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Kavoussi PK, Henderson HT, Hudson K, Mehrabani-Farsi R, Machen GL. Cremaster muscle thickening: the anatomic difference in men with testicular retraction due to hyperactive cremaster muscle reflex. Asian J Androl 2023; 25:484-486. [PMID: 36510859 PMCID: PMC10411256 DOI: 10.4103/aja202296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Accepted: 10/19/2022] [Indexed: 12/12/2022] Open
Abstract
The objective was to assess whether men suffering from testicular retraction secondary to hyperactive cremaster muscle reflex have an anatomic difference in the thickness of the cremaster muscle in comparison to men who do not have retraction. From March 2021 to December 2021, 21 men underwent microsurgical subinguinal cremaster muscle release (MSCMR) on 33 spermatic cord units, as 12 of them had bilateral surgery, at Surgicare of South Austin Ambulatory Surgery Center in Austin, TX, USA. During that same time frame, 36 men underwent subinguinal microsurgical varicocele repair on 41 spermatic cord units, as 5 were bilateral for infertility. The thickness of cremaster muscles was measured by the operating surgeon in men undergoing MSCMR and varicocele repair. Comparison was made between the cremaster muscle thickness in men with testicular retraction due to a hyperactive cremaster muscle reflex undergoing MSCMR and the cremaster muscle thickness in men undergoing varicocele repair for infertility with no history of testicular retraction, which served as an anatomic control. The mean cremaster muscle thickness in men who underwent MSCMR was significantly greater than those undergoing varicocele repair for infertility, with a mean cremaster muscle thickness of 3.9 (standard deviation [s.d.]: 1.2) mm vs 1.0 (s.d.: 0.4) mm, respectively. Men with testicular retraction secondary to a hyperactive cremaster muscle reflex demonstrate thicker cremaster muscles than controls, those undergoing varicocele repair. An anatomic difference may be a beginning to understanding the pathology in men who struggle with testicular retraction.
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Affiliation(s)
- Parviz K Kavoussi
- Austin Fertility and Reproductive Medicine/Westlake IVF, Austin, TX 78746, USA
| | - Hayden T Henderson
- Austin Fertility and Reproductive Medicine/Westlake IVF, Austin, TX 78746, USA
| | - Kayla Hudson
- Austin Fertility and Reproductive Medicine/Westlake IVF, Austin, TX 78746, USA
| | | | - Graham Luke Machen
- Austin Fertility and Reproductive Medicine/Westlake IVF, Austin, TX 78746, USA
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Jourdan A, Le Troter A, Daude P, Rapacchi S, Masson C, Bège T, Bendahan D. Semiautomatic quantification of abdominal wall muscles deformations based on dynamic MRI image registration. NMR Biomed 2021; 34:e4470. [PMID: 33525062 DOI: 10.1002/nbm.4470] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
Quantitative analysis of abdominal organs motion and deformation is crucial to better understand biomechanical alterations undermining respiratory, digestive or perineal pathophysiology. In particular, biomechanical characterization of the antero-lateral abdominal wall is central in the diagnosis of abdominal muscle deficiency. Here, we present a dedicated semiautomatic dynamic MRI postprocessing method enabling the quantification of spatial and temporal deformations of the antero-lateral abdominal wall muscles. Ten healthy participants were imaged during a controlled breathing session at the L3-L4 disc level using real-time dynamic MRI at 3 T. A coarse feature-tracking step allowed the selection of the inhalation cycle of maximum abdominal excursion. Over this image series, the described method combines (1) a supervised 2D+t segmentation procedure of the abdominal wall muscles, (2) the quantification of muscle deformations based on masks registration, and (3) the mapping of deformations within muscle subzones leveraging a dedicated automatic parcellation. The supervised 2D+t segmentation (1) provided an accurate segmentation of the abdominal wall muscles throughout maximum inhalation with a 0.95 ± 0.03 Dice similarity coefficient (DSC) value and a 2.3 ± 0.7 mm Hausdorff distance value while requiring only manual segmentation of 20% of the data. The robustness of the deformation quantification (2) was indicated by high indices of correspondence between the registered source mask and the target mask (0.98 ± 0.01 DSC value and 2.1 ± 1.5 mm Hausdorff distance value). Parcellation (3) enabled the distinction of muscle substructures that are anatomically relevant but could not be distinguished based on image contrast. The present genuine postprocessing method provides a quantitative analytical frame that could be used in further studies for a better understanding of abdominal wall deformations in physiological and pathological situations.
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Affiliation(s)
- Arthur Jourdan
- Aix-Marseille Université, Université Gustave Eiffel, LBA, Marseille, France
| | | | - Pierre Daude
- Aix Marseille Université, CNRS, CRMBM, Marseille, France
| | | | - Catherine Masson
- Aix-Marseille Université, Université Gustave Eiffel, LBA, Marseille, France
| | - Thierry Bège
- Aix-Marseille Université, Université Gustave Eiffel, LBA, Marseille, France
- Department of General Surgery, Aix Marseille Université, North Hospital, APHM, Marseille, France
| | - David Bendahan
- Aix Marseille Université, CNRS, CRMBM, Marseille, France
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Cope AG, Wetzstein MM, Mara KC, Laughlin-Tommaso SK, Warner NS, Burnett TL. Abdominal Ice after Laparoscopic Hysterectomy: A Randomized Controlled Trial. J Minim Invasive Gynecol 2020; 28:342-350.e2. [PMID: 32622918 DOI: 10.1016/j.jmig.2020.06.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2020] [Revised: 06/26/2020] [Accepted: 06/30/2020] [Indexed: 11/18/2022]
Abstract
STUDY OBJECTIVE To assess the impact of abdominal ice packs on opioid use and pain control after laparoscopic hysterectomy DESIGN: Randomized controlled trial. SETTING Academic tertiary care medical center. PATIENTS Total of 142 adult women undergoing laparoscopic (either conventional or robotic) hysterectomy were randomized to control (n = 69) or intervention (n = 73). Exclusion criteria included preoperative opioid use, planned intensive care unit admission or same-day discharge, an incision ≥4 cm, and regional anesthesia use. INTERVENTIONS Subjects in the intervention group had a large ice pack placed directly on the lower abdomen before leaving the operating room. The ice pack was maintained continuously for 12 hours postoperation, as desired thereafter until discharge, and continued use encouraged after discharge for up to 48 hours. MEASUREMENTS AND MAIN RESULTS Total opioids administered postoperatively, while inpatient and after dismissal, were assessed in morphine milligram equivalents. Postoperative pain, as well as analgesia acceptability and side effects, were assessed using validated measures: Brief Pain Inventory and Overall Benefit of Analgesia Score. Median morphine milligram equivalent was lower in the intervention group than the controls from inpatient stay on the floor to completion of opioid use as an outpatient (22.5 vs 26.2) but was not statistically significant (p = .79). There was no significant difference between the groups in Brief Pain Inventory assessment of postoperative pain severity (p = .80) or pain interference (p = .36) or Overall Benefit of Analgesia Score total score (p = .88). Most patients in the intervention group were very satisfied with ice pack use (n = 51, 79.7%) and very likely to recommend it to friends or family (n = 54, 83.1%). There were no adverse events related to ice pack use. CONCLUSION There was no significant difference in postoperative opioid use or pain assessment with ice pack use after laparoscopic hysterectomy. However, most of the subjects expressed high satisfaction specific to ice pack use and would recommend its use to others, suggesting potential desirability as adjunct therapy in postoperative pain control.
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Affiliation(s)
- Adela G Cope
- Department of Obstetrics and Gynecology (Drs. Cope, Wetzstein, Laughlin-Tommaso, and Burnett)
| | - Marnie M Wetzstein
- Department of Obstetrics and Gynecology (Drs. Cope, Wetzstein, Laughlin-Tommaso, and Burnett)
| | - Kristin C Mara
- Division of Biomedical Statistics and Informatics (Dr. Mara)
| | | | - Nafisseh S Warner
- Department of Anesthesiology and Perioperative Medicine (Dr. Warner); Kern Center for the Science of Health Care Delivery (Dr. Warner), Mayo Clinic, Rochester, Minnesota
| | - Tatnai L Burnett
- Department of Obstetrics and Gynecology (Drs. Cope, Wetzstein, Laughlin-Tommaso, and Burnett).
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Wang X, He K, Zhu Y, Fu X, Huang Z, Ding R, Yao Q, Chen H. Use of Shear Wave Elastography to Quantify Abdominal Wall Muscular Properties in Patients With Incisional Hernia. Ultrasound Med Biol 2020; 46:1651-1657. [PMID: 32402672 DOI: 10.1016/j.ultrasmedbio.2020.03.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Revised: 03/17/2020] [Accepted: 03/24/2020] [Indexed: 06/11/2023]
Abstract
Shear wave elastography (SWE) is a potential modality that quantitatively measures the elasticity (shear wave speed [SWS]) of musculoskeletal structure. This SWS was bilaterally measured in the rectus abdominis (RA), external oblique (EO) muscle, internal oblique (IO) muscle and transversus abdominis (TrA) using SWE in 28 patients with incisional hernia and 14 healthy controls. The differences in muscle thickness for IO and TrA were significant between the two groups (p < 0.05). The SWS of RA, EO, IO and TrA was significantly higher in the incisional hernia patient group than in the healthy controls (p < 0.05). Significant differences were also observed between the upper and lower points in both groups (p < 0.05). The measurements of SWS help in evaluating the elastic properties of abdominal wall muscles, which could further aid in preparing treatment plans to improve muscle strength.
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Affiliation(s)
- Xiaohong Wang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Kai He
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Yulan Zhu
- Department of Rehabilitation, Huashan Hospital, Fudan University, Shanghai, China
| | - Xiaojian Fu
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhifang Huang
- Department of Ultrasound, Huashan Hospital, Fudan University, Shanghai, China
| | - Rui Ding
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Qiyuan Yao
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China
| | - Hao Chen
- Department of General Surgery, Huashan Hospital, Fudan University, Shanghai, China.
