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PubMed2000

Retracted: The hippocampus in spontaneously hypertensive rats: a quantitative microanatomical study.

The influence of hypertension on the morphology of hippocampus was assessed in spontaneously hypertensive rats of two, four and six months and in age-matched normotensive Wistar-Kyoto rats. Values of systolic pressure were slightly increased in two-month-old spontaneously hypertensive rats in comparison with age-matched Wistar-Kyoto rats and augmented progressively with age in spontaneously hypertensive rats. No microanatomical changes were observed in the hippocampus of spontaneously hypertensive rats of two months in comparison with age-matched Wistar-Kyoto rats, whereas a decrease of white matter volume was observed in the CA(1) subfield and in the dentate gyrus of four-month-old spontaneously hypertensive rats. In the hippocampus of six-month-old spontaneously hypertensive rats a reduction of grey matter volume both in the CA(1) subfield and in the dentate gyrus, a loss of neurons affecting to a greater extent the CA(1) subfield and an increase of glial fibrillary acid protein-immunoreactive astrocytes was found. The occurrence of apoptosis and/or necrosis identified using the terminal deoxyribonucleotidyl transferase-mediated biotin-16-dUTP nick end labelling technique was also observed in the CA(1) subfield and to a lesser extent in the dentate gyrus. The only change noticeable in the CA(3) subfield of six-month-old spontaneously hypertensive rats was a slight increase in the number of glial fibrillary acid protein-immunoreactive astrocytes. These findings indicate the occurrence of neuronal loss and of astrocyte changes in the hippocampus of spontaneously hypertensive rats of six months, being the CA(1) subfield the area most affected. The relevance of these neurodegenerative changes in hypertension and the possible occurrence of apoptosis and/or necrosis as expression of hypertensive brain damage is discussed.

Animals↗
PubMed1990

[Hemorrhoids. Medico-surgical treatment].

The clinical history of 300 patients examined by the author at San Fernando Clinic and 90 consecutive cases operated at CHMCSS were studied. The frequency and characteristics of symptoms, the gender prevalence, the physical findings, the clinical classification and the various therapeutic methods used were determined. It was noticed that 84% of the patients received conservative treatment and 16% were subjected to surgery. The conservative treatment consisted of high fiber diets, warm sits baths, psyllium, hemorrhoidal sclerosis or ligature with rubber bands. The surgical treatment consisted of the ligature and excision of the three primary hemorrhoids and of the hemorrhoidal plexus(5), which is a simple, fast and effective technique, because the removal of the hemorrhoidal cushion avoids recurrences. Furthermore, the suturing of the longitudinal fibers and the pedicle and their fixation to the external sphincter avoids the upward retraction of the pedicle and the formation of denuded areas in the anal canal that can lead to stenosis at the level of the anorectal ring.

Adolescent↗
PubMed2006

Wuchereria bancrofti: effect of single and multiple larval inoculations on infection dynamics and development of clinical manifestations in non-human primate Presbytis entellus.

