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In situ anterior vaginal wall sling formation with preservation of the endopelvic fascia for treatment of stress urinary incontinence.

The indications for sling procedures have evolved and encompass patients with either intrinsic sphincteric deficiency (ISD), anatomic incontinence or both. We have refined a technique that can be performed in a minimally invasive fashion with low attendant morbidity to provide a reproducible method of sling formation. Twenty patients with stress urinary incontinence underwent the in situ sling (ISS) with bone fixation. Subsequent evaluation at 24-29 months (mean = 26.2 months) revealed that 95% of patients were cured. No recurrent cystoceles, paravaginal defects or significant detrusor instability have been noted. Urinary retention appeared transiently in only 3 patients and resolved in under 3 weeks. We feel the in situ sling with bone fixation provides a safe and effective means of management for stress urinary incontinence. Furthermore, the reduced surgical dissection may minimize the incidence of postoperative ISD and recurrent paravaginal defects that may accompany more traditional needle suspension procedures.

Female↗

The relationship of the fronto-temporal branches of the facial nerve to the fascias of the temporal region: a literature review applied to practical anatomical dissection.

The understanding of the course of the facial nerve and its relationship to the different connective tissue layers in the temporal area is paramount to preserving this nerve during surgery. But the use of different nomenclatures for anatomical structures such as for the different fascial layers or fat pads in the temporal region as well as the difference in description of the course of the fronto-temporal branches of the facial nerve in relationship to the fascial layers can lead to confusion. Therefore we have reviewed the literature about this topic and tried to apply the information to practical anatomical dissection.

Facial Nerve↗

Astrocyte proliferation precedes a decrease in basket cells in the dentate fascia following chronic ethanol treatment in mice.

The effect of chronic ethanol administration on the density of basket cells in the dentate gyrus of mice selectively bred for their sensitivity to acute ethanol exposure (long-sleep, LS and short-sleep, SS) was assessed in two experiments. In addition, the effect of chronic ethanol on the density of dentate granule cells and astrocytes was examined. In the first experiment, mice received 3 weeks of a liquid ethanol diet with 35% of their calories derived from ethanol (EDC). In this experiment, LS mice did not demonstrate a change in the density of granule cells or in the density of basket cells. There was, however, a significant increase in the density of astrocytes as a result of this treatment for the LS mice. The SS mice were unaffected on all measures. In the second experiment, portions of which have been reported previously, mice received a diet with 23% EDC for 3 months. As a result of this exposure, LS mice showed a significant decrease in the density of basket cells, but there was no change in the density of granule cells or astrocytes. There was no difference between controls and experimental mice from the SS group on any of these parameters. These results suggest that at least in the dentate gyrus, chronic ethanol treatment selectively reduces the density of basket cells but only in mice that are more sensitive to the hypnotic effects of acute ethanol exposure. Furthermore, this effect seems to be preceded by an apparent increase in the density of astrocytes.(ABSTRACT TRUNCATED AT 250 WORDS)

Alcoholism↗

Role of the medial septum and hippocampal theta rhythm in exploration-related synaptic efficacy changes in rat fascia dentata.

Animals transferred from their home cages to a different environment exhibited an increase in exploratory behavior which was accompanied by a substantial increase in perforant path-evoked population excitatory postsynaptic potentials and decreases in both the areas and the onset latencies of population spikes. As reported previously, these changes substantially outlasted the exploratory behaviors that induced them. Electrolytic lesions of the medial septum severely attenuated the theta rhythm of the hippocampal EEG, but had no significant effect on the exploration related changes in the synaptic and postsynaptic components of the evoked response. In urethane-anesthetized animals, long trains of hippocampal theta produced by sensory stimulation failed to affect the amplitude of evoked responses. These results show that the information critical for the exploration-related alterations in dentate evoked responses does not originate in or pass through the medial septum, and that the changes are not linked to hippocampal EEG states.

Animals↗