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Ladanyi C, Sticco P, Blevins M, Boyd S, Gutmann D, Holcombe J, Mohling S. Efficacy and Safety of a Surgeon-Performed Laparoscopic-Guided, 4-point Transversus Abdominis Plane Block: A retrospective review. J Minim Invasive Gynecol 2020; 28:124-130. [PMID: 32562766 DOI: 10.1016/j.jmig.2020.06.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2019] [Revised: 05/28/2020] [Accepted: 06/10/2020] [Indexed: 11/19/2022]
Abstract
We performed a retrospective chart review from October 2017 to March 2019 to demonstrate the safety and efficacy of a surgeon-performed, laparoscopically guided, transversus abdominis plane (TAP) blocks for robot-assisted gynecologic procedures. A total of 116 patients who underwent robot-assisted gynecologic surgery, at 1 academic hospital, with administration of a 4-point TAP block were included. A 4-point TAP block was performed under laparoscopic visualization, by the same surgeon, after induction of anesthesia and immediately after placement of the laparoscope. Liposomal bupivacaine (20 mL) and 0.5% bupivacaine (20 mL) mixed with saline were used as the injectant. All information from the surgical admission and the postoperative follow-up were reviewed. Data were presented in our descriptive study. A total of 116 patients were included with a mean age of 40.6 years (19-80 years) and a mean body mass index of 30.6 kg/m2 (17.2-53.3 kg/m2). Of the patients, 70.7% were discharged to home on the day of surgery. Of the 29.3% of patients who were admitted, 20.6% were admitted because of pain control. Those who were admitted for pain control comprised 6.0% of the total of all study participants. There were no adverse events in our cohort and no readmissions because of pain control. A surgeon-performed TAP block, under laparoscopic visualization, is a safe and efficacious intervention to reduce postoperative pain and may add to a multimodal approach for enhanced recovery protocols.
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Affiliation(s)
- Camille Ladanyi
- Minimally Invasive Gynecologic Surgery Fellow, Department of Obstetrics and Gynecology, Erlanger Hospital, University of Tennessee College of Medicine, 979 E 3rd St #725, Chattanooga, TN 37403 (Drs. Ladanyi and Sticco).
| | - Peter Sticco
- Minimally Invasive Gynecologic Surgery Fellow, Department of Obstetrics and Gynecology, Erlanger Hospital, University of Tennessee College of Medicine, 979 E 3rd St #725, Chattanooga, TN 37403 (Drs. Ladanyi and Sticco)
| | - Miranda Blevins
- Department of Obstetrics and Gynecology, Erlanger Hospital, University of Tennessee College of Medicine, 979 E 3rd St #725, Chattanooga, TN 37403 (Drs. Blevins and Boyd)
| | - Sarah Boyd
- Department of Obstetrics and Gynecology, Erlanger Hospital, University of Tennessee College of Medicine, 979 E 3rd St #725, Chattanooga, TN 37403 (Drs. Blevins and Boyd)
| | - Daniel Gutmann
- Clinical Assistant Professor, Department of Emergency Medicine, Erlanger Hospital, University of Tennessee College of Medicine, 975 E 3rd St, Chattanooga, TN 37403 (Dr. Gutmann)
| | - Jenny Holcombe
- University of Tennessee School of Nursing & School of Education, University of Tennessee Health Science Center College of Medicine, 615 McCallie Ave, chattanooga, TN 37403 (Dr. Holcombe)
| | - Shanti Mohling
- Directory of Gynecology, Pearl Women's Center, 140 NW 14th Ave, Portland, OR 97209 (Dr. Mohling)
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Abstract
The anterior abdominal wall, which is composed of three layers (skin and adipose tissues; the myofascial layer; and the deep layer, consisting of the transversalis fascia, preperitoneal fat, and the parietal peritoneum), has many functions: containment, support and protection for the intraperitoneal contents, and involvement in movement and breathing. While hernias are often encountered and well reviewed in the literature, the other abdominal wall pathologies are less commonly described. In this pictorial review, we briefly discuss the normal anatomy of the anterior abdominal wall, describe the normal ultrasonographic anatomy, and present a wide range of pathologic abnormalities beyond hernias. Sonography emerges as the diagnostic imaging of first choice for assessing abdominal wall disorders, thus representing a valuable tool for ensuring appropriate management and limiting functional impairment.
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Affiliation(s)
- Ferdinando Draghi
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Giulio Cocco
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Via dei Vestini 31, 66100, Chieti, Italy.
| | - Filippo Maria Richelmi
- Radiology Institute, IRCCS Policlinico San Matteo Foundation, University of Pavia, Viale Camillo Golgi 19, 27100, Pavia, Italy
| | - Cosima Schiavone
- Unit of Ultrasound in Internal Medicine, Department of Medicine and Aging Sciences, University of Chieti G d'Annunzio, Via dei Vestini 31, 66100, Chieti, Italy
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7
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Fields AC, Weiner SG, Maldonado LJ, Cavallaro PM, Melnitchouk N, Goldberg J, Stopfkuchen-Evans MF, Baker O, Bordeianou LG, Bleday R. Implementation of liposomal bupivacaine transversus abdominis plane blocks into the colorectal enhanced recovery after surgery protocol: a natural experiment. Int J Colorectal Dis 2020; 35:133-138. [PMID: 31797098 DOI: 10.1007/s00384-019-03457-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/11/2019] [Indexed: 02/04/2023]
Abstract
BACKGROUND Enhanced recovery after surgery (ERAS) programs are now standard of care for colorectal surgery. Efforts have been aimed at decreasing postoperative opioid consumption. The goal of this study is to evaluate the effect of liposomal bupivacaine transversus abdominis plane (TAP) blocks on opioid use and its downstream effect on rates of ileus and hospital length of stay (LOS). METHODS We performed a retrospective pre- and postintervention time-trend analysis (2016-2018) of ERAS patients undergoing laparoscopic colorectal surgery at two academic medical centers within the same hospital system. The intervention was liposomal bupivacaine TAP blocks versus standard local infiltration with bupivacaine with a primary outcome of total morphine milligram equivalents (MME) administered within 72 h of surgery. Secondary outcomes included hospital LOS and rate of postoperative ileus. RESULTS There were 556 patients included at the control hospital, and 384 patients were included at the treatment hospital. Patients at both hospitals were similar with regard to age, body mass index, comorbidities, and surgical indication. In an adjusted time-trend analysis, the treatment hospital was associated with a significant decrease in MME administered (- 15.9 mg, p = 0.04) and hospital LOS (- 0.8 days, p < 0.001). There was no significant decrease in the rate of ileus at the treatment hospital (- 6.9%, p = 0.08). CONCLUSIONS In a time-trend analysis, the addition of liposomal bupivacaine TAP blocks into the ERAS protocol resulted in significantly reduced opioid use and shorter hospital LOS for patients undergoing surgery at the treatment hospital. Liposomal bupivacaine TAP blocks should be considered for inclusion in the standard ERAS protocol.
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Affiliation(s)
- Adam C Fields
- Division of Colorectal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Quality and Safety, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Scott G Weiner
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Luisa J Maldonado
- Division of Colorectal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul M Cavallaro
- Division of Colorectal Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nelya Melnitchouk
- Division of Colorectal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Joel Goldberg
- Division of Colorectal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | | | - Olesya Baker
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Liliana G Bordeianou
- Division of Colorectal Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Ronald Bleday
- Division of Colorectal Surgery, Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Wakahara T, Shiraogawa A. Effects of neuromuscular electrical stimulation training on muscle size in collegiate track and field athletes. PLoS One 2019; 14:e0224881. [PMID: 31721812 PMCID: PMC6853328 DOI: 10.1371/journal.pone.0224881] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Accepted: 10/23/2019] [Indexed: 11/18/2022] Open
Abstract
The purpose of this study was to examine the effects of neuromuscular electrical stimulation training for 12 weeks on the abdominal muscle size in trained athletes. Male collegiate track and field athletes participated in the present study and were randomly allocated to either training or control groups. Eleven participants of the training group completed a 60-session training program over a 12-week period (23 min/session, 5 days/week) involving neuromuscular electrical stimulation (mostly 20 Hz) for the abdominal muscles in addition to their usual training for the own events. The participants of the control group (n = 13) continued their usual training. Before and after the intervention period, cross-sectional areas of the rectus abdominis and abdominal oblique muscles (the internal and external obliques and transversus abdominis) and subcutaneous fat thickness were measured with magnetic resonance and ultrasound imaging. There were no significant changes in cross-sectional area of the rectus abdominis or abdominal oblique muscles or in subcutaneous fat thickness in the training or control groups after the intervention period. The change in cross-sectional area of the rectus abdominis in each participant was not significantly correlated with pre-training cross-sectional area and neither was the mean value of fat thickness at pre- and post-training. These results suggest that low-frequency (20 Hz) neuromuscular electrical stimulation training for 12 weeks is ineffective in inducing hypertrophy of the abdominal muscles in trained athletes, even when they have a thin layer of subcutaneous fat.