We earlier reported the successful experimental transmission of Wuchereria bancrofti from humans to the Indian leaf monkey (Presbytis entellus) [Misra, S., Tyagi, K., Chatterjee, R.K., 1997. Experimental transmission of nocturnally periodic Wuchereria bancrofti to Indian leaf monkey (Presbytis entellus). Experimental Parasitology 86,155-157.; Dube, A., Murthy, P.K., Puri, S.K., Misra-Bhattacharya, S., 2004. Presbytis entellus: a primate model for parasitic disease research. Trends in Parasitology 20(8), 358-360.] using a small number of animals. The present study, involving 27 langur monkeys, found the development of pathological manifestations ranging from filarial fever, lymphangitis, lymphadenitis, hydrocoele, and limb edema to minor histopathological changes in tissues after single, double, triple, or multiple inoculations of infective larvae of W. bancrofti recovered from Culex quinquefasciatus fed on human microfilaraemic blood. Thirty-eight percent of the infected langurs developed detectable microfilaraemia in their blood. Single or double larval exposure resulted in better worm establishment than multiple exposures with small numbers of larvae. All of the langurs receiving a single large inoculum and 85.71% of those receiving two inoculations harbored adult parasites. Worm establishment decreased with increasing number of larval inoculations. In all, 60% of infected langurs developed classical gross-pathological symptoms of lymphatic filariasis. Of these, 29.16% developed thickening of the lymphatics, 25% suffered from periodic rise in rectal temperature, and 16.66% developed scrotal swelling with presence of microfilariae in the hydrocoele fluid. Only one out of 25 langurs (4%) developed acute limb edema. It appeared that a single inoculum of a large number of infective larvae was able to induce maximum pathology. Fifty-six percent of the infected langurs acquired a peculiar sitting posture, retracting both the hind limbs, usually after 4-5 months of larval inoculation and eventually resulting in reduced mobility. Oral administration of diethylcarbamazine (citrate) at 12mg/kg for 12 consecutive days to one langur caused 80% suppression in microfilaraemia on day 8, killing all the adult parasites. Of the two immunosuppressed (cortisone- or prednisolone-treated) male rhesus monkeys included in the study, neither developed any of the above lymphatic symptoms or parasites after receiving larval inoculations on two or three occasions; however, a rise in rectal temperature in one of the animals was noticed. The present study thus reveals that the Indian leaf monkey, P. entellus, may serve as an ideal non-human primate model of human bancroftian filariasis for carrying out longitudinal studies on pathology, host-parasite interactions, and preclinical evaluation of candidate anti-filarial drugs or vaccines.

Animals↗
PubMed2004

A simplified approach to the treatment of Duane's syndrome.

INTRODUCTION: To report the results of a large series of patients undergoing treatment for Duane's syndrome. METHODS: Patients with Duane's syndrome undergoing strabismus surgery of a horizontal muscle recession procedure, medial rectus recession for an esodeviation or lateral rectus recession for an exodeviation, in order to correct an abnormal head position (AHP) and a significant tropia in primary position were identified. Amount of recession varied with the angle of deviation in forced primary position, versions and ductions, and intraoperative forced ductions. Elimination of AHP was used as a criterion for success. RESULTS: Fifty nine patients were treated with either unilateral or bilateral medial or lateral rectus recession. Mean follow up was 3.1 years. Ninety three percent achieved a postoperative alignment of < or =15 degrees AHP, 66% achieved < or =5 degrees AHP. Only three patients, two from the unilateral Type II group and one from the bilateral combined Types I and II group, went on to have a second procedure for a noticeable residual AHP. CONCLUSIONS: Success (good to excellent results) of horizontal muscle recession was achieved in 93% of patients. Unilateral or bilateral horizontal rectus muscle recession offers a simple and effective surgical option for eliminating AHP and is our treatment of choice in patients with Duane's syndrome.

Adolescent↗
PubMedDate not supplied

Unexpected bleeding caused by arterial variation inferolateral to levator palpebrae.

When incisional or nonincisional double-eyelid operations are in process, unexpected bleeding adjacent to the lateral canthal area is often encountered. The unexpected bleeding may result in intraoperative hematoma and swelling. It may also cause temporary intraoperative ptosis. The intraoperative swelling along the designed double-eyelid line or temporary ptosis may prevent surgeons from taking an accurate measurement of the height of fold. Therefore, surgeons might have difficulties making symmetrical double-eyelid lines. Among the detailed dissections of 230 eyelids along the orbital septum and levator palpebrae during incisional double-eyelid operations, 25 cases of noticeable arterial variation were found adjacent to the inferolateral end of levator palpebrae. The artery is located 4-5 mm medial from the lateral canthus, at the inferior margin of levator palpebrae. During the dissections, the artery was found to be superficial to the orbital septum and it could be traced down into a deeper layer along the inferior end of levator palpebrae. It connects to the lateral canthal artery behind the levator palpebrae. During double-eyelid operations, accidental tearing of this artery, even at the superficial layer of orbital septum, might cause the retraction of the cleaved arterial end down into the levator palpebrae. The bleeding from the retracted arterial end rapidly makes a large hematoma posterior to the levator palpebrae, causing temporary intraoperative ptosis and an asymmetric double fold, and possibly retrobulbar hematoma and blindness. We should bear in mind the possibility of presence of this artery. Once bleeding of this artery begins, clamping this artery and the inferolateral portion of levator palpebrae with a hemostat is effective in preventing massive hematoma posterior to levator palpebrae and ptosis, but electocoagulation is not effective. A cadaver dissection study, with red colored latex injection into the ophthalmic artery, is in progress.

