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Sample records for anterolateral thigh muscle

  1. Free anterolateral thigh flap raised on musculocutaneous perforators of rectus femoris muscle.

    PubMed

    Ehtesham-ul-Haq; Aslam, Ayesha; Hameed, Shahid; Ahmad, Rao Saood; Majid, Abdul; Waqas, Muhammad

    2011-08-01

    The anterolateral thigh flap (ALTF) has been in wide clinical use for the last two decades, its major disadvantage has been its variable anatomy. We are presenting a case in which no substantial perforators were found to be arising from either the lateral septum of thigh or Vastus Laterlis muscle. In this case, instead of raising another flap, we used the same skin paddle raised on the musculocutaneous perforators of rectus femoris muscle. PMID:21798144

  2. The clinical application of anterolateral thigh flap.

    PubMed

    Lee, Yao-Chou; Chiu, Haw-Yen; Shieh, Shyh-Jou

    2011-01-01

    The anterolateral thigh flap can provide a large skin paddle nourished by a long and large-caliber pedicle and can be harvested by two-team work. Most importantly, the donor-site morbidity is minimal. However, the anatomic variations decreased its popularity. By adapting free-style flap concepts, such as preoperative mapping of the perforators and being familiar with retrograde perforator dissection, this disadvantage had been overcome gradually. Furthermore, several modifications widen its clinical applications: the fascia lata can be included for sling or tendon reconstruction, the bulkiness could be created by including vastus lateralis muscle or deepithelization of skin flap, the pliability could be increased by suprafascial dissection or primary thinning, the pedicle length could be lengthening by proximally eccentric placement of the perforator, and so forth. Combined with these technical and conceptual advancements, the anterolateral thigh flap has become the workhorse flap for soft-tissue reconstructions from head to toe. PMID:22567234

  3. Neural Anatomy of the Anterolateral Thigh Flap.

    PubMed

    Luenam, Suriya; Prugsawan, Krit; Kosiyatrakul, Arkaphat; Chotanaphuti, Thanainit; Sriya, Piyanee

    2015-06-01

    The anterolateral thigh (ALT) flap is one of the commonly used sensate flaps for intra-oral, hand, and foot reconstruction. The objective of this study was to describe the anatomic location of the sensory nerves supplying the ALT flap in relation to the surface landmarks and with the vascular pedicles. The dissections were carried out in 28 embalmed specimens. An axial line from the anterior superior iliac spine to the superolateral border of the patella and two circles with radii of 5 and 10 cm centered on the midpoint of the former line were used for the surface landmarks. At the intersection point of the axial line and the 10-cm circle, the main lateral femoral cutaneous nerve (LFCN) and its anterior branch were located within 1 and 2.4 cm, respectively. At the intersection point of the axial line and the 5-cm circle, the anterior branch of the LFCN was located within 2.8 cm. The anterior branch of the LFCN can be detected within 3 cm from the central perforator pedicle in all specimens. The posterior branch of the LFCN, superior perforator nerve, and median perforator nerve were found in more variable locations. The findings from our study provide additional information for clinical use in the planning of sensate ALT flap harvest. PMID:26078503

  4. Chimeric Anterolateral Thigh Flap for Total Thoracic Esophageal Reconstruction.

    PubMed

    Ruiz-Moya, Alejandro; Segura-Sampedro, Juan J; Sicilia-Castro, Domingo; Carvajo-Pérez, Francisco; Gómez-Cía, Tomás; Vázquez-Medina, Antonio; Ibáñez-Delgado, Francisco

    2016-01-01

    Gastric pull-up is generally the first choice for a total thoracic esophageal reconstruction. Malfunction of this gastric conduit is uncommon, but devastating when it occurs: it causes marked comorbidity to the patient, preventing oral intake and worsening quality of life. Secondary salvage thoracic esophageal reconstruction surgery is usually performed with free or pedicled jejunum flaps or colon interposition. We present a case of a total thoracic esophageal reconstruction with an externally monitored chimeric anterolateral thigh flap, extending from the cervical esophagus to the retrosternal gastroplasty remnant. Intestinal reconstructive techniques were not an available option for this patient. PMID:26694271

  5. Free anterolateral thigh flap harvesting from paralytic limbs in post-polio syndrome

    PubMed Central

    Changchien, Chih-Hsuan; Chen, Wei-Chen; Su, Yu-Min

    2016-01-01

    Abstract We report two cases of poliomyelitis in which an anterolateral thigh myocutaneous free flap was harvested from the paralytic limb for oral reconstruction. We observed a decrease in the pedicle diameter of the anterolateral thigh flap, but the blood supply to the skin paddle was adequate. PMID:27583272

  6. Free anterolateral thigh flap harvesting from paralytic limbs in post-polio syndrome.

    PubMed

    Changchien, Chih-Hsuan; Chen, Wei-Chen; Su, Yu-Min

    2016-01-01

    We report two cases of poliomyelitis in which an anterolateral thigh myocutaneous free flap was harvested from the paralytic limb for oral reconstruction. We observed a decrease in the pedicle diameter of the anterolateral thigh flap, but the blood supply to the skin paddle was adequate. PMID:27583272

  7. Knee and Ankle Reconstruction With Reverse Anterolateral Thigh and Free Anterolateral Thigh Flap From One Donor Site.

    PubMed

    Choi, KyeongBeom; Cho, JaeHo; Park, MyongChul; Park, Dong Ha; Lee, Il Jae

    2016-09-01

    Traditionally, the anterolateral thigh (ALT) free flap is used in distal lower extremity reconstruction. Reverse ALT flap has become one of the most popular choices for knee joint soft tissue defects. A 53-year-old man sustained a degloving injury in the right lateral side of the lower extremity from the lateral malleolar area to the knee joint area. The contamination was severe, necessitating serial debridement and negative pressure wound therapy. After 4 weeks, no more soft tissue necrosis was evident. No more microorganism growth was confirmed by swab culture. ALT free flap using proximal perforator was planned for lateral malleolar area reconstruction and reverse ALT flap using distal perforator was planned to cover knee joint after confirming the pedicle length was sufficient for simultaneous knee and lateral malleolar area reconstruction. PMID:27317019

  8. Reconstruction of Chopart’s Amputation Stump Using Artificial Dermis Combined with Free Anterolateral Thigh Flap

    PubMed Central

    Shimizu, Mari; Takeuchi, Masaki

    2015-01-01

    Summary: A 63-year-old man dropped a metal chunk onto his left foot during his work and suffered a crush injury of the left forefoot. He underwent Chopart’s amputation followed by stump coverage with sole skin at the orthopedic department on the same day. He was referred to our department for reconstruction because of poor vascularization and subsequent necrosis of tissue at the stump. After the necrotic tissue was debrided, exposure of the talus bone was noted. An artificial dermis was then applied to the stump wound, followed by local negative pressure wound therapy. After 3 weeks, the generation of a strong dermis-like tissue was observed at the site of artificial dermis grafting. We then performed flow-through free anterolateral thigh flap grafting to reconstruct the stump wound. This procedure involved suturing of the peroneal muscle group and tibialis anterior muscle, which were cut off during Chopart’s amputation, and suturing the soft tissue surrounding the calcaneus firmly to the fascia lata of the anterolateral thigh flap, followed by suturing of the flap to the skin defect of the left foot. There were neither postoperative complications, such as skin ulcer and equinus/varus deformity, nor need for secondary repair of the grafted flap, so the patient was able to smoothly enter a rehabilitation program including gait training. The current reconstruction technique for the tissue defect following Chopart’s amputation, consisting of artificial dermis grafting, negative pressure wound therapy, and flow-through free anterolateral thigh flap grafting, enabled safe and smooth gait rehabilitation with a forefoot prosthesis. PMID:26893983

  9. Multipaddled Anterolateral Thigh Chimeric Flap for Reconstruction of Complex Defects in Head and Neck

    PubMed Central

    Li, Ning; Liu, Wen; Su, Tong; Chen, Xinqun; Zheng, Lian; Jian, Xinchun

    2014-01-01

    The anterolateral thigh flap has been the workhouse flap for coverage of soft-tissue defects in head and neck for decades. However, the reconstruction of multiple and complex soft-tissue defects in head and neck with multipaddled anterolateral thigh chimeric flaps is still a challenge for reconstructive surgeries. Here, a clinical series of 12 cases is reported in which multipaddled anterolateral thigh chimeric flaps were used for complex soft-tissue defects with several separately anatomic locations in head and neck. Of the 12 cases, 7 patients presented with trismus were diagnosed as advanced buccal cancer with oral submucous fibrosis, 2 tongue cancer cases were found accompanied with multiple oral mucosa lesions or buccal cancer, and 3 were hypopharyngeal cancer with anterior neck skin invaded. All soft-tissue defects were reconstructed by multipaddled anterolateral thigh chimeric flaps, including 9 tripaddled anterolateral thigh flaps and 3 bipaddled flaps. The mean length of skin paddle was 19.2 (range: 14–23) cm and the mean width was 4.9 (range: 2.5–7) cm. All flaps survived and all donor sites were closed primarily. After a mean follow-up time of 9.1 months, there were no problems with the donor or recipient sites. This study supports that the multipaddled anterolateral thigh chimeric flap is a reliable and good alternative for complex and multiple soft-tissue defects of the head and neck. PMID:25180680

  10. Extended Anterolateral Thigh Flaps for Reconstruction of Extensive Defects of the Foot and Ankle

    PubMed Central

    Liu, Lifeng; Cao, Xuexin; Zou, Lin; Li, Zongyu; Cao, Xuecheng; Cai, Jinfang

    2013-01-01

    The anterolateral thigh flap has been used for coverage of defects in the foot and ankle for years. Conventional extended anterolateral thigh flaps do not undergo thinning procedures, which limit their application. Here, a clinical series of 24 patients is reported in which extended anterolateral thigh flaps were used for posttraumatic foot and ankle reconstruction. Of the 24 flaps, 14 were simple extended anterolateral thigh fasciocutaneous flaps and 10 were thinned extended anterolateral thigh flaps. One artery and two veins, including a superficial vein and an accompanying vein, were anastomosed to vascularize each flap. Follow-up of the 24 patients ranged from 10 months to 4 years postoperatively. All 24 flaps survived successfully, except one case that had partial flap necrosis distally due to excessive thinning. The cutaneous flap territory ranged from 250 cm2 to 400 cm2 (mean, 297 cm2). Only one patient received a debulking procedure. No ulceration occurred in any of the flaps due to contact with the shoe. The extended anterolateral thigh flap is a good alternative for extensive soft tissue defects of the foot and ankle. This study also supports the high reliability and excellent vascular supply of moderate thinned extended ALT flaps. PMID:24376731

  11. Bilateral diabetic thigh muscle infarction.

    PubMed

    Barohn, R J; Bazan, C; Timmons, J H; Tegeler, C

    1994-01-01

    A 19-year-old woman with insulin-dependent diabetes mellitus developed pain and tenderness in the medial aspect of the left thigh and calf, followed 1 week later by similar symptoms in the right leg. Technetium 99m pyrophosphate (PYP) radionuclide scans showed increased flow and uptake in the medial thigh muscles. Magnetic resonance imaging (MRI) of the thigh showed increased signal on proton density and T2-weighted images in the medial and lateral thigh compartments. High-resolution B-mode ultrasound showed hyperechoic changes in the anteromedial thigh muscles, with loss of normal myofascial interfaces, and a mixed appearance, bilaterally. Two months later, after the symptoms had begun to resolve, the images had improved. This case documents bilateral diabetic thigh infarction identified by abnormal technetium 99m PYP flow studies, MRI signal, and B-mode ultrasound imaging. PMID:8136579

  12. Total Posterior Leg Open Wound Management With Free Anterolateral Thigh Flap: Case and Literature Review

    PubMed Central

    Osman, Soleiman; Chou, Stephanie; Rosing, James; Sahar, David E.

    2013-01-01

    Soft tissue coverage of the exposed Achilles tendon is a unique reconstructive challenge. In this report, we describe the management of a large posterior leg wound with exposed Achilles tendon using a free anterolateral thigh (ALT) flap. A careful review of alternative reconstructive options is included, along with their respective advantages and disadvantages. A 32-year-old white man suffered a fulminant right lower extremity soft tissue infection requiring extensive debridement of the entire posterior surface of the right leg. The resulting large soft tissue defect included exposure of the Achilles tendon. Reconstruction of the defect was achieved with an ALT flap and split-thickness skin graft for coverage of the Achilles tendon and gastrocnemius muscle, respectively. The patient was able to ambulate independently within 2 months of the procedure. PMID:24106563

  13. Salvage Free Anterolateral Thigh Composite Flap Transfer Based on the Musculocutaneous Perforator Retrograde Blood Flow Principle.

    PubMed

    Zhao, Jingyi; Chan, Fuan Chiang; Yang, Xiaonan; Zong, Xianlei; Sun, Hengyun; Qi, Zuoliang; Jin, Xiaolei

    2016-03-01

    An anterolateral thigh myo-adipofascial flap was used in the definitive management of a patient presented with chronic infective process associated with a large fronto-nasal defect. Unfortunately, the risk of free flap transfer failure emerged when intraoperative dissection showed absence of a reliable ipsilateral superficial temporal artery as the recipient artery. This rare incident happened at the stage whereby the anterolateral thigh flap was nearly completely raised with a distal perforator in situ. In this article, the authors presented an innovative strategy to salvage the flap by transforming the flap into a modified composite flap based on the retrograde blood flow principle. To the best of our knowledge, this is the first report of using such a technique in reconstructive microsurgery. This successful salvage strategy has clinical application and could potentially minimize free flap transfer failure. PMID:26854778

  14. Anatomical variations and pre-operative imaging technique concerning the anterolateral thigh flap: guiding the surgeon.

    PubMed

    De Beule, Tom; Van Deun, Wouter; Vranckx, Jan; de Dobbelaere, Bart; Maleux, Geert; Heye, Sam

    2016-07-01

    The anterolateral thigh (ALT) flap has widespread use throughout the body because of the many engineering options. The ALT has a complex local vasculature, which can be of importance for the surgical approach. In general, the flap receives its perfusion from branches of the lateral circumflex femoral artery (LCFA). The LCFA, however, has a large anatomic variance. CT angiography can guide the surgeon in the selection of the most suitable site and aid in the surgical approach. PMID:27150071

  15. Reconstruction of complex thoraco-abdominal defects with extended anterolateral thigh flap

    PubMed Central

    Yadav, Prabha S.; Ahmad, Quazi G.; Shankhdhar, Vinay Kant; Nambi, G. I.; Pramesh, C. S.

    2010-01-01

    Background: The reconstruction of complex thoraco-abdominal defects following tumour ablative procedures has evolved over the years from the use of pedicle flaps to free flaps. The free extended anterolateral thigh flap is a good choice to cover large defects in one stage. Materials and Methods: From 2004 to 2009, five patients with complex defects of the thoracic and abdominal wall following tumour ablation were reconstructed in one stage and were studied. The commonest tumour was chondrosarcoma. The skeletal component was reconstructed with methylmethacrylate bone cement and polypropylene mesh and the soft tissue with free extended anterolateral thigh flap. The flaps were anastomosed with internal mammary vessels. The donor sites of the flaps were covered with split-skin graft. Result: All the flaps survived well. One flap required re-exploration for venous congestion and was successfully salvaged. Two flaps had post operative wound infection and were managed conservatively. All flap donor sites developed hyper-pigmentation, contour deformity and cobble stone appearance. Conclusion: Single-stage reconstruction of the complex defects of the thoraco-abdominal region is feasible with extended anterolateral thigh flap and can be adopted as the first procedure of choice. PMID:21217973

  16. [Coverage of anterior knee defect by reverse flow anterolateral thigh flap: About two cases].

    PubMed

    Montoya-Faivre, D; Pineau, V; Colson, T; Brix, M; Simon, E

    2016-08-01

    The coverage of soft-tissue defects concerning the front of the knee and the proximal lower leg is a complex procedure. The reverse flow anterolateral thigh flap represents a good solution for this defects, especially when the coverage surface is large-sized and a free flap is not appropriate regarding the difficulty of the process. Flap retrograde vascularization is based on the anastomosis between the descending branch of the circumflex femoral artery and lateral superior genicular artery. It is an easy solution with low morbidity. The authors have chosen this flap to cover soft-tissue defect of anterior knee from two patients with total knee prothesis. PMID:26169962

  17. Use of the anterolateral thigh flap for reconstruction of the pediatric anophthalmic orbit.

    PubMed

    Hynes, Sally L; Forrest, Christopher R; Borschel, Gregory H

    2016-01-01

    Children with acquired anophthalmia pose unique reconstructive challenges. With implant-based reconstruction, the current standard of care, there is a tendency toward intraorbital and adnexal tissue contraction and an increasing volume discrepancy with orbital growth, resulting in enophthalmos and eyelid retraction, and also difficulty in retaining an ocular prosthesis. We describe a novel technique for secondary reconstruction of the pediatric anophthalmic orbit using a small free anterolateral thigh (ALT) flap. The technique involves release of retracted eyelids and restoration of orbital volume with an ALT flap based on the superficial temporal vessels. The purpose of this study is to detail the results of treatment of a series of four consecutive patients with unilateral acquired anophthalmia managed with ALT flaps. Improved symmetry, successful retention of an ocular prosthesis, and patient satisfaction were achieved in all cases. PMID:26689123

  18. Anterolateral thigh adipofascial flap for the restoration of facial contour deformities.

    PubMed

    Jin, Xiaolei; Teng, Li; Xu, Jiajie; Lu, Jianjian; Zhang, Chao; Zhang, Bo; Zhao, Zhenmin

    2010-07-01

    From January 2000 to May 2008, 50 patients with facial contour deformities underwent soft tissue augmentation with 51 anterolateral thigh (ALT) adipofascial flaps. Fifty flaps survived with no complications; partial fat necrosis occurred in one flap. Mean follow-up was 16 months. Flaps ranged from 10 x 6 cm to 20 x 12 cm. Perforators were found in 50 flaps, 43 musculocutaneous perforators (84.3%) and 7 septocutaneous perforators (13.7%), with a mean of 2.5 perforators per flap. In one flap (2.0%), no perforator was found. In this case, we used an anteromedial thigh adipofascial flap using the medial branch of the descending branch of lateral circumflex femoral artery as the vascular pedicle. Relatively symmetric facial contour was achieved in 20 cases. In 30 cases, adjunctive procedures including flap debulking, fat injection, and resuspension were necessary, and 23 patients achieved satisfactory outcomes. We conclude that the ALT adipofascial flap can be successfully elevated and transplanted for the correction of soft tissue facial defects. This flap can provide tissue to fill large defects, and posses the qualities of pliability, an excellent blood supply, ease of suspension and fixation, and minimal morbidity at the donor site. PMID:20049917

  19. Selection of ideal perforators and the use of a free-style free flap during dissection of an anterolateral thigh flap for reconstruction in the head and neck.

    PubMed

    Chang, Chang-Cheng; Shen, Jen-Hsiang; Chan, Karen Kar-Wun; Wei, Fu-Chan

    2016-09-01

    The technique of raising an anterolateral thigh (ALT) perforator flap has been revolutionised by free-style retrograde intramuscular dissection of perforators to overcome anatomical variations, but choosing the appropriate perforator is still the key to success. We have shown this in a 41-year-old man with cancer of the buccal mucosa treated by wide excision and reconstruction with an ALT free flap that failed because of formation of microthrombi within the perforator. We identified only one tiny perforator that followed an 8cm, tortuous course within the vastus lateralis muscle. A long, narrow lumen in the perforator increases resistance proportionally to the length and four times the radius. Difficult dissection of the root makes the vessels prone to spasm. If no sizeable perforator is found, adjacent tissues on the medial or proximal thigh could be raised as alternative free-style flaps. PMID:27086511

  20. Aesthetic scrotal reconstruction following extensive Fournier’s gangrene using bilateral island pedicled sensate anterolateral thigh flaps: A case report

    PubMed Central

    Dayan, Joseph H.; Clarke-Pearson, Emily M.; Dayan, Erez; Smith, Mark L.

    2014-01-01

    Achieving an aesthetic appearance of the scrotum after extensive Fournier’s gangrene is a reconstructive challenge. Testicular coverage is often prioritized over scrotal cosmesis due to the comorbidities typically seen in this patient population. We describe our treatment of a young, healthy male with extensive Fournier’s gangrene, with loss of the scrotum. Bilateral neurotized anterolateral thigh flaps were used to achieve a sensate and aesthetically acceptable result. PMID:24554975

  1. Individual design of the anterolateral thigh flap for functional reconstruction after hemiglossectomy: experience with 238 patients.

    PubMed

    Wang, L; Liu, K; Shao, Z; Shang, Z-J

    2016-06-01

    The aim of this study was to evaluate tongue function in patients with oral cancer treated surgically and reconstructed with anterolateral thigh free flaps (ALTFs). Patients (N=238) underwent primary reconstruction after hemiglossectomy between September 2012 and October 2014. Patients were divided into two groups according to the flap design: 'individual design' (ABC flap) and 'common design'. Patients were followed postoperatively and assessed after 6 months for the following functional outcomes: speech, deglutition, tongue mobility, and donor site morbidity. Intelligibility and deglutition were each scored by an independent investigator. Data were analyzed using SPSS version 16.0 software. No differences in mean speech intelligibility scores were observed between the two groups (good: P=0.908; acceptable: P=0.881). However, the ABC flap offered recovery advantages for swallowing capacity compared to the common design flap (MTF classification good: P=0.028; acceptable: P=0.001). The individualized ABC flap not only provides volume but also preserves mobility, speech intelligibility, and swallowing capacity. ALTFs require further improvement for the individualized functional reconstruction of the tongue after hemiglossectomy, but this work lays the foundation for these improvements. PMID:26826782

  2. Reconstructive Surgery for Severe Penile Inadequacy: Phalloplasty with a Free Radial Forearm Flap or a Pedicled Anterolateral Thigh Flap

    PubMed Central

    Lumen, N.; Monstrey, S.; Ceulemans, P.; van Laecke, E.; Hoebeke, P.

    2008-01-01

    Objectives. Severe penile inadequacy in adolescents is rare. Phallic reconstruction to treat this devastating condition is a major challenge to the reconstructive surgeon. Phallic reconstruction using the free radial forearm flap (RFF) or the pedicled anterolateral thigh flap (ALTF) has been routinely used in female-to-male transsexuals. Recently we started to use these techniques in the treatment of severe penile inadequacy. Methods. Eleven males (age 15 to 42 years) were treated with a phallic reconstruction. The RFF is our method of choice; the ALTF is an alternative when a free flap is contraindicated or less desired by the patient. The RFF was used in 7 patients, the ALTF in 4 patients. Mean followup was 25 months (range: 4–49 months). Aesthetic and functional results were evaluated. Results. There were no complications related to the flap. Aesthetic results were judged as “good” in 9 patients and “moderate” in 2 patients. Sensitivity in the RFF was superior compared to the ALTF. Four patients developed urinary complications (stricture and/or fistula). Six patients underwent erectile implant surgery. In 2 patients the erectile implant had to be removed due to infection or erosion. Conclusion. In case of severe penile inadequacy due to whatever condition, a phalloplasty is the preferred treatment nowadays. The free radial forearm flap is still the method of choice. The anterolateral thigh flap can be a good alternative, especially when free flaps are contraindicated, but sensitivity is markedly inferior in these flaps. PMID:19009034

  3. Bipaddled anterolateral thigh perforator flap for simultaneous reconstruction of bilateral buccal defects following oral cancer ablation or release of oral submucous fibrosis

    PubMed Central

    Chen, Wei-Chen; Changchien, Chih-Hsuan; Su, Yu-Min

    2016-01-01

    It is a challenge to simultaneously reconstruct bilateral buccal defects following oral cancer ablation or release of oral submucous fibrosis. In this study, we report two cases where bipaddled anterolateral thigh perforator flaps were used to resurface two separate buccal defects. PMID:27619322

  4. Metachronous carcinoma of rectum with reconstruction of a full-thickness abdominal wall defect using a pedicled anterolateral thigh flap

    PubMed Central

    Kok, Amy Siu Yan

    2016-01-01

    Reconstruction of large, complex defects of the abdominal wall after resection of malignant tumors can be challenging. The transfer of an anterolateral thigh (ALT) flap is a feasible and effective option. However, no report has been published on the use of ALT flap after metachronous colonic tumor resection so far. We present an original case of resection of metachronous carcinoma of rectum with reconstruction of the abdominal wall defect using an ALT flap harvested with its aponeurosis. The postoperative course was uncomplicated. Functional and esthetic results were satisfactory. There was no postoperative incisional hernia or tumor recurrence. We conclude that abdominal wall defects of large sizes can be successfully reconstructed using an appropriately designed ALT flap; a simple, single-stage effective reconstruction. PMID:27161142

  5. Combined Use of the Latissimus Dorsi Musculocutaneous Flap and the Anterolateral Thigh Flap to Reconstruct an Extensive Shoulder Defect in an NF-1 Patient

    PubMed Central

    Fujiki, Masahide; Sakisaka, Masanobu; Kawai, Akira

    2016-01-01

    Summary: Soft tissue coverage after the resection of a large malignant peripheral neural sheath tumor (MPNST) is a challenge. We report the successful reconstruction of an extensive shoulder defect after MPNST resection in a patient with a type 1 neurofibromatosis with a novel combination of flaps. A 70-year-old man with type 1 neurofibromatosis presented with a recurrent MPNST on his right shoulder. He underwent a wide excision of the tumor, which resulted in a huge soft tissue defect around the shoulder joint. The resultant defect was reconstructed with a pedicled latissimus dorsi musculocutaneous flap and a free anterolateral thigh flap. The flaps survived, and the wounds healed uneventfully. His affected arm was useful. The combination of a pedicled latissimus dorsi musculocutaneous flap and a free anterolateral thigh flap is a versatile option for the reconstruction of an extensive shoulder defect. PMID:27200231

  6. A 10-year retrospective study of free anterolateral thigh flap application in 872 head and neck tumour cases.

    PubMed

    Xu, Z; Zhao, X P; Yan, T L; Wang, M; Wang, L; Wu, H J; Shang, Z J

    2015-09-01

    The aim of this study was to report the clinical features, reliability, and various applications of free anterolateral thigh (ALT) flaps and to provide a 10-year retrospective review of the application of this flap in head and neck tumour patients. A retrospective study was performed of 872 patients who underwent immediate reconstruction of head and neck tumour-induced defects with ALT flaps between April 2005 and April 2014. The study sample consisted of 609 males and 263 females aged 18-79 years. The shapes and sizes of the flaps were designed individually to meet various demands of reconstruction in the head and neck region. The overall rate of successful reconstruction was 97.4%. The reasons for 57 cases of flap compromise were analyzed. The time to detection of flap crisis was often within the first 8h after surgery (64.9%). One- and two-vein anastomosis strategies in microsurgery were compared, and significant differences were observed in terms of the time to detection of flap compromise and the rate of successful flap salvage. In conclusion, the free ALT flap provides unique features for the reconstruction of oral and facial defects in a reliable and versatile approach. The ALT flap is a favourable and versatile 'workhorse' flap for head and neck reconstruction. PMID:26154948

  7. Aesthetic and Functional Outcomes of the Innervated and Thinned Anterolateral Thigh Flap in Reconstruction of Upper Limb Defects

    PubMed Central

    Torres-Ortíz Zermeño, Carlos Alberto; López Mendoza, Javier

    2014-01-01

    Background. The anterolateral thigh (ALT) flap has been widely described in reconstruction of the upper extremity. However, some details require refinement to improve both functional and aesthetic results. Methods. After reconstruction of upper extremity defects using thinned and innervated ALT flaps, functional and aesthetic outcomes were evaluated with the QuickDASH scale and a Likert scale for aesthetic assessment of free flaps, respectively. Results. Seven patients with a mean follow-up of 11.57 months and average flap thickness of 5 mm underwent innervation by an end-to-end neurorrhaphy. The average percentage of disability (QuickDASH) was 21.88% with tenderness, pain, temperature, and two-point discrimination present in 100% of cases, and the aesthetic result gave an overall result of 15.40 (good) with the best scores in color and texture. Conclusions. Simultaneous thinning and innervation of the ALT flap lead to a good cosmetic result and functional outcome with a low percentage of disability, which could result in minor surgical procedures and better recovery of motor and sensory function. Level of Evidence. IV. PMID:25478219

  8. Repeated Elevation of the Anterolateral Thigh Flap for Lower Extremity Orthopedic Trauma Does Not Affect Flap Viability.

    PubMed

    Kotick, James D; Mitchell, William; Bayouth, Lilly; Klein, Richard; Lee, Ken

    2016-03-01

    Background The anterolateral thigh (ALT) flap has a key role regarding limb salvage and has facilitated the preservation of function and esthetics in lower extremity reconstruction. The purpose of this study is to review the advantages of the ALT flap when used early in the reconstruction of the trauma patient; specifically, its long-term viability when ALT flap reconstruction is followed by recurrent flap elevation performed to allow a variety of sequential orthopedic operations including washout, antimicrobial disc placement, and reinstrumentation. Methods A retrospective analysis was performed to review all ALT flaps performed by the authors from January 2009 to October 2012 at the Orlando Regional Medical Center. A total of 69 patients with an average age of 38 years were included in the study leading to a total of 69 ALT flaps indicated for traumatic orthopedic wounds. Out of these, 29 flaps were elevated at least once leading to a total of 49 flap elevations. Results The median number of days to flap elevation was 117 with a minimum of 1 day and a maximum of 540 days. A total of 42% flaps were elevated at least once after initial placement for reinstrumentation, washout, or antibiotic disk placement. Overall, 52% of the flaps were lifted once, 34% were lifted twice, and 14% were lifted more than thrice. There is no statistically significant difference in the complication rate between elevating the flap compared with primary ALT placement. Conclusion We conclude, therefore, there is no elevated risk to long-term viability by elevating the ALT flap. This combined with the ease of elevation makes it a safe procedure to be performed as needed for access to the deep tissues. PMID:26382873

  9. Isokinetic performance of hip muscles after revision total hip arthroplasty via previous anterolateral approach.

    PubMed

    Cankaya, Deniz; Aydin, Cemal; Karakus, Dilek; Toprak, Ali; Ozkurt, Bulent; Tabak, Yalçın

    2015-09-01

    We investigated the isokinetic performance of hip muscles and clinical outcomes after revision total hip arthroplasty (THA) via same anterolateral approach used in primary surgery. Thirty patients who had undergone previous THA via an anterolateral approach underwent both acetabular and femoral component revision after aseptic loosening. The Harris Hip Score (HHS) was evaluated during a minimum 2-year follow-up. The isokinetic muscle strength of the operated and nonoperated hips was assessed 1 year after surgery. The HHS improved from 49.0 to 77.4. Operated and nonoperated hips exhibited similar isokinetic performance during all measurements (flexion, extension, and abduction) (p>0.05). This prospective study showed that the anterolateral approach preserves abductor strength after revision THA in aseptic cases with acceptable functional and clinical results. The main clinical relevance of this study is that the same anterolateral approach used in previous primary THA is also safe and viable for revision THA. PMID:26435233

  10. Neuromuscular diversity in archosaur deep dorsal thigh muscles.

    PubMed

    Gatesy, S M

    1994-01-01

    The living members of the clade Archosauria, crocodilians and birds, differ markedly in the morphology of their deep dorsal thigh muscles. To investigate whether this diversity is accompanied by differences in motor pattern and muscle function, the hindlimbs of representative archosaurs were studied by electromyography and cineradiography during terrestrial locomotion. In a crocodilian, Alligator, the iliofemoralis and pubo-ischio-femoralis internus part 2 are both active during the swing phase of the stride cycle. This appears to be the primitive motor pattern for archosaurs. There are four avian homologues of these muscles in the helmeted guineafowl, Numida. These are primarily active in the propulsive phase (iliotrochantericus caudalis and iliotrochantericus medius), the swing phase (iliotrochantericus cranialis) and a speed-dependent combination of the propulsive and/or swing phases (iliofemoralis externus). Differences between Alligator and Numida in the number and attachment of deep dorsal muscles are associated with dissimilar motor patterns and functions. Evolutionary modifications of neuromuscular control must be recognized when evaluating avian locomotor history, but are rarely considered by paleontologists. Even within the deep dorsal thigh muscles of Numida, developmentally and anatomically similar muscles are active out-of-phase. Therefore, although the actions of two adjacent muscles appear equivalent, their functions may differ dramatically. The diversity of deep dorsal thigh muscles in modern birds may be a good model for studying the relationship between activity pattern and peripheral morphology. PMID:8306187

  11. Unilateral absence of thigh muscles confirmed by CT scan.

    PubMed

    Peterson, J E; Currarino, G

    1981-01-01

    A 5-month-old infant is presented with congenital absence of a group of muscles of the right thigh including the three adductors, gracilis, semimembranosus and semitendinosus. The diagnosis was suspected from the conventional radiographs and was confirmed by computerized tomography. PMID:7322654

  12. Association between Thigh Muscle Volume and Leg Muscle Power in Older Women

    PubMed Central

    Machann, Juergen; Blatzonis, Konstantinos; Rapp, Kilian

    2016-01-01

    The construct of sarcopenia is still discussed with regard to best appropriate measures of muscle volume and muscle function. The aim of this post-hoc analysis of a cross-sectional experimental study was to investigate and describe the hierarchy of the association between thigh muscle volume and measurements of functional performance in older women. Thigh muscle volume of 68 independently living older women (mean age 77.6 years) was measured via magnetic resonance imaging. Isometric strength was assessed for leg extension in a movement laboratory in sitting position with the knee flexed at 90° and for hand grip. Maximum and habitual gait speed was measured on an electronic walk way. Leg muscle power was measured during single leg push and during sit-to-stand performance. Thigh muscle volume was associated with sit-to-stand performance power (r = 0.628), leg push power (r = 0.550), isometric quadriceps strength (r = 0.442), hand grip strength (r = 0.367), fast gait speed (r = 0.291), habitual gait speed (r = 0.256), body mass index (r = 0.411) and age (r = -0.392). Muscle power showed the highest association with thigh muscle volume in healthy older women. Sit-to-stand performance power showed an even higher association with thigh muscle volume compared to single leg push power. PMID:27315060

  13. Surgical management of a giant condyloma of Buschke-Löwenstein in a patient with Netherton syndrome using the pedicled anterolateral thigh flap--a case report.

    PubMed

    Li, Adrienne L K; Walsh, Scott; McKay, Douglas R

    2011-11-01

    The surgical management of a giant condyloma of Buschke and Löwenstein poses particular reconstructive challenges, given the wound size, depth, and infection risk. We present a case where a pedicled anterolateral thigh flap is used to reconstruct a complex wound following resection of a giant condyloma of Buschke and Löwenstein arising in a patient with Netherton syndrome. Our operative technique re-iterates the utility of this flap in perineal reconstruction and demonstrates the possibility for an 18 cm wide arc of rotation. To our knowledge, this is the first report of a successful complex excision of a giant condyloma in Netherton syndrome, the subsequent reconstruction, and periodic maintenance with topical therapies. PMID:21463975

  14. Ultrasound assessment of hamstring muscle size using posterior thigh muscle thickness.

    PubMed

    Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

    2016-05-01

    Several studies have investigated the relationship between ultrasound-measured muscle thickness (MT) and individual muscle cross-sectional area (CSA) and muscle volume (MV) in extremity and trunk muscles; however, the hamstring muscle has not been studied. The purpose of this study was to examine the relationship between posterior thigh MT by ultrasound and the muscle CSA and MV of the hamstring obtained by magnetic resonance imaging (MRI). Ten young women aged 20-31 had MT measured by ultrasound at three sites on the medial anterior (50% of thigh length; TL) and posterior (50% and 70% of TL) aspects of the thigh. On the same day, a series of continuous muscle CSA along the thigh was measured by MRI. In each slice, the anatomical CSA of the hamstring (biceps femoris, semitendinosus and semimembranosus) and quadriceps muscle was analysed, and the CSAs at 50% and 70% of TL and maximal CSA of the hamstring (CSAmax ) were determined. MV was calculated by multiplying CSA by slice thickness. A significant correlation was observed between posterior 50% MT and 50% hamstring CSA (r = 0·848, P = 0·002) and between posterior 70% MT and 70% hamstring CSA (r = 0·679, P = 0·031). Posterior 50% MT (r = 0·732, P = 0·016) and 50% MTxTL (r = 0·873, P = 0·001) were also correlated to hamstring MV. Anterior:posterior 50% thigh MT ratio was correlated to MV ratio of quadriceps and hamstring muscles (r = 0·803, P = 0·005). Our results suggest that posterior thigh MT reflects hamstring muscle CSA and MV. The anterior:posterior MT ratio may serve as a surrogate for MV ratio of quadriceps and hamstring. PMID:25363847

  15. Complete rupture of the anterolateral papillary muscle caused by coronary spasm.

    PubMed

    Yamazaki, Masataka; Fukui, Toshihiro; Mahara, Keitaro; Takanashi, Shuichiro

    2015-12-01

    Papillary muscle rupture usually occurs as a catastrophic complication of acute myocardial infarction in patients with coronary artery stenosis; it is therefore less common in patients without coronary artery stenosis. We report the case of a 67-year old woman without coronary artery stenosis who suffered an acute anterolateral papillary muscle rupture and was successfully treated with mitral valve replacement. Evidence of coronary spasm was found on a coronary vasomotion test, suggesting that a high sensitivity to coronary spasm may explain a mechanism of isolated papillary muscle infarction. PMID:26330339

  16. Analysis of right anterolateral impacts: the effect of head rotation on the cervical muscle whiplash response

    PubMed Central

    Kumar, Shrawan; Ferrari, Robert; Narayan, Yogesh

    2005-01-01

    Background The cervical muscles are considered a potential site of whiplash injury, and there are many impact scenarios for whiplash injury. There is a need to understand the cervical muscle response under non-conventional whiplash impact scenarios, including variable head position and impact direction. Methods Twenty healthy volunteers underwent right anterolateral impacts of 4.0, 7.6, 10.7, and 13.0 m/s2 peak acceleration, each with the head rotated to the left, then the head rotated to the right in a random order of impact severities. Bilateral electromyograms of the sternocleidomastoids, trapezii, and splenii capitis following impact were measured. Results At a peak acceleration of 13.0 m/s2, with the head rotated to the right, the right trapezius generated 61% of its maximal voluntary contraction electromyogram (MVC EMG), while all other muscles generated 31% or less of this variable (31% for the left trapezius, 13% for the right spleinus. capitis, and 16% for the left splenius capitis). The sternocleidomastoids muscles also tended to show an asymmetric EMG response, with the left sternocleidomastoid (the one responsible for head rotation to the right) generating a higher percentage (26%) of its MVC EMG than the left sternocleidomastoid (4%) (p < 0.05). When the head is rotated to the left, under these same conditions, the results are reversed even though the impact direction remains right anterolateral. Conclusion The EMG response to a right anterolateral impact is highly dependent on the head position. The sternocleidomastoid responsible for the direction of head rotation and the trapezius ipsilateral to the direction of head rotation generate the most EMG activity. PMID:15927056

  17. Three-dimensional contrast-enhanced magnetic resonance angiography for anterolateral thigh flap outlining: A retrospective case series of 68 patients

    PubMed Central

    Jiang, Chunjing; Lin, Ping; Fu, Xiaoyan; Shu, Jiner; Li, Huimin; Hu, Xiaogang; He, Jianrong; Ding, Mingxing

    2016-01-01

    Flap transfer is increasingly used for repairing limb defects secondary to trauma or tumor, and appropriate preoperative planning plays a critical role. The present study aimed to examine the use of three-dimensional (3D) contrast-enhanced magnetic resonance angiography (CE-MRA) in evaluating the blood supply distribution and perforating branch pattern of anterolateral thigh (ALT) flaps. Bilateral donor lower limbs were scanned in 68 patients (136 limbs) using a Siemens Avanto 1.5 T magnetic resonance imaging scanner with a 3D fast low-angle shot sequence, following the thin-slab maximum intensity projection (TS-MIP) technique. The lateral femoral circumflex artery (LFCA) was visualized in all patients: 101 limbs (101/136, 74.3%) were type I; 20 limbs (20/136, 14.7%) were type II; 3 limbs (3/136, 2.2%) were type III; and 12 limbs (12/136, 8.8%) were type IV. Tertiary branches were identified in 94 limbs (94/136, 69.1%). Donor flaps were outlined according to MRA TS-MIP findings in 4 patients. All flaps survived uneventfully following the transfer. In donor flap outlining, 3D CE-MRA with the TS-MIP technique allowed an accurate, direct visualization of the branching pattern and distribution profile of the LFCA supplying the ALT flap.

  18. Thigh Muscle Strength in Senior Athletes and Healthy Controls

    PubMed Central

    McCrory, Jean L; Salacinski, Amanda J; Hunt, Sarah E; Greenspan, Susan L

    2016-01-01

    Exercise is commonly recommended to counteract aging-related muscle weakness. While numerous exercise intervention studies on the elderly have been performed, few have included elite senior athletes, such as those who participate in the National Senior Games. The extent to which participation in highly competitive exercise affects muscle strength is unknown, as well as the extent to which such participation mitigates any aging-related strength losses. The purpose of this study was to examine isometric thigh muscle strength in selected athletes of the National Senior Games and healthy noncompetitive controls of similar age, as well as to investigate strength changes with aging in both groups. In all, 95 athletes of the Games and 72 healthy controls participated. Of the senior athletes, 43 were runners, 12 cyclists, and 40 swimmers. Three trials of isometric knee flexion and extension strength were collected using a load cell affixed to a custom-designed chair. Strength data were normalized to dual-energy x-ray absorptiometry-obtained lean mass of the leg. A 3-factor multivariate analysis of variance (group × gender × age group) was performed, which included both the extension and flexion variables ([alpha] = 0.05). Athletes exhibited 38% more extension strength and 66% more flexion strength than the controls (p < 0.001). Strength did not decrease with advancing age in either the athletes or the controls (p = 0.345). In conclusion, senior athletes who participate in highly competitive exercise have greater strength than healthy aged-matched individuals who do not. Neither group displayed the expected strength losses with aging. Our subject cohorts, however, were not typical of those over age 65 years because individuals with existing health conditions were excluded from the study. PMID:19972628

  19. Outcomes of anterolateral thigh-free flaps and conversion from external to internal fixation with bone grafting in gustilo type IIIB open tibial fractures.

    PubMed

    Lee, Jae Hoon; Chung, Duke Whan; Han, Chung Soo

    2012-09-01

    The purpose of this study was to analyze the utility and the clinical outcomes of anterolateral thigh (ALT)-free flaps and conversion from external to internal fixation with plating and bone grafting in Gustilo type IIIB open tibial fractures. A total of 21 patients were analyzed retrospectively. The mean follow-up period was 18 months and the mean age was 46.7 years. There were 18 men and three women. The mean time from injury to flap coverage was 11.6 days. The mean size of flaps used was 15.3 × 8.2 cm. The mean size of bone defects was 2.26 cm. Segmental bone defects were observed in 5 five cases, for which bone transport or vascularized fibular graft were performed. When flaps were successful and the fracture sites did not have any evidence of infection, internal fixation with plates and bone grafting were performed. Flaps survived in 20 cases. In the 20 cases with successful flaps, two cases developed osteomyelitis, but the 20 cases achieved solid bone union at a mean of 8.6 months after the injury, salvaging the lower extremity in 100% of the cases. At the last follow-up, 9 nine cases were measured excellent or good; 6, fair; and 6, poor in the functional assessment based on the method developed by Puno et al. ALT- free flaps to cover soft tissue defects in Gustilo type IIIB open tibial fractures are considered as useful option for the treatment of composite defects. In addition, conversion to internal fixation and bone grafting can be an alternative method in order to reduce the risk of complications and inconvenience of external fixators. PMID:22434519

  20. Reconstruction of knee joint soft tissue and patellar tendon defects using a composite anterolateral thigh flap with vascularized fascia lata.

    PubMed

    Kuo, Yur-Ren; An, Po-Chung; Kuo, Mei-Hui; Kueh, Nai-Siong; Yao, Sheng-Fa; Jeng, Seng-Feng

    2008-01-01

    Reconstruction of a complex knee trauma with knee joint exposure and composite soft tissue and patellar tendon deficiency remains a challenging task. Multiple-stage reconstruction is time-consuming and produces considerable suffering for patients. Early mobilization following knee reconstruction has achieved good outcomes. Herein, we reported one-stage reconstruction with an ALT myocutaneous flap with vascularized fascia lata was utilized for one patient with a large complex knee joint soft tissue defect, and segmental deficiency of the patellar tendon. The fascia lata sheet was rolled to mimic a patellar tendon. The exposed knee joint was obturated by the vastus lateralis muscle of the ALT myocutaneous flap. The skin and soft tissue defect was reconstructed using the skin paddle of the ALT flap. The patient's postoperative course was uneventful. An MRI examination demonstrated good continuity of the reconstructed patellar tendon. The active ROM of the injured knee reached 100 degrees (extension deficiency 20 degrees and flexion 120 degrees ) at 5 years. Objective functional assessment of the patella-femoral joint utilized a kinetic communicator machine (Kin-Com 500H, Chattecx, Chattanooga, TN, USA) revealed still mild extension insufficiency. However, the patient reported that he was able to perform normal daily activities without difficulty at 5-year follow-up. PMID:18215803

  1. Thigh muscle volume in relation to age, sex and femur volume.

    PubMed

    Maden-Wilkinson, T M; McPhee, J S; Rittweger, J; Jones, D A; Degens, H

    2014-02-01

    Secular changes and intra-individual differences in body shape and size can confound cross-sectional studies of muscle ageing. Normalising muscle mass to height squared is often suggested as a solution for this. We hypothesised that normalisation of muscle volume to femur volume may be a better way of determining the extent of muscle lost with ageing (sarcopenia). Thigh and femur muscle volumes were measured from serial magnetic resonance imaging sections in 20 recreationally active young men (mean age 22.4 years), 25 older men (72.3 years), 18 young women (22.1 years) and 28 older women (72.0 years). There were no age-related differences in femur volume. The relationship between thigh muscle volume and femur volume (R (2) = 0.76; exponent of 1.12; P < 0.01) was stronger than that with height (R (2) = 0.49; exponent of 3.86; P < 0.01) in young participants. For young subjects, the mean muscle/bone ratios were 16.0 and 14.6 for men and women, respectively. For older men and women, the mean ratios were 11.6 and 11.5, respectively. The Z score for the thigh muscle/bone volume ratio relative to young subjects was -2.2 ± 0.7 for older men and -1.4 ± 0.8 for older women. The extent of sarcopenia judged by the muscle/bone ratio was approximately twice that determined when normalising to height squared. These data suggest that the muscle/bone ratio captures the intra-individual loss of muscle mass during ageing, and that the age-related loss of muscle mass may be underestimated when normalised to height squared. The quadriceps seems relatively more affected by ageing than other thigh muscles. PMID:23934008

  2. Thigh muscles injuries in professional soccer players: a one year longitudinal study

    PubMed Central

    Corazza, Angelo; Orlandi, Davide; Baldari, Amedeo; Gatto, Pietro; Stellatelli, Marco; Mazzola, Claudio; Galli, Roberto; Longo, Stefano; Sconfienza, Luca Maria; Silvestri, Enzo

    2013-01-01

    Summary Thigh muscles indirect injuries are common finding in soccer and represent a critical challenge for teams medical staffs. Indirect injuries are classified on the basis of their site and their clinical and radiological findings, but the assessment of a precise prognosis remains a crucial point. Both ultrasound (US) and magnetic resonance (MR) represent effective techniques not only to detect indirect injuries but also to accurately determine severity, location, and, consequently, the prognosis. In this setting, our aim is to review imaging findings of professional athletes muscle tears at three time points (3 days, 2 weeks, and 4 weeks after the time of injury) and, further, to investigate the correlation between tears extent and lay-off time of the athletes. Combined US-MR assessment could be helpful in the management of thigh muscles indirect injuries providing accurate information about the site, the extent, and the healing process. PMID:24596698

  3. Electromyographic analysis of thigh muscles during track cycling on a velodrome.

    PubMed

    Watanabe, Kohei; Sato, Takayuki; Mukaimoto, Takahiro; Takashima, Wataru; Yamagishi, Michio; Nishiyama, Tetsunari

    2016-08-01

    We aimed to investigate neuromuscular activation of thigh muscles during track cycling at various speeds. Eight male competitive cyclists volunteered to participate in this study. Surface electromyography of the vastus lateralis, biceps femoris and adductor magnus muscles of the bilateral legs was recorded during track cycling on velodromes with a 250-m track. The participants were instructed to maintain three different lap times: 20, 18 and 16 s. The average rectified value (ARV) was calculated from the sampled surface electromyography. Significantly higher ARVs were observed in the right compared to left leg for the biceps femoris muscle during both straight and curved sections at 18- and 16-s lap times (P < 0.05). In the biceps femoris muscle, significant changes in ARVs during the recovery phase with an increase in speed were seen in the right leg only (P < 0.05). There were no significant differences in ARVs between the straight and curved sections for all three muscles (P > 0.05). From our findings, it was suggested that during track cycling on a velodrome the laterality of the biceps femoris muscle activity is a key strategy to regulate the speed, and fixed neuromuscular strategies are adopted between straight and curved sections for thigh muscles. PMID:26571039

  4. Quantifying the Elastic Property of Nine Thigh Muscles Using Magnetic Resonance Elastography

    PubMed Central

    Chakouch, Mashhour K.; Charleux, Fabrice; Bensamoun, Sabine F.

    2015-01-01

    Background Pathologies of the muscles can manifest different physiological and functional changes. To adapt treatment, it is necessary to characterize the elastic property (shear modulus) of single muscles. Previous studies have used magnetic resonance elastography (MRE), a technique based on MRI technology, to analyze the mechanical behavior of healthy and pathological muscles. The purpose of this study was to develop protocols using MRE to determine the shear modulus of nine thigh muscles at rest. Methods Twenty-nine healthy volunteers (mean age = 26 ± 3.41 years) with no muscle abnormalities underwent MRE tests (1.5 T MRI). Five MRE protocols were developed to quantify the shear moduli of the nine following thigh muscles at rest: rectus femoris (RF), vastus medialis (VM), vastus intermedius (VI), vastus lateralis (VL), sartorius (Sr), gracilis (Gr), semimembranosus (SM), semitendinosus (ST), and biceps (BC). In addition, the shear modulus of the subcutaneous adipose tissue was analyzed. Results The gracilis, sartorius, and semitendinosus muscles revealed a significantly higher shear modulus (μ_Gr = 6.15 ± 0.45 kPa, μ_ Sr = 5.15 ± 0.19 kPa, and μ_ ST = 5.32 ± 0.10 kPa, respectively) compared to other tissues (from μ_ RF = 3.91 ± 0.16 kPa to μ_VI = 4.23 ± 0.25 kPa). Subcutaneous adipose tissue had the lowest value (μ_adipose tissue = 3.04 ± 0.12 kPa) of all the tissues tested. Conclusion The different elasticities measured between the tissues may be due to variations in the muscles' physiological and architectural compositions. Thus, the present protocol could be applied to injured muscles to identify their behavior of elastic property. Previous studies on muscle pathology found that quantification of the shear modulus could be used as a clinical protocol to identify pathological muscles and to follow-up effects of treatments and therapies. These data could also be used for modelling purposes. PMID:26397730

  5. Postoperative changes in the tensor fascia lata muscle after using the modified anterolateral approach for total hip arthroplasty.

    PubMed

    Unis, Douglas B; Hawkins, Evan J; Alapatt, Michael F; Benitez, Carlos L

    2013-04-01

    The modified Watson-Jones approach to the hip has been described as a minimally invasive approach with the potential for fewer postoperative complications than the traditional approach. Because the approach relies on an intermuscular rather than an internervous plane, there is potential for injury to the superior gluteal nerve. The aim of this study was to evaluate incidence of tensor fascia lata (TFL) denervation in patients undergoing this approach. Twenty-six patients underwent total hip arthroplasty (THA) using a modified anterolateral approach. Postoperative MRIs were analyzed for signs of muscle denervation including atrophy, hypertrophy and fat replacement. At a median follow-up of 9.3months, 74% of patients exhibited either atrophy or hypertrophy of the TFL and 42% exhibited fat replacement on MRI. PMID:23253300

  6. NMR imaging estimates of muscle volume and intramuscular fat infiltration in the thigh: variations with muscle, gender, and age.

    PubMed

    Hogrel, Jean-Yves; Barnouin, Yoann; Azzabou, Noura; Butler-Browne, Gillian; Voit, Thomas; Moraux, Amélie; Leroux, Gaëlle; Behin, Anthony; McPhee, Jamie S; Carlier, Pierre G

    2015-06-01

    Muscle mass is particularly relevant to follow during aging, owing to its link with physical performance and autonomy. The objectives of this work were to assess muscle volume (MV) and intramuscular fat (IMF) for all the muscles of the thigh in a large population of young and elderly healthy individuals using magnetic resonance imaging (MRI) to test the effect of gender and age on MV and IMF and to determine the best representative slice for the estimation of MV and IMF. The study enrolled 105 healthy young (range 20-30 years) and older (range 70-80 years) subjects. MRI scans were acquired along the femur length using a three-dimension three-point Dixon proton density-weighted gradient echo sequence. MV and IMF were estimated from all the slices. The effects of age and gender on MV and IMF were assessed. Predictive equations for MV and IMF were established using a single slice at various femur levels for each muscle in order to reduce the analysis process. MV was decreased with aging in both genders, particularly in the quadriceps femoris. IMF was largely increased with aging in men and, to a lesser extent, in women. Percentages of MV decrease and IMF increase with aging varied according to the muscle. Predictive equations to predict MV and IMF from single slices are provided and were validated. This study is the first one to provide muscle volume and intramuscular fat infiltration in all the muscles of the thigh in a large population of young and elderly healthy subjects. PMID:26040416

  7. Atlas-registration based image segmentation of MRI human thigh muscles in 3D space

    NASA Astrophysics Data System (ADS)

    Ahmad, Ezak; Yap, Moi Hoon; Degens, Hans; McPhee, Jamie S.

    2014-03-01

    Automatic segmentation of anatomic structures of magnetic resonance thigh scans can be a challenging task due to the potential lack of precisely defined muscle boundaries and issues related to intensity inhomogeneity or bias field across an image. In this paper, we demonstrate a combination framework of atlas construction and image registration methods to propagate the desired region of interest (ROI) between atlas image and the targeted MRI thigh scans for quadriceps muscles, femur cortical layer and bone marrow segmentations. The proposed system employs a semi-automatic segmentation method on an initial image in one dataset (from a series of images). The segmented initial image is then used as an atlas image to automate the segmentation of other images in the MRI scans (3-D space). The processes include: ROI labeling, atlas construction and registration, and morphological transform correspondence pixels (in terms of feature and intensity value) between the atlas (template) image and the targeted image based on the prior atlas information and non-rigid image registration methods.

  8. Non small-cell lung cancer with metastasis to thigh muscle and mandible: two case reports

    PubMed Central

    2013-01-01

    Introduction Lung cancer is the leading cause of cancer-related death in Europe and the US. Isolated metastases to skeletal muscle and the mandible are very uncommon. Case presentation This report presents two cases. Case 1 concerns a 45-year-old Caucasian woman affected by muscle metastasis of the right thigh from non-small-cell lung cancer. Case 2 concerns a 61-year-old Caucasian man affected by mandible metastasis from non-small-cell lung cancer. Both metastases were detected by diagnostic imaging studies. Both patients were treated with radiation therapy with palliative and antalgic intent. Conclusion Radiation therapy was effective and well tolerated in both cases. Both our patients are alive, with follow-up of 18 months and five months, respectively. PMID:23566415

  9. Intermuscular adipose tissue and thigh muscle area dynamics during an 18-month randomized weight loss trial.

    PubMed

    Yaskolka Meir, Anat; Shelef, Ilan; Schwarzfuchs, Dan; Gepner, Yftach; Tene, Lilac; Zelicha, Hila; Tsaban, Gal; Bilitzky, Avital; Komy, Oded; Cohen, Noa; Bril, Nitzan; Rein, Michal; Serfaty, Dana; Kenigsbuch, Shira; Chassidim, Yoash; Zeller, Lior; Ceglarek, Uta; Stumvoll, Michael; Blüher, Matthias; Thiery, Joachim; Stampfer, Meir J; Rudich, Assaf; Shai, Iris

    2016-08-01

    It remains unclear whether intermuscular adipose tissue (IMAT) has any metabolic influence or whether it is merely a marker of abnormalities, as well as what are the effects of specific lifestyle strategies for weight loss on the dynamics of both IMAT and thigh muscle area (TMA). We followed the trajectory of IMAT and TMA during 18-mo lifestyle intervention among 278 sedentary participants with abdominal obesity, using magnetic resonance imaging. We measured the resting metabolic rate (RMR) by an indirect calorimeter. Among 273 eligible participants (47.8 ± 9.3 yr of age), the mean IMAT was 9.6 ± 4.6 cm(2) Baseline IMAT levels were directly correlated with waist circumference, abdominal subdepots, C-reactive protein, and leptin and inversely correlated with baseline TMA and creatinine (P < 0.05 for all). After 18 mo (86.3% adherence), both IMAT (-1.6%) and TMA (-3.3%) significantly decreased (P < 0.01 vs. baseline). The changes in both IMAT and TMA were similar across the lifestyle intervention groups and directly corresponded with moderate weight loss (P < 0.001). IMAT change did not remain independently associated with decreased abdominal subdepots or improved cardiometabolic parameters after adjustments for age, sex, and 18-mo weight loss. In similar models, 18-mo TMA loss remained associated with decreased RMR, decreased activity, and with increased fasting glucose levels and IMAT (P < 0.05 for all). Unlike other fat depots, IMAT may not represent a unique or specific adipose tissue, instead largely reflecting body weight change per se. Moderate weight loss induced a significant decrease in thigh muscle area, suggesting the importance of resistance training to accompany weight loss programs. PMID:27402560

  10. ‘Serious thigh muscle strains’: beware the intramuscular tendon which plays an important role in difficult hamstring and quadriceps muscle strains

    PubMed Central

    Brukner, Peter; Connell, David

    2016-01-01

    Why do some hamstring and quadriceps strains take much longer to repair than others? Which injuries are more prone to recurrence? Intramuscular tendon injuries have received little attention as an element in ‘muscle strain’. In thigh muscles, such as rectus femoris and biceps femoris, the attached tendon extends for a significant distance within the muscle belly. While the pathology of most muscle injures occurs at a musculotendinous junction, at first glance the athlete appears to report pain within a muscle belly. In addition to the musculotendinous injury being a site of pathology, the intramuscular tendon itself is occasionally injured. These injuries have a variety of appearances on MRIs. There is some evidence that these injuries require a prolonged rehabilitation time and may have higher recurrence rates. Therefore, it is important to recognise the tendon component of a thighmuscle strain’. PMID:26519522

  11. Mechanisms producing coordinated function across the breadth of a large biarticular thigh muscle

    PubMed Central

    Carr, Jennifer A.; Ellerby, David J.; Rubenson, Jonas; Marsh, Richard L.

    2011-01-01

    SUMMARY We examined the hypothesis that structural features of the iliotibialis lateralis pars postacetabularis (ILPO) in guinea fowl allow this large muscle to maintain equivalent function along its anterior–posterior axis. The ILPO, the largest muscle in the hindlimb of the guinea fowl, is a hip and knee extensor. The fascicles of the ILPO originate across a broad region of the ilium and ischium posterior to the hip. Its long posterior fascicles span the length of the thigh and insert directly on the patellar tendon complex. However, its anterior fascicles are shorter and insert on a narrow aponeurosis that forms a tendinous band along the anterior edge of the muscle and is connected distally to the patellar tendon. The biarticular ILPO is actively lengthened and then actively shortened during stance. The moment arm of the fascicles at the hip increases along the anterior to posterior axis, whereas the moment arm at the knee is constant for all fascicles. Using electromyography and sonomicrometry, we examined the activity and strain of posterior and anterior fascicles of the ILPO. The activation was not significantly different in the anterior and posterior fascicles. Although we found significant differences in active lengthening and shortening strain between the anterior and posterior fascicles, the differences were small. The majority of shortening strain is caused by hip extension and the inverse relationship between hip moment arm and fascicle length along the anterior–posterior axis was found to have a major role in ensuring similar shortening strain. However, because the knee moment arm is the same for all fascicles, knee flexion in early stance was predicted to produce much larger lengthening strains in the short anterior fascicles than our measured values at this location. We propose that active lengthening of the anterior fascicles was lower than predicted because the aponeurotic tendon of insertion of the anterior fascicles was stretched and only a

  12. Effect of thigh muscle fatigue on the biomechanical factors of the lower limbs when walking in a squatted position

    PubMed Central

    Hong, Wan-Ki; Lee, Chul-Gab; Ko, Dae-Sik

    2016-01-01

    [Purpose] The purpose of this study was to compare and analyze the effects of thigh muscle fatigue caused by walking in a squatted position on biomechanical factors, to evaluate the risk of a job performed sitting in a squatted position for a long period of time. [Subjects and Methods] Eighteen right foot dominant women without any injuries in their joints and body in the last 6 months were selected. They walked in a squatted position, and then muscle fatigue was induced by using an isokinetic muscular function measuring device (CSMI, USA). After the CSMI measurement, the participants performed walking in a squatted position again. [Results] After inducing thigh muscle fatigue, the knee joint maximum adduction moment significantly increased and the required duration was reduced. The muscle fatigue index was positively correlated with adduction moment and negatively with the duration. It influenced the changes of maximum adduction moment; 55.0% of the adduction moment change was explained by the degree of fatigue. [Conclusion] A quantitative analysis of working in a squatted position was performed. The thigh muscle fatigue index negatively the knee joint during walking in a squatted position. Therefore, this experiment can be used as an ergonomic analysis tool of general farm work. PMID:27134402

  13. Differential segmental strain during active lengthening in a large biarticular thigh muscle during running

    PubMed Central

    Carr, Jennifer A.; Ellerby, David J.; Marsh, Richard L.

    2011-01-01

    SUMMARY The iliotibialis lateralis pars postacetabularis (ILPO) is the largest muscle in the hindlimb of the guinea fowl and is thought to play an important role during the stance phase of running, both absorbing and producing work. Using sonomicrometry and electromyography, we examined whether the ILPO experiences differential strain between proximal, central and distal portions of the posterior fascicles. When the ILPO is being lengthened while active, the distal portion was found to lengthen significantly more than either the proximal or central portions of the muscle. Our data support the hypothesis that the distal segment lengthened farther and faster because it began activity at shorter sarcomere lengths on the ascending limb of the length–tension curve. Probably because of the self-stabilizing effects of operating on the ascending limb of the length–tension curve, all segments reached the end of lengthening and started shortening at the same sarcomere length. During shortening, this similarity in sarcomere length among the segments was maintained, as predicted from force–velocity effects, and shortening strain was similar in all segments. The differential active strain during active lengthening is thus ultimately determined by differences in strain during the passive portion of the cycle. The sarcomere lengths of all segments of the fascicles were similar at the end of active shortening, but after the passive portion of the cycle the distal segment was shorter. Differential strain in the segments during the passive portion of the cycle may be caused by differential joint excursions at the knee and hip acting on the ends of the muscle and being transmitted differentially by the passive visco-elastic properties of the muscle. Alternatively, the differential passive strain could be due to the action of active or passive muscles in the thigh that transmit force to the IPLO in shear. Based on basic sarcomere dynamics we predict that differential strain is

  14. The influence of changes in trunk and pelvic posture during single leg standing on hip and thigh muscle activation in a pain free population

    PubMed Central

    2014-01-01

    Background Thigh muscle injuries commonly occur during single leg loading tasks and patterns of muscle activation are thought to contribute to these injuries. The influence trunk and pelvis posture has on hip and thigh muscle activation during single leg stance is unknown and was investigated in a pain free population to determine if changes in body posture result in consistent patterns of changes in muscle activation. Methods Hip and thigh muscle activation patterns were compared in 22 asymptomatic, male subjects (20–45 years old) in paired functionally relevant single leg standing test postures: Anterior vs. Posterior Trunk Sway; Anterior vs. Posterior Pelvic Rotation; Left vs. Right Trunk Shift; and Pelvic Drop vs. Raise. Surface EMG was collected from eight hip and thigh muscles calculating Root Mean Square. EMG was normalized to an “upright standing” reference posture. Repeated measures ANOVA was performed along with associated F tests to determine if there were significant differences in muscle activation between paired test postures. Results In right leg stance, Anterior Trunk Sway (compared to Posterior Sway) increased activity in posterior sagittal plane muscles, with a concurrent deactivation of anterior sagittal plane muscles (p: 0.016 - <0.001). Lateral hip abductor muscles increased activation during Left Trunk Shift (compared to Right) (p :≤ 0.001). Lateral Pelvic Drop (compared to Raise) decreased activity in hip abductors and increased hamstring, adductor longus and vastus lateralis activity (p: 0.037 - <0.001). Conclusion Changes in both trunk and pelvic posture during single leg stance generally resulted in large, predictable changes in hip and thigh muscle activation in asymptomatic young males. Changes in trunk position in the sagittal plane and pelvis position in the frontal plane had the greatest effect on muscle activation. Investigation of these activation patterns in clinical populations such as hip and thigh muscle injuries may

  15. COMPETITIVE ATHLETIC PARTICIPATION, THIGH MUSCLE STRENGTH, AND BONE DENSITY IN ELITE SENIOR ATHLETES AND CONTROLS

    PubMed Central

    McCrory, Jean L.; Salacinski, Amanda J.; Hunt Sellhorst, Sarah E.; Greenspan, Susan L.

    2016-01-01

    The relationship between participation in highly competitive exercise, thigh muscle strength, and regional and total body bone mineral density (BMD) in elite senior athletes and healthy elderly controls was investigated. One hundred and four elite senior athletes (72.6±6.4yrs, 168.7±8.6cm, 72.6±13.5kg, 57M:47F) and 79 healthy controls (75.4±5.6yrs, 170.8±25.5cm, 79.5± 11.7kg, 46M:33F) participated in this cross-sectional study. Vitamin D and calcium intake were assessed via a recall survey. Isometric knee extension and flexion peak torque was measured via a custom strength measurement device. Total body and regional BMD of the hip, radius, and spine were assessed with DXA. For each BMD site assessed, multivariate linear regression analysis was performed in four steps (α=0.10) to examine the contribution of (1) age, sex, bodyweight, and calcium and vitamin D intake (2) group (elite senior athlete, control), (3) knee extension peak torque and (4) knee flexion peak torque on BMD. Sex, age, bodyweight, and calcium and vitamin D intake explained a significant amount of variance in BMD in each site. Group was not significant. Knee extension peak torque explained an additional 3.8% of the variance in hip BMD (p=0.06). Knee flexion peak torque was not correlated to BMD at any of the sites assessed. In conclusion, participation in highly competitive athletics was not related to total body or regional BMD. Age, sex, bodyweight, and vitamin D and calcium intake were significantly related to BMD at all of the sites assessed. Quadriceps strength contributed slightly to hip BMD. Our results imply that participation in highly competitive senior athletics does not have a protective effect on BMD, perhaps because of a lower bodyweight or other confounding factors. PMID:23442279

  16. Inhibition of α-adrenergic vasoconstriction in exercising human thigh muscles

    PubMed Central

    Wray, D Walter; Fadel, Paul J; Smith, Michael L; Raven, Peter; Sander, Mikael

    2004-01-01

    The mechanisms underlying metabolic inhibition of sympathetic responses within exercising skeletal muscle remain incompletely understood. The aim of the present study was to test whether α2-adrenoreceptor-mediated vasoconstriction was more sensitive to metabolic inhibition than α1-vasoconstriction during dynamic knee-extensor exercise. We studied healthy volunteers using two protocols: (1) wide dose ranges of the α-adrenoreceptor agonists phenylephrine (PE, α1 selective) and BHT-933 (BHT, α2 selective) were administered intra-arterially at rest and during 27 W knee-extensor exercise (n = 13); (2) flow-adjusted doses of PE (0.3 μg kg−1 l−1) and BHT (15 μg kg−1 l−1) were administered at rest and during ramped exercise (7 W to 37 W; n= 10). Ultrasound Doppler and thermodilution techniques provided direct measurements of femoral blood flow (FBF). PE (0.8 μg kg−1) and BHT (40 μg kg−1) produced comparable maximal reductions in FBF at rest (−58 ± 6 versus−64 ± 4%). Despite increasing the doses, PE (1.6 μg kg−1 min−1) and BHT (80 μg kg−1 min−1) caused significantly smaller changes in FBF during 27 W exercise (−13 ± 4 versus−3 ± 5%). During ramped exercise, significant vasoconstriction at lower intensities (7 and 17 W) was seen following PE (−16 ± 5 and −16 ± 4%), but not BHT (−2 ± 4 and −4 ± 5%). At the highest intensity (37 W), FBF was not significantly changed by either drug. Collectively, these data demonstrate metabolic inhibition of α-adrenergic vasoconstriction in large postural muscles of healthy humans. Both α1- and α2-adrenoreceptor agonists produce comparable vasoconstriction in the resting leg, and dynamic thigh exercise attenuates α1- and α2-mediated vasoconstriction similarly. However, α2-mediated vasoconstriction appears more sensitive to metabolic inhibition, because α2 is completely inhibited even at low workloads, whereas α1 becomes progressively inhibited with increasing workloads. PMID

  17. Differential Proteome Analysis of Breast and Thigh Muscles between Korean Native Chickens and Commercial Broilers

    PubMed Central

    De Liu, Xian; Jayasena, Dinesh D.; Jung, Yeonkuk; Jung, Samooel; Kang, Bo Seok; Heo, Kang Nyeong; Lee, Jun Heon; Jo, Cheorun

    2012-01-01

    The Korean native chickens (Woorimotdak™, KNC) and commercial broilers (Ross, CB) show obvious differences in meat flavor after cooking. To understand the contribution of protein and peptide for meat flavor, 2-dimensional (2-D) gel electrophoresis and matrix-assisted laser desorption-ionization time-of-flight (MALDI-TOF) mass spectrometry was performed. A total of 16 protein spots were differentially expressed in the breast and thigh meat between the two breeds. A total of seven protein spots were represented by different levels between KNC and CB for breast meat. Among them three protein spots (TU39149, TU40162 and TU39598) showed increases in their expressions in KNC while other four protein spots (BU40125, BU40119, BU40029 and BU39904) showed increases in CB. All nine protein spots that were represented by different levels between KNC and CB for thigh meat showed increases in their expression in KNC. Phosphoglucomutase 1 (PGM 1), myosin heavy chain (MyHC), heat shock protein B1 (HSP27), cytochrome c reductase (Enzyme Q), Glyoxylase 1, DNA methyltransferase 3B (DNA MTase 3) were identified as the main protein spots by MALDI-TOF mass spectrometry. These results can provide valuable basic information for understanding the molecular mechanism responsible for breed specific differences in meat quality, especially the meat flavour. PMID:25049642

  18. Muscle-skeletal model of the thigh: a tool for understanding the biomechanics of gait in patients with cerebral palsy

    NASA Astrophysics Data System (ADS)

    Ravera, Emiliano Pablo; Catalfamo Formento, Paola Andrea; José Crespo, Marcos; Andrés Braidot, Ariel

    2011-12-01

    Cerebral Palsy represents the most common cause of physical disability in modern world and within the pediatrics orthopedics units. The gait analysis provides great contributions to the understanding of gait disorders in CP. Giving a more comprehensive treatment plan, including or excluding surgical procedures that can potentially decrease the number of surgical interventions in the life of these patients. Recommendations for orthopedic surgery may be based on a quantitative description of how to alter the properties probably muscle force generation, and how this affects the action of the muscle to determine how these muscles, impaired by disease or surgery, contributing to the movement of the segments of the limb during crouch gait. So the causes and appropriate treatment of gait abnormalities are difficult to determine because the movements generated by the muscular forces of these patients are not clearly understood. A correct determination of the etiology of abnormal patterns of the knee is the key to select the appropriate therapy, presenting a major challenge at present since there is no theoretical basis to determine the biomechanical causes of abnormal gait of these patients. The potential and necessity of using correct biomechanical models that consistently study the abnormalities becomes clear. Reinforcing and correcting a simple gait analysis and eliminating the unknowns when selecting the appropriate treatment is crucial in clinical settings. In this paper a computer muscle-skeletal model is proposed. The model represents a person's thigh simulating the six most representative muscles and joints of the hip and knee. In this way you can have a better understanding of gait abnormalities present in these patients. So the quality of these estimates of individual muscle dynamics facilitate better understanding of the biomechanics of gait pathologies helping to reach better diagnosis prior to surgery and rehabilitation treatments.

  19. Sonography of thigh abscess: detection, diagnosis, and drainage.

    PubMed

    vanSonnenberg, E; Wittich, G R; Casola, G; Cabrera, O A; Gosink, B B; Resnick, D L

    1987-10-01

    Sonographic characteristics and percutaneous catheter drainage of thigh abscesses in 18 patients are described. Most of these patients had underlying diseases including osteomyelitis, trauma, diabetes mellitus, rheumatoid arthritis, leukemia, lymphoma, sepsis, bleeding dyscrasia, and autoimmune disease. Previous procedures on these thigh collections included seven operations and 12 nondiagnostic ward aspirations. All collections were shown by sonography to be either anterior or anterolateral. Two cases referred for drainage were posteromedial; sonography showed these to be mycotic pseudoaneurysms. The abscesses were either anechoic or hypoechoic, and occasionally had debris and septations. Abscesses associated with underlying osteomyelitis abutted the femur; those related to other causes generally were more superficial within muscle or fascial layers. Sonographically guided catheter drainage successfully cured all patients, even those in whom ward aspiration or formal surgery had been unsuccessful. Sonography is a simple and inexpensive method of imaging and guiding the drainage of thigh abscesses. Percutaneous catheter drainage is the treatment of choice in cases in which simple emergency room or ward incision and drainage are inadequate. PMID:3307356

  20. The 6-minute walk test, motor function measure and quantitative thigh muscle MRI in Becker muscular dystrophy: A cross-sectional study.

    PubMed

    Fischer, Dirk; Hafner, Patricia; Rubino, Daniela; Schmid, Maurice; Neuhaus, Cornelia; Jung, Hans; Bieri, Oliver; Haas, Tanja; Gloor, Monika; Fischmann, Arne; Bonati, Ulrike

    2016-07-01

    Becker muscular dystrophy (BMD) has an incidence of 1 in 16 000 male births. This cross-sectional study investigated the relation between validated functional scores and quantitative MRI (qMRI) of thigh muscles in 20 ambulatory BMD patients, aged 18.3-60 years (mean 31.2; SD 11.1). Clinical assessments included the motor function measure (MFM) and its subscales, as well as timed function tests such as the 6-minute walk test (6MWT) and the timed 10-m run/walk test. Quantitative MRI of the thigh muscles included the mean fat fraction (MFF) using a 2-point Dixon (2-PD) technique, and transverse relaxation time (T2) measurements. The mean MFM value was 80.4%, SD 9.44 and the D1 subscore 54.5%, SD 19.9. The median 6MWT was 195m, IQR 160-330.2. The median 10-m run/walk test was 7.4 seconds, IQR 6.1-9.3. The mean fat fraction of the thigh muscles was 55.6%, SD 17.4%, mean T2 relaxation times of all muscles: 69.9 ms, SD 14.4. The flexors had the highest MFF and T2 relaxation times, followed by the extensors and the adductors. MFF and global T2 relaxation times were highly negatively correlated with the MFM total, D1-subscore and 6MWT, and positively correlated with the 10 m run/walk test time (p < 0.01). Age was not correlated with MFF, global T2 relaxation time or clinical assessments. Both MFF and T2 measures in the thigh muscle were well correlated with clinical function in BMD and may serve as a surrogate outcome measure in clinical trials. PMID:27209345

  1. Patterns of strain and activation in the thigh muscles of goats across gaits during level locomotion.

    PubMed

    Gillis, Gary B; Flynn, John P; McGuigan, Polly; Biewener, Andrew A

    2005-12-01

    Unlike homologous muscles in many vertebrates, which appear to function similarly during a particular mode of locomotion (e.g. red muscle in swimming fish, pectoralis muscle in flying birds, limb extensors in jumping and swimming frogs), a major knee extensor in mammalian quadrupeds, the vastus lateralis, appears to operate differently in different species studied to date. In rats, the vastus undergoes more stretching early in stance than shortening in later stance. In dogs, the reverse is true; more substantial shortening follows small amounts of initial stretching. And in horses, while the vastus strain trajectory is complex, it is characterized mainly by shortening during stance. In this study, we use sonomicrometry and electromyography to study the vastus lateralis and biceps femoris of goats, with three goals in mind: (1) to see how these muscles work in comparison to homologous muscles studied previously in other taxa; (2) to address how speed and gait impact muscle actions and (3) to test whether fascicles in different parts of the same muscle undergo similar length changes. Results indicate that the biceps femoris undergoes substantial shortening through much of stance, with higher strains in walking and trotting [32-33% resting length (L0)] than galloping (22% L0). These length changes occur with increasing biceps EMG intensities as animals increase speed from walking to galloping. The vastus undergoes a stretch-shorten cycle during stance. Stretching strains are higher during galloping (15% L0) than walking and trotting (9% L0). Shortening strains follow a reverse pattern and are greatest in walking (24% L0), intermediate in trotting (20% L0) and lowest during galloping (17% L0). As a result, the ratio of stretching to shortening increases from below 0.5 in walking and trotting to near 1.0 during galloping. This increasing ratio suggests that the vastus does relatively more positive work than energy absorption at the slower speeds compared with galloping

  2. Kinesiology Tape or Compression Sleeve Applied to the Thigh Does Not Improve Balance or Muscle Activation Before or Following Fatigue.

