Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “Tenotomy”

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 757 records · Page 42Linked to original sources
PubMed1996

Patellar tendinosis (jumper's knee): findings at histopathologic examination, US, and MR imaging. Victorian Institute of Sport Tendon Study Group.

PURPOSE: To determine the histopathologic findings of patellar tendinosis ("jumper's knee") demonstrated with ultrasonography (US) and magnetic resonance (MR) imaging. MATERIALS AND METHODS: Twenty-four athletes (28 knees) with jumper's knee (23 men, one women; mean age, 30.9 years) scheduled to undergo open tenotomy underwent US patellar tendon examination. Seventeen patients (19 knees) also underwent MR imaging. Tissue was obtained for histopathologic examination in all 28 cases. Eleven age-, height-, and weight-matched athletes (22 knees) without previous knee symptoms served as control subjects for the US examination. Control material for histopathologic examination was obtained in 20 cadavers (39 knees). Data were analyzed with standard statistical methods. RESULTS: MR imaging and US both revealed an abnormal zone at the proximal patellar tendon attachment. Histopathologic examination revealed mucoid degeneration in all tendons in patients and in 8% (three of 39) of tendons in cadavers (P < .01). CONCLUSION: Jumper's knee is characterized by consistent changes at MR imaging, US, and histopathologic examination and is appropriately described as patellar tendinosis.

Adult↗
PubMed2002

Dystrophin-glycoprotein complex and Ras and Rho GTPase signaling are altered in muscle atrophy.

The dystrophin-glycoprotein complex (DGC) is a sarcolemmal complex whose defects cause muscular dystrophies. The normal function of this complex is not clear. We have proposed that this is a signal transduction complex, signaling normal interactions with matrix laminin, and that the response is normal growth and homeostasis. If so, the complex and its signaling should be altered in other physiological states such as atrophy. The amount of some of the DGC proteins, including dystrophin, beta-dystroglycan, and alpha-sarcoglycan, is reduced significantly in rat skeletal muscle atrophy induced by tenotomy. Furthermore, H-Ras, RhoA, and Cdc42 decrease in expression levels and activities in muscle atrophy. When the small GTPases were assayed after laminin or beta-dystroglycan depletion, H-Ras, Rac1, and Cdc42 activities were reduced, suggesting a physical linkage between the DGC and the GTPases. Dominant-negative Cdc42, introduced with a retroviral vector, resulted in fibers that appeared atrophic. These data support a putative role for the DGC in transduction of mechanical signals in muscle.

Animals↗
PubMed1991

Muscle acetylcholinesterase adapts to compensatory overload by a general increase in its molecular forms.

We have investigated the impact of compensatory overload on the content of acetylcholinesterase (AChe) molecular forms in the rat fast-twitch medial gastrocnemius (MG). Overload was induced by way of a bilateral tenotomy of the MG's functional synergists coupled to a daily walking training program (15 m/min, 30% incline, up to 60 min per session, 12-18 wks). This latter condition ensured that the MG were used on a regular basis. In comparison to control values, overloaded MG showed 25 and 19% increases (P less than 0.05) in muscle wet weight and protein concentration, respectively. The content in AChe (activity per muscle) was also increased in these MG (28%, P less than 0.05). Sedimentation analyses revealed a general elevation in the content of AChe molecular forms, with A8, G2, and G1 displaying significant changes (35-42%, P less than 0.05). In a second group of rats, daily running training (27 m/min, 30% incline, using the same timetable) was supplemented to the compensatory overload. In this group, the additional running training led to a greater hypertrophic response as attested to by increases (P less than 0.05) in the MG wet weight (41%) and protein concentration (35%) in comparison to controls. However, total AChe content of these muscles was increased to an extent similar to that observed in the MG subjected only to compensatory overload (24%, P less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholinesterase↗
PubMed1980

Spatial localization in cats reared with strabismus.