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Affiliation(s)
- Taku Wakahara
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Kyoto, Japan
- Human Performance Laboratory, Waseda University, Tokorozawa, Saitama, Japan
- * E-mail:
| | - Ayumu Shiraogawa
- Faculty of Health and Sports Science, Doshisha University, Kyotanabe, Kyoto, Japan
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9
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Granados A, Gebremariam A, Gidding SS, Terry JG, Carr JJ, Steffen LM, Jacobs DR, Lee JM. Association of abdominal muscle composition with prediabetes and diabetes: The CARDIA study. Diabetes Obes Metab 2019; 21:267-275. [PMID: 30159995 PMCID: PMC6329642 DOI: 10.1111/dom.13513] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2018] [Revised: 08/13/2018] [Accepted: 08/21/2018] [Indexed: 12/28/2022]
Abstract
AIM To evaluate the relationship of abdominal muscle lean tissue and adipose tissue volumes with prediabetes and diabetes. RESEARCH DESIGN AND METHODS We measured abdominal muscle composition in 3170 participants in the Coronary Artery Risk Development in Young Adults (CARDIA) study who underwent computed tomography (CT) at Year 25 of follow-up (ages, 43-55 years). Multinomial regression analysis was used to evaluate the associations of CT-measured intermuscular adipose tissue (IMAT), lean muscle tissue (lean) and visceral adipose tissue (VAT) volumes with diabetes at any point during the CARDIA study, newly detected prediabetes, prior history of prediabetes, and normal glucose tolerance. Models were adjusted for potential confounding factors: age, sex, race, height, smoking status, hypertension, hyperlipidaemia, cardiorespiratory fitness and study centre. RESULTS Higher IMAT, lean and VAT volumes were all separately associated with a higher prevalence of prediabetes and diabetes. Inclusion of VAT volume in models with both IMAT volume and lean volume attenuated the association of IMAT with both prediabetes and diabetes, but higher lean volume retained its association with prediabetes and diabetes. Individuals in the highest IMAT quartile, coupled with VAT in its lower three quartiles, had a higher prevalence of diabetes, but not of prediabetes, than those with both IMAT and VAT in their respective lower three quartiles. Adjusting for cardiorespiratory fitness did not substantially change the findings. CONCLUSION Higher IMAT volume was associated with a higher prevalence of diabetes even after adjustment for VAT volume. However, further study is warranted to understand the complicated relationship between abdominal muscle and adipose tissues.
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Affiliation(s)
- Andrea Granados
- Department of Pediatrics, Pediatric Endocrinology, Washington University, St Louis, Missouri
| | - Achamyeleh Gebremariam
- Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, Michigan
| | - Samuel S Gidding
- Nemours Cardiac Center, A. I. DuPont Hospital for Children, Wilmington, Delaware
| | - James G Terry
- Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University Medical Center, Nashville, Tennessee
| | - John Jeffrey Carr
- Department of Radiology and Vanderbilt Translational and Clinical Cardiovascular Research Center (VTRACC), Vanderbilt University Medical Center, Nashville, Tennessee
| | - Lyn M Steffen
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - David R Jacobs
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, Minnesota
| | - Joyce M Lee
- Child Health Evaluation and Research Center (CHEAR), University of Michigan, Ann Arbor, Michigan
- Department of Pediatric Endocrinology, University of Michigan, Ann Arbor, Michigan
- Department of Nutrition, School of Public Health, University of Minnesota, Minneapolis, Minnesota
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10
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Lahelma M, Sädevirta S, Lallukka-Brück S, Sevastianova K, Mustelin L, Gylling H, Rockette-Wagner B, Kriska AM, Yki-Järvinen H. Effects of Weighted Hula-Hooping Compared to Walking on Abdominal Fat, Trunk Muscularity, and Metabolic Parameters in Overweight Subjects: A Randomized Controlled Study. Obes Facts 2019; 12:385-396. [PMID: 31216547 PMCID: PMC6758714 DOI: 10.1159/000500572] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 04/24/2019] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND Weighted hula-hoops have gained popularity, but whether they indeed reshape the trunk or have beneficial metabolic effects in overweight subjects is unknown. OBJECTIVES To determine effects of hula-hooping and walking matched for energy expenditure on android fat %, trunk muscle mass, and metabolic parameters in a randomized cross-over study. DESIGN We recruited 55 overweight nondiabetic subjects, who were randomized to hula-hooping (HULA) for 6 weeks using a 1.5-kg weighted hula-hoop followed by walking (WALK) for another 6 weeks or vice versa. The increments in energy expenditure were similar by HULA and WALK. Body composition (dual-energy X-ray absorptiometry) and metabolic parameters were measured at baseline and after HULA and WALK. The primary endpoint was the change in fat % in the android region. RESULTS A total of 53subjects (waist 92 ± 1 cm, body mass index 28 ± 1 kg/m2) completed the study. Body weight changed similarly (-0.6 ± 0.2 vs. -0.5 ± 0.2 kg, nonsignificant; HULA vs. WALK). During the intervention the subjects hula-hooped on average 12.8 ± 0.5 min/day and walked 9,986 ± 376 steps/day. The % fat in the android region decreased significantly by HULA but not by WALK (between-group change p < 0.001). Trunk muscle mass increased more by HULA than by WALK (p < 0.05). Waist circumference decreased more by HULA than by WALK (-3.1 ± 0.3 cm vs. -0.7 ± 0.4 cm, p < 0.001; HULA vs. WALK). WALK but not HULA significantly lowered systolic blood pressure and increased HDL cholesterol while HULA significantly decreased LDL cholesterol. CONCLUSIONS Hula-hooping with a weighted hula-hoop can be used to decrease abdominal fat % and increase trunk muscle mass in overweight subjects. Its LDL lowering effect resembles that described for resistance training.
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Affiliation(s)
- Mari Lahelma
- Minerva Foundation Institute for Medical Research, Helsinki, Finland,
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland,
| | - Sanja Sädevirta
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Susanna Lallukka-Brück
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Ksenia Sevastianova
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Linda Mustelin
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Helena Gylling
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | | | - Andrea M Kriska
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
| | - Hannele Yki-Järvinen
- Minerva Foundation Institute for Medical Research, Helsinki, Finland
- Department of Medicine, Helsinki University Hospital, University of Helsinki, Helsinki, Finland
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11
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Abstract
Acquired abdominal intercostal hernia (AAIH) is an infrequent occurrence whereby intra-abdominal contents herniate into intercostal space directly from the peritoneal cavity through an acquired defect in the abdominal wall musculature and fascia. These hernias are difficult to diagnose and should always be suspected when a chest wall swelling occur after major or minor trauma. Surgical repair is warranted in symptomatic patients. The majority of AAIHs are repaired through an open approach using tension-free mesh, with significant recurrence risk. Recently, laparoscopic and robot-assisted repairs have been proposed. We discuss a 49-year-old man presented through outpatient setting with a 5-year history of ongoing left subcostal discomfort and a reducible lump. His history included a workplace accident 5 years ago. Contrast-enhanced abdominal CT confirmed AAIH with omentum herniation into the sac. A successful laparoscopic repair with intraperitoneal onlay mesh technique using composite mesh was performed.
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Affiliation(s)
| | - Afzaal Mughal
- General Surgery, Mayo General Hospital, Castlebar, Ireland
| | - Ronan Waldron
- General Surgery, Mayo General Hospital, Castlebar, Ireland
| | - Iqbal Z Khan
- General Surgery, Mayo General Hospital, Castlebar, Ireland
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Gabrielsen DA, Carney MJ, Weissler JM, Lanni MA, Hernandez J, Sultan LR, Enriquez F, Sehgal CM, Fischer JP, Chauhan A. Application of ARFI-SWV in Stiffness Measurement of the Abdominal Wall Musculature: A Pilot Feasibility Study. Ultrasound Med Biol 2018; 44:1978-1985. [PMID: 29980451 DOI: 10.1016/j.ultrasmedbio.2018.05.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 04/09/2018] [Accepted: 05/03/2018] [Indexed: 06/08/2023]
Abstract
The purpose of this study was to assess the feasibility of acoustic radiation force impulse shear wave velocity and textural features for characterizing abdominal wall musculature and to identify subject-related and technique-related factors that can potentially affect measurements. Median shear wave velocity measurements for the right external abdominal oblique were the same (1.89 ± 0.16 m/s) for both the active group (healthy volunteers with active lifestyles) and the control group (age and body mass index-matched volunteers from an ongoing hernia study). When corrected for thickness, the ratio of right external abdominal oblique shear wave velocity -to-muscle thickness was significantly higher in the control group than in the active volunteers (4.33 s-1 versus 2.88 s-1; p value 0.006). From the textural features studied for right external abdominal oblique, 8 features were found to be statistically different between the active and control groups. In conclusion, shear wave velocity is a feasible and reliable technique to evaluate the stiffness of the abdominal wall musculature. Sonographic texture features add additional characterization of abdominal wall musculature.
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Affiliation(s)
- David A Gabrielsen
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Martin J Carney
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jason M Weissler
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael A Lanni
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jorge Hernandez
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Laith R Sultan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Fabiola Enriquez
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Chandra M Sehgal
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - John P Fischer
- Division of Plastic Surgery, Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Anil Chauhan
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA.
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Sugarbaker PH. Psoas/iliacus muscle invasion from mucinous appendiceal neoplasm. Radiologic appearance and outcome of treatment in 3 patients. Surg Oncol 2018; 27:154-157. [PMID: 29937165 DOI: 10.1016/j.suronc.2018.02.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2018] [Accepted: 02/04/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mucinous appendiceal neoplasms have a pattern of metastases that is different from the other gastrointestinal cancers. The first site for cancer dissemination is the peritoneal space surrounding the primary tumor and this is followed by increasingly extensive peritoneal spread. Invasion of the psoas and iliacus muscle is an unusual phenomenon. METHOD From a prospective database of appendiceal mucinous neoplasms treated by cytoreductive surgery (CRS) and perioperative hyperthermic chemotherapy (HIPEC), patients with psoas muscle invasion were reviewed. Their clinical features and treatments were tabulated. RESULTS Three patients with ages 33, 60, and 63 were identified. Two patients had disease progression into the psoas muscle 33 and 95 months after CRS plus HIPEC. One had dissecting mucinous tumor into psoas, iliacus and quadratus lumborum muscle at the time of diagnosis of the appendiceal mucinous neoplasm. All three survived at least five years from their initial treatment. CONCLUSION Despite the fact that mucinous tumor invasion was outside the peritoneal cavity, long term benefit from psoas muscle resection with a mucinous appendiceal neoplasm is possible and resection possibly with HIPEC should be considered.
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Affiliation(s)
- Paul H Sugarbaker
- Program in Peritoneal Surface Oncology, MedStar Washington Cancer Institute, MedStar Washington Hospital Center, 106 Irving St., NW, Suite 3900, Washington, DC 20010, USA.