    PubMed

    Cavanaugh, M Tyler; Quigley, Patrick J; Hodgson, Daniel D; Reid, Jonathan C; Behm, David G

    2016-07-01

    Cavanaugh, MT, Quigley, PJ, Hodgson, DD, Reid, JC, and Behm, DG. Kinesiology tape or compression sleeve applied to the thigh does not improve balance or muscle activation before or following fatigue. J Strength Cond Res 30(7): 1992-2000, 2016-Compression sleeves (CS) and kinesiology tape (KT) are purported to enhance proprioception, however, there is substantial conflict in the literature. Because the beneficial effects of CS and KT are more evident in the literature with recovery, the objective of this study was to examine the effects of CS and KT on balance under acute nonfatigued and postfatigued conditions. Using a within-subject, repeated-measures design, 12 university participants (5 females and 7 males) performed in a random order CS, KT, and Control conditions. Two trials of each test were conducted before the application of CS or KT (pretest 1), immediately after the application (pretest 2), with posttests at 1 and 10 minutes after 4 sets of unilateral Bulgarian squats to failure (1 minute rest between sets). Tests included a Y balance test (measures: distance reached by nondominant foot in anterior, posterior lateral, and posterior medial directions) and drop jump landing balance test from a 50-cm platform (measures: ground reaction force, electromyography, and center of pressure). The fatigue protocol induced 25.3% decrease in unilateral squat repetitions from set 1 to set 4. There were no significant condition main effects or interactions for any balance measure or EMG before or after fatigue. In conclusion, independent of fatigue, there was no significant effect of CS or KT on balance outcomes immediately and up to 10 minutes following the fatiguing intervention. Thus, nonfatigued or muscles weakened by fatigue did not benefit from CS and KT application. PMID:26705066

  3. Dorsiflexion, Plantar-Flexion, and Neutral Ankle Positions During Passive Resistance Assessments of the Posterior Hip and Thigh Muscles

    PubMed Central

    Palmer, Ty B.; Akehi, Kazuma; Thiele, Ryan M.; Smith, Douglas B.; Warren, Aric J.; Thompson, Brennan J.

    2015-01-01

    Context: Passive straight-legged–raise (SLR) assessments have been performed with the ankle fixed in dorsiflexion (DF), plantar-flexion (PF), or neutral (NTRL) position. However, it is unclear whether ankle position contributes to differences in the passive resistance measured during an SLR assessment. Objective: To examine the influence of ankle position during an SLR on the passive torque, range of motion (ROM), and hamstrings electromyographic (EMG) responses to passive stretch of the posterior hip and thigh muscles. Design: Crossover study. Setting: Research laboratory. Patients or Other Participants: A total of 13 healthy volunteers (5 men: age = 24 ± 3 years, height = 178 ± 6 cm, mass = 85 ± 10 kg; 8 women: age = 21 ± 1 years, height = 163 ± 8 cm, mass = 60 ± 6 kg). Intervention(s): Participants performed 6 randomly ordered passive SLR assessments involving 2 assessments at each condition, which included the ankle positioned in DF, PF, and NTRL. All SLRs were performed using an isokinetic dynamometer programmed in passive mode to move the limb toward the head at 5°/s. Main Outcome Measure(s): During each SLR, maximal ROM was determined as the point of discomfort but not pain, as indicated by the participant. Passive torque and EMG amplitude were determined at 4 common joint angles (θ) separated by 5° during the final common 15° of ROM for each participant. Results: Passive torque was greater for the DF condition than the NTRL (P = .008) and PF (P = .03) conditions at θ3 and greater for the DF than NTRL condition (P = .02) at θ4. Maximal ROM was lower for the DF condition than the NTRL (P = .003) and PF (P < .001) conditions. However, we found no differences among conditions for EMG amplitude (P = .86). Conclusions: These findings suggest that performing SLRs with the ankle positioned in DF may elicit greater passive torque and lower ROM than SLRs with the ankle positioned in PF or NTRL. The greater passive torque and lower ROM induced by the DF

  4. [Bilateral diabetic infarction of the thigh adductor muscles in a diabetic female patient-- A case report and review of the literature].

    PubMed

    Satoh, A; Watanabe, M; Ohkoshi, N; Tamaoka, A; Shoji, S

    1999-01-01

    A 30-year-old female complained of lancinating pain in the bilateral thighs for 10 days. The patient had a 22-year history of insulin-dependent diabetes mellitus. Physical examination revealed swelling of the bilateral lower extremities. There was exquisite tenderness on palpation over the medial thighs, with marked increase in pain on hip and knee flexion. Muscle strength of quadriceps, hamstrings, and hip adductor was decreased due to muscle pain. Pedal pulses were palpable bilaterally. Roentogenograms of the left femur revealed calcification of the left femoral arterial wall. Venogram revealed no obstruction with normal drainage. Complete blood cell count showed left shift of the neutrophils, markedly accelerated erythrocyte sedimentation rate, prolonged prothorombin time of 9 sec (normal 11.7 sec), C-reactive protein of 7.3 mg/dl and serum creatine kinase level of 175 IU/L. FBS was 225 mg/dl and Hb A 1 c was 16.4%. An MR imaging of the thighs revealed high signal intensities in the bilateral adductor muscles on T 2-weighted images. The symptoms resolved spontaneously over a three week period. From the course of the illness and MR imaging, the patient was diagnosed having diabetic muscle infarction (DMI), a rare complication of diabetes mellitus. To our knowledge, this is the first reported case of DMI in Japan. Diabetic microangiopathy and hypercoagulability are thought to be responsible for inducing DMI. Because the diagnosis can be made from the characteristic clinical and the typical MR imaging findings, muscle biopsy is not always necessary to obtain the diagnosis of DMI. PMID:10391074

  5. Efficacy of thigh protectors in preventing thigh haematomas.

    PubMed

    Mitchell, B

    2000-03-01

    Thigh haematomas are extremely common in Australian Rules Football (ARF). This is in contrast to contact sports overseas, the likely reason is the increased use of thigh protectors as part of team uniforms in contact sports such as American football. Thigh haematomas can have a significant impact on an athlete's performance, ranging from short term performance impairment, muscle deconditioning and compartment syndromes, to long term problems, such as career threatening myositis ossificans and possibly muscle tears. To assess the efficacy of thigh protectors made for Australian Football, a prospective study was undertaken involving two teams in the elite junior (U 18) VSFL competition in SE Australia. One team wore thigh protectors over the course of the season while the other team acted as controls and did not wear thigh protectors. The control group suffered nine thigh haematomas, while the protected group had none (p<0.01). The possible de-conditioning effect of the haematomas was evidenced by two of the control group suffering torn quadriceps within four weeks of the haematoma. The protectors were generally well tolerated by all but one player, except in hot conditions, when they were uncomfortable. PMID:10839226

  6. “Target” and “Sandwich” Signs in Thigh Muscles have High Diagnostic Values for Collagen VI-related Myopathies

    PubMed Central

    Fu, Jun; Zheng, Yi-Ming; Jin, Su-Qin; Yi, Jun-Fei; Liu, Xiu-Juan; Lyn, He; Wang, Zhao-Xia; Zhang, Wei; Xiao, Jiang-Xi; Yuan, Yun

    2016-01-01

    Background: Collagen VI-related myopathies are autosomal dominant and recessive hereditary myopathies, mainly including Ullrich congenital muscular dystrophy (UCMD) and Bethlem myopathy (BM). Muscle magnetic resonance imaging (MRI) has been widely used to diagnosis muscular disorders. The purpose of this study was to evaluate the diagnostic value of thigh muscles MRI for collagen VI-related myopathies. Methods: Eleven patients with collagen VI gene mutation-related myopathies were enrolled in this study. MRI of the thigh muscles was performed in all patients with collagen VI gene mutation-related myopathies and in 361 patients with other neuromuscular disorders (disease controls). T1-weighted images were used to assess fatty infiltration of the muscles using a modified Mercuri's scale. We assessed the sensitivity and specificity of the MRI features of collagen VI-related myopathies. The relationship between fatty infiltration of muscles and specific collagen VI gene mutations was also investigated. Results: Eleven patients with collagen VI gene mutation-related myopathies included six UCMD patients and five BM patients. There was no significant difference between UCMD and BM patients in the fatty infiltration of each thigh muscle except sartorius (P = 0.033); therefore, we combined the UCMD and BM data. Mean fatty infiltration scores were 3.1 and 3.0 in adductor magnus and gluteus maximus, while the scores were 1.3, 1.3, and 1.5 in gracilis, adductor longus, and sartorius, respectively. A “target” sign in rectus femoris (RF) was present in seven cases, and a “sandwich” sign in vastus lateralis (VL) was present in ten cases. The “target” and “sandwich” signs had sensitivities of 63.6% and 90.9% and specificities of 97.3% and 96.9% for the diagnosis of collagen VI-related myopathies, respectively. Fatty infiltration scores were 2.0–3.0 in seven patients with mutations in the triple-helical domain, and 1.0–1.5 in three of four patients with

  7. Delayed onset thigh compartment syndrome secondary to contusion.

    PubMed

    Joglekar, Siddharth B; Rehman, Saqib

    2009-08-01

    While thigh compartment syndrome is relatively uncommon, it can occur in various situations. Multiple reports document thigh contusions as a cause of acute compartment syndrome; however, compartment syndrome of the thigh presenting primarily in a delayed fashion secondary to a contusion has not been described. This article reports a case of thigh compartment syndrome. A 39-year-old man sustained a left thigh contusion while playing basketball. He continued to play and also worked at the office over the next 2 days. Fifty-two hours postinjury, he developed severe pain in the thigh after a long walk. Increased swelling of the thigh followed, with numbness in the anterolateral thigh and pain with knee motion. He presented 60 hours postinjury with a compartment syndrome, and a lateral decompressive fasciotomy of the thigh was performed 62 hours postinjury. The wound was closed after 5 days. Three months postoperatively, the patient returned to playing basketball with no deficits. Treatment of established compartment syndrome in such cases is controversial, with some reports recommending nonoperative management. Contusion-related compartment syndromes are frequently associated with intramuscular bleeding in the involved compartment, which may accumulate slowly or worsen with further activity. Guidelines regarding return to sports need to be established in individuals sustaining severe contusions during sports-related activities to prevent compartment syndrome. Any individual sustaining such an injury should be under surveillance for delayed onset symptoms or signs of this potentially devastating syndrome. PMID:19708619

  8. Statistical mapping of the effect of knee extension on thigh muscle viscoelastic properties using magnetic resonance elastography.

    PubMed

    Barnhill, Eric; Kennedy, Paul; Hammer, Steven; van Beek, Edwin J R; Brown, Colin; Roberts, Neil

    2013-12-01

    Skeletal muscle viscoelastic properties reflect muscle microstructure and neuromuscular activation. Elastographic methods, including magnetic resonance elastography, have been used to characterize muscle viscoelastic properties in terms of region of interest (ROI) measurements. The present study extended this approach to create thresholded pixel-by-pixel maps of viscoelastic properties of skeletal muscle during rest and knee extension in eleven subjects. ROI measurements were taken for individual quadricep muscles and the quadriceps region as a whole, and the viscoelastic parameter map pixels were statistically tested at positive false discovery rate q ≤ 0.25. ROI measurements showed significant (p ≤ 0.05) increase in storage modulus (G') and loss modulus (G″), with G″ increasing more than G', in agreement with previous findings. The q-value maps further identified the vastus intermedius as the primary driver of this change, with greater G″/G' increase than surrounding regions. Additionally, a cluster of significant decrease in G″/G' was found in the region of vastus lateralis below the fulcrum point of the lift. Viscoelastic parameter mapping of contracted muscle allows new insight into the relationship between physiology, neuromuscular activation, and human performance. PMID:24254405

  9. A new anterolateral approach for type C fractures of the distal femur.

    PubMed

    Bin, Zhang; Song, Luo; Binghua, Wu; Ping, Qiu; Min, Dai

    2014-01-01

    To provide an anatomic basis for treating type C distal femoral fractures by a new anterolateral approach. Twenty surgical procedures were performed in 10 adult cadaveric specimens using a new anterolateral approach followed by dissection of all lower limbs. The main anterolateral muscles and ligaments were observed. Vessels and nerves related to the new anterolateral approach were also evaluated. Full exposure of the distal femur was achieved. The iliotibial band was protected, and damage to the quadriceps femoris was reduced. The distance between the common peroneal nerve and the new incision line at the level of the lateral epicondyle of the femur was (χ̄ ± s) 8.19 ± 0.79 cm (range, 7.48-9.57 cm). This new anterolateral approach to the distal femur is safe. Although it induces slight soft tissue damage, its exposure is excellent. Knee rehabilitation can be performed in the early postoperative period. PMID:25437603

  10. Multi-parametric MRI Characterization of Healthy Human Thigh Muscles at 3.0T - Relaxation, Magnetization Transfer, Fat/Water, and Diffusion Tensor Imaging

    PubMed Central

    Li, Ke; Dortch, Richard D.; Welch, E. Brian; Bryant, Nathan D.; Buck, Amanda K.W.; Towse, Theodore F.; Gochberg, Daniel F.; Does, Mark D.; Damon, Bruce M.; Park, Jane H.

    2014-01-01

    Muscle diseases commonly have clinical presentations of inflammation, fat infiltration, fibrosis, and atrophy. However, the results of existing laboratory tests and clinical presentations are not well correlated. Advanced quantitative MRI techniques may allow the assessment of myo-pathological changes in a sensitive and objective manner. To progress towards this goal, an array of quantitative MRI protocols was implemented for human thigh muscles, their reproducibility was assessed, and the statistical relationships among parameters were determined. These quantitative methods included fat/water imaging, multiple spin-echo T2 imaging (with and without fat signal suppression, FS), selective inversion recovery for T1 and quantitative magnetization transfer (qMT) imaging (with and without FS), and diffusion tensor imaging. Data were acquired at 3.0 T from nine healthy subjects. To assess the repeatability of each method, the subjects were re-imaged on an average of 35 days later. Pre-testing lifestyle restrictions were applied to standardize physiological conditions across scans. Strong between-day intra-class correlations were observed in all quantitative indices except for the macromolecular-to-free water pool size ratio (PSR) with FS, a metric derived from qMT data. Two-way analysis of variance revealed no significant between-day differences in the mean values for any parameter estimate. The repeatability was further assessed with Bland-Altman plots, and low repeatability coefficients were obtained for all parameters. Among-muscle differences in the quantitative MRI indices and inter-class correlations among the parameters were identified. There were inverse relationships between fractional anisotropy (FA) and the 2nd eigenvalue, the 3rd eigenvalue, and the standard deviation of first eigenvector. The FA was positively related to the PSR, while the other diffusion indices were inversely related to the PSR. These findings support the use of these T1, T2, fat

  11. Tissue reactivity and suture handling characteristics of “jimat” against silk and chromic gut in cat thigh muscle: A comparative study

    PubMed Central

    Bekele, Tilahun; Bhokre, A. P.; Tesfaye, Abreha

    2015-01-01

    Aim: This study was conducted to evaluate and compare the tissue reactivity and suture handling characteristics of chromic gut, silk, and ‘jimat’ suture materials in cat thigh muscle. Materials and Methods: This experimental study was conducted from November, 2013 to April, 2014 in Kombolcha Animal Diseases Survey, Research and Diagnostic Laboratory, Kombolcha, Ethiopia. A total of 36 local breed male cats were randomly assigned into chromic gut, silk, and “jimat” groups of 12 cats each as A, B, and C, respectively. The hind leg muscle biceps femoris was incised and sutured with suture materials according to their groups. The muscle samples with its suture were collected at six different days interval i.e. 1, 3, 7, 14, 21, and 28 and processed histopathologically to assess the degree of leukocytic infiltration and fibrous and granulation tissue formation (GTF). In addition, all suture materials were evaluated intraoperatively about their handling characteristics, by rating the precision of knot tying, square knot positioning, and resistance to knot slippage. The statistical analysis was done with two-way ANOVA, Kruskal–Wallis, and Chi-square tests. Results: The histopathology showed that “jimat” thread (2.4±1.2) had produced least leukocytic infiltration than chromic gut (4.5±1.9) and silk (4.3±1.5) sutures during the study period. Higher GTF was seen at day 3 (6 [100%]), 7 (6 [100%]) and day 14 (4 [66.7%]) in all sutures, whereas “jimat” showed significantly (p<0.05) higher fibrous tissue formation (10 [83.3%]) than others. Moreover, “jimat” suture had equal suture handling characteristics (p>0.05) with both chromic gut and silk. Conclusion: The result indicated that a single strand “jimat” thread appears to be the most satisfactory suture material as regards to both tissue reaction and suture handling characteristics for skeletal muscle approximation in cats and provided that studies on its carcinogenic effects should be done. PMID

  12. Anterolateral Approach to the Pilon.

    PubMed

    Hickerson, Lindsay E; Verbeek, Diederik O; Klinger, Craig E; Helfet, David L

    2016-08-01

    This video reviews the indications, surgical approach, and case examples of the anterolateral approach to a distal tibial plafond fracture. If this approach is used in a staged fashion, when the soft envelope is ready, it affords excellent visualization for fracture fixation through thick skin flaps. An associated article reviews a cohort of 44 mainly type C3 pilon injuries treated by 2 orthopaedic traumatologist using the anterolateral approach after staged external fixation. An anatomic or good fracture reduction was obtained in 41 fractures with 13.6% of patients undergoing a secondary surgical procedure for infection or nonunion. PMID:27441938

  13. [Experimental subendocardial anterolateral infarctions].

    PubMed

    Medrano, G A; de Micheli, A

    1989-01-01

    Epicardial and thoracic unipolar tracings were recorded in 44 dog hearts after chemical necrosis had been produced on the anterior face of the free left ventricular wall by intramural injection of 96 percent alcohol. The damaged area was transmural (22 cases), intramural (10 cases) or localized in the interior half of the left ventricular wall. The last is commonly described as subendocardial necrosis (12 cases). Generally, direct leads recorded QrS complexes, with the R wave delayed according to the degree of damage to the myocardial muscle. These complexes were registered in at least one of the direct or semi-direct leads when myocardial necrosis was transmural or subendocardial in the interior half of the wall. Nevertheless, a small subendocardial (3 mm or less) or intramural necrosis created tiny Q waves, somewhat slurred but of normal duration, followed by R waves of low voltage. These signs alone are not diagnostic of myocardial necrosis. However, the presence of these Q waves in V2 and V3 only, or from V2 to V4 with greater voltage than in V5 and V6, implies the existence of non-transmural necrosis. The same applies when polyphasic ventricular morphologies are recorded in two intermediate precordial leads in absence of intraventricular conduction disturbances. These can mask the manifestation of transmural myocardial necrosis. Electrophysiologic data are sufficient to establish diagnosis if the infarcted area involves a substantial part of the thickness of the ventricular wall. However, in cases of small subendocardial or intramural necrosis, there are not always signs of dead tissue. At the same time, if the extension of transmural necrosis is more longitudinal than transverse, there is less probability of recording QS complexes in the precordial leads. PMID:2818092

  14. Anterolateral rotatory instability of the knee.

    PubMed

    Guenther, Daniel; Griffith, Chad; Lesniak, Bryson; Lopomo, Nicola; Grassi, Alberto; Zaffagnini, Stefano; Fu, Freddie H; Musahl, Volker

    2015-10-01

    Recent publications have generated renewed interest in the anatomy of the anterolateral capsule. Knowledge of the biomechanical function of the anterolateral components is lacking. Further research is required to evaluate the influence of the anterolateral capsule on rotatory laxity of the knee. The role of surgical procedures, such as an extra-articular tenodesis or lateral plasty, has to be defined based on quantification of the injury. This article seeks to summarize the current literature and discusses the role of the anterolateral capsule and reconstructive techniques in combined ligamentous knee trauma. Level of evidence V. PMID:25941044

  15. Anterolateral Extra-articular Soft Tissue Reconstruction in Anterolateral Rotatory Instability of the Knee.

    PubMed

    Kernkamp, Willem A; van de Velde, Samuel K; Bakker, Eric W P; van Arkel, Ewoud R A

    2015-12-01

    Anterolateral rotatory instability (ALRI) occurs after injury to the anterior cruciate ligament (ACL) and the anterolateral structures of the knee. We present a technique for anterolateral extra-articular soft-tissue (ALES) reconstruction of the knee that can be used in revision ACL reconstruction cases, cases of persistent ALRI after adequate ACL reconstruction, and cases with severe ALRI after primary ACL rupture. The surgeon performs ALES reconstruction with a strip of iliotibial tract autograft while respecting the anatomic origin and insertion of the anterolateral ligament. The purpose of this reconstruction is to restore the normal anterolateral rotatory stability of the knee in ALES-deficient patients. PMID:27284525

  16. The tell-tale thigh.

    PubMed

    Scheurer, Johannes; Stoevesandt, Dietrich; Siekmann, Holger; Kielstein, Heike

    2016-01-01

    A body of a 91-year-old donor underwent whole-body CT scanning before being transferred for use in an anatomical dissection course. Metallic objects were detected in the thigh muscles, extensive bone abnormalities were found in the left femur and the diaphysis of the left femur was 50% wider than that of the right diaphysis. History revealed that the body donor had been seriously wounded at the end of World War II by a rocket explosion. His multiple fractures and lesions had not been surgically treated either in an Austrian military hospital or in a French prisoner of war camp. The patient suffered for almost 70 years from this violation of the Geneva Conventions. In the light of current armed conflicts, the present case is an example of how one injustice can result in severe, lifelong medical consequences. It also shows that the history behind a wounded thigh can have an enormous impact on teaching ethics to today's medical students. PMID:27216934

  17. The Gluteus Medius Vs. Thigh Muscles Strength Ratio and Their Relation to Electromyography Amplitude During a Farmer’s Walk Exercise

    PubMed Central

    Stastny, Petr; Lehnert, Michal; Zaatar, Amr; Svoboda, Zdenek; Xaverova, Zuzana; Pietraszewski, Przemysław

    2015-01-01

    The strength ratio between hamstrings and quadriceps (H/Q) is associated with knee injuries as well as hip abductor muscle (HAB) weakness. Sixteen resistance trained men (age, 32.5 ± 4.2 years) performed 5 s maximal isometric contractions at 75° of knee flexion/extension and 15° of hip abduction on a dynamometer. After this isometric test they performed a Farmer’s walk exercise to find out if the muscle strength ratio predicted the electromyography amplitude expressed as a percentage of maximum voluntary isometric contraction (%MVIC). The carried load represented a moderate intensity of 75% of the exercise six repetitions maximum (6RM). Electromyography data from the vastus medialis (VM), vastus lateralis (VL), biceps femoris (BF) and gluteus medius (Gmed) on each leg were collected during the procedure. The groups selected were participants with H/Q ≥ 0.5, HQ < 0.5, HAB/H ≥ 1, HAB/H < 1, HAB/Q ≥ 0.5 and HAB/Q < 0.5. One way ANOVA showed that Gmed activity was significantly greater in the group with HAB/H < 1 (42 ± 14 %MVIC) as compared to HAB/H ≥ 1 (26 ± 10 %MVIC) and HAB/Q < 0.5 (47 ± 19 %MVIC) compared to HAB/Q ≥ 0.5 (26 ± 12 %MVIC). The individuals with HAB/H < 1 were found to have greater activation of their Gmed during the Farmer’s walk exercise. Individuals with HAB/Q < 0.5 had greater activation of the Gmed. Gmed strength ratios predict the muscle involvement when a moderate amount of the external load is used. The Farmer’s walk is recommended as an exercise which can strengthen the gluteus medius, especially for individuals with a HAB/H ratio < 1 and HAB/Q < 0.5. PMID:25964819

  18. Anterolateral Meniscofemoral Ligament of the Lateral Meniscus

    PubMed Central

    Kim, Young-Mo; Yeon, Kyu-Woong; Lee, Ki-Young

    2016-01-01

    Anatomical variations of the meniscus are a common anomaly that knee surgeons frequently encounter. However, anomalies of the anterior horn of the lateral meniscus (AHLM) are extremely rare. In this report, we present a newly discovered anomaly of the AHML: an anterolateral meniscofemoral ligament is described with clinical features and radiographic and arthroscopic findings. PMID:27595080

  19. Effects of Home-Based Interval Walking Training on Thigh Muscle Strength and Aerobic Capacity in Female Total Hip Arthroplasty Patients: A Randomized, Controlled Pilot Study

    PubMed Central

    Morishima, Yutaka; Mizushima, Takashi; Yamauchi, Katsuya; Morikawa, Mayuko; Masuki, Shizue; Nose, Hiroshi

    2014-01-01

    Due to the reduced physical activity of patients who have undergone total hip arthroplasty (THA), there are no home-based exercise training regimens for preventing muscle atrophy and aerobic capacity impairment in these patients. We examined whether interval walking training (IWT) could prevented these issues. Twenty-eight female patients (∼60 years of age) who had undergone THA more than 2 months prior were randomly divided into IWT (n = 14) and control (CNT, n = 14) groups. The IWT subjects trained at a target of 60 min of fast walking at >70% peak aerobic capacity for walking (O2peak) per wk for 12 wk, while those in the CNT maintained their previous sedentary life during the same period. We measured the energy expenditure of the daily physical activity, except during sleeping and bathing, every minute and every day during the intervention. We also measured the isometric knee extension (FEXT) and flexion (FFLX) forces, O2peak, and anaerobic threshold during the graded cycling exercise (O2AT) before and after the intervention. All subjects, except for one in IWT, completed the protocol. FFLX increased by 23% on the operated side (P = 0.003) and 14% on the non-operated side of IWT (P = 0.006), while it only increased on the operated side of CNT (P = 0.03). The O2peak and O2AT in IWT increased by 8% (P = 0.08) and 13% (P = 0.002), respectively, and these changes were significantly higher in the IWT than in CNT group (both, P<0.05). In conclusion, IWT might be an effective home-based training regimen for preventing the muscle atrophy from reduced daily physical activity in THA patients. Trial Registration UMIN-CTR UMIN000013172 PMID:25268505

  20. Three dimensional analysis of the vascular perfusion for anterolateral thigh perforator flaps

    NASA Astrophysics Data System (ADS)

    Xue, Jiaxing; Gao, Jean; Arbique, Gary; Saint-Cyr, Michel; Hatef, Dan; Brown, Spencer

    2007-03-01

    Quantitative analysis of three dimentional (3D) blood flow direction and location will benefit and guide the surgical thinning and dissection process. Toward this goal, this study was performed to reconstruct 3D vascular trees with the incorporation of temporal information from contrast-agent propagation. A computational technique based on our previous work to segment the 3D vascular tree structure from the CT scan volume image sets was proposed. This technique utilizes the deformation method which is a moving grid methodology and which in tradition is used to improve the computational accuracy and efficiency in solving differential equations. Compared with our previous work, we extended the moving grid deformation method to 3D and incorporated 3D region growing method for an initial segmentation. At last, a 3D divergence operator was applied to delineate vascular tree structures from the 3D grid volume plot. Experimental results show the 3D nature of the vascular structure and four-dimensional (4D) vascular tree evolving process. The proposed computational framework demonstrates its effectiveness and improvement in the modeling of 3D vascular tree.

  1. Hot-boning enhances cook yield of boneless skinless chicken thighs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Three experiments were conducted to evaluate effects of postmortem deboning time on cook yield of boneless skinless chicken thighs. In Experiment 1 (3 replications), chicken thigh meat was separated from bones at 0.45 (hot-bone), 2, and 24 h and trimmed to obtain iliotibialis muscle. The iliotibiali...

  2. Surgical Dissection of the Anterolateral Ligament.

    PubMed

    Daggett, Matthew; Busch, Kyle; Sonnery-Cottet, Bertrand

    2016-02-01

    Recent investigations into the structure and function of the anterolateral ligament (ALL) have resulted in renewed interest in the role of the lateral extra-articular structures in rotational control of the knee. With increased focus on the ALL, debate about the anatomic characteristics, the functional role in knee stability, and even the existence of this lateral structure has ensued. This article describes our dissection method for the ALL. Through careful dissection and precise elevation of the iliotibial band, the ALL can be clearly identified as a distinct structure with an attachment near the lateral epicondyle on the femur and an insertion in a fan-like fashion onto the tibia, between the Gerdy tubercle and the fibular head. This investigation provides the surgeon with anatomic landmarks to use during surgical reconstruction of the ALL. PMID:27274451

  3. Unique muscularity in cyclists' thigh and trunk: A cross-sectional and longitudinal study.

    PubMed

    Ema, R; Wakahara, T; Yanaka, T; Kanehisa, H; Kawakami, Y

    2016-07-01

    This study examined the influence of regular training in competitive cycling on individual muscle volume of the thigh and psoas major cross-sectionally and longitudinally. T1-weighted magnetic resonance (MR) images of the trunk and right thigh were obtained from eight experienced varsity male cyclists (experience: > 4 years) and 10 untrained men (experiment 1), and from 12 (10 males, two females) varsity cyclists before and after competitive cycling training for 6 months (experiment 2). From the MR images, the volumes of each of the quadriceps femoris and hamstrings, total adductors, gracilis, sartorius, and psoas major were determined. The volumes of the monoarticular thigh muscles, semitendinosus, and psoas major muscles were significantly greater in the experienced cyclists than in the untrained men (experiment 1), and increased significantly after the competitive training for 6 months (experiment 2). In contrast, the volumes of the other biarticular thigh muscles were similar among the experienced cyclists and untrained men (experiment 1), and did not change by competitive cycling training (experiment 2). The results indicate that competitive cycling training induces muscle-specific hypertrophy of the synergistic muscles, especially between the monoarticular and biarticular muscles, leading to quantitative profiles of the musculature in experienced cyclists. PMID:26148051

  4. Necrotising fasciitis of the thigh

    PubMed Central

    Haemers, K; Peters, R; Braak, S; Wesseling, F

    2013-01-01

    Necrotising fasciitis (NF) is an extremely virulent form of infectious fasciitis. It affects skin, subcutaneous fat and superficial and deep muscular fascia by rapidly progressive necrosis. Expeditious diagnosis and radical debridement is necessary to prevent the onset of sepsis, multisystem organ failure and possible death. Perforated rectal cancer resulting in NF can spread to the perineum and genitals known as Fournier gangrene. This case describes an unusual case of NF of the right thigh as first presentation highly suggestive for rectal cancer. PMID:23771967

  5. Arthroscopic Debridement of Pediatric Accessory Anterolateral Talar Facet Causing Impingement.

    PubMed

    Neumann, Julie A; Mannava, Sandeep; Gross, Christopher E; Wooster, Benjamin M; Busch, Michael T

    2016-04-01

    Symptomatic subfibular and/or lateral talocalcaneal impingement in pediatric patients may result from an accessory anterolateral talar facet (AALTF). This impingement may cause pain and disability and may limit athletic performance in high-level athletes. We report the case of a 12-year-old female competitive gymnast who had refractory, lateral-sided right ankle pain for 4 months and underwent right ankle arthroscopic resection of the AALTF causing impingement. Standard medial and anterolateral portals with the addition of an accessory anterolateral-distal portal were used in conjunction with a 30° 2.7-mm-diameter arthroscope. The AALTF was resected with a combination of a shaver and a motorized rasp. Intraoperative fluoroscopy was used to verify successful debridement of the bony facet. This case illustrates that arthroscopic debridement is a technique to treat subfibular and/or talocalcaneal impingement associated with an AALTF. PMID:27462543

  6. Temperatures in human thighs after hot pack treatment followed by ultrasound.

    PubMed

    Lehmann, J F; Stonebridge, J B; deLateur, B J; Warren, C G; Halar, E

    1978-10-01

    Temperature distributions were measured in the anterior thigh of human volunteers after preheating with a hot pack followed by ultrasound, a frequently used therapeutic procedure. The skin surface temperature is elevated by this procedure but the highest temperature is still produced at the bone-muscle interface at the end of the treatment session. PMID:363094

  7. Editorial Commentary: Anterolateral Ligament: How Do We Find It?

    PubMed

    Verma, Nikhil N

    2016-01-01

    There is considerable current interest in the role of the anterolateral ligament in persistent instability after anterior cruciate ligament reconstruction. The normal ligament may be identified using magnetic resonance imaging or ultrasound techniques. However, imaging evaluation of the ligament in vivo after injury requires further study to determine indications for repair or reconstruction. PMID:26743415

  8. Distraction-free ankle arthroscopy for anterolateral impingement.

    PubMed

    Rouvillain, Jean Louis; Daoud, Wael; Donica, Adrian; Garron, Emmanuel; Uzel, André Pierre

    2014-08-01

    The origin of chronic pain after external ankle sprain is better known with arthroscopy's contribution. Chronic hypertrophic synovitis of the anterolateral ankle region is seemingly the cause, resulting in "anterolateral ankle impingement." But is partial synovectomy with fibrosis resection under arthroscopy always possible without any distraction? Are results affected? This retrospective study concerned only patients with soft tissue ankle impingement. All cases with bone and joint diseases were excluded. The final sample of 24 patients had a mean age of 35 years (21-54 years) and presented anterolateral mechanical pain associated with oedema following external ankle sprain. Medical and rehabilitative treatment was undertaken for more than 6 months before arthroscopy. Average time between trauma and arthroscopy was 21 months (5-60 months). Clinical examination revealed no ankle instability or laxity. Debridement with joint lavage was systematically performed under arthroscopy without any distraction. Average patient follow-up was 22 months (12-92 months). All patients had a good Kitaoka score, with 22 patients registering excellent results. There were no septic complications or algodystrophy. Two transient hypoesthesias were observed in the dorsal surface and lateral border of the foot with full postoperative recovery at 6 months. Distraction was never used and simple dorsiflexion was sufficient to perform arthroscopic debridement. In this study, anterolateral ankle impingement diagnosis was primarily clinical. Arthroscopic treatment yielded significant benefits on pain, oedema and resumption of sport activities. Arthroscopic treatment of anterolateral ankle impingements is thus possible with simple dorsiflexion and no distraction, resulting in a possible decrease in complication rates. Level of evidence Retrospective cohort study, Level IV. PMID:24220747

  9. Donor-Site Morbidity Following Free Tissue Harvest from the Thigh: A Systematic Review and Pooled Analysis of Complications.

    PubMed

    Lakhiani, Chrisovalantis; DeFazio, Michael V; Han, Kevin; Falola, Reuben; Evans, Karen

    2016-06-01

    Background Donor-site morbidity significantly influences patient satisfaction and quality of life following reconstructive surgery. The relevant donor-site morbidities associated with more commonly utilized thigh-based flaps are reviewed. Methods A systematic search of the MEDLINE and Cochrane databases from 1994 to 2014 was conducted to identify all reports of "anterolateral thigh (ALT)," "vastus lateralis (VL)," "anteromedial thigh (AMT)," "transverse upper gracilis (TUG)," tensor fascia latae (TFL)," "gracilis," and "rectus femoris (RF)," flaps. Only studies that investigated donor-site outcomes related to pain, paresthesia, wound dehiscence, infection, hematoma, seroma, contour deformity, and/or objective functional performance were included. Case series or anecdotal reports with less than five flaps, non-English, and animal studies were excluded. Results A total of 116 articles representing 4,554 flaps were reviewed, including 2,922 ALT/VL, 148 AMT, 436 TUG, 278 TFL, 527 gracilis, and 243 RF flaps. The most frequently cited donor-site complication was paresthesia (range: 0-36.4%), followed by wound dehiscence (range: 0.9-8.3%), contour deformity (range: 0-5.2%), pain (range: 0-6.3%), and seroma (range: 0.4-2.0%). Despite mixed results regarding functional performance, pooled-analysis of dynamometric studies demonstrated a significant reduction in strength only after RF flap harvest (21%). Conclusions Donor-site morbidity for thigh-flaps is minimal and appears to be well-tolerated by the majority of patients. Nevertheless, the appropriate flap selection is highly individualized, and patients must be informed of potential complications and morbidities specific to each flap. We have established the most current review of donor-site morbidity for thigh-based flaps to aid the surgeon in this important discussion. PMID:27144952

  10. An unusual cause of mass localized on vastus lateralis muscle in childhood: Hydatid cyst

    PubMed Central

    Çiçekli, Özgür; Akgül, Turgut

    2014-01-01

    Summary Introduction Musculoskeletal hydatid disease is a rare pathology and its diagnosis is often delayed because of slowly growing mass without inflammation. It is critical to suspicious clinical diagnosis in rural endemic areas and for preoperative diagnosis of this disease. Presentation of case We present a 9-year-old boy referred with mass located on the anterolateral part of distal thigh. Diagnosis was verified with MRI histopathologically for the presence of hydatid cyst located in vastus lateralis muscle. Magnetic resonance imaging (MRI) was performed for further imaging. MRI showed an oval cystic mass approximately 77 × 20 × 18 mm in the left vastus lateralis muscle, containing round-shaped daughter cysts. Patients were treated with surgical excision and medical therapy. Clinical, radiological and serologic tests showed no recurrence after treatment. Discussion The muscle is considered an unfavorable site for hydatidosis because of its high lactic acid level that creates an unfavorable milieu for growth. The detachment of the germinative membrane from pericyst (water–lily sign) is considered to be pathognomonic and is reported in locations other than the liver and lung in magnetic resonance imaging. Surgery is the most effective way to treat hydatid cysts. Complete surgical resection and medical therapy are the preferred treatment for isolated echinococcosis. Conclusion Hydatid cyst in vastus lateralis is a very rare disease. Hydatid cyst should be kept in mind when observing soft tissue mass of the extremities in patients from areas endemic of Echinococcus granulosus. PMID:25544487

  11. Treatment of compartment syndrome of the thigh associated with acute renal failure after the Wenchuan earthquake.

    PubMed

    Duan, Xin; Zhang, Kaiwei; Zhong, Gang; Cen, Shiqiang; Huang, Fuguo; Lv, Jingtong; Xiang, Zhou

    2012-04-01

    Compartment syndrome of the thigh is a rare emergency often treated operatively. The purpose of this study was to evaluate the effects of nonoperative treatment for compartment syndrome of the thigh associated with acute renal failure after the 2008 Wenchuan earthquake. Nonoperative treatment, which primarily involves continuous renal replacement therapy, was performed in 6 patients (3 men and 3 women) who presented with compartment syndrome of the thigh associated with acute renal failure. The mean mangled extremity severity score (MESS) and laboratory data regarding renal function were analyzed before and after treatment, and the clinical outcome was evaluated at 17-month follow-up. Laboratory data regarding renal function showed improvements. All 6 patients survived with the affected lower limbs intact after nonoperative treatment. Follow-up revealed active knee range of motion and increased muscle strength, as well as a recovery of sensation. A positive linear correlation was found between MESS and the time required to achieve a reduction in swelling, as well as the time required for the recovery of sensation and knee range of motion (r>0.8; P<.05). Satisfactory clinical outcomes were obtained in patients with compartment syndrome of the thigh associated with acute renal failure.Urine alkalization, electrolyte and water balance, and continuous renal replacement therapy have played an important role in saving lives and extremities. Nonoperative treatment should be considered in the treatment of compartment syndrome of the thigh associated with acute renal failure. PMID:22495847

  12. Recurrent spontaneous compartment syndrome of the thigh

    PubMed Central

    Rohman, Lebur; Chan, Sheung; Hadi, Saifullah; Maruszewski, Daniel

    2014-01-01

    Acute comparment syndrome (ACS) is a surgical emergency, in which tissue pressure becomes greater than perfusion pressure leading to tissue ischaemia. It is typically a consequence of trauma. We present a case in which a patient suffers blunt trauma to the thigh, but develops ACS 2 years after this injury and consequently endures 10-episodes of ACS (no perciptating event or cause) in the same thigh over 10 years. On the 10th presentation the patient was found to have arteriovenous malformation on MR angiography which were embolised and the fasciotomy wound closed with a split-thickness skin graft. A thorough literature search deemed this case to be the first reported recurrent spontaneous ACS of the thigh. Prompt recognition and treatment of ACS is vital. Clinicians should thoroughly investigate such patients postoperatively and involve vascular/plastic surgeons and interventianal radiologist to provide optimum care and prevent recurrence. PMID:25150230

  13. Anterolateral Ligament of the Knee: Back to the Future in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Bonasia, Davide Edoardo; D’Amelio, Andrea; Pellegrino, Pietro; Rosso, Federica; Rossi, Roberto

    2015-01-01

    Although the importance of the anterolateral stabilizing structures of the knee in the setting of anterior cruciate ligament (ACL) injuries has been recognized since many years, most of orthopedic surgeons do not take into consideration the anterolateral structures when performing an ACL reconstruction. Anatomic single or double bundle ACL reconstruction will improve knee stability, but a small subset of patients may experience some residual anteroposterior and rotational instability. For this reason, some researchers have turned again towards the anterolateral aspect of the knee and specifically the anterolateral ligament. The goal of this review is to summarize the existing knowledge regarding the anterolateral ligament of the knee, including anatomy, histology, biomechanics and imaging. In addition, the most common anterolateral reconstruction/tenodesis techniques are described together with their respective clinical outcomes. PMID:26330991

  14. Myositis Ossificans in the Thigh of a Lacrosse Player.

    PubMed

    Goyal, Kamal; Pettis, Christopher R; Bancroft, Ashley E; Wasyliw, Christopher W; Scherer, Kurt F

    2015-08-01

    An 18-year-old man presented with mid left thigh pain after sequential lacrosse injuries 1 month and 2 weeks prior. Physical examination was significant for a tender mass in the mid left thigh. PMID:26313164

  15. Giant extra-articular synovial osteochondromatosis of the left proximal thigh: A case report

    PubMed Central

    YU, XIAOLONG; LI, WEI; DAI, MIN; ZHANG, BIN; ZOU, FAN; LIU, HUCHENG

    2015-01-01

    Extra-articular synovial osteochondromatosis is a rare disease. The present study describes the case of a 46-year-old female who suffered from extra-articular synovial osteochondromatosis of the left proximal thigh with limited hip movement. The patient underwent a total tumor resection and recovered well. The tumor was 15×14×5 cm3 in size and located in the muscle gap. After a 3-month follow-up, the patient's left hip motion was improved and a computed tomography scan demonstrated no evidence of recurrence. However, the long-term efficacy of this procedure requires continuous observation of the patient. To the best of our knowledge, this is the first case of a giant extra-articular synovial osteochondromatosis of the proximal thigh muscle gap. PMID:26788172

  16. Proximal Humerus Fracture Plating Through the Extended Anterolateral Approach.

    PubMed

    Gardner, Michael J

    2016-08-01

    Several approaches to the proximal humerus for fracture fixation are possible. The traditional utilitarian approach to the shoulder, the deltopectoral, has distinct disadvantages when performing fracture reduction and locked plating. The anterolateral acromial approach exploits the intermuscular plane between the anterior and middle heads of the deltoid. After identifying the position of the axillary nerve as it crosses this interval, fracture reduction and fixation is performed. Direct access to both the greater and the lesser tuberosities is facilitated. The cancellous surface of the humeral head fragment provides an excellent surface for direct manipulation without further endangering the extraosseous soft tissue attachments. PMID:27441923

  17. Correlation of Magnetic Resonance Imaging With Knee Anterolateral Ligament Anatomy

    PubMed Central

    Helito, Camilo Partezani; Helito, Paulo Victor Partezani; Bonadio, Marcelo Batista; Pécora, José Ricardo; Bordalo-Rodrigues, Marcelo; Camanho, Gilberto Luis; Demange, Marco Kawamura

    2015-01-01

    Background: Anatomic and magnetic resonance imaging (MRI) studies have recently characterized the knee anterolateral ligament (ALL). So far, no study has focused on confirming whether the evaluated MRI parameters truly correspond with ALL anatomy. Purpose: To assess the validity of MRI in detecting the ALL using an anatomic evaluation as reference. Study Design: Descriptive laboratory study. Methods: A total of 13 cadaveric knees were subjected to MRI and then to anatomic dissection. Dissection was performed according to previous anatomic study methodology. MRIs were performed with a 0.6- to 1.5-mm slice thickness and prior saline injection. The following variables were analyzed: distance from the origin of the ALL to the origin of the lateral collateral ligament (LCL), distance from the origin of the ALL to its bifurcation point, maximum length of the ALL, distance from the tibial insertion of the ALL to the articular surface of the tibia, ALL thickness, and ALL width. The 2 sets of measurements were analyzed using the Spearman correlation coefficient (ρ) and Bland-Altman plots. Results: The ALL was clearly observed in all dissected knees and MRI scans. It originated anterior and distal to the LCL, close to the lateral epycondile center, and showed an anteroinferior path toward the tibia, inserting between the Gerdy tubercle and the fibular head, around 5 mm under the lateral plateau. The ρ values tended to increase together for all studied variables between the 2 methods, and all were statistically significant, except for thickness (P = .077). Bland-Altman plots showed a tendency toward a reduction of ALL thickness and width by MRI compared with anatomic dissection. Conclusion: MRI scanning as described can accurately assess the ALL and demonstrates characteristics similar to those seen under anatomic dissection. Clinical Relevance: MRI can accurately characterize the ALL in the anterolateral region of the knee, despite the presence of structures that might

  18. Skeletal Muscle Magnetic Resonance Imaging of the Lower Limbs in Late-onset Lipid Storage Myopathy with Electron Transfer Flavoprotein Dehydrogenase Gene Mutations

    PubMed Central

    Liu, Xin-Yi; Jin, Ming; Wang, Zhi-Qiang; Wang, Dan-Ni; He, Jun-Jie; Lin, Min-Ting; Fu, Hong-Xia; Wang, Ning

    2016-01-01

    Background: Lipid storage myopathy (LSM) is a genetically heterogeneous group with variable clinical phenotypes. Late-onset multiple acyl-coenzyme A dehydrogenation deficiency (MADD) is a rather common form of LSM in China. Diagnosis and clinical management of it remain challenging, especially without robust muscle biopsy result and genetic detection. As the noninvasion and convenience, muscle magnetic resonance imaging (MRI) is a helpful assistant, diagnostic tool for neuromuscular disorders. However, the disease-specific MRI patterns of muscle involved and its diagnostic value in late-onset MADD have not been systematic analyzed. Methods: We assessed the MRI pattern and fat infiltration degree of the lower limb muscles in 28 late-onset MADD patients, combined with detailed clinical features and gene spectrum. Fat infiltration degree of the thigh muscle was scored while that of gluteus was described as obvious or not. Associated muscular atrophy was defined as obvious muscle bulk reduction. Results: The mean scores were significantly different among the anterior, medial, and posterior thigh muscle groups. The mean of fat infiltration scores on posterior thigh muscle group was significantly higher than either anterior or medial thigh muscle group (P < 0.001). Moreover, the mean score on medial thigh muscle group was significantly higher than that of anterior thigh muscle group (P < 0.01). About half of the patients displayed fat infiltration and atrophy in gluteus muscles. Of 28 patients, 12 exhibited atrophy in medial and/or posterior thigh muscle groups, especially in posterior thigh muscle group. Muscle edema pattern was not found in all the patients. Conclusions: Late-onset MADD patients show a typical muscular imaging pattern of fat infiltration and atrophy on anterior, posterior, and medial thigh muscle groups, with major involvement of posterior thigh muscle group and gluteus muscles and a sparing involvement of anterior thigh compartment. Our findings also

  19. Sciatica due to malignant nerve sheath tumour of sciatic nerve in the thigh.

    PubMed

    Sharma, R R; Pawar, S J; Mahapatra, A K; Doctor, M; Musa, M M

    2001-06-01

    Malignant peripheral nerve sheath tumour (MPNST) is a rare malignant neoplasm arising from the supportive non-neural component of the peripheral nerves. An unusual case of pain and weakness of the foot and calf muscles due to a giant MPNST of the sciatic nerve in the posterior compartment of the thigh is presented. The patient was already investigated as a case of sciatica due to a lumbar disc disease with a negative magnetic resonance imaging and then unsuccessfully operated elsewhere twice, with a misdiagnosis of tarsal tunnel syndrome. Neurosurgical referral prompted a diagnostic magnetic resonance study of the thigh, revealing the lesion, which was completely excised microsurgically with total relief in the pain and partial improvement in the weakness and sensations in the sole of the foot. PMID:11447444

  20. The Anterolateral Ligament of the Knee: What the Radiologist Needs to Know.

    PubMed

    Van Dyck, Pieter; De Smet, Eline; Lambrecht, Valérie; Heusdens, Christiaan H W; Van Glabbeek, Francis; Vanhoenacker, Filip M; Gielen, Jan L; Parizel, Paul M

    2016-02-01

    The anterolateral ligament (ALL) was recently identified as a distinct component of the anterolateral capsule of the human knee joint with consistent origin and insertion sites. Biomechanical studies revealed that the current association between the pivot shift and an injured anterior cruciate ligament (ACL) should be loosened and that the rotational component of the pivot shift is significantly affected by the ALL. This may change the clinical approach toward ACL-injured patients presenting with anterolateral rotatory instability (ALRI), the most common instability pattern after ACL rupture. Radiologists should be aware of the importance of the ALL to ACL injuries. They should not overlook pathology of the anterolateral knee structures, including the ALL, when reviewing MR images of the ACL-deficient knee. In this article, the current knowledge regarding the anatomy, biomechanical function, and imaging appearance of the ALL of the knee is discussed with emphasis on the clinical implications of these findings. PMID:27077584

  1. Anterolateral Versus Medial Plating of Distal Extra-articular Tibia Fractures: A Biomechanical Model.

    PubMed

    Pirolo, Joseph M; Behn, Anthony W; Abrams, Geoffrey D; Bishop, Julius A

    2015-09-01

    Both medial and anterolateral plate applications have been described for the treatment of distal tibia fractures, each with distinct advantages and disadvantages. The objective of this study was to compare the biomechanical properties of medial and anterolateral plating constructs used to stabilize simulated varus and valgus fracture patterns of the distal tibia. In 16 synthetic tibia models, a 45° oblique cut was made to model an Orthopedic Trauma Association type 43-A1.2 distal tibia fracture in either a varus or valgus injury pattern. Each fracture was then reduced and plated with a precontoured medial or anterolateral distal tibia plate. The specimens were biomechanically tested in axial and torsional loading, cyclic axial loading, and load to failure. For the varus fracture pattern, medial plating showed less fracture site displacement and rotation and was stiffer in both axial and torsional loading (P<.05). For the valgus fracture pattern, there was no statistically significant difference between medial and anterolateral plating. There were no significant differences between the 2 constructs for either fracture pattern with respect to ultimate load, displacement, or energy absorption in load to failure testing. When used to stabilize varus fracture patterns, medial plates showed superior biomechanical performance compared with anterolateral plates. In this application, the medial plates functioned in anti-glide mode. For valgus fracture patterns, no biomechanical differences between anterolateral and medial plating were observed. In clinical practice, surgeons should take this biomechanical evidence into account when devising a treatment strategy for fixation of distal tibia fractures. PMID:26375532

  2. Scrotal reconstruction with modified pudendal thigh flaps.

    PubMed

    Mopuri, Nabil; O'Connor, Edmund Fitzgerald; Iwuagwu, Fortune C

    2016-02-01

    Scrotal skin loss can occur following trauma, Fournier's gangrene, post tumour excision, burns, etc. There are many techniques described in the literature including residual scrotal skin mobilization, skin grafts, pedicled and free flaps. The management is complex and challenging shown by the multiplicity of flaps and techniques described in the literature. We used a modified pudendal thigh flap to reconstruct scrotal defects in five patients. This study describes the vascularity of the flap, technique of elevation and the inset of the flap. The elevation and particularly the insetting make it different from other flaps raised on this vascular network for scrotal reconstruction. This pedicled flap is robust, reliable, resilient and produces a neo-scrotum that looks natural in appearance, offers good-quality skin cover and cushion to the testes as well as protective sensation. PMID:26774357

  3. Primary ilio-psoas abscess extending to the thigh in a neonate: US, CT and MR findings.

    PubMed

    Prassopoulos, P K; Giannakopoulou, C A; Apostolaki, E G; Charoulakis, N Z; Gourtsoyiannis, N C

    1998-08-01

    Psoas abscess in children, and especially in neonates, is an uncommon condition which is difficult to diagnose clinically. The US, CT and MR findings of a psoas abscess in a neonate, which extended to the thigh, are reported. Imaging was helpful in revealing the abnormality, in demonstrating its extension and in determining its nature. The child was treated conservatively and the abscess resolved, leaving atrophy of the psoas muscle. PMID:9716633

  4. Gossypiboma in Thigh- A Case Report

    PubMed Central

    Arora, Ram Krishan; Johal, Karandeep Singh

    2014-01-01

    Introduction: The word Gossypiboma has been used for a retained surgical sponge/swab and is derived from gossypium(latin:cotton) and boma(Swahili-place of concealment). Other synonyms for this entity are textiloma, retained textile foreign body(RTFB)”/muslinoma. It is rare in muskulo-skeletal surgery. Case Report: An eighteen year old boy was operated upon for failed plating of right femur. He had a globular swelling in mid thigh. There were no discharging sinuses, no signs/symptoms of infection. While operating on him to remove the failed implant and fix the fracture, while following standard procedures, we found a full size sponge embedded in the fracture site. Conclusion: In all cases presenting with an incidental mass with/without sinus, Gossypiboma be kept in the differential diagnosis. Awareness of the condition is a must to diagnose such a rare condition. While operating one should make sure that no sponge is left inside-which can have serious medicolegal consequences. PMID:27298975

  5. Development and Validation of a High Anatomical Fidelity FE Model for the Buttock and Thigh of a Seated Individual.

    PubMed

    Al-Dirini, Rami M A; Reed, Matthew P; Hu, Jingwen; Thewlis, Dominic

    2016-09-01

    Current practices for designing new cushions for seats depend on superficial measurements, such as pressure mapping, which do not provide sufficient information about the condition of sub-dermal tissues. Finite element (FE) modelling offers a unique alternative to integrate assessment of sub-dermal tissue condition into seat/cushion design and development processes. However, the development and validation of such FE models for seated humans requires accurate representation of the anatomy and material properties, which remain challenges that are yet to be addressed. This paper presents the development and validation of a detailed 3D FE model with high anatomical fidelity of the buttock and thigh, for a specific seated subject. The developed model consisted of 28 muscles, the pelvis, sacrum, femur, and one layer of inter-muscular fat, subcutaneous fat and skin. Validation against in vivo measurements from MRI data confirmed that the FE model can simulate the deformation of soft tissues under sitting loads with an accuracy of (mean ± SD) 4.7 ± 4.4 mm. Simulation results showed that the maximum strains (compressive, shear and von-Mises) on muscles (41, 110, 79%) were higher than fat tissues (21, 62, 41%). The muscles that experienced the highest mechanical loads were the gluteus maximus, adductor magnus and muscles in the posterior aspect of the thighs (biceps femoris, semitendinosus and semimembranosus muscles). The developed FE model contributes to the progression towards bio-fidelity in modelling the human body in seated postures by providing insight into the distribution of stresses/strains in individual muscles and inter-muscular fat in the buttock and thigh of seated individuals. Industrial applications for the developed FE model include improving the design of office and household furniture, automotive and airplane seats and wheelchairs as well as customisation and assessment of sporting and medical equipment to meet individual requirements. PMID:26857008

  6. Anterolateral acromial approach in locking plate fixation of proximal humerus fractures in elderly patients.

    PubMed

    Cai, Jun-Feng; Yuan, Feng; Ma, Min; Zhou, Wei; Luo, Shu-Lin; Yin, Feng

    2013-10-01

    We describe our experience with a two-incision anterolateral acromial approach in locking plate fixation of proximal humeral fractures in older adults. Mean time between injury and surgery was 3.08 +/- 1.24 days. A proximal anterolateral transverse incision and a more distal longitudinal incision were used. A locking plate was inserted along the lateral side of the humerus from the proximal incision to the distal fragment of the humerus. Mean operation time was 62.37 +/- 19.05 minutes. There were no instances of axillary nerve paralysis or infection. Postoperative imaging results were satisfactory in all cases. Three obese patients experienced fat liquefaction at the incision site. Mean total Neer score one year after surgery was 88.16 +/- 5.05. We conclude that the two-incision anterolateral acromial approach with use of locking plates appears to be an effective means to treat proximal humeral fractures in older adults. PMID:24350509

  7. Cerebrovascular effects of the thigh cuff maneuver.

    PubMed

    Panerai, R B; Saeed, N P; Robinson, T G

    2015-04-01

    Arterial hypotension can be induced by sudden release of inflated thigh cuffs (THC), but its effects on the cerebral circulation have not been fully described. In nine healthy subjects [aged 59 (9) yr], bilateral cerebral blood flow velocity (CBFV) was recorded in the middle cerebral artery (MCA), noninvasive arterial blood pressure (BP) in the finger, and end-tidal CO2 (ETCO2) with nasal capnography. Three THC maneuvers were performed in each subject with cuff inflation 20 mmHg above systolic BP for 3 min before release. Beat-to-beat values were extracted for mean CBFV, BP, ETCO2 , critical closing pressure (CrCP), resistance-area product (RAP), and heart rate (HR). Time-varying estimates of the autoregulation index [ARI(t)] were also obtained using an autoregressive-moving average model. Coherent averages synchronized by the instant of cuff release showed significant drops in mean BP, CBFV, and RAP with rapid return of CBFV to baseline. HR, ETCO2 , and ARI(t) were transiently increased, but CrCP remained relatively constant. Mean values of ARI(t) for the 30 s following cuff release were not significantly different from the classical ARI [right MCA 5.9 (1.1) vs. 5.1 (1.6); left MCA 5.5 (1.4) vs. 4.9 (1.7)]. HR was strongly correlated with the ARI(t) peak after THC release (in 17/22 and 21/24 recordings), and ETCO2 was correlated with the subsequent drop in ARI(t) (19/22 and 20/24 recordings). These results suggest a complex cerebral autoregulatory response to the THC maneuver, dominated by myogenic mechanisms and influenced by concurrent changes in ETCO2 and possible involvement of the autonomic nervous system and baroreflex. PMID:25659488

  8. Three-dimensional visualization of the human face using DICOM data and its application to facial contouring surgery using free anterolateral thigh flap transfer.

    PubMed

    Shimizu, Fumiaki; Uehara, Miyuki; Oatari, Miwako; Kusatsu, Manami

    2016-01-01

    One of the main challenges faced by surgeons performing reconstructive surgery in cases of facial asymmetry due to hemifacial atrophy or tumor surgery is the restoration of the natural contour of the face. Soft-tissue augmentation using free-flap transfer is one of the most commonly used methods for facial reconstruction. The most important part of a successful reconstruction is the preoperative assessment of the volume, position, and shape of the flap to be transplanted. This study focuses on three cases of facial deformity due to hemifacial progressive atrophy or tumor excision. For the preoperative assessment, digital imaging and communications in medicine (DICOM) data obtained from computed tomography was used and applied to a three-dimensional (3D) picture software program (ZedView, LEXI, Tokyo, Japan). Using computer simulation, a mirror image of the unaffected side of the face was applied to the affected side, and 3D visualization was performed. Using this procedure, a postoperative image of the face and precise shape, position, and amount of the flap that was going to be transferred was simulated preoperatively. In all cases, the postoperative shape of the face was acceptable, and a natural shape of the face could be obtained. Preoperative 3D visualization using computer simulation was helpful for estimating the reconstructive procedure and postoperative shape of the face. Using free-flap transfer, this procedure facilitates the natural shape after reconstruction of the face in facial contouring surgery. PMID:26319058

  9. The efficacy of cryolipolysis treatment on arms and inner thighs.

    PubMed

    Wanitphakdeedecha, Rungsima; Sathaworawong, Angkana; Manuskiatti, Woraphong

    2015-11-01

    Cryolipolysis has emerged as a new non-invasive body contouring method using controlled cooling to selectively destroy fat cells. Previous studies demonstrated the safety and efficacy of cryolipolysis for the reduction of localized subcutaneous fat on abdomen and flanks. Recently, the new flat cup vacuum applicator has been developed to treat localized subcutaneous fat on arms and inner thighs. The objective of this study was to determine the efficacy of non-invasive cryolipolysis for body contouring with a flat cup vacuum applicator on arms and inner thighs. Twenty females with excess localized subcutaneous fat on arms or inner thighs received a single cryolipolysis treatment. Forty treatment areas have been treated including 10 arms and 30 inner thighs. Subjects were evaluated using standardized photographs and measurements of body weight and circumference of arms or inner thighs at baseline, 3-month, and 6-month follow-up visits. Physicians' evaluation and patient's satisfaction of clinical improvement were also measured. Of all 20 subjects, 17 (10 arms and 24 inner thighs) completed the treatment protocol and attended all follow-up visits. Three subjects were withdrawn from the study, 1 subject could not complete the treatment session due to pain and numbness during treatment, 1 subject became pregnant after treatment, and the other subject could not attend all required follow-up visits. There was significant circumference reduction of 0.41 and 0.72 cm at 3-month and 6-month follow-up visits (p = 0.017), respectively. Most of the patients were rated to have 1-25% improvement at 6 months after treatment and were satisfied with the treatment outcome. The new cryolipolysis flat cup vacuum applicator provided beneficial effects for circumferential reduction of arms and inner thighs. PMID:26100004

  10. Asymmetry of Muscle Strength in Elite Athletes

    ERIC Educational Resources Information Center

    Drid, Patrik; Drapsin, Miodrag; Trivic, Tatjana; Lukac, Damir; Obadov, Slavko; Milosevic, Zoran

    2009-01-01

    "Study aim": To determine muscle strength variables in elite judoists and wrestlers since thigh muscle strength and bilaterally balanced flexor-to-extensor ratio minimise injury risk and are desirable for achieving sport successes. "Material and methods": Judoists, wrestlers and untrained subjects, 10 each, were subjected to isokinetic strength…

  11. A cause of severe thigh injury: Battery explosion

    PubMed Central

    Görgülü, Tahsin; Torun, Merve; Olgun, Abdulkerim

    2015-01-01

    Introduction In parallel with technological improvements, humankind encounter with equipments/devices transforming chemical energy to electrical energy. Especially automobile batteries, watch and mobile phone batteries are the most encountered ones. In the literature, there are mainly facial burn cases due to mobile phone battery explosion. On the other hand very few examples of serious lower limb. injury is present. Presentation of case 12-year-old female patient referred to emergency room with skin and soft tissue injuries on bilateral anteromedial thigh area as a result of battery explosion. The widest axis of skin defect was approximately 16 × 8 cm on the right side, and 17 × 4 cm on the left side. In addition, there were tattooing caused by chemical injury and multiple pin-point like lesions extending to dermal level on anterior region of thigh. Chemically dirty and necrotized dermal and subdermal tissues were debrided and foreign materials were removed from regions with multiple tattooing. Left thigh was closed primarily. In order to close the defect on right anterior thigh, skin flap from right medial thigh is advanced in Y–V fashion. Discussion Battery explosion causing lower extremity tissue defect is a type of injury that is rarely seen in the literature. Regardless of battery size and energy level, they should be considered as potential explosive material and protector masks, clothing should be worn during contact with this type of material. PMID:26862395

  12. News You Can Use: The Knee Anterolateral Ligament and the ISAKOS Journal.

    PubMed

    Lubowitz, James H; Provencher, Matthew T; Rossi, Michael J; Brand, Jefferson C

    2016-05-01

    The knee anterolateral ligament may be fiction, but we thought it fact. As true anatomic restoration of the anterior cruciate ligament (ACL) may not be possible today, we are open to the possibility that lateral augmentation of ACL reconstruction could be of benefit in some patients. PMID:27151446

  13. Anterolateral Portal Is Less Painful than Superolateral Portal in Knee Intra-Articular Injection

    PubMed Central

    Lee, Sung Yup; GN, Kiran Kumar; Chung, Byung June; Lee, Sang Wook

    2015-01-01

    Purpose Intra-articular knee injections are commonly performed in clinical practice for treating various knee joint disorders such as osteoarthritis and rheumatoid arthritis. When selecting the portal for injection, not only intra-articular needle accuracy but also procedural pain should be taken into consideration. The purpose of this study was to determine whether injection through anterolateral portal provokes less pain and provides better pain relief compared to superolateral portal. Materials and Methods A total of 60 patients with primary osteoarthritis of the knee receiving intra-articular injections were randomized into 2 groups according to the type of portal approach; anterolateral or superolateral. All patients received hyaluronic acid (20 mg) and triamcinolone (40 mg) as the first injection followed by second and third injections of hyaluronic acid on a weekly basis. Underlying knee pain, procedural pain, and knee pain at 4 weeks were evaluated using visual analogue scale (VAS). Results Injection through anterolateral portal provoked less pain (VAS, 1.5±1.3) than the superolateral portal (VAS, 1.5 vs. 2.7; p=0.004). No differences were found in the degree of pain relief at weeks between the two groups (p=0.517). Conclusions We recommend the use of anterolateral portal for intra-articular knee injection as it provokes less pain and comparably short-term pain relief than the superolateral portal. PMID:26676089

  14. Biomechanical Analysis of Simulated Clinical Testing and Reconstruction of the Anterolateral Ligament of the Knee

    PubMed Central

    Spencer, Luke; Burkhart, Timothy A.; Tran, Michael N.; Rezansoff, Alex James; Deo, Shaneel; Caterine, Scott; Getgood, Alan M

    2016-01-01

    Background: Anatomic anterolateral ligament (ALL) reconstruction has been proposed to assist anterior cruciate ligament (ACL) reconstruction in controlling anterolateral rotational laxity of the knee. However, the biomechanical effects have not been reported. Purpose: (1) To investigate the effect of ALL transection on rotational knee kinematics and (2) to determine the effect on knee biomechanics of ALL reconstruction procedures compared with lateral extra-articular tenodesis (LET). Study Design: Controlled laboratory study. Methods: A total of 12 cadaveric knee specimens were tested in the following sequence: (1) ACLintact, (2) anteromedial bundle of ACL sectioned (ACLamb), (3) complete ACL sectioned (ACLfull), (4) ALL sectioned (ALLsec), (5) anatomic ALL reconstruction (ALLanat), and (6) LET. Biomechanical anterior drawer and Lachman tests were performed in which a 90-N load was applied to the posterior tibia, and anterior translation was measured. A combined load to simulate the early phase of the pivot-shift test was executed in which a 5-N·m internal rotation moment was applied to a fully extended knee; anterior translation and internal rotation were measured. Results: Anterior translation increased across conditions for the biomechanical tests. Internal rotation during the simulated early-phase pivot-shift test was significantly different between ACLfull and ALLsec. Anatomic ALL reconstruction did not significantly reduce internal rotation or anterior translation during the simulated early-phase pivot-shift test. After LET, a significant decrease in anterior translation was found. There was no evidence of over-constraint of the knee with either anatomic ALL reconstruction or LET. Conclusion: The ALL demonstrated a role in controlling anterolateral laxity. LET had a composite effect in governing both anterior and rotational laxity. Anatomic ALL reconstruction did not reduce anterolateral rotational laxity. Clinical Relevance: Profiling the biomechanical

  15. Missed acute appendicitis presenting as necrotising fasciitis of the thigh

    PubMed Central

    Taif, Sawsan; Alrawi, Asif

    2014-01-01

    Necrotising fasciitis is a rapidly progressive soft tissue infection that leads to diffuse tissue necrosis. It is associated with systemic toxicity and rapid deterioration resulting in high mortality. Rapid diagnosis and prompt treatment are essential to improve the outcome. We report the case of a 26-year-old woman who presented with severe thigh pain and swelling associated with irritability of a few hours’ duration following 2 days history of right abdominal pain. Urgent MRI and CT scan showed features of necrotising fasciitis in the thigh spreading from an inflamed appendix. Emergency surgery was performed which revealed perforated appendix with disseminated infection in the intraperitoneal and retroperitoneal spaces as well as the right thigh. The patient rapidly deteriorated with evidence of sepsis, shock and renal impairment. In spite of surgery and all supportive measures, she succumbed shortly postoperatively. Blood culture revealed Staphylococcus aureus and Streptococci, while tissue culture showed growth of Escherichia coli and proteus. PMID:24792028

  16. Missed acute appendicitis presenting as necrotising fasciitis of the thigh.

    PubMed

    Taif, Sawsan; Alrawi, Asif

    2014-01-01

    Necrotising fasciitis is a rapidly progressive soft tissue infection that leads to diffuse tissue necrosis. It is associated with systemic toxicity and rapid deterioration resulting in high mortality. Rapid diagnosis and prompt treatment are essential to improve the outcome. We report the case of a 26-year-old woman who presented with severe thigh pain and swelling associated with irritability of a few hours' duration following 2 days history of right abdominal pain. Urgent MRI and CT scan showed features of necrotising fasciitis in the thigh spreading from an inflamed appendix. Emergency surgery was performed which revealed perforated appendix with disseminated infection in the intraperitoneal and retroperitoneal spaces as well as the right thigh. The patient rapidly deteriorated with evidence of sepsis, shock and renal impairment. In spite of surgery and all supportive measures, she succumbed shortly postoperatively. Blood culture revealed Staphylococcus aureus and Streptococci, while tissue culture showed growth of Escherichia coli and proteus. PMID:24792028

  17. Idiopathic perniosis of the buttocks and thighs - clinical report.

    PubMed

    António, Ana Marta; Alves, João; Matos, Diogo; Coelho, Ricardo

    2015-01-01

    Perniosis manifests as inflammatory cutaneous lesions mostly located on acral skin in association with cold and damp conditions. Perniosis of the thighs is quite uncommon and has been associated in the literature with horse riding (equestrian perniosis) or with other recreational activities with long time exposure to cold and humidity. We report a rare case of perniosis of the buttocks and thighs in a 34-year-old healthy woman without a previous history of horse riding or other high-risk activities. In this case, the use of thin and tight clothes is believed to have been enough for the development of perniosis in this susceptible subject. PMID:25612119

  18. Liposarcoma of the thigh with mixed calcification and ossification.

    PubMed

    Child, Jeremy R; Young, Colin R; Amini, Behrang

    2016-09-01

    Liposarcoma is one of the most common soft-tissue sarcomas. Calcification and ossification can occur in liposarcoma; however, the presence of both ossification and calcification is a very rare entity. We present a case of a partially calcified and ossified dedifferentiated liposarcoma of the thigh in a 76-year-old woman, which contained heterologous elements of chondrosarcoma and rhabdomyosarcoma. PMID:27594953

  19. Pudendal thigh flap for repair of rectovaginal fistula.

    PubMed

    Sathappan, S; Rica, M A I

    2006-08-01

    The pudendal thigh flap or the Singapore flap is a versatile flap that can be used in the repair of recto-vaginal fistulae. Apart from the potential problem of hair growth, this neurovascular flap proves to be surprisingly simple in technique, robust and has a high potential for normal or near-normal function. PMID:17240589

  20. 78 FR 68906 - Agency Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire) Under...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-11-15

    ... AFFAIRS Agency Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire) Under... Disability Benefits Questionnaire)'' in any correspondence. FOR FURTHER INFORMATION CONTACT: Crystal Rennie... and Thigh Conditions Disability Benefits Questionnaire''. SUPPLEMENTARY INFORMATION: Title: Hip...

  1. 78 FR 36304 - Proposed Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire...

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-06-17

    ... AFFAIRS Proposed Information Collection (Hip and Thigh Conditions Disability Benefits Questionnaire... Disability Benefits Questionnaire)'' in any correspondence. During the comment period, comments may be viewed.... SUPPLEMENTARY INFORMATION: ] Title: Hip and Thigh Conditions Disability Benefits Questionnaire, VA Form...

  2. Knee extension strength and post-operative functional prediction in quadriceps resection for soft-tissue sarcoma of the thigh

    PubMed Central

    Tanaka, A.; Aoki, K.; Kito, M.; Okamoto, M.; Suzuki, S.; Momose, T.; Kato, H.

    2016-01-01

    Objectives Our objective was to predict the knee extension strength and post-operative function in quadriceps resection for soft-tissue sarcoma of the thigh. Methods A total of 18 patients (14 men, four women) underwent total or partial quadriceps resection for soft-tissue sarcoma of the thigh between 2002 and 2014. The number of resected quadriceps was surveyed, knee extension strength was measured with the Biodex isokinetic dynamometer system (affected side/unaffected side) and relationships between these were examined. The Musculoskeletal Tumor Society (MSTS) score, Toronto Extremity Salvage Score (TESS), European Quality of Life-5 Dimensions (EQ-5D) score and the Short Form 8 were used to evaluate post-operative function and examine correlations with extension strength. The cutoff value for extension strength to expect good post-operative function was also calculated using a receiver operating characteristic (ROC) curve and Fisher’s exact test. Results Extension strength decreased when the number of resected quadriceps increased (p < 0.001), and was associated with lower MSTS score, TESS and EQ-5D (p = 0.004, p = 0.005, p = 0.006, respectively). Based on the functional evaluation scales, the cutoff value of extension strength was 56.2%, the equivalent to muscle strength with resection of up to two muscles. Conclusion Good post-operative results can be expected if at least two quadriceps muscles are preserved. Cite this article: A. Tanaka, Y. Yoshimura, K. Aoki, M. Kito, M. Okamoto, S. Suzuki, T. Momose, H. Kato. Knee extension strength and post-operative functional prediction in quadriceps resection for soft-tissue sarcoma of the thigh. Bone Joint Res 2016;5:232–238. DOI: 10.1302/2046-3758.56.2000631. PMID:27317788

  3. Combined anterolateral ligament and anatomic anterior cruciate ligament reconstruction of the knee.

    PubMed

    Smith, James O; Yasen, Sam K; Lord, Breck; Wilson, Adrian J

    2015-11-01

    Although anatomic anterior cruciate ligament (ACL) reconstruction is established for the surgical treatment of anterolateral knee instability, there remains a significant cohort of patients who continue to experience post-operative instability. Recent advances in our understanding of the anatomic, biomechanical and radiological characteristics of the native anterolateral ligament (ALL) of the knee have led to a resurgent interest in reconstruction of this structure as part of the management of knee instability. This technical note describes our readily reproducible combined minimally invasive technique to reconstruct both the ACL and ALL anatomically using autologous semitendinosus and gracilis grafts. This method of ALL reconstruction can be easily integrated with all-inside ACL reconstruction, requiring minimal additional operative time, equipment and expertise. Level of evidence V. PMID:26387120

  4. Minimally Invasive Anterolateral Ligament Reconstruction in the Setting of Anterior Cruciate Ligament Injury.

    PubMed

    Sonnery-Cottet, Bertrand; Barbosa, Nuno Camelo; Tuteja, Sanesh; Daggett, Matt; Kajetanek, Charles; Thaunat, Mathieu

    2016-02-01

    Recent evidence on the anatomy, function, and biomechanical properties of the anterolateral ligament has led to the recognition of the importance of this structure in the rotational control of the knee. This article describes a technique that allows for minimally invasive anterolateral ligament reconstruction as a complement to most techniques of anterior cruciate ligament reconstruction. A gracilis tendon autograft is harvested and prepared in a double-strand, inverted V-shaped graft. The graft is percutaneously placed through a femoral stab incision, and each strand is then passed deep to the iliotibial band, emerging through each tibial stab incision. After the femoral-end loop graft is fixed, the tibial fixation of each strand is performed in full extension for optimal isometry. PMID:27274456

  5. Triple pelvic osteotomy in Legg-Calvé-Perthes disease using a single anterolateral incision.

    PubMed

    O'Connor, Philip A; Mulhall, Kevin J; Kearns, Stephen R; Sheehan, Eoin; McCormack, Damien; Mullhall, Kevin J

    2003-11-01

    Pelvic osteotomy has a small role to play in the management of Legg-Calvé-Perthes disease. Residual acetabular dysplasia or incongruity can be corrected by rotational acetabuloplasty. In skeletally immature patients this can be performed by complete or incomplete innominate osteotomies. We present the case of a 12-year-old child with residual acetabular dysplasia, resulting from Legg-Calvé-Perthes disease, which was treated by a triple pelvic osteotomy performed by a small single anterolateral incision. PMID:14530696

  6. Congenital anterolateral bowing of the tibia with ipsilateral polydactyly of the great toe.

    PubMed

    Kitoh, H; Nogami, H; Hattori, T

    1997-12-31

    We report on two cases of congenital unilateral anterolateral bowing and focal defect of the tibia associated with ipsilateral polydactyly of the great toe. Computed tomographic examination showed an unusual partial cleft of the tibia at the site of bowing. A long follow-up of one patient showed spontaneous resolution of the bowing without progression to pseudoarthrosis. These anomalies should be considered as a new entity related to the tibial developmental field. PMID:9415465

  7. Articular capsule repair in initial artificial hip replacement via anterolateral approach to the hip joint.

    PubMed

    Zhang, B L; Wang, F; Tian, M B; Yin, W L; You, X Y; Li, D; Ma, L G; Xing, L Q

    2016-01-01

    This study was carried out to explore articular capsule repair in first artificial hip replacement (AHR) via anterolateral approach and its influence on postoperative dislocation. A total of 292 patients who received AHR via anterolateral approach and had the articular capsule repaired in People’s Hospital of Zhengzhou (Henan, China) from February 2008 to February 2014 were selected and divided into total hip replacement (THR) group (group A1) and artificial femoral head replacement (AFHR) group (group A2). Five hundred and five cases in the control group treated using the same approach but receiving no articular capsule repair were divided into THR group (group B1) and AFHR group (group B2). Condition of postoperative dislocation was compared between the two groups. All cases were followed up for 6 months to 5 years (average: 3.75 years); it was noted that the difference in average age, gender, disease constitution and follow-up time in the two groups was not significant (P>0.05). Moreover, groups A1 and B1 were found with 1 case of early hip joint dislocation (0.73%) and 13 cases of hip joint dislocation (5.24%) respectively post-operatively, and the comparison between the two groups was statistically significant (P less than 0.05). One case of hip joint dislocation (0.65%) was found in group A2 and 5 cases (1.95%) in group B2 in early post operation and the difference between two groups had no statistical significance (P>0.05). Neither the repair group nor the control group developed late-onset dislocation after the operation. Thus, we can state that articular capsule repair is feasible during the first AHR via anterolateral approach, which decreases the occurrence of early hip joint dislocation after operation and proves that repairing articular capsule during AFHR via anterolateral approach is unnecessary. PMID:27358130

  8. Combined Anterior and Anterolateral Stabilization of the Knee With the Iliotibial Band.

    PubMed

    Lutz, Christian; Sonnery-Cottet, Bertrand; Imbert, Pierre; Barbosa, Nuno Camelo; Tuteja, Sanesh; Jaeger, Jean-Henri

    2016-04-01

    Interest and knowledge on the anatomy, function, and biomechanical properties of the anterolateral ligament has led to the recognition of the importance of this structure in rotational control of the knee. This article describes a technique that allows for a combined anterior cruciate ligament (ACL) and anterolateral reconstruction, using an Iliotibial band (ITB) autograft. The graft is detached from the vastus lateralis from proximal to distal, at the center portion from ITB, preserving its distal insertion on the Gerdy tubercle. Its width is 1 cm for the distal part, used for the anterolateral ligament reconstruction, and 3 cm for the proximal part. An outside-in femoral tunnel is drilled respecting both the preferred favorable isometric femoral insertion site and the femoral ACL footprint. An ACL reconstruction combined with a lateral tenodesis with a continuous ITB graft respects the anatomical and isometric rules providing superior internal rotational control of the knee in comparison with a stand-alone ACL reconstruction. PMID:27354943

  9. Muscle oxygen saturation heterogeneity among leg muscles during ramp exercise.

    PubMed

    Takagi, Shun; Kime, Ryotaro; Niwayama, Masatsugu; Murase, Norio; Katsumura, Toshihito

    2013-01-01

    We examined whether O(2) saturation in several leg muscles changes as exercise intensity increases. Twelve healthy young males performed 20 W/min ramp bicycle exercise until exhaustion. Pulmonary O(2) uptake (VO(2)) was monitored continuously during the experiments to determine peak oxygen uptake. Muscle O(2) saturation (SmO(2)) was also monitored continuously at the belly of the vastus lateralis (VL), rectus femoris, vastus medialis, biceps femoris, gastrocnemius lateralis, gastrocnemius medialis, and tibialis anterior by near-infrared spatial resolved spectroscopy. Although the VL muscle mainly contributes during cycling exercise, deoxygenation was enhanced not only in the VL muscle but also in the other thigh muscles and lower leg muscles with increased exercise intensity. Furthermore, SmO(2) response during ramp cycling exercise differed considerably between leg muscles. PMID:22879044

  10. Complications Associated With Medial Thigh Lift: A Comprehensive Literature Review

    PubMed Central

    Sisti, Andrea; Cuomo, Roberto; Zerini, Irene; Tassinari, Juri; Brandi, Cesare; Grimaldi, Luca; D’Aniello, Carlo; Nisi, Giuseppe

    2015-01-01

    Medial contouring of the thigh is frequently requested to improve appearance and function of medial thigh deformities, following massive weight loss or aging process. This surgical procedure can be associated with a significant rate of complications. Our aim was to consider the complications and outcomes according to the performed technique, through a wide and comprehensive review of the literature. A search on PubMed/Medline was performed using “medial thighplasty”, “medial thigh lifting” and “technique” as key words. As inclusion criteria, we selected the clinical studies describing techniques of medial thighplasty. We excluded the papers in which complications related to medial thighplasty were not specified. We also excluded literature-review articles. We found 16 studies from 1988 to 2015. Overall, 447 patients were treated. Different techniques were applied. Complications were observed in 191/447 patients (42.72%). The most frequent complications were wound dehiscence(18.34%) and seroma (8.05%). No major complications, such as thromboembolism and sepsis, were observed. Minor complications occurred in a high percent of patients, regardless of the performed surgical procedure. Patients should be informed about the possible occurrence of wound dehiscence and seroma, as common complications associated with this surgical procedure. PMID:26865783

  11. Complications Associated With Medial Thigh Lift: A Comprehensive Literature Review.

    PubMed

    Sisti, Andrea; Cuomo, Roberto; Zerini, Irene; Tassinari, Juri; Brandi, Cesare; Grimaldi, Luca; D'Aniello, Carlo; Nisi, Giuseppe

    2015-01-01

    Medial contouring of the thigh is frequently requested to improve appearance and function of medial thigh deformities, following massive weight loss or aging process. This surgical procedure can be associated with a significant rate of complications. Our aim was to consider the complications and outcomes according to the performed technique, through a wide and comprehensive review of the literature. A search on PubMed/Medline was performed using "medial thighplasty", "medial thigh lifting" and "technique" as key words. As inclusion criteria, we selected the clinical studies describing techniques of medial thighplasty. We excluded the papers in which complications related to medial thighplasty were not specified. We also excluded literature-review articles. We found 16 studies from 1988 to 2015. Overall, 447 patients were treated. Different techniques were applied. Complications were observed in 191/447 patients (42.72%). The most frequent complications were wound dehiscence(18.34%) and seroma (8.05%). No major complications, such as thromboembolism and sepsis, were observed. Minor complications occurred in a high percent of patients, regardless of the performed surgical procedure. Patients should be informed about the possible occurrence of wound dehiscence and seroma, as common complications associated with this surgical procedure. PMID:26865783

  12. High prevalence of anterolateral ligament abnormalities in magnetic resonance images of anterior cruciate ligament-injured knees.