1. The capacity for judging the location of an object relative to the body (egocentric localization) was assessed in cats by measuring the landing position attained when the cat jumped toward a platform viewed from a known distance. 2. Normal cats and kittens land at center of the platform when using one eye or both. In contrast, nine animals tested immediately after tenotomy of the medial rectus muscle of one eye all landed consistently off-center when using the operated eye. The direction of the error was predictable from the assumption that the cat was unaware of the eye's deviation from its natural position. Thus, proprioceptive reafference is not capable, under these conditions, of supporting an accurate awareness of eye position. 3. After initial testing, all cats were maintained in a normal environment with both eyes open and were tested intermittently. Jumps guided by the deviated eye became accurate over a period of weeks in kittens younger than 4 mo. In contrast, behavioral adjustment in older kittens required many months. An adult cat displayed almost no adjustment over a period of 9 mo. 4. Five additional kittens were first tested several months after the onset of strabismus. These animals manifested accurate use of the operated eye from the first trial onward. Therefore, acquisition of accurate use of the deviated eye is not dependent on repeated testing. 5. Two kittens subjected to early exodeviation of one eye displayed a reduced capacity for adjustment when subjected to late exodeviation of the second eye. Thus, changes in neural function resulting from early strabismus (for instance, the loss of binocular connectivity in striate cortex) do not produce persistent behavioral flexibility. 6. In two strabismic kittens with a fully developed compensatory adjustment of monocular egocentric localization, the capacity for judging the relative location of two objects viewed simultaneously through separate eyes was assessed through use of a two-choice visual discrimination paradigm. One animal made predictable systematic errors, while the other exhibited correct judgments. Thus, it appears that a compensatory shift of retinal correspondence may occur in some strabismic kittens, but that such a change is not necessary for accurate use of the deviated eye in monocular visual guidance. 7. A number of observations are described that tend to indicate that cats reared with strabismus continue to use both the deviated and the nondeviated eye for visual guidance under binocular viewing conditions, unlike many human strabismics.

Adaptation, Physiological↗
PubMed1991

Disruption of binocularly correlated signals alters the postnatal development of spatial properties in cat striate cortical neurons.

1. Extracellular single-cell recording techniques were employed to investigate the effects of ocular misalignment on the postnatal development of the spatial response properties of striate cortical neurons. The primary objective of the study was to gain insight into the neural basis of strabismic amblyopia. 2. Two basic rearing strategies were used to study specific aspects of experimental strabismus in developing kittens. In one group, strabismus was optically induced by fitting kittens with goggles that held a 15-diopter base-in prism in front of one eye (MP) or both eyes (BP) between the ages of 4 wk and 4 mo. In the second group, a unilateral esotropia was surgically induced at 3 wks of age either by the simple resection of the lateral rectus muscle tendon (tenotomy) or by a more drastic procedure that involved removing sections of the lateral rectus and superior oblique muscles (myectomy). In addition, the eyelids of the nondeviating eyes of these kittens were sutured closed (ESO/MD). The first rearing paradigm isolated the effects of conflicting visual inputs on neural development, whereas the second procedure isolated the effects of anomalous ocular motility by producing a misalignment without putting the deviated eye at a competitive disadvantage. 3. The recording experiments were conducted when the animals were greater than or equal to 9 mo of age. A total of 445 striate cortical neurons were isolated and quantitatively studied in 17 cats (3 MPs, 3 BPs, 5 ESO/MDs, 3 goggle-reared controls, and 3 normals). In addition, we analyzed the distribution of preferred stimulus orientations of 1,205 single units that had been studied qualitatively in our previous investigation of 42 kittens reared with optically induced strabismus. 4. As expected, the proportion of binocularly driven units was reduced in both MP and BP cats. The great majority of units in ESO/MD animals were exclusively driven or highly dominated by the open deviating eye. 5. Prism-reared animals showed physiological deficits in spatial resolution, contrast sensitivity, contrast gain, and peak firing rate. These effects were manifest in both eyes, although there was always an interocular asymmetry in the deficits observed in the two eyes. In MP animals, the units dominated by the treated eye, which was contralateral to the recording hemisphere, were on the average more severely affected. The interocular asymmetry was smaller in BP cats; however, two of the three BP animals also showed a greater deficit in those units dominated by the contralateral eye.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1993

Cat hindlimb muscles exert substantial torques outside the sagittal plane.

