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Thos Harnroongroj - One of the best experts on this subject based on the ideXlab platform.
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Vertical Pelvic ring displacement in Pelvic ring injury: Measurements in Pelvic Outlet radiograph and in cadavers.
Indian journal of orthopaedics, 2015Co-Authors: Krit Boontanapibul, Thos Harnroongroj, Narumol SudjaiAbstract:Background: Vertical Pelvic ring displacement (VPRD) is a serious injury and needs assessment. Pelvic Outlet radiographs are routinely taken. However, relationship of radiographic and actual VPRD is still in question. Thus, measurement of VPRD from Pelvic radiographs was studied. Materials and Methods: 2 dry Pelvic bones and 1 sacrum from same cadaver was reconstructed to be the Pelvic ring. Five specimens were enrolled. 10, 20 and 30 mm vertical displacement of right Pelvic bone was performed at levels of sacroiliac joint and pubic symphysis for representing right VPRD. Then, the pelvis was set sacral inclination at 60° from X-ray table for Outlet and anteroposterior Pelvic radiographs. Right VPRD was measured by referring to superior most Pelvic articular surface of both sacroiliac joints and sacral long axis. Radiographic VPRD and actual displacement were analyzed by Pearson correlation coefficient at more than 0.90 for the strong correlation and strongly significant simple regression analysis was set at P Results: Radiographic VPRD from Outlet and anteroposterior Pelvic views at 10 mm actual displacement were 20.12 ± 1.98 and 4.08 ± 3.76 mm, at 20 mm were 40.31 ± 1.97 and 9.94 ± 7.27 mm and at 30 mm were 58.56 ± 2.53 and 11.29 ± 2.89 mm. Statistical analyses showed that radiographic VPRD from Pelvic Outlet view is 1.95 times of actual displacement with strong correlation at 0.992 coefficient and strongly significant regression analysis ( P adiograph was not strongly significant. Conclusion: Pelvic Outlet radiograph provides efficient measurement of VPRD with 2 times of actual displacement.
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Vertical Pelvic ring displacement in Pelvic ring injury Measurements in Pelvic Outlet radiograph and in cadavers
Wolters Kluwer Medknow Publications, 2015Co-Authors: Krit Boontanapibul, Thos Harnroongroj, Narumol SudjaiAbstract:Background: Vertical Pelvic ring displacement (VPRD) is a serious injury and needs assessment. Pelvic Outlet radiographs are routinely taken. However, relationship of radiographic and actual VPRD is still in question. Thus, measurement of VPRD from Pelvic radiographs was studied. Materials and Methods: 2 dry Pelvic bones and 1 sacrum from same cadaver was reconstructed to be the Pelvic ring. Five specimens were enrolled. 10, 20 and 30 mm vertical displacement of right Pelvic bone was performed at levels of sacroiliac joint and pubic symphysis for representing right VPRD. Then, the pelvis was set sacral inclination at 60° from X-ray table for Outlet and anteroposterior Pelvic radiographs. Right VPRD was measured by referring to superior most Pelvic articular surface of both sacroiliac joints and sacral long axis. Radiographic VPRD and actual displacement were analyzed by Pearson correlation coefficient at more than 0.90 for the strong correlation and strongly significant simple regression analysis was set at P < 0.01. Results: Radiographic VPRD from Outlet and anteroposterior Pelvic views at 10 mm actual displacement were 20.12 ± 1.98 and 4.08 ± 3.76 mm, at 20 mm were 40.31 ± 1.97 and 9.94 ± 7.27 mm and at 30 mm were 58.56 ± 2.53 and 11.29 ± 2.89 mm. Statistical analyses showed that radiographic VPRD from Pelvic Outlet view is 1.95 times of actual displacement with strong correlation at 0.992 coefficient and strongly significant regression analysis (P < 0.001) with 0.984 of R[2] value. Whereas, the measurement from anteroposterior Pelvic radiograph was not strongly significant. Conclusion: Pelvic Outlet radiograph provides efficient measurement of VPRD with 2 times of actual displacement
Kyoji Okada - One of the best experts on this subject based on the ideXlab platform.
