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At least 19 recordsLinked to original sources

Effects of rectal distension on the sphincter ani externus and levator ani muscles in cats.

The response characteristics of levator ani (LA) muscles to rectal distension and its rectified and integrated EMG activity was recorded and compared with the responses of the sphincter ani externus (SAE) to the same stimuli. Experiments were performed in 42 cats anesthetized with chloralose (70 mg/kg) dissolved in a 25% urethan-saline solution. Fast (about 1-2 s) rectal distension (10-40 ml of air were injected into a rubber balloon in the rectum, reaching pressures of up to 80 mmHg) produced a reflex contraction of both LA and SAE muscles. Sustained distension elicited a sustained discharge from the LA muscles that endured for the duration of the distension, up to 2-3 min. These changes were observed in 75% of 210 trials. EMG activity increased from 30 to over 600% of base-line levels, with the majority, 65% of trials, showing greater than 100% increase. In contrast to these excitatory responses of the LA muscles, SAE responded to sustained rectal inflation with inhibition of ongoing activity, an inhibition that could reach muscular silence. Fast intermittent distension, one every 2-3 s, however, produced an increase in the level of activity of the SAE. Analysis of the EMG activity preceding defecation revealed an increase of LA activity 1-2 min before actual expelling. We believe this result to be consistent with the hypothesis that these muscles may contribute to anorectal evacuation. In the anesthetised animal, during the passage of solid material through the anus, the SAE showed increased activity. We believe this to be the result of a local phenomenon, the development of a tonic stretch reflex in the SAE.(ABSTRACT TRUNCATED AT 250 WORDS)

Anal Canal

A possible role for endogenous glucocorticoids in orchiectomy-induced atrophy of the rat levator ani muscle: studies with RU 38486, a potent and selective antiglucocorticoid.

We employed RU 38486, a potent and selective antiglucocorticoid, to study a possible role for endogenous glucocorticoids in atrophy of the levator ani muscle secondary to castration of male rats. RU 38486 was shown to block [3H]triamcinolone acetonide binding to cytosol from levator ani muscle. Daily oral administration of RU 38486 to castrated rats partially prevented atrophy of the levator ani muscle, as well as a decrease in RNA concentration. In a control group receiving RU 38486 alone, the levator ani underwent significant (20%) hypertrophy. Administration of exogenous dexamethasone also caused pronounced atrophy of the levator ani muscle. This atrophy was prevented, to a significant degree, by simultaneous oral administration of RU 38486. It is concluded that endogenous glucocorticoids, the actions of which are blocked by RU 38486, may be involved in regulation of the mass of the levator ani muscle in intact rats.

Animals

[Comparative and functional morphology of musculus canalis ani in tetrapod mammals and primates].

Comparative anatomy of structure and function of the M. canalis ani in tetrapode mammals and primates is described for the first time. The muscle itself lies on the sphincter ani internus in the area between the anorectal ("pectinate") and anocutaneal ("white") lines and its circumference is intact around the entire anal canal. The canalis ani muscle orginates from the superior part of the sphincter ani internus and concomitantly receives additional fibers from the longitudinal muscle. Caudally the muscle dips back into the sphincter ani internus and, at the same time, a small portion of the fibers go to the longitudinal muscle and, likewise, a portion also sets itself on the perinaal skin. On the basis of its morphological relationship to the convoluted vessels of the rectal venous plexus, the canalis ani muscle appears to be able to complete the closing of the anus in the continence phase to such an extent that a complete closing of the anal lumen is guaranted.

Anal Canal

Clinical evaluation of the Vitek ANI card for identification of anaerobic bacteria.

