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Query: UMLS:C0033377 (prolapse)
 11,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Manometric studies of internal sphincter responses were carried out on 15 patients--14 with rectal prolapse and one with mucosal prolapse with proctitis cystica profunda. In all 12 patients studied preoperatively, the internal sphincter reflexes (inhibitory reflex) were absent or markedly obtunded. Anterior resection was performed on three of the patients in whom preoperative and postoperative manometric studies could be carried out. In one, the inhibitory reflex returned to normal after successful corrective surgery and in one, absence of the reflex persisted after anterior resection and this patient eventually had recurrent rectal prolapse.
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PMID:Manometric studies in rectal prolapse. 646 87

Direct contrasting of the anterior epidural space with 9-10% verografin solution was conducted in 123 patients (120 with discogenic radiculitis, 2 with tumors, and 1 with injury to the spine). The epidural space was contrasted for a distance of 3-4 intervertebral spaces and no stimulation of the epidural structures occurred. The epidurograms demonstrated convincing information concerning the character of the protrusion and prolapse of the intervertebral discs and the existence of block of the epidural space in tumors. Phenomena of "spinal epilepsy" occurred in 5 cases, which regressed rapidly after a complex of measures was applied. Anterior epidurography with water-soluble contrast media of low concentration is an informative and safe method.
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PMID:[Anterior epidurography with verographin]. 683 10

We studied the prevalence of mitral valve prolapse (MVP) in presumably healthy young students using two-dimensional echocardiography and compared their clinical pictures with those of hospital patients with MVP. In 265 students undergoing routine physical examination (228 males and 37 females, aged from 18 to 25 years), 29 (11%) were diagnosed as having MVP. There was no sex difference (11% for males and 8% for females). Anterior leaflet prolapse was seen in 26 cases, and anterior and posterior leaflets prolapse was in 3 cases. Twenty-four of the 29 MVP students revealed neither midsystolic click, late systolic murmur nor holosystolic murmur on phonocardiograms (PCG). These 24 students had no cardiac symptoms and the incidence of electrocardiographic (ECG) abnormalities, such as arrhythmias and ST-T changes, was similar to that of students without MVP (4/24 vs 50/236). In contrast, of 54 patients (32 males and 22 females, aged from 15 to 25 years) who were diagnosed as having MVP in the hospital, 28 patients (52%) had no PCG abnormalities. The anterior leaflet was predominantly involved in 42 patients and both anterior and posterior leaflets in 12 patients. These 28 patients visited the hospital because of cardiac symptoms; dyspnea on exertion (3 patients), palpitation (2 patients) or atypical chest pain (7 patients), or abnormal physical examination (11 patients). ECG abnormalities were noticed in 15 of 28 patients (54%). The prevalence of cardiac symptoms and ECG abnormalities were similar to those in 26 patients with PCG evidence of MVP. It was concluded that the prevalence of MVP in young healthy students is 11% and the anterior leaflet is predominantly involved. Most cases were asymptomatic and had no PCG or ECG abnormalities. In contrast, age-matched MVP patients, diagnosed in the hospital with the same two-dimensional echocardiographic criteria, demonstrated similar predominancy of the anterior leaflet prolapse, but had more cardiac symptoms and ECG abnormalities, irrespective of the presence or absence of PCG findings.
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PMID:[Two dimensional echocardiographic diagnosis of mitral valve prolapse syndrome in presumably healthy young students]. 711 94

The clinical presentation, investigative findings, classification, and management of 17 acute pseudotumors based on patterns of orbital involvement is presented. Acute pseudotumors developed over days to weeks and were dominated by pain, neuropraxia, and inflammatory clinical features. Five patterns of acute inflammatory pseudotumor were seen. Anterior and diffuse acute pseudotumors were characterized by manifestations of inflammation of the globe and orbit including pain, lid swelling, ptosis, diplopia, uveitis, papillitis, optic neuropathy, and exudative retinal detachment. Anterior or diffuse orbital infiltration was noted on computerized tomography (CT) and ultrasound. Lacrimal involvement was characterized by local pain, tenderness, lid swelling and inflammation, with CT and ultrasound confirming an anterior inflammatory mass. Posterior or apical involvement led to an early optic neuropathy, and myositic lesions were characterized by features of muscle infiltration. Management with steroids was effective and could be followed by serial CT studies.
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PMID:The classification and management of acute orbital pseudotumors. 717 69

A theoretical explanation of the mechanism of iris prolapse is presented using simple flow mechanics and the Bernouille principle, which states that fluid pressure varies inversely to fluid velocity. Rapid aqueous escape into an anterior chamber perforation thus creates a relative vacuum anterior to the iris. Further analysis shows that the tendency of the iris to prolapse into an anterior chamber wound increases as an inverse function of the fourth power of the radial distance between the iris and the perforation. Anterior wound placement, clear of the iris plane, should help to prevent iris prolapse. Minimizing the irrigation velocity (and hence the fluid outflow velocity) should also help to prevent intraoperative prolapse.
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PMID:Mechanism of iris prolapse: a qualitative analysis and implications for surgical technique. 779 Oct 59