Arteries↗
PubMedDate not supplied

The evolution of the painful sensitivity in acute and chronic stress.

The clinical research was made on two groups of young volunteer students. We considered stress consisting in chronic informational overexposure during the examination session and the acute stress from their emotions before a hard examination. The painful sensitivity was analysed by measuring the retraction time of the finger from water at 55 degrees C. The experimental research was made on a group of 100 male mice. The acute stress was performed by subjecting each mouse to swim (behavioral despair test). Painful sensitivity was determined by the test of the hot plate heated at 50 degrees C. Individuals with hyper (H) and hypo (h) painful sensitivity were selected for the tests. In chronic stress, the results proved increased painful sensitivity (hyperalgia) more important at "h" compared to "H" (p < 0.05). In acute stress decreased painful sensitivity (stress analgesia) was noticed more significant at "H" compared to h" (p < 0.05). All these results suggested that the extreme "H" and "h" are two different stress behaviors with opposite mechanisms involved in stress analgesia. This hypothesis is related with studies which demonstrate the involvement in stress analgesia of non-opioid monoaminergic mechanisms together with the opioid mechanisms (Lewis, 1980).

Acute Disease↗
PubMed1981

External septorhinoplasty: a tool for teaching and for improved results.

The external septorhinoplasty incision is basically a 5 mm. incision across the columella connecting a left and right alar margin incision. This allows retraction of the dorsal skin to expose the entire dorsal skeletal structure. It has great advantage to both surgeon and assistant for teaching and studying deformed nasal anatomy, and for improved rhinoplasty results because it allows binocular visual monitoring of surgery, the use of both hands, control of bleeding by electrocautery, accurate diagnosis of revisional surgery, and structures so that postoperative distortion from healing does not occur. If grafts or implants are needed they can be accurately modelled and sutured in place to prevent post-operative wobbling. The columellar scar it properly closed becomes inconspicuous in a few months, and even early in the healing process it is not noticed because the observer is viewing it at a very oblique angle. It is felt that this operation will be a very valuable addition to every doing rhinoplasties and septoplasties.

Adult↗
PubMed1985

[Posterior fossa microvascular decompression for hemifacial spasm and trigeminal neuralgia--some improvements on operative devices and technique].

Microvascular decompression has been widely used as a method for the treatment of hemifacial spasm and trigeminal neuralgia. We have experienced 30 such cases in the last 2 years; 25 of them were hemifacial spasm and 5 trigeminal neuralgia. Excellent results were obtained in 26 cases; the remaining two cases, both hemifacial spasm, were partially cured. Mild facial paresis appeared several days after the operation in 3 patients. In all the cases, the facial paresis recovered completely within several weeks. The cause of the facial paresis was not known. In 2 cases a slight hearing deficits were noticed after surgery, which has been gradually improving over several months. As this operation is functional surgery, operative complications must be avoided as much as possible. It has been our policy that we first try medical treatment and/or some kinds of nerve block and if no effects are obtained, we recommend the microvascular decompression. For microvascular decompression, suboccipital craniectomy is performed in lateral position. From the point of view of surgical technique, we stress several important points as follows: The head is elevated about 30 degrees, and it is kept approximately horizontal and should not be excessively rotated. Craniectomy is made as far laterally as the sigmoid sinus; its shape is elongated oval. Retraction of the cerebellum should not be done in the direction of the cranial nerves to avoid post-operative hearing deficit. Two tapered retractors are effectively used for cerebellar retraction. A third slim, tapered retractor is useful for holding an offending artery when exploring the root exit zone or placing a sponge for decompression.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed2005

Inequity of upper gastrointestinal cancer distribution and survival with socioeconomic deprivation: a population-based study.

