The effect of lateral electrical surface stimulation (LESS) on motor end-plates in an animal model of experimental scoliosis.

The treatment of idiopathic scoliosis is challenging because of its diverse etiology, age of onset, and long duration of intensive treatment. We examined the effect of lateral electrical surface stimulation (LESS) in an animal model of experimental scoliosis (ES) assessing the number of motor end-plates (MEPs) as a study end-point. The control group (n=5) was adapted to the experimental apparatus without stimulation, whereas ES was induced in rabbits by one-sided LESS of the longissimus dorsi muscle (LDM) for a duration of 2 months. The ES group (n=5) were subjected to a short-term corrective electrostimulation applied at the contralateral side of the spine compared to the previous LESS stimulation for 2 h daily for 3 (n=5) or 6 months (n=5). Another group of ES rabbits was subjected to a long-term corrective electrostimulation applied for 9 h daily for 3 (n=5) or 6 months (n=5). LESS applied for 2 months (ES), significantly increased the number of MEPs in LDM. The short-term corrective electrostimulation for 3 months resulted in an increased number of MEPs. However, a decrease was observed in the animals treated for 6 months. The long-term corrective electrostimulation for 3 months did not change the density of MEPs in the LDM, but for 6 months the number of MEPs in the LMD significantly decreased by ES and control groups. Thus, the results of the present study clearly show that the short-term LESS is able to influence both the number of MEPs and the effectiveness of muscle correctional adaptation in a more efficient and harmless manner than the long-term procedure.

Exogenously administered bombesin and gastrin releasing peptide contract the female rat urethra in vivo and in vitro.

BACKGROUND: Bombesin (BOM) and gastrin releasing peptide (GRP) have been located to the lower urinary tract (LUT). However, there is a paucity of data demonstrating the impact of these endogenous peptides. OBJECTIVES: The aim of the present study was to investigate the contractile actions of BOM and GRP on the female rat urethra in vitro and in vivo. Female Sprague-Dawley rats (n = 37) weighing approximately 225 g were used. Intraurethral pressure was recorded by a catheter placed at the maximum pressure zone corresponding to the intrinsic urethral sphincter. MEASUREMENTS: In vitro, changes in intraurethral pressure was conducted on perfused intact urethral/bladder preparations and are expressed as percentages of sphincteric intraurethral pressure achieved with noradrenaline. In vivo, changes in intraurethral pressure was conducted in anesthetized subjects and compared with the baseline intraurethral pressure and sham controls. RESULTS: In vitro, the increase in intraurethral pressure induced by BOM was 23.6 ± 3.2 cmH(2)O, exceeding the pressure evoked with NA by 9.6 cmH(2) O or 174.4% whereas GRP induced a maximum pressure of 10.7 ± 1.6 cmH(2) O, an increase of 2.2 ± 0.5 cmH(2) O or 82.9% (P < 0.05) of the NA evoked pressure. In vivo, the mean baseline pressure was 22.9 ± 1.4 cmH(2) O. The intraurethral pressure evoked by BOM was 50.6 ± 6.3 cmH(2) O (P < 0.05), and for GRP, the evoked intraurethral pressure was 56.2 ± 13.4 cmH(2) O (P < 0.05). CONCLUSIONS: The present data suggest that both BOM and GRP may contribute to the control of continence by their contractile action on the sphincters of the LUT outflow region.

Multiple sclerosis produces significant changes in urinary bladder innervation which are partially reflected in the lower urinary tract functional status-sensory nerve fibers role in detrusor overactivity.

BACKGROUND: Detrusor overactivity is often observed in patients with multiple sclerosis (MS), and neurotoxins are emerging as second-line therapies albeit with different degrees of success per patient basis. OBJECTIVE: To investigate lower urinary tract (LUT) functional status and bladder innervation (calcitonin gene related peptide [CGRP] and substance P [SP] positive nerve fibers) in patients with MS. METHOD: Eighteen MS patients with LUT symptoms underwent urodynamic investigations, and six non-MS patients undergoing cystoscopy due to microscopic hematuria served as controls. Cold cut bladder biopsies were taken from the bladder trigone region. Neurotransmitter expression was determined by individual immunohistochemical staining. RESULTS: Two distinct groups could be distinguished: group 1 with pronounced neurogenic detrusor overactivity and mild outflow obstruction; group 2 with some degree of neurogenic detrusor overactivity, detrusor hypocontractility during voiding, and high degree of an outflow obstruction. The presence of SP and CGRP immunoreactive + fiber density was observed in greater numbers in group 1. CONCLUSION: Density of CGRP and SP positive nerve fibers within the urinary bladder of patients with MS may be suggestive of functional status of the lower urinary tract, namely denser innervation is observed in patients with mild outflow obstruction and strong detrusor overactivity. This observation could be useful when planning second-line treatment (neurotoxins) in these patients. Patients with denser innervation probably will respond better to such a therapy.