1. We studied the contributions of several hindlimb muscles to ankle torque in adult cats deeply anesthetized with pentobarbital sodium. Isometric torques were measured with a multiaxis, force-moment sensor connected to the plantar surface of the foot. 2. Individual muscle torques were provoked by using a combination of muscle nerve stimulation and selective denervations and tenotomies. Torques were represented by three orthogonal components; defined as dorsiflexion/plantarflexion, inversion/eversion (rotation about the long axis of the foot), and toe-in/toe-out (rotation about the axis of the tibia). 3. Most of the muscles tested exerted substantial torques about more than one of the orthogonal axes, each of which shared a common origin centered midway between the medial and lateral malleoli. The lateral and especially the medial head of the gastrocnemius muscle exhibited large toe-out torques and eversion torques as well as the classical plantarflexion components. 4. The torque exerted by tibialis anterior was seen to oppose that of both medial and lateral gastrocnemius in each of the three directions. The toe-in and inversion torques exerted by tibialis posterior was opposed in these directions by both peroneus brevis and peroneus longus. Flexor hallucis longus exerted approximately 10 times more plantarflexion torque than did flexor digitorum longus; therefore, these two muscles cannot be considered pure synergists. 5. The major plantarflexors and dorsiflexor of the cat ankle joint contribute substantial torques outside the sagittal plane. Their opposing torques lead to increased joint stiffness; the net effect of coactivation of these muscles causes ground reaction forces oriented so as to maintain stability during quadrupedal stance.

Animals↗
PubMed1999

Proprioceptive and retinal afference modify postsaccadic ocular drift.

Drift of the eyes after saccades produces motion of images on the retina (retinal slip) that degrades visual acuity. In this study, we examined the contributions of proprioceptive and retinal afference to the suppression of postsaccadic drift induced by a unilateral ocular muscle paresis. Eye movements were recorded in three rhesus monkeys with a unilateral weakness of one vertical extraocular muscle before and after proprioceptive deafferentation of the paretic eye. Postsaccadic drift was examined in four visual states: monocular viewing with the normal eye (4-wk period); binocular viewing (2-wk period); binocular viewing with a disparity-reducing prism (2-wk period); and monocular viewing with the paretic eye (2-wk period). The muscle paresis produced vertical postsaccadic drift in the paretic eye, and this drift was suppressed in the binocular viewing condition even when the animals could not fuse. When the animals viewed binocularly with a disparity-reducing prism, the drift in the paretic eye was suppressed in two monkeys (with superior oblique pareses) but generally was enhanced in one animal (with a tenotomy of the inferior rectus). When drift movements were enhanced, they reduced the retinal disparity that was present at the end of the saccade. In the paretic-eye-viewing condition, postsaccadic drift was suppressed in the paretic eye and was induced in the normal eye. After deafferentation in the normal-eye-viewing state, there was a change in the vertical postsaccadic drift of the paretic eye. This change in drift was idiosyncratic and variably affected the amplitude and velocity of the postsaccadic drift movements of the paretic eye. Deafferentation of the paretic eye did not affect the postsaccadic drift of the normal eye nor did it impair visually mediated adaptation of postsaccadic drift. The results demonstrate several new findings concerning the roles of visual and proprioceptive afference in the control of postsaccadic drift: disconjugate adaptation of postsaccadic drift does not require binocular fusion; slow, postsaccadic drift movements that reduce retinal disparity but concurrently increase retinal slip can be induced in the binocular viewing state; postsaccadic drift is modified by proprioception from the extraocular muscles, but these modifications do not serve to minimize retinal slip or to correct errors in saccade amplitude; and visually mediated adaptation of postsaccadic drift does not require proprioceptive afference from the paretic eye.

