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Sample records for rectus muscle surgery

  1. Vertical Rectus Muscles Transposition in Large Exotropia with Medial Rectus Muscle Transection Following Endoscopic Sinus Surgery

    PubMed Central

    Cho, Yoonae A.; Rah, Sang Hoon; Kim, Myung Mi

    2008-01-01

    Purpose To evaluate the effect of transposition procedures on the vertical rectus muscle (VRM) in the patients who underwent a medial rectus muscle (MR) transection after endoscopic sinus surgery (ESS). Methods In 4 patients with exotropia (XT) and a lack of adduction after ESS, orbital CT or MRI revealed a complete transection of the midportion of the MR. Full-tendon VRM transposition was performed within 3 months after injury (early surgery) in 2 patients with 40Δ XT. Two patients with 70Δ and 85Δ XT underwent an X-type augmented Hümmelsheim procedure, which involved pulling each half-tendon and crossing it through the undersurface of the severed MR to the other end of the MR insertion, concurrently with an ipsilateral lateral rectus (LR) recession 11 months and 36 months after ESS, respectively. The adduction deficits were divided into -1 through to -8. The patients were followed up for more than than 1.5 years. Results Postoperatively, 3 patients showed orthophoria and no diplopia in the primary position. The adduction deficits improved to -3.5 or -4. One patient who underwent an X-type augmented Hümmelsheim procedure showed a residual XT of 25Δ. Conclusions VRM transposition is effective in correcting a large XT secondary to a MR transection after ESS. When a longstanding large-angle XT with severe contracture of the ipsilateral LR and massive scarring of the adjacent tissues is present, the X-type augmented Hümmelsheim procedure coupled with an ipsilateral LR recession had an augmenting effect. PMID:18612228

  2. Correction of Excyclotropia by Surgery on the Inferior Rectus Muscle in Patients with Thyroid Eye Disease: A Retrospective, Observational Study

    PubMed Central

    Takahashi, Yasuhiro; Kitaguchi, Yoshiyuki; Nakakura, Shunsuke; Mito, Hidenori; Kimura, Akiko; Kakizaki, Hirohiko

    2016-01-01

    Purpose To examine the characteristics of excyclotropia correction through surgery on the inferior rectus muscle in patients with thyroid eye disease. Methods This was a retrospective, observational study at a single institution. We reviewed 36 patients who had undergone unilateral inferior rectus muscle recession, with or without nasal inferior rectus muscle transposition. The following factors were investigated as possibly influencing excyclotropia correction: inferior rectus muscle thickness, degree of adipose change in the inferior rectus muscle, smoking status, history of orbital radiotherapy, and the amount of inferior rectus muscle recession. Using T1-weighted coronal magnetic resonance imaging, we measured the cross-sectional area of the inferior rectus muscle at its largest point, as well as the bright-signal area of the inferior rectus muscle, which reflects intermuscular adipose change. We then calculated the percentage internal bright-signal area at the point of the largest inferior rectus muscle cross-sectional area. The history of orbital radiotherapy was graded using a binary system. We evaluated correlations among excyclotropia correction, the amount of nasal inferior rectus muscle transposition, and the possible influencing factors listed, using stepwise multiple regression analyses. Results The multiple regression model demonstrated a significant relationship among excyclotropia correction, amount of nasal inferior rectus muscle transposition, and the amount of inferior rectus muscle recession (YCORRECTION = 8.546XTENDON WIDTH + 0.405XRECESSION− 0.908; r = 0.844; adjusted r2 = 0.695; P < 0.001). Conclusions Excyclotropia correction was correlated with the amount of nasal inferior rectus muscle transposition and the amount of inferior rectus muscle recession, but not with the other factors. The regression model presented in this study will enable us to determine more precisely the amount of nasal inferior rectus muscle transposition in patients

  3. Correlation between the Limbus-Insertion Distance of the Lateral Rectus Muscle and Lateral Rectus Recession Surgery in Intermittent Exotropia

    PubMed Central

    Lee, Ju-Yeun; Lee, Eun Jung; Park, Kyung-Ah; Oh, Sei Yeul

    2016-01-01

    The aim of this study was to investigate whether the limbus-insertion distance (LID) of the lateral rectus (LR) muscle can be a useful indicator for predicting the surgical effect of recession surgery in intermittent exotropia (IXT). Patients who underwent unilateral or bilateral LR recession for the basic type of IXT were included. The distance between the corneal limbus and the posterior edge of the insertion of LR muscle (limbus-insertion distance) was measured intraoperatively using surgical calipers (graded with 0.25 mm precision). We calculated the actual dose-response effect as the difference between the angle of preoperative deviation and the angle of postoperative deviation, and then divided the figure by the total amount of recession at postoperative months 1, 3, and 6. The correlation between the limbus-insertion distance (LID) of LR muscle and each dose-response effect was statistically analyzed. A total of 60 subjects were enrolled in this study. The mean LID of LR muscle was 5.8±0.7 mm. The dose-response effect was 3.2±1.0 prism diopters (PD)/mm at postoperative month 1, 3.4±1.0 PD/mm at postoperative month 3, and 3.4±1.1 PD/mm at postoperative month 6. The LID of the LR muscle was significantly correlated with dose-response effects in cases of unilateral and bilateral LR recession at postoperative months 3 and 6 (P = 0.01, <0.01, 0.04 and <0.01 respectively). As the LID of the LR muscle increased by 1 mm, the dose-response effect increased by 0.2PD/mm in unilateral LR recession, and by 0.4 PD/mm in bilateral LR recession at postoperative month 6. In conclusion, the LID of the LR muscle can be used as one predictor of the recession effect to assist in surgical planning for IXT. Moreover, undercorrection at the time of LR recession might be considered in patients with long LID of the LR muscle. PMID:27463100

  4. Surgical results of the slipped medial rectus muscle after hang back recession surgery

    PubMed Central

    Duranoglu, Yasar; Ilhan, Hatice Deniz; Guler Alis, Meryem

    2014-01-01

    AIM To analyze the surgical results of a slipped medial rectus muscle (MRM) after hang back recession surgery for esotropia. METHODS Twenty-one patients who underwent re-exploration for diagnosed slipped muscle after hang back recession surgery were included in this retrospective study. Dynamic magnetic resonance imaging was performed to identify the location of the slipped muscle. Ocular motility was evaluated with assessment with prism and cover test in gaze at cardinal positions. The operations were performed by the same consultant. Intraoperative forced duction test was performed under general anesthesia. The empty sheath of the slipped MRM was resected and the muscle was advanced to the original insertion site in all patients. RESULTS The average age of 21 patients who had consecutive exotropia with a slipped MRM at the time of presentation was 17.4±5.4y (5-50y). The average duration between the first operation and the diagnosis of the slipped muscle was 25mo (12 to 36mo). The mean follow up after the corrective surgery was 28mo. The mean preoperative adduction limitation in the field of action of the slipped muscle was -2.26 (ranging from -1 to -4). All patients had full adduction postoperatively. CONCLUSION The diagnosis of the slipped muscle should be confirmed during the strabismus surgery. The slipped muscle may be caused due to insufficient suture and excessive rubbing of the eye. When divergent strabismus is observed after the recession of the MRM, a slipped muscle should be considered in the differential diagnosis. PMID:25540761

  5. Orbital Imaging to Identify a "Lost" Lateral Rectus Muscle.

    PubMed

    Waite, Christopher; Dai, Shuan

    2016-01-01

    A 36-year-old man presented with a large-angle esotropia and limited abduction of the right eye. A computed tomography scan of his orbits showed an absent lateral rectus muscle. At the time of surgery, a normal-appearing lateral rectus muscle was found. Postoperative magnetic resonance imaging showed a present but atrophic lateral rectus muscle. PMID:27383383

  6. Bilateral superior rectus transposition for congenital exotropia associated with anomalous medial rectus muscles.

    PubMed

    Kodsi, Sylvia R

    2015-10-01

    Superior rectus transposition to the lateral rectus insertion without inferior rectus transposition has been used to correct esotropic deviations secondary to Duane syndrome and abducens nerve palsy. This is usually combined with an augmented posterior fixation suture of the superior rectus muscle to the lateral rectus muscle and ipsilateral medial rectus recession. We report a child with a large-angle congenital exotropia who was found to have anomalous medial rectus muscles bilaterally. Bilateral superior rectus transposition to the medial rectus insertion with bilateral lateral rectus recessions achieved good ocular alignment in primary position. PMID:26486030

  7. Surgery for Complete Vertical Rectus Paralysis Combined with Horizontal Strabismus

    PubMed Central

    Zou, Leilei; Liu, Rui; Liu, Yan; Lin, Jing; Liu, Hong

    2014-01-01

    Aims. To report outcomes of the simultaneous surgical correction of vertical rectus paralysis combined with moderate-to-large angle horizontal strabismus. Methods. If a preoperative forced duction test was positive, antagonist muscle weakening surgery was performed, and then augmented partial rectus muscle transposition (APRMT) + partial horizontal rectus recession-resection was performed 2 months later. If a preoperative forced duction test was negative, APRMT + partial horizontal rectus recession-resection was performed. Antagonistic muscle weakening surgery and/or conventional recession-resection of the horizontal and/or vertical muscles of the contralateral eye was performed 2 months later, as needed. Results. Ten patients with a mean age of 22.3 ± 13.0 years were included and mean follow-up was 7.1 months. The mean vertical deviation that APRMT corrected was 21.4 ± 3.7 PD (prism diopter). The absolute deviation in horizontal significantly decreased from a preoperative value of 48.5 ± 27.4 PD to a value of 3.0 ± 2.3 PD 6 months postoperatively. The movement score decreased from a value of −5 ± 0 preoperatively to a value of −2.7 ± 0.8 at 6 months postoperatively. Conclusion. For patients with complete vertical rectus paralysis combined with a moderate- to-large angle of horizontal strabismus, combined APRMT and partial horizontal rectus recession-resection is safe and effective for correcting vertical and horizontal strabismus. PMID:24883204

  8. Rectus abdominis muscle strains in tennis players.

    PubMed

    Maquirriain, Javier; Ghisi, Juan P; Kokalj, Antonio M

    2007-11-01

    Rectus abdominis muscle strains are common and debilitating injuries among competitive tennis players. Eccentric overload, followed by forced contraction of the non-dominant rectus abdominis during the cocking phase of the service motion is the accepted injury mechanism. A tennis-specific rehabilitation program emphasising eccentrics and plyometric strengthening of the abdominal wall muscles, contributes to the complete functional recovery in tennis players, and could help reduce recurrences. PMID:17957025

  9. Rectus abdominis muscle strains in tennis players

    PubMed Central

    Maquirriain, Javier; Ghisi, Juan P; Kokalj, Antonio M

    2007-01-01

    Rectus abdominis muscle strains are common and debilitating injuries among competitive tennis players. Eccentric overload, followed by forced contraction of the non‐dominant rectus abdominis during the cocking phase of the service motion is the accepted injury mechanism. A tennis‐specific rehabilitation program emphasising eccentrics and plyometric strengthening of the abdominal wall muscles, contributes to the complete functional recovery in tennis players, and could help reduce recurrences. PMID:17957025

  10. Iatrogenic Injury to Medial Rectus After Endoscopic Sinus Surgery.

    PubMed

    Mukherjee, Bipasha; Priyadarshini, Omega; Ramasubramanian, Srikanth; Agarkar, Sumita

    2015-12-01

    Endoscopic sinus surgery (ESS) is the mainstay of the treatment in sinus disorders, to re-establish the drainage of the affected sinus. The close proximity of the orbital structures to paranasal sinuses makes them vulnerable to inadvertent injury during the sinus surgery. Medial rectus (MR) muscle is the most commonly injured extraocular muscle during ESS due to its anatomic proximity to the thin medial wall of the orbit. This is a non-comparative, retrospective, interventional case series of six patients presenting with MR injury after ESS. We discuss the management, outcome and review the published literature. A total of six patients met the inclusion criteria. The presenting complaints were diplopia, squinting and limitation of ocular movements. Two patients underwent surgical exploration of the MR muscle and reattachment of the muscle along with injection botulinum to the antagonist lateral rectus muscle. Two patients who had small angle strabismus and who were able to fuse were advised orthoptic exercises and prisms as management. Remaining two patients were advised surgical intervention to correct strabismus but they declined further surgical intervention. Management of MR injury following ESS is complex, often resulting in suboptimal outcomes. Since early intervention is associated with better outcomes, early referral by otolaryngologists to ophthalmologists would result in better outcome. PMID:26693458

  11. Traumatic transection of the lateral rectus muscle with chorioretinitis sclopetaria.

    PubMed

    MacKenzie, Kelly; Verity, David; Ali, Nadeem

    2015-01-01

    A man, aged 67 years, sustained monocular trauma to the left eye while gardening, presenting with light perception, complete absence of abduction, and chorioretinitis sclopetaria. At surgery, the lateral rectus was found to be transected at the equator of the globe, with an area of locally abraded sclera. A few posterior muscle fibers were identified and sutured to the residual anterior fibers. With a partial improvement of the esodeviation, after a further 6 months he proceeded to lateral transposition of the superior and inferior recti to healthy sclera 4 mm from the limbus, with adjunctive medial rectus botulinum toxin. Six months later, the angle of primary deviation remained stable at 4 prism diopters base out with improved abduction. Vision in the eye remained reduced at 20/200 (with eccentric fixation) due to macular changes secondary to the sclopetaria. In conclusion, this case describes a rare example of complete traumatic transection of the lateral rectus with chorioretinitis sclopetaria, due to orbital injury. With appropriate surgery, the angle of deviation can be considerably improved despite complete muscle transection and scleral injury. PMID:25790075

  12. Compartmentalized Innervation of Primate Lateral Rectus Muscle

    PubMed Central

    Peng, Michelle; Poukens, Vadims; da Silva Costa, Roberta Martins; Yoo, Lawrence; Tychsen, Lawrence

    2010-01-01

    Purpose. Skeletal and craniofacial muscles are frequently composed of multiple neuromuscular compartments that serve different physiological functions. Evidence of possible regional selectivity in LR intramuscular innervation was sought in a study of the anatomic potential of lateral rectus (LR) muscle compartmentalization. Methods. Whole orbits of two humans and five macaque monkeys were serially sectioned at 10-μm thickness and stained with Masson trichrome. The abducens nerve (CN6) was traced anteriorly from the deep orbit as it branched to enter the LR and arborized among extraocular muscle (EOM) fibers. Three-dimensional reconstruction was performed in human and monkey orbits. Results. Findings were in concordance in the monkey and human orbits. External to the LR global surface, CN6 bifurcated into approximately equal-sized trunks before entering the global layer. Subsequent arborization showed a systematic topography, entering a well-defined inferior zone 0.4 to 2.5 mm more posteriorly than branches entering the largely nonoverlapping superior zone. Zonal innervation remained segregated anteriorly and laterally within the LR. Conclusions. Consistent segregation of intramuscular CN6 arborization in humans and monkeys suggests functionally distinct superior and inferior zones for the LR. Since the LR is shaped as a broad vertical strap, segregated control of the two zones could activate them separately, potentially mediating previously unappreciated but substantial torsional and vertical oculorotary LR actions. PMID:20435590

  13. Free rectus femoris muscle transfer for one-stage reconstruction of established facial paralysis.

    PubMed

    Koshima, I; Moriguchi, T; Soeda, S; Hamanaka, T; Tanaka, H; Ohta, S

    1994-09-01

    The free vascularized rectus femoris muscle graft with a long motor nerve was used for reconstruction of unilateral established facial paralysis in one stage. The pedicle vessels were anastomosed to the recipient vessels in the ipsilateral face, and the motor nerve of the muscle, which was led through the upper lip, was sutured to the contralateral facial nerve. The advantages of this one-stage reconstruction as compared with surgery involving second-stage reconstruction are that the reconstruction can be completed in one stage and that the period required for muscle refunctioning after surgery is short. The vascular supply of the rectus femoris muscle can emanate mainly from the lateral circumflex femoral artery. In our cadaveric study, five types of variation were found for origination of a nutrient artery of the muscle. The most common type was one in which the artery derived from the descending branch of the lateral circumflex femoral artery (39 percent). The motor nerve of the rectus femoris muscle is derived from the femoral nerve under the inguinal ligament and runs downward through the intermuscular space between the sartorius muscle and the iliopsoas muscle before entering the posteromedial part of the upper third of the rectus muscle. The advantages of using the rectus muscle are as follows: (1) safety and simplicity exist with one main large arterial supply for arterial anastomosis; (2) the length of the femoral nerve (more than 20 cm) is adequate for reaching the contralateral facial nerve for suturing; (3) a simultaneous operation by two teams is possible with the patient in the supine position; (4) the force and distance of contraction are appropriate to reanimate the face; (5) the rectus muscle can be separated as a segment with appropriate lengths, size, and power for replacing lost muscles in the face; (6) the tendinous fascia in both ends provides a reliable point for anchoring sutures, which provides firmer attachment; and (7) no loss of donor

  14. Two Cases of Rectus Sternalis Muscle

    PubMed Central

    Ramakrishnan, Swapna; Mayilswamy, Mahendran

    2016-01-01

    The sternalis muscle, an uncommon anatomical variant of the chest wall musculature, though perhaps well known to anatomists, is quite unfamiliar to clinicians and radiologists despite attempts to highlight its clinical importance in recent years. During routine dissection for undergraduate medical teaching, in the department of anatomy, we came across two cases of sternalis muscle. The first was a unique case of unilateral right sternalis with contralateral insertion on the left sternocleidomastoid, and the second case where bilateral presence of the muscle was noted with ipsilateral insertion. The former was supplied by medial pectoral nerve and the latter by lower intercostal nerves. Usually present between the pectoral and superficial fasciae, wide ranging prevalence and morphology have been attributed to this muscular variant. Opinions differ on its development and nerve supply. Its presence can be misdiagnosed as a wide range of benign and malignant anterior chest wall lesions and tumours, but it is also of great use as a pedicle flap or flap microvascular anastomosis in reconstructive surgeries of anterior chest wall, head and neck and breast. In this paper, two cases of sternalis muscle which presented very differently from each other are discussed. PMID:26894052

  15. Traumatic longitudinal splitting of the inferior rectus muscle.

    PubMed

    Laursen, Jessica; Demer, Joseph L

    2011-04-01

    Orbital floor fractures and associated injuries can cause strabismus. We present the case of a 34-year-old man with incomitant strabismus after orbital reconstruction following a high-impact baseball injury. Multipositional, high-resolution magnetic resonance imaging revealed extensive longitudinal splitting of the inferior rectus muscle by an orbital floor implant that separated its orbital and global layers. PMID:21463958

  16. Surgical Responses of Medial Rectus Muscle Recession in Thyroid Eye Disease-Related Esotropia.

    PubMed

    Lyu, In Jeong; Lee, Ju-Yeun; Kong, Mingui; Park, Kyung-Ah; Oh, Sei Yeul

    2016-01-01

    We evaluate the surgical outcomes and surgical responses of medial rectus muscle (MR) recession patients with thyroid eye disease (TED)-related esotropia (ET). The surgical dose-response curves 1 week postoperatively and at the final visit were analyzed. Univariable and multivariable linear regression analyses were applied to investigate factors influencing surgical dose-response. A total of 43 patients with TED-related ET that underwent MR recession were included. The final success rate was 86.0% and the rate of undercorrection was 14.0%. The surgical dose-response curves of TED-related ET showed a gentle slope compared with those of standard surgical tables. In the univariable model, simultaneous vertical rectus muscle recession was the only significant factor influencing surgical dose-response of MR recession in TED-related ET (β = -0.397, P = 0.044). In a model adjusted for age, sex, type of surgery, and preoperative horizontal angle of deviation, simultaneous vertical rectus muscle recession showed marginal significance (β = -0.389, P = 0.064). The surgical dose-response curve of TED-related ET was unique. Simultaneous vertical rectus muscle recession was associated with increased surgical dose-response in TED-related ET. PMID:26796354

  17. Surgical Responses of Medial Rectus Muscle Recession in Thyroid Eye Disease-Related Esotropia

    PubMed Central

    Lyu, In Jeong; Lee, Ju-Yeun; Kong, Mingui; Park, Kyung-Ah; Oh, Sei Yeul

    2016-01-01

    We evaluate the surgical outcomes and surgical responses of medial rectus muscle (MR) recession patients with thyroid eye disease (TED)-related esotropia (ET). The surgical dose-response curves 1 week postoperatively and at the final visit were analyzed. Univariable and multivariable linear regression analyses were applied to investigate factors influencing surgical dose-response. A total of 43 patients with TED-related ET that underwent MR recession were included. The final success rate was 86.0% and the rate of undercorrection was 14.0%. The surgical dose-response curves of TED-related ET showed a gentle slope compared with those of standard surgical tables. In the univariable model, simultaneous vertical rectus muscle recession was the only significant factor influencing surgical dose-response of MR recession in TED-related ET (β = -0.397, P = 0.044). In a model adjusted for age, sex, type of surgery, and preoperative horizontal angle of deviation, simultaneous vertical rectus muscle recession showed marginal significance (β = -0.389, P = 0.064). The surgical dose-response curve of TED-related ET was unique. Simultaneous vertical rectus muscle recession was associated with increased surgical dose-response in TED-related ET. PMID:26796354

  18. Electromyography study of the portions of the abdominal rectus muscle.

    PubMed

    Negrao Filho, R de F; Bérzin, F; Souza, G da C

    1997-01-01

    This study objective was to verify the behavior of three portions of the abdominal rectus muscle through a quantitative analysis of the electromyographic signal in different types of abdominal exercises. Ten young male between 16 and 27 years old were studied and they had no previous history of muscle and joint illness. They were well-trained and did seven abdominal exercises chosen considering the types of contraction (isotonic and isometric) as well as the muscle fixation points. The electric activity of the superior, medium (above umbilicus) and inferior (below umbilicus) portions at the left side of the abdominal rectus muscle was taken using Beckman type surface mini-electrodes. The registers were collected from computerized 8-channel Nicholet electromyography equipment, model Viking II. The signals were quantified using the MVA (Maximum Volunteer Activity) software, being considered for analysis the values of RMS (Root Mean Square). The obtained data were submitted to a parametric analysis using the variance analysis (F test) and also the Tukey test, besides a descriptive graphic analysis starting from the average RMS values of each muscle portion. This study results suggest that for the majority of the subjects, the functional activities of the abdominal rectus muscle are performed with electric activity differences among their portions, showing a tendency of producing more electric activity in the superior portion than in the medium and inferior portions. The experiment also demonstrated an absence of a common behavior pattern in the three portions of the ten tested subjects. PMID:9444489

  19. Aetiology and management of the 'detached' rectus muscle.

    PubMed Central

    MacEwen, C J; Lee, J P; Fells, P

    1992-01-01

    The clinical features and management of 17 cases of detached extraocular muscles are described. They are classified into four groups: (1) the muscle which is cut and lost during squint surgery, (2) the muscle which breaks during squint surgery, (3) the muscle which slips following squint surgery, and (4) the muscle which is damaged during facial or orbital trauma. The prognosis for group 1 is poor whereas groups 2-4 have a good chance of successful muscle relocation. Images PMID:1540554

  20. Longitudinal tear of the inferior rectus muscle in orbital floor fracture.

    PubMed

    Kashima, Tomoyuki; Akiyama, Hideo; Kishi, Shoji

    2012-06-01

    We report a case of longitudinal avulsion of the inferior rectus muscle following orbital floor fracture and describe its clinical presentation, computed tomography (CT) features and management. A 53-year-old man felt vertical diplopia in all gaze immediately after the trauma. Orthoptic assessment showed left over right hypertropia of 20 prism diopters and left exotropia of 10 prism diopters in primary position. The left orbital floor fracture and the prolapse of orbital contents into the maxillary sinus were presented by CT. Exploration of the orbit was performed under general anesthesia. The displaced bone fragment was elevated and repositioned below the slastic implant. Diplopia continued in all directions of gaze, although the impairment of depression was reduced postoperatively. A residual left hypertropia of 10 prism diopters and exotropia of 10 prism diopters was present in primary position 1 month after surgery, though there were no enopthalmos or worsening of hypesthesia. Repeated CT revealed the muscle avulsion of inferior rectus at the lateral portion of the belly. The avulsion of a small segment of the inferior rectus and its herniation into maxillary sinus in more posterior views was detected by review of the preoperative images. Muscle avulsion should be considered in the management of orbital fracture if orbital tissue entrapment and nerve paresis are excluded as causes of reduction in ocular motility. A thorough review of the imaging studies for possible muscle injury is required before surgery in all cases of orbital fracture. PMID:22551369

  1. Isolated inferior rectus muscle rupture after blunt orbital trauma

    PubMed Central

    Tomasetti, Patrick; Metzler, Philipp; Jacobsen, Christine

    2013-01-01

    A 44-year-old man was referred to our department with diplopia, periorbital swelling and haematoma of the left eye after orbital trauma due to a punch. During the examination, mild enophthalmos, hypertropia and a total absence of infraduction were observed. An orbital computed tomography (CT) scan demonstrated a left orbital floor blow-out fracture, with caudal herniation of periorbital fat and rectus inferior muscle. Repair was performed under total anaesthesia with placement of a Titan mesh. The following days were marked by the persistence of diplopia without improvement of infraduction. A postoperative, 0.5 mm CT scan highlighted a complete rupture of the inferior rectus muscle, not seen before operation, by a 1.0 mm-sliced CT. In this case, orthoptic therapy was undertaken with good results after 6 months and without need of a second repair. PMID:24963904

  2. Function of transected or avulsed rectus muscles following recovery using an anterior orbitotomy approach

    PubMed Central

    Pineles, Stacy L.; Laursen, Jessica; Goldberg, Robert A.; Demer, Joseph L.; Velez, Federico G.

    2013-01-01

    PURPOSE To assess the function of muscles retrieved from a retrobulbar location using an anterior orbitotomy approach and to identify the prognostic factors favoring a good outcome. METHODS The records of all patients undergoing anterior orbitotomy for the retrieval of a transected or avulsed muscle in a retrobulbar location were reviewed. Ocular motility, before and after retrieval (with ductions scaled from −4 to +4), was evaluated. RESULTS Record review identified 11 patients who had suffered trauma to 12 muscles (5 inferior, 6 medial, and 1 lateral rectus muscle). Ductions improved from −4 ± 0.4 preoperatively to −2.7 ± 0.9 postoperatively (P = 0.002); mean primary position deviation improved from 34Δ ± 14Δ-15Δ ± 9Δ (P < 0.001), and mean deviation in the field of action improved from 47Δ ± 20Δ-20Δ ± 22Δ (P = 0.02). Ductions improved by at least two units in three patients, all of whom had medial rectus trauma. Single binocular vision in primary gaze was achieved in 6 patients. Patients with medial rectus muscle injury and patients injured by sinus surgery had the lowest likelihood of recovering single binocular vision. CONCLUSIONS Our results are similar to historical series in which muscles were not retrieved and transpositions performed; however, muscle retrieval avoids risks associated with transposition surgeries such as anterior segment ischemia. Muscle recovery via the anterior orbitotomy approach may be reasonable to consider in those cases with a reasonable possibility of having active force generation postoperatively. PMID:22835914

  3. An interesting case of bilateral bifid insertion of superior rectus muscle as an intra-operative finding in a patient with oculocutaneous albinism.

    PubMed

    Verma, Rashmi; Hertle, Richard W

    2014-08-01

    We report a case of bilateral bifid insertion of superior rectus muscles, in a patient with oculocutaneous albinism as an incidental intraoperative finding during eye muscle surgery. The muscle was successfully operated on and the patient did well postoperatively. To our knowledge, this is the first report of this anomaly. PMID:23975092

  4. Avoiding Complications in Abdominal Wall Surgery: A Mathematical Model to Predict the Course of the Motor Innervation of the Rectus Abdominis.

    PubMed

    Tessone, Ariel; Nava, Maurizio; Blondeel, Phillip; Spano, Andrea

    2016-02-01

    Ever since its introduction, the transverse rectus abdominis myocutaneous flap has become the mainstay of autologous breast reconstruction. However, concerns regarding donor site morbidity due to the breach of abdominal wall musculature integrity soon followed. Muscle-sparing techniques, eventually eliminating the muscle from the flap all-together with the deep inferior epigastric artery perforator flap, did not eliminate the problem of abdominal wall weakness. This led to the conclusion that motor innervation might be at fault. Studies have shown that even in the presence of an intact rectus abdominis muscle, and an intact anterior rectus sheath, denervation of the rectus abdominis muscle results in significant abdominal wall weakness leading to superior and inferior abdominal bulges, and abdominal herniation. Our aim was to establish a mathematical model to predict the location of the motor innervation to the rectus abdominis muscle, and thus provide surgeons with a tool that will allow them to reduce abdominal morbidity during deep inferior epigastric artery perforator and free muscle-sparing transverse rectus abdominis myocutaneous surgery. We dissected 42 cadaveric hemiabdomens and mapped the course of the thoracolumbar nerves. We then standardized and analyzed our findings and presented them as a relative map which can be adjusted to body type and dimensions. Our dissections show that the motor innervation is closely related to the lateral vascular supply. Thus, when possible, we support the preferred utilization of the medial vascular supply, and the preservation of the lateral supply and motor innervation. PMID:26756600

  5. Clinical and Radiologic Characteristics of Inferior Rectus Muscle Sheath Entrapment in Orbital Blowout Fracture.

    PubMed

    Bagheri, Abbas; Tavakoli, Mehdi; Khosravifard, Keivan; Yazdani, Shahin

    2015-10-01

    Blowout fracture is a common condition in the oculoplastics clinic. One of the indications for its repair is entrapment of the inferior rectus muscle within the fracture site. Herein, the authors present 3 patients of inferior rectus muscle sheath entrapment without entrapment of the muscle itself. The outcome of treatment was excellent in all patients. The aim of this report is to present the special clinical and radiologic findings in such patients. PMID:26413961

  6. Rectus abdominis muscle endometriosis after cesarean section--case report.

    PubMed

    Dordević, Momcilo; Jovanović, Bozidar; Mitrović, Slobodanka; Dordević, Gordana; Radovanović, Dragce; Sazdanović, Predrag

    2009-09-01

    Endometriosis is defined by the presence of functional endometrial tissue outside the uterus, where it is normally located. Endometriosis is one of the most common gynecologic entities affecting 8%-18% of menstrual women. Endometriosis can occur at intra- and extrapelvic localizations. The most common intrapelvic localizations are those involving the ovaries, Douglas' area, pelvic peritoneum, uterus, bladder and rectum. Abdominal endometriosis is the most common localization of extrapelvic endometriosis and usually develops in connective tissue. Extra-pelvic implantation of endometrial tissue may develop in any organ including the skin, lungs, liver, extremities, brain and stomach. Three years after cesarean section, a 35-year-old female was operated on for suspected anterior abdominal hernia at the site of previous section. An egg-sized tumor was removed from the rectus abdominis muscle and referred for histopathologic and immunohistochemical analyses. The results showed endometriosis of the muscle with positive estrogen and progesterone receptors. A year after the procedure, treatment with gonadotropin-releasing hormone analogs was continued due to recurrent pain in the scar area, along with ultrasonography and biochemical marker (carbohydrate antigen 125) follow-up. Clinical diagnosis of scar endometriosis can be made by thorough history and physical, ultrasonography and biochemical examinations. Scar endometriosis should always be considered when the symptoms occur in a cyclic and hormone-dependent pattern, mostly after gynecologic operations, and worsening during menstruation. Definitive diagnosis is based on histopathologic analysis. PMID:20405641

  7. Recognition and repair of the slipped rectus muscle.

    PubMed

    Plager, D A; Parks, M M

    1988-01-01

    Since the first description of the slipped muscle as a complication of strabismus surgery in 1979, the distinctions between it and the lost muscle have become blurred both in the literature and in general understanding. Sixtytwo slipped muscles in 52 consecutive patients were reviewed in an effort to more fully describe this Important and often unrecognized entity. The range of clinical presentation of slipped muscle is large: from the immediate large postoperative over- or undercorrection with absent duction, to the gradual moderate deviation with subtly reduced excursion. The auctions provided by the slipped muscles ranged from complete absence to almost normal, with an average of 19° excursion beyond the midline. At surgery, recognizing the empty muscle capsule attached to the sclera with the tendon slipped posteriorly within it is imperative for its repair. Recognition is facilitated by suspecting it from clinical findings. Correction of the motility defect requires advancement of the muscle tissue and not just its empty capsule. Slippage can probably be prevented by using a surgical technique, which firmly locks the suture to the tendon and not just to the muscle capsule. PMID:24880054

  8. Variation in Tendinous Intersections of Rectus Abdominis Muscle in North Indian Population with Clinical Implications

    PubMed Central

    Haque, Mahboobul; Gupta, Amrita; Nasar, Areeba

    2015-01-01

    Aim of the study Incisions through the abdominal wall are based on anatomical principles and Rectus abdominis muscle provides an excellent myocutaneous flap. The present work was proposed to identify variations in numbers and location of tendinous intersections of the Rectus Abdominis muscle in the cadavers as a guide to the surgical procedures. Materials and Methods The study was conducted on 54 cadavers of North Indian origin allotted to undergraduate medical student for Anatomy dissection classes. Manual dissection was done to identify tendinous intersections of the Rectus Abdominis muscle with reference to number and location. Results In the present study one cadaver had five tendinous intersections (1.85%), one cadaver had four tendinous intersections (1.85%) and 52 cadavers had three tendinous intersections (96.29%). Conclusion The present study is an effort to provide data about the anatomical variation in numbers and location of tendinous intersections of the Rectus Abdomini muscles. Rectus abdominis muscle provides an excellent myocutaneous flap because the muscle belly is separated from surrounding tissue within the rectus sheath. This study is representative of a small study of the human population and only serves to illustrate the variations in the anatomy of the tendinous intersections. More extensive studies are required to establish a definitive pattern among local populations to serve as a guide for surgical procedures. PMID:26266107

  9. Use of the rectus abdominis muscle and fascia flap in reconstruction of epispadias/exstrophy.

    PubMed

    Horton, C E; Sadove, R C; Jordan, G H; Sagher, U

    1988-07-01

    Inferiorly based rectus abdominis muscle flaps and fascial flaps have been used to construct a firm abdominal wall without hernias and to provide coverage of the bladder, bladder neck, and proximal urethra in the secondary reconstruction of patients with epispadias/exstrophy complex. They have also been used to produce an elevation of the mons area, which is lacking in the typical exstrophy patient. Rectus fascial flaps have been the mainstay of abdominal closure when wide diastasis of the rectal muscles is present and when the lower abdomen lacks fascial support. We are pleased with the results of utilizing either the rectus muscle or rectus fascia in this complex condition. We have been using fascial flaps for over 10 years in our epispadias/exstrophy closures and abdominal wall strengthening procedures. We have been using bone grafts and the rectus muscle for the construction of a mons for the past 5 years. Although the rectus muscle procedure to cover the bladder and the bladder neck has been in use for only 2 years, we have seen patients with incontinence restored to a continent state; these patients have not been plagued with fistula problems when a neourethra has to be constructed to elongate the phallus. Previous attempts at urethral repair in this area have been successful in the main, but an occasional fistula at the junction between the penile skin and the abdominopubic skin has resulted. Since using the rectus muscle to cover the bladder and bladder neck area, we have not had this problem. Patients with epispadias/exstrophy remain such difficult problems that every advance in technique should be used to improve results.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:3391008

  10. Intraoperative monitoring of torsion to prevent vertical deviations during augmented vertical rectus transposition surgery

    PubMed Central

    Holmes, Jonathan M.; Hatt, Sarah R.; Leske, David A.

    2012-01-01

    Background Total transposition of the superior and inferior rectus muscle laterally, with augmentation sutures, may be complicated by induction of an undesirable vertical deviation. Induced vertical misalignment may be associated with changes in torsion. We have developed a simple method to monitor intraoperative torsion that may reduce the incidence of vertical deviations. Methods We reviewed consecutive cases of total abducens palsy or esotropic Duane syndrome treated with augmented lateral transposition of the superior and inferior rectus muscles, where the 12 o’clock and 6 o’clock intraoperative positions were initially marked with a dot at the limbus using a surgical pen. The location of the marks was monitored during tying of the augmentation sutures; changes in torsion were monitored intraoperatively. Results Records of 9 cases of augmented vertical rectus transposition were reviewed. Based on intraoperative assessment of torsion by observing the position of the preplaced limbal dots, the inferior rectus augmentation suture was tied less tightly than the superior rectus suture, leaving a gap of 1–3 mm between the inferior and lateral rectus muscles in 8 of 9 cases. The augmentation suture was totally removed in 1 case. Following these intraoperative adjustments, there was no induced intraoperative torsion, whereas further tightening of the inferior suture induced extorsion. Six weeks postoperatively, 8 of 9 patients did not experience a symptomatic vertical deviation. Conclusions When performing augmented transposition procedures, intraoperative monitoring of torsion may reduce the incidence of inadvertent vertical deviations and torsion. This technique may also be useful in other cases where correction or avoidance of torsion is needed. PMID:22525168

  11. 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

  12. Alveolar rhabdomyosarcoma presenting as an acute orbital mass in the medial rectus muscle.

    PubMed

    Ehlers, Justis P; Penne, Robert B; Eagle, Ralph C; Carrasco, Jacqueline R

    2007-01-01

    Rhabdomyosarcoma is the most common pediatric primary neoplasm in the orbit, often presenting with rapid proptosis and orbital symptoms. We describe a 15-year-old girl who presented with an acute mass in her medial rectus muscle that was subsequently diagnosed as widely disseminated alveolar rhabdomyosarcoma. To our knowledge, this represents the first reported case in which an enlarged extraocular muscle was the initial manifestation of disseminated alveolar rhabdomyosarcoma. PMID:17413634

  13. Rectus abdominis muscle injuries in elite handball players: management and rehabilitation

    PubMed Central

    Balius, Ramon; Pedret, Carles; Pacheco, Laura; Gutierrez, Josep Antoni; Vives, Joan; Escoda, Jaume

    2011-01-01

    Muscle injuries generally occur in two-joint muscles with a high percentage of type II fibers during the performance of eccentric activity. Some muscle injuries, such as those located in the adductor longus, a monoarticular muscle, as well as rectus abdominis do not fully comply with these requirements. This study examines five cases of elite handball players with ruptured rectus abdominals. Sonographically, lesions in rectus abdominis are shown as a disruption of the fibrillar pattern with a hematic suffusion that invades the entire lesion. In some of the cases, the ultrasound study was complemented with a MRI. A unified rehabilitation protocol was applied and the return to play time of each handball player ranged between 16 and 22 days, with an average of 18.2 days. Follow-up at 15 months showed no evidence of re-injury or residual discomfort and all of them are playing at their highest level. The aim of this study was to illustrate a feature of handball injury that, as in tennis and volleyball, is uncommon and so far has not been specifically reported. The phenomenon of contralateral abdominal hypertrophy in handball appears in the dominant arm as in tennis and volleyball. PMID:24198573

  14. Patterns of attachment of the myodural bridge by the rectus capitis posterior minor muscle.

    PubMed

    Yuan, Xiao-Ying; Yu, Sheng-Bo; Li, Yun-Fei; Chi, Yan-Yan; Zheng, Nan; Gao, Hai-Bin; Luan, Bing-Yi; Zhang, Zhao-Xi; Sui, Hong-Jin

    2016-03-01

    The myodural bridge was first described by Hack in 1995 and was thought to be related to chronic cervicogenic headaches. For a long time, few studies revealed the patterns of the myodural bridge considering the rectus capitis posterior minor muscle. In this study, P45 plastination technology and anatomical dissection were performed on head specimens, and four different terminal region types of the rectus capitis posterior minor muscle were observed, including the posterior atlanto-occipital interspace, posterior arch of the atlas and posterior atlanto-axial interspace. We propose that the myodural complex structures in the posterior atlanto-occipital and posterior atlanto-axial interspace have cooperative effects on cerebrospinal fluid and work together. This force might be an important source for the circulation of cerebrospinal fluid. PMID:25859757

  15. Early Results of Slanted Recession of the Lateral Rectus Muscle for Intermittent Exotropia with Convergence Insufficiency

    PubMed Central

    Kang, Kyung Min

    2015-01-01

    The aim of this study was to evaluate the efficacy of slanted recession of the lateral rectus muscle for intermittent exotropia with convergence insufficiency. This prospective study included 31 patients who underwent slanted lateral rectus recession for intermittent exotropia with convergence insufficiency between June 2010 and June 2012. Following parameters were recorded and analyzed: patient sex, age, preoperative and postoperative near and distance ocular alignment, and changes in stereopsis. The mean age of the patients was 9.2 years. The preoperative mean deviation angle was 32.4 PD at distance and 43.4 PD at near. After 6 months, slanted lateral rectus recession reduced the deviation angles to 2 PD at distance and 3.4 PD at near. In addition, the mean difference between distance and near deviation angles was significantly reduced from 11 PD to 1.4 PD at 6 months postoperatively. Slanted lateral rectus recession for intermittent exotropia with convergence insufficiency in children successfully reduced the distance and near exodeviations and the near-distance difference without increasing the risk of long-term postoperative esotropia or diplopia. PMID:25688298

  16. [Free rectus abdominis muscle perforating artery flaps for reconstruction of the head and neck defects].

    PubMed

    Koshima, I; Handa, T; Satoh, Y; Akisada, K; Orita, Y; Yamamoto, H

    1995-01-01

    During the past eight years, tissue defects of the head and neck region in a total of 45 patients were repaired with free rectus abdominis muscle perforating artery flaps. These flaps are subclassified into (1) reduced musculocutaneous flaps, (2) thin reduced musculocutaneous flaps, (3) paraumbilical perforator-based flaps, and (4) thin paraumbilical perforator-based flaps. The advantages of these flaps are as follows. Since the flaps involve no or only a small portion of the rectus abdominis muscle, (1) the muscle can be left intact on the abdominal wall, and (2) a thin flap can be easily created by simple defatting of the flap. These flaps overcome the major disadvantages of the conventional rectus abdominis musculocutaneous flap, i.e., bulkiness of the flap and frequent postoperative abdominal herniation. The territory of the thin flaps is within 10 cm around the perforator. These flaps are suitable for defects in the head and neck region, because simultaneous flap elevation is possible at the time of tumor resection. Paraumbilical perforator-based flaps are suitable for young females and elderly patients. PMID:7897566

  17. Retrospective study of recession of four horizontal rectus muscle in periodic alternating nystagmus

    PubMed Central

    Mimura, Osamu; Ishikawa, Hiroto; Kimura, Naoki; Kimura, Akiko; Borlongan, Cesar V

    2014-01-01

    Purpose Periodic alternating nystagmus (PAN) is a spontaneous horizontal nystagmus observed in disorders of the central nervous system. Patients with congenital PAN complain of oscillating vision at high rates. Medication is the first-choice treatment for PAN; however, clinicians still seek better therapy. The aim of this study was to evaluate outcomes of recession of four horizontal rectus muscle (R-FHR) in patients with congenital PAN. Patients and methods This study reports a retrospective case series of ten patients (seven males and three females; mean age 24.4±10.9) with congenital PAN who underwent R-FHR between 2007 and 2012, which was performed by the same surgeon at the Hyogo College of Medicine. Patients were evaluated for complications, recession amount, deviation angle, eye movements including a nystagmus amplitude, and visual acuity during pre- and post-operative periods. Results Pre-operatively, patients complained of oscillating vision, abnormal head posture, esotropia, and congenital superior oblique palsy. Post-operatively, changes from the previous observations of nystagmus amplitudes and abnormal head posture demonstrated a complete reversal in all patients. In addition, visual acuity determined with a Snellen chart improved in two patients. However, esotropia occurred in three patients who underwent additional strabismus surgery 2 days after R-FHR. R-FHR was particularly effective in eight patients who pre-operatively had periodic oscillating vision with a regular pattern of periodic nystagmus. Conclusion We demonstrated that ten patients with congenital PAN had improved vision following R-FHR, indicating that R-FHR was an effective procedure, especially in patients suffering PAN with periodic oscillating vision. PMID:25525330

  18. Large Asymmetric Hypertrophy of Rectus Abdominis Muscle in Professional Tennis Players

    PubMed Central

    Sanchis-Moysi, Joaquin; Idoate, Fernando; Dorado, Cecilia; Alayón, Santiago; Calbet, Jose A. L.

    2010-01-01

    Purpose To determine the volume and degree of asymmetry of the musculus rectus abdominis (RA) in professional tennis players. Methods The volume of the RA was determined using magnetic resonance imaging (MRI) in 8 professional male tennis players and 6 non-active male control subjects. Results Tennis players had 58% greater RA volume than controls (P = 0.01), due to hypertrophy of both the dominant (34% greater volume, P = 0.02) and non-dominant (82% greater volume, P = 0.01) sides, after accounting for age, the length of the RA muscle and body mass index (BMI) as covariates. In tennis players, there was a marked asymmetry in the development of the RA, which volume was 35% greater in the non-dominant compared to the dominant side (P<0.001). In contrast, no side-to-side difference in RA volume was observed in the controls (P = 0.75). The degree of side-to-side asymmetry increased linearly from the first lumbar disc to the pubic symphysis (r = 0.97, P<0.001). Conclusions Professional tennis is associated with marked hypertrophy of the musculus rectus abdominis, which achieves a volume that is 58% greater than in non-active controls. Rectus abdominis hypertrophy is more marked in the non-dominant than in the dominant side, particularly in the more distal regions. Our study supports the concept that humans can differentially recruit both rectus abdominis but also the upper and lower regions of each muscle. It remains to be determined if this disequilibrium raises the risk of injury. PMID:21209832

  19. Spread patterns and effectiveness for surgery after ultrasound-guided rectus sheath block in adult day-case patients scheduled for umbilical hernia repair

    PubMed Central

    Manassero, Alberto; Bossolasco, Matteo; Meineri, Maurizio; Ugues, Susanna; Liarou, Chrysoula; Bertolaccini, Luca

    2015-01-01

    Background and Aims: We conducted a prospective study to examine the local anesthetic (LA) spread and the effectiveness for surgical anesthesia of ultrasound (US)-guided rectus sheath block (RSB) in adult patients undergoing umbilical hernia repair. Material and Methods: Thirty patients received at T-10 level a bilateral US-guided injection of 20 mL levobupivacaine 0.375% + epinephrine 5 μg/mL behind the rectus muscle to detach it from its sheath. Anesthetic spread into the rectus sheath was evaluated ultrasonographically at T-9 and T-11 levels and scored from 0 to 4. The RSB was defined effective for surgical anesthesia if it was able to guarantee an anesthetic level sufficient for surgery without any mepivacaine supplementation. Results: Overall, the block was effective for surgical anesthesia in 53.3% of patients (95% confidence interval, ±17.8). In the remaining patients, anesthesia supplementation was needed at cutaneous incision, whereas manipulation of the muscle and fascial planes was painless. No patients required general anesthesia. LA spreads as advocated (to T-9 and to T-11 bilaterally = spread score 4) in 8/30 patients (26.6%); in these cases, the block was 75% effective for surgery. The anesthetic spread was most negatively influenced by increased body mass index. Postoperative analgesia was excellent in 97% of patients. Conclusion: Use of RSB as an anesthetic management of umbilical herniorrhaphy is recommended only with anesthetic supplementation at the incision site. PMID:26330714

  20. Quantitative end qualitative analysis of the electrical activity of rectus abdominis muscle portions.

    PubMed

    Negrão Filho, R de Faria; Bérzin, F; Souza, G da Cunha

    2003-01-01

    The purpose of this study was to investigate the electrical behavior pattern of the Rectus abdominis muscle by qualitative and quantitative analysis of the electromyographic signal obtained from its superior, medium and inferior portions during dynamic and static activities. Ten voluntaries (aged X = 17.8 years, SD = 1.6) athletic males were studied without history of muscle skeletal disfunction. For the quantitative analysis the RMS (Root Mean Square) values obtained in the electromyographic signal during the isometric exercises were normalized and expressed in maximum voluntary isometric contraction percentages. For the qualitative analysis of the dynamic activity the electromyographic signal was processed by full-wave rectification, linear envelope and normalization (amplitude and time), so that the resulting curve of the processed signal was submitted to descriptive graphic analysis. The results of the quantitative study show that there is not a statistically significant difference among the portions of the muscle. Qualitative analysis demonstrated two aspects: the presence of a common activation electric pattern in the portions of Rectus abdominis muscle and the absence of significant difference in the inclination angles in the electrical activity curve during the isotonic exercises. PMID:12964259

  1. Use of topical mitomycin C in myoplasty of the medial rectus muscle of rabbits.

    PubMed

    Mamede, Fabrício V; Laus, José L; Cabral, Vânia P; Vicenti, Felipe A M; Barbieri-Neto, José

    2004-01-01

    To possibly reduce postoperative adhesions that occur after ocular myoplasties, we investigated the topical effects of 0.04% mitomycin C on the repaired areas of the medial rectus muscle using an equine renal capsule preserved in 98% glycerin for reinforcement of the sutures. Twenty-four rabbits, divided into two groups of 12 animals each [untreated (control) and treated group (MMC)], were submitted to surgical rupture of the medial rectus muscle of one eye and repair of the defect 24 h later with sutures and an equine renal capsule. Post-operative prophylactic treatment of the two groups consisted of the administration of eye drops containing neomycin, polymyxin B and dexamethasone at regular 6-h intervals for eight consecutive days and daily rinsing with physiological saline. MMC animals received additional treatment with topical 0.04% mitomycin C every 6 h for 14 consecutive days. Slit lamp biomicroscopy showed greater irritation of the ocular surface in MMC animals during the first days post operatively. Adhesions were observed at 15 and 30 days of assessment in the two groups, but were more extensive in control animals at 60 days. Histopathology revealed inflammatory exudation in both groups, which was greater in MMC animals. Mitomycin C (0.04%) instilled at 6-h intervals for 14 consecutive days reduced the occurrence of fibrosis in the myoplastic areas. However, the equine renal capsule was found to be of little benefit for the reinforcement of myoplasties. PMID:15310293

  2. Anatomic and physiological characteristics of the ferret lateral rectus muscle and abducens nucleus.

    PubMed

    Bishop, Keith N; McClung, J Ross; Goldberg, Stephen J; Shall, Mary S

    2007-11-01

    The ferret has become a popular model for physiological and neurodevelopmental research in the visual system. We believed it important, therefore, to study extraocular whole muscle as well as single motor unit physiology in the ferret. Using extracellular stimulation, 62 individual motor units in the ferret abducens nucleus were evaluated for their contractile characteristics. Of these motor units, 56 innervated the lateral rectus (LR) muscle alone, while 6 were split between the LR and retractor bulbi (RB) muscle slips. In addition to individual motor units, the whole LR muscle was evaluated for twitch, tetanic peak force, and fatigue. The abducens nucleus motor units showed a twitch contraction time of 15.4 ms, a mean twitch tension of 30.2 mg, and an average fusion frequency of 154 Hz. Single-unit fatigue index averaged 0.634. Whole muscle twitch contraction time was 16.7 ms with a mean twitch tension of 3.32 g. The average fatigue index of whole muscle was 0.408. The abducens nucleus was examined with horseradish peroxidase conjugated with the subunit B of cholera toxin histochemistry and found to contain an average of 183 motoneurons. Samples of LR were found to contain an average of 4,687 fibers, indicating an LR innervation ratio of 25.6:1. Compared with cat and squirrel monkeys, the ferret LR motor units contract more slowly yet more powerfully. The functional visual requirements of the ferret may explain these fundamental differences. PMID:17717110

  3. Extraocular muscle injury during endoscopic sinus surgery: an ophthalmologic perspective.

    PubMed

    Park, K-A; Oh, S Y

    2016-05-01

    PurposeThe purpose of this study is to describe the clinical characteristics and treatment results of medial rectus muscle (MR) transection incurred during endoscopic sinus surgery.MethodsThis retrospective study included 16 patients with MR transection incurred during endoscopic sinus surgery between 1994 and 2015. The operative notes of the surgical procedure, the pattern of strabismus, the type of muscle injury, the type of corrective strabismus surgery, and the surgical outcomes were reviewed.ResultsNine patients had partial resection of MR and seven patients had complete transection of MR, resulting from an injury incurred during endoscopic sinus surgery. Three of the nine patients with partial resection injury were initially diagnosed as complete resection and subsequently re-diagnosed as partial resection in a review of the images during this study. Five of the nine patients with partial MR resection underwent only simple recession/resection surgery. Patients with complete MR transection underwent muscle transposition or globe fixation surgeries and often multiple operations were required.ConclusionsThe results of this study showed that the treatment strategies could vary depending on the nature of muscle injury. In cases with complete transection, muscle transposition or globe fixation surgeries are often required, with multiple operations. However, partial muscle resection with only simple recession/resection surgery shows a favorable outcome in many cases. The use of proper imaging techniques, a thorough review of the images with various planes, and close follow-up are important for determining the nature of the muscle injury. PMID:26892024

  4. INTERNAL ORGANIZATION OF MEDIAL RECTUS AND INFERIOR RECTUS MUSCLE NEURONS IN THE C-GROUP OF THE OCULOMOTOR NUCLEUS IN MONKEY

    PubMed Central

    Tang, Xiaofang; Büttner-Ennever, Jean A.; Mustari, Michael J.; Horn, Anja K. E.

    2015-01-01

    Summary Mammalian extraocular muscles contain singly-innervated twitch muscle fibers (SIF) and multiply-innervated non-twitch muscle fibers (MIF). In monkey, MIF motoneurons lie around the periphery of oculomotor nuclei and have different premotor inputs from the motoneurons inside the nuclei. The most prominent MIF motoneuron group is the C-group, which innervates the medial rectus (MR) and inferior rectus (IR) muscle. To explore the organization of both cell groups within the C-group we performed small injections of choleratoxin subunit B into the myotendinous junction of MR or IR in monkeys. In three animals the IR and MR myotendinous junction of one eye was injected simultaneously with different tracers (choleratoxin subunit B and wheatgerm agglutinin). It revealed that both muscles were supplied by two different non-overlapping populations in the C-group. The IR neurons lie adjacent to the dorsomedial border of the oculomotor nucleus, whereas MR neurons are located further medially. A striking feature was the differing pattern of dendrite distribution of both cell groups. Whereas the dendrites of IR neurons spread into the supraoculomotor area bilaterally, those of the MR neurons were restricted to the ipsilateral side and sent a focussed bundle dorsally to the preganglionic neurons of the Edinger-Westphal nucleus, which are involved in the ‘near response’. In conclusion, MR and IR are innervated by independent neuron populations from the C-group. Their dendritic branching pattern within the supraoculomotor area indicates a participation in the near response providing vergence, but also reflects their differing functional roles. PMID:25684641

  5. Surface electromyography activity of the rectus abdominis, internal oblique, and external oblique muscles during forced expiration in healthy adults.

    PubMed

    Ito, Kenichi; Nonaka, Koji; Ogaya, Shinya; Ogi, Atsushi; Matsunaka, Chiaki; Horie, Jun

    2016-06-01

    We aimed to characterize rectus abdominis, internal oblique, and external oblique muscle activity in healthy adults under expiratory resistance using surface electromyography. We randomly assigned 42 healthy adult subjects to 3 groups: 30%, 20%, and 10% maximal expiratory intraoral pressure (PEmax). After measuring 100% PEmax and muscle activity during 100% PEmax, the activity and maximum voluntary contraction of each muscle during the assigned experimental condition were measured. At 100% PEmax, the external oblique (p<0.01) and internal oblique (p<0.01) showed significantly elevated activity compared with the rectus abdominis muscle. Furthermore, at 20% and 30% PEmax, the external oblique (p<0.05 and<0.01, respectively) and the internal oblique (p<0.05 and<0.01, respectively) showed significantly elevated activity compared with the rectus abdominis muscle. At 10% PEmax, no significant differences were observed in muscle activity. Although we observed no significant difference between 10% and 20% PEmax, activity during 30% PEmax was significantly greater than during 20% PEmax (external oblique: p<0.05; internal oblique: p<0.01). The abdominal oblique muscles are the most active during forced expiration. Moreover, 30% PEmax is the minimum intensity required to achieve significant, albeit very slight, muscle activity during expiratory resistance. PMID:27077819

  6. Using the traditional model to evaluate the active force of the human lateral rectus muscle

    NASA Astrophysics Data System (ADS)

    Gao, ZhiPeng; Chen, WeiYi; Jing, Lin; Feng, PengFei; Wu, XiaoGang; Guo, HongMei

    2014-05-01

    The information on the force of extraocular muscles (EOMs) is beneficial for strabismus diagnosis and surgical planning, and a direct and simple method is important for surgeons to obtain these forces. Based on the traditional model, a numerical simulation method was proposed to achieve this aim, and then the active force of the lateral rectus (LR) muscle was successfully simulated when the eye rotated every angle from 0° to 30° in the horizontal plane from the nasal to the temporal side. In order to verify these simulations, the results were compared with the previous experimental data. The comparison shows that the simulation results diverged much more than the experimental data in the range of 0°-10°. The errors were corrected to make the simulation results closer to the experimental data. Finally, a general empirical equation was proposed to evaluate the active force of the LR muscle by fitting these data, which represent the relationship between the simulation forces and the contractive amounts of the LR muscle.

  7. Peculiar indications for the pedicled or free rectus abdominis flap in reconstructive surgery. A review of our experience.

    PubMed

    Sinsel, N K; Guelinckx, P J

    1995-01-01

    Among all known flaps, the rectus abdominis muscle flap possesses an unique diversity in flap designs due to the special vascular supply of the abdominal wall. The axial vascularization of the rectus abdominis muscle gives ofF several musculocutaneous perforators, which are mainly located in the periumbilical region. Abdominal wall skin perfusion is guaranteed by spoke-wheel like vessels arising from these perforators. Subsequently several designs (muscle, myocutaneous and myosubcutaneous) are possible, by varying the included tissue and the position of the skin island. We described 7 cases where the rectus abdominis muscle was used as a muscle or myocutaneous flap for reconstruction of large defects. In most cases a pedicled transfer was necessary, possible and sufficient to reconstruct the difficult defects in various body regions. Great amounts of well perfused tissue can be transferred with still possible primary closure of the donor site. Due to its rich perfusion and constancy of vascular pattern, it represents an excellent and safe pedicled reconstructive procedure for large defects of the thorax, the abdomen, the forearm or the hip and pelvis where free tissue transfers are impossible or contraindicated. No other local transposition would have achieved this goal, due to the lack of volume and mobility. Moreover the flap is ideal for reconstruction of contour deficiencies due to the abundance of fat, as for example in breast or buttock reconstruction. However the flap is not the first choice for traumatic and infected wounds where fat tissue is not desired. PMID:8571724

  8. Proteasome activities in the rectus abdominis muscle of young and older individuals.

    PubMed

    Bossola, Maurizio; Pacelli, Fabio; Costelli, Paola; Tortorelli, Antonio; Rosa, Fausto; Doglietto, Giovan Battista

    2008-08-01

    Sarcopenia is one of the most striking effects of age, the causes and the pathogenic mechanisms being largely unknown. Unfortunately, there is limited information on the effect of aging on muscle protein breakdown in basal conditions. The present study aimed at investigating if skeletal muscle ubiquitn mRNA levels and proteasome activities vary with age in healthy individuals. Ub mRNA levels were measured by northern blot analysis whereas proteasome activities were determined by evaluating the cleavage of specific fluorogenic substrates in the rectus abdominis muscle of 14 healthy male individuals. Patients were divided in three groups according to the age: (1) 20-30 years (N = 3); (2) 31-64 years (N = 5); (3) > or = 65 years (N = 6). Quantitation of the ubiquitin mRNA levels (expressed in arbitrary units) (mean (SD) showed no differences among the three groups of age (20-30 years: 1352 +/- 441; 31-64 years: 1324 +/- 439; > or = 65 years: 884 +/- 400; P = 0.33). The correlation between age and muscle ubiquitin mRNA levels was not statistically significant (r = -0.4, P = 0.26). The three proteasome activities, chymotrypsin-like (CTL), trypsin-like (TL) and peptidyl-gutamyl-peptidase (PGP), expressed as nkatal x 10(-3)/mg protein, were similar in the three groups of patients stratified according to the age. There was no correlation between age with either CTL (r = 0.22, P = 0.4), PGP (r = 0.002, P = 0.9), and TL (r = 0.28, P = 0.33) activities. In conclusion, the present study shows that the skeletal muscle proteasome activities do not differ with age in healthy male individuals. PMID:18330717

  9. Consecutive exotropia: why does it happen, and can medial rectus advancement correct it?

    PubMed Central

    Leon, Bhambi Gesite-de; Demer, Joseph L.

    2014-01-01

    Purpose To investigate whether consecutive exotropia following medial rectus muscle recession is associated with muscle slippage and to assess the effectiveness of treating the condition with medial rectus advancement. Methods The records of patients with consecutive exotropia after medial rectus recession were reviewed to determine medial rectus muscle insertion location at the time of advancement surgery. Measurements before and after medial rectus advancement were compared. Success was defined as alignment within 10Δ of orthotropia. The dose effect of medial rectus advancement was determined by nonlinear regression. Results A total of 20 patients were included. The mean age (± standard deviation) at time of surgery was 19 ± 19 years (range, 1.1–65.4). The mean preoperative exotropia was 28Δ ± 16Δ (range, 12Δ–60Δ). Medial rectus slippage of 2.5 ± 1.7 mm (range, 1.0–5.0 mm) was found in 14 patients (36%) who had previously undergone medial rectus recession. Surgery corrected about 4Δ of exotropia per mm total medial rectus advancement. Although 95% of patients were aligned successfully immediately after surgery, averaging 2Δ ± 4Δ esotropia, there was significant late exodrift, averaging 17Δ at final follow-up. At final follow-up, 1.6 ± 1.8 (range, 0.10–6.2) years after surgery, 50% of patients maintained alignment within 10Δ of orthotropia (mean, 3Δ ± 4Δ exotropia); the rest experienced recurrent exotropia of 25Δ ± 8Δ. Conclusions Medial rectus slippage is common in consecutive exotropia. Medial rectus advancement effectively treated consecutive exotropia, whether or not there was muscle slippage. It is however, associated with late exodrift; hence patients should be warned about potential for further XT recurrence. PMID:25454022

  10. Predictability of horizontal versus vertical muscle surgery outcomes in thyroid eye disease.

    PubMed

    Iordanous, Yiannis; Sharan, Sapna; Robitaille, Johanne; Walsh, Leah; LaRoche, G Robert

    2016-08-01

    Surgical repair of vertical muscles in thyroid eye disease (TED) is believed to yield more unpredictable results than horizontal muscle surgery. The purpose of this study is to determine if the short-term outcomes for strabismus surgery in TED are equally predictable for horizontal and vertical muscle surgery. We retrospectively reviewed the charts of 27 consecutive patients who underwent strabismus surgery for TED from a single surgeon's practice. Eligibility for inclusion in the study included biochemically stable thyroid disease for at least a year and stable orthoptic measurements for at least 6 months prior to surgery. Nine patients had surgery only on vertical rectus muscles, three only on horizontal, and fifteen on both vertical and horizontal rectus muscles. Mean follow-up was 2.4 ± 5.2 months. In primary gaze at 6 m, a mean horizontal deviation of 16.6 ± 22.3 PD, and a mean vertical deviation of 19.7 ± 14.1 PD were measured pre-operatively. Post-operatively, this measured 2.3 ± 8.4 PD horizontally and 2.1 ± 7.8 PD vertically (p = 0.933). There was no statistically significant difference between post-operative horizontal and vertical deviations in elevation, depression, adduction, and abduction. Nine patients required reoperation to attain satisfactory ocular alignment; seven of these cases involved repeat surgery on vertical muscles, while two cases required operation on both horizontal and vertical muscles. Results suggest that surgical outcomes of both horizontal and vertical muscle surgery are equally predictable in stable TED; however, reoperation rates were higher for vertical muscles compared to horizontal muscles. PMID:26559967

  11. Enthesitis of the direct tendon of the rectus femoris muscle in a professional volleyball player: A case report

    PubMed Central

    Bortolotto, C.; Coscia, D.R.; Ferrozzi, G.

    2011-01-01

    Enthesitis of the direct tendon of the rectus femoris muscle is a rare pathology which mainly affects professional athletes, and it is caused by overuse and repetitive microtrauma. Athletic jumping and kicking exert a great stress on the direct tendon of the rectus femoris muscle, and volleyball and football players are therefore most frequently affected. Enthesitis may occur suddenly causing pain and functional impairment possibly associated with partial or complete tendon injuries, or it may be a chronic condition causing non-specific clinical symptoms. We present the case of a professional volleyball player who felt a sudden pain in the left side of the groin area during a training session although she had suffered no accidental injury. The pain was associated with impaired ipsilateral limb function. Tendon rupture was suspected, and magnetic resonance imaging (MRI) was performed. MRI showed a lesion at the myotendinous junction associated with marked inhomogeneity of the direct tendon. Ultrasound (US) examination confirmed the presence of both lesions and allowed a more detailed study of the pathology. This is a typical case of enthesitis which confirms that MRI should be considered the examination of choice in hip pain, particularly when the patient is a professional athlete, thanks to its panoramic visualization. However, also US is an ideal imaging technique for evaluating tendon injuries thanks to its high spatial resolution, and it can therefore be used effectively as a second line of investigation. PMID:23396666

  12. [Effects of surgery on muscles on clinical and radiographic findings in the hip joint region in cerebral palsy patients].

    PubMed

    Schejbalová, A; Havlas, V

    2008-10-01

    PURPOSE OF THE STUDY Isolated or combined surgical procedures on muscles around the hip joint are currently indicated by many authors. In cerebral palsy patients they are regarded as essential intervention. MATERIAL In the years 2005-2007, surgery in the hip joint region was essential for 150 children between 3 and 18 years of age. At the time of surgery, the patients' locomotion ranged from stage 1 to stage 7 of the Vojta system. METHODS The outcome was evaluated by clinical and radiographic examination at 2 and 6 months post-operatively and hip migration percentage and Wiberg's CE angle were measured. RESULTS The best clinical and radiographic outcomes were achieved in children younger than 6 years of age. On the other hand, isolated transfer of the distal rectus femoris muscle significantly affected pelvis anteflexion in adolescent patients. The most marked decrease in migration percentage was found after adductor tenotomy combined with surgery on the iliopsoas muscle (55.6 %) or when the two procedures were combined with distal rectus femoris transfer. DISCUSSION Combined surigical procedures, i.e., adductor tenotomy, surgery on the iliopsoas muscle or rectus femoris muscle and medial hamstrings, with fixation using an abduction modified Atlanta brace, are effective in patients with marked lateral hip migration who are younger that 6 years. Isolated adductor tenotomy and distal transfer of the rectus femoris muscle markedly improve standing position in walking patients. CONCLUSION An appropriate combination of surgical procedures on muscles in the hip region and on medial hamstrings can significantly improve the patient's locomotion and, if lateral migration is present, help to avoid surgery on bones. PMID:19026189

  13. Electromyography analysis of the rectus abdominis and external oblique muscles of children 8 to 10 years old.

    PubMed

    Moraes, A C; Bankoff, A D; Pellegrinotti, L L; Moreira, Z W; Galdi, E H

    1995-11-01

    The objective of this work was to study through in the electromyography the upper and lower umbilical rectus abdominis and the anterior and posterior parts of the external oblique muscles of children 8 to 10 years old. The children studied practice artistic and rhythmical gymnastic sports at the training and learning level and the study was made during abdominal exercise in the dorsal decubitus position on the ground and on a board. The children were divided into 2 groups: Group I - ten already trained children; Group II - nineteen learners. The participants in Group I practiced an average of 5 times a week and those in Group II practiced 2 times a week. The exercises analyzed were: on the ground, lifting the legs 30, 20 and 10 cm high with the knees flexed 90 degrees; flexing the trunk while maintaining the legs elevated and the knees flexed; flexing the trunk with homo and heterolateral rotation of the trunk while maintaining the legs elevated and the knees flexed. On the board, flexing the trunk with the knees flexed 90 degrees on top of the board inclined 30, 20 and 10 cm; flexing the trunk with rotation of the trunk homo and heterolateral with the knees flexed on the board inclined 30, 20 and 10 cm. The results showed that the superior umbilical part of the rectus abdominis muscle presented more intense action potential than the inferior-umbilical part; the more intense action potential occurred at the flexing of the trunk and at the flexing of the trunk with homo and heterolateral rotation. The anterior part of the external oblique muscle presented more intense action potential than the posterior part; the more intense action potential occurred at the flexing of the trunk and at the flexing of the trunk with heterolateral rotation. In both of the muscles the more intense action potential occurred between 45 and 60 degrees of flexing the trunk; the children in Group I presented more intense action potential than those in Group II; the exercise of lifting the

  14. 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 ...

