Adjacent Muscle Tissue Research Articles

The cavitation threshold of human tissue exposed to 0.2-MHz pulsed ultrasound: Preliminary measurements based on a study of clinical lithotripsy

Evidence of acoustic cavitation was identified in the form of transient echoes in ultrasound B-scan images of patients receiving extracorporeal shock-wave lithotripsy treatment on a Storz Modulith SL20. This lithotripter generates 10-μs duration pulses with a centre frequency of 0.2 MHz at a pulse repetition frequency of 1 Hz. The visual appearance of B-scan images was examined in a total of 30 patients and a quantitative analysis of echogenicity changes was carried out in six cases involving lithotripsy treatment of stones in the renal pelvis. In these patients new echoes were identified in images unaffected by movement artefacts and were found to occur in perinephric fat and adjacent muscle and kidney tissue at positions close to the axis of the shock-wave field between 1 and 2 cm in advance of the indicated beam focus of the lithotripter. The echogenicity within each region increased significantly above the background level when the output of the lithotripter was increased above a threshold value. The acoustic pressures corresponding to this threshold were measured in water using a calibrated PVDF membrane hydrophone. After correction for attenuation in tissue the cavitation thresholds, in terms of the temporal peak negative pressure, are found to lie between 1.5 MPa and 3.5 MPa in all six cases. Interpretation of the measured values in terms of the likely threshold at the higher frequencies used in diagnostic ultrasound is considered using a theoretical model.

Distribution and photosensitizing efficiency of porphyrins induced by application of exogenous 5-aminolevulinic acid in mice bearing mammary carcinoma.

By means of a chemical extraction procedure and confocal laser scanning microscopy, we investigated the kinetic patterns of uptake and biolocalization of 5-aminolevulinic acid (ALA)-induced porphyrins in s.c. transplanted tumors, adjacent normal skin and muscle, and liver of mice bearing mammary carcinoma, after i.p. injection of 250 mg/kg ALA or topical application of ALA (20% in an oil-in-water emulsion). Furthermore, we evaluated the tumor responses after either i.p. injection or topical application of 5-ALA followed by laser irradiation (632 nm, 150 mW/cm2, 25 min) by measuring the treated tumor regression/regrowth time and by light and electron microscopy. Strong fluorescence of ALA-induced porphyrins was detected in the tumor, skin and liver tissues, while little fluorescence was seen in the adjacent muscle tissue. Moreover, the highest amounts of ALA-induced porphyrins in the tumor and skin tissues were found 1 hr after i.p. injection, whereas the amounts of the porphyrins in both tissues increased with increasing time after topical application of ALA. The fluorescence of the porphyrins was localized in several components of the skin tissue (epidermis, hair follicles and their associated sebaceous glands). Furthermore, the fluorescence was diffusely distributed in the s.c. transplanted tumor tissue. Little could be observed under a confocal laser scan microscope (CLSM) in the muscle tissue. The uptake and biolocalization data correlate well with the results of PCT efficiency of the same tumor model with ALA-induced porphyrins. Light and electron microscopy showed that the mitochondria of the tumor cells and of the endothelial cells and the basal lamina of vascular walls beneath the endothelium in the tumor tissue were initially extensively destroyed after PCT with ALA-induced porphyrins. Thereafter, diffuse degeneration followed by local and/or diffuse severe necrosis of the tumor cells was found. This may be due mainly to the initial damage to mitochondria in the cancerous and endothelial cells and also to the destruction of the vascular wall in the tumor tissue.

