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Effect of indomethacin on the development of eccentric exercise-induced localized sensitive region in the fascia of the rabbit.

The effect of indomethacin on the development of delayed onset muscle soreness (DOMS) and localized sensitive region produced by eccentric exercise was examined in lightly anesthetized rabbits (n=12, 2.0-3.3 kg). Repeated eccentric contractions of the gastrocnemius (GS) muscle were made by manual extensions during the tetanic contractions induced by electrical stimulation of the tibial nerve. The development of DOMS was confirmed by evoked reflex EMG in the biceps femoris (BF) muscle elicited by a quantitative manual extension of the GS muscle. The distribution of thresholds for the evoked BF EMG was measured by focal electrical stimulations of the GS muscle. Indomethacin (5 mg/kg in 2% sodium bicarbonate) or a vehicle was injected subcutaneously before, during, and after the exercise (a total of 60 mg/kg in 12 doses). A clear ropy taut band was palpated at the GS muscle on the second day after the exercise and a localized sensitive region for evoked BF EMG was detected at the depth of the fascia of the band in the exercise and vehicle groups, whereas no such phenomena appeared in the control and indomethacin groups. The palpable band and sensitive region disappeared on the seventh day after the exercise. That indomethacin inhibits the development of DOMS and the localized sensitive region suggests that a sensitization of polymodal-type nociceptors in the fascia mediated by prostaglandins is a possible mechanism for the development of DOMS and the localized sensitive region.

Animals↗

Extended vascularized temporalis muscle-fascia flap.

The use of an extended vascularized temporalis muscle flap is described. The deep layer of the temporalis fascia is partially everted over the temporalis muscle preserving its vascularity. A composite flap comprising temporalis muscle and its fascia attached along its superior border, is rotated for reconstruction of postoperative defects in the middle cranial fossa floor and mastoidectomy cavities. The versatility of this flap is discussed.

Cholesteatoma↗

Sensory innervation of human thoracolumbar fascia. An immunohistochemical study.

We have studied the human thoracolumbar fascia by using antiserum against neurofilament protein (NFP) and S-100 protein to identify sensory nerve fibers and their endings. Seven surgical specimens from 7 patients were studied with light microscopy. In addition to free nerve endings, two types of encapsulated mechanoreceptors (Ruffini's and Vater-Pacini corpuscles) were identified. These findings support the hypothesis that the thoracolumbar fascia may play a neurosensory role in the lumbar spine mechanism.

Adult↗

Symptomatic forearm muscle hernia: repair by autologous fascia lata inlay.

Eleven cases of symptomatic muscle hernias of the forearm requiring surgical intervention have been described previously. Pain on extremity exertion and an unaesthetic bulge of the forearm were the primary indications for surgery. Advocated treatment modalities range from forearm fasciotomy to anatomic repair of the fascial defect. Although fasciotomy relieves the narrow fascial constriction around the herniated muscle reliably, it often yields an unappealing forearm deformity and incomplete resolution of pain on extremity exertion. Anatomic repair provides the theoretical advantage of restoring normal muscle fascia relationships while concomitantly improving the aesthetic appearance of the extremity. The authors report a case of symptomatic forearm muscle herniation treated successfully with an autologous fascia lata inlay graft.

Adult↗

[TRAM flap breast reconstruction using a fascia-sparing technique].

Although the TRAM flap has been accepted as one of the most common methods for breast reconstruction utilizing the autologous tissue, its disadvantage is that scarring of the abdominal sheath and muscle may result in postoperative abdominal bulge or hernia. To solve this problem, the authors developed the fascia-sparing technique in TRAM flap breast reconstruction. The technique, in which most of the anterior rectus sheath is preserved, has been applied in 3 patients after radical mastectomy and 7 patients after modified radical mastectomy. With an average follow-up period of 1 year and 2 months, no abdominal bulge or hernia was noted in any patient without the use of prosthetic mesh for the abdominal closure. This fascia sparing technique is particularly effective for TRAM flap reconstruction requiring bilateral rectus abdominis muscle portions and containing only a few minor perforators, for which a DIEP flap is not suitable.

Adult↗

[Anatomical study and clinical applications of the tensor fascia lata myocutaneous flap].

OBJECTIVE: To explore the causes of blood circulation problems in 3 of 6 cases of pedicled tensor fascia lata myocutaneous flap transferring. METHODS: Anatomical study was performed on 16 cadavers (32 sides) after red emulsion injection. RESULTS: On 22 sides of 12 cadavers, the nutrient arteries lie in the muscle; on 2 sides of 2 cadavers, intramuscular nutrient arteries coexist with the big branches anterior to the muscle; on 4 sides of 3 cadavers, intramuscular nutrient arteries coexist with the big branches in the loose connective tissue deep to the muscle; on 4 sides of 3 cadavers, the nutrient arteries locate in the subcutaneous layer. According to the anatomical observations, much attention were paid to protect the vessels deep, superficial and anterior to the muscle during surgery, which resulted in successful clinical applications in 8 cases. CONCLUSIONS: The supplying arteries of the tensor fascia lata myocutaneous flap may exit not only intramuscularly, but also deep, superficial and anterior to the muscle. Special attention should be paid to them during operation.

