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At least 505 records · Page 28Linked to original sources

PubMed1995

Use of the "elephant trunk technique" in aortic surgery.

BACKGROUND: In aortic replacement, the "elephant trunk technique" uses surplus intravascular graft length to facilitate subsequent operations on the downstream aorta. This study investigates the experience with the technique since its conception by our group. METHODS: Between 1982 and 1994, 80 elephant trunks were implanted in 72 patients. In 40 cases the primary position was in the proximal descending thoracic aorta, extending an aortic arch graft. In 32 instances the elephant trunk was placed in the distal descending thoracic aorta, extending descending aortic replacement. Aortic pathology comprised aneurysms in 22 cases, chronic dissection in 47, and acute dissection in 3. Fourteen patients had Marfan's syndrome. RESULTS: There was a total of 10 early deaths, 7 of which occurred during the early experience. Subsequent downstream aortic operation was undertaken in 24 patients after a mean interval of 14 months, replacing the descending thoracic aorta in 17 cases and the thoracoabdominal portion in 7 cases. Six patients underwent third-stage procedures. Several technical modifications were developed, helping to ease placement and unfolding of the trunk. CONCLUSIONS: The elephant trunk technique greatly facilitates and at the same time reduces the risk of multiple-stage aortic replacement.

Acute Disease↗

PubMed1995

Diurnal variation in trunk kinematics during a typical work shift.

Diurnal variation in trunk flexibility, defined as changes in range of motion, has been previously observed and quantified. Prior studies have shown that decreased disk height occurs as the day progresses and allows the spinal ligaments to slacken, resulting in an increase in the range of motion (flexibility) and a possible reduction in the risk of injury. This risk may be accentuated under dynamic motions of the spine. This study was conducted to observe the change in dynamic trunk mobility as a function of time of the day. Trunk motions of 21 men were observed at three specific times of the day using a triaxial electrogoniometer. No variation in trunk range of motion in any of the cardinal planes was observed. However, velocity and acceleration in the sagittal plane showed significant variations, suggesting the reexamination of the "slack ligaments" hypothesis. This study asserts that identifying flexibility by only its static component, range of motion, gives only partial information about the diurnal variation experienced by the spine. Industrial injuries occurring in the early morning hours may be a result of insufficient trunk mobility. This study indicates that risk associated with diurnal variation is far more complex than originally thought.

Acceleration↗

PubMed1994

Surgical angioplasty of the coronary trunks: an alternative to bypass techniques.

AIM: To test the value of surgical angioplasty of the coronary trunks as an alternative to bypass techniques. PATIENTS AND METHODS: Surgical angioplasty of the coronary trunks was performed in 12 patients (mean age 59 +/- 9 years), of whom nine underwent right coronary trunk angioplasty, five underwent left main coronary artery angioplasty, and two patients underwent bilateral coronary trunk angioplasty. A transpulmonary approach to the left main coronary artery was used. The patch consisted of saphenous vein in the first two patients but in the rest pericardium was preferred. Associated bypass procedures to the other coronary network using internal mammary or gastroepiploic arteries were performed in six patients, and one patient had a concomitant aortic valve replacement. RESULTS: No early mortality (30-day) or morbidity was observed and all procedures were successful. A 15-day angiographic study revealed an excellent result in all 14 angioplasties. After 6 months, all patients were free of symptoms during exercise stress testing (maximum level of exercise 140 +/- 20 W). One patient with a recurrence of angina underwent a second operation after 1 year because of left anterior descending coronary artery occlusion after bilateral angioplasty. Another angiographic study was obtained after 1 year in three other patients, which showed excellent results (four angioplasties controlled). After a mean follow-up period of 17 +/- 7 months (range 6-31), all patients were symptom-free, and with the exception of the one reoperation, no cardiac events were reported. CONCLUSIONS: Provided that contraindications (calcifications, involvement of the distal bifurcation) are respected, surgical angioplasty of the coronary trunks is safe, restores physiologic coronary perfusion, is economical with bypass material, and provides good results.

Adult↗

PubMed1993

[Changes in microcirculation in the facial nerve with electrical stimulation and chemical blockade of cervical sympathetic trunks].