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patterns of soft tissue tumor extension in and out of the pelvis
American Journal of Roentgenology, 2010Co-Authors: Shunsuke Sugawara, Shigeru Ehara, Shin Hitachi, Kyoji OkadaAbstract:OBJECTIVE. The purpose of this article is to present the route of extension in nine soft-tissue tumors and tumorlike lesions of the Pelvic wall.CONCLUSION. Soft-tissue tumors of the pelvis, particularly malignant ones, extend into other compartments through specific pathways that are bordered by bones, ligaments, and fasciae. Such pathways include the greater sciatic foramen, the obturator foramen, the femoral canal, the muscular lacuna, the Pelvic Outlet, and the inguinal canal.
Keiichi Akita - One of the best experts on this subject based on the ideXlab platform.
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Muscles of the Pelvic Outlet in the rhesus monkey (Macaca mulatta) with special reference to nerve supply
The Anatomical record, 1995Co-Authors: Keiichi Akita, Hirokazu Sakamoto, Tatso SatoAbstract:Background: The Manner of innervation of the muscles of the inferior limb, Pelvic Outlet, and tail in rhesus monkey (Macaca maulatta) was investigated in detail in 11 Pelvic halves of lour males and two females. Results: The origins of the pudendal nerve were widespread and overlapped the sacral plexus. After removal of the bone structures, detailed dissection revealed the origin of the pudendal nerve to ventrocaudally overlap the sacral plexus. This dorsoventral branching pattern between the sacral plexus and the pudendal nerve is similar to that in Urodela (akita, 1992b) Lacertilia (Akita, 1992a) and AVes (Akita et al., 1992a), and is a basis for morphological understanding of the muscles of the Pelvic Outlet. Conclusion: The muscles of the Pelvic Outlet consist of the leavtor, sphincter, and tail muscle groups, based on the stratification of the supplying nerves the former two groups likely dervice from the ventral muscles of the inferior limb, and the latter group from the ventral caudal (trunk) muscles. © 1995 Wiley-Liss, Inc.
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An anatomical investigation of the muscles of the Pelvic Outlet in Japanese giant salamander (Cryptobranchidae Megalobatrachus japonicus) with special reference to their nerve supply
Annals of Anatomy-anatomischer Anzeiger, 1992Co-Authors: Keiichi AkitaAbstract:Summary Four Pelvic halves from two Japanese giant salamanders (Cryptobranchidae Megalobatrachus japonicus , one male and one female) were dissected in order to obtain detailed morphological data on the lumbosacral plexus and the muscles of the Pelvic Outlet. According to the positions of the passage of the metazonal nerves, the nerves can be divided into three groups: 1) the nerves passing dorsal to the caudofemoralis muscle, 2) the nerves passing between the caudofemoralis and the caudoischiadicus, 3) the nerves passing ventral to the caudoischiadicus. In consideration of the sites of origin from the lumbosacral plexus, a three-way stratificational analysis can be made, group 1 arising craniodorsal to group 2, and group 3 caudoventral to group 2. It is suggested that the three Pelvic Outlet muscles, the caudofemoralis, caudocruralis, and caudoischiadicus, have derived from the ventral muscles of the posterior limb, and have extended ventrocaudalwards.
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An anatomical investigation of the muscles of the Pelvic Outlet in iguanas (Iguanidae Iguana iguana) and varanus (Varanidae Varanus (dumerillii)) with special reference to their nerve supply.