Mitral regurgitation (MR) was evaluated by color Doppler echocardiography during percutaneous transluminal coronary angioplasty (PTCA) in 28 patients with one-vessel artery disease (left anterior descending artery in 11, right coronary artery in 8, and circumflex artery in 9) and normal left ventricular function. In all three groups, left ventricular ejection fraction (LVEF) and wall motion score index (WMSI) decreased significantly during artery occlusion in comparison with baseline values (no differences among various groups). Anterior and inferior akinesia/dyskinesia was observed in all patients during left anterior descending and right coronary artery occlusion, respectively. Lateral akinesia/dyskinesia was induced by occlusion of the circumflex artery in six patients (all with proximal lesions [p < 0.05 vs the other two groups]) and the right coronary artery in one. Only the six patients with circumflex artery occlusion showed PTCA-related MR (> 2+ in two). LVEF and WMSI were similar during artery occlusion in patients with and without MR. Neither mitral leaflet prolapse nor anulus dilation occurred during PTCA in any of the patients. Our data show that during brief occlusion of the proximal circumflex artery, functional MR (usually mild) frequently occurs in relation to specific lateral akinesia/dyskinesia.
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PMID:Color Doppler study of mitral regurgitation during percutaneous transluminal coronary angioplasty. 819 73

Between 1971 and 1991, 41 patients underwent anterior resection for the treatment of complete rectal prolapse. Anterior resection was performed after full rectal mobilization to the levator ani muscles with reanastomosis (39 hand-sewn and two stapled) carried out to peritonealized distal rectum. The 41 patients comprised 35 women and six men with an average age of 56 years (range, 7-88 years). Postoperative follow-up averaged 6 years (range, 6 months to 18 years). Three patients (7%) suffered recurrent prolapse in 2, 2.5, and 5.5 years, respectively. Mortality was 0 per cent; morbidity was 15 per cent including three incisional herniae, two small bowel obstructions, and one stroke. No pelvic sepsis, abscess, or anastomotic dehiscence occurred. Anal incontinence was a preoperative finding in 21 patients (51%) with rectal prolapse. Nineteen of these patients (90%) noted either improvement or no change in postoperative continence. Anterior resection is a familiar, frequently performed operation that does not require a foreign body or rectal suspension. We believe this to be the procedure of choice for patients with complete rectal prolapse. Anterior resection withstands long-term scrutiny both in terms of recurrence rate and associated complications.
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PMID:Anterior resection for the treatment of rectal prolapse: a 20-year experience. 848 90

Pelvic prolapse has a myriad of clinical manifestations ranging from urethral incontinence to total vault prolapse. The evaluation and treatment of these conditions is facilitated by dividing them into three anatomic regions. Anterior vaginal wall prolapse is the most common type and includes simple urethral hypermobility as well as severe cystocele. Surgical treatment includes the modified anterior vaginal wall sling, six-corner bladder neck suspension, and formal cystocele repair. Posterior vaginal wall prolapse, manifested by rectocele and perineal relaxation, is corrected by plication of the prerectal and pararectal fascia, reconstruction of the levator hiatus, and repair of the perineal body. Vault prolapse includes enterocele, uterine prolapse, and generalized vault prolapse. The choice of treatment depends on the presence of anterior vaginal wall prolapse, the degree of vault prolapse, and the patient's desire to remain sexually active. It is important to remember that urethral incontinence is only one manifestation of pelvic prolapse, and must be treated in conjunction with other prolapse to avoid recurrence or poor results.
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PMID:Transvaginal correction of pelvic prolapse. 874 Mar 84

Vestibular fistula and perineal ectopic anus are the most common anorectal malformations in female children. Anterior saggital anorectoplasty (ASARP) was used to treat 416 patients with these anomalies, as well as cases of perineal canal and third-degree perineal tear, during a 20 year period. Preliminary colostomy was performed in only four patients, who had a perineal tear. For ASARP, a midline incision was made and the rectum was separated from the vagina and placed in the center of the sphincteric muscle complex. The perineal body was reconstructed, and normal appearance of the perineum was achieved. Six patients had complications postoperatively (4 had secondary hemorrhage, 2 had wound infection). One patient with hemorrhage and one with infection required laying open of the wound and revision surgery after 12 weeks. Both recovered well. Of the 416 patients, 397 returned for follow-up 12 weeks after the surgery. Of these, 390 had a normal-looking perineum and normal defecation. Of the remaining seven patients, three had retraction of the rectum, one had recurrence of the fistula, and another had acquired perineal canal. These five children required revision ASARP and recovered successfully. The other two patients had mucosal prolapse, which reduced spontaneously. Three hundred twenty-six children of the 416 patients have had follow-up beyond the age of 3 years. Of these, 291 had normal bowel habits without the use of laxatives. Of the other 35, four had fecal impaction of unknown etiology, which was managed conservatively, 6 had anal stenosis (four underwent posterior Barrow's flap interposition and two responded to dilatation), and 25 had a posterior ledge that caused constipation and required cutback. Overall, eight patients (1.9%) required revision ASARP and 40 others (9.8%) had minor complications. This operation provides consistently good results, and the authors recommend it for the management of anorectal malformations and perineal trauma in female children.
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PMID:Anterior sagittal anorectoplasty for anorectal malformations and perineal trauma in the female child. 888 92

Preoperative echocardiography provides good planning information for successful repair of mitral valve regurgitation, but identifying the prolapse of both the anterior and posterior leaflets is sometimes difficult. To clarify the cause of this problem, preoperative echocardiographic findings and intraoperative observations of the prolapse were analyzed in 124 patients with non-rheumatic pure mitral regurgitation. In 48 patients with final diagnoses of bileaflet prolapse, 16 (33%) were considered to have only single leaflet prolapse before the operation. Anterior leaflet prolapse was overlooked in 14, and prolapse of either of its commissural segments was the least detectable by echocardiography. Chordal rupture was seen more in the posterior leaflet than in the anterior leaflet. Movement of the anterior leaflet may be influenced by a prolapsed and hypermobile posterior leaflet and/or regurgitant jet flow caused by the posterior leaflet prolapse.
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PMID:[Pitfalls in echocardiographic diagnosis of mitral bileaflet prolapse]. 966 99


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