  15. Rectus abdominis myocutaneous flap for primary vaginal reconstruction.

    PubMed

    Carlson, J W; Soisson, A P; Fowler, J M; Carter, J R; Twiggs, L B; Carson, L F

    1993-12-01

    Reconstructive procedures are being performed with increasing frequency in conjunction with pelvic exenterations and other radical gynecologic surgeries. The most common reconstructive procedures include continent urinary diversion, rectosigmoid anastomosis, and vaginal reconstruction. Historically, the gracilis myocutaneous flap has been the procedure of choice for vaginal reconstruction. However, the gracilis myocutaneous flap has a history of partial to severe necrosis, a propensity to prolapse, and leaves ipsilateral donor scars on the thigh. In contrast, neovaginal reconstruction using a relatively new procedure, the distally based rectus abdominis myocutaneous flaps, has the advantage of using a large, single flap that can be incorporated into the primary incision. This flap is mobilized on a long vascular pedicle, the rectus muscle. In relation to the underlying rectus muscle, the orientation of the cutaneous portion of this flap may be customized to accommodate the pelvic defect or the surgeon's preference. Depending on their primary orientation, they are referred to as either a vertical or transverse rectus abdominis myocutaneous flap. The versatility and reliability of the rectus flap is demonstrated here through the presentation of a small pilot series of seven patients. The technique was used for vaginal reconstruction, primarily in conjunction with pelvic exenteration. The flaps were mobilized from the supraumbilical area and had a flap viability of 100% for the 2 years that they have been followed. There were no postoperative incisional or flap infections. There was one infraumbilical fascial dehiscence. The advantages of primary pelvic reconstruction along with the description of the operative techniques are presented. PMID:8112640

  16. 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

  17. Superior rectus transposition combined with medial rectus recession for Duane syndrome and sixth nerve palsy

    PubMed Central

    Mehendale, Reshma A.; Dagi, Linda R.; Wu, Carolyn; Ledoux, Danielle; Johnston, Suzanne; Hunter, David G.

    2013-01-01

    Objective Vertical rectus transposition (VRT) is used to treat abduction limitation, but new vertical deviations and anterior segment ischemia are concerns. Johnston and Crouch described superior rectus transposition (SRT), a procedure in which only the superior rectus muscle is transposed temporally. We describe our results using augmented temporal SRT with adjustable medial rectus muscle recession (MRc) for treatment of Duane syndrome I (DS) and sixth nerve palsy. Methods Retrospective surgical case review of patients undergoing the SRT procedure. Pre- and post-operative orthoptic measurements were recorded. Minimum follow-up was 6 weeks. Main outcome measures included angle of esotropia in primary position and the angle of head turn. Secondary outcomes included duction limitation, stereopsis, and new vertical deviations. Results The review identified seventeen patients (10 with DS and 7 with sixth nerve palsy). SRT+MRc improved esotropia [from 44 PD to 10.1 PD (p< 0.0001)], reduced abduction limitation [from −4.3 to −2.7 (p<0.0001)] and improved compensatory head posture [from 28°to 4° (p<0.0001)]. Stereopsis was recovered in eight patients (p=0.03). Three patients required a reoperation; one for overcorrection and 2 for undercorrection. A new primary position vertical deviation was observed in 2/7 patients with complex sixth nerve palsy and 0/10 DS patients. No patient described torsional diplopia. Conclusions SRT allows for the option of simultaneous medial rectus recession in patients with severe abduction imitation who require transposition surgery. SRT+MRc improved esotropia, head position, abduction limitation, and stereopsis without inducing torsional diplopia. PMID:22332212

  18. The Efficacy of Botulinum Toxin Treatment for Children with a Persistent Esotropia Following Bilateral Medial Rectus Recessions and Lateral Rectus Resections

    PubMed Central

    Lambert, Scott R.; Shainberg, Marla J.

    2015-01-01

    Background and Purpose To report on the outcomes of treating children with a persistent esotropia with an injection of botulinum toxin in a medial rectus muscle. Patients and Methods The medical records of all children at one institution with a persistent esotropia after bilateral medial rectus recessions and bilateral lateral rectus resections who were then treated with a botulinum toxin injection were reviewed. Results Five patients with a mean preoperative esotropia of 37 PD (range, 25-50 PD) underwent bilateral medial rectus recessions and then bilateral lateral rectus resections. Their residual esotropia (mean, 25 PD; range, 18-35) was then treated with a single injection of 3- 5 units of botulinum toxin into one medial rectus muscle. The patients were then followed for a mean of 34 months (range, 14 to 79 months). At last follow-up, 2 patients had an esotropia <10 PD. The other 3 patients had no long-term improvement in their ocular alignment. Two of these patients then underwent additional strabismus surgery. In both cases, they then developed a consecutive exotropia. Conclusion Treatment with a single injection of botulinum toxin was beneficial in 2 of 5 children. Botulinum toxin treatment alone did not result in a consecutive exotropia in any patients treated. PMID:24260804

  19. Nylon versus polydioxanone in the correction of rectus diastasis.

    PubMed

    Nahas, F X; Augusto, S M; Ghelfond, C

    2001-03-01

    Nylon and polydioxanone are two sutures commonly used to correct rectus diastasis. Polydioxanone, as an absorbable suture, has the advantage of not being palpable in thin patients. Because several forces act against the plication, an absorbable suture would not be efficient in these cases. In this study, two groups of 10 patients each were studied. These patients underwent abdominoplasty and correction of rectus diastasis. In the control group, 2-0 nylon was used to plicate the anterior aponeurosis and 0-polydioxanone was used in the experimental group. The tension of the abdominal wall was measured with a dynamometer in both groups. The width of rectus diastasis was measured 3 cm above and 2 cm below the umbilicus, using a computed tomography (CT) scan before the operation and 3 weeks and 6 months after surgery. The width of rectus diastasis was measured intraoperatively at the same levels. The data were analyzed by Student's t test. Both groups had similar abdominal wall tension on both levels. The diastasis recti was completely corrected at both levels, as confirmed by the 3-week postoperative CT scan and the 6-month CT scan. At the superior level, the width of the rectus diastasis on the preoperative CT scan (2.6 +/- 0.7 cm) was similar to the values obtained intraoperatively (2.7 +/- 0.6 cm), showing no significant statistical difference. At the inferior level, the largest difference between the preoperative CT scan and the intraoperative finding was 0.3 cm. In conclusion, the correction of rectus diastasis with 2-0 nylon and 0-polydioxanone was achieved and maintained after 6 months. CT scans are an accurate method for studying rectus diastasis and other muscles of the abdominal wall. PMID:11304594

  20. The affinity and activity of compounds related to nicotine on the rectus abdominis muscle of the frog (Rana pipiens)

    PubMed Central

    Barlow, R. B.; Thompson, G. M.

    1969-01-01

    1. Series of pyridylalkyl- and substituted phenylalkyl-trimethylammonium salts, triethylammonium salts, diethylamines and di-n-propylamines have been made. The substituents in the benzene ring were nitro, chloro, bromo, methoxy, hydroxy and amino groups and the alkyl residues had one, two, or three methylene groups separating the aromatic nucleus from the cationic head. 2. Most of the trimethylammonium compounds caused a contracture of the frog rectus muscle, but some were partial agonists and a few were antagonists. The di-n-propylamines were all antagonists, as were most of the diethylamines and triethylammonium compounds, though some of these were partial agonists and a few triethylammonium compounds were agonists. The affinities of the antagonists and partial agonists for the receptors stimulated by β-pyridylmethyltrimethylammonium (and by nicotine) were measured. The equipotent molar ratios of all the agonists were measured relative to β-pyridylmethyltrimethylammonium. 3. The dissociation constants of the pyridylmethyldiethylamines and substituted benzyldiethylamines were measured. The effects of substituents on the pKa of benzyldiethylamine were similar to their effects on the pKa of aniline, though there were differences with some of the o-substituted compounds, which could be attributed to internal hydrogen-bond formation. 4. There is no obvious correlation between the effects of a substituent on the pKa of benzyldiethylamine and its effects on affinity. Although increasing the size of the cationic group usually increased affinity, it did not always do so. The compounds with the highest affinity, p-hydroxybenzyldiethylamine (log K, 5·90) had about half the affinity of (+)-tubocurarine (log K, 6·11), but the triethylammonium analogue (log K, 4·17) had only about one-fiftieth of the affinity of the tertiary base. The binding of the drug to the receptor appears to involve many factors which include the size of the groups as well as their electron

  1. Surgery Effective Against Immune Disorder That Weakens Muscles

    MedlinePlus

    ... html Surgery Effective Against Immune Disorder That Weakens Muscles Myasthenia gravis affects 60,000 Americans, but removal ... gravis, an autoimmune disorder that causes life-threatening muscle weakness, researchers report. Since the 1940s, doctors have ...

  2. Ultrasound-guided rectus sheath and transversus abdominis plane blocks for perioperative analgesia in upper abdominal surgery: A randomized controlled study

    PubMed Central

    Abdelsalam, Khaled; Mohamdin, OW

    2016-01-01

    Background: Regional anesthetic techniques can be used to alleviate postoperative pain in patients undergoing major upper abdominal surgery. Our aim was to evaluate the efficacy of bilateral ultrasound (US)-guided rectus sheath (RS) and transversus abdominis plane (TAP) blocks for better perioperative analgesia. Patients and Methods: It is a prospective, observer-blinded, randomized clinical study. 40 eligible patients undergoing elective liver resection or Whipple procedure were included. All patients received a standardized anesthetic technique. Group 1 (n = 20) received preincisional US-guided bilateral RS and TAP blocks using 20 ml volume of bupivacaine 0.25% for each, and group 2 (n = 20) received local wound infiltration at end of surgery with 40 ml of bupivacaine 0.25%. A standardized postoperative analgesic regimen composed of intravenous paracetamol and a morphine patient-controlled analgesia (PCA). The use of intraoperative fentanyl and recovery room morphine boluses, PCA-administered morphine, pain scores as well as number of patients’ experienced postoperative nausea and vomiting in the ward at 6 and 24 h were recorded. Results: Group 1 patients received a significantly lower cumulative intraoperative fentanyl, significantly lesser boluses of morphine in postanesthesia care unit, as well, significantly lower cumulative 24 h postoperative morphine dosage than the group 2 patients. Pain visual analog scale scores were significantly lower at both 6 and 24 h postoperatively in TAP group when compared with the no-TAP group. There were no complications related to the TAP block procedures. No signs or symptoms of local anesthetic systemic toxicity were detected. Conclusion: The combination of bilateral US-guided RS and TAP blocks provides excellent perioperative analgesia for major upper abdominal surgery. PMID:26955306

  3. Rectus sheath hematoma: three case reports

    PubMed Central

    Kapan, Selin; Turhan, Ahmet N; Alis, Halil; Kalayci, Mustafa U; Hatipoglu, Sinan; Yigitbas, Hakan; Aygun, Ersan

    2008-01-01

    Introduction Rectus sheath hematoma is an uncommon cause of acute abdominal pain. It is an accumulation of blood in the sheath of the rectus abdominis, secondary to rupture of an epigastric vessel or muscle tear. It could occur spontaneously or after trauma. They are usually located infraumblically and often misdiagnosed as acute abdomen, inflammatory diseases or tumours of the abdomen. Case presentation We reported three cases of rectus sheath hematoma presenting with a mass in the abdomen and diagnosed by computerized tomography. The patients recovered uneventfully after bed rest, intravenous fluid replacement, blood transfusion and analgesic treatment. Conclusion Rectus sheath hematoma is a rarely seen pathology often misdiagnosed as acute abdomen that may lead to unnecessary laparotomies. Computerized tomography must be chosen for definitive diagnosis since ultrasonography is subject to error due to misinterpretation of the images. Main therapy is conservative management. PMID:18221529

  4. Evaluation of Risk Factors for Rectus Sheath Hematoma.

    PubMed

    Sheth, Heena S; Kumar, Rohit; DiNella, Jeannine; Janov, Cheryl; Kaldas, Hoda; Smith, Roy E

    2016-04-01

    Rectus sheath hematoma (RSH) develops due to rupture of epigastric arteries or the rectus muscle. Although RSH incidence rate is low, it poses a significant diagnostic dilemma. We evaluated the risk factors for RSH, its presentation, management, and outcomes for 115 patients hospitalized with confirmed RSH by computed tomography scan between January 2005 and June 2009. More than three-fourth (77.4%) of the patients were on anticoagulation therapy, 58.3% patients had chronic kidney disease (CKD) stage ≥3, 51.3% had abdominal injections, 41.7% were on steroids/immunosuppressant therapy, 37.4% had abdominal surgery/trauma, 33.9% had cough, femoral puncture was performed in 31.3% of patients, and 29.5% were on antiplatelet therapy. Rectus sheath hematoma was not an attributable cause in any of the 17 deaths. Mortality was significantly higher in patients with CKD stage ≥3 (P = .03) or who required transfusion (P = .007). Better understanding of RSH risk factors will facilitate early diagnoses and improve management. PMID:25294636

  5. Computer system for forecasting surgery on the eye muscles

    NASA Astrophysics Data System (ADS)

    Avrunin, Oleg G.; Kukharenko, Dmitriy V.; Romanyuk, Sergii O.; Kalizhanova, Aliya; Toygozhinova, Aynur; Gromaszek, Konrad

    2015-12-01

    For the successful surgery on the eye muscles it is recommended to use a computer system of preoperative planning of the surgical correction of strabismus. With using the computer system at surgery planning, ophthalmologist surgeon will be able to choose the best surgical treatment and surgery dosage for a particular patient.

  6. Breast reconstruction with a turbocharged transverse rectus abdominis myocutaneous flap on the contralateral perforator.

    PubMed

    Sbalchiero, Juliano Carlos; de Albuquerque Leal, Paulo Roberto; dos Santos, César Cabello

    2014-11-01

    Seventeen patients were submitted to delayed unilateral breast reconstruction using pedicled, muscle-sparing turbocharged transverse rectus abdominis myocutaneous flap based on the contralateral perforator vessels. The lateral portion of the rectus abdominis muscle on the pedicled side was preserved in 12 patients. Zones II and IV were included in the flap in all cases. Mean duration of surgery was 7 hours and 15 minutes. Four complications developed in the abdominal donor site: contralateral abdominal bulging (n=1), minor suture dehiscence (n=2), and epidermolysis at the border of the abdominal flap and umbilical scar (n=1). Three partial losses (10%-30%) occurred in the reconstructed breast (17.64% of cases), whereas 2 cases of fat necrosis were associated with partial losses. One patient developed deep vein thrombosis with pulmonary embolism; however, outcome was favorable. This proved a viable alternative for breast reconstruction, with satisfactory results in most patients and acceptable morbidity and surgical time. PMID:24625511

  7. Transient increase of higher-order aberrations after lateral rectus recession in children.

    PubMed

    Seo, Kyoung Yul; Hong, Samin; Song, Won Kyoung; Chung, Seung Ah; Lee, Jong Bok

    2011-05-01

    The changes of higher-order aberrations (HOAs) after bilateral lateral rectus muscle recession were evaluated. Forty eyes of 20 children were enrolled and their wavefront information was assessed until postoperative 3 months. Even though the root mean square (RMS) of total aberration was not changed, the RMS of HOA was transiently increased at postoperative 1 week and returned to baseline level after 1 month. Among individual Zernike coefficient, secondary astigmatism, quadrafoil, secondary coma, secondary trefoil, and pentafoil showed similar tendency with the RMS of HOA. However, coma, trefoil, and spherical aberration were not changed. Regarding recession amount, it did not correlate with any Zernike coefficient. In summary, our data imply that the HOAs are transiently increased after lateral rectus recession surgery. These results are in collusion with previous reports that strabismus surgery induced transient corneal astigmatism. PMID:21488198

  8. Surgical Outcome of Medial Rectus Resection in Recurrent Exotropia: A Novel Surgical Formula

    PubMed Central

    Luk, Abbie Sheung-Wan; Yam, Jason Cheuk-Sing; Lau, Henry Hing-Wai; Yip, Wilson Wai-Kuen; Young, Alvin Lerrmann

    2015-01-01

    Purpose. To evaluate the surgical outcomes of unilateral or bilateral medial rectus (MR) muscle resection for recurrent exotropia after bilateral lateral rectus (BLR) muscle recession based on a novel surgical formula. Methods. Forty-one consecutive patients with unilateral or bilateral MR muscle resection for recurrent exotropia after BLR muscle recession were included in this retrospective study. All surgeries were performed according to the formula: 1.0 mm MR muscle resection for every 5 prism dioptres (PD) of exotropia, with an addition of 0.5 mm to each MR muscle operated on. Results. The mean recurrent exotropia distant deviation was 28 PD ± 11.2 (range 14 to 55 PD). Overall at postoperative 1 month, 36 (88%) achieved successful outcomes, 4 (10%) had undercorrection, and 1 (2%) had overcorrection. At postoperative 6 months, 29 (71%) achieved successful outcomes, 12 (29%) had undercorrection, and none had overcorrection. Subgroup analysis showed no statistically significant difference in success rates between unilateral and bilateral MR groups. Conclusion. Unilateral or bilateral MR muscle resection using our surgical formula is a safe and effective method for calculating the amount of MR resection in moderate to large angle recurrent exotropia, with a low overcorrection rate. PMID:25866673

  9. Comparative study of linear and curvilinear ultrasound probes to assess quadriceps rectus femoris muscle mass in healthy subjects and in patients with chronic respiratory disease

    PubMed Central

    Mandal, S; Suh, E; Thompson, A; Connolly, B; Ramsay, M; Harding, R; Puthucheary, Z; Moxham, J; Hart, N

    2016-01-01

    Introduction Ultrasound measurements of rectus femoris cross-sectional area (RFCSA) are clinically useful measurements in chronic obstructive pulmonary disease (COPD) and critically ill patients. Technical considerations as to the type of probe used, which affects image resolution, have limited widespread clinical application. We hypothesised that measurement of RFCSA would be similar with linear and curvilinear probes. Methods Four studies were performed to compare the use of the curvilinear probe in measuring RFCSA. Study 1 investigated agreement of RFCSA measurements using linear and curvilinear probes in healthy subjects, and in patients with chronic respiratory disease. Study 2 investigated the intra-rater and inter-rater agreement using the curvilinear probe. Study 3 investigated the agreement of RFCSA measured from whole and spliced images using the linear probe. Study 4 investigated the applicability of ultrasound in measuring RFCSA during the acute and recovery phases of an exacerbation of COPD. Results Study 1 showed demonstrated no difference in the measurement of RFCSA using the curvilinear and linear probes (308±104 mm2 vs 320±117 mm2, p=0.80; intraclass correlation coefficient (ICC)>0.97). Study 2 demonstrated high intra-rater and inter-rater reliability of RFCSA measurement with ICC>0.95 for both. Study 3 showed that the spliced image from the linear probe was similar to the whole image RFCSA (308±103.5 vs 263±147 mm2, p=0.34; ICC>0.98). Study 4 confirmed the clinical acceptability of using the curvilinear probe during an exacerbation of COPD. There were relationships observed between admission RFCSA and body mass index (r=+0.65, p=0.018), and between RFCSA at admission and physical activity levels at 4 weeks post-hospital discharge (r=+0.75, p=0.006). Conclusions These studies have demonstrated that clinicians can employ whole and spliced images from the linear probe or use images from the curvilinear probe, to measure RFCSA. This will extend

  10. Effects of surgery on the function of the respiratory muscles.

    PubMed

    Siafakas, N M; Mitrouska, I; Argiana, E; Bouros, D

    1999-12-01

    The function of the respiratory muscles (RM) is affected positively or negatively by a variety of surgical procedures. Cardiac, thoracic and upper abdominal surgery impair the RM function and lead to postoperative complications such as hypoxia, atelectasis, aspiration and infections. Preoperative assessment of RM function is cardinal to avoid or attenuate these complications. Three types of surgical procedures, lung transplantation, lung volume reduction surgery and surgery for obesity have been shown to improve RM function. A mechanism by which these types of operation have shown beneficial effects on RM function is multifactorial, depending on geometrical factors, from the reduction of hyperinflation and those depending on changes on the control of breathing. Physicians dealing with postoperative care of patients should be aware of the pathophysiological mechanisms that impair or improve respiratory muscle function as a result of a surgery as well as of the therapeutic modalities. PMID:10695325

  11. Reducing Postoperative Opioid Consumption by Adding an Ultrasound-Guided Rectus Sheath Block to Multimodal Analgesia for Abdominal Cancer Surgery With Midline Incision

    PubMed Central

    Bashandy, Ghada Mohammad Nabih; Elkholy, Abeer Hassan Hamed

    2014-01-01

    Background: Many multimodal analgesia techniques have been tried to provide adequate analgesia for midline incisions extending above and below the umbilicus aiming at limiting the perioperative use of morphine thus limiting side effects. Ultrasound (US) guidance made the anesthesiologist reconsider old techniques for wider clinical use. The rectus sheath block (RSB) is a useful technique under-utilized in the adult population. Objectives: Our study examined the efficacy of a preemptive single-injection rectus sheath block in providing better early postoperative pain scores compared to general anesthesia alone. Patients and Methods: Sixty patients were recruited in this randomized controlled trial. These patients were divided into two groups: RSB group had an RSB after induction of anesthesia and before surgical incision, and GA (general anesthesia) group had general anesthesia alone. Both groups were compared for verbal analogue scale (VAS) score, opioid consumption and hemodynamic variables in the post-anesthesia care unit (PACU). Analgesic requirements in surgical wards were recorded in postoperative days (POD) 0, 1 and 2. Results: The median VAS score was significantly lower in RSB group compared with GA group in all 5 time points in the PACU (P ˂ 0.05). Also PACU morphine consumption was lower in RSB group than GA group patients (95% confidence interval [CI] of the difference in means between groups, −4.59 to −2.23 mg). Morphine consumption was also less in the first 2 postoperative days (POD0 and POD1). Conclusions: Ultrasound-guided rectus sheath block is an easy technique to learn. This technique, when it is used with general anesthesia, will be more effective in reducing pain scores and opioid consumption compared with general anesthesia alone. PMID:25289373

  12. A novel technique for inferior rectus recession

    PubMed Central

    Gokyigit, Birsen; Akar, Serpil; Yilmaz, Omer Faruk

    2014-01-01

    Purpose To introduce a novel technique of inferior rectus recession operation to allow larger amounts of recession without causing lower lid retraction and to compare this method with the results obtained in standard inferior rectus recession. Material and methods This study included 20 patients operated on in the authors’ clinic. The median age of the patients was 24.5±18.6 (4–73) years and the median follow-up was 9.3±11.8 (3–43) months. Ten patients operated on with the standard method were labeled Group 1 and ten patients operated on with the new method were labeled Group 2. Without exceeding 4 mm, inferior rectus recession to the whole muscle was performed in Group 1 patients. Inferior rectus recession was also performed on patients in Group 2 following the new method. Using a spatula, approximately 10% of the muscle surface fibers were detached intact as a thin layer, and the remaining 90% of deeper fibers were recessed 4–8 mm as planned. Patients’ preoperative deviations and lower lid positions were recorded. The same parameters were checked in the first and third month postoperatively. Both groups were evaluated retrospectively by screening their files, and the Mann–Whitney U test was used for statistical evaluation. Results Lower lid retraction was seen in four patients of Group 1. There was no retraction in Group 2. While there was a need to perform additional vertical muscle procedures for vertical deviations and lower lid retractions in Group 1, it was observed that there was no need for additional procedures in Group 2 patients. There was a statistically meaningful difference between the two procedures (P<0.05). Conclusion This novel technique was found to be an effective surgical method for permitting more recession without the risk of lower lid retraction. PMID:24492531

  13. [Severed musculus rectus internus caused by a dog bite].

    PubMed

    Reese, P D; Judisch, G F

    1988-11-01

    A four-year-old girl sustained facial injuries from multiple dog bites. Although the globe exhibited slight adduction saccades the medial rectus muscle appeared to be intact when examined by computer tomography. However, on surgical exploration of the orbit the muscle parenchyma was found to have been completely severed. PMID:3210647

  14. Predictive Factors Affecting the Short Term and Long Term Exodrift in Patients with Intermittent Exotropia after Bilateral Rectus Muscle Recession and Its Effect on Surgical Outcome

    PubMed Central

    Yam, Jason C. S.; Chong, Gabriela S. L.; Wu, Patrick K. W.; Wong, Ursula S. F.; Chan, Clement W. N.; Ko, Simon T. C.

    2014-01-01

    Purpose. To determine the predictive factors that affect short term and long term postoperative drift in intermittent exotropia after bilateral lateral rectus recession and to evaluate its effect on surgical outcome. Methods. Retrospective review of 203 patients with diagnosis of intermittent exotropia, who had surgical corrections with more than 3 years of followup. Different preoperative parameters were obtained and evaluated using Pearson's correlation analysis. Results. The proportion of exodrift increased from 62% at 6 weeks to 84% at 3 years postoperatively. The postoperative drift was 4.3 ± 8.1 PD at 6 weeks, 5.8 ± 8.4 PD at 6 months, 7.2 ± 8.3 PD at 1 year, 7.4 ± 8.4 PD at 2 years, and 7.7 ± 8.5 PD at 3 years. Preoperative deviation and initial overcorrection were significant factors affecting the postoperative drift at 3 years (r = 0.177, P = 0.011, r = −0.349, and P < 0.001, resp.). Conclusions. Postoperative exodrift along three years occurs in a majority of patients after bilateral lateral rectus recession for intermittent exotropia. The long term surgical success is significantly affected by this postoperative exodrift. A larger preoperative deviation and a larger initial overcorrection are associated with a larger early and late postoperative exodrift. PMID:25093170

  15. Missing lateral rectus force and absence of medial rectus co-contraction in ocular convergence.

    PubMed

    Miller, Joel M; Bockisch, Christopher J; Pavlovski, Dmitri S

    2002-05-01

    For a given position of the eye in the orbit, most abducens motoneurons (LRMNs) fire at higher rates in converged gaze than when convergence is relaxed, implying that lateral rectus (LR) muscle force will be higher for a given eye position in convergence. If medial rectus (MR) muscle force balances LR force, it too would be higher in convergence, that is, LRMN recording studies predict horizontal rectus co-contraction in convergence. Three trained rhesus monkeys with binocular eye coils and custom muscle force transducers (MFTs) on LR and MR of one eye alternately fixated near (approximately 7 cm) and far (200 cm) targets with vergence movements of 20-30 degrees. Tonic muscle forces were also measured during conjugate fixation of far targets over a 30 x 30 degrees field. MFT characteristics and effects on oculomotility were assessed. Contrary to predictions, we found small (<1 g) decreases in both LR and MR forces in convergence, for those gaze positions that were used in the brain stem recording studies. This missing LR force paradox (higher LRMN firing rates in convergence but lower LR forces) suggests that motoneurons or muscle fibers contribute differently to oculorotary forces in converged and unconverged states, violating the final common path hypothesis. The absence of MR co-contraction is consistent with, and supports, the missing LR force finding. Resolution of the missing LR force paradox might involve nonlinear interactions among muscle fibers, mechanical specialization of muscle fibers and other articulations of the peripheral oculomotor apparatus, or extranuclear contributions to muscle innervation. PMID:11976379

  16. Medial transposition of split lateral rectus augmented with fixation sutures in cases of complete third nerve palsy.

    PubMed

    Saxena, Rohit; Sharma, Medha; Singh, Digvijay; Dhiman, Rebika; Sharma, Pradeep

    2016-05-01

    Surgical management of complete third nerve paralysis is a challenge. While several techniques have been described over the years, they result in less than satisfactory outcomes with residual deviations in primary gaze or postoperative drifts. One of the described techniques for management of oculomotor palsy has been medial transposition of the lateral rectus muscle which provides a good surgical alternative but often can result in undercorrection. We describe a modification of the existing technique of medial transposition of the split lateral rectus by force augmentation through the use of equatorial fixation sutures resulting in an improved outcome in primary gaze alignment. The modified technique involves splitting of the lateral rectus into two halves followed by transposing the superior half from below the superior oblique and superior rectus and inferior half from below the inferior oblique and inferior rectus to attach them at the superior and inferior edge of the medial rectus insertion, respectively. This is followed by placing non-absorbable sutures to fix each split belly of the transposed muscles to the sclera at the equator adjacent to the medial rectus such that the split muscles lie nearly parallel to the medial rectus till the equator before reflecting away. These sutures augment the force of the transposed muscles by redirecting the force vectors in the direction of action of the medial rectus. Satisfactory postoperative primary gaze alignment was achieved in three cases of complete third nerve paralysis. PMID:26758537

  17. Imaging of rectus femoris proximal tendinopathies.

    PubMed

    Pesquer, Lionel; Poussange, Nicolas; Sonnery-Cottet, Bertrand; Graveleau, Nicolas; Meyer, Philippe; Dallaudiere, Benjamin; Feldis, Matthieu

    2016-07-01

    The rectus femoris is the most commonly injured muscle of the anterior thigh among athletes, especially soccer players. Although the injury pattern of the muscle belly is well documented, less is known about the anatomy and specific lesions of the proximal tendons. For each head, three distinctive patterns may be encountered according to the location of the injury, which can be at the enthesis, within the tendon, or at the musculotendinous junction. In children, injuries correspond most commonly to avulsion of the anteroinferior iliac spine from the direct head and can lead to subspine impingement. Calcific tendinitis and traumatic tears may be encountered in adults. Recent studies have shown that traumatic injuries of the indirect head may be underdiagnosed and that injuries of both heads may have a surgical issue. Finally, in the case of tears, functional outcome and treatment may vary if the rupture involves one or both tendons and if the tear is partial or complete. Thus, it is mandatory for the radiologist to know the different ultrasound and magnetic resonance imaging (MRI) patterns of these lesions in order to provide accurate diagnosis and treatment. The purpose of this article is to recall the anatomy of the two heads of rectus femoris, describe a reliable method of assessment with ultrasound and MRI and know the main injury patterns, through our own experience and literature review. PMID:26956398

  18. Abdominal wall competence after free transverse rectus abdominis musculocutaneous flap harvest: a prospective study.

    PubMed

    Suominen, S; Asko-Seljavaara, S; Kinnunen, J; Sainio, P; Alaranta, H

    1997-09-01

    A prospective study was designed to evaluate the possible changes in abdominal wall strength following free transverse rectus abdominis musculocutaneous (TRAM) flap surgery for breast reconstruction. Twenty-two patients were examined 1 day before surgery, and at 3, 6, and 12 months postoperatively. Trunk muscle strength was measured by the same physiotherapist using an isokinetic dynamometer (Lido Multi Joint II, Loredan Biomedical Inc., Davies, CA). The peak torque and average torque for both flexion and extension at 60 degrees per second angular velocity were recorded from the curves obtained. There was a significant reduction in trunk flexion strength at 3 months postoperatively (peak torque mean, 92% of the preoperative value; p = 0.04), but this was corrected by 6 months (mean, 96%), and improved to 98% by 12 months. The patient's ability to do curled trunk sit-ups was evaluated by the same physiotherapist and graded on a scale from 1 to 6. In 9 of 19 patients the operation had no effect on sit-up performance during follow-up. In 10 of 19 patients there was a reduction of one or two grades at 3 months that did not improve by 12 months. Magnetic resonance imaging of the abdominal wall was performed on 9 patients. The mean area of the upper third of both rectus muscles was measured on the axial images. At 3 months postoperatively the mean area of the upper third of the donor muscle was significantly larger than the contralateral (p = 0.03). There was no difference in size at 6 months, and by 12 months the donor side was smaller. This prospective study shows that harvesting of a free TRAM flap can cause a subclinical reduction in abdominal strength, although this was not noticed by the patients themselves. PMID:9326701

  19. New technical approach for the repair of an abdominal wall defect after a transverse rectus abdominis myocutaneous flap: a case report

    PubMed Central

    Kaemmer, Daniel A; Conze, Joachim; Otto, Jens; Schumpelick, Volker

    2008-01-01

    Introduction Breast reconstruction with autologous tissue transfer is now a standard operation, but abnormalities of the abdominal wall contour represent a complication which has led surgeons to invent techniques to minimize the morbidity of the donor site. Case presentation We report the case of a woman who had bilateral transverse rectus abdominis myocutaneous flap (TRAM-flap) breast reconstruction. The surgery led to the patient developing an enormous abdominal bulge that caused her disability in terms of abdominal wall and bowel function, pain and contour. In the absence of rectus muscle, the large defect was repaired using a combination of the abdominal wall component separation technique of Ramirez et al and additional mesh augmentation with a lightweight, large-pore polypropylene mesh (Ultrapro®). Conclusion The procedure of Ramirez et al is helpful in achieving a tension-free closure of large defects in the anterior abdominal wall. The additional mesh augmentation allows reinforcement of the thinned lateral abdominal wall. PMID:18416835

  20. Video-assisted thoracic surgery lobectomy preserves more latissimus dorsi muscle than conventional surgery.

    PubMed

    Karasaki, Takahiro; Nakajima, Jun; Murakawa, Tomohiro; Fukami, Takeshi; Yoshida, Yukihiro; Kusakabe, Masashi; Ohtsu, Hiroshi; Takamoto, Shinichi

    2009-03-01

    Video-assisted thoracic surgery (VATS) lobectomy for early lung cancer has become technically feasible. We sought to determine if VATS preserved chest wall muscle postoperatively better than thoracotomy. Consecutive patients who underwent lobectomy between 2004 and 2006 for clinical Stage IA non-small cell lung cancer through VATS (VATS group) or posterolateral thoracotomy (PLT group) at our institution were eligible for the study. The cross-sectional areas of bilateral latissimus dorsi muscle (LDM) at the lower end of the scapula were obtained by computed tomography preoperatively and one year after surgery. These were quantified with image analysis by two researchers in a blinded manner. Fourteen patients in the VATS group (mean age, 68 years; 8 men, 6 women) and 24 patients in the PLT group (mean age, 62 years; 14 men, 10 women) were assessed. Postoperative/preoperative ratios of the LDM cross-section areas on the surgical side were 89+/-20% (Mean+/-S.D.) in the VATS group and 57+/-16% in the PLT group (P<0.001). Those on the non-surgical side were 89+/-23% in the VATS group and 97+/-16% in the PLT group (P=0.23). We conclude that VATS may prevent atrophy of LDM on the surgical side better than conventional thoracotomy. PMID:19059949

  1. Differential Lateral Rectus Compartmental Contraction during Ocular Counter-Rolling

    PubMed Central

    Clark, Robert A.; Demer, Joseph L.

    2012-01-01

    Purpose. The lateral rectus (LR) and medial rectus (MR) extraocular muscles (EOMs) have largely nonoverlapping superior and inferior innervation territories, suggesting functional compartmental specialization. We used magnetic resonance imaging (MRI) in humans to investigate differential compartmental activity in the rectus EOMs during head tilt, which evokes ocular counter-rolling, a torsional vestibulo-ocular reflex (VOR). Methods. MRI in quasi-coronal planes was analyzed during target-controlled central gaze in 90° right and left head tilts in 12 normal adults. Cross sections and posterior partial volumes of the transverse portions of the four rectus EOMs were compared in contiguous image planes 2 mm thick spanning the orbit from origins to globe equator, and used as indicators of contractility. Results. Horizontal rectus EOMs had significantly greater posterior volumes and maximum cross sections in their inferior compartments (P < 10−8). In orbit tilt up (extorted) compared with orbit tilt down (intorted) head tilts, contractile changes in LR maximum cross section (P < 0.0001) and posterior partial volume (P < 0.05) were significantly greater in the inferior but not in the superior compartment. These changes were not explainable by horizontal or vertical eye position changes. A weaker compartmental effect was suggested for MR. The vertical rectus EOMs did not exhibit significant compartmental contractile changes during head tilt. Mechanical modeling suggests that differential LR contraction may contribute to physiological cyclovertical effects. Conclusions. Selective activation of the two LR, and possibly MR, compartments correlates with newly recognized segregation of intramuscular innervation into distinct compartments, and probably contributes to noncommutative torsion during the VOR. PMID:22427572

  2. The origins and insertions of the extraocular muscles: development, histologic features, and clinical significance.

    PubMed Central

    Sevel, D

    1986-01-01

    The tendinous origins and insertions of the extraocular muscles were studied embryologically by macroscopic and microscopic methods. It is concluded from this investigation that these tendons of origin and insertion arise from mesenchymal tissue similar to that of their respective muscles. These tendon-muscle groups have developed from superior and inferior mesenchymal complexes. The origins of the extraocular muscles are attached to the periorbita by an interlocking of the tendinous and muscular fibers, which allows for mobility of the extraocular muscles in all extreme directions of gaze and also results in a strong mechanical mooring for these muscles. Avulsion at the origins of the extraocular muscles following severe traction or trauma is rare. The additional origin of the superior and medial rectus muscles to the dura of the optic nerve explains the pain that may occur on movement of the eye in optic neuritis. Optic nerve compression and thyroid myopathy is explained by mucopolysaccharide and inflammatory cell infiltration of the muscular interdigitations that extend up to the site of origin of the rectus muscles. Findings of this investigation suggest that the association of ptosis and superior rectus muscle underaction may be due to a persistence of fibrous tissue that has endured from embryologic development between the superior rectus and levator palpebrae superioris muscles. Superior oblique tendon sheath syndrome is explained by embryologic strands remaining between the tendon of the superior oblique muscle and the trochlea. The insertions of the rectus muscles extend from the equator of the eye to the limbus early on in development. By processes of differential degeneration between the sclera and the rectus tendon, posterior recession of the tendon from the limbus, and contemporaneous growth of the anterior segment of the eye, these tendons reach their adult location only between the ages of 18 months and 2 years. In strabismus surgery, measurements

  3. Robotic Total Pelvic Exenteration with Laparoscopic Rectus Flap: Initial Experience

    PubMed Central

    Winters, Brian R.; Mann, Gary N.; Louie, Otway; Wright, Jonathan L.

    2015-01-01

    Total pelvic exenteration is a highly morbid procedure performed for locally advanced pelvic malignancies. We describe our experience with three patients who underwent robotic total pelvic exenteration with laparoscopic rectus flap and compare perioperative characteristics to our open experience. Demographic, tumor, operative, and perioperative factors were examined with descriptive statistics reported. Mean operative times were similar between the two groups. When compared to open total pelvic exenteration cases (n = 9), median estimated blood loss, ICU stay, and hospital stay were all decreased. These data show robotic pelvic exenteration with laparoscopic rectus flap is technically feasible. The surgery was well tolerated with low blood loss and comparable operative times to the open surgery. Further study is needed to confirm the oncologic efficacy and the suggested improvement in surgical morbidity. PMID:25960911

  4. Classification of Chronic Back Muscle Degeneration after Spinal Surgery and Its Relationship with Low Back Pain

    PubMed Central

    Orita, Sumihisa; Yamauchi, Kazuyo; Eguchi, Yawara; Aoki, Yasuchika; Nakamura, Junichi; Ishikawa, Tetsuhiro; Miyagi, Masayuki; Kamoda, Hiroto; Suzuki, Miyako; Kubota, Gou; Inage, Kazuhide; Sainoh, Takeshi; Sato, Jun; Shiga, Yasuhiro; Abe, Koki; Fujimoto, Kazuki; Kanamoto, Hirohito; Inoue, Gen; Takahashi, Kazuhisa

    2016-01-01

    Study Design Retrospective case series. Purpose To classify back muscle degeneration using magnetic resonance imaging (MRI) and investigate its relationship with back pain after surgery. Overview of Literature Back muscle injury and degeneration often occurs after posterior lumbar surgery, and the degeneration may be a cause of back pain. However, the relationship between back muscle degeneration and back pain remains controversial. Methods A total of 84 patients (average age, 65.1 years; 38 men, 46 women) with lumbar spinal stenosis underwent posterior decompression surgery alone. MRI (1.5 tesla) was evaluated before and more than a year after surgery in all patients. Muscle on MRI was classified into three categories: low intensity in T1-weighted imaging, high intensity in T2-weighted imaging (type 1), high intensity in both T1- and T2-weighted images (type 2), and low intensity in both T1- and T2-weighted imaging (type 3). The prevalence of the types and their relationship with back pain (determined on a visual analog scale) were evaluated. Results MRI revealed muscle degeneration in all patients after surgery (type 1, 6%; type 2, 82%; and type 3, 12%). Type 2 was significantly more frequent compared with types 1 and 3 (p<0.01). Low back pain was significantly improved after surgery (p<0.01). Low back pain was not associated with any MRI type of muscle degeneration after surgery (p>0.05). Conclusions Various pathologies of back muscle degeneration after posterior lumbar surgery were revealed. Type 2 (fatty) change was most frequent, and other patients had type 3 (scar) or type 1 (inflammation or water-like) changes. According to the Modic classification of bone marrow changes, Modic type 1 change is associated with inflammation and back pain. However, no particular type of back muscle degeneration was correlated with back pain after surgery. PMID:27340532

  5. Rectus abdominis overuse injury in a tennis athlete treated with traumeel

    PubMed Central

    Natsis, Konstantinos; Lyrtzis, Christos; Papathanasiou, Efthymia; Anastasopoulos, Nikos

    2012-01-01

    Summary Background: Rectus abdominis injuries are common in tennis players at all levels of competition. Traumeel® injection can be used for treatment of muscle strains and hematomas. Case Report: A 21-year-old female tennis athlete was injured on the non-dominant rectus abdominis during the cocking phase of the service motion. She suffered from pain and tenderness. One week later, during a serve, she experienced severe pain on the contralateral side of her abdomen. Conservative treatment was performed by the team physician with rest, ice therapy and analgesics for 20 days, but she had recurrent injuries. The ultrasonography and MRI showed hematoma of the rectus abdominis muscle. She was treated with 2 injections of Traumeel® on the 2nd, 4th, 6th post-traumatic day and received 1 injection on the 10th post-traumatic day. She also modified her serve technique. On the fourth post-treatment week the athlete had pain-free function and both the MRI appearance and the size of rectus abdominal muscle were normal. She returned to her sport activities. There is no recurrence of her injury 2 years later. Conclusions: Rectus abdominis hematoma must be diagnosed early. Traumeel® injections are effective, safe and well-tolerated for the treatment of overuse injury of the rectus abdominis following strain. PMID:23569472

  6. Adaptability of the Immature Ocular Motor Control System: Unilateral IGF-1 Medial Rectus Treatment

    PubMed Central

    Willoughby, Christy L.; Fleuriet, Jérome; Walton, Mark M.; Mustari, Michael J.; McLoon, Linda K.

    2015-01-01

    Purpose. Unilateral treatment with sustained release IGF-1 to one medial rectus muscle in infant monkeys was performed to test the hypothesis that strabismus would develop as a result of changes in extraocular muscles during the critical period of development of binocularity. Methods. Sustained release IGF-1 pellets were implanted unilaterally on one medial rectus muscle in normal infant monkeys during the first 2 weeks of life. Eye position was monitored using standard photographic methods. After 3 months of treatment, myofiber and neuromuscular size, myosin composition, and innervation density were quantified in all rectus muscles and compared to those in age-matched controls. Results. Sustained unilateral IGF-1 treatments resulted in strabismus for all treated subjects; 3 of the 4 subjects had a clinically significant strabismus of more than 10°. Both the treated medial rectus and the untreated ipsilateral antagonist lateral rectus muscles had significantly larger myofibers. No adaptation in myofiber size occurred in the contralateral functionally yoked lateral rectus or in myosin composition, neuromuscular junction size, or nerve density. Conclusions. Sustained unilateral IGF-1 treatment to extraocular muscles during the sensitive period of development of orthotropic eye alignment and binocularity was sufficient to disturb ocular motor development, resulting in strabismus in infant monkeys. This could be due to altering fusion of gaze during the early sensitive period. Serial measurements of eye alignment suggested the IGF-1-treated infants received insufficient coordinated binocular experience, preventing the establishment of normal eye alignment. Our results uniquely suggest that abnormal signaling by the extraocular muscles may be a cause of strabismus. PMID:26030103

  7. Prediction of Muscle Fatigue during Minimally Invasive Surgery Using Recurrence Quantification Analysis

    PubMed Central

    Keshavarz Panahi, Ali; Cho, Sohyung

    2016-01-01

    Due to its inherent complexity such as limited work volume and degree of freedom, minimally invasive surgery (MIS) is ergonomically challenging to surgeons compared to traditional open surgery. Specifically, MIS can expose performing surgeons to excessive ergonomic risks including muscle fatigue that may lead to critical errors in surgical procedures. Therefore, detecting the vulnerable muscles and time-to-fatigue during MIS is of great importance in order to prevent these errors. The main goal of this study is to propose and test a novel measure that can be efficiently used to detect muscle fatigue. In this study, surface electromyography was used to record muscle activations of five subjects while they performed fifteen various laparoscopic operations. The muscle activation data was then reconstructed using recurrence quantification analysis (RQA) to detect possible signs of muscle fatigue on eight muscle groups (bicep, triceps, deltoid, and trapezius). The results showed that RQA detects the fatigue sign on bilateral trapezius at 47.5 minutes (average) and bilateral deltoid at 57.5 minutes after the start of operations. No sign of fatigue was detected for bicep and triceps muscles of any subject. According to the results, the proposed novel measure can be efficiently used to detect muscle fatigue and eventually improve the quality of MIS procedures with reducing errors that may result from overlooked muscle fatigue. PMID:27313884

  8. Decellularized Human Skeletal Muscle as Biologic Scaffold for Reconstructive Surgery.

    PubMed

    Porzionato, Andrea; Sfriso, Maria Martina; Pontini, Alex; Macchi, Veronica; Petrelli, Lucia; Pavan, Piero G; Natali, Arturo N; Bassetto, Franco; Vindigni, Vincenzo; De Caro, Raffaele

    2015-01-01

    Engineered skeletal muscle tissues have been proposed as potential solutions for volumetric muscle losses, and biologic scaffolds have been obtained by decellularization of animal skeletal muscles. The aim of the present work was to analyse the characteristics of a biologic scaffold obtained by decellularization of human skeletal muscles (also through comparison with rats and rabbits) and to evaluate its integration capability in a rabbit model with an abdominal wall defect. Rat, rabbit and human muscle samples were alternatively decellularized with two protocols: n.1, involving sodium deoxycholate and DNase I; n.2, trypsin-EDTA and Triton X-NH4OH. Protocol 2 proved more effective, removing all cellular material and maintaining the three-dimensional networks of collagen and elastic fibers. Ultrastructural analyses with transmission and scanning electron microscopy confirmed the preservation of collagen, elastic fibres, glycosaminoglycans and proteoglycans. Implantation of human scaffolds in rabbits gave good results in terms of integration, although recellularization by muscle cells was not completely achieved. In conclusion, human skeletal muscles may be effectively decellularized to obtain scaffolds preserving the architecture of the extracellular matrix and showing mechanical properties suitable for implantation/integration. Further analyses will be necessary to verify the suitability of these scaffolds for in vitro recolonization by autologous cells before in vivo implantation. PMID:26140375

  9. Decellularized Human Skeletal Muscle as Biologic Scaffold for Reconstructive Surgery

    PubMed Central

    Porzionato, Andrea; Sfriso, Maria Martina; Pontini, Alex; Macchi, Veronica; Petrelli, Lucia; Pavan, Piero G.; Natali, Arturo N.; Bassetto, Franco; Vindigni, Vincenzo; De Caro, Raffaele

    2015-01-01

    Engineered skeletal muscle tissues have been proposed as potential solutions for volumetric muscle losses, and biologic scaffolds have been obtained by decellularization of animal skeletal muscles. The aim of the present work was to analyse the characteristics of a biologic scaffold obtained by decellularization of human skeletal muscles (also through comparison with rats and rabbits) and to evaluate its integration capability in a rabbit model with an abdominal wall defect. Rat, rabbit and human muscle samples were alternatively decellularized with two protocols: n.1, involving sodium deoxycholate and DNase I; n.2, trypsin-EDTA and Triton X-NH4OH. Protocol 2 proved more effective, removing all cellular material and maintaining the three-dimensional networks of collagen and elastic fibers. Ultrastructural analyses with transmission and scanning electron microscopy confirmed the preservation of collagen, elastic fibres, glycosaminoglycans and proteoglycans. Implantation of human scaffolds in rabbits gave good results in terms of integration, although recellularization by muscle cells was not completely achieved. In conclusion, human skeletal muscles may be effectively decellularized to obtain scaffolds preserving the architecture of the extracellular matrix and showing mechanical properties suitable for implantation/integration. Further analyses will be necessary to verify the suitability of these scaffolds for in vitro recolonization by autologous cells before in vivo implantation. PMID:26140375

  10. Tourniquet Use During Knee Replacement Surgery May Contribute to Muscle Atrophy in Older Adults.

    PubMed

    Dreyer, Hans C

    2016-04-01

    Muscle atrophy after total knee arthroplasty (TKA) occurs at a rate of 1% per day for the first 2 wk. Our hypothesis is that tourniquet-induced ischemia-reperfusion injury occurring during TKA influences metabolism and may contribute to atrophy. Identifying pathways that are upregulated during this critical "14-d window" after surgery may help us delineate therapeutic approaches to avoid muscle loss. PMID:26829246

  11. Predictive Factors in the Outcome of Surgical Repair of Abdominal Rectus Diastasis

    PubMed Central

    Clay, Leonard; Stark, Birgit; Gunnarsson, Ulf

    2016-01-01

    Background: The aim of this study was to define the indicators predicting improved abdominal wall function after surgical repair of abdominal rectus diastasis (ARD). Preoperative subjective assessment quantified by the validated Ventral Hernia Pain Questionnaire (VHPQ) was related to relative postoperative functional improvement in abdominal muscle strength. Methods: Fifty-seven patients undergoing surgery for ARD completed the VHPQ before surgery. Preoperative pain assessment results were compared with the relative improvement in muscle strength measured with the BioDex system 4. Results: There was a correlation between the relative improvement in muscle strength measured by the BioDex System 4 for flexion at 30 degrees (P = 0.046) and 60 degrees per second (P = 0.004) and the preoperative question, “Do you find it painful to sit for more than 30 minutes?” There was also a correlation between BioDex improvement for flexion at 30 degrees (P = 0.022) and for isometric work load (P = 0.038) and the preoperative question, “Has abdominal pain limited your ability to perform sports activities?” The VHPQ responses also formed a pattern with a fairly good correlation between other BioDex modalities (with the exception of extension at 60 degrees per second) and the response to the question regarding complaints when performing sports. Postoperative visual analog scale ratings of abdominal wall stability correlated to the questions regarding complaints when sitting (P = 0.040) and standing (P = 0.047). No other correlation was seen. Conclusion: VHPQ ratings concerning pain while being seated for more than 30 minutes and pain limiting the ability to perform sports are promising indicators in the identification of patients likely to benefit from surgical correction of their ARD. PMID:27579227

  12. Combined Muscle Motor and Somatosensory Evoked Potentials for Intramedullary Spinal Cord Tumour Surgery

    PubMed Central

    Choi, Il; Hyun, Seung-Jae; Kang, Joong-Koo

    2014-01-01

    Purpose To evaluate whether intraoperative neurophysiologic monitoring (IONM) with combined muscle motor evoked potentials (mMEPs) and somatosensory evoked potentials is useful for more aggressive and safe resection in intramedullary spinal cord tumour (IMSCT) surgery. Materials and Methods We reviewed data from consecutive patients who underwent surgery for IMSCT between 1998 and April 2012. The patients were divided into two groups based on whether or not IONM was applied. In the monitored group, the procedures were performed under IONM using 75% muscle amplitude decline weaning criteria. The control group was comprised of patients who underwent IMSCT surgery without IONM. The primary outcome was the rate of gross total excision of the tumour on magnetic resonance imaging at one week after surgery. The secondary outcome was the neurologic outcome based on the McCormick Grade scale. Results The two groups had similar demographics. The total gross removal tended to increase when intraoperative neurophysiologic monitoring was used, but this tendency did not reach statistical significance (76% versus 58%; univariate analysis, p=0.049; multivariate regression model, p=0.119). The serial McCormick scale score was similar between the two groups (based on repeated measure ANOVA). Conclusion Our study evaluated combined IONM of trans-cranial electrical (Tce)-mMEPs and SEPs for IMSCT. During IMSCT surgery, combined Tce-mMEPs and SEPs using 75% muscle amplitude weaning criteria did not result in significant improvement in the rate of gross total excision of the tumour or neurologic outcome. PMID:24954338

  13. Laparoscopic surgery and muscle relaxants: is deep block helpful?

    PubMed

    Kopman, Aaron F; Naguib, Mohamed

    2015-01-01

    It has been hypothesized that providing deep neuromuscular block (a posttetanic count of 1 or more, but a train-of-four [TOF] count of zero) when compared with moderate block (TOF counts of 1-3) for laparoscopic surgery would allow for the use of lower inflation pressures while optimizing surgical space and enhancing patient safety. We conducted a literature search on 6 different medical databases using 3 search strategies in each database in an attempt to find data substantiating this proposition. In addition, we studied the reference lists of the articles retrieved in the search and of other relevant articles known to the authors. There is some evidence that maintaining low inflation pressures during intra-abdominal laparoscopic surgery may reduce postoperative pain. Unfortunately most of the studies that come to these conclusions give few if any details as to the anesthetic protocol or the management of neuromuscular block. Performing laparoscopic surgery under low versus standard pressure pneumoperitoneum is associated with no difference in outcome with respect to surgical morbidity, conversion to open cholecystectomy, hemodynamic effects, length of hospital stay, or patient satisfaction. There is a limit to what deep neuromuscular block can achieve. Attempts to perform laparoscopic cholecystectomy at an inflation pressure of 8 mm Hg are associated with a 40% failure rate even at posttetanic counts of 1 or less. Well-designed studies that ask the question "is deep block superior to moderate block vis-à-vis surgical operating conditions" are essentially nonexistent. Without exception, all the peer-reviewed studies we uncovered which state that they investigated this issue have such serious flaws in their protocols that the authors' conclusions are suspect. However, there is evidence that abdominal compliance was not increased by a significant amount when deep block was established when compared with moderate neuromuscular block. Maintenance of deep block for

  14. Pre-operative inspiratory muscle training preserves postoperative inspiratory muscle strength following major abdominal surgery – a randomised pilot study

    PubMed Central

    Kulkarni, SR; Fletcher, E; McConnell, AK; Poskitt, KR; Whyman, MR

    2010-01-01

    INTRODUCTION The aim of this pilot study was to assess the effect of pre-operative inspiratory muscle training (IMT) on respiratory variables in patients undergoing major abdominal surgery. PATIENTS AND METHODS Respiratory muscle strength (maximum inspiratory [MIP] and expiratory [MEP] mouth pressure) and pulmonary functions were measured at least 2 weeks before surgery in 80 patients awaiting major abdominal surgery. Patients were then allocated randomly to one of four groups (Group A, control; Group B, deep breathing exercises; Group C, incentive spirometry; Group D, specific IMT). Patients in groups B, C and D were asked to train twice daily, each session lasting 15 min, for at least 2 weeks up to the day before surgery. Outcome measurements were made immediately pre-operatively and postop-eratively. RESULTS In groups A, B and C, MIP did not increase from baseline to pre-operative assessments. In group D, MIP increased from 51.5 cmH2O (median) pre-training to 68.5 cmH2O (median) post-training pre-operatively (P < 0.01). Postoperatively, groups A, B and C showed a fall in MIP from baseline (P < 0.01, P < 0.01) and P = 0.06, respectively). No such significant reduction in postoperative MIP was seen in group D (P = 0.36). CONCLUSIONS Pre-operative specific IMT improves MIP pre-operatively and preserves it postoperatively. Further studies are required to establish if this is associated with reduced pulmonary complications. PMID:20663275

  15. Myositis Ossificans of Rectus Femoris: A Rare Case Report

    PubMed Central

    Srikanth, I Muni; Vishal, Amar; Kiran, K Ravi

    2015-01-01

    Introduction: Myositis ossificans (MO), heterotopic ossification, occurs in muscles and soft tissue. This lesion contains actively proliferating fibroblasts and osteoblasts. It commonly affects vigorous young men and more so among athletes. It occurs as a result of trauma, either acute or chronic and can also arise near joints in neurological disorders. By time of presentation, ossification is extensive and the benign nature of the lesion is usually evident on radiological studies. Most common muscles involved in MO are the flexor muscles of the arm, the hamstrings and quadriceps femoris. Case Report: We present a case of MO with isolated involvement of rectus femoris in mid-thigh and sparing of other three muscles of quadriceps femoris, with no improvement following physiotherapy and medical management requiring surgical excision for better prognosis with no recurrence. Conclusion: MO, a benign lesion, is known to affect the flexors of the arm, the hamstrings, and quadriceps femoris; it must be noted that even individual muscle can also be affected as shown in the above case presentation without involving whole group of muscles. Surgical excision is indicated if non-operative measures are not successful. PMID:27299083

  16. The spinal accessory nerve plexus, the trapezius muscle, and shoulder stabilization after radical neck cancer surgery.

    PubMed Central

    Brown, H; Burns, S; Kaiser, C W

    1988-01-01

    A clinical and anatomic study of the spinal accessory, the eleventh cranial nerve, and trapezius muscle function of patients who had radical neck cancer surgery was conducted. This study was done not only to document the indispensibility of the trapezius muscle to shoulder-girdle stability, but also to clarify the role of the eleventh cranial nerve in the variable motor and sensory changes occurring after the loss of this muscle. Seventeen male patients, 49-69 years of age, (average of 60 years of age) undergoing a total of 23 radical neck dissections were examined for upper extremity function, particularly in regard to the trapezius muscle, and for subjective signs of pain. The eleventh nerve, usually regarded as the sole motor innervation to the trapezius, was cut in 17 instances because of tumor involvement. Dissection of four fresh and 30 preserved adult cadavers helped to reconcile the motor and sensory differences in patients who had undergone loss of the eleventh nerve. The dissections and clinical observations corroborate that the trapezius is a key part of a "muscle continuum" that stabilizes the shoulder. Variations in origins and insertions of the trapezius may influence its function in different individuals. As regards the spinal accessory nerve, it is concluded that varying motor and sensory connections form a plexus with the eleventh nerve, accounting, in part, for the variations in motor innervation and function of the trapezius, as well as for a variable spectrum of sensory changes when the eleventh nerve is cut. For this reason, it is suggested that the term "spinal accessory nerve plexus" be used to refer to the eleventh nerve when it is considered in the context of radical neck cancer surgery. Images Fig. 4. Fig. 6. Fig. 7. Fig. 8. PMID:3056289

  17. Control of a Six Degree-of-Freedom Prosthetic Arm after Targeted Muscle Reinnervation Surgery

    PubMed Central

    Miller, Laura A.; Lipschutz, Robert D.; Stubblefield, Kathy A.; Lock, Blair A.; Huang, He; Williams, T. Walley; Weir, Richard F.; Kuiken, Todd A.

    2011-01-01

    Objectives To fit and evaluate the control of a complex prosthesis for a shoulder disarticulation level amputee subject with targeted muscle reinnervation. Design One participant who had targeted muscle reinnervation surgery was fit with an advanced prosthesis and usage with this device was compared to the device used in the home setting. Setting The experiments were completed within a laboratory setting. Participants The first recipient of targeted muscle reinnervation: a bilateral shoulder disarticulation level amputee. Interventions Two years after surgery, the subject was fit with a 6 degree of freedom (DOF) prosthesis (shoulder flexion, humeral rotation, elbow flexion, wrist rotation, wrist flexion, and hand control). Control of this device was compared to his commercially available 3 DOF system (elbow, wrist rotation, and powered hook terminal device). Main Outcome Measure In order to assess performance, movement analysis and timed movement tasks were executed. Results The subject was able to independently operate all 6 arm functions with good control. He could simultaneously operate 2 DOF of several different joint combinations with relative ease. He operated up to 4 DOF simultaneously, but with poor control. Work space was markedly increased and some timed-tasks were faster with the 6-DOF system. Conclusions This proof-of-concept study shows that advances in control of shoulder disarticulation level prostheses can improve the quality of movement. Additional control sources may spur the development of more advanced and complex componentry for these amputees. PMID:18996233

  18. Loop Myopexy Surgery for Strabismus Associated with High Myopia

    PubMed Central

    Su, Yun; Shen, Qin; Fan, Xianqun

    2016-01-01

    Strabismus associated with high myopia is a rare abnormality of ocular motility, leading to the impairment of abduction and supraduction. Loop myopexy of the superior rectus (SR) and lateral rectus (LR) muscles is now the most preferred surgery for restoring the dislocated eye globe back into the muscle cone. Various procedural modifications have been made based on this concept, and satisfactory outcomes have been reached in most cases. In this paper, we review various surgical modifications published in the literature that are based on the loop myopexy surgery in patients with high myopic strabismus and summarize the applicable scope of different surgical procedures for patients with different degrees of strabismus. Three major surgical procedures are identified and different modifications have been applied based on their concept. Most of these modifications have been proven to be safe and effective and result in good ocular alignments. The selection of such modifications is of great importance in different patients. Careful evaluation before surgery should be made not only to make the correct diagnosis but also to choose an appropriate surgical procedure and offer individualized modifications in the surgery. PMID:27239338

  19. Role of calf muscle stimulation in the prevention of DVT in Indian patients undergoing surgeries for fractures around the hip

    PubMed Central

    Goyal, Aman; Arora, Sumit; Batra, Sumit; Sharma, Rohit; Mittal, Mahesh Kumar; Sharma, Vinod K

    2012-01-01

    Background: The venous stasis of soleal vein during surgery may be an important factor in the development of deep vein thrombosis (DVT). The stimulation of calf muscle during surgery may help in preventing DVT. The present study is conducted to evaluate the role of peroperative calf muscle electrostimulation in prevention of DVT in patients undergoing surgeries around the hip joint. Materials and Methods: The study comprised 200 patients undergoing surgeries around the hip joint. The patients having risk factors (such as previous myocardial infarction, malignancies, paraplegia or lower limb monoplegia, previous history of DVT or varicose veins, etc.) for the development of DVT were excluded. They were randomized into two groups: 100 cases were given peroperative calf muscle electrostimulation for DVT prophylaxis (Group A) and the remaining 100 patients were taken as controls without any prophylaxis (Group B). The color Doppler ultrasound was performed to exclude pre-existing DVT and on 7th day postoperative to find out the incidence of DVT in both the groups. Results: Two patients among Group A and six patients among Group B demonstrated DVT on ultrasonography, but the difference was not found to be statistically significant (P=0.279). None of the patients had any clinical evidence of DVT. Conclusion: The role of peroperative calf muscle electrostimulation for DVT prophylaxis remains controversial. The risk of developing DVT in patients undergoing surgeries around the hip joint is very less in patients analysed in our series. PMID:23162147

  20. [Spontaneous hematoma of the musculus rectus sheath].

    PubMed

    Mandarano, R; Sereni, P; Ceccherini, E; Ciccone, A

    1990-10-31

    Spontaneous haematoma of the musculus rectus is a rare event and can lead to a clinical picture comparable to what is seen in acute abdomen, thus posing a differential diagnosis problem. Three personally observed cases are reported, stress being laid on the fact that echography, in the light of clinical and laboratory data, made correct diagnosis possible. On the basis of clinical and echographic findings, one patient was subjected to surgical treatment and the others to conservative medical treatment because of the small dimensions of haematoma. PMID:2150543

  1. Lateral rectus palsy following coronary angiography and percutaneous coronary intervention

    PubMed Central

    Nicholson, Luke; Jones, Ruth; Hughes, David S

    2014-01-01

    We present a rare case of unilateral lateral rectus palsy following an elective coronary angiography and percutaneous coronary intervention in a 78-year-oldwoman. Ophthalmoplegia following coronary angiography is extremely rare and this is the first case of a unilateral lateral rectus palsy following the procedure. PMID:24536054

  2. Morphometrics of the Anterior Belly and Intermediate Tendon of the Digastric Muscle: Sexual Dimorphism and Implications for Surgery.

    PubMed

    Zdilla, Matthew J; Pancake, Alex R; Lambert, H Wayne

    2016-07-01

    The anterior belly of the digastric muscle (ABDM) is important in a variety of surgeries including submental lipectomy, rhytidectomy, alteration of the cervicomental angle via muscle resection, the "digastric corset" procedure for submental rejuvenation, the submental artery flap, and reanimation of the mouth after facial nerve palsy. Despite its clinical significance, little information exists regarding the morphometrics of the ABDM or its associated intermediate tendon. This study analyzed a total of 35 intact ABDMs and 43 intact intermediate tendons from 23 cadavers. Measurements were taken of the following parameters: muscle belly area, muscle belly length, intermediate tendon length, and intermediate tendon width at mid-tendon. Normative descriptive statistics are included within the report. Males were found to have significantly longer left-sided muscle bellies than right-sided bellies from males (U = 23.0; P = 0.044), left-sided bellies from females (U = 19.0; P = 0.020), and right-sided bellies from females (U = 12.0; P = 0.035). The morphometry, including sexual dimorphism, presented in this report can aid in the surgical planning and execution of numerous operations performed in head and neck, especially digastric muscle transfer surgery. PMID:27258716

  3. Three cases of severe invasive infections caused by Campylobacter rectus and first report of fatal C. rectus infection.

    PubMed

    Lam, Jimmy Y W; Wu, Alan K L; Ngai, Dickson C; Teng, Jade L L; Wong, Elsa S Y; Lau, Susanna K P; Lee, Rodney A; Woo, Patrick C Y

    2011-04-01

    We report the first fatal case of Campylobacter rectus infection due to a subdural empyema and ruptured mycotic intracranial aneurysm and two cases of limb-threatening C. rectus necrotizing soft tissue and bone infection and empyema thoracis that responded to amoxicillin-clavulanate and surgical debridement and drainage. All three strains were identified by 16S rRNA sequencing. PMID:21270212

  4. Three Cases of Severe Invasive Infections Caused by Campylobacter rectus and First Report of Fatal C. rectus Infection▿

    PubMed Central

    Lam, Jimmy Y. W.; Wu, Alan K. L.; Ngai, Dickson C.; Teng, Jade L. L.; Wong, Elsa S. Y.; Lau, Susanna K. P.; Lee, Rodney A.; Woo, Patrick C. Y.

    2011-01-01

    We report the first fatal case of Campylobacter rectus infection due to a subdural empyema and ruptured mycotic intracranial aneurysm and two cases of limb-threatening C. rectus necrotizing soft tissue and bone infection and empyema thoracis that responded to amoxicillin-clavulanate and surgical debridement and drainage. All three strains were identified by 16S rRNA sequencing. PMID:21270212

  5. Neurovascular free-muscle transfer for the treatment of established facial paralysis following ablative surgery in the parotid region.