Annals of Anatomy-anatomischer Anzeiger, 1992Co-Authors: Keiichi AkitaAbstract:Abstract Five Pelvic halves from three male iguanas (Iguanidae Iguana iguana) and two Pelvic halves from one male varanus (Varanidae Varanus (dumerillii)), were dissected in order to obtain detailed data on the relationship of the lumbosacral plexus and the muscles of the Pelvic Outlet. According to the positions of the passage of the metazonal nerves, the nerves can be divided into three groups: 1) the nerves passing dorsal to the caudofemoralis muscle, 2) the nerves passing between the caudofemoralis and the caudoischiadicus major, 3) the nerves passing ventral to the caudoischiadicus major. In consideration of the sites of origin from the lumbosacral plexus, a stratificational analysis can be proposed; group 1 arises craniodorsal to group 2, and group 3 caudoventral to group 2. It is suggested that the Pelvic Outlet muscles (caudofemoralis, quadratus caudae, obliquus cloacae, transversus cloacae profundus, retractor penis, caudoischiadicus major, and the caudoischiadicus minor) are derived from the ventral muscles of the posterior limb, and have moved caudally concomitant with the caudal migration of the cloaca.
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Muscles of the Pelvic Outlet in the fowl (Gallus gallus domesticus) with special reference to their nerve supply.
Journal of morphology, 1992Co-Authors: Keiichi Akita, Hirokazu Sakamoto, Tatsuo SatoAbstract:The manner of innervation of the Pelvic Outlet muscles in fowl (Gallus gallus domesticus) was examined in detail in four male Pelvic halves. The segmental arrangement of the nerve supply in the sacral and pudendal plexuses was compared to that of Lacertilia and Urodela as a basis for a morphologiccal analysis of the Pelvic Outlet muscles. From the viewpoint of innervation, the Pelvic Outlet muscles of fowl are classified into two groups: a sphincter muscle group and a levator muscle group. These two groups are closely related to the ventral muscles of the Pelvic limb. In contrast to the morphology of Pelvic Outlet muscles in lacertilians, in fowl the caudal muscle element does not contribute to the formation of these muscles. © 1992 Wiley-Liss, Inc.
Steven D. Wexner - One of the best experts on this subject based on the ideXlab platform.
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Pelvic Outlet obstruction.
Current treatment options in gastroenterology, 2005Co-Authors: Orit Kaidar-person, Seth A. Rosen, Steven D. WexnerAbstract:Despite the wide variety of definitions and descriptions of constipation, ideally, the diagnostic approach should be uniform. The evaluation process should begin with a careful and thorough patient history and physical exam; appropriate efforts should be made to exclude organic causes of constipation. Patients suffering from Pelvic Outlet obstruction often respond poorly to conservative treatment. Diagnostic tests include intestinal transit studies, anorectal manometry, defecography, balloon expulsion, and anal sphincter electromyography. For many patients constipation is multifactorial and accordingly, so is the treatment. In our opinion the first line of treatment should be based on conservative measures including adequate intake of fluids, dietary fiber supplementation, and laxatives. Biofeedback training should be offered, particularly to patients with paradoxical puborectalis contraction. Surgical management can, in very limited circumstances, be offered only to those patients with disabling symptoms who have failed other standard therapeutic measures.
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Surgery for constipation: a review.
Diseases of the colon and rectum, 1996Co-Authors: J. Pfeifer, Feran Agachan, Steven D. WexnerAbstract:PURPOSE : Constipation is related to intestinal motility disorders (colonic inertia (CI)), Pelvic floor disturbances (Pelvic Outlet obstruction), or a combination of both problems. This review summarizes the physiologic and pathophysiologic changes in patients with intractable constipation and gives an overview of surgical treatment options. RESULTS : Although subtotal colectomy with ileorectal anastomosis is the best surgery for CI, there are still approximately 10 percent of patients who will complain of pain and constipation. A completion proctectomy and an ileoanal pouch procedure may be a viable option in a highly select group of patients. In patients with megabowel, reported results are mixed. Subtotal colectomy, partial colectomy for megacolon, and the Duhamel procedure for megarectum have all been reported with variable results. In patients with an isolated distended sigmoid colon, sigmoid colectomy has achieved good results. Anorectal myectomy has not been proven to be successful in the long term. However, in patients with adult short segment Hirschsprung's disease, myectomy can be successful. Patients with Pelvic Outlet obstruction can be successfully treated with biofeedback. In a small group of patients with a rectocele or a third degree sigmoidocele, surgical intervention yields a high success rate. Division or resection of the puborectalis muscle is not recommended. In patients with a mixed pattern of CI and Pelvic Outlet obstruction, surgical intervention alone is often not successful. These patients achieve better results by conservative treatment of Pelvic Outlet obstruction, followed by a colectomy. CONCLUSION : Surgical intervention for patients with intractable constipation is rarely necessary. However, thorough preoperative physiologic testing is mandatory for a successful outcome.