The cervical sympathetic trunks send peripheral branches to the external carotid artery system which in turn provides feeding vessels to the facial nerves. In this study, the changes in the tonus of these trunks and the associated changes in the microcirculation of the facial nerves were studied by electrical stimulation and by chemical blockade of the cervical sympathetic trunks in mongrel dogs. With electrical stimulation, marked increases in arterial blood pressure and the heart rate were observed although the common carotid arterial blood flow and tissue blood flow in facial nerves decreased markedly. This suggests that microcirculation in the facial nerve is definitely impaired by electrical stimulation of the cervical sympathetic trunks and that hypertonicity of the sympathetic nervous system is closely involved in the onset of facial palsy. When chemical blockade was applied to the same trunks, the arterial blood pressure and heart rate showed no significant changes. However, there were marked increases of the blood flow in common carotid artery and facial nerve tissue. This finding of improved microcirculation in the facial nerve after chemical blockade suggests that stellate ganglion block may be a very effective treatment for Bell's palsy.

Animals↗

PubMed1979

Ganglion cells in the facial nerve trunk of the mouse.

Numbers and distribution of the ganglion cells in the facial trunk distal to the ggl. geniculi of the mouse were examined with the light microscope. Counts of the ganglion cells in 22 nerves from 14 mice showed that all specimens contained some ganglion cells and numbers of the ganglion cells were various (1--80) and, on an average, there were 24 ganglion cells in each facial trunk. Ganglion cells existed most frequently in the dorsal corner and the dorso-lateral border of the small fiber zone of the facial trunk near the level of the origin of the n. stapedius. Also they were often found in the facial trunk near the origin of the chorda tympani and near the cross contact of the r. auricularis n. vagi with the facial trunk. These ganglion cells may be sensory neurons.

Animals↗

PubMedDate not supplied

Trunk distortion in adolescent idiopathic scoliosis.

Trunk images of children with scoliosis were examined to determine features that contribute to the impression of trunk distortion. Twenty subjects with spinal deformity ranging from none to severe were photographed in a relaxed standing position. Seven blinded evaluators subjectively scored their impressions of the trunk appearance, shoulder-height difference, shoulder-angle asymmetry, decompensation, scapula asymmetry, waist crease, waist asymmetry, and pelvic asymmetry. Regression analysis was used with the latter seven features to predict overall impression. The seven measures of the deformity predicted 85% of the overall impression of trunk distortion; scapular asymmetry was the best predictor. Trunk deformity is the most obvious effect of scoliosis to the patients. Objective approaches to the assessment of this important but difficult-to-quantify aspect of idiopathic scoliosis are available and should be used to evaluate treatment outcomes.

Adolescent↗

PubMed1998

[Excitability of spinal alpha-motoneurons in gunshot injuries of nervous trunks of lower limbs in patients in rehabilitation].

Excitability of functionally different alpha-motoneurons was studied in 62 patients with gunshot injuries of nervous trunks of lower extremities both before and during process of rehabilitation by means of physical factors. The correlation of reactions of spinal cord motoneurons and the degree of injuries of nervous trunks was observed. Neuroapraxia of nervous trunks was accompanied by multidirectional alterations in reflex activity of large and small alpha-motoneurons. It was depressed in axonothermesis and lost in simultaneous full anatomic interruption of ischiatic nerve and trunks of both fibular and tibial nerves. Under influence of physical factors the function of motoneurons was normalized in neuroapraxia and was improved in axonothermesis of nervous trunks.

Apraxias↗

PubMed1998

Increased submucosal nerve trunk caliber in aganglionosis: a "positive" and objective finding in suction biopsies and segmental resections in Hirschsprung's disease.