BACKGROUND: It is postulated that patients with upper gastrointestinal cancers from affluent classes have better survival outcomes than those from deprived backgrounds. We aimed to analyze the incidence, mortality, and survival trends of esophageal, gastric, and pancreatic cancers in West Midlands, England, from 1986 to 2000 in terms of socioeconomic deprivation. METHODS: A well-validated demographic score, the Townsend Band, was employed as a measure of socioeconomic status. Data were collated from a cancer registry database; the individuals were allocated to 1 of 5 Townsend bands by using the postcodes at diagnosis. Relative survival rates were calculated by using stratified actuarial life tables, regression trend analysis at 1 and 5 years was performed, and the P value was derived from a t test statistic. RESULTS: An increase in esophageal cancer incidence was more marked in the affluent categories (127%), compared with the deprived categories (57%). Gastric cancer incidence fell preferentially by 31% and 47% in the most-deprived men and women, respectively, but remained relatively unchanged in the affluent groups. A marginal overall decrease in pancreatic cancer incidence masked preferential increases in the most-affluent men (39%) and women (41%). Small increases in 1- and 5-year survival were noted in affluent subgroups, with the 1-year survival advantage for esophageal cancer achieving significant levels in the most-affluent categories (P = .05). CONCLUSIONS: The esophageal cancer incidence increased preferentially in the affluent groups but with a marginally better survival rate. The gastric cancer incidence decreased noticeably in the most-deprived groups, suggesting that improvements in hygiene with consequent reduction in Helicobacter pylori primarily could be responsible. Pancreatic cancer trends were unrelated to social deprivation and warrant further studies.

Adult↗
PubMed1993

Enhancement of the synthesis and secretion of nerve growth factor in primary cultures of glial cells by proteases: a possible involvement of thrombin.

Newborn rat brain astrocytes cultured in vitro in a chemically defined medium are shown to secrete enhanced levels of nerve growth factor (NGF) when they are exposed to various types of proteases. Proteolytic enzymes such as alpha-thrombin or collagenase induce a continuous, dose-dependent enhancement of the levels of cell-secreted NGF. Incubation of astrocytes for a 24-h period with 300 ng/ml of alpha-thrombin (approximately 9 nM, or 1 U/ml) results in an increase of the levels of cell-secreted NGF by a factor of three- to fourfold, and at doses 10 times higher, stimulation by a factor of up to four- to fivefold was observed. This phenomenon reflects an enhancement of the cellular pool of NGF mRNA, already noticeable after 3 h of treatment, which is preceded by a temporary activation of protooncogenes encoding transcription factors of the AP-1 family, such as c-fos, c-jun or junB. Trypsin, plasmin, alpha-chymotrypsin, or elastase also enhanced, to different extents, the levels of cell-secreted NGF. However, unlike alpha-thrombin or collagenase, these enzymes cause, above a critical concentration, an extensive cell detachment from the solid support, and this is accompanied by a decrease of their activity on the production of NGF, so that their dose-response curves are bell shaped. Stimulation was maximal at those concentrations that cause a limited loosening of the cell-substratum interactions, as evidenced by a retraction of some cell processes after 24 h of treatment. Studies of the effect of alpha-thrombin indicate that the proteolytic activity itself is required to enhance the production of NGF by astrocytes. Inactivation of alpha-thrombin with D-phenyl-alanyl-L-propyl-L-arginine chloromethyl ketone, phenylmethylsulfonyl fluoride, antithrombin III, or hirudin results in a marked decrease of the stimulatory effect. Furthermore, the prolonged presence of alpha-thrombin is required to elicit a maximal effect on the levels of extracellular NGF, which was observed after 48 h of treatment. It is known that some effects of alpha-thrombin require binding to the cell surface. We found that gamma-thrombin, which still has some proteolytic activity but has lost its ability to bind to the cell surface, is almost as potent as alpha-thrombin in promoting the release of NGF. It is concluded that the effect of thrombin on NGF synthesis is essentially mediated by its proteolytic activity.(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗
PubMed1992

Cytoskeleton-dependent surface blebbing induced by the polar solvent N-methylformamide.

