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At least 271 records · Page 15Linked to original sources
PubMed1997

Posterior cruciate recession in total knee arthroplasty.

Incremental recession of the posterior cruciate ligament (PCL), as a part of ligamentous balancing in total knee arthroplasty, is critical if the PCL is too tight. This study was undertaken to evaluate any possible untoward effects of PCL recession. Twenty-one patients who underwent simultaneous bilateral total knee arthroplasty between 1988 and 1992 with a PCL recession performed only on one side (necessary to balance the knee) served as the study group. The average follow-up period was 4 years. The patients were evaluated subjectively, by manual physical testing, by radiography, and by KT-1000 arthrometry (Medmetric, San Diego, CA). There were no significant differences between the recessed and nonrecessed knees. The conclusion is that PCL recession is appropriate and safe long-term for the patient in whom the PCL is found to be too tight at the time of knee arthroplasty.

Aged↗
PubMed2003

Treatment of upshoot and downshoot in Duane syndrome by recession and Y-splitting of the lateral rectus muscle.

BACKGROUND: Duane syndrome is characterized by abduction deficiency, narrowing of the palpebral fissure with retraction of globe on attempted adduction, and upshoot or downshoot, which can be the most prominent feature of the motility disorder. The upshoot and downshoot is believed to be caused by a tautness or leash effect from the lateral rectus muscle. The purpose of this study was to present the results of recession of the lateral rectus muscle with Y-splitting in the treatment of upshoot and downshoot in Duane syndrome. METHODS: Ten patients with Duane syndrome underwent surgery for severe upshoot or downshoot. Lateral rectus muscles recession from 5.0 to 9.0 mm and Y-splitting was accomplished in all patients. In 6 patients, the medial rectus muscles were recessed simultaneously from 5.0 to 6.0 mm to correct the associated marked globe retraction and ocular deviation. RESULTS: Mean age at the time of surgery was 9.9 +/- 6.9 years (range, 3 to 20). Median follow up was 6 months (range, 3 weeks to 3 years). After surgery, all patients showed a marked decrease in upshoot or downshoot as well as improvement in globe retraction and face turn, where present. CONCLUSIONS: Recession of lateral rectus muscle with Y-splitting is an extremely effective procedure in the treatment of significant upshoot and downshoot associated with globe retraction in Duane syndrome. When combined with simultaneous recession of the medial rectus muscle, it improves globe retraction and corrects ocular deviation.

Adolescent↗
PubMed1997

Combined bilateral superior rectus muscle recession and inferior oblique muscle weakening for dissociated vertical deviation.

PURPOSE: Dissociated vertical deviation (DVD) is a common disorder that is often difficult to treat satisfactorily with extraocular muscle surgery. Weakening both elevators in a single eye is uncommonly performed because of possible severe upgaze deficiency or chin-up head posture postoperatively. METHODS: A retrospective review of medical records was performed that yielded 14 patients who had undergone bilateral superior rectus muscle recessions (mean 8.1 mm, range 5-10 mm) and bilateral inferior oblique muscle recession, myectomy, or anterior transposition in the treatment of DVD. Three additional patients with asymmetric inferior oblique muscle overaction or true hypertropia in primary gaze position were identified who had bilateral superior rectus muscle recessions combined with unilateral inferior oblique muscle weakening. RESULTS: Mild-to-moderate elevation deficiencies were common postoperatively but never exceeded -2 up-gaze limitation (scale 0 to -4) except in the immediate postoperative period and were not associated with persistent chin-up head posturing. Cosmetically objectionable upper eyelid retraction occurred in one patient after re-recession of a superior rectus muscle but before inferior oblique muscle surgery. Only three patients undergoing four vertical muscle surgeries had residual DVD >10 PD in primary gaze position, and none exhibited manifest dissociated strabismus warranting further treatment. CONCLUSION: Bilateral superior rectus muscle recession of up to 10 mm combined with inferior oblique muscle weakening appears to be a safe surgical approach in the management of patients with large angle or recurrent DVD. Our data further suggest that simultaneous four vertical muscle surgery may be preferred in some patients to weakening the superior rectus or inferior oblique muscles alone.