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15
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Azadinia F, Ebrahimi E, Kamyab M, Parnianpour M, Cholewicki J, Maroufi N. Can lumbosacral orthoses cause trunk muscle weakness? A systematic review of literature. Spine J 2017; 17:589-602. [PMID: 27988341 DOI: 10.1016/j.spinee.2016.12.005] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2016] [Revised: 11/14/2016] [Accepted: 12/09/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Wearing lumbosacral orthosis (LSO) is one of the most common treatments prescribed for conservative management of low back pain. Although the results of randomized controlled trials suggest effectiveness of LSO in reducing pain and disability in these patients, there is a concern that prolonged use of LSO may lead to trunk muscle weakness and atrophy. PURPOSE The present review aimed to evaluate available evidence in literature to determine whether LSO results in trunk muscle weakness or atrophy. STUDY DESIGN This is a systematic review. METHODS A systematic search of electronic databases including PubMed, Scopus, ScienceDirect, and Medline (via Ovid) followed by hand search of journals was performed. Prospective studies published in peer-reviewed journals, with full text available in English, investigating the effect of lumbar orthosis on trunk muscle activity, muscle thickness, strength or endurance, spinal force, and intra-abdominal pressure in healthy subjects or in patients with low back pain, were included. Methodological quality of selected studies was assessed by using the modified version of Downs and Black checklist. This research had no funding source, and the authors declare no conflicts of interest-associated biases. RESULTS Thirty-five studies fulfilled the eligibility criteria. The mean and standard deviation of the quality score was 64±9.7%. Most studies investigating the effect of lumbar orthosis on electromyographic activity (EMG) of trunk muscles demonstrated a decrease or no change in the EMG parameters. A few studies reported increased muscle activity. Lumbosacral orthosis was found to have no effect on muscle strength in some studies, whereas other studies demonstrated increased muscle strength. Only one study, which included ultrasound assessment of trunk muscle stabilizers, suggested reduced thickness of the abdominal muscles and reduced cross-sectional area of the multifidus muscles. Out of eight studies that investigated spinal compression load, the load was reduced in four studies and unchanged in three studies. One study showed that only elastic belts reduced compression force compared to leather and fabric belts and ascribed this reduction to the elastic property of the lumbar support. CONCLUSION The present review showed that the changes in outcome measures associated with muscle work demands were inconsistent in their relation to the use of lumbar supports. This review did not find conclusive scientific evidence to suggest that orthosis results in trunk muscle weakness.
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Affiliation(s)
- Fatemeh Azadinia
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Esmaeil Ebrahimi
- Department of Physical therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Mojtaba Kamyab
- Department of Orthotics and Prosthetics, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Mohamad Parnianpour
- Biomechanics Laboratory, Department of Mechanical Engineering, Sharif University of Technology, Tehran, Iran
| | - Jacek Cholewicki
- MSU Center for Orthopedic Research, Department of Surgical Specialties, College of Osteopathic Medicine, Michigan State University, East Lansing, MI, USA
| | - Nader Maroufi
- Department of Physical therapy, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Silveira RK, Coelho ARB, Pinto FCM, de Albuquerque AV, de Melo Filho DA, de Andrade Aguiar JL. Bioprosthetic mesh of bacterial cellulose for treatment of abdominal muscle aponeurotic defect in rat model. J Mater Sci Mater Med 2016; 27:129. [PMID: 27379627 DOI: 10.1007/s10856-016-5744-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2016] [Accepted: 06/29/2016] [Indexed: 06/06/2023]
Abstract
The use of meshes for treatment of hernias continues to draw attention of surgeons and the industry in the search of an ideal prosthesis. The purpose of this work is to use meshes manufactured from bacterial cellulose, evaluate their organic tissue interaction and compare with an expanded polytetrafluorethylene (ePTFE's) prosthesis used to repair acute defect of muscle aponeurotic induced in rats. Forty-five male Wistar rats were classified using the following criteria: (1) surgical repair of acute muscle aponeurotic defect with perforated bacterial cellulose film (PBC; n = 18); (2) compact bacterial cellulose film (CBC; n = 12) and (3) ePTFE; (n = 15). After postoperative period, rectangles (2 × 3 cm) including prosthesis, muscles and peritoneum were collected for biomechanical, histological and stereological analysis. In all cases, the maximum acceptable error probability for rejecting the null hypothesis was 5 %. Between PBC and CBC samples, the variables of strain (P = 0.011) and elasticity (P = 0.035) were statistically different. The same was found between CBC and ePTFE (elasticity, P = 0.000; strain, P = 0.009). PBC differed from CBC for giant cells (P = 0.001) and new blood vessels (P = 0.000). In conclusion, there was biological integration and biomechanical elasticity of PBC; therefore, we think this option should be considered as a new alternative biomaterial for use as a bio prosthesis.
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Affiliation(s)
- Raquel Kelner Silveira
- Department of Surgery, Center for Health Sciences, Federal University of Pernambuco, UFPE, R. Major João Ribeiro Pinheiro, N. 245, Apt. 310, Edf. São Paulo, Recife, Pernambuco, CEP 50-740-170, Brazil
| | - Antônio Roberto Barros Coelho
- Department of Surgery, Center for Health Sciences, Federal University of Pernambuco, UFPE, R. Major João Ribeiro Pinheiro, N. 245, Apt. 310, Edf. São Paulo, Recife, Pernambuco, CEP 50-740-170, Brazil
| | - Flávia Cristina Morone Pinto
- Center for Experimental Surgery, Department of Surgery, Center for Health Sciences, Federal University of Pernambuco, UFPE, Recife, Pernambuco, Brazil
| | - Amanda Vasconcelos de Albuquerque
- Center for Experimental Surgery, Department of Surgery, Center for Health Sciences, Federal University of Pernambuco, UFPE, Recife, Pernambuco, Brazil.
| | - Djalma Agripino de Melo Filho
- Department of Surgery, Center for Health Sciences, Federal University of Pernambuco, UFPE, R. Major João Ribeiro Pinheiro, N. 245, Apt. 310, Edf. São Paulo, Recife, Pernambuco, CEP 50-740-170, Brazil
| | - José Lamartine de Andrade Aguiar
- Department of Surgery, Center for Health Sciences, Federal University of Pernambuco, UFPE, R. Major João Ribeiro Pinheiro, N. 245, Apt. 310, Edf. São Paulo, Recife, Pernambuco, CEP 50-740-170, Brazil
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17
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Landi P, Dorado E, Paz LA. [Colon cancer with abdominal wall infiltration and clinical factors of poor prognosis]. Medicina (B Aires) 2016; 76:403-407. [PMID: 27959855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
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18
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Hölmich P. Groin injuries in athletes--development of clinical entities, treatment, and prevention. Dan Med J 2015; 62:B5184. [PMID: 26621401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The doctoral thesis is based on eight papers published in peer-reviewed journals and a review of the literature. The papers are published between 1997 and 2013 in cooperation with Sankt Elisabeth Hospital, Herlev Hospital, Glostrup Hospital, Rigshospitalet, Hvidovre Hospital, Amager Hospital, Copenhagen Trial Unit, and Institute of Preventive Medicine, Copenhagen. Groin injuries in sport are very common and in football they are among the most common and most time-consuming injuries. These injuries are treated very differently around the world. There is no consensus in the literature regarding definitions, examination methods, diagnosis or treatment and in general the level of evidence is very low. There is a need for identification of the painful anatomical structures, how to examine them and how to define clinical entities to develop effective treatment and prevention. The aim of these studies were: - To review the literature to create an overview of the ideas and the knowledge in order to plan future studies in this field. - Develop and test clinical examination techniques of the relevant tendons and muscles in the region. - Since no evidence-based diagnosis exist; to develop a set of clinical entities to identify the different groups of patients. - To test the effect of a dedicated exercise program developed for treatment of long-standing adductor-related groin pain in athletes in a randomised clinical trial comparing it to the treatment modalities used at that time. - To examine the long-term effect of the above mentioned training program for treatment of long-standing adductor-related groin pain. - To develop a training program for prevention of groin injuries in soccer and test it in a randomised clinical trial. - To describe the occurrence and presentation in clinical entities of groin injuries in male football and to examine the characteristics of these injuries. - Evaluate if radiological signs of femuro-acetabular impingement (FAI) or dysplasia affect the clinical outcome of treatment of long-standing adductor-related groin pain, initially and at 8-12 year follow-up. The main findings of the eight papers were: - No randomised trials existed in this area; there was no consensus in the literature and the majority of the literature was Level 4 and 5. From the existing literature and the author' experience an injury mechanism was suggested and the term ''adductor-related groin injury'' was suggested. - A well-defined clinical examination of the adductor-, iliopsoas, and abdominal muscles and the symphysis joint for pain, strength, and flexibility was reproducible with only limited intra- and inter-observer variation. - By utilising a well-defined classification long-standing groin injuries could be classified with a system of clinical entities.
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Usenko OY, Gomolyako IV, Kondratenko BM, Moskalenko VV. [MORPHOLOGICAL PECULIARITIES OF MUSCULO-APONEUROTIC TISSUES OF ANTERIOR ABDOMINAL WALL IN PATIENTS, SUFFERING MORBID OBESITY]. Klin Khir 2015:28-29. [PMID: 26939422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Results of morphological investigation of musculo-aponeurotic structures of anterior abdominal wall were presented in the morbid obesity patients. The role of obesity as a primary cause for morphofunctional insufficience of musculo-aponeurotic structures was established.
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20
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Cuomo R, Nisi G, Grimaldi L, Brandi C, Sisti A, D'Aniello C. Immunosuppression and Abdominal Wall Defects: Use of Autologous Dermis. In Vivo 2015; 29:753-755. [PMID: 26546532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
AIM The purpose of the present study was to analyze the use of autologous dermis compared to non-biological meshes in repair of abdominal wall defects in patients with redundant skin and immunosuppression. PATIENTS AND METHODS Eighteen patients with abdominal wall defects, immunosuppression and with redundant skin were divided into two groups: Group A consisted of 11 patients treated with autologous dermis. In these patients, autologous dermis was isolated from the amount of skin resected from the inferior abdominal region that was used as a reinforcement of fascial margins above the defect. Group B consisted of seven patients treated with non-biological meshes We evaluated the infection rate of these groups. RESULTS The infection rate was significantly lower in group A patients. CONCLUSION The transplantation of autologous dermis as a reinforcement for the reconstruction of abdominal wall defects is reasonable for highly selected patients. The use of the dermis was proven useful and we found a lower rate of infection and recurrence.