    PubMed

    Claes, Steven; Bartholomeeusen, Stijn; Bellemans, Johan

    2014-03-01

    The purpose of this study was to identify the newly described anterolateral ligament of the human knee on magnetic resonance imaging and to describe its eventual radiological abnormalities in anterior cruciate ligament-injured subjects. A retrospective cohort study on a series of consecutive subjects undergoing anterior cruciate ligament reconstructive surgery was performed. The MR images of 206 included knees were studied and the status of the anterolateral ligament status was judged to be either "non-visualized", "normal" or "abnormal". Of all the visualized anterolateral ligaments, 44 (21.3%) were considered uninjured, while 162 (78.8%) knees demonstrated radiological ALL abnormalities. The majority of ALL abnormalities were situated in the distal part of the ligament (77.8%). In conclusion, the anterolateral ligament can be identified on classic knee magnetic resonance images. Although anterior cruciate ligament injured subjects often demonstrated associated anterolateral ligament lesions, further research is needed in order to establish the clinical relevance of these highly frequent radiological abnormalities. PMID:24873084

  13. Morphological and functional relationships with ultrasound measured muscle thickness of the lower extremity: a brief review.

    PubMed

    Abe, Takashi; Loenneke, Jeremy P; Thiebaud, Robert S

    2015-08-01

    Ultrasound is a potential method for assessing muscle size of the extremity and trunk. In a large muscle, however, a single image from portable ultrasound measures only muscle thickness (MT), not anatomical muscle cross-sectional area (CSA) or muscle volume (MV). Thus, it is important to know whether MT is related to anatomical CSA and MV in an individual muscle of the extremity and trunk. In this review, we summarize previously published articles in the lower extremity demonstrating the relationships between ultrasound MT and muscle CSA or MV as measured by magnetic resonance imaging and computed tomography scans. The relationship between MT and isometric and isokinetic joint performance is also reviewed. A linear relationship is observed between MT and muscle CSA or MV in the quadriceps, adductor, tibialis anterior, and triceps surae muscles. Intrarater correlation coefficients range from 0.90 to 0.99, except for one study. It would appear that anterior upper-thigh MT, mid-thigh MT and posterior thigh MT are the best predictors for evaluating adductor, quadriceps, and hamstrings muscle size, respectively. Despite a limited number of studies, anterior as well as posterior lower leg MT appear to reflect muscle CSA and MV of the lower leg muscles. Based on previous studies, ultrasound measured anterior thigh MT may be a valuable predictor of knee extension strength. Nevertheless, more studies are needed to clarify the relationship between lower extremity function and MT. PMID:27433253

  14. [TREATMENT OF POST-SPONDYLODESIS, ADJACENT-SEGMENT DISEASE WITH MINIMALLY INVASIVE, ANTEROLATERAL SURGERY ON THE LUMBAR SPINE: IS THERE IS NO NEED FOR DORSAL OPERATION?].

    PubMed

    Schwarcz, Attila; Szakály, Péter; Büki, András; Dóczi, Tamás

    2015-07-30

    Adjacent segment disease (ASD) occurs with a probability of 30% in the lumbar spine following spinal fusion surgery. Usually advanced degenerative changes happen cranially to the fused lumbar segment. Thus, secondary spinal instability, stenosis, spodylolisthesis, foraminal stenosis can lead to the recurrence of the pain not always amenable to conservative measures. A typical surgical solution to treat ASD consists of posterior revision surgery including decompression, change or extension of the instrumentation and fusion to the rostral level. It results in a larger operation with considerable risk of complications. We present a typical case of ASD treated surgically with a new minimally invasive method not yet performed in Hungary. We use anterolateral abdominal muscle splitting approach to reach the lumbar spine through the retroperitoneum. A discectomy is performed by retracting the psoas muscle dorsally. The intervertebral bony fusion is achieved by implanting a cage with large volume that is stuffed with autologous bone or tricalcium phosphate. A cage with large volume results in excellent annulus fibrosus tension, immediate stability and provides large surface for bony fusion. A stand-alone cage construct can be supplemented with lateral screw/rod/plate fixation. The advantage of the new technique for the treatment of ASD includes minimal blood loss, short operation time, significantly less postoperative pain and much lower complication rate. PMID:26380422

  15. Hybrid Anterolateral Approach for Open Reduction and Internal Fixation of Femoral Neck Fractures.

    PubMed

    Vopat, Bryan G; Daniels, Alan H; Lareau, Craig R; Christino, Melissa A; Kane, Patrick M; Hayda, Roman A; Born, Christopher T

    2015-07-01

    Displaced femoral neck fractures in physiologically young patients are best treated with anatomic reduction and stable fixation. Several surgical approaches to the femoral neck have previously been described, although they are fraught with disadvantages such as poor visualization, the need for 2 incisions, and risk of injury to the lateral femoral cutaneous nerve and branches of the medial femoral circumflex artery. The authors' hybrid anterolateral approach to the hip allows for excellent visualization of femoral neck fractures and for placement of plate and/or screw constructs through a single incision. This surgical technique additionally minimizes risk to neurovascular structures. PMID:26186310

  16. Glomus Tumor Causing Anterior Thigh Pain: A Case Report

    PubMed Central

    So, Sang Young; Kim, Byng Mook; Lee, Sun Yeul; Shin, Yong Sup; Lee, Won Hyung

    2014-01-01

    Glomus tumors are a rare, benign neoplasm and 75% exist in the subungual region. Extradigital glomus tumors are much more difficult to diagnose because of their atypical location and symptoms. Furthermore, if their symptoms are similar to neuropathic pain, the patient can suffer from misdirected treatment due to misdiagnosis. It is essential to perform careful evaluation of the lesion itself in order to reduce misdiagnosis. Ultrasonography is a useful, non-invasive method that can be easily performed in the pain clinic for local evaluation and diagnosis. We report a case of misdiagnosed glomus tumor in the thigh which was properly diagnosed after ultrasonography. PMID:24748947

  17. Muscle imaging data in late-onset Pompe disease reveal a correlation between the pre-existing degree of lipomatous muscle alterations and the efficacy of long-term enzyme replacement therapy

    PubMed Central

    Gruhn, Kai Michael; Heyer, Christoph Malte; Güttsches, Anne-Katrin; Rehmann, Robert; Nicolas, Volkmar; Schmidt-Wilcke, Tobias; Tegenthoff, Martin; Vorgerd, Matthias; Kley, Rudolf Andre

    2015-01-01

    Background Late-onset Pompe disease (LOPD) is a metabolic myopathy caused by mutations in GAA and characterized by proximal muscle weakness and respiratory insufficiency. There is evidence from clinical studies that enzyme replacement therapy (ERT) with human recombinant alpha-glucosidase improves motor performance and respiratory function in LOPD. Objective We analyzed quantitative muscle MRI data of lower limbs to evaluate the effects of long-term ERT on muscle parameters. Methods Three symptomatic LOPD patients who received ERT for five years and four untreated presymptomatic LOPD patients were included in the study. T1-weighted MRI images were used to determine volumes of thigh and lower leg muscles. In addition, mean gray values of eight individual thigh muscles were calculated to assess the degree of lipomatous muscle alterations. Results We detected a decrease in thigh muscle volume of 6.7% (p < 0.001) and an increase in lower leg muscle volume of 8.2% (p = 0.049) after five years of ERT. Analysis of individual thigh muscles revealed a positive correlation between the degree of lipomatous muscle alterations at baseline and the increase of gray values after five years of ERT (R2 = 0.68, p < 0.001). Muscle imaging in presymptomatic patients showed in one case pronounced lipomatous alteration of the adductor magnus muscle and mild to moderate changes in further thigh muscles. Conclusions The results demonstrate that fatty muscle degeneration can occur before clinical manifestation of muscle weakness and suggest that mildly affected muscles may respond better to ERT treatment than severely involved muscles. If these findings can be validated by further studies, it should be discussed if muscle alterations detected by muscle MRI may be an objective sign of disease manifestation justifying an early start of ERT in clinically asymptomatic patients in order to improve the long-term outcome. PMID:26937398

  18. Minimally Invasive Plate Osteosynthesis of Distal Tibia and Fibular Fractures Through a Single Distal Anterolateral Incision.

    PubMed

    Unlu, Serhan; Catma, Mehmet F; Bilgetekin, Yenel G; Altay, Murat; Ates, Yalim; Bozkurt, Murat; Kapicioglu, Mehmet I Safa

    2015-01-01

    Treating distal tibia fractures is often challenging given the extent of soft tissue damage around the fracture and the risk of infection and other complications with internal fixation and the accompanying incisions. Minimally invasive plate osteosynthesis minimizes these complications and can be performed through a single incision. From April 2009 to January 2011, we treated 20 patients who had both tibial and fibular distal fractures through a distal anterolateral approach with this technique. The mean follow-up period was 15.5 (range 12 to 26) months. The mean interval to bony union was 21 (range 18 to 25) weeks. A 5° varus deformity was found in 1 patient. Another patient, who had a history of alcohol consumption and smoking, developed wound necrosis that was treated successfully with debridement and without skin grafting. The mean American Orthopaedic Foot and Ankle Society score for all patients was 91.8 (range 84 to 97). The anterolateral, minimally invasive plate osteosynthesis technique is a useful method for treating distal tibial and fibular fractures at the same level, with a low complication rate. PMID:26190782

  19. Open Reduction and Internal Fixation of the Tibial Plateau Through the Anterolateral Approach.

    PubMed

    Hake, Mark E; Goulet, James A

    2016-08-01

    Fractures of the tibial plateau are challenging injuries to treat. The lateral tibial plateau is fractured more commonly than the medial plateau and the workhorse approach for these fractures is the anterolateral approach. This approach allows visualization of the lateral joint, metaphysis, and can be extensile if there is shaft extension. We present our technique for performing the anterolateral approach while treating a Schatzker III tibial plateau fracture. Special attention is given to performing a submeniscal arthrotomy to view the joint surface and judge the reduction. A femoral distractor is placed to assist with elevation the joint surface and visualization of the lateral plateau. A cortical window is created using a triple reamer from the sliding hip screw set. The reduction is performed and supported with cancellous bone chips. Finally, a lateral locking plate with rafting screws is placed. Knowledge of this approach and the strategies needed to address lateral and some bicondlar tibial plateau fractures are crucial to good patient outcomes. PMID:27441932

  20. Legacy effects of short-term intentional weight loss on total body and thigh composition in overweight and obese older adults

    PubMed Central

    Chmelo, E A; Beavers, D P; Lyles, M F; Marsh, A P; Nicklas, B J; Beavers, K M

    2016-01-01

    Objective: Weight regain following intentional weight loss may negatively impact body composition, accelerating fat regain and increasing risk of physical disability. The purpose of this study was to compare long-term changes in whole body and thigh composition in obese older adults who intentionally lost and then partially regained weight to obese older adults who remained weight stable. Subjects/Methods: This pilot study analyzed total body (dual-energy X-ray absorptiometry (DXA)) and thigh (computed tomography (CT)) composition data collected from 24 older (65–79 years) adults 18 months after completion of a 5-month randomized trial that compared resistance training alone (RT) with RT plus caloric restriction (RT+CR). Results: Mean loss of body mass in the RT+CR group (n=13) was 7.1±2.4 kg during the 5-month intervention (74% fat mass; 26% lean mass; all P<0.01), whereas RT (n=11) remained weight stable (+0.3±1.8 kg; P=0.64). Differential group effects were observed for all DXA and CT body composition measures at 5 months (all P⩽0.01); however, by 23 months, group differences persisted only for total body (RT+CR: 81.6±10.0 kg vs RT: 88.5±14.9 kg; P=0.03) and lean (RT+CR: 50.8±9.3 kg vs RT: 54.4±12.0 kg; P<0.01) mass. All RT+CR participants regained weight from 5 to 23 months (mean gain=+4.8±2.6 kg; P<0.01). Total fat mass and all thigh fat volumes increased, whereas thigh muscle volume decreased, during the postintervention follow-up in RT+CR (all P⩽0.01). In the RT group, body mass did not change from 5 to 23 months (−0.2±0.9 kg; P=0.87). Decreased total thigh volume, driven by the loss of thigh muscle volume, were the only postintervention body composition changes observed in the RT group (both P<0.04). Conclusions: Short-term body composition benefits of an RT+CR intervention may be lost within 18 months after completion of the intervention. PMID:27043417

  1. Liposuction-Assisted Medial Thigh Lift in Obese and Non Obese Patients

    PubMed Central

    Aboueldahab, Abdelmohsen Khalaf

    2013-01-01

    Introduction: The abdomen, thighs and buttocks are often the areas of greatest concern to patients following massive weight loss due to bariatric surgery. The typical appearance of the patient who has lost a massive amount of weight derives from a combination of factors, including gender-dependent body morphology and a change in body mass index, which lead to skin and soft-tissue excess and poor skin tone. Thigh laxity and redundancy represents a great challenge to both patients and surgeons. Not only because of the difficulty to satisfy the patients, but also due to the higher incidence of complications especially, with those obese patients who have not undergone bariatric surgery before. The problems with such patients are due to the heavy thighs that require both debulking and tight anchorage to prevent scar migration or labial distortion. Aim of the Work: The aim of the present study is to improve the aesthetic outcome and avoid the complications of medial thigh lifting with simultaneous liposuction in obese and non-obese. Patients and Methods: A total of 25 female patients presented during the period from January 2007 to July 2011 complaining of moderate to severe thigh laxity with or without lipodystrophy. In 20 patients medial transverse thigh lift was performed, to treat medial thigh friction and laxity particularly in the upper half. Whereas, in the other five patients were suffering from upper and lower medial thigh bulkiness, vertical thigh lift was performed. Results: All patients recovered well in 2 weeks and showed improvement of thigh contour. Scar downward displacement in one patient. No skin necrosis or seroma. No labial distortion or separation encountered. Conclusion: Simultaneous liposuction and thigh lift gave good results provided proper patients selection, appropriate technique to each patient, meticulous, cautious liposuction and handling of the tissues and most importantly is the deep tight anchorage sutures to guard against the effect of

  2. Misdiagnosis of primary pleomorphic rhabdomyosarcoma of the right thigh in a young adult: A case report

    PubMed Central

    Yu, Xiaolong; Yang, Yong; Zhang, Bin; Liu, Hucheng; Guo, Runsheng; Dai, Min

    2016-01-01

    Pleomorphic rhabdomyosarcoma (PRMS) is a rare type of soft tissue tumor accounting for <2% of all adult sarcomas. The present study describes a case of a 28-year-old male patient with primary PRMS of the right thigh. The patient was initially diagnosed with a schwannoma and underwent conservative therapy at a local hospital. At the 6-month follow-up, the patient reported a marked increase in the size of the mass. Finally, the patient underwent fine-needle aspiration and total tumor resection. The tumor measured 11×9×5 cm3 in size and was located in the vastus intermedius muscle. According to histological and immunohistochemical findings, a diagnosis of PRMS was confirmed by an expert pathology consultant. Postoperative follow-up at 3 months revealed no evidence of recurrent disease or residual side effects from therapy. However, it is imperative that such cases are closely monitored following surgery, in order to evaluate the long-term efficacy of the procedure, since misdiagnosis may increase the risk of recurrence and metastasis. The present case is noteworthy due to the misdiagnosis of PRMS, the large size of the mass and the young age of the patient. PMID:27588141

  3. Delayed Carcass Deboning Results in Significantly Reduced Cook Yields of Boneless Skinless Chicken Thighs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Boneless skinless chicken thighs are a new deboned poultry product in the retail market. Three trials were conducted to investigate the effect of postmortem carcass deboning time on the cook yields of boneless skinless chicken thighs as well as boneless skinless chicken breasts. Broiler carcasses ...

  4. Saphenous vein forearm grafts and gortex thigh grafts as alternative forms of vascular access.

    PubMed

    Bhandari, S; Wilkinson, A; Sellars, L

    1995-11-01

    To compare the survival and complication rates of saphenous vein forearm grafts and gortex thigh grafts. Retrospective study over a twelve-year period with review of case-notes. Saphenous vein forearm grafts were constructed in 17 males and 12 females, mean age 61 years and gortex thigh grafts in 24 males and 22 females (49 grafts), mean age 49 years. Grafts were the primary form of access in 9 patients in each group. Follow-up was 45.6 and 135.2 patient years on dialysis for forearm grafts and thigh grafts respectively. One-year total survival was 89.4% (89.4% at 2 years and 71.5% at 3 years) and 84.9% (82.3% at 2 years and 70.4% at 3 years) for saphenous vein forearm grafts and gortex thigh grafts respectively. The overall complication rates were 0.22 and 0.61 per patient year on dialysis for saphenous vein forearm grafts and gortex thigh grafts respectively. Thrombosis occurred in 10% and 52%, infection in 0% and 35% and no complications in 62% and 24% of saphenous vein forearm grafts and gortex thigh grafts respectively. Both saphenous vein forearm grafts and gortex thigh grafts can provide satisfactory vascular access. The survival is similar at one year but gortex thigh grafts have a higher complication rate. PMID:8605714

  5. Graduated compression stockings: knee length or thigh length.

    PubMed

    Benkö, T; Cooke, E A; McNally, M A; Mollan, R A

    2001-02-01

    The mechanisms by which graduated compression stockings prevent deep venous thrombosis are not completely understood. In the current study the physiologic effect of low-pressure graduated compression stockings on the venous blood flow in the lower limb and the practical aspects of their use were assessed. Patients having elective orthopaedic surgery at a university orthopaedic department were randomized into five groups to wear two different types of graduated compression stockings in thigh and knee lengths. Patients in the fifth control group did not wear graduated compression stockings. Venous occlusion strain gauge plethysmography was used to measure venous flow. After 20-minutes bed rest there was a highly significant increase in venous capacitance and venous outflow in patients in all of the four groups wearing stockings. There was no difference in the mean of the percentage change of venous capacitance in patients in the four groups wearing stockings. The knee length Brevet stockings were less efficient in increasing the venous outflow. There was no significant change in the venous capacitance and venous outflow in patients in the control group. Visual assessment of the fit and use of stockings was done, and patients' subjective opinion of comfort was sought. The knee length graduated compression stockings wrinkled significantly less, and significantly fewer patients reported discomfort with them. All stockings were reported to be difficult to use. Thigh and knee length stockings have a significant effect on decreasing venous stasis of the lower limb. Knee length graduated compression stockings are similarly efficient in decreasing venous stasis, but they are more comfortable to wear, and they wrinkle less. PMID:11210954

  6. Open antero-lateral dislocation of the elbow. A case report

    PubMed Central

    Alonso, Juan A; Roy, Bibas R; Shaw, David L

    2002-01-01

    Background Open dislocations are infrequent, often associated with damage to the neuro vascular structures. We present an unusual case of an open antero-lateral dislocation of the elbow, which was not associated with any vascular or neural injury. Case presentation A 34 year female dance instructor sustained an open dislocation of her elbow. Surgical exploration was undertaken. No major neurovascular injury was present. There was almost complete disruption of all the muscular and ligamentous attachments to the distal humerus and the proximal radius and ulna, which were not formally repaired during surgery. The elbow was found to be very unstable, and was placed in a back slab. The functional recovery was complete in about six months, the patient regaining full range of elbow movement. Elbow dislocations without associate fractures are adequately treated by manipulation and reduction, in spite of the almost complete disruption of the soft tissues around the joint. PMID:11806760

  7. A Traumatic Bilateral Anterolateral Compartment Syndrome and Subsequent small Bowel Obstruction in a Patient with Schizophrenia

    PubMed Central

    Kapur, Benjamin Pal; Grant, Michael; Ramakrishnan, Muthukrishnan

    2015-01-01

    Introduction: A traumatic bilateral compartment syndrome is not widely reported. There is usually a precipitating event to cause compartment syndrome for example open and closed fractures, plaster of Paris application, burns and post-ischaemia reperfusion injury. This case confirms the need for a high index of suspicion for compartment syndrome in a patient presenting with bilateral leg pain, swelling and erythema as early diagnosis and urgent decompression by fasciotomy is of vital importance to preserve limb function and avoid complications. Case Report: We wish to report the case of atraumatic bilateral anterolateral compartment syndrome in a 58-year-old Caucasian man with a medical history of schizophrenia. He presented to Accident and Emergency with bilateral leg pain, swelling and erythema with no preceding history of trauma. Initially he was treated for bilateral lower leg cellulitis with a late diagnosis of compartment syndrome. Conclusion: This case illustrates the need for a broad differential diagnosis. PMID:27299031

  8. Step-by-Step Arthroscopic Assessment of the Anterolateral Ligament of the Knee Using Anatomic Landmarks.

    PubMed

    Zein, Assem Mohamed Nour Eldin

    2015-12-01

    New insights into the existence and function of the anterolateral ligament (ALL) of the knee have redirected and refocused attention on the secondary restraints of rotational stability of the knee. The importance of assessing the ALL is increasing, especially in anterior cruciate ligament reconstruction surgery, to decide on the need for an adjunctive extra-articular reconstruction of the ALL to control rotational instability of the knee. However, preoperative assessment of this ligament is difficult. Clinical assessment of rotatory instability has poor reproducibility. Moreover, it is difficult to assess by current imaging techniques. We describe an easy, simple, practical, safe, and reproducible arthroscopic technique to fully assess the ALL of the knee. PMID:27284519

  9. Vitamin C prevents the effects of high rearing temperatures on the quality of broiler thigh meat1.

    PubMed

    Ferreira, I B; Matos Junior, J B; Sgavioli, S; Vicentini, T I; Morita, V S; Boleli, I C

    2015-05-01

    We investigated the effects of incubation temperatures and vitamin C injections into eggs (treatments: 37.5ºC, 39ºC, 39ºC+vitamin C) on resultant chick pectoralis major and sartorius muscle fiber hypertrophy, as well as their effects on the quality of breast and over-thigh meat of broilers reared under cold, control, or hot temperatures. Incubation at 39ºC increased the shear force and reduced meat redness in breast meat (P < 0.05). Vitamin C prevented these high temperature incubation effects [shear force (kgf cm(-2)): 37.5ºC = 2.34, 39ºC = 2.79, 39ºC+vitamin C = 2.44; redness: 37.5ºC = 2.64, 39ºC = 1.90, 39ºC+vitamin C = 2.30], but reduced water content (37.5ºC = 74.81%, 39ºC = 74.53%, 39ºC+vitamin C = 69.39%) (P < 0.05). Cold rearing temperatures increased breast meat redness (a*: cold = 2.78, control = 2.12, hot = 1.98), while hot rearing temperatures reduced the muscle fiber area (cold = 5.413 μm(2), control = 5.612 μm(2), hot = 4.448 μm(2)) (P < 0.05) without altering meat quality (P > 0.05). Hot rearing temperatures increased the cooking loss (cold = 30.10%, control = 33.66%, hot = 37.01%), shear force (cold = 3.05 kgf cm(-2), control = 3.43 kgf cm(-2), hot = 4.29 kgf cm(-2)) and redness (a*: cold = 4.63, control = 3.55, hot = 3.20) in the over-thigh meat of broilers from eggs incubated at 37.5ºC, increasing the area of muscle fibers, while cold rearing temperatures diminished cooking loss and shear force, reducing the muscle fiber area (P < 0.05). Incubation at 39ºC and 39ºC+vitamin C prevented the effects of hot and cold rearing temperatures, by diminishing and increasing the muscle fiber area, respectively. PMID:25810411

  10. Muscle strength and endurance following lowerlimb suspension in man

    NASA Technical Reports Server (NTRS)

    Tesch, Per A.; Berg, Hans E.; Haggmark, Tom; Ohlsen, Hans; Dudley, Gary A.

    1991-01-01

    The effect of lower-limb suspension on the muscle strength and muscle endurance was investigated in six men subjected to four weeks of unilateral unloading of a lower limb (using of a harness attached to a modified shoe), followed by seven weeks of weight-bearing recovery. Results showed a decrease in the cross-sectional area (CSA) of the thigh muscle and in the average peak torque (APT) during three bouts of 30 concentric knee extensions. While the the thigh muscle CSA returned to normal after seven weeks of recovery, the APT recovery was still reduced by 11 percent, suggesting that muscle metabolic function was severely affected by unloading and was not restored by ambulation.

  11. MRI of the tibioastragalus anticus of Gruber muscle: a rare accessory muscle and normal anatomical variant.

    PubMed

    Berkowitz, Yaron; Mushtaq, Nadeem; Amiras, Dimitri

    2016-06-01

    We present the case of a 31-year-old man who sustained a hyperplantar flexion injury of his right ankle, and was evaluated using computed tomography and MRI to assess for osseous and ligamentous injury. The MRI and CT studies demonstrated a tibioastragalus anticus of Gruber (TAAG) muscle in the lower limb's anterior compartment. To our knowledge, the imaging of this muscle has not been previously described. The TAAG muscle arises from the lower third of the anterolateral tibia and the interosseous membrane. Its tendon passes laterally, deep to the tibialis anterior and extensor hallucis longus tendons, and inserts onto the anterior superolateral neck of the talus in a fan-like manner. Knowledge and recognition of this tendon are important for both diagnostic accuracy and surgical planning, and could potentially be used as a tendon transfer or graft in the appropriate clinical setting. The presence of this accessory muscle should not be confused with a pathological condition. PMID:27037809

  12. Muscle Size Not Density Predicts Variance in Muscle Strength and Neuromuscular Performance in Healthy Adult Men and Women.

    PubMed

    Weeks, Benjamin K; Gerrits, Tom A J; Horan, Sean A; Beck, Belinda R

    2016-06-01

    Weeks, BK, Gerrits, TAJ, Horan, SA, and Beck, BR. Muscle size not density predicts variance in muscle strength and neuromuscular performance in healthy adult men and women. J Strength Cond Res 30(6): 1577-1584, 2016-The purpose of this study was to determine the relationships between peripheral quantitative computed tomography (pQCT)-derived measures of muscle area and density and markers of muscle strength and performance in men and women. Fifty-two apparently healthy adults (26 men, 26 women; age 33.8 ± 12.0 years) volunteered to participate. Dual-energy x-ray absorptiometry (XR-800; Norland Medical Systems, Inc., Trumbull, CT, USA) was used to determine whole body and regional lean and fat tissue mass, whereas pQCT (XCT-3000; Stratec, Pforzheim, Germany) was used to determine muscle cross-sectional area (MCSA) and muscle density of the leg, thigh, and forearm. Ankle plantar flexor and knee extensor strengths were examined using isokinetic dynamometry, and grip strength was examined with dynamometry. Impulse generated during a maximal vertical jump was used as an index of neuromuscular performance. Thigh, forearm, and leg MCSA strongly predicted variance in knee extensor (R = 0.77, p < 0.001) and grip strength (R = 0.77, p < 0.001) and weakly predicted variance in ankle plantar flexor strength (R = 0.20, p < 0.001), respectively, whereas muscle density was only a weak predictor of variance in knee extensor strength (R = 0.18, p < 0.001). Thigh and leg MCSA accounted for 79 and 69% of the variance in impulse generated from a maximal vertical jump (p < 0.001), whereas thigh muscle density predicted only 18% of the variance (p < 0.002). In conclusion, we found that pQCT-derived muscle area is more strongly related to strength and neuromuscular performance than muscle density in adult men and women. PMID:26473521

  13. Kinematic characteristics of myositis ossificans of the semimembranosus muscle in a dog.

    PubMed

    Vilar, José Manuel; Ramirez, Gustavo; Spinella, Giuseppe; Martinez, Alfonso

    2010-03-01

    A 6-year-old Doberman pinscher dog was presented with myositis ossificans of the semimembranosus muscle. Linear, temporal, and angular kinematic patterns were recorded and compared with those of sound dogs of the same breed. The results indicate that the specific gait compensations occurring with this disease may aid in the diagnosis of myositis ossificans of the caudal thigh muscles. PMID:20514253

  14. Acute appendicitis presenting as thigh abscess in a child: a case report.

    PubMed

    Sharma, S B; Gupta, Vipul; Sharma, S C

    2005-04-01

    A case of retrocecal appendicitis is described in a 6-year-old male child who presented with thigh abscess. The presence of a positive psoas stretch test, feculent discharge, an enteric growth on bacteriological examination, and intraabdominal fluid collection on abdominal ultrasound provided clues to the presence of an intraabdominal source of sepsis. Laparotomy revealed a perforated retrocecal appendix with surrounding collection communicating into the thigh. Appendectomy with drainage of retroperitoneal and thigh collections under adequate antibiotic coverage resulted in a satisfactory recovery. We describe our experience with the present case and discuss the pertinent literature. PMID:15756560

  15. Your Muscles

    MedlinePlus

    ... Homework? Here's Help White House Lunch Recipes Your Muscles KidsHealth > For Kids > Your Muscles Print A A ... and skeletal (say: SKEL-uh-tul) muscle. Smooth Muscles Smooth muscles — sometimes also called involuntary muscles — are ...

  16. Combined Intra- and Extra-articular Reconstruction of the Anterior Cruciate Ligament: The Reconstruction of the Knee Anterolateral Ligament

    PubMed Central

    Helito, Camilo Partezani; Bonadio, Marcelo Batista; Gobbi, Riccardo Gomes; da Mota e Albuquerque, Roberto Freire; Pécora, José Ricardo; Camanho, Gilberto Luis; Demange, Marco Kawamura

    2015-01-01

    We present a new technique for the combined intra- and extra-articular reconstruction of the anterior cruciate ligament. Intra-articular reconstruction is performed in an outside-in manner according to the precepts of the anatomic femoral tunnel technique. Extra-articular reconstruction is performed with the gracilis tendon while respecting the anatomic parameters of the origin and insertion points and the path described for the knee anterolateral ligament. PMID:26258037

  17. In Vivo Assessment of Muscle Contractility in Animal Studies.

    PubMed

    Iyer, Shama R; Valencia, Ana P; Hernández-Ochoa, Erick O; Lovering, Richard M

    2016-01-01

    In patients with muscle injury or muscle disease, assessment of muscle damage is typically limited to clinical signs, such as tenderness, strength, range of motion, and more recently, imaging studies. Animal models provide unmitigated access to histological samples, which provide a "direct measure" of damage. However, even with unconstrained access to tissue morphology and biochemistry assays, the findings typically do not account for loss of muscle function. Thus, the most comprehensive measure of the overall health of the muscle is assessment of its primary function, which is to produce contractile force. The majority of animal models testing contractile force have been limited to the muscle groups moving the ankle, with advantages and disadvantages depending on the equipment. Here, we describe in vivo methods to measure torque, to produce a reliable muscle injury, and to follow muscle function within the same animal over time. We also describe in vivo methods to measure tension in the leg and thigh muscles. PMID:27492180

  18. Medial thigh pain: An unusual presentation of giant calculi in sigmoid neobladder

    PubMed Central

    Abrol, Nitin; Gupta, Narmada; Kumar, Rajeev

    2011-01-01

    Calculi in a neobladder usually present with irritative lower urinary tract symptoms, flank pain, and haematuria. We report a case of giant stones in a sigmoid neobladder, who presented with medial thigh pain. PMID:21814323

  19. Follicularly-based papules on the thigh of a young woman.

    PubMed

    Brahmbhatt, Shreena; Wu, Peggy A; Zimarowski, Mary Jane; Burgin, Susan

    2016-01-01

    Varicella zoster virus (VZV) is an uncommon cause of folliculitis. We present a case of a 29-year-old woman who presented with an atypical follicularly-based eruption localized to her inner thigh with an associated pain in her lower back and inner thigh prior to the papular eruption. She was successfully treated with valacyclovir 1,000 mg three times daily with no complications. PMID:26990477

  20. Treatment of Thoracolumbar Spinal Infections through Anterolateral Approaches Using Expandable Titanium Mesh Cage for Spine Reconstruction

    PubMed Central

    Roberto, Tarantino; Daniele, Marruzzo; Martina, Cappelletti; Tiziano, De Giacomo; Roberto, Delfini

    2012-01-01

    Pyogenic vertebral osteomyelitis (PVO) is still a rare pathology. However, its incidence is on the rise. This is due to an increasing population with predisposing factors. Also, the availability of more effective diagnostic tools has brought it increasingly to the surgeon's attention. In this study the patients were treated in the Neurosurgery Division of the Department of Neurological Sciences and Psychiatry of the Sapienza University of Rome, between 2001 and 2009. They had thoracolumbar pyogenic spondylitis. This study was undertaken in order to identify the correct diagnostic and therapeutic treatment needed in such cases. From the cases studied here, it is evident that spinal infections can be extremely insidious and that diagnosis tends to be reached late. Surgery, along with the antibiotic treatment, allows for eradication of the causes of the pathology by the reclamation of the affected region. Surgery is also fundamental in helping to recover vital functions and in restoring as much as possible the correct curvature of the rachises. The use of an anterolateral approach is dictated by the necessity of obtaining 360° stability as well as by the need to clear away extensive infections, which are not always reachable using a posterior approach. PMID:23193382

  1. Anterolateral minithoracotomy versus median sternotomy for mitral valve disease: a meta-analysis

    PubMed Central

    Ding, Chao; Jiang, Da-ming; Tao, Kai-yu; Duan, Qun-jun; Li, Jie; Kong, Min-jian; Shen, Zhong-hua; Dong, Ai-qiang

    2014-01-01

    Objective: Mitral valve disease tends to be treated with anterolateral minithoracotomy (ALMT) rather than median sternotomy (MS), as ALMT uses progressively smaller incisions to promote better cosmetic outcomes. This meta-analysis quantifies the effects of ALMT on surgical parameters and post-operative outcomes compared with MS. Methods: One randomized controlled study and four case-control studies, published in English from January 1996 to January 2013, were identified and evaluated. Results: ALMT showed a significantly longer cardiopulmonary bypass time (P=0.001) and aortic cross-clamp time (P=0.05) compared with MS. However, the benefits of ALMT were evident as demonstrated by a shorter length of hospital stay (P<0.00001). According to operative complications, the onset of new arrhythmias following ALMT decreased significantly as compared with MS (P=0.05); however, the incidence of peri-operative mortality (P=0.62), re-operation for bleeding (P=0.37), neurologic events (P=0.77), myocardial infarction (P=0.84), gastrointestinal complications (P=0.89), and renal insufficiency (P=0.67) were similar to these of MS. Long-term follow-up data were also examined, and revealed equivalent survival and freedom from mitral valve events. Conclusions: Current clinical data suggest that ALMT is a safe and effective alternative to the conventional approach and is associated with better short-term outcomes and a trend towards longer survival. PMID:24903989

  2. Two Cases of Lower Body Contouring with a Spiral and Vertical Medial Thigh Lift

    PubMed Central

    Kim, Sang Wha; Han, Hyun Ho; Seo, Je Won; Lee, Jung Ho; Oh, Deuk Young; Ahn, Sang Tae

    2012-01-01

    Massive weight loss results in skin excess, leading to an unsatisfying body contour. Various thigh lift procedures can correct flabby skin in the lower leg. We present a lower body contouring technique with a report on two patients. The procedure is determined by the body contour of the patient. As the skin excess in the thigh area tended to appear mostly on the medial side, a vertical medial thigh lift was considered. Moreover, for patients with a pear/guitar-shaped body contour, we added the spiral thigh lift for skin excess in the buttocks and the lateral thigh area. The extent of tissue to excise was determined by pinching the patient in a standing position. The inferior skin flap was fixed to non-movable tissue, which was helpful for lifting the tissue and preventing the widening of the scar. After the operation, a drain was kept for 3 to 4 days. A compressive garment was used after removing the drain. There were no complications. The patients were discharged 6 to 8 days after the operation. In conclusion, skin excess, especially in the lower body, can be corrected by a thigh lift combining several procedures, varying from person to person. PMID:22783496

  3. Two cases of lower body contouring with a spiral and vertical medial thigh lift.

    PubMed

    Kim, Sang Wha; Han, Hyun Ho; Seo, Je Won; Lee, Jung Ho; Oh, Deuk Young; Ahn, Sang Tae; Rhie, Jong Won

    2012-01-01

    Massive weight loss results in skin excess, leading to an unsatisfying body contour. Various thigh lift procedures can correct flabby skin in the lower leg. We present a lower body contouring technique with a report on two patients. The procedure is determined by the body contour of the patient. As the skin excess in the thigh area tended to appear mostly on the medial side, a vertical medial thigh lift was considered. Moreover, for patients with a pear/guitar-shaped body contour, we added the spiral thigh lift for skin excess in the buttocks and the lateral thigh area. The extent of tissue to excise was determined by pinching the patient in a standing position. The inferior skin flap was fixed to non-movable tissue, which was helpful for lifting the tissue and preventing the widening of the scar. After the operation, a drain was kept for 3 to 4 days. A compressive garment was used after removing the drain. There were no complications. The patients were discharged 6 to 8 days after the operation. In conclusion, skin excess, especially in the lower body, can be corrected by a thigh lift combining several procedures, varying from person to person. PMID:22783496

  4. Abdomen-thigh contact during forward reaching tasks in obese individuals.

    PubMed

    Singh, Bhupinder; Brown, Thomas D; Callaghan, John J; Yack, H John

    2013-10-01

    During seated forward reaching tasks in obese individuals, excessive abdominal tissue can come into contact with the anterior thigh. This soft tissue apposition acts as a mechanical restriction, altering functional biomechanics at the hip, and causing difficulty in certain daily activities such as bending down, or picking up objects from the floor. The purpose of the study was to investigate the contact forces and associated moments exerted by the abdomen on the thigh during seated forward-reaching tasks in adult obese individuals. Ten healthy subjects (age 58.1 ± 4.4) with elevated BMI (39.04 ± 5.02) participated in the study. Contact pressures between the abdomen and thigh were measured using a Tekscan Conformat pressure-mapping sensor during forward-reaching tasks. Kinematic and force plate data were obtained using an infrared motion capture system. The mean abdomen-thigh contact force was 10.17 ± 5.18% of body weight, ranging from 57.8 N to 200 N. Net extensor moment at the hip decreased by mean 16.5 ± 6.44% after accounting for the moment generated by abdomen-thigh tissue contact. In obese individuals, abdomen-thigh contact decreases the net moment at the hip joint during seated forward-reaching activities. This phenomenon should be taken into consideration for accurate biomechanical modeling in these individuals. PMID:23183157

  5. Hydatid cyst confined to the papillary muscle: a very rare cause of mitral regurgitation.

    PubMed

    Apaydin, Anil Z; Oguz, Emrah; Ayik, Fatih; Nalbantgil, Sanem; Ceylan, Naim

    2009-01-01

    Cardiac involvement of hydatid cysts is rare. Hydatidosis of the valvular apparatus can be treated successfully by the careful application of valvular surgical procedures. To the best of our knowledge, cardiac hydatidosis confined to the anterolateral papillary muscle has not been reported. Herein, we present a case involving a hydatid cyst that was located in a cardiac papillary muscle and that caused mitral regurgitation in a 37-year-old woman. The cyst was removed by papillary muscle incision, and the mitral valve was repaired. The patient experienced an uneventful recovery. PMID:20069089

  6. The Synergistic Role of the Lateral Meniscus Posterior Root and the ALL in Providing Anterolateral Rotational Stability of the Knee

    PubMed Central

    Getgood, Alan M.; Lording, Timothy; Corbo, Gillian; Burkhart, Tim A.

    2016-01-01

    Objectives: Injury to the anterolateral ligament (ALL) has been reported to contribute to high-grade anterolateral laxity following anterior cruciate ligament (ACL) injury. Failure to address ALL injury has been suggested as a cause of persistent rotational laxity following ACL reconstruction. However, lateral meniscus posterior root (LMPR) tears have also has been shown to cause increased internal rotation and anterior translation of the knee. Due to the anatomic relationship of the ALL and the lateral meniscus, we hypothesize that the ALL and lateral meniscus work synergistically, and that a tear to the LMPR will have the same effect on anterolateral laxity as an ALL tear in the ACL deficient knee. Methods: Sixteen fresh frozen cadaveric knee specimens (mid -femur to mid-tibia) were potted into a hip simulator (femur) and a six degree-of-freedom load cell (tibia). Two rigid optical trackers were inserted into the proximal femur and distal tibia, allowing for the motion of the tibia with respect to the femur to be tracked during biomechanical tests. A series of points on the femur and tibia were digitized to create bone coordinate systems that were used to calculate the kinematic variables. Biomechanical testing involved applying a 5 Nm internal rotation moment to the tibia while the knee was in full extension and tested sequentially in the following three conditions: i) ACLintact; ii) Partial ACL injury (ACLam) -anteromedial bundle sectioned; iii) Full ACL injury (ACLfull). The specimens were then randomized to either have the ALL sectioned first (ALLsec) followed by the LMPRsec or vice versa. Internal rotation and anterior translation of the tibia with respect to the femur were calculated. A mixed two-way (serial sectioning by ALL section order) repeated measures ANOVA (α = 0.05). Results: Compared to the ACLintact condition, internal rotation was found to be 1.78° (p=0.06), 3.74° (p=0.001), and 3.84° (p=0.001) greater following ACLfull, LMPRsec and ALLsec

  7. Clinical effects of thigh cuffs during a 7-day 6° head-down bed rest

    NASA Astrophysics Data System (ADS)

    Pavy-Le Traon, Anne; Maillet, Alain; Vasseur Clausen, Pascale; Custaud, Marc-Antoine; Alferova, Irina; Gharib, Claude; Fortrat, Jacques-Olivier

    2001-08-01

    Thigh cuffs are used by Russian cosmonauts to limit the fluid shift induced by space flight. A ground simulation using the head-down bed rest (HDBR) model was performed to assess the effects of thigh cuffs on clinical tolerance and orthostatic adaptation. 8 male healthy volunteers (32.4±1.9 years) participated twice in a 7-day HDBR — one time with thigh cuffs (worm daily from 9 am to 7 pm) (TC) and one time without (WTC). Orthostatic tolerance was assessed by a 10 minute stand test and by a LBNP test (5 min at -15, -30, -45 mmHg) before (BDC-1) and at the end of the HDBR period (R+1). Plasma volume was measured before and at the end of HDBR by the Evans blue dye dilution technique. Thigh cuffs limits headache due to fluid shift, as well as the loss in plasma volume (TC: -5.85±0.95%; WTC: -9.09±0.82%, p<0.05). The mean duration of the stand test (R+1) did not differ in the two group (TC 7.1±1.3 min; WTC 7.0±1.0 min). The increase in HR and decrease in diastolic blood pressure were slightly but significantly larger without thigh cuffs. Duration of the LBNP tests did not differ with thigh cuffs. Thigh cuffs limit the symptoms due to fluid shift and the loss in plasma volume. They partly reduced the increase in HR during orthostatic stress but had no effect on duration of orthostatic stress tests.

  8. Anatomic Anterolateral Ligament Reconstruction of the Knee Leads to Overconstraint at any Fixation Angle

    PubMed Central

    Schon, Jason; Brady, Alex; Moatshe, Gilbert; Cruz, Raphael; Chahla, Jorge; Dornan, Grant; Turnbull, Travis L.; Engebretsen, Lars

    2016-01-01

    Objectives: Anterior cruciate ligament (ACL) tears are one of the most common injuries among athletes. However, the ability to fully restore rotational stability with ACL reconstruction (ACLR) remains a challenge because up to 25% of patients may present with a residual pivot shift following surgery. Advocacy for reconstruction of the anterolateral ligament (ALL) is rapidly increasing because biomechanical studies have reported that the ALL is a significant contributor to internal rotational stability of the knee. Although several graft fixation angles for the anatomic ALL reconstruction (ALLR) have been reported in literature, none have been biomechanically validated. Therefore, the purpose of this study was to assess the effect of ALLR graft fixation angle on knee joint kinematics in the clinically relevant setting of a concomitant ACLR. The goal was to find the optimal knee flexion angle for fixation of the ALLR graft that would most accurately restore native knee kinematics without introducing overconstraint to the knee. It was hypothesized that all fixation angles would significantly reduce rotational laxity compared to the sectioned ALL state and that fixation at 30° would best reproduce native joint kinematics. Methods: Eight non-paired fresh-frozen human cadaveric knees with no prior injury, surgical history, or gross anatomic abnormality were evaluated with a 6 degree-of-freedom robotic system. Each specimen underwent a full kinematic assessment in each of the following states: 1) intact, 2) anatomic single-bundle (SB) ACLR with intact ALL, 3) anatomic SB ACLR with sectioned ALL, 4) 7 anatomic SB ACLR and ALLR states utilizing ALL graft fixation knee flexion angles of 0°, 15°, 30°, 45°, 60°, 75° and 90°, and 5) sectioned ACL and ALL. Internal rotation during a 5 N-m internal rotation torque and anterior displacement during an 88 N anterior load were recorded at 15° intervals between 0° and 120° of knee flexion. Axial plane displacement and

  9. Chronic exercise preserves lean muscle mass in masters athletes.

    PubMed

    Wroblewski, Andrew P; Amati, Francesca; Smiley, Mark A; Goodpaster, Bret; Wright, Vonda

    2011-09-01

    Aging is commonly associated with a loss of muscle mass and strength, resulting in falls, functional decline, and the subjective feeling of weakness. Exercise modulates the morbidities of muscle aging. Most studies, however, have examined muscle-loss changes in sedentary aging adults. This leaves the question of whether the changes that are commonly associated with muscle aging reflect the true physiology of muscle aging or whether they reflect disuse atrophy. This study evaluated whether high levels of chronic exercise prevents the loss of lean muscle mass and strength experienced in sedentary aging adults. A cross-section of 40 high-level recreational athletes ("masters athletes") who were aged 40 to 81 years and trained 4 to 5 times per week underwent tests of health/activity, body composition, quadriceps peak torque (PT), and magnetic resonance imaging of bilateral quadriceps. Mid-thigh muscle area, quadriceps area (QA), subcutaneous adipose tissue, and intramuscular adipose tissue were quantified in magnetic resonance imaging using medical image processing, analysis, and visualization software. One-way analysis of variance was used to examine age group differences. Relationships were evaluated using Spearman correlations. Mid-thigh muscle area (P = 0.31) and lean mass (P = 0.15) did not increase with age and were significantly related to retention of mid-thigh muscle area (P < 0.0001). This occurred despite an increase in total body fat percentage (P = 0.003) with age. Mid-thigh muscle area (P = 0.12), QA (P = 0.17), and quadriceps PT did not decline with age. Specific strength (strength per QA) did not decline significantly with age (P = 0.06). As muscle area increased, PT increased significantly (P = 0.008). There was not a significant relationship between intramuscular adipose tissue (P = 0.71) or lean mass (P = 0.4) and PT. This study contradicts the common observation that muscle mass and strength decline as a function of aging alone. Instead, these

  10. Relationship between BMI and Postoperative Complications with Free Flap in Anterolateral Craniofacial Reconstruction

    PubMed Central

    Yagi, Shunjiro; Toriyama, Kazuhiro; Takanari, Keisuke; Fujimoto, Yasushi; Nishio, Naoki; Fujii, Masazumi; Saito, Kiyoshi; Takahashi, Masakatsu; Kamei, Yuzuru

    2016-01-01

    Background: Although we have seen tremendous advancement in microsurgery over the last 2 decades and free tissue transfer has become standard for head and neck reconstruction, surgeons still struggle to prevent postoperative complications. We examined the relationship between body mass index (BMI) and postoperative complications in patients undergoing rectus abdominis free flap transfer after anterolateral craniofacial resection. Methods: This was a retrospective review of reconstructive surgery using rectus abdominis musculocutaneous free flap in patients with locally advanced maxillary sinus carcinoma from 2003 to 2014 (n = 35, 27 men and 8 women; average age, 60.9 ± 7.8 years). All patients underwent craniofacial reconstruction after anterior and middle cranial fossa skull base resection and maxillectomy (class IV, subtype a) with palatal resection. Patients were categorized based on sex, BMI, and other parameters. Results: Recipient-site infection occurred in 11 patients (31.4%), cerebrospinal fluid leakage in 6 (17.1%), partial flap necrosis in 2 (5.7%), total flap necrosis in 1 (2.9%), and facial fistula in 4 (11.4%). Women showed partial flap necrosis significantly more frequently (P = 0.047), probably owing to poor vascular supply of the subcutaneous fat layer. Patients with low BMI (<20 kg/m2) showed recipient-site infection (P = 0.02) and facial fistula (P = 0.01) significantly more frequently owing to insufficient tissue volume and poor vascular supply. Conclusion: Postoperative recipient-site infection and facial fistula occurred mainly in low-BMI patients. Surgeons should take care to achieve sufficient donor tissue on low-BMI patients. Using a prosthetic obturator in low-BMI patients for craniofacial reconstruction can be a good alternative option to reduce postoperative complications due to insufficient donor tissue volume. PMID:27257566

  11. Anterolateral radical debridement and interbody bone grafting combined with transpedicle fixation in the treatment of thoracolumbar spinal tuberculosis.

    PubMed

    Cheng, Zhaohui; Wang, Jian; Zheng, Qixin; Wu, Yongchao; Guo, Xiaodong

    2015-04-01

    This retrospective cohort study was conducted to evaluate the clinical outcomes of radical anterolateral debridement and autogenous ilium with rib or titanium cage interbody autografting with transpedicle fixation for the treatment of thoracolumbar tuberculosis. Spinal tuberculosis operation aims to remove the lesions and necrotic tissues, remove spinal cord compression, and reconstruct spinal stability. However, traditional operation methods cannot effectively correct cyrtosis or stabilize the spine. In addition, the patient needs to stay in bed for a long time and may have many complications. So far, the best surgical method and fixation method for spinal tuberculosis remain controversial. There were a total of 43 patients, 16 involving spinal cord injury, from January 2004 to January 2011. The patients were surgically treated for radical anterolateral debridement via posterolateral incision and autogenous ilium with rib or titanium cage interbody autografting and single-stage transpedicle fixation. All the patients were followed up to determine the stages of intervertebral bone fusion and the corrections of spinal kyphosis with the restoration of neurological deficit. The erythrocyte sedimentation rate (ESR) of these patients decreased to normal levels for a mean of 2.8 months. The function of feeling, motion, and sphincter in 16 paraplegia cases gradually recovered after 1 week to 3 months postoperatively, and the American Spinal Injury Association scores significantly increased at the final follow-up. Intervertebral bone fusions were all achieved postoperatively. No internal fixation devices were loose, extracted, or broken. There was no correction degree loss during the follow-up. The method of radical anterolateral debridement and autogenous ilium with rib or titanium cage interbody autografting and single-stage transpedicle fixation was effective for the treatment of thoracolumbar tuberculosis, correcting kyphotic deformity, and reconstructing spinal

  12. Evaluation of the Length and Isometric Pattern of the Anterolateral Ligament With Serial Computer Tomography

    PubMed Central

    Helito, Camilo Partezani; Helito, Paulo Victor Partezani; Bonadio, Marcelo Batista; da Mota e Albuquerque, Roberto Freire; Bordalo-Rodrigues, Marcelo; Pecora, Jose Ricardo; Camanho, Gilberto Luis; Demange, Marco Kawamura

    2014-01-01

    Background: Recent anatomical studies have identified the anterolateral ligament (ALL). Injury to this structure may lead to the presence of residual pivot shift in some reconstructions of the anterior cruciate ligament. The behavior of the length of this structure and its tension during range of motion has not been established and is essential when planning reconstruction. Purpose: To establish differences in the ALL length during range of knee motion. Study Design: Descriptive laboratory study. Methods: Ten unpaired cadavers were dissected. The attachments of the ALL were isolated. Its origin and insertion were marked with a 2 mm–diameter metallic sphere. Computed tomography scans were performed on the dissected parts under extension and 30°, 60°, and 90° of flexion; measurements of the distance between the 2 markers were taken at all mentioned degrees of flexion. The distances between the points were compared. Results: The mean ALL length increased with knee flexion. Its mean length at full extension and at 30°, 60°, and 90° of flexion was 37.9 ± 5.3, 39.3 ± 5.4, 40.9 ± 5.4, and 44.1 ± 6.4 mm, respectively. The mean increase in length from 0° to 30° was 3.99% ± 4.7%, from 30° to 60° was 4.20% ± 3.2%, and from 60° to 90° was 7.45% ± 4.8%. From full extension to 90° of flexion, the ligament length increased on average 16.7% ± 12.1%. From 60° to 90° of flexion, there was a significantly higher increase in the mean distance between the points compared with the flexion from 0° to 30° and from 30° to 60°. Conclusion: The ALL shows no isometric behavior during the range of motion of the knee. The ALL increases in length from full extension to 90° of flexion by 16.7%, on average. The increase in length was greater from 60° to 90° than from 0° to 30° and from 30° to 60°. The increase in length at higher degrees of flexion suggests greater tension with increasing flexion. Clinical Relevance: Knowledge of ALL behavior during the range of

  13. Positional relationships between the masticatory muscles and their innervating nerves with special reference to the lateral pterygoid and the midmedial and discotemporal muscle bundles of temporalis

    PubMed Central

    AKITA, KEIICHI; SHIMOKAWA, TAKASHI; SATO, TATSUO

    2000-01-01

    For an accurate assessment of jaw movement, it is crucial to understand the comprehensive formation of the masticatory muscles with special reference to the relationship to the disc of the temporomandibular joint. Detailed dissection was performed on 26 head halves of 14 Japanese cadavers in order to obtain precise anatomical information of the positional relationships between the masticatory muscles and the branches of the mandibular nerve. After complete removal of the bony elements, the midmedial muscle bundle in all specimens and the discotemporal muscle bundle in 6 specimens, derivatives of the temporalis, which insert into the disc were observed. On the anterior area of the articular capsule and the disc of the temporomandibular joint, the upper head of the lateral pterygoid, the midmedial muscle bundle of temporalis and the discotemporal bundle of temporalis were attached mediolaterally, and in 3 specimens the posterosuperior margin of the zygomaticomandibularis was attached to the anterolateral area of the disc. It is suggested that these muscles and muscle bundles contribute to various mandibular movements. Although various patterns of the positional relationships between the muscles and muscle bundles and the their innervating nerves are observed in the present study, relative positional relationships of the muscles and muscle bundles and of nerves of the mandibular nerve are consistent. A possible scheme of the developmental formation of the masticatory muscles based on the findings of the positional relationships between the muscles and the nerves is presented. PMID:11005720

  14. Muscle atrophy

    MedlinePlus

    Muscle wasting; Wasting; Atrophy of the muscles ... There are two types of muscle atrophy. Disuse atrophy occurs from a lack of physical activity. In most people, muscle atrophy is caused by not using the ...

  15. Muscle Disorders

    MedlinePlus

    Your muscles help you move and help your body work. Different types of muscles have different jobs. There are many problems that can affect muscles. Muscle disorders can cause weakness, pain or even ...

  16. Muscle atrophy

    MedlinePlus

    Muscle wasting; Wasting; Atrophy of the muscles ... There are two types of muscle atrophy: disuse and neurogenic. Disuse atrophy is caused by not using the muscles enough . This type of atrophy can often be ...

  17. Muscle Cramps

    MedlinePlus

    Muscle cramps are sudden, involuntary contractions or spasms in one or more of your muscles. They often occur after exercise or at night, ... to several minutes. It is a very common muscle problem. Muscle cramps can be caused by nerves ...

  18. Effect of postmortem deboning time on sensory descriptive flavor and texture profiles of cooked boneless skinless chicken thighs

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Three replicate trials were conducted to investigate the effect of deboning time on sensory descriptive profiles of cooked boneless skinless thigh meat (iliotibialis, iliofibularis and the femoritibialis). Carcasses (42-d old birds) were obtained from a commercial processing plant. Thighs were hot-b...

  19. The relationships of waist and mid-thigh circumference with performance of college golfers

    PubMed Central

    Son, Seungbum; Han, Kunho; So, Wi-Young

    2016-01-01

    [Purpose] Our aim was to evaluate the relationships between waist and mid-thigh circumference, used as proxy measures of trunk and lower limb strengths, respectively, and selected parameters of driver and putting performance in Korean college golfers. [Subjects and Methods] The participants were 103 college golfers (81 male, 20 to 27 years old). Measurements of body composition, waist and mid-thigh circumference, and grip strength, as well as assessment of golf performance, including driver distance, driver swing speed, putting accuracy, and putting consistency, were performed at the golf performance laboratory at Konkuk University in Chungju-si, Republic of Korea. Average round score was obtained from 10 rounds of golf completed during the study period. The relationships between strength measures and golf performance were evaluated by partial correlation analysis, with adjustment for age, golf experience, and body mass index. [Results] Waist circumference did not correlate with any of the performance variables in both males and females. Mid-thigh circumference correlated with putting consistency (r = 0.364) in males and with putting consistency (r = 0.490) and accuracy (r = 0.547) in females. No other significant correlations between waist and mid-thigh circumference and golf performance were identified. [Conclusion] Lower limb strength may be an important component of putting performance. Further studies are needed to fully characterize the contributions of trunk strength to performance. PMID:27134346

  20. Validity and repeatability of a depth camera-based surface imaging system for thigh volume measurement.

    PubMed

    Bullas, Alice M; Choppin, Simon; Heller, Ben; Wheat, Jon

    2016-10-01

    Complex anthropometrics such as area and volume, can identify changes in body size and shape that are not detectable with traditional anthropometrics of lengths, breadths, skinfolds and girths. However, taking these complex with manual techniques (tape measurement and water displacement) is often unsuitable. Three-dimensional (3D) surface imaging systems are quick and accurate alternatives to manual techniques but their use is restricted by cost, complexity and limited access. We have developed a novel low-cost, accessible and portable 3D surface imaging system based on consumer depth cameras. The aim of this study was to determine the validity and repeatability of the system in the measurement of thigh volume. The thigh volumes of 36 participants were measured with the depth camera system and a high precision commercially available 3D surface imaging system (3dMD). The depth camera system used within this study is highly repeatable (technical error of measurement (TEM) of <1.0% intra-calibration and ~2.0% inter-calibration) but systematically overestimates (~6%) thigh volume when compared to the 3dMD system. This suggests poor agreement yet a close relationship, which once corrected can yield a usable thigh volume measurement. PMID:26928458

  1. The relationships of waist and mid-thigh circumference with performance of college golfers.

    PubMed

    Son, Seungbum; Han, Kunho; So, Wi-Young

    2016-03-01

    [Purpose] Our aim was to evaluate the relationships between waist and mid-thigh circumference, used as proxy measures of trunk and lower limb strengths, respectively, and selected parameters of driver and putting performance in Korean college golfers. [Subjects and Methods] The participants were 103 college golfers (81 male, 20 to 27 years old). Measurements of body composition, waist and mid-thigh circumference, and grip strength, as well as assessment of golf performance, including driver distance, driver swing speed, putting accuracy, and putting consistency, were performed at the golf performance laboratory at Konkuk University in Chungju-si, Republic of Korea. Average round score was obtained from 10 rounds of golf completed during the study period. The relationships between strength measures and golf performance were evaluated by partial correlation analysis, with adjustment for age, golf experience, and body mass index. [Results] Waist circumference did not correlate with any of the performance variables in both males and females. Mid-thigh circumference correlated with putting consistency (r = 0.364) in males and with putting consistency (r = 0.490) and accuracy (r = 0.547) in females. No other significant correlations between waist and mid-thigh circumference and golf performance were identified. [Conclusion] Lower limb strength may be an important component of putting performance. Further studies are needed to fully characterize the contributions of trunk strength to performance. PMID:27134346

  2. Modified total thigh musculocutaneous flap: 'operation of last resort' for massive pressure ulcers.

    PubMed

    Cheng, Paul Ting-Yuan; Adams, Brandon Michael; Chunilal, Ashwin

    2014-02-01

    Massive bilateral pressure ulcers of dependent areas may complicate spinal cord injuries. These may be life threatening to patients and challenging for reconstructive surgeons. In massive recurrent ulcers, local tissue is either inadequate or previously exhausted. The total thigh musculocutaneous flap is an operation of last resort; we present a new variation of this procedure and a case of life threatening pressure ulcers with underlying osteomyelitis. A paraplegic patient had recurrent, extensive, bilateral pressure areas with some preserved tissue bridges. The nature of the pressure areas and lack of local options in this patient required modification of previously described total thigh flaps. An extended total thigh flap was partially de-epithelialised to fill the extensive sacral defect and a tunnelled extension was fashioned to cover the contralateral trochanteric defect. The timing of surgery was determined by balancing pre-operative nutritional optimisation against life-threatening drug resistance of infective organisms. The total thigh flap can close massive bilateral pressure ulcers. Modifications are presented which preserve viable local tissue and demonstrate the versatility of this technique. It remains a 'last-resort' salvage procedure. PMID:23806262

  3. [Marinesco-Sjögren syndrome--report of two patients in a family with muscle CT study].

    PubMed

    Higuchi, S; Taku, K; Fukuhara, N; Hozumi, I; Yamazaki, M

    1993-01-01

    Two patients with Marinesco-Sjögren syndrome in a family were characterized by autosomal recessive inheritance, congenital cataract, cerebellar ataxia, mental retardation, short stature and variable skeletal abnormalities. Muscle biopsy specimens showed replacement of muscle fibers by fat and fibrous tissue, a marked variation of fiber size and a rimmed vacuole formation. Nerve biopsy specimens showed a reduced number of myelinated nerve fibers in the sural nerves. Muscle CT revealed atrophy of the quadriceps femoris, semitendinosus, gastrocnemius and soleus muscles. Accordingly, extensor muscles in the thighs were more preferentially involved than flexor muscles in the legs. PMID:8334784

  4. Pharmacodynamics of the New Fluoroquinolone Gatifloxacin in Murine Thigh and Lung Infection Models

    PubMed Central

    Andes, D.; Craig, W. A.

    2002-01-01

    Gatifloxacin is a new 8-methoxy fluoroquinolone with enhanced activity against gram-positive cocci. We used the neutropenic murine thigh infection model to characterize the time course of antimicrobial activity of gatifloxacin and determine which pharmacokinetic (PK)-pharmacodynamic (PD) parameter best correlated with efficacy. The thighs of mice were infected with 106.5 to 107.4 CFU of strains of Staphylococcus aureus, Streptococcus pneumoniae, or Escherichia coli, and the mice were then treated for 24 h with 0.29 to 600 mg of gatifloxacin per kg of body weight per day, with the dose fractionated for dosing every 3, 6, 12, and 24 h. Levels in serum were measured by microbiologic assay. In vivo postantibiotic effects (PAEs) were calculated from serial values of the log10 numbers of CFU per thigh 2 to 4 h after the administration of doses of 8 and 32 mg/kg. Nonlinear regression analysis was used to determine which PK-PD parameter best correlated with the numbers of CFU per thigh at 24 h. Pharmacokinetic studies revealed peak/dose values of 0.23 to 0.32, area under the concentration-time curve (AUC)/dose values of 0.47 to 0.62, and half-lives of 0.6 to 1.1 h. Gatifloxacin produced in vivo PAEs of 0.2 to 3.1 h for S. pneumoniae and 0.4 to 2.3 h for S. aureus. The 24-h AUC/MIC was the PK-PD parameter that best correlated with efficacy (R2 = 90 to 94% for the three organisms, whereas R2 = 70 to 81% for peak level/MIC and R2 = 48 to 73% for the time that the concentration in serum was greater than the MIC). There was some reduced activity when dosing every 24 h was used due to the short half-life of gatifloxacin in mice. In subsequent studies we used the neutropenic and nonneutropenic murine thigh and lung infection models to determine if the magnitude of the AUC/MIC needed for the efficacy of gatifloxacin varied among pathogens (including resistant strains) and infection sites. The mice were infected with 106.5 to 107.4 CFU of four isolates of S. aureus (one methicillin

  5. Supporting the upper body with the hand on the thigh reduces back loading during lifting.

    PubMed

    Kingma, Idsart; Faber, Gert S; van Dieën, Jaap H

    2016-04-11

    When picking objects from the floor, low back pain patients often tend to support the upper body by leaning with one hand on a thigh. While this strategy may reduce back load, this has not yet been assessed, probably due to the difficulty of measuring the forces between hand and thigh. Ten healthy male subjects lifted a pencil and a crate from the floor, with four lifting techniques (free, squat, stoop and a Weight Lifters Technique (WLT)), each of which was performed with and without supporting with one hand on the thigh. A six Degrees of Freedom force transducer, with a comfortable surface to support the hand on, was mounted just above the subject׳s left knee. Hand forces, ground reaction forces, full body kinematics, and trunk EMG were measured. Using inverse dynamics and taking the forces between hand and thigh into account, we calculated 3D L5S1 joint moments, and subsequently estimated spine forces using an EMG-assisted trunk model. For lifting a pencil, hand support reduced average peak total moments by 17-25%, dependent on lifting technique. For crate lifting, hand support reduced total moments by 13-19% compared with one-handed lifting and by 14-26% compared to two-handed lifting. Hand support slightly increased asymmetric motions and caused a substantial increase in asymmetric moments in crate lifting. For compression forces, reductions (up to 28%) were seen in all techniques except in stoop lifts. It is concluded that leaning with a hand on the thigh can lead to substantial reductions of low back loading during lifting. PMID:26475223

  6. Glucose Infusion into Exercising Dogs after Confinement: Rectal and Active Muscle Temperatures

    NASA Technical Reports Server (NTRS)

    Greenleaf, J. E.; Kruk, B.; Nazar, K.; Falecka-Wieczorek, I.; Kaciuba-Uscilko, H.

    1995-01-01

    Intravenous glucose infusion into ambulatory dogs results in attenuation of exercise-induced increase of both rectal and thigh muscle temperatures. That glucose (Glu) infusion attenuates excessive increase in body temperature from restricted activity during confinement deconditioning. Intravenous glucose infusion attenuates the rise in exercise core temperature in deconditioned dogs by a yet undefined mechanism.

  7. Evaluation of muscle injury using magnetic resonance imaging

    NASA Technical Reports Server (NTRS)

    LeBlanc, A. D.; Jaweed, M.; Evans, H.

    1993-01-01

    The objective of this study was to investigate spin echo T2 relaxation time changes in thigh muscles after intense eccentric exercise in healthy men. Spin echo and calculated T2 relaxation time images of the thighs were obtained on several occasions after exercise of one limb; the contralateral limb served as control. Muscle damage was verified by elevated levels of serum creatine kinase (CK). Thirty percent of the time no exercise effect was discernible on the magnetic resonance (MR) images. In all positive MR images (70%) the semitendinosus muscle was positive, while the biceps femoris, short head, and gracilis muscles were also positive in 50% and 25% of the total cases, respectively. The peak T2 relaxation time and serum CK were correlated (r = 0.94, p<0.01); temporal changes in muscle T2 relaxation time and serum CK were similar, although T2 relaxation time remained positive after serum CK returned to background levels. We conclude that magnetic resonance imaging can serve as a useful tool in the evaluation of eccentric exercise muscle damage by providing a quantitative indicator of damage and its resolution as well as the specific areas and muscles.

  8. Effect of dietary oregano essential oil on performance of chickens and on iron-induced lipid oxidation of breast, thigh and abdominal fat tissues.

    PubMed

    Botsoglou, N A; Florou-Paneri, P; Christaki, E; Fletouris, D J; Spais, A B

    2002-05-01

    1. We studied the effect of dietary oregano essential oil (50 and 100 mg/kg of feed) on the performance of broilers, and determined the susceptibility of the resulting broiler meat to iron-induced lipid oxidation. 2. Performance of the birds was unaffected by the experimental diets. Therefore, dietary oregano oil exerted no growth-promoting effect on broilers. 3. Iron-induced lipid oxidation showed that as oregano oil increased in the diet, malondialdehyde values decreased in tissue samples, suggesting that the oil, particularly at 100 mg/kg of feed, exerted an antioxidant effect on chicken tissues. 4. Dietary alpha-tocopheryl acetate supplementation at 200 mg/kg of feed displayed greater antioxidant activity than oregano oil at either supplementation rate. 5. Thigh muscle was more susceptible to oxidation than breast muscle, although the former contained alpha-tocopherol at higher concentration. Muscle alpha-tocopherol is an important factor influencing lipid oxidation, but the influence of polyunsaturated fatty acids and content of pro-oxidants must be taken into consideration too. PMID:12047086

  9. Muscle MRI findings in limb girdle muscular dystrophy type 2L.

    PubMed

    Sarkozy, Anna; Deschauer, Marcus; Carlier, Robert-Yves; Schrank, Bertold; Seeger, Jürgen; Walter, Maggie C; Schoser, Benedikt; Reilich, Peter; Leturq, France; Radunovic, Aleksandar; Behin, Anthony; Laforet, Pascal; Eymard, Bruno; Schreiber, Herbert; Hicks, Debbie; Vaidya, Sujit S; Gläser, Dieter; Carlier, Pierre G; Bushby, Kate; Lochmüller, Hanns; Straub, Volker

    2012-10-01

    Limb girdle muscular dystrophy type 2L (LGMD2L) is an adult-onset slowly progressive muscular dystrophy associated with recessive mutations in the ANO5 gene. We analysed the muscle MRI pattern in a cohort of 25 LGMD2L patients in order to understand the extent and progression of muscle pathology in LGM2L and assess if muscle MRI might help in the diagnostic work-up of these patients. Our results showed a homogeneous pattern of muscle pathology on muscle MRI, with a predominant involvement of the posterior compartment muscles in both the thighs and calves. The muscles of the anterior compartments in the leg together with the sartorius and gracilis muscles were best preserved, which partially overlaps with patterns observed for other recessive LGMDs. Muscle MRI therefore does not appear to be as useful in the diagnostic work up of LGMD2L as for other neuromuscular diseases, such as Bethlem myopathy or myofibrillar myopathy. PMID:22980763

  10. Skeletal muscle

    Technology Transfer Automated Retrieval System (TEKTRAN)

    There are approximately 650-850 muscles in the human body these include skeletal (striated), smooth and cardiac muscle. The approximation is based on what some anatomists consider separate muscle or muscle systems. Muscles are classified based on their anatomy (striated vs. smooth) and if they are v...

  11. MRI demonstration of an anterolateral plaque at C1: a note on some sensory changes including analgesia.

    PubMed Central

    Schott, G D

    1993-01-01

    A patient developed a partial right-sided Brown-Séquard syndrome at C1. Impairment of left-sided spinothalamic function was associated with abolition of pre-existing left- (but not right-) sided low back pain and sciatica, and prevented the postoperative pain expected after surgery for a benign left-sided breast lump. Later, slight left-sided alteration of light touch appreciation, then allodynia and spontaneous burning pain developed. MRI scanning revealed an isolated abnormality in the right anterolateral quadrant of the spinal cord at C1, consistent with a plaque of demyelination. The site of this abnormality, demonstrated during life and non-invasively, accounted for the partial Brown-Séquard syndrome, the analgesic effects of interrupting spinothalamic pathways, and perhaps the delayed-onset central pain phenomena. Images PMID:8331363

  12. Thigh-calf contact: does it affect the loading of the knee in the high-flexion range?

    PubMed

    Zelle, J; Barink, M; De Waal Malefijt, M; Verdonschot, N

    2009-03-26

    Recently, high-flexion knee implants have been developed to provide for a large range of motion (ROM>120 degrees ) after total knee arthroplasty (TKA). Since knee forces typically increase with larger flexion angles, it is commonly assumed that high-flexion knee implants are subjected to larger loads than conventional knee implants. However, most high-flexion studies do not consider thigh-calf contact which occurs during high-flexion activities such as squatting and kneeling. In this study, we hypothesized that thigh-calf contact reduces the knee forces during deep knee flexion as the tibio-femoral load shifts from occurring inside the knee towards the thigh-calf contact interface. Hence, the effect of thigh-calf contact on the knee loading was evaluated using a free body diagram and a finite element model and both the knee forces and polyethylene stresses were analyzed. Thigh-calf contact force characteristics from an earlier study were included and a squatting movement was simulated. In general, we found thigh-calf contact considerably reduced both the knee forces and polyethylene stresses during deep knee flexion. At maximal flexion (155 degrees ), the compressive knee force decreased from 4.89 to 2.90 times the bodyweight (BW) in case thigh-calf contact was included and the polyethylene contact stress at the tibial post decreased from 49.3 to 28.1MPa. Additionally, there was a clear correlation between a subject's thigh and calf circumference and the force reduction at maximal flexion due to thigh-calf contact (R=0.89). The findings presented in this study can be used to optimize the mechanical behavior of high-flexion total knee arthroplasty designs. PMID:19200996

  13. Muscle Deoxygenation Causes Muscle Fatigue

    NASA Technical Reports Server (NTRS)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D.

    1999-01-01

    Muscle fatigue is a common musculoskeletal disorder in the work place, and may be a harbinger for more disabling cumulative trauma disorders. Although the cause of fatigue is multifactorial, reduced blood flow and muscle oxygenation may be the primary factor in causing muscle fatigue during low intensity muscle exertion. Muscle fatigue is defined as a reduction in muscle force production, and also occurs among astronauts who are subjected to postural constraints while performing lengthy, repetitive tasks. The objectives of this research are to: 1) develop an objective tool to study the role of decreased muscle oxygenation on muscle force production, and 2) to evaluate muscle fatigue during prolonged glovebox work.

  14. Muscle disorder

    MedlinePlus

    Blood tests sometimes show abnormally high muscle enzymes. If a muscle disorder might also affect other family members, genetic testing may be done. When someone has symptoms and signs of a muscle disorder, tests such as an electromyogram , ...

  15. Muscle aches

    MedlinePlus

    ... common cause of muscle aches and pain is fibromyalgia , a condition that causes tenderness in your muscles ... imbalance, such as too little potassium or calcium Fibromyalgia Infections, including the flu, Lyme disease , malaria , muscle ...

  16. Muscle disorder

    MedlinePlus

    Myopathic changes; Myopathy; Muscle problem ... Blood tests sometimes show abnormally high muscle enzymes. If a muscle disorder might also affect other family members, genetic testing may be done. When someone has symptoms and signs ...

  17. Iatrogenic Seeding of Tumor Cells in Thigh Soft Tissue Upon Surgical Removal of Intracranial Meningioma

    PubMed Central

    Maddah, Ghodratollah; Shabahang, Hossein; Zehi, Vahid; Sharifi Sistani, Nouriyeh; Mashhadi Nejad, Hossein

    2016-01-01

    Introduction: Meningioma is a benign and slowly-growing tumor that is responsible for 20% of brain neoplasms. It can be accompanied by some genetic disorders such as neurofibromatosis type 2 and is more common among women. As a space occupying lesion, it produces a wide range of signs and symptoms by compressing the adjacent and underlying tissues in the brain. Trauma and viruses are possible etiologies for meningioma. The ideal treatment of benign meningioma is surgical resection. Case Presentation: In this case report, we present a middle-aged man with a seeding metastasis of the cranial meningioma (after its removal) in the left thigh. During the removal operation, fascia lata had been used to repair the dura mater and the skin defect was repaired primarily. Conclusion: We believe that the occurrence of meningioma at the site of incision in the thigh is related to using the same surgical instruments for the removal of the brain tumor. PMID:27303610

  18. [Complications of superficial venous surgery of the legs: thigh hematomas and abscess].