An evaluation of the Vitek Anaerobe Identification (ANI) card was performed with 341 bacterial isolates, including 313 clinical isolates and 28 stock strains of anaerobic microorganisms. Identifications obtained with the ANI card were compared with those determined by conventional methods. The card identified 73.2% of 149 anaerobic gram-negative bacilli, 63.6% of 44 Clostridium spp., 65.8% of 38 anaerobic nonsporeforming gram-positive bacilli, and 69.1% of 110 anaerobic cocci, with no further testing required. When genus-level identifications were included, 83.9% of the anaerobic gram-negative bacilli, 70.5% of Clostridium spp., 73.7% of the anaerobic nonsporeforming gram-positive bacilli, and 73.6% of the anaerobic cocci were identified. Nineteen isolates (5.6%) produced identifications of good confidence but marginal separation or questionable biotype, in which the correct identification was listed with one or two other possible choices and extra tests were required and suggested. A total of 28 (8.2%) were not identified and 29 isolates (8.5%) were misidentified by the ANI card. Among the commonly isolated clinically significant anaerobes, the ANI card identified 100% of 55 Bacteroides fragilis and 100% of 8 Clostridium perfringens. Use of supplemental tests and expansion of the data base to include additional strains of organisms that are difficult to separate even with conventional methods may improve the accuracy of the ANI card as a method for identification of anaerobic bacteria in the clinical laboratory.

Bacteria, Anaerobic

The mycotic flora in proctological patients with and without pruritus ani.

The perianal mycotic flora was studied in proctological patients with and without pruritus ani, as well as in control subjects. Four groups of patients underwent perianal mycoculture. In Group 1, 53 patients with anal pruritus were treated for benign anorectal disease. In Group 2, 24 patients with no underlying disease presented with anal pruritus. Both of these groups underwent concomitant chemical and parasitical examination of the faeces and an oral glucose tolerance test. In Group 3, 50 patients without pruritus ani at present or in the past were treated for benign anorectal diseases. In Group 4, 47 surgical patients without pruritus ani were treated for benign (9) and malignant (38) non-proctological diseases. In Group 1 the mycoculture was positive in 24/53 patients (Candida albicans 14, dermatophytes 10). In Group 2 fungal infections were seen in 16/24 patients (C. albicans 7, dermatophytes 9). No parasites or diabetes were found in either group. In Group 3 C. albicans was isolated in 14/50 patients. In Group 4 C. albicans was found in 11/47 cases (2 in benign, 9 in malignant diseases). Infection by C. albicans was observed in all groups studied, independent of the presence of disease or anal pruritus. The presence of dermatophytes was always associated with pruritus ani.

Adolescent

Globular and asymmetric forms of acetylcholinesterase in the rat levator ani muscle.

The endplate (+EP) and non-endplate (-EP) distribution of molecular forms of acetylcholinesterase (AChE) was compared in the dimorphic levator ani and diaphragm muscles from adult male rats. Enzyme activity was measured by the thiocholine method and AChE forms were separated on the basis of solubility in sodium phosphate buffer of different ionic strength. For the dimorphic levator ani muscle, total AChE activity was 324.6 +/- 18.9 nmol ASCh hydrolyzed min-1 muscle-1, 90% of which was globular and predominated in the -EP region (78%). The asymmetric forms were almost exclusively detected in the +EP region (9%). In diaphragm muscle, total AChE activity was 176.7 +/- 11.0 units; 66% was mainly globular and located in the -EP region (56%); the asymmetric forms (34%) were either in -EP (11%) or +EP (23%) regions. Thus, a greater proportion of globular form was present in the dimorphic levator ani muscle than in diaphragm muscle. In view of the control exerted by testosterone on dimorphic muscles, it is suggested that the greater synthesis of the globular form in the levator ani occurs under the trophic influence of testosterone.

Acetylcholinesterase

Histology of the connection between the vagina and levator ani muscles. Implications for urinary tract function.