    PubMed

    Takushima, Akihiko; Harii, Kiyonori; Asato, Hirotaka; Ueda, Kazuki; Yamada, Atsushi

    2004-05-01

    Neurovascular free-muscle transfer for facial reanimation was performed as a secondary reconstructive procedure for 45 patients with facial paralysis resulting from ablative surgery in the parotid region. This intervention differs from neurovascular free-muscle transfer for treatment of established facial paralysis resulting from conditions such as congenital dysfunction, unresolved Bell palsy, Hunt syndrome, or intracranial morbidity, with difficulties including selection of recipient vessels and nerves, and requirements for soft-tissue augmentation. This article describes the authors' operative procedure for neurovascular free-muscle transfer after ablative surgery in the parotid region. Gracilis muscle (n = 24) or latissimus dorsi muscle (n = 21) was used for transfer. With gracilis transfer, recipient vessels comprised the superficial temporal vessels in 12 patients and the facial vessels in 12. For latissimus dorsi transfer, recipient vessels comprised the facial vessels in 16 patients and the superior thyroid artery and superior thyroid or internal jugular vein in four. Facial vessels on the contralateral side were used with interpositional graft of radial vessels in the remaining patient with latissimus dorsi transfer. Cross-face nerve grafting was performed before muscle transfer in 22 patients undergoing gracilis transfer. In the remaining two gracilis patients, the ipsilateral facial nerve stump was used as the primary recipient nerve. Dermal fat flap overlying the gracilis muscle was used for cheek augmentation in one patient. In the other 23 patients, only the gracilis muscle was used. With latissimus dorsi transfer, the ipsilateral facial nerve stump was used as the recipient nerve in three patients, and a cross-face nerve graft was selected as the recipient nerve in six. The contralateral facial nerve was selected as the recipient nerve in 12 patients, and a thoracodorsal nerve from the latissimus dorsi muscle segment was crossed through the upper lip

  6. Muscle activity in the lower limbs during push-down movement with a new active-exercise apparatus for the leg

    PubMed Central

    Tanaka, Kenta; Kamada, Hiroshi; Shimizu, Yukiyo; Aikawa, Shizu; Irie, Shun; Ochiai, Naoyuki; Sakane, Masataka; Yamazaki, Masashi

    2016-01-01

    [Purpose] Lower-limb deep vein thrombosis is a complication of orthopedic surgery. A leg-exercise apparatus named “LEX” was developed as a novel active-exercise apparatus for deep vein thrombosis prevention. Muscle activity was evaluated to assess the effectiveness of exercise with LEX in the prevention. [Subjects] Eight healthy volunteers participated in this study. [Methods] Muscle activities were determined through electromyography during exercise with LEX [LEX (+)] and during active ankle movements [LEX (−)]. The end points were peak % maximum voluntary contraction and % integrated electromyogram of rectus femoris, vastus lateralis, biceps femoris, tibialis anterior, gastrocnemius, and soleus. [Results] LEX (+) resulted in higher average values in all muscles except the tibialis anterior. Significant differences were noted in the peak of the biceps femoris and gastrocnemius and in the integrated electromyogram of the rectus femoris, vastus lateralis, gastrocnemius, and soleus. The LEX (+)/LEX (−) ratio of the peak was 2.2 for the biceps femoris and 2.0 for the gastrocnemius . The integrated electromyogram was 1.8 for the gastrocnemius, 1.5 for the rectus femoris, 1.4 for the vastus lateralis, and 1.2 for the soleus. [Conclusion] Higher muscle activity was observed with LEX (+). LEX might be a good tool for increasing lower-limb blood flow and deep vein thrombosis prevention. PMID:27134410

  7. Muscle activity in the lower limbs during push-down movement with a new active-exercise apparatus for the leg.

    PubMed

    Tanaka, Kenta; Kamada, Hiroshi; Shimizu, Yukiyo; Aikawa, Shizu; Irie, Shun; Ochiai, Naoyuki; Sakane, Masataka; Yamazaki, Masashi

    2016-03-01

    [Purpose] Lower-limb deep vein thrombosis is a complication of orthopedic surgery. A leg-exercise apparatus named "LEX" was developed as a novel active-exercise apparatus for deep vein thrombosis prevention. Muscle activity was evaluated to assess the effectiveness of exercise with LEX in the prevention. [Subjects] Eight healthy volunteers participated in this study. [Methods] Muscle activities were determined through electromyography during exercise with LEX [LEX (+)] and during active ankle movements [LEX (-)]. The end points were peak % maximum voluntary contraction and % integrated electromyogram of rectus femoris, vastus lateralis, biceps femoris, tibialis anterior, gastrocnemius, and soleus. [Results] LEX (+) resulted in higher average values in all muscles except the tibialis anterior. Significant differences were noted in the peak of the biceps femoris and gastrocnemius and in the integrated electromyogram of the rectus femoris, vastus lateralis, gastrocnemius, and soleus. The LEX (+)/LEX (-) ratio of the peak was 2.2 for the biceps femoris and 2.0 for the gastrocnemius . The integrated electromyogram was 1.8 for the gastrocnemius, 1.5 for the rectus femoris, 1.4 for the vastus lateralis, and 1.2 for the soleus. [Conclusion] Higher muscle activity was observed with LEX (+). LEX might be a good tool for increasing lower-limb blood flow and deep vein thrombosis prevention. PMID:27134410

  8. Mechanical characterisation of porcine rectus sheath under uniaxial and biaxial tension.

    PubMed

    Lyons, Mathew; Winter, Des C; Simms, Ciaran K

    2014-06-01

    Incisional hernia development is a significant complication after laparoscopic abdominal surgery. Intra-abdominal pressure (IAP) is known to initiate the extrusion of intestines through the abdominal wall, but there is limited data on the mechanics of IAP generation and the structural properties of rectus sheath. This paper presents an explanation of the mechanics of IAP development, a study of the uniaxial and biaxial tensile properties of porcine rectus sheath, and a simple computational investigation of the tissue. Analysis using Laplace׳s law showed a circumferential stress in the abdominal wall of approx. 1.1MPa due to an IAP of 11kPa, commonly seen during coughing. Uniaxial and biaxial tensile tests were conducted on samples of porcine rectus sheath to characterise the stress-stretch responses of the tissue. Under uniaxial tension, fibre direction samples failed on average at a stress of 4.5MPa at a stretch of 1.07 while cross-fibre samples failed at a stress of 1.6MPa under a stretch of 1.29. Under equi-biaxial tension, failure occurred at 1.6MPa with the fibre direction stretching to only 1.02 while the cross-fibre direction stretched to 1.13. Uniaxial and biaxial stress-stretch plots are presented allowing detailed modelling of the tissue either in silico or in a surrogate material. An FeBio computational model of the tissue is presented using a combination of an Ogden and an exponential power law model to represent the matrix and fibres respectively. The structural properties of porcine rectus sheath have been characterised and add to the small set of human data in the literature with which it may be possible to develop methods to reduce the incidence of incisional hernia development. PMID:24725440

  9. Spontaneous rectus sheath hematoma in a patient treated with apixaban

    PubMed Central

    Aktas, Halil; Inci, Sinan; Dogan, Pinar; Izgu, Ibrahim

    2016-01-01

    Summary Apixaban, a non-vitamin K antagonist oral anticoagulants, is a Factor Xa inhibitor that is prescribed for the treatment of non valvular atrial fibrillation. Rectus sheath hematoma is a rare but significant complication of oral anticoagulant treatment. The important causes of rectus sheath hematoma include treatment with anticoagulants, hematologic diseases, trauma, intense physical activity, coughing, sneezing and pregnancy. In this report, we describe case of a 71-year-old woman undergoing apixaban treatment for non valvular atrial fibrillation who presented with spontaneous rectus sheath hematoma. PMID:26989650

  10. Spontaneous rectus sheath hematoma in a patient treated with apixaban.

    PubMed

    Aktas, Halil; Inci, Sinan; Dogan, Pinar; Izgu, Ibrahim

    2016-02-01

    Apixaban, a non-vitamin K antagonist oral anticoagulants, is a Factor Xa inhibitor that is prescribed for the treatment of non valvular atrial fibrillation. Rectus sheath hematoma is a rare but significant complication of oral anticoagulant treatment. The important causes of rectus sheath hematoma include treatment with anticoagulants, hematologic diseases, trauma, intense physical activity, coughing, sneezing and pregnancy. In this report, we describe case of a 71-year-old woman undergoing apixaban treatment for non valvular atrial fibrillation who presented with spontaneous rectus sheath hematoma. PMID:26989650

  11. A panel data set on harvest and perfusion decellularization of porcine rectus abdominis.

    PubMed

    Zhang, Jian; Cheng, Wen Yue; Hu, Zhi Qian; Turner, Neill J; Zhang, Li; Wang, Qiang; Badylak, Stephen F

    2016-06-01

    In this dataset, we particularly depicted the harvest and perfusion decellularization of porcine rectus abdominis (RA), accompanied with displaying of the retained vascular trees within the perfusion-decellularized skeletal muscle matrix (pM-ECM) using vascular corrosion casting. In addition, several important tips for successful pM-ECM preparation were emphasized, which including using anatomically isolated skeletal muscle as tissue source with all main feeding and draining vessels perfused, preserving the internal microcirculation availability, aseptic technique and pyrogen free in all steps, sequential perfusion via artery or vein, and longtime washing after decellularization. The data are supplemental to our original research article describing detailed associations of pM-ECM as a clinically relevant scale, three-dimensional scaffold with a vascular network template for tissue-specific regeneration, "Perfusion-decellularized skeletal muscle as a three-dimensional scaffold with a vascular network template" Zhang et al. (2016) [1]. PMID:27158653

  12. A panel data set on harvest and perfusion decellularization of porcine rectus abdominis

    PubMed Central

    Zhang, Jian; Cheng, Wen Yue; Hu, Zhi Qian; Turner, Neill J.; Zhang, Li; Wang, Qiang; Badylak, Stephen F.

    2016-01-01

    In this dataset, we particularly depicted the harvest and perfusion decellularization of porcine rectus abdominis (RA), accompanied with displaying of the retained vascular trees within the perfusion-decellularized skeletal muscle matrix (pM-ECM) using vascular corrosion casting. In addition, several important tips for successful pM-ECM preparation were emphasized, which including using anatomically isolated skeletal muscle as tissue source with all main feeding and draining vessels perfused, preserving the internal microcirculation availability, aseptic technique and pyrogen free in all steps, sequential perfusion via artery or vein, and longtime washing after decellularization. The data are supplemental to our original research article describing detailed associations of pM-ECM as a clinically relevant scale, three-dimensional scaffold with a vascular network template for tissue-specific regeneration, “Perfusion-decellularized skeletal muscle as a three-dimensional scaffold with a vascular network template” Zhang et al. (2016) [1]. PMID:27158653

  13. Early American Strabismus Surgery: 1840-1845.

    PubMed

    Currie, Benjamin D; Feibel, Robert M

    2015-01-01

    The discovery of effective surgical therapy for strabismus was one of the outstanding triumphs of the first half of 19th-century ophthalmology, just prior to the invention of the ophthalmoscope in 1850. Although priority for the development of strabismus surgery belongs to Johann Friedrich Dieffenbach of Germany, who first reported his surgical results in 1839, 4 cases of tenotomy of the medial rectus muscle had been performed in the United States by William Gibson in 1818 but never published. By 1840, the reports of surgery in Europe had rapidly spread to America where surgeons immediately began using these procedures. The first American surgeon to perform eye muscle surgery and publish his results was John Dix of Boston, and other surgeons were soon reporting their cases as well. We discuss 8 American pioneers in this field during the time (1840-1845) of the first burst of enthusiasm for this surgery. Although these surgeons were active in performing a large number of cases and carefully reporting their experiences and results, they did not make any major advances in the field. PMID:26669424

  14. Sternalis Muscle: An Unexpected Finding during Mastectomy

    PubMed Central

    Sasmal, Prakash K.; Meher, Susanta; Mishra, Tushar S.; Deep, N.; Tripathy, Prabhas R.; Rath, Satyajit

    2015-01-01

    Sternalis muscle also called rectus sternalis, rectus thoracis, or episternalis is an anomalous muscle of the anterior chest wall with unknown anatomical function. It is regularly observed in lower animal but infrequently in humans. Presence of this muscle can create confusion with tumours of the anterior chest wall during routine mammography. Although less is known about its origin and innervations, knowledge about this muscle can have many clinical implications. A case of unilateral sternalis muscle detected during mastectomy, in a female with carcinoma of the right breast, is being reported with a brief review of the literature and highlighting its clinical significance. PMID:26609461

  15. Horizontal muscle transposition or oblique muscle weakening for the correction of V pattern?

    PubMed Central

    Sekeroglu, H T; Turan, K E; Uzun, S; Sener, E C; Sanac, A S

    2014-01-01

    Purpose To report and to analyze the efficacy of horizontal rectus muscle transposition and inferior oblique muscle weakening in terms of pattern correction for patients with V pattern. Methods The review of the medical files identified 55 patients who had esotropia (ET) or exotropia (XT) with V pattern. The primary outcome measure was the amount of V pattern collapse (Δ). Results Of the 55 patients (mean age 22.1±9.5 years), 27 (49.1%) were males and 28 (50.9%) were females. The type of deviations was XT in 30 patients (54.5%) and ET in 25 patients (45.5%). Inferior oblique muscle weakening was performed in 43 (78.2%) patients, whereas horizontal muscle transposition was carried out in 12 (21.8%) patients in addition to recession-resection procedures. The amount of pattern was significantly reduced in both groups (P=0.01 for the horizontal offset group and P<0.01 for the oblique muscle weakening group). Conclusion Oblique muscle weakening surgery and horizontal muscle offset are effective in the correction of V pattern when the amount of pattern is under 30Δ. PMID:24525866

  16. Isolated Total Rupture of Extraocular Muscles.

    PubMed

    Chen, Jingchang; Kang, Ying; Deng, Daming; Shen, Tao; Yan, Jianhua

    2015-09-01

    Total rupture of extraocular muscles is an infrequent clinical finding. Here we conducted this retrospective study to evaluate their causes of injury, clinical features, imaging, surgical management, and final outcomes in cases of isolated extraocular muscle rupture at a tertiary center in China. Thirty-six patients were identified (24 men and 12 women). Mean age was 34 years (range 2-60). The right eye was involved in 21 patients and the left 1 in 15. A sharp object or metal hook was the cause of this lesion in 16 patients, sinus surgery in 14 patients, traffic accident in 3 patients, orbital surgery in 2 patients, and conjunctive tumor surgery in 1 patient. The most commonly involved muscles were medial (18 patients) and inferior rectus muscles (13 patients). The function of the ruptured muscles revealed a scale of -3 to -4 defect of ocular motility and the amount of deviation in primary position varied from 10 to 140 PD (prism diopter). Computerized tomography (CT) confirmed the presence of ruptured muscles. An end-to-end muscle anastomosis was performed and 3 to 5 mm of muscle was resected in 23 patients. When the posterior border of the injured muscle could not be identified (13 patients), a partial tendon transposition was performed, together with recession of the antagonist in most patients, whereas a recession of the antagonist muscle plus a resection of the involved muscle with or without nasal periosteal fixation was performed in the remaining patients. After an average of 16.42 months of follow-up an excellent result was achieved in 23 patients and results of 13 patients were considered as a failure. In most patients, the posterior border of the ruptured muscle can be identified and an early surgery can be performed to restore function. Alternatively, a partial tendon transposition should be performed. When muscular rupture is suspected, an early orbital CT is required to confirm this possibility, which can then verify the necessity for an early surgical

  17. Isolated Total Rupture of Extraocular Muscles

    PubMed Central

    Chen, Jingchang; Kang, Ying; Deng, Daming; Shen, Tao; Yan, Jianhua

    2015-01-01

    Abstract Total rupture of extraocular muscles is an infrequent clinical finding. Here we conducted this retrospective study to evaluate their causes of injury, clinical features, imaging, surgical management, and final outcomes in cases of isolated extraocular muscle rupture at a tertiary center in China. Thirty-six patients were identified (24 men and 12 women). Mean age was 34 years (range 2–60). The right eye was involved in 21 patients and the left 1 in 15. A sharp object or metal hook was the cause of this lesion in 16 patients, sinus surgery in 14 patients, traffic accident in 3 patients, orbital surgery in 2 patients, and conjunctive tumor surgery in 1 patient. The most commonly involved muscles were medial (18 patients) and inferior rectus muscles (13 patients). The function of the ruptured muscles revealed a scale of −3 to −4 defect of ocular motility and the amount of deviation in primary position varied from 10 to 140 PD (prism diopter). Computerized tomography (CT) confirmed the presence of ruptured muscles. An end-to-end muscle anastomosis was performed and 3 to 5 mm of muscle was resected in 23 patients. When the posterior border of the injured muscle could not be identified (13 patients), a partial tendon transposition was performed, together with recession of the antagonist in most patients, whereas a recession of the antagonist muscle plus a resection of the involved muscle with or without nasal periosteal fixation was performed in the remaining patients. After an average of 16.42 months of follow-up an excellent result was achieved in 23 patients and results of 13 patients were considered as a failure. In most patients, the posterior border of the ruptured muscle can be identified and an early surgery can be performed to restore function. Alternatively, a partial tendon transposition should be performed. When muscular rupture is suspected, an early orbital CT is required to confirm this possibility, which can then verify the necessity for

  18. Identification of Novel Changes in Human Skeletal Muscle Proteome After Roux-en-Y Gastric Bypass Surgery.

    PubMed

    Campbell, Latoya E; Langlais, Paul R; Day, Samantha E; Coletta, Richard L; Benjamin, Tonya R; De Filippis, Elena Anna; Madura, James A; Mandarino, Lawrence J; Roust, Lori R; Coletta, Dawn K

    2016-09-01

    The mechanisms of metabolic improvements after Roux-en-Y gastric bypass (RYGB) surgery are not entirely clear. Therefore, the aim of our study was to investigate the role of obesity and RYGB on the human skeletal muscle proteome. Basal muscle biopsies were obtained from seven obese (BMI >40 kg/m(2)) female subjects (45.1 ± 3.6 years) pre- and 3 months post-RYGB, and euglycemic-hyperinsulinemic clamps were used to assess insulin sensitivity. Four age-matched (48.5 ± 4.7 years) lean (BMI <25 kg/m(2)) females served as control subjects. We performed quantitative mass spectrometry and microarray analyses on protein and RNA isolated from the muscle biopsies. Significant improvements in fasting plasma glucose (104.2 ± 7.8 vs. 86.7 ± 3.1 mg/dL) and BMI (42.1 ± 2.2 vs. 35.3 ± 1.8 kg/m(2)) were demonstrated in the pre- versus post-RYGB, both P < 0.05. Proteomic analysis identified 2,877 quantifiable proteins. Of these, 395 proteins were significantly altered in obesity before surgery, and 280 proteins differed significantly post-RYGB. Post-RYGB, 49 proteins were returned to normal levels after surgery. KEGG pathway analysis revealed a decreased abundance in ribosomal and oxidative phosphorylation proteins in obesity, and a normalization of ribosomal proteins post-RYGB. The transcriptomic data confirmed the normalization of the ribosomal proteins. Our results provide evidence that obesity and RYGB have a dynamic effect on the skeletal muscle proteome. PMID:27207528

  19. 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 ...

  20. Exercise and Weight Loss Improve Muscle Mitochondrial Respiration, Lipid Partitioning, and Insulin Sensitivity After Gastric Bypass Surgery.

    PubMed

    Coen, Paul M; Menshikova, Elizabeth V; Distefano, Giovanna; Zheng, Donghai; Tanner, Charles J; Standley, Robert A; Helbling, Nicole L; Dubis, Gabriel S; Ritov, Vladimir B; Xie, Hui; Desimone, Marisa E; Smith, Steven R; Stefanovic-Racic, Maja; Toledo, Frederico G S; Houmard, Joseph A; Goodpaster, Bret H

    2015-11-01

    Both Roux-en-Y gastric bypass (RYGB) surgery and exercise can improve insulin sensitivity in individuals with severe obesity. However, the impact of RYGB with or without exercise on skeletal muscle mitochondria, intramyocellular lipids, and insulin sensitivity index (SI) is unknown. We conducted a randomized exercise trial in patients (n = 101) who underwent RYGB surgery and completed either a 6-month moderate exercise (EX) or a health education control (CON) intervention. SI was determined by intravenous glucose tolerance test. Mitochondrial respiration and intramyocellular triglyceride, sphingolipid, and diacylglycerol content were measured in vastus lateralis biopsy specimens. We found that EX provided additional improvements in SI and that only EX improved cardiorespiratory fitness, mitochondrial respiration and enzyme activities, and cardiolipin profile with no change in mitochondrial content. Muscle triglycerides were reduced in type I fibers in CON, and sphingolipids decreased in both groups, with EX showing a further reduction in a number of ceramide species. In conclusion, exercise superimposed on bariatric surgery-induced weight loss enhances mitochondrial respiration, induces cardiolipin remodeling, reduces specific sphingolipids, and provides additional improvements in insulin sensitivity. PMID:26293505

  1. Cranial-base surgery: a reconstructive algorithm.

    PubMed

    Georgantopoulou, A; Hodgkinson, P D; Gerber, C J

    2003-01-01

    Skull-base surgery is associated with a high risk of cerebrospinal fluid (CSF) leak, infection, and functional and aesthetic deformity. Appropriate reconstruction of cranial-base defects following surgery helps to prevent these complications. Between March 1998 and May 2000, 28 patients (age: 1-68 years) underwent reconstruction of the anterior and middle cranial fossae. The indications for surgery were tumours, trauma involving the anterior cranial fossa, midline dermoid cysts with intracranial extension, late post-traumatic CSF leak, craniofacial deformity and recurrent frontal mucocoele. We used local anteriorly based pericranial flaps (23 flaps, alone or in combination with other flaps), bipedicled galeal flaps (seven patients) and free flaps (nine patients; radial forearm fascial/fasciocutaneous flaps, rectus abdominis muscle flap and latissimus dorsi muscle flap). Follow-up has been 4-24 months. We had no deaths, no flap failure and no incidence of infection. Complications included two CSF leaks, three intracranial haematomas and one pulsatile enophthalmos. All patients had a very good aesthetic result. We present an algorithm for skull-base reconstruction and comment on the design and vascularity of the bipedicled galeal flap. The monitoring of intracranial flaps and the difficulties of perioperative management of free flaps in neurosurgical patients are also discussed. PMID:12706142

  2. Initial experience with breast reconstruction using the transverse rectus abdominis myocutaneous flap: a study of 45 patients.

    PubMed Central

    Andrews, E.; Bond, J.; Dolan, S.; Kirk, S.

    1999-01-01

    Breast conserving surgery for breast cancer has led to an increased interest in reconstruction following mastectomy. The transverse rectus abdominis myocutaneous flap has been proven to give good results in terms of restoration of body symmetry with near normal contour and consistency. Furthermore, immediate reconstruction has the advantage of a single procedure with less psychological morbidity, and reduction in hospital stay and overall complication rate. The aim of this study was to review our experience with the transverse rectus abdominis myocutaneous flap procedure an initial series of 45 patients. The overall complication rate of 27% is similar to that reported in the literature, with no total flap loss and nine patients with partial flap loss. There was no delay in commencement of adjuvant chemotherapy or radiotherapy and we believe our ability to detect local recurrence has not been compromised. We consider that immediate breast reconstruction is now an integral part of the surgical treatment of breast cancer. PMID:10489808

  3. Anatomical mapping of the nasal muscles and application to cosmetic surgery.

    PubMed

    Konschake, Marko; Fritsch, Helga

    2014-11-01

    We present an anatomical mapping of the most important muscles influencing the nose, incorporating constant anatomical structures, and their spatial correlations. At our disposal were the midfaces of 18 bodies of both sexes, obtained by informed consent from body donors aged between 60 and 80 years. Macroscopically, we dissected the nasal regions of eight corpses, six midfaces were prepared according to plastination histology, four by creating plastinated slices. On their way from their periosteal origin to the edge of the skin, the muscles of the nose cross the subcutaneous adipose tissue, dividing it into superficial and deep layers. The individual muscle fibers insert into the skin directly at the reticular corium. Sometimes, they reach the border of the epidermis which represents a special arrangement of corial muscle attachments. The course of the anatomical fibers of individual nasal muscles presented macroscopically and microscopically in this study offers surgeons a detailed overview of the anatomically important muscular landmarks of the midface. PMID:24863980

  4. Effects of fast and slow squat exercises on the muscle activity of the paretic lower extremity in patients with chronic stroke

    PubMed Central

    Choi, Young-Ah; Kim, Jin-Seop; Lee, Dong-Yeop

    2015-01-01

    [Purpose] The purpose of this study was to investigate the effects of the speed of squat exercises on paretic lower extremity muscle activity in patients with hemiplegia following a stroke. [Subjects and Methods] Ten stroke patients performed fast and slow squat exercises for 2 seconds and 8 seconds, respectively. The muscle activities of the paretic and non-paretic sides of the rectus femoris muscle, the biceps femoris muscle, and the tibialis anterior muscle were assessed and compared using surface electromyography. [Results] The paretic side of the rectus femoris muscle showed statistically significant differences in the fast squat exercise group, which demonstrated the highest muscle activity during the rapid return to the upright position. [Conclusion] The rectus femoris muscle showed the highest muscle activity during the return to the upright position during the fast squat exercise, which indicates that the rectus femoris muscle is highly active during the fast squat exercise. PMID:26356385

  5. Bilateral Rectus Sheath Hematoma in Kidney Transplant Patient: Case Study and Literature Review

    PubMed Central

    Feizzadeh Kerigh, Behzad; Maddah, Ghodratolah

    2013-01-01

    Rectus sheath hematoma usually occurs unilateral but rare cases of bilateral hematoma have been reported. Herein we report the first case of spontaneous bilateral Rectus Sheath Hematoma in the kidney transplanted patient. PMID:24350093

  6. Myocyte Dedifferentiation Drives Extraocular Muscle Regeneration in Adult Zebrafish

    PubMed Central

    Saera-Vila, Alfonso; Kasprick, Daniel S.; Junttila, Tyler L.; Grzegorski, Steven J.; Louie, Ke'ale W.; Chiari, Estelle F.; Kish, Phillip E.; Kahana, Alon

    2015-01-01

    Purpose The purpose of this study was to characterize the injury response of extraocular muscles (EOMs) in adult zebrafish. Methods Adult zebrafish underwent lateral rectus (LR) muscle myectomy surgery to remove 50% of the muscle, followed by molecular and cellular characterization of the tissue response to the injury. Results Following myectomy, the LR muscle regenerated an anatomically correct and functional muscle within 7 to 10 days post injury (DPI). Following injury, the residual muscle stump was replaced by a mesenchymal cell population that lost cell polarity and expressed mesenchymal markers. Next, a robust proliferative burst repopulated the area of the regenerating muscle. Regenerating cells expressed myod, identifying them as myoblasts. However, both immunofluorescence and electron microscopy failed to identify classic Pax7-positive satellite cells in control or injured EOMs. Instead, some proliferating nuclei were noted to express mef2c at the very earliest point in the proliferative burst, suggesting myonuclear reprogramming and dedifferentiation. Bromodeoxyuridine (BrdU) labeling of regenerating cells followed by a second myectomy without repeat labeling resulted in a twice-regenerated muscle broadly populated by BrdU-labeled nuclei with minimal apparent dilution of the BrdU signal. A double-pulse experiment using BrdU and 5-ethynyl-2′-deoxyuridine (EdU) identified double-labeled nuclei, confirming the shared progenitor lineage. Rapid regeneration occurred despite a cell cycle length of 19.1 hours, whereas 72% of the regenerating muscle nuclei entered the cell cycle by 48 hours post injury (HPI). Dextran lineage tracing revealed that residual myocytes were responsible for muscle regeneration. Conclusions EOM regeneration in adult zebrafish occurs by dedifferentiation of residual myocytes involving a muscle-to-mesenchyme transition. A mechanistic understanding of myocyte reprogramming may facilitate novel approaches to the development of molecular

  7. A case series of laparoscopic components separation and rectus medialization with laparoscopic ventral hernia repair.

    PubMed

    Malik, Kashif; Bowers, Steven P; Smith, C Daniel; Asbun, Horacio; Preissler, Susanne

    2009-10-01

    Laparoscopic ventral hernia repair has been shown to offer improved patient recovery, when compared to open repair. It has also been shown to offer a lower complication rate. However, in patients with high body-mass index and large defects, the intraperitoneal on-lay technique of laparoscopic repair is criticized for an increased incidence of failure. In 1990, a study introduced the technique of open-component separation, hence enabling the medialization of the rectus muscle and decreasing the incidence of recurrence associated with primary repair. Open-component separation is associated with increased wound problems due to extensive dissection. Different laparoscopic and endoscopic modifications to the open-component-separation technique have been tried to minimize wound problems. In this article, we present our case series of 4 patients involving the laparoscopic component-separation technique of rectus medialization and, laparoscopic ventral hernia combined. This is one of the first series ever reported to involve both modalities of hernia repair in using an exclusive laparoscopic technique. PMID:19694565

  8. Isolated Medial Rectus Nuclear Palsy as a Rare Presentation of Midbrain Infarction

    PubMed Central

    Al-Sofiani, Mohammed; Kwen, Peterkin Lee

    2015-01-01

    Patient: Male, 83 Final Diagnosis: Midbrain infarction Symptoms: Diplopia Medication: — Clinical Procedure: Computed tomography of the head and magnetic resonance image of the brain Specialty: Neurology Objective: Rare disease Background: Diplopia is a common subjective complaint that can be the first manifestation of a serious pathology. Here, we report a rare case of midbrain infarction involving the lateral subnucleus of the oculomotor nuclear complex presenting as diplopia, with no other stroke manifestations. Case Report: An 83-year-old right-handed white man with past medical history of diabetes mellitus, hypertension, dyslipidemia, and coronary artery disease presented to the emergency department (ED) with diplopia and unsteadiness. Two days prior to admission, the patient woke up with constant horizontal diplopia and unsteadiness, which limited his daily activities and led to a fall at home. He denied any weakness, clumsiness, nausea, vomiting, photophobia, fever, or chills. Ocular exam showed a disconjugate gaze at rest, weakness of the left medial rectus muscle, impaired convergence test, and bilateral 3-mm reactive pupils. The diplopia resolved by closing either eye. The remaining extraocular muscles and other cranial nerves were normal. There was no nystagmus, ptosis, or visual field deficit. Sensation, muscle tone, and strength were normal in all extremities. Magnetic resonance imaging (MRI) of the brain revealed a tiny focus of restricted diffusion in the left posterior lateral midbrain. Conclusions: A thorough history and physical examination is essential to diagnose and manage diplopia. Isolated extraocular palsy is usually thought to be caused by orbital lesions or muscular diseases. Here, we report a case of mid-brain infarction manifested as isolated medial rectus palsy. PMID:26447784

  9. Spontaneous Rectus Sheath Hematoma in the Elderly: An Unusual Case and Update on Proper Management

    PubMed Central

    Galyfos, George; Karantzikos, Georgios; Palogos, Konstantinos; Sianou, Argiri; Filis, Konstantinos; Kavouras, Nikolaos

    2014-01-01

    Spontaneous rectus sheath hematoma (SRSH) is an uncommon medical emergency in the elderly. We present a case of SRSH with an atypical clinical presentation and discuss literature regarding diagnosis and proper management. A 75-year-old female patient was transferred to the emergency department due to acute dyspnoea and confusion. Her medical history revealed a viral infection of the upper respiratory tract, and no coughing or use of anticoagulants. The clinical examination showed tenderness of the left lower abdomen, although palpation was misleading due to patient's obesity. Laboratory investigations showed light anaemia. Ultrasonography and computed tomography revealed a large rectus sheath hematoma of the left abdominal wall. Despite further deterioration of the patient, conservative management including bed rest, fluid replacement, blood products transfusion, and proper analgesia was successful. No surgical intervention was needed. Prompt diagnosis and management of SRSH plays significant role in the prognosis, especially in elder patients. Independently of size and severity, conservative management remains the first therapeutic choice. Only by failure of supportive management, progressive and large hematoma or uncontrollable hemodynamic patients, interventional management including surgery or less invasive newer techniques is indicated. PMID:24839570

  10. A cadaver knee simulator to evaluate the biomechanics of rectus femoris transfer.

    PubMed

    Anderson, Michael C; Brown, Nicholas A T; Bachus, Kent N; Macwilliams, Bruce A

    2009-07-01

    A cadaver knee simulator has been developed to model surgical transfer of the rectus femoris. The simulator allows knee specimens six degrees of freedom and is capable of modeling both the swing and stance phases of human gait. Experiments were conducted using a mechanical hinge analog of the knee to verify that time, flexion angle, and knee extension force measurements recorded when using the simulator were not influenced by its design or operation. A ballistic double pendulum model was used to model the swing phase of gait, and the contributions of hip and ankle torques and hamstrings cocontraction were included when modeling the stance phase of gait. When modeling swing, range of motion and time to peak knee flexion in swing for the hinge knee were similar to those of in vivo test subjects. Measurements of hinge knee extension force when modeling stance under various biomechanical conditions matched those predicted using an analytical model. Future studies using cadaver knee specimens will apply techniques described in this paper to further our understanding of changes in knee biomechanics caused by rectus femoris transfer surgery. PMID:19403312

  11. Long-term postoperative outcomes of bilateral lateral rectus recession vs unilateral recession-resection for intermittent exotropia

    PubMed Central

    Yang, Xian; Man, Teng-Teng; Tian, Qiao-Xia; Zhao, Gui-Qiu; Kong, Qing-Lan; Meng, Yan; Gao, Yan; Ning, Mei-Zhen

    2014-01-01

    AIM To discuss the long-term postoperative results of bilateral lateral rectus recession (BLR) and unilateral lateral rectus recession-medial rectus resection (RR) in therapy of intermittent exotropia. METHODS We retrospectively analyzed 213 cases of intermittent exotropia who underwent surgery between 2008 and 2010. The patients were grouped into BLR group and RR group. Motor outcomes were divided into three groups on the basis of the angle of deviation after surgery: overcorrection (esotropia/phoria >5Δ), orthophoria (esotropia/phoria ≤5Δ to exotropia/phoria ≤10Δ), and undercorrection/recurrence (exotropia/phoria >10Δ). Titmus test was used to evaluate stereoacuity, the stereoacuity <800s of arc meaned the patients had stereopsis. Surgical outcome including motor criteria and sensory status were compared at postoperative 6, 12, 24mo and at 36mo examination between groups. RESULTS At 12, 24mo after surgery, the motor outcomes had no difference (P>0.05) between groups. However, the motor outcomes at 6, 36mo were signally different in each group, indicating the success rate in RR group at 6mo was higher than that in BLR group (83.02% vs 82.24%, P<0.05) but the result was contrary at the 3y examination (60.75% vs 43.40%, P<0.05). No statistical significance were found in the sensory outcomes between the groups at mean of 3.7y follow-up. CONCLUSION The motor outcomes in RR group were better than in BLR group at 6mo after surgery, while the 3y outcomes were better in BLR group. This may be due to the recurrence rate of the BLR was lower than the RR group's. PMID:25540763

  12. Gynecologic reconstruction with a rectus abdominis myocutaneous flap: an update.

    PubMed

    Carlson, J W; Carter, J R; Saltzman, A K; Carson, L F; Fowler, J M; Twiggs, L B

    1996-06-01

    This series reports the outcomes and significant complications associated with the rectus myocutaneous flap when used for pelvic or inguinal reconstruction in patients with gynecologic cancers. Perioperative variables were retrospectively reviewed to identify social and medical risk factors as well as intraoperative and postoperative complications that predisposed to rectus flap failure. Fifteen patients with gynecologic malignancies underwent reconstructive procedures using a vertically oriented rectus abdominis myocutaneous flap for either vaginal (n = 14) or inguinal (n = 1) reconstruction. The patients' primary cancers were cervical (n = 11), rectal (n = 1), ovarian (n = 1), vulvar (n = 1), and vaginal (n = 1). The median age was 50 years. The median follow-up was 17 months. All flaps were mobilized in conjunction with a radical salvage operation. There were no cases of vaginal prolapse and no abdominal wound infections. However, 4 patients (27%) had major postoperative morbidity in this small series. There was one wound dehiscence and three episodes of necrosis of the subcutaneous and cutaneous portions of the flap. All 4 of these patients required additional operative intervention or debridement. Eleven patients had complete healing of the flap. The rectus abdominis myocutaneous flap is a valuable option for gynecologic reconstructive procedures. Perioperative strategies for improving flap viability include the identification of risk factors that may compromise flap perfusions such as prior abdominal incisions, peripheral vascular disease, and obesity. Meticulous surgical technique is required to preserve the vascular pedicle. These strategies may be useful in preoperative counseling, the perioperative evaluation, and the intraoperative management. PMID:8641616

  13. Intramuscular Innervation of Primate Extraocular Muscles: Unique Compartmentalization in Horizontal Recti

    PubMed Central

    da Silva Costa, Roberta Martins; Kung, Jennifer; Poukens, Vadims; Yoo, Lawrence; Tychsen, Lawrence

    2011-01-01

    Purpose. It has been proposed that the lateral rectus (LR), like many skeletal and craniofacial muscles, comprises multiple neuromuscular compartments subserving different physiological functions. To explore the anatomic potential of compartmentalization in all four rectus extraocular muscles (EOMs), evidence was sought of possible regional selectivity in intramuscular innervation of all rectus EOMs. Methods. Whole orbits of two humans and one macaque monkey were serially sectioned at 10 μm thickness and stained with Masson's trichrome. Three-dimensional reconstruction was performed of the intramuscular courses of motor nerves from the deep orbit to the anterior extents of their arborizations within all four rectus EOMs in each orbit. Results. Findings concorded in monkey and human orbits. Externally to the global surface of the lateral (LR) and medial rectus (MR) EOMs, motor nerve trunks bifurcated into approximately equal-sized branches before entering the global layer and observing a segregation of subsequent arborization into superior zones that exhibited minimal overlap along the length of the LR and only modest overlap for MR. In contrast, intramuscular branches of the superior and the nasal portion of the inferior rectus were highly mixed. Conclusions. Consistent segregation of intramuscular motor nerve arborization suggests functionally distinct superior and inferior zones within the horizontal rectus EOMs in both humans and monkeys. Reduced or absent compartmentalization in vertical rectus EOMs supports a potential functional role for differential innervation in horizontal rectus zones that could mediate previously unrecognized vertical oculorotary actions. PMID:21220556

  14. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review.

    PubMed

    Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano

    2012-04-01

    Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscular strength is targeted by overload training in the gym or aquatherapy; core stability exercises seem to be useful in this phase. Finally, specific sport actions are introduced by increasingly complex exercises along with a preventive program to limit pain recurrences. PMID:23738289

  15. Insertional tendinopathy of the adductors and rectus abdominis in athletes: a review

    PubMed Central

    Valent, Alessandro; Frizziero, Antonio; Bressan, Stefano; Zanella, Elena; Giannotti, Erika; Masiero, Stefano

    2012-01-01

    Summary Insertional tendinopathy of the adductors and rectus abdominis is common in male athletes, especially in soccer players. It may be worsened by physical activity and it usually limits sport performance. The management goal in the acute phase consists of analgesic and anti-inflammatory drugs and physical rehabilitation. In the early stages of rehabilitation, strengthening exercises of adductors and abdominal muscles, such as postural exercises, have been suggested. In the sub-acute phase, muscular strength is targeted by overload training in the gym or aquatherapy; core stability exercises seem to be useful in this phase. Finally, specific sport actions are introduced by increasingly complex exercises along with a preventive program to limit pain recurrences. PMID:23738289

  16. Relative Activity of Abdominal Muscles during Commonly Prescribed Strengthening Exercises.

    ERIC Educational Resources Information Center

    Willett, Gilbert M.; Hyde, Jennifer E.; Uhrlaub, Michael B.; Wendel, Cara L.; Karst, Gregory M.

    2001-01-01

    Examined the relative electromyographic (EMG) activity of upper and lower rectus abdominis (LRA) and external oblique (EOA) muscles during five abdominal strengthening exercises. Isometric and dynamic EMG data indicated that abdominal strengthening exercises activated various abdominal muscle groups. For the LRA and EOA muscle groups, there were…

  17. Enhanced insulin signaling in human skeletal muscle and adipose tissue following gastric bypass surgery.

    PubMed

    Albers, Peter H; Bojsen-Møller, Kirstine N; Dirksen, Carsten; Serup, Annette K; Kristensen, Dorte E; Frystyk, Jan; Clausen, Trine R; Kiens, Bente; Richter, Erik A; Madsbad, Sten; Wojtaszewski, Jørgen F P

    2015-09-01

    Roux-en-Y gastric bypass (RYGB) leads to increased peripheral insulin sensitivity. The aim of this study was to investigate the effect of RYGB on expression and regulation of proteins involved in regulation of peripheral glucose metabolism. Skeletal muscle and adipose tissue biopsies from glucose-tolerant and type 2 diabetic subjects at fasting and during a hyperinsulinemic-euglycemic clamp before as well as 1 wk and 3 and 12 mo after RYGB were analyzed for relevant insulin effector proteins/signaling components. Improvement in peripheral insulin sensitivity mainly occurred at 12 mo postsurgery when major weight loss was evident and occurred concomitantly with alterations in plasma adiponectin and in protein expression/signaling in peripheral tissues. In skeletal muscle, protein expression of GLUT4, phosphorylated levels of TBC1D4, as well as insulin-induced changes in phosphorylation of Akt and glycogen synthase activity were enhanced 12 mo postsurgery. In adipose tissue, protein expression of GLUT4, Akt2, TBC1D4, and acetyl-CoA carboxylase (ACC), phosphorylated levels of AMP-activated protein kinase and ACC, as well as insulin-induced changes in phosphorylation of Akt and TBC1D4, were enhanced 12 mo postsurgery. Adipose tissue from glucose-tolerant subjects was the most responsive to RYGB compared with type 2 diabetic patients, whereas changes in skeletal muscle were largely similar in these two groups. In conclusion, an improved molecular insulin-sensitive phenotype of skeletal muscle and adipose tissue appears to contribute to the improved whole body insulin action following a substantial weight loss after RYGB. PMID:26062634

  18. Localisation of motoneurons supplying the extra-ocular muscles of the rat using horseradish peroxidase and fluorescent double labelling.

    PubMed Central

    Labandeira Garcia, J L; Gomez Segade, L A; Suarez Nuñez, J M

    1983-01-01

    This paper describes a qualitative and quantitative investigation into the location of the motoneurons innervating the extra-ocular muscles of the rat. Injections of horseradish peroxidase, bisbenzimide, propidium iodide and DAPI-primuline were made either in one or simultaneously in two muscles. Unlike those of the cat, rabbit and monkey, the motoneurons which make up the oculomotor nucleus of the rat are not arranged in spatially separate subgroups belonging each to its corresponding extra-ocular muscle, but instead allow a high degree of superposition among the motor pools which they compose. The motoneurons innervating the lateral rectus and inferior oblique muscles are all homolateral; those of the medial and inferior rectus muscles are mainly homolateral with a few contralateral exceptions; and those of the superior rectus, levator palpebrae and superior oblique muscles are mainly contralateral with a small minority of homolateral exceptions. As well as from the main motor pools with which they are associated, the medial rectus, inferior rectus, superior rectus, levator palpebrae, superior oblique and lateral rectus muscles all receive innervation from motoneurons lying among the fibres of the fasciculus longitudinalis medialis. All these observations are supported by quantitative data. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6195140

  19. Penetration of teicoplanin into heart valves and subcutaneous and muscle tissues of patients undergoing open-heart surgery.

    PubMed

    Frank, U K; Schmidt-Eisenlohr, E; Mlangeni, D; Schindler, M; Hoh, A; Beyersdorf, F; Daschner, F D

    1997-11-01

    Penetration of teicoplanin into serum, heart valves, and subcutaneous and muscle tissues was determined in 22 patients undergoing open-heart surgery. Each patient received 12 mg of teicoplanin per kg of body weight as a 30-min intravenous infusion preoperatively. Within 10 h, serum concentrations of teicoplanin declined from 43.1 to 2.8 microg/ml. Teicoplanin concentrations in subcutaneous tissues reached their peak of 9.2 microg/g after 2 to 3 h and decreased slowly to 2.3 microg/g after 9 to 10 h. Concentrations in muscle decreased from 8.7 microg/g to nondetectable levels. Teicoplanin concentrations in cardiac valvular tissue reached their peak of 6.1 microg/g and decreased thereafter to 1.7 microg/g. Teicoplanin concentrations in heart valves were high enough to inhibit methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci, which are known to cause postoperative wound infections and infective endocarditis. PMID:9371368

  20. Penetration of teicoplanin into heart valves and subcutaneous and muscle tissues of patients undergoing open-heart surgery.

    PubMed Central

    Frank, U K; Schmidt-Eisenlohr, E; Mlangeni, D; Schindler, M; Hoh, A; Beyersdorf, F; Daschner, F D

    1997-01-01

    Penetration of teicoplanin into serum, heart valves, and subcutaneous and muscle tissues was determined in 22 patients undergoing open-heart surgery. Each patient received 12 mg of teicoplanin per kg of body weight as a 30-min intravenous infusion preoperatively. Within 10 h, serum concentrations of teicoplanin declined from 43.1 to 2.8 microg/ml. Teicoplanin concentrations in subcutaneous tissues reached their peak of 9.2 microg/g after 2 to 3 h and decreased slowly to 2.3 microg/g after 9 to 10 h. Concentrations in muscle decreased from 8.7 microg/g to nondetectable levels. Teicoplanin concentrations in cardiac valvular tissue reached their peak of 6.1 microg/g and decreased thereafter to 1.7 microg/g. Teicoplanin concentrations in heart valves were high enough to inhibit methicillin-resistant Staphylococcus aureus and coagulase-negative staphylococci, which are known to cause postoperative wound infections and infective endocarditis. PMID:9371368

  1. Extending the use of the gracilis muscle flap in perineal reconstruction surgery.

    PubMed

    Goldie, Stephen J; Almasharqah, Riyadh; Fogg, Quentin A; Anderson, William

    2016-08-01

    Reconstruction of the perineum is required following oncological resections. Plastic surgical techniques can be used to restore the aesthetics and function of the perineum. The gracilis myocutaneous flap provides a substantial skin paddle, with minimal donor site morbidity. The flap is pedicled on a perforator from the medial circumflex femoral artery, giving it limited reach across the perineum. Tunnelling the flap under the adductor longus muscle may free up more of the arterial pedicle, increasing its reach. On three female cadavers, bilateral gracilis flaps were raised in the standard surgical manner, giving six flaps in total. With the flaps pedicled across the perineum, the distance from the tip of each flap was measured to the anterior superior iliac spine (ASIS). The flaps were then tunnelled under the adductor longus muscle. The distances to the ASIS were measured again. The average pedicle length was greater than 7 cm. Tunnelling the flap under the adductor longus muscle increased the reach by more than 4 cm on average. Cadaveric dissection has shown that tunnelling of the flap in a novel way increase its reach across the perineum. This additional flexibility improves its use clinically and is of benefit to plastic surgeons operating in perineal reconstruction. PMID:27221783

  2. [History of strabismus surgery].

    PubMed

    Remy, C; Aracil, P

    1984-01-01

    The history of strabismus surgery starts from the end of the eighteenth century. The first surgical trials consisted of performing myotomies of the medial rectus. Although Taylor from Great Britain could be one of the first to be mentioned, it was Dieffenbach from Germany who accomplished the first official myotomy in 1839. He is followed by many authors as Roux, Velpeau in Paris, and Bonnet in Lyon, the latter performing tenotomy instead of myotomy. In 1849 Guerin performed muscular advancement. In 1883, de Wecker described the muscular pleating, and Blascowiczs the muscular resection. Thus, by the end of the nineteenth century, the surgical treatment of esodeviations was supported by methods aimed to weaken the medial rectus (tenotomies, myotomies) and to strengthen the lateral rectus (advancement, pleating and resection). During twentieth century, progress achieved in anesthesiology and the quality of suture material led Jameson (1922) to substitute tenotomy by muscular recession. Since then, the surgery of squint has never been modified basically up to 1970 when Cuppers created the retro-equatorial myopexy. Thus, two kinds of surgical technics are currently available to surgeons: classic surgery, recession, resection and their variants, dealing with the static component of the deviation angle, and the Faden Operation of Cuppers struggling against the dynamic or innervational component. PMID:6389657

  3. Influence of angular velocity on vastus lateralis and rectus femoris oxygenation dynamics during knee extension exercises.

    PubMed

    Denis, Romain; Wilkinson, Jennifer; De Vito, Giuseppe

    2011-09-01

    The purpose of this study was to investigate whether changes in angular velocity would alter vastus lateralis (VL) and rectus femoris (RF) oxygenation status during maximal isokinetic knee extension exercises. Eleven recreationally active male participants randomly performed ten maximal knee extensions at 30, 60, 120 and 240° s(-1). Tissue oxygenation index (TOI) and total haemoglobin concentration ([tHb]) were acquired from the VL and RF muscles by means of near-infrared spectroscopy (NIRS). Breath-by-breath pulmonary oxygen consumption (VO(2p)) was recorded throughout the tests. Peak torque and VO(2p) significantly decreased as a function of velocity (P<0·05). Interestingly, RF and VL TOI significantly increased as a function of velocity (P<0·05), whereas [tHb] significantly decreased as a function of velocity (P<0·05). A greater number of muscle fibre recruited at slow velocity, where the torque and VO(2p) were the highest, might explain the lower VL and RF TOI observed herein. Furthermore, the increase in local blood flow (suggested by [tHb] changes) during isokinetic knee extension exercises performed at slow angular velocity might have been induced by a higher intramuscular pressure during the contraction phases as well as a greater microcirculatory vasodilatation during relaxation phases. Implementing slow-velocity isokinetic exercises in rehabilitation or other training programmes could delay the short-term anoxia generated by such exercises and result in muscle metabolism enhancement. PMID:21771253

  4. Spontaneous intraperitoneal rupture of a postpartum rectus sheath haematoma.

    PubMed

    Elmoghrabi, Adel; Mohamed, Mohamed; McCann, Michael; Sachwani-Daswani, Gul

    2016-01-01

    A 35-year-old woman presented to the emergency department (ED) with acute severe abdominal pain at 4 days postpartum. CT of the abdomen revealed a type II rectus sheath haematoma for which she was initially treated conservatively and discharged. A few hours later, she returned to the ED with a picture suggestive of peritonitis. Exploratory laparoscopy was performed and revealed haemoperitoneum and a ruptured area on the posterior rectus sheath. Approximately 2 L of blood was aspirated. Haemostatic control was achieved and closed suction drains secured in position. The patient was discharged in stable condition on postadmission day 6. She continued to follow-up on an outpatient basis and was doing well 3 months postoperatively. PMID:26961567

  5. Acute Calcific Tendinitis of the Rectus Femoris: A Case Series

    PubMed Central

    IKobayashi, Hideo; Kaneko, Haruka; Homma, Yasuhiro; Baba, Tomonori; Kaneko, Kazuo

    2015-01-01

    Introduction: Periarticular calcific tendinitis is a common cause of Orthopedic outpatient referral. Calcific tendinitis of the rectus femoris, however, is very rare and not well known. Due to its rarity, correct diagnosis and prompt treatment are not fully understood. Case Report: Two females (38 and 40 years old) of acute calcific tendinitis of the rectus femoris with the good clinical course without any operative treatment were presented. The pain was managed with oral non-steroidal antiinflammatory drugs and/or local steroid injection. Interval radiographic assessment showed complete resorption of the calcification. Conclusion: Establishing the correct diagnosis and initiating prompt treatment are shown to be important in achieving resolution of symptoms and in avoiding unnecessary investigations. PMID:27299063

  6. DOES RECTUS FEMORIS TRANSFER INCREASE KNEE FLEXION DURING STANCE PHASE IN CEREBRAL PALSY?

    PubMed Central

    de Morais, Mauro César; Blumetti, Francesco Camara; Kawamura, Cátia Miyuki; Lopes, José Augusto Fernandes; Neves, Daniella Lins; Cardoso, Michelle de Oliveira

    2016-01-01

    ABSTRACT Objective: To evaluate whether distal rectus femoris transfer (DRFT) is related to postoperative increase of knee flexion during the stance phase in cerebral palsy (CP). Methods: The inclusion criteria were Gross Motor Function Classification System (GMFCS) levels I-III, kinematic criteria for stiff-knee gait at baseline, and individuals who underwent orthopaedic surgery and had gait analyses performed before and after intervention. The patients included were divided into the following two groups: NO-DRFT (133 patients), which included patients who underwent orthopaedic surgery without DRFT, and DRFT (83 patients), which included patients who underwent orthopaedic surgery that included DRFT. The primary outcome was to evaluate in each group if minimum knee flexion in stance phase (FMJFA) changed after treatment. Results: The mean FMJFA increased from 13.19° to 16.74° (p=0.003) and from 10.60° to 14.80° (p=0.001) in Groups NO-DRFT and DRFT, respectively. The post-operative FMJFA was similar between groups NO-DRFT and DRFT (p=0.534). The increase of FMJFA during the second exam (from 13.01° to 22.51°) was higher among the GMFCS III patients in the DRFT group (p<0.001). Conclusion: In this study, DRFT did not generate additional increase of knee flexion during stance phase when compared to the control group. Level of Evidence III, Retrospective Comparative Study. PMID:26997910

  7. 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 ...

  8. Maze Surgery

    MedlinePlus

    ... for Hemodialysis Ventricular Assist Devices Maze Surgery | Share Electrical impulses in your heart muscle (the myocardium) cause your heart to beat (contract). This electrical signal begins in the sinoatrial (SA) node, located ...

  9. Complications and oncologic outcomes of pedicled transverse rectus abdominis myocutaneous flap in breast cancer patients

    PubMed Central

    Somintara, Ongart; Lertsithichai, Panuwat; Kongdan, Youwanush; Supsamutchai, Chairat; Sukpanich, Rupporn

    2016-01-01

    Background There are several techniques for harvesting the pedicled transverse rectus abdominis myocutaneous (TRAM) flap after mastectomy in breast cancer patients. We examined the whole muscle with partial sheath sparing technique and determined factors associated with its complications and oncological outcomes. Methods We retrospectively reviewed the results of 168 TRAM flaps performed between January 2003 and December 2010, focusing on complications and oncologic outcomes. Results Among the 168 pedicled TRAM flap procedures in 158 patients, flap complications occurred in 34%. Most of the flap complications included some degree of fat necrosis. There was no total flap loss. Flap complications were associated with elderly patients and the presence of major donor site complications. Abdominal bulging and hernia occurred in 12% of patients. The bi-pedicled TRAM flap and higher body mass index (BMI) were significant factors associated with increased donor site complications. Seven patients (4%) developed loco-regional recurrence. Within a median follow-up of 27 months, distant metastasis and death occurred in 6% and 4% of patients, respectively. Conclusions The pedicled TRAM flap using the whole muscle with partial sheath sparing technique in the present study is consistent with the results from previous studies in flap complication rates and oncological outcomes. PMID:27563562

  10. Association Between Rectus Abdominis Denervation and Ventilation Dysfunction in Patients with Amyotrophic Lateral Sclerosis

    PubMed Central

    Zhang, Hua-Gang; Zhang, Shuo; Xu, Ying-Sheng; Zhang, Nan; Fan, Dong-Sheng

    2016-01-01

    Background: Spontaneous potentials in electromyography (EMG) of paraspinal muscles are associated with diaphragm denervation and, therefore, poor respiratory function in amyotrophic lateral sclerosis (ALS) is understandable. EMG changes in the rectus abdominis (RA) display an effect similar to those in paraspinal muscles with respect to the function of lower motor neurons in the thoracic spinal cord. The RA denervation was examined to determine its association with ventilation dysfunction in ALS. Methods: We collected the clinical data of 128 patients with sporadic ALS in Department of Neurology of Peking University Third Hospital from 2009 to 2013. EMG, Revised ALS Functional Rating Scale (ALSFRS-R) and forced vital capacity (FVC) were performed in all patients and the differences in the EMG changes in RA between those with and without FVC ≥ 80% were analysed. Results: The mean FVC value was 83.4% ± 17.1% (range: 45%–131%) of the predicted value. A total of 79 patients displayed FVC ≥80%, and 49 patients displayed FVC <80%. Compared with the patients displaying a normal FVC (60/79, 75.9%), spontaneous activity in RA was significantly different among those patients displaying an FVC <80% (47/49, 95.9%). In addition, spontaneous potentials in RA were more frequently detected in patients exhibiting dyspnea (32/33, 97.0%) than in patients without dyspnea (75/95, 78.9%). Conclusion: Spontaneous potentials in RA are associated with ventilation dysfunction and dyspnea in ALS patients. PMID:27569232

  11. Functional Improvement Following Diastasis Rectus Abdominus Repair in an Active Duty Navy Female.

    PubMed

    Gallus, Katerina M; Golberg, Kathy F; Field, Robert

    2016-08-01

    Return to physical activity following childbirth can be a difficult process complicated by structural changes during pregnancy. A common problem is the development of a diastasis of the rectus abdominus (DRA), defined as a horizontal separation of the abdominus muscles at the linea alba. Recent data indicate that the greater the distance of separation of the muscle, the worse the functional ability. We describe a 24-year-old active duty U.S. Navy female G1P2 with a diagnosis of DRA. At 2 months postpartum, she was referred to physical therapy because of back pain and inability to meet baseline activities of daily living. After 4 months of physical therapy, she was unable to complete curl ups as required by U.S. Navy physical fitness standards. Abdominoplasty with imbrication of the abdominal wall diastasis was performed followed by additional physical therapy, after which she returned to baseline functioning. The restoration of functional ability postoperatively suggests there is a therapeutic indication for surgical correction of DRA. In high-functioning military patients with DRA who fail to return to baseline level of activity following a trial of physical therapy, surgical intervention should be considered to obtain the optimal functional ability. PMID:27483541

  12. Cortical motor representation of the rectus femoris does not differ between the left and right hemisphere.

    PubMed

    Ward, Sarah; Bryant, Adam L; Pietrosimone, Brian; Bennell, Kim L; Clark, Ross; Pearce, Alan J

    2016-06-01

    Transcranial magnetic stimulation (TMS) involves non-invasive magnetic stimulation of the brain, and can be used to explore the corticomotor excitability and motor representations of skeletal muscles. However there is a lack of motor mapping studies in the lower limb and few conducted in healthy cohorts. The cortical motor representations of muscles can vary between individuals in terms of center position and area despite having a general localized region within the motor cortex. It is important to characterize the normal range for these variables in healthy cohorts to be able to evaluate changes in clinical populations. TMS was used in this cross-sectional study to assess the active motor threshold (AMT) and cortical representation area for rectus femoris in 15 healthy individuals (11M/4F 27.3±5.9years). No differences were found between hemispheres (Left vs. Right P=0.130) for AMT. In terms of y-axis center position no differences were found between hemispheres (Left vs. Right P=0.539), or for the x-axis center position (Left vs. Right P=0.076). Similarly, no differences in calculated area of the motor representation were found (Left vs. Right P=0.699) indicating symmetry between hemispheres. PMID:26999234

  13. Ultrasound Assessment of the Rectus Femoris Cross-Sectional Area: Subject Position Implications.

    PubMed

    Hacker, Eileen Danaher; Peters, Tara; Garkova, Miglena

    2016-09-01

    Ultrasonic measurement of the rectus femoris (RF) is a novel, proxy measure for muscle strength. The impact of hip flexion/head of bed positioning on RF cross-sectional area (CSA) has not been fully explored. This study describes and compares differences in RF CSA across four degrees of hip flexion. This repeated-measures, comparative study enrolled healthy, pre-menopausal women (n = 20). RF CSA of the dominant leg was measured using the SonoSite M-Turbo ultrasound system with the head of bed at 0°, 20°, 30°, and 60°. One-way repeated measures indicated significant differences in RF CSA, F(3, 17) = 14.18, p < .001, with variation in hip flexion/head of bed elevation and significant RF CSA differences between: (a) 0° and 20°, (b) 0° and 30°, (c) 0° and 60°, and (d) 20° and 60°. Standardizing patient positioning when conducting ultrasonic measurement of RF CSA is vital for researchers who assess muscle mass. PMID:27090872

  14. Muscle Relaxation in Laparoscopic Surgery: What is the Evidence for Improved Operating Conditions and Patient Outcome? A Brief Review of the Literature.

    PubMed

    Ledowski, Thomas

    2015-08-01

    When neuromuscular blocking agents (NMBA) were introduced into clinical practice in 1942, the event was called the "second revolution in anesthesia." Despite some significant side effects, NMBAs have remained in the anesthetists' repertoire, not at least because muscle relaxation has been claimed to allow or facilitate many surgical procedures. Aim of this literature review was to investigate the evidence for the use of NMBA as well as the optimum depth of neuromuscular blockade during laparoscopic surgery. Muscle relaxation may optimize laparoscopic operating conditions by preventing patient movement and achieving more intra-abdominal space for a given intra-abdominal insufflation pressure. In this context, deeper than normally maintained levels of neuromuscular blockade appear to be superior. However, the decision to utilize deeper than standard muscle relaxation should currently be based on a risk-benefit analysis for each individual patient. Thus good communication between surgeon and anesthetist remains crucial to achieve best outcomes. PMID:26121545

  15. Situational Restriction of Elevation in Adduction Relieved by Faden on the Medial Rectus

    PubMed Central

    Muralidhar, R.; Vijayalakshmi, P.; Sujatha, K.; Shetty, Shashikanth; Malay, K.; Rosenberg, Steve

    2016-01-01

    We describe a patient with situational restriction of elevation in adduction in his left eye. Clinical examination pointed to instability of the left medial rectus pulley. This was corrected by Faden on the medial rectus. The importance of this relatively new concept in identifying and treating orbital pulley instability is discussed. PMID:27162460

  16. Scar remodeling after strabismus surgery.

    PubMed Central

    Ludwig, I H

    1999-01-01

    PURPOSE: Patients with overcorrected strabismus (and several patients with undercorrection after extraocular muscle resection) underwent exploration of previously operated muscles, with the intention of advancing their tendons to prevent the need for surgery on additional muscles. Unexpectedly, it was found that, in many cases, an elongated scar segment of variable length was interposed between the muscle and its insertion site on the sclera. Laboratory investigations were carried out to elucidate the underlying mechanism(s) and to create an animal model of the disorder. METHODS: Lengthened scars were repaired on 198 muscles during 134 procedures performed on 123 patients. The scars consisted of amorphous connective tissue interposed between the globe and normal tendon. Repair was accomplished by excision of the scar and reattachment of the muscle to sclera, using absorbable sutures in 64 cases and nonabsorbable sutures in 70 cases. Histopathologic examination was performed on 82 clinical specimens, and tissue culture studies were performed on 7 specimens. To develop an animal model, 10 New Zealand white rabbits underwent bilateral superior rectus resection. Half of the eyes received sub-Tenon's injections of collagenase over the operative site during weeks 2, 3, 5, and 6 postoperatively; the other half received saline solution injections on the same schedule. At 10 weeks, half the sites were studied histologically, and the other half underwent collagen creep analysis. In a second study, the use of absorbable versus nonabsorbable sutures was compared in the rabbit model. RESULTS: In the clinical cases, the mean length of the elongated scar segments was 4.2 mm. A total of 105 of the 134 repair procedures were judged successful. Thirty-one procedures resulted in recurrence of the original overcorrection; 7 of these had documented restretches. Factors that distinguished patients with stretched scars from patients with classic slipped muscles included minimal or no

  17. Predictive Factors Affecting Long-Term Outcome of Unilateral Lateral Rectus Recession

    PubMed Central

    Yang, Hee Kyung; Kim, Mi-Jin; Hwang, Jeong-Min

    2015-01-01

    Background There are few long-term outcome reports of unilateral lateral rectus (LR) recession for exotropia including a large number of subjects. Previous reports on unilateral LR recession commonly show extremely low rates of initial overcorrection and large exodrifts after surgery suggesting that the surgical dose may be increased. However, little is known of the long-term outcome of a large unilateral LR recession for exotropia. Objectives To determine long-term outcomes and predictive factors of recurrence after a large unilateral LR recession in patients with exotropia. Data Extraction Retrospective analysis was performed on 92 patients aged 3 to 17 years who underwent 10 mm unilateral LR recession for exotropia of ≤ 25 prism diopters (Δ) with prism and alternate cover testing and were followed up for more than 2 years after surgery. Final success rates within 10Δ of exophoria/tropia and 5Δ of esophoria/tropia at distance in the primary position, improvement in stereopsis and the predictive factors for recurrence were evaluated. Results At 24 months after surgery, 54% of patients had ocular alignment meeting the defined criteria of success, 45% had recurrence and 1% had overcorrection. After a mean follow-up of 39 months, 36% showed success, 63% showed recurrence and 1% resulted in overcorrection. The average time of recurrence was 23.4±14.7 months (range, 1–60 months) and the rate of recurrence per person-year was 23% after unilateral LR recession. Predictive factors of recurrence were a larger preoperative near angle of deviation (>16Δ) and larger initial postoperative exodeviation (>5Δ) at distance. Conclusions Long-term outcome of unilateral LR recession for exotropia showed low success rates with high recurrence, thus should be reserved for patients with a small preoperative near angle of exodeviation. PMID:26418819

  18. Acquired oculomotor muscle fibrosis in infant: case report.

    PubMed

    Souza-Dias, Carlos Ramos de; Goldchmit, Mauro; Uesugui, Carlos Fumiaki

    2011-01-01

    The authors report the case of a 5 year-old boy who up to 2 years old presented normal eyes, when his right eye started to deviate upward and laterally, until be hidden under the superior lid. At the surgery, a strong passive limitation to infraduction of this eye was felt. He had already been operated on in another clinic, but the surgeon could not succeed in hooking his superior rectus. With great difficulty, the only thing that we could do was a free tenotomy of the superior rectus. As the eye was equilibrated in a moderate abduction, we performed an 8 mm recession of the lateral rectus. As there was still a small hypertropia and exotropia postoperatively, we performed in a second operation an eight millimeters resection of the medial rectus, a recession with anterior transposition of the inferior oblique and an advancement of the inferior rectus according to the Romero-Apis technique, in order to avert circulatory problems to the anterior segment of the eye. As he presented a small blepharoptosis, we did, in a third surgery, a tarsectomy according to the Fasanella-Servat technique, with good result. He ended with good eye position, almost no limitation of the horizontal movements and - 3 limitation of up and down ductions. The magnetic resonance imaging showed an altered image of the superior rectus, suggesting fibrosis post myositis. PMID:21915451

  19. 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

  20. Minimally invasive strabismus surgery versus paralimbal approach: A randomized, parallel design study is minimally invasive strabismus surgery worth the effort?

    PubMed Central

    Sharma, Richa; Amitava, Abadan K; Bani, Sadat AO

    2014-01-01

    Introduction: Minimal access surgery is common in all fields of medicine. We compared a new minimally invasive strabismus surgery (MISS) approach with a standard paralimbal strabismus surgery (SPSS) approach in terms of post-operative course. Materials and Methods: This parallel design study was done on 28 eyes of 14 patients, in which one eye was randomized to MISS and the other to SPSS. MISS was performed by giving two conjunctival incisions parallel to the horizontal rectus muscles; performing recession or resection below the conjunctival strip so obtained. We compared post-operative redness, congestion, chemosis, foreign body sensation (FBS), and drop intolerance (DI) on a graded scale of 0 to 3 on post-operative day 1, at 2-3 weeks, and 6 weeks. In addition, all scores were added to obtain a total inflammatory score (TIS). Statistical Analysis: Inflammatory scores were analyzed using Wilcoxon's signed rank test. Results: On the first post-operative day, only FBS (P =0.01) and TIS (P =0.04) showed significant difference favoring MISS. At 2-3 weeks, redness (P =0.04), congestion (P =0.04), FBS (P =0.02), and TIS (P =0.04) were significantly less in MISS eye. At 6 weeks, only redness (P =0.04) and TIS (P =0.05) were significantly less. Conclusion: MISS is more comfortable in the immediate post-operative period and provides better cosmesis in the intermediate period. PMID:24088635

  1. Abdominal muscle paralysis associated with herpes zoster.

    PubMed

    Gottschau, P; Trojaborg, W

    1991-10-01

    We describe a 77-year-old women with cutaneous herpes zoster in the area of the right T9-T11 dermatomes complicated by abdominal muscle paralysis. Four months after onset of paralysis, stimulation of appropriate intercostal nerves failed to evoke responses from the corresponding segments of the rectus abdominis muscle. Three months later EMG of these muscle segments revealed profuse denervation activity and spontaneous long-lasting burst of high frequency discharges. Magnetic stimulation applied transcranially and peripherally at T10 evoked responses from the left, but not from the right paralytic rectus abdominis muscle. Electric stimulation of right T10 elicited a markedly delayed, prolonged and polyphasic response in the transverse abdominis muscle and EMG revealed polyphasia and increased motor unit potential duration in muscle segments underlying herpes zoster eruption. One and a half years after onset, the paralysis of the rectus abdominis muscle was still present. A survey of the literature concerning this rare type of zoster paralysis is presented. PMID:1837649

  2. Using your shoulder after surgery

    MedlinePlus

    Shoulder surgery - using your shoulder; Shoulder surgery - after ... You had surgery on your shoulder to repair a muscle, tendon, or cartilage tear. The surgeon may have removed damaged tissue. You will need to know how ...

  3. Contributions to enhanced activity in rectus femoris in response to Lokomat-applied resistance.

    PubMed

    Klarner, Taryn; Blouin, J-S; Carpenter, M G; Lam, T

    2013-03-01

    The application of resistance during the swing phase of locomotion is a viable approach to enhance activity in the rectus femoris (RF) in patients with neurological damage. Increased muscle activity is also accompanied by changes in joint angle and stride frequency, consequently influencing joint angular velocity, making it difficult to attribute neuromuscular changes in RF to resistance. Thus, the purpose of this study was to evaluate the effects of resistance on RF activity while constraining joint trajectories. Participants walked in three resistance conditions; 0 % (no resistance), 5 and 10 % of their maximum voluntary contraction (MVC). Visual and auditory biofeedback was provided to help participants maintain the same knee joint angle and stride frequency as during baseline walking. Lower limb joint trajectories and RF activity were recorded. Increasing the resistance, while keeping joint trajectories constant with biofeedback, independently enhanced swing phase RF activity. Therefore, the observed effects in RF are related to resistance, independent of any changes in joint angle. Considering resistance also affects stride frequency, a second experiment was conducted to evaluate the independent effects of resistance and stride frequency on RF activity. Participants walked in four combinations of resistance at 0 and 10 %MVC and natural and slow stride frequency conditions. We observed significant increases in RF activity with increased resistance and decreased stride frequency, confirming the independent contribution of resistance on RF activity as well as the independent effect of stride frequency. Resistance and stride frequency may be key parameters in gait rehabilitation strategies where either of these may be manipulated to enhance swing phase flexor muscle activity in order to maximize rehabilitation outcomes. PMID:23183638

  4. 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 ...

