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.

抽象的 该提议的总体目的是提高女性的生活质量 退伍军人人数。最近的调查表明女性患者 人口构成VA医疗保健使用者的增长最快的部分和 骨盆地板障碍（粪便和尿失禁，骨盆脱垂）是 在该患者人群中极为常见。据报道粪便失禁 大约60岁以上的妇女中有7-10％。与儿童相关的伤害/ 外部肛门括约肌受伤（EAS）的创伤归因于最常见的 粪便失禁的原因。最常见的手术程序 为了治疗粪便失禁，是括约肌成形术重叠的 术语后续研究表明，这种手术校正的成功率很差。我们 计划使用动物模型研究EAS的长度张力特性， 然后执行一系列实验，以表明这些知识可以是 用于增强肛管压力和连续性功能。我们的初步 数据表明，体内操作的EAS肌肉肌肉肌肉长度很大 小于其最佳长度，可以通过 增加EAS肌节长度。我们研究的具体目标是：1） 确定EAS手术膜对EAS肌膜的影响 在动物模型（兔）中的长度和肛管压力。我们将 还可以确定EAS Plication对增益耐用性的长期影响 EAS肌肉功能。 2）我们还将研究以下内容，以了解为什么 括约肌成形术操作不会带来持久的效果。目标 这些动物模型（兔子）中的这些研究将确定：a） 关于粪便尿失禁发展的EAS肌关节。 b）效果 对肌节长度的EAS肌切开术c）括约肌成形术的影响 EAS肌肉功能上的重叠程度不同。 3）长度张力 EAS肌肉在人类中的关系表明长度张力 兔子和人类的特性相似。