Depth Perception↗
PubMed1998

Results of a combined adjustable recession and posterior fixation suture of the same vertical rectus muscle for incomitant vertical strabismus.

PURPOSE: The posterior fixation suture (fadenoperation) is an effective treatment for complicated incomitant vertical strabismus. Traditional operative methods do not permit the simultaneous use of an adjustable recession of the same muscle. METHODS: Seven patients with incomitant vertical strabismus and diplopia were treated with a combined adjustable recession and posterior fixation suture of the same vertical rectus muscle. Preoperative vertical misalignments in the primary position ranged from 4 to 10 prism diopters. Vertical incomitance from the primary position into the field of action of the recessed vertical rectus muscle ranged from 6 to 30 prism diopters (mean, 17 prism diopters). This was the sole operation in five patients and was combined with other vertical muscle surgery in two others. RESULTS: All seven patients experienced improvement in their diplopia. Five of 7 patients (71%) required postoperative adjustments to achieve orthophoria in the primary position. This combined procedure reduced large deviations in the field of action of the recessed vertical muscle in all cases. Six of 7 patients (86%) did not require prismatic correction after this operation. One patient required prism only in his reading glasses. CONCLUSIONS: A combined adjustable recession and posterior fixation suture of the same vertical rectus muscle was effective in reducing or eliminating vertical incomitant strabismus.

Adult↗
PubMedDate not supplied

Eye alignment and cortical binocularity in strabismic kittens: a comparison between tenotomy and recession.

Interocular alignment was assessed by corneal light reflex photography in 15 normal and 26 strabismic kittens. Strabismus was induced at 3-4 weeks of age by severing one extraocular muscle (tenotomy), by cutting and reinserting the muscle at another position on the ocular globe (recession), or by combining recession of the medial rectus muscle with resection of the lateral rectus muscle of the same eye. Nineteen strabismic and five normal kittens were followed longitudinally from 12 days to about 6 months of age. Three out of six longitudinally followed tenotomized cats and six out of the 13 recessed cats conserved their postoperative ocular deviation throughout the testing period ("large-angle strabismics"). Three tenotomized and seven recessed cats showed a transient deviation for 1-2 weeks after surgery, after which the interocular deviation diminished to values found in normal cats ("microstrabismic" cats). Both recessed-resected cats showed a transient interocular deviation. In spite of their different developmental histories, all cats showed a clear breakdown of binocularity in area 17. Large-angle strabismics showed a dominance of the non-operated eye, while in microstrabismic cats, both eyes were equally effective in driving cortical cells. It thus appears that a transient strabismus is sufficient to produce a reduction of binocularity in area 17.

Animals↗
PubMed2000

Smoking habits-a question of trend or unemployment? A comparison of young men and women between boom and recession.

The increased unemployment rates during the 1990s were followed by decreased cigarette consumption. The aim of this study was to analyse the association between unemployment and smoking habits among young men and women during times of prosperity and recession. Two groups of final-year pupils were surveyed five years after leaving school, at the age of 21, in 1986 (boom) and 1994 (recession). The boom group included 1083 pupils; the recession group 898 pupils. The non-response rate was 2% in the boom group and 10% in the recession group. Daily tobacco use was measured through self-administered questionnaires. Daily cigarette smoking was of a lower magnitude during the recession (9.7% among men and 21.9% among women) compared to the boom (19.8% and 37.8%, respectively). A low level of education, and among women also financial problems and motherhood, were associated with more frequent smoking. Unemployment was associated with tobacco consumption, especially among women and during the boom. Thus, smoking habits were found to be a question of both unemployment and tobacco trends in society.

Adult↗
PubMed2000

Recessive expression of the H2A-controlled immune response phenotype depends critically on antigen dose.