OBJECTIVE: To establish the diagnostic usefulness of submucosal hypertrophic nerve trunk morphology in Hirschsprung's disease as a quantifiable parameter supportive of aganglionosis on hematoxylin-eosin-stained sections. DESIGN: We retrospectively evaluated size and density of submucosal nerves on hematoxylin-eosin-stained sections and S100 protein-stained sections of resected segments from 13 patients with Hirschsprung's disease, and in sections of 20 aganglionic and 50 ganglionic rectal suction biopsies. SETTING: All patients were seen at Childrens Hospital Los Angeles (Calif), a tertiary-care pediatric center; the age of patients at diagnosis or resection ranged between 2 days and 3 years. RESULTS: Aganglionic segments contain many distinct nerve trunks greater than 40 microm in diameter. Ganglionic segments/biopsies showed no nerve trunk larger than this threshold value (P approximately .0000). Nerve trunks of such caliber are rarely encountered in pathologic transition zones and sites of colostomy. CONCLUSIONS: Submucosal nerve trunks that are 40 microm or greater in diameter strongly correlate with abnormal innervation/aganglionosis. Use of this objective parameter in evaluating suction biopsies should be helpful in the morphologic diagnosis of Hirschsprung's disease in infancy and early childhood.

Biopsy, Needle↗

PubMed1977

[Surgical treatment of occlusive lesions of the brahciocephalic trunk].

Surgery was performed on 41 patients for an occlusive process in the brachycephalic trunk. As concerns the clinical form of the occlusive process these patients were divided into 4 groups, viz. with symptomless occlusion--4, with transitory form--18, with chronic cerebro-vascular insufficiency--5 and with complete ischemic stroke--14. The diagnosis was established on the ground of routine clinical and instrumental examination findings. The authors consider an angiographic investigation of the patients to be indispensible. In the presence of an angiographically confirmed occlusion of the brachycephalic trunk the authors hold indicated reconstructive surgery in patients of all the mentioned clinical groups. As a basic type of the reconstructive operation is regarded resection of the trunk with prosthetics. The circulation could be restored in all of the patients operated upon. Late follow-up of the surgically treated patients (up to 10 years) proves that in the treatment of arterial insufficiency of the brain the reconstructive operation on the occluded brachycephalic trunk is a highly effective method.

Adult↗

PubMed2005

The metabolic syndrome, cardiopulmonary fitness, and subcutaneous trunk fat as independent determinants of arterial stiffness: the Amsterdam Growth and Health Longitudinal Study.

BACKGROUND: The mechanisms that link the metabolic syndrome to increased cardiovascular risk are incompletely understood, especially in young people. We therefore examined whether the metabolic syndrome was associated with arterial stiffness and whether any such associations were independent of cardiopulmonary fitness and subcutaneous trunk fat. METHODS: Cross-sectional analyses of data on 364 men and women aged 36 years from the Amsterdam Growth and Health Longitudinal Study (ninth follow-up measurement, year 2000). The prevalence of the metabolic syndrome was defined by a slightly modified National Cholesterol Education Program (NCEP) definition. Arterial stiffness was ultrasonically estimated by distensibility and compliance of the carotid, femoral, and brachial arteries and by the carotid elastic modulus. RESULTS: The prevalence of the metabolic syndrome in this young adult population was 18.3% in men and 3.2% in women. Individuals with the syndrome compared with individuals without risk factors had 11.2% and 17.0% less distensibility and 9.0% and 18.2% less compliance of the carotid and femoral arteries, respectively, and 15.9% higher carotid elastic modulus. After adjustment for cardiopulmonary fitness and subcutaneous trunk fat, the metabolic syndrome remained significantly associated with stiffness of the carotid but not the femoral artery. In addition, poor cardiopulmonary fitness and high subcutaneous trunk fat were associated with arterial stiffness, and this was independent of the metabolic syndrome. CONCLUSIONS: A modified NCEP definition of the metabolic syndrome identified young individuals with increased arterial stiffness. The mechanisms that link the metabolic syndrome, poor cardiopulmonary fitness, and high subcutaneous trunk fat to greater arterial stiffness overlap but are partly independent of each other.

Adolescent↗

PubMed1997

Nonneoplastic diseases of aorta and pulmonary trunk--Part V.

This five-part review focuses on selected nonneoplastic diseases of the aorta and pulmonary trunk. Because many more diseases affect the aorta compared with the pulmonary trunk and the right and left main pulmonary arteries, most of this review will be devoted to disorders of the aorta. Part V of this five-part series on diseases of the aorta and the pulmonary trunk focuses on nonneoplastic diseases of the pulmonary trunk and the right and left main pulmonary arteries.