Tfe-Plasma Polymerized Dermal Sheep Collagen for the Repair of Abdominal Wall Defects

The aim of this study was to design and evaluate a degradable biomaterial for the repair of abdominal wall defects. Hexamethylenediisocyanate-tanned dermal sheep collagen (HDSC) was plasma-polymerized with tetrafluoroethylene (TFE) which resulted in a hydrophobic surface on the visceral side (TFE-HDSC). Full-thickness abdominal wall defects were made in rats and repaired with HDSC or TFE-HDSC implants. Unmodified HDSC implants showed excellent fixation to the adjacent muscle tissue but intestinal adhesions were observed. These implants showed insufficient strength after four weeks, illustrated by bulging of the peritoneal contents (herniation). Plasma-polymerized implants after four weeks of implantation showed firm incorporation into the surrounding muscle tissue. With one exception there were no bowel adhesions. Fewer herniations were observed, indicating a prolonged degradation period. Further studies on the optimalization of degradation time are in progress.

Tissue Reaction to Polypropylene Mesh: A Study of Oedema, Blood Flow, and Inflammation in the Abdominal Wall

The purpose of the present work was to study the tissue reaction to polypropylene mesh (Marlex) implanted in three different layers of the abdominal wall, comparable to common clinical practices. The reaction to mesh was compared in terms of tissue oedema, blood flow, and histological appearance in rats. When mesh was placed between muscle layers, blood flow in the abdominal wall was high during the first 4 days after implantation but similar to flow in nonoperated rats 14 and 140 days after implantation. When mesh was placed under skin or on the peritoneum, there was no hyperaemia early after implantation, and flow rate was clearly lower than in non-operated controls 140 days after implantation. The operative procedure produced increased tissue water content, declining from the 1st to the 14th day after operation. Mesh induced additional oedema in adjacent muscle tissue irrespective of localization of the implant (p less than 0.01, vs. sham). Except when separated by peritoneum, mesh caused hyperaemia in muscle tissue in direct contact with mesh the 1st and the 4th day after implantation. After 14 and 140 days no mesh-induced hyperaemia was present. The inflammatory response to mesh was similar in the peritoneum and between muscles, less pronounced in the subcutis. It was characterized by the accumulation of macrophages and the formation of inflammatory granulation tissue in the subacute phase, later followed by the formation of fibrous tissue around mesh fibres. This study suggests that mesh implants should be placed in apposition to muscles in order to obtain well-vascularized healing.

Autoradiographic evidence of muscarinic cholinergic receptors in the corpora cavernosa penis of the rat

Recent studies have questioned the role of acetylcholine in the physiology of penile erectile tissue. The responsiveness of penile erectile tissue to acetylcholine would depend, in part, on the presence of cholinergic receptors on the smooth muscle, The specific binding of [ 3H]quinuclidinyl benzilate (QNB) to cholinergic receptors in sections of penile crura of the rat was analyzed by in vitro neurotransmitter autoradiography. Silver grain density measurements indicated that muscarinic cholinergic receptor binding sites are located almost entirely over the corpora cavernosa penis. Virtually no specific [ 3H]QNB binding was present in the tunica albuginea or adjacent skeletal muscle tissue. Within the erectile tissue, specific binding occurred both over the columns of intrinsic smooth muscle which form the walls of the cavernous spaces and around the more distal branches of the penile arteries. The high concentration of muscarinic cholinergic receptors in the corpora cavernosa penis is consistent with the suggestion that acetylcholine has an important, albeit undefined role in the function of penile erectile tissue.

Congenital infiltrating lipomatosis of the face: Report of cases and review of the literature

Three cases of infiltrating congenital lipomatosis of the face are presented. These lesions shared the following morphologic criteria: 1) nonencapsulated congenital fatty tumor; 2) infiltration of adjacent muscle and soft tissue; 3) absence of lipoblast and malignant characteristics; 4) presence of fibrous elements with numerous nerve bundles and vessels; and 5) hypertrophy of subjacent bone. Although these tumors are benign, all three recurred after surgical excision. Extensive specimen sampling is advisable to exclude infiltrating lipoma, diffuse angiomatosis, infiltrating angiolipoma, and well-differentiated liposarcoma. Relationship with lipoblastomatosis and histogenesis of infiltrating congenital lipomatosis of the face are discussed.