In vivo and in vitro studies performed on the polar solvent N-methylformamide (NMF), as well as on its association with chemotherapeutic agents or X rays, have clearly demonstrated that this compound is capable of inducing changes in biological characteristics of tumor cells, e.g., cell differentiation. However, the mechanism of action of NMF is far from being elucidated. Hence, in order to better clarify such a mechanism an in vitro study was carried out by using mouse fibroblasts in primary culture (MEF) and human melanoma cultured cells (M14). Results obtained by immunocytochemical and ultrastructural methods with doses of NMF ranging from 0.1 to 7% are reported here. As a general rule, a different sensitivity (in terms of cytopathologic changes induced by NMF) was found between the cell types considered. In fact, melanoma cells appeared to be highly susceptible to the action of the drug, undergoing severe morphological modifications represented mainly by a reversible dose and time-dependent cell rounding and surface blebbing. In contrast, NMF-induced injury in MEF cells was characterized mainly by a simple retraction of the cell body. A cytochemical analysis of the expression of certain membrane antigens (e.g., glycoproteins, epidermal growth factor receptor, B2 microglobulin) in NMF-treated M14 cells undergoing blebbing was also carried out. A randomly distributed labeling of such molecules was observed. Accordingly, freeze-fracturing electron microscopic analysis also displayed a random distribution of intramembrane particles over the plasma membrane. When subcellular changes induced by the drug were investigated, a remarkable modification of cytoskeletal components was detected in both cell types. In particular, cross-linked actin microfilament bundles were easily observed in NMF-exposed MEF cells. Finally, when different experimental conditions which perturb calcium ion homeostasis or restore protein thiol group reduced state were analyzed, a noticeable impairment of the blebbing phenomenon was observed. Thus, a target effect of NMF on the microfilament system, probably leading, in turn, to several subcellular changes and cell surface blebbing, can be hypothesized. Such a cytoskeletal element-dependent cytopathology appears to be related to changes of the oxidized state of such molecules as well as to calcium ion perturbations.

Actin Cytoskeleton↗
PubMed2002

Embryonic expression of three mouse genes with homology to the Drosophila melanogaster prickle gene.

The Drosophila melanogaster gene prickle-spiny-legs (pk) functions in an intercellular feedback loop that is central to the establishment of planar cell polarity in the eye and epidermis of the fly, by modulating Frizzled-Disheveled signalling. Here we identify three mouse prickle-related genes (dyxin, testin and prickle) and describe their expression pattern during murine embryogenesis (E7.5-E15.5). We report that the three genes are expressed in restricted areas of the developing mouse brain: dyxin in the most ventral region of the neural tube and in some localized regions of the ventricular layer of the mesencephalon and rhombencephalon, prickle in the pons region, ventrolateral part of rhombencephalon and motoneurons in the spinal cord, and testin in differentiating neurons of the spinal cord and retina. At the stages analyzed, the main site of expression of testin is the migrating cranial neural crest, while the expression of dyxin is noticeable in myotomal cells and its derivatives, with prickle expression being reciprocally localized to some sclerotomal derivatives, like bone primordia. prickle is also expressed in the apical ectodermal ridge and the most distal mesenchyme of the forming limb buds.

Amino Acid Sequence↗
PubMed2006

Endoscopic video-assisted breast surgery: procedures and short-term results.

BACKGROUND: We devised a new endoscopic operation for breast diseases. We report the aesthetic and treatment results of this procedure. METHODS: A 2.5-cm axillary skin incision was made for a single approaching port, and a working space was created by retraction. Under video assistance, we resected the mammary gland partially or totally, and in the case of malignant diseases we also performed a sentinel lymph node biopsy and dissected axillary lymph nodes (levels I and II). RESULTS: From December 2001 through April 2005, we performed endoscopic video-assisted breast surgery (VABS) in 100 patients with breast diseases. The diseases were benign in 18 patients and malignant in 82 patients. Of the malignant diseases, 80 underwent breast-conserving surgery and 2 underwent skin-sparing mastectomy. There was no significant difference in operation time, blood loss, or blood examinations related with the acute phase reaction between VABS and conventional breast-conserving procedures. All surgical margins were negative on examination of permanent histological preparations. The wounds healed without noticeable scarring. The original shapes of the breast were preserved. All patients expressed their great satisfaction with VABS. CONCLUSIONS: VABS can be considered as a surgical option and can provide aesthetic advantages for patients with breast disease.

Adult↗
PubMed1991

Audex Medical, a new system for digital processing and analysis of ultrasonographic images of the prostate.