  5. Avulsion fracture of the straight and reflected heads of rectus femoris.

    PubMed

    Deehan, D J; Beattie, T F; Knight, D; Jongschaap, H

    1992-09-01

    We present a rare case of avulsion fracture of the reflected head of rectus femoris. This occurred in a 13-year-old male footballer. Diagnosis was made with pelvic radiology and treatment was bed rest and analgesia. PMID:1449579

  6. Post-strabismus surgery aqueous misdirection syndrome.

    PubMed

    Angmo, Dewang; Nayak, Bhagabat; Gupta, Viney

    2015-01-01

    A 24-year-old man was referred to the glaucoma clinic of our tertiary eye care centre in view of uncontrolled intraocular pressure (IOP) in the left eye despite maximal medication. The patient had undergone left eye cosmetic squint surgery 1 month before (medial rectus resection 9 mm and lateral rectus recession 12 mm) for congenital third nerve palsy. Post-squint surgery, the patient developed pain and was being managed symptomatically. However, 1 week later, he developed diffuse corneal oedema and severe pain, and was readmitted for management in the same hospital. He presented to our centre with an IOP of 16 mm Hg in the right eye and 58 mm Hg in the left eye. We made a diagnosis of left eye post-strabismus surgery aqueous misdirection syndrome, and performed left eye core vitrectomy with 360° goniosynechialysis and ultimately a trabeculectomy to reduce IOP. PMID:26243745

  7. Development of estimation system of knee extension strength using image features in ultrasound images of rectus femoris

    NASA Astrophysics Data System (ADS)

    Murakami, Hiroki; Watanabe, Tsuneo; Fukuoka, Daisuke; Terabayashi, Nobuo; Hara, Takeshi; Muramatsu, Chisako; Fujita, Hiroshi

    2016-04-01

    The word "Locomotive syndrome" has been proposed to describe the state of requiring care by musculoskeletal disorders and its high-risk condition. Reduction of the knee extension strength is cited as one of the risk factors, and the accurate measurement of the strength is needed for the evaluation. The measurement of knee extension strength using a dynamometer is one of the most direct and quantitative methods. This study aims to develop a system for measuring the knee extension strength using the ultrasound images of the rectus femoris muscles obtained with non-invasive ultrasonic diagnostic equipment. First, we extract the muscle area from the ultrasound images and determine the image features, such as the thickness of the muscle. We combine these features and physical features, such as the patient's height, and build a regression model of the knee extension strength from training data. We have developed a system for estimating the knee extension strength by applying the regression model to the features obtained from test data. Using the test data of 168 cases, correlation coefficient value between the measured values and estimated values was 0.82. This result suggests that this system can estimate knee extension strength with high accuracy.

  8. Successful repair of injury to the eyelid, lacrimal passage, and extraocular muscle

    PubMed Central

    Shah, Shreya Mehul; Shah, Mehul Ashvin; Shah, Prerna D.; Patel, Kashyap B.

    2016-01-01

    Introduction: Injury is a known cause of monocular blindness. Ocular trauma may affect lacrimal canaliculi and the extraocular muscle. We report this case as it includes injury to lid, lacrimal canaliculi and inferior rectus. Case description: A 25-year-old male presented with an injury caused by a sharp object that resulted in a conjunctival tear, lid tear involving the lacrimal canal, and rupture of the inferior rectus muscle. All of the structures were repaired successfully during a single procedure. Conclusion: An extraocular injury involving the conjunctiva, lid, lacrimal passages, and extraocular muscles can be repaired successfully during a single procedure.

  9. Cloning and Characterization of Two Bistructural S-Layer-RTX Proteins from Campylobacter rectus

    PubMed Central

    Braun, Martin; Kuhnert, Peter; Nicolet, Jacques; Burnens, André P.; Frey, Joachim

    1999-01-01

    Campylobacter rectus is an important periodontal pathogen in humans. A surface-layer (S-layer) protein and a cytotoxic activity have been characterized and are thought to be its major virulence factors. The cytotoxic activity was suggested to be due to a pore-forming protein toxin belonging to the RTX (repeats in the structural toxins) family. In the present work, two closely related genes, csxA and csxB (for C. rectus S-layer and RTX protein) were cloned from C. rectus and characterized. The Csx proteins appear to be bifunctional and possess two structurally different domains. The N-terminal part shows similarity with S-layer protein, especially SapA and SapB of C. fetus and Crs of C. rectus. The C-terminal part comprising most of CsxA and CsxB is a domain with 48 and 59 glycine-rich canonical nonapeptide repeats, respectively, arranged in three blocks. Purified recombinant Csx peptides bind Ca2+. These are characteristic traits of RTX toxin proteins. The S-layer and RTX domains of Csx are separated by a proline-rich stretch of 48 amino acids. All C. rectus isolates studied contained copies of either the csxA or csxB gene or both; csx genes were absent from all other Campylobacter and Helicobacter species examined. Serum of a patient with acute gingivitis showed a strong reaction to recombinant Csx protein on immunoblots. PMID:10198015

  10. Preoperative overnight parenteral nutrition (TPN) improves skeletal muscle protein metabolism indicated by microarray algorithm analyses in a randomized trial.

    PubMed

    Iresjö, Britt-Marie; Engström, Cecilia; Lundholm, Kent

    2016-06-01

    Loss of muscle mass is associated with increased risk of morbidity and mortality in hospitalized patients. Uncertainties of treatment efficiency by short-term artificial nutrition remain, specifically improvement of protein balance in skeletal muscles. In this study, algorithmic microarray analysis was applied to map cellular changes related to muscle protein metabolism in human skeletal muscle tissue during provision of overnight preoperative total parenteral nutrition (TPN). Twenty-two patients (11/group) scheduled for upper GI surgery due to malignant or benign disease received a continuous peripheral all-in-one TPN infusion (30 kcal/kg/day, 0.16 gN/kg/day) or saline infusion for 12 h prior operation. Biopsies from the rectus abdominis muscle were taken at the start of operation for isolation of muscle RNA RNA expression microarray analyses were performed with Agilent Sureprint G3, 8 × 60K arrays using one-color labeling. 447 mRNAs were differently expressed between study and control patients (P < 0.1). mRNAs related to ribosomal biogenesis, mRNA processing, and translation were upregulated during overnight nutrition; particularly anabolic signaling S6K1 (P < 0.01-0.1). Transcripts of genes associated with lysosomal degradation showed consistently lower expression during TPN while mRNAs for ubiquitin-mediated degradation of proteins as well as transcripts related to intracellular signaling pathways, PI3 kinase/MAPkinase, were either increased or decreased. In conclusion, muscle mRNA alterations during overnight standard TPN infusions at constant rate altered mRNAs associated with mTOR signaling; increased initiation of protein translation; and suppressed autophagy/lysosomal degradation of proteins. This indicates that overnight preoperative parenteral nutrition is effective to promote muscle protein metabolism. PMID:27273879

  11. Effect of craniocervical posture on abdominal muscle activities

    PubMed Central

    Su, Jung Gil; Won, Shin Ji; Gak, Hwangbo

    2016-01-01

    [Purpose] The aim of this study was to investigate the influence of the craniocervical posture on abdominal muscle activities in hook-lying position. [Subjects] This study recruited 12 healthy young adults. [Methods] Each subject was asked to adopt a supine position with the hip and knee flexed at 60°. Surface electromyographic signals of transversus abdominis/internal oblique, rectus abdominis, and external oblique in different craniocervical postures (extension, neutral, and flexion) were compared. [Results] The transversus abdominis and rectus abdominis showed increased muscle activities in craniocervical flexion compared to craniocervical extension and neutral position. Greater muscle activities of the external oblique were seen in craniocervical flexion than in craniocervical extension. [Conclusion] Craniocervical flexion was found to be effective to increase the abdominal muscle activities. Consideration of craniocervical posture is recommended when performing trunk stabilization exercises. PMID:27065558

  12. Anti-reflux surgery - children

    MedlinePlus

    ... stomach). Problems with these muscles can lead to gastroesophageal reflux disease (GERD). This surgery can also be done ... laparoscopic antireflux operations in infants and children for ... American Pediatric Surgery Association. J Pediatr Surg . ...

  13. Avulsion fracture of the straight and reflected heads of rectus femoris.

    PubMed Central

    Deehan, D J; Beattie, T F; Knight, D; Jongschaap, H

    1992-01-01

    We present a rare case of avulsion fracture of the reflected head of rectus femoris. This occurred in a 13-year-old male footballer. Diagnosis was made with pelvic radiology and treatment was bed rest and analgesia. Images Fig. 1 Fig. 2 PMID:1449579

  14. The Significance of Rectus Femoris for the Favorable Functional Outcome After Total Femur Replacement

    PubMed Central

    Nakayama, Takayuki; Shimoji, Takashi; Ae, Keisuke; Tanizawa, Taisuke; Gokita, Tabu

    2016-01-01

    Background: In treatment of tumors, we usually reconstruct after resection of the entire femur using only metallic modular endoprostheses among many procedures and defined it as a total femur replacement. We studied the interrelation between the preservation of rectus femoris and the functional outcome after total femur replacement. Methods: We rated the functional outcomes of 21 patients who underwent total femur replacement. We categorized the subjects into 2 groups: group A (rectus femoris preserved) and group B (rectus femoris unpreserved). We examined them based on the Mann-Whitney U test between the 2 groups in average through the Musculoskeletal Tumor Society functional scores. Results: The average score of group A was 20 of 25 (11–25; 80%), whereas the average score of group B was 10 of 25 (4–13; 40%). There was significant difference between the groups (P = 0.00168877). Conclusion: We found that the preservation of rectus femoris is imperative for achieving the favorable functional outcome in total femur replacement.

  15. The first Iraqi experience with the rectus fascia sling and transobturator tape for female stress incontinence: A randomised trial

    PubMed Central

    Al-Azzawi, Issam S.

    2014-01-01

    Objectives To present the first experience in Iraq of autologous rectus fascia sling (RFS) procedures and transobturator tape (TOT) for treating female stress urinary incontinence (SUI), and to review the validity of the RFS in the era of synthetic tapes. Patients and methods From December 2004 to July 2012, 80 female patients with SUI were enrolled in the study, and randomly assigned into two types of surgery, with 40 treated by RFS (retropubic route) and 40 by TOT. The surgical results were compared between the groups and with those from previous studies. Results The mean operative duration was 80 min for RFS vs. 20 min for TOT. The early cure rate was 98% for RFS (with one failure due to prolonged urinary retention) and 95% for TOT (with two failures due to persistent incontinence). The early complications were mainly abdominal wound problems (20%) for RFS, and groin and upper thigh pain (13%) for TOT. The late complications were the development of postvoid residual urine (8% in RFS vs. 5% in TOT) and de novo detrusor overactivity (5% in each group). There were no vaginal or urethral erosions up to the end of the study. Conclusions RFS and TOT have comparable efficacy and safety in treating SUI. Nevertheless RFS, with its more invasive nature and long operative duration, should only be used when synthetic tapes are not available or not preferable. PMID:26019950

  16. MUSCLE ACTIVATION OF THE TORSO DURING THE MODIFIED RAZOR CURL HAMSTRING EXERCISE

    PubMed Central

    Stone, Audrey J.; Wyman, James W.; Blazquez, Ivan N.

    2012-01-01

    Purpose/Background: The RAZOR curl has been introduced as a hamstring exercise. However, modifications to the exercise have been developed which are proposed to utilize some of the muscles of the lumbo-pelvic-hip complex. Thus, it was the purpose of this study to quantitatively examine the modified RAZOR curl using surface electromyography (sEMG), as an exercise that may recruit the trunk muscles of the lumbo-pelvic-hip complex. Methods: Twenty-eight active male and female graduate students (24.2±1.3 years; 174.8±9.9 cm; 74.9±14.9 kg), consented to participate. Dependent variables were muscle activation of trunk musculature (dominant side gluteus medius, gluteus maximus, multifidus, longissimus, lower rectus abdominis, upper rectus abdominis, external obliques) reported as percent of maximum voluntary isometric contraction (%MVIC) during the exercise while the independent variable was the muscle selected. Results: The multifidus and longissimus demonstrated moderately strong activation (35-50%MVIC) while the upper rectus abdominis demonstrated strong activation (20-35%MVIC) and the gluteus medius, gluteus maximus, lower rectus abdominis, and external obliques had minimal activation. Conclusions: These findings allow the practitioner to utilize an exercise that provides a functional training stimulus that activates not only the hamstrings but also some musculature of the trunk muscles of the lumbopelvic-hip complex at strong to moderately strong levels. Level of Evidence: 5 PMID:22319680

  17. Interrelationships between meat quality traits, texture measurements and physicochemical characteristics of M. rectus abdominis from Charolais heifers.

    PubMed

    Oury, M P; Picard, B; Briand, M; Blanquet, J P; Dumont, R

    2009-10-01

    Ninety-nine Charolais heifers were used to study the variability of meat quality traits in relation to the physicochemical characteristics of M. rectus abdominis. The heifers of the same trade class were slaughtered at 33months of age (±4months) and 381kg carcass weight (±31kg). Muscle and bone development scores were evaluated before slaughter. Carcass weight, slaughter age and life average daily gain were recorded. Shear force measurements and meat quality traits were evaluated after 14days of aging. Some physicochemical characteristics were measured 24h post-slaughter. Tenderness was correlated with slaughter age (r=-0.31), bone development (r=-0.22) and life average daily gain (r=+0.37). Tenderness was significantly related to total collagen content (r=-0.24), lipid content (r=+0.27) and I myosin heavy chain proportion (r=+0.24). Juiciness was positively correlated with lipid content (r=+0.31) and I myosin heavy chain proportion (r=+0.20). Flavor intensity was correlated with lipid content (r=+0.26) and mean fiber area (r=+0.24). Shear force was correlated with total collagen, lipid and 27K proteasome sub-unit contents. Taking animal characteristics and muscle properties together in a multiple regression analysis increased the explained tenderness variability to 33%. The independent variables listed in order of importance were life average daily gain, total collagen content, bone development, lipid content, I myosin heavy chain isoform proportion, shear force of broiled meat and slaughter age. PMID:20416732

  18. Impact of decline-board squat exercises and knee joint angles on the muscle activity of the lower limbs

    PubMed Central

    Lee, Daehee; Lee, Sangyong; Park, Jungseo

    2015-01-01

    [Purpose] This study aims to investigate how squat exercises on a decline board and how the knee joint angles affect the muscle activity of the lower limbs. [Subjects] The subjects were 26 normal adults. [Methods] A Tumble Forms wedge device was used as the decline board, and the knee joint angles were measured with a goniometer. To examine the muscle activity of the biceps femoris, rectus femoris, gastrocnemius lateralis, and tibialis anterior of the lower limbs, a comparison analysis with electromyography was conducted. [Results] The muscle activity of the biceps femoris, rectus femoris, gastrocnemius lateralis, and tibialis anterior increased with increased knee joint angles, both for squat exercises on the decline board and on a flat floor. When the knee joint angle was 45°, 60°, and 90°, the muscle activity of the rectus femoris was significantly higher and that of the tibialis anterior was significantly lower during squat exercises on the decline board than on the flat floor. When the knee joint angle was 90°, the muscle activity of the gastrocnemius lateralis was significantly lower. [Conclusion] Squat exercises on a decline board are an effective intervention to increase the muscle activity of the rectus femoris with increased knee joint angles. PMID:26357447

  19. Use of Oral Mucoperiosteal and Pterygo-Masseteric Muscle Flaps as Interposition Material in Surgery of Temporomandibular Joint Ankylosis: A Comparative Study

    PubMed Central

    Anyanechi, CE; Osunde, OD; Bassey, GO

    2015-01-01

    Background: The most common complication of surgery for the release of temporomandibular joint (TMJ) ankylosis is relapse of the ankylosis. To prevent re-ankylosis, a variety of interpositional materials have been used. Aim: The aim was to compare the surgical outcome of oral mucoperiosteal flap, not hitherto used as interpositional material, with pterygo-masseteric muscles flap after surgical release of TMJ ankylosis. Subjects and Methods: This was a prospective randomized study of all consecutive patients treated for the release of complete TMJ bony ankylosis, from January 2003 to December 2012, at the Oral and Maxillofacial unit of our institution. The patients were randomized into two groups: The pterygo-masseteric group comprises 22 patients while the oral mucoperiosteal group had 23 patients. Information on demographics, clinical characteristics, and postoperative complications over a 5 year follow-up period were obtained, and analyzed using the statistical package for social sciences (Statistical Package for the Social Sciences version 13, Chicago, IL, USA). A P < 0.05 was considered significant. Results: The age of the patients ranged from 15 to 28 mean 20.3 (3.35) years while the duration of ankylosis ranged from 2 to 16 mean 5.1 (3.4) years. The baseline demographic (gender; P = 0.92; side; P = 0.58) and clinical characteristics in terms of etiology (P = 0.60) and age (P = 0.52) were comparable in both treatment groups. All the patients presented with complete bony TMJ ankylosis with a preoperative inter-incisal distance of <0.5 cm. The intraoperative mouth opening achieved ranged from 4 cm to 5 cm, mean 4.6 (0.27) cm and this was not different for either group (P = 0.51). The patients were followed up postoperatively for a period ranging from 3 to 5 years, mean 3.4 (0.62) years. The mouth opening decreased, over the period of postoperative review, from the initial range of 4–5 cm to 2.9–3.6 cm, and this was not different in both groups (P = 0

  20. Discomfort and muscle activation during car egress in drivers with hemiplegia following stroke

    PubMed Central

    Jung, Nam-hae; Kim, Hwanhee; Chang, Moonyoung

    2015-01-01

    [Purpose] This study investigated and compared the discomfort experienced during car egress with the car door opened at different angles and muscle activation in drivers with hemiplegia following stroke and non-disabled drivers. [Subjects and Methods] The participants were five drivers with hemiplegia and five non-disabled drivers. The discomfort experienced during car egress was measured using the nine-point Likert scale when the door was opened wide and when it was opened 45°. Muscle activation was measured using the TeleMyo 2400T G2 electromyography system. Electromyograph electrodes were placed on the erector spinae, rectus abdominis, and rectus femoris muscles. [Results] In the non-disabled drivers, there was no significant difference in the discomforts they experienced during car egress when the door was opened wide and when it was opened 45°. However, the discomfort experienced by drivers with hemiplegia when the door was opened 45° was significantly higher than that experienced when it was opened wide. There was a significant difference in the activation of the erector spinae, but no difference in the activation of the rectus abdominis or rectus femoris muscles. [Conclusion] This study will help to understand the difficulties experienced by drivers with hemiplegia following stroke during car ingress and egress. PMID:26834350

  1. Effects of a multichannel dynamic functional electrical stimulation system on hemiplegic gait and muscle forces

    PubMed Central

    Qian, Jing-guang; Rong, Ke; Qian, Zhenyun; Wen, Chen; Zhang, Songning

    2015-01-01

    [Purpose] The purpose of the study was to design and implement a multichannel dynamic functional electrical stimulation system and investigate acute effects of functional electrical stimulation of the tibialis anterior and rectus femoris on ankle and knee sagittal-plane kinematics and related muscle forces of hemiplegic gait. [Subjects and Methods] A multichannel dynamic electrical stimulation system was developed with 8-channel low frequency current generators. Eight male hemiplegic patients were trained for 4 weeks with electric stimulation of the tibia anterior and rectus femoris muscles during walking, which was coupled with active contraction. Kinematic data were collected, and muscle forces of the tibialis anterior and rectus femoris of the affected limbs were analyzed using a musculoskelatal modeling approach before and after training. A paired sample t-test was used to detect the differences between before and after training. [Results] The step length of the affected limb significantly increased after the stimulation was applied. The maximum dorsiflexion angle and maximum knee flexion angle of the affected limb were both increased significantly during stimulation. The maximum muscle forces of both the tibia anterior and rectus femoris increased significantly during stimulation compared with before functional electrical stimulation was applied. [Conclusion] This study established a functional electrical stimulation strategy based on hemiplegic gait analysis and musculoskeletal modeling. The multichannel functional electrical stimulation system successfully corrected foot drop and altered circumduction hemiplegic gait pattern. PMID:26696734

  2. Herpes Zoster in a Free Transverse Rectus Abdominis Myocutaneous Flap After Delayed Breast Reconstruction

    PubMed Central

    Lee, Jeong Hui; Ahn, Hee Chang; Chung, Min Sung

    2015-01-01

    Abstract In concert with advances in surgical reconstruction techniques and improved survival after breast cancer, both the aesthetic and functional outcomes, especially sensory recovery, of breast reconstruction have been addressed. Most studies on sensory recovery in reconstructed breasts have utilized patients’ subjective responses to touch, pain, temperature, and pressure. In contrast, this report describes a case of herpes zoster that developed in a free transverse rectus abdominis myocutaneous flap, which provides objective evidence of spontaneous reinnervation after breast reconstruction. PMID:25974118

  3. An analysis on muscle tone of lower limb muscles on flexible flat foot

    PubMed Central

    Um, Gi-Mai; Wang, Joong-San; Park, Si-Eun

    2015-01-01

    [Purpose] The aim of this study was to examine differences in the muscle tone and stiffness of leg muscles according to types of flexible flat foot. [Subjects and Methods] For 30 subjects 10 in a normal foot group (NFG), 10 in group with both flexible flat feet (BFFG), and 10 in a group with flexible flat feet on one side (OFFG), myotonometry was used to measure the muscle tone and stiffness of the tibialis anterior muscle (TA), the rectus femoris muscle (RF), the medial gastrocnemius (MG), and the long head of the biceps femoris muscle (BF) of both lower extremities. [Results] In the measurement results, only the stiffness of TA and MG of the NFG and the BFFG showed significant differences. The muscle tone and stiffness were highest in the BFFG, followed by the OFFG and NFG, although the difference was insignificant. In the case of the OFFG, there was no significant difference in muscle tone and stiffness compared to that in the NGF and the BFFG. Furthermore, in the NFG, the non-dominant leg showed greater muscle tone and stiffness than the dominant leg, although the difference was insignificant. [Conclusion] During the relax condition, the flexible flat foot generally showed a greater muscle tone and stiffness of both lower extremities compared to the normal foot. The stiffness was particularly higher in the TA and MG muscles. Therefore, the muscle tone and stiffness of the lower extremity muscles must be considered in the treatment of flat foot. PMID:26644650

  4. Actions of Two Bi-Articular Muscles of the Lower Extremity: A Review

    PubMed Central

    Landin, Dennis; Thompson, Melissa; Reid, Meghan

    2016-01-01

    The extremities of the human body contain several bi-articular muscles. The actions produced by muscles at the joints they cross are greatly influenced by joint moment arms and muscle length. These factors are dynamic and subject to change as joint angles are altered. Therefore, to more completely understand the actions of such muscles, the angles of both joints must be manipulated. This report reviews investigations, which have explored the actions of two bi-articular muscles of the lower extremities (gastrocnemius and rectus femoris) as the joints they cross are moved into various combinations of angles. The findings have both clinical and physical performance ramifications. PMID:27298656

  5. Actions of Two Bi-Articular Muscles of the Lower Extremity: A Review.

    PubMed

    Landin, Dennis; Thompson, Melissa; Reid, Meghan

    2016-07-01

    The extremities of the human body contain several bi-articular muscles. The actions produced by muscles at the joints they cross are greatly influenced by joint moment arms and muscle length. These factors are dynamic and subject to change as joint angles are altered. Therefore, to more completely understand the actions of such muscles, the angles of both joints must be manipulated. This report reviews investigations, which have explored the actions of two bi-articular muscles of the lower extremities (gastrocnemius and rectus femoris) as the joints they cross are moved into various combinations of angles. The findings have both clinical and physical performance ramifications. PMID:27298656

  6. Localization of motoneurons innervating individual abdominal muscles of the cat

    NASA Technical Reports Server (NTRS)

    Miller, Alan D.

    1987-01-01

    The paper presents the results of a systematic investigation of the innervation of the cat's individual abdominal muscles. The segmental distribution of the different motor pools was determined by using electrical microstimulation of the ventral horn to produce visible localized muscle twitches and by retrograde transport of horseradish peroxidase injected into individual muscles. The segmental distribution of each motor pool was as follows: rectus abdominis, T4-L3; external oblique, T6-L3; transverse abdominis, T9-L3; and internal oblique, T13-L3.

  7. The muscle activation patterns of lower limb during stair climbing at different backpack load.

    PubMed

    Yali, Han; Aiguo, Song; Haitao, Gao; Songqing, Zhu

    2015-01-01

    Stair climbing under backpack load condition is a challenging task. Understanding muscle activation patterns of lower limb during stair climbing with load furthers our understanding of the factors involved in joint pathology and the effects of treatment. At the same time, stair climbing under backpack load requires adjustments of muscle activations and increases joint moment compared to level walking, which with muscle activation patterns are altered as a result of using an assistive technology, such as a wearable exoskeleton leg for human walking power augmentation. Therefore, the aim of this study was to analyze lower limb muscles during stair climbing under different backpack load. Nine healthy volunteers ascended a four-step staircase at different backpack load (0 kg, 10 kg, 20 kg, 30 kg). Electromyographic (EMG) signals were recorded from four lower limb muscles (gastrocnemius, tibialis anterior, hamstring, rectus femoris). The results showed that muscle activation amplitudes of lower limb increase with increasing load during stair climbing, the maximum RMS of gastrocnemius are greater than tibialis anterior, hamstring and rectus femoris whether stair climbing or level walking under the same load condition. However, the maximum RMS of hamstring are smaller than gastrocnemius, tibialis anterior and rectus femoris. The study of muscle activation under different backpack load during stair climbing can be used to design biomechanism and explore intelligent control based on EMG for a wearable exoskeleton leg for human walking power augmentation. PMID:26899302

  8. The comparison of abdominal muscle activation on unstable surface according to the different trunk stability exercises

    PubMed Central

    Lee, Jung-seok; Kim, Da-yeon; Kim, Tae-ho

    2016-01-01

    [Purpose] This study aimed to determine the effect of abdominal muscle activities and the activation ratio related to trunk stabilization to compare the effects between the abdominal drawing-in maneuver and lumbar stabilization exercises on an unstable base of support. [Subjects and Methods] Study subjects were 20 male and 10 female adults in their 20s without lumbar pain, who were equally and randomly assigned to either the abdominal drawing-in maneuver group and the lumbar stabilization exercise group. Abdominal muscle activation and ratio was measured using a wireless TeleMyo DTS during right leg raise exercises while sitting on a Swiss ball. [Results] Differences in rectus abdominis, external oblique abdominis, and internal oblique abdominis muscle activation were observed before and after treatment. Significant differences were observed between the groups in the muscle activation of the external oblique abdominis and internal oblique abdominis, and the muscle activation ratio of external oblique abdominis/rectus abdominis and internal oblique abdominis/rectus abdominis. [Conclusion] Consequently trunk stability exercise enhances internal oblique abdominis activity and increases trunk stabilization. In addition, the abdominal drawing-in maneuver facilitates the deep muscle more than LSE in abdominal muscle. Therefore, abdominal drawing-in maneuver is more effective than lumbar stabilization exercises in facilitating trunk stabilization. PMID:27134401

  9. Optimizing Muscle Parameters in Musculoskeletal Modeling Using Monte Carlo Simulations

    NASA Technical Reports Server (NTRS)

    Hanson, Andrea; Reed, Erik; Cavanagh, Peter

    2011-01-01

    Astronauts assigned to long-duration missions experience bone and muscle atrophy in the lower limbs. The use of musculoskeletal simulation software has become a useful tool for modeling joint and muscle forces during human activity in reduced gravity as access to direct experimentation is limited. Knowledge of muscle and joint loads can better inform the design of exercise protocols and exercise countermeasure equipment. In this study, the LifeModeler(TM) (San Clemente, CA) biomechanics simulation software was used to model a squat exercise. The initial model using default parameters yielded physiologically reasonable hip-joint forces. However, no activation was predicted in some large muscles such as rectus femoris, which have been shown to be active in 1-g performance of the activity. Parametric testing was conducted using Monte Carlo methods and combinatorial reduction to find a muscle parameter set that more closely matched physiologically observed activation patterns during the squat exercise. Peak hip joint force using the default parameters was 2.96 times body weight (BW) and increased to 3.21 BW in an optimized, feature-selected test case. The rectus femoris was predicted to peak at 60.1% activation following muscle recruitment optimization, compared to 19.2% activation with default parameters. These results indicate the critical role that muscle parameters play in joint force estimation and the need for exploration of the solution space to achieve physiologically realistic muscle activation.

  10. The muscles of the infrapubic abdominal wall of a 6-month-old Crocodylus niloticus (Reptilia: Crocodylia).

    PubMed

    Fechner, R; Schwarz-Wings, D

    2013-06-01

    The muscles of the infrapubic abdominal wall of crocodilians play an important role in their ventilatory mechanism. Yet the anatomy and homology of these muscles is poorly understood. To gain new insights into the anatomy of the crocodilian infrapubic abdominal wall, we dissected a specimen of Crocodylus niloticus. Origin and insertion of the muscles, as well as their arrangement relative to each other was examined in great detail. The findings were compared with those of other crocodilian taxa to detect potential variability of the muscles of interest. The homology of the muscles was studied by comparing the muscles of the crocodilian infrapubic abdominal wall with those of other diapsids. In Crocodylus niloticus, the infrapubic abdominal wall consists of four muscles: Musculus truncocaudalis, M. ischiotruncus, and Mm. rectus abdominis externus and internus. The arrangement of the muscles of the infrapubic abdominal wall of Crocodylus niloticus is consistent with that found in most other crocodilian taxa. In some crocodilian taxa, an additional muscle, M. ischiopubis, is found. In the remaining diapsids, only M. rectus abdominis is present. The crocodilian M. truncocaudalis, M. ischiotruncus and, if present, M. ischiopubis appear to be derivates of M. rectus abdominis; the development of those might be related to the evolution of the unique crocodilian ventilatory mechanism. PMID:22909340

  11. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... Robotic surgery is similar to laparoscopic surgery. It can be performed through smaller cuts than open surgery. ...

  12. Comparative analysis of trunk muscle activities in climbing of during upright climbing at different inclination angles

    PubMed Central

    Park, Byung-Joon; Kim, Joong-Hwi; Kim, Jang-Hwan; Choi, Byeong-Ho

    2015-01-01

    [Purpose] This study was performed to provide evidence for the therapeutic exercise approach through a compative analysis of muscle activities according to climbing wall inclination. [Subjects and Methods] Twentyfour healthy adult subjects without climbing experience performed static exercises at a therapeutic climbing at with various inclination angles (0°, 10°, 20°), and the activities of the trunk muscles (rectus abdominis, obliquus externus abdominis, obliquus internus abdominis, erector spinae) were measured using surface electromyography (EMG) for 7 seconds. [Results] Significant differences were found between the inclination angles of 10° and 0°, as well as 20° in the rectus abdominis, obliquus internus abdominis, right obliquus externus abdominis, and right erector spinae. [Conclusion] Based on measurements of trunk muscle activity in a static climbing standing position at different angles, significant changes in muscle activity appear to be induced at 10 degrees. Therefore, the results appear to provide clinically relevant evidence. PMID:26644661

  13. Muscle Activation during Push-Ups with Different Suspension Training Systems

    PubMed Central

    Calatayud, Joaquin; Borreani, Sebastien; Colado, Juan C.; Martín, Fernando F; Rogers, Michael E.; Behm, David G.; Andersen, Lars L.

    2014-01-01

    The purpose of this study was to analyze upper extremity and core muscle activation when performing push-ups with different suspension devices. Young fit male university students (n = 29) performed 3 push-ups each with 4 different suspension systems. Push-up speed was controlled using a metronome and testing order was randomized. Average amplitude of the electromyographic root mean square of Triceps Brachii, Upper Trapezius, Anterior Deltoid, Clavicular Pectoralis, Rectus Abdominis, Rectus Femoris, and Lumbar Erector Spinae was recorded. Electromyographic signals were normalized to the maximum voluntary isometric contraction (MVIC). Electromyographic data were analyzed with repeated-measures analysis of variance with a Bonferroni post hoc. Based upon global arithmetic mean of all muscles analyzed, the suspended push-up with a pulley system provided the greatest activity (37.76% of MVIC; p < 0.001). Individually, the suspended push-up with a pulley system also provided the greatest triceps brachii, upper trapezius, rectus femoris and erector lumbar spinae muscle activation. In contrast, more stable conditions seem more appropriate for pectoralis major and anterior deltoid muscles. Independent of the type of design, all suspension systems were especially effective training tools for reaching high levels of rectus abdominis activation. Key Points Compared with standard push-ups on the floor, suspended push-ups increase core muscle activation. A one-anchor system with a pulley is the best option to increase TRICEP, TRAPS, LUMB and FEM muscle activity. More stable conditions such as the standard push-up or a parallel band system provide greater increases in DELT and PEC muscle activation. A suspended push-up is an effective method to achieve high muscle activity levels in the ABS. PMID:25177174

  14. 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 ...

  15. Does the rectus femoris nerve block improve knee recurvatum in adult stroke patients? A kinematic and electromyographic study.

    PubMed

    Gross, R; Delporte, L; Arsenault, L; Revol, P; Lefevre, M; Clevenot, D; Boisson, D; Mertens, P; Rossetti, Y; Luauté, J

    2014-02-01

    Knee recurvatum (KR) during gait is common in hemiplegic patients. Quadriceps spasticity has been postulated as a cause of KR in this population. The aim of this study was to assess the role of rectus femoris spasticity in KR by using selective motor nerve blocks of the rectus femoris nerve in hemiparetic stroke patients. The data from six adult, post-stroke hemiplegic patients who underwent a rectus femoris nerve block for a stiff-knee gait were retrospectively analyzed. An extensive clinical and functional evaluation was performed and gait was assessed by motion analysis (kinematic, kinetic and electromyographic parameters) before and during the block realized using 2% lidocaine injected under a neurostimulation and ultrasonographic targeting procedure. The main outcome measures were the peak knee extension in stance and peak knee extensor moment obtained during gait analysis. No serious adverse effect of the nerve block was observed. The block allowed a reduction of rectus femoris overactivity in all patients. Peak knee extension and extensor moment in stance did not improve in any patient, but peak knee flexion during the swing phase was significantly higher after block (mean: 31.2° post, 26.4 pre, p < 0.05). Our results provide arguments against the hypothesis that the spasticity of the rectus femoris contributes to KR. PMID:24286615

  16. Scrub Typhus Presenting with Bilateral Lateral Rectus Palsy in A Female

    PubMed Central

    Mishra, Jaya; Barman, Bhupen; Mondal, Sumantro; Sivam, Rondeep Kumar Nath

    2016-01-01

    Scrub typhus, a rickettsial disease is endemic in several parts of India usually presenting with acute symptoms. Fever, maculopapular rash, eschar, history of tick exposure and supportive diagnostic tests usually leads to diagnosis. Scrub typhus should be included in the differential diagnosis in occasions when a patient presents with fever with or without eschar and isolated cranial nerve palsy. Here we are reporting a case of Scrub typhus who presented with fever and altered sensorium of short duration, eschar formation and bilateral lateral rectus palsy. Patient was treated with doxycycline with complete reversal of neurodeficit. PMID:27190871

  17. Scrub Typhus Presenting with Bilateral Lateral Rectus Palsy in A Female.

    PubMed

    Ete, Tony; Mishra, Jaya; Barman, Bhupen; Mondal, Sumantro; Sivam, Rondeep Kumar Nath

    2016-04-01

    Scrub typhus, a rickettsial disease is endemic in several parts of India usually presenting with acute symptoms. Fever, maculopapular rash, eschar, history of tick exposure and supportive diagnostic tests usually leads to diagnosis. Scrub typhus should be included in the differential diagnosis in occasions when a patient presents with fever with or without eschar and isolated cranial nerve palsy. Here we are reporting a case of Scrub typhus who presented with fever and altered sensorium of short duration, eschar formation and bilateral lateral rectus palsy. Patient was treated with doxycycline with complete reversal of neurodeficit. PMID:27190871

  18. Hepatocellular carcinoma with extension to the diaphragm, falciform ligament, rectus abdominis and paraumbilical vein

    PubMed Central

    Kaur, R; Abdullah, BJJ; Rajasingam, V

    2008-01-01

    Hepatocellular carcinoma is the most common primary tumour of the liver. The most common extrahepatic metastatic sites are the lung, lymph nodes, bones and adrenal glands. All forms of HCC demonstrate a tendency for vascular invasion, producing extensive intrahepatic metastases and, occasionally, portal vein or inferior vena cava extension with spread into the right atrium in extreme cases. Tumour spread of abdominal diseases via hepatic ligaments has also been previously reported. We report a rare case of hepatocellular carcinoma with extension into the falciform ligament, overlying rectus sheath and adjacent diaphragm with concomitant infiltration into the recanalised paraumbilical vein. PMID:21611019

  19. The clinical course of recurrent intermittent exotropia following one or two surgeries over 24 months postoperatively

    PubMed Central

    Kim, W J; Kim, M M

    2014-01-01

    Purpose The aim of this study is to investigate the difference of the clinical course in recurrent intermittent exotropia after second surgery compared with both recurrent intermittent exotropia after its first of two surgeries and intermittent exotropia after only a single surgery. Methods We retrospectively reviewed the medical records of patients diagnosed with intermittent exotropia who underwent lateral rectus recession and medial rectus resection (R&R) between January 1992 and January 2011 at Yeungnam University Hospital. Repeated measure ANOVA (rmANOVA) was used to compare the clinical course of recurrent intermittent exotropia before and after a second surgery with that of intermittent exotropia with a single surgery. Results A total of 352 intermittent exotropia patients who underwent one R&R procedure and 77 recurrent intermittent exotropia patients who underwent a second R&R in the contralateral eye were included in this study. Although exodrift of recurrent intermittent exotropia was observed at 24 months of follow-up even after a second surgery, it was significantly lower than both intermittent exotropia with a single surgery and after its first of two surgeries (P<0.001, rmANOVA). Conclusion The clinical course of recurrent intermittent exotropia after a second surgery was improved compared with both recurrent intermittent exotropia after its first of two surgeries and intermittent exotropia after a single surgery. PMID:24788017

  20. Effects of age and inactivity due to prolonged bed rest on atrophy of trunk muscles.

    PubMed

    Ikezoe, Tome; Mori, Natsuko; Nakamura, Masatoshi; Ichihashi, Noriaki

    2012-01-01

    This study investigated the effects of age and inactivity due to being chronically bedridden on atrophy of trunk muscles. The subjects comprised 33 young women (young group) and 41 elderly women who resided in nursing homes or chronic care institutions. The elderly subjects were divided into two groups: independent elderly group who were able to perform activities of daily living involving walking independently (n = 28) and dependent elderly group who were chronically bedridden (n = 13). The thickness of the following six trunk muscles was measured by B-mode ultrasound: the rectus abdominis, external oblique, internal oblique, transversus abdominis, thoracic erector spinae (longissimus) and lumbar multifidus muscles. All muscles except for the transversus abdominis and lumbar multifidus muscles were significantly thinner in the independent elderly group compared with those in the young group. The thicknesses of all muscles in the dependent elderly group was significantly smaller than that in the young group, whereas there were no differences between the dependent elderly and independent elderly groups in the muscle thicknesses of the rectus abdominis and internal oblique muscles. In conclusion, our results suggest that: (1) age-related atrophy compared with young women was less in the deep antigravity trunk muscles than the superficial muscles in the independent elderly women; (2) atrophy associated with chronic bed rest was more marked in the antigravity muscles, such as the back and transversus abdominis. PMID:21472438

  1. Cosmetic Surgery

    MedlinePlus

    ... Body Looking and feeling your best Cosmetic surgery Cosmetic surgery Teens might have cosmetic surgery for a ... about my body? What are the risks of cosmetic surgery? top People who have cosmetic surgery face ...

  2. Extraocular muscle: cellular adaptations for a diverse functional repertoire.

    PubMed

    Porter, John D

    2002-04-01

    Oculomotor control systems are considerably more complex and diverse than are spinal skeletomotor systems. Moreover, individual skeletal muscles are frequently functional role-specific, while all extraocular muscles operate across a very wide dynamic range. We contend that the novel phenotype of the extraocular muscles is a direct consequence of the functional demands imposed upon this muscle group by the central eye movement controllers. This review highlights five basic themes of extraocular muscle biology that set them apart from more typical skeletal muscles, specifically, the (a) novel innervation pattern, (b) heterogeneity in contractile proteins, (c) structural and functional compartmentalization of the rectus and oblique muscles, (d) diversity of extraocular muscle fiber types, and (e) relationship between the novel muscle phenotype and the differential response of these muscles in neuromuscular and endocrine disease. Finally, new data from broad genome-wide profiling studies are reviewed, with global gene expression patterns lending substantial support to the notion that the extraocular muscles are fundamentally different from traditional skeletal muscle. This novel eye muscle phenotype represents an adaptation that exploits the full range of variability in skeletal muscle to meet the needs of visuomotor systems. PMID:11960789

  3. Bilateral Orbital Abscesses After Strabismus Surgery.

    PubMed

    Dhrami-Gavazi, Elona; Lee, Winston; Garg, Aakriti; Garibaldi, Daniel C; Leibert, Michelle; Kazim, Michael

    2015-01-01

    Infectious orbital complications after strabismus surgery are rare. Their incidence is estimated to be 1 case per 1,100 surgeries and include preseptal cellulitis, orbital cellulitis, subconjunctival and sub-Tenon's abscesses, myositis, and endophthalmitis. This report describes the case of an otherwise healthy 3-year-old boy who underwent bilateral medial rectus recession and disinsertion of the inferior obliques. A few days after surgery, the patient presented with bilateral periorbital edema and inferotemporal chemosis. A series of CT scans with contrast revealed inferotemporal orbital collections OU. The patient immediately underwent transconjunctival drainage of fibrinous and seropurulent collections in the sub-Tenon's space and experienced rapid improvement a few days later. The patient is reported to be in stable condition in a follow-up examination performed more than a year after the reported events. PMID:24896771

  4. Sensitivity of subject-specific models to Hill muscle-tendon model parameters in simulations of gait.

    PubMed

    Carbone, V; van der Krogt, M M; Koopman, H F J M; Verdonschot, N

    2016-06-14

    Subject-specific musculoskeletal (MS) models of the lower extremity are essential for applications such as predicting the effects of orthopedic surgery. We performed an extensive sensitivity analysis to assess the effects of potential errors in Hill muscle-tendon (MT) model parameters for each of the 56 MT parts contained in a state-of-the-art MS model. We used two metrics, namely a Local Sensitivity Index (LSI) and an Overall Sensitivity Index (OSI), to distinguish the effect of the perturbation on the predicted force produced by the perturbed MT parts and by all the remaining MT parts, respectively, during a simulated gait cycle. Results indicated that sensitivity of the model depended on the specific role of each MT part during gait, and not merely on its size and length. Tendon slack length was the most sensitive parameter, followed by maximal isometric muscle force and optimal muscle fiber length, while nominal pennation angle showed very low sensitivity. The highest sensitivity values were found for the MT parts that act as prime movers of gait (Soleus: average OSI=5.27%, Rectus Femoris: average OSI=4.47%, Gastrocnemius: average OSI=3.77%, Vastus Lateralis: average OSI=1.36%, Biceps Femoris Caput Longum: average OSI=1.06%) and hip stabilizers (Gluteus Medius: average OSI=3.10%, Obturator Internus: average OSI=1.96%, Gluteus Minimus: average OSI=1.40%, Piriformis: average OSI=0.98%), followed by the Peroneal muscles (average OSI=2.20%) and Tibialis Anterior (average OSI=1.78%) some of which were not included in previous sensitivity studies. Finally, the proposed priority list provides quantitative information to indicate which MT parts and which MT parameters should be estimated most accurately to create detailed and reliable subject-specific MS models. PMID:27131851

  5. Reconstruction of full-thickness chest wall defects using rectus abdominis musculocutaneous flap: A report of fifteen cases

    SciTech Connect

    Miyamoto, Y.; Hattori, T.; Niimoto, M.; Toge, T. )

    1986-02-01

    In 15 patients chest walls were excised because of recurrent breast cancer, radiation ulcer, or rib tumor. In most cases the full-thickness defect of the chest wall was about 10 x 10 cm. Reconstruction was performed using only a rectus abdominis musculocutaneous flap. No patient developed circulation problems in the flap or severe flail chest, and we had successful results in all our cases. These results show that the rectus abdominis musculocutaneous flap is quite effective and safe to use in the reconstruction of chest wall defects.

  6. Pedicled TRAM Flap in Presence of Desmoid Tumor of the Rectus Sheath; a Case Report.

    PubMed

    Khater, Ashraf

    2015-12-01

    Creating TRAM flap in obese patient is a challenging issue with a hazard of flap ischemia and breast envelope loss or sepsis. In this case we show our experience in doing an interval TRAM flap in markedly obese patient (BMI index 39) in the presence of Desmoid tumor of the anterior abdominal wall on top of previous mesh hernioplasty in the contralateral side of the tumor. Interval TRAM was decided with achieving of a complete vascular delay in the same sitting with skin sparing mastectomy. On doing abdominal ultrasonography for perforator mapping a desmoid tumor was encountered in the contralateral side. The decision was to elevate the flap together with excision of the desmoid tumor with the flap to be sutured in situ at the end of operation and after 5 days to transfer the flap to the mastectomy site. There was no major complications apart from mild wound sepsis of the breast pocket that was controlled medically. According to our proposed aesthetical score, our patient expressed the outcome as good (8/10 points). Pedicled TRAM flap creation in markedly obese patients is hazardous and we recommend this new concept of interval TRAM for this situation. Moreover the presence of desmoid tumor in the rectus sheath is not a contraindication to this flap elevation. The presence of abdominal desmoid tumor is not a contraindication for TRAM flap provided that it can be resected with sparing of perforators on one side of the rectus sheath. PMID:27065672

  7. Muscular activity of lower limb muscles associated with working on inclined surfaces

    PubMed Central

    Lu, Ming-Lun; Kincl, Laurel; Lowe, Brian; Succop, Paul; Bhattacharya, Amit

    2015-01-01

    This study investigated effects of visual cues, muscular fatigue, task performance and experience of working on inclined surfaces on activity of postural muscles in the lower limbs associated with maintaining balance on three inclined surfaces—0°, 14° and 26°. Normalized electromyographic (NEMG) data were collected on 44 professional roofers bilaterally from the rectus femoris, biceps femoris, tibialii anterior, and gastrocnemii medial muscle groups. The 50th and 95th percentile normalized EMG amplitudes were used as EMG variables. Results showed that inclination angle and task performance caused a significant increase in the NEMG amplitudes of all postural muscles. Visual cues were significantly associated with a decrease in the 95th percentile EMG amplitude for the right gastrocnemius medial and tibialis anterior. Fatigue was related to a significant decrease in the NEMG amplitude for the rectus femoris. Experience of working on inclined surfaces did not have a significant effect on the NEMG amplitude. PMID:25331562

  8. Oculomotor nerve and muscle abnormalities in congenital fibrosis of the extraocular muscles.

    PubMed

    Engle, E C; Goumnerov, B C; McKeown, C A; Schatz, M; Johns, D R; Porter, J D; Beggs, A H

    1997-03-01

    Congenital fibrosis of the extraocular muscles is an autosomal dominant congenital disorder characterized by bilateral ptosis, restrictive external ophthalmoplegia with the eyes partially or completely fixed in an infraducted (downward) and strabismic position, and markedly limited and aberrant residual eye movements. It has been generally thought that these clinical abnormalities result from myopathic fibrosis of the extraocular muscles. We describe the intracranial and orbital pathology of 1 and the muscle pathology of 2 other affected members of a family with chromosome 12-linked congenital fibrosis of the extraocular muscles. There is an absence of the superior division of the oculomotor nerve and its corresponding alpha motor neurons, and abnormalities of the levator palpebrae superioris and rectus superior (the muscles innervated by the superior division of the oculomotor nerve). In addition, increased numbers of internal nuclei and central mitochondrial clumping are found in other extraocular muscles, suggesting that the muscle pathology extends beyond the muscles innervated by the superior division of cranial nerve III. This report presents evidence that congenital fibrosis of the extraocular muscles results from an abnormality in the development of the extraocular muscle lower motor neuron system. PMID:9066352

  9. Analysis of muscle forces acting on fragments in pelvic fractures.

    PubMed

    Elabjer, Esmat; Nikolić, Vasilije; Matejcić, Aljosa; Stancić, Marin; Kuzmanović Elabjer, Biljana

    2009-12-01

    CT was used in 50 adult pelvic fractures to determine the size and the position of relevant muscles with regard to bony elements in order to calculate muscle forces acting upon certain pelvic portions. Muscle length was measured to calculate muscle volume and physiological muscle cross-section. Among others, the size and direction of muscle forces were calculated for iliac, pubic and ischiadic fractures. The strongest muscle acting in iliac fractures is m. gluteus medius. The strongest upward pulling of iliac bone fragments is exerted by the erector muscles, while the major anterior, medial and downward pulling is performed by the iliopsoas muscle. In pubic bone fractures, eight muscles push bone fragments downward, the strongest among them being m. adductor magnus. Two muscles pull them upwards: m. rectus abdominis and m. obliquus externus. Nine muscles are responsible for downward displacement of bone fragments in ischiadic fractures, but the strongest is m. semitendinosus. Calculation of moments of muscle forces acting upon bone fragments using CT of pelvic fractures gives additional data for planning of optimal operative treatment that can guarantee stable fixation in individual patients. PMID:20102053

  10. Overexpression of follistatin in trout stimulates increased muscling.

    PubMed

    Medeiros, Erika F; Phelps, Michael P; Fuentes, Fernando D; Bradley, Terence M

    2009-07-01

    Deletion or inhibition of myostatin in mammals has been demonstrated to markedly increase muscle mass by hyperplasia, hypertrophy, or a combination of both. Despite a remarkably high degree of conservation with the mammalian protein, the function of myostatin remains unknown in fish, many species of which continue muscle growth throughout the lifecycle by hyperplasia. Transgenic rainbow trout (Oncorhynchus mykiss) overexpressing follistatin, one of the more efficacious antagonists of myostatin, were produced to investigate the effect of this protein on muscle development and growth. P(1) transgenics overexpressing follistatin in muscle tissue exhibited increased epaxial and hypaxial muscling similar to that observed in double-muscled cattle and myostatin null mice. The hypaxial muscling generated a phenotype reminiscent of well-developed rectus abdominus and intercostal muscles in humans and was dubbed "six pack." Body conformation of the transgenic animals was markedly altered, as measured by condition factor, and total muscle surface area increased. The increased muscling was due almost exclusively to hyperplasia as evidenced by a higher number of fibers per unit area and increases in the percentage of smaller fibers and the number of total fibers. In several individuals, asymmetrical muscling was observed, but no changes in mobility or behavior of follistatin fish were observed. The findings indicate that overexpression of follistatin in trout, a species with indeterminate growth rate, enhances muscle growth. It remains to be determined whether the double muscling in trout is due to inhibition of myostatin, other growth factors, or both. PMID:19474387

  11. The progression of bone and muscle atrophy in mice hind limb with immobilization.

    PubMed

    Minematsu, Akira; Imagita, Hidetaka; Kanemura, Naohiko; Yoshimura, Osamu

    2006-09-01

    This study investigated the time course of changes of bone and muscle atrophy in mice with immobilization by denervation and fixation. The animals were fifty-two male C57 BL/6J mice, aged 10 weeks old. Eight mice were used as the base line, and the remaining ones were cut at the sciatic nerve of the left hind limb and fixed with a plaster cast. At week 1, 2, 3, and 4 after the operation, a cross-sectional area of the rectus femoris muscles and bone mechanical strength with a three-point bending test of the femur and tibia were measured. The time course of changes of the bone mechanical strength and of the cross-sectional area of the rectus femoris muscles between the intact and experimental limbs in each period compared with the control limbs, was determined. The bone mechanical strength of the femur, tibia, and the cross-sectional area of the rectus femoris muscles of the experimental limbs significantly decreased compared with those of the intact limbs at week 4, 3, 2 and 1 after the operation (p<0.05). Compared with the intact limbs, the bone mechanical strength and the cross-sectional area of the rectus femoris muscles of the experimental limbs declined approximately 10% and 30%, respectively, during the experiment (p<0.05). It was demonstrated that bone and muscle atrophy occurred at an early stage after immobilization by denervation and fixation, and that both types of atrophy progressed simultaneously in the present study. PMID:16995493

  12. Influence of exercise training on the oxidative capacity of rat abdominal muscles

    NASA Technical Reports Server (NTRS)

    Uribe, J. M.; Stump, C. S.; Tipton, C. M.; Fregosi, R. F.

    1992-01-01

    Our purpose was to determine if endurance exercise training would increase the oxidative capacity of the abdominal expiratory muscles of the rat. Accordingly, 9 male rats were subjected to an endurance training protocol (1 h/day, 6 days/week, 9 weeks) and 9 litter-mates served as controls. Citrate synthase (CS) activity was used as an index of oxidative capacity, and was determined in the following muscles: soleus, plantaris, costal diaphragm, crural diaphragm, and in all four abdominal muscles: rectus abdominis, transversus abdominis, external oblique, and internal oblique. Compared to their non-trained litter-mates, the trained rats had higher peak whole body oxygen consumption rates (+ 16%) and CS activities in plantaris (+34%) and soleus (+36%) muscles. Thus, the training program caused substantial systemic and locomotor muscle adaptations. The CS activity of costal diaphragm was 20% greater in the trained animals, but no difference was observed in crural diaphragm. The CS activity in the abdominal muscles was less than one-half of that in locomotor and diaphragm muscles, and there were no significant changes with training except in the rectus abdominis where a 26% increase was observed. The increase in rectus abdominis CS activity may reflect its role in postural support and/or locomotion, as none of the primary expiratory pumping muscles adapted to the training protocol. The relatively low levels of CS activity in the abdominal muscles suggests that they are not recruited frequently at rest, and the lack of an increase with training indicates that these muscles do not contribute significantly to the increased ventilatory activity accompanying exercise in the rat.

  13. The characterization of decellularized human skeletal muscle as a blueprint for mimetic scaffolds.

    PubMed

    Wilson, Klaire; Terlouw, Abby; Roberts, Kevin; Wolchok, Jeffrey C

    2016-08-01

    The use of decellularized skeletal muscle (DSM) as a cell substrate and scaffold for the repair of volumetric muscle loss injuries has shown therapeutic promise. The performance of DSM materials motivated our interest in exploring the chemical and physical properties of this promising material. We suggest that these properties could serve as a blueprint for the development of next generation engineered materials with DSM mimetic properties. In this study, whole human lower limb rectus femoris (n = 10) and upper limb supraspinatus muscle samples (n = 10) were collected from both male and female tissue donors. Skeletal muscle samples were decellularized and nine property values, capturing key compositional, architectural, and mechanical properties, were measured and statistically analyzed. Mean values for each property were determined across muscle types and sexes. Additionally, the influence of muscle type (upper vs lower limb) and donor sex (male vs female) on each of the DSM material properties was examined. The data suggests that DSM materials prepared from lower limb rectus femoris samples have an increased modulus and contain a higher collagen content then upper limb supraspinatus muscles. Specifically, lower limb rectus femoris DSM material modulus and collagen content was approximately twice that of lower limb supraspinatus DSM samples. While muscle type did show some influence on material properties, we did not find significant trends related to sex. The material properties reported herein may be used as a blueprint for the data-driven design of next generation engineered scaffolds with muscle mimetic properties, as well as inputs for computational and physical models of skeletal muscle. PMID:27324779

  14. Antagonist coactivation of trunk stabilizer muscles during Pilates exercises.

    PubMed

    Rossi, Denise Martineli; Morcelli, Mary Hellen; Marques, Nise Ribeiro; Hallal, Camilla Zamfolini; Gonçalves, Mauro; Laroche, Dain P; Navega, Marcelo Tavella

    2014-01-01

    The purpose of this study was to compare the antagonist coactivation of the local and global trunk muscles during mat-based exercises of Skilled Modern Pilates. Twelve women performed five exercises and concurrently, surface EMG from internal oblique (OI), multifidus (MU), rectus abdominis (RA) and iliocostalis lumborum (IL) muscles was recorded bilaterally. The percentage of antagonist coactivation between local (OI/MU) and global muscles (RA/IL) was calculated. Individuals new to the practice of these exercises showed differences in coactivation of the trunk muscles between the exercises and these results were not similar bilaterally. Thus, in clinical practice, the therapist should be aware of factors such as compensation and undesirable rotation movements of the trunk. Moreover, the coactivation of global muscles was higher bilaterally in all exercises analyzed. This suggests that the exercises of Skilled Modern Pilates only should be performed after appropriate learning and correct execution of all principles, mainly the Centering Principle. PMID:24411147

  15. Cataract Surgery

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ...

  16. Influence of exercise intensity on atrophied quadriceps muscle in the rat.

    PubMed

    Tanaka, Shoji; Obatake, Taishi; Hoshino, Koichi; Nakagawa, Takao

    2015-11-01

    [Purpose] The aim of this study was to determine the effect of resistance training on atrophied skeletal muscle in rats based on evidence derived from physical therapy. [Subjects and Methods] Rats were forced to undergo squats as resistance training for 3 weeks after atrophying the rectus femoris muscle by hindlimb suspension for 2 weeks. The intensity of resistance training was adjusted to 50% and 70% of the maximum lifted weight, i.e., 50% of the one-repetition maximum and 70% of the one-repetition maximum, respectively. [Results] Three weeks of training did not alter the one-repetition maximum, and muscle fibers were injured while measuring the one-repetition maximum and reloading. The decrease in cross-sectional area in the rectus femoris muscle induced by unloading for 2 weeks was significantly recovered after training at 70% of the one-repetition maximum. The levels of muscle RING-finger protein-1 mRNA expression were significantly lower in muscles trained at 70% of the one-repetition maximum than in untrained muscles. [Conclusion] These results suggest that high-intensity resistance training can promote atrophic muscle recovery, which provides a scientific basis for therapeutic exercise methods for treatment of atrophic muscle in physical therapy. PMID:26696716

  17. Influence of exercise intensity on atrophied quadriceps muscle in the rat

    PubMed Central

    Tanaka, Shoji; Obatake, Taishi; Hoshino, Koichi; Nakagawa, Takao

    2015-01-01

    [Purpose] The aim of this study was to determine the effect of resistance training on atrophied skeletal muscle in rats based on evidence derived from physical therapy. [Subjects and Methods] Rats were forced to undergo squats as resistance training for 3 weeks after atrophying the rectus femoris muscle by hindlimb suspension for 2 weeks. The intensity of resistance training was adjusted to 50% and 70% of the maximum lifted weight, i.e., 50% of the one-repetition maximum and 70% of the one-repetition maximum, respectively. [Results] Three weeks of training did not alter the one-repetition maximum, and muscle fibers were injured while measuring the one-repetition maximum and reloading. The decrease in cross-sectional area in the rectus femoris muscle induced by unloading for 2 weeks was significantly recovered after training at 70% of the one-repetition maximum. The levels of muscle RING-finger protein-1 mRNA expression were significantly lower in muscles trained at 70% of the one-repetition maximum than in untrained muscles. [Conclusion] These results suggest that high-intensity resistance training can promote atrophic muscle recovery, which provides a scientific basis for therapeutic exercise methods for treatment of atrophic muscle in physical therapy. PMID:26696716

  18. Reconstruction of large composite oromandibulomaxillary defects with free vertical rectus abdominis myocutaneous flaps.

    PubMed

    Butler, Charles E; Lewin, Jan S

    2004-02-01

    Large composite oromandibulomaxillary defects resulting from oncologic resection can be challenging to reconstruct with a single flap, and functional outcomes remain anecdotal. The purpose of this study was to evaluate the authors' surgical experience and scientifically analyze and describe the functional outcomes associated with the use of the vertical rectus abdominis myocutaneous flap for reconstruction of these defects. The records of seven patients (mean age, 62 years) who underwent composite resection including hemimandibulectomy, partial maxillectomy, partial pharyngectomy, and floor-of-mouth resection followed by immediate free vertical rectus abdominis myocutaneous flap reconstruction at The University of Texas M. D. Anderson Cancer Center (1998 to 2002) were retrospectively reviewed. The tumor type was squamous cell carcinoma in all seven cases; four patients had T4 primary lesions and three had local recurrences. Radiotherapy was used preoperatively in each of the three recurrent cases (mean dose, 70.6 Gy) and postoperatively in three of the four patients with primary tumors (mean dose, 63.0 Gy). The mean length of hospitalization was 8.7 days. There were no major flap complications, fistulas, or donor-site complications. Partial flap necrosis (4 percent of flap area) occurred in one patient and dehiscence of the neck incision occurred in another. Both cases were managed with surgical débridement and closure. A third patient developed a 0.75-cm superficial suture line abscess that healed with dressing changes. The mean postoperative follow-up was 15 months. Six of the seven patients remained tube dependent for their nutrition despite some swallowing improvement; one patient returned to full oral intake. The most common swallowing deficit was impaired laryngeal excursion, which occurred in all six patients evaluated with videofluoroscopic examination and resulted in risk for aspiration in patients and frank aspiration in 83 percent. Speech was

  19. Histochemical study on the atrophy of the quadriceps femoris muscle caused by knee joint injuries of rats.

    PubMed

    Okada, Y

    1989-03-01

    Atrophy developing in the quadriceps femoris muscle following knee injury is one of the serious problems not only in the field of orthopedics but also of rehabilitation. However the pathogenesis of this atrophy has not yet been elucidated. The author therefore produced a complex ligament injury model using the knee joints of rats in order to study the pathogenesis of this atrophy. After severing the anterior cruciate ligament, the medial collateral ligament and tibial insertion of the medial meniscus of rats, these animals were sacrificed at 4, 8 and 12 weeks. After removing the vastus lateralis muscle, vastus medialis muscle, and rectus femoris muscle, specimens of these muscles were stained for ATPase. The transection area of the muscle fibers was measured and the fiber type composition was determined. At 4 weeks the vastus medialis muscle and at 12 weeks the vastus lateralis muscle showed marked atrophy. The rectus femoris muscle exhibited the least atrophy throughout the entire observation period. In examining the atrophy of the quadriceps femoris muscle by muscle fiber type, the degree of atrophy was found to differ among the venters and even the same venter showed a different reaction depending on the elapsed time after sustaining the injury. Neither changes in the fiber type composition not neurogenic findings could be observed. PMID:2526800

  20. Expression of Dihydropyridine and Ryanodine Receptors in Type IIA Fibers of Rat Skeletal Muscle

    PubMed Central

    Anttila, Katja; Mänttäri, Satu; Järvilehto, Matti

    2007-01-01

    In this study, the fiber type specificity of dihydropyridine receptors (DHPRs) and ryanodine receptors (RyRs) in different rat limb muscles was investigated. Western blot and histochemical analyses provided for the first time evidence that the expression of both receptors correlates to a specific myosin heavy chain (MHC) composition. We observed a significant (p=0.01) correlation between DHP as well as Ry receptor density and the expression of MHC IIa (correlation factor r=0.674 and r=0.645, respectively) in one slow-twitch, postural muscle (m. soleus), one mixed, fast-twitch muscle (m. gastrocnemius) and two fast-twitch muscles (m. rectus femoris, m. extensor digitorum longus). The highest DHP and Ry receptor density was found in the white part of m. rectus femoris (0.058±0.0060 and 0.057±0.0158 ODu, respectively). As expected, the highest relative percentage of MHC IIa was also found in the white part of m. rectus femoris (70.0±7.77%). Furthermore, histochemical experiments revealed that the IIA fibers stained most strongly for the fluorophore-conjugated receptor blockers. Our data clearly suggest that the expression of DHPRs and RyRs follows a fiber type-specific pattern, indicating an important role for these proteins in the maintenance of an effective Ca2+ cycle in the fast contracting fiber type IIA. PMID:17576431

  1. 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 ...

  2. 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 ...

  3. 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 ...

  4. 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 ...

  5. Fundamental study of lower limb muscle activity using an angled whole body vibration exercise instrument.

    PubMed

    Yu, Chang Ho; Kang, Seung Rok; Kwon, Tae Kyu

    2014-01-01

    This research was performed to assess the effects of angled whole body vibration on muscle activity of the lower limbs, by examining adults in their twenties during squat exercises, taking into account two variables of exercise intensity (vibration frequency and gradient). Twenty healthy males in their twenties with previous experience of more than 6 month's weight training and no past medical history were included in this study. The experiment was performed by participating in squat exercises which consisted of 3 sets (1 set = 5 seconds x 3 repetitions of exercise), and the muscle activities of the Rectus Femoris, Vastus Lateralis, Vastus Medialis were measured with variation in the gradients of 0°, 10°, and 20°, and vibration frequencies of 20, 30, and 40 Hz. At 30 and 40 Hz, the vastus lateralis showed the highest change in muscle activity, while activity of the vastus medialis also increased significantly. Analysis of muscle activity according to the gradient showed a significant increase of the vastus lateralis at 20°, while the highest muscle activity at 20° was observed for the vastus medialis. In comparison of the change in lower limb muscle activity according to simultaneous stimulation, at a gradient of 10°, high activity was shown in muscle, while at 20°, high muscle activities were produced at 40 Hz in the vastus lateralis, 40 Hz in the rectus femoris, and both 30 and 40 Hz in the vastus medialis. PMID:25226944

  6. Immediate effects of kinematic taping on lower extremity muscle tone and stiffness in flexible flat feet

    PubMed Central

    Wang, Joong-San; Um, Gi-Mai; Choi, Jung-Hyun

    2016-01-01

    [Purpose] This study aimed to examine the immediate effects of kinematic taping on the tone and stiffness in the leg muscles of subjects with flexible flat feet. [Subjects and Methods] A total of 30 subjects, 15 in the kinematic taping and 15 in the sham taping group, were administered respective taping interventions. Subsequently, the foot pressure and the tone and stiffness in the tibialis anterior, rectus femoris, medial gastrocnemius, and the long head of the biceps femoris muscles of both the lower extremities were measured. [Results] The foot pressure of the dominant leg significantly decreased in the kinematic taping group. The muscle tone and stiffness in the rectus femoris muscle of the dominant and non-dominant leg, tibialis anterior muscle of the dominant leg, medial gastrocnemius muscle of the non-dominant leg, and the stiffness in the dominant leg significantly decreased. The muscle tone and stiffness generally increased in the sham taping group. However, no significant difference was observed between the 2 groups. [Conclusion] This study demonstrated that kinematic taping on flexible flat feet had positive effects of immediately reducing the abnormally increased foot pressure and the tone and stiffness in the lower extremity muscles. PMID:27190479

  7. Expression of sarcoplasmic reticulum Ca(2+)-ATPase isoforms in marlin and swordfish muscle and heater cells.

    PubMed

    Tullis, A; Block, B A

    1996-07-01

    The superior rectus muscles of marlin, swordfish, sailfish, and spearfish are modified for generating heat rather than force. This study focuses on the sarcoplasmic reticulum calcium-adenosinetriphosphatase (SR Ca(2+)-ATPase) to gain further insight into the muscle fiber type origin of the billfish "heater cell." Direct sequencing and immunolocalization demonstrated that marlin and swordfish epaxial swimming muscles express two forms of the SR Ca(2+)-ATPase in a fiber type-specific manner; red slow-twitch skeletal and cardiac muscles express the same SERCA2 message, whereas white fast-twitch skeletal muscles express a SERCA1 message. Thus the expression pattern of the SR Ca2+ pump is similar in both billfish and tetrapod muscles. Molecular and immunological studies revealed that billfish heater tissue and superior rectus muscle express both fast and slow SR Ca2+ pump isoforms. Immunohistochemical results suggest that heater cells and most extraocular muscle fibers express the fast SR Ca2+ pump. Expression of the fast SR Ca(2+)-ATPase by heater cells has implications for heater cell origin and thermogenic control. PMID:8760229

  8. Extraocular Muscle Motor Units Characterized By Spike-Triggered Averaging In Alert Monkey

    PubMed Central

    Gamlin, Paul D.; Miller, Joel M.