    PubMed

    Millien, J P; Coget, J M

    1993-01-01

    A series of 1,000 patients has been studied. I. HEMATOMAE: They are nearly continuous during internal saphena stripping but depend on various parameters. 1) Anatomical: a) Varicose veins topography. Perforating veins. Perforating veins of the thigh cause haemorrhage but reactions of venous construction are quite important and precocious not to observe subcutaneous bleedings. More or less "soft" stripping creates a reaction of reflex vasoconstriction. Fore saphenous vein of the thigh Hematomae are more and more numerous and important because the fore saphenous vein is a vein whose wall is thinner, more fragile and almost more superficial. b) Type of patient. In an obese patient, hematoma seems to be more spectacular. In the thin patient, it appears faster, if hematic expression is too late. 2) Stripping techniques: It is possible to propose different techniques of stripping, but none of them can lower specifically post-surgical hematomae. 3) Anaesthesiae: a) General anaesthesia. A bilateral surgery under general anaesthesia was helpful to observe in some cases a less important hematoma at the level of the second operated leg. b) Rachi-anaesthesia. Physiological vasoconstriction requires a latent period for this kind of anaethesia which causes a vasomotor paralysis due to a blockade of the sympathetic nerve. c) Local anaesthesia. It is obtained by crural block in association with injection of Xylocaine Adrenalina at the level of perforating veins of the thigh. This technique causes less hematomae. II. ABSCESSES: Only 4 cases out of 1,000 operated legs have been reported. No related pathology have been observed particularly about lymphatic disorders (erysipelas or lymphoedema), no previous infection known which could not have explained such complications. Therapy was simple: incision at mid-thigh and draining by lamina. The patient recovered within two weeks. PMID:8115469

  19. KNEE-JOINT LOADING IN KNEE OSTEOARTHRITIS: INFLUENCE OF ABDOMINAL AND THIGH FAT

    PubMed Central

    Messier, Stephen P.; Beavers, Daniel P.; Loeser, Richard F.; Carr, J. Jeffery; Khajanchi, Shubham; Legault, Claudine; Nicklas, Barbara J.; Hunter, David J.; DeVita, Paul

    2014-01-01

    Purpose Using three separate models that included total body mass, total lean and total fat mass, and abdominal and thigh fat as independent measures, we determined their association with knee-joint loads in older overweight and obese adults with knee osteoarthritis (OA). Methods Fat depots were quantified using computed tomography and total lean and fat mass determined with dual energy x-ray absorptiometry in 176 adults (age = 66.3 yr., BMI = 33.5 kg·m−2) with radiographic knee OA. Knee moments and joint bone-on-bone forces were calculated using gait analysis and musculoskeletal modeling. Results Higher total body mass was significantly associated (p ≤ 0.0001) with greater knee compressive and shear forces, compressive and shear impulses (p < 0.0001), patellofemoral forces (p< 0.006), and knee extensor moments (p = 0.003). Regression analysis with total lean and total fat mass as independent variables revealed significant positive associations of total fat mass with knee compressive (p = 0.0001), shear (p < 0.001), and patellofemoral forces (p = 0.01) and knee extension moment (p = 0.008). Gastrocnemius and quadriceps forces were positively associated with total fat mass. Total lean mass was associated with knee compressive force (p = 0.002). A regression model that included total thigh and total abdominal fat found both were significantly associated with knee compressive and shear forces (p ≤ 0.04). Thigh fat was associated with the knee abduction (p = 0.03) and knee extension moment (p = 0.02). Conclusions Thigh fat, consisting predominately of subcutaneous fat, had similar significant associations with knee joint forces as abdominal fat despite its much smaller volume and could be an important therapeutic target for people with knee OA. PMID:25133996

  20. Robotic Powered Transfer Mechanism modeling on Human Muscle Structure

    NASA Astrophysics Data System (ADS)

    Saito, Yukio

    It is considered in engineering that one power source can operate one joint. However, support movement mechanism of living organism is multi joint movement mechanism. Considerably different from mechanical movement mechanism, two pairs of uni-articular muscles and a pair of bi-articular muscles are involved in it. In leg, movements observed in short run including leg idling, heel contact and toeing are operated by bi-articular muscles of the thigh showing strong legs to support body weight. Pursuit of versatility in welfare robot brings its comparison with conventional machinery or industrial robot to the fore. Request for safety and technology allowing elderly people to operate the robot is getting stronger in the society. The robot must be safe when it is used together with other welfare equipment and simpler system avoiding difficult operation has to be constructed. Appearance of recent care and assistance robot is getting similar to human arm in comparison with industrial robot. Being easily able to imagine from industrial robot, mid-heavyweight articulated robot to support 60-70kgf combined with large output motor and reduction gears is next to impossible to be installed in the bath room. This research indicated that upper limb arm and lower limb thigh of human and animals are holding coalitional muscles and movement of uni-artcular muscle and bi-articular muscle conjure the image of new actuators.

  1. In Vivo Quantification of Femoral-Popliteal Compression during Isometric Thigh Contraction: Assessment using MR Angiography

    PubMed Central

    Brown, Ryan; Nguyen, Thanh D.; Spincemaille, Pascal; Prince, Martin R.; Wang, Yi

    2009-01-01

    Purpose To quantify femoral-popliteal vessel deformation during thigh contraction. Materials and Methods Eleven subjects underwent an MR examination of the femoral-popliteal vasculature on a 1.5 T system. A custom 3D balanced steady state free precession (SSFP) sequence was implemented to image a 15–20 cm segment of the vasculature during relaxation and voluntary isometric thigh contraction. The arterial and venous lumina were outlined using a semi-automated method. For the artery, this outline was fit to an ellipse whose aspect ratio was used to describe arterial deformation, while venous deformation was characterized by its cross-sectional area. Results Focal compression of the femoral-popliteal artery during contraction was observed 94 to 143 mm superior to the condyle that corresponds to the distal adductor canal (AC) immediately superior to the adductor hiatus. This was illustrated by a significant reduction (p ≤ 0.05) in aspect ratio from 0.88 ± 0.06 during relaxation to 0.77 ± 0.09 during contraction. A negligible change in arterial aspect ratio was observed inferior to the AC and in the proximal AC. Similarly, venous area was dramatically reduced in the distal AC region during contraction. Conclusion Rapid 3D SSFP MR angiography of the femoral-popliteal vasculature during thigh contraction demonstrated focal compression of the artery in the distal AC region. This may help explain the high stent failure rate and the high likelihood of atherosclerotic disease in the AC. PMID:19388112

  2. Neurofibromatous sensory neuropathy of the thigh in a 7-year-old boy.

    PubMed

    Shetty, Gautam M; Murari, Ashok Shyam; Song, Hae-Ryong; Lee, Seok Hyun; Yang, Jae Hyuk

    2008-10-01

    Neuropathy is considered to be an unusual complication of neurofibromatosis 1 (NF1). Neurofibromatous neuropathy is extremely rare in the setting of paediatric age group, pure sensory mononeuropathy and NF1. The following is a description of a 7-year-old boy who presented with complains of discomfort and parasthesia on the anterior aspect of his left thigh which is an unusual mode of presentation and site of involvement. Clinical examination and imaging revealed an isolated sensory neuropathy of the left anterior femoral cutaneous nerve of the thigh secondary to plexiform neurofibromatosis involving the L1-L4 nerve roots and the anterior femoral cutaneous nerve of thigh. The main abnormality in this patient was segmental hypertrophy of the left lower limb and dilatation of left lumbar neural foramens. Subtotal excision of the neurofibromas of the anterior femoral cutaneous nerve was performed and the patient was asymptomatic at the end of 27 months (2.25 years) of followup. Although the result of treatment in this case was good, long-term followup is necessary in view of greater risk of malignant transformation and development of spinal deformity and overall long-term poor prognosis in this particular patient subgroup of NF1. PMID:17929043

  3. Pseudotumor associated with cemented bipolar hemiarthroplasty: an unusual presentation as a granulomatous thigh mass.

    PubMed

    Goto, Tomohiro; Mineta, Kazuaki; Takasago, Tomoya; Hamada, Daisuke; Sairyo, Koichi

    2015-10-01

    Although polyethylene wear-induced osteolysis is a common complication of hip arthroplasty, extensile osteolysis developing into a large granulomatous thigh mass at a site distant from the joint is rare. We report a case of a thigh pseudotumor 25 years after cemented bipolar hemiarthroplasty, in which x-rays revealed a radiolucent line around the stem at the proximal site only, not at the diaphysis of the femur. We initially suspected a real tumor because it had a unique appearance, as if the mass resorbed the posterior cortex of the femur, and it was located at a site distant from the proximal osteolytic lesions. We clearly showed the existence of a connection between the thigh mass and the joint space by performing intra-articular injection of contrast medium with continuous pressure. It seemed that polyethylene wear particles were transported distally along the stem-cement interface by fluid pressure, and an osteolytic reaction against polyethylene wear particles had occurred at the posterior middle third of the stem where the cement mantle was nonuniform and polyethylene particles first came into contact with the bone. Our findings suggest that nonuniform cemented prosthesis with osteolysis, even if it is low grade in a limited area, carries the risk of extensile osteolysis with asymptomatic development of an extra-articular granulomatous mass. PMID:26096584

  4. Skeletal muscle adiposity is associated with physical activity, exercise capacity and fibre shift in COPD.

    PubMed

    Maddocks, Matthew; Shrikrishna, Dinesh; Vitoriano, Simone; Natanek, Samantha A; Tanner, Rebecca J; Hart, Nicholas; Kemp, Paul R; Moxham, John; Polkey, Michael I; Hopkinson, Nicholas S

    2014-11-01

    Quadriceps muscle phenotype varies widely between patients with chronic obstructive pulmonary disease (COPD) and cannot be determined without muscle biopsy. We hypothesised that measures of skeletal muscle adiposity could provide noninvasive biomarkers of muscle quality in this population. In 101 patients and 10 age-matched healthy controls, mid-thigh cross-sectional area, percentage intramuscular fat and skeletal muscle attenuation were calculated using computed tomography images and standard tissue attenuation ranges: fat -190- -30 HU; skeletal muscle -29-150 HU. Mean±sd percentage intramuscular fat was higher in the patient group (6.7±3.5% versus 4.3±1.2%, p = 0.03). Both percentage intramuscular fat and skeletal muscle attenuation were associated with physical activity level, exercise capacity and type I fibre proportion, independent of age, mid-thigh cross-sectional area and quadriceps strength. Combined with transfer factor of the lung for carbon monoxide, these variables could identify >80% of patients with fibre type shift with >65% specificity (area under the curve 0.83, 95% CI 0.72-0.95). Skeletal muscle adiposity assessed by computed tomography reflects multiple aspects of COPD related muscle dysfunction and may help to identify patients for trials of interventions targeted at specific muscle phenotypes. PMID:24993908

  5. Effect of unloading on muscle volume with and without resistance training

    NASA Astrophysics Data System (ADS)

    Akima, Hiroshi; Ushiyama, Jun-ichi; Kubo, Junjiro; Fukuoka, Hideoki; Kanehisa, Hiroaki; Fukunaga, Tetsuo

    2007-04-01

    The present study aimed to investigate the effect of resistance training on the volume of four muscle groups and/or 17 individual muscles of the human lower limb during 20 days of 6∘ head-down tilt bed rest. Twelve healthy men were divided into two groups: the resistance training group: BR-Tr (n=6) and the control group: BR-Cont (n=6). The volumes of the knee extensor, knee flexor, adductor, plantar flexor, and dorsiflexor muscle groups and their individual muscles were calculated. After the bed rest, the BR-Tr subjects showed no significant change in the volume in almost all tested muscles; in contrast, the volumes of the four muscle groups significantly decreased in the BR-Cont group ( -12% to -8%). These results suggest that resistance training during bed rest can prevent the deteriorating of thigh muscles and calf muscles.

  6. Long-term Outcomes of Arteriovenous Thigh Grafts in Hemodialysis Patients: A Comparison with Tunneled Dialysis Catheters

    PubMed Central

    Ong, Song; Barker-Finkel, Jill

    2013-01-01

    Summary Background and objective Arteriovenous thigh grafts are a potential vascular access option in hemodialysis patients who have exhausted all upper-limb sites. This study compared the outcomes of thigh grafts with outcomes obtained with dialysis catheters. Design, setting, participants, & measurements A prospective vascular access database was queried to identify 209 thigh grafts placed from January 1, 2003, to June 30, 2011. The following were calculated: secondary graft survival (from graft creation to permanent failure), assisted primary graft survival (from graft creation to first thrombosis), and infection-free graft survival (from graft creation to first graft infection). Graft outcomes were compared with those observed with 472 tunneled internal jugular dialysis catheters. Results The median duration of patient follow-up was 340 days for grafts and 91 days for catheters. The surgical technical failure rate of thigh grafts was 8.1% and was higher in patients with vascular disease (hazard ratio [HR], 2.94; 95% confidence interval [CI], 1.07–8.04; P=0.03). Secondary and assisted primary graft survival rates at 1, 2, and 5 years were 62%, 54%, and 38% and 38%, 27%, and 17%, respectively. Infection-free graft survival rates at 1, 2, and 5 years were 79%, 73%, and 61%. Secondary survival was much worse for dialysis catheters than thigh grafts (HR, 4.44; 95% CI, 3.65–5.22; P<0.001). Likewise, infection-free survival was far worse for catheters than for thigh grafts (HR, 3.77; 95% CI, 2.80–4.82; P<0.001). Conclusions Thigh grafts are a viable vascular option in patients who have exhausted upper-extremity options. Outcomes with thigh grafts are superior to those obtained with dialysis catheters. PMID:23371958

  7. The Relationship between Balance, Muscles, and Anthropomorphic Features in Young Adults.

    PubMed

    Zagyapan, Ragıba; Iyem, Cihan; Kurkcuoglu, Ayla; Pelin, Can; Tekindal, Mustafa Agah

    2012-01-01

    Posture can be defined as the form of the body when sitting, walking, or standing. There would be no problem if muscles interact in harmony with musculoskeletal system or nervous system. Posture analysis is crucial for clinical assessments in physical medicine and rehabilitation. However, studies into this issue are limited. In this study, the relationship between static standing balance and anthropomorphic features in healthy subjects was investigated. The study was carried out with a total of 240 students at Baskent University (116 females, 124 males) aged between 18 and 25 years. Type of balance of the subjects was determined with lateral posture analysis. Additionally, muscle shortness tests, subcutaneous fat thickness, and waist and thigh circumference were measured. As the results of lateral posture analysis, 107 subjects (71 males, 36 females) were detected to have anterior balance, 89 (41 males, 48 females) posterior balance, and 44 (12 males, 32 girls) neutral balance. Values of waist circumference, thigh circumference, and waist/thigh ratio were compared with all three balance types. A statistically significant difference was detected between these values in the subjects who had anterior balance (P < 0.05). In conclusion, a significant relationship was detected between muscle shortness, waist and thigh circumferences, and postural balance type. PMID:22567305

  8. Pharmacodynamics of Ceftazidime and Avibactam in Neutropenic Mice with Thigh or Lung Infection

    PubMed Central

    Melchers, Maria J.; van Mil, Anita C.; Lagarde, Claudia M.; Schuck, Virna J.; Nichols, Wright W.

    2015-01-01

    Avibactam is a new non-β-lactam β-lactamase inhibitor that shows promising restoration of ceftazidime activity against microorganisms producing Ambler class A extended-spectrum β-lactamases (ESBLs) and carbapenemases such as KPCs, class C β-lactamases (AmpC), and some class D enzymes. To determine optimal dosing combinations of ceftazidime-avibactam for treating infections with ceftazidime-resistant Pseudomonas aeruginosa, pharmacodynamic responses were explored in murine neutropenic thigh and lung infection models. Exposure-response relationships for ceftazidime monotherapy were determined first. Subsequently, the efficacy of adding avibactam every 2 h (q2h) or q8h to a fixed q2h dose of ceftazidime was determined in lung infection for two strains. Dosing avibactam q2h was significantly more efficacious, reducing the avibactam daily dose for static effect by factors of 2.7 and 10.1, whereas the mean percentage of the dosing interval that free drug concentrations remain above the threshold concentration of 1 mg/liter (%fT>CT 1 mg/liter) yielding bacteriostasis was similar for both regimens, with mean values of 21.6 (q2h) and 18.5 (q8h). Dose fractionation studies of avibactam in both the thigh and lung models indicated that the effect of avibactam correlated well with %fT>CT 1 mg/liter. This parameter of avibactam was further explored for four P. aeruginosa strains in the lung model and six in the thigh model. Parameter estimates of %fT>CT 1 mg/liter for avibactam ranged from 0 to 21.4% in the lung model and from 14.1 to 62.5% in the thigh model to achieve stasis. In conclusion, addition of avibactam enhanced the effect of ceftazidime, which was more pronounced at frequent dosing and well related with %fT>CT 1 mg/liter. The thigh model appeared more stringent, with higher values, ranging up to 62.5% fT>CT 1 mg/liter, required for a static effect. PMID:26525790

  9. Control of arachidonic acid release in chick muscle cultures

    NASA Technical Reports Server (NTRS)

    Templeton, G. H.; Padalino, M.; Wright, W.

    1985-01-01

    Cultures from thigh muscles of 12 day old embryonic chicks are utilized to examine arachidonic release, prostaglandin (PG) biosynthesis, and protein synthesis. The preparation of the cultures is described. It is observed that exogenous arachidonic acid is formed into photsphatidylethanolamine and phosphatidylcholine, is released by a calcium ionosphere or phospholiphase simulator, and is the substrate for the biosynthesis of PG; the epidermal growth factor and PGF do not stimulate protein synthesis over the basal levels. The relationship between arachidonate release and melittin is studied. The data reveal that a change in intracellular calcium stimulates phospholiphase activity, arachidonate release, and PG synthesis in chick muscle culture.

  10. Efficiency of work production by spastic muscles.

    PubMed

    Stoquart, G G; Detrembleur, C; Nielens, H; Lejeune, T M

    2005-12-01

    The present study compared the muscular efficiency in spastic and healthy lower limbs producing the same mechanical work. Sixteen chronic post-stroke hemiparetic and spastic patients and 14 age-matched healthy subjects were submitted to a submaximal stepwise exercise testing on a bicycle ergometer, pedalling with only one lower limb. Net energetic expenditure was computed from oxygen consumption above resting values. Electrical activity of antagonistic muscles in the thigh and in the shank was recorded and co-contraction was defined as the percentage of the pedalling cycle when antagonistic muscles were activated simultaneously. The efficiency was calculated as the ratio between the mechanical work done on the ergometer and the net energetic expenditure. Spasticity was quantitatively evaluated by measuring passive ankle plantar flexor muscle stiffness. The working capacity of the patients' paretic lower limb was very low (<40W). The energy expenditure increased linearly as a function of work intensity, without statistical difference between the patients paretic lower limb (PPL), the patients healthy lower limb (PHL) and the healthy subjects lower limb (HSL). Shank co-contraction was 2.9 times greater in PPL (p<0.05) and 2.3 times greater in PHL (p<0.05) than in HSL. Thigh co-contraction was also 1.8 times greater in PPL than in HSL (p<0.05). The ankle plantar flexor muscle stiffness was statistically greater in PPL than in PHL and HSL (p<0.05). The efficiency was not statistically different between the three groups (p=0.155). In conclusion, the efficiency of work production by paretic and spastic lower limb muscles was normal ( congruent with 20%) despite significant neurological impairments. PMID:16274915

  11. The anterolateral ligament (ALL) and its role in rotational extra-articular stability of the knee joint: a review of anatomy and surgical concepts.

    PubMed

    Roessler, Philip P; Schüttler, Karl F; Heyse, Thomas J; Wirtz, Dieter C; Efe, Turgay

    2016-03-01

    The anterolateral ligament of the knee (ALL) has caused a lot of rumors in orthopaedics these days. The structure that was first described by Segond back in 1879 has experienced a long history of anatomic descriptions and speculations until its rediscovery by Claes in 2013. Its biomechanical properties and function have been examined recently, but are not yet fully understood. While the structure seems to act as a limiter of internal rotation and lateral meniscal extrusion its possible proprioceptive effect remains questionable. Its contribution to the pivot shift phenomenon has been uncovered in parts, therefore it has been recognized that a concomitant anterolateral stabilization together with ACL reconstruction may aid in prevention of postoperative instability after severe ligamentous knee damages. However, there are a lot of different methods to perform this procedure and the clinical outcome has yet to be examined. This concise review will give an overview on the present literature to outline the long history of the ALL under its different names, its anatomic variances and topography as well as on histologic examinations, imaging modalities, arthroscopic aspects and methods for a possible anterolateral stabilization of the knee joint. PMID:26714471

  12. Postmenopausal hormone replacement therapy modifies skeletal muscle composition and function: a study with monozygotic twin pairs.

    PubMed

    Ronkainen, Paula H A; Kovanen, Vuokko; Alén, Markku; Pöllänen, Eija; Palonen, Eeva-Maija; Ankarberg-Lindgren, Carina; Hämäläinen, Esa; Turpeinen, Ursula; Kujala, Urho M; Puolakka, Jukka; Kaprio, Jaakko; Sipilä, Sarianna

    2009-07-01

    We investigated whether long-term hormone replacement therapy (HRT) is associated with mobility and lower limb muscle performance and composition in postmenopausal women. Fifteen 54- to 62-yr-old monozygotic female twin pairs discordant for HRT were recruited from the Finnish Twin Cohort. Habitual (HWS) and maximal (MWS) walking speeds over 10 m, thigh muscle composition, lower body muscle power assessed as vertical jumping height, and maximal isometric hand grip and knee extension strengths were measured. Intrapair differences (IPD%) with 95% confidence intervals (CI) were calculated. The mean duration of HRT use was 6.9 +/- 4.1 yr. MWS was on average 7% (0.9 to 13.1%, P = 0.019) and muscle power 16% (-0.8 to 32.8%, P = 0.023) greater in HRT users than in their cotwins. Thigh muscle cross-sectional area tended to be larger (IPD% = 6%, 95% CI: -0.07 to 12.1%, P = 0.065), relative muscle area greater (IPD% = 8%, CI: 0.8 to 15.0%, P = 0.047), and relative fat area smaller (IPD% = -5%, CI: -11.3 to 1.2%, P = 0.047) in HRT users than in their sisters. There were no significant differences in maximal isometric strengths or HWS between users and nonusers. Subgroup analyses revealed that estrogen-containing therapies (11 pairs) significantly decreased total body and thigh fat content, whereas tibolone (4 pairs) tended to increase muscle cross-sectional area. This study showed that long-term HRT was associated with better mobility, greater muscle power, and favorable body and muscle composition among 54- to 62-yr-old women. The results indicate that HRT is a potential agent in preventing muscle weakness and mobility limitation in older women. PMID:19246654

  13. Postinjection Muscle Fibrosis from Lupron

    PubMed Central

    Tsilianidis, Laurie A.; Ballock, Tracy; Haider, Anzar; Rogers, Douglas G.; Schweiger, B. Michelle

    2015-01-01

    We describe the case of a 6.5-year-old girl with central precocious puberty (CPP), which signifies the onset of secondary sexual characteristics before the age of eight in females and the age of nine in males as a result of stimulation of the hypothalamic-pituitary-gonadal axis. Her case is likely related to her adoption, as children who are adopted internationally have much higher rates of CPP. She had left breast development at Tanner Stage 2, adult body odor, and mildly advanced bone age. In order to halt puberty and maximize adult height, she was prescribed a gonadotropin releasing hormone analog, the first line treatment for CPP. She was administered Lupron (leuprolide acetate) Depot-Ped (3 months) intramuscularly. After her second injection, she developed swelling and muscle pain at the injection site on her right thigh. She also reported an impaired ability to walk. She was diagnosed with muscle fibrosis. This is the first reported case of muscle fibrosis resulting from Lupron injection. PMID:26101682

  14. Postinjection Muscle Fibrosis from Lupron.

    PubMed

    Everest, Erica; Tsilianidis, Laurie A; Raissouni, Nouhad; Ballock, Tracy; Blatnik, Terra; Haider, Anzar; Rogers, Douglas G; Schweiger, B Michelle

    2015-01-01

    We describe the case of a 6.5-year-old girl with central precocious puberty (CPP), which signifies the onset of secondary sexual characteristics before the age of eight in females and the age of nine in males as a result of stimulation of the hypothalamic-pituitary-gonadal axis. Her case is likely related to her adoption, as children who are adopted internationally have much higher rates of CPP. She had left breast development at Tanner Stage 2, adult body odor, and mildly advanced bone age. In order to halt puberty and maximize adult height, she was prescribed a gonadotropin releasing hormone analog, the first line treatment for CPP. She was administered Lupron (leuprolide acetate) Depot-Ped (3 months) intramuscularly. After her second injection, she developed swelling and muscle pain at the injection site on her right thigh. She also reported an impaired ability to walk. She was diagnosed with muscle fibrosis. This is the first reported case of muscle fibrosis resulting from Lupron injection. PMID:26101682

  15. Skeletal muscle responses to lower limb suspension in humans

    NASA Technical Reports Server (NTRS)

    Hather, Bruce M.; Adams, Gregory R.; Tesch, Per A.; Dudley, Gary A.

    1992-01-01

    The morphological responses of human skeletal muscle to unweighting were assessed by analyzing multiple transaxial magnetic resonance (MR) images of both lower limbs and skeletal muscle biopsies of the unweighted lower limb before and after six weeks of unilaterial (left) lower limb suspension (ULLS). Results indicated that, as a results of 6 weeks of unweighting (by the subjects walking on crutches using only one limb), the cross sectional area (CSA) of the thigh muscle of the unweighted left limb decreased 12 percent, while the CSA of the right thigh muscle did not change. The decrease was due to a twofold greater response of the knee extensors than the knee flexors. The pre- and post-ULLS biopsies of the left vastus lateralis showed a 14 percent decrease in average fiber CSA due to unweighting. The number of capillaries surrounding the different fiber types was unchanged after ULLS. Results showed that the adaptive responses of human skeletal muscle to unweighting are qualitatively, but not quantitatively, similar to those of lower mammals and not necessarily dependent on the fiber-type composition.

  16. Proximal placement of lateral thigh skin markers reduces soft tissue artefact during normal gait using the Conventional Gait Model.

    PubMed

    Cockcroft, John; Louw, Quinette; Baker, Richard

    2016-11-01

    A primary source of measurement error in gait analysis is soft-tissue artefact. Hip and knee angle measurements, regularly used in clinical decision-making, are particularly prone to pervasive soft tissue on the femur. However, despite several studies of thigh marker artefact it remains unclear how lateral thigh marker height affects results using variants of the Conventional Gait Model. We compared Vicon Plug-in Gait hip and knee angle estimates during gait using a proximal and distal thigh marker placement for ten healthy subjects. Knee axes were estimated by optimizing thigh rotation offsets to minimize knee varus-valgus range during gait. Relative to the distal marker, the proximal marker produced 37% less varus-valgus range and 50% less hip rotation range (p < 0.001), suggesting that it produced less soft-tissue artefact in knee axis estimates. The thigh markers also produced different secondary effects on the knee centre estimate. Using whole gait cycle optimization, the distal marker showed greater minimum and maximum knee flexion (by 6° and 2° respectively) resulting in a 4° reduction in range. Mid-stance optimization reduced distal marker knee flexion by 5° throughout, but proximal marker results were negligibly affected. Based on an analysis of the Plug-in Gait knee axis definition, we show that the proximal marker reduced sensitivity to soft-tissue artefact by decreasing collinearity between the points defining the femoral frontal plane and reducing anteroposterior movement between the knee and thigh markers. This study suggests that a proximal thigh marker may be preferable when performing gait analysis using the Plug-in Gait model. PMID:26929983

  17. Ganglion Cyst of Knee from Hoffa’s Fat Pad Protruding Anterolaterally Through Retinacular Rent: A Case Report

    PubMed Central

    Saha, Partha; Bandyopadhyay, Utpal; Mukhopadhyay, Anindya S.; Kundu, Srikanta; Mandal, Subhadip

    2015-01-01

    Introduction: Intra-articular ganglion cysts of the knee joint are rare occurrences. They are usually encountered as incidental findings in magnetic resonance imaging (MRI), or in arthroscopy. They may originate from both the cruciate ligaments and the menisci, from the popliteus tendon and alar folds, infrapatellar fat pad of Hoffa, and subchondral bone cysts. Those arising from the Hoffa’s fat pad, usually present as palpable mass at anterior aspect of the knee joint. We report a case of intraarticular ganglion cyst of knee arising from the infrapatellar fat pad and protruding anterolaterally through retinacular rent into the subcutaneous plane. Case Report: A 19-year-old young man, presented with a painless gradually increasing swelling at the anterior aspect of left knee of 9 months duration. MRI scan revealed a multilobulated, cyst with septations within the anterior aspect of the knee joint, just inferolateral to the patella, with deep extension into the infrapatellar fat pad, and superficial extension into the subcutaneous space across the retinaculum. After diagnostic arthroscopy, we performed an open excision of the cystic mass and confirmed the retinacular rent pre-operatively. Conclusion: Arthroscopic resection and debridement is the gold standard treatment in ganglion cyst of the knee. However, a subcutaneous extension may lead to incomplete arthroscopic resection: Leaving behind the residual tissue which may cause recurrence. Therefore, proper pre-operative evaluation of MR images of these cases is very important. PMID:27299075

  18. Whole-Body Muscle MRI in Patients with Hyperkalemic Periodic Paralysis Carrying the SCN4A Mutation T704M: Evidence for Chronic Progressive Myopathy with Selective Muscle Involvement

    PubMed Central

    Lee, Young Han; Lee, Hyung-Soo; Lee, Hyo Eun; Hahn, Seok; Nam, Tai-Seung; Choi, Young-Chul; Kim, Seung Min

    2015-01-01

    Background and Purpose Hyperkalemic periodic paralysis (hyperKPP) is a muscle sodium-ion channelopathy characterized by recurrent paralytic attacks. A proportion of affected individuals develop fixed or chronic progressive weakness that results in significant disability. However, little is known about the pathology of hyperKPP-induced fixed weakness, including the pattern of muscle involvement. The aim of this study was to characterize the patterns of muscle involvement in hyperKPP by whole-body magnetic resonance imaging (MRI). Methods We performed whole-body muscle MRI in seven hyperKPP patients carrying the T704M mutation in the SCN4A skeletal sodium-channel gene. Muscle fat infiltration, suggestive of chronic progressive myopathy, was analyzed qualitatively using a grading system and was quantified by the two-point Dixon technique. Results Whole-body muscle MRI analysis revealed muscle atrophy and fatty infiltration in hyperKPP patients, especially in older individuals. Muscle involvement followed a selective pattern, primarily affecting the posterior compartment of the lower leg and anterior thigh muscles. The muscle fat fraction increased with patient age in the anterior thigh (r=0.669, p=0.009), in the deep posterior compartment of the lower leg (r=0.617, p=0.019), and in the superficial posterior compartment of the lower leg (r=0.777, p=0.001). Conclusions Our whole-body muscle MRI findings provide evidence for chronic progressive myopathy in hyperKPP patients. The reported data suggest that a selective pattern of muscle involvement-affecting the posterior compartment of the lower leg and the anterior thigh-is characteristic of chronic progressive myopathy in hyperKPP. PMID:26256659

  19. Regional changes in muscle mass following 17 weeks of bed rest

    NASA Technical Reports Server (NTRS)

    Leblanc, Adrian D.; Schneider, Victor S.; Evans, Harlan J.; Pientok, Colette; Rowe, Roger; Spector, Elisabeth

    1992-01-01

    This work reports on the muscle loss and recovery after 17 wk of continuous bed rest and 8 wk of reambulation in eight normal male volunteers. Muscle changes were assessed by urinary levels of 3-methylhistidine (3-MeH), nitrogen balance, dual-photon absorptiometry (DPA), magnetic resonance imaging (MRI), and isokinetic muscle performance. The total body lean tissue loss during bed rest calculated from nitrogen balance was 3.9 +/- 2.1 kg. Although the total loss is minimal, DPA scans showed that nearly all of the lean tissue loss occurred in the lower limbs. Similarly, MRI muscle volume measurements showed greater percent loss in the limbs relative to the back muscles. MRI, DPA, and nitrogen balance suggest that muscle atrophy continued throughout bed rest with rapid recovery after reambulaton. Isokinetic muscle strength decreased significantly in the thigh and calf with no loss in the arms and with rapid recovery during reambulation.

  20. Inflammatory Myofibroblastic Tumor of the Thigh: Presentation of a Rare Case and Review of the Literature

    PubMed Central

    Savvidou, O. D.; Sakellariou, V. I.; Papakonstantinou, O.; Skarpidi, E.; Papagelopoulos, P. J.

    2015-01-01

    Inflammatory myofibroblastic tumors are uncommon neoplasms; presentation of these tumors in the lower extremities is extremely rare. We present a case of a 47-year-old male with fever, fatigue, and a slow-growing thigh mass. The inflammatory markers were elevated and the MR images showed a well-defined intermuscular lesion with mild heterogeneous enhancement. The lesion was excised and histologic examination was consistent with an inflammatory myofibroblastic tumor. No adjuvant therapy was needed and the patient remained asymptomatic with no evidence of tumor recurrence during the 2 years of follow-up. PMID:25945274

  1. Propeller Flap Reconstruction in Post Oncological Thigh Defect: "The Move in Flap".

    PubMed

    Nambi, G I; Salunke, Abhijeet Ashok

    2015-06-01

    Reconstruction of soft tissue defects of the limb after tumor resection is challenging question for oncosurgeons. The management differs from reconstruction of post traumatic defects due to the complexity of the primary surgery and subsequent radiation. The conventional propeller flap is based on a perforator which is located close to the defect; but in present case the perforator was located far away from the defect. So we describe it as "Move in flap" as the flap rotated a large volume of soft tissue lying between the defect and the perforator. We present a case of post oncological thigh defect with reconstruction using a propeller flap based on distal anteromedial perforator. PMID:26405422

  2. Compartment syndrome of the thigh complicating surgical treatment of ipsilateral femur and ankle fractures

    NASA Technical Reports Server (NTRS)

    Moore, M. R.; Garfin, S. R.; Hargens, A. R.

    1987-01-01

    A 26-year-old man presented with ipsilateral femur and ankle fractures. The patient was treated with interlocking nail of his femur fracture, followed by open reduction and internal fixation of his ankle fracture under tourniquet control. Postoperatively, the patient developed compartment syndrome of his thigh with elevated pressures, requiring decompressive fasciotomies. This case illustrates the possible complication of treating a femur fracture with intramedullary nailing and then immediately applying a tourniquet to treat an ipsilateral extremity fracture. Because of the complication with this patient, we feel the procedure should be staged, or a tourniquet should be avoided if possible.

  3. Anteromedial thigh perforator flap to cover the inguinal region in a crossover femorofemoral bypass

    PubMed Central

    Maldonado, Andrés A.; García-Domínguez, Jose; González-Hidalgo, Carmen; Fernández-Casado, Jose Luis; Fonseca, Raúl

    2015-01-01

    Abstract We report the case of a 48-year-old male with an exposition of a femorofemoral crossover bypass in the inguinal region and superficial femoral occlusion. This was successfully treated using an anteromedial thigh (AMT) pedicled flap based on the perforator vessel of the descending branch of the lateral circumflex femoral artery. Our report focuses on: i) considering the AMT flap as a safe and easy option to cover the inguinal region in cases of bypass exposure; ii) describing the attachment of this flap to the deep femoral artery in a patient with superficial femoral occlusion, in spite of some literature controversy. PMID:27252966

  4. Prenatal diagnosis of a fibrosarcoma of the thigh: a case report.

    PubMed

    Durin, Luc; Jeanne-Pasquier, Corinne; Bailleul, Patrick; Eboué, Cyril; Aicardi, Stéphanie; Herlicoviez, Michel; Dreyfus, Michel

    2006-01-01

    We report a rare case of fibrosarcoma of the thigh suspected prenatally. At 27 weeks of gestation a voluminous, vascularised mass was discovered at ultrasound on the foetus' left leg, suggestive of haemangioma or a fibrosarcoma. There were no signs of heart failure. A rapid increase in the tumour mass was noted and a caesarean section was carried out at 39 weeks because of abnormal foetal heart rate. Postnatal ultrasound examination was comparable to that carried out prenatally; pathological examination of the mass biopsied and immunohistochemical investigation provided a diagnosis of congenital fibrosarcoma. After neoadjuvant chemotherapy and surgery the infant is now in complete remission without amputation. PMID:16968999

  5. Comparing clinical data and muscle imaging of DYSF and ANO5 related muscular dystrophies.

    PubMed

    Ten Dam, Leroy; van der Kooi, Anneke J; Rövekamp, Fleur; Linssen, Wim H J P; de Visser, Marianne

    2014-12-01

    In this retrospective cross-sectional study clinical and muscle imaging data of patients with Miyoshi distal myopathy phenotype (MMD1 and MMD3) and limb girdle muscular dystrophy 2L (LGMD2L) were described. MMD1 and MMD3 are genetically heterogenous diseases based on DYSF and ANO5 gene defects. MMD3 and LGMD2L are clinically different diseases caused by an ANO5 gene defect. All groups showed predominant fatty degeneration of the gluteus minimus muscle and of the posterior segments of the thigh and calf muscles with sparing of the gracilis muscle. Muscle atrophy, hypertrophy and asymmetric muscle involvement on muscle imaging did not differ between groups. The pattern of fatty degeneration of muscles and of muscle weakness shows only minor differences between MMD1 (n=6) and MMD3 (n=8) patients with more frequently fatty degeneration of the rectus femoris, anterior tibial, and extensor digitorum muscles and more frequently muscle weakness in the anterior tibial, peroneal and calf muscle in MMD1. In the ANO5 related phenotypes the lateral head of the gastrocnemius muscle was less frequently involved in LGMD2L (n=13) and no differences in the incidence of muscle weakness was found. Therefore, MMD3 and LGMD2L should be considered as part of one spectrum of ANO5 related muscle disease. PMID:25176504

  6. Muscle biopsy

    MedlinePlus

    ... that affect the muscles (such as trichinosis or toxoplasmosis ) Muscle disorders such as muscular dystrophy or congenital ... nodosa Polymyalgia rheumatica Polymyositis - adult Thyrotoxic periodic paralysis Toxoplasmosis Trichinosis Update Date 9/8/2014 Updated by: ...

  7. Muscle Disorders

    MedlinePlus

    ... cause weakness, pain or even paralysis. Causes of muscle disorders include Injury or overuse, such as sprains or strains, cramps or tendinitis A genetic disorder, such as muscular dystrophy Some ... muscles Infections Certain medicines Sometimes the cause is not ...

  8. Effect of Dietary Supplementation of the Combination of Gallic and Linoleic Acid in Thigh Meat of Broilers

    PubMed Central

    Lee, Kyung Haeng; Jung, Samooel; Kim, Hyun Joo; Kim, Il Suk; Lee, Jun Heon; Jo, Cheorun

    2012-01-01

    This study was performed to investigate the combined effect of dietary supplementation of gallic and linoleic acid (GL) on the antioxidative effect and quality of thigh meat from broilers. Broilers received 3 dietary treatments: i) commercial finisher diet (control), ii) 0.5% GL (gallic:linoleic acid = 1 M:1 M), and iii) 1.0% GL during the 22 to 36 d. The pH value of broiler thigh meat was increased by GL supplementation. Water holding capacity of the thigh meat was enhanced by the 1.0% dietary GL supplementation. Antioxidative effect (total phenolic content, DPPH radical scavenging activity, ABTS+ reducing activity, reducing power, and TBARS value) in the thigh from the broilers improved significantly with 1.0% GL. Linoleic acid and docosahexaenoic acids were higher in the broilers fed both levels of dietary GL. However, volatile basic nitrogen content and microbiological quality was not shown to be different between control and treated group. Results indicate that 1.0% dietary supplementation of GL can improve the antioxidant activity of broiler thigh meat and may enhance the meat quality. PMID:25049528

  9. Modeling Muscles

    ERIC Educational Resources Information Center

    Goodwyn, Lauren; Salm, Sarah

    2007-01-01

    Teaching the anatomy of the muscle system to high school students can be challenging. Students often learn about muscle anatomy by memorizing information from textbooks or by observing plastic, inflexible models. Although these mediums help students learn about muscle placement, the mediums do not facilitate understanding regarding integration of…

  10. Housing system influences abundance of Pax3 and Pax7 in postnatal chicken skeletal muscles.

    PubMed

    Yin, H D; Li, D Y; Zhang, L; Yang, M Y; Zhao, X L; Wang, Y; Liu, Y P; Zhu, Q

    2014-06-01

    Paired box (Pax) proteins 3 and 7 are associated with activation of muscle satellite cells and play a major role in hyperplastic and hypertrophic growth in postnatal skeletal muscle fibers. The objective of this study was to evaluate the effect of housing system on abundance of Pax3 and Pax7 in postnatal chicken skeletal muscles. At 42 d, 1,200 chickens with similar BW were randomly assigned to cage, pen, and free-range group. The mRNA abundance was measured in pectoralis major and thigh muscle at d 56, 70, and 84, and the protein expression was quantified at d 84. Increases in mRNA abundance of PAX3 and PAX7 with age were less pronounced in caged system chickens than in pen and free-range chickens from d 56 to 84, and free-range chickens showed a more pronounced increase in gene expression with age compared with penned chickens. At d 84, quantities of PAX3 and PAX7 mRNA and protein were highest in both pectoralis major and thigh muscle of chickens raised in the free-range group, lowest in penned chickens, and intermediate in caged chickens (P < 0.05). These data indicate that housing system may influence muscle fiber muscle accretion by coordinating the expression of Pax3 and Pax7 in adult chicken skeletal muscles. PMID:24879683

  11. Muscle Quantitative MR Imaging and Clustering Analysis in Patients with Facioscapulohumeral Muscular Dystrophy Type 1

    PubMed Central

    Lareau-Trudel, Emilie; Le Troter, Arnaud; Ghattas, Badih; Pouget, Jean; Attarian, Shahram; Bendahan, David; Salort-Campana, Emmanuelle

    2015-01-01

    Background Facioscapulohumeral muscular dystrophy type 1 (FSHD1) is the third most common inherited muscular dystrophy. Considering the highly variable clinical expression and the slow disease progression, sensitive outcome measures would be of interest. Methods and Findings Using muscle MRI, we assessed muscular fatty infiltration in the lower limbs of 35 FSHD1 patients and 22 healthy volunteers by two methods: a quantitative imaging (qMRI) combined with a dedicated automated segmentation method performed on both thighs and a standard T1-weighted four-point visual scale (visual score) on thighs and legs. Each patient had a clinical evaluation including manual muscular testing, Clinical Severity Score (CSS) scale and MFM scale. The intramuscular fat fraction measured using qMRI in the thighs was significantly higher in patients (21.9 ± 20.4%) than in volunteers (3.6 ± 2.8%) (p<0.001). In patients, the intramuscular fat fraction was significantly correlated with the muscular fatty infiltration in the thighs evaluated by the mean visual score (p<0.001). However, we observed a ceiling effect of the visual score for patients with a severe fatty infiltration clearly indicating the larger accuracy of the qMRI approach. Mean intramuscular fat fraction was significantly correlated with CSS scale (p≤0.01) and was inversely correlated with MMT score, MFM subscore D1 (p≤0.01) further illustrating the sensitivity of the qMRI approach. Overall, a clustering analysis disclosed three different imaging patterns of muscle involvement for the thighs and the legs which could be related to different stages of the disease and put forth muscles which could be of interest for a subtle investigation of the disease progression and/or the efficiency of any therapeutic strategy. Conclusion The qMRI provides a sensitive measurement of fat fraction which should also be of high interest to assess disease progression and any therapeutic strategy in FSHD1 patients. PMID:26181385

  12. Visualization of hypertrophied papillary muscle mimicking left ventricular mass on gated blood pool and T1-201 myocardial perfusion imaging

    SciTech Connect

    Bunko, H.; Nakajima, K.; Tonami, N.; Asanoi, H.; Hisada, K.

    1981-12-01

    A sixty-year old man with acute myocardial infarction was incidentally found to have a hypertrophied anterolateral papillary muscle (ALPPM) of the left ventricle on gated blood pool (GBP) and T1-201 myocardial perfusion images. Hypertrophy of the ALPPM was visualized as a movable defect in the lateral basal area on GBP imaging throughout the cardiac cycle and on the TI-201 study as a radionuclide accumulating structure, consistent with the defect in the GBP. A combination of these findings may suggest the presence of a hypertrophied papillary muscle of the left ventricle.

  13. Gossypiboma of the Thigh Mimicking Soft Tissue Sarcoma: Case Report and Review of Literature

    PubMed Central

    Malot, Rajat; Meena, Devi Sahai

    2012-01-01

    Introduction: Foreign body granulomas due to surgical swab left after surgery (Gossypiboma) are rare. There are few cases of such lesion after orthopaedic procedure in thigh. Presentations vary from pathological fracture to painless mass. Gossipyboma with radiological appearance of soft tissue sarcoma are rare and we report one such case Case Report: 32 year old male laborer had fracture shaft femur 13 years back which went into malunion after conservative treatment. Osteoclasis, open reduction and K-nailing was done at 6 months. Fracture united and K nail was removed 3 years later. Patient was asymptomatic for 10 years after which he presented to us with swelling and pain in the medial aspect of thigh. Radiograph showed soft tissue mass with excavating lesion of the posteromedial aspect of femur resembling soft tissue sarcoma. Biopsy revealed cystic lesion with sterile fluid with no malignant cells. Explorations of the lesion lead to discovery of shredded surgical swab. Complete removal of all granulomatous tissue was done and patient was given hip spica for 3 months after which he was gradually mobilized and is currently walking full weight bearing at one year follow up. Conclusion: Cases with radiologically destructive lesions close to previous surgery scars should be assessed with gossypiboma as one of the differentials.

  14. Determination of optimal placements of markers on the thigh during walking and landing

    NASA Astrophysics Data System (ADS)

    Thouzé, A.; Monnet, T.; Begon, M.; Pain, M. T. G.

    2010-06-01

    Kinematics of skin markers are affected by skin tissue artefact with respect to the bone during sports activities or locomotion. The purpose of this study is to determine the less disturbed marker’s location for walking and landing. Twenty-six markers were put on the thigh of nine male subjects. Each subject performed a static trial, a setup movement for determining a functional hip joint centre and five walking and landing trials. The marker displacements were obtained by comparing recorded marker positions and solidified marker positions based on the geometry of the static acquisition. The markers were subsequently ranked from the worst to the least deformed. The ranking of each trial for each subject was analyzed with the concordance coefficient of Kendall and descriptive statistics were used to determine the most and the least disturbed markers. The results show reproducibility between trials for each subject for the two movements. Statistical analysis shows that the most deformed markers during walking were located close to the hip and knee joints whereas the least disturbed were on the mid-thigh. The landing analysis does not permit to determine the best markers from the worst.

  15. Posteromedial thigh (PMT) propeller flap for perineoscrotal reconstruction: A case report.

    PubMed

    Scaglioni, Mario F; Chen, Yen-Chou; Yang, Johnson Chia-Shen

    2015-10-01

    Fournier's gangrene can lead to extensive defects of the perineoscrotal area with exposure of the testes. Such defect poses challenging tasks for both functional and cosmetic reconstruction. Due to its proximity, medial thigh skin appeared to be the most versatile donor site for perineoscrotal reconstruction. In this report, we present a case of reconstruction of a large perineoscrotal defect because of Fournier's gangrene using a posteromedial thigh (PMT) perforator propeller flap. A 58 year-old male who suffered from Fournier's gangrene resulted in a scrotal defect of 10 × 12 cm(2) with a large dead space. A pedicled PMT propeller flap measuring 9 × 23 cm(2) with two perforators that originated from the profunda femoris artery (PFA) was harvested for scrotal defect reconstruction and dead space obliteration. The flap survived completely, with no recipient or donor site morbidity. The length of followup was 3 months and was uneventful. The pedicled PMT propeller flap may be considered as a valid option for perineoscrotal reconstruction. PMID:26314393

  16. Steady state and transient temperature distributions in the human thigh covered with a cooling pad

    NASA Technical Reports Server (NTRS)

    Leo, R. J.; Shitzer, A.; Chato, J. C.; Hertig, B. A.

    1971-01-01

    An analytical and experimental study was done on the performance of cooling pads attached to a human thigh. Each cooling pad consisted of a long, water cooled tube formed into a serpentine shape with uniform spacing between the parallel sections. The analytical work developed a cylindrical model for the human thigh. The transient times predicted by this model ranged from 25 to 80 minutes, which is reasonably close to the experimental results. Calculated and measured steady state temperature profiles were in fair agreement. The transient times associated with a change from a high metabolic rate of 1800 Btu/hr (528 w) to a low level of 300 Btu/hr (88 w), were found to be about 120 minutes. A change from 300 Btu/hr (264 w) to 300 Btu/hr (88 w) resulted in 90 to 100 minute transients. However, the transient times for a change in metabolic rate in the opposite direction from 300 Btu/hr (88 w) to 1800 Btu/hr (528 w) were 40 to 60 minutes.

  17. The scaling of postcranial muscles in cats (Felidae) II: hindlimb and lumbosacral muscles.

    PubMed

    Cuff, Andrew R; Sparkes, Emily L; Randau, Marcela; Pierce, Stephanie E; Kitchener, Andrew C; Goswami, Anjali; Hutchinson, John R

    2016-07-01

    In quadrupeds the musculature of the hindlimbs is expected to be responsible for generating most of the propulsive locomotory forces, as well as contributing to body support by generating vertical forces. In supporting the body, postural changes from crouched to upright limbs are often associated with an increase of body mass in terrestrial tetrapods. However, felids do not change their crouched limb posture despite undergoing a 300-fold size increase between the smallest and largest extant species. Here, we test how changes in the muscle architecture (masses and lengths of components of the muscle-tendon units) of the hindlimbs and lumbosacral region are related to body mass, to assess whether there are muscular compensations for the maintenance of a crouched limb posture at larger body sizes. We use regression and principal component analyses to detect allometries in muscle architecture, with and without phylogenetic correction. Of the muscle lengths that scale allometrically, all scale with negative allometry (i.e. relative shortening with increasing body mass), whereas all tendon lengths scale isometrically. Only two muscles' belly masses and two tendons' masses scale with positive allometry (i.e. relatively more massive with increasing body mass). Of the muscles that scale allometrically for physiological cross-sectional area, all scale positively (i.e. relatively greater area with increasing body mass). These muscles are mostly linked to control of hip and thigh movements. When the architecture data are phylogenetically corrected, there are few significant results, and only the strongest signals remain. None of the vertebral muscles scaled significantly differently from isometry. Principal component analysis and manovas showed that neither body size nor locomotor mode separate the felid species in morphospace. Our results support the inference that, despite some positively allometric trends in muscle areas related to thigh movement, larger cats have

  18. Necrotising fasciitis of the thigh secondary to colonic perforation: the femoral canal as a route for infective spread.

    PubMed

    Wiberg, A; Carapeti, E; Greig, A

    2012-12-01

    A 57 year-old man with a history of corticosteroid use presented with abdominal pain and diarrhoea. He was initially treated for presumed Clostridium difficile colitis, but later developed a left inguinal mass with spreading erythema. A CT scan showed gas within the retroperitoneal tissues, with surgical emphysema of the left groin. Necrotising fasciitis was diagnosed, and the patient underwent extensive debridement of the left thigh and inguinal region. The femoral vein was covered in infected fascia in the femoral canal, and a laparotomy revealed a posterior perforation of the sigmoid colon. Necrotising fasciitis of the thigh is a rare complication of colonic perforation. Our case highlights the femoral canal as a potential channel for the spread of intra-abdominal infection into the thigh. PMID:22541736

  19. Identification of Histone Deacetylase 2 as a Functional Gene for Skeletal Muscle Development in Chickens

    PubMed Central

    Shahjahan, Md.; Liu, Ranran; Zhao, Guiping; Wang, Fangjie; Zheng, Maiqing; Zhang, Jingjing; Song, Jiao; Wen, Jie

    2016-01-01

    A previous genome-wide association study (GWAS) exposed histone deacetylase 2 (HDAC2) as a possible candidate gene for breast muscle weight in chickens. The present research has examined the possible role of HDAC2 in skeletal muscle development in chickens. Gene expression was measured by quantitative polymerase chain reaction in breast and thigh muscles during both embryonic (four ages) and post-hatch (five ages) development and in cultures of primary myoblasts during both proliferation and differentiation. The expression of HDAC2 increased significantly across embryonic days (ED) in breast (ED 14, 16, 18, and 21) and thigh (ED 14 and 18, and ED 14 and 21) muscles suggesting that it possibly plays a role in myoblast hyperplasia in both breast and thigh muscles. Transcript abundance of HDAC2 identified significantly higher in fast growing muscle than slow growing in chickens at d 90 of age. Expression of HDAC2 during myoblast proliferation in vitro declined between 24 h and 48 h when expression of the marker gene paired box 7 (PAX7) increased and cell numbers increased throughout 72 h of culture. During induced differentiation of myoblasts to myotubes, the abundance of HDAC2 and the marker gene myogenic differentiation 1 (MYOD1), both increased significantly. Taken together, it is suggested that HDAC2 is most likely involved in a suppressive fashion in myoblast proliferation and may play a positive role in myoblast differentiation. The present results confirm the suggestion that HDAC2 is a functional gene for pre-hatch and post-hatch (fast growing muscle) development of chicken skeletal muscle. PMID:26949948

  20. Muscle activity pattern dependent pain development and alleviation.

    PubMed

    Sjøgaard, Gisela; Søgaard, Karen

    2014-12-01

    Muscle activity is for decades considered to provide health benefits irrespectively of the muscle activity pattern performed and whether it is during e.g. sports, transportation, or occupational work tasks. Accordingly, the international recommendations for public health-promoting physical activity do not distinguish between occupational and leisure time physical activity. However, in this body of literature, attention has not been paid to the extensive documentation on occupational physical activity imposing a risk of impairment of health - in particular musculoskeletal health in terms of muscle pain. Focusing on muscle activity patterns and musculoskeletal health it is pertinent to elucidate the more specific aspects regarding exposure profiles and body regional pain. Static sustained muscle contraction for prolonged periods often occurs in the neck/shoulder area during occupational tasks and may underlie muscle pain development in spite of rather low relative muscle load. Causal mechanisms include a stereotype recruitment of low threshold motor units (activating type 1 muscle fibers) characterized by a lack of temporal as well as spatial variation in recruitment. In contrast during physical activities at leisure and sport the motor recruitment patterns are more dynamic including regularly relatively high muscle forces - also activating type 2 muscles fibers - as well as periods of full relaxation even of the type 1 muscle fibers. Such activity is unrelated to muscle pain development if adequate recovery is granted. However, delayed muscle soreness may develop following intensive eccentric muscle activity (e.g. down-hill skiing) with peak pain levels in thigh muscles 1-2 days after the exercise bout and a total recovery within 1 week. This acute pain profile is in contrast to the chronic muscle pain profile related to repetitive monotonous work tasks. The painful muscles show adverse functional, morphological, hormonal, as well as metabolic characteristics. Of

  1. The Effect of Polymethyl Methacrylate Augmentation on the Primary Stability of Cannulated Bone Screws in an Anterolateral Plate in Osteoporotic Vertebrae: A Human Cadaver Study.

    PubMed

    Rüger, Matthias; Sellei, Richard M; Stoffel, Marcus; von Rüden, Christian

    2016-02-01

    Study Design Cohort study. Objective Expandable anterolateral plates facilitate the reduction of posttraumatic deformities of thoracolumbar spine injuries and are commonly used in cases of unstable injuries or compromised bone quality. In this in vitro study, the craniocaudal yield load of the osseous fixation of an anterior angular stable plate fixation system and the effect of polymethyl methacrylate (PMMA) screw augmentation on the primary stability of the screw-bone interface during kyphosis reduction was evaluated in 12 osteoporotic human thoracolumbar vertebrae. Methods The anterolateral stabilization device used for this study is comprised of two swiveling flanges and an expandable midsection. It facilitates the controlled reduction of kyphotic deformities in situ with a geared distractor. Single flanges were attached to 12 thoracolumbar vertebrae. Six specimens were augmented with PMMA by means of cannulated bone screws. The constructs were subjected to static, displacement-controlled craniocaudal loading to failure in a servohydraulic testing machine. Results The uncemented screws cut out at a mean 393 ± 66 N, whereas the cemented screws showed significantly higher yield load of 966 ± 166 N (p < 0.02). We detected no significant correlation between bone mineral density and yield load in this setting. Conclusion Our results indicate that PMMA augmentation is an effective method to increase two- to threefold the primary stability of the screw-bone interface of an anterolateral spine stabilization system in osteoporotic bone. We recommend it in cases of severely compromised bone quality to reduce the risk of screw loosening during initial kyphosis correction and to increase long-term construct stability. PMID:26835201

  2. The Effect of Polymethyl Methacrylate Augmentation on the Primary Stability of Cannulated Bone Screws in an Anterolateral Plate in Osteoporotic Vertebrae: A Human Cadaver Study

    PubMed Central

    Rüger, Matthias; Sellei, Richard M.; Stoffel, Marcus; von Rüden, Christian

    2015-01-01

    Study Design Cohort study. Objective Expandable anterolateral plates facilitate the reduction of posttraumatic deformities of thoracolumbar spine injuries and are commonly used in cases of unstable injuries or compromised bone quality. In this in vitro study, the craniocaudal yield load of the osseous fixation of an anterior angular stable plate fixation system and the effect of polymethyl methacrylate (PMMA) screw augmentation on the primary stability of the screw–bone interface during kyphosis reduction was evaluated in 12 osteoporotic human thoracolumbar vertebrae. Methods The anterolateral stabilization device used for this study is comprised of two swiveling flanges and an expandable midsection. It facilitates the controlled reduction of kyphotic deformities in situ with a geared distractor. Single flanges were attached to 12 thoracolumbar vertebrae. Six specimens were augmented with PMMA by means of cannulated bone screws. The constructs were subjected to static, displacement-controlled craniocaudal loading to failure in a servohydraulic testing machine. Results The uncemented screws cut out at a mean 393 ± 66 N, whereas the cemented screws showed significantly higher yield load of 966 ± 166 N (p < 0.02). We detected no significant correlation between bone mineral density and yield load in this setting. Conclusion Our results indicate that PMMA augmentation is an effective method to increase two- to threefold the primary stability of the screw–bone interface of an anterolateral spine stabilization system in osteoporotic bone. We recommend it in cases of severely compromised bone quality to reduce the risk of screw loosening during initial kyphosis correction and to increase long-term construct stability. PMID:26835201

  3. Is a single anterolateral screw-plate fixation sufficient for the treatment of spinal fractures in the thoracolumbar junction? A biomechanical in vitro investigation.

    PubMed

    Schreiber, Ulrich; Bence, Tibor; Grupp, Thomas; Steinhauser, Erwin; Mückley, Thomas; Mittelmeier, Wolfram; Beisse, Rudolf

    2005-03-01

    Controversy exists about the indications, advantages and disadvantages of various surgical techniques used for anterior interbody fusion of spinal fractures in the thoracolumbar junction. The purpose of this study was to evaluate the stabilizing effect of an anterolateral and thoracoscopically implantable screw-plate system. Six human bisegmental spinal units (T12-L2) were used for the biomechanical in vitro testing procedure. Each specimen was tested in three different scenarios: (1) intact spinal segments vs (2) monosegmental (T12/L1) anterolateral fixation (macsTL, Aesculap, Germany) with an interbody bone strut graft from the iliac crest after both partial corpectomy (L1) and discectomy (T12/L1) vs (3) bisegmental anterolateral instrumentation after extended partial corpectomy (L1), and bisegmental discectomy (T12/L1 and L1/L2). Specimens were loaded with an alternating, nondestructive maximum bending moment of +/-7.5 Nm in six directions: flexion/extension, right and left lateral bending, and right and left axial rotation. Motion analysis was performed by a contact-less three-dimensional optical measuring system. Segmental stiffness of the three different scenarios was evaluated by the relative alteration of the intervertebral angles in the three main anatomical planes. With each stabilization technique, the specimens were more rigid, compared with the intact spine, for flexion/extension (sagittal plane) as well as in left and right lateral bending (frontal plane). In these planes the bisegmental instrumentation compared to the monosegmental case had an even larger stiffening effect on the specimens. In contrast to these findings, axial rotation showed a modest increase of motion after bisegmental instrumentation. To conclude, the immobilization of monosegmental fractures in the thoracolumbar junction can be secured by means of bone grafting and the implant used in this study for all three anatomical planes. After bisegmental anterolateral stabilization a

  4. Papillary intralymphatic angioendothelioma of the thigh: A case report and review of the literature.

    PubMed

    Ward, Katherine A; Ecker, Phillip M; White, Rebekah R; Melnik, Tanya E; Gulbahce, Evin H; Wilke, Mark S; Sangueza, Omar P

    2010-01-01

    The term angiosarcoma, encompasses several neoplasms, all of which exhibit a malignant process derived from endothelial cells of the vessels. The most common form of angiosarcoma is highly aggressive, often fatal, and usually affects the head and neck region of elderly white men. Other low-grade forms of angiosarcoma, including papillary intralymphatic angioendothelioma, also known as Dabska tumor, are less invasive, affect a wider age range, and offer a better prognosis. There are several predisposing factors that increase the risk of angiosarcoma and include chronic lymphedema of the extremities, preexisting vascular lesions, and prior radiation, often as therapy for other malignancies. We report an unusual case of a very small, low-grade angiosarcoma on the thigh of an adult female with no known predisposing risk factors. PMID:20409411

  5. Measurement of tibial torsion and thigh-foot angle using goniometry and computed tomography.

    PubMed

    Stuberg, W; Temme, J; Kaplan, P; Clarke, A; Fuchs, R

    1991-11-01

    Three therapists measured tibiofibular torsion and thigh-foot angle (TFA) goniometrically in 17 normal subjects, aged three to 24 years. Tibiofibular torsion was also measured using computed tomography (CT). Differences between testers for the goniometric measures were analyzed using a nonparametric analysis of variance. Wilcoxon's rank sum test was used to determine differences between goniometric and CT measures for tibiofibular torsion. No significant difference for goniometric measures was found between testers for tibiofibular torsion or TFA. A significant difference averaging 5 degrees between goniometric and CT torsion measures was found between testers. Although a significant difference was found between the two measurement methods, the degree of difference may not represent a significant clinical difference, as a range at 5 degrees is commonly reported as the margin of error for goniometric measurements. PMID:1934735

  6. Neuroendocrine tumor arising de novo in the left upper thigh: a case report.

    PubMed

    Păun, Ion; Costin, Andrei; Păun, Mariana; Ţenovici, Mihaela; Georgescu, Claudia Valentina; Georgescu, Corneliu Cristian; Constantin, Vlad Denis

    2015-01-01

    Neuroendocrine tumors (NETs) originate in the neuroendocrine cells of the neural crest (Kulchitsky cells). If neuroendocrine tumors arising in the digestive tract or lung may occasionally result in skin metastases, primary soft tissue or skin NETs are infrequent. The current paper presents the case of an elderly woman patient with neuroendocrine tumors arising de novo in the left upper thigh, accompanied by lymph nodes metastases in the left groin and in the left pelvic sidewall, in close vicinity of the iliac vessels. The diagnosis of NET was performed based on immunohistochemical tests. Such tumors show a slow growth and, generally, have a good prognosis. It is emphasized that complete surgical excision, in some cases associated with adjuvant external radiotherapy is the optimal therapeutic modality in dealing with such lesions. PMID:26429186

  7. Comparison of Activity Type Classification Accuracy from Accelerometers Worn on the Hip, Wrists, and Thigh in Young, Apparently Healthy Adults

    ERIC Educational Resources Information Center

    Montoye, Alexander H. K.; Pivarnik, James M.; Mudd, Lanay M.; Biswas, Subir; Pfeiffer, Karin A.

    2016-01-01

    The purpose of this article is to compare accuracy of activity type prediction models for accelerometers worn on the hip, wrists, and thigh. Forty-four adults performed sedentary, ambulatory, lifestyle, and exercise activities (14 total, 10 categories) for 3-10 minutes each in a 90-minute semi-structured laboratory protocol. Artificial neural…

  8. Glycyrrhetinic acid, the active principle of licorice, can reduce the thickness of subcutaneous thigh fat through topical application.

    PubMed

    Armanini, Decio; Nacamulli, Davide; Francini-Pesenti, Francesco; Battagin, Giuliana; Ragazzi, Eugenio; Fiore, Cristina

    2005-07-01

    Cortisol is involved in the distribution and deposition of fat, and its action is regulated by the activity of 11beta-hydroxysteroid dehydrogenase. Glycyrrhetinic acid, the active principle of licorice root, blocks 11beta-hydroxysteroid dehydrogenase type 1, thus reducing the availability of cortisol at the level of adipocytes. We evaluated the effect of topical application of a cream containing glycyrrhetinic acid in the thickness of fat at the level of the thigh. Eighteen healthy women (age range 20-33 years) with normal BMI were randomly allocated to treatment, at the level of the dominant thigh, with a cream containing 2.5% glycyrrhetinic acid (n=9) or with a placebo cream containing the excipients alone (n=9). Before and after 1 month of treatment both the circumference and the thickness of the superficial fat layer of the thighs (by ultrasound analysis) were measured. The circumference and the thickness of the superficial fat layer were significantly reduced in comparison to the controlateral untreated thigh and to control subjects treated with the placebo cream. No changes were observed in blood pressure, plasma renin activity, plasma aldosterone or cortisol. The effect of glycyrrhetinic acid on the thickness of subcutaneous fat was likely related to a block of 11beta-hydroxysteroid dehydrogenase type 1 at the level of fat cells; therefore, glycyrrhetinic acid could be effectively used in the reduction of unwanted local fat accumulation. PMID:15894038

  9. Skeletal muscle mass and muscular function in master swimmers is related to training distance.

    PubMed

    Abe, Takashi; Kojima, Kosuke; Stager, Joel M

    2014-10-01

    It is unknown whether or not the daily swim training distances of master swimmers (MS) affect the observed changes in skeletal muscle mass (SM) and physical function commonly associated with the aging process. Twenty-two male MS aged 52-82 years were divided into two groups based upon training distance: High MS (>3000 meters swim/session and 4.1 times/week; n=11) and moderate MS (1500-2800 meters swim/session and 3.4 times/week; n=11). Eleven age- and body mass index-matched older (aged 56-80 years) men served as controls (AMC). Subjects who performed resistance training were excluded in this study. Muscle thickness (MTH) was measured by ultrasound at nine sites on the anterior/posterior aspects of the body (forearm, upper arm, trunk, thigh, and lower leg), and from this, total and segmental SM mass values were estimated. Thigh MTH (anterior:posterior mid-thigh, A50:P50) ratio was calculated to assess the site-specific thigh muscle loss. Straight and zigzag walking performance and maximum knee extension/flexion strength were also measured. Arm SM was greater for high MS and moderate MS than for AMC. Total SM index was higher for high MS than for moderate MS and AMC. A50:P50 ratio was greater for high MS than for AMC. Absolute and relative knee extension strength, but not flexion strength, was greater in high MS than in AMC. The A50:P50 ratio inversely correlated (p<0.05) with zigzag walking time, whereas relative knee extension strength positively correlated (p<0.05) with both straight and zigzag walking performance. Training distance in older MS may be an important factor for maintaining muscle mass and function in the aging process. PMID:24797514

  10. Systematic Review of Thigh Symptoms after Lateral Transpsoas Interbody Fusion for Adult Patients with Degenerative Lumbar Spine Disease

    PubMed Central

    Gammal, Isaac D.; Bendo, John A.

    2015-01-01

    Background Lateral transpsoas interbody fusion (LTIF) is a minimally invasive technique for achieving lumbar spinal fusion. While it has many advantages over open techniques it carries with it a distinct set of risks, most commonly post-operative ipsilateral thigh pain, weakness and sensory disturbances. It is vital for both the surgeon and patient to understand the risks for and outcomes of injury associated with this procedure. We conducted a systematic review of the literature to evaluate the incidence, risks, and long-term clinical outcomes of post-operative thigh symptoms in patients treated with LTIF. Methods We conducted a search of MEDLINE, EMBASE, CINAHL, Scopus, Web of Science and the Cochrane Collaboration Library, using keywords and MeSH terms, for English-language literature published through September 2014, as well as reference lists from key articles. Studies were then manually filtered to retrieve articles that met inclusion criteria. We were interested in studies that reported postoperative lower extremity symptoms after LTIF, such as pain, weakness and changes in sensation. The strength of evidence was determined based on precepts outlined by the Grades of Recommendation Assessment, Development and Evaluation Working Group (GRADE). Results A total of 392 articles were initially retrieved, with 24 ultimately meeting criteria for inclusion. The incidence of any post-operative thigh symptom varied, ranging as high as 60.7%, with 9.3% of patients experiencing a motor deficit related to direct nerve injury. Several studies reported cases of persistent symptoms at 6 months follow up. Additionally, inclusion of the L4-5 disc space and a longer duration of surgery were both identified as risks for developing postoperative thigh symptoms. Conclusion The risk of postoperative thigh symptoms after LTIF is high. Thigh pain, paresthesias and weakness were the most commonly reported symptoms. While most patients’ symptoms resolved by 6 months follow up

  11. Muscle cramps.

    PubMed

    Miller, Timothy M; Layzer, Robert B

    2005-10-01

    Muscle cramps are a common problem characterized by a sudden, painful, involuntary contraction of muscle. These true cramps, which originate from peripheral nerves, may be distinguished from other muscle pain or spasm. Medical history, physical examination, and a limited laboratory screen help to determine the various causes of muscle cramps. Despite the "benign" nature of cramps, many patients find the symptom very uncomfortable. Treatment options are guided both by experience and by a limited number of therapeutic trials. Quinine sulfate is an effective medication, but the side-effect profile is worrisome, and other membrane-stabilizing drugs are probably just as effective. Patients will benefit from further studies to better define the pathophysiology of muscle cramps and to find more effective medications with fewer side-effects. PMID:15902691

  12. Intra-arterial delivery of triolein emulsion increases vascular permeability in skeletal muscles of rabbits

    PubMed Central

    Kim, Hak Jin; Kim, Yong Woo; Lee, In Sook; Song, Jong Woon; Jeong, Yeon Joo; Choi, Seon Hee; Choi, Kyung Un; Suh, Kuen Tak; Cho, Byung Mann

    2009-01-01

    Background To test the hypothesis that triolein emulsion will increase vascular permeability of skeletal muscle. Methods Triolein emulsion was infused into the superficial femoral artery in rabbits (triolein group, n = 12). As a control, saline was infused (saline group, n = 18). Pre- and post-contrast T1-weighted MR images were obtained two hours after infusion. The MR images were qualitatively and quantitatively evaluated by assessing the contrast enhancement of the ipsilateral muscles. Histologic examination was performed in all rabbits. Results The ipsilateral muscles of the rabbits in the triolein group showed contrast enhancement, as opposed to in the ipsilateral muscles of the rabbits in the saline group. The contrast enhancement of the lesions was statistically significant (p < 0.001). Histologic findings showed that most examination areas of the triolein and saline groups had a normal appearance. Conclusion Rabbit thigh muscle revealed significantly increased vascular permeability with triolein emulsion; this was clearly demonstrated on the postcontrast MR images. PMID:19604410

  13. Quadriceps intramuscular fat fraction rather than muscle size is associated with knee osteoarthritis

    PubMed Central

    Kumar, Deepak; Karampinos, Dimitrios C.; MacLeod, Toran D.; Lin, Wilson; Nardo, Lorenzo; Li, Xiaojuan; Link, Thomas M; Majumdar, Sharmila; Souza, Richard B

    2014-01-01

    Objectives To compare thigh muscle intramuscular fat (intraMF) fractions and area between people with and without knee radiographic osteoarthritis (ROA); and to evaluate the relationships of quadriceps adiposity and area with strength, function and knee MRI lesions. Methods Ninety six subjects (ROA: KL >1; n = 30, control: KL = 0,1; n = 66) underwent 3-Tesla MRI of the thigh muscles using chemical shift-based water/fat MR imaging (fat fractions) and the knee (clinical grading). Subjects were assessed for isometric/isokinetic quadriceps/hamstrings strength, function (KOOS, stair climbing test [SCT], and 6-minute walk test [(6MWT]. Thigh muscle intraMF fractions, muscle area and strength, and function were compared between controls and ROA subjects, adjusting for age. Relationships between measures of muscle fat/area with strength, function, KL and lesion scores were assessed using regression and correlational analyses. Results The ROA group had worse KOOS scores but SCT and 6MWT were not different. The ROA group had greater quadriceps intraMF fraction but not for other muscles. Quadriceps strength was lower in ROA group but the area was not different. Quadriceps intraMF fraction but not area predicted self-reported disability. Aging, worse KL, and cartilage and meniscus lesions were associated with higher quadriceps intraMF fraction. Conclusion Quadriceps intraMF is higher in people with knee OA and is related to symptomatic and structural severity of knee OA, where as the quadriceps area is not. Quadriceps fat fraction from chemical shift-based water/fat MR imaging may have utility as a marker of structural and symptomatic severity of knee OA disease process. PMID:24361743

  14. Muscle cramps

    MedlinePlus

    ... The most common cause of muscle cramps during sports activity is not getting enough fluids. Often, drinking ... alone does not always help. Salt tablets or sports drinks, which also replenish lost minerals, can be ...

  15. Muscle aches

    MedlinePlus

    ... be done include: Complete blood count (CBC) Other blood tests to look at muscle enzymes (creatine kinase) and possibly a test for Lyme disease or a connective tissue disorder Physical therapy may be helpful.