Diffusion during dehydrogenase reactions: the effects of intermediate electron acceptors.

A hamster cheek pouch model has been used to study the diffusion of reactants from the epithelium into adjacent muscle and connective tissue during the histochemical demonstration of glucose-6-phosphate dehydrogenase activity. The effects of the addition of intermediate electron acceptors to the incubation medium varied considerably from one acceptor to another, but were independent of the grade of polyvinyl alcohol incorporated into the medium. Menadione was the least effective intermediate both in transferring reducing equivalents from the primary dehydrogenase to Neotetrazolium chloride and in preventing diffusion. Phenazine methosulphate, Methylene Blue and Thionin were more efficient intermediates. Nevertheless, considerable diffusion occurred in the presence of Phenazine methosulphate, although very little diffusion was detectable with either of the thiazine dyes. It is suggested that these differences are related to different modes and sites of action of the carriers.

An immunoperoxidase investigation of S-100 protein in granular cell myoblastomas: evidence for Schwann cell derivation.

Five cases of granular cell myoblastoma have been studied for detection of the neuroectodermal protein S-100. Immunoperoxidase staining on paraffin sections, using an antibody raised against calf brain S-100 protein, was utilized to demonstrate positive cytoplasmic and nuclear reactivity in all cases. Negative staining in adjacent muscle and connective tissue elements was contrasted to in situ control staining of Schwann cells in peripheral nerves and staining of Langerhans cells and melanocytes in overlying stratified epithelia. These observations are interpreted as support for possible Schwann cell origin of granular cell myoblastomas.

Blood antidiuretic activity and pharmacological correction of the hypothalamic-neurohypophyseal system after thermal trauma

Experiments on rabbits with infiltrates induced by intracutaneous injection of staphylococcal culture were made to examine the content of cyclic nucleotides in the adjacent muscle tissue under the effect of administering ampiox alone or combined with guanosine triphosphate (GTP). Combined injection of ampiox and GTP to the infected animals produced a considerable elevation in the content of cAMP (more than 2 1/2-fold) and in the cAMP/cGMP ratio along with a beneficial therapeutic effect. The possible mechanisms of action of the agents administered are discussed.

Microwave power absorption differences between normal and malignant tissue

An open-ended coaxial probe that produced a fringing field in the termination tissue was used to measure the fractional power absorption for malignant tumors and normal adjacent tissue in female W/Fu isogeneic rats over the 30 to 2000 MHz range. The fractional power absorption was determined as the difference in measured incident and reflected power divided by the incident power for SMT-2A tumors, and for normal adjacent muscle and mammary tissue. For the coaxial probe, the ratio of power absorbed in málignant to that in normal adjacent tissue peaked at 180 MHz with values of 4.28 and 1.40 for malignant/mammary and malignant/ muscle, respectively. By fitting the measured data to an equation for power absorption because of the fringing-field probe, tissue conductivity and dielectric constant versus frequency were determined. These tissue properties were used to determine the ratio of power absorbed in malignant to normal tissue versus frequency for a propagating plane wave. For plane waves, peak differential absorption occurs at 300 MHz; 4.81 and 1.46 for malignant/ mammary and malignant/muscle, respectively. Since direct-contact applicators for microwave hyperthermia have both fringing-field and plane-wave characteristics, our results indicate that any operating frequency from 180 to 300 MHz would provide a near optimum differential power absorption between malignant and normal tissue.