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Affiliation(s)
- Roberto Cuomo
- Plastic Surgery Division, General and Specialist Surgery Department, S. Maria alle Scotte Polyclinic, University of Siena, Siena, Italy
| | - Giuseppe Nisi
- Plastic Surgery Division, General and Specialist Surgery Department, S. Maria alle Scotte Polyclinic, University of Siena, Siena, Italy
| | - Luca Grimaldi
- Plastic Surgery Division, General and Specialist Surgery Department, S. Maria alle Scotte Polyclinic, University of Siena, Siena, Italy
| | - Cesare Brandi
- Plastic Surgery Division, General and Specialist Surgery Department, S. Maria alle Scotte Polyclinic, University of Siena, Siena, Italy
| | - Andrea Sisti
- Plastic Surgery Division, General and Specialist Surgery Department, S. Maria alle Scotte Polyclinic, University of Siena, Siena, Italy
| | - Carlo D'Aniello
- Plastic Surgery Division, General and Specialist Surgery Department, S. Maria alle Scotte Polyclinic, University of Siena, Siena, Italy
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21
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Kinda B, Ouédraogo C, Ouagré E, Ghilat N, Simporé A, Bonkougou P, Sanou J. [Atypical localization of myomas during surgery: report of two cases including one in an emergency context]. Pan Afr Med J 2015; 22:79. [PMID: 26848326 PMCID: PMC4732623 DOI: 10.11604/pamj.2015.22.79.7846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2015] [Accepted: 09/20/2015] [Indexed: 11/22/2022] Open
Abstract
Les fibromyomes sont des tumeurs bénignes de localisation utérine courante. Elles sont fréquentes chez la femme noire, le diagnostique est échographique et anatomo-histologique. La localisation extra utérine est rare et de physio-pathogénie mal connue. Cette localisation pose des problèmes de diagnostique. Nous rapportons deux cas cliniques de fibromes localisés sur le segment sigmoïdien de l'intestin et sur la paroi interne du muscle transverse de l'abdomen d'une part chez une patiente âgée de 41 ans et d'autre part en région épigastrique, chez une patiente de 47 ans. Toutes les patientes ont été opérées respectivement l'une de myomes utérins pour infertilité et l'autre de laparotomie en urgence pour syndrome sub-occlusif au cinquante huitième jour post hystérectomie. Ces observations doivent inciter les cliniciens ou les radiologistes à réaliser un bilan étendu à la recherche de localisation extra-utérine avant une myomectomie ou hystérectomie car un myome peut en cacher un autre en dehors de l'utérus.
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Affiliation(s)
- Boureima Kinda
- Département d'Anesthésie et Réanimation, CHU Yalgado Ouédraogo, Ouagadougou
| | | | - Edgar Ouagré
- Département de Chirurgie et Spécialités Chirurgicales, CHU Yalgado Ouédraogo, Ouagadougou
| | - Nadine Ghilat
- Service de Gynécologie et Obstétrique du Centre Médical de Saint Camille, Ouagadougou
| | - André Simporé
- Département d'Anesthésie et Réanimation, CHU Yalgado Ouédraogo, Ouagadougou
| | | | - Joachim Sanou
- Département d'Anesthésie et Réanimation, CHU Yalgado Ouédraogo, Ouagadougou
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Grubnik VV, Parfentyeva ND, Parfentyev RS. [FUNCTIONAL PLASTIC OF ANTERIOR ABDOMINAL WALL HERNIAS]. Klin Khir 2015:22-25. [PMID: 26591212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
In order to improve the treatment efficacy of postoperative anterior abdominal wall hernias the method of plastic with restoration of anatomical and physiological properties of the muscles of the anterior abdominal wall was used. After the intervention by the improved method, regardless of the location of the hernia defect yielded promising results for the conservation of anterior abdominal wall muscle function in 75% of cases completely restored functional ability of muscles recti abdomini.
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Tchatalbachev VV, Kirkpatrick DL, Duff DJ, Travis MD. Seeding of the rectus sheath with hepatocellular carcinoma after image guided percutaneous liver biopsy using coaxial biopsy needle system. J Radiol Case Rep 2015; 9:18-25. [PMID: 25926917 DOI: 10.3941/jrcr.v9i1.1887] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Needle track seeding following image guided needle biopsy is a known but uncommon complication in the workup of hepatocellular carcinoma. We present the case of a 55 year-old male who was found to have a recurrent hepatocellular carcinoma in the rectus sheath five years following a CT guided biopsy with the biopsy needle passing through the anterior abdominal wall muscles.
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Affiliation(s)
| | | | - Deiter J Duff
- Department of Pathology and Anatomical Sciences, University of Missouri, Columbia, Missouri, USA
| | - Mark D Travis
- Department of Radiology, University of Missouri, Columbia, Missouri, USA
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Affiliation(s)
- Kazuma Sugie
- Department of Neurology, Nara Medical University School of Medicine, Japan
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25
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Gave AA, Hopkins MA. Laparoscopy and unsuspected intraabdominal malignancy with rapid peritoneal spread. Surg Endosc 2014; 15:518. [PMID: 11353976 DOI: 10.1007/s004640040033] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/1999] [Accepted: 10/25/1999] [Indexed: 10/28/2022]
Abstract
Use of the laparoscopic approach for intra-abdominal malignancy remains controversial because there have been multiple reports of tumor metastases at port sites after laparoscopy. Although several randomized trials have documented no difference in recurrence rates between laparoscopic and open surgery, there are still many questions about the behavior of tumor cells in laparoscopic conditions. The speed of tumor spread and time to recurrence appear to be variable. Abdominal insufflation and other effects of laparoscopy are only now being delineated. It is not clear whether tumor characteristics, preoperative tumor stage, or the laparoscopic milieu itself affect tumor spread during and after laparoscopic surgery. We present an unusual case of very rapid tumor dissemination in a young patient who underwent diagnostic laparoscopy.
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Affiliation(s)
- A A Gave
- Staten Island University Hospital, Staten Island, NY, 10305, USA
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Xu C, Zhang Z, Wang H, Song Q, Wei R, Yu Y, Li J, Sun Y. A new tool for distinguishing muscle invasive and non-muscle invasive bladder cancer: the initial application of flexible ultrasound bronchoscope in bladder tumor staging. PLoS One 2014; 9:e92385. [PMID: 24704988 PMCID: PMC3976253 DOI: 10.1371/journal.pone.0092385] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2013] [Accepted: 02/21/2014] [Indexed: 01/29/2023] Open
Abstract
Objectives To validate the flexible ultrasound bronchoscope (FUB) as a tool in distinguishing muscle invasive and non-muscle invasive bladder tumors. Materials and Methods From June 2010 to April 2012, 62 patients (11 female and 51 male) with 92 bladder urothelial carcinoma were treated in our study. The mean (±SD) patient age was 64.0±12.5 years old (ranged from 22 to 87). Clinical T stage was assessed by FUB at first in operating room, then immediately initial diagnostic transurethral resection (TUR) was performed. A second TUR would be done 2–4 weeks after initial TUR when the latter was incomplete (in large and multiple tumours, no muscle in the specimen) or when an exophytic high-grade and/or T1 tumour was detected. And radical cystectomy would be performed for the patients who were diagnosed with muscle-invasive tumors. FUB staging and initial TUR staging, final pathological results were compared. Results In ultrasonic images, the normal muscle layer of bladder wall could be clearly distinguished into three layers, which were hyperechogenic mucosa, hypoechogenic muscle and hyperechogenic serosal. For non-muscle invasive tumors, the muscle layers were continuous. And distorted or discontinuous muscle layers could be seen in muscle-invasive case. The overall accuracy (95.7%) and the specificity of muscle invasion detection of FUB (98.8%) were comparable to TUR (overall accuracy 90.2% and specificity 100%), but sensitivity of muscle invasion detection of FUB was significantly higher than initial TUR (72.7%VS18.2%). Moreover, the tumor's diameter could not affect the FUB's accuracy of muscle invasion detection. For tumors near the bladder neck, FUB also showed the similar validity as those far from bladder neck. Conclusions To conclude, the flexible ultrasound bronchoscope is an effective tool for muscle invasion detection of bladder tumor with ideal ultrasonic images. It is an alternative option for bladder tumor staging besides TUR. It might have the potentiality to change the bladder diagnostic strategy.
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Affiliation(s)
- Chuanliang Xu
- Department of Urology, Changhai Hospital, Second Military University, Shanghai, China
| | - Zhensheng Zhang
- Department of Urology, Changhai Hospital, Second Military University, Shanghai, China
| | - Haifeng Wang
- Department of Urology, Changhai Hospital, Second Military University, Shanghai, China
| | - Qixiang Song
- Department of Urology, Changhai Hospital, Second Military University, Shanghai, China
- Department of Biomedical Engineering, the Cleveland Clinic, Cleveland, Ohio, United States of America
| | - Rongchao Wei
- Department of Urology, Changhai Hospital, Second Military University, Shanghai, China
| | - Yongwei Yu
- Department of Pathology, Changhai Hospital, Second Military University, Shanghai, China
| | - Jian Li
- Department of Ultrasound, Changhai Hospital, Second Military University, Shanghai, China
| | - Yinghao Sun
- Department of Urology, Changhai Hospital, Second Military University, Shanghai, China
- * E-mail:
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Kalish II, Baĭbekov IM, Ametov LZ, Ĭigitaliev SK. [Morphological characteristic of tissues, surrounding prosthesis in patients, suffering cutaneo-prosthetic fistulas and paraprosthetic hernias]. Klin Khir 2014:34-36. [PMID: 25097974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
While application of the net prostheses in surgery of anterior abdominal wall hernias (AAWH) the complications are noted, such as the prosthesis cyst development, the net wrinkling, migration and separation with the hernia recurrence. Morphological investigation of tissues were conducted in regions of cutaneo-prosthetic fistulas and hernial gates, formatted by the prosthesis edge, in 22 patients, operated for AAWH, in 6 of them cutaneo-prosthetic fistulas were observed. Morphological changes in region of prosthesis, taking part in the hernial defect development, as well as in the wrinkled part of the prosthesis, were characterized by pronounced inflammation, development of rude cicatrices and infiltration of tissues. While durable existence of cutaneo-prosthetic fistulas the prosthesis degradation and destruction occurs as well as the breaks and cracks; on sites of the tissue, surrounding the prosthesis, the microorganisms and fungi vegetations may evolve, trusting its secondary infectioning.