The proximal urethra is a mobile structure, and voluntary control of its position is an integral part of the initiation of urination and continence. This paper describes the histology of the vagina's attachment to the medial portion of the levator ani muscles, which, because of the intimate attachment of the vagina and urethra, is responsible, in part, for control of the urethral position. A histologic examination of 1,500 serial microscopic slides from eight women, dissection of four bodies and study of whole pelvis cross-sections from two cadavers were performed. Smooth muscle, collagen and elastin fibers of the vaginal wall and paraurethral tissues directly interdigitate with the muscle fibers of the most medial portion of the levator ani, in the region of the proximal urethra. This strong connection lies at a level just below the entry of the urethra into the bladder and extends downward to the level of the perineal membrane (urogenital diaphragm) in an area corresponding to the mobile portion of the urethra. The inseparable nature of the vagina and urethra in this region makes it possible for the connection of the levator ani to the vagina to control the proximal urethral position. These observations suggest a specific role of the medial levator ani muscle in controlling vesical neck position and open the question of the specific part played by this arrangement in voiding and continence relative to other factors known to influence lower urinary tract function.

Adolescent

Physiological study of pruritus ani.

Physiological abnormalities in the anorectum of 34 patients with pruritus ani, and 20 age and sex matched controls were assessed. A saline infusion (1500 ml) test showed that leakage started after infusion of 600 ml in patients with pruritus ani compared with 1300 ml in controls (median values: P less than 0.001). There was an inverse relationship between the severity of the symptoms of pruritus ani and the volume of first leakage on the saline infusion test P less than 0.02. Studies to assess anal sphincter function, rectal sensation to balloon distension, rectal compliance, and perineal descent did not show any significant differences between pruritic patients and controls. However, pruritic patients without co-existing anal pathology had a significantly greater fall of anal pressure when a rectal balloon was inflated (57 per cent) when compared with controls (40 per cent) P less than 0.05.

Adult

Treatment of intractable pruritus ani.

The majority of patients with idiopathic pruritus ani respond favorably to conservative treatment. Moreover, response to specific medical therapy is almost always favorable in certain dermatologic diseases such as psoriasis, mycotic dermatitis, and contact dermatitis. When surgery is performed for anorectal disorders such as hemorrhoids and fistulas, or potentially malignant entities such as extramammary Paget's disease, the accompanying pruritus ani invariably improves as well. Only patients with chronic intractable pruritus ani are included in the current study. Methylene blue (methylthionine chloride) 0.5 percent is injected intracutaneously on the anodermal and perianal skin. With one treatment, long-term cure has been observed.

Adult

The fecal microflora in pruritus ani.

Pruritus ani is a common condition in which there is a tendency for liquids to leak from the anal canal, resulting in perianal soiling. In order to ascertain if an abnormal fecal flora contributes to the irritant effects of fecal material, qualitative and quantitative measurement of the fecal microflora was performed in 20 patients with pruritus ani and 20 matched controls. No differences were found between the two groups. This study has failed to provide evidence for a microbiologic basis for pruritus ani.

Adult

Pruritus ani.

Although the importance of the anal zone is well known in psychoanalysis, pruritus ani has not been studied recently in the psychoanalytic literature. This paper is presented to show how bisexuality in a male patient has been analysed through pruritus ani as the main presenting symptom. After giving the case history of Fernand, pruritus ani is analysed from three main points of view: phallic, anal and oral. This is done to illustrate the connexions of the psychopathological material at the three stages and their expression through one symptom of the 'instincts and their vicissitudes'. Finally, the importance of the anal stage and its symptomatology as an attempt to diminish the affective charge brought up in the individual by the oral and phallic conflicts is discussed briefly.

Adult

[The importance of the Musculus canalis ani for continence and anorectal diseases (author's transl)].

The functional morphology of the M. canalis ani is described. Hitherto this muscle has not been studied in detail. The M. canalis ani is located inside of the M. sphincter ani internus and reaches through the spatium submucosum et subcutaneum of the analcanal. This muscle is part of a described "organ of continence". Its importance in the course of anorectal disease is shown.

Anal Canal

The same myosin isoforms are found in the female and male sexually dimorphic levator ani muscle of the rat, but their postnatal transitions are not synchronous.

The levator ani of the female adult rat is greatly atrophied in comparison to the same muscle in males. In the present study, the female levator ani was, nevertheless, found to contain type IIb myosin isoforms similar to those contained in the male muscle. These adult type isoforms were, however, synthesized later in the female than in the male levator ani: the half-transition times of the myosin transition curve were 20 days postnatal in the male and 35 days postnatal in the female. The transition curves for castrated and uncastrated male rats were the same. Thus, the presence of male gonadal hormones apparently did not affect the myosin transition.