Adolescent↗

[Expanded extra-long fascia flap in the trapezius region for repair of scar contracture of the neck].

OBJECTIVE: In order to gain a larger fascia flap in the trapezius region and to close the donor site easily and primarily. METHODS: We applied tissue expansion to form the expanded extra-long trapezius fascia flap. RESULTS: The flap was used to repair the neck scar contracture with satisfactory effects. CONCLUSIONS: The flap is very useful for patients who have a large burned defect and are short of donor sites, especially the children.

Adolescent↗

Formaldehyde-formed autogenous fascia graft tympanoplasty.

The formaldehyde-formed autogenous fascia graft represents another step toward more reliable functional restoration of the diseased tympanic membrane. It combines the advantages of the availability and high nonperforation rate of autogenous fascia with the more normal anatomic restoration experienced with homograft tympanic membrane grafts. Its primary indication is in total membrane perforations with intact malleus although the concept can be employed in conjunction with various types of ossicular reconstruction.

Dilatation↗

[Comparison of biomechanical properties between human nasal periosteum and fascia].

There has been a lot of controversies on which layer the silastic implants should be inserted in the augmentation rhinoplasty, i.e. subperiosteal or deep subfascial. This study is to investigate the biomechanical properties of human nasal periosteum and deep fascia, including tensile strength, stress-strain and stress relaxation characters under uniaxial tension system. The periosteum is stronger in tensile strength than that of the fascia, but it is less elastic. Under a sudden increase of load, the periosteum relaxes far less than the fasia. Therefore, in view of biomechanics, the periosteum is thicker, tougher, stiffer and less relaxation than facia, thus has a better fixation effect.

Biomechanical Phenomena↗

Treatment of femoral neck fracture with muscle-bone flap of both tensor fasciae latae and sartorius.

OBJECTIVE: To evaluate the effect of muscular pedicle bone grafts with sartorius or tensor fasciae latae and sartorius in fresh transcervical or subcapital fractures of the femoral neck. METHODS: Thirty cases of fresh transcervical and subcapital fractures of the femoral neck were treated by the tail breakable screws and sartorius pedicle bone grafts (single muscular pedicle, SMP group). The other 23 cases were treated by cannulated pressure screws and bone grafts with the muscular pedicles of both sartorius and tensor fasciae latae (double muscular pedicles, DMP group). RESULTS: Fifty-two cases were followed up for 3 to 5 years (mean, 4 years). In SMP group, ten cases showed poor therapeutic results. Excellent therapeutic effects were achieved in all cases of DMP group. CONCLUSIONS: The transcervical or subcapital fractures of the femoral neck can be treated by double muscular pedicles bone graft. The bone graft with double muscular pedicles is more effective than single sartorius muscular pedicles for fresh transcervical and subcapital fractures of the femoral neck during short and medium terms.

Bone Transplantation↗

[Morphological evaluation of fascia lata tissue implantation for chondral defects in the knee joint of sheep under active motion and load].

Experiments carried out on 64 knees of 32 Lein sheep with superficial and deep chondral defects of the patella and femoral condyles covered by autogenic fascia lata grafts indicate that under active motion and load the grafted tissue after 6 weeks is thinner, fragile and lustreless. Quantitative and qualitative deterioration of collagen fibers, almost complete atrophy of elastic fibers and increase in number of cells and vessels is observed under microscope. After 9 weeks remodeling of the fascia occurs which thickens and increases in number of fascicular collagen fibres, after 12 weeks the foci of neochondrogenesis can be found. After 26 weeks a new hyaline like cartilage is generated surrounded by connective tissue containing fascicular collagen and elastic fibers. At this point remodeling is not yet completed.

Animals↗

Glaucoma implant surgery with autogenous fascia lata in scleromalacia perforans.

A 51-year-old woman with bilateral scleromalacia perforans and advanced glaucoma in the left eye was evaluated. Glaucoma implant surgery with autogenous fascia lata graft for reinforcement of the underlying sclera and a patch graft overlying the tube to prevent tube erosion was planned because of insufficient response to medical glaucoma therapy. Intraocular pressure decreased from 55 to 15 mm Hg and remained under 20 mm Hg throughout the follow-up period of 24 months. No complication was noted. Glaucoma implant surgery using autogenous fascia lata to form a healthy ground and a patch graft to prevent tube erosion seems to be a safe and effective method when normal sclera is lacking, such as in scleromalacia perforans.

Fascia Lata↗

Tissue reactions of the rabbit urinary bladder to cadaveric human fascia lata and polypropylene surgical mesh.