  16. Lower limb gigantism, lymphedema, and painful varicosities following a thigh vascular access graft.

    PubMed

    Thompson, Michael; Mathuram Thiyagarajan, Umasankar; Akoh, Jacob A

    2014-07-01

    Prosthetic arteriovenous grafts (AVGs) are associated with greater morbidity than autogenous arteriovenous fistulas (AVFs), but their use is indicated when AVF formation is not possible. This report adds to the literature a case of lower limb gigantism, painful varicosities, and lymphedema following long-term use of AVG in the upper thigh. The patient's past medical history included renal transplantation on the same side well before the AVG was inserted and right leg deep vein thrombosis. Suspicion of AVG thrombosis was excluded by Doppler ultrasound, which demonstrated an access flow of 1700 mL/min. A computed tomography (CT) scan of the abdomen and pelvis did not identify the cause of her symptoms. Whereas functional incompetence of the iliac vein valve might be responsible for the varicosities, the extent of hypertrophy in this case raises the suspicion of lymphatic blockage possibly secondary to groin dissection undertaken at the time of graft insertion, in addition to the previous dissection at the time of transplantation. This case highlights the need for minimal groin dissection during AVG insertion, particularly in patients with a history of previous abdominopelvic surgery. PMID:24467313

  17. Salmonella infection in illegally imported spur-thighed tortoises (Testudo graeca).

    PubMed

    Percipalle, M; Giardina, G; Lipari, L; Piraino, C; Macrì, D; Ferrantelli, V

    2011-06-01

    The prevalence of Salmonella infection was determined in a group of spur-thighed tortoises (Testudo graeca) seized during two smuggling attempts and in a population of captive Hermann's tortoises (Testudo hermanni) sheltered in a wildlife rescue centre. Salmonella spp. was isolated in 81 of 220 (36.8%) and in 17 of 67 (25.4%) cloacal swabs collected from the T. graeca and T. hermanni tortoises respectively. Overall, a total of 21 different Salmonella serotypes were found. Some of these serotypes are common to terrestrial chelonians while others have never been reported. All cultured serotypes were non-typhoidal but nonetheless many of these have been previously reported as source of human outbreaks of reptile-related salmonellosis. Eighty-two per cent and 5.3% of the isolates were resistant to two and three anti-microbial agents respectively. However, the isolates were highly susceptible to the anti-microbials of choice for the treatment of salmonellosis such as cephalosporins and fluoroquinolones. Our findings confirm that tortoises can be considered a reservoir for Salmonella and that care should be employed when handling and breeding these animals. Tight surveillance should be enforced to avoid illegal importation and prevent the trading of live tortoises, carriers of zoonotic pathogens. PMID:20626717

  18. Treatment of post-traumatic myositis ossificans of the anterior thigh with extracorporeal shock wave therapy

    PubMed Central

    Torrance, David Allen; deGraauw, Christopher

    2011-01-01

    Objective This case study demonstrates the effectiveness of a novel approach to the treatment of post-traumatic myositis ossificans with extracorporeal shockwave therapy in an elite athlete. Clinical Features A 20 year-old male semi-professional rugby player presented with progressive pain and loss of range of motion after sustaining a severe, right quadriceps contusion nine weeks earlier. The differential diagnosis of myositis ossificans was suspected and confirmed on radiographic examination. Intervention and Outcome A two week treatment protocol was undertaken consisting of three sessions of extracorporeal shockwave therapy and an unsupervised exercise program consisting of active and passive range of motion, gradual strengthening and balance exercises. The patient experienced appreciable improvements in pain and range of motion in two weeks and was able to participate in sport specific activity four weeks after presentation. Summary This case illustrates the successful conservative management of post-traumatic myositis ossificans of the anterior thigh with extracorporeal shockwave therapy and a primarily unsupervised graded exercise program within a condensed treatment time frame of 2 weeks. PMID:22131560

  19. A recurrent solitary fibrous tumor of the thigh with malignant transformation: A case report

    PubMed Central

    Yoshimura, Yasuo; Sano, Kenji; Isobe, Ken-ichi; Aoki, Kaoru; Kito, Munehisa; Kato, Hiroyuki

    2016-01-01

    Introduction We describe an unusual case of a uniformly high-grade malignant solitary fibrous tumor (SFT) of the thigh with recurrence after wide resection in a 31-year-old man. Presentation of case Our current case showed a long-term benign course before the operation, although the subcutaneous tumor was larger than 10 cm at presentation. The SFT was diagnosed by needle biopsy, and wide resection was performed. Histological findings showed proliferation of capillaries surrounded by masses of spindle-shaped cells without any cytologic atypia, and the percentage of MIB-1-positive nuclei was 2.1%. However, a rapidly enlarging recurrent tumor was observed 11 months after the operation. A second wide resection for the recurrent tumor was performed. Histologically, the tumor cells uniformly displayed significant cytologic atypia and pleomorphism, and had 40–50 mitoses per 10 high-power fields. The proportion of MIB-1-positive nuclei was 48%. Consequently, the tumor was diagnosed as a SFT with malignant transformation. Discussion The malignant transformation described in past studies showed high-grade areas within benign, low-grade, or intermediate-grade SFTs. Therefore, in contrast to our case, uniformly high-grade malignant histological findings at recurrence were not described. Conclusion Even if a tumor is non-malignant during the clinical course, as confirmed by tissue biopsy, the possibility of tumor progression to high-grade sarcoma at recurrence should be considered, and the treatment strategy should be determined carefully. PMID:26967903

  20. A case of extrapleural solitary fibrous tumor of the thigh with eight years follow-up.

    PubMed

    Hariga, Cristian Sorin; Achim, Sanda Claudia; Savu, Adina Carmen; Enache, Valentin; Jecan, Cristian Radu

    2016-01-01

    Solitary fibrous tumor (SFT) is a rare neoplasia. Now classified as SFT, it was first described in 1942 as "hemangiopericytoma" (HPC), and its origin was supposed to be the pericytes. The location outside the pleura is considered uncommon and the tumor situation on the thigh is much more unusual. In this article, we present a case of a SFT located in the hip. Even if the limb situation of the SFT is considered rare, some tumors in lower limb were reported in the past few years. Our initial clinical diagnosis, in this case, was a variant of lipoma (fibrolipoma), so no further investigations were performed before surgery at that time, and the surgery was planned as a simple procedure. The mimics of SFT with a large variety of benign tumors, especially in long-term evolution cases, make the preoperative diagnosis much more difficult. After the excision of the tumor and histological and immunohistochemical (IHC) tests, the diagnosis was finally stated. Even the findings in the exam conducted us to a most likely benign evolution, the eight years follow-up allowed us to strongly correlate the evolution with laboratory findings in this case. Further follow-up in this case can and will be performed. PMID:27151726

  1. An optimized mouse thigh infection model for enterococci and its impact on antimicrobial pharmacodynamics.

    PubMed

    Rodriguez, Carlos A; Agudelo, Maria; Gonzalez, Javier M; Vesga, Omar; Zuluaga, Andres F

    2015-01-01

    Negligible in vivo growth of enterococci and high-level dispersion of data have led to inaccurate estimations of antibiotic pharmacodynamics (PD). Here we improved an in vivo model apt for PD studies by optimizing the in vitro culture conditions for enterococci. The PD of vancomycin (VAN), ampicillin-sulbactam (SAM), and piperacillin-tazobactam (TZP) against enterococci were determined in vivo, comparing the following different conditions of inoculum preparation: aerobiosis, aerobiosis plus mucin, and anaerobiosis plus mucin. Drug exposure was expressed as the ratio of the area under the concentration-time curve for the free, unbound fraction of the drug to the MIC (fAUC/MIC) (VAN) or the time in a 24-h period that the drug concentration for the free, unbound fraction exceeded the MIC under steady-state pharmacokinetic conditions (fT(>MIC)) (SAM and TZP) and linked to the change in log10 CFU/thigh. Only anaerobiosis plus mucin enhanced the in vivo growth, yielding significant PD parameters with all antibiotics. In conclusion, robust in vivo growth of enterococci was crucial for better determining the PD of tested antibacterial agents, and this was achieved by optimizing the procedure for preparing the inoculum. PMID:25348523

  2. Chronic rhinitis associated with herpesviral infection in captive spur-thighed tortoises from Spain.

    PubMed

    Muro, J; Ramis, A; Pastor, J; Velarde, R; Tarres, J; Lavin, S

    1998-07-01

    An epidemic of chronic rhinitis in a population of 50 captive spur-thighed tortoises (Testudo graeca graeca) from Palafrugell (Girona, Spain) is described, in which eight animals died and 12 were euthanatized to perform necropsies and post-mortem studies. The main clinical sign was a bilateral, seromucous rhinitis often accompanied by stomatitis and glossitis. Hematology and serum biochemistry were performed in 33 of the 50 ill animals and in 29 healthy tortoises from three disease-free populations. Lymphocyte count, aspartate aminotransferase (AST) activity, and alpha-globulin levels were significantly higher in the animals from the sick population. The heterophil count was significantly lower in the sick animals. Some of the diseased tortoises also showed a normocytic-normochromic anemia. Lesions were restricted to the respiratory system and oral cavity. Marked epithelial hyperplasia and presence of a severe mixed inflammatory infiltrate in the epithelium of the oral, nasal, and tracheal mucosae were observed. Electron microscopy demonstrated the presence of intracytoplasmic and intranuclear viral particles of the size, shape, and distribution pattern typical of a herpesvirus. PMID:9706558

  3. An Optimized Mouse Thigh Infection Model for Enterococci and Its Impact on Antimicrobial Pharmacodynamics

    PubMed Central

    Rodriguez, Carlos A.; Agudelo, Maria; Gonzalez, Javier M.; Vesga, Omar

    2014-01-01

    Negligible in vivo growth of enterococci and high-level dispersion of data have led to inaccurate estimations of antibiotic pharmacodynamics (PD). Here we improved an in vivo model apt for PD studies by optimizing the in vitro culture conditions for enterococci. The PD of vancomycin (VAN), ampicillin-sulbactam (SAM), and piperacillin-tazobactam (TZP) against enterococci were determined in vivo, comparing the following different conditions of inoculum preparation: aerobiosis, aerobiosis plus mucin, and anaerobiosis plus mucin. Drug exposure was expressed as the ratio of the area under the concentration-time curve for the free, unbound fraction of the drug to the MIC (fAUC/MIC) (VAN) or the time in a 24-h period that the drug concentration for the free, unbound fraction exceeded the MIC under steady-state pharmacokinetic conditions (fT>MIC) (SAM and TZP) and linked to the change in log10 CFU/thigh. Only anaerobiosis plus mucin enhanced the in vivo growth, yielding significant PD parameters with all antibiotics. In conclusion, robust in vivo growth of enterococci was crucial for better determining the PD of tested antibacterial agents, and this was achieved by optimizing the procedure for preparing the inoculum. PMID:25348523

  4. [Mirror therapy for the treatment of phantom limb pain after bilateral thigh amputation. A case report].

    PubMed

    Wosnitzka, M; Papenhoff, M; Reinersmann, A; Maier, C

    2014-12-01

    This case study is the first to report successful treatment of bilateral phantom limb pain (PLP) in a patient with bilateral thigh amputation and inefficacious medical treatment using a protocol of graded interventions including mirror therapy (MT). MT is a common treatment for PLP but requires the induction of a visual illusion of an intact limb in the mirror, usually achieved by mirroring the healthy extremity. Here, we illustrate how application of a unilateral prosthesis sufficed to induce the necessary illusion. After sequential imagery, then lateralization training, which alleviated pain attacks, the patient received a further 3-week treatment of mirror treatment. Pain intensity was reduced by more than 85 %; the number of attacks were decreased by more than 90% per day. The analgesic efficacy lasted until the unexpected death of the patient several months later. This case illustrates the mechanisms of MT through overcoming the sensory incongruences underlying the distorted body schema and its efficacy in patients with bilateral amputation. PMID:25392090

  5. Activity of imipenem against VIM-1 metallo-beta-lactamase-producing Klebsiella pneumoniae in the murine thigh infection model.

    PubMed

    Daikos, G L; Panagiotakopoulou, A; Tzelepi, E; Loli, A; Tzouvelekis, L S; Miriagou, V

    2007-02-01

    The in-vivo activity of imipenem against VIM-1-producing Klebsiella pneumoniae (VPKP) was assessed in a thigh infection model in neutropenic mice. Animals were infected with three VPKP isolates (imipenem MICs 2, 4 and 32 mg/L, respectively) and a susceptible clinical isolate (MIC 0.125 mg/L) that did not produce any beta-lactamase with broad-spectrum activity. Bacterial density at the site of infection was determined after imipenem treatment (30 and 60 mg/kg every 2 h for 24 h). The log(10) reduction in CFU/thigh was greatest for the wild-type isolate, intermediate for the two imipenem-susceptible VPKP isolates, and lowest for the imipenem-resistant VPKP isolate. Whilst in-vivo imipenem activity appeared reduced against in-vitro susceptible VIM-1 producers compared with a VIM-1-negative control, an increased drug dosage could moderate this reduction. PMID:17328735

  6. Small Multifidus Muscle Size Predicts Football Injuries

    PubMed Central

    Hides, Julie A.; Stanton, Warren R.; Mendis, M. Dilani; Franettovich Smith, Melinda M.; Sexton, Margot J.

    2014-01-01

    Background: In Australian football, lower limb injuries have had the highest incidence and prevalence rates. Previous studies have shown that football players with relatively more severe preseason and playing season hip, groin, and thigh injuries had a significantly smaller multifidus muscle compared with players with no lower limb injuries. Rehabilitation of the multifidus muscle, with restoration of its size and function, has been associated with decreased recurrence rates of episodic low back pain and decreased numbers of lower limb injuries in football players. Assessment of multifidus muscle size and function could potentially be incorporated into a model that could be used to predict injuries in football players. Purpose: To examine the robustness of multifidus muscle measurements as a predictor of lower limb injuries incurred by professional football players. Study Design: Cohort study; Level of evidence, 2. Methods: Ultrasound examinations were carried out on 259 male elite football players at the start of the preseason and 261 players at the start of the playing season. Injury data were obtained from records collected by the Australian Football League (AFL) club staff during the preseason and the playing season. Results: Decreased size of the multifidus muscle at L5 consistently predicted injury in the preseason and playing season. Asymmetry of the multifidus muscle and low back pain were significantly related to lower limb injuries in the preseason, and having no preferred kicking leg was related to season injuries. Seasonal change in the size of the multifidus muscle indicating a decrease in muscle mass was linked to injury. Sensitivity and specificity of the model were 60.6% and 84.9% for the preseason and 91.8% and 45.8% for the playing season, respectively. Conclusion: A model was developed for prediction of lower limb injuries in football players with potential utility for club medical staff. Of particular note is the finding that changes in muscle

  7. The physicochemical properties and antioxidative potential of raw thigh meat from broilers fed a dietary medicinal herb extract mixture

    PubMed Central

    Shirzadegan, K.; Falahpour, P.

    2014-01-01

    A 6-wk feeding study was conducted to evaluate the antioxidative potential, indices such as quality of the thigh meat and liver of broiler chickens fed with a dietary medicinal herb extract mixture (HEM, consisting: Iranian green tea, cinnamon, garlic and chicory at a ratio of 25:15:45:15). A total of 320, one-d-old Ross (male) broiler chickens were used to investigate the effects of 0.0, 2.5, 5.0 and 7.5 g/kg HEM in the diet, on aforementioned factors. The HEM supplementation did not influence the composition of raw thigh meat except for the total phenols and crude ash (P<0.05). Furthermore, pH, water-holding capacity (WHC) and acceptability of thigh meat were affecting by administration of HEM in diets (P<0.05). Meat flavor increased in the supplemented groups (P<0.05). According to our data, HEM supplementation decreased the amount of thiobarbituric acid reactive substance (TBARS) in various times of storage and improved the liver lipid peroxides and superoxide dismutase (SOD) activities at week 6 (P<0.05), but did not influence the catalase activity. Our results reveal that the addition of 7.5 g/kg or higher HEM in diet could be sufficient to increase the antioxidative activity and 2.5 g/kg for meat taste of broilers in maximum levels. PMID:26623342

  8. Renal cell carcinoma with rhabdoid and sarcomatoid features presented as a metastatic thigh mass with an unusual immunohistochemical profile.

    PubMed

    Abdou, Asmaa Gaber; Kandil, Mona; Elshakhs, Soliman; El-Dien, Marwa Serag; Abdallah, Rania

    2014-01-23

    Renal cell carcinoma (RCC) may metastasize anywhere in the body and sometimes the primary tumor is missing and necessitates extensive investigations to detect. In this report, we describe a case of RCC metastasizing to the thigh in a 70 year old male with a highly pleomorphic morphology suggesting a high grade sarcoma that showed unequivocal positivity for desmin directing the diagnosis for pleomorphic rhabdomyosarcoma. After completion of 33 cycles of radiotherapy, the patient developed large intraabdominal mass that showed conventional areas of RCC with immunoreactivity for CD10, CK, EMA, carbonic anhydrase IX and vimentin. The tumor cells in other areas resembled that of thigh mass which raised suspicions whether the two masses represented the same tumor or not. Surprisingly, the tumor cells of thigh mass showed diffuse positivity for CD10 and focal expression for CK, EMA and carbonic anhydrase IX. Extensive investigations failed to detect any primary renal lesions. The present case demonstrated that RCC can metastasize to virtually any body site and can have significant morphologic overlap with other non-renal neoplasms. Absence of primary origin of RCC according to radiological and operative data should not hinder the diagnosis of metastatic RCC. RCC with sarcomatoid and rhabdoid features carries aggressive behavior manifested by great metastatic potential and short survival time. PMID:24711903

  9. Measurement of the quadriceps femoris muscle using magnetic resonance and ultrasound imaging.

    PubMed Central

    Walton, J M; Roberts, N; Whitehouse, G H

    1997-01-01

    OBJECTIVES: To define a method for measurement of the cross sectional area and volume of the quadriceps femoris muscle using magnetic resonance imaging (MRI) in conjunction with stereology, and to compare the results of measurements obtained by the MRI method with those obtained by the conventional method of static B-mode ultrasound in order to evaluate whether MRI is a reliable alternative to ultrasound. METHODS: A preliminary MRI study was undertaken on a single female volunteer in order to optimise the scanning technique and sampling design for estimating the muscle volume using the Cavalieri method. Ten healthy volunteers participated in the method comparison study. Each volunteer underwent static B-mode ultrasonography, immediately followed by MRI. The cross sectional area of the quadriceps femoris was estimated at the junction of the proximal one third and distal two thirds of the thigh, and seven systematic sections of the thigh were obtained in order to estimate muscle volume by both modalities. RESULTS: Seven sections through the muscle are required to achieve a coefficient of error of 4-5%. There was no significant difference in the cross sectional area estimates or volume estimates when ultrasound and MRI were compared. CONCLUSION: Muscle cross sectional area and volume can be measured without bias by MRI in conjunction with stereological methods and the method is a reliable alternative to static B-mode ultrasound for this purpose. Images Figure 1 Figure 4 Figure 5 PMID:9132215

  10. Myogenic regulatory factor (MRF) expression is affected by exercise in postnatal chicken skeletal muscles.

    PubMed

    Yin, Huadong; Li, Diyan; Wang, Yan; Zhao, Xiaoling; Liu, Yiping; Yang, Zhiqin; Zhu, Qing

    2015-05-01

    The MyoD1, MyoG, Myf5, and Mrf4 proteins belong to the family of muscle regulatory factors (MRFs) and play important roles in skeletal muscle hyperplasia and hypertrophy. We hypothesized that exercise would affect MRF mRNA and protein abundance in postnatal chicken skeletal muscle driving molecular changes that could ultimately lead to increased muscle fiber diameter. At day (d) 43, twelve hundred chickens with similar body weight were randomly assigned to cage, pen, and free-range groups. The MRF mRNA abundance was measured in the pectoralis major and thigh muscle at d56, d70, and d84, and the protein levels of MRFs were determined from the thigh muscle at d84. The results showed no significant difference in mRNA of the MRFs among the three groups at d56 (P>0.05). At d84, chicken in the pen and free-range group showed higher MyoD1, MyoG, Myf5, and Mrf4 mRNA abundance compared to the caged chickens (P<0.05). Free-range chickens had higher Mrf4 and MyoG expression than those in penned ones (P<0.05). Protein abundances of all four factors were lowest in the caged group, and Mrf4 and MyoG protein quantities were greatest in free-range chickens (P<0.05), but Myf5 and MyoD1 protein abundance did not differ between penned and caged groups. The results suggested that exercise up-regulated MRF expression in the postnatal skeletal muscles, which led to an increase in muscle fiber diameter, and eventually affected the meat quality of the skeletal muscles in adult chickens. PMID:25701607

  11. Muscle Oxygenation During Running Assessed by Broad Band NIRS.

    PubMed

    Steimers, A; Vafiadou, M; Koukourakis, G; Geraskin, D; Neary, P; Kohl-Bareis, M

    2016-01-01

    We used spatially resolved near-infrared spectroscopy (SRS-NIRS) to assess calf and thigh muscle oxygenation during running on a motor-driven treadmill. Two protocols were used: An incremental speed protocol was performed in 5-min stages, while a pacing paradigm modulated the step frequency (2.3 Hz [SLow]; 3.3 Hz [SHigh]) during a constant velocity for 2 min each. A SRS-NIRS broadband system was used to measure total haemoglobin concentration and oxygen saturation (SO2). An accelerometer was placed on the hip joints to measure limb acceleration through the experiment. The data showed that the calf desaturated to a significantly lower level than the thigh. During the pacing protocol, SO2 was significantly different between the high and low step frequencies. Additionally, physiological data as measured by spirometry were different between the SLow vs. SHigh pacing trials. Significant differences in VO2 at the same workload (speed) indicate alterations in mechanical efficiency. These data suggest that SRS broadband NIRS can be used to discern small changes in muscle oxygenation, making this device useful for metabolic exercise studies in addition to spirometry and movement monitoring by accelerometers. PMID:26782193

  12. Bioluminescence and 19F magnetic resonance imaging visualize the efficacy of lysostaphin alone and in combination with oxacillin against Staphylococcus aureus in murine thigh and catheter-associated infection models.

    PubMed

    Hertlein, Tobias; Sturm, Volker; Lorenz, Udo; Sumathy, K; Jakob, Peter; Ohlsen, Knut

    2014-01-01

    Staphylococci are the leading cause of hospital-acquired infections worldwide. Increasingly, they resist antibiotic treatment owing to the development of multiple antibiotic resistance mechanisms in most strains. Therefore, the activity and efficacy of recombinant lysostaphin as a drug against this pathogen have been evaluated. Lysostaphin exerts high levels of activity against antibiotic-resistant strains of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). The therapeutic value of lysostaphin has been analyzed in two different clinically relevant in vivo models, a catheter-associated infection model and a thigh infection model. We infected mice with luciferase-expressing S. aureus Xen 29, and the efficacies of lysostaphin, vancomycin, oxacillin, and combined lysostaphin-oxacillin were investigated by determining numbers of CFU, detecting bioluminescent signals, and measuring the accumulation of perfluorocarbon emulsion at the site of infection by (19)F magnetic resonance imaging. Lysostaphin treatment significantly reduced the bacterial burden in infected thigh muscles and, after systemic spreading from the catheter, in inner organs. The efficiency of lysostaphin treatment was even more pronounced in combinatorial therapy with oxacillin. These results suggest that recombinant lysostaphin may have potential as an anti-S. aureus drug worthy of further clinical development. In addition, both imaging technologies demonstrated efficacy patterns similar to that of CFU determination, although they proved to be less sensitive. Nonetheless, they served as powerful tools to provide additional information about the course and gravity of infection in a noninvasive manner, possibly allowing a reduction in the number of animals needed for research evaluation of new antibiotics in future studies. PMID:24366730

  13. Bioluminescence and 19F Magnetic Resonance Imaging Visualize the Efficacy of Lysostaphin Alone and in Combination with Oxacillin against Staphylococcus aureus in Murine Thigh and Catheter-Associated Infection Models

    PubMed Central

    Hertlein, Tobias; Sturm, Volker; Lorenz, Udo; Sumathy, K.; Jakob, Peter

    2014-01-01

    Staphylococci are the leading cause of hospital-acquired infections worldwide. Increasingly, they resist antibiotic treatment owing to the development of multiple antibiotic resistance mechanisms in most strains. Therefore, the activity and efficacy of recombinant lysostaphin as a drug against this pathogen have been evaluated. Lysostaphin exerts high levels of activity against antibiotic-resistant strains of Staphylococcus aureus, including methicillin-resistant S. aureus (MRSA). The therapeutic value of lysostaphin has been analyzed in two different clinically relevant in vivo models, a catheter-associated infection model and a thigh infection model. We infected mice with luciferase-expressing S. aureus Xen 29, and the efficacies of lysostaphin, vancomycin, oxacillin, and combined lysostaphin-oxacillin were investigated by determining numbers of CFU, detecting bioluminescent signals, and measuring the accumulation of perfluorocarbon emulsion at the site of infection by 19F magnetic resonance imaging. Lysostaphin treatment significantly reduced the bacterial burden in infected thigh muscles and, after systemic spreading from the catheter, in inner organs. The efficiency of lysostaphin treatment was even more pronounced in combinatorial therapy with oxacillin. These results suggest that recombinant lysostaphin may have potential as an anti-S. aureus drug worthy of further clinical development. In addition, both imaging technologies demonstrated efficacy patterns similar to that of CFU determination, although they proved to be less sensitive. Nonetheless, they served as powerful tools to provide additional information about the course and gravity of infection in a noninvasive manner, possibly allowing a reduction in the number of animals needed for research evaluation of new antibiotics in future studies. PMID:24366730

  14. Effects of rhythmic muscle compression on arterial blood pressure at rest and during dynamic exercise in humans.

    PubMed

    Nishiyasu, T; Sone, R; Tan, N; Maekawa, T; Kondo, N

    2001-11-01

    This study was designed to examine the hypothesis that a rhythmic mechanical compression of muscles would affect systemic blood pressure regulation at rest and during dynamic exercise in humans. We measured the changes in mean arterial pressure (MAP) occurring (a) at rest with pulsed (350 ms pulses at 50 pulses min(-1)) or static compression (50 and 100 mmHg) of leg muscles with or without upper thigh occlusion, and (b) during 12-min supine bicycle exercise (75 W, 50 r.p.m.) with or without pulsed compression (50, 100, 150 mmHg) of the legs in synchrony with the thigh extensor muscle contraction. At rest with thigh occlusion, MAP increased by 4-8 mmHg during static leg compression, and by 5-9 mmHg during pulsed leg compression. This suggests that at rest pulsed leg compression elicits a reflex pressor response of similar magnitude to that evoked by static compression. During dynamic exercise without leg compression, MAP (having risen initially) gradually declined, but imposition of graded pulsed leg compression prevented this decline, the MAP values being significantly higher than those recorded without pulsed leg compression by 7-10 mmHg. These results suggest that the rhythmic increase in intramuscular pressure that occurs during dynamic exercise evokes a pressor response in humans. PMID:11736691

  15. Muscle strain (image)

    MedlinePlus

    A muscle strain is the stretching or tearing of muscle fibers. A muscle strain can be caused by sports, exercise, a ... something that is too heavy. Symptoms of a muscle strain include pain, tightness, swelling, tenderness, and the ...

  16. Differential effect of denervation on free radical scavenging enzymes in slow and fast muscle of rat

    NASA Technical Reports Server (NTRS)

    Asayama, K.; Dettbarn, W. D.; Burr, I. M.

    1985-01-01

    To determine the effect of denervation on the free radical scavenging systems in relation to the mitochondrial oxidative metabolism in the slow twitch soleus and fast twitch extensor digitorum longus (EDL) muscles, the sciatic nerve of the rat was crushed in the mid-thigh region and the muscle tissue levels of 5 enzymes were studied 2 and 5 weeks following crush. Radioimmunoassays were utilized for the selective measurement of cuprozinc (cytosolic) and mangano (mitochondrial) superoxide dismutases. These data represent the first systematic report of free radical scavening systems in slow and fast muscles in response to denervation. Selective modification of cuprozinc and manganosuperoxide dismutases and differential regulation of GSH-peroxidase was demonstrated in slow and fast muscle.

  17. Obturator internus muscle abscess in children: report of seven cases and review.

    PubMed

    Viani, R M; Bromberg, K; Bradley, J S

    1999-01-01

    Obturator internus muscle (OIM) abscess is an uncommon entity often mistaken for septic arthritis of the hip. We describe seven children with OIM abscess and review seven previously reported cases. The most common presenting symptoms were hip or thigh pain (14 patients), fever (13), and limp (13). The hip was flexed, abducted, and externally rotated in 11 patients. Magnetic resonance imaging and computed tomography (CT) were diagnostic for OIM abscess in the 14 patients. Associated abscesses were located in the obturator externus muscle (5 patients), psoas muscle (2), and iliac muscle (1). The etiologic agents were Staphylococcus aureus (8 patients), Streptococcus pyogenes (2), Neisseria gonorrhoeae (2), and Enterococcus faecalis (1). Three patients underwent CT-guided percutaneous drainage, and three had surgical drainage. Three patients had ischial osteomyelitis in addition to OIM abscess. The 11 children with uncomplicated OIM abscess were treated for a median of 28 days. All patients had an uneventful recovery. PMID:10028081

  18. Longitudinal decline of lower extremity muscle power in healthy and mobility-limited older adults: influence of muscle mass, strength, composition, neuromuscular activation and single fiber contractile properties

    PubMed Central

    Reid, Kieran F.; Pasha, Evan; Doros, Gheorghe; Clark, David J.; Patten, Carolynn; Phillips, Edward M.; Frontera, Walter R.; Fielding, Roger A.

    2013-01-01

    Purpose This longitudinal study examined the major physiological mechanisms that determine the age-related loss of lower extremity muscle power in two distinct groups of older humans. We hypothesized that after ~ 3 years of follow-up, mobility-limited older adults (mean age: 77.2 ± 4, n = 22, 12 females) would have significantly greater reductions in leg extensor muscle power compared to healthy older adults (74.1 ± 4, n = 26, 12 females). Methods Mid-thigh muscle size and composition were assessed using computed tomography. Neuromuscular activation was quantified using surface electromyography and vastus lateralis single muscle fibers were studied to evaluate intrinsic muscle contractile properties. Results At follow-up, the overall magnitude of muscle power loss was similar between groups: mobility-limited: −8.5% vs. healthy older: −8.8%, P > 0.8. Mobility-limited elders had significant reductions in muscle size (−3.8%, P< 0.01) and strength (−5.9%, P< 0.02), however, these parameters were preserved in healthy older (P ≥ 0.7). Neuromuscular activation declined significantly within healthy older but not in mobility-limited participants. Within both groups, the cross sectional areas of type I and type IIA muscle fibers were preserved while substantial increases in single fiber peak force ( > 30%), peak power (> 200%) and unloaded shortening velocity (>50%) were elicited at follow-up. Conclusion Different physiological mechanisms contribute to the loss of lower extremity muscle power in healthy older and mobility-limited older adults. Neuromuscular changes may be the critical early determinant of muscle power deficits with aging. In response to major whole muscle decrements, major compensatory mechanisms occur within the contractile properties of surviving single muscle fibers in an attempt to restore overall muscle power and function with advancing age. PMID:24122149

  19. MRI-guided gas bubble enhanced ultrasound heating in in vivo rabbit thigh.

    PubMed

    Sokka, S D; King, R; Hynynen, K

    2003-01-21

    In this study, we propose a focused ultrasound surgery protocol that induces and then uses gas bubbles at the focus to enhance the ultrasound absorption and ultimately create larger lesions in vivo. MRI and ultrasound visualization and monitoring methods for this heating method are also investigated. Larger lesions created with a carefully monitored single ultrasound exposure could greatly improve the speed of tumour coagulation with focused ultrasound. All experiments were performed under MRI (clinical, 1.5 T) guidance with one of two eight-sector, spherically curved piezoelectric transducers. The transducer, either a 1.1 or 1.7 MHz array, was driven by a multi-channel RF driving system. The transducer was mounted in an MRI-compatible manual positioning system and the rabbit was situated on top of the system. An ultrasound detector ring was fixed with the therapy transducer to monitor gas bubble activity during treatment. Focused ultrasound surgery exposures were delivered to the thighs of seven New Zealand while rabbits. The experimental, gas-bubble-enhanced heating exposures consisted of a high amplitude 300 acoustic watt, half second pulse followed by a 7 W, 14 W or 21 W continuous wave exposure for 19.5 s. The respective control sonications were 20 s exposures of 14 W, 21 W and 28 W. During the exposures, MR thermometry was obtained from the temperature dependency of the proton resonance frequency shift. MRT2-enhanced imaging was used to evaluate the resulting lesions. Specific metrics were used to evaluate the differences between the gas-bubble-enhanced exposures and their respective control sonications: temperatures with respect to time and space, lesion size and shape, and their agreement with thermal dose predictions. The bubble-enhanced exposures showed a faster temperature rise within the first 4 s and higher overall temperatures than the sonications without bubble formation. The spatial temperature maps and the thermal dose maps derived from the MRI

  20. Numerical Investigations of Interactions between the Knee-Thigh-Hip Complex with Vehicle Interior Structures.

    PubMed

    Kim, Yong Sun; Choi, Hyeong Ho; Cho, Young Nam; Park, Yong Jae; Lee, Jong B; Yang, King H; King, Albert I

    2005-11-01

    Although biomechanical studies on the knee-thigh-hip (KTH) complex have been extensive, interactions between the KTH and various vehicular interior design parameters in frontal automotive crashes for newer models have not been reported in the open literature to the best of our knowledge. A 3D finite element (FE) model of a 50(th) percentile male KTH complex, which includes explicit representations of the iliac wing, acetabulum, pubic rami, sacrum, articular cartilage, femoral head, femoral neck, femoral condyles, patella, and patella tendon, has been developed to simulate injuries such as fracture of the patella, femoral neck, acetabulum, and pubic rami of the KTH complex. Model results compared favorably against regional component test data including a three-point bending test of the femur, axial loading of the isolated knee-patella, axial loading of the KTH complex, axial loading of the femoral head, and lateral loading of the isolated pelvis. The model was further integrated into a Wayne State University upper torso model and validated against data obtained from whole body sled tests. The model was validated against these experimental data over a range of impact speeds, impactor masses and boundary conditions. Using Design Of Experiment (DOE) methods based on Taguchi's approach and the developed FE model of the whole body, including the KTH complex, eight vehicular interior design parameters, namely the load limiter force, seat belt elongation, pretensioner inlet amount, knee-knee bolster distance, knee bolster angle, knee bolster stiffness, toe board angle and impact speed, each with either two or three design levels, were simulated to predict their respective effects on the potential of KTH injury in frontal impacts. Simulation results proposed best design levels for vehicular interior design parameters to reduce the injury potential of the KTH complex due to frontal automotive crashes. This study is limited by the fact that prediction of bony fracture was

  1. Thigh length versus knee length antiembolism stockings for the prevention of deep vein thrombosis in postoperative surgical patients; a systematic review and network meta-analysis

    PubMed Central

    Wade, Ros; Paton, Fiona; Rice, Stephen; Stansby, Gerard; Millner, Peter; Flavell, Hayley; Fox, Dave; Woolacott, Nerys

    2016-01-01

    Objectives To assess the clinical effectiveness of thigh length versus knee length antiembolism stockings for the prevention of deep vein thrombosis (DVT) in surgical patients. Design Systematic review and meta-analysis using direct methods and network meta-analysis. Methods Previous systematic reviews and electronic databases were searched to February 2014 for randomised controlled trials (RCTs) of thigh length or knee length antiembolism stockings in surgical patients. Study quality was assessed using the Cochrane Risk of Bias Tool. The primary outcome was incidence of DVT. Analysis of the DVT data was performed using ORs along with 95% CIs. The I2 statistic was used to quantify statistical heterogeneity. Results 23 RCTs were included; there was substantial variation between the trials and many were poorly reported with an unclear risk of bias. Five RCTs directly comparing thigh length versus knee length stockings were pooled and the summary estimate of effect favouring thigh length stockings was not statistically significant (OR 1.48, 95% CI 0.80 to 2.73). 13 RCTs were included in the network meta-analysis; thigh length stockings with pharmacological prophylaxis were more effective than knee length stockings with pharmacological prophylaxis, but again results were not statistically significant (OR 1.76, 95% credible intervals 0.82 to 3.53). Conclusions Thigh length stockings may be more effective than knee length stockings, but results did not reach statistical significance and the evidence base is weak. Further research to confirm this finding is unlikely to be worthwhile. While thigh length stockings appear to have superior efficacy, practical issues such as patient acceptability may prevent their wide use in clinical practice. Systematic review registration number CRD42014007202. PMID:26883236

  2. Muscle MRI reveals distinct abnormalities in genetically proven non-dystrophic myotonias.

    PubMed

    Morrow, Jasper M; Matthews, Emma; Raja Rayan, Dipa L; Fischmann, Arne; Sinclair, Christopher D J; Reilly, Mary M; Thornton, John S; Hanna, Michael G; Yousry, Tarek A

    2013-08-01

    We assessed the presence, frequency and pattern of MRI abnormalities in non-dystrophic myotonia patients. We reviewed T1-weighted and STIR (short-tau-inversion-recovery) 3T MRI sequences of lower limb muscles at thigh and calf level in 21 patients with genetically confirmed non-dystrophic myotonia: 11 with CLCN1 mutations and 10 with SCN4A mutations, and 19 healthy volunteers. The MRI examinations of all patients showed hyperintensity within muscles on either T1-weighted or STIR images. Mild extensive or marked T1-weighted changes were noted in 10/21 patients and no volunteers. Muscles in the thigh were equally likely to be affected but in the calf there was sparing of tibialis posterior. Oedema was common in calf musculature especially in the medial gastrocnemius with STIR hyperintensity observed in 18/21 patients. In 10/11 CLCN1 patients this included a previously unreported "central stripe", also present in 3/10 SCN4A patients but no volunteers. Degree of fatty infiltration correlated with age (rho=0.46, p<0.05). Muscle MRI is frequently abnormal in non-dystrophic myotonia providing evidence of fatty infiltration and/or oedema. The pattern is distinct from other myotonic disorders; in particular the "central stripe" has not been reported in other conditions. Correlations with clinical parameters suggest a potential role for MRI as a biomarker. PMID:23810313

  3. Capillary muscle

    PubMed Central

    Cohen, Caroline; Mouterde, Timothée; Quéré, David; Clanet, Christophe

    2015-01-01

    The contraction of a muscle generates a force that decreases when increasing the contraction velocity. This “hyperbolic” force–velocity relationship has been known since the seminal work of A. V. Hill in 1938 [Hill AV (1938) Proc R Soc Lond B Biol Sci 126(843):136–195]. Hill’s heuristic equation is still used, and the sliding-filament theory for the sarcomere [Huxley H, Hanson J (1954) Nature 173(4412):973–976; Huxley AF, Niedergerke R (1954) Nature 173(4412):971–973] suggested how its different parameters can be related to the molecular origin of the force generator [Huxley AF (1957) Prog Biophys Biophys Chem 7:255–318; Deshcherevskiĭ VI (1968) Biofizika 13(5):928–935]. Here, we develop a capillary analog of the sarcomere obeying Hill’s equation and discuss its analogy with muscles. PMID:25944938

  4. Capillary muscle.

    PubMed

    Cohen, Caroline; Mouterde, Timothée; Quéré, David; Clanet, Christophe

    2015-05-19

    The contraction of a muscle generates a force that decreases when increasing the contraction velocity. This "hyperbolic" force-velocity relationship has been known since the seminal work of A. V. Hill in 1938 [Hill AV (1938) Proc R Soc Lond B Biol Sci 126(843):136-195]. Hill's heuristic equation is still used, and the sliding-filament theory for the sarcomere [Huxley H, Hanson J (1954) Nature 173(4412):973-976; Huxley AF, Niedergerke R (1954) Nature 173(4412):971-973] suggested how its different parameters can be related to the molecular origin of the force generator [Huxley AF (1957) Prog Biophys Biophys Chem 7:255-318; Deshcherevskiĭ VI (1968) Biofizika 13(5):928-935]. Here, we develop a capillary analog of the sarcomere obeying Hill's equation and discuss its analogy with muscles. PMID:25944938

  5. Characterization of thigh and shank segment angular velocity during jump landing tasks commonly used to evaluate risk for ACL injury.

    PubMed

    Dowling, Ariel V; Favre, Julien; Andriacchi, Thomas P

    2012-09-01

    The dynamic movements associated with anterior cruciate ligament (ACL) injury during jump landing suggest that limb segment angular velocity can provide important information for understanding the conditions that lead to an injury. Angular velocity measures could provide a quick and simple method of assessing injury risk without the constraints of a laboratory. The objective of this study was to assess the inter-subject variations and the sensitivity of the thigh and shank segment angular velocity in order to determine if these measures could be used to characterize jump landing mechanisms. Additionally, this study tested the correlation between angular velocity and the knee abduction moment. Thirty-six healthy participants (18 male) performed drop jumps with bilateral and unilateral landing. Thigh and shank angular velocities were measured by a wearable inertial-based system, and external knee moments were measured using a marker-based system. Discrete parameters were extracted from the data and compared between systems. For both jumping tasks, the angular velocity curves were well defined movement patterns with high inter-subject similarity in the sagittal plane and moderate to good similarity in the coronal and transverse planes. The angular velocity parameters were also able to detect differences between the two jumping tasks that were consistent across subjects. Furthermore, the coronal angular velocities were significantly correlated with the knee abduction moment (R of 0.28-0.51), which is a strong indicator of ACL injury risk. This study suggested that the thigh and shank angular velocities, which describe the angular dynamics of the movement, should be considered in future studies about ACL injury mechanisms. PMID:22938373

  6. Characterizing In Vivo Pharmacodynamics of Carbapenems against Acinetobacter baumannii in a Murine Thigh Infection Model To Support Breakpoint Determinations

    PubMed Central

    MacVane, Shawn H.; Crandon, Jared L.

    2014-01-01

    Pharmacodynamic profiling data of carbapenems for Acinetobacter spp. are sparse. This study aimed to determine the pharmacodynamic targets of carbapenems for Acinetobacter baumannii based on a range of percentages of the dosing interval in which free drug concentrations remained above the MIC (fT>MIC) in the neutropenic murine thigh infection model. fT>MIC values of 23.7%, 32.8%, and 47.5% resulted in stasis, 1-log reductions, and 2-log reductions in bacterial density after 24 h, respectively. The pharmacodynamic targets of carbapenems for A. baumannii demonstrated in vivo are similar to those of other Gram-negative bacteria. PMID:24165174

  7. Hyperbaric oxygen reduces edema and necrosis of skeletal muscle in compartment syndromes associated with hemorrhagic hypotension

    SciTech Connect

    Skyhar, M.J.; Hargens, A.R.; Strauss, M.B.; Gershuni, D.H.; Hart, G.B.; Akeson, W.H.

    1986-10-01

    This study examined the effect of exposures to hyperbaric oxygen on the development of the edema and necrosis of muscle that are associated with compartment syndromes that are complicated by hemorrhagic hypotension. A compartment syndrome (twenty millimeters of mercury for six hours) was induced by infusion of autologous plasma in the anterolateral compartment of the left hind limb of seven anesthetized dogs while the mean arterial blood pressure was maintained at sixty-five millimeters of mercury after 30 per cent loss of blood volume. These dogs were treated with hyperbaric oxygen (two atmospheres of pure oxygen) and were compared with six dogs that had an identical compartment syndrome and hypotensive condition but were not exposed to hyperbaric oxygen. Forty-eight hours later, edema was quantified by measuring the weights of the muscles (the pressurized muscle compared with the contralateral muscle), and necrosis of muscle was evaluated by measuring the uptake of technetium-99m stannous pyrophosphate. The ratio for edema was significantly (p = 0.01) greater in dogs that had not been exposed to hyperbaric oxygen (1.15 +/- 0.01) than in the dogs that had been treated with hyperbaric oxygen (1.01 +/- 0.03), and the ratio for necrosis of muscle was also significantly (p = 0.04) greater in dogs that had not had hyperbaric oxygen (1.96 +/- 0.41) than in those that had been treated with hyperbaric oxygen (1.05 +/- 0.11). Comparisons were also made with the muscles of four normal control dogs and separately with the muscles of six normotensive dogs that had an identical compartment syndrome and normal blood pressure and were not treated with hyperbaric oxygen.

  8. Skeletal muscle fat content is inversely associated with bone strength in young girls.

    PubMed

    Farr, Joshua N; Funk, Janet L; Chen, Zhao; Lisse, Jeffrey R; Blew, Robert M; Lee, Vinson R; Laudermilk, Monica; Lohman, Timothy G; Going, Scott B

    2011-09-01

    Childhood obesity is an established risk factor for metabolic disease. The influence of obesity on bone development, however, remains controversial and may depend on the pattern of regional fat deposition. Therefore, we examined the associations of regional fat compartments of the calf and thigh with weight-bearing bone parameters in girls. Data from 444 girls aged 9 to 12 years from the Jump-In: Building Better Bones study were analyzed. Peripheral quantitative computed tomography (pQCT) was used to assess bone parameters at metaphyseal and diaphyseal sites of the femur and tibia along with subcutaneous adipose tissue (SAT, mm(2) ) and muscle density (mg/cm(3) ), an index of skeletal muscle fat content. As expected, SAT was positively correlated with total-body fat mass (r = 0.87-0.89, p < .001), and muscle density was inversely correlated with total-body fat mass (r = -0.24 to -0.28, p < .001). Multiple linear regression analyses with SAT, muscle density, muscle cross-sectional area, bone length, maturity, and ethnicity as independent variables showed significant associations between muscle density and indices of bone strength at metaphyseal (β = 0.13-0.19, p < .001) and diaphyseal (β = 0.06-0.09, p < .01) regions of the femur and tibia. Associations between SAT and indices of bone strength were nonsignificant at all skeletal sites (β = 0.03-0.05, p > .05), except the distal tibia (β = 0.09, p = .03). In conclusion, skeletal muscle fat content of the calf and thigh is inversely associated with weight-bearing bone strength in young girls. PMID:21544865

  9. [Primary thinning and de-epithelialization of microsurgical transplants from the lateral thigh].

    PubMed

    Wolff, K D; Plath, T; Frege, J; Hoffmeister, B

    2000-03-01

    To expand the indicational spectrum of the myocutaneous vastus lateralis flap, which is often too voluminous for intraoral application, we performed extreme, primary thinning of the fat and muscle component of this microsurgical transplant in 14 patients. After subfascial localization of the 0.5- to 1.0-mm-thick perforating vessel, it is exposed through the fascia and muscles up to its exit from the descending branch of the lateral circumflex femoral artery. After isolating the perforating vessel, it is no longer necessary to include parts of the vastus lateralis muscle in the flap. The fatty tissue of the remaining epifascial fat component is completely removed except for a ca. 1- to 2-cm-wide cuff of fatty tissue and fascia around the perforating vessel. When performing this primary radical removal of the subcutaneous fatty tissue, care should be taken not to injure the deep subdermal vascular plexus. In addition to the thinning procedure, de-epithelialization of the skin was performed using scalpel blade dissection (five patients) or carbon dioxide laser (6 W, five patients). This thinning technique was used for covering ten intraoral and four extraoral defects and enabled the raising of skin flaps with a thickness of 3-5 mm even in obese patients. The vessel pedicle length of thinned flaps was between 12 and 16 cm; flap size varied between 4 x 5 and 9 x 15 cm, and the donor sites were directly closed. In one case, there was a partial necrosis (20%), but the remaining flaps healed without complications. On the intraoral flaps, a thin, smooth and pliable surface developed after re-epithelialization within 3-6 weeks. The described method expands the application possibilities of the myocutaneous vastus lateralis flap for a large number of intraoral and flat defects with minimal donor-site morbidity. PMID:10851881

  10. Cardiac and Vascular Responses to Thigh Cuffs and Respiratory Maneuvers on Crewmembers of the International Space Station

    NASA Technical Reports Server (NTRS)

    Hamilton, Douglas; Sargsyan, Ashot E.; Garcia, Kathleen; Ebert, Douglas; Whitson, Peggy A.; Feiveson, Alan; Alferova, Irina V.; Dulchavsky, Scott A.; Matveev, Vladimir P.; Bogomolov, Valery V.; Duncan, J. Michael

    2011-01-01

    The transition to microgravity eliminates the hydrostatic gradients in the vascular system. The resulting fluid redistribution commonly manifests as facial edema, engorgement of the external neck veins, and a decrease in leg diameter. This experiment examined the responses to modified Valsalva and Mueller maneuvers measured by cardiac and vascular ultrasound (ECHO) in a baseline steady state and during preload reduction introduced with thigh occlusion cuffs used as a counter-measure device (Braslet cuffs) measured by cardiac and vascular ultrasound examinations. Methods: Nine International Space Station crewmember subjects (Expeditions 16 - 20) were examined in 15 experiment sessions 101 +/- 46.days after launch (mean +/- SD; 33 - 185). Twenty Seven cardiac and vascular parameters were obtained with/without respiratory maneuvers before and after tightening of the Braslet cuffs. Results: Non-physicians performed diagnostic-quality cardiac and vascular ultrasound examinations using remote guidance. Three of 27 combinations of maneuvers and Braslet or Braslet alone were identified as being significant changed when compared to baseline. Eleven of 81 differences between combinations of Mueller, Valsalva or baseline were significant and related to cardiac preload reduction or increase in lower extremity venous volume. Conclusions: Acute application of Braslet occlusion cuffs causes lower extremity fluid sequestration and exerts commensurate measurable effects on cardiac performance in microgravity. Ultrasound techniques to measure the hemodynamic effects of thigh cuffs in combination with respiratory maneuvers may serve as an invaluable tool in determining the volume status of the cardiac patient at the 'microgravity bedside'.

  11. Giacomini vein: thigh extension of the small saphenous vein - report of two cases and review of the literature

    PubMed Central

    Natsis, K; Paraskevas, G; Lazaridis, N; Sofidis, G; Piagkou, M

    2015-01-01

    Background Varicose vein surgery is very commonly performed. Also, it is very frequently employed for recurrent disease. The recognition of the normal or variant veins, inducing incompetency, is a prerequisite for effective treatment. The thigh extension of the small saphenous vein, the so-called Giacomini vein, was extensively described in 1873 by Carlo Giacomini in an incidence of 72%. However, such a vein is usually underestimated in classic surgical textbooks. Description of cases We present two cases of Giacomini vein found in two cadavers, dissected for academic purposes in the Department of Anatomy, where the small saphenous vein displayed a thigh extension without terminating into the popliteal vein. In one case Giacomini vein drained into the large saphenous vein, while in the other case the vein divided into two branches, separately draining into the large saphenous vein and the subcutaneous tissue of the gluteal region. Conclusion Due to the fact that Giacomini vein could be incompetent, associated with or without varicose saphenous vein trunks, the vascular surgeon should keep in mind that anatomical entity, to include it in preoperative ultrasound scanning control. Moreover, this vein could be utilized as an autologous graft, when the large saphenous is not available. Hippokratia 2015; 19 (3): 263-265.

  12. Oncocin Onc72 is efficacious against antibiotic-susceptible Klebsiella pneumoniae ATCC 43816 in a murine thigh infection model.

    PubMed

    Knappe, Daniel; Adermann, Knut; Hoffmann, Ralf

    2015-11-01

    Oncocins and apidaecins are short proline-rich antimicrobial peptides (PrAMPs) representing novel antibiotic drug lead compounds that kill bacteria after internalization and inhibition of intracellular targets (e.g. 70S ribosome and DnaK). Oncocin Onc72 is highly active against Gram-negative bacteria in vitro and in vivo protecting mice in systemic infection models with Escherichia coli and KPC-producing Klebsiella pneumoniae. Here we studied its efficacy in a murine thigh infection model using meropenem as antibiotic comparator that had a 44-fold higher molar in vitro activity than Onc72. Male CD1 mice were rendered neutropenic using cyclophosphamide for four days before intramuscular infection with K. pneumoniae ATCC 43816. After 75 min oncocin Onc72 or the antibiotic comparator meropenem were administered subcutaneously with 100 mg (43 µmol) and 25 mg (65 µmol) per kg of body weight, respectively, six times every 75 min. Onc72 and meropenem administered subcutaneously reduced the thigh tissue burden of K. pneumoniae ATCC 43816 in neutropenic mice significantly by 4.14 and 4.65 a log10 cfu/g, respectively. The bacterial counts were ∼0.5 and ∼1 log10 below the pre-treatment burden, respectively, indicating bactericidal effects for both compounds. Thus, Onc72 was as efficacious as meropenem in vivo despite its much lower in vitro activity determined according to CLSI standard antimicrobial activity tests. PMID:25968331

  13. Relative shank to thigh length is associated with different mechanisms of power production during elite male ergometer rowing.

    PubMed

    Greene, Andrew J; Sinclair, Peter J; Dickson, Michael H; Colloud, Floren; Smith, Richard M

    2009-11-01

    The effect of anthropometric differences in shank to thigh length ratio upon timing and magnitude of joint power production during the drive phase of the rowing stroke was investigated in 14 elite male rowers. Rowers were tested on the RowPerfect ergometer which was instrumented at the handle and foot stretcher to measure force generation, and a nine segment inverse dynamics model used to calculate the rower's joint and overall power production. Rowers were divided into two groups according to relative shank thigh ratio. Time to half lumbar power generation was significantly earlier in shorter shank rowers (p = 0.028) compared to longer shank rowers, who showed no lumbar power generation during the same period of the drive phase. Rowers with a relatively shorter shank demonstrated earlier lumbar power generation during the drive phase resulting from restricted rotation of the pelvic segment requiring increased lumbar extension in these rowers. Earlier lumbar power generation and extension did not appear to directly affect performance measures of the short shank group, and so can be attributed to a technical adaptation developed to maximise rowing performance. PMID:20169760

  14. Muscle disease.

    PubMed

    Tsao, Chang-Yong

    2014-02-01

    On the basis of strong research evidence, Duchenne muscular dystrophy (DMD), the most common severe childhood form of muscular dystrophy, is an X-linked recessive disorder caused by out-of-frame mutations of the dystrophin gene. Thus, it is classified asa dystrophinopathy. The disease onset is before age 5 years. Patients with DMD present with progressive symmetrical limb-girdle muscle weakness and become wheelchair dependent after age 12 years. (2)(3). On the basis of some research evidence,cardiomyopathy and congestive heart failure are usually seen in the late teens in patients with DMD. Progressive scoliosis and respiratory in sufficiency often develop once wheelchair dependency occurs. Respiratory failure and cardiomyopathy are common causes of death, and few survive beyond the third decade of life. (2)(3)(4)(5)(6)(7). On the basis of some research evidence, prednisone at 0.75 mg/kg daily (maximum dose, 40 mg/d) or deflazacort at 0.9 mg/kg daily (maximum dose, 39 mg/d), a derivative of prednisolone (not available in the United States), as a single morning dose is recommended for DMD patients older than 5 years, which may prolong independent walking from a few months to 2 years. (2)(3)(16)(17). Based on some research evidence, treatment with angiotensin-converting enzyme inhibitors, b-blockers, and diuretics has been reported to be beneficial in DMD patients with cardiac abnormalities. (2)(3)(5)(18). Based on expert opinion, children with muscle weakness and increased serum creatine kinase levels may be associated with either genetic or acquired muscle disorders (Tables 1 and 3). (14)(15) PMID:24488829

  15. Resistance exercise-induced fluid shifts: change in active muscle size and plasma volume

    NASA Technical Reports Server (NTRS)

    Ploutz-Snyder, L. L.; Convertino, V. A.; Dudley, G. A.

    1995-01-01

    The purpose of this study was to test the hypothesis that the reduction in plasma volume (PV) induced by resistance exercise reflects fluid loss to the extravascular space and subsequently selective increase in cross-sectional area (CSA) of active but not inactive skeletal muscle. We compared changes in active and inactive muscle CSA and PV after barbell squat exercise. Magnetic resonance imaging (MRI) was used to quantify muscle involvement in exercise and to determine CSA of muscle groups or individual muscles [vasti (VS), adductor (Add), hamstring (Ham), and rectus femoris (RF)]. Muscle involvement in exercise was determined using exercise-induced contrast shift in spin-spin relaxation time (T2)-weighted MR images immediately postexercise. Alterations in muscle size were based on the mean CSA of individual slices. Hematocrit, hemoglobin, and Evans blue dye were used to estimate changes in PV. Muscle CSA and PV data were obtained preexercise and immediately postexercise and 15 and 45 min thereafter. A hierarchy of muscle involvement in exercise was found such that VS > Add > Ham > RF, with the Ham and RF showing essentially no involvement. CSA of the VS and Add muscle groups were increased 10 and 5%, respectively, immediately after exercise in each thigh with no changes in Ham and RF CSA. PV was decreased 22% immediately following exercise. The absolute loss of PV was correlated (r2 = 0.75) with absolute increase in muscle CSA immediately postexercise, supporting the notion that increased muscle size after resistance exercise reflects primarily fluid movement from the vascular space into active but not inactive muscle.

  16. Changes in volume, muscle compartment, and compliance of the lower extremities in man following 30 days of exposure to simulated microgravity

    NASA Technical Reports Server (NTRS)

    Convertino, Victor A.; Doerr, Donald F.; Buchanan, Paul; Mathes, Karen L.; Stein, Steward L.

    1989-01-01

    To investigate the relationship between leg compliance and a reduction in the size of the leg muscle compartment due to long-duration exposure to microgravity, eight men were exposed for 30 d of continuous 6-deg headdown tilt, and changes in vascular compliance (vol pct/mm Hg x 100) of the calf and serial circumferences of the thigh and the calf were measured before, during, and after the tilt. It was found that the tilt exposure led to calculated leg volume decreases of 9.9 percent in the calf and of 4.5 in the thigh. Leg compliance was found to increase from 3.9 to about 4.9. Calf compliance measured before and after bedrest was found to be inversely related to calf-muscle compartment cross-sectional area (CSA).

  17. [Visualization of Anterolateral Ligament of the Knee Using 3D Reconstructed Variable Refocus Flip Angle-Turbo Spin Echo T2 Weighted Image].

    PubMed

    Yokosawa, Kenta; Sasaki, Kana; Muramatsu, Koichi; Ono, Tomoya; Izawa, Hiroyuki; Hachiya, Yudo

    2016-05-01

    Anterolateral ligament (ALL) is one of the lateral structures in the knee that contributes to the internal rotational stability of tibia. ALL has been referred to in some recent reports to re-emphasize its importance. We visualized the ALL on 3D-MRI in 32 knees of 27 healthy volunteers (23 male knees, 4 female knees; mean age: 37 years). 3D-MRIs were performed using 1.5-T scanner [T(2) weighted image (WI), SPACE: Sampling Perfection with Application optimized Contrast using different flip angle Evolutions] in the knee extended positions. The visualization rate of the ALL, the mean angle to the lateral collateral ligament (LCL), and the width and the thickness of the ALL at the joint level were investigated. The visualization rate was 100%. The mean angle to the LCL was 10.6 degrees. The mean width and the mean thickness of the ALL were 6.4 mm and 1.0 mm, respectively. The ALL is a very thin ligament with a somewhat oblique course between the lateral femoral epicondyle and the mid-third area of lateral tibial condyle. Therefore, the slice thickness and the slice angle can easily affect the ALL visualization. 3D-MRI enables acquiring thin-slice imaging data over a relatively short time, and arbitrary sections aligned with the course of the ALL can later be selected. PMID:27211087

  18. The role of the anterolateral ligament in ACL insufficient and reconstructed knees on rotatory stability: A biomechanical study on human cadavers.

    PubMed

    Tavlo, M; Eljaja, S; Jensen, J T; Siersma, V D; Krogsgaard, M R

    2016-08-01

    Studies suggest that the anterolateral ligament (ALL) is important for knee stability. The purpose was to clarify ALL's effect on rotatory and anterior-posterior stability in the anterior cruciate ligament (ACL)-insufficient and reconstructed knees and the effect of reconstruction of an insufficient ALL. Eighteen cadaveric knees were included. Stability was tested for intact (+ALL), detached (-ALL) and reconstructed (+ reALL) ALL, with ACL removed (-ACL) and reconstructed (+ACL) in six combinations. All were tested in 0, 30, 60, and 90 °C flexion. Anterior-posterior stability was measured with a rolimeter. Rotation with a torque of 8.85 Nm was measured photographically. The ALL was well defined in 78% of knees. ACL reconstruction had a significant effect on anterior-posterior stability. Detaching the ALL had a significant effect on internal rotatory stability and on anterior-posterior stability in ACL-insufficient knees. Reconstruction of ACL and ALL reestablished knee stability. The appearance of the ALL was not uniform. The ALL was an internal rotational stabilizer. Anatomical ALL reconstruction in combination with ACL reconstruction could reestablish stability. ALL reconstruction might be considered in patients with combined ACL and ALL tears, but the clinical effect should be established in a controlled clinical study. PMID:26247376

  19. Antibiotic residues distribute uniformly in broiler chicken breast muscle tissue.

    PubMed

    Reyes-Herrera, Ixchel; Donoghue, Dan J

    2008-01-01

    Use of antibiotics by the poultry industry has the potential to produce residues in edible tissues. In order to protect consumers, the U.S. federal government performs extensive evaluations to quantify residues in edible tissues to ensure that concentrations do not exceed the tolerance level. However, in the case of muscle tissue, the regulatory process does not differentiate between different edible muscle types in poultry. Previous studies performed by our laboratory determined higher fluoroquinolone residue concentrations in breast versus thigh muscle. Thus, if thigh tissues were used for residue monitoring, it would not accurately depict the higher concentrations. It is also possible that residue concentrations vary within tissues. To evaluate this possibility, fluoroquinolone antibiotic residues were determined for different breast sections. One hundred sixty chickens were randomly divided into four groups and dosed at 33 days of age with the fluoroquinolone antibiotic, enrofloxacin (Baytril), at either 25 ppm for 3 days, 25 ppm for 7 days, 50 ppm for 3 days, or 50 ppm for 7 days. Breast fillets were collected from each bird (n = 5 birds per day per group) during the dosing and withdrawal period. Each breast was divided into four sections (upper left, upper right, lower left, and lower right) that were analyzed as individual samples for determination of fluoroquinolone concentration. Our results indicated no significant difference (P > 0.05) in the levels of enrofloxacin residues between breast sections during the dosing or withdrawal periods. Consequently, samples can be collected from any breast section to evaluate fluoroquinolone residue concentrations during the regulatory monitoring process. PMID:18236689

  20. The Quantitative Effects of Inclusion of Fat on Muscle Diffusion Tensor MRI Measurements

    PubMed Central

    Williams, Sarah E.; Heemskerk, Anneriet M.; Welch, E. Brian; Li, Ke; Damon, Bruce M.; Park, Jane H.

    2012-01-01

    Purpose To determine the minimum water percentage in a muscle region of interest that would allow diffusion tensor (DT-) MRI data to reflect the diffusion properties of pure muscle accurately. Materials and Methods Proton density-weighted images with and without fat saturation were obtained at the mid-thigh in four subjects. Co-registered DT-MR images were used to calculate the diffusion tensor’s eigenvalues and fractional anisotropy. Results The eigenvalues transitioned monotonically as a function of water signal percentage from values near to those expected for pure fat to those for pure muscle. Also, the fractional anisotropy transitioned monotonically from 0.50 (fat) to 0.20 (muscle). For water signal percentages >55%, none of the diffusion indices differed significantly from those for regions of >90% muscle. Conclusion Accounting for the T1 and T2 values of muscle and fat and the pulse sequence properties, it is concluded that, as a conservative estimate, regions must contain at least 76% muscle tissue to reflect the diffusion properties of pure muscle accurately. PMID:23418124

  1. Muscle Quality and Myosteatosis: Novel Associations With Mortality Risk: The Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study.

    PubMed

    Reinders, Ilse; Murphy, Rachel A; Brouwer, Ingeborg A; Visser, Marjolein; Launer, Lenore; Siggeirsdottir, Kristin; Eiriksdottir, Gudny; Gudnason, Vilmundur; Jonsson, Palmi V; Lang, Thomas F; Harris, Tamara B

    2016-01-01

    Muscle composition may affect mortality risk, but prior studies have been limited to specific samples or less precise determination of muscle composition. We evaluated associations of thigh muscle composition, determined using computed tomography imaging, and knee extension strength with mortality risk among 4,824 participants aged 76.4 (standard deviation (SD), 5.5) years from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik Study (2002-2006). Cox proportional hazards models were used to estimate hazard ratios. After 8.8 years of follow-up, there were 1,942 deaths. For men, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 11% and 22%. Each SD-increment increase in intermuscular adipose tissue and intramuscular adipose tissue was associated with higher mortality risk (hazard ratio (HR) = 1.13 (95% confidence interval (CI): 1.06, 1.22) and HR = 1.23 (95% CI: 1.15, 1.30), respectively). For women, each SD-increment increase in muscle lean area, muscle quality, and strength was associated with lower mortality risk, with decreases ranging between 12% and 19%. Greater intramuscular adipose tissue was associated with an 8% higher mortality risk (HR = 1.08, 95% CI: 1.01, 1.16). This study shows that muscle composition is associated with mortality risk. These results also show the importance of improving muscle strength and area and lowering muscle adipose tissue infiltration. PMID:26643983

  2. Eye muscle repair - discharge

    MedlinePlus

    ... Lazy eye repair - discharge; Strabismus repair - discharge; Extraocular muscle surgery - discharge ... You or your child had eye muscle repair surgery to correct eye muscle ... term for crossed eyes is strabismus. Children most often ...

  3. Extraocular muscle function testing

    MedlinePlus

    Extraocular muscle function testing examines the function of the eye muscles. A health care provider observes the movement of ... evaluate weakness or other problem in the extraocular muscles. These problems may result in double vision or ...

  4. Eye muscle repair - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000111.htm Eye muscle repair - discharge To use the sharing features on ... enable JavaScript. You or your child had eye muscle repair surgery to correct eye muscle problems that ...

  5. Muscle strain treatment

    MedlinePlus

    Treatment - muscle strain ... Question: How do you treat a muscle strain ? Answer: Rest the strained muscle and apply ice for the first few days after the injury. Anti-inflammatory medicines or acetaminophen ( ...

  6. Insulin resistance and muscle insulin receptor substrate‐1 serine hyperphosphorylation

    PubMed Central

    Stuart, Charles A.; Howell, Mary E. A.; Cartwright, Brian M.; McCurry, Melanie P.; Lee, Michelle L.; Ramsey, Michael W.; Stone, Michael H.

    2014-01-01

    Abstract Insulin resistance in metabolic syndrome subjects is profound in spite of muscle insulin receptor and insulin‐responsive glucose transporter (GLUT4) expression being nearly normal. Insulin receptor tyrosine kinase phosphorylation of insulin receptor substrate‐1 (IRS‐1) at Tyr896 is a necessary step in insulin stimulation of translocation of GLUT4 to the cell surface. Serine phosphorylation of IRS‐1 by some kinases diminishes insulin action in mice. We evaluated the phosphorylation status of muscle IRS‐1 in 33 subjects with the metabolic syndrome and seventeen lean controls. Each underwent euglycemic insulin clamps and a thigh muscle biopsy before and after 8 weeks of either strength or endurance training. Muscle IRS‐1 phosphorylation at six sites was quantified by immunoblots. Metabolic syndrome muscle IRS‐1 had excess phosphorylation at Ser337 and Ser636 but not at Ser307, Ser789, or Ser1101. Ser337 is a target for phosphorylation by glycogen synthase kinase 3 (GSK3) and Ser636 is phosphorylated by c‐Jun N‐terminal kinase 1 (JNK1). Exercise training without weight loss did not change the IRS‐1 serine phosphorylation. These data suggest that baseline hyperphosphorylation of at least two key serines within muscle IRS‐1 diminishes the transmission of the insulin signal and thereby decreases the insulin‐stimulated translocation of GLUT4. Excess fasting phosphorylation of muscle IRS‐1 at Ser636 may be a major cause of the insulin resistance seen in obesity and might prevent improvement in insulin responsiveness when exercise training is not accompanied by weight loss. PMID:25472611

  7. MRI in DNM2-related centronuclear myopathy: evidence for highly selective muscle involvement.

    PubMed

    Schessl, Joachim; Medne, Livija; Hu, Ying; Zou, Yaqun; Brown, Mark J; Huse, Jason T; Torigian, Drew A; Jungbluth, Heinz; Goebel, Hans-Hilmar; Bönnemann, Carsten G

    2007-01-01

    Dynamin 2 has recently been recognized as a causative gene for the autosomal dominant form of centronuclear myopathy (dominant centronuclear myopathy). Here we report an affected father and daughter with dynamin 2 related AD CNM with predominantly distal onset of weakness. In addition to the diagnostic central location of myonuclei the muscle biopsy also showed core-like structures. Muscle MRI in the lower leg revealed prominent involvement of the soleus, but also of the gastrocnemius and the tibialis anterior whereas in the thigh there was a consistent pattern of selective involvement of adductor longus, semimembranosus, biceps femoris, rectus femoris, and vastus intermedius with relative sparing of vastus lateralis and medialis, sartorius, gracilis, and partly of the semitendinosus. These characteristic findings on muscle MRI confirm similar findings reported for CT imaging in dynamin 2 related dominant centronuclear myopathy and may help to differentiate this disorder from central core disease and other myopathies. PMID:17134899

  8. Adipose tissue and skeletal muscle blood flow during mental stress

    SciTech Connect

    Linde, B.; Hjemdahl, P.; Freyschuss, U.; Juhlin-Dannfelt, A.

    1989-01-01

    Mental stress (a modified Stroop color word conflict test (CWT)) increased adipose tissue blood flow (ATBF; 133Xe clearance) by 70% and reduced adipose tissue vascular resistance (ATR) by 25% in healthy male volunteers. The vasculatures of adipose tissue (abdomen as well as thigh), skeletal muscle of the calf (133Xe clearance), and the entire calf (venous occlusion plethysmography) responded similarly. Arterial epinephrine (Epi) and glycerol levels were approximately doubled by stress. Beta-Blockade by metoprolol (beta 1-selective) or propranolol (nonselective) attenuated CWT-induced tachycardia similarly. Metoprolol attenuated stress-induced vasodilation in the calf and tended to do so in adipose tissue. Propranolol abolished vasodilation in the calf and resulted in vasoconstriction during CWT in adipose tissue. Decreases in ATR, but not in skeletal muscle or calf vascular resistances, were correlated to increases in arterial plasma glycerol (r = -0.42, P less than 0.05), whereas decreases in skeletal muscle and calf vascular resistances, but not in ATR, were correlated to increases in arterial Epi levels (r = -0.69, P less than 0.01; and r = -0.43, P less than 0.05, respectively). The results suggest that mental stress increases nutritive blood flow in adipose tissue and skeletal muscle considerably, both through the elevation of perfusion pressure and via vasodilatation. Withdrawal of vasoconstrictor nerve activity, vascular beta 2-adrenoceptor stimulation by circulating Epi, and metabolic mechanisms (in adipose tissue) may contribute to the vasodilatation.

  9. Muscle injury induced beneath and distal to a pneumatic tourniquet: A quantitative animal study of effects of tourniquet pressure and duration

    SciTech Connect

    Pedowitz, R.A.; Gershuni, D.H.; Schmidt, A.H.; Friden, J.; Rydevik, B.L.; Hargens, A.R. )

    1991-07-01

    Previous recommendations regarding the safe period of tourniquet hemostasis were based largely on studies of ischemia distal to the tourniquet. This study quantitatively analyzed skeletal muscle injury induced beneath and distal to a pneumatic tourniquet applied to the hindlimbs of rabbits for 1, 2, or 4 hours with a cuff inflation pressure of 125, 200, or 350 mm Hg. Technetium Tc 99m pyrophosphate incorporation after systemic injection (Tc 99 uptake) and correlative histology were used to evaluate tissue damage 2 days after tourniquet application. Compared with the contralateral control limbs, compression and ischemia induced statistically significant increases in Tc 99 uptake in the thigh and leg regions of all groups. Pyrophosphate incorporation was significantly greater in the thigh region than in the leg region after 2 hours of compression in the 200 and 350 mm Hg pressure groups and following 4 hours of compression in all pressure groups. Focal and regional fiber necrosis and degeneration were observed in thigh muscles after 2 hours of tourniquet compression. Two hours of continuous tourniquet application at clinically relevant cuff inflation pressures induced significant skeletal muscle necrosis beneath the tourniquet. Use of the lowest possible inflation pressure for a limited duration should minimize the degree of tissue injury caused by tourniquet application.

  10. Automated unsupervised multi-parametric classification of adipose tissue depots in skeletal muscle

    PubMed Central

    Valentinitsch, Alexander; Karampinos, Dimitrios C.; Alizai, Hamza; Subburaj, Karupppasamy; Kumar, Deepak; Link, Thomas M.; Majumdar, Sharmila

    2012-01-01

    Purpose To introduce and validate an automated unsupervised multi-parametric method for segmentation of the subcutaneous fat and muscle regions in order to determine subcutaneous adipose tissue (SAT) and intermuscular adipose tissue (IMAT) areas based on data from a quantitative chemical shift-based water-fat separation approach. Materials and Methods Unsupervised standard k-means clustering was employed to define sets of similar features (k = 2) within the whole multi-modal image after the water-fat separation. The automated image processing chain was composed of three primary stages including tissue, muscle and bone region segmentation. The algorithm was applied on calf and thigh datasets to compute SAT and IMAT areas and was compared to a manual segmentation. Results The IMAT area using the automatic segmentation had excellent agreement with the IMAT area using the manual segmentation for all the cases in the thigh (R2: 0.96) and for cases with up to moderate IMAT area in the calf (R2: 0.92). The group with the highest grade of muscle fat infiltration in the calf had the highest error in the inner SAT contour calculation. Conclusion The proposed multi-parametric segmentation approach combined with quantitative water-fat imaging provides an accurate and reliable method for an automated calculation of the SAT and IMAT areas reducing considerably the total post-processing time. PMID:23097409

  11. Characterizing rapid-onset vasodilation to single muscle contractions in the human leg.

    PubMed

    Credeur, Daniel P; Holwerda, Seth W; Restaino, Robert M; King, Phillip M; Crutcher, Kiera L; Laughlin, M Harold; Padilla, Jaume; Fadel, Paul J

    2015-02-15

    Rapid-onset vasodilation (ROV) following single muscle contractions has been examined in the forearm of humans, but has not yet been characterized in the leg. Given known vascular differences between the arm and leg, we sought to characterize ROV following single muscle contractions in the leg. Sixteen healthy men performed random ordered single contractions at 5, 10, 20, 40, and 60% of their maximum voluntary contraction (MVC) using isometric knee extension made with the leg above and below heart level, and these were compared with single isometric contractions of the forearm (handgrip). Single thigh cuff compressions (300 mmHg) were utilized to estimate the mechanical contribution to leg ROV. Continuous blood flow was determined by duplex-Doppler ultrasound and blood pressure via finger photoplethysmography (Finometer). Single isometric knee extensor contractions produced intensity-dependent increases in peak leg vascular conductance that were significantly greater than the forearm in both the above- and below-heart level positions (e.g., above heart level: leg 20% MVC, +138 ± 28% vs. arm 20% MVC, +89 ± 17%; P < 0.05). Thigh cuff compressions also produced a significant hyperemic response, but these were brief and smaller in magnitude compared with single isometric contractions in the leg. Collectively, these data demonstrate the presence of a rapid and robust vasodilation to single muscle contractions in the leg that is largely independent of mechanical factors, thus establishing the leg as a viable model to study ROV in humans. PMID:25539935

  12. The importance of being earnest about shank and thigh kinematics especially when using ankle-foot orthoses.

    PubMed

    Owen, Elaine

    2010-09-01

    This paper reviews and summarizes the evidence for important observations of normal and pathological gait and presents an approach to rehabilitation and orthotic management, which is based on the significance of shank and thigh kinematics for standing and gait. It discusses normal gait biomechanics, challenging some traditional beliefs, the interrelationship between segment kinematics, joint kinematics and kinetics and their relationship to orthotic design, alignment and tuning. It proposes a description of four rather than three rockers in gait; a simple categorization of pathological gait based on shank kinematics abnormality; an algorithm for the designing, aligning and tuning of AFO-Footwear Combinations; and an algorithm for determining the sagittal angle of the ankle in an AFO. It reports the results of research on Shank to Vertical Angle alignment of tuned AFO-Footwear Combinations and on the use of 'point loading' rocker soles. PMID:20738230

  13. The Impact of Chocolate Goat's and Cow's Milk on Postresistance Exercise Endocrine Responses and Isometric Mid-Thigh Pull Performance.

    PubMed

    Bellar, David; LeBlanc, Nina R; Murphy, Kellie; Moody, Kaitlyn M; Buquet, Gina

    2016-01-01

    The present investigation examined the effects of chocolate cow's and goat's milk on endocrine responses and isometric mid-thigh pull performance post back squat exercise. Twelve college-aged males volunteered to participate and reported to the lab on four occasions. The first visit included anthropometric measurement, one-repetition back squat (1RM), and familiarization with the isometric mid-thigh pull assessment (IMTP). During the subsequent three visits, five sets of eight repetitions of the back squat exercise at 80% of 1RM were performed. For these trials, the participants performed an IMTP and gave a saliva sample prior to, immediately after, 1 hr and 2 hr post exercise. After exercise, a treatment of low-fat chocolate goat's milk (355 ml, 225 kcal), low-fat chocolate cow's milk (355 ml, 225 kcal), or control (water 355 ml, 0 kcal) was given in a counterbalanced order. Saliva samples were analyzed for testosterone, cortisol, and dehydroepiandrosterone (DHEA). Cortisol and DHEA hormone were unaffected by exercise; however, testosterone values did increase significantly post exercise. For IMTP, there was a significant main effect for time (F = 8.41, p = .007) but no treatment or interactions effects. N changes were noted post supplementation for cortisol or DHEA, but testosterone was found to be significantly reduced in both diary treatments compared to control (F = 4.27, p = .022). Based upon these data, it appears that a single treatment of chocolate goat's or cow's milk results in similar endocrine alterations but both fail to enhance postexercise isometric strength following resistance exercise. PMID:26900896

  14. Differences in Physicochemical and Nutritional Properties of Breast and Thigh Meat from Crossbred Chickens, Commercial Broilers, and Spent Hens

    PubMed Central

    Chen, Yulian; Qiao, Yan; Xiao, Yu; Chen, Haochun; Zhao, Liang; Huang, Ming; Zhou, Guanghong

    2016-01-01

    The objective of this study was to compare the physicochemical and nutritional properties of breast and thigh meat from commercial Chinese crossbred chickens (817 Crossbred chicken, 817C), imported commercial broilers (Arbor Acres broiler, AAB), and commercial spent hens (Hyline Brown, HLB). The crossbred chickens, commercial broilers and spent hens were slaughtered at their typical market ages of 45 d, 40 d, and 560 d, respectively. The results revealed that several different characteristic features for the three breeds. The meat of the 817C was darker than that of the other two genotypes. The 817C were also characterized by higher protein, lower intramuscular fat, and better texture attributes (cooking loss, pressing loss and Warner-Bratzler shear force [WBSF]) compared with AAB and HLB. The meat of the spent hens (i.e. HLB) was higher in WBSF and total collagen content than meat of the crossbred chickens and imported broilers. Furthermore, correlation analysis and principal component analysis revealed that there was a clear relationship among physicochemical properties of chicken meats. With regard to nutritional properties, it was found that 817C and HLB exhibited higher contents of essential amino acids and essential/non-essential amino acid ratios. In addition, 817C were noted to have highest content of microelements whereas AAB have highest content of potassium. Besides, 817C birds had particularly higher proportions of desirable fatty acids, essential fatty acids, polyunsaturated/saturated and (18:0+18:1)/16:0 ratios. The present study also revealed that there were significant differences on breast meat and thigh meat for the physicochemical and nutritional properties, regardless of chicken breeds. In conclusion, meat of crossbred chickens has some unique features and exhibited more advantages over commercial broilers and spent hens. Therefore, the current investigation would provide valuable information for the chicken meat product processing, and

  15. Generic vancomycin enriches resistant subpopulations of Staphylococcus aureus after exposure in a neutropenic mouse thigh infection model.

    PubMed

    Rodriguez, Carlos A; Agudelo, Maria; Zuluaga, Andres F; Vesga, Omar

    2012-01-01

    Previous studies have shown that "bioequivalent" generic products of vancomycin are less effective in vivo against Staphylococcus aureus than the innovator compound. Considering that suboptimal bactericidal effect has been associated with emergence of resistance, we aimed to assess in vivo the impact of exposure to innovator and generic products of vancomycin on S. aureus susceptibility. A clinical methicillin-resistant S. aureus (MRSA) strain from a liver transplant patient with persistent bacteremia was used for which MIC, minimum bactericidal concentration (MBC), and autolytic properties were determined. Susceptibility was also assessed by determining a population analysis profile (PAP) with vancomycin concentrations from 0 to 5 mg/liter. ICR neutropenic mice were inoculated in each thigh with ∼7.0 log(10) CFU. Treatment with the different vancomycin products (innovator and three generics; 1,200 mg/kg of body weight/day every 3 h) started 2 h later while the control group received sterile saline. After 24 h, mice were euthanized, and the thigh homogenates were plated. Recovered colonies were reinoculated to new groups of animals, and the exposure-recovery process was repeated until 12 cycles were completed. The evolution of resistance was assessed by PAP after cycles 5, 10, 11, and 12. The initial isolate displayed reduced autolysis and higher resistance frequencies than S. aureus ATCC 29213 but without vancomycin-intermediate S. aureus (VISA) subpopulations. After 12 cycles, innovator vancomycin had significantly reduced resistant subpopulations at 1, 2, and 3 mg/liter, while the generic products had enriched them progressively by orders of magnitude. The great capacity of generic vancomycin to select for less susceptible organisms raises concerns about the role of therapeutic inequivalence of any antimicrobial on the epidemiology of resistance worldwide. PMID:22064531

  16. Comparative Efficacies of Human Simulated Exposures of Tedizolid and Linezolid against Staphylococcus aureus in the Murine Thigh Infection Model

    PubMed Central

    Keel, R. A.; Tessier, P. R.; Crandon, J. L.