Major histocompatibility complex (MHC) alleles acting as immune response genes are coexpressed in heterozygous individuals and therefore control of immune responses is usually codominant. As an exception to this rule, however, several examples of recessive immune responses have been ascribed to regulatory, e.g. suppressive, interactions. We report here that the recessive phenotype of both antibody and T-cell responses to the mycobacterial 16 000-MW antigen depends critically on a low antigen dose for immunization. On the basis of similar responses in hemi- and heterozygous mice, we suggest that the mechanism of recessive MHC control does not involve regulation by the low-responder allele. We also demonstrated mixed haplotype restriction of peptide recognition for a significant fraction of high-antigen-dose primed T cells. Their paucity under limiting antigen dose conditions may lead to the recessive expression of MHC control. In conclusion, our results suggest that recessive MHC control can be explained as a simple gene dosage effect under conditions where antigen is limiting, without a need for regulatory mechanisms.

Alleles↗
PubMed2000

Are recession populations of the desert locust (Schistocerca gregaria) remnants of past swarms?

The desert locust (Schistocerca gregaria) undergoes crowding-induced phase transformation from solitary to gregarious, which involves changes in behaviour, colour, development, morphometry, fecundity and endocrine physiology. During recession, solitary locusts persist in the central, drier part of the species' range in small pocket populations that are prone to extinction. During the intermittent upsurges and the subsequent plagues, gregarious swarms attain huge population size and invade a vast area causing major damage to agriculture. A highly variable nuclear DNA marker, a noncoding 3' end fragment of an antennapedia-class homeobox gene, was screened in locust samples from Eritrea. Despite the homogenizing potential of plague swarms, the last of which was in 1986-89 and originated in this region, the population genetic structure of solitary phase locusts along the Red Sea coast of Eritrea revealed significant divergence. The pattern of divergence indicated that the invasion of the western and northern plains in the summer of 1995 may not, as reported then, have originated in eastern Chad or western Sudan. A number of interrelated hypotheses have been presented to explain the observed genetic heterogeneity between the sampled populations. We conclude, with caution due to the limited sample sizes, that: (i) geographical isolation between breeding sites during plagues and recession; (ii) the marked differences in the flight behaviour of plague swarms and recession populations; (iii) possible failure of gregarious locusts to solitarize and re-establish in recession areas; and (iv) the effect of repeated extinction and recolonization in the meta-population contribute to the maintenance of the genetic structure of recession populations. Potentially productive future research has been identified.

Animals↗
PubMedDate not supplied

Morbidity associated with high gastrocnemius recession: retrospective review of 126 cases.

To evaluate morbidity associated with surgical lengthening of the gastrocnemius, medical records were reviewed retrospectively for 126 patients (mean age, 49.7 years; range, 8-78 years) who had undergone open gastrocnemius recession. Ten patients had isolated recession; 116 had gastrocnemius recession with an additional foot or ankle procedure on the ipsilateral limb. During a mean follow-up period of 19 months (range, 6-50 months), all patients were examined for any postoperative complications associated with the recession. Complications were defined as the presence of postoperative infection, wound dehiscence, nerve problems, decreased muscle strength, scar problems, or calcaneus gait (overlengthening). Uncomplicated outcome was defined as absence of all these complications and return to regular activity, both occurring during a follow-up of at least 6 months. Postsurgical complications developed in 9 (6%) of the 126 patients: 6 (4%) had scar problems, 2 (1.33%) had wound dehiscence, 2 (1.33%) had infection, 3 (2%) had nerve problems, and 1 (0.67%) developed complex regional pain syndrome. No patient complained of either a limp or gait disturbance. Neither persistent decrease in muscle strength nor calcaneus gait was seen. These data suggest that the open gastrocnemius recession procedure has low associated morbidity.

Adolescent↗
PubMed2000

Bilateral lateral rectus recession for consecutive exotropia.