By transrectal ultrasonography the volume of the prostate is determined two times using the conventional planimetric method. Thereafter the US scanner is placed in a fixture which is retracted repeatedly. For this a motordrive has been developed. The images of each section are improved by digital processing, and the prostatic outline is determined interactively by developed image processing software. In this manner the total volume of the prostate is calculated. In a post-mortem study prostates of 9 cadavers were measured with the conventional planimetry and by means of digital processing and analysis. The results were compared with the results obtained after removal of the prostate. In a clinical study the prostatic volumes of 20 patients were measured in a similar way. The results of the two methods are compared. Both in the cadaver study and the patient study we found a good correlation between the conventional method and the computerized method. In the cadaver study we noticed a better correlation between the prostatic volume found with the computerized method and the volume obtained after prostatectomy. Also the reproducibility of this method turned out to be better.

Humans↗
PubMed2005

[Analysis of the expression of collagen VI in congenital muscular dystrophy].

Congenital muscular dystrophy (CMD) composes a group of disorders characterized by hypotonia and muscular weakness noticed in the first year of life. The Ullrich's form is characterized by proximal joint contractures and distal hiperextensibility. About 40% of these patients present mutations in one of the genes that codify the sub-units of the collagen VI protein (COL6), producing total or partial deficiency of the protein expression. We analyzed, through immunohistochemistry, the expression of COL6 in muscle fragments of 50 patients with CMD; 20 of them presented merosin expression deficiency. We identified 4 cases with total COL6 deficiency (8% of the total), representing 13% of the cases with normal merosin expression. The histological findings of patients with deficiency of COL6 were indistinguishable from other forms of CMD, but milder than that abnormalities observed in merosin deficient patients. In three COL6 deficient patients were observed hypotonia and weakness in the neonatal period, delayed of motor milestones, muscular retractions of knees and elbows, distal joint hiperextensibility and congenital hip dislocation (two patients). One patient lost the ability to walk; and one died due to respiratory problems. The analysis of COL6 expression, as well as merosin expression, in the muscle tissue from CMD patients, can be important for identification and phenotypic characterization of different CMD subtypes.

Biomarkers↗
PubMed2000

[Arthroscopic debridement of full-thickness tears of the rotator cuff: a retrospective multicenter study of 283 cases with 3-year follow-up].

PURPOSE OF THE STUDY: The purpose of this study was to assess clinical and radiological course of full-thickness rotator cuff tears treated by arthroscopic debridement and to discuss surgical indications according to patient demands and anatomical lesions. MATERIAL AND METHODS: This retrospective and multicentric study included patients with a minimal 3 years follow-up. The coronal extent of the supraspinatus tear was described as distal, intermediate or retracted. The sagittal extent to the infraspinatus and/or subscapularis and rotator interval was detailed. All patients were evaluated pre and post-operatively using Constant score and radiological A-P view for sub-acromial space measurement. In order to assess the influence of age, anatomical extent of the tear and follow-up, results were analyzed for 4 groups of patients according to their age: group I (19 cases less than 50 years), group II (88 cases from 51 to 60 years), group III (58 cases from 61 to 65 years) and group IV (118 cases over 65 years). Results were finally evaluated according the arthroscopic procedure (isolated acromioplasty and biceps tenotomy, or association of both). RESULTS: 283 patients, aged 63.1 years (range 32 to 82) entered this study. A complete antero-posterior tear of the supra-spinatus tendon was noticed in 93.2 p. 100 of cases. The tear extended to the infraspinatus tendon in 57.3 p. 100, and to the subscapularis tendon in 29 p. 100 of cases. The long head of the biceps was involved in 73 p. 100 of cases. 218 acromioplasties and 116 biceps tenotomies were performed. The 2 procedures were combined in nearly 25 p. 100 of cases. At final revision (mean follow-up of 4.7 years), 98 patients (34.6 p. 100) were very satisfied, 122 (43.1 p. 100) satisfied, 43 (15.2 p. 100) moderatly satisfied and 20 (7.1 p. 100) were disappointed. The average Constant score increased from 42.4 to 67.6 points. The radiological study showed a 1 mm narrowing of the sub-acromial space. Objective results were surprisingly good for group I at a 5.4 years follow-up but dropped from group II to group IV, mainly in relation with the extent of the tear. A deleterious effect of the isolated biceps tenotomy was demonstrated in case of subacromial space superior to 7 mm. Inversely after this procedure patients with a narrowed space improved. DISCUSSION: Even if traditional bias of retrospective and mullticentric study could not be avoided, the large number of patients and long follow-up of this study are superior to most of the published papers. The extent of the supraspinatus tear seems to progress during the 50-60 years decade. Objective results appeared to be much more related to the anatomical lesions than to the arthroscopic procedure. CONCLUSION: This series did not demonstrate a secondary clinical or radiological deterioration after an endoscopic treatment without repair of full-tickness rotator cuff tears. Subacromial decompression and/or biceps tenotomy indications depend on age and extension of the tear.