    2012-01-01

    Tedizolid (formally torezolid) is an expanded-spectrum oxazolidinone with enhanced in vitro potency against Gram-positive pathogens, including methicillin-susceptible Staphylococcus aureus (MSSA) and methicillin-resistant S. aureus (MRSA). The efficacies of human simulated exposures of tedizolid and linezolid against S. aureus in an immunocompetent mouse thigh model over 3 days were compared. Four strains of MRSA and one of MSSA with tedizolid and linezolid MICs ranging from 0.25 to 0.5 and from 2 to 4 μg/ml, respectively, were utilized. Tedizolid or linezolid was administered in a regimen simulating a human steady-state 24-h area under the free concentration-time curve of 200 mg every 24 h (Q24) or 600 mg Q12, respectively. Thighs were harvested after 4, 8, 12, 24, 36, 48, and 72 h, and efficacy was determined by the change in bacterial density. The mean bacterial density in control mice increased over the 3-day period. After 24 h of treatment, a reduction in bacterial density of ≥1 log CFU was observed for both the tedizolid and linezolid treatments. Antibacterial activity was enhanced for both agents with a reduction of ≥2.6 log CFU after 72 h of treatment. Any statistically significant differences (P ≤ 0.05) in efficacy between the agents were transient and did not persist throughout the 72-h treatment period. The tedizolid and linezolid regimens demonstrated similar in vivo efficacies against the S. aureus isolates tested. Both agents were bacteriostatic at 24 h and bactericidal on the third day of treatment. These data support the clinical utility of tedizolid for skin and skin structure infections caused by S. aureus, as well as the bactericidal activity of the oxazolidinones after 3 days of treatment. PMID:22687504

  17. Differences in Physicochemical and Nutritional Properties of Breast and Thigh Meat from Crossbred Chickens, Commercial Broilers, and Spent Hens.

    PubMed

    Chen, Yulian; Qiao, Yan; Xiao, Yu; Chen, Haochun; Zhao, Liang; Huang, Ming; Zhou, Guanghong

    2016-06-01

    The objective of this study was to compare the physicochemical and nutritional properties of breast and thigh meat from commercial Chinese crossbred chickens (817 Crossbred chicken, 817C), imported commercial broilers (Arbor Acres broiler, AAB), and commercial spent hens (Hyline Brown, HLB). The crossbred chickens, commercial broilers and spent hens were slaughtered at their typical market ages of 45 d, 40 d, and 560 d, respectively. The results revealed that several different characteristic features for the three breeds. The meat of the 817C was darker than that of the other two genotypes. The 817C were also characterized by higher protein, lower intramuscular fat, and better texture attributes (cooking loss, pressing loss and Warner-Bratzler shear force [WBSF]) compared with AAB and HLB. The meat of the spent hens (i.e. HLB) was higher in WBSF and total collagen content than meat of the crossbred chickens and imported broilers. Furthermore, correlation analysis and principal component analysis revealed that there was a clear relationship among physicochemical properties of chicken meats. With regard to nutritional properties, it was found that 817C and HLB exhibited higher contents of essential amino acids and essential/non-essential amino acid ratios. In addition, 817C were noted to have highest content of microelements whereas AAB have highest content of potassium. Besides, 817C birds had particularly higher proportions of desirable fatty acids, essential fatty acids, polyunsaturated/saturated and (18:0+18:1)/16:0 ratios. The present study also revealed that there were significant differences on breast meat and thigh meat for the physicochemical and nutritional properties, regardless of chicken breeds. In conclusion, meat of crossbred chickens has some unique features and exhibited more advantages over commercial broilers and spent hens. Therefore, the current investigation would provide valuable information for the chicken meat product processing, and

  18. Effects of seat-thigh contact on kinematics performance in sit-to-stand and trunk flexion tasks.

    PubMed

    Diakhaté, D G; Do, M C; Le Bozec, S

    2013-03-15

    It has been shown that thigh-seat contact-surface influences performance of isometric push-force with upper-limbs. The push-force performance is higher when subjects are seated with partial ischio-femoral / seat contact than when they are seated with full ischio-femoral contact. This was ascribed to greater pelvis and spine mobility induced by the short thigh-seat contact-surface. The present study tested the generalization of this hypothesis during movements involving body segment displacement, namely trunk flexion (TF) and sit-to-stand (STS) motor tasks. Both motor tasks were carried out in similar conditions to those implemented in the isometric push-force tasks, i.e. full ischio-femoral / seat contact (100-IFC) and short ischio-femoral contact (30-IFC, i.e. 30% of full ischio-femoral / seat contact). Results showed that kinematic performances (maximal antero-posterior and vertical center of mass velocity and maximal backward displacement of center of pressure) in both motor tasks were higher in 30-IFC than in 100-IFC. In the sit-to-stand task, time of seat-off is shorter in 30-IFC. As the subject's initial global posture was comparable across the experimental conditions, it can be discarded as a source of performance change. It is discussed that it is the enhanced pelvis mobility induced by the sitting condition which is responsible for the increase of motor performance in both trunk flexion and sit-to-stand tasks. Our results highlight the role of joint mobility in motor performance. PMID:23380307

  19. Image-based Tissue Distribution Modeling for Skeletal Muscle Quality Characterization

    PubMed Central

    Fishbein, K. W.; Moore, A. Z.; Spencer, R. G.; Ferrucci, L.

    2016-01-01

    The identification and characterization of regional body tissues is essential to understand changes that occur with aging and age-related metabolic diseases such as diabetes and obesity and how these diseases affect trajectories of health and functional status. Imaging technologies are frequently used to derive volumetric, area, and density measurements of different tissues. Despite the significance and direct applicability of automated tissue quantification and characterization techniques, these topics have remained relatively under-explored in the medical image analysis literature. We present a method for identification and characterization of muscle and adipose tissue in the mid-thigh region using MRI. We propose an image-based muscle quality prediction technique that estimates tissue-specific probability density models and their eigenstructures in the joint domain of water- and fat-suppressed voxel signal intensities along with volumetric and intensity-based tissue characteristics computed during the quantification stage. We evaluated the predictive capability of our approach against reference biomechanical muscle quality measurements using statistical tests and classification performance experiments. The reference standard for muscle quality is defined as the ratio of muscle strength to muscle mass. The results show promise for the development of non-invasive image-based muscle quality descriptors. PMID:26336111

  20. [Reconstruction of the anterior chest wall by a sandwich-type combination of a synthetic support and a muscle flap from the latissimus dorsi. Apropos of a case].

    PubMed

    Lanfrey, E; Grolleau, J L; Glock, Y; Chavoin, J P; Costagliola, M

    1996-04-01

    Reconstruction of the chest wall after balistic or other trauma requires good and muscle cover and creation of a new, stable and airtight wall. The authors present a case of balistic trauma of the right anterolateral chest wall which was urgently debrided and subsequently reconstructed by sandwich combination of a latissimus dorsi muscle flap and synthetic material composed of a sheet of PTFE and creation of two methylmethylacrylate ribs. The advantage of this technique is that it avoids the use of autologous tissue from an already weakened chest wall and confers a new chest stability in several sites corresponding to the wall defect with easily available and easy-to-use materials. PMID:8761064

  1. Muscle mass, visceral fat, and plasma levels of B-type natriuretic peptide in healthy individuals (from the J-SHIPP Study).

    PubMed

    Yamashita, Taiji; Kohara, Katsuhiko; Tabara, Yasuharu; Ochi, Masayuki; Nagai, Tokihisa; Okada, Yoko; Igase, Michiya; Miki, Tetsuro

    2014-08-15

    A paradoxical negative association between obesity and the plasma B-type natriuretic peptide (BNP) level has been firmly established. An individual's fat mass increases and muscle mass decreases with aging. Because aging is a potent determinant of plasma BNP levels, BNP may be related not only to fat mass but also to muscle mass. However, no studies have evaluated the associations between body composition and plasma levels of BNP. We performed a cross-sectional study to investigate these associations in 1,431 apparently healthy middle-aged to elderly subjects. The abdominal visceral fat area and thigh muscle cross-sectional area (CSA) were quantified by computed tomography. Plasma adiponectin and leptin levels were measured as possible confounding parameters. The brachial-ankle pulse wave velocity was measured as an index of arterial stiffness, and the pulse pressure (PP) of the second peak of the radial systolic blood pressure waveform (PP2) was used as an estimate of the central PP. Plasma BNP levels were significantly and negatively associated with the visceral fat area (r = -0.13, p <0.0001) and thigh muscle CSA (r = -0.25, p <0.0001). Corrections with possible confounding parameters including age, gender, heart rate, mean blood pressure, body weight, body height, adiponectin, leptin, brachial-ankle pulse wave velocity, and PP2 eliminated the association of BNP with visceral fat area but not with thigh muscle CSA (β = -0.27, p <0.0001). These findings indicate that along with adiposity, muscle mass is an independent determinant of plasma BNP. PMID:25001150

  2. Hoffmann's syndrome with unusually long duration: Report on clinical, laboratory and muscle imaging findings in two cases.

    PubMed

    Nalini, Atchayaram; Govindaraju, C; Kalra, Pramila; Kadukar, Prashanth

    2014-04-01

    Two adult men presented with the rare Hoffmann's syndrome (HS). Case 1: A 35-year-old male patient had progressive stiffness of lower limbs of 13 years and generalized muscle hypertrophy and myalgia of 3 years duration. Had periorbital edema, dry skin, generalized muscle hypertrophy and spastic dysarthria with hoarseness. Muscle power was normal. Jaw jerk and deep tendon reflexes were exaggerated. Case 2: A 24-year-old male patient presented with muscle hypertrophy from childhood, slowness in motor activities and hearing impairment. For 6 months, he had severe muscle pains, cramps and further increase in hypertrophy. He had yellow tinged, dry skin, hoarseness of voice, gross muscle hypertrophy and minimal weakness. Both had markedly elevated serum creatine kinase (CK) levels and high thyroid stimulating hormone, low free triiodothyronine and free thyroxine levels. Levothyroxine treatment demonstrated remarkable reduction in muscle bulk at 2 months in both and no symptoms at 6 months. Magnetic resonance imaging of lower limbs in both cases revealed almost identical features with involvement of the muscles of posterior and adductor compartment of thighs and posterior and lateral compartments of the legs. Differential diagnosis of long duration muscle pseudohypertrophy and elevated CK levels should include HS. PMID:25024579

  3. Hoffmann's syndrome with unusually long duration: Report on clinical, laboratory and muscle imaging findings in two cases

    PubMed Central

    Nalini, Atchayaram; Govindaraju, C.; Kalra, Pramila; Kadukar, Prashanth

    2014-01-01

    Two adult men presented with the rare Hoffmann's syndrome (HS). Case 1: A 35-year-old male patient had progressive stiffness of lower limbs of 13 years and generalized muscle hypertrophy and myalgia of 3 years duration. Had periorbital edema, dry skin, generalized muscle hypertrophy and spastic dysarthria with hoarseness. Muscle power was normal. Jaw jerk and deep tendon reflexes were exaggerated. Case 2: A 24-year-old male patient presented with muscle hypertrophy from childhood, slowness in motor activities and hearing impairment. For 6 months, he had severe muscle pains, cramps and further increase in hypertrophy. He had yellow tinged, dry skin, hoarseness of voice, gross muscle hypertrophy and minimal weakness. Both had markedly elevated serum creatine kinase (CK) levels and high thyroid stimulating hormone, low free triiodothyronine and free thyroxine levels. Levothyroxine treatment demonstrated remarkable reduction in muscle bulk at 2 months in both and no symptoms at 6 months. Magnetic resonance imaging of lower limbs in both cases revealed almost identical features with involvement of the muscles of posterior and adductor compartment of thighs and posterior and lateral compartments of the legs. Differential diagnosis of long duration muscle pseudohypertrophy and elevated CK levels should include HS. PMID:25024579

  4. A new species of the feather mite genus Dubininia Vassilev, 1958 (Acari: Xolalgidae) from the Black-thighed Falconet Microhierax fringillarius (Falconiformes: Falconidae).

    PubMed

    Dabert, Jacek; Mironov, Sergei V

    2015-06-01

    A new feather mite species Dubininia microhieracis sp. n. (Analgoidea: Xolalgidae) is described from the Black-thighed Falconet Microhierax fringillarius (Drapiez) (Falconiformes: Falconidae) from Java. This is the second species of the genus Dubininia found on falconiform hosts; most known species of this genus are associated with parrots (Psittaciformes). PMID:26203992

  5. Lower Extremity Muscle Thickness During 30-Day 6 degrees Head-Down Bed Rest with Isotonic and Isokinetic Exercise Training

    NASA Technical Reports Server (NTRS)

    Ellis, S.; Kirby, L. C.; Greenleaf, J. E.

    1993-01-01

    Muscle thickness was measured in 19 Bed-Rested (BR) men (32-42 year) subjected to IsoTonic (ITE, cycle orgometer) and IsoKi- netic (IKE, torque orgometer) lower extremity exercise training, and NO Exercise (NOE) training. Thickness was measured with ultrasonography in anterior thigh-Rectus Femoris (RF) and Vastus Intermadius (VI), and combined posterior log-soleus, flexor ballucis longus, and tibialis posterior (S + FHL +TP) - muscles. Compared with ambulatory control values, thickness of the (S + FHL + TP) decreased by 90%-12% (p less than 0.05) In all three test groups. The (RF) thickness was unchanged in the two exercise groups, but decreased by 10% (p less than 0.05) in the NOE. The (VI) thickness was unchanged In the ITE group, but decreased by 12%-l6% (p less than 0.05) in the IKE and NOE groups. Thus, intensive, alternating, isotonic cycle ergometer exercise training is as effective as intensive, intermittent, isokinetic exercise training for maintaining thicknesses of rectus femoris and vastus lntermedius anterior thigh muscles, but not posterior log muscles, during prolonged BR deconditioning.

  6. The use of the greater trochanter marker in the thigh segment model: implications for hip and knee frontal and transverse plane motion

    PubMed Central

    Graci, Valentina; Salsich, Gretchen

    2015-01-01

    Background The greater trochanter marker is commonly used in 3-dimensional models; however, its influence on hip and knee kinematics during gait is unclear. Understanding the influence of the greater trochanter marker is important when quantifying frontal and transverse plane hip and knee kinematics, parameters which are particularly relevant to investigate in individuals with conditions such as patellofemoral pain, knee osteoarthritis, ACL injury and hip pain. The aim of this study was to evaluate the effect of including the greater trochanter in the construction of the thigh segment on hip and knee kinematics during gait. Methods Three-dimensional kinematics were collected in 19 healthy subjects during walking using a surface marker system. Hip and knee angles were compared across two thigh segment definitions (with and without greater trochanter) at two time points during stance: peak knee flexion (PKF) and minimum knee flexion (MinKF). Results Hip and knee angles differed in magnitude and direction in the transverse plane at both time points. In the thigh model with the greater trochanter the hip was more externally rotated than in the thigh model without the greater trochanter, (PKF −9.34°±5.21° vs 1.40°±5.22°, MinKF −5.68°±4.24° vs 5.01°±4.86°, p<0.001). In the thigh model with the greater trochanter, the knee angle was more internally rotated compared to the knee angle calculated using the thigh definition without the greater trochanter (PKF 14.67°±6.78° vs 4.33°±4.18°, MinKF 10.54°±6.71° vs −0.01°±2.69°, p<.001). Small but significant differences were detected in the sagittal and frontal plane angles at both time points (p<.001). Conclusion Hip and knee kinematics differed across different segment definitions including or excluding the greater trochanter marker, especially in the transverse plane. Therefore when considering whether to include the greater trochanter in the thigh segment model when using a surface markers to

  7. The thigh extension of the small saphenous vein: a hypothesis about its significance, based on morphological, embryological and anatomo-comparative reports.

    PubMed

    Barberini, Fabrizio; Cavallini, Alvise; Caggiati, Alberto

    2006-01-01

    The small saphenous vein in its modal pattern flows into the popliteal vein by means of a terminal arch (sapheno-popliteal junction), and frequently gives off an anastomotic branch, ascending on the medial aspect of the thigh, to the great saphenous vein. This branch has often been termed thigh extension of the small saphenous vein. As resulted in this report from autopsy, the venous extension coursed on the midline of the posterior aspect of the thigh, tributary to the deep femoral vein, and the small saphenous vein presented neither a sapheno-popliteal terminal arch, nor evident intersaphenous anastomoses. As a consequence, the small saphenous vein by means of its prolongation continued directly from the calf into the deep femoral vein. In the human embryo the small saphenous vein appears as direct communication with the posterior cardinal vein, and accompanies the developing ischiatic artery and nerve, as the main vein (ischiatic vein) of the lower limb bud. At the end of development, its proximal part persists as inferior gluteal vein. Comparative anatomy indicates that in animals the small saphenous vein is the only superficial vein well developed and that in humans its termination into the popliteal one might be an adaptation to the elongation and relative rigidity of the lower limb. In the horse a posterior vein of the thigh connects the small saphenous with the ischiatic one, and ascends along the ischiatic nerve to anastomose with the deep femoral vein. It would appear also that in the lower animals the small saphenous vein ascends to a higher level on the posterior aspect of the thigh. Thus, a venous extension like that we observed might be an atavism. Therefore, on the basis of these embryological and phylogenetical data, the Authors hypothesized that a small saphenous vein and a thigh extension of such a feature might be regarded as a unique venous channel, wholly axial throughout its course, formed by the small saphenous vein proper in the leg and by a

  8. Quickly progressive amyotrophy of the thigh: An unusual cause of rapid chondrolysis of the knee.

    PubMed

    Ferrari, Maeva; Louati, Karine; Miquel, Anne; Behin, Anthony; Benveniste, Olivier; Sellam, Jérémie

    2015-05-01

    While rapidly destructive OA is more recognized in hip, we report the case of a 50-year-old woman who presented a rapid chondrolysis in the patellofemoral joint in a context of rapid loss of muscular strength. She had arthralgia, myalgia and proximal muscular deficit of the limbs. Creatine phospho kinase level was elevated and electromyogram exam showed a myogenic syndrome. Neither immune nor visceral disease was highlighted. As we suspected a polymyositis, we started corticosteroids and physiotherapy, then methotrexate and intravenous immunoglobulin. Concomitantly to the worsening of the muscular deficit and atrophy of hamstrings, she developed a persistent and disabling knee pain. Initial radiographs and magnetic resonance imaging (MRI) showed only a patellofemoral dysplasia and tiny cartilage damages. Because of aggravation of myalgia, we treated by mycophenolate mofetyl then rituximab. One year later, the knee remained painful and swollen. MRI showed signs of advanced osteoarthritis including an important loss of cartilage with an atrophy of hamstrings. Several articular corticosteroids injections were done. In the same time, the evolution of the muscular disease was unusual. Another histological analysis of muscle has highlighted a genetic myopathy due to mutation of calpain. Immunosuppressive treatments were stopped and a total joint replacement was performed. We show for the first time a case of rapid chondrolysis of patellofemoral joint related to a severe genetic myopathy. PMID:25680228

  9. Abdominal wall muscle elasticity and abdomen local stiffness on healthy volunteers during various physiological activities.

    PubMed

    Tran, D; Podwojewski, F; Beillas, P; Ottenio, M; Voirin, D; Turquier, F; Mitton, D

    2016-07-01

    The performance of hernia treatment could benefit from more extensive knowledge of the mechanical behavior of the abdominal wall in a healthy state. To supply this knowledge, the antero-lateral abdominal wall was characterized in vivo on 11 healthy volunteers during 4 activities: rest, pullback loading, abdominal breathing and the "Valsalva maneuver". The elasticity of the abdominal muscles (rectus abdominis, obliquus externus, obliquus internus and transversus abdominis) was assessed using ultrasound shear wave elastography. In addition, the abdomen was subjected to a low external load at three locations: on the midline (linea alba), on the rectus abdominis region and on lateral muscles region in order to evaluate the local stiffness of the abdomen, at rest and during "Valsalva maneuver". The results showed that the "Valsalva maneuver" leads to a statistically significant increase of the muscle shear modulus compared to the other activities. This study also showed that the local stiffness of the abdomen was related to the activity. At rest, a significant difference has been observed between the anterior (0.5N/mm) and the lateral abdomen locations (1N/mm). Then, during the Valsalva maneuver, the local stiffness values were similar for all locations (ranging from 1.6 to 2.2N/mm). This work focuses on the in vivo characterization of the mechanical response of the human abdominal wall and abdomen during several activities. In the future, this protocol could be helpful for investigation on herniated patients. PMID:26994992

  10. Influence of Gender and Muscle Architecture Asymmetry on Jump and Sprint Performance

    PubMed Central

    Mangine, Gerald T.; Fukuda, David H.; LaMonica, Michael B.; Gonzalez, Adam M.; Wells, Adam J.; Townsend, Jeremy R.; Jajtner, Adam R.; Fragala, Maren S.; Stout, Jeffrey R.; Hoffman, Jay R.

    2014-01-01

    Muscle architecture is a determinant for sprinting speed and jumping power, which may be related to anaerobic sports performance. In the present investigation, the relationships between peak (PVJP) and mean (MVJP) vertical jump power, 30m maximal sprinting speed (30M), and muscle architecture were examined in 28 college-aged, recreationally-active men (n = 14; 24.3 ± 2.2y; 89.1 ± 9.3kg; 1.80 ± 0.07 m) and women (n = 14; 21.5 ± 1.7y; 65.2 ± 12.4kg; 1.63 ± 0.08 m). Ultrasound measures of muscle thickness (MT), pennation angle (PNG), cross-sectional area (CSA), and echo intensity (ECHO) were collected from the rectus femoris (RF) and vastus lateralis (VL) of both legs; fascicle length (FL) was estimated from MT and PNG. Men possessed lower ECHO, greater muscle size (MT & CSA), were faster, and were more powerful (PVJP & MVJP) than women. Stepwise regression indicated that muscle size and quality influenced speed and power in men. In women, vastus lateralis asymmetry negatively affected PVJP (MT: r = –0.73; FL: r = –0.60) and MVJP (MT: r = –0.76; FL: r = –0.64), while asymmetrical ECHO (VL) and FL (RF) positively influenced MVJP (r = 0.55) and 30M (r = 0.57), respectively. Thigh muscle architecture appears to influence jumping power and sprinting speed, though the effect may vary by gender in recreationally-active adults. Appropriate assessment of these ultrasound variables in men and women prior to training may provide a more specific exercise prescription. Key points The manner in which thigh muscle architecture affects jumping power and sprinting speed varies by gender. In men, performance is influenced by the magnitude of muscle size and architecture. In women, asymmetrical muscle size and architectural asymmetry significantly influence performance. To develop effective and precise exercise prescription for the improvement of jumping power and/or sprinting speed, muscle architecture assessment prior to the onset of a training program is advised. PMID

  11. Fish oil–derived n–3 PUFA therapy increases muscle mass and function in healthy older adults1

    PubMed Central

    Smith, Gordon I; Julliand, Sophie; Reeds, Dominic N; Sinacore, David R; Klein, Samuel; Mittendorfer, Bettina

    2015-01-01

    Background: Age-associated declines in muscle mass and function are major risk factors for an impaired ability to carry out activities of daily living, falls, prolonged recovery time after hospitalization, and mortality in older adults. New strategies that can slow the age-related loss of muscle mass and function are needed to help older adults maintain adequate performance status to reduce these risks and maintain independence. Objective: We evaluated the efficacy of fish oil–derived n–3 (ω-3) PUFA therapy to slow the age-associated loss of muscle mass and function. Design: Sixty healthy 60–85-y-old men and women were randomly assigned to receive n–3 PUFA (n = 40) or corn oil (n = 20) therapy for 6 mo. Thigh muscle volume, handgrip strength, one-repetition maximum (1-RM) lower- and upper-body strength, and average power during isokinetic leg exercises were evaluated before and after treatment. Results: Forty-four subjects completed the study [29 subjects (73%) in the n–3 PUFA group; 15 subjects (75%) in the control group]. Compared with the control group, 6 mo of n–3 PUFA therapy increased thigh muscle volume (3.6%; 95% CI: 0.2%, 7.0%), handgrip strength (2.3 kg; 95% CI: 0.8, 3.7 kg), and 1-RM muscle strength (4.0%; 95% CI: 0.8%, 7.3%) (all P < 0.05) and tended to increase average isokinetic power (5.6%; 95% CI: −0.6%, 11.7%; P = 0.075). Conclusion: Fish oil–derived n–3 PUFA therapy slows the normal decline in muscle mass and function in older adults and should be considered a therapeutic approach for preventing sarcopenia and maintaining physical independence in older adults. This study was registered at clinicaltrials.gov as NCT01308957. PMID:25994567

  12. Role of Muscle Morphology in Jumping, Sprinting, and Throwing Performance in Participants With Different Power Training Duration Experience.

    PubMed

    Methenitis, Spyridon K; Zaras, Nikolaos D; Spengos, Konstantinos M; Stasinaki, Angeliki-Nikoletta E; Karampatsos, Giorgos P; Georgiadis, Giorgos V; Terzis, Gerasimos D

    2016-03-01

    The aim of the study was to examine the correlation between muscle morphology and jumping, sprinting, and throwing performance in participants with different power training duration experience. Thirty-six power-trained young men were assigned to 3 groups according to the length of their power training: less experienced (<1 year), moderately experienced (1-3 years), and experienced (4-7 years). All participants performed countermovement and squat jumps, 60-m sprint, and shot throws twice. Lean body mass (LBM) was evaluated with dual-energy x-ray absorptiometry and thigh muscle cross-sectional area (CSA) with anthropometry. The vastus lateralis architecture and fiber type composition were evaluated with ultrasonography and muscle biopsies, respectively. When all subjects were considered as 1 group (n = 36), jumping performance was correlated with LBM, fascicle length, and type II fiber CSA; sprinting performance was correlated with estimated thigh muscle CSA alone; and shot throwing was correlated with LBM and type I, IIA fiber CSA. In the least experienced group, the LBM of the lower extremities was the most significant contributor for power performance, whereas in the moderately experienced group, the LBM, architectural properties, and type II fiber percentage CSA were the most significant contributors. For the experienced group, fascicle length and type II fiber percentage CSA were the most significant factors for power performance. These data suggest that jumping performance is linked with muscle morphology, regardless of strength or power training. The vastus lateralis muscle morphology could only partially explain throwing performance, whereas it cannot predict sprinting performance. Power performance in experienced participants rely more on the quality of the muscle tissue rather than the quantity. PMID:26907845

  13. Muscle magnetic resonance imaging in congenital myasthenic syndromes

    PubMed Central

    Morrow, Jasper M.; Rodriguez Cruz, Pedro M.; Sinclair, Christopher D.J.; Fischmann, Arne; Thornton, John S.; Knight, Steve; Norbury, Ray; White, Mel; Al‐hajjar, Michal; Carboni, Nicola; Jayawant, Sandeep; Robb, Stephanie A.; Yousry, Tarek A.; Beeson, David; Palace, Jacqueline

    2016-01-01

    ABSTRACT Introduction In this study we investigated muscle magnetic resonance imaging in congenital myasthenic syndromes (CMS). Methods Twenty‐six patients with 9 CMS subtypes and 10 controls were imaged. T1‐weighted (T1w) and short‐tau inversion recovery (STIR) 3‐Tesla MRI images obtained at thigh and calf levels were scored for severity. Results Overall mean the T1w score was increased in GFPT1 and DPAGT1 CMS. T1w scans of the AChR‐deficiency, COLQ, and CHAT subjects were indistinguishable from controls. STIR images from CMS patients did not differ significantly from those of controls. Mean T1w score correlated with age in the CMS cohort. Conclusions MRI appearances ranged from normal to marked abnormality. T1w images seem to be especially abnormal in some CMS caused by mutations of proteins involved in the glycosylation pathway. A non‐selective pattern of fat infiltration or a normal‐appearing scan in the setting of significant clinical weakness should suggest CMS as a potential diagnosis. Muscle MRI could play a role in differentiating CMS subtypes. Muscle Nerve 54: 211–219, 2016 PMID:26789134

  14. Relationships between organochlorine concentrations in liver and muscle of otters

    SciTech Connect

    Mason, C.F. )

    1989-10-01

    The European otter (Lutra lutra) is now threatened or endangered over much of its European range. The decline, which has taken place mainly during the past three decades, has been attributed to the toxic effects of organochlorine residues, with emphasis being placed on dieldrin or PCBs. Few otters were analyzed for organochlorines during the main period of decline but there is not considerable interest in the species. Experiments with ranch mink (Mustela vison) have shown that reproductive failure occurs when PCB concentrations in thigh muscle approach 50 mg kg{sup {minus}1} lipid. Because otters are closely related and have similar habits this value is becoming widely used to interpret the potential significance of PCB concentrations determined in otters. Furthermore, although the mink data refer to concentrations in muscle, interpretations of concentrations in otters have frequently been based on analyses of livers. Because of the diverse sources of material in Europe, only limited tissues may be made available for analysis, while costs may also prohibit the analysis of several tissues from a single carcass. The relationship between concentrations of organochlorines in muscle and liver tissues in otters has not been determined. This is the purpose of the present communication.

  15. CAN DUAL ENERGY X-RAY ABSORPTIOMETRY PROVIDE A VALID ASSESSMENT OF CHANGES IN THIGH MUSCLE MASS WITH STRENGTH TRAINING IN OLDER ADULTS?

    Technology Transfer Automated Retrieval System (TEKTRAN)

    A longitudinal strength training (ST) intervention study was conducted in fifty previously sedentary, relatively healthy men (n = 23, 60 [SD=7.5] yr) and women (n = 27, 60 [SD=9.3] yr). One part of the study determined how dual-energy x-ray absorptiometry (DXA) compares to computed tomography (CT) f...

  16. [Muscle fiber atrophy].

    PubMed

    Nonaka, Ikuya

    2012-01-01

    Muscle fibers have been classified into two major forms of red (slow twitch) and white (fast twitch) muscles. The red muscle utilizes lipid as energy source through mitochondrial metabolism and function to sustain the position against gravity (sometimes called as antigravity muscle). Under microgravity the red muscle is selectively involved. In our unloading study by hindlimb suspension experiment on rats, the one of the representative red muscle of soleus muscle underwent rapid atrophy; they reduced their weights about 50% after 2 week-unloading. In addition, myofibrils were occasionally markedly disorganized with selective thin filament loss. Mitochondria in the degenerated area were decreased in number. The white muscle fibers in the soleus muscle had mostly transformed to the red ones. It took about 1 month to recover morphologically. The satellite cell playing a major role in muscle regeneration was not activated. There still remained unsolved what are the mechanosensors to keep muscle function under normal gravity. Dr Nikawa's group proposed that one of ubiquitin ligases, Cbl-b is activated under microgravity and induces muscle fiber degeneration. There might be many factors to induce muscle atrophy and degeneration under microgravity. Further study is necessary to explore the pathomechanism of muscle atrophy in disused and under immobility conditions. PMID:23196603

  17. Multi-scale complexity analysis of muscle coactivation during gait in children with cerebral palsy

    PubMed Central

    Tao, Wen; Zhang, Xu; Chen, Xiang; Wu, De; Zhou, Ping

    2015-01-01

    The objective of this study is to characterize complexity of lower-extremity muscle coactivation and coordination during gait in children with cerebral palsy (CP), children with typical development (TD) and healthy adults, by applying recently developed multivariate multi-scale entropy (MMSE) analysis to surface electromyographic (EMG) signals. Eleven CP children (CP group), eight TD children and seven healthy adults (considered as an entire control group) were asked to walk while surface EMG signals were collected from five thigh muscles and three lower leg muscles on each leg (16 EMG channels in total). The 16-channel surface EMG data, recorded during a series of consecutive gait cycles, were simultaneously processed by multivariate empirical mode decomposition (MEMD), to generate fully aligned data scales for subsequent MMSE analysis. In order to conduct extensive examination of muscle coactivation complexity using the MEMD-enhanced MMSE, 14 data analysis schemes were designed by varying partial muscle combinations and time durations of data segments. Both TD children and healthy adults showed almost consistent MMSE curves over multiple scales for all the 14 schemes, without any significant difference (p > 0.09). However, distinct diversity in MMSE curve was observed in the CP group when compared with the control group. There appears to be diverse neuropathological processes in CP that may affect dynamical complexity of muscle coactivation and coordination during gait. The abnormal complexity patterns emerging in the CP group can be attributed to different factors such as motor control impairments, loss of muscle couplings, and spasticity or paralysis in individual muscles. This study expands our knowledge of neuropathology of CP from a novel point of view of muscle co-activation complexity, which might be useful to derive a quantitative index for assessing muscle activation characteristics as well as motor function in CP. PMID:26257622

  18. Muscle activation patterns in the Nordic hamstring exercise: Impact of prior strain injury.

    PubMed

    Bourne, M N; Opar, D A; Williams, M D; Al Najjar, A; Shield, A J

    2016-06-01

    This study aimed to determine: (a) the spatial patterns of hamstring activation during the Nordic hamstring exercise (NHE); (b) whether previously injured hamstrings display activation deficits during the NHE; and (c) whether previously injured hamstrings exhibit altered cross-sectional area (CSA). Ten healthy, recreationally active men with a history of unilateral hamstring strain injury underwent functional magnetic resonance imaging of their thighs before and after six sets of 10 repetitions of the NHE. Transverse (T2) relaxation times of all hamstring muscles [biceps femoris long head (BFlh); biceps femoris short head (BFsh); semitendinosus (ST); semimembranosus (SM)] were measured at rest and immediately after the NHE and CSA was measured at rest. For the uninjured limb, the ST's percentage increase in T2 with exercise was 16.8%, 15.8%, and 20.2% greater than the increases exhibited by the BFlh, BFsh, and SM, respectively (P < 0.002 for all). Previously injured hamstring muscles (n = 10) displayed significantly smaller increases in T2 post-exercise than the homonymous muscles in the uninjured contralateral limb (mean difference -7.2%, P = 0.001). No muscles displayed significant between-limb differences in CSA. During the NHE, the ST is preferentially activated and previously injured hamstring muscles display chronic activation deficits compared with uninjured contralateral muscles. PMID:26059634

  19. Localization and quantification of intramuscular damage using statistical parametric mapping and skeletal muscle parcellation

    PubMed Central

    Fouré, Alexandre; Le Troter, Arnaud; Guye, Maxime; Mattei, Jean-Pierre; Bendahan, David; Gondin, Julien

    2015-01-01

    In the present study, we proposed an original and robust methodology which combines the spatial normalization of skeletal muscle images, the statistical parametric mapping (SPM) analysis and the use of a specific parcellation in order to accurately localize and quantify the extent of skeletal muscle damage within the four heads of the quadriceps femoris. T2 maps of thigh muscles were characterized before, two (D2) and four (D4) days after 40 maximal isometric electrically-evoked contractions in 25 healthy young males. On the basis of SPM analysis of coregistrated T2 maps, the alterations were similarly detected at D2 and D4 in the superficial and distal regions of the vastus medialis (VM) whereas the proportion of altered muscle was higher in deep muscle regions of the vastus lateralis at D4 (deep: 35 ± 25%, superficial: 23 ± 15%) as compared to D2 (deep: 18 ± 13%, superficial: 17 ± 13%). The present methodology used for the first time on skeletal muscle would be of utmost interest to detect subtle intramuscular alterations not only for the diagnosis of muscular diseases but also for assessing the efficacy of potential therapeutic interventions and clinical treatment strategies. PMID:26689827

  20. Non-Instrumental Movement Inhibition (NIMI) Differentially Suppresses Head and Thigh Movements during Screenic Engagement: Dependence on Interaction

    PubMed Central

    Witchel, Harry J.; Santos, Carlos P.; Ackah, James K.; Westling, Carina E. I.; Chockalingam, Nachiappan

    2016-01-01

    Background: Estimating engagement levels from postural micromovements has been summarized by some researchers as: increased proximity to the screen is a marker for engagement, while increased postural movement is a signal for disengagement or negative affect. However, these findings are inconclusive: the movement hypothesis challenges other findings of dyadic interaction in humans, and experiments on the positional hypothesis diverge from it. Hypotheses: (1) Under controlled conditions, adding a relevant visual stimulus to an auditory stimulus will preferentially result in Non-Instrumental Movement Inhibition (NIMI) of the head. (2) When instrumental movements are eliminated and computer-interaction rate is held constant, for two identically-structured stimuli, cognitive engagement (i.e., interest) will result in measurable NIMI of the body generally. Methods: Twenty-seven healthy participants were seated in front of a computer monitor and speakers. Discrete 3-min stimuli were presented with interactions mediated via a handheld trackball without any keyboard, to minimize instrumental movements of the participant's body. Music videos and audio-only music were used to test hypothesis (1). Time-sensitive, highly interactive stimuli were used to test hypothesis (2). Subjective responses were assessed via visual analog scales. The computer users' movements were quantified using video motion tracking from the lateral aspect. Repeated measures ANOVAs with Tukey post hoc comparisons were performed. Results: For two equivalently-engaging music videos, eliminating the visual content elicited significantly increased non-instrumental movements of the head (while also decreasing subjective engagement); a highly engaging user-selected piece of favorite music led to further increased non-instrumental movement. For two comparable reading tasks, the more engaging reading significantly inhibited (42%) movement of the head and thigh; however, when a highly engaging video game was

  1. Pharmacokinetics and Penetration of Ceftazidime and Avibactam into Epithelial Lining Fluid in Thigh- and Lung-Infected Mice

    PubMed Central

    Melchers, Maria J.; van Mil, Anita C.; Lagarde, Claudia M.; Nichols, Wright W.

    2015-01-01

    Ceftazidime and the β-lactamase inhibitor avibactam constitute a new, potentially highly active combination in the battle against extended-spectrum-β-lactamase (ESBL)-producing bacteria. To determine possible clinical use, it is important to know the pharmacokinetic profiles of the compounds related to each other in plasma and the different compartments of infection in experimentally infected animals and in humans. We used a neutropenic murine thigh infection model and lung infection model to study pharmacokinetics in plasma and epithelial lining fluid (ELF). Mice were infected with ca. 106 CFU of Pseudomonas aeruginosa intramuscularly into the thigh or intranasally to cause pneumonia and were given 8 different (single) subcutaneous doses of ceftazidime and avibactam in various combined concentrations, ranging from 1 to 128 mg/kg of body weight in 2-fold increases. Concomitant samples of serum and bronchoalveolar lavage fluid were taken at up to 12 time points until 6 h after administration. Pharmacokinetics of both compounds were linear and dose proportional in plasma and ELF and were independent of the infection type, with estimated half-lives (standard deviations [SD]) in plasma of ceftazidime of 0.28 (0.02) h and of avibactam of 0.24 (0.04) h and volumes of distribution of 0.80 (0.14) and 1.18 (0.34) liters/kg. The ELF-plasma (area under the concentration-time curve [AUC]) ratios (standard errors [SE]) were 0.24 (0.03) for total ceftazidime and 0.27 (0.03) for unbound ceftazidime; for avibactam, the ratios were 0.20 (0.02) and 0.22 (0.02), respectively. No pharmacokinetic interaction between ceftazidime and avibactam was observed. Ceftazidime and avibactam showed linear plasma pharmacokinetics that were independent of the dose combinations used or the infection site in mice. Assuming pharmacokinetic similarity in humans, this indicates that similar dose ratios of ceftazidime and avibactam could be used for different types and sites of infection. PMID:25645843

  2. Pharmacokinetics and penetration of ceftazidime and avibactam into epithelial lining fluid in thigh- and lung-infected mice.

    PubMed

    Berkhout, Johanna; Melchers, Maria J; van Mil, Anita C; Seyedmousavi, Seyedmojtaba; Lagarde, Claudia M; Nichols, Wright W; Mouton, Johan W

    2015-04-01

    Ceftazidime and the β-lactamase inhibitor avibactam constitute a new, potentially highly active combination in the battle against extended-spectrum-β-lactamase (ESBL)-producing bacteria. To determine possible clinical use, it is important to know the pharmacokinetic profiles of the compounds related to each other in plasma and the different compartments of infection in experimentally infected animals and in humans. We used a neutropenic murine thigh infection model and lung infection model to study pharmacokinetics in plasma and epithelial lining fluid (ELF). Mice were infected with ca. 10(6) CFU of Pseudomonas aeruginosa intramuscularly into the thigh or intranasally to cause pneumonia and were given 8 different (single) subcutaneous doses of ceftazidime and avibactam in various combined concentrations, ranging from 1 to 128 mg/kg of body weight in 2-fold increases. Concomitant samples of serum and bronchoalveolar lavage fluid were taken at up to 12 time points until 6 h after administration. Pharmacokinetics of both compounds were linear and dose proportional in plasma and ELF and were independent of the infection type, with estimated half-lives (standard deviations [SD]) in plasma of ceftazidime of 0.28 (0.02) h and of avibactam of 0.24 (0.04) h and volumes of distribution of 0.80 (0.14) and 1.18 (0.34) liters/kg. The ELF-plasma (area under the concentration-time curve [AUC]) ratios (standard errors [SE]) were 0.24 (0.03) for total ceftazidime and 0.27 (0.03) for unbound ceftazidime; for avibactam, the ratios were 0.20 (0.02) and 0.22 (0.02), respectively. No pharmacokinetic interaction between ceftazidime and avibactam was observed. Ceftazidime and avibactam showed linear plasma pharmacokinetics that were independent of the dose combinations used or the infection site in mice. Assuming pharmacokinetic similarity in humans, this indicates that similar dose ratios of ceftazidime and avibactam could be used for different types and sites of infection. PMID

  3. In Vivo Pharmacokinetics and Pharmacodynamics of the Lantibiotic NAI-107 in a Neutropenic Murine Thigh Infection Model

    PubMed Central

    Lepak, Alexander J.; Marchillo, Karen; Craig, William A.

    2014-01-01

    NAI-107 is a novel lantibiotic compound with potent in vitro activity against Gram-positive bacteria, including methicillin-resistant Staphylococcus aureus (MRSA). The purpose of this study was to examine the activity of NAI-107 against S. aureus strains, including MRSA, in the neutropenic murine thigh infection model. Serum pharmacokinetics were determined and time-kill studies were performed following administration of single subcutaneous doses of 5, 20, and 80 mg/kg body weight. The dose fractionation included total doses ranging from 1.56 to 400 mg/kg/72 h, divided into 1, 2, 3, or 6 doses. Studies of treatment effects against 9 S. aureus strains (4 methicillin-susceptible Staphylococcus aureus [MSSA] and 5 MRSA) using a 12-h dosing interval and total dose range of 1.56 to 400 mg/kg/72 h were also performed. A maximum effect (Emax) model was used to determine the pharmacokinetic/pharmacodynamic (PK/PD) index that best described the dose-response data and to estimate the doses required to achieve a net bacteriostatic dose (SD) and a 1-log reduction in CFU/thigh. The pharmacokinetic studies demonstrated an area under the concentration-time curve (AUC) range of 26.8 to 276 mg · h/liter and half-lives of 4.2 to 8.2 h. MICs ranged from 0.125 to 0.5 μg/ml. The 2 highest single doses produced more than a 2-log kill and prolonged postantibiotic effects (PAEs) ranging from 36 to >72 h. The dose fractionation-response curves were similar, and the AUC/MIC ratio was the most predictive PD index (AUC/MIC, coefficient of determination [R2] = 0.89; maximum concentration of drug in serum [Cmax]/MIC, R2 = 0.79; time [T] > MIC, R2 = 0.63). A ≥2-log kill was observed against all 9 S. aureus strains. The total drug 24-h AUC/MIC values associated with stasis and a 1-log kill for the 9 S. aureus strains were 371 ± 130 and 510 ± 227, respectively. NAI-107 demonstrated concentration-dependent killing and prolonged PAEs. The AUC/MIC ratio was the predictive PD index. Extensive

  4. Human Muscle Fiber

    NASA Technical Reports Server (NTRS)

    2003-01-01

    The stimulus of gravity affects RNA production, which helps maintain the strength of human muscles on Earth (top), as seen in this section of muscle fiber taken from an astronaut before spaceflight. Astronauts in orbit and patients on Earth fighting muscle-wasting diseases need countermeasures to prevent muscle atrophy, indicated here with white lipid droplets (bottom) in the muscle sample taken from the same astronaut after spaceflight. Kerneth Baldwin of the University of California, Irvine, is conducting research on how reducing the stimulus of gravity affects production of the RNA that the body uses as a blueprint for making muscle proteins. Muscle proteins are what give muscles their strength, so when the RNA blueprints aren't available for producing new proteins to replace old ones -- a situation that occurs in microgravity -- the muscles atrophy. When the skeletal muscle system is exposed to microgravity during spaceflight, the muscles undergo a reduced mass that translates to a reduction in strength. When this happens, muscle endurance decreases and the muscles are more prone to injury, so individuals could have problems in performing extravehicular activity [space walks] or emergency egress because their bodies are functionally compromised.

  5. Using broadband spatially resolved NIRS to assess muscle oxygenation during altered running protocols

    NASA Astrophysics Data System (ADS)

    Koukourakis, Georg; Vafiadou, Maria; Steimers, André; Geraskin, Dmitri; Neary, Patrick; Kohl-Bareis, Matthias

    2009-07-01

    We used spatially resolved near-infrared spectroscopy (SRS-NIRS) to assess calf and thigh muscle oxygenation during running on a motor-driven treadmill. Two protocols were used: An incremental speed protocol (velocity = 6 - 12 km/h, ▵v = 2 km/h) was performed in 3 minute stages, while a pacing paradigm modulated step frequency alternatively (2.3 Hz [SLow]; 3.3 Hz [SHigh]) during a constant velocity for 2 minutes each. A SRS-NIRS broadband system (600 - 1000 nm) was used to measure total haemoglobin concentration and oxygen saturation (SO2). An accelerometer was placed on the hip joints to measure limb acceleration through the experiment. The data showed that the calf (SO2 58 to 42%) desaturated to a significantly lower level than the thigh (61 to 54%). During the pacing protocol, SO2 was significantly different between the SLow vs. SHigh trials. Additionally, physiological data as measured by spirometry were different between the SLow vs. SHigh pacing trials (VO2 (2563+/- 586 vs. 2503 +/- 605 mL/min). Significant differences in VO2 at the same workload (speed) indicate alterations in mechanical efficiency. These data suggest that SRS broadband NIRS can be used to discern small changes in muscle oxygenation, making this device useful for metabolic exercise studies in addition to spirometry and movement monitoring by accelerometers.

  6. Three-layered architecture of the popliteal fascia that acts as a kinetic retinaculum for the hamstring muscles.

    PubMed

    Satoh, Masahiro; Yoshino, Hiroyuki; Fujimura, Akira; Hitomi, Jiro; Isogai, Sumio

    2016-09-01

    When patients report pain in the popliteal fossa upon knee extension, the pain is usually localized in the lower region of the popliteal fossa. However, some patients complain of pain in the upper region of the popliteal fossa as the knee is flexed, which motivated us to examine the role of the popliteal fascia as the retinaculum of the hamstring muscles. Thirty-four thighs from 19 Japanese cadavers were dissected. The popliteal fascia was defined as the single aponeurotic sheet covering the popliteal fossa. We found that the fascia acted as a three-layered retinaculum for the flexor muscles of the thigh and provided a secure route for neurovascular structures to the lower leg in any kinetic position of the knee joint. The superficial layer of the popliteal fascia covering the thigh was strongly interwoven with the epimysium of biceps femoris along its lateral aspect and with that of the semimembranosus along its medial aspect, ensuring that the flexor muscles remained in their correct positions. The intermediate layer arose from the medial side of biceps femoris and merged medially with the superficial layer. The profound layer stretched transversely between the biceps femoris and the semimembranosus. Moreover, we investigated the nerve distribution in the popliteal fascia using Sihler's staining and whole-mount immunostaining for neurofilaments. The three-layered fascia was constantly innervated by branches from the posterior femoral cutaneous or saphenous nerve. The nerves were closely related and distributed to densely packed collagen fibers in the superficial layer as free or encapsulated nerve endings, suggesting that the fascia is involved in pain in the upper region of the popliteal fossa. PMID:26467331

  7. Engineering skeletal muscle repair.

    PubMed

    Juhas, Mark; Bursac, Nenad

    2013-10-01

    Healthy skeletal muscle has a remarkable capacity for regeneration. Even at a mature age, muscle tissue can undergo a robust rebuilding process that involves the formation of new muscle cells and extracellular matrix and the re-establishment of vascular and neural networks. Understanding and reverse-engineering components of this process is essential for our ability to restore loss of muscle mass and function in cases where the natural ability of muscle for self-repair is exhausted or impaired. In this article, we will describe current approaches to restore the function of diseased or injured muscle through combined use of myogenic stem cells, biomaterials, and functional tissue-engineered muscle. Furthermore, we will discuss possibilities for expanding the future use of human cell sources toward the development of cell-based clinical therapies and in vitro models of human muscle disease. PMID:23711735

  8. Healthy Muscles Matter

    MedlinePlus

    ... keep my muscles more healthy? Definitions What can go wrong? Injuries Almost everyone has had sore muscles ... If you have been inactive, “start low and go slow” by gradually increasing how often and how ...

  9. Eye muscle repair - slideshow

    MedlinePlus

    ... page: //medlineplus.gov/ency/presentations/100062.htm Eye muscle repair - series—Normal anatomy To use the sharing ... the eyeball to the eye socket. The external muscles of the eye are found behind the conjunctiva. ...

  10. Muscle function loss

    MedlinePlus

    ... nervous system that cause muscle function loss include: Amyotrophic lateral sclerosis (ALS, or Lou Gehrig's disease) Bell's palsy Botulism ... of recent progress. Curr Opin Rheum Read More Amyotrophic lateral sclerosis Botulism Broken bone Guillain-Barré syndrome Muscle cramps ...

  11. In vivo observation of quadrupolar splitting in (39)K magnetic resonance spectroscopy of human muscle tissue.

    PubMed

    Rösler, M B; Nagel, A M; Umathum, R; Bachert, P; Benkhedah, N

    2016-04-01

    The purpose of this work was to explore the origin of oscillations of the T(*)2 decay curve of (39)K observed in studies of (39)K magnetic resonance imaging of the human thigh. In addition to their magnetic dipole moment, spin-3/2 nuclei possess an electric quadrupole moment. Its interaction with non-vanishing electrical field gradients leads to oscillations in the free induction decay and to splitting of the resonance. All measurements were performed on a 7T whole-body MRI scanner (MAGNETOM 7T, Siemens AG, Erlangen, Germany) with customer-built coils. According to the theory of quadrupolar splitting, a model with three Lorentzian-shaped peaks is appropriate for (39)K NMR spectra of the thigh and calf. The frequency shifts of the satellites depend on the angle between the calf and the static magnetic field. When the leg is oriented parallel to the static magnetic field, the satellites are shifted by about 200 Hz. In the thigh, rank-2 double quantum coherences arising from anisotropic quadrupolar interaction are observed by double-quantum filtration with magic-angle excitation. In addition to the spectra, an image of the thigh with a nominal resolution of (16 × 16 × 32) mm(3) was acquired with this filtering technique in 1:17 h. From the line width of the resonances, (39)K transverse relaxation time constants T(*)2, fast  = (0.51 ± 0.01) ms and T(*)2, slow  = (6.21 ± 0.05) ms for the head were determined. In the thigh, the left and right satellite, both corresponding to the short component of the transverse relaxation time constant, take the following values: T(*)2, fast  = (1.56 ± 0.03) ms and T(*)2, fast  = (1.42 ± 0.03) ms. The centre line, which corresponds to the slow component, is T(*)2, slow  = (9.67 ± 0.04) ms. The acquisition time of the spectra was approximately 10 min. Our results agree well with a non-vanishing electrical field gradient interacting with (39)K nuclei in the intracellular space of

  12. [An Adult Case of Transperineal Repair of Congenital Rectourethral Fistula Using Gracilis Muscle Flap Interposition].

    PubMed

    Yo, Toeki; Kanematsu, Akihiro; Hanasaki, Takeshi; Nakanishi, Yukako; Togo, Yoshikazu; Suzuki, Toru; Higuchi, Yoshihide; Nojima, Michio; Yamamoto, Shingo; Okuyama, Hiroomi

    2015-07-01

    A man in his 50s was referred to our hospital after recurrent severe urinary tract infection. He had undergone anoplasty for anorectal malformation during early infancy. He noticed urinary leakage from the anus for a long time. Under diagnosis of congenital rectourethral fistula, we performed fistula closure. The fistula was transsected via transperineal incision and each stump was closed. A gracilis muscle flap approximately 30 cm long was harvested from the left thigh, brought into the deepest part between the separated rectum and urethra through a subcutaneous tunnel and fixed there. The urinary leakage from the anus disappeared, and the infection resolved. Application of gracilis muscle flap for congenital diseases is rare, but was useful in the present case. PMID:26278215

  13. Simulating Non-Specific Influences of Body Posture and Temperature on Thigh-Bioimpedance Spectroscopy during Continuous Monitoring Applications

    NASA Astrophysics Data System (ADS)

    Ismail, A. H.; Leonhardt, S.

    2013-04-01

    Application of bioimpedance spectroscopy (BIS) for continuous monitoring of body fluid volumes is gaining considerable importance in personal health care. Unless laboratory conditions are applied, both whole-body or segmental BIS configurations are subject to nonspecific influences (e.g. temperature and change in body position) reducing the method's accuracy and reproducibility. In this work, a two-compartment mathematical model, which describes the thigh segment, has been adapted to simulate fluid and solute kinetics during change in body position or variation in skin temperature. The model is an improved version of our previous one offering a good tradeoff between accuracy and simplicity. It represents the kinetics of fluid redistribution, sodium-, potassium-, and protein-concentrations based on simple equations to predict the time course of BIS variations. Validity of the model was verified in five subjects (following a sequence of 7 min supine, 20 min standing, and 40 min supine). The output of the model may reduce possible influences on BIS by up to 80%.

  14. Fulminant Necrotizing Fasciitis of the Thigh, Following an Infection of the Sacro-iliac Joint in an Immunosuppressed, Young Woman.

    PubMed

    Gothner, Martin; Dudda, Marcel; Kruppa, Christiane; Schildhauer, Thomas A; Swol, Justyna

    2015-09-28

    Necrotizing soft tissue infection of an extremity is a rare but life-threatening disease. The disease is an infection that involves the soft tissue layer and is characterized by rapidly spreading inflammation (especially of the fascial planes and the surrounding tissues) with a high mortality. Early diagnosis is essential for the outcome of the patients. Radical surgical debridement is the treatment of choice. The predisposing factors are immunosuppression, diabetes mellitus and drug abuse. This report presents a case of necrotizing fasciitis in the thigh, following an abscess of the sacro-iliac joint, as a rare complication in a young, immunosuppressed woman. The patient's history revealed intravenous drug abuse and hepatitis C. After immediate diagnosis by magnetic resonance imaging, radical surgical debridement was required and performed. Prior to soft tissue coverage with a split skin graft, five additional sequential debridements were necessary. During her hospital stay, the patient experienced further cerebral and pulmonary septic embolisms and an infection of the elbow. Six months after admission, the patient was discharged in good condition to a rehabilitation center. Necrotizing fasciitis is a life-threatening complication following an abscess of the sacro-iliac joint. Physicians must be vigilant to inflammatory signs and pain in immunosuppressed patients. An abscess of the sacro-iliac joint is rare, but complications of an untreated abscess can be fatal in these patients. PMID:26605024

  15. Munchausen syndrome by proxy presented as recurrent respiratory arrest and thigh abscess: a case study and overview.

    PubMed

    Foto Özdemir, Dilşad; Yalçın, Sıdıka Songül; Zeki, Ayşe; Yurdakök, Kadriye; Özusta, Şeniz; Köse, Aslıhan; Karadağ, Ferda; Yıldız, Irem; Balseven Odabaşı, Aysun; Kale, Gülsev

    2013-01-01

    While many physicians are familiar with the sexual or physical abuse of children, there is little awareness about Munchausen syndrome by proxy (MSBP). As case reports of MSBP increase, awareness among physicians is thought to increase as well. We thus present herein a 16-month-old girl who admitted to Hacettepe University İhsan Doğramacı Children's Hospital with the complaint of seizure, recurrent apnea and thigh abscess, who was later diagnosed as MSBP. The case was being followed by the Child Protection Team of the hospital (Haceteppe University Child Protection Unit [HU-CPU]). HU-CPU contributed to the early detection of this case and protected the child from a possible fatal outcome. The mother was confronted for MSBP and refused to take responsibility for her child's symptoms. As seen in this case, when MSBP is suspected, psychiatric evaluation of the mother, evaluation of the mother-child interaction and collection of a detailed family and social history can have a positive impact on the prognosis in these cases. This case report underlines the importance of multidisciplinary team work to share the responsibility and reduce the burden during the treatment process of these difficult and complicated cases. PMID:24217085

  16. Exercising with a Muscle Disease

    MedlinePlus

    ... are: • cramping in muscles (probably related to insufficient energy supply for muscles) • pain in muscles • weakness of exercised muscles • dark urine that looks like cola, following exercise (seek ...

  17. Migration of the Anterior Spinal Rod to the Right Thigh, a Rare Complication of Anterior Spinal Instrumentations: A Case Report and a Literature Review

    PubMed Central

    Gaston, Camino Willhuber; Danilo, Taype Zamboni; Guido, Carabelli; Jorge, Barla; Carlos, Sancineto

    2015-01-01

    Posterior and anterior fusion procedures with instrumentation are well-known surgical treatments for scoliosis. Rod migration has been described as unusual complication in anterior spinal instrumentations; migration beyond pelvis is a rare complication. A 32-year-old female presented to the consultant with right thigh pain, rod migration was diagnosed, rod extraction by minimal approach was performed, and spinal instrumentation after nonunion diagnosis was underwent. A rod migration case to the right thigh is presented; this uncommon complication of spinal instrumentation should be ruled out as unusual cause of sudden pain without any other suspicions, and long-term follow-up is important to prevent and diagnose this problem. PMID:26613058

  18. Muscle Session Summary

    NASA Technical Reports Server (NTRS)

    Baldwin, Kenneth; Feeback, Daniel

    1999-01-01

    Presentations from the assembled group of investigators involved in specific research projeects related to skeletal muscle in space flight can categorized in thematic subtopics: regulation of contractile protein phenotypes, muscle growth and atrophy, muscle structure: injury, recovery,and regeneration, metabolism and fatigue, and motor control and loading factors.

  19. Serial Changes of Quadriceps and Hamstring Muscle Strength Following Total Knee Arthroplasty: A Meta-Analysis

    PubMed Central

    Ahn, Hyeong-Sik; Lee, Dae-Hee

    2016-01-01

    This meta-analysis was performed to analyze serial changes in thigh muscles, including quadriceps and hamstring muscles, from before to one year after total knee arthroplasty (TKA). All studies sequentially comparing isokinetic quadriceps and hamstring muscle strengths between the TKA side and the contralateral uninjured limb were included in this meta-analysis. Five studies with 7 cohorts were included in this meta-analysis. The mean differences in the strengths of quadriceps and hamstring muscles between the TKA and uninjured sides were greatest three months after surgery (26.8 N∙m, 12.8 N∙m, P<0.001), but were similar to preoperative level at six months (18.4 N∙m, 7.4 N∙m P<0.001) and were maintained for up to one year (15.9 N∙m, 4.1 N∙m P<0.001). The pooled mean differences in changes in quadriceps and hamstring strengths relative to preoperative levels were 9.2 N∙m and 4.9 N∙m, respectively, three months postoperatively (P = 0.041), but were no longer significant after six months and one year. During the year after TKA, quadriceps and hamstring muscle strengths were lowest after 3 months, recovering to preoperative level after six months, but not reaching the muscle strength on the contralateral side. Relative to preoperative levels, the difference in muscle strength between the TKA and contralateral knees was only significant at three months. Because decrease of strength of the quadriceps was significantly greater than decrease in hamstring muscle strength at postoperative three months, early rehabilitation after TKA should focus on recovery of quadriceps muscle strength. PMID:26849808

  20. Clinical and Muscle Imaging Findings in 14 Mainland Chinese Patients with Oculopharyngodistal Myopathy

    PubMed Central

    Zhao, Juan; Liu, Jing; Xiao, Jiangxi; Du, Jing; Que, Chengli; Shi, Xin; Liang, Wei; Sun, Weiping; Zhang, Wei; Lv, He; Yuan, Yun; Wang, Zhaoxia

    2015-01-01

    Oculopharyngodistal myopathy (OPDM) is an extremely rare, adult-onset hereditary muscular disease characterized by progressive external ocular, pharyngeal, and distal muscle weakness and myopathological rimmed vacuole changes. The causative gene is currently unknown; therefore, diagnosis of OPDM is based on clinical and histopathological features and genetic exclusion of similar conditions. Moreover, variable manifestations of this disorder are reported in terms of muscle involvement and severity. We present the clinical profile and magnetic resonance imaging (MRI) changes of lower limb muscles in 14 mainland Chinese patients with OPDM, emphasizing the role of muscle MRI in disease identification and differential diagnosis. The patients came from 10 unrelated families and presented with progressive external ocular, laryngopharyngeal, facial, distal limb muscle weakness that had been present since early adulthood. Serum creatine kinase was mildly to moderately elevated. Electromyography revealed myogenic changes with inconsistent myotonic discharge. The respiratory function test revealed subclinical respiratory muscle involvement. Myopathological findings showed rimmed vacuoles with varying degrees of muscular dystrophic changes. All known genes responsible for distal and myofibrillar myopathies, vacuolar myopathies, and muscular dystrophies were excluded by PCR or targeted next-generation sequencing. Muscle MRI revealed that the distal lower legs had more severe fatty replacement than the thigh muscles. Serious involvement of the soleus and long head of the biceps femoris was observed in all patients, whereas the popliteus, gracilis and short head of biceps femoris were almost completely spared, even in advanced stages. Not only does our study widen the spectrum of OPDM in China, but it also demonstrates that OPDM has a specific pattern of muscle involvement that may provide valuable information for its differential diagnosis and show further evidence supporting

  1. Impact response and biomechanical analysis of the knee-thigh-hip complex in frontal impacts with a full human body finite element model.

    PubMed

    Ruan, Jesse S; El-Jawahri, Raed; Barbat, Saeed; Rouhana, Stephen W; Prasad, Priya

    2008-11-01

    Changes in vehicle safety design technology and the increasing use of seat-belts and airbag restraint systems have gradually changed the relative proportion of lower extremity injuries. These changes in real world injuries have renewed interest and the need of further investigation into occupant injury mechanisms and biomechanical impact responses of the knee-thigh-hip complex during frontal impacts. This study uses a detailed finite element model of the human body to simulate occupant knee impacts experienced in frontal crashes. The human body model includes detailed anatomical features of the head, neck, shoulder, chest, thoracic and lumbar spine, abdomen, pelvis, and lower and upper extremities. The material properties used in the model for each anatomic part of the human body were obtained from test data reported in the literature. The human body model used in the current study has been previously validated in frontal and side impacts. It was further validated with cadaver knee-thigh-hip impact tests in the current study. The effects of impactor configuration and flexion angle of the knee on biomechanical impact responses of the knee-thigh-hip complex were studied using the validated human body finite element model. This study showed that the knee flexion angle and the impact direction and shape of the impactors affected the injury outcomes of the knee-thigh-hip complex significantly. The 60 degrees flexed knee impact showed the least impact force, knee pressure, femoral von Mises stress, and pelvic von Mises stress but largest relative displacements of the Posterior Cruciate Ligament (PCL) and Anterior Cruciate Ligament (ACL). The 90 degrees flexed knee impact resulted in a higher impact force, knee pressure, femoral von Mises stress, and pelvic von Mises stress; but smaller PCL and ACL displacements. Stress distributions of the patella, femur, and pelvis were also given for all the simulated conditions. PMID:19085174

  2. A chair with a platform setup to measure the forces under each thigh when sitting, rising from a chair and sitting down.

    PubMed

    Nadeau, S; Desjardins, P; Brière, A; Roy, G; Gravel, D

    2008-03-01

    This paper describes the design, technical characteristics and first results of an adjustable instrumented chair with a sitting surface that records the forces under each thigh. The seat includes a force platform assembly suitable for measuring the magnitude, position and direction of the force applied to each thigh while sitting or rising from the chair. The natural frequency of the chair fixed to the floor was found to be 14.0 +/- 2 Hz with an estimated damping of xi = 0.20. Static tests showed that the maximal errors were 2% of the full-scale output (726 N vertically, 164 N horizontally) for both vertical and horizontal forces. The root mean square error of the center of pressure location was estimated as 5 mm. Preliminary data on the net joint moment at the hips of one healthy subject computed with and without consideration for the forces under the thighs revealed significant amplitude differences. In conclusion, the results indicate that the characteristics of the instrumented chair are acceptable and the chair can be used to assess the biomechanics of sitting and sit-to-stand and stand-to-sit tasks in various subject populations. PMID:18193467

  3. Venous-supercharged freestyle posterior thigh flap without a descending branch of the inferior gluteal artery for reconstruction in the infragluteal region.

    PubMed

    Fukunaga, Yutaka; Miyamoto, Shimpei; Kobayashi, Eisuke; Sakuraba, Minoru

    2014-12-01

    The posterior thigh flap is a workhorse flap for reconstruction in the gluteal region. The main vascular pedicle of the flap is commonly the descending branch of the inferior gluteal artery, although it is at risk for transection during sarcoma resection. We report successful reconstruction of an infragluteal defect resulting from sarcoma resection with a venous-supercharged freestyle posterior thigh flap in the absence of the descending branch of the inferior gluteal artery. A 77-year-old man underwent sarcoma resection in the infragluteal region. The descending branch of the inferior gluteal artery was sacrificed. We found a sizable perforator through the long head of the biceps femoris and harvested a posterior thigh flap on the basis of that perforator with a freestyle approach. The flap gradually developed a congestive appearance after transfer. We therefore anastomosed the vein of the second perforator to an accompanying vein of the sciatic nerve at the recipient site. The complete flap survived, and the postoperative course was uneventful. We believe that combined use of the freestyle approach and the perforator-supercharging technique can enhance the versatility and the safety of pedicled perforator flap transfer. PMID:25193397

  4. A pilot study comparison of a new method for aortic pulse wave velocity measurements using transthoracic bioimpedance and thigh cuff oscillometry with the standard tonometric method.

    PubMed

    Brinkmann, Julia; Jordan, Jens; Tank, Jens

    2015-04-01

    Aortic pulse wave velocity (aPWV) can be measured with different methodologies, including applanation tonometry. These pilot study findings suggest that impedance cardiography combined with thigh oscillometry provides comparable results. Intra- and inter-observer variability was tested by two observers in two subjects. We instrumented 41 patients and 12 healthy normotensive controls for impedance cardiography and consecutive applanation tonometry and compared methods using the Bland-Altman method. Observer variability for the impedance-thigh cuff method (range, 3.61%-7.77%) was comparable with the tonometric method (range, 2.93%-7.37%). Comparison of the two methods based on the Bland-Altman plot revealed a good agreement between methods. The bias between impedance and tonometric measurements was -0.28 ± 0.37 m/s. Both measurements were significantly correlated (r(2) = 0.94; P < .0001; slope = 1.038).Impedance cardiography combined with thigh oscillometry is an easy to use approach which, in addition to providing hemodynamic information, yields aPWV measurements comparable to applanation tonometry. Following full validation according to current guidelines, the methodology could prove useful in cardiovascular risk stratification. PMID:25816714

  5. Glucocorticoids and Skeletal Muscle.

    PubMed

    Bodine, Sue C; Furlow, J David

    2015-01-01

    Glucocorticoids are known to regulate protein metabolism in skeletal muscle, producing a catabolic effect that is opposite that of insulin. In many catabolic diseases, such as sepsis, starvation, and cancer cachexia, endogenous glucocorticoids are elevated contributing to the loss of muscle mass and function. Further, exogenous glucocorticoids are often given acutely and chronically to treat inflammatory conditions such as asthma, chronic obstructive pulmonary disease, and rheumatoid arthritis, resulting in muscle atrophy. This chapter will detail the nature of glucocorticoid-induced muscle atrophy and discuss the mechanisms thought to be responsible for the catabolic effects of glucocorticoids on muscle. PMID:26215994

  6. Oxidative Metabolism in Muscle

    NASA Astrophysics Data System (ADS)

    Ferrari, M.; Binzoni, T.; Quaresima, V.

    1997-06-01

    Oxidative metabolism is the dominant source of energy for skeletal muscle. Near-infrared spectroscopy allows the non-invasive measurement of local oxygenation, blood flow and oxygen consumption. Although several muscle studies have been made using various near-infrared optical techniques, it is still difficult to interpret the local muscle metabolism properly. The main findings of near-infrared spectroscopy muscle studies in human physiology and clinical medicine are summarized. The advantages and problems of near-infrared spectroscopy measurements, in resting and exercising skeletal muscles studies, are discussed through some representative examples.

  7. Leg and trunk muscle coordination and postural sway during increasingly difficult standing balance tasks in young and older adults.

    PubMed

    Donath, Lars; Kurz, Eduard; Roth, Ralf; Zahner, Lukas; Faude, Oliver

    2016-09-01

    Ageing impairs body balance and increases older adults' fall risk. Balance training can improve intrinsic fall risk factors. However, age comparisons of muscle activity responses during balance tasks are lacking. This study investigated relative muscle activity, muscle coordination and postural sway during various recommended static balance training tasks. Muscle activity (%MVC), amplitude ratios (AR) and co-activity (CAI) were determined during standing tasks for 30s (1: double limb stance on a foam surface, eyes open; 2: double limb stance on firm ground, eyes closed; 3: double limb stance, feet in step position on a foam surface, eyes open; 4: double limb stance, feet in step position on firm ground, eyes closed; 5: single limb stance on firm ground, eyes open) in 20 healthy young adults (24±2 y) and 20 older adults (73±6 y). Surface electromyography (SEMG) was applied (SENIAM guidelines) to ankle (tibialis anterior, soleus, medial gastrocnemius, peroneus longus) and thigh (vastus lateralis, vastus medialis, biceps femoris, semitendinosus) muscles (non-dominant leg). Electrodes over trunk (multifidus and internal oblique) muscles were applied bilaterally. Two- to six-fold higher levels of relative muscle activity were found in older adults for ankle (0.0002thigh (0.0008muscles. Co-activation was elevated in young adults for the trunk (0.001muscle coordination patterns during all stance conditions at the ankle (0.06<ηp(2)<0.28) and the trunk (0.14<ηp(2)<0.23). Older adults had higher electrophysiological costs for all stance conditions. Muscle coordination showed inverse activity patterns at the ankle and trunk. Optimal balance and strength training programs should take into account age-specific alterations in muscle activity. PMID:27451322

  8. Early rehabilitation with weight-bearing standing-shaking-board exercise in combination with electrical muscle stimulation after anterior cruciate ligament reconstruction.

    PubMed

    Takahashi, Kingo; Hayashi, Masamichi; Fujii, Toshihiro; Kawamura, Kenji; Ozaki, Toshifumi

    2012-01-01

    The objective of early rehabilitation after anterior cruciate ligament (ACL) reconstruction is to increase the muscle strength of the lower extremities. Closed kinetic chain (CKC) exercise induces co-contraction of the agonist and antagonist muscles. The purpose of this study was to compare the postoperative muscle strength/mass of subjects who performed our new CKC exercise (new rehabilitation group:group N) from week 4, and subjects who received traditional rehabilitation alone (traditional rehabilitation group:group T). The subjects stood on the device and maintained balance. Then, low-frequency stimulation waves were applied to 2 points each in the anterior and posterior region of the injured thigh 3 times a week for 3 months. Measurement of muscle strength was performed 4 times (before the start, and then once a month). Muscle mass was evaluated in CT images of the extensor and flexor muscles of 10 knees (10 subjects) in each group. The injured legs of group N showed significant improvement after one month compared to group T. The cross-sectional area of the extensor muscles of the injured legs tended to a show a greater increase at 3 months in group N. This rehabilitation method makes it possible to contract fast-twitch muscles, which may be a useful for improving extensor muscle strength after ACL reconstruction. PMID:22729103

  9. Genetic effects of polymorphisms in myogenic regulatory factors on chicken muscle fiber traits.

    PubMed

    Yang, Zhi-Qin; Qing, Ying; Zhu, Qing; Zhao, Xiao-Ling; Wang, Yan; Li, Di-Yan; Liu, Yi-Ping; Yin, Hua-Dong

    2015-06-01

    The myogenic regulatory factors is a family of transcription factors that play a key role in the development of skeletal muscle fibers, which are the main factors to affect the meat taste and texture. In the present study, we performed candidate gene analysis to identify single-nucleotide polymorphisms in the MyoD, Myf5, MyoG, and Mrf4 genes using polymerase chain reaction-single strand conformation polymorphism in 360 Erlang Mountain Chickens from three different housing systems (cage, pen, and free-range). The general linear model procedure was used to estimate the statistical significance of association between combined genotypes and muscle fiber traits of chickens. Two polymorphisms (g.39928301T>G and g.11579368C>T) were detected in the Mrf4 and MyoD gene, respectively. The diameters of thigh and pectoralis muscle fibers were higher in birds with the combined genotypes of GG-TT and TT-CT (p<0.05). Moreover, the interaction between housing system and combined genotypes has no significant effect on the traits of muscle fiber (p>0.05). Our findings suggest that the combined genotypes of TT-CT and GG-TT might be advantageous for muscle fiber traits, and could be the potential genetic markers for breeding program in Erlang Mountain Chickens. PMID:25925055

  10. Muscle imaging in patients with tubular aggregate myopathy caused by mutations in STIM1

    PubMed Central

    Tasca, Giorgio; D'Amico, Adele; Monforte, Mauro; Nadaj-Pakleza, Aleksandra; Vialle, Marc; Fattori, Fabiana; Vissing, John; Ricci, Enzo; Bertini, Enrico

    2015-01-01

    Tubular aggregate myopathy is a genetically heterogeneous disease characterized by tubular aggregates as the hallmark on muscle biopsy. Mutations in STIM1 have recently been identified as one genetic cause in a number of tubular aggregate myopathy cases. To characterize the pattern of muscle involvement in this disease, upper and lower girdles and lower limbs were imaged in five patients with mutations in STIM1, and the scans were compared with two patients with tubular aggregate myopathy not caused by mutations in STIM1. A common pattern of involvement was found in STIM1-mutated patients, although with variable extent and severity of lesions. In the upper girdle, the subscapularis muscle was invariably affected. In the lower limbs, all the patients showed a consistent involvement of the flexor hallucis longus, which is very rarely affected in other muscle diseases, and a diffuse involvement of thigh and posterior leg with sparing of gracilis, tibialis anterior and, to a lesser extent, short head of biceps femoris. Mutations in STIM1 are associated with a homogeneous involvement on imaging despite variable clinical features. Muscle imaging can be useful in identifying STIM1-mutated patients especially among other forms of tubular aggregate myopathy. PMID:26255678

  11. Muscle imaging in patients with tubular aggregate myopathy caused by mutations in STIM1.

    PubMed

    Tasca, Giorgio; D'Amico, Adele; Monforte, Mauro; Nadaj-Pakleza, Aleksandra; Vialle, Marc; Fattori, Fabiana; Vissing, John; Ricci, Enzo; Bertini, Enrico

    2015-11-01

    Tubular aggregate myopathy is a genetically heterogeneous disease characterized by tubular aggregates as the hallmark on muscle biopsy. Mutations in STIM1 have recently been identified as one genetic cause in a number of tubular aggregate myopathy cases. To characterize the pattern of muscle involvement in this disease, upper and lower girdles and lower limbs were imaged in five patients with mutations in STIM1, and the scans were compared with two patients with tubular aggregate myopathy not caused by mutations in STIM1. A common pattern of involvement was found in STIM1-mutated patients, although with variable extent and severity of lesions. In the upper girdle, the subscapularis muscle was invariably affected. In the lower limbs, all the patients showed a consistent involvement of the flexor hallucis longus, which is very rarely affected in other muscle diseases, and a diffuse involvement of thigh and posterior leg with sparing of gracilis, tibialis anterior and, to a lesser extent, short head of biceps femoris. Mutations in STIM1 are associated with a homogeneous involvement on imaging despite variable clinical features. Muscle imaging can be useful in identifying STIM1-mutated patients especially among other forms of tubular aggregate myopathy. PMID:26255678

  12. Intramuscular pressure varies with depth. The tibialis anterior muscle studied in 12 volunteers

    NASA Technical Reports Server (NTRS)

    Nakhostine, M.; Styf, J. R.; van Leuven, S.; Hargens, A. R.; Gershuni, D. H.

    1993-01-01

    Pressures in the tibialis anterior muscle were recorded at rest and during exercise with transducer-tipped catheters in 12 volunteers while they were supine or standing. The recordings were repeated with venous stasis created by an inflated tourniquet cuff on the thigh. Catheters were placed at 3 different sites in the muscle: catheter I adjacent to the deep surface of the fascia over the anterior compartment; catheter II between the fascia and the central tendon; and catheter III deep in the muscle close to the interosseous membrane. In both the supine and standing positions the intramuscular pressure at rest and the muscle relaxation pressure during exercise, obtained by catheter II, were greater than the corresponding pressures measured by the superficially located catheter I in the normal as well as in the volume loaded limb. The same conditions for pressure measurement consistently revealed lower pressures recorded by catheter III compared to II, but the difference was not significant. Our results indicate that intramuscular pressure increases centripetally, as the centrally lying tendon is approached. We conclude that pressure measurements for diagnosis of acute and chronic compartment syndromes and in ergonomic studies should be based on recordings from a standard location of the catheter within the muscle and a standard posture of the subject.

  13. Genetic Effects of Polymorphisms in Myogenic Regulatory Factors on Chicken Muscle Fiber Traits

    PubMed Central

    Yang, Zhi-Qin; Qing, Ying; Zhu, Qing; Zhao, Xiao-Ling; Wang, Yan; Li, Di-Yan; Liu, Yi-Ping; Yin, Hua-Dong

    2015-01-01

    The myogenic regulatory factors is a family of transcription factors that play a key role in the development of skeletal muscle fibers, which are the main factors to affect the meat taste and texture. In the present study, we performed candidate gene analysis to identify single-nucleotide polymorphisms in the MyoD, Myf5, MyoG, and Mrf4 genes using polymerase chain reaction-single strand conformation polymorphism in 360 Erlang Mountain Chickens from three different housing systems (cage, pen, and free-range). The general linear model procedure was used to estimate the statistical significance of association between combined genotypes and muscle fiber traits of chickens. Two polymorphisms (g.39928301T>G and g.11579368C>T) were detected in the Mrf4 and MyoD gene, respectively. The diameters of thigh and pectoralis muscle fibers were higher in birds with the combined genotypes of GG-TT and TT-CT (p<0.05). Moreover, the interaction between housing system and combined genotypes has no significant effect on the traits of muscle fiber (p>0.05). Our findings suggest that the combined genotypes of TT-CT and GG-TT might be advantageous for muscle fiber traits, and could be the potential genetic markers for breeding program in Erlang Mountain Chickens. PMID:25925055

  14. Skeletal muscle blood flow measured by Rb-82 during changes in plasma glucose

    SciTech Connect

    Mossberg, K.A.; Mullani, N.; Gould, K.L.; Taegtmeyer, H.