Animals

Effect of almond and anis oils on mouse liver alcohol dehydrogenase, aldehyde dehydrogenase and heart lactate dehydrogenase isoenzymes.

The effects of short-term intraperitoneal injection of diluted almond or anis oil on heart lactate dehydrogenase isoenzymes, liver alcohol dehydrogenase and subcellular aldehyde dehydrogenase were studied in the female mouse. Hepatic alcohol dehydrogenase was induced from control by administration of almond oil 3.2 g/kg/d for 7 days, or anis oil 1.6 g/kg/d for 7 days. Treatment with almond but not anis oil inhibited both cytoplasmic and mitochondrial liver aldehyde dehydrogenase. The mitochondrial isoenzyme with an apparently low Km was also inhibited by the almond oil trial. No significant changes occurred in heart lactate dehydrogenase isoenzymes by the treatments used. The enzymatic inhibition kinetics were found to be non-competitive. The apparent Km for almond-treated mouse aldehyde dehydrogenase was greater than the controls. This indicates lower substrate affinity for almond oil than for acetaldehyde. The results suggest adverse hepatic metabolic interaction between almond oil and alcohol.

Alcohol Dehydrogenase

New concept of the anatomy of the anal sphincter mechanism and the physiology of defecation. II. Anatomy of the levator ani muscle with special reference to puborectalis.

A study of the surgical anatomy of the levator ani muscles, with special stress on the puborectalis, was performed on 22 cadaveric specimens. The study comprised dissection and microscopic examination. The levator ani was found to consist of two portions only: pubococcygeus and iliococcygeus, the puborectalis being a part of the external anal sphincter. Both levatores decussate at the anococcygeal raphe, which represents a "decussation line" and not a site of insertion for the muscle fibers. A "digastric" pattern of the levator is demonstrated, which is responsible for the harmonic nature of the function of the muscle bundles on each side of the pelvis. The levator hiatus was found to be formed of the medial borders of the pubococcygeus, , and not the puborectalis. A "hiatal ligament" was identified, stretched between the edges of the levator hiatus and the intrahiatal viscera. The role of the pubococcygeus in anal fixation is discussed, and a new concept that the puborectalis does not belong to the levator ani but constitutes na integral portion of the external and sphincter. The puborectalis and the deep external anal sphincter were found to be fused together and identical from the morphologic, histologic, and functional points of view as well as with respect to innervation. Both form a single U-shaped loop which is given the name "top loop."

Adolescent

[Levator muscles pf the anus (levator ani). Normal or pathological cytoarchitecture of endorectal biopsies in man].

The structure and ultrastructure of normal or pathological needle biopsies of the human levator ani are studied. Disturbances of the muscular cyto-architecture: cellular degeneration with infiltration of glycogen and disorganization of the myofibrillar A, I and Z stripes are shown. The comparison between the histological data and the clinical results demonstrates that the quality of the levator ani is not always clearly defined by the clinic. The muscular biopsy reaches its main interest when in physical reeducation or in surgical correction of the incontinence, some doubt remains on the clinical value of the levator ani.

Anal Canal

Coccygeus and levator ani muscles in the rabbit: morphology and proprioceptive innervation.

The Authors have studied the morphological features and the proprioceptive nervous component in the coccygeus and levator ani muscles of the rabbit, using Ruffini's and Barker-Ip's impregnations. The coccygeus muscle originates from ischiatic spine and inserts on the last three sacral vertebrae and on the first four or five caudal vertebrae. The levator ani muscle originates from the ischiatic spine and the coccygeus muscle aponeurosis and inserts directly on the caudal vertebrae 3-5 or 4-6. The proprioceptive innervation in both muscles is constituted by muscle spindles and Golgi tendon organs with a typical structure. Muscle spindles are more numerous than Golgi tendon organs and the spindle density is higher in the levator ani muscle.

Animals