Distribution and neurochemical characterization of sensory dorsal root ganglia neurons supplying porcine urinary bladder.

UNLABELLED: Pig has been used recently as an animal model for studying diseases of human urinary tract, however, the sensory innervations of urinary bladder in this species has not been yet described. OBJECTIVE: The present study was aimed at neurochemical characterization of sensory neurons of dorsal root ganglia (DRGs) supplying porcine urinary bladder. METHODS: Retrograde tracer Fast Blue (FB) was injected into the right half of the urinary bladder wall of six juvenile female pigs. Three weeks later ipsi- and contralateral DRGs of interest were harvested from all animals and a neurochemical characterization of retrogradely-labeled neurons was performed using routine single-immunofluorescence labeling technique on 10 microm-thick cryostat sections. RESULTS: 85% of spinal sensory neurons supplying porcine urinary bladder was located in ipsilateral sacral S3-S4 ganglia and in first coccygeal ganglion (Cq1),whereas rest of FB-positive (FB+) nerve cells were found in lumbar L3-L6 DRGs. FB+ neurons belonged mostly to the medium-sized (54%) and small-sized afferent perikarya (45%). Bladder sensory neurons contained substance P (SP), calcitonin gene-related peptide (CGRP), pituitary adenylate cyclase-activating peptide (PACAP), galanin (GAL), neuronal nitric oxide synthase (nNOS), somatostatin (SOM) and/or calbindin-28k (CB), and these neurons constituted 45%, 36%, 26%, 6%, 6%, 4% and 3% of all retrogradely traced DRGs perikarya, respectively. Distinct differences in the number of traced cells and their neuropeptide content were observed between the lumbar and sacral/coccygeal division of bladder-projecting DRG neurons. Thus, FB+ neurons expressing CGRP, GAL, nNOS or SOM were more numerous in lumbar DRGs (44%, 9%, 9% and 6%, respectively), than in sacral/coccygeal ganglia (23%, 2%, 1.5% and 0.3%, respectively). On the other hand, more FB+ cells expressed PACAP in sacral (31%) than in lumbar DRGs (23%). However, fractions of SP-IR or CB-IR bladder sensory neurons were similar in lumbar and sacral/coccygeal DRGs. CONCLUSIONS: This novel description of both spatial and neurochemical organization pattern of porcine urinary bladder sensory innervation constitutes a basis for further functional studies aimed at unraveling neurogenic mechanisms of urinary bladder diseases.

New hope for Treacher-Collins syndrome: a surgical case report.

The objective of this case report is to discuss the possibility of developing a surgical treatment paradigm for patients with some of the noted characteristics of Treacher-Collins syndrome, mainly mandibular ankylosis and/or retrognathia (mandibular retrusion), in a way that would provide lasting, predictable results and minimize the frequently seen mandibular ankylosis. Through various medical imaging techniques, mainly computed tomography (CT) scan, the radiology imaging technologist produces accurate CT scan images of the particular patient's osseous cranial structures. These images can then be used by the stereolithography (SLA) technician to construct accurate SLA models. The SLA models can then be used by the surgical and implant design team to not only prescribe the surgical correction necessary, but also design and construct the actual temporomandibular joint (TMJ) and mandibular implants, as well as perform mock surgery, which will be needed to restore function and esthetics for the patient. The early results from this alloplastic reconstructive surgery have provided the anticipated results of relieving the ankylosis, improving jaw function and frequently dental occlusion, as well as improving the esthetics. Without this breakthrough surgical development, many of these Treacher-Collins syndrome patients will not be able to enjoy normal breathing, mastication, jaw function, esthetics, oral and dental health, and the emotional relief these corrections allow. Many patients who suffer the disfiguring and functionally damaging affects of Treacher-Collins syndrome never receive the surgical correction necessary. Many have had autogenous reconstruction of missing mandibular and TMJ structures, only to sometimes relapse into a more disfiguring and lasting condition. By simply placing a Christensen Fossa-Eminence Prosthesis(r) (TMJ Implants, Inc., Golden CO, USA) between the cranial base and any bone graft, one is more likely to achieve satisfactory TMJ mobility. If a condylar or mandibular reconstruction is necessary, the Christensen Total TMJ Prostheses(r) (TMJ Implants, Inc., Golden CO, USA) are available and provide excellent results.