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Abstract
Spigelian hernias represent 1-2% of all abdominal wall hernias. The pathogenesis often involves a dehiscence of the transverse and internal oblique muscle aponeurosis. The diagnosis is made by physical examination; but sometimes it is complicated by obesity. The risk of strangulation is important and can reach 30%. The abdominal CT scan is helpful in the description of hernia's topography and sometimes in diagnostic confirmation. The treatment is surgical. The rate of recurrence after direct closure is considerable. Synthetic mesh repair seems to be a more adequate alternative. The advent of laparoscopy has improved the management of these hernias.
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Affiliation(s)
- Rabii Noomene
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie.
| | - Ahmed Bouhafa
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie
| | - Anis Ben Maamer
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie
| | - Noomen Haoues
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie
| | | | - Abderraouf Cherif
- Hôpital Habib Thameur, service de chirurgie générale, Tunis, Tunisie
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Sukovatykh BS, Valuĭskaia NM, Netiaga AA, Zhukovskiĭ VA, Gerasimchuk EV. [The influence of anatomical and functional failure of the abdominal wall on the prognosis of postoperative ventral hernias]. Khirurgiia (Mosk) 2014:43-47. [PMID: 24429714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
It was analyzed the results of clinical and ultrasound examination of the abdominal wall in 180 patients with different surgical diseases of the abdominal cavity. All patients were divided into 3 groups of 60 persons on the basis of the preoperative examination results. The first group included patients without clinical and ultrasound disorders, the second and the third - with mild and severe anatomical and functional failure of the abdominal wall. 20% of patients from the first group had single strain of the abdominal wall after operation without the development of postoperative hernias. 3.3% of patients in the second group had defects and 15% of patient from the same group had severe thinning of the abdominal wall. 45% of patients in the third group had postoperative hernias. Relative and absolute indications for preventive replacement of the abdominal wall were defined.
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Vorovskyĭ OO. [Preventive abdominoplasty using polypropylene prosthesis during primary laparotomy in the elderly and aged patients as a method of prophylaxis to occurrence of the postoperative abdominal wall defects]. Klin Khir 2013:34-37. [PMID: 24501986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
The results of preventive abdominoplasty, using polypropylene prosthesis during initial laparotomy performance in 66 patients more than 62 years old, were analyzed. In accordance to the objective and ultrasound investigation data, critical parameters, witnessing anatomic-functional insufficiency of abdominal wall, were confirmed in the patients. Operative interventions were concluded with the laparotomy wound plasty, using polypropylene prosthesis, which was put on lay--in 4 (6.1%) patients, sub lay--in 62 (93.9%). The best results were observed in the abdominal wall prosthesis in accordance to the sub lay method with the rectal abdominal muscles defect elimination, using application of a "the figure of 8 like" sutures with polypropylene thread.
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Jensky NE, Allison MA, Loomba R, Carnethon MR, de Boer IH, Budoff MJ, Burke GL, Criqui MH, Ix JH. Null association between abdominal muscle and calcified atherosclerosis in community-living persons without clinical cardiovascular disease: the multi-ethnic study of atherosclerosis. Metabolism 2013; 62:1562-9. [PMID: 23916063 PMCID: PMC3740763 DOI: 10.1016/j.metabol.2013.06.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Revised: 05/30/2013] [Accepted: 06/03/2013] [Indexed: 11/21/2022]
Abstract
OBJECTIVE Lean muscle loss has been hypothesized to explain J-shaped relationships of body mass index (BMI) with cardiovascular disease (CVD), yet associations of muscle mass with CVD are largely unknown. We hypothesized that low abdominal lean muscle area would be associated with greater calcified atherosclerosis, independent of other CVD risk factors. MATERIALS/METHODS We investigated 1020 participants from the Multi-Ethnic Study of Atherosclerosis who were free of clinical CVD. Computed tomography (CT) scans at the 4th and 5th lumbar disk space were used to estimate abdominal lean muscle area. Chest and abdominal CT scans were used to assess coronary artery calcification(CAC), thoracic aortic calcification (TAC), and abdominal aortic calcification (AAC). RESULTS The mean age was 64±10 years, 48% were female, and mean BMI was 28±5 kg/m2. In models adjusted for demographics, physical activity, caloric intake, and traditional CVD risk factors, there was no inverse association of abdominal muscle mass with CAC (prevalence ratio [PR] 1.02 [95% CI 0.95,1.10]), TAC (PR 1.13 [95% CI 0.92, 1.39]) or AAC (PR 0.99 [95% CI 0.94, 1.04]) prevalence. Similarly, there was no significant inverse relationship between abdominal lean muscle area and CAC, TAC, and AAC severity. CONCLUSION In community-living individuals without clinical CVD, greater abdominal lean muscle area is not associated with less calcified atherosclerosis.
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Affiliation(s)
- Nicole E. Jensky
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA
| | - Matthew A. Allison
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA
| | - Rohit Loomba
- Division of Gastroenterology, Department of Medicine, University of California San Diego, La Jolla, CA
| | - Mercedes R. Carnethon
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Ian H. de Boer
- Division of Nephrology and Kidney Research Institute, Department of Medicine, University of Washington, Seattle, WA
| | - Matthew J. Budoff
- Division of Cardiology, Los Angeles Biomedical Research Institute at Harbor-UCLA, Torrance, CA
| | - Greg L. Burke
- Division of Public Health Services, Department of Medicine, Wake Forest University, Winston-Salem, NC
| | - Michael H. Criqui
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA
| | - Joachim H. Ix
- Division of Preventive Medicine, Department of Family and Preventive Medicine, University of California San Diego, La Jolla, CA
- Nephrology Section, Veterans Affairs San Diego Healthcare System, La Jolla, CA
- Division of Nephrology, Department of Medicine, University of California San Diego, La Jolla CA
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Kim JM, Choi SH. Healing effect of acellular dermal matrixes for repair of abdominal wall defects in a rat model. In Vivo 2013; 27:755-760. [PMID: 24292579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND Although acellular dermal matrix (ADM) is a widely used graft material for abdominal wall repair, differences in processing methods might yield different healing activities. The aim of this study was to compare the healing effects of two human-derived ADM prototypes in abdominal wall reconstruction. MATERIALS AND METHODS A standardized 15×50 mm abdominal wall defect was created in 28 Sprague-Dawley rats, which were then implanted with either an EDTA-treated ADM prototype or a salt/solvent-treated ADM prototype. Adhesion formation, tensile strength, tissue ingrowth, neovascularization and inflammatory cell infiltration were then assessed in the two ADM prototypes during the experimental period. RESULTS In both ADM prototypes, mild adhesion formation with the omentum was observed at autopsy at one and four weeks post-implantation. Tensile strength was higher at four weeks post-implantation than that at one week post-implantation. Good neovascularization was observed in the periphery of the ADM, but not in the ADM core. Muscles facing the ADM and muscle-ADM junctions were thick and long at one week post-implantation and had been replaced by new host collagen at four weeks post-implantation. No mesothelial cells at the margins were observed at one and four weeks post-implantation. The thickness of the remaining implanted ADM at four weeks post-implantation was less than that at one week post-implantation. There were no statistical differences between the two ADM prototypes in terms of adhesion formation, tensile strength, tissue ingrowth, neovascularization and inflammatory cell infiltration during the experimental period. CONCLUSION These results indicate that both ADM prototypes are applicable implant materials for repair of abdominal wall defects.
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Affiliation(s)
- Jong Min Kim
- Veterinary Medical Center, Chungbuk National University, 361-763, Republic of Korea.
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Sheu Y, Marshall LM, Holton KF, Caserotti P, Boudreau RM, Strotmeyer ES, Cawthon PM, Cauley JA. Abdominal body composition measured by quantitative computed tomography and risk of non-spine fractures: the Osteoporotic Fractures in Men (MrOS) Study. Osteoporos Int 2013; 24:2231-41. [PMID: 23471565 PMCID: PMC3947542 DOI: 10.1007/s00198-013-2322-9] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 01/30/2013] [Indexed: 12/25/2022]
Abstract
UNLABELLED The effect of abdominal adiposity and muscle on fracture is unclear in older men; therefore, we examined the association among 749 men aged 65+. Among various adipose tissues and muscle groups, lower psoas muscle volume and higher fatty infiltration of abdominal muscle contribute to higher fracture risk independent of BMD. INTRODUCTION The association of abdominal adiposity and muscle composition with incident fracture is unclear, especially in older men. Therefore, we examined the relationship of subcutaneous adipose tissue (SAT), visceral adipose tissue (VAT), abdominal intermuscular adipose tissue (IMAT), and muscle volume with incident non-spine fractures among 749 men aged 65 and older. METHODS A case-cohort study design was used with a total of 252 fracture cases and 497 non-cases. We measured volumes (in centimeters) of adipose and muscle tissues obtained from quantitative computed tomography scan at the L4-5 intervertebral space. Three groups of muscle and IMAT were evaluated: total abdominal, psoas, and paraspinal. Cox proportional hazards regression with a robust variance estimator was used to estimate the hazard ratio (HR) of non-spine fractures per standard deviation (SD) increase in the abdominal body composition measures. The mean age among men in the random subcohort was 74.2 ± 6.1 years, and the average follow-up time was 5.2 ± 1.1 years. RESULTS After adjusting for age, race, clinic site, percent body fat, and femoral neck bone mineral density (BMD), no significant relationship was found between incident fractures and SAT or VAT. One SD increase in muscle volume at the psoas, but not paraspinal, was associated with 28 % lower fracture risk (95 % CI = 0.55-0.95). When IMAT models were further adjusted for corresponding muscle volumes, only abdominal IMAT was significantly associated with fracture risk (HR = 1.30 (95 % CI = 1.04-1.63)). CONCLUSION Our findings suggest that lower total psoas muscle volume and higher IMAT of the total abdominal muscle contribute to higher fracture risk in older men independent of BMD.