    2011-01-01

    Single-unit recording in macaque monkeys has been widely used to study extraocular motoneuron behavior during eye movements. However, primate extraocular motor units have only been studied using electrical stimulation in anesthetized animals. To study motor units in alert, behaving macaques, we combined chronic muscle force transducer (MFT) and single-unit extracellular motoneuron recordings. During steady fixation with low motoneuron firing rates, we used motoneuron spike-triggered averaging of MFT signals (STA-MFT) to extract individual motor unit twitches, thereby characterizing each motor unit in terms of twitch force and dynamics. It is then possible, as in conventional studies, to determine motoneuron activity during eye movements, but now with knowledge of underlying motor unit characteristics. We demonstrate the STA-MFT technique for medial rectus motor units. Recordings from 33 medial rectus motoneurons in three animals identified 20 motor units, which had peak twitch tensions of 0.5 – 5.25 mg, initial twitch delays averaging 2.4ms, and time to peak contraction averaging 9.3ms. These twitch tensions are consistent with those reported in unanesthetized rabbits, and with estimates of the total number of medial rectus motoneurons and twitch tension generated by whole-nerve stimulation in monkey, but are substantially lower than those reported for lateral rectus motor units in anesthetized squirrel monkey. Motor units were recruited in order of twitch tension magnitude with stronger motor units reaching threshold further in the muscle’s ON-direction, showing that, as in other skeletal muscles, medial rectus motor units are recruited according to the “size principle”. PMID:22108141

  9. 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

  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 thigh ‘muscle strain’. PMID:26519522

  11. Robotic surgery

    MedlinePlus

    Robot-assisted surgery; Robotic-assisted laparoscopic surgery; Laparoscopic surgery with robotic assistance ... computer station and directs the movements of a robot. Small surgical tools are attached to the robot's ...

  12. Outpatient Surgery

    MedlinePlus

    Policymakers | Members | Patients | News Media Anesthesia 101 Patient Safety Stories Resources About Home » Patients » Preparing For Surgery » Types of Surgery » Outpatient Surgery Share this Page Preparing For ...

  13. Plastic Surgery

    MedlinePlus

    ... How Can I Help a Friend Who Cuts? Plastic Surgery KidsHealth > For Teens > Plastic Surgery Print A ... her forehead lightened with a laser? What Is Plastic Surgery? Just because the name includes the word " ...

  14. Lung surgery

    MedlinePlus

    ... Pneumonectomy; Lobectomy; Lung biopsy; Thoracoscopy; Video-assisted thoracoscopic surgery; VATS ... You will have general anesthesia before surgery. You will be asleep and unable to feel pain. Two common ways to do surgery on your lungs are thoracotomy and video- ...

  15. Foot Surgery

    MedlinePlus

    ... About Feet » Foot Health Information Surgery When is Foot Surgery Necessary? Many foot problems do not respond ... restore the function of your foot. Types of Foot Surgery Fusions: Fusions are usually performed to treat ...

  16. 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

  17. Clinical utility of the Duncan-Ely test for rectus femoris dysfunction during the swing phase of gait.

    PubMed

    Marks, M C; Alexander, J; Sutherland, D H; Chambers, H G

    2003-11-01

    The Ely Test (or Duncan-Ely test) has been accepted as a clinical tool to assess rectus femoris spasticity by passively flexing the knee rapidly while the patient lies prone in a relaxed state. In this retrospective review, patients' dynamic knee range of motion (ROM) during gait and an electromyogram (EMG) were compared with the results of the Ely test. Data for 70 patients (44 males, 26 females; 104 limbs) were included. Mean age of patients was 13 years, SD 9 years, range 4 years 5 months to 54 years. All patients were diagnosed with cerebral palsy (spastic diplegia, n = 42; spastic quadriplegia, n = 15, and hemiplegia, n = 13). All patients were ambulatory (50 independent, 20 with assistive devices). A standard matrix was used to calculate sensitivity and specificity of the Ely test as well as its positive and negative predictive value. For the gait variables examined (decreased dynamic knee ROM, timing of peak knee flexion, and abnormal EMG in swing) the sensitivity of the Ely test ranged from 56 to 59% and the specificity ranged from 64 to 85%. For the same variables the positive predictive value ranged from 91 to 98% and the negative predictive value ranged from 4 to 19%. The Ely test was shown to have a good positive predictive value (i.e. the certainty about the presence of rectus spasticity in patients with a positive Ely test result) for rectus femoris dysfunction during gait. PMID:14580132

  18. Arthroscopic Labrum Reconstruction in the Hip Using the Indirect Head of Rectus Femoris as a Local Graft: Surgical Technique.

    PubMed

    Sharfman, Zachary T; Amar, Eyal; Sampson, Thomas; Rath, Ehud

    2016-04-01

    The importance of the acetabular labrum has been well documented for the health and function of the hip joint. Labral reconstruction has proven effective but often requires the use of a cadaveric allograft or auto graft from the fascia lata or gracilis. The indirect head of the rectus femoris is in close proximity with the anterior superior acetabulum, which is the most common site of labral tears. Using the indirect head of the rectus femoris as a local graft minimizes surgical invasiveness by mitigating the need to harvest the graft from a different location, in case of an autograft, and by minimizing donor site morbidity and damage to local tissues. The graft is harvested and fixed to the acetabular rim through the same arthroscopic portals. Hip labral reconstruction using the reflected head of the rectus femoris tendon is a minimally invasive surgical procedure that restores stability to the hip joint, is applicable in all patients undergoing hip labral reconstruction, and offers decreased tissue morbidity compared with other grafting techniques. PMID:27462534

  19. Indirect Neuromonitoring of the Spinal Cord by Near-Infrared Spectroscopy of the Paraspinous Thoracic and Lumbar Muscles in Aortic Surgery.

    PubMed

    Luehr, Maximilian; Mohr, Friedrich-Wilhelm; Etz, Christian D

    2016-06-01

    Paraplegia remains the most devastating complication of open and endovascular thoracic/thoracoabdominal aortic aneurysm (TAA/A) repair. However, the assessment of currently available neuromonitoring modalities remains challenging and difficult to interpret. Near-infrared spectroscopy (NIRS) has been introduced as a strategy for noninvasive, real-time monitoring of the paraspinous collateral network (CN) to detect potential spinal cord ischemia at our institution. Prior to TAA/A repair, a cerebrospinal fluid catheter is placed and four NIRS optodes are bilaterally positioned on the patient's back to transcutaneously monitor regional muscle oxygenation at the thoracic and lumbar levels. Indirect surveillance of the spinal cord by NIRS seems to be a tempting option with increasing evidence supporting the CN concept. PMID:26011674

  20. Closure and augmentation of bladder exstrophy using rectus abdominis musculo-peritoneal flap

    PubMed Central

    Agarwal, P.

    2011-01-01

    Background: The aim of this study was to investigate the efficacy of the rectus abdominis myo-peritoneal flap (RAMP) technique for the closure and augmentation of small, non-elastic, non-compliant bladder exstrophies. Materials and Methods: The RAMP technique was used in three boys with bladder exstrophy who presented late with small, non-elastic, non-compliant bladder. The clinical outcome, imaging, cystoscopy, biochemical and microbiological studies were assessed during a follow-up of 36 months. Results: Bladder closure and augmentation was achieved in all patients without any complications. There were no urinary tract infections, metabolic problems or electrolyte disturbances and the kidney function remained normal in all patients. Radiography confirmed intact function and anatomy of the urinary tract and cystoscopy showed complete coverage of the inner peritoneal layer of RAMP with uroepithelium. No stone formation or mucous production was detected. Conclusions: The RAMP technique is a good alternative for closing bladder exstrophies and achieves an increase in bladder capacity and compliance. The technique is indicated in the closure of large bladder defects, bladder exstrophies with small, inelastic, non-compliant bladder remnants and failed primary closures. PMID:22279277

  1. 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...

  2. Influence of different control strategies on muscle activation patterns in trunk muscles

    PubMed Central

    Hansen, Laura; Anders, Christoph

    2014-01-01

    Abstract Adequate training of the trunk muscles is essential to prevent low back pain. Although sit‐ups are simple to perform, the perceived high effort is the reason why training the abdominal muscles is seldom continued over a longer period of time. It is well known that the abdominal muscles are inferior to the back muscles in terms of force, but this cannot explain the extreme difference in perceived effort between trunk flexion and extension tasks. Therefore, this study was aimed at the identification of control strategy influences on the muscular stress level. Thirty‐nine subjects were investigated. The performed tasks were restricted to the sagittal plane and were implemented with simulated and realized tilt angles. Subjects were investigated in an upright position with their lower bodies fixed and their upper bodies free. Posture‐controlled tasks involved graded forward and backward tilting, while force‐controlled tasks involved the application of force based on a virtual tilt angle. The Surface EMG (SEMG) was taken from five trunk muscles on both sides. Control strategies seemed to have no systematic influence on the SEMG amplitudes of the back muscles. In contrast, the abdominal muscles exhibited significantly higher stress levels under posture‐controlled conditions without relevantly increasing antagonistic co‐activation of back muscles. The abdominal muscles' relative differences ranged from an average of 20% for the external oblique abdominal muscle to approximately 40% for the rectus abdominal muscle. The perceived high effort expended during sit‐ups can now be explained by the posture‐controlled contractions that are required. PMID:25501425

  3. Effects of bridge exercise performed on an unstable surface on lumbar stabilizing muscles according to the knee angle

    PubMed Central

    Lee, Sangyong; Park, Jungseo; Lee, Daehee

    2015-01-01

    [Purpose] This study aimed to determine the effects of bridge exercise performed on an unstable surface on lumbar stabilizing muscles according to the knee angle. [Subjects] Fifteen healthy adult men were selected for this study. [Methods] The study subjects performed the bridge exercise on an unstable surface and a stable surface, with the knees at different angles (45°, 90°, and 120°). An aero-step device was used as the unstable surface, and the flat ground was used as the stable surface. External oblique, internal oblique, and rectus abdominis muscle activities were assessed and compared using electromyography. [Results] The study results demonstrated that performing the bridge exercise on an unstable surface with a knee angle of 120° led to a greater increase in the external oblique, internal oblique, and rectus abdominis muscle activities than when performed on a stable surface. [Conclusion] The bridge exercise with the knees at a 120° angle was found to be an effective intervention for increasing the external oblique, internal oblique, and rectus abdominis muscle activities. PMID:26357450

  4. Loss of MAFB Function in Humans and Mice Causes Duane Syndrome, Aberrant Extraocular Muscle Innervation, and Inner-Ear Defects.

    PubMed

    Park, Jong G; Tischfield, Max A; Nugent, Alicia A; Cheng, Long; Di Gioia, Silvio Alessandro; Chan, Wai-Man; Maconachie, Gail; Bosley, Thomas M; Summers, C Gail; Hunter, David G; Robson, Caroline D; Gottlob, Irene; Engle, Elizabeth C

    2016-06-01

    Duane retraction syndrome (DRS) is a congenital eye-movement disorder defined by limited outward gaze and retraction of the eye on attempted inward gaze. Here, we report on three heterozygous loss-of-function MAFB mutations causing DRS and a dominant-negative MAFB mutation causing DRS and deafness. Using genotype-phenotype correlations in humans and Mafb-knockout mice, we propose a threshold model for variable loss of MAFB function. Postmortem studies of DRS have reported abducens nerve hypoplasia and aberrant innervation of the lateral rectus muscle by the oculomotor nerve. Our studies in mice now confirm this human DRS pathology. Moreover, we demonstrate that selectively disrupting abducens nerve development is sufficient to cause secondary innervation of the lateral rectus muscle by aberrant oculomotor nerve branches, which form at developmental decision regions close to target extraocular muscles. Thus, we present evidence that the primary cause of DRS is failure of the abducens nerve to fully innervate the lateral rectus muscle in early development. PMID:27181683

  5. Coordination of two-joint rectus femoris and hamstrings during the swing phase of human walking and running.

    PubMed

    Prilutsky, B I; Gregor, R J; Ryan, M M

    1998-06-01

    It has been hypothesized previously that because a strong correlation was found between the difference in electromyographic activity (EMG) of rectus femoris (RF) and hamstrings (HA; EMG(RF)-EMG(HA)) and the difference in the resultant moments at the knee and hip (Mk-Mh) during exertion of external forces on the ground by the leg, input from skin receptors of the foot may play an important role in the control of the distribution of the resultant moments between the knee and hip by modulating activation of the two-joint RF and HA. In the present study, we examined the coordination of RF and HA during the swing phase of walking and running at different speeds, where activity of foot mechanoreceptors is not modulated by an external force. Four subjects walked at speeds of 1.8 m/s and 2.7 m/s and ran at speeds of 2.7 m/s and 3.6 m/s on a motor-driven treadmill. Surface EMG of RF, semimembranosus (SM), and long head of biceps femoris (BF) and coordinates of the four leg joints were recorded. An inverse dynamics analysis was used to calculate the resultant moments at the ankle, knee, and hip during the swing phase. EMG signals were rectified and low-pass filtered to obtain linear envelopes and then shifted in time to account for electromechanical delay between EMG and joint moments. During walking and running at all studied speeds, mean EMG envelope values of RF were statistically (P<0.05) higher in the first half of the swing (or at hip flexion/knee extension combinations of joint moments) than in the second half (or at hip extension/knee flexion combinations of joint moments). Mean EMG values of BF and SM were higher (P<0.05) in the second half of the swing than in the first half. EMG and joint moment peaks were substantially higher (P<0.05) in the swing phase of walking at 2.7 m/s than during the swing phase of running at the same speed. Correlation coefficients calculated between the differences (EMG(RF)-EMG(HA)) and (Mk-Mh), taken every 1% of the swing phase, were

  6. Corticospinal Excitability of Trunk Muscles during Different Postural Tasks

    PubMed Central

    Chiou, Shin-Yi; Gottardi, Sam E. A.; Hodges, Paul W.; Strutton, Paul H.

    2016-01-01

    Evidence suggests that the primary motor cortex (M1) is involved in both voluntary, goal-directed movements and in postural control. Trunk muscles are involved in both tasks, however, the extent to which M1 controls these muscles in trunk flexion/extension (voluntary movement) and in rapid shoulder flexion (postural control) remains unclear. The purpose of this study was to investigate this question by examining excitability of corticospinal inputs to trunk muscles during voluntary and postural tasks. Twenty healthy adults participated. Transcranial magnetic stimulation was delivered to the M1 to examine motor evoked potentials (MEPs) in the trunk muscles (erector spinae (ES) and rectus abdominis (RA)) during dynamic shoulder flexion (DSF), static shoulder flexion (SSF), and static trunk extension (STE). The level of background muscle activity in the ES muscles was matched across tasks. MEP amplitudes in ES were significantly larger in DSF than in SSF or in STE; however, this was not observed for RA. Further, there were no differences in levels of muscle activity in RA between tasks. Our findings reveal that corticospinal excitability of the ES muscles appears greater during dynamic anticipatory posture-related adjustments than during static tasks requiring postural (SSF) and goal-directed voluntary (STE) activity. These results suggest that task-oriented rehabilitation of trunk muscles should be considered for optimal transfer of therapeutic effect to function. PMID:26807583

  7. The effect of increase in baggage weight on elderly women's lower extremity muscle activation during gait.

    PubMed

    Kim, Seong-Gil; Nam, Chan-Woo; Yong, Min-Sik

    2014-01-01

    The aim of the present study was to examine the effect of increased baggage weight on the muscle activation of elderly women's lower extremities during gait. A total of 24 elderly women who were residing in communities in Daegu, South Korea aged 79.6±6.2, 149.7±7.0cm in height, and 53.5±7.2kg in weight participated in this study. The muscle activation of each muscle was measured three times at 2kg, 3kg, and 4kg of baggage weight while the subjects were conducting treadmill walking wearing backpacks. Electrodes were placed on four muscles: the quadriceps muscle (rectus femoris), the hamstring muscle (semitendinosus), the tibialis anterior muscle, and the soleus muscle. The results show that the rates of increase in muscle activation in the tibialis anterior and soleus muscles according to baggage weight increase were higher than those in the quadriceps and hamstring muscles (<0.05). These results indicate that the heavier weight loads increase the activation of muscles that control the ankle joints causing muscle fatigue. Moreover, a decrease in balance ability through muscle fatigue can be a risk factor for falls. Thus, elderly people should be instructed not to carry heavy objects. PMID:25179442

  8. Congenital fibrosis of the extraocular muscles.

    PubMed Central

    Harley, R D; Rodrigues, M M; Crawford, J S

    1978-01-01

    Congential fibrosis of the extraocular muscles is characterized by the replacement of normal contractile muscle tissue by fibrous tissue or fibrous bands in varying degrees. The clinical entities which result from the fibrous replacement can be classified under the following headings: general fibrosis syndrome, congenital fibrosis of the inferior rectus muscle with blepharoptosis, strabismus fixus, vertical retraction syndrome and congential unilateral fibrosis, enophthalmos and blepharoptosis. Genetic factors may or may not be apparent. One pedigree with general fibrosis syndrome was traced through five generations. Light and electron microscopy demonstrated replacement of normal muscle by collagen and dense fibrous tissue with occasional areas of degenerated skeletal muscle. The surgical mangement attempts to achieve some functional readjustment of the ocular and lid position as well as the abnormal head posture. The surgical results were considered satisfactory when compared with the original position of the eyes and the backward head tilt. Images FIGURE 1 A FIGURE 1 B FIGURE 1 C FIGURE 2 A FIGURE 2 B FIGURE 2 C FIGURE 3 A FIGURE 3 B FIGURE 4 FIGURE 5 FIGURE 6 FIGURE 7 A FIGURE 7 B FIGURE 7 C FIGURE 8 A FIGURE 8 B FIGURE 9 A FIGURE 9 B FIGURE 9 C FIGURE 9 D PMID:754372

  9. 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.

  10. 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 , ...

  11. 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 ...

  12. 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 ...

  13. 3D False Color Computed Tomography for Diagnosis and Follow-Up of Permanent Denervated Human Muscles Submitted to Home-Based Functional Electrical Stimulation

    PubMed Central

    Carraro, Ugo; Edmunds, Kyle J.

    2015-01-01

    This report outlines the use of a customized false-color 3D computed tomography (CT) protocol for the imaging of the rectus femoris of spinal cord injury (SCI) patients suffering from complete and permanent denervation, as characterized by complete Conus and Cauda Equina syndrome. This muscle imaging method elicits the progression of the syndrome from initial atrophy to eventual degeneration, as well as the extent to which patients' quadriceps could be recovered during four years of home-based functional electrical stimulation (h-b FES). Patients were pre-selected from several European hospitals and functionally tested by, and enrolled in the EU Commission Shared Cost Project RISE (Contract n. QLG5-CT-2001-02191) at the Department of Physical Medicine, Wilhelminenspital, Vienna, Austria. Denervated muscles were electrically stimulated using a custom-designed stimulator, large surface electrodes, and customized progressive stimulation settings. Spiral CT images and specialized computational tools were used to isolate the rectus femoris muscle and produce 3D and 2D reconstructions of the denervated muscles. The cross sections of the muscles were determined by 2D Color CT, while muscle volumes were reconstructed by 3D Color CT. Shape, volume, and density changes were measured over the entirety of each rectus femoris muscle. Changes in tissue composition within the muscle were visualized by associating different colors to specified Hounsfield unit (HU) values for fat, (yellow: [-200; -10]), loose connective tissue or atrophic muscle, (cyan: [-9; 40]), and normal muscle, fascia and tendons included, (red: [41; 200]). The results from this analysis are presented as the average HU values within the rectus femoris muscle reconstruction, as well as the percentage of these tissues with respect to the total muscle volume. Results from this study demonstrate that h-b FES induces a compliance-dependent recovery of muscle volume and size of muscle fibers, as evidenced by the

  14. The adaptive changes in muscle coordination following lumbar spinal fusion.

    PubMed

    Wang, Ting-Yun; Pao, Jwo-Luen; Yang, Rong-Sen; Jang, Jyh-Shing Roger; Hsu, Wei-Li

    2015-04-01

    Limited back motion and damage of paraspinal muscles after spinal fusion surgery may lead to abnormal compensatory movements of the body. Whether neuromuscular control changes after surgery remains unclear. The purpose of the study was to identify the muscle activation patterns employed before and after lumbar spinal fusion. Nineteen patients having low back pain and undergoing minimally invasive lumbar spinal fusion were evaluated at 1 day before and 1 month after fusion surgery. Nineteen matched healthy participants were recruited as controls. Patients' pain severity and daily activity functioning were recorded. All participants were instructed to perform forward reaching, and the muscle activities were monitored using surface electromyography (EMG) with sensors placed on both sides of their trunk and lower limbs. The muscle activation patterns were identified using the principal component analysis (PCA). All patients had significant improvements in pain intensity and daily activity functioning after surgery, but exhibited an adaptive muscle activation pattern during forward reaching movement compared with the controls. Significant loading coefficients in the dominant movement pattern (reflected in the first principal component) were observed in back muscles for controls whereas in leg muscles for patients, both pre- and postoperatively. Despite substantial improvements in pain intensity and daily activity functioning after surgery, the patients exhibited decreased paraspinal muscle activities and adaptive muscle coordination patterns during forward reaching. They appeared to rely mainly on their leg muscles to compensate for their insufficient paraspinal muscle function. Early intervention focusing on training paraspinal muscles should be considered after spinal fusion surgery. PMID:25625813

  15. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain.

    PubMed

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-06-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain. PMID:27390406

  16. Effect of exhalation exercise on trunk muscle activity and oswestry disability index of patients with chronic low back pain

    PubMed Central

    Kang, Jeong-Il; Jeong, Dae-Keun; Choi, Hyun

    2016-01-01

    [Purpose] This study investigated the effect of exhalation exercises on trunk muscle activity and Oswestry Disability Index by inducing trunk muscle activity through increasing intra-abdominal pressure and activating muscles, contributing to spinal stability. [Subjects and Methods] This intervention program included 20 male patients with chronic low back pain. A total of 10 subjects each were randomly assigned to an exhalation exercise group as the experimental group and a spinal stabilization exercise group as the control group. [Results] There were significant differences in the activities of the rectus abdominis, transverse abdominis, external oblique abdominal, and erector spinae muscles as well as in the Oswestry Disability Index within the experimental group. There were meaningful differences in the activities of the rectus abdominis, external oblique abdominal, and erector spinae muscles and in the Oswestry Disability Index within the control group. In addition, there was a meaningful intergroup difference in transverse abdominis muscle activity alone and in the Oswestry Disability Index. [Conclusion] The breathing exercise effectively increased muscle activity by training gross and fine motor muscles in the trunk. Moreover, it was verified as a very important element for strengthening body stability because it both released and prevented low back pain. PMID:27390406

  17. Muscular Activity and Fatigue in Lower-Limb and Trunk Muscles during Different Sit-To-Stand Tests

    PubMed Central

    Roldán-Jiménez, Cristina; Bennett, Paul; Cuesta-Vargas, Antonio I.

    2015-01-01

    Sit-to-stand (STS) tests measure the ability to get up from a chair, reproducing an important component of daily living activity. As this functional task is essential for human independence, STS performance has been studied in the past decades using several methods, including electromyography. The aim of this study was to measure muscular activity and fatigue during different repetitions and speeds of STS tasks using surface electromyography in lower-limb and trunk muscles. This cross-sectional study recruited 30 healthy young adults. Average muscle activation, percentage of maximum voluntary contraction, muscle involvement in motion and fatigue were measured using surface electrodes placed on the medial gastrocnemius (MG), biceps femoris (BF), vastus medialis of the quadriceps (QM), the abdominal rectus (AR), erector spinae (ES), rectus femoris (RF), soleus (SO) and the tibialis anterior (TA). Five-repetition STS, 10-repetition STS and 30-second STS variants were performed. MG, BF, QM, ES and RF muscles showed differences in muscle activation, while QM, AR and ES muscles showed significant differences in MVC percentage. Also, significant differences in fatigue were found in QM muscle between different STS tests. There was no statistically significant fatigue in the BF, MG and SO muscles of the leg although there appeared to be a trend of increasing fatigue. These results could be useful in describing the functional movements of the STS test used in rehabilitation programs, notwithstanding that they were measured in healthy young subjects. PMID:26506612

  18. Electromyographic analysis of lower limb muscles during the golf swing performed with three different clubs.

    PubMed

    Marta, Sérgio; Silva, Luís; Vaz, João Rocha; Castro, Maria António; Reinaldo, Gustavo; Pezarat-Correia, Pedro

    2016-01-01

    The aim of this study was to describe and compare the EMG patterns of select lower limb muscles throughout the golf swing, performed with three different clubs, in non-elite middle-aged players. Fourteen golfers performed eight swings each using, in random order, a pitching wedge, 7-iron and 4-iron. Surface electromyography (EMG) was recorded bilaterally from lower limb muscles: tibialis anterior, peroneus longus, gastrocnemius medialis, gastrocnemius lateralis, biceps femoris, semitendinosus, gluteus maximus, vastus medialis, rectus femoris and vastus lateralis. Three-dimensional high-speed video analysis was used to determine the golf swing phases. Results showed that, in average handicap golfers, the highest muscle activation levels occurred during the Forward Swing Phase, with the right semitendinosus and the right biceps femoris muscles producing the highest mean activation levels relative to maximal electromyography (70-76% and 68-73% EMG(MAX), respectively). Significant differences between the pitching wedge and the 4-iron club were found in the activation level of the left semitendinosus, right tibialis anterior, right peroneus longus, right vastus medialis, right rectus femuris and right gastrocnemius muscles. The lower limb muscles showed, in most cases and phases, higher mean values of activation on electromyography when golfers performed shots with a 4-iron club. PMID:26197882

  19. Avulsion of the direct head of rectus femoris following arthroscopic subspine impingement resection: a case report.

    PubMed

    Devitt, Brian M; Smith, Bjorn; Stapf, Robert; O'Donnell, John M

    2016-04-01

    Arthroscopic resection of the anterior inferior iliac spine (AIIS) for subspine impingement has become a relatively common procedure. The AIIS is the origin of the direct head of rectus femoris (dhRF). Previous studies have reported that removal of the contributing portion of the AIIS causing impingement is unlikely to weaken the attachment of the dhRF. The purpose of this article is to report a case of avulsion of the dhRF, following revision hip arthroscopy for the treatment of subspine impingement. A 23-year-old professional footballer underwent revision left hip arthroscopy for the treatment of subspine impingement. 5-mm of bone was resected inferior to the AIIS. Two-weeks post-operatively, he presented with sudden onset, severe left anterior thigh pain following a fall and hyperextension of his left hip. The patient felt a pop over the anterior aspect of his hip. He noticed immediate swelling, severe pain and stiffness. Examination revealed diffuse swelling, 4/5-power on straight-leg-raise, focal tenderness over the AIIS but no palpable gap. MRI confirmed the clinical suspicion of a dhRF avulsion. Given the minimal loss of power and the lack of significant retraction, the patient was treated conservatively. He was instructed to avoid excessive hip extension. He returned to full participation at 3-months. This article highlights a case of avulsion of the dhRF due to a hyperextension injury of the hip following arthroscopic resection of subspinal impingement, a previously unreported complication. Resection of soft and bone from the AIIS may weaken the insertion of the dhRF. Care should be taken during post-operative rehabilitation to avoid trauma and excessive forces on the dhRF tendon, which may lead to rupture. Rehabilitation should be focused on range of motion of the hip. PMID:27026819

  20. Avulsion of the direct head of rectus femoris following arthroscopic subspine impingement resection: a case report

    PubMed Central

    Devitt, Brian M.; Smith, Bjorn; Stapf, Robert; O’Donnell, John M.

    2016-01-01

    Arthroscopic resection of the anterior inferior iliac spine (AIIS) for subspine impingement has become a relatively common procedure. The AIIS is the origin of the direct head of rectus femoris (dhRF). Previous studies have reported that removal of the contributing portion of the AIIS causing impingement is unlikely to weaken the attachment of the dhRF. The purpose of this article is to report a case of avulsion of the dhRF, following revision hip arthroscopy for the treatment of subspine impingement. A 23-year-old professional footballer underwent revision left hip arthroscopy for the treatment of subspine impingement. 5-mm of bone was resected inferior to the AIIS. Two-weeks post-operatively, he presented with sudden onset, severe left anterior thigh pain following a fall and hyperextension of his left hip. The patient felt a pop over the anterior aspect of his hip. He noticed immediate swelling, severe pain and stiffness. Examination revealed diffuse swelling, 4/5-power on straight-leg-raise, focal tenderness over the AIIS but no palpable gap. MRI confirmed the clinical suspicion of a dhRF avulsion. Given the minimal loss of power and the lack of significant retraction, the patient was treated conservatively. He was instructed to avoid excessive hip extension. He returned to full participation at 3-months. This article highlights a case of avulsion of the dhRF due to a hyperextension injury of the hip following arthroscopic resection of subspinal impingement, a previously unreported complication. Resection of soft and bone from the AIIS may weaken the insertion of the dhRF. Care should be taken during post-operative rehabilitation to avoid trauma and excessive forces on the dhRF tendon, which may lead to rupture. Rehabilitation should be focused on range of motion of the hip. PMID:27026819

  1. Open-sky isolated subtotal Muller's muscle resection for ptosis surgery: a review of over 300 cases and assessment of long-term outcome

    PubMed Central

    Peter, N M; Khooshabeh, R

    2013-01-01

    Purpose To evaluate short- and long-term success rates on isolated subtotal Muller resection in over 300 cases of ptosis over a 10-year period. Methods Clinical records were retrospectively evaluated for aetiology and severity of ptosis, levator function, response to phenylephrine, pre- and postoperative margin reflex distance of the upper lid (MRD1), postoperative lid contour and symmetry, complications and follow-up duration. Main outcome measures: change in MRD1 and eyelid contour. Surgical success: postoperative MRD1 ≥2 and ≤4.5 mm, symmetry to within 1.0 mm and satisfactory contour. All patients were also sent patient satisfaction questionnaires, and invited to attend for a longer-term assessment of their surgical outcome. Results In total, 92 and 95% of 309 eyelids met all three criteria for success after an average follow-up of 4 and 47 months, respectively. Mean improvement in MRD1 was 2.56 mm. In all, 97% had postoperative MRD1 of ≥2 and ≤4.5 mm and over 99% had an excellent contour. Altogether, 95 and 89% were within 1.0 and 0.5 mm symmetry of the fellow eye, respectively. In total, 51% of eyelids continued to rise, 17% maintained the same initial postoperative height, and 32% dropped by 1 mm or less. In all, 92% felt that their initial postoperative eyelid height had been maintained. Only 2% required repeat surgery and minor complications occurred in 4%. Conclusions Isolated subtotal Muller's resection is safe and effective for the repair of the majority of ptosis with moderate-to-good levator function. It results in a more predictable height, which is maintained over time, less frequent contour abnormalities, and lower re-operation rates compared with anterior levator advancement. PMID:23306727

  2. Breast Microsurgery in Plastic Surgery Literature: A 21-Year Analysis of Publication Trends.

    PubMed

    Daly, Lauren Tracy; Mowlds, Donald; Brodsky, Merrick A; Abrouk, Michael; Gandy, Jessica R; Wirth, Garrett A

    2016-05-01

    Introduction Microsurgical reconstruction of the breast represents an area of continual evolution, as new autologous flaps are introduced and principles are refined. This progression can be demonstrated by bibliometric analysis of the scientific literature. Methods The top 10 plastic surgery journals were determined by impact factor (IF). Each issue of every journal from 1993 to 2013 was accessed directly, and all articles discussing microsurgery on the female breast were classified by authors' geographic location, study design, and level of evidence (LOE, I-V). The productivity index and productivity share of each geographic region was calculated based on number of articles published and IF. Results A total of 706 breast microsurgery articles were analyzed. There was a significant increase in microsurgical breast research (p < 0.01), with an average 33.6 ± 31.1 articles per year and a mean increase of 4.4 articles per year. Most research was of lower LOE, with level I constituting 0.14% and level II constituting 5.21% of all articles. United States contributed the most research with 336.4 articles, followed by Western Europe with 242.2. However, Western Europe experienced the greatest increase in productivity share, with + 0.50 ± 0.29 growth, while United States demonstrated the greatest decrease in productivity share with - 1.23 ± 0.31 growth. Among autologous flaps, transverse rectus abdominis muscle research had the greatest yearly publication volume until 2002, when overtaken by deep inferior epigastric perforator flap research. Conclusion Over the 21-year study period, the United States not only contributed the greatest volume of research on female breast microsurgery but also demonstrated the greatest decline in research productivity. Efforts should be made to increase the LOE in breast microsurgery research. PMID:26645157

  3. Optimizing the Distribution of Leg Muscles for Vertical Jumping.

    PubMed

    Wong, Jeremy D; Bobbert, Maarten F; van Soest, Arthur J; Gribble, Paul L; Kistemaker, Dinant A

    2016-01-01

    A goal of biomechanics and motor control is to understand the design of the human musculoskeletal system. Here we investigated human functional morphology by making predictions about the muscle volume distribution that is optimal for a specific motor task. We examined a well-studied and relatively simple human movement, vertical jumping. We investigated how high a human could jump if muscle volume were optimized for jumping, and determined how the optimal parameters improve performance. We used a four-link inverted pendulum model of human vertical jumping actuated by Hill-type muscles, that well-approximates skilled human performance. We optimized muscle volume by allowing the cross-sectional area and muscle fiber optimum length to be changed for each muscle, while maintaining constant total muscle volume. We observed, perhaps surprisingly, that the reference model, based on human anthropometric data, is relatively good for vertical jumping; it achieves 90% of the jump height predicted by a model with muscles designed specifically for jumping. Alteration of cross-sectional areas-which determine the maximum force deliverable by the muscles-constitutes the majority of improvement to jump height. The optimal distribution results in large vastus, gastrocnemius and hamstrings muscles that deliver more work, while producing a kinematic pattern essentially identical to the reference model. Work output is increased by removing muscle from rectus femoris, which cannot do work on the skeleton given its moment arm at the hip and the joint excursions during push-off. The gluteus composes a disproportionate amount of muscle volume and jump height is improved by moving it to other muscles. This approach represents a way to test hypotheses about optimal human functional morphology. Future studies may extend this approach to address other morphological questions in ethological tasks such as locomotion, and feature other sets of parameters such as properties of the skeletal

  4. Comparison of trunk muscle activities in lifting and lowering tasks at various heights

    PubMed Central

    Lee, Hyun; Hong, Ji Heon

    2016-01-01

    [Purpose] Biomechanical data for manual material handling are important for appropriate engineering design. The goal of this study was to investigate differences in trunk muscle activity in lifting and lowering tasks at various heights. [Subjects and Methods] Thirty healthy, young adult subjects performed 6 asymmetrical lifting and lowering tasks at various heights. Trunk muscle activity of the abdominal external oblique muscle (EO), rectus abdominis muscle (RA), and lumbar erector spinae muscles (ES) were recorded using surface electromyography (EMG). [Results] The EMG activities of the bilateral ES differed significantly among heights. The left EO activity in the ankle to knee lifting task was significantly increased compared with that of the knee to ankle lowering task. However, there were no significant differences in the right EO, bilateral ES, or RA between lifting and lowering tasks. [Conclusion] The results show that the optimal range for manual material handling was at trunk height, not only for lifting but also for lowering tasks. PMID:27065548

  5. Extensive dural sinus thrombosis and bilateral lateral rectus palsy as an uncommon complication of chronic suppurative otitis media

    PubMed Central

    Balasubramanian, Anusha; Mohamad, Irfan; Sidek, Dinsuhaimi

    2013-01-01

    Dural venous sinus thrombosis, especially of the sigmoid sinus, is a known but uncommon intracranial extradural complication of chronic suppurative otitis media. Even rarer is the simultaneous occurrence of bilateral abducens palsy in the same patient. We report the case of an adolescent male who presented with signs of raised intracranial pressure, diplopia and bilateral lateral rectus palsy associated with a history of left ear discharge and neck swelling. Extensive dural sinus thrombosis extending right up to the left internal jugular vein was confirmed on CT imaging. The patient was successfully treated with thrombolytic agents and antibiotic therapy. The pathophysiology of the concurrent complications is discussed. PMID:23355565

  6. Blocking the rectus sheath guided by ultrasound in an 8-year-old patient with cystic fibrosis: reporting a case

    PubMed Central

    Encarnación-Martínez, Juan; Barberá-Alacreu, Manuel

    2015-01-01

    Cystic fibrosis (CF) is a severe disease that is transmitted with an autosomal recessive inheritance pattern, and is the commonest disease among Caucasian populations (1/2,500). There are many clinical manifestations that derive from its multiorgan dysfunctions, mainly in the respiratory and digestive tract. In addition, lung disease injury is principally responsible for morbidity and mortality in CF patients. Blocking the rectus sheath, first described by Schleich in 1899, is a loco-regional technique that provides adequate analgesia in those surgical procedures with midline or umbilical incisions. PMID:26733116

  7. [Perineal soft-tissue reconstruction with vertical rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal resection for cancer].

    PubMed

    Bognár, Gábor; Novák, András; István, Gábor; Lóderer, Zoltán; Ledniczky, György; Ondrejka, Pál

    2012-10-01

    Perineal wound healing problems following extended abdomino-perineal resection of ano-rectal cancer represent a great challenge to the surgeon. Perineal soft-tissue reconstruction with a myocutan flap was thought to reduce surgical wound healing complications. A review of the relevant literature was carried out on perineal soft-tissue reconstruction with rectus abdominis myocutan (VRAM) flap following extended abdomino-perineal rectal resection for cancer. The more commonly used neoadjuvant chemo- and radiotherapy as well as extended surgical radicality resulted in increased perioperative risks, therefore combined procedures between the colorectal and plastic surgical teams are inevitable. This case report illustrates the above trend. PMID:23086826

  8. Brain surgery

    MedlinePlus

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... Before surgery, the hair on part of the scalp is shaved and the area is cleaned. The doctor makes ...

  9. After Surgery

    MedlinePlus

    ... side effects. There is usually some pain with surgery. There may also be swelling and soreness around ... the first few days, weeks, or months after surgery. Some other questions to ask are How long ...

  10. Turbinate surgery

    MedlinePlus

    Turbinectomy; Turbinoplasty; Turbinate reduction; Nasal airway surgery ... There are several types of turbinate surgery: Turbinectomy: All or part of the lower turbinate is taken out. This can be done in several different ways, but sometimes a ...

  11. Adaptation of Slow Myofibers: The Effect of Sustained BDNF Treatment of Extraocular Muscles in Infant Nonhuman Primates

    PubMed Central

    Willoughby, Christy L.; Fleuriet, Jérome; Walton, Mark M.; Mustari, Michael J.; McLoon, Linda K.

    2015-01-01

    Purpose. We evaluated promising new treatment options for strabismus. Neurotrophic factors have emerged as a potential treatment for oculomotor disorders because of diverse roles in signaling to muscles and motor neurons. Unilateral treatment with sustained release brain-derived neurotrophic factor (BDNF) to a single lateral rectus muscle in infant monkeys was performed to test the hypothesis that strabismus would develop in correlation with extraocular muscle (EOM) changes during the critical period for development of binocularity. Methods. The lateral rectus muscles of one eye in two infant macaques were treated with sustained delivery of BDNF for 3 months. Eye alignment was assessed using standard photographic methods. Muscle specimens were analyzed to examine the effects of BDNF on the density, morphology, and size of neuromuscular junctions, as well as myofiber size. Counts were compared to age-matched controls. Results. No change in eye alignment occurred with BDNF treatment. Compared to control muscle, neuromuscular junctions on myofibers expressing slow myosins had a larger area. Myofibers expressing slow myosin had larger diameters, and the percentage of myofibers expressing slow myosins increased in the proximal end of the muscle. Expression of BDNF was examined in control EOM, and observed to have strongest immunoreactivity outside the endplate zone. Conclusions. We hypothesize that the oculomotor system adapted to sustained BDNF treatment to preserve normal alignment. Our results suggest that BDNF treatment preferentially altered myofibers expressing slow myosins. This implicates BDNF signaling as influencing the slow twitch properties of EOM. PMID:26030102

  12. Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series

    PubMed Central

    Bhave, Anil; Zywiel, Michael G; Ulrich, Slif D; McGrath, Mike S; Seyler, Thorsten M; Marker, David R; Delanois, Ronald E; Mont, Michael A

    2009-01-01

    Background Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty. Methods Ten patients (14 hips) who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks. Results At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees). Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points) prior to injection to a mean of 96 points (range, 93 to 98) at final follow-up. There were no serious treatment-related adverse events. Conclusion Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy. PMID:19709429

  13. Changes in Activation of Abdominal Muscles at Selected Angles During Trunk Exercise by Using Ultrasonography

    PubMed Central

    Kim, Hyun-Dong; Bae, Hyun-Woo; Kim, Jong-Gil; Han, Nami; Eom, Mi-Ja

    2015-01-01

    Objective To investigate the changes of activation of the abdominal muscles depending on exercise angles and whether the activation of rectus abdominis differs according to the location, during curl up and leg raise exercises, by measuring the thickness ratio of abdominal muscles using ultrasonography. Methods We examined 30 normal adults without musculoskeletal problems. Muscle thickness was measured in the upper rectus abdominis (URA), lower rectus abdominis (LRA), obliquus externus (EO), obliquus internus (IO), and transversus abdominis (TrA), at pre-determined angles (30°, 60°, 90°) and additionally at the resting angle (0°). Muscle thickness ratio was calculated by dividing the resting (0°) thickness for each angle, and was used as reflection of muscle activity. Results The muscle thickness ratio was significantly different depending on the angles in URA and LRA. For curl up-URA p=0 (30°<60°), p=0 (60°>90°), p=0.44 (30°<90°) and LRA p=0.01 (30°<60°), p=0 (60°>90°), p=0.44 (30°>90°), respectively, by one-way ANOVA test-and for leg raise-URA p=0 (30°<60°), p=0 (60°<90°), p=0 (30°<90°) and LRA p=0.01 (30°<60°), p=0 (60°<90°), p=0 (30°<90°), respectively, by one-way ANOVA test-exercises, but not in the lateral abdominal muscles (EO, IO, and TrA). Also, there was no significant difference in the muscle thickness ratio of URA and LRA during both exercises. In the aspect of muscle activity, there was significant difference in the activation of RA muscle by selected angles, but not according to location during both exercises. Conclusion According to this study, exercise angle is thought to be an important contributing factor for strengthening of RA muscle; however, both the exercises are thought to have no property of strengthening RA muscle selectively based on the location. PMID:26798609

  14. Orthopedic surgery.

    PubMed

    Gehrig, Laura M B

    2011-09-01

    Orthopedic surgery is a specialty of surgery dedicated to the prevention, diagnosis, and treatment of diseases and injuries of the musculoskeletal system in all age groups. Careers in orthopedic surgery span the spectrum from general orthopedics to those of subspecialty expertise in orthopedic trauma, hand, pediatrics, total joint, foot and ankle, sports medicine, and oncology to name a few. PMID:21871990

  15. The Gross Morphology and Histochemistry of Respiratory Muscles in Bottlenose Dolphins, Tursiops truncatus

    PubMed Central

    Cotten, Pamela B.; Piscitelli, Marina A.; McLellan, William A.; Rommel, Sentiel A.; Dearolf, Jennifer L.; Pabst, D. Ann

    2011-01-01

    Most mammals possess stamina because their locomotor and respiratory (i.e., ventilatory) systems are mechanically coupled. These systems are decoupled, however, in bottlenose dolphins (Tursiops truncatus) as they swim on a breath-hold. Locomotion and ventilation are coupled only during their brief surfacing event, when they respire explosively (up to 90% of total lung volume in approximately 0.3s) (Ridgway et al., 1969). The predominantly slow-twitch fiber profile of their diaphragm (Dearolf, 2003) suggests that this muscle does not likely power their rapid ventilatory event. Based upon Bramble's (1989) biomechanical model of locomotor-respiratory coupling in galloping mammals, it was hypothesized that locomotor muscles function to power ventilation in bottlenose dolphins. It was further hypothesized that these muscles would be composed predominantly of fast-twitch fibers to facilitate the bottlenose dolphin's rapid ventilation. The gross morphology of cranio-cervical (scalenus, sternocephalicus, sternohyoid), thoracic (intercostals, transverse thoracis), and lumbo-pelvic (hypaxialis, rectus abdominis, abdominal obliques) muscles (n=7) and the fiber-type profiles (n=6) of selected muscles (scalenus, sternocephalicus, sternohyoid, rectus abdominis) of bottlenose dolphins were investigated. Physical manipulations of excised thoracic units were carried out to investigate potential actions of these muscles. Results suggest that the cranio-cervical muscles act to draw the sternum and associated ribs cranio-dorsally, which flares the ribs laterally, and increases the thoracic cavity volume required for inspiration. The lumbo-pelvic muscles act to draw the sternum and caudal ribs caudally, which decreases the volumes of the thoracic and abdominal cavities required for expiration. All muscles investigated were composed predominantly of fast-twitch fibers (range 61-88% by area) and appear histochemically poised for rapid contraction. These combined results suggest that

  16. The hyal and ventral branchial muscles in caecilian and salamander larvae: homologies and evolution.

    PubMed

    Kleinteich, Thomas; Haas, Alexander

    2011-05-01

    Amphibians (Lissamphibia) are characterized by a bi-phasic life-cycle that comprises an aquatic larval stage and metamorphosis to the adult. The ancestral aquatic feeding behavior of amphibian larvae is suction feeding. The negative pressure that is needed for ingestion of prey is created by depression of the hyobranchial apparatus as a result of hyobranchial muscle action. Understanding the homologies of hyobranchial muscles in amphibian larvae is a crucial step in understanding the evolution of this important character complex. However, the literature mostly focuses on the adult musculature and terms used for hyal and ventral branchial muscles in different amphibians often do not reflect homologies across lissamphibian orders. Here we describe the hyal and ventral branchial musculature in larvae of caecilians (Gymnophiona) and salamanders (Caudata), including juveniles of two permanently aquatic salamander species. Based on previous alternative terminology schemes, we propose a terminology for the hyal and ventral branchial muscles that reflects the homologies of muscles and that is suited for studies on hyobranchial muscle evolution in amphibians. We present a discussion of the hyal and ventral branchial muscles in larvae of the most recent common ancestor of amphibians (i.e. the ground plan of Lissamphibia). Based on our terminology, the hyal and ventral branchial musculature of caecilians and salamanders comprises the following muscles: m. depressor mandibulae, m. depressor mandibulae posterior, m. hyomandibularis, m. branchiohyoideus externus, m. interhyoideus, m. interhyoideus posterior, m. subarcualis rectus I, m. subarcualis obliquus II, m. subarcualis obliquus III, m. subarcualis rectus II-IV, and m. transversus ventralis IV. Except for the m. branchiohyoideus externus, all muscles considered herein can be assigned to the ground plan of the Lissamphibia with certainty. The m. branchiohyoideus externus is either apomorphic for the Batrachia (frogs

  17. Trunk Muscle Activation and Estimating Spinal Compressive Force in Rope and Harness Vertical Dance.

    PubMed

    Wilson, Margaret; Dai, Boyi; Zhu, Qin; Humphrey, Neil

    2015-12-01

    Rope and harness vertical dance takes place off the floor with the dancer suspended from his or her center of mass in a harness attached to a rope from a point overhead. Vertical dance represents a novel environment for training and performing in which expected stresses on the dancer's body are different from those that take place during dance on the floor. Two male and eleven female dancers with training in vertical dance performed six typical vertical dance movements with electromyography (EMG) electrodes placed bilaterally on rectus abdominus, external oblique, erector spinae, and latissimus dorsi. EMG data were expressed as a percentage of maximum voluntary isometric contraction (MVIC). A simplified musculoskeletal model based on muscle activation for these four muscle groups was used to estimate the compressive force on the spine. The greatest muscle activation for erector spinae and latissimus dorsi and the greatest trunk compressive forces were seen in vertical axis positions where the dancer was moving the trunk into a hyper-extended position. The greatest muscle activation for rectus abdominus and external oblique and the second highest compressive force were seen in a supine position with the arms and legs extended away from the center of mass (COM). The least muscle activation occurred in positions where the limbs were hanging below the torso. These movements also showed relatively low muscle activation compression forces. Post-test survey results revealed that dancers felt comfortable in these positions; however, observation of some positions indicated insufficient muscular control. Computing the relative contribution of muscles, expressed as muscle activation and estimated spinal compression, provided a measure of how much the muscle groups were working to support the spine and the rest of the dancer's body in the different movements tested. Additionally, identifying typical muscle recruitment patterns in each movement will help identify key exercises

  18. Neuromuscular independence of abdominal wall muscles as demonstrated by middle-eastern style dancers.

    PubMed

    Moreside, Janice M; Vera-Garcia, Francisco J; McGill, Stuart M

    2008-08-01

    Previous studies analyzing neuromuscular independence of the abdominal wall have involved a participant population with no specific training in separating individual muscle segments. We chose to study nine women trained in the art of middle-eastern dance, anticipating they may have unique skills in motor control. Specifically, we were searching for evidence of separation of upper rectus abdominis (URA) from lower rectus abdominis (LRA), as well as understanding what role the oblique muscles play in abdominal wall synergies. EMG analysis was done on eight trunk muscles bilaterally as the dancers participated in 30 dance, planar, and curl-up activities. The filtered data were then cross-correlated to determine the time lag between pairs of signals. Only three dance movements demonstrated consistent evidence of an ability to separate URA/LRA activation timing. The external and internal oblique muscles tend to align themselves temporally with the LRA. However, these findings were only evident in these three specific "belly-roll" conditions, all with low levels of muscle activation, and no external torque. Evidence of significantly different activation levels (% MVC) between URA/LRA was demonstrated in eight conditions, all of which required various pelvis movements with minimal thorax motion. PMID:17329127

  19. Sarcopenia in Orthopedic Surgery.

    PubMed

    Bokshan, Steven L; DePasse, J Mason; Daniels, Alan H

    2016-01-01

    Sarcopenia is a loss of skeletal muscle mass in the elderly that is an independent risk factor for falls, disability, postoperative complications, and mortality. Although its cause is not completely understood, sarcopenia generally results from a complex bone-muscle interaction in the setting of chronic disease and aging. Sarcopenia cannot be diagnosed by muscle mass alone. Diagnosis requires 2 of the following 3 criteria: low skeletal muscle mass, inadequate muscle strength, and inadequate physical performance. Forty-four percent of elderly patients undergoing orthopedic surgery and 24% of all patients 65 to 70 years old are sarcopenic. Although dual-energy x-ray absorptiometry and bioelectrical impedance analysis may be used to measure sarcopenia and are relatively inexpensive and accessible, they are generally considered less specific for sarcopenia compared with computed tomography and magnetic resonance imaging. Sarcopenia has been shown to predict poor outcomes within the medical and surgical populations and has been directly correlated with increases in taxpayer costs. Strengthening therapy and nutritional supplementation have become the mainstays of sarcopenia treatment. Specifically, the American Medical Directors Association has released guidelines for nutritional supplementation. Although sarcopenia frequently occurs with osteoporosis, it is an independent predictor of fragility fractures. Initiatives to diagnose, treat, and prevent sarcopenia in orthopedic patients are needed. Further investigation must also explore sarcopenia as a predictor of surgical outcomes in orthopedic patients. PMID:26913764

  20. Skeletal muscle responses to unloading in humans

    NASA Technical Reports Server (NTRS)

    Dudley, G.; Tesch, P.; Hather, B.; Adams, G.; Buchanan, P.

    1992-01-01

    This study examined the effects of unloading on skeletal muscle structure. Method: Eight subjects walked on crutches for six weeks with a 110 cm elevated sole on the right shoe. This removed weight bearing by the left lower limb. Magnetic resonance imaging of both lower limbs and biopsies of the left m. vastus laterallis (VL) were used to study muscle structure. Results: Unloading decreased (P less than 0.05) muscle cross-sectional areas (CSA) of the knee extensors 16 percent. The knee flexors showed about 1/2 of this response (-7 percent, P less than 0.05). The three vasti muscles each showed decreases (P less than 0.05) of about 15 percent. M. rectus femoris did not change. Mean fiber CSA in VL decreased (P less than 0.05) 14 percent with type 2 and type 1 fibers showing reductions of 15 and 11 percent respectively. The ankle extensors showed a 20 percent decrease (P less than 0.05) in CSA. The reduction for the 'fast' m. gastrocnemius was 27 percent compared to the 18 percent decrease for the 'slow' soleus. Summary: The results suggest that decreases in muscle CSA are determined by the relative change in impact loading history because atrophy was (1) greater in extensor than flexor muscles, (2) at least as great in fast as compared to slow muscles or fibers, and (3) not dependent on single or multi-joint function. They also suggest that the atrophic responses to unloading reported for lower mammals are quantitatively but not qualitatively similar to those of humans.

  1. Simulated recruitment of medial rectus motoneurons by abducens internuclear neurons: synaptic specificity vs. intrinsic motoneuron properties.

    PubMed

    Dean, P

    1997-09-01

    Ocular motoneuron firing rate is linearly related to conjugate eye position with slope K above recruitment threshold theta. Within the population of ocular motoneurons K increases as theta increases. These differences in firing rate between motoneurons might be determined either by the intrinsic properties of the motoneurons, or by differences in synaptic input to them, or by a combination of the two. This question was investigated by simulating the input signal to medial rectus motoneurons (MR-MNs) from internuclear neurons of the abducens nucleus (INNs). INNs were represented as input nodes in a two-layer neural net, each with weighted connections to every output node representing an MR-MN. Individual simulated MR-MNs were assigned parameters corresponding to an intrinsic current threshold I(R) and an intrinsic frequency-current (f-I) slope gamma. Their firing rates were calculated from these parameters, together with the effective synaptic current produced by their synaptically weighted INN inputs, with the use of assumptions employed in computer simulations of spinal motoneuron pools. The experimentally observed firing rates of MR-MNs served as training data for the net. The following two training conditions were used: 1) synaptic weights were fixed and the intrinsic parameters of the MR-MNs were allowed to vary, corresponding to the situation in which each MR-MN receives a common synaptic drive and 2) intrinsic MR-MN properties were fixed and synaptic weights were allowed to vary. In each case, the varying quantities were trained with a form of gradient descent error reduction. The simulations revealed the following three problems with the common-drive model: 1) the recruitment of INNs produced nonlinear responses in MR-MNs with low thetas; 2) the range of I(R)s required to reproduce the observed range of theta were generally larger than those measured experimentally for cat ocular motoneurons; and 3) the intrinsic f-I slope gamma increased with I

  2. Core Muscle Activation in One-Armed and Two-Armed Kettlebell Swing.

    PubMed

    Andersen, Vidar; Fimland, Marius S; Gunnarskog, Aril; Jungård, Georg-Andrè; Slåttland, Roy-Andrè; Vraalsen, Øyvind F; Saeterbakken, Atle H

    2016-05-01

    The aim of the study was to compare the electromyographic activity of rectus abdominis, oblique external, and lower and upper erector spinae at both sides of the truncus in 1-armed and 2-armed kettlebell swing. Sixteen healthy men performed 10 repetitions of both exercises using a 16-kg kettlebell in randomized order. For the upper erector spinae, the activation of the contralateral side during 1-armed swing was 24% greater than that of the ipsilateral side during 1-armed swing (p < 0.001) and 11% greater during 2-armed swing (p = 0.026). Furthermore, the activation in 2-armed swing was 12-16% greater than for the ipsilateral side in 1-armed swing (p < 0.001). For rectus abdominis, however, 42% lower activation of the contralateral side was observed during 1-armed swing compared with ipsilateral sides during 2-armed swing (p = 0.038) and 48% compared with the ipsilateral side during 1-armed swing (p = 0.044). Comparing the different phases of the swing, most differences in the upper erector spinae were found in the lower parts of the movement, whereas for the rectus abdominis, the differences were found during the hip extension. In contrast, similar muscle activity in the lower erector spinae and external oblique between the different conditions was observed (p = 0.055-0.969). In conclusion, performing the kettlebell swing with 1 arm resulted in greater neuromuscular activity for the contralateral side of the upper erector spinae and ipsilateral side of the rectus abdominis, and lower activation of the opposite side of the respective muscles. PMID:26473519

  3. Optimizing the Distribution of Leg Muscles for Vertical Jumping

    PubMed Central

    Wong, Jeremy D.; Bobbert, Maarten F.; van Soest, Arthur J.; Gribble, Paul L.; Kistemaker, Dinant A.

    2016-01-01

    A goal of biomechanics and motor control is to understand the design of the human musculoskeletal system. Here we investigated human functional morphology by making predictions about the muscle volume distribution that is optimal for a specific motor task. We examined a well-studied and relatively simple human movement, vertical jumping. We investigated how high a human could jump if muscle volume were optimized for jumping, and determined how the optimal parameters improve performance. We used a four-link inverted pendulum model of human vertical jumping actuated by Hill-type muscles, that well-approximates skilled human performance. We optimized muscle volume by allowing the cross-sectional area and muscle fiber optimum length to be changed for each muscle, while maintaining constant total muscle volume. We observed, perhaps surprisingly, that the reference model, based on human anthropometric data, is relatively good for vertical jumping; it achieves 90% of the jump height predicted by a model with muscles designed specifically for jumping. Alteration of cross-sectional areas—which determine the maximum force deliverable by the muscles—constitutes the majority of improvement to jump height. The optimal distribution results in large vastus, gastrocnemius and hamstrings muscles that deliver more work, while producing a kinematic pattern essentially identical to the reference model. Work output is increased by removing muscle from rectus femoris, which cannot do work on the skeleton given its moment arm at the hip and the joint excursions during push-off. The gluteus composes a disproportionate amount of muscle volume and jump height is improved by moving it to other muscles. This approach represents a way to test hypotheses about optimal human functional morphology. Future studies may extend this approach to address other morphological questions in ethological tasks such as locomotion, and feature other sets of parameters such as properties of the skeletal

  4. Rectus-Sparing Technique for Driveline Insertion of Ventricular Assist Device.

    PubMed

    Asaki, S Yukiko; Dean McKenzie, E; Elias, Barbara; Adachi, Iki

    2015-11-01

    We present a new technique for driveline insertion of the HeartWare ventricular assist device (HVAD) designed to preserve the integrity of the abdominal wall structure. Because of the size of the HVAD driveline connector (12 mm in diameter: triple the size of the driveline cable), the standard tunneling maneuver can result in tearing of the abdominal wall muscle layer, which is a primary mechanism to prevent ascending driveline infection. We find that our technique is particularly useful in children because their abdominal wall muscles are more fragile and thereby prone to accidental injury with blunt penetration when the standard technique is used. PMID:26522548

  5. Muscle Activation during Gait in Children with Duchenne Muscular Dystrophy.

    PubMed

    Ropars, Juliette; Lempereur, Mathieu; Vuillerot, Carole; Tiffreau, Vincent; Peudenier, Sylviane; Cuisset, Jean-Marie; Pereon, Yann; Leboeuf, Fabien; Delporte, Ludovic; Delpierre, Yannick; Gross, Raphaël; Brochard, Sylvain

    2016-01-01

    The aim of this prospective study was to investigate changes in muscle activity during gait in children with Duchenne muscular Dystrophy (DMD). Dynamic surface electromyography recordings (EMGs) of 16 children with DMD and pathological gait were compared with those of 15 control children. The activity of the rectus femoris (RF), vastus lateralis (VL), medial hamstrings (HS), tibialis anterior (TA) and gastrocnemius soleus (GAS) muscles was recorded and analysed quantitatively and qualitatively. The overall muscle activity in the children with DMD was significantly different from that of the control group. Percentage activation amplitudes of RF, HS and TA were greater throughout the gait cycle in the children with DMD and the timing of GAS activity differed from the control children. Significantly greater muscle coactivation was found in the children with DMD. There were no significant differences between sides. Since the motor command is normal in DMD, the hyper-activity and co-contractions likely compensate for gait instability and muscle weakness, however may have negative consequences on the muscles and may increase the energy cost of gait. Simple rehabilitative strategies such as targeted physical therapies may improve stability and thus the pattern of muscle activity. PMID:27622734

  6. Breakpoints in ventilation, cerebral and muscle oxygenation, and muscle activity during an incremental cycling exercise

    PubMed Central

    Racinais, Sebastien; Buchheit, Martin; Girard, Olivier

    2014-01-01

    The aim of this study was to locate the breakpoints of cerebral and muscle oxygenation and muscle electrical activity during a ramp exercise in reference to the first and second ventilatory thresholds. Twenty-five cyclists completed a maximal ramp test on an electromagnetically braked cycle-ergometer with a rate of increment of 25 W/min. Expired gazes (breath-by-breath), prefrontal cortex and vastus lateralis (VL) oxygenation [Near-infrared spectroscopy (NIRS)] together with electromyographic (EMG) Root Mean Square (RMS) activity for the VL, rectus femoris (RF), and biceps femoris (BF) muscles were continuously assessed. There was a non-linear increase in both cerebral deoxyhemoglobin (at 56 ± 13% of the exercise) and oxyhemoglobin (56 ± 8% of exercise) concomitantly to the first ventilatory threshold (57 ± 6% of exercise, p > 0.86, Cohen's d < 0.1). Cerebral deoxyhemoglobin further increased (87 ± 10% of exercise) while oxyhemoglobin reached a plateau/decreased (86 ± 8% of exercise) after the second ventilatory threshold (81 ± 6% of exercise, p < 0.05, d > 0.8). We identified one threshold only for muscle parameters with a non-linear decrease in muscle oxyhemoglobin (78 ± 9% of exercise), attenuation in muscle deoxyhemoglobin (80 ± 8% of exercise), and increase in EMG activity of VL (89 ± 5% of exercise), RF (82 ± 14% of exercise), and BF (85 ± 9% of exercise). The thresholds in BF and VL EMG activity occurred after the second ventilatory threshold (p < 0.05, d > 0.6). Our results suggest that the metabolic and ventilatory events characterizing this latter cardiopulmonary threshold may affect both cerebral and muscle oxygenation levels, and in turn, muscle recruitment responses. PMID:24782786

  7. Timing of Muscle Response to a Sudden Leg Perturbation: Comparison between Adolescents and Adults with Down Syndrome

    PubMed Central

    Valle, Maria Stella; Cioni, Matteo; Pisasale, Mariangela; Pantò, Maria Rosita; Casabona, Antonino

    2013-01-01

    Movement disturbances associated with Down syndrome reduce mechanical stability, worsening the execution of important tasks such as walking and upright standing. To compensate these deficits, persons with Down syndrome increase joint stability modulating the level of activation of single muscles or producing an agonist-antagonist co-activation. Such activations are also observed when a relaxed, extended leg is suddenly released and left to oscillate passively under the influence of gravity (Wartenberg test). In this case, the Rectus femoris of adults with Down syndrome displayed peaks of activation after the onset of the first leg flexion. With the aim to verify if these muscular reactions were acquired during the development time and to find evidences useful to give them a functional explanation, we used the Wartenberg test to compare the knee joint kinematics and the surface electromyography of the Rectus femoris and Biceps femoris caput longus between adolescents and adults with Down syndrome. During the first leg flexion, adolescents and adults showed single Rectus femoris activations while, a restricted number of participants exhibited agonist-antagonist co-activations. However, regardless the pattern of activation, adults initiated the muscle activity significantly later than adolescents. Although most of the mechanical parameters and the total movement variability were similar in the two groups, the onset of the Rectus femoris activation was well correlated with the time of the minimum acceleration variability. Thus, in adolescents the maximum mechanical stability occurred short after the onset of the leg fall, while adults reached their best joint stability late during the first flexion. These results suggest that between the adolescence and adulthood, persons with Down syndrome explore a temporal window to select an appropriate timing of muscle activation to overcome their inherent mechanical instability. PMID:24278374

  8. 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: ...

  9. 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 ...

  10. Muscle-specific modulation of vestibular reflexes with increased locomotor velocity and cadence.

    PubMed

    Dakin, Christopher J; Inglis, John Timothy; Chua, Romeo; Blouin, Jean-Sébastien

    2013-07-01

    Vestibular information is one of the many sensory signals used to stabilize the body during locomotion. When locomotor velocity increases, the influence of these signals appears to wane. It is unclear whether vestibular signals are globally attenuated with velocity or are influenced by factors such as whether a muscle is contributing to balance control. Here we investigate how vestibular sensory signals influence muscles of the leg during locomotion and what causes their attenuation with increasing locomotor velocity. We hypothesized that 1) vestibular signals influence the activity of all muscles engaged in the maintenance of medio-lateral stability during locomotion and 2) increases in both cadence and velocity would be associated with attenuation of these signals. We used a stochastic vestibular stimulus and recorded electromyographic signals from muscles of the ankle, knee, and hip. Participants walked using two cadences (52 and 78 steps/min) and two walking velocities (0.4 and 0.8 m/s). We observed phase-dependent modulation of vestibular influence over ongoing muscle activity in all recorded muscles. Within a stride, reversals of the muscle responses were observed in the biceps femoris, tibialis anterior, and rectus femoris. Vestibular-muscle coupling decreases with increases in both cadence and walking velocity. These results show that the observed vestibular suppression is muscle- and phase dependent. We suggest that the phase- and muscle-specific influence of vestibular signals on locomotor activity is organized according to each muscle's functional role in body stabilization during locomotion. PMID:23576695

  11. 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…

  12. Myofascial force transmission between transferred rat flexor carpi ulnaris muscle and former synergistic palmaris longus muscle

    PubMed Central

    Maas, Huub; Huijing, Peter A.

    2011-01-01

    Summary We investigated the extent of mechanical interaction between rat flexor carpi ulnaris (FCU) and palmaris longus (PL) muscles following transfer of FCU to the distal tendons of extensor carpi radialis brevis and longus (ECRB/L) muscles. Five weeks after recovery from surgery, isometric forces exerted at the distal tendons of FCU and PL were quantified at various FCU lengths. PL was kept at a constant length. Changing the muscle-tendon complex length of transferred FCU (by maximally 3.5 mm) decreased PL force significantly (by 7%). A linear relationship was found between changes in FCU muscle belly length, being a measure of muscle relative positions, and PL force. These results indicate that despite transfer of FCU muscle to the extensor side of the forearm, changing FCU length still affects force transmission of its, now, antagonistic PL muscle. We conclude that a transferred muscle may still be mechanically linked to its former synergistic muscles. PMID:23738260

  13. Comparison of the Effects of Hollowing and Bracing Exercises on Cross-sectional Areas of Abdominal Muscles in Middle-aged Women

    PubMed Central

    Koh, Hyung-Woo; Cho, Sung-Hyoun; Kim, Cheol-Yong

    2014-01-01

    [Purpose] The purpose of this study was to examine the effects of hollowing and bracing exercises on cross-sectional areas of abdominal muscles. [Subjects] Thirty healthy female adults participated in this study. The exclusion criteria were orthopedic or neurologic diseases. [Methods] The subjects of this study were assigned randomly to one of two groups, each with 15 people. Each group performed a 60-minute exercise program, one performed a bracing exercise, and the other performed a hollowing exercise, with both groups performing the exercise three times a week for six weeks. [Results] The changes in cross-sectional areas after the bracing exercise showed statistically significant differences in the left rectus abdominis and both internal and external obliques. The changes in cross-sectional areas after the hollowing exercise showed statistically significant differences in the left and right transversus abdominis and left rectus abdominis. [Conclusion] Performing bracing exercises rather than hollowing exercises is more effective for activating the abdominal muscles. PMID:24648652

  14. Strabismus Surgery

    MedlinePlus

    ... used. Some surgeons prescribe an antibiotic or combination antibiotic/steroid drop or ointment after surgery. More technical ... Screening Recommendations Loading... Most Common Searches Adult ...