Adaptation, Physiological↗
PubMed1986

Developmental and functional adaptation of contractile proteins in cardiac and skeletal muscles.

The goal of this review is to summarize our knowledge of the plasticity of striated muscles in terms of contractile proteins. During development or when the working conditions are changed, the intrinsic physiological properties of both cardiac and skeletal muscles are modified. These modifications generally adapt the muscle to the new environmental requirements. One of the best examples is compensatory overload obtained in fast skeletal muscle by synergistic tenotomy and in a fast ventricle, such as in rats, by aortic banding. In both cases, after a few weeks the initial speed of shortening for the unloaded muscle drops, whereas the maximum tension developed remains unchanged. Heat measurements show that efficiency (i.e., g work/mol ATP) is improved at the fiber level. The fast skeletal muscle becomes slow, fatigue resistant, and then more adapted to endurance. For the ventricle as a whole to become slow is beneficial only if one contraction is considered; however, it is detrimental in terms of cardiac output and leads finally to failure. This adaptational process is partly explained by quantitative and qualitative changes in contractile proteins. Protein synthesis is rapidly enhanced and muscles hypertrophy, which in turn multiplies the contractile units and for the cardiac cylinder normalizes the wall stress. In the meantime the structure and, for myosin, the biological activity of several contractile proteins are modified. These modifications are very unlikely to be posttranscriptional and are in fact explained by several isoform shifts. In both tissues, for example, the expression of the gene coding for a fast myosin (MHCf in skeletal muscle, alpha-MHC in ventricles) is repressed and that of the gene coding for a slow myosin (beta-MHC in both tissues) is stimulated. This is accompanied by a coordinated increase in synthesis of other contractile proteins and, in skeletal muscle only, by isoform shifts of myosin light chains and of the TM-TN regulatory system. Other changes are less well understood. During development it has recently been discovered that three different MHCs (MHCemb, MHCneo, and MHCf) appear sequentially in fast skeletal muscle, which explains, for example, several contradictions of immunological cross-reactions. Currently, however, the functional significance of this finding is unknown, and the well-known decrease of shortening velocity observed in cardiac and skeletal muscles during fetal life is unexplained in terms of contractile proteins.(ABSTRACT TRUNCATED AT 400 WORDS)

Actins↗
PubMed1999

Blood-aqueous barrier disruption in experimental anterior segment ischemia in rabbit eyes.

The blood-aqueous barrier (BAB) in experimentally induced anterior segment ischemia (ASI) following strabismus or retinal detachment surgery in pigmented rabbits was evaluated by laser flare photometry. Four simultaneous rectus tenotomies produced a significantly higher flare value on the 1st postoperative day. Obstruction of one or two vortex veins produced significantly high flare values on the 1st and 3rd postoperative days. Scleral buckling with interference of one vortex vein produced a higher flare value than that with buckling alone. Interference of three vortex veins by diathermy and the encircling procedure produced serious ASI. Disruption of BAB in ASI can be detected quantitatively with laser flare photometry. Introduction of prostaglandin synthetase inhibitor resulted in a significant reduction of flare values following surgery. Prostaglandin synthetase inhibitor can partly ameliorate BAB disruption.

Animals↗
PubMed1991

Effect of experimental ocular hypertension on macrovacuolation in Schlemm's canal endothelial cells of monkey eyes.

The severance of all the extraocular muscles (tenotomy) caused temporary ocular hypertension, lasting a few days, in Japanese monkey (Macaca fuscata) eyes. We studied the morphology of Schlemm's canal endothelium of the eyes under a light microscope after quick fixation through continuous irrigation of the anterior chamber with a 10% acrolein solution, with precise control of the hydrostatic pressure on the eyes during fixation. A statistically significant increase in macrovacuolation in endothelial cells of Schlemm's canal of normal eyes was observed when additional hydrostatic pressure was applied. However, such an increase was not observed in the case of tenotomized temporary hypertensive eyes.

