Presence Of Muscle Tissue Research Articles

Effect of obturator nerve block during transurethral resection of bladder tumors on the disease recurrence, progression and surgery outcomes.

In our study, we aimed to evaluate the effect of the obturator nerve block (ONB) on the operation time, duration of hospital stay, complete resection, presence of muscle tissue in the pathology, second resection, recurrence, and progression, when applied in addition to spinal anesthesia in patients with primary bladder lateral wall tumor and Transurethral Resection of Bladder Tumor (TURBT) was planned. Seventy patients with bladder lateral wall tumors were included in the study. In addition, ONB was applied to 35 of the patients who underwent spinal anesthesia. The two groups were compared in terms of obturator reflex development, perforation, complete resection, presence of muscle tissue in pathology samples, need for second resection, need for second resection due to inadequate muscle tissue, and 1year recurrence and progression rates. When the two groups were compared for obturator reflex and bladder perforation, both were found to be lower in the ONB group (p = 0.002, p = 0.198, respectively). The rate of complete resection and the presence of muscle tissue in the pathology samples were higher in the ONB group (p = 0.045, p = 0.034, respectively). The rates of second resection and second resection due to inadequate muscle tissue were found to be higher in the group without ONB (p = 0.015, p = 0.106, respectively). In the 1-year follow-up, the recurrence rate was significantly lower in the ONB group (p < 0.001), while there was no significant difference between the progression rates (p = 0.106). In our study, we found out that ONB applied in addition to spinal anesthesia increases the rate of complete and muscle tissue resection by decreasing the obturator reflex, and causes a significant reduction in the need for second resection and tumor recurrence.

Efficacy of Obturator Nerve Block During Transurethral Resection on Non-muscle invasive Intermediate and High Risk Lateral Wall Bladder Tumours: A Prospective Randomized Controlled Study.

We aimed to investigate the effects of obturator nerve block (ONB) on obturator reflex, incomplete resection, perforation, progression and recurrence of tumor, presence of muscle tissue in the specimen, need for a second transurethral resection (TURBT) of bladder tumors, and postoperative complications in patients who underwent TURBT for intermediate-high risk lateral wall non-muscle invasive bladder cancers (NMIBC). Patients were assigned to one of two groups by drawing lots: ONB or none ONB. Early and late recurrence, tumor progression, obturator reflex beat, incomplete resection, perforation, presence of muscle layer in pathology, second TURBT application, operation time, postoperative hospital stay, and complications were compared between the two groups. The median follow-up time of the study was32 (23-41) months. Interquartile range (IQR) was 9. Tumor recurrence at the 3rd month cystoscopy controls was observed in 5 (9.8%) patients in the ONB group, while it was observed in 11 (20.8%) patients in the nONB group (p=0.01). Late tumor recurrence was observed in 10 patients (19.6%) in the ONB group, and in 20 patients (37.7%) in the nONB group (p=0.041). The RFS rate at 12th month was 84% in the ONB group, 69% in the nONB group, 79% in the ONB group at 36th month, and 58% in the nONB group at 36 months, the PFS rate was 94% in the ONB group, while it was 85% in the nONB group (p=0.041). Our study showed that ONB decrease the early and late recurrence and increase recurrence free survival in patients with intermediate-high risk lateral wall bladder cancer.

Single-sided NMR for the diagnosis of osteoporosis: Diffusion weighted pulse sequences for the estimation of trabecular bone volume fraction in the presence of muscle tissue