  15. Abdominal muscle activity according to knee joint angle during sit-to-stand

    PubMed Central

    Eom, Juri; Rhee, Min-Hyung; Kim, Laurentius Jongsoon

    2016-01-01

    [Purpose] This study assessed the activity of the abdominal muscles according to the angle of the knee joints during sit-to-stand. [Subjects and Methods] Thirty healthy adult males participated in this study. Subjects initiated sit-to-stand at knee joint angles of 60°, 90°, or 120°. An electromyography system was used to measure the maximum voluntary isometric contraction of the rectus abdominis, external oblique, and internal oblique and transverse abdominis muscles. [Results] Percent contraction differed significantly among the three knee joint angles, most notably for the internal oblique and transverse abdominis muscles. [Conclusion] Wider knee joint angles more effectively activate the abdominal muscles, especially those in the deep abdomen, than do narrower angles. PMID:27390431

  16. Lower muscle co-contraction in flutter kicking for competitive swimmers.

    PubMed

    Matsuda, Yuji; Hirano, Masami; Yamada, Yosuke; Ikuta, Yasushi; Nomura, Teruo; Tanaka, Hiroaki; Oda, Shingo

    2016-02-01

    The purpose of this study was to examine the difference in muscle activation pattern and co-contraction of the rectus and biceps femoris in flutter-kick swimming between competitive and recreational swimmers, to better understand the mechanism of repetitive kicking movements during swimming. Ten competitive and 10 recreational swimmers swam using flutter kicks at three different velocities (100%, 90%, and 80% of their maximal velocity) in a swimming flume. Surface electromyographic signals (EMG) were obtained from the rectus (RF) and biceps femoris (BF), and lower limb kinematic data were obtained at the same time. The beginning and ending of one kick cycle was defined as when the right lateral malleolus reached its highest position in the vertical axis. The offset timing of muscle activation of RF in the recreational swimmers was significantly later at all velocities than in the competitive swimmers (47-48% and 26-33% of kick time of one cycle for recreational and competitive swimmers, respectively), although the kinematic data and other activation timing of RF and BF did not differ between groups. A higher integrated EMG of RF during hip extension and knee extension induced a higher level of muscle co-contraction between RF and BF in the recreational swimmers. These results suggest that long-term competitive swimming training can induce an effective muscle activation pattern in the upper legs. PMID:26590483

  17. Applications of microvascular surgery.

    PubMed

    Miller, C W; Fowler, J D

    1990-09-01

    The advent of microvascular surgery has radically changed the discipline of human reconstructive surgery over the last decade. The ability to anastomose vessels less than 1 mm in diameter allows the distant transfer of tissues with a known blood supply from one area of the body to another. These tissues can be detached from their local blood supply and reperfused by anastomosing vessels supplying the tissue transfer to vessels near the recipient site. This technique has been used to transfer a variety of tissues and combinations of tissues including skin, muscle, bone, and bowel to solve a variety of difficult reconstructive problems. Applications, potential applications, and problems associated with microvascular free tissue transfer will be discussed in this chapter. PMID:2134600

  18. Muscle Activation Patterns When Passively Stretching Spastic Lower Limb Muscles of Children with Cerebral Palsy

    PubMed Central

    Bar-On, Lynn; Aertbeliën, Erwin; Molenaers, Guy; Desloovere, Kaat

    2014-01-01

    The definition of spasticity as a velocity-dependent activation of the tonic stretch reflex during a stretch to a passive muscle is the most widely accepted. However, other mechanisms are also thought to contribute to pathological muscle activity and, in patients post-stroke and spinal cord injury can result in different activation patterns. In the lower-limbs of children with spastic cerebral palsy (CP) these distinct activation patterns have not yet been thoroughly explored. The aim of the study was to apply an instrumented assessment to quantify different muscle activation patterns in four lower-limb muscles of children with CP. Fifty-four children with CP were included (males/females n = 35/19; 10.8±3.8 yrs; bilateral/unilateral involvement n =  32/22; Gross Motor Functional Classification Score I–IV) of whom ten were retested to evaluate intra-rater reliability. With the subject relaxed, single-joint, sagittal-plane movements of the hip, knee, and ankle were performed to stretch the lower-limb muscles at three increasing velocities. Muscle activity and joint motion were synchronously recorded using inertial sensors and electromyography (EMG) from the adductors, medial hamstrings, rectus femoris, and gastrocnemius. Muscles were visually categorised into activation patterns using average, normalized root mean square EMG (RMS-EMG) compared across increasing position zones and velocities. Based on the visual categorisation, quantitative parameters were defined using stretch-reflex thresholds and normalized RMS-EMG. These parameters were compared between muscles with different activation patterns. All patterns were dominated by high velocity-dependent muscle activation, but in more than half, low velocity-dependent activation was also observed. Muscle activation patterns were found to be both muscle- and subject-specific (p<0.01). The intra-rater reliability of all quantitative parameters was moderate to good. Comparing RMS-EMG between incremental

  19. A comparative study of the electromyographic activities of lower extremity muscles during level walking and Pedalo riding

    PubMed Central

    Lee, DongGeon; Kim, YouJeong; Yun, JiHyeon; Jung, MiHye; Lee, GyuChang

    2016-01-01

    [Purpose] To analyze the electromyographic (EMG) activities of several lower extremity muscles during ground walking and pedaling using the Pedalo Reha-Bar device. [Subjects and Methods] Fifteen healthy adults aged 20–29 year participated in this study. The subjects’ surface EMG signals while walking and Pedalo Reha-Bar riding were recorded. The subjects performed 20 steps on flat ground and 20 cycles on the Pedalo Reha-Bar. During the tasks, EMG signals of the rectus femoris, biceps femoris, tibialis anterior, soleus, and gastrocnemius within a 20-second period were recorded. The mean EMG signals within the 10 seconds from 6 to 15 seconds were used for the data analysis. [Results] There was a significant increase in the bilateral use of the rectus femoris and a significant decrease in the use of the left tibialis anterior and left soleus in pedaling using the Pedalo Reha-Bar device compared to ground walking. [Conclusion] Level walking and the Pedalo Reha-Bar riding utilize different types of muscles activities. These results suggest that Pedalo Reha-Bar riding may be used for neuromuscular activation, especially of the rectus femoris. PMID:27313354

  20. Effects of walking speed and age on the muscle forces of unimpaired gait subjects

    NASA Astrophysics Data System (ADS)

    Fliger, Carlos G.; Crespo, Marcos J.; Braidot, Ariel A.; Ravera, Emiliano P.

    2016-04-01

    Clinical gait analysis provides great contributions to the understanding of gait disorders and also provides a mean for a more comprehensive treatment plan. However, direct measures of muscle forces are difficult to obtain in clinical settings because it generally requires invasive techniques. Techniques of musculoskeletal modeling have been used for several decades to improve the benefits of clinical gait analysis, but many of the previous studies were focused on analyzing separately the muscle forces distribution of children or adult subjects with only one condition of walking speed. For these reason, the present study aims to enhance the current literature by describing the age and speed gait effects on muscle forces during walking. We used a musculoskeletal model with 23 degrees of freedom and 92 musculotendon actuators to represent 76 muscles in the lower extremities and torso. The computed muscle control algorithm was used to estimate the muscle forces from the kinematics and to adjust the model obtained in the residual reduction algorithm. We find that hamstrings has an important peak in the mid-stance phase in the adult group but this peak disappears in the children group with the same walking speed condition. Furthermore, the rectus femoris presents an increase in the muscle force during the pre- and mid-swing in concordance with the increment in the walking speed of subjects. This behavior could be associated with the role that the rectus femoris has in the acceleration of the knee joint. Finally, we show that the soleus is the muscle that perform the major force throughout the gait cycle regardless of age and walking speed.

  1. Effectiveness of the Wavelet Transform on the Surface EMG to Understand the Muscle Fatigue During Walk

    NASA Astrophysics Data System (ADS)

    Hussain, M. S.; Mamun, Md.

    2012-01-01

    Muscle fatigue is the decline in ability of a muscle to create force. Electromyography (EMG) is a medical technique for measuring muscle response to nervous stimulation. During a sustained muscle contraction, the power spectrum of the EMG shifts towards lower frequencies. These effects are due to muscle fatigue. Muscle fatigue is often a result of unhealthy work practice. In this research, the effectiveness of the wavelet transform applied to the surface EMG (SEMG) signal as a means of understanding muscle fatigue during walk is presented. Power spectrum and bispectrum analysis on the EMG signal getting from right rectus femoris muscle is executed utilizing various wavelet functions (WFs). It is possible to recognize muscle fatigue appreciably with the proper choice of the WF. The outcome proves that the most momentous changes in the EMG power spectrum are symbolized by WF Daubechies45. Moreover, this research has compared bispectrum properties to the other WFs. To determine muscle fatigue during gait, Daubechies45 is used in this research to analyze the SEMG signal.

  2. Rhabdomyosarcoma: Surgery

    MedlinePlus

    ... is and what type of operation is done. Physical changes after surgery can range from little more than a scar to changes in appearance or in how some parts of the body function, which may require physical rehabilitation. For more on surgery as a treatment ...

  3. Refractive Surgery

    PubMed Central

    Kellum, Keith

    2000-01-01

    The concept of surgically altering the eye to correct refractive errors has been considered for hundreds of years, but only in the past 60 years has interest grown considerably due to the development of modern refractive surgery techniques such as astigmatic keratotomies to correct astigmatism induced by cataract surgery and future technologies currently being investigated. Modern refractive surgery is more involved than setting the correct parameters on the laser. Patient selection and examination, proper technique, and postoperative follow-up for potential complications are essential for a successful refractive procedure. Critical evaluation of new techniques is vital to avoid the pitfall of overly exuberant enthusiasm for new and unproven methods of refractive surgery. Kellum K. Refractive surgery. The Ochsner Journal 2000; 2:164-167. PMID:21765686

  4. Relationship between magnetic resonance imaging signal intensity and volume of extraocular muscles in thyroid-associated ophthalmopathy with methylprednisolone pulse therapy

    PubMed Central

    Higashiyama, Tomoaki; Nishida, Yasuhiro; Ohji, Masahito

    2016-01-01

    Purpose To characterize the relationship between inflammation and swelling of extraocular muscles in thyroid-associated ophthalmopathy before and after methylprednisolone pulse therapy. Methods The signal intensities and volumes of the superior rectus (SR), inferior rectus (IR), lateral rectus (LR), medial rectus (MR), and superior oblique (SO) muscles were measured with magnetic resonance imaging in 25 eyes of 25 patients with thyroid-associated ophthalmopathy in the acute inflammatory phase before and after methylprednisolone pulse therapy. The signal intensity ratios (SIRs) of muscles and brain white matter were calculated. Result The mean SIRs before treatment were 2.28±0.74 in SR, 2.66±0.57 in IR, 2.03±0.42 in LR, 2.45±0.49 in MR, and 1.98±0.48 in SO muscles. The mean SIRs after treatment were 1.82±0.62, 1.84±0.52, 1.70±0.35, 1.95±0.46, and 1.60±0.36, respectively. The mean volumes (cm3) before treatment were 1.35±0.67 in SR, 1.21±0.39 in IR, 0.66±0.13 in LR, 0.94±0.31 in MR, and 0.58±0.14 in SO muscles. Those after treatment were 1.12±0.45, 0.91±0.31, 0.61±0.12, 0.85±0.28, and 0.49±0.11, respectively. The SIRs showed significantly positive correlations with volumes both before and after treatment in SR muscles (before, r=0.77; after, r=0.69), IR muscles (before, r=0.65; after, r=0.60), MR muscles (before, r=0.69; after, r=0.73), and SO muscles (before, r=0.52; after, r=0.50) (P<0.01 for all correlations). Conclusion Swelling reflected the inflammation in extraocular muscles of thyroid-associated ophthalmopathy both before and after treatment. PMID:27143850

  5. Quadratus lumborum catheters for breast reconstruction requiring transverse rectus abdominis myocutaneous flaps.

    PubMed

    Spence, Nicole Z; Olszynski, Patrycja; Lehan, Anne; Horn, Jean-Lois; Webb, Christopher A J

    2016-06-01

    Patients diagnosed with breast cancer may opt to undergo surgical reconstructive flaps at the time of or after mastectomies. These surgeries leave patients with significant postoperative pain and sometimes involve large surgical beds including graft sites from the abdomen to reconstruct the breast. Consequently, multimodal methods of pain management have become highly favored. Quadratus lumborum catheters offer an opioid-sparing technique that can be performed easily and safely. We present a case of a patient who underwent a breast flap reconstruction and had bilateral quadratus lumborum catheters placed for perioperative pain control. PMID:26984687

  6. Dynamic Frequency Analyses of Lower Extremity Muscles during Sit-To-Stand Motion for the Patients with Knee Osteoarthritis

    PubMed Central

    Suzuki, Kentaro; Yagi, Masahide

    2016-01-01

    Objective Muscle activities during the sit-to-stand motion (STS) are characterized by coordinated movements between hip extensors and knee extensors. However, previous reports regarding the STS and lower extremity muscle activities have focused on some quantitative assessment, but little qualitative research. This study aimed to examine the muscle activities of the lower extremity both quantitatively and qualitatively. Methods Study participants included 13 patients with knee osteoarthritis (knee OA) and 11 age-matched asymptomatic controls. The task was STS from a chair with a height-adjustable seat. EMG activities were acquired using surface electromyogram. The root mean square signals normalized as a percentage of maximum voluntary isometric contraction values (RMS%MVC) and the mean power frequency (MPF) were calculated. Results During STS, knee OA patients had increased RMS%MVC of the vastus medialis and raised MPF of the rectus femoris before buttocks-off. Conclusion These findings suggest that STS of knee OA patients not only increased relative muscle activity of the vastus medialis, but also enlisted the rectus femoris in knee extension to improve muscle contraction force by activating more type II fibers to accomplish buttocks-off. PMID:26807578

  7. Functional morphometry demonstrates extraocular muscle compartmental contraction during vertical gaze changes.

    PubMed

    Clark, Robert A; Demer, Joseph L

    2016-01-01

    Anatomical studies demonstrate selective compartmental innervation of most human extraocular muscles (EOMs), suggesting the potential for differential compartmental control. This was supported by magnetic resonance imaging (MRI) demonstrating differential lateral rectus (LR) compartmental contraction during ocular counterrolling, differential medial rectus (MR) compartmental contraction during asymmetric convergence, and differential LR, inferior rectus (IR), and superior oblique (SO) compartmental contraction during vertical vergence. To ascertain possible differential compartmental EOM contraction during vertical ductions, surface coil MRI was performed over a range of target-controlled vertical gaze positions in 25 orbits of 13 normal volunteers. Cross-sectional areas and partial volumes of EOMs were analyzed in contiguous, quasi-coronal 2-mm image planes spanning origins to globe equator to determine morphometric features correlating best with contractility. Confirming and extending prior findings for horizontal EOMs during horizontal ductions, the percent change in posterior partial volume (PPV) of vertical EOMs from 8 to 14 mm posterior to the globe correlated best with vertical duction. EOMs were then divided into equal transverse compartments to evaluate the effect of vertical gaze on changes in PPV. Differential contractile changes were detected in the two compartments of the same EOM during infraduction for the IR medial vs. lateral (+4.4%, P = 0.03), LR inferior vs. superior (+4.0%, P = 0.0002), MR superior vs. inferior (-6.0%, P = 0.001), and SO lateral vs. medial (+9.7%, P = 0.007) compartments, with no differential contractile changes in the superior rectus. These findings suggest that differential compartmental activity occurs during normal vertical ductions. Thus all EOMs may contribute to cyclovertical actions. PMID:26538608

  8. The Effect of Warm-Up and Cool-Down Exercise on Delayed Onset Muscle Soreness in the Quadriceps Muscle: a Randomized Controlled Trial

    PubMed Central

    Olsen, Olav; Sjøhaug, Mona; van Beekvelt, Mireille; Mork, Paul Jarle

    2012-01-01

    The aim of the present study was to investigate the effect of warm-up and cool-down exercise on delayed onset of muscle soreness at the distal and central parts of rectus femoris following leg resistance exercise. Thirty-six volunteers (21 women, 15 men) were randomly assigned to the warm-up (20 min ergometer cycling prior to the resistance exercise), cool-down (20 min cycling after the resistance exercise), or control group performing resistance exercise only. The resistance exercise consisted of front lunges (10×5 repetitions/sets) with external loading of 40% (women) and 50% (men) of body mass. Primary outcomes were pressure pain threshold along rectus femoris and maximal isometric knee extension force. Data were recorded before the resistance exercise and on the two consecutive days. Pressure pain threshold at the central muscle belly was significantly reduced for the control group on both day 2 and 3 (p≤0.003) but not for the warm-up group (p≥0.21). For the cool-down group, pressure pain threshold at the central muscle belly was significantly reduced on day 2 (p≤0.005) and was also lower compared to the warm-up group (p=0.025). Force was significantly reduced on day 2 and 3 for all groups (p<0.001). This study indicates that aerobic warm-up exercise performed prior to resistance exercise may prevent muscle soreness at the central but not distal muscle regions, but it does not prevent loss of muscle force. PMID:23486850

  9. Cosmetic Surgery

    MedlinePlus

    ... defect or cosmetic flaw that has diminished their self-esteem over time. It's important to remember that cosmetic ... can create both physical changes and changes in self-esteem. But if you are seeking surgery with the ...

  10. Thyroid Surgery

    MedlinePlus

    ... thyroid surgery, requiring treatment with thyroid hormone (see Hypothyroidism brochure ). This is especially true if you had ... Nodules Goiter Graves’ Disease Hashimoto’s Thyroiditis Hyperthyroidism (Overactive) Hypothyroidism (Underactive) Iodine Deficiency Low Iodine Diet Radioactive Iodine ...

  11. Brain surgery

    MedlinePlus

    Craniotomy; Surgery - brain; Neurosurgery; Craniectomy; Stereotactic craniotomy; Stereotactic brain biopsy; Endoscopic craniotomy ... cut depends on where the problem in the brain is located. The surgeon creates a hole in ...

  12. Rodding Surgery

    MedlinePlus

    ... Rods can be made of stainless steel or titanium. Regular rods do not expand. They have many ... v regular), the rod materials (stainless steel v titanium) and the age for a first rodding surgery. ...

  13. Advances in quantitative muscle ultrasonography using texture analysis of ultrasound images.

    PubMed

    Molinari, Filippo; Caresio, Cristina; Acharya, U Rajendra; Mookiah, Muthu Rama Krishnan; Minetto, Marco Alessandro

    2015-09-01

    Musculoskeletal ultrasound imaging can be used to investigate the skeletal muscle structure in terms of architecture (thickness, cross-sectional area, fascicle length and fascicle pennation angle) and texture. Gray-scale analysis is commonly used to characterize transverse scans of the muscle. Gray mean value is used to distinguish between normal and pathologic muscles, but it depends on the image acquisition system and its settings. In this study, quantitative ultrasonography was performed on five muscles (biceps brachii, vastus lateralis, rectus femoris, medial gastrocnemius and tibialis anterior) of 20 healthy patients (10 women, 10 men) to assess the characterization performance of higher-order texture descriptors to differentiate genders and muscle types. A total of 53 features (7 first-order descriptors, 24 Haralick features, 20 Galloway features and 2 local binary pattern features) were extracted from each muscle region of interest (ROI) and were used to perform the multivariate linear regression analysis (MANOVA). Our results show that first-order descriptors, Haralick features (energy, entropy and correlation measured along different angles) and local binary pattern (LBP) energy and entropy were highly linked to the gender, whereas Haralick entropy and symmetry, Galloway texture descriptors and LBP entropy helped to distinguish muscle types. Hence, the combination of first-order and higher-order texture descriptors (Haralick, Galloway and LBP) can be used to discriminate gender and muscle types. Therefore, multi-texture analysis may be useful to investigate muscle damage and myopathic disorders. PMID:26026375

  14. How different modes of child delivery influence abdominal muscle activities in the active straight leg raise.

    PubMed

    Kwon, Yu-Jeong; Hyung, Eun-Ju; Yang, Kyung-Hye; Lee, Hyun-Ok

    2014-08-01

    [Purpose] The purpose of this study was to examine the activities of the abdominal muscles of women who had experienced vaginal delivery in comparison with those who had experienced Cesarean childbirth. [Subjects and Methods] A total of 14 subjects (7 vaginal delivery, 7 Cesarean section) performed an active straight leg raise to 20 cm above the ground, and we measured the activities of the internal oblique abdominal muscle, the external oblique abdominal muscle, and the rectus abdominal muscle on both sides using electromyography. The effort required to raise the leg was scored on a Likert scale. Then, the subjects conducted maximum isometric contraction for hip joint flexion with the leg raised at 20 cm, and maximum torque and abdominal muscle activities were measured using electromyography. [Results] During the active straight leg raise, abdominal muscle activities were higher in the Cesarean section subjects. The Likert scale did not show a significant difference. The activities of the abdominal muscles and the maximum torque of the hip joint flexion at maximum isometric contraction were higher in the vaginal delivery subjects. [Conclusion] The abdominal muscles of Cesarean section subjects showed greater recruitment for maintaining pelvic stability during the active straight leg raising, but were relatively weaker when powerful force was required. Therefore, we consider that more abdominal muscle training is necessary for maintaining pelvic stability of Cesarean section subjects. PMID:25202194

  15. Kinesiology Taping does not Modify Electromyographic Activity or Muscle Flexibility of Quadriceps Femoris Muscle: A Randomized, Placebo-Controlled Pilot Study in Healthy Volleyball Players

    PubMed Central

    Halski, Tomasz; Dymarek, Robert; Ptaszkowski, Kuba; Słupska, Lucyna; Rajfur, Katarzyna; Rajfur, Joanna; Pasternok, Małgorzata; Smykla, Agnieszka; Taradaj, Jakub

    2015-01-01

    Background Kinesiology taping (KT) is a popular method of supporting professional athletes during sports activities, traumatic injury prevention, and physiotherapeutic procedures after a wide range of musculoskeletal injuries. The effectiveness of KT in muscle strength and motor units recruitment is still uncertain. The objective of this study was to assess the effect of KT on surface electromyographic (sEMG) activity and muscle flexibility of the rectus femoris (RF), vastus lateralis (VL), and vastus medialis (VM) muscles in healthy volleyball players. Material/Methods Twenty-two healthy volleyball players (8 men and 14 women) were included in the study and randomly assigned to 2 comparative groups: “kinesiology taping” (KT; n=12; age: 22.30±1.88 years; BMI: 22.19±4.00 kg/m2) in which KT application over the RF muscle was used, and “placebo taping” (PT; n=10; age: 21.50±2.07 years; BMI: 22.74±2.67 kg/m2) in which adhesive nonelastic tape over the same muscle was used. All subjects were analyzed for resting sEMG activity of the VL and VM muscles, resting and functional sEMG activity of RF muscle, and muscle flexibility of RF muscle. Results No significant differences in muscle flexibility of the RF muscle and sEMG activity of the RF, VL, and VM muscles were registered before and after interventions in both groups, and between the KT and PT groups (p>0.05). Conclusions The results show that application of the KT to the RF muscle is not useful to improve sEMG activity. PMID:26232122

  16. Open heart surgery

    MedlinePlus

    ... Heart bypass surgery (coronary artery bypass graft - CABG) Heart transplant Heart valve surgery Hypoplastic left heart repair Minimally ... Heart bypass surgery Heart bypass surgery - minimally invasive Heart transplant Heart valve surgery Hypoplastic left heart syndrome Patent ...

  17. Tennis elbow surgery

    MedlinePlus

    Lateral epicondylitis - surgery; Lateral tendinosis - surgery; Lateral tennis elbow - surgery ... Surgery to repair tennis elbow is usually an outpatient surgery. This means you will not stay in the hospital overnight. You will be ...

  18. 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

  19. 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

  20. The effect of backpack heaviness on trunk-lower extremity muscle activities and trunk posture.

    PubMed

    Al-Khabbaz, Yusuf S S M; Shimada, Tomoaki; Hasegawa, Masashi

    2008-08-01

    The purpose of the present study is to analyze trunk-lower extremity muscle activities and trunk postural changes during the carriage of different backpacks. Nineteen male university students (21+/-3 years) participated in the experiment's four standing modes: (1) unloaded standing, (2) 10% body weight (BW) load (in the form of a backpack), (3) 15% BW load and (4) 20% BW load. Bilateral rectus abdominis, erector spinae, vastus medialis and biceps femoris muscle activities were recorded using surface electromyography (SEMG), while trunk inclination, side flexion and rotation were measured by using VICON 250 during all standing modes. The results showed that rectus abdominis muscle activities increased progressively and disproportionably as the backpack load increased. As for the trunk posture, almost the same backward inclination was adapted even with increasing backpack heaviness. Twenty percent BW backpack causes the most significant muscular and postural changes so it should be avoided. However, it is recommended to study other backpack factors such as frequency of usage, usage time, type of the backpack and age to come up with a complete usage recommendation. PMID:18329270

  1. Changes in hip joint muscle-tendon lengths with mode of locomotion.

    PubMed

    Riley, Patrick O; Franz, Jason; Dicharry, Jay; Kerrigan, D Casey

    2010-02-01

    We have reported that peak hip extension is nearly identical in walking and running, suggesting that anatomical constraints, such as flexor muscle tightness may limit the range of hip extension. To obtain a more mechanistic insight into mobility at the hip and pelvis we examined the lengths of the muscle-tendons units crossing the hip joint. Data defining the three-dimensional kinematics of 26 healthy runners at self-selected walking and running speeds were obtained. These data were used to scale and drive musculoskeletal models using OpenSIM. Muscle-tendon unit (MTU) lengths were calculated for the trailing limb illiacus, rectus femoris, gluteus maximus, and biceps femoris long head and the advancing limb biceps femoris and gluteus maximus. The magnitude and timing of MTU length peaks were each compared between walking and running. The peak length of the right (trailing limb) illiacus MTU, a pure hip flexor, was nearly identical between walking and running, while the maximum length of the rectus femoris MTU, a hip flexor and knee extensor, increased during running. The maximum length of the left (leading limb) biceps femoris was also unchanged between walking and running. Further, the timing of peak illiacus MTU length and peak contralateral biceps femoris MTU length occurred essentially simultaneously during running, at a time during gait when the hamstrings are most vulnerable to stretch injury. This latter finding suggests exploring the role for hip flexor stretching in combination with hamstring stretching to treat and/or prevent running related hamstring injury. PMID:20022251

  2. Electromechanical delay of abdominal muscles is modified by low back pain prevention exercise.

    PubMed

    Szpala, Agnieszka; Rutkowska-Kucharska, Alicja; Drapala, Jaroslaw

    2014-01-01

    The objective of the research was to assess the effect of a 4-week-long training program on selected parameters: electromechanical delay (EMD) and amplitude of electromyographic signal (EMG). Fourteen female students of the University School of Physical Education participated in the study. Torques and surface electromyography were evaluated under static conditions. Surface electrodes were glued to both sides of the rectus abdominis (RA), external oblique (EO), and erector spinae (ES) muscles. The 4-week-long program was aimed at strengthening the abdominal muscles and resulted in increased EMD during maximum torque production by flexors of the trunk, increased amplitudes of the signals of the erector spinae ( p = 0.005), and increased EMG amplitude asymmetry of the lower ( p = 0.013) and upper part ( p = 0.006) of the rectus abdominis muscle. In a training program composed of a large number of repetitions of strength exercises, in which the training person uses their own weight as the load (like in exercises such as curl-ups), the process of recruitment of motor units is similar to that found during fatiguing exercises and plyometric training. PMID:25307027

  3. Muscle Activation Differs between Three Different Knee Joint-Angle Positions during a Maximal Isometric Back Squat Exercise

    PubMed Central

    Jarbas da Silva, Josinaldo; Jon Schoenfeld, Brad; Nardi, Priscyla Silva Monteiro; Pecoraro, Silvio Luis; D'Andréa Greve, Julia Maria; Hartigan, Erin

    2016-01-01

    The purpose of this study was to compare muscle activation of the lower limb muscles when performing a maximal isometric back squat exercise over three different positions. Fifteen young, healthy, resistance-trained men performed an isometric back squat at three knee joint angles (20°, 90°, and 140°) in a randomized, counterbalanced fashion. Surface electromyography was used to measure muscle activation of the vastus lateralis (VL), vastus medialis (VM), rectus femoris (RF), biceps femoris (BF), semitendinosus (ST), and gluteus maximus (GM). In general, muscle activity was the highest at 90° for the three quadriceps muscles, yet differences in muscle activation between knee angles were muscle specific. Activity of the GM was significantly greater at 20° and 90° compared to 140°. The BF and ST displayed similar activation at all joint angles. In conclusion, knee position alters muscles activation of the quadriceps and gluteus maximus muscles. An isometric back squat at 90° generates the highest overall muscle activation, yet an isometric back squat at 140° generates the lowest overall muscle activation of the VL and GM only. PMID:27504484

  4. Effect of the Mandibular Orthopedic Repositioning Appliance on Trunk and Upper Limb Muscle Activation during Maximum Isometric Contraction

    PubMed Central

    Lee, Sang-Yeol; Hong, Min-Ho; Park, Min-Chull; Choi, Sung-Min

    2013-01-01

    [Purpose] The purpose of this study was to measure the muscle activities of the trunk muscles and upper limb muscles during maximum isometric contraction when temporomandibular joint alignment was achieved with a mandibular orthopedic repositioning appliance in order provide basic data on the effects of mandibular orthopedic repositioning appliance on the entire body. [Subjects] The present study was conducted with healthy Korean adults in their 20s (males=10, females=10). [Methods] An 8 channel surface electromyography system was used to measure the muscle activities of the upper limb muscles and neck muscles of the subjects during maximum isometric contraction with and without use of a mandibular orthopedic repositioning appliance. [Results] The maximum isometric contractions of the trunk and upper limb muscles when mandibular orthopedic repositioning appliance were used were compared with those when no mandibular orthopedic repositioning appliance was used. The results showed that the sternocleidomastoid muscle, cervical and lumbar erector spinae, upper trapezius, biceps, triceps, rectus abdominis and internal oblique and external oblique muscles all showed significant increases in maximum isometric contractions with a mandibular orthopedic repositioning appliance. [Conclusion] The use of a mandibular orthopedic repositioning appliance is considered to be a method for normal adults to improve the stability of the entire body with the improvement of the stability of the TMJ. The proximal improvement in stability improves of the proximal thereby improving not only muscle strength with increased muscle activation but also stability during exercises. PMID:24396194

  5. Evaluation of surgeon’s muscle fatigue during thoracoscopic pulmonary lobectomy using interoperative surface electromyography

    PubMed Central

    Yoon, Seung-Hyun; Jung, Myung-Chul

    2016-01-01

    Background The aim of this study was to document the physical stress experienced by a surgeon during thoracoscopic pulmonary lobectomy and mediastinal lymph node dissection for lung cancer by measuring the intraoperative electromyography (EMG). Methods Surface EMG was recorded during 12 cases of thoracoscopic lobectomy. During the operation, 16 channels of a wireless EMG were used to measure muscle activity and fatigue from the bilateral muscles of the splenius capitis (SC), upper trapezius (UT), middle deltoid (MD), flexor carpi radialis (FCR), extensor carpi radialis (ECR), lumbar erector spinae (LES), rectus femoralis (RF), and tibialis anterior (TA). The EMG signals were processed to collect the values of the root mean square for muscle activity and median frequency (MF) for muscle fatigue. Results All operations were completed without adverse events. The mean operating time was 99.16±35.15 minutes. During the operation, the mean muscle activity of all muscles was 21.91±12.85 mV. High muscle activity was observed in the bilateral FCR and ECR, whereas low muscle activity was observed in the bilateral SC and LES. The final MFs in the bilateral SC and LES were found to be decreased from the initial status, which implied increased muscle fatigue. The muscles of the right and left LES were significantly fatigued by up to 29% and 37% compared to their initial status (P=0.021 and P=0.007, respectively). The MFs of the bilateral LES decreased with time (an average decreases of 0.008/5 minutes, P=0.002 in right LES and 0.004/5 minutes, P=0.018 in left LES). Conclusions During thoracoscopic lobectomy, muscle fatigue was observed in muscles related to a static posture, such as the bilateral SC, UT, and ES. Further studies are required to investigate the ergonomic adjustments needed to reduce muscle fatigue in these static muscles. PMID:27293833

  6. 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

  7. The impact of the pelvic floor muscles on dynamic ventilation maneuvers

    PubMed Central

    Park, Hankyu; Hwang, Byoungha; Kim, Yeoungsung

    2015-01-01

    [Purpose] The aim of the present study was to examine the impact of the pelvic floor muscles (PFM) on dynamic ventilation maneuvers. [Subjects and Methods] The subjects were 19 healthy female adults in their 20s who consented to participate in the present study. Electromyography (EMG) was used to examine respiratory muscle activity, and a spirometer was used to examine vital capacity before and during contraction of the PFM. [Results] There were statistically significant differences in the sternocleidomastoid (SCM), rectus abdominis (RA), external oblique (EO), transverse abdominis/internal oblique (TrA/IO), and maximal voluntary ventilation (MVV) when the PFM was contracted. [Conclusion] Contraction of the PFM can be effective in promoting activation of the respiratory muscles and vital capacity. Therefore, the PFM should be considered to improve the effects of respiratory activity. PMID:26644664

  8. Behavior of the Linea Alba During a Curl-up Task in Diastasis Rectus Abdominis: An Observational Study.

    PubMed

    Lee, Diane; Hodges, Paul W

    2016-07-01

    Study Design Cross-sectional repeated measures. Background Rehabilitation of diastasis rectus abdominis (DRA) generally aims to reduce the inter-rectus distance (IRD). We tested the hypothesis that activation of the transversus abdominis (TrA) before a curl-up would reduce IRD narrowing, with less linea alba (LA) distortion/deformation, which may allow better force transfer between sides of the abdominal wall. Objectives This study investigated behavior of the LA and IRD during curl-ups performed naturally and with preactivation of the TrA. Methods Curl-ups were performed by 26 women with DRA and 17 healthy control participants using a natural strategy (automatic curl-up) and with TrA preactivation (TrA curl-up). Ultrasound images were recorded at 2 points above the umbilicus (U point and UX point). Ultrasound measures of IRD and a novel measure of LA distortion (distortion index: average deviation of the LA from the shortest path between the recti) were compared between 3 tasks (rest, automatic curl-up, TrA curl-up), between groups, and between measurement points (analysis of variance). Results Automatic curl-up by women with DRA narrowed the IRD from resting values (mean U-point between-task difference, -1.19 cm; 95% confidence interval [CI]: -1.45, -0.93; P<.001 and mean UX-point between-task difference, -0.51 cm; 95% CI: -0.69, -0.34; P<.001), but LA distortion increased (mean U-point between-task difference, 0.018; 95% CI: 0.0003, 0.041; P = .046 and mean UX-point between-task difference, 0.025; 95% CI: 0.004, 0.045; P = .02). Although TrA curl-up induced no narrowing or less IRD narrowing than automatic curl-up (mean U-point difference between TrA curl-up versus rest, -0.56 cm; 95% CI: -0.82, -0.31; P<.001 and mean UX-point between-task difference, 0.02 cm; 95% CI: -0.22, 0.19; P = .86), LA distortion was less (mean U-point between-task difference, -0.025; 95% CI: -0.037, -0.012; P<.001 and mean UX-point between-task difference, -0.021; 95% CI: -0.038, -0

  9. Robotic Surgery

    PubMed Central

    Lanfranco, Anthony R.; Castellanos, Andres E.; Desai, Jaydev P.; Meyers, William C.

    2004-01-01

    Objective: To review the history, development, and current applications of robotics in surgery. Background: Surgical robotics is a new technology that holds significant promise. Robotic surgery is often heralded as the new revolution, and it is one of the most talked about subjects in surgery today. Up to this point in time, however, the drive to develop and obtain robotic devices has been largely driven by the market. There is no doubt that they will become an important tool in the surgical armamentarium, but the extent of their use is still evolving. Methods: A review of the literature was undertaken using Medline. Articles describing the history and development of surgical robots were identified as were articles reporting data on applications. Results: Several centers are currently using surgical robots and publishing data. Most of these early studies report that robotic surgery is feasible. There is, however, a paucity of data regarding costs and benefits of robotics versus conventional techniques. Conclusions: Robotic surgery is still in its infancy and its niche has not yet been well defined. Its current practical uses are mostly confined to smaller surgical procedures. PMID:14685095

  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. Evaluation of three-dimensional printing for internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach: a preliminary report

    PubMed Central

    Zeng, Canjun; Xiao, Jidong; Wu, Zhanglin; Huang, Wenhua

    2015-01-01

    Objective: The aim of this study is to evaluate the efficacy and feasibility of three-dimensional printing (3D printing) assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach. Methods: A total of 38 patients with unstable pelvic fractures were analyzed retrospectively from August 2012 to February 2014. All cases were treated operatively with internal fixation assisted by three-dimensional printing from minimal invasive para-rectus abdominis approach. Both preoperative CT and three-dimensional reconstruction were performed. Pelvic model was created by 3D printing. Data including the best entry points, plate position and direction and length of screw were obtained from simulated operation based on 3D printing pelvic model. The diaplasis and internal fixation were performed by minimal invasive para-rectus abdominis approach according to the optimized dada in real surgical procedure. Matta and Majeed score were used to evaluate currative effects after operation. Results: According to the Matta standard, the outcome of the diaplasis achieved 97.37% with excellent and good. Majeed assessment showed 94.4% with excellent and good. The imageological examination showed consistency of internal fixation and simulated operation. The mean operation time was 110 minutes, mean intraoperative blood loss 320 ml, and mean incision length 6.5 cm. All patients have achieved clinical healing, with mean healing time of 8 weeks. Conclusion: Three-dimensional printing assisted internal fixation of unstable pelvic fracture from minimal invasive para-rectus abdominis approach is feasible and effective. This method has the advantages of trauma minimally, bleeding less, healing rapidly and satisfactory reduction, and worthwhile for spreading in clinical practice. PMID:26550226

  12. Structural functional associations of the orbit in thyroid eye disease: Kalman filters to track extraocular rectal muscles

    NASA Astrophysics Data System (ADS)

    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L.; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-03-01

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention, and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, it is shown that the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease.

  13. 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.

  14. Structural Functional Associations of the Orbit in Thyroid Eye Disease: Kalman Filters to Track Extraocular Rectal Muscles

    PubMed Central

    Chaganti, Shikha; Nelson, Katrina; Mundy, Kevin; Luo, Yifu; Harrigan, Robert L; Damon, Steve; Fabbri, Daniel; Mawn, Louise; Landman, Bennett

    2016-01-01

    Pathologies of the optic nerve and orbit impact millions of Americans and quantitative assessment of the orbital structures on 3-D imaging would provide objective markers to enhance diagnostic accuracy, improve timely intervention and eventually preserve visual function. Recent studies have shown that the multi-atlas methodology is suitable for identifying orbital structures, but challenges arise in the identification of the individual extraocular rectus muscles that control eye movement. This is increasingly problematic in diseased eyes, where these muscles often appear to fuse at the back of the orbit (at the resolution of clinical computed tomography imaging) due to inflammation or crowding. We propose the use of Kalman filters to track the muscles in three-dimensions to refine multi-atlas segmentation and resolve ambiguity due to imaging resolution, noise, and artifacts. The purpose of our study is to investigate a method of automatically generating orbital metrics from CT imaging and demonstrate the utility of the approach by correlating structural metrics of the eye orbit with clinical data and visual function measures in subjects with thyroid eye disease. The pilot study demonstrates that automatically calculated orbital metrics are strongly correlated with several clinical characteristics. Moreover, the superior, inferior, medial and lateral rectus muscles obtained using Kalman filters are each correlated with different categories of functional deficit. These findings serve as foundation for further investigation in the use of CT imaging in the study, analysis and diagnosis of ocular diseases, specifically thyroid eye disease. PMID:27127330

  15. Tissue reactivity and degradation patterns of absorbable vascular ligating clips implanted in peritoneum and rectus fascia.

    PubMed

    Chegini, N; Metz, S A; Masterson, B J

    1990-07-01

    Absorbable vascular ligating clips are finding increasing use in intraabdominal surgery. We report the results of a light and scanning electron microscope investigation of the tissue reactivity and clip degradation patterns of two such materials, Absolok (polydioxanone) and Lactomer (copolymer of glycolic and lactic acid), implanted in the fascia and peritoneum of rabbits for intervals of 2 to 70 days. Cellular response to the clips, defined as the number of inflammatory cells/10(4) microns 2, was maximum at day 4 postimplantation, then gradually declined as the duration of implantation increased. This pattern, seen with both types of clips, was similar to that seen with polydioxanone (PDS) suture, but significantly greater than that associated with polypropylene (Prolene) suture. Although cellular response to the clips was greater in peritoneum than in fascia, especially on two occasions associated with adhesion formation, this was not statistically significant. Based on our morphological observations, the signs of clip degradation which were indicated by the appearance of surface crazing and cracks occurred earlier in peritoneum than in fascia. PMID:2118910

  16. Changes in Tibiofemoral Forces due to Variations in Muscle Activity during Walking

    PubMed Central

    DeMers, Matthew S.; Pal, Saikat; Delp, Scott L.

    2015-01-01

    Muscles induce large forces in the tibiofemoral joint during walking and thereby influence the health of tissues like articular cartilage and menisci. It is possible to walk with a wide variety of muscle coordination patterns, but the effect of varied muscle coordination on tibiofemoral contact forces remains unclear. The goal of this study was to determine the effect of varied muscle coordination on tibiofemoral contact forces. We developed a musculoskeletal model of a subject walking with an instrumented knee implant. Using an optimization framework, we calculated the tibiofemoral forces resulting from muscle coordination that reproduced the subject’s walking dynamics. We performed a large set of optimizations in which we systematically varied the coordination of muscles to determine the influence on tibiofemoral force. Model-predicted tibiofemoral forces arising with minimum muscle activation matched in vivo forces measured during early stance, but were greater than in vivo forces during late stance. Peak tibiofemoral forces during late stance could be reduced by increasing the activation of the gluteus medius, uniarticular hip flexors, and soleus, and by decreasing the activation of the gastrocnemius and rectus femoris. These results suggest that retraining of muscle coordination could substantially reduce tibiofemoral forces during late stance. PMID:24615885

  17. 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 ...

  18. 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.

  19. FGFR1 inhibits skeletal muscle atrophy associated with hindlimb suspension

    PubMed Central

    Eash, John; Olsen, Aaron; Breur, Gert; Gerrard, Dave; Hannon, Kevin

    2007-01-01

    Background Skeletal muscle atrophy can occur under many different conditions, including prolonged disuse or immobilization, cachexia, cushingoid conditions, secondary to surgery, or with advanced age. The mechanisms by which unloading of muscle is sensed and translated into signals controlling tissue reduction remains a major question in the field of musculoskeletal research. While the fibroblast growth factors (FGFs) and their receptors are synthesized by, and intimately involved in, embryonic skeletal muscle growth and repair, their role maintaining adult muscle status has not been examined. Methods We examined the effects of ectopic expression of FGFR1 during disuse-mediated skeletal muscle atrophy, utilizing hindlimb suspension and DNA electroporation in mice. Results We found skeletal muscle FGF4 and FGFR1 mRNA expression to be modified by hind limb suspension,. In addition, we found FGFR1 protein localized in muscle fibers within atrophying mouse muscle which appeared to be resistant to atrophy. Electroporation and ectopic expression of FGFR1 significantly inhibited the decrease in muscle fiber area within skeletal muscles of mice undergoing suspension induced muscle atrophy. Ectopic FGFR1 expression in muscle also significantly stimulated protein synthesis in muscle fibers, and increased protein degradation in weight bearing muscle fibers. Conclusion These results support the theory that FGF signaling can play a role in regulation of postnatal skeletal muscle maintenance, and could offer potentially novel and efficient therapeutic options for attenuating muscle atrophy during aging, illness and spaceflight. PMID:17425786

  20. Adaptation of muscle coordination to altered task mechanics during steady-state cycling.

    PubMed

    Neptune, R R; Herzog, W

    2000-02-01

    The objective of this work was to increase our understanding of how motor patterns are produced during movement tasks by quantifying adaptations in muscle coordination in response to altered task mechanics. We used pedaling as our movement paradigm because it is a constrained cyclical movement that allows for a controlled investigation of test conditions such as movement speed and effort. Altered task mechanics were introduced using an elliptical chainring. The kinematics of the crank were changed from a relatively constant angular velocity using a circular chainring to a widely varying angular velocity using an elliptical chainring. Kinetic, kinematic and muscle activity data were collected from eight competitive cyclists using three different chainrings--one circular and two different orientations of an elliptical chainring. We tested the hypotheses that muscle coordination patterns (EMG timing and magnitude), specifically the regions of active muscle force production, would shift towards regions in the crank cycle in which the crank angular velocity, and hence muscle contraction speeds, were favorable to produce muscle power as defined by the skeletal muscle power-velocity relationship. The results showed that our hypothesis with regards to timing was not supported. Although there were statistically significant shifts in muscle timing, the shifts were minor in absolute terms and appeared to be the result of the muscles accounting for the activation dynamics associated with muscle force development (i.e. the delay in muscle force rise and decay). But, significant changes in the magnitude of muscle EMG during regions of slow crank angular velocity for the tibialis anterior and rectus femoris were observed. Thus, the nervous system used adaptations to the muscle EMG magnitude, rather than the timing, to adapt to the altered task mechanics. The results also suggested that cyclists might work on the descending limb of the power-velocity relationship when pedaling at

  1. 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.

  2. Whole-Body muscle MRI in a series of patients with congenital myopathy related to TPM2 gene mutations.

    PubMed

    Jarraya, Mohamed; Quijano-Roy, Susana; Monnier, Nicole; Béhin, Anthony; Avila-Smirnov, Daniela; Romero, Norma Beatriz; Allamand, Valérie; Richard, Pascale; Barois, Annie; May, Adrien; Estournet, Brigitte; Mercuri, Eugenio; Carlier, Pierre G; Carlier, Robert-Yves

    2012-10-01

    Beta-tropomyosin 2 (TPM2) gene mutations are a rare cause of congenital myopathy with variable clinical and histological features. We describe muscle involvement using Whole-Body muscle Magnetic Resonance Imaging (WBMRI) in 8 individuals with genetically proven TPM2 mutations and different clinical and histological features (nemaline myopathy, 'cap disease', Bethlem-like phenotype, arthrogryposis). Most patients shared a recognizable MRI pattern with the involvement of masticatory and distal lower leg muscles. The lower leg showed constant soleus muscle involvement, and often also involvement of peroneus, tibialis anterior, and toe flexor muscles. Pelvic and shoulder girdles, and upper limbs muscles were quite spared. Two adult subjects (a patient and a paucisymptomatic parent) had a more diffuse involvement with striking fat infiltration of the rectus femoris muscle. Two children showed variant findings: one presented with masseter involvement associated with severe axial fat infiltration, the second had masticatory and distal leg muscle involvement (soleus and gastrocnemius muscles). Our study suggests that, independently of the clinical and histological presentation, most patients with TPM2 mutations show a predominant involvement of masticatory and distal leg muscles with the other regions relatively spared. More spread involvement may be observed. This cephalic-distal MRI pattern is not frequent in other known myopathies. PMID:22980765

  3. Articular geometry of the medial tarsometatarsal joint in the foot: comparison of metatarsus primus adductus and metatarsus primus rectus.

    PubMed

    Dykyj, D; Ateshian, G A; Trepal, M J; MacDonald, L R

    2001-01-01

    The three-dimensional surface geometry of the medial tarsometatarsal joint ("first metatarsocuneiform") of the first ray was analyzed to determine if the shape of the joint is distinct in the medially deviated first metatarsal with metatarsus primus adductus (MPA). Clinical evaluation of 29 cadaver feet identified 13 feet with MPA and 16 with metatarsus primus rectus (MPR). Three-dimensional (3D) coordinates x, y, z of the first metatarsal and medial cuneiform joint facets of the feet were digitized on a Coordinate Measuring Machine (accuracy = 0.01 mm) and the data fitted with B-spline surfaces from which 3D curvature maps were generated. Comparison of means of surface-averaged maximum and minimum principal curvatures and root-mean-square curvatures showed significant (p < .0005) differences between the MPA and MPR subsets, male and female subsets, and metatarsal and cuneiform subsets. These results show that the articular shape of the medial tarsometatarsal joint in feet with MPA is significantly less contoured, or is flatter, than the same joint in normal or MPR feet. Results also showed that the female joints are more curved than male joints, and that metatarsal and cuneiform facets closely conform in shape to each other. These preliminary results may be related to questions concerning the anatomical and functional basis for the first metatarsal deviation, for radiographic presentation of the joint and surgical options in correcting related forefoot deformities. PMID:11777231

  4. Carotid artery surgery

    MedlinePlus

    Carotid endarterectomy; CAS surgery; Carotid artery stenosis - surgery; Endarterectomy - carotid artery ... through the catheter around the blocked area during surgery. Your carotid artery is opened. The surgeon removes ...

  5. Arthroscopic Surgery.

    ERIC Educational Resources Information Center

    Connors, G. Patrick

    Arthroscopic surgery (or microsurgery) is a significant breakthrough in treating knee injuries. Its applications range from basic diagnosis to arthroscopic menisectomy, although its use in some procedures is still highly controversial. Many surgeons perform the diagnostic procedure, but follow this with the conventional surgical approach.…

  6. Preprosthetic Surgery.

    PubMed

    Ephros, Hillel; Klein, Robert; Sallustio, Anthony

    2015-08-01

    Preprosthetic oral and maxillofacial surgery has changed dramatically over the last 3 decades. Surgical preparation for dentures has been displaced by site development for implants. Nonetheless, there is still a role to play for several preprosthetic procedures. In this article, historical context is provided, enduring concepts are reviewed, and procedures that remain relevant are described and discussed. PMID:26231818

  7. Cosmetic surgery.

    PubMed Central

    Harris, D. L.

    1989-01-01

    The psychotherapeutic nature of cosmetic surgery is emphasised by outlining the range of symptoms from which patients suffer and by explaining the sequence of psychological reactions which cause them. The principles which govern the selection of patients are defined. A brief account of each of the main cosmetic operations is given together with notes on their limitations and risks. PMID:2589786

  8. Cardiac Surgery

    PubMed Central

    Weisse, Allen B.

    2011-01-01

    Well into the first decades of the 20th century, medical opinion held that any surgical attempts to treat heart disease were not only misguided, but unethical. Despite such reservations, innovative surgeons showed that heart wounds could be successfully repaired. Then, extracardiac procedures were performed to correct patent ductus arteriosus, coarctation of the aorta, and tetralogy of Fallot. Direct surgery on the heart was accomplished with closed commissurotomy for mitral stenosis. The introduction of the heart-lung machine and cardiopulmonary bypass enabled the surgical treatment of other congenital and acquired heart diseases. Advances in aortic surgery paralleled these successes. The development of coronary artery bypass grafting greatly aided the treatment of coronary heart disease. Cardiac transplantation, attempts to use the total artificial heart, and the application of ventricular assist devices have brought us to the present day. Although progress in the field of cardiovascular surgery appears to have slowed when compared with the halcyon times of the past, substantial challenges still face cardiac surgeons. It can only be hoped that sufficient resources and incentive can carry the triumphs of the 20th century into the 21st. This review covers past developments and future opportunities in cardiac surgery. PMID:22163121

  9. Relationship between back muscle endurance and voluntary activation.

    PubMed

    Bottle, Emily; Strutton, Paul H

    2012-06-01

    There is some evidence that the Biering-Sorensen endurance test can discriminate low back pain sufferers from healthy individuals and can predict future back pain. This test relies on the subject's ability to voluntarily drive the back muscles. This neural drive, termed voluntary activation (VA) can be measured using the twitch interpolation technique. The aim of the current study was to investigate the relationship between back muscle endurance and VA. Twenty-one healthy volunteers (10 males) participated. Bilateral electromyographic recordings were obtained from erector spinae and rectus abdominis. Back extensor torque was recorded using a dynamometer. The protocol consisted of measurement of VA (using magnetic stimulation of the brain and assessment of the sizes of the evoked twitches) and measurement of endurance. There was a linear correlation (r(2)=1, P<0.01) between voluntary torque and VA. The mean (SEM) endurance time was 174.9 (12.8)s. There was no correlation between endurance and VA at either 100% MVC (r(2)=0.01, P=0.72) or at 50% MVC (r(2)=0.11, P=0.16). These findings indicate that the endurance of the back muscles, as assessed using this widely utilised test does not appear to be related to a subject's ability to drive their back muscles voluntarily either maximally or submaximally. PMID:22387330

  10. Chest wall reconstruction using iliac bone allografts and muscle flaps.

    PubMed

    Garcia-Tutor, Emilio; Yeste, Luis; Murillo, Julio; Aubá, Cristina; Sanjulian, Mikel; Torre, Wenceslao

    2004-01-01

    Technically we can divide full-thickness thoracic reconstruction into 2 parts: providing a rigid support and ensuring well-vascularized coverage. Since 1986, the authors' center has had ample experience with bone banks and the use of cryopreserved bone grafts, which led them to consider the possibility of using these grafts for full-thickness chest wall reconstruction. They describe 3 patients in whom resection of the tumor and reconstruction of the thorax were carried out using iliac bone allografts covered with muscle flaps (1 pectoralis major and 2 rectus abdominis). None of the patients experienced breathing difficulties, pain, or instability after 14 months, 18 months, and 11 years of follow-up. The result of the reconstruction was excellent in all 3 patients in terms of function and aesthetics. The advantage of allografts compared with synthetic materials is their potential integration; they can become part of the host patient's living tissue. PMID:14676700

  11. Abdominal perforator vs. muscle sparing flaps for breast reconstruction

    PubMed Central

    Wu, Liza C.

    2015-01-01

    Abdominally based free flaps have become the mainstay for women that desire to use their own tissue as a means of breast reconstruction after mastectomy. As the techniques have evolved, significant effort has been invested in finding the best means of minimizing morbidity to the abdominal donor site while ensuring a viable reconstructed breast that is aesthetically pleasing. This manuscript reviews and compares the muscle sparing free transverse rectus abdominis myocutaneous (MsfTRAM), the deep inferior epigastric artery perforator (DIEP), and the superficial inferior epigastric artery (SIEA) flaps, regarding flap success rate, operative times, abdominal donor site morbidity and residual functionality, hospital lengths of stay and associated costs, impact of co-morbid conditions, and resilience after adjuvant radiation treatment. PMID:26161306

  12. Abdominal perforator vs. muscle sparing flaps for breast reconstruction.

    PubMed

    Butler, Paris D; Wu, Liza C

    2015-06-01

    Abdominally based free flaps have become the mainstay for women that desire to use their own tissue as a means of breast reconstruction after mastectomy. As the techniques have evolved, significant effort has been invested in finding the best means of minimizing morbidity to the abdominal donor site while ensuring a viable reconstructed breast that is aesthetically pleasing. This manuscript reviews and compares the muscle sparing free transverse rectus abdominis myocutaneous (MsfTRAM), the deep inferior epigastric artery perforator (DIEP), and the superficial inferior epigastric artery (SIEA) flaps, regarding flap success rate, operative times, abdominal donor site morbidity and residual functionality, hospital lengths of stay and associated costs, impact of co-morbid conditions, and resilience after adjuvant radiation treatment. PMID:26161306

  13. Electrophoretic analysis of proteins from single bovine muscle fibres.

    PubMed Central

    Young, O A; Davey, C L

    1981-01-01

    A number of single fibres were isolated by dissection of four bovine masseter (ma) muscles, three rectus abdominis (ra) muscles and eight sternomandibularis (sm) muscles. By histochemical criteria these muscles contain respectively, solely slow fibres (often called type I), predominantly fast fibres (type II), and a mixture of fast and slow. The fibres were analysed by conventional sodium dodecyl sulphate/polyacrylamide-gel electrophoresis and the gels stained with Coomassie Blue. Irrespective of the muscle, every fibre could be classed into one of two broad groups based on the mobility of proteins in the range 135000-170000 daltons. When zones containing myosin heavy chain were cut from the single-fibre gel tracks and 'mapped' [Cleveland, Fischer, Kirschner & Laemmli (1977) J. Biol. Chem. 252, 1102-1106] with Staphylococcus proteinase, it was found that one group always contained fast myosin heavy chain, whereas the second group always contained the slow form. Moreover, a relatively fast-migrating alpha-tropomyosin was associated with the fast myosin group and a slow-migrating form with the slow myosin group. All fibres also contained beta-tropomyosin; the coexistence of alpha- and beta-tropomyosin is at variance with evidence that alpha-tropomyosin is restricted to fast fibres [Dhoot & Perry (1979) Nature (London) 278, 714-718]. Fast fibres containing the expected fast light chains and troponins I and C fast were identified in the three ra muscles, but in only four sm muscles. In three other sm muscles, all the fast fibres contained two troponins I and an additional myosin light chain that was more typical of myosin light chain 1 slow. The remaining sm muscle contained a fast fibre type that was similar to the first type, except that its myosin light chain 1 was more typical of the slow polymorph. Troponin T was bimorphic in all fast fibres from a ra muscles and in at least some fast fibres from one sm muscle. Peptide 'mapping' revealed two forms of fast myosin

  14. Simultaneous bilateral breast reconstruction with the transverse rectus abdominus musculocutaneous free flap.

    PubMed Central

    Khouri, R K; Ahn, C Y; Salzhauer, M A; Scherff, D; Shaw, W W

    1997-01-01

    OBJECTIVE: The purpose of the study was to assess the results and morbidity associated with simultaneous bilateral TRAM free flap breast reconstruction and describe refinements in its surgical technique. SUMMARY BACKGROUND DATA: Bilateral prophylactic total mastectomies might be an agreeable option for those patients at highest risk for breast cancer if autogenous tissue breast reconstruction could be performed with reasonable technical ease and acceptable morbidity. However, some surgeons harbor reservations regarding the extensiveness of the surgery, the associated morbidity, and the aesthetic quality of the resulting outcome. METHODS: A multicenter retrospective review of clinical experience with 120 consecutive patients who underwent 240 simultaneous bilateral TRAM free flap breast reconstructions was developed. RESULTS: The average operating time, including the time required for the breast ablative portion of the procedures, was 8.6 hours. The average length of hospitalization was 7.6 days. However, for the last 40 patients, these figures were reduced to 7.1 hours and 6.1 days, respectively. Nonautologous blood transfusions were needed in 33 cases (28%), but only 1 was required in the last 40 patients. Thromboses developed in six of 240 flaps (2.5%): 4 were arterial and 2 were venous. Re-exploration allowed us to restore circulation in five flaps, whereas one flap was unsalvageable and was replaced successfully with an alternate flap. An uncomplicated deep vein thromboses developed in one patient with a history of recurrent deep vein thromboses that had no adverse effect on her outcome. Minor complications developed in 18 patients (15%) (e.g., hematoma, partial wound necrosis, wound infection, or prolonged postoperative ileus) that did not affect the long-term outcome. Fourteen patients (11.6%) had abdominal wall weakness or hernias. Follow-up time averaged 37.2 months (range, 14-62 months). On last follow-up, patients' self-reported overall satisfaction with

  15. Surgery for Breast Cancer

    MedlinePlus

    ... Next Topic Breast-conserving surgery (lumpectomy) Surgery for breast cancer Most women with breast cancer have some type ... Relieve symptoms of advanced cancer Surgery to remove breast cancer There are two main types of surgery to ...

  16. Scoliosis surgery - child

    MedlinePlus

    Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child ... Before surgery, your child will receive general anesthesia. This will make ... and unable to feel pain during the operation. During ...

  17. Lung Carcinoid Tumor: Surgery

    MedlinePlus

    ... for lung carcinoid tumor symptoms Surgery to treat lung carcinoid tumors Surgery is the main treatment for ... often be cured by surgery alone. Types of lung surgery Different operations can be used to treat ( ...

  18. LASIK - Laser Eye Surgery

    MedlinePlus

    ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ... Uveitis Focus On Pediatric Ophthalmology Education Center Oculofacial Plastic Surgery Center Laser Surgery Education Center Redmond Ethics ...

  19. Refractive corneal surgery - discharge

    MedlinePlus

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... You had refractive corneal surgery to help improve your vision. This surgery uses a laser to reshape your cornea. It corrects ...

  20. What Is Refractive Surgery?

    MedlinePlus

    ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Academy Publications EyeNet Ophthalmology ... Plastic Surgery Center Laser Surgery Education Center Redmond Ethics Center Global Ophthalmology Guide Find an Ophthalmologist Advanced ...

  1. Bloodless surgery in geriatric surgery.

    PubMed

    Guarino, Salvatore; Di Matteo, Filippo; Sorrenti, Salvatore; Greco, Roberto; Nardi, Matteo; Favoriti, Pasqualino; De Antoni, Enrico; Filippini, Angelo; Catania, Antonio

    2014-01-01

    In bloodless surgery a series of measures has to be implemented to reduce the perioperative need for transfusion of whole blood or its components. Jehovah's Witness are the most representative group of patients opting for bloodless surgery as their faith follows strict believes that prohibits receiving blood. Geriatric patients requiring bloodless surgery are even more delicate and represent a challenge for surgeons. The physiological response of the over 65 year population to decreased hemoglobin level is slower and less effective than in young and adult patients. Herby we describe the perioperative protocol implemented in our surgical Department offered to geriatric Jehovah's Witness patients. Preoperative optimization of the patients is the key step in the preparation period. Intraoperative anesthetic and surgical measures are also required along with a strict postoperative follow-up. From our experience, bloodless surgery is feasible in the geriatric population as long as it is performed in specialized centers where a multidisciplinary team is prepared to specifically manage this scenario. Rigorous patients selection and preparation are mandatory. PMID:25183638

  2. [Tumor surgery].

    PubMed

    Hausamen, J E

    2000-05-01

    Surgery is still the primary therapeutic approach in treatment of tumors in the head and neck area, dating back to the early nineteenth century. More than 150 years ago, hemimaxillectomies and mandibular resections as well as hemiglossectomies were already performed by leading surgeons. The block principle we are now following dates back to Crile, who also established the principle of cervical lymph node dissection. Ablative oncologic surgery has always been closely linked with plastic and reconstructive surgery, rendering radical surgical interventions possible without disfiguring patients. The development of facial reconstructive surgery proceeded in stages, in the first instance as secondary reconstruction using tube pedicled flaps. The change to the concept of primary reconstruction occurred via arterialized skin flaps and myocutaneous flaps to the widely accepted and performed free tissue transfer. Free bone grafting, inaugurated earlier and still representing the majority of bone grafting, has been supplemented for certain reconstructive purposes by free vascularized bone transfer from various donor sites. Although the five-year-survival rate of carcinoma of the oral cavity has remained unchanged in the past 30 years, distinctive improvements in tumor surgery can be recorded. This is primarily based on improved diagnostics such as modern imaging techniques and the refinement of surgical techniques. The DOSAK has worked out distinctive guidelines for effective ablative oncologic surgery. Surgical approaches offering wide exposure and carrying low morbidity play a decisive role in radical resections. For this reason, midfacial degloving offers an essential improvement for the resection of midface tumors, especially from an aesthetic point of view. Tumors situated deep behind the viscerocranium at the skull base can be clearly exposed either through a lateral approach following a temporary osteotomy of the mandibular ramus or a transmandibular, transmaxillar, or

  3. Eye muscle prosthesis.

    PubMed

    Scott, A B; Miller, J M; Collins, C C

    1992-01-01

    We inserted a silicone rubber elastic band along the course of a paralyzed lateral rectus and of a paralyzed superior oblique to restore alignment and to provide a spring against which the antagonist could pull. The lateral rectus band has been in place for 7 years. It provides alignment and a field of single binocular vision of 20 degrees. The superior oblique band has been in place for 17 months. It provides alignment and single vision over 30 degrees from the primary position except for a restriction in upgaze-adduction to 25 degrees (Brown syndrome) and in downgaze-adduction to 20 degrees. Such engineered elastic bands are a useful addition to current surgical techniques for management of cases of paralysis and restriction. PMID:1512661

  4. Motor nucleus activity fails to predict extraocular muscle forces in ocular convergence.

    PubMed

    Miller, Joel M; Davison, Ryan C; Gamlin, Paul D

    2011-06-01

    For a given eye position, firing rates of abducens neurons (ABNs) generally (Mays et al. 1984), and lateral rectus (LR) motoneurons (MNs) in particular (Gamlin et al. 1989a), are higher in converged gaze than when convergence is relaxed, whereas LR and medial rectus (MR) muscle forces are slightly lower (Miller et al. 2002). Here, we confirm this finding for ABNs, report a similarly paradoxical finding for neurons in the MR subdivision of the oculomotor nucleus (MRNs), and, for the first time, simultaneously confirm the opposing sides of these paradoxes by recording physiological LR and MR forces. Four trained rhesus monkeys with binocular eye coils and custom muscle force transducers on the horizontal recti of one eye fixated near and far targets, making conjugate saccades and symmetric and asymmetric vergence movements of 16-27°. Consistent with earlier findings, we found in 44 ABNs that the slope of the rate-position relationship for symmetric vergence (k(V)) was lower than that for conjugate movement (k(C)) at distance, i.e., mean k(V)/k(C) = 0.50, which implies stronger LR innervation in convergence. We also found in 39 MRNs that mean k(V)/k(C) = 1.53, implying stronger MR innervation in convergence as well. Despite there being stronger innervation in convergence at a given eye position, we found both LR and MR muscle forces to be slightly lower in convergence, -0.40 and -0.20 g, respectively. We conclude that the relationship of ensemble MN activity to total oculorotary muscle force is different in converged gaze than when convergence is relaxed. We conjecture that LRMNs with k(V) < k(C) and MRMNs with k(V) > k(C) innervate muscle fibers that are weak, have mechanical coupling that attenuates their effective oculorotary force, or serve some nonoculorotary, regulatory function. PMID:21451064

  5. What to Expect After Heart Surgery

    MedlinePlus

    ... call your doctor right away. After-effects of heart surgery are normal. They may include muscle pain, chest pain, or swelling (especially if you have an incision in your leg from coronary artery bypass grafting , or CABG). Other after-effects may include loss of appetite, problems sleeping, ...

  6. Active behavior of abdominal wall muscles: Experimental results and numerical model formulation.

    PubMed

    Grasa, J; Sierra, M; Lauzeral, N; Muñoz, M J; Miana-Mena, F J; Calvo, B

    2016-08-01

    In the present study a computational finite element technique is proposed to simulate the mechanical response of muscles in the abdominal wall. This technique considers the active behavior of the tissue taking into account both collagen and muscle fiber directions. In an attempt to obtain the computational response as close as possible to real muscles, the parameters needed to adjust the mathematical formulation were determined from in vitro experimental tests. Experiments were conducted on male New Zealand White rabbits (2047±34g) and the active properties of three different muscles: Rectus Abdominis, External Oblique and multi-layered samples formed by three muscles (External Oblique, Internal Oblique, and Transversus Abdominis) were characterized. The parameters obtained for each muscle were incorporated into a finite strain formulation to simulate active behavior of muscles incorporating the anisotropy of the tissue. The results show the potential of the model to predict the anisotropic behavior of the tissue associated to fibers and how this influences on the strain, stress and generated force during an isometric contraction. PMID:27111629

  7. Electromyographic responses of erector spinae and lower limb's muscles to dynamic postural perturbations in patients with adolescent idiopathic scoliosis.

    PubMed

    Farahpour, Nader; Ghasemi, Safoura; Allard, Paul; Saba, Mohammad Sadegh

    2014-10-01

    The aim of this study was to evaluate electromyographic (EMG) responses of erector spinae (ES) and lower limbs' muscles to dynamic forward postural perturbation (FPP) and backward postural perturbation (BPP) in patients with adolescent idiopathic scoliosis (AIS) and in a healthy control group. Ten right thoracic AIS patients (Cobb=21.6±4.4°) and 10 control adolescents were studied. Using bipolar surface electrodes, EMG activities of ES muscle at T10 (EST10) and L3 (ESL3) levels, biceps femoris (BF), gastrocnemius lateralis (G) and rectus femoris (RF) muscles in the right and the left sides during FPP and BPP were evaluated. Muscle responses were measured over a 1s time window after the onset of perturbation. In FPP test, the EMG responses of right EST10, ESL3 and BF muscles in the scoliosis group were respectively about 1.40 (p=0.035), 1.43 (p=0.07) and 1.45 (p=0.01) times greater than those in control group. Also, in BPP test, at right ESL3 muscle of the scoliosis group the EMG activity was 1.64 times higher than that in the control group (p=0.01). The scoliosis group during FPP displayed asymmetrical muscle responses in EST10 and BF muscles. This asymmetrical muscle activity in response to FPP is hypothesized to be a possible compensatory strategy rather than an inherent characteristic of scoliosis. PMID:25008019

  8. [Minimally invasive breast surgery].