Partial regeneration of the above‐elbow amputated rat forelimb. I. Innate responses

Although a number of recent studies describe the facilitation of limb regeneration by electrical and other forms of stimulation, little is known of innate regenerative capacity in the mammalian limb. The present report describes spontaneous regenerative responses following subtotal forelimb amputation in the young white rat. In one group of animals the forelimb was amputated through the lower humerus and the skin sutured closed. In a second group, adjacent muscle tissue still attached to bone at its origin(s) was interposed between the cut surface of the humerus and the skin. Among animals of the first group (skin closure only) bone growth and limb regenerative responses were generally not observed. Animals of the second group displayed significant elaborations of cartilage and bone at the limb terminus. The appearance and subsequent modification of these tissues suggest that some capacity for limb regeneration exists innately in the young rat and can be more readily evoked than has been recognized heretofore. It is concluded that extant and forthcoming reports of electrically stimulated skeletal tissue growth, repair and regeneration among eutherial mammals should be examined to determine whether reported responses to stimulation represent advances beyond what might be expected from innate replacement processes alone.

Ruptured Mycotic Aneurysm

Mycotic aneurysms occurred in five narcotics addicts treated between 1969 and 1975. Fever, localized tenderness, swelling, loss of distal pulses, and leukocytosis were common findings. The aneurysms were located in the femoral (two patients), brachial (two), and superior mesenteric arteries (one). They occurred at the site of arterial injection in three patients. In one patient with subacute bacterial endocarditis, an aneurysm of the superior mesenteric artery developed. In one patient, the pathogenesis was uncertain. All patients had rupture of the arterial wall, with hemorrhage contained by adjacent muscle or soft tissue. Four patients were treated by ligation and debridement. One, with preexisting ischemia, required amputation below the knee. One patient underwent repair with autogenous artery. Recurrent hemorrhage necessitated ligation of the artery. In all patients, extensive sepsis and tissue necrosis precluded repair with prosthetic material. All patients survived, without evident of ischemia.

Further studies on the relationship of a rhabdomyosarcoma virus to muscle tissue.

AbstractThe pathogenesis of a rhabdomyosarcoma virus isolate was studied in a total of 300 newborn BALB/c mice, 11 different routes of inoculation being used. The latent periods, or time in days to palpable tumor, varied over a wide range among the inoculated groups. The growth of the tumor was very rapid in the muscle tissue. Regardless of the route of inoculation, the neoplasms arose from the adjacent muscle tissue attaching to and proliferating into the different organs and from their surfaces. Secondary tumor nodules were also observed in different areas of muscle tissue demonstrating the affinity of this virus to muscle tissue. Exceptions were found in some of the intrasplenically and intramyocardially inoculated mice where primary tumor nodules were found within these organs. Histologically the tumor cells were less differentiated toward myocytes than those described in a previous study.It is suggested that this host response is a reflection of the high initiating virus dose employed.Increase in spleen and liver weights and decrease in hematocrit values correlated closely to the extent of tumor development.

THE PEDICLE OPERATION FOR CORONARY INSUFFICIENCY: TECHNIQUE AND PRELIMINARY RESULTS

SUMMARY A pedicle has been constructed from the internal mammary artery, vein, adjacent muscle, and connective tissue. It has been used to provide a source for collateral channels to coronary arteries. It will reliably provide these collaterals if it is implanted within the left ventricular wall of a dog, and if it passes under a branch of the coronary artery which has an abnormally low pressure. This type of pedicle is also believed to be capable of providing significant collateral channels to the coronary arterial system of patients, if it is implanted in an area of myocardium with “demand” for collateral channels. Coronary cinearteriographic criteria for identification of this “demand” is reviewed. The pedicle operation has been performed on 40 patients. There were two surgical deaths early in the series and there were two “coronary” deaths within the first 3 postoperative months. There have been no later deaths from any cause. The majority of the patients are partly or completely relieved of their symptoms. Mammary cinearteriography has been done in 4 patients. The artery was open in all. The only mammary arteriogram done after a moderately long-term follow-up (10½ months) showed extensive filling of the anterior descending artery and its branches from collateral channels from the pedicle.

Chest repair following mammary lymphadenectomy.