Aortic Diseases↗

PubMed1979

Localization of neurons in the rat superior cervical ganglion that project into different postganglionic trunks.

Horseradish peroxidase (HRP) was used to determine whether neurons in the rat superior cervical ganglion (SCG) are localized in regions of the ganglion as a function of the postganglionic trunk they utilize. In separate experiments, each of the two major postganglionic trunks was cut 1-3 mm from the SCG and solid HRP was applied to the cut end proximal to the ganglion. The results demonstrated that the cell bodies of neurons whose axons project out the internal carotid nerve (ICN) were located primarily in the rostral part of the ganglion. Cell bodies of neurons whose axons project out the external carotid nerve (ECN) were located primarily in the caudal part. The total percentages of neuronc with axons in the ICN and ECN were about 35% and 45%, respectively. When HRP was applied to both these trunks, 73% of the neurons in the SCG were labeled. In the caudal portion of the ganglion, an additional group of neurons was observed whose axons project into the cervical sympathetic trunk. Control studies indicated that the neuronal labeling observed in our experiments was due to retrograde axonal transport rather than the direct uptake of HRP by neuronal cell bodies. Thus, neuronal subpopulations exist in specific regions of the rat SCG. The significance of these results to biochemical and electrophysiological studies is discussed.

Animals↗

PubMed2007

Migratory patterns and developmental potential of trunk neural crest cells in the axolotl embryo.

Using cell markers and grafting, we examined the timing of migration and developmental potential of trunk neural crest cells in axolotl. No obvious differences in pathway choice were noted for DiI-labeling at different lateral or medial positions of the trunk neural folds in neurulae, which contributed not only to neural crest but also to Rohon-Beard neurons. Labeling wild-type dorsal trunks at pre- and early-migratory stages revealed that individual neural crest cells migrate away from the neural tube along two main routes: first, dorsolaterally between the epidermis and somites and, later, ventromedially between the somites and neural tube/notochord. Dorsolaterally migrating crest primarily forms pigment cells, with those from anterior (but not mid or posterior) trunk neural folds also contributing glia and neurons to the lateral line. White mutants have impaired dorsolateral but normal ventromedial migration. At late migratory stages, most labeled cells move along the ventromedial pathway or into the dorsal fin. Contrasting with other anamniotes, axolotl has a minor neural crest contribution to the dorsal fin, most of which arises from the dermomyotome. Taken together, the results reveal stereotypic migration and differentiation of neural crest cells in axolotl that differ from other vertebrates in timing of entry onto the dorsolateral pathway and extent of contribution to some derivatives.

Ambystoma↗

PubMed2005

Bilateral cortical representation of the trunk midline in human first somatic sensory area.

The cortical representation of the trunk zone in the human first somatosensory area was studied with functional magnetic resonance imaging (fMRI) to establish whether the cutaneous regions close to the midline are represented in this area of both hemispheres. Cortical activation foci evoked by unilateral tactile stimulation of ventral trunk regions were detected in the postcentral gyrus of the contralateral hemisphere slightly medial to or just behind the omega-shaped region of the central sulcus and in the anterior bank of the postcentral sulcus. These regions probably correspond to the trunk ventral midline representation zones of areas 3a-3b and 1-2, respectively. Stimulation of cutaneous regions adjacent to the midline evoked activation foci also in the ipsilateral postcentral gyrus in regions symmetrical to those activated in the contralateral hemisphere. These data demonstrate that in humans, as in nonhuman primates, the cutaneous regions adjacent to the trunk midline are represented bilaterally in the first somatic sensory cortex. Whether the ipsilateral activation depends on callosal or extracallosal inputs remains to be elucidated.

Abdomen↗

PubMed1991

Trunk positioning accuracy in the frontal and sagittal planes.

The accuracy with which the head and spine could be positioned in the frontal and sagittal planes relative to the pelvis was measured and compared in ten healthy adult males. Subjects were tested with eyes closed, while standing with their pelvis externally restrained. The positions of markers, attached to the back of the head and over each of the T1, T6, T11, and L3 spinous processes, were measured to the nearest mm using strain-gaged flexible beam transducers. Subjects were tested for their accuracy in sensing return of the trunk to an initial neutral position under different test conditions. Results showed that positioning was 16-45% more accurate in the frontal than in the sagittal plane, although the difference did not reach statistical significance. T1 could be centered to within 7 and 10 mm in the frontal and sagittal planes, respectively. No significant differences were found between active and passive positioning accuracies. Presence of an external trunk moment did not significantly affect trunk positioning accuracy, although it systematically caused overshoot of the neutral position. Lastly, lateral trunk shifts exceeding 12 mm may be classified as abnormal in young adults.

