Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “ANI”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 199 records · Page 11Linked to original sources
PubMed2002

Study of the levator ani muscle in the multipara: role of levator dysfunction in defecation disorders.

The levator ani muscle (LAM) shares in the mechanism of defecation and urination as well as in visceral support. Levator dysfunction occurs in conditions of chronic straining or increased intra-abdominal pressure. Studies have shown that the gravid uterus, by virtue of its weight and associated increased intraabdominal pressure, might disturb the levator function. It is postulated that this effect is augmented with repeated pregnancies. The current study investigated the functional activity of the LAM in 50 multipara, 30 primipara and 20 nullipara (controls). The 50 multipara (age 46.4 years, 4-7 deliveries) were divided into group A (28 women with normal deliveries) and group B (22 women with a prolonged 2nd stage of labour). Of the 30 primipara (age 44.2 years) 18 had normal delivery (group A) and 12 prolonged 2nd stage of labour (group B). The mean age of the nullipara was 45.3+/-7.6. The LAM activity at rest and on contraction was recorded. The rectal and anal canal pressure response to LAM stimulation was also registered. In group A of the multipara, the LAM EMG activity at rest was similar to (P>0.05), and on contraction lower (P<0.05) than the LAM EMG of the controls (nullipara). Group B exhibited a lower activity at rest and on contraction (P<0.01, both). Primipara group A had a resting and contractile EMG activity similar to the controls, while group B showed diminished activity in both conditions (P<0.05, both) which was significantly higher (P<0.05, P<0.01, respectively) than that of group B multipara. The rectal pressure in the multipara and primipara did not differ from the nullipara (P>0.05, both). In groups A and B of multiparous women, the anal canal pressure at rest was significantly lower and on LAM contraction significantly higher than that of nullipara. Group A of the primipara showed no significant difference against the controls, while group B exhibited a decline at rest (P<0.05) and no difference on LAM contraction (P>0.05). In conclusion, levator dysfunction might occur in the parous women. It was more common in the multipara than the primipara and in particular those with a history of a prolonged 2nd stage of labour. Levator dysfunction may lead to constipation and faecal or urinary incontinence as a result of pudendal neuropathy and the development of pudendal canal syndrome.

Adult↗
PubMed2001

Evidence of apoptosis in the castration-induced atrophy of the rat levator ani muscle.

Apoptosis or programmed cell death has been previously reported in androgen-responsive tissue such as the prostate. We tested the hypothesis that apoptosis may also represent a component of the castration-induced atrophy of the sexually dimorphic levator ani (LA) muscle of the male rat. Gonadectomy (GDX) induced a severe decrease in the LA muscle wet weight accompanied by important modifications in cytoarchitecture including an increase in myofibrillar interspace and condensed mitochondria. These alterations were almost completely reversed after 7 days of testosterone propionate replacement therapy (GDX + TP). In GDX rats, internucleosomal DNA fragmentation was confirmed by both agarose gel electrophoresis and electron microscopy. DNA fragmentation was no longer detected in GDX + TP rats. In GDX rats, overexpression of the trpm-2/clusterin gene, used as an early marker of apoptosis, further confirmed that an apoptotic response, typical of androgen-responsive tissues, is taking place following androgen withdrawal.

Animals↗
PubMed1986

Early repair of an external sphincter ani muscle and rectal mucosal dehiscence.

Little information is available to assist in the management of a dehiscence subsequent to a fourth degree episiotomy repair. Delayed repair of the external sphincter ani muscle and rectal mucosa may result in weeks or months of disability and inconvenience for these women. A series of eight women is presented whose fourth degree episiotomy repair dehiscence was managed by early puerperal repair. The details of wound and bowel preparation, the operative technique, and postoperative care are described. Because all eight women had a successful repair, the authors believe that early surgical correction is an acceptable treatment for this puerperal complication.

Anal Canal↗
PubMed2006

Interaction among apical support, levator ani impairment, and anterior vaginal wall prolapse.