    1985-05-01

    The purpose of this work was to assess the feasibility of measuring skeletal muscle blood flow with the K+ analogue Rb-82. Flow measurements were made in the thigh muscle of anesthetized rabbits after simultaneous sortic injection of radiolabeled microspheres (15..mu..m diam) and a bolus of Rb-82. Estimates of flow as determined by Rb-82 were based on peak tissue uptake and arterial concentration achieved over 150 sc post injection and the assumption that the extraction fraction of Rb-82 in resting muscle is unity. No significant difference was found between the microsphere and Rb-82 methods. Flow estimates were an average of 18% higher with the Rb-82 method. However, the rubidium method showed less variability since the ratio of standard deviation to the mean flow ranged from .23 to .46 compared to a ratio of .47 to .56 for the microsphere method. The values for mean flow and its variability are consistent with previously published reports on blood flow measurements in the resting skeletal muscle of the anesthetized rabbit. This study suggests that valid measurements of skeletal muscle blood flow can be made using positron emitting radionuclides.

  15. Chronic effects of low-frequency low-intensity electrical stimulation of stretched human muscle

    NASA Astrophysics Data System (ADS)

    Shenkman, Boris S.; Lyubaeva, Ekaterina V.; Popov, Daniil V.; Netreba, Aleksey I.; Bravy, Yan R.; Tarakin, Pavel P.; Lemesheva, Yulia S.; Vinogradova, Olga L.

    2007-02-01

    Effects of low-frequency electrical stimulation, which is currently considered to be a possible countermeasure for long-duration spaceflights, with and without stretch were evaluated. Twelve young male volunteers were randomly distributed into two groups. In one group anterior thigh muscles—knee extensors of both legs were stimulated with frequency of 15 Hz for 4.5 wks, six times a week; each session was 6-h long. In the other group, electrical stimulation with the same parameters was applied to stretched knee extensors. Following stimulation the subjects exhibited an increase in fatigue resistance, and in the succinate dehydrogenase activity and a 10% gain in the percentage of muscle fibers with slow myosin heavy chain isoforms. In a stimulated group the peak voluntary strength went down significantly, the CSA of fast muscle fibers in m. quadriceps femoris became slightly less in size (10%). Electrical stimulation of the stretched muscles induced an insignificant decline in their strength and an increase of cross-sectional area of muscle fibers of both types. Thus chronic low-frequency electrical stimulation may be proposed as a candidate countermeasure against muscle strength and mass loss if it is combined with stretch.

  16. Erythropoietin administration alone or in combination with endurance training affects neither skeletal muscle morphology nor angiogenesis in healthy young men.

    PubMed

    Larsen, Mads S; Vissing, Kristian; Thams, Line; Sieljacks, Peter; Dalgas, Ulrik; Nellemann, Birgitte; Christensen, Britt

    2014-10-01

    The aim was to investigate the ability of an erythropoiesis-stimulating agent (ESA), alone or in combination with endurance training, to induce changes in human skeletal muscle fibre and vascular morphology. In a comparative study, 36 healthy untrained men were randomly dispersed into the following four groups: sedentary-placebo (SP, n = 9); sedentary-ESA (SE, n = 9); training-placebo (TP, n = 10); or training-ESA (TE, n = 8). The ESA or placebo was injected once weekly. Training consisted of progressive bicycling three times per week for 10 weeks. Before and after the intervention period, muscle biopsies and magnetic resonance images were collected from the thigh muscles, blood was collected, body composition measured and endurance exercise performance evaluated. The ESA treatment (SE and TE) led to elevated haematocrit, and both ESA treatment and training (SE, TP and TE) increased maximal O2 uptake. With regard to skeletal muscle morphology, TP alone exhibited increases in whole-muscle cross-sectional area and fibre diameter of all fibre types. Also exclusively for TP was an increase in type IIa fibres and a corresponding decrease in type IIx fibres. Furthermore, an overall training effect (TP and TE) was statistically demonstrated in whole-muscle cross-sectional area, muscle fibre diameter and type IIa and type IIx fibre distribution. With regard to muscle vascular morphology, TP and TE both promoted a rise in capillary to muscle fibre ratio, with no differences between the two groups. There were no effects of ESA treatment on any of the muscle morphological parameters. Despite the haematopoietic effects of ESA, we provide novel evidence that endurance training rather than ESA treatment induces adaptational changes in angiogenesis and muscle morphology. PMID:25128327

  17. A muscle stem cell for every muscle: variability of satellite cell biology among different muscle groups

    PubMed Central

    Randolph, Matthew E.; Pavlath, Grace K.

    2015-01-01

    The human body contains approximately 640 individual skeletal muscles. Despite the fact that all of these muscles are composed of striated muscle tissue, the biology of these muscles and their associated muscle stem cell populations are quite diverse. Skeletal muscles are affected differentially by various muscular dystrophies (MDs), such that certain genetic mutations specifically alter muscle function in only a subset of muscles. Additionally, defective muscle stem cells have been implicated in the pathology of some MDs. The biology of muscle stem cells varies depending on the muscles with which they are associated. Here we review the biology of skeletal muscle stem cell populations of eight different muscle groups. Understanding the biological variation of skeletal muscles and their resident stem cells could provide valuable insight into mechanisms underlying the susceptibility of certain muscles to myopathic disease. PMID:26500547

  18. Alteration of Muscle Function After Electrical Stimulation Bout of Knee Extensors and Flexors

    PubMed Central

    Vanderthommen, Marc; Triffaux, Mylène; Demoulin, Christophe; Crielaard, Jean-Michel; Croisier, Jean-Louis

    2012-01-01

    The purpose was to study the effects on muscle function of an electrical stimulation bout applied unilaterally on thigh muscles in healthy male volunteers. One group (ES group, n = 10) received consecutively 100 isometric contractions of quadriceps and 100 isometric contractions of hamstrings (on-off ratio 6-6 s) induced by neuromuscular electrical stimulations (NMES). Changes in muscle torque, muscle soreness (0-10 VAS), muscle stiffness and serum creatine kinase (CK) activity were assessed before the NMES exercise (pre-ex) as well as 24h (d+1), 48h (d+2) and 120h (d+5) after the bout. A second group (control group, n = 10) were submitted to the same test battery than the ES group and with the same time-frame. The between-group comparison indicated a significant increase in VAS scores and in serum levels of CK only in the ES group. In the ES group, changes were more pronounced in hamstrings than in quadriceps and peaked at d+2 (quadriceps VAS scores = 2.20 ± 1.55 a.u. (0 at pre-ex); hamstrings VAS scores = 3.15 ± 2.14 a.u. (0 at pre-ex); hip flexion angle = 62 ± 5° (75 ± 6° at pre-ex); CK activity = 3021 ± 2693 IU·l-1 (136 ± 50 IU·l-1 at pre-ex)). The results of the present study suggested the occurrence of muscle damage that could have been induced by the peculiar muscle recruitment in NMES and the resulting overrated mechanical stress. The sensitivity to the damaging effects of NMES appeared higher in the hamstrings than in quadriceps muscles. Key points A stimulation bout of quadriceps and hamstrings that reflects usual application of NMES, increases indirect markers of muscle damage (muscle soreness, muscle weakness and stiffness and serum CK activity). The occurrence of muscle damage could have been induced by the peculiar muscle recruitment in NMES and the resulting overrated mechanical stress. The sensitivity to the damaging effects of NMES appears higher in the hamstrings than in quadriceps muscles. PMID:24150067

  19. Quadriceps function relates to muscle size following ACL reconstruction.

    PubMed

    Kuenze, Christopher M; Blemker, Silvia S; Hart, Joseph M

    2016-09-01

    It remains unclear what role reduced volume and cross-section area (CSA) of individual quadriceps muscles may play in persistent quadriceps weakness and more global dysfunction following ACL reconstruction (ACLR). The purpose of this investigation was to establish the relationship between cross-sectional area of the quadriceps muscle group and measures of knee related and quadriceps function following ACLR. Thirty participants with a history of primary, unilateral ACLR experiencing persistent quadriceps activation failure participated in this cohort study. Clinical factors including International Knee Documentation Committee (IKDC) score, normalized knee extension MVIC torque (Nm/kg) and quadriceps central activation ratio (CAR, %) were assessed in addition to CSA. Quadriceps CSA was measured via magnetic resonance imaging (MRI; Siemens Avanto 1.5T). Quadriceps CSA (cm(2) ) and quadriceps volume (cm(3) ) as well as individual muscle estimates were identified within a 10 cm mid-thigh capture area. Pearson's product-moment correlation coefficients (r) established relationships between CSA and all other variables. Stepwise linear regression established which CSA factors were able to successfully predict clinical factors. Knee extension MVIC torque was strongly correlated with Vastus Intermedius (VI; r =  0.857, p < 0.001) CSA as well as partial VI (r = 0.849, p < 0.001) and quadriceps (r = 0.830, p < 0.001) volume. Partial VI (r = 0.365, p = 0.047) volume was weakly correlated with IKDC score. Knee extension MVIC torque was strongly predicted using VI CSA alone (R(2)  = 0.725) or in combination with Vastus Medialis CSA (VM; R(2)  = 0.756). Statement of Clinical Significance: Atrophy of the VI and VM muscles negatively impacts knee extension strength following ACLR. © 2016 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 34:1656-1662, 2016. PMID:26763833

  20. Muscle metastases: comparison of features in different primary tumours

    PubMed Central

    2014-01-01

    Background Muscle metastases (MM) from solid tumours are rare. The aim of this study was to describe radiological features of MM, and to compare their patterns in different malignancies. Methods A retrospective search in the statistical database of our institution revealed 61 cases of MM. Additionally, a retrospective search in Pubmed database was performed. Together with our cases the present analysis comprises 461 patients (682 MM). Results MM derived from the following malignancies: lung cancer (25.1%), gastrointestinal tumours (21.0%), and urological tumours (13.2%). Other neoplasias with MM were rare. MM were localised most frequently in the thigh muscles, the extraocular musculature, and the gluteal and paravertebral muscles. The localisation of MM was different in several primary malignancies. On computed tomography (CT), five different patterns of MM occurred: masses with homogeneous contrast enhancement (type I, 46.5%), abscess-like lesions (type II, 27.7%), diffuse infiltration with muscle swelling (type III, 18.1%), intramuscular calcifications (type IV, 6.5%), or MM presented as intramuscular bleeding (type V, 1.2%). MM from several primary tumours manifested with different CT patterns. On MRI, most MM were hyperintense in comparison to unaffected musculature in T2 weighted images and hypo- to isointense on T1 weighted images with a heterogeneous enhancement. There were no differences in MRI features of MM in different primary tumours. On ultrasound, most MM were hypoechoic. On positron emission tomography, MM presented as focally abnormal intramuscular uptake. Conclusion MM present with a broad spectrum of radiological features. Different CT imaging findings of MM were observed in different primary tumours. The localisation of MM also varies with different primary malignancies. PMID:25608474

  1. CT-Guided Needle Biopsy of Deep Pelvic Lesions by Extraperitoneal Approach Through Iliopsoas Muscle

    SciTech Connect

    Gupta, Sanjay; Madoff, David C.; Ahrar, Kamran; Morello, Frank A.; Wallace, Michael J.; Murthy, Ravi; Hicks, Marshall E.

    2003-11-15

    We report our experience with computed tomography (CT)-guided coaxial needle biopsy of deep pelvic lesions by an extraperitoneal approach through the iliopsoas muscle, using a curved needle for difficult-to-reach lesions. We reviewed the records of all patients with pelvic masses who underwent CT-guided percutaneous biopsy via iliopsoas muscle between January 1999 and December 2001. Direct anterior or posterior approach to the lesion was obstructed by bowel, bladder, vessels, or bones in all patients. An 18-gauge guide needle was advanced through the iliopsoas muscle and a 22-gauge Chiba needle was used to perform the biopsy. A custom-tailored curved 22-g needle was used in 17 procedures when the location of the iliac vessels and the slope of the iliac wing obstructed a straight path to the lesion. Fifty-three patients underwent 57 CT-guided needle biopsies during the study period. The lesions comprised obturator (n = 25), internal iliac (n = 11), anterior external iliac (n = 4), and common iliac nodes (n = 4); soft tissue masses along pelvic side-wall (n = 6); adnexal lesions (n = 5); a loculated fluid collection, and a perirectal node. All lesions were safely accessed, and major vessels and viscera were avoided in all cases. Of the 57 biopsies, 53 (93%) yielded diagnostic specimens. No major complications were encountered. CT-guided coaxial needle biopsy by an anterolateral approach through the iliopsoas muscle, with the use of a curved needle in selected cases is safe and effective for obtaining samples from deep pelvic lesions.

  2. Noninvasive Sensor for Measuring Muscle Metabolism During Exercise

    NASA Technical Reports Server (NTRS)

    Soller, B. R.; Yang, Y.; Lee, S. M. C.; Soyemi, O. O.; Wilson, C.; Hagan, R. D.

    2007-01-01

    The measurement of oxygen uptake (VO2) and lactate threshold (LT) are utilized to assess changes in aerobic capacity and the efficacy of exercise countermeasures in astronauts. During extravehicular activity (EVA), real-time knowledge of VO2 and relative work intensity can be used to monitor crew activity levels and organize tasks to reduce the cumulative effects of fatigue. Currently VO2 and LT are determined with complicated measurement techniques that require sampling of expired ventilatory gases, which may not be accurate in enclosed, oxygen-rich environments such as the EVA suit. The UMMS team has developed a novel near infrared spectroscopic (NIRS) system which noninvasively, simultaneously and continuously measures muscle oxygen tension, oxygen saturation, pH (pHm), and hematocrit from a small sensor placed on the leg. This system is unique in that it allows accurate, absolute measurement of these parameters in the thigh muscle by correcting spectra for the interference from skin pigment and fat. These parameters can be used to estimate VO2 and LT. A preliminary evaluation of the system s capabilities was performed in the NASA JSC Exercise Physiology Lab.

  3. Muscle Changes in Aging

    PubMed Central

    Siparsky, Patrick N.; Kirkendall, Donald T.; Garrett, William E.

    2014-01-01

    Muscle physiology in the aging athlete is complex. Sarcopenia, the age-related decrease in lean muscle mass, can alter activity level and affect quality of life. This review addresses the microscopic and macroscopic changes in muscle with age, recognizes contributing factors including nutrition and changes in hormone levels, and identifies potential pharmacologic agents in clinical trial that may aid in the battle of this complex, costly, and disabling problem. Level of Evidence: Level 5. PMID:24427440

  4. An artificial muscle computer

    NASA Astrophysics Data System (ADS)

    Marc O'Brien, Benjamin; Alexander Anderson, Iain

    2013-03-01

    We have built an artificial muscle computer based on Wolfram's "2, 3" Turing machine architecture, the simplest known universal Turing machine. Our computer uses artificial muscles for its instruction set, output buffers, and memory write and addressing mechanisms. The computer is very slow and large (0.15 Hz, ˜1 m3); however by using only 13 artificial muscle relays, it is capable of solving any computable problem given sufficient memory, time, and reliability. The development of this computer shows that artificial muscles can think—paving the way for soft robots with reflexes like those seen in nature.

  5. MUSCLE INJURIES IN ATHLETES

    PubMed Central

    Barroso, Guilherme Campos; Thiele, Edilson Schwansee

    2015-01-01

    This article had the aim of demonstrating the physiology, diagnosis and treatment of muscle injuries, focusing on athletes and their demands and expectations. Muscle injuries are among the most common complaints in orthopedic practice, occurring both among athletes and among non-athletes. These injuries present a challenge for specialists, due to the slow recovery, during which time athletes are unable to take part in training and competitions, and due to frequent sequelae and recurrences of the injuries. Most muscle injuries (between 10% and 55% of all injuries) occur during sports activities. The muscles most commonly affected are the ischiotibial, quadriceps and gastrocnemius. These muscles go across two joints and are more subject to acceleration and deceleration forces. The treatment for muscle injuries varies from conservative treatment to surgery. New procedures are being used, like the hyperbaric chamber and the use of growth factors. However, there is still a high rate of injury recurrence. Muscle injury continues to be a topic of much controversy. New treatments are being researched and developed, but prevention through muscle strengthening, stretching exercises and muscle balance continues to be the best “treatment”. PMID:27027021

  6. Functional genomics of the muscle response to restraint and transport in chickens.

    PubMed

    Hazard, D; Fernandez, X; Pinguet, J; Chambon, C; Letisse, F; Portais, J-C; Wadih-Moussa, Z; Rémignon, H; Molette, C

    2011-09-01

    In the present study, we used global approaches (proteomics, transcriptomics, and metabolomics) to assess the molecular basis of the muscle response to stress in chickens. A restraint test, combined with transport for 2 h (RT test) was chosen as the potentially stressful situation. Chickens (6 wk old) were either nontreated (control chickens) or submitted to the RT test (treated chickens). The RT test induced a 6-fold increase in corticosterone concentrations, suggesting hypothalamic-pituitary-adrenal axis activation. The RT test decreased the relative abundance of several hexose phosphates [glucose-1-P (G1P), glucose-6-P (G6P), fructose-6-P (F6P), and mannose-6-P (M6P)] in thigh muscle. In addition, 55 transcripts, among which 39 corresponded to unique annotated genes, were significantly up- (12 genes) or downregulated (27 genes) by treatment. Similarly, 45 proteic spots, among which 29 corresponded to unique annotated proteins, were overexpressed (11 proteins), underexpressed (14 proteins), or only expressed in treated chickens. Integrative analysis of differentially expressed genes and proteins showed that most transcripts and proteins belong to 2 networks whose genes were mainly related with cytoskeleton structure or carbohydrate metabolism. Whereas the decrease in energetic metabolites suggested an activation of glycogenolysis and glycolysis in response to the RT test, the reduced expression of genes and proteins involved in these pathways suggested the opposite. We hypothesized that the prolonged RT test resulted in a repression of glycogenolysis and glycolysis in thigh muscle of chickens. The down-expression of genes and proteins involved in the formation of fiber stress after the RT test suggests a reinforcement of myofibrils in response to stress. PMID:21512117

  7. Accurate, in vivo NIR measurement of skeletal muscle oxygenation through fat

    NASA Astrophysics Data System (ADS)

    Jin, Chunguang; Zou, Fengmei; Ellerby, Gwenn E. C.; Scott, Peter; Peshlov, Boyan; Soller, Babs R.

    2010-02-01

    Noninvasive near infrared (NIR) spectroscopic measurement of muscle oxygenation requires the penetration of light through overlying skin and fat layers. We have previously demonstrated a dual-light source design and orthogonalization algorithm that corrects for inference from skin absorption and fat scattering. To achieve accurate muscle oxygen saturation (SmO2) measurement, one must select the appropriate source-detector distance (SD) to completely penetrate the fat layer. Methods: Six healthy subjects were supine for 15min to normalize tissue oxygenation across the body. NIR spectra were collected from the calf, shoulder, lower and upper thigh muscles with long SD distances of 30mm, 35mm, 40mm and 45mm. Spectral preprocessing with the short SD (3mm) spectrum preceded SmO2 calculation with a Taylor series expansion method. Three-way ANOVA was used to compare SmO2 values over varying fat thickness, subjects and SD distances. Results: Overlying fat layers varied in thickness from 4.9mm to 19.6mm across all subjects. SmO2 measured at the four locations were comparable for each subject (p=0.133), regardless of fat thickness and SD distance. SmO2 (mean+/-std dev) measured at calf, shoulder, low and high thigh were 62+/-3%, 59+/-8%, 61+/-2%, 61+/-4% respectively for SD distance of 30mm. In these subjects no significant influence of SD was observed (p=0.948). Conclusions: The results indicate that for our sensor design a 30mm SD is sufficient to penetrate through a 19mm fat layer and that orthogonalization with short SD effectively removed spectral interference from fat to result in a reproducible determination of SmO2.

  8. Ischemia causes muscle fatigue.

    PubMed

    Murthy, G; Hargens, A R; Lehman, S; Rempel, D M

    2001-05-01

    The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1 ms). Baseline measurements of blood volume, muscle oxygenation and twitch force were recorded continuously, then a tourniquet on the upper arm was inflated to one of five different pressure levels: 20, 40, 60 mm Hg (randomized order) and diastolic (69 +/- 9.8 mm Hg) and systolic (106 +/- 12.8 mm Hg) blood pressures. Each pressure level was maintained for 3-5 min, and was followed by a recovery period sufficient to allow measurements to return to baseline. For each respective tourniquet pressure level, mean TO2 decreased from resting baseline (100% TO2) to 99 +/- 1.2% (SEM), 96 +/- 1.9%, 93 +/- 2.8%, 90 +/- 2.5%, and 86 +/- 2.7%, and mean twitch force decreased from resting baseline (100% force) to 99 +/- 0.7% (SEM), 96 +/- 2.7%, 93 +/- 3.1%, 88 +/- 3.2%, and 86 +/- 2.6%. Muscle oxygenation and twitch force at 60 mm Hg tourniquet compression and above were significantly lower (P < 0.05) than baseline value. Reduced twitch force was correlated in a dose-dependent manner with reduced muscle oxygenation (r = 0.78, P < 0.001). Although the correlation does not prove causation, the results indicate that ischemia leading to a 7% or greater reduction in muscle oxygenation causes decreased muscle force production in the forearm extensor muscle. Thus, ischemia associated with a modest decline in TO2 causes muscle fatigue. PMID:11398857

  9. Ischemia causes muscle fatigue

    NASA Technical Reports Server (NTRS)

    Murthy, G.; Hargens, A. R.; Lehman, S.; Rempel, D. M.

    2001-01-01

    The purpose of this investigation was to determine whether ischemia, which reduces oxygenation in the extensor carpi radialis (ECR) muscle, causes a reduction in muscle force production. In eight subjects, muscle oxygenation (TO2) of the right ECR was measured noninvasively and continuously using near infrared spectroscopy (NIRS) while muscle twitch force was elicited by transcutaneous electrical stimulation (1 Hz, 0.1 ms). Baseline measurements of blood volume, muscle oxygenation and twitch force were recorded continuously, then a tourniquet on the upper arm was inflated to one of five different pressure levels: 20, 40, 60 mm Hg (randomized order) and diastolic (69 +/- 9.8 mm Hg) and systolic (106 +/- 12.8 mm Hg) blood pressures. Each pressure level was maintained for 3-5 min, and was followed by a recovery period sufficient to allow measurements to return to baseline. For each respective tourniquet pressure level, mean TO2 decreased from resting baseline (100% TO2) to 99 +/- 1.2% (SEM), 96 +/- 1.9%, 93 +/- 2.8%, 90 +/- 2.5%, and 86 +/- 2.7%, and mean twitch force decreased from resting baseline (100% force) to 99 +/- 0.7% (SEM), 96 +/- 2.7%, 93 +/- 3.1%, 88 +/- 3.2%, and 86 +/- 2.6%. Muscle oxygenation and twitch force at 60 mm Hg tourniquet compression and above were significantly lower (P < 0.05) than baseline value. Reduced twitch force was correlated in a dose-dependent manner with reduced muscle oxygenation (r = 0.78, P < 0.001). Although the correlation does not prove causation, the results indicate that ischemia leading to a 7% or greater reduction in muscle oxygenation causes decreased muscle force production in the forearm extensor muscle. Thus, ischemia associated with a modest decline in TO2 causes muscle fatigue.

  10. In Vivo Pharmacodynamics of Cefquinome in a Neutropenic Mouse Thigh Model of Streptococcus suis Serotype 2 at Varied Initial Inoculum Sizes

    PubMed Central

    Guo, Chunna; Liao, Xiaoping; Wang, Mingru; Wang, Feng; Yan, Chaoqun; Xiao, Xia; Sun, Jiang

    2015-01-01

    Streptococcus suis serotype 2 is an emerging zoonotic pathogen and causes severe disease in both pigs and human beings. Cefquinome (CEQ), a fourth-generation cephalosporin, exhibits broad-spectrum activity against Gram-positive bacteria such as S. suis. This study evaluated the in vitro and in vivo antimicrobial activities of CEQ against four strains of S. suis serotype 2 in a murine neutropenic thigh infection model. We investigated the effect of varied inoculum sizes (106 to 108 CFU/thigh) on the pharmacokinetic (PK)/pharmacodynamic (PD) indices and magnitudes of a particular PK/PD index or dose required for efficacy. Dose fractionation studies included total CEQ doses ranging from 0.625 to 640 mg/kg/24 h. Data were analyzed via a maximum effect (Emax) model using nonlinear regression. The PK/PD studies demonstrated that the percentage of time that serum drug levels were above the MIC of free drug (%ƒT>MIC) in a 24-h dosing interval was the primary index driving the efficacy of both inoculum sizes (R2 = 91% and R2 = 63%). CEQ doses of 2.5 and 40 mg/kg body weight produced prolonged postantibiotic effects (PAEs) of 2.45 to 8.55 h. Inoculum sizes had a significant influence on CEQ efficacy. Compared to the CEQ exposure and dosages in tests using standard inocula, a 4-fold dose (P = 0.006) and a 2-fold exposure time (P = 0.01) were required for a 1-log kill using large inocula of 108 CFU/thigh. PMID:26666923

  11. Ultrasound-Derived Abdominal Muscle Thickness Better Detects Metabolic Syndrome Risk in Obese Patients than Skeletal Muscle Index Measured by Dual-Energy X-Ray Absorptiometry.

    PubMed

    Ido, Ayumi; Nakayama, Yuki; Ishii, Kojiro; Iemitsu, Motoyuki; Sato, Koji; Fujimoto, Masahiro; Kurihara, Toshiyuki; Hamaoka, Takafumi; Satoh-Asahara, Noriko; Sanada, Kiyoshi

    2015-01-01

    Sarcopenia has never been diagnosed based on site-specific muscle loss, and little is known about the relationship between site-specific muscle loss and metabolic syndrome (MetS) risk factors. To this end, this cross-sectional study aimed to investigate the relationship between site-specific muscle size and MetS risk factors. Subjects were 38 obese men and women aged 40-82 years. Total body fat and lean body mass were assessed by whole-body dual-energy X-ray absorptiometry (DXA) scan. Muscle thickness (MTH) was measured using B-mode ultrasound scanning in six body regions. Subjects were classified into general obesity (GO) and sarcopenic obesity (SO) groups using the threshold values of one standard deviation below the sex-specific means of either MTH or skeletal muscle index (SMI) measured by DXA. MetS risk score was acquired by standardizing and summing the following continuously distributed variables: visceral fat area, mean blood pressure, HbA1c, and serum triglyceride / high density lipoprotein cholesterol, to obtain the Z-score. Multiple regression analysis revealed that the MetS risk score was independently associated with abdominal MTH in all subjects, but not with MTH in other muscle regions, including the thigh. Although HbA1c and the number of MetS risk factors in the SO group were significantly higher than those in the GO group, there were no significant differences between GO and SO groups as defined by SMI. Ultrasound-derived abdominal MTH would allow a better assessment of sarcopenia in obese patients and can be used as an alternative to the conventionally-used SMI measured by DXA. PMID:26700167

  12. Ultrasound-Derived Abdominal Muscle Thickness Better Detects Metabolic Syndrome Risk in Obese Patients than Skeletal Muscle Index Measured by Dual-Energy X-Ray Absorptiometry

    PubMed Central

    Ido, Ayumi; Nakayama, Yuki; Ishii, Kojiro; Iemitsu, Motoyuki; Sato, Koji; Fujimoto, Masahiro; Kurihara, Toshiyuki; Hamaoka, Takafumi; Satoh-Asahara, Noriko; Sanada, Kiyoshi

    2015-01-01

    Sarcopenia has never been diagnosed based on site-specific muscle loss, and little is known about the relationship between site-specific muscle loss and metabolic syndrome (MetS) risk factors. To this end, this cross-sectional study aimed to investigate the relationship between site-specific muscle size and MetS risk factors. Subjects were 38 obese men and women aged 40–82 years. Total body fat and lean body mass were assessed by whole-body dual-energy X-ray absorptiometry (DXA) scan. Muscle thickness (MTH) was measured using B-mode ultrasound scanning in six body regions. Subjects were classified into general obesity (GO) and sarcopenic obesity (SO) groups using the threshold values of one standard deviation below the sex-specific means of either MTH or skeletal muscle index (SMI) measured by DXA. MetS risk score was acquired by standardizing and summing the following continuously distributed variables: visceral fat area, mean blood pressure, HbA1c, and serum triglyceride / high density lipoprotein cholesterol, to obtain the Z-score. Multiple regression analysis revealed that the MetS risk score was independently associated with abdominal MTH in all subjects, but not with MTH in other muscle regions, including the thigh. Although HbA1c and the number of MetS risk factors in the SO group were significantly higher than those in the GO group, there were no significant differences between GO and SO groups as defined by SMI. Ultrasound-derived abdominal MTH would allow a better assessment of sarcopenia in obese patients and can be used as an alternative to the conventionally-used SMI measured by DXA. PMID:26700167

  13. Hemodynamic Instability after Low-Energy Thigh Contusion Caused by Injury to the Femoral Artery: A Case Report and Literature Review

    PubMed Central

    Rodríguez-Roiz, Juan Miguel; Ballesteros-Betancourt, José; García-Tarriño, Raquel; Rodríguez-Roiz, Victor Antonio; Llusa, Manuel

    2016-01-01

    Acute vascular injuries have been described in relation to high-energy trauma accidents or in patients undergoing surgery in the femoral area. We describe a healthy patient who sustained a direct, low-energy contusion in the thigh and presented haemodynamic instability. Arteriography was used to locate the point of bleeding, and embolisation and vessel occlusion were carried out to stop the haemorrhage. The genetic study identified the COL3A1 gene mutation; accordingly, the patient was diagnosed with the Ehlers-Danlos syndrome type IV (vascular type). PMID:27293936

  14. Hemodynamic Instability after Low-Energy Thigh Contusion Caused by Injury to the Femoral Artery: A Case Report and Literature Review.

    PubMed

    Rodríguez-Roiz, Juan Miguel; Ballesteros-Betancourt, José; García-Tarriño, Raquel; Rodríguez-Roiz, Victor Antonio; Llusa, Manuel

    2016-01-01

    Acute vascular injuries have been described in relation to high-energy trauma accidents or in patients undergoing surgery in the femoral area. We describe a healthy patient who sustained a direct, low-energy contusion in the thigh and presented haemodynamic instability. Arteriography was used to locate the point of bleeding, and embolisation and vessel occlusion were carried out to stop the haemorrhage. The genetic study identified the COL3A1 gene mutation; accordingly, the patient was diagnosed with the Ehlers-Danlos syndrome type IV (vascular type). PMID:27293936

  15. Neural Network Model for Survival and Growth of Salmonella enterica Serotype 8,20:-:z6 in Ground Chicken Thigh Meat during Cold Storage: Extrapolation to Other Serotypes.

    PubMed

    Oscar, T P

    2015-10-01

    Mathematical models that predict the behavior of human bacterial pathogens in food are valuable tools for assessing and managing this risk to public health. A study was undertaken to develop a model for predicting the behavior of Salmonella enterica serotype 8,20:-:z6 in chicken meat during cold storage and to determine how well the model would predict the behavior of other serotypes of Salmonella stored under the same conditions. To develop the model, ground chicken thigh meat (0.75 cm(3)) was inoculated with 1.7 log Salmonella 8,20:-:z6 and then stored for 0 to 8 -8 to 16°C. An automated miniaturized most-probable-number (MPN) method was developed and used for the enumeration of Salmonella. Commercial software (Excel and the add-in program NeuralTools) was used to develop a multilayer feedforward neural network model with one hidden layer of two nodes. The performance of the model was evaluated using the acceptable prediction zone (APZ) method. The number of Salmonella in ground chicken thigh meat stayed the same (P > 0.05) during 8 days of storage at -8 to 8°C but increased (P < 0.05) during storage at 9°C (+0.6 log) to 16°C (+5.1 log). The proportion of residual values (observed minus predicted values) in an APZ (pAPZ) from -1 log (fail-safe) to 0.5 log (fail-dangerous) was 0.939 for the data (n = 426 log MPN values) used in the development of the model. The model had a pAPZ of 0.944 or 0.954 when it was extrapolated to test data (n = 108 log MPN per serotype) for other serotypes (S. enterica serotype Typhimurium var 5-, Kentucky, Typhimurium, and Thompson) of Salmonella in ground chicken thigh meat stored for 0 to 8 days at -4, 4, 12, or 16°C under the same experimental conditions. A pAPZ of ≥0.7 indicates that a model provides predictions with acceptable bias and accuracy. Thus, the results indicated that the model provided valid predictions of the survival and growth of Salmonella 8,20:-:z6 in ground chicken thigh meat stored for 0 to 8 days at -8 to

  16. Effectiveness of thigh-length graduated compression stockings to reduce the risk of deep vein thrombosis after stroke (CLOTS trial 1): a multicentre, randomised controlled trial

    PubMed Central

    2009-01-01

    Summary Background Deep vein thrombosis (DVT) and pulmonary embolism are common after stroke. In small trials of patients undergoing surgery, graduated compression stockings (GCS) reduce the risk of DVT. National stroke guidelines extrapolating from these trials recommend their use in patients with stroke despite insufficient evidence. We assessed the effectiveness of thigh-length GCS to reduce DVT after stroke. Methods In this outcome-blinded, randomised controlled trial, 2518 patients who were admitted to hospital within 1 week of an acute stroke and who were immobile were enrolled from 64 centres in the UK, Italy, and Australia. Patients were allocated via a central randomisation system to routine care plus thigh-length GCS (n=1256) or to routine care plus avoidance of GCS (n=1262). A technician who was blinded to treatment allocation undertook compression Doppler ultrasound of both legs at about 7–10 days and, when practical, again at 25–30 days after enrolment. The primary outcome was the occurrence of symptomatic or asymptomatic DVT in the popliteal or femoral veins. Analyses were by intention to treat. This study is registered, number ISRCTN28163533. Findings All patients were included in the analyses. The primary outcome occurred in 126 (10·0%) patients allocated to thigh-length GCS and in 133 (10·5%) allocated to avoid GCS, resulting in a non-significant absolute reduction in risk of 0·5% (95% CI −1·9% to 2·9%). Skin breaks, ulcers, blisters, and skin necrosis were significantly more common in patients allocated to GCS than in those allocated to avoid their use (64 [5%] vs 16 [1%]; odds ratio 4·18, 95% CI 2·40–7·27). Interpretation These data do not lend support to the use of thigh-length GCS in patients admitted to hospital with acute stroke. National guidelines for stroke might need to be revised on the basis of these results. Funding Medical Research Council (UK), Chief Scientist Office of Scottish Government, Chest Heart and Stroke

  17. In Vivo Pharmacodynamic Target Investigation of Two Bacterial Topoisomerase Inhibitors, ACT-387042 and ACT-292706, in the Neutropenic Murine Thigh Model against Streptococcus pneumoniae and Staphylococcus aureus.

    PubMed

    Lepak, A J; Seiler, P; Surivet, J P; Ritz, D; Kohl, C; Andes, D R

    2016-06-01

    ACT-387042 and ACT-292706 are two novel bacterial topoisomerase inhibitors with broad-spectrum activity against Gram-positive and -negative bacteria, including methicillin-resistant Staphylococcus aureus and penicillin- and fluoroquinolone-resistant Streptococcus pneumoniae We used the neutropenic murine thigh infection model to characterize the pharmacokinetics (PK)/pharmacodynamics (PD) of these investigational compounds against a group of 10 S. aureus and S. pneumoniae isolates with phenotypic resistance to beta-lactams and fluoroquinolones. The in vitro activities of the two compounds were very similar (MIC range, 0.03 to 0.125 mg/liter). Plasma pharmacokinetics were determined for each compound by using four escalating doses administered by the subcutaneous route. In treatment studies, mice had 10(7.4) to 10(8) CFU/thigh at the start of therapy with ACT-387042 and 10(6.7) to 10(8.3) CFU/thigh at the start of therapy with ACT-292706. A dose-response relationship was observed with all isolates over the dose range. Maximal kill approached 3 to 4 log10 CFU/thigh compared to the burden at the start of therapy for the highest doses examined. There was a strong relationship between the PK/PD index AUC/MIC ratio (area under the concentration-time curve over 24 h in the steady state divided by the MIC) and therapeutic efficacy in the model (R(2), 0.63 to 0.82). The 24-h free-drug AUC/MIC ratios associated with net stasis for ACT-387042 against S. aureus and S. pneumoniae were 43 and 10, respectively. The 24-h free-drug AUC/MIC ratios associated with net stasis for ACT-292706 against S. aureus and S. pneumoniae were 69 and 25, respectively. The stasis PD targets were significantly lower for S. pneumoniae (P < 0.05) for both compounds. The 1-log-kill AUC/MIC ratio targets were ∼2- to 4-fold higher than stasis targets. Methicillin, penicillin, or ciprofloxacin resistance did not alter the magnitude of the AUC/MIC ratio required for efficacy. These results should be

  18. Research opportunities in muscle atrophy

    NASA Technical Reports Server (NTRS)

    Herbison, G. J.; Talbot, J. M.

    1984-01-01

    A trophy of skeletal muscle; muscle a trophy associated with manned space flight; the nature, causes, and mechanisms of muscle atrophy associated with space flight, selected physiological factors, biochemical aspects, and countermeasures are addressed.

  19. Types of muscle tissue (image)

    MedlinePlus

    ... appear striated, and are under involuntary control. Smooth muscle fibers are located in walls of hollow visceral organs, ... shaped, and are also under involuntary control. Skeletal muscle fibers occur in muscles which are attached to the ...

  20. Types of muscle tissue (image)

    MedlinePlus

    The 3 types of muscle tissue are cardiac, smooth, and skeletal. Cardiac muscle cells are located in the walls of the heart, appear striated, and are under involuntary control. Smooth muscle fibers are located in walls of hollow ...

  1. Pelvic floor muscle training exercises

    MedlinePlus

    Pelvic floor muscle training exercises are a series of exercises designed to strengthen the muscles of the pelvic floor. ... Pelvic floor muscle training exercises are recommended for: Women ... Men with urinary stress incontinence after prostate surgery ...

  2. SMOOTH MUSCLE STEM CELLS

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vascular smooth muscle cells (SMCs) originate from multiple types of progenitor cells. In the embryo, the most well-studied SMC progenitor is the cardiac neural crest stem cell. Smooth muscle differentiation in the neural crest lineage is controlled by a combination of cell intrinsic factors, includ...

  3. Autoimmune muscle disease.

    PubMed

    Mammen, Andrew

    2016-01-01

    Patients with polymyositis (PM), dermatomyositis (DM), and immune-mediated necrotizing myopathy (IMNM) present with the subacute onset of symmetric proximal muscle weakness, elevated muscle enzymes, myopathic findings on electromyography, and autoantibodies. DM patients are distinguished by their cutaneous manifestations. Characteristic features on muscle biopsy include the invasion of nonnecrotic muscle fibers by T cells in PM, perifascicular atrophy in DM, and myofiber necrosis without prominent inflammation in IMNM. Importantly, these are regarded as autoimmune diseases and most patients respond partially, if not completely, to immunosuppressive therapy. Patients with inclusion body myositis (IBM) usually present with the insidious onset of asymmetric weakness in distal muscles (e.g., wrist flexors, and distal finger flexors), often when more proximal muscle groups are relatively preserved. Although IBM muscle biopsies usually have focal invasion of myofibers by lymphocytes, the majority of IBM biopsies also include rimmed vacuoles. While most IBM patients do have autoantibodies, treatment with immunosuppressive agents does not improve their clinical course. Along with the presence of abnormally aggregated proteins on muscle biopsy, the refractory nature and relentless course of IBM suggest that the underlying pathophysiology may include a dominant myodegenerative component. This chapter will focus on the epidemiology, clinical presentation, and treatment of the autoimmune myopathies and IBM. An emphasis will be placed on recent advances, indicating that these are a diverse family of diseases and that each of more than a dozen myositis autoantibodies is associated with a distinct clinical phenotype. PMID:27112692

  4. Structure of Skeletal Muscle

    MedlinePlus

    ... Cells, Tissues, & Membranes Cell Structure & Function Cell Structure Cell Function Body Tissues Epithelial Tissue Connective Tissue Muscle Tissue ... nerves. This is directly related to the primary function of skeletal muscle, ... an impulse from a nerve cell. Generally, an artery and at least one vein ...

  5. Longer Interset Rest Periods Enhance Muscle Strength and Hypertrophy in Resistance-Trained Men.

    PubMed

    Schoenfeld, Brad J; Pope, Zachary K; Benik, Franklin M; Hester, Garrett M; Sellers, John; Nooner, Josh L; Schnaiter, Jessica A; Bond-Williams, Katherine E; Carter, Adrian S; Ross, Corbin L; Just, Brandon L; Henselmans, Menno; Krieger, James W

    2016-07-01

    Schoenfeld, BJ, Pope, ZK, Benik, FM, Hester, GM, Sellers, J, Nooner, JL, Schnaiter, JA, Bond-Williams, KE, Carter, AS, Ross, CL, Just, BL, Henselmans, M, and Krieger, JW. Longer interset rest periods enhance muscle strength and hypertrophy in resistance-trained men. J Strength Cond Res 30(7): 1805-1812, 2016-The purpose of this study was to investigate the effects of short rest intervals normally associated with hypertrophy-type training versus long rest intervals traditionally used in strength-type training on muscular adaptations in a cohort of young, experienced lifters. Twenty-one young resistance-trained men were randomly assigned to either a group that performed a resistance training (RT) program with 1-minute rest intervals (SHORT) or a group that employed 3-minute rest intervals (LONG). All other RT variables were held constant. The study period lasted 8 weeks with subjects performing 3 total body workouts a week comprised 3 sets of 8-12 repetition maximum (RM) of 7 different exercises per session. Testing was performed prestudy and poststudy for muscle strength (1RM bench press and back squat), muscle endurance (50% 1RM bench press to failure), and muscle thickness of the elbow flexors, triceps brachii, and quadriceps femoris by ultrasound imaging. Maximal strength was significantly greater for both 1RM squat and bench press for LONG compared to SHORT. Muscle thickness was significantly greater for LONG compared to SHORT in the anterior thigh, and a trend for greater increases was noted in the triceps brachii (p = 0.06) as well. Both groups saw significant increases in local upper body muscle endurance with no significant differences noted between groups. This study provides evidence that longer rest periods promote greater increases in muscle strength and hypertrophy in young resistance-trained men. PMID:26605807

  6. Onion artificial muscles

    NASA Astrophysics Data System (ADS)

    Chen, Chien-Chun; Shih, Wen-Pin; Chang, Pei-Zen; Lai, Hsi-Mei; Chang, Shing-Yun; Huang, Pin-Chun; Jeng, Huai-An

    2015-05-01

    Artificial muscles are soft actuators with the capability of either bending or contraction/elongation subjected to external stimulation. However, there are currently no artificial muscles that can accomplish these actions simultaneously. We found that the single layered, latticed microstructure of onion epidermal cells after acid treatment became elastic and could simultaneously stretch and bend when an electric field was applied. By modulating the magnitude of the voltage, the artificial muscle made of onion epidermal cells would deflect in opposing directions while either contracting or elongating. At voltages of 0-50 V, the artificial muscle elongated and had a maximum deflection of -30 μm; at voltages of 50-1000 V, the artificial muscle contracted and deflected 1.0 mm. The maximum force response is 20 μN at 1000 V.

  7. New minimally invasive option for the treatment of gluteal muscle contracture.

    PubMed

    Ye, Bin; Zhou, Panyu; Xia, Yan; Chen, Youyan; Yu, Jun; Xu, Shuogui

    2012-12-01

    Gluteal muscle contracture is a clinical syndrome that involves contracture and distortion of the gluteal muscles and fascia fibers due to multiple causes. Physical examination demonstrates a characteristic gait due to hip adduction and internal thigh rotation. This study introduces a new minimally invasive method for surgical release of gluteal muscle contracture. Patients with gluteal muscle contracture were assigned to 4 categories: type A, contracture occurred mainly in the iliotibial tract; type B, contracture occurred in the Iliotibial tract and gluteus maximus; type C1, movement of the contraction band was palpable and a snapping sound was audible during squatting; and type C2, movement of the contraction band was not palpable or almost absent and a snapping sound was audible during squatting. This classification method allowed prediction of the anatomic location of these pathological contractures and determination of the type of surgery required. Four critical points were used to define the operative field and served as points to mark a surgical incision smaller than 4 mm. The contracture was easily released in this carefully marked operative field without causing significant neurovascular damage. Over a period of 5 years, between March 2003 and June 2008, the authors treated 1059 patients with this method and achieved excellent outcomes. Most patients were fully active within 12 weeks, with the assistance of an early postoperative rehabilitation program. The most significant complication was a postoperative periarticular hematoma, which occurred in 3 patients within 10 days postoperatively and required surgical ligation of the bleeding vessel. PMID:23218623

  8. The effects of smartphone use on upper extremity muscle activity and pain threshold.

    PubMed

    Lee, Minkyung; Hong, Yunkyung; Lee, Seunghoon; Won, Jinyoung; Yang, Jinjun; Park, Sookyoung; Chang, Kyu-Tae; Hong, Yonggeun

    2015-06-01

    [Purpose] The purpose of this study was to determine whether muscle activity and pressure-induced pain in the upper extremities are affected by smartphone use, and to compare the effects of phone handling with one hand and with both hands. [Subjects] The study subjects were asymptomatic women 20-22 years of age. [Methods] The subjects sat in a chair with their feet on the floor and the elbow flexed, holding a smartphone positioned on the thigh. Subsequently, the subjects typed the Korean anthem for 3 min, one-handed or with both hands. Each subject repeated the task three times, with a 5-min rest period between tasks to minimize fatigue. Electromyography (EMG) was used to record the muscle activity of the upper trapezius (UT), extensor pollicis longus (EPL), and abductor pollicis (AP) during phone operation. We also used a dolorimeter to measure the pressure-induced pain threshold in the UT. [Results] We observed higher muscle activity in the UT, AP, and EPL in one-handed smartphone use than in its two-handed use. The pressure-induced pain threshold of the UT was lower after use of the smartphone, especially after one-handed use. [Conclusion] Our results show that smartphone operation with one hand caused greater UT pain and induced increased upper extremity muscle activity. PMID:26180311

  9. The effects of smartphone use on upper extremity muscle activity and pain threshold

    PubMed Central

    Lee, Minkyung; Hong, Yunkyung; Lee, Seunghoon; Won, Jinyoung; Yang, Jinjun; Park, Sookyoung; Chang, Kyu-Tae; Hong, Yonggeun

    2015-01-01

    [Purpose] The purpose of this study was to determine whether muscle activity and pressure-induced pain in the upper extremities are affected by smartphone use, and to compare the effects of phone handling with one hand and with both hands. [Subjects] The study subjects were asymptomatic women 20–22 years of age. [Methods] The subjects sat in a chair with their feet on the floor and the elbow flexed, holding a smartphone positioned on the thigh. Subsequently, the subjects typed the Korean anthem for 3 min, one-handed or with both hands. Each subject repeated the task three times, with a 5-min rest period between tasks to minimize fatigue. Electromyography (EMG) was used to record the muscle activity of the upper trapezius (UT), extensor pollicis longus (EPL), and abductor pollicis (AP) during phone operation. We also used a dolorimeter to measure the pressure-induced pain threshold in the UT. [Results] We observed higher muscle activity in the UT, AP, and EPL in one-handed smartphone use than in its two-handed use. The pressure-induced pain threshold of the UT was lower after use of the smartphone, especially after one-handed use. [Conclusion] Our results show that smartphone operation with one hand caused greater UT pain and induced increased upper extremity muscle activity. PMID:26180311

  10. Symmetric corticospinal excitability and representation of vastus lateralis muscle in right-handed healthy subjects.

    PubMed

    Al Sawah, Mohomad; Rimawi, Mohammad; Concerto, Carmen; Amer, Bahaa; Cao, Yisheng; D'Antoni, Anthony V; Chusid, Eileen; Battaglia, Fortunato

    2014-10-01

    The purpose of this study was to determine the size and location of the representations of the anterior thigh muscles on the human motor cortex in the dominant and non-dominant hemispheres. Motor-evoked potentials (MEPs) induced by transcranial magnetic stimulation were recorded from the right and left vastus lateralis (rVL, lVL) muscles. A total of ten right-handed healthy volunteers participated in the study. In a single session experiment, we investigated VL muscle corticospinal excitability (motor threshold, MEP size, short interval intracortical inhibition, intracortical facilitation) and cortical representation (map area, volume, and location) in the dominant and non-dominant hemispheres. The motor threshold, MEPs, and intracortical excitability did not differ significantly between the hemispheres (P > 0.05). Furthermore, no difference between sides was found in the location of VL motor representation (mediolateral and anteroposterior axis) or in map area and volume (P > 0.05). Vastus lateralis muscle corticospinal excitability and cortical map were symmetrical in right-handed subjects. Future studies on patients with unilateral lower extremity injuries could examine side-to-side plastic reorganization in corticomotor output and map location in both hemispheres. PMID:25066941

  11. Musculotendon variability influences tissue strains experienced by the biceps femoris long head muscle during high-speed running

    PubMed Central

    Fiorentino, Niccolo M.; Blemker, Silvia S.

    2014-01-01

    The hamstring muscles frequently suffer injury during high-speed running, though the factors that make an individual more susceptible to injury remain poorly understood. The goals of this study were to measure the musculotendon dimensions of the biceps femoris long head (BFlh) muscle, the hamstring muscle injured most often, and to use computational models to assess the influence of variability in the BFlh’s dimensions on internal tissue strains during high-speed running. High-resolution magnetic resonance (MR) images were acquired over the thigh in 12 collegiate athletes, and musculotendon dimensions were measured in the proximal free tendon/aponeurosis, muscle and distal free tendon/aponeurosis. Finite element meshes were generated based on the average, standard deviation and range of BFlh dimensions. Simulation boundary conditions were defined to match muscle activation and musculotendon length change in the BFlh during high-speed running. Muscle and connective tissue dimensions were found to vary between subjects, with a coefficient of variation (CV) of 17 ± 6% across all dimensions. For all simulations peak local strain was highest along the proximal myotendinous junction, which is where injury typically occurs. Model variations showed that peak local tissue strain increased as the proximal aponeurosis width narrowed and the muscle width widened. The aponeurosis width and muscle width variation models showed that the relative dimensions of these structures influence internal muscle tissue strains. The results of this study indicate that a musculotendon unit’s architecture influences its strain injury susceptibility during high-speed running. PMID:25189094

  12. Strength Training Induces Muscle Hypertrophy and Functional Gains in Black Prostate Cancer Patients Despite Androgen Deprivation Therapy

    PubMed Central

    Hurley, Ben F.

    2013-01-01

    Background. Androgen deprivation therapy (ADT) for prostate cancer (PCa) is associated with weakness, fatigue, sarcopenia, and reduced quality of life (QoL). Black men have a higher incidence and mortality from PCa than Caucasians. We hypothesized that despite ADT, strength training (ST) would increase muscle power and size, thereby improving body composition, physical function, fatigue levels, and QoL in older black men with PCa. Methods. Muscle mass, power, strength, endurance, physical function, fatigue perception, and QoL were measured in 17 black men with PCa on ADT before and after 12 weeks of ST. Within-group differences were determined using t tests and regression models. Results. ST significantly increased total body muscle mass (2.7%), thigh muscle volume (6.4%), power (17%), and strength (28%). There were significant increases in functional performance (20%), muscle endurance (110%), and QoL scores (7%) and decreases in fatigue perception (38%). Improved muscle function was associated with higher functional performance (R 2 = 0.54) and lower fatigue perception (R 2 = 0.37), and both were associated with improved QoL (R 2 = 0.45), whereas fatigue perception tended to be associated with muscle endurance (R 2 = 0.37). Conclusions. ST elicits muscle hypertrophy even in the absence of testosterone and is effective in counteracting the adverse functional consequences of ADT in older black men with PCa. These improvements are associated with reduced fatigue perception, enhanced physical performance, and improved QoL. Thus, ST may be a safe and well-tolerated therapy to prevent the loss of muscle mass, strength, and power commonly observed during ADT. PMID:23089339

  13. Quantifying fat and lean muscle in the lower legs of women with knee osteoarthritis using two different MRI systems.

    PubMed

    Beattie, Karen; Davison, Michael J; Noseworthy, Michael; Adachi, Jonathan D; Maly, Monica R

    2016-06-01

    Decreased muscle mass and increased fat mass are commonly seen in the thighs of individuals with knee osteoarthritis (OA). Despite the role of calf muscles in activities of daily living and knee mechanics, little work has investigated calf changes in knee OA. Unlike the thigh, muscle and fat in the lower leg can be imaged using a peripheral magnetic resonance imaging (MRI) scanner. We aimed to assess agreement between subcutaneous fat, intermuscular fat (IMF), intramuscular fat (intraMF), and lean muscle volumes acquired using a peripheral 1.0T as compared to a reference whole-body 3.0T MRI scanner. A calf MRI scan from each scanner was acquired from twenty women >55 years with knee OA. The different tissues were segmented on each of ten axial slices for every participant using SliceOmatic 5.0 (Tomovision, Magog, QC). Tissue volumes were determined for each outcome. Agreement between tissue volumes from the two scanners was assessed using intraclass correlation (ICC(2,1)) coefficients, standard error, and Bland-Altman plots. Agreement between tissue volumes was strong to very strong, with ICCs ranging from 0.842 to 0.991 for all outcomes. However, wide confidence intervals for IMF and intraMF suggest there is less confidence in agreement with segmentation of images from the 1.0T scanner generally underestimating fat volume relative to the 3.0T scanner. The 3.0T's superior between-tissue contrast likely resulted in more accurate segmentation of IMF and intraMF compared to the 1.0T scanner. Comparisons of tissue volume between studies using different scanners/sequences should be interpreted cautiously. PMID:26979605

  14. Respiratory Muscle Plasticity

    PubMed Central

    Gransee, Heather M.; Mantilla, Carlos B.; Sieck, Gary C.

    2014-01-01

    Muscle plasticity is defined as the ability of a given muscle to alter its structural and functional properties in accordance with the environmental conditions imposed on it. As such, respiratory muscle is in a constant state of remodeling, and the basis of muscle’s plasticity is its ability to change protein expression and resultant protein balance in response to varying environmental conditions. Here, we will describe the changes of respiratory muscle imposed by extrinsic changes in mechanical load, activity, and innervation. Although there is a large body of literature on the structural and functional plasticity of respiratory muscles, we are only beginning to understand the molecular-scale protein changes that contribute to protein balance. We will give an overview of key mechanisms regulating protein synthesis and protein degradation, as well as the complex interactions between them. We suggest future application of a systems biology approach that would develop a mathematical model of protein balance and greatly improve treatments in a variety of clinical settings related to maintaining both muscle mass and optimal contractile function of respiratory muscles. PMID:23798306

  15. Validation of a noninvasive, real-time imaging technology using bioluminescent Escherichia coli in the neutropenic mouse thigh model of infection.

    PubMed

    Rocchetta, H L; Boylan, C J; Foley, J W; Iversen, P W; LeTourneau, D L; McMillian, C L; Contag, P R; Jenkins, D E; Parr, T R

    2001-01-01

    A noninvasive, real-time detection technology was validated for qualitative and quantitative antimicrobial treatment applications. The lux gene cluster of Photorhabdus luminescens was introduced into an Escherichia coli clinical isolate, EC14, on a multicopy plasmid. This bioluminescent reporter bacterium was used to study antimicrobial effects in vitro and in vivo, using the neutropenic-mouse thigh model of infection. Bioluminescence was monitored and measured in vitro and in vivo with an intensified charge-coupled device (ICCD) camera system, and these results were compared to viable-cell determinations made using conventional plate counting methods. Statistical analysis demonstrated that in the presence or absence of antimicrobial agents (ceftazidime, tetracycline, or ciprofloxacin), a strong correlation existed between bioluminescence levels and viable cell counts in vitro and in vivo. Evaluation of antimicrobial agents in vivo could be reliably performed with either method, as each was a sound indicator of therapeutic success. Dose-dependent responses could also be detected in the neutropenic-mouse thigh model by using either bioluminescence or viable-cell counts as a marker. In addition, the ICCD technology was examined for the benefits of repeatedly monitoring the same animal during treatment studies. The ability to repeatedly measure the same animals reduced variability within the treatment experiments and allowed equal or greater confidence in determining treatment efficacy. This technology could reduce the number of animals used during such studies and has applications for the evaluation of test compounds during drug discovery. PMID:11120955

  16. Real-time monitoring of bacterial infection in vivo: development of bioluminescent staphylococcal foreign-body and deep-thigh-wound mouse infection models.

    PubMed

    Kuklin, Nelly A; Pancari, Gregory D; Tobery, Timothy W; Cope, Leslie; Jackson, Jesse; Gill, Charles; Overbye, Karen; Francis, Kevin P; Yu, Jun; Montgomery, Donna; Anderson, Annaliesa S; McClements, William; Jansen, Kathrin U

    2003-09-01

    Staphylococcal infections associated with catheter and prosthetic implants are difficult to eradicate and often lead to chronic infections. Development of novel antibacterial therapies requires simple, reliable, and relevant models for infection. Using bioluminescent Staphylococcus aureus, we have adapted the existing foreign-body and deep-wound mouse models of staphylococcal infection to allow real-time monitoring of the bacterial colonization of catheters or tissues. This approach also enables kinetic measurements of bacterial growth and clearance in each infected animal. Persistence of infection was observed throughout the course of the study until termination of the experiment at day 16 in a deep-wound model and day 21 in the foreign-body model, providing sufficient time to test the effects of antibacterial compounds. The usefulness of both animal models was assessed by using linezolid as a test compound and comparing bioluminescent measurements to bacterial counts. In the foreign-body model, a three-dose antibiotic regimen (2, 5, and 24 h after infection) resulted in a decrease in both luminescence and bacterial counts recovered from the implant compared to those of the mock-treated infected mice. In addition, linezolid treatment prevented the formation of subcutaneous abscesses, although it did not completely resolve the infection. In the thigh model, the same treatment regimen resulted in complete resolution of the luminescent signal, which correlated with clearance of the bacteria from the thighs. PMID:12936968

  17. The effect of a thigh tourniquet on the incidence of deep venous thrombosis after operations on the fore part of the foot

    SciTech Connect

    Simon, M.A.; Mass, D.P.; Zarins, C.K.; Bidani, N.; Gudas, C.J.; Metz, C.E.

    1982-02-01

    A prospective randomized clinical study was performed to determine whether use of a thigh tourniquet influences the incidence of deep venous thrombosis. The lower limbs of patients who were scheduled for elective surgery on the fore part of the foot were randomized and assigned to one of three treatment categories: Group I, no tourniquet; Group II, exsanguination by an Esmarch bandage before tourniquet application; and Group III, exsanguination by elevation of the extremity prior to application of a tourniquet. The 117 limbs of seventy-one patients included in this study were evaluated preoperatively and twenty-four and seventy-two hours postoperatively with 125I-labeled fibrinogen, and preoperatively and seventy-two hours postoperatively with Doppler ultrasound studies and phleborheography. The findings in all of the Doppler ultrasound studies and all of the phleborheograms were normal. Two of the 125I-fibrinogen studies were positive, but subsequent contrast venography revealed that these were false-positive findings. We therefore concluded that the use of a thigh tourniquet does not increase the risk of deep venous thrombosis in patients who have had an operation on the fore part of the foot.

  18. A Six-week Low-level Laser Therapy Protocol is Effective for Reducing Waist, Hip, Thigh, and Upper Abdomen Circumference

    PubMed Central

    Thaxton, Paul M.; Hornfeldt, Carl S.

    2016-01-01

    Objective: The efficacy of low-level laser therapy for noninvasive body contouring has been previously demonstrated in clinical trials leading to its market clearance. Subjects achieved these beneficial effects following three weekly low-level laser therapy treatments for two weeks. The objective of this study was to determine if the same aesthetic benefit can be achieved following one weekly low-level laser therapy treatment for six weeks. Setting: Two private dermatology practices. Participants: Healthy adults with a body mass index of 25 to 40kg/m2 (N=54). Measurements: Subjects underwent one weekly low-level laser therapy procedure for six consecutive weeks using a device consisting of six 17mW, 635nm red diodes. Waist, hip, thigh, and upper abdomen circumference were measured weekly. Study success criteria was a 4.5-inch mean decrease in combined body circumference. Results: The mean decrease in combined circumference reduction at six weeks was 5.4 inches (p<0.001), and most subjects (72.2%) achieved a ≥4.5-inch decrease. Most subjects (81.0%) were Satisfied (27%) or Very Satisfied (54%) with the aesthetic results they achieved. There were no adverse events. Conclusion: One weekly low-level laser therapy treatment for six weeks is clinically effective for reducing waist, hip, thigh, and upper abdomen circumference and may be more effective than the previous two-week treatment protocol. ClinicalTrials.gov Identifier: NCT02109107. PMID:27386049

  19. Slipped and lost extraocular muscles.

    PubMed

    Lenart, T D; Lambert, S R

    2001-09-01

    A slipped or lost muscle should be considered in the differential diagnosis of a patient presenting with a marked limitation of duction and inability to rotate the eye beyond the midline. Loss of a rectus muscle can occur after strabismus surgery, trauma, paranasal sinus surgery, orbital surgery, or retinal detachment surgery. The extraocular rectus muscle most frequently slipped or lost is the medial rectus muscle. Forced ductions, active force generation, saccadic velocity studies, differential intraocular pressure measurements, and orbital imaging studies may aid in identifying a slipped or lost muscle. However, no single diagnostic test provides absolute reliability for determining a lost muscle. Slipped muscles develop when the muscular capsule is imbricated without including the muscle or muscle tendon during strabismus surgery. When the capsule is reattached to the sclera, the tendon and muscle are then free to slip posteriorally from the site of attachment. Slipped muscles are retrieved by following the thin avascular muscle capsule posteriorally until the muscle is identified. A lost muscle can be found using a traditional conjunctival approach, by an external orbitotomy, or by an endoscopic transnasal approach. Although many diagnostic maneuvers are useful in identifying a lost rectus muscle, the oculocardiac reflex is the most important. Once the lost muscle is identified, the muscle should be imbricated with a nonabsorbable synthetic suture and securely reattached to the globe. PMID:11705143

  20. Thyrotoxic muscle disease

    PubMed Central

    Ramsay, Ian

    1968-01-01

    Evidence suggests that most hyperthyroid patients have a proximal myopathy. The more severe this is the more frequently are distal muscles, and ultimately, bulbar muscles involved. Probably acute thyrotoxic myopathy or encephalopathy supervenes on a previous chronic background or occurs concurrently with skeletal muscle involvement. Using careful electromyographic techniques evidence of myopathy may be found in most thyrotoxics; it disappears with adequate treatment of the primary disease. Myasthenia gravis and periodic paralysis are also associated with thyrotoxicosis and their differentiation is discussed. Infiltrative ophthalmopathy is not related to the effects of excess thyroid hormone, but is possibly due to EPS working in conjunction with LATS. ImagesFig. 2 PMID:4871773

  1. Volumetric Muscle Loss.

    PubMed

    Pollot, Beth E; Corona, Benjamin T

    2016-01-01

    Volumetric muscle loss (VML) injury is prevalent in severe extremity trauma and is an emerging focus area among orthopedic and regenerative medicine fields. VML injuries are the result of an abrupt, frank loss of tissue and therefore of different etiology from other standard rodent injury models to include eccentric contraction, ischemia reperfusion, crush, and freeze injury. The current focus of many VML-related research efforts is to regenerate the lost muscle tissue and thereby improve muscle strength. Herein, we describe a VML model in the anterior compartment of the hindlimb that is permissible to repeated neuromuscular strength assessments and is validated in mouse, rat, and pig. PMID:27492162

  2. Caring for muscle spasticity or spasms

    MedlinePlus

    High muscle tone - care; Increased muscle tension - care; Upper motor neuron syndrome - care; Muscle stiffness - care ... Muscle spasticity, or spasms, causes your muscles to become stiff or rigid. It can also cause exaggerated, ...

  3. Forces of individual cat ankle extensor muscles during locomotion predicted using static optimization.

    PubMed

    Prilutsky, B I; Herzog, W; Allinger, T L

    1997-10-01

    In order to test the principles of the control of synergistic muscles that were proposed in the literature, forces of cat soleus (SO), gastrocnemius (GA), and plantaris (PL) measured during locomotion were compared with the corresponding forces predicted using different optimization criteria. Forces of cat SO, GA, and PL, and the corresponding cat kinematics were recorded simultaneously using E-shaped force transducers and high-speed video, respectively. Measurements were obtained from three cats walking and trotting on a treadmill at five nominal speeds ranging from 0.4 to 1.8 m s-1. Muscle forces were predicted using static optimization and a musculoskeletal model of the cat hindlimb consisting of three segments (foot, shank, and thigh) and three muscles (SO, GA, and PL). Six optimization criteria which had been proposed in the literature were tested. Linear criteria based on the principles of minimum muscle force and stress predicted forces during the stance phase with an average normalized error of 59-322%. Three other criteria--minimization of the sum of the relative muscle forces squared, minimization of the sum of the muscle stresses cubed, and minimization of the upper bound for all of the muscle stresses-showed a better performance: (i) the average error was 43-119% and (ii) the correlation coefficient calculated between the predicted and actual forces exceeded 0.9 for all three muscles. A criterion that was based on the principle of minimum fatigue and accounted for the percentage of slow-twitch fibers in the muscles, had the lowest average error (26-52%). The high correlation (0.97-0.99) between the measured forces and forces predicted by using the minimum fatigue criterion suggested that force sharing among SO, GA, and PL during cat locomotion may be the same for a given set of joint moments and muscle moment arms. It was concluded that static optimization with the appropriate criterion can predict muscle forces adequately for specific movement

  4. Excess subcutaneous tissue may preclude intramuscular delivery when using adrenaline autoinjectors in patients with anaphylaxis.

    PubMed

    Johnstone, J; Hobbins, S; Parekh, D; O'Hickey, S

    2015-06-01

    Intramuscular adrenaline is the gold standard treatment for anaphylaxis. Intramuscular injection provides more rapid and higher plasma concentrations than subcutaneous routes. Given the increasing epidemic of obesity patients are at increased risk of subcutaneous delivery, we therefore assessed the depth of subcutaneous tissue in a population of patients with anaphylaxis. Patients already prescribed adrenaline autoinjectors (AAIs) for anaphylaxis were examined with ultrasound, and measurements of skin-to-muscle depth (STMD) at anterolateral thigh and anterior thigh were performed. Twenty-eight patients (23 female, 5 male) with an age range of 18-75 took part in the study, and in 68%, the STMD was greater than AAI needle length (15.02 mm), using the anterolateral thigh as the recommended administration site. The key predictors for increased STMD were female gender (P=0.0003) and a BMI > 30 (P=0.04). AAIs require longer needles to ensure intramuscular administration, and ultrasound at point of prescription would aid needle length selection. PMID:25676800

  5. Muscle Fiber Types and Training.

    ERIC Educational Resources Information Center

    Karp, Jason R.

    2001-01-01

    The specific types of fibers that make up individual muscles greatly influence how people will adapt to their training programs. This paper explains the complexities of skeletal muscles, focusing on types of muscle fibers (slow-twitch and fast-twitch), recruitment of muscle fibers to perform a motor task, and determining fiber type. Implications…

  6. Research opportunities in muscle atrophy

    NASA Technical Reports Server (NTRS)

    Herbison, G. J. (Editor); Talbot, J. M. (Editor)

    1984-01-01

    Muscle atrophy in a weightless environment is studied. Topics of investigation include physiological factors of muscle atrophy in space flight, biochemistry, countermeasures, modelling of atrophied muscle tissue, and various methods of measurement of muscle strength and endurance. A review of the current literature and suggestions for future research are included.

  7. Eye muscle repair

    MedlinePlus

    ... Your child's eyes should look normal a few weeks after the surgery. ... Surgical Approach to the Rectus Muscles. In: Tasman W, Jaeger EA, ... Hug D, Plummer LS, Stass-Isern M. Disorders of eye movement and ...

  8. Neurogenic muscle cramps.

    PubMed

    Katzberg, Hans D

    2015-08-01

    Muscle cramps are sustained, painful contractions of muscle and are prevalent in patients with and without medical conditions. The objective of this review is to present updates on the mechanism, investigation and treatment of neurogenic muscle cramps. PubMed and Embase databases were queried between January 1980 and July 2014 for English-language human studies. The American Academy of Neurology classification of studies (classes I-IV) was used to assess levels of evidence. Mechanical disruption, ephaptic transmission, disruption of sensory afferents and persistent inward currents have been implicated in the pathogenesis of neurogenic cramps. Investigations are directed toward identifying physiological triggers or medical conditions predisposing to cramps. Although cramps can be self-limiting, disabling or sustained muscle cramps should prompt investigation for underlying medical conditions. Lifestyle modifications, treatment of underlying conditions, stretching, B-complex vitamins, diltiezam, mexiletine, carbamazepine, tetrahydrocannabinoid, leveteracitam and quinine sulfate have shown evidence for treatment. PMID:25673127

  9. Muscles of the Trunk

    MedlinePlus

    ... Home » Cancer Registration & Surveillance Modules » Anatomy & Physiology » Muscular System » Muscle Groups » Trunk Cancer Registration & Surveillance Modules Anatomy & Physiology Intro to the Human Body Body Functions & Life Process Anatomical Terminology Review Quiz ...

  10. Muscle biopsy (image)

    MedlinePlus

    A muscle biopsy involves removal of a plug of tissue usually by a needle to be later used for examination. Sometimes ... there is a patchy condition expected an open biopsy may be used. Open biopsy involves a small ...

  11. Muscle fatigue (image)

    MedlinePlus

    ... above your shoulders until they drop is one exercise that may be performed during the Tensilon test. In this test, the drug Tensilon is administered, and the response in the muscles are evaluated to help diagnose myasthenia gravis or ...

  12. Changes in muscle and joint coordination in learning to direct forces.

    PubMed

    Hasson, Christopher J; Caldwell, Graham E; van Emmerik, Richard E A

    2008-08-01

    While it has been suggested that bi-articular muscles have a specialized role in directing external reaction forces, it is unclear how humans learn to coordinate mono- and bi-articular muscles to perform force-directing tasks. Participants were asked to direct pedal forces in a specified target direction during one-legged cycling. We expected that with practice, performance improvement would be associated with specific changes in joint torque patterns and mono- and bi-articular muscular coordination. Nine male participants practiced pedaling an ergometer with only their left leg, and were instructed to always direct their applied pedal force perpendicular to the crank arm (target direction) and to maintain a constant pedaling speed. After a single practice session, the mean error between the applied and target pedal force directions decreased significantly. This improved performance was accompanied by a significant decrease in the amount of ankle angular motion and a smaller increase in knee and hip angular motion. This coincided with a re-organization of lower extremity joint torques, with a decrease in ankle plantarflexor torque and an increase in knee and hip flexor torques. Changes were seen in both mono- and bi-articular muscle activity patterns. The mono-articular muscles exhibited greater alterations, and appeared to contribute to both mechanical work and force-directing. With practice, a loosening of the coupling between bi-articular thigh muscle activation and joint torque co-regulation was observed. The results demonstrated that participants were able to learn a complex and dynamic force-directing task by changing the direction of their applied pedal forces through re-organization of joint torque patterns and mono- and bi-articular muscle coordination. PMID:18405988

  13. Changes in Muscle and Joint Coordination in Learning to Direct Forces

    PubMed Central

    Hasson, Christopher J.; Caldwell, Graham E.; van Emmerik, Richard E.A.

    2008-01-01

    While it has been suggested that biarticular muscles have a specialized role in directing external reaction forces, it is unclear how humans learn to coordinate mono- and bi-articular muscles to perform force-directing tasks. Subjects were asked to direct pedal forces in a specified target direction during one-legged cycling. We expected that with practice, performance improvement would be associated with specific changes in joint torque patterns and mono- and bi-articular muscular coordination. Nine male subjects practiced pedaling an ergometer with only their left leg, and were instructed to always direct their applied pedal force perpendicular to the crank arm (target direction) and to maintain a constant pedaling speed. After a single practice session, the mean error between the applied and target pedal force directions decreased significantly. This improved performance was accompanied by a significant decrease in the amount of ankle angular motion and a smaller increase in knee and hip angular motion. This coincided with a re-organization of lower extremity joint torques, with a decrease in ankle plantarflexor torque and an increase in knee and hip flexor torques. Changes were seen in both mono- and bi-articular muscle activity patterns. The monoarticular muscles exhibited greater alterations, and appeared to contribute to both mechanical work and force directing. With practice, a loosening of the coupling between biarticular thigh muscle activation and joint torque co-regulation was observed. The results demonstrated that subjects were able to learn a complex and dynamic force-directing task by changing the direction of their applied pedal forces through re-organization of joint torque patterns and mono- and bi-articular muscle coordination. PMID:18405988

  14. An invertebrate smooth muscle with striated muscle myosin filaments

    PubMed Central

    Sulbarán, Guidenn; Alamo, Lorenzo; Pinto, Antonio; Márquez, Gustavo; Méndez, Franklin; Padrón, Raúl; Craig, Roger

    2015-01-01

    Muscle tissues are classically divided into two major types, depending on the presence or absence of striations. In striated muscles, the actin filaments are anchored at Z-lines and the myosin and actin filaments are in register, whereas in smooth muscles, the actin filaments are attached to dense bodies and the myosin and actin filaments are out of register. The structure of the filaments in smooth muscles is also different from that in striated muscles. Here we have studied the structure of myosin filaments from the smooth muscles of the human parasite Schistosoma mansoni. We find, surprisingly, that they are indistinguishable from those in an arthropod striated muscle. This structural similarity is supported by sequence comparison between the schistosome myosin II heavy chain and known striated muscle myosins. In contrast, the actin filaments of schistosomes are similar to those of smooth muscles, lacking troponin-dependent regulation. We conclude that schistosome muscles are hybrids, containing striated muscle-like myosin filaments and smooth muscle-like actin filaments in a smooth muscle architecture. This surprising finding has broad significance for understanding how muscles are built and how they evolved, and challenges the paradigm that smooth and striated muscles always have distinctly different components. PMID:26443857

  15. Bound potassium in muscle II.

    PubMed

    Hummel, Z

    1980-01-01

    Experiments were performed to decide between the alternatives a) the ionized K+ is in a dissolved state in the muscle water, or b) a part of the muscle potassium is in a "bound' state. Sartorius muscles of Rana esculenta were put into glicerol for about one hour at 0-2 degrees C. Most of muscle water came out, but most of muscle potassium remained in the muscles. In contrast to this: from muscle in heat rigor more potassium was released due to glicerol treating than from the intact ones. 1. Supposition a) is experimentally refuted. 2. Supposition b) corresponds to the experimental results. PMID:6969511

  16. Diabetic Muscle Infarction

    PubMed Central

    Morcuende, José A; Dobbs, Matthew B; Buckwalter, Joseph A; Crawford, Haemish

    2000-01-01

    Diabetic muscle infarction is a rare complication of diabetes mellitus that is not clearly defined in the orthopaedic literature. This study is a descriptive case series of 7 new cases of diabetic muscle infarction and 55 previously reported cases in the literature. In the majority of patients, diabetic muscle infarction presents as a localized, exquisitely painful swelling and limited range of motion of the lower extremity. No cases affecting the muscles of the upper extremity have been observed. The onset is usually acute, persists for several weeks, and resolves spontaneously over several weeks to months without the need for intervention. Diabetic muscle infarction is a condition that should be considered in the differential diagnosis of any diabetic patient with lower extremity pain and swelling without systemic signs of infection. Magnetic resonance imaging is sensitive and specific enough to make the diagnosis. Muscle biopsy and surgical irrigation and debridement are not recommended since they are associated with complications. Pain management and activity restriction in the acute phase followed by gentle physical therapy is the treatment of choice. Recurrences in the same or opposite limb are common. Although the short-term prognosis is very good and the majority of cases resolve spontaneously, the long-term survival is uncertain in this patient population. PMID:10934627

  17. Differences in muscle strength after ACL reconstruction do not influence cardiorespiratory responses to isometabolic exercise

    PubMed Central

    Andrade, Marília S.; Lira, Claudio A. B.; Vancini, Rodrigo L.; Nakamoto, Fernanda P.; Cohen, Moisés; Silva, Antonio C.

    2014-01-01

    Objectives To investigate whether the muscle strength decrease that follows anterior cruciate ligament (ACL) reconstruction would lead to different cardiorespiratory adjustments during dynamic exercise. Method Eighteen active male subjects were submitted to isokinetic evaluation of knee flexor and extensor muscles four months after ACL surgery. Thigh circumference was also measured and an incremental unilateral cardiopulmonary exercise test was performed separately for both involved and uninvolved lower limbs in order to compare heart rate, oxygen consumption, minute ventilation, and ventilatory pattern (breath rate, tidal volume, inspiratory time, expiratory time, tidal volume/inspiratory time) at three different workloads (moderate, anaerobic threshold, and maximal). Results There was a significant difference between isokinetic extensor peak torque measured in the involved (116.5±29.1 Nm) and uninvolved (220.8±40.4 Nm) limbs, p=0.000. Isokinetic flexor peak torque was also lower in the involved limb than in the uninvolved limb (107.8±15.4 and 132.5±26.3 Nm, p=0.004, respectively). Lower values were also found in involved thigh circumference as compared with uninvolved limb (46.9±4.3 and 48.5±3.9 cm, p=0.005, respectively). No differences were found between the lower limbs in any of the variables of the incremental cardiopulmonary tests at all exercise intensities. Conclusions Our findings indicate that, four months after ACL surgery, there is a significant deficit in isokinetic strength in the involved limb, but these differences in muscle strength requirement do not produce differences in the cardiorespiratory adjustments to exercise. Based on the hypotheses from the literature which explain the differences in the physiological responses to exercise for different muscle masses, we can deduce that, after 4 months of a rehabilitation program after an ACL reconstruction, individuals probably do not present differences in muscle oxidative and peripheral

  18. Arthroscopic Marginal Resection of a Lipoma of the Supraspinatus Muscle in the Subacromial Space

    PubMed Central

    Pagán Conesa, Alejandro; Aznar, Carlos Verdú; Herrera, Manuel Ruiz; Lopez-Prats, Fernando Anacleto

    2015-01-01

    Subacromial impingement syndrome is a common cause of shoulder pain in young adults and seniors at present. The etiology of this syndrome is associated with several shoulder disorders, most related to aging, overhead activities, and overuse. The subacromial space is well circumscribed and limited in size, and soft-tissue growing lesions, such as tumors, can endanger the normal function of the shoulder girdle. We present a case of shoulder impingement syndrome caused by an intramuscular lipoma of the supraspinatus muscle in the subacromial space in a 50-year-old male bank manager. Radiographs, magnetic resonance imaging, and a computed tomography scan showed a well-circumscribed soft-tissue tumor at the supraspinatus-musculotendinous junction. It was arthroscopically inspected and dissected and complete marginal excision was performed through a conventional augmented anterolateral portal, avoiding the need to open the trapezius fascia or perform an acromial osteotomy. Microscopic study showed a benign lipoma, and the shoulder function of the patient was fully recovered after a rehabilitation period of 4 months. This less invasive technique shows similar results to conventional open surgery. PMID:26759779

  19. Arthroscopic Marginal Resection of a Lipoma of the Supraspinatus Muscle in the Subacromial Space.

    PubMed

    Pagán Conesa, Alejandro; Aznar, Carlos Verdú; Herrera, Manuel Ruiz; Lopez-Prats, Fernando Anacleto

    2015-08-01

    Subacromial impingement syndrome is a common cause of shoulder pain in young adults and seniors at present. The etiology of this syndrome is associated with several shoulder disorders, most related to aging, overhead activities, and overuse. The subacromial space is well circumscribed and limited in size, and soft-tissue growing lesions, such as tumors, can endanger the normal function of the shoulder girdle. We present a case of shoulder impingement syndrome caused by an intramuscular lipoma of the supraspinatus muscle in the subacromial space in a 50-year-old male bank manager. Radiographs, magnetic resonance imaging, and a computed tomography scan showed a well-circumscribed soft-tissue tumor at the supraspinatus-musculotendinous junction. It was arthroscopically inspected and dissected and complete marginal excision was performed through a conventional augmented anterolateral portal, avoiding the need to open the trapezius fascia or perform an acromial osteotomy. Microscopic study showed a benign lipoma, and the shoulder function of the patient was fully recovered after a rehabilitation period of 4 months. This less invasive technique shows similar results to conventional open surgery. PMID:26759779

  20. Muscle hardness characteristics of the masseter muscle after repetitive muscle activation: comparison to the biceps brachii muscle.