OBJECTIVE: To evaluate and compare histological tissue reactions of the urinary bladder to human cadaveric fascia lata (CFX) slings and synthetic mesh. METHODS: Thirty rabbits were randomized to three groups: group A (multifilament - Surgipro Mesh) 12 animals, group B (CFX) 12 animals, and group C (surgical controls) 6 animals. A piece of Mesh or CFX was fixed in direct contact with the anterior bladder neck wall. The control group simply underwent sham bladder manipulation. The animals were sacrificed at 6- and 12-week intervals, and their bladders were collected for histological analysis. RESULTS: Group A showed fibrosis within the detrusor of the bladder wall in half of specimens, including marked trans-mural inflammation in one case. The graft was incorporated within a plate of fibrous tissue with a foreign body-type granulomatous reaction to the synthetic material. In group B, no fibrosis or inflammation was seen within the bladder wall. The graft showed marked inflammation (mixed cell infiltrate) in all specimens, whereas foci of devitalized collagen with associated foreign body-type granulomatous changes and dystrophic calcification were present in more than half of specimens. No histopathological alteration was found in the control group. CONCLUSION: Significant histopathological changes within the bladder wall occur in response to synthetic mesh as compared to CFX over two tested time intervals. We believe these differences are related to the lack of reported adverse outcome with the use of cadaveric fascia lata slings in regard to graft erosion or infection when compared to complications occurring with the use of artificial materials.

Animals↗

[Treatment of the Goebell-Stoeckel fascia lata sling operation for female stress urinary incontinence].

OBJECTIVE: To observe the efficacy and safety of the goebell-stoeckel fascia lata sling operation for female stress urinary incontinence. METHODS: Thirteen patients suffering from stress urinary incontinence (SUI) with prolapsed vagina were enrolled into this study. The average follow-up time was thirty months. The outcomes and complications after operation were analysed. RESULTS: All patients had complete cure. There were no vaginal bleeding, infection, rejection for surgery and no recurrent cases. Five patients had mild temporary dysuria, which disappeared within one month. CONCLUSION: The goebell-stoeckel fascia lata sling operation is an effective, safe, well-tolerated procedure for treatment of SUI.

Aged↗

Treatment of temporomandibular joint ankylosis with temporalis superficial fascia flap.

Temporomandibular joint (TMJ) ankylosis is characterized by the formation of bony or fibrous mass, which replaces the normal articulation and limitation of mouth opening. This study aims to determine the efficacy of arthroplasty and interpositional fascia flap in the treatment of unilateral and bilateral TMJ ankylosis in three young adult men. Our operative protocol for unilateral and bilateral TMJ ankylosis entailed resection of ankylotic mass, intraoral ipsilateral and bilateral arthroplasty, interpositional tissue transfer to the TMJ with temporalis superficial fascia flap, maxillomandibular fixation, and early mobilization and aggressive physiotherapy. Early postoperative initial exercise, physiotherapy, and strict follow-up play an important role in preventing postoperative adhesions. The temporalis superficial facia flap is an autogenous graft that has the advantages of close proximity to the TMJ minimal surgical morbidity, and successful clinical results. It was found to be a valuable option for TMJ ankylosis reconstruction.

Adult↗

[Suspending of M. temporal, temporal fascia and parietal periosteum to correct late facial palsy].

OBJECTIVE: To explore a simply, effective dynamical method to correct late facial palsy. METHODS: The method of suspending of M. temporalis, temporal fascia was reformed below: (1) To prolong flap of M. temporalis, temporal fascia by parietal periosteum. (2) To elevate the reversal level of compound flap. (3) To fill depressed temporal area by silica gel piece. RESULTS: The compound flap is united structurally and long enough to transfer. Temporal defect is recontoured. And zygomatic area is no longer protruded. CONCLUSIONS: The reformative method resists defect of the old one and obtains a dynamical result.

Adult↗

[Extracellular matrix of xenogenic femoral fascia for the repair of renal trauma].

OBJECTIVE: To study the effect of extracellular matrix of xenogenic femoral fascia in repair of renal trauma. METHODS: Twelve adult dogs were used and randomly assigned to 6 groups, and the animals were sacrificed separately in 1 and 2 weeks 1,2,4 and 8 months after renal repair operations. The examinations of blood and urine routine, blood urea nitrogen and creatinine, electrolyte and serum renin were performed before and after operations at various times. The creatinine clearances of affected and contralateral normal kidneys were evaluated before death and the local areas of renal repair were studied by light and electron microscopy. RESULTS: Bleeding was stopped completely after the entire patch was sutured, and only mild adhesions to around tissues were found in various times after operations. As time passed, the repair patch was replaced by smooth neocapsule like normal renal capsule. CONCLUSION: Extracellular matrix of xenogenic femoral fascia might be an ideal tissue engineering material for renal repair.

Animals↗

[The fascia of the inguinal canal ring].

The fascial anatomy of the inguinal canal has been investigated. The spermatic cord is fixed by two cords in addition to its embedding in connective tissue after leaving the inguinal canal. The spermatic cord has a special fastening in form of a noose at the deep inguinal ring. The transversalis fascia consists of an internal and an external leaf. A part of the internal leaf forms with three cords this noose and builds so a sphincter-like closure mechanism, which reduces the size of the deep inguinal ring by a local erection of the transversalis fascia. The internal leaf protects from an indirect inguinal hernia as well as from a direct inguinal hernia, because the wall of the so-called Hesselbach's triangle only consists of the internal leaf. A list of the anatomical synonyms is added.

Abdominal Muscles↗