OBJECTIVE: To use a biomechanical model to explore how impairment of the pubovisceral portion of the levator ani muscle, the apical vaginal suspension complex, or both might interact to affect anterior vaginal wall prolapse severity. METHODS: A biomechanical model of the anterior vaginal wall and its support system was developed and implemented. The anterior vaginal wall and its main muscular and connective tissue support elements, namely the levator plate, pubovisceral muscle, and cardinal and uterosacral ligaments were included, and their geometry was based on midsagittal plane magnetic resonance scans. Material properties were based on published data. The change in the sagittal profile of the anterior vaginal wall during a maximal Valsalva was then predicted for different combinations of pubovisceral muscle and connective tissue impairment. RESULTS: Under raised intra-abdominal pressure, the magnitude of anterior vaginal wall prolapse was shown to be a combined function of both pubovisceral muscle and uterosacral and cardinal ligament ("apical supports") impairment. Once a certain degree of pubovisceral impairment was reached, the genital hiatus opened and a prolapse developed. The larger the pubovisceral impairment, the larger the anterior wall prolapse became. A 90% impairment of apical support led to an increase in anterior wall prolapse from 0.3 cm to 1.9 cm (a 530% increase) at 60% pubovisceral muscle impairment, and from 0.7 cm to 2.4 cm (a 240% increase) at 80% pubovisceral muscle impairment. CONCLUSION: These results suggest that a prolapse can develop as a result of impairment of the muscular and apical supports of the anterior vaginal wall.

Biometry↗
PubMed1980

Abdominoperineal levator ani repair for rectal prolapse: technique.

A review some twenty years ago of the then popular rectosigmoidectomy for complete rectal prolapse having shown an excessive recurrence rate and a high incidence of incontinence, it was felt essential to seek for a more satisfactory and reliable surgical procedure for its management. This was achieved in the form of an operation, carried out from above and below, approximating the levator ani anterior to the rectum. This has given very much more satisfactory results, and is described in detail in this paper.

Adult↗
PubMed2004

Morphologies of the interfaces between the levator ani muscle and pelvic viscera, with special reference to muscle insertion into the anorectum in elderly Japanese.

A specific, smooth muscle-mediated interface between the levator ani muscle (LA) and the pelvic viscera has been reported. Using 110 sagittally trimmed anorectal tissue strips (80 lateral, 15 anterior and 15 dorsal specimens) obtained from the donated cadavers of 46 elderly subjects, we examined variations in the interface between the LA and the rectal muscularis propria, including the so-called conjoined longitudinal muscles. In type A (9/46), little or no tissue connected the LA to the external rectal muscularis propria, but the LA and external sphincteric mass formed a definite complex. In type B (26/46), the covering fascia of the LA changed abruptly into smooth muscles, which merged into the external rectal muscularis propria. In type C (11/46), most of the LA-associated connective tissues, composed of smooth muscles, were tightly connected to the internal and external rectal muscularis propria. These variations seemed to depend on the morphology of the recto-urethralis, the lateral extension of which reinforced the LA-associated smooth muscles sufficiently to form type B and C insertions. We also demonstrated differences in the interfacial tissues between the LA and other pelvic viscera. We hypothesize that, to avoid injury of the LA and its interfaces during strong movement of the pelvic viscera, for example during childbirth, coitus or squeezed evacuation, the pelvic connective tissue-like smooth muscles play an important role as an autonomic buffer and/or modulator of pelvic floor function. Digital examination and transrectal or transvaginal sonography may be useful for evaluating interindividual variation in these interfacial tissues in elderly patients.

Aged↗
PubMed2004

Pilot study of botulinum toxin type A in the treatment of chronic pelvic pain associated with spasm of the levator ani muscles.

OBJECTIVE: To investigate whether botulinum toxin type A (BOTOX) injected into the levator ani muscles of women with objective pelvic floor muscle spasm decreases pain symptoms and improves quality of life. DESIGN: A prospective cohort study. SETTING: Outpatient clinic in a tertiary referral centre, Sydney, Australia. SAMPLE: Twelve women, aged 18-55 years, with objective pelvic floor muscle hypertonicity and a minimum 2-year history of chronic pelvic pain were recruited. METHODS: All women completed visual analog scale pain assessments; questionnaires relating to bladder and bowel symptoms and quality of life; and specific examinations. Forty units of BOTOX at three different dilutions were given bilaterally into the puborectalis and pubococcygeus muscles under conscious sedation. RESULTS: Median visual analog scale scores were significantly improved for dyspareunia (80 vs 28; P=0.01) and dysmenorrhea (67 vs 28; P=0.03), with non-significant reductions in non-menstrual pelvic pain (64 vs 37) and dyschesia (47 vs 29). Pelvic floor muscles manometry showed a 37% reduction in resting pressure at week 4 and a 25% reduction was maintained at week 12 (P <0.0001). Quality of life scores (EQ-5D and SF-12) were improved from baseline at week 12, but did not reach statistical significance. Sexual activity scores were markedly improved, with a significant reduction in discomfort (4.8 vs 2.2; P=0.02) and improvement in habit (0.2 vs 1.9; P=0.03). These results were not influenced by dilution. CONCLUSION: There is evidence from the present pilot study suggesting that women with pelvic floor muscles hypertonicity and pelvic pain may respond to BOTOX injections into the pelvic floor muscles. Further research into this novel treatment of chronic pelvic pain is strongly recommended.