Animals↗
PubMed1981

Congenital dislocation of the hip. A review.

Congenital dislocation of the hip usually results from capsular stretching caused by fetal malposition and crouching late in the third trimester. Early recognition of hip dislocation or instability soon after birth permits prompt treatment. Ortolani's and Barlow's maneuvers, respectively, reduce into and displace from the acetabulum a femoral head that is insecurely contained therein. The diagnosis of CDH in the first month of life usually depends on these clinical components of the physical examination of the newborn, because similar device, in this age group can usually maintain the displaced hip in sufficient flexion and abduction to permit reduction and normal development. By 3 months of age, the nuclei of the pelvis and upper femur have ossified enough to permit radiologic diagnosis of CDH. Problems related to treatment increase as the child grows older. In infants up to 6 months of age, closed methods with a harness usually succeed. Beyond 6 months, the soft tissues shorten and prevent easy reduction. These patients almost always require pre-reduction traction. An adductor tenotomy also facilitates reduction and apparently lessens compressive forces on the femoral head, an important consideration in preventing avascular necrosis of the head. Children over 1 year old develop bony changes, such as excessive femoral valgus and anteversion and deformity of the acetabulum. Treatment in these patients requires realignment of bony deformities with femoral or pelvic osteotomies in addition to the measures noted previously. The gentleness and high success rate of early treatment make early diagnosis of CDH an important consideration in infants and newborns.

Acetabulum↗
PubMedDate not supplied

Fibromatosis colli: a case report.

Fibromatosis colli is a distinctive form of fibromatosis that develops in the sternocleidomastoid muscle of the newborn. When the diagnosis is certain, the treatment of choice is frequent passive stretching of the sternocleidomastoid muscle. Open tenotomy or excision of the mass may be needed if the problem persists beyond the age of 6 months. A case report is presented, and the literature is reviewed.

Collagen↗
PubMedDate not supplied

Patellar tendinopathy in athletes. Outcome of nonoperative and operative management.

We report the results of nonoperative and operative management of patellar tendinopathy in 42 athletes with Blazina stage 2 (26 patients) or stage 3 (16 patients) patellar tendinopathy. All patients were initially managed nonoperatively with nonsteroidal antiinflammatory drugs, physical therapy, and a progressive rehabilitation program based on isometric exercises, stretching, and eccentric exercises. After 6 months, 33 patients showed symptomatic improvement and were able to resume their sports. In nine patients with Blazina stage 3 tendinopathy, nonoperative measures failed, and surgery was performed. Operative treatment consisted of removal of the degenerated areas of the tendon, multiple longitudinal tenotomies, and drilling of the lower pole of the patella at the site of tendon attachment. Histologic examination of the excised tendon tissue showed areas of necrosis and mucoid degeneration, and alterations of the bone-tendon junction. After a mean follow-up of 4.8 years, clinical results were excellent or good in all patients. In the group treated nonoperatively, results were better in the patients who had stage 2 tendinopathy than in those with stage 3.

Adult↗
PubMedDate not supplied

Regeneration of the semitendinosus tendon harvested for anterior cruciate ligament reconstruction. Evaluation using ultrasonography.

In a prospective study, 40 consecutive patients who underwent anterior cruciate ligament reconstruction with doubled semitendinosus and gracilis tendon autografts were examined pre- and postoperatively by ultrasound to investigate the anatomy of the donor site before and after the harvest of the tendons. The patients underwent ultrasonography at 2 weeks and 1, 2, 3, 6, 12, 18, and 24 months postoperatively. A total of 298 postoperative sonographic evaluations were performed. The semitendinosus tendon was imaged in the sagittal and axial planes: structure and margins were evaluated with the sagittal views; thickness and width were measured with the axial views. In all cases the following sequence of healing was documented: 2 weeks after surgery the semitendinosus tendon site was occupied by an area of increased thickness and decreased echogenicity, suggesting the presence of traumatic edema of the soft tissue surrounding the tenotomy. At 1 month, an irregular hypoechoic structure appeared in a near-anatomic position; at 2 months after surgery, thickness, width, and cross-sectional area of this structure were significantly greater than preoperatively. The amount of regenerated tissue increased up to that seen in the tissue of the 6-month examinations, which also showed a more uniform echostructure. The scans performed at 1 year showed distinct edges and reduction in thickness and width. At 18 and 24 months the echogenicity of the structure occupying the donor site was very similar to that of the normal semitendinosus tendon. However, this structure was clearly identified about 4 cm proximal to the pes anserinus, revealing a more proximal insertion of the regenerated semitendinosus tendon.

