Gastric Regulationin
Lara Wijayasiri, Kate McCombe, Paul Hatton, David Bogod in The Primary FRCA Structured Oral Examination Study Guide 1, 2017
A sphincter is a structure, usually made up of circular muscle, that surrounds the opening of a hollow organ or body and constricts to close it. Sphincters can be anatomical, where they are clearly different from the surrounding tissue, e.g. the anus, or functional where the histological distinction is not so clear, e.g. lower oesophageal sphincter. Sphincters can be under voluntary or involuntary control. There are many sphincters in the gastrointestinal tract: Upper oesophagealLower oesophagealPyloricIleocaecalSphincter of OddiAnus
Trunk Muscles
Eve K. Boyle, Vondel S. E. Mahon, Rui Diogo in Handbook of Muscle Variations and Anomalies in Humans, 2022
Anorectal malformations occur in about 1 out of 5,000 live births and are slightly more common in males (Alamo et al. 2013). In 23 patients with anorectal anomalies studied by Kohda et al. (1985), only ten patients (43.5%) had normal development of the anorectal sphincter muscles (internal anal sphincter, external anal sphincter, and levator ani), while four had intermediate development of these muscles (17.4%) and the remaining nine had poor development of these muscles (39.1%). Among 20 patients with Down syndrome that had anorectal malformations, Torres et al. (1998) found that only one of them (5%) had poorly developed perineal muscles (specific muscles not indicated). However, the authors state that the sphincter mechanism in all 20 patients was normal (Torres et al. 1998).
The Role of Evacuation Proctography (Defecography) in the Evaluation of Fecal Incontinence
Han C. Kuijpers in Colorectal Physiology: Fecal Incontinence, 2019
Despite the useful overview and unique information obtained at proctography, there are several limitations to the technique and it should never be considered in isolation from clinical and physiological data. The main limitations are The wide range of normality and the overlap in appearance between normal subjects and patients.The lack of data on the changes of the appearances with age.The inability to detect specific sphincter defects accurately.A relatively high radiation dose, which is a particular consideration in those patients still hoping to have children and also for those subjected to repeated studies to monitor therapy.The lack of data on the variation of proctographic appearances that different stool consistencies produce and the difficulty in making and inserting a sufficiently viscous contrast to simulate normal stool.Only the posterior compartment of the pelvis is well visualized and the interrelations of the different pelvic compartments in pelvic floor descent and prolapse are not demonstrated.
Biomedical applications of muscle-derived stem cells: from bench to bedside
Published in Expert Opinion on Biological Therapy, 2020
Other clinical trials have been attempted using the local transplantation method due to the aforementioned reasons. One of the studies focused on applications in the functional recovery of the lower urinary tract, such as stress urinary incontinence (SUI). The lower urinary tract is mainly composed of smooth and skeletal muscle sphincters, and decreased tonus of these sphincters causes SUI. The supporting connective tissue networks are also considered to contribute to the sphincter tonus. Therefore, by using a mixture of myoblasts and myofibroblasts, a certain level of clinical improvement, such as an increase in thickness of the urethral sphincter and maximum urethral closure pressure, has been demonstrated [72–76]. Moreover, the patients did not present any adverse side effects, indicating the safety of this therapy, and the effects lasted at least up to 12 months [73,77]. Therefore, this therapy is potentially more effective as the engrafted cells have the capacity of vascular and peripheral nerve reconstitution [78].
Current development and clinical applications of artificial anal sphincter
Published in Expert Review of Medical Devices, 2023
Minghui Wang, Yunlong Liu, Qingjun Nong, Hongliu Yu
This article first reviews the treatment of fecal incontinence. Then introduces the frontier studies of artificial sphincter. Then introduces the meaning of artificial anal sphincters in animal studies and the complications of artificial anal sphincters in clinical applications. According to the clinical and experimental result of artificial anal sphincter, the safety and effectiveness of artificial sphincter technology in clinical application are discussed. Emphasizing the maintenance of long-term biomechanical compatibility artificial sphincter with surrounding tissues is a key issue in clinical applications. Finally, this article proposes the new design of artificial anal sphincter embedding a constant force element to improve the biomechanical compatibility of the equipment, which provides a new direction for solving the clinical application of artificial anal sphincter.
Prognostic Nutritional Index Prior to Rectal Cancer Resection Predicts Overall Survival
Published in Nutrition and Cancer, 2022
Mufaddal Kazi, Jayesh Gori, Sajith Sasi, Nishit Srivastava, Afreen Mohsin Khan, Soumi Mukherjee, Vidur Garg, Lovedeep Singh, Rohit Mundhada, Prachi Patil, Ashwin Desouza, Avanish Saklani
Two-thirds received neoadjuvant CTRT (227 patients), and 52 (15.3%) were operated after SCRT (Table 2). Consolidation chemotherapy was delivered to 94 patients (27.6%). The distribution of surgical approach was nearly equal (Table 2) with 112 (32.9%), 118 (34.7%) and 110 (32.4%) patients in open, laparoscopic, and robotic groups, respectively. After the definitive surgery, 88.8% (302 patients) had a diverting stoma. Sphincter preservation was possible in 247 patients (72.6%). Thirty-two patients (9.4%) had complications > grade II with 3.2% anastomotic leaks. ROC curve generated for PNI (Supplement file 1, Figure S3) predicting complications yielded an AUC of 0.544 and an OR of 1.042 (95% CI: 0.986 − 1.102; p − 0.401). However, a threshold of PNI could not be determined due to the absence of correlation.
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