Adolescent↗
PubMed2005

Alterations in levator ani morphology in elite nulliparous athletes: a pilot study.

BACKGROUND: A difficult vaginal birth is known to be one of the causes of damage to the pelvic floor muscles. Prolonged second stage of labour is thought to be one of the implicating factors in this damage. If the muscles of the pelvic floor were hypertrophied in response to repetitive high impact training, then the 'suspected phenomenon' of a more difficult childbirth for very athletic women might be related to these muscles reducing pelvic floor compliance. AIM: To document the muscle morphology of the pelvic floor using magnetic resonance imaging (MRI) in a group of nulliparous female athletes and to compare this to the findings in a similar group of age-matched nulliparous nonathletic women. METHODS: Static Magnetic Resonance (MR) imaging of the pelvic floor was performed with particular reference to the muscle morphology of levator ani and puborectalis. The cross-sectional area of the urogenital hiatus and the diameter of the bony pelvic outlet were also assessed. RESULTS: Significant differences in the cross-sectional area and width of the pelvic floor muscles, measured in the line of the anal canal, were found between the athletic group and the controls. There were no differences found between the two groups in the cross-sectional area of the urogenital hiatus, and the adequacy of the pelvic outlet was established with reference to normative data. CONCLUSIONS: The differences shown in the pelvic floor muscles in the athletes and nonathletes provide a focus for further research into this area. This change might influence the function of the pelvic floor muscles in this subgroup of women.

Adult↗
PubMed1990

Actin and creatine kinase mRNAs in rat levator ani and vastus muscles as a function of androgen status.

The plasticity of two selected mRNAs was studied in two typical fast-twitch muscles at different time intervals after orchiectomy (GDX). The levator ani muscle of the rat (LA) is exquisitely sensitive to androgens, whereas the superficial vastus lateralis (SVL) lacks such sensitivity. In vitro translation of RNA isolated from both tissues indicated that actin was among the most repressed proteins of the LA at day 10 postsurgery (GDX-10 days), whereas the template activity of the SVL mRNAs remains virtually unmodified. We used an available actin cDNA and demonstrated that the expression of the LA actin message is reduced by 85% in GDX-10 days and can be recovered after testosterone propionate (TP) injections (GDX + TP). In contrast, the actin expression in SVL remains constant up to day 20 postsurgery. In the LA, the expression of creatine kinase (CK) mRNA was increased 140% in GDX-5 days and decreased 34 and 17% in GDX-10 days and GDX-20 days, respectively, although the measured CK activity, as well as the in vitro translation of the message, remained elevated in those two latter groups. Control level of the CK mRNA expression was recovered in the GDX + TP group. Again, the expression of the message was unchanged in SVL, suggesting that the protein synthesis of this skeletal muscle is far less sensitive to androgen deprivation than that of the LA muscle.

Actins↗
PubMed1996

Congenital psoriasiform erythrokeratodermia with cleidocranial dysplasia, urogenital anomalies and atresia ani.

We describe two siblings with unique psoriasiform erythrokeratodermia associated with cleidocranial dysplasia, urogenital anomalies and atresia ani. The skin lesions were characterized by demarcated psoriasiform erythema with scaling. A skin biopsy revealed small abscesses containing polymorphonuclear leukocytes in the parakeratotic horny layer, elongation of the rete ridges and dermal papillae, and other findings consistent with psoriasis. A reverse-transcription polymerase chain reaction analysis disclosed increased expression of transforming growth factor alpha in the affected skin lesion of one of the siblings as well as in the skin of a patient with psoriasis. It is suggested that these cases are a variant of a congenital form of psoriasiform erythrokeratodermia.

Adolescent↗
PubMed1980

Aromatization of androgens to estrogens mediates increased activity of glucose 6-phosphate dehydrogenase in rat levator ani muscle.