INTRODUCTION: Treatment of consecutive exotropia after bilateral medial rectus recessions has been rarely studied. Though several series have reported results of medial rectus advancement, none has described results of lateral rectus recessions. METHODS: We reviewed our results in 31 patients who underwent bilateral lateral rectus recessions for consecutive exotropia after bilateral medial rectus recessions. Mean follow-up was 30 months (range, 1-140 months) after the exotropia repair. RESULTS: At last follow-up, 20 of 31 patients (65%) had deviations of less than or equal to 10 PD. Limitation of adduction was not apparent. DISCUSSION: Cooper's dictum states that lateral rectus recession should be performed instead of medial rectus advancement. Our results suggest that this approach is generally successful. The outcome after exotropia repair in consecutive deviations is comparable to that after repair of primary exotropia.

Adolescent↗
PubMed2003

Retroequatorial recession of horizontal recti with loop suture in the treatment of congenital nystagmus.

PURPOSE: The authors wished to evaluate the effectiveness and safety of retroequatorial recession of all four horizontal recti using loop sutures for the treatment of congenital nystagmus SUBJECTS AND METHODS: Twelve patients with congenital nystagmus were enrolled in this prospective study. All patients underwent retroequatorial recession of horizontal recti with loop sutures. All recti were recessed 8 mm measuring from the insertion, then the amount of loop suture was determined according to the preoperative ocular alignment of the patients. Electronystagmographic recordings were made in every patient preoperatively and postoperatively as well as an ophthalmological examination. The follow-up period ranged from 6 to 26 months. RESULTS: All four horizontal recti were recessed 9 to 12 mm including the loop suture (range 1-4 mm). Compared to preoperative values, postoperative amplitude and intensity of nystagmus decreased statistically significantly in all patients (p = 0.002). The postoperative decrease in the frequency of nystagmus was not statistically significant (p = 0.173). Improvement of both distance and near visual acuity was achieved in 10 patients. Five of seven patients who had ocular misalignment preoperatively were aligned within 10 PD postoperatively. Improvement in head posture was seen in two of three patients. The authors determined that the improvement in the nystagmus characteristics was most prominent in the immediate postoperative period. CONCLUSION: Retroequatorial recession of all four horizontal recti using loop sutures is a safe and effective procedure for the management of congenital nystagmus.

Adolescent↗
PubMed2006

Increasing children's physical activity levels during recess periods in elementary schools: the effects of providing game equipment.

BACKGROUND: During recess, children can be active on a daily basis, making it an important school environmental factor for the promotion of health-related physical activity. The aim of the present study was to investigate the effects of providing game equipment on children's physical activity levels during morning recess and lunch break in elementary schools. METHODS: Seven elementary schools were randomly assigned to the intervention group (four schools), including 122 children (75 boys, 47 girls, mean age: 10.8 +/- 0.6 years), and to the control group (three schools), including 113 children (46 boys, 67 girls, mean age: 10.9 +/- 0.7 years). Children's activity levels were measured before and three months after providing game equipment, using MTI accelerometers. RESULTS: During lunch break, children's moderate and vigorous physical activity significantly increased in the intervention group (moderate: from 38 to 50%, vigorous: from 10 to 11%), while it decreased in the control group (moderate: from 44 to 39%, vigorous: from 11 to 5%). At morning recess, providing game equipment was effective in increasing children's moderate physical activity (from 41 to 45%), while it decreased in the control group (from 41 to 34%). CONCLUSION: Providing game equipment during recess periods was found to be effective in increasing children's physical activity levels. This finding suggests that promoting physical activity through game equipment provision during recess periods can contribute to reach the daily activity levels recommended for good health.

Analysis of Variance↗
PubMed2004

A novel mechanism in recessive nephrogenic diabetes insipidus: wild-type aquaporin-2 rescues the apical membrane expression of intracellularly retained AQP2-P262L.