Adult↗
PubMedDate not supplied

Rotator cuff tears in middle-aged tennis players: results of surgical treatment.

BACKGROUND: Tennis players, like participants in other overhead sports, are vulnerable to rotator cuff tears. In players who continue to play into their middle-age years, the incidence of such injury increases. HYPOTHESIS: Surgical treatment of rotator cuff tears in middle-aged tennis players is largely successful in allowing return to tennis. STUDY DESIGN: Retrospective review. METHODS: We evaluated the results of surgical treatment of 51 middle-aged tennis players (average age, 51 years) with a rotator cuff tear in their dominant shoulder. Tennis participation among the group had averaged 3.5 hours per week for an average of 25 years. Forty-two patients underwent open repair of the tear with or without biceps tenodesis, whereas 9 patients underwent arthroscopic debridement of the tear with or without a biceps tenotomy. Patients were reviewed at an average of 57 months after surgery with an activities score, a subjective questionnaire, and a questionnaire regarding their postoperative participation in tennis. RESULTS: The activities score averaged 26.6 of 30 possible points. Forty-seven patients were satisfied with their result, and 40 patients were able to return to tennis at an average of 9.8 months after surgery. No difference was found in the ability to return to tennis between the open repair group and the arthroscopic debridement group. CONCLUSIONS: The results of this study indicate that it is possible for nearly 80% of middle-aged tennis players to return to participation after operative treatment of rotator cuff tears.

Adult↗
PubMed2005

Arthroscopic release of the long head of the biceps tendon: functional outcome and clinical results.

BACKGROUND: Treatment of chronic, refractory biceps tendinitis remains controversial. The authors sought to evaluate clinical and functional outcomes of arthroscopic release of the long head of the biceps tendon. HYPOTHESIS: In specific cases of refractory biceps tendinitis, site-specific release of the long head of the biceps tendon may yield relief of pain and symptoms. STUDY DESIGN: Case series; Level of evidence, 4. METHODS: Fifty-four patients diagnosed with biceps tendinitis underwent arthroscopic release of the long head of the biceps tendon as an isolated procedure or as part of a concomitant shoulder procedure over a 2-year period. Patients were not excluded for concomitant shoulder abnormality, including degenerative joint disease, rotator cuff tears, Bankart lesions, or instability. Nine of 40 patients had an isolated arthroscopic release of the biceps tendon. At a minimum of 2 years, the American Shoulder and Elbow Surgeons; the University of California, Los Angeles; and the L'Insalata shoulder questionnaires as well as ipsilateral and contralateral metrics were used for evaluation. RESULTS: The L'Insalata; University of California, Los Angeles; and American Shoulder and Elbow Surgeons scores were 77.6, 27.6, and 75.6, respectively. Seventy percent had a Popeye sign at rest or during active elbow flexion; 82.7% of men and 36.5% of women had a positive Popeye sign (P < .05); 68% were rated as good, very good, or excellent. No patient reported arm pain at rest distally or proximally; 38% of patients complained of fatigue discomfort (soreness) isolated to the biceps muscle after resisted elbow flexion. CONCLUSION: Arthroscopic release of the long head of the biceps tendon is an appropriate and reliable intervention for patients with chronic, refractory biceps tendinitis. Cosmetic deformity presenting as a positive Popeye sign and fatigue discomfort were the primary complaints. CLINICAL RELEVANCE: Although tenotomy is not the ideal intervention for patients of all ages with various shoulder abnormalities, data suggest that it may be an acceptable surgical intervention for a specifically selected cohort of individuals.