Adolescent↗

PubMed2005

Trunk sway in patients with spinocerebellar ataxia.

We investigated whether quantified measurements of trunk sway during stance and gait tests in patients with autosomal dominant spinocerebellar ataxia (SCA) could be a useful approach to assess ataxia, which is highly relevant for adequate follow-up and future intervention studies. Examined were 11 SCA patients and 11 age-matched, healthy controls. Postural and balance control were quantified using peak-to-peak measurements of trunk angle and angular velocity, in the roll (lateral) and pitch (anterior-posterior) directions, during a battery of stance and gait tasks. In all stance tasks, trunk angle displacement and angular velocity in both the pitch and roll planes were significantly larger in the SCA group compared with the control group. Among the ataxia patients instability was more increased in the pitch than in the roll direction for two-legged stance tasks, especially when standing on foam, with pronounced oscillations in the pitch plane at 1.4 and 2.5 Hz. A similar dominance of pitch over roll instability was also observed in most gait tasks, especially for tandem gait and while walking with simultaneous head rotations. Trunk sway measurements were effective in detecting and quantifying the gait and balance abnormalities in SCA patients, suggesting that this method might be used for follow-up studies of SCA patients. Furthermore, the method might help to identify early symptomatic individuals and those patients at risk of falling. The postural instability in SCA was found to be multidirectional, although there is generally more pitch than roll instability corresponding with predominant involvement of the spinocerebellum.

Adult↗

PubMed2002

Nerve regeneration through a healthy peripheral nerve trunk as a nerve conduit: a preliminary study of a new concept in peripheral nerve surgery.

The popularity of nerve conduits has increased recently due to the need for alternative nerve reconstruction techniques, obviating the harvest of nerve grafts. Based on ideas suggesting nerve tissue itself, which was the most physiologic environment for nerve regeneration, a study using 40 sciatic nerves of 20 rats was performed. The proximal stumps of transected peroneal nerves were sutured to the lateral wall of healthy tibial nerve trunks after removal of the epineurium. Twelve weeks later, tissue samples were taken from the anastomosis sites and from the levels above and below these sites. Configurations of fascicles were evaluated, and numbers of fibers were estimated. It was observed that the fibers of peroneal nerves regenerated into and through the tibial nerve trunk distally. This suggested that active regenerating fibers of a proximal stump of a nerve could regenerate and progress as a fascicular unit in optimum condition at the trunk of another healthy nerve. This preliminary study should stimulate further studies based on this new concept: that a nerve trunk can serve as the host for the regenerating fibers of another nerve.

Animals↗

PubMed2000

Pressure pain thresholds of upper limb peripheral nerve trunks in asymptomatic subjects.

BACKGROUND AND PURPOSE: Palpation of peripheral nerve trunks has been advocated as a method of assessing the presence of hyperalgesic nerve tissue as a contributing factor to pain syndromes in musculoskeletal disorders of the upper quadrant. This study investigated, in the first instance, the pressure pain thresholds of the median, radial and ulnar nerve trunks of the upper limb in healthy, asymptomatic subjects. METHOD: Forty-five male and 50 female healthy volunteer subjects participated in this study which involved measurement of pressure pain thresholds by use of pressure algometry bilaterally over the three peripheral nerve trunks in the upper limbs. RESULTS: Pressure pain thresholds were shown to be lowest in the median nerve (p = 0.001) and lower in female subjects (p = 0.001). Laterality (p = 0.077) or the age of the subject (p = 0.254) did not significantly influence results. CONCLUSIONS: The study demonstrated differences in pressure pain thresholds in the three nerve trunks of the upper limb. These findings should be taken into account when interpreting the findings of nerve palpation in musculoskeletal upper quadrant disorders.

Adolescent↗