The bone volume fraction, defined as the Bone-Volume-To-Total-Volume ratio (BV/TV), is an important parameter in the assessment of the bone's micro-structure, and is related to the fracture risk in osteoporosis. Although Magnetic Resonance Imaging (MRI) can assess bone micro-architecture parameters in-vivo, high-field whole body MRI scanners are hardly suitable for wide-scale screening campaigns. Recently, a new NMR application to assess in laboratory the BV/TV of trabecular bone (TB) has been proposed using low-field single-sided NMR. This paper presents an improvement of this technique that allows detection of only the signal from the marrow in the TB suppressing signals from other tissues, which may be present in the sensitive volume of single-sided scanners in a real scenario. The improvement was achieved by filtering signal acquisition by molecular diffusion. Experiments based on an ad-hoc designed Diffusion Weighted T1−T2 pulse sequence have demonstrated that muscle and cartilage signals can be suppressed by using diffusion weighting. On the basis of those experiments, a 1D measurement was established to allow correct estimation of the BV/TV of a TB sample also in the presence of muscle tissue in the sensitive volume of the NMR-scanner. The experiments presented, carried out with the NMR-MOUSE PM10 and the NMR-MOLE, exploiting diffusion-weighted pulse sequences, may pave the way for the in-vivo BV/TV evaluation using single-sided scanners.

Effect of obturator nerve block during transurethral resection of lateral bladder wall tumors on the presence of detrusor muscle in tumor specimens and recurrence of the disease

We investigated the effect of spinal anesthesia combined with obturator nerve block (ONB) during the transurethral resection of lateral bladder wall tumors (TUR-BT) on the presence of detrusor muscle tissue in tumor specimens and on tumor recurrence. TUR-BT was performed on 96 patients with a lateral bladder wall tumor under spinal anesthesia in our clinic between January 2011 and December 2015. The patients were divided into two groups: 49 patients only received spinal anesthesia and 47 patients received spinal anesthesia combined with ONB. The groups were retrospectively compared in terms of adductor muscle contraction, bladder perforation, complete tumor resection, presence of muscle tissue in the pathology material, and recurrence rate during follow-up. The obturator reflex was significantly observed in the non-ONB group (p < 0.05). In the ONB group, the percentages of complete resection and detrusor muscle tissue were significantly higher (p = 0.003 and p = 0.001, respectively). The postoperative recurrence rate was found to be significantly higher in the non-ONB group than in the ONB group (p = 0.025). Spinal anesthesia combined with ONB during TUR-BT prevent obturator reflex and facilitate complete resection including detrusor muscle tissue, independent from the size or number of tumors, thus reducing the recurrence of the disease.

Contribution of ultrasound to confirm the injection sites of botulinum toxin identified by electrostimulation in the treatment of spasticity of the biceps brachii and brachial muscles

Objective To study the contribution of ultrasound to confirm clinically identified injection points and then identified with electrostimulation. Type of study Observational, descriptive, prospective. Material and methods Fifteen patients having already received botulinum toxin injections were included (30 injected muscles). Two injectors realized the gesture with electrostimulation followed by an echographic examination of the position of the needle. Patients received treatment twice at a distance of at least 3 months. During the second injection, spasticity and GAS (goal attentment scaling) were reassessed before proceeding. Results Ultrasound confirmed a concurring needle position in 80% of cases. Three discrepancies were observed in each series, one in one of the two points of the brachii biceps muscle and the other two on one of the two points of the brachial muscle. Spasticity decreased in 60% of cases according to the Tardieu scale and in 40% according to the Ashworth scale. GAS was at zero in 73.3% of cases. Discussion This study showed that tracking with muscle electrostimulation afforded less precision than with ultrasound. Ultrasound helped for gesture accuracy and effectiveness. Spasticity decreased more when the location was good. The injection of botulinum toxin into the muscles with electrically stimulated tracking coupled with ultrasound would appear as a complementary technique, the accuracy of the gesture being reinforced by ultrasound and the presence of muscle tissue being confirmed with electrostimulation.