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Pudendal neuropathy is not related to physiologic Pelvic Outlet obstruction
Diseases of the colon and rectum, 1995Co-Authors: Carlos A. Vaccaro, Steven D. Wexner, Tiong-ann Teoh, Sang Kyung Choi, Denis M. O. Cheong, Virgilio D. SalangaAbstract:Chronic straining because of Pelvic Outlet obstruction is hypothesized to cause pudendal neuropathy (PN) by stretch injury. PURPOSE: The aim of this study was to determine any association between PN and Pelvic Outlet obstruction. METHODS: One hundred forty-seven constipated patients were evaluated by cinedefecography and pudendal nerve terminal motor latency assessment. PN was defined as a latency longer than 2.2 ms. Pelvic Outlet obstructive patterns of evacuation included paradoxic contraction, nonrelaxation of the puborectalis muscle, or failure of opening of the anal canal. RESULTS: Median length of constipation including straining during evacuation was eight (range, 1–47) years. Ninety-one (62 percent) subjects had a normal pattern of evacuation, and 56 (38 percent) had an obstructed pattern. Both groups had a similar median age (68tvs.69 years, respectively;P>0.05) and same median length of symptoms. Overall incidence of PN was 23.8 percent (10.9 percent unilateral and 12.9 percent bilateral). There was no difference in the incidence of PN between patients with normal evacuation and patients with obstructed evacuation (24.2 percentvs.23.2 percent, respectively;P>0.05). Patients with PN had a similar incidence of physiologic Pelvic Outlet obstruction as did patients without PN. However, median age of patients with PN was higher than those without PN (73tvs.66 years, respectively;P>0.05). CONCLUSION: There was a difference in the incidence of PN between normal and obstructed patterns of evacuation. Therefore, the espoused theory that obstructed defecation causes PN appears flawed.
Tatso Sato - One of the best experts on this subject based on the ideXlab platform.
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Muscles of the Pelvic Outlet in the rhesus monkey (Macaca mulatta) with special reference to nerve supply
The Anatomical record, 1995Co-Authors: Keiichi Akita, Hirokazu Sakamoto, Tatso SatoAbstract:Background: The Manner of innervation of the muscles of the inferior limb, Pelvic Outlet, and tail in rhesus monkey (Macaca maulatta) was investigated in detail in 11 Pelvic halves of lour males and two females. Results: The origins of the pudendal nerve were widespread and overlapped the sacral plexus. After removal of the bone structures, detailed dissection revealed the origin of the pudendal nerve to ventrocaudally overlap the sacral plexus. This dorsoventral branching pattern between the sacral plexus and the pudendal nerve is similar to that in Urodela (akita, 1992b) Lacertilia (Akita, 1992a) and AVes (Akita et al., 1992a), and is a basis for morphological understanding of the muscles of the Pelvic Outlet. Conclusion: The muscles of the Pelvic Outlet consist of the leavtor, sphincter, and tail muscle groups, based on the stratification of the supplying nerves the former two groups likely dervice from the ventral muscles of the inferior limb, and the latter group from the ventral caudal (trunk) muscles. © 1995 Wiley-Liss, Inc.