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Affiliation(s)
- Y Sheu
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
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Leordean V, Lazăr D, Trofenciuc M. Morphological aspects in a urogenital malformation, complex and rare, in a child. Rom J Morphol Embryol 2012; 53:421-425. [PMID: 22732818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The aim of this study follows the detailed evolution of a child diagnosed with prune-belly syndrome. This syndrome is a complex dysplasia, a rare pathology in children, characterized by the triad--the classic--hypo- or aplasia of righteous abdominal, cryptorchidism, abnormality of the urinary tract; also, it can be associated with pulmonary, cardiac, digestive, osteoarticular, and other malformations. Diagnostic criteria and etiopathogeny aspects are presented showing embryopathy and X-linked hereditary transmission theories as the most plausible, as proofed by recent genetic studies. Analyzing therapeutic aspects, it is stressed that medical treatment precedes or follows surgery, which cannot resolve urinary infection unless dysplastic urinary reconstruction is performed. Serious forms of prune-belly syndrome have a development and poor prognosis. Intrauterine and neonatal mortality is 20% and 50% in the first two years of life. The risk of urinary infection and/or lungs burdens the patient's clinical condition, allowing further appreciation on evolution of the disease. For cases solvable by plastic surgical reconstruction, as those who respond to medical therapy, differentiation will be monitored in territory and check-ups by the specialized consulting room from Polyclinic Health Center. Urinary infection relapse danger is permanent, requiring differentiated supervision. These case interest practitioners, by at least two aspects: the rarity of the disease, and complexity of dysplasia constituent, which has serious implications on the body economy.
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Affiliation(s)
- Viorica Leordean
- IInd Clinic of Pediatrics, Emergency County Hospital, Arad, Romania.
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35
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Takada J, Watanabe K, Kuraya D, Kina M, Hayashi S, Hamada H, Katsuk Y. [An example of metastasis to the iliopsoas muscle from sigmoid colon cancer]. Gan To Kagaku Ryoho 2011; 38:2294-2297. [PMID: 22202360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Even though skeletal muscle, making up about 40% of body weight, is the largest organ in the human body, metastasis from malignant lesions is rare. Among reports of metastasis, those involving the iliopsoas muscle are numerous but few reports involve resection. Reported here is one example we experienced where metastasis developed in the iliopsoas muscle following colectomy, resection was then made possible by radiotherapy and chemotherapy. The case involved a 71-year- old male in which a Hartmann procedure was performed for sigmoid colon cancer. The pathology was Type 3 (8 × 7 cm, adenocarcinoma( mod), ss or more, ly1, v1, n0, ow(-), aw or ew(+), stage II). Upon additional sampling, thermal degredation of neoplastic cells was shown and outpatient oral UFT was performed. Five years following surgery, lymphoadenopathy was noted in the area of the left iliac artery upon US and CT. PET showed a probable metastasis to the left iliopsoas muscle. Early esophageal and stomach cancer were diagnosed by GFT. The esophageal cancer was located 30-32 cm from the incisors, unstained, Borrmann type 1, penetrating deeper than the muscularis propria. Biopsy revealed a diagnosis of tubular adenocarcinoma. ESD was performed for the esophageal cancer and one month later, a total gastrectomy D1+β was performed. During surgery, the iliopsoas muscle tumor was determined to be large and impossible to resect. Radiotherapy of 10MV X-ray, 8 fields, 65-70 Gy/26 times for 6 . 5 weeks was performed for residual tumor but had no effect on tumor size. Fifteen courses of FOLFOX+bevacizumab were then performed. The tumor was markedly reduced in size, unidentifiable upon CT but showed slight uptake on PET and resection of the suspected residual tumor was performed. Histologically, atypical cells were shown in scarred muscle and connective tissue, however, degradation by chemotherapy was high. Residual tumor at resection margins was found, findings consistent with metastasis form sigmoid colon cancer. Taking into account the age and condition of the patient following surgery, chemotherapy was changed to S-1. Currently, 5 months after resection, there has been no recurrence.
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36
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Sukovatykh BS, Valuĭskaia NM, Pravednikova NV, Netiaga AA, Kas'ianova MA, Zhukovskiĭ VA. [Prophylactics and treatment of postoperative hernias of the lateral abdominal walls using polypropylene endoprosthesis]. Vestn Khir Im I I Grek 2011; 170:53-57. [PMID: 21848240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
An analysis of complex examination and treatment of 151 patients after planned and performed surgical interventions on organs of the retroperitoneal space was made. The patients were divided into 4 groups. The first group (of comparison) included 46 patients who were treated by lumbotomy for different diseases of organs of the urinary system. In 35 patients of the second group (prophylactics) the indications were determined and in 20 patients preventive endoprosthesis of the lateral abdominal wall using polypropylene endoprosthesis was fulfilled. Herniotomy with plasty of the lateral abdominal wall using local tissues was fulfilled in 30 patients. Prosthesing hernioplasty of the lateral abdominal wall was fulfilled in 40 patients of the main group. It was found that preventive endoprosthesis of the lateral abdominal wall allowed prevention of progressing anatomo-functional i/isufficiency and the appearance of postoperative hernias. The application of polypropylene endoprosthesis for the treatment of postoperative hernias allows obtaining 36.4% more good results as compared with the control group, 21.7% decreased number of satisfactory results and no recurrent hernias.
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37
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Agha-Mohammadi S, Hurwitz DJ. Management of upper abdominal laxity after massive weight loss: reverse abdominoplasty and inframammary fold reconstruction. Aesthetic Plast Surg 2010; 34:226-31. [PMID: 19936825 DOI: 10.1007/s00266-009-9432-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2009] [Accepted: 09/28/2009] [Indexed: 11/29/2022]
Abstract
BACKGROUND Central to body contouring after weight loss surgery is treatment of the abdominal region, often through a circumferential abdominoplasty. This procedure, however, neglects the laxity of the lower thoracic/upper abdominal region. A reverse abdominoplasty with reconstruction of a new inframammary fold (IMF) corrects this deformity through removal of excess skin along the IMF. Since 2002, we have performed 88 reverse abdominoplasty procedures within the context of a single or staged total-body lift (TBL). METHODS A retrospective chart review of 129 TBL cases indicated that 88 patients had a combined or staged reverse abdominoplasty and circumferential abdominoplasty. Complication rates were noted as localized or generalized. RESULTS Fifty-three of our patients had combined reverse abdominoplasty and circumferential abdominoplasty and 35 had the reverse abdominoplasty during a second stage. The complication rates for both groups were about 5% per patient per procedure with differences that were not statistically significant. Also, the revision rates for reverse abdominoplasty and circumferential abdominoplasty were similar for both groups, indicating patient satisfaction with the procedures. CONCLUSION In selected patients, effective treatment of the abdominal region demands correction of both the upper and lower abdominal laxity and contour. This can be performed safely, effectively, and reliably by a reverse abdominoplasty with IMF reconstruction independently or simultaneously with circumferential abdominoplasty.
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Naik RP, Joshipura VP, Patel NR, Patwari SI, Bhavsar MS. A rare case of predominantly muscular infiltrative eosinophilic gastroenteritis with ascites: a case report and review of the literature. Trop Gastroenterol 2009; 30:225-226. [PMID: 20426285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Affiliation(s)
- Rahul P Naik
- Department of GI Surgery & Laparoscopic Surgery, Sterling Hospital, Ahmedabad, India.
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Dordević M, Jovanović B, Mitrović S, Dordević G, Radovanović D, Sazdanović P. Rectus abdominis muscle endometriosis after cesarean section--case report. Acta Clin Croat 2009; 48:439-443. [PMID: 20405641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023] Open
Abstract
Endometriosis is defined by the presence of functional endometrial tissue outside the uterus, where it is normally located. Endometriosis is one of the most common gynecologic entities affecting 8%-18% of menstrual women. Endometriosis can occur at intra- and extrapelvic localizations. The most common intrapelvic localizations are those involving the ovaries, Douglas' area, pelvic peritoneum, uterus, bladder and rectum. Abdominal endometriosis is the most common localization of extrapelvic endometriosis and usually develops in connective tissue. Extra-pelvic implantation of endometrial tissue may develop in any organ including the skin, lungs, liver, extremities, brain and stomach. Three years after cesarean section, a 35-year-old female was operated on for suspected anterior abdominal hernia at the site of previous section. An egg-sized tumor was removed from the rectus abdominis muscle and referred for histopathologic and immunohistochemical analyses. The results showed endometriosis of the muscle with positive estrogen and progesterone receptors. A year after the procedure, treatment with gonadotropin-releasing hormone analogs was continued due to recurrent pain in the scar area, along with ultrasonography and biochemical marker (carbohydrate antigen 125) follow-up. Clinical diagnosis of scar endometriosis can be made by thorough history and physical, ultrasonography and biochemical examinations. Scar endometriosis should always be considered when the symptoms occur in a cyclic and hormone-dependent pattern, mostly after gynecologic operations, and worsening during menstruation. Definitive diagnosis is based on histopathologic analysis.
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Affiliation(s)
- Momcilo Dordević
- University Department of Obstetrics and Gynecology, Kragujevac Clinical Center, Kragujevac.