Vasopressin regulates water homeostasis through insertion of homotetrameric aquaporin-2 (AQP2) water channels in the apical plasma membrane of renal cells. AQP2 mutations cause recessive and dominant nephrogenic diabetes insipidus (NDI), a disease in which the kidney is unable to concentrate urine in response to vasopressin. Until now, all AQP2 mutants in recessive NDI were shown to be misfolded, retained in the endoplasmic reticulum (ER) and unable to interact with wild-type (wt)-AQP2, whereas AQP2 mutants in dominant NDI are properly folded and interact with wt-AQP2, but, due to the mutation, cause missorting of the wt-AQP2/mutant complex. Here, patients of two families with recessive NDI appeared compound heterozygotes for AQP2-A190T or AQP2-R187C mutants, together with AQP2-P262L. As mutations in the AQP2 C-tail, where P262 resides, usually cause dominant NDI, the underlying cell-biological mechanism was investigated. Upon expression in oocytes, AQP2-P262L was a properly folded and functional aquaporin in contrast to the classical mutants, AQP2-R187C and AQP2-A190T. Expressed in polarized cells, AQP2-P262L was retained in intracellular vesicles and did not localize to the ER. Upon co-expression, however, AQP2-P262L interacted with wt-AQP2, but not with AQP2-R187C, resulting in a rescued apical membrane expression of AQP2-P262L. In conclusion, our study reveals a novel cellular phenotype in recessive NDI in that AQP2-P262L acts as a mutant in dominant NDI, except for that its missorting is overruled by apical sorting of wt-AQP2. Also, it demonstrates for the first time that the recessive inheritance of a disease involving a channel can be due to two cell-biological mechanisms.

Amino Acid Sequence↗
PubMed2005

Autosomal recessive Alport syndrome: an in-depth clinical and molecular analysis of five families.

BACKGROUND: Alport syndrome (ATS) is a progressive inherited nephropathy characterized by irregular thinning, thickening and splitting of the glomerular basement membrane (GBM) often associated with hearing loss and ocular symptoms. ATS has been shown to be caused by COL4A5 mutations in its X-linked form and by COL4A3 and COL4A4 mutations in its autosomal forms. METHODS: Five families with a suspicion of ATS were investigated both from a clinical and molecular point of view. COL4A3 and COL4A4 genes were analysed by DHPLC. Automated sequencing was performed to identify the underlying mutation. RESULTS: Molecular analysis indicated that in all 5 cases the correct diagnosis was autosomal recessive ATS. In three families in which parental consanguinity clearly pinpointed to autosomal recessive ATS, we found COL4A4 homozygous mutations in two of them and COL4A3 homozygous mutation in the other one. In the remaining two families a differential diagnosis including X-linked ATS, autosomal recessive ATS and thin basement membrane nephropathy was considered. The molecular analysis demonstrated that the probands were genetic compounds for two different mutations in the COL4A4 gene pinpointing to the correct diagnosis of autosomal recessive ATS. CONCLUSIONS: A clinical evaluation of probands and their relatives of the five families carrying mutations in either the COL4A3 or the COL4A4 gene was carried out to underline the natural history of the autosomal recessive ATS. In addition, this paper stresses the complexity of the clinics and genetics of ATS and how a correct diagnosis is based on a combination of: (i) an in-depth clinical investigation; (ii) a detailed formal genetic analysis; (iii) a correct technical choice of the gene to be investigated; (iv) a correct technical choice of the family member to be included in the mutational screening. A correct diagnosis is the basis for an appropriate genetic counselling dealing with both the correct prognosis and the accurate recurrence risk for the patients and family members.

Adolescent↗
PubMed1996

Fluid collection in the pericardial sinuses and recesses. Thin-section helical computed tomography observations and hypothesis.