Administration of testosterone propionate to immature male rats caused a 50% increase in the specific activity of glucose 6-phosphate dehydrogenase, the rate-limiting enzyme of the pentose phosphate pathway, in the levator ani muscle. This effect appears to be mediated by conversion of testosterone to estradiol because of the following results: 1) the effect was not mimicked by the nonaromatizable androgens fluoxymesterone or 5 alpha-dihydrotestosterone; 2) it was mimicked by 17 beta-estradiol and diethylstilbestrol; 3) it was blocked by an estrogen antagonist but not by an androgen antagonist; 4) the inactive steroid 17 alpha-estradiol was without effect on glucose 6-phosphate dehydrogenase; and 5) the effect of testosterone was blocked by an inhibitor of androgen aromatase. These results demonstrate a direct effect of estrogen on striated muscle.

Androgens↗
PubMed2003

Renal and ureteral fusion in a calf with atresia ani.

A 10-day old male calf exhibited multiple congenital anomalies of the urinary and gastrointestinal tracts, including renal fusion (horseshoe kidney), ureteral fusion, rectovesicular fistula, and atresia ani. In horseshoe kidney, the organs were fused together at the caudal poles. The left kidney and cranial half of right kidney were shrunken, while the remaining lobules were hypertrophic. Ureters were fused cranially and bifurcated caudally. The terminal rectum was narrowed and connected with the bladder. The anus was imperforate. The cause of these anomalies could not be determined.

Animals↗
PubMed1976

Comparison between the binding of 19-nortestosterone, 5alpha-dihydrotestosterone and testosterone in rat prostate and bulbocavernosus/levator ani muscle.

Specific binding of (3H)19-nortestosterone in the 100000 g cytosol of the rat bulbocavernosus/levator ani muscle (BCLA) and prostate was demonstrated by agargel electrophoresis at low temperature and compared qualitatively and quantitatively with the binding of tritiated testosterone and 5alpha-dihydrotestosterone (5alpha-DHT). Both tissues showed a greater binding affinity for 5alpha-DHT than for 19-nortestosterone, with testosterone binding the least well of the three. The relative binding affinities in the BCLA and prostate were: 19-nortestosterone:testosterone=1-4, 1.-nortestosterone: 5alpha-DHT = 0.7 The differences were statistically significant (P less than 0-02). The concentrations of receptor sites for 5alpha-DHT were 171 +/- 20 (S.D.) fmol/mg prostatic cytosol protein and 24 +/- 4 (S.D.) fmol/mg BCLA cytosol protein. The in-vitro metabolism of the three steroids in both tissues was aldo investigated by thin-layer chromatography. After incubating for 2 h at 0 degrees C the prostate was shown to reduce 26% of the 5alpha-DHT to androstanediols whilst the BCLA showed a 5% conversion. Testosterone was converted by the prostate to 5alpha-DHT (10%) and the androstanediols (6%) whilst the BCLA showed little activity in this respect. Comparing these in-vitro data with in-vivo findings from the literature, in both organs there is a positive correlation of the extent of binding in vitro to the stimulation of growth in vivo, bearing in mind that testosterone is metabolized to 5alpha-DHT in the prostate whilst in the BCLA, 5alpha-reductase is essentially absent.

Animals↗
PubMed2000

Levator ani muscle activity in pregnancy and the postpartum period: a myoelectric study.

The levator ani (LA) is a muscle of evacuation and acts as well to support the pelvic viscera. An increase of the intra-abdominal pressure beyond the physiologic limits and visceral overload are speculated to interfere with LA functional activity. This consideration was a stimulus to study the effect of pregnancy on the LA muscle. The EMG activity of the LA muscle was recorded before and during pregnancy and after delivery in 36 women (mean age 27.2+/-3.1 years, 20 multigravida, 16 primigravida). A needle electrode was inserted into the muscle and LA activity was recorded at rest, and on squeezing and straining in both the erect and recumbent position. In the erect position, the resting and squeezing EMG activity during the first 8 weeks of pregnancy, showed no significant difference (p>0.05) from that before pregnancy, and after that, increased progressively and significantly until delivery. On straining, the EMG activity showed no significant difference from that before pregnancy in the first 8 weeks, and after that, decreased progressively and significantly till delivery. In the recumbent position, the LA EMG registered similar activity to that in the erect position but with significantly lower values (p<0.05). The reduction in the LA EMG activity was more evident in the multi-than in the primigravida. In the postpartum period, no LA EMG activity was recorded in the first month; the activity increased progressively after that time to reach the pre-pregnancy level in the forth postpartum month. In conclusion, pregnancy interferes with EMG and functional activity of the LA from the 8th week onwards due to the progressively increasing size and weight of the uterus. This effect was most marked in the last 12 weeks. Delivery seems to maximally inhibit the LA activity in the first postpartum month. Excessive LA traumatization may eventually lead to levator dysfunction syndrome.

