients (mean age 22.5 years, range 18,40) with MRKHS underwent CVP. A physical examination was used to evaluate the anatomical results, 27 patients had vaginography, and biopsies of the neovaginal wall and cytohormonal smears were taken in two. Functional sexual and urinary results, and opinions on CVP, were evaluated by an inventory mailed to 37 patients in 2000. RESULTS The anatomical result was good in 37 patients during a mean (range) follow-up of 9 (0.25,19) years; the result was good in 30 patients, but seven developed vaginal stenosis that was successfully repaired. There were two cases of post-coital vesicovaginal fistula (VVF) at 18 months after CVP. Vaginal biopsies showed epithelialization of the posterior vaginal wall and gradual metaplastic changes from urothelium to stratified nonsquamous epithelium. Cytological smears showed a normal biphasic pattern and neovaginal susceptibility to hormonal milieu. In all, 27 patients (73%) responded to the questionnaire. All had sexual partners and started sexual intercourse at a mean of 14 months after CVP; 89% experience orgasms and in 48% the vagina was the source; 40% sometimes used lubricants and seven (26%) used vaginal dilators. Lower urinary tract symptoms (LUTS) after CVP were reported by 19 (66%) of the women and in six the LUTS were persistent. One patient was not satisfied with the functional and anatomical result of CVP, 89% declared that it improved sexual life, 93% would undergo CVP again and in 92% the quality of their sexual life was improved. All patients, when asked, stated that they would recommend CVP to another patient with MRKHS. CONCLUSIONS Vaginal reconstruction by CVP is characterized by good anatomical and functional results, sustained by long-term observation. The resultant epithelium is very similar to that of the native vagina in histology and function. All vaginas are functional and the level of patient satisfaction was high. The level of complications was acceptable, but in some patients LUTS can persist. [source]


Temporal endosonographic evaluation of anal sphincter integrity after primary repair for obstetric ruptures: a case for specific training of obstetricians

COLORECTAL DISEASE, Issue 7Online 2010
P. Pronk
Abstract Objective, To evaluate primary repaired obstetric lesions of the anal sphincter complex on anal endo-ultrasound within a few days and 8 weeks after primary repair and to investigate in this way the influence of suboptimal woundhealing on the final anatomical result. Furthermore to investigate the relation between faecal incontinence and sphincter defects. Design, A prospective cohort study. Setting, The obstetric clinic and coloproctology outpatient clinic of the Zaans Medical Centre in Zaandam, the Netherlands. Subjects, A cohort of 32 consecutive women with primary surgically repaired 3B, 3C or 4th degree anal sphincter defect after vaginal delivery. Main outcome measures, Appearance of the anal sphincter complex on anal endo-ultrasound within a few days week and 8 weeks after primary surgical repair, i.e. first and second ultrasound, respectively. Evaluation of anal continence, using the Vaizey incontinence score, at second ultrasound. Results, No major wound breakdown was seen and four women had superficial, skin related wound problems. Twenty-eight women (87.5%) had a repaired external anal sphincter on the first and the second ultrasound. Of four external anal sphincter defects on first ultrasound one defect was not present on second ultrasound. The internal sphincter showed a defect on first ultrasound in 11 women and this was still present in 10 on second ultrasound. A total of 11 women had a persisting anal sphincter defect (external, internal or in combination). Mean Vaizey scores were significantly higher in women with a persisting sphincter defect (EAS, IAS or in combination) than in women with no sphincter defects, 2.3 and 0.4 respectively (95% CI 0.1,3.6, P = 0.04). Conclusion, Anal endo-ultrasound may be used for early evaluation of surgical repair of anal sphincter lesions after vaginal delivery. Persisting defects in the anal sphincters, in this series not because of major wound breakdown, can be explained by inadequate surgical repair. [source]


Activation of M2 muscarinic receptors leads to sustained suppression of hippocampal transmission in the medial prefrontal cortex