Adolescent↗
PubMed2003

Demand dynamic bio-girdling in heart failure: improved efficacy of dynamic cardiomyoplasty by LD contraction during aortic out-flow.

PURPOSE: The value of dynamic cardiomyoplasty has been brought into question by the disappointing results produced by slow contraction-relaxation cycle and possibly degeneration of the latissimus dorsi muscle (LD) secondary to temporary tenotomy and chronic daily electrical stimulation. Objective of our study is to determine whether daily periods of rest introduced by demand stimulation in the continuous contraction protocol produce systolic assistance and improve clinical results. METHODS: Twelve dynamic cardiomyoplasty patients (mean age 58.2 +/- 5.8 years, M/F=11/1, sinus rhythm/atrial fibrillation=11/1) with dilated myocardiopathy were enrolled in an unrandomized trial of Demand Dynamic Heart Bio-Girdling in a public regional teaching hospital. Periods of LD inactivity, each lasting several hours, were introduced daily on a heart rate-based demand regime. To avoid full transformation of LD, fewer impulses per day were delivered, daily providing the LD with long periods of rest (Demand light stimulation). The contractile properties were measured by transcutaneous non-invasive LD tensiomyogram interrogation (LD tensiomyogram). Bio-Girdle activation was synchronized to heart beat by combining tensiomyogram and echocardiography. Clinical, echocardiographic and hemodynamic records, as well as aortic flow measurements by Doppler aortic flow wire were taken during the follow-up. MAIN FINDINGS: Mean duration of the demand stimulation follow-up was 40.2+13.8 months. At five years, "Demand stimulation" shows: 1) no operative death; 2) 83% actuarial survival; 3) highly significant 47.4% decrease of the NYHA class (from 3.17 +/- 0.38 to 1.67 +/- 0.77, p=0.0001); 4) 41.6% improvement of LVEF (from 22.6 +/- 4.38 to 32.0 +/- 7.0, p=0.001); 5) 7.5 +/- 3.0% increase in aortic flow velocity peak in assisted vs. unassisted beats, and 6) preservation of LD from slowness (TFF value 33 +/- 7.86 at follow-up versus 15.8 +/- 11.1 Hz just before switching from continuous to demand stimulation, p=0.0001) and muscle degenerative atrophy. CONCLUSIONS: In dynamic cardiomyoplasty the demand light stimulation maintains LD contraction properties over time, produces effective systolic assistance, and improves clinical results. Demand dynamic bio-girdling is a safe and effective treatment for end-stage heart failure in selected patients.

Aorta↗
PubMed2000

The effects of early mobilization in the healing of achilles tendon repair.

Twenty-four male New Zealand rabbits underwent suture repair of a tenotomy of the left achilles tendon. The rabbits were randomized into two groups of 12 animals; in group (A), the ankle was immobilized by pinning for 35 days, while in the group (B), the ankle was immobilized for only 14 days followed by active mobilization. Following sacrifice at 35 days postoperatively, the retrieved tendons were evaluated by biomechanical testing and histologic examination. Approximately 50% of stretching occurred in the first four days; average overall elongation was 9.5+/-1.0 mm and 12.7+/-1.5 mm (p=0.102) and average stiffness recovery was 67.4+/- 2.0% and 82.9 +/- 1.9% (p=0.0004) for groups A and B respectively. Histologically both groups demonstrated traces of disorganized neo-collagen fibers at the repair site as early as the fourth day with subsequent appearance of more mature collagen. The results obtained from our study favor early mobilization of the repaired tendon, which seems to restore the functional properties of the tendons more rapidly than continuous immobilization of an identical surgical repair.

Achilles Tendon↗