Thoracic wall defects secondary to surgery for tumors in this area frequently are sufficiently small so that they require no specific attention. Even when their size might lead to detrimental paradoxical respiration, covering them with the overlying muscle layers minimizes such motion. When overlying muscle layers are not present, adjacent muscle bundles such as the pectoralis major or latissimus dorsi can be mobilized as pedicle flaps with their intact neurovascular supply in order to cover the defect. Whenever possible, we utilize overlying or adjacent muscle tissue to effect such repair. However, thoracic wall defects secondary to internal mammary lymphadenectomy done in continuity with a radical mastectomy pose unique problems in their repair. The defect extends from the lateral one centimeter of sternum to the costochondral junction, and from the first to the fifth interspace (Fig. 1,<i>A</i>). As can be seen from the accompanying diagram (Fig. 1,<i>B</i>), in a

SURGICAL TREATMENT OF NON-UNION OF LONG BONES

1. The intramedullary nail provides an excellent method of fixation for certain cases of non-union of the long bones. Its advantages for the femur and humerus are particularly striking; it reduces the time of immobilization in a cast to one month, and affords early rehabilitation of the muscles and joints. This is very important, as these patients have already been confined to bed for many months. However, the Kuntscher nail must be discarded in all cases with previous deep infection, because of the risk of recurrent infection, as well as in those cases in which a large bone defect is present, especially at the femur or tibia. In addition, it must always be combined with a bone graft, firmly fixed to the fragments by screws. 2. The tibial graft alone is the best method for the tibia (inlay graft) and for the forearm (onlay graft). It must be fixed very firmly. If the onlay method is employed, screws are the best means of fixation (Tables IX and X). 3. The cancellous bone taken from the iliac crest is the best material to fill bone defects, if the fragments are firmly fixed either by a tibial graft (for the tibia or femur) or by an intramedullary nail (for the humerus). See table in the PDF file In all cases, the bones must be surrounded by healthy soft tissue, made possible by the excision of the fibrous tissue. This tissue must he replaced, where superficial bones are concerned, by a pedicled skin graft made in a preliminary stage. In the case of deeplying bones, replacement is made in the same stage, by approximating the adjacent muscle tissue.

LEIOMYOSARCOMA OF THE UTERUS WITH METASTASIS TO THE FEMUR. REPORT OF A CASE AND REVIEW OF THE LITERATURE

Sarcoma of the uterus was first described by Virchow in 1860. Since then, many isolated cases and collected series of cases have been reported. In most cases the sarcoma is discovered unexpectedly as a result of removing a fibroid tumor, and thus these cases are usually reported as a percentage of cases of uterine fibroids examined pathologically. Opinion differs as to whether malignant myomas are malignant from the beginning or whether they represent a malignant change in an originally benign tumor. Ewing 1 said that these tumors are malignant from the start. Masson 2 took a different viewpoint and felt that they may originate in fibromyomas or in adjacent connective, muscle or endometrial tissue. The reported incidence of uterine sarcoma varies from 0.2 to 10 per cent, with the majority of observers favoring an incidence of 0.5 to 2 per cent. Vogt 3 collected reports of 72,116 cases of myoma

LEIOMYOSARCOMA OF THE UTERUS WITH METASTASIS TO THE FEMUR

Sarcoma of the uterus was first described by Virchow in 1860. Since then, many isolated cases and collected series of cases have been reported. In most cases the sarcoma is discovered unexpectedly as a result of removing a fibroid tumor, and thus these cases are usually reported as a percentage of cases of uterine fibroids examined pathologically. Opinion differs as to whether malignant myomas are malignant from the beginning or whether they represent a malignant change in an originally benign tumor. Ewing 1 said that these tumors are malignant from the start. Masson 2 took a different viewpoint and felt that they may originate in fibromyomas or in adjacent connective, muscle or endometrial tissue. The reported incidence of uterine sarcoma varies from 0.2 to 10 per cent, with the majority of observers favoring an incidence of 0.5 to 2 per cent. Vogt 3 collected reports of 72,116 cases of myoma