Novel Applications of Sarcomere Length to Improve Anal Continence

肌节长度在改善肛门失禁方面的新应用

• 批准号: 7888236
• 负责人: RAVINDER K. MITTAL
• 金额: --
• 依托单位: VA SAN DIEGO HEALTHCARE SYSTEM
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2012-09-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7888236
• 关键词: Actins; Acute; Adult; Affect; Age; Anal canal; Animal Model; Anus; Area; Birth; Bladder Control; Cause of Death; Child; Circular layer of muscularis propria of anal canal; Colon Carcinoma; Complex; Consensus; Data; Databases; Defect; Development; Dimensions; Disease; External anal sphincter structure; Extravasation; Fecal Incontinence; Feces; Female; Follow-Up Studies; Foundations; Functional disorder; Goals; Healthcare; Human; Imaging Techniques; Incontinence; Individual; Inflammatory Bowel Diseases; Injury; Knowledge; Laboratories; Lead; Learning; Length; Long-Term Effects; Maintenance; Maps; Medical; Military Personnel; Modeling; Motor; Muscle; Muscle Contraction; Muscle function; Myosin ATPase; Nursing Homes; Operative Surgical Procedures; Organ; Oryctolagus cuniculus; Pathogenesis; Patients; Pelvic Floor Disorders; Pelvic Floor Muscle; Pelvis; Physiological; Physiology; Play; Population; Property; Ptosis; Quality of life; Rectum; Reporting; Research; Research Personnel; Research Priority; Rest; Role; Sarcomeres; Security; Sensory; Series; Sphincter; Study Subject; Surgical sutures; Surveys; Techniques; Thick Filament; Thin Filament; Translational Research; Trauma; Ultrasonography; United States; Urinary Incontinence; Veterans; Woman; Women' s Health; base; fundamental research; human disease; improved; in vivo; novel; operation; patient population; pressure; rectal; research and development; research study; restoration; skeletal; sphincter ani muscle structure; success; symposium; treatment strategy

ABSTRACT The overall objective of this proposal is to improve the quality of life of female Veteran patient population. Recent surveys indicate that the female patient population constitutes the fastest growing segment of VA health care users and pelvic floor disorders (fecal and urinary incontinence, pelvic organ prolapse) are extremely common in this patient population. Fecal incontinence is reported approximately, 7-10% of women over the age of 60. Child birth related injury/ trauma to external anal sphincter injury (EAS) is attributed as the most common cause of fecal incontinence. The most commonly performed surgical procedure for the treatment of fecal incontinence is overlapping sphincteroplasty and long term follow up studies show a poor success rate with this surgical correction. We plan to use an animal model to study the length tension properties of the EAS, and then perform a series of experiments to show that this knowledge can be used to enhance anal canal pressure and continence function. Our preliminary data show that the in-vivo operational EAS muscle sarcomere length is much smaller than its optimal length and it is possible to gain EAS muscle function by increasing the EAS sarcomere length. The specific goals of our study are: 1) To determine the effects of surgical plication of the EAS on the EAS sarcomere length and the anal canal pressure in-vivo in an animal model (rabbit). We will also determine the long-term effects of EAS plication on the durability of gain in the EAS muscle function. 2) We will also study the following to understand why sphincteroplasty operation does not provide the long lasting effects. The goals of these studies in our animal model (rabbit) will be to determine: a) The effects of the EAS myotomy on the development of fecal incontinence. b) The effect of EAS myotomy on the sarcomere length c) The effects of sphincteroplasty with varying degrees of overlap on the EAS muscle function. 3) The length tension relationship of the EAS muscle in the humans to show that the length tension properties of the rabbit and humans are similar.

摘要 这项建议的总体目标是提高妇女的生活质量， 退伍军人患者人群。最近的调查显示， 人口构成VA医疗保健用户增长最快的部分， 骨盆底疾病（大便和尿失禁，盆腔器官脱垂）是 在这个病人群体中非常常见。据报道， 60岁以上的妇女中约有7-10%。与分娩有关的伤害/ 肛门外括约肌损伤是最常见的创伤 大便失禁的原因最常进行的外科手术 治疗大便失禁的方法是重叠括约肌成形术和长 长期随访研究显示这种手术矫正成功率很低。我们 计划使用动物模型来研究EAS的长度张力特性， 然后进行一系列的实验来证明这些知识可以 用于增强肛管压力和排便功能。我们的初步 数据显示，体内可操作EAS肌肉肌节长度是 小于其最佳长度，并且有可能通过以下方式获得EAS肌肉功能： 增加EAS肌节长度。本研究的具体目标是：1） 确定EAS手术折叠对EAS肌节的影响 长度和肛管压力在动物模型（兔）体内。我们将 还确定EAS折叠对增益持久性的长期影响， EAS肌肉功能。2)我们还将研究以下内容以了解原因 括约肌成形术不能提供持久的效果。的目标 在我们的动物模型（兔）中的这些研究将确定：a） EAS肌切开术对大便失禁发展的影响。B）的影响 EAS肌切开术对肌节长度的影响 不同程度的重叠在EAS肌肉功能上。3)长度张力 在人类EAS肌肉的关系，以表明，长度张力 兔子和人类的特性相似。