    PubMed

    Kashima, Koji; Higashinaka, Shuichi; Watanabe, Naoshi; Maeda, Sho; Shiba, Ryosuke

    2004-10-01

    The purpose of this study was to compare hardness characteristics of the masseter muscle to those of the biceps brachii muscle during repetitive muscle movements. Seventeen asymptomatic female subjects participated in this study. Each subject, on separate days, undertook a 5-minute unilateral chewing gum task on the right side and a 5-minute flexion-extension exercise on the right hand with a 2kg dumbbell. Using a handheld hardness meter, muscle hardness was measured in the right masseter and in the biceps brachii muscle at eight time points (before the task, immediately after the task, and at 1, 3, 5, 10, 30, and 60 minutes after the task), and the data obtained before and after the task on each muscle were compared. Comparisons of the normalized data were also performed between the two muscles at each time point. As a result, a significant increase in muscle hardness was seen at 1 minute after the task in the biceps brachii muscle (p=0.0093). In contrast, the masseter muscle showed a tendency to lower hardness, with the lowest point of hardness occurring at 10 minutes after the task (p = 0.0160). Between the two muscles, there was a difference in the normalized data immediately after the task, and at 1, 5, and 10 minutes after the task (0.01 muscle hardness characteristics of the masseter muscle completely differed from those of the biceps brachii muscle after repetitive muscle activation. PMID:15532311

  1. Effects in skeletal muscle.

    PubMed

    Young, Andrew

    2005-01-01

    The first biological action of amylin to be described was the inhibition of insulin-stimulated incorporation of radiolabeled glucose into glycogen in the isolated soleus muscle of the rat. This antagonism of insulin action in muscle was non-competitive, occurring with equal potency and efficacy at all insulin concentrations. Amylin inhibited activation of glycogen synthase, partially accounting for the inhibition of radiolabeled glucose incorporation. However, this did not account for a low rate of labeling at higher amylin concentrations, wherein the radioglycogen accumulation was even less than in incubations where insulin was absent. The principal action of amylin accounting for reduction of insulin-stimulated accumulation of glycogen was activation of glycogen phosphorylase via a cyclic AMP-, protein kinase C-dependent signaling pathway to cause glycogenolysis (glycogen breakdown). At physiological concentrations, amylin activated glycogen phosphorylase at its ED50, but because glycogen phosphorylase is present in such high activity, the resulting flux out of glycogen was estimated to be similar to insulin-mediated flux of glucosyl moieties into glycogen. Thus, in the rat, endogenous amylin secreted in response to meals appeared to mobilize carbon from skeletal muscle. Amylin-induced glycogenolysis resulted in intramuscular accumulation of glucose-6-phosphate and release of lactate from tissue beds that included muscle. When muscle glycogen was pre-labeled with tritium in the three position, amylin could be shown to evoke the release of free glucose. This is made possible by glucosyl moieties cleaved at the branch points in glycogen being released as free glucose, rather than being phosphorylated, as occurs with the bulk of the glycogen glucosyls. Free glucose is free to exit cells via facilitated transport, down a concentration gradient that might exist under such circumstances. When measured by a sensitive technique utilizing efflux of labeled glucose, amylin

  2. Posterior Thigh Flap Pedicled on the Cutaneous Vessels Arising From the Popliteo-posterior Intermediate Artery: A Report of 5 Cases.

    PubMed

    Sun, Xi-Guang; Gong, Xu; Song, Liang-Song; Cui, Jian-Li; Yu, Xin; Liu, Bin; Lu, Lai-Jin

    2016-08-01

    Surgical repair of soft tissue defects of the knee and leg remains challenging. Using a case study approach, the anatomy of the popliteo-posterior intermediate cutaneous artery was examined, and a reverse island flap method was developed and implemented. After obtaining informed consent, 5 patients (1 woman, 4 men, age range 31 to 57 years) underwent the experimental use of a reverse island flap with a posterior thigh flap pedicled on the cutaneous vessels arising from the popliteo-posterior intermediate artery to repair soft-tissue defects of the knee and leg. The defects were caused by burned skin below the knee (n = 1), progressive skin necrosis in the knee after fracture surgery (n = 2), and skin infections associated with diabetes mellitus (n = 2). Skin defect sizes ranged from 15 cm x 5 cm to 30 cm x 12 cm. These large defects did not heal spontaneously; wound duration ranged from 1 week to 1 year, and all patients had refused defect repair with free flaps. Patients received posterior thigh flaps pedicled on the popliteo-posterior intermediate artery with areas ranging from 17 cm x 6 cm to 25 cm x 12 cm. All patients were treated with antibiotics and local dressings (iodoform and alcohol) changed daily post surgery, and blood supply was monitored by assessing the texture and color of the flap and venous regurgitation (ie, vein drainage disturbance). Four (4) of the five flaps survived completely. In 1 patient, partial survival of the flap, which had a good blood supply despite a venous circulation disorder, occurred: in this case, complete survival was achieved after treatment with a retrograde fascial flap and skin grafting. The appearance and texture of all flaps were satisfactory (ie, patients underwent only 1 operation, healing time was approximately 2 weeks, flap quality was close to normal skin, the donor site closed directly, and the shape and function of the knee and leg recovered well). No donor site abnormality was observed, and no postsurgical

  3. Individual variation and intraclass correlation in arachidonic acid and eicosapentaenoic acid in chicken muscle

    PubMed Central

    2010-01-01

    Chicken meat with reduced concentration of arachidonic acid (AA) and reduced ratio between omega-6 and omega-3 fatty acids has potential health benefits because a reduction in AA intake dampens prostanoid signaling, and the proportion between omega-6 and omega-3 fatty acids is too high in our diet. Analyses for fatty acid determination are expensive, and finding the optimal number of analyses to give reliable results is a challenge. The objective of the present study was i) to analyse the intraclass correlation of different fatty acids in five meat samples, of one gram each, within the same chicken thigh, and ii) to study individual variations in the concentrations of a range of fatty acids and the ratio between omega-6 and omega-3 fatty acid concentrations among fifteen chickens. Fifteen newly hatched broilers were fed a wheat-based diet containing 4% rapeseed oil and 1% linseed oil for three weeks. Five muscle samples from the mid location of the thigh of each chicken were analysed for fatty acid composition. The intraclass correlation (sample correlation within the same animal) was 0.85-0.98 for the ratios of total omega-6 to total omega-3 fatty acids and of AA to eicosapentaenoic acid (EPA). This indicates that when studying these fatty acid ratios, one sample of one gram per animal is sufficient. However, due to the high individual variation between chicken for these ratios, a relatively high number of animals (minimum 15) are required to obtain a sufficiently high power to reveal significant effects of experimental factors (e.g. feeding regimes). The present experiment resulted in meat with a favorable concentration ratio between omega-6 and omega-3 fatty acids. The AA concentration varied from 1.5 to 2.8 g/100 g total fatty acids in thigh muscle in the fifteen broilers, and the ratio between AA and EPA concentrations ranged from 2.3 to 3.9. These differences among the birds may be due to genetic variance that can be exploited by breeding for lower AA

  4. Comparison of Twice Refocused Spin Echo versus Stimulated Echo Diffusion Tensor Imaging for Tracking Muscle Fibers

    PubMed Central

    Noehren, Brian; Andersen, Anders; Feiweier, Thorsten; Damon, Bruce; Hardy, Peter

    2014-01-01

    Purpose To compare the precision of measuring the pennation angle and fiber length in the Vastus Lateralis (VL) using two distinctly different diffusion tensor imaging sequences. Materials and Methods We imaged the thigh of ten normal subjects on a 3T MR imager with twice refocused spin echo (TRSE) and stimulated echo (STEAM) DTI-MRI techniques. Both techniques took the same total acquisition time, employed the same diffusion weighting and gradient directions. Using the diffusion tensor images produced by each sequence muscle fiber bundles were tracked from the aponeurosis by following the first eigenvector of the diffusion tensor. From these tracks we calculated the pennation angle and fiber length. Results The STEAM acquisition resulted in significantly higher SNR, lower ADC, higher FA values and longer fibers than the TRSE. Although no difference in the pennation angle between the two acquisitions was found, the TRSE sequence had a significantly greater within subject dispersion in the pennation angle of tracked fibers which may indicate a reduction in the coherence of fiber bundles. Conclusion Diffusion tensor imaging of muscle using a STEAM acquisition resulted in significant improvements in the SNR and FA, resulting in tracking a larger number of muscle fiber bundles over longer distances and with less within subject dispersion. PMID:24554376

  5. A rare but serious complication of GreenLight HPS photoselective vaporization of the prostate: Prostatic capsular perforation with bilateral thigh urinomas and osteitis pubis.

    PubMed

    Harriman, David; Mayson, Brian E; Leone, Ercole F

    2013-01-01

    The use of lasers to perform photoselective vaporization of the prostate (PVP) has been widely accepted as a safe and effective treatment for benign prostatic hyperplasia with very few reported complications. To date, most of the published data report outcomes for the 80-W potassium-titanyl-phosphate laser. A more potent laser, the 120-W GreenLight HPS, was introduced in 2006 and provides more efficient vaporization of prostatic tissue and decreased operating times. Despite these benefits, the increased energy applied to the prostate evokes concerns of potential serious complications, including capsular perforation and injury to adjacent structures. A more powerful laser system, the 180-W GreenLight XPS laser (American Medical Systems, Minnetonka, MN) has recently become available. We report a rare but serious complication of GreenLight HPS PVP resulting in prostatic capsular perforation with urinary extravasation, presenting with bilateral thigh urinomas and osteitis pubis. PMID:23671496

  6. Illicit Transport via Dipeptide Transporter Dpp is Irrelevant to the Efficacy of Negamycin in Mouse Thigh Models of Escherichia coli Infection.

    PubMed

    McKinney, David C; Bezdenejnih-Snyder, Natascha; Farrington, Krista; Guo, Jian; McLaughlin, Robert E; Ruvinsky, Anatoly M; Singh, Renu; Basarab, Gregory S; Narayan, Sridhar; Buurman, Ed T

    2015-05-01

    Negamycin is a hydrophilic antimicrobial translation inhibitor that crosses the lipophilic inner membrane of Escherichia coli via at least two transport routes to reach its intracellular target. In a minimal salts medium, negamycin's peptidic nature allows illicit entry via a high-affinity route by hijacking the Dpp dipeptide transporter. Transport via a second, low-affinity route is energetically driven by the membrane potential, seemingly without the direct involvement of a transport protein. In mouse thigh models of E. coli infection, no evidence for Dpp-mediated transport of negamycin was found. The implication is that for the design of new negamycin-based analogs, the physicochemical properties required for cell entry via the low-affinity route need to be retained to achieve clinical success in the treatment of infectious diseases. Furthermore, clinical resistance to such analogs due to mutations affecting their ribosomal target or transport is expected to be rare and similar to that of aminoglycosides. PMID:27622650

  7. Positronium Formation in Muscle

    PubMed Central

    Gustafson, D. R.

    1970-01-01

    Positronium formation in muscle at +4°C and -4°C was examined by the measurement of the angular correlation of positron annihilation radiation. Since the positronium formation rate in ice is considerably higher than it is in water, there should be a comparable increase in the positronium formation rate in muscle tissue if recent speculation that cellular water is ordered in a semicrystalline icelike state is correct. Comparison of the angular correlation from muscle at +4°C with that from water at +4°C shows no enhancement of the positronium formation rate. Frozen muscle at -4°C shows an enhancement of the positronium formation rate of approximately half that found in ice at -4°C, indicating that most cellular water undergoes a normal water-ice transition when frozen. It is concluded therefore that cell water in muscle is not ordered in a hexagonal icelike structure. While the results are consistent with the hypothesis that cell water is in the liquid state, the hypothesis that cell water is ordered in an undetermined close packed structure which transforms to the hexagonal ice structure at or near 0°C cannot be ruled out. PMID:5436881

  8. Muscle Injuries in Athletes

    PubMed Central

    Delos, Demetris; Maak, Travis G.; Rodeo, Scott A.

    2013-01-01

    Context: Muscle injuries are extremely common in athletes and often produce pain, dysfunction, and the inability to return to practice or competition. Appropriate diagnosis and management can optimize recovery and minimize time to return to play. Evidence Acquisition: Contemporary papers, both basic science and clinical medicine, that investigate muscle healing were reviewed. A Medline/PubMed search inclusive of years 1948 to 2012 was performed. Results: Diagnosis can usually be made according to history and physical examination for most injuries. Although data are limited, initial conservative management emphasizing the RICE principles and immobilization of the extremity for several days for higher grade injuries are typically all that is required. Injection of corticosteroids may clinically enhance function after an acute muscle strain. Additional adjunctive treatments (nonsteroidal anti-inflammatory drugs, platelet-rich plasma, and others) to enhance muscle healing and limit scar formation show promise but need additional data to better define their roles. Conclusion: Conservative treatment recommendations will typically lead to successful outcomes after a muscle injury. There is limited evidence to support most adjunctive treatments. PMID:24459552

  9. Activity of Colistin in Combination with Meropenem, Tigecycline, Fosfomycin, Fusidic Acid, Rifampin or Sulbactam against Extensively Drug-Resistant Acinetobacter baumannii in a Murine Thigh-Infection Model

    PubMed Central

    Wang, Xiumei; Cong, Yulong

    2016-01-01

    Few effective therapeutic options are available for treating severe infections caused by extensively drug-resistant Acinetobacter baumannii (XDR-AB). Using a murine thigh-infection model, we examined the in vivo efficacy of colistin in combination with meropenem, tigecycline, fosfomycin, fusidic acid, rifampin, or sulbactam against 12 XDR-AB strains. Colistin, tigecycline, rifampin, and sulbactam monotherapy significantly decreased bacterial counts in murine thigh infections compared with those observed in control mice receiving no treatment. Colistin was the most effective agent tested, displaying bactericidal activity against 91.7% of strains at 48 h post-treatment. With strains showing a relatively low minimum inhibitory concentration (MIC) for meropenem (MIC ≤ 32 mg/L), combination therapy with colistin plus meropenem caused synergistic inhibition at both 24 h and 48 h post-treatment. However, when the meropenem MIC was ≥64 mg/L, meropenem did not significantly alter the efficacy of colistin. The addition of rifampin and fusidic acid significantly improved the efficacy of colistin, showing a synergistic effect in 100% and 58.3% of strains after 24 h of treatment, respectively, while the addition of tigecycline, fosfomycin, or sulbactam did not show obvious synergistic activity. No clear differences in activities were observed between colistin-rifampin and colistin-fusidic acid combination therapy with most strains. Overall, our in vivo study showed that administering colistin in combination with rifampin or fusidic acid is more efficacious in treating XDR-AB infections than other combinations. The colistin-meropenem combination may be another appropriate option if the MIC is ≤32 mg/L. Further clinical studies are urgently needed to confirm the relevance of these findings. PMID:27315107

  10. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test.

    PubMed

    Vigotsky, Andrew D; Lehman, Gregory J; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson's r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = -1.39° (-5.53, +2.75); t(22) = -0.70; p = 0.4933; Cohen's d = - 0.15 (-0.58, 0.29)) or rectus femoris length (change = -0.005 (-0.013, +0.003); t(22) = -1.30; p = 0.2070; Cohen's d = - 0.27 (-0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol. PMID:26421244

  11. Artificial muscles on heat

    NASA Astrophysics Data System (ADS)

    McKay, Thomas G.; Shin, Dong Ki; Percy, Steven; Knight, Chris; McGarry, Scott; Anderson, Iain A.

    2014-03-01

    Many devices and processes produce low grade waste heat. Some of these include combustion engines, electrical circuits, biological processes and industrial processes. To harvest this heat energy thermoelectric devices, using the Seebeck effect, are commonly used. However, these devices have limitations in efficiency, and usable voltage. This paper investigates the viability of a Stirling engine coupled to an artificial muscle energy harvester to efficiently convert heat energy into electrical energy. The results present the testing of the prototype generator which produced 200 μW when operating at 75°C. Pathways for improved performance are discussed which include optimising the electronic control of the artificial muscle, adjusting the mechanical properties of the artificial muscle to work optimally with the remainder of the system, good sealing, and tuning the resonance of the displacer to minimise the power required to drive it.

  12. Neural control of muscle

    NASA Technical Reports Server (NTRS)

    Max, S. R.; Markelonis, G. J.

    1983-01-01

    Cholinergic innervation regulates the physiological and biochemical properties of skeletal muscle. The mechanisms that appear to be involved in this regulation include soluble, neurally-derived polypeptides, transmitter-evoked muscle activity and the neurotransmitter, acetylcholine, itself. Despite extensive research, the interacting neural mechanisms that control such macromolecules as acetylcholinesterase, the acetylcholine receptor and glucose 6-phosphate dehydrogenase remain unclear. It may be that more simplified in vitro model systems coupled with recent dramatic advances in the molecular biology of neurally-regulated proteins will begin to allow researchers to unravel the mechanisms controlling the expression and maintenance of these macromolecules.

  13. [Muscle-skeletal pain].

    PubMed

    Vygonskaya, M V; Filatova, E G

    2016-01-01

    The paper is devoted to the most complicated aspects of low back pain. The differences between specific and nonspecific low back pain using the "red flags" system is highlighted. The authors consider the causes of pain chronification (the "yellow flags" system) and the necessity of using a biopsychosocial model. Main pathogenetic mechanisms of chronic muscle/skeletal pain are considered and the possible involvement of several mechanism in the pathogenesis of chronic pain as well as the use of complex therapy is discussed. The high efficacy and safety of ketorolac in treatment of nonspecific muscle/skeletal pain is demonstrated. PMID:27042717

  14. Effect of dietary selenium and omega-3 fatty acids on muscle composition and quality in broilers

    PubMed Central

    Haug, Anna; Eich-Greatorex, Susanne; Bernhoft, Aksel; Wold, Jens P; Hetland, Harald; Christophersen, Olav A; Sogn, Trine

    2007-01-01

    Background Human health may be improved if dietary intakes of selenium and omega-3 fatty acids are increased. Consumption of broiler meat is increasing, and the meat content of selenium and omega-3 fatty acids are affected by the composition of broiler feed. A two-way analyses of variance was used to study the effect of feed containing omega-3 rich plant oils and selenium enriched yeast on broiler meat composition, antioxidation- and sensory parameters. Four different wheat-based dietary treatments supplemented with 5% rapeseed oil or 4% rapeseed oil plus 1% linseed oil, and either 0.50 mg selenium or 0.84 mg selenium (organic form) per kg diet was fed to newly hatched broilers for 22 days. Results The different dietary treatments gave distinct different concentrations of selenium and fatty acids in thigh muscle; one percent linseed oil in the diet increased the concentration of the omega-3 fatty acids 18:3, 20:5 and 22:5, and 0.84 mg selenium per kg diet gave muscle selenium concentration at the same level as is in fish muscle (0.39 mg/kg muscle). The high selenium intake also resulted in increased concentration of the long-chain omega-3 fatty acids EPA (20:5), DPA (22:5) and DHA (22:6), thus it may be speculated if high dietary selenium might have a role in increasing the concentration of EPA, DPA and DHA in tissues after intake of plant oils contning omega-3 fatty acids. Conclusion Moderate modifications of broiler feed may give a healthier broiler meat, having increased content of selenium and omega-3 fatty acids. High intakes of selenium (organic form) may increase the concentration of very long-chain omega-3 fatty acids in muscle. PMID:17967172

  15. Effects of caffeine on muscle glycogen utilization and the neuroendocrine axis during exercise.

    PubMed

    Laurent, D; Schneider, K E; Prusaczyk, W K; Franklin, C; Vogel, S M; Krssak, M; Petersen, K F; Goforth, H W; Shulman, G I

    2000-06-01

    To examine the effect of caffeine ingestion on muscle glycogen utilization and the neuroendocrine axis during exercise, we studied 20 muscle glycogen-loaded subjects who were given placebo or caffeine (6 mg/kg) in a double blinded fashion 90 min before cycling for 2 h at 65% of their maximal oxygen consumption. Exercise-induced glycogen depletion in the thigh muscle was noninvasively measured by means of 13C nuclear magnetic resonance spectroscopy (NMR) spectroscopy, and plasma concentrations of substrates and neuroendocrine hormones, including beta-endorphins, were also assessed. Muscle glycogen content was increased 140% above normal values on the caffeine trial day (P < 0.001). After cycling for 2 h, caffeine ingestion was associated with a greater increase in plasma lactate (caffeine: +1.0 +/- 0.2 mmol/L; placebo, +0.1 +/- 0.2 mmol/L; P < 0.005), epinephrine (caffeine, +223 +/- 82 pg/mL; placebo, +56 +/- 26 pg/mL; P < 0.05), and cortisol (caffeine, +12 +/- 3 mg/mL; placebo, +2 +/- 2 mg/mL; P < 0.001) levels. However, plasma free fatty acid concentrations increased (caffeine, +814 +/- 133 mmol/L; placebo, +785 +/- 85 mmol/L; P = NS), and muscle glycogen content decreased (caffeine, -57 +/- 6 mmol/L muscle; placebo, -53 +/- 5 mmol/L muscle; P = NS) to the same extent in both groups. At the same time, plasma beta-endorphin levels almost doubled (from 30 +/- 5 to 53 +/- 13 pg/mL; P < 0.05) in the caffeine-treated group, whereas no change occurred in the placebo group. We conclude that caffeine ingestion 90 min before prolonged exercise does not exert a muscle glycogen-sparing effect in athletes with high muscle glycogen content. However, these data suggest that caffeine lowers the threshold for exercise-induced beta-endorphin and cortisol release, which may contribute to the reported benefits of caffeine on exercise endurance. PMID:10852448

  16. Reduction of delayed onset muscle soreness by a novel curcumin delivery system (Meriva®): a randomised, placebo-controlled trial

    PubMed Central

    2014-01-01

    Background Delayed onset muscle soreness (DOMS) due to eccentric muscle activity is associated with inflammatory responses and production of reactive oxygen species (ROS) that sustain both inflammation and oxidative stress. Curcumin, a powerful promoter of anti-oxidant response, is one of the best-investigated natural products, and is now commercially available as a lecithin delivery system (Meriva®, Indena SpA, Milan) with improved bio-availability. The aim of this study was to test whether curcumin could attenuate damage from oxidative stress and inflammation related to acute muscle injury induced by eccentric continuous exercise Methods This was a randomised, placebo-controlled, single-blind pilot trial. Twenty male healthy, moderately active volunteers were randomised to curcumin given as the Phytosome® delivery system 1 g twice daily (200 mg curcumin b.i.d.) or matching placebo. Supplementation was initiated 48 hours prior to a downhill running test and was continued for 24 hours after the test (4 days in total). Muscle damage was quantified by magnetic resonance imaging, laboratory tests and histological analyses on muscle samples obtained 48 hours after the test. Patient-reported pain intensity was also recorded. Results Subjects in the curcumin group reported less pain in the lower limb as compared with subjects in the placebo group, although significant differences were observed only for the right and left anterior thighs. Significantly fewer subjects in the curcumin group had MRI evidence of muscle injury in the posterior or medial compartment of both thighs. Increases in markers of muscle damage and inflammation tended to be lower in the curcumin group, but significant differences were only observed for interleukin-8 at 2 h after exercise. No differences in markers of oxidative stress and muscle histology were observed Conclusions Curcumin has the potential for preventing DOMS, as suggested by its effects on pain intensity and muscle injury

  17. Implanted depleted uranium fragments cause soft tissue sarcomas in the muscles of rats.

    PubMed Central

    Hahn, Fletcher F; Guilmette, Raymond A; Hoover, Mark D

    2002-01-01

    In this study, we determined the carcinogenicity of depleted uranium (DU) metal fragments containing 0.75% titanium in muscle tissues of rats. The results have important implications for the medical management of Gulf War veterans who were wounded with DU fragments and who retain fragments in their soft tissues. We compared the tissue reactions in rats to the carcinogenicity of a tantalum metal (Ta), as a negative foreign-body control, and to a colloidal suspension of radioactive thorium dioxide ((232)Th), Thorotrast, as a positive radioactive control. DU was surgically implanted in the thigh muscles of male Wistar rats as four squares (2.5 x 2.5 x 1.5 mm or 5.0 x 5.0 x 1.5 mm) or four pellets (2.0 x 1.0 mm diameter) per rat. Ta was similarly implanted as four squares (5.0 x 5.0 x 1.1 mm) per rat. Thorotrast was injected at two sites in the thigh muscles of each rat. Control rats had only a surgical implantation procedure. Each treatment group included 50 rats. A connective tissue capsule formed around the metal implants, but not around the Thorotrast. Radiographs demonstrated corrosion of the DU implants shortly after implantation. At later times, rarifactions in the radiographic profiles correlated with proliferative tissue responses. After lifetime observation, the incidence of soft tissue sarcomas increased significantly around the 5.0 x 5.0 mm squares of DU and the positive control, Thorotrast. A slightly increased incidence occurred in rats implanted with the 2.5 x 2.5 mm DU squares and with 5.0 x 5.0 mm squares of Ta. No tumors were seen in rats with 2.0 x 1.0 mm diameter DU pellets or in the surgical controls. These results indicate that DU fragments of sufficient size cause localized proliferative reactions and soft tissue sarcomas that can be detected with radiography in the muscles of rats. PMID:11781165

  18. Hemodynamic and oxidative mechanisms of tourniquet-induced muscle injury: near-infrared spectroscopy for the orthopedics setting

    NASA Astrophysics Data System (ADS)

    Shadgan, Babak; Reid, W. Darlene; Harris, R. Luke; Jafari, Siavash; Powers, Scott K.; O'Brien, Peter J.

    2012-08-01

    During orthopedic procedures, the tourniquets used to maintain bloodless surgical fields cause ischemia and then reperfusion (I/R), leading to oxidative muscle injury. Established methods exist neither for monitoring orthopedic I/R nor for predicting the extent of tourniquet-associated oxidative injury. To develop a predictive model for tourniquet-associated oxidative muscle injury, this study combined real-time near-infrared spectroscopy (NIRS) monitoring of I/R with Western blotting (WB) for oxidized proteins. We hypothesized strong correlations between NIRS-derived I/R indices and muscle protein oxidation. In 17 patients undergoing ankle fracture repair, a thigh tourniquet was inflated on the injured limb (300 mmHg). Using a continuous-wave (CW) NIRS setup, oxygenated (O2Hb), deoxygenated (HHb), and total (tHb) hemoglobin were monitored bilaterally (tourniquet versus control) in leg muscles. Leg muscle biopsies were collected unilaterally (tourniquet side) immediately after tourniquet inflation (pre) and before deflation (post). Average ischemia duration was 43.2±14.6 min. In post-compared to pre-biopsies, muscle protein oxidation (quantified using WB) increased 172.3%±145.7% (P<0.0005). Changes in O2Hb and tHb were negatively correlated with protein oxidation (respectively: P=0.040, R2=0.25 and P=0.003, R2=0.58). Reoxygenation rate was positively correlated with protein oxidation (P=0.041, R2=0.25). These data indicate that using CW NIRS, it is possible to predict orthopedic tourniquet-associated muscle oxidative injury noninvasively.

  19. Inter-sport variability of muscle volume distribution identified by segmental bioelectrical impedance analysis in four ball sports

    PubMed Central

    Yamada, Yosuke; Masuo, Yoshihisa; Nakamura, Eitaro; Oda, Shingo

    2013-01-01

    The aim of this study was to evaluate and quantify differences in muscle distribution in athletes of various ball sports using segmental bioelectrical impedance analysis (SBIA). Participants were 115 male collegiate athletes from four ball sports (baseball, soccer, tennis, and lacrosse). Percent body fat (%BF) and lean body mass were measured, and SBIA was used to measure segmental muscle volume (MV) in bilateral upper arms, forearms, thighs, and lower legs. We calculated the MV ratios of dominant to nondominant, proximal to distal, and upper to lower limbs. The measurements consisted of a total of 31 variables. Cluster and factor analyses were applied to identify redundant variables. The muscle distribution was significantly different among groups, but the %BF was not. The classification procedures of the discriminant analysis could correctly distinguish 84.3% of the athletes. These results suggest that collegiate ball game athletes have adapted their physique to their sport movements very well, and the SBIA, which is an affordable, noninvasive, easy-to-operate, and fast alternative method in the field, can distinguish ball game athletes according to their specific muscle distribution within a 5-minute measurement. The SBIA could be a useful, affordable, and fast tool for identifying talents for specific sports. PMID:24379714

  20. Limb girdle muscular dystrophy type 2G with myopathic-neurogenic motor unit potentials and a novel muscle image pattern

    PubMed Central

    2014-01-01

    Background Limb girdle muscular dystrophy type 2G (LGMD2G) is a subtype of autosomal recessive muscular dystrophy caused by mutations in the telethonin gene. There are few LGMD2G patients worldwide reported, and this is the first description associated with early tibialis anterior sparing on muscle image and myopathic-neurogenic motor unit potentials. Case presentation Here we report a 31 years old caucasian male patient with progressive gait disturbance, and severe lower limb proximal weakness since the age of 20 years, associated with subtle facial muscle weakness. Computed tomography demonstrated soleus, medial gastrocnemius, and diffuse thigh muscles involvement with tibialis anterior sparing. Electromyography disclosed both neurogenic and myopathic motor unit potentials. Muscle biopsy demonstrated large groups of atrophic and hypertrophic fibers, frequent fibers with intracytoplasmic rimmed vacuoles full of autophagic membrane and sarcoplasmic debris, and a total deficiency of telethonin. Molecular investigation identified the common homozygous c.157C > T in the TCAP gene. Conclusion This report expands the phenotypic variability of telethoninopathy/ LGMD2G, including: 1) mixed neurogenic and myopathic motor unit potentials, 2) facial weakness, and 3) tibialis anterior sparing. Appropriate diagnosis in these cases is important for genetic counseling and prognosis. PMID:25298746

  1. Eye muscle repair - series (image)

    MedlinePlus

    ... the eyeball to the eye socket. The external muscles of the eye are found behind the conjunctiva. ... The extraocular muscles of the eye (external to the eyeball) control the positioning of the eyes. They coordinate of the eye ...

  2. Anti-smooth muscle antibody

    MedlinePlus

    ... medlineplus.gov/ency/article/003531.htm Anti-smooth muscle antibody To use the sharing features on this page, please enable JavaScript. Anti-smooth muscle antibody is a blood test that detects the ...

  3. Sports Hernia: Misdiagnosed Muscle Strain

    MedlinePlus

    ... Manipulative Treatment Becoming a DO Video Library Misdiagnosed Muscle Strain Can Be A Pain Page Content If ... speeds, sports hernias are frequently confused with common muscle strain ,” says Michael Sampson, DO, who practices in ...

  4. Muscle Cramp - A Common Pain

    MedlinePlus

    ... Osteopathic Manipulative Treatment Becoming a DO Video Library Muscle Cramp – A Common Pain Page Content Has a ... body’s natural tendency toward self-healing. Causes of Muscle Cramps Unfortunately, cramps can occur anywhere, anytime to ...

  5. Active vs. inactive muscle (image)

    MedlinePlus

    ... may lose 20 to 40 percent of their muscle -- and, along with it, their strength -- as they ... have found that a major reason people lose muscle is because they stop doing everyday activities that ...

  6. Fluid mechanics of muscle vibrations.

    PubMed Central

    Barry, D T; Cole, N M

    1988-01-01

    The pressure field produced by an isometrically contracting frog gastrocnemius muscle is described by the fluid mechanics equations for a vibrating sphere. The equations predict a pressure amplitude that is proportional to the lateral acceleration of the muscle, inversely proportional to the square of the distance from the muscle, and cosinusoidally related to the major axis of lateral movement. The predictions are confirmed by experiments that measure the pressure amplitude distribution and by photographs of muscle movement during contraction. The lateral movement of muscle has the appearance of an oscillating system response to a step function input--the oscillation may be at the resonant frequency of the muscle and therefore may provide a means to measure muscle stiffness without actually touching the muscle. PMID:3260803

  7. A Rare Case of Perforated Descending Colon Cancer Complicated with a Fistula and Abscess of Left Iliopsoas and Ipsilateral Obturator Muscle

    PubMed Central

    Cacurri, Alban; Trastulli, Stefano; Desiderio, Jacopo; Pressi, Eleonora; Giovannelli, Giorgio; Parisi, Amilcare

    2014-01-01

    Perforation of descending colon cancer combined with iliopsoas abscess and fistula formation is a rare condition and has been reported few times. A 67-year-old man came to our first aid for an acute pain in the left iliac fossa, in the flank, and in the ipsilateral thigh. Ultrasonography and computed tomography revealed a left abdominal wall, retroperitoneal, and iliopsoas abscess that also involved the ipsilateral obturator muscle. It proceeded with an exploratory laparotomy that showed a tumor of the descending colon adhered and perforated in the retroperitoneum with abscess of the iliopsoas muscle on the left-hand side, with presence of a fistula and liver metastases. A left hemicolectomy with drainage of the broad abscess was performed. Pathologic report findings determined adenocarcinoma of the resected colon. PMID:24744948

  8. Genetics Home Reference: rippling muscle disease

    MedlinePlus

    ... Genetics Home Health Conditions rippling muscle disease rippling muscle disease Enable Javascript to view the expand/collapse ... Download PDF Open All Close All Description Rippling muscle disease is a condition in which the muscles ...

  9. Contractures and muscle disease.

    PubMed

    Walters, R Jon

    2016-08-01

    Contractures are one of a handful of signs in muscle disease, besides weakness and its distribution, whose presence can help guide us diagnostically, a welcome star on the horizon. Contractures are associated with several myopathies, some with important cardiac manifestations, and consequently are important to recognise; their presence may also provide us with a potential satisfying 'penny dropping' diagnostic moment. PMID:26867558

  10. Sculpturing new muscle phenotypes

    NASA Technical Reports Server (NTRS)

    Babij, P.; Booth, F. W.

    1988-01-01

    Changes in the pattern of muscle activity are followed by new patterns of protein synthesis, both in the contractile elements and in the enzymes of energy metabolism. Although the signal transducers have not been identified, techniques of molecular biology have clearly shown that the adaptive responses are the regulated consequence of differential gene expression.

  11. Hindlimb suspension reduces muscle regeneration

    NASA Technical Reports Server (NTRS)

    Mozdziak, P. E.; Truong, Q.; Macius, A.; Schultz, E.

    1998-01-01

    Exposure of juvenile skeletal muscle to a weightless environment reduces growth and satellite cell mitotic activity. However, the effect of a weightless environment on the satellite cell population during muscle repair remains unknown. Muscle injury was induced in rat soleus muscles using the myotoxic snake venom, notexin. Rats were placed into hindlimb-suspended or weightbearing groups for 10 days following injury. Cellular proliferation during regeneration was evaluated using 5-bromo-2'-deoxyuridine (BrdU) immunohistochemistry and image analysis. Hindlimb suspension reduced (P < 0.05) regenerated muscle mass, regenerated myofiber diameter, uninjured muscle mass, and uninjured myofiber diameter compared to weightbearing rats. Hindlimb suspension reduced (P < 0.05) BrdU labeling in uninjured soleus muscles compared to weight-bearing muscles. However, hindlimb suspension did not abolish muscle regeneration because myofibers formed in the injured soleus muscles of hindlimb-suspended rats, and BrdU labeling was equivalent (P > 0.10) on myofiber segments isolated from the soleus muscles of hindlimb-suspended and weightbearing rats following injury. Thus, hindlimb suspension (weightlessness) does not suppress satellite cell mitotic activity in regenerating muscles before myofiber formation, but reduces growth of the newly formed myofibers.

  12. Effects of Active Individual Muscle Stretching on Muscle Function

    PubMed Central

    Nakamura, Kouichi; Kodama, Takayuki; Mukaino, Yoshito

    2014-01-01

    [Purpose] We investigated the effect of active individual muscle stretching (AID) on muscle function. [Subjects] We used the right legs of 40 healthy male students. [Methods] Subjects were divided into an AID group, which performed stretching, and a control group, which did not. We examined and compared muscle function before and after stretching in the AID and control groups using a goniometer and Cybex equipment. [Results] A significant increase in flexibility and a significant decrease in muscle strength output were observed in the AID group after the intervention. [Conclusion] These results suggest that AID induces an increase in flexibility and a temporary decrease in muscle output strength. PMID:24707080

  13. Dystrophic calcification in muscles of legs in calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly, and telangiectasia syndrome: Accurate evaluation of the extent with (99m)Tc-methylene diphosphonate single photon emission computed tomography/computed tomography.

    PubMed

    Chakraborty, Partha Sarathi; Karunanithi, Sellam; Dhull, Varun Singh; Kumar, Kunal; Tripathi, Madhavi

    2015-01-01

    We present the case of a 35-year-old man with calcinosis, Raynaud's phenomenon, esophageal dysmotility, sclerodactyly and telangiectasia variant scleroderma who presented with dysphagia, Raynaud's phenomenon and calf pain. (99m)Tc-methylene diphosphonate bone scintigraphy was performed to identify the extent of the calcification. It revealed extensive dystrophic calcification in the left thigh and bilateral legs which was involving the muscles and was well-delineated on single photon emission computed tomography/computed tomography. Calcinosis in scleroderma usually involves the skin but can be found in deeper periarticular tissues. Myopathy is associated with a poor prognosis. PMID:26430328

  14. Nerve-muscle interactions during flight muscle development in Drosophila

    NASA Technical Reports Server (NTRS)

    Fernandes, J. J.; Keshishian, H.

    1998-01-01

    During Drosophila pupal metamorphosis, the motoneurons and muscles differentiate synchronously, providing an opportunity for extensive intercellular regulation during synapse formation. We examined the existence of such interactions by developmentally delaying or permanently eliminating synaptic partners during the formation of indirect flight muscles. When we experimentally delayed muscle development, we found that although adult-specific primary motoneuron branching still occurred, the higher order (synaptic) branching was suspended until the delayed muscle fibers reached a favourable developmental state. In reciprocal experiments we found that denervation caused a decrease in the myoblast pool. Furthermore, the formation of certain muscle fibers (dorsoventral muscles) was specifically blocked. Exceptions were the adult muscles that use larval muscle fibers as myoblast fusion targets (dorsal longitudinal muscles). However, when these muscles were experimentally compelled to develop without their larval precursors, they showed an absolute dependence on the motoneurons for their formation. These data show that the size of the myoblast pool and early events in fiber formation depend on the presence of the nerve, and that, conversely, peripheral arbor development and synaptogenesis is closely synchronized with the developmental state of the muscle.

  15. The muscle spindle as a feedback element in muscle control

    NASA Technical Reports Server (NTRS)

    Andrews, L. T.; Iannone, A. M.; Ewing, D. J.

    1973-01-01

    The muscle spindle, the feedback element in the myotatic (stretch) reflex, is a major contributor to muscular control. Therefore, an accurate description of behavior of the muscle spindle during active contraction of the muscle, as well as during passive stretch, is essential to the understanding of muscle control. Animal experiments were performed in order to obtain the data necessary to model the muscle spindle. Spectral density functions were used to identify a linear approximation of the two types of nerve endings from the spindle. A model reference adaptive control system was used on a hybrid computer to optimize the anatomically defined lumped parameter estimate of the spindle. The derived nonlinear model accurately predicts the behavior of the muscle spindle both during active discharge and during its silent period. This model is used to determine the mechanism employed to control muscle movement.

  16. Muscle microvasculature's structural and functional specializations facilitate muscle metabolism.

    PubMed

    Kusters, Yvo H A M; Barrett, Eugene J

    2016-03-15

    We review the evolving findings from studies that examine the relationship between the structural and functional properties of skeletal muscle's vasculature and muscle metabolism. Unique aspects of the organization of the muscle microvasculature are highlighted. We discuss the role of vasomotion at the microscopic level and of flowmotion at the tissue level as modulators of perfusion distribution in muscle. We then consider in some detail how insulin and exercise each modulate muscle perfusion at both the microvascular and whole tissue level. The central role of the vascular endothelial cell in modulating both perfusion and transendothelial insulin and nutrient transport is also reviewed. The relationship between muscle metabolic insulin resistance and the vascular action of insulin in muscle continues to indicate an important role for the microvasculature as a target for insulin action and that impairing insulin's microvascular action significantly affects body glucose metabolism. PMID:26714849

  17. Muscle-specific vascular endothelial growth factor deletion induces muscle capillary rarefaction creating muscle insulin resistance.

    PubMed

    Bonner, Jeffrey S; Lantier, Louise; Hasenour, Clinton M; James, Freyja D; Bracy, Deanna P; Wasserman, David H

    2013-02-01

    Muscle insulin resistance is associated with a reduction in vascular endothelial growth factor (VEGF) action and muscle capillary density. We tested the hypothesis that muscle capillary rarefaction critically contributes to the etiology of muscle insulin resistance in chow-fed mice with skeletal and cardiac muscle VEGF deletion (mVEGF(-/-)) and wild-type littermates (mVEGF(+/+)) on a C57BL/6 background. The mVEGF(-/-) mice had an ~60% and ~50% decrease in capillaries in skeletal and cardiac muscle, respectively. The mVEGF(-/-) mice had augmented fasting glucose turnover. Insulin-stimulated whole-body glucose disappearance was blunted in mVEGF(-/-) mice. The reduced peripheral glucose utilization during insulin stimulation was due to diminished in vivo cardiac and skeletal muscle insulin action and signaling. The decreased insulin-stimulated muscle glucose uptake was independent of defects in insulin action at the myocyte, suggesting that the impairment in insulin-stimulated muscle glucose uptake was due to poor muscle perfusion. The deletion of VEGF in cardiac muscle did not affect cardiac output. These studies emphasize the importance for novel therapeutic approaches that target the vasculature in the treatment of insulin-resistant muscle. PMID:23002035

  18. Acute effects of anterior thigh foam rolling on hip angle, knee angle, and rectus femoris length in the modified Thomas test

    PubMed Central

    Lehman, Gregory J.; Contreras, Bret; Beardsley, Chris; Chung, Bryan; Feser, Erin H.

    2015-01-01

    Background. Foam rolling has been shown to acutely increase range of motion (ROM) during knee flexion and hip flexion with the experimenter applying an external force, yet no study to date has measured hip extensibility as a result of foam rolling with controlled knee flexion and hip extension moments. The purpose of this study was to investigate the acute effects of foam rolling on hip extension, knee flexion, and rectus femoris length during the modified Thomas test. Methods. Twenty-three healthy participants (male = 7; female = 16; age = 22 ± 3.3 years; height = 170 ± 9.18 cm; mass = 67.7 ± 14.9 kg) performed two, one-minute bouts of foam rolling applied to the anterior thigh. Hip extension and knee flexion were measured via motion capture before and after the foam rolling intervention, from which rectus femoris length was calculated. Results. Although the increase in hip extension (change = +1.86° (+0.11, +3.61); z(22) = 2.08; p = 0.0372; Pearson’s r = 0.43 (0.02, 0.72)) was not due to chance alone, it cannot be said that the observed changes in knee flexion (change = −1.39° (−5.53, +2.75); t(22) = −0.70; p = 0.4933; Cohen’s d = − 0.15 (−0.58, 0.29)) or rectus femoris length (change = −0.005 (−0.013, +0.003); t(22) = −1.30; p = 0.2070; Cohen’s d = − 0.27 (−0.70, 0.16)) were not due to chance alone. Conclusions. Although a small change in hip extension was observed, no changes in knee flexion or rectus femoris length were observed. From these data, it appears unlikely that foam rolling applied to the anterior thigh will improve passive hip extension and knee flexion ROM, especially if performed in combination with a dynamic stretching protocol. PMID:26421244

  19. Skeletal muscle adaptations and muscle genomics of performance horses.

    PubMed

    Rivero, José-Luis L; Hill, Emmeline W

    2016-03-01

    Skeletal muscles in horses are characterised by specific adaptations, which are the result of the natural evolution of the horse as a grazing animal, centuries of selective breeding and the adaptability of this tissue in response to training. These adaptations include an increased muscle mass relative to body weight, a great locomotor efficiency based upon an admirable muscle-tendon architectural design and an adaptable fibre-type composition with intrinsic shortening velocities greater than would be predicted from an animal of comparable body size. Furthermore, equine skeletal muscles have a high mitochondrial volume that permits a higher whole animal aerobic capacity, as well as large intramuscular stores of energy substrates (glycogen in particular). Finally, high buffer and lactate transport capacities preserve muscles against fatigue during anaerobic exercise. Many of these adaptations can improve with training. The publication of the equine genome sequence in 2009 has provided a major advance towards an improved understanding of equine muscle physiology. Equine muscle genomics studies have revealed a number of genes associated with elite physical performance and have also identified changes in structural and metabolic genes following exercise and training. Genes involved in muscle growth, muscle contraction and specific metabolic pathways have been found to be functionally relevant for the early performance evaluation of elite athletic horses. The candidate genes discussed in this review are important for a healthy individual to improve performance. However, muscle performance limiting conditions are widespread in horses and many of these conditions are also genetically influenced. PMID:26831154

  20. Mentalis muscle related reflexes.

    PubMed

    Gündüz, Ayşegül; Uyanık, Özlem; Ertürk, Özdem; Sohtaoğlu, Melis; Kızıltan, Meral Erdemir

    2016-05-01

    The mentalis muscle (MM) arises from the incisive fossa of the mandible, raises and protrudes the lower lip. Here, we aim to characterize responses obtained from MM by supraorbital and median electrical as well as auditory stimuli in a group of 16 healthy volunteers who did not have clinical palmomental reflex. Reflex activities were recorded from the MM and orbicularis oculi (O.oc) after supraorbital and median electrical as well as auditory stimuli. Response rates over MM were consistent after each stimulus, however, mean latencies of MM response were longer than O.oc responses by all stimulation modalities. Shapes and amplitudes of responses from O.oc and MM were similar. Based on our findings, we may say that MM motoneurons have connections with trigeminal, vestibulocochlear and lemniscal pathways similar to other facial muscles and electrophysiological recording of MM responses after electrical and auditory stimulation is possible in healthy subjects. PMID:26721248

  1. Piriformis muscle syndrome.

    PubMed

    Kuncewicz, Elzbieta; Gajewska, Ewa; Sobieska, Magdalena; Samborski, Włodzimierz

    2006-01-01

    Sciatica is characterized by radiating pain from the sacro-lumbar region to the buttocks and down to the lower limb. The causes of sciatica usually relate to degenerative changes in the spine and lesions to the intervertebral discs. Secondary symptomatic sciatica may by caused by metastases to the vertebra, tuberculosis of the spine, tumors located inside the vertebral channel, or entrapment of the sciatic nerve in the piriformis muscle. The piriformis syndrome is primarily caused by fall injury, but other causes are possible, including pyomyositis, dystonia musculorum deformans, and fibrosis after deep injections. Secondary causes like irritation of the sacroiliac joint or lump near the sciatic notch have been described. In the general practice the so-called posttraumatic piriformis muscle syndrome is common. The right treatment can be started following a thorough investigation into the cause of symptoms. PMID:17385355

  2. Mechanotransduction in skeletal muscle

    PubMed Central

    Burkholder, Thomas J.

    2007-01-01

    Mechanical signals are critical to the development and maintenance of skeletal muscle, but the mechanisms that convert these shape changes to biochemical signals is not known. When a deformation is imposed on a muscle, changes in cellular and molecular conformations link the mechanical forces with biochemical signals, and the close integration of mechanical signals with electrical, metabolic, and hormonal signaling may disguise the aspect of the response that is specific to the mechanical forces. The mechanically induced conformational change may directly activate downstream signaling and may trigger messenger systems to activate signaling indirectly. Major effectors of mechanotransduction include the ubiquitous mitogen activated protein kinase (MAP) and phosphatidylinositol-3’ kinase (PI-3K), which have well described receptor dependent cascades, but the chain of events leading from mechanical stimulation to biochemical cascade is not clear. This review will discuss the mechanics of biological deformation, loading of cellular and molecular structures, and some of the principal signaling mechanisms associated with mechanotransduction. PMID:17127292

  3. Muscle Motion Solenoid Actuator

    NASA Astrophysics Data System (ADS)

    Obata, Shuji

    It is one of our dreams to mechanically recover the lost body for damaged humans. Realistic humanoid robots composed of such machines require muscle motion actuators controlled by all pulling actions. Particularly, antagonistic pairs of bi-articular muscles are very important in animal's motions. A system of actuators is proposed using the electromagnetic force of the solenoids with the abilities of the stroke length over 10 cm and the strength about 20 N, which are needed to move the real human arm. The devised actuators are based on developments of recent modern electro-magnetic materials, where old time materials can not give such possibility. Composite actuators are controlled by a high ability computer and software making genuine motions.

  4. Hyperammonemia results in reduced muscle function independent of muscle mass.

    PubMed

    McDaniel, John; Davuluri, Gangarao; Hill, Elizabeth Ann; Moyer, Michelle; Runkana, Ashok; Prayson, Richard; van Lunteren, Erik; Dasarathy, Srinivasan

    2016-02-01

    The mechanism of the nearly universal decreased muscle strength in cirrhosis is not known. We evaluated whether hyperammonemia in cirrhosis causes contractile dysfunction independent of reduced skeletal muscle mass. Maximum grip strength and muscle fatigue response were determined in cirrhotic patients and controls. Blood and muscle ammonia concentrations and grip strength normalized to lean body mass were measured in the portacaval anastomosis (PCA) and sham-operated pair-fed control rats (n = 5 each). Ex vivo contractile studies in the soleus muscle from a separate group of Sprague-Dawley rats (n = 7) were performed. Skeletal muscle force of contraction, rate of force development, and rate of relaxation were measured. Muscles were also subjected to a series of pulse trains at a range of stimulation frequencies from 20 to 110 Hz. Cirrhotic patients had lower maximum grip strength and greater muscle fatigue than control subjects. PCA rats had a 52.7 ± 13% lower normalized grip strength compared with control rats, and grip strength correlated with the blood and muscle ammonia concentrations (r(2) = 0.82). In ex vivo muscle preparations following a single pulse, the maximal force, rate of force development, and rate of relaxation were 12.1 ± 3.5 g vs. 6.2 ± 2.1 g; 398.2 ± 100.4 g/s vs. 163.8 ± 97.4 g/s; -101.2 ± 22.2 g/s vs. -33.6 ± 22.3 g/s in ammonia-treated compared with control muscle preparation, respectively (P < 0.001 for all comparisons). Tetanic force, rate of force development, and rate of relaxation were depressed across a range of stimulation from 20 to 110 Hz. These data provide the first direct evidence that hyperammonemia impairs skeletal muscle strength and increased muscle fatigue and identifies a potential therapeutic target in cirrhotic patients. PMID:26635319

  5. [Myokines - muscle tissue hormones].

    PubMed

    Stránská, Zuzana; Svačina, Štěpán

    2015-04-01

    Physical inactivity is demonstrably related to the manifestation of chronic diseases which significantly modify the quality and prognosis of life in a negative way. The benefits of exercise are surely mediated by many pathophysiological mechanisms interrelated in varying degrees, which have not yet been fully examined in their complexity. In the late 20th century it was positively proven that a working striated muscle really regulates the metabolic and physiological response in the other organs. These involve several hundred substances with autocrine, paracrine and endocrine effects. These proteins and peptides, if released into the blood stream, substantially affect the metabolism of distant organs. They were classified as "myokines" (cytokines produced by myocytes). The identified myokines include e.g. IL4, IL6, IL7, IL15, myostatin, LIF (leukemia inhibitory factor), BDNF (brain-derived neurotrophic factor), IGF1 (insulin-like growth factor), FGF2 (fibroblast growth factor 2), FGF21, FSTL1 (follistatin-related protein 1), irisin, EPO (erythropoetin) and BAIBA (β-aminoisobutyric acid). Myokines have first of all an immunoregulatory role in the human body. Another important effect of myokines is, coincidentally also in the interaction with adipose tissue, the regulation of energy homeostasis. They also affect the growth of muscle fibres and their regeneration, stimulate angiogenesis, they are involved in the regulation of glucose metabolism and have a proven effect on lipids. Considering their diverse function, myokines present a prospective therapeutic goal in the treatment of disorders of muscle growth and regeneration as well as obesity. Another recent research moves toward uncovering of the "myokine resistance" as a result of long-term muscle inactivity and its association with chronic subclinical inflammation. PMID:25894270

  6. Relationships Between Lower-Body Muscle Structure and, Lower-Body Strength, Explosiveness and Eccentric Leg Stiffness in Adolescent Athletes

    PubMed Central

    Secomb, Josh L.; Nimphius, Sophia; Farley, Oliver R.L.; Lundgren, Lina E.; Tran, Tai T.; Sheppard, Jeremy M.

    2015-01-01

    The purpose of the present study was to determine whether any relationships were present between lower-body muscle structure and, lower-body strength, variables measured during a countermovement jump (CMJ) and squat jump (SJ), and eccentric leg stiffness, in adolescent athletes. Thirty junior male (n = 23) and female (n = 7) surfing athletes (14.8 ± 1.7 y; 1.63 ± 0.09 m; 54.8 ± 12.1 kg) undertook lower-body muscle structure assessment with ultrasonography and performed a; CMJ, SJ and an isometric mid-thigh pull (IMTP). In addition, eccentric leg stiffness was calculated from variables of the CMJ and IMTP. Moderate to very large relationships (r = 0.46-0.73) were identified between the thickness of the vastus lateralis (VL) and lateral gastrocnemius (LG) muscles, and VL pennation angle and; peak force (PF) in the CMJ, SJ and IMTP. Additionally, moderate to large relationships (r = 0.37-0.59) were found between eccentric leg stiffness and; VL and LG thickness, VL pennation angle, and LG fascicle length, with a large relationship (r = 0.59) also present with IMTP PF. These results suggest that greater thickness of the VL and LG were related to improved maximal dynamic and isometric strength, likely due to increased hypertrophy of the extensor muscles. Furthermore, this increased thickness was related to greater eccentric leg stiffness, as the associated enhanced lower-body strength likely allowed for greater neuromuscular activation, and hence less compliance, during a stretch-shortening cycle. Key points Greater thickness of the VL and LG muscles were significantly related to an enhanced ability to express higher levels of isometric and dynamic strength, and explosiveness in adolescent athletes. Isometric strength underpinned performance in the CMJ and SJ in these athletes. Greater lower-body isometric strength was significantly related to eccentric leg stiffness, which is potentially the result of greater neuromuscular activation in the muscle-tendon unit. PMID

  7. Muscle paralysis in thyrotoxicosis.

    PubMed

    Siddiqui, Fraz Anwar; Sheikh, Aisha

    2015-01-01

    Thyrotoxic periodic paralysis (TPP) is a condition characterised by muscle paralysis due to hypokalaemia usually secondary to thyrotoxicosis. We report a case of a 31-year-old man with no known comorbidities who presented to a tertiary healthcare unit with a 1-month history of difficulty in breathing, palpitations, weight loss and hoarseness of voice. On examination, his thyroid gland was palpable and fine hand tremors were present. An initial provisional diagnosis of hyperthyroidism was made. Three months after initial presentation, the patient presented in emergency with severe muscle pain and inability to stand. Laboratory results revealed hypokalaemia. All the symptoms reverted over the next few hours on administration of intravenous potassium. A diagnosis of TTP was established. After initial presentation, the patient was treated with carbimazole and propranolol. Once he was euthyroid, radioactive iodine ablation therapy (15 mCi) was carried out as definitive therapy, after which the patient's symptoms resolved; he is currently doing fine on levothyroxine replacement and there has been no recurrence of muscle paralysis. PMID:26025973

  8. Acute effects of ginger extract on biochemical and functional symptoms of delayed onset muscle soreness

    PubMed Central

    Hoseinzadeh, Khadijeh; Daryanoosh, Farhad; Baghdasar, Parvin Javad; Alizadeh, Hamid

    2015-01-01

    Background: Inflammation and pain induced by delayed onset muscle soreness (DOMS) as a result of eccentric exercise (EE) or unaccustomed activity cause some difficulties in exercise for athletes. The purpose of this study was to survey the effect of ginger extract on biochemical and functional symptom of delayed onset muscle soreness. Methods: In a quasi-experimental study, 36 healthy female subjects, who were recruited by intra dormitory calls, randomly divided into 3 groups, including: ginger intake 1 hour before exercise (GIBE), ginger intake immediately after exercise (GIAE) and placebo group (PL). Subjects consumed capsules contain 60 mg of ginger extract (equivalent of 2 g dried ginger powder) or placebo before and after exercise. The exercise protocol consisted of a 20 minute step test using a 46cm step at a rate of 15 steps per minute. The blood samples were taken before, 1, 24 and 48 hour after exercise to assay creatine kinase (CK) and interleukin-6 (IL-6). Muscle pain scores, isometric strength and circumference of thigh muscle, and hip range of motion were recorded at mentioned times. The analysis of variance (ANOVA) with repeated measure was used to determine the differences between groups. Results: The results showed a significant reduction of pain in GIBE compared to GIAE after 24 and 48h of EE and GIAE compared to PL (p<0.05). IL-6 changed significantly in GIBE compared to PL (p<0.05) after 1, 24, and 48h after EE. The other factors didn’t change meaningfully. Conclusion: The finding of this study suggests that 2 grams of ginger may have anti-inflammation and analgesic effect on DOMS. PMID:26793652

  9. Pathological changes associated with white striping in broiler breast muscles.

    PubMed

    Kuttappan, V A; Shivaprasad, H L; Shaw, D P; Valentine, B A; Hargis, B M; Clark, F D; McKee, S R; Owens, C M

    2013-02-01

    White striping is a condition in broiler chickens characterized grossly by the occurrence of white striations, seen parallel to the direction of muscle fibers, on broiler breast fillets and thighs. Based on visual evaluation of the intensity of white striping, breast fillets can be categorized into normal (NORM), moderate (MOD), and severe (SEV) categories. This study was undertaken to evaluate the details of changes in histology as well as proximate composition occurring in the fillets with respect to the 3 degrees of white striping. In experiment 1, representative breast fillets for each degree of white striping (n = 20) were collected from 45-d-old broilers, approximately 2 h postmortem. From each fillet, 2 skeletal muscle samples were obtained and fixed in 10% neutral buffered formalin. To identify and differentiate the histological changes, slides were prepared and stained using hematoxylin and eosin, Masson's Trichrome, and Oil Red O stains. In experiment 2, samples with 3 degrees of white striping were collected from 57-d-old birds for conducting proximate analysis. Major histopathological changes observed in the MOD and SEV samples consisted of loss of cross striations, variability in fiber size, floccular/vacuolar degeneration and lysis of fibers, mild mineralization, occasional regeneration (nuclear rowing and multinucleated cells), mononuclear cell infiltration, lipidosis, and interstitial inflammation and fibrosis. Microscopic lesions were visually scored for degeneration and necrosis, fibrosis, and lipidosis. The scale used to score the samples ranged from 0 (normal) to 3 (severe). There was an increase (P < 0.05) in mean scores for degenerative or necrotic lesions, fibrosis, and lipidosis as the degree of white striping increased from NORM to SEV. The results from the histopathological study were supported by the findings from proximate analysis confirming that the fat and protein contents of muscle increased (P < 0.05) and decreased (P < 0

  10. Correlative analysis of MRI-evident abductor hip muscle degeneration and power after minimally invasive versus conventional unilateral cementless THA.

    PubMed

    Vasilakis, Ioannis; Solomou, Ekaterini; Vitsas, Vasilis; Fennema, Peter; Korovessis, Panagiotis; Siamblis, Dimitrios K

    2012-12-01

    The 2 main null hypotheses of this study were: (1) the 4-year surgical trauma-related degeneration within the hip abductor muscles after a minimally invasive approach to total hip arthroplasty would be similar to that following a conventional approach; and (2) no differences in perioperative blood loss or postoperative hip pain would be observed between the minimally invasive and conventional approaches.In 40 consecutive randomly selected adult patients with unilateral primary hip osteoarthritis, a cementless Zweymüller-Plus THA (Smith & Nephew Orthopaedics, Baar, Switzerland) was implanted by a single surgeon in 1 institution during the same period. Twenty patients underwent a minimally invasive approach (group A), and 20 patients underwent a conventional anterolateral approach (group B). Four years postoperatively, the operated and contralateral nonoperated hips of 37 available patients from both groups were examined with magnetic resonance imaging to show any changes in the gluteus medius and tensor fascia latae. Simultaneously, hip abductor power was measured bilaterally in both groups. Anthropometric data, blood loss, Short Form 36 self-assessment questionnaire, visual analog pain score, and walking distance were also analyzed.The reliability of magnetic resonance imaging and hip abductor power measurements was high. No difference was found in hip abductor power on the operated side between the 2 groups, whereas hip abductor power on the nonoperated side was significantly higher in both groups. This study revealed no mechanical and functional benefits in favor of patients undergoing minimally invasive vs conventional total hip arthroplasty. PMID:23218622

  11. Skeletal muscle satellite cells

    NASA Technical Reports Server (NTRS)

    Schultz, E.; McCormick, K. M.

    1994-01-01

    Evidence now suggests that satellite cells constitute a class of myogenic cells that differ distinctly from other embryonic myoblasts. Satellite cells arise from somites and first appear as a distinct myoblast type well before birth. Satellite cells from different muscles cannot be functionally distinguished from one another and are able to provide nuclei to all fibers without regard to phenotype. Thus, it is difficult to ascribe any significant function to establishing or stabilizing fiber type, even during regeneration. Within a muscle, satellite cells exhibit marked heterogeneity with respect to their proliferative behavior. The satellite cell population on a fiber can be partitioned into those that function as stem cells and those which are readily available for fusion. Recent studies have shown that the cells are not simply spindle shaped, but are very diverse in their morphology and have multiple branches emanating from the poles of the cells. This finding is consistent with other studies indicating that the cells have the capacity for extensive migration within, and perhaps between, muscles. Complexity of cell shape usually reflects increased cytoplasmic volume and organelles including a well developed Golgi, and is usually associated with growing postnatal muscle or muscles undergoing some form of induced adaptive change or repair. The appearance of activated satellite cells suggests some function of the cells in the adaptive process through elaboration and secretion of a product. Significant advances have been made in determining the potential secretion products that satellite cells make. The manner in which satellite cell proliferative and fusion behavior is controlled has also been studied. There seems to be little doubt that cellcell coupling is not how satellite cells and myofibers communicate. Rather satellite cell regulation is through a number of potential growth factors that arise from a number of sources. Critical to the understanding of this form

  12. Pharmacodynamics of SMP-601 (PTZ601) against Vancomycin-Resistant Enterococcus faecium and Methicillin-Resistant Staphylococcus aureus in Neutropenic Murine Thigh Infection Models▿

    PubMed Central

    Eguchi, Ken; Kanazawa, Katsunori; Eriguchi, Yoshiro; Ueda, Yutaka

    2009-01-01

    SMP-601 (also known as PTZ601, PZ-601, or SM-216601) is a novel parenteral carbapenem with potent activity against multidrug-resistant gram-positive pathogens, including vancomycin-resistant Enterococcus faecium (VREF) and methicillin-resistant Staphylococcus aureus (MRSA). The pharmacodynamics of SMP-601 against VREF and MRSA were investigated in neutropenic murine thigh infection models. The percentage of the dosing interval that the unbound SMP-601 concentration exceeded the MIC (f%T>MIC) was the pharmacokinetic-pharmacodynamic parameter that correlated most closely with efficacy with R2 values of 0.81 to 0.84 for two strains of VREF and 0.92 to 0.93 for two strains of MRSA, whereas the R2 values for the area under the concentration-time curve from 0 to 24 h divided by the MIC were 0.12 to 0.89, and the R2 values for the peak level divided by the MIC were 0 to 0.22. The f%T>MIC levels required for static or killing efficacy against two strains of VREF (9 to 19%) apparently were lower than those against two strains of MRSA (23 to 37%). These results suggested that SMP-601 showed time-dependent in vivo efficacy against VREF and MRSA, and SMP-601 had a sufficient therapeutic effect against VREF infections at lower exposure conditions compared to those for with MRSA infections. PMID:19487438

  13. Schwannoma extending from the umbilical region to the mid-thigh, compressing the major vessels of the right leg: A case report and review of the literature.

    PubMed

    Yorke, Joseph; Duduyemi, Babatunde M; Yifieyeh, Abiboye C; Fiifi-Yankson, P K S; Appiah, Collins; Afful-Yorke, Dorcas; Adinku, Michael O; Ahulu, D

    2016-07-01

    Schwannomas are benign, usually encapsulated, nerve sheath tumours derived from Schwann cells. They commonly arise from the cranial nerves as acoustic schwannomas and are extremely rare in the pelvis and retroperitoneal area (<0.5% of reported cases) unless they are combined with Von Recklinghausen disease (type 1 neurofibromatosis). We report the case of a 23-year-old woman with a mass extending from the umbilical region in the abdomen to the upper two-thirds of the thigh. As this tumour is so rare, and in order to ensure optimal treatment and survival for our patient, a computed tomography-guided biopsy was performed before en bloc tumour excision. Because of the possibility of malignancy, complete excision of the mass was performed, with pelvic blunt dissection. Histological examination showed a benign neoplasm, originating from the cells of peripheral nerve sheaths; the diagnosis was a schwannoma. Abdominal schwannomas are rare neoplasms that can be misdiagnosed. Laparoscopy is a safe and efficient option for approaching benign pelvic tumours and may offer the advantage of better visualisation of structures owing to the magnification in laparoscopic view, especially in narrow anatomical spaces. However, in our case laparoscopy was not considered owing to the size and anatomical location of the tumour. PMID:27384363

  14. Treatment of elderly patients with advanced lipedema: a combination of laser-assisted liposuction, medial thigh lift, and lower partial abdominoplasty

    PubMed Central

    Wollina, Uwe; Heinig, Birgit; Nowak, Andreas

    2014-01-01

    Background Lipedema is a rare female disorder with a characteristic distribution of adipose tissue hypertrophy on the extremities, with pain and bruising. In advanced stages, reduction of adipose tissue is the only available effective treatment. In elderly patients with advanced lipedema, correction of increased skin laxity has to be considered for an optimal outcome. Methods We report on a tailored combined approach to improve advanced lipedema in elderly females with multiple comorbidities. Microcannular laser-assisted liposuction of the upper legs and knees is performed under tumescent anesthesia. Medial thigh lift and partial lower abdominoplasty with minimal undermining are used to correct skin laxity and prevent intertrigo. Postsurgical care with nonelastic flat knitted compression garments and manual lymph drainage are used. Results We report on three women aged 55–77 years with advanced lipedema of the legs and multiple comorbidities. Using this step-by-step approach, a short operation time and early mobilization were possible. Minor adverse effects were temporary methemoglobinemia after tumescent anesthesia and postsurgical pain. No severe adverse effects were seen. Patient satisfaction was high. Conclusion A tailored approach may be useful in advanced lipedema and is applicable even in elderly patients with multiple comorbidities. PMID:24489474

  15. Muscle-specific microRNAs in skeletal muscle development.

    PubMed

    Horak, Martin; Novak, Jan; Bienertova-Vasku, Julie

    2016-02-01

    Proper muscle function constitutes a precondition for good heath and an active lifestyle during an individual's lifespan and any deviations from normal skeletal muscle development and its functions may lead to numerous health conditions including e.g. myopathies and increased mortality. It is thus not surprising that there is an increasing need for understanding skeletal muscle developmental processes and the associated molecular pathways, especially as such information could find further uses in therapy. The understanding of complex skeletal muscle developmental networks was broadened with the discovery of microRNA (miRNA) molecules. MicroRNAs are evolutionary conserved small non-coding RNAs capable of negatively regulating gene expression on a post-transcriptional level by means of miRNA-mRNA interaction. Several miRNAs expressed exclusively in muscle have been labeled myomiRs. MyomiRs represent an integral part of skeletal muscle development, i.e. playing a significant role during skeletal muscle proliferation, differentiation and regeneration. The purpose of this review is to provide a summary of current knowledge regarding the involvement of myomiRs in the individual phases of myogenesis and other aspects of skeletal muscle biology, along with an up-to-date list of myomiR target genes and their functions in skeletal muscle and miRNA-related therapeutic approaches and future prospects. PMID:26708096

  16. Age-related appearance of muscle trauma in primary total hip arthroplasty and the benefit of a minimally invasive approach for patients older than 70 years

    PubMed Central

    Tohtz, Stephan; Dewey, Marc; Springer, Ivonne; Perka, Carsten

    2010-01-01

    Old age is frequently associated with a poorer functional outcome after THA. This might be based upon muscular damage resulting from surgical trauma. Minimally invasive approaches have been widely promoted on the basis of the muscle sparing effect. The aim of the study was to evaluate of the functional outcome and the grade of fatty muscle atrophy of the gluteus medius muscle by magnetic-resonance-imaging (MRI) in patients undergoing minimally invasive or traditional THA. Forty patients (21 female, 19 male) underwent THA either via a modified direct lateral (mDL) or a minimally invasive anterolateral (ALMI) approach. Patients were evaluated clinically and by MRI in terms of age (< or ≥70 y) preoperatively and at three and 12 months postoperatively. The Harris hip score and Trendelenburg’s sign were recorded and a survey of a pain (using a numeric rating scale of 0–10) and satisfaction score (using a numeric rating scale of 1–6) was performed. Fatty atrophy (FA) of gluteus medius muscle was rated by means of a five-point rating scale (0 indicates no fat and 4 implies more fat than muscle). Younger patients reached a significantly higher Harris hip score, lower pain score and lower rate of positive Trendelenburg’s sign accompanied by a significantly lower rate of postoperative FA (P = 0.03; young: FA (MW) = (preop. / 3 / 12 months), 0.15 / 0.7 / 0.7; old: FA (MW) = 0.18 / 1.3 / 1.36). Older patients with an mDL-approach had the significantly lowest clinical scores, the highest rate of positive Trendelenburg’s sign and also the highest rate of fatty atrophy (P = 0.03; FA (old) mDL: 1.8; ALMI: 0.7). Interestingly, no influence of the approach could be detected within the younger group. Patients older than 70 years had a poorer functional outcome and a higher postoperative extent of FA when compared to younger patients, which must be based upon a higher vulnerability and a reduced regenerative capacity of their skeletal muscle. Through a

  17. Free combined composite flaps using the lateral circumflex femoral system for repair of massive defects of the head and neck regions: an introduction to the chimeric flap principle.

    PubMed

    Koshima, I; Yamamoto, H; Hosoda, M; Moriguchi, T; Orita, Y; Nagayama, H

    1993-09-01

    Chimeric composite flaps combined using microanastomoses consist of two or more flaps or tissues, each with an isolated pedicle and a single vascular source. Free combined chimeric flaps using the lateral circumflex femoral system were used to treat massive composite defects of the head and neck in 10 cases. A combined anterolateral thigh flap and vascularized iliac bone graft based on the lateral circumflex femoral system and the deep circumflex iliac system was the most commonly used combination. An anteromedial thigh flap and a paraumbilical perforator-based flap were also combined with this principal combination. The advantages of this chimeric flap over other osteocutaneous flaps are: (1) The flap is relatively thin and the pedicle vessels are up to 10 cm longer and are wider than those of other flaps for easier harvesting of the flap. (2) It is unnecessary to reposition the patient. (3) The vascular pedicle to the skin can be separated from that of the bone. (4) The donor site is not close to the recipient site. (5) The donor scar is in an unexposed area. (6) The skin territory of this flap is extremely wide. (7) A combined anterolateral and anteromedial thigh flap and vascularized iliac bone graft can be easily obtained as an extended combined osteocutaneous flap. (8) Other neighboring skin flaps, such as a groin flap, a paraumbilical perforator-based flap, or a medial thigh flap, can be combined with this chimeric flap because several major muscle branches to be anastomosed derive from the lateral circumflex femoral system. Chimeric composite flaps using the lateral circumflex femoral system are considered suitable for the repair of massive composite defects of the head and neck. PMID:8341739

  18. Rippling muscle disease in childhood.

    PubMed

    Schara, Ulrike; Vorgerd, Matthias; Popovic, Nikola; Schoser, Benedikt G H; Ricker, Kenneth; Mortier, Wilhelm

    2002-07-01

    Rippling muscle disease is a rare autosomal dominant disorder first described in 1975. Recently, it could be classified as a caveolinopathy; in European families, mutations in the caveolin-3 gene were revealed as causing this disease. Although clinical symptoms were almost all described in adulthood, we are now reporting clinical data of seven children with rippling muscle disease owing to mutations in the caveolin-3 gene. Initial symptoms were frequent falls, inability to walk on heels, tiptoe walking with pain and a warm-up phenomenon, calf hypertrophy, and an elevated serum creatine kinase level. Percussion-/pressure-induced rapid contractions, painful muscle mounding, and rippling could be observed even in early childhood. The diagnosis can be confirmed by molecular genetic analysis. Muscle biopsy must be considered in patients without muscle weakness or mechanical hyperirritability to differentiate between rippling muscle disease and limb-girdle muscular dystrophy 1C. PMID:12269726

  19. Design and Validation of a Novel Method to Measure Cross-Sectional Area of Neck Muscles Included during Routine MR Brain Volume Imaging

    PubMed Central

    Kilgour, Alixe H. M.; Subedi, Deepak; Gray, Calum D.; Deary, Ian J.; Lawrie, Stephen M.; Wardlaw, Joanna M.; Starr, John M.

    2012-01-01

    Introduction Low muscle mass secondary to disease and ageing is an important cause of excess mortality and morbidity. Many studies include a MR brain scan but no peripheral measure of muscle mass. We developed a technique to measure posterior neck muscle cross-sectional area (CSA) on volumetric MR brain scans enabling brain and muscle size to be measured simultaneously. Methods We performed four studies to develop and test: feasibility, inter-rater reliability, repeatability and external validity. We used T1-weighted MR brain imaging from young and older subjects, obtained on different scanners, and collected mid-thigh MR data. Results After developing the technique and demonstrating feasibility, we tested it for inter-rater reliability in 40 subjects. Intraclass correlation coefficients (ICC) between raters were 0.99 (95% confidence intervals (CI) 0.98–1.00) for the combined group (trapezius, splenius and semispinalis), 0.92 (CI 0.85–0.96) for obliquus and 0.92 (CI 0.85–0.96) for sternocleidomastoid. The first unrotated principal component explained 72.2% of total neck muscle CSA variance and correlated positively with both right (r = 0.52, p = .001) and left (r = 0.50, p = .002) grip strength. The 14 subjects in the repeatability study had had two MR brain scans on three different scanners. The ICC for between scanner variation for total neck muscle CSA was high at 0.94 (CI 0.86–0.98). The ICCs for within scanner variations were also high, with values of 0.95 (CI 0.86–0.98), 0.97 (CI 0.92–0.99) and 0.96 (CI 0.86–0.99) for the three scanners. The external validity study found a correlation coefficient for total thigh CSA and total neck CSA of 0.88. Discussion We present a feasible, valid and reliable method for measuring neck muscle CSA on T1-weighted MR brain scans. Larger studies are needed to validate and apply our technique with subjects differing in age, ethnicity and geographical location. PMID:22509305

  20. Muscle dysmorphia: current insights.

    PubMed

    Tod, David; Edwards, Christian; Cranswick, Ieuan

    2016-01-01

    Since 1997, there has been increasing research focusing on muscle dysmorphia, a condition underpinned by people's beliefs that they have insufficient muscularity, in both the Western and non-Western medical and scientific communities. Much of this empirical interest has surveyed nonclinical samples, and there is limited understanding of people with the condition beyond knowledge about their characteristics. Much of the existing knowledge about people with the condition is unsurprising and inherent in the definition of the disorder, such as dissatisfaction with muscularity and adherence to muscle-building activities. Only recently have investigators started to explore questions beyond these limited tautological findings that may give rise to substantial knowledge advances, such as the examination of masculine and feminine norms. There is limited understanding of additional topics such as etiology, prevalence, nosology, prognosis, and treatment. Further, the evidence is largely based on a small number of unstandardized case reports and descriptive studies (involving small samples), which are largely confined to Western (North American, British, and Australian) males. Although much research has been undertaken since the term "muscle dysmorphia" entered the psychiatric lexicon in 1997, there remains tremendous scope for knowledge advancement. A primary task in the short term is for investigators to examine the extent to which the condition exists among well-defined populations to help determine the justification for research funding relative to other public health issues. A greater variety of research questions and designs may contribute to a broader and more robust knowledge base than currently exists. Future work will help clinicians assist a group of people whose quality of life and health are placed at risk by their muscular preoccupation. PMID:27536165