    PubMed

    Mátrai, Zoltán; Gulyás, Gusztáv; Kunos, Csaba; Sávolt, Akos; Farkas, Emil; Szollár, András; Kásler, Miklós

    2014-02-01

    Due to the development in medical science and industrial technology, minimally invasive procedures have appeared in the surgery of benign and malignant breast diseases. In general , such interventions result in significantly reduced breast and chest wall scars, shorter hospitalization and less pain, but they require specific, expensive devices, longer surgical time compared to open surgery. Furthermore, indications or oncological safety have not been established yet. It is quite likely, that minimally invasive surgical procedures with high-tech devices - similar to other surgical subspecialties -, will gradually become popular and it may form part of routine breast surgery even. Vacuum-assisted core biopsy with a therapeutic indication is suitable for the removal of benign fibroadenomas leaving behind an almost invisible scar, while endoscopically assisted skin-sparing and nipple-sparing mastectomy, axillary staging and reconstruction with latissimus dorsi muscle flap are all feasible through the same short axillary incision. Endoscopic techniques are also suitable for the diagnostics and treatment of intracapsular complications of implant-based breast reconstructions (intracapsular fluid, implant rupture, capsular contracture) and for the biopsy of intracapsular lesions with uncertain pathology. Perception of the role of radiofrequency ablation of breast tumors requires further hands-on experience, but it is likely that it can serve as a replacement of surgical removal in a portion of primary tumors in the future due to the development in functional imaging and anticancer drugs. With the reduction of the price of ductoscopes routine examination of the ductal branch system, guided microdochectomy and targeted surgical removal of terminal ducto-lobular units or a "sick lobe" as an anatomical unit may become feasible. The paper presents the experience of the authors and provides a literature review, for the first time in Hungarian language on the subject. Orv. Hetil

  9. Assessment of bioelectrical activity of synergistic muscles during pelvic floor muscles activation in postmenopausal women with and without stress urinary incontinence: a preliminary observational study

    PubMed Central

    Ptaszkowski, Kuba; Paprocka-Borowicz, Małgorzata; Słupska, Lucyna; Bartnicki, Janusz; Dymarek, Robert; Rosińczuk, Joanna; Heimrath, Jerzy; Dembowski, Janusz; Zdrojowy, Romuald

    2015-01-01

    Objective Muscles such as adductor magnus (AM), gluteus maximus (GM), rectus abdominis (RA), and abdominal external and internal oblique muscles are considered to play an important role in the treatment of stress urinary incontinence (SUI), and the relationship between contraction of these muscles and pelvic floor muscles (PFM) has been established in previous studies. Synergistic muscle activation intensifies a woman’s ability to contract the PFM. In some cases, even for continent women, it is not possible to fully contract their PFM without involving the synergistic muscles. The primary aim of this study was to assess the surface electromyographic activity of synergistic muscles to PFM (SPFM) during resting and functional PFM activation in postmenopausal women with and without SUI. Materials and methods This study was a preliminary, prospective, cross-sectional observational study and included volunteers and patients who visited the Department and Clinic of Urology, University Hospital in Wroclaw, Poland. Forty-two patients participated in the study and were screened for eligibility criteria. Thirty participants satisfied the criteria and were categorized into two groups: women with SUI (n=16) and continent women (n=14). The bioelectrical activity of PFM and SPFM (AM, RA, GM) was recorded with a surface electromyographic instrument in a standing position during resting and functional PFM activity. Results Bioelectrical activity of RA was significantly higher in the incontinent group than in the continent group. These results concern the RA activity during resting and functional PFM activity. The results for other muscles showed no significant difference in bioelectrical activity between groups. Conclusion In women with SUI, during the isolated activation of PFM, an increased synergistic activity of RA muscle was observed; however, this activity was not observed in asymptomatic women. This may indicate the important accessory contribution of these muscles in the

  10. Correlation between Extraocular Muscle Size Measured by Computed Tomography and the Vertical Angle of Deviation in Thyroid Eye Disease

    PubMed Central

    Lee, Ju-Yeun; Bae, Kunho; Park, Kyung-Ah; Lyu, In Jeong; Oh, Sei Yeul

    2016-01-01

    The aim of this study was to investigate extraocular muscle (EOM) volume and cross-sectional area using computed tomography (CT), and to determine the relationship between EOM size and the vertical angle of deviation in thyroid eye disease (TED). Twenty-nine TED patients (58 orbits) with vertical strabismus were enrolled in the study. All patients underwent complete ophthalmic examination including prism, alternate cover, and Krimsky tests. Orbital CT scans were also performed on each patient. Digital image analysis was used to quantify superior rectus (SR) and inferior rectus (IR) muscle cross-sectional areas and volumes. Measurements were compared with those of controls. The correlation between muscle size and degree of vertical angle deviation was evaluated. The mean vertical angle of deviation was 26.2 ± 4.1 prism diopters. The TED group had a greater maximum cross-sectional area and EOM volume in the SR and IR than the control group (all p<0.001). Area and volume of the IR were correlated with the angle of deviation, but the SR alone did not show a significant correlation. The maximum cross-sectional area and volume of [Right IR + Left SR − Right SR − Left IR] was strongly correlated with the vertical angle of deviation (P<0.001). Quantitative CT of the orbit with evaluation of the area and volume of EOMs may be helpful in anticipating and monitoring vertical strabismus in TED patients. PMID:26820406

  11. 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 ...

  12. Importance of sarcomere length when determining muscle physiological cross-sectional area: a spine example.

    PubMed

    Brown, Stephen H M; Gerling, Michael E

    2012-05-01

    Muscle physiological cross-sectional area predicts the maximum capability of a muscle to generate isometric force. Biomechanical models often use estimates of individual muscle physiological cross-sectional area to partition internal forces among different muscles and predict joint forces and stability. In the spine literature, these physiological cross-sectional area values are generally obtained from imaging or cadaveric studies that have not accounted for a potential lengthened or shortened (and thus thinned or thickened, respectively) state of the muscles in question. Sarcomere length measurements can be used to normalize muscle lengths and correct for these length discrepancies. This article was designed to demonstrate potential effects of not accounting for instantaneous sarcomere length when calculating the physiological cross-sectional area of muscles of the spine region. Because some muscles of the spine region appear to be shortened and others lengthened in the neutral spine posture, both over- and under-estimations of physiological cross-sectional area are possible. Specifically, it is shown that the muscle physiological cross-sectional area could be over-estimated or under-estimated by as much as + 36% (multifidus) and -21% (rectus abdominis), respectively. This differential error effect poses difficulties in accurately estimating individual muscle forces and subsequent spine forces and stability that result from biomechanical models incorporating physiological cross-sectional area data obtained in the absence of sarcomere length measurements. Future work is needed to measure the dynamic range of sarcomere lengths of all spinal muscles to ensure correct inputs to biomechanical models. PMID:22720391

  13. Muscle activation patterns during walking from transtibial amputees recorded within the residual limb-prosthetic interface

    PubMed Central

    2012-01-01

    Background Powered lower limb prostheses could be more functional if they had access to feedforward control signals from the user’s nervous system. Myoelectric signals are one potential control source. The purpose of this study was to determine if muscle activation signals could be recorded from residual lower limb muscles within the prosthetic socket-limb interface during walking. Methods We recorded surface electromyography from three lower leg muscles (tibilias anterior, gastrocnemius medial head, gastrocnemius lateral head) and four upper leg muscles (vastus lateralis, rectus femoris, biceps femoris, and gluteus medius) of 12 unilateral transtibial amputee subjects and 12 non-amputee subjects during treadmill walking at 0.7, 1.0, 1.3, and 1.6 m/s. Muscle signals were recorded from the amputated leg of amputee subjects and the right leg of control subjects. For amputee subjects, lower leg muscle signals were recorded from within the limb-socket interface and from muscles above the knee. We quantified differences in the muscle activation profile between amputee and control groups during treadmill walking using cross-correlation analyses. We also assessed the step-to-step inter-subject variability of these profiles by calculating variance-to-signal ratios. Results We found that amputee subjects demonstrated reliable muscle recruitment signals from residual lower leg muscles recorded within the prosthetic socket during walking, which were locked to particular phases of the gait cycle. However, muscle activation profile variability was higher for amputee subjects than for control subjects. Conclusion Robotic lower limb prostheses could use myoelectric signals recorded from surface electrodes within the socket-limb interface to derive feedforward commands from the amputee’s nervous system. PMID:22882763

  14. Changes in Quadriceps Muscle Activity During Sustained Recreational Alpine Skiing

    PubMed Central

    Kröll, Josef; Müller, Erich; Seifert, John G.; Wakeling, James M.

    2011-01-01

    During a day of skiing thousands of repeated contractions take place. Previous research on prolonged recreational alpine skiing show that physiological changes occur and hence some level of fatigue is inevitable. In the present paper the effect of prolonged skiing on the recruitment and coordination of the muscle activity was investigated. Six subjects performed 24 standardized runs. Muscle activity during the first two (PREskiing) and the last two (POSTskiing) runs was measured from the vastus lateralis (VL) and rectus femoris (RF) using EMG and quantified using wavelet and principal component analysis. The frequency content of the EMG signal shifted in seven out of eight cases significantly towards lower frequencies with highest effects observed for RF on outside leg. A significant pronounced outside leg loading occurred during POSTskiing and the timing of muscle activity peaks occurred more towards turn completion. Specific EMG frequency changes were observed at certain time points throughout the time windows and not over the whole double turn. It is suggested that general muscular fatigue, where additional specific muscle fibers have to be recruited due to the reduced power output of other fibers did not occur. The EMG frequency decrease and intensity changes for RF and VL are caused by altered timing (coordination) within the turn towards a most likely more uncontrolled skiing technique. Hence, these data provide evidence to suggest recreational skiers alter their skiing technique before a potential change in muscle fiber recruitment occurs. Key points The frequency content of the EMG signal shifted in seven out of eight cases significantly towards lower frequencies with highest effects observed for RF. General muscular fatigue, where additional specific fibers have to be recruited due to the reduced power output of other fibers, did not occur. A modified skiing style towards a less functional and hence more uncontrolled skiing technique seems to be a key

  15. A newly discovered muscle: The tensor of the vastus intermedius.

    PubMed

    Grob, K; Ackland, T; Kuster, M S; Manestar, M; Filgueira, L

    2016-03-01

    The quadriceps femoris is traditionally described as a muscle group composed of the rectus femoris and the three vasti. However, clinical experience and investigations of anatomical specimens are not consistent with the textbook description. We have found a second tensor-like muscle between the vastus lateralis (VL) and the vastus intermedius (VI), hereafter named the tensor VI (TVI). The aim of this study was to clarify whether this intervening muscle was a variation of the VL or the VI, or a separate head of the extensor apparatus. Twenty-six cadaveric lower limbs were investigated. The architecture of the quadriceps femoris was examined with special attention to innervation and vascularization patterns. All muscle components were traced from origin to insertion and their affiliations were determined. A TVI was found in all dissections. It was supplied by independent muscular and vascular branches of the femoral nerve and lateral circumflex femoral artery. Further distally, the TVI combined with an aponeurosis merging separately into the quadriceps tendon and inserting on the medial aspect of the patella. Four morphological types of TVI were distinguished: Independent-type (11/26), VI-type (6/26), VL-type (5/26), and Common-type (4/26). This study demonstrated that the quadriceps femoris is architecturally different from previous descriptions: there is an additional muscle belly between the VI and VL, which cannot be clearly assigned to the former or the latter. Distal exposure shows that this muscle belly becomes its own aponeurosis, which continues distally as part of the quadriceps tendon. PMID:26732825

  16. [Robotic surgery].

    PubMed

    Sándor, József; Haidegger, Tamás; Kormos, Katalin; Ferencz, Andrea; Csukás, Domokos; Bráth, Endre; Szabó, Györgyi; Wéber, György

    2013-10-01

    Due to the fast spread of laparoscopic cholecystectomy, surgical procedures have been changed essentially. The new techniques applied for both abdominal and thoracic procedures provided the possibility for minimally invasive access with all its advantages. Robots - originally developed for industrial applications - were retrofitted for laparoscopic procedures. The currently prevailing robot-assisted surgery is ergonomically more advantageous for the surgeon, as well as for the patient through the more precise preparative activity thanks to the regained 3D vision. The gradual decrease of costs of robotic surgical systems and development of new generations of minimally invasive devices may lead to substantial changes in routine surgical procedures. PMID:24144815

  17. The influence of visual information on multi-muscle control during quiet stance: a spectral analysis approach.

    PubMed

    Danna-Dos-Santos, Alessander; Degani, Adriana M; Boonstra, Tjeerd W; Mochizuki, Luis; Harney, Allison M; Schmeckpeper, Megan M; Tabor, Lori C; Leonard, Charles T

    2015-02-01

    Standing upright requires the coordination of neural drives to a large set of muscles involved in controlling human bipedal stance (i.e., postural muscles). The coordination may deteriorate in situations where standing is performed under more challenging circumstances, such as standing on a smaller base of support or not having adequate visual information. The present study investigates the role of common neural inputs in the organization of multi-muscle synergies and the effects of visual input disruption to this mechanism of control. We analyzed the strength and distribution of correlated neural inputs (measured by intermuscular coherence) to six postural muscles previously recognized as components of synergistic groups involved in the maintenance of the body's vertical positioning. Two experimental conditions were studied: quiet bipedal stance performed with opened eyes (OEs) and closed eyes (CEs). Nine participants stood quietly for 30 s while the activity of the soleus, biceps femoris, lumbar erector spinae, tibialis anterior, rectus femoris, and rectus abdominis muscles were recorded using surface electrodes. Intermuscular (EMG-EMG) coherence was estimated for 12 muscle pairs formed by these muscles, including pairs formed solely by either posterior, anterior, or mixed (one posterior and one anterior) muscles. Intermuscular coherence was only found to be significant for muscle pairs formed solely by either posterior or anterior muscles, and no significant coherence was found for mixed muscle pairs. Significant intermuscular coherence was only found within a distinct frequency interval bounded between 1 and 10 Hz when visual input was available (OEs trials). The strength of correlated neural inputs was similar across muscle pairs located in different joints but executing a similar function (pushing body either backward or forward) suggesting that synergistic postural groups are likely formed based on their functional role instead of their anatomical location

  18. Recruitment of some respiratory muscles during three maximal inspiratory manoeuvres.

    PubMed Central

    Nava, S; Ambrosino, N; Crotti, P; Fracchia, C; Rampulla, C

    1993-01-01

    BACKGROUND--A study was undertaken to determine the level of recruitment of the muscles used in the generation of respiratory muscle force, and to ascertain whether maximal diaphragmatic force and maximal inspiratory muscle force need to be measured by separate tests. The level of activity of three inspiratory muscles and one expiratory muscle during three maximal respiratory manoeuvres was studied: (1) maximal inspiration against a closed airway (Muller manoeuvre or maximal inspiratory pressure (MIP)); (2) maximal inspired manoeuvre followed by a maximal expiratory effort (combined manoeuvre); and (3) maximal inspiratory sniff through the nose (sniff manoeuvre). METHODS--All the manoeuvres were performed from functional residual capacity. The gastric (PGA) and oesophageal (POES) pressures and their difference, transdiaphragmatic pressure (PDI), and the integrated EMG activity of the diaphragm (EDI), the sternomastoid (ESTR), the intercostal parasternals (ERIC), and the rectus abdominis muscles (ERA) were recorded. RESULTS--Mean (SD) PDI values for the Muller, combined, and sniff manoeuvres were: 127.6 (19.4), 162.7 (22.2), and 136.6 (24.8) cm H2O, respectively. The pattern of rib cage muscle recruitment (POES/PDI) was similar for the Muller and sniff manoeuvres (88% and 80% respectively), and was 58% in the combined manoeuvre, confirming data previously reported in the literature. Peak EDI amplitude was greater during the sniff manoeuvre in all subjects (100%) than during the combined (88.1%) and Muller (61.1%) manoeuvres. ESTR and EIC were more active in the Muller and the sniff manoeuvres. The contribution of the expiratory muscle (ERA) to the three manoeuvres was 100% in the combined, 26.1% for the sniff, and 11.5% for the Muller manoeuvre. CONCLUSIONS--Each of these three manoeuvres results in different mechanisms of inspiratory and expiratory muscle activation and the intrathoracic and intra-abdominal pressures generated are a reflection of the interaction

  19. Differences in abdominal muscle activation during coughing between smokers and nonsmokers.

    PubMed

    Rhee, Min-Hyung; Lee, Dong-Rour; Kim, Laurentius Jongsoon

    2016-04-01

    [Purpose] The purpose of this study was to compare the activity of the abdominal muscles during coughing between smokers and nonsmokers. [Subjects] A total of 30 healthy adults (15 smokers, 15 nonsmokers) participated. [Methods] The percentage maximal voluntary isometric contraction values (%MVIC) of the rectus abdominis (RA), external abdominal oblique (EO), and internal abdominal oblique (IO) and transversus abdominis (TrA) were measured using surface electromyography. [Results] The %MVIC of the IO and TrA statistically significantly differed and the %MVIC of IO and TrA was found to be higher during coughing in nonsmokers compared with during coughing in smokers. [Conclusion] The activity of the deep abdominal muscles in nonsmokers was also higher than that of smokers during coughing. PMID:27190443

  20. Differences in abdominal muscle activation during coughing between smokers and nonsmokers

    PubMed Central

    Rhee, Min-Hyung; Lee, Dong-Rour; Kim, Laurentius Jongsoon

    2016-01-01

    [Purpose] The purpose of this study was to compare the activity of the abdominal muscles during coughing between smokers and nonsmokers. [Subjects] A total of 30 healthy adults (15 smokers, 15 nonsmokers) participated. [Methods] The percentage maximal voluntary isometric contraction values (%MVIC) of the rectus abdominis (RA), external abdominal oblique (EO), and internal abdominal oblique (IO) and transversus abdominis (TrA) were measured using surface electromyography. [Results] The %MVIC of the IO and TrA statistically significantly differed and the %MVIC of IO and TrA was found to be higher during coughing in nonsmokers compared with during coughing in smokers. [Conclusion] The activity of the deep abdominal muscles in nonsmokers was also higher than that of smokers during coughing. PMID:27190443

  1. Bariatric Surgery

    PubMed Central

    2005-01-01

    Executive Summary Objective To conduct an evidence-based analysis of the effectiveness and cost-effectiveness of bariatric surgery. Background Obesity is defined as a body mass index (BMI) of at last 30 kg/m2.1 Morbid obesity is defined as a BMI of at least 40 kg/m2 or at least 35 kg/m2 with comorbid conditions. Comorbid conditions associated with obesity include diabetes, hypertension, dyslipidemias, obstructive sleep apnea, weight-related arthropathies, and stress urinary incontinence. It is also associated with depression, and cancers of the breast, uterus, prostate, and colon, and is an independent risk factor for cardiovascular disease. Obesity is also associated with higher all-cause mortality at any age, even after adjusting for potential confounding factors like smoking. A person with a BMI of 30 kg/m2 has about a 50% higher risk of dying than does someone with a healthy BMI. The risk more than doubles at a BMI of 35 kg/m2. An expert estimated that about 160,000 people are morbidly obese in Ontario. In the United States, the prevalence of morbid obesity is 4.7% (1999–2000). In Ontario, the 2004 Chief Medical Officer of Health Report said that in 2003, almost one-half of Ontario adults were overweight (BMI 25–29.9 kg/m2) or obese (BMI ≥ 30 kg/m2). About 57% of Ontario men and 42% of Ontario women were overweight or obese. The proportion of the population that was overweight or obese increased gradually from 44% in 1990 to 49% in 2000, and it appears to have stabilized at 49% in 2003. The report also noted that the tendency to be overweight and obese increases with age up to 64 years. BMI should be used cautiously for people aged 65 years and older, because the “normal” range may begin at slightly above 18.5 kg/m2 and extend into the “overweight” range. The Chief Medical Officer of Health cautioned that these data may underestimate the true extent of the problem, because they were based on self reports, and people tend to over-report their

  2. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time

    PubMed Central

    Taeger, Christian D.; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I.; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E.; Präbst, Konstantin

    2015-01-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research. PMID:26145230

  3. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time.

    PubMed

    Taeger, Christian D; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E; Präbst, Konstantin

    2015-01-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research. PMID:26145230

  4. Effects of wearing gumboots and leather lace-up boots on lower limb muscle activity when walking on simulated underground coal mine surfaces.

    PubMed

    Dobson, Jessica A; Riddiford-Harland, Diane L; Steele, Julie R

    2015-07-01

    This study aimed to investigate the effects of wearing two standard underground coal mining work boots (a gumboot and a leather lace-up boot) on lower limb muscle activity when participants walked across simulated underground coal mining surfaces. Quadriceps (rectus femoris, vastus medialis, vastus lateralis) and hamstring (biceps femoris, semitendinosus) muscle activity were recorded as twenty male participants walked at a self-selected pace around a circuit while wearing each boot type. The circuit consisted of level, inclined and declined surfaces composed of rocky gravel and hard dirt. Walking in a leather lace-up boot, compared to a gumboot, resulted in increased vastus lateralis and increased biceps femoris muscle activity when walking on sloped surfaces. Increased muscle activity appears to be acting as a slip and/or trip prevention strategy in response to challenging surfaces and changing boot features. PMID:25766420

  5. Assessing viability of extracorporeal preserved muscle transplants using external field stimulation: a novel tool to improve methods prolonging bridge-to-transplantation time

    NASA Astrophysics Data System (ADS)

    Taeger, Christian D.; Friedrich, Oliver; Dragu, Adrian; Weigand, Annika; Hobe, Frieder; Drechsler, Caroline; Geppert, Carol I.; Arkudas, Andreas; Münch, Frank; Buchholz, Rainer; Pollmann, Charlotte; Schramm, Axel; Birkholz, Torsten; Horch, Raymund E.; Präbst, Konstantin

    2015-07-01

    Preventing ischemia-related cell damage is a priority when preserving tissue for transplantation. Perfusion protocols have been established for a variety of applications and proven to be superior to procedures used in clinical routine. Extracorporeal perfusion of muscle tissue though cumbersome is highly desirable since it is highly susceptible to ischemia-related damage. To show the efficacy of different perfusion protocols external field stimulation can be used to immediately visualize improvement or deterioration of the tissue during active and running perfusion protocols. This method has been used to show the superiority of extracorporeal perfusion using porcine rectus abdominis muscles perfused with heparinized saline solution. Perfused muscles showed statistically significant higher ability to exert force compared to nonperfused ones. These findings can be confirmed using Annexin V as marker for cell damage, perfusion of muscle tissue limits damage significantly compared to nonperfused tissue. The combination of extracorporeal perfusion and external field stimulation may improve organ conservation research.

  6. Trunk muscle activation during golf swing: Baseline and threshold.

    PubMed

    Silva, Luís; Marta, Sérgio; Vaz, João; Fernandes, Orlando; Castro, Maria António; Pezarat-Correia, Pedro

    2013-10-01

    There is a lack of studies regarding EMG temporal analysis during dynamic and complex motor tasks, such as golf swing. The aim of this study is to analyze the EMG onset during the golf swing, by comparing two different threshold methods. Method A threshold was determined using the baseline activity recorded between two maximum voluntary contraction (MVC). Method B threshold was calculated using the mean EMG activity for 1000ms before the 500ms prior to the start of the Backswing. Two different clubs were also studied. Three-way repeated measures ANOVA was used to compare methods, muscles and clubs. Two-way mixed Intraclass Correlation Coefficient (ICC) with absolute agreement was used to determine the methods reliability. Club type usage showed no influence in onset detection. Rectus abdominis (RA) showed the higher agreement between methods. Erector spinae (ES), on the other hand, showed a very low agreement, that might be related to postural activity before the swing. External oblique (EO) is the first being activated, at 1295ms prior impact. There is a similar activation time between right and left muscles sides, although the right EO showed better agreement between methods than left side. Therefore, the algorithms usage is task- and muscle-dependent. PMID:23816264

  7. Lumbar spinal loads and muscle activity during a golf swing.

    PubMed

    Lim, Young-Tae; Chow, John W; Chae, Woen-Sik

    2012-06-01

    This study estimated the lumbar spinal loads at the L4-L5 level and evaluated electromyographic (EMG) activity of right and left rectus abdominis, external and internal obliques, erector spinae, and latissimus dorsi muscles during a golf swing. Four super VHS camcorders and two force plates were used to obtain three-dimensional (3D) kinematics and kinetics of golf swings performed by five male collegiate golfers. Average EMG levels for different phases of golf swing were determined. An EMG-assisted optimization model was applied to compute the contact forces acting on the L4-L5. The results revealed a mean peak compressive load of over six times the body weight (BW) during the downswing and mean peak anterior and medial shear loads approaching 1.6 and 0.6 BW during the follow-through phases. The peak compressive load estimated in this study was high, but less than the corresponding value (over 8 BW) reported by a previous study. Average EMG levels of different muscles were the highest in the acceleration and follow-through phases, suggesting a likely link between co-contractions of paraspinal muscles and lumbar spinal loads. PMID:22900401

  8. Modelling of Muscle Force Distributions During Barefoot and Shod Running

    PubMed Central

    Sinclair, Jonathan; Atkins, Stephen; Richards, Jim; Vincent, Hayley

    2015-01-01

    Research interest in barefoot running has expanded considerably in recent years, based around the notion that running without shoes is associated with a reduced incidence of chronic injuries. The aim of the current investigation was to examine the differences in the forces produced by different skeletal muscles during barefoot and shod running. Fifteen male participants ran at 4.0 m·s-1 (± 5%). Kinematics were measured using an eight camera motion analysis system alongside ground reaction force parameters. Differences in sagittal plane kinematics and muscle forces between footwear conditions were examined using repeated measures or Freidman’s ANOVA. The kinematic analysis showed that the shod condition was associated with significantly more hip flexion, whilst barefoot running was linked with significantly more flexion at the knee and plantarflexion at the ankle. The examination of muscle kinetics indicated that peak forces from Rectus femoris, Vastus medialis, Vastus lateralis, Tibialis anterior were significantly larger in the shod condition whereas Gastrocnemius forces were significantly larger during barefoot running. These observations provide further insight into the mechanical alterations that runners make when running without shoes. Such findings may also deliver important information to runners regarding their susceptibility to chronic injuries in different footwear conditions. PMID:26557186

  9. Muscle force distribution during forward and backward locomotion.

    PubMed

    Błażkiewicz, Michalina

    2013-01-01

    Backward walking (BW) is a common technique employed in the treatment of a variety of orthopedic and neurological diseases. BW training may offer some benefits especially in balance and motor control ability beyond those experienced through forward walking (FW). The purpose of this study was to determine whether BW represented a simple reversal of FW and, hence muscle force distribution is the same. The study involved one male healthy student of physical education (22 years, h = 185 cm, m = 80 kg). Measurements of spatial-temporal gait parameters were conducted using eight Vicon system cameras, and Kistler plates. Noraxon EMG was used to obtain muscles activity. OpenSim software was used to compute muscle force distribution during both types of gait. During FW and BW there is small difference for force curves produced by m. gluteus maximus (RMS = 0.04), m. biceps femoris short head (RMS = 0.19) and m. tibialis anterior (RMS = 0.16). Good validation by EMG signal was obtained for m. rectus femoris, m. biceps femoris short head, m. tibialis posterior during FW and BW. For m. iliacus, only during BW good validation was achived. PMID:24215105

  10. Cutaneous reinnervation of the rectus abdominis musculocutaneous flap after chest wall reconstruction: development of herpes zoster in the transplanted musculocutaneous flap.

    PubMed

    Tomita, K; Inoue, K

    1998-08-01

    We report a patient in whom herpes zoster developed in the transplanted rectus abdominis musculocutaneous flap 14 months after a chest wall reconstruction for recurrent breast cancer. Based on the distribution of the varicella zoster virus spreading along the sensory nerve fibers, we concluded that the virus spread along the reinnervated sensory nerves from the dorsal ganglia, through the intercostal nerves, and into the flap skin. It is suggested that this finding demonstrates the pathway of reinnervation into the transferred musculocutaneous flap on the chest wall. PMID:9718154

  11. 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

  12. Internal Oblique and Transversus Abdominis Muscle Fatigue Induced by Slumped Sitting Posture after 1 Hour of Sitting in Office Workers

    PubMed Central

    Waongenngarm, Pooriput; Rajaratnam, Bala S.; Janwantanakul, Prawit

    2015-01-01

    Background Prolonged sitting leads to low back discomfort and lumbopelvic muscle fatigue. This study examined the characteristics of body perceived discomfort and trunk muscle fatigue during 1 hour of sitting in three postures in office workers. Methods Thirty workers sat for 1 hour in one of three sitting postures (i.e., upright, slumped, and forward leaning postures). Body discomfort was assessed using the Body Perceived Discomfort scale at the beginning and after 1 hour of sitting. Electromyographic (EMG) signals were recorded from superficial lumbar multifidus, iliocostalis lumborum pars thoracis, internal oblique (IO)/transversus abdominis (TrA), and rectus abdominis muscles during 1 hour of sitting. The median frequency (MDF) of the EMG power spectrum was calculated. Results Regardless of the sitting posture, the Body Perceived Discomfort scores in the neck, shoulder, upper back, low back, and buttock significantly increased after 1 hour of sitting compared with baseline values (t(9) = −11.97 to −2.69, p < 0.05). The MDF value of the EMG signal of rectus abdominis, iliocostalis lumborum pars thoracis, and multifidus muscles was unchanged over time in all three sitting postures. Only the right and left IO/TrA in the slumped sitting posture was significantly associated with decreased MDF over time (p = 0.019 to 0.041). Conclusion Prolonged sitting led to increased body discomfort in the neck, shoulder, upper back, low back, and buttock. No sign of trunk muscle fatigue was detected over 1 hour of sitting in the upright and forward leaning postures. Prolonged slumped sitting may relate to IO/TrA muscle fatigue, which may compromise the stability of the spine, making it susceptible to injury. PMID:27014491

  13. Detection of abnormal muscle activations during walking following spinal cord injury (SCI).

    PubMed

    Wang, Ping; Low, K H; McGregor, Alison H; Tow, Adela

    2013-04-01

    In order to identify optimal rehabilitation strategies for spinal cord injury (SCI) participants, assessment of impaired walking is required to detect, monitor and quantify movement disorders. In the proposed assessment, ten healthy and seven SCI participants were recruited to perform an over-ground walking test at slow walking speeds. SCI participants were given assistance from physiotherapists, if required, while they were walking. In agreement with other research, larger cadence and smaller step length and swing phase of SCI gait were observed as a result of muscle weakness and resultant gait instability. Muscle activation patterns of seven major leg muscles were collected. The EMG signal was processed by the RMS in frequency domain to represent the muscle activation power, and the distribution of muscle activation was compared between healthy and SCI participants. The alternations of muscle activation within the phases of the gait cycle are highlighted to facilitate our understanding of the underlying muscular activation following SCI. Key differences were observed (p-value=0.0006) in the reduced activation of tibialis anterior (TA) in single stance phase and rectus femoris (RF) in swing phase (p-value=0.0011). We can then conclude that the proposed assessment approach of gait provides valuable information that can be used to target and define therapeutic interventions and their evaluation; hence impacting the functional outcome of SCI individuals. PMID:23396198

  14. A new approach to assess the spasticity in hamstrings muscles using mechanomyography antagonist muscular group.

    PubMed

    Krueger, Eddy; Scheeren, Eduardo M; Nogueira-Neto, Guilherme N; Button, Vera Lúcia da S N; Nohama, Percy

    2012-01-01

    Several pathologies can cause muscle spasticity. Modified Ashworth scale (MAS) can rank spasticity, however its results depend on the physician subjective evaluation. This study aims to show a new approach to spasticity assessment by means of MMG analysis of hamstrings antagonist muscle group (quadriceps muscle). Four subjects participated in the study, divided into two groups regarding MAS (MAS0 and MAS1). MMG sensors were positioned over the muscle belly of rectus femoris (RF), vastus lateralis (VL) and vastus medialis (VM) muscles. The range of movement was acquired with an electrogoniometer placed laterally to the knee. The system was based on a LabVIEW acquisition program and the MMG sensors were built with triaxial accelerometers. The subjects were submitted to stretching reflexes and the integral of the MMG (MMG(INT)) signal was calculated to analysis. The results showed that the MMG(INT) was greater to MAS1 than to MAS0 [muscle RF (p = 0.004), VL (p = 0.001) and VM (p = 0.007)]. The results showed that MMG was viable to detect a muscular tonus increase in antagonist muscular group (quadriceps femoris) of spinal cord injured volunteers. PMID:23366325

  15. Aging affects spatial distribution of leg muscle oxygen saturation during ramp cycling exercise.

    PubMed

    Takagi, Shun; Kime, Ryotaro; Murase, Norio; Watanabe, Tsubasa; Osada, Takuya; Niwayama, Masatsugu; Katsumura, Toshihito

    2013-01-01

    We compared muscle oxygen saturation (SmO2) responses in several leg muscles and within a single muscle during ramp cycling exercise between elderly men (n = 8; age, 65 ± 3 years; ELD) and young men (n = 10; age, 23 ± 3 years; YNG). SmO2 was monitored at the distal site of the vastus lateralis (VLd), proximal site of the vastus lateralis (VLp), rectus femoris (RF), vastus medialis (VM), biceps femoris (BF), gastrocnemius lateralis (GL), gastrocnemius medialis (GM), and tibialis anterior (TA) by near-infrared spatial resolved spectroscopy. During submaximal exercise, significantly lower SmO2 at a given absolute work rate was observed in VLd, RF, BF, GL, and TA but not in VLp, VM, and GM in ELD than in YNG. In contrast, at all measurement sites, SmO2 at peak exercise was not significantly different between groups. These results indicate that the effects of aging on SmO2 responses are heterogeneous between leg muscles and also within a single muscle. The lower SmO2 in older men may have been caused by reduced muscle blood flow or altered blood flow distribution. PMID:23852490

  16. 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

  17. 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

  18. COMPARISON OF TRUNK AND LOWER EXTREMITY MUSCLE ACTIVITY AMONG FOUR STATIONARY EQUIPMENT DEVICES: UPRIGHT BIKE, RECUMBENT BIKE, TREADMILL, AND ELLIPTIGO®

    PubMed Central

    Baker, Ryan; Gibson, Chris; Kearney, Andrew; Busemeyer, Tommy

    2016-01-01

    Background Stationary equipment devices are often used to improve fitness. The ElliptiGO® was recently developed that blends the elements of an elliptical trainer and bicycle, allowing reciprocal lower limb pedaling in an upright position. However, it is unknown whether the muscle activity used for the ElliptiGO® is similar to walking or cycling. To date, there is no information comparing muscle activity for exercise on the treadmill, stationary upright and recumbent bikes, and the ElliptiGO®. Purpose/Hypothesis The purpose of this study was to assess trunk and lower extremity muscle activity among treadmill walking, cycling (recumbent and upright) and the ElliptiGO® cycling. It was hypothesized that the ElliptiGO® and treadmill would elicit similar electromyographic muscle activity responses compared to the stationary bike and recumbent bike during an exercise session. Study Design Cohort, repeated measures Methods Twelve recreationally active volunteers participated in the study and were assigned a random order of exercise for each of the four devices (ElliptiGO®, stationary upright cycle ergometer, recumbent ergometer, and a treadmill). Two-dimensional video was used to monitor the start and stop of exercise and surface electromyography (SEMG) were used to assess muscle activity during two minutes of cycling or treadmill walking at 40-50% heart rate reserve (HRR). Eight muscles on the dominant limb were used for analysis: gluteus maximus (Gmax), gluteus medius (Gmed), biceps femoris (BF), lateral head of the gastrocnemius (LG), tibialis anterior (TA), rectus femoris (RF). Two trunk muscles were assessed on the same side; lumbar erector spinae at L3-4 level (LES) and rectus abdominus (RA). Maximal voluntary isometric contractions (MVIC) were determined for each muscle and SEMG data were expressed as %MVIC in order to normalize outputs. Results The %MVIC for RF during ElliptiGO® cycling was higher than recumbent cycling. The LG muscle activity was highest

  19. Effect of acute noxious stimulation to the leg or back on muscle synergies during walking.

    PubMed

    van den Hoorn, Wolbert; Hodges, Paul W; van Dieën, Jaap H; Hug, François

    2015-01-01

    This study aimed to examine how acute muscle pain affects muscle coordination during gait with consideration of muscle synergies (i.e., group of muscles activated in synchrony), amplitude of muscle activity and kinematics. A secondary aim was to determine whether any adaptation was specific to pain location. Sixteen participants walked on a treadmill during 5 conditions [control, low back pain (LBP), washout LBP, calf pain (CalfP), and washout CalfP]. Five muscle synergies were identified for all of the conditions. Cross-validation analysis showed that muscle synergy vectors extracted for the control condition accounted for >81% of variance accounted for from the other conditions. Muscle synergies were altered very little in some participants (n = 7 for LBP; n = 10 for CalfP), but were more affected in the others (n = 9 for LBP; n = 6 for CalfP). No systematic differences between pain locations were observed. Considering all participants, synergies related to propulsion and weight acceptance were largely unaffected by pain, whereas synergies related to other functions (trunk control and leg deceleration) were more affected. Gastrocnemii activity was less during both CalfP and LBP than control. Soleus activity was further reduced during CalfP, and this was associated with reduced plantar flexion. Some lower leg muscles exhibited adaptations depending on pain location (e.g., greater vastus lateralis and rectus femoris activity during CalfP than LBP). Overall, these changes in muscle coordination involve a participant-specific strategy that is important to further explore, as it may explain why some people are more likely to develop persistence of a painful condition. PMID:25298391

  20. Altered lower leg muscle activation patterns in patients with cerebral palsy during cycling on an ergometer

    PubMed Central

    Alves-Pinto, Ana; Blumenstein, Tobias; Turova, Varvara; Lampe, Renée

    2016-01-01

    Objective Cycling on a recumbent ergometer constitutes one of the most popular rehabilitation exercises in cerebral palsy (CP). However, no control is performed on how muscles are being used during training. Given that patients with CP present altered muscular activity patterns during cycling or walking, it is possible that an incorrect pattern of muscle activation is being promoted during rehabilitation cycling. This study investigated patterns of muscular activation during cycling on a recumbent ergometer in patients with CP and whether those patterns are determined by the degree of spasticity and of mobility. Methods Electromyographic (EMG) recordings of lower leg muscle activation during cycling on a recumbent ergometer were performed in 14 adult patients diagnosed with CP and five adult healthy participants. EMG recordings were done with an eight-channel EMG system built in the laboratory. The activity of the following muscles was recorded: Musculus rectus femoris, Musculus biceps femoris, Musculus tibialis anterior, and Musculus gastrocnemius. The degree of muscle spasticity and mobility was assessed using the Modified Ashworth Scale and the Gross Motor Function Classification System, respectively. Muscle activation patterns were described in terms of onset and duration of activation as well as duration of cocontractions. Results Muscle activation in CP was characterized by earlier onsets, longer periods of activation, a higher occurrence of agonist–antagonist cocontractions, and a more variable cycling tempo in comparison to healthy participants. The degree of altered muscle activation pattern correlated significantly with the degree of spasticity. Conclusion This study confirmed the occurrence of altered lower leg muscle activation patterns in patients with CP during cycling on a recumbent ergometer. There is a need to develop feedback systems that can inform patients and therapists of an incorrect muscle activation during cycling and support the training

  1. Robotic Surgery

    NASA Technical Reports Server (NTRS)

    2000-01-01

    The Automated Endoscopic System for Optimal Positioning, or AESOP, was developed by Computer Motion, Inc. under a SBIR contract from the Jet Propulsion Lab. AESOP is a robotic endoscopic positioning system used to control the motion of a camera during endoscopic surgery. The camera, which is mounted at the end of a robotic arm, previously had to be held in place by the surgical staff. With AESOP the robotic arm can make more precise and consistent movements. AESOP is also voice controlled by the surgeon. It is hoped that this technology can be used in space repair missions which require precision beyond human dexterity. A new generation of the same technology entitled the ZEUS Robotic Surgical System can make endoscopic procedures even more successful. ZEUS allows the surgeon control various instruments in its robotic arms, allowing for the precision the procedure requires.

  2. Prognostic value of sarcopenia in liver surgery.

    PubMed

    Cornet, M; Lim, C; Salloum, C; Lazzati, A; Compagnon, P; Pascal, G; Azoulay, D

    2015-11-01

    Current knowledge indicates that malnutrition increases the rate of post-operative complications, particularly respiratory and infectious, after major surgery. Almost all liver surgery is performed in patients with cancer, a factor that increases the risk of malnutrition. The primary risk factors for post-operative complications are pre-operative hypo-albuminemia and a body mass index less than 20 kg/m(2). To improve the prediction of complications in these patients, some teams have suggested measurement of muscle thickness by computed tomography. Muscular mass can thus be quantified by measuring the total surface of the psoas muscle or the total surface of all muscles (i.e. external and internal oblique, transverse, psoas and paravertebral muscles) seen on an axial CT slice at L3. As well, data exist suggesting that sarcopenia is an independent predictive factor of post-operative morbidity and poor long-term survival after resection for cancer. Nonetheless, the literature on the subject is limited, there are no standardized definitions for sarcopenia, and the need of special software to calculate the surfaces limits its usefulness. Lastly, there are little if any data concerning the nutritional or pharmacologic means to treat sarcopenia. This update, based on a literature review, deals with the value and the prognostic impact of sarcopenia in surgery for liver tumors. The current definition of sarcopenia, validated internationally, the methods of measurement, and the consequences of sarcopenia on the outcome of liver resections are detailed in this review. PMID:26476674

  3. Pediatric heart surgery - discharge

    MedlinePlus

    ... reduced appetite Alternate Names Congenital heart surgery - discharge; Patent ductus arteriosus ligation - discharge; Hypoplastic left heart repair - ... of the aorta Congenital heart defect - corrective surgery Patent ductus arteriosus Pediatric heart surgery Tetralogy of Fallot ...

  4. Scoliosis surgery - child

    MedlinePlus

    Spinal curvature surgery - child; Kyphoscoliosis surgery - child; Video-assisted thoracoscopic surgery - child; VATS - child ... may also do the procedure using a special video camera. A surgical cut in the back is ...

  5. Coronary Artery Bypass Surgery

    MedlinePlus

    ... t help, you may need coronary artery bypass surgery. The surgery creates a new path for blood to flow ... more than one bypass. The results of the surgery usually are excellent. Many people remain symptom-free ...

  6. Tennis elbow surgery - discharge

    MedlinePlus

    ... epicondylitis surgery - discharge; Lateral tendinosis surgery - discharge; Lateral tennis elbow surgery - discharge ... long as you are told. This helps ensure tennis elbow will not return. You may be prescribed ...

  7. Laser surgery - skin

    MedlinePlus

    Surgery using a laser ... used is directly related to the type of surgery being performed and the color of the tissue ... Laser surgery can be used to: Close small blood vessels to reduce blood loss Remove warts , moles , sunspots, and ...

  8. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... after the baby is born. For others, your child may be able to safely wait for months ...

  9. Rehabilitation and Return to Sport Following Surgical Repair of the Rectus Abdominis and Adductor Longus in a Professional Basketball Player: A Case Report.

    PubMed

    Short, Steven M; Anloague, Philip A; Strack, Donald S

    2016-08-01

    Study Design Case report. Background Acute traumatic avulsion of the rectus abdominis and adductor longus is rare. Chronic groin injuries, often falling under the athletic pubalgia spectrum, have been reported to be more common. There is limited evidence detailing the comprehensive rehabilitation and return to sport of an athlete following surgical or conservative treatment of avulsion injuries of the pubis or other sports-related groin pathologies. Case Description A 29-year-old National Basketball Association player sustained a contact injury during a professional basketball game. This case report describes a unique clinical situation specific to professional sport, in which a surgical repair of an avulsed rectus abdominis and adductor longus was combined with a multimodal impairment- and outcomes-based rehabilitation program. Outcomes The patient returned to in-season competition at 5 weeks postoperation. Objective measures were tracked throughout rehabilitation and compared to baseline assessments. Measures such as the Copenhagen Hip and Groin Outcome Score and numeric pain-rating scale revealed progress beyond the minimal important difference. Discussion This case report details the clinical reasoning and evidence-informed interventions involved in the return to elite sport. Detailed programming and objective assessment may assist in achieving desired outcomes ahead of previously established timelines. Level of Evidence Therapy, level 4. J Orthop Sports Phys Ther 2016;46(8):697-706. Epub 3 Jul 2016. doi:10.2519/jospt.2016.6352. PMID:27374014

  10. Walking at the preferred stride frequency minimizes muscle activity.

    PubMed

    Russell, Daniel M; Apatoczky, Dylan T

    2016-03-01

    This study determined whether walking at the preferred stride frequency minimizes muscle activity compared with other cadences at the same speed. Anthropometric measurements were recorded from 10 subjects and used to estimate their predicted resonant stride frequency. The preferred walking speed and stride frequency were determined from freely adopted walking on a treadmill. For the experimental trials the treadmill was set at each individual's preferred walking speed. Participants walked for 6 min at eight cadences prescribed by an auditory metronome: preferred stride frequency and -35, -25, -15, 0, +15, +25, +35% of predicted resonant stride frequency. Oxygen consumption was measured via gas analysis. Muscle activity of the right leg gastrocnemius (GA), tibialis anterior (TA), biceps femoris (BF) and rectus femoris (RF) muscles was recorded via electromyography (EMG). On average, participants preferred to walk with a stride frequency .07 Hz lower than their predicted resonant stride frequency, however a strong positive correlation was observed between these variables. Stride frequency had a significant and large quadratic effect on VO2 (RLR(2)=.76), and activity of the GA (RLR(2)=.66), TA (RLR(2)=.83), BF (RLR(2)=.70) and RF (RLR(2)=.78) muscles. VO2, GA and TA activity were all minimal at the preferred stride frequency and increased for faster or slower cadences. BF and RF activity were minimal across a broad range of slow frequencies including the preferred stride frequency and increased for faster frequencies. The preferred stride frequency that humans readily adopt during walking minimizes the activation of the GA, TA, BF and RF muscles, which in turn minimizes the overall metabolic cost. PMID:26979903

  11. Compartmental Innervation of the Superior Oblique Muscle in Mammals

    PubMed Central

    Le, Alan; Poukens, Vadims; Ying, Howard; Rootman, Daniel; Goldberg, Robert A.; Demer, Joseph L.

    2015-01-01

    Purpose Intramuscular innervation of mammalian horizontal rectus extraocular muscles (EOMs) is compartmental. We sought evidence of similar compartmental innervation of the superior oblique (SO) muscle. Methods Three fresh bovine orbits and one human orbit were dissected to trace continuity of SO muscle and tendon fibers to the scleral insertions. Whole orbits were also obtained from four humans (two adults, a 17-month-old child, and a 33-week stillborn fetus), two rhesus monkeys, one rabbit, and one cow. Orbits were formalin fixed, embedded whole in paraffin, serially sectioned in the coronal plane at 10-μm thickness, and stained with Masson trichrome. Extraocular muscle fibers and branches of the trochlear nerve (CN4) were traced in serial sections and reconstructed in three dimensions. Results In the human, the lateral SO belly is in continuity with tendon fibers inserting more posteriorly on the sclera for infraducting mechanical advantage, while the medial belly is continuous with anteriorly inserting fibers having mechanical advantage for incycloduction. Fibers in the monkey superior SO insert more posteriorly on the sclera to favor infraduction, while the inferior portion inserts more anteriorly to favor incycloduction. In all species, CN4 bifurcates prior to penetrating the SO belly. Each branch innervates a nonoverlapping compartment of EOM fibers, consisting of medial and lateral compartments in humans and monkeys, and superior and inferior compartments in cows and rabbits. Conclusions The SO muscle of humans and other mammals is compartmentally innervated in a manner that could permit separate CN4 branches to selectively influence vertical versus torsional action. PMID:26426404

  12. Lower Extremity Muscle Activity During a Women's Overhand Lacrosse Shot.

    PubMed

    Millard, Brianna M; Mercer, John A

    2014-06-28

    The purpose of this study was to describe lower extremity muscle activity during the lacrosse shot. Participants (n=5 females, age 22±2 years, body height 162.6±15.2 cm, body mass 63.7±23.6 kg) were free from injury and had at least one year of lacrosse experience. The lead leg was instrumented with electromyography (EMG) leads to measure muscle activity of the rectus femoris (RF), biceps femoris (BF), tibialis anterior (TA), and medial gastrocnemius (GA). Participants completed five trials of a warm-up speed shot (Slow) and a game speed shot (Fast). Video analysis was used to identify the discrete events defining specific movement phases. Full-wave rectified data were averaged per muscle per phase (Crank Back Minor, Crank Back Major, Stick Acceleration, Stick Deceleration). Average EMG per muscle was analyzed using a 4 (Phase) × 2 (Speed) ANOVA. BF was greater during Fast vs. Slow for all phases (p<0.05), while TA was not influenced by either Phase or Speed (p>0.05). RF and GA were each influenced by the interaction of Phase and Speed (p<0.05) with GA being greater during Fast vs. Slow shots during all phases and RF greater during Crank Back Minor and Major as well as Stick Deceleration (p<0.05) but only tended to be greater during Stick Acceleration (p=0.076) for Fast vs. Slow. The greater muscle activity (BF, RF, GA) during Fast vs. Slow shots may have been related to a faster approach speed and/or need to create a stiff lower extremity to allow for faster upper extremity movements. PMID:25114727

  13. [Modern mitral valve surgery].

    PubMed

    Bothe, W; Beyersdorf, F

    2016-04-01

    At the beginning of the 20th century, Cutler and Levine performed the first successful surgical treatment of a stenotic mitral valve, which was the only treatable heart valve defect at that time. Mitral valve surgery has evolved significantly since then. The introduction of the heart-lung machine in 1954 not only reduced the surgical risk, but also allowed the treatment of different mitral valve pathologies. Nowadays, mitral valve insufficiency has become the most common underlying pathomechanism of mitral valve disease and can be classified into primary and secondary mitral insufficiency. Primary mitral valve insufficiency is mainly caused by alterations of the valve (leaflets and primary order chords) itself, whereas left ventricular dilatation leading to papillary muscle displacement and leaflet tethering via second order chords is the main underlying pathomechanism for secondary mitral valve regurgitation. Valve reconstruction using the "loop technique" plus annuloplasty is the surgical strategy of choice and normalizes life expectancy in patients with primary mitral regurgitation. In patients with secondary mitral regurgitation, implanting an annuloplasty is not superior to valve replacement and results in high rates of valve re-insufficiency (up to 30 % after 3 months) due to ongoing ventricular dilatation. In order to improve repair results in these patients, we add a novel subvalvular technique (ring-noose-string) to the annuloplasty that aims to prevent ongoing ventricular remodeling and re-insufficiency. In modern mitral surgery, a right lateral thoracotomy is the approach of choice with excellent repair and cosmetic results. PMID:26907868

  14. Independent Passive Mechanical Behavior of Bovine Extraocular Muscle Compartments

    PubMed Central

    Shin, Andrew; Yoo, Lawrence; Chaudhuri, Zia; Demer, Joseph L.

    2012-01-01

    Purpose. Intramuscular innervation of horizontal rectus extraocular muscles (EOMs) is segregated into superior and inferior (transverse) compartments, while all EOMs are also divided into global (GL) and orbital (OL) layers with scleral and pulley insertions, respectively. We sought evidence of potential independent action by examining passive mechanical coupling between EOM compartments. Methods. Putative compartments of each of the six whole bovine anatomical EOMs were separately clamped to a physiologically controlled, dual channel microtensile load cell (5-mN force resolution) driven by independent, high-speed, linear motors having 20-nm position resolution. One channel at a time was extended or retracted by 3 to 5 mm, with the other channel stationary. Fiducials distributed on the EOM global surface enabled optical tracking of local deformation. Loading rates of 5 to 100 mm/sec were applied to explore speeds from slow vergence to saccades. Control loadings employed transversely loaded EOM and isotropic latex. Results. All EOM bellies and tendons exhibited substantial compartmental independence when loaded in the physiologic direction, both between OL and GL, and for arbitrary transverse parsings of EOM width ranging from 60%:40% to 80%:20%. Intercompartmental force coupling in the physiologic direction was less than or equal to 10% in all six EOMS even for saccadic loading rates. Coupling was much higher for nonphysiologic transverse EOM loading and isotropic latex. Optical tracking demonstrated independent strain distribution between EOM compartments. Conclusions. Substantial mechanical independence exists among physiologically loaded fiber bundles in bovine EOMs and tendons, providing biomechanical support for the proposal that differential compartmental function in horizontal rectus EOMs contributes to novel torsional and vertical actions. PMID:23188730

  15. 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

  16. Cosmetic Plastic Surgery Statistics

    MedlinePlus

    2014 Cosmetic Plastic Surgery Statistics Cosmetic Procedure Trends 2014 Plastic Surgery Statistics Report Please credit the AMERICAN SOCIETY OF PLASTIC SURGEONS when citing statistical data or using ...

  17. Cosmetic ear surgery

    MedlinePlus

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... 31. Thorne CH. Otoplasty. In: Neligan PC, ed. Plastic Surgery . 3rd ed. Philadelphia, PA: Elsevier Saunders; 2013:chap ...

  18. [Relationship between lumbosacral multifidus muscle and lumbar disc herniation].

    PubMed

    Chen, Wei-ye; Wang, Kuan; Yuan, Wei-an; Zhan, Hong-sheng

    2016-06-01

    As a common disease in clinical, the treatment of lumbar disc herniation (LDH) focused on local intervertebral disc, such as surgery and other interventional therapy treatment, but postoperative complications and recurrence rate has been a difficult problem in the field of profession. With the development of spine biomechanics and anatomy, researches on lumbar herniation also increased. Researchers discovered that the incidence and prognosis of LDH were inseparable with local muscle and soft tissue. As the deep paraspinal muscles, multifidus muscle plays an important role to make lumbar stability. Its abnormal function could reduce the stable of lumbar spine, and the chronic lumbar disease could also lead to multifidus muscle atrophy. PMID:27534095

  19. Adynamic and dynamic muscle transposition techniques for anal incontinence

    PubMed Central

    Barišić, Goran; Krivokapić, Zoran

    2014-01-01

    Gracilis muscle transposition is well established in general surgery and has been the main muscle transposition technique for anal incontinence. Dynamization, through a schedule of continuous electrical stimulation, converts the fatigue-prone muscle fibres to a tonic fatigue-resistant morphology with acceptable results in those cases where there is limited sphincter muscle mass. The differences between gluteoplasty and graciloplasty, as well as the techniques and complications of both procedures, are outlined in this review. Overall, these techniques are rarely carried out in specialized units with experience, as there is a high revision and explantation rate. PMID:24759348

  20. Is coordination of two-joint leg muscles during load lifting consistent with the strategy of minimum fatigue?

    PubMed

    Prilutsky, B I; Isaka, T; Albrecht, A M; Gregor, R J

    1998-11-01

    The purpose of this study was to examine if strong correlations reported for a back lift task between activity (EMG) of two-joint rectus femoris (RF), hamstrings (HA), and gastrocnemius (GA) and the difference in the joint moments could be predicted by minimizing an objective function of minimum fatigue. Four subjects lifted barbell weights (9 and 18 kg) using a back lift technique at three speeds normal, slow, and fast. Recorded ground reaction forces and coordinates of the leg joints were used to calculate the resultant joint moments. Surface EMG of five muscles crossing the knee joint were also recorded. Forces of nine muscles were calculated using static optimization and a minimum fatigue criterion. Relationships (i) (RF EMG-HA EMG) vs (knee moment hip moment) and (ii) GA EMG vs. (ankle moment knee moment) were closely related (coefficients of determination were typically 0.9 and higher). Qualitatively similar relationships were predicted by minimizing fatigue. Gastrocnemius and hamstrings had the agonistic action at both joints they cross during load lifting, and their activation and predicted forces increased with increasing flexion knee moments and extension ankle and hip moments. The rectus femoris typically had the antagonistic action at the knee and hip, and its activation and predicted force were low. Patterns of predicted muscle forces were qualitatively similar to the corresponding EMG envelopes (except in phases of low joint moments where accuracy of determining joint moments was presumably poor). It was suggested that muscle coordination in load lifting is consistent with the strategy of minimum muscle fatigue. PMID:9880059

  1. Aesthetic surgery of the orbits and eyelids.

    PubMed

    Broujerdi, Joseph A

    2012-11-01

    This article discusses the relevant anatomy, the aging process of the eyelid with periorbital structure, and how to evaluate patients for a proper surgical approach. A description is given of how to achieve an aesthetic balance between the forehead, eyelids, and midface to provide the patient with a natural youthful appearance. The paradigm in oculoplastic surgery has shifted to more conservative eyelid skin, muscle, and fat resection as well as more periorbital soft tissue lift, suspension, and volumization. Recent innovations and developments are discussed as well as the most common complications in eyelid and periorbital surgery. PMID:22995154

  2. Transoral Surgery

    PubMed Central

    Rock, Jack P.; Tomecek, Frank J.; Ross, Lawrence

    1993-01-01

    The transoral approaches have become commonplace in modern neurosurgical practice for treatment of ventral midline lesions of the clivus and upper cervical spine. Although the standard technique of transoral surgery is conceptually simple, anatomic relationships are not so readily appreciated. The present study was undertaken in an effort to define more clearly the midline anatomic relationships as they pertain to the standard transoral and transpalatine operations. The anatomic relationships involved in planning microsurgical transoral approaches were examined in 15 human cadavers. Landmarks approximating the midline of the skull base and the upper cervical spinal canal were defined to assist the surgeon's orientation. Measurements were made in axial, sagital, and parasagittal planes to various neurovascular structures in the posterior cranial fossa and upper cervical spinal canal. The study revealed that, for the standard transoral and transoral-transpalatine dissections, the carotid arteries, abducens nerves, interior petrosal sinuses, hypoglossal nerves, and vertebral arteries would be a greatest risk being 0.76, 1.06, 1.51, 1.34, and 1.52 cm from the midline at specified locations. The measurements and the computed tomography images provide a useful reference for the surgeon. ImagesFigure 1Figure 9 PMID:17170899

  3. Vestibular schwannoma surgery and headache.

    PubMed

    Levo, H; Blomstedt, G; Pyykkö, I

    2000-01-01

    The aim of the study was to evaluate aetiological factors for postoperative headache after vestibular schwannoma (VS) surgery with respect to asymmetric activation of vestibular reflexes. After surgery, 27 VS patients with persistent postoperative headache, 16 VS patients without headache and 9 healthy controls were examined. The vestibular, cervicocollic and cervicospinal reflexes were evaluated to study whether asymmetric activation of vestibular reflexes could cause headache. The effect of neck muscle and occipital nerve anaesthesia and the effect of sumatriptan on headache were also evaluated. The vestibular function of VS patients with headache did not differ from that of VS patients without headache, but was abnormal when compared to that of normal controls. The cervicospinal and cervicocollic reflexes did not differ in the patient groups. Injection of lidocaine around the operation scar gave pain relief to two patients, and one of them had occipital nerve entrapment. Infiltration of lidocaine deep in the neck muscles in the vicinity of the C2 root did not alleviate headache, but caused vertigo. Nine patients with musculogenic headache got pain relief from supportive neck collars, and two patients with cervicobrachial syndrome got pain relief from manual neck traction. The study shows that asymmetric activation of cervicocollic reflexes does not seem to be the reason for headache. Headache seems to be linked to neuropathic pain, allegedly caused by trigeminal irritation of the inner ear and the posterior fossa, which has recently been linked to vascular pain. PMID:10908966

  4. Muscle coordination during breaststroke swimming: Comparison between elite swimmers and beginners.

    PubMed

    Vaz, João R; Olstad, Bjørn Harald; Cabri, Jan; Kjendlie, Per-Ludvik; Pezarat-Correia, Pedro; Hug, François

    2016-10-01

    The present study aimed to compare muscle coordination strategies of the upper and lower limb muscles between beginners and elite breaststroke swimmers. Surface electromyography (EMG) of eight muscles was recorded in 16 swimmers (8 elite, 8 beginners) during a 25 m swimming breaststroke at 100% of maximal effort. A decomposition algorithm was used to identify the muscle synergies that represent the temporal and spatial organisation of muscle coordination. Between-groups indices of similarity and lag times were calculated. Individual muscle patterns were moderately to highly similar between groups (between-group indices range: 0.61 to 0.84). Significant differences were found in terms of lag time for pectoralis major (P < 0.05), biceps brachii, rectus femoris and tibialis anterior (P < 0.01), indicating an earlier activation for these muscles in beginners compared to elites (range: -13.2 to -3.8% of the swimming cycle). Three muscle synergies were identified for both beginners and elites. Although their composition was similar between populations, the third synergy exhibited a high within-group variability. Moderate to high indices of similarity were found for the shape of synergy activation coefficients (range: 0.63 to 0.88) but there was a significant backward shift (-8.4% of the swimming cycle) in synergy #2 for beginners compared to elites. This time shift suggested differences in the global arm-to-leg coordination. These results indicate that the synergistic organisation of muscle coordination during breaststroke swimming is not profoundly affected by expertise. However, specific timing adjustments were observed between lower and upper limbs. PMID:26878097

  5. The effects of aquatic trunk exercise on gait and muscle activity in stroke patients: a randomized controlled pilot study.

    PubMed

    Park, Byoung-Sun; Noh, Ji-Woong; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

    2015-11-01

    [Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study's participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject's comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients' pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters. PMID:26696736

  6. The effects of aquatic trunk exercise on gait and muscle activity in stroke patients: a randomized controlled pilot study

    PubMed Central

    Park, Byoung-Sun; Noh, Ji-Woong; Kim, Mee-Young; Lee, Lim-Kyu; Yang, Seung-Min; Lee, Won-Deok; Shin, Yong-Sub; Kim, Ju-Hyun; Lee, Jeong-Uk; Kwak, Taek-Yong; Lee, Tae-Hyun; Kim, Ju-Young; Park, Jaehong; Kim, Junghwan

    2015-01-01

    [Purpose] The purpose of this study was to investigate the relationship between muscle activity and gait function following aquatic trunk exercise in hemiplegic stroke patients. [Subjects and Methods] This study’s participants included thirteen hemiplegic patients (ten males and three females). The aquatic therapy consisted of administering concentrative aquatic therapy for four weeks in a therapeutic pool. Gait parameters were measured using a gait analysis system adjusted to each subject’s comfortable walking speed. Electromyographic signals were measured for the rectus abdominis, external abdominal oblique, transversus abdominis/internal-abdominal oblique, and erector spine of each patients. [Results] The pre- and post-training performances of the transversus abdominis/internal-abdominal oblique were compared statistically. There was no statistical difference between the patients’ pre- and post-training values of maximal voluntary isometric contraction of the rectus abdominis, but the external abdominal oblique values tended to improve. Furthermore, gait factors improved significantly in terms of walking speeds, walking cycles, affected-side stance phases, affected-stride lengths, and stance-phase symmetry indices, respectively. [Conclusion] These results suggest that the trunk exercise during aquatic therapy may in part contribute to clinically relevant improvements in muscle activities and gait parameters. PMID:26696736

  7. Effects of combined exercise on changes of lower extremity muscle activation during walking in older women.

    PubMed

    Park, Jaehyun; Lee, Joongsook; Yang, Jeongok; Lee, Bomjin; Han, Dongwook

    2015-05-01

    [Purpose] The purpose of this study was to demonstrate the effects of combined exercise for a period of 12 weeks on the changes in lower extremity muscle activation during walking in older women. [Subjects] The subjects of this study were 22 elderly women who were 65 years of age or older and living in B-City. The subjects had no nervous system or muscular system diseases that might affect walking in the previous two years. [Methods] Muscle activation was measured by using surface EMG (QEMG-8, Laxtha, Daejeon, Republic of Korea). The subjects were asked to walk on an 8 m of footpath at a natural speed. In order to minimize the noise from the cable connecting the EMG measuring instrument to the electrodes, tape was used to affix the electrodes so that they would not fall off the subjects. The EMG data were analyzed by using the RMS. [Results] Muscle activation of the rectus femoris, biceps femoris, tibialis anterior, and gastrocnemius was increased significantly after combined exercise for 12 weeks. However, no increase was observed in the left biceps femoris. [Conclusion] It was demonstrated that our exercise program, which includes aerobic walking exercises, senior-robics, and muscle strengthening exercises using elastic bands, is very effective for reorganizing the normal gait pattern in the cerebral cortex and improving muscle strength. PMID:26157253

  8. Effect of gait retraining for reducing ambulatory knee load on trunk biomechanics and trunk muscle activity.

    PubMed

    Nüesch, Corina; Laffer, Dominik; Netzer, Cordula; Pagenstert, Geert; Mündermann, Annegret

    2016-06-01

    The purpose of this study was to test the hypothesis that walking with increased medio-lateral trunk sway is associated with lower external knee adduction moment and lower extremity muscle activation, and higher external ipsilateral trunk moment and trunk muscle activity than walking with normal trunk sway in healthy participants. Fifteen participants performed walking trials with normal and increased medio-lateral trunk sway. Maximum trunk sway, first maximum knee adduction moment, lateral trunk bending moment, and bilateral vastus medialis, vastus lateralis, gluteus medius, rectus abdominis, external oblique and erector spinae muscle activity were computed. Walking with increased trunk sway was associated with lower maximum knee adduction moment (95% confidence interval (CI): 0.50-0.62Nm/kg vs. 0.62-0.76Nm/kg; P<.001) and ipsilateral gluteus medius (-17%; P=.014) and erector spinae muscle activity (-24%; P=.004) and greater maximum lateral trunk bending moment (+34%; P<.001) and contralateral external oblique muscle activity (+60%; P=.009). In all participants, maximum knee adduction moment was negatively correlated and maximum trunk moment was positively correlated with maximum trunk sway. The results of this study suggest that walking with increased trunk sway not only reduces the external knee adduction moment but also alters and possibly increases the load on the trunk. Hence, load-altering biomechanical interventions should always be evaluated not only regarding their effects on the index joint but on other load-bearing joints such as the spine. PMID:27264398

  9. Perfusion-decellularized skeletal muscle as a three-dimensional scaffold with a vascular network template.

    PubMed

    Zhang, Jian; Hu, Zhi Qian; Turner, Neill J; Teng, Shi Feng; Cheng, Wen Yue; Zhou, Hai Yang; Zhang, Li; Hu, Hong Wei; Wang, Qiang; Badylak, Stephen F

    2016-05-01

    There exists a great need for repair grafts with similar volume to human skeletal muscle that can promote the innate ability of muscle to regenerate following volumetric muscle loss. Perfusion decellularization is an attractive technique for extracellular matrix (ECM) scaffold from intact mammalian organ or tissue which has been successfully used in tissue reconstruction. The perfusion-decellularization of skeletal muscle has been poorly assessed and characterized, but the bioactivity and functional capacity of the obtained perfusion skeletal muscle ECM (pM-ECM) to remodel in vivo is unknown. In the present study, pM-ECM was prepared from porcine rectus abdominis (RA). Perfusion-decellularization of porcine RA effectively removed cellular and nuclear material while retaining the intricate three-dimensional microarchitecture and vasculature networks of the native RA, and many of the bioactive ECM components and mechanical properties. In vivo, partial-thickness abdominal wall defects in rats repaired with pM-ECM showed improved neovascularization, myogenesis and functional recellularization compared to porcine-derived small intestinal submucosa (SIS). These findings show the biologic potential of RA pM-ECM as a scaffold for supporting site appropriate, tissue reconstruction, and provide a better understanding of the importance maintaining the tissue-specific complex three-dimensional architecture of ECM during decellularization and regeneration. PMID:26963901

  10. Relationship between spinal range of motion and trunk muscle activity during trunk rotation

    PubMed Central

    Sugaya, Tomoaki; Sakamoto, Masaaki; Nakazawa, Rie; Wada, Naoki

    2016-01-01

    [Purpose] The aim of this study was to clarify the relationship between spinal range of motion and trunk muscle activity during trunk rotation using a three-dimensional motion analysis system and surface electromyography. [Subjects and Methods] The subjects comprised 11 healthy men. A three-dimensional motion analysis system measured the trunk rotational angle of 4 segments of the thoracic vertebrae and 2 segments of the lumbar vertebrae. Surface electromyography measured the activities of the unilateral latissimus dorsi, lumbar multifidus, rectus abdominis, external oblique, internal oblique, and transversus abdominis muscles. [Results] During ipsilateral rotation at thoracic vertebral levels, the muscle activity of the latissimus dorsi and external oblique was significantly increased compared with the activity in the 0–10% range of trunk rotation. During early ipsilateral rotation at lumbar vertebral levels, the muscle activity of the internal oblique and transversus abdominis was significantly increased compared with that in the 0–10% range of trunk rotation. During contralateral rotation at both thoracic and lumbar vertebral levels, the muscle activity of the external oblique was significantly increased compared with that in the 0–10% range of trunk rotation. [Conclusion] This study indicates that it is important to consider vertebral segments and spinal range of motion during trunk rotation. PMID:27065549

  11. Maintenance of skeletal muscle energy homeostasis during prolonged wintertime fasting in the raccoon dog (Nyctereutes procyonoides).