RATIONALE AND OBJECTIVES: This study describes the thin-section helical computed tomography (CT) appearance of near-water-density structures situated posterior to the pulmonary trunk and right main pulmonary artery, and to consider the implications of these CT images. METHODS: Three-millimeter-thick helical CT scans of the mediastina of 133 patients were reviewed to determine the incidence and range of appearance of near-water-density structures situated posterior to the pulmonary trunk and right main pulmonary artery. Thin-section helical CT appearance was compared with that of fluid collection in the pericardial sinuses and recesses of patients with pericardial effusion, and with descriptions of the pericardial sinuses and recesses in the literature. RESULTS: Near-water-density structures showing varied appearance ranging from bands to mass-like densities were observed on thin-section helical CT images of 49 patients (37%) who had no obvious effusion in the pericardial cavity proper. The locations of the structures corresponded to the sites of recesses in the transverse and oblique sinuses, and their appearance was similar to that of fluid in the pericardial sinuses and recesses. CONCLUSION: Near-water-density structures situated posterior to the pulmonary trunk and right main pulmonary artery in patients without obvious pericardial effusion were concluded to be physiologic fluid collections in the recesses of the transverse and oblique sinuses.

Carcinoma, Bronchogenic↗
PubMed2001

Clinical importance of supratubal recess in cholesteatoma surgery.

OBJECTIVE: To determine the importance of supratubal recess in cholesteatoma surgery by presenting the clinical presentation, imaging findings, and surgical treatment methods of 66 patients with cholesteatoma. We propose that the management of supratubal recess allows the opportunity for total removal of the cholesteatoma with the prevention of recurrence. STUDY DESIGN: Retrospective review of surgical cases. SETTING: Tertiary referral center. INTERVENTIONS: Diagnostic and therapeutic procedures were performed. PATIENTS AND METHODS: We present a series of patients with involvement of supratubal recess by reviewing the operative charts of 347 patients surgically treated for aural cholesteatoma between 1990 and 1999. RESULTS: We detected the involvement of supratubal recess in 19% (n = 66) of our operations for aural cholesteatoma removal. CONCLUSION: The intent of this study is to improve the chance for a successful outcome by decreasing the rate of recurrence. The surgical approach to supratubal recess in cholesteatoma operations is emphasized with our series.

Adolescent↗
PubMed2025

Biallelic variants in RNU2-2 cause the most prevalent known recessive neurodevelopmental disorder.

We recently showed that mutations in RNU4-2 and RNU2-2, two genes that are transcribed into small nuclear RNA (snRNA) components of the major spliceosome, are prevalent causes of dominant neurodevelopmental disorders (NDDs). By genetic association comparing 12,776 NDD cases with 56,064 controls, we now demonstrate the existence of a recessive form of RNU2-2 syndrome that, in England, is even more common than the dominant form. We inferred log Bayes factors for dominant and recessive models of association of 14.0 and 18.2, respectively, and observed 17 rare variants with a posterior probability of pathogenicity conditional on recessive association >0.8. This conservative threshold identified 18 probands (all with unaffected parents) and five affected siblings, each carrying two alleles in trans at these variants. A relaxed threshold of >0.6 identified a further 13 candidate probands. We estimate that recessive RNU2-2 syndrome accounts for 7-10% of families with a diagnosed recessive NDD, and is 36-62% as prevalent as the dominant RNU4-2-related disorder ReNU syndrome. We identified a further seven cases in five pedigrees in two replication collections. Cases are characterized by intellectual disability, global developmental delay and seizures. The variants are predicted to destabilize stem loops and binding domains of the U2-2 snRNA that contribute to spliceosome quaternary structure, intron recognition and catalytic function. Despite this, whole-blood derived RNA-seq data from three patients did not reveal splicing defects, in line with previous analogous observations for dominant RNU2-2 syndrome.

Journal Article↗
PubMed1977

Gingival recession and tooth mobility.

Tooth mobility measurements were carried out on 107 teeth with gingival recession in 20 subjects. Alveolar bone dehiscence around 43 of these teeth was measured during flap surgery in 13 subjects. No significant correlation was found between gingival recession and tooth mobility, and between tooth mobility and alveolar bone dehiscence. A positive, significant correlation was present between gingival recession and bone dehiscence. In 17 of the subjects, tooth mobility of 29 homologous contralateral teeth with and without gingival recession was compared. The difference was not significant. The role of trauma from occlusion in the etiology of gingival recession is questioned.

Adolescent↗