Adult↗
PubMed2004

Elevated neurotrophin and neurotrophin receptor expression in spontaneously hypertensive rat lungs.

Spontaneously hypertensive rats represent a widely used animal model of hypertension. Altered neurotrophin regulation has been related to systemic hypertension. Lung cells synthesize and release neurotrophins(NT) which are involved in several pulmonary disturbances. Our study explored the expression of NT and their receptors using molecular biology and immunohistochemistry. Spontaneously 6-, 20- and 29- weeks hypertensive (SHR) and Wistar Kyoto rat (WKY) lungs were used. SHR and WKY lungs expressed neurotrophin and neurotrophin receptor mRNAs and protein transcripts. Age and hypertension dependent increase was clearly noticeable. Furthermore, immunohistochemistry revealed that their increase was mainly noticeable within bronchial and vascular components of the lung. Although the role of NT in sympathetic hyperinnervation and progression of systemic hypertension is a well established phenomenon, their increase in SHR lungs, strongly suggest that NT may be operative during pulmonary hypertension and in subsequent airway and pulmonary vascular remodeling.

Animals↗
PubMed1996

[A study of the neurologic risk in tendino-muscular advancement of supra-spinatus and infra-spinatus in the repair of large rotator cuff rupture].

PURPOSE OF THE STUDY: An anatomical study by Warner et al. (1992) showed that an advancement of supra and infra-spinatus of more than 3 cm could be deleterious for the suprascapular nerve or its branches. In pathological conditions, the limit of possible advancement could even be less than 3 cm. The authors wanted to know whether this technique, which they use for the repair of large rotator cuff tears, could have neurological effects in surgical practice. MATERIAL: 24 shoulders among 24 patients having had a rotator cuff repair using a musclar advancement have been studied. In 13 cases only the supraspinatus had been advanced, and in 11 cases both supra and infraspinatus have been advanced. METHODS: The suprascapular nerve status has been studied postoperatively by EMG. EMG was performed at a mean 8.5 months follow-up. Motor unit potentials were studied at rest and after maximal contraction. Electro-stimulation at Erb's point was used to evaluate muscular latency. All repairs have been controlled by opaque arthrography, and a CT scan grading of muscular fatty degeneration was performed. In 19 cases EMG had also been performed preoperatively. RESULTS: At revision, 17 EMG were considered normal. In one case there was an impairment of the first primary trunk, already noticed preoperatively. Only 6 EMG anomalies probably related to surgery have been noticed, although the width of the tear in the coronal plane was nearly always of more than 3 cm. 4 of these 6 shoulders had been explored preoperatively by EMG, and were recorded as normal before surgery. Electric impairment was limited to the supraspinatus in 3 cases (increase of muscular latency after single advancement in two cases, polyphasic motor unit potential after double advancement in one case), to the infraspinatus in one case (polyphasic motor unit potentials recorded in the infraspinatus after single advancement of the supraspinatus), and concerned both muscles in 2 cases (increase of muscular latencies after double advancement). DISCUSSION: Muscular advancement was usually performed for tears of more than 2.5 cm wide, and so should be deleterious for suprascapular nerve, according to Warner et al. studies. But in most cases no neurological impairment could be observed in surgical practice. This could be due to the fact that the gap to repair is due not only to a loss of substance in the tendons but also to muscular retraction. In a first step, the muscular release allows to correct this muscular retraction ("muscular" advancement). The advancement remaining then to be performed is about 2 cm wide ("tendino-muscular" advancement). CONCLUSION: It appears that in surgical practice supra and infraspinatus advancement threatens only moderatly the suprascapular nerve or its branches, even if the width of the tear is greater than 3 cm. Postoperative immobilization in slight lateral elevation further reduces the importance of this advancement.

Arthrography↗