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Torres K, Chrościcki A, Torres A, Maciejewski R, Palczak R, Staśkiewicz G, Drop A, Thomas N, Łoś T, Alexander J. Spiegelian hernia - - anatomy, diagnosing and imaging difficulties-report of 2 cases. Folia Morphol (Warsz) 2009; 68:179-183. [PMID: 19722163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Spiegelian hernias account for less than 1% of all hernias diagnosed in the adult population. The most important factors in the proper diagnostic process are detailed physical examination combined with imaging procedures. Two cases of Spiegelian hernias are presented. The anatomical background of the pathology, as well as diagnostic procedures and surgical treatment, is discussed.
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Affiliation(s)
- K Torres
- Human Anatomy Department, Medical University of Lublin, Poland
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41
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Bikman BT, Zheng D, Pories WJ, Chapman W, Pender JR, Bowden RC, Reed MA, Cortright RN, Tapscott EB, Houmard JA, Tanner CJ, Lee J, Dohm GL. Mechanism for improved insulin sensitivity after gastric bypass surgery. J Clin Endocrinol Metab 2008; 93:4656-63. [PMID: 18765510 PMCID: PMC2729236 DOI: 10.1210/jc.2008-1030] [Citation(s) in RCA: 78] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
CONTEXT Surgical treatments of obesity have been shown to induce rapid and prolonged improvements in insulin sensitivity. OBJECTIVE The aim of the study was to investigate the effects of gastric bypass surgery and the mechanisms that explain the improvement in insulin sensitivity. DESIGN We performed a cross-sectional, nonrandomized, controlled study. SETTING This study was conducted jointly between the Departments of Exercise Science and Physiology at East Carolina University in Greenville, North Carolina. SUBJECTS Subjects were recruited into four groups: 1) lean [body mass index (BMI) < 25 kg/m(2); n = 93]; 2) weight-matched (BMI = 25 to 35 kg/m(2); n = 310); 3) morbidly obese (BMI > 35 kg/m(2); n = 43); and 4) postsurgery patients (BMI approximately 30 kg/m(2); n = 40). Postsurgery patients were weight stable 1 yr after surgery. MAIN OUTCOME MEASURES Whole-body insulin sensitivity, muscle glucose transport, and muscle insulin signaling were assessed. RESULTS Postsurgery subjects had insulin sensitivity index values that were similar to the lean and higher than morbidly obese and weight-matched control subjects. Glucose transport was higher in the postsurgery vs. morbidly obese and weight-matched groups. IRS1-pSer(312) in the postsurgery group was lower than morbidly obese and weight-matched groups. Inhibitor kappaBalpha was higher in the postsurgery vs. the morbidly obese and weight-matched controls, indicating reduced inhibitor of kappaB kinase beta activity. CONCLUSIONS Insulin sensitivity and glucose transport are greater in the postsurgery patients than predicted from the weight-matched group, suggesting that improved insulin sensitivity after bypass is due to something other than, or in addition to, weight loss. Improved insulin sensitivity is related to reduced inhibitor of kappaB kinase beta activity and enhanced insulin signaling in muscle.
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Affiliation(s)
- Benjamin T Bikman
- The Metabolic Institute for the Study of Diabetes and Obesity, East Carolina University, 6N98 600 Moye Boulevard, Greenville, North Carolina 27834, USA
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Novruzov RM. [Hemomicrocirculation channel and mastocyte population in outer oblique aponeurosis stomach muscles and uterus ligament in women with small pelvic organ prolapses]. Georgian Med News 2008:69-72. [PMID: 19075348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The aim of the research was histochemical and morphometric investigation of microcirculation channel and study of mastocytes in outer oblique aponeurosis stomach muscles and sacrouterine ligaments. The study was carried out on 36 patients with small pelvic organs prolapse and on 22 patients without such. Patients with different forms and severity of small pelvic organs prolapse displayed the reduction of aponeurosis microcirculatory channel, sacrouterine and round ligament of the uterus (p<0.05) in contrast to women without small pelvic organs prolapse. It was found that outer oblique aponeurosis stomach muscles in patients contains large amount of labrocytes, which degranulate with statistically significant intensiveness, in contrast to women without prolapses (p<0.05). The state of microcirculation channel and local aponeurosis secretor regulator apparatus of the outer oblique aponeurosis stomach muscles and the sacrouterine ligaments must be considered in choosing the most suitable method of suspension and fixations of small pelvic organs prolapse.
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Hougård K, Bergenfeldt M. [Abdominal fistula 7 years after laparoscopic cholecystectomy]. Ugeskr Laeger 2008; 170:2803. [PMID: 18761878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
A 64-year old female presented with fistulas on the abdomen 7 years after laparoscopic cholecystectomy. During fistula excision, several gallstones were found. Scrutiny of the medical records revealed that spillage of gallstones had occurred during the cholecystectomy. We conclude that spilled gallstones may cause fistulas or abscesses even several years after cholecystectomy. Preventive measures such as gentle handling of the gallbladder and vigorous efforts to retrieve all lost gallstones seem important.
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Affiliation(s)
- Kirsten Hougård
- Herlev Hospital, Kirurgisk Gastroenterologisk Afdeling, Herlev
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Olejek A, Zamłyński J, Podwińska E, Horak S, Paliga-Zytniewska M, Kellas-Sleczka S. [Abdominal wall endometrioma in the cesarean section scar]. Ginekol Pol 2008; 79:612-615. [PMID: 18939511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVES The study presents a retrospective review of patients diagnosed with abdominal wall endometrioma in the cesarean section scar between the years 2001-2006. MATERIAL AND METHODS The study presented age symptoms, size of tumor, time between cesarean section and symptoms, results of treatment. RESULTS Between 2001-2006, 34 patients, all of which suffered from abdominal pain and palpable mass, were diagnosed and treated in our hospital. In 8 cases the disease returned and reoperation was necessary. In one case we observed adenocarcinoma papillare. CONCLUSIONS Endometriosis in postoperative abdominal wall scar after cesarean section is rarely observed. Because to the fact that the number of cesarean sections is constantly increasing, this complication becomes more frequent. The treatment of choice is surgical resection.
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Affiliation(s)
- Anita Olejek
- Katedra i Oddział Kliniczny Ginekologii, Połoinictwa i Ginekologii Onkologicznej w Bytomiu, Slaski Uniwersytet Medyczny w Katowicach.
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Momin TA, Deyrup AT, Grist WJ, Khuri FR, Kooby DA. Laryngeal squamous cell carcinoma metastatic to a flank intramuscular lipoma. Am Surg 2008; 74:447-448. [PMID: 18481507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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Zygowicz WM. Anything but routine: responders answer unprecedented evisceration call. ACTA ACUST UNITED AC 2008; 33:38, 40. [PMID: 18179980 DOI: 10.1016/s0197-2510(08)70012-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Walocha J, Jagła G, Mazur M, Skrzat J, Jaworek JK. [Origin of abdominal herniae--anatomical aspects]. Folia Med Cracov 2008; 49:85-94. [PMID: 19140494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
Based on anatomical background authors review the current knowledge on mechanisms and anatomical predisposes causing abdominal herniations. They are giving a brief summary of limitations of potential spaces involved into dislocation of abdominal visceral through natural spaces. Authors try to join anatomical knowledge with clinical information what might be useful in understanding of the patomechanism of these surgical disorders.
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D'Costa S, Ramanathan LA, Madhyastha S, Nayak SR, Prabhu LV, Rai R, Saralaya VV. An accessory iliacus muscle: a case report. Rom J Morphol Embryol 2008; 49:407-409. [PMID: 18758649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
We present a case of an anomalous accessory iliacus muscle in the iliac fossa which gets originated from the iliac crest and inserting along with iliopsoas, and appear to compress the L4 root of femoral nerve. During the routine dissection of a male cadaver aged 58 years, we found an accessory iliacus muscle. The L2 and L3 nerve roots joined the L4 root distal to the accessory iliacus muscle. The L4 root of the femoral nerve supplied accessory iliacus muscle. Accessory iliacus muscle might cause tension on the femoral nerve resulting in referred pain to the hip and knee joints and to the lumbar dermatome L4. The clinical significance of this variant muscle and its importance in the femoral nerve entrapment has been discussed.
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Affiliation(s)
- Sujatha D'Costa
- Department of Anatomy, Centre for Basic Sciences, Kasturba Medical College, Bejai, Mangalore, Karnataka, India.
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Abstract
The aim of this study is to evaluate the imaging features of neoplastic iliopsoas masses detected on abdominal CT and determine the association with other metastatic sites in the abdomen. Thirty-three patients with a neoplastic mass detected in the iliopsoas muscles on a CT were included in this study. The CT were evaluated for imaging features of the focal psoas lesion and for the presence of additional metastatic disease in the abdomen. All 33 patients had a history of primary neoplasm. The most common primary neoplasms were renal in five, melanoma in four, lung in three, pharyngeal in three, colorectal in two, ovarian in two and other neoplasms in 14 patients. Although the majority of the iliopsoas masses were of lower density than the muscle, four patients had a mass with hyperdense ring and four other patients had a uniformly hyperdense mass on contrast enhanced CT. Eight (24%) patients had gluteal muscle metastases and 6 (18%) had subcutaneous metastases. Secondary iliopsoas neoplasms are most commonly hypodense lesions and are most commonly due to primary neoplasm from renal, lung, pharyngeal, ovarian, colorectal neoplasm and melanoma. The detection of an iliopsoas mass warrants a careful search for gluteal muscles and subcutaneous metastases.
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Affiliation(s)
- Ajay K Singh
- Department of Radiology, University of Massachusetts Medical Center, Worcester, MA, USA.
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Abstract
Intrathecal baclofen is an invaluable therapeutic modality in the management of severe spasticity, especially in patients with cerebral palsy, multiple sclerosis, and spinal cord and brain injuries. This case report presents a rare complication of long-term intrathecal infusion with the development of a huge anterior abdominal wall hematoma with extension to the retroperitoneal space as a result of a repeated blunt trauma to the site of the intrathecal pump with erosion of the inferior epigastric artery. This inferior epigastric artery erosion could be avoided by implanting the intrathecal pump laterally away from the rectus abdominus muscle sheath.
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Affiliation(s)
- Samer N Narouze
- Pain Management Center, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA.
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