Adult↗
PubMed1975

Effect of foreign innervation on contractile and histochemical properties of the transplanted levator ani muscle of the rat.

Heterotopic transplantation of the levator ani (LA) muscle into the bed of the fast tibialis anterior (TA) or slow soleus (SOL) muscle respectively results in transformation of contractile and histochemical properties of the muscle dependent on the new "foreign" innervation. This transformation is observed after transplantation of minced muscle tissue and of free grafts. The result of transformation is more pronounced in the case of free LA-TA grafts which show progressive shortening of contractile response, whereas the LA-SOL shows slight shortening. The heterotopically transplanted free LA-SOL and the LA-TA grafts become relatively faster than the respective original muscle, suggesting operation of myogenic factors related to the fast LA muscle. Maximal tetanic tension output of the free heterotopic grafts 60 days after transplantation recovers to only about a quarter of the correspondong control muscles. Recovery of speed of contraction in the transplanted LA muscle is similar to that observed after selfreinnervation after crushing the pudendal nerve close to its entry into the muscle. In the heterotopically transplanted muscles the reversal of the originally uniform histochemical fibre pattern to a mixed fibre pattern in respect to ATPase and SDH activity is dependent on the type of innervation. After selfreinnervation of the LA muscle by the pudendal nerve a uniform fibre pattern is maintained with regeneration of the nerve.

Adenosine Triphosphatases↗
PubMed1975

Genetic differences in the levator ani muscle weight between inbred and congenic mouse strains.

Significant differences in relative weight of the levator ani muscle (LAW) between inbred and congenic mouse strains, differing genetically only by the major histocompatibility H-2 complex were found. It is assumed that a genetic factor (Hom-1), identical or closely associated wi th the H-2 complex, is one of the genes which influence LAW. These experiments suggest that for assay methods for myotropic activity of androgens groups of animals may be used with a homogenous genotype.

Anabolic Agents↗
PubMed1992

Hormonal regulation of motor unit size and synaptic strength during synapse elimination in the rat levator ani muscle.

Previous anatomical studies suggest that androgen regulates synapse elimination in the androgen-sensitive levator ani(LA) muscle of the rat. Androgen treatment beginning on postnatal day 7 (P7) prevents some of the normal loss of multiaxonal innervation in this muscle. The present study used physiological techniques to measure the number and size of LA motor units during the synapse elimination period in muscles from normals, and castrates treated with either testosterone propionate or oil. The number of increments in LA twitch tension as nerve stimulation intensity increased, a measure of the number of motor units, was the same at the end (P28) of synapse elimination as near the beginning (P7) of this process. This result indicates that motoneuronal cell death does not contribute to synapse elimination in the LA. Moreover, androgen during this period did not influence the number of LA motor units. In contrast, between P7 and P28, there was a dramatic decline in the size of LA motor units, as indicated by a decrease in the percentage of twitch or tetanus tension of individual motor units relative to the maximal twitch or tetanus tension of the whole muscle. In addition, androgen treatment of castrated males during this period prevented some of the normal decline in the size of LA motor units. Estimates of the number of inputs per LA muscle fiber derived from the number of LA motor units and their average size indicate that androgen maintains polyneuronal innervation in the LA muscle. This finding supports previous anatomical studies suggesting that androgen can prevent synapse elimination in this muscle. The strength of LA synapses was also examined by measuring the tetanus: twitch ratio of individual motor units and by measuring the safety margin of LA synapses. Both measurements indicated that the average strength of LA synapses increases during synapse elimination. Moreover, androgen appeared to spare synapses from elimination without increasing their strength, since androgen-treated muscles generally had larger motor units but the same mean tetanus:twitch ratio and safety margins as untreated LA muscles except at P28, when synapses in androgen-treated LA muscles had appreciably lower safety margins than normal. These results suggest that androgen regulates synapse elimination through a mechanism(s) independent of synaptic strength.

Androgens↗