THE JOURNAL OF PHYSIOLOGY, Issue 21 2009
Lang Wang
Cholinergic innervation of the prefrontal cortex is critically involved in arousal, learning and memory. Dysfunction of muscarinic acetylcholine receptors and their downstream signalling pathways has been identified in mental retardation. To assess the role played by the muscarinic receptors at the hippocampal,frontal cortex synapses, an important relay in information storage, we used a newly developed frontal slice preparation in which hippocampal afferent fibres are preserved. Transient activation of muscarinic receptors by carbachol results in a long-lasting depression of synaptic efficacy at the hippocampal but not cortical pathways or local circuitry. On the basis of a combination of electrophysiological, pharmacological and anatomical results, this input-specific muscarinic modulation can be partially attributed to the M2 subtype of muscarinic receptors, possibly through a combination of pre- and postsynaptic mechanisms. [source]


Twenty years of experience with Krzeski's cystovaginoplasty for vaginal agenesis in Mayer-Rokitansky-Küster,Hauser syndrome: anatomical, histological, cytological and functional results

BJU INTERNATIONAL, Issue 11 2008
Andrzej Borkowski
OBJECTIVE To evaluate the long-term anatomical results using the original method of vaginal reconstruction with a pedicled bladder flap (Krzeski's cystovaginoplasty, CVP) in women with Mayer-Rokitansky-Küster,Hauser syndrome (MRKHS) and the evaluation of radiological, histological, cytohormonal and functional results of CVP. PATIENTS AND METHODS Between 1981 and 2000, 38 patients (mean age 22.5 years, range 18,40) with MRKHS underwent CVP. A physical examination was used to evaluate the anatomical results, 27 patients had vaginography, and biopsies of the neovaginal wall and cytohormonal smears were taken in two. Functional sexual and urinary results, and opinions on CVP, were evaluated by an inventory mailed to 37 patients in 2000. RESULTS The anatomical result was good in 37 patients during a mean (range) follow-up of 9 (0.25,19) years; the result was good in 30 patients, but seven developed vaginal stenosis that was successfully repaired. There were two cases of post-coital vesicovaginal fistula (VVF) at 18 months after CVP. Vaginal biopsies showed epithelialization of the posterior vaginal wall and gradual metaplastic changes from urothelium to stratified nonsquamous epithelium. Cytological smears showed a normal biphasic pattern and neovaginal susceptibility to hormonal milieu. In all, 27 patients (73%) responded to the questionnaire. All had sexual partners and started sexual intercourse at a mean of 14 months after CVP; 89% experience orgasms and in 48% the vagina was the source; 40% sometimes used lubricants and seven (26%) used vaginal dilators. Lower urinary tract symptoms (LUTS) after CVP were reported by 19 (66%) of the women and in six the LUTS were persistent. One patient was not satisfied with the functional and anatomical result of CVP, 89% declared that it improved sexual life, 93% would undergo CVP again and in 92% the quality of their sexual life was improved. All patients, when asked, stated that they would recommend CVP to another patient with MRKHS. CONCLUSIONS Vaginal reconstruction by CVP is characterized by good anatomical and functional results, sustained by long-term observation. The resultant epithelium is very similar to that of the native vagina in histology and function. All vaginas are functional and the level of patient satisfaction was high. The level of complications was acceptable, but in some patients LUTS can persist. [source]


Long-term functional and anatomical results of OOKP and tibial OKP: Barcelona experience

ACTA OPHTHALMOLOGICA, Issue 2009
MF DE LA PAZ
Purpose To report the long-term functional and anatomical results of OOKP and Tibial OKP performed at the Barraquer Eye Center from 1974-2006. Different factors like surgical technique, clinical diagnosis, age and post-operative complications are also analyzed and reported. Methods A retrospective study on 330 eyes of 227 patients who underwent OOKP or tibia OKP was performed. Kaplan Meier survival curves and multivariate analysis using Cox regression model of the different variables mentioned are presented. Results OOKP and Tibia OKP have comparable functional and anatomical results in the long-term. Best long-term functional and anatomical results are for patients with chemical burns, cicatricial trachoma and Stevens-Johnsons/Lyell syndrome. Thermal burns have a higher anatomical retention than other diagnostic categories. Younger patients have better visual prognosis and anatomical retention than older patients. Patients must be warned of the possibility of sight-threatening complications like extrusion of the prosthesis, retinal detachment and glaucoma. Conclusion Our more than 35 years experience with biological keratoprosthesis using the OOKP and the tibia OKP shows that the two techniques are comparable. Certain variables like clinical diagnosis, age and post-operative complications affect the anatomical and functional results in the long-term. [source]