HOMOGENIZATION AND μCT ANALYSIS FOR THE TRABECULAR BONE REMODELLING

The bone volume fraction, defined as the Bone-Volume-To-Total-Volume ratio (BV/TV), is an important parameter in the assessment of the bone's micro-structure, and is related to the fracture risk in osteoporosis. Although Magnetic Resonance Imaging (MRI) can assess bone micro-architecture parameters in-vivo, high-field whole body MRI scanners are hardly suitable for wide-scale screening campaigns. Recently, a new NMR application to assess in laboratory the BV/TV of trabecular bone (TB) has been proposed using low-field single-sided NMR. This paper presents an improvement of this technique that allows detection of only the signal from the marrow in the TB suppressing signals from other tissues, which may be present in the sensitive volume of single-sided scanners in a real scenario. The improvement was achieved by filtering signal acquisition by molecular diffusion. Experiments based on an ad-hoc designed Diffusion Weighted T1−T2 pulse sequence have demonstrated that muscle and cartilage signals can be suppressed by using diffusion weighting. On the basis of those experiments, a 1D measurement was established to allow correct estimation of the BV/TV of a TB sample also in the presence of muscle tissue in the sensitive volume of the NMR-scanner. The experiments presented, carried out with the NMR-MOUSE PM10 and the NMR-MOLE, exploiting diffusion-weighted pulse sequences, may pave the way for the in-vivo BV/TV evaluation using single-sided scanners.

Repeat transurethral resection for non-muscle invasive bladder cancer

To investigate the efficacy of repeat transurethral resection of tumor in patients with non-muscle invasive bladder cancer. From March 2004 to August 2008, 462 patients (350 males, 112 females, aged from 35 to 83 years old) with non-muscle invasive bladder cancer, were evaluated according to tumor stage, grade and muscle or no muscle tissue in initial transurethral resected sample. One hundred and twenty-five patients underwent repeat transurethral resection of bladder tumor within 4 to 6 weeks after initial resection. Of these 125 patients 49 were Ta, 76 were T1, 58 were low grade carcinoma, 67 were high grade carcinoma and 30 were not found presence of muscle tissue in initial resected sample in patients with T1 stage. Of the 125 cases, 34.4% (43/125) had residual tumor and 65.6% (82/125) had no tumor on repeat transurethral resection. Of 43 cases with residual tumor 35 had non-muscle invasive tumor including 15 in Ta and 20 in T1. The patients with high grade carcinoma had more residual tumor than those with low grade carcinoma (P < 0.05). The patients with muscle tissue in initial transurethral resected sample had fewer residual tumor than those without (P < 0.05). Twelve cases (9.6%) were understated at initial resection. Six cases (4.8%) had bladder perforation and 7 (5.6%) had bleeding during repeat transurethral resection. All cases were followed up for 3 to 56 months (median 26 months), 37.2% (16/43) patients with residual tumor in repeat transurethral resection had recurrence while only 12.2% (10/82) without residual tumor in repeat transurethral resection did (P < 0.05). Routine repeat transurethral resection is advised to non-muscle invasive bladder cancer patients with T1 tumor or high grade carcinoma or no muscle tissue in initial transurethral resected sample within 4 to 6 weeks after initial resection. Repeat transurethral resection could increases the stage accuracy.

Alterations in the distal extension of the musculus peroneus brevis with foot movement.

A low-lying belly of the musculus peroneus brevis (presence of muscle tissue within the fibular groove) is said to be a risk factor for rupture or dislocation of the peroneal tendons. However, alterations in foot position may affect the position of the musculotendinous junction. The purpose of this study was to evaluate the normal position of the musculotendinous junction of the musculus peroneus brevis in full dorsiflexion and plantar flexion. The ankles of 12 adult asymptomatic volunteers were imaged in full dorsiflexion and plantar flexion. The number of scans between the fibular groove and the first scan imaging the muscle belly of the musculus peroneus brevis was documented in each patient in full dorsiflexion and plantar flexion. Distal extension of muscle belly into or beyond the fibular groove was present in 11 subjects in dorsiflexion and in seven subjects in plantar flexion. Extension of the muscle belly of musculus peroneus brevis into and distal to the fibular groove is part of the normal excursion of the muscle during foot motion. Care should be taken not to misdiagnose this normal finding as a pathologic condition when interpreting MR studies of the ankle.