    PubMed

    Kinnunen, Sanni; Mänttäri, Satu; Herzig, Karl-Heinz; Nieminen, Petteri; Mustonen, Anne-Mari; Saarela, Seppo

    2015-05-01

    The raccoon dog (Nyctereutes procyonoides) is a canid species with autumnal fattening and prolonged wintertime fasting. Nonpathological body weight cycling and the ability to tolerate food deficiency make this species a unique subject for studying physiological mechanisms in energy metabolism. AMP-activated protein kinase (AMPK) is a cellular energy sensor regulating energy homeostasis. During acute fasting, AMPK promotes fatty acid oxidation and enhances glucose uptake. We evaluated the effects of prolonged fasting on muscle energy metabolism in farm-bred raccoon dogs. Total and phosphorylated AMPK and acetyl-CoA carboxylase (ACC), glucose transporter 4 (GLUT 4), insulin receptor and protein kinase B (Akt) protein expressions of hind limb muscles were determined by Western blot after 10 weeks of fasting. Plasma insulin, leptin, ghrelin, glucose and free fatty acid levels were measured, and muscle myosin heavy chain (MHC) isoform composition analyzed. Fasting had no effects on AMPK phosphorylation, but total AMPK expression decreased in m. rectus femoris, m. tibialis anterior and m. extensor digitorum longus resulting in a higher phosphorylation ratio. Decreased total expression was also observed for ACC. Fasting did not influence GLUT 4, insulin receptor or Akt expression, but Akt phosphorylation was lower in m. flexor digitorum superficialis and m. extensor digitorum longus. Three MHC isoforms (I, IIa and IIx) were detected without differences in composition between the fasted and control animals. The studied muscles were resistant to prolonged fasting indicating that raccoon dogs have an effective molecular regulatory system for preserving skeletal muscle function during wintertime immobility and fasting. PMID:25652584

  12. Skeletal muscle blood flow and flow heterogeneity during dynamic and isometric exercise in humans.

    PubMed

    Laaksonen, Marko S; Kalliokoski, Kari K; Kyröläinen, Heikki; Kemppainen, Jukka; Teräs, Mika; Sipilä, Hannu; Nuutila, Pirjo; Knuuti, Juhani

    2003-03-01

    The effects of dynamic and intermittent isometric knee extension exercises on skeletal muscle blood flow and flow heterogeneity were studied in seven healthy endurance-trained men. Regional muscle blood flow was measured using positron emission tomography (PET) and an [(15)O]H(2)O tracer, and electromyographic (EMG) activity was recorded in the quadriceps femoris (QF) muscle during submaximal intermittent isometric and dynamic exercises. QF blood flow was 61% (P = 0.002) higher during dynamic exercise. Interestingly, flow heterogeneity was 13% (P = 0.024) lower during dynamic compared with intermittent isometric exercise. EMG activity was significantly higher (P < 0.001) during dynamic exercise, and the change in EMG activity from isometric to dynamic exercise was tightly related to the change in blood flow in the vastus lateralis muscle (r = 0.98, P < 0.001) but not in the rectus femoris muscle (r = -0.09, P = 0.942). In conclusion, dynamic exercise causes higher and less heterogeneous blood flow than intermittent isometric exercise at the same exercise intensity. These responses are, at least partly, related to the increased EMG activity. PMID:12446282

  13. 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 ...

  14. 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 ( ...

  15. Patterns of muscle coordination during stepping responses post-stroke.

    PubMed

    Gray, V L; Pollock, C L; Wakeling, J M; Ivanova, T D; Garland, S J

    2015-12-01

    This study compared self-induced stepping reactions of seventeen participants after stroke and seventeen controls. Surface electromyographic (EMG) signals were recorded bilaterally from the soleus (SOL), tibialis anterior (TA), biceps femoris (BF) and rectus femoris (RF) muscles. Principal component analysis (PCA) was used to reduce the data into muscle activation patterns and examine group differences (paretic, non-paretic, control leg). The first principal component (PC1) explained 46.7% of the EMG signal of the stepping leg. Two PCs revealed distinct activation features for the stepping paretic leg: earlier TA onset at step initiation and earlier BF and SOL onset at mid-step. For the stance leg, PC1 explained 44.4% of the EMG signal and significant differences were found in the non-paretic leg compared to paretic (p < 0.001) and control (p < 0.001). In PC1, at step onset the BF and SOL EMG and the RF and TA EMG were increased over the latter half of the step. No PC loadings were distinct for the paretic leg during stance, however differences were found in the non-paretic leg: earlier TA burst and increased BF and SOL EMG at step initiation. The results suggest impairments in the paretic leg when stepping and compensatory strategies in the non-paretic stance leg. PMID:26475243

  16. Physically-based modeling and simulation of extraocular muscles.

    PubMed

    Wei, Qi; Sueda, Shinjiro; Pai, Dinesh K

    2010-12-01

    Dynamic simulation of human eye movements, with realistic physical models of extraocular muscles (EOMs), may greatly advance our understanding of the complexities of the oculomotor system and aid in treatment of visuomotor disorders. In this paper we describe the first three dimensional (3D) biomechanical model which can simulate the dynamics of ocular motility at interactive rates. We represent EOMs using "strands", which are physical primitives that can model an EOM's complex nonlinear anatomical and physiological properties. Contact between the EOMs, the globe, and orbital structures can be explicitly modeled. Several studies were performed to assess the validity and utility of the model. EOM deformation during smooth pursuit was simulated and compared with published experimental data; the model reproduces qualitative features of the observed nonuniformity. The model is able to reproduce realistic saccadic trajectories when the lateral rectus muscle was driven by published measurements of abducens neuron discharge. Finally, acute superior oblique palsy, a pathological condition, was simulated to further evaluate the system behavior; the predicted deviation patterns agree qualitatively with experimental observations. This example also demonstrates potential clinical applications of such a model. PMID:20868704

  17. A comparison of optimisation methods and knee joint degrees of freedom on muscle force predictions during single-leg hop landings.

    PubMed

    Mokhtarzadeh, Hossein; Perraton, Luke; Fok, Laurence; Muñoz, Mario A; Clark, Ross; Pivonka, Peter; Bryant, Adam L

    2014-09-22

    The aim of this paper was to compare the effect of different optimisation methods and different knee joint degrees of freedom (DOF) on muscle force predictions during a single legged hop. Nineteen subjects performed single-legged hopping manoeuvres and subject-specific musculoskeletal models were developed to predict muscle forces during the movement. Muscle forces were predicted using static optimisation (SO) and computed muscle control (CMC) methods using either 1 or 3 DOF knee joint models. All sagittal and transverse plane joint angles calculated using inverse kinematics or CMC in a 1 DOF or 3 DOF knee were well-matched (RMS error<3°). Biarticular muscles (hamstrings, rectus femoris and gastrocnemius) showed more differences in muscle force profiles when comparing between the different muscle prediction approaches where these muscles showed larger time delays for many of the comparisons. The muscle force magnitudes of vasti, gluteus maximus and gluteus medius were not greatly influenced by the choice of muscle force prediction method with low normalised root mean squared errors (<48%) observed in most comparisons. We conclude that SO and CMC can be used to predict lower-limb muscle co-contraction during hopping movements. However, care must be taken in interpreting the magnitude of force predicted in the biarticular muscles and the soleus, especially when using a 1 DOF knee. Despite this limitation, given that SO is a more robust and computationally efficient method for predicting muscle forces than CMC, we suggest that SO can be used in conjunction with musculoskeletal models that have a 1 or 3 DOF knee joint to study the relative differences and the role of muscles during hopping activities in future studies. PMID:25129166

  18. Skeletal Muscle Phospholipid Metabolism Regulates Insulin Sensitivity and Contractile Function.

    PubMed

    Funai, Katsuhiko; Lodhi, Irfan J; Spears, Larry D; Yin, Li; Song, Haowei; Klein, Samuel; Semenkovich, Clay F

    2016-02-01

    Skeletal muscle insulin resistance is an early defect in the development of type 2 diabetes. Lipid overload induces insulin resistance in muscle and alters the composition of the sarcoplasmic reticulum (SR). To test the hypothesis that skeletal muscle phospholipid metabolism regulates systemic glucose metabolism, we perturbed choline/ethanolamine phosphotransferase 1 (CEPT1), the terminal enzyme in the Kennedy pathway of phospholipid synthesis. In C2C12 cells, CEPT1 knockdown altered SR phospholipid composition and calcium flux. In mice, diet-induced obesity, which decreases insulin sensitivity, increased muscle CEPT1 expression. In high-fat diet-fed mice with skeletal muscle-specific knockout of CEPT1, systemic and muscle-based approaches demonstrated increased muscle insulin sensitivity. In CEPT1-deficient muscles, an altered SR phospholipid milieu decreased sarco/endoplasmic reticulum Ca(2+) ATPase-dependent calcium uptake, activating calcium-signaling pathways known to improve insulin sensitivity. Altered muscle SR calcium handling also rendered these mice exercise intolerant. In obese humans, surgery-induced weight loss increased insulin sensitivity and decreased skeletal muscle CEPT1 protein. In obese humans spanning a spectrum of metabolic health, muscle CEPT1 mRNA was inversely correlated with insulin sensitivity. These results suggest that high-fat feeding and obesity induce CEPT1, which remodels the SR to preserve contractile function at the expense of insulin sensitivity. PMID:26512026

  19. Pasture-feeding of Charolais steers influences skeletal muscle metabolism and gene expression.

    PubMed

    Cassar-Malek, I; Jurie, C; Bernard, C; Barnola, I; Micol, D; Hocquette, J-F

    2009-10-01

    Extensive beef production systems on pasture are promoted to improve animal welfare and beef quality. This study aimed to compare the influence on muscle characteristics of two management approaches representative of intensive and extensive production systems. One group of 6 Charolais steers was fed maize-silage indoors and another group of 6 Charolais steers grazed on pasture. Activities of enzymes representative of glycolytic and oxidative (Isocitrate dehydrogenase [ICDH], citrate synthase [CS], hydroxyacyl-CoA dehydrogenase [HAD]) muscle metabolism were assessed in Rectus abdominis (RA) and Semitendinosus (ST) muscles. Activities of oxidative enzymes ICDH, CS and HAD were higher in muscles from grazing animals demonstrating a plasticity of muscle metabolism according to the production and feeding system. Gene expression profiling in RA and ST muscles was performed on both production groups using a multi-tissue bovine cDNA repertoire. Variance analysis showed an effect of the muscle type and of the production system on gene expression (P<0.001). A list of the 212 most variable genes according to the production system was established, of which 149 genes corresponded to identified genes. They were classified according to their gene function annotation mainly in the "protein metabolism and modification", "signal transduction", "cell cycle", "developmental processes" and "muscle contraction" biological processes. Selenoprotein W was found to be underexpressed in pasture-fed animals and could be proposed as a putative gene marker of the grass-based system. In conclusion, enzyme-specific adaptations and gene expression modifications were observed in response to the production system and some of them could be candidates for grazing or grass-feeding traceability. PMID:19996487

  20. Development of software for human muscle force estimation.

    PubMed

    Tang, Gang; Qian, Li-wei; Wei, Gao-feng; Wang, Hong-sheng; Wang, Cheng-tao

    2012-01-01

    Muscle force estimation (MFE) has become more and more important in exploring principles of pathological movement, studying functions of artificial muscles, making surgery plan for artificial joint replacement, improving the biomechanical effects of treatments and so on. At present, existing software are complex for professionals, so we have developed a new software named as concise MFE (CMFE). CMFE which provides us a platform to analyse muscle force in various actions includes two MFE methods (static optimisation method and electromyographic-based method). Common features between these two methods have been found and used to improve CMFE. A case studying the major muscles of lower limb of a healthy subject walking at normal speed has been presented. The results are well explained from the effect of the motion produced by muscles during movement. The development of this software can improve the accuracy of the motion simulations and can provide a more extensive and deeper insight in to muscle study. PMID:21607886

  1. Magnetic resonance-guided thermal surgery.

    PubMed

    Cline, H E; Schenck, J F; Watkins, R D; Hynynen, K; Jolesz, F A

    1993-07-01

    A demonstration of MR guided thermal surgery involved experiments with imaging of focused ultrasound in an MRI system, measurements of the thermal transients and a thermal analysis of the resulting images. Both the heat distribution and the creation of focused ultrasound lesions in gel phantoms, in vitro bovine muscle and in vivo rabbit muscle were monitored with magnetic resonance imaging. Thermal surgical procedures were modeled by an elongated gaussian heat source where heat flow is controlled by tissue thermal properties and tissue perfusion. Temperature profiles were measured with thermocouples or calculated from magnetic resonance imaging in agreement with the model. A 2-s T1-weighted gradient-refocused acquisition provided thermal profiles needed to localize the heat distribution produced by a 4-s focused ultrasound pulse. Thermal analysis of the images give an effective thermal diffusion coefficient of 0.0015 cm2/s in gel and 0.0033 cm2/s in muscle. The lesions were detected using a T2-weighted spin-echo or fast spin-echo pulse sequence in agreement with muscle tissue sections. Potential thermal surgery applications are in the prostate, liver, kidney, bladder, breast, eye and brain. PMID:8371680

  2. Expression of L-type calcium channels associated with postnatal development of skeletal muscle function in mouse.

    PubMed

    Mänttäri, S; Pyörnilä, A; Harjula, R; Järvilehto, M

    2001-01-01

    Several factors have an influence on the improvement of muscle activity and motor co-ordination of mammals during post-natal development. One of them is voltage sensitive L-type calcium channel function. In striated muscles of adult mammals these channels are located in T-tubule membranes thus linking the on-coming action potential to the molecular process of muscle contraction. The postnatal development of L-type calcium channels is therefore critical not only for contraction but also for all subsequent motor learning. We used high affinity enantiomer of dihydropyridine labelled with a fluorophore in order to show the relative amount of L-type calcium channels by histofluorescence in tissue. We found by qualitative microscopical analysis that the amount of L-type calcium channels increased during the postnatal development in the mouse skeletal muscle (m. rectus femoris and m. gastrocnemius). We also noted variation between different fibre types in the increase of the amount of L-type calcium channels, as judged by the intensity of histofluorescence. We showed by histochemical staining and statistical analysis that the high density of L-type calcium channels in adult muscles is correlated with fast oxidative glycolytic fibre type of striated muscles rather than slow oxidative or fast glycolytic fibres. Based on this finding we propose that the development of L-type calcium channels can be considered as one of the factors determining the different physiological properties of fibre types. PMID:11563550

  3. The effects of isometric exercise types on pain and muscle activity in patients with low back pain.

    PubMed

    Rhyu, Hyun-Seung; Park, Hun-Kyung; Park, Jung-Sub; Park, Hye-Sang

    2015-08-01

    The purpose of the present study is to evaluate the effects of isometric exercise types on low back pain (LBP) patients. Isometric exercise types were mat exercise and I-Zer exercise. Subjects were divided into 3 groups: LBP control group, LBP mat exercise group, and LBP I-Zer exercise group in 23-25 aged men. Visual analogue scale (VAS) and electromyography (EMG) were used to evaluate the degree of pain and the muscle activity in LBP patients. Root mean square (RMS), median frequency (MDF), and mean frequency (MNF) were checked by EMG power spectrum analysis on longissimus thoracic (LT), iliocostalis lumborum (IL), mulitifidus (M), and rectus abdominis (RA). LBP mat exercise program and LBP I-Zer exercise program were conducted 5 sets once time, 3 times per week during 6 weeks. The two-way ANOVA with repeated measure was used to check the pain degree and muscle activity. The present results showed that muscle activity in the LBP I-Zer exercise group was increased compared to the LBP mat exercise group and LBP control group (P<0.05). LBP I-Zer exercise group and LBP mat exercise group showed increased mean frequency in LT, IL, M, and RA muscles than the LBP control group. Therefore, LBP patients performed isometric exercise may have positive effect to reduce pain degree and to increase muscle activity. Especially, LBP I-Zer exercise type showed more effectiveness in reducing pain degree and enhancing muscle activity. PMID:26331136

  4. The effects of isometric exercise types on pain and muscle activity in patients with low back pain

    PubMed Central

    Rhyu, Hyun-Seung; Park, Hun-Kyung; Park, Jung-Sub; Park, Hye-Sang

    2015-01-01

    The purpose of the present study is to evaluate the effects of isometric exercise types on low back pain (LBP) patients. Isometric exercise types were mat exercise and I-Zer exercise. Subjects were divided into 3 groups: LBP control group, LBP mat exercise group, and LBP I-Zer exercise group in 23–25 aged men. Visual analogue scale (VAS) and electromyography (EMG) were used to evaluate the degree of pain and the muscle activity in LBP patients. Root mean square (RMS), median frequency (MDF), and mean frequency (MNF) were checked by EMG power spectrum analysis on longissimus thoracic (LT), iliocostalis lumborum (IL), mulitifidus (M), and rectus abdominis (RA). LBP mat exercise program and LBP I-Zer exercise program were conducted 5 sets once time, 3 times per week during 6 weeks. The two-way ANOVA with repeated measure was used to check the pain degree and muscle activity. The present results showed that muscle activity in the LBP I-Zer exercise group was increased compared to the LBP mat exercise group and LBP control group (P<0.05). LBP I-Zer exercise group and LBP mat exercise group showed increased mean frequency in LT, IL, M, and RA muscles than the LBP control group. Therefore, LBP patients performed isometric exercise may have positive effect to reduce pain degree and to increase muscle activity. Especially, LBP I-Zer exercise type showed more effectiveness in reducing pain degree and enhancing muscle activity. PMID:26331136

  5. Muscle Activation and Performance During Trunk Strength Testing in High-Level Female and Male Football Players.

    PubMed

    Roth, Ralf; Donath, Lars; Zahner, Lukas; Faude, Oliver

    2016-06-01

    For performance and injury prevention in sport, core strength and endurance are focused prerequisites. Therefore we evaluated characteristics of trunk muscle activation and performance during strength-endurance related trunk field tests. Strength-endurance ability, as total time to failure, and activation of trunk muscles was measured in 39 football players of the highest German female football league (Bundesliga) (N = 18, age: 20.7 y [SD 4.4]) and the highest national male under-19 league (N = 21, age: 17.9 y [0.7]) in prone plank, side plank, and dorsal position. Maximal isometric force was assessed during trunk extension and flexion, rotation, and lateral flexion to normalize EMG and to compare with the results of strength-endurance tests. For all positions of endurance strength tests, a continuous increase in normalized EMG activation was observed (P < .001). Muscle activation of the rectus abdominis and external oblique in prone plank position exceeded the maximal voluntary isometric contraction activation, with a significantly higher activation in females (P = .02). We conclude, that in the applied strength-endurance testing, the activation of trunk muscles was high, especially in females. As high trunk muscle activation can infer fatigue, limb strength can limit performance in prone and side plank position, particularly during high trunk muscle activation. PMID:26671894

  6. A Case of Reverse Palmaris Longus Muscle- An Additional Muscle in the Anterior Compartment of the Forearm

    PubMed Central

    Bhat, Ashwini Lagadamane Sathynarayana; Gadahad, Mohandas Rao Kappettu

    2016-01-01

    It is uncommon to have additional muscles in the upper limb. Some of them may restrict the movements or compress the nerves and vessels, while others may go unnoticed. During the routine dissection for undergraduate medical students, we observed an additional muscle in the anterior compartment of the forearm in about 60-year-old male cadaver. The muscle had a prominent belly and a long tendon. Distally, it was attached to the flexor retinaculum by a short and thick tendon. Proximally, long tendon of the muscle passed between the flexor carpi ulnaris and palmaris longus and was attached to the common aponeurosis shared by the extensor carpi ulnaris and flexor digitorum profundus muscles. The additional muscle belly was supplied by a branch from the anterior interosseous nerve. The ulnar nerve and artery was passing deep to the fleshy belly of the muscle. The muscle reported here might compress the ulnar nerve and artery and may produce neurovascular symptoms. On the other hand, the tendon and fleshy belly of the muscle could be useful in muscle/tendon grafts. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for surgeons during the forearm and hand surgeries. PMID:27134851

  7. A Case of Reverse Palmaris Longus Muscle- An Additional Muscle in the Anterior Compartment of the Forearm.

    PubMed

    Marpalli, Sapna; Bhat, Ashwini Lagadamane Sathynarayana; Gadahad, Mohandas Rao Kappettu

    2016-03-01

    It is uncommon to have additional muscles in the upper limb. Some of them may restrict the movements or compress the nerves and vessels, while others may go unnoticed. During the routine dissection for undergraduate medical students, we observed an additional muscle in the anterior compartment of the forearm in about 60-year-old male cadaver. The muscle had a prominent belly and a long tendon. Distally, it was attached to the flexor retinaculum by a short and thick tendon. Proximally, long tendon of the muscle passed between the flexor carpi ulnaris and palmaris longus and was attached to the common aponeurosis shared by the extensor carpi ulnaris and flexor digitorum profundus muscles. The additional muscle belly was supplied by a branch from the anterior interosseous nerve. The ulnar nerve and artery was passing deep to the fleshy belly of the muscle. The muscle reported here might compress the ulnar nerve and artery and may produce neurovascular symptoms. On the other hand, the tendon and fleshy belly of the muscle could be useful in muscle/tendon grafts. The observations made by us in the present case will supplement our knowledge of variations of the muscles in this region which could be useful for surgeons during the forearm and hand surgeries. PMID:27134851

  8. Frontalis Suspension Surgery in Upper Eyelid Blepharoptosis

    PubMed Central

    Takahashi, Yasuhiro; Leibovitch, Igal; Kakizaki, Hirohiko

    2010-01-01

    Frontalis suspension is a commonly used surgery that is indicated in patients with blepharoptosis and poor levator muscle function. The surgery is based on connecting the tarsal plate to the eyebrow with various sling materials. Although fascia lata is most commonly used due to its long-lasting effect and low rate of complications, it has several limitations such as difficulty of harvesting, insufficient amounts in small children, and postoperative donor-site complications. Other sling materials have overcome these limitations, but on the other hand, have been reported to be associated with other complications. In this review we focus on the different techniques and materials which are used in frontalis suspension surgeries, as well as the advantage and disadvantage of these techniques. PMID:21331314

  9. Effects of jump training on procollagen alpha(1)(i) mRNA expression and its relationship with muscle collagen concentration.

    PubMed

    Ducomps, Christophe; Larrouy, Dominique; Mairal, Aline; Doutreloux, Jean-Paul; Lebas, Francois; Mauriege, Pascale

    2004-04-01

    The aim of this study was to examine the effects of a prolonged high-intensity exercise, jumping, on procollagen alpha(1)(I) mRNA level and collagen concentration in different muscles of trained (T) and control (C) rabbits. Procollagen alpha(1)(I) mRNA expression was much higher (2.8 to 23.5 times) in semimembranosus proprius (SMP), a slow-twitch oxidative muscle, than in extensor digitorum longus (EDL), rectus femoris (RF), and psoas major (Psoas) muscles, both fast-twitch mixed and glycolytic, whatever group was considered (p < 0.001). Procollagen alpha(1)(I) mRNA level also decreased significantly between 50 and 140 days in all muscles (0.001< p < 0.01). However, mRNA levels were 16 to 97% greater at 140 days in all muscles of T animals compared to C ones (0.01< p <0.05). Collagen concentrations of EDL and RF muscles were also higher (14 to 19%) in T than in C rabbits at 90 and 140 days (0.001 < p < 0.05). In the whole sample, collagen concentration was negatively associated with the procollagen alpha(1)(I) mRNA level in EDL and RF muscles (- 0.49 < r < (- 0.44, p < 0.05), while being positively related to mRNA expression in SMP and Psoas muscles (0.65 < r < 0.85, p < 0.01). It is concluded that jump training clearly restricts the decrease of procollagen (I) mRNA level and probably affects collagen synthesis level. In trained rabbit muscles, the maintenance of a better synthesis level could partly explain the higher collagen concentrations found in EDL and RF at 140 days. Nevertheless, the collagen degradation process seems to play the main role in the increase of total collagen concentration with age in EDL and RF muscles. PMID:15064425

  10. Abdominal wall surgery

    MedlinePlus

    ... skin. Abdominoplasty can be helpful when: Diet and exercise have not helped improve muscle tone, such as in women who have had more than one pregnancy. Skin and muscle cannot regain its normal tone. ...

  11. Independent Active Contraction of Extraocular Muscle Compartments

    PubMed Central

    Shin, Andrew; Yoo, Lawrence; Demer, Joseph L.

    2015-01-01

    Purpose. Intramuscular innervation of horizontal rectus extraocular muscle (EOMs) is segregated into superior and inferior (transverse) compartments, whereas all EOMs are also divided into global (GL) and orbital (OL) layers with scleral and pulley insertions, respectively. Mechanical independence between both types of compartments has been demonstrated during passive tensile loading. We examined coupling between EOM compartments during active, ex vivo contraction. Methods. Fresh bovine EOMs were removed, and one compartment of each was coated with hydrophobic petrolatum. Contraction of the uncoated compartment was induced by immersion in a solution of 50 mM CaCl2 at 38°C labeled with sodium fluorescein dye, whereas tensions in both compartments were monitored by strain gauges. Control experiments omitted petrolatum so that the entire EOM contracted. After physiological experiments, EOMs were sectioned transversely to demonstrate specificity of CaCl2 permeation by yellow fluorescence dye excited by blue light. Results. In control experiments without petrolatum, both transverse and GL and OL compartments contracted similarly. Selective compartmental omission of petrolatum caused markedly independent compartmental contraction whether measured at the GL or the OL insertions or for transverse compartments at the scleral insertion. Although some CaCl2 spread occurred, mean (±SD) tension in the coated compartments averaged only 10.5 ± 3.3% and 6.0 ± 1.5% in GL/OL and transverse compartments, respectively relative to uncoated compartments. Fluorescein penetration confirmed selective CaCl2 permeation. Conclusions. These data confirm passive tensile findings of mechanical independence of EOM compartments and extend results to active contraction. EOMs behave actively as if composed of mechanically independent parallel fiber bundles having different insertional targets, consistent with the active pulley and transverse compartmental hypotheses. PMID:25503460

  12. Trunk muscle activation during stabilization exercises with single and double leg support.

    PubMed

    García-Vaquero, María Pilar; Moreside, Janice M; Brontons-Gil, Evaristo; Peco-González, Noelia; Vera-Garcia, Francisco J

    2012-06-01

    The aim of this study was to analyze trunk muscle activity during bridge style stabilization exercises, when combined with single and double leg support strategies. Twenty-nine healthy volunteers performed bridge exercises in 3 different positions (back, front and side bridges), with and without an elevated leg, and a quadruped exercise with contralateral arm and leg raise ("bird-dog"). Surface EMG was bilaterally recorded from rectus abdominis (RA), external and internal oblique (EO, IO), and erector spinae (ES). Back, front and side bridges primarily activated the ES (approximately 17% MVC), RA (approximately 30% MVC) and muscles required to support the lateral moment (mostly obliques), respectively. Compared with conventional bridge exercises, single leg support produced higher levels of trunk activation, predominantly in the oblique muscles. The bird-dog exercise produced greatest activity in IO on the side of the elevated arm and in the contralateral ES. In conclusion, during a common bridge with double leg support, the antigravity muscles were the most active. When performed with an elevated leg, however, rotation torques increased the activation of the trunk rotators, especially IO. This information may be useful for clinicians and rehabilitation specialists in determining appropriate exercise progression for the trunk stabilizers. PMID:22436839

  13. Reliability of Abdominal Muscle Stiffness Measured Using Elastography during Trunk Rehabilitation Exercises.

    PubMed

    MacDonald, David; Wan, Alan; McPhee, Megan; Tucker, Kylie; Hug, François

    2016-04-01

    The aim of this study was to assess the intra-session and inter-rater reliability of shear modulus measured in abdominal muscles during two commonly used trunk stability exercises. Thirty healthy volunteers performed a series of abdominal hollow and abdominal brace tasks. Supersonic shear imaging was used to measure the shear modulus (considered an index of muscle tension) of the four anterior trunk muscles: obliquus externus abdominis, obliquus internus abdominis, transversus abdominis and rectus abdominis. Because of measurement artifacts, internus abdominis and transversus abdominis data were not analyzed for 36.7% and 26.7% of the participants, respectively. These participants exhibited thicker superficial fat layers than the others. For the remaining participants, fair to excellent intra-session and inter-rater reliability was observed with moderate to high intra-class coefficients (0.45-0.97) and low to moderate standard error of measurement values (0.38-3.53 kPa). Reliability values were consistently greater for superficial than for deeper muscles. PMID:26746381

  14. Trunk kinematics and trunk muscle activity during a rapidly applied load.

    PubMed

    Thomas, J S; Lavender, S A; Corcos, D M; Andersson, G B

    1998-08-01

    This study investigated the trunk kinematics and electromyographic (EMG) activity of eight trunk muscles when "expected" and "unexpected" loads were applied directly to the torso. Twenty individuals (mean age: 25.1 yr; range 20-33 yr) participated in this mixed model study in which gender was the between-subjects factor, and expectancy and symmetry of the applied load were within-subject factors. The sudden load was delivered to the subject via a cable attached to a thoracic harness and motion was restricted to the lumbar spine by strapping the pelvis to a rigid fixation apparatus. Surface EMG was recorded bilaterally from the longissimus thoracis (LGT), erector spinae (ERS), rectus abdominis (RAB) and the external obliques (EXO). Trunk kinematics were measured with a Lumbar Motion Monitor. During expected loading conditions, the peak muscle activity was reduced for the RAB and EXO bilaterally, and for the ERS(R) (p < 0.01) relative to the unexpected conditions. Conversely, the normalized area of EMG activity prior to the onset of load was increased for the ERS and EXO bilaterally, and for the RAB(R) (p < 0.05) during an expected loading event. Trunk motion in the sagittal and frontal planes was reduced during expected loading. Activation of the trunk muscles just prior to a rapid loading event increases trunk stiffness, decreasing trunk displacement and peak muscle activity. PMID:9779395

  15. Effects of breathing exercises on lung capacity and muscle activities of elderly smokers

    PubMed Central

    Jun, Hyun-Ju; Kim, Ki-Jong; Nam, Ki-Won; Kim, Chang-Heon

    2016-01-01

    [Purpose] Elderly smokers have a reduced chest diameter due to weakening of the respiratory muscles, and this results in decreased ventilation, leading to a vicious circle. Therefore, the present study investigated the effects of an intervention program to enhance the pulmonary function and muscle activity of elderly smokers. [Subjects and Methods] Participants were randomly assigned to one of two experimental groups or a control (CG) group. The experimental groups performed exercises three times per week for six weeks, whereas the CG performed no exercises. One of the experimental groups performed a Feedback Breathing Exercise (FBE) for 15 minutes, and the other repeated three sets of Balloon-Blowing Exercises (BBE) with sufficient rest of more than one minute between sets. [Results] In the experimental groups, FVC, FEV1/FVC, PEF and muscle activity of the rectus abdominis significantly improved after four weeks, but no significant differences were observed in FEV1 or VC after six weeks. [Conclusion] The results show that FBE and BBE improved the pulmonary functions of elderly smokers, demonstrating the potential benefits of the development of various training methods using balloons, and group programs, including recreational factors, for increasing respiratory muscles strength. PMID:27390394

  16. Reliability of Trunk Muscle Electromyography in the Loaded Back Squat Exercise.

    PubMed

    Clark, D; Lambert, M I; Hunter, A M

    2016-06-01

    Trunk muscle activation (TMA) has been reported during back squat exercise, however reliability and sensitivity to different loads alongside kinematic measures has not. Hence the aim was to determine the interday reliability and load sensitivity of TMA and kinematics during back squats. 10 males performed 3 test sessions: 1) back squat 1RM, 2) and 3) 3 reps at 65, 75, 85 and 95% of system mass max (SMmax). Kinematics were measured from an electrogoniometer and linear transducer, and surface electromyography (sEMG) recorded 4 muscles of the trunk: rectus abdominis (RA), external oblique (EO), upper lumbar erector spinae (ULES) and lumbar sacral erector spinae (LSES), and a reference leg muscle, the vastus lateralus (VL). sEMG amplitude was root mean squared (RMS). No differences (p>0.05) found between tests for any kinematic and RMS data. CV demonstrated moderate interday reliability (~16.1%) for EO, LSES and ULES but not RA (29.4%) during the velocity-controlled eccentric phase; whereas it was moderately acceptable for just LSES and ULES (~17.8%) but not RA and EO (27.9%) during the uncontrolled concentric phase. This study demonstrated acceptable interday reliability for kinematic data while sEMG for most trunk muscle sites was moderately acceptable during controlled contraction. sEMG responded significantly to load. PMID:26928915

  17. Changes in muscle architecture induced by low load blood flow restricted training.

    PubMed

    Martín-Hernández, Juan; Marín, P J; Menéndez, H; Loenneke, J P; Coelho-e-Silva, M J; García-López, D; Herrero, A J

    2013-12-01

    In order to ascertain whether differing structural mechanisms could underlie blood flow restricted training (BFRT) and high intensity training (HIT), this study had two aims: (i) to gain an insight into the acute variations of muscle architecture following a single bout of two different volumes of BFRT, and (ii) to compare these variations with those observed after HIT. Thirty-five young men volunteered for the study and were randomly divided into three groups: BFRT low volume (BFRT LV), BFRT high volume (BFRT HV) and traditional high intensity resistance training (HIT). All subjects performed a bilateral leg extension exercise session with a load of 20% of one repetition maximum (1RM) in the BFRT groups, whereas the load of the HIT group was equivalent to an 85% of their 1RM. Before and immediately after the exercise bout, ultrasound images were taken from the rectus femoris (RF) and the vastus lateralis (VL). All groups increased their RF (p < 0.001) and VL (p < 0.001) muscle thickness, while the increases in pennation angle were larger in HIT as compared to BFRT LV (p = 0.013) and BFRT HV (p = 0.037). These results support the hypothesis that acute muscle cell swelling may be involved in the processes underlying BFRT induced muscle hypertrophy. Furthermore, our data indicate differing structural responses to exercise between BFRT and HIT. PMID:24013941

  18. Long-term results of pectoralis major muscle transposition for infected sternotomy wounds.

    PubMed Central

    Pairolero, P C; Arnold, P G; Harris, J B

    1991-01-01

    During an 11.5-year period, 100 consecutive patients (79 male, 21 female) underwent repair of an infected sternotomy wound. Sixty-five patients had failed attempts at wound closure by other physicians. Median age was 61.5 years (range, 5 to 85 years). Reconstruction included muscle in 79 patients, omentum in 4, and both in 15. A total of 175 muscles were transposed, including 169 pectoralis major, 3 rectus abdominis, 2 external oblique, and 1 latissimus dorsi. Median number of operations was four (range, 1 to 11). Mechanical ventilation was required in 30 patients. Two perioperative deaths occurred, one related to sepsis. Median follow-up was 4.2 years (range, 1.3 to 13.5 years). Twenty-six patients had recurrent infection. Median time from our closure to recurrence was 5.5 months (range, 0.3 to 27.6 months). Cause of recurrence was inadequate removal of cartilage in 16 patients, bone in 6, and retained foreign body in 4. Eighteen patients had the wound reopened with further resection; 10 had another muscle or omentum transposition. There were 30 late deaths, only one related to recurrent infection. At the time of death or last follow-up, 92 patients had a healed chest wall. Transposition of the pectoralis major muscle remains an excellent method of management for infected sternotomy wounds. Failure is directly related to persistent infection of cartilage, bone, or retained foreign bodies. PMID:2039289

  19. The effect of the weight of equipment on muscle activity of the lower extremity in soldiers.

    PubMed

    Lindner, Tobias; Schulze, Christoph; Woitge, Sandra; Finze, Susanne; Mittelmeier, Wolfram; Bader, Rainer

    2012-01-01

    Due to their profession and the tasks it entails, soldiers are exposed to high levels of physical activity and strain. This can result in overexertion and pain in the locomotor system, partly caused by carrying items of equipment. The aim of this study was to analyse the extent of muscle activity in the lower extremities caused by carrying specific items of equipment. For this purpose, the activity of selected groups of muscles caused by different items of equipment (helmet, carrying strap, backpack, and rifle) in the upper and lower leg was measured by recording dynamic surface electromyograms. Electrogoniometers were also used to measure the angle of the knee over the entire gait cycle. In addition to measuring muscle activity, the study also aimed to determine out what influence increasing weight load has on the range of motion (ROM) of the knee joint during walking. The activity of recorded muscles of the lower extremity, that is, the tibialis anterior, peroneus longus, gastrocnemius lateralis, gastrocnemius medialis, rectus femoris, and biceps femoris, was found to depend on the weight of the items of equipment. There was no evidence, however, that items of equipment weighing a maximum of 34% of their carrier's body weight had an effect on the ROM of the knee joint. PMID:22973179

  20. The Development of a Flexible Measuring System for Muscle Volume Using Ultrasonography

    NASA Astrophysics Data System (ADS)

    Fukumoto, Kiyotaka; Fukuda, Osamu; Tsubai, Masayoshi; Muraki, Satoshi

    Quantification of muscle volume can be used as a means for the estimation of muscle strength. Its measuring process does not need the subject's muscular contractions so it is completely safe and particularly suited for elderly people. Therefore, we have developed a flexible measuring system for muscle volume using ultrasonography. In this system, an ultrasound probe is installed on a link mechanism which continuously scans fragmental images along the human body surface. These images are then measured and composed into a wide area cross-sectional image based on the spatial compounding method. The flexibility of the link mechanism enables the operator to measure the images under any body postures and body site. The spatial compounding method significantly reduces speckle and artifact noises from the composed cross-sectional image so that the operator can observe the individual muscles, such as Rectus femoris, Vastus intermedius, and so on, in detail. We conducted the experiments in order to examine the advantages of this system we have developed. The experimental results showed a high accuracy of the measuring position which was calculated using the link mechanism and presented the noise reduction effect based on the spatial compounding method. Finally, we confirmed high correlations between the MRI images and the ones of the developed system to verify the validity of the system.

  1. Do Changes in Muscle Architecture Affect Post-Activation Potentiation?

    PubMed Central

    Reardon, Danielle; Hoffman, Jay R.; Mangine, Gerald T.; Wells, Adam J.; Gonzalez, Adam M.; Jajtner, Adam R.; Townsend, Jeremy R.; McCormack, William P.; Stout, Jeffrey R.; Fragala, Maren S.; Fukuda, David H.

    2014-01-01

    The purpose of this randomized, cross-over design study was to examine the effect of three different muscle potentiation protocols on acute changes in muscle architecture and vertical jump performance. Eleven experienced, resistance trained men (25.2±3.6y) completed three potentiation squat protocols using moderate intensity (MI; 75%, 3 sets x 10 repetitions), high intensity (HI; 90%, 3 sets x 3 repetitions) and 100% (1RM; 1 set x 1repetition) of their 1RM. In addition, all participants completed a control session (CTL) in which no protocol was performed. During each testing session, muscle architecture and vertical jump testing were assessed at baseline (BL), 8min post (8P) and 20min post (20P) workout. Ultrasound measures included cross sectional area (CSA) and pennation angle (PANG) of both the rectus femoris (RF) and vastus lateralis (VL). Following each ultrasound measure, peak vertical jump power (PVJP) and mean (MVJP) power was assessed using an accelerometer. Magnitude based inferences were used to make comparisons between trials. The MI trial resulted in a likely greater increase from BL to 8P and 20P in RF-CSA and VL-CSA, while the HI trial resulted in a likely greater change from BL to 20P in both RF-CSA and VL-CSA. Meanwhile, changes in PVJP and MVJP for the MI trial was likely decreased at BL-8P and BL–20P, while the HI trial was shown to result in a likely or possible decrease compared to CTL at BL-8P and BL–20P, respectively. A likely negative relationship was observed between changes in VL-PANG and MVJP (r = -0.35; p , 0.018) at BL-8P, and between changes in PVJP and RF-CSA (r = -0.37; p , 0.014) at BL–20P. Results of this study were unable to demonstrate any potentiation response from the trials employed, however these protocols did result in acute muscle architectural changes. Key points Three squat protocols using moderate intensity (75% 1-RM; 3 sets x 10 repetitions), high intensity (90% 1-RM, 3 sets x 3 repetitions) and maximal intensity

  2. [Errors in the diagnosis of ruptures of the straight muscle of the abdomen].

    PubMed

    Raĭkevich, N P

    1975-03-01

    Based on study of the clinical picture of ruptures of straight abdominal muslces in 9 patients, it is considered that this pathology is considered to occur in males as frequently as in females, a spontaneous rupture being observed more frequently in females over 40 years of age, who had multiple deliveries previously and show arterial hypertension. The man signs of spontaneous or traumatic rupture of straight muscles are as follows: a sudden onset of pains conditioned by hematoma, pressure on the parietal peritoneum, in palpation a detection of tumor in the tumor in the region of m. rectus abdomins that would not disappear in abdominal tension; and also intensification of pains in the hematoma region in elevating the head in a supine position. As a rule, the body temperature is normal, but the leucocyte count may be somewhat increased. Usually, such patients are treated conservatively. Surgical intervention seems to be indicated only in organization of hematoma or its suppuration. PMID:123380

  3. The Role of Magnetic Resonance Imaging in Athletic Pubalgia and Core Muscle Injury.

    PubMed

    Coker, Dana J; Zoga, Adam C

    2015-08-01

    Magnetic resonance imaging (MRI) has become the standard of care imaging modality for a difficult, often misunderstood spectrum of musculoskeletal injury termed athletic pubalgia or core muscle injury. Armed with a dedicated noncontrast athletic pubalgia protocol and a late model phased array receiver coil, the musculoskeletal imager can play a great role in effective diagnosis and treatment planning for lesions, including osteitis pubis, midline pubic plate lesions, and rectus abdominis/adductor aponeurosis injury. Beyond these established patterns of MRI findings, there are many confounders and contributing pathologies about the pelvis in patients with activity related groin pain, including internal and periarticular derangements of the hip. The MRI is ideally suited to delineate the extent of expected injury and to identify the unexpected visceral and musculoskeletal lesions. PMID:26244616

  4. Lasik eye surgery - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000525.htm Lasik eye surgery - discharge To use the sharing features on this page, please enable JavaScript. Lasik eye surgery permanently changes the shape of the cornea ( ...

  5. Ear Plastic Surgery

    MedlinePlus

    ... Meeting Calendar Find an ENT Doctor Near You Ear Plastic Surgery Ear Plastic Surgery Patient Health Information ... they may improve appearance and self-confidence. Can Ear Deformities Be Corrected? Formation of the ear during ...

  6. Plastic Surgery for Teenagers

    MedlinePlus

    ... or severe acne and scarring. Teens frequently gain self-esteem and confidence when their physical problems are corrected. ... art as a helpful index of anxiety and self-esteem with plastic surgery. Plastic and Reconstructive Surgery 2002. ...

  7. Refractive corneal surgery - discharge

    MedlinePlus

    ... after surgery, it should be okay to use artificial tears. Check with your doctor. Do NOT wear contact lenses on the eye that had surgery, even if you have blurry vision. Do NOT use any makeup, creams, or lotions ...

  8. Pediatric heart surgery - discharge

    MedlinePlus

    ... discharge; Heart valve surgery - children - discharge; Heart surgery - pediatric - discharge; Heart transplant - pediatric - discharge ... Keane JF, Lock JE, Fyler DC, eds. Nadas' Pediatric Cardiology . 2nd ed. St. Louis, MO; WB Saunders; ...

  9. Periodontal Plastic Surgery

    MedlinePlus

    ... Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and Aligners Periodontal Plastic Surgery Porcelain Crowns Porcelain ... Dental Implants Dentures Direct Bonding Implants versus Bridges Orthodontics and Aligners Periodontal Plastic Surgery Porcelain Crowns Porcelain ...

  10. American Board of Surgery

    MedlinePlus

    ... How to Apply Certifying Exam Specialty Definition Surgical Critical Care Related Policies Exam Admissibility Policy Leave Policy Certifying ... Surgery About the Exam How to Apply Surgical Critical Care About the Exam How to Apply Hand Surgery ...

  11. Carotid artery surgery - discharge

    MedlinePlus

    ... page: //medlineplus.gov/ency/patientinstructions/000238.htm Carotid artery surgery - discharge To use the sharing features on this page, please enable JavaScript. You had carotid artery surgery to restore proper blood flow to your ...

  12. Complications of Sinus Surgery

    MedlinePlus

    ... further intracranial surgeries. Impaired sense of taste or smell : The sense of smell usually improves after the procedure because airflow is ... in their voice after sinus surgery. Impairment of smell or taste: (see above) Infection: The most common ...

  13. Cosmetic ear surgery

    MedlinePlus

    Otoplasty; Ear pinning; Ear surgery - cosmetic; Ear reshaping; Pinnaplasty ... Cosmetic ear surgery may be done in the surgeon's office, an outpatient clinic, or a hospital. It can be performed under ...

  14. Hip fracture surgery

    MedlinePlus

    ... neck fracture repair; Trochanteric fracture repair; Hip pinning surgery; Osteoarthritis-hip ... You may receive general anesthesia before this surgery. This means ... spinal anesthesia. With this kind of anesthesia, medicine is ...

  15. Cataract surgery - series (image)

    MedlinePlus

    Cataract surgery usually works very well. The operation has few risks, the pain and recovery period are short, ... improved. Ninety-five percent or more of all cataract surgeries result in improved vision.

  16. Cosmetic breast surgery - discharge

    MedlinePlus

    ... Higdon KK. Reduction mammoplasty. In: Neligan PC, ed. Plastic Surgery . 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 8. ... Gabriel A. Breast augmentation. In: Neligan PC, ed. Plastic Surgery . 3rd ed. Philadelphia, PA: Elsevier; 2013:chap 2.

  17. Targeted Muscle Reinnervation and Advanced Prosthetic Arms

    PubMed Central

    Cheesborough, Jennifer E.; Smith, Lauren H.; Kuiken, Todd A.; Dumanian, Gregory A.

    2015-01-01

    Targeted muscle reinnervation (TMR) is a surgical procedure used to improve the control of upper limb prostheses. Residual nerves from the amputated limb are transferred to reinnervate new muscle targets that have otherwise lost their function. These reinnervated muscles then serve as biological amplifiers of the amputated nerve motor signals, allowing for more intuitive control of advanced prosthetic arms. Here the authors provide a review of surgical techniques for TMR in patients with either transhumeral or shoulder disarticulation amputations. They also discuss how TMR may act synergistically with recent advances in prosthetic arm technologies to improve prosthesis controllability. Discussion of TMR and prosthesis control is presented in the context of a 41-year-old man with a left-side shoulder disarticulation and a right-side transhumeral amputation. This patient underwent bilateral TMR surgery and was fit with advanced pattern-recognition myoelectric prostheses. PMID:25685105

  18. Myositis Ossificans of the Temporalis Muscle.

    PubMed

    Becker, Otávio Emmel; Avelar, Rafael Linard; Rivero, Elena Riet Correa; De Oliveira, Rogério Belle; Meurer, Maria Inês; Santos, Aira Maria Bonfim; Haas Júnior, Orion Luis; Meurer, Eduardo

    2016-09-01

    Traumatic myositis ossificans (TMO) is a rare ossifying disease that occurs in the muscle or soft tissues. A case of TMO isolated in the temporalis muscle is reported. In the case described, calcification in the temporalis muscle was confirmed after computed tomography. Surgery, physiotherapy, and histopathological analysis were performed. One year after treatment, further ossification was present but without interference in function. The most accepted treatment for TMO in the maxillofacial region is excision followed by physiotherapy. The high rate of non-recurrence may be concealed due to the short follow-up period. TMO is a lesion that may frequently recur and long-term follow-up must be provided. PMID:26703385

  19. Trunk Muscle Activation at the Initiation and Braking of Bilateral Shoulder Flexion Movements of Different Amplitudes

    PubMed Central

    Eriksson Crommert, M.; Halvorsen, K.; Ekblom, M. M.

    2015-01-01

    The aim of this study was to investigate if trunk muscle activation patterns during rapid bilateral shoulder flexions are affected by movement amplitude. Eleven healthy males performed shoulder flexion movements starting from a position with arms along sides (0°) to either 45°, 90° or 180°. EMG was measured bilaterally from transversus abdominis (TrA), obliquus internus (OI) with intra-muscular electrodes, and from rectus abdominis (RA), erector spinae (ES) and deltoideus with surface electrodes. 3D kinematics was recorded and inverse dynamics was used to calculate the reactive linear forces and torque about the shoulders and the linear and angular impulses. The sequencing of trunk muscle onsets at the initiation of arm movements was the same across movement amplitudes with ES as the first muscle activated, followed by TrA, RA and OI. All arm movements induced a flexion angular impulse about the shoulders during acceleration that was reversed during deceleration. Increased movement amplitude led to shortened onset latencies of the abdominal muscles and increased level of activation in TrA and ES. The activation magnitude of TrA was similar in acceleration and deceleration where the other muscles were specific to acceleration or deceleration. The findings show that arm movements need to be standardized when used as a method to evaluate trunk muscle activation patterns and that inclusion of the deceleration of the arms in the analysis allow the study of the relationship between trunk muscle activation and direction of perturbing torque during one and the same arm movement. PMID:26562017

  20. Complications in Eyelid Surgery.

    PubMed

    Karimnejad, Kaveh; Walen, Scott

    2016-05-01

    Eyelid surgery consists of challenging reconstructive and cosmetic procedures. Because of the complex anatomy and corresponding vital functions of the upper and lower eyelids, the avoidance of eyelid complications is of vital importance. Complications after eyelid surgery include basic complications (infection, granuloma) and vision-threatening complications. Preoperative history, physical examination, surgical planning, and meticulous surgical technique must be undertaken to prevent complications after eyelid surgery. In addition, patient knowledge, expectations, and motivations must be determined before surgery is performed. PMID:27105805

  1. Robotic liver surgery

    PubMed Central

    Leung, Universe

    2014-01-01

    Robotic surgery is an evolving technology that has been successfully applied to a number of surgical specialties, but its use in liver surgery has so far been limited. In this review article we discuss the challenges of minimally invasive liver surgery, the pros and cons of robotics, the evolution of medical robots, and the potentials in applying this technology to liver surgery. The current data in the literature are also presented. PMID:25392840

  2. [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

  3. Refractive surgery and strabismus.

    PubMed

    Kowal, Lionel; Battu, Ravindra; Kushner, Burton

    2005-02-01

    This review discusses the potential for strabismic complications after refractive surgery for hyperopia, myopia, anisomyopia, astigmatism and monovision, and how to avoid these complications. Guidelines are given for assessing patients with strabismus seeking refractive surgery. Screening tests are suggested that lead to stratification of refractive surgery patients into different risk groups each warranting a different intensity of evaluation. PMID:15670088

  4. Pediatric heart surgery

    MedlinePlus

    Heart surgery - pediatric; Heart surgery for children; Acquired heart disease; Heart valve surgery - children ... There are many kinds of heart defects. Some are minor, and others are more serious. Defects can occur inside the heart or in the large blood vessels ...

  5. Infection after hand surgery.

    PubMed

    Eberlin, Kyle R; Ring, David

    2015-05-01

    Postoperative infections are uncommon after hand surgery. Infection can delay recovery and contribute to scarring and stiffness. Measures intended to reduce the risk of infection after hand surgery include hand washing, skin preparation, sterile technique, and prophylactic antibiotics. The role of prophylactic antibiotics for small, clean, elective hand surgery procedures lasting less than 2 hours is debated. PMID:25934209

  6. Cavus Foot Surgery

    MedlinePlus

    ... Toes All Site Content AOFAS / FootCareMD / Treatments Cavus Foot Surgery Page Content What is a cavus foot? A cavus or high-arched foot may have ... related problems. What are the goals of cavus foot surgery? The main goal of surgery is to ...

  7. On high heels and short muscles: A multiscale model for sarcomere loss in the gastrocnemius muscle

    PubMed Central

    Zöllner, Alexander M.; Pok, Jacquelynn M.; McWalter, Emily J.; Gold, Garry E.; Kuhl, Ellen

    2014-01-01

    High heels are a major source of chronic lower limb pain. Yet, more than one third of all women compromise health for looks and wear high heels on a daily basis. Changing from flat footwear to high heels induces chronic muscle shortening associated with discomfort, fatigue, reduced shock absorption, and increased injury risk. However, the long-term effects of high-heeled footwear on the musculoskeletal kinematics of the lower extremities remain poorly understood. Here we create a multiscale computational model for chronic muscle adaptation to characterize the acute and chronic effects of global muscle shortening on local sarcomere lengths. We perform a case study of a healthy female subject and show that raising the heel by 13 cm shortens the gastrocnemius muscle by 5% while the Achilles tendon remains virtually unaffected. Our computational simulation indicates that muscle shortening displays significant regional variations with extreme values of 22% in the central gastrocnemius. Our model suggests that the muscle gradually adjusts to its new functional length by a chronic loss of sarcomeres in series. Sarcomere loss varies significantly across the muscle with an average loss of 9%, virtually no loss at the proximal and distal ends, and a maximum loss of 39% in the central region. These changes reposition the remaining sarcomeres back into their optimal operating regime. Computational modeling of chronic muscle shortening provides a valuable tool to shape our understanding of the underlying mechanisms of muscle adaptation. Our study could open new avenues in orthopedic surgery and enhance treatment for patients with muscle contracture caused by other conditions than high heel wear such as paralysis, muscular atrophy, and muscular dystrophy. PMID:25451524

  8. On high heels and short muscles: a multiscale model for sarcomere loss in the gastrocnemius muscle.

    PubMed

    Zöllner, Alexander M; Pok, Jacquelynn M; McWalter, Emily J; Gold, Garry E; Kuhl, Ellen

    2015-01-21

    High heels are a major source of chronic lower limb pain. Yet, more than one third of all women compromise health for looks and wear high heels on a daily basis. Changing from flat footwear to high heels induces chronic muscle shortening associated with discomfort, fatigue, reduced shock absorption, and increased injury risk. However, the long-term effects of high-heeled footwear on the musculoskeletal kinematics of the lower extremities remain poorly understood. Here we create a multiscale computational model for chronic muscle adaptation to characterize the acute and chronic effects of global muscle shortening on local sarcomere lengths. We perform a case study of a healthy female subject and show that raising the heel by 13cm shortens the gastrocnemius muscle by 5% while the Achilles tendon remains virtually unaffected. Our computational simulation indicates that muscle shortening displays significant regional variations with extreme values of 22% in the central gastrocnemius. Our model suggests that the muscle gradually adjusts to its new functional length by a chronic loss of sarcomeres in series. Sarcomere loss varies significantly across the muscle with an average loss of 9%, virtually no loss at the proximal and distal ends, and a maximum loss of 39% in the central region. These changes reposition the remaining sarcomeres back into their optimal operating regime. Computational modeling of chronic muscle shortening provides a valuable tool to shape our understanding of the underlying mechanisms of muscle adaptation. Our study could open new avenues in orthopedic surgery and enhance treatment for patients with muscle contracture caused by other conditions than high heel wear such as paralysis, muscular atrophy, and muscular dystrophy. PMID:25451524

  9. Combined study on the causes of strabismus after the retinal surgery.

    PubMed

    Hwang, J M; Wright, K W

    1994-12-01

    Extraocular muscle imbalance and diplopia after retina surgery have been previously reported, but the etiology is still controversial. In order to better understand the cause of strabismus after retinal surgery, the authors retrospectively studied 30 patients with persistent strabismus following retinal surgery and combined the result about seven patients of strabismus after retinal surgery in the previous report. Results showed multiple etiologies for the strabismus. Causes of strabismus included fat adherence syndrome (14 patients), non-specific restrictive adhesion (11), displacement of superior oblique tendon (2), scleral explant interfering with ocular motility (1), lost or slipped muscle with adhesion (2), sensory strabismus (2), macular pucker causing ectopic fovea (2), and previous strabismus before the retinal surgery (3). Knowledge of the varieties of abnormalities that can cause strabismus and diplopia will help both the retina and strabismus surgeon prevent and treat strabismus after retinal surgery. PMID:7853737

  10. Altered muscle coordination when pedaling with independent cranks

    PubMed Central

    Hug, François; Boumier, Florian; Dorel, Sylvain

    2013-01-01

    Pedaling with independent cranks ensures each leg cycles independently of the other, and thus eliminates the contribution of the contralateral leg during the upstroke phase. Consequently the subject is required to actively pull-up the pedal to complete the cycle. The present study aimed to determine the acute effect of the use of independent cranks on muscle coordination during a submaximal pedaling exercise. Ten healthy males were asked to perform submaximal pedaling exercises at 100 Watts with normal fixed cranks (control condition) or independent cranks. Both 2-D pedal forces and electromyographic (EMG) SIGNALS of 10 lower limb muscles were recorded. When the mean EMG activity across the cycle was considered, the use of independent cranks significantly increased the activity level compared to control for Tibialis anterior (TA) (P = 0.0017; +336 ± 302%), Gastrocnemius medialis (GM) (P = 0.0005; +47 ± 25%), Rectus femoris (RF) (P = 0.005; +123 ± 153%), Biceps femoris (BF)—long head (P = 0.0001; +162 ± 97%), Semimembranosus (SM) (P = 0.0001; +304 ± 192%), and Tensor fascia latae (P = 0.0001; +586 ± 262%). The analysis of the four pedaling sectors revealed that the increased activity of hip and knee flexors mainly occurred during the top dead center and the upstroke phase. In addition, a high inter-individual variability was found in the way the participants adapted to pedaling with independent cranks. The present results showed that the enforced pull-up action required when using independent cranks was achieved by increasing the activation of hip and knee flexors. Further studies are needed to determine whether training with independent cranks has the potential to induce long-term changes in muscle coordination, and, if so, whether these changes are beneficial for cycling performance. PMID:24009587

  11. Anesthetic Management of a Patient with Myasthenia Gravis for Meningioma Surgery - A Case Report.

    PubMed

    Srivastava, V K; Agrawal, S; Ahmed, M; Sharma, S

    2015-01-01

    Myasthenia gravis is a disease of great challenge to the anesthesiologist, because it affects the neuromuscular junction. Anesthetic management involves either muscle relaxant or non-muscle relaxant techniques. This case report documents the safe use of fentanyl, propofol and sevoflurane combination guided by bispectral index, without the use of muscle relaxants in a patient with myasthenia gravis who presented for meningioma surgery. PMID:26620756

  12. Motoneuronal and muscle synergies involved in cat hindlimb control during fictive and real locomotion: a comparison study.

    PubMed

    Markin, Sergey N; Lemay, Michel A; Prilutsky, Boris I; Rybak, Ilya A

    2012-04-01

    We compared the activity profiles and synergies of spinal motoneurons recorded during fictive locomotion evoked in immobilized decerebrate cat preparations by midbrain stimulation to the activity profiles and synergies of the corresponding hindlimb muscles obtained during forward level walking in cats. The fictive locomotion data were collected in the Spinal Cord Research Centre, University of Manitoba, and provided by Dr. David McCrea; the real locomotion data were obtained in the laboratories of M. A. Lemay and B. I. Prilutsky. Scatterplot representation and minimum spanning tree clustering algorithm were used to identify the possible motoneuronal and muscle synergies operating during both fictive and real locomotion. We found a close similarity between the activity profiles and synergies of motoneurons innervating one-joint muscles during fictive locomotion and the profiles and synergies of the corresponding muscles during real locomotion. However, the activity patterns of proximal nerves controlling two-joint muscles, such as posterior biceps and semitendinosus (PBSt) and rectus femoris (RF), were not uniform in fictive locomotion preparations and differed from the activity profiles of the corresponding two-joint muscles recorded during forward level walking. Moreover, the activity profiles of these nerves and the corresponding muscles were unique and could not be included in the synergies identified in fictive and real locomotion. We suggest that afferent feedback is involved in the regulation of locomotion via motoneuronal synergies controlled by the spinal central pattern generator (CPG) but may also directly affect the activity of motoneuronal pools serving two-joint muscles (e.g., PBSt and RF). These findings provide important insights into the organization of the spinal CPG in mammals, the motoneuronal and muscle synergies engaged during locomotion, and their afferent control. PMID:22190626

  13. Motoneuronal and muscle synergies involved in cat hindlimb control during fictive and real locomotion: a comparison study

    PubMed Central

    Markin, Sergey N.; Lemay, Michel A.; Prilutsky, Boris I.

    2012-01-01

    We compared the activity profiles and synergies of spinal motoneurons recorded during fictive locomotion evoked in immobilized decerebrate cat preparations by midbrain stimulation to the activity profiles and synergies of the corresponding hindlimb muscles obtained during forward level walking in cats. The fictive locomotion data were collected in the Spinal Cord Research Centre, University of Manitoba, and provided by Dr. David McCrea; the real locomotion data were obtained in the laboratories of M. A. Lemay and B. I. Prilutsky. Scatterplot representation and minimum spanning tree clustering algorithm were used to identify the possible motoneuronal and muscle synergies operating during both fictive and real locomotion. We found a close similarity between the activity profiles and synergies of motoneurons innervating one-joint muscles during fictive locomotion and the profiles and synergies of the corresponding muscles during real locomotion. However, the activity patterns of proximal nerves controlling two-joint muscles, such as posterior biceps and semitendinosus (PBSt) and rectus femoris (RF), were not uniform in fictive locomotion preparations and differed from the activity profiles of the corresponding two-joint muscles recorded during forward level walking. Moreover, the activity profiles of these nerves and the corresponding muscles were unique and could not be included in the synergies identified in fictive and real locomotion. We suggest that afferent feedback is involved in the regulation of locomotion via motoneuronal synergies controlled by the spinal central pattern generator (CPG) but may also directly affect the activity of motoneuronal pools serving two-joint muscles (e.g., PBSt and RF). These findings provide important insights into the organization of the spinal CPG in mammals, the motoneuronal and muscle synergies engaged during locomotion, and their afferent control. PMID:22190626

  14. A preliminary study on the differences in male and female muscle force distribution patterns during squatting and lunging maneuvers

    PubMed Central

    Hale, Rena; Hausselle, Jerome G.; Gonzalez, Roger V.

    2014-01-01

    In the United States, 250,000 people tear their anterior cruciate ligament (ACL) annually with females at higher risk of ACL failure then males. By predicting muscle forces during low impact maneuvers we may be able to estimate possible muscle imbalances that could lead to ACL failure during highly dynamic maneuvers. The purpose of this initial study was to predict muscle forces in males and females similar in size and activity level, during squat and lunge maneuvers. We hypothesized that during basic low impact maneuvers (a) distribution of quadriceps forces are different in males and females and (b) females exhibit quadriceps dominance when compared to males. Two males and three females performed squatting and lunging maneuvers while electromyography (EMG) data, motion capture data, and ground reaction forces were collected. Nine individual muscle forces for muscles that cross the knee were estimated using an EMG-driven model. Results suggest that males activate more their rectus femoris muscle than females, who in turn activate more their vastus lateralis muscle at their maximum flexion angle, and more their vastus medialis muscle when ascending from a squat. During the lunge maneuver, males used greater biceps femoris force than females, throughout the lunge, and females exhibited higher semitendinosus force. Quadriceps dominance was evident in both males and females during the prescribed tasks, and there was no statistical difference between genders. Understanding individual muscle force distributions in males and females during low impact maneuvers may provide insights regarding failure mechanisms during highly dynamic maneuvers, when ACL injuries are more prevalent. PMID:25016289

  15. Strength and muscle activities during the toe-gripping action: comparison of ankle angle in the horizontal plane between the sitting upright and standing positions

    PubMed Central

    Soma, Masayuki; Murata, Shin; Kai, Yoshihiro; Nakae, Hideyuki; Satou, Yousuke

    2016-01-01

    [Purpose] The aim of this study was to investigate whether toe grip strength and muscle activities are affected by the ankle angle in the horizontal plane in the sitting upright and standing positions. [Subjects] The subjects were 16 healthy young women. [Methods] We measured toe grip strength and the maximum voluntary contraction activities of the rectus femoris, biceps femoris, anterior tibialis, and medial head of the gastrocnemius. In addition, we calculated the percent integrated electromyography during foot gripping in 3 different ankle joint positions between the long axis of the foot and the line of progression on the horizontal plane, namely 10° of internal rotation, 0°, and 10° of external rotation. [Results] Two-way analysis of variance revealed significant differences. A significant main effect was observed in the measurement conditions for the percent integrated electromyography of the rectus femoris muscle and long head of the biceps femoris. However, two-way analysis of variance did not reveal any significant difference, and a significant main effect was not observed in toe grip strength. [Conclusion] These findings suggest that exerted toe grip strength is only slightly affected by the ankle angle in the horizontal plane in the sitting upright and standing positions. Therefore, the current measurement positions were shown to be optimal for measurement. PMID:27134399

  16. Clinical strategies for addressing muscle weakness following knee injury.

    PubMed

    Pietrosimone, Brian; Blackburn, J Troy; Harkey, Matthew S; Luc, Brittney A; Pamukoff, Derek N; Hart, Joe M

    2015-04-01

    Muscle strength is a determinate of physical function and increasing muscle strength is an important clinical goal for patients with knee injury. This article discusses the emerging evidence regarding a novel rehabilitation strategy that uses disinhibitory modalities to increase neuromuscular activation in conjunction with traditional muscle strengthening for the purpose of maximizing strength gains following acute knee injury or surgery and in patients with knee osteoarthritis. The use of disinhibitory modalities and specific types of neuromuscular training for clinically maximizing strength are discussed. PMID:25818714

  17. 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.

  18. Phasic-to-tonic shift in trunk muscle activity relative to walking during low-impact weight bearing exercise

    NASA Astrophysics Data System (ADS)

    Caplan, Nick; Gibbon, Karl; Hibbs, Angela; Evetts, Simon; Debuse, Dorothée

    2014-11-01

    The aim of this study was to investigate the influence of an exercise device, designed to improve the function of lumbopelvic muscles via low-impact weight-bearing exercise, on electromyographic (EMG) activity of lumbopelvic, including abdominal muscles. Surface EMG activity was collected from lumbar multifidus (LM), erector spinae (ES), internal oblique (IO), external oblique (EO) and rectus abdominis (RA) during overground walking (OW) and exercise device (EX) conditions. During walking, most muscles showed peaks in activity which were not seen during EX. Spinal extensors (LM, ES) were more active in EX. Internal oblique and RA were less active in EX. In EX, LM and ES were active for longer than during OW. Conversely, EO and RA were active for a shorter duration in EX than OW. The exercise device showed a phasic-to-tonic shift in activation of both local and global lumbopelvic muscles and promoted increased activation of spinal extensors in relation to walking. These features could make the exercise device a useful rehabilitative tool for populations with lumbopelvic muscle atrophy and dysfunction, including those recovering from deconditioning due to long-term bed rest and microgravity in astronauts.

  19. Using Electromyography to Detect the Weightings of the Local Muscle Factors to the Increase of Perceived Exertion During Stepping Exercise

    PubMed Central

    Chang, Ya-Ju; Liu, Chin-Chih; Lin, Cheng-Hsiang; Tsaih, Peih-Ling; Hsu, Miao-Ju

    2008-01-01

    Rate of perceived exertion (RPE) is a clinically convenient indicator for monitoring exercise intensity in cardiopulmonary rehabilitation. It might not be sensitive enough for clinicians to determine the patients' physiological status because its association with the cardiovascular system and local muscle factors is unknown. This study used the electromyographic sensor to detect the local muscle fatigue and stabilization of patella, and analyzed the relationship between various local muscle and cardiovascular factors and the increase of RPE during stepping exercise, a common exercise program provided in cardiopulmonary rehabilitation. Ten healthy adults (4 males and 6 females) participated in this study. Each subject used their right bare foot to step up onto a 23-cm-high step at a constant speed until the RPE score reached 20. The RPE, heart rate (HR), and surface EMG of the rectus femoris (RF), vastus medialis, and vastus lateralis were recorded at 1-minute intervals during the stepping exercise. The generalized estimating equations (GEE) analysis indicated that the increase in RPE significantly correlated with the increase in HR, and decrease in median frequency (MF) of the EMG power spectrum of the RF. Experimental results suggest that the increase in RPE during stepping exercise was influenced by the cardiovascular status, localized muscle fatigue in the lower extremities. The weighting of the local muscle factors was more than half of the weighting of the cardiovascular factor.

  20. The effects of progressive functional training on lower limb muscle architecture and motor function in children with spastic cerebral palsy

    PubMed Central

    Lee, MiHye; Ko, YoungJun; Shin, Mary Myong Sook; Lee, Wanhee

    2015-01-01

    [Purpose] To investigate the effects of progressive functional training on lower limb muscle architecture and motor function of children with spastic cerebral palsy (CP). [Subjects] The subjects of this study were 26 children with spastic CP. [Methods] Thirteen subjects in the experimental group performed general neurodevelopmental treatment (NDT) and additional progressive functional trainings and 13 subjects in the control group performed only general NDT 3 times a week for 6 weeks. Ultrasonography, gross motor function measurement (GMFM) and the mobility questionnaire (MobQue) were evaluated. [Results] After the intervention, the muscle thickness of the quadriceps femoris (QF), cross-sectional area of the rectus femoris (RF), pennation angle of the gastrocnemius (GCM) and the MobQue score of the experimental group were significantly greater than those of the control group. The muscle thickness of QF correlated with the cross-sectional area (CSA) of RF and the pennation angle of GCM, and GMFM score correlated with the pennation angle of GCM. [Conclusion] Progressive functional training can increase muscle thickness, CSA, and the pennation angle of the lower limb muscles, and improve the mobility of spastic CP children making it useful as a practical adjunct